Addendum No. 2 Correction to RFP 25-165.pdf

Request For Proposals for

Substance Use Disorder and Recovery Services Perinatal

Services

RFP DBH # 25-165

ADDENDUM NO. 2 to RFP DBH # 25-165

This Addendum No. 2 is to provide the following changes to RFP DBH # 25-165 (ePro Document ID #

DBHE26-ADMN-6323):

I. ARTICLE III PROCUREMENT CONDITIONS, Section A. is hereby replaced in its entirety as follows:

A. All Proposers must:

1. Be a nonprofit corporation as required by the Substance Use Prevention and Treatment Recovery Services (SUBG) Block Grant guidelines. (See United States Code (USC), Title 42, Chapter 6A, subchapter XVII, Part B, subpart ii, Section 300x-31 (a) (1) (E) and Code of Federal Regulations (CFR) Title 45, Part 96, Section 135 (a) (5).).

2. Have a current Medi-Cal Certification or have the ability to become Medi-Cal Certified.

3. Have no record of unsatisfactory performance with any government agency or County Department including DBH. Proposers who are or have been seriously deficient in current or recent [within last five (5) years] contract performance, in the absence of circumstances properly beyond the control of the Proposer, shall be presumed to be unable to meet this requirement.

4. Register in the County’s Electronic Procurement Network (ePro) system.

5. Meet other presentation and participation requirements listed in this RFP.

II. ARTICLE V CONTRACT REQUIREMENTS, Section A., Number 19. Contract Reimbursement is hereby replaced in its entirety as follows:

19. Contract Reimbursement

a. During the term of this Agreement, the County shall reimburse Contractor in arrears for eligible expenditures provided under this Agreement and in accordance with the terms. County reimbursements to Contractor for performance of eligible expenditures hereunder are provisional until the completion of all settlement activities.

b. County’s adjustments to reimbursements to Contractor will be based upon State adjudication of Medi-Cal claims, contractual limitations of this Agreement, application of various County, State and/or Federal reimbursement limitations, application of any County, State and/or Federal policies, procedures and regulations and/or County, State or Federal audits, all of which take precedence over monthly claim reimbursement. State adjudication of Medi-Cal claims, audits, as such payments, are subject to future County, State and/or Federal adjustments.

c. All expenses claimed to DBH must be specifically related to the contract. After DBH’s review and approval of the billing or invoice, County shall reimburse Contractor, subject to the limitations and conditions specified in this Agreement, in accordance with the following:

1) The County will reimburse Contractor based upon Contractor’s submitted and approved claims for rendered services/activities subject to claim adjustments.

2) Reimbursement during the fiscal year for SUD services claimed and billed through the DBH treatment claims processing information system will utilize interim rates, actual cost, and funding budgets.

3) Year-end cost settlement will be based on actual allowable cost, not to exceed the contract maximum.

4) Contractor shall pull a revenue report monthly from the DBH billing and transactional database system and reconcile its denied claims. It is the responsibility of Contractor to make any necessary corrections to the denied services and notify DBH SUDRS Administration. The County will resubmit the corrected services to DHCS for adjudication.

5) In the event that the denied claims cannot be corrected, and the State DHCS will not approve the denied claims, the County may recover the paid funds from Contractor’s current invoice payment.

d. Contractor shall bill the County monthly in arrears after the month of services has ended, for services provided by Contractor on claim forms provided by DBH. All claims submitted shall clearly reflect all required information specified regarding the services for which claims are made. Contractor shall submit the organizations’ Profit and Loss Statement with each monthly claim. Each claim shall reflect any and all payments made to Contractor by, or on behalf of, patients. Claims for reimbursement shall be completed and forwarded to DBH within ten (10) days after the close of the month in which services were rendered. Following receipt of a complete and correct monthly claim, the County shall make payment within a reasonable period. Payment, for any service covered hereunder, shall be limited as noted.

e. In order for the County to properly report accurate expenditures to the State at the end of the fiscal year, Contractor must submit the final Claim for Reimbursement Report to the County within 30 (thirty) days following the end of the fiscal year, which is June 30.

f. Contractor shall ensure that the proposed interim reimbursement rates do not exceed the Contractor’s actual cost.

g. Reportable revenues are fees paid by persons receiving services or fees paid on behalf of such persons by the Federal Government, by the California Medical Assistance Program (set forth commencing with Section 14000 of the Welfare and Institutions Code) and by other public or private sources.

h. Total revenue collected pursuant to this Agreement from fees collected for services rendered and/or claims for reimbursement from the County shall not exceed the cost of services delivered by the Contractor. In no instance will the Contractor be reimbursed more than the actual net cost of delivering services under this Contract.

i. Contractor shall input Charge Data Invoices (CDI’s) into the County’s billing and transactional database system by the seventh (7th) day of the month for the previous month’s services. Contractor will be paid based on Drug Medi-Cal claimed services in the County’s billing and transactional database system for the previous month. Services cannot be billed by the County to the State until they are input into the County’s billing and transactional database system.

1) In order to properly reimburse Contractor for eligible monthly services, service data entry must be entered in the month of service. Failure to enter current data may result in delay of payment or non-payment.

j. Contractor shall accept all payments from the County via electronic funds transfer (EFT) directly deposited into the Contractor’s designated checking or other bank account. Contractor shall promptly comply with directions and accurately complete forms provided by the County required to process EFT payments.

k. Contractor shall be in compliance with the Deficit Reduction Act of 2005, Section 6032 Implementation. As a condition of payment for services, goods, supplies and merchandise provided to beneficiaries in the Medical Assistance Program (“Medi- Cal”), providers must comply with the False Claims Act employee training and policy requirements in 1902(a) of the Social Security Act [42 USC 1396(a) (68)], set forth in that subsection and as the federal Secretary of the United States Department of Health and Human Services may specify.

l. Contractor agrees that no part of any federal funds provided under this Contract shall be used to pay the salary of an individual per fiscal year at a rate in excess of Level 1 of the Executive Schedule at http://www.opm.gov (U.S. Office of Personnel Management).

m. County is exempt from Federal excise taxes and no payment shall be made for any personal property taxes levied on Contractor or any taxes levied on employee wages. The County shall only pay for any State or local sales or use taxes on the http://www.opm.gov/ services rendered or equipment and/or parts supplied to the County pursuant to the Contract.

n. Contractor shall have a written policy and procedures which outline the allocation of direct and indirect costs. These policies and procedures should follow the guidelines set forth in the Uniform Grant Guidance (UGG), Cost Principles and Audit Requirements for Federal Awards. Calculation of allocation rates must be based on actual data (total direct cost, labor costs, labor hours, etc.) from current fiscal year. Contractor shall acquire actual data necessary for indirect costs allocation purpose. Estimated costs must be reconciled to actual cost and Contractor must notify DBH SUDRS Administration in writing if the indirect cost rate changes.

o. As applicable, for Federal Funded Programs, Contractor shall charge the County program the applicable UGG de Minimis rate of the Modified Total Direct Cost (MTDC) as indirect cost unless Contractor has obtained a “Negotiated Indirect Cost Rates Agreement” from a cognizant agency, a federal agency that has authority over the area that the Contractor operates under, responsible for negotiating and approving indirect cost rate for non-profit organizations on behalf of all Federal agencies.

Contractor’s total non-Federal indirect cost shall be capped at 15% of the MTDC unless Contractor obtained a “Federal Agency Acceptance of Negotiated Indirect Cost Rates Agreement.”In that case, total indirect cost capped will be based on the Federally Negotiated Indirect Cost Rate. Indirect cost allocation method must be in compliance with Title 2 Code of Federal Regulations (CFR) Chapter II Part 200 Subpart E: Cost Principles.

The total cost of the program must be composed of the total allowable direct cost and allocable indirect cost less applicable credits. Cost must be consistently charged as either indirect or direct costs but, may not be double charged or inconsistently charged as both. (See Title 2CFR §200.414 Indirect costs). All costs must be based on actual costs, instead of estimated costs.

p. Contractor shall not request additional payments and acknowledges payment for services covered under this contract can only be made to the Contractor, no other network provider or agency.

q. Prohibited Payments

1) County shall make no payment to Contractor other than payment for services covered under this Contract.

2) Federal Financial Participation is not available for any amount furnished to an excluded individual or entity, or at the direction of a physician during the period of exclusion when the person providing the service knew or had reason to know of the exclusion, or to an individual or entity when the County failed to suspend payments during an investigation of a credible allegation of fraud [42 U.S.C. section 1396b(i)(2)].

3) In accordance with Section 1903(i) of the Social Security Act, County is prohibited from paying for an item or service:

i. Furnished under contract by any individual or entity during any period when the individual or entity is excluded from participation under Title V, XVIII, or XX or under this title pursuant to sections 1128, 1128A, 1156, or 1842(j)(2) of the Social Security Act.

ii. Furnished at the medical direction or on the prescription of a physician, during the period when such physician is excluded from participation under title V, XVIII, or XX or under this title pursuant to sections 1128, 1128A, 1156, or 1842(j)(2) of the Social Security Act and when the person furnishing such item or service knew, or had reason to know, of the exclusion (after a reasonable time period after reasonable notice has been furnished to the person).

iii. Furnished by an individual or entity to whom the County has failed to suspend payments during any period when there is a pending investigation of a credible allegation of fraud against the individual or entity, unless the County determines there is good cause not to suspend such payments.

iv. With respect to any amount expended for which funds may not be used under the Assisted Suicide Funding Restriction Act (ASFRA) of 1997.

The following provisions are applicable to Contractor for Fee-For-Service (FFS):

r. Monthly payments for Substance Use Disorder & Recovery Services providing billable outpatient Drug Medi-Cal Organized Delivery System (DMC-ODS) services will be based on actual units of service reported on Charge Data Invoices claimed to and reimbursed by the State, and services deemed by the State to be DBH responsibility at the rates specified on the referenced agreed upon FFS reimbursement rates of this agreement, and non-billable outpatient DMC-ODS services will be based on cost reimbursement, provided that the total of all payments to Contractor [and all other contract providers if applicable for an aggregate] shall not exceed the Contract amount or County’s Maximum Obligation.

s. Contractor shall bill the County monthly in arrears for services provided by Contractor on claim forms provided by DBH. All claims submitted shall clearly reflect all required information specified regarding the services for which claims are made. Claims for Reimbursement shall be completed and forwarded to DBH within ten (10) days after the close of the month in which services were rendered.

Following receipt of a complete and correct monthly claim, the County shall make payment within a reasonable period.

t. The Parties acknowledge that each party is solely responsible for any tax obligations it may incur as a result of the payment or receipt of the Settlement Amount, as applicable.

u. Contractor shall accept all payments from County via electronic funds transfer (EFT) directly deposited into the Contractor's designated checking or other bank account. Contractor shall promptly comply with directions and accurately complete forms provided by County required to process EFT payments.

v. Contractor shall be in compliance with the Deficit Reduction Act of 2005, Section 6032 Implementation. As a condition of payment for services, goods, supplies and merchandise provided to beneficiaries in the Medical Assistance Program (“Medi- Cal”), providers must comply with the False Claims Act employee training and policy requirements in 1902(a) of the Social Security Act [42 U.S.C. 1396(a) (68)], set forth in that subsection and as the Federal Secretary of the United States Department of Health and Human Services may specify.

w. As this contract may be funded in whole or in part with Mental Health Services Act (MHSA) funds signed into law January 1, 2005, Contractor must verify client eligibility for other categorical funding, prior to utilizing MHSA funds. Failure to verify eligibility for other funding may result in non-payment for services. Also, if audit findings reveal Contractor failed to fulfill requirements for categorical funding, funding source will not revert to MHSA. Contractor will be required to reimburse funds to the County.

x. The Fee-For-Service reimbursement rates are established by DBH for San Bernardino County. DBH will take into consideration requests for changes to Contract funding as applicable and appropriate. All requests for changes must be submitted in writing by Contractor to the DBH Deputy Director of SUDRS of program, or designee. Any modification must be approved in writing by DBH and shall be subject to all applicable provisions of this Contract.

y. If DHCS or the County determines there is a credible allegation of fraud, waste or abuse against government funds, the County shall suspend payments to the Contractor.

z. Contractor may contact DBH Quality Management directly with questions pertaining to appropriate and compliant documentation via telephone at (909) 386- 8227, or via email at DBH-QualityManagementDivision@dbh.sbcounty.gov so that DBH QM may respond or direct questions to a designee for response.

III. ARTICLE V CONTRACT REQUIREMENTS Section B., Number 11. Insurance Specifications., letter e. is hereby replaced in its entirety as follows

11. Insurance Specifications

e. Cyber Liability Insurance

Cyber Liability Insurance with limits of no less than $1,000,000 for each occurrence or event with an annual aggregate of $2,000,000 covering privacy violations, information theft, damage to or destruction of electronic information, intentional and/or unintentional release of private information, alteration of electronic information, extortion and network security. The policy shall protect the involved County entities and cover breach response cost as well as regulatory fines and penalties.

mailto:DBH-QualityManagementDivision@dbh.sbcounty.gov

IV. ARTICLE X SUBCONTRACTOR STATUS, is hereby replaced in its entirety as follows:

A. Contractor agrees not to enter into any subcontracting contracts for services under the Contractor without first obtaining written approval from the County. Any subcontractor shall be subject to all applicable terms and conditions as the Contractor. The Contractor will be fully responsible for any performance of a subcontracting agency. County will not reimburse Contractor or subcontractor for any expenses rendered without County approval in writing of any contract between the Contractor and any subcontractor for the fiscal year in which the subcontracting services started.

B. Contractor shall obtain County’s written consent, which County may withhold in its sole discretion, before entering into Contracts with or otherwise engaging any subcontractors who may supply any part of the Services to County. At County’s request, Contractor shall provide information regarding the subcontractor’s qualifications and a listing of a subcontractor’s key personnel including, if requested by County , resumes of proposed subcontractor personnel.

C. Contractor shall remain directly responsible to the County for its subcontractors and shall indemnify the County for the actions or omissions of its subcontractors under the terms and conditions specified in Indemnification and Insurance Article.

V. ARTICLE XI PROPOSAL SUBMISSION, Paragraph C. Proposal Format, Number 7. Subcontractor Information, is hereby amended to read as follows:

7. Subcontractor Information

If Proposer plans to subcontract any portion of the service delivery described in the RFP, include a written justification for subcontracting.

□ a. Complete and include Attachment F.

□ b. Any subcontractor must be approved in writing by the County and shall be subject to all applicable terms and conditions as the Contractor. The Contractor will be fully responsible for any performance of a subcontractor.

NOTE: County will not reimburse Contractor or subcontractor for any expenses rendered by a subcontractor NOT approved in writing by the County .