HomeMy WebLinkAboutDoc 552 - CORIL AgrmtDeschutes County Board of Commissioners
1300 NW Wall St, Suite 200, Bend, OR 97701 -1960
(541) 388 -6570 - Fax (541) 385 -3202 - www.deschutes.orq
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of November 9, 2009
Please see directions for completing this document on the next page.
DATE: November 2, 2009
FROM: Kathy Drew, Behavioral Health Program Manager Phone: 322 -7557
Health Services -- Behavioral Health Division
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2009 -552, personal services contract between
Central Oregon Resources for Independent Living and Deschutes County Health Services.
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
County manages a residential care facility, which is designed to serve the needs of adults with
developmental disabilities. The Contractor, Central Oregon Resources for Independent Living
(CORIL), provides personal care services to residents. Funds provided to this Contractor are
considered pass - through dollars from the 2009 -2011 Financial Assistance Contract between County
and State #127295.
Contractor shall perform the service described as supported living, vocational services and
vocational transportation services under Service Elements 51, 53 and 54. Contractor shall maintain
their Assisted Living Facility license, as a condition to receiving payment. Subject to availability of
funds, County shall approve monthly payments to Contractor upon receipt of billing notice through
the EXPRS system from Department of Human Services.
FISCAL IMPLICATIONS:
Maximum compensation of $709,800.
RECOMMENDATION & ACTION REQUESTED:
Behavioral Health recommends approval.
ATTENDANCE: Kathy Drew, Behavioral Health Program Manager
DISTRIBUTION OF DOCUMENTS:
An executed copies to:
Nancy England, Contract Specialist, Health Services
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This form is required to be submitted with ALL contracts and other agreements,
regardless of whether the document is to be on a Board agenda or can be signed by the County
Administrator or Department Director. If the document is to be on a Board agenda, the Agenda
Request Form is also required. If this form is not included with the document, the document will
be retumed to the Department. Please submit documents to the Board Secretary for tracking
purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In
addition to submitting this form with your documents, please submit this form electronically to
the Board Secretary.)
Date:
Please complete all sections above the Official Review line.
September 22, 2009
Department:
Health Services, Behavioral Health
Contractor /Supplier /Consultant Name:
kCORIL)I
Contractor Contact:
Glenn Van Cise
Central Oregon Resources for Independent Living'
Contractor Phone #:
Type of Document: Personal Services Contract
541- 388 -8103
Goods and /or Services: Consideration and signature of document number 2009 -552,
personal services contract between Central Oregon Resources for Independent Living and
Deschutes County Health Services.
Background & History: County manages a residential care facility which is designed to serve
the needs of adults with developmental disabilities. The Contractor, Central Oregon Resources
for Independent Living (CORIL), provides personal care services to residents. Funds provided
to this Contractor is considered pass- through dollars from the 2009 -2011 Financial Assistance
Contract between County and State #127295.
Contractor shall perform the service described as Supported living, vocational services and
vocational transportation services under Service Elements 51, 53 and 54. Contractor shall
maintain their Assisted Living Facility license, as a condition to receiving payment. Subject to
availability of funds, County shall approve monthly payments to Contractor upon receipt of
billing notice through the EXPRS system from Department of Human Services.
Agreement Starting Date: October 1, 20097 Ending Date:
June 30, 2011
Annual Value or Total Payment: Maximum compensation is $709,800
® Insurance Certificate Received check box)
Insurance Expiration Date: June 14, 2010
Check all that apply:
❑ RFP, Solicitation or Bid Process
❑ Informal quotes (<$150K)
Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
9/22/2005
REVIE ED
Yea
LEGAL OUNSEL
For Recording Stamp Only
DESCHUTES COUNTY SERVICES CONTRACT
CONTRACT NO. 2009 -552
This Contract is made and entered into by and between Deschutes County Health Services, a political subdivision of the
State of Oregon, 2577 NE Courtney Drive, Bend, OR 97701, hereinafter referred to as "County ", and Central Oregon
Resources for Independent Living, PO Box 9425, Bend, OR 97708, hereinafter referred to as "Contractor ". The parties
agree as follows:
Effective Date and Termination Date. The effective date of this Contract shall be October 1, 2009 or the date, on which
each party has signed this Contract, whichever is later. Unless extended or terminated earlier in accordance with its terms,
this Contract shall terminate when County accepts Contractor's completed performance or on June 30, 2011, whichever date
occurs last. Contract termination shall not extinguish or prejudice County's right to enforce this Contract with respect to any
default by Contractor that has not been cured. This Agreement may be renewed or extended only upon written agreerient of
the parties.
Statement of Work. Contractor shall perform the work described in Exhibit 1.
Payment for Work. County agrees to pay Contractor in accordance with Exhibit 1.
Contract Documents. This Contract includes Page 1 -11 and Exhibits 1, 2, 3, 4, 5, 6 and 7.
CONTRACTOR DATA AND SIGNATURE
Contractor Address: PO Box 9425, Bend, OR 97708
Federal Tax ID# or Social Security #: 93- 0823952
Is Contractor a nonresident alien? ❑Yes ❑ No
Business Designation (check one): ❑ Sole Proprietorship
❑ Corporation -for profit ❑ Corporation- non - profit
❑ Partnership
❑ Other, describe: LLC
A Federal tax ID number or Social Security number is required to be provided by the Contractor and shall be used for the
administration of state, federal and local tax laws. Payment information shall be reported to the Internal Revenue Service
under the name and Federal tax ID number or, if none, the Social Security number provided above.
I have read this Contract including the attached Exhibits. I understand this Contract and agree to be bound by its
terms. NO . ontractof shall also sign Exhibits 3 and 4 and, if applicable, Exhibit 6 and 7.
Signature
kny, CiLk-
11
i L Picv119(—
Title
617;440
Date
Name (please print)
DESCHUTES COUNTY SIGNATURE
Contracts with a maximum consideration of not greater than $25,000 are not valid and not binding on the Cou ity until
signed by the appropriate Deschutes County Department Head. Additionally, Contracts with a maximum consideration
greater than $25,000 but less than $150,000 are not valid and not binding on the County until signed by the County
Administrator or the Board of County Commissioners.
Dated this of , 2009 Dated this of , 2009
Scott Johnson, Director David Kanner, County Administrator
Page 1 of 11— Behavioral Health - Personal Services Contract No. 2009 -552
DC- 2009 -r;52
STANDARD TERMS AND CONDITIONS
1. Time is of the Essence. Contractor agrees that time is of the essence in the performance of this Contract.
2. Compensation. Payment for all work performed under this Contract shall be made in the amounts and manner set
forth in Exhibit 1.
a. Payments shall be made to Contractor following County's review and approval of billings and deli%erables
submitted by Contractor.
b. All Contractor billings are subject to the maximum compensation amount of this Contract.
c. Contractor shall not submit billings for, and County shall not pay, any amount in excess of the m 3ximum
compensation amount of this Contract, including any reimbursable expenses, (See Exhibit 5).
1) If the maximum compensation amount is increased by amendment to this Contract, the amendment shall be
signed by both parties and fully executed before Contractor performs work subject to the amendment.
2) No payment shall be made for any services performed before the beginning date or after the expiratior date of
this Contract.
d. This Contract shall not be amended after the expiration date.
e. Unless otherwise specifically provided in Exhibit 5, Contractor shall submit monthly invoices for work performed.
The invoices shall describe all work performed with particularity and by whom it was performed and shal itemize
and explain all expenses for which reimbursement is claimed.
f. The invoices also shall include the total amount invoiced to date by Contractor prior to the current invoice.
g. Prior to approval or payment of any billing, County may require and Contractor shall provide any informatic n which
County deems necessary to verify work has been properly performed in accordance with the Contract.
h. Contractor shall not expend funds on the delivery of a service in excess of the amount reasonable and necessary to
provide quality service. Funds may only be used for the delivery of the service or services set out in this p ragraph
unless written permission is granted to use the funds for other services in accordance with this Contract. F ands for
Alcohol and Drug Abuse Services may not be used for: (1) inpatient hospital services; (2) cash payments to ntended
recipients of health services; (3) to purchase or improve land, to purchase, construct or permanently improve (other
than minor remodeling) any building or other facility or to purchase major medical equipment; (4) to satisfy any
requirement for expenditure of non - federal funds as a condition for receipt of federal funds (whether the federal funds
are to be paid under this Agreement; (5) to provide financial assistance to any entity other than a public or non- profit
entity; (6) to carry out any program prohibited by section 245(b) of the Health Omnibus Programs Extensicn Act of
1988 (codified at 42 USC 300ee(5); and (7) expend amounts in excess of allowable costs under federal OMB Circular
A -133.
i. Contractor shall submit the final monthly expenditure report under this Contract no later than thirty (30) days 'allowing
the end of the fiscal year. Fiscal year shall be based on the period July 1 through June 30.
j. Expenditures of Contractor may be charged to this Contract only if they: (1) are in payment for services performed
under this Contract; (2) conform to applicable State and Federal regulations and statutes; (3) are in payment of an
obligation incurred during the period of this Contract; and (4) are not in excess of 100% of program costs. An County
funds spent for purposes not authorized by this Contract shall be deducted from payments or refunded to County, at
County's option. Payments by County in excess of authorized actual expenditures shall be deducted from payment or
refunded to County no later than thirty (30) days after the expiration of this Contract. If Contractor fails to provide an
acceptable audit performed by a certified public accountant for federal funds received under this Contract, or f federal
authorities demand the repayment of federal funds received under this Contract, County may recover all fede -al funds
paid under this Contract, unless a smaller amount is disallowed or demanded. If Department disallows or -equests
repayment for any funds paid under this Contract due to Contractors' acts or omissions, Contractor sh,311 make
payment to the County of the amount disallowed or requested. In the event that the Department determ nes that
County is responsible for the repayment of any funds owed to the Department by Contractor, Contractor agrees to
make such payment within ten days of notification by County or the Department of said determination by the
Department.
k. In the event that a statutorily required operating license or letter of approval is not extended or suspended, County's
obligation to provide reimbursement for services or program expenses hereunder related to services rendere i without
the necessary license or approval will cease on the date of termination of this Contract (whether in whole or i' i part) or
the date of expiration or suspension of the license or letter of approval, whichever date is earlier.
Page 2 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
3. Delegation, Subcontracts and Assignment. Contractor shall not delegate or subcontract any of the work req aired by
this Contract or assign or transfer any of its interest in this Contract, without the prior written consent of County
a. Any delegation, subcontract, assignment, or transfer without prior written consent of County shall constitute a
material breach of this contract.
b. Any such assignment or transfer, if approved, is subject to such conditions and provisions as the County may
deem necessary.
c. No approval by the County of any assignment or transfer of interest shall be deemed to create any obligation of
the County to increase rates of payment or maximum Contract consideration.
d. Prior written approval shall not be required for the purchase by the Contractor of articles, supplies and services
which are incidental to the provision of services under this Contract that are necessary for the performance of the
work.
e. Any subcontracts that the County may authorize shall contain all requirements of this contract, and unless
otherwise specified by the County the Contractor shall be responsible for the performance of the subcontra: tor.
4. No Third Party Beneficiaries.
a. County and Contractor are the only parties to this Contract and are the only parties entitled to enforce its teems.
b. Nothing in this Contract gives or provides any benefit or right, whether directly, indirectly, or otherwise, to third
persons unless such third persons are individually identified by name in this Contract and expressly desc; ibed as
intended beneficiaries of this Contract.
5. Successors in Interest. The provisions of this Contract shall be binding upon and inure to the benefit of the_ parties
and their successors and approved assigns, if any.
6. Early Termination. This Contract may be terminated as follows:
a. Mutual Consent. County and Contractor, by mutual written agreement, may terminate this Contract at any t me.
b. Party's Convenience. County or Contractor may terminate this Contract for any reason upon 30 calendar days
written notice to the other party.
c. For Cause. County may also terminate this Contract effective upon delivery of written notice to the Contractor, or
at such later date as may be established by the County, under any of the following conditions:
1) If funding from state or other sources is not obtained and continued at levels sufficient to allow for the
purchase of the indicated quantity of services as required in this Contract.
2) This Contract may be modified to accommodate the change in available funds.
3) If state laws, regulations or guidelines are modified, changed or interpreted in such a way that the services are
no longer allowable or appropriate for purchase under this Contract or are no longer eligible for the funding
proposed for payments authorized by this Contract.
4) In the event sufficient funds shall not be appropriated for the payment of consideration required to be paid
under this Contract, and if County has no funds legally available for consideration from other sources.
5) If any license or certificate required by law or regulation to be held by the Contractor to provide the services
required by this Contract is for any reason denied, revoked, suspended, not renewed or changed it such a
way that the Contractor no longer meets requirements for such license or certificate.
d. Contractor Default or Breach. The County, by written notice to the Contractor, may immediately terminate the
whole or any part of this Contract under any of the following conditions:
1) If the Contractor fails to provide services called for by this Contract within the time specified or any e: <tension
thereof.
2) If the Contractor fails to perform any of the other requirements of this Contract or so fails to pursue the work
so as to endanger performance of this Contract in accordance with its terms, and after receipt of written notice
from the County specifying such failure, the Contractor fails to correct such failure within 10 calendar days or
such other period as the County may authorize.
3) Contractor institutes or has instituted against it insolvency, receivership or bankruptcy proceedings, makes an
assignment for the benefit of creditors, or ceases doing business on a regular basis.
e. County Default or Breach.
1) Contractor may terminate this Contract in the event of a breach of this Contract by the County. Prior to such
termination, the Contractor shall give to the County written notice of the breach and intent to terminate.
2) If the County has not entirely cured the breach within 10 calendar days of the date of the notice, hen the
Contractor may terminate this Contract at any time thereafter by giving notice of termination.
Page 3 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
7. Payment on Early Termination. Upon termination pursuant to paragraph 6, payment shall be made as follow:
a. If terminated under subparagraphs 6 a. through c. of this Contract, the County shall pay Contractor 'For work
performed prior to the termination date if such work was performed in accordance with the Contract. Provided
however, County shall not pay Contractor for any obligations or liabilities incurred by Contractor after Cc ntractor
receives written notice of termination.
b. If this Contract is terminated under subparagraph 6 d. of this Contract, County obligations shall be limited to
payment for services provided in accordance with this Contract prior to the date of termination, less any damages
suffered by the County.
c. If terminated under subparagraph 6 e of this Contract by the Contractor due to a breach by the County, 'hen the
County shall pay the Contractor for work performed prior to the termination date if such work was performed in
accordance with the Contract:
1) with respect to services compensable on an hourly basis, for unpaid invoices, hours worked within a )y limits
set forth in this Contract but not yet billed, authorized expenses incurred if payable according to this Dontract
and interest within the limits set forth under ORS 293.462, and
2) with respect to deliverable -based Work, the sum designated for completing the deliverable multiplied by the
percentage of Work completed and accepted by County, less previous amounts paid and any claini(s) that
County has against Contractor.
3) Subject to the limitations under paragraph 8 of this Contract.
8. Remedies. In the event of breach of this Contract the parties shall have the following remedies:
a. Termination under subparagraphs 6 a. through c. of this Contract shall be without prejudice to any oblige: tions or
liabilities of either party already reasonably incurred prior to such termination.
1) Contractor may not incur obligations or liabilities after Contractor receives written notice of termination.
2) Additionally, neither party shall be liable for any indirect, incidental, consequential or special damages under
this Contract or for any damages of any sort arising solely from the termination of this Contract in accordance
with its terms.
b. If terminated under subparagraph 6 d. of this Contract by the County due to a breach by the Contractor County
may pursue any remedies available at law or in equity.
1) Such remedies may include, but are not limited to, termination of this contract, return of all or a portion of this
Contract amount, payment of interest earned on this Contract amount, and declaration of ineligibility for the
receipt of future contract awards.
2) Additionally, County may complete the work either by itself, by agreement with another Contractor, or by a
combination thereof. If the cost of completing the work exceeds the remaining unpaid balance of The total
compensation provided under this Contract, then the Contractor shall be liable to the County for the amount of
the reasonable excess.
c. If amounts previously paid to Contractor exceed the amount due to Contractor under this Contract, Contractor
shall repay any excess to County upon demand.
d. Neither County nor Contractor shall be held responsible for delay or default caused by fire, civil unrest, labor
unrest, riot, acts of God, or war where such cause was beyond reasonable control of County or Contractor,
respectively; however, Contractor shall make all reasonable efforts to remove or eliminate such a cause of delay
or default and shall, upon the cessation of the cause, diligently pursue performance of its obligations under this
Contract. For any delay in performance as a result of the events described in this subparagraph, Contractor shall
be entitled to additional reasonable time for performance that shall be set forth in an amendment to this Cc ntract.
e. The passage of this Contract expiration date shall not extinguish or prejudice the County's or Contractor':, right to
enforce this Contract with respect to any default or defect in performance that has not been cured.
f. County's remedies are cumulative to the extent the remedies are not inconsistent, and County may pursue any
remedy or remedies singly, collectively, successively or in any order whatsoever.
g. Differences between a Contractor and County, or between contractors, will be resolved when possible at appropriate
management levels, followed by consultation between boards, if necessary. County's Director will have ultimate
responsibility for resolution of disagreements among subcontract agencies.
9. Contractor's Tender upon Termination. Upon receiving a notice of termination of this Contract, Contrac:or shall
immediately cease all activities under this Contract unless County expressly directs otherwise in such r otice of
termination.
a. Upon termination of this Contract, Contractor shall deliver to County all documents, information, works -in- )rogress
and other property that are or would be deliverables had this Contract been completed.
b. Upon County's request, Contractor shall surrender to anyone County designates, all documents, research objects
or other tangible things needed to complete the work.
Page 4 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
10. Work Standard.
a. Contractor shall be solely responsible for and shall have control over the means, methods, techniques, secuences
and procedures of performing the work, subject to the plans and specifications under this Contract and shall be
solely responsible for the errors and omissions of its employees, subcontractors and agents.
b. For goods and services to be provided under this contract, Contractor agrees to:
1) perform the work in a good, workmanlike, and timely manner using the schedule, materials, plans and
specifications approved by County;
2) comply with all applicable legal requirements;
3) comply with all programs, directives, and instructions of County relating to safety, storage of equipment or
materials;
4) take all precautions necessary to protect the safety of all persons at or near County or Contractor's facilities,
including employees of Contractor, County and any other contractors or subcontractors and to protect the
work and all other property against damage.
11. Drugs and Alcohol. Contractor shall adhere to and enforce a zero tolerance policy for the use of alcohol and the
unlawful selling, possession or use of controlled substances while performing work under this Contract.
12. Insurance. Contractor shall provide insurance in accordance with Exhibit 2 attached hereto and incorporated by
reference herein.
a. Prior to executing this Contract, the Contractor shall provide County the Certificates of Insurance, or cc pies of
Insurance policies and declarations, issued by an insurance company licensed to do business in the State of Dregon
as evidence of meeting insurance required under this paragraph.
b. Contractor shall immediately notify County if any insurance coverage required by this Contract will be canceed, not
renewed, restricted or modified in any way. Contractor shall immediately notify County orally of the cancellation or
restriction and shall confirm the oral notification in writing within three days of notification by the insurance company of
Contractor.
c. Thirty-day cancellation notice endorsement is required on all policies.
d. County reserves the right to require complete, certified copies of all required insurance policies at any time.
e. The insurance coverages provided for herein must be endorsed as primary and non - contributory to any insurance of
Owner, its officers, employees or agents.
13. Expense Reimbursement. If the consideration under this Contract provides for the reimbursement of Contractor for
expenses, in addition to Exhibit 5, Exhibit 1 shall state that Contractor is or is not entitled to reimbursement for such
expenses.
a. County shall only reimburse Contractor for expenses reasonably and necessarily incurred in the performance of
this Contract.
b. Expenses reimbursed shall be at the actual cost incurred; including any taxes paid, and shall not include any
mark -up unless the mark -up on expenses is specifically agreed to in this Contract.
c. The cost of any subcontracted work approved in this Contract shall not be marked up.
d. Contractor shall not bill County for any time expended to complete the documents necessary for reimbursement of
expenses or for payment under this Contract.
e. The limitations applicable to reimbursable expenses are set forth in Exhibit "5," attached hereto and by ret rence
incorporated herein.
14. Criminal Background Investigations. Contractor understands that Contractor and Contractor's employees and
agents are subject to periodic criminal background investigations by County and, if such investigations d sclose
criminal activity not disclosed by Contractor, such non - disclosure shall constitute a material breach of this Contract and
County may terminate this Contract effective upon delivery of written notice to the Contractor, or at such later date as
may be established by the County.
15. Confidentiality. Contractor shall maintain confidentiality of information obtained pursuant to this Contract as foll )ws:
a. Contractor shall not use, release or disclose any information concerning any employee, client, applicant or Jerson
doing business with the County for any purpose not directly connected with the administration of County's or the
Contractor's responsibilities under this Contract except upon written consent of the County, and if applicat le, the
employee, client, applicant or person.
b. The Contractor shall ensure that its agents, employees, officers and subcontractors with access to Cour ty and
Contractor records understand and comply with this confidentiality provision.
Page 5 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
c. Contractor shall treat all information as to personal facts and circumstances obtained on Medicaid eligible
individuals as privileged communication, shall hold such information confidential, and shall not disclo,;e such
information without the written consent of the individual, his or her attorney, the responsible parent of a miner child,
or the child's guardian, except as required by other terms of this Contract.
d. Nothing prohibits the disclosure of information in summaries, statistical information, or other form that coes not
identify particular individuals.
e. Personally identifiable health information about applicants and Medicaid recipients will be subject to the
transaction, security and privacy provisions of the Health Insurance Portability and Accountability Act ( "HIPAA ").
f. Contractor shall cooperate with County in the adoption of policies and procedures for maintaining the privacy and
security of records and for conducting transactions pursuant to HIPAA requirements.
g. This Contract may be amended in writing in the future to incorporate additional requirements related to coripliance
with H I PAA.
h. If Contractor receives or transmits protected health information, Contractor shall enter into a Business A ;sociate
Agreement with County, which, if attached hereto, shall become a part of this Contract.
16. Reports. Contractor shall provide County with periodic reports at the frequency and with the information presc-ibed by
County. Further, at any time, County has the right to demand adequate assurances that the services pro), ided by
Contractor shall be in accordance with the Contract. Such assurances provided by Contractor shall be supp )rted by
documentation in Contractor's possession from third parties.
a. Contractor agrees to prepare and furnish such reports and data as may be required by County and the Dep artment,
including but not limited, to financial reports documenting all expenditures of funds under this Agreement in
accordance with generally accepted accounting procedures, client records which contain client identification, problem
assessment, treatment (including any training and /or care plan), appropriate medical information, and progre: s notes,
including a service termination summary and current assessment or evaluation instrument as designate) in the
administrative rules. It is understood that due to the limited nature of Contractor's services under this Contra(: t, not all
of these documents will have been prepared by Contractor and therefore need not be furnished. Department Client
Process Monitoring System (CPMS) data, Community Mental Health Provider Report, and Termination Service
Recording Form shall, if necessary, be completed in accordance with Department requirements and submitted to
Department through County. Contractor agrees to, and does hereby grant County and the Department th€ right to
reproduce, use and disclose for County or Department purposes, all or any part of the reports, data, and technical
information furnished to County under this Contract. Contractor shall make available to County, Department and any
client of Contractor as defined in Exhibit "A" of the contract referenced in Exhibit 1, paragraph 1 A., of this Contract,
any and all written materials in alternate formats in compliance with Department's policies or administrative rules. For
purposes of the foregoing, "written materials" includes, without limitation, all work product and contracts related to this
Contract.
b. Contractor shall prepare and furnish the following information to Department when a Service is delivered:
1) Client, Service and financial information as specified in the Service Description.
2) All additional information and reports that Department or County reasonably requests.
17. Access to Records. Contractor shall maintain fiscal records and all other records pertinent to this Contract.
a. All fiscal records shall be maintained pursuant to generally accepted accounting standards, and other reco -ds shall
be maintained to the extent necessary to clearly reflect actions taken.
1) All records shall be retained and kept accessible for at least three years following the final payme it made
under this Contract or all pending matters are closed, whichever is later.
2) If an audit, litigation or other action involving this Contract is started before the end of the three yea • period,
the records shall be retained until all issues arising out of the action are resolved or until the end of tie three
year period, whichever is later.
b. County and its authorized representatives shall have the right to direct access to all of Contractor's books,
documents, papers and records related to this Contract for the purpose of conducting audits and examinations
and making copies, excerpts and transcripts.
1) These records also include licensed software and any records in electronic form, including but not l—nited to
computer hard drives, tape backups and other such storage devices. County shall reimburse Contractor for
Contractor's cost of preparing copies.
2) At Contractor's expense, the County, the Secretary of State's Office of the State of Oregon, the Federal
Government, and their duly authorized representatives, shall have license to enter upon Contractor's F remises
to access and inspect the books, documents, papers, computer software, electronic files and a y other
records of the Contractor which are directly pertinent to this Contract.
Page 6 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
3) If Contractor's dwelling is Contractor's place of business, Contractor may, at Contractor's expense, make the
above records available at a location acceptable to the County.
18. Ownership of Work. All work of Contractor that results from this Contract (the "Work Product ") is the a <clusive
property of County.
a. County and Contractor intend that such Work Product be deemed "work made for hire" of which County shall be
deemed author.
b. If, for any reason, the Work Product is not deemed "work made for hire," Contractor hereby irrevocably assigns to
County all of its right, title, and interest in and to any and all of the Work Product, whether arising from copyright,
patent, trademark, trade secret, or any other state or federal intellectual property law or doctrine.
c. Contractor shall execute such further documents and instruments as County may reasonably request in order to
fully vest such rights in County.
d. Contractor forever waives any and all rights relating to Work Product, including without limitation, any and ;1II rights
arising under 17 USC § 106A or any other rights of identification of authorship or rights of approval, rest ction or
limitation on use or subsequent modifications.
e. County shall have no rights in any pre- existing work product of Contractor provided to County by Contract )r in the
performance of this Contract except an irrevocable, non - exclusive, perpetual, royalty -free license to copy, ase and
re -use any such work product for County use only.
f. If this Contract is terminated prior to completion, and County is not in default, County, in addition to any oth rights
provided by this Contract, may require Contractor to transfer and deliver all partially completed work p.oducts,
reports or documentation that Contractor has specifically developed or specifically acquired for the performance of
this Contract.
g. In the event that Work Product is deemed Contractor's Intellectual Property and not "work made for hire," Contractor
hereby grants to County an irrevocable, non - exclusive, perpetual, royalty-free license to use, reproduce, prepare
derivative works based upon, distribute copies of, perform and display the Contractor Intellectual Property, and to
authorize others to do the same on County's behalf.
h. In the event that Work Product is Third Party Intellectual Property, Contractor shall secure on the County's behalf and
in the name of the County, an irrevocable, non - exclusive, perpetual, royalty-free license to use, reproduce, prepare
derivative works based upon, distribute copies of, perform and display the Third Party Intellectual Property, and to
authorize others to do the same on County's behalf.
19. County Code Provisions. Except as otherwise specifically provided, the provisions of Deschutes County Code,
Section 2.37.150 are incorporated herein by reference. Such code section may be found at the following URL
address: http: / /www.co. deschutes. or. us / dccode /Title2 /html /Chapter2.37.htm.
20. Partnership. County is not, by virtue of this Contract, a partner or joint venturer with Contractor in connection with
activities carried out under this Contract, and shall have no obligation with respect to Contractor's debt3 or any
other liabilities of each and every nature.
21. Indemnity and Hold Harmless.
a. To the fullest extent authorized by law Contractor shall defend, save, hold harmless and indemnify the Co mty and
its officers, employees and agents from and against all claims, suits, actions, losses, damages, liabilities costs and
expenses of any nature resulting from or arising out of, or relating to the activities of Contractor or its officers,
employees, contractors, or agents under this Contract, including without limitation any claims that the tiork, the
work product or any other tangible or intangible items delivered to County by Contractor that may be the s ibject of
protection under any state or federal intellectual property law or doctrine, or the County's use thereof, infrir ges any
patent, copyright, trade secret, trademark, trade dress, mask work utility design or other proprietary rigt t of any
third party.
b. Contractor shall have control of the defense and settlement of any claim that is subject to subparagraph a of this
paragraph; however neither contractor nor any attorney engaged by Contractor shall defend the claim in t'ie name
of Deschutes County or any department or agency thereof, nor purport to act as legal representative of th( County
or any of its departments or agencies without first receiving from the County's legal counsel, in a form and manner
determined appropriate by the County's legal counsel, authority to act as legal counsel for the County, for shall
Contractor settle any claim on behalf of the Count without the approval of the County's legal counsel.
c. To the extent permitted by Article XI, Section 10, of the Oregon Constitution and the Oregon Tort Claims / ct, ORS
30.260 through 30.300, County shall defend, save, hold harmless and indemnify Contractor and its officers,
employees and agents from and against all claims, suits, actions, losses, damages, liabilities costs and e <penses
Page 7 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
of any nature resulting from or arising out of, or relating to the activities of County or its officers, emi. loyees,
contractors, or agents under this Contract.
22. Compliance with provisions, requirements of funding source and Federal and State laws, statutes. rules,
regulations, executive orders and policies. Debt Limitation. This Contract is expressly subject to the debt
limitation of Oregon counties set forth in Article XI, Section 10, of the Oregon Constitution, and is contingent upon
funds being appropriated therefore.
a. Any provisions herein, which would conflict with law, are deemed inoperative to that extent.
b. Contractor shall comply with all federal, state and local laws, regulations, executive orders and ordinances
applicable to the Contract.
c. Without limiting the generality of the foregoing, Contractor expressly agrees to comply with the following laws,
regulations and executive orders to the extent they are applicable to the Contract:
1) Titles VI and VII of the Civil Rights Act of 1964, as amended;
2) Sections 503 and 504 of the Rehabilitation Act of 1973, as amended;
3) the Americans with Disabilities Act of 1990, as amended and ORS 659A.112 through 659A.139;
4) Executive Order 11246, as amended;
5) the Health Insurance Portability and Accountability Act of 1996;
6) the Age Discrimination in Employment Act of 1967, as amended, and the Age Discrimination Act of 1'175, as
amended;
7) the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended;
8) ORS Chapter 659A, as amended;
9) all regulations and administrative rules established pursuant to the foregoing laws; and
10) all other applicable requirements of federal and state civil rights and rehabilitation statutes, rules and
regulations.
d. The above listed laws, regulations and executive orders and all regulations and administrative rules established
pursuant to those laws are incorporated by reference herein to the extent that they are applicable to the Contract
and required by law to be so incorporated.
e. Contractor shall comply with all mandatory standards and policies that relate to resource conservation and recovery
pursuant to the Resource Conservation and Recovery Act (codified at 42 USC 6901 et. seq.). Section 6002 of that
Act (codified at 42 USC 6962) requires that preference be given in procurement programs to the purchase of Specific
products containing recycled materials identified in guidelines developed by the Environmental Protection Agency.
Current guidelines are set forth in 40 CFR Parts 247 -253.
f. Contractor shall comply with federal rules and statutes pertaining to the Substance Abuse, Prevention, and Treatment
Block Grant, including the reporting provisions of the Public Health Services Act (42 USC 300x through 30Dx -64).
Without limiting the generality of the preceding sentence, Contractor shall comply with the requirements set forth
below:
1) Women's Services. All Providers of A &D 61 and A &D 62 services (including Counties that provide
such services directly), must:
a) Treat the family as a unit and admit both women and their children if appropriate.
b) Provide or arrange for the following services to pregnant women and women with dependent
children:
1. Primary medical care, including referral for prenatal care;
2. Pediatric care, including immunizations, for their children;
3. Gender - specific treatment and other therapeutic interventions, e.g. sexual and piysical
abuse counseling, parenting training, and child care;
4. Therapeutic interventions for children in custody of women in treatment, which address,
but are not limited to, the children's developmental needs and issues of abw,e and
neglect; and
5. Appropriate case management services and transportation to ensure that women and
their children have access to the services in (1) through (2) above.
2) Pregnant Women. All Providers of A &D services other than A &D 70 services (including Counties that
provide such services directly) must:
a) Within the priority categories, if any, set forth in a particular Service Descriptior , give
preference in admission to pregnant women in need of treatment who seek, or are n ferred
for, and would benefit from, such services;
b) Perform outreach to inform pregnant women of the availability of treatment services tE rgeted
to them and the fact the at pregnant women receive preference in admission to these
programs;
Page 8 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
c) If the Provider has insufficient capacity to provide treatment services to a pregnant 'woman,
refer the woman to another Provider with capacity or if no available treatment capacity can be
located, refer the women to the Department's Office of Alcohol and Drug Abuse programs for
referral to another provider in the state.
3) Intravenous Drug Abusers. All Providers of A &D services other than A &D 70 services (including
Counties that provide such services directly) must:
a) Within the priority categories, if any, set forth in a particular Service Description and subject to
the preference for pregnant women described above, give preference in admission to
intravenous drug abusers;
b) If the Provider reaches 90 percent of its capacity to admit intravenous drug abusers, the
Provider must attempt to refer an intravenous drug abuser seeking admission, to another
Provider and provide notice of such referral or attempted referral to the Department's Office of
Alcohol and Drug Abuse Programs;
c) If the Provider receives a request for admission to treatment from an intravenous drug abuser,
the Provider must, unless the Provider succeeds in referring the individual to another Provider
with treatment capacity under the circumstances described in (2) above, admit the individual
to treatment not later than:
1) 14 days after the request for admission to Provider's services is made; or
2) 120 days after the date of such request if no provider has the capacity to ad nit the
individual on the date of such request and, if interim services are made available rot less
than 48 hours after such request.
d) For purposes of (3) above, "Interim Services" means:
1) Services for reducing the adverse health effects of such abuse, for promoting the health
of the individual, and for reducing the risk of transmission of disease, including counseling
and education about HIV and tuberculosis, the risks of needle sharing, the asks of
transmission of disease to sexual partners and infants, and steps that can be taken to
ensure that HIV and tuberculosis transmission does not occur;
2) Referral for HIV to TB treatment services, where necessary; and
3) Referral for prenatal care if appropriate, until the individual is admitted to a Prcvider's
services.
4) Providers who treat recent intravenous drug users (those who have injected drugE, within
the past year) in more than one -third of their capacity, shall carry out outreach actin ities to
encourage individual intravenous drug abusers in need of such treatment to undergo
treatment, and shall document such activities.
4) Infectious Diseases. All Providers of A &D services other than A &D 70 services (including Counties
that provide such services directly) must:
a) Complete a risk assessment for infectious disease including Human Immunodeficiencj Virus
(HIV) and tuberculosis, as well as sexually transmitted diseases, based on protocols
established by the Department, for every individual seeking services from the Provider; and
b) Routinely make tuberculosis services available to each individual receiving services for
alcohol/drug abuse either directly or through other arrangements with public or non- profit
entities and, if the Provider denies an individual admission on the basis of lack of capacity,
refer the individual to another provider of tuberculosis services.
c) For purposes of (2) above, "tuberculosis services" means:
1) Counseling the individual with respect to tuberculosis;
2) Testing to determine whether the individual has contracted such disease and te. ting to
determine the form of treatment for the disease that is appropriate for the individual and
3) Appropriate treatment services.
5) Infectious Diseases. Neither County nor any Provider of A &D services shall knowingly and willfully
make or cause to be made any false statement or representation of a material fact in connection with
the furnishing of items or services for which payments may be made by the Department.
6) Oregon Residency. A &D services funded through this Agreement may only be provided to re idents
of Oregon. Residents of Oregon are individuals who live in Oregon. There is no minimum am )unt of
time an individual must live in Oregon to qualify as a resident so long as the individual intE nds to
remain in Oregon. A child's residence is not dependent on the residence of his or her parents. \ child
living in Oregon may meet the residency requirement if the caretaker relative with whom the :hild is
living is an Oregon resident.
7) Tobacco Use. All Providers of A &D services (including Counties that provide such services c rectly)
that have designated treatment capacity for children, adolescents, pregnant women, and worm ,n with
Page 9 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
g.
dependent children must implement a policy to eliminate smoking and other use of tobacc( at the
facilities where the services are delivered to on the grounds of such facilities.
8) Department of Human Services Referrals. All providers of A &D Services other than A &D 70 services
must, within the priority categories, if any, set forth in a particular Service Description and su eject to
the preference for pregnant women and intravenous drug users described above, give preference in
service delivery to persons referred by the Department.
9) Barriers to Treatment. Where there is a barrier to delivery of an A &D Service due to culture, gender,
language, illiteracy, or disability, Contractor shall develop support services available to address or
overcome the barrier, including:
a) Providing, if needed, hearing impaired or foreign language interpreters.
b) Providing translation of written materials to appropriate language or method of communic.3tion.
c) Providing devices that assist in minimizing the impact of the barrier.
d) Not charging clients for the costs of measures, such as interpreters, that are required to provide
nondiscriminatory treatment.
10) Contractor shall not knowingly and willfully make or cause to be made any false statement or
representation of a material fact in connection with the furnishing of items or Services for which
payments may be make by Department.
To the extent Contractor provides any service whose costs are paid in whole or in part by Medicaid, Contractor shall
comply with the federal and state Medicaid statutes and regulations applicable to the service, including but not limited
to:
1) Keep such records as may be necessary to disclose the extent of services furnished to clients and, upon
request, furnish such records or other information to the Department, the Medicaid fraud section of the
Oregon Department of Justice and the Secretary of Health and Human Services;
2) Comply with all applicable disclosure requirements set forth in 42 CFR Part 455, Subpart B;
3) Comply with any applicable advance directive requirements specified in 42 CFR Section 431.107(b)(4);
and
4) Comply with the certification requirements of 42 CFR Sections 455.18 and 455.19.
h. Contractor shall comply with the Pro - Children Act of 1995 (codified at 20 USC Section 6081 et. seq.).
23. Waiver.
a. County's delay in exercising, or failure to exercise any right, power, or privilege under this Contract sl all not
operate as a waiver thereof, nor shall any single or partial exercise or any right, power, or privilege unc: er this
Contract preclude any other or further exercise thereof or the exercise of any other such right, power, or privilege.
b. The remedies provided herein are cumulative and not exclusive of any remedies provided by law.
24. Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Oregon
without regard to principles of conflicts of law.
a. Any claim, action, suit or proceeding (collectively, "Claim ") between County and Contractor that arises f-om or
relates to this Contract shall be brought and conducted solely and exclusively within the Circuit Court of Deschutes
County for the State of Oregon; provided, however, if a Claim shall be brought in federal forum, then it shall be
brought and conducted solely and exclusively within the United States District Court for the District of Oregoai.
b. CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY CONSENTS TO THE IN PERSONAM
JURISDICTION OF SAID COURTS. The parties agree that the UN Convention on International Sales of Goods
shall not apply.
25. Severability. If any term or provision of this Contract is declared by a court of competent jurisdiction to be illegal or in
conflict with any law, the validity of the remaining terms and provisions shall not be affected, and the rigl is and
obligations of the parties shall be construed and enforced as if this Contract did not contain the particular term or
provision held invalid.
26. Counterparts. This Contract may be executed in several counterparts, all of which when taken togethe shall
constitute one agreement binding on all parties, notwithstanding that all parties are not signatories to the same
counterpart. Each copy of this Contract so executed shall constitute on original.
27. Notice. Except as otherwise expressly provided in this Contract, any communications between the parties he 'eto or
notices to be given hereunder shall be given in writing, to Contractor or County at the address or number sE t forth
below or to such other addresses or numbers as either party may hereafter indicate in writing. Delivery may be by
personal delivery, facsimile, or mailing the same, postage prepaid.
Page 10 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
a. Any communication or notice by personal delivery shall be deemed delivered when actually given to the
designated person or representative.
b. Any communication or notice sent by facsimile shall be deemed delivered when the transmitting machine
generates receipt of the transmission. To be effective against County, such facsimile transmission shall be
confirmed by telephone notice to the County Administrator.
c. Any communication or notice mailed shall be deemed delivered five (5) days after mailing. Any notice under this
Contract shall be mailed by first class postage or delivered as follows:
To Contractor: To County:
Glenn Van Cise
Central Oregon Resources for Independent Living
PO Box 9425
Bend, OR 97708
Phone No. 541 - 388 -8103
Scott Johnson
Deschutes County Health Services
2577 NE Courtney Dr.
Bend, Oregon 97701
Phone No. 541 - 322 -7500
28. Merger Clause. This Contract and the attached exhibits constitute the entire agreement between the parties.
a. All understandings and agreements between the parties and representations by either party concern ng this
Contract are contained in this Contract.
b. No waiver, consent, modification or change in the terms of this Contract shall bind either party unless it writing
signed by both parties.
c. Any written waiver, consent, modification or change shall be effective only in the specific instance and for the
specific purpose given.
29. Identity Theft Protection. Contractor and subcontractors shall comply with the Oregon Consumer Identity Theft
Protection Act (ORS 646A.600 et seq.).
30. Survival. All rights and obligations shall cease upon termination or expiration of this Contract, except for the rights and
obligations set forth in Sections 4, 5, 8, 9, 15, 17, 18, 20 -28, 29 and 31.
31. Representations and Warranties.
a. Contractor's Representations and Warranties. Contractor represents and warrants to County that:
1) Contractor has the power and authority to enter into and perform this Contract;
2) this Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in
accordance with its terms;
3) Contractor has the skill and knowledge possessed by well- informed members of its industry, trade or
profession and Contractor will apply that skill and knowledge with care and diligence to perform the Work in a
professional manner and in accordance with standards prevalent in Contractor's industry, trade or profession;
4) Contractor shall, at all times during the term of this Contract, be qualified, professionally competent, :Ind duly
licensed to perform the Work;
5) Contractor prepared its proposal related to this Contract, if any, independently from all other propos ors, and
without collusion, fraud, or other dishonesty; and
6) Contractor's making and performance of this Contract do not and will not violate any provision of any applicable
law, rule or regulation or order of any court, regulatory commission, board or other administrative agency.
b. Warranties Cumulative. The warranties set forth in this paragraph are in addition to, and not in lieu of, any other
warranties provided
Page 11 of 11— Behavioral Health- Personal Services Contract No. 2009 -552
EXHIBIT 1
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
STATEMENT OF WORK, COMPENSATION
PAYMENT TERMS and SCHEDULE
1. Contractor shall perform the following work:
Contractor shall perform the services described Supported Living, vocational services and vocational
transportation services (Described in Exhibit 1A, Service Element 51, 53 and 54), for eligible clients as
funded by and through County's contract with the State of Oregon Department of Human Services
(Department) Contractor shall maintain their Assisted Living Facility License, as a condition to recei� - -'ing
payment pursuant to this Contract.
A. REGULATIONS & DUTIES
Contactor shall comply with all applicable provisions of that certain 2009 -2011 County Financial Assistance
Contract, as amended, including applicable Service Descriptions attached thereto, effective July 1, 2009,
Contract #127295 between the State of Oregon acting by and through its Department of Human Services and
Deschutes County. Contractor agrees to comply with the rules and regulations of County, applicable provisi Dns
in the Contract between County and the Department, incorporated herein by reference, as of the effective sate
of the Contract, applicable provisions of the Administrative Rules and Procedures of the Department, applicHble
Federal regulations and all provisions of Federal and State statutes, rules and regulations relatinc to
Contractor's performance of services under this Contract. Any act or duty of County, imposed upon Count by
Department, which, by the nature of this Contract County determines to be within the scope of this Contract and
is to be performed by Contractor, Contractor shall perform on behalf of County. No federal funds may be a ed
to provide services in violation of 42 USC 14402.
B. Definitions:
a. Supported Living Services:
For the purposes of this Contract, Supported Living Services are individualized suppc rts,
delivered in a personalized manner, to people with developmental disabilities. Servi :es
include care, training and support that promote opportunities for individuals to live in heir
own homes, apartments, or in their family homes, and to be a part of and participate in the
communities in which they live.
b. Transportation Services:
For the purposes of this Contract, Transportation Services are public or private
transportation provided to individuals with developmental disabilities when: (a) unsubsidized
public or private transportation is not available and (b) transportation is required for effective
participation in employment or other services needed by an individual (such as community
access).
c. Employment & Community Inclusion Services:
For the purposes of this Contract, Employment Services & Community Inclusion Services
are out -of -home employment or community training services and related supports, delivered
to individuals aged 18 or older with developmental disabilities, to improve the individuals'
productivity, independence and integration in the community.
C. Reporting
Contractor agrees to prepare and furnish such reports and data as may be required by County and the
Department, including but not limited, to financial reports documenting all expenditures of funds un ier
this Agreement in accordance with generally accepted accounting procedures, client records wF ich
contain client identification, problem assessment, treatment (including any training and /or care ply n),
appropriate medical information, and progress notes, including a service termination summary ; nd
current assessment or evaluation instrument as designated in the administrative rules. Departrr ant
Client Process Monitoring System (CPMS) data, Community Mental Health Provider Report, ind
Termination Service Recording Form shall be completed in accordance with Department requiremE nts
and submitted to Department through County. Contractor agrees to, and does hereby grant County end
Page 1 of 2 - Exhibit 1 — Personal Service Contract No.2009 -552
the Department the right to reproduce, use and disclose for County or Department purposes, all or any
part of the reports, data, and technical information furnished to County under this Contract. Contractor
shall make available to County Department and Client of Contractor any and all written material; in
alternate formats in compliance with Department's policies or administrative rules. For purposes of the
foregoing, "written materials" includes, without limitation, all work product and contracts related to this
Contract.
2. County Services. County shall provide Contractor, at county's expense, with material and services
described as follows:
A. Services will be paid for as outlined under Paragraph 3 and Paragraph 4.
3. Consideration. Subject to availability of funds, County shall approve monthly payments to Contractor u -Jon
receipt of billing notice through the EXPRS system from the Department, for rendering the services listed in
this Contract. Contractor shall not approve funds on the delivery of a service in excess of the amc: unt
reasonable and necessary to provide quality service. Funds may only be used for the delivery of the service
or services set out in this paragraph unless written permission is granted to use the funds for other sery yes
in accordance with this Contract.
a. Contractor shall submit monthly expenditure or reimbursement reports, if applicable, on fo ms
provided by County as soon as possible following the end of each calendar month but no later t Ian
30 days following the end of the calendar month. County may require quarterly cost reports, to
monitor the expenditure of Department monies so that Department monies are not reimbursed at
more than 100% of program costs.
b. Contractor shall submit the final monthly expenditure report under this Contract no later than August
1, 2010. Fiscal year shall be based on the period July 1, 2009 through June 30, 2010.
c. Contractor shall be entitled to reimbursement for expenses as set forth in Exhibit 5 ❑ YES ® NO
[Check one]
4. The maximum compensation and payment method.
The maximum compensation under this Contract, including allowable expenses is, $709,800, under Service
Element 51, 53, 54. When such funds are exhausted, County will notify Contractor and no further payrr ent
under this Contract will be made or required. The maximum total amount of funds to be paid to Contra:tor
for the period of this Contract under the specific Service Elements are as follows:
a. SERVICE ELEMENT MAXIMUM AMOUNT
51 $ 106,300 Supported Living Services
53 $ 62,400 Transportation Services
54 $ 541,100 Vocational Services
b. Contractor shall not submit invoices for, and County shall not pay for any amount in excess of the
maximum compensation amount set forth above.
1) If this maximum compensation amount is increased by amendment of this Contract, the amendment
shall be fully effective before Contractor performs work subject to the amendment.
2) Contractor shall notify County in writing of the impending expiration of this Contract thirty (30)
calendar days prior to the expiration date.
5. Schedule of Performance or Delivery.
a. County's obligation to pay depends upon Contractor's delivery or performance in accordance with the
schedule listed in Exhibit 1, Paragraph 1.
b. County will only pay for completed work performed under Service Element 51, 53 and 54, that confcvms
to the terms of this Contract.
6. Renewal. This Contract may be renewed, subject to the following conditions:
a. Renewal will be based on the County Annual Implementation Plan approved by the Department.
b. Renewal is subject to the availability of funding.
Page 2 of 2 - Exhibit 1 — Personal Service Contract No.2009 -552
EXHIBIT 1A
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
SERVICE ELEMENT 51, 53, 54
Service Name: SUPPORTED LIVING SERVICES
Service I.D. Code: DD 51
1. Service Description
Supported Living Services (DD 51) are individualized supports, delivered in a personalized
• manner, to people with developmental disabilities. DD 51 Services include care, training, and
support that promote opportunities for individuals to live in their own homes, apartments, or
in their family homes, and to be a part of and participate in the communities in which they
live.
For purposes of this Agreement, an individual shall be considered to have received DD 51
services only when one of the following conditions is met:
A. The Provider is actively involved in planning, assessment and support activities for the
individual, including the development and implementation of the individual's
"Individual Support Plan" ( "ISP ") as defined in OAR 309 - 041 -1300 through 309 -041 -
1370, as such rules maybe revised frotn time to time; or
B. The individual had been receiving DD 51 Services from Provider, as described in
Section I(A) above, immediately prior to the absence and the individual is absent from
Provider's DD 51 Services for not more than 5 consecutive days (excluding weekends
and holidays), unless an exception is granted by Department, as a result of incarceration,
or absence without leave, and it has not been determined that the individual will not be
returning to Provider's DD 51 Services; or
C. The individual had been receiving DD 51 Services from Provider, as described in
Section I(A) above, immediately prior to the absence and the individual is absent from
Provider's DD 51 Services for not more than 14 consecutive days, not to exceed 45 days
in any one-year period unless an exception is granted by the Department, as a result of
being on vacation or family visit, and it has not been determined that the individual will
not be returning to Provider's DD 51 Services; or
D. The individual had been receiving DD 51 Services from Provider, as described in
Section I(A) above, immediately prior to the absence and the individual is absent from
Provider's DD 51 Services for not more than 90 consecutive days as a result of being on
convalescent leave, or admittance to either a medical hospital, psychiatric hospital, or a
State - Operated Community Program, and it has not been determined that the individual
will not be returning to Provider's DD 51 Services.
Page 1 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
11. Performance Requirements
A. Providers of DD 51 Services funded through this Agreement must comply with OAR
309 - 041 -0551 through 309- 041 -0830, as such rules may be revised from time to time.
B. All individuals receiving DD 51 Services funded through this Agreement must be
eligible for developmental disability services, with eligibility determined in accordance
with OAR 411Division 320, as such rule maybe revised from time to time.
C. Vacancy Reserve Fund: The Board of Directors (or other governing authority as
applicable)'of each Provider of DD 51 Services funded through this Agreement must
define, establish, and maintain a "Vacancy Reserve" fund in an amount sufficient to
ensure that the Provider can continue to provide services that meet applicable statutory,
administrative rule, and contract requirements when payments are reduced due to
vacancies. If the reserve fund falls below the level established by the Board/governing
authority, the Board/governing authority must develop and implement a plan to replenish
the reserve fund in a timely manner. Each Provider subject to the vacancy reserve fund
requirement must include a line item on its routine financial statements that documents
the status of its vacancy reserve fund.
D. Providers of DD 51 Services funded through this Agreement must comply with Section
3 of Exhibit D entitled "Additional Requirements for Developmental Disability
Residential Services ".
TH. Special Reporting Requirements
A. For purposes of Medicaid compliance, Department must be notified when an eXPRS
Disbursement Claim is submitted, with respect to DD 51 Services described in section
I(B), (C) or (D) of this Service Description. Notification required under this section must
be provided to Department's Seniors and People with Disabilities Office of Federal
Resources and Eligibility Determination, using forms and procedures designated by
Department.
B. Vacancy Reserve Fund: Providers of DD 51 Services funded through this Agreement
must submit their vacancy reserve fiend plans, and/or the current status of these reserve
funds, to County or Department upon request.
C. Direct Service Staff Wages and Tiunover: Providers of DD 51 Services funded through
this Agreement must report to Department staff wages and turnover data using forms and
procedures designated by Department.
Page 2 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
IV. Financial Assistance Calculation and Disbursement Procedures
A. Calculation of Financial Assistance: Department will provide financial assistance for
DD 51 Services, from DD 51 funds included in the Service Element Prior
Authorization, in an amount equal to the monthly rate set forth in a CPA authorizing
the use of financial assistance for delivery of DD 51 services to an individual specified
in that CPA, multiplied by the number of months of DD 51 Services delivered (as
defined in section I (A) through (D) above) to that individual during the period
specified in the CPA, subject to the following:
1. Total Department financial assistance for delivery of DD 51 Services to an
individual specified in a CPA shall not exceed the amount of financial
assistance authorized in that CPA. If no CPAs are submitted for DD 51
Services, no financial assistance will be provided for DD 51 Services.
2. The financial assistance for a partial month of DD 51 Service will be
prorated.
3. Department will reduce the financial assistance for DD 51 Services
delivered to an individual during the period specified in the CPA by the
amount received, as payment of a portion of the cost of those Services, by
the Provider of the DD 51 Services from the individual receiving the
Services.
4. If during any month during the period specified in a particular line of the
Service Element Prior Authorization that awards funds for DD 51 Services
and that specifies one or more units in the Service Element Prior
Authorization Detail, fewer than 95% of the units of DD 51 Service so
specified are delivered under that line, Department may unilaterally reduce
the amount of financial assistance specified in that line of the Service
Element Prior Authorization, and the number of units of Service, to make it
consistent with the actual delivery of DD 51 Services under that line and
County shall accept an appropriate SEPA Adjustment to reflect that
reduction.
5. Department is not obligated to provide financial assistance for a unit of DD
51 Service, from funds awarded in the Service Element Prior Authorization,
if a Disbursement Claim for financial assistance for that unit of DD 51
Service is not received by Department by the date 60 days after the earlier
of termination of this Agreement, termination of Department's obligation to
provide financial assistance for DD 51 Services, or termination of County's
obligation to include the Program Area, in which DD 51 Services fall, in its
CMHP.
Page 3 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
B. Disbursement of Financial Assistance: Department will disburse to Provider the
financial assistance awarded for DD 51 Services under a particular line of the Service
Element Prior Authorization and as approved by County in a CPA authorizing use of
financial assistance for delivery of DD 51 services to an individual specified in the
CPA in response to and as soon as reasonably possible after submission. and
Department verification of a Disbursement Claim with respect to DD 51 Services.
C. Exceptions to Pay for Vacancies: In exceptional circumstances, the Department may
agree to provide financial assistance for delivery of DD 51 Service capacity that is not
utilized, as opposed to the normal DD 51 Services financial assistance calculation
methodology that provides financial assistance only for DD 51 Services actually
delivered. Exceptional circumstances include: (i) when Department agrees to provide
financial assistance for unutilized DD 51 Service capacity in order to ensure the
availability of DD 51 Services for a particular individual in the near future, or (ii) when
unexpected financial difficulties are encountered by a particular Provider as a result of an
unusually high rate of unutilized service capacity in that Provider's system, through no
fault of that Provider. Department will award, disburse and settle finds for unutilized DD
51 Service capacity in service element DD 57 (DD Special Projects, Start -Up).
Page 4 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
Service Name: TRANSPORTATION SERVICES
Service I.D. Code: DD 53
I. Service Description
Transportation Services (DD 53) are public or private transportation provided to individuals
with developmental disabilities when: (a) unsubsidized public or private transportation is not
available and (b) transportation is required for effective participation in employment or other
services needed by an individual (such as community access).
II. Performance Requirements
Unless otherwise authorized in writing by Department, all individuals receiving DD 53
Services funded through this Agreement must also be receiving, at the same time, either: (a)
one or more of the following services funded through this Agreement: Employment and
Community Inclusion Services (DD 54), Residential Facilities (DD 50) Services, Supported
Living Services (DD 51), Comprehensive In -Home Support Services For Adults (DD 49),
Host Homes (DD52), and/or DD Foster Homes (DD 58) Services.
III. Special Reporting Requirements
A. All individuals receiving DD 53 services must be enrolled in CPMS, and the
individual's CPMS record for DD 53 services must be maintained, as specified in
Department's CPMS manual for Developmental Disability Services, and, if applicable,
as further specified in this Service Description, special conditions, Special Terms and
Conditions of this Agreement, or as otherwise instructed by Department.
B. If requested by Department, County shall submit information on actual expenditures of
DD 53 funds under this Agreement. Information shall be provided using forms and
procedures designated by Department.
IV. Financial Assistance Calculation and Disbursement Procedures
A. Calculation of Financial Assistance: Department will provide financial assistance for
DD 53 Services identified in a particular line of the Financial Assistance Award in an
amount equal to the amount specified on that line, subject to the following:
1. If at the end of any month during the period specified on a particular line of the
Financial Assistance Award the cumulative-to--date monthly average number of
units of DD 53 Services delivered under that line of the Financial Assistance
Award is below 95% of the number of units specified in that line of the Financial
Assistance Award, Department may reduce the amount of financial assistance and
Page 5 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
the number of units specified in that line of the Financial Assistance Award
consistent with the under delivery and County shall execute and deliver to
Department an appropriate amendment to the Financial Assistance Award to
reflect that reduction. For purposes of the reduction in financial assistance under
this Section IV(A)(1), the amount of the reduction shall be consistent with the
under utilization of the rates for DD 53 Services set forth in the Developmental
Disability Rate Schedule, as reflected in CPMS data submitted to Department for
DD 53 Services.
2. The financial assistance provided under this Agreement for DD 53 Services may
only be used to deliver DD 53 Services at the rate or rates set forth on the
Developmental Disability Rate Schedule. The rate or rates specified in the
Developmental Disability Rate Schedule will be identified by Provider, may vary
from Provider to Provider and may be changed by amendment to the Financial
Assistance Award. The rate or rates specified in the Developmental Disability Rate
Schedule are not tied to any particular line in the Financial Assistance Award and
County is not required to contract for service delivery with any particular Provider
identified in the Developmental Disability Rate Schedule; provided, however, that,
in aggregate across all lines of the Financial Assistance Award that award funds for
DD 53 Services, Department will not provide fmancial assistance at any rate
specified in the Developmental Disability Rate Schedule for a particular month for
more than the number of units specified at that rate for that month; provided,
further, that, if County wishes to shift units among Providers listed in the
Developmental Disability Rate Schedule or shift units from a Provider listed in the
Developmental Disability Rate Schedule to a Provider not listed in the
Developmental Disability Rate Schedule, County must notify Department in
writing of the change and execute an amendment to the Agreement implementing
the change.
B. Disbursement of Financial Assistance: Unless a different disbursement method is
specified in that line of the Financial Assistance Award, Department will disburse the
financial assistance awarded for DD 53 Services in a particular line of the Financial
Assistance Award to County in substantially equal monthly allotments during the
period specified in that line of the Financial Assistance Award, subject to the
following:
1. Department may, after 30 days (unless parties agree otherwise) written notice to
County, reduce the monthly allotments based on under used allotments identified
through CPMS or through other reports required or permitted by this Service
Description or applicable Special Terms and Conditions.
2. Department may, upon written request of County, adjust monthly allotments.
Page 6 of 11- Exhibit 1A — Personal Service Contract No.2009 -552
3. Upon amendment to the Financial Assistance Award, Department shall adjust
monthly allotments as necessary, to reflect changes in the funds awarded for DD 53
Services on that line of the Financial Assistance Award.
C. Agreement Settlement: Agreement Settlement will reconcile any discrepancies that may
have occurred during the term of this Agreement between actual Department
disbursements of financial assistance awarded for DD 53 Services under a particular line
of the Financial Assistance Award and amounts due for such Services under the teams of
this Agreement.
Page 7 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
Service Name: EMPLOYMENT AND COMMUNITY INCLUSION SERVICES
Service I.D. Code: DD 54
I. Service Deserintion
Employment and Community Inclusion Services (DD 54) are out -of -home employment or
community training services and related supports, delivered to individuals aged 18 or older
with developmental disabilities, to improve the individuals' productivity, independence and
integration in the community.
For purposes of this Agreement, an individual shall be considered to have received DD 54
services only when one of the following conditions is met:
A. The Provider is actively involved in initial planning and assessment activities for the
individual, including development of the individual's "Individual Support Plan" ( "ISP ")
as defined in OAR 309 - 041 -1300 through 309 - 041 -1370, as such rules may be revised
from time to time, prior to implementation of the ISP. Such planning activity performed
on behalf of the individual shall be noted on the Attendance Records required in section
III (A) below. The individual may be considered to have received DD 54 Services under
this Section I(A) for a maximum of 15 consecutive days, beginning with the date the
individual is first enrolled in the Provider's services; or
B. In any given calendar month, the individual is at the Provider's site, or at the
individual's work site, for the days and hours specified in the individual's ISP. If
during that month the individual is at the Provider's site, or at the individual's work
site, for the days and hours specified in the individual's ISP, the individual will be
considered to have received DD 54 Services under this Section I(B) for the entire
month; or
C. The Provider is actively involved in job development activity for the individual while
that individual is temporarily unemployed, and that job development activity has been
reviewed and approved by the ISP Team, as defined in OAR 309 -041 -1300 through
309 - 041 -1370, as such rules may be revised from time to tune. Job development
performed on behalf of the individual shall be noted in the Attendance Records
required in section III (A) below. The individual may be considered to have received
DD 54 Services under this Section I(C) for a maximum of 90 consecutive days, unless
the ISP Team approves continued job development for up to an additional 45 day
period.
D. The individual had been receiving DD 54 Services from the Provider, as described in
Sections I(A) through (C), immediately prior to the absence and the individual is absent
from Provider's DD 54 Services, for not more than 5 consecutive days (excluding
weekends and holidays), unless an exception is granted by Department, as a result of
incarceration or absence without leave, and it has not been determined that the
individual will not be returning to Provider's DD 54 Services; or
Page 8 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
E. The individual had been receiving DD 54 Services from the Provider, as described in
Sections I(A) through (C), immediately prior to the absence and the individual is absent
from Provider's DD 54 Services for not more than 14 consecutive days, not to exceed
45 days in any one -year period unless an exception is granted by the Department, as a
result of being on vacation or family visit and it has not been determined that the
individual will not be returning to Provider's DD 54 Services; or
F. The individual had been receiving DD 54 Services from the Provider, as described in
Sections I(A) through (C), immediately prior to the absence and the individual is absent
from Provider's DD 54 Services for not more than 90 consecutive days as a result of
being on convalescent leave, on leave under the Family Medical Leave Act, or
admittance to either a medical hospital, psychiatric hospital, or a State - Operated
Community Program, and it has not been determined that the individual will not be
returning to Provider's DD 54 Services,
II. Performance Requirements
A. Providers of DD 54 Services funded through this Agreement must comply with OAR
Chapter 411, Division 345, as such rules may be revised from time to time.
B. All individuals receiving DD 54 Services funded through this Agreement must be
eligible for developmental disability services, with eligibility determined in accordance
with OAR Chapter 411, Division 320, as such rule may be revised from time to time.
C. Providers of DD 54 services funded through this Agreement may not expend any funds
received through this Agreement to cover any of the following costs arising from or
related to the work of individuals receiving DD 54 Services funded through this
Agreement or the goods or services produced thereby: (1) the wages of individuals
receiving DD 54 Services funded through this Agreement; (2) other indirect labor costs;
(3) supply, equipment or marketing costs; or (4) other production costs.
D. Unless otherwise authorized in writing by Department, all individuals receiving DD 54
Services funded through this Agreement must also be receiving, at the same tithe, one of
the following Services funded through this Agreement: Comprehensive In -Home
Supports for Adults (DD 49); Residential Facilities (DD 50) Services; Supported Living
Services (DD 51); or DD Foster Homes (DD 58) Services.
Ill. Special Reporting Requirements
A. Attendance Records: Providers of DD 54 Services funded through this Agreement shall
maintain daily attendance records, in a format and procedure approved by Department,
for all individuals to whom they deliver DD 54 Services funded through this Agreement
(as defined in section 1(A) through (F) above), and shall make such records available to
Department or County upon request.
Page 9 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
B. For purposes of Medicaid compliance, Department must be notified when an eXPRS
Disbursement Claim is submitted, with respect to DD 54 Services described in section
I(D), (E) or (F) of this Service Description. Notification required under this section must
be provided to Department's Seniors and People with Disabilities Office of Federal
Resources and Eligibility Determination, using forms and procedures designated by
Department.
C. Employment Outcomes Systems (EOS): Providers of DD 54 Services funded through
this Agreement shall submit reports, as part of the Department's Employment Outcomes
System (EOS) or a successor reporting system developed by the Department, that
include data that measure individual and program outcomes. Reports must be
completed semi - annually, following instructions provided by Department.
D. Direct Service Staff Wages and Turnover: Providers of DD 54 Services funded through
this Agreement must report to Department staff wages and turnover data using forms
and procedures designated by Department.
IV. Financial Assistance Calculation and Disbursement Procedures
A. Calculation of Financial Assistance: Department will provide financial assistance for
DD 54 Services, from DD 54 funds included in the Service Element Prior
Authorization, in an amount equal to the monthly rate set forth in a CPA authorizing the
use of financial assistance for delivery of DD 54 services to an individual specified in
that CPA, multiplied by the number of months of DD 54 Services delivered (as defined
in section I (A) through (F) above) to that individual during the period specified in the •
CPA, subject to the following:
1. Total Department financial assistance for delivery of DD 54 Services to an
individual specified in a CPA shall not exceed the amount of financial assistance
authorized in that CPA. If CPAs are submitted for DD 54 Services, no
financial assistance will be provided for DD 54 Services.
2. The financial assistance for a partial month of DD 54 Service will be prorated.
3. If during any month during the period specified in a particular line of the Service
Element Prior Authorization that awards fiords for DD 54 Services and that
specifies one or more units in the Service Element Prior Authorization Detail,
fewer than 95% of the units of DD 54 Service so specified are delivered under that
line, Department may reduce the amount of financial assistance specified in that
line of the Service Element Prior Authorization, and the number of units of
Service, to make it consistent with the actual delivery of DD 54 Services under
that line and County shall accept an appropriate SEPA Adjustment to reflect that
reduction.
Page 10 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
4. Department is not obligated to provide financial assistance for a unit of DD 54
Service, from funds awarded in the Service Element Prior Authorization, if a
Disbursement Claim for financial assistance for that unit of DD 54 Service is not
received by Department by the date 60 days after the earlier of termination of this
Agreement, termination of Department's obligation to provide financial assistance
for DD 54 Services, or termination of County's obligation to include the Program
Area, in which DD 54 Services fall, in its CMHP.
B. Disbursement of Financial Assistance: Department will disburse to Provider the
financial assistance awarded for DD 54 Services under a particular line of the Service
Element Prior Authorization and approved by County in a CPA authorizing use of
financial assistance for delivery of DD 54 services to an individual specified in that
CPA in response to and as soon as reasonably possible after submission and
Department verification of a Disbursement Claim with respect to DD 54 Services.
C. Exceptions to Pay for Vacancies: In exceptional circumstances, the Department may
agree to provide financial assistance for delivery of DD 54 Service capacity that is not
utilized, as opposed to .the normal DD 54 Services financial assistance calculation
methodology that provides financial assistance only for DD 54 Services actually
delivered. Exceptional circumstances include: (i) when Department agrees to provide
financial assistance for unutilized DD 54 Service capacity in order to ensure the
availability of DD 54 Services for a particular individual in the near future, or (ii) when
unexpected financial difficulties are encountered by a particular Provider as a result of an
unusually high rate of unutilized service capacity in that Provider's system, through no
fault of that Provider. Department will award, disburse and settle funds for unutilized
DD 54 Service capacity in service element DD 57 (DD Special Projects, Start -Up).
Page 11 of 11 - Exhibit 1A — Personal Service Contract No.2009 -552
EXHIBIT 2
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
INSURANCE REQUIREMENTS
Contractor shall at all times maintain in force at Contractor's expense, each insurance noted below.
Insurance coverage must apply on a primary or non - contributory basis. All insurance policies,
except Professional Liability, shall be written on an occurrence basis and be in effect for the term of
this contract. Policies written on a "claims made" basis must be approved and authorized by
Deschutes County.
Contractor Name: Central Oregon Resources for Independent Living
Workers Compensation insurance in compliance with ORS 656.017, requiring Contractor and all
subcontractors to provide workers' compensation coverage for all subject workers, or provide certification
of exempt status. Employer's Liability Insurance with coverage limits of not less than $500,000 must be
included.
Professional Liability insurance with an occurrence combined single limit of not Tess than:
Per Occurrence limit Annual Aggregate limit
❑ $500,000 ❑ $500,000
® $1,000,000 ❑ $1,000,000
❑ $2,000,000 ® $2,000,000
Professional Liability insurance covers damages caused by error, omission, or negligent acts related to
professional services provided under this Contract. The policy must provide extended reporting period
coverage, sometimes referred to as "tail coverage" for claims made within two years after this contract is
completed.
® Required by County ❑ Not required by County (one box must be checked)
Commercial General Liability insurance with a combined single limit of not less than:
Per Single Claimant and Incident All Claimants Arising from Single Incident
❑ Oregon Tort Claims Act limits ❑ Oregon Tort Claims Act limits
® $1,000,000 ❑ $2,000,000
❑ $2,000,000 ® $3,000,000
Commercial General Liability insurance includes coverage for personal injury, bodily injury, advertising
injury, property damage, premises, operations, products, completed operations and contractual damages
The Oregon Legislature has adopted legislation which establishes tort claims limits for actions against local
public bodies, including their officers, agents and employees. The tort claims act limits are automatically
adjusted on July 1 every year.
By separate endorsement, the policy shall name Deschutes County, its officers, agents, employees
and volunteers as an additional insured. The additional insured endorsement shall not include:
declarations that reduce any per occurrence or aggregate insurance limit. The contractor shall provide
additional coverage based on any outstanding claim(s) made against policy limits to ensure that minimum
insurance limits required by the County are maintained. Construction contracts may include aggregate
limits that apply on a "per location" or "per project" basis.
• Required by County ❑ Not required by County (One box must be checked)
Page 1 of 2 - Exhibit 2 - Personal Service Contract No. 2009 -487
Automobile Liability insurance with a combined single limit of not less than:
Per Occurrence
❑ $500,000
❑ $1,000,000
❑ $2,000,000
Automobile Liability insurance includes coverage for bodily injury and property damage resulting from
operation of a motor vehicle. Commercial Automobile Liability Insurance shall provide coverage for any
motor vehicle (symbol 1 on some insurance certificates) driven by or on behalf of Contractor during the
course of providing services under this contract. Commercial Automobile Liability is required for contractors
that own business vehicles registered to the business. Examples include: plumbers, electricians or
construction contractors. An Example of an acceptable personal automobile policy is a contractor who is a
sole proprietor that does not own vehicles registered to the business.
❑ Required by County ® Not required by County (one box must be checked)
Additional Requirements. Contractor shall pay all deductibles and self- insured retentions. A cross - liability cla.Jse
or separation of insured's condition must be included in all commercial general liability policies required by his
Contract. Contractor's coverage will be primary in the event of loss.
Certificate of Insurance Required. Contractor shall furnish a current Certificate of Insurance to the County witi
the signed Contract. The Certificate shall provide that there shall be no cancellation, termination, material change,
or reduction of limits of the insurance coverage without at least 30 days written notice from the Contractor's insu -er
to the County. The Certificate shall also state the deductible or, if applicable, the self- insured retention level. For
commercial general liability coverage, the Certificate shall also provide, by policy endorsement, that Deschutes
County, its agents, officers, employees and volunteers are additional insureds with respect to Contractor'E
services provided under this Contract. The endorsement must be in a format acceptable to Deschutes County. 1'
requested, complete copies of insurance policies shall be provided to the County.
Risk Management review Date
Page 2 of 2 - Exhibit 2 - Personal Services Contract No. 2009 -552
EXHIBIT 3
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
CERTIFICATION STATEMENT FOR CORPORATION
OR INDEPENDENT CONTRACTOR
NOTE: Contractor Shall Complete A or B in addition to C below:
A. CO TRACTOR IS A CORPORATION, LIMITED LIABILITY COMPANY OR A PARTNERSHIP.
y under penalty of perjury that Contractor is a [check one]:
Corporation ❑ Limited Liability Company ❑ Partnership authorized to do business in the State of Oreg m.
ce
Signature
Title Date
B. CONTRACTOR IS A SOLE PROPRIETOR WORKING AS AN INDEPENDENT CONTRACTOR.
Contractor certifies under penalty of perjury that the following statements are true:
1. If Contractor performed labor or services as an independent Contractor last year, Contractor filed federal I,,nd
state income tax returns last year in the name of the business (or filed a Schedule C in the name of :he
business as part of a personal income tax return), and
2. Contractor represents to the public that the labor or services Contractor provides are provided by an
independently established business registered with the State of Oregon, and
3. All of the statements checked below are true.
NOTE: Check all that apply. You shall check at least three (3) - to establish that you are an
Independent Contractor.
A. The labor or services I perform are primarily carried out at a location that is separate from my
residence or primarily carried out in a specific portion of my residence that is set aside as he
location of the business.
B. I bear the risk of loss related to the business or provision of services as shown by factors such
as: (a) fixed -price agreements; (b) correcting defective work; (c) warranties over the services or
(d) indemnification agreements, liability insurance, performance bonds or professional liabr ity
insurance.
C. I have made significant investment in the business through means such as: (a) purchas ig
necessary tools or equipment; (b) paying for the premises or facilities where services re
provided; or (c) paying for licenses, certificates or specialized training.
D. I have the authority to hire other persons to provide or to assist in providing the services anc if
necessary to fire such persons.
E. Each year I perform labor or services for at least two different persons or entities or I routinely
engage in business advertising, solicitation or other marketing efforts reasonably calculated to
obtain new contracts to provide similar services.
Contractor Signature Date
Page 1 of 2 - Exhibit 3 - Personal Services Contract No. 2009 -552
C. Representation and Warranties.
Contractor certifies under penalty of perjury that the following statements are true to the best -of
Contractor's knowledge:
1. Contractor has the power and authority to enter into and perform this contract;
2. This contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable
in accordance with its terms;
3. The services under this Contract shall be performed in a good and workmanlike manner and in accordance
with the highest professional standards; and
4. Contractor shall, at all times during the term of this contract, be qualified, professionally competent, and duly
licensed to perform the services.
5. To the best of Contractor's knowledge, Contractor is not in violation of any tax laws described in ORS
305.380(4),
6. Contractor understands that Contractor is responsible for any federal or state taxes applicable to Eny
consideration and payments paid to Contractor under this contract; and
7. Contractor has not discriminated against minority, women or small business enterprises in obtaining any
required subcontracts.
(4°
S
Coni'ractor Signature Date
Page 2 of 2 - Exhibit 3 - Personal Services Contract No. 2009 -552
EXHIBIT 4
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
Workers' Compensation Exemption Certificate
(To be used only when Contractor claims to be exempt from Workers' Compensation coverage requirements,
Contractor is exempt from the requirement to obtain workers' compensation insurance under ORS Chapter 656 for the following re. ison
(check the appropriate box):
❑ SOLE PROPRIETOR
• Contractor is a sole proprietor, and
• Contractor has no employees, and
• Contractor shall not hire employees to perform this contract.
❑ CORPORATION - FOR PROFIT
• Contractor's business is incorporated, and
• All employees of the corporation are officers and directors and have a substantial ownership interest* in the
corporation, and
• The officers and directors shall perform all work. Contractor shall not hire other employees to perform this
contract.
❑ CORPORATION - NONPROFIT
• Contractor's business is incorporated as a nonprofit corporation, and
• Contractor has no employees; all work is performed by volunteers, and
• Contractor shall not hire employees to perform this contract.
❑ PARTNERSHIP
• Contractor is a partnership, and
• Contractor has no employees, and
• All work shall be performed by the partners; Contractor shall not hire employees to perform this contract, anc
• Contractor is not engaged in work performed in direct connection with the construction, alteration, rer air,
improvement, moving or demolition of an improvement to real property or appurtenances thereto.
❑ LIMITED LIABILITY COMPANY
• Contractor is a limited liability company, and
• Contractor has no employees, and
• All work shall be performed by the members; Contractor shall not hire employees to perform this contract, anti
• If Contractor has more than one member, Contractor is not engaged in work performed in direct connection with
the construction, alteration, repair, improvement, moving or demolition of an improvement to real property or
appurtenances thereto.
*NOTE: Under OAR 436- 050 -050 a shareholder has a "substantial ownership" interest if the shareholder owns 10% of the corporation or,
if less than 10% is owned, the shareholder has ownership that is at least equal to or greater than the average percentage of ownershim of
all shareholders.
* *NOTE: Under certain circumstances partnerships and limited liability companies can claim an exemption even when performing
construction work. The requirements for this exemption are complicated. Consult with County Counsel before an exemption reque5. t is
accepted from a contractor who shall perform construction work.
Contractor Printed Name Contractor Signature
Contractor Title Date
Page 1 of 1 - Exhibit 4 - Personal Services Contract No. 2009 -552
EXHIBIT 5
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
Expense Reimbursement
1. Travel and Other Expenses. (When travel and other expenses are reimbursed.)
a. It is the policy of the County that all travel shall be allowed only when the travel is essential to the normal
discharge of the County responsibilities.
1) All travel shall be conducted in the most efficient and cost effective manner resulting in the best
value to the County.
2) Travel expenses shall be reimbursed for official County business only.
3) County shall not reimburse Contractor for any item that is not otherwise available for reimbursement
to an employee of Deschutes County per Deschutes County Finance Policy F -1,
"REIMBURSEMENT FOR MISCELLANEOUS EXPENSES AND EXPENSES INCURRED WHILE
TRAVELING ON COUNTY BUSINESS," dated 11/8/06.
4) County may approve a form other than the County Employee Reimbursement Form for Contractor to
submit an itemized description of travel expenses for payment.
5) Personal expenses shall not be authorized at anytime.
6) All expenses are included in the total maximum contract amount.
b. Travel expenses shall be reimbursed only in accordance with rates approved by the County and oily
when the reimbursement of expenses is specifically provided for in Exhibit 1, paragraph 3 of his
Contract.
c. The current approved rates for reimbursement of travel expenses are set forth in the above described
policy.
d. County shall not reimburse for any expenses related to alcohol consumption or entertainment.
e. Except where noted, detailed receipts for all expenses shall be provided.
f. Charge slips for gross amounts are not acceptable.
g. County shall not reimburse Contractor for any item that is not otherwise available for reimbursement to
an employee of Deschutes County.
2. Approved reimbursements:
a. Mileage. Contractor shall be entitled to mileage for travel in a private automobile while Contractor is
acting within the course and scope of Contractor's duties under this Contract and driving over the most
direct and usually traveled route to and from Bend, Oregon.
1) Reimbursement for mileage shall be equal to but not exceed those set by the United States General
Services Administration ( "GSA ") and are subject to change accordingly.
2) To qualify for mileage reimbursement, Contractor shall hold a valid, current driver's license for the
class of vehicle to be driven and carry personal automobile liability insurance in amounts not le ;s
than those required by this contract.
3) No mileage reimbursement shall be paid for the use of motorcycles or mopeds.
b. Meals.
1) Any reimbursement for meals shall be for actual cost of meals incurred by Contractor while acting
within the course and scope of Contractor's duties under this contract.
2) For purposes of calculating individual meals where the Contractor is entitled only to a partial diy
reimbursement, the following maximum allocation of the meal expenses applies:
a) Breakfast, $10;
b) Lunch, $12;
c) Dinner, $22.
3) Except in the event of necessary overnight travel as provided below, partial day meal expenses shall
be reimbursed as follows and only while Contractor is acting within the course and scope . f
Contractor's duties under this contract:
a) Breakfast expenses are reimbursable if Contractor is required to travel more than two (2) hour
before the start Contractor's regular workday (i.e. 8:00 a.m.).
b) Lunch expenses are reimbursable only if Contractor is required to travel overnight and begir s
the journey before 11:00 am or ends the journey after 11:00 a.m.
c) Dinner expenses are reimbursable only if Contractor is required to travel more than two (:')
hours after Contractor's regular workday (i.e. 5:00 p.m.).
Page 1 of 2 - Exhibit 5 to Personal Services Contract No. 2009 -552
4) Breakfast and dinner expenses are reimbursable during Contractor's necessary overnight travel
while acting within the course and scope of Contractor's duties under this contract and shall not
exceed those set by the GSA. and are subject to change accordingly.
c. Lodging.
1) County shall reimburse Contractor for Contractor's actual cost of lodging necessary to provide
service to the County and shall not exceed the maximum lodge set by the GSA for Bend, Oregon.
2) Reimbursement rates for lodging are not considered "per diem" and receipts are required for
reimbursement.
d County shall not reimburse Contractor in excess of the lowest fair for any airline ticket or vehicle rental
charges.
3. Exceptions. Contractor shall obtain separate written approval of the County Administrator for any
exceptions to the expense items listed above prior to incurring any expense for which reimbursement shall
be sought.
Page 2 of 2 - Exhibit 5 to Personal Services Contract No. 2009 -552
Exhibit 6
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
Compliance with provisions, requirements of funding source and
Federal and State laws, statutes, rules, regulations, executive orders and policies.
Conflicts of Interest
Contractor certifies under penalty of perjury that the following statements are true to the best of
Contractor's knowledge:
1. If Contractor is currently performing work for the County, State of Oregon or federal government, Contractor
by signature to this Contract declares certifies that; Contractor's Work to be performed under this Contract
create no potential or actual conflict of interest as defined by ORS 244 and no rules or regulations of
Contractor's employee agency (County State or Federal) would prohibit Contractor's Work under this
Contract. Contractor is not an "officer," "employee," or "agent" of the County, as those terms are used in
ORS 30.265.
2. No federally appropriated funds have been paid or shall be paid, by or on behalf of Contractor, to any person
for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an
officer or employee of Congress, or an employee of a member of Congress in connection with the award,ng
of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
federal contract, grant, loan, or cooperative agreement.
a. If any funds other than federally appropriated funds have been paid or shall be paid to any person or
influencing or attempting to influence an officer or employee of any agency, a member of Congress, 3n
officer or employee of Congress, or an employee of a member of Congress in connection with this
federal contract, grant, loan, or cooperative agreement, Contractor agrees to complete and subriit
Standard Form -LLL "Disclosure Form to Report Lobbying," in accordance with its instructions.
1) Standard Form -LLL and instructions are located in 45 CFR Part 93 Appendix B.
2) If instructions require filing the form with the applicable federal entity, Contractor shall then as a
material condition of this Contract also file a copy of the Standard Form -LLL with the Department.
3) This filing shall occur at the same time as the filing in accordance with the instructions.
b. Contractor understands this certification is a material representation of fact upon which the County and
the Department has relied in entering into this Contract. Contractor further understands that submission
of this certification is a prerequisite, imposed by 31 USC 1352 for entering into this Contract.
c. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
d. Contractor shall include the language of this certification in the award documents for all sub - awards at all
tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative
agreements) and that all sub - recipients shall certify and disclose accordingly.
e. Contractor is solely responsible for all liability arising from a failure by Contractor to comply with ttle
terms of this certification.
f. Contractor promises to indemnify County for any damages suffered by County as a result of Contractor's
failure to comply with the terms of this certification.
L
3. Contractor understands that, if this Contract involves federally appropriated funds, this certification is a
material representation of facts upon which reliance was placed when this Contract was made or entered
into, submission of this certification is a prerequisite for make or entering into this Contract imposed by
Section 1352, Title 311, U.S. Code and that any person who fails to file the required certification shall Le
subject to a civil penalty of not less than $10,000 and not more han $100,000 for each failure.
z
Contractor Signature
Date
Page 1 of 1 - Exhibit 6 to Personal Services Contract No. 2009 -552
Exhibit 7
DESCHUTES COUNTY SERVICES CONTRACT
Contract No. 2009 -552
BUSINESS ASSOCIATE AGREEMENT
County will make available and /or transfer to Contractor certain Information, in conjunction with goods or
services that are being provided by Contractor to County, that is confidential and must be afforded special
treatment and protection.
Contractor will have access to and /or receive from County certain Information that can be used or disclosed only
in accordance with this Agreement and the HHS Privacy Regulations.
To the extent required by 42 U.S.C. 1171 et seq. enacted by the Health Insurance Portability and Accountability
Act of 1996 and regulations promulgated thereunder, Contractor assures County that Contractor will
appropriately safeguard protected health information made available to or obtained by Contractor.
Contractor further agrees to comply with applicable laws relating to protected health information and with respect
to any task or other activity Contractor performs on behalf of County, to the extent County would be required to
comply with such requirements.
For purposes of this Agreement, the following terms shall apply:
A. Contractor shall be considered a BUSINESS ASSOCIATE;
B. County shall be considered a COVERED ENTITY;
C. HHS Privacy Regulations shall mean the Code of Federal Regulations (C.F.R.) at Title 45, Sections
160 and 164;
D. Individual shall mean the person who is the subject of the Information, and has the same meaning
as the term 'individual' is defined by 45 C.F.R. 164.501; and
E. Secretary shall mean the Secretary of the Department of Health and Human Services (HHS) and
any other officer or employee of HHS to whom the authority involved has been delegated;
F. Information shall mean any health information provided and /or made available by County to
Contractor, and has the same meaning as the term 'health information' as defined by 45 C.F.R.
160.102.
Contractor agrees it shall:
1. Not use or further disclose such information other than as permitted or required by this Agreement.
Contractor shall not, except as necessary for the proper management, administration and performance
of its duties under this Agreement, use, reproduce, disclose, or provide to third parties, any confidential
document or information relating to the County, its members or to clients of County or its members
without the prior written consent or authorization of the County or of the client. If Contractor uses such
information for the purposes set forth above, it will only do so if the disclosure is required by law or
Contractor obtains reasonable assurances from the person to whom the information is disclosed that it
will be held confidentially and used or further disclosed only as required by law or for the purpose for
which Contractor disclosed it to the person. Contractor shall ensure that its personnel, employees,
affiliates and agents maintain the confidentiality of patient health information and business information c f
County.
Page 1 of 2 - Exhibit 7 to Personal Services Contract No. 2009 -552
2. Not use or further disclose the information in a manner that would violate the requirements of applicable
law, if done by County;
3. Use appropriate safeguards to prevent use or disclosure of such information other than as provided fcr
by this Agreement;
4. Report to County any use or disclosure of such information not provided for by this Agreement of which
Contractor becomes aware;
5. Ensure that any subcontractors or agents to whom Contractor provides protected health information
received from County agree to the same restrictions and conditions that apply to Contractor with resp€ ct
to such information;
6. Make available protected health information in accordance with applicable law, i.e., the Code of Feder 31
Regulations (C.F.R.) at Title 45, Sections 160 and 164;
7. Maintain standard records, pursuant to this agreement, and to provide such records and other necess 3ry
information to the County as may be requested in writing and as permitted by law. Contractor agrees
that all records kept in connection with this agreement are subject to review and audit by the County
upon reasonable notice of a minimum of 14 work days from the date of written request by the County.
8. Make Contractor's internal practices, books, and records relating to the use and disclosure of
protected health information received from County available to the Secretary of the United States
Health & Human Services for purposes of determining County's compliance with applicable law
(in all events, Contractor shall immediately notify County upon receipt by Contractor of any such
request, and shall provide County with copies of any such materials);
9. Upon termination of this Agreement, Contractor shall promptly return all protected health
information received from County. If the return of protected health information is not feasible,
Contractor shall continue the protections required under this contract to the protected health
information consistent with the requirements of this Attachment and the HIPAA privacy
standards.
Date: g /J0ignature:
Contractor: Central Oregon Resources for In endent Living
Title
Page 2 of 2 - Exhibit 7 to Personal Services Contract No. 2009 -552
- Pl(-cam
ACORGM CERTIFICAT OF LIABILITY INSURANC
PRODUCER (541)382 -2421
Lumbermens Insurance
965 SW Emkay Drive
PO Box 940
Bend, OR 97709
FAX (541)385 -3231
DATE (MM/DD/YYYY)
05/213/2009
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERT FICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEN!) OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIL: #
INSURED Central Oregon Resources for Independent Living
PO Box 9425
Bend, OR 97708 -9425
INSURERA: Philadelphia Indemnity Ins Co
INSURER 8:
INSURER C:
INSURER D:
INSURER E:
COVERAGE
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH RESPECT TO W HICH THIS CERTIFICATE MAYBE ISSUE D OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM /DD/YY)
POLICY EXPIRATION
DATE (MM /DD/YYI
LIMITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
PHPK320281
06/14/2009
06/14/2010
EACH OCCURRENCE
$ 1,000,000
X
DAMAGE TO RENTED
PRFMI.SFS (Fa nrri vcnce)
$ 100,000
CLAIMS MADE X OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ 1,000,000
POLICY PRO LOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS /UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC S7 OTH-
.TORY LIM T- MITS. FR
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER IS AN ADDITIONAL INSURED BUT ONLY REGARDING THEIR INTEREST IN THE OPERATIONS
OF THE NAMED INSURED AS A FUNDING SOURCE.
CERTIFICATE HOLDER
CANCELLATION
DESCHUTES COUNTY MENTAL HEALTH
ATTN: KATHY DREW
2577 COURTNEY DRIVE
BEND, OR 97701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAI
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH : LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIAE LITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Holly Hills /HHILL
ACORD 25 (2001108)
OACORD CORPORA PION 1988