HomeMy WebLinkAbout010614_ca12i PS ®L
W JEFFERSON COUNTY PUBLIC HEALTH Consent Agenda
�SHINOT�� 615 Sheridan Street o Port Townsend o Washington o 98368
www.jeffersoncountypublichealth.org
December 23, 2013
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Jean Baldwin, Director
DATE: i—ar)LA Ckrij t,7, 201 i(-
SUBJECT: Agenda Item — Agency Agreement — Division of Behavioral Health and
Recovery with DSHS, Amendment #8, January 1, 2014 —
June 30, 2015; add'I $46,618 total $139,963
STATEMENT OF ISSUE:
Jefferson County Public Health is requesting Board approval of the Agency Agreement — Division of
Behavioral Health and Recovery with DSHS, Amendment #8, January 1, 2014 — June 30, 2015; add'I
$46,618 total $139,963
ANALYSIS /STRATEGIC GOALS /PRO'S and CON'S:
This amendment with DBHR is a continuation of services that will provide for substance abuse prevention
infrastructure under the Special Funding program called Prevention Redesign Initiative. The DBHR contract
will fund the Prevention Redesign Community Coordinator's work with Chimacum Prevention Coalition, and
will involve the continuing development and implementation of the Strategic Plan. Jefferson County will
continue to network with community partners.
FISCAL IMPACT /COST BENEFIT ANALYSIS:
Revenue for this contract comes from federal Substance Abuse Prevention and Treatment (SAPT) Block
Grant.
RECOMMENDATION:
JCPH management request approval of the Agency Agreement — Division of Behavioral Health and Recovery
with DSHS, Amendment #8, January 1, 2014 — June 30, 2015; add'I $46,618 total $139,963
REVIEWED
}
Ph' one u ministrator Date
COMMUNITY HEALTH PUBLIC HEALTH ENVIRONMENTAL HEALTH
DEVELOPMENTAL DISABILITIES WATER QUALITY
MAIN: (360) 385 -9400 ALWAYS WORKING FOR A SAFER AND MAIN: (360) 385 -9444
FAX: (360) 385 -9401 HEALTHIER COMMUNITY FAX: (360) 379 -4487
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1611CS -63 Program Agreement Amendment (12 -20 -2013) l.C4 --{t
k4eraon Co �( �rosectaorz tae
David Alvarez, Chief Civil DPA
DSHS Agreement Number
IL Washington Stare
COUNTY PROGRAM AGREEMENT
1163 -27310
C Department of social
AMENDMENT
7 { & Health services
Amendment No.
08
This Program Agreement Amendment is by and between the State of Washington
Administration or Division
Department of Social and Health Services (DSHS) and the County identified below.
Agreement Number
County Agreement Number
DSHS ADMINISTRATION
DSHS DIVISION
DSHS INDEX NUMBER
CCS CONTRACT CODE
Behavioral Health and Service
Division of Behavioral
1223
1223
Integration
Health and Recovery
DSHS CONTACT NAME AND TITLE
DSHS CONTACT ADDRESS
Harvey Funai
400 Mercer Street, Suite 600
Seattle, WA 98109
DSHS CONTACT TELEPHONE
DSHS CONTACT FAX
DSHS CONTACT E -MAIL
206 272 -2156
206 298 -4443
Harvey. Fu nai dshs.wa. ov
COUNTY NAME
COUNTY ADDRESS
Jefferson County
615 Sheridan St
Port Townsend, WA 98368 -
COUNTY FEDERAL EMPLOYER IDENTIFICATION
COUNTY CONTACT NAME
NUMBER
Julia Danskin
COUNTY CONTACT TELEPHONE
COUNTY CONTACT FAX COUNTY CONTACT E -MAIL
360 385 -9420
360 385 -9401 danskin co.'efferson.wa.us
IS THE COUNTY A SUBRECIPIENT FOR PURPOSES OF THIS PROGRAM
CFDA NUMBERS
AGREEMENT?
93.959
No
AMENDMENT START DATE
PROGRAM AGREEMENT END DATE
01101/2014
06/30/2015
PRIOR MAXIMUM PROGRAM AGREEMENT
AMOUNT OF INCREASE OR DECREASE
TOTAL MAXIMUM PROGRAM AGREEMENT
AMOUNT
AMOUNT
$93,345.00
$46,618.00
$139,963.00
REASON FOR AMENDMENT;
CHANGE OR CORRECT CONTRACT TERMS OR SOW, SEE PAGE TWO
EXHIBITS. When the box below is marked with a check (4) or an X, the following Exhibits are attached and are
incorporated into this Program Agreement Amendment by reference:
® Exhibits (specify): Exhibits A through I
This Program Agreement Amendment, including all Exhibits and other documents incorporated by reference, contains all
of the terms and conditions agreed upon by the parties as changes to the original Program Agreement. No other
understandings or representations, oral or otherwise, regarding the subject matter of this Program Agreement Amendment
shall be deemed to exist or bind the parties. All other terms and conditions of the original Program Agreement remain in
full force and effect. The parties signing below warrant that they have read and understand this Program Agreement
Amendment, and have authority to enter into this Pro ram A regiment Amendment.
COUNTY SIGNATURE(S)
PRINTED NAME(S) AND TITLE(S)
DATE(S) SIGNED
DSHS SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
DBHR Contracts
f�/�� ��
1611CS -63 Program Agreement Amendment (12 -20 -2013) l.C4 --{t
k4eraon Co �( �rosectaorz tae
David Alvarez, Chief Civil DPA
Table of Contents
1. Definitions . ...............................
2. Applicable Law .........................
3. Purpose ..... ...............................
4. Service Availability ..................
5. Requirements ...........................
6. Subcontracting.. r ........ .............
7. Strategic Plan ...........................
8. Prevention Statement of Work.
9. Treatment Statement of Work.
10. Additional Services ..................
Vino M101 b,,jmi"A
2 °
............. 4
.................... 8
..................... 9
..................... 9
..................... 9
....................13
....................15
....................19
....................28
....................62
This Amendment supersedes the previous Contract Special Terms and Conditions (as
amended) in its entirety. The purpose of this Amendment is to clarify the content going
forward through re- ordering the sections, to add new requirements, to delete some
requirements (such as ADATSA and Disability Lifeline which are now taken care of
through Medicaid /Apple Health) and to clean up inaccuracies. All Exhibits have been
renumbered due to the addition of Exhibit A — Data Security. The effective date of the
Amendment is January 1, 2014.
All language is applicable to each County/Contractor unless noted below or as identified
in specific sections within the Amendment.
Section 8. Prevention Statement of Work does not apply to the following:
Beacon of Hope
Kittitas County
Palouse River Counseling
Skamania County
Stevens /Ferry County
Yakima County
Section 9. Treatment Statement of Work does not apply to the following:
Jefferson County Skamania County ( Skamania Sherriffs Office)
Kittitas CCPHS Network Tekoa School District
Republic School District Mt. Adams School District
Sunnyside School District
Section 10. Additional Services applies only to the identified County for the specific
Exhibit(s):
County /Contractor
Exhibit(s):
County/Contractor
Exhibit(s):
Clark County
D
Pierce County
D, E
Grant County
F
Snohomish County
D
King County
D, E, G, H
Spokane County
D, E
Kitsap County
H
Mt. Adams SD
I
Exhibit C. Service Rate Plan does not apply to the following:
Jefferson County Republic School District
Kittitas CCPHS Network Sunnyside School District
Mt. Adams School District Tekoa School District
Definitions.
a. "Assessment" means diagnostic services provided by a CDP or CDP trainee under
CDP supervision to determine a client's involvement with alcohol and other drugs.
See WAC 388 -877 & 388 -877B for a detailed description of assessment
requirements.
b. "Awards and Revenues" or "A &R" details the County's Awards and Revenues
attached as Exhibit B
c. "Awards" means the total funding of all individual awards DSHS allocates to the
County, and the total of all awards in this Contract's Maximum Amount, which is
itemized, per service, in Exhibit B.
d. "BARS" means — "Fiscal /Program Requirements ", see below, which replaces BARS
document.
e. "BHSIA" means the Behavioral Health and Service Integration Administration.
f. "Boilerplate Language" means the standard contract language, including General
and Special terms, which will be common to all subcontracts issued by the County
for provision of the services required by this Contract.
g. "Capacity Management" means a continually updated system for identifying
treatment capacity for clients who cannot be admitted and a mechanism for
matching clients to treatment programs with sufficient capacity.
h. "Chemical Dependency" means an alcohol or drug addiction, or dependence on
alcohol and one or more other psychoactive chemicals.
i. "Community Prevention and Wellness Initiative" or "CPWI" means the DSHS substance
abuse prevention delivery system that focuses prevention services in high -need
communities in Washington State as selected by County and approved by DSHS.
j. "Contract Manager" means the DSHS contact identified on page one of this
Contract.
k. "County Community Services" means the state, SAPT and grant funding allocated
to the County by the state and is a term used in TARGET.
I. "County Coordinator' means the person designated by the legislative authority of a
County to carry out administrative and oversight responsibilities of the County
chemical dependency and prevention programs.
m. "Criminal Justice Treatment Account Funds" means a state revenue source
appropriated for drug and alcohol treatment and support services for offenders.
n. "Data" means information that is disclosed or exchanged as described by this
Contract.
o. "Date of first contact' means the date a person contacts an agency by any means
(walk -in, telephone call, referral through a physician, counselor or CDP, etc.) to
request a service when the date for the service is scheduled at the time of the
contact.
p. "DBHR" means the Division of Behavioral Health and Recovery or its successor.
q. "Dependent children" means children under age 18 living with the parent or through
age 20 if enrolled in school and financially supported by the parent.
r. "Drug Court Funds" means funds appropriated for drug and alcohol treatment and
support services for offenders within a Drug Court Program.
s. `DSHS Contact" means the DSHS Contact staff identified on page one of this
Contract.
t. "Ensure" as to this Agreement means to make sure that something will happen or
will be available within the resources identified in Exhibit B, A &R.
u. °FiscaVProgram Requirements" means the new title of the updated version of the
formerly titled BARS manual including the DSHS BHSIA/DIVISION OF
BEHAVIORAL HEALTH AND RECOVERY /CHEMICAL DEPENDENCY
Supplementary Instructions and Fiscal Policy Standards for Reimbursable Costs as
used by DBHR located at:
hftp://www.dshs.wa.gov/dbhr/daprovider.shtmI
v. "GAIN -SS" means the Global Assessment of Individual Needs — Short Screener tool
for conducting the integrated comprehensive screening for coordinating chemical
dependency and mental health issues. The GAIN -SS is completed by the patient
and interpreted by a CDP or CDP trainee under CDP supervision.
w. "Integrated Screen and Assessment" means a CDP or CDP trainee under CDP
supervision conducts a face- to-face meeting with the patient to determine the
patient's involvement with alcohol and /or other drugs and indications of a co-
occurring disorder.
x. "Indigent Patients' means those receiving a DSHS income assistance grant (e.g.,
TANF, SSI) or medical assistance program (Categorically Needy, Medically Needy,
Medical Care Services). They are usually identified by a medical coupon or
Medicaid identification card. Food stamp recipients are not considered indigent
patients unless they also receive one of the above grant or medical assistance
programs.
y. "Interim Services" means services offered to an eligible patient denied admission to
treatment due to a lack of capacity.
z. "Intravenous Drug User" (IVDU) means a person or patient who has used a needle
one or more times to illicitly inject drugs.
aa. "Low- Income Patient" means that individual whose gross household monthly
income does not exceed the monthly income determined by 220% of the Federal
Poverty Guidelines as eligible for low- income services. These individuals are
eligible to receive services partially supported by County Community Services.
bb. "Media materials and publications" means:
(1) News Release: A brief written announcement your agency provides to reporters
highlighting key events, research, results, new funding and programs, and other
news.
(2) Paid Media: Any advertising space/time that is purchased for
prevention /coalition messages (printed publications /newspapers, online,
outdoor, on- screen, TV and radio).
(3) Earned Media: Published news stories (print, broadcast or online) resulting from
the County's contacts with reporters.
(4) Donated Media: Also known as public service announcements. Any free
advertising space or time from broadcast, print, outdoor, online, and other
advertising vendors. Social Media: Also referred to as new media: messages
posted online on Facebook, Twitter, YouTube and similar sites.
cc. "Medicaid State Match" means those funds allocated and identified in the County's
Service Rates Plan, from the state Awards provided under this Contract to pay the
state's share of the costs of services provided to Medicaid - eligible clients.
dd. "Opiate Substitution Treatment Services" (OST) means provision of treatment
services and medication management (methadone, etc.) to individuals addicted to
opiates.
ee. "Patient" means individuals who are actively receiving assessment or treatment
services.
ff. "Performance -based Prevention System" or "PBPS" means the management
information system maintained by DSHS that collects planning, demographic, and
prevention service data.
gg. "P- 1 -T -A" means Prevention, Intervention, Treatment and Aftercare.
hh. "Pregnant and Post -partum Women and Parenting Persons' (PPW) means
(1) Women who are pregnant.
(2) Women who are postpartum during the first year after pregnancy completion
regardless of the outcome of the pregnancy or placement of children.
(3) Men or women who are parenting children under the age of six, including those
attempting to gain custody of children supervised by the Department of Social
and Health Services, Division of Children and Family Services (DCFS).
it. "Prevention Activity Data" means information input to PBPS to record all active
prevention services including outcome measures. This information will be used to
verify services identified in A -19 invoices prior to payment and must be entered into
PBPS by the close of business on the fifteenth (15th) of each month for prevention
activities provided during the previous month.
jj. "Prevention System Manager" (PSM) means the designee assigned by the DSHS
Contact to manage day to day responsibilities associated with this Contract.
kk. "Resource Development" means Expenditure types allowable through the
Substance Abuse Prevention and Treatment (SAPT) Block Grant that can be billed
with SAPT treatment under FISCAUPROGRAM REQUIREMENTS 99 beginning
January 1, 2014, these include:
(1) Planning, coordination, and needs assessment; including local personnel
salaries prorated for time spent in planning meetings, data collection (i.e.
TARGET), analysis, writing and travel. It also includes operating costs such as
printing, advertising, and conducting meetings. Any contracts with community -
based organizations or local government for planning and coordination fall into
this category, as do needs assessment projects to identify the scope and
magnitude of the problem, resources available, gaps in services, and strategies
to close those gaps.
(2) Quality assurance; this includes activities to assure conformity to acceptable
professional standards and to identify problems that need to be remedied.
(3) Program development; this includes consultation, technical assistance, and
materials to support subcontracted providers and planning groups.
11. "Revenues" or "County Participation Match" means the County's cost share of this
Contract, as identified in the Awards and Revenues Exhibit.
mm. "Service Rate Plan" (SRP) means the biennial plan that itemizes the services and
activities to be provided by the County and states the negotiated reimbursement
rate for the service and applies to treatment services only.
nn. "TARGET" means the Treatment and Assessment Report Generation Tool, the
management information system maintained by DSHS that retains demographic,
treatment, and ancillary service data on each individual receiving publicly- funded
outpatient and residential chemical dependency treatment services in Washington
State, as well as data on other general services provided.
oo. "Treatment Data" means information input to TARGET to record treatment services
provided to patients. This information will be used to verify services identified in A-
19 invoices prior to payment and work towards entering input data into TARGET by
the end of r calendar day after the date of service.
pp. "Treatment Provider Worksheet" or "TPW' means the listing of the DSHS- certified
agencies who are subcontractors of the County. The TPW identifies the type of
service provided by each subcontractor and indicates if the subcontractor may bill
Medicaid.
qq. "Waiting List' means a list of persons for whom a date for service has not been
scheduled due to a lack of capacity. A person will be selected from the list to fill an
opening based on the required order of precedence identified in the Contract.
rr. "Young adult' means a person or patient from age 18 through age 20.
ss. "Youth" means a person or patient from age 10 through age 17.
2. Applicable Law.
This Contract contains links to both DSHS and Federal websites to provide references,
information and forms for your use. Links may break or become inactive if a website is
reorganized; DSHS is not responsible for links that do not respond as expected.
These legal resources identified below are incorporated by reference and include but
are not limited to the following:
a. 21 CFR Food and Drugs
Chapter 1, Subchapter C, Drugs: General
hftp: / /ecfr. g i)oaccess. g ov /cg i /t/text/text-
idx? sid= e05a5d3b5c9521fa83bb6cf863ec842d &c= ecfr &tpl= /ecfrbrowsefTitle2l /21 cf
rv4 02.tpl
b. 42 CFR Subchapter A-- General Provisions
Part 2 Confidentiality of Alcohol and Drug Abuse Patient Records
http: / /ecfr. gDoaccess.g ov /cgi /t/text/text-
idx?c= ecfr &tpl= /ecfrbrowse/Title42 /42cfr2 main 02 tpl
Part 8 Certification of Opioid Treatment Programs
http: / /www.access.gpo.gov /nara /cfr /waisidx 08/42cfr8 08 html
c. 45 CFR Public Welfare, Part 96 Block Grants, Subpart L Substance Abuse
Prevention and Treatment Block Grant
5:1.0.1.1.54 & i d n o = 45#45:1.0.1.1.54.12
d. Office of Management and Budget (OMB) links regarding federally required audit
requirements A -87, A -122, A -133
http:// www .whitehouse.(iov /ombi'circulars default/ (scroll just over halfway down
the page)
e. Washington Administrative Code, Department of Social and Health Services
(WAC) Chemical Dependency assistance programs 388 -800, Certification
Requirements 3388 -877 & 388 -877B, WorkFirst 388 -310
htti)jfapps.ieg.wg.gov/wacidefault.ass)x?cite=388
Washington Administrative Code, Department of Early Learning 170.295, 170.296
http://apps.leg.wo.gov/wac/default.aspx?cite=170
f. Revised Code of Washington (RCW)
Counselors 18.19, CDP's 18.205, Regulation of Health Professions 18.130,
Abuse of Children 26.44, Public Officers and Agencies 42, State Government
(Executive) 43, Rules of the Road 46.61, Uniform Controlled Substances Act
69.50, Treatment for alcoholism, intoxication, and drug addiction 70.96A,
Involuntary Commitment 70.96A.140, Developmental Disabilities 71.A, Abuse of
Vulnerable Adults 74.34.
http://apps.leg.wa.gov/rcw/
g. Fiscal /Program Requirements (Formerly BARS)
"Fiscal /Program Requirements" means the new title of the updated version of the
formerly titled BARS manual including the DSHS BHSIA/DIVISION OF
BEHAVIORAL HEALTH AND RECOVERY /CHEMICAL DEPENDENCY
Supplementary Instructions and Fiscal Policy Standards for Reimbursable Costs as
used by DBHR located at:
http://www.dshs.wa.gov/dbhr/daprovider.shtmi
3. Purpose.
The purpose of this Amendment is for the County to provide chemical dependency
prevention, treatment and support services as specified on page 3, generally in an
outpatient setting, to eligible persons as part of the P -I -T -A continuum. These services
and activities are identified and defined in RCW 70.96A and WAC 388 -877 & 388 -8778.
4. Service Availability.
The County shall budget funds awarded under this Contract that are allocated for
prevention, assessment and treatment services in such a manner to ensure availability
of such services throughout the entire term of this Contract. If necessary, the County
shall limit access to services and make use of waiting lists for this purpose.
5. Requirements.
a. Background Checks (RCW 43.43, WAC 388 -877 & 388 -877B)
The County shall ensure a criminal background check is conducted for all staff
members; case managers, outreach staff members, etc.; or volunteers who have
unsupervised access to children, adolescents, vulnerable adults, and persons who
have developmental disabilities.
When providing services to youth, the County shall ensure that requirements of
WAC 388 -06 -0170 are met.
b. Services and Activities to Ethnic Minorities and Diverse Populations
The County shall:
(1) Ensure all services and activities provided by the County or subcontractor under
this Contract shall be designed and delivered in a manner sensitive to the needs
of all ethnic minorities.
(2) Initiate actions to ensure or improve access, retention, and cultural relevance of
treatment, prevention or other appropriate services, for ethnic minorities and
other diverse populations in need of treatment and prevention services as
identified in their needs assessment.
(3) Take the initiative to strengthen working relationships with other agencies
serving these populations. The County shall require its subcontractors to adhere
to these requirements.
c. Continuing Education
(1) Ensure that continuing education is provided for employees of any entity
providing treatment services or prevention activities. (42 USC 300x -28(b) and 45
CFR 96.132(b)).
(2) Continuing Education for Youth Counselors
When working with youth, the County shall require that Chemical Dependency
Professionals (CDPs) who are working with the youth outpatient treatment
population dedicate 10 of the 40 required Continuing Education credits for CDP
recertification to adolescent specific training or professional development
activities.
d. Single Source Funding
The County shall ensure:
(1) Subcontractors understand that Single Source funding means that a
subcontractor can use only one source of funds at any given time.
(2) All treatment services provided to an individual patient during any one period of
time must be funded from a sole source of funds under this Contract.
(3) The funding designated by the treatment subcontractor in TARGET defines the
single source of funds to be used to fund the treatment services provided to an
individual patient.
e. Audit Requirements.
(1) County A-133 Audit
10
(2) The County shall submit a copy of the A -133 audit performed by the State
Auditor to the DSHS Contact identified on page one of the Contract within 90
days of receipt by the County of the completed audit.
(3) Subcontractor Audit
(a) If a County subcontractor is subject to OMB Circular A -133, the County shall
require a copy of the completed Single Audit and ensure corrective action is
taken for any audit finding, per A -133 requirements.
(b) If a County subcontractor is not subject to OMB Circular A-1 33, the County
shall perform subrecepient monitoring in compliance with federal
requirements.
f. Federal Block Grant Funding Requirements.
The County shall comply with the following:
(1) Charitable Choice (42 USC 300x -65 and 42 CFR Section 54)
(a) The County shall ensure that Charitable Choice Requirements of 42 CFR
Part 54 are followed and that Faith -Based Organizations (FBO) are provided
opportunities to compete with traditional alcohol /drug abuse prevention and
treatment providers for funding.
(b) If the County subcontracts with FBOs, the County shall require the FBO to
meet the requirements of 42 CFR Part 54 as follows:
i. Applicants /recipients for /of services shall be provided with a choice of
prevention and treatment providers.
ii. The FBO shall facilitate a referral to an alternative provider within a
reasonable time frame when requested by the recipient of services.
iii. The FBO shall report to the County all referrals made to alternative
providers.
iv. The FBO shall provide recipients with a notice of their rights.
v. The FBO provides recipients with a summary of services that includes
any inherently religious activities.
vi. Funds received from the federal block grant must be segregated in a
manner consistent with Federal regulations.
vii. No funds may be expended for religious activities.
(2) Notice of Federal Block Grant Funding Requirement
11
The County shall:
(a) Notify subcontractors in writing of the federal funds, when federal block grant
funds are allocated by the County to subcontractors for the delivery of
services and activities under this Contract.
(b) Ensure all subcontractors comply with all conditions and requirements for
use of federal block grant funds within any subcontracts or other
agreements. (OMB A -133).
(3) Peer Review Required (42 USC 300x -53(a) and 45 CFR 96.136)
The SAPT Block Grant requires annual peer reviews by individuals with
expertise in the field of drug abuse treatment, of at least five percent of
treatment providers. The County and subcontractors shall participate in the
peer review process when requested by DSHS.
(4) Identical Treatment
All facilities receiving Federal Block Grant Funding are required to provide the
same services to all patients who are financially eligible to receive state or
federal assistance and are in need of services. No distinction shall be made
between state and federal funding when providing the following services
including, but not limited to:
(a) Women's services
(b) Intravenous drug user services
(c) Tuberculosis services
(d) Childcare services for parenting patients
(e) Interim services
g. Other Requirements.
(1) Collaboration with other Systems (42 USC 300x -28 (c) and 45 CFR 96.132 (c))
The County shall take the initiative to work with other systems to reduce
fragmentation or duplication and to strengthen working relationships by
addressing at least one substance abuse system issue or a collaborative effort
mutually identified by the County and a respective system regarding such as the
examples below:
(a) Treatment issues or efforts, examples of such systems are criminal justice,
corrections, juvenile rehabilitation, mental health, child protection and
welfare, adult protection and welfare, and primary health care plans
(b) Prevention issues or efforts, examples of such systems are education,
juvenile justice, and other publicly- funded entities promoting substance
abuse prevention
12
(2) Report Forms — Treatment Only
The County shall ensure use of the DBHR provided report forms which can be
found on the Provider page at:
http: /lwww.dshs.wa.gov/DBHR/dai)rovider.shtml#dbhr
6. Subcontracting.
a. Subcontract Language
(1) The County shall include in its boilerplate language all requirements and
conditions in this Contract that the County is required to meet when providing
services to patients, clients, or persons seeking assistance, which include but
are not limited to:
(a) Identification of funding sources (see Section 5. g. (2) Federal Block Grant
Funding Requirements above)
(b) How eligibility will be determined
(c) That subcontracts shall be fee - for - service, cost related, or price related as
defined in Fiscal /Program Requirements.
(d) That termination of a subcontract shall not be grounds for a fair hearing for
the service applicant or a grievance for the recipient if similar services are
immediately available in the County
(e) What actions the County will take in the event of a termination of a
subcontractor to ensure all treatment data on services provided have been
entered into TARGET; and all prevention data on activities be entered into
the PBPS.
(f) How service applicants and recipients will be informed of their right to a
grievance in the case of:
i. Denial or termination of service
ii. Failure to act upon a request for services with reasonable promptness
(g) Audit requirements - OMB Circular A -133 audit requirements if applicable to
the subcontractor
(h) Authorizing facility inspection
(i) Background Checks
Q) Conflict of interest
(k) Debarment and suspension certification
(1) Indemnification
13
(m) Nondiscrimination in employment
(n) Nondiscrimination in patient services
(o) Performance Based Contracts
(p) Providing data
(q) Records and reports
(r) Requirements outlined in the Data Sharing provision in the Contract
(s) Services provided in accordance with law and rule and regulation
(t) TARGET and PBPS data input and reconciliation
(u) Treatment of assets
(v) Unallowable use of federal funds
(2) DSHS reserves the right to inspect any subcontract document.
b. Subcontract approvals
The County shall obtain prior approval before entering into any subcontracting
arrangement. In addition, the County shall submit to the DSHS Program Manager
identified on Page 1 of the contract at least one of the following for review and
approval purposes:
(1) Copy of the proposed subcontract to ensure it meets all DSHS requirements; or
(2) Copy of the County's standard contract template to ensure it meets all
requirements and approve only subcontracts entered into using that template; or
(3) Certify in writing that the subcontractor meets all requirements under the
contract and that the subcontract contains all required language under the
contract, including any data security, confidentiality and /or Business Associate
language, as appropriate.
c. Subcontractor Termination Requirements
When terminating a subcontract, the County shall withhold the final payment of any
treatment sub - contract until the open (admitted for treatment services) cases in the
TARGET reporting system have been discharged from the system. This applies for
all subcontractor closures. For subcontract termination, only publicly funded cases
must be discharged.
d. Subcontractor Monitoring —Treatment Only.
(1) On -Site Monitoring
The County shall conduct a subcontractor review which shall include at least
14
one on -site visit during the biennium Contract period to each subcontractor site
providing treatment services during the period of performance of this Contract in
order to monitor compliance with subcontract performance criteria for the
purpose of documenting that the subcontractors are fulfilling the requirements of
the subcontract.
(2) TARGET Monitoring
The County shall ensure that subcontractors have:
(a) Entered services funded under this Contract in TARGET.
(b) Updated patient funding information as needed when the funding source
changes.
(3) Additional Monitoring Activities
The County shall maintain records of additional monitoring activities in the
County's subcontractor file and make them available to DSHS upon request
including any audit and any independent documentation.
e. Subcontractor Monitoring — Prevention Only
The County shall ensure:
(1) On -Site Monitoring
Subcontractor monitoring, using a DSHS approved subcontract monitoring
protocol, including annual on -site reviews of programs that directly serve
children and /or families during the period of performance of this Contract in
order to monitor compliance with subcontract performance criteria for the
purpose of documenting that the subcontractors are fulfilling the requirements of
the subcontract.
(2) PBPS Monitoring
The County shall ensure that subcontractors have entered all services and
participant information funded under this Contract in PBPS.
(3) Additional Monitoring Activities
The County shall maintain records of additional monitoring activities in the
County's subcontractor file and make them available to DSHS upon request
including any audit and any independent documentation.
Strategic Plan.
a. Guidelines for County Six Year Strategic Planning 2014 -2020
The County Strategic Planning Guidelines is a document created to assist with the
development of a six year plan that spans July 1, 2014 through June 30, 2020 and
addresses the Prevention - Intervention- Treatment- Aftercare (P- 1 -T -A) continuum of
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services.
(1) Plan is Due: July 1, 2014
(2) Guidelines on process:
(a) Networking and community assessment
(b) Mobilize and /or build capacity to address needs
(c) Develop comprehensive strategic plan
(d) Implementation
(e) Evaluation
(3) Authorities:
RCW 70.96A.320 (3) - the County legislative authority shall submit a plan that
meets the following conditions:
(a) Describes the services and activities to be provided;
(b) Anticipated expenditures and revenues;
(c) Plan must be prepared by the County CD board and adopted by the County
legislative authority;
(d) Reflect maximum effective use of existing services and programs, and;
(e) Meet other conditions as defined by DSHS.
b. Block Grant requirements
County shall provide responses to the following Block Grant requirements:
(1) Needs assessment (45 CFR 96.133, 45 CFR96.122, and 42 USC 300x.29).
(a) Include copies of any other demographic reports used for the responses.
(b) What change, if any, does the data indicate since the last reporting period?
(c) How have the needs of the populations identified or other demographic
report been met?
(d) What have been challenges and successes in meeting the needs?
(e) What strategies have been used to improve existing programs, create new
programs, or actions taken to remove barriers?
(2) Provide specialized services for pregnant women and women with dependent
children (42 USC 300x- 22(b)(1)(C) and 45 CFR 96.124(c)(e)).
16
(a) Describe treatment services within the count that are designed for pregnant
women and women with dependent children.
(b) Describe how the County ensures subcontractors make available prenatal
care and child care.
(3) Provide continuing education for treatment and prevention staff (42 USC 300x-
28(b) and 45 CFR 96.132(b)).
(a) Describe efforts made to ensure that training is made available to treatment
and prevention staff.
(b) Describe what the County has done to ensure that subcontractors provide
opportunities for staff to attend trainings.
(4) Coordinate prevention activities and treatment services with other appropriate
services. (42 USC 300x -29(c) and 45 CFR 96.132(c))
(a) Describe what activities or initiatives have been implemented to coordinate
services.
(b) Provide details on work groups, task forces, or councils that have been
developed to establish better coordination. What were the outcomes? What
challenges have there been?
(c) Have there been activities to raise public awareness in communities?
(5) Additional Requirements:
(a) Strategies for monitoring the increased capacity need for Medicaid services.
(b) Details on how counties will meet Medicaid expansion including how the
determination will be made to increase capacity and the subsequent
processes.
(c) Address how counties will incorporate Systems of Care principles
(d) What steps will counties take to help support EBP's within their community.
(e) Details on how counties will support care coordination and linkages to
primary health care.
(f) Identify Recovery Support Services and resources.
(6) CJTA:
(a) Requirements Specific to the Criminal Justice Section
A narrative describing how funds from the Criminal Justice Treatment
Account (CJTA) allocation will be expended, to include:
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i. Estimated number of offenders with an addiction problem against whom
charges are filed by a prosecuting attorney in Washington State
ii. Estimated numbers of persons with a substance abuse problem that, if
not treated would result in addiction, against whom charges are filed by a
prosecuting attorney in Washington State
iii. Estimated number of nonviolent offenders for a drug court program
iv. Role of the County's judicial system in delivery of PITA services
v. Residential service needs for offenders
(b) A narrative describing how funds from the Innovated Grant portion of the
CJTA allocation will be expended to include:
Selection of one or more of the following types of projects:
i. Innovation Project: An approach that contains either traditional /cultural
treatment methods, or elements of a Best Practice to treat an
underserved population(s) of offenders.
ii. Best Practice Project: A treatment strategy that has been documented as
a Best Practice in published research. See the following website to assist
in identifying Best Practices: Evidence Based Practices for Treating
Substance Use Disorders - Home page.
iii. Regional Project: A project in which a minimum of two (2) counties
combine funding to provide treatment services to offenders.
(c) A narrative of the type of project(s) chosen (see above) that includes:
i. A description of the project and how it will enhance treatment services
ii. Reason for choosing either a drug court or non -drug court project
iii. Number of persons that will receive services
iv. Measurable goals and objectives
(7) Prevention:
The Counties must follow the strategic plan guidelines as set forth in the DBHR
Community Coalition Guide for each Community Prevention and Wellness
Initiative (CPWI) community. If funding permits County to provide community
based coordination (CBC) services in addition to meeting CPWI requirements,
(Le. contractors with CPWI communities that each have at least $110,000 per
community of DBHR funding budgeted for CPWI implementation annually) and
services will be provided at the County level the County must include plans for
CBC prevention services in their County strategic plan. Narrative should include:
is
(a) Goals, objectives, and strategies/activities for CBC
(b) Explanation for how CBC strategies and activities connects to overall County
strategic plan including the assessment
(c) Explanation of how it supports furthering work of CPWI
(d) The CBC goals and objectives must be entered into PBPS and approved
prior to implementation
8. Prevention Statement of Work.
The County shall provide the services and staff, and otherwise do all things necessary
for or incidental to the performance of work, as set forth below.
a. The County shall use prevention funds to coordinate and implement prevention
programs designed to prevent or delay the misuse and abuse of alcohol, tobacco,
marijuana, and other drugs. Prevention programs and services include, but are not
limited to:
(1) Community Prevention and Wellness Initiative. http: /hvww.theathenaforum.org
The County shall:
(a) Provide CPWI services in accordance with the Key Objectives and
Community Coalition Guide found on the Athena Forum website which
outlines the minimal standards to participate in the CPWI.
(b) Submit an annual budget with projected expenditures, including salary and
benefits for DSHS funded prevention staff, program costs, training and travel
to the Prevention System Manager within 30 days upon request. A template
will be provided.
(c) Ensure all programs are submitted and approved in PBPS prior to
implementation.
Enter approved programs into the PBPS by July 31, 2013 based on the
priorities, goals and objectives described in the approved Strategic Plan.
Cohort 3 approved programs include the CPWI Coalition and may include
other programs as negotiated with BHA or designee.
(d) Ensure sixty percent (unless negotiated with BHA or designee) of programs
supported by DSHS funds will be replications or adaptations of "Evidence -
based Practice" substance abuse prevention programs as identified in the
PBPS.
(e) Ensure all of the programs supported by DSHS will meet the Center for
Substance Abuse Prevention's (CSAP) Principles of Effective Substance
Abuse Prevention, found on the Athena Forum Website.
(2) Coordination of Prevention Services
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If funding permits the County to provide Community Based Coordination
services in addition to meeting CPWI requirements, (i.e., Counties with
communities that each have at least $110,000 per community of DSHS funding
budgeted for CPWI implementation, annually) services may be provided at the
County level. Services shall reflect work of the County staff coordinating,
organizing, building capacity, providing education and information related to
prevention initiatives at the County level.
(3) Prevention Training
(a) The County shall participate in all required training events identified by
DSHS and listed in the DBHR Community Coalition Guide.
(b) Non - Required Training in CPWI
i. In the absence of a strategic plan and for trainings not identified in the
approved strategic plan, all additional (non- required) training paid for by
DSHS shall be approved by BHA or designee prior to training and meet
the approved goals and objectives in PBPS.
ii. The County shall ensure any requests for training are requested in
writing and sent directly to the PSM, a minimum of ten working days
before the date of the proposed training. Trainings shall relate to one of
the following four categories:
(A) Coalition building and community organization.
(B) Capacity building regarding prevention theory and practice.
(C) Capacity building for evidence based practice and environmental
strategy implementation, related to the goals and objectives of the
coalition's approved strategic plan.
(D) Capacity building in high need communities that meets overall goals
and objectives of CPWI in order to expand CPWI efforts may be
approved by BHA or designee upon request.
iii. The County shall ensure training paid for by DSHS that requires travel
follows state travel reimbursement guidelines accessible at
http: / /www.ofm.wa.gov /policy /10.90 htm.
iv. The County shall bill for training events on an A -19 per Fiscal /Program
Requirements code 22.7 and record training events in the DSHS
Performance Based Prevention System (PBPS) in accordance with the
monthly reporting requirements described in Section 8. c. (1) (d)
Prevention only / Due Dates.
b. Media Materials and Publications
(1) Media Materials and Publications developed with DSHS funds shall be
submitted to the PSM for approval prior to publication (DSHS will respond within
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5 working days). DSHS must be cited as the funding source in news releases,
publications, and advertising messages created with or about DSHS funding.
The funding source shall be cited as: Washington State Department of Social
and Health Services. The DSHS /BHSIA logo may also be used in place of the
above citation.
Exceptions: The County does not need to submit the following items to PSM:
(a) Newsletters and fact sheets
(b) News coverage resulting from interviews with reporters including online
news coverage
(c) Newspaper editorials or letters to the editor
(d) Posts on Facebook, YouTube, Tumblr, Twitter and other social media sites
(e) When a statewide media message developed by DBHR is localized
(f) When the current SAMHSA- sponsored media campaign is localized (As of
August 2013, this is the "Talk They Hear You" campaign)
htta:// www.samhsa.gov /underagedrinking .
(g) The County is still encouraged to submit copies of these items to PSM.
c. Prevention Reporting Requirements
(1) Prevention Activity Data Reports
The County shall:
(a) Ensure that monthly prevention activities are reported in the DSHS PBPS in
accordance with the requirements and timelines set forth below.
(b) Ensure demographic information is provided for each participant in single
events, mentoring, environmental and recurring programs.
(c) Provide Community Coalition Coordination Reports on its efforts in the
PBPS for each month of the calendar year.
(d) Complete Prevention Reports according to the Schedule / Due Dates,
below:
Reporting
Report(s)
Report Due Dates
Reporting
Period
System
Programs approved by
Prior to
One —time
DBHR for Biennium ending
implementation of
PEPS
Reports
June 30, 2015
program.
GPRA measures
As re uested
revention activity data
15 of each
Monthly
y
input for all active
I month for
PBPS
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d. Outcome Measures
(1) The County shall report on all required pre /post -tests in PBPS Program
Selection Instruments identified in the PBPS.
(2) Special situations and exceptions regarding pre /post tests and Program
Selection Instruments identified in the PBPS include, but are not limited to, the
following:
(a) The County may negotiate with the Prevention System Manager to reduce
multiple administrations of surveys to individual participants.
(b) Participants in recurring program groups in which the majority of participants
are younger than 10 years old on the date of that group's first service.
(c) Recurring programs that spend less than $1,000 of DSHS prevention funds
each biennium.
(d) Programs that only provide single service events.
(e) Environmental /Media services.
e. Performance Work Statement/ Evaluation
(1) The County shall ensure program results show positive outcomes for at least
half of the participants in each program group.
(a) Positive outcomes means that at least half of the participants in a group
report change between pre and post -tests consistent with the positive
outcome goal.
(b) Positive outcomes will be determined using the pre -test and post -test data
reported in the Performance Based Prevention System (PBPS).
(c) Survey results will be compared against the stated outcome for the program.
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services including
activities from the
coalition efforts, services,
previous month
participant information,
pre- tests, post- tests, and
assessments.
• Training Report
• Community -Based
Coordination (if
applicable)
d. Outcome Measures
(1) The County shall report on all required pre /post -tests in PBPS Program
Selection Instruments identified in the PBPS.
(2) Special situations and exceptions regarding pre /post tests and Program
Selection Instruments identified in the PBPS include, but are not limited to, the
following:
(a) The County may negotiate with the Prevention System Manager to reduce
multiple administrations of surveys to individual participants.
(b) Participants in recurring program groups in which the majority of participants
are younger than 10 years old on the date of that group's first service.
(c) Recurring programs that spend less than $1,000 of DSHS prevention funds
each biennium.
(d) Programs that only provide single service events.
(e) Environmental /Media services.
e. Performance Work Statement/ Evaluation
(1) The County shall ensure program results show positive outcomes for at least
half of the participants in each program group.
(a) Positive outcomes means that at least half of the participants in a group
report change between pre and post -tests consistent with the positive
outcome goal.
(b) Positive outcomes will be determined using the pre -test and post -test data
reported in the Performance Based Prevention System (PBPS).
(c) Survey results will be compared against the stated outcome for the program.
22
(d) Evaluation of PBPS data will occur on the 15th of the month following the
final date of service for each group.
(2) DSHS shall use the following protocol for evaluation:
(a) Matched pre -test and post -test pairs will be used in the analysis.
(b) To allow for normal attendance drop -off, a 20% leeway will be given for
missing post- tests.
(c) If there are missing post -tests for entered pre -tests in excess of 20% of pre-
tests, missing post -test will be counted as a negative outcome.
Example: there are 10 pre -tests and 7 post- tests. The denominator would be
8 and the maximum numerator would be 7.
(3) Different groups receiving the same program will be clustered by school district.
(a) In cases where multiple providers are serving the same school district,
groups will be clustered by school district and provider.
(b) The results of one provider in a given school district will not impact another
provider in the same district.
(4) In cases where the survey instrument selected for a given program includes
more than one scale, the scale that is most closely aligned with the outcome
linked to the program in PBPS will be used.
(5) Results for groups with services that span two contracting periods will be
analyzed in the contracting period that the post -test was administered.
If fewer than half of the participants in a group, within a given school district,
report positive change in the intended outcome:
(a) The County shall submit a Performance Improvement Plan (PIP) for the non-
compliant program to the DSHS Contact or designee within 45 days of
notice by DSHS.
(b) Reimbursement for the CSAP Category row on the A -19 for that program will
be held until the PI P is approved by the DSHS Contact or their designee.
(c) If a second group within that same school district has fewer than half of the
participants report positive change in the intended outcome, then the
following steps will be taken:
i. In cases where there is no active non - compliant program, the Contractor
shall discontinue implementation of that program within the specified
geography.
ii. In cases where the same programs as the non - compliant program are
active and continuing in the same school district, those groups will be
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allowed to complete the expected number of sessions. No new groups
will be started.
iii. Following the conclusion of all groups completing the program, results
will be reviewed for those groups.
iv. If the results do not show positive change for each group, the County
shall take the following action:
(A) In cases where the program is being delivered by a single provider in
the specified geography, the County shall discontinue
implementation of that program in the specified geography.
(B) In cases where the program is being delivered by multiple providers
in the specified geography, the County shall discontinue
implementation of that program by the underperforming provider in
the specified geography.
(6) A non - compliant program that resulted in the need for a Performance
Improvement Plan during July 1, 2013 to December 31, 2013 will carry that
record forward into the January 2014 to June 30, 2015 contract period.
(7) Monitoring
The County shall:
(a) Implement and monitor prevention programs and reporting to assure
compliance with these guidelines.
(b) Develop and submit a protocol for monitoring subcontractors.
(c) Conduct an on -site visit of prevention subcontractors.
f. Consideration:
Maximum consideration payable to County for satisfactory performance of the work
under the Prevention Statement of Work is identified on the Awards and Revenue
document attached as Exhibit B, including any and all expenses, and shall be based
on the following:
(1) The source of funds is the federal Substance Abuse Prevention and Treatment
(SAPT) Block Grant. The Catalog of Federal Domestic Assistance number is
93.959.
(2) Reimbursable Costs
The County shall ensure all expenditures for services and activities under this
Contract are submitted on the A -19 invoice appropriate for PBPS entry.
(3) Funding Allocation
24
The County shall manage the contract to ensure that services are provided in a
manner that allocates the available resources over the period of the Contract
which DSHS provides funding.
(4) Administrative Cost Limitations
Contract funds shall not be used for administrative costs.
(5) Period of Performance Service Costs
The County shall ensure that service costs incurred are within the period of
performance of this Contract.
(6) Fiscal Year Allocation and Exceptions
With the exception of funding provided for prevention services by SAPT block
grant, the use of funds is limited to the fiscal year for which it is allocated. SAPT
block grant prevention allocation is a biennial allocation.
(7) Prevention State Grant -in -Aid Match
To utilize State Grant -In -Aid funds for Prevention Services administration the
County must:
(a) Pass a local sales tax in accordance with Senate Bill 5763, or secure local
funds through other private or public entities.
(b) Provide a hard dollar match, used for prevention services, equal to or
exceeding the amount billed to "State Grant -In -Aid" funds for prevention
administration.
(c) Submit a letter of request to the DSHS contact identifying the
i. Amount of prevention administration funding requested, up to 10% of the
total prevention allocation.
ii. Date the local sales tax was adopted, if applicable.
iii. Amount and source of hard dollar match funds.
iv. Description of prevention services to be implemented with match funds.
v. Proposed start date of the prevention administration (30 days advance
notice required).
vi. Enter all services purchased through match funds into the DBHR
Performance -Based Prevention System (PBPS) upon approval of the
prevention administration request.
(d) The DSHS Contact will reply, in writing, to the prevention administration
request within 30 days of receipt of the request.
pw
(8) Award Adjustment Request
With regard to all services:
(a) DSHS reserves the right to reduce the Prevention funds awarded in this
Contract if the County fails to provide the Prevention services /activities as
stated in the Performance Based Prevention System (PBPS).
(b) If DSHS decides to exercise the right to reduce treatment or prevention
funds, DSHS will provide written notification 30 days prior to the reduction.
The notice will specify the reason for the reduction, the amount to be
reduced, and the effective date of the reduction.
g. Billing and Payment for the Prevention Statement of Work.
(1) Invoice System
The County shall submit invoices using State Form A -19 Invoice Voucher, or
such other form as designated by DSHS. Consideration for services rendered
shall be payable upon receipt of properly completed invoices which shall be
submitted to the DSHS Contact stated on page one (1) of this contract, by the
Contractor, not more often than monthly. The invoices shall describe and
document to DSHS' satisfaction a description of the work performed, activities
accomplished, the progress of the project, and fees. The rates shall be in
accordance with those set forth in Section 8. f. Consideration above, of this
Contract.
(2) Billing for CSAP
The County shall ensure expenditures for each of the CSAP strategies are
reported monthly as part of the A -19 invoice. Training shall be reported in
"Other" category.
(3) DSHS Obligation for Payment
DSHS shall not be obligated to reimburse the County for any services or
activities, performed prior to having a fully executed copy of this Contract.
(4) Claims for Payment
The County shall:
(a) Submit invoices for costs due and payable under this agreement that were
incurred prior to the expiration date within 90 days of the date services were
provided.
(b) The County shall submit final billing for services provided during each fiscal
year within 90 days after the end of that fiscal year.
h. Timely Payment by DSHS
:FM
Payment shall be considered timely if made by DSHS within thirty (30) days after
receipt and acceptance by the DSHS Contact Person of the properly completed
invoices. Payment shall be sent to the address designated by the County on page
one (1) of this Contract. DSHS may, at its sole discretion, withhold payment
claimed by the County for services rendered if County fails to satisfactorily comply
with any term or condition of this Contract.
i. Fiscal Year -end Billing
The County shall ensure that final billing for services provided under this Contract
shall occur no more than 90 days after the end of each fiscal year of this Contract.
j. Non - Compliance
(1) Failure to Maintain Reporting Requirements:
In the event the County or a subcontractor fails to maintain its reporting
obligations under this Contract, DSHS reserves the right to withhold
reimbursements to the County until the obligations are met.
(2) Recovery of Costs Claimed in Error:
If the County claims and DSHS reimburses for expenditures under this Contract
which DSHS later finds were (1) claimed in error or (2) not allowable costs under
the terms of the Contract, DSHS shall recover those costs and the County shall
fully cooperate with the recovery.
k. Advance Payment and Billing Limitations.
(1) Advance Payment
DSHS shall not make any payments in advance or in anticipation of the delivery
of services to be provided pursuant to this Contract.
(2) Authorized Services
DSHS shall pay the County only for authorized services provided in accordance
with this Contract. If this Contract is terminated for any reason, DSHS shall pay
only for services authorized and provided through the date of termination.
(a) Timely Billing
DSHS shall not pay any claims for payment for services submitted more
than ninety (90) days after the calendar month in which the services were
performed, unless otherwise specified in this Contract.
(b) Exception to 90 -day billing limitation
The County may submit a bill for services beyond the 90 -day limitation when
additional funds are added to or funds are decreased from the Contract by
written amendment, those services previously provided shall be entered in
PBPS.
27
(c) Multiple Payments for the Same Claim /Duplication
i. The County assures that work performed and invoiced does not
duplicate work to be charged to the State of Washington under any other
contract or agreement with the Contractor.
ii. The County shall not bill DSHS for services performed under this
Contract, and DSHS shall not pay the County, if the County has charged
or will charge the State of Washington or any other party under any other
contract or agreement for the same services.
(d) Awards
The County shall acknowledge and ensure the following limitations on
Awards and Revenue:
i. Funds designated solely for a specific state fiscal year in this Contract
may be obligated only for work performed in the designated fiscal year.
ii. The Substance Abuse Prevention and Treatment (SAPT) Block Grant
CFDA number is 93.959.
9. Treatment Statement of Work.
a. Outpatient Treatment (WAC 388 -877 & 388 -877B)
The County shall ensure outpatient chemical dependency services are provided to
eligible patients according to the requirements identified in WAC.
b. OTHER treatment
(1) Access to Services
The County shall ensure that treatment services to eligible persons are not
denied to any person regardless of:
(a) The person's drug(s) of choice.
(b) The fact that a patient is taking medically - prescribed medications.
(c) The fact that that a person is using over the counter nicotine cessation
medications or actively participating in a Nicotine Replacement Therapy
regimen.
(d) Washington State resident's County of residence. The County shall, subject
to available funds and service availability, serve all eligible Washington State
residents who may be transient and require services.
c. Interim Services (42 USC 300x -23 and 45 CFR 96.126)
The County shall, as required by the SAPT Block Grant:
28
(1) Ensure interim services are provided by the agency, or referred outside the
agency for services the agency is not qualified to provide, for pregnant and
parenting women and intravenous drug users.
(a) Interim services shall be made available within 48 hours of seeking
treatment for pregnant and parenting women and intravenous drug users.
(b) Admission to treatment services for the intravenous drug user shall be
provided within 14 days after the patient makes the request, regardless of
funding source.
(c) If there is no treatment capacity within 14 days of the initial patient request,
the County shall have up to 120 days, after the date of such request, to
admit the patient into treatment, while offering or referring to interim services
within 48 hours of the initial request for treatment services. Interim services
must be documented in TARGET and include, at a minimum:
i. Counseling on the effects of alcohol and drug use on the fetus for the
pregnant patient.
ii. Prenatal care for the pregnant patient.
iii. Human immunodeficiency virus (HIV) and tuberculosis (TB) education.
iv. HIV or TB treatment services if necessary for an intravenous drug user.
The interim service documentation requirement is specifically for the admission
of priority populations with any funding source; and any patient being served
with SAPT Block Grant funds.
(2) A pregnant woman who is unable to access residential treatment due to lack of
capacity and is in need of detoxification, can be referred to a Chemical Using
Pregnant (CUP) program for admission, typically within 24 hours. The directory
for these hospital -based detoxification programs for pregnant women is located
in Appendix F in the DBHR Directory of Certified Chemical Dependency
Programs in Washington State. Appendix F is located at
hftp: / /www.dshs.wa.ciov /d bhr /dadirecto ry.shtmVgov /dbh r /dadi rectory /AP PN DXF.
d. Waiting Lists Requirements
All publicly funded agencies shall:
(1) Collect patient information as required on the DBHR TARGET Data Elements
Waiting List -First Contact form, DSHS Form #04 -444.
(2) Enter the "Date of First Contact' into TARGET, at least every seven (7) days, by
collecting data at the time the patient first contacts the agency to request
services and is given a specific date for when services will begin.
29
e. Tuberculosis Screening, Testing, and Referral 42 USC 300x -24 (a) and 45 CFR
96.127
(1) The County shall either directly, or through arrangements through other entities,
make tuberculosis services available to each individual receiving chemical
dependency treatment funded through the federal SAPT Block Grant. Services
must include tuberculosis counseling, testing, and treatment.
(a) Follow the Centers for Disease Control TB Guidelines located at:
http: / /www.dshs.wa. qov / pdf /dbhr /certforms/TB- TAGuidelines pdf
(b) Follow the Tuberculosis Infection Control Program Model Policies for
Chemical Dependency Treatment Agencies in Washington State, located at:
http: / /wv4w.dshs.wa .qov /pdf /dbhr /certforms/TBPolicv pdf
(2) WAC 246 - 101 -101 requires all health care providers to report every case of
tuberculosis to the local health department immediately at the time of diagnosis
or suspected diagnosis.
f. Determine Patient Financial Eligibility: Low - income Services
(1) The County shall ensure that all persons applying for services supported by
County Community Services are screened for financial eligibility and shall:
(a) Conduct an inquiry regarding each patient's continued financial eligibility no
less than once each month.
(b) Document the evidence of each financial screening in individual patient
records.
(c) Refer client to Health Plan Finder Website for eligibility determination.
(2) Low - income
The County and its subcontractors are authorized to and shall determine
financial eligibility for patients.
Charging Fee Requirements — Low - income Patients
(a) If any service defined in this Contract is available free of charge from the
County to persons who have the ability to pay, the County shall ensure
DSHS is not charged for Fee Requirements for low- income patients.
(b) The County shall use 220% of the Federal Poverty Guidelines to determine
low- income service eligibility and shall provide this information to its
subcontractors. The Federal Poverty Guidelines can be found by accessing
the Provider page of the DSHS website at http: / /www.dshs.wa.gov /DBHR/
(c) For patients who are already receiving services who did not qualify for low -
income services under the former eligibility requirement, but do qualify under
El
the new eligibility requirement, the County shall convert those patients to
low- income treatment services.
(d) The County shall ensure sliding fee schedules are used in determining the
fees for low- income eligible services.
(e) The County shall ensure that persons who have a gross monthly income
(adjusted for family size) that does not exceed the 220% of the Federal
Poverty Guidelines are eligible to receive services partially supported by
funds included in this Contract.
(f) The County shall charge fees in accordance with the Low - income Service
Eligibility Table to all patients receiving assessment and treatment services
that are determined through a financial screening, to meet the requirements
of the Low - income Service Eligibility Table.
(g) If a County's subcontractor determines that the imposition of a fee on an
individual will preclude the low- income eligible patient from continuing
treatment, the fee requirement may be waived by the subcontractor.
(h) The minimum fee per counseling visit is $2.00. The maximum fee per
service is the reimbursement cost of the service provided as identified on the
SRP.
i. Indigent patients are exempt from this fee requirement.
ii. Interim Services are exempted from this fee requirement.
g. Screening and Assessment
RCW 70.96C.010 Integrated, comprehensive screening and assessment process
for chemical dependency and mental disorders.
The County shall ensure:
(1) The GAIN -SS screening tool is used for conducting the integrated
comprehensive screen on all new patients and ensure the GAIN -SS scores are
documented in TARGET. Additional information can be found by accessing the
Contractor and Provider page of the DSHS website at
hftp7//www.dshs.wa.gov/DBHR/daprovider.shtml#dbhr.
(2) If the results of the GAIN -SS are indicative of the presence of a co- occurring
disorder, this information shall be considered in the development of the
treatment plan including appropriate referrals.
(3) Documentation of the quadrant placement during the assessment process and
again on discharge are input to TARGET.
(4) Subcontractors receive training on the GAIN -SS process.
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(5) The maximum number of DBHR- funded assessments provided to each client,
within a one (1) year period, is two (2).
h. Detoxification Services
(1) The County may provide detoxification services to those patients qualifying for
those services.
(2) The County shall ensure that detoxification facilities have a protocol established
on how they will serve methadone patients who need detoxification from other
substances.
i. Youth Outpatient Services (WAC 388 -877 & 388 -877B)
(1) Service Eligibility
The County shall ensure:
(a) Services are provided to youth ages 10 through 17.
(b) The age at which a youth may self -refer for treatment without parental
consent (age of consent) is 13 years of age.
(c) Patients under age 10 may be served with the approval of DSHS.
(d) Young adult patients, age 18 through 20 who, based on developmental
needs, may be more appropriately served in a youth outpatient treatment
setting. The case file shall contain documentation supporting the clinical
decision.
(e) Youth patients who, based on developmental needs, may be more
appropriately served in an adult outpatient treatment setting. The case files
shall contain documentation supporting the clinical decision.
(2) Youth Family Support Services
(a) The County shall ensure that young adults who have been approved for
youth treatment shall be billed as youth patients.
(b) Youth funds may be used for family support services using Fiscal /Program
Requirements codes including:
i. 566.57 Youth Group Therapy (youth and young adults ages 10 through
20).
Services to family members of persons admitted to treatment and costs
incurred to provide supervised recreational activities in conjunction with a
chemical dependency outpatient program. Family Services shall be
coded as family support services and Supervised Therapeutic
Recreation shall be coded as group therapy.
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ii. 566.58. Youth Individual Therapy (youth and young adults ages 10
through 20).
This also includes services to family and significant others of persons in
treatment. These expenses should be coded as defined in the TARGET
Data dictionary.
(c) The County shall ensure Fiscal /Program Requirements coding instructions
are followed for billing purposes.
(3) Title -XIX funding for youth in treatment
The County shall ensure:
(a) Treatment services provided to youth are billed under Title -XIX unless the
youth is determined to be ineligible for this funding.
(b) Documentation identifying a youth as ineligible for Title -XIX is documented
within the patient case file.
(4) Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Services
The County shall encourage subcontractors to refer Title -XIX eligible youth that
have not previously received an EPSDT health screen to an EPSDT primary
health care provider for an EPSDT health screen.
(5) Assessment Services
The County shall ensure that each youth receives a multi - dimensional
assessment per Chapter 388 -877 & 388 -8776 WAC: Requirements for
chemical dependency assessments.
(6) Treatment Services
For youth that meet the financial and eligibility standards for publicly - funded
chemical dependency treatment services the County shall ensure:
(a) Youth outpatient services include treatment appropriate for substance abuse
disorder in addition to treatment for substance dependency.
(b) Youth outpatient services address the needs of youth waiting for placement
in youth residential treatment, and youth requiring aftercare following youth
residential treatment.
(c) Outpatient subcontractors are involved in the continuum of services and the
treatment planning for youth they have referred to residential treatment
programs.
(7) Youth Outpatient Services, described in the Statement of Work above, will be
delivered in accordance with the DSHS Guiding Principles listed below:
Guiding Principles for Youth Services
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(a) Family and Youth Voice and Choice: Family and youth voice, choice and
preferences are intentionally elicited and prioritized during all phases of the
process, including planning, delivery, transition, and evaluation of services.
(b) Family- focused and Youth - centered: Services and interventions are family -
focused and child- centered from the first contact with or about the family or
child.
(c) Team - based: Services and supports are planned and delivered through a
multi- agency, collaborative teaming approach. Team members are chosen
by the family and connected to them through natural, community, and formal
support and service relationships. The team works together to develop and
implement a plan to address unmet needs and work toward the family's
vision.
(d) Natural Supports: The team actively seeks out and encourages the full
participation of team members drawn from family members' networks of
interpersonal and community relationships (e.g. friends, neighbors,
community and faith -based organizations). The recovery plan reflects
activities and interventions that draw on sources of natural support to
promote recovery and resiliency.
(e) Collaboration: The system responds effectively to the behavioral health
needs of multi- system involved youth and their caregivers, including children
in the child welfare, juvenile justice, developmental disabilities, substance
abuse, primary care, and education systems.
(f) Culturally Relevant: Services are culturally relevant and provided with
respect for the values, preferences, beliefs, culture, and identity of the youth
and family and their community.
(g) Individualized: Services, strategies, and supports are individualized and
tailored to the unique strengths and needs of each youth and family. They
are altered when necessary to meet changing needs and goals or in
response to poor outcomes.
(h) Outcome - based: Based on the family's needs and vision, the team develops
goals and strategies, ties them to observable indicators of success, monitors
progress in terms of these indicators, and revises the plan accordingly.
Services and supports are persistent and flexible so as to overcome
setbacks and achieve their intended goals and outcomes.
j. Intravenous Drug Users Outpatient Services (42 USC 300x -23 and 45 CFR
96.126)
The County shall ensure:
(1) Outreach is provided to IVDUs.
(a) Outreach activities shall be specifically designed to reduce transmission of
HIV and encourage (VDUs to undergo treatment.
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(b) Outreach models shall be used, or if no models are available which apply in
the local situation, an approach is used which reasonably can be expected
to be an effective outreach method.
(c) Outreach activities may include:
i. Street outreach activities
ii. Formal education
iii. Risk - reduction counseling at the treatment site
(d) The County may provide outreach by:
Utilizing one subcontractor who works in close collaboration with all of
the County's subcontractors providing treatment to IVDUs.
ii. Requiring each IVDU treatment subcontractor to provide outreach
services.
(2) Assessment and treatment services are provided to IVDU patients (42 USC
300x -22 and 45 CFR 96.128)
(a) Comprehensive chemical dependency assessment and treatment services
shall be provided to male and non - pregnant women no later than 14 days
after the service has been requested by the individual.
(b) Interim Services are provided to male and non - pregnant women if the
patient cannot be placed in treatment within 14 days and comprehensive
services are not immediately available.
(c) The DSHS provided IVDU Report shall be completed and provided as part
of the State annual reporting process.
k. Pregnant, Post -partum and Parenting Persons Outpatient Services
The County shall ensure:
(1) Parenting Persons
(a) Persons Identified as Parents or Parenting Persons include:
i. Persons currently under DSHS supervision who are attempting to regain
custody of their children.
ii. Postpartum women for up to one -year post delivery.
(b) Low - income eligibility applies to women who are pregnant or post -partum up
to one year post delivery.
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(c) Subcontractors who are receiving SAPT grant funding give admission
preference to pregnant and parenting persons who have been referred to
treatment.
(d) Upon request for services, pregnant, post -partum and parenting persons
shall be offered Interim Services when comprehensive services are not
immediately available.
(e) Subcontractors whenever possible, assign gender specific counselors as
primary counselors for pregnant, postpartum, and parenting patients.
(f) Subcontractors make information /education available to treatment staff for
addressing the specific issues related to pregnant, postpartum, and
parenting patients.
(2) Chemical Dependency Assessment Services Specific to Pregnant Women
The County shall ensure assessment requirements in addition to standard
assessment services:
(a) Are provided within 48 hours of referral or request for services.
(b) Include a review of the gestational age of fetus, mother's age, living
arrangements and family support data.
(c) Pregnant women identified through assessment to be eligible and
appropriate for outpatient care shall be:
i. Admitted to outpatient treatment services no later than seven (7) days
after the assessment has been completed.
ii. Provided a referral for prenatal care.
iii. Assessed as priority for placement in an inpatient treatment program or a
Chemical Using Pregnant (CUP) detoxification facility if identified as
actively using substantial amounts of alcohol or other substances in any
stage of pregnancy.
(3) Services Specific to Pregnant Women and Women with Children (CFR Title 45,
Part 96.124)
The County shall ensure:
(a) Pregnant women and women with children receiving treatment are treated
as a family unit.
(b) The following services are provided directly or arrangements are made for
provision of the following services:
i. Primary medical care for women, including referral for prenatal care and,
while the women are receiving such services, child care.
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ii. Primary pediatric care including immunization for their children.
iii. Gender specific substance abuse treatment and other therapeutic
interventions for women which may address issues of relationships,
sexual and physical abuse and parenting are provided and child care
while the women are receiving these services.
iv. Therapeutic interventions for children in custody of women in treatment
which may, among other things, address their developmental needs,
their issues of sexual, physical abuse and neglect.
v. Sufficient case management and transportation to ensure women and
their children have access to services provided by sections i, through iv.
(4) Services Specific to Post -partum Women
The County shall ensure:
(a) Assessment and treatment services are provided within 90 days after the
service has been requested.
(b) Interim services shall include counseling on the effects of alcohol and drug
use on the fetus.
(c) Services may continue to be provided for up to one year postpartum.
(5) Services Specific to Parenting Persons
The County shall ensure:
(a) Assessment and treatment services are delivered no later than 90 days after
the service has been requested.
(b) Notification of the availability of childcare.
Opiate Substitution Treatment Services (OST)
(1) A County funding OST services shall ensure they are provided through a service
provider that maintains accreditation from the Center for Substance Abuse
Treatment (CSAT) and complies with the following rules:
(a) WAC 388 -877 & 388 -877B
(b) 42 CFR, Part 8
(c) Washington State Board of Pharmacy WAC 246 -887; as such regulations
now exist or are hereafter amended.
(2) The County shall ensure that OST patients utilizing the Medicaid transportation
broker services will receive priority for filling a vacant slot at another publicly -
funded OST facility if the transfer would result in a savings in transportation
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costs. The patient will not be required to transfer to a closer agency if there are
clinical reasons to support not transferring the patient
m. Performance -based Goals
The County shall make progress toward, meet or exceed the statewide average 90
day retention rate as determined by DSHS. The 90 -day retention performance
measure will be determined by using a rolling 6 -month average and be monitored
on a monthly basis through SCOPE or a report generated by DSHS. Baseline
outcomes for completion will be set according to past County performance.
For purposes of this contract the word "progress" means achieving a minimum
improvement increase of 1.5% in a fiscal quarter.
(1) Youth
(a) Effective July 1, 2013, if the County's baseline is in good standing at or
above the statewide average of 65% for 90 -day retention, the County shall
maintain good standing.
If, during any monitored calendar quarter, the County falls below the
statewide average, the County shall follow the process for correction in
Section "n." below.
(b) Effective July 1, 2013, if the County's baseline for 90 -day retention
performance is lower than the statewide average, the County shall increase
the 90 -day retention performance rate by 10% of their individual baseline or
reach the statewide average, by the end of the fiscal contract year. For
example, if the County has a baseline completion rate of 46 %, the
expectation would be an increase of 4.6 %.
If, during any monitored calendar quarter, the County does not demonstrate
progress towards the expected 90 day- retention goal, the County shall follow
the process for correction in Section `o." below.
(2) Adult
(a) Effective July 1, 2013, if the County is in good standing at or above the
statewide average of 62% for 90 -day retention, the County shall maintain
good standing.
If, during any monitored calendar quarter, the County falls below the
statewide average, the County shall follow the process for correction in
Section "n." below.
(b) Effective July 1, 2013, if the County's baseline for 90 -day retention
performance is lower than the statewide average, the County shall increase
the 90 -day retention performance rate by 10% of their individual baseline or
reach the statewide average, by the end of the fiscal contract year. For
example, if the County has a baseline completion rate of 46 %, the
expectation would be an increase of 4.6 %.
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If, during any monitored calendar quarter, the County does not demonstrate
progress towards the expected 90 day- retention goal, the County shall follow
the process for correction in Section 'b." below
n. Performance Goals Results /Actions for a County falling below the statewide
average
If performance outcome falls below the statewide average or performance
expectation within a calendar quarter, as determined through SCOPE or report
generated by DSHS, the County shall:
(1) Submit a Performance Improvement Plan (PIP) to the DSHS Manager within 45
days of notice by DSHS.
(2) Have 90 days to return to the original individual 90 -day retention baseline
percentage.
(3) Submit an updated PIP requesting an additional 90 days for performance
improvement to the DSHS Manager, if after the original 90 days, the 90 -day
retention baseline percentage has still not been reached.
o. Performance Goals Results /Actions for a County starting below the statewide
average
If performance outcome does not demonstrate progress toward the expected rate
for 90 -day retention within a calendar quarter, as determined through SCOPE or
report generated by DSHS, the County shall:
(1) Submit a Performance Improvement Plan (PIP) to the DSHS Manager within 45
days of notice by DSHS.
(2) Have 90 days to demonstrate progress toward the expected rate for 90 -day
retention.
(3) Submit an updated PIP requesting an additional 90 days for performance
improvement to the DSHS Manager, if after the original 90 days, the 90 -day
retention baseline percentage has still not been reached.
p. Performance Review
(1) If, at 180 days or at the end of the fiscal contract year, the County has not met
its performance expectations (maintaining performance at or above the average,
increasing by 10% or returning to previous baseline percentage) the County
shall re- procure for services.
(2) The County shall submit its Request for Proposals (RFP) to the DSHS Manager
for approval prior to sending it to prospective providers and be able to identify
what new parameters will be used in seeking a provider that can meet the
performance expectations.
q. Performance Review When County is Service Provider
(1) If, at 180 days or at the end of the fiscal contract year, the County has not met
its performance expectations (maintaining performance at or above the average,
increasing performance by 10% or returning to previous baseline percentage)
the County shall:
(2) Submit a technical assistance plan and a PIP to the DSHS Manager, within 45
days. The plan shall identify who provided technical assistance to the County
and highlight identified challenges and potential solutions to help increase
performance. The PIP shall include strategies for performance improvement
based on the results of the technical assistance plan.
(3) DSHS shall not pay for technical assistance.
r. DSHS will continue to monitor and review the 90 -day retention performance rate. If,
based on statewide data, there is a need to adjust the statewide average, the
County will be consulted prior to any change and a letter sent from DSHS
authorizing the change.
s. Capacity Management
Beginning January 1, 2014, DSHS will begin to calculate the statewide baseline
measurement of capacity (the percentage of persons getting into treatment within
14 days of first contact) using TARGET data for calendar year 2014. In addition
DSHS will calculate each County's individual baseline percentage for calendar year
2014.
In January, 2015 DSHS will notify the County of the statewide baseline percentage
and its individual baseline percentage for that period.
For example, in January 2015, the statewide baseline is calculated to be X% and
this percentage will be considered 100% capacity. The County's calculated
baseline is Y %.
(1) If Y% is greater than or equal to X %, then the goal is to maintain and /or increase
the current Y %, but not fall below X %.
(2) If Y% is less than X %, then the County shall increase their percentage by a
minimum of 5% of Y %, or achieve X %, whichever improvement percentage is
less.
(a) In the event that Y% is less than X %, DSHS will provide technical assistance
in an effort to increase capacity.
(b) If Y is not increased by 5 %, or the County has not achieved the statewide
baseline percentage within six (6) months, the County shall submit a
Corrective Action Plan within 30 days of notice from DSHS outlining their
Performance Measures actions to increase the percentage.
Note: Data derived from this section will be used as the baseline in contracts
issued after June 30, 2015 that include Capacity Management. Future contracts will
link performance to payment.
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t. Out - stationed Staff
The County shall ensure Out - stationed staff reports all client data in TARGET,
monthly, using the DSHS TARGET Client Support Activities (Non- treatment) form.
u. Case Management (WAC 388 -877 & 388 -877B)
The County shall ensure:
(1) Case Management Services being billed under the Contract shall only include
the following activities:
(a) Services that assist patients in accessing needed medical, social, or
education services
(b) Services designed to engage, maintain, and retain patients in treatment
(c) Case planning, case consultation, and referral for other services
(2) Requirements for Billing for Case Management Services are met as follows:
(a) Low - income eligible patients
Case management services provided to patients eligible for low- income
services and billed under this Contract may be provided by a Chemical
Dependency Professionals (CDP), CDP Trainee, or other staff as deemed
appropriate by the County.
(b) Medicaid eligible patients
Case management services provided to patients who are Medicaid eligible
and billed under this Contract shall be provided by a Chemical Dependency
Professionals (CDP) or CDP Trainee, under the clinical supervision of a
CDP.
(c) Written documentation in the patient's case file giving date, duration, and
referral information of each contact. The County shall maintain files and
forms to document case management activities and services received and
recorded in TARGET using form #DSHS O4 -418 (REV. 10/2006) which can
be accessed through Provider page of the DSHS website at
hftp://www.dshs.wa,gov/DBHR/.
(d) Referrals for service must include contact information of other agencies that
are involved in providing services to the person.
(e) Required release(s) of information are in the case file.
(f) Documentation of the outcome of case management services.
(3) Limitations to billing for Case Management Services
The County shall not bill for case management under the following situations:
41
(a) If a pregnant woman is receiving maternity case management services
under the First Steps Program.
(b) If a person is receiving HIV /AIDS Case Management Services through the
Department of Health.
(c) If a youth is in foster care through the Division of Children and Family
Services (DCFS).
(d) If a youth is on parole in a non - residential setting and under Juvenile
Rehabilitation Administration (JJRA) supervision; youth served under the
CDDA program are not under JJRA supervision.
(e) If a patient is receiving case management services through any other
funding source from any other system (i.e. Mental Health, Children's
Administration, and Juvenile Justice and Rehabilitation Administration). For
Medicaid billings, youth in foster care through the DCFS who are receiving
case management services through DCFS.
(f) DSHS funds shall be the dollar of last resort for case management services.
(4) The County shall not bill for Case Management for the following activities:
(a) Outreach activities
(b) Services for people in residential treatment
(c) Time spent by a CDP reviewing a CDP Trainee's file notes and signing off
on them
(d) Time spent on internal staffing
(e) Time spent on writing treatment compliance notes and monthly progress
reports to the court
(f) Direct treatment services or treatment planning activities as required in WAC
388 -877 & 388 -8776
(g) Maximum time limitations for services billed under the County Contract are
as follows:
i. Case Management Services are limited to a maximum of five (5) hours
per month per patient.
ii. Exceptions to the five -hour limitation may be granted on an individual
basis based on the clinical needs of the individual patient. The County
shall be responsible for monitoring and granting exceptions to the five -
hour limit. Exceptions may not be granted to Medicaid - billed services.
v. Other Required Services
(1) Childcare Services (45 CFR 96.131).
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The County shall provide, directly or through arrangements with other public or
nonprofit private entities, childcare to patients participating in assessment and
treatment activities, and support activities such as support groups, parenting
education and other supportive activities when those activities are
recommended as part of the recovery process and noted in the patient's
treatment plan.
The County shall ensure:
(a) Childcare and prenatal services are provided or arrangements for provision
of these services are made for patients receiving chemical dependency
assessment and treatment services from subcontracted providers.
(b) All parenting recipients of treatment services are informed that childcare
services are available and are offered such services while participating in
treatment. Documentation regarding the offer and parent acknowledgement
of such offer shall be maintained in the patient file.
(c) Off -site childcare services (with the exception of care provided in the child's
or relative's home) are delivered by childcare providers licensed or certified
by the Department of Early Learning in accordance with WAC 170 -296A.
(d) Childcare provided at a treatment facility site shall be licensed or certified by
the Department of Early Learning (DEL) in accordance with WAC 170 -295.
(e) Treatment subcontractors supply the parent with information to assist the
parent in making a responsible decision regarding the selection of an off -site
childcare provider when on -site childcare is not available. The information
supplied by subcontractors shall include at a minimum:
i. Direction to the DEL website address for information on childcare
services at http: / /www.del.wa.gov /care
ii. Direction to the DEL website address for information on selecting
childcare services at: hftp://www.del.wa.gov/care/find-
facility/Default.aspx
iii. Written verification indicating the location of the childcare services, the
number of hours and length of child care authorization and the payment
process for the type of care selected
(2) Screens and Urinalysis (UA) Testing
(a) General Requirements
The County shall ensure:
i. Screens and UA testing is an allowable cost only within the context of a
treatment plan.
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Screens and UA tests are limited to no more than eight (8) tests per
month for each patient. All UA tests paid for with public funds shall be
documented in TARGET.
iii. Medicaid Eligible Methadone Patients and Pregnant Women
Urinalysis testing is provided by the DSHS contracted vendor.
iv. Low - income Eligible Patients
If UA testing on these patients is done by a laboratory other than the DSHS
contracted vendor, the subcontractor shall use the testing standards
identified on the County Minimum Urinalysis Testing Requirements
document found accessing the Provider page of the DSHS Website:
_http://www.dshs.wa.gov/DBHR/.
(b) Screens and UA Testing Standards and Protocols for Low - income Eligible
Patients
The County shall ensure the following standards and protocols are used as
minimum requirements when contracting for urinalysis testing services with
testing laboratories:
i. Certification
The County must maintain current laboratory certifications with the
Department of Health and Human Services (HHS) and one of the
following:
(A) Substance Abuse and Mental Health Services Administration
(SAMHSA)
(B) Other national laboratory certification body
ii. Screening Tests
(A) Screening tests shall meet all forensic standards for certified
laboratories.
(B) The use of "Instant Test Kits" is allowed only as a screen and
requires laboratory confirmation of positive test results.
iii. Confirmation Testing
(A) Gas Chromatography /Mass Spectrometry (GC /MS) or Liquid
Chromatography/Tandem Mass Spectroscopy must automatically
confirm all positive screens, with the exception of methadone. For
individuals on methadone, an immunoassay- screening reagent that
detects EDDP (methadone) may be utilized.
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(B) Confirmation testing is not required on negative tests. If a client
requests confirmation of a negative test, it shall be done at the
client's expense.
iv. Chain of Custody and Tampering
The laboratory shall provide a secure chain of custody for handling and
processing of specimens. The laboratory's procedures shall be
acceptable by a court of law.
v. Specimen Retention
(A) Laboratories shall retain samples in a frozen condition, for those
samples that tested positive, for a period of not less than six (6)
months after the test results are sent to the provider.
(B) All specimens subject to any court action shall be retained in a frozen
condition until such time as the matter is disposed of by the court.
vi. Test Result Reporting
(A) Initial results may be communicated by fax, carrier delivery, mail or
electronically downloaded. Results communicated other than with
the original report must be confirmed by mailing the originals to the
subcontractor where the specimen originated, upon request.
(B) Negative results will be communicated to the subcontractor where
the specimen originated within twenty -four hours from receipt of
specimens at the laboratory.
(C) Positive results will be communicated to the subcontractor where the
specimen originated within seventy -two (72) hours receipt of
specimens at the laboratory.
vii. Forms and Supplies
The laboratory shall supply order forms, and all other necessary supplies
for sample collection and transportation, which are unique to the services
provided.
(c) Alcohol Testing
Alcohol testing should be part of the drug testing panel only when the donor
is suspect by odor or overt behavior.
(3) Tuberculosis Services (CFR 45 96.121, 96.127, WAC 388 -877 & 388 -87713)
(a) The County shall ensure all programs that receive SAPT block grant funds
shall provide tuberculosis services whether directly or through arrangements
with other entities.
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(b) Tuberculosis services include but are not limited to:
i. Counseling the individual with respect to tuberculosis
ii. Screening to determine whether the individual has been infected with
mycobacteria tuberculosis to determine the appropriate referral for
treatment of the individual
iii. Providing treatment for or referring the individuals infected by
mycobacteria tuberculosis for appropriate medical evaluation and
treatment
(4) Employee Education about False Claims Recovery
If the County makes or receives payments under Title -XIX (Medicaid) of at least
$5,000,000 annually the County shall:
(a) Establish written policies for all employees and subcontractors that provide
detailed information about the False Claims Act established in section
1902(a)(68)(A) of the Social Security Act
(b) Include detailed information about the County's policies and procedures for
detecting and preventing waste, fraud, and abuse
(c) Include a specific discussion of the laws described in the written policies in
the County's employee handbook, if there is one. The discussion shall
emphasize the right of employees to be protected as whistleblowers and
include a specific discussion of the County's policies and procedures for
detecting and preventing fraud, waste, and abuse
w. Specific Eligibility and /or Funding Requirements for Criminal Justice Services.
(1) Criminal Justice Treatment Account (CJTA) (RCW 70.96A, RCW 70.96A.055:
Drug Courts, RCW2.28.170; Drug Courts) and Drug Court funding.
(2) The County shall provide alcohol and drug treatment and treatment support
services per Chapter 70.96A RCW: Treatment for alcoholism, intoxication, and
drug addiction (formerly uniform alcoholism and intoxication treatment) to the
following eligible offenders:
(a) Adults with an addiction or a substance abuse problem that, if not treated,
would result in addiction, against whom a prosecuting attorney in
Washington State has filed charges
(b) Alcohol and drug treatment services and treatment support services to adult
or juvenile offenders within a drug court program as defined in RCW
70.96A.055: Drug courts and RCW 2.28.170: Drug courts
(3) A County receiving funds identified in Exhibit B, A &R, as from CJTA, State Drug
Court funds and County participation shall provide services to eligible criminal
46
offenders and others in accordance with the Criminal Justice section of their
Strategic Plan.
(a) Service Rates
The County shall not bill DSHS at rates that exceed the prevailing County
rates for outpatient services or state rates for residential services.
(b) CJTA Funding Guidelines
The County shall use:
i. No more than ten percent of the total CJTA funds for County
administration.
ii. No more than ten percent of the CJTA funds for administrative and
overhead costs associated with the operation of a drug court.
Hi. No more than ten percent of the total CJTA funds for the following
support services combined:
(A) Transportation
(B) Child Care Services
iv. At a minimum thirty percent of the CJTA funds for special projects that
meet any or all of the following conditions:
(A) An acknowledged best practice (or treatment strategy) that can be
documented in published research, or
(B) An approach utilizing either traditional or best practice approaches to
treat significant underserved population(s).
(C) A regional project conducted in partnership with at least one other
County.
(c) Allowable /Unallowable Services
The County may provide any of the following services:
i. Title -XIX Set Aside
ii. Community Outreach, Intervention, and Referral services. Restriction:
Although Alcohol /Drug Information School is a component of Community
Outreach, Intervention, and Referral Services, CJTA funds cannot be
used to purchase Alcohol /Drug Information School services.
iii. Interim Services
iv. Crisis Services
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v. Detoxification Services
vi. Outpatient Treatment, (adult and youth)
vii. Opiate Substitution Treatment
viii. Case Management, (adult and youth)
ix. Residential Treatment Services
(A) Intensive Inpatient
(B) Long Term Care
(C) Recovery House
(D) Parenting and Pregnant Women's Services including Residential
Services and Therapeutic Childcare
(E) Youth Intensive Inpatient Level 1
(F) Youth Intensive Inpatient Level 2
(G) Youth Recovery House
(H) Youth Acute Detoxification
(1) Youth Sub -acute Detoxification
(J) Involuntary Commitment
x. Screens and UA tests are limited to no more than eight (8) tests per
month for each patient.
(d) Criminal Justice Treatment Account Special Projects Annual Report
The County shall submit an annual progress report to the appropriate DSHS
CONTACT that summarizes the status of the County's innovative project
and includes the following required information.
i. Type of project (acknowledge best practice /treatment strategy,
significant underserved population(s), or regional)
ii. Current Status:
(A) Describe the project and how it is consistent with your strategic plan.
(B) Describe how the project has enhanced treatment services for
offenders.
(C) Indicate the number of offenders who were served using innovative
funds.
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(D) Indicate the cost of service per participant.
iii. Goals and Objectives:
(A) Detail the original goals and objectives of the project.
(B) Document how the goals and objectives were achieved.
(C) If any goals or objectives were not achieved indicate any changes in
the project that will allow for the goals and objectives to be met.
iv. Evaluation Strategy:
(A) What is the treatment retention and completion rate for offenders
being treated with innovative funds?
(B) Are these rates the same, better, or worse than other offenders?
(C) What is the recidivism rate for offenders being treated with innovative
funds?
(D) Is this rate the same, better, or worse than other offenders?
x. Driving Under the Influence (DUI) repeat offender Services.
(1) For the time period January 1, 2014 through June 30, 2014, the County shall
provide court ordered chemical dependency assessment and treatment services
for low- income or Medicaid eligible "repeat DUI offenders." Eligible individuals,
defined as "repeat DUI offenders, must meet the following conditions:
(2) Have a current offense for a violation of RCW 46.61.502 (Driving Under the
Influence) or 46.61.504 (Physical Control of Vehicle Under the Influence),
(3) Have at least one prior conviction for a violation of RCW 46.61.502 (Driving
Under the Influence) or 46.61.504 (Physical Control of Vehicle Under the
Influence) within ten years of the arrest for the current offense, and
(4) Is ordered by a court to participate in chemical dependency assessment and
treatment services for low- income or Medicaid eligible repeat DUI offenders.
(5) The County shall:
(a) Prioritize the use of the DUI funds as the first source for reimbursement of
services to the DUI repeat offenders.
(b) Use no more than ten percent of the total DUI funds for County
administration.
(c) Use no more than ten percent of the total DUI funds for the combined cost of
the following support services:
i. Transportation
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ii. Child Care Services
(6) The County may provide any of the following treatment services for adults and
youth:
(a) Interim Services
(b) Crisis Services
(c) Detoxification Services
(d) Outpatient Treatment,
(e) Opiate Substitution Treatment
(f) Case Management
(g) Screens and UA tests limited to no more than eight (8) tests per month for
each repeat DUI offender.
(h) Residential Treatment Services:
i. Intensive Inpatient
ii. Long Term Care
iii. Recovery House
iv. Parenting and Pregnant Women's Services including Residential
Services and Therapeutic Childcare
v. Youth Intensive Inpatient Level 1
vi. Youth Intensive Inpatient Level 2
vii. Youth Recovery House
viii. Youth Acute Detoxification
ix. Youth Sub -acute Detoxification
x. Involuntary Commitment
(7) TARGET Requirements. The County shall require subcontractors to document
"repeat DUI Offender" services in TARGET using the following codes:
(a) Contract Type — Criminal Justice
(b) State Special projects — the County shall use one of the following:
i. CJ — DUI Court - to be used in those cases where the client is enrolled in
a state - recognized DUI Court.
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ii. CJ — Non -DUI Court- to be used in those cases where the client is not
enrolled in a state - recognized DUI Court.
(8) The County shall bill for DUI Repeat Offender Services on a monthly basis on
an invoice provided by DBHR. DUI Repeat Offender Services shall be billed
separately from the other services outlined in this Contract.
(9) The County shall maintain documentation in the client's file of the following:
(a) That both the previous and current offense occurred within ten years of the
arrest for the current offense, and
(b) The order by a court that the client participate in participate in chemical
dependency assessment and treatment services for low- income or Medicaid
eligible repeat DUI offenders.
y. Incentive Project.
DSHS has received a grant from Brandeis University o participate in an incentive
awards project to improve performance in "treatment engagement" for Outpatient
and Intensive Outpatient treatment agencies (including qualified subcontractors)
and detox facilities. The project will run from October 1, 2013 through March 31,
2015.
(1) Brandeis University will randomize the list of qualifying agencies and place each
agency into one of three or one of four categories ( "arms ").
(2) Because of the small number of detox facilities, they will be randomized into one
of the following three:
(a) Control group
(b) Incentives only
(c) Alerts Only
(3) Outpatient agencies will be randomized into one of the following:
(a) Control group
(b) Incentives only
(c) Alerts Only
(d) Incentives and Alerts
(4) Funding for incentive award payments is provided by DSHS.
(a) These funds are pooled and not reflected in Exhibit B, Awards and
Revenues.
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(b) The earned incentive award payments shall be passed through to the
subcontracted providers or directly to the agency providing services that are
identified by DSHS as a quarterly awardee.
(c) The County is authorized to take up to an 8% administrative fee for each
award and therefore may receive additional funding over and above that
identified on the A &R.
(5) By September 30, 2013 DSHS will kick off the start of the program with
information and a Webinar opportunity about:
(a) The randomization process
(b) The requirements for identification as a qualifying agency
(c) The award formula which identifies those who have earned an award based
on a calculation using a combination of:
i. Achievement points
ii. Improvement points
(6) DSHS will notify you in writing and /or by e -mail of the status of your
subcontractors as to:
(a) Which have qualified to participate in the project
(b) Into which each of the categories in a. above it has been placed after the
randomization
(c) If any of your providers have achieved an incentive award payment and the
amount awarded
(d) Provide a separate A -19 for billing purposes that will cover only the incentive
payments.
(7) The County shall:
(a) Familiarize itself with the incentive program and be prepared to answer
basic questions from subcontractors about the project.
(b) Forward the information provided to the County in section (6) (b) -(c). above
to all qualified subcontractors.
(c) Within 10 days of receiving the awardee list from DSHS, notify each
awardee agency in writing and/or by electronic means that they have
achieved an incentive award and to expect to receive it within the quarter
following the quarter in which the reward was achieved.
(d) Send the separate A -19 for the project to Eric Larson at
Eric.LarsonCa)dshs.wa.gov or designee who will review and forward valid A-
19s for payment.
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z. Chemical Dependency Treatment Provider Worksheet.
(1) Certification
The County shall ensure agencies, including all branch facilities receiving a
subcontract are certified by DSHS to provide the services they are to deliver.
(2) Treatment Provider Worksheet (TPW)
(a) The County shall ensure the TPW is signed and received by the DSHS
Contact.
(b) The County shall notify the appropriate DSHS Contact if the County adds or
terminates a subcontract with any agency or branch facility, by submitting a
revised Treatment Provider Worksheet to the appropriate DSHS Contact
identified on page 1 of the Contract within five (5) business days of the
change. The revised TPW shall include:
i. The name of the agency or branch facility whose subcontract has been
added or terminated.
ii. The date the subcontract was added or the "as of" date of termination.
iii. If the subcontract was terminated, the effective date of the termination of
the subcontract.
aa. Admission Priority Populations
(1) The County shall ensure treatment admissions to all Medicaid eligible
individuals as a service priority.
(2) The County shall ensure treatment admissions are prioritized in the order as
follows, per the Substance Abuse Prevention and Treatment (SAPT) Block
Grant (45 CFR 96.131 and 42 USC 300x -27):
(a) Pregnant injecting drug users
(b) Pregnant substance abusers
(c) Injecting drug users
bb. TARGET Requirements.
(1) Access and Security Requirements
A TARGET User ID is assigned to an individual employee and not to the Agency
as a whole; therefore the County shall ensure:
(a) At least one trained primary and one trained backup data operator must
have a User ID from the secure Access Washington (SAW) system.
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(b) Procedures are implemented to ensure that there is no sharing of User IDs,
pass phrases or TARGET logon information and that new employees
requiring access do not make use of User IDs issued to others.
(c) Computers that access TARGET shall be located in secure areas away from
general public viewing and traffic.
(d) The TARGET Helpdesk (888- 461 -8898) shall be contacted in the following
situations:
i. When a staff member who holds a User ID for access to TARGET
resigns or is terminated, the Helpdesk shall be notified within three (3)
business days.
ii. The Helpdesk is notified when new staff needs access to TARGET data
so an ID can be created.
iii. Relevant County staff has access to the technical assistance through the
TARGET Helpdesk to keep TARGET resources operational.
(e) The County may enter into a qualified Service Agreement with another
organization to meet TARGET Program Agreement reporting requirements
and shall ensure section a. (1) -(4) above are included in the Service
Agreement.
(f) The instructions for new users are available through the DBHR website or
through the TARGET Helpdesk.
(2) Data Protection
The County shall:
(a) Not share TARGET user ID's or passwords between staff members or other
workers.
(b) Ensure that there is at least one trained back -up data -entry worker at the
service agency throughout the Program Agreement period.
(c) Take due care to protect said data from unauthorized physical and electronic
access.
(3) Data Disposition
The data provided to DSHS shall be maintained in a secure fashion until such
time as the Department determines that it should be destroyed.
(4) Requirements for Patient and Client Treatment Encounter DATA
Documentation of non - compliance with any reporting requirements may result in
corrective actions towards the County or the withholding of funds.
The County shall:
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(a) Enter the date of first contact into TARGET at least every seven (7) days.
(b) Work towards entering all information into TARGET by the end of the 7'h
calendar day after the date of service.
(c) Ensure all reporting requirements are met.
(d) Enter full and complete patient and client information including but not
limited to Interim Waiting List Services, Assessment Services and Treatment
Services, is entered into TARGET.
(e) Provide special TARGET -based reports to the DSHS Contract Manager as
requested.
(f) Prior to the implementation of a new program of service, the County and
DSHS shall agree upon a program guidance /instruction document that will
specify the process for reporting the service activity under that program.
(g) To ensure on -time payment of submitted invoices
Work towards all TARGET input data by the end of the 71h calendar day after
the date of service.
(h) Verification of TARGET data input will be made prior to payment.
cc. Consideration.
(1) Maximum Consideration
The maximum consideration for this Contract is identified in Exhibit B, Awards &
Revenues.
(2) For Services to Pregnant and Parenting Women, SAPT may only be used as
payment of last resort.
(3) Fiscal Year Allocation and Exceptions
With the exception of funding provided by CJTA, the use of funds is limited to
the fiscal year for which it is allocated. CJTA is a biennial allocation.
(4) Reimbursement Rates
DSHS shall reimburse the County based upon Exhibit C, Service Rate Plan.
(a) The total amount of reimbursement, including reimbursement for
administration costs, shall not exceed the Maximum Contract Amount
identified in Exhibit B, Awards & Revenues.
(b) The total amount of reimbursement for each Award shall not exceed the
itemized Awards in Exhibit B, Awards & Revenues.
(5) Period of Performance Service Costs
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The County shall ensure that service costs incurred are within the period of
performance of this Contract.
(6) Allocating Medicaid Match
(a) The County shall allocate state funds in a manner that will provide adequate
Medicaid State Match, as described in Section II. (2) (d) i. -iv. Medicaid
Rules and Limitations.
(b) The County and DSHS acknowledge that the amount identified on the SRP
as the Medicaid Set -aside is an estimate which will require periodic review
based on the flow of patient eligibility categories; the County and DSHS shall
work together when updating the amount of set - aside.
(7) County Participation Match Requirement:
The County shall provide County participation match, to share in the cost of
services under this Contract, in accordance with the following requirements:
(a) In accordance with RCW 70.96A.047 the County shall provide a cost share
match for all services according to the formulas as shown below. This
match requirement is in addition to any Title -XIX Medicaid Match
requirements.
(b) Non - Criminal Justice Match Requirement — The County shall provide a ten
percent participation match of all DSHS provided non - criminal justice
awards. The formula for this match is the total of all non - criminal justice
awards divided by 0.9 times 0.1. Using this formula, the match requirement
for $100,000 would be $11,111.
(c) Criminal Justice Match Requirement — the County shall provide a local
participation match of all DSHS provided criminal justice awards using the
following formulas:
i. A dollar- for - dollar participation match for services to patients who are
receiving services under the supervision of a drug court
ii. A ten percent participation match (as formulated in non - criminal justice,
see f. 2. above) for services to patients who are not under the
supervision of a drug court but against whom a prosecuting attorney in
Washington State has filed charge
(d) Local Cost Sharing Agreement: The County shall submit a completed Local
Cost Sharing Agreement, along with the June monthly A -19 Invoice
Voucher, to the DSHS Contact annually.
(8) Prevention State Grant -in -Aid Match
To utilize State Grant -In -Aid funds for Prevention Services administration the
County must:
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(a) Pass a local sales tax in accordance with Senate Bill 5763, or secure local
funds through other private or public entities.
(b) Provide a hard dollar match, used for prevention services, equal to or
exceeding the amount billed to "State Grant -In -Aid" funds for prevention
administration.
(c) Submit a letter of request to the DSHS contact identifying the:
i. Amount of prevention administration funding requested, up to 10% of the
total prevention allocation.
ii. Date the local sales tax was adopted, if applicable.
iii. Amount and source of hard dollar match funds.
iv. Description of prevention services to be implemented with match funds.
v. Proposed start date of the prevention administration (30 days advance
notice required).
vi. Enter all services purchased through match funds into the DBHR
Performance -Based Prevention System (PBPS) upon approval of the
prevention administration request.
(d) The DSHS Contact will reply, in writing, to the prevention administration
request within 30 days of receipt of the request.
(9) Award Adjustment Request
With regard to all services:
(a) DSHS reserves the right to reduce the treatment funds awarded in this
Contract if the County's expenditures for treatment services /activities fall
below 85% of expected levels during any fiscal year quarter.
(b) If DSHS decides to exercise the right to reduce treatment or prevention
funds, DSHS will provide written notification 30 days prior to the reduction.
The notice will specify the reason for the reduction, the amount to be
reduced, and the effective date of the reduction.
dd. Billing and Payment for the Treatment Statement of Work.
(1) Invoice System
The County shall submit invoices using State Form A -19 Invoice Voucher, or
such other form as designated by DSHS. Consideration for services rendered
shall be payable upon receipt of properly completed invoices which shall be
submitted to the DSHS Contact stated on page one (1) of this contract, by the
Contractor, not more often than monthly. The invoices shall describe and
document to DSHS' satisfaction a description of the work performed, activities
accomplished, the progress of the project, and fees. The rates shall be in
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accordance with those set forth in Section 8. i. Consideration above, of this
Contract.
(2) DSHS Obligation for Payment
DSHS shall not be obligated to reimburse the County for any services or
activities, performed prior to the effective date of this Contract, which shall
include the mutually agreed upon County's SRP which shall be attached as an
exhibit to the Contract.
(a) Billing for Allowable Costs and Documented Costs
The County shall ensure all expenditures for services and activities under
this Contract are:
Expended for allowable costs, which are in accordance with the
Fiscal /Program Requirements.
ii. Documented in TARGET at the time the billing is submitted. This applies
to billings for:
(A) Medicaid eligible services
(B) Low - income services
(C) Out - stationed staff
(D) Any other billings submitted on the A -19 invoice appropriate for
TARGET entry
in. All documentation including reports must be submitted with the billing
documents.
(3) Claims for Payment
The County shall:
(a) Submit invoices for costs due and payable under this agreement that were
incurred prior to the expiration date within 90 days of the date services were
provided.
(b) The County shall submit final billing for services provided during each fiscal
year within 90 days after the end of that fiscal year.
ee. Billing for Medicaid - eligible Patients
(1) The County shall ensure the Medicaid billing process is used for all Medicaid -
eligible patients.
(2) Services to Medicaid patients shall be billed directly through the Medicaid billing
process. Billing instructions for Medicaid can be found by accessing the
Provider page of the DSHS website at http: / /www.dshs.wa.gov /DBHR /.
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ff. Billing for Non - Medicaid Patients
The County shall send a properly completed A -19 invoice voucher and supporting
documentation for services provided to non - Medicaid patients to the appropriate
DSHS Contact identified on page 1 of the Contract for review, approval and
forwarding to the ADSA accounting office.
gg. Administration Expenditure Limits
(1) The County may bill for Administration Costs based on 1112 of the amount
designated for County State GIA Administration in Exhibit B, Awards and
Revenues, on a monthly basis through the A -19 process.
(2) In the event money is removed from this Contract by written amendment, to
maximize services in other areas of the state, the monthly billing for
Administration Costs shall be adjusted accordingly based on the amount of
eligible funds remaining.
(3) The County shall ensure that CJTA and Drug Court awarded in this contract are
limited to the following conditions regarding administration:
(a) No more than 10% of the CJTA and no more than 10% of the Drug Court
award is spent on Fiscal /Program Requirements Line Item 566.11 for
County Administration.
(b) No more than 10% of the CJTA and no more than 10% of the Drug Court
award is spent on Fiscal /Program Requirements Line Item 566.11 for Drug
Court Administration.
hh. Timely Payment by DSHS
Payment shall be considered timely if made by DSHS within thirty (30) days after
receipt and acceptance by the DSHS Contact Person of the properly completed
invoices. Payment shall be sent to the address designated by the County on page
one (1) of this Contract. DSHS may, at its sole discretion, withhold payment
claimed by the County for services rendered if County fails to satisfactorily comply
with any term or condition of this Contract.
ii. Fiscal Year -end Billing
The County shall ensure that final billing for services provided under this Contract
shall occur no more than 90 days after the end of each fiscal year of this Contract.
jj. Non - Compliance
(1) Failure to Maintain Reporting Requirements:
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In the event the County or a subcontractor fails to maintain its reporting
obligations under this Contract, DSHS reserves the right to withhold
reimbursements to the County until the obligations are met.
(2) Recovery of Costs Claimed in Error:
If the County claims and DSHS reimburses for expenditures under this Contract
which DSHS later finds were (1) claimed in error or (2) not allowable costs under
the terms of the Contract, DSHS shall recover those costs and the County shall
fully cooperate with the recovery.
(3) Stop Placement:
DSHS may stop the placement of clients in a treatment facility immediately upon
finding that the County or a subcontractor is not in substantial compliance, as
determined by DSHS, with provisions of any WAC related to chemical
dependency treatment or Contract. The treatment facility will be notified by
DSHS of this decision in writing.
(4) Additional Remuneration Prohibited:
The County shall not charge or accept additional fees from any patient, relative,
or any other person, for services provided under this Contract other than those
specifically authorized by DSHS. The County shall require its subcontractors to
adhere to this requirement. In the event the County or subcontractor charges or
accepts prohibited fees, DSHS shall have the right to assert a claim against the
County or subcontractors on behalf of the client, per RCW 74.09. Any violation
of this provision shall be deemed a material breach of this Contract.
kk. Advance Payment and Billing Limitations.
(1) Advance Payment
DSHS shall not make any payments in advance or in anticipation of the delivery
of services to be provided pursuant to this Contract.
(2) Authorized Services
DSHS shall pay the County only for authorized services provided in accordance
with this Contract. If this Contract is terminated for any reason, DSHS shall pay
only for services authorized and provided through the date of termination.
(a) Timely Billing
DSHS shall not pay any claims for payment for services submitted more
than ninety (90) days after the calendar month in which the services were
performed, unless otherwise specified in this Contract.
(b) Exception to 90 -day billing limitation
The County may submit a bill for services beyond the 90 -day limitation:
M
i. When additional funds are added to or funds are decreased from the
Contract by written amendment, those services previously provided shall
be entered in TARGET as "County Community Services'.
ii. When a billing submitted to the Medicaid payment system is denied due
to ineligibility, the County may submit a billing for the denied service
using an A -19 invoice. The County shall attach a copy of the Medicaid
payment system denial to the A -19 to document the denial.
(c) Multiple Payments for the Same Claim /Duplication
i. The County assures that work performed and invoiced does not
duplicate work to be charged to the State of Washington under any other
contract or agreement with the Contractor.
ii. The County shall not bill DSHS for services performed under this
Contract, and DSHS shall not pay the County, if the County has charged
or will charge the State of Washington or any other party under any other
contract or agreement for the same services.
(d) Medicaid Rules and Limitations
The County shall adhere to the following Medicaid rules and limitations and
shall ensure its subcontractors adhere to these rules as appropriate:
i. Designate Medicaid State Match, from state - funded awards that shall be
allocated and identified on a DBHR - provided form.
ii. Ensure that their designated Medicaid State Match is sufficient to cover
the County's expenditures for covered Medicaid chemical dependency
treatment services during the Contract's period of performance.
iii. Increase Medicaid State Match funds in the event the original amount of
designated Medicaid State Match funds is less than the amount required
to meet the covered Medicaid chemical dependency treatment service
expenditures, and send revised SRP for approval to the DSHS Contact.
iv. Ensure covered Medicaid chemical dependency treatment services for
Medicaid - eligible patients are not charged as non - Medicaid expenditure.
Any such expenditure under this Contract shall constitute an
overpayment.
v. Ensure that all subcontractors that serve Medicaid - eligible patients
maintain a Core Provider Agreement with the Health Care Authority
(HCA).
vi. Ensure that policies and procedures are established and utilized to
screen all potential Medicaid - eligible patients for Medicaid eligibility, and
shall require its subcontractors to adhere to the County's policies and
procedures.
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vii. Ensure that potential Medicaid - eligible patients are referred to the
appropriate DSHS Community Services Office (CSO) to apply for
medical assistance.
viii. The County shall charge all covered Medicaid services provided to
Medicaid - eligible patients as a Medicaid expenditure through the State's
Medicaid payment system, and shall require its subcontractors to do the
same.
ix. With the exception of (x.) below, Title -XIX (Medicaid) eligible patients are
not charged any fees for any reason including, but not limited to
appointments for:
(A) Screening
(B) Brief risk intervention therapy
(C) Interim services
(D) Assessments
(E) Individual sessions
(F) Group sessions
x. Title -XIX (Medicaid) eligible patients, who are not diagnosed as
chemically dependent but who receive substance abuse services titled
Alcohol and other Drug Information School (ADIS), may be charged for
ADIS because they are not Medicaid billable services.
(e) Awards
The County shall acknowledge and ensure the following limitations on
Awards and Revenue:
i. Funds designated solely for a specific state fiscal year in this Contract
may be obligated only for work performed in the designated fiscal year.
ii. The Substance Abuse Prevention and Treatment (SAPT) Block Grant
CFDA number is 93.959.
10. Additional Services.
If County or Contractor is listed as having additional services on Page 3, these services
are found in the Exhibit(s) below.
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Exhibit A — Data Security Requirements
1. Definitions. The words and phrases listed below, as used in this Exhibit, shall each have the following
definitions:
a. "Authorized User(s)" means an individual or individuals with an authorized business requirement to
access DSHS Confidential Information.
b. "Hardened Password" means a string of at least eight characters containing at least one alphabetic
character, at least one number and at least one special character such as an asterisk, ampersand
or exclamation point.
c. "Unique User ID" means a string of characters that identifies a specific user and which, in
conjunction with a password, passphrase or other mechanism, authenticates a user to an
information system.
2. Data Transport. When transporting DSHS Confidential Information electronically, including via email,
the Data will be protected by:
a. Transporting the Data within the (State Governmental Network) SGN or Contractor's internal
network, or;
b. Encrypting any Data that will be in transit outside the SGN or Contractor's internal network. This
includes transit over the public Internet.
3. Protection of Data. The Contractor agrees to store Data on one or more of the following media and
protect the Data as described:
a. Hard disk drives. Data stored on local workstation hard disks. Access to the Data will be
restricted to Authorized User(s) by requiring logon to the local workstation using a Unique User ID
and Hardened Password or other authentication mechanisms which provide equal or greater
security, such as biometrics or smart cards.
b. Network server disks. Data stored on hard disks mounted on network servers and made available
through shared folders. Access to the Data will be restricted to Authorized Users through the use of
access control lists which will grant access only after the Authorized User has authenticated to the
network using a Unique User ID and Hardened Password or other authentication mechanisms
which provide equal or greater security, such as biometrics or smart cards. Data on disks mounted
to such servers must be located in an area which is accessible only to authorized personnel, with
access controlled through use of a key, card key, combination lock, or comparable mechanism.
For DSHS Confidential Information stored on these disks, deleting unneeded Data is sufficient as
long as the disks remain in a Secured Area and otherwise meet the requirements listed in the
above paragraph. Destruction of the Data as outlined in Section 5. Data Disposition may be
deferred until the disks are retired, replaced, or otherwise taken out of the Secured Area.
c. Optical discs (CDs or DVDs) in local workstation optical disc drives. Data provided by DSHS
on optical discs which will be used in local workstation optical disc drives and which will not be
transported out of a Secured Area. When not in use for the contracted purpose, such discs must be
locked in a drawer, cabinet or other container to which only Authorized Users have the key,
combination or mechanism required to access the contents of the container. Workstations which
access DSHS Data on optical discs must be located in an area which is accessible only to
authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
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d. Optical discs (CDs or DVDs) in drives or jukeboxes attached to servers. Data provided by
DSHS on optical discs which will be attached to network servers and which will not be transported
out of a Secured Area. Access to Data on these discs will be restricted to Authorized Users through
the use of access control lists which will grant access only after the Authorized User has
authenticated to the network using a Unique User ID and Hardened Password or other
authentication mechanisms which provide equal or greater security, such as biometrics or smart
cards. Data on discs attached to such servers must be located in an area which is accessible only
to authorized personnel, with access controlled through use of a key, card key, combination lock, or
comparable mechanism.
e. Paper documents. Any paper records must be protected by storing the records in a Secured Area
which is only accessible to authorized personnel. When not in use, such records must be stored in
a locked container, such as a file cabinet, locking drawer, or safe, to which only authorized persons
have access.
f. Remote Access. Access to and use of the Data over the State Governmental Network (SGN) or
Secure Access Washington (SAW) will be controlled by DSHS staff who will issue authentication
credentials (e.g. a Unique User ID and Hardened Password) to Authorized Users on Contractor
staff. Contractor will notify DSHS staff immediately whenever an Authorized User in possession of
such credentials is terminated or otherwise leaves the employ of the Contractor, and whenever an
Authorized User's duties change such that the Authorized User no longer requires access to
perform work for this Contract.
g. Data storage on portable devices or media.
(1) Except where otherwise specified herein, DSHS Data shall not be stored by the Contractor on
portable devices or media unless specifically authorized within the terms and conditions of the
Contract. If so authorized, the Data shall be given the following protections:
(a) Encrypt the Data with a key length of at least 128 bits
(b) Control access to devices with a Unique User ID and Hardened Password or stronger
authentication method such as a physical token or biometrics.
(c) Manually lock devices whenever they are left unattended and set devices to lock
automatically after a period of inactivity, if this feature is available. Maximum period of
inactivity is 20 minutes.
Physically Secure the portable device(s) and /or media by
(d) Keeping them in locked storage when not in use
(e) Using check -in /check -out procedures when they are shared, and
(f) Taking frequent inventories
(2) When being transported outside of a Secured Area, portable devices and media with DSHS
Confidential Information must be under the physical control of Contractor staff with authorization
to access the Data.
(3) Portable devices include, but are not limited to; smart phones, tablets, flash memory devices
(e.g. USB flash drives, personal media players), portable hard disks, and
laptop /notebook/netbook computers if those computers may be transported outside of a
Secured Area.
64
(4) Portable media includes, but is not limited to; optical media (e.g. CDs, DVDs), magnetic media
(e.g. floppy disks, tape), or flash media (e.g. CompactFlash, SD, MMC).
h. Data stored for backup purposes.
(1) DSHS data may be stored on portable media as part of a Contractor's existing, documented
backup process for business continuity or disaster recovery purposes. Such storage is
authorized until such time as that media would be reused during the course of normal backup
operations. If backup media is retired while DSHS Confidential Information still exists upon it,
such media will be destroyed at that time in accordance with the disposition requirements in
Section 5. Data Disposition
(2) DSHS Data may be stored on non - portable media (e.g. Storage Area Network drives, virtual
media, etc.) as part of a Contractor's existing, documented backup process for business
continuity or disaster recovery purposes. If so, such media will be protected as otherwise
described in this exhibit. If this media is retired while DSHS Confidential Information still exists
upon it, the data will be destroyed at that time in accordance with the disposition requirements in
Section 5. Data Disposition.
4. Data Segregation.
a. DSHS Data must be segregated or otherwise distinguishable from non -DSHS data. This is to
ensure that when no longer needed by the Contractor, all DSHS Data can be identified for return or
destruction. It also aids in determining whether DSHS Data has or may have been compromised in
the event of a security breach. As such, one or more of the following methods will be used for data
segregation.
b. DSHS Data will be kept on media (e.g. hard disk, optical disc, tape, etc.) which will contain no
non -DSHS data. And /or,
c. DSHS Data will be stored in a logical container on electronic media, such as a partition or folder
dedicated to DSHS Data. And /or,
d. DSHS Data will be stored in a database which will contain no non -DSHS data. And /or,
e. DSHS Data will be stored within a database and will be distinguishable from non -DSHS data by the
value of a specific field or fields within database records.
f. When stored as physical paper documents, DSHS Data will be physically segregated from non -
DSHS data in a drawer, folder, or other container.
g. When it is not feasible or practical to segregate DSHS Data from non -DSHS data, then both the
DSHS Data and the non -DSHS data with which it is commingled must be protected as described in
this exhibit.
5. Data Disposition. When the contracted work has been completed or when no longer needed, except
as noted in Section 3. Protection of Data b. Network Server Disks above, Data shall be returned to
DSHS or destroyed. Media on which Data may be stored and associated acceptable methods of
destruction are as follows:
Data stored on:
Will be destroyed by:
Server or workstation hard disks, or
Using a "wipe' utility which will overwrite the Data at
least three (3) times using either random or single
Removable media (e. . flo pies, USB flash drives,
character data, or
65
portable hard disks) excluding optical discs
Degaussing sufficiently to ensure that the Data cannot
be reconstructed, or
Physically destroying the disk
Paper documents with sensitive or Confidential
Information
Recycling through a contracted firm provided the
contract with the recycler assures that the
confidentiality of Data will be protected.
Paper documents containing Confidential Information
requiring special handling (e.g. protected health
information
On -site shredding, pulping, or incineration
Optical discs (e.g. CDs or DVDs)
Incineration, shredding, or completely defacing the
readable surface with a coarse abrasive
Magnetic tae
Degaussing, ncinerating or crosscut shreddin
6. Notification of Compromise or Potential Compromise. The compromise or potential compromise of
DSHS shared Data must be reported to the DSHS Contact designated in the Contract within one (1)
business day of discovery. If no DSHS Contact is designated in the Contract, then the notification must
be reported to the DSHS Privacy Officer at dshsprivacyofficer @dshs.wa.gov. Contractor must also
take actions to mitigate the risk of loss and comply with any notification or other requirements imposed
by law or DSHS.
7. Data shared with Subcontractors. If DSHS Data provided under this Contract is to be shared with a
subcontractor, the Contract with the subcontractor must include all of the data security provisions within
this Contract and within any amendments, attachments, or exhibits within this Contract. If the
Contractor cannot protect the Data as articulated within this Contract, then the contract with the sub -
Contractor must be submitted to the DSHS Contact specified for this contract for review and approval.
M
AWARD AND REVENUES
2013 -2015 Biennium
COUNTY Jefferson (Prevention)
PROGRAM AGREEMENT NUMBER 1163 -27310
The above named County(ies), is hereby awarded thefollowing amounts far the purposes listed.
REVENUE
SOURCE TYPE OF SERVICE
CODE:
333.99,59 SAPT Grant -in -Aid
r�OT Tr in _onY
334.04.6X
334.04.6X
334.04.6X
334.04.6X
334.04.6X
333.97.78
AWARD AMOUNTS
SPY 14 SFY 15
$31,079 $31,079
$0 $0
Biennial
Funds
Exhibit 6
Total 13 -15
Biennium
$62,158
State Grant -in -Aid
$D
$0
$0
state GIA Administration
$0
$0
$0
Criminal Justice Treatment Account
$0
$0
$0
Drug Court - State Funds
$0
$0
$0
STATE - SPECIAL PROJECTS
$0
$0
$0
TANF Treatment Services
_ $0
$0
$0
CA Parents in Reunification
FEDERAL GRANTS
*TVX -Fed Waiver for DL and ADATSA clients ONLY
Total Federal Funds
Total State Funds
$0
$0
$31,079
$0
$0 $0
$0
$31,079 $0
$0
$0
$62,158
$0
TOTAL ALL AWARDS $31,079 $31,079 $0 $621158
Federal CFDA:
SAPT Grant -in -Aid -CFDA 93.959 Substance Abuse and Mental Health Services Administration (SAMHSA)
*Title XIX - CFDA 93.778 - DL and ADATSA is for July- December, 2013 services only
County participation match programs include State Grant -in -Aid, Federal SAPT Grant -in -Aid, and CJTA.
2013 -15 Jefferson Amend 9
Exhibit B
Awards & Revenues (A &R)
This individualized document will be sent as an attachment to e-mail and is incorporated
by reference to the specifically identified contract for which it is meant.
67
Exhibit C
Service Rates Plan (SRP)
This individualized document will be sent as an attachment to e-mail and is incorporated
by reference to the specifically identified contract for which it is meant.
Organizations only providing Prevention Services will not receive an SRP.
M_
Exhibit D
PROGRAM STANDARD AND GUIDELINES
CHEMICAL DEPENDENCY ASSESSMENT AND TREATMENT SERVICES
FOR CHILDREN'S ADMINISTRATION CLIENTS (CAR)
The County shall provide funding for chemical dependency assessment, detoxification,
treatment, and case management services to clients who are not Medicaid eligible and seeking
to remain or reunify with their families. These clients shall be known as "Children's
Administration Parents in Reunification" patients and shall have priority access category status.
DSHS shall reimburse the County as identified on Exhibit B, Awards & Revenues
1. Limitations:
The County may provide any of the following services as described in the Division of
Behavioral Health and Recovery (DBHR) Budgeting, Accounting and Reporting
System supplement:
a. Chemical Dependency Assessment
b. Outpatient Treatment, General
c. Case Management, General
d. Chemical Dependency Detoxification
e. Opiate Substitution Treatment
2. Patient Identification and Referral
The CA social workers are the primary source of referrals for this program. CA social
workers will identify clients as "CA Parents in Reunification" on the referral form.
The treatment provider or CA social worker is responsible for notifying the county when a
client may need ancillary services, such as transportation and childcare, in order to
participate in assessment and treatment.
3. Medicaid Eligibility
The County shall ensure that all clients are screened for Title XIX financial eligibility and
referred to the local DSHS Community Services Office (CSO) for Title XIX eligibility
determination if the financial screen so warrants. State funding source shall only be the
payer of last resort. If the client is eligible for Medicaid, the County shall ensure
services are paid through the Medicaid funding source. This funding source is
designed to serve CA clients who cannot access other sources of funding.
4. Eligible Providers
All assessment, detoxification, and treatment services provided by these funds must be
by DBHR certified treatment providers.
M
5. Service Rates
The rates paid shall not exceed the County negotiated low income rates for services
outlined above.
6. Reporting Requirements
a. The County shall comply with the DBHR TARGET data entry and reporting
requirements using a specific TARGET state special project code, CA- REUNITE, to
identify clients for treatment, interim and ancillary services (support services).
b. The County shall ensure the treatment provider communicates with the CA social
worker regarding the client progress, with appropriate written consent.
Communication is expected to include but not be limited to:
(1) verification of client attendance at appointments;
(2) efforts made to engage the client;
(3) treatment recommendations; and
(4) client progress and outcomes.
c. GAIN -SS shall be entered into TARGET by the treatment provider of first access,
either the Children's Administration social worker or the treatment provider.
70
EXHIBIT E
PROGRAM STANDARD AND GUIDELINES
HEPATITIS AND AIDS SUBSTANCE ABUSE PROGRAM
ADULT CARE ENHANCEMENT
Consideration:
In consideration for the Hepatitis and Aids Substance Abuse Program (HASAP) Adult
Care Enhancement services provided under this Agreement, the Department of Social
and Health Services (DSHS) shall reimburse the County as identified on Exhibit B,
Awards & Revenues.
In the event that an FTE is not available for a full month, the Contractor shall pro -rate its
billing accordingly.
2. Purpose:
The purpose of HASAP Adult Care Enhancement is to provide chemical dependency
and intervention services for HIV positive or Hepatitis C positive clients at the host
agency and to successfully integrate these services within the host site's overall
program model and agency organization. The goals of the program are to deliver
chemical dependency treatment and intervention services in the overall treatment
culture of each of the following host site facilities /agencies as named in the Payment
and Billing clause of this Contract.
3. Services:
The Contractor shall:
a. Outstation a chemical dependency professional to provide Alternative Care
Enhancement services at the host site(s). CDP's shall be out - stationed from site
other than CD contracted agency. A full -time equivalent staff person (1.0 FTE) shall
provide not less than 100 hours per month of direct services or consultation to HIV
positive or Hepatitis C positive clients or host agency staff during this contract
period. Hours shall be pro -rated when the contract is for less than one FTE. If the
Contractor provides less than 85 percent of a quarterly allocation of the contract in
any quarter, these funds may be re- negotiated to ensure full utilization.
b. Establish a Memorandum of Agreement with the host site(s) that shall include the
requirement for an annual report/evaluation and quarterly reports that includes input
from the host site that includes:
(1) The name of host site submitting the annual report;
(2) Name and title of the person submitting the report;
(3) The date the report was submitted;
(4) The name of Contractor;
71
(5) Summary of activities accomplished by the Contractor as outlined in the
Statement of Work.
(6) Problems encountered by the host site and the resolutions
attempted /accomplished; and
(7) Requests for information, clarification or technical assistance from the Division
of Behavioral Health and Recovery (DBHR)
4. Scope of Services
The following services fall within the scope of this contract. Counseling services shall
provide a mix of services based on the needs of the host facility, and shall be delivered
by the Contractor's staff assigned to work at approved residential or healthcare
agencies serving patients.
The County shall:
a. Provide substance abuse screening education to HIV and /or Hepatitis C case
managers and outreach workers staffed at the host agencies.
b. Network and serve as a referral resource for local needle exchange sites serving
intravenous drug- users.
c. Ensure that professionals assigned as counselors under this contract and their
direct supervisors attend bi- monthly Adult Care Enhancement coordinating
meetings.
d. Ensure that HASAP Providers participate in the Rapid HIV Testing Initiative (RHTI)
by obtaining the following within one year of contract:
(1) Basic fundamentals of HIV /AIDS training, as recognized by the State.
(2) State - certification in HIV Counseling, Testing, and Referral Services (CTRS)
training program.
(3) Fundamentals of Rapid HIV Testing and Prevention Counseling with the
OraQuick® Rapid HIV -1 Antibody Test (provided by SAMHSA or CDC, and
respective State required training).
e. Ensure that all HASAP Chemical Dependency Professionals or CDP's obtain
training and certification in Holistic Health Recovery Program (HHRP) Curriculum.
5. Treatment Services: The County shall provide the following:
a. Individual Treatment:
Individual treatment is defined as a planned therapeutic or counseling activity
specific to chemical dependency provided to an eligible client by a chemical
dependency professional. Individual treatment of more than 45 minutes is defined
as a full visit, and 15 to 45 minutes is a brief visit. Each patient enrolled for services
shall be seen no less than once every 20 hours of treatment services.
72
b. Group Treatment:
Group treatment is defined as a planned therapeutic or counseling activity specific
to chemical dependency provided to a group of three or more non - related clients
and less than twelve clients. The County shall abide by the following requirements
when conducting a group session:
(1) A group session shall be conducted by one or more therapists, one of which
must be a HASAP Adult Care Enhancement Chemical Dependency
Professional.
(2) Two staff members are required when there are more than eight patients.
(3) Family members of clients may attend a group treatment session.
(4) The group treatment session lasts 50 minutes or more.
(5) The Contractor must provide group treatment services at least two times per
week when possible at the site.
(6) Individual services may be substituted when group sessions are not possible.
c. Conjoint Treatment:
Conjoint treatment is defined as a planned therapeutic or counseling activity specific
to chemical dependency provided to a client and one or more of his /her family by
one or more therapist. Conjoint treatment session lasts 50 minutes or more as a full
visit or 15 to 45 minutes as a brief visit.
d. Assessments /Screens:
Initial chemical dependency screening shall] be maintained on current clients and all
new placements to assist in determining the need for additional chemical
dependency treatment services. Based on the results of the patient chemical
dependency screens, individual patient assessments and be completed and
maintained on current clients and all new placements identified as needing a full
chemical dependency assessment. Intake assessments must meet requirements
for chemical dependency assessment as per WAC 388 - 805 -320.
6. Other Services:
The County shall:
a. Develop and implement an on -going staff development plan for all direct service
facility staff specific to chemical dependency. This plan is to be updated on an
annual basis. The Contractor must maintain documentation of progress toward
accomplishment of the staff development plan.
b. In conjunction with host site staff, develop and carry out ongoing group sessions for
patients in residence.
c. Provide liaison, information and referral, and collaboration with community
73
substance abuse /chemical dependency agencies and resources. Provide no less
than two staff training /education programs per biennium.
d. Provide consultation and technical assistance to staff in areas related to substance
abuse /chemical dependency.
e. Cooperate with case workers and clinicians on individual and /or family counseling
needs as resource staff.
f. Collaborate with the host site staff in providing information needed to complete
progress reporting on clients to the placing agencies. Participate in regular staffing
with host facility staff.
g. Collaborate with host site staff in treatment, transition, and discharge planning for
program clients. Provide a written chemical dependency continuing care plan for all
patients receiving services prior to discharge.
h. Provide case management and outreach services as defined below:
(1) Case Management - Costs incurred for clients assessed as needing treatment
to provide case planning, case consultation and referral services, and other
support services for the purpose of engaging and retaining clients in treatment
or maintaining clients in treatment. Case management services are services
provided by a Chemical Dependency Professional (CDP), CDP Trainee or
person under the clinical supervision of a CDP who will assist clients in gaining
access to needed medical, social, educations, and other services. Does not
include direct treatment services in the sub - element.
(2) Outreach Services - Activities funded to provide Community Education, Alcohol
and Drug Information School, Community Outreach, Intervention, Referral and
Crisis services in the community.
i. Cooperate with research, data collection, and outcome measurement studies with
DSHS.
j. Submit monthly documentation in the form of TARGET reports with the Invoice
Voucher billing showing the following:
(1) The number of chemical dependency assessments;
(2) The Number of individual sessions;
(3) The Number of group sessions; and
(4) The Hours of non - treatment support activities.
k. Complete an annual progress evaluation to include the following elements:
(1) Agency submitting Evaluation
(2) Report Completed By
74
(3) Date Submitted
(4) Name of Host Site
(5) Summary of activities accomplished by the Contractor as outlined in the
Statement of Work
(6) Problems encountered by the Contractor and the resolutions attempted or
accomplished
(7) Describe specific goals, efforts or changes for program planning and operations
during the next three months
(8) Describe creative and innovative efforts being made by your program to
enhance services provided to the clients in your program
(9) Requests for information, clarification, or technical assistance from DBHR
I. Deadline for submitting the annual evaluation to the DBHR Contract Manager within
60 days following the end of state fiscal year.
Interagency Protocol:
a. The County shall maintain a written interagency protocol with the host agencies
cooperating with the direct service requirements of this contract. The protocol shall
cover the following areas of administration and coordination.
b. The Contractor shall collaborate with the host care agency on the selection and /or
hiring of chemical dependency staff that will work at the residential or healthcare
agency.
75
Exhibit F
Parent Child Assistance Program (PCAP) — Grant County
1. Definitions Specific to Exhibit. The words and phrases listed below, as used in this
Exhibit, shall each have the following definitions:
a. "Advocate' means a paraprofessional case manager working within the Parent Child
Assistance Program.
b. "Agencies" means any state office or activity of the executive and judicial branches of the
state government, including state agencies, departments, offices, divisions, boards,
commissions, and educational, correctional, and other types of institutions.
c. "Agreement" means this Interlocal Agreement, including all Exhibits and other documents
attached or incorporated by reference.
d. "Contract Manager" means DSHS contact person stated on page one (1) of this contract,
responsible for the day to day management of the contract.
e. "Contract Monitor' means the person identified by the Contract Manager that monitors the
contract.
f. "DBHR" means the DSHS Division of Behavioral Health and Recovery.
g. "DSHS" means the Department of Social and Health Services.
h. "PCAP" means Parent Child Assistance Program for women who abuse alcohol and /or
drugs during pregnancy or postpartum.
2. Statement of Work.
The Contractor shall:
a. Maintain the Parent Child Assistance Program (PCAP) site.
b. Ensure that the site has a minimum number of slots, as identified in I. below to serve the
highest risk women in the Contractor County.
c. Enroll women who:
(1) Abuse alcohol and/or drugs during pregnancy; and
(2) Are pregnant or postpartum (priority shall be given to women who are pregnant
and up to six months postpartum; referrals shall be accepted up to twelve
months postpartum on a space available basis); and
(3) Are not successfully or effectively engaged with community service providers.
d. Alternatively, women may be enrolled who:
(1) Have previously had a child diagnosed with Fetal Alcohol Spectrum Disorders,
76
and
(2) Are currently abusing alcohol and /or drugs; and
(3) Are in childbearing years.
e. Ensure that each advocate have an active caseload of up to eighteen clients, with a
minimum full -time advocates on staff as identified in I. below.
f. Provide advocacy services to clients and their families that shall include, but are not limited
to, the following:
(1) Identification and prioritization of realistic goals, initiation of necessary steps,
and evaluation of progress toward these goals.
(2) Support for substance abuse treatment, recovery, and follow -up.
(3) Support for utilization of local resources including, but not limited to, family
planning, safe housing, health care, domestic violence services, parenting skills,
and mental health services.
(4) Respond appropriately to client needs in a timely manner.
(5) Provision of funds for food, unmet health needs, other necessities, and
incentives as needed. The contractor shall only use State funds to pay for this
component.
g. Provide appropriate and timely PCAP supervision at the FTE level, as identified in I. below
at each site and ongoing training to advocates to ensure provision of the best advocacy
possible, and to safeguard advocates, clients, and their families.
h. Provide comprehensive training to ensure maintenance of the core components of the
PCAP advocacy model and consistency among sites.
i. Participate in the protection of Human Subjects for clients enrolled in research activities at
the PCAP site through the State of Washington Department of Social and Health Services'
Human Research Review Section using approved protocols and informed consent
procedures, and the Federal Certificate of Confidentiality.
Develop and maintain professional relationships with community providers.
k. Submit monthly reports to the PCAP State Director at the University of Washington,
describing the number of clients enrolled at the site. Submit to the PCAP Director at the
University of Washington, quarterly reports (every six months) describing progress at the
site, number of referrals, advocate training, community linkages, client characteristics, and
client and child outcomes.
I. Site Requirements
(1) Each site will provide appropriate supervision. Complaints or concerns by
regional partners, DBHR, other PCAP sites or other entities will be referred to
the Clinical Supervisor of the appropriate PCAP site or the PCAP State Director
S
at the University of Washington.
(2) Each site will have a minimum FTE to support staff in clerical and administrative
duties as follows:
Minimum Full Time
Advocates
2.0
Supervision FTE
1 0.3
Staff Support FTE
I 0.2
Minimum Client Slots
30
(3) Each site will hire an exit interviewer to conduct interviews with clients who
complete PCAP (approximately three years after enrollment). The exit
interviewer will be trained by PCAP at the University of Washington according to
evaluation protocols. Each exit interview will require approximately five hours (1
hour for scheduling /rescheduling /transportation; 2 hours to conduct the
interview; 2 hours to code the interview and enter data in the PCAP web -based
system). There is not a minimum FTE requirement. Exit interviewers may be
paid on a per exit interview basis. Exit interviewers cannot be an advocate, the
site Supervisor, or the same person who did the intake interview. A site
Supervisor may administer exit interviews to clients from other PCAP sites.
(4) Each site (to include program staff and host site staff) will attend PCAP
meetings as requested by the PCAP State Director at the University of
Washington or the DBHR Contract Manager.
m. CORE COMPONENTS REQUIRED FOR THE PARENT -CHILD ASSISTANCE PROGRAM
This is a three -year home visitation case management model for very high -risk
substance abusing women and their children. Caseload recommendation is fifteen
to eighteen active client families per advocate.
The Contractor shall ensure that the following Core components of the program are
met:
(1) Clients are not asked to leave the program because of relapse or setbacks.
(2) To facilitate an effective service plan, advocates develop and coordinate a
network of contacts with family, friends, and providers involved in a client's life.
(3) At least every four months, advocates work with clients to define and evaluate
the clients' personal goals and steps towards those goals; advocates coordinate
client goals with program goals.
(4) Advocates link clients with appropriate and available community services.
(5) Advocates work with both mother and target child regardless of who has
custody, and provide advocacy for other family members as needed.
(6) A minimum of twice- monthly group staffing sessions are required.
78
(7) A minimum of twice- monthly individual supervision is required. Notes from
these sessions shall be submitted monthly to University of Washington PCAP
State Director for review.
(8) Supervisors and advocates are required to submit completed evaluation
instruments according to PCAP protocol.
3. Performance Work Statement.
The Contractor shall provide the services and staff, and otherwise do all things
necessary to serve 85% or more of contracted monthly clients as set forth in 2.
Statement of Work above.
4. Consideration. Total consideration available for PCAP services is based on
performance and is identified on Exhibit B, Awards & Revenues.
a. Reaching the 85% goal:
Number of Clients At
Set Rate Per Month if
85% and Above
Utilization is 85% and
Above
26
$13,594
b. Failing to reach the 85% goal:
Number of Clients
Rate Per Client if
Below 85%
Utilization is Below
85% or Less
25
$453
c. Unless otherwise specified in this Contract, DSHS shall not pay any claims for payment for
services submitted more than 90 days after the calendar month in which the services were
performed.
5. Billing and Payment.
a. Invoice System. The Contractor shall submit invoices using State Form A -19 Invoice
Voucher, or such other form as designated by DSHS. Consideration for services rendered
shall be payable upon receipt of properly completed invoices which shall be submitted to
the DSHS Contact Person stated on page one (1) of this contract by the Contractor not
more often than monthly. The invoices shall describe and document to DSHS' satisfaction
a description of the work performed, activities accomplished, the progress of the project,
and fees. The rates shall be in accordance with those set forth in Section 5, Consideration,
of this Contract.
b. The Contractor shall bill monthly for services under this contract: The invoice shall list:
(1) Month of service; and
79
(2) Number of clients served during the billing month; and
(3) If serving less than 85% of contracted slots per month, the invoice shall reflect
and DSHS shall pay $453 per client, per month as identified in 4. Consideration
above; or
(4) If serving 85% clients or more per month, the invoice shall reflect and DSHS
shall pay the monthly set rate as identified in the 4. Consideration above.
c. Payment. Payment shall be considered timely if made by DSHS within thirty (30) days after
receipt and acceptance by DSHS Contact Person of the properly completed invoices.
Payment shall be sent to the address designated by the Contractor on page one (1) of this
Contract. DSHS may, at its sole discretion, withhold payment claimed by the Contractor for
services rendered if Contractor fails to satisfactorily comply with any term or condition of
this Contract.
6. Background Checks. Revised Code of Washington (RCW) 43.43 and Washington
Administrative Code (WAC) 388 - 805- 200(2) require criminal background checks
(CBCs) when employing staff members, including volunteers and subcontractors, who
have unsupervised access to child, adolescents, vulnerable adults, and persons who
have developmental disabilities. All Contractor's staff members; subcontractors, such
as treatment staff members, prevention staff members, case managers, outreach staff
members, etc.; or volunteers who have unsupervised access to children, adolescents,
or vulnerable adults are required to have a background check.
7. Reporting. When a participant in Parent Child Assistance Program (PCAP) also
participates in the WorkFirst program, the contractor shall:
a. Coordinate the PCAP and services at the local level with the Community Service Offices
and WorkFirst Case Manager.
b. When a verification form is provided by WorkFirst program Specialist or Social Worker, the
Contractor will return a completed WorkFirst participation Verification Form, DSHS O4 -432,
or its successor, on the fifth (5th) of every month to the WorkFirst Program Specialist or
Social Worker indicating that a TANF participant received services from the Contractor.
8. Data Security Requirements — See Exhibit A
rn
Exhibit G
PROGRAM STANDARDS AND GUIDELINES
THERAPEUTIC CHILDCARE/DEVELOPMENT DAYCARE
KING COUNTY
In consideration of maximum funds awarded for Therapeutic Childcare /Development Daycare,
as identified on Exhibit B, Awards & Revenues, the county shall ensure childcare is provided
that includes ongoing assessment, therapeutic and behavioral interventions and parenting
skills training as described below:
The County shall ensure the delivery of services for the protection, care and treatment of
children of chemically dependent parents currently participating in substance abuse treatment.
Services shall include the following elements:
1. A developmental assessment using recognized, standardized instruments;
2. Play therapy;
3. Behavior modification;
4. Individual counseling;
5. Self- esteem building;
6. Family intervention to modify parenting behavior and /or the child's environment to
eliminate /prevent the child's dysfunctional behavior.
The County shall ensure the Contractor provide therapeutic child care services for a minimum
of four hours per day per child, including staffing time, five days per week. The Contractor shall
maintain a ratio of one staff person for every three children under 25 months, and one staff
person for every five children over 24 months.
Families referred from Child Protective Services shall not be admitted under this program for
payment.
Priority for placement shall be the child(ren) of pregnant and postpartum women (up to one
year post delivery). Infants shall be considered priority admissions. Services shall be provided
for children from one month through five years of age. A child may continue to be eligible for
funding under this program for the first month following the month in which the child becomes
six years of age.
The Contractor shall accept referrals from the county contracted drug /alcohol treatment center
where the parent is enrolled. Children may participate in the program for a maximum of 15
months. The contract manager may grant extensions to this time on a case -by -case basis.
The child may continue to attend therapeutic childcare for one month in the event the parent
prematurely leaves treatment or is terminated by the treatment program.
CHILD CARE STANDARDS: The Contractor shall maintain a current state of Washington
Child Care Center License for the site at which this program is operated. The program site
shall be maintained in a safe, sanitary, attractive manner.
ASSESSMENTS: The Contractor shall:
Provide or arrange for an initial health assessment for each child within six weeks of admission
or as recommended by the well baby schedule. Document the dates and results of the
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assessment in the child's record. Assessments completed within a month prior to the child's
admission do not need to be repeated.
Results of the previous assessment must be obtained and placed in the child's record. Health
assessments shall be completed by a licensed practitioner of the healing arts. The health care
provided shall submit a statement of medical necessity to participate in this program.
Health assessments shall include:
• Medical history; assessment of physical growth and nutrition status; inspection for obvious
disabilities; inspection of eyes, ears, nose, throat; visual screening; auditory screening;
screening for cardiac abnormalities; screening for anemia; urine screening; assessments of
immunization status and updating immunizations; referral to a dentist for children three
years old and up;
• Provide or arrange for a standardized developmental assessment for each child within six
weeks of admission that includes gross motor, fine motor, social, self -help, and
communication /language skills. The assessment shall be administered by an individual
trained in the method and use of the instrument;
• Observe parent/child, staff /child/ and peer interactions and record it. An initial observation
shall be completed in the child's home. The observations shall note both positive and
negative interactions and be used for developmental goal setting for the child and parent;
• Assess each child's physical and emotional status daily using a checklist. Any suspicions
of child abuse or neglect shall be documented and reported to DSHS Child Protective
Services. The chemical dependency treatment program shall be informed of the referral;
• Complete quarterly reviews and six month reassessments for each child; and
• Consult with the chemical dependency treatment program regarding their goals and
objectives for the child and parent while in their treatment. Document this in the flow notes
of the case.
THERAPEUTIC PLANS: Based on information obtained through initial assessments and
observations the Contractor shall:
• Establish goals and objectives for the child's individual development plan while in the
childcare program. Document same and develop a time schedule to assess achievement.
Share this information with the parent at a scheduled appointment, both verbally and in
writing;
• Assist the parent in goal setting for their child's behavior /development while in the program.
Document these goals in the case record. Include parent in quarterly case review
meetings;
• Assist the parent in goal setting for their interaction with their child(ren). Document these
goals in the case record. Document and develop a methodology to assist the parent in
assessing the achievement of these goals.
PARENTING EDUCATION The Contractor shall:
Develop and document an initial individualized parenting education plan within fourteen
days of admission. The plan shall be developed in conjunction with the parent and the
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treatment program and shall include goal setting and assessment for the child's and
parent's behavior;
• Develop the plan based on the following options: child care laboratory, formal classroom
instruction, group discussion, and formalized staff interaction;
Implement the plan at an appropriate time.
HEALTH MAINTENANCE: The Contractor shall:
• Follow upon any items noted in the initial health assessment that can be accomplished
while the child is in treatment,
• Provide onsite health care consultations with a professional health care provided a
minimum of once per month. The consultations shall deal with individual children's health
care needs and ongoing health practices at the center;
• Monitor and document health issues and refer the child for any needed medical attention.
TREATMENT PROGRAM INTERACTION: The Contractor shall:
• Develop plans to establish working relationships with referring chemical dependency
treatment programs. At a minimum, the relationship shall include joint staffing and case
reviews;
• Include a description of the service expertise in the plan that the Contractor can offer a
treatment agency.
CHILD'S RECORD: The program shall maintain records on the child(ren) in care. These
records shall include, at a minimum, the following:
• Written intake assessment;
• Medical history, including immunization status;
• Initial medical assessments and statement of medical necessity;
• Developmental assessments;
• Individual child development plan;
• Observations of any significant parent/child interactions;
• Evaluation of success of the child development plan;
• Parent Education Plan that includes goals and objectives of parent for child and for
parent/child relationship;
• Quarterly case review and six month assessment notes;
• Goals and objectives of chemical dependency treatment program;
Goals and objectives of Child Protective Services (if involved);
• Authorizations for release of information;
• Outcome of parent conferences /interventions;
• Permission for medical treatment; and
• Exit summary.
The records shall be kept in a place accessible in an emergency.
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REPORTING REQUIREMENTS:
• The County shall ensure the Contractor participates fully in information systems as
specified by DASA.
• The County shall prepare and submit to the department fiscal and expenditure reports as
the department may require for determining rates of payment and accounting.
• The County shall submit a biennial quarterly report to the Contract Manager detailing the
number of children admitted and discharged, the total number of hours of service provided,
the unduplicated count of the number of children served. Address significant changes in
funding level of staffing and any requests for technical assistance.
• The Contractor shall notify the chemical dependency treatment provider of the child's
parent on a weekly basis of any missed appointments or requests to reschedule
appointments, including the child's absence from scheduled service days. If the Contractor
has any safety concerns related to missed appointments, the Contractor shall immediately
notify the child's assigned DCFS social worker by telephone, and shall follow up with
written notification by fax to the DCFS social worker within 24 hours.
EXIT REVIEW: The Contractor shall:
Submit a written summary to the chemical dependency treatment program, CPS social worker,
and parent within three weeks of the child's exit from the program. The exit summary shall
include, but not be limited to, the following:
• The reason for the child's exit from the program;
• The child's developmental, health /medical, emotional, and behavioral progress and status;
• A statement regarding the Contractor's impression of the child's progress;
• Recommendations for continuing plans and referrals needed for the child.
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Exhibit H
PROGRAM STANDARD AND GUIDELINES
YOUTH GROUP CARE ENHANCEMENT
1. Consideration
In consideration for the Youth Group Care Enhancement services provided under this
Agreement, the Department of Social and Health Services (DSHS) shall pay the County
as identified on Exhibit B, Awards & Revenues
2. Statement of Purpose:
The purpose of the Group Care Enhancement Counselor is to develop and provide
chemical dependency /substance abuse services to the host agency and to successfully
integrate these services within the host sites overall program model and agency
organization. The goals of the program are to deliver chemical dependency treatment
and prevention services in the overall treatment culture of each host site facility.
3. The Contractor shall:
a. Outstation a full -time equivalent staff person (1.0 FTE) Chemical Dependency
Professional (CDP) to provide Group Care Enhancement services at the host site(s)
as follows:
(1) A full -time equivalent staff person (1.0 FTE) shall provide a minimum of 100
hours per month of direct services or consultation to youth or group home staff
during this contract period.
(2) Hours will be pro -rated when the contract is for less than (1.0 FTE). If the
Contractor provides less than 85 percent of a quarterly allocation of this contract
in any quarter, the funds may be re- negotiated to ensure full utilization.
b. Establish a Memorandum of Agreement with the host site that shall include the
requirement for an annual report and quarterly reports. The annual report shall be
to submitted to the Division of Behavioral Health and Recovery (DBHR) Contract
Manager no later than July 31't of each year, and the Quarterly report shall be
submitted according to the schedule set forth in section (4)(k) of this Statement
Work. The annual report shall include:
(a) The name of the host site submitting the annual report;
(b) The name and title of the person completing the report;
(c) The date the report is submitted;
(d) The name of the Contractor;
(e) Summary of activities accomplished by the Contractor as outlined in the
Statement of Work,
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(f) Problems encountered by the host site and the resolutions attempted or
accomplished; and
(g) Requests for information, clarification or technical assistance from DBHR.
4. Scope of Services:
The Contractor shall ensure that the CDP provides the following mixed treatment
services based on the needs of the host facility:
a. Individual Treatment
Individual treatment is defined as a planned therapeutic or counseling activity
specific to chemical dependency provided to an eligible patient by a chemical
dependency professional. Individual treatment of more than 45 minutes is
considered a full visit, and 15 to 45 minutes is a brief visit. Each patient enrolled in
the individual treatment shall be seen once every 20 hours of treatment services.
b. Group Treatment
Group treatment is defined as a planned therapeutic or counseling activity specific
to chemical dependency provided to a group of three or more non - related patients
and less than twelve (12) patients. The contractor shall abide by the following
requirements when conducting a group session:
(1) A group session shall be conducted by one or more therapists, one of which
must be a Group Enhancement Chemical Dependency Professional.
(2) Two staff members are required when there are more than eight (8) patients.
(3) Family members of patients may attend a group treatment session_
(4) The group treatment session may last 50 minutes or more.
(5) The Contractor shall provide group treatment services two (2) times a week at
the site.
(6) Individual services may be substituted when group sessions are not possible.
c. Conjoint Treatment
Conjoint treatment is defined as a planned therapeutic or counseling activity specific
to chemical dependency provided to a patient and one or more of his or her family
by one or more therapist. Conjoint treatment session may last 50 minutes or more
as a full visit or 15 to 45 minutes as a brief visit.
d. Assessments /Screens
Initial chemical dependency screening shall be carried out on current patients and
all new placements to determine the need for additional chemical dependency
treatment services. Based on the results of the patient chemical dependency
screens, individual patient assessments shall be completed and maintained on
M
current patients and all new placements identified as needing a full chemical
dependency assessment. Intake assessments must meet requirements for
chemical dependency assessment per WAC 388 - 805 -320.
5. Other Services:
The Contractor shall:
a. Develop and implement an on -going staff development plan for all direct service
facility staff specific to chemical dependency. This plan is to be updated on an
annual basis. The Contractor must maintain documentation of progress toward
accomplishment of the staff development plan.
b. In conjunction with host site staff, develop and carry out on -going group sessions for
patients in residence.
c. Provide liaison, information and referral, and collaboration with community
substance abuse and chemical dependency agencies and resources. Provide a
minimum of two staff training or education programs per biennium.
d. Provide consultation and technical assistance to staff in areas related to substance
abuse and chemical dependency.
e. Cooperate with case workers and clinicians on individual and /or family counseling
needs as resource staff.
f. Collaborate with the host site staff in providing information needed to complete
progress reporting on patients to the placing agencies. Participate in regular
staffing with host facility staff.
g. Collaborate with host site staff in treatment, transition, and discharge planning for
program patients. Provide a written chemical dependency continuing care plan for
all patients receiving services prior to discharge.
h. Cooperate in research, data collection, and outcome measurement studies with
DSHS.
i. Submit monthly documentation in the form of TARGET reports with the Invoice
Voucher billing showing the following:
(1) The number of chemical dependency assessments;
(2) The number of individual sessions;
(3) The number of group sessions; and
(4) The hours of non - treatment support activities.
j. Complete quarterly progress evaluations to include the following:
(1) The agency submitting the evaluation;
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(2) The name and title of the person completing the Evaluation Report;
(3) The date the evaluation is submitted;
(4) The name of Host Site;
(5) Summary of activities accomplished by the Contractor as outlined in the
Statement of Work;
(6) Problems encountered by the Contractor and the resolutions attempted or
accomplished;
(7) Description of specific goals, efforts or changes for program planning and
operations during the next three months;
(8) Description of creative and innovative efforts being made by the program to
enhance services provided to the youth in the program; and
(9) Requests for information, clarification, or technical assistance from DBHR.
k. Deadlines for submitting quarterly evaluations to the DBHR Contract Manger are as
follows:
(1) First quarter: January-March — due April 15
(2) Second quarter: April -June — due July 15
(3) Third quarter: July -Sept. — due October 15
(4) Fourth quarter: October - December— due January 15
I. Ensure that group care enhancement counselors attend all group care
enhancement - coordinating meetings.
6. Interagency Protocol:
The Contractor shall maintain a written interagency protocol with the host agencies
cooperating with the direct service requirements of this contract. The protocol shall
cover the following areas of administration and coordination:
a. The Contractor shall collaborate with the host agency on the selection and/or hiring
of chemical dependency staff who shall work at the residential care agency.
b. Day -to -day supervision of the staff shall be provided by the host agency.
c. The Contractor shall provide supervision specific to chemical dependency expertise.
d. The host agency shall review agency policies and patient expectations for
consistency with the concept of a 'Drug -Free Workplace."
e. Disputes resolution: On discovery of a dispute between the Contractor and the
Host Agency, both parties shall make reasonable efforts to informally resolve such
0
dispute. If informal resolution cannot be achieved the DBHR Contract Manager or
designee may be called upon to resolve disputes.
f. Clinical staff shall be physically located at the host agency on a (1.0 FTE) basis.
The Contractor shall coordinate with the host agency(s) on the use of employee
leave and release to ensure continuous staffing of the host agency
g. Clinical staff provided under this protocol shall be certified Chemical Dependency
Professionals (CDP). Prior to placing a CDP trainee, the Contractor shall consult
with, and gain approval from, the DBHR Contract Manager or designee.
h. Stipulate that staff available under this contract shall not be used by the residential
facility to meet the staffing requirements of other contracts.
i. List services provided at the time of the Agreement.
j. List program development goals for the upcoming year.
k. Day -to -day supervision of the staff will be provided by the residential care agency.
I. The Contractor shall provide supervision specific to chemical dependency expertise.
m. The host agency will review their agency policies and patient expectations for
consistency with the concept of a "Drug -Free Workplace."
n. Disputes between the Contractor and the host agency(s) shall be resolved between
the two agencies. As necessary, the DBHR Contract Manager or designee may be
called upon to resolve disputes.
o. Clinical staff will be physically located at the host agency on a 1.0 full -time
equivalent basis. The Contractor shall coordinate with the host agency(s) on the
use of leave and release time necessary to maintain the qualified status of
employees.
p. Clinical staff provided under this protocol shall be certified Chemical Dependency
Professionals. Prior to placing CDP trainee, the Contractor must consult with, and
gain approval from, the DBHR Contract Manager or designee.
q. Stipulate that staff available under this Contract shall not be used by the host
agency to meet the staffing requirements of other contracts.
r. List services provided at the time of the Agreement.
s. List program development goals for the upcoming year.
m
Exhibit I
VETCORP
The Contractor shall provide services through its VetCorp Project grant with CADCA, beginning
January 1, 2014. DSHS assistance with the grant match will be found on Exhibit B, Awards &
Revenues.
i