27-02__In-Home_Intervention_Program.pdf

RFP # 27-02, In-Home Intervention Program

ST. MARY’S COUNTY HEALTH DEPARTMENT (SMCHD)

LOCAL BEHAVIORAL HEALTH AUTHORITY – LBHA

IN-HOME INTERVENTION PROGRAM

REQUEST FOR PROPOSALS (RFP)

RFP 27-02

OVERVIEW

The St. Mary’s County Health Department Local Behavioral Health Authority (SMCHD LBHA) is issuing this RFP 27-02 to contract with a qualified provider or provider(s) to deliver an In-Home Intervention Program for Children to St. Mary’s County, Charles County and Calvert County (Local LBHA Units).

This RFP and resulting contracts will allow for four (4) one (1) year optional renewals, with mutual consent, on the anniversary of the agreement in subsequent years, pending grant availability and funding.

Each Local LBHA Unit is responsible for funding, coordination, planning, and contracting in each individual county. Fidelity and compliance monitoring will be done as a joint basis across all three local LBHA units. Services are expected to commence on July 1, 2026, or upon the effective date of the contract between Offeror and each jurisdiction.

ELIGIBILITY REQUIREMENTS

The Proposer shall be an approved Psychiatric Rehabilitation Program (PRP) under COMAR 10.63.

Proposers must provide assurance to become and maintain approval as a 1915(i) Intensive In Home Services/Promising Practice IHIS Provider (non-EBP), under COMAR 10.08.89.

Providers will be required to actively accept referrals and serve families for individuals that qualify for the 1915i IHIS. These referrals come through care coordination organizations. Billing for those individuals is through Medicaid and not through the grant. Providers must adhere to any additional COMAR regulations when serving those youth.

PROGRAM EMPHASIS

This RFP is designed to contract with a qualified provider or provider(s) to deliver an In-Home Intervention Program for Children to St. Mary’s County, Charles County and Calvert County with the Local LBHA Units.

PROGRAM BACKGROUND

As a result of the closing of Crownsville Hospital Center and the recommendations of a broad-based Task Force Report, the Maryland General Assembly appropriated funding in FY 2005 to support the expansion of community mental health services in Anne Arundel, Calvert, Charles, Prince George’s and St. Mary’s Counties, this was the catchment area of the soon to be closed Crownsville Hospital Center. The five counties identified the need for in-home intervention services for children and adolescents at risk for admission to institutional care (hospitals and/or Residential Treatment Centers) covered by Medical Assistance and determined to be “high users” of the Public Behavioral Health System (PBHS). The youth targeted for this voluntary in-home intervention program are eligible for and/or are receiving services through the PBHS.

This program is based on a Psychiatric Rehabilitation Program (PRP) platform, with additional grant funded activities that are outside the services covered under PRP.

PROGRAM REQUIREMENTS

Program must:

● Assurance must be made to become and maintain approval as a 1915(i) Intensive In Home Services/Promising Practice IHIS Provider (non-EBP), under COMAR 10.08.89.

● Shall be an approved Psychiatric Rehabilitation Program (PRP) under COMAR 10.63.

● Provider must also actively accept referrals and serve families for individuals that qualify for the 1915i IHIS. These referrals come through care coordination organizations. Billing for those individuals is through Medicaid and not through the grant. Provider must adhere to any additional COMAR regulations when serving those youth.

● Demonstrate adherence to monthly IHIP-C Fidelity Scale and achieve at a minimum a monthly score of 4.2 and overall average of 4.5 for the year (attachment 7). Maintaining treatment fidelity is tied to payment. These standards include and are not limited to:

o Maintaining small case load of 2.5 staff to 12 youth, o Meeting at least weekly to review each case o Team leader provides services directly related to IHIP-C cases 50% of the time o For the first 45 days of service, provide at a minimum average of 6 hours of direct clinical service hours to each youth. and an average of 2 hours after the initial 45-day period in the home or in an agreed upon community location.

FACILITY REQUIREMENTS AND PROVIDER SERVICES

● Assists with generating appropriate referrals that are sent to the CSA/ LBHA for approval. (Referrals may come from a variety of sources behavioral health therapist or psychiatrist; Care Coordination Organization; Local Care Team (LCT) members;

Inpatient hospital, RTC or community program such as Therapeutic Foster Care or Therapeutic Group Home; or CSA/LBHA identified high cost user or potential high cost user.) All referrals must also be endorsed with a letter from the child’s treating clinician and have a current psychiatric evaluation.

o Participate in outreach and education activities (e.g. tabling at local resource fairs, emails, flyers) at least twice a year to generate referrals o Meet monthly with LBHA o Track and follow up on incomplete referrals

● Be expected to accept 95 percent of the qualifying referrals received from the

CSA/LBHA.

● Serve a daily caseload of 7 youth in St. Mary’s County, 10 youth in Calvert County and 7 youth in Charles County.

o Length of service is on average less than fifteen months. Service extensions are reviewed and approved by the CSA/LBHA in each jurisdiction on a monthly basis thereafter.

● For the first 45 days of service, provide at a minimum average of 6 hours of direct face-to-face clinical service hours per week to each youth and/ or family and an average of 2 hours/week after the initial 45-day period in the home or in an agreed upon community location.

● Ensure treatment incorporates caregivers and family members.

● Communicate and collaborate with not only the child and family but other key participants that may influence the child’s overall wellbeing, including therapists, school staff, probation officers, psychiatrists, and or extended family.

o Conduct at least monthly collaboration with therapist o Document all collaborations

● IHIP-C programming includes the following basic components:

o Evaluation and assessment (including the CANS, strengths-based family assessment & family systems theory-based skills);

o Collaboration and communication with key stakeholders, particularly treating clinicians.

o Youth and family directed Individualized Service Planning (ISP);

o Brief intervention, crisis intervention and stabilization;

o Skills training (preventative maintenance);

o Services coordination and monitoring.

● Provide services in the home or in mutually agreed-upon location- services should not be delivered in an office setting.

● Services are most effective in person. Only when clinically indicated or services cannot be provided otherwise (safety, weather, illness) these services can be conducted by telehealth or phone.

● Provide treatment that builds on the youth, family and community strengths. Promote culturally and linguistically competent services to meet the youth and family’s needs.

● Assure youth and family participate as a full partner and are actively involved in individual service planning.

● As needed, assist with access to and provide ongoing collaboration with behavioral health, educational, and community support services.

● Once referrals are approved by the LBHA, assure timely initiation of services. Within 2 business days of receiving a completed referral:

o Render a decision of acceptance or denial.

o Communicate with the caregiver to initiate services.

o Communicate with the referral source and/ or therapist.

o Submits authorization for PRP to ASO.

● Utilize the CANS within fifteen days of admission, at 6 months, and 12 months of service and upon discharge.

● Develop, with full participation of the youth and family, an initial Individualized Service Plan (ISP) within 15 days of admission to the IHIP-C; update plan whenever necessary.

4. 5. 6.

● Continue services based on the following criteria:

o More time is needed to meet ISP goals;

o The CANS indicate moderate to serious problems remain; and/or o A significant event in the youth’s life requires continuation of services for a specific time period.

● Transition family/ youth to other services based on the following criteria:

o Successful completion of goals listed on the ISP or, o Realistic meeting of goals within the stated period of time; and o Child and Adolescent Needs and Strengths (CANS) indicates significant improvement.

● Assure aftercare plan is completed prior to discharge delineating referral to other resources as appropriate.

STAFFING REQUIREMENTS

The Contractor shall:

● Be able to serve a team of 12 youth. For each team of 12 youth, the Offeror will have at minimum a 0.5 FTE Masters Level licensed mental health clinician and 2.0 FTE Bachelor’s level staff with greater than two years of experience.

● Each IIHIP-C team shall have qualified staff on-call and available for home visits 24 hours a day, seven days a week to handle crisis/emergency situations and to accommodate the schedules of program participants.

● Hire and verify the credentials of the licensed mental health professionals and complete background checks on all project staff directly involved with youth and their families.

● Provide ongoing training to staff to ensure competency and continued skill building.

● Assure each treatment specialist has a minimum of an hour of clinical supervision each week by a qualified mental health professional privileged and approved by the appropriate Licensing Board. Documentation of each case being reviewed weekly must be kept and made available upon request.

● Minimize staff turnover and demonstrate commitment to maintaining the same staffing over time. Document staff turnover rates

OVERALL GOAL

The In-Home Intervention Program intervenes immediately when there is an emergent or crisis/emergency situation, provides brief and intensive interventions, strengthens family functioning, teaches coping skills, links the youth and family to behavioral health and other community support services, and averts visits to costly local emergency departments and/or admissions to a hospital or residential treatment center.

The goals for the In-Home Intervention Program are as follows:

● Provide effective, family focused, community-based intervention services for children and adolescents with behavioral health issues at risk of out-of-home displacement.

● Deliver services that are individualized, culturally and linguistically competent, family focused, coordinated and built on strengths and resilience.

● Either reduce admissions to costlier and more restrictive institutional placements or assist the family with reunification following an out-of-home placement.

● Services should follow the In-Home Intervention Program model outlined in the IHIP-C Manual supplied as attachment 8 to this RFP.

DATA AND REPORTING

The Awardee will make any/all documents and records available for audit/evaluation to entitled Federal, State and County officials upon request. Local LBHA Units will establish and conduct regular program monitoring site visits and record reviews that will include assessing compliance with all Federal, State, and Local conditions of award, health and safety reviews, fiscal and data information, and quality management of service processes. Program and Fiscal Reviews will occur at least biannually.

Monthly reports are due by the 15 following the conclusion of the prior month.

Local LBHA Units reserve the right to adjust and change data reporting requirements as the project evolves and/or as MDH guidelines dictate.

Local LBHA Units will conduct an annual financial audit with a schedule specific to the funds in this agreement.

Submit monthly fidelity scale and IHIP-C monthly performance measures that include but are not limited to:

● Demographic Information of participants served.

● Number of Individuals served

● Average length of episode of care

● Percentage of sessions conducted in person and via telehealth

● Number of Collaborations conducted with therapists

● Number of Outreach/ Marketing activities conducted

● Number of completed referrals

● Number of accepted referrals

● Number or referrals not accepted

● Number of admissions.

● Percentage of youth with new juvenile justice involvement

● Percentage of behavioral health hospitalization

● Percentage of out-of-home placements

● Percentage of CANS completed and percentage of CANS within 15 day of admission

● Average length of crisis call response time

● Average number of direct service hours/week before 45 days of treatment

● Average number of direct service hours/ week after 45 days of treatment

● Percentage of treatment plans created within 15 days of admission

● Percentage of sessions conducted within the community or home

● Percentage of sessions that include not only the child but other family and key participants.

● Percentage of individuals that received referrals or were enrolled in behavioral health treatment upon discharge

Submit consumer satisfaction surveys at 6 months and discharge that include a measure of wellbeing.

Allow LBHA access to electronic health records for ongoing fidelity monitoring and quality assurance.

Reports Shall be submitted to:

Saint Mary’s County Health Department

SMCHD Behavioral Health System Management Team Email: smchd.bhgrants@maryland.gov

With a copy to:

Tammy M. Loewe, Behavioral Health Division Director: tammym.loewe@maryland.gov

Calvert County Health Department

Danielle Reumoun, Agency Grant Specialist: Danielle.Reumont@maryland.gov And

Justin Thompson, Agency Grant Specialist: Justins.Thompson@maryland.gov

Charles County Health Department

Tessa Young: tessa.young2@maryland.gov Linda Deanoo: linda.deanoo@maryland.gov

INVOICING

Invoices for work, services, and items not on the project timeline and/or not approved by SMCHD may result in the denial of further funding. The awardee must provide receipts and/or other documentation of expenditures. Receipts and proof of payment will be required for reimbursement.

Invoices are to be submitted monthly or quarterly as agreed upon in the service contract by the 15th of the month following the end of the invoicing period to:

Saint Mary’s County Health Department smchd.bhgrants@maryland.gov With a copy to:

Tammy M. Loewe, Behavioral Health Division Director tammym.loewe@maryland.gov

Accounts Payable Team smchd.ap@maryland.gov

Calvert County Health Department

Justin Thompson, Agency Grant Specialist: Justins.Thompson@maryland.gov And

Sarah Bailey, Child & Adolescent Coordinator: Sarah.Bailey@maryland.gov

Charles County Health Department

Tessa Young: tessa.young2@maryland.gov Linda Deanoo: linda.deanoo@maryland.gov mailto:smchd.bhgrants@maryland.gov mailto:tammym.loewe@maryland.gov mailto:Danielle.Reumont@maryland.gov mailto:Justins.Thompson@maryland.gov mailto:tessa.young2@maryland.gov mailto:linda.deanoo@maryland.gov mailto:smchd.bhgrants@maryland.gov mailto:tammym.loewe@maryland.gov mailto:smchd.ap@maryland.gov mailto:Justins.Thompson@maryland.gov mailto:Sarah.Bailey@maryland.gov mailto:tessa.young2@maryland.gov mailto:linda.deanoo@maryland.gov

GRANT AUDITING/MONITORING

Auditing/monitoring ensures compliance with applicable regulations, laws, and grant requirements. Sub-recipient agrees as per State of Maryland Department of Health Local Health Department Funding Systems Manual section 2180.04 to be audited by the MDH Chief, Audit Division or by the Local LBHA Units Fiscal Chiefs or appointed representative at least once annually.

Staff will conduct monitoring on an ongoing basis. Monitors may examine but not limited to: the review of monthly and/or quarterly reports as required to include financial reports, chart audits, organization operations, policies and procedures, internal and management controls, complaints, grant subaward-related activities and expenditures, and site visits.

AGREEMENT

The Awardee shall enter into a Grant Agreement/contract with Local LBHA Units.

A blank Saint Mary’s County Health Department Grant Agreement is provided (attachment 3), Charles County Health Department (attachment 5) and Calvert County Health Department (attachment 6). By submitting a response to this RFP, you are agreeing to the terms and conditions outlined in the Agreement and are agreeing to enter into the Agreement upon award.

The Local LBHA units will not enter into any other agreement.

A BAA is required under the Health Insurance Portability and Accountability Act of 1996, and regulations enacted pursuant thereto (collectively “HIPAA”). The awardee agrees to sign the BAA which has been provided as attachment 4.

Attachment 3 -6 are provided for reference, proposers do not need to complete and submit these as part of their response.

TERMINATION

Termination language is provided under each LBHA units provided contracts. Attachment 3, 5 and 6.

AWARD

The Offeror(s) with the highest overall score(s) will be selected to participate in this Contract.

Each Local LBHA Unit is responsible for funding, coordination, planning, and contracting in each individual county. Fidelity and compliance monitoring will be done as a joint basis across all three local LBHA units. Award of this Contract and its continuance are based on the ability to meet the needs of all three local LBHA units. Failure to adequately meet requirements and provide services in one LBHA district will result in a termination of all three LBHA units.

REQUESTS FOR INFORMATION

If any person contemplating submitting a Proposal in response to this RFP, is in doubt to its true meaning, is seeking clarification, has any inquiries or any general questions, they must be submitted in writing to the Procurement Team @ smchd.contracts@maryland.gov. All mailto:smchd.contracts@maryland.gov submissions are due seven (7) calendar days prior to the date and time of the solicitation due date, unless otherwise addressed in an addendum.

In response to requests properly received, the Procurement Team will issue a written response providing determination, interpretation or approval. Every such written response shall be an Amendment to this Solicitation and shall be posted in accordance with SMCHD Procurement Policy.

PRE-PROPOSAL MEETING

A Pre-Proposal meeting will be held via Google Meet on May 26th, 2026 at 10:00 AM EST. To register for the Pre-Proposal meeting, email smchd.bhgrants@maryland.gov with the subject line “RSVP Pre-Proposal Meeting RFP 27-02” by Monday May 25th, 2026. In the body of the email, please include the following information for all attendees: Full name and title, email, phone, facility/organization name.

This Pre-Proposal meeting is mandatory due to the complexity of services provided. Only those who attend the Pre-Proposal meeting may submit a proposal in response to this RFP.

PROPOSAL PROCESS

Proposals submitted in response to this request will be evaluated by a committee using a two-step process. During the first step the committee will review and rank all proposals based on technical qualifications.

All responding Technical Proposals will be reviewed and graded based on the below outlined categories.

Technical Proposals will be evaluated utilizing the following criteria and as identified in Attachment 1:

Category Points Possible

Qualification of Offeror and Staff 15

Philosophy and Approach to Service Delivery 10

Quality Improvement and Reporting 10

Implementation and Operations Strategy 35

Submitted proposals deemed qualified will then have pricing evaluated, with a maximum of 30 points available.

Line Item budget should be broken down into three identifiable portions, one for each LBHA based off of number served.

DEADLINE AND SUBMISSION

mailto:smchd.bhgrants@maryland.gov

Proposals submitted in response to RFP # # 27-02, In-Home Intervention Program must be submitted by 3:00 PM Eastern Standard Time on June 3rd, 2026, application instructions are in Attachment 1.

Submit via email one copy of the Technical Proposal and Pricing Proposal as separate files.

Cover page (Attachment 2) shall be submitted as page one of both the Technical Proposal and Pricing Proposal. Submission shall be made with the subject line “Response to RFP #27-02” to smchd.contracts@maryland.gov.

Proposals received after the identified deadline will not be considered for review. Faxed, mailed or delivered proposals will not be accepted.

Attachment 1 – Application Instructions

ATTACHMENT 1

ST. MARY’S COUNTY HEALTH DEPARTMENT

IN-HOME INTERVENTION PROGRAM

APPLICATION INSTRUCTIONS

Technical Proposals and pricing proposals must be submitted in accordance with RFP # 27-02, In-Home Intervention Program, DEADLINE AND SUBMISSION.

TECHNICAL PROPOSALS

Technical Proposals in response to the RFP # 27-02, In-Home Intervention Program must not exceed 15 single-spaced pages using 12-point font in Times New Roman. Please use headings that correspond to the evaluation criterion outlined below. Please provide detailed information in your narrative to address all the elements in the evaluation criteria listed below:

1. Qualification of Offeror and Staff:

a. Documentation of Offeror and Proposed Structure

i. Current Legal Status (e.g. Articles of Incorporation)

ii. Board resolution approving submission of proposal.

b. Financial Capability to Perform:

i. Description of Offeror’s financial capability to carry out work of RFP.

ii. Audited financial statements for the last two years.

c. Summary of Relevant Experience

i. Specific Documentation of experience with other similar projects.

d. Organization Structure/Chart

i. Description of organizational structure.

ii. Explanation of how project will relate to the whole.

iii. Table of Organization/organizational relationships.

e. Staffing

i. Resumes of administrative/supervisory staff.

ii. Description of staff assigned.

iii. Description of duties and qualifications.

iv. Names and resumes for all staff and consultants, if to be reassigned or already committed to the project.

2. Philosophy and Approach to Service Delivery

a. Basic Values and beliefs about mental health services.

b. Knowledge of population.

c. Knowledge of public mental health system.

d. Importance of youth and family involvement.

3. Quality Improvement and Reporting

a. Clearly stated outcomes.

b. Listed mission, goals, and objectives.

c. Clearly lists how progress will be measured and recorded.

d. Efforts or method to ensure youth/family involvement.

e. Confidentiality and record security.

4. Implementation and Operations strategy

a. Clear and concise timelines.

b. Clear and concise work plan.

c. Staff adequate for tasks.

d. Orientation, training and supervision.

e. Process and content of individual service plans.

f. Report requirements.

g. Problem solving if encountered.

h. Grievance procedures.

PRICING PROPOSALS

Attachment 2, APPLICATION COVER PAGE must be included as page one of the submitted Pricing Proposal.

Line Item Budget and Budget Narrative:

i. Line Item Budget for FY2027 (July 01, 2026 - June 30, 2027) Budget should align with the proposed activities.

i. Line Item budget should be broken down into three identifiable portions, one for each LBHA based off of number served.

j. Budget Narrative describing the funding needed to support the proposed services.

The pricing proposal must outline all applicable charges and fees associated with this work.

Attachment 2 – Application Cover Page

ATTACHMENT 2

ST. MARY’S COUNTY HEALTH DEPARTMENT

IN-HOME INTERVENTION

APPLICATION COVER PAGE

ORGANIZATION INFORMATION:

LEGAL NAME: ____________________________________________________________________________

FEDERAL ID #: ____________________________________________________________________________ (or SS # if Applicable)

ADDRESS: ____________________________________________________________________________

ADDRESS 2: ____________________________________________________________________________

City, State, Zip: ____________________________________________________________________________

Office Phone Number: ____________________________________________________________________________

Contact Person 1: Title:

Email:

Phone:

Contact Person 2: Title:

Email:

Phone:

Acknowledgment of Amendments:

The offeror acknowledges receipt of amendments to the Solicitation:

Amendment Number: Date:

I DO SOLEMNLY DECLARE AND AFFIRM THAT THE CONTENTS OF THIS APPLICATION ARE TRUE AND CORRECT

TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.

Printed Name Title

Signature Date

Attachment 3 – Saint Mary’s County Grant Agreement

GRANT AGREEMENT

CONTRACT # 27-XXX (WILL BE PROVIDED UPON AWARD)

IN-HOME PREVENTION PROGRAM

BETWEEN ST. MARY’S COUNTY HEALTH DEPARTMENT

AND

(CONTRACTOR)

THIS GRANT AGREEMENT (“Agreement”) made this 1st day of July, 2026 by and between ST.

MARYS COUNTY HEALTH DEPARTMENT (“SMCHD”) as an agency or instrumentality of the State of Maryland (“Grantor”) and (NAME OF COMPANY AND ADDRESS) (“Contractor”).

WHEREAS, the Maryland Department of Health (MDH) awards funds for to support an In-Home Intervention Program for Children to St. Mary’s County.

WHEREAS, the Health Officer of SMCHD may make awards for certain activities undertaken by eligible non-profit organizations to benefit its residents and

WHEREAS, the Contractor serves the needs of citizens of St. Mary’s County and

WHEREAS, the SMCHD finds it desirable to assist in financing this program for the Contractor and

WHEREAS, this Agreement's purpose is to describe the Contractor's formal rights and obligations arising from the Grant's acceptance.

NOW, THEREFORE, WITNESSETH, that for and in consideration of the mutual promises and covenants outlined in this Agreement, the parties do now agree as follows:

1. The Grant.

a. The Grantor now issues the Contractor the sum of up to (AMOUNT).

b. The Contractor will submit monthly invoices for services completed according to the approved budget (Attachment A—Form 432).

c. The Grant Administrator must approve the release of payment to the Contractor.

d. Requests to modify the budget must be made in writing and submitted to the Grant Administrator. The Budget Modification must be approved before funds are spent.

e. The Contractor will adhere to the MDH Human Services Agreement Manual requirements.

(https://health.maryland.gov/docs/hsam_093005.pdf) https://health.maryland.gov/docs/hsam_093005.pdf

f. The Contractor may be required to fill out the following forms: 432 (Attachment A—Budget), 437 (Attachment B—Fiscal Invoicing), and 438 (Attachment C—Fiscal Reporting) to comply with MDH Grant policy and Form 440/440A (Attachment E—Year End Reporting), which is due 7/29 following the end of the Fiscal Year.

2. Purpose of the Grant.

a. The purpose of the Grant is to contract with the Contractor to provide:

i. Develop a behavioral health assisted living pilot program to support adults living with serious mental illness.

ii. Attachments

a. Attachment A - Budget (Form 432)

b. Attachment B - Fiscal Invoicing Form (Form 437)

c. Attachment C - Fiscal Reporting Forms (Form 438)

d. Attachment D - Budget Modification Form (Form 436)

e. Attachment E - Year End Reporting Form (Form 440/440A)

b. Reimbursable costs and services for this Grant are as follows and are based on the approved budget (Attachment A Form 432):

i. Other items and/or services approved by SMCHD related to the purpose of this agreement. Before purchasing items or services with the Agreement funds, SMCHD must approve them.

c. Restrictions on Grant funding:

i. The Contractor shall use no part of the Agreement to supplant existing funding.

ii. No part of the Agreement shall supplement existing or future programs unrelated to the issued grant.

iii. No part of the Agreement shall be used for lobbying or fundraising.

iv. As a tax-exempt entity, SMCHD shall not reimburse any sales tax paid by the vendor.

3. Scope of Services. The Contractor shall perform the services described in RFP 27- 02 and any amendments, which is herby incorporated and made part of this agreement.

4. Term. The term of the Grant Agreement shall be from July 01, 2026 through June 30, 2027 (the “Initial Term”) with four one-year renewal options, contingent upon grant funding, unless terminated earlier per this agreement.

5. Modifications and Amendments. All changes to the terms of the Agreement shall be in writing and made by an addendum setting forth the modifications and amendments, except as otherwise noted in 1a concerning changes in Attachment A, Form 432 for subsequent renewal terms that will be documented in a Renewal Request.

6. Record-keeping/ Audits. Using generally accepted accounting principles, the Contractor shall maintain complete and accurate books and records of its financial activities, including records of all activities connected with this Grant. The Contractor shall make these books and records available upon reasonable notice for inspection and copying by the County and State representatives. The books and records shall be kept and maintained for at least three (3) years after the last payment under this Agreement. The Contractor agrees that the Auditor may audit all books and records of the Contractor, except that the Contractor shall be subjected to up to one audit of its books and records in any twelve months. The Contractor will make all Grant-related documents and records available for audit and evaluation to entitled Federal, State, and County officials upon request.

SMCHD will conduct regular program monitoring site visits and record reviews, including compliance with all Federal, State, and local conditions of award, health and safety standards, fiscal and data information, and quality management of service processes. Program and budgetary reviews will occur at least semi-annually. SMCHD will conduct an annual financial audit that includes a schedule specific to the funds in this agreement. Independent auditors will conduct an audit under contract with the Contractor and vendor or the Department of Health's in-house staff every other year. Audits, including frequency, preparation, performance, and reporting, will comply with Standards for Audit of Human Services Sub-Vendors, Section E, numbers 1-5 (https://health.maryland.gov/docs/audit_standards.DOC). Audit reports will include verification of the information reported on the MD 440, review of internal controls, compliance with laws and conditions of award, and determination of findings and questionable costs. Contractors must provide a copy of their Single Audit Report for the fiscal year if they expend more than $750,000 in federal funds.

The Contractor is responsible for providing a copy of the annual report if more than $100,000 in Maryland Department of Health (MDH) funds is received for a cost-reimbursement contract/agreement for the fiscal year. Not meeting the criteria above, an attestation must be submitted signed by an authorized agency official stating that the agency does not need a Single Audit or an MDH Human Services Sub-vendor Audit.

7. Grant Requirements.

a. The Contractor must comply with the RFP 27-02 and any amendments and relevant local, state, and federal laws and regulations.

https://health.maryland.gov/docs/audit_standards.DOC

b. The Contractor shall only use the Agreement funds for items outlined in the Contractor’s proposal and further specified in the Agreement and the Conditions of Award.

c. The Contractor must allow external evaluators to evaluate the agreement-funded items and/or services, as determined by SMCHD.

d. The Contractor shall designate one person to liaise with the SMCHD Grant Administrator, provide information and reports on Agreement activity, and network with other groups that receive Agreements.

e. The Contractor shall participate in meetings and initiatives as requested by

SMCHD.

f. The Contractor will ensure that all staff participate in all required training as put forth by SMCHD.

8. Reports.

Contractor:

a. The Contractor will submit reports as outlined in RFP 27-02 and any amendments.

b. SMCHD will conduct an annual financial audit that includes a schedule specific to the funds in this agreement.

c. SMCHD reserves the right to adjust and change data reporting requirements as the project evolves, improves, and/or as the guidelines dictate.

9. Invoices and Payment.

a. Upon receipt of a fully executed agreement, the Contractor will submit invoices monthly once expenses have been incurred. The invoices, with supporting documentation, will be submitted by the 15th of each month.

b. The Contractor will submit invoices to:

St. Mary’s County Health Department smchd.bhgrants@maryland.gov With a copy to:

Tammy M. Loewe, Behavioral Health Division Director tammym.loewe@maryland.gov Accounts Payable Team smchd.ap@maryland.gov

c. Proof-of-purchase for all expenditures funded by the Agreement should be submitted with the monthly invoice.

mailto:smchd.bhgrants@maryland.gov mailto:tammym.loewe@maryland.gov mailto:smchd.ap@maryland.gov

d. A new invoice must be approved after the funds are reconciled. The Grant Administrator must approve the invoice.

e. Certain purchases may be approved based on a quote with proof of expenditure to be sent within 30 days of being funded.

f. At the end of this Agreement's term, any funds disbursed for services that were not performed may be subject to reimbursement to SMCHD.

10. Conflict of Interest Policies. The Contractor agrees to maintain in full force and effect written policies and procedures prohibiting conflicts of interest of its officers and board members in the activities of the Contractor and restrictions of interested director transactions. The Contractor further agrees to maintain in full force and effect written policies and procedures prohibiting any financial or business transactions between the Contractor’s officers and directors and the Contractor.

Within ninety (90) days of the execution of this Agreement, the Contractor shall provide SMCHD with copies of the policies and procedures and of any amendments to the policies and procedures as they are made and shall allow SMCHD to comment thereon.

11. Contractor Compliance. The Contractor will adopt and maintain all policies and procedures necessary to comply with all State and Federal grant award conditions and State of Maryland policies, hereby incorporated herein.

12. Termination.

a. This Agreement may be terminated by either party after giving sixty (60) days written notice to the other party.

b. If the Contractor shall fail to fulfill in a timely and proper manner its obligations under this Agreement, or if the Contractor shall violate any terms of this Agreement, within the sole discretion of SMCHD, SMCHD may immediately terminate this Agreement by giving written notice to the Contractor. Within thirty (30) days of termination, the Contractor shall comply with its obligations under paragraphs 6, 7, and 10 of this Agreement.

c. In the event that funds, in whole or in part, are not available to begin or to continue this Agreement at the level of services specified, SMCHD may immediately terminate or amend this Agreement. SMCHD shall not be obligated to pay for any services rendered after the Contractor has received written notice of termination pursuant to this section. Any funds disbursed after termination are limited to allowable work approved by SMCHD.

13. Distribution of Assets Upon Termination or Dissolution. If, at the time of the termination of this Agreement or the dissolution of the Contractor, the Contractor has on hand any SMCHD funds or any accounts receivable attributable to the use of SMCHD funds or accounts, then those funds and accounts shall be returned to and transferred to SMCHD within thirty (30) days.

14. Confidentiality of Information. To the extent permitted by law, SMCHD agrees to keep as confidential and not to disclose as public records any proprietary or financial information regarding any private individual or business entity that the Contractor received while administering the Grant and that is in the custody of SMCHD. Upon receipt by SMCHD of a request to make information available, SMCHD shall promptly notify the Contractor of the request and give the Contractor an opportunity to comment on the disclosure.

15. Public Information. The Contractor agrees to treat all requests for information from members of the public as requests made under the Maryland Public Information Act, whether or not the Act governs the Contractor. The Contractor agrees to respond to all requests for information in the manner required by the Act. The Contractor may withhold from disclosure all documents for which the Act does not require disclosure. Any publications, presentations, conference abstracts, or planned promotional events partially or fully funded by this award must be reviewed and approved by SMCHD.

16. Penalty for Noncompliance.

a. Any grant funds not expended in compliance with the provisions of this Agreement shall be returned to SMCHD.

b. Noncompliance by the Contractor with this Agreement's record-keeping, auditing, monitoring, or reporting requirements shall be grounds for SMCHD to recover from the Contractor the total amount paid under this Grant.

c. Should legal action be necessary to collect any funds owed, the State shall be entitled to a percent (10%) per annum accruing on any balance thirty (30) days after SMCHD demands the return of the funds because of such noncompliance. The demand upon the Contractor shall be effective as of the date of mailing the Contractor's notice.

17. Nondiscrimination. The Contractor shall not discriminate against any person in any of its activities concerning membership policies, employment practices, or provision of services based on race, color, religion, national origin, ancestry, sex, age, or disability. This provision shall not be construed to prevent the Contractor from rendering services to categories of individuals with specific needs.

18. Administrator of the Grant. The Administrator of the Grant for SMCHD is the Health Officer or his/her successor or designee. The Contractor shall inform the Grant Administrator of the name, telephone number, and address of the Chief Executive Officer of the Contractor or the Chief Executive Officer’s designee.

19. Notices. Notices to the parties shall be directed as follows:

GRANTOR: Meenakshi G. Brewster, MD, MPH, FAAFP Health Officer

St. Mary’s County Health Department 21580 Peabody Street

Leonardtown, Maryland 20650

GRANT ADMINISTRATOR:

Tammy Loewe Program Manager St. Mary’s County Health Department 21580 Peabody Street Leonardtown, Maryland 20650

CONTRACTOR: Name of Provider Contact

Title Provider Street Address City, Maryland Zip Code

18. Non-assignment of Grant Funds. The Contractor shall apply the Grant directly as a first party for the purposes stated herein. The Contractor may not act as the agent of others, and neither the Grant received under this Agreement, nor the Agreement may be assigned, transferred, or otherwise passed to another organization or agency.

19. No Pledge of State or County Credit. The Contractor agrees that it will not pledge the full faith and credit of the State or County and will not obligate the State or County to incur any pecuniary liability other than the Agreement to the Contractor as provided herein.

20. Acknowledgment. The Contractor shall acknowledge and credit SMCHD for the Agreement in its brochures, news releases, programs, publications, and other publicity materials. When no printed information is used, verbal credit will be given whenever appropriate and practicable.

21. Independent Contractor Relationship. In performing this Agreement, the Contractor shall act solely as an independent contractor, and nothing contained in or implied by this Agreement shall be construed at any time to create the relationship of employer and employee, partnership, principal and agent, or joint adventurer as between SMCHD and the Contractor.

22. Insurance and Indemnification. The Contractor shall comply with the following insurance requirements:

a. The Contractor shall purchase and maintain while this Agreement is in effect:

i. Comprehensive Liability Insurance with liability limits of at least $1,000,000 combined single limit on an occurrence basis covering all premises and operations and including Personal Injury, Independent Contractor, Contractual Liability, and, where applicable to the Work, as determined by the Purchasing Agent, Products and Completed Operations;

ii. Comprehensive Business Automobile Liability Insurance with liability limits of at least $1,000,000 combined single limit to include owned, non-owned, and hired vehicles;

iii. Workers’ Compensation Insurance with statutory coverage as required by the laws of the State of Maryland, with limits of at least $100,000 per accident, $100,000 per employee disease, and $500,000 disease policy limit;

iv. Directors and Officers Liability Insurance with minimum coverage limits of $1,000,000; and

v. Professional Liability Insurance with minimum coverage limits of $1,000,000.

b. For the Comprehensive Liability and Comprehensive Business Automobile Liability policies, the Contractor shall provide SMCHD with a certificate evidencing the coverage and naming SMCHD, its officers, agents, and employees as additional insureds. The certificate shall give SMCHD at least 30 days written notice before any cancellation, intention not to renew, or material change in coverage. The certificate shall be emailed to SMCHD’s contract manager, smchd.contracts@maryland.gov.

c. The Contractor agrees to indemnify, defend, and hold harmless SMCHD, its officers, agents, and employees; the State of Maryland, its agents and employees;

and St. Mary’s County, its agents and employees; from any losses, damages, liabilities, claims, and costs arising out of or resulting from any act or omission made by the Contractor, its directors, officers, agents, employees, and contractors in performance of this Agreement. This indemnification is limited to the extent of the Contractor’s assets, including insurance.

23. HIPAA. If a Business Associate Agreement under the Health Insurance Portability and Accountability Act of 1996, and regulations enacted pursuant thereto (collectively “HIPAA”), is deemed necessary by SMCHD based on the services provided by the Contractor, the Contractor agrees to enter into a Business Associate Agreement as an Addendum to this Agreement.

24. PROHIBITION ON REDISCLOSURE: This information has been disclosed to you from the records protected by Federal confidentiality rules (42 CFR Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR Part 1. There must be more than a general authorization for releasing medical or other information. Federal rules restrict any use of the information to investigate or prosecute any alcohol or drug abuse patient criminally.

25. Applicable Law. This agreement shall be governed and construed per Maryland law, and any action brought by or between the parties shall invest jurisdiction and venue exclusively in the courts located in St. Mary’s County.

26. General.

a. This Agreement represents the complete total and final understanding between the parties, and no other understandings or representations, whether written or oral, regarding the subject matter of this Agreement, shall be deemed to exist or bind the parties after the execution of this Agreement unless set forth in writing and executed by both parties hereto.

b. This Agreement shall benefit the parties hereto, their successors, legal representatives, and assigns.

c. The captions to the paragraphs of this Agreement are for reference purposes only and are not substantive parts of this Agreement.

d. Contractor must sign the Certification Regarding Environmental Tobacco Smoke, a copy of which is attached hereto as Attachment 3.

e. Contractor must sign the Certification of Drug-Free Workplace, a copy of which is attached hereto as Attachment 4.

IN WITNESS WHEREOF, the parties do hereby set their hands and seals on the date and year first above written.

APPROVED BY THE LOCAL HEALTH DEPARTMENT:

Meenakshi G. Brewster MD, MPH, FAAFP. Date St. Mary’s County Health Officer St. Mary’s County Health Department

SIGNATURE OF CONTRACTING ENTITY:

Name of Provider Contact Date Title Provider

Attachment 4 - Saint Mary’s County BAA

BUSINESS ASSOCIATE AGREEMENT

This Business Associate Agreement (the “Agreement”) is made by and between St. Mary’s County Health Department, a unit of the Maryland Department of Health (MDH) (herein referred to as “Covered Entity”) and (Insert Name of Contractor) (hereinafter known as “Business Associate”). Covered Entity and Business Associate shall collectively be known herein as the “Parties.”

WHEREAS, Covered Entity has a business relationship with Business Associate that is memorialized in a separate agreement (the “Underlying Agreement”) dated XXXX, pursuant to which Business Associate may be considered a “business associate” of Covered Entity as defined in the Health Insurance Portability and Accountability Act of 1996 including all pertinent privacy regulations (45 C.F.R. Parts 160 and 164) and security regulations (45 C.F.R. Parts 160, 162, and 164), as amended from time to time, issued by the U.S. Department of Health and Human Services as either have been amended by Subtitle D of the Health Information Technology for Economic and Clinical Health Act (the “HITECH Act”), as Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act of 2009 (Pub. L. 111–5), and the HIPAA Omnibus Final Rule of 2013 (collectively, “HIPAA”); and

WHEREAS, the nature of the contractual relationship between Covered Entity and Business Associate may involve the exchange of Protected Health Information (“PHI”) as that term is defined under HIPAA; and

WHEREAS, for good and lawful consideration as set forth in the Underlying Agreement, Covered Entity and Business Associate enter into this Agreement for the purpose of ensuring compliance with the requirements of HIPAA and the Maryland Confidentiality of Medical Records Act (Md. Ann. Code, Health-General §§4-301 et seq.)

(“MCMRA”); and

WHEREAS, this Agreement supersedes and replaces any and all Business Associate Agreements the Covered Entity and Business Associate may have entered into prior to the date hereof;

NOW THEREFORE, the premises having been considered and with acknowledgment of the mutual promises and of other good and valuable consideration herein contained, the Parties, intending to be legally bound, hereby agree as follows:

I. DEFINITIONS

A. Catch-all definition. The following terms used in this Agreement, whether capitalized or not, shall have the same meaning as those terms in the HIPAA Rules: Breach, Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, Protected Health Information, Required by Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use.

B. Specific definitions:

1. Business Associate. “Business Associate” shall generally have the same meaning as the term “business associate” at 45 C.F.R. § 160.103, and in reference to the party to this Agreement, shall mean (Insert Name of Contractor).

2. Covered Entity. “Covered Entity” shall generally have the same meaning as the term “covered entity” at 45 C.F.R. § 160.103, and in reference to the party to this Agreement shall mean St.

Mary’s County Health Department.

3. HIPAA Rules. “HIPAA Rules” shall mean the Privacy, Security, Breach Notification, and Enforcement Rules at 45 C.F.R. Parts 160 and Part 164.

4. Protected Health Information (“PHI”). Protected Health Information or “PHI” shall generally have the same meaning as the term “protected health information” at 45 C.F.R. § 160.103.

II. PERMITTED USES AND DISCLOSURES OF PHI BY BUSINESS ASSOCIATE

A. Business Associate may only use or disclose PHI as necessary to perform the services set forth in the

Underlying Agreement or as required by law.

B. Business Associate agrees to make uses and disclosures and requests for PHI consistent with Covered Entity’s policies and procedures regarding minimum necessary use of PHI.

C. Business Associate may not use or disclose PHI in a manner that would violate Subpart E of 45 C.F.R.

Part 164 if done by Covered Entity.

D. Business Associate may, if directed to do so in writing by Covered Entity, create a limited data set as defined at 45 C.F.R. § 164.514(e)(2), for use in public health, research, or health care operations.

Any such limited data sets shall omit any of the identifying information listed in 45 C.F.R. § 164.514(e)(2). Business Associate will enter into a valid, HIPAA-compliant Data Use Agreement as described in 45 C.F.R. § 164.514(e)(4), with the limited data set recipient. Business Associate will report any material breach or violation of the data use agreement to Covered Entity immediately after it becomes aware of any such material breach or violation.

E. Except as otherwise limited in this Agreement, Business Associate may disclose PHI for the proper management and administration or legal responsibilities of the Business Associate, provided that disclosures are Required By Law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as Required By law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

F. The Business Associate shall not directly or indirectly receive remuneration in exchange for any PHI of an individual pursuant to §§ 13405(d)(1) and (2) of the HITECH Act. This prohibition does not apply to the State’s payment of a Business Associate for its performance pursuant to the Underlying Agreement.

G. The Business Associate shall comply with the limitations on marketing and fundraising communications provided in § 13406 of the HITECH Act in connection with any PHI of individuals.

III. DUTIES OF BUSINESS ASSOCIATE RELATIVE TO PHI

A. Business Associate agrees that it will not use or…