HomeMy WebLinkAboutAgreements/Contracts - RenewDocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Washington State
coNrw4cT for
HCA Contract Number: K6946
Health CareuL�����
Prevention and Promotion
Client Services
(DBHR), SUD Prevention and MH Promotion
THIS CONTRACT is made by and between the Washington State Health Care Authority (HCA) and Grant
County, (Contractor).
CONTRACTOR NAME
HCA DIVISION/SECTION
CONTRACTOR DOING BUSINESS AS (DBA)
Grant County
Prevention and Promotion Local Services
(DBHR), SUD Prevention and MH Promotion
CONTRACTOR ADDRESS Street
Section
City
State
Zip Code
840 E Plum St
Services
Moses Lake
WA
98837
CONTRACTOR CONTACT
CONTRACTOR TELEPHONE
CONTRACTOR E-MAIL ADDRESS
Dell Anderson
(509) 765-9239
daanderson@grantcountywa.gov
Is Contractor a Subrecipient under this Contract?
NYES ❑NO
HCA PROGRAM
HCA DIVISION/SECTION
DATE SIGNED
Division of Behavioral Health and Recovery
Prevention and Promotion Local Services
(DBHR), SUD Prevention and MH Promotion
HCA SIGNATURE
Section
HCA CONTACT NAME AND TITLE
HCA CONTACT ADDRESS
Kasey Kates, Supervisor, CPWI Community and School -Based
Health Care Authority
Services
626 8th Avenue SE
7/7/2023
PO Box 42730
Olympia, WA 98504-2730
HCA CONTACT TELEPHONE
HCA CONTACT E-MAIL ADDRESS
(360) 725-2054
Kase ,Kates hea.wa, ov
CONTRACT START DATE I CONTRACT END DATE I TOTAL MAXIMUM CONTRACT AMOUNT
July 1, 2023 1 June 30, 2025 1 $1,710,000.00
PURPOSE OF CONTRACT:
Contractor will provide substance use disorder prevention and mental health promotion services to individuals, families
and communities. The services will be provided through individual Task Orders, as funded and agreed to between both
parties.
The parties signing below warrant that they have read and understand this Contract and have authority to
execute this Contract. This Contract will be binding on HCA only upon signature by both parties.
CONTRACTOR SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
Rob Jones, Chair
5-0
HCA SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
Docu8lpned by.
lAlyson Beck
��SOIn.15t&
Contracts Administrator
7/7/2023
APPROVED
JUL 2 5 ZU23
CONSEN
T
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
TABLE OF CONTENTS
1. Statement of Work (SOW)............................................................................................................5
2. Definitions....................................................................................................................................5
3. Special Terms and Conditions..................................................................................................14
3.1
Performance Expectations...............`...................................................................................14
3.2
Term............................................................................:.......................................................15
3.3
Compensation and Billing....................................................................................................15
3.4
Invoice and Payment..........................................................................................................19
3.5
Contractor and HCA Contract Managers.............................................................................21
3.6
Legal Notices......................................................................................................................21
3.7
Incorporation of Documents and Order of Precedence........................................................22
3.8
Insurance........................................................................................................ ................23
3.9
Promotion and Prevention Services Requirements..............................................................24
3.10
Background Checks..........................................................................................................26
3.11
Services and Activities to Diverse Populations....................................................................26
3.12
Continuing Education..........................................................................................................26
3.13
Single Source Funding........................................................................................................26
3.14
Contractor Monitoring..........................................................................................................27
3.15
Subcontracting....................................................................................................................29
3.16
Contract Closeout..............................................................................................................31
3.17
Fees/Licenses....................1.................................................................................................32
'
3.18
Antitrust Assignment..........................................................................................................32
3.19
Fraud and Abuse Requirements.....................................................:....................................32
3.20
Health and Safety................................................................................................................33
4. General Terms andCondition's .................................................................................................33
4.1
Access to Data....................................................................................................................33
4.2
Accessibility.........................................................................................................................33
4.3
Advance Payment Prohibited..............................................................................................34
4.4
Amendments.......................................................................................................................34
4.5
Assignment.........................................................................................................................34
4.6
Attorneys' Fees.................................................................................................................35
4.7
Change in Status.................................................................................................................35
4.8
Conflict of Interest...............................................................................................................35
4.9
Conformance.......................................................................................................................35
4.10
Covered Information Protection...........................................................................................35
4.11
Contractor's Proprietary Information....................................................................................36
4.12
Covenant Against Contingent Fees.....................................................................................36
Washington State 2 Description of Services
Health Care Authority HCA Contract #K6946
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
4.13 Debarment..........................................................................................................................36
4.14
Disputes..............................................................................................................................37
....................................................................................................42
4.15
Entire Agreement................................................................................................................37
4.34 Site Security........................................................................................................................43
4.16
Force Majeure.....................................................................................................................38
4.17
Funding withdrawn, Reduced, or Limited.............................................................................38
4.37 Survival...............................................................................................................................45
4.18
Governing Law....................................................................................................................39
4.19
HCA Network Security.........................................................................................................39
4.20
Indemnification....................................................................................................................39
4.21 Independent Capacity of the Contractor..............................................................................39
4.22 Legal and Regulatory Compliance.......................................................................................39
4.23 Limitation of Authority..........................................................................................................40
4.24 No Third -Party Beneficiaries................................................................................................40
4.25 Nondiscrimination................................................................................................................40
4.26 Overpayments to the Contractor..........................................................................................40
4.27 Pay Equity...........................................................................................................................40
4.28 Publicity............................................................................................................................41
4.29 Records and Document Review..........................................................................................41
4.30 Remedies Non-Exclusive....................................................................................................42
4.31 Right of Inspection...............................................................................................................42
4.32 Rights in Data/Ownership
....................................................................................................42
4.33 Severability..........................................................................................................................43
4.34 Site Security........................................................................................................................43
4.35 Subcontracting....................................................................................................................44
4.36 Subrecipient........................................................................................................................44
4.37 Survival...............................................................................................................................45
4.38 Taxes..................................................................................................................................46
4.39 Termination.........................................................................................................................46
4.40 Termination Procedures......................................................................................................47
4.41 Transition Obligations..........................................................................................................48
4.42 Treatment of Assets............................................................................................................49
4.43 Waiver................................................................................................................................. 50
4.44 Warranties...........................................................................................................................50
Attachment 1: Task Order #01 - CPWI Community.......................................................................51
Attachment 2: Task Order #02 - CPWI School..............................................................................60
Attachment 3: Task Order #03 - CBO............................................................................................67
Attachment 4: Data Sharing Terms................................................................................................78
1. Description of Data to be Shared / Data Licensing Statements............................................78
Washington State 3 Description of Services
Health Care Authority HCA Contract #K6946
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
2. HCA System Access Requirements and Process................................................................78
3. Data Classification .............................................................................................................79
4. Constraints on Use of Data/Limited License........................................................................80
5. Data Modification(s)..........................................................................................................81
6. Security of Data...................................................................................................................82
7. Data Confidentiality and Non-Disclosure.............................................................................82
8. Data Shared with Subcontractors........................................................................................83
9. Audit....................................................................................................................................83
10. Data Breach Notification and Obligations............................................................................83
11. HIPAA Compliance..............................................................................................................84
12. Survival Clauses..................................................................................................................85
Attachment A: Data Security Requirements..................................................................................86
Attachment B: HCA Small Numbers Standard...............................................................................90
Attachment C: User Agreement on Non -Disclosure of Confidential Information ........................94
Attachment D: Certification of Destruction/Disposal of Confidential Information
......................95
Attachment 5: Federal Compliance, Certifications and Assurances............................................96
Attachment 6: SAMHSA Federal General Terms and Conditions...............................................103
Attachment 7: SOR III — H79TIO85727 Terms and Conditions .....................................................104
Washington State 4 Description of Services
Health Care Authority HCA Contract #K6946
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Recitals
The State of Washington, acting by and through the Health Care Authority (HCA), seeks to
secure substance use disorder prevention and mental health promotion services to individuals,
families, and communities.
Client services contracts, such as this Contract, are exempt from the requirement of competitive
solicitation (RCW 39.26.125(6)).
HCA has determined that Contractor is qualified and willing to provide the services described in
this Contract.
Nothing herein precludes HCA from seeking applicants to provide these services as part. of the
contracting or procurement process.
THEREFORE, HCA awards to Grant County this Contract, the terms and conditions of which
will govern Contractor's providing to HCA the substance use disorder prevention and mental
health promotion services to individuals, families, and communities.
IN CONSIDERATION of the mutual promises set forth in this Contract, the sufficiency of which
the parties acknowledge, the parties agree as follows:
The Recitals listed above are incorporated by reference into this Contract. _
1. STATEMENT OF WORK (SOW)
The Contractor will furnish the necessary personnel, equipment, material and/or service(s) and
otherwise do all things necessary for or incidental to the performance of work set forth in each
attached Task Order.
2. DEFINITIONS
"Administrative Costs" or "Indirect Costs" means the elements of costs incurred by the
Contractor_ as costs that are necessary to administrate or operate a program that are not
considered direct program costs. Criteria for Administrative/Indirect Costs, Contract -Specific
Direct Costs, and Shared Direct Costs are outlined in the Substance Use Disorder
Prevention and Mental Health Promotion Services Billing Guide.
"Agent" means the Director of the Health Care Authority and/or the Director's delegate
authorized in writing to act on behalf of the Director.
"Allowable Cost" means an expenditure which meets the test of the appropriate executive
office of the President of the United States' Office of Management and Budget (OMB)
circular. The most significant factors which determine whether a cost is allowable' are the
extent to which the cost is:
• Necessary and reasonable;
• Allocable;
• Authorized or not prohibited under Washington state or local
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laws and regulations;
• Adequately documented.
"Authorized Representative" means a person to whom signature authority has been
delegated in writing acting within the limits of his/her authority.
"Authorized User" means an individual or individuals with an authorized business need to
access HCA's Confidential Information under this Contract.
"Awards and Revenues" or "A&R" means the details of the Contractor's Awards and
Revenues. The Contractor must budget and bill according to each Award and
Revenues.
"Awards and Revenues (A&Rs) and Federal Subaward Identification (FSI)
documents" or "A&R/FSI document" means the document that is issued after
execution of the Contract and is fully incorporated by reference. that identifies the most
current: sources of funds available; amount available for expenditure by Task Order;
and federal subaward identification of funding by source. The A&R/FSI identify funding
assigned to each Task Order up to the total maximum consideration.
"Breach" means the unauthorized acquisition, access, use, or disclosure of confidential
information that compromises the security, confidentiality, or integrity of the confidential
information.
"Business Days and Hours" means Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific
Time, except for holidays observed by the state of Washington.
"Certified Prevention Professional" or "CPP" means the Prevention Specialist certification
recognized by the International Credentialing and Reciprocity Consortium (IC&RC) and
supported by the Prevention Specialist Certification Board of Washington,
hit ://www. sobw.com-
"Client" means an individual who is eligible for or receiving services through HCA program(s).
"CFR" means the Code of Federal Regulations. All references in this Contract to CFR.
chapters or sections include any successor, amended, or replacement regulation. The CFR
may be accessed at hti ://www.eC. F. R.. ov/c i-bin/EC. F. R.? a e�browse.
"Coalition" means a formal arrangement for cooperation and collaboration between groups or
sectors of a community. Each participant in the Coalition retains their identity, but all agree to
work together toward a common goal of building a safe, healthy, and drug-free community.
"Community" means an approved geographic area within school district
boundaries, or within High School Attendance Areas (HSAA) and their feeder
schools.
"Community -Based Organization" or "CBO" means a public or private nonprofit
organization of demonstrated effectiveness that is representative of a community, or of
significant segments of a community, and that provides educational or related services to
individuals in the community. This includes faith -based and religious organizations.
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"Community Prevention and Wellness Initiative" or "CPWI" means the HCA substance
use disorder prevention delivery system that focuses prevention services in high -need and
risk from alcohol, tobacco, marijuana, opioids, and other substances in Washington State as
selected and approved by HCA.
"Confidential Information" means information that is exempt from disclosure to the public or
other unauthorized persons under chapter 42.56 RCW or other federal or state laws.
Confidential Information includes, but is not limited to, both Category 3 and Category 4 Data
as described in Attachment 4, Section 3 Data Classification, which includes, but is not limited
to, Personal Information and Protected Health Information.
"Contract" means this Contract document and all schedules, exhibits, attachments,
incorporated documents and amendments.
"Contract Manager" means the individual identified on the cover page of this Contract who
will provide oversight of the activities conducted under this Contract.
"Contractor" means Grant County its employees and agents. Contractor includes any firm,
provider, organization, individual or other entity performing services under this Contract. It also
includes any Subcontractor retained by Contractor as permitted under the terms of this
Contract.
"Covered Entity" has the same meaning as defined in 45 C.F.R. §160.103.
"The Center for Substance Abuse Prevention" or "CSAP" - means the unit within the
federal Substance Abuse and Mental Health Services Administration (SAMHSA), which
works with federal, state, public, and private organizations to develop comprehensive
prevention systems. CSAP has developed and recognized the six prevention strategy
categories listed below.
CSAP Categories:
• Alternative Activities: Activities that involve participation by targeted
groups/individuals that purposefully exclude alcohol and other substances by way of
providing pro -social and healthy alternatives.
• Community -Based Process: Providing an organized forum to enhance prevention
activities by forming a group. The group organizes, plans, and implements
prevention activities through this format.
• Education: Activities to provide education to identified group/individuals aimed at
teaching decision - making skills, refusal skills, parental management skills, social
skill development etc. Education activities involve two-way communication and
involve an educator teaching participants.
• Environmental; Establish or change Community attitudes,. norms, and policies that
can influence substance use occurrence within.the Community.
• Information Dissemination: Provide information about drug use, misuse, and abuse,
and the effects of substance use on individuals. Provide information on prevention
related programs and resources available.
• Problem Identification and Referral: Identify individuals with misuse/abuse of
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substances in order to provide interventions that can deter those individuals of
continued misuse through education and motivation strategies.
"Data" means information produced, furnished, acquired, or used by Contractor in meeting
requirements under this Contract. Confidential Information, Personal Information, and
Protected Health Information are all considered Data for the purposes of this Contract. For
Attachment 4, Data Sharing Terms, Data specifically refers to the information that is disclosed
or exchanged as described in the Attachment. 0
"Data Breach" means the acquisition, access, use, or Disclosure of Data in a manner not
permitted under law or by this Contract, including but not limited to the HIPAA Pr�yacy Rule,
which compromises the security or privacy of Protected Health Information, with the exclusions
and exceptions listed in 45 C.F.R.. § 164.402.
"DBHR" means the "Division of Behavioral Health and Recovery," a division of HCA, or its
successors.
"DEA" means the federal Drug Enforcement Agency.
"Designated Record Set" means a group of records maintained by or for a Covered Entity,
that is: the medical and billing records about individuals maintained by or for a covered health
care provider; the enrollment, payment, claims adjudication, and case or medical management
record systems maintained by or for a health plan; or used in whole or part by or for the
Covered Entity to make decisions about individuals.
"Disclosure" means the release, transfer, provision of, access to, or divulging in any other
manner of information outside the entity holding the information.
"Division of Behavioral Health and Recovery" (DBHR) - The division within the Health Care
Authority that provides program support for behavioral health services, including substance use
disorder prevention and treatment, mental health pro -motion and treatment, and recovery
support services.
"Diagnostic and Statistical Manual of Mental Disorders" or "DSM -5" means The
Diagnostic and Statistical Manual of Mental Disorders., Fifth Edition, which is the 2013
update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and
diagnostic tool published by the American Psychiatric Association.
"Debarment" means an action taken by a federal agency or official to exclude a
person or business entity from participating in transactions.involving certain federal
funds.
"Dedicated Cannabis Account" or "DCA" means revenue generated by taxation of retail
cannabis as a result of the implementation RCW 69.50.540; State Funds.
"Direct Service Programs" means services that are provided to an individual or group
using and in-person program delivery method.
Washington State 8 HCA Contract #K6946
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"Educational Service District" or "ESD" means the regional agency established by RCW
28A.310.010 to (1) provide cooperative and informational services to local school districts;
(2) assist the superintendent of public instruction and the state board of education in the
performance of their respective statutory or constitutional duties; and (3) provide services to
school districts and to the Washington state center for childhood deafness and hearing loss
and the school for the blind to assure equal educational opportunities.
"Effective Date" means the first date this Contract is in full force and effect. It may be a
specific date agreed to by the parties in this Contract; or, if not so specified, the date of the last
signature of a party to this Contract. For the purposes of this contract, effective date is same as
Contract Start Date listed on the Contract face page.
"Evidence -Based Program" or "EBP" means a program that has been tested in
heterogeneous or intended populations that can be implemented with a set of procedures to all
successful replication in Washington. An EBP has showed favorable effects and no harmful -
effects in one or more evaluation studies including at least one rigorous randomized controlled
trial or two rigorous quasi -experimental evaluation studies. This is determined through a
secondary review of evidence -based program registry ratings and/or a review of program
evaluation literature.
"Fidelity" means the degree of exactness with which something is copied or reproduced.
"General Fund State" or "GFS" or "SFG" means the funds from the Washington state
general funds. Also known as: State Funds.
"HCA Contract Manager" means the individual identified on the cover page of this Contract
who will provide oversight of the Contractor's activities conducted under this Contract.
"Health Care Authority" or "HCA" means the Washington State Health Care Authority, any
division, section, office, unit or other entity of HCA, or any of the officers or other officials
lawfully representing HCA.
"Health Equity" means when every person has the opportunity to attain their full health
potential, and no one is disadvantaged from achieving this potential because of social
position or other socially determined circumstances, and that everyone has a fair and just
opportunity to be as healthy as possible. This requires removing obstacles to health such as
poverty, discrimination, and their consequences, including powerlessness and lack of
access to good jobs with fair pay, quality education and housing, safe environments, and
health care. Health Equity is a core value of HCA.
"Health Disparities" means a particular type of health difference that is closely linked with
social, economic, and/or environmental disadvantage. Health disparities adversely affect
groups of people who have systematically experienced greater obstacles to health based on
their racial or ethnic group; religion; socioeconomic status; gender; age; mental health;
cognitive sensory, or physical disability; sexual orientation or gender identity; geographic
location; or other characteristics historically linked to discrimination or exclusion.
"HIPAA" means the Health Insurance Portability and Accountability Act of 1996, as codified at
42 USC 1320d -d8, as amended, and its attendant regulations as promulgated by the U.S.
Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid
Services, the HHS Office of the Inspector General, and the HHS Office for Civil Rights. HIPAA
Washington State 9 HCA Contract #K6946
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inlcudes the Privacy, Security, Breach Notification, and Enforcement Rules at 45 C.F.R. Part
160 and Part 164.
"Individual(s)" means the person(s) who is the subject of PHI and includes a person who
qualifies as a personal representative in accordance with 45 C.F.R. § 164.502(g).
"Innovative Program" means a program that does not fall into the other categories of
Evidence -based, Research -based, or Promising.
"The Institute of Medicine Model categories" or "IOM categories". The Institute of
Medicine classification by population to the differing objectives of various interventions and
matches the objectives to the needs of the target population. The IOM identifies these
categories based on the level of risk, see below.
IOM Classifications:
• Universal -Indirect: Targets the general population and are not
directed at a specific risk group.
• Universal -Direct: Interventions directly serve an identifiable group of
participants but who have not been identified on the basis of individual
risk.
• Selective: Targets those at higher -than -average risk for substance
abuse; individuals are identified by the magnitude and nature of risk
factors for substance abuse to which they are exposed.
• Indicated: Targets those already using or engaged in other high-risk
behaviors to prevent heavy or chronic use.
"Limited Data Set(s)" means a data set that meets the requirements of 45 C.F.R. §§
164.514(e)(2) and 164.514(e)(3).
"Media Materials and Publications" means:
• News Release: A brief written announcement the agency provides to
reporters highlighting key events, research, results, new funding and
programs, and other news;
• Paid Media: Any advertising space/time that is purchased for
prevention/coalition messages (printed publications/newspapers, online,
outdoor, on-screen, TV and radio);
• Earned Media: Published news stories (print, broadcast or online)
resulting from Contractor's Agreements with reporters;
• Donated Media, including public service announcements. Any free
advertising space or timefrom broadcast, print, outdoor, online, and
other advertising vendors;
• Social Media: Also referred to as new media: messaged posted
online of Facebook, Twitter, YouTube, Instagram, Snapchat and
similar sites.
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• Other Media Material .and Publications: Other print and video materials that are
created under this Contract.
"Mental Health" means a person's condition with regard to their psychological and
emotional well-being.
"Mental Health Promotion Projects" or "MHPP" means a program or strategy with the
overall goal of maximizing mental health and well-being among populations and individuals.
"Minimum Necessary" means the least amount of PHI necessary to accomplish the purpose
for which the PHI is needed.
"Opioid Abatement Settlement Account" or "DASA" (this and any variations of) means
State funding provided by the accounts created from the state settlement(s) with companies
found to have played key roles in/fueling the opioid epidemic. This is categorized as State
Funds.
"OMB" means the Office of Management and Budget of the executive office of the President of
the United States.
"Overpayment" means any payment or benefit to the Contractor in excess of that to which the
Contractor is entitled by law, rule, or this Contract, including amounts in dispute.
"Partnerships for Success" or "PFS", means the federal Substance Abuse and Mental
Health Services Administration (SMHSAA) Grant 2013 and 2018, CFDA number 93.243;
Federal Discretionary Funds.
"Permissible Use" means only those uses authorized in this Contract and as specifically
defined herein.
"Personal Information" means information identifiable to any person, including, but not
limited to, information that relates to a person's name, health, finances, education, business,
use or receipt of governmental services or other activities, addresses (including or excluding
zip code), telephone numbers, social security numbers, driver's license numbers, credit card
numbers, any other identifying numbers, and any financial identifiers.
"Prevention Activity Data" means information input to the agreed upon reporting system to
record all active prevention services including outcome measures. Reporting systems include
the "Substance Abuse Disorder Prevention Mental Health Promotion Online Reporting System"
or "Minerva" and the Student Assistance Prevention Intervention Spervices Program (SAPISP)
data reporting system or any successor systems established for the same purpose. This
information will be used to verify services identified in A-19 invoices prior to payment and must
be entered into the reporting system by the close of business of the fifteenth (15th) of each
month for prevention activities provided during the previous month.
"Prevention System Manager" or "PSM" means the designee assigned to manage day to day
responsibilities associated with this Contract.
"Primary Prevention" means the approach that strategically incorporates programs,
policies, and interventions that occur prior to the onset of a substance use disorder that are
intended to prevent or reduce risk for developing substance use disorder(s). Includes
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universal, selected, and indicated populations. These strategies are directed at individuals
not identified to be in need of treatment. Example: Substance use prevention education for
young people.
"Program Income" means gross income earned by the Contractor that is directly generated
by a supported activity or earned as a result of the federal award during the period of
performance.
"Promising Program" means a program that shows favorable outcomes based on
statistical analyses or a well-established theory of change, can be implemented with a set of
procedures to ensure implementation within Washington state's prevention service delivery
system, and shows potential for meeting the "evidence -based" or "research -based" criteria.
A promising program could include a program that is evidence -based or research -based for
outcomes that are related to, but not directly connected to, a particular funding source
priority.
"Proprietary Information" refers to any information which has commercial value and is either:
(1) technical information, including patent, copyright, trade secret, and other proprietary
information, techniques, sketches, drawings, models, inventions, know-how, processes,
apparatus, equipment, algorithms, software programs, software source documents, and
formulae related to the current, future, and proposed products and services; or (2) non-
technical information relating to products, including without limitation pricing, margins,
merchandising plans and strategies, finances, financial and accounting data and information,
suppliers, customers, customer lists, purchasing data, sales and marketing plans, future
business plans, and any other information which is proprietary and confidential. Contractor's
Proprietary Information is information owned by Contractor to which Contractor claims a
protectable interest under law.
"Protected Health Information" or "PHI" means information that relates to the provision of
health care to an individual; the past, present, or future physical or mental health or condition of
an individual; or past, present or future payment for provision of health care to an individual. 45
C.F.R. § 103. 45 C.F.R. §§ 160 and 164. PHI includes demographic information that identifies
the individual or about which there is reasonable basis to believe, can be used to identify the
individual. 45 C.F.R. § 160.103. PHI is information transmitted, maintained, or stored in any
form or medium. 45 C.F.R. § 164.501. PHI does not include education records covered by the
Family Educational Right and Privacy Act, as amended, 20 USC 1232g(a)(4)(b)(iv).
"RCW" means the Revised Code of Washington. All references in this Contract to RCW
chapters or sections include any successor, amended, or replacement statute. Pertinent RCW
chapters can be accessed at: htt ://a s.le .wa. ov/row/.
"Regular Annual Schedule" means consistent, reliable services with a pattern of
implementation intervals throughout the year.
"Regulation" means any federal, state, or local regulation, rule, or ordinance.
"Research -Based Program" (or RBP) means a program that has been tested and can be
implemented with a set of procedures to ensure successful replication within Washington
state's prevention service delivery system. An RBP has showed favorable effects and no
harmful effects with a single randomized and/or statistically controlled evaluation,
demonstrates sustained desirable outcomes, or where a the weight of the evidence from a
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systematic review supports sustained favorable outcomes, similar to the criteria as identified in
the term "evidence -based," but does not meet the full criteria for "evidence -based."
"SAMHSA" means the federal Substance Abuse and Mental Health Services Administration.
"Sensitive information" means information that is not specifically protected by law, but
should be limited to official use only, and protected against unauthorized access.
"State Opioid Response" or "SOR," "SOR II," or "SOR III" and any further iterations
means the federal Substance Abuse and Mental Health Services Administration (SAMHSA)
Grant, CFDA number 93.788; Federal Discretionary Funds.
"Statement of Work" or "SOW" means a detailed description of the work activities the
Contractor is required to perform under this Contract, including the deliverables and timeline,
and is included in the Contract and task orders.
"Student Assistance Prevention Intervention Services Program" or "SAPISP"
means the school-based prevention and intervention services as part of CPWI as
agreed upon between HCA and Contractor.
"Student Assistance Prevention Intervention Services Program (SAPISP) Data
Reporting System" or "wasapisp.com" means the online reporting system used to enter
service data for the SAPISP services, or successor. b,tt.p.s,:,//www.wa,sa.pi,sp.com
"Subaward" means an award provided by a pass-through entity to a subrecipient for the
subrecipient to carry out part of a federal award received by the pass-through entity. It does
not include payments to a contractor or payments to an individual that is a beneficiary of a
federal program. A subaward may be provided through any form of legal agreement,
including an agreements that the pass-through entity considers a contract.
"Subcontract" means any separate agreement or contract between the Contractor and an
individual or entity ("Subcontractor") to perform any duties that give rise to a business
requirement to access the Data that is the subject of this Contract.
"Subcontractor" means a person or entity that is not in the employment of the Contractor,
who is performing all or part of the business activities under this Contract under a separate
contract with Contractor. The term "Subcontractor" means subcontractor(s) of any tier.
"Substance Abuse Block Grant" or "SABG" or "Substance Use Prevention Treatment and
Recovery Services" or "SUPTRS" means federal Substance Abuse Block Grant and/or
Substance Use Prevention Treatment and Recovery Services funded by the Substance Abuse
and Mental Health Services Administration (SAMHSA), CFDA number 93.959; Federal Funds.
"Substance Use Disorder" or "SUD" means the patterns of symptoms caused by using a
substance that an individual continues taking despite its negative effects, as defined further by
the diagnostic criteria within the DSM -5.
"Substance Use Disorder Prevention" means the "Interventions that occur prior to the onset
of a disorder that are intended to prevent or reduce risk for the disorder."
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"Substance Use Disorder Prevention and Mental Health Promotion Online Reporting
System" or "Minerva" or its successor means the management information system
maintained by HCA that collects planning, demographic, and prevention service data.
"Substance Use Disorder Prevention and Mental Health Promotion Services Billing
Guide" means the Supplementary Instructions and Fiscal Policy Standards for
Reimbursable Costs as used by HCA, located at https://theathenaforum.org/billing
"Subrecipient" means a non-federal entity that expends federal awards received from a pass-
through entity to carry out a federal program, but does not include an individual that is a
beneficiary of such a program. A Subrecipient may also be a recipient of other federal awards
directly from a federal awarding agency. As in 45 C.F.R. 75.2, or any successor or replacement
to such definition, for any federal award from HHS; or 2 C.F.R. 200.93, or any successor or
replacement to such definition, for any other federal award. See OMB circular a-133 for
additional details.
"Successor" means any entity which, through amalgamation, consolidation, or other legal
succession, becomes invested with rights and assumes the burdens of the original contractor.
"Task Order" or "TO" means an agreement between HCA and Contractor containing a
detailed statement of work, and' any special terms and conditions for the provision of the
services under this Contract, entered into pursuant to this.
"USG" means the United States Code. All references in this Contract to USC chapters or
sections will include *any successor, amended, or replacement statute. The USC may be
accessed at htt ://uscode.house. ov/.
"Vendor" means a dealer, distributor, merchant, or other seller providing goods or services
that. are required for the conduct of a federal program,. These goods or services may be for
an organization's own use or for the use of beneficiaries of the federal program.
"WAC" means the Washington Administrative Code. All references to WAC chapters or
sections will include any successor, amended, or replacement regulation. Pertinent WACs may
be accessed at:
3. SPECIAL TERMS AND CONDITIONS
3.1 PERFORMANCE EXPECTATIONS
The Contractor's expected performance under this Contract includes, but is not limited to,
the following:
Knowledge of applicable state and federal laws and regulations pertaining to subject of
this Contract;
3.1.1 Use of professional judgment;
3.1.2 Collaboration with HCA staff in Contractor's conduct of the services;
3.1.3 Conformance with HCA directions regarding the delivery of the services;
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3.1.4 Timely, accurate, and informed communications;
3.1.5 Regular completion and updating of project plans, reports, documentation, and
communications;
3.1.6 Attendance at all required and necessary meetings;
3.1.7 Provision of high-quality services; and
3.1.8 Ensure services and activities provided by the Contractor or subcontractors are
designed and delivered in a culturally competent manner that addresses health
disparities with the goal of achieving health equity. Prior to payment of invoices,
HCA will review and evaluate the performance of Contractor in accordance with
Contract and these performance expectations and may withhold payment if
expectations are not met or Contractor's performance is unsatisfactory.
3.2 TERM
3.2.1 The initial term of the Contract will commence on July 1, 2023, and continue
through June 30, 2025, unless terminated sooner as provided herein.
3.2.2 This Contract may be extended by mutually agreed amendment in whatever time
increments HCA deems appropriate. No change in terms and conditions will be
permitted during these extensions unless specifically agreed to in writing.
3.2.3 _ Work performed without a contract or amendment signed by the authorized
representatives of both parties will be at the sole risk of the Contractor. HCA will
not pay any costs incurred before a contract or any subsequent amendment(s) is
fully executed.
3.3 COMPENSATION AND BILLING
3.3.1 Compensation and Source of Funds
A. Total consideration payable to Contractor for satisfactory performance of the
work under this Contract is up to a maximum of $1,710,000.00, including any
and all expenses, in accordance with the Awards and Revenues document.
B. Funding for any additional periods past the initial term are contingent on
satisfactory completion of all Contract requirements and continued state
and/or federal funding. Contractor may be required to submit an updated
Action Plan/Service and Program Staffing and Budget to HCA in order to
receive funding for additional terms.
C. Funding that supports this Contract comes from state and/or federal grant
funds, HCA, and the Catalog of Federal Domestic Assistance (CFDA) as
listed within the FSI table. Any state or federal funds obligated under this
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Contract which are not expended according to the timeline on the Awards
and Revenues may not be used or carried forward to any other Contract or
time period.
D. Subrecipients shall only use federal award funds under this Contract to
supplement existing funds and will not use them to replace (supplant) non-
federal funds that have been budgeted for the same purpose. The
Subrecipient may be required to demonstrate and document that a reduction
in non-federal resources occurred for reasons other than the receipt or
expected receipt of federal funds.
3.3.2 Awards and Revenues (A&Rs) and Federal Subaward Identification (FSI)
Document Incorporated by Reference
A. HCA has identified a maximum level of consideration for this Contract, which
may include one or more funding sources. The Parties agree that the
administrative burden of amending the Contract when funding sources and/or
amounts change (other than the maximum level of consideration) is
substantial. The Parties further agree that all Awards and Revenues (A&Rs)
and Federal Subaward Identification (FSI) documents that are issued after
the execution of the Contract are hereby fully incorporated by reference into
this Contract.
B. The A&R/FSI document will identify the most current: task order contact,
sources of funds available; amount available for expenditure by Task Order;
and federal subaward identification of funding by source with the FFATA 2
CFR Chapter 1, Part 170 Reporting Sub -Award and Executive Compensation
Information.
C. The A&R/FSI Documents will identify funding assigned to each Task Order
up to the total maximum consideration. The process for exchange and
incorporation of these forms must adhere to the process below:
i) HCA will provide to Contractor an updated A&R/FSI Document at least
one (1) time per state fiscal year, but may provide updated forms more
than one (1) time per state fiscal year.
ii) HCA will send forms via email to the Task Order Contract Manager
identified on each A&R/FSI document.
iii) Contractor must acknowledge receipt of updated forms via email within
ten (10) business days.
iv) If acknowledgment of receipt of updated forms is not received within ten
(10) business days, the HCA Contract Manager will follow up with
Contractor until acknowledgement of receipt is received. Contractor's
failure to respond with acknowledgement within thirty (30) calendar
days may result in loss of funds, unapproved invoices, or delays in
payment.
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D. Contractor's failure to adhere to the process described above will result in
non -incorporation of the A&R/FSI Document in question. In such event, the
most recent A&R/FSI Document will remain as the active amount and source
of funds supporting the maximum consideration.
3.3.3 HCA reserves the right to reduce the funds awarded in the Contract if the
Contractor expenditures are below 60% of expected levels during each fiscal
quarter. HCA will review the expenditures quarterly.
3.3.4 Reimbursements
A. HCA shall reimburse the Contractor only for actual incurred and allowable
costs for the services identified in this Contract and in accordance with the
Substance Use Disorder Prevention and Mental Health Promotion Services
Billing Guide.
B. Contractor shall not bill and HCA shall not pay for services performed under
this Contract, if Contractor has charged or will charge another agency of the
state of Washington or any other party for the same services.
C. Reimbursement requests will not be approved for payment until Contractor is
current with all reporting requirements contained in this Contract.
D. HCA shall not make any payments in advance or anticipation of the delivery
of services to be provided pursuant to this Contract.
E. Federal Discretionary Grant and State funds may not be carried forward from
year to year, based upon their respective fiscal year noted on the Awards and
Revenues.
F. Reimbursement will only be made in accordance with Awards and Revenue
in effect at the time the services were rendered.
3.3.5 Food Costs.
A. Food costs are generally unallowable during program implementation except
within the following parameters:
i) Light refreshment costs for training events and meetings lasting lasting
two (2) hours or more in duration are allowable. Contractor will ensure
that light refreshment costs do not exceed $3.00 per person, and
Contractor will be responsible for all costs over that amount.
i) Meals are not allowable costs with discretionary grant funds.
ii) Meals may be provided for participant with state and block grant funds
only if:
a) The training is four (4) hours or more in duration; or
b) The program is a recurring, direct service in the family domain,
lasting two (2) hours or more in duration and must be approved
in the action plan and budget.
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iii) Contractor shall adhere to current state per -diem rates for meals
accessible at www.ofm.wa,.,gov/p,o,licy/10.90.htm.
iv) No more than a total of $1,500 may be spent on food or light
refreshments per CPWI Site and/or CBO contract per year.
3.3.6 State and federal Funding Requirements
The Contractor shall comply with the following:
A. Comply with all applicable provisions of the Notice of Awards for the
discretionary and block grants, and any other federal grants noted on the
Awards and Revenues;
B. Comply with RCW 69.50.540 Dedicated Cannabis Account Appropriations;
C. Maintain records that identify, in its accounts, all federal awards received and
expended and the federal programs under which they were received, by
CFDA title and number, award number and year, name of the federal agency,
and name of the pass-through entity;
D. Maintain internal controls that provide reasonable assurance that the
Subrecipient is managing federal awards in compliance with laws,
regulations, and provisions of contracts or grant agreements that could have
a material effect on each of its federal programs;
E. Contractor shall ensure that Charitable Choice Requirements of 42 CFR Part
54 are followed and that Faith -Based Organizations (FBO) are provided
opportunities to compete with traditional alcohol/drug use disorder prevention
providers for funding;
F. If Contractor subcontracts with FBOs, Contractor shall require the FBO to
meet the requirements of 42 CFR Part 54 as follows:
i)
Applicants/recipients for/of services shall be provided with a choice of
prevention providers.
ii)
The FBO shall facilitate a referral to an alternative provider within a
reasonable time frame when requested by the recipient of services.
iii)
The FBO shall report to the Contractor all referrals made to alternative
providers.
iv)
The FBO shall provide recipients with a notice of their rights.
v)
The FBO provides recipients with a summary of services that includes
any inherently religious activities. Prepare appropriate financial
statements, including a schedule of expenditures of federal awards.
vi)
Funds received from the federal block grant must be segregated in a
manner consistent with federal regulations.
G. No funds may be expended for religious activities.
3.3.7 Single Source Funding.
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A. Contractor shall comply with the Single Source Funding requirements of
stating that a Contractor can use only one (1) source of funds at any given
time. Contractors are responsible to ensure all subcontractors also comply
with single source funding requirements.
B. Each cost reimbursement Prevention service provided must be billed only
one (1) time through the source selected for funding this expense. At no time
may the same expense be billed through more than one (1) funding source
3.4 INVOICE AND PAYMENT
3.4.1 In order to receive payment for services or products provided to a state agency,
Contractor must register with the Statewide Payee Desk at htt s://ofm.wa. ov/it-
s stems/statewide-vendor a ee-services/receivin g - Pav ment-state.
3.4.2 Invoices must describe and document to the HCA Contract Manager's
satisfaction a description of the work performed, the progress of the project, and
fees. If expenses are invoiced, invoices must provide a detailed breakdown of
each type. All fund sources are to be billed for separately as outlined on the A-19
Invoice Voucher. All invoices and deliverables will be approved by the HCA
Contract Manager, or designee, prior to payment. Approval will not be
unreasonably withheld or delayed.
3.4.3 Invoices must be submitted to A-19DBHR@hca.wa.gov with the HCA Contract
number in the subject line of the email. The Contractor shall ensure all
expenditures for services and activities under the Contract are submitted on the
A-19 invoice and have the associated appropriate prevention activity data entry.
A. The Contractor shall submit invoices using State Form A-19 Invoice Voucher,
or such other form as designated by HCA. Consideration for services
rendered shall be payable upon receipt of properly completed invoices.
B. Contractor must include the contract number in the subject line of the email,
followed by the Prevention System Naming Convention and cc the Contract
Manager or designee when submitting the invoice. Contractor may bill for
cost reimbursement for month of service if appropriate prevention activity
data is completed.
C. Invoices shall not be submitted by the Contractor more often than monthly
unless otherwise specified.
3.4.4 HCA will return incorrect or incomplete invoices for correction and reissue.
3.4.5 HCA will deny incorrect or incomplete invoices to the Contractor for correction
and reissue. The Contract Number must appear on all invoices, bills of lading,
packages, and correspondence relating to this Contract.
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3.4.6 The Contractor must submit invoices for costs due and payable under this
contract within forty-five (45) calendar days of the date services were provided or
within forty-five (45) calendar days after the Contract expiration date or funding
source(s) end date, whichever comes first.
3.4.7 HCA is under no obligation to pay any claims that are submitted forty-six (46) or
more calendar days after the funding source(s) end date ("Belated Claims"). HCA
will pay Belated Claims at its sole discretion, and any such potential payment is
contingent upon the availability of funds.
3.4.8 Any supplemental billings must be received within thirty (30) calendar days of the
billing due date to be considered for payment. No supplemental billings will be
accepted after forty-five calendar (45) days of a funding source end date.
3.4.9 Payment shall be considered timely if made by HCA within thirty (30) business
days after receipt and acceptance by HCA of the properly completed invoices.
HCA may, at its sole discretion, withhold payment claimed by the Contractor for
services rendered if Contractor fails to satisfactorily comply with any term or
condition of this Contract.
3.4.10 Upon expiration, suspension, or termination of the Contract, invoices for work
performed or allowable expenses incurred after the start of the Contract and prior
to the date of expiration, suspension, or termination must be submitted by the
Contractor within forty-five (45) calendar days. HCA is under no obligation to pay
invoices submitted forty-six (46) or more calendar days after the Contract
expiration, suspension, or termination date ("Belated Claims"). HCA will pay
Belated Claims at its sole discretion.
3.4.11 Administrative/indirect costs shall be billed separately from direct prevention
services as indicated on the A-19 invoice.
A. Administrative/indirect costs are defined in Section 1. Definitions.
B. The Contractor shall use no more than ten percent (10%) of each fund source
allocation for administrative/indirect costs.
C. Contractor may bill up to 10% of total costs to admin/indirect by fund source
as specified on the A&R however the following also applies:
i) Admin/indirect costs must be billed in proportion to direct expenses.
Admin/indirect should be charged using the following formula: Direct costs
/ (1 -allowed admin/indirect rate) =Total costs; Total costs -Direct costs =
Admin/indirect costs.
ii) AdMinistrative/indirect costs are to be reconciled at the end of each fund
source time period to ensure adherence.
iii) Contractor may use less than 10% of the Admin/Indirect allocations
provided. If the Contractor chooses to use less than 10% for
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Admin/Indirect costs, Contractor shall use any funds remaining of the 10%
for direct program implementation costs. Contractor shall indicate adjusted
percentage budgeted for Admin/Indirect and direct program costs on
Action Plan budget/Service and Program Staffing Plan and Budget for
HCA review and approval.
3.5 CONTRACTOR AND HCA CONTRACT MANAGERS
3.5.1 The Contract Manager for each of the parties, named on the Cover Page of this
Contract, is responsible for, and will be the contact person for, nonformal
communications regarding the performance of this Contract.
A. Management of individual Task Orders is the responsibility of the Contract
Managers identified within the A&R/FSI document.
B. Should an issue arise, which cannot be resolved by the Contract Managers
identified in the A&R/FSI document, the Contract Managers named on the
Cover Page of this Contract may be contacted to assist.
3.5.2 HCA's Contract Manager is responsible for monitoring the Contractor's
performance and will be the contact person for all communications regarding
contract performance and deliverables. The HCA Contract Manager has the
authority to accept or reject the services provided and must approve Contractor's
invoices prior to payment.
3.5.3 Either party must notify the other party within thirty (30) calendar days of the
change of Contract Managers. Changes may be provided by email to the other
party's Contract Manager.
3.6 LEGAL NOTICES
Any notice or demand or other communication required or permitted to be given under this
Contract or applicable law is effective only if it is in writing and signed by the applicable
party, properly addressed, and delivered in person, via email, or by a recognized courier
service, or deposited with the United States Postal Service as first-class mail, postage
prepaid certified mail, return receipt requested, to the parties at the addresses provided in
this section.
3.6.1 In the case of notice to the Contractor:
Grant County Board of County Commissioners
840 E Plum St
Moses Lake, WA 98837
N/A
3.6.2 In the case of notice to HCA:
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Attention: Contracts Administrator
Health Care Authority
Division of Legal Services
Post Office Box 42702
Olympia, WA 98504-2702
contracts@hca.wa.gov
3.6.3 Notices are effective upon receipt or four (4) Business Days after mailing,
whichever is earlier.
3.6.4 The notice address and information provided above may be changed by written
notice of the change given as provided above.
3.7 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE
Each of the documents listed below is by this reference incorporated into this Contract. In
the event of an inconsistency, the inconsistency will be resolved in the following order of
precedence:
3.7.1 Applicable federal statutes and regulations
3.7.2 The federal statute authorizing the grant program and any other federal statutes
directly affecting performance of the award, including the federal Funding
Accountability and Transparency Act (FFATA), as applicable)
3.7.3 Federal policy and program requirements
3.7.4 Applicable State of Washington statutes and regulations
3.7.5 State policy and program requirements
3.7.6 Attachment 4, Data Sharing Terms (including the Washington OCIO Security
Standard 141.10)
3.7.7 Recitals;
3.7.8 Special Terms and Conditions;
3.7.9 General Terms and Conditions;
3.7.10 Attachment 5: Federal Compliance, Certifications and Assurances,-
3.7.11
ssurances,
3.7.11 Attachments 1, 2, and 3: Task Orders;
3.7.12 Awards and Revenues and Federal Reporting Subrecipient Tables incorporated
by reference;
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3.7.13 Any other provision, term or material incorporated herein by reference or
otherwise incorporated.
3.8 INSURANCE
Contractor must provide insurance coverage as set out in this section. The intent of the
required insurance is to protect the State should there be any claims, suits, actions, costs,
damages or expenses arising from any negligent or intentional act or omission of
Contractor or Subcontractor, or agents of either, while performing under the terms of this
Contract. Contractor must provide insurance coverage that is maintained in full force and
effect during the term of this Contract, as follows:
3.8.1 Commercial General Liability Insurance Policy - Provide a Commercial General
Liability Insurance Policy, including contractual liability, in adequate quantity to
protect against legal liability arising out of contract activity but no less than
$1 million per occurrence/$2 million general aggregate. Additionally, Contractor is
responsible for ensuring that any Subcontractors provide adequate insurance
coverage for the activities arising out of Subcontracts.
3.8.2 Business Automobile Liability. In the event that services delivered pursuant to
this Contract involve the use of vehicles, either owned, hired, or non -owned by
the Contractor, automobile liability insurance is required covering the risks of
bodily injury (including death) and property damage, including coverage for
contractual liability. The minimum limit for automobile liability is $1,000,000 per
occurrence, using a Combined Single Limit for bodily injury and property
damage.
3.8.3 Professional Liability Errors and Omissions — Provide a policy witf-6coverage of
not less than $1 million per claim/$2 million general aggregate.
3.8.4 Industrial Insurance Coverage
Prior to performing work under this Contract, Contractor must provide or
purchase industrial insurance coverage for the Contractor's employees, as may
be required of an "employer" as defined in Title 51 RCW and must maintain full
compliance with Title 51 RCW during the course of this Contract.
3.8.5 The insurance required must be issued by an insurance companyhes authorized
to do business within the state of Washington, and must name HCA and the state
of Washington, its agents and employees as additional insureds under any
Commercial General and/or Business Automobile Liability policy/ies. All policies
must be primary to any other valid and collectable insurance. In the event of
cancellation, non -renewal, revocation or other termination of any insurance
coverage required by this Contract, Contractor must provide written notice of
such to HCA within one (1) Business Day of Contractor's receipt of such notice.
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Failure to buy and maintain the required insurance may, at HCA's sole option,
result in this Contract's termination.
3.8.6 Upon request, Contractor must submit to HCA a certificate of insurance that
outlines the coverage and limits defined in the Insurance section. If a certificate
of insurance is requested, Contractor must submit renewal certificates as
appropriate during the term of the contract.
3.8.7 If Contractor is self-insured, the Receiving Party certifies that it is self-insured, is
a member of a risk pool, or maintains the types and amounts of insurance
identified above and will provide certificates of insurance to that effect to HCA
upon request.
3.9 PROMOTION AND PREVENTION SERVICES REQUIREMENTS
3.9.1 Media Materials
A. HCA must be cited as the funding source in news releases, publications, and
advertising messages created with HCA funding. The funding source shall be
cited as: Washington State Health Care Authority. The HCA logo may also be
used in place of the above citation.
B. Media materials and publications developed with HCA funds, including
messaging specifically directed to youth, shall be submitted to the Contract
Manager or designee for approval prior to publication. HCA will respond
within five (5) business days.
C. Exceptions: Contractor does not need to submit the following items to
Contract Manager or designee:
i) Newsletters and fact sheets.
ii) News coverage resulting from interviews with reporters. This includes
online news coverage.
iii) Newspaper editorials or letters to the editor.
iv) Posts on Facebook, YouTube, Tumblr, Twitter, Instagram, Snapchat and
other social media sites.
v) When a statewide media message is developed by HCA, is localized, and
if the only change is the local CBO/coalition information and funding
source acknowledgment from CBO, coalition or public health entities.
vi) When a national prevention media campaign is developed by SAMHSA, is
localized, and if the only change is the local CBO/coalition information and
funding source acknowledgement from CBO, coalition or public health
entities.
3.9.2 Secure Prescription Take -Back and Lock Box project.
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Contractors who implement a Secure Prescription Take -Back and/or Lock Box
project must ensure the following additional requirements:
A. The Secure Prescription Take -Back and/or Lock Box project must align with
the community needs assessment and will increase local capacity to address
prescription drug misuse and abuse by reducing social availability of
prescriptions in the community.
B. Contractor shall provide the services and staff, and otherwise do all things
necessary for or incidental to the Secure Prescription Take -Back and/or Lock
Box project as set forth below:
i) Enhance community capacity to practice safe disposal of medications by
promoting permanent secure drop box in the location where community
readiness has been established. (Installation and disposal must follow all
DEA rules and all federal and state laws and regulations.)
ii) Collaborate with community partners to maintain and/or enhance policies
and procedures necessary to maintain a permanent secure medicine take -
back drop box.
iii) Overtime wages for law enforcement officers and staff as outlined in
strategic plan and outside of normal duties and other real costs (including
mileage reimbursement) associated with transporting and properly
disposing of collected medicines at Environmental Protection Agency
(EPA) approved locations may be permitted depending upon source of
funds and must be approved by the Contract Manager in advance.
iv) Create, utilize and disseminate public education information materials to
increase awareness of the secure medicine take -back project, local
treatment resources, naloxone information and medical response (Good
Samaritan law) cards.
v) Disseminate public information including information on local treatment
resources, naloxone information and medical response cards and posters.
(Print ready materials are available online at www.sto overdose.or ).
vi) Utilize publications already available through HCA/DBHR and other
websites. (i.e., SAMHSA Opioid Overdose Toolkit, and
downloadable/printable materials on www.sto overdose.or and
www.takeback ourmeds.or .
vii) Submit locally -developed educational and informational materials to
HCA/DBHR for approval at least ten (10) business days prior to
publication.
viii) Prior to purchasing home medication lock boxes or bags Contractor will
submit to HCA/DBHR in writing a plan for the purchase and distribution of
home medication storage device including the cost and source of the
home storage devices, the number of devices to be purchased, a clear
plan for distribution, and method for tracking the use of the devices.
Contractor must also demonstrate how the distributed home medication
devices will be altered (by engraving, indelible ink, or other means) to have
no cash value.
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ix) Contractor is required to maintain records of pre and post surveys for lock
box distribution and record in Minerva upon request from HCA/DBHR.
3.10 BACKGROUND CHECKS
3.10.1 The Contactor must have criminal background check policies and procedures to
include but not limited to ensuring background checks are completed per 3.10.2,
how results of background checks are reviewed and considered, and procedures
for ensuring forms are stored in secure area.
3.10.2 The Contactor shall ensure a criminal background check is conducted for all staff
members, case managers, outreach staff members, or volunteers who have
unsupervised access to children, adolescents, vulnerable adults, and persons
who have developmental disabilities.
3.10.3 At the request of, HCA, Contractor must provide policies and procedures and
verification of completed background checks.
3.11 SERVICES AND ACTIVITIES TO DIVERSE POPULATIONS
3.11.1 Contractor shall ensure all services and activities provided by Contractor or
subcontractor under this Contract shall be designed and*delivered in a manner
sensitive to the needs of all diverse populations.
3.11.2 Contractor shall initiate actions to ensure or improve access, retention, and
cultural relevance of prevention or other appropriate services, diverse
populations in need of prevention services as identified in their needs
assessment.
3.11.3 Contractor shall take the initiative to strengthen working relationships with other
agencies serving these populations. Contractor shall require its subcontractors to
adhere to these requirements.
3.12 CONTINUING EDUCATION
3.12.1 Contractor shall ensure that continuing education is provided for employees of
any entity providing prevention activities in accordance with 42 U.S.C. § 300x -
28(b) and 45 C.F.R. § 96.132(b).
3.13 SINGLE SOURCE FUNDING
3.13.1 Contractor must adhere to Single Source Funding, which means Contractor can
use only one (1) source of funds at any given time for the same expense.
Contractor also must ensure that subcontractors adhere to Single Source
Funding.
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3.13.2 Each cost reimbursement service provided must be billed only one (1) time
through the source selected for funding this expense. At no time may the same
expense be billed through more than one (1) funding source
3.14 CONTRACTOR MONITORING
HCA will monitor the performance of the Contractor against goals and performance
standards as stated in Task Orders 1, 2, and 3 attached to this Contract. Substandard
performance as determined by HCA will constitute non-compliance with this Contract. If
action to correct such substandard performance is not taken by the Contractor within a
reasonable period of time after being notified by HCA, suspension or termination
procedures will be initiated.
3.14.1 Monitoring Activities
The Contractor is required to meet or exceed the monitoring activities, as
outlined below. Compliance will be monitored throughout the performance period
to assess risk. Concern will be addressed through a Corrective Action Plan
(CAP). Monitoring activities may include, but are not limited to:
A. Review of financial and performance reports;
B. Monitoring and documenting the completion of Contract deliverables;
C. Documentation of phone calls, meetings (e.g. agendas, sign -in sheets,
meeting minutes), e-mails and correspondence;
D. Review of reimbursement requests and supporting documentation to ensure
allowability and consistency with Contract work plan, budget and federal
requirements;
E. Observation and documentation of Contract -related activities, such as
trainings and events;
F. On-site visits or desk audits to review records and inventories, to verify
source documentation for reimbursement requests and performance reports,
and to verify completion of deliverables.
3.14.2 Remedial Action
HCA may initiate remedial action if HCA determines any of the following
situations exists:
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A. A problem exists that negatively impacts individuals receiving services under
this Contract;
B. The Contractor has failed to perform any of the requirements or services
required under this Contract;
C. The Contractor has failed to develop, produce, and/or deliver to HCA any of
the statements, reports, data, data corrections, accountings, claims, and/or
documentation required under this Contracts;
D. The Contractor has failed to perform any administrative functions required
under this Contract, where administrative function is defined as any obligation
other than the actual provision of behavioral health services;
E. The Contractor has failed to implement corrective action required by HCA
within prescribed timeframes.
3.14.3 Corrective Action Plans
HCA may require the Contractor to develop a Corrective Action Plan (CAP),
which must be submitted for approval to HCA within fifteen (15) calendar days of
notification unless otherwise specified. CAPs may require modification to any
policies or procedures by the Contractor relating to fulfillment of its obligations
pursuant to this Contract. HCA, at its sole discretion, may extend or reduce the
time allowed for corrective action depending upon the nature of the situation.
A. CAPs must at a minimum include:
i) A brief description of the finding(s), including all relevant information
specific to the issue(s);
ii) Specific actions taken and to be taken by the Contractor, including a
timetable and a description of the monitoring to be performed.
B. CAPs are subject to approval by HCA. HCA may:
i) Accept the plan as submitted;
ii) Accept the plan with specified modifications;
iii) Request a modified plan;
iv) Reject the plan.
3.14.4 Extension to Deliverables
-A. The Contractor must request written written approval from the HCA Contract
Manager to waive or extend a due date identified in Task Order 1, 2, or 3
attached to this Contract, once approved, submit those deliverables and the
associated costs on the next scheduled reimbursement due date.
B. Waiving or missing deadlines serves as an indicator for assessing an
agency's level of risk of noncompliance with the regulations, requirements,
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and the terms and conditions of the Contract and may increase required
monitoring activities.
C. Any request for a waiver or extension of a due date identified in any Task
Order will be treated as a request for an Amendment of the Contract. This
request must be submitted to the HCA Contract Manager sufficiently in
advance of the due date to provide adequate time for HCA to review and
consideration and may be granted or denied within RCA's sole discretion.
3.15 SUBCONTRACTING
The Contractor is responsible to ensure that terms and conditions of this contract are met
when subcontracting for services. At RCA's request, Contractor shall provide
documentation of any or all subcontractor related documentation including but not limited
to subcontracts and subcontractor monitoring.
3.15.1 Subcontract Review and Approval
A. The Contractor shall obtain prior approval from HCA before entering into any
subcontracting arrangement.
B. In addition, the Contractor shall submit to HCA's Contract Manager at least
one of the following for review within thirty (30) business days of the intended
start date of the subcontract:
i) Copy of the proposed subcontract;
ii) Copy of the Contractor's standard contract template; or
iii) Certify in writing that the subcontractor meets all requirements under the
Contract and that the subcontract contains all required language under the
Contract, including any data security, confidentiality and/or Business
Associate language, as appropriate.
3.15.2 Subcontract Language
It is the Contractor's sole responsibility to ensure that its subcontractors
performing services under this Contract are meeting the requirements below and
as otherwise outlined in this Contract when providing services to patients, clients,
or persons seeking assistance, which include but are not limited to:
A. Subcontractor's identifying information, including UEI number and Zip code
+4 of subcontractor.
B. Applicable definitions. `
C. Identification of purpose and term of subcontract
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D. Federal and state laws as applicable:
i) This includes, but is not limited to, 45 C.F.R. Part 75, Uniform
Administrative Requirements, Cost Principles, and Audit Requirements, if
applicable to the subcontractor.
E. Subrecipient requirements as applicable.
F. Identification of funding sources and associated funding requirements.
G. Determination of eligible clients.
H. Compensation and billing arrangement in compliance with this Contract and
the Substance Use Disorder Prevention and Mental Health Promotion
Services Billing Guide (see definitions for more information).
I. Termination and contract closeout language as applicable to include:
i) That termination of a subcontract shall not be grounds for a fair hearing for
the service applicant or a grievance for the recipient if similar services are
immediately available in the county; and
ii) What actions the Subrecipient wi11 take in the event of a termination of a
subcontractor to ensure all prevention data on services provided have
been entered into Minerva and/or SAPISP data reporting system
J. How service recipients will be informed of their right to a grievance in the
case of:
i) Denial or termination of service; or
ii) Failure to act upon a request for services with reasonable promptness.
K. Statement of work and/or identification of deliverables and plan for
monitoring.
L. Identification of data entry into Minerva and/or SAPISP data reporting system,
as applicable.
M. Authorization for Contractor to conduct an inspection of any and all
subcontractor facilities where services are performed, including for contract
monitoring activities:
i) Requirement that subcontractors will perform background checks on its
employees and independent contractors used to perform the services.
N. FBO requirements, if applicable.
O. Insurance requirements.
P. Debarment and suspension certification.
Q. Protection of confidential Information and restrictions on the providing and
sharing of data.
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R. Federal compliance, certifications, and assurances as applicable.
S. SAM HSA award terms as applicable; and
T. Identifying unallowable uses of federal funds if applicable.
3.15.3 On -Site Monitoring
The Contractor shall:
A. Conduct a subcontractor review which shall include at least one (1) on-site
visit, annually, to each subcontractor site providing services to monitor fiscal
and programmatic compliance with subcontract performance criteria for the
purpose of documenting that the subcontractors are fulfilling the requirements
of the subcontract unless otherwise specified.
B. Submit written documentation of each on-site visit within thirty (30) calendar
days upon completion to HCA's Contract Manager or designee. A copy of the
full report shall be kept on file by the Contractor.
3.15.4 Service Data Monitoring
Contractor shall ensure that Subcontractors have entered services funded under
this Contract in Minerva and/or SAPISP data reporting system.
A. Ensure accurate and unduplicated reporting. Contractor may not require
Subcontractor to enter duplicate prevention service data that is entered into
SAPISP data reporting system.
B. Ensure proper training of staff and designated back-up staff for Minerva and/or
SAPISP reporting systems data entry to meet report due dates.
3.15.5 Additional Monitoring Activities
The Contractor shall maintain records of additional monitoring activities in the
Contractor's subcontractor file and make them available to HCA upon request
including any audit and any independent documentation.
3.16 CONTRACT CLOSEOUT
3.16.1 Upon termination or lapse of this Contract in whole or in part for any reason,
including completion of the project, the following provisions may apply:
A. Upon written request by Contractor, HCA may make or arrange for payments
to Contractor of allowable reimbursable costs not covered by previous
payments.
B. Disposition of program assets (including the return and/or transfer of all
unused materials, equipment, unspent cash advances, and program income
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balances) to include creating an inventory list of all property purchased or
furnished by HCA for use by Contractor during performance of this Contract.
C. Contractor shall submit within thirty (30) calendar days after the date of
expiration of this Contract, all financial, performance and other reports
required by this Contract, and in addition, will cooperate in a program audit by
HCA or its designee as requested; and
D. Closeout of funds will hot occur unless all requirements of the Contract's
associated state .and federal funds are met and all outstanding issues with
Contractor have been resolved to the satisfaction of HCA.
3.16.2 Contractor's obligation to HCA shall not end until all closeout requirements are
completed. Notwithstanding the foregoing, the terms of this Contract shall remain
in effect during any period that Contractor has control of the Contract's
associated state and federal funds, including program income.
3.17 FEES/LICENSES
Contractor shall pay for and maintain in a current status any license fees, assessments,
permit changes, or similar charges which are necessary for Contract performance. It is the
Contractor's sole responsibility to monitor and determine any changes -of the enactment of
any subsequent regulations for said fees, assessments or charges and to immediately
comply with said changes or regulations during the entire term of this Contract.
3.18 ANTITRUST ASSIGNMENT
The Contractor hereby assigns to the State of Washington any and all of its claims for
price fixing or overcharges which arise under the antitrust laws of the United States, or the
antitrust laws of the State of Washington, relating to the goods, products or services
obtained under this Contract.
3.19 FRAUD AND ABUSE REQUIREMENTS
3.19.1 The Contractor shall report in writing all verified cases of fraud and abuse,
including fraud and abuse by the Contractor's employees and/or subcontractors,
within five (5) business days, to the HCA Contract Manager. The report shall
include the following information:
A. Subject(s) of complaint by name and either provider/subcontractor type or
employee position;
B. Source of complaint by name and provider/subcontractor type or employee
position;
C. Nature of compliant;
D. Estimate of the amount of funds involved; and
E. Legal and administrative disposition of case.
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3.20 HEALTH AND SAFETY
Contractor shall perform any and all of its obligations under this Contract in a manner that
does not compromise the health and safety of any HCA client with whom the Contractor
has contact.
4. GENERAL TERMS AND CONDITIONS
4.1 ACCESS TO DATA
In compliance with RCW 39.26.180(2) and federal rules, the Contractor must provide
access to any data generated under this Contract to HCA, the Joint Legislative Audit and
Review Committee, the State Auditor, and any other state or federal officials so authorized
by law, rule, regulation, or agreement. Contractor shall provide the data at no additional
cost to HCA or the recipient. This includes access to all information that supports the
findings, conclusions, and recommendations of the Contractor's reports, including
computer models and methodology for those models.
4.2 ACCESSIBILITY
4.2.1 REQUIREMENTS AND STANDARDS. Each Information and Communication
Technology (ICT) product or service furnished under this Contract shall be
accessible to and usable by individuals with disabilities in accordance with the
Americans with Disabilities Act (ADA) and other applicable federal and state laws
and policies, including OCIO Policy 188, et seq. For purposes of this clause,
Contractor shall be considered in compliance with the ADA and other applicable
federal and state laws if it satisfies the requirements (including exceptions)
specified in the regulations implementing Section 508 of the Rehabilitation Act,
including the Web Content Accessibility Guidelines (WCAG) 2.1 Level AA
Success Criteria and Conformance Requirements (2008), which are incorporated
by reference, and the functional performance criteria.
4.2.2 DOCUMENTATION. Contractor shall maintain and retain, subject to review by
HCA, full documentation of the measures taken to ensure compliance with the
applicable requirements and functional performance criteria, including records of
any testing or simulations conducted.
4.2.3 REMEDIATION. If Contractor claims that its products or services satisfy the
applicable requirements and standards specified in Section 4.2.1 and it is later
determined by HCA that any furnished product or service is not in compliance
with such requirements and standards, HCA will promptly inform Contractor in
writing of noncompliance. Contractor shall, at no additional cost to HCA, repair or
replace the non-compliant products or services within the period specified by
HCA. If the repair or replacement is not completed within the specified time, HCA
may cancel the Contract, delivery, task order, or work order, or purchase line
item without termination liabilities or have any necessary changes made or
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repairs performed by employees of HCA or by another contractor, and Contractor
shall reimburse HCA for any expenses incurred thereby.
4.2.4 DEFINITION. Information and Communication Technology (ICT) means
information technology and other equipment, systems, technologies, or
processes, for which the principal function is the creation, manipulation, storage,
display, receipt, or transmission of electronic data and information, as well as any
associated content. Examples include computers and peripheral equipment;
information kiosks and transaction machines; telecommunications equipment;
customer premises equipment; multifunction office machines; software;
applications; websites; videos; and electronic documents.
4.2.5 INDEMNIFICATION. Contractor agrees to indemnify and hold harmless HCA
from any claim arising out of failure to comply with the aforesaid requirements.
4.3 ADVANCE PAYMENT PROHIBITED
HCA shall not make any advance payment for services furnished by the Contractor
pursuant to this Contract.
4.4 AMENDMENTS
This Contract may be amended by mutual agreement of the parties. Such amendments
will not be binding unless they are in writing and signed by personnel authorized to bind
each of the parties.
4.5 ASSIGNMENT
4.5.1 Contractor may not assign or transfer all or any portion of this Contract or any of
its rights hereunder, or delegate any of its duties hereunder, except delegations
as set forth in Section 4.35, Subcontracting, without the prior written consent of
HCA. Any permitted assignment will not operate to relieve Contractor of any of its
duties and obligations hereunder, nor will such assignment affect any remedies
available to HCA that may arise from any breach of the provisions of this
Contract or warranties made herein, including but not limited to, rights of setoff.
Any attempted assignment, transfer or delegation in contravention of this
Subsection 4.5.1 of the Contract will be null and void.
4.5.2 HCA may assign this Contract to any public agency, commission, board, or the
like, within the political boundaries of the State of Washington, with written notice
of thirty (30) calendar days to Contractor.
4.5.3 This Contract will inure to the benefit of and be binding on the parties hereto and
their permitted successors and assigns.
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4.6 ATTORNEYS' FEES
In the event of litigation or other action brought to enforce the terms of this Contract, each
party agrees to bear its own attorneys' fees and costs.
4.7 CHANGE IN STATUS
In the event of any substantive change in its legal status, organizational structure, or fiscal
reporting responsibility, Contractor will notify HCA of the change. Contractor must provide
notice as soon as practicable, but no later than thirty (30) calendar days after such a
change takes effect.
4.8 CONFLICT OF INTEREST
Contractor represents and warrants that it has not undertaken and will not undertake any
work with third parties that will conflict with the work Contractor is performing for HCA
under this Contract. In case of doubt, before commencing such activities, Contractor shall
review areas of possible conflict with HCA and obtain RCA's approval prior to
commencing such activities.
4.9 CONFORMANCE
If any provision of this Contract is in conflict with or violates any statute or rule of law of
the state of Washington, it is considered modified to conform to that statute or rule of law.
4.10 COVERED INFORMATION PROTECTION
4.10.1 Contractor acknowledges that some of the material and information that may
come into its possession or knowledge in connection with this Contract or its
performance may consist of HCA Proprietary Information or Confidential
Information. For the purposes of this section, HCA Proprietary Information and
Confidential Information are together referred to as Covered Information.
4.10.2 Nondisclosure and Non -Use Obligations. In the event of Disclosure of Covered
Information to Contractor by HCA, Contractor agrees to: (1) hold Covered
Information in strictest confidence and to take all reasonable precautions to
protect such Covered Information (including, without limitation, all precautions the
Contractor employs with respect to its own confidential. materials); (2) not
disclose any such Covered Information or any other information derived
therefrom to any third party; (3) not make use of Covered Information for any
purpose other than the performance of this Contract; (4) release it only to
authorized employees or Subcontractors requiring such information for the
purposes of carrying out this Contract;, and (5) not release, divulge, publish,
transfer, sell, disclose, or otherwise make the information known to any other
party without HCA's express written consent or as provided by law.
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4.10.3 Contractors that come into contact with Protected Health Information may be
required to enter into a Business Associate Agreement with HCA in compliance
with the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-
191, as amended by the American Recovery and Reinvestment Act of 2009
("ARRA"), Sec. 13400 — 13424, H.R. 1 (2009) (HITECH Act) (HIPAA), and
applicable regulations.
4.10.4 HCA reserves the right to monitor, audit, or investigate the use of Confidential
Information collected, used, or acquired by Contractor through this Contract.
Violation of this section by Contractor or its Subcontractors may result in
termination of this Contract and demand for return of all Confidential Information,
monetary damages, or penalties.
4.10.5 The obligations set forth in this Section will survive completion, cancellation,
expiration, or termination of this Contract.
4.11 CONTRACTOR'S PROPRIETARY INFORMATION
Contractor acknowledges that HCA is subject to chapter 42.56 RCW, the Public Records
Act, and that this Contract will be a public record as defined in chapter 42.56 RCW. Any
specific information that is claimed by Contractor to be Proprietary Information must be
clearly identified as such by Contractor. To the extent consistent with chapter 42.56 RCW,
HCA will maintain the confidentiality of Contractor's information in its possession that is
marked Proprietary. If a public disclosure request is made to view Contractor's Proprietary
Information, HCA will notify Contractor of the request and of the date that such records will
be released to the requester unless Contractor obtains a court order from a court of
competent jurisdiction enjoining that disclosure. If Contractor fails to obtain the court order
enjoining disclosure, HCA will release the requested information on the date specified.
4.12 COVENANT AGAINST CONTINGENT FEES
Contractor warrants that no person or selling agent has been employed or retained to
solicit or secure this Contract upon an agreement or understanding for a commission,
percentage, brokerage or contingent fee, excepting bona fide employees or bona fide
established agents maintained by the Contractor for the purpose of securing business.
HCA will have the right, in the event of breach of this clause by the Contractor, to annul
this Contract without liability or, in its discretion, to deduct from the contract price or
consideration or recover by other means the full amount of such commission, percentage,
brokerage or contingent fee.
4.13 DEBARMENT
By signing this Contract, Contractor certifies that it is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded in any Washington
State or federal department or agency from participating. in transactions (debarred).
Contractor agrees to include the above requirement in any and all Subcontracts into which
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it enters, and also agrees that it will not employ debarred individuals. Contractor must
immediately notify HCA if, during the term of this Contract, Contractor becomes debarred.
HCA may immediately terminate this Contract by providing Contractor written notice, if
Contractor becomes debarred during the term hereof.
4.14 DISPUTES
The parties will use their best, good faith efforts to cooperatively resolve disputes and
problems that arise in connection with this Contract. Both parties will continue without
delay to carry out their respective responsibilities under this Contract while attempting to
resolve any dispute. When a genuine dispute arises between HCA and the Contractor
regarding the terms of this Contract or the responsibilities imposed herein and it cannot be
resolved between the parties' Contract Managers, either party may initiate the following
dispute resolution process.
4.14.1 The initiating party will reduce its description of the dispute to writing and deliver
it to the responding party (email acceptable). The responding party will respond
in writing within five (5) Business Days (email acceptable). If the initiating party is
not satisfied with the response of the responding party, then the initiating party
may request that the HCA Director review the dispute. Any such request from the
initiating party must be submitted in writing to the HCA Director within five (5)
Business Days after receiving the response of the responding party. The HCA
Director will have sole discretion in determining the procedural manner in which
he or she will review the dispute. The HCA Director will inform the parties in
writing within five (5) Business Days of the procedural manner in which he or she
will review the dispute, including a timeframe in which he or she will issue a
written decision.
4.14.2 A party's request for a dispute resolution must:
A. Be in writing;
B. Include a written description of the dispute;
C. State the relative positions of the parties and the remedy sought; and
D. State the Contract Number and the names and contact information for the
parties.
4.14.3 This dispute resolution process constitutes the sole administrative remedy
available under this Contract. The parties agree that this resolution process will
precede any action in a judicial or quasi-judicial tribunal.
4.15 ENTIRE AGREEMENT
HCA and Contractor agree that the Contract is the complete statement of the agreement
between the parties relating to the subject matter of the Contract and supersedes all
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letters of intent, oral or written, between the parties relating to the subject matter of the
Contract, except as provided in Section 4.44, Warranties.
4.16 FORCE MAJEURE
A party will not be liable for any failure of or delay in the performance of this Contract for
the period that such failure or delay is due to causes beyond its reasonable control,
including but not limited to acts of God, war, strikes or labor disputes, embargoes,
government orders or any other force majeure event.
4.17 FUNDING WITHDRAWN, REDUCED, OR LIMITED
r
If HCA determines in its sole discretion that the funds it relied upon to establish this
Contract have been withdrawn, reduced or limited, or if additional or modified conditions
are placed on such funding after the effective date of this contract but prior to the normal
completion of this Contract, then HCA, at its sole discretion, may:
4.17.1 Terminate this Contract pursuant to Section 4.39.3, Termination for Non -
Allocation of Funds;
4.17.2 Renegotiate the Contract under the revised funding conditions; or
4.17.3 Suspend Contractor's performance under the Contract upon five (5) Business
Days' advance written notice to Contractor. HCA will use this option only when
HCA determines that there is reasonable likelihood that the funding insufficiency
may be resolved in a timeframe that would allow Contractor's performance to, be
resumed prior to the normal completion date of this Contract.
A. During the period of suspension of performance, each party will inform the
other of any conditions that may reasonably affect the potential for
resumption of performance.
B. When HCA determines in its sole discretion that the funding insufficiency is
resolved, it will give Contractor written notice to resume performance. Upon
the receipt of this notice, Contractor will provide written notice to HCA
informing HCA whether it -can resume performance and, if so, the date of
resumption. For purposes of this subsection, "written notice" may include
email.
C. If the Contractor's proposed resumption date is not acceptable to HCA and
an acceptable date cannot be negotiated, HCA may terminate the contract by
giving written notice to Contractor. The parties agree that the Contract will be
terminated retroactive to the date of the notice of suspension. HCA will be
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liable only for payment in accordance with the terms of this Contract for
services rendered prior to the retroactive date of termination.
4.18 GOVERNING LAW
This Contract is governed in all respects by the laws of the state of Washington, without
reference to conflict of law principles. The jurisdiction for any action hereunder is
exclusively in the Superior Court for the state of Washington, and the venue of any action
hereunder is in the Superior Court for Thurston County, Washington. Nothing in this
Contract will be construed as a waiver by HCA of the State's immunity under the 11th
Amendment to the United States Constitution.
4.19 HCA NETWORK SECURITY
Contractor agrees not to attach any Contractor -supplied computers, peripherals or
software to the HCA Network without prior written authorization from HCA's Chief
Information Officer. Unauthorized access to HCA networks and systems is a violation of
HCA Policy and constitutes computer trespass in the first degree pursuant to RCW
9A.52.110. Violation of any of these laws or policies could result in termination of the
contract and other penalties.
Contractor will have access to the HCA visitor Wi-Fi Internet connection while on site.
4.20 INDEMNIFICATION
Contractor must defend, indemnify, and save HCA harmless from and against all claims,
including reasonable attorneys' fees resulting from such claims and breach of
confidentiality obligations as contained herein, arising from intentional or negligent acts or
omissions of Contractor, its officers, employees, or agents, or Subcontractors, their
officers, employees, or agents, in the performance of this Contract.
4.21 INDEPENDENT CAPACITY OF THE CONTRACTOR
The parties intend that an independent contractor relationship will be created by this
Contract. Contractor and its employees or agents performing under this Contract are not
employees or agents of HCA. Contractor will not hold itself out as or claim to be an officer
or employee of HCA or of the State of Washington by reason hereof, nor will Contractor
make any claim of right, privilege or benefit that would accrue to such employee under
law. Conduct and control of the work will be solely with Contractor.
4.22 LEGAL AND REGULATORY COMPLIANCE
4.22.1 During the term of this Contract, Contractor must comply with all local, state, and
federal licensing, accreditation and registration requirements/standards,
necessary for the performance of this Contract and all other applicable federal,
state and local laws, rules, and regulations.
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4.22.2 While on the HCA premises, Contractor must comply with HCA operations and
process standards and policies (e.g., ethics, Internet / email usage, data, network
and building security, harassment, as applicable). HCA will make an electronic
copy of all such policies available to Contractor.
4.22.3 Failure to comply with any provisions -of this section may result in Contract
termination.
4.23 LIMITATION OF AUTHORITY
Only the HCA Authorized Representative has the express, implied, or apparent authority
to alter, amend, modify, or waive any clause or condition of this Contract. Furthermore,
any alteration, amendment, modification, or waiver or any clause or condition of this
Contract is not effective or binding unless made in writing and signed by the HCA
Authorized Representative.
4.24 NO THIRD -PARTY BENEFICIARIES
HCA and Contractor are the only parties to this contract. Nothing in this Contract gives or
is intended to give any benefit of this Contract to any third parties.
4.25 NONDISCRIMINATION
During the performance of this Contract, the Contractor must comply with all federal and
state nondiscrimination laws, regulations and policies, including but not limited to: Title VII
of the Civil Rights Act, 42 U.S.C. §12101 et seq.; the Americans with Disabilities Act of
1990 (ADA), 42 U.S.C. §12101 et seq., 28 C.F.R. Part 35; and Title 49.60 RCW,
Washington -Law Against Discrimination. In the event of Contractor's noncompliance or
refusal to comply with any nondiscrimination law, regulation or policy, this Contract may
be rescinded, canceled, or terminated in whole or in part under the Termination for Default
sections, and Contractor may be declared ineligible for further contracts with HCA.
4.26 OVERPAYMENTS TO THE CONTRACTOR
In the event that overpayments or erroneous payments have been made to the Contractor
under this Contract, HCA will provide written notice to Contractor and Contractor will
refund the full amount to HCA within thirty (30) calendar days of the notice. If Contractor
fails to make timely refund, HCA may charge Contractor one percent (1 %) per month on
the .amount due, until paid in full. If the Contractor disagrees with HCA's actions under this
section, then it may invoke the dispute resolution provisions of Section 4.14, Disputes.
4.27 PAY EQUITY
4.27.1 Contractor represents and warrants that, as required by Washington state law
2023 (Engrossed Senate Bill 5187, Sec 919), during the term of this Contract, it
agrees to equality among its workers by ensuring similarly employed individuals
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are compensated as equals. For purposes of this provision, employees are
similarly employed if (i) the individuals work for Contractor, (ii) the performance of
the job requires comparable skill, effort, and responsibility, and (iii) the jobs are
performed under similar working conditions. Job titles alone are not determinative
of whether employees are similarly employed.
4.27.2 Contractor may allow differentials in compensation for its workers based in good
faith on any of the following: (i) a seniority system; (ii) a merit system; (iii) a
system that measures earnings by quantity or quality of production; (iv) bona fide
job-related factor(s); or (v) a bona fide regional difference in compensation levels.
4.27.3 "Bona fide job-related factor(s)" may include, but not be limited to, education,
training, or experience, that is: (i) consistent with business necessity; (ii) not
based on or derived -from a gender-based differential; and (iii) accounts for the
entire differential.
4.27.4 A "bona fide regional difference in compensation level" must be (i) consistent with
business necessity; (ii) not based on or derived from agender-based differential;
and (iii) account for the entire differential.
4.27.5 Notwithstanding any provision to the contrary, upon breach of warranty and -
Contractor's failure to provide satisfactory evidence of compliance within thirty
(30) Days of HCA's request for such evidence, HCA may suspend or terminate
this Contract.
4.28 PUBLICITY
4.28.1 The award of this Contract to Contractor is not in any way an endorsement of
Contractor or Contractor's Services by HCA and must not be so construed by
Contractor in any advertising or other publicity materials.
4.28.2 Contractor agrees to submit to HCA, all advertising, sales promotion, and other
publicity materials relating to this Contract or any Service furnished by Contractor
in which RCA's name is mentioned, language is used, or Internet links are
provided from which the connection of RCA's name with Contractor's Services
may, in HCA's judgment, be inferred or implied. Contractor further agrees not to
publish or use such advertising, marketing, sales promotion materials, publicity or
the like through print, voice, the Web, and other communication media in
existence or hereinafter developed without the express written consent of HCA
prior to such use.
4.29 RECORDS AND DOCUMENT REVIEW
4.29.1 The Contractor must maintain books, records, documents, magnetic media,
receipts, invoices or other evidence relating to this Contract and the performance
of the services rendered, along with accounting procedures and practices, all of
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which sufficiently and properly reflect all direct and indirect costs of any nature
expended in the performance of this Contract. At no additional cost, these
records, including materials generated under this Contract, are subject at all
reasonable times to inspection, review, or audit by HCA, the Office of the State
Auditor, and state and federal officials so authorized by law, rule, regulation, or
agreement [See 42 USC 1396a(a)(27)(B); 42 USC 1396a(a)(37)(B); 42 USC
1396a(a)(42(A); 42 C.F.R. 431, Subpart Q; and 42 C.F.R. 447.202].
4.29.2 The Contractor must retain such records for a period of six (6) years after the
date of final payment under this Contract.
4.29.3 If any litigation, claim, or audit is started before the expiration of the six (6) year
period, the records must be retained until all litigation, claims, or audit findings
Involving the records have been resolved.
4.30 REMEDIES NON-EXCLUSIVE
The remedies provided in this Contract are not exclusive but are in addition to all other
remedies available under law.
4.31 RIGHT OF INSPECTION
The Contractor must provide right of access to its facilities to HCA, or any of its officers, or
to any other authorized agent or official of the state of Washington or the federal
government, at all reasonable times, in order to monitor and evaluate performance,
compliance, and/or quality assurance under this Contract.
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4.32 RIGHTS IN DATA/OWNERSHIP
4.32.1 HCA and Contractor agree that all data and work products produced pursuant to
this Contract (collectively "Work Product") will be considered a "work made for
hire" as defined under the U.S. Copyright Act of 1976 and Title 17 U.S.C. §101 et
seq, and will be owned by HCA. Contractor is hereby commissioned to create the
Work Product. Work Product includes, but is not limited to, discoveries, formulae,
ideas, improvements, inventions, methods, models, processes, techniques,
findings, conclusions, recommendations, reports, designs, plans, diagrams,
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drawings, software, databases, documents, pamphlets, advertisements, books,
magazines, surveys, studies, computer programs, films, tapes, and/or sound
reproductions, to the extent provided by law. Ownership includes the right to
copyright, patent, register and the ability to transfer these rights and all
information used to formulate such Work Product.
4.32.2 If for any reason the Work Product would not be cdnsidered a "work made for
hire" under applicable law, Contractor assigns and transfers to HCA, the entire
right, title and interest in and to all rights in the Work Product and any
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registrations and copyright applications relating thereto and any renewals and
extensions thereof.
4.32.3 Contractor will execute all documents and perform such other proper acts as
HCA may deem necessary to secure for HCA the rights pursuant to this section.
4.32.4 Contractor will not use or in any manner disseminate any Work Product to any
third party, or represent in any way Contractor ownership of any Work Product,
without the prior written permission of HCA. Contractor will take all reasonable
steps necessary to ensure that its agents, employees, or Subcontractors will not
copy or disclose, transmit or perform any Work Product or any portion thereof, in
any form, to any third party.
4.32.5 Material that is delivered under this Contract, but that does not originate
therefrom ("Preexisting Material"), must be transferred to HCA with a
nonexclusive, royalty -free, irrevocable license to publish, translate, reproduce,
deliver, perform, display, and dispose of such Preexisting Material, and to
authorize others to do so. Contractor agrees to obtain, at its own expense,
express written consent of the copyright holder for the inclusion of Preexisting
Material. HCA will have the right to modify or remove any restrictive markings
placed upon the Preexisting Material by Contractor.
4.32.6 Contractor must identify all Preexisting Material when it is delivered under this
Contract and must advise HCA of any and all known or potential infringements of
publicity, privacy or of intellectual property affecting any Preexisting Material at
the time of delivery of such Preexisting Material. Contractor must provide HCA
with prompt written notice of each notice or claim of copyright infringement or
infringement of other intellectual property right worldwide received by Contractor
with respect to any Preexisting Material delivered under this Contract.
4.33 SEVERABILITY
If any provision of this Contract or the application thereof to any person(s) or
circumstances is held invalid, such invalidity will not affect the other provisions or
applications of this Contract that can be given effect without the invalid provision, and to
this end the provisions or application of this Contract are declared severable.
4.34 SITE SECURITY
While on HCA premises, Contractor, its agents, employees, or Subcontractors must
conform in all respects with physical, fire or other security policies or regulations. Failure
to comply with these regulations may be grounds for revoking or suspending security
access to these facilities. HCA reserves the right and authority to immediately revoke
security access to Contractor staff for any real or threatened breach of this provision.
Upon reassignment or termination of any Contractor staff, Contractor agrees to promptly
notify HCA.
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4.35 SUBCONTRACTING
4.35.1 Neither Contractor, nor any Subcontractors, may enter into Subcontracts for any
of the work contemplated under this Contract without prior written approval of
HCA. HCA has sole discretion to determine whether or not to approve any such
Subcontract. In no event will the existence of the Subcontract operate to release
or reduce the liability of Contractor to HCA for any breach in the performance of
Contractor's duties.
4.35.2 Contractor is responsible for ensuring that all terms, conditions, assurances and
certifications set forth in this Contract are included in any Subcontracts.
4.35.3 If at any time during the progress of the work HCA determines in its sole
judgment that any Subcontractor is incompetent or undesirable, HCA will notify
Contractor, and Contractor must take immediate steps to terminate the
Subcontractor's involvement in the work.
4.35.4 The rejection or approval by the HCA of any Subcontractor or the termination of a
Subcontractor will not relieve Contractor of any of its responsibilities under the
Contract, nor be the basis for additional charges to HCA.
4.35.5 HCA has no contractual obligations to any Subcontractor or vendor under
contract to the Contractor. Contractor is fully responsible for all contractual
obligations, financial or otherwise, to its Subcontractors.
4.36 SUBRECIPIENT
4.36.1 General
If the Contractor is a subrecipient (as defined in 45 C.F.R. § 75.2 and 2 C.F.R. §
200.93) of federal awards, then the Contractor, in accordance with 2 C.F.R. §
200, Subpart F and 45 C.F.R. § 75., Subpart F, shall:
A. Maintain records that identify, in its accounts, all federal awards received and
expended and the federal programs under which they were received, by
Catalog of Federal Domestic Assistance (CFDA) title and number, award
number and year, name of the federal agency, and name of the pass-through
entity;
B. Maintain internal controls that provide reasonable assurance that the
Contractor is managing federal awards in compliance with laws, regulations,
and provisions of contracts or grant agreements that could have a material
effect on each of its federal programs;
C. Prepare appropriate financial statements, including a schedule of
expenditures of federal awards;
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D. Incorporate 2 C.F.R. 200, Subpart F and 45 C.F.R. 75 Subpart F audit
requirements into all agreements between the Contractor and its
Subcontractors who are subrecipients;
E. Comply with any future amendments to 2 C.F.R. 200 Subpart F and 45
C.F.R. § 75 Subpart F and any successor or replacement Circular or
regulation;
F. Comply with the applicable requirements of 2 C.F.R. 200 Subpart F and 45
C.F.R. 75. Subpart F and any future amendments to 2 C.F.R. 200. Subpart F
1 and 45 C.F.R. 75 Subpart F, and any successor or replacement Circular or
regulation; and
G. Comply with the Omnibus Crime Control and Safe Streets Act of 1968, Title
VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of
1973, Title II of the Americans with Disabilities Act of 1990, Title IX of the
Education Amendments of 1972, The Age Discrimination Act of 1975, and
The Department of Justice Non -Discrimination Regulations, 28 C.F.R. Part
42, Subparts C.D.E. and G, and 28 C.F.R. Part 35 and 39. (Go to
htt ://o' ov/about/offices/ocr.htm for additional information and access to
the aforementioned federal laws and regulations.)
4.36.2 Single Audit Act Compliance
If the Contractor is a subrecipient and expends $750,000 or more in federal
awards from any and/or all sources in any fiscal year, the Contractor will procure
and pay for a single audit or a program -specific audit for that fiscal year. Upon
completion of each audit, the Contractor will:
A. Submit to the Authority contact person the data collection form and reporting
package specified in OMB Super Circular 2 C.F.R. 200, Subpart F and 45
C.F.R. 75. Subpart F , reports required by the program -specific audit guide (if
applicable), and a copy of any management letters issued by the auditor;
B. Follow-up and develop corrective action for all audit findings; in accordance
with 2 C.F.R. 200, Subpart F and 45 C.F.R. 75, Subpart F prepare a
"Summary Schedule of Prior Audit Findings."
4.36.3 Overpayments
If it is determined by HCA, or during the course of a required audit, that
Contractor has been paid unallowable costs under this or any Program
Agreement, Contractor will refund the full amount to HCA as provided in Section
4.26, Overpayments to Contractors.
4.37 SURVIVAL
The terms and conditions contained in this Contract that, by their sense and context, are
intended to survive the completion, cancellation, termination, or expiration of the Contract
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will survive. In addition, the terms of the sections titled Covered Information Protection,
Contractor's Proprietary Information, Disputes, Overpayments to Contractor, Publicity,
Records and Documents Review, Rights in Data/Ownership, and Legal and Regulatory
Compliance and all clauses identified in Attachment 4, Data Sharing Terms, Subsection
13, Survival, will survive the termination of this Contract. The right of HCA to recover any
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overpayments will also survive the termination of this Contract.
4.38 TAXES
HCA will pay sales or use taxes, if any, imposed on the services acquired hereunder.
Contractor must pay all other taxes, including, but not limited to, Washington Business
and Occupation Tax, other taxes based on Contractor's income or gross receipts, or
personal property taxes levied or assessed on Contractor's. personal property. HCA, as an
agency of Washington State government, is exempt from property tax.
Contractor must complete registration with the Washington State Department of Revenue
and be responsible for payment of all taxes due on payments made under this Contract.
4.39 TERMINATION
4.39.1 Termination for Default
In the event HCA determines that Contractor has failed to comply with the terms
and conditions of this Contract, HCA has the right to suspend or terminate this
Contract. HCA will notify Contractor in writing of the need to take corrective
action. If corrective action is not taken within ten (10) Business Days, or other
time period agreed to in writing by both parties, the Contract may be terminated.
HCA reserves the right to suspend all or part of the Contract, withhold further
payments, or prohibit Contractor from incurring additional obligations of funds
during investigation of the alleged compliance breach and pending corrective
action by Contractor or a decision by HCA to terminate the Contract.
In the event of termination for default, Contractor will be liable for damages as
authorized by law including, but not limited to, any cost difference between the
original Contract and the replacement or cover Contract and all administrative
costs directly related to the replacement Contract, e.g., cost of the competitive
bidding, mailing, advertising, and staff time.
If it is determined that Contractor: (i) was not in default, or (ii) its failure to perform
was outside of its control, fault or negligence, the termination will be deemed a
"Termination for Convenience."
4.39.2 Termination for Convenience
When, at RCA's sole discretion, it is in the best interest of the State, HCA may
terminate this Contract in whole or in part by providing thirty (30) calendar days'
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written notice. If this Contract is so terminated, HCA will be liable only for
payment in accordance with the terms of this Contract for services rendered prior
to the effective date of termination. No penalty will accrue to HCA in the event the
termination option in this section is exercised.
4.39.3 Termination for Nonallocation of Funds
If funds are not allocated to continue this Contract in any future period, HCA may
terminate this Contract by providing fifteen (15) days written notice to the
Contractor. The termination will be effective on the date specified in the
termination notice. HCA will be liable only for payment in accordance with the
terms of this Contract for services rendered prior to the effective date of
termination. HCA agrees to notify Contractor of such nonallocation at the earliest
possible time. No penalty will accrue to HCA in the event the termination option
in this section is exercised.
4.39.4 Termination for Withdrawal of Authority
In the event that the authority of HCA to perform any of its duties is withdrawn,
reduced, or limited in any way after the commencement of this Contract and prior
to normal completion, ,HCA may immediately terminate this Contract by providing
written notice to the Contractor. The termination will be effective on the date
specified in the termination notice. HCA will be liable only for payment in
accordance with the terms of this Contract for services rendered prior to the
effective date of termination. HCA agrees to notify Contractor of such withdrawal
of authority at the earliest possible time. No penalty will accrue to HCA in the
event the termination option in this section is exercised.
4.39.5 Termination for Conflict of Interest
HCA may terminate this Contract by written notice to the Contractor if HCA
determines, after due notice and examination, that there is a violation of the
Ethics in Public Service Act, Chapter 42.52 RCW, or any other laws regarding
ethics in public acquisitions and procurement and performance of contracts. In
the event this Contract is so terminated, HCA will be entitled to pursue the same
remedies against the Contractor as it could pursue in the event Contractor
breaches the contract.
4.40 TERMINATION PROCEDURES
4.40.1 Upon termination of this Contract, HCA, in addition to any other rights provided in
this Contract, may require Contractor to deliver to HCA any property specifically
produced or acquired for the performance of such part of this Contract as has
been terminated.
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4.40.2 HCA will pay Contractor the agreed-upon price, if separately stated, for
completed work and services accepted by HCA and the amount agreed upon b
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the Contractor and HCA for (i) completed work and services for which no
separate price is stated; (ii) partially completed work and services; (iii) other
property or services that are accepted by HCA; and (iv) the protection and
preservation of property, unless the termination is for default, in which case HCA
will determine the extent of the liability. Failure to agree with such determination
will be a dispute within the meaning of Section 4.14, Disputes. HCA may withhold
from any amounts due the Contractor such sum as HCA determines to be
necessary to protect HCA against potential loss or liability.
4.40.3 After receipt of notice of termination, and except as otherwise directed by HCA,
Contractor must:
A. Stop work under the Contract on the date of, and to the extent specified in,
the notice;
B. Place no further orders or Subcontracts for materials, services, or facilities
except as may be necessary for completion of such portion of the work under
the Contract that is not terminated;
C. Assign to HCA, in the manner, at the times, and to the extent directed by
HCA, all the rights, title, and interest of the Contractor under the orders and
Subcontracts so terminated; in which case HCA has the right, at its
discretion, to settle or pay any or all claims arising out of the termination of
such orders and Subcontracts;
D. Settle all outstanding liabilities and all claims arising out of such termination
of orders and Subcontracts, with the approval or ratification of HCA to the
extent HCA may require, which approval or ratification will be final for all the
purposes of this clause;
E. Transfer title to and deliver as directed by HCA any property required to be
furnished to HCA;
F. Complete performance of any part of the work that was not terminated b
HCA; and Y
G. Take such action as may be necessary, or as HCA may direct, for the
protection and preservation of the records related to this Contract that are in
the possession of the Contractor and in which HCA has or may acquire an
interest.
4.41 TRANSITION OBLIGATIONS
Contractor must provide for reasonable transition assistance requested by HCA to allow
for the expired or terminated Contract, in whole or in part, to continue without interruption
or adverse effect, and to facilitate the orderly transfer of such services to HCA or its
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designees. Such transition assistance will be deemed by the parties to be governed by the
terms and conditions of this Contract, except for those terms or conditions that do not
reasonably apply to such transition assistance.
4.42 TREATMENT OF ASSETS
4.42.1 Ownership
HCA shall retain title to all property furnished by HCA to Contractor under this
Contract. Title to all property furnished by Contractor, for the cost of which the
Contractor is entitled to reimbursement as a direct item of cost under this
Contract, excluding intellectual property provided by Contractor, shall pass to and
vest in HCA upon delivery of such property by Contractor. Title to other property,
the cost of which is reimbursable to Contractor under this Contract, shall pass to
and vest in HCA upon (i) issuance for use of such property in the performance of
this Contract, (ii) commencement of use of such property in the performance of
1 this Contract, or (iii) reimbursement of the cost thereof by HCA, in whole or in
part, whichever occurs first.
4.42.2 Use of Property
Any property furnished to Contractor shall, unless otherwise provided herein, or
approved in writing by the HCA Contract Manager, be used only for the
performance of and subject to the terms of this Contract. Contractor's use of the
equipment shall be subject to HCA's security, administrative, and other
requirements.
4.42.3 Damage to Property
Contractor shall continuously protect and be responsible for an loss
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destruction, or damage to property which results from or is caused by
Contractor's acts or omissions. Contractor shall be liable to HCA for costs of
repair or replacement for property or equipment that has been lost, destroyed, or
damaged by Contractor or Contractor's employees, agents, or Subcontractors.
Cost of replacement shall be the current market value of the property,and
equipment on'the date of the loss as determined by HCA.
4.42.4 Notice of Damage
Upon the loss of, destruction of, or damage to any of the property, Contractor
shall notify the HCA Contract Manager thereof within one (1) Business Day and
shall take all reasonable steps to protect that property from further damage.
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4.42.5 Surrender of Property
Contractor will ensure that the property will be returned to HCA in like condition
to that in which it was furnished to Contractor, reasonable wear and tear
expected. Contractor shall surrender to HCA all property upon the earlier of
expiration or termination of this Contract.
4.43 WAIVER
Waiver of any breach of any term or condition of this Contract will not be deemed a waiver
of any prior or subsequent breach or default. No term or condition of this Contract will be
held to be waived, modified, or deleted except by a written instrument signed by the
parties. Only the HCA Authorized Representative has the authority to waive any term or
condition of this Contract on behalf of HCA.
4.44 WARRANTIES
4.44.1 Contractor represents and warrants that its services will be of professionalualit
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and will be rendered in accordance with prevailing professional standards and
ethics. Services performed by Contractor under this Contract shall be conducted
in a manner consistent with the level of care and skill standard to the industry.
Contractor agrees to immediately re -perform any services that are not in
compliance with this representation and warranty at no cost to HCA.
4.44.2 Contractor represents and warrants that it will comply with all applicable local,
State, and federal licensing, accreditation and registration requirements and
standards necessary in the performance of the Services.
4.44.3 EXECUTIVE ORDER 18-03 — WORKERS' RIGHTS (MANDATORY INDIVIDUAL
ARBITRATION). Contractor represents and warrants that Contractor does NOT
require its employees, as a condition of employment, to sign or agree to
mandatory individual arbitration clauses or class or collective action waivers.
Contractor further represents and warrants that, during the term of this Contract,
Contractor shall not, as a condition of employment, require its employees to sign
9
or agree to mandatory individual arbitration clauses or class or collective action
waivers.
4.44.4 Any written commitment by Contractor within the scope of this Contract will be
binding upon Contractor. Failure of Contractor to fulfill such a commitment may
constitute breach and will render Contractor liable for damages under the terms
of this Contract. For purposes of this section, a commitment by Contractor
includes: (i) Prices, discounts, and options committed to remain in force over a
specified period of time; and (ii) any warranty or representation made by
Contractor to HCA or contained in any Contractor publications, or descriptions of
services in written or other communication medium, used to influence HCA to
enter into this Contract.
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ATTACHMENT 1: TASK ORDER #01 — CPWI COMMUNITY
Community Prevention and Wellness Initiative — Community Prevention Services
1. Purpose
The purpose of this Task Order is to implement Community Prevention and Wellness Initiative —
Community Prevention Services in order to increase capacity to implement direct and
environmental substance use disorder prevention services in high need communities to
Implement identified evidence -based practices and programs to prevent and reduce the misuse
and abuse of alcohol, tobacco, cannabis, opioids, and/or other drugs.
2. Term
The initial term of this Task Order begins July 1, 2023, and ends June 30, 2025, unless
terminated sooner as provided herein; work performed prior to the Effective Date will be at the
sole risk of Contractor. This Task Order may be extended in whatever time increments HCA
deems appropriate.
This Task Order shall be in effect only when funding is included in the Awards and Revenues
document incorporated by reference.
3. Contacts
As designated on the A&R/FSI document for Contract Manager information related to this
task order.
4. Statement of Work
Contractor shall ensure services, and staff, and otherwise do all things necessary for or
incidental to the performance of work, as set forth below in this section.
Prevention programs and services include, but are not limited to:
4.1 Coordination of Prevention Services.
Contractor shall ensure:
4.1.1 The provision of CPWI services in accordance with the CPWI Community
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Coalition ition Guide located on the Athena Forum website
https://vwvw.theathenaforum.org/cpwi-community-coalition-guide which outlines
the minimal standards to participate in the CPWI. Contractor shall plan to reach
the ideal benchmarks related to the community coalition's efforts and staffing to
include:
A. Hire or identify a minimum of a 0.5 FTE staff member to serve as the
qualified Community Coalition Coordinator upon contract execution. Full-
time employment (1.0 FTE) for the Community Coalition Coordinator is
allowable and strongly recommended in order to meet the scope of the
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project. Coalitions may request an exception to this requirement if they can
demonstrate quality ongoing coordination and service delivery. Any
exceptions to the minimum must be submitted in writing at least thirty (30)
days prior to the start of the position and will only be considered if the
Contractor and community are in -compliance and able to demonstrate they
are achieving the benchmarks as outlined in the CPWI Guide.
Ensure Community Coalition Coordinator(s) meet required position
qualifications and workstation requirements found in the CPWI
Community Coalition Guide.
Confirm an office space in the designated community for the
Community Coalition Coordinator.
Contractor shall submit a completed Community Coalition
Coordinator Qualification Checklist to Contract Manager or designee
for review. HCA shall review and respond within five (5) business
days.
A. Ensure Community Coalition Coordinators are Certified Prevention
Professionals (CPP).
i) Ensure currently certified Community Coalition Coordinator(s)
maintain CPP credential status, and
ii) Ensure Certified Prevention Professional (CPP) certification within
eighteen (18) months of new Community Coalition Coordinator start
date.
HCA reserves the right to require Contractor to develop a
Community Coalition Coordinator training plan if candidate does not
meet required qualifications.
4.1.2 Contractor shall ensure that a regular annual schedule of direct prevention
services for public dissemination is established.
A. Regular annual schedule shall take into account items including, but not
limited to: implementation times that maximize participation and service
outcomes, local needs and gaps; leveraged resources, and other locally
Identified factors that influence service delivery throughout the year.
B. Regular annual schedule and community dissemination plan shall be
identified as part of the CPWI Action Plan and Budget Update and
submitted to Contract Manager or designee for HCA review annually in
accordance with the timeline in the CPWI Community Coalition Guide.
4.1.3 Submit an annual Action Plan and Budget with projected expenditures, including
salary and benefits for HCA funded prevention staff, program costs, training and
travel to the Contract Manager or designee, according to the CPWI Community
Coalition Guide or within thirty (30) -business days upon request. A template will
be provided at least thirty (30) business days prior to the due date, unless
Washington State 52 HCA Contract #K6946
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otherwise specified. Updated Action Plan and Budget is due by June 15 of each
year that this Contract is active, unless otherwise specified in writing from HCA.
4.1.4 Budget adjustments that are ten percent (10%) or more of the total of the
i
approved Contractor and/or CPWI coalition budget shall submit a budget revision
for approval to Contract Manager or designee at least fifteen (15) business days
prior to expending adjusted budget items. Approval must be granted prior to
expending funds.
4.1.5 Enter approved programs, based on the priorities, goals, and objectives
described in the approved Strategic Plan, into Minerva within thirty (30) business
days of initial Action Plan approval and any subsequent updates, or as directed
by PSM.
4.1.6 Ensure that overall sixty percent (60%) of programs supported by HCA funds will
be replications or approved adaptations of "Evidence -based Practice" substance
abuse prevention programs as identified in the list provided by DBHR at
https://theathenaforum.org/EBP. Additionally, Contractors must follow funding
specific requirements as outlined below:
A. For cohorts who receive SOR, OASA, and/or DCA funds, use the
associated EBP/RBP/PP list at https://theathenaforum.org/EBP and
implement at least one (1) evidence/research-based direct service program
or strategy from the list.
i) Once one (1) or more evidence/research based direct service
program or strategy is selected, Contractor may select additional
promising program(s) from the list or use the funding to support
other costs to include training and/or coalition coordinator costs.
B. Coalitions who receive SOR and OASA funding are also required to
implement the Starts with One opioid prevention campaign and participate
in the National Drug Take Back Days in October and April, according to the
Drug Enforcement Agency (DEA) guidelines, recommendations, and
regulations.
https://www.deadiversion, usdoj.gov/drug_disposal/takeback/poc. htm.
4.1.7 Ensure that all of the programs, including any approved innovativerams
ro
p g ,
supported by HCA meet the Center for Substance Abuse Prevention's CSAP)
Principles of Substance Abuse Prevention, found on the Athena Forum Website:
www.TheAthenaForum.org/CSAPprinciples.
4.1.8 Contractor is encouraged to collaborate and partner with community-based
organizations that operate within or serve the CPWI community.
4.1.9 If funding permits Contractor to provide Community Based Coordination services
in addition to meeting CPWI requirements, (i.e., Counties with communities that
each have at least $130,000 per community of DBHR funding budgeted for CPWI
Implementation, annually) services may be provided at the county or regional
level. Services shall reflect work of Contractor staff coordinating, organizing,
g
Washington State 53 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
building capacity, and providing education and information related to prevention
Initiatives at the county level with a goal to expand CPWI communities.
4.1.10 If applicable to Contractor, develop plan for services listed above and submit to
Contract Manager or designee for review and approval within sixty (60) business
days of expected implementation.
4.2 Prevention Training
4.2.1 Required Training in CPWI
Contractor Manager for this Task Order as identified in the A&R/FSI document
and primary fiscal staff or their designee(s) shall attend an annual contractor
training or meeting that will be scheduled for a minimum of four (4) hours in
duration. Date and location will be announced by DBHR at least thirty (30)
business days prior to the training.
Contractor shall participate in all required training events identified by HCA and
listed in the CPWI Community Coalition Guide.
4.2.2 Non -Required Training in CPWI
A. In the absence of trainings identified in the approved strategic plan and
Budget/Action Plan, all additional (non -required) training paid for by HCA
shall be approved by Contract Manager or designee prior to training and
meet the approved goals and objectives in approved Strategic Plan and
Budget/Action Plan.
B. Contractor shall ensure any requests for training in addition to the
approved training in the Strategic plan and Budget/Action Plan are
requested in writing and sent directly to the Contract Manager or designee,
a minimum of ten (10) business days before the date of the proposed
training. Trainings shall relate to one (1) of the following four (4) categories:
i) Coalition building and/or community organization.
ii) Capacity building regarding prevention theory and practice.
Capacity building for Evidence -based Practice and environmental
strategy implementation, related to the goals and objectives of the
coalition's approved strategic plan and Budget/Action Plan.
iv) Capacity building in non-CPWI communities to expand CPWI efforts
and meets overall goals and objectives of CPWI may be approved
by Contract Manager or designee upon request.
C. Contractor shall ensure training paid for by HCA that requires travel follows
state travel reimbursement guidelines and rates accessible at
www.ofm.wa.gov/policy/10.90.htm.
D. Contractor shall bill for training events on an A-19 invoice templatep er
billing code according to the Substance Use Disorder and Mental Health
Washington State 54 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Promotion Services Billing Guide and record training events in the HCA
Substance Use Disorder Prevention and Mental Health Promotion Online
Reporting Systems or Minerva in accordance with the monthly reporting
requirements described in Prevention Report Schedule/Due Dates.
4.3 Reporting Requirements
4.3.1 Prevention Reporting Requirements
Contractor shall report on all requirements as identified in the HCA Substance
Use Disorder Prevention and Mental Health Promotion Online Reporting System
or Minerva. HCA reserves the right to add reporting requirements based on
requirements of funding source(s).
4.3.2 Prevention Activity Data Reports
Contractor shall:
A. Ensure that monthly prevention activities are reported in Minerva in
accordance with the requirements and timelines set forth.
B. Ensure accurate and unduplicated reporting.
C. Ensure proper training of staff and designated staff for back-up Minerva
data entry to meet report due dates.
D. If special circumstances arise and Contractor is unable to enter the data by
the reporting deadline(s), Contractor shall ensure any requests for
extensions to repotting deadlines are requested in writing and sent directly
to the PSM via email five (5) business days before the report due date.
E. The maximum extension request permitted is ten (10) business days.
F. Monthly invoices submitted with active data entry extensions will be denied
and may be re -submitted by Contractor once data for the months) in
question is complete.
G. Contractors with three (3) or more consecutive months of data entry
extensions or late reporting or four (4) or more program data entry
extensions or late reporting within a six (6) month period shall be required
to submit a Corrective Action Plan to HCA.
H. Extensions granted due to Minerva technical issues will be excluded from
this count.
I. Ensure all required demographic information is provided for individual
participant; population reach; aggregate; and mentoring or 1=to-1 services
in Minerva.
J. Report Community Coalition Coordination Staff Hours in Minerva for each
month of the calendar year.
Washington State 55 HCA Contract #K6946
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K. Complete prevention reporting, according to the Schedule/Due Dates
below:
Reporting
Report(sj
Report Due
Re orcin
p g
Period
Dates`
S stem a ;
Enter programs listed on
Within 30
Annuallyapproved
Strategic
business days of
Minerva
Action Plan b HCA into
y
Strategic Action
Minerva.
Plan approval
Prevention activity data
input for all active
services including
15th of each
Monthly
community coalition
month for
coordination staff hours
activities from
Minerva
and efforts, services,
the previous
participant information,
month
training, evaluation tools
and assessments.
October 15
Quarterly
CPWI Quarterly
January 15
Reporting.
April 15.
Minerva
July 15
As
re nested
q
GPRA Measures.
As requested
Minerva
Minerva or
As
As required by
requested
SAMHSA.
As requested
as
required
4.3.3 Outcome Measures
A. Contractor shall report on all required evaluation tools identified in Minerva
that measure primary program objective.
Pre/Post test are required for all recurring direct service programs.
The Coalition Assessment Tool is required to be completed by
coalition members.
Specific surveys for Information Dissemination or Environmental
strategies/programs based on specific program to be determined and
approved in Action Plan.
Washington State 56 HCA Contract #K6946
Health Care Authority Attachment 1 -SOW CPWI Community
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
B. Special situations and exceptions regarding evaluation tools identified in
Minerva include, but are not limited to, the following:
i) Contractor may negotiate with the HCA to reduce multiple
administrations of surveys to individual participants. Contractor shall
submit for exception in writing to the HCA Contract Manager or
designee.
ii) Participants in recurring program groups in which the majority of
participants are younger than ten (10) years old on the date of that
group's first service.
4.3.4 Performance Work Statement/Evaluation.
A. Contractor shall ensure program results show positive outcomes for at
least half of the participants in each program group as determined by
Cohorts/Campaigns with individual participant sessions.
i) "Positive outcomes" means that at least half of the participants in a
group report positive improvement or maintenance as determined by
the program measurable objective between pre and post-tests.
Positive outcomes will be determined using the pre-test and post-test
data reported in Minerva.
iii) Evaluation of Minerva data will occur on the 15th of the month
following the final date of service for each group.
B. HCA shall use the following protocol for evaluation:
i) Matched pre-test and post-test pairs will be used in the analysis.
ii) To allow for normal attendance drop-off, a 20% leeway will be given
for missing post-tests.
iii) If there are missing post-tests for entered pre-tests in excess of 20%
of pre-tests, missing post-test will be counted as a negative outcome.
iv) Example: there are ten (10) pre-tests and seven (7) post-tests. The
denominator would be eight (8) and the maximum numerator would
be seven (7).
C. Different groups, as determined by Cohorts/Campaigns, receiving the
same program will be clustered by school district.
i) In cases where multiple providers are serving the same school district,
groups will be clustered by school district and provider.
ii) The results of one (1) provider in a given school district will not impact
another provider in the same district.
a) In cases where the survey instrument selected for a given program
includes more than one scale, the scale that is most closely
aligned with the measurable objective linked to the program in
Minerva will be used.
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b) Results for groups, as determined by Cohorts/Campaigns, with
services that span two (2) contracting periods will be analyzed in
the contracting period that the post-test was administered.
iii) If fewer than half of the participants in a group, as determined by
Cohorts/Campaigns within a given school district, report positive
change in the Intended outcome:
iv)
Washington State
Health Care Authority
a) Contractor shall submit a Performance Improvement Plan (PIP) for
the non-compliant program to the Contract Manager or designee or
designee within forty-five (45) calendar days of notice by HCA.
b) Reimbursement for the CSAP Category row on the A-19 for that
program will be held until the PIP is approved by Contractor
Manager or designee or their designee.
c) If a second group, as determined by Cohort/Campaigns, within that
same school district has fewer than half of the participants report
positive change in the intended outcome, then the following steps
will be taken:
In cases where there is no active non-compliant program,
Contractor shall discontinue implementation of that program
within the specified geography.
ii. In cases where the same programs as the non-compliant
program are active and continuing in the same school
district, those groups, as determined by Cohorts/Campaigns,
will be allowed to complete the expected number of
sessions. No new groups, as determ-fined by
Cohorts/Campaigns, will be started.
Following the conclusion of all groups, as determined by
Cohorts/Campaigns, completing the program, results will be
reviewed for those groups.
d) If the results do not show positive change for each group, as
determined by Cohorts/Campaigns, Contractor shall take the
following action:
In cases where the program is being delivered by a single
provider in the specified geography, Contractor shall
discontinue implementation of that program in the specified
geography.
ii. In cases where the program is being delivered by multiple
providers in the specified geography, Contractor shall
discontinue implementation of that program by the
underperforming provider in the specified geography.
A program that resulted in the need for a Performance Improvement
Plan and Plan during the former Contract period will not carry that
58 HCA Contract #K6946
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record forward into the new Contract period. Implement and monitor
prevention programs and reporting to assure compliance with these
guidelines.
Washington State 59 HCA Contract #K6946
Health Care Authority Attachment 1- SOW CPWI Community
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT 2: TASK ORDER #02 — CPWI SCHOOL
Community Prevention and Wellness Initiative - School -Based Services
1. Purpose
The purpose of this Task Order is to implement the Community Prevention and Wellness
Initiative - Student Assistance Prevention Intervention Services Program services to support
prevention and intervention services in schools within high -need communities in order to
prevent and reduce the misuse and abuse of alcohol, tobacco, cannabis, opioids, and/or
other drugs.
2. Te rm
The initial term of this Task Order begins July 1, 2023, and ending June 30, 2025 unless
terminated sooner as provided herein; work performed prior to the Effective Date will be at
the sole risk of Contractor. This Task Order may be extended in whatever time increments
HCA deems appropriate.
This Task Order shall be in effect only when funding is included in the Awards and Revenue
incorporated by reference.
3. Contacts
As designated on the A&R/FSI document for Contract Manager information related to this
task order.
4. Statement of Work
Contractor shall ensure services, and staff, and otherwise do all things necessaryfor or
incidental to the performance of work, as set forth below in this section.
Prevention programs and services include, but are not limited to:
4.1 Coordination of Prevention Services.
4.1.1 Contractor shall ensure the provision of SAPISP services in accordance with the
Project SUCCESS program and in alignment with the CPWI Community Coalition
-Guide located on the Athena Forum website
https://www.theathenaforum.org/cpwi-community-coalition-guide which outlines
the minimal standards to participate in the CPWI. Contractor shall plan to reach
the ideal benchmarks related to the role of the Educational Service District (ESD)
and Student Assistance Professional (SAP) to include:
A. Hire or identify a minimum of one full-time (1.0 FTE) staff member to serve
as the qualified Student Assistance professional in each identified CPWI
community upon contract execution.
i) Contractor shall notify HCA/DBHR of staff vacancies, transitions and new
hires within 5 business days of changes.
Washington State 60 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Training is provided to new SAPISP staff. Training plan for new SAPISP
staff is to be submitted to Contract Manager within 30 days of hire using
the SAPISP Training Plan. The SAPISP Training Plan will address at
least the following:
a) Project SUCCESS (Schools Using Coordinated Community
Efforts to Strengthen Students)
b) If the SAPISP staff is hired during a period where there is no
scheduled Project SUCCESS training, the ESD will either
deliver the training themselves or arrange for the training to be
delivered by a qualified individual.
c) Prevention activities (including Prevention Education series
preparation)
d) Confidentiality requirements and practices
e) Intake procedures
fl Screening with the Global Appraisal of Individual Needs Short
Screener (GAINS -SS)
g) Group counseling strategies
h) Referral procedures and practices
i) Data collection procedures
j) Pre -post evaluation protocols
k) Record-keeping practices
I) Prevention -best practices —including prevention science and
community organizing
m) Establishing the program and relationships in the school.
B. Ensure implementation of Project SUCCESS programming for schools
receiving services as part of CPWI. Adaptations to Project SUCCESS shall
be agreed upon by HCA and ESD.
i) The ESD must submit the request in writing 30 calendar days before
implementation of adaptation.
C. Contractor shall ensure that a regular annual schedule of direct prevention
and intervention services are provided to include:
i) Submitting a Service and Program Staffing Plan and Budget using the
template mutually agreed upon by HCA and the ESDs by July 5 prior
to each school year to include:
a) Location of service and relevant description.
b) School(s) being served.
c) Name of the SAP and known credentials.
d), Anticipate start date of SAP services.
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e) Funds source by SAP.
fl A workforce retention plan with strategies and activities to
achieve the primary goal of increasing recruitment and
retention of SAPs.
g) Identifying the program(s) that each DCA funded SAP is
implementing to ensure implementation of a school-based
EBP/RBP from the DCA funded program list for any SAP
funded by DCA.
h) Confirmation of match. Contractor is responsible to secure and
utilize local matching funds from Local School Districts or other
organizations in the amount of twenty percent (20%) as
required match of the staff salary and benefits costs of each
the SAP position, to ensure a minimum of a 1.0 FTE SAP is
placed in the middle and/or high school in each identified
CPWI community.
ii) Submitting a Service and Program Staffing Plan and Budget using the
template mutually agreed upon by HCA and the ESDs by July 5 for
the school year starting September of the same year to include:
a) Location of service and relevant description.
b) School(s) being served.
c) Name of the SAP and known credentials.
d) Anticipate start date of SAP services.
e) Funds source by SAP.
fl A workforce retention plan with strategies and activities to
achieve the primary goal of increasing recruitment and
retention of SAPs.
g) Identifying the program(s) that each DCA funded SAP is
implementing to ensure implementation of a school-based
EBP/RBP from the DCA funded program list for any SAP
funded by DCA.
h) Confirmation of match. Contractor is responsible to secure
local matching funds from Local School Districts or
organizations in the amount of twenty percent (20%) as
required match of the staff salary and benefits costs of each
the SAP position, to ensure a minimum of a 1.0 FTE SAP is
placed in the middle and/or high school in each identified
CPWI community.
iii) Ensure the use of the GAINS -SS to screen and refer students.
Screening results will be entered into SAPISP data reporting system.
iv) Contractor will monitor each site receiving SAPISP using a review
protocol. Documentation of onsite program monitoring will be
submitted to HCA within 30 days of completion of visit.
Washington State 62 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDQA1-C9C4-4168-8626-72A7C65C8198
v) Contractor will host at least one site visit with HCA staff every two years.
Additional site visits may be scheduled at the discretion of HCA or the
ESD
D. Contractor shall ensure that the Healthy Youth Survey is administered by
the school district/high school attendance area of each identified CPWI site.
4.2 Prevention Training
4.2.1 Required Training
A. Contractor Manager for this Task Order as identified in the A&R/FSI
document and primary fiscal staff or their designee(s) shall attend an
annual Contractor training or meeting that will be scheduled for a minimum
of four (4) hours in duration. Date and location will be announced by DBHR
at least thirty (30) business days prior to the training.
B. Contractor shall participate in all required training events identified by HCA
and/or listed in the CPWI Community Coalition Guide including:
i) Learning Community Meetings.
ii) Prevention Provider Meeting in the fall.
iii) Day one of the summer Coalition Leadership Institute.
iv) Monthly Contractor calls.
4.2.2 Non -Required Training in CPWI/SAPISP
A. In the absence of trainings identified within the Statement of Work or
approved Service and Program Staffing Plan and Budget, all additional
(non- required) training paid for by HCA shall be approved by Contract
Manager or designee prior to training and meet the approved goals and
objectives of the specified fund source.
B. Contractor shall ensure training paid for by HCA that requires travel follows
state travel reimbursement guidelines and rates accessible at
www.ofm.wa.gov/policy/10.90. htm.
C. Contractor shall bill for training events on an A-19 per billing code
according to the Substance Use Disorder Prevention and Mental Health
Promotion Services Billing Guide and record training events in the
identified reporting system in accordance with the monthly reporting
requirements described in Prevention Report Schedule/Due Dates.
4.3 Reporting Requirements
4.3.1 Prevention Reporting Requirements
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Contractor shall report on all required elements in the SAPISP data reporting
system. HCA reserves the right to add reporting requirements based on
requirements of funding source(s).
4.3.2 Prevention Activity Data Reports
Contractor shall:
A. Ensure that monthly SAPISP activities are reported in the agreed upon
reporting system in accordance with the requirements and timelines set
forth.
B. Ensure accurate and unduplicated reporting.
C. Ensure proper training of staff and designated staff for back-up data entry
to meet report due dates.
D. If special circumstances arise and Contractor is unable to enter the data by
the reporting deadline(s), Contractor shall ensure any requests for
extensions to reporting deadlines are requested in writing and sent directly
to the Contract Manager via email five (5) business days before the report
due date.
E. The maximum extension request permitted is ten (10) business days.
F. Monthly invoices submitted with active data entry extensions will be denied
and may be re -submitted by Contractor once data for the month(s) in
question is complete:
G. Contractors with three (3) or more consecutive months of data entry
extensions or late reporting or four (4) or more program data entry `
extensions or late reporting within a six (6) month period shall be required
to submit a Corrective Action Plan to HCA.
H. Extensions granted due to reporting system technical issues will be
excludedfrom this count.
I. Ensure all required demographic information isrovided for or services
provided to individual participants; CSAP and IOM categories, in reporting
system.
J. Complete prevention reporting, according to the Schedule/Due Dates below:
Washington State 64 HCA Contract #K6946
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Annually
Performance Work
End of school
SAPISP
Statement/Evaluation
year before
Reporting
beginning of
System
next school
year
Annual
Report
Federal
SAPISP Success
45 days after
Written
fiscal year
Story; minimum of one
the end of the
report
per ESD
federal fiscal
year
As
As required by
As requested
As agreed
requested
SAMHSA.
upon or as
required
4.3.3 Performance Work Statement/Evaluation
A. A minimum of 60% of the students who participate in the program
selected/indicated) must complete both a pre-test and a post-test.
B. A minimum of 85% of the students with a pre-test and post-test who
participated in the program must have the following outcomes on each of
the following 3 indicators:
i) Overall, how important has this program been to you? Very important
or pretty important.
ii) Are you glad you participated in this program? Yes, or YES!
Iii) Are you more likely to attend school because of this program? Yes, or
does, not apply to me.
C. A minimum of 50 students or 15% of the student population at the school(s)
(whichever is fewer), served by the SAP within each CPWI community will
receive selective/indicated services and the remaining SAP time will be
spent on universal prevention activities.
D. At the end of each school year, HCA will review and analyze data with
commencement of school-based services to determine that each ESD has
successfully met the identified goals as identified in section 4.3.3.A -C.
E. If the ESD does not meet the requirements of the Performance Work
Statement, the ESD will be asked to submit to the HCA Contract Manager
a Corrective Action Plan (CAP) within 30 days of notification. The plan
must identify the problems causing failure to reach the goal and provide a
plan for addressing those problems.
i) Once a CAP is required, if at the closure of the following school year,
the ESD is still not meeting the requirements of the Performance
Work Statement and successfully closed the CAP, HCA may reduce
Washington State 65 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
the coordination funding for ESDs by eight percent (8%) for the next
school year.
Once a CAP is closed and the Performance Work Statement is met
full funding will be restored for the next school year. If the ESD fails met,
meet the requirements, the corrective action/funding reduction
process will begin again.
iii) The ESD may submit a request for performance measures to be
waived due to extenuating circumstances. Requests must be received
as part of the Performance Evaluation process. Request should
include related sites and justification for why measure could not be
met. HCA will review and if approved, waive the CAP requirements.
4.4 SAPISP Planning for Services
4.4.1 ESD will participate in regularly scheduled meetings with HCA regarding planning
g gp g
to include, but not limited to, the following items for discussion:
A. Contractual expectations and relationship between HCA and ESDs;
B. Reporting requirements and system for reporting;
C. Streamlining and clarification of required project and reporting( fiscal and
program) timelines;
D. Clarification and alignment of fiscal terminology and (i.e.,
methodolo iesg
match clarification defining terms "admin" vs "indirect");
E. Outcome goals including expected numbers served and Performance Work
Statement;
F. Focus of SAP services including opportunities for enhancements;
G. Future of workforce enhancement funding tracking and reporting; • and
H. SAPISP Training Plan for new hires.
4.4.2 ESD will participate in meetings with HCA regarding planning for SAPISP service
as related to efforts necessary to potential for long-term contracting for continued
provision of quality student prevention and intervention services within schools.
Washington State 66 HCA Contract #K6946
Health Care Authority Attachment 2- SOW CPWI Schools
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT 3: TASK ORDER #03 — CBO
Community Based Organization Services
1. Purpose
The purpose of this Task Order is to provide quality and culturally competent Evidence -
Based Programs, Research -Based Programs, and Promising Programs rams to address
,
Substance Use Disorder Prevention and Mental Health Promotion Programs and/or
Suicide Prevention. Contractors will implement direct primary preventionrams
ro
p g ,
environmental and public education strategies to prevent and reduce substance use
and/or promote mental wellness and prevent suicide in high need communities.
2. Term
The initial term of this Task Order begins July 1, 2023, and ends June 30, 2025 unless
terminated sooner as provided herein; work performed prior to the Effective Date will be at
the sole risk of Contractor. This Task Order may be extended in whatever time increments
HCA deems appropriate.
This Task Order shall be in effect only when funding is included in the Awards and
Revenue incorporated by reference.
3. Contacts
As designated on the A&R/FSI document for Contract Manager information related to this
task order.
4. Statement of Work ,
Contractor shall ensure services, and staff, and otherwise do all things necessary for or
,
incidental to the performance of work, as set forth belowin this section.
I.
Contractor must manage the Contract to ensure that services are provided in a manner
that allocates the available resources over the life of the Contract utilizingonly th
y e funding
assigned within each respective fiscal year.
HCA reserves the right to reduce the funds awarded in the Contract if the Contractor does
not implement services within 45 calendar days of the services start date in the approved
Action Plan.
Prevention programs and services include, but are not limited to:
4.1 Implementation of Prevention Services.
Contractor must implement the approved programs and strategies in accordance with
approved Action Plan and as outlined below:
Washington State 67 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
4.1.1 Program implementation must be in alignment with the approved Action Plan and
Budget as negotiated between Contractor and HCA. This includes the approved
program(s), dates and timelines, scope, dosage, target audience(s), leadership,
and responsible parties.
4.1.2 If requested by HCA, submit a revised Action Plan and/or Budget to
accommodate federal or state funding requirements within 15 days of executed
contact or as needed. Contractor must receive approval of Action Planp rior to
implementation and spending.
4.1.3 Funds must only be used to support program costs included in the approved
Action Plan. This includes staff for program planning, training, implementation
service data entry, and evaluation.
4.1.4 Programs must be implemented for the target audience for which they were
designed, in an ongoing cycle, and within the communities designated in the
HCA approved Action Plan.
4.1.5 Ensure only program facilitators which are formally trained or certified as trainers
are used for the program(s) selected, if indicated as necessary by the program.
4.1.6 Ensure program is implemented with full fidelity. Specified adaptations must be
submitted in writing, via email, to the HCA Contract Manager for approval no less
than twenty (20) days in advance of program implementation. Specified
adaptations may not affect the core components of the program.
4.1.7 All mentoring programs must be implementing the 4th edition of the Elements of
Effective Practice for Mentoring, htt s://www.mentorin .er /resource/elements-
of-effective- ractice-for-mentorin / .
4.1.3 Participate in monthly check-in phone calls with HCA Contract Manager or
designee. Frequency of check-in calls may change if deemed appropriate by
HCA and will be based on technical assistance needs and contract compliance.
4.1.9 Contractor shall ensure that a regular annual schedule of direct prevention
services for public dissemination is established.
4.1.10 Regular annual schedule shall take into account items including, but not limited
to: implementation times that maximize participation and service outcomes; local
needs and gaps; leveraged resources; and, other locally identified factors that
influence service delivery throughout the year.
4.1.11 Regular annual schedule and community dissemination plan shall be identified
as part of the CBO Action Plan and Budget Update and submitted to Contract
Manager or designee for HCA review annually.
Washington State 68 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
A. Submit an annual Action Plan and Budget with projected expenditures
including salary and benefits for HCA funded prevention staff, program
costs, training and travel to the Contract Manager or designee, or within
thirty (30) business days upon request. A template will be provided at least
thirty (30) business days prior to due date, unless otherwise specified.
Updated Action Plan and Budget is due by June 15 of each year that this
Contract is active, unless otherwise specified in writing Budget adjustments
that are ten percent (10%) or more of the total of the approved Contractor
budget shall submit a budget revision for approval to Contract Manager or
designee at least fifteen (15) business days prior to expending adjusted
budget items. Approval must be granted prior to expending funds.
B. Enter approved programs, based on the priorities, goals and objectives
described in the approved Action Plan, into Minerva within thirty (30)
business days of Action Plan approval or as directed by PSM.
4.1 Contractors must follow funding specific requirements as outlined below:
4.1.1 SOR Program Requirements:
A. State Opioid Response (SOR) funds shall be used for program and
strategy training and implementation.
B. All programs planned and implemented with SOR shall be programs
selected from the current DBHR provided youth opioid use prevention and
reduction program list as outlined by DBHR and in accordance with
approved Action Plan.
C. For SOR grants, ensure sixty percent (60%) of programs supported b
pp Y
HCA funds will be replications or approved adaptations of "Evidence -based
Practice" substance use disorder prevention programs as identified in the
list provided by DBHR. Ensure that all of the programs supported by HCA
meet the Center for Substance Abuse Prevention's (CSAP) Principles of
Substance Abuse Prevention, found on the Athena Forum Website:
www.TheAthenaForum.or /CSAP rinci les.
D. All contractors are required to:
i) Implement at least one Direct Service Program or Strategy on the
Opioid Prevention Direct Service Programs and Strategies list. The
program is expected to be implemented on a regular annual schedule
over the course of the grant year, which may mean implementing
multiple series or cycles of a program.
Washington State
Health Care Authority
Participate in the National Drug Take -Back Days (information
dissemination strategy) held in April and October each year, or at
least twice annually based on local implementation, according to the
Drug Enforcement Agency (DEA) guidelines, recommendations, and
regulations.
bttPs://www.deadiversion.usdoi.qov/drug disr)osal/takeback/poc.htm.
HCA Contract #K6946
Attachment 3: SOW CBO
oocuoignEnvelope ID: 4oacooA1+:eo+*1 1e8
�U
Implementation ofthe Starts with One oo�� prevention public
eduoet�noonlpo' nUnfommat�n'dissemination .
Implementation means tohave arecurring cycle (at
monthly) ofmedia reach, through oneormoremediuma`ocia
|
media, ads, radio, billboards, traditional nedio).Local implementationand/or translations may occur in consultation with HCA/DBHR.
E Optional programs and strategiesthat are allowed, assuming requirements
U
Implementation ofopioid prevention anvnonmento|.y�uot
beopprovodbv[JBH�� ~' --
iU
Social Norms Campaign Unfonnationdisoenmineton:
guidance must be followed according to:htip.s.;I/theathenaforu m-. orq/social norms. ~''
Must beapproved b»[)BHR.
4.1.2 DCA Program Requirements:
A. Dedicated Cannabis Account Funds (DCA) shall be used for program and
strategy training and implementation.
B. All programs planned and implemented with DCA shall beprograms
selected from the current DBHRprovided Prevention Program and
Strategies for Youth Cannabis Use Prevention list asoutlined by DBHR
and found ot htt.ps://www.theathenaforum.grg/EBP.
C. All contractors are required tootaminimum:
U /nm Gtkeostone Direct Service
Program
http
....s://www.theathenaforum.o.rq/EBP. The program is expected to be
implemented on a regular annual schedule over the course of the
grant year, wh.ich may mean implementing multiple series or cycles of
iU
Once two C8ormore roh-BeaedProgremoare
selected, Contractor may select one (1)Promising Program.
4.1.3 IVIIHIPP Program Requirements:
A. MHPP funds shall be used for program and strategy training and
implementation.
B.All programs planned and implemented with MHPP shall beprograms
selected from the current [)BHRprovided onthe Prevention Program and
Strategies for MHP/Suicide prevention list aeoutlined bv[)BHRand found
at htt.g.s://www.th(4athenaforum.o[q
C. All contractors are required to at minimum:
U |[n etka�atoneD�oot8en/�eproo
, p="='^ Program ~~
on the
WHpP/8uicideprevention list. The program expected to
implemented onaregular annual schedule over the course ofthe
Washington State '70 HCA Contract #K0846
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
grant year, which may mean implementing multiple series or cycles of
a program.
A minimum of one(1) Youth Mental Health First Aid (YMHFA) training
per year will be provided and must include the following:
a) Must be delivered by certified YMHFA instructors;
b) Must take place in the community identified in the application;
c) Must utilize the training curriculum and instructional materials
associated with Youth Mental Health First Aid, a trademarked
program marketed by the National Council for Behavioral Health,
htt ://www.thenationalcouncil.or /about/mental-health-first-aid.
d) Up to $5,000 from this award can be used to support
implementation of each required YMHFA training in Year 1 and
Year 2, not to exceed $5,000 per state fiscal year and for a total
of $10,000 over the grant period. Eligible expenses include
trainer fees, materials, facility rental and all other expenses
associated with the training.
e) These funds can be used to train individuals to participate in
YMHFA Training of Trainers.
f) Must be delivered in one of the following formats:
1. One (1) session with eight (8) hours of instruction: or,
2. Two (2) sessions with a total of eight (8) hours of instruction;
g) Contractor must implement, with fidelity, one (1) required YMHFA
Trainings per state fiscal year.
h) If Contractor has previously held a contract with HCA for
MHPP/Suicide Prevention CBO services and has fully saturated
their Community with this training, they may submit a request for
an exception to this requirement. This must be approved by the
HCA Contract Manager.
Contractor will implement at least one (1) community awareness
event per fiscal year, focusing on mental health promotion or suicide
prevention, or both.
4.1.4 Opioid Abatement Settlement Account (DASA) Program Requirements:
A. Opioid Abatement Settlement Account (OASA) funds shall be used for
program and strategy training and implementation.
B. All programs planned and implemented with OSF shall be programs
selected from the current DBHR provided Prevention Program and
Strategies for Opioid Use Prevention list as outlined by DBHR and found at
Washington State
Health Care Authority
71
HCA Contract #K6946
Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
https://www.theathenaforum.org/EBP and in accordance with approved
Action Plan.
C. For OASA grants, ensure sixty percent (60%) of programs supported by
HCA funds will be replications or approved adaptations of "Evidence -based
Practice" substance use disorder prevention programs as identified in the
Prevention Program and Strategies for Opioid Use Prevention list provided
by DBHR. Ensure that all of the programs supported by HCA meet the
Center for Substance Abuse Prevention's (CSAP) Principles of Substance
Abuse Prevention, found on the Athena Forum Website:
www. TheAthenaForum . org/CSAPprinciples.
D. All contractors are required to:
i) Implement at least one Direct Service Program or Strategy on the
Prevention Program and Strategies for Opioid Use Prevention. The
program is expected to be implemented on a regular annual schedule
over the course of the grant year, which may mean implementing
multiple series or cycles of a program.
Participate in the National Drug Take -Back Days (information
dissemination strategy) held in April and October each year, or at
least twice annually based on local implementation, according to the
Drug Enforcement Agency (DEA) guidelines, recommendations, and
regulations.
htt §--://www. dead iversion.usdoi. ov/drug dis osal/takeb.agk/poc.htm.
iii) Implementation of the Starts with One opioid prevention public
education campaign (information dissemination strategy).
Implementation means to have a recurring cycle (at least once
monthly) of media reach, through one or more mediums (social
media, ads, radio, billboards, traditional media). Local implementation
and/or translations may occur in consultation with HCA/DBHR.
E. Optional programs and strategies that are allowed, assuming requirements
above are met:
i) Implementation of opioid prevention environmental strategy/ies. Must
be approved by DBHR
Social Norms Campaign (information dissemination strategy):
guidance must be followed according to:
https;//theathenaforum.orq/socialnorms. Must be approved by DBHR.
4.2 Prevention Training
4.2.1 Required Training in CBO
A. Contractor shall participate in all required onboarding training events
identified by HCA at the start of the contract. To include but not limited to
Washington State 72 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
trainings on fiscal requirements, contract compliance, data reporting and
program implementation. -
B. Contractor Manager for this Task Order as identified in the A&R/FSI
document and primary fiscal staff or their designee(s) shall attend an
annual contractor training or meeting that will be scheduled for a minimum
of four (4) hours in duration. Date and location will be announced by DBHR
at least thirty (30) business days prior to the training.
C. Contractor contact shall participate in all required training events identified
by HCA and listed in CBO Community Implementation Guide.
4.2.2 Non -Required Training in CBO contracts
A. In the absence of trainings identified in the approved Action Plan, all
additional (non -required) training paid for by HCA shall be approved by
Contract Manager or designee prior to training and meet the approved
goals and objectives in approved Action Plan.
B. Contractor shall ensure any requests for training in addition to the
approved training in the Action Plan are requested in writing and sent
directly to the Contract Manager or designee, a minimum of ten (10)
business days before the date of the proposed training. Trainings shall
relate to one (1) of the following four (4) categories:
i) Coalition building and/or community organization.
Capacity building regarding prevention theory and practice.
iii) Capacity building for Evidence -based Practice and environmental
strategy implementation, related to the goals and objectives of the
approved Action Plan.
iv) Capacity building in non-CPWI communities to expand CBO efforts
and meets overall goals and objectives of CBO grants may be
approved by Contract Manager or designee upon request.
C. Contractor shall ensure training paid for by HCA that requires travel follows
state travel reimbursement guidelines and rates accessible at -�
www.ofm.wa. ov/ olic /10.90.htm.
D. Contractor shall bill for training events on an A-19 invoice templateer
billingp
code according to the Substance Use Disorder and Mental Health
f Promotion Services Billing Guide and record training events in the HCA
Substance Use Disorder Prevention and Mental Health Promotion Online
Reporting Systems or Minerva in accordance with the monthly reporting
requirements described in Prevention Report Schedule/Due Dates.
4.3 Reporting Requirements
Contractor shall report on all requirements as identified in the HCA Substance
Use Disorder Prevention and Mental Health Promotion Online Reporting p rting System
Washington State 73 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
or Minerva. HCA reserves the right to add reporting requirements based on the
requirements of funding sources.
4.3.1 Prevention Activity Data Reports
Contractor shall:
A. Ensure that monthly prevention activities are reported in Minerva in
accordance with the requirements and timelines set forth.
B. Ensure accurate and unduplicated reporting.
C. Ensure proper training of staff and designated staff for back-up Minerva
data entry to meet report due dates.
D. If special circumstances arise and Contractor is unable to enter the data by
the reporting deadline(s), Contractor shall ensure any requests for
extensions to reporting deadlines are requested in writing and sent directly
to the PSM via email five (5) business days before the report due date.
E. The maximum extension request permitted is ten (10) business days.
F. Monthly invoices submitted with active data entry extensions will be denied
and may be re -submitted by Contractor once data for the month(s) in
question is complete.
G. Contractors with three (3) or more consecutive months of data entry
extensions or late reporting or four (4) or more program data entry
extensions or late reporting within a six (6) month period shall be required
to submit a Corrective Action Plan to HCA.
H. Extensions granted due to Minerva technical issues will be excluded from
this count.
I. Ensure all required demographic information is provided for individual
participant; population reach; aggregate; and mentoring or 1 -to -1 services
in Minerva.
J. Report Community Coalition Coordination Staff Hours in Minerva for each
month of the calendar year.
K. Complete prevention reporting, according to the Schedule/Due Dates
below:
Washington State
Health Care Authority
'Reporting
PeriodDates
Reports)
Report Due
Reporl.11ting
System
Minerva
Annually
Enter programs listed on
Within 30
and as
approved Action Plan by
business
Action
HCA into Minerva.
days of
Plan
revisions
74
HCA Contract #K6946
Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
are
Action Plan
approved
approval
Monthly
Prevention activity data
15th of each
Minerva
input for all active
month for
services including
activities
coordination staff hours
from the
and efforts, services,
previous
participant information,
month
training, evaluation tools
and assessments.
As
GPRA Measures.
As requested
Minerva or as
requested
required
As
As required by SAMHSA
As requested
Minerva or as
requested
or HCA/DBHR.
required
4.3.2 Outcome Measures
A. Contractor shall report on all required evaluation tools identified in Minerva
that measure primary program objective.
i) Pre/Post test are required for all recurring direct service programs.
ii) Specific surveys for Information Dissemination or Environmental
strategies/programs based on specific program to be determined and
approved in Action Plan.
B. Special situations and exceptions regarding evaluation tools identified in
Minerva include, but are not limited to, the following:
i) Contractor may negotiate with the Contract Manager or designee to
reduce multiple administrations of surveys to individual participants.
ii) Participants in recurring program groups in which the majority of
participants are younger than ten (10) years old on the date of that
group's first service.
4.3.3 Performance Work Statement/Evaluation.
A. Contractor shall ensure program results show positive outcomes for at
least half of the participants in each program group as determined by
Cohorts/Campaigns with individual participant sessions.
i) "Positive outcomes" means that at least half of the participants in a
group report positive Improvement or maintenance as determined by
the program measurable objective between pre and post-tests.
Washington State 75 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Positive outcomes will be determined using the pre-test and post-test
data reported in Minerva.
iii) Evaluation of Minerva data will occur on the 15th of the month
following the final date of service for each group.
B. HCA shall use the following protocol for evaluation:
i) Matched pre-test and post-test pairs will be used in the analysis.
ii) To allow for normal attendance drop-off, a 20% leeway will be given
for missing post-tests.
If there are missing post-tests for entered pre-tests in excess of 20%
of pre-tests, missing post-test will be counted as a negative outcome.
iv) Example: there are ten (10) pre-tests and seven (7) post-tests. The
denominator would be eight (8) and the maximum numerator would
be seven (7).
C. Different groups, as determined by Cohorts/Campaigns, receiving the
same program will be clustered by school district.
i) In cases where multiple providers are serving the same school district,
groups will be clustered by school district and provider.
ii) The results of one (1) provider in a given school district will not impact
another provider in the same district.
a) In cases where the survey instrument selected for a given
program includes more than one scale, the scale that is most
closely aligned with the measurable objective linked to the
program in Minerva will be used.
b) Results for groups, as determined by Cohorts/Campaigns, with
services that span two (2) contracting periods will be analyzed in
the contracting period that the post-test was administered.
iii) If fewer than half of the participants in a group, as determined by
Cohorts/Campaigns, within a given school district, report positive
change in the intended outcome:
a) Contractor shall submit a Performance Improvement Plan (PIP)
� for the non-compliant program to the Contract Manager or
designee or designee within forty-five (45) calendar days of
notice by HCA.
Washington State
Health Care Authority'
b) Reimbursement for the CSAP Category row on the A-19 for that
program will be held until the PIP is approved by Contractor
Manager or designee or their designee.
c) If a second group, as determined by Cohorts/Campaigns, within
that same school district has fewer than half of the participants
report positive change in the intended outcome, then the
following steps will be taken:
76
HCA Contract #K6946
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i. In cases where there is no active non-compliant
program, Contractor shall discontinue implementation
of that program within the specified geography.
ii. In cases where the same programs as the non-
compliant program are active and continuing in the
same school district, those groups, as determined by
Cohorts/Campaigns; will be allowed to complete the
expected number of sessions. No new groups, as
determined by Cohorts/Campaigns, will be started.
iii. Following the conclusion of all groups, as determined
by Cohorts/Campaigns, completing the program,
results will be reviewed for those groups.
iv. If the results do not show positive change for each
group, as determined by Cohorts/Campaigns,
Contractor shall take the following action:
1. In cases where the program is being delivered
by a single provider in the specified geography,
Contractor shall discontinue implementation of
that program in the specified geography.
2. In cases where the program is being delivered
by multiple providers in the specified
geography, Contractor shall discontinue
implementation of that program by the
underperforming provider in the specified
geography.
iv) A program that resulted in the need for a Performance Improvement
Plan and Plan during the former Contract period will not carry that
record forward into the new Contract period. Implement and monitor
prevention programs and reporting to assure compliance with these
guidelines.
Washington State 77 HCA Contract #K6946
Health Care Authority Attachment 3: SOW CBO
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT 4: DATA SHARING TERMS
1. Description of Data to be Shared/ Data Licensing Statements
1.1 Contractors collect various data elements associated with prevention programming and
service delivery. The Data will be provided by contractors on a monthly and aquarterly
basis and entered into Minerva and/or the SAPSIS reporting systems.
1.2 Data Use Purpose. The data is used by state and local providers for contract
.management, program monitoring, and to evaluate outcomes.
1.3 Data elements associated with prevention programming including but not limited to:
A. Program and service details such as:
i. Name of program
ii. Program length in time and date
iii. Target service populations
iv. Target age groups
V. Location of activity
vi. Number of participants
vii. Survey instruments used as well as fidelity plan
viii. Indirect and direct hours contributed by program staff and community
coalition coordinators
ix. EBP status
X. CSAP strategy and service code
A. IOM category
xii. Target substance and behavioral health problem
1.4 The Data may be linked with the following: contract management and cost analysis via
Powel-Bl.
2. HCA System Access Requirements and Process
2.1 The Contractor may request access to the Minerva and/or the SAPSIS reporting systems
for up to sixty (60) Authorized Users under this Contract.
2.2 The Contractor Contract Manager, identified in Section 2.4 must send the request to the
HCA Prevention MIS manager at PrevMLS-CcD-hca wa.g,ov.
2.3 The Contractor must access the system(s) through the State Governmental Network
(SGN), or SecureAccessWashington (SAW), or through another method of secure access
approved by HCA in writing.
Washington State 78 HCA Contract #K6946
Health Care Authority Attachment 4: Data Sharing Terms
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
2.4 Contractor Point of Contact. The Contractor Point of Contact will be the single source ce of
access requests and the person HCA will contact for any follow-up information or to
initiate an audit under this Contract. Initial point of contact is the person named as
Contract Contact on Face page. Contractor Point of Contact may be changed by written
notice to the HCA Prevention MIS manager, email acceptable, with a copy to the HCA
Contract Manager and HCA Office of Contracts and Procurements at
contracts hca.wa. ov.
2.5 HCA will grant the appropriate access permissions to Contractor Authorized Users
with I n
30 calendar days from the date of receipt of a complete and accurate request form. HCA
A
will respond within 5 business days of receipt of request form if there is a need for
clarification or revisions to any inaccurate or incomplete request form(s).
2.6 HCA does not allow shared User IDs and passwords for use with Confidential Information
or to access systems that contain Confidential Information. Contractor must ensure that
only Authorized Users access and use the system(s) in this Contract, use onlytheir
own
User ID and password to access the system(s), and do not allow employees or others
who are not authorized to borrow a User ID or password to access any system(s).
stem(s) .
2.7 Contractor must notify HCA within 5 business days whenever an Authorized User who has
access to the Data is no longer employed by the Receiving Part or whenever an
Authorized User's duties change such that the user no longer requires access to the Data.
2.8 Contractor's access to the systems may be continuously tracked and monitored. HCA
reserves the right, at any time, to terminate Data access for an individual, conduct audits
of system(s) access and use, and to investigate possible violations of this Contract and/or
violations of federal and state laws and regulations governing access to PHI.
3. Data Classification
The State classifies data into categories based on the sensitivity of the dataursuant t
p o the
Security policy and standards promulgated by the Office of the state of Washington Chief
ref
Information Officer. (See Section 4, Data Security, of Securing IT Assets Standards No.
141.10 in the State Technology Manual at htt s://ocio.wa. ov/ olicies/14'1-securin -
information-technolo -assets/14110-securin -information-technolo -assets.
The Data that is -the subject of this Contract is classified as indicated below:
3.1 ❑ Category 1 — Public Information
Public information is information that .can be or currently is released to theublic. It does es not
need protection from unauthorized disclosure but does need integrity and availability protection
3.2 ❑ Category 2 — Sensitive Information
Sensitive information may not be specifically protected from disclosure b law and is
Y for official
use only. Sensitive information is generally not released to the public unless specifically
requested. p Y
3.3 R Category 3 — Confidential Information
Washington State 79 HCA Contract #K6946
Health Care Authority Attachment 4: Data Sharing Terms
,. g
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
Confidential information is information that is specifically protected from disclosure
by law. It
may include but Is not limited to:
A. Personal Information about individuals, regardless of how that information is
obtained;
B. Information concerning employee personnel records;
C. Information regarding IT infrastructure and security of computer and
telecommunications systems;
3.4 ❑ Category 4 — Confidential Information Requiring Special Handling
Confidential information requiring special handling is information that is specifically protected
from disclosure by law and for which:
p
A. Especially strict handling requirements are dictated, such as by statutes,
regulations, or agreements;
B. Serious consequences could arise from unauthorized disclosure, such as
threats to health and safety, or legal sanctions.
4. Constraints on Use of Data/Limited License
4.1 Subject to the Terms and Conditions of this Contract, HCA hereby grants Contractor a
limited license for the access and Permissible Use of Data. This grant of access may not
be deemed as providing Contractor with ownership rights to the Data. The Data being
shared/accessed is owned and belongs to HCA.
4.2 For Limited Data Sets, Contractor agrees to not attempt to re -identify individuals in the
Data shared or attempt to contact said individuals.
4.3 If Data shared under this Contract includes data protected by 42 C.F.R. Part 2. In
accordance with 42 C.F.R. § 2.32, this Data has been disclosed from records protected by
federal confidentiality rules (42 C.F.R. Part 2). The federal rules prohibit Contractor from
making any further disclosure(s) of the Data that identifies a patient as having or having
had a substance use disorder either directly, by reference to publicly available information,
or through verification of such identification by another person unless further disclosure is
expressly permitted by the written consent of the individual whose information is being
disclosed or as otherwise permitted by 42 C.F.R. Part 2. A general authorization for the
release of medical or other information is NOT sufficient for this purpose (42 C.F.R. §
2.31). The federal rules restrict any use of the SUD data to investigate or prosecute with
regard to a crime any patient with a substance use disorder, except as provided at 42
C.F.R. §§ 2.12(c)(5) and 2.65.
4.4 This Contract does not constitute a release of the Data for the Contractor's discretionary
use. Contractor must use the Data received or accessed under this Contract onlyto
carry
out the purpose and justification of this Contract as set out in the Data Licensing
Statement(s). Any analysis, use, or reporting that is not within the Purpose of this
p Contract
Is not permitted without HCA's prior written consent.
Washington State 80 HCA Contract #K6946
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4.5 This Contract does not constitute a release for Contractor to share the Data with any third
parties, including Subcontractors, even if for authorized use(s) under this Contract, without
the third party release being approved in advance by HCA and identified in the Data
Licensing Statement(s).
4.6 Derivative Data Product Review and Release Process.
A. All reports derived from Data shared under this Contract,roduced b
p Y
Contractor that are created with the intention of being published for or shared
with external customers (Data Product(s)) must be sent to HCA for review of
usability, data sensitivity, data accuracy, completeness, and consistency with
HCA standards prior to disclosure. This review will be conducted, and response
of suggestions, concerns, approval, or notification of additional review time
needed provided to Receiving Party within 10 business days. HCA reserves the
right to extend the review period as needed for approval or denial.
B. Small Numbers. Contractor will adhere to HCA Small Numbers Standards
Attachment C. HCA and Contractor may agree to individual Permissible Use
exceptions to the Small Numbers Standards, in writing (email )
acce table .
p
4.7 Any disclosure of Data contrary to this Contract is unauthorized and is subject to penalties
identified in law.
�
4.8 The Receiving Party must comply with the Minimum Necessary Standard, which means
that Receiving Party will use the least amount of PHI necessary to accomplish the
Purpose of sharing as described in the attached Attachment A(s): Data Licensing
Statement(s).
A. Receiving Party must identify:
Those persons or classes of persons in its workforce who need access to PHI
to carry out their duties; and
ii. For each such person or class of persons, the category or categories of PHI
to which access is needed and any conditions appropriate to such access.
B. Receiving Party must implement policies and procedures that limit the PHI
disclosed to such persons or classes of persons to the amount reasonably
necessary to achieve the purpose of the disclosure, in accordance with the
attached Data Licensing Statement(s).
5. Data Modification(s)
Any modification to the Purpose, Justification, Description of Data to be Shared/Data
Licensing Statement(s), and Permissible Use, is required to be approved through H '
pp g HCA's Data
Request Process. Contractor must notify HCA's Contract an Manager of requested g Y q changes
to the Data elements, use, records linking needs, research needs, and an other changes
from this Contract, immediate) to start Y nges
y rt the review process. Approved changes will be
documented in an Amendment to the Contract.
Washington State 81 HCA Contract #K6946
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DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
6. Security of Data
6.1 Data Protection
The Contractor must protect and maintain all Confidential Informationained b
g y reason of this
Contract against unauthorized use, access, disclosure, modificatiGn, or loss. This duty
the Contractor to employ reasonable securityme requires
measures, which Include restricting access to the
Confidential Information by:
A. Allowing access only to staff that have an authorized business requirement to
view the Confidential Information.
B. Physically securing any computers, documents,, or other media containing the
Confidential Information.
6.2 Data Security Standards
.Contractor must comply with the Data Security Requirements set out in Attachment B and the
Washington OCIO Security Standard, 141.10 (http,s:Hocio.wa. ov/ olicies/141-securin -
Informatlan-technolo -assets/14110-securin -information-technola -assets.
6.3 Data Disposition and Retention
A. Contractor will dispose of HCA Data in accordance with this section.
B. Upon request by HCA, or at the end of the Contract term, or when no longer
needed, Confidential Information/Data must be disposed of as set out in
Attachment A, Section 5 Data Disposition, except as required to be maintained
for compliance or accounting purposes. Contractor will provide written
certification to HCA of disposition using Attachment D, Certification of
Destruction/Disposition of Confidential Information.
7. Data Confidentiality and Non -Disclosure
7.1 Data Confidentiality.
The Contractor will not use, publish, transfer, sell, or otherwise disclose an Confidential
al
Information gained by reason of this Contract for any purpose that is not directly connected with
the purpose, Justification, and Permissible Use of this Contract,, as set out in the attached Data
Licensing Statement(s), except: (a) as provided by law; or (b) with therior written consent ent of
the person or personal representative of the person who is the subject of the Data.
7.2 Non -Disclosure of Data
The Contractor must ensure that all employees or Subcontractors who will have access to the
Data described in this Contract (including both employees who will use the Data and IT support
staff are instructed and made aware of the use restrictions and protection requirements of this
Contract before gaining access to the Data identified herein. The Contractor will also instruct
and, make any new employee aware of the use restrictions and protection requirements of this
Contract before they gain access to the Data.
The Contractor will ensure that each employee or Subcontractor who will access the Data signs
the User Agreement on Non -Disclosure of Confidential Information, Attachment D hereto. The
Washington State 82 HCA Contract #K6946
Health Care Authority Attachment 4: Data Sharin Terms
g
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Contractor will retain the signed copy of the User Agreement on Non -Disclosure of Confidential
Information in each employee's personnel file for a minimum of six ears from the date
'employee's access to the Data Y the
Y ends. The documentation must be available to HCA upon
request.
7.3 Penalties for Unauthorized Disclosure of Data
Applicable state laws and federal regulations prohibit unauthorized access use or disclosure of
Confidential Information. Violation of these laws may result in criminal or civilenalties
p or fines.
The Contractor accepts full responsibility and liability for any noncompliance b itself,
p y its
employees, and its Subcontractors with these laws and any violations of the Contract.
8. Data Shared with Subcontractors
If Data access is to be provided to a Subcontractor under this Contract it will onlybe for
the
Permissible Use authorized by HCA and the Contractor must Include all of the Data security
terms, conditions and requirements set forth in this Attach
Attachment In any such Subcontract. In no
event will the existence of the Subcontract operate to release or reduce the liabilityof the
Contractor to HCA for an Data Breach in the
Y performance of the Contractor's responsibilities.
9. Audit
At HCA's request or in accordance with OCIO 141.10, the Contractor must respond to audit
inquiries.
p
10. Data Breach Notification and Obligations
10.1 The Data Breach or potential compromise of Data shared under this Contract must be
reported to the HCA Privacy Officer at Privac Officer hca.wa. ov within one 1 business
day of discovery.
10.2 If the Data Breach or potential compromise of Data includes PHI, and the Contractor does
not have full details, it will report what information it has and provide full details within
fifteen (15) Business Days of discovery. To the extent possible, these reports must include
the following:
p
A. The identification of each individual whose PHI has been or mayhave been
improperly accessed, acquired, used, or disclosed.
B. The nature of the unauthorized use or disclosure, includinga brief description o
p f
what happened, the date of the event(s), and the date of discovery.
C. A description of the types of PHI involved;
D. The investigative and remedial actions the Contractor or its Subcontractor took
or will take to prevent and mitigate harmful effects and protect against
recurrence.
E. Any details necessary for a determination of the potential harm to Clients
whose PHI is believed to have been used or disclosed and the steps those
Clients should take to protect themselves; and,
Washington State 83 HCA Contract #K6946
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F. Any other information HCA reasonably requests.
10.3 The Contractor must also take actions to mitigate the risk of loss and comply p y wifih any
notification or other requirements imposed by law or HCA includingbut not limited
to 45
C. F. R. Part 164 Subpart D; RCW 42.56.590; RCW 19.255.010; or WAC 284-04-
625.
10.4 If notification must, in the sole judgement of HCA must be made Contractor well further
cooperate and facilitate notification to necessary individuals, to the U.S. Health and Human Services
Department of
p Secretary, and to the media. At HCA's discretion,
Contractor may be required to directly perform notification requirements, or if HCA CA elects
to perform the. notifications, Contractor must reimburse HCA for all costs associated with
notification (s).
10.5 Contractor is responsible for all costs incurred in connection with a security Incident, Data
Breach, or potential compromise of Data, including:
A. The reasonable costs of notification to individuals, media, andovernme
g ntal
agencies and of other actions HCA reasonably considers
appropriate to protect
HCA clients.
p
B. Computer forensics assistance to assess the impact of a Data Breach
determine root cause, and help determine whether and the extent to which
notification must be provided to comply with Data Breach notification laws.
C. Notification and call center services, and other appropriate services (as
determined exclusively by HCA) for individuals affected by a securityincident t or
Data Breach, including fraud prevention, credit monitoring, and identify theft
assistance; and
D. Regulatory defense, fines, and penalties from any claim in the form of a
regulatory proceeding resulting from a violation of any applicable privacy or
security law(s) or regulation(s).
E. Compensation to HCA clients for harms caused to them by any Data Breach or
possible Data Breach.
10.6 Any Breach of this section may result in termination of the Contract and the demand for
return or disposition, as described in Section 6.3, of all HCA Data.
10.7 Contractor's obligations regarding Data Breach notification survive the termination of this
Contract and continue for as long as Contractor maintains the Data and for any Data
Breach or potential compromise, at any time.
11. HIPAA Compliance
11.1 Contractor must perform all of its duties, activities, and tasks under this Attachment In
compliance with HIPAA, and all applicable regulations as promulgated b the U.S.
Department of Health g y
p and Human Services, Office for Civil Rights, as applicable.
11.2 Within ten (10) Business Days, Contractor must notify the HCA Privacy Officer at
Privac Officer hca.wa. ov of any complaint, enforcement, or compliance action coon initiated
by the Office for Civil Rights based on an allegation of violation of HIPAA and
must inform
Washington State 84 HCA Contract #K6946
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HCA of the outcome of that action. Contractor bears all responsibility for
p Y any penalties,
altles,
fines, or sanctions imposed against Contractor for violations of HIPAA and for any
sanction Imposed against its Subcontractors or agents for which it is found liable.
12. Survival Clauses
The terms and conditions contained in this Attachment that by their sense and context are
intended to survive the expiration or other termination of this Attachment must survive.
Surviving terms Include but are not limited to: Constraints on Use of Data /Limited License,
Security of Data, Data Confidentiality and Non -Disclosure, Audit, HIPAA Compliance,
Data Breach Notification and Obligations. and
Washington State 85 HCA Contract #K6946
Health Care Authority Attachment 4: Data Sharing Terms
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT A: DATA SECURITY REQUIREMENTS
1. Definitions
In addition to the definitions set out in the Data Use, Security, and Confidentiality Attachment, thedefinitions below apply to this Attachment.
1.1 "Hardened Password" means a string of characters containingat least three
of the
following character classes: upper case letters; lower case letters; numerals; and special
characters, such as an asterisk, ampersand or exclamation point.
A. Passwords for external authentication must be a minimum of 10 characters long.
B. Passwords for internal authentication must be a minimum of 8 characters long.
C. Passwords used for system service or service accounts must be a minimum
of 20
characters long.
1.2 "Portable/Removable Media" means any data storage device that can be detached or
removed from a computer and transported, including but not limited to: optical media(e.g.
CDs DVDs � USB r' p
), drives; or flash media (e.g. CompactFlash, SD, MMC).
1.3 "Portable/Removable Devices" means any small computingdevice that can b
e
transported, including but not limited to: hand helds/PDAs/Smartphones; Ultramobile PCs,
flash memory devices (e.g. USB flash drives, personal media
players); and
laptop/notebook/tablet computers. If used to store Confidential Information devices
should
be federal Information Processing Standards (FIPS) Level 2 compliant.
1.4 "Secured Area" means an area to which only Authorized Users have access.
Secured
Areas may include buildings, rooms, or locked storage containersfilin such as a
( g cabinet)
within a room, as long as access to the Confidential Information is not available to
unauthorized personnel.
1.5 "Transmitting" means the transferring of data electronically, such as via email, , SFTP,
webservices, AWS Snowball, etc.
1.6 "Trusted System(s)" means the following methods of physical delivery: Y ry ha nd-
delivery by
a person authorized to have access to the Confidential Information with written
acknowledgement of receipt; (2) United States Postal Service ("USPS") first class mail, or
USPS delivery services that include Tracking, such as Certified Mail Express Mail, , or
Registered Mail; (3) commercial delivery services (e.g. FedEx, UPS DHL which
� ) offer
tracking and receipt confirmation; and (4) the Washington State Campus mails stem. F
p y or
electronic transmission, the Washington State Governmental NetworkSGN
( ) is a Trusted
System for communications within that Network.
1.7 "Unique User ID" means a string of characters that identifies a specific user
p and which, in
conjunction with a password, passphrase, or other mechanism, authenticates a user to
an
information system.
2. Data Transmission
2.1 When transmitting RCA's Confidential Information electronically, including via
email, the Data
must be encrypted using NIST 800 -series approved algorithms
(hftr):Hcsrc.nista c
lov/r)ublications/PubsSPs.html). This includes transmission over the public
Internet.
Washington State 86 HCA Contract #K6946
Health Care Authority Attachment 4-A
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
2.2 When transmitting RCA's Confidential Information via paper documents the Contractor ntractor must
use a Trusted System and must be physically kept in possession of an authorizedp erson.
3. Protection of Data
Contractor agrees to store and protect Confidential Information as described:
3.1 Data at Rest:
A. Data will be encrypted with NIST 800 -series approved algorithms. Encryption g ryp keys
will be stored and protected independently of the data. Access to the Data will be
restricted to Authorized Users through the use of access control lists, a Unique
User ID, and a Hardened Password, or other authentication mechanisms which
provide equal or greater security, such as biometrics or smart cards. Systems
which contain or provide access to Confidential Information must be located in an
area that is accessible only to authorized personnel, with access controlled
through use of a key, card key, combination lock, or comparable mechanism.
B. Data stored on Portable/Removable Media or Devices:
i. Confidential Information provided by HCA on Removable Media will be
encrypted with NIST 800 -series approved algorithms. Encryption keys will be
stored and protected independently of the Data.
ii. HCA's data must not be stored by the Contractor on Portable Devices or Media
unless specifically authorized within the Contract. If so authorized, the
Contractor must protect the Data by:
a. Encrypting with NIST 800 -series approved algorithms. Encryption keys
ryp y
will be stored and protected independently of the data;
b. Control access to the devices with a Unique User ID and Hardened
Password or stronger authentication method such as a physical token or
biometrics;
c. Keeping devices in locked storage when not in use;
d. Using check-in/check-out procedures when devices are shared;
e. Maintain an inventory of devices; and
f. Ensure that when being transported outside of a Secured Area all
devices with Data are under the physical control of an Authorized User.
3.2 Paper documents. Any paper records containing Confidential Information must be protected
by storing the records in a Secured Area that is accessible only to authorized personnel.
When not in use, such records must be stored in a locked container, such as a file
cabinet,
locking drawer, or safe, to which only authorized persons have access.
4. Data Segregation
4.1 HCA's Data received under this Contract must be segregated or otherwise distinguishable
ngulshable
from non -HCA Data. This is to ensure that when no longer needed b the Contractor, tor, a I I of
HCA's Data can be identified for return or destruction. It also aids in determiningwhether
ether
HCA's Data has or may have been compromised in the event of a security breach.
HCA's Data must be kept in one of the following ways:
Washington State 87 HCA Contract #K6946
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A. on media (e.g. hard disk, optical disc, tape, etc.) which will contain onlyHCA D
or Data;
B. in a logical container on electronic media such as aartiti
p on or folder dedicated to
HCA's Data; or
C. in a database that will contain only HCA Data; or
D. within a database and will be distinguishable from non -HCA Data b the value
Y of a
specific field or fields within database records; or
E. when stored as physical paper documents, physically segregated from non -HCA
GA
Data in a drawer, folder, or other container.
4.2 When it is not feasible or practical to segregate HCA'
s Data from non HCA data, then both
HCA's Data and the non -HCA data with which it is commingled must be protected
as
described in this Attachment.
4.3 Contractor must designate and be able to identify all computingequipment on whic
h they
store, process, and maintain HCA Data. No Data at any time may be processed Y p on or
transferred to any portable storage medium. Laptop/tablet computing devices are not
considered portable storage medium devices for purposes of this Contractp rovided it is
installed with end-point encryption.
5. Data Disposition
5.1 Consistent with Chapter 40.14 RCW, Contractor shall erase, destroy, and render
unrecoverable all HCA Confidential Data and certify in writing that these actions have been
completed within thirty (30) days of the disposition requirement or termination of this
Contract, whichever is earlier. At a minimum, media sanitization is to beerformed according
cording
to the standards enumerated by NIST SP 800-88r1 Guidelines for Media Sanitization.
5.2 For HCA's Confidential Information stored on network disks deleting g unn eeded Data is
sufficient as long as the disks remain in a Secured Area and otherwise meet the
requirements listed in Section 3, above. Destruction of the Data as outlined in this section of
this Attachment may be deferred until the disks are retired, replaced, or otherwise taken out
of the Secured Area.
6. Network Security
Contractor's network security must include the following:
6.1 Network firewall provisioning;
6.2 Intrusion detection;
6.3 Quarterly vulnerability assessments; and
6.4 Annual penetration tests.
7. Application Security
Contractor must maintain and support its software and subsequent upgrades, updates,
pg �patches, and
bug fixes such that the software is
and remains secure from known vulnerabilities.
Washington State
Health Care Authority
HCA Contract #K6946
Attachment 4-A
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
9. Computer Security
Contractor shall maintain computers that access Data by ensuring the operating system and software
are updated and patched monthly, such that they remain secure from known vulnerabilities. Contractor
computer device(s) must also be installed with an Anti-Malware solution and signatures updated no
less than monthly.
9. Offshoring
9.1 Contractor must maintain all hardcopies containing Confidential Information only from
locations in the United States.
9.2 Contractor may not directly or indirectly (including through Subcontractors) transport any
Data, hardcopy or electronic, outside the United States unless it has advance written
approval from HCA.
Washington State 89 HCA Contract #K6946
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ATTACHMENT B: HCA SMALL NUMBERS STANDARD
1. Why do we need a Small Numbers Standard?
It is the Washington State Health Care Authority's (HCA) legal and ethical responsibility
privacyof its clients and mem p Ilty to protect the
members. However, HCA also supports open data and recognizes the ability
of Information to be used to further RCA's mission and vision. As HC
A continues down the path of Data
Governance maturity, establishing standards such as this is keyin helping HCA
p g analysts a n d
management meet the needs of external data requestors while maintaining the trust of our clients and
members and complying with agency, state and federal laws and policies.
Publishing data products that include small numbers creates two concerns. As a reported
in p rted number gets
smaller, the risk of re -identifying g an HCA client or member increases. This is especial) true when a
combination of variables are included in the data product Y
p t to arrive at the small number (e.g. location,
race/ethnicity, age, or other demographic information).
Small numbers can also create questions around statistical relevance. When it comes to publicly
posting data products on HCA's internet site, or sharing outside theagency, the need to
know the
exact value in a cell that is less than 11 must be questioned.
As the agency moves away from traditional, static reports to a dynamic reporting environment (e.g.
Tableau visualizations), it is easier for external data consumers to arrive at small numbers. Further,
those external consumers have an increasing amount of their own data that could be used to re -identify
individuals. As a result, more rigor and a consistent approach In roach needs to be ' place to protect the
privacy of HCA's clients and members. Until now, some HCA data teams have elected to follow small
numbers guidelines established by the Department of Health, which include examples of
p suppression
methods for working with small numbers. HCA is now establishing its own standard, but is planning to
work with DOH and other agencies dealing with healthcare data to try and develop a consistent smallnumbers methodology at a statewide level.
1. Scope
HCA often uses Category 4 data to create summary data products forublic consumption. ption. This
Standard is intended to define one of the requirements for a summarydata product to
p be considered
Category 1. Specifically, it is intended to define the level of suppression that must be
p applied to an
aggregated data product derived from Category 4 data for the data product toualif Cat
products that q Y as Category 1.
Category 1 products are data
p at are shared external to the agency, in large part those
products that are posted on HCA's Internet website (www.hca.wa.clov). The rimarprimary scope of this
Standard is for those data products posted publicly (e.g. on the website), or, shared as public
information.
The following are examples of when this Standard does not apply to data products are:
1.1 Those shared directly with an external entity outside HCA, the Standard suppression pp ssion of small
numbers would not be required. However, you should notify the recipient that the data
a
products contain sensitive information and should not be shared orp ublished.
1.2 Those exchanged under a data share agreement (DSA) that will not beosted
p or shared
outside the Contractor.
1.3 Those created for HCA -only internal use.
This standard does not supersede any federal and state laws and regulation.
Washington State 90 HCA Contract #K6946
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2. Approach
In 2017, an impromptu workgroup was formed to tackle the issue of small numbers and determine what
the general approach for handling data products that contain them would be. This initial
's Analytics, Interoperability tial effort was led
by the agenc
Y Y perability and Measurement (AIM) team who had an immediate need
for guidance in handling and sharing of data products containing small numbers. The result of that work
was a set of Interim Small Numbers Guidelines, which required suppression of cells containing values
of less than 10. In addition, data products that contain small numbers are considered
Category 2 under
HCA's Data Classification Guidelines.
In spring 2018,. a new cross -divisional and chartered Small Numbers Workgroup wa
developa formal agency scan g p s formed to
g y dard. Representatives from each of the mayor HCA divisions that produce
data and analytic products were selected. The charter, complete
p with membership, can be found here
(available to internal HCA staff only). The Workgroup considered other state agency g y standards, and
national standards and methods when forming this standard. The Workgroup also consulted business
users and managers to determine the potential impact of implementinga small numbers suppression
standard. All of this information was ppression
processed and used to form the HCA Small Numbers Standard.
3. State and National Small Numbers Standards Considered
When developing these standards, HCA reviewed other organizations' small numbers standards at
both a state and federal level. At the state level, DOH recently published a revised Small Numbers
Standard, which emphasizes the need for suppression for both privacy concerns an
p Y d statistical
relevance. HCA also convened a meeting of other state agencies to discuss their approach
policies (if an around Small Numb pp oach and
Y) Numbers. Feedback from that convening was also taken into
consideration for this Standard as well.
Federal health organizations such as the Centers for Disease Control and Prevention (CDC) and the
National Center for Health Statistics (NCHS) also maintain small numbers standards. HCA's federal
oversight agency and funding partner, the Centers for Medicare and Medicaid Services (CMS) adopts
suppression of any cell with a count of 10 or less.
4. WA Health Care Authority Small Numbers Standard
Any HCA external publication of data products are to be compliant with both HIPAA
and Washington
State privacy laws. Data products are not to contain small numbers that could allow-
re identification of
individual beneficiaries. HCA analysts are to adhere to the following requirements when developingCategorY 1 data products for distribution and publication. Category
1 data is information that can be
released to the public. These products do not need protection from unauthorized disclosure but do
need integrity and availability protection controls. Additionally, all contractorsstate and
( private) that
use HCA's data to
produce derivative reports and data products are required to adhere to this standar
as well. HCA's Contracts team will ensure that proper d
p per contractual references are included to this and
all HCA Data Release and Publishing Standards. The requirements discussed herein
are not intended
for Category 2, Category 3, or Category 4 data products.
5. HCA's Small Number Standard:
5.1 There are no automatic exemptions from this standard.
5.2 Standard applies for all geographical representations, including statewide.
5.3 Exceptions to this standard will be considered on a case-by-case basis. Contractor must
contact HCA contract contact to request exception.
5.4 Ensure that no cells with 0 < n < 11 are reported (0 < n < 11 suppressed)
Washington State 91 HCA Contract #K6946
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5.5 Apply a marginal threshold of 1 - 10 and cell threshold of 1 - 10 to all tabulations
5.6 (0 < n < 11 suppressed).
5.7 To protect against secondary disclosure, suppress additional cells to ensure the primary
suppressed small value cannot be recalculated.
5.8 Suppression of percentages that can be used to recalculate a small number is also required.
5.9 Use aggregation to prevent small numbers but allow reporting of data. Age ranges are a very
good example of where aggregation can be used to avoid small numbers but avoid
suppressing data (see example below).
6. Small Numbers Examples
6.1 Example (Before Applying Standard)
Client Gender County Accountable Community of Health (ACH) Statewide
Male 6 8 14
Female 11 15 26
TOTAL
[T7 23 40
6.2 Example (After Applying Standard)
IIn oraer to protect the privacy of individuals, cells in this data product that contain small numbers
from 1 to 10 are not displayed.
The above examples show in order to comply with the standard, analysts must not o
directlythose cells where n < Y my suppress
11, but also in this case secondary suppression is necessaryof the
county and ACH totals in order to avoid calculation of those
cells that contained small numbers.
6.3 Example (Suppression with no aggregation)
Age Range County
0-3 5 (would be suppressed)
4-6 17 (would be suppressed)
Washington State 92
Health Care Authority
ACH I Statewide
8 (would be suppressed) 13 (would be
suppressed)
18 25 (would be
suppressed)
HCA Contract #K6946
Attachment 4-13
DocuSign Envelope ID: 4B9CD4A1-C9C4-4168-8626-72A7C65C8198
15
10-12 1 24
23 13-8
TOTAL 151 (would be suppressed) 82 (would be suppressed) 1 133
6.4 Example (Using aggregation instead of suppression)
Age Range
County
ACH
26
23
33
82
Statewide -
0 -6
12
38
7-9
15
38
10-12
24
57
TOTAL
51
133
The above examples provide guidance for using aggregation to avoid small number
suppression and still provide analytic value to the end user. Aggregation is an excellent
method to avoid presenting Information with many holes and empty values.
Washington State 93 HCA Contract #K6946
Health Care Authority Attachment 4-13
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT C: USER AGREEMENT ON NON -DISCLOSURE OF CONFIDENTIAL INFORMATION
N
(To Be Signed by Each Individual User with Access to Confidential HCA Data)
Your organization has entered into a Data Share Agreement with the state of Washington Health Care Authority (HCA) that will allow
you access to data and records that are deemed Confidential Information as defined below. Prior to
accessing this Confidential
Information you must sign this User Agreement on Non -Disclosure of Confidential Information.
"Confidential Information" means information that is exempt from disclosure to the public or other unauthorized persons under
Chapter 42.56 RCW or other federal or state laws. Confidential Information includes, but is not limited to, Protected Health
Information and Personal Information. For purposes of the pertinent Data Share Agreement, Confidential Information means the
same as "Data."
"Protected Health Information" means information that relates to: the provision of health care to an individual; the past, present, or
future physical or mental health or condition of an individual; or the past, present or future payment for provision of health
individual and includes demographic information that identifies the individual or can be used to identifyhe individual.
care to an
"Personal Information" means information identifiable to any person, including, but not limited to, information that relates to a person's
name, health, finances, education, business, use or receipt of governmental services or other activities, addresses, telephone
numbers, social security numbers, driver license numbers, credit card numbers, any other identifying numbers, and an financial
identifiers. Y
State laws (including, but not limited to, RCW 74.04.060, RCW 74.34.095, and RCW 70.02.020) and federal re/ ulations includin
but not limited to, HIPAA Privacy and Security Rules, 45 C.F.R. Part 160 and Part 164; Confidentialityg ( g,
of Alcohol and Drug Abuse
Patient Records, 42 C.F.R., Part 2; and Safeguarding Information on Applicants and Beneficiaries, 42 C.F.R. Part 431, Subpart F
prohibit unauthorized access, use, or disclosure of Confidential Information. Violation of these laws may result in i p )
penalties or fines. Y criminal or civil
__User, s urance of Cor�fiidentialrt_ __ _1i,____1__ __,
In consideration for HCA granting me access to the Confidential Information that is the subject of this Agreement, I a
J g gree that 1:
1. Will access, use, and disclose Confidential Information only in accordance with the terms of this Agreement and consistent with applicable
statutes, regulations, and policies.
2. Have an authorized business requirement to access and use the Confidential Information.
3. Will not use or disclose any Confidential Information gained by reason of this Agreement for any commercial or personal purpose, or any other
purpose that is not directly connected with this Agreement.
4. Will not use my access to look up or view information about family members, friends, the relatives or friends of other employees, or any persons
who are not directly related to my assigned job duties.
5. Will not discuss Confidential Information in public spaces in a manner in which unauthorized individuals could overhear and will not discuss
Confidential Information with unauthorized individuals, including spouses, domestic partners, family members, or friends.
6. Will protect all Confidential Information against unauthorized use, access, disclosure, or loss by employing reasonable security measures
including physically securing any computers, documents, or other media containing Confidential Information and viewing Confidential Information
only on secure workstations in non-public areas.
7. Will not make copies of Confidential Information or print system screens unless necessary to perform my assigned job duties and will not transfer
any Confidential Information to a portable electronic device or medium, or remove Confidential Information on a portable device or medium from
facility premises, unless the information is encrypted and I have obtained prior permission from my supervisor.
8. Will access, use or disclose only the "Minimum Necessary" Confidential Information required to perform my assigned job duties.
9. Will not distribute, transfer, or otherwise share any software with anyone.
10. Will forward any requests that I may receive to disclose Confidential Information to my supervisor for resolution and will immediately inform m
supervisor of any actual or potential security breaches involving Confidential Information, or of any access to or use of Confidential Information b
unauthorized users. Y
11. Understand at any time, HCA may audit, investigate, monitor, access, and disclose information about my use of the Confidential Information and
that my intentional or unintentional violation of the terms of this Agreement -may result in revocation of privileges to access the Confidential
Information, disciplinary actions against me, or possible civil or criminal penalties or fines.
12. Understand that my assurance of confidentiality and these requirements will continue and do not cease at the time I terminate my relationship with
my employer. p
5
i nat r
u
e
/
iDrCE"YT�I��t'r'►P;['a��!"v:M'■s/1-/��/���/.�/�/��/.. /,/��i �t�l �/1./////�/�//�/-///////%//%////////////i////:�/ ,������ � ������� .��,,,,, ,,.,,,._,,,_ .- .1+-��
Washington State 94 ' HCA Contract #K6946
Health Care Authority Attachment 4-C
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT D: CERTIFICATION OF DESTRUCTION/DISPOSAL OF CONFIDENTIAL
INFORMATION
(To Be Filled Out and Returned to HCA Contract Manager Upon Termination of Contract)
NAME OF CONTRACTOR: I CONTRACT #:
(Contractor) herby certifies that the data elements
listed below or attached, received as a part of the data provided in accordance with DSA have
been:
F-1 DISPOSED OF/DESTROYED ALL COPIES
You certify that you destroyed, and returned if requested by HCA, all identified confidential
information received from HCA, or created, maintained, or received by you on behalf of HCA.
You certify that you did not retain any copies of the confidential information received by HCA.
Description of Information Disposed of/ Destroyed:
Date of Destruction and/or Return:
Method(s) of destroying/disposing of Confidential Information:
Disposed of/Destroyed by:
Signature
Date
Printed Name:
Title:
Washington State 95 HCA Contract #K6946
Health Care Authority Attachment 4-D
DocuSign Envelope ID: 4B9CDQA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT 5: FEDERAL COMPLIANCE CERTIFICATIONS AND ASSURANCES
The following terms are applicable as determined by funds sources included in A&R/FSI Document.
FEDERAL COMPLIANCE - The use of federal funds requires additional compliance and
control mechanisms to be in place. The following represents the majority of compliance
elements that may apply to any federal funds provided under this contract. For clarification
regarding any of these elements or details specific to the federal funds in this contract,
contact HCA DBHR Contract Task Order Manager.
a. Source of Funds as identified on the A&R/FSI document: In the event this agreement is
being funded partially or in full through Cooperative Agreement, the full and complete
terms and provisions of which are hereby incorporated into this Contract. The sub-
awardee is responsible for tracking and reporting the cumulative amount expended under
HCA Contract K6946.
b. Period of Availability of Funds: Pursuant to 45 CFR 92.23, Sub-awardee may charge to
the award only costs resulting from obligations of the funding period specified in A&R/FSI
document unless carryover of unobligated balances is permitted, in which case the
carryover balances may be charged for costs resulting from obligations of the subsequent
funding period. All obligations incurred under the award must be liquidated no later than
90 days after the end of the funding period.
c. Single Audit Act: A sub-awardee (including private, for-profit hospitals and non-profit
institutions) shall adhere to the federal Office of Management and Budget (OMB) Super
Circular 2 CFR200, Subpart F and 45 CFR 75, Subpart F. A sub-awardee who expends
$750,000 or more in federal awards during a given fiscal year shall have a single or
program -specific audit for that year in accordance with the provisions of OMB Super
Circular 2 CFR 200. Subpart F and 45 CFR 75. Subpart F.
d. Modifications: This agreement may not be modified or amended, nor may any term or
provision be waived or discharged, including this particular Paragraph, except in writing,
signed upon by both parties.
1. Examples of items requiring Health Care Authority prior written approval include,
but are not limited to, the following:
i. Deviations from the budget and Project plan.
ii. Change in scope or objective of the agreement.
iii. Change in a key person specified in the agreement.
iv. The absence for more than one (1) months'or a 25% reduction in time by
the Project Manager/Director.
v. Need for additional funding.
vi. Inclusion of costs that require prior approvals as outlined in the appropriate
cost principles.
vii. Any changes in budget line item(s) of greater than twenty percent (20%) of
the total budget in this agreement.
2. No changes are to be implemented by the Sub-awardee until a written notice of
approval is received from the Health Care Authority.
e. Sub -Contracting: The sub-awardee shall not enter into a sub -contract for any of the work
performed under this agreement without obtaining the prior written approval of the Health
Care Authority. If sub -contractors are approved by the Health Care Authority, the
subcontract, shall contain, at a minimum, sections of the agreement pertaining to
Debarred and Suspended Vendors, Lobbying certification, Audit requirements, and/or any
Washington State 96 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
other project federal, state, and local requirements.
f. Condition for Receipt of Health Care Authority Funds: Funds provided by Health Care
Authority to the sub-awardee under this agreement may not be used by the sub-awardee
as a match or cost-sharing provision to secure other federal monies without prior written
approval by the Health Care Authority.
g. Unallowable Costs: The sub-awardees' expenditures shall be subject to reduction for
amounts included in any invoice or prior payment made which determined by HCA not to
constitute allowable costs on the basis of audits, reviews, or monitoring of this agreement.
h. Supplanting Compliance: Federal Grants will not be used to supplant state funding of
substance use disorder prevention and treatment programs. (45 CFR § 96.123(a) (10)).
i. Citizenship/Alien Verification/Determination: The Personal Responsibility and Work
Opportunity Reconciliation Act (PRWORA) of 1996 (PL 104-193) states that federal public
benefits should be made available only to U.S. citizens and qualified aliens. Entities that
offer a service defined as a "federal public benefit" must make a citizenship/qualified alien
determination/ verification of applicants at the time of application as part of the eligibility
criteria. Non -US citizens and unqualified aliens are not eligible to receive the services. PL
104-193 also includes specific reporting requirements.
j. Federal Compliance: The sub-awardee shall comply with all applicable state and federal
statutes, laws, rules, and regulations in the performance of this agreement, whether
included specifically in this agreement or not.
k. Civil Rights and Non -Discrimination Obligations During the performance of this
agreement, the Contractor shall comply with all current and future federal statutes relating
to nondiscrimination. These include but are not limited to: Title VI of the Civil Rights Act of
1964 (PL 88-352), Title IX of the Education Amendments of 1972 (20 U.S.C. §§ 1681-
1683 and 1685-1686), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794), the
Age Discrimination Act of 1975 (42 U.S.C. §§ 6101- 6107), the Drug Abuse Office and
Treatment Act of 1972 (PL 92-255), the Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616)7 §§523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. §§290dd-3 and 290ee-3), Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), and the Americans with Disability Act
(42 U.S.C., Section 12101 et seq.) hftr)://www. h hs. ev/ocr/civiIrights.
HCA Federal Compliance Contact Information
Federal Grants and Budget Specialist Health Care Policy
Washington State Health Care Authority
Post Office Box 42710
Olympia, Washington 98504-2710
II. CIRCULARS `COMPLIANCE MATRIX' - The following compliance matrix identifies the OMB
Circulars that contain the requirements which govern expenditure of federal funds. These
requirements apply to the Washington State Health Care Authority (HCA), as the primary
recipient of federal funds and then follow the funds to the sub-awardee Grant County. The
federal Circulars which provide the applicable administrative requirements, cost principles
and audit requirements are identified by sub-awardee organization type.
Washington State 97 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
III. STANDARD FEDERAL CERTIFICATIONS AND ASSURANCES - Following are the
Assurances, Certifications, and Special Conditions that apply to all federally funded (in whole
or in part) agreements administered by the Washington State Health Care Authority.
CERTIFICATIONS
1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
The undersigned (authorized official signing for the contracting organization) certifies to the best of his or
her knowledge and belief, that the contractor, defined as the primary participant in accordance with 45 CFR
Part 76, and its principals:
are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or agency have not
within a 3 -year period preceding this contract been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction; violation of federal or state antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property; are not presently indicted or otherwise criminally or
civilly charged by a governmental entity (federal, state, or local) with commission of any of the
offenses enumerated in Section 2 of this certification; and have not within a 3 -year period
preceding this contract had one or more public transactions (federal, state, or local) terminated
for cause or default.
Should the contractor not be able to provide this certification, an explanation as to why should be placed
after the assurances page in the contract.
The contractor agrees by signing this contract that it will include, without modification, the clause titled
"Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion --Lower Tier
Covered Transactions" in all lower tier covered transactions (i.e., transactions with sub -grantees and/or
contractors) and in all solicitations for lower tier covered transactions in accordance with 45 CFR Part 76.
Washington State 98 HCA Contract #K6946
Health Care Authority Attachment 5
OMB CIRCULAR
ENTITY TYPE
ADMINISTRATIVE
COST
AUDIT
REQUIREMENTS
PRINCIPLES
REQUIREMENTS
State. Local and Indian Tribal
OMB Super Circular 2 CFR 200, Subpart F and 45 CFR
Governments and Governmental
75. Subpart F
Hospitals
Non -Profit Organizations and Non -
Profit Hospitals
Colleges or Universities and Affiliated
Hospitals
For -Profit Organizations
III. STANDARD FEDERAL CERTIFICATIONS AND ASSURANCES - Following are the
Assurances, Certifications, and Special Conditions that apply to all federally funded (in whole
or in part) agreements administered by the Washington State Health Care Authority.
CERTIFICATIONS
1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
The undersigned (authorized official signing for the contracting organization) certifies to the best of his or
her knowledge and belief, that the contractor, defined as the primary participant in accordance with 45 CFR
Part 76, and its principals:
are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any federal department or agency have not
within a 3 -year period preceding this contract been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction; violation of federal or state antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property; are not presently indicted or otherwise criminally or
civilly charged by a governmental entity (federal, state, or local) with commission of any of the
offenses enumerated in Section 2 of this certification; and have not within a 3 -year period
preceding this contract had one or more public transactions (federal, state, or local) terminated
for cause or default.
Should the contractor not be able to provide this certification, an explanation as to why should be placed
after the assurances page in the contract.
The contractor agrees by signing this contract that it will include, without modification, the clause titled
"Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion --Lower Tier
Covered Transactions" in all lower tier covered transactions (i.e., transactions with sub -grantees and/or
contractors) and in all solicitations for lower tier covered transactions in accordance with 45 CFR Part 76.
Washington State 98 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
The undersigned (authorized official signing for the contracting organization) certifies that the contractor
will, or will continue to, provide a drug-free workplace in accordance with 45 CFR Part 76 by:
I. Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession or use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against employees for violation of such
prohibition; Establishing an ongoing drug-free awareness program to inform employees about:
a. The dangers of drug abuse in the workplace;
b. The contractor's policy of maintaining a drug-free workplace;
c. Any available drug counseling, rehabilitation, and employee assistance programs; and
d. The penalties that may be imposed upon employees for drug abuse violations occurring
in the workplace;
II. Making it a requirement that each employee to be engaged in the performance of the contract
be given a copy of the statement required by paragraph (1) above;
III. Notifying the employee in the statement required by paragraph (1), above, that, as a condition
of employment under the contract, the employee will
a. Abide by the terms of the statement; and
b. Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five (5) calendar days after such
conviction;
IV. Notifying the agency in writing within ten calendar days after receiving notice under paragraph
(III)(b) from an employee or otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title, to every contract officer or
other designee on whose contract activity the convicted employee was working, unless the
federal agency has designated a central point for the receipt of such notices. Notice shall
include the identification number(s) of each affected grant;
V. Taking one of the following actions, within thirty (30) calendar days of receiving notice under
paragraph (III) (b), with respect to any employee who is so convicted
a. Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
b. Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a federal, state, or local health,
law enforcement, or other appropriate agency;
VI. Making a good faith effort to continue to maintain a drug-free workplace through implementation
of paragraphs (1) through (V).
For purposes of paragraph (V) regarding agency notification of criminal drug convictions, HCA has
designated the following central point for receipt of such notices:
Legal Services Manager
WA State Health Care Authority
PO Box 42700
Olympia, WA 98504-2700
Washington State 99 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
3. CERTIFICATION REGARDING LOBBYING
Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to influence
certain federal contracting and financial transactions," generally prohibits recipients of federal grants and
cooperative agreements from using federal (appropriated) funds for lobbying the Executive or Legislative
Branches of the federal Government in connection with a SPECIFIC grant or cooperative agreement.
Section 1352 also requires that each person who requests or receives a federal grant or cooperative
agreement must disclose lobbying undertaken with non-federal (nonappropriated) funds. These
requirements apply to grants and cooperative agreements EXCEEDING $100,000 in total costs (45 CFR
Part 93).
The undersigned (authorized official signing for the contracting organization) certifies, to the best of his or
her knowledge and belief, that:
VII. No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any federal contract, the making of
any federal grant, the making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
federal contract, grant, loan, or cooperative agreement.
VIII. If any funds other than federally appropriated funds have been paid or will be paid to any person
for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit Standard Form -LLL, "Disclosure - of Lobbying Activities," in
accordance with its instructions. (If needed, Standard Form -LLL, "Disclosure of Lobbying
Activities," its instructions, and continuation sheet are included at the end of this application
form.)
IX. The undersigned shall require that the language of this certification be included in the award
documents for all subcontracts at all tiers (including subcontracts, subcontracts, and contracts
under grants, loans and cooperative agreements) and that all sub -recipients shall certify and
disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIL REMEDIES ACT (PFCRA)
The undersigned (authorized official signing for the contracting organization) certifies that the statements
herein are true, complete, and accurate to the best of his or her knowledge, and that he or she is aware
that any false, fictitious, or fraudulent statements o.r claims may subject him or her to criminal, civil, or
administrative penalties. The undersigned agrees that the contracting organization will comply with the
Public Health Service terms and conditions of award if a contract is awarded.
5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE
Public Law 103-227, also known as the Pro -Children Act of 1994 (Act), requires that smoking not be
permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, day care, early childhood development services, education
Washington State 100 HCA Contract #K6946
Health Care Authority
Attachment 5
DocuSign Envelope ID: 4B9CD4A1-C9C4-4168-8626-72A7C65C8198
or library services to children under the age of 18, if the services are funded by federalro rams either
p g
directly or through state or local governments, by federal grant, contract, loan, or loang uarantee. The law
also applies to children's services that are provided in indoor facilities that are constructed operated, or
p
maintained with such federal funds. The law does not apply to children's services
rovided in private
p
residence, portions of facilities used for inpatient drug or alcohol treatment, service providers whose sole
source of applicable federal funds is Medicare or Medicaid, or facilities where WIC coupons are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetarypenalty of
up to $1,000 for each violation and/or the imposition p Y
p n of an administrative compliance order on the
responsible entity.
By signing the certification, the undersigned certifies that the contracting organization will comply with the
requirements of the Act and will not allow smoking within any portion of any indoor facility used for the
provision of services for children as defined by the Act.
The contracting organization agrees that it will require that the language of this certification be included in
any subcontracts which contain provisions for children's services and that all sub -recipients shall certify
accordingly.
The Public Health Services strongly encourages all recipients to provide a smoke-free workplace
and promote the non-use of tobacco products. This is consistent with the PHS mission top rotect
and advance the physical and mental health of the American people.
6. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS INSTRUCTIONS FOR CERTIFICATION
I. By signing and submitting this proposal, the prospective contractor is providing the certification
set out below.
II. The inability of a person to provide the certification required below will not necessarily result in
denial of participation in this covered transaction. The prospective contractor shall submit an
explanation of why it cannot provide the certification set out below. The certification or
explanation will be considered in connection with the department or agency's determination
whether to enter into this transaction. However, failure of the prospective contractor to furnish
a certification or an explanation shall disqualify such person from participation in this
transaction.
III. The certification in this clause is a material representation of fact upon which reliance was
placed when the department or agency determined to enter into this transaction. If it is later
determined that the prospective contractor knowingly rendered an erroneous certification in
addition to other remedies available to the federal government, the department ora enc may
terminate this transaction for cause of default. agency
Y
IV. The prospective contractor shall provide immediate written notice to the department or agency
to whom this contract is submitted if at any time the prospective contractor g y
p p actor learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. g
V. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction
participant, person, primary covered transaction, principal, proposal, and voluntarily excluded'
as used in this clause,
have the meanings set out in the Definitions and Coverage sections of'
the rules implementing Executive Order 12549. You may contact the person to whom this
contract is submitted for assistance in obtaining a copy of those regulations.
Vl. The prospective contractor agrees by submitting this contract that should ther
covered transaction be entered into it shall not p oposed
knowingly enter into any lower tier covered
transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by HCA
.
Washington State 101 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
VII. The prospective contractor further agrees by submitting this contract that it will include the
clause titled "'Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion -- Lower Tier Covered Transaction," provided by HHS without modification, cation, in all
lower tier covered transactions and in all solicitations for lower tier covered transactions.
VIII. A participant in a covered transaction may rely upon a certification of a prospective participant
in a lower tier covered transaction that it is not debarred p p p
,suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the certification is erroneous. A
participant may decide the method and frequency by which it determines the eligibilityof its
Non -procurement List (of
principals. Each participant may, but is not required to check the Non-
excluded parties).
IX. Nothing contained in the foregoing shall be construed to require establishment of a system of
required b
records in order to render in good faith the certification re y
q y this clause. The knowledge
and information of a participant is not required to exceed that which is normally possessed b
a prudent person in the ordinary course of business dealings.
Y
X. Except for transactions authorized under paragraph 6 of these instructions, if aartici ant in a
covered transaction knowingly enters into a lower tier covered p p
transaction with a person who
is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction
in addition to other remedies available to the federal government, HCA may terminate this
transaction for cause or default.
7. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS -- PRIMARY COVERED TRANSACTIONS
I. The prospective contractor certifies to the best of its knowledge and belief, that it and its
principals. N
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions b an federal d g
Y y department or agency,
b. Have not within a three-year period preceding this contract been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (federal, state or
local) transaction or contract under a public transaction; violation of federal or state
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (federal, state or local) with commission of any of the offenses enumerated in
paragraph 7(I)(b) of this certification; and
d. Have not within a three-year period preceding this contract had one or moreublic
transactions (federal, state or local) terminated for cause or default.p
II. Where the prospective contractor is unable to certify to any of the statements in this
certification, such prospective contractor shall attach an explanation to this proposal.
CONTRACTOR SIGNATURE REQUIRED
Washington State 102 HCA Contract #K6946
Health Care Authority Attachment 5
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198 11,
ATTACHMENT 6: SAMHSA FEDERAL GENERAL TERMS AND CONDITIONS
SAMHSA Grants Management:
Recipients must comply with standard terms and conditions for the fiscal year in which the grant
was originally awarded. Grant fiscal years are included on the A&R/FSI Document.
Grant awards issued with funds from SAMHSA are subject to legally binding requirements
called standard terms and conditions. These are provided by HHS. By drawing funds from the
Payment Management System, the grantee agrees to the terms and conditions of the award.
Recipients are responsible to ensure they are following the most updated guidance. Guidance
is regularly updated and posted https://www.samhsa.gov/grants/grants-management/notice-
It is Contractor's sole responsibility to ensure that it is aware of, and in compliance with, the
updated SAMHSA guidance referenced above.
Washington State 103 HCA Contract #K6946
Health Care Authority Attachment 6
DocuSign Envelope ID: 4B9CDQA1-C9C4-4168-8626-72A7C65C8198
ATTACHMENT 7: SOR III — H79TIO85727 TERMS AND CONDITIONS
SOR 2022 Special Terms and Conditions
1. Only U.S. Food and Drug Administration (FDA) -approved products that address opioid use disorder
and/or opioid overdose can be purchased with Opioid SOR grant funds.
2.. Medication for Opioid Use Disorder (MOUD) using one of the FDA -approved medications for the
maintenance treatment of opioid use disorder. MOUD includes methadone, buprenorphine
products, including single -entity buprenorphine products, J
buprenorphine/naloxone tablets films
buccal preparations, long-acting injectable buprenorphine products, and injectable extended-
release naltrexone.
3. SOR grant funds must be used to fund prevention, harm reduction, treatment, and recovery support
ort
services and evidence -based practices that are appropriate for the population(s) of focus.
4. SOR funds shall not be utilized for services that can be supported through other accessible sources
of funding such as other federal discretionary and formula grant funds, ((e.g., H HS, CDC CMS HRSA
and SAMHSA), DOJ (OJP/BJA)), and non-federal funds, third part insurance and sliding Y � g s cafe self
pay among others.
5. SOR funds for treatment and recovery support services shall only be utilized to provide services to
individuals that specifically address opioid or stimulant misuse issues. If either an opioid or
stimulant misuse problem (history) exists concurrently with other substance use, all substance use
issues may be addressed. Individuals who have no history of or no current issues with opioids or
stimulants misuse shall not receive treatment or recovery services with SOR grant funds.
6. Funds may not be expended through the grant or a subaward by any agency which would deny any
eligible client, patient or individual access to their program because of their use of FDA -approved
medications for treatment of substance use disorders (e.g., methadone,
buprenorphine products
p
including buprenorphine/naloxone combination formulations and buprenorphine monop roduct
formulations, naltrexone products including extended-release and oral formulations or longacting
g
products such as extended release injectable or implantable buprenorphine.) Specifically, patients
must be allowed to participate in methadone treatment rendered in accordance with current
federal and state methadone dispensing regulations from an Opioid Treatment Program and
ordered by a physician who has evaluated the client and determined that methadone is an
appropriate medication treatment for the individual's opioid use disorder. Similarly, medications
available by prescription or office -based implantation must be permitted if it is appropriately
authorized through prescription by a licensed prescriber or provider. In all cases, MOUD must be
permitted to be continued for as long as the prescriber or treatment provider determines that the
medication is clinically beneficial. Recipients must assure that clients will not be compelled to no
longer use MOUD as part of the conditions of any programming if stopping is inconsistent with a
licensed prescriber's recommendation or valid prescription.
Washington State 104 HCA Contract #K6946
Health Care Authority Attachment 7
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
7. Procurement of DATA waiver training is not allowable use of SOR funds as this training is offered
free of charge from SAMHSA at pcssnow.org. No fundingbe used
may to procure DATA waiver
training by recipients or subrecipients of SOR funding.
8. SOR funds shall not be utilized to provide incentives to any Health Care Professional for receipt of
a Data Waiver or any type of Professional Development Training.
g
9. SOR funds may not be used, directly or indirectly, to purchase, prescribe, or provide marihuana or
treatment using marijuana. Treatment in this context includes the treatment of opioid '
p use disorder
and stimulant use disorder. SOR funds also cannot bean to rovided
P y individual who or
organization that provides or permits marijuana use for the purposes of treatingsubstance tante use or
mental disorders. See, e.g., 45 C.F.R. § 75.300(a) (requiring HHS to "ensure that Federal funding is
expended ... in full accordance with U.S. statutory and publicolic . requirements.");
P Y 21 U.S.C. §§
812(c)(10) and 841 (prohibiting the possession, manufacture saleurchase
p , or distribution of
marihuana). This prohibition does not apply to those providingsuch treatment in
the context of
clinical research permitted by the DEA and under an FDA -approved investigational tigational new drug
application where the article being evaluated is marijuana ora constituent thereof
a banned controlled substance under federal law.
10. Subrecipients must also comply with SAMHSA's standard funding restrictions included below.
SAMHSA Standard Funding Restrictions
HHS codified the Uniform Administrative Requirements, Cost Principles, and Audit Requirements equirements for
HHS Awards, 45 CFR Part 75. In Subpart E, cost principles are described and
allowable and
unallowable expenditures for HHS recipients are delineated. 45 CFR Part
75 is available at
htt s.' ecfr.federalre ister. ov current title -45 subtitle -A subcha ter -A ar -
75.
Unless superseded by program statute or regulation, follow the costrinci
p pies in 45 CFR Part 75
and the standard funding restrictions below.
You may also reference the SAMHSA site for grantee guidelines on financial management
requirements at
hops://www.samv/grants/rants-management/policies regulations/financial
management -requirements.
SAMHSA grant funds may not be used to:
A. SAMHSA grant funds may not be used to purchase, prescribe, orrovide marijuana � na ortreatment
using marijuana. See, e.g., 45 C.F.R. 75.300(a) (requiring HHS to ensure that Federal funding
expended in full accordance with U.S. statutory and public policy requirements);
21 U.S.C.
812(c)(10) and 841 (prohibiting the possession, manufacture saleurchase
p , or distribution of
marijuana).
B. Pay for promotional items including, but not limited to, clothing and commemorative items
such as pens, mugs/cups, folders/folios, lanyards, and conference bags (See 45 CFR
75.421(e)(3)).
Washington State 105 HCA Contra
Health Care Authority Contract #K6946
Attachment 7
DocuSign Envelope ID: 4B9CDOA1-C9C4-4168-8626-72A7C65C8198
C. Pay for the purchase or construction of any building or structure to house any part of the
program. Minor alterations and renovations (A&R) may be authorized for u to $150 000 or o
. P 5 /o
of the overall indirect costs (whichever is more) of a given bud et period for existing facilities, if
necessary and appropriate to the project. Minor A&R may not include a structural change
to the foundation roof, floor,g (e.g.,
or exterior or loadbea.ring walls of a facility, or extension of an
existing facility) to achieve the following: Increase the floor area; and/or, change / g the function
and purpose of the facility. All minorA&R must be approved by SAMHSA.
D. Make direct payments to individuals to enter treatment or continue toartici ate
p p in prevention
or treatment services (See 42 U.S.C. § 1320a -7b).
a. Note:A recipient or treatment or prevention provider may provide up to $30 non -
cash
incentive to individuals to participate in required data collection follow-up. This
amount may be paid for participation in each required follow-up interview. For
programs including contingency management as a component of the treatment
program, clients many not receive contingencies totaling more than $75er budget
get
period. The contingency amounts are subject to change.
E. Meals are generally unallowable unless they are an integral art of a conference g p grant or
specifically stated as an allowable expense in the Special Terms and Conditions. dati
ons. (See
htt s: www.hhs. ov rants contracts contract- olicies-re Mations sendinon-
food/i n dex. htm l)
F. General Provisions under Departments of Labor, Health d Human Services '
anand Education,
,and Related Agencies Appropriations Act Public Law 116-260, Consolidated Appropriations
Act,
2021, Division H, Title V, Section 527, notwithstanding any other provision of this Act no
appropriated in thisActshall be used to purchase sterile needles ors rin esforthe hypodermic
Y g yp dermic
injection of any illegal drug. Provided, that such limitation does nota l th
apply to e use of funds
for elements of a program otherthan making such purchases if the relevant State or local health
department, in consultation with the Centers for Disease Control and Prevention, determines
that the State or local jurisdiction, as applicable, is experiencing,or is at risk for, '
r, a significant
increase in hepatitis infections or an HIV outbreak due to injection drugand such
use, program
is operating in accordance with state and local law.
G. Salary Limitation: The Consolidated Appropriations Act, 2021(Public Law 116-260 Division ),Division H,
Title II, Section 202, provides a salary rate limitation. The law'limits the salaryam
be awarded and charged amount that may
g to SAMHSA grants and cooperative agreements. Award funds may not
be used to pay the salary of an individual at a r Y
ate more than Executive Level II, which is
$203,700. This amount reflects an individual's base salaryexclusive of fringe ge and any income
that an individual may be permitted to earn outside of the duties toour organization. ganization. This
salary limitation also applies to subrecipients under a SAM HSArant or cooperative g p e agreement.
Note that these or other salary limitations will apply in the followingfiscal
law. years, as required, by
Washington State 106 HCA Contract #
Health Care Authority K6946
Attachment 7