DRAFT Civil Contract SOW .docx

EXHIBIT A – Statement of Work- Contracted Civil Beds

CONTRACT PURPOSE

This contract outlines the agreement between the Colorado Department of Human Services, Office of Civil and Forensic Mental Health (OCFMH), and __________ (Contractor) for inpatient psychiatric bed availability for patients on long term civil certifications. The Contractor's primary responsibility is to ensure the appropriate placement of patients requiring inpatient psychiatric care, in full compliance with the established inpatient psychiatry transfer pathway principles and all applicable State and Federal laws and rules.

1. PROGRAMMING FOR CIVIL COMMITMENT INPATIENT SERVICES

The Contractor shall develop and maintain specialized programming tailored to the unique needs of individuals under short-term, extended short-term, long-term, and extended long-term civil certifications.

1.1 This programming must focus on:

Stabilization and Recovery: Utilizing evidence-based treatment modalities (e.g., Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy for Psychosis (CBTp), Acceptance and Commitment Therapy (ACT) and Trauma-Informed Care), Electro Conclusive Therapy (ECT), and appropriate medications to stabilize acute symptoms.

1.2 Life Skills and Community Readiness: Providing daily groups focused on independent living skills, medication management, social skills training, pro-social behaviors, and vocational readiness to prepare patients for the least restrictive environment.

1.3 Personalized Treatment Planning: Multidisciplinary teams must conduct comprehensive assessments and update treatment plans every 30 days to ensure progress toward specific discharge goals.

1.4 TRANSITION AND DISCHARGE COORDINATION

1.4.1 Community Integration: The Contractor shall initiate discharge planning upon admission, identifying potential community-based placements and supports immediately.

1.4.2 Transition Services: Contractor must provide "bridge" services, such as coordinating with comprehensive safety net providers (CSNPS), and/or coordination with Contrator’s outpatient services, and facilitating site visits to future residential placements, to ensure a seamless transition from inpatient care.

1.5 KEY PERFORMANCE METRICS (KPMs)

To ensure high-quality care and avoid incentivizing indefinite stays, the following metrics will be tracked and reported monthly:

1.5.1 Average Length of Stay (ALOS) Benchmarking: Tracking ALOS against clinical milestones. Any stay exceeding 180 days requires a formal clinical review with OCFMH to justify continued inpatient necessity.

1.5.2 Patient Progress toward Goals: A monthly report showing the percentage of patients making documented progress on at least 75% of their active treatment plan goals.

1.6 FINANCIAL INCENTIVES, RISK, COMPLIANCE, AND BILLING

1.6.1 Incentive and Risk Agreement: Unnecessarily continuing certifications, delaying discharge, or “bed-blocking” is strictly prohibited by this agreement and state law. To ensure the contract does not reward keeping patients beyond what is medically necessary and reasonable, OCFMH shall implement a performance-based risk and incentive. This includes a "Shared Incentive and Risk" agreement for the Contractor as described below in 1.7 1.6..2 Audit of Medical Necessity: Patients under this contract must meet established Medical Necessity requirements for care. OCFMH reserves the right to conduct unannounced utilization reviews, and the Contractor agrees to allow access for such reviews. If it is determined a patient meets criteria for a lower level of care but the Contractor has not actively pursued discharge, OCFMH may reduce the daily reimbursement rate for that specific patient.

1.6.3Compliance with Colorado False Claims Act CRS 24-31-12: All aspects of this contract will fall under Colorado False Claims Act, including but not limited to false or fraudulent claims of Medical necessity and required 27-65 applicability, to ensure that patient treatment is reasonable, necessary, and free from illegal inducements.

1.7 Shared Incentive and Risk Value Based Agreement

1.7.1 In a shared savings and risk model, the following metrics will be used to incentivize activities that support and/or are indicative of successful transitions from care.

Specific metrics are tied to both the potential of a Contractor being rewarded for metric being met, and the potential of their payments being cut or fees clawed back if they fall into the risk metric.

2. PRIORITIZATION OF BED PLACEMENT

1. Individuals on Civil Certifications moving from Colorado Mental Health Hospital at Fort Logan, as identified by OCFMH.

2. Individuals on Civil Certifications that are identified by OCFMH, to include:

2.2.1 ITP to STC conversions.

2.2.2 Individuals in the State Hospitals on Civil Certifications

2.2.3 Individuals on Civil Certifications currently residing in other OCFMH treatment services, Forensic Community Based Services, Mental Health Transitional Living, or Outpatient Services requiring a different level of care.

3. CLINICAL INCLUSION CRITERIA

3.1 Patients being considered for transfer shall be evaluated by the attending psychiatrist or designee on the treatment team, through an initial records review when OCFMH sends records to the Contractor within 24 hours. The Contractor consults with OCMFH regarding referrals prior to admission.

3.1.1 Patient admissions shall be accepted Monday – Friday.

3.1.2 Psychiatric disorder that is treatable in inpatient psychiatric hospitalization.

3.1.3 Patients that are greater than or equal to 18 years old.

3.1.4 Patients will be on a current short term, extended short term, long term, or extended long term civil certification that the Contractor shall accept transfer of.

3.2 Patients must be assessed for and offered appropriate Occupational Therapy and Physical Therapy, based on Medical necessity.

3.2.1 Physical therapy and Occupational therapy may be billed to the patients insurance, as applicable.

4. EXCLUSION CRITERIA

4.1 Patients with the following pending criminal charges:

4.1.1 Homicide, including attempted homicide

4.1.2 Serious assault, including attempted assaults (Assault with a deadly weapon, Assault resulting in Serious Bodily Injury, and sexual violence).

4.2 The contractor agrees to discuss such cases with OCFMH to ensure all information has been reviewed and agreed upon.

5. CLINICAL EXCLUSION CRITERIA

5.1 Patients with a confirmed primary or sole diagnosis of Autism Spectrum Disorder (ASD).

5.2 Patients with a confirmed primary or sole diagnosis of Dementia or an Intellectual Disability.

5.3 Patients with a confirmed primary or sole diagnosis of Antisocial Personality Disorder.

5.4 Patients with a documented or estimated IQ below 70 as the primary mental health diagnosis.

5.5 Patients with a primary or sole diagnosis of Substance Use Disorder.

5.6 Patients with a primary or sole diagnosis of Pedophilia or Sexual Paraphilias.

5.7 The contractor agrees to discuss such cases with OCFMH to ensure all information has been reviewed and agreed upon.

6. MEDICAL EXCLUSION CRITERIA

6.1 Current acute medical diagnosis requiring medical hospitalization.

6.2 Patient with an IV portal.

6.3 Patients who require frequent off site medical care such as dialysis or radiation, etc.

6.4 Patients who need total care.

6.5 Patients who cannot ambulate independently or with an assistive device.

6.6 The contractor agrees to discuss such cases with OCFMH to ensure all information has been reviewed and agreed upon.

7. SPECIAL CASES

7.1 For each of the following situations, a conversation between OCFMH, Contractor and the attending psychiatrist shall coordinate care before transfer:

· Cases with complex medical/surgical/Obstetrics conditions needing hospital level care shall require coordination with Contractor and OCFMH medical team prior to acceptance.

· The Contractor shall provide supervision to patients referred to facilities based on clinical need and or court requirements on a case-by-case basis. Examples would include providing supervision of the individual to a medical appointment. Contractor shall provide emergency transportation to and from an acute medical facility when emergency services are needed for OCFMH patients (in accordance with paragraph 15.2).

7.2 Contractor shall use its own Critical Incident Policy and Grievance policies and procedures, and those policies must be in compliance with BHA and CDPHE rule and applicable law.

7.2.1 Contractor agrees to share with OCFMH Contractor’s policies regarding, at a minimum:

· Emergency Medications

· Seclusion and Restraint

· Patient Rights

· Abuse and Neglect Reporting

· Background Screening

· Suicide Prevention

· Staff Training

· Elopement

7.3 Contractor shall notify OCFMH regarding the following Contractor policy items:

7.3.1 Report all grievances to BHA, CDPHE, and OCFMH submitted by a patient while in their care within three (3) business days, including the resolution of each report. If a grievance is not resolved, Contractor shall provide updates weekly for unresolved grievances. Contractor should comply with all BHA and CDPHE provided recommendations for any unresolved grievances, and shall include OCFMH on all communications regarding this grievance.

7.4 Contractor shall report all critical incidents to the BHA, CDPHE, and OCFMH within one (1) business day after the incident. Critical incidents must also be reported to BHA, CDPHE, and OCFMH within one (1) business day of when either agency determines that a reportable incident has occurred and such reporting is requested.

7.5 Contractor shall provide organized secure copies of the patient's full medical record within 24 hours (or the next business day, whichever is later) after patient discharge without prompting. Copies are to be provided to OCFMH.

7.6 Contractor shall follow all applicable privacy rules, including HIPAA, HITECH, and 41 CFR part 2, as applicable.

7.6.1 Patient information may be released without prior coordination for continuity of care.

7.7 For grievances and critical incidents including patients in contracted beds, contact OCFMH point of contact by an encrypted email.

8. CONSULT AND TRANSFER PROCESS

8.1 OCFMH will send referrals to the Contractor by encrypted email.

8.2 Referrals will include available records for review and OCFMH will follow up with consultation with the Contractor, as needed or requested.

8.3 Contractor will notify Admissions Manager , of acceptance or denial of the patient within two business days of referral.

8.4 Transfer of patient information and process:

8.4.1 OCFMH’s referring program will send appropriate medical, legal and psychiatric records to Contractor via encrypted email.

8.5 Discharge of patient information and process:

8.5.1 Contractor shall report the number of patients who have received maximum inpatient psychiatric benefit, and who were referred for discharge or transfer.

8.5.2 On completion of treatment or if treatment needs are determined to be better addressed in another setting, the Contractor will contact OCFMH to refer the patient for transfer to OCFMH designated facility (e.g. Colorado Mental Health Institute at Pueblo (CMHIP), Fort Logan, or other facility).

8.5.2.1 Contractor may, with OCFMH approval, move patients into Contractor’s PHP or IOP program to facilitate step-down.

8.5.3 When a patient is being transferred to another non-contractor facility, or discharged from the Contractor, Contractor will provide organized copies of patient’s full medical records to OCFMH point of contact or designee in electronic encrypted format 24 hours prior to discharge, as well as any notification and coordination with the BHA, as applicable by rule.

8.6 All discharges and transfers will be coordinated between Contractor and OCFMH point of contact or designee, in accordance with paragraph 11.11. For discharges and transfers of patients in contracted beds, contact OCFMH point of contact or designee.

8.7. Return of Patient to OCFMH direct care.

8.7.1Upon review and agreement from OCFMH, OCFMH will accept transfers back from Contractor as a result of the following:

8.7.1.1 Patient exhibits or demonstrably presents an elevated unreasonable risk to the safety of themselves or any other person, including other patients and treatment personnel, or

8.7.1.2 Patient has reached a state of maximum psychiatric recovery but still meets 27-65 criteria.

8.7.1.3 Contractor may petition OCFMH to accept the return of the patient to OCFMH direct care.

8.7.1.3.1 OCFMH shall review Contractor’s petition and retain the exclusive discretion to determine whether return of the patient is warranted under the circumstances, or whether Contractor shall continue to provide treatment and care to the patient.

8.7.1.3.2 Maximum medical benefit must be achieved prior to transfer back to OCFMH.

8.7.1.3.3 Should OCFMH determine that the return of the patient is not warranted, Contractor shall continue therapeutic treatment and care of the patient. Contractor may submit a new petition, independent from the prior petition, upon presentation of new facts or circumstances for OCFMH consideration.

8.7.1.3.4 If OCFMH agrees but is unable to accept the return of a patient due to capacity, parties will establish an estimated date for return and work together to adjust as necessary. In this case, no further petition is required.

9. INPATIENT BED RESERVATION:

9.1 Contractor agrees to provide twenty four (24) contracted inpatient psychiatric beds for appropriate placement of OCFMH patients requiring civil certification behavioral health services. These beds will be made available no later than 30 days from the execution of this contract.

9.2 Contractor shall provide inpatient psychiatric care for each individual in these beds in alignment with requirements and standards in BHA rules, CDPHE rules, as well as CMS regulations.

10.2 Other Treatment Services

10.2.1 Contractor shall provide participants with additional evidenced-based treatment groups and services, as appropriate.

10.3 Patients should be assessed within twenty four (24) hours of admission, and treatment plans shall be completed within seventy two (72) hours of admission.

10.4 Compliance with Civil Certification requirements

10.4.1 Contractor shall comply with all requirements and timelines as included in CRFS 27-65 and BHA rule to continue Civil Certifications.

11. OCFMH SERVICES

OCFMH will provide the following services at the Contractors facility in conjunction with a patient’s inpatient stay:

11.1 Oversight of the contract, to include both announced and unannounced visits.

11.2 Oversight of Contractor-provided curriculum and guidance on evidence-based practices.

11.3 Contact with the committing court.

11.4 Support and oversight for individuals receiving psychiatric services at Contractor’s facility, to include ongoing chart reviews and on-site visits.

11.5 Coordination of transportation of patients to and from transferring facilities and Contractor.

11.6 Admission and discharge coordination and notifications.

11.7 OCFMH reserves the authority to monitor and audit Contractor’s Services.

OCFMH shall conduct both unannounced and announced monitoring visits, to assure that individuals placed in the custody of the State are receiving appropriate services and are cared for in accordance with all Federal, State rules, regulations, policies and procedures, and in compliance with this contract.

11.8 If the OCFMH notifies Contractor of deficiencies found, Contractor shall respond with an action plan to correct any identified deficiencies within the time frames specified in the written findings of the monitoring visit, and shall perform in accordance with the remedial action plan until all deficiencies are corrected. Failure to meet the terms of any action plan may result in breach of Contract.

11.10 OCFHM reserves the right to review, inspect or otherwise approve any proposed subcontractor, and all services delivered by any subcontractor related to this Contract.Only written express approval will be allowable to add a subcontractor.

11.10.1 Contractor shall ensure any subcontractor complies with this Contract and any State requirements.

11.10.2 Failures in performance by subcontractors and/or Contractor will subject Contractor to liquidated Damages. This includes failure to admit patients in violation of the terms of this contract.

12. CONTRACTOR ADJUNCT SERVICES

Contractor shall provide Clients with access to culturally and linguistically appropriate services (CLAS), including but not limited to bilingual staff, qualified translators, and sign-language interpreters, where applicable. These services shall be paid for by Contractor.Contractor and must be in compliance with BHA CLAS rule.

12.1 Contractor shall ensure materials are made available in large print for those Clients who are visually impaired but can read enlarged print.

12.2 Contractor shall use language line services, or other adequate services, and collaborate with other providers to ensure language barriers are overcome.

12.3 Contractor shall utilize TDD machines for deaf Clients.

12.4 Contractor shall meet CLAS standards through BHA required applicable training for all staff.

13. MEDICAL RECORDS

13.1 Contractor shall maintain a complete record of all medication, treatment and services provided to Clients, in alignment with standards of care and BHA requirements.

13.1.1 The organization and contents of the record shall comply with standards provided by Contractor and OCFMH. The complete medical record shall consist of, but is not limited to, the following contents:

13.1.1.1 Diagnosis

13.1.1.2 Plan of Care

13.1.1.3 Plan of Care updates

13.1.1.4 Initial assessments by all disciplines

13.1.1.5 Labs

13.1.1.6 Medication Administration Record (MAR)

13.1.1.7 All physician orders (i.e., medication, seclusion, testing, etc.)

13.1.1.8 Copies of all testing (i.e. medical imaging, psychological assessments, etc.)

13.1.1.9 Notes (to include progress notes towards goal of ending certification and discharge)

13.1.1.10 Release of Information (ROI) disclosure log

13.1.1.11 Patient Rights Receipt with Signature

13.1.1.12 HIPAA confirmation with signature

13.1.1.13 Discharge Summary

13.1.1.14 Psychiatric Discharge Summary

13.1.1.15 Nursing Discharge Summary

13.1.1.16 Social Work Discharge Summary

13.1.1.17 Aftercare Plan

13.1.1.18 Medication Orders

13.2 Medical record reports shall be 100% accurate and shall be provided prior to discharge to OCFMH.

13.3 Both parties agree that the transfer of the medical records will be done electronically and the electronic method and process will be discussed and mutually agreed to and in compliance with HIPAA and all other applicable regulations.

13.4 Contractor and OCFMH agree that the following medical records are needed at time of discharge and shall include records of all referrals and care coordination, and all legal records related to civil certification, and this information should be sent to OCFMH within 24 hours post discharge. This record shall be complete, organized, and readable.

13.4.1 Discharge information that shall be sent to the OCFMH shall include the following core data elements.

Core Data Elements:

13.4.1.1 Patient Identifying Information (e.g. name, date of birth, medical record number)

13.4.1.2 All psychiatric diagnoses

13.4.1.3 All medical diagnoses and health status of the Patient

13.4.1.4 Discharge date

13.4.1.5 Discharge medication list

13.4.1.6 Discharge summary completed by psychiatrist

13.5 OCFMH shall have access to medical records upon request. Contractor will retain books and records respecting services rendered to Clients for time periods required under all applicable laws (including the requirements of the Secretary of Health and Human Services (HHS) and allow access to such books and records by duly authorized agents of the Secretary of HHS, the Controller General and others to the extent required by law.

13.6 Exchange and transmission of (PHI) between OCFMH and Contractor shall be: Paper, Fax via a secure line, Direct Messaging via a secure, healthcare-defined, messaging system, or Health Information Exchange (HIE), as agreed upon expressly through writing prior to transmission.

14. INVOICES, BILLING AND PAYMENT

14.1 OCFMH will pay Contractor $___ per patient per day for twenty four (24) inpatient certification psychiatric beds, only when occupied.

14.2 Invoices should clearly identify the date and whether the bed was occupied or not. The fee shall be inclusive of all costs of care and treatment included, but not limited to:

14.2.1 Room and board

14.2.2 Security sitters

14.2.3 Food, beverage, snacks

14.2.4 Daily pharmacy services

14.2.5 Daily psychiatry visits

14.2.6 Daily clinical therapy groups

14.2.7 Daily nursing lead groups

14.2.8 Daily non-clinical groups

14.2.9 History and Physical examination every 30-days

14.2.10 24 hr. nursing care

14.2.11 Daily fitness and recreation therapy groups

14.2.12 Nutrition consults as needed

14.2.13 Interpreter services

14.2.14 All administrative work, including that to support continued certification.

14.3 Invoices shall include the following:

14.3.1 Include Contractor's name, address, remit address, tax id number

14.3.2 Include State issued encumbrance number

14.3.3 Billing invoice number

14.3.4 Invoice billing period

14.3.5 Patient name and billing account number

14.3.6 Admission date and occurrence span from and through

14.3.7 Total days

14.3.8 Contracted Rate

14.3.9 Invoice total

14.4 OCFMH shall pay Contractor within forty-five (45) days after receipt of each such invoice. Payment by OCFMH shall be considered final unless Contractor requests adjustments in writing within thirty (30) days following receipt of such payment.

14.4.1 Contractor shall accept all amounts paid hereunder as payment in full for all services furnished and shall not seek or accept additional compensation from patients or their families, representatives, or third-party payors, except as provided in this Exhibit A.

14.4.2 Except as expressly provided in Exhibit A, OCFMH shall have no obligation whatsoever to make any payments to Contractor or any Contractor Personnel. In addition, OCFMH shall have no obligation to reimburse Contractor for any charges, costs, expenses, or other fees for services that are not in conformity with any Psychiatry Patient’s standard of care for inpatient psychiatric admission and/or the terms and conditions of this Agreement.

14.4.3 Invoices shall be sent by secure encrypted email and addressed to the OCFMH point of contact or their designee. Current point of contact is Jason Folbigg at jason.folbigg@state.co.us.

14.4.4 Invoices should also be mailed via USPS Certified mail to the Office of Civil and Forensic Mental Health, Colorado Department of Human Services, Attention: CFO Office, 1575 Sherman St, Denver, CO 80203.

14.4.6 Contractor shall invoice OCFMH on a monthly basis, by the fifteenth (15th) Business Day of the month following the month for which the Services were rendered. Monthly census sheet shall be attached to each invoice. The Contractor shall not invoice OCFMH for a month prior to the last day of the month.

14.5 Terms from the Shared Savings and Risk Value Based Payment System will be as follows

14.5.1 Contractor shall submit data for the four (2) metric areas, being readmission rate and coordination of care rate, submitted quarterly to OCFMH, as aggregate numbers, attesting to their accuracy upon submission.

14.5.2 OCFMH will have 15 calendar days to review aggregate data and have the ability to request disaggregate data associated with these metrics. Contractor will have 15 calendar days from this request to provide supporting disaggregated data, following all encryption and HIPAA requirements.

14.5.3 OCFM will provide the appropriate payment for any applicable incentive related to these data as they match required metrics within 45 days of receipt of the last requested and received data set. OCFMH shall withhold payment at a rate equal to any applicable penalty, related to these data as they match required metrics.

14.5.4 Contractor may appeal any penalty amount or dispute a finding that an incentive was not met, and must do so within 15 days of OCFMH’s findings. Any request for appeal must be in writing. OCFMH will review and respond within 15 calendar days with findings of this appeal, including details of the process to review the request, conduct the appeal, outcomes of such an appeal, and results and timelines for response and applicable payment.

15. OUTSIDE EMERGENCY CARE

15.1 In the event a patient is transported to an acute care hospital, OCFMH point of contact or their designee must be notified immediately but no later than within 24 hours of transport. BHA and CDPHE must also be notified in compliance with rule.

15.2 Emergency transportation, security, and facility charges shall be handled in the manner Contractor uses for all other patients.

16. DATA COLLECTION AND REPORTING

16.1 Contractor shall provide OCFMH with a monthly written report (in MS Word format) and an electronic file submission (in either MS Excel or MS Access formats) due by the tenth (10th) day of each month for the prior month. Contractor shall transmit all files utilizing email security and archiving services provided in writing by OCFMH.

16.2 Data collected will include but not be limited to, diagnosis, daily bed capacity, numbers transferred vs. unable to transfer with reason for action, length of stay, payment source, county of origin, disposition.

16.3 The monthly Word document shall summarize relevant monthly and trend data broken down by general admission patients and patients admitted for an initial evaluation only.

16.4 In addition to 16.2, the monthly data requirements submitted in MS Excel for Patients shall include:

16.4.1 Patients admitted by name, admission date, and originating Facility;

Cert type, initiation date, renewal date

16.4.2 Patients discharged by name, discharge date, and originating Facility, along with reason for discharge as follows: a) Discharged due to certification being terminated due to no longer meeting 27-65 criteria, b) Discharged for other reason (explain with detailed narrative), c) Transferred to another facility, d) Patient eloped, e) Patient died, f) Other (explain with detailed narrative);

16.4.3 Number of patients on involuntary medications, as a percentage;

16.4.4 Patient Daily Census for month;

16.4.5 Number of Days from Admission to Discharge and reason for discharge as above;

16.4.6 Identify Patients receiving Interpretive Services by way of supplemental devices, or outside services. This does not include interpretive services that are available because staff is bilingual and approved for service delivery. Identify service received.

16.4.8 Critical incidents during month by type (assault, self-harm, attempted suicide, suicide gesture, injury requiring medical treatment, escape, etc.)

16.4.9 Disruptions to programming e.g.., group canceled.

16.4.10 Percentage of Patients refusing medications.

16.4.11 Any and all errors in submitting required reports or documentation to continue civil certifications.

16.4.12 Nothing in this contract will replace reporting requirements under BHA

17. HIPAA BAA - Exhibit E

17.1 Contractor shall be liable for any fines levied or costs as a result of loss of PHI data or claims based upon alleged violations of privacy rights through improper use or disclosure of PHI.

18. BACKGROUND CHECKS

18.1 Contractor shall initiate background checks for all employees who may have direct or indirect contact with OCFMH referred patients. Contractor shall ensure its employees cooperate with any reasonable requests to undergo previous employment and background checks, whether made by Contractor, BHA, or OCFMH, which are deemed reasonably necessary by OCFMH or BHA at any time before or during their employment. These background checks may include, without limitation, security checks, criminal record checks, checks on licenses and credentials, education, and relevant regulatory requirements applicable in the sector in which they undertake, work, and operate.

18.2 Contractor shall ensure that each employee working with OCFMH patients attend any meetings required by OCFMH or prospective client before undertaking an assignment. It is a condition of this Contract that Contractor’s employees are and continue to be competent to properly carry out the duties of their position and that any representations as to the qualifications, skills, experience, industry knowledge, business influence, client contacts, and employment history made by Contractor or a person on their behalf are true and correct. The basic background screening shall cover all state residences of the Contractor’s employees for the preceding seven (7) years.

18.3 Contractor shall notify the OCFMH, BHA, and DORA of any confirmed felony convictions or misdemeanors associated with the employee prior to allowing the employee to work with any OCFMH patient or immediately upon discovery of a confirmed felony or misdemeanor conviction. OCFMH must consent explicitly in writing to allow the employee with a criminal history of felony or misdemeanor conviction to have any direct or indirect contact with a patient under this contract. OCFMH has the option of obtaining further background screening services provided by the Colorado Bureau of Investigations www.cbi.gov or background screening services, and may require any Contractor employee to submit to additional background screening. If any employee refuses, the Contractor shall remove the employee from all work and services related to the Contract, and the employee shall have no direct or indirect contact with any OCFMH patient.

19. IMMUNIZATION AND RELATED REQUIREMENTS

19.1 Contractor shall attest that all persons working under this Contract have fully met all applicable CDPHE and BHA rules regarding vaccinations and screenings for tuberculosis.

19.2 Contractor shall comply with any future new or updated Public Health Orders as they may apply for State Contractors.

20. TERMINATION

20.1 Subject to any other provision in this Contract, this Contract may be terminated on the first to occur of the following:

20.1.1 OCFMH, at any time during the term of this Contract, may terminate with cause upon giving Contractor thirty (30) days’ prior written notice.

20.1.1.1 OCFMH, at any time during the contract, may terminate this contract to comply with changes to policy, without further cause, as directed by State fiscal rules and State law.

20.1.2 Contractor, at any time during the term of this Contract, may terminate this Contract with or upon giving OCFMH thirty (30) days prior written notice.

20.1.3 OCFMH, in cases where OCFMH determines in good faith that the health, safety or welfare of the patient is jeopardized by the continuation of this Contract with Contractor, if Contractor loses BHA license or related accreditation or licenses to operate, or if Contractor (i) professional liability insurance coverage lapses, OCFMH may terminate this Contract immediately upon delivery of written notice.

20.1.4 Written notice of termination by Contractor shall be sent by certified mail and will be addressed to the Chief Financial Officer, Office of Civil and Forensic Mental Health, 1575 Sherman St, Denver, CO 80203.

20.1.5 Unless due to the health, safety or welfare of the patient is jeopardized by the continuation of this Contract with Contractor, if Contractor loses BHA license or related accreditation or licenses to operate, or if Contractor (i) professional liability insurance coverage lapses, there will be an up to 90-day timeframe for OCMFH and BHA to place patients, wherein the payments of the contract will continue even after such termination until the patient is placed, unless there are willful acts to block or delay such transfers.

20.1.6 Nothing in this contract, including termination, shall allow Contractor to discontinue care for patients in a way that jeopardizes their health, safety, or patient rights, nor override the authority and rules related to BHA care coordination for placement of these certified individuals.

21. NOTICES AND REPRESENTATIVES

21.1 Each individual identified below is the principal representative of the designating Party. All notices required to be given hereunder shall be hand delivered with receipt required or sent by certified or registered mail to such Party’s principal representative at the address set forth below. In addition to, but not in lieu of a hard-copy notice, notice also may be sent by email to the email addresses, if any, set forth below. Either Party may from time to time designate by written notice substitute addresses or persons to whom such notices shall be sent. Unless otherwise provided herein, all notices shall be effective upon receipt.

If to OCFMH:

If to Contractor:

End of Exhibit A.