California Department of Veterans Affairs Agreement Number: 25FS0040 Exhibit A - Scope of Work TBD

PHARMACY REGIMEN SERVICES

1. INTRODUCTION/SERVICES

A. The Contractor shall provide Pharmacy Regimen Services to the California Department of Veterans

Affairs (CalVet) for the benefit and care of the Veterans Home Residents. The Contractor shall provide all labor, materials, staff, licenses, permits, and every other item of expense necessary to perform services, unless otherwise stated. Services shall be provided at the Veterans Home of California - Fresno, located at 2811 West Cesar Chavez Blvd., Fresno, CA 93706.

B. The Contractor/Provider must perform services under the scope of their license and in accordance with federal and state laws and regulations, as well as CalVet policies and procedures.

C. All services performed outside the scope of this Agreement will be at the sole risk and expense of the

Contractor.

2. CONTRACTOR’S RESPONSIBILITIES

A. The Contractor shall provide consultation regarding all material aspects of providing pharmaceutical services to the Home.

B. Services and all requirements as stated below and as required by law shall be provided by the Contractor, at the request of the Chief Medical Officer (CMO), Contract Manager, or designee.

C. Services shall be rendered for the Home's one hundred eighty (180) bed capacity Residential Care

Facility for the Elderly (RCFE) and the one hundred twenty (120) bed capacity Skilled Nursing Facility

(SNF).

D. The Contractor shall collaborate with the Home and the Home’s CMO to:

1) Develop, implement, evaluate, and revise (as necessary) procedures for the provision of pharmaceutical services.

2) Strive to assure that medications and/or biologicals are requested, received, and administered in a timely manner as ordered by the authorized prescriber (in accordance with applicable law).

3) Assist Home in determining that residents’ medication therapy is necessary and appropriate.

4) Assist Home in determining that medications are labeled in accordance with federal and state labeling requirements and accepted standards of practice.

5) Assist Home in reviewing the safe and secure storage of medications in locked compartments under proper temperature controls in accordance with the manufacturer’s specifications.

6) Assist Home in developing and implementing safeguards and systems to control, account for, and periodically reconcile controlled medications.

E. The Contractor shall conduct a medication regimen review (MRR) for each SNF resident at least once a month and 6 months or as directed for RCFE residents. This review must be done in-house by the Pharmacist in person, and eventually might be able to be done off-site remotely using EHR once the system is fully operational and the Home is in agreement.

F. For residents with an acute change of condition, the Contractor will provide, upon written request of the

Home, an Interim Medication Regimen Review (iMRR).

• The Home will be going electronic (EHR) as of April 1, 2026, and the contractor will have access to those records. Therefore can provide iMRR while being offsite.

G. The Contractor may collaborate with the Home and the Home’s CMO to develop, implement, perform, participate in, or advise with respect to any of the following:

1) Medication observation evaluations of the Home’s capabilities in person.

2) Meetings in addition to the quarterly Quality Assurance Committee meeting.

3) Facility staff in-service education programs beyond two (2) per year.

4) Non-financial audits relating to the provisions of medications.

5) Potential narcotic diversion investigations.

6) Family and/or resident council activities.

7) Facility accreditation services.

8) Drug utilization and/or evaluation activities at the request of the Home.

9) Assistance in getting the Facility prepared for surveys.

10) Narcotic and/or drug destruction, regardless of whether such a task is required by law, is to be completed in person and done on a regular basis.

11) Anticoagulation dosing as requested by a prescriber; and/or

12) Services provided by the Contractor as part of corrective action plans.

H. The Contractor agrees to provide services in accordance with the health standards, policies, and procedures of the Home and in compliance with the requirements of Title 22, California Code of Regulations (CCR) and Title 42 (42 CFR}, Chapter IV, §483.60 pertaining to Intermediate Care Facilities, United States Department of Veterans Affairs (USDVA) Standards for Domiciliary Care C 10, Pharmacy, a through f and Standards for Nursing Home Care, Section 51.120 m and Quality of Care, Unnecessary Drugs and Medications Errors.

I. Drug regimen reviews shall be in accordance with California Code of Regulations Title 22, §72375, Code of Federal Regulations, Title 42 (42 CFR), Chapter IV, §483.60, and internal operational policies and procedures currently in effect at the Home.

J. The Contractor shall consult with the Fresno and Yountville Home's Pharmacy Services Committee to provide workable pharmacy policies and procedures to ensure the Home's compliance with pharmaceutical federal, state, and local food and drug regulations.

K. The Contractor shall provide the Home's Pharmacy Services Committee with current, updated, and pertinent new drug information, including indications and interactions information.

L. The Contractor shall coordinate monthly inspections of each nursing station and its related drug storage area.

M. The Contractor shall maintain a detailed log of time spent in Contractor-related activities and submit copies of the log on a monthly basis to the contract manager. The log shall, at a minimum, list date(s) of service, type(s) of service, hours of service, results, and/or recommendations.

N. The Contractor shall conduct a planned in-service education program for the Home's nursing staff and physician staff on topics related to pharmacy services on an ad-hoc basis. Training sessions should be of sufficient time to cover topics presented.

O. The Contractor shall serve on Home committees, as required by regulation and as requested by the Home. A pharmacist is a required member of the Home's Pharmaceutical Services Committee and the Infection Control Committee which meet at least quarterly. A pharmacist is a required member of the Home's Patient Care Policy Committee that meets at least annually. A pharmacist may be requested to serve on the Home's Quality Assurance Committee or a committee of similar functions.

P. The Contractor shall provide support to and be available by telephone to the Home's staff during Department of Public Health (CDPH) or USDVA reviews and inspections.

Q. The Contractor shall participate in the Home's Quality Assurance Program upon written request by the contract manager or his/her designee and submit a Quarterly ORR QA Report to the contract manager during the term of the contract. The Quarterly ORR QA Report must include:

1) Pharmacist's activities for the quarter

2) Drug regimen review

3) Pharmacy Systems review (Yountville)

4) Facility Systems review (Fresno)

5) Chart orders

6) Controlled drugs

7) Medication preparation, administration, and documentation

8) Psychotic medication orders

9) Medication storage

10) Recommendation

R. The Contractor shall ensure employees performing work at the Home possess current, valid licenses for the performance of their contract responsibilities and provide copies of licenses and a completed resume for each contract participant who will exercise a major administrative role or major policy or Contractor role, as identified by the Contractor. The Contractors should follow Veteran Home HR guidelines for any other requirements, such as physical exams or background checks

S. The Contractor shall notify, arrange, and meet with the contract manager to implement policies and procedures for the administration of the contract.

T. The Contractor shall notify, arrange, and meet, at least quarterly, with the Contract Manager to discuss the Contractor's performance under the terms and conditions and provisions of this contract.

U. Reports

1) A written report regarding the provision of pharmaceutical services will be provided to the Home Monthly for SNF and quarterly for RCFE (or more frequently if required by applicable law). The report should include, but not be limited to, the resident's name, drug regimen, findings, including irregularities, and comments/recommendations. The report must be submitted to the contract manager at a time mutually agreed upon by the Contractor and the Home.

2) The Contractor shall provide the Home's contract manager with a detailed Inspection Report on each nursing station and drug storage area.

3) CalVet reserves the right to request the Contractor provide additional reports or information as needed. The reports shall be submitted in electronic format and sent via electronic mail as requested by CalVet. If electronic mail is not available, arrangements will be mutually agreed upon by the Contractor and CalVet Contract Manager or designee.

3. CONTRACTOR/PROVIDER’S QUALIFICATIONS

A. The Contractor must meet the requirements and have the ability to adequately provide services to the

Home’s Residents. The Contractor may use Providers to perform services that meet the requirements specified in this Agreement. The Contractor must provide the State with proof of any required training, licenses, permits, certifications, and any other documents required by law, including documents for each Provider performing services under this Agreement.

B. The Contractor must possess at least five (5) years of experience providing pharmacy consulting services in intermediate, skilled, and other domiciliary facilities within the State of California. The five (5) years of experience must have occurred within the last ten (10) years and must have included:

1) Providing monthly drug regimen reviews - Communicating problems and recommendations to physicians, nurses, and administrators

2) Providing drug storage inspections

3) Auditing nurses’ medication pass-techniques

4) Providing recapitulation services (Physician Orders, Treatment Records, and Medication

Administration Records).

C. The Contractor/Providers must have the required licenses, insurance, permits, and/or certifications noted herein.

D. Resident health care is of paramount importance. Accuracy in communications is critical to ensure that timely, correct care is provided. Therefore, any Provider(s) providing services through this Agreement must be able to communicate effectively with CalVet.

E. Any Provider who fails to meet the qualifications shall not be permitted to perform service. The Home’s

CMO, SNF Administrator, Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet qualifications. After notification of failure to meet qualifications has been provided, CalVet shall not pay the Contractor for additional services identified as not meeting the qualifications.

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

A. Prior to providing services specified in this Agreement, Contractor or Contractor’s Provider shall possess and maintain throughout the term of this Agreement all licenses, permits, and certification requirements.

B. Bidder must possess a current license issued by the California State Board of Pharmacy.

C. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CalVet may withhold payment for services rendered during the expiration period and/or immediately terminate this Agreement.

D. Assume responsibility for verifying, through the appropriate licensing boards, that no current or unresolved adverse actions have been taken by the State licensing authorities against any Provider(s) assigned to CalVet, and that all licenses are active and void of misconduct. CalVet may, at its discretion, verify the current status of the Provider(s) assigned.

5. BACKGROUND CLEARANCE

A. Background clearance involving fingerprinting is required by the Home’s policy of State employees, contract employees, and volunteers prior to assignment to the Home to meet State facility licensure requirements.

B. The Home’s Personnel Office will coordinate fingerprinting at the local Live-Scan site. Live-scan is the only acceptable form of fingerprinting for the Home. The Home will bear the one-time cost of fingerprinting fees for the Contractor selected to perform services at the Home only when the Contractor utilizes the Live-Scan site recognized by the Home.

C. In the event the prospective Contractor fails to appear for the Live-Scan fingerprinting within the prescribed period or appointment, the individual will not be considered for assignment at the Home.

D. Contractor shall be solely responsible for the cost when selecting an alternate Live-Scan site. The

Home’s Personnel Office must receive the Live-Scan results prior to approving the assignment to the Home.

6. HEALTH CLEARANCE

The Contractor shall comply with the Home’s infection control policies and procedures including COVID and Flu Policy and processes, Initial and annual health clearance, at the Contractor’s cost, to include tuberculosis (TB) screening and Hepatitis B vaccine series (initial only) is required by the Home policy of all contract employees and volunteers in order to meet state facility licensure requirements.

A. Initial TB screening may include, but not be limited to, 2-step TST/PPD testing and/or X-ray, and TB questionnaire. Annual TB screening may include, but not be limited to, 1-step TST/PPD testing and/or X-ray, and TB questionnaire. The health clearance process must be completed prior to initiation of services or employee assignment, and within the required timeframe stipulated by the Home for the annual requirement.

B. Pre-employment or pre-assignment health screening performed for the Contractor will be at the Contractor’s expense. As part of compliance with OSHA Regulation 1910.1030 – Bloodborne Pathogens, the Home will extend the Hepatitis B vaccine series offer to the requesting Contractor. The Home reserves the right to charge a per-individual fee consistent with community rates for health screening and vaccination services performed at the Home. Such fee(s) will be deducted from the Contractor’s invoice.

C. Requests to utilize the Contractor’s own health care provider for employment health clearance to include, but not limited to, TB Testing and/or X-Ray, and Hepatitis B vaccination series offer, shall be made directly to the Contract Manager. When utilizing the Contractor’s own health care provider, the Contractor shall submit medical reports/documentation to the Home’s Ambulatory Care Clinic indicating clearance to perform duties and be free of communicable disease. The medical documentation must be submitted prior to initiation of services and within the required timeframe stipulated by the Home for the annual

D. Failure to comply with the Home’s infection control policies shall result in immediate suspension, contract suspension, or termination. Any suspension will remain in effect until a medical clearance is provided to the Home’s Infection Control Specialist or Chief Physician & Surgeon.

7. INDEPENDENT CONTRACTOR STATUS

The Contractor/Providers shall be considered “Independent Contractors” in relation to CalVet and the State.

Therefore, the Contractor/Providers shall not be considered employee(s) of the Home and shall not be entitled to any employee benefits from CalVet or the State, including, but not limited to, the following:

A. Premium Pay, Overtime Pay, or Holiday Pay, B. Medical Insurance, C. Vacation or Sick Leave, D. Worker’s Compensation; and E. Other employee benefits.

8. AMENDMENT OPTION

If it is determined to be in the best interest of the State, the State may extend the term of the Agreement for an additional twelve (12) months through an amendment signed by both parties. The rates specified in Exhibit B shall remain in effect for the term of the Agreement, including any extension of the term through a formal amendment.

9. CONTACT INFORMATION

A. The project representatives during the term of this Agreement will be:

1. CalVet Home Representative:

TBD

2. Contractor Representative:

B. Project Representatives, addresses, and phone/fax numbers may be changed by issuing a twenty (20)-day prior written notification and shall not require a formal amendment to this Agreement. The notifying party shall provide complete contact information for the replacement Project Representative, including name, title, mailing address, phone/fax numbers, and email address.

PHARMACY REGIMEN SERVICES

1. INTRODUCTION/SERVICES

A. The Contractor shall provide Pharmacy Regimen Services to the California Department of Veterans

Affairs (CalVet) for the benefit and care of the Veterans Home Residents. The Contractor shall provide all labor, materials, staff, licenses, permits, and every other item of expense necessary to perform services, unless otherwise stated. Services shall be provided at the Veterans Home of California - Fresno, located at 2811 West Cesar Chavez Blvd., Fresno, CA 93706.

B. The Contractor/Provider must perform services under the scope of their license and in accordance with federal and state laws and regulations, as well as CalVet policies and procedures.

C. All services performed outside the scope of this Agreement will be at the sole risk and expense of the

Contractor.

2. CONTRACTOR’S RESPONSIBILITIES

A. The Contractor shall provide consultation regarding all material aspects of providing pharmaceutical services to the Home.

B. Services and all requirements as stated below and as required by law shall be provided by the Contractor, at the request of the Chief Medical Officer (CMO), Contract Manager, or designee.

C. Services shall be rendered for the Home's one hundred eighty (180) bed capacity Residential Care

Facility for the Elderly (RCFE) and the one hundred twenty (120) bed capacity Skilled Nursing Facility

(SNF).

D. The Contractor shall collaborate with the Home and the Home’s CMO to:

1) Develop, implement, evaluate, and revise (as necessary) procedures for the provision of pharmaceutical services.

2) Strive to assure that medications and/or biologicals are requested, received, and administered in a timely manner as ordered by the authorized prescriber (in accordance with applicable law).

3) Assist Home in determining that residents’ medication therapy is necessary and appropriate.

4) Assist Home in determining that medications are labeled in accordance with federal and state labeling requirements and accepted standards of practice.

5) Assist Home in reviewing the safe and secure storage of medications in locked compartments under proper temperature controls in accordance with the manufacturer’s specifications.

6) Assist Home in developing and implementing safeguards and systems to control, account for, and periodically reconcile controlled medications.

E. The Contractor shall perform a Medication Regimen Review (MRR) for each resident as follows:

1) SNF Residents: At least once every thirty (30) calendar days.

2) RCFE Residents: At least once every six (6) months, or more frequently if authorized by the Home.

MRR services shall be conducted on-site and in person by a licensed Pharmacist. MRR services may be performed remotely only after full implementation of the Home’s Electronic Health Record (EHR) system and with prior written approval from the Home. All remote services must comply with applicable confidentiality and data security requirements.

The Contractor shall document all MRR activities, findings, and recommendations in the resident’s medical record in accordance with Home requirements.

F. For residents with an acute change of condition, the Contractor will provide, upon written request of the

Home, an Interim Medication Regimen Review (iMRR).

• The Home will be going electronic (EHR) as of April 1, 2026, and the contractor will have access to those records. Therefore can provide iMRR while being offsite.

G. The Contractor may collaborate with the Home and the Home’s CMO to develop, implement, perform, participate in, or advise with respect to any of the following:

1) Medication observation evaluations of the Home’s capabilities in person.

2) Meetings in addition to the quarterly Quality Assurance Committee meeting.

3) Facility staff in-service education programs beyond two (2) per year.

4) Non-financial audits relating to the provisions of medications.

5) Potential narcotic diversion investigations.

6) Family and/or resident council activities.

7) Facility accreditation services.

8) Drug utilization and/or evaluation activities at the request of the Home.

9) Assistance in getting the Facility prepared for surveys.

10) Narcotic and/or drug destruction, regardless of whether such a task is required by law, is to be completed in person and done on a regular basis.

11) Anticoagulation dosing as requested by a prescriber; and/or

12) Services provided by the Contractor as part of corrective action plans.

H. The Contractor agrees to provide services in accordance with the health standards, policies, and procedures of the Home and in compliance with the requirements of Title 22, California Code of Regulations (CCR) and Title 42 (42 CFR}, Chapter IV, §483.60 pertaining to Intermediate Care Facilities, United States Department of Veterans Affairs (USDVA) Standards for Domiciliary Care C 10, Pharmacy, a through f and Standards for Nursing Home Care, Section 51.120 m and Quality of Care, Unnecessary Drugs and Medications Errors.

I. Drug regimen reviews shall be in accordance with California Code of Regulations Title 22, §72375, Code of Federal Regulations, Title 42 (42 CFR), Chapter IV, §483.60, and internal operational policies and procedures currently in effect at the Home.

J. The Contractor shall consult with the Fresno and Yountville Home's Pharmacy Services Committee to provide workable pharmacy policies and procedures to ensure the Home's compliance with pharmaceutical federal, state, and local food and drug regulations.

K. The Contractor shall provide the Home's Pharmacy Services Committee with current, updated, and pertinent new drug information, including indications and interactions information.

L. The Contractor shall coordinate monthly inspections of each nursing station and its related drug storage area.

M. The Contractor shall maintain a detailed log of time spent in Contractor-related activities and submit copies of the log on a monthly basis to the contract manager. The log shall, at a minimum, list date(s) of service, type(s) of service, hours of service, results, and/or recommendations.

N. The Contractor shall conduct a planned in-service education program for the Home's nursing staff and physician staff on topics related to pharmacy services on an ad-hoc basis. Training sessions should be of sufficient time to cover topics presented.

O. The Contractor shall serve on Home committees, as required by regulation and as requested by the Home. A pharmacist is a required member of the Home's Pharmaceutical Services Committee and the Infection Control Committee which meet at least quarterly. A pharmacist is a required member of the Home's Patient Care Policy Committee that meets at least annually. A pharmacist may be requested to serve on the Home's Quality Assurance Committee or a committee of similar functions.

P. The Contractor shall provide support to and be available by telephone to the Home's staff during Department of Public Health (CDPH) or USDVA reviews and inspections.

Q. The Contractor shall participate in the Home's Quality Assurance Program upon written request by the contract manager or his/her designee and submit a Quarterly ORR QA Report to the contract manager during the term of the contract. The Quarterly ORR QA Report must include:

1) Pharmacist's activities for the quarter

2) Drug regimen review

3) Pharmacy Systems review (Yountville)

4) Facility Systems review (Fresno)

5) Chart orders

6) Controlled drugs

7) Medication preparation, administration, and documentation

8) Psychotic medication orders

9) Medication storage

10) Recommendation

R. The Contractor shall ensure employees performing work at the Home possess current, valid licenses for the performance of their contract responsibilities and provide copies of licenses and a completed resume for each contract participant who will exercise a major administrative role or major policy or Contractor role, as identified by the Contractor. The Contractors should follow Veteran Home HR guidelines for any other requirements, such as physical exams or background checks

S. The Contractor shall notify, arrange, and meet with the contract manager to implement policies and procedures for the administration of the contract.

T. The Contractor shall notify, arrange, and meet, at least quarterly, with the Contract Manager to discuss the Contractor's performance under the terms and conditions and provisions of this contract.

U. Reports

1) A written report regarding the provision of pharmaceutical services will be provided to the Home Monthly for SNF and quarterly for RCFE (or more frequently if required by applicable law). The report should include, but not be limited to, the resident's name, drug regimen, findings, including irregularities, and comments/recommendations. The report must be submitted to the contract manager at a time mutually agreed upon by the Contractor and the Home.

2) The Contractor shall provide the Home's contract manager with a detailed Inspection Report on each nursing station and drug storage area.

3) CalVet reserves the right to request the Contractor provide additional reports or information as needed. The reports shall be submitted in electronic format and sent via electronic mail as requested by CalVet. If electronic mail is not available, arrangements will be mutually agreed upon by the Contractor and CalVet Contract Manager or designee.

3. CONTRACTOR/PROVIDER’S QUALIFICATIONS

A. The Contractor must meet the requirements and have the ability to adequately provide services to the

Home’s Residents. The Contractor may use Providers to perform services that meet the requirements specified in this Agreement. The Contractor must provide the State with proof of any required training, licenses, permits, certifications, and any other documents required by law, including documents for each Provider performing services under this Agreement.

B. The Contractor must possess at least five (5) years of experience providing pharmacy consulting services in intermediate, skilled, and other domiciliary facilities within the State of California. The five (5) years of experience must have occurred within the last ten (10) years and must have included:

1) Providing monthly drug regimen reviews - Communicating problems and recommendations to physicians, nurses, and administrators

2) Providing drug storage inspections

3) Auditing nurses’ medication pass-techniques

4) Providing recapitulation services (Physician Orders, Treatment Records, and Medication

Administration Records).

C. The Contractor/Providers must have the required licenses, insurance, permits, and/or certifications noted herein.

D. Resident health care is of paramount importance. Accuracy in communications is critical to ensure that timely, correct care is provided. Therefore, any Provider(s) providing services through this Agreement must be able to communicate effectively with CalVet.

E. Any Provider who fails to meet the qualifications shall not be permitted to perform service. The Home’s

CMO, SNF Administrator, Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet qualifications. After notification of failure to meet qualifications has been provided, CalVet shall not pay the Contractor for additional services identified as not meeting the qualifications.

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

A. Prior to providing services specified in this Agreement, Contractor or Contractor’s Provider shall possess and maintain throughout the term of this Agreement all licenses, permits, and certification requirements.

B. Bidder must possess a current license issued by the California State Board of Pharmacy.

C. If, during the course of this Agreement, any of the licenses and/or requirements are found to be inactive or not in compliance, CalVet may withhold payment for services rendered during the expiration period and/or immediately terminate this Agreement.

D. Assume responsibility for verifying, through the appropriate licensing boards, that no current or unresolved adverse actions have been taken by the State licensing authorities against any Provider(s) assigned to CalVet, and that all licenses are active and void of misconduct. CalVet may, at its discretion, verify the current status of the Provider(s) assigned.

5. BACKGROUND CLEARANCE

A. Background clearance involving fingerprinting is required by the Home’s policy of State employees, contract employees, and volunteers prior to assignment to the Home to meet State facility licensure requirements.

B. The Home’s Personnel Office will coordinate fingerprinting at the local Live-Scan site. Live-scan is the only acceptable form of fingerprinting for the Home. The Home will bear the one-time cost of fingerprinting fees for the Contractor selected to perform services at the Home only when the Contractor utilizes the Live-Scan site recognized by the Home.

C. In the event the prospective Contractor fails to appear for the Live-Scan fingerprinting within the prescribed period or appointment, the individual will not be considered for assignment at the Home.

D. Contractor shall be solely responsible for the cost when selecting an alternate Live-Scan site. The

Home’s Personnel Office must receive the Live-Scan results prior to approving the assignment to the Home.

6. HEALTH CLEARANCE

The Contractor shall comply with the Home’s infection control policies and procedures, including COVID and Flu Policy and processes, Initial and annual health clearance, at the Contractor’s cost, to include tuberculosis

(TB) screening and Hepatitis B vaccine series (initial only) is required by the Home policy of all contract employees and volunteers in order to meet state facility licensure requirements.

A. Initial TB screening may include, but not be limited to, 2-step TST/PPD testing and/or X-ray, and TB questionnaire. Annual TB screening may include, but not be limited to, 1-step TST/PPD testing and/or X-ray, and TB questionnaire. The health clearance process must be completed prior to initiation of services or employee assignment, and within the required timeframe stipulated by the Home for the annual

B. Pre-employment or pre-assignment health screening performed for the Contractor will be at the Contractor’s expense. As part of compliance with OSHA Regulation 1910.1030 – Bloodborne Pathogens, the Home will extend the Hepatitis B vaccine series offer to the requesting Contractor. The Home reserves the right to charge a per-individual fee consistent with community rates for health screening and vaccination services performed at the Home. Such fee(s) will be deducted from the Contractor’s invoice.

C. Requests to utilize the Contractor’s own health care provider for employment health clearance to include, but not limited to, TB Testing and/or X-Ray, and Hepatitis B vaccination series offer, shall be made directly to the Contract Manager. When utilizing the Contractor’s own health care provider, the Contractor shall submit medical reports/documentation to the Home’s Ambulatory Care Clinic indicating clearance to perform duties and be free of communicable disease. The medical documentation must be submitted prior to initiation of services and within the required timeframe stipulated by the Home for the annual

D. Failure to comply with the Home’s infection control policies shall result in immediate suspension, contract suspension, or termination. Any suspension will remain in effect until a medical clearance is provided to the Home’s Infection Control Specialist or Chief Physician & Surgeon.

7. INDEPENDENT CONTRACTOR STATUS

The Contractor/Providers shall be considered “Independent Contractors” in relation to CalVet and the State.

Therefore, the Contractor/Providers shall not be considered employee(s) of the Home and shall not be entitled to any employee benefits from CalVet or the State, including, but not limited to, the following:

A. Premium Pay, Overtime Pay, or Holiday Pay, B. Medical Insurance, C. Vacation or Sick Leave, D. Worker’s Compensation; and E. Other employee benefits.

8. AMENDMENT OPTION

If it is determined to be in the best interest of the State, the State may extend the term of the Agreement for an additional twelve (12) months through an amendment signed by both parties. The rates specified in Exhibit B shall remain in effect for the term of the Agreement, including any extension of the term through a formal

9. CONTACT INFORMATION

A. The project representatives during the term of this Agreement will be:

1. CalVet Home Representative:

2. Contractor Representative:

B. Project Representatives, addresses, and phone/fax numbers may be changed by issuing a twenty (20)-day prior written notification and shall not require a formal amendment to this Agreement. The notifying party shall provide complete contact information for the replacement Project Representative, including name, title, mailing address, phone/fax numbers, and email address.

Exhibit B - Budget Detail and Payment Provisions TBD

1. STANDARD BUDGET DETAIL AND PAYMENT PROVISIONS

A. Invoicing and Payment

1. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to compensate the Contractor for services rendered in accordance with the rates in Exhibit B-1.

2. Invoices shall include the Agreement Number and shall be submitted not more frequently than monthly in arrears to:

Original Invoice Approval Copy Department of Veterans Affairs CalVet Accounting Office 1227 “O” Street Room 402 Sacramento, CA 95814 APInvoices@calvet.ca.gov

Veterans Home of California – Fresno Attn: TBD 2811 West Cesar Chavez Blvd Fresno, CA 93706

B. Budget Contingency Clause

1. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further form and effect. In this event, the State shall have no liability to pay any funds whatsoever to the Contractor or to furnish any other considerations under this Agreement, and the Contractor shall not be obligated to perform any provisions of this Agreement.

2. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State or offer an Agreement amendment to the Contractor to reflect the reduced amount.

C. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code, Chapter 4.5, commencing with Section 927.

2. SPECIAL BUDGET DETAIL AND PAYMENT PROVISIONS

Submissions of Invoices/Claims

A. All invoices/claims must be completed thoroughly and legibly, with all applicable fields completed.

Invoices/claims that are submitted to the appropriate location but have been altered, or are inaccurate, or do not provide all necessary information will not be accepted and will be returned to the Contractor for correction.

B. Any changes to this provision relating to the invoice/claim submittal process, including but not limited to an address, form, or process change, shall be an administrative change managed through the appropriate designated CalVet office and shall not require a contract amendment.

C. Contractor shall submit monthly invoices to the CalVet Contract Manager for approval and processing.

Invoices/claims submitted shall include the following information in order to be considered complete and acceptable for processing, or the invoice/claim will be returned:

1) Contractor’s Company name exactly as it appears on the Payee Data Record (STD.204)

2) Contractor’s Company address, phone number, and e-mail

3) Date of invoice/claim

4) Invoice/claim number

Exhibit B - Budget Detail and Payment Provisions TBD

5) CalVet location where services were performed

6) Contract/Agreement Number

7) Date(s) of Service

8) Total dollar amount being billed

9) First and Last name of Contractor or Provider performing services, if applicable

10) Contractor’s or Provider’s Classification, whichever is applicable

11) When applicable, Contractors shall include the following information on the invoice/claim submitted for hourly reimbursement:

a) Hourly Rate

b) Time in and time out

c) Total hours worked

d) Any other information or documentation reasonably required to verify and substantiate the provision of services and the charges for such services.

3. CONTRACTOR OVERPAYMENTS

A. If the State determines that an overpayment has been made to the Contractor, the State will seek recovery immediately upon discovery of the overpayment by: (a) calling the Contractor’s accounting office to request a refund of the overpayment amount, or (b) offsetting subsequent Contractor payments by the amount of the overpayment if Contractor repayment or credit is not received within thirty (30) days from the date of notice.

B. If the Contractor discovers it has received an overpayment, the Contractor must notify the State and refund the overpayment immediately.

4. DVBE Withhold

A. For contracts with DVBE subcontractors pursuant to Mil. & Vet. Code Section 999.7, ten thousand dollars ($10,000) will be withheld from the final payment, or the full final payment if less than ten thousand dollars ($10,000), until the prime contractor complies with the certification requirements of subdivision (d) of Mil.

& Vet. Code Section 999.5. The prime contractor shall be given 30 days’ notice to cure the defect. If, after 30 calendar days from the date of notice, the prime contractor refuses to comply with the certification requirements, CalVet shall permanently deduct ten thousand dollars ($10,000) from the final payment, or the full payment if less than ten thousand dollars ($10,000).

B. CalVet shall maintain all records of the information provided by the prime contractor pursuant to Section

999.5 and shall establish appropriate review procedures for those records to ensure the accuracy and completeness of the award amounts and paid amounts reported. The records shall be maintained in a manner that facilitates access and review by external auditors. Records collected pursuant to this section shall be retained for a minimum of six years after collection. (Mil. & Vet. Code Section 999.55)

Exhibit B-1, Rate Sheet TBD

RATE SHEET

The Contractor must be able to provide the services listed below. Subcontractors may be used to comply with this requirement. Subcontractor Agreements may be used to comply with this requirement. Subcontractor(s) information must be identified on the Bidder Declaration (GSPD-05-105). If additional Subcontractors are added during the term of the Agreement, an updated GSPD-05-105 must be submitted.

The rates listed below are in effect for the term of the Agreement, including any extension of the term through an

Description of Service Hourly Rate Monthly Pharmacy and Medication Regimen Services (estimated 50 hours per month for 36 months) $

Exhibit C, General Terms and Conditions TBD

1. General Terms and Conditions

A. General Terms and Conditions (GTCs)

The (GTCs) are hereby incorporated by reference and made part of this agreement as if attached.

hereto. These documents may also be viewed at the California Department of General Services website: https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225- February-2025.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225-February-2025.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225-February-2025.pdf

Exhibit D – Special Terms and Conditions TBD

1. EXCISE TAX

The State of California is exempt from Federal Excise Taxes, and no payment will be made for any taxes levied on employees' wages. The State will pay for any applicable State of California or local sales or use taxes on the services rendered or equipment or parts supplied pursuant to this Contract. California may pay any applicable sales or use tax imposed by another state.

2. STATUTORY AND REGULATORY PROVISIONS

A. This Contract shall be governed and construed in accordance with all applicable statutory and regulatory provisions including, but not limited to:

1) Title XVIII of the Federal Social Security Act

2) Title XIX of the Federal Social Security Act

3) Chapters 7 and 8 (commencing with Section 14000), Part 3, Division 9, Welfare and Institutions Code

4) Division 3, Title 22, California Code of Regulations (CCR)

5) Health and Safety Code Section 1340 et seq.

6) All applicable Federal provisions which regulate the administration of health care programs and budget revisions, as contained in the Code of Federal Regulations (CFR), Title 42, and Title 45, Part 74, Title 42 United States Code, Sections 1395 et seq. and 1396 et seq.

7) Sub-chapter 13 (commencing with Section 6800), Chapter 4, Part 1, Title 17, CCR; and

8) All other applicable laws and regulations.

B. Any provision of this Contract in conflict with the applicable laws and regulations is hereby amended to conform to the provisions of those laws and regulations. Such amendment of the Contract shall be effective on the effective date of the statutes or regulations necessitating it, and shall be binding on the parties even though the amendment may not have been reduced to writing and formally agreed upon and executed by the parties. If, due to amendment in laws of regulations, Contractor is unable or unwilling to comply with the provisions of the amendment(s), State or Contractor may terminate this Contract in accordance with the Termination provision of this Contract.

3. EXAMINATION AND AUDIT

A. Contractor shall allow the State and its related entities, the Comptroller General of the United States, Department of Justice (DOJ), and the Bureau of Medi-Cal Fraud, or their duly authorized representatives, to inspect or otherwise evaluate the quality, appropriateness, and timeliness of services performed under this Contract, and to inspect, evaluate, and audit any and all books, records, and facilities maintained by the Contractor and Subcontractors pertaining to services under this Contract at any time during normal business hours.

B. Contractor shall be subject to the examination and audit of the State Auditor for a period of three (3) years after final payment under this Contract in accordance with Government Code, Section 85467.7. The examination and audit shall be confined to those matters directly connected with the performance of the contract, including, but not limited to, the costs of administering the Contract.

C. Books and records include, but are not limited to, all physical records originated or prepared pursuant to the performance under this Contract, including working papers, reports, financial records, and books of account, Medical Records, prescriptions files, Subcontracts, and any other documentation pertaining to medical and non-medical services for residents of the Home. Upon request, at any time during the term of this Contract, the Contractor shall furnish any record or copy.

4. RESOLUTION OF DISPUTES

A. The Contractor may dispute and appeal a decision or action by the State arising out of the Interpretation or administration of this Contract. A written dispute notice shall be submitted to the Contract Manager within thirty (30) calendar days from the date the Contractor receives notice of the decision or action in dispute.

The Contractor’s dispute notice shall state the following, based on the most accurate information available to the Contractor:

1) That it is a dispute pursuant to this Section.

2) The date, nature, and circumstances of the conduct, which is the subject of dispute.

3) The names, telephone numbers, function, and activity of each contractor, subcontractor, State official, or employee involved in or knowledgeable about the conduct.

4) The identification of any documents and the substance of any oral communications involved in the conduct. Copies of all identified documents shall be attached.

5) The reason why the Contractor is disputing the conduct.

6) The cost impact to the Contractor directly attributable to the alleged conduct, if any.

7) The Contractor’s desired remedy.

B. The State and the Contractor agree to try to resolve all contractual issues by negotiation and mutual agreement at the Contract Manager level. The parties recognize that the implementation of this policy depends on open-mindedness, and the need for both sides to present adequate supporting information on matters in question. The Contract Manager, in a written decision stating the factual basis for the decision, will decide any disputes concerning performance of this Contract. Before issuance of the Contract Manager’s decision, informal discussions between the parties by the individuals who have not participated substantially in the matter in dispute will be considered by the parties in efforts to reach mutual agreement.

C. The Contract Manager will render a decision or request additional substantiating documentation from the

Contractor within thirty (30) days of receipt of the Contractor’s appeal. A copy of the decision will be provided to the Contractor. The decision shall be final and conclusive unless, within thirty (30) days from the date of the decision, the Contractor files a written appeal addressed to the Undersecretary, California Department of Veterans Affairs.

D. The Undersecretary’s decision shall be final and conclusive unless the decision is arbitrary, capricious, grossly erroneous or if any determination of fact is unsupported by substantiating evidence. The Undersecretary’s decision will be in writing and may encompass facts, interpretations of the Contract, and determination or application of law. The Contractor may, prior to the Undersecretary’s decision, present oral or documentary evidence, and arguments in support of the Contractor’s appeal. The decision will either:

1) Find in favor of the Contractor, in which case the Undersecretary may:

a) Countermand the earlier conduct which caused the Contractor to file a dispute; or

b) Reaffirm the conduct and, if there is a cost impact sufficient to constitute a change in obligations pursuant to the payment provisions, direct the State to comply with that Section.

2) Deny the Contractor’s dispute and, where necessary, direct the manner of future performance; or

3) Request additional substantiating documentation in the event the information in the Contractor’s dispute or appeal is inadequate to permit a decision to be made under paragraphs (1) or (2) above, advise the Contractor as to what additional information is required, and establish how that information will be furnished. The Contractor shall have thirty (30) days to respond to the Undersecretary’s request for further information. Upon receipt of this additional requested information, the

Undersecretary will have thirty (30) days to respond with a decision. Failure to supply additional information required by the Undersecretary within the time period specified above shall constitute waiver by the Contractor of all claims.

E. Attorney’s fees and costs for any dispute or subsequent trial shall be borne by the respective parties.

Both parties waive trial by jury, and any trial in superior or municipal court shall be by a judge alone. Any litigation arising out of this Contract shall be conducted in a California Court pursuant to California law.

F. Contractor shall continue with the responsibilities under this Contract during any dispute.

5. AGENCY LIABILITY (Applies only to Federally Funded Contracts)

The Contractor warrants by execution of this Contract, that no person or selling agency has been employed or retained to solicit or secure this Contract upon Contract or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide established commercial or selling agencies maintained by the Contractor for the purpose of securing business. For breach or violation of this warranty, the State shall, in addition to other remedies provided by law, have the right to annul this Contract without liability, paying only for the value of the work actually performed, or otherwise recover the full amount of such commission, percentage, brokerage, or contingent fee.

6. POTENTIAL SUBCONTRACTORS

For all Agreements, with the exception of Interagency Agreements and other governmental entities/auxiliaries exempt from bidding, nothing contained in this Contract or otherwise shall create any contractual relation between the State and any subcontractors, and no subcontract shall relieve the Contractor of Contractor’s responsibilities and obligations hereunder. The Contractor agrees to be as fully responsible to the State for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by any of them, as it is for the acts and omissions of persons directly employed by the Contractor.

The Contractor's obligation to pay its subcontractors is an independent obligation from the State’s obligation to make payments to the Contractor. As a result, the State shall have no obligation to pay or enforce the payment of any moneys to any subcontractor.

7. REPORTING SMALL BUSINESS (SB)/MICRO BUSINESS (MB) AND /OR DISABLED VETERANS

BUSINESS ENTERPRISE (DVBE) UTILIZATION

A. If SB/MB and/or DVBE Subcontractor participation is a requirement on this Agreement, the Contractor must report the actual amount paid to certified Subcontractors. The Contractor must comply with Government Code Section 14841 and Military and Veterans Code Section 999.5(d) by reporting the actual utilization of certified Subcontractor(s) during the performance of this Agreement.