New Hampshire Department of Health and Human Services Money Follows the Person Transitional Case Management

Appendix A – Scope of Services

RFA-2027-DLTSS-03-MFPTC Contractor Initials __________

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Scope of Services

1. Statement of Work

1.1. The Contractor must provide transitional case management services to individuals who are over the age of sixty (60) or between the ages of eighteen

(18) and sixty (60) with a chronic illness or disability, who meet Medicaid long term supports and services (LTSS) medical and financial eligibility criteria, are residing in qualified Money Follows the Person (MFP) institution for at least sixty (60) continuous days, are assessed to need assistance to transition into a community-based setting have been referred to the Contractor from the Department (hereinafter “participants”) and determined to be eligible for participation in the MFP program.

1.2. The Contractor must provide services in one (1) or more of the following awarded counties:

1.2.1. Belknap.

1.2.2. Carroll.

1.2.3. Cheshire.

1.2.4. Coos.

1.2.5. Grafton.

1.2.6. Hillsborough.

1.2.7. Merrimack.

1.2.8. Rockingham.

1.2.9. Strafford.

1.2.10. Sullivan.

1.3. The Contractor must provide MFP Transitional Case Management services during business hours, 8:00 AM to 5:00 PM, Monday through Friday.

1.4. The Contractor must maintain a toll-free telephone line that is operational twenty-four (24) hours a day, seven (7) days a week for participant outreach.

1.4.1. The Contractor must maintain policies and procedures related to after-hours response and escalation and provide such policies and procedures to the Department upon request.

1.4.2. The Contractor must provide guidance to participants and their support teams on how to access after-hours assistance, including appropriate use of emergency services, crisis response services and service providers as appropriate.

1.5. Pre-Transition Services

1.5.1. The Contractor must accept referrals for MFP Transitional Case

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Management services from the Department under this Agreement unless the Contractor notifies the Department of a conflict of interest

1.5.2. The Contractor must confirm receipt and acceptance of the initial referral within two (2) business days of the date in which the Contractor receives the notification from the Department.

1.5.3. The Contractor must conduct and document a person-centered face-to-face comprehensive assessment of the MFP participant’s strengths and needs utilizing the MFP Community Transition Assessment and Plan provided by the Department within fifteen (15) business days of receiving the initial referral, unless a later date is approved by the Department.

1.5.4. The Contractor must use the MFP Community Transition Assessment and Plan in conjunction with the participant’s most recent Minimum Data Set (MDS), Medical Eligibility Assessment (MEA) and/or Pre- Admission Screening and Resident Review (PASRR) to help inform the development of the Initial Care Plan.

1.5.5. The Contractor must complete a Risk Identification and Mitigation Plan (RIMP) with the participant and use the information gathered to help inform completion of the participant’s Contingency Plan as specified in 1.5.13.

1.5.6. The Contractor must confirm Medicaid and Choices for Independence (CFI) Waiver eligibility for the participant and support completion of requirements, if applicable.

1.5.7. The Contractor must collaborate with the institution to schedule and complete functional ability assessments related to participant skills needed for community living.

1.5.8. The Contractor must meet face-to-face, in person, with the participant twice monthly to discuss and provide transition coordination, which must include, but is not limited to:

1.5.8.1. Convening and facilitating person-centered service planning meetings.

1.5.8.2. Actively engaging and recruiting formal and informal support providers to participate in both the transition and service delivery.

1.5.8.3. Facilitating the transition from the institutional setting to community-based living.

1.5.8.4. Coordinating any other person-centered activities that are needed to support the participant’s transition to a community-based setting.

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1.5.9. The Contractor must work with the participant and their care team to develop a care plan and identify goals and objectives to address the medical, social and other services needed by the participant.

1.5.10. The Contractor must work with the participant to identify and engage the participant’s support team members as applicable, including:

1.5.10.1. Institution staff;

1.5.10.2. Informal supports;

1.5.10.3. Community based service providers; and

1.5.10.4. Housing navigators.

1.5.11. The Contractor must collaborate with the participant and other members of the participant’s support team to develop the participant’s transition plan, which must include:

1.5.11.1. Participant preferences;

1.5.11.2. Person-Centered Goals;

1.5.11.3. Needed Services; and

1.5.11.4. Transition Target date.

1.5.12. The Contractor must facilitate transition planning meetings for the participant, which must include:

1.5.12.1. An initial transition planning meeting, in order to:

1.5.12.1.1. Identify a transition date;

1.5.12.1.2. Outline tasks; and

1.5.12.1.3. Assign roles and responsibilities.

1.5.12.2. Ongoing transition planning meetings, in order to:

1.5.12.2.1. Confirm discharge date; and

1.5.12.2.2. Review and modify the transition plan, role

assignments and tasks as needed.

1.5.13. The Contractor must develop and monitor a Contingency Plan for services outlined in the participant’s care plan in the event normally scheduled providers are not available.

1.5.14. The Contractor must assist the participant to connect with the following services at the participant’s request:

1.5.14.1. Medical services;

1.5.14.2. Behavioral health services;

1.5.14.3. Social, educational or other programs; and

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1.5.14.4. Additional resources and services that address identified needs and/or support achievement of the participant’s goals.

1.5.15. The Contractor must support the participant by:

1.5.15.1. Facilitating the choice and selection of service providers to deliver services; and

1.5.15.2. Conducting outreach to providers to confirm capacity and ability to provide services.

1.5.16. The Contractor must provide pre-transition support as outlined in

Appendix A-1 - Medicaid Billable Supplemental Services for the following:

1.5.16.1. Transportation that has been arranged by Housing

Navigators for home visits that allow participants to view available housing options in the community prior to transition;

1.5.16.2. Housing application and related fees including criminal background checks, credit checks and vital record request fees;

1.5.16.3. Home accessibility modifications;

1.5.16.4. Home cleaning and/or pest eradication;

1.5.16.5. Security deposits;

1.5.16.6. Utility deposits; and

1.5.16.7. Securing items needed to establish a household.

1.5.17. The Contractor must coordinate all furniture and equipment delivery and set up.

1.5.18. The Contractor must confirm readiness the day the participant is discharged from the institution by ensuring all needed services are arranged and transition day activities are understood by the participant and care/support teams.

1.5.19. The Contractor must submit service authorizations for all needed services prior to transition and for the 365 day MFP program enrollment period.

1.5.20. The Contractor must provide a copy of the Initial Care Plan and Contingency Plan to the participant and distribute to care providers as directed by the participant.

1.6. Post Transition Services

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1.6.1. The Contractor must provide pantry and kitchen stocking as outlined in Appendix A-1 - Medicaid Billable Supplemental Services.

1.6.2. The Contractor must conduct and document an in person, face-to-face visit with the participant within twenty-four (24) hours following transition at the participant’s community residence.

1.6.3. The Contractor must maintain contact with the participant at the minimum following frequencies:

1.6.3.1. During the first three (3) months following the transition date:

1.6.3.1.1. Three (3) weekly phone contacts and one (1)

face-to-face contact each month.

1.6.3.2. During the remaining nine months of MFP participation:

1.6.3.2.1. One (1) face-to-face contact each month.

Monthly face-to-face contacts may be made by phone under extenuating circumstances which must be documented and include:

1.6.3.2.1.1. Participant illness or extended

hospitalization;

1.6.3.2.1.2. Case manager illness; and

1.6.3.2.1.3. Participant request which then

must document contact with at least one of the participant’s direct service providers in lieu of the face-to-face visit.

1.6.4. The Contractor must complete a monthly review of the participant’s care plan and update as needed, based on:

1.6.4.1. A participant’s request to change service delivery including amount, scope and/or duration of the service;

1.6.4.2. Changes in diagnosis or demographic information;

1.6.4.3. Change in legal status, such as guardianship or marital status;

1.6.4.4. Changes in rendering provider for a service; and

1.6.4.5. Any other relevant changes impacting the participant’s access to or receipt of services.

1.6.5. The Contractor must monitor and document changes to the RIMP.

1.6.6. The Contractor must monitor and update Contingency Plan as needed.

1.6.7. The Contractor must continue to support the participant as specified in

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1.6.8. The Contractor must assist the participant and/or the participant’s guardian or representative as necessary to access and maintain benefits for which they are eligible, including but not limited to:

1.6.8.1. Public benefits.

1.6.8.2. Medical benefits.

1.6.8.3. Financial benefits.

1.6.8.4. Specific grant programs.

1.6.9. The Contractor must continue to ensure home modifications, vehicle adaptations, and home cleaning and/or pest eradication are completed as needed and align with the RIMP and care plans.

1.6.10. The Contractor must monitor utilization of services and follow up with the participant and rendering providers for any under or over utilization that is not in alignment with the care plan and develop recommendations to realign utilization with the documented service needs.

1.6.11. The Contractor must monitor the services provided to the participant by:

1.6.11.1. Ensuring services are adequate and appropriate for the participants’ needs and are being provided as outlined in the care plan;

1.6.11.2. Ensuring the participant is actively engaging in the services described in the care plan;

1.6.11.3. Ensuring the participant is satisfied with the care plan; and

1.6.11.4. Identifying any changes in the participant’s condition, discussing these changes with the participant to determine if any changes are needed to the care plan and making changes to the care plan as needed.

1.6.12. The Contractor must:

1.6.12.1. Monitor the participant for post-transition challenges;

1.6.12.2. Share critical information with and seek guidance from the

Department related to crisis mitigation and management;

1.6.12.3. Coordinate, complete, and document appropriate follow up related to incident reports and sentinel events, including reporting to the Department; and

1.6.12.4. Participate in and follow up with complaint investigations.

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1.6.13. The Contractor must ensure that service documentation is maintained as outlined in NH Administrative Rule He-E 805, Targeted Case Management Services and adhere to record retention requirements.

The documentation must be:

1.6.13.1. Timely, complete and maintained using Department

approved templates or systems, as applicable; and

1.6.13.2. Clearly reflective of face-to-face contacts, participant involvement, service coordination activities and care plan updates.

1.6.14. The Contractor must continue to provide copies of Care and Contingency Plans to the participant and distribute to care teams as agreed to by the participant.

1.6.15. The Contractor must monitor participant satisfaction with services monthly.

1.6.16. The Contractor must notify the Department within one (1) business day if a participant re-enters an institutional setting during the MFP participation period. The Contractor must collaborate with the Department to determine whether transition planning will pause, resume, or require modification, and must document all actions taken.

1.7. The Contractor must ensure services are delivered in accordance with federal MFP requirements, including:

1.7.1. Applicable CMS guidelines;

1.7.2. Definitions;

1.7.3. Reporting standards; and

1.7.4. Participant protections.

1.8. The Contractor must participate in meetings with the Department on a monthly basis, or as otherwise requested by the Department.

1.9. The Contractor may be required to facilitate reviews of files conducted by the Department on an annual basis, or as otherwise requested by the Department, that may include, but are not limited to:

1.9.1. MFP participant case records.

1.9.2. Records that pertain to staff training requirements and background checks under this Agreement.

1.10. The Contractor is required to ensure staff participate in annual training as required by the Department.

1.11. Reporting

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1.11.1. The Contractor must submit quarterly reports by the fifteenth (15th) of the month following the end of the quarter which include, but are not limited to:

1.11.1.1. The number of assigned participants residing in an

institution by institution type.

1.11.1.2. The number and percentage of participants transitioned to the community by institution type.

1.11.1.3. The total number of transitions completed during the quarter.

1.11.1.4. The average number of days from referral to completed community transition.

1.11.1.5. Percentage of participants with current Care Plan, Contingency Plan and RIMPs.

1.11.1.6. Completion rate of required post-transition contacts by type (phone and in person, face-to-face).

1.11.1.7. Number and type of services that are not in alignment with care plans.

1.11.1.8. Number of critical incidents and crisis interventions involving participants reported to the Department.

1.11.1.9. Number and percentage of participants re-institutionalized within thirty (30), ninety (90) and 365 days.

1.11.2. The Contractor must support the Department in meeting all CMS MFP reporting, monitoring and audit requirements.

1.11.3. The Contractor may be required to provide other key data and metrics to the Department in a format specified by the Department.

1.12. Background Checks

1.12.1. Prior to permitting any individual to provide services under this Agreement, the Contractor must ensure that said individual has undergone:

1.12.1.1. A criminal background check, at the Contractor’s expense, and has no convictions for crimes that represent evidence of behavior that could endanger individuals served under this Agreement; and

1.12.1.2. A name search of the Department’s Bureau of Adult and Aging Services (BAAS) State Registry, pursuant to RSA 161-F:49, with results indicating no evidence of behavior that could endanger individuals served under this

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Agreement.

1.13. Confidential Data

1.13.1. The Contractor must meet all information security and privacy requirements as set by the Department and in accordance with the Department’s Information Security Requirements Exhibit as referenced below.

1.13.2. The Contractor must ensure any individuals involved in delivering services through this Agreement contract sign an attestation agreeing to access, view, store, and discuss Confidential Data in accordance with federal and state laws and regulations and the Department’s Information Security Requirements Exhibit. The Contractor must ensure said individuals have a justifiable business need to access confidential data. The Contractor must provide attestations upon Department request.

1.14. Privacy Impact Assessment

1.14.1. Upon request, the Contractor must allow and assist the Department in conducting a Privacy Impact Assessment (PIA) of its system(s)/application(s)/web portal(s)/website(s) or Department system(s)/application(s)/web portal(s)/website(s) hosted by the Contractor, if Personally Identifiable Information (PII) is collected, used, accessed, shared, or stored. To conduct the PIA the Contractor must provide the Department access to applicable systems and documentation sufficient to allow the Department to assess, at minimum, the following:

1.14.1.1. How PII is gathered and stored;

1.14.1.2. Who will have access to PII;

1.14.1.3. How PII will be used in the system;

1.14.1.4. How individual consent will be achieved and revoked; and

1.14.1.5. Privacy practices.

1.14.2. The Department may conduct follow-up PIAs in the event there are either significant process changes or new technologies impacting the collection, processing or storage of PII.

1.15. Department Owned Devices, Systems and Network Usage

1.15.1. If Contractor End Users, defined in the Department’s Information

Security Requirements Exhibit that is incorporated into this Agreement, are authorized by the Department’s Information Security Office to use a Department issued device (e.g. computer, tablet, mobile telephone) or access the Department network in the fulfilment

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1.15.1.1. Sign and abide by applicable Department and New

Hampshire Department of Information Technology (NH DoIT) use agreements, policies, standards, procedures and guidelines, and complete applicable trainings as required;

1.15.1.2. Use the information that they have permission to access solely for conducting official Department business and agree that all other use or access is strictly forbidden including, but not limited, to personal or other private and non-Department use, and that at no time shall they access or attempt to access information without having the express authority of the Department to do so;

1.15.1.3. Not access or attempt to access information in a manner inconsistent with the approved policies, procedures, and/or agreement relating to system entry/access;

1.15.1.4. Not copy, share, distribute, sub-license, modify, reverse engineer, rent, or sell software licensed, developed, or being evaluated by the Department, and at all times must use utmost care to protect and keep such software strictly confidential in accordance with the license or any other agreement executed by the Department;

1.15.1.5. Only use equipment, software, or subscription(s)

authorized by the Department’s Information Security Office or designee;

1.15.1.6. Not install non-standard software on any Department equipment unless authorized by the Department’s Information Security Office or designee;

1.15.1.7. Agree that email and other electronic communication messages created, sent, and received on a Department-issued email system are the property of the Department of New Hampshire and to be used for business purposes only. Email is defined as “internal email systems” or “Department-funded email systems.”

1.15.1.8. Agree that use of email must follow Department and NH DoIT policies, standards, and/or guidelines; and

1.15.1.9. Agree when utilizing the Department’s email system:

1.15.1.9.1. To only use a Department email address

assigned to them with a “@ affiliate.DHHS.NH.Gov”.

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1.15.1.9.2. Include in the signature lines information

identifying the End User as a non-Department workforce member; and

1.15.1.9.3. Ensure the following confidentiality notice is

embedded underneath the signature line:

CONFIDENTIALITY NOTICE: “This message may contain information that is privileged and confidential and is intended only for the use of the individual(s) to whom it is addressed. If you receive this message in error, please notify the sender immediately and delete this electronic message and any attachments from your system. Thank you for your cooperation.”

1.15.1.10. Contractor End Users with a Department issued email, access or potential access to Confidential Data, and/or a workspace in a Department building/facility, must:

1.15.1.10.1. Complete the Department’s Annual

Information Security & Compliance Awareness Training prior to accessing, viewing, handling, hearing, or transmitting Department Data or Confidential Data.

1.15.1.10.2. Sign the Department’s Business Use

and Confidentiality Agreement and Asset Use Agreement, and the NH DoIT Department wide Computer Use Agreement upon execution of the Agreement and annually thereafter.

1.15.1.10.3. Only access the Department’s intranet

to view the Department’s Policies and Procedures and Information Security webpages.

1.15.1.11. Contractor agrees, if any End User is found to be in violation of any of the above terms and conditions, said End User may face removal from the Agreement, and/or criminal and/or civil prosecution, if the act constitutes a violation of law.

1.15.1.12. Contractor agrees to notify the Department a minimum of three business days prior to any upcoming transfers or terminations of End Users who possess Department credentials and/or badges or who have system privileges.

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If End Users who possess Department credentials and/or badges or who have system privileges resign or are dismissed without advance notice, the Contractor agrees to notify the Department’s Information Security Office or designee immediately.

1.15.2. Workspace Requirement

1.15.2.1. If applicable, the Department will work with Contractor to determine requirements for providing necessary workspace and State equipment for its End Users.

1.16. Contract End-of-Life Transition Services

1.16.1. General Requirements

1.16.1.1. If applicable, upon early termination or expiration of the Agreement the parties agree to cooperate in good faith to effectuate a secure transition of the services (“Transition Services”) from the Contractor to the Department and, if applicable, the new Contractor (“Recipient”) engaged by the Department to assume the services. Ninety (90) days prior to the end-of the contract or unless otherwise specified by the Department, the Contractor must begin working with the Department and if applicable, the Recipient to develop a Data Transition Plan (DTP). The Department shall provide the DTP template to the Contractor.

1.16.1.2. The Contractor must assist the Recipient, in connection with the transition from the performance of Services by the Contractor and its End Users to the performance of such Services. This may include assistance with the secure transfer of records (electronic and hard copy),transition of historical data (electronic and hard copy), the transition of any such Service from the hardware, software, network and telecommunications equipment and internet-related information technology infrastructure (“Internal IT Systems”) of Contractor to the Internal IT Systems of the Recipient and cooperation with and assistance to any third-party consultants engaged by Recipient in connection with the Transition Services.

1.16.1.3. If a system, database, hardware, software, and/or software licenses (Tools) was purchased or created to manage, track, and/or store Department Data in relationship to this contract said Tools will be inventoried and returned to the Department, along with the inventory document, once transition of Department data is complete.

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1.16.1.4. The internal planning of the Transition Services by the Contractor and its End Users shall be provided to the Department and if applicable the Recipient in a timely manner. Any such Transition Services shall be deemed to be Services for purposes of this Agreement.

1.16.1.5. In the event the data Transition extend beyond the end of the Agreement, the Contractor agrees that the Information Security Requirements, and if applicable, the Department’s Business Associate Agreement terms and conditions remain in effect until the Data Transition is accepted as complete by the Department.

1.16.1.6. In the event the Contractor has comingled Department Data and the destruction or Transition of said data is not feasible, the Department and Contractor will jointly evaluate regulatory and professional standards for retention requirements prior to destruction, refer to the terms and conditions of the Department’s DHHS Information Security Requirements Exhibit.

1.16.2. Completion of Transition Services

1.16.2.1. Each service or transition phase shall be deemed completed

(and the transition process finalized) at the end of fifteen

(15) business days after the product, resulting from the Service, is delivered to the Department and/or the Recipient in accordance with the mutually agreed upon Transition plan, unless within said fifteen (15) business day term the Contractor notifies the Department of an issue requiring additional time to complete said product.

1.16.2.2. Once all parties agree the data has been migrated the Contractor will have thirty (30) days to destroy the data per the terms and conditions of the Department’s Information Security Requirements Exhibit.

1.16.3. Disagreement over Transition Services Results

1.16.3.1. In the event the Department is not satisfied with the results of the Transition Service, the Department shall notify the Contractor, in writing, stating the reason for the lack of satisfaction within fifteen (15) business days of the final product or at any time during the data Transition process.

The Parties shall discuss the actions to be taken to resolve the disagreement or issue. If an agreement is not reached, at any time the Department shall be entitled to initiate actions in accordance with the Agreement.

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1.17. Website and Social Media

1.17.1. The Contractor must work with the Department’s Communications

Bureau to ensure that any social media or website designed, created, or managed on behalf of the Department meets all Department and NH Department of Information Technology (DoIT) website and social media requirements and policies.

1.17.2. State of New Hampshire’s Website Copyright

1.17.2.1. All right, title and interest in the State WWW site, including copyright to all data and information, shall remain with the State of New Hampshire. The State of New Hampshire shall also retain all right, title and interest in any user interfaces and computer instructions embedded within the WWW pages. All WWW pages and any other data or information shall, where applicable, display the State of New Hampshire’s copyright.

2. Exhibits Incorporated

2.1. The Contractor must comply with all Exhibit D Federal Requirements, which are attached hereto and incorporated by reference herein.

2.2. The Contractor must manage all confidential data related to this Agreement in accordance with the terms of Exhibit E, DHHS Information Security Requirements.

2.3. The Contractor must use and disclose Protected Health Information in compliance with the Standards for Privacy of Individually Identifiable Health Information (Privacy Rule) (45 CFR Parts 160 and 164) under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and in accordance with the attached Exhibit F, Business Associate Agreement, which has been executed by the parties.

3. Additional Terms

3.1. Impacts Resulting from Court Orders or Legislative Changes

3.1.1. The Contractor agrees that, to the extent future state or federal legislation or court orders may have an impact on the Services described herein, the State has the right to modify Service priorities and expenditure requirements under this Agreement so as to achieve compliance therewith.

3.2. Federal Civil Rights Laws Compliance: Culturally and Linguistically Appropriate Programs and Services

3.2.1. The Contractor must submit:

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3.2.1.1. A detailed description of the language assistance services, within ten (10) days of the Effective Date of the Agreement, to be provided to ensure meaningful access to programs and/or services to individuals with limited English proficiency; individuals who are deaf or have hearing loss;

individuals who are blind or have low vision; and individuals who have speech challenges.

3.2.1.2. A written attestation, within forty-five (45) days of the Effective Date of the Agreement and annually thereafter, that all personnel involved the provision of services to individuals under this Agreement have completed, within the last twelve (12) months, the Contractor Required Training Video on Civil Rights-related Provisions in DHHS Procurement Processes, which is accessible on the Department’s website (https://www.dhhs.nh.gov/doing-business-dhhs/civil-right-compliance-dhhs-vendors); and

3.2.1.3. The Department’s Federal Civil Rights Compliance

Checklist within ten (10) days of the Effective Date of the Agreement. The Federal Civil Rights Compliance Checklist must have been completed within the last twelve (12) months and is accessible on the Department’s website (https://www.dhhs.nh.gov/doing-business-dhhs/civil-right-compliance-dhhs-vendors).

3.3. Credits and Copyright Ownership

3.3.1. All documents, notices, press releases, research reports and other materials prepared during or resulting from the performance of the services of the Agreement must include the following statement, “The preparation of this (report, document etc.) was financed under an Contract with the State of New Hampshire, Department of Health and Human Services, with funds provided in part by the State of New Hampshire and/or such other funding sources as were available or required, e.g., the United States Department of Health and Human Services.”

3.3.2. All materials produced or purchased under the Agreement must have prior approval from the Department before printing, production, distribution or use.

3.3.3. The Department must retain copyright ownership for any and all original materials produced, including, but not limited to reports, protocols, guidelines, brochures, posters, and resource directories.

3.3.4. The Contractor must not reproduce any materials produced under the Agreement without prior written approval from the Department.

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4. Records

4.1. The Contractor must keep records that include, but are not limited to:

4.1.1. Books, records, documents and other electronic or physical data evidencing and reflecting all costs and other expenses incurred by the Contractor in the performance of the Contract, and all income received or collected by the Contractor.

4.1.2. All records must be maintained in accordance with accounting procedures and practices, which sufficiently and properly reflect all such costs and expenses, and which are acceptable to the Department, and to include, without limitation, all ledgers, books, records, and original evidence of costs such as purchase requisitions and orders, vouchers, requisitions for materials, inventories, valuations of in-kind contributions, labor time cards, payrolls, and other records requested or required by the Department.

4.1.3. Statistical, enrollment, attendance or visit records for each recipient of services, records regarding the provision of services and all invoices submitted to the Department to obtain payment for such services.

4.1.4. Medical records on each patient/recipient of services.

4.2. During the term of this Agreement and the period for retention hereunder, the

Department, the United States Department of Health and Human Services, and any of their designated representatives must have access to all reports and records maintained pursuant to the Agreement for purposes of audit, examination, excerpts and transcripts.

4.3. If, upon further review, the Department must disallow any expenses claimed by the Contractor as costs hereunder, the Department retains the right, at its discretion, to deduct the amount of such expenses as are disallowed or to recover such sums from the Contractor.