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Insert Contract # HC11 Insert Date Managing Entity ATTACHMENT I A. Services To Be Provided 1. Definition of Terms a. Contract Terms Unless specifically defined in this contract, definitions for terms used in this document can be found in the Department of Children and Families’ Glossary of Contract Terms – Incorporated Document 1, which is incorporated herein by reference and may be located at: http://www.myflfamilies.com/service-programs/substance- abuse/managing-entities b. Program/Service Specific Terms (1) Behavioral Health Network (BNet) - A statewide network of providers of Behavioral Health Services that serve children with mental health or substance use disorders, who are ineligible for Medicaid, and are determined eligible for Title XXI of the United States Public Health Services Act. (2) Behavioral Health Services – Substance Abuse and Mental Health Services defined pursuant to section 394.9082(2)(a), Florida Statutes (F.S.). (3) Continuous Quality Improvement (CQI) - Internal and external improvements in service provision and administrative functions. These functions include the systematic ongoing process of improving performance, both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. For purposes of this contract, CQI will include quality assurance functions including, but not limited to, periodic external review activities conducted by the Department and the Managing Entity to assure that the agreed upon level of service is achieved and maintained by the Managing Entity and its Network Service Providers. CQI will also include assessing compliance with contract requirements, state and federal law and associated administrative rules, regulations, and operating <Provider Name> Last Update: September 5, 2013 9

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Insert Contract # HC11Insert Date Managing Entity

ATTACHMENT IA. Services To Be Provided

1. Definition of Termsa. Contract TermsUnless specifically defined in this contract, definitions for terms used in this document can be found in the Department of Children and Families’ Glossary of Contract Terms – Incorporated Document 1, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

b. Program/Service Specific Terms(1) Behavioral Health Network (BNet) - A statewide network of providers of Behavioral Health Services that serve children with mental health or substance use disorders, who are ineligible for Medicaid, and are determined eligible for Title XXI of the United States Public Health Services Act.

(2) Behavioral Health Services – Substance Abuse and Mental Health Services defined pursuant to section 394.9082(2)(a), Florida Statutes (F.S.).

(3) Continuous Quality Improvement (CQI) - Internal and external improvements in service provision and administrative functions. These functions include the systematic ongoing process of improving performance, both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. For purposes of this contract, CQI will include quality assurance functions including, but not limited to, periodic external review activities conducted by the Department and the Managing Entity to assure that the agreed upon level of service is achieved and maintained by the Managing Entity and its Network Service Providers. CQI will also include assessing compliance with contract requirements, state and federal law and associated administrative rules, regulations, and operating procedures, and, validating quality improvement systems and findings.

(4) Electronic Health Record (EHR) - Defined pursuant to section 408.051(2)(a), F.S.

(5) Evidence-Based Practice (EBP) – Defined pursuant to Evidence-Based Practice Guidelines – Incorporated Document 2, which is incorporated herein by reference, and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(6) Indigent Drug Program (IDP) – Provided pursuant to section 394.676, F.S.

(7) Individual(s) Served - An individual who receives substance abuse or mental health services, the cost of which is paid, either in part or whole, by Department appropriated funds or local match (matching).

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(8) Juvenile Incompetent to Proceed (JITP) - "Child," "juvenile" or "youth" as defined in section 985.03(6), F.S., deemed incompetent to proceed for accused crimes as specified in section 985.19, F.S.

(9) Local Match (Matching) - Defined pursuant to Rule 65E-14.005, F.A.C.

(10) Managing Entity – Defined pursuant to section 394.9082(2)(d), F.S. Throughout Attachment I, the term Managing entity is synonymous with the definition of Provider in the Department’s Standard Contract.

(11) Mental Health Services – Defined pursuant to section 394.67(15), F.S.

(12) Mental Health Treatment Facilities – Civil and forensic state Mental Health Treatment Facilities serving adults who have been committed for intensive inpatient treatment by a circuit court and pursuant to Chapter 394, or 916, F.S.

(13) Network Service Provider - A direct service agency providing Substance Abuse or Mental Health Services that is under contract with a Managing Entity as part of the System of Care (SOC).

(14) Operational Costs - The allowable direct expenses incurred by a Managing Entity in performing its contracted functions and delivering its contracted services.

(15) Payor Class – Defined pursuant to section 394.461(4)(b), F.S.

(16) Projects for Assistance in Transition from Homelessness (PATH) - A federal grant to support homeless individuals with mental illnesses, who may also have co-occurring substance abuse and mental health treatment needs.

(17) Risk Assessment - A process for evaluating the threat of damage, loss, liability, or other negative occurrence caused by external or internal vulnerabilities that may be avoided through pre-emptive action. An effective Risk Assessment prioritizes the extent and degree of appropriate monitoring activities. Risk Assessment results should guide annual monitoring plans including decisions regarding type (desk review, on-site), frequency (annual, quarterly, or monthly), and level of detail (aggregate or client level data). As an example, a Risk Assessment for a Managing Entity’s SOC might evaluate each Network Service provider on the following factors:

(a) Complexity of services;

(b) Incident history;

(c) Commitment level;

(d) Service cost;

(e) Provider experience; and

(f) Past provider monitoring results

(18) Stakeholders - Individuals or groups with an interest in the provision of treatment services for individuals with substance use, mental health, and co-occurring disorders in the circuits outlined in Section A.2.a.(1), of this

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contract. This includes, but is not limited to, the key community constituents included in section 394.9082(6)(f)5., F.S.

(19) Statewide Inpatient Psychiatric Programs (SIPP) - Residential inpatient facilities for children under age 18 to provide diagnostic and active treatment services in a secure setting. SIPP providers must be under contract with the Agency for Health Care Administration (AHCA) under a Medicaid waiver authorized by Title XIX, Section 1915(b)(4) of the Social Security Act (42 U.S.C. 1396n); and, in accordance with Chapters 394, 408, and 409, F.S., and Rules 59G-4.120 and 65E-9.008(4), F.A.C. Submit – Unless otherwise specified, the term “Submit” as used in this attachment shall be construed to mean submission of a contractual requirement to the Contract Manager.

(20) Substance Abuse and Mental Health Information System (SAMHIS) - The Department’s current substance abuse and mental health web-based data system or any replacement system to which a Managing Entity and all Network Service Providers are required to report data in accordance with this contract.

(21) Substance Abuse Services – Substance abuse prevention and treatment services pursuant to section 397.331(1)(a), F.S.

(22) Supplemental Security Income and Social Security Disability Insurance (SSI and SSDI) Outreach, Access, and Recovery (SOAR) - A Substance Abuse and Mental Health Services Administration (SAMHSA) technical assistance initiative designed to help individuals increase earlier access to SSI and SSDI through improved approval rates on initial Social Security applications by providing training, technical assistance, and strategic planning to Network Service Providers.

(23) System of Care (SOC) – A comprehensive array of Behavioral Health Services and program that meet the local need for Behavioral Health Services and are accessible and responsive to the needs of Individuals Served, their families, and community Stakeholders that includes the following elements:

(a) Prevention and early intervention;

(b) Emergency care;

(c) Acute care;

(d) Residential treatment;

(e) Outpatient treatment;

(f) Rehabilitation;

(g) Supportive intervention;

(h) Recovery support; and

(i) Consumer support services.

(24) Temporary Assistance to Needy Families (TANF) - Pursuant to section 414.1585, F.S., the Substance Abuse and Mental Health TANF diversion program for families at risk of welfare dependency due to substance

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use disorders or mental illnesses is intended to provide services as clinically necessary to assist families in achieving self-sufficiency, so that children can be cared for in their own homes.

(25) Wait List - A master wait list maintained by a Managing Entity that shows the number of persons waiting for access to the recommended service or program.

2. General Descriptiona. General Statement

(1) The Department is contracting with _____, as a Managing Entity, within the annual appropriation, to administer, provide, manage, and support the contractually specified duties of the Department as they relate to the publicly funded Behavioral Health Services pursuant to section 394.9082, F.S. in circuit(s) ____.

(2) The Managing Entity shall contract with a network of qualified service providers to establish a System of Care (SOC) to provide Behavioral Health Services to children, adolescents, adults, and elders, in accordance with Chapters 394, 397, 916, and section 985.03, F.S., and that is consistent with the State Substance Abuse and Mental Health Services Plan dated January 2013, or the latest version thereof.

b. AuthoritySections 20.19, 39.001(2), 39.001(4), 394.457(3), 394.74, 394.9082, 397.305(2), 397.305(3), 397.321(4), F.S., and Chapter 916, F.S., provide the Department with the authority to contract for these services.

c. Scope of Service(1) The Managing Entity shall be responsible for the management and delivery of a comprehensive array of Behavioral Health Services to the target populations identified in section 394.674, F.S.

(2) The Managing Entity shall comply with all applicable federal and state laws and regulations. In addition, the Managing Entity shall comply with all policies, directives and guidelines published by the Department as of the date of contract execution. In the event the Department has cause to amend policies, directives, or guidelines, after contract execution, the Department will provide electronic notice to the Managing Entity. The parties shall agree on a timeframe for response and agreement with the amended terms of the policy, directive, or guideline. Further to this, the parties will develop and implement a procedure that shall outline the process for agreement to occur. This procedure shall be developed no later than six (6) months after execution.

(3) The Managing Entity shall be responsible for compliance with the requirements of the Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and the Community Mental Health Block Grant (CMHBG). The Managing Entity agrees that failure to comply with the requirements of these federal block grants represents a material breach of this contract, and shall subject the Managing Entity to performance deficiencies, and financial

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consequences will apply as referenced in Section 21 of the Standard Contract and as outlined in Exhibit D, Financial Consequences.

3. Individuals to be Serveda. General DescriptionThe Managing Entity shall provide Behavioral Health Services to eligible individuals, as detailed in section A.3.b. below, and to individuals residing in civil and forensic state Mental Health Treatment Facilities pursuant to section 394.4573, F.S., and Rule 65E-15.031 and 65E-15.071, F.A.C.

b. Eligibility of Individuals Served(1) The Managing Entity shall deliver Behavioral Health services to eligible persons pursuant to section 394.674, F.S.

(2) Priority for Behavioral Health Services shall be given to families with children that have been determined to be “unsafe” by child protective investigators who also meet the following target populations:

(a) Section 394.674(1)(a)2., F.S., for adult mental health services for the parents, based upon the emotional crisis experienced from the potential removal of children; and

(b) Section 394.674(1)(c)3., F.S., for substance abuse services based on parents who put children at risk due to a substance use disorder.

Such priority is limited to individuals that are not enrolled in Medicaid or another insurance program, or require services that are not included as reimbursable by another payor source. The parties agree that a statewide third party payor source policy will be developed, in conjunction with other contracted Managing Entities, no later than six (6) months after execution.

(3) Eligibility for Crisis Counseling Program (CCP) services shall be established according to the terms and conditions of any CCP grant award approved by representatives of the Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

c. Determination of Individuals Served(1) The Managing Entity shall include in contracts with Network Service Providers the requirement for compliance with the Department’s eligibility requirements for Individuals Served, as specified in the State and Federal Laws, Rules, and Regulations – Incorporated Document 3, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(2) In the event of an eligibility dispute, the determination made by the Department is final and binding on all parties. The Department, in accordance with state law, is exclusively responsible for defining eligibility of Individuals Served for services provided through this contract. The Managing Entity shall apply this definition to persons on a case-by-case basis.

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(3) The Managing Entity may delegate eligibility determinations to the Network Service Providers, subject to the determination of the Department.

d. Contract Limits(1) The Managing Entity may not seek reimbursement from the Department

for services not specified and approved in the Programmatic Allocation Plan - Incorporated Document 4. The plan template is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(2) The Department’s obligation to pay for services provided under this contract is expressly limited by the availability of funds and subject to annual appropriations by the Legislature.

(3) The Managing Entity is expressly prohibited from authorizing or incurring indebtedness on behalf of the Department.

(4) The Managing Entity is expressly prohibited from utilizing accounting practices or redirecting funds to circumvent legislative intent.

(5) Services shall only be provided to eligible residents, children, and adults outlined in Section A.3.b. receiving authorized services within the circuits outlined in Section A.a.(1).

(6) The Managing Entity may not enter into grant agreements with a for-profit entity using Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Block Grant (CMHBG) Restriction on the use of funds may be obtained from the SAMH Funding Restrictions Resource Guide - Incorporated Document 5, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

B. Manner of Service Provision1. Service Tasks

a. The Managing Entity shall perform all functions necessary for the proper delivery of services including, but not limited to, the following:

(1) Function 1. System of Care Development and Maintenance(a) The Managing Entity shall develop and manage an integrated network that meets the Behavioral Health Service needs for the community. The SOC shall be accessible and responsive to individuals, families, and community Stakeholders, including:

1. Residents of assisted living facilities as required in sections 394.4574 and 429.075, F.S.;

2. Persons ordered into involuntary outpatient placement in accordance with section 394.4655, F.S.;

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3. Eligible children referred for residential placement in compliance with the guidance provided in Rule 65E-9.008(4), F.A.C. and the guidance document Statewide Inpatient Psychiatric Programs (SIPP) Residential Placements Using SIPP Funding and Referral Process – Incorporated Document 6 which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

4. Inmates approaching the End of Sentence per Children and Families Operating Procedure (CFOP) 155-47;

5. Forensic-involved individuals pursuant to CFOP 155-18 and the guidance document Outpatient Forensic Mental Health Services – Incorporated Document 7 which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

6. Individuals that are currently in civil and forensic state Mental Health Treatment Facilities, committed pursuant to Chapter 394, or 916, F.S. The guidance document Forensic and Civil Treatment Facility Admission and Discharge Processes – Incorporated Document 8 is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

7. Individuals who are at risk of being admitted into a civil or forensic state Mental Health Treatment Facility. This shall include diversionary community treatment and services prior to admission.

(b) The Managing Entity shall establish and maintain a comprehensive SOC that provides an adequate and reasonable network in terms of geographic distribution to meet the service needs of consumers without excessive time and travel requirements.

(c) The Managing Entity shall collaborate with diverse Stakeholder groups to develop and administer community-focused Behavioral Health Services, with community input, to receive feedback on the required Assisted Living Facility (ALF) annual plan pursuant to section 394.4574, F.S. and Rule 58A-5.029, F.A.C.

(d) The Managing Entity shall monitor Network Service Providers delivering substance abuse and mental health treatment, prevention, and supportive services for the administration and delivery of appropriate EBPs.

(e) The Managing Entity shall coordinate with the civil state Mental Health Treatment Facilities and Network Service Providers to re-integrate into the community individuals identified as discharge ready. To achieve this, the

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Managing Entity shall develop and implement a plan for reintegrating discharge ready individuals. The Managing Entity shall submit this plan by September 30th each fiscal year.

(2) Function 2. Utilization Management(a) The Managing Entity shall develop and submit a utilization management plan within (60) days of execution, which shall be approved by the Department prior to implementation. The plan shall, at minimum, address the following areas:

1. Delivery of quality, clinically necessary services to eligible individuals in a timely fashion;

2. Improvement of clinical outcomes;

3. Realization of service efficiencies;

4. Incentives, financial or otherwise, are not used to encourage under-utilization of services;

5. Service costs are monitored, evaluated, and determined to be appropriate;

6. Guidelines, standards, and criteria set by regulatory and accrediting agencies are adhered to, as appropriate, for the client population;

7. Clinical evidence is used to make utilization management decisions, taking into account the local SOC and the individual’s circumstances; and

8. The utilization management program is integrated with the Continuous Quality Improvement (CQI) program.

(b) The Managing Entity shall provide a quarterly report, in a format that has been agreed upon by the Contract Manager, to demonstrate the validity of the utilization management plan.

(3) Function 3. Network Service Provider Management(a) The Managing Entity shall engage, manage, and monitor Network Service Providers, both administratively and programmatically. The Managing Entity shall perform Risk Assessments to develop an annual monitoring schedule, to be submitted to the Department within sixty (60) days of the beginning of each fiscal year. The monitoring schedule shall distinguish between onsite monitoring and desk reviews.

(b) The Managing Entity shall review a sample of case management records to verify that services identified in the community living support plan for individuals residing in Assisted Living Facilities with Limited Mental Health Licenses are provided pursuant to section 394.4574, F.S.

(c) The Managing Entity shall notify the Department within 48 hours of conditions related to Network Service Provider performance that may interrupt the continuity of service delivery or involve media coverage.

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(d) The Managing Entity shall use the results of compliance monitoring, quality improvement reviews, and achievement of performance outcomes measures to improve the quality of services provided by Network Service Providers.

(e) The Managing Entity shall develop a fraud and abuse prevention protocol within sixty (60) days of contract execution that complies with all state and federal requirements applicable to all funding categories covered through this contract.

(f) The Managing Entity shall certify Network Service Provider compliance with background screening for staff and volunteers pursuant to sections 394.4572, 397.451, and 408.809, F.S., and Chapter 435, F.S. Additional guidance regarding background screening is incorporated herein by reference and may be located at:

www.dcf.state.fl.us/programs/backgroundscreening/

(g) The Managing Entity shall require that all Network Service Providers:

1. Afford access to services based on the needs of the Individuals Served;

2. Possess all licenses and credentials necessary to legally render the services being provided; and

3. Facilitate the execution a Memorandum of Understanding (MOU) with the appropriate Federally Qualified Health Center (FQHC), publically funded medical clinics or tax-assisted hospitals, with the exception of those Network Service Providers that only provide non-client specific services.

(4) Function 4. Continuous Quality Improvement (CQI)(a) The Managing Entity shall maintain a CQI program that provides quality Behavioral Health Services and consistently achieves positive outcomes. The Managing Entity shall develop and submit a CQI plan within (60) days of execution. This plan shall be approved by the Department prior to implementation. The Managing Entity shall be responsible, upon discovery of an incident, for the management and oversight of incident reporting in accordance with the Department’s Operating Procedure (CFOP) 215-6, Incident Reporting and Analysis System (IRAS). The Managing Entity shall incorporate trending data from incidents and complaints into the quality improvement process to mitigate risk and improve quality of services.

(b) The Managing Entity shall communicate performance issues and trends to Network Service Providers and the Department.

(c) The Managing Entity shall actively participate in the Department’s local and statewide processes for quality assurance and quality improvement.

(5) Function 5. Technical Assistance/Training

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(a) The Managing Entity shall develop and implement technical assistance and training that incorporates best practices identified by nationally recognized organizations in behavioral health, EBPs, and findings from monitoring, clinical supervision, and CQI.

(b) The Managing Entity shall promote the implementation of EBPs through:

1. Contracting requirements;

2. Program development and design;

3. Training; and

4. A quality improvement system that includes monitoring the implementation of EBPs, in partnership with the Department.

(c) The Managing Entity shall facilitate Limited Mental Health Assisted Living Facility (LMH-ALF) training pursuant to Rule 58A-5.0191, F.A.C. Additional guidance for the LMH-ALF Training – Incorporated Document 9 is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(d) The Managing Entity shall promote the SSI/SSDI Outreach, Access, and Recovery (SOAR) initiative with appropriate Network Service Providers in conjunction with the Department’s state team lead. Additional guidance for the implementation of SOAR– Incorporated Document 10 are incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

Guidelines for training and State Team Lead contact information may be located at: www.prainc.com/SOAR/

(6) Function 6. Data Collection, Reporting, and Analysis(a) The Managing Entity shall develop and implement policies and procedures that protect and maintain the confidentiality of sensitive information of Individuals Served, relative to paper and computer-based file system (mainframes, servers and laptops) across a complex and comprehensive network of Network Service Providers.

(b) The Managing Entity shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. §§ 300gg et seq., P.L. 104-191, and require that all subcontractors that come into contact with protected health information comply with HIPAA.

(c) The Managing Entity shall develop and submit within ninety (90) days of execution, a record transition plan to be implemented in the case of contract termination or non-renewal by either party, in accordance with the Managing Entity Expiration/Termination Transition Planning Requirements – Incorporated Document 11, which is incorporated herein by reference and may be located at:

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http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(d) The Managing Entity shall require accurate and timely data entry required for performance outcomes measurement, in accordance with the PAM 155-2, section 394.74(3)(e), F.S., and Chapter 65E-14.022, F.A.C. The data must enable costs to be tracked by service level cost center, service utilization by type and recipient, quality of care, access to services, all facets of utilization management, and outcomes for each Individual Served within the SOC.

(e) The Managing Entity shall electronically submit data, as specified in PAM 155-2, to the SAMHIS by the 18th of each month.

(f) The Managing Entity shall develop and submit an information technology plan within (60) days of execution. This plan shall be approved by the Department prior to implementation. The plan shall provide that, by the end of the initial contract period, the Managing Entity’s data system shall be able to meet the following requirements including, but not limited to:

1. The exchange of screening and assessment results among Network Service Providers to better coordinate care;

2. Automated referral and electronic consent for release of confidential information within and between Network Service Providers;

3. Integrated processes for tracking and coordinating intake, admission, discharge and follow-up throughout the SOC;

4. Determination of financial and clinical eligibility of Individuals Served;

5. Subject to the availability of data from external sources, processes that include the ability to electronically send and receive eligibility, coverage, or benefit inquiry transactions (ANSI ASC X12N 270 Health Care Eligibility Inquiry) and, eligibility, coverage, or benefit response transactions (ANSI ASC X12N 271 Health Care Eligibility Response);

6. Electronic reconciliation of invoices submitted to the Department, including reconciliation of the amount of funding and services specified in this contract as well as the Managing Entity’s audit report and information system for Individuals Served;

7. Automated processes for state and federal data analysis and reporting; and

8. Compliance with federal and state laws, and regulations pertaining to security and privacy of protected health information.

(g) The Managing Entity shall coordinate with Network Service Providers, by December 2014, for compliance with federal Block Grant standards by using a meaningful-use compliant Electronic Health Record (EHR) to capture clinical and financial data of Individuals Served. These standards are incorporated herein by reference:

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www.healthit.gov/policy-researchers-implementers/meaningful - use (h) The Managing Entity shall use analysis of data to improve the quality of care, utilization management functions, and impact on technical assistance and training.

(i) The Managing Entity shall provide access to its data system for Department-approved staff, located at both Headquarters and in the Regional Office, for Department funded clients and services. In addition, the Managing Entity shall provide data system training and training products (i.e., webinars) for Department-approved staff.

(j) The Managing Entity shall create and maintain accurate and complete Network Service Provider information for its SOC in the SAMHIS Provider Table. The Managing Entity shall require that changes or updates to SAMHIS Network Service Provider records are made within thirty (30) days of a known change.

(k) The Managing Entity shall be responsible for maintaining all SAMHIS data accounts for persons affiliated with its SOC.

(l) The Managing Entity shall be responsible for identifying a data officer to participate in statewide data activities. The Managing Entity data officer or designee shall participate in standing Department SAMHIS data conference calls or meetings. When possible, the Managing Entity shall make arrangements for the Managing Entity data officer or designee to attend policy or strategic meetings in person.

(m) The Managing Entity’s delegated data officer shall participate in the Department’s SAMHIS training. The Managing Entity shall be responsible for training other required Managing Entity staff and affiliated personnel on accessing and using SAMHIS.

(n) The Managing Entity shall verify that all data submitted is consistent with the data maintained locally by Network Service Providers in their Individuals Served files.

(o) The Managing Entity shall review the Department's File Upload History screen in SAMHIS to determine the number of records accepted, updated, and rejected. Based on this review, the Managing Entity shall correct the erroneous records for resubmission in SAMHIS within sixty (60) days after submission.

(p) In the event a Managing Entity’s total monthly submission per data set results in a rejection rate greater than 5% for two (2) consecutive months, the Managing Entity shall submit a corrective action plan within thirty (30) days of the second deficient month that outlines a solution to correctly submitting the required records.

(q) Pursuant to section 394.461(4)(a)-(c), F.S., The Managing Entity shall require that a facility designated as a public receiving facility, and is a part of the SOC, report the appropriate SAMH-related Payor Class data. The

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Managing Entity shall submit Payor Class data for the fiscal year ending June 30th, in the format and directions provided by the Department, no later than ninety (90) days following the end of the state fiscal year.

(r) The Managing Entity shall submit to the Department, within ten (10) business days of the request being made by the Department, service data for the Community Mental Health Services Block Grant or the Substance Abuse Prevention and Treatment Block Grant.

(s) The Managing Entity shall require that all data collection required as a result of Federal and State grant awards is submitted to the appropriate parties and completed within the stated timeframes established by the grantor.

(7) Function 7. Financial Management(a) The Managing Entity shall only subcontract with entities that are fiscally sound, and that can adequately ensure the accountability of public funds.

(b) The Managing Entity’s financial management and accounting system must have the capability to generate financial reports on individual service recipient utilization, cost, and billing for the Department.

(c) The Managing Entity shall ensure that it budgets and accounts for revenues and expenditures.

(d) The Managing Entity shall ensure that accounting systems and accounting procedures and practices conform to generally accepted accounting principles and standards.

(e) In addition to the annual financial audits required in Attachment III, the Managing Entity shall submit copies of all interim financial statements or other financial analyses provided to its Board of Directors to the Contract Manager no later than thirty (30) days after their report to the Board.

(8) Function 8. Planning(a) The Managing Entity shall participate in community, circuit, regional and state planning in accordance with sections 394.9082 and 394.4574, 394.4674, 394.745, and 394.75, F.S.

(b) The Managing Entity shall provide data and program information to the Department for development of required state and federal plans including the Department’s Substance Abuse and Mental Health Services Plan, in accordance with section 394.75, F.S., annual updates thereof, and information for the Department’s Long Range Program Plan and Annual Business Plan.

(c) The Managing Entity shall develop operational plans to assist in the development and implementation of the Department’s strategic plan.

(9) Function 9. Board Development and GovernanceThe structure and membership of Managing Entity’s Board of Directors shall comply with section 394.9082, F.S. and Chapter 617, F.S.

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(10) Function 10. Disaster Planning and Response(a) Planning. The Managing Entity shall cooperate with the Department to develop a regional disaster plan that reflects the Managing Entity’s planned involvement with community based disaster plans. The regional disaster plan shall include, but not be limited to, pre-disaster records protection, alternative suitable accommodations and supplies for Individuals Served during a disaster or emergency and post-disaster recovery efforts which allow for post-disaster continuity of services.

(b) Response. The Managing Entity shall be responsible for providing the FEMA Crisis Counseling Program (CCP) services in the event of a qualifying declared major disaster.

1. The Managing Entity shall designate a CCP Network Service Provider for each county within the Managing Entity’s service area and provide a comprehensive list of said Network Service Providers to the Department’s Disaster Behavioral Health Coordinator within sixty (60) days of execution and within ten (10) days of any changes to the designated Network Service Provider.

2. At the direction of the Department’s Disaster Behavioral Health Coordinator, the Managing Entity shall implement CCP services through the designated CCP Network Service Provider according to the terms and conditions of any CCP grant award approved by representatives of FEMA and SAMHSA, using the CCP contract template, provided in the guidance document Crisis Counseling Program – Incorporated Document 12 which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

3. The Managing Entity shall ensure compliance with the CCP Guidance, which is incorporated herein by reference and may be located at:

www.samhsa.gov/dtac/CCPtoolkit/pdf/CCP_Program_Guidance_3.4.pdf

(11) System of Care Efficiency (a) The Managing Entity shall develop and implement a Department-approved System Efficiency Plan. In addition, the System Efficiency Plan must include a narrative detailing how the Managing Entity intends to improve access to quality care, promote service continuity, implement EBPs, expand the services array, and develop necessary infrastructure. The Managing Entity shall develop and submit this plan within (60) days of execution. This plan shall be approved by the Department prior to implementation.

(b) Operational and Indirect costs eligible for payment from Department funds are expenses directly incurred by the Managing Entity to manage

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Behavioral Health Services under and pursuant to this contract and in accordance with the following:

1. OMB Circular A-122, Cost Principles for Non-profit Organizations;

2. OMB Circular A-133, Audits of States, Local Governments and Non-Profit Organizations; and

3. the Reference Guide for State Expenditures, which is incorporated herein by reference and may be located at:

www.myfloridacfo.com/aadir/reference_guide/

(c) Managing Entity operational and indirect costs shall not include any Network Service Provider indirect costs.

b. Task LimitsThe Managing Entity shall perform only Department-approved tasks and services with Department funding and shall ensure that Network Service Providers do the same, as applicable. With the exception of consumers from statewide Mental Health Treatment Facilities, services shall only be provided in the following circuit(s): Circuit(s) ________

2. Staffing Changesa. The Managing Entity shall comply with their staffing plan contained in the Department-approved Exhibit C, Line Item Budget Detail. b. The Managing Entity shall, within five (5) business days, submit written notification to the Contract Manager if any of the following positions are to be changed and identify the individual and qualifications of the successor:

(1) Chief Executive Officer (CEO);

(2) Chief Operations Officer (COO);

(3) Chief Financial Officer (CFO);

(4) Chief Information Technology Officer (CITO); or

(5) Any other equivalent position within the Managing Entity’s organizational chart.

3. Network Service Providers Subcontractsa. The Managing Entity shall subcontract with Network Service Providers to provide community-based Behavioral Health Services, as authorized in section 394.74, F.S., subject to the provisions of section 7 of the Standard Contract.

b. The Managing Entity shall not subcontract administration, management and oversight responsibilities without prior written approval from the Department.

c. The Managing Entity shall not subcontract for Behavioral Health Services with any person or entity which:

(1) Is barred, suspended, or otherwise prohibited from doing business with any government entity, or has been barred, suspended, or otherwise

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prohibited from doing business with any government entity in accordance with section 287.133, F.S.;

(2) Is under investigation or indictment for criminal conduct, or has been convicted of any crime which would adversely reflect on its ability to provide services, or which adversely reflects its ability to properly handle public funds;

(3) Has had a contract terminated by the Department for failure to satisfactorily perform or for cause;

(4) Has failed to implement a corrective action plan approved by the Department or any other governmental entity, after having received due notice; or

(5) Has had any prohibited business activity with the Governments of Sudan and Iran as described in section 215.473, F.S. Pursuant to section 287.135(5), F.S., the Managing Entity shall immediately terminate the subcontract for cause if the Network Service Provider is found to have submitted a false certification or if the Provider is placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List during the term of the subcontract.

d. All subcontracts for Behavioral Health Services shall include the applicable terms and conditions of this contract and the appropriate provisions of Rule 65E-14.014, F.A.C.

e. The Managing Entity shall conduct cost analysis for each subcontract for Behavioral Health Services and all supporting documentation shall be retained in the Managing Entity’s contract file for the respective Network Service Provider. The Managing Entity shall submit the cost analyses to the Department within five (5) days of request for such documentation.

f. Subject to the limitations of chapter 2013-41, Laws of Florida, the Managing Entity shall develop and submit a plan to implement competitive procurement for Behavioral Health Services that will ensure maximum service quality at competitive pricing. The plan shall describe the manner in which the Managing Entity will improve services, including, at a minimum; anticipated cost savings; improved quality of care; expected efficiencies; and how implementing this plan will achieve the goal of meeting community and consumer identified needs. This plan shall be submitted within ninety (90) days of contract execution, and must be approved by the Department prior to implementation.

g. Subcontract documents shall be made available electronically through an internet site that can be accessed at any time by the Department. The Managing Entity shall ensure that all documents are clearly legible and those not requiring an original signature are uploaded in their original formats. All contracts initially assigned to the Managing Entity must be uploaded to the electronic site within sixty (60) days of assignment to the Managing Entity. All new subcontracts or changes to existing subcontracts shall be uploaded within ten (10) business days of the effective date or subcontract execution.

h. The Managing Entity shall assess the financial stability of its Network Service

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Providers using a Risk Assessment approach to examine the impact of programmatic requirements on each Network Service Provider’s financial stability.

4. Service Location and Equipmenta. Service Delivery LocationThe location of services will be as specified in the Programmatic Allocation Plan. The Managing Entity must maintain an administrative office within the service area.

b. Changes in Location(1) The Managing Entity shall notify the Department’s Contract Manager, in writing, at least ten (10) calendar days prior to any changes in locations where services are being provided. Changes must continue to meet the service needs of consumers without excessive time and travel requirements.

(2) The Managing Entity must provide a point of contact to the Department that is available for providing an immediate response twenty-four (24) hours a day, seven (7) days a week. The Managing Entity shall notify the Department in writing a minimum of thirty (30) days prior to making changes in location that will affect the Department’s ability to contact the Managing Entity by telephone or facsimile transmission.

c. Equipment(1) The Managing Entity and all Network Service Providers shall supply all equipment necessary to provide services and fulfill the terms and conditions of this contract, including but not limited to; computers, telephones, copier, and fax machines, supplies and maintenance, and necessary office supplies.

(2) The Managing Entity shall ensure that Network Service Providers comply with requirements in the Tangible Property Requirements & Contract Provider Property Inventory Form – Incorporated Document 13, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

5. Deliverablesa. ServicesThe Managing Entity shall perform the functions and deliver the services specified in Section B.1.a., and in the Programmatic Allocation Plan, including a progress report completed each month, and submitted with the invoice for payment.

b. Records and Documentation(1) The Managing Entity shall protect the confidentiality of all records in its possession and ensure that all Network Service Providers protect confidential records from disclosure and protect the confidentiality of Individuals Served in accordance with federal and state law, including but not limited to: sections

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394.455(3), 394.4615, 397.501(7), 414.295, F.S., 42 C.F.R. section 2, and 45 C.F.R. part 164.

(2) The Managing Entity shall notify the Department of any requests made for public records within ten (10) business days of receipt of the request and shall assume all financial responsibility for records requests, records storage, and retrieval costs.

(3) The Managing Entity shall maintain documentation of the provision of all tasks and deliverables, and shall ensure that Network Service Providers maintain documentation of the provision of all Behavioral Health Services, including but not limited to: the total number of Individuals Served, the names (or unique identifiers) of individuals to whom services were provided, and the date(s) that the services were provided, so that an audit trail documenting service provision can be maintained.

c. Reports(1) The Managing Entity shall submit all required documentation specified in Exhibit A, Required Plans, Reports, and Statistics, by the dates specified therein.

(2) Additionally, the Managing Entity shall ensure that all required documentation is made available electronically through an internet site that can be accessed at any time by Department approved personnel. The Managing Entity shall ensure that all documents are clearly legible and are uploaded in their original formats (i.e. Microsoft Word, Excel, etc.). All reports and plans or changes to existing reports and plans shall be uploaded within ten (10) business days of the change or Department approval, when approval of a plan is required.

(3) Within thirty (30) days after the finalization of the Department’s Annual Operating Budget the Managing Entity shall submit the Programmatic Allocation Plan to the Department. The Managing Entity shall require that the Projected Cost Center Operating and Capital Budget submitted pursuant to Rule 65E-14.021, F.A.C., is reviewed annually.

(4) For all client non-specific services where unit rates are set pursuant to Rule 65E-14.021, F.A.C., the budgeted SAMH funding per cost center shall be updated to reflect the utilization pattern established in the previous fiscal year(s) of the contract period .

(5) Where this contract requires the delivery of reports to the Department, mere receipt by the Department shall not be construed to mean or imply acceptance of those reports. It is specifically intended by the parties that acceptance of required reports shall require a separate act in writing within fifteen (15) days of receipt of the report by the Department. The Department reserves the right to reject reports as incomplete, inadequate, or unacceptable according to the parameters set forth in this contract, and must notice the Managing Entity electronically within fifteen (15) days of receipt of the report by the Department. The Department, at its option, may allow additional time within which the Managing Entity may remedy the objections

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noted by the Department or the Department may, after having given the Managing Entity a reasonable opportunity to complete, make adequate, or acceptable, such reports, declare the contract to be in default.

(6) The Managing Entity shall require that all Network Service Providers comply with Attachment III to the Standard contract.

d. Performance SpecificationsThe Managing Entity shall be solely and uniquely responsible for the satisfactory performance of the tasks described in this contract. By execution of this contract, the Managing Entity recognizes its singular responsibility for the tasks, activities, and deliverables described herein and warrants that it fully understands all relevant factors affecting accomplishment of the tasks, activities, and deliverables and agrees to be fully accountable for the performance thereof whether performed by the Managing Entity or its Network Service Providers.

e. Performance Outcomes Measures(1) In addition to any criteria for approval of deliverables and services for payment, the Managing Entity must meet the performance outcomes measures specified in Exhibit B Performance Outcome Measures. (2) Performance outcomes measures will be evaluated during each Quarterly Performance Review, pursuant to Section C.10.b. The Managing Entity is responsible and accountable for meeting all performance outcomes measure targets. The Managing Entity shall manage the SOC and oversee the collection of data in order to assure that targets are met.

(3) The performance outcome measures targets are subject to periodic review by the Department and adjustments to the targets or the measures may be made by mutual agreement.

(4) The Managing Entity agrees that the SAMHIS will be the source for all data used to determine compliance with performance outcomes measures. Performance of Network Service Providers shall be monitored and tracked by the Managing Entity. The Managing Entity shall provide applicable technical assistance to Network Service Providers and initiate corrective actions, as required, and will report to the Department on a quarterly basis during the Quarterly Performance Review specified in Section C.10.b.

f. Performance Measurement TermsPAM 155-2 provides the definitions of the data elements used for various performance outcomes measures and contains policies and procedures for submitting the required data into the Department’s data system.

g. Performance Evaluation MethodologyThe methodology and algorithms to be used in assessing the Managing Entity’s performance are outlined in the guidance document Performance Outcomes Measurement Manual – Incorporated Document 14, which is incorporated herein and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-

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entities

h. Performance Standards Statement(1) By execution of this contract, the Managing Entity hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the Managing Entity fails to meet these standards, the Department, at its exclusive option, may allow a reasonable period, not to exceed six (6) months, for the Managing Entity to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the Department within the prescribed time, and if no extenuating circumstances can be documented by the Managing Entity to the Department’s satisfaction, the Department may terminate the contract. The Department has the exclusive authority to determine whether there are extenuating or mitigating circumstances.

(2) The Managing Entity further hereby acknowledges and agrees that during any period in which the Managing Entity fails to meet these standards, regardless of any additional time allowed to correct performance deficiencies, financial consequences will apply as referenced in Section 21 of the Standard Contract and as outlined in Exhibit D, Financial Consequences.

6. Managing Entity Responsibilitiesa. Managing Entity Unique ActivitiesThe Managing Entity shall:

(1) Collaborate with the Department to amend into this contract all applicable requirements of any awards, initiatives, or Federal grants received by the Department.

(2) Make available and communicate all plans, policies, procedures, and manuals to the Managing Entity staff, Network Service Providers, Individuals Served, and Stakeholders, as applicable;

(3) Cooperate with the Department when investigations are conducted regarding a regulatory complaint relevant to a licensed facility operated by one of the Managing Entity’s Network Service Providers;

(4) Integrate the Department’s current initiatives, new state and federal requirements, and policy initiatives into its operations;

(5) Contract for the provision of prevention services, in compliance with the guidance document for Prevention Services – Incorporated Document 15, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(6) Ensure that Network Service Providers that receive federal block grant funds from the Substance Abuse Prevention and Treatment Block Grant comply with all of the requirements of the SAMHSA Charitable Choice provisions and the implementing regulations of 42 C.F.R. section 54a;

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(7) Ensure that Network Service Providers that receive federal block grant funds from the Substance Abuse Prevention and Treatment Block Grant comply with 42 C.F.R. part 2;

(8) Comply with, and ensure that all Network Service Providers comply with 45 C.F.R. section 164.504(e)(2)(ii); and

b. Coordination with other Providers/Entities(1) The Managing Entity shall participate with the Department to develop and implement a working agreement with the Community Based Care lead agency. The agreement must be completed in accordance with the guidance document for Integration Planning – Incorporated Document 16, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(2) The Managing Entity shall develop a staff position designed to serve common clients of the Managing Entity and the Community Based Care lead agency to improve family engagement in substance abuse and mental health treatment and to divert children from out of home placement. This position must, at a minimum, meet the requirements of the guidance document for the Integration Position – Incorporated Document 17, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

(3) The Managing Entity shall coordinate with the judicial system, the criminal justice system, and the local law enforcement agencies in the geographic area, to develop strategies and alternatives for diverting individuals from the criminal justice system to the civil system. Such diversion shall be as provided under part I of Chapter 397, F.S., and section 394.9082, F.S., and apply to persons with substance use and mental health disorders who are included in the priority population pursuant to section 394.674, F.S., who are arrested for a misdemeanor;

(4) The Managing Entity shall coordinate with the judicial system to provide services covered through this contract that address the substance abuse and mental health needs of children and parents in the child welfare system and the juvenile justice system; and

(5) The Managing Entity shall participate in the interagency team meetings created as a result of the Interagency Agreement for child-serving agencies, the guidance document for the Local Review Team– Incorporated Document 18, is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

7. Department Responsibilitiesa. Department Obligations

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(1) The Department will provide technical assistance and support to the Managing Entity to facilitate the continued integration of services and support for Individuals Served, including assistance to gain access to relevant information from other State of Florida Agency data systems.

(2) The Department will participate in the development and implementation of a working agreement with the Community Based Care lead agencies and the Managing Entity to facilitate the integration of services and support within the community.

(3) The Department will collaborate with the Community Based Care lead agencies to integrate other services with the substance abuse and mental health treatment and supports, and to require their providers to participate on family or clinical teams.

(4) The Department will review the proposed policies, procedures, and plans required to be submitted by the Managing Entity. The Department will respond in writing indicating approval or noting any deficiencies within thirty (30) business days from the date of receipt. Once approved by the Department, the Managing Entity’s policies and procedures may be amended provided that they conform to state and federal laws, state rules, and federal regulations. Substantive amendments to Department approved policies, procedures, and plans must be submitted to the Department for review and approval as outlined above.

b. Department DeterminationsThe Managing Entity agrees that services other than those set out in this contract, will be provided only upon receipt of a written authorization from the Contract Manager. The Department has final authority to make any and all determinations that affect the health, safety, and well-being of the people of the State of Florida.

c. Monitoring Requirements(1) The Managing Entity shall be monitored in accordance with section 394.741, F.S., and CFOP 75-8, Contract Monitoring Operating Procedures. The Managing Entity shall comply with any requests made by the Department’s evaluator(s) as part of the conduct of such monitoring. At no cost to the Department, the Managing Entity shall provide complete access to all programmatic, administrative, management, budget and financial information related to services provided under this contract.

(2) The Department will provide a written report to the Managing Entity within thirty (30) days of the monitoring team’s exit. If the report indicates corrective action is necessary, the Managing Entity shall provide a proposed corrective action plan for the Department’s approval, except in the case of threat to life or safety of Individuals Served, in which case the Managing Entity shall take immediate action to ameliorate the threat and associated causes.

(3) In addition to the monitoring outlined above, the Department will assess the overall performance of the Managing Entity, as detailed in Section C.10.

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(4) Assessment shall include, but may not be limited to, reviews of procedures, data systems, program service delivery, accounting records, financial management policies and procedures and support documentation, internal quality improvement reviews, and documentation of service of Individuals Served. The Managing Entity shall cooperate at all times with the Department to conduct these reviews and shall provide all documentation requested by the reviewers in a timely manner at its administrative office or other location, as determined by the Department.

C. Method of Payment1. Payment Clauses

a. This fixed price contract is comprised of federal and state funds, and includes advance and fixed payments, subject to reconciliation. The Exhibit E, Schedule of Funds identifies the type and amount of funding provided. At the beginning of each fiscal year, the Exhibit E, Schedule of Funds will be amended into this Contract, and the total contract amount will be adjusted accordingly. The Department will pay the Managing Entity for the delivery of services provided in accordance with the terms and conditions of this contract for a total dollar amount not to exceed $_________, subject to the availability of funds, as outlined below:

State Fiscal Year Total

2012-2013

2013-2014

2014-2015

Contract Total

b. Further details regarding funding are outlined in the Managing Entity’s Cost Allocation Plan, as specified in section C.2.

2. Advance Paymentsa. In accordance with section 394.9082 F.S., an advance payment shall be equal to 16.72% of the current fiscal year contract value or, in the event that the fiscal year contract value is adjusted during the year, the monthly advance payment will be equal to the fiscal year contract amount not yet paid divided by the remaining months to be paid.

b. Advances may be requested at the beginning of the fiscal year for the entire term of the contract. The request shall be made through submission of a properly completed Managing Entity Fixed Payment Invoice – Incorporated Document 19, which is herein incorporated by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

c. Surplus advance funds shall be temporarily invested by the Managing Entity

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in an insured or interest bearing account. In accordance with section 216.181(16)(b), F.S., interest earned on advance funds shall be remitted on a quarterly basis to the Department via check. The Managing Entity must submit documentation from the financial entity where said funds are invested, evidencing the Annual Percentage Rate and actual interest income for each month.

d. The Managing Entity shall reimburse the Department for any nonallowable expenditure. Such nonallowable expenditures shall be collected, following monthly reconciliation, as an adjustment to the invoice received for the following month, or in the case of the end of the state fiscal year, the Managing Entity shall remit the nonallowable expenditures to the Department via check.

e. The Managing Entity shall expend any advance in accordance with the General Appropriations Act.

f. The Department will pay the Managing Entity according to the following schedule:

Month Payment Amount Date of Submission of Invoice

Advance 16.72% of the State Fiscal Year Contract Amount

July 1st

July 6.94% of the State Fiscal Year Contract Amount

August 20th

August 6.94% of the State Fiscal Year Contract Amount

September 20th

September 6.94% of the State Fiscal Year Contract Amount

October 20th

October 6.94% of the State Fiscal Year Contract Amount

November 20th

November 6.94% of the State Fiscal Year Contract Amount

December 20th

December 6.94% of the State Fiscal Year Contract Amount

January 20th

January 6.94% of the State Fiscal Year Contract Amount

February 20th

February 6.94% of the State Fiscal Year Contract Amount

March 20th

March 6.94% of the State Fiscal Year Contract Amount

April 20th

April 6.94% of the State Fiscal May 20th

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Year Contract Amount

May 6.94% of the State Fiscal Year Contract Amount

June 20th

June 6.94% of the State Fiscal Year Contract Amount

August 1st

g. The Department reserves the right to modify the schedule in sub-paragraph f., based on the availability of funds.

2. Cost Allocation Plana. The Managing Entity shall submit an initial Cost Allocation Plan within thirty (30) days of execution and a revised Cost Allocation Plan to the Contract Manager by July 31st of each state fiscal year. The Cost Allocation Plan – Incorporated Document 20 must be structured in accordance with the approved Template, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

b. The Department will review the Cost Allocation Plan and provide any comments within 15 days of submission. Revisions required by the Department shall be submitted by the date of the payment request for September. Failure to have an approved Cost Allocation Plan by September 20th will result in no further payment being made to the Managing Entity until the Department approves the Cost Allocation Plan.

c. The Managing Entity may request to amend or revise their Cost Allocation Plan at any time during the state fiscal year, in writing to the Contract Manager. The Managing Entity shall submit the amended or revised Cost Allocation Plan within 20 days of providing written notification. The Department will review and provide written comments within 15 days of submission. The Managing Entity must submit a revised Cost Allocation Plan addressing any revisions required by the Department, within 15 days of the date of the Department’s written response.

3. Invoice Requirementsa. The Managing Entity shall request payment monthly through the submission of a properly completed Managing Entity Monthly Fixed Payment Invoice – Incorporated Document 19, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

b. The Managing Entity shall submit invoices no later than the twentieth (20th) calendar day following the month for which payment is being requested, in accordance with the Payment Table above. In addition, with the submission of each invoice, the Managing Entity shall submit:

(1) A properly completed Managing Entity Monthly Expenditure Report -

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Incorporated Document 21, detailing actual costs incurred by the Managing Entity for the previous month and year to date expenditures; and

(2) A properly completed Managing Entity Monthly Carry Forward Expenditure Report, Incorporated Document 22 detailing the expenditure of approved carry forward funds, until said funds are fully expended.

The Managing Entity Monthly Expenditure Report and Managing Entity Monthly Carry Forward Expenditure Report templates are incorporated herein by reference, and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

c. Within five (5) business days of receipt of a properly completed invoice and all supporting documentation from the Managing Entity, the Contract Manager will either approve the invoice for payment or notify the Managing Entity, in writing, of any deficiencies that must be corrected by the Managing Entity before resubmission of the invoice.

d. Failure to submit the required documentation shall cause payment to be delayed until such documentation is received.

e. The Department and the state’s Chief Financial Officer reserve the right to request supporting documentation at any time.

4. Carry Forward Fundinga. In accordance with section 394.9082, F.S., the Managing Entity may carry forward documented unexpended state funds from one fiscal year to the next. However, the cumulative amount carried forward may not exceed 8 percent of the contract total. Any unexpended state funds in excess of 8 percent must be returned to the Department. The funds carried forward may not be used in any way that would create increased recurring future obligations, and such funds may not be used for any type of program or service that is not currently authorized by this contract. Any unexpended funds that remain at the end of the contract period shall be returned to the Department. Funds carried forward may be retained through any contract renewals and new procurement as long as the Managing Entity is retained by the Department.

b. The Managing Entity shall submit a properly completed Managing Entity Spending Plan for Carry Forward Report – Incorporated Document 23, within thirty (30) days after receiving confirmation of the approved amount from the Department. The template for this report is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

5. Other Fund Sourcesa. The Managing Entity shall ensure that Network Service Providers complete and submit the Department-approved Local Match Calculation Form – Incorporated Document 24, which is incorporated herein by reference and may be located at:

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b. In addition, the Managing Entity must maintain, at a minimum, a listing of the total match amount calculated for each Network Service Provider and reflect the total match documented as a component of the SAMH Other Funds Source Report – Incorporated Document 25, which shall be updated quarterly. The template for this report is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

6. Allowable Costsa. All costs associated with performance of the services contemplated by this contract must be both reasonable and necessary and in compliance with the Cost Principles for non-profit organizations, pursuant to 2 C.F.R., pt. 230) and the Financial Rules specified in Rule 65E-14, F.A.C.

b. Any compensation paid for an expenditure subsequently disallowed as a result of the Managing Entity’s or any Network Service Providers’ non-compliance with state or federal funding regulations shall be repaid to the Department upon discovery.

c. Invoices must be dated and signed by an authorized representative of the Managing Entity, and submitted in accordance with the submission schedule in this contract, with appropriate service utilization and Individuals Served data accepted into SAMHIS, in accordance with PAM 155-2.

d. The annual SOC Administrative Costs (which will include the operational costs for the Managing Entity and the administrative cost of Network Service Providers) shall not exceed a maximum of 15% of the total annual contract amount. Additionally, the annual Managing Entity Operational Cost shall not exceed a maximum of 5% of the total annual contract amount.

e. The Managing Entity is required to submit a new Form W-9 through the DFS website at http://flvendor.myfloridacfo.com. This website provides a new substitute Form W-9 that is unique to Florida and collects and integrates the information with other electronic data to facilitate payment. Consequently, all Managing Entities (regardless of their business type, size, or tax status) who have not already completed this requirement must use this website and complete the required information. The DFS W-9 system includes a verification of the data submitted with the Internal Revenue Service (IRS). Mismatches will be identified and returned to the grant recipients for resolution. DFS will reject invoices from grant recipients who have not submitted a new substitute W-9 that has been validated by the IRS.

7. Third Party Billinga. In accordance with the plan developed in Section 3.B.2., the Managing Entity shall adhere to the following guidelines for payment and billing:

(1) The Managing Entity shall not bill the Department for services provided

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to:

(a) Individuals who have third party insurance coverage when the services provided are covered under the insurance plan; or

(b) Medicaid enrollees or recipients of another publically funded health benefits assistance program, when the services provided are covered by said program, regardless of limitation.

(2) The Managing Entity may bill the Department if services are provided to:

(a) Individuals who have lost coverage through Medicaid, or any other publically funded health benefits assistance program coverage for any reason during the period of non-coverage; or

(b) Individuals who have a net family income at or above 150 percent of the Federal Poverty Income Guidelines, subject to the sliding fee scale requirements in Rule 65E-14.018 F.A.C.

(3) In no event shall Medicaid, any health insurance, another publically funded health benefits assistance program, or the Department be billed for the same service provided to the same individual on the same day.

b. The Managing Entity shall report Network Service Provider Medicaid earnings and earnings from other publically funded health benefits assistance programs separately from all other fees during the Quarterly Performance Review specified in Section C.10.b.

8. Temporary Assistance to Needy Families (TANF) BillingThe Managing Entity must comply with the applicable obligations under Part A or Title IV of the Social Security Act. The Managing Entity agrees that TANF funds shall be expended for TANF participants as outlined in the Temporary Assistance to Needy Families (TANF) Guidelines, which is incorporated herein by reference and may be located at:

www.dcf.state.fl.us/programs/samh/contract/tanf.pdf

9. Payments from Medicaid Health Maintenance Organizations, Prepaid Mental Health Plans, or Provider Services NetworksUnless waived in Section D (Special Provisions) of this contract, the Managing Entity agrees that subcapitated rates from a Medicaid health maintenance organization, prepaid mental health plan, or provider services network are considered to be “third party payer” contractual fees as defined in Rule 65E-14.001, F.A.C. Services that are covered by the subcapitated contracts and provided to persons covered by these subcapitated contracts must not be billed to the Department. The Managing Entity shall ensure that Medicaid funds will be accounted for separately from funds for this contract at both the Network Service Provider and Managing Entity levels. This includes services such as SIPP and the Florida Assertive Community Team (FACT).

10.Financial Reconciliation & Performance Review The Reconciliation & Performance Review is composed of an assessment of financial reconciliation and Managing Entity performance, as detailed below. A

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final report shall be submitted within sixty (60) days of the end of each state fiscal year.

a. Monthly Financial ReconciliationThe Managing Entity shall submit a monthly expenditure report that reconciles actual costs incurred by the Managing Entity to funds disbursed to the Managing Entity by the Department. These expenditure reports must include:

(1) The Managing Entity’s actual operational cost.

(a) Any funds disbursed to the Managing Entity for operational costs that are not expended or are determined to be expended for unallowable costs, as identified in the expenditure reports, shall be considered overpayment to the Managing Entity. Such overpayments may be recouped by the Department or redirected to service costs, as mutually agreed upon by both the Department and the Managing Entity. Recoupment of overpayment, if applicable, may be accomplished by deducting the overpayment from future invoices within the same state fiscal year or repayment must be made immediately per section 22 of the Standard Contract.

(b) Any discrepancy discovered during the reconciliation of payments to the Managing Entity for operational costs may be used to negotiate appropriate rates to compensate the Managing Entity for operational costs for each year of the Contract.

(2) The actual service cost of the SOC.

(a) Any variances discovered during the reconciliation of Department payments and actual expenditures that are determined to be either expenditures of unearned funding or unallowable expenditures may be recouped by the Department.

(b) To maximize the earned use of funding, at the sole discretion of the Department, such reconciliation related variances may, where appropriate, be redirected within the Managing Entity’s budget.

(3) Any efficiency achieved through utilization management, or other cost-saving measures, are dependent on a mutual determination of how the Managing Entity proposes to reinvest these efficiencies. Such redirection will take into account the Managing Entity’s achievement of the performance outcomes measures specified in Exhibit B, Performance Outcome Measures and requires the approval of the Department.

b. Quarterly Performance ReviewThe Managing Entity shall submit a quarterly report within twenty (20) days of the end of each quarter detailing its activities and performance related to the following:

(1) Exhibit B, Performance Outcome Measures;(2) Overview of necessary adjustments to required plans;

(3) Medicaid enrollment reporting specified in Section C.7.

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(4) SOC management including:

(a) New subcontracts with Network Service Providers;

(b) Collaborative strategies and activities with the Department and other community partners or Stakeholders; and

(c) Adverse fiscal impact of proposed SOC changes and recommendations for resolution.

(5) Network Service Provider performance including:

(a) Monitoring and review results, including reports and corrective action plans or other necessary follow-up actions;

(b) Performance and outcome measures; and

(c) Assessment of Network Service Provider financial risk specified in Section B.3.p.

c. Any adverse finding or report against a Network Service Provider by any regulatory or law enforcement entity. To provide technical assistance, the Department will produce a report reflecting the Managing Entity’s performance, and any Department determinations regarding satisfaction or failure in meeting the terms and conditions of this contract, and the determination of any necessary adjustments to subsequent monthly payments.

d. Any necessary corrective action must be addressed within timelines specified in the report.

11.Financial ConsequencesThe Contract Manager will apply the provisions of Exhibit D, Financial Consequences to make any necessary reductions to the invoice for any funds to be withheld as payment adjustments. The parties agree that the payment adjustments described in Exhibit D, Financial Consequences, constitute financial consequences under section 287.058(1)(h), F.S., for the Managing Entity’s failure to perform in accordance with the performance standards set forth in Exhibit D, Financial Consequences. This provision shall not limit additional financial consequences as referenced in Section 21 of the Standard Contract.

D. Special Provisions1. Dispute Resolution

a. The parties agree to cooperate in resolving any differences in interpreting the contract. Within five (5) working days of the execution of this contract, each party shall designate one person, with the requisite authority, to act as its representative for dispute resolution purposes, and shall notify the other party of the person’s name and business address and telephone number. Within five (5) working days from delivery to the designated representative of the other party of a written request for dispute resolution, the representatives will conduct a face-to-face meeting to resolve the disagreement amicably. If the representatives are unable to reach a mutually satisfactory resolution, either representative may request referral of the issue to the Managing Entity’s Chief Executive Officer (CEO) and the Department’s Regional SAMH Director. Upon referral to this

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second step, the respective parties shall confer in an attempt to resolve the issue.

b. If the CEO and Regional SAMH Director are unable to resolve the issue within ten (10) days, the parties’ appointed representatives shall meet within ten (10) working days and select a third representative. These three representatives shall meet within ten (10) working days to seek resolution of the dispute. If the representatives’ good faith efforts to resolve the dispute fail, the representatives shall make written recommendations to the Secretary who will work with both parties to resolve the dispute. The parties reserve all their rights and remedies under Florida law. Venue for any court action will be in Leon County, Florida.

2. MyFloridaMarketPlace Transaction FeeThis contract is exempt from the MyFloridaMarketPlace Transaction Fee in accordance with Rule 60A-1.032(1) (d), F.A.C.

3. Contract RenewalThis contract may be renewed for a term not to exceed three (3) years or for the term of the original contract, whichever period is longer. Such renewal shall be made by mutual agreement and shall be contingent upon satisfactory performance evaluations as determined by the Department and shall be subject to the availability of funds. Any renewal shall be in writing and shall be subject to the same terms and conditions as set forth in the initial contract and any subsequent amendments.

4. Special Insurance Provisionsa. The Managing Entity shall notify the Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance, including but not limited to, cancellation or modification to policy limits.

b. The Managing Entity acknowledges that as an independent contractor, the Managing Entity and its Network Service Providers at all tiers are not covered by the State of Florida Risk Management Trust Fund for liability created by section 284.30, F.S.

c. The Managing Entity shall obtain and provide proof to the Department of comprehensive general liability insurance coverage (broad form coverage), specifically including premises, fire and legal liability to cover managing the Managing Entity and all of its employees. The limits of Managing Entity’s coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. The Managing Entity shall cause all Network Service Providers, at all tiers, who the Managing Entity reasonably determines to present a risk of significant loss to the Managing Entity or the Department, to obtain and provide proof to Managing Entity and the Department of comprehensive general liability insurance coverage (broad form coverage), specifically including premises, fire and legal liability covering the Network Service Provider and all of its employees. The limits of coverage for the Managing Entity’s Network Service Providers, at all tiers, shall be in such amounts as the Managing Entity reasonably determines to be sufficient to cover the risk of loss.

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d. If in the course of the performance of its duties under this contract any officer, employee, or agent of the Managing Entity operates a motor vehicle, the Managing Entity shall obtain and provide proof to the Department of comprehensive automobile liability insurance coverage. The limits of the Managing Entity’s coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. If in the course of the performance of the duties of any Network Service Provider, at all tiers, any officer, employee, or agent of the Network Service Provider operates a motor vehicle, the Managing Entity shall cause the Network Service Provider, at all tiers, to obtain and provide proof to the Managing Entity and the Department of comprehensive automobile liability insurance coverage with the same limits.

e. The Managing Entity shall obtain and provide proof to the Department of professional liability insurance coverage, including errors and omissions coverage, to cover the Managing Entity and all of its employees. If in the course of the performance of the duties of the Managing Entity under this contract any officer, employee, or agent of the Managing Entity administers any prescription drug or medication or controlled substance, the professional liability coverage shall include medical malpractice liability and errors and omissions coverage, to cover the Managing Entity and all of its employees. The limits of the coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. If in the course of the performance of the duties of any Network Service Provider, at all tiers, any officer, employee, or agent of the Network Service Provider, at all tiers, provides any professional services or provides or administers any prescription drug or medication or controlled substance, the Managing Entity shall cause the Network Service Provider, at all tiers, to obtain and provide proof to the Managing Entity and the Department of professional liability insurance coverage, including medical malpractice liability and errors and omissions coverage, to cover all Network Service Provider employees with the same limits.

f. The Department shall be exempt from, and in no way liable for, any sums of money that may represent a deductible or self-insured retention under any such insurance. The payment of any deductible on any policy shall be the sole responsibility of the Managing Entity, or Network Service Provider purchasing the insurance.

g. All such insurance policies of the Managing Entity and its Network Service Providers, at all tiers, shall be provided by insurers licensed or eligible to do and that are doing business in the State of Florida. Each insurer must have a minimum rating of “A” by A. M. Best or an equivalent rating by a similar insurance rating firm, and shall name the Department as an additional insured under the policy(ies). The Managing Entity shall use its best good faith efforts to cause the insurers issuing all such general, automobile, and professional liability insurance to use a policy form with additional insured provisions naming the Department as an additional insured or a form of additional insured endorsement that is acceptable to the Department in the reasonable exercise of its judgment.

h. All such insurance proposed by the Managing Entity shall be submitted to and confirmed by the Contract Manager by March 31st of each year.

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i. The requirements of this section shall be in addition to, and not in replacement of, the requirements of section 10, of the Standard Contract to which this Attachment I is attached, but in the event of any inconsistency between the requirements of this section and the requirements of the Standard Contract, the provisions of this section shall prevail and control.

5. Use of Department’s Operating ProceduresThe Managing Entity shall use the Department's Operating Procedures until its agency procedures are approved by the Department for implementation. In the event of differing interpretation, the parties agree to meet for resolution. The Managing Entity shall have its operating procedures approved within one hundred and eighty (180) days of contract execution. The Department agrees to review proposed operating procedures submitted by the Managing Entity and will respond in writing with comments, or will approve within thirty (30) working days from the day of receipt. Once approved by the Department, the Managing Entity's operating procedures may be amended without further Departmental review provided that they conform to state and federal laws and regulations.

6. Employment Eligibility Verification (E-Verify)a. Definitions as used in this clause:

(1) “Employee assigned to the contract” means all persons employed during the contract term by the Managing Entity to perform work pursuant to this contract within the United States and its territories, and all persons (including Network Service Providers) assigned by the Managing Entity to perform work pursuant to this contract with the Department.

(2) “Subcontract” means any contract entered into by a Network Service Provider to furnish supplies or services for performance of a prime contract or a subcontract. It includes but is not limited to purchase orders, and changes and modifications to purchase orders.

(3) “Service Provider” means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime provider or another Network Service Provider.

b. Enrollment and Verification Requirements(1) The Managing Entity shall:

(a) Enroll as a provider in the E-Verify program within thirty (30) calendar days of contract award or amendment.

(b) Within ninety (90) calendar days of enrollment in the E-Verify program, begin to use E-Verify to initiate verification of employment eligibility. All new employees assigned by the Managing Entity or a Service Provider to perform work pursuant to the contract with the Department shall be verified as employment eligible within three (3) business days after the date of hire.

(2) The Managing Entity shall comply, for the period of performance of this contract, with the requirement of the E-Verify program enrollment.

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(a) The Department of Homeland Security (DHS) or the Social Security Administration (SSA) may terminate the Managing Entity’s enrollment and deny access to the E-Verify system in accordance with the terms of the enrollment. In such case, the Managing Entity will be referred to a DHS or SSA suspension or debarment official.

(b) During the period between termination of the enrollment and a decision by the suspension or debarment official whether to suspend or debar, the Managing Entity is excused from its obligations under paragraph (b) of this clause. If the suspension or debarment official determines not to suspend or debar the Managing Entity, then the Managing Entity must re-enroll in E-Verify.

(c) Information on registration for and use of the E-Verify program can be obtained via the Internet at the Department of Homeland Security Web site: http://www.dhs.gov/E-Verify.

(d) The Managing Entity is not required by this clause to perform additional employment verification using E-Verify for any employee whose employment eligibility was previously verified by the Managing Entity through the E-Verify program.

(e) Evidence of the use of the E-Verify system will be maintained in the employee’s personnel file.

(f) The Managing Entity shall include the requirements of this section, including this paragraph (f) (appropriately modified for identification of the parties), in each subcontract.

(g) The Service Provider at any tier level must comply with the E-Verify clause as subject to the same requirements as the Managing Entity.

7. Preference to Florida-Based BusinessesThe Managing Entity shall maximize the use of state residents, state products, and other Florida-based businesses in fulfilling its contractual duties under this contract.

8. Sliding Fee ScaleThe Managing Entity shall ensure compliance with the provisions of Rule 65E-14.018, F.A.C. A copy of each Network Service Provider’s sliding fee scales that reflects the uniform schedule of discounts referenced in Rule 65E-14.018, F.A.C., shall be kept in the Network Service Provider’s file. The Managing Entity shall submit to the Contract Manager, within thirty (30) days of the execution, a validation that all sliding fee scales have been received from all appropriate Network Service Providers.

9. Trust Funds for Individual Served a. The Managing Entity shall comply with 20 C.F.R. section 416 and 31 C.F.R. section 240, as well as all other applicable federal laws, regarding the establishment and management of individual client trust accounts when the Network Service Providers are the representative payee, the entity who is legally authorized to receive Supplemental Security Income, Social Security Income,

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Veterans Administration benefits, or other federal benefits on behalf of Individuals Served.

b. The Managing Entity shall provide oversight so that Network Service Providers comply with the applicable federal laws regarding the establishment and management of individual client trust accounts, in accordance with 20 C.F.R. section 416 and 31 C. F. R. section 240.

c. The Managing Entity shall require that the Network Service Providers assuming responsibility for administration of the personal property and funds of clients shall follow the Department’s Accounting Procedures Manual AMP 7, Volume 6, incorporated herein by reference (7APM6). The Department personnel or their designees, upon request, may review all records relating to this section. Any shortages of client funds that are attributable to the Network Service Providers shall be repaid, plus applicable interest, within one week of the determination.

d. Notwithstanding 7APM6 section 15, the Managing Entity shall ensure that Network Service Providers maintain all reconciliation records on-site for review.

10.National Provider Identifier (NPI)a. All health care providers, including Managing Entities and Network Service Providers, are eligible to be assigned a Health Insurance Portability and Accountability Act (HIPAA) National Provider Identifiers (NPIs); however, health care providers who are covered entities (which include all state-contracted community SAMH providers and State Treatment Facilities) must obtain and use NPIs.

b. An application for an NPI may be submitted online at:

https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart

c. Additional information can be obtained from one of the following websites:

(1) The Florida Medicaid Health Insurance Portability and Accountability Act:

http://www.fdhc.state.fl.us/medicaid/hipaa/

(2) The National Plan and Provider Enumeration System (NPPES):

https://nppes.cms.hhs.gov/NPPES/Welcome.do

(3) The CMS NPI:

http://www.cms.hhs.gov/NationalProvIdentStand/

11.Files of Individuals ServedThe Managing Entity shall require that Network Service Providers maintain all current and subsequent medical records/clinical files of Individuals Served. In the event a Network Service Provider program closes, the Managing Entity shall obtain files from the Network Service Provider and transport them to the Department.

12.Satisfaction Survey for Individuals ServedThe Managing Entity shall ensure all Network Service Providers conduct

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satisfaction surveys of Individuals Served pursuant to PAM 155-2.

E. Program Specific Requirements1. Adult Forensic Services

The Managing Entity shall comply and ensure Network Provider compliance with the provisions of the Forensic Mental Health Services Model, pursuant to CFOP 155-18.

2. Prevention Partnership Grants (PPG)The Managing Entity shall be responsible for procuring, contracting, and providing oversight of the Prevention Partnership Grant (PPG), section 397.99, F.S.. The Managing Entity shall require that each year, Network Service Providers receiving PPG funding complete the Evidence-Based Self-Assessment Survey.

3. Projects for Assistance to Transition from Homelessness (PATH)a. The Managing Entity shall contract with Network Service Providers that receive federal PATH funds provide support services for individuals who have a serious mental illness or a serious mental illness and co-occurring substance use issues and are homeless or at imminent risk of becoming homeless. The Managing Entity shall encourage PATH providers to partner with local resources to link people with safe, affordable housing of their choice.

b. The Managing Entity shall require that PATH Network Service Providers implement an approved and signed Local Intended Use Application.

c. The Managing Entity shall expend eligible PATH local matching funds in the provision of PATH eligible services to PATH eligible persons. The expenditures must match the types of services outlined in the Local Intended Use Plan. The formula to be followed is cited in Title V, Part C, Section 524 of the Public Health Services Act (42 U.S.C. 290cc-21 et. Seq).

d. The Managing Entity shall require that PATH Network Providers submit annual reports as directed by the Department. More information and guidelines for annual report submission may be located at: http://www.pathprogram.samhsa.gov

4. Indigent Drug Program (IDP)If the Managing Entity receives funding under the Indigent Drug Program (IDP), the Managing Entity shall provide oversight to ensure that:

a. Funds allocated for use of purchasing psychotropic medications or medications accessed through line of credit from the IDP are used for individuals who meet any of the following criteria:

(1) Have an annual income that is at or below 150% of the Federal Poverty Income Guidelines, as published annually in the Federal Register.

(2) Have no liable third-party insurance or other source of psychotropic medications available, nor is the individual a participant in a program where psychotropic medications are paid for by any other funding source.

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(3) If the individual has third party insurance for psychotropic medications but has temporarily been denied benefits for these medications, they may receive IDP medications until such time as eligibility has been reestablished.

b. Network Service Providers receiving these funds actively participate in manufacturer’s patient assistance programs for medications needed by a significant portion of Individuals Served by Network Service Providers: and

c. Network Service Providers receiving these funds participate in any regional training events made available by the Department. The Managing Entity shall participate in any training events made available by the Louis De La Parte Florida Mental Health Institute at the University of South Florida’s Medicaid Drug Therapy Management System Program for Behavioral Health which are posted on the at Program’s website at: http://flmedicaidbh.fmhi.usf.edu/

5. Statewide Inpatient Psychiatric Programs (SIPP)The Managing Entity shall require the implementation and operation of the Statewide Inpatient Psychiatric Programs (SIPP), in compliance with the guidance document Statewide Inpatient Psychiatric Programs (SIPP) Residential Placements Using SIPP Funding and Referral Process – Incorporated Document 6, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

6. Juvenile Incompetent to Proceed (JITP)The Managing Entity shall ensure the implementation and operation of the Juvenile Incompetent to Proceed (JITP) program, in compliance with section 9185.19, F.S., and the guidance document JITP – Incorporated Document 26, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

7. Behavioral Health Network (BNet)The Managing Entity shall be responsible for the duties and responsibilities contained in Chapters 394, 397 and 916, F.S., in the delivery of the BNet. BNet Guidelines and Requirements – Incorporated Document 27, which is incorporated herein by reference and may be located at:

http://www.myflfamilies.com/service-programs/substance-abuse/managing-entities

8. Additional Program Specific FundsThe Managing Entity shall incorporate any additional program-specific funds appropriated by the Legislature for Behavioral Health Services. Any increases will be documented through an amendment to this contract, resulting in a current fiscal year funding and corresponding service increase. Such increase in services must be supported by additional deliverables as outlined in the amendment.

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F. The following exhibits, or the latest revisions thereof, are incorporated herein and made a part of the Contract:

1. Exhibit A - Required Plans, Reports, and Statistics

2. Exhibit B – Performance Outcome Measures

3. Exhibit C - Line Item Budget Detail

4. Exhibit D – Financial Consequences

5. Exhibit E – Schedule of Funds

G. The following documents, or the latest revision thereof, are incorporated herein and made a part of the Contract.

1. Incorporated Document 1 - Department of Children and Families’ Glossary of Contract Terms

2. Incorporated Document 2 - Evidence-Based Practice Guidelines

3. Incorporated Document 3 - State and Federal Laws, Rules, and Regulations

4. Incorporated Document 4 – Programmatic Allocation Plan

5. Incorporated Document 5 – SAMH Funding Restrictions Resource Guide

6. Incorporated Document 6 - Statewide Inpatient Psychiatric Programs (SIPP) Residential Placements Using SIPP Funding and Referral Process

7. Incorporated Document 7 - Outpatient Forensic Mental Health Services

8. Incorporated Document 8 – Forensic and Civil Treatment Facility Admission and Discharge Processes

9. Incorporated Document 9 – LMH-ALF Training

10. Incorporated Document 10 - SOAR

11. Incorporated Document 11 – Managing Entity Expiration/Termination Transition Planning Requirements

12. Incorporated Document 12 – Crisis Counseling Program

13. Incorporated Document 13 – Tangible Property Requirements and Contract Provider Property Inventory Form

14. Incorporated Document 14 – Performance Outcomes Measurement Manual

15. Incorporated Document 15 – Prevention Services

16. Incorporated Document 16 – Integration Planning

17. Incorporated Document 17 – Integration Position

18. Incorporated Document 18 – Local Review Team

19. Incorporated Document 19 – Managing Entity Fixed Payment Invoice

20. Incorporated Document 20 – Cost Allocation Plan

21. Incorporated Document 21 – ME Monthly Fixed Invoice Expenditure Report

22. Incorporated Document 22 – ME Monthly Carry Forward Expenditure Report

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23. Incorporated Document 23 – ME Spending Plan for Carry Forward Report

24. Incorporated Document 24 – Local Match Calculation Form

25. Incorporated Document 25 – SAMH Other Funds Source Report

26. Incorporated Document 26 – JITP Guidance

27. Incorporated Document 27 – BNet Guidelines & Requirements

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