HomeMy WebLinkAboutWashington State Healthcare Authority DocuSign Envelope ID:046 1 2028-8 72D-413B-B962-9091EE78C79D
Washington State PROFESSIONAL SERVICES HCA Contract Number: K5736
CONTRACT for
Health Carekuef-horit� LEAD Expansion Services
THIS CONTRACT is made by and between Washington State Health Care Authority, (HCA) and Mason
County Community Service, (Contractor).
CONTRACTOR NAME CONTRACTOR DOING BUSINESS AS (DBA)
Mason County Community Service
CONTRACTOR ADDRESS I Street City State Zip Code
415 N 6"' Street Shelton WA 98584
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS
Casey Bingham 360-427-9670, ext 562 caseyb(a)_mason countywa.gov
Is Contractor a Subrecioient under this Contract? CFDA NUMBER(S): FFATA Form Reauired
®YES ❑NO 93.959 ®YES ❑NO
HCA PROGRAM HCA DIVISION/SECTION
Division of Behavioral Health and Recovery (DBHR)
HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS
Health Care Authority
Michele Gayle, Contract Manager 626 8th Avenue SE
PO Box 42730
Olympia, WA 98504-2730
HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS
(360) 725-9817 michele.gayle(@hca.wa.gov
CONTRACT START DATE CONTRACT END DATE TOTAL MAXIMUM CONTRACT AMOUNT
Date of Execution June 30, 2023 $1,098,950
PURPOSE OF CONTRACT:
Provide intesive case management services to recently arrested and/or high risk for arrest individuals through the
expansion of the WA State LEAD program throughout Mason County.
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
� '1
z�v►,✓ �riu/7 KA tK I r3oCL 10/ 22
HCA SIGNATURE PRINTED NAME AN6 TITLE DATE SIGNED
rD—SWrod by: Annette Schuffenhauer
4"X& S 12/30/2021
Chief Legal Officer
Rev 5/6/2019
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
TABLE OF CONTENTS
Recitals.............................................................................................................................................. 4
1. STATEMENT OF WORK (SOW)................................................................................................. 4
2. DEFINITIONS..............................................................................................................................4
3. SPECIAL TERMS AND CONDITIONS........................................................................................ 7
3.1 PERFORMANCE EXPECTATIONS ..................................................................................... 7
3.2 TERM................................................................................................................................... 7
3.3 COMPENSATION ................................................................................................................ 7
3.4 INVOICE AND PAYMENT.................................................................................................... 8
3.5 CONTRACTOR and HCA CONTRACT MANAGERS........................................................... 9
3.6 KEY STAFF........................................................................................................................ 10
3.7 LEGAL NOTICES............................................................................................................... 10
3.8 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE .......................... 11
3.9 INSURANCE ...................................................................................................................... 11
4. GENERAL TERMS AND CONDITIONS.................................................................................... 13
4.1 ACCESS TO DATA............................................................................................................ 13
4.2 ADVANCE PAYMENT PROHIBITED ................................................................................. 13
4.3 AMENDMENTS.................................................................................................................. 13
4.4 ASSIGNMENT.................................................................................................................... 13
4.5 ATTORNEYS' FEES .......................................................................................................... 14
4.6 CHANGE IN STATUS......................................................................................................... 14
4.7 CONFIDENTIAL INFORMATION PROTECTION ............................................................... 14
4.8 CONFIDENTIAL INFORMATION SECURITY..................................................................... 15
4.9 CONFIDENTIAL INFORMATION BREACH - REQUIRED NOTIFICATION ....................... 15
4.10 CONTRACTOR'S PROPRIETARY INFORMATION ........................................................... 16
4.11 COVENANT AGAINST CONTINGENT FEES .................................................................... 16
4.12 DEBARMENT..................................................................................................................... 16
4.13 DISPUTES ......................................................................................................................... 16
4.14 ENTIRE AGREEMENT....................................................................................................... 17
4.15 FEDERAL FUNDING ACCOUNTABILITY & TRANSPARENCY ACT (FFATA) .................. 17
4.16 FORCE MAJEURE............................................................................................................. 18
4.17 FUNDING WITHDRAWN, REDUCED OR LIMITED ........................................................... 18
4.18 GOVERNING LAW............................................................................................................. 19
4.19 HCA NETWORK SECURITY.............................................................................................. 19
4.20 INDEMNIFICATION............................................................................................................ 19
4.21 INDEPENDENT CAPACITY OF THE CONTRACTOR ....................................................... 19
4.22 INDUSTRIAL INSURANCE COVERAGE ........................................................................... 20
4.23 LEGAL AND REGULATORY COMPLIANCE...................................................................... 20
Washington State Page 2 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
DocuSign Envelope ID:04612028-872D-413B-B962-9091 EE78C79D
4.24 LIMITATION OF AUTHORITY............................................................................................ 20
4.25 NO THIRD-PARTY BENEFICIARIES ................................................................................. 20
4.26 NONDISCRIMINATION...................................................................................................... 20
4.27 OVERPAYMENTS TO CONTRACTOR.............................................................................. 21
4.28 PAY Equity......................................................................................................................... 21
4.29 PUBLICITY......................................................................................................................... 22
4.30 RECORDS AND DOCUMENTS REVIEW .......................................................................... 22
4.31 REMEDIES NON-EXCLUSIVE........................................................................................... 22
4.32 RIGHT OF INSPECTION.................................................................................................... 22
4.33 RIGHTS IN DATA/OWNERSHIP........................................................................................ 23
4.34 RIGHTS OF STATE AND FEDERAL GOVERNMENTS ..................................................... 24
4.35 SEVERABILITY.................................................................................................................. 24
4.36 SITE SECURITY ................................................................................................................ 24
4.37 SUBCONTRACTING.......................................................................................................... 24
4.38 SUBRECIPIENT................................................................................................................. 25
4.39 SURVIVAL.......................................................................................................................... 26
4.40 TAXES ............................................................................................................................... 26
4.41 TERMINATION................................................................................................................... 27
4.42 TERMINATION PROCEDURES......................................................................................... 28
4.43 WAIVER............................................................................................................................. 29
4.44 WARRANTIES.................................................................................................................... 29
Attachments
Attachment 1: Confidential Information Security Requirements
Attachment 2: Federal Compliance, Certifications and Assurances
Attachment 3: Federal Funding Accountability and Transparency Act (FFATA) Data
Collection Form
Attachment 4: Substance Abuse and Mental Health Services Agency (SAMHSA) Award
Terms
Attachment 5: Federal Award Identification for Subrecipients
Schedules
Schedule A: Statement of Work (SOW) LEAD Expansion Services
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Health Care Authority HCA Contract#K5736
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
Contract #K5736 for LEAD Expansion Services
Recitals
The state of Washington, acting by and through the Health Care Authority (HCA), seeks client
services for LEAD Expansion Services; and
WHEREAS, client services are exempt from competitive solicitation (RCW 39.26.125(6)) and
Mason County Community Service (Contractor) seeks to provide such services.
HCA has determined that entering into a Contract with Mason County Community Service will
meet FICA's needs and will be in the State's best interest.
NOW THEREFORE, HCA awards to Mason County Community Service this Contract, the
terms and conditions of which will govern Contractor's providing to HCA the LEAD Expansion
Services.
IN CONSIDERATION of the mutual promises as set forth in this Contract, the parties agree as
follows:
1. STATEMENT OF WORK (SOW)
The Contractor will provide the services and staff as described in Schedule A: Statement of
Work.
2. DEFINITIONS
"Authorized Representative" means a person to whom signature authority has been
delegated in writing acting within the limits of his/her authority.
"Breach" means the unauthorized acquisition, access, use, or disclosure of Confidential
Information that compromises the security, confidentiality, or integrity of the Confidential
Information.
"Business Associate" means a Business Associate as defined in 45 CFR 160.103, who
performs or assists in the performance of an activity for or on behalf of HCA, a Covered Entity,
that involves the use or disclosure of protected health information (PHI). Any reference to
Business Associate in this DSA includes Business Associate's employees, agents, officers,
Subcontractors, third party contractors, volunteers, or directors.
"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.
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"Centers for Medicare and Medicaid Services" or "CMS" means the federal office under the
Secretary of the United States Department of Health and Human Services, responsible for the
Medicare and Medicaid programs.
"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 http://www.ecfr.gov/cqi-bin/ECFR?page=browse.
"Confidential Information" means information that may be exempt from disclosure to the
public or other unauthorized persons under chapter 42.56 RCW or chapter 70.02 RCW or other
state or federal statutes or regulations. Confidential Information includes, but is not limited to,
any information identifiable to an individual that relates to a natural person's health, (see also
Protected Health Information); finances, education, business, use or receipt of governmental
services, names, addresses, telephone numbers, social security numbers, driver license
numbers, financial profiles, credit card numbers, financial identifiers and any other identifying
numbers, law enforcement records, HCA source code or object code, or HCA or State security
information.
"Contract" means this Contract document and all schedules, exhibits, attachments,
incorporated documents and amendments.
"Contractor" means Mason County Community Service, 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" means a health plan, a health care clearinghouse or a health care provider
who transmits any health information in electronic form to carry out financial or administrative
activities related to health care, as defined in 45 CFR 160.103.
"Data" means information produced, furnished, acquired, or used by Contractor in meeting
requirements under this Contract.
"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; or, if not so specified, the date of the last signature of a
party to this Contract.
"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.
"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.
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"Proprietary Information" means information owned by Contractor to which Contractor claims
a protectable interest under law. Proprietary Information includes, but is not limited to,
information protected by copyright, patent, trademark, or trade secret laws.
"Protected Health Information" or "PHI" means individually identifiable 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, as defined in 45 CFR 160.103. Individually identifiable information
is information that identifies the individual or about which there is a reasonable basis to believe
it can be used to identify the individual, and includes demographic information. PHI is
information transmitted, maintained, or stored in any form or medium. 45 CFR 164.501. PHI
does not include education records covered by the Family Educational Rights 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: http://apps.leg.wa.gov/rcw/.
"Statement of Work" or "SOW" means a detailed description of the work activities the
Contractor is required to perform under the terms and conditions of this Contract, including the
deliverables and timeline, and is Schedule A hereto.
"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.
"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 sub-recipient 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.
"USC" 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 http://uscode.house.gov/
"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: hftp://app.leg.wa.gov/wac/-
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3. SPECIAL TERMS AND CONDITIONS
3.1 PERFORMANCE EXPECTATIONS
Expected performance under this Contract includes, but is not limited to, the following:
3.1.1 Knowledge of applicable state and federal laws and regulations pertaining to subject
of contract;
3.1.2 Use of professional judgment;
3.1.3 Collaboration with HCA staff in Contractor's conduct of the services;
3.1.4 Conformance with HCA directions regarding the delivery of the services;
3.1.5 Timely, accurate and informed communications;
3.1.6 Regular completion and updating of project plans, reports, documentation and
communications;
3.1.7 Regular, punctual attendance at all meetings; and
3.1.8 Provision of high quality services.
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 Date of Executionand continue
through June 30, 2023, unless terminated sooner as provided herein.
3.2.2 This Contract may be extended 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
3.3.1 The Maximum Compensation payable to Contractor for the performance of all
things necessary for or incidental to the performance of work as set forth in
Schedule A: Statement of Work is $1,098,950, and includes any allowable
expenses.
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3.3.2 Contractor's compensation for services rendered will be based on the following
rates or in accordance with the following terms.
3.3.3 Day-to-day expenses related to performance under the Contract, including but not
limited to travel, lodging, meals, and incidentals, will not be reimbursed to
Contractor. If Contractor is required by HCA to travel, any such travel must be
authorized in writing by the HCA Contract Manager and reimbursement will be at
rates not to exceed the then-current rules, regulations, and guidelines for State
employees published by the Washington State Office of Financial Management in
the Washington State Administrative and Accounting Manual
(http://www.ofm.wa.gov/policy/10.htm); reimbursement will not exceed expenses
actually incurred.
To receive reimbursement, Contractor must provide a detailed breakdown of
authorized expenses and receipts for any expenses of$50 or more.
3.3.4 Federal funds disbursed through this Contract were received by HCA through OMB
Catalogue of Federal Domestic Assistance (CFDA) Number: 93.959, Substance
Abuse Block Grant, B08T10839777. Contractor agrees to comply with applicable
rules and regulations associated with these federal funds and has signed
Attachment 2: Federal Compliance, Certification and Assurances, attached.
3.4 INVOICE AND PAYMENT
3.4.1 Contractor must submit accurate invoices to the following address for all amounts to
be paid by HCA via e-mail to: HCAAdminAccountsPayable(a�hca.wa.gov with a cc
to HCA Contract Manager. Include the HCA Contract number in the subject line of
the email.
3.4.2 Invoices must describe and document to HCA'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. Any single expense in the
amount of$50.00 or more must be accompanied by a receipt in order to receive
reimbursement. All invoices will be reviewed and must be approved by the Contract
Manager or his/her designee prior to payment.
3.4.3 Contractor must submit properly itemized invoices to include the following
information, as applicable:
3.4.3.1 HCA Contract number K5736;
3.4.3.2 Contractor name, address, phone number;
3.4.3.3 Description of Services;
3.4.3.4 Deliverable number;
3.4.3.5 Date(s) of delivery;
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3.4.3.6 Net invoice price for each item;
3.4.3.7 Applicable taxes;
3.4.3.8 Total invoice price; and
3.4.3.9 Payment terms and any available prompt payment discount.
3.4.4 HCA will return 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.
3.4.5 In order to receive payment for services or products provided to a state agency,
Contractor must register with the Statewide Payee Desk at https://ofm.wa.gov/it-
systems/statewide-vendorpayee-services/receiving-payment-state. Payment will be
considered timely if made by HCA within thirty (30) calendar days of receipt of
properly completed invoices. Payment will be directly deposited in the bank account
or sent to the address Contractor designated in its registration.
3.4.6 Upon expiration of the Contract, any claims for payment for costs due and payable
under this Contract that are incurred prior to the expiration date must be submitted
by the Contractor to HCA within sixty (60) calendar days after the Contract
expiration date. HCA is under no obligation to pay any claims that are submitted
sixty-one (61) or more calendar days after the Contract expiration date ("Belated
Claims"). HCA will pay Belated Claims at its sole discretion, and any such potential
payment is contingent upon the availability of funds.
3.5 CONTRACTOR AND HCA CONTRACT MANAGERS
3.5.1 Contractor's Contract Manager will have prime responsibility and final authority for
the services provided under this Contract and be the principal point of contact for
the HCA Contract Manager for all business matters, performance matters, and
administrative activities.
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.
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3.5.3 The contact information provided below may be changed by written notice of the
change (email acceptable) to the other party.
CONTRACTOR Health Care Authority
Contract Manager Information Contract Manager Information
Name: Casey Bingham Name: Michele Gayle
Title: Fiscal Manager Title: Contract Manager
415 N 6th Street 626 8th Avenue SE
Address: Address: PO Box 42730
Shelton, WA 98584 Olympia, WA 98504-2730
Phone: 360-427-9670, ext 562 Phone: 360-725-9817
Email: caseyb(a),masoncountywa.gov Email: michele.gayle0fta.wa.gov
3.6 KEY STAFF
3.6.1 Except in the case of a legally required leave of absence, sickness, death,
termination of employment or unpaid leave of absence, Key Staff must not be
changed during the term of the Statement of Work (SOW)from the people who
were described in the Response for the first SOW or those Key Staff initially
assigned to subsequent SOWs, without the prior written approval of HCA until
completion of their assigned tasks.
3.6.2 During the term of the Statement of Work (SOW), HCA reserves the right to
approve or disapprove Contractor's Key Staff assigned to this Contract, to approve
or disapprove any proposed changes in Contractor's Key Staff, or to require the
removal or reassignment of any Contractor staff found unacceptable by HCA,
subject to HCA's compliance with applicable laws and regulations. Contractor must
provide a resume to HCA of any replacement Key Staff and all staff proposed by
Contractor as replacements for other staff must have comparable or greater skills
for performing the activities as performed by the staff being replaced.
3.7 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.
3.7.1 In the case of notice to the Contractor, send notification to the contact listed on
Page 1 of this Contract
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DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
3.7.2 In the case of notice to HCA:
Attention: Contracts Administrator
Health Care Authority
Division of Legal Services
Post Office Box 42702
Olympia, WA 98504-2702
CONTRACTS@hca.wa.gov
3.7.3 Notices are effective upon receipt or four (4) Business Days after mailing, whichever
is earlier.
3.7.4 The notice address and information provided above may be changed by written
notice of the change given as provided above.
3.8 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:
3.8.1 Applicable Federal and State of Washington statutes and regulations;
3.8.2 Recitals
3.8.3 Special Terms and Conditions;
3.8.4 General Terms and Conditions;
3.8.5 Attachment 1: Confidential Information Security Requirements;
3.8.6 Attachment 2: Federal Compliance, Certifications and Assurances;
3.8.7 Attachment 3: Federal Funding Accountability and Transparency Act Data
Collection Form;
3.8.8 Schedule A(s): Statement(s) of Work;
3.8.9 Any other provision, term or material incorporated herein by reference or otherwise
incorporated.
3.9 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
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Contract. Contractor must provide insurance coverage that is maintained in full force and
effect during the term of this Contract, as follows:
3.9.1 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.
3.9.2 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.
3.9.3 Professional Liability Errors and Omissions —Provide a policy with coverage of not
less than $1 million per claim/$2 million general aggregate.
3.9.4 The insurance required must be issued by an insurance company/ies authorized to
do business within the state of Washington, and must name HCA and the state of
Washington, its agents and employees as additional insured's 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. Failure to
buy and maintain the required insurance may, at HCA's sole option, result in this
Contract's termination.
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.
3.9.5 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 provde
certificates of insurance to that effect to HCA upon request.
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.
3.9.6 Privacy Breach Response Coverage. Contractor must maintain insurance to cover
costs incurred in connection with a Breach, or potential Breach, including:
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3.9.6.1 Computer forensics assistance to assess the impact of the Breach or
potential Breach, determine root cause, and help determine whether and
the extent to which notification must be provided to comply with Breach
notification laws.
3.9.6.2 Notification and call center services for individuals affected by a Breach.
3.9.6.3 Breach resolution and mitigation services for individuals affected by a
Breach, including fraud prevention, credit monitoring and identity theft
assistance.
3.9.6.4 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).
The policy must be maintained for the term of this Agreement and three (3) years following
its termination.
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 at no additional cost. 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 ADVANCE PAYMENT PROHIBITED
No advance payment will be made for services furnished by the Contractor pursuant to
this Contract.
4.3 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.
4.4 ASSIGNMENT
4.4.1 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 4.37, 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
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made herein, including but not limited to, rights of setoff. Any attempted assignment,
transfer or delegation in contravention of this Subsection 4.4.1 of the Contract will
be null and void.
4.4.2 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.
4.4.3 This Contract will inure to the benefit of and be binding on the parties hereto and
their permitted successors and assigns.
4.5 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.
4.6 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.
4.7 CONFIDENTIAL INFORMATION PROTECTION
4.7.1 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 Confidential Information. Contractor agrees to hold Confidential
Information in strictest confidence and not to make use of Confidential Information
for any purpose other than the performance of this Contract, to release it only to
authorized employees or Subcontractors requiring such information for the
purposes of carrying out this Contract, and not to 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. Contractor agrees to
implement physical, electronic, and managerial safeguards to prevent unauthorized
access to Confidential Information (See Attachment 1: Confidential Information
Security Requirements).
4.7.2 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 requirements of the Health Insurance Portability and Accountability Act of 1996,
Pub. L. 104-191, as modified by the American Recovery and Reinvestment Act of
2009 ("ARRA"), Sec. 13400 — 13424, H.R. 1 (2009) (HITECH Act) (HIPAA).
4.7.3 HCA reserves the right to monitor, audit, or investigate the use of Confidential
Information collected, used, or acquired by Contractor through this Contract.
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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.
4.7.4 The obligations set forth in this Section will survive completion, cancellation,
expiration, or termination of this Contract.
4.8 CONFIDENTIAL INFORMATION SECURITY
The federal government, including the Centers for Medicare and Medicaid Services
(CMS), and the State of Washington all maintain security requirements regarding privacy,
data access, and other areas. Contractor is required to comply with the Confidential
Information Security Requirements set out in Attachment 1 to this Contract and
appropriate portions of the Washington OCIO Security Standard, 141.10
(https:Hocio.wa.gov/policies/141-securing-information-technology-assets/14110-securinq-
information-technology-assets).
4.9 CONFIDENTIAL INFORMATION BREACH — REQUIRED NOTIFICATION
4.9.1 Contractor must notify the HCA Privacy Officer (PrivacyOfficer(@-hca.wa.gov) within
five Business Days of discovery of any Breach or suspected Breach of Confidential
Information.
4.9.2 Contractor will take steps necessary to mitigate any known harmful effects of such
unauthorized access including, but not limited to, sanctioning employees and taking
steps necessary to stop further unauthorized access. Contractor agrees to
indemnify and hold HCA harmless for any damages related to unauthorized use or
disclosure of Confidential Information by Contractor, its officers, directors,
employees, Subcontractors or agents.
4.9.3 If notification of the Breach or possible Breach must (in the judgment of HCA) be
made under the HIPAA Breach Notification Rule, or RCW 42.56.590 or RCW
19.255.010, or other law or rule, then:
4.9.3.1 HCA may choose to make any required notifications to the individuals, to
the U.S. Department of Health and Human Services Secretary (DHHS)
Secretary, and to the media, or direct Contractor to make them or any of
them.
4.9.3.2 In any case, Contractor will pay the reasonable costs of notification to
individuals, media, and governmental agencies and of other actions HCA
reasonably considers appropriate to protect HCA clients (such as paying
for regular credit watches in some cases).
4.9.3.3 Contractor will compensate HCA clients for harms caused to them by any
Breach or possible Breach.
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4.9.4 Any breach of this clause may result in termination of the Contract and the demand
for return or disposition (Attachment 1, Section 6) of all Confidential Information.
4.9.5 Contractor's obligations regarding Breach notification survive the termination of this
Contract and continue for as long as Contractor maintains the Confidential
Information and for any breach or possible breach at any time.
4.10 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.
4.11 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.
4.12 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
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.
4.13 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
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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.
4.13.1 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.
4.13.2 A party's request for a dispute resolution must:
4.13.2.1 Be in writing;
4.13.2.2 Include a written description of the dispute;
4.13.2.3 State the relative positions of the parties and the remedy sought;
4.13.2.4 State the Contract Number and the names and contact information for the
parties;
4.13.3 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.
4.14 ENTIRE AGREEMENT
HCA and Contractor agree that the Contract is the complete and exclusive statement of
the agreement between the parties relating to the subject matter of the Contract and
supersedes all letters of intent or prior contracts, oral or written, between the parties
relating to the subject matter of the Contract, except as provided in Section 4.44
Warranties.
4.15 FEDERAL FUNDING ACCOUNTABILITY & TRANSPARENCY ACT (FFATA)
4.15.1 This Contract is supported by federal funds that require compliance with the Federal
Funding Accountability and Transparency Act (FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the
public can see how federal funds are spent.
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4.15.2 To comply with the act and be eligible to enter into this Contract, Contractor must
have a Data Universal Numbering System (DUNS®) number. A DUNS® number
provides a method to verify data about your organization. If Contractor does not
already have one, a DUNS® number is available free of charge by contacting Dun
and Bradstreet at www.dnb.com.
4.15.3 Information about Contractor and this Contract will be made available on
www.uscontractorregistration.com by HCA as required by P.L. 109-282. HCA's
Attachment 3: Federal Funding Accountability and Transparency Act Data
Collection Form, is considered part of this Contract and must be completed and
returned along with the Contract.
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
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 4.41.3, 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.
4.17.3.1 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.
4.17.3.2 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
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date of resumption. For purposes of this subsection, "written notice" may
include email.
4.17.3.3 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 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 11 th
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, for any or all injuries to
persons or damage to property, or Breach of its confidentiality and notification obligations
under Section 4.7 Confidential Information Protection and Section 4.8 Confidentiality
Breach-Required Notification, 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
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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 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.
4.23 LEGAL AND REGULATORY COMPLIANCE
4.23.1 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.
4.23.2 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.
4.23.3 Failure to comply with any provisions of this section may result in Contract
termination.
4.24 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.
4.25 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.
4.26 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 CFR 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
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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.
4.27 OVERPAYMENTS TO 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 4.13 Disputes.
4.28 PAY EQUITY
4.28.1 Contractor represents and warrants that, as required by Washington state law
(Engrossed House Bill 1109, Sec. 211), during the term of this Contract, it agrees to
equality among its workers by ensuring similarly employed individuals 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.
4.28.2 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.
4.28.3 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.
4.28.4 A "bona fide regional difference in compensation level" must be (i) consistent with
business necessity; (ii) not based on or derived from a gender-based differential;
and (iii) account for the entire differential.
4.28.5 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.
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4.29 PUBLICITY
4.29.1 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.
4.29.2 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 HCA's name is mentioned, language is used, or Internet links are provided
from which the connection of HCA'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.
4.30 RECORDS AND DOCUMENTS REVIEW
4.30.1 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 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 CFR 431,
Subpart Q; and 42 CFR 447.202].
4.30.2 The Contractor must retain such records for a period of six (6) years after the date
of final payment under this Contract.
4.30.3 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.
4.31 REMEDIES NON-EXCLUSIVE
The remedies provided in this Contract are not exclusive, but are in addition to all other
remedies available under law.
4.32 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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4.33 RIGHTS IN DATA/OWNERSHIP
4.33.1 HCA and Contractor agree that all data and work products (collectively "Work
Product') produced pursuant to this Contract will be considered a work for hire
under the U.S. Copyright Act, 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, 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.
4.33.2 If for any reason the Work Product would not be considered a work 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 registrations and copyright
applications relating thereto and any renewals and extensions thereof.
4.33.3 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.
4.33.4 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.
4.33.5 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.
4.33.6 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
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infringement of other intellectual property right worldwide received by Contractor
with respect to any Preexisting Material delivered under this Contract.
4.34 RIGHTS OF STATE AND FEDERAL GOVERNMENTS
In accordance with 45 C.F.R. 95.617, all appropriate state and federal agencies, including
but not limited to the Centers for Medicare and Medicaid Services (CMS), will have a
royalty-free, nonexclusive, and irrevocable license to reproduce, publish, translate, or
otherwise use, and to authorize others to use for Federal Government purposes: (i)
software, modifications, and documentation designed, developed or installed with Federal
Financial Participation (FFP) under 45 CFR Part 95, subpart F; (ii)the Custom Software
and modifications of the Custom Software, and associated Documentation designed,
developed, or installed with FFP under this Contract; (iii) the copyright in any work
developed under this Contract; and (iv) any rights of copyright to which Contractor
purchases ownership under this Contract.
4.35 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.
4.36 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.
4.37 SUBCONTRACTING
4.37.1 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.
4.37.2 Contractor is responsible for ensuring that all terms, conditions, assurances and
certifications set forth in this Contract are included in any subcontracts.
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4.37.3 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.
4.37.4 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.
4.37.5 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.
4.38 SUBRECIPIENT
4.38.1 General
If the Contractor is a subrecipient (as defined in 45 CFR 75.2 and 2 CFR 200.93)
of federal awards, then the Contractor, in accordance with 2 CFR 200.501 and 45
CFR 75.501, shall:
4.38.1.1 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;
4.38.1.2 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;
4.38.1.3 Prepare appropriate financial statements, including a schedule of
expenditures of federal awards;
4.38.1.4 Incorporate OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501
audit requirements into all agreements between the Contractor and its
Subcontractors who are subrecipients;
4.38.1.5 Comply with any future amendments to OMB Super Circular 2 CFR
200.501 and 45 CFR 75.501 and any successor or replacement Circular
or regulation;
4.38.1.6 Comply with the applicable requirements of-OMB Super Circular 2 CFR
200.501 and 45 CFR 75.501 and any future amendments to OMB Super
Circular 2 CFR 200.501 and 45 CFR 75.501, and any successor or
replacement Circular or regulation; and
4.38.1.7 Comply with the Omnibus Crime Control and Safe streets Act of 1968,
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Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation
Act of 1973, Title 11 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 http://oip.gov/about/offices/ocr.htm for additional information and
access to the aforementioned Federal laws and regulations.)
4.38.2 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:
4.38.2.1 Submit to the Authority contact person the data collection form and
reporting package specified in OMB Super Circular 2 CFR 200.501 and
45 CFR 75.501, reports required by the program-specific audit guide (if
applicable), and a copy of any management letters issued by the auditor;
4.38.2.2 Follow-up and develop corrective action for all audit findings; in
accordance with OMB Super Circular 2 CFR 200.501 and 45 CFR
75.501, prepare a "Summary Schedule of Prior Audit Findings."
4.38.3 Overpayments
4.38.3.1 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 4.27 Overpayments to Contractors.
4.39 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
will survive. In addition, the terms of the sections titled Confidential Information Protection,
Confidential Information Breach— Required Notification, Contractor's Proprietary
Information, Disputes, Overpayments to Contractor, Publicity, Records and Documents
Review, Rights in Data/Ownership, and Rights of State and Federal Governments will
survive the termination of this Contract. The right of HCA to recover any overpayments
will also survive the termination of this Contract.
4.40 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
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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.
4.41 TERMINATION
4.41.1 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 five (5) 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."
4.41.2 TERMINATION FOR CONVENIENCE
When, at HCA's sole discretion, it is in the best interest of the State, HCA may
terminate this Contract in whole or in part by providing ten (10) calendar days'
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.
4.41.3 TERMINATION FOR NONALLOCATION OF FUNDS
If funds are not allocated to continue this Contract in any future period, 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
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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.
4.41.4 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.
4.41.5 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.
4.42 TERMINATION PROCEDURES
4.42.1 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.
4.42.2 HCA will pay Contractor the agreed-upon price, if separately stated, for completed
work and services accepted by HCA and the amount agreed upon by 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 4.13 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.
4.42.3 After receipt of notice of termination, and except as otherwise directed by HCA,
Contractor must:
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4.42.3.1 Stop work under the Contract on the date of, and to the extent specified
in, the notice;
4.42.3.2 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;
4.42.3.3 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;
4.42.3.4 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;
4.42.3.5 Transfer title to and deliver as directed by HCA any property required to
be furnished to HCA;
4.42.3.6 Complete performance of any part of the work that was not terminated by
HCA; and
4.42.3.7 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.
4.43 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 it will perform all services pursuant to this
Contract in a professional manner and with high quality and will 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.
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4.44.3 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
Confidential Information Security Requirements
1. Definitions
In addition to the definitions set out in Section 2 of this Contract K5736 for LEAD Expansion
Services, the definitions below apply to this Attachment.
a. "Hardened Password" means a string of characters containing at 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.
i. Passwords for external authentication must be a minimum of 10 characters long.
ii. Passwords for internal authentication must be a minimum of 8 characters long.
iii. Passwords used for system service or service accounts must be a minimum of 20
characters long.
b. "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 drives; or flash media (e.g. CompactFlash, SD, MMC).
c. "Portable/Removable Devices" means any small computing device that can be transported,
including but not limited to: handhelds/PDAs/Smartphones; Ultramobile PC's, flash memory
devices (e.g. USB flash drives, personal media players); and laptops/notebook/tablet
computers. If used to store Confidential Information, devices should be Federal Information
Processing Standards (FIPS) Level 2 compliant.
d. "Secured Area" means an area to which only Authorized Users have access. Secured Areas
may include buildings, rooms, or locked storage containers (such as a filing cabinet) within a
room, as long as access to the Confidential Information is not available to unauthorized
personnel.
e. "Transmitting" means the transferring of data electronically, such as via email, SFTP,
webservices, AWS Snowball, etc.
f. "Trusted System(s)" means the following methods of physical delivery: (1) hand-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. Fed Ex, UPS, DHL)which offer
tracking and receipt confirmation; and (4) the Washington State Campus mail system. For
electronic transmission, the Washington State Governmental Network (SGN) is a Trusted
System for communications within that Network.
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g. "Unique User ID" means a string of characters that identifies a specific user and which, in
conjunction with a password, passphrase, or other mechanism, authenticates a user to an
information system.
2. Confidential Information Transmitting
a. When transmitting HCA's Confidential Information electronically, including via email, the
Data must be encrypted using NIST 800-series approved algorithms
(http://csrc.nist.gov/publications/PubsSPs.html). This includes transmission over the public
internet.
b. When transmitting HCA's Confidential Information via paper documents, the Receiving Party
must use a Trusted System.
3. Protection of Confidential Information
The Contractor agrees to store Confidential Information as described:
a. Data at Rest:
i. Data will be encrypted with NIST 800-series approved algorithms. Encryption 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.
ii. Data stored on Portable/Removable Media or Devices:
• 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.
• HCA's data must not be stored by the Receiving Party on Portable Devices or
Media unless specifically authorized within the Data Share Agreement. If so
authorized, the Receiving Party must protect the Data by:
1. Encrypting with NIST 800-series approved algorithms. Encryption keys will
be stored and protected independently of the data;
2. Control access to the devices with a Unique User ID and Hardened
Password or stronger authentication method such as a physical token or
biometrics;
3. Keeping devices in locked storage when not in use;
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4. Using check-in/check-out procedures when devices are shared;
5. Maintain an inventory of devices; and
6. Ensure that when being transported outside of a Secured Area, all devices
with Data are under the physical control of an Authorized User.
b. 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. Confidential Information Segregation
HCA Confidential Information received under this Contract must be segregated or otherwise
distinguishable from non-HCA data. This is to ensure that when no longer needed by the
Contractor, all HCA Confidential Information can be identified for return or destruction. It also
aids in determining whether HCA Confidential Information has or may have been compromised
in the event of a security Breach.
a. The HCA Confidential Information must be kept in one of the following ways:
i. on media (e.g. hard disk, optical disc, tape, etc.) which will contain only HCA Data;
or
ii. in a logical container on electronic media, such as a partition or folder dedicated to
HCA's Data; or
iii. in a database that will contain only HCA Data; or
iv. within a database and will be distinguishable from non-HCA Data by the value of a
specific field or fields within database records; or
V. when stored as physical paper documents, physically segregated from non-HCA
Data in a drawer, folder, or other container.
b. When it is not feasible or practical to segregate HCA Confidential Information from non-
HCA data, then both the HCA Confidential Information and the non-HCA data with which it
is commingled must be protected as described in this Attachment.
5. Confidential Information Shared with Subcontractors
If HCA Confidential Information provided under this Contract is to be shared with a
Subcontractor, the contract with the Subcontractor must include all of the Confidential
Information Security Requirements.
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6. Confidential Information Disposition
When the Confidential Information is no longer needed, except as noted below, the Confidential
Information must be returned to HCA or destroyed. Media are to be destroyed using a method
documented within NIST 800-88 (http://csrc.nist.gov/publications/PubsSPs.html).
a. For HCA's Confidential Information stored on network disks, deleting unneeded
Confidential Information 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 Confidential
Information 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.
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ATTACHMENT 2
Federal Compliance, Certifications and Assurances
I. 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: Michele Gayle.
a. Source of Funds SABG-AR: This Contract is being funded partially or in full through
Cooperative Contract number B08T10839777, the full and complete terms and provisions
of which are hereby incorporated into this Contract. Federal funds to support this Contract
are identified by the Catalog of Federal Domestic Assistance (CFDA) number 93.959 in the
amount of $1,098,950. The Contractor or Subrecipient is responsible for tracking and
reporting the cumulative amount expended under HCA Contract K5736.
b. Period of Availability of Funds SABG-AR: Pursuant to 45 CFR 92.23, Contractor or
Subrecipient may charge to the award only costs resulting from obligations of the funding
period specified in 608T10839777 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: This section applies to subrecipients only. Subrecipient (including private,
for-profit hospitals and non-profit institutions) shall adhere to the federal Office of
Management and Budget (OMB) Super Circular 2 CFR 200.501 and 45 CFR 75.501. A
Subrecipient 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 200.501 and 45 CFR 75.501.
d. Modifications: This Contract 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 Contract.
iii. Change in a key person specified in the Contract.
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 Contract.
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 Contractor or Subrecipient shall not enter into a sub-contract for any
of the work performed under this Contract 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 Contract pertaining to Debarred
and Suspended Vendors, Lobbying certification, Audit requirements, and/or any other
project Federal, state, and local requirements.
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f. Condition for Receipt of Health Care Authority Funds: Funds provided by Health Care
Authority to the Contractor or Subrecipient under this Contract may not be used by the
Contractor or Subrecipient 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 Contractor or Subrecipient's 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
Contract.
h. Supplanting Compliance: SABG: If SABG funds support this Contract, the Block Grant will
not be used to supplant State funding of alcohol and other drug prevention and treatment
programs. (45 CFR section 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 Contractor or Subrecipient shall comply with all applicable State
and Federal statutes, laws, rules, and regulations in the performance of this Contract,
whether included specifically in this Contract or not.
k. Civil Rights and Non-Discrimination Obligations: During the performance of this Contract,
the Contractor or Subrecipient 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), §§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.) http://www.hhs.gov/ocr/civilrights.
HCA Federal Compliance Contact Information
Washington State Health Care Authority
Post Office Box 42710
Olympia, Washington 98504-2710
Il. 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, Mason County Community Service. The federal Circulars which
provide the applicable administrative requirements, cost principles and audit requirements are identified
by sub-awardee organization type.
OMB CIRCULAR
ENTITY TYPE ADMINISTRATIVE COST AUDIT REQUIREMENTS
REQUIREMENTS PRINCIPLES
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State. Local and Indian OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501
Tribal Governments and
Governmental 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) Contracts
administered by the Washington State Health Care Authority.
a. 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 or Subrecipient 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 above certification 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.
b. 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:
1. 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
i. The dangers of drug abuse in the workplace;
ii. The contractor's policy of maintaining a drug-free workplace;
iii. Any available drug counseling, rehabilitation, and employee assistance programs; and
iv. The penalties that may be imposed upon employees for drug abuse violations occurring in the
workplace;
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2. 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;
3. Notifying the employee in the statement required by paragraph (1), above, that, as a condition of
employment under the contract, the employee Will—
i. Abide by the terms of the statement; and
ii. 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;
4. 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;
5. 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—
i. 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
ii. 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;
6. 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, Authority
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
c. 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
Contracts from using Federal (appropriated) funds for lobbying the Executive or Legislative
Branches of the Federal Government in connection with a SPECIFIC grant or cooperative
Contract. Section 1352 also requires that each person who requests or receives a Federal
grant or cooperative Contract must disclose lobbying undertaken with non-Federal
(nonappropriated) funds. These requirements apply to grants and cooperative Contracts
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:
1. 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 Contract, and the
extension, continuation, renewal, amendment, or modification of any Federal contract, grant,
loan, or cooperative Contract.
2. 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
Washington State Page 38 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 2—Federal Compliance, Certifications and Assurances
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78c79D
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 Contract, 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.)
3. 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 Contracts) 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.
d. 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 or 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.
e. 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 or library services to children under the age of 18, if the
services are funded by Federal programs either directly or through State or local
governments, by Federal grant, contract, loan, or loan guarantee. The law also applies to
children's services that are provided in indoor facilities that are constructed, operated, or
maintained with such Federal funds. The law does not apply to children's services provided
in private residence, portions of facilities used for inpatient drug or alcohol treatment, service
providers whose sole source of applicable Federal funds is Medicare or Medicaid, orfacilities
where WIC coupons are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetary
penalty of up to $1,000 for each violation and/or the imposition 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 to protect and advance the physical and mental health of the American
people.
f. CERTIFICATION REGARDING OTHER RESPONSIBILITY MATTERS
Washington State Page 39 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 2—Federal Compliance, Certifications and Assurances
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
1. 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.
2. 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 or agency may terminate this
transaction for cause of default.
3. 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 learns that its certification
was erroneous when submitted or has become erroneous by reason of changed circumstances.
4. 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.
5. The prospective contractor agrees by submitting this contract that, should the proposed covered
transaction be entered into, it shall not 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 Authority.
6. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
7. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered 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.
CONTRACTOR SIGNATURE REQUIRED
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL: TITLE:
�e sq�- CIk ►Sc►CL
PLEASE ALSO PRINT OR TYPE NAME:
I,ev�n SNuWy
ORGANIZATION NAME: (if applicable) DATE:
Mason CoUn�y /10/2.on
Washington State Page 40 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 2—Federal Compliance, Certifications and Assurances
DocuSign Envelope ID:04612028-872D413B-B962-9091EE78C79D
ATTACHMENT 3
Federal Funding Accountability and Transparency Act (FFATA)
Data Collection Form
This Contract is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act
(FFATA or the Transparency Act). The purpose of the Transparency Act is to make information available online so the public can
see how federal funds are spent.
To comply with the act and be eligible to enter into this contract, your organization must have a Data Universal Numbering System
(DUNS®)number. A DUNS®number provides a method to verify data about your organization. If you do not already have one,
you may receive a DUNS®number free of charge by contacting Dun and Bradstreet at www.dnb.com.
Required Information about your organization and this contract will be made available on USASpending.gov by HCA as required
by P.L. 109-282. As a tool to provide the information, HCA encourages registration with the Central Contractor Registry(CCR)
because less data entry and re-entry is required by both HCA and your organization. You may register with CCR on-line at
https://www.uscontractorregistration.com/.
CONTRACTOR
1. Legal Name: Mason County Community Service 2. DUNS Number: 69580751
3. Principle Place of Performance:415 N 6th Street 3a. Congressional District
3b. City: Shelton 3c. State:WA
3d. Zip+4: 98584 3e. Country
4. Are you registered in CCR(https://www.uscontractorregistration.com/)? ❑YES (skip to page 2. Sign,date and return) ONO
In the preceding fiscal year did your organization:
a. Receive 80%or more of annual gross revenue from procurement federal contracts, Subcontracts, grants, loans, sub-grants,
and/or cooperative agreements; and
b. $25,000,000 or more in annual gross revenues from federal procurement contracts, Subcontracts,grants, loans,subgrants,
and/or cooperative agreements; and
c. The public does not have access to information about the compensation of the executives through periodic reports filed with the
IRS or the Security and Exchange Commission per 2 CFR Part 170.330
❑ NO(skip the remainder of this section-Sign,date and return)
❑YES(You must report the names and total compensation of the top 5 highly compensated officials of your organization).
Name Of Official Total Compensation
1.
2.
3.
4.
5.
Note: "Total compensation"means the cash and noncash dollar value earned by the executive during the sub-recipient's past fiscal
year of the following (for more information see 17 CFR 229.402 (c) (2))
By signing this document,the Contractor Authorized Representative attests to the information.
Washington State Page 41 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 3—Federal Funding Accountability and Transparency Act(FFATA)Data Collection Form
DocuSign Envelope ID:04612028-872D-413B-B962-9091 EE78C79D
Signature of Contractor Authorized Representative Date
q.�. D Z .z
HCA will not endorse the Contractor's sub-award until this form is completed and returned.
FOR HEALTH CARE AUTHORITY USE ONLY
HCA Contract Number: K5736
FAIN: B08T10839777
Sub-award Project Description (see instructions and examples below)
Provide intesive case management services to recently arrested and/or high risk for arrest individuals through the
expansion of the WA State LEAD program throughout Mason County.
Instructions for Sub-award Project Description:
In the first line of the description provide a title for the sub-award that captures the main purpose of
the Subrecipients work. Then, indicate the name of the Subrecipient and provide a brief description
that captures the overall purpose of the sub-award, how the funds will be used, and what will be
accomplished.
Example of a Sub-award Project Description:
Increase Healthy Behaviors: Educational Services District XYZ will provide training and technical
assistance to chemical dependency centers to assist the centers to integrate tobacco use into their
existing addiction treatment programs. Funds will also be used to assist centers in creating tobacco
free treatment environments.
Washington State Page 42 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 3—Federal Funding Accountability and Transparency Act(FFATA)Data Collection Form
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
ATTACHMENT 4
Substance Abuse and Mental Health Services Agency (SAMHSA) Award Terms
By drawing or otherwise obtaining funds as a subawardee or contractor of a non-federal entity
drawing or otherwise obtaining funds from SAMHSA, a branch of the United States Department of
Health and Human Services (HHS), you agree to the following pass-through terms and conditions.
Name Language
Acceptance of the This Subaward is subject to the SAMHSA Fiscal Year 2021 —Award
Terms of an Award Standard Terms, included directly, or incorporated by reference on the Notice
of Award (NoA) support the grant.
Non-Supplanting Federal award funds must supplement, not supplant, nonfederal funds. All
recipients who receive awards under programs that prohibit supplanting by
law must ensure that federal funds do not supplant funds that have been
budgeted for the same purpose through non-federal sources. Applicants or
award recipients may be required to demonstrate and document that a
reduction in non-federal resources occurred for reasons other than the
receipt of expected receipt of federal funds.
Block grant funds (SABG and MHBG) will not be used to supplant state
funding of alcohol and other drug prevention programs. See 45 CFR §
98.123
Unallowable Costs All costs incurred prior to the award issue date and costs not consistent with
the funding opportunity, 45 CFR Part 75, and the HHS Grants Policy
Statement, are not allowable under this subaward.
Marijuana Grant funds may not be used, directly or indirectly, to purchase, prescribe, or
Restrictions provide marijuana treatment using marijuana. Treatment in this context
includes the treatment or opioid use disorder. Grant funds also cannot be
provided to any individual who or organization that provides or permits
marijuana use for the purposes of treating substance use or mental
disorders. See, e.g., 45 CFR 75.300(a); 21 USC 812(c)(10) and 841. This
prohibition does not apply to those providing such treatment in the context of
clinical research permitted by the DEA and under an FDA-approved
investigational new drug application where the article being evaluated is
marijuana or a constituent thereof that is otherwise a banned controlled
substances under the federal law.
Executive Pay The Consolidated Appropriations Act, 2021 (Public Law 116-260), signed into
law on December 27, 2020 restricts the amount of direct salary to Executive
Level II of the Federal Executive Pay scale. Effective January 3, 2021, the
salary limitation for Executive Level II is $199,300.
Washington State Page 43 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 4-SAMHSA Award Terms
DocuSign Envelope ID:04612028-872D-413B-B962-9091 EE78C79D
Name Language
Promotional Items SAMHSA grant funds may not be used for Promotional Items. Promotional
Items include but are not limited to: Clothing and commemorative items such
as pens, mugs/cups, folders/folios, lanyards, and conference bags.
Acknowledgment of When a conference is funded by a grant or cooperative agreement, the
Federal Funding at recipient must include the following statement in all conference materials
Conferences and (including promotional materials, agenda, and internet sites):
Meetings Funding for this conference was made possible 9in part) by(insert grant or
cooperative agreement award number) from SAMHSA. The views expressed
in written conference materials or publications and by speakers and
moderators do not necessarily reflect the official policies of the Department of
Health and Human Services; nor does mention of trade names, commercial
practices, or organizations imply endorsements by the U.S. Government.
Rights in Data and As applicable, recipients agree to the requirements for intellectual property,
Publications rights in data, access to research data, publications, and sharing research
tools, and intangible property and copyrights as described in 45 CFR 75.322
and the HHS Grants Policy Statement.
HCA may copyright any work that is subject to copyright and was developed,
or for which ownership was acquired, under a Federal Award. SAMHSA
reserves a royalty-free, nonexclusive and irrevocable right to reproduce,
publish, or otherwise use the work for Federal purposes, and to authorize
others to do so.
Mandatory Consistent with 45 CFR 75.113, Subrecipients must disclose, in a timely
Disclosures manner, in writing to HCA and the HHS Office of Inspector General (OIG), all
information related to violations, or suspected violations, of Federal criminal
law involving fraud, bribery, or gratuity violations potentially affecting the
Federal award. Disclosures must be sent in writing to HCA and the HHS OIG
at the following addresses:
U.S. Department of Health and Human Services
Office of Inspector General
ATTN: Mandatory Grant Disclosures, Intake Coordinator
330 Independence Avenue, SW, Cohen Building Room 5527
Washington DC 20201
Fax: (202) 205-0604 (include "Mandatory Grant Disclosures" in subject line
or email)
Washington State Page 44 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 4-SAMHSA Award Terms
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
Name Language
MandatoryGranteeDisclosures(_a,)oiq.hhs..qov
Failure to make required disclosures can result in any of the remedies
described in 45 CFR 75.371 remedies for noncompliance, including
suspension or debarment (See 2 CFR parts 180 & 376 and 31 USC 3321)
Lobbying Restrictions Per 45 CFR §75.215, Subrecipients are subject to the restrictions on
lobbying as set forth in 45 CFR part 93.
U.S.C. > Title 18 > Part I > Chapter 93 > Section 1913, No part of the money
appropriated by any enactment of Congress shall, in the absence of express
authorization by Congress, be used directly or indirectly to pay for any
personal service, advertisement, telegram, telephone, letter, printed or
written matter, or other device, intended or designed to influence in any
manner a Member of Congress, a jurisdiction, or an official of any
government, to favor, adopt, or oppose, by vote or otherwise, any legislation,
law, ratification, policy, or appropriation, whether before or after the
introduction of any bill, measure, or resolution proposing such legislation,
law, ratification, policy, or appropriation; but this shall not prevent officers or
employees of the United States or of its departments or agencies from
communicating to any such Member or official, at his/her request, or to
Congress or such official, through the proper official channels, requests for
any legislation, law, ratification, policy, or appropriations which they deem
necessary for the efficient conduct of the public business, or from making any
communication whose prohibition by this section might, in the opinion of the
Attorney General, violate the Constitution or interfere with the conduct of
foreign policy, counter-intelligence, intelligence, or national security activities.
Violations of this section shall constitute as a violation of section 1352 (a) of
Title 31.
Drug Free Workplace The Drug-Free Workplace Act of 1988 (41 U.S.C. § 701 et seq.) requires that
all organizations receiving grants from any Federal agency agree to maintain
a drug-free workplace. By signing this Contract, you agree that the grantee
will provide a drug-free workplace and will comply with the requirement to
notify NIH if an employee is convicted of violating a criminal drug statute.
Failure to comply with these requirements may be cause for debarment.
Government wide requirements for Drug-Free Workplace for Financial
Assistance are found in 2 CFR part 182; HHS implementing regulations are
set forth in 2 CFR part 382.400. All recipients of NIH grant funds must
comply with the requirements in Subpart B (or Subpart C if the recipient is an
individual) of part 382.
Trafficking Victims The Trafficking Victims Protection Act of 2000 authorizes termination of
Protection Act of financial assistance provided to a private entity, without penalty to the
Washington State Page 45 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 4-SAMHSA Award Terms
DocuSign Envelope ID:04612028-8720-413B-B962-9091EE78C79D
Name Language
2000 (22 USC Federal government, if the recipient or subrecipient engages in certain
7104(G)), as activities related to trafficking in persons.
amended, and 2 CFR SAMHSA or HCA may unilaterally terminate this award, without penalty, if a
Part 175 private entity recipient, or a private entity subrecipient, or their employees: a)
Engage in severe forms of trafficking in persons during the period of time that
the award is in effect; b) Procure a commercial sex act during the period of
time that the award is in effect; or, c) Use forced labor in the performance of
the award or subawards under the award.
The text of the full award term is available at 2 C.F.R. § 175.15(b). See
http://www.gpo.gov/fdsys/pkq/CFR-2012-title2-volt/pdf/CFR-2012-title2-vol1-
sec175-15.pdf
Confidentiality of The regulations (42 CFR 2) are applicable to any information about alcohol
Alcohol and Drug and other drug abuse patients obtained by a "program" (42 CFR 2.11), if the
Abuse Patient program is federally assisted in any manner (42 CFR 2.12b). Accordingly, all
Records project patient records are confidential and may be disclosed and used only
in accordance with 42 CFR Part 2. The Subrecipient is responsible for
assuring compliance with these regulations and principles, including
responsibility for assuring the security and confidentiality of all electronically
transmitted patient material.
Healthy People 2020 Healthy People 2020 is a national initiative led by HHS that set priorities for
all SAMHSA programs. The initiative has two major goals: (1) increase the
quality and years of a healthy life; and (2) eliminate our country's health
disparities. The program consists of 28 focus areas and 467 objectives.
SAMHSA has actively participated in the work groups of all the focus areas
and is committed to the achievement of the Healthy People 2020 goals.
Healthy People 2010 and the conceptual framework for the forthcoming
Healthy People 2020 process can be found online at:
http://www.healthypeople.gov/
Accessibility Recipients of Federal financial assistance (FFA) from HHS must administer
Provisions their programs in compliance with Federal civil rights law. This means that
recipients of HHS funds must ensure equal access to their programs without
regard to a person's race, color, national origin, disability, age, and in some
circumstances, sex and religion. This includes ensuring your programs are
accessible to persons with limited English proficiency.
The HHS Office for Civil Rights also provides guidance on complying with
civil rights laws enforced by HHS. Please see:
http://www.hhS.gov/ocr/civiIrights/understanding/section 1557/index.htm1.
Washington State Page 46 of 55 LEAD Expansion Services
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Attachment 4-SAMHSA Award Terms
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
Name Language
Recipients of FFA also have specific legal obligations for serving qualified
individuals with disabilities. Please see-
http://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
Please contact the HHS Office for Civil Rights for more information about
obligations and prohibitions under Federal civil rights laws at
https://www.hhs.gov/civil- rights/index.html or call 1-800-368-1019 or TDD 1-
800- 537-7697.
Also note that it is an HHS Departmental goal to ensure access to quality,
culturally competent care, including long-term services and supports, for
vulnerable populations. For further guidance on providing culturally and
linguistically appropriate services, recipients should review the National
Standards for Culturally and Linguistically Appropriate Services in Health and
Health Care at
https://minoritVhealth.hhs.gov/omh/browse.aspx?lvl=1&Mid=6.
Legislative Mandates Certain statutory provisions under P.L. 115-245, Department of Defense and
Labor, Health and Human Services, and Education Appropriations Act, 2019,
Division B, Title V, Title ll, General Provisions limit the use of funds on
SAMHSA grants, cooperative agreements, and contract awards. Such
provisions are subject to change annually based on specific appropriation
language that restricts the use of grant funds. The full text of P.L. 115-245 is
available at https://www.congress.gov/bill/115th-
congress/housebill/6157/text? Format=txt.
Ad Hoc Submissions Throughout the project period, SAMHSA may determine that a grant requires
submission of additional information beyond the standard deliverables. This
information may include, but is not limited to, the following:
• Payroll
• Purchase orders
• Contract documentation
• Proof of project implementation
Washington State Page 47 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Attachment 4-SAMHSA Award Terms
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
ATTACHMENT 5
Federal Award Identification for Subrecipients
Substance Abuse Prevention and Treatment Block Grant -AR
(i) Subrecipient name (which must match the Mason County Community Service
name associated with its unique entity
identifier);
(ii) Subrecipient's unique entity identifier; (DUNS) 69580751
(iii) Federal Award Identification Number (FAIN); B08T10839777
(iv) Federal Award Date (see §200.39 Federal 9/1/2021 —9/30/2025
award date);
(v) Subaward Period of Performance Start and Date of Execution —6/30/2023
End Date;
(vi) Amount of Federal Funds Obligated by this $1,098,950
action;
(vii) Total Amount of Federal Funds Obligated to $1,098,950
the subrecipient;
(xiii) Total Amount of the Federal Award; $30,586,435
(ix) Federal award project description, as required Block Grants for Prevention and
to be responsive to the Federal Funding Treatment of Substance Abuse
Accountability and Transparency Act (FFATA);
(x) Name of Federal awarding agency, pass- SAMHSA
through entity, and contact information for WA State Health Care Authority
awarding official, Keri Waterland, Assistant Director
DBHR
626 8th Ave SE; Olympia, WA 98504-
5330
Keri.waterland(a)-hca.wa.gov
(xi) CFDA Number and Name; the pass-through 93.959
entity must identify the dollar amount made Substance Abuse Prevention and
available under each Federal award and the Treatment Block Grant
CFDA number at time of disbursement;
(xii) Identification of whether the award is R&D; and ❑ Yes ® No
(xiii) Indirect cost rate for the Federal award de minimus (10%)
(including if the de minimis rate is charged per
§200.414 Indirect (F&A) costs).
Washington State Page 48 of 55 LEAD Expansion Services
Health Care Authority FICA Contract#K5736
Attachment 5—Federal Award Identification for Subrecipients
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
SCHEDULE A
Statement of Work
1. PURPOSE
HCA intends to enter into an agreement with the contractor for purposes of establishing a LEAD
program that adheres to the Core Principles of the LEAD program as noted in SSB 5380 and
RCW 71.24.589, which indicates that the HCA must partner with the Public Defender's
Association-National Support Bureau (NSB) to expand availability of Law Enforcement Assisted
Diversion (LEAD) programs statewide.
2. DEFINITIONS
"Julota" means a case management electronic record system
"LEAD" or"Law Enforcement Assisted Diversion" means a registered trademark referring to the
LEAD program developed by the Seattle-King County LEAD Policy Coordinating Group. The
LEAD program is managed by the Public Defender Association, and is recognized as an
evidence-based practice in the Washington Medicaid Waiver Toolkit and falls under the Office of
Justice Programs standards for evidence-based practices.
"NSB" or"National Support Bureau" means project of the Public Defender Association. The LEAD
National Support Bureau will be providing strategic guidance and technical assistance to the pilot
sites developing LEAD programs under this Contract. Including providing guidance on
implementation with a commitment to the LEAD program's core principles.
"PDA" or"Public Defender Association" means the agency that will provide technical assistance
for LEAD site selection, implementation and evaluation.
"ROI" means Release of Information
"URICA" means University of Rhode Island Change Assessment scale
3. HCA RESPONSIBILITIES
3.1. Provide a contract manager to monitor all progress under the program; and
3.2. Provide timely responses to all inquiries from the Contractor
4. CONTRACTOR RESPONSIBILITIES
4.1. Coordinate with NSB for purposes of receiving technical assistance;
4.2. Coordinate with NSB for training on policies and protocols for LEAD program referrals and
diversion-eligible offenses;
Washington State Page 49 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091 EE78C79D
4.3. Coordinate with NSB to develop a LEAD program site evaluation plan with the intent of
yielding the following results:
4.3.1. Reduction in arrests, time spent in custody, and/or recidivism for program
participants;
4.3.2. Increase access to and utilization of non-emergency community behavioral health
and/or substance use services;
4.3.3. Reduction in the utilization in emergency services;
4.3.4. Increased resilience, stability, and well-being for program participants; and
4.3.5. Reduction in cost for the justice system in comparison to processing cases as
usual through the justice system.
4.4. Under this contract provide intensive case management services through a pilot project
for the LEAD program which shall adhere to core principles recognized by the law
enforcement assisted diversion NSB, the efficacy of which have been demonstrated in
peer-reviewed research studies. A major component of this will include the maintaining an
executive committee that consists of the following members:
4.4.1. Community-based organizations;
4.4.2. Local government;
4.4.3. Law enforcement;
4.4.4. Prosecutors;
4.4.5. Public health experts; and
4.4.6. Organizations led by and representing individuals with past justice system
involvement
4.5. As a LEAD program pilot site Contractor will:
4.5.1. Accept and follow all guidance provided by the PDA technical assistance team to
ensure that the pilot site maintains fidelity to the LEAD program model as
referenced in RCW 71.24.589.
4.5.2. Ensure that the program is managed to achieve expected outcomes that are
measurable and will be used in the future to evaluate the performance and to
ensure accountability for the use of this funding. As such, the Contractor will work
with the HCA to utilize a Julota data collection and case management system,
including being required to:
Washington State Page 50 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
4.5.2.1. Establish effective workflows for case managers to record needed
data in Julota and/or establish any needed data uploads or interfaces
to ensure needed data are included in the Julota platform for reporting
to the HCA and lessen any duplicate data entry burden on staff(e.g.,
bringing data in from local EHR systems, law enforcement, emergency
departments, etc.)
4.5.2.2. Implement the referral functions to be used to identify possible
participants and track referral data related to participants of the LEAD
program, including use of external referral links to receive referrals
directly from partners and resources in the community who identify
eligible participants
4.5.2.3. Utilize the automation of notifications/alerts to maximize on efficiency
of communication and processing of data related to the system
4.5.2.4. Use the participant surveys to evaluate program participation and
engagement
4.5.2.5. Implement user accounts with trusted partners who may be providing
services to participants on behalf of the case management company
so the outcomes of those connections and services can be included in
the data provided to HCA
4.5.2.6. Collect the number or individuals contacted through law enforcement
response and/or social contact referrals;
4.5.2.7. Collect the number of individuals admitted into LEAD program;
4.5.2.8. Collect aggregated demographics for individuals admitted, including;
A. Race;
B. Gender;
C. Age; and
D. Housing status
4.5.2.9. Collect aggregated intake form:
E. Self-reported behavioral health;
F. Employment;
G. Family; and
Washington State Page 51 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
H. Financial information
4.5.2.10. Collect the following LEAD program evaluation metrics:
I. Number of police contacts related to criminal behavior/suspected
criminal behavior
J. Number of arrests-categorize by type
K. Number or warrants
L. Number of criminal charges categorize by type
M. Number of jail bookings
N. Number of jail bed days
O. Number of visits to an emergency room
P. Number of inpatient admits to hospital care
Q. Number of contacts with fire/EMS
R. Number of times team meets with participants-categorized by
type: case management, peer counseling, brief outreach
S. Number of referrals to service-categorized by type: mental
health, substance use disorder, medical, housing, insurance,
benefits, food, shelter, employment, etc.
T. Number of connections to services-categorized by type: mental
health, substance use disorder, medical, housing, insurance,
benefits, food, shelter, employment, etc.
U. Percentage of individuals that received a URICA score
V. Participant survey baseline, at six (6) months and one (1) year
4.5.3. The LEAD program manager will provide logistical coordination, support, and
record-keeping to the local LEAD advisory board and operational workgroup.
Meetings will be scheduled as frequently as necessary to maintain the integrity
and operation of the LEAD program; This support shall include, but not limited to
the following:
4.5.3.1. Set meeting dates and provide coordination of presenters and subject
matter experts for the LEAD advisory board and Steering Board
meetings;
Washington State Page 52 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
4.5.3.2. Work with PDA program manager to develop and provide an agenda
to LEAD advisory board members for each meeting;
4.5.3.3. Provide all meeting agendas, minutes and pertinent documents to the
PDA program manager and the HCA Contract Manager
4.5.3.4. Meet at least monthly with the PDA program manager to ensure
communication and coordination of project;
4.5.3.5. Upon request, participate in presentations to key state and local
stakeholders on progress;
4.5.3.6. Create and/or renew MOUs to facilitate information sharing; and
4.5.3.7. Provide a satisfaction survey to participants, officers, and stake
holders within the last quarter of the program.
4.5.4. Operational workgroup meetings are for the purposes of coordinating care for
LEAD program participants and only those participants that have signed an ROI
with operational workgroups members are to be discussed during the workgroup
meetings.
4.5.5. Coordinate, schedule and conduct operational workgroup meetings, as needed,
and is to include the following participants:
4.5.5.1. Law Enforcement Officers referring to the LEAD program
4.5.5.2. Prosecutors considering cases involving LEAD program participants
4.5.5.3. Case Managers assisting LEAD program participants
4.5.5.4. LEAD program project managers
4.5.6. The LEAD program manager will participate in technical assistance calls with the
PDA program manager, at least once a month, to maintain the integrity and
fidelity of the LEAD program.
4.5.7. Maintain employees and/or contract clinical support positions, to include the
following:
4.5.7.1. Outreach Coordinator;
4.5.7.2. Clinical Supervisor, and
4.5.7.3. Case Manager.
Washington State Page 53 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091 EE78C79D
4.5.8. Coordinate, schedule, and conduct LEAD steering committee and advisory board
meetings as needed to maintain the integrity and fidelity of the LEAD program.
4.5.9. Provide referrals to local community agencies for intensive case management
services, including but not limited to substance use, mental health, and behavioral
health assessment and treatment.
4.5.10. Monitor to ensure LEAD program has made at least 350 referrals of new,
previously referred or previously discharged participants, admit at least the
minimum required to maintain a case load of at least 45 individuals per case
manager, by June 30, 2023.
4.5.11. Submit Monthly Reports as detailed in the Deliverable Table with the invoice to
the HCA Contract Manager, including but not limited to: how many individuals
referred, number of active participants, current barriers, attempts to resolve
barriers, any staffing changes, any success stories, and TA needs.
4.5.12. Ensure travel pe diem, computers, office supplies and all the other supplies and
tools necessary to perform defined duties are provided to LEAD program staff
and/or contract staff.
5. Deliverables Table
# Deliverable Due Date Payment
1 Renew contract with Julota Case Within thirty (45) days of the Date One-time
Management and Data Collection of Execution payment of
Software platform. $83,868
2 Minutes detailing all local LEAD Due the 15'h of each month, $2,000 per
advisory board and operational following the month of service meeting, not to
workgroup meetings. exceed $126,000
Up to 63 meetings throughout the
duration of this Contract.
(averaging 3 meetings per month).
3 Monthly Technical Assistance (TA) No less than one (1) call per $10,000 per
calls with the PDA Technical month. month, not to
Assistance Team. exceed $210,000
4 Monthly Data Collection Report Due the 15' of each month, $15,000 per
following the month of service month, not to
exceed $315,000
Washington State Page 54 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work
DocuSign Envelope ID:04612028-872D-413B-B962-9091EE78C79D
# Deliverable Due Date Payment
5 LEAD Monthly Progress Report Due the 15'h of each month, $11,000 per
following the month of service month, not to
exceed $231,000
6 Successfully refer a minimum of June 30, 2023 One-time
350 individuals, admit at least the payment of
minimum required to maintain an $23,187
average case load of at least 45
per case manager hired, each year.
7 Indirect (administrative) costs: Only Monthly, and no later than 60 10% of direct
10% of direct costs. days following the Contract end costs- up to
date. $109,895
Maximum Consideration for HCA Contract K5736 $1,098,950
Washington State Page 55 of 55 LEAD Expansion Services
Health Care Authority HCA Contract#K5736
Schedule A—Statement of Work