HomeMy WebLinkAboutResolutions - 2017.09.06 - 23098MISCELLANEOUS RESOLUTION #17255 September 6, 2017
BY: Commissioner Christine Long, Chairperson, General Government Committee,
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES CHILDREN'S VILLAGE DIVISION —
INTERLOCAL AGREEMENT BETWEEN OAKLAND COUNTY AND THE MICHIGAN DEPARTMENT
OF HEALTH AND HUMAN SERVICES FOR THE PROVISION OF SHELTER RESIDENTIAL FOSTER
CARE—AMENDMENT #1
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Oakland County Children's Village provides shelter care services for neglected and
abused youth; and
WHEREAS the Michigan Department of Health and Human Services requires a contract in order for
Oakland County Children's Village to receive reimbursement for shelter care services to abused and
neglected youth placed in shelter care; and
WHEREAS the contract was adopted by the Board of Commissioners on July 19, 2017 via Miscellaneous
Resolution #17197; and
WHEREAS the Michigan Department of Health and Human Services has issued an amendment to extend
the Interlocal Agreement for one year; and
WHEREAS the amendment will extend the contract from the September 30, 2017 expiration to
September 30, 2018.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves and
authorizes the Chairperson to sign the attached Interlocal Agreement — Amendment #1 between Oakland
County and the Michigan Department of Health and Human Services for shelter care services at Oakland
County Children's Village.
BE IT FURTHER RESOLVED that this amendment extends the contract period through September 30,
2018 and will take effect upon Board of Commissioner approval and authorization.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
Commihi ri:fji ir Christine Long, Distri #7
Chairperson, General Government tnmittee
GENERAL GOVERNMENT COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Long absent.
ADR REVIEW SIGN OFF — Department of Health & Human Services/
Children's Village
RESOLUTION TITLE: Oakland County Interlocal Agreement Between Oakland County and the Michigan
Department of Health and Human Services for the Provision of Shelter Residential
Foster Care - Amendment #1
DEPARTMENT CONTACT PERSON: Joanna Overal1/858-1164
DATE: August 15, 2017
DEPARTMENT REVIEW
Department of Management and Budget:
Approved w/ Modifications - Lynn Sonkiss (8/11/2017)
- WHEREAS the contract was adopted by the Board of Commissioners on July 19, 2017 wvia
Miscellaneous Resolution #17197; and
- WHEREAS the amendment will extend the contract from the September 30, 2017 expiration
to from October 1, 2017 to September 30, 2018a-n4
- NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners
approves and authorizes the Chairperson to sign the attached Interlocal Agreement —
Amendment #1 between Oakland County and Tthe Michigan Department of Health and
Human Services for shelter care services at Oakland County Children's Village.
- BE IT FURTHER RESOLVED that this ogreement amendment extends the contract period
through September 30, 2018 and will take effect upon Board of Commissioner approval and
authorization.
Corporation Counsel:
Approved — Bradley Benn (8/15/2017)
Department of Human Resources:
Approved (No Committee) - Heather Mason (8/15/2107)
AGREEMENT NUMBER: SHFC17-63001
AMENDMENT NUMBER:
Between
THE STATE OF MICHIGAN
DEPARTMENT OF HEALTH AND HUMAN SERVICES
And
CONTRACTOR County of Oakland-Children's Village
CONTRACTOR ADDRESS 1200 N. Telegraph Road, Bldg. 34E., Pontiac, MI 48341
CONTRACTOR EMAIL forzleyk@oakgov.com
CONTRACT ADMINISTRATOR
EMAIL
Sarah Goad goads@michigan.gov
AGREEMENT SUMMARY
SERVICE DESCRIPTION Shelter Home Foster Care
GEOGRAPHIC AREA Statewide
INITIAL EFFECTIVE DATE July 27, 2017 CURRENT EXPIRATION DATE 1 September 30, 2017
CURRENT AGREEMENT VALUE $2,000,000.00
AGREEMENT TYPE I Unit Rate/Per Diem
AMENDMENT DESCRIPTION
EXTEND EXPIRATION DATE , n YES fl NO NEW EXPIRATION DATE September 30, 2018
AMENDMENT AMOUNT ESTIMATED REVISED AGGREGATE AGREEMENT VALUE
$1,600,000.00 [Z] INCREASE DECREASE $3,600,000.00
NATURE OF CHANGE This amendment exercises an option year, increases the agreement value, and changes
language in the agreement.
The undersigned have the lawful authority to bind the Contractor and the Michigan Department of Health and Human
Services (MDHHS) to the terms set forth in this Agreement.
FOR THE CONTRACTOR:
FOR THE STATE:
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN
SERVICES County of Oakland-Children's Village
Contractor
Signature of Director or Authorized Designee Signature of Director or Authorized Designee
Christine H. Sanches
Print Name Print Name
Date Date
Agreement Number: SHFC17-63001
Amendment Number: 1
Anticipated Total Agreement Value: $3,600,000.00
Check all agreement years
Z Year 1 Z Year 2 El Year 3
affected by this amendment: Year 4 I] Year 5 7 Year 6
STATE OF MICHIGAN
DEPARTMENT OF HEALTH AND HUMAN SERVICES
WHEREAS, the Michigan Department of Health and Human Services (hereinafter referred to
as "MDHHS") entered into a contractual Agreement effective July 27, 2017, with County of
Oakland-Children's Village (hereinafter referred to as "Contractor"), having a mailing address
of 1200 N. Telegraph Road, Bldg. 34E., Pontiac, MI 48341, for the provision of certain
services as set forth therein; and,
WHEREAS, it is mutually desirable to MDHHS and to the Contractor to amend the aforesaid
Agreement.
THEREFORE, in consideration of the promises and mutual covenants hereinabove and
hereinafter contained, the parties hereto agree to the following amendment of said
Agreement. This amendment shall be attached to the Agreement, said Agreement being
hereby reaffirmed and made a part hereof.
Article I
This amendment shall be effective on the date of MDHHS signature.
Article II
MDHHS will exercise the first of two, one-year options to extend. Therefore, the end date of
the Agreement shall be changed from September 30, 2017 to September 30, 2018.
Article III
The maximum dollar amount of the Agreement shall be increased by $1,600,000.00 from
$2,000,000.00 to $3,600,000.00 for the period, July 27, 2017 through September 30, 2018.
Article IV
In Section 1., Program Requirements, Item 1.2., Referrals, a., 2), Item 1.3., Admission
Criteria, Item 1.4., Service Planning and Delivery, c., d., h., i. and j. shall be deleted and
replaced with:
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Agreement Number: SHFC17-63001
Amendment Number: 1
1.2. Referrals
a. Referrals
2). The referring MDHHS caseworker, Regional Placement Unit (RPU) or PAFC
provider shall provide to the Contractor referral material which complies with
this Agreement.
1.3 Admission Criteria
The emergency shelter program is available to males and females ages 0 through 17;
who are unable to be placed in a family foster home and need temporary placement due
to at least one of the following factors:
a. Presents at removal significant behavioral challenges or other complex factors
requiring a comprehensive assessment to either reunify or select an out-of-home
placement.
b. Currently be on a waiting list for a long term residential program
c. Be in the process of stepping down from hospitalization
d. Have a documented severe score on the Mental Health and Well-Being item on the
Child Assessment of Needs and Strengths within the past 90 days and have repeated
placement instability and a more thorough assessment is needed to either reunify or
make a stable next placement
The Contractor shall accept all children referred 24 hours per day, 7 days per week, 365
days a year. The Contractor shall not reject or eject any eligible child referred for
placement by any MDHHS County Office, RPU or 24 Hour Unit.
The Contractor shall obtain approval of the Business Service Center Director, or their
designee, prior to accepting any youth for placement if that placement occurs during
regular business hours. If a placement is made after regular business hours the
Contractor shall notify the BSC 5 Director (or designee) immediately the morning of the
next business day.
1.4. Service Planning and Delivery
c. The MDHHS caseworker, or PAFC provider responsible for placement shall have
weekly contact (phone, e-mail or face-to-face) with the Contractor to provide status
updates regarding achievement of the discharge plan.
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Agreement Number: SHFC17-63001
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d. The MDHHS caseworker, or PAFC provider responsible for placement shall review
and approve or request modification of the Contractor's initial and updated case
plans submitted by the Contractor.
h. The MDHHS caseworker, or PAFC provider responsible for placement shall visit
the child weekly face-to-face until discharge. The first visit shall occur within five
business days of placement. The caseworker's visit includes observing the child's
daily living and sleeping areas (FOM-722-06H, Caseworker Contacts). The
Contractor shall allow the MDHHS caseworker, WCPRU or PAFC provider
responsible for placement to meet in private with the child during a portion of each
visit.
i. The Contractor shall allow the assigned MDHHS caseworker or PAFC provider
responsible for placement or another staff designated by the MDHHS caseworker,
or PAFC provider responsible for placement to visit the child face-to-face upon
request, and shall provide a place for them to meet privately, if requested.
j. If an MDHHS caseworker, RPU or PAFC provider responsible for placement does
not meet the responsibilities outlined in this Agreement, the Contractor shall notify
the local MDHHS office County Director responsible for child welfare case
management. If the dispute is not resolved, the Contractor is to contact the
MDHHS Director of Field Operations, located in MDHHS Central Office
Administration.
Article V
In Section 2., CONTRACTOR RESPONSIBILITIES, Item 2.9., Compliance Requirements, c.,
Item 2.10., Services to be Provided, b,, Standardized Assessment Tools, c. Referral and
Intake Process, e., Reporting, m., Inclusion and Involvement of Parents, Other Family
Members or Caregivers., p., Medical and Dental Care and Item 2.17 Billing shall be deleted
and replaced with:
2.9. Compliance Requirements
c. Michigan Department of Health and Human Services (MDHHS) will not
discriminate against any individual or group because of race, sex, religion, age,
national origin, color, height, weight, marital status, gender identity or expression,
sexual orientation, political beliefs, or disability.
The above statement applies to all MDHHS supervised children, and to all
licensed and unlicensed caregivers and families that could potentially provide care
or are currently providing care for MDHHS supervised children, including MDHHS
supervised children assigned to a contracted agency.
2.10. Services to be Provided
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Agreement Number: SHFC17-63001
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b. Standardized Assessment Tools
The Contractor shall utilize the following assessment tools to assess the child's
overall progress in functioning while in the program:
1) Child Assessment of Needs and Strengths (CANS)
2) Casey Life Skills Assessment or Daniel Memorial Assessment (For children 14
years of age and older)
The Contractor shall administer the assessment tools within 14 calendar days of
admission.
Throughout the term of this Agreement the Contractor shall maintain the capability
to provide services 24 hours a day, 365 days a year as specified in the treatment
plan for each child and his/her family accepted for care.
The range of services specified below establishes a range and number of services
to be provided. Services provided to each child shall be individually determined
based on the CANS, and AnseII Casey Life Skills Assessment, and shall be
documented in the child's assessment.
c. Referral and Intake Process
1) Referral Packet
At the time of referral, the MDHHS caseworker, RPU, county placement
worker or PAFC provider shall provide the contractor with a complete referral
packet as outlined in Section 1.2 of this Agreement.
2) Referral
a) The Contractor shall accept and act on referrals from either RPU,
county placement worker, MDHHS or 24 hour unit upon receipt of a
referral. The Contractor shall obtain approval of the Business
Service Center Director prior to accepting any youth from outside
Contractor's county of operation. The referring MDHHS case worker,
RPU, county placement worker, or a PAFC provider shall not be
required to complete application or other Contractor forms for
inclusion in the agency case record or agency files or for any other
purpose.
b) The Contractor shall not accept a child for placement prior to a fully
executed Individual Service Agreement (DHS-3600). In event of an
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Agreement Number: SHFC17-63001
Amendment Number: 1
emergency placement, the DHS-3600 shall be fully executed no later
than the first working day following placement.
3) Intake
a) The Contractor and the assigned MDHHS caseworker, RPU, county
placement worker, or PAFC provider shall meet at the time of
placement to share information which will assist in the care and
supervision of the child. If the placement occurs after normal
business hours, the meeting shall take place in the next business day.
b) The Contractor shall complete a DHS-3377 and document all of the
personal belongings that a child has at placement.
c) The Contractor shall develop a preliminary assessment within seven
calendar days of admission. The plan shall include:
i. A comprehensive assessment of the child's physical/mental health
needs
ii, An assessment of the child's immediate and specific needs &
diagnosis.
iii. The specific services to be provided by the contractor and other
resources to meet the identified needs
iv. Goals, outcomes, and timeframes for achievement
v. Placement recommendation
vi. Barriers to achievement of the recommended placement and plans
to eliminate barriers
d) The Contractor shall develop an assessment-based plan within 20
calendar days of placement, and every 15 calendar days thereafter.
The Contractor shall document the assessment-based plan on the
identified Children's Foster Care Residential Care Case Plans. The
Contractor shall ensure that licensed clinical personnel (master's level
social worker, master's level counselor, licensed psychiatrist, and/or
psychologist) conduct a bio-psychosocial evaluation, or review a
recent bio-psychosocial evaluation (within the past year) that includes:
i. A psychiatric history, as necessary
ii. Social history
iii. A mental status examination
iv. A trauma assessment
v. Intelligence and projective tests, if necessary
vi. A behavioral appraisal
vii. Family, environmental, cultural, and religious or spiritual
preferences
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Agreement Number: SHFC17-63001
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viii. Behaviors that necessitated a more restrictive placement setting
for the child
ix. Reviewing previous psychotherapeutic and psychiatric
assessments and treatment
x. An updated assessment of the child's specific needs & diagnosis.
xi. Placement recommendations
xii. Recommended service to meet the child's identified needs.
e. Reporting
The Contractor shall develop and submit to the MDHHS caseworker, county
placement worker or PAFC provider responsible for placement: all case
summaries, incident reports, arrests, death notifications and other reports as
required in the Children's Foster Care Manual (FOM) and the MDHHS DOM_
standards specific to the Contractor's license specified in Section 2.4 of this
Agreement.
The Contractor shall submit the Preliminary Assessment to the responsible
MDHHS caseworker, county placement worker or PAFC provider within 14
calendar days of placement.
The Contractor shall complete a comprehensive assessment-based plan within 20
calendar days of placement and every 15 calendar days thereafter. The
Contractor shall submit all subsequent case service plans to the responsible
MDHHS caseworker, county placement worker or PAFC provider within 7
calendar days after the due date.
The Contractor shall submit a photo of the child to the MDHHS caseworker,
county placement worker or PAFC provider responsible for placement taken at the
time of placement. A copy of the photo shall be maintained in the child's file.
The Contractor shall provide the local MDHHS County Office and RPU with a daily
bed availability report.
m. Inclusion and Involvement of Parents, Other Family Members or Caregivers:
Families (including incarcerated parents) and placement caregiver(s) shall be
included as extensively as possible from the beginning of the admission process
through discharge whenever it is in the best interest of the child. Families and
caregiver(s) shall be supported and involved in all aspects of the child's treatment
and discharge planning.. All services shall be provided in a manner that ensures
children, families and placement caregiver(s) receive comprehensive, culturally
competent interventions.
The Contractor shall, in accordance with each child's individual plan:
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Agreement Number: SHFC17-63001
Amendment Number: 1
1) Include the family (birth, relative, identified adult support or permanent
caregiver) in the development of the initial and updated plans and specifically
document the family's involvement in the plan and permanency goal.
2) Provide routine transportation and flexible hours to accommodate the family's
time schedule to facilitate the family's accomplishment of the treatment goals.
Routine transportation is defined as any travel, including travel for family
visitation, required by the child or family for treatment purposes which occurs in
the Contractor's geographic area to be served, that may not reasonably be
provided by the parents or other funding source. The Contractor shall
coordinate/collaborate with the MDHHS caseworker or PAFC provider
responsible for placement to resolve transportation barriers.
3) Describe the agency's plan to reduce the barrier of distance of a family to the
agency to ensure ongoing family contact as outlined in the FOM 722-061,
Maintaining Connections Through Visitation and Contact.
4) Actively facilitate and supervise parental visits as outlined in the FOM 722-061,
Maintaining Connections Through Visitation and Contact. The Contractor shall
maintain for each child a record of parental visits including dates, times,
lengths of visit, and any other significant information.
5) Provide an identifiable area for family visits which offer privacy and comfort.
6) In collaboration with the agency responsible for placement, allow for regular
sibling visitation and other required sibling interaction as outlined in the FOM
and provide supported intervention, based on the child's treatment needs, to
encourage and strengthen sibling relationships.
7) Make arrangements for the child to make immediate phone contact (within two
hours of placement) with his parents and/or siblings whenever reasonably
possible.
8) Not withhold family contact (in any form) as a method of discipline.
9) Make concerted efforts to ensure the child is present for identified special
recruitment activities if the child is available for adoption without an identified
adoptive family. If there are safety concerns or other identified treatment
concerns, the Contractor shall consult with the assigned MDHHS caseworker
or PAFC provider responsible for placement.
P. Medical and Dental Care
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Agreement Number: SHFC17-63001
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The Contractor shall assure that children receive routine and non-routine medical
and dental care as required in the FOM 801, Health Services for Foster Children
and the MDHHS DCVVL standards for the license specified in Section 2.4 of this
Agreement and as detailed in the Implementation, Sustainability, and Exit Plan.
The Contractor shall provide all medical and dental information to the assigned
MDHHS caseworker/PAFC provider responsible for placement to facilitate
maintenance of the Medical Passport (DHS-221). In addition, the Contractor shall
assure that specific health care is provided, including:
1) Rehabilitative, physical or dental procedures by medical personnel as
necessary.
2) Utilization of enrolled Medicaid providers or a board certified physician or
dentist volunteering his/her time for health procedures.
3) Provision of medication as prescribed by a treating physician. Agency
must have a Standard Operating Procedure for dispensing and storage of
medication.
4) Special diets provided as needed and regularly reassessed utilizing
appropriate specialized personnel.
5) Forwarding the above DCVVL required medical and dental examination
reports to the MDHHS caseworker/PAFC provider within five (5) working
days of completion.
6) Coordination with the MDHHS caseworker or PAFC provider for securing
of prosthetic or mechanical equipment.
7) Review of prescriptive non-routine health care by medical personnel.
2.17. Billing
The Contractor shall submit through the MiSACWIS system the bi-weekly roster
for any child in the Contractors care per the instructions within the MiSACWIS
system. The billing shall indicate the units of service provided by the Contractor
and shall be submitted to MDHHS within 30 days from the end of the billing
period.
No original request for payment submitted by the Contractor more than three
years after the close of the two week billing period during which services were
provided shall be honored for payment.
When the Contractor's financial records reveal that payment for a child has not
been provided by MDHHS within 90 days of the date of service, the Contractor
will seek payment resolution by contacting the direct supervisor of the assigned
MDHHS worker in writing. Any concerns over a payment authorization or
issuance that cannot be resolved within 60 days of the written notice must be
reported to the MDHHS County Director for immediate resolution. The
Contractor will apprise MDHHS of any ongoing, unresolved payment concerns.
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Agreement Number: SHFC17-63001
Amendment Number: 1
Article VI
Attachment A., shall be deleted and replaced with:
Attachment A: Glossary of Acronyms and Forms
ABPN:
AWOLP:
DCWL:
CANS:
FOM:
GED:
IEP:
IETP:
LGAL:
MiSACWIS:
PAFC:
RPU:
American Board of Psychiatry and Neurology
Absent Without Legal Permission
Division of Child Welfare Licensing
Child Assessment of Needs and Strengths
Foster Care Online Manual
General Education Development
Individualized Education Plan
Individual Education Program Team
Legal Guardian ad Litem
Statewide Automated Child Welfare Information System
Placing Agency Foster Care
Regional Placement Unit
DHS-815-Non MDHHS: Staff Profile Security Agreement
DHS-65: Children's Foster Care Initial Service Plan
DHS-66: Updated Service Plan
DHS-69: Foster Care Juvenile Justice Action Summary
DHS-221: Medical Passport
DNS-365: Residential Initial Treatment Plan
PAGE 10 of 10
Rev. 3-16
Signature of Director Authorized signe
r=2,
Michigan Department of Health and Hainan Services
Office of Contracts and Purchasing (0CP)
PO Box 30037, Lansing, Ml 48909
Or
235 S. Grand Avenue, Suite 1201, Lansing, MI 48933
AGREEMENT NUMBER: SHFC17.63001
Between
MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES
And
CONTRACTOR PRIMARY CONTACT EMAIL
County of Oakland-Childrens Village Kathleen Forzley forzleyk@oakgov.com
CONTRACTOR ADDRESS TELEPHONE
1200 N. Telegraph Road, Bldg. 34E, Pontiac, MI 48341 248-858..1293
STATE CONTACT NAME TELEPHONE EMAIL
Contract Administrator Sarah Goad 517-599-8408 goads@Michigan.gov
OCP Analyst Bonnie Finals 517-373.4108 fineisb@Michigan,gov
AGREEMENT SUMMARY
SERVICE DESCRIPTION Shelter Residential Foster Care
GEOGRAPHIC AREA Statewide
INITIAL TERM EFFECTIVE DATE EXPIRATION DATE AVAILABLE OPTION YEARS
3 months 06/01117 09/30/17 2
MISCELLANEOUS INFORMATION $234.16
ESTIMATED CONTRACT VALUE AT TIME OF EXECUTION 2,000,000.00
CONTRACT TYPE Per Diem
The effective date of the contract shall be the date listed in the "Effective Date" box above, or the date of Michigan
Department of Health and Human Services (MDHHS) signature below, whichever Is later.
The undersigned have the lawful authority to bind the Contractor and MDHHS to the terms set forth In this Agreement.
Section 291 of the fiscal year 2016 Omnibus Budget, PA 84 of 2015, requires verification that all new employees of the
Contractor and all new employees of any approved subcontractor, working under this Agreement, are legally present to
work in the United States. The Contractor shall perform this verification using the E-verify system
(http://www.uscIsmov/portal/sitehiscis), The Contractor's signature on this Agreement Is the Contractor's certification that
verification has and will be performed. The Contractor's signature also certifies that the Contractor is not an Iran linked
business as defined in MCL 129.312,
FOR THE CONTRACTOR: FOR THE STATE:
County of Oakland-Children's Village MICHIGAN DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Christine H. Sanches
Print Name Print Name
Date Date
- ignature of Director or Authorized Designee
Agreement Number: SHFC17-63001
Anticipated Total Agreement Value: $2,000,000.00
This Agreement will be in effect from the date of MDI -11-15 signature through 09130117, No
service will be provided and no costs to the State will be incurred before June 1, 2017, or the
effective date of the Agreement, whichever is later. Throughout this Agreement, the date of
MDHFIS signature or June 1, 2017, whichever is later, shall be referred to as the begin date.
1. PROGRAM REQUIREMENTS
1.1. Client Eligibility Criteria
a. Eligible Clients
Services provided by the Contractor under this Agreement are limited to
those children for whom MDHHS can legally provide care and services and
for whom MDFIFIS makes a State payment, including those whom are Title
IV-E eligible,
County child-care funded children referred to MDHHS for care and
supervision by probate court but for whom MDHHS may have no legal
responsibility to make a payment are also eligible children.
b. Determination of Eligibility
MDHHS shall determine the children and families' eligibility and document
this in the Michigan Statewide Automated Child Welfare Information System
(MiSACW1S).
1.2. Referrals
a. Referrals
1). MDHHS shall be responsible for determination of client eligibility for
funding.
2). The referring MD111-1S caseworker, WCPRU or PAFC provider shall
provide to the Contractor referral material which complies with this
Agreement,
3). MD1-11-15 shall not transfer legal responsibility for any child to the
Contractor except as provided herein,
b. Referral Packet
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At the time of referral, the referring DHHS casewarker/PAFC provider shall
provide the Contractor with a referral packet (every attempt will be made to
include all items) which shall include:
1) A copy of the commitment order or placement and care order from the
court, or appropriate documentation of authorization from the local law
enforcement agency.
MDHHS shall not refer a child for placement prior to a fully executed
Individual Service Agreement (DRS 3600). In event of an emergency
placement, the DHS-3600 shall be fully executed no later than the first
working day following placement,
2) A MiHealth card or the Medicaid recipient identification number, if the
child is active for Medicaid and the MiHealth card is not available. If the
child is to be enrolled in Medicaid, MDHHS shall provide a copy of the
Medicaid recipient ID number to the Contractor as soon as it is issued or
the status of the Medicaid ID number application of activation.
3) Child's behavioral history including incidences of aggression, prior
hospitalizations, etc.
4) Child's placement history.
c. Within 10 business days of a child's placement, the referring MDHHS/PAFC
provider shall provide the following:
1) A photocopy of the birth verification, or copy of the request for verification.
MDHHS shall Immediately forward a copy of the birth verification upon
receipt.
2) A photocopy of the Social Security Card or verification provided by
MDHHS identifying the child's Social Security Number.
3) A copy of the Medical Passport (DHS-221).
4) A MiHealth card or the Medicaid recipient Identification number, if the
child is active for Medicaid and the MiHealth card is not available. If the
child is to enrolled in Medicaid, MDHHS shall provide a copy of the
Medicaid recipient ID number to the Contractor as soon as it is issued or
the status of the Medicaid ID number application of activation
5) If available, a copy of the Youth Health and Dental Record or other
documentation of physical and dental examination(s) within the past 12
months and history including immunization record.
6) An Initial Placement Outline and Information Record (DI-IS-3307), if
required, and other documentation required by MDHHS policy as
specified in FOM.
7) Court studies and reports, when available.
8) Copies of all psychological/psychiatric reports, evaluations, assessments,
medication monitoring visits related to mental health care.
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9) Psychological assessments are not to be routinely required for intake
decision-making. lithe Contractor requests a psychological evaluation
and the local MDHHS office agrees that a psychological evaluation is
appropriate, the local MDHHS office shall arrange and pay for the
evaluation within the allowable payment maximum.
lithe local MDHHS office does not agree that an evaluation is necessary,
the Contractor is responsible for arranging the evaluation. The cost of the
evaluation may be billed to the child's medical insurance provider if the
service is covered, if not the costs are covered by the per diem
reimbursement rate.
10) Copies of current Psychotropic Medication Consent (DHS-1643) for
current prescriptions. (See rom 802-4 The referring MDHHS/PAFC
caseworker shall coordinate with the attending medical provider to ensure
the child has a minimum of a 14-day supply of prescribed medications
AND a prescription for all current medications, OR a 30-day supply of all
medications.
11) Copy of the Child Protective Services Transfer Summary as specified in
the FOM 722-01.
12) Educational reports, when available.
13) Exception request approval from DCWL for the placement of an
adjudicated delinquent child in an abuse/neglect program.
When a child is discharged from the shelter the Contractor is not required to
continue efforts to obtain any items not obtained above prior to discharge.
1.3 Admission Criteria
The emergency shelter program is available to males &females ages 0 through
17; who are unable to be placed in a family foster home and need temporary
placement due to at least one of the following factors:
a. Presents at removal significant behavioral challenges or other complex
factors requiring a comprehensive assessment to either reunify or select an
out-of-home placement.
b. Is on a waiting list for a long term residential program.
c. Is in the process of stepping down from hospitalization.
d. Has a documented severe score on the Mental Health and Well-Being item
on the Child Assessment of Needs and Strengths within the past 90 days
and have repeated placement instability and a more thorough assessment is
needed to either reunify or make a stable next placement.
The Contractor shall accept all children referred 24 hours per day, 7 days per
week, 365 days a year. The Contractor shall not reject or eject any eligible child
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Agreement Number: SHFC17-63001
referred for placement by a local MDHHS County Office, VVCPRU or 24 Hour
Unit.
The Contractor shall obtain approval of the Business Service Center Director
prior to accepting any youth from outside Contractor's county of operation.
1.4. Service Planning and Delivery
a. MDHHS shall cooperate with the Contractor in completing the DHS-3600
and developing a service plan for the child and family. MDHHS shall ensure
the Contractor receives the DHS-3600 at the time of the child's admission. In
event of an emergency placement, the DHS-3600 shall be completed and
signed no later than the first working day following placement.
b. When a child is placed in an out-of-county, private, child-caring institution, the
MDHHS caseworker may request monitoring service from the local MDHHS
office where the child is placed. In that event, the MDHHS caseworker
responsible for placement shall ensure that the DHS-3600 clearly states
which local MDHHS office is responsible for ongoing monitoring of the child's
care, as well as determining if the MDHHS caseworker or the Contractor will
be responsible for ongoing service to the child's family. In the event of an
emergency placement, the MDHHS caseworker responsible for placement
shall ensure that the DHS-3600 is completed and signed no later than the
first working day following placement.
c. The MDHHS caseworker, WCPRU or PAFC provider responsible for
placement shall have weekly contact (phone, e-mail or face-to-face) with the
Contractor to provide status updates regarding achievement of the discharge
plan.
d, The MDHHS caseworker, WCPRU or PAFC provider responsible for
placement shall review and approve or request modification of the
Contractors initial and updated case plans submitted by the Contractor.
e. The MDHHS caseworker responsible for placement shall provide the
Contractor a copy of the Foster Care Payment Authorization (DHS-626-YA)
at the time of placement for all State paid placements.
f. The MDHHS caseworker responsible for placement shall assure that the
child has a basic wardrobe, as defined and documented by the DHS-3377
upon entering the Contractors care.
9. The MDHHS worker responsible for placement , except in emergencies or
when constrained by a court order or parental demand, shall give at least 14
calendar days notification to the Contractor of any discharge decision made
without the Contractor's concurrence.
PAGE 5 of 46
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Agreement Number: SHFC17-63001
h. The MDHHS caseworker, VVCPRU or PAFC provider responsible for
placement shall visit the child weekly face-to-face until discharge. The first
visit shall occur within five business days of placement. The caseworker's
visit includes observing the child's daily living and sleeping areas (F0M-722-
06H, Caseworker Contacts). The Contractor shall allow the MDHHS
caseworker, WCPRU or PAFC provider responsible for placement to meet in
private with the child during a portion of each visit.
i, The Contractor shall allow the assigned MDHHS caseworker, WCPRU or
PAFC provider responsible for placement or another staff designated by the
MDHHS caseworker, WCPRU or PAFC provider responsible for placement
to visit the child face-to-face upon request, and shall provide a place for them
to meet privately, if requested.
If an MDHHS caseworker, WCPRU or PAFC provider responsible for
placement does not meet the responsibilities outlined in this Agreement, the
Contractor shall notify the local MDHFIS office County Director responsible
for child welfare case management. If the dispute is not resolved, the
Contractor is to contact the MDHHS Director of Field Operations, located in
MDHHS Central Office Administration.
1.5. Legal or Court Related
MDHHS shall not transfer legal responsibility for any child to the Contractor
except as provided herein.
MDHHS shall involve the Contractor, to the extent allowed by law, in matters
relating to any legal or court activities concerning the child while in the
Contractor's care. If the Contractor is to be involved in the court proceedings,
MDHHS shall provide the Contractor with written reports for court use upon
request, subject to confidentiality requirements imposed by statute.
The Contractor shall ensure all directives and services ordered by the court are
completed to the satisfaction of the court within the timeframes ordered.
2. CONTRACTOR RESPONSIBILITIES
2.1. Email Address
The Contractor authorizes MDHHS to use the contact Information below to
send Agreement related communications. The Contractor shall provide
MDHHS with updated contact information if it changes. The Contractor
confirms that this person is either authorized to sign Agreements or is
recognized by this organization to assume this responsibility.
Contact email address: forzleykoakciov.com
PAGE 6 of 46
Rev, 5-16
Agreement Number: SHFC17-63001
2,2. Requests for Information
The Contractor may be required to meet and communicate with MDHHS
representatives and from time to time MDFIFIS may require that the
Contractor create reports or fulfill requests for information as necessary to
fulfill the MDHHS obligations under statute and/or Dwayne B. v. Snyder, et
al., 2;06-cv-13548, herein referred to as the Implementation, Sustainability,
and Exit Plan (ISEP).
2,3. Geographic Area
The Contractor shall provide all services described herein in the following
geographic area: Statewide
2.4. Licensing Requirements and Number of Children in Care
The MDHHS DCWL Division of Child Welfare Licensing (DCVVL) is the licensing
agency for Child Caring Institutions (CCI). A license is issued to a certain person
or organization at a specific location, is non-transferable, and remains the
property of the Department. Therefore, an institution must be established at a
specific location.
The Contractor shall ensure that, for the duration of this agreement, it shall
maintain a license for those program areas and services that are provided for in
this Agreement. If the Contractor fails to comply with this section, MDHHS may
terminate this Agreement for default.
The Contractor is licensed to provide service under this agreement under the
following license number: CE630201059
At no time shall the number of children in care exceed the licensed capacity of
the facility specified in the Contractor's license. On no day during this
Agreement period, shall there be more than 18 children in placement for whom
MDHHS has the responsibility to make a State payment. MDHHS does not
guarantee any minimum number of referrals or children In care at any point in
time.
2.5. Location of Facilities
The Contractor shall provide services described herein at the following
location(s):
1200 N. Telegraph, Pontiac, MI 48341
2,6. Prooram Name ,Statement and Focus
PAGE 7 of 46
Rev, 5-16
Agreement Number: SHFC17-63001
Program Name: Mandy's Place
a, The focus of the shelter program is to:
1) Provide a safe residential environment in which children who have been
removed from their home can be evaluated for services.
2) Provide an evaluation of the appropriate placement for a child to ensure
that appropriate Information Is obtained in order to facilitate service
planning and placement stability.
b. This program is only available for thirty days or less unless an exception is
made in writing by the MDHHS County Director or designee. An exception to
this limitation may be made for:
1) Children who have an identified and approved placement but the
placement is not available within 30 days of the child's entry to an
emergency or temporary facility.
2) Children whose behavior has changed so significantly that the County
Director or his/her manager designee has certified that a temporary
placement for the purposes of assessment is critical for the determination
of an appropriate foster placement. In no case shall a child remain in an
emergency or temporary facility more than 45 days.
c, The Contractor shall provide MDHHS with copies of its program statement
for the program covered under this Agreement. The program statement shall
comply with the requirements of MDHHS DCWL standards specific to the
license listed in Section 2.4 and with all federal laws related to the mixing of
abuse/neglect and juvenile justice programs. The Contractor shall inform
MDHHS of any changes made to the program statement at any point during
the term of this Agreement and provide copies of the new statement to
MDFIHS.
2.7. Provider Numbers
MiSACWIS Provider Number: 10400607
Bridges Provider Number; 6358407
2.8. Credentials
The Contractor shall assure that all staff performing functions under this
Agreement, including contractor employees, volunteers and/or subcontractors,
are appropriately screened, credentialed, and trained. Additional staff
requirements are identified in Section 2.10, d. of this Agreement
2,9, Compliance Reouirements
PAGE 8 of 46
Rev. 5-18
Agreement Number: SHFC17-63001
a. The Contractor shall comply with all applicable MDHHS policy Children's
Foster Care Manual (FOM) and MDFIHS policy amendments, including
interim policy bulletins,
b. Throughout the term of this Agreement, the Contractor shall ensure that
it provides all applicable MDHHS policy and MDHHS policy amendments
(including interim policy bulletins) and applicable Administrative Codes to
social service staff. The Contractor shall ensure that social service staff
complies with all applicable requirements.
MDHHS policies, amendments and policy bulletins, are published on the
following Internet link: https://dhhs.michigan.gov/olmweb/ex/htmli .
Administrative Codes are published at on the following Internet link:
htto://michicran.gov/lara/0,4601 ,7-154-35738 5698-118524--.00.html
c. Michigan Department of Health and Human Services (MDHHS) will not
discriminate against any individual or group because of race, sex,
religion, age, national origin, color, height, weight, marital status, gender
identity or expression, sexual orientation, political beliefs, or disability.
The above statement applies to all licensed and unlicensed caregivers
and families that could potentially provide care or are currently providing
care for MDHHS supervised children, including MDHHS supervised
children assigned to a contracted agency.
d. The Contractor shall provide services within the framework of Michigan's
Child Welfare Practice Model, MiTEAM. The Contractor shall utilize the
skills of engagement, assessment, teaming and mentoring in partnering
and building trust based relationships with families and children by
exhibiting empathy, professionalism, genuineness and respect.
Treatment planning shall be from the perspective of family/child centered
practice.
e. The Contractor shall comply with the following provisions of 2015 PA 53.
Specifically, once a Contractor accepts a referral from MDHHS, by doing
either of the following:
1) Submitting to MDHHS a written agreement to perform the services
related to the particular child or particular individuals that the Department
referred to the Contractor: or
2) Engaging in any other activity that results in the MDHHS being obligated
to pay the Contractor for the services related to the particular child or
particular individuals that the Department referred to the Contractor.
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Agreement Number: SHFC17-63001
The Contractor acknowledges that it has waived any legal protections under
MCL 722.124e, MCL 722.124f, and/or MCL 710.23g to decline to provide
such services based on an assertion that to do so would conflict with the
Contractor's sincerely held religious beliefs contained within its statement of
faith, written policy, or other document adhered to by the Contractor.
f. The Contractor shall ensure compliance with all applicable provisions
and requirements of the Dwayne B. V. Snyder, et al., 2:06-cv-13548,
Implementation, Sustainability, and Exit Plan.
Additional Compliance Provisions
The contractor shall also comply with the provisions of:
1) 1984 Public Act, 114, as amended being M.C.L. 3,711 et seq., Interstate
Compact on the Placement of Children.
2) 1975 Public Act 238, as amended, being M.C,L, 722.621 at seq., Child
Protection Law.
3) 1982 Public Act 162, as amended, being M.C.L. 450.2101 at seq., Michigan
Nonprofit Corporation Act.
4) 1994 Public Act 204, as amended, being M.C.L. 722.921 at seq., Michigan
Children's Ombudsman Act.
5) 1973 Public Act 116, as amended, being M.C.L. 722.111 at seq., Michigan
Child Care Organization Act.
6) 1939 Public Act 288, Chapter X, being M.C, L. 710.1 et seq., Michigan
Adoption Code.
7) 1984 Public Act 203, as amended, being M.C.L. 722.951 et seq., Michigan
Foster Care and Adoption Services Act.
8) The Social Security Act as amended by the Multiethnic Placement Act of
1994 (MEPA); Public Law 103-382, and as amended by Section 1808 of the
Small Business Job Protection, the Interethnic Adoption Provision (IEAP),
9) The Indian Child Welfare Act (ICWA); Public Law 95-608 being 25 U.S.C.
1901 et seq.
10)1976 Public Act 453, as amended, being M.C.L 37.2101 at seq., Elliott-
Larsen Civil Rights Act.
11)Fostering Connections to Success Act of 2008
12) Preventing Sex Trafficking and Strengthening Families Act, Federal PL113-
183
13) Social Security Act, 42 USC 671(a)(20)
2.10. Services to be Provided
Services provided under this Agreement shall be trauma informed and based on
evidence and best practices to effect optimal outcomes. Services must be
delivered according to each child's assessed needs with interventions aligned
PAGE SO of 46
Rev. 546
Agreement Number: SHFC17-63001
with the identified needs and desirable outcomes. Resources for evidence based
interventions and practices can be found at:
o American Academy of Pediatrics;
http://www2.aap.orq/commpeds/dochs/mentalhealth/KevResources.html
• SAMHSA's National Registry of Evidence-based Programs and Practices;
www.nrepp.samhsa,aov
9 California Evidence-Based Clearinghouse for Child Welfare;
htlp://www.cebc4cw.orq
• The National Child Traumatic Stress Network; www,NCTSN.orq
9 American Academy of Child and Adolescent Psychiatry (AACAP);
vvww.aacap.ore,
The Contractor, within the constraints of the agency's agreement, shall
incorporate normalcy activities into residential programing. These activities must
comply with the reasonable and prudent parent standard to help children
develop skills essential for positive development.
a. Residential Care
The Contractor shall ensure that each child in its care shall be provided with
the elements of residential care outlined in the MDHHS DCWL Child Caring
Institution standards specific to the license listed in Section 2.4 of this
Agreement.
b. Standardized Assessment Tools
The Contractor shall utilize the following assessment tools to assess the
child's overall progress in functioning while in the program:
1) Child Assessment of Needs and Strengths (CANS)
2) Ansel! Casey Life Skills Assessment or Daniel Memorial Assessment
(For children 14 years of age and older)
The Contractor shall administer the assessment tools within 14 calendar
days of admission.
Throughout the term of this Agreement the Contractor shall maintain the
capability to provide services 24 hours a day, 365 days a year as specified in
the treatment plan for each child and his/her family accepted for care.
The range of services specified below establishes a range and number of
services to be provided. Services provided to each child shall be individually
determined based on the CANS, and Ansell Casey Life Skills Assessment,
and shall be documented in the child's assessment plan.
PAGE 11 of 46
Rev. 6.16
Agreement Number: SHFC17-63001
c. Referral and Intake Process
1) Referral Packet
At the time of referral, the MDHHS caseworker, VVCPRU or PAFC
provider shall provide the contractor with a complete referral packet as
outlined in Section 1.2 of this Agreement.
2) Referral
a) The Contractor shall accept and act on referrals from either MDHHS
WCPRU or 24 hour unit upon receipt of a referral. The Contractor
shall obtain approval of the Business Service Center Director prior to
accepting any youth from outside Contractor's county of operation.
The referring MDHHS case worker, VVCPRU or a PAFC provider
shall not be required to complete application or other Contractor forms
for inclusion in the agency case record or agency files or for any other
purpose,
b) The Contractor shall not accept a child for placement prior to a fully
executed Individual Service Agreement (DHS-3600). In event of an
emergency placement, the DHS-3600 shall be fully executed no later
than the first working day following placement,
3) Intake
a) The Contractor and the assigned MDHHS caseworker, WCPRU or
PAFC provider shall meet at the time of placement to share
information which will assist in the care and supervision of the child. If
the placement occurs after normal business hours, the meeting shall
take place in the next business day.
b) The Contractor shall complete a Di-IS-3377 and document all of the
personal belongings that a child has at placement.
c) The Contractor shall develop a preliminary assessment within seven
calendar days of admission, The plan shall include:
A comprehensive assessment of the child's physical/mental health
needs
ii. An assessment of the child's immediate and specific needs &
diagnosis.
iii, The specific services to be provided by the contractor and other
resources to meet the identified needs
iv. Goals, outcomes, and timeframes for achievement
v. Placement recommendation
PAGE 12 of 46
Rev, 5-16
Agreement Number: SHFC17-63001
vi. Barriers to achievement of the recommended placement and plans
to eliminate barriers
d) The Contractor shall develop an assessment-based plan within 20
calendar days of placement, and every 15 calendar days thereafter.
The Contractor shall document the assessment-based plan on the
identified Children's Foster Care Residential Care Case Plans, The
Contractor shall ensure that licensed clinical personnel (master's level
social worker, master's level counselor, licensed psychiatrist, and/or
psychologist) conduct a bio-psychosocial evaluation, or review a
recent bio-psychosoctal evaluation (within the past year) that includes:
i, A psychiatric history, as necessary
ii. Social history
iii. A mental status examination
iv. A trauma assessment
v. Intelligence and projective tests, if necessary
vi. A behavioral appraisal
vii. Family, environmental, cultural, and religious or spiritual
preferences
viii. Behaviors that necessitated a more restrictive placement setting
for the child
ix. Reviewing previous psychotherapeutic and psychiatric
assessments and treatment
x. An updated assessment of the child's specific needs & diagnosis.
xi. Placement recommendations
xii. Recommended service to meet the child's identified needs.
d. Staffing
The Contractor shall provide trained staff sufficient to adequately fulfill the
terms of this Agreement and shall demonstrate a good faith effort to recruit
and employ staff that reflect the racial, ethnic and cultural composition of the
Contractors client population.
1) Child Care Services
Child care services are defined as those activities necessary to meet the
daily physical, social and emotional needs of the child. Specific direct
care staffing ratios are defined within. The Contractor shall:
a) Assure the availability, within 10 minutes, of on-call Contractor
support staff or contracted staff for emergency assistance at all times.
b) Have available to all staff a written emergency plan for contacting
police, fire, or emergency medical staff.
PAGE 13 of 46
Rev, 5-16
Agreement Number: SHFC17-63001
c) Develop and implement standard operating procedures relative to
emergency planning, to be shared with all staff and contain at a
minimum the following:
i Procedures that provide direction to staff encountering the following
situations:
• Bomb threat/device
• Chemical spill
• Fire
Natural disaster (tornado, heavy snow, flood, etc.)
• Loss of utilities (heat, electricity, water, or other power outages)
• Other disruptions (hostage situations, armed intruders, etc.)
11 A list of emergency telephone numbers (Police, Fire Department,
Ambulance and Utilities).
iii Clear direction:
• For emergency evacuation, including type of evacuation and exit
route assignments.
• To employees performing rescue or medical duties.
• To ensure notification of administration.
• To account for all children and staff.
• For contacting emergency services.
• To provide notification to MDHHS of the emergency no later
than the next business day.
Directions must be placed in areas readily available to staff. The
Contractor shall review and annually update (or more frequently as
needed) the emergency plans and written directions.
2) Staff Education and Experience Qualifications:
a) All program staff shall possess the following minimum qualifications:
i A non-judgmental, positive attitude toward children with mental
health and behavioral problems
ii Training, education or experience in the area of human services
iii Training or experience working with at risk children and families
iv Cultural and ethnic sensitivity, as well as diversity competency
v Knowledge and training of and skills in the area of mental health,
substance abuse, child sexual behavior and child development
vi Ability to engage with, and relate to, children with multiple problems
vii Skills in crisis intervention, assessment of potentially violent
situations and short-term goal setting
b) Therapy services shall be provided by one of the following:
i. Licensed Masters Level Social Worker
ii. Licensed Masters Level Counselor
Hi. Limited License Masters Level Psychologist
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Rev, 5-16
Agreement Number: SHFC17-63001
iv. Licensed Psychologist, PhD
v. Limited License Master's level counselor or Limited License
Masters level Social Worker under the supervision of a Licensed
Counselor or a Licensed Masters level Social Worker
vi. Individuals with a Master's Degree in psychology, counseling, or
social work under the supervision of a Licensed Counselor,
Licensed Masters level Social Worker or Licensed Psychologist,
Ph.D., or Psychiatrist
vii. Child Psychiatrist
If therapy services are subcontracted, the Contract must ensure the
subcontracted provider has the appropriate credentials outlined in this
Agreement
3) Staff Training Requirements
a) The Contractor shall provide 50 hours of training during a new hire's first
year of employment. The Contractor shall provide a minimum of 40
hours within the first 30 calendar days of employment. Sixteen of the 40
hours of training shall occur prior to direct care staff having
unsupervised contact with children. The remaining 10 hours shall be
completed prior to the end of the first year of employment
Orientation shall include topics identified in the Licensing Rules for
Child Caring Institutions R400.4128, as well as the Child Protection
Law, mandated reporting requirements, family/child engagement,
interpersonal communication, appropriate discipline, crisis intervention,
child handling and de-escalation techniques and basic group dynamics.
b) A minimum of 25 hours per year of staff training shall be provided to
existing direct care staff.
c) Annual training topics shall be selected from but not limited to the areas
identified in R400.4128 and the following:
i. Working as part of a team
ii. Relationship building
iii. Family/child engagement
iv. Understanding and analyzing problem behaviors
v. Positive behavior support
vi. Setting clear limits
vii. Interpersonal communication
viii. Appropriate discipline, crisis intervention, child handling and de-
escalation techniques
ix. The significance of the birth family, value of visitation, importance
of attachment and strengthening family relationships, impact of
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Rev. 5-16
Agreement Number: SHFC17-83001
separation, grief and loss issues for children in foster care, and
children's need for permanency
x. Understanding and recognizing the emotional and behavioral
issues and/or physical needs of abused/neglected children
xi. Medication management: Administration, monitoring, recording,
secure storage, medication side effects and procedure for
reporting side effects, medication reviews and foster care child
specific process for obtaining informed consents for medication
changes
xii. Cultural competency
xiii. Effects of trauma
xiv. Suicide prevention and/or intervention
xv. Child development
xvi. Trauma informed practices
xvii. Strength-based interventions and interactions
xviii. Defusing threatening behaviors
xix. Solution focused assessment and case planning
d) All program staff will be trained to serve as a role model for the
following: appropriate social skills, prioritizing needs, negotiation
skills, accessing local resources, hygiene and grooming
preparation, food preparation and anger management.
e) All program staff shall be provided with annual trauma-focused program
training to maintain a trauma-informed milieu and treatment
environment. Trauma-focused programming must be based on an
evidence-based treatment model.
4) Staffing Ratio
The Contractor shall:
a) Provide a minimum of one on-duty direct child care staff for every four
children during waking hours
b) Maintain a minimum of one on-duty direct child care staff for every
eight children during sleeping hours. All of these staff shall be awake
during this period. Room checks must be conducted at variable
intervals of no more than every 15 minutes between checks during
sleeping hours.
If the child poses a threat to self or others, the Contractor may be approved
to provide 1:1 staffing ratio. The approval for 1:1 staffing must be requested
in writing to DCWL by email or fax. For requests sent via email, the request
must be secured and encrypted to protect the child's personal information.
PAGE 18 of 48
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Agreement Number; SHFC17-63001
e. Reporting
The Contractor shall develop and submit to the MDH HS caseworker,
WCPRU or PAFC provider responsible for placement: all case summaries,
incident reports, arrests, death notifications and other reports as required in
the Children's Foster Care Manual (FOM) and the MDHHS DCWL standards
specific to the Contractor's license specified in Section 2.4 of this Agreement.
The Contractor shall submit the Preliminary Assessment to the responsible
MDHHS caseworker, WCPRU or PAFC provider within 14 calendar days of
placement
The Contractor shall complete a comprehensive assessment-based plan
within 20 calendar days of placement and every 15 calendar days thereafter.
The Contractor shall submit all subsequent case service plans to the
responsible MDHHS caseworker, WCPRU or PAFC provider within 7
calendar days after the due date.
The Contractor shall submit a photo of the child to the MDHHS caseworker,
WCPRU or PAFC provider responsible for placement taken at the time of
placement. A copy of the photo shall be maintained in the child's file.
The Contractor shall provide the local MDHHS County Office or WCPRU
with a daily bed availability report.
f. Restraint and Seclusion
The Contractor shall not use Positive Peer Culture, peer-on-peer restraint or
any forms of corporal punishment.
The Contractor shall report the use of seclusion/isolation and restraint within
24 hours (or the next business day) of the use of seclusion/isolation or
•restraint. The Contractor will utilize the Incident Reporting Form in
MISACWIS to record all incidents of seclusion/isolation and restraint,
g. Transition and Discharge Planning
Transition and discharge planning shall begin at the time of admission. The
Contractor shall develop a transition/discharge plan in collaboration with the
child, parent or guardian, agency with placement responsibility, foster
parents, relative caregiver and Lawyer Guardian ad Litem (LGAL) during the
initial and subsequent Family Team Meeting to be held, within seven
calendar days of admission. The child's transition/discharge plan shall
include:
1) A projected date for discharge
PAGE 17 of 46
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Agreement Number: SHFC17-63001
2) The level of care projected to be needed at discharge
3) Transfer of information (e.g. medical records, mental health records, etc.)
4) A planned contact schedule, to prepare the family/caregiver(s) for a well-
supported discharge placement
The Contractors shall provide the following for a child whose placement
recommendation is residential
1) Child-specific information and provide all required documentation for a
child whose placement recommendation is residential.
2) Notification to the local MDHHS County Office or WCPRU staff and
assigned caseworker of pre-placement interviews held at the facility.
3) Will work with the case worker to ensure transportation and coordinate
transportation for the child to pre-placement interviews held off site if
requested by local MDHHS County Office or WCPRU or PAFC staff,
h. Family Team Meetings,
Family Team Meetings are an essential component of MITEAM and serve as
the primary forum for collaborative case planning for the child and family.
The overall goals of the Family Team Meetings are used to plan and review
for the child ensuring the child receives an appropriate array and quantity of
services necessary to stabilize him/her clinically and behaviorally and to
prepare him/her to succeed in less restrictive community based settings after
discharge.
Upon admission, the Contractor shall coordinate with the DHHS
caseworker/PAFC provider responsible for placement, the family and the
child to identify members of the child's team for ongoing participation in case
planning Family Team Meetings facilitated by DHHS/PAFC or designee.
The Contractor shall incorporate relevant planning goals/action steps
regarding the child(ren) from previous Family Team Meetings into the
Contractor developed initial case plan due 30 days from admission. The
Contractor and child(ren) shall participate in quarterly Case Planning Family
Team Meetings facilitated by the assigned DHHS caseworker/PAPC
provider/designee, and align Contractor developed quarterly case plans with
Family Team Meeting/Parent Agency Treatment plans.
For youth who are developmentally appropriate to participate in a Family
Team Meeting, the Contractor shall facilitate a Pre-Meeting Discussion with
the child at least 24 hours prior to the Family Team Meeting. The Contractor
shall participate with the youth in person or via phone conference at all Case
Planning/Case Plan Reassessment Family Team Meeting.
The Contractor shall work with the child, family, treatment team, DH HS
caseworker/PAFC provider and local CMH provider to assist the child in
developing ties to his/her community and other non-family resources. These
PAGE 18 of 46
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Agreement Number: SHFC17-03001
ties provide assistance and connections with caregivers to help meet the
child's relationship needs.
i. Legal or Court Related
The Contractor shall cooperate with the MDHHS caseworker, WCPRU or
PAFC provider responsible for placement of the child in matters relating to
any legal or court activities concerning the child. These activities may
include, but are not limited to:
1) Transportation of the child to and from court hearings
2) Supervision of the child during transport or while present at the hearing
3) Court testimony, recommendations, and reports to the court as requested
by the court If court reports and recommendations are requested, the
Contractor shall send the reports to the local MDHHS County Office or
WCPRU for review three business days prior to the court hearing.
j. Absent Without Legal Permission
The Contractor shall have a clearly defined process for determining when a
child is AWOLP from the placement. The process shall delineate how the
facility and grounds are searched, what personnel will be involved in the
search, and how the determination will be made that the child is AWOLP
from the placement.
Once determined that a child is AWOLP from the placement, the Contractor
shall:
1) Immediately notify law enforcement agencies that the child under their
care has failed to return at the expected time
2) Immediately file a missing person report with law enforcement
3) Immediately notify the local office the MDHHS caseworker, WCPRU or
PAFC provider responsible for place mentor designee of the child's
AWOLP status
k. Independent Living Preparation
Independent Living preparation is defined as a comprehensive and
coordinated set of activities that will assist children aged 14 and older in
preparing for a state of independence or providing care of oneself socially,
economically, and psychologically.
The Contractor shall support the child's independent living plan as outlined in
the child's case plan including any independent living preparation skills
including, but not limited to: budgeting and money management;
employment seeking skills; communication skills; relationship building;
establishing health and hygiene routines; household maintenance and
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Agreement Number: SHFC17-63001
upkeep; educational assistance; preventive health services; parenting skills
and accessing community services.
I. Clinical Case Management and Day to Day Crisis Counseling
The Contractor shall provide clinical case management and day-to-day crisis
counseling for each child.
m. Inclusion and Involvement of Parents, Other Family Members or Caregivers:
Families (including incarcerated parents) and placement caregiver(s) shall be
included as extensively as possible from the beginning of the admission
process through discharge whenever it is in the best interest of the child.
Families and caregiver(s) shall be supported and involved in all aspects of
the child's treatment and discharge planning. All services shall be provided
in a manner that ensures children, families and placement caregiver(s)
receive comprehensive, culturally competent interventions.
The Contractor shall, in accordance with each child's individual plan:
1) Include the family (birth, relative, identified adult support or permanent
caregiver) in the development of the initial and updated plans and
specifically document the family's involvement In the plan and
permanency goal.
2) Provide routine transportation and flexible hours to accommodate the
family's time schedule to facilitate the family's accomplishment of the
treatment goals. Routine transportation is defined as any travel, including
travel for family visitation, required by the chlici or family for treatment
purposes which occurs in the Contractor's geographic area to be served,
that may not reasonably be provided by the parents or other funding
source. The Contractor shall coordinate/collaborate with the MDHHS
caseworker, VVCPRU or PAFC provider responsible for placement to
resolve transportation barriers.
3) Describe the agency's plan to reduce the barrier of distance of a family to
the agency to ensure ongoing family contact as outlined in the FOIVI 722-
061, Maintaining Connections Through Visitation and Contact.
4) Actively facilitate and supervise parental visits as outlined in the FOM
722-061, Maintaining Connections Through Visitation and Contact, The
Contractor shall maintain for each child a record of parental visits
including dates, times, lengths of visit, and any other significant
information,
PAGE 20 of 40
Rev, 5•16
Agreement Number SHFC17-63001
5) Provide an identifiable area for family visits which offer privacy and
comfort.
6) In collaboration with the agency responsible for placement, allow for
regular sibling visitation and other required sibling interaction as outlined
in the FOM and provide supported intervention, based on the child's
treatment needs, to encourage and strengthen sibling relationships.
7) Make arrangements for the child to make immediate phone contact
(within two hours of placement) with his parents and/or siblings whenever
reasonably possible.
8) Not withhold family contact (in any form) as a method of discipline.
9) Make concerted efforts to ensure the child is present for identified special
recruitment activities if the child is available for adoption without an
identified adoptive family. If there are safety concerns or other identified
treatment concerns, the Contractor shall consult with the assigned
MDHHS caseworker, VVCPRU or PAFC provider responsible for
placement.
n. Religion and Cultural
The Contractor shall respect the religious preference of the child and his/her
parent(s) or legal guardian,
The Contractor shall ensure each child is afforded opportunities to attend
religious services or activities in his/her religious faith of choice. The
Contractor shall arrange for or ensure reasonable means are provided for
transportation of a child to services or activities on or off site, Safety of the
child must always be a priority concern when transporting and supervising
children
The Contractor shall not require or coerce a child to participate in religious
services or activities, shall not discipline, discriminate against, or deny
privileges to any child who chooses not to participate. The Contractor shall
recognize and take into consideration the racial, cultural, ethnic and religious
backgrounds of a child when planning various activities or religious activities.
o. Education
The Contractor shall ensure every child is provided with appropriate
educational services. Those services shall be provided in accordance with
the requirements set forth in the FOM, and MDHHS DCWL standards for the
license specified in Section 2.4 of this Agreement, and as detailed in the
Implementation, Sustainability, and Exit Plan.
PAGE 2i of 46
Rev. 5-16
Agreement Number: SHFC17-63001
In addition, the Contractor shall:
1) Collaborate with the child's identified school to screen for possible
educational disabilities; and if a disability is suspected, refer the child for
an Individual Education Program Team (IEPT) evaluation within the first
five calendar days of placement to assess, plan and place the child in the
most appropriate educational/vocational program.
2) Request prior educational assessments within five calendar days of
placement to assist in assessing the current educational needs.
Documentation of diligence in requesting records must be included in the
child's file,
3) Assure that program staff are available to the school staff in crisis
situations to assist in managing the crisis or to call for assistance.
4) Provide or arrange structured educational and/or vocational activities for
children suspended from or expelled from school, or who have passed
their General Education Development (GED) test, (i.e., structured
homework time, additional reading or writing activities, online educational
programming, independent study assignments and independent living
skills).
5) Take an active role in monitoring and maintaining school progress for
children whether or not they attend a structured school program.
Interventions may include, but are not limited to, obtaining school
assignments, monitoring completion of homework, capturing and
reporting grades and test scores when and where available, and
additional tutoring.
6) Provide tutorial services to a child, as necessary, based on the child's
Individualized Education Plan (IEP) or treatment plan. Tutorial staff must
have appropriate educational credentials to provide tutorial services.
Appropriate educational credentials are determined by the Contractors
Permanency/Educational Specialist.
7) Provide advocacy and service planning for children that are expelled.
8) Be in compliance with Michigan's Department of Education rules and
requirements if operating a school on grounds.
9) Provide transportation to and from the child's identified school if public
school transportation is not available.
10) Provide behavioral aides as necessary to maintain a child in school.
P. Medical and Dental Care
The Contractor shall assure that children receive routine and non-routine
medical and dental care as required In the FOM 801, Health Services for
Foster Children and the MDHHS DCWL standards for the license specified in
Section 2.4 of this Agreement and as detailed In the Implementation,
Sustainability, and Exit Plan. The Contractor shall provide all medical and
dental information to the assigned MDHHS caseworker/PAFC provider
responsible for placement to facilitate maintenance of the Medical Passport
PAGE 22 of 46
Rev. 5-16
Agreement Number: SHFC17-63001
(DHS-221). In addition, the Contractor shall assure that specific health care
is provided, including:
1) Rehabilitative, physical or dental procedures by medical personnel as
necessary.
2) Utilization of enrolled Medicaid providers or a board certified physician or
dentist volunteering his/her time for health procedures,
3) Provision of medication as prescribed by a treating physician. Agency
must have a Standard Operating Procedure for dispensing and storage
of medication.
4) Special diets provided as needed and regularly reassessed utilizing
appropriate specialized personnel,
5) Forwarding the above DCWL required medical and dental examination
reports to the MDHHS caseworker/PAFC provider within five (5) working
days of completion.
6) Coordination with the MDHHS caseworker, WCPRU or PAFC provider
for securing of prosthetic or mechanical equipment.
7) Review of prescriptive non-routine health care by medical personnel.
q, Wardrobe
The Contractor shall assure that children have an adequate wardrobe as
defined by and documented on the Clothing Inventory Checklist (DHS-3377)
while In placement and upon leaving placement. The Contractor shall
complete the DHS-3377 upon placement and discharge, The Contractor
shall provide the DHS-3377 to the assigned MDHHS WCCFS/PAFC worker
within five business days of placement and discharge. When the child is
absent or at the conclusion of the placement, the Contractor shall have a
process In place to keep the child's wardrobe and possessions safe until
claimed by the child or MDHHS. If the possessions are not claimed within 90
calendar days, the Contractor may dispose of the items at its discretion.
r. Recreation Activities
The Contractor shall provide daily access to appropriate recreation activities
as defined by MDHHS DCWL standards for the license specified in Section
2,4 of this Agreement.
s. Transitional Service Following Discharge
The Contractor shall send the case worker the discharge report based on the
child's assessment and subsequent Contractor's recommendation.
2.11. Expected Program Performance Oblectives
PAGE 23 of 46
Ftev. 5-16
Agreement Number: SHFC17-63001
During the contract period, the Contractor shall work toward the
achievement of the performance objectives listed below The Contractor shall
supply the Oakland County Business Service Center contract administrator with
monthly reports that include the statistics for the expected outcome measures
listed below. These reports shall be submitted no later than the tenth day of the
month following the reporting period.
a. 99.68% of all children supervised by the Contractor will not be victims of
substantiated maltreatment by facility staff.
b. 100% of children will be fully assessed within 7 days of placement
c. 90% of children will remain in their home school if the referral originates
in the county the shelter is located.
d. No more than 5% of children discharged from the Contractor's program,
will be discharged due to AVVOLP status.
e. 100% of the children will have a family visit within seven calendar days
of placement and weekly thereafter unless any of the following
exceptions are documented:
1) The court orders less frequent visits
2) The parents are not attending the visits despite the worker taking
adequate steps to ensure the parent's ability to visit.
3) One or both parents cannot attend the visits due to compelling
circumstances such as hospitalization or incarceration
4) The child is above the age of 16 and refuses such visits take place.
f. 100% of the children discharged from the program will have participated
in a planned visitation schedule as outline in his/her transition plan
g. 100% of children and families will be offered the opportunity to
participate in Family Team Meetings
h. 100% of families will be actively involved in the planning for the child
unless any of the following exceptions are documented:
1) The court orders no contact with the child
2) The parents are not cooperating despite the worker taking adequate
steps to engage the parents in the process
3) One or both parents cannot participate due to compelling
circumstances such as hospitalization or incarceration.
The Contractor shall not be penalized financially If the Performance
Objectives are not met and will be held harmless in meeting the goals.
2.12. Audit Requirements
ContractorNendor Relationship
This Agreement constitutes a contractor/vendor relationship with MDFIHS. The
Contractor must immediately report to the MDHHS Bureau of Audit any audit
findings of a Going Concern or accounting irregularities, including
noncompliance with provisions of this Agreement.
PAGE 24 of 46
Rev. 6.16
Agreement Number: SHFC17-63001
2.13. Financial Audit Requirements
a. Required Audit or Notification Letter
Contractors must submit to the Department either a Single Audit, Financial
Statement Audit, or Audit Status Notification Letter as described below. If
submitting a Single Audit or Financial Statement Audit, Contractors must also
submit a Corrective Action Plan for any audit findings that impact MDHHS-
funded programs, and management letter (if issued) with a response.
1) Single Audit
Contractors that are a non-profit organization and that expend $750,000
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 Title 2 Code of Federal Regulations, Subpart F.
2) Financial Statement Audit
Contractors exempt from the Single Audit requirements with fiscal years
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).
3) Audit Status Notification Letter
Contractors exempt from the Single Audit and Financial Statement Audit
requirements (1 and 2 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.michician.gov/mdhhs by selecting Inside MDHHS menu, then
MDHHS Audit, then Audit Reporting.
b. 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 Contractors fiscal year by e-mail to the Department at MDHHS-
AuditReports@michigan,gov.mmito: The required submissions must be in
PDF files and 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,
c. Penalty
Failure to meet reporting responsibilities as identified in this Agreement may
result in delay or withholding of future payments.
d. Other Audits
PAGE 25 of 46
Rev. 5.16
Agreement Number: SHFC17-63001
The Department or federal agencies may also conduct or arrange for
"agreed upon procedures" or additional audits to meet their needs.
2.14, Cost Reporting
The Contractor shall submit annual financial cost reports based on the state's
fiscal year which begins October 1 and ends September 30 in the following
calendar year. The reports shall contain the actual costs incurred by providers in
delivering services required in this agreement to MDHHS clients for the reporting
period. Costs for non-MDHHS children are not to be included. Reports will be
submitted using a template provided by MDHHS. The financial reports shall be
submitted annually, and will be due November 30 of each fiscal year. The
Contractor must comply with all other program and fiscal reporting procedures
as are or may hereinafter be established by MDHHS. Reports shall be
submitted electronically to MDHHS-Foster-Care-Auditsmichigan.gov with the
subject line: SHFC Actual Cost Report. Failure to meet reporting responsibilities
as identified in this Agreement may result in delay or withholding of future
payments.
2.15. Service Documentation
The Contractor agrees to maintain program records required by MDHHS,
program statistical records required by MDHHS, and to produce program
narrative and statistical data at times prescribed by, and on forms furnished by,
MDHHS.
2.16. Private Agency MiSACWIS
The Contractor shall ensure that residential payment staff has access to the
Michigan Statewide Automated Child Welfare Information System (MISACWIS)
through a web-based interface, henceforth referred to as the "MiSACWIS
application." Requirements for MiSACWIS for CCI contracts may be found at
http://www.michigan.gov/mdhhs/0,5885,7-339-71551 7199--,00.html
2.17. Billing
The Contractor shall submit through the MISACWIS system the bi-weekly roster
for any child in the Contractors care per the instructions within the MiSACWIS
system. The billing shall indicate the units of service provided by the Contractor
and shall be submitted to MDHHS within 30 days from the end of the billing
period.
No original request for payment submitted by the Contractor more than three
years after the close of the two week billing period during which services were
provided shall be honored for payment.
PAGE 26 of 46
Nev. 5-16
Agreement Number: SHFC17-63001
When the Contractor's financial records reveal that payment for a child has not
been provided by MDHHS within 90 days of the date of service, the Contractor
will seek payment resolution by contacting the direct supervisor of the assigned
MDHHS worker in writing. Any concerns over a payment authorization or
issuance that cannot be resolved within 60 days of the written notice must be
reported to the MDHHS County Director for immediate resolution. The
Contractor will apprise MDFIHS of any ongoing, unresolved payment concerns.
2,18. Fees and Other Sources of Funding
The Contractor guarantees that any claims made to MDHHS under this
Agreement shall not be financed by any source other than MDHHS under the
terms of this Agreement. If funding is received through any other source, the
Contractor agrees to deduct from the amount billed to MDHHS the greater of
either the fee amounts, or the actual costs of the services provided.
The Contractor may not accept reimbursement from a client unless the
Agreement specifically authorizes such reimbursement in the "Contractor
Responsibility" Section. In such case, a detailed fee scale and criteria for
charging the fee must be included. If the Contractor accepts reimbursement from
a client in accordance with the terms of the Agreement, the Contractor shall
deduct these fees from billings to MDHHS.
Other third party funding sources, e.g., insurance companies, may be billed for
contracted client services, Third party reimbursement shall be considered
payment in full unless the third party fund source requires a co-pay, in which
case IVIDHHS may be billed for the amount of the co -pay. No supplemental
billing is allowed.
2.19. Recoupment of Funding and Repayment of Debts
a. Recoupment of Funding
If the Contractor fails to comply with requirements as set forth in this
Agreement, or fails to submit a revised payment request within allotted time
frames established by MDHHS in consultation with the Contractor, MDHHS
may, at its discretion, recoup or require the Contractor to reimburse
payments made under this Agreement which MDHHS has determined that
the Contractor has been overpaid. The Contractor is liable for any cost
incurred by MDHHS in the recoupment of any funding.
Upon notification by MDHHS that repayment is required, the Contractor shall
make payment directly to MDHHS within 30 days or MDFIRS may withhold
current or future payments made under this or any other agreements, current
or future, between MDHHS and the Contractor.
PAGE 27 of 46
Rev. 5-16
Agreement Number: SHFC17-63001
If the Contractor fails to: (1) correct noncompliance activities identified by
MDHHS, (2) submit revised billings as requested as part of a Corrective
Action Plan when required; or (3) remit overpayments or make arrangements
to have the overpayments deducted from future payments within 30 days,
such failure shall constitute grounds to terminate immediately any or all of
MDHHS agreements with the Contractor. MDHHS shall also report
noncompliance of the Contractor to Michigan's Department of Technology,
Management and Budget. Such report may result in the Contractors
debarment from further contracts with the state of Michigan.
b. Repayment of Debts and Other Amounts due MDHHS
By entering into this Agreement, the Contractor agrees to honor all prior
repayment agreements established by MDHHS with the Contractor or
Contractors predecessors. If the Contractor has an outstanding debt due to
MDHHS but does not have a repayment agreement, the Contractor agrees
to make monthly payments to MDHHS at an amount not less than 5% of any
outstanding balance and to begin on the date this Agreement is executed.
If the Contractor fails to honor prior repayment agreements, or the Contractor
falls to begin repayment on an obligation due MDHHS that is not subject to a
repayment agreement, MDHHS will initiate the administrative process to
reduce payments to the Contractor under this Agreement to recoup the debt
The payment reduction will be made at the amount originally established in
the repayment agreement or at an amount not less than 5% of any
outstanding balance effective on the date this Agreement is executed.
2.20. Child Protection Law Reporting Requirements
a. The Contractor shall ensure that all employees who have reasonable
cause to suspect child abuse or neglect shall report any suspected
abuse or neglect of a child in care to MDHHS for investigation as
required by Public Acts of 1975, Act Number 238.
b. Failure of the Contractor or its employees to report suspected abuse or
neglect of a child to MDHHS shall result in an immediate investigation to
determine the appropriate corrective action up to and including
termination of the contract.
c. Failure of the Contractor or its employees to report suspected child
abuse or neglect two or more times within a one-year period shall result
in a review of the contract agency's violations by a designated
Administrative Review Team, which shall include the Director of CSA
and the Director of DCWL or its successor agency, that shall consider
mitigating and aggravating circumstances to determine the appropriate
corrective action up to and included license revocation and contract
termination.
2.21. The Division of Child Welfare Licensing (DCWL)
PAGE 28 of 46
Roy. 5..16
Agreement Number: SHFC17-63001
DCWL shall be responsible for review of the Contractor's compliance with the
Agreement and any court orders, via an Annual Compliance Review (ACR) and
Special Investigations. DCWL may review, analyze and comment on all
activities covered within the terms of the Agreement or court order, If the ACR of
Special Investigation reveals that the Contractor has not complied with the
requirements of this Agreement or court order, the following procedures shall be
implemented:
a. DCWL shall notify the Contractor of the Agreement or court noncompliance.
This notification shall occur verbally during an exit conference, and be
followed with a written report of the findings. The Contractor may request a
meeting to discuss and examine the identified Agreement or court
noncompliance.
b. Following the identification of the Agreement or court noncompliance, DCWL
will request the Contractor submit a Corrective Action Plans (CAP) to DCWL
within 15 days of receiving the written report of findings,
c. After the Contractor's CAP has been reviewed and approved by DCWL, the
Contractors compliance with the CAP shall be reviewed in accordance with
time frames established by DCWL in the written notification of acceptance of
the CAP.
d. Based on the severity or repeated nature of cited violations, a
recommendation may be made by DCWL at any time to place a moratorium
on new placements with the contractor or to cancel the contract, If either
recommendation is made, a meeting will be convened with the director of the
contracted agency, the division director of DCVVL and the Children's Services
Agency (GSA) director or designee to provide the contractor with the
opportunity to provide documented information on why the moratorium or
cancellation of the contract should not occur.
e. If a moratorium on new placements Is put into place, it shall be for a
minimum of 90 days to allow the contractor to remedy cited violations and
comply with any agreed on CAP. If the cited violations are not corrected
during the period of the moratorium or additional serious violations are cited,
consideration shall be given to cancellation of the agency's contract, Final
decisions regarding the cancellation of a contract shall be made by the CSA
director.
2.22 Corrective Action Requirements
If a program review by MDHHS reveals a lack of compliance with the
requirements of this Agreement, the Contractor shall:
a. Meet with MDHHS to discuss the noncompliance.
b. Prepare a corrective action plan within 30 days of receiving MDHHS' written
findings.
PAGE 29 of 46
Rev. 5-16
Agreement Number: SHFC17-63001
c, Achieve compliance within 60 days of receipt of MDHHS' approval of the
corrective action plan (unless other time frames are agreed to in writing by
MDHHS) or MDHHS may terminate this Agreement, subject to the standard
contract terms.
3. MDHHS RESPONSIBILITIES
3.1. Payment
MDHHS shall make payments to the Contractor pursuant to MCL 17.51-17.57
and State of Michigan Financial Management Guide, Part II-Accounting and
Financial Reporting, Chapter 25, Section 100, "Prompt Payment for Goods and
Services."
a. The per diem rate(s) for services provided under this Agreement shall be
Service Code
Program Name
Per Diem Rate
Effective Date
Bridges Provider Number
MISACVVIS Provider Number
745
Mandy's Place
$234.16
06/01/17
6358407
10400607
b, For County Child Care Fund funded children, MDHHS is not statutorily
obligated to make payment to the Contractor. Payment for these children is
the statutory responsibility of the County. If payment is not made, MDHHS
shall make reasonable efforts to assist the Contractor to obtain payment.
3.2. Performance Evaluation and Monitoring
The services provided by the Contractor under this Agreement shall be
evaluated and assessed at least annually by MDHHS.
MD}-{HS shall perform contract monitoring through activities such as:
a. MDHHS shall be responsible for performance reviews as outlined in Section
2.11 of this Agreement.
b. MDHHS shall be responsible for contract compliance audits as outlined in
Section 2.11 of this Agreement,
4, Standard Contract Terms
4.1 Duties of Contractor
PAGE 30o1.16
Rev. 5-16
Agreement Number: SHFC17-63001
Contractor must perform the services and provide the deliverables described in
Sections 1 and 2. (the "Agreement Activities").
Contractor must furnish all labor, equipment, materials, and supplies necessary for the
performance of the Agreement Activities, and meet operational standards, unless
otherwise specified in Section 2.10 — Services to be Provided.
Contractor must:
a. Perform the Agreement Activities in a timely, professional, safe, and workman
like manner consistent with standards in the trade, profession, or industry;
b. Meet or exceed the performance and operational standards, and specifications
of this Agreement;
c. Provide all Agreement Activities in good quality, with no material defects;
d. Not interfere with MDHHS's operations;
e. Obtain and maintain all necessary licenses, permits or other authorizations
necessary for the performance of this Agreement;
f. Cooperate with MDHHS, including MDHHS's quality assurance personnel, and
any third party to achieve the objectives of this Agreement;
9. Return to MDHHS any State-furnished equipment or other resources in the
same condition as when provided when no longer required for this Agreement;
h, Not make any media releases without prior written authorization from MDHHS;
i. Assign to MDHHS any claims resulting from state or federal antitrust violations
to the extent that those violations concern materials or services supplied by
third parties toward fulfillment of this Agreement;
j. Comply with all State physical and IT security policies and standards which will
be made available upon request; and
k. Provide MDHHS priority in performance of this Agreement except as
mandated by federal disaster response requirements.
Any breach under this provision is considered a material breach.
Contractor must also be clearly identifiable while on State property by wearing
identification issued by the State, and clearly identify themselves whenever
making contact with the State,
4.2 Notices
All notices and other communications required or permitted under this Agreement must be in
writing and will be considered given and received: (a) when verified by written receipt if sent
by courier; (b) when actually received if sent by mail without verification of receipt; or (c) when
verified by automated receipt or electronic logs if sent by facsimile or email.
4.3 Reserved
4.4 Reserved
4.5 Reserved
PAGE 31 of 46
Rev, 316
Agreement Number. SHFC17-63001
4.6 Insurance Requirements
Contractor is self-insured and will provide the following:
a. Proof of self-Insurance from the Michigan Department of Insurance and Financial
Services for auto liability.
b. Proof of self-insurance from the Michigan Department of Licensing and Regulatory
Affairs for worker's compensation and employer's liability.
c. A copy of most recent independently audited financial statements.
This Section is not intended to and is not to be construed in any manner as waiving,
restricting or limiting the liability of either party for any obligations under this Agreement.
4.7 Reserved
4.8 Reserved
4.9 Independent Contractor
Contractor is an independent contractor and assumes all rights, obligations and liabilities set
forth in this Agreement. Contractor, its employees, and agents will not be considered
employees of MDHHS. No partnership or joint venture relationship is created by virtue of this
Agreement. Contractor, and not MDHHS, is responsible for the payment of wages, benefits
and taxes of Contractor's employees and any subcontractors. Prior performance does not
modify Contractor's status as an independent contractor.
4.10 Reserved
4.11 Reserved
4.12 Reserved
4.13 Assignment
Contractor may not assign this Agreement to any other party without the prior written
approval of MDHHS. Upon notice to Contractor, MDHHS, by mutual agreement of the
parties, may assign in whole or in part, its rights or responsibilities under this Agreement
to any other party.
4.14 Reserved
4.15 Reserved
4.16 Reserved
PAGE 32 of 40
Rev. 6-16
Agreement Number: SHFC17-63001
4.17 Reserved
4,18 Reserved
4.19 Reserved
4.20 Terms of Payment
invoices must conform to the requirements communicated from time-to-time by
MDFIHS. All undisputed amounts are payable within 45 days of MDHHS's receipt.
Contractor may only charge for Agreement Activities performed as specified in Section
2.10. MDHHS is exempt from State sales tax for direct purchases and may be exempt
from federal excise tax, if Agreement Activities are for MDHHS's exclusive use.
MDHHS will only disburse payments under this Agreement through Electronic Funds
Transfer (EFT). Contractor must register with the State at
http://www.michigan.gov/cpexpress to receive electronic fund transfer payments. If
Contractor does not register, MDHHS is not liable for failure to provide payment.
4.21 Reserved
4.22 Stop Work Order
MDHHS may suspend any or all activities under this Agreement at any time. MDFIHS
will provide Contractor a written stop work order detailing the suspension. Contractor
must comply with the stop work order upon receipt. Within 90 calendar days, or any
longer period agreed to by Contractor, MDHHS will either: (a) issue a notice authorizing
Contractor to resume work, or (b) terminate this Agreement or purchase order. MDHHS
will not pay for Agreement Activities, Contractor's lost profits, or any additional
compensation during a stop work period.
4,23 Termination
Either Party may terminate and/or cancel this Agreement upon thirty (30) Days written
notice to the other Party or as otherwise provided in this Agreement. The effective date
of termination and/or cancellation shall be clearly stated in the written notice.
Termination of this Agreement does not release any Party from any obligations that
Party has pursuant to any law.
The Parties agree and acknowledge that either Party's decision to terminate and/or
cancel this Agreement, or any one or more individual Agreement activities identified
herein, shall not relieve the MDHHS or any MDHHS of its payment obligation for any
Contractor Services rendered prior to the effective date of any termination or
cancellation of this Agreement. The provisions of this Subsection shall survive the
termination, cancellation, and/or expiration of this Agreement.
4.24 Reserved
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Rev, 5-16
Agreement Number: SHFC17-63001
4.25 Transition Responsibilities
Upon termination or expiration of this Agreement for any reason, Contractor must, for a
period of time specified by MDHHS (not to exceed 90 calendar days), provide all
reasonable transition assistance requested by MDHHS, to allow for the expired or
terminated portion of the Agreement Activities to continue without interruption or
adverse effect, and to facilitate the orderly transfer of such Agreement Activities to
MDHHS or its designees. Such transition assistance may include, but is not limited to:
a, Continuing to perform the Agreement Activities at the established Agreement
rates;
b. Taking all reasonable and necessary measures to transition performance of the
work, including all applicable Agreement Activities, training, equipment, software,
leases, reports and other documentation, to MDHHS or MDHHS's designee;
c. Taking all necessary and appropriate steps, or such other action as MDHHS may
direct, to preserve, maintain, protect, or return to MDHHS all materials, data,
property, and confidential information provided directly or indirectly to Contractor
by any entity, agent, vendor, or employee of MDHHS;
d. Transferring title in and delivering to MDHHS, at MDHHS's discretion, all
completed or partially completed deliverables prepared under this Agreement as
of the Agreement termination date; and
e. Preparing an accurate accounting from which MDHHS and Contractor may
reconcile all outstanding accounts (collectively, "Transition Responsibilities").
This Agreement will automatically be extended through the end of the transition period.
4.26 General Indemnification
Each Party shall be responsible for any Claims made against that Party, and to the
extent required by law, for the acts of its Employees or Agents.
In any Claim that may arise from the performance of this Agreement, each Party shall
seek its own legal representation and bear the costs associated with such
representation including any attorney fees.
Except as otherwise provided in this Agreement, neither Party shall have any right
under any legal principle to be indemnified by the other Party or any of its employees or
Agents in connection with any Claim.
This Agreement does not, and is not intended to, impair, divest, delegate or contravene
any constitutional, statutory, and/or other legal right, privilege, power, obligation, duty or
PAGE 34 of 46
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Agreement Number: SHFC17-63001
immunity of the Parties. Nothing in this Agreement shall be construed as a waiver of
governmental immunity for either Party.
4.27 Reserved
4,28 Limitation of Liability
MDHHS is not liable for consequential, incidental, indirect, or special damages,
regardless of the nature of the action,
4,29 Disclosure of Litigation, or Other Proceeding
Contractor must notify MDHHS within 14 calendar days of receiving notice of any
Litigation, investigation, arbitration, or other proceeding (collectively, "Proceeding")
involving Contractor or an officer or director of Contractor or subcontractor, that arises
out of this Agreement.
4.30 Reserved
4.31 State Data
a. Ownership. MDHHS's data ("State Data," which will be treated by Contractor as
Confidential Information) includes:
1) MDHHS's data collected, used, processed, stored, or generated as the result of
the Agreement Activities;
2) Personally identifiable information ("P11") collected, used, processed, stored, or
generated as the result of the Agreement Activities, including, without limitation,
any information that identifies an individual, such as an individual's social security
number or other government-issued identification number, date of birth, address,
telephone number, biometric data, mother's maiden name, email address, credit
card information, or an individual's name in combination with any other of the
elements here listed; and,
3) Personal health information ("PHI") collected, used, processed, stored, or
generated as the result of the Agreement Activities, which is defined under the
Health Insurance Portability and Accountability Act (HIPAA) and its related rules
and regulations. State Data is and will remain the sole and exclusive property of
MDHHS and all right, title, and interest in the same is reserved by MDHHS.
This Section survives the termination of this Agreement.
b. Contractor Use of State Data. Contractor is provided a limited license to State Data
for the sole and exclusive purpose of providing the Agreement Activities, including a
license to collect, process, store, generate, and display State Data only to the extent
necessary in the provision of the Agreement Activities. Contractor must;
1) Keep and maintain State Data in strict confidence, using such degree of care as
is appropriate and consistent with its obligations as further described in this
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Agreement Number: SHFC17-63001
Agreement and applicable law to avoid unauthorized access, use, disclosure, or
loss;
2) Use and disclose State Data solely and exclusively for the purpose of providing
the Agreement Activities, such use and disclosure being in accordance with this
Agreement, any applicable Statement of Work, and applicable law; and
3) Not use, sell, rent, transfer, distribute, or otherwise disclose or make available
State Data for Contractor's own purposes or for the benefit of anyone other than
MDHHS without MDHHS's prior written consent.
This Section survives the termination of this Agreement.
c. Extraction of State Data. Contractor must, within five business days of MDHHS's
request, provide MDHHS, without charge and without any conditions or contingencies
whatsoever (including but not limited to the payment of any fees due to Contractor), an
extract of the State Data in the format specified by MDHHS.
d. Backup and Recovery of State Data, Unless otherwise specified in Section 2.5 —
Services to be Delivered, Contractor is responsible for maintaining a backup of State
Data and for an orderly and timely recovery of such data. Unless otherwise described in
Section 2.10 — Services to be Provided, Contractor must maintain a contemporaneous
backup of State Data that can be recovered within two hours at any point in time.
e. Loss of Data. In the event of any act, error or omission, negligence, misconduct, or
breach that compromises or Is suspected to compromise the security, confidentiality, or
integrity of State Data or the physical, technical, administrative, or organizational
safeguards put in place by Contractor that relate to the protection of the security,
confidentiality, or integrity of State Data, Contractor must, as applicable:
1) Notify MDHHS as soon as practicable but no later than 24 hours of becoming
aware of such occurrence;
2) Cooperate with MDHHS in investigating the occurrence, Including making
available all relevant records, logs, files, data reporting, and other materials
required to comply with applicable law or as otherwise required by MDHHS;
3) In the case of Pll or PHI, at MDHHS's sole election, (I) notify the affected
individuals who comprise the Pll or PHI as soon as practicable but no later than
is required to comply with applicable law, or, in the absence of any legally
required notification period, within five calendar days of the occurrence; or (ii)
reimburse MDHHS for any costs in notifying the affected individuals;
4) In the case of P11, provide third-party credit and identity monitoring services to
each of the affected individuals who comprise the Pll for the period required to
comply with applicable law, or, in the absence of any legally required monitoring
services, for no less than 24 months following the date of notification to such
individuals;
5) Perform or take any other actions required to comply with applicable law as a
result of the occurrence;
6) Without limiting Contractor's obligations of indemnification as further described In
this Agreement, indemnify, defend, and hold harmless MDHHS for any and all
PAGE 36 of 46
Rev. 6-16
Agreement Number: SHFC17-63001
claims, including reasonable attorneys' fees, costs, and expenses incidental
thereto, which may be suffered by, accrued against, charged to, or recoverable
from MDHHS in connection with the occurrence;
7) Be responsible for recreating lost State Data in the manner and on the schedule
set by MDHHS without charge to MDHHS; and,
8) Provide to MDHHS a detailed plan within 10 calendar days of the occurrence
describing the measures Contractor will undertake to prevent a future
occurrence.
Notification to affected individuals, as described above, must comply with applicable
law, be written in plain language, and contain, at a minimum: name and contact
information of Contractor's representative; a description of the nature of the loss; a list
of the types of data involved: the known or approximate date of the loss; how such loss
may affect the affected individual; what steps Contractor has taken to protect the
affected individual; what steps the affected individual can take to protect himself or
herself; contact information for major credit card reporting agencies; and, information
regarding the credit and identity monitoring services to be provided by Contractor.
4.32 Non-Disclosure of Confidential Information
The parties acknowledge that each party may be exposed to or acquire communication
or data of the other party that is confidential, privileged communication not intended to
be disclosed to third parties. The provisions of this Section survive the termination of
this Agreement.
a. Meaning of Confidential Information. For the purposes of this Agreement, the term
"Confidential Information" includes State Data as stated in Section 4.31 above, and
also means all information and documentation of a party that:
1) Has been marked "confidential" or with words of similar meaning, at the time of
disclosure by such party;
2) If disclosed orally or not marked "confidential" or with words of similar meaning,
was subsequently summarized in writing by the disclosing party and marked
"confidential" or with words of similar meaning; and,
3) Should reasonably be recognized as confidential information of the disclosing
party.
The term "Confidential Information" does not include any information or documentation
that was:
1) Subject to disclosure under the Michigan Freedom of Information Act (FOIA);
2) Already in the possession of the receiving party without an obligation of
confidentiality;
3) Developed independently by the receiving party, as demonstrated by the
receiving party, without violating the disclosing party's proprietary rights;
4) Obtained from a source other than the disclosing party without an obligation of
confidentiality; or,
PAGE 37 of 46
Rev. 5.16
Agreement Number: SHFC17-63001
5) Publicly available when received, or thereafter became publicly available (other
than through any unauthorized disclosure by, through, or on behalf of, the
receiving party).
For purposes of this Agreement, in all cases and for all matters, State Data is
deemed to be Confidential Information.
b. Obligation of Confidentiality. The parties agree to hold all Confidential Information in
strict confidence and not to copy, reproduce, sell, transfer, or otherwise dispose of, give
or disclose such Confidential Information to third parties other than employees, agents,
or subcontractors of a party who have a need to know in connection with this
Agreement or to use such Confidential Information for any purposes whatsoever other
than the performance of this Agreement. The parties agree to advise and require their
respective employees, agents, and subcontractors of their obligations to keep all
Confidential Information confidential. Disclosure to a subcontractor is permissible
where:
1) Use of a subcontractor is authorized under this Agreement;
2) The disclosure is necessary or otherwise naturally occurs in connection with work
that is within the subcontractor's responsibilities; and
3) Contractor obligates the subcontractor in a written contract to maintain MDHHS's
Confidential Information in confidence.
At MDHHS's request, any employee of Contractor or any subcontractor may be required
to execute a separate agreement to be bound by the provisions of this Section.
c. Cooperation to Prevent Disclosure of Confidential Information. Each party must use
its best efforts to assist the other party in identifying and preventing any unauthorized
use or disclosure of any Confidential Information. Without limiting the foregoing, each
party must advise the other party immediately in the event either party learns or has
reason to believe that any person who has had access to Confidential Information has
violated or intends to violate the terms of this Agreement and each party will cooperate
with the other party in seeking injunctive or other equitable relief against any such
person.
d. Remedies for Breach of Obligation of Confidentiality. Each party acknowledges that
breach of its obligation of confidentiality may give rise to irreparable injury to the other
party, which damage may be inadequately
comperisable in the form of monetary damages. Accordingly, a party may seek and
obtain injunctive relief against the breach or threatened breach of the foregoing
undertakings, in addition to any other legal remedies which may be available, to include,
in the case of MDHHS, at the sole election of MDHHS, the immediate termination,
without liability to MDHHS, of this Agreement Or any Statement of Work corresponding
to the breach or threatened breach.
e. Surrender of Confidential Information upon Termination. Upon termination of this
Agreement or a Statement of Work, in whole or in part, each party must, within five
calendar days from the date of termination, return to the other party any and all
PAGE 38 of 45
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Agreement Number: SHFC17-63001
Confidential Information received from the other party, or created or received by a party
on behalf of the other party, which are in such party's possession, custody, or control;
provided, however, that Contractor must return State Data to MDHHS following the
timeframe and procedure described further in this Agreement. Should Contractor or
MDHI-IS determine that the return of any Confidential Information is not feasible, such
party must destroy the Confidential Information and must certify the same in writing
within five calendar days from the date of termination to the other party. However,
MDHHS's legal ability to destroy Contractor data may be restricted by its retention and
disposal schedule, in which case Contractor's Confidential Information will be destroyed
after the retention period expires.
4.33 Data Privacy and Information Security.
a. Undertaking by Contractor. Without limiting Contractor's obligation of confidentiality
as further described, Contractor is responsible for establishing and maintaining a data
privacy and information security program, including physical, technical, administrative,
and organizational safeguards, that is designed to:
1) Ensure the security and confidentiality of the State Data;
2) Protect against any anticipated threats or hazards to the security or integrity of
the State Data;
3) Protect against unauthorized disclosure, access to, or use of the State Data;
4) Ensure the proper disposal of State Data; and
5) Ensure that all employees, agents, and subcontractors of Contractor, if any,
comply with all of the foregoing. In no case will the safeguards of Contractor's
data privacy and information security program be less stringent than the
safeguards used by MDHHS, and Contractor must at all times comply with all
applicable State IT policies and standards, which are available to Contractor
upon request.
b. Audit by Contractor. No less than annually, Contractor must conduct a
comprehensive independent third-party audit of its data privacy and information security
program and provide such audit findings to MDHHS.
c. Right of Audit by the State. Without limiting any other audit rights of MDHHS, MDHHS
has the right to review Contractor's data privacy and information security program prior
to the commencement of Agreement Activities and from time to time during the term of
this Agreement. During the providing of the Agreement Activities, on an ongoing basis
from time to time and without notice, MDHHS, at its own expense, is entitled to perform,
or to have performed, an on-site audit of Contractor's data privacy and information
security program. In lieu of an on-site audit, upon request by MDHHS, Contractor
agrees to complete, within 45 calendar days of receipt, an audit questionnaire provided
by MDHHS regarding Contractor's data privacy and information security program.
d. Audit Findings, Contractor must implement any required safeguards as identified by
MDHHS or by any audit of Contractor's data privacy and information security program.
PAGE 39 of 46
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Agreement Number: SHFC17-63001
e, State's Right to Termination for Deficiencies. MDHHS reserves the right, at its sole
election, to immediately terminate this Agreement or a Statement of Work without
limitation and without liability if MDHHS determines that Contractor fails or has failed to
meet its obligations under this Section.
4,34 Reserved
4.35 Reserved
4.36 Records Maintenance, Inspection, Examination, and Audit
MDHFIS or its designee rosy audit Contractor to verify compliance with this Agreement.
Contractor must retain, and provide to MDHHS or its designee and the auditor general
upon request, all financial and accounting records related to this Agreement through the
term of this Agreement and for four years after the latter of termination, expiration, or
final payment under this Agreement or any extension ("Audit Period"). If an audit,
litigation, or other action involving the records is initiated before the end of the Audit
Period, Contractor must retain the records until all issues are resolved.
Within 10 calendar days of providing notice, MDHHS and its authorized representatives
or designees have the right to enter and inspect Contractor's premises or any other
places where Agreement Activities are being performed, and examine, copy, and audit
all records related to this Agreement. Contractor must cooperate and provide
reasonable assistance. If any financial errors are revealed, the amount in error must be
reflected as a credit or debit on subsequent invoices until the amount is paid or
refunded. Any remaining balance at the end of this Agreement must be paid or refunded
within 45 calendar days.
This Section applies to Contractor, any parent, affiliate, or subsidiary organization of
Contractor, and any subcontractor that performs Agreement Activities in connection with
this Agreement.
4.37 Warranties and Representations
Contractor represents and warrants:
1) Contractor is the owner or licensee of any Agreement Activities that it licenses,
sells, or develops and Contractor has the rights necessary to convey title,
ownership rights, or licensed use;
2) All Agreement Activities are delivered free from any security interest, lien, or
encumbrance and will continue in that respect;
3) The Agreement Activities will not infringe the patent, trademark, copyright, trade
secret, or other proprietary rights of any third party;
4) Contractor must assign or otherwise transfer to MOHHS or its designee any
manufacturer's warranty for the Agreement Activities;
PAGE 4016
Rev. 6-16
Agreement Number: SHFC17-63001
5) The Agreement Activities are merchantable and fit for the specific purposes
identified in this Agreement;
6) The Agreement signatory has the authority to enter into this Agreement;
7) All information furnished by Contractor in connection with this Agreement fairly
and accurately represents Contractor's business, properties, finances, and
operations as of the dates covered by the information, and Contractor will inform
MDHHS of any material adverse changes; and
8) All information furnished and representations made in connection with the award
of this Agreement is true, accurate, and complete, and contains no false
statements or omits any fact that would make the information misleading.
9) A breach of this Section is considered a material breach of this Agreement, which
entitles MDHHS to terminate this Agreement under Section 4.23, Termination for
Cause
4.38 Conflicts and Ethics
Contractor will uphold high ethical standards and is prohibited from:
a. Holding or acquiring an interest that would conflict with this Agreement;
b. Doing anything that creates an appearance of impropriety with respect to the
award or performance of this Agreement;
c. Attempting to influence or appearing to influence any State employee by the
direct or indirect offer of anything of value; or
d. Paying or agreeing to pay any person, other than employees and consultants
working for Contractor, any consideration contingent upon the award of this
Agreement.
e. Contractor must immediately notify MDHHS of any violation or potential violation
of these standards. This Section applies to Contractor, any parent, affiliate, or
subsidiary organization of Contractor, and any subcontractor that performs
Agreement Activities In connection with this Agreement.
4.39 Compliance with Laws
Contractor must comply with all federal, state and local laws, rules and regulations.
4.40 Reserved
4.41 Reserved
4.42 Nondiscrimination
Under the Elliott-Larsen Civil Rights Act, 1976 PA 453, MCL 37.2101, et seq., and the
Persons with Disabilities Civil Rights Act, 1976 PA 220, MCL 37.1101, et seq.,
Contractor and its subcontractors agree not to discriminate against an employee or
applicant for employment with respect to hire, tenure, terms, conditions, or privileges of
employment, or a matter directly or indirectly related to employment, because of race,
color, religion, national origin, age, sex, height, weight, marital status, or mental or
physical disability. Breach of this covenant is a material breach of this Agreement.
PAGE 41 of 46
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Agreement Number: SHFC17-63001
4.43 Unfair Labor Practice
Under MCL 423.324, MDHHS may void any Agreement with a Contractor or
subcontractor who appears on the Unfair Labor Practice register complied under MCL
423.322.
4.44 Governing Law
This Agreement is governed, construed, and enforced in accordance with Michigan law,
excluding choice-of-law principles, and all claims relating to or arising out of this
Agreement are governed by Michigan law, excluding choice-of-law principles. Any
dispute against the State arising from this Agreement must be resolved in the Michigan
Court of Claims.
4.45 Non-Exclusivity
Nothing contained in this Agreement is intended nor will be construed as creating any
requirements contract with Contractor. This Agreement does not restrict the State or its
agencies from acquiring similar, equal, or like Agreement Activities from other sources.
4.46 Force Maieure
Neither party will be in breach of this Agreement because of any failure arising from any
disaster or acts of god that are beyond their control and without their fault or negligence.
Each party will use commercially reasonable efforts to resume performance. Contractor
will not be relieved of a breach or delay caused by its subcontractors. If immediate
performance is necessary to ensure public health and safety, MDHHS may immediately
contract with a third party.
4.47 Dispute Resolution
The parties will endeavor to resolve any Agreement dispute In accordance with this
provision. The parties must submit the dispute to a senior executive if unable to resolve
the dispute within 15 business days. The parties will continue performing while a dispute
is being resolved, unless the dispute precludes performance. A dispute involving
payment does not preclude performance.
Litigation to resolve the dispute will not be instituted until after the dispute has been
elevated to the parties senior executive and either concludes that resolution is unlikely,
or fails to respond within 15 business days. The parties are not prohibited from
instituting formal proceedings: (a) to avoid the expiration of statute of limitations period;
(b) to preserve a superior position with respect to creditors; or (c) where a party makes
a determination that a temporary restraining order or other injunctive relief is the only
adequate remedy. This Section does not limit MDHHS's right to terminate this
Agreement.
PAGE 42 o(4
Rev. 5113
Agreement Number: SHFC17-63001
4.48 Media Releases
News releases (including promotional literature and commercial advertisements)
pertaining to the Agreement or project to which it relates must not be made without prior
written MDHHS approval, and then only in accordance with the explicit written
instructions of MDHHS.
4.49 Website Incorporation
MDHHS is not bound by any content on Contractor's website unless expressly
incorporated directly into this Agreement.
4.50 Entire Agreement
This Agreement is the entire agreement of the parties related to the Agreement
Activities. This Agreement supersedes and replaces all previous understandings and
agreements between the parties for the Agreement Activities.
4,51 Severability
If any part of this Agreement is held invalid or unenforceable, by any court of competent
Jurisdiction, that part wili be deemed deleted from this Agreement and the severed part
will be replaced by agreed upon language that achieves the same or similar objectives.
The remaining Agreement will continue in full force and effect.
4.52 Waiver
Failure to enforce any provision of this Agreement will not constitute a waiver.
4.53 Survival
The provisions of this Agreement that Impose continuing obligations, including
warranties and representations, termination, transition, insurance coverage,
indemnification, and confidentiality, will survive the expiration or termination of this
Agreement.
PAGE 43 of 46
Rev. .5-1.6
Agreement Number; SHFC17-63001
4.54 Agreement Modification
This Agreement may not be amended except by signed agreement between the parties.
Notwithstanding the foregoing, no subsequent Statement of Work or amendment
executed after the effective date will be construed to amend this Agreement unless it
specifically states its intent to do so and cites the section or sections amended.
The Contractor shall, upon request of MDHHS and receipt of a proposed amendment,
amend this Agreement, if and when required in the opinion of MDHHS, due to the
revision of federal or state laws or regulations.
4.55 Options to Renew
At the discretion of MDHHS, this Agreement may be renewed in writing by an
amendment not less than 30 days before Its expiration. This Agreement may be
renewed for up to two additional one-year periods.
4.56 Certification Regarding Debarment, Suspension, and Other Responsibility Matters
Assurance is hereby given to MDHHS 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;
a. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, sentenced to a denial of federal benefits by a state or federal court, or
voluntarily excluded from covered transactions by any federal or state
department or agency;
b. Have not within a three-year period preceding this Agreement been convicted of
or had 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;
c. Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (federal, state, or local) with commission of any of the
offenses enumerated in section 2, and;
d. 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.
Where the parties are unable to certify to any of the statements in this certification, the
Contractor shall attach an explanation to this Agreement.
The Contractor certifies to the best of its knowledge that within the past three years, the
Contractor has not;
PAGE 44 of 46
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Agreement Number; SHFC17-63001
a. Failed to substantially perform a state contract, agreement, or subcontract
according to its terms, conditions, and specifications within specified time limits.
b. Refused to provide information or documents required by a contract or
agreement including, but not limited to information or documents necessary for
monitoring contract performance.
c. Failed to respond to requests for information regarding contract or agreement
compliance, or accumulated repeated substantiated complaints regarding
performance of a contract or agreement.
d. Failed to perform a state contract, agreement, or subcontract in a manner
consistent with any applicable state or federal law, rule, regulation, order, or
decree.
The Contractor shall include Section 4.56 (Certification Regarding Debarment,
Suspension, and Other Responsibility Matters) language as written above In all
subcontracts with other parties.
The Contractor shall require each primary subcontractor, whose subcontract will exceed
$25,000, to disclose to the Contractor, in writing, whether at the time of the award of the
subcontract, the subcontractor, or its principals, is or is not debarred, suspended, or
proposed for debarment by the state of Michigan. The Contractor shall then inform
MDHHS of the subcontractor's status and reasons for the Contractor's decision to use
such subcontractor, if the Contractor so decides.
If it is determined that the Contractor knowingly rendered an erroneous certification
under this provision, in addition to the other remedies available to the state, MDHHS
may immediately terminate this Agreement.
If the State finds that grounds to debar exist, it shall send notice to the Contractor of
proposed debarment indicating the grounds for proposed debarment and the
procedures for requesting a hearing. If the Contractor does not respond with a written
request for a hearing within 20 calendar days, the state shall issue the decision to debar
without a hearing. The debarment period may be of any length up to eight years. After
the debarment period expires, the Contractor may reapply for inclusion on bidder lists
through the regular application process by authority of Executive Order 2003-1.
Attachment A: Glossary of Acronyms and Forms
ABPN: American Board of Psychiatry and Neurology
AWOLP: Absent Without Legal Permission
DCWL: Division of Child Welfare Licensing
CANS: Child Assessment of Needs and Strengths
FOM: Foster Care Online Manual
GED: General Education Development
IEP: Individualized Education Plan
IETP: Individual Education Program Team
LGAL: Legal Guardian ad Litern
PAGE 45 01 46
Rev. 5-16
Agreement Number: SHFC17-63001
MISACWIS: Statewide Automated Child Welfare Information System
PAFC: Placing Agency Foster Care
VVCPRU: Wayne County Placement Resource Unit
DHS-815-Non MDHHS: Staff Profile Security Agreement
DHS-65: Children's Foster Care Initial Service Plan
DHS-66: Updated Service Plan
DHS-69:
DHS-221:
DHS-365:
DHS-366:
DHS-626-YA:
OHS-1643:
DHS-2840:
DNS-3307:
DHS-3377:
DHS-3600:
Foster Care Juvenile Justice Action Summary
Medical Passport
Residential Initial Treatment Plan
Residential Updated Treatment Plan
Foster Care Payment Authorization
Psychotropic Medication Consent
Prescription Information Form
Initial Placement Outline and Information Record
Clothing Inventory Checklist
Individual Service Agreement
PAGE 460148
Rev, 5-16
FISCAL NOTE .(MISC . #17255) September 6, 2017
BY: Commissioner Thomas Middleton, Chairperson, Finance Committee
IN RE DEPARTMENT OF HEALTH AND HUMAN SERVICES CHILDREN'S VILLAGE DIVISION —
INTERLOCAL AGREEMENT BETWEEN OAKLAND COUNTY AND THE MICHIGAN DEPARTMENT OF
HEALTH AND HUMAN SERVICES FOR THE PROVISION OF SHELTER RESIDENTIAL FOSTER
CARE —AMENDMENT #1
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. Resolution authorizes Amendment #1 to the Interlocal Agreement between Oakland County and
the Michigan Department of Health and Human Services for continuation of shelter care services
for neglected and abused youth.
2. The existing contract was adopted by the Board of Commissioners on July 19, 2017 via
Miscellaneous Resolution #17197.
3. The amendment extends the contract expiration from September 30, 2017 to September 30,
2018, during which Oakland County Children's Village will continue to be reimbursed in
accordance with the established Michigan Department of Health and Human Services per diem
rate of $234.16.
4. No budget amendment is required.
orfimissioner Thomas Middleton, District #4
Chairperson, Finance Committee
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote.
Resolution #17255 September 6, 2017
Moved by KowaII supported by Bowman the resolutions (with fiscal notes attached) on the Consent
Agenda be adopted (with accompanying reports being accepted).
AYES: Crawford, Dwyer, Fleming, Gershenson, Jackson, Kochenderfer, KowaII, Long,
McGillivray, Middleton, Quarles, Spisz, Taub, Tietz, Weipert, Woodward, Zack, Berman,
Bowman. (19)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the Consent
Agenda were adopted (with accompanying reports being accepted).
a; 9
I HERO
APP1410109 VAES01.0014
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ACING PURSUP,1n
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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 September 6,
2017, 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 6th day of September, 2017.
Lisa Brown, Oakland County