26WS0010_-_Exhibits_A-E.pdf

California Department of Veterans Affairs Agreement Number: 26WS0010 Exhibit A - Scope of Work TBD

TEMPORARY/RELIEF PHYSICIAN/SURGEON AND CHIEF MEDICAL OFFICER

1. INTRODUCTION

A. The Contractor shall provide temporary/relief services, on an as-needed basis, to the California

Department of Veterans Affairs (CalVet). The Contractor shall provide services for the benefit and care of residents at the Veterans Home of California – West Los Angeles (Home) located at 11500 Nimitz Avenue. Los Angeles, CA. 90049. The Contractor shall provide all labor, materials, staff, transportation, license, permits, and every other item of expense necessary, unless otherwise stated, to provide Physician/Surgeon OR Chief Medical Officer (CMO) services. For purposes of this Agreement, the Contract Manager or designee must be a civil service employee. Services shall be provided at the Home, upon request and in compliance with the terms of this Agreement.

B. Contracted services shall be used to fill temporary vacancies, substitute for full-time CalVet employees while on extended leave, provide temporary services when appropriate staffing levels cannot be maintained with civil service staff, or when the requested services are not available within state civil service.

C. Provider must be able to perform the tasks associated with providing services under the scope of their license. The Contractor agrees that all Providers will be required to render health services as stated below and as required by law on an as-needed basis. Providers will perform services in accordance with federal and state laws and regulations, CalVet policies and procedures, and shall at all times comply with universal safety precautions and maintain CalVet security measures and a safe work environment.

D. The Contractor agrees that, unless otherwise stated, all expenses associated with travel to and from the

Veterans Home, lodging, and all training expenses for Providers shall be borne by the Contractor or the Provider, and will not be reimbursed separately by CalVet. Any and all services performed outside the scope of this Agreement will be at the sole risk and expense of the Contractor.

E. The Contractor is not authorized to deliver or commence performance of services as described in the

Agreement until written approval has been obtained from CalVet Contract Manager, or Designee, and the Contractor has received a copy of an executed contract from CalVet. Any delivery or performance of service commenced prior to the Contractor obtaining all written approvals shall be considered voluntary on the part of the Contractor.

2. THE CONTRACTOR’S RESPONSIBILITIES

A. Services and all requirements as stated below and as required by law shall be provided by the Contractor for the contracted services, at the request of the Contract Manager or designee. The services shall include, but are not limited to, the following:

1. The Contractor must have a minimum number of Providers to adequately provide services who meet the requirements specified in Exhibit A–1, Service Specifications. The Contractor must provide the State with proof of any required training, licenses, permits, certifications, and any other required documents as stated below and as required by law, for each of the Providers providing services under this Agreement. Services will be performed only by Providers who meet the requirements outlined in this Agreement.

2. The Contract Manager, or designee, shall approve in advance all required Providers assigned to the

Agreement. If any Provider of the Contractor is unable to perform due to illness, resignation, or factors beyond the Contractor’s control, the Contractor shall immediately submit qualifications of a proposed substitute Provider to the Home for approval. Failure to do so may be cause for termination of this Agreement. The Home shall be notified of any additions or corrections to the Contractor’s list of prospective Providers at least five (5) working days before the Provider’s start date.

3. The Contractor shall ensure each Provider has an identification badge which includes the name of the Provider, the name of the Contractor (if different), and a photo identification. The badge shall be worn by the Provider at all times while at the Home.

B. Reports

CalVet reserves the right to request that the Contractor provide 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. PROVIDER’S QUALIFICATIONS

Provider’s qualifications are noted in Exhibit A–1, Service Specifications.

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, the Contractor shall ensure that each Provider possesses and maintains throughout the term of this Agreement, all licenses, permits, and certification requirements noted in Exhibit A–1, Service Specifications.

5. REQUEST FOR SERVICES

A. Services shall be provided as specified in Exhibit A-1, Service Specifications, as scheduled by the Contract Manager or on an as-needed basis, in accordance with CalVet policies and procedures, to ensure the best quality of treatment to meet the needs of residents at the Home.

B. The Contractor shall have a telephone number and a contact person available by telephone twenty-four

(24) hours per day, seven (7) days per week for the duration of the contract. The initial contact will be by telephone; however, CalVet will make every attempt to follow up with an email.

6. RESPONDING TO A REQUEST FOR SERVICES

A. The Contractor shall respond to a request for services within a one (1) hour response time unless otherwise stated by the Home. CalVet may extend the response time at the discretion of the Contract Manager or designee, dependent upon the urgency of the request for services. The response time shall be included on the request for service. The Contractor shall respond to the Home’s request for services within the stated response time AND submit the following documents:

1. Provider’s current Resume/Curriculum Vitae, which shall include the following information:

a. All education, including name and location of university or college, business, correspondence, trade, or service school; course of study; units completed (semester/quarter); diploma, degree, or certificate obtained; and date completed;

b. All relevant work history, including classification/job title, job duties performed, “to and from” dates (month and year), and any other information necessary to determine the qualifications of Providers;

c. Name of organization for which work was performed;

d. Supervisor name and contact information for each job;

e. If the applicant has provided services to CalVet previously, the Provider must include the name of the specific Home, to and from dates of service, and the immediate supervisor’s full name and telephone number; and

f. At least two (2) professional references and their contact information.

Note: Contact information shall be current and have a valid telephone number and/or e-mail address.

2. Copies of any current and valid license(s), permits, and/or certification(s) as stated and as required by law. (Refer to Exhibit A-1, Service Specifications, for requirements.)

7. CREDENTIAL VERIFICATION

A. For services provided at a Home, the Contractor has to comply with the following credentialing requirements:

1. If the Contractor and/or Provider enter into an Agreement for medical services at the Home, the

Contractor and/or Provider shall comply with all CalVet Home credentialing standards, requirements, policies, and procedures. The Contractor shall provide necessary information for the successful credentialing not less than thirty (30) days prior to the scheduled date of service unless otherwise agreed upon by CalVet. Services cannot start until the credential process and approval is completed by the Home.

2. The Contractor and/or Provider are required to coordinate with the Contract Manager or designee to submit documentation for credentialing.

3. The Contract Manager or designated representative will notify the Provider once credential verification has been completed to arrange for an effective date for the Contractor or Provider to render services at the Home.

4. The Contractors providing temporary/relief registry services are responsible for the completed

Credential Verification Packet and submitting it to the Contract Manager or designee at the Home where services are to be provided.

5. The Contractor must assume responsibility for obtaining credentials. The Contractor must verify 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 status of Provider(s) assigned.

8. SCHEDULING

A. The Contractor and Provider shall ensure that all ordered services have prior authorization in accordance with the Home and are mutually agreed upon between the Contract Manager, or designee, and the Contractor.

B. At the time of scheduling, CalVet shall provide the Contractor with an estimated period of time the Home anticipates the need for contracted services. This will be a good-faith estimate based on the circumstances known to CalVet at the time of the request. It is not a guarantee of business, and is subject to change depending on CalVet’s ability to fill staff vacancies and/or the return to work of CalVet staff from long-term leave, and fluctuations in the Resident population. However, CalVet shall endeavor to provide five (5) working days' notice prior to cancellation of the Provider’s assignment.

C. The Contractor shall provide services to Home within twenty-four (24) hours of notification by CalVet or as mutually agreed upon between the Home Contract Manager or designee and The Contractor.

Requests for services shall be for a minimum of two (2) hours. When requesting services, CalVet shall inform the Contractor of 1) the duration of services, 2) the number of staff required, and 3) the length of each shift assignment. If the duration of services must be extended, CalVet shall make every attempt to notify the Contractor not less than twenty-four (24) hours before the end of the current service period.

The Contract Manager, or designee, shall document the request in writing.

D. Providers shall report for beginnings/endings of shifts in accordance with the policies and procedures of the requesting Home.

9. PROVIDER’S RESPONSIBILITIES

Please refer to Exhibit A–1, Service Specifications, for details.

10. CANCELLATION

A. The Contractor shall give advanced notice to the Contract Manager, or designee, prior to cancellation of scheduled clinics/services, if for reasons other than illness, as follows:

1. For scheduled clinics: one (1) week’s written notice

2. For all other scheduled services: at least twenty-four (24) hours' notice

B. CalVet may cancel or change assignments by telephone, before the Contractor’s and/or Provider’s scheduled reporting time.

11. INDEPENDENT CONTRACTOR STATUS

A. 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 the CalVet or the State, including, but not limited to, the following:

1. Premium Pay, Overtime Pay, or Holiday Pay.

2. Medical Insurance.

3. Vacation or Sick Leave.

4. Worker’s Compensation.

5. Other employee benefits.

Note: It is the Contractor’s responsibility to rotate providers if necessary to avoid overtime hours.

12. ORIENTATION/TRAINING

A. The Contractor agrees that prior to reporting for work at the Home, all Providers shall complete any required orientation and training to become familiar with the operations of the Home, its medical facilities, Title 22 of the California Code of Regulations, Title 42 of the Code of Federal Regulations, and any other laws or bylaws that may apply to the Home.

B. To maintain continuity of services and ensure safety for all workers, the Contractor shall make available to the Home only those Providers who have completed the required orientation and training.

C. Each provider must attend the Home’s orientation. The orientation will take approximately four (4) hours, and the Contractor shall be solely responsible for the cost.

13. HEALTH CLEARANCE

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

B. 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 Provider assignment, and within the required timeframe stipulated by the Home for the annual requirement.

C. Pre-employment/pre-assignment and annual health screening performed for The Contractor or The

Contractor’s Provider will be at The Contractor’s expense.

D. All Providers must show proof of receiving an annual vaccination for influenza (flu). If the Provider cannot show proof of receiving the current vaccination, they must sign a declination form and wear a mask while in the Home during the entire duration of flu season.

E. The Contractor shall submit medical reports/documentation to the Home’s Ambulatory Care Clinic indicating the individual is cleared to perform their duties and is free of communicable disease. The medical documentation must be submitted prior to initiation of services or Provider assignment, and within the required timeframe stipulated by the Home for the annual requirement.

F. During times of endemic or pandemic (such as COVID-19) or other instances of widespread viral or bacterial infections, additional precautionary infection control steps may be implemented and required by the Home. These may include, but are not limited to: wearing CalVet-approved masks and/or face shields, extra or special cleanings, social distancing, partitions, adjusted hours, vaccinations, booster shots, and obtaining additional clearance certifications that may be required by local, state, or federal health authorities. Providers shall comply with the Home’s COVID-19 Mitigation or Infection Control Plan and follow all current COVID-19 guidelines for precautions.

G. Failure to comply with the Home’s infection control policies shall result in immediate Provider suspension, contract suspension, or termination. Any suspension will remain in effect until a medical clearance is provided to the Home’s Infection Control Specialist, Contract Manager, or designee.

14. BACKGROUND CLEARANCE

A. Background clearance involving fingerprinting is required by Home policy of contract Providers and volunteers prior to assignment to the Home in order to meet state facility licensure requirements. Live- Scan is the only acceptable form of fingerprinting for the Home.

B. The Contractor shall coordinate with the Home’s Personnel Office to arrange Live-Scan services. At a minimum, DOJ results must show California State-level and Federal Bureau of Investigation (FBI) level criminal offender record information (CORI) clearances.

C. The Home’s Personnel Office must receive the Live-Scan results and DOJ clearances prior to approving assignment to the Home.

15. FAILURE TO PERFORM

A. CalVet shall routinely evaluate the work performance of the Contractor and/or Provider to determine if CalVet standards and Departmental/Home policies and procedures are being maintained. Any Contractor, and/or Provider who fails to perform or who is physically or mentally incapable of performing the required duties of this Agreement shall not be permitted to perform service.

B. Failure to provide services on three (3) or more occasions may result in termination of the Agreement.

C. The Home’s Contract Manager, or designee, shall state in writing the reasons the Contractor and/or

Provider did not meet the required policies or standards and submit a copy to the Contractor and to the Contract file. CalVet shall not pay The Contractor for any services performed by The Contractor and/or Provider which are deemed unacceptable in accordance with the required services contemplated by this Agreement.

16. TRANSITION OF SERVICES

In the event the Contractor has an Agreement from a prior bid for the same services in this Agreement, the State shall pay for services using the rate(s) in the prior Agreement for the period of time up to and including the term end date of that Agreement.

The transition period is defined as the time when the new Agreement(s) with new The Contractor(s) are approved by the DGS/Office of Legal Services (DGS/OLS), and the Home(s) must begin transition activities such as canvassing the Contractor(s) with new contract(s) and providing Orientation Training, Credential Requirements, Background, or Health Clearances to the new The Contractor’s Providers to ensure there is not a break in services. During the transition period, providers working from prior Agreements may continue to provide services based on the Home(s) needs up to the expiration/termination date of the prior Agreements.

17. CONTACT INFORMATION

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

1. CalVet Contract Manager:

Veterans Home of California, West Los Angeles

TBD

11500 Nimitz Avenue Los Angeles, CA 90049 Phone:

Fax:

2. The Contractor Representative:

TBD

B. Contract 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 Contract Representative, including name, title, mailing address, phone/fax numbers, and email address. All other changes require a formal written amendment to this Agreement.

Exhibit A-1 – Service Specifications TBD

TEMPORARY/RELIEF PHYSICIAN/SURGEON AND CHIEF MEDICAL OFFICER

1. PROVIDER’S QUALIFICATIONS

A. Providers assigned to CalVet must have the minimum experience/education outlined below:

1. Physician/Chief Medical Officer

a. Minimum of twelve (12) continuous months of experience within the last three (3) years performing services similar in scope to those defined herein, preferably in a public or private institution.

b. Education: Graduation from a medical school as recognized by the State of California.

B. 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.

C. Any Provider(s) who fail to meet the minimum qualifications shall not be permitted to perform service.

The Home’s Contract Manager, or designee, shall state in writing the reason(s) the Provider does not meet the minimum.

2. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

Prior to providing services as outlined in this Agreement, Contractor shall:

A. Ensure that each Provider possesses and maintains all current and valid licenses, permits, and certifications throughout the term of this Agreement for each classification noted below:

1. Physician/Chief Medical Officer:

A current and valid license recognized by the California Board of Medical Quality Assurance or the California Board of Osteopathic Examiners authorizing the physician’s medical practice in the State of California. Board Certified / Board Eligible in Geriatric Medicine, Internal Medicine, or Family Practice.

B. Provide copies of any required license(s), permits, and/or certification(s) for each Provider to the Home’s Contract Manager, or designee, to be kept on file at the Home throughout the term of this Agreement.

Contractor shall ensure that all required licenses, permits, certifications, and any other requirements outlined herein are always current and in effect during the term of this Agreement.

C. Provide current/renewed license(s), permit(s), and/or certification(s) to CalVet not less than thirty (30) calendar days prior to their expiration. If, during 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 status of Provider(s) assigned.

E. Maintain current Cardiopulmonary Resuscitation (CPR) and Basic Life Support (BLS) certification for each Provider at Contractor’s expense.

3. PROVIDER’S RESPONSIBILITIES

Under the direction of the Home’s SNF Administrator, Contract Manager, or designee, Provider shall provide services as permitted within the scope of practice for Physician/Surgeon and/or Chief Medical Officer in accordance with CalVet/Home policies and procedures.

A. Duties/Responsibilities shall include, but are not limited to:

1. Physician/Chief Medical Officer:

a. Perform the direct medical services and functions customary of an Ambulatory Care Clinic (ACC), Skilled Nursing Facility (SNF), and Residential Care Facility for the Elderly (RCFE) medical director as required by federal and state Medicare and Medicaid (Medi-Cal) laws, regulations, rules, and policies, and in compliance with the Home medical care bylaws, rules, and regulations.

b. Provide on-site coverage from 7:30 a.m. to 5:30 p.m. as needed.

c. Directly supervise the civil servant Nurse Practitioner (NP), currently classified as a 103 NP, as required by California Assembly Bill 890 until the NP is classified as a 104 NP.

d. Perform all functions associated with the medical care management of resident patients in the ACC, SNF, and the RCFE.

e. Provide Physician services with emphasis on geriatric medicine.

f. Provide consultation and assessment, treatment plan, and monitoring of response to treatment for each Home resident.

g. Call and discuss with Home Administrator and/or attending physician any pending admission of Home resident prior to admission of the resident for inpatient acute hospital care.

h. Provide administrative review of all Home Policies and Procedures relating to medical care.

i. Provide administrative consultation regarding the Home’s operations issues.

j. Assist with preparations for United States Department of Veterans Affairs and California Department of Healthcare Services surveys and/or resurveys.

k. Perform the physician’s role in admission prescreening and admission physicals.

l. As Chief Medical Officer, provide oversight for all physician services, PAs, and NPs.

m. Provide review of referrals by PAs and NPs.

n. Provide consultation for the NPs in providing clinic services, especially regarding patient care and management.

o. Perform all medical duties required for health care facilities under Title 22 (22CCR) of the California Codes of Regulations, and Titles 42 and 38 of the Code of Federal Regulations (42CFR and 38CFR).

p. Refer residents of the Home to other appropriate medical contractors only after consultation with the Home Administrator, or designee.

q. Ensure there is a continuity of care for residents of the Home during periods of absence by the Provider. The cross coverage selected by Contractor shall be approved and credentialed in advance by the Home.

r. Comply with the rules and regulations contained in Title 22 (22CCR) of the California Codes of Regulations and the Home Administrative Manual.

s. Shall assist in arranging for continuous physician coverage for medical emergencies.

t. Shall assist in obtaining the services of qualified professionals to serve as consultants to help meet residents’ special needs.

u. Contractor shall complete all resident medical documentation, charting, assessments, and treatment notes within twenty-four (24) hours of the patient encounter unless otherwise required by Home policy.

v. Contractor shall attend required interdisciplinary meetings, medical staff meetings, quality assurance meetings, and care coordination meetings as directed by the Home Administrator or designee.

w. Contractor shall acknowledge urgent consultation requests within one (1) hour and routine consultation requests within one (1) business day unless otherwise directed by the Home

B. The Contractor must currently employ Physician(s), Physician Assistant(s), and Nurse Practitioner(s), residing within a 30-mile radius from the Veterans Home of California – West Los Angeles or must have a place-of-business where Physician(s), Physician Assistant(s), and Nurse Practitioner(s) employed by the Contractor report to the Contractor’s place-of-business within a 30-mile radius from the Home. The 30-mile distance limit has been established because the medical providers will be needed within a short time period (1.5 hours or less) after Home staff have contacted the Contractor.

C. Shall acknowledge and sign Home policies on Resident Rights, Confidentiality, Discrimination, Sexual Harassment, and Zero Tolerance of Elder Abuse, and any other required policies.

D. Sign in at the clinic when entering the facility and sign out when leaving, by using the contractor’s binder, and shall understand that if this sign-in and sign-out procedure is not followed, the Home may dispute any or all invoices.

E. Provider shall wear an identification badge which includes the name of the Contractor, the Provider’s name, and a photo ID. This badge shall be worn at all times while on the grounds of the Veteran’s Home.

F. Provider shall ensure resident medical record information is maintained as “CONFIDENTIAL” and shall be held in trust and confidence. Information shall be used only for the purposes contemplated under this contract.

G. Provider shall obtain the approval and authorization from the primary care physician through the Contract

Manager, or designee, prior to referring the resident to other health care/medical vendors/contractors.

Referral shall be made only to the health care/medical vendors/contractors set forth on the Home’s health care/medical vendor/contract list.

H. Prior Authorization Documentation shall include, but is not limited to, the following:

1. Veterans Home referral process.

2. Resident progress notes/summary pertinent to the reason for referral.

I. Equipment and/or supplies owned or customarily stocked by the Home and which are necessary for services may be used by the Provider. If the lack of equipment and/or supplies creates a limitation to services requested, the Provider shall make a recommendation to the Contract Manager, or designee, identifying equipment or supplies necessary for treatment. The Provider will not procure equipment or supplies and expect reimbursement from the Home/CalVet.

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 in 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 – West LA Attn: TBD Home Address Home City, State, and Zip code

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 Contractor or to furnish any other considerations under this Agreement, and 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 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) Contractor’s final invoice must be clearly marked as “Final Invoice”

12) 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 Contractor discovers it has received an overpayment, 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 amendment.

Description of Services Hourly Rate Physician

Physician - Phone Consultations (Alternative) Description of Services Hourly Rate

Chief Medical Officer Chief Medical Officer - Phone Consultations

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. The Contractor shall prepare and submit the report to the Contract Manager within 60 days from receipt of final payment.

B. Withhold: 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. 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).

8. SUBSTITUTION OF DVBEs

A. If applicable, DVBE subcontractors shall be used per the California Code of Regulations (CCR), Title 2 §

1896.70 unless a substitution is approved in writing by the Department of General Services (DGS),Office of Small Business & Disabled Veteran Business Enterprise (OSDS). A DVBE subcontractor shall be replaced by another DVBE to perform the work originally stated. The substitution shall maintain, at minimum, the level of participation goal stated in the bid.

1) The Contractor shall simultaneously notify the DVBE and the CalVet Contract Manager of the intended substitution. The written notice shall contain the reasons for the substitution and be sent by certified mail. The Contractor shall submit the following to the CalVet Contract Manager:

i. A copy of the written notice issued to the DVBE with proof of delivery. In the absence of proof of delivery, provide the certified mail receipts.

ii. A copy of the DVBE’s consent or opposition to the substitution. In the absence of the consent or opposition, provide the returned and unopened certified mail.

iii. The name and supplier number of the business being substituted and the name and supplier number of the proposed replacement. If a DVBE cannot be identified as a replacement, the Contractor shall document the absence of DVBEs. This documentation shall include but is not limited to:

1. Contact CalVet’ SB/DVBE Coordinator regarding the absence of DVBEs to perform the specific work.

2. Search results from the DGS website for DVBEs to perform the specific work.

3. Communication with a DVBE Community Organization nearest the worksite regarding the absence of DVBEs, if applicable.

4. Documented communication with DVBEs describing the work to be performed, its percentage of the overall contract, the corresponding dollar amount, and their responses to the request.

2) The DVBE shall have up to five (5) business days from the postmark date to consent or oppose the substitution. A copy of the DVBE’s reply shall be sent simultaneously by certified mail to the Contractor and the CalVet Contract Manager.

3) When written oppositions to a substitution are filed, CalVet shall grant the DVBE a hearing. The hearing notice shall be issued within five (5) business days from receipt of the opposition. If CalVet grants the substitution, continue to G, below.

4) The CalVet Contract Manager shall submit the substitution request to the DGS, OSDS:

i. The request must meet the criteria as specified above or § 4107 of the Public Contract Code for

Public Works.

ii. The substitution request shall be accompanied by the hearing decision, when applicable.

5) The OSDS will respond to substitution requests within three (3) business days. The OSDS shall consent to the substitution of another DVBE in any of the following situations:

i. When the DVBE becomes bankrupt, insolvent or goes out of business.

ii. When the DVBE does not perform as listed in the Bidder Declaration.

iii. When the DVBE does not meet the bond requirements of the contractor.

iv. When the DVBE’s name is incorrect due to an inadvertent clerical error. In the case of public works contracts, compliance with § 4107.5 of the Public Contract Code is required.

v. When the DVBE is not licensed as required by any State of California regulatory agency.

vi. When CalVet, or its duly authorized officer, determines that the DVBE:

1. Did not perform in accordance with the plans and specifications; or,

2. Has delayed or disrupted the progress of the work.

6) The DVBE substitution process shall not be used as an excuse for noncompliance with any provision of law. This includes, but is not limited to, the Subletting and Subcontracting Fair Practices Act (§ 4100 et seq., Public Contract Code) or any Agreement requirements relating to substitution of subcontractors.

7) Contractors who proceed with work pending a substitution decision may be subject to contract termination, recovery of damages under rights, remedies and penalties. This is outlined in § 999.9 of the Military and Veterans Code, § 10115.10 of the Public Contract Code or § 4110 of the Public Contract Code (applies to public works only). Failure to adhere to the DVBE participation in the performance of the Agreement may be cause for Agreement termination and recovery of damages under the rights and remedies due CalVet.

8) Any DVBE firm acting/working under subcontract must be responsible for providing materials, supplies, equipment or services and must carry out its responsibility by actually performing, managing, or supervising the work involved that is normal for its business services and functions.

9) The Contractor shall maintain records of all subcontracts entered into with DVBE Subcontractors including records of materials purchased from DVBE suppliers. Such records shall show the name and address of each DVBE Subcontractor or supplier and the total dollar amount paid to each one.

Upon completion of the Agreement, a summary of these records shall be prepared and certified correct by the Contractor or his…