HomeMy WebLinkAboutHealth Care AuthorityRev 5/6/2019
PROFESSIONAL SERVICES
CONTRACT for
CJTA Funded Treatment and
Recovery Support Services
HCA Contract Number: K7098
Contractor/Vendor Contract Number:
23-083
THIS CONTRACT is made by and between the Washington State Health Care Authority, (HCA) and Mason
County, (Contractor).
CONTRACTOR NAME CONTRACTOR DOING BUSINESS AS (DBA)
Mason County
CONTRACTOR ADDRESS Street City State Zip Code
411 N 5th Street Shelton WA 98584
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS
Kayla Henley (360) 427-9670 ext. 296 KHenley@masoncountywa.gov
Is Contractor a Subrecipient under this Contract?
YES NO
HCA PROGRAM HCA DIVISION/SECTION
Criminal Justice Treatment Account – State Appropriations DBHR / SUD
HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS
Zach Lynch, Criminal Justice Treatment Account Manager
Health Care Authority
626 8th Avenue SE
Olympia, WA 98504
HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS
(360) 725-9992 zach.lynch@hca.wa.gov
CONTRACT START DATE CONTRACT END DATE TOTAL MAXIMUM CONTRACT AMOUNT
July 1, 2023 June 30, 2025 $182,950.00
PURPOSE OF CONTRACT:
Contractor to provide Criminal Justice Treatment Account funds to provide treatment and recovery support services to
individuals involved in the criminal justice system in accordance with RCW 71.24.580.
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
HCA SIGNATURE PRINTED NAME AND TITLE DATE SIGNED
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10/12/2023
Andria Howerton
Deputy Contracts Administrator
Comissioner 10/12/2023
Sharon Trask
Washington State 2 CJTA Funded Treatment and Recovery Support
Health Care Authority HCA Contract #K7098
TABLE OF CONTENTS
1. Statement of Work (SOW) ............................................................................................................4
2. Definitions ....................................................................................................................................4
3. Special Terms and Conditions ....................................................................................................7
3.1 Performance Expectations ....................................................................................................7
3.2 Term ......................................................................................................................................8
3.3 Compensation .......................................................................................................................8
3.4 Revenue and Expenditure Payment ......................................................................................9
3.5 Contractor and HCA Contract Managers ............................................................................. 10
3.6 Legal Notices ...................................................................................................................... 10
3.7 Incorporation of Documents and Order of Precedence ........................................................ 11
3.8 Insurance ............................................................................................................................ 11
4. General Terms and Conditions ................................................................................................. 13
4.1 Access to Data .................................................................................................................... 13
4.2 Accessibility ......................................................................................................................... 13
4.3 Advance Payment Prohibited .............................................................................................. 14
4.4 Amendments ....................................................................................................................... 14
4.5 Assignment ......................................................................................................................... 14
4.6 Attorneys’ Fees ................................................................................................................... 14
4.7 Change in Status ................................................................................................................. 15
4.8 Conflict of Interest ............................................................................................................... 15
4.9 Conformance ....................................................................................................................... 15
4.10 Covered Information Protection ........................................................................................... 15
4.11 Contractor’s Proprietary Information .................................................................................... 16
4.12 Covenant Against Contingent Fees ..................................................................................... 16
4.13 Debarment .......................................................................................................................... 16
4.14 Disputes .............................................................................................................................. 17
4.15 Entire Agreement ................................................................................................................ 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 Legal and Regulatory Compliance ....................................................................................... 19
4.23 Limitation of Authority .......................................................................................................... 20
4.24 No Third-Party Beneficiaries ................................................................................................ 20
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Washington State 3 CJTA Funded Treatment and Recovery Support
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4.25 Nondiscrimination ................................................................................................................ 20
4.26 Overpayments to the Contractor .......................................................................................... 20
4.27 Pay Equity ........................................................................................................................... 21
4.28 Publicity ............................................................................................................................... 21
4.29 Records and Document Review .......................................................................................... 22
4.30 Remedies Non-Exclusive .................................................................................................... 22
4.31 Right of Inspection ............................................................................................................... 22
4.32 Rights in Data/Ownership .................................................................................................... 22
4.33 Severability .......................................................................................................................... 23
4.34 Site Security ........................................................................................................................ 23
4.35 Subcontracting .................................................................................................................... 24
4.36 Survival ............................................................................................................................... 24
4.37 Taxes .................................................................................................................................. 24
4.38 Termination ......................................................................................................................... 25
4.39 Termination Procedures ...................................................................................................... 26
4.40 Transition Obligations .......................................................................................................... 27
4.41 Treatment of Assets ............................................................................................................ 27
4.42 Waiver ................................................................................................................................. 28
4.43 Warranties ........................................................................................................................... 29
Schedule A: Statement of Work ........................................................................................................ 30
Schedule B: Data Share Agreement ................................................................................................. 41
Attachment 1: Quarterly Progress Report Template .......................................................................... 63
Attachment 2: Quarterly Revenue and Expenditure Report Template ............................................... 66
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Washington State 4 CJTA Funded Treatment and Recovery Support
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The State of Washington, acting by and through the Health Care Authority (HCA), seeks to
secure treatment and recovery support services to individuals involved in the criminal justice
system; and
Client services, as described in this Contract, are exempt from competitive solicitation (RCW
39.26.125(6)) and Mason County (Contractor) seeks to provide such services.
HCA has determined that entering into a Contract with Mason County will meet HCA’s needs
and will be in the State’s best interest.
THEREFORE, HCA awards to Mason County this Contract, the terms and conditions of which
will govern Contractor’s providing to HCA the Treatment and Recovery Support 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.
“Authorized User” means an individual or individuals with an authorized business need to
access HCA’s Confidential Information under this Contract.
“Business Associate” means a Business Associate as defined in 45 C.F.R. § 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 Contract includes Business Associate’s employees, agents,
officers, Subcontractors, third party contractors, volunteers, or directors.
“Business Days” means Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific Time, except
for holidays observed by the state of Washington.
“C.F.R.” means the Code of Federal Regulations. All references in this Contract to C.F.R.
chapters or sections include any successor, amended, or replacement regulation. The C.F.R.
may be accessed at http://www.eC.F.R..gov/cgi-bin/EC.F.R.?page=browse.
“Client” means an individual who is eligible for or receiving services through HCA program(s).
“Confidential Information” means information that is exempt from disclosure to the public or
other unauthorized persons under chapter 42.56 RCW or other federal or state laws.
Confidential Information includes, but is not limited to, any information identifiable to an
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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 infomration.
“Contract” means this Contract document and all schedules, exhibits, attachments,
incorporated documents and amendments.
“Contract Administrator” means the HCA individual designated to receive legal notices and
to administer, amend, or terminate this Contract.
“Contract Manager” means the individual identified on the cover page of this Contract who
will provide oversight of the activities conducted under this Contract.
“Contractor” means Mason County, its employees and agents. Contractor includes any firm,
provider, organization, individual or other entity performing services under this Contract. It also
includes any Subcontractor retained by Contractor as permitted under the terms of this
Contract.
“Covered Entity” 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 adminstrative
activities to health care as defined in 45 C.F.R. 160.103.
“Data” means information produced, furnished, acquired, or used by Contractor in meeting
requirements under this Contract.
“Disclosure” means the release, transfer, provision of, access to, or divulging in any other
manner of information outside the entity holding the information.
“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.
“Electronic Protected Health Information” or “ePHI” means Protected Health Information
that is transmitted by electronic media or maintained in any medium described in the definition
of electronic media at 45 C.F.R. § 160.103.
“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.
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“HIPAA” means the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104-
191, as amended by the American Recovery and Reinvestment Act of 2009 (“ARRA”), Sec.
13400 – 13424, H.R. 1 (2009) (HITECH Act). HIPAA inlcudes the Privacy, Security, Breach
Notification, and Enforcement Rules at 45 C.F.R. Part 160 and Part 164.
“Individual(s)” means the person(s) who is the subject of PHI and includes a person who
qualifies as a personal representative in accordance with 45 C.F.R. § 164.502(g).
"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.
“Personal Information” means information identifiable to any person, including, but not
limited to, information that relates to a person’s name, health, finances, education, business,
use or receipt of governmental services or other activities, addresses (including or excluding
zip code), telephone numbers, social security numbers, driver’s license numbers, credit card
numbers, any other identifying numbers, and any financial identifiers.
“Proprietary Information” refers to any information which has commercial value and is
either: (1) technical information, including patent, copyright, trade secret, and other proprietary
information, techniques, sketches, drawings, models, inventions, know-how, processes,
apparatus, equipment, algorithms, software programs, software source documents, and
formulae related to the current, future, and proposed products and services; or (2) non-
technical information relating to products, including without limitation pricing, margins,
merchandising plans and strategies, finances, financial and accounting data and information,
suppliers, customers, customer lists, purchasing data, sales and marketing plans, future
business plans, and any other information which is proprietary and confidential. Contractor’s
Proprietary Information is information owned by Contractor to which Contractor claims a
protectable interest under law.
“Protected Health Information” or “PHI” means information that relates to the provision of
health care to an individual; the past, present, or future physical or mental health or condition
of an individual; or past, present or future payment for provision of health care to an individual.
45 C.F.R. 160 and 164. PHI includes demographic information that identifies the individual or
about which there is reasonable basis to believe, can be used to identify the individual. 45
C.F.R. 160.103. PHI is information transmitted, maintained, or stored in any form or medium.
45 C.F.R. 164.501. PHI does not include education records covered by the Family Educational
Right and Privacy Act, as amended, 20 USC 1232g(a)(4)(b)(iv).
“RCW” means the Revised Code of Washington. All references in this Contract to RCW
chapters or sections include any successor, amended, or replacement statute. Pertinent RCW
chapters can be accessed at: http://apps.leg.wa.gov/rcw/.
“Regulation” means any federal, state, or local regulation, rule, or ordinance.
“State Fiscal Quarter” means quarterly periods of January 1 through March 31, April 1
through June 30, July 1 through September 30, and October 1 through December 31.
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“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.
“Subcontract” means any separate agreement or contract between the Contractor and an
individual or entity (“Subcontractor”) to perform any duties that give rise to a business
requirement to access the Data that is the subject of this Contract.
“Subcontractor” means a person or entity that is not in the employment of the Contractor,
who is performing all or part of the business activities under this Contract under a separate
contract with Contractor. The term “Subcontractor” means subcontractor(s) of any tier.
“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: http://app.leg.wa.gov/wac/.
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; and
3.1.7 Provision of high-quality services.
HCA will review and evaluate the performance of Contractor in accordance with Contract
and these performance expectations and may withhold allocation of funding if
expectations are not met or Contractor’s performance is unsatisfactory.
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3.2 TERM
3.2.1 The initial term of the Contract will commence on July 1, 2023, and continue
through June 30, 2025, unless terminated sooner as provided herein.
3.2.2 This Contract may be extended by mutually agreed amendment in whatever time
increments HCA deems appropriate. No change in terms and conditions will be
permitted during these extensions unless specifically agreed to in writing.
3.2.3 Work performed without a contract or amendment signed by the authorized
representatives of both parties will be at the sole risk of the Contractor. HCA will
not pay any costs incurred before a contract or any subsequent amendment(s) is
fully executed.
3.3 COMPENSATION
3.3.1 The parties have determined the cost of accomplishing the work herein will not
exceed $182,950.00, inclusive of all fees, taxes, and expenses. The Maximum
Compensation includes $182,950.00 CJTA funding and $0.00 State Drug Court
funding. Compensation for satisfactory performance of the work will not exceed
this amount unless the parties agree to a higher amount through an amendment.
3.3.2 Contractor’s compensation for services rendered will be based on the
deliverables table in Schedule A, Statement of Work.
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.
3.3.4 Source of Funds. The above Maximum Compensation payable under this
Contract is based on the funding from the following sources:
a) 100% is allocated under this Contract from Washington state CJTA
appropriations.
b) Funding Stipulations:
i. No Federal Match. The Contractor shall not use funds payable
under this Contract as match toward federal funds.
ii. Supplanting. The Contractor must use these funds to
supplement, not supplant, the amount of federal, state and
local funds otherwise expended or services provided under
this Contract.
iii. Prohibition of Use of Funds for Lobbying Activities. The
Contractor must not use funds payable under this Contract for
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lobbying activities of any nature. The Contractor certifies that
no state or federal funds payable under this Contract shall be
paid to any person or organization to influence, or attempt to
influence, either directly or indirectly, an officer or employee of
a state or federal agency, or an officer or member of any state
or federal legislative body or committee, regarding the award,
amendment, modification, extension, or renewal of a state or
federal contract or grant.
iv. Per RCW 71.24.580(11), the HCA is required to reclaim any
unspent allocations each state fiscal year.
3.4 REVENUE AND EXPENDITURE PAYMENT
3.4.1 Contractor must submit accurate and complete Revenue and Expenditure
Reports for all amounts allocated by HCA via email to the HCA Contract
Manager, identified in Section 3.5.3. Contractor must include the County name
in the subject line of the email and the title of the Report attachment.
3.4.2 Revenue and Expenditure Reports must provide a detailed breakdown of each
type. All Revenue and Expenditure Reports will be reviewed and must be
approved by the HCA Contract Manager or his/her designee prior to ongoing
payment.
3.4.3 HCA will return incorrect or incomplete Revenue and Expenditure Reports to the
Contractor for correction and reissue. HCA reserves the right to request any
supplemental documentation related to the information contained in the Revenue
and Expenditure Report, including applicable invoices between the Contractor
and their subcontractor.
3.4.4 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 directly deposited in the bank account or sent to the address Contractor.
3.4.5 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.
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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
Revenue and Expenditure Reports prior to subsequent payment(s).
3.5.3 The contact information provided below may be changed by written notice of the
change (email acceptable) to the other party.
CONTRACTOR
Contract Manager Information
Health Care Authority
Contract Manager Information
Name: Kayla Henley Name: Zach Lynch
Title: Title: Criminal Justice Treatment
Account Manager
Address: 411 N. 5th Street
Shelton, WA 98584 Address: 626 8th Avenue SE
Olympia, WA 98504
Phone: (360) 427-9670 ext. 296 Phone: (360) 725-9992
Email: KHenley@masoncountywa.gov Email: zach.lynch@hca.wa.gov
3.6 LEGAL NOTICES
Any notice or demand or other communication required or permitted to be given under this
Contract or applicable law is effective only if it is in writing and signed by the applicable
party, properly addressed, and delivered in person, via email, or by a recognized courier
service, or deposited with the United States Postal Service as first-class mail, postage
prepaid certified mail, return receipt requested, to the parties at the addresses provided in
this section.
3.6.1 In the case of notice to the Contractor:
Mason County
411 N. 5th Street
Shelton, WA 98584
3.6.2 In the case of notice to HCA:
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Attention: Contracts Administrator
Health Care Authority
Division of Legal Services
Post Office Box 42702
Olympia, WA 98504-2702
contracts@hca.wa.gov
3.6.3 Notices are effective upon receipt or four (4) Business Days after mailing,
whichever is earlier.
3.6.4 The notice address and information provided above may be changed by written
notice of the change given as provided above.
3.7 INCORPORATION OF DOCUMENTS AND ORDER OF PRECEDENCE
Each of the documents listed below is by this reference incorporated into this Contract. In
the event of an inconsistency, the inconsistency will be resolved in the following order of
precedence:
3.7.1 Applicable Federal and State of Washington statutes and regulations;
3.7.2 Recitals;
3.7.3 Special Terms and Conditions;
3.7.4 General Terms and Conditions;
3.7.5 Schedule B: Data Share Agreement;
3.7.6 Schedule A(s): Statement(s) of Work;
3.7.7 Attachment 1: Quarterly Progress Report Template;
3.7.8 Attachment 2: Quarterly Revenue and Expenditure Report Template; and
3.7.9 Any other provision, term or material incorporated herein by reference or
otherwise incorporated.
3.8 INSURANCE
Contractor must provide insurance coverage as set out in this section. The intent of the
required insurance is to protect the State should there be any claims, suits, actions, costs,
damages or expenses arising from any negligent or intentional act or omission of
Contractor or Subcontractor, or agents of either, while performing under the terms of this
Contract. Contractor must provide insurance coverage that is maintained in full force and
effect during the term of this Contract, as follows:
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3.8.1 Commercial General Liability Insurance Policy - Provide a Commercial General
Liability Insurance Policy, including contractual liability, in adequate quantity to
protect against legal liability arising out of contract activity but no less than
$1 million per occurrence/$2 million general aggregate. Additionally, Contractor is
responsible for ensuring that any Subcontractors provide adequate insurance
coverage for the activities arising out of Subcontracts.
3.8.2 Business Automobile Liability. In the event that services delivered pursuant to
this Contract involve the use of vehicles, either owned, hired, or non-owned by
the Contractor, automobile liability insurance is required covering the risks of
bodily injury (including death) and property damage, including coverage for
contractual liability. The minimum limit for automobile liability is $1,000,000 per
occurrence, using a Combined Single Limit for bodily injury and property
damage.
3.8.3 Professional Liability Errors and Omissions – Provide a policy with coverage of
not less than $1 million per claim/$2 million general aggregate.
3.8.4 Industrial Insurance Coverage
Prior to performing work under this Contract, Contractor must provide or
purchase industrial insurance coverage for the Contractor’s employees, as may
be required of an “employer” as defined in Title 51 RCW and must maintain full
compliance with Title 51 RCW during the course of this Contract.
3.8.5 The insurance required must be issued by an insurance 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 insureds under any
Commercial General and/or Business Automobile Liability policy/ies. All policies
must be primary to any other valid and collectable insurance. In the event of
cancellation, non-renewal, revocation or other termination of any insurance
coverage required by this Contract, Contractor must provide written notice of
such to HCA within one (1) Business Day of Contractor’s receipt of such notice.
Failure to buy and maintain the required insurance may, at HCA’s sole option,
result in this Contract’s termination.
3.8.6 Upon request, Contractor must submit to HCA a certificate of insurance that
outlines the coverage and limits defined in the Insurance section. If a certificate
of insurance is requested, Contractor must submit renewal certificates as
appropriate during the term of the contract.
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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 ACCESSIBILITY
4.2.1 REQUIREMENTS AND STANDARDS. Each Information and Communication
Technology (ICT) product or service furnished under this Contract shall be
accessible to and usable by individuals with disabilities in accordance with the
Americans with Disabilities Act (ADA) and other applicable Federal and State
laws and policies, including OCIO Policy 188, et seq. For purposes of this clause,
Contractor shall be considered in compliance with the ADA and other applicable
Federal and State laws if it satisfies the requirements (including exceptions)
specified in the regulations implementing Section 508 of the Rehabilitation Act,
including the Web Content Accessibility Guidelines (WCAG) 2.1 Level AA
Success Criteria and Conformance Requirements (2008), which are incorporated
by reference, and the functional performance criteria.
4.2.2 DOCUMENTATION. Contractor shall maintain and retain, subject to review by
HCA, full documentation of the measures taken to ensure compliance with the
applicable requirements and functional performance criteria, including records of
any testing or simulations conducted.
4.2.3 REMEDIATION. If Contractor claims that its products or services satisfy the
applicable requirements and standards specified in Section 4.2.1 and it is later
determined by HCA that any furnished product or service is not in compliance
with such requirements and standards, HCA will promptly inform Contractor in
writing of noncompliance. Contractor shall, at no additional cost to HCA, repair or
replace the non-compliant products or services within the period specified by
HCA. If the repair or replacement is not completed within the specified time, HCA
may cancel the Contract, delivery, task order, or work order, or purchase line
item without termination liabilities or have any necessary changes made or
repairs performed by employees of HCA or by another contractor, and Contractor
shall reimburse HCA for any expenses incurred thereby.
4.2.4 DEFINITION. Information and Communication Technology (ICT) means
information technology and other equipment, systems, technologies, or
processes, for which the principal function is the creation, manipulation, storage,
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display, receipt, or transmission of electronic data and information, as well as any
associated content. Examples include computers and peripheral equipment;
information kiosks and transaction machines; telecommunications equipment;
customer premises equipment; multifunction office machines; software;
applications; websites; videos; and electronic documents.
4.2.5 INDEMNIFICATION. Contractor agrees to indemnify and hold harmless HCA
from any claim arising out of failure to comply with the aforesaid requirements.
4.3 ADVANCE PAYMENT PROHIBITED
No advance payment will be made for services furnished by the Contractor pursuant to
this Contract.
4.4 AMENDMENTS
This Contract may be amended by mutual agreement of the parties. Such amendments
will not be binding unless they are in writing and signed by personnel authorized to bind
each of the parties.
4.5 ASSIGNMENT
4.5.1 Contractor may not assign or transfer all or any portion of this Contract or any of
its rights hereunder, or delegate any of its duties hereunder, except delegations
as set forth in Section 4.36, Subcontracting, without the prior written consent of
HCA. Any permitted assignment will not operate to relieve Contractor of any of its
duties and obligations hereunder, nor will such assignment affect any remedies
available to HCA that may arise from any breach of the provisions of this
Contract or warranties made herein, including but not limited to, rights of setoff.
Any attempted assignment, transfer or delegation in contravention of this
Subsection 4.5.1 of the Contract will be null and void.
4.5.2 HCA may assign this Contract to any public agency, commission, board, or the
like, within the political boundaries of the State of Washington, with written notice
of thirty (30) calendar days to Contractor.
4.5.3 This Contract will inure to the benefit of and be binding on the parties hereto and
their permitted successors and assigns.
4.6 ATTORNEYS’ FEES
In the event of litigation or other action brought to enforce the terms of this Contract, each
party agrees to bear its own attorneys’ fees and costs.
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4.7 CHANGE IN STATUS
In the event of any substantive change in its legal status, organizational structure, or fiscal
reporting responsibility, Contractor will notify HCA of the change. Contractor must provide
notice as soon as practicable, but no later than thirty (30) calendar days after such a
change takes effect.
4.8 CONFLICT OF INTEREST
Contractor represents and warrants that it has not undertaken and will not undertake any
work with third parties that will conflict with the work Contractor Is performing for HCA
under this Contract. In case of doubt, before commencing such activities, Contractor shall
review areas of possible conflict with HCA and obtain HCA’s approval prior to
commencing such activities.
4.9 CONFORMANCE
If any provision of this Contract is in conflict with or violates any statute or rule of law of
the state of Washington, it is considered modified to conform to that statute or rule of law.
4.10 COVERED INFORMATION PROTECTION
4.10.1 Contractor acknowledges that some of the material and information that may
come into its possession or knowledge in connection with this Contract or its
performance may consist of HCA Proprietary Information or Confidential
Information. Contractor agrees to comply with the requirements of Schedule B:
Data Share Agreement. For the purposes of this section, HCA Proprietary
Information and Confidential Information are together referred to as Covered
Information.
4.10.2 Nondisclosure and Non-Use Obligations. In the event of Disclosure of Covered
Information to Contractor by HCA, Contractor agrees to: (1) hold Covered
Information in strictest confidence and to take all reasonable precautions to
protect such Covered Information (including, without limitation, all precautions the
Contractor employs with respect to its own confidential materials); (2) not
disclose any such Covered Information or any other information derived
therefrom to any third party; (3) not make use of Covered Information for any
purpose other than the performance of this Contract; (4) release it only to
authorized employees or Subcontractors requiring such information for the
purposes of carrying out this Contract; and (5) not release, divulge, publish,
transfer, sell, disclose, or otherwise make the information known to any other
party without HCA’s express written consent or as provided by law.
4.10.3 Contractors that come into contact with Protected Health Information may be
required to enter into a Business Associate Agreement with HCA in compliance
with the requirements of the Health Insurance Portability and Accountability Act
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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).
4.10.4 HCA reserves the right to monitor, audit, or investigate the use of Confidential
Information collected, used, or acquired by Contractor through this Contract.
Violation of this section by Contractor or its Subcontractors may result in
termination of this Contract and demand for return of all Confidential Information,
monetary damages, or penalties.
4.10.5 The obligations set forth in this Section will survive completion, cancellation,
expiration, or termination of this Contract.
4.11 CONTRACTOR’S PROPRIETARY INFORMATION
Contractor acknowledges that HCA is subject to chapter 42.56 RCW, the Public Records
Act, and that this Contract will be a public record as defined in chapter 42.56 RCW. Any
specific information that is claimed by Contractor to be Proprietary Information must be
clearly identified as such by Contractor. To the extent consistent with chapter 42.56 RCW,
HCA will maintain the confidentiality of Contractor’s information in its possession that is
marked Proprietary. If a public disclosure request is made to view Contractor’s Proprietary
Information, HCA will notify Contractor of the request and of the date that such records will
be released to the requester unless Contractor obtains a court order from a court of
competent jurisdiction enjoining that disclosure. If Contractor fails to obtain the court order
enjoining disclosure, HCA will release the requested information on the date specified.
4.12 COVENANT AGAINST CONTINGENT FEES
Contractor warrants that no person or selling agent has been employed or retained to
solicit or secure this Contract upon an agreement or understanding for a commission,
percentage, brokerage or contingent fee, excepting bona fide employees or bona fide
established agents maintained by the Contractor for the purpose of securing business.
HCA will have the right, in the event of breach of this clause by the Contractor, to annul
this Contract without liability or, in its discretion, to deduct from the contract price or
consideration or recover by other means the full amount of such commission, percentage,
brokerage or contingent fee.
4.13 DEBARMENT
By signing this Contract, Contractor certifies that it is not presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded in any Washington
State or Federal department or agency from participating in transactions (debarred).
Contractor agrees to include the above requirement in any and all Subcontracts into which
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.
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HCA may immediately terminate this Contract by providing Contractor written notice, if
Contractor becomes debarred during the term hereof.
4.14 DISPUTES
The parties will use their best, good faith efforts to cooperatively resolve disputes and
problems that arise in connection with this Contract. Both parties will continue without
delay to carry out their respective responsibilities under this Contract while attempting to
resolve any dispute. When a genuine dispute arises between HCA and the Contractor
regarding the terms of this Contract or the responsibilities imposed herein and it cannot be
resolved between the parties’ Contract Managers, either party may initiate the following
dispute resolution process.
4.14.1 The initiating party will reduce its description of the dispute to writing and deliver
it to the responding party (email acceptable). The responding party will respond
in writing within five (5) Business Days (email acceptable). If the initiating party is
not satisfied with the response of the responding party, then the initiating party
may request that the HCA Director review the dispute. Any such request from the
initiating party must be submitted in writing to the HCA Director within five (5)
Business Days after receiving the response of the responding party. The HCA
Director will have sole discretion in determining the procedural manner in which
he or she will review the dispute. The HCA Director will inform the parties in
writing within five (5) Business Days of the procedural manner in which he or she
will review the dispute, including a timeframe in which he or she will issue a
written decision.
4.14.2 A party's request for a dispute resolution must:
A. Be in writing;
B. Include a written description of the dispute;
C. State the relative positions of the parties and the remedy sought; and
D. State the Contract Number and the names and contact information for the
parties.
4.14.3 This dispute resolution process constitutes the sole administrative remedy
available under this Contract. The parties agree that this resolution process will
precede any action in a judicial or quasi-judicial tribunal.
4.15 ENTIRE AGREEMENT
HCA and Contractor agree that the Contract is the complete 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
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relating to the subject matter of the Contract, except as provided in Section 4.43,
Warranties.
4.16 FORCE MAJEURE
A party will not be liable for any failure of or delay in the performance of this Contract for
the period that such failure or delay is due to causes beyond its reasonable control,
including but not limited to acts of God, war, strikes or labor disputes, embargoes,
government orders or any other force majeure event.
4.17 FUNDING WITHDRAWN, REDUCED, OR LIMITED
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 4.38.3, Termination for Non-
Allocation of Funds;
4.17.2 Renegotiate the Contract under the revised funding conditions; or
4.17.3 Suspend Contractor’s performance under the Contract upon five (5) Business
Days’ advance written notice to Contractor. HCA will use this option only when
HCA determines that there is reasonable likelihood that the funding insufficiency
may be resolved in a timeframe that would allow Contractor’s performance to be
resumed prior to the normal completion date of this Contract.
A. During the period of suspension of performance, each party will inform the
other of any conditions that may reasonably affect the potential for
resumption of performance.
B. When HCA determines in its sole discretion that the funding insufficiency is
resolved, it will give Contractor written notice to resume performance. Upon
the receipt of this notice, Contractor will provide written notice to HCA
informing HCA whether it can resume performance and, if so, the date of
resumption. For purposes of this subsection, “written notice” may include
email.
C. If the Contractor’s proposed resumption date is not acceptable to HCA and
an acceptable date cannot be negotiated, HCA may terminate the contract by
giving written notice to Contractor. The parties agree that the Contract will be
terminated retroactive to the date of the notice of suspension. HCA will be
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liable only for payment in accordance with the terms of this Contract for
services rendered prior to the retroactive date of termination.
4.18 GOVERNING LAW
This Contract is governed in all respects by the laws of the state of Washington, without
reference to conflict of law principles. The jurisdiction for any action hereunder is
exclusively in the Superior Court for the state of Washington, and the venue of any action
hereunder is in the Superior Court for Thurston County, Washington. Nothing in this
Contract will be construed as a waiver by HCA of the State’s immunity under the 11th
Amendment to the United States Constitution.
4.19 HCA NETWORK SECURITY
Contractor agrees not to attach any Contractor-supplied computers, peripherals or
software to the HCA Network without prior written authorization from HCA’s Chief
Information Officer. Unauthorized access to HCA networks and systems is a violation of
HCA Policy and constitutes computer trespass in the first degree pursuant to RCW
9A.52.110. Violation of any of these laws or policies could result in termination of the
contract and other penalties.
Contractor will have access to the HCA visitor Wi-Fi Internet connection while on site.
4.20 INDEMNIFICATION
Contractor must defend, indemnify, and save HCA harmless from and against all claims,
including reasonable attorneys’ fees resulting from such claims and breach of
confidentiality obligations as contained herein, arising from intentional or negligent acts or
omissions of Contractor, its officers, employees, or agents, or Subcontractors, their
officers, employees, or agents, in the performance of this Contract.
4.21 INDEPENDENT CAPACITY OF THE CONTRACTOR
The parties intend that an independent contractor relationship will be created by this
Contract. Contractor and its employees or agents performing under this Contract are not
employees or agents of HCA. Contractor will not hold itself out as or claim to be an officer
or employee of HCA or of the State of Washington by reason hereof, nor will Contractor
make any claim of right, privilege or benefit that would accrue to such employee under
law. Conduct and control of the work will be solely with Contractor.
4.22 LEGAL AND REGULATORY COMPLIANCE
4.22.1 During the term of this Contract, Contractor must comply with all local, state, and
federal licensing, accreditation and registration requirements/standards,
necessary for the performance of this Contract and all other applicable federal,
state and local laws, rules, and regulations.
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4.22.2 While on the HCA premises, Contractor must comply with HCA operations and
process standards and policies (e.g., ethics, Internet / email usage, data, network
and building security, harassment, as applicable). HCA will make an electronic
copy of all such policies available to Contractor.
4.22.3 Failure to comply with any provisions of this section may result in Contract
termination.
4.23 LIMITATION OF AUTHORITY
Only the HCA Authorized Representative has the express, implied, or apparent authority
to alter, amend, modify, or waive any clause or condition of this Contract. Furthermore,
any alteration, amendment, modification, or waiver or any clause or condition of this
Contract is not effective or binding unless made in writing and signed by the HCA
Authorized Representative.
4.24 NO THIRD-PARTY BENEFICIARIES
HCA and Contractor are the only parties to this contract. Nothing in this Contract gives or
is intended to give any benefit of this Contract to any third parties.
4.25 NONDISCRIMINATION
During the performance of this Contract, the Contractor must comply with all federal and
state nondiscrimination laws, regulations and policies, including but not limited to: Title VII
of the Civil Rights Act, 42 U.S.C. §12101 et seq.; the Americans with Disabilities Act of
1990 (ADA), 42 U.S.C. §12101 et seq., 28 C.F.R. Part 35; and Title 49.60 RCW,
Washington Law Against Discrimination. In the event of Contractor’s noncompliance or
refusal to comply with any nondiscrimination law, regulation or policy, this Contract may
be rescinded, canceled, or terminated in whole or in part under the Termination for Default
sections, and Contractor may be declared ineligible for further contracts with HCA.
4.26 OVERPAYMENTS TO THE CONTRACTOR
In the event that overpayments or erroneous payments have been made to the Contractor
under this Contract, HCA will provide written notice to Contractor and Contractor will
refund the full amount to HCA within thirty (30) calendar days of the notice. If Contractor
fails to make timely refund, HCA may withhold up to five percent (5%) of the monthly
amount Contractor reports on the Revenue and Expenditure Report(s) per month, until the
overpayment amount is recouped in full. If the Contractor disagrees with HCA’s actions
under this section, then it may invoke the dispute resolution provisions of Section 4.14,
Disputes.
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4.27 PAY EQUITY
4.27.1 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.
4.27.2 Contractor may allow differentials in compensation for its workers based in good
faith on any of the following: (i) a seniority system; (ii) a merit system; (iii) a
system that measures earnings by quantity or quality of production; (iv) bona fide
job-related factor(s); or (v) a bona fide regional difference in compensation levels.
4.27.3 Bona fide job-related factor(s)” may include, but not be limited to, education,
training, or experience, that is: (i) consistent with business necessity; (ii) not
based on or derived from a gender-based differential; and (iii) accounts for the
entire differential.
4.27.4 A “bona fide regional difference in compensation level” must be (i) consistent with
business necessity; (ii) not based on or derived from a gender-based differential;
and (iii) account for the entire differential.
4.27.5 Notwithstanding any provision to the contrary, upon breach of warranty and
Contractor’s failure to provide satisfactory evidence of compliance within thirty
(30) Days of HCA’s request for such evidence, HCA may suspend or terminate
this Contract.
4.28 PUBLICITY
4.28.1 The award of this Contract to Contractor is not in any way an endorsement of
Contractor or Contractor’s Services by HCA and must not be so construed by
Contractor in any advertising or other publicity materials.
4.28.2 Contractor agrees to submit to HCA, all advertising, sales promotion, and other
publicity materials relating to this Contract or any Service furnished by Contractor
in which 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.
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4.29 RECORDS AND DOCUMENT REVIEW
4.29.1 The Contractor must maintain books, records, documents, magnetic media,
receipts, invoices or other evidence relating to this Contract and the performance
of the services rendered, along with accounting procedures and practices, all of
which sufficiently and properly reflect all direct and indirect costs of any nature
expended in the performance of this Contract. At no additional cost, these
records, including materials generated under this Contract, are subject at all
reasonable times to inspection, review, or audit by HCA, the Office of the State
Auditor, and state and federal officials so authorized by law, rule, regulation, or
agreement [See 42 USC 1396a(a)(27)(B); 42 USC 1396a(a)(37)(B); 42 USC
1396a(a)(42(A); 42 C.F.R. 431, Subpart Q; and 42 C.F.R. 447.202].
4.29.2 The Contractor must retain such records for a period of six (6) years after the
date of final payment under this Contract.
4.29.3 If any litigation, claim or audit is started before the expiration of the six (6) year
period, the records must be retained until all litigation, claims, or audit findings
involving the records have been resolved.
4.30 REMEDIES NON-EXCLUSIVE
The remedies provided in this Contract are not exclusive but are in addition to all other
remedies available under law.
4.31 RIGHT OF INSPECTION
The Contractor must provide right of access to its facilities to HCA, or any of its officers, or
to any other authorized agent or official of the state of Washington or the federal
government, at all reasonable times, in order to monitor and evaluate performance,
compliance, and/or quality assurance under this Contract.
4.32 RIGHTS IN DATA/OWNERSHIP
4.32.1 HCA and Contractor agree that all data and work products produced pursuant to
this Contract (collectively “Work Product”) will be considered a “work made for
hire” as defined under the U.S. Copyright Act of 1976 and Title 17 U.S.C. §101 et
seq, and will be owned by HCA. Contractor is hereby commissioned to create the
Work Product. Work Product includes, but is not limited to, discoveries, formulae,
ideas, improvements, inventions, methods, models, processes, techniques,
findings, conclusions, recommendations, reports, designs, plans, diagrams,
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.
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4.32.2 If for any reason the Work Product would not be considered a “work made for
hire” under applicable law, Contractor assigns and transfers to HCA, the entire
right, title and interest in and to all rights in the Work Product and any
registrations and copyright applications relating thereto and any renewals and
extensions thereof.
4.32.3 Contractor will execute all documents and perform such other proper acts as
HCA may deem necessary to secure for HCA the rights pursuant to this section.
4.32.4 Contractor will not use or in any manner disseminate any Work Product to any
third party, or represent in any way Contractor ownership of any Work Product,
without the prior written permission of HCA. Contractor will take all reasonable
steps necessary to ensure that its agents, employees, or Subcontractors will not
copy or disclose, transmit or perform any Work Product or any portion thereof, in
any form, to any third party.
4.32.5 Material that is delivered under this Contract, but that does not originate
therefrom (“Preexisting Material”), must be transferred to HCA with a
nonexclusive, royalty-free, irrevocable license to publish, translate, reproduce,
deliver, perform, display, and dispose of such Preexisting Material, and to
authorize others to do so. Contractor agrees to obtain, at its own expense,
express written consent of the copyright holder for the inclusion of Preexisting
Material. HCA will have the right to modify or remove any restrictive markings
placed upon the Preexisting Material by Contractor.
4.32.6 Contractor must identify all Preexisting Material when it is delivered under this
Contract and must advise HCA of any and all known or potential infringements of
publicity, privacy or of intellectual property affecting any Preexisting Material at
the time of delivery of such Preexisting Material. Contractor must provide HCA
with prompt written notice of each notice or claim of copyright infringement or
infringement of other intellectual property right worldwide received by Contractor
with respect to any Preexisting Material delivered under this Contract.
4.33 SEVERABILITY
If any provision of this Contract or the application thereof to any person(s) or
circumstances is held invalid, such invalidity will not affect the other provisions or
applications of this Contract that can be given effect without the invalid provision, and to
this end the provisions or application of this Contract are declared severable.
4.34 SITE SECURITY
While on HCA premises, Contractor, its agents, employees, or Subcontractors must
conform in all respects with physical, fire or other security policies or regulations. Failure
to comply with these regulations may be grounds for revoking or suspending security
access to these facilities. HCA reserves the right and authority to immediately revoke
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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.
4.35 SUBCONTRACTING
4.35.1 Neither Contractor, nor any Subcontractors, may enter into Subcontracts for any
of the work contemplated under this Contract without prior written approval of
HCA. HCA has sole discretion to determine whether or not to approve any such
Subcontract. In no event will the existence of the Subcontract operate to release
or reduce the liability of Contractor to HCA for any breach in the performance of
Contractor’s duties.
4.35.2 Contractor is responsible for ensuring that all terms, conditions, assurances and
certifications set forth in this Contract are included in any Subcontracts.
4.35.3 If at any time during the progress of the work HCA determines in its sole
judgment that any Subcontractor is incompetent or undesirable, HCA will notify
Contractor, and Contractor must take immediate steps to terminate the
Subcontractor's involvement in the work.
4.35.4 The rejection or approval by the HCA of any Subcontractor or the termination of a
Subcontractor will not relieve Contractor of any of its responsibilities under the
Contract, nor be the basis for additional charges to HCA.
4.35.5 HCA has no contractual obligations to any Subcontractor or vendor under
contract to the Contractor. Contractor is fully responsible for all contractual
obligations, financial or otherwise, to its Subcontractors.
4.36 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 Covered Information Protection,
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.
4.37 TAXES
HCA will pay sales or use taxes, if any, imposed on the services acquired hereunder.
Contractor must pay all other taxes including, but not limited to, Washington Business and
Occupation Tax, other taxes based on Contractor’s income or gross receipts, or personal
property taxes levied or assessed on Contractor’s personal property. HCA, as an agency
of Washington State government, is exempt from property tax.
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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.
4.38 TERMINATION
4.38.1 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.”
4.38.2 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.
4.38.3 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
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.
4.38.4 Termination for Withdrawal of Authority
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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.
4.38.5 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.
4.39 TERMINATION PROCEDURES
4.39.1 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.
4.39.2 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 4.14, Disputes. HCA may withhold
from any amounts due the Contractor such sum as HCA determines to be
necessary to protect HCA against potential loss or liability.
4.39.3 After receipt of notice of termination, and except as otherwise directed by HCA,
Contractor must:
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A. Stop work under the Contract on the date of, and to the extent specified in,
the notice;
B. Place no further orders or Subcontracts for materials, services, or facilities
except as may be necessary for completion of such portion of the work under
the Contract that is not terminated;
C. Assign to HCA, in the manner, at the times, and to the extent directed by
HCA, all the rights, title, and interest of the Contractor under the orders and
Subcontracts so terminated; in which case HCA has the right, at its
discretion, to settle or pay any or all claims arising out of the termination of
such orders and Subcontracts;
D. Settle all outstanding liabilities and all claims arising out of such termination
of orders and Subcontracts, with the approval or ratification of HCA to the
extent HCA may require, which approval or ratification will be final for all the
purposes of this clause;
E. Transfer title to and deliver as directed by HCA any property required to be
furnished to HCA;
F. Complete performance of any part of the work that was not terminated by
HCA; and
G. Take such action as may be necessary, or as HCA may direct, for the
protection and preservation of the records related to this Contract that are in
the possession of the Contractor and in which HCA has or may acquire an
interest.
4.40 TRANSITION OBLIGATIONS
Contractor must provide for reasonable transition assistance requested by HCA to allow
for the expired or terminated Contract, in whole or in part, to continue without interruption
or adverse effect, and to facilitate the orderly transfer of such services to HCA or its
designees. Such transition assistance will be deemed by the parties to be governed by the
terms and conditions of this Contract, except for those terms or conditions that do not
reasonably apply to such transition assistance.
4.41 TREATMENT OF ASSETS
4.41.1 Ownership
HCA shall retain title to all property furnished by HCA to Contractor under this
Contract. Title to all property furnished by Contractor, for the cost of which the
Contractor is entitled to reimbursement as a direct item of cost under this
Contract, excluding intellectual property provided by Contractor, shall pass to and
vest in HCA upon delivery of such property by Contractor. Title to other property,
the cost of which is reimbursable to Contractor under this Contract, shall pass to
and vest in HCA upon (i) issuance for use of such property in the performance of
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this Contract, (ii) commencement of use of such property in the performance of
this Contract, or (iii) reimbursement of the cost thereof by HCA, in whole or in
part, whichever occurs first.
4.41.2 Use of Property
Any property furnished to Contractor shall, unless otherwise provided herein, or
approved in writing by the HCA Contract Manager, be used only for the
performance of and subject to the terms of this Contract. Contractor's use of the
equipment shall be subject to HCA's security, administrative, and other
requirements.
4.41.3 Damage to Property
Contractor shall continuously protect and be responsible for any loss,
destruction, or damage to property which results from or is caused by
Contractor's acts or omissions. Contractor shall be liable to HCA for costs of
repair or replacement for property or equipment that has been lost, destroyed, or
damaged by Contractor or Contractor’s employees, agents, or Subcontractors.
Cost of replacement shall be the current market value of the property and
equipment on the date of the loss as determined by HCA.
4.41.4 Notice of Damage
Upon the loss of, destruction of, or damage to any of the property, Contractor
shall notify the HCA Contract Manager thereof within one (1) Business Day and
shall take all reasonable steps to protect that property from further damage.
4.41.5 Surrender of Property
Contractor will ensure that the property will be returned to HCA in like condition
to that in which it was furnished to Contractor, reasonable wear and tear
expected. Contractor shall surrender to HCA all property upon the earlier of
expiration or termination of this Contract.
4.42 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.
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4.43 WARRANTIES
4.43.1 Contractor represents and warrants that its services will be of professional quality
and will be rendered in accordance with prevailing professional standards and
ethics. Services performed by Contractor under this Contract shall be conducted
in a manner consistent with the level of care and skill standard to the industry.
Contractor agrees to immediately re-perform any services that are not in
compliance with this representation and warranty at no cost to HCA.
4.43.2 Contractor represents and warrants that it will comply with all applicable local,
State, and federal licensing, accreditation and registration requirements and
standards necessary in the performance of the Services.
4.43.3 EXECUTIVE ORDER 18-03 – WORKERS’ RIGHTS (MANDATORY INDIVIDUAL
ARBITRATION). Contractor represents and warrants that Contractor does NOT
require its employees, as a condition of employment, to sign or agree to
mandatory individual arbitration clauses or class or collective action waivers.
Contractor further represents and warrants that, during the term of this Contract,
Contractor shall not, as a condition of employment, require its employees to sign
or agree to mandatory individual arbitration clauses or class or collective action
waivers.
4.43.4 Any written commitment by Contractor within the scope of this Contract will be
binding upon Contractor. Failure of Contractor to fulfill such a commitment may
constitute breach and will render Contractor liable for damages under the terms
of this Contract. For purposes of this section, a commitment by Contractor
includes: (i) Prices, discounts, and options committed to remain in force over a
specified period of time; and (ii) any warranty or representation made by
Contractor to HCA or contained in any Contractor publications, or descriptions of
services in written or other communication medium, used to influence HCA to
enter into this Contract.
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Schedule A
SCHEDULE A: STATEMENT OF WORK
Contractor will provide the services and staff, and otherwise do all things necessary for, or incidental to,
the performance of work as set forth below.
1. DEFINITIONS
“American Society of Addiction Medicine” or “ASAM” means the six dimensions to identify the
intensity of treatment services that best fits the individual’s needs and provides a common language
of holistic, biopsychosocial assessment, and treatment across addiction treatment, physical health,
and mental health services, which also addresses the spiritual issues relevant in recovery.
“Case Management” or “Case Management Services” means services provided by a Substance
Use Disorder Professional (SUDP) or Substance Use Disorder Professional Trainee (SUDPT)
licensed by the Washington Department of Health, or a person under the direct clinical supervision of
a SUDP, to individuals assessed as needing treatment and admitted into treatment. Services are
provided to assist clients in gaining access to needed medical, social, educational, and other
services. Services include case planning, case consultation and referral, and other support services
for the purpose of engaging and retaining or maintaining clients in treatment.
“Continuity of Care” means the provision of continuous care for chronic or acute medical and
behavioral health conditions to maintain care that has started or been authorized to start as the
Individual transitions between: facility to home; facility to another facility; providers or service areas;
managed care contractors; and Medicaid fee-for-service and managed care arrangements.
Continuity of Care occurs in a manner that prevents secondary illness, health care complications, or
re-hospitalization; and promotes optimum health recovery.
“County Match” means that jurisdictions must match, on a dollar-for-dollar basis, state moneys
allocated for therapeutic courts with local cash or in-kind resources. Moneys allocated by the state
may be used to supplement, not supplant other federal, state, and local funds for therapeutic courts
(RCW 2.30.040).
“Criminal Justice Treatment Account” or “CJTA” means the account created by Washington State
Legislature that may be expended solely for: substance use disorder treatment and treatment
support services for individuals with a substance use disorder that, if not treated, would result in
addiction, against whom charges are filed by a prosecuting attorney in Washington State (RCW
71.24.580).
“CJTA Plan” or “Plan” means the plan that is developed by the county human services or behavioral
health services department, county prosecutor, county sheriff, county superior court, a substance use
disorder treatment provider appointed by the county legislative authority, a member of the criminal
defense bar appointed by the county legislative authority, and, in counties with a drug court, a
representative of the drug court (RCW 71.24.580(6)). The plan shall be approved by the county
legislative authority or authorities; and, submitted to the panel established in 71.24.580(5)(b) of this
section, for disposition of all the funds provided from the CJTA within that county.
“Culturally and Linguistically Appropriate Services” or “CLAS” means the national standards in
health and health care intended to advance health equity, improve quality, and eliminate health
disparities by establishing a blueprint for health and health care organizations.
“Division of Behavioral Health and Recovery” or “DBHR” means the Health Care Authority’s
Division of Behavioral Health and Recovery, and its employees and authorized agents.
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Schedule A
“Drug Court” means a court utilizing a program structured to achieve both a reduction in criminal
recidivism and an increase in the likelihood of rehabilitation through continuous and intense judicially
supervised treatment and the appropriate use of services, sanctions, and incentives (RCW 2.30.020).
“Drug Enforcement Agency” or “DEA” means a federal agency which is a component of the United
State Department of Justice and whose mission is to enforce the controlled substances laws and
regulations of the United States and bring to the criminal and civil justice system of the United States,
or any other competent jurisdiction, those organizations and principal members of organizations,
involved in the growing, manufacture, or distribution of controlled substances appearing in or
destined for illicit traffic in the United States; and to recommend and support non-enforcement
programs aimed at reducing the availability of illicit controlled substances on the domestic and
international markets.
“Evidence-based Practice” or “EBP” means a prevention or treatment service or practice that has
been validated by some form of documented research evidence and is appropriate for use with
individuals with a substance use disorder that are involved in the criminal justice system. EBP also
means a program or practice that has been tested where the weight of the evidence from review
demonstrates sustained improvements in at least one outcome, and/or a program or practice that
can be implemented with a set of procedures to allow successful replication in Washington and,
when possible, is determined to be cost-beneficial.
“Individual” means any person in the criminal justice system who is in need of behavioral health
services, regardless of income, ability to pay, insurance status or county of residence.
“Medications for Opioid Use Disorder” or “MOUD” or “MAT” means the use of FDA-approved
opioid agonist medications (e.g., methadone, buprenorphine products including
buprenorphine/naloxone combination formulations and buprenorphine mono-product formulations)
for the treatment of opioid use disorder and the use of opioid antagonist medication (e.g. naltrexone
products including extended-release and oral formulations) to prevent relapse to opioid use.
“Outreach” or “Community Outreach” means identification of hard-to-reach Individuals with a
possible SUD and engagement of these individuals in assessment and ongoing treatment services
as necessary.
“Research-based” means a program or practice that has been tested with a single randomized, or
statistically controlled evaluation, or both, demonstrating sustained desirable outcomes; or where the
weight of the evidence from a systemic review supports sustained outcomes as described in this
subsection but does not meet the full criteria for evidence-based (RCW 2.30.020).
“Recovery Support Services” or “RSS” means services that are intended to promote an individual’s
socialization, recovery, self-advocacy, development of natural support, and maintenance of
community living skills. RSS include, but are not limited to, the following services: Supported
employment services, supportive housing services, peer support services, wraparound facilitation
services, and any other services that are conducive to an individual’s recovery in an Substance Use
Disorder (SUD) Program (WAC 246-341-0718).
“Substance Use Disorder” or “SUD” means a problematic pattern of using alcohol or another
substance that results in the impairment in daily life or noticeable distress; and, whereby the
individualcontinues use despite leading to clinically significant impairment or distress as categorized
in the DSM-5.
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Schedule A
“Substance Use Disorder Professional” or “SUDP” means an individual who is certified according
to RCW 18.205.020 and the certification requirements of WAC 246-811-030 to provide SUD
services.
“Substance Use Disorder Professional Trainee” or “SUDPT” means an individual working toward
the education and experience requirements for certification as a chemical dependency professional,
and who has been credentialed as a CDPT.
“Therapeutic Courts” means a court utilizing a program or programs structured to achieve both a
reduction in recidivism and an increase in the likelihood of rehabilitation, or to reduce child abuse and
neglect, out-of-home placements of children, termination of parental rights, and substance use and
mental health symptoms among parents or guardians and their children through continuous and
intense judicially supervised treatment and the appropriate use of services, sanctions, and incentives
(RCW 2.30.020).
"Treatment" means services that are critical to a participant's successful completion of his or her
substance use disorder treatment program, including but not limited to the recovery support and
other programmatic elements outlined in Chapter 246-341 WAC.
"Treatment Support" means services such as transportation to or from inpatient or outpatient
treatment services when no viable alternative exists, and child care services that are necessary to
ensure a participant's ability to attend outpatient treatment sessions.
“Washington State Jail” or “Jail” means any city, county, regional, or tribal jail operating in the state
of Washington.
2. Purpose
Contractor will provide treatment and recovery support services, funded by Criminal Justice
Treatment Account funds, to individuals involved in the criminal justice system in accordance with
RCW 71.24.580.
3. CTJA Account Services Specific Eligibility and Funding Requirements
a) In accordance with RCW 71.24.580, the Contractor will be responsible for treatment and
recovery support services for criminally involved individuals.
b) CJTA Statutory Funding Guidelines
1. In accordance with RCW 2.30.040 counties that allocate CJTA and/or State Drug Court
funds to support or provide services to Therapeutic Court Program participants must
match, on a dollar-for-dollar basis, an equal amount of local funding through cash or in-
kind resources. Moneys appropriated under this provision may be used to supplement,
not supplant other federal, state, and local funds for therapeutic courts.
2. No more than ten percent (10%) of the total CJTA funds may be used for the following
support services combined:
i. Transportation; and
ii. Child Care Services.
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Schedule A
3. State Drug Court
i. In addition to state funding under the CJTA, several counties receive
additional state funding specifically for Drug Courts. State Drug Court
funding is provided to the following counties: Clallam, Cowlitz, King, Kitsap,
Pierce, Skagit, Spokane, and Thurston. The counties that receive State
Drug Court funding must ensure the provision of substance use disorder
treatment and support services detailed in this Contract, and in accordance
with RCW 71.24.580 and RCW 2.30.030.
4. Supplemental Appropriations for State Fiscal Year 2024
i. Engrossed Substitute Senate Bill 6168; Section 215 § 72 provided one-
time supplemental funding under the CJTA:
a. $4,500,000 of the criminal justice treatment account –
state appropriation for fiscal year 2024 is provided solely
for the authority to provide funding for the setting up of
new therapeutic courts for cities or counties or for the
expansion of services being provided to an already
existing therapeutic court that engages in evidence-based
practices, to include medication assisted treatment in jail
settings pursuant to RCW 71.24.580. Funding provided
under this subsection shall not supplant existing funds
utilized for this purpose.
ii. Per RCW 71.24.580(5)(a), the HCA will distribute this funding through this
agreement, with the understanding that the Contractor will confer with the
local CJTA Panels for purpose of developing an amendment to the county
or region’s strategic plans for the utilization of funding through the CJTA.
This will allow the Contractor, in concert with the local CJTA Panel, to
collectively determine how to best use the supplemental funding in the
context of the proviso.
iii. Cities or counties interested in developing new therapeutic courts will be
referred to the County CJTA Panel.
iv. Contractor will work with the local CJTA Panel to update their CJTA Plan,
referenced in Schedule A, Statement of Work, Section 6, below, to account
for how the supplemental appropriation will be utilized at their county
and/or regional level.
5. At a minimum, thirty percent (30%) of the CJTA funds, including State Drug Court and
State Fiscal Year 2024 supplemental funding, is to be dedicated to special projects that
meet any or all of the following conditions:
i. An acknowledged best practice (or treatment strategy) that can be
documented in published research;
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Schedule A
ii. An approach utilizing either traditional or best practice approaches to treat
significant underserved population(s) and populations who are
disproportionately affected by the criminal justice system;
iii. A regional project conducted in partnership with at least one other entity
serving the service area; and/or
iv. CJTA Special Projects. A special project would HCA retains the right to
request progress reports on CJTA special projects.
4. CJTA Funding – Allowable Services
a) Brief Intervention (any level, assessment not required);
b) Acute Withdrawal Management (ASAM Level 3.7WM);
c) Sub-Acute Withdrawal Management (ASAM Level 3.2WM);
d) Outpatient Treatment (ASAM Level 1);
e) Intensive Outpatient Treatment (ASAM Level 2.1);
f) Opioid Treatment Program (ASAM Level 1);
g) Case Management (ASAM Level 1.2);
h) Intensive Inpatient Residential Treatment (ASAM Level 3.5);
i) Long-term Care Residential Treatment (ASAM Level 3.3);
j) Recovery House Residential Treatment (ASAM Level 3.1);
k) Assessment (to include Assessments done while in jail);
l) Interim Services;
m) Community Outreach;
n) Involuntary Commitment Investigations and Treatment;
o) Room and Board (Residential Treatment Only);
p) Transportation;
q) Childcare Services;
r) Urinalysis;
s) Recovery Support Services that may include:
1. Employment services and job training;
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Schedule A
2. Relapse prevention;
3. Family/marriage education;
4. Peer-to-peer services, mentoring and coaching;
5. Self-help and spiritual, religious support groups;
6. Housing support services (rent and/or deposits);
7. Life skills;
8. Education Training (e.g. GED Assistance); and
9. Parent education and child development.
t) Substance Use Disorder treatment in the Jail:
1. CJTA funds may not supplement or supplant any currently funded programs that
previously existed in a Jail environment.
2. The Contractor may not use more than 30% of their allocation for treatment in the Jail
unless they receive written authorization from the HCA Contract Manager or justification
for doing so is detailed in the CJTA Plan discussed in Schedule A, Statement of Work,
Section 6, below.
3. If CJTA funds are utilized for these purposes, the Contractor must attempt to provide
treatment with the following stipulations:
i. Identify and provide transition services to persons with substance use disorder, who
meet the CJTA requirements as defined in RCW 71.24.580, to expedite and facilitate
their return to the community;
ii. Continue treatment services with individuals who were engaged in community-based
treatment prior to their incarceration, with the intent to complete the outpatient
treatment episode; and
iii. Initiate outpatient treatment services with individuals who will be released and
transition into community-based treatment.
4. The following treatment modalities may be provided through CJTA funding:
i. Engaging individuals in SUD treatment;
ii. Screening, assessing, and inducting individuals on MOUD;
iii. Referral to SUD services;
iv. Providing continuity of care; and
v. Planning for an individual’s transition from Jail.
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Schedule A
5. MAT in Therapeutic Courts
Per RCW 71.24.580, “If a region or county uses criminal justice treatment account funds to support a
therapeutic court, the therapeutic court must allow the use of all medications approved by the federal
food and drug administration for the treatment of opioid use disorder as deemed medically
appropriate for a participant by a medical professional. If appropriate medication-assisted treatment
resources are not available or accessible within the jurisdiction, the health care authority's designee
for assistance must assist the court with acquiring the resource.”
a) The Contractor, under the provisions of this Contract, will abide by the following guidelines
related to CJTA and Therapeutic Courts:
1. The Contractor will only subcontract with Therapeutic Courts that have policy and
procedures allowing Participants at any point in their course of treatment to seek FDA-
approved medication for any substance use disorder and ensuring the agency will
provide or facilitate the induction of any prescribed FDA approved medications for any
substance use disorder.
2. The Contractor will only subcontract with Therapeutic Court programs that work with
licensed SUD behavioral health treatment agencies that have policy and procedures in
place ensuring they will not deny services to Enrollees who are prescribed any of the
Federal Drug Administration (FDA) approved medications to treat all substance use
disorders.
3. The Contractor may not subcontract with a Therapeutic Court program that is known to
have policies and procedures in place that mandate titration of any prescribed FDA
approved medications to treat any substance use disorder, as a condition of participants
being admitted into the program, continuing in the program, or graduating from the
program, with the understanding that decisions concerning medication adjustment are
made solely between the participant and their prescribing provider.
4. The Contractor must notify the HCA if it discovers that a CJTA funded Therapeutic
program is practicing any of the following:
i. Requiring discontinuation, titration, or alteration of their medication regimen as a
precluding factor in admittance into a Therapeutic Court program;
ii. Requiring participants already in the program discontinue MOUD in order to be in
compliance with program requirements;
iii. Requiring discontinuation, titration, or alteration of their MOUD medication regimen
as a necessary component of meeting program requirements for graduation from a
Therapeutic Court program.
5. All decisions regarding an individual’s amenability and appropriateness for MOUD will
be made by the individual in concert with a medical professional.
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Schedule A
6. CJTA Plan
a) The Contractor must coordinate with the local CJTA panel for the county in order to facilitate
the planning requirement as described in RCW 71.24.580(6). County level funding priorities
are established by the local CJTA Panel. The plans should detail the coordination within the
county, leverage the needed services for the community, and reach the intended population
for the CJTA fund. Any CJTA funded efforts must be included in the CJTA Plan, including
the following specific elements:
1. Describe in detail how substance use disorder treatment and support services will be
delivered within the region;
2. Per section 3.b.1 of this Statement of Work, address the CJTA Account Match
Requirement if funds provide treatment or recovery support services for therapeutic
court participants;
3. Include details on special projects such as best practices/treatment strategies,
significant underserved population(s), or regional endeavors, including the following:
i. Describe the project and how it will be consistent with the strategic plan;
ii. Describe how the project will enhance treatment services for individuals in the
criminal justice system;
iii. Indicate the number of individuals who will be served using innovative funds;
iv. If applicable, indicate plans for inclusion of MOUD within the county’s Therapeutic
Court programs; and
v. Address the Fiscal and programmatic Data Reporting requirements found in Section
7 of this Statement of Work.
4. The final plan must be approved by the county’s legislative authority.
5. Completed and legislatively approved plans must be submitted to the HCA for Review
and Approval. Plan will be forwarded to the State CJTA Panel once approved by the
HCA. The Contractor must implement the plan as it is written and notify the HCA if any
changes are made.
6. CJTA Plans are due by October 11, 2023 and are updated every two years, unless
special circumstances dictate and approved by HCA, to coincide with the state fiscal
biennium. Contractor may request an extension of up to 30 calendar days on the CJTA
Plan due date, and HCA may approve the extension in its sole discretion.
7. Data Reporting Requirements
a) The Contractor shall ensure that staffing is sufficient to support CJTA-related data analytics
and related data systems to oversee all data interfaces and support the specific reporting
requirements under Contract.
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Schedule A
b) The Contractor will work with HCA should system data reporting submission requirements
change (such as using Edifecs).
c) The Contractor shall ensure that all Subcontractors required to report programmatic data
have the capacity to submit all HCA required data to enable the Contractor to meet the
requirements under the Contract.
d) There are three quarterly reports that the Contractor will be responsible for submitting: The
Quarterly Progress Report (QPR), the Revenue and Expenditure Report (R&E), and the
Programmatic Treatment Report (PTR):
1. The Contractor will be responsible for submitting the QPR. The HCA will provide the
Contractor with a template form that will report on the following program elements:
i. Number of individuals served under CJTA funding for that time period;
ii. Barriers to providing services to the Criminal Justice Population;
iii. Strategies to overcome the identified barriers;
iv. Training and Technical assistance needs;
v. Success stories or narratives from individuals receiving CJTA services; and
vi. If a Therapeutic Court receives CJTA funded services, the number of admissions of
individuals into the program who were either already on MOUD, referred to MOUD,
or were provided information regarding MOUD.
2. The Contractor will be responsible for submitting the R&E on a quarterly basis. The HCA
will provide the Contractor with a template form that captures the fiscal expenditures for
that quarter. The Contractor:
i. Will use the Excel document provided by the HCA;
ii. Will report the amount of CJTA expenditures in their Contractor for each state fiscal
quarter (State Fiscal quarters end on March 31, June 30, September 30, and
December 31);
iii. Complete the document in its entirety; and
iv. Submit the internally reviewed and complete R&E report within 45 days of the end of
each State Fiscal Quarter.
3. The Contractor is responsible for submitting the PTR each quarter through a Managed
File Transfer (MFT). The HCA will provide the Contractor with an excel workbook
template that will capture a variety of demographic and programmatic data that supports
the services being provided by the state appropriations. In addition, this process will
include the following:
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i. The Contractor will ensure that their subcontractor has the bandwidth to complete all
data elements requested in the PTR.
ii. The Contractor may allow the subcontractor to do all data entry but the PTR must be
submitted into the Behavioral Health Data System (BHDS) by the Contractor through
the established Secure File Transfer procedure within 45 days of the end of each
State Fiscal Quarter. The Contractor may request an extension of this requirement
during the first Contract term. Files submitted must conform to the following naming
convention: _<County Name>_<Date of Upload>.
iii. The Contractor will review for completeness and accuracy each PTR that they
receive from the subcontractor.
iv. The Contractor will work with their subcontractors to ensure that any applicable
Release of Information (ROI) forms are updated to account for the sharing of
Personal Health Information (PHI) with the HCA.
8. Billing and Payment
Deliverables Table
July 1, 2023 through June 30, 2024
# Deliverable Due Date (Quarterly)
Maximum Amount
1 Submit an updated county Criminal Justice
Treatment Account (CJTA) Plan that was
approved by the local CJTA panel and signed
by County Legislative Authority that indicates
how the CJTA Supplemental will be utilized.
*October 11, 2023 $22,868.75
2 Submit quarterly progress reports 45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
3 Submit quarterly CJTA Revenue and
Expenditure Reports
45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
4 Submit monthly and/or quarterly
Programmatic Treatment Reports through
Managed File Transfer (MFT) process
45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
State Fiscal 2024 Total Maximum Compensation
$91,475.00
*CJTA Plan can be submitted as early as 7/1/2023 and no later than 10/11/2023.
Deliverables Table
July 1, 2024 through June 30, 2025
# Deliverable Due Date (Quarterly)
Maximum Amount
1 Submit an updated county Criminal Justice
Treatment Account (CJTA) Plan that was
approved by the local CJTA panel and signed
by County Legislative Authority that indicates
how the CJTA Supplemental will be utilized.
*October 2, 2024 $22,868.75
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Schedule A
2 Submit quarterly progress reports 45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
3 Submit quarterly CJTA Revenue and
Expenditure Reports
45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
4 Submit monthly and/or quarterly
Programmatic Treatment Reports through
Managed File Transfer (MFT) process
45 calendar days of
end of State Fiscal
Quarter
$22,868.75
($1,905.73 x 12)
State Fiscal 2025 Total Maximum Compensation
$91,475.00
*CJTA Plan can be submitted as early as 7/1/2024 and no later than 10/2/2024.
a) This contract total is for $91,475.00 and is for services rendered between July 1, 2023 and
June 30, 2024.
b) This contract total is for $91,475.00 and is for services rendered between July 1, 2024 and
June 30, 2025.
c) Contractor’s compensation for services rendered will be paid monthly in amounts of 1/12th of
the State Fiscal Year Total Maximum Compensation, in accordance with the deliverables table
above. Payment will be contingent upon HCA Contract Manager acceptance of the
deliverable, and approval of a correct and complete Revenue and Expenditure Report from
Contractor.
d) The Contractor is required to limit Administration costs to no more than ten percent (10%) of
the Contract Maximum Compensation. Administration costs will be measured on a fiscal year
basis and based on the information reporting in the Revenue and Expenditure reports and
reviewed by the HCA Behavioral Health Administration.
e) Funding to support workforce (i.e., retention bonuses) must be reviewed and approved by
HCA.
f) Payment shall be considered timely if made by HCA within thirty (30) days after receipt and
acceptance by HCA of the properly completed reports.
g) Payment may be withheld if the deliverables are not met by the date indicated in the table
above.
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Schedule B
SCHEDULE B: DATA SHARE AGREEMENT
1. Description of Data to be Shared / Data Licensing Statements
Data Licensing Statements are the written statements that determine the following issues, at a
minimum:
A. Identification of costs (if any);
B. Identification of costs (if any);
C. Identification of transmission method; and
D. Identification of the file layout.
There must be at least one Data Licensing Statement attached hereto, but more than one
Data Licensing Statement may be included or incorporated into this Contract at different times.
Each Data Licensing Statement is incorporated into this Contract by using the same
Attachment reference letter (A) and then further marking it with sequential identifying numbers
(A1, A2, A3).
2. Data Classification
The State classifies data into categories based on the sensitivity of the data pursuant to the
Security policy and standards promulgated by the Office of the state of Washington Chief
Information Officer. (See Section 4, Data Security, of Securing IT Assets Standards No.
141.10 in the State Technology Manual at https://ocio.wa.gov/policies/141-securing-
information-technology-assets/14110-securing-information-technology-assets.
The Data that is the subject of this Contract is classified as indicated below:
☐ Category 1 – Public Information
Public information is information that can be or currently is released to the public. It does
not need protection from unauthorized disclosure but does need integrity and availability
protection controls.
☐ Category 2 – Sensitive Information
Sensitive information may not be specifically protected from disclosure by law and is for
official use only. Sensitive information is generally not released to the public unless
specifically requested.
☐ Category 3 – Confidential Information
Confidential information is information that is specifically protected from disclosure by law.
It may include but is not limited to:
Personal Information about individuals, regardless of how that information is
obtained;
Information concerning employee personnel records;
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Schedule B
Information regarding IT infrastructure and security of computer and
telecommunications systems;
☒ Category 4 – Confidential Information Requiring Special Handling
Confidential information requiring special handling is information that is specifically
protected from disclosure by law and for which:
A. Especially strict handling requirements are dictated, such as by statutes,
regulations, or agreements;
B. Serious consequences could arise from unauthorized disclosure, such as
threats to health and safety, or legal sanctions.
3. Constraints on Use of Data/Limited License
A. Subject to the Terms and Conditions of this Contract, HCA hereby grants
Contractor a limited license for the access and Permissible Use of Data. This grant
of access may not be deemed as providing Contractor with ownership rights to the
Data. The Data being shared/accessed is owned and belongs to HCA.
B. For Limited Data Sets, Contractor agrees to not attempt to re-identify individuals in
the Data shared or attempt to contact said individuals.
C. If Data shared under this Contract includes data protected by 42 C.F.R. Part 2. In
accordance with 42 C.F.R. § 2.32, this Data has been disclosed from records
protected by federal confidentiality rules (42 C.F.R. Part 2). The federal rules
prohibit Contractor from making any further disclosure(s) of the Data that identifies
a patient as having or having had a substance use disorder either directly, by
reference to publicly available information, or through verification of such
identification by another person unless further disclosure is expressly permitted by
the written consent of the individual whose information is being disclosed or as
otherwise permitted by 42 C.F.R. Part 2. A general authorization for the release of
medical or other information is NOT sufficient for this purpose (42 C.F.R. § 2.31).
The federal rules restrict any use of the SUD data to investigate or prosecute with
regard to a crime any patient with a substance use disorder, except as provided at
42 C.F.R. §§ 2.12(c)(5) and 2.65.
D. This Contract does not constitute a release of the Data for the Contractor’s
discretionary use. Contractor must use the Data received or accessed under this
Contract only to carry out the purpose and justification of this Contract as set out in
the Data Licensing Statement(s). Any analysis, use, or reporting that is not within
the Purpose of this Contract is not permitted without HCA’s prior written consent.
E. This Contract does not constitute a release for Contractor to share the Data with
any third parties, including Subcontractors, even if for authorized use(s) under this
Contract, without the third party release being approved in advance by HCA and
identified in the Data Licensing Statement(s).
F. Derivative Data Product Review and Release Process.
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Schedule B
i. All reports derived from Data shared under this Contract, produced by
Contractor that are created with the intention of being published for or
shared with external customers (Data Product(s)) must be sent to HCA for
review of usability, data sensitivity, data accuracy, completeness, and
consistency with HCA standards prior to disclosure. This review will be
conducted, and response of suggestions, concerns, approval, or
notification of additional review time needed provided to Receiving Party
within 10 business days. HCA reserves the right to extend the review
period as needed for approval or denial.
ii. Small Numbers. Contractor will adhere to HCA Small Numbers Standards,
Attachment C. HCA and Contractor may agree to individual Permissible
Use exceptions to the Small Numbers Standards, in writing (email
acceptable).
G. Any disclosure of Data contrary to this Contract is unauthorized and is subject to
penalties identified in law.
4. Data Modification(s)
Any modification to the Purpose, Justification, Description of Data to be Shared/Data
Licensing Statement(s), and Permissible Use, is required to be approved through HCA’s Data
Request Process. Contractor must notify HCA’s Contract Manager of any requested changes
to the Data elements, use, records linking needs, research needs, and any other changes
from this Contract, immediately to start the review process. Approved changes will be
documented in an Amendment to the Contract.
5. Security of Data
A. Data Protection
The Contractor must protect and maintain all Confidential Information gained by reason of
this Contract against unauthorized use, access, disclosure, modification, or loss. This duty
requires the Contractor to employ reasonable security measures, which include restricting
access to the Confidential Information by:
i. Allowing access only to staff that have an authorized business requirement
to view the Confidential Information.
ii. Physically securing any computers, documents, or other media containing
the Confidential Information.
B. Data Security Standards
Contractor must comply with the Data Security Requirements set out in Attachment B and
the Washington OCIO Security Standard, 141.10 (https://ocio.wa.gov/policies/141-
securing-information-technology-assets/14110-securing-information-technology-assets.)
C. Data Disposition and Retention
i. Contractor will dispose of HCA Data in accordance with this section.
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Schedule B
ii. Upon request by HCA, or at the end of the Contract term, or when no
longer needed, Confidential Information/Data must be disposed of as set
out in Attachment B, Section 5 Data Disposition, except as required to be
maintained for compliance or accounting purposes. Contractor will provide
written certification to HCA of disposition using Attachment E, Certification
of Destruction/Disposition of Confidential Information.
6. Data Confidentiality and Non-Disclosure
A. Data Confidentiality.
The Contractor will not use, publish, transfer, sell, or otherwise disclose any Confidential
Information gained by reason of this Contract for any purpose that is not directly connected
with the purpose, justification, and Permissible Use of this Contract, as set out in the
attached Data Licensing Statement(s), except: (a) as provided by law; or (b) with the prior
written consent of the person or personal representative of the person who is the subject of
the Data.
B. Non-Disclosure of Data
The Contractor must ensure that all employees or Subcontractors who will have access to
the Data described in this Contract (including both employees who will use the Data and IT
support staff) are instructed and made aware of the use restrictions and protection
requirements of this Contract before gaining access to the Data identified herein. The
Contractor will also instruct and make any new employee aware of the use restrictions and
protection requirements of this Contract before they gain access to the Data.
The Contractor will ensure that each employee or Subcontractor who will access the Data
signs the User Agreement on Non-Disclosure of Confidential Information, Attachment D
hereto. The Contractor will retain the signed copy of the User Agreement on Non-
Disclosure of Confidential Information in each employee’s personnel file for a minimum of
six years from the date the employee’s access to the Data ends. The documentation must
be available to HCA upon request.
C. Penalties for Unauthorized Disclosure of Data
State laws (including RCW 74.04.060 and RCW 70.02.020) and federal regulations
(including HIPAA Privacy and Security Rules, 45 C.F.R. Part 160 and Part 164;
Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R., Part 2; and
Safeguarding Information on Applicants and Beneficiaries, 42 C.F.R. Part 431, Subpart F)
prohibit unauthorized access, use, or disclosure of Confidential Information. Violation of
these laws may result in criminal or civil penalties or fines.
The Contractor accepts full responsibility and liability for any noncompliance by itself, its
employees, and its Subcontractors with these laws and any violations of the Contract.
7. Data Shared with Subcontractors
If Data access is to be provided to a Subcontractor under this Contract it will only be for the
Permissible Use authorized by HCA and the Contractor must include all of the Data security
terms, conditions and requirements set forth in this Attachment in any such Subcontract. In no
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Schedule B
event will the existence of the Subcontract operate to release or reduce the liability of the
Contractor to HCA for any Data Breach in the performance of the Contractor’s responsibilities.
8. Audit
A. At HCA’s request or in accordance with OCIO 141.10, Contractor shall obtain
audits covering Data Security and Permissible Use. Contractor may cover both the
Permissible Use and the Data Security Requirements under the same audit, or
under separate audits. The term, “independent third-party” as referenced in this
section means an outside auditor that is an independent auditing firm.
B. Data Security audits must demonstrate compliance with Data Security standards
adopted by the Washington State Office of the Chief Information Officer (OCIO),
and as set forth in Attachment B, Data Security Requirements. At a minimum,
audit(s) must determine whether Data Security policies, procedures, and controls
are in place to ensure compliance with all Data Security Requirements set forth
herein and as required by state and federal law.
C. Permissible Use Audits must demonstrate compliance with Permissible Use
standards as set forth in this Contract and each Attachment A. Audit(s) must
determine whether Permissible Use policies, procedures, and controls are in place
to ensure compliance with all Permissible Use requirements in this Contract.
D. HCA may monitor, investigate, and audit the use of Personal Information received
by Contractor through this Contract. The monitoring and investigating may include
the act of introducing data containing unique but false information (commonly
referred to as “salting” or “seeding”) that can be used later to identify inappropriate
use or disclosure of Data.
E. During the term of this Contract and for six (6) years following termination or
expiration of this Contract, HCA will have the right at reasonable times and upon
no less than five (5) business days prior written notice to access the Contractor’s
records and place of business for the purpose of auditing and evaluating the
Contractor’s compliance with this Contract and applicable laws and regulations.
9. Data Breach Notification and Obligations
A. The Data Breach or potential compromise of Data shared under this Contract must
be reported to the HCA Privacy Officer at PrivacyOfficer@hca.wa.gov within one
(1) business day of discovery.
B. If the Data Breach or potential compromise of Data includes PHI, and the
Contractor does not have full details, it will report what information it has and
provide full details within 15 business days of discovery. To the extent possible,
these reports must include the following:
i. The identification of each individual whose PHI has been or may have been
improperly accessed, acquired, used, or disclosed;
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Schedule B
ii. The nature of the unauthorized use or disclosure, including a brief
description of what happened, the date of the event(s), and the date of
discovery;
iii. A description of the types of PHI involved;
iv. The investigative and remedial actions the Contractor or its Subcontractor
took or will take to prevent and mitigate harmful effects and protect against
recurrence;
v. Any details necessary for a determination of the potential harm to Clients
whose PHI is believed to have been used or disclosed and the steps those
Clients should take to protect themselves; and
vi. Any other information HCA reasonably requests.
C. The Contractor must also take actions to mitigate the risk of loss and comply with
any notification or other requirements imposed by law or HCA including but not
limited to 45 C.F.R. Part 164 Subpart D; RCW 42.56.590; RCW 19.255.010; or
WAC 284-04-625.
D. If notification must, in the sole judgement of HCA, must be made Contractor will
further cooperate and facilitate notification to necessary individuals, to the U.S.
Department of Health and Human Services (DHHS) Secretary, and to the media.
At HCA’s discretion, Contractor may be required to directly perform notification
requirements, or if HCA elects to perform the notifications, Contractor must
reimburse HCA for all costs associated with notification(s).
E. Contractor is responsible for all costs incurred in connection with a security
incident, Data Breach, or potential compromise of Data, including:
i. The reasonable costs of notification to individuals, media, and
governmental agencies and of other actions HCA reasonably considers
appropriate to protect HCA clients.
ii. Computer forensics assistance to assess the impact of a Data Breach,
determine root cause, and help determine whether and the extent to which
notification must be provided to comply with Data Breach notification laws;
iii. Notification and call center services, and other appropriate services (as
determined exclusively by HCA) for individuals affected by a security
incident or Data Breach, including fraud prevention, credit monitoring, and
identify theft assistance; and
iv. 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).
v. Compensation to HCA clients for harms caused to them by any Data
Breach or possible Data Breach.
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Schedule B
F. Any Breach of this section may result in termination of the Contract and the
demand for return or disposition, as described in Section 5(C), of all HCA Data.
G. Contractor’s obligations regarding Data Breach notification survive the termination
of this Contract and continue for as long as Contractor maintains the Data and for
any Data Breach or potential compromise, at any time.
10. HIPAA Compliance
This section of the Attachment is the Business Associate Agreement required by HIPAA. The
Contractor is a “Business Associate” of HCA as defined by HIPAA.
A. HIPAA Point of Contact. The point of contact for the Contractor for all required
HIPAA-related reporting and notification communications from this Section 11,
HIPAA Compliance, and all required Data Breach notification communications from
Section 10, Data Breach Notification and Obligations, is:
HCA Privacy Officer
Washington State Health Care Authority
626 8th Avenue SE
Olympia, WA 98504-2700
Telephone: (360) 725-1116
E-mail: PrivacyOfficer@hca.wa.gov
B. Compliance. Business Associate must perform all Contract duties, activities, and
tasks in compliance with HIPAA, and all attendant regulations as promulgated by
the U.S. Department of Health and Human Services, Office for Civil Rights, as
applicable.
C. Use and Disclosure of PHI. Business Associate is limited to the following permitted
and required uses or disclosures of PHI:
i. Duty to Protect PHI. Business Associate must protect PHI from, and will
use appropriate safeguards, and comply with Subpart C of 45 C.F.R. Part
164, Security Standards for the Protection of Electronic Protected Health
Information, with respect to ePHI, to prevent the unauthorized use or
disclosure of PHI for as long as the PHI is within its possession and control,
even after the termination or expiration of this Contract.
ii. Minimum Necessary Standard. Business Associate will apply the HIPAA
Minimum Necessary standard to any use or disclosure of PHI necessary to
achieve the purposes of this Contract (45 C.F.R. § 164.514(d)(2) through
(d)(5)).
iii. Disclosure as Part of the Provision of Services. Business Associate will
only use or disclose PHI as necessary to perform the services specified in
this Contract or as required by law and will not use or disclose such PHI in
any manner that would violate Subpart E of 45 C.F.R. 164, Privacy of
Individually Identifiable Health Information, if done by Covered Entity,
except for the specific uses and disclosures set forth below.
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Schedule B
iv. Use for Proper Management and Administration. Business Associate may
use PHI for the proper management and administration of the Business
Associate or to carry out the legal responsibilities of the Business
Associate.
v. Disclosure for Proper Management and Administration. Business Associate
may disclose PHI for the proper management and administration of
Business Associate, subject to HCA approval, or to carry out the legal
responsibilities of Business Associate, provided the disclosures are
required by law, or Business Associate obtains reasonable assurances
from the person to whom the information is disclosed that the information
will remain confidential and used or further disclosed only as required by
law or for the purposes for which it was disclosed to the person, and the
person notifies Business Associate of any instances of which it is aware in
which the confidentiality of the information has been breached.
vi. Impermissible use or Disclosure of PHI. Business Associate must report to
the contact identified in subsection 11.1, in writing, all uses or disclosures
of PHI not provided for by this Contract within one business day of
becoming aware of the unauthorized use or disclosure of PHI, including
Data Breaches of unsecured PHI as required at 45 C.F.R. § 164.410,
Notification by a Business Associate, as well as any Security Incident of
which it becomes aware. Upon request by HCA, Business Associate will
mitigate, to the extent practicable, any harmful effect resulting from the
impermissible use or disclosure.
vii. Failure to Cure. If HCA learns of a pattern or practice of Business
Associate that constitutes a violation of the Business Associate’s
obligations under the terms of this Contract and reasonable steps by the
Business Associate do not end the violation, HCA may terminate this
Contract, if feasible. In addition, if Business Associate learns of a pattern or
practice of its Subcontractors that constitutes a violation of the Business
Associate’s obligations under the terms of their contract and reasonable
steps by Business Associate do not end the violation, Business Associate
must terminate the Subcontract, if feasible.
viii. Termination for Cause. Business Associate authorizes immediate
termination of this Contract by HCA, if HCA determines that Business
Associate has violated a material term of this Business Associate
Agreement. HCA may, at their sole option, offer Business Associate an
opportunity to cure a violation of this Business Associate Agreement before
exercising a termination for cause.
ix. Consent to Audit. Business Associate must give reasonable access to PHI,
its internal practices, records, books, documents, electronic data, and all
other business information received from, or created or received by
Business Associate on behalf of, HCA to the Secretary of DHHS and/or to
HCA for use in determining compliance with HIPAA privacy requirements.
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Schedule B
x. Obligations of Business Associate Upon Expiration or Termination. Upon
expiration or termination of this Contract for any reason, with respect to PHI
received from HCA, or created, maintained, or received by Business
Associate or any Subcontractors on behalf of HCA, Business Associate
must:
1. Retain only that PHI which is necessary for Business Associate to
continue its proper management and administration or to carry out its
legal responsibilities;
2. Return to HCA or destroy the remaining PHI that the Business
Associate or any Subcontractors still maintain in any form;
3. Continue to use appropriate safeguards and comply with Subpart C of
45 C.F.R. Part 164, Security Standards for the Protection of Electronic
Projected Health Information, with respect to ePHI to prevent use or
disclosure of the PHI, other than as provided for in this Section, for as
long as Business Associate or any Subcontractors retain the PHI.
4. Not use or disclose the PHI retained by the Business Associate or any
Subcontractors other than for the purposes for which such PHI was
retained and subject to the same conditions set out in subsection 11.1,
Use and Disclosure of PHI, that applied prior to termination; and
5. Return to HCA or destroy the PHI retained by Business Associate, or
any Subcontractors, when it is no longer needed by Business
Associate for its proper management and administration or to carry out
its legal responsibilities.
xi. Survival. The obligations of Business Associate under this section will
survive the termination or expiration of this Contract.
D. Individual Rights
i. Accounting of Disclosures
1. Business Associate will document all disclosures, except those disclosures
that are exempt under 45 C.F.R. § 164.528, of PHI and information related
to such disclosures.
2. Within ten business days of a request from HCA, Business Associate will
make available to HCA the information in Business Associate’s possession
that is necessary for HCA to respond in a timely manner to a request for an
accounting of disclosures of PHI by the Business Associate (45 C.F.R. §§
164.504(e)(2)(ii)(G) and 164.528(b)(1)).
3. At the request of HCA or in response to a request made directly to the
Business Associate by an Individual, Business Associate will respond, in a
timely manner and in accordance with HIPAA, to requests by Individuals for
an accounting of disclosures of PHI.
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Schedule B
4. Business Associate record keeping procedures will be sufficient to respond
to a request for an accounting under this section for the six years prior to
the date on which the accounting was requested.
E. Access
i. Business Associate will make available PHI that it holds that is part of
a Designated Record Set when requested by HCA or the Individual as
necessary to satisfy HCA’s obligations under 45 C.F.R. § 164.524,
Access of Individuals to Protected Health Information.
ii. When the request is made by the Individual to the Business Associate
or if HCA asks the Business Associate to respond to a request, the
Business Associate must comply with the requirements in 45 C.F.R. §
164.524, Access of Individuals to Protected Health Information, on
form, time, and manner of access. When the request is made by HCA,
the Business Associate will provide the records to HCA within ten
business days.
F. Amendment
i. If HCA amends, in whole or in part, a record or PHI contained in an
Individual’s Designated Record Set and HCA has previously provided
the PHI or record that is the subject of the amendment to Business
Associate, then HCA will inform Business Associate of the amendment
pursuant to 45 C.F.R. § 164.526(c)(3), Amendment of Protected
Health Information.
ii. Business Associate will make any amendments to PHI in a Designated
Record Set as directed by HCA or as necessary to satisfy HCA’s
obligations under 45 C.F.R. § 164.526, Amendment to Protected
Health Information.
G. Subcontracts and other Third Party Agreements. In accordance with 45 C.F.R. §§
164.502(e)(1)(ii), 164.504(e)(1)(i), and 164.308(b)(2), Business Associate must
ensure that any agents, Subcontractors, independent contractors, or other third
parties that create, receive, maintain, or transmit PHI on Business Associate’s
behalf, enter into a written contract that contains the same terms, restrictions,
requirements, and conditions as the HIPAA compliance provisions in this Contract
with respect to such PHI. The same provisions must also be included in any
contracts by a Business Associate’s Subcontractor with its own business
associates as required by 45 C.F.R. §§ 164.314(a)(2)(b) and 164.504(e)(5).
H. Obligations. To the extent the Business Associate is to carry out one or more of
HCA’s obligation(s) under Subpart E of 45 C.F.R. Part 164, Privacy of Individually
Identifiable Health Information, Business Associate must comply with all
requirements that would apply to HCA in the performance of such obligation(s).
I. Liability. Within ten business days, Business Associate must notify the contact
identified in subsection 11.1 of any complaint, enforcement, or compliance action
initiated by the Office for Civil Rights based on an allegation of violation of HIPAA
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Schedule B
and must inform HCA of the outcome of that action. Business Associate bears all
responsibility for any penalties, fines, or sanctions imposed against the Business
Associate for violations of HIPAA and for any imposed against its Subcontractors
or agents for which it is found liable.
J. Data Breach Notification. Data Breach Notification and Obligations are detailed in
Section 10.
K. Miscellaneous Provisions
i. Regulatory References. A reference in this Attachment to a section of
HIPAA means the section as in effect or as amended.
ii. Interpretation. Any ambiguity in this Attachment will be interpreted to permit
compliance with the HIPAA.
11. Data Breach Response Insurance Requirements
For the term of this Contract and 3 years following its termination or expiration, Contractor
must maintain insurance to cover costs incurred in connection with a security incident, Data
Breach, or potential compromise of Data, including:
A. Computer forensics assistance to assess the impact of a Data Breach, determine
root cause, and help determine whether and the extent to which notification must
be provided to comply with Data Breach notification laws;
B. Notification and call center services for individuals affected by a security incident,
or Data Breach;
C. Data Breach resolution and mitigation services for individuals affected by a security
incident or Data Breach, including fraud prevention, credit monitoring, and identity
theft assistance; and
D. Regulatory defense, fines, and penalties from any claim in the form of a regulatory
proceeding resulting from a violation of any applicable privacy or security law(s) or
regulation(s).
12. Survival Clauses
The terms and conditions contained in this Attachment that by their sense and context are
intended to survive the expiration or other termination of this Attachment must survive.
Surviving terms include but are not limited to: Constraints on Use of Data / Limited License,
Security of Data, Data Confidentiality and Non-Disclosure, Audit, HIPAA Compliance, Data
Breach Notification and Obligations and Data Breach Response Coverage Requirements.
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Attachment A1: Data Licensing Statement
1. Justification and Authority for Data Sharing
The Data to be shared under this DSA are necessary for the CJTA Programmatic Treatment
Report, Attachment 1. The Data will be submitted directly into the Behavioral Health Data
System (BHDS).
2. Purpose / Use / Description of Data
The purpose of this Attachment is to provide terms and conditions under which HCA will allow the
restricted use of its Data to the Contractor, and under which the Contractor may receive and use the
Data. This Attachment ensures that HCA Data is provided, protected, and used only for purposes
authorized by state and federal law governing such Data use.
The scope of this Attachment only provides the Contractor with access and Permissible Use of
Data; it does not establish an agency relationship or independent contractor relationship between
HCA and the Contractor.
A. Permissible Use: Contractor may only use the Data for the purposes of performing the
duties under this Contract.
B. File Layout: The Parties will exchange Data using the mutually agreed upon file layouts
below. The Parties may edit and/or change the File Layout as considered necessary.
i. Method of Access/Transfer: Once an established Managed Data Transfer
connection with the host computer at Contractor’s location is confirmed, HCA will
provide Data listed in File Layout list below, to Contractor.
ii. Delivery Method: Managed File Transfer
iii. Frequency of Data Delivery: HCA will receive Data quarterly.
iv. Costs: N/A
v. Description of Shared data is attached as Attachment 1, Quarterly Progress Report
Template.
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Attachment B: Data Security Requirements
2. Definitions
In addition to the definitions set out in the Data Use, Security, and Confidentiality Attachment, 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 PCs,
flash memory devices (e.g. USB flash drives, personal media players); and
laptop/notebook/tablet computers. If used to store Confidential Information, devices should
be Federal Information Processing Standards (FIPS) Level 2 compliant.
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. FedEx, 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.
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.
3. Data Transmission
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.
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B. When transmitting HCA’s Confidential Information via paper documents, the Contractor
must use a Trusted System and must be physically kept in possession of an authorized
person.
4. Protection of Data
The Contractor agrees to store and protect 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.
B. Data stored on Portable/Removable Media or Devices:
i. Confidential Information provided by HCA on Removable Media will be
encrypted with NIST 800-series approved algorithms. Encryption keys will be
stored and protected independently of the Data.
ii. HCA’s data must not be stored by the Contractor on Portable Devices or Media
unless specifically authorized within the Contract. If so authorized, the
Contractor must protect the Data by:
a) Encrypting with NIST 800-series approved algorithms. Encryption keys will
be stored and protected independently of the data;
b) Control access to the devices with a Unique User ID and Hardened
Password or stronger authentication method such as a physical token or
biometrics;
c) Keeping devices in locked storage when not in use;
d) Using check-in/check-out procedures when devices are shared;
e) Maintain an inventory of devices; and
C. Ensure that when being transported outside of a Secured Area, all devices with Data are
under the physical control of an Authorized User.
D. 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.
5. Data Segregation
HCA’s Data 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 of HCA’s Data can be
identified for return or destruction. It also aids in determining whether HCA’s Data has or may have
been compromised in the event of a security breach.
A. HCA’s Data must be kept in one of the following ways:
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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’s Data from non-HCA data, then both
HCA’s Data and the non-HCA data with which it is commingled must be protected as
described in this Attachment.
C. Contractor must designate and be able to identify all computing equipment on which they
store, process and maintain HCA Data. No Data at any time may be processed on or
transferred to any portable storage medium. Laptop/tablet computing devices are not
considered portable storage medium devices for purposes of this Contract provided it is
installed with end-point encryption.
6. Data Disposition
A. Consistent with Chapter 40.14 RCW, Contractor shall erase, destroy, and render
unrecoverable all HCA Confidential Data and certify in writing that these actions have been
completed within thirty (30) days of the disposition requirement or termination of this
Contract, whichever is earlier. At a minimum, media sanitization is to be performed
according to the standards enumerated by NIST SP 800-88r1 Guidelines for Media
Sanitization.
B. For HCA’s Confidential Information stored on network disks, deleting unneeded Data is
sufficient as long as the disks remain in a Secured Area and otherwise meet the
requirements listed in Section 3, above. Destruction of the Data as outlined in this section of
this Attachment may be deferred until the disks are retired, replaced, or otherwise taken out
of the Secured Area.
7. Network Security
Contractor’s network security must include the following:
A. Network firewall provisioning;
B. Intrusion detection;
C. Quarterly vulnerability assessments; and
D. Annual penetration tests.
8. Application Security
Contractor must maintain and support its software and subsequent upgrades, updates, patches, and
bug fixes such that the software is, and remains secure from known vulnerabilities.
9. Computer Security
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Contractor shall maintain computers that access Data by ensuring the operating system and software
are updated and patched monthly, such that they remain secure from known vulnerabilities. Contractor
computer device(s) must also be installed with an Anti-Malware solution and signatures updated no
less than monthly.
10. Offshoring
A. Contractor must maintain all hardcopies containing Confidential Information only from
locations in the United States.
B. Contractor may not directly or indirectly (including through Subcontractors) transport any
Data, hardcopy or electronic, outside the United States unless it has advance written
approval from HCA.
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Attachment C: HCA Small Numbers Standard
1. Why do we need a Small Numbers Standard?
It is the Washington State Health Care Authority’s (HCA) legal and ethical responsibility to protect the
privacy of its clients and members. However, HCA also supports open data and recognizes the ability
of information to be used to further HCA’s mission and vision. As HCA continues down the path of Data
Governance maturity, establishing standards such as this is key in helping HCA analysts and
management meet the needs of external data requestors while maintaining the trust of our clients and
members and complying with agency, state and federal laws and policies.
Publishing data products that include small numbers creates two concerns. As a reported number gets
smaller, the risk of re-identifying an HCA client or member increases. This is especially true when a
combination of variables are included in the data product to arrive at the small number (e.g. location,
race/ethnicity, age, or other demographic information).
Small numbers can also create questions around statistical relevance. When it comes to publicly
posting data products on HCA’s internet site, or sharing outside the agency, the need to know the
exact value in a cell that is less than 11 must be questioned.
As the agency moves away from traditional, static reports to a dynamic reporting environment (e.g.
Tableau visualizations), it is easier for external data consumers to arrive at small numbers. Further,
those external consumers have an increasing amount of their own data that could be used to re-identify
individuals. As a result, more rigor and a consistent approach needs to be in place to protect the
privacy of HCA’s clients and members. Until now, some HCA data teams have elected to follow small
numbers guidelines established by the Department of Health, which include examples of suppression
methods for working with small numbers. HCA is now establishing its own standard, but is planning to
work with DOH and other agencies dealing with healthcare data to try and develop a consistent small
numbers methodology at a statewide level.
2. Scope
HCA often uses Category 4 data to create summary data products for public consumption. This
Standard is intended to define one of the requirements for a summary data product to be considered
Category 1. Specifically, it is intended to define the level of suppression that must be applied to an
aggregated data product derived from Category 4 data for the data product to qualify as Category 1.
Category 1 products are data products that are shared external to the agency, in large part those
products that are posted on HCA’s Internet website (www.hca.wa.gov). The primary scope of this
Standard is for those data products posted publicly (e.g. on the website), or, shared as public
information.
The following are examples of when this Standard does not apply to data products are:
A. Those shared directly with an external entity outside HCA, the Standard suppression of
small numbers would not be required. However, you should notify the recipient that the data
products contain sensitive information and should not be shared or published.
B. Those exchanged under a data share agreement (DSA) that will not be posted or shared
outside the Contractor.
C. Those created for HCA-only internal use.
This standard does not supersede any federal and state laws and regulation.
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3. Approach
In 2017, an impromptu workgroup was formed to tackle the issue of small numbers and determine what
the general approach for handling data products that contain them would be. This initial effort was led
by the agency’s Analytics, Interoperability and Measurement (AIM) team who had an immediate need
for guidance in handling and sharing of data products containing small numbers. The result of that work
was a set of Interim Small Numbers Guidelines, which required suppression of cells containing values
of less than 10. In addition, data products that contain small numbers are considered Category 2 under
HCA’s Data Classification Guidelines.
In spring 2018, a new cross-divisional and chartered Small Numbers Workgroup was formed to
develop a formal agency standard. Representatives from each of the major HCA divisions that produce
data and analytic products were selected. The charter, complete with membership, can be found here
(available to internal HCA staff only). The Workgroup considered other state agency standards, and
national standards and methods when forming this standard. The Workgroup also consulted business
users and managers to determine the potential impact of implementing a small numbers suppression
standard. All of this information was processed and used to form the HCA Small Numbers Standard.
4. State and National Small Numbers Standards Considered
When developing these standards, HCA reviewed other organizations’ small numbers standards at
both a state and federal level. At the state level, DOH recently published a revised Small Numbers
Standard, which emphasizes the need for suppression for both privacy concerns and statistical
relevance. HCA also convened a meeting of other state agencies to discuss their approach and
policies (if any) around Small Numbers. Feedback from that convening was also taken into
consideration for this Standard as well.
Federal health organizations such as the Centers for Disease Control and Prevention (CDC) and the
National Center for Health Statistics (NCHS) also maintain small numbers standards. HCA’s federal
oversight agency and funding partner, the Centers for Medicare and Medicaid Services (CMS) adopts
suppression of any cell with a count of 10 or less.
5. WA Health Care Authority Small Numbers Standard
Any HCA external publication of data products are to be compliant with both HIPAA and Washington
State privacy laws. Data products are not to contain small numbers that could allow re-identification of
individual beneficiaries. HCA analysts are to adhere to the following requirements when developing
Category 1 data products for distribution and publication. Category 1 data is information that can be
released to the public. These products do not need protection from unauthorized disclosure but do
need integrity and availability protection controls. Additionally, all contractors (state and private) that
use HCA’s data to produce derivative reports and data products are required to adhere to this standard
as well. HCA’s Contracts team will ensure that proper contractual references are included to this and
all HCA Data Release and Publishing Standards. The requirements discussed herein are not intended
for Category 2, Category 3, or Category 4 data products.
6. HCA’s Small Number Standard:
A. There are no automatic exemptions from this standard
B. (See Exception Request Process section below)
C. Standard applies for all geographical representations, including statewide.
D. Exceptions to this standard will be considered on a case-by-case basis (see Exception
Request Process section later in this document for more information).
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E. Ensure that no cells with 0 < n < 11 are reported (0 < n < 11 suppressed)
F. Apply a marginal threshold of 1 - 10 and cell threshold of 1 - 10 to all tabulations
G. (0 < n < 11 suppressed).
H. To protect against secondary disclosure, suppress additional cells to ensure the primary
suppressed small value cannot be recalculated.
I. Suppression of percentages that can be used to recalculate a small number is also
required.
J. Use aggregation to prevent small numbers but allow reporting of data. Age ranges are a
very good example of where aggregation can be used to avoid small numbers but avoid
suppressing data (see example below).
7. Small Numbers Examples
A. Example (Before Applying Standard)
Client Gender County Accountable Community of Health (ACH) Statewide
Male 6 8 14
Female 11 15 26
TOTAL 17 23 40
B. Example (After Applying Standard)
Client Gender County ACH Statewide
Male ---¹ --- 14
Female 11 15 26
TOTAL --- --- 40
¹In order to protect the privacy of individuals, cells in this data product that contain small numbers
from 1 to 10 are not displayed.
The above examples show in order to comply with the standard, analysts must not only suppress
directly those cells where n < 11, but also in this case secondary suppression is necessary of the
county and ACH totals in order to avoid calculation of those cells that contained small numbers.
C. Example (Suppression with no aggregation)
Age
Range
County ACH Statewide
0-3 5 (would be suppressed) 8 (would be suppressed) 13 (would be
suppressed)
4-6 7 (would be suppressed) 18 25 (would be
suppressed)
15 23 38
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10-12 24 33 57
TOTAL 51 (would be suppressed) 82 (would be suppressed) 133
D. Example (Using aggregation instead of suppression)
Age Range County ACH Statewide
0-6 12 26 38
7-9 15 23 38
10-12 24 33 57
TOTAL 51 82 133
The above examples provide guidance for using aggregation to avoid small number suppression
and still provide analytic value to the end user. Aggregation is an excellent method to avoid
presenting information with many holes and empty values.
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Attachment D: User Agreement on Non-Disclosure of Confidential Information
(To Be Signed by Each Individual User with Access to Confidential HCA Data)
Your organization has entered into a Data Share Agreement with the state of Washington Health Care Authority (HCA) that will allow
you access to data and records that are deemed Confidential Information as defined below. Prior to accessing this Confidential
Information you must sign this User Agreement on Non-Disclosure of Confidential Information.
Confidential Information
“Confidential Information” means information that is exempt from disclosure to the public or other unauthorized persons under
Chapter 42.56 RCW or other federal or state laws. Confidential Information includes, but is not limited to, Protected Health
Information and Personal Information. For purposes of the pertinent Data Share Agreement, Confidential Information means the
same as “Data.”
“Protected Health Information” means information that relates to: the provision of health care to an individual; the past, present, or
future physical or mental health or condition of an individual; or the past, present or future payment for provision of health care to an
individual and includes demographic information that identifies the individual or can be used to identify the individual.
“Personal Information” means information identifiable to any person, including, but not limited to, information that relates to a person’s
name, health, finances, education, business, use or receipt of governmental services or other activities, addresses, telephone
numbers, social security numbers, driver license numbers, credit card numbers, any other identifying numbers, and any financial
identifiers.
Regulatory Requirements and Penalties
State laws (including, but not limited to, RCW 74.04.060, RCW 74.34.095, and RCW 70.02.020) and federal regulations (including,
but not limited to, HIPAA Privacy and Security Rules, 45 C.F.R. Part 160 and Part 164; Confidentiality of Alcohol and Drug Abuse
Patient Records, 42 C.F.R., Part 2; and Safeguarding Information on Applicants and Beneficiaries, 42 C.F.R. Part 431, Subpart F)
prohibit unauthorized access, use, or disclosure of Confidential Information. Violation of these laws may result in criminal or civil
penalties or fines.
User Assurance of Confidentiality
In consideration for HCA granting me access to the Confidential Information that is the subject of this Agreement, I agree that I:
Will access, use, and disclose Confidential Information only in accordance with the terms of this Agreement and consistent with applicable statutes,
regulations, and policies.
Have an authorized business requirement to access and use the Confidential Information.
Will not use or disclose any Confidential Information gained by reason of this Agreement for any commercial or personal purpose, or any other
purpose that is not directly connected with this Agreement.
Will not use my access to look up or view information about family members, friends, the relatives or friends of other employees, or any persons who
are not directly related to my assigned job duties.
Will not discuss Confidential Information in public spaces in a manner in which unauthorized individuals could overhear and will not discuss
Confidential Information with unauthorized individuals, including spouses, domestic partners, family members, or friends.
Will protect all Confidential Information against unauthorized use, access, disclosure, or loss by employing reasonable security measures, including
physically securing any computers, documents, or other media containing Confidential Information and viewing Confidential Information only on
secure workstations in non-public areas.
Will not make copies of Confidential Information or print system screens unless necessary to perform my assigned job duties and will not transfer
any Confidential Information to a portable electronic device or medium, or remove Confidential Information on a portable device or medium from
facility premises, unless the information is encrypted and I have obtained prior permission from my supervisor.
Will access, use or disclose only the “Minimum Necessary” Confidential Information required to perform my assigned job duties.
Will not distribute, transfer, or otherwise share any software with anyone.
Will forward any requests that I may receive to disclose Confidential Information to my supervisor for resolution and will immediately inform my
supervisor of any actual or potential security breaches involving Confidential Information, or of any access to or use of Confidential Information by
unauthorized users.
Understand at any time, HCA may audit, investigate, monitor, access, and disclose information about my use of the Confidential Information and that
my intentional or unintentional violation of the terms of this Agreement may result in revocation of privileges to access the Confidential
Information, disciplinary actions against me, or possible civil or criminal penalties or fines.
Understand that my assurance of confidentiality and these requirements will continue and do not cease at the time I terminate my relationship with
my employer.
Signature
Print User’s Name User Signature Date
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Attachment E: Certification of Destruction/Disposal of Confidential Information
(To Be Filled Out and Returned to HCA Upon Termination of Contract)
NAME OF CONTRACTOR:
CONTRACT #:
___________________________________ (Contractor) herby certifies that the data elements listed
below or attached, received as a part of the data provided in accordance with DSA have been:
DISPOSED OF/DESTROYED ALL COPIES
You certify that you destroyed, and returned if requested by HCA, all identified confidential
information received from HCA, or created, maintained, or received by you on behalf of HCA. You
certify that you did not retain any copies of the confidential information received by HCA.
Description of Information Disposed of/ Destroyed:
Date of Destruction and/or Return:
Method(s) of destroying/disposing of Confidential Information:
Disposed of/Destroyed by:
Signature Date
Printed Name:
Title:
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ATTACHMENT 1: QUARTERLY PROGRESS REPORT TEMPLATE
CRIMINAL JUSTICE TREATMENT ACCOUNT
QUARTERLY PROGRESS REPORT
Please respond to each question and submit as a separate attachment with your quarterly R&E Report to:
zach.lynch@hca.wa.gov
Report Quarter
☐July 2023 to September 2023 ☐October 2023 to December 2023
☐January 2024 to March 2024 ☐April 2024 to June 2024
Name of County completing Report: Click or tap here to enter text.
Please enter your status for each item, if item is incomplete please list your plan of correction (POC)
including actions to be taken and target date for completion.
1. Contractor entered all encounters and supplemental transactions funded by CJTA into the “CJTA
Provider Entry Workbook”? ☐Yes ☐No
If no, please enter POC.
2. County submitted the CJTA Programmatic Treatment Report through the Managed File Transfer? ☐Yes ☐No
If no, please enter POC.
3. County submitted the Quarterly Revenue and Expenditure Report? ☐Yes ☐No
If no, please enter POC.
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4. County has made attempts to expand access to Recovery Support Services for the intended
population? ☐Yes ☐No
If no, please enter POC.
5. CJTA funding provides services for individual in a Therapeutic Court Program? ☐Yes ☐No
If Yes, please indicate the number of individuals who were admitted into the program during this
quarter who are receiving medication assisted treatment or medications for opioid use disorder:
If Yes, please indicate what medications the individuals admitted into the program during this quarter
are receiving (e.g. Buprenorphine, Methadone, Naltexone):
6. Is there any indication that the Therapeutic Court programs benefitting from CJTA are denying access
to, or requiring titration from, any medications for opioid use disorder? ☐Yes ☐No
Please enter any additional comments here:
7. CJTA funding used in the local, county, city, or tribal Jail? ☐Yes ☐No
If Yes, please indicate any barriers to providing treatment services and transitioning individuals into
the community:
8. List any other significant accomplishments.
9. List any training or technical assistance needs.
10. Summarize any barrier(s) encountered and plans to overcome the barrier(s) with timeline.
11. Please include any other comments you would like to convey to the HCA Contract Manager:
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Washington State 65 CJTA Funded Treatment and Recovery Support
Health Care Authority HCA Contract K7098
Completed By:
Date:
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ATTACHMENT 2: QUARTERLY REVENUE AND EXPENDITURE REPORT
TEMPLATE
CJTA Revenue & Expenditure Report
County Name
[Month] - [Month] [Year]
EVENUES AMOUNT
Non-Medicaid Revenues
Criminal Justice Treatment Acct (CJTA)
State Drug Court (CJTA)
TOTAL REVENUES $ -
EXPENDITURES - Substance Use Disorder AMOUNT Number
Served
Assessment (to include assessments done while in jail)
Interim Services
Community Outreach
Brief Intervention (Any level, assessment not required)
Acute Withdrawal Management (Detoxification)
Involuntary Commitment Investigations and Treatment
Sub-Acute Withdrawal Management (Detoxification)
Outpatient Treatment (Group or Individual)
Intensive Outpatient Treatment
Opiate Substitution Treatment
Case Management
Urinalysis
Room and Board (Residential Treatment only)
Intensive Inpatient Residential Treatment Services
Long-Tem Care Residential Treatment Services
Recovery House Residential Treatment Services
Treatment in the jail (8 Sessions)
Recovery Support Services
Administration-10% Maximum
Transportation
Childcare Services
TOTAL EXPENDITURES $ - -
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Additional Required Reporting:
CJTA Amount
Adult
Youth
PPW
Total $ -
Discrepancy $ -
CJTA - Minimum 30% Innovative $ -
100%
Match
Contracted Directly with Courts $0.00 $0.00
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