1-Exhibits D-M (TFSS).pdf

EXHIBIT “D”

CODE OF CONDUCT

Mission

Provide comprehensive, cost-effective, compassionate health care for our diverse community, especially those facing barriers, through an exceptional workforce, education, and forward-thinking leadership.

Vision

Setting the standard in health care excellence. Healthy people in healthy communities throughout Ventura County

CODE OF CONDUCT SERVICE

EXPERIENCE

Ventura County Health Care Agency’s (HCA) employees and agents shall strive to deliver quality, patient-centered health care services.

• Patients have the right to choose their health care. Patients will be involved in decisions regarding their care to the greatest practical extent possible.

• No person shall be denied care by HCA solely based on race, gender, religion, creed, color, economic status, or source and amount of payment. Further, employees are to be impartial and are not to discriminate in providing service based on race, color, national origin, religion, ancestry, medical condition, gender, sexual orientation, age, marital status, or disability.

• HCA employees and its agents will seek to understand and respect a patient's objectives for care and shall treat patients in a manner respecting their background, culture, religion, and heritage.

• HCA's employees and agents shall treat all patients with dignity, respect, and courteousness.

• Patients have the right to information for informed health care decisions including therapeutic alternatives and risks associated with their care. Patients also have a right to receive information about HCA’s policies, procedures, and charges.

• Quality patient care will only be delivered by qualified, competent staff.

• HCA will maintain an accurate medical record for each patient that is promptly completed, accessible, and retained.

CODE OF CONDUCT BUSINESS PRACTICES

HCA's employees and agents shall comply with all applicable laws and regulations.

• HCA, by and through its employees and agents, shall comply with all applicable laws, regulations, standards, and other requirements including those of Federal and State health care programs.

• Employees or agents who perform billing and/or coding of claims must take reasonable precautions to ensure that their work is accurate, timely, and in compliance with federal and state laws and regulations and policies.

• HCA will bill only for services rendered and which are fully documented in the patient’s medical records. If the services are coded, then only billing codes that accurately describe the services provided will be used.

• No claims for payment or reimbursement of any kind that are false, fraudulent, inaccurate, or fictitious will be submitted. No falsification of medical conditions, services, time, or other records that are the basis of claims submission will be tolerated.

• HCA shall act promptly to investigate and correct the problem when errors in claims that have been submitted are discovered.

• All reports or other information required to be provided to any federal, state, or local government agency shall be accurate, complete, and timely filed, including the reporting of overpayments related to the Medicare and Medi-Cal Programs.

• HCA shall maintain a complete and thorough medical and billing record and ensure they are retained according to regulatory requirements and organizational policy.

• HCA will seek positive relationships with government programs and third-party payers including ongoing communication about patient progress and billing.

• No employee or agent is authorized to enter any joint venture, partnership or other risk sharing arrangement with any entity that is a potential or actual referral source unless the arrangement has been reviewed and approved by

County Counsel and the Board of Supervisors.

CODE OF CONDUCT BUSINESS PRACTICES

HCA's employees and agents shall engage in ethical business relationships including maintaining confidentiality.

• Employees and agents must perform their duties in a way that promotes the public’s trust in HCA.

• The Federal government prohibits payment for services provided by an individual or entity that the government has excluded from participating in a Federally funded health care program. HCA will not knowingly employ, conduct business with or contract with excluded providers.

• HCA's employees and agents shall comply with all laws governing the confidentiality of medical information.

• Employees or agents shall not use or reveal any confidential information obtained as an employee or agent of HCA concerning HCA or its patients.

• HCA, in accordance with CCR, Title 22, § 70707, believes that the patient has the right to full consideration of privacy concerning their health care.

• No employee or agent should subordinate his or her professional standards, or objectivity to any individual. If significant differences of opinion in professional judgment occur, then they should be referred to management for resolution.

• Employees and agents should be honest and forthright in any representations made to patients, vendors, payers, other employees or agents, and the community.

• Each employee or agent has an obligation to the citizens, to the people's elected representatives, to fellow employees, and to the County’s administration, to accomplish its goals, to expose corruption wherever discovered, to refrain from disclosure of any confidential information, to preserve and safeguard the County's assets, and to uphold these principles, ever conscious that public office is a public trust.

CODE OF CONDUCT CONFLICTS OF INTEREST

Employees and agents must avoid situations in which their interests’ conflict with the duty to act in HCA’s best interest.

• Employees and agents should report any potential conflicts of interest concerning themselves or their family members to HCA in accordance with the Conflict-of- Interest Code.

• Employees and agents should avoid any activity that conflicts with the interests of HCA or its patients. Even the appearance of impropriety should be avoided. If an employee or agent suspects that a conflict may exist or be created, then he or she should consult with management.

• Employees and agents should not have other jobs that interfere with their ability to perform their duties at HCA.

• Employees and agents should not become involved, directly, or indirectly, in outside commercial activities that could improperly influence their actions or otherwise conflict with the Conflict-of-Interest Code without first disclosing that relationship to management.

• Conducting business with any firm in which there is a family relationship may constitute a conflict of interest. Advance disclosure and approval may be required as set forth in Ventura's Conflict of Interest Code for the Health Care Agency (Conflict of Interest Code).

• Employees and agents should not accept or provide benefits that could be seen as creating conflict between their personal interests and legitimate business interests. This includes accepting expensive meals, gifts, refreshments, transportation, or entertainment in connection with the job.

• No employee shall accept any fee, compensation, payment of expense, or any other item of monetary value in which acceptance may result in, or create the appearance of resulting in, the use of public office for private gain;preferential treatment of any person, impeding governmental efficiency or economy; any loss of complete independence or impartiality; the making of a County decision outside official channels; or any adverse effect on the confidence of the public in the integrity of County government.

• Gifts and benefits to clinicians or referral sources are not appropriate.

PROTECTION AND USE OF INFORMATION, PROPERTY AND ASSETS

HCA's employees and agents shall protect the County’s property and respect the property rights of others.

• HCA will not pursue any business opportunity that requires engaging in unethical or illegal activity.

• Employees and agents must obtain authorization prior to committing or spending HCA's funds.

• Employees and agents are personally responsible and accountable for the proper expenditure of HCA funds and for the proper use of its property.

• Employees and agents may not use either HCA or patient resources for personal or improper purposes or permit others to do so.

• HCA equipment is intended to be used only for HCA or County business.

• Use of electronic assets is for business. Employees and agents may only use computer systems and networks, in a manner consistent with HCA's policies, and shall take reasonable steps to protect systems and software from unauthorized access or intrusion. Misuse will result in disciplinary action in accordance with HCA policy.

• Surplus, obsolete, or junked property shall be disposed of in accordance with HCA's and County's procedures. Unauthorized disposal is a misuse of assets.

• Employees and agents have a duty to be productive during work time.

• Any improper financial gain through misconduct involving misuse of either HCA's or a patient's property is prohibited, including the theft of property or of money.

• HCA's confidential and proprietary information is valuable and should be protected from unauthorized use or exploitation. Employees and agents are also expected to respect the intellectual property rights of others with whom HCAdoes business.

• Employees and agents are expected to report any observed misuse of property to their supervisor or through the Compliance Line established for reporting concerns, including anonymously.

• Reasonable meal expenditures or entertainment must comply with the County Reimbursement Policy.

CODE OF CONDUCT HUMAN RESOURCES

HCA's employees and agents shall respect each other as human beings and health care professionals.

• Applicants and employees shall be afforded equal employment and advancement opportunities, pursuant to policies.

• Employees and agents are expected to conform to the standards of their respective professions and exercise sound judgment in the performance of their duties. Any differences of opinion in professional judgment should be referred to appropriate management levels for resolution in accordance with standard grievance procedures.

• All employees and agents should show proper respect and consideration for each other, regardless of position. Discriminatory treatment, harassment, abuse, or intimidation will not be tolerated. Unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature are serious violations of the standards of conduct and will not be condoned or permitted.

• Employees will be provided with reasonable accommodation, as outlined by the provisions of the Americans with Disabilities Act of 1990 (ADA) and/or California Fair Employment and Housing Act (FEHA). As an employer, we are responsible for providing reasonable accommodations to the known physical or mental impairments of a qualified individual with a disability, unless doing so would impose an undue hardship on the operation of County business.

• HCA will contribute to an employee's or agent's competence by making available continuing job-related education and training (within the limits of its resources).

• HCA will not permit any action of retaliation or reprisal against an employee who reports a violation of law, policy, or procedure.

CODE OF CONDUCT HEALTH AND SAFTEY

Our highest priority is the health and safety of our patients and ourselves. We shall strive to do our jobs so that no harm is caused to our patients, the public, or ourselves.

• Employees and agents are expected to comply with all work and safety rules.

• HCA shall only employ or work with people with proper credentials, experience, and expertise.

• HCA is a drug and alcohol-free workplace.

• Smoking is not permitted near any entrance to any HCA buildings or vehicles.

• Drugs, including controlled substances and other pharmaceuticals shall be safely stored, secured, dispensed, and inventoried in conformance with all applicable laws and regulations. Shortages and missing items shall be reported promptly to supervisors.

• Medical and/or County waste or other hazardous materials shall be disposed of properly and lawfully.

CODE OF CONDUCT REPORTING CONCERNS

Employees and agents shall promptly report all suspected violations of the Code of Conduct, Compliance Guidelines, operational policies, laws, or regulations to their manager or supervisor, through the confidential Compliance Line or to the Compliance Officer. You are protected from retaliation if you make a good-faith report.

• One option is to speak with your supervisor or another manager. If you are not comfortable speaking with him/her, or you believe the matter has not been adequately resolved, you should contact the Compliance Officer.

• If you want to anonymously report a concern, HCA has a third-party that takes confidential reports at 1.888.488.3146. This number is available 24 hours a day, seven days a week. Reports will be forwarded to the Compliance Department for investigation and resolution. You may remain anonymous if you choose, however if you identify yourself, it may assist in the investigation of the matter.

• Retaliation against any employee who, in good faith, reports potential or suspected violations is unlawful and will not be tolerated.

ATTESTION OF COMPLIANCE

I agree to comply with the Code of Conduct. I represent that I am in complete compliance with the requirements of the Code of Conduct as it applies to my job responsibilities.

I also represent and warrant that I have not been excluded from, or sanctioned by, any Federal health care benefits program, including but not limited to Medicare, Medi- Cal, CHAMPUS or the federal retired railway workers benefit program.

CONTRACTOR:

Signature

Date

EXHIBIT “E”

QUALITY MANAGEMENT PROGRAM

VCBH is committed to assuring that VCBH members receive care that meets State and Federal requirements.

CONTRACTOR adherence to the VCBH Quality Assurance standards is mandatory and includes the following provider responsibilities:

1. Adhere to the VCBH Grievance and Appeals policy.

2. Post the Notice of Problem Resolution Processes which explains the grievance, appeal, and expedited appeal procedures.

3. Provide: (a) a master copy of the VCBH “Ventura County Medi-Cal Behavioral Health Member Handbook” brochure in English, Spanish, Large Font, and Audio format, (b) the Medi-Cal Provider Directory in English and Spanish, and (c) Grievance and Appeal forms and postage paid envelopes in all waiting areas.

4. Provide the VCBH MCO team with notification of all adverse incidents involving members within one business day of the incident or first knowledge of the incident.

5. Follow all documentation standards and respond to requests for plans of correction when requested by VCBH.

6. Conduct a Utilization Review process twice per year and provide remediation evidence to VCBH Utilization Review staff during or following VCBH Utilization Review.

VCBH will be responsible for providing the following:

1. Provide updates to any member grievance procedures.

2. Provide updates of the Ventura County Medi-Cal Behavioral Health Member Handbook and Medi-Cal Provider Directory.

3. Supply the postage paid envelopes for use in waiting rooms.

4. Provide assistance and training in documentation in coordination with the VCBH Division Chiefs and assigned contract managers.

5. Provide technical assistance and conduct Medi-Cal site certification and re-certification.

6. Provide utilization review as required by the VCBH policy on Contractor Utilization review.

7. Notify contractor of disallowances that occur as a result of utilization review.

EXHIBIT “F”

GOOD NEIGHBOR POLICY

The COUNTY contracts with service providers committed to providing neighborhood-based treatment services for members. In addition to the standard COUNTY contract language, contractors providing services to COUNTY members must comply with this Good Neighbor Policy.

A. Facility and Facility Operations

1) Each facility shall establish early communication with the affected neighborhoods and communities as a way to (1) identify potential physical impacts on neighborhoods; (2) establish mitigation as necessary; and (3) implement appropriate management practices to minimize neighborhood complaints and encourage consideration of neighbors.

B. Neighborhood Complaints

1) Each facility shall develop a written procedure for handling neighborhood complaints to ensure ease of communication to the appropriate regulatory agency.

2) The neighborhood complaint process must be available on site so that it is readily accessible upon request.

3) The written procedure must include a contact number for the COUNTY liaison.

C. Staff and Resident Conduct

1) Staff and residents are expected to conduct themselves in a manner that demonstrates that they are community members.

2) Staff and residents are encouraged to be considerate of neighbors when outdoors.

D. Community Service and Involvement

1) In order to foster good relations between the staff and residents of a residential facility and other members of the community where the facility is located, staff and residents are encouraged to participate in community service activities that would tend to foster good will between the recovery community and their neighborhood.

EXHIBIT “G”

UTILIZATION REVIEW AND CONTRACTORS INVOICE PROCEDURE

1. Utilization Review staff will contact CONTRACTOR to schedule the chart review site visits.

2. A random selection of charts documenting services provided the previous month will be reviewed, per COUNTY policy.

3. For out of county contractors who are not using the COUNTY Electronic Health Record System as their primary Electronic Health Record System, all clinical documentation for the previous month, including updated treatment plans and assessments, will be encrypted and emailed securely to VCBH MCO Quality Assurance Utilization Review at QM.UR@ventura.org or provide COUNTY access to CONTRACTOR’s Electronic Health Record.

4. CONTRACTOR will submit its monthly invoice(s) to VCBH Fiscal Administration Accounts Payable by email to: bh_accountspayable@ventura.org or by mail to:

Ventura County Behavioral Health Fiscal Administration Accounts Payable

1911 Williams Drive, Suite 210 Oxnard, CA 93036

Invoices MUST include the following information: (1) remit to name and address, (2) invoice date, (3) invoice number, (4) Federal identification number, (5) service month,

(6) rate(s), (7) units of service, and (8) Electronic Health Record System report from the County system that demonstrates and ties to the specific units of service that are included in the invoice.

5. MCO Quality Assurance Utilization Review staff will review documentation for compliance with the Department of Health Care Services documentation standards and notify CONTRACTOR of any out of compliance items via a chart remediation memo, on a quarterly basis. If the CONTRACTOR does not remediate issues and demonstrates continuous areas of concern and/or disallowances, the frequency of the Utilization Reviews may increase. Items that may be corrected to prevent disallowance of units will be identified and CONTRACTOR will have two (2) weeks to return evidence of correction to the Utilization Review office.

6. Items that are not remediated or cannot be corrected will be noted and units will be disallowed from CONTRACTOR’s invoice. CONTRACTOR’s invoice will be reduced to reflect the reduction of the disallowed units multiplied by the associated unit rate of service.

EXHIBIT “H”

CERTIFICATION OF CLAIMS FOR PAYMENT FOR SERVICES RENDERED

CONTRACTOR and its duly authorized representative(s) understand and agree as follows:

I HEREBY CERTIFY under penalty of perjury that I am the official responsible for the administration of Mental Health services under this Agreement in and for said CONTRACTOR; that I have not violated any of the provisions of GOV §§ 1090 through 1098; that any amounts for which reimbursement is claimed herein are in accordance with WIC §§ 5700 et seq.; and that to the best of my knowledge and belief all claims submitted for services rendered will, in all respects, be true, correct, and in accordance with law. CONTRACTOR agrees and shall certify under penalty of perjury that all claims for services provided to COUNTY mental health members under this Agreement have been provided to the members by CONTRACTOR. The services were, to the best of the CONTRACTOR’s knowledge, provided in accordance with the member’s treatment needs. The CONTRACTOR shall also certify that all information submitted to the Behavioral Health Department and the State is accurate and complete. CONTRACTOR understands that payment of claims under this Agreement will be from Federal and/or State or COUNTY funds and any falsification or concealment of a material fact may be prosecuted under Federal and/or State or COUNTY laws. CONTRACTOR agrees to keep for a minimum period of ten (10) years from the expiration of the term of the Agreement or completion of an audit or investigation by COUNTY, State, and Federal agencies, including the exhaustion of all legal remedies, whichever is later, a printed representation of all records which are necessary to disclose fully the extent of services furnished to the member. CONTRACTOR agrees to furnish these records and any information regarding payments claimed for providing the services, on request, within the State of California, to the DHCS, the Medi-Cal Fraud Unit, California Department of Justice, Office of the State Controller, DHHS, COUNTY’s Behavioral Health Department, or their duly authorized representatives. CONTRACTOR also agrees that services are offered and provided without discrimination based on race, color, national or ethnic origin, sex, age or physical or mental disability. CONTRACTOR agrees that the Office of the Inspector General’s Exclusion List, Medi-Cal List of Suspended or Ineligible Providers, Excluded Parties List System/System Award Management (EPLS/SAM), databases are checked monthly, prior to providing services under this Agreement. CONTRACTOR also agrees that the Social Security Administration Death Master file database will be checked prior to: (1) contracting with COUNTY, (2) employing staff, and (3) contract renewal. CONTRACTOR agrees that prior to providing services under this Agreement, CONTRACTOR has complied with the credentialing and re-credentialing requirements specified in all applicable DHCS information notices for service providers (employees and contractors) that deliver Medi-Cal covered services and that signed attestations, as required by the information notice, are on file for each direct service provider. Per all applicable DHCS information notices, CONTRACTOR agrees to immediately: (1) report an overpayment received from COUNTY and (2) notify COUNTY in writing of the reason for the overpayment. The process for providing written notice is described in Section 4 (NOTICES) of page 1 of this Agreement. The overpayment must be returned to COUNTY within sixty (60) calendar days after the date on which the overpayment was identified.

CONTRACTOR:

BY _______________________ ______________________

Signature - Authorized Officer Date

BY _______________________ ______________________

Signature - Authorized Officer Date

EXHIBIT “I”

LOBBYING RESTRICTIONS AND DISCLOSURE CERTIFICATION

Applicable to any Federally funded contract in excess of $100,000 per Title 31, USC, § 1352.

1. Certification and Disclosure Requirements

(a) Each person (or recipient) who requests or receives a contract, subcontract, grant, or subgrant, which is subject to Title 31, USC, § 1352, and which exceeds $100,000 at any tier, shall file a certification (immediately following this Exhibit, entitled Certification Regarding Lobbying) that the recipient has not made, and will not make, any payment prohibited by Paragraph 2 of this Exhibit.

(b) Each recipient shall file a disclosure (in the form entitled “Disclosure of Lobbying Activities – Standard Form –LLL”) if such recipient has made or has agreed to make any payment using nonappropriated funds (to include profits from any covered Federal action) in connection with a contract, or grant or any extension or amendment of the Agreement, or grant, which would be prohibited under Paragraph 2 of this provision if paid for with appropriated funds.

Form available at: http://www.whitehouse.gov/omb/grants/sfillin.pdf

(c) Each recipient shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by such person under paragraph 1(b) above. An event that materially affects the accuracy of the information reported includes:

i. A cumulative increase of $25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action;

ii. A change in the person(s) or individuals(s) influencing or attempting to influence a covered Federal action; or

iii. A change in the officer(s), employee(s) or member(s) contacted for the purpose of influencing or attempting to influence a covered Federal action,

(d) Each person (or recipient) who requests or receives from a person referred to in Paragraph 1(a) of this provision a contract or agreement, subcontract, grant or subgrant exceeding $100,000 at any tier under a contract or agreement, or grant shall file a certification, and a disclosure form, if required, to the next tier above.

(e) All disclosure forms (but not certifications) shall be forwarded from tier to tier until received by the person referred to in Paragraph 1(a) of this provision. That person shall forward all disclosures forms to VCBH Contracts who will forward to DHCS Program Contract Manager.

2. Prohibition

31 USC § 1352, provides in part that no appropriated funds may be expended, by the recipient of a Federal contract or agreement, grant, loan, or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any of the following covered Federal actions: the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

CERTIFICATION REGARDING LOBBYING

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making, awarding or entering into of this Federal contract, Federal grant, or cooperative agreement, and the extension, continuation, renewal, amendment, or modification of this Federal contract, grant, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency of the U.S. Government, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, or cooperative agreement, the undersigned shall complete and submit a Disclosure of Lobbying Activities – Standard Form –LLL in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontractors, subgrants, and contracts under grants and cooperative agreements) of $100,000 or more, and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of the fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 USC § 1352, any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

CONTRACTOR:

Signature Date

Printed Name of Person Signing for Contractor and Title

Signature Date

Printed Name of Person Signing for Contractor and Title

EXHIBIT “J”

PROHIBITED ASSOCIATIONS

An individual or entity that is debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation (FAR) or from participating in non-procurement activities under regulations issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 (42 CFR § 438.610(a)(1)).

An individual or entity who is an affiliate, as defined in the FAR at 48 CFR § 2.101, of a person described in this section (42 CFR § 438.610(a)(2)).

A. By signing this Agreement, CONTRACTOR agrees to comply with the FAR and CFR as specified above. “Debarred” means excluded or disqualified from contracting with the Federal, State, or local government.

B. By signing this Agreement, CONTRACTOR certifies to the best of his or her knowledge and belief, that CONTRACTOR, its principals, and subcontractors:

1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency.

2) Have not within a three (3) year period preceding this Agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, State or local) violation of federal or State antitrust;

violation of Federal or State antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false claims, tax evasion, receiving stolen property, making false claims, obstruction of justice, or the commission of any offense indicating a lack of business integrity or business honesty that seriously affects its business honesty;

3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in Paragraph b(2) herein;

4) Have not within a three (3) year period preceding this agreement had one or more public transactions (Federal, State, or local) terminated for cause or default;

5) Have not, within a three (3) year period preceding this application/proposal/agreement, engaged in any of the violations listed under 2 CFR § 180, Subpart C as supplemented by 2 CFR § 376;

6) Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under Federal regulations (i.e., 48 CFR § 9, Subpart 9.4), debarred, suspended, declared ineligible, or voluntarily excluded from participation in such transaction, unless authorized by the State.

7) Will include a clause entitled, Prohibited Associations essentially sets forth the provisions herein, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

C. If CONTRACTOR is unable to certify to any of the statements in this certification, CONTRACTOR shall submit an explanation to the VCBH Provider Network Management Manager.

D. The terms and definitions herein have the meanings set out in 2 CFR § 180 as supplemented by 2 CFR § 376.

E. If the CONTRACTOR knowingly violates this certification, in addition to other remedies available to the Federal Government, the COUNTY may terminate this Agreement for cause or default.

CONTRACTOR’s certification herein is a material representation of facts upon which the COUNTY is relying in entering into this Agreement. COUNTY has the right to immediately terminate this Agreement if CONTRACTOR’s certification herein is erroneous or becomes erroneous by reason of changed circumstances.

CONTRACTOR:

BY _______________________ __________________________

Signature - Authorized Officer Printed Name and Title Date

BY _______________________ __________________________

Signature - Authorized Officer Printed Name and Title Date

EXHIBIT “K”

SMOKE-FREE WORKPLACE CERTIFICATION

Applicable to federally funded agreements/grants and subcontracts/subawards that provide health, day care, early childhood development services, education or library services to children under eighteen (18) directly or through local governments.

A. Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by federal programs either directly or through state or local governments, by federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed.

B. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible party.

C. By signing this Certificate, CONTRACTOR certifies that it will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The prohibitions herein are effective December 26, 1994.

D. CONTRACTOR further agrees that it will insert this Certification into any subawards (subcontracts or subgrants) entered into that provide for children's services as described in the Act.

CONTRACTOR:

BY _______________________ __________________________

Signature - Authorized Officer Printed Name and Title Date

EXHIBIT “L”

ASSURANCE REGARDING USE OF SMALL, MINORITY OWNED AND WOMEN’S

BUSINESSES

A. Applicable to that portion of an agreement that is federally funded and entered into with institutions of higher education, hospitals, nonprofit organizations or commercial businesses.

B. Positive efforts shall be made to use small businesses, minority-owned firms and women's business enterprises, whenever possible (i.e., procurement of goods and/or services). CONTRACTOR shall take all of the following steps to further this goal:

1) Ensure that small businesses, minority-owned firms, and women's business enterprises are used to the fullest extent practicable.

2) Make information on forthcoming purchasing and contracting opportunities available and arrange time frames for purchases and contracts to encourage and facilitate participation by small businesses, minority-owned firms, and women's business enterprises.

3) Consider in the contract process whether firms competing for larger contracts intend to subcontract with small businesses, minority-owned firms, and women's business enterprises.

4) Encourage contracting with consortiums of small businesses, minority-owned firms and women's business enterprises when a contract is too large for one of these firms to handle individually.

5) Use the services and assistance, as appropriate, of such organizations as the Federal Small Business Administration and the U.S. Department of Commerce's Minority Business Development Agency in the solicitation and utilization of small businesses, minority-owned firms and women's business enterprises.

CONTRACTOR:

BY _______________________ __________________________

Signature - Authorized Officer Printed Name and Title Date

GENERAL CONDITIONS, ASSURANCES AND CERTIFICATIONS

Revised 4/2/2021

GENERAL CONTRACT CONDITIONS – EXHIBIT M

Table of Contents

INTRODUCTION

A. GENERAL CONTRACT CONDITIONS

1. Reports

2. Limits of Obligation

3. Documentation and Procurement Requirements

4. Disallowed Costs

5. Availability of Funds

6. Administrative Directives, Unilateral Modifications, Contract Directives

7. Venue and Construction

8. Ownership of Work Product

9. Personnel Disclosure

10. Responsibility for Equipment

11. Contamination and Pollution

12. Hiring/Paying Board of Directors Prohibited

13. Subcontracts

14. Political Activities Prohibited (Hatch Act) & Byrd Anti-Lobbying Amendment .. 7

15. Energy Efficiency

16. Clean Air and Water Acts

17. Solid Waste Disposal Act

18. Sectarian Activities

19. Licenses and Standards

20. Maintenance of Records (Records Retention)

21. Internal Monitoring (fiscal and program review)

22. Inspection of Records/Monitoring/Audits

23. In-Kind or Cash Match

24. Termination

25. Closeout Upon Termination

26. Partial Performance

27. Non-Discrimination/Grievance/Complaint Procedures

28. Purchase of Service

29. Supplemental Invoices

Revised 4/2/2021

30. Budgeted Expenses and Payments

31. Working Capital

32. Budget Deviations

33. Minimum Standards for Salaries and Benefits

34. Audit Exceptions

35. Conditions Prerequisite to Payments

36. Reimbursement from Other Sources

37. Authority to Bind/Independent Contractor

38. Standard of Conduct/Conflict of Interest

39. Technical Assistance

40. Corrective Action

41. Penalties

42. Staff Representatives

43. Copyrights (applicable only if funds provided are used to develop a copyright or if purchasing ownership of a copyright)

44. Signatures

45. Remedies

46. Employment of Convicted Individuals

47. Drug-Free Workplace Certification

48. Debarment and Suspension Certification

49. Modification Provision

50. Fiscal Control

51. Submittal and Payment of Claims and Source Documents

52. Program Income

53. False Claims

54. Protection of Personally Identifiable Information (PII)

55. Domestic Preference for Procurements

B. WORKFORCE INNOVATION & OPPORTUNITY ACT (WIOA) PROGRAMS . 19

1. Compliance

2. Charging of Costs

3. Allowable Costs

4. Maintenance of Effort/Union Concurrence

5. Prevailing Wage

6. Minimum Wage

7. Benefits and Working Conditions

Revised 4/2/2021

8. Additional Nondiscrimination and Equal Opportunity Provisions

9. Conflict of Provisions

10. Definitions

11. Tracking Costs by WIOA Cost Category

12. Financial Aid

13. Reporting Fraud and Abuse

14. California Labor Code, Fair Labor Standard Acts as Amended

15. Training Conditions

16. Recovery of WIOA Tuition and Training Refunds

17. Property Management

18. Theft and Embezzlement

19. Duplicate Funding

20. Relocation Act

21. Selective Service Act

22. Employment Generating Activities Prohibition

23. Duplication of Facilities or Services

24. Rights

INTRODUCTION

The General Conditions, Assurances and Certifications shall apply to and are incorporated into this contract. To the extent there is any conflict between the General Conditions, Assurances and Certifications and any other provision in this contract, the General Conditions, Assurances and Certifications shall prevail. To the extent that provisions in the General Conditions, Assurances and Certifications relate to services or activities not encompassed in the subject contract, those provisions do not apply.

A. GENERAL CONTRACT CONDITIONS

1. Reports The Contractor shall submit timely and accurate programmatic and financial reports in accordance with the contract and County Directives.

2. Limits of Obligation The Contractor shall be paid in accordance with the contract and budget, not to exceed the maximum amount specified. Any cost incurred by the Contractor over and above the maximum amount obligated by the contract and budget shall be at the sole risk and expense of the Contractor.

3. Documentation and Procurement Requirements The Contractor shall maintain documentation of all services and contract costs and comply with all applicable procurement requirements. Such documentation and procurement must be in accordance with the contract requirements and all applicable federal, State, and County requirements, and provide sufficient detail (i.e., original source documents) to support Contractor purchases, claims for reimbursement and payments made under the contract.

4. Disallowed Costs Contractor shall be liable for all amounts which are determined to be due as a result of disallowance by the Federal Government, the State of California, or the County of Ventura or any other governmental agency with jurisdiction, when such disallowance is the result of the Contractor’s or its Subcontractor’s conduct. Payment of any disallowed costs must be made within 30 days of notification of the disallowed costs, unless otherwise specified by County. The Contractor shall comply with the provisions set forth in the County’s Audit Resolution Procedure, hereby incorporated by reference, regarding Contractor’s liability for expenditures disallowed by an auditor. Contractor will be notified of any disallowed costs or any other controversy or proceeding between County, the State of California or the federal government arising from the performance of the contract.

5. Availability of Funds

a. The contract is valid and enforceable only if sufficient funds are made available to the County from the appropriate funding source and are appropriated by the County Board of Supervisors for the purpose set forth in the contract.

b. At the expiration of the term of the contract or upon termination prior to the

Revised 4/2/2021 expiration of the contract, and after all payments have been made to the Contractor for services provided, any remaining funds that were previously obligated under the contract shall revert to the County.

c. The County retains the right to suspend financial assistance, in whole or in part, to protect the integrity of the funds or to ensure proper operation of the program, providing the Contractor is given prompt notice and the opportunity for a hearing within 30 days from such suspension. Failure on the part of the Contractor or a Subcontractor to comply with the provisions of the contract or with applicable law, when such failure involves the allegation of fraud as a result of a monitoring or other program review or misappropriation of funds, may result in immediate de-obligation and withholding of funds and debarment from program operation.

6. Administrative Directives, Unilateral Modifications, Contract Directives The County may issue administrative directives, unilateral modifications and contract directives concerning interpretations of Federal or State laws, rules and regulations, and directives received from the Federal Government or the State, and/or from the County Board of Supervisors, which may require changes in procedures by the Contractor.

Contractor will be deemed responsible for complying with such administrative and contract directives and/or modifications only after being formally notified in writing of appropriate action necessary.

7. Venue and Construction The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties under this contract, will be construed pursuant to and in accordance with the laws of the State of California. The parties acknowledge that the contract is entered into and is to be performed in the County of Ventura, State of California. In any legal proceeding relating to the contract, the parties agree that for all purposes venue shall be in the County of Ventura, State of California.

8. Ownership of Work Product Upon the termination of the contract for any reason, all data, documents, films, tapes and all reports or any other work products paid for by grant or other funds provided by federal, State, and County and prepared by the Contractor in the course of operating the program, will become the property of the County. This will not include any information that is proprietary to the Contractor, unless otherwise agreed to by the parties in writing.

9. Personnel Disclosure Contractor shall make available to County, upon request, a current list of all personnel providing services under the contract. The list shall include: (1) the names and job titles of all full or part-time staff and volunteers providing services under the contract, (2) a brief description of each position and the FTE hours allocated, and (3) the professional degree, if applicable, and experience required for each position.

10. Responsibility for Equipment County shall not be responsible nor be held liable for any damage to person or property

Revised 4/2/2021 consequent upon the use, misuse, or failure of any equipment used by Contractor or any of Contractor’s employees, even though such equipment is furnished, rented, or loaned to Contractor by County. The acceptance or use of any such equipment by Contractor or Contractor’s employees shall be construed to mean that Contractor accepts full responsibility for and agrees to exonerate, indemnify and hold harmless County from and against any and all claims for any damage whatsoever resulting from the use, misuse, or failure of such equipment.

11. Contamination and Pollution Contractor, solely at its own cost and expense, will provide clean up of any premises, property or natural resources contaminated or polluted due to Contractor activities. Any fines, penalties, punitive or exemplary damages assigned due to contaminating or polluting activities of the Contractor will be borne entirely by the Contractor.

12. Hiring/Paying Board of Directors Prohibited Contractor shall not hire, nor compensate from contract funds, any of its governing body to provide services under the contract without the written approval of County.

13. Subcontracts All subcontracts between Contractor and another party involving the operation of the contract must be in writing and will first be presented to the County for approval, and do not create a contractual relationship between such third party and the County. Failure to obtain such prior approval of the County may result in the immediate termination of the contract at the sole and absolute discretion of the County.

a. Any subcontracts entered into by the Contractor must be in compliance with all applicable Federal and State procurement laws, policies, or regulations.

b. Any of the work or services specified in the contract which will be performed by other than the Contractor will be evidenced by a written agreement specifying the terms and conditions of such performance.

c. The Contractor will maintain and adhere to an appropriate system, consistent with Federal, state, and local law, for the procurement, award and monitoring of contracts which contain acceptable standards for insuring accountability.

d. The system for awarding contracts will contain safeguards to ensure that the Contractor does not contract with any entity whose officers have been convicted of fraud or misappropriation of funds within the last five (5) years.

e. The system for soliciting and/or developing fixed unit price contracts must include sufficient documented analysis to assure that costs billed as a single-unit charge are reasonable and supportable, based on the prevailing rate of such services obtained from competitive sources, or that costs are justifiable, predicated on the unique nature of the service provided.

f. No subcontract shall alter in any way any legal responsibility of Contractor to

Revised 4/2/2021

County. County has the right to refuse reimbursement for obligations incurred under any subcontract which does not comply with the terms of the contract.

g. For any contract being supported in part or in whole with federal funds, it is the responsibility of the Contractor to ensure that any subcontractors are not debarred or suspended from receiving from federal funds prior to issuance of the subaward, and that subcontracts adhere to the same criteria set forth in this contract in section

48. Debarment and Suspension Certification. Contractors must verify that subcontractors have no active exclusions by using the System for Award Management at www.SAM.gov.

14. Political Activities Prohibited (Hatch Act) & Byrd Anti-Lobbying Amendment None of the funds, provided directly or indirectly, under the contract shall be used for any political activities or to further the election or defeat of any candidate for public office. In addition, the Contractor will comply with the provisions of the Hatch Act as amended, which limits the political activities of employees.

For contracts over $100,000 Contractor must comply with the Byrd Anti-Lobbying Amendment (31 U.S.C. 1352).

15. Energy Efficiency Contractor shall comply with mandatory standards and policies relating to energy efficiency in the California Energy Code, Title 24, part 6, as required by the U.S. Energy Policy and Conservation Act (42 U. S. C. § § 6201 et seq.).

16. Clean Air and Water Acts For all contracts between County and Contractor in excess of $150,000, Contractor shall comply with Section 306 of the Clean Air Act (42 USC § 7606), Section 508 of the Clean Water Act (33 USC 1368), Executive Order 11738 and United States Environmental Protection Agency regulations (Title 2 of CFR).

17. Solid Waste Disposal Act.

For all contracts between County and Contractor in which an item or items in excess of $10,000 are procured, Contractor shall comply with Section 6002 of the Solid Waste Disposal Act (42 U.S.C. § 6962) and 40 CFR part 247.

18. Sectarian Activities As part of or in connection with the performance of this contract, Contractor shall not engage in, aid or permit religious instruction, proselytization, or any other activities that would amount to an improper aid to or establishment of religion, or a violation of "free exercise" rights, in violation of the United States Constitution (First Amendment), California Constitution (Art. I, § 4; art.