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HomeMy WebLinkAboutResolution - 2023-R0364 - Contract 17194, Mindfulness Behavioral Health Services, LLC - 07/25/2023Resolution No. 2023-R0364 Item No. 5.19 July 25, 2023 RESOLUTION BE IT RESOLVCD BY 'I'H� CITY COUNCII, Or TI IE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, Contract No. 17194 for Substancc Use Disorder Treatment Services as per IZFP 23-17194-YB, by and betwcen the City of Lubbock and Mindfulness Behavioral Health Services, LLC, and related documents. Said Contract is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on �uly 25, 2a23 ATT � ST: Courtney Paz, City Sec tary APPROVLD AS TO CON1'ENT: Bill Ho��fton, Deputy City APPROVLD AS "1'O 1�ORM: Rachael Postcr, ASsistant City Attorncy ccdocs IIIRES.ServiceContract 17194- Mindfulness I3ehavioral } Iealth Scrvices, LLC 6.29.23 Resolution No. 2023-R0364 City of Lubbock Substance Use Disorder Treatment Providers Agreement Contract 17194 This Service Agreement (this "Agreement") is entered into as of the �day of Julv 2023 ("Effective Date") by and between Mindfulness Behavioral Health Services, LLC (the Contractor), and the City of Lubbock (the "City"). RECITALS WHEREAS, the City has issued a Request for Proposals 23-17194-YB, Substance Use Disorder Treatment Providers and WHEREAS, the proposal submitted by the Contractor has been selected as the proposal which best meets the needs of the City for this service; and WHEREAS, Contractor desires to perform as an independent contractor to provide Substance Use Disorder Treatment Providers, upon terms and conditions maintained in this Agreement; and NOW THEREFORE, for and in consideration of the mutual promises contained herein, the City and Contractor agree as follows: City and Contractor acknowledge the Agreement consists of the following exhibits which are attached hereto and incorporated herein by reference, listed in their order of priority in the event of inconsistent or contradictory provisions: 1. This Agreement 2. Exhibit A— General Requirements 3. Exhibit B— Service Type and Unit Rates 4. Exhibit C— Business Associate Agreement 5. Exhibit D— Insurance Requirements Scope of Work Contractor shall provide the services that are specified in Exhibit A. The Contractor shall comply with all the applicable requirements set forth in Exhibit B, Exhibit C and Exhibit D attached hereto. Article 1 1.1 The contract shall be for a term of one (1) year, with the option of four (4), one (1) year extensions, said date of term beginning upon formal approval. This Contract will renew automatically for the additional terms, unless either Party gives ninety (90) day written notice to terminate the Contract. 1.1 All stated annual quantities are approximations of usage during the time period to be covered by pricing established by this bid. Actual usage may be more or less. Order quantities will be determined by actual need. The City of Lubbock does not guarantee any specific amount of compensation, volume, minimum, or maximum amount of services under this bid and resulting contract. 1.2 The Contractor must maintain the insurance coverage required during the term of this contract including any extensions. It is the responsibility of the Contractor to ensure that valid insurance is 1.3 A) Prices quoted shall be guaranteed for a period for six (6) months upon City approval. The rate may be adjusted at the City's discretion for the effective change in Consumer Price Index (CPI) or Product Price Index (PPI) as appropriate. B) Further, if the Contractor can provide documentation for actual charges for material, labor, etc. that demonstrates that the change in CPI or PPI is not sufficient, the Contractor shall provide such documentation to the City, and at the City's sole discretion, the contractual rate may be further adjusted. If agreement regarding a new rate cannot be reached, the City shall terminate at the end of the current contract period. C) If an adjustment to pricing is granted under this section, the Contractor must provide the Director of Purchasing and Contract Management written, quarterly documentation to justify the ongoing adjustment. If no such documentation is timely received, the rate will automatically revert to the initial, awarded rate. 1.4 This contract shall remain in effect until the first of the following occurs: (1) the expiration date, (2) performance of services ordered, or (3) termination of by either party with a 30 day written notice. The City of Lubbock reserves the right to award the canceled contract to the next lowest and best bidder as it deems to be in the best interest of the city. Article 2 Miscellaneous. 2.1 This Agreement is made in the State of Texas and shall for all purposes be construed in accordance with the laws of said State, without reference to choice of law provisions. 2.2 This Agreement is performable in, and venue of any action related or pertaining to this Agreement shall lie in, Lubbock, Texas. 2.3 This Agreement and its Exhibits contains the entire agreement between the City and Contractor and supersedes any and all previous agreements, written or oral, between the parties relating to the subject matter hereof. No amendment or modification of the terms of this Agreement shall be binding upon the parties unless reduced to writing and signed by both parties. 2.4 This Agreement may be executed in counterparts, each of which shall be deemed an original. 2.5 In the event any provision of this Agreement is held illegal or invalid, the remaining provisions of this Agreement shall not be affected thereby. 2.6 The waiver of a breach of any provision of this Agreement by any parties or the failure of any parties otherwise to insist upon strict performance of any provision hereof shall not constitute a waiver of any subsequent breach or of any subsequent failure to perform. 2.7 This Agreement shall be binding upon and inure to the benefit of the parties and their respective heirs, representatives and successors and may be assigned by Contractor or the City to any successor only on the written approval of the other party. 2.8 All claims, disputes, and other matters in question between the Parties arising out of or relating to this Agreement or the breach thereof, shall be formally discussed and negotiated between the Parties for resolution. In the event that the Parties are unable to resolve the claims, disputes, or other matters in question within 30 days of written notification from the aggrieved Party to the other Party, the aggrieved Party shall be free to pursue all remedies available at law or in equity. 2.9 At any time during the term of the contract, or thereafter, the City, or a duly authorized audit representative of the City or the State of Texas, at its expense and at reasonable times, reserves the right to audit Contractor's records and books relevant to all services provided to the City under this Contract. In the event such an audit by the City reveals any errors or overpayments by the City, Contractor shall refund the City the full amount of such overpayments within 30 days of such audit findings, or the City, at its option, reserves the right to deduct such amounts owing the City from any payments due Contractor. 2.10 The City reserves the right to exercise any right or remedy to it by law, contract, equity, or otherwise, including without limitation, the right to seek any and all forms of relief in a court of competent jurisdiction. Further, the City shall not be subject to any arbitration process prior to exercising its unrestricted right to seek judicial remedy. The remedies set forth herein are cumulative and not exclusive, and may be exercised concurrently. To the extent of any conflict between this provision and another provision in, or related to, this document, this provision shall control. 2.11 The contractor shall not assign or sublet the contract, or any portion of the contract, without written consent from the Director of Purchasing and Contract Management. Should consent be given, the Contractor shall insure the Subcontractor or shall provide proof of insurance from the Subcontractor that complies with all contract insurance requirements document, this provision shall control. 2.12 Contractor acknowledges by supplying any Goods or Services that the Contractor has read, fully understands, and will be in full compliance with all terms and conditions and the descriptive material contained herein and any additional associated documents and Amendments. The City disclaims any terms and conditions provided by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and conditions and any terms and conditions provided by the Contractor, the terms and conditions provided herein shall prevail. The terms and conditions provided herein are the final terms agreed upon by the parties, and any prior conflicting terms shall be of no force or effect. 2.13 Contracts with Companies Engaged in Business with Iran, Sudan, or Foreign Terrorist Organization Prohibited. Pursuant to Section 2252.152 of the Texas Government Code, prohibits the City from entering into a contract with a vendor that is identified by The Comptroller as a company known to have contracts with or provide supplies or service with Iran, Sudan or a foreign terrorist organization. 2.14 Texas Public Information Act. The requirements of Subchapter J, Chapter 552, Government Code, may apply to this contract and the contractor or vendor agrees that the contract can be terminated if the contractor or vendor knowingly or intentionally fails to comply with a requirement of that subchapter. To the extent Subchapter J, Chapter 552, Government Code applies to this agreement, Contractor agrees to: (1) preserve all contracting information related to the contract as provided by the records retention requirements applicable to the governmental body for the duration of the contract; (2) promptly provide to the governmental body any contracting information related to the contract that is in the custody or possession of the entity on request of the governmental body; and (3) on completion of the contract, either: (A) provide at no cost to the governmental body all contracting information related to the contract that is in the custody or possession of the entity; or (B) preserve the contracting information related to the contract as provided by the records retention requirements applicable to the governmental body. 2.15 No Boycott of Israel. Pursuant to Section 2271.002 of the Texas Government Code, a) This section applies only to a contract that: (1) is between a governmental entity and a company with 10 or more full-time employees; and (2) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. (b) A governmental entity may not enter into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 2.16 Texas Government Code 2274. By entering into this Agreement, Contractor verifies that: (1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during the term of the contract against a firearm entity or firearm trade association. 2.17 Contractor represents and warrants that: (1) it does not, and will not for the duration of the contract, boycott energy companies or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not boycott energy companies; and will not boycott energy companies during the term of the Agreement. This verification is not required for an agreement where a governmental entity determines that these requirements are inconsistent with the governmental entity's constitutional or statutory duties related to the issuance, incurrence, or management of debt obligations or the deposit, custody, management, borrowing, or investment of funds. 2.18 Confidentiality. The Contractor shall retain all information received from or concerning the City and the City's business in strictest confidence and shall not reveal such information to third parties without prior written consent of the City, unless otherwise required by law. 2.19 Indemnify. The Contractor shall indemnify and save harmless the city of Lubbock and its elected officials, officers, agents, and employees from all suits, actions, losses, damages, claims, or liability of any kind, character, type, or description, including without limiting the generality of the foregoing, all expenses of litigation, court costs, and attorney's fees, for injury or death to any person, or injury to any property, received or sustained by any person or persons or property, to the extent arising out of, related to or occasioned by, the negligent acts of the Contractor, its agents, employees, andlor subcontractors, related to the performance, operations or omissions under this agreement andlor the use or occupation of city owned property. The indemnity obligation provided herein shall survive the expiration or termination of this agreement. -----INTENTIONALLY LEFT BLANK----- IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day and year first above written. Executed in triplicate. CITY OF BOCK Tray Payne ayor A EST: Courtney Paz, City Secr ry A OV .D AS TO CONTENT: y, Katherine Wells, Director of Public Health CO RACTOR BY: � Authorized Representative C��vl,�� n tc •�� t �CS W Print Name � �.� �� G�vlti�in 1 ✓ � Address �sl�� i 7�C �7yy � City, State, Zip Code APPROVED AS TO FORM Rachael roster, Assis ant City Attorney Exhibit A City of Lubbock RFP 23-17194-YB Substance Use Disorder Treatment Providers GENERAL REQUIREMENTS 1. INTENT The Health Department is soliciting proposals from qualified providers to join the network. Eligible providers must meet the state minimum requirements to participate in this program. Preference will be given to providers who can exceed the requirements. Network providers must accept the state unit rate as payment in full. At this time additional funds are not available to supplement to state rate, however, individuals receiving service through the network will be assigned a case manager to monitor progress, address treatment barriers and assist with discharge planning to help improve short and long term success rates. 2. SCOPE OF WORK The City of Lubbock Health Department currently has a network of substance use disorder treatment providers and would like to expand their network. Providers in the network will serve individuals with qualifying substance use disorders who have been screened and approved for services by health department staff. The goal of this network is to establish a diverse group of substance use disorder treatment options to meet the individual needs of those entering treatment. This network is funded through the Substance Use Prevention Service grants from the Texas Department of Health and Human Services. General 1. All Subcontractors shall become familiar with the treatment contracts such as; Adult Treatment (TRA), Specialized Female Treatment (TRF), Co-Occurring Psychiatric and Substance Abuse Disorders (COSPD) and Youth Treatment (TRY) to help assist with grant guidelines, to help inform and provide substance use disorder treatment to the targeted population. The below service typesllevels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: https://hhs.texas.gov/doing-business- hhs/provider- portals/behavioral-health-servicesproviders/behavioral-health-provider- resources/utilization- management-guidelines-manual, and American Society of Addiction Medicine (ASAM) criteria located at the following link: www.asam.com, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning. Subcontractors will provide a copy of their roster and make sure it is current. The roster will also contain the hours of operation and the services provided. Subcontractors must utilize the Clinical Management for Behavioral Health Services (CMBHS) system and attend training after contract execution and before subcontracted services begin. CMBHS will also be used to report Wait List and Daily Capacity Management. Subcontractors are required to submit billing sheets weekly and make any necessary corrections in order to *Service Delivery Subcontractor shall: Adhere to the Priority Populations for Treatment Programs as stated in the SUD UM Guidelines. 1. Maintain a Waiting List to track all eligible individuals who have been screened but cannot be admitted to SUD treatment immediately. 2. Subcontractor that has an individual identified as a federal and State priority population on the waiting list shall confirm this in the Daily Capacity Management Report. 3. Subcontractor shall arrange for appropriate services in another treatment facility orprovide access to interim services as indicated within forty-eight (48) hours when efforts to refer to other appropriate services are exhausted. 4. Subcontractor shall offer directly or through refenal interim services to waitlisted individuals. 5. Establish a wait list that includes priority populations and interim services while awaiting admission to treatment services. 6. Develop a mechanism for maintaining contact with individuals awaiting admission. 7. Maintain a waiting list that includes a unique individual identifier for each injecting drug abuser seeking treatment, including individuals receiving interim services whileawaiting admission. 8. Send wait list numbers to Subcontractor by 9:30am Monday through Friday. 9. If unable to provide admissions to individuals within Priority Populations for TreatmentPrograms according to SUD UM Guidelines: 10. Implement written procedures that address maintaining weekly contact with individuals waiting for admissions as well as what referrals are made when a Client cannot be admittedfor services immediately. 11. When Subcontractor cannot admit a Client, who is at risk for dangerous withdrawal, Subcontractor shall ensure that an emergency medical care provider is notified. 12. Coordinate with an alternate provider for immediate admission. Notify Substance Use Disorder (Substance_Use_Disorder@hhsc.state.tx.us) so that assistance can be provided that ensures immediate admission to other appropriate services and proper coordination when appropriate. 13. Provide pre-admission service coordination to reduce barriers to treatment, enhance motivation, stabilize life situations, and facilitate engagement in treatment. 14. Adhere to Informed Consent Document for Opioid Use Disorder applicable to individual asstated in the SUD UM Guidelines. 15. When an individual is placed on the Wait List, Subcontractor shall document interim services as referrals that provides applicable testing, counseling, and treatment for Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and sexually transmitted infections (STIs). ensure payments are submitted in a timely manner. Examples of billing sheets will be provided. Monitoring tools will be used to perform (I) audit per service type provided by the subcontractors every quarter or as needed. An audit will be done at the facility and in the CMBHS database. Corrections or discrepancies must be corrected in a timely manner or by the due date provided by City of Lubbock Behavioral Program staff. The monitoring tool will be provided to the subcontractor. Subcontractors are required to demonstrate a five percent (5%) match of either in-kind donations or supplemental service committed specifically for the proposed project. 2. Service Requirements *Administrative Requirements 1. Adhere to the most current SUD UM Guidelines. 2. Provide age-appropriate medical and psychological therapeutic services designed to treat an individual's SUD and restore functions while promoting Recovery. 3. Adhere to Level of CarelService Type licensure requirements. 4. Comply with all applicable TAC rules adopted by System Agency related to SUD treatment. 5. Document all specified required activities and services in the Clinical Management of Behavioral Health Services (CMBHS) system. Documents that require Client or staff signature shall be maintained according to TAC requirements and made available to SystemAgency for review upon request. 6. Client Retention in services, including protocols for addressing Clients absent from treatment and policies defining treatment non-compliance; and all policies and procedures shall be provided to System Agency upon request. 7. Ensure that Program Directors participate in their specific Program and service type conference calls as scheduled by System Agency. Program Directors shall participate unless otherwise agreed to by System Agency in writing. Subcontractor executive management may participate in the conference calls. 8. Actively attend and share representative knowledge about Subcontractor's system and services at the Outreach, Screening, Assessment, and Referrals (OSAR) quarterly regional collaborative meetings. 9. Ensure compliance with Client Eligibility requirements to include: Texas residence eligibility, Financial Eligibility and clinical eligibility as specified in SUD UM Guidelines. Document a Life Event Note in CMBHS upon active Client's delivery of newbom. 10. Subcontractor will develop a local agreement with DFPS local offices to address referral process, coordination of services, and sharing of information as allowed per the consent and agreement form. 11. Adhere to Memorandum of Understanding requirements as stated in the SUD UMGuidelines. 12. Maintain a list of community resources and document referrals when appropriate to ensure that children of the client have access to services to address their needs and support healthy development including primary pediatric care, early childhood intervention services, and other therapeutic interventions that address the children's development needs and any issues of abuse and neglect. *Screening and Assessment Subcontractor shall: 1. Comply with all applicable rules in the TAC for SUD progams as stated in the SUD UM Guidelines Information, Rules, and Regulations regarding Screening and Assessment. 2. When documenting a CMBHS Substance Use Disorder screening, Subcontractor shall conduct the screening in a confidential, face-to-face interview unless there is documented justification for an interview by phone. 3. Document Financial Eligibility in CMBHS as required in the SUD UM Guidelines. 4. Conduct and document a CMBHS SUD Initial Assessment with the Client to determine the appropriate levels of care for SUD treatment. The CMBHS assessment will identifythe impact of substances on the physical, mental health, and other identified issues including TB, Hepatitis B and C, STI, HIV. If Client indicates risk for these communicable diseases, Subcontractor shall refer the Client to the appropriate community resources for further testing and counseling. ii. If the Client is at risk for HIV, Subcontractorshall refer the Client to pre and posttest counseling on HIV. 5. If the Client is living with HIV, Subcontractor will refer the Client to the appropriate community resources to complete the necessary referrals and health related paperwork. 6. The assessment shall be signed by a Qualified Credential Counselor (QCC) and filed in the Client record within three (3) Service Days of admission or a program may accept an evaluation from an outside entity if it meets the criteria for admission and was completed during the thirty (30) calendar days preceding admission. *Treatment Planning, Implementation and Review Subcontractor shall: 1. Comply with all applicable rules for SUD programs in the TAC regarding Treatment Planning, Implementation and Review, as referenced in Information, Rules, and Regulations of the SUD Program 2. Guide. Collaborate actively with clients and family, when appropriate, to develop and implement an individualized, written treatment plan that identifies services and support needed to address problems and needs identified in the assessment. The treatment plan shall document the expected length of stay and treatment intensity. Subcontractor shall use clinical judgment to assign a projected length of stay for each individual client. 3. Document referral and referral follow-up in CMBHS to the appropriate community resources based on the individual need of the client. 4. The treatment plan shall be signed by a QCC and filed in the client record within five service days of admission. *Discharge Subcontractor shall: 1. Comply with all applicable rules in the TAC regarding Discharge, as referenced in Information, Rules, and Regulations of the SUD Program Guide. 2. Develop and implement an individualized discharge plan with the client to assist in sustaining recovery. 3. Document in CMBHS the client-specific information that supports the reason for discharge listed on the discharge report. A QCC shall sign the discharge summary. Appropriate referrals shall be made and documented in the client record. A client's treatment is considered successfully completed, if the following criteria are met: i. Client has completed the clinically recommended number of treatment units (either initially projected or modified with clinical justification) as indicated in CMBHS. ii. All problems on the treatment plan have been addressed. 4. Utilize the treatment plan component of CMBHS to create a final and completed treatment plan version. 5. Problems designated as "treat" or "case manage" status shall have all objectives resolved priorto discharge: iii. Problems that have been "referred" shall have associated documented referrals in CMBHS; iv. Problems with "deferred" status shall be re-assessed. Upon successful discharge, all deferred problems shall be resolved, either through referral, withdrawal, treatment, or case management with clinical justification reflected in CMBHS, through the Progress Note and Treatment Plan Review Components; and v. "Withdrawn" problems shall have clinical justification reflected in CMBHS, through the Progress Note and Treahnent Plan Review Components. *Additional Service Requirements Subcontractor shall: 1. Comply with all applicable rules in the TAC for SUD programs, as stated in Information, Rules, and Regulations of the SUD Program Guide. 2. Deliver and provide access to services at times and locations that meet the needs of the target population. Provide or arrange for transportation to all required services not provided at Subcontractor's facility. 3. Accept referrals from the OSAR. 4. Provide evidenced-based education to clients at minimum on the following topics: 5. 6. 7. 8. 9. (i) Tuberculosis; (ii) HIV; Hepatitis B and C; (iii) Sexually Transmitted InfectionslDiseases; and (iv) Health risks of tobacco and nicotine product use. Provide Case Management as needed with documentation in CMBHS, as Case Management is essential to the ultimate success of the client. Ensure client access to the full continuum of treatment services and shall provide sufficient treatment intensity to achieve treatment plan goals. Provide all services in a culturally, linguistically, non-threatening, respectful and developmentally appropriate manner for clients, families, andlor significant others. Provide trauma-informed services that address the multiple and complex issues related to violence, trauma, and substance use disorders. Provide overdose prevention and reversal education to all clients. 10. Specific overdose prevention activities shall be conducted with clients with opioid use disorders and those clients that use drugs intravenously. Subcontractor will directly provide or refer to community support services for overdose prevention and reversal education to all identified at risk clients prior to discharge. Subcontractor will document all overdose prevention and reversal education in CMBHS. 11. Ensure access to adequate and appropriate medical and psychosocial tobacco cessation treatment as follows: 12. Utilize System Agency as the payer of last resort if the client has other 1 outside funding available (i.e., wages, insurance, etc.) *Staff Competencies and Requirements 1. All personnel shall receive the training and supervision necessary to ensure compliance with System Agency rules, provision of appropriate and individualized treatment, and protection of client health, safety, and welfare. 2. Ensure that all direct care staff receive a copy of this statement of work and SUD Program Guide. 3. Ensure that all direct care staff review all policies and procedures related to the program or organization on an annual basis. 4. Ensure compliance with all applicable rules in the TAC for SUD Programs regarding Personnel Practices and Development, as stated in Personnel Requirements and Documentation of the SUD Program Guide. 5. Within 90 business days of hire and prior to service delivery, direct care staff shall have specific documented training in the following: i. Motivational interviewing techniques or Motivational Enhancement Therapy; ii. Trauma-informed care; iii. Cultural competency; iv. Harm reduction trainings; v. HIPAA and 42 CFR Part 2 training; and vi. State of Texas co-occurring psychiatric and substance use disorder (COPSD) training located at the following website: www.centralizedtraining.com 6. Ensure all direct care staff complete annual education on Health Insurance Portability and Accountability Act (HIPAA) and 42 CFR Part 2 training. DocuSign Envelope ID: 1D1EC09B-A3AF-4B6D-8A54-14CB34153271. 7. Ensure all direct care staff complete a minimum of 10 hours of training each state fiscal year in any of the following areas: i. Motivational interviewing techniques; ii. Cultural competencies; iii. Reproductive health education; iv. Risk and harm reduction strategies; v. Trauma informed care; or vi. Suicide prevention and intervention. 8. Individuals responsible for planning, directing, or supervising treatment services shall be a QCC. 9. Subcontractor shall have a clinical program director known as a"Program Director" with at least two years of post-QCC licensure experience providing substance use disorder treatment. 10. Substance Use Disorder counseling shall be provided by a QCC or Chemical Dependency Counselor Intern. Substance use disorder education and life skills training shall be provided by counselors or individuals who have appropriate specialized education and expertise. All counselor interns shall work under the direct supervision of a QCC. 11. Licensed Chemical Dependency Counselors shall recognize the limitations of their licensee's ability and shall not provide services outside the licensee's scope of practice of licensure or use techniques that exceed the person's license authorization or professional competence. 12. Develop a policy and procedure on staff training, available for HHSC review, to ensure that information is gathered from clients in a respectful, non-threatening, and culturally competent manner. 13. For HIV Residential Subcontractor, all counseling staff will have one year of experience working with persons living with HIV or the at-risk population. i. Specific training for direct care staff is required annually in harm, risk reduction, and overdose training. ii.The Registered Nurse (RN), Licensed Vocational Nurse (LVN), or Physician's Assistant must have at least two years' experience working with persons living with HIV. All shifts will be staffed with either a LVN or RN. iii. Food service staff will include at least one full time employee who has certification in food service management and the ability to plan and accommodate diets recommended for individuals served by Subcontractor. 4. Levels of Care/Service Types 1. Adult Treatment (TRA) i. Adult Intensive Residential Services; ii. Adult Ambulatory Detoxification Services iii. Adult Residential Detoxification Services; iv. Adult Outpatient Services: (a) Adult Outpatient Group Counseling; (b) Adult Outpatient Group Education; (c) Adult Outpatient Individual Counseling. 2. Youth Treatment (TRY) i. Youth Outpatient Services (a) Youth Outpatient Group Counseling; (b) Youth Outpatient Group Education; (c) Youth Outpatient Individual Counseling; (d) Youth Adolescent Support; (e) Youth Family Counseling; ( fl Youth Family Support; (g) Youth Psychiatrist Consultation. 3. Specialized Female Treatment (TRF) i. Adult Specialized Female Intensive Residential Services; ii. Adult Specialized Female Supportive Residential Services; iii. Adult Specialized Female Women with Children Intensive Residential Services; iv. Adult Specialized Female Outpatient Services (a) Adult Specialized Female Outpatient Group Counseling; (b) Adult Specialized Female Outpatient Group Education; (c) Adult Specialized Female Outpatient Individual Counseling. 4. Co-Occurring Psychiatric and Substance Abuse Disorders (COPSD) 5. Target Population Texas residents who meet Client Eligibility for System Agency-funded substance use disorder services as stated in the Substance Use Disorder (SUD) Program Guide, https:llhhs.texas. govldoing-business-hhslprovider-portals/behavioral-health- servicesproviderslsubstance-use-disorder-service-providers Forms that will need to be completed and uploaded: Business Associate Agreement Form A Respondent Information Form B-1 Governmental Entity Form C Nonprofit or For-Profit Entity Form D Contact Person Information Form E-1 TRA, TRF, TRY, Outpatient Treatment Services Exhibit B City of Lub6ock RFP 23-17194-YB Substance Use Disorder Treatment Providers Service Types and Unit Rates Treatment for Adults (TRA) Service T e Unit Rate Adult Intensive Residential $113.02 Adult Out atient Out atient — Grou Counselin $18.84 Out atient — Grou Education $17.79 Out atient — Individual Counseling $60.69 Adult — Su ortive Residential $42.90 Adult — Residential Detoxification $234.41 Treatment for Youth (TR� Service T e Unit Rate Youth Out atient Services $62.79 Co-Occurring Psychiatric and Substance Use Disorder Services Contract (COPSD) Service T e Unit Rate COPSD Services $66.98 Network providers accepts the state unit rate as payment in full. �h'`��''� � �� 04/26/2023 Name Date Treatment for Females (TRF) Exhibit C BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (the "Agreement"), effective July 25, 2023 is entered into by and between the City of Lubbock ("City" or "Covered Entity") Mindfulness Behavioral Health Services, LLC ,(the "Business Associate"), (each a "Party" and collectively the "Parties"). Business Associate is a provider of City clients for Substance Use Disorder Treatment Services. (the "Services"), and the Covered Entity is a political subdivision of the State of Texas. The Parties have an agreement (the "Master Agreement") under which the Business Associate regularly uses and/or discloses Protected Health Information in its performance of the Services described. Both Parties are committed to complying with the Standards for Privacy of Individually Identifiable Health Information under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). This Agreement sets forth the terms and conditions, pursuant to which the Protected Health Information, that is provided, created, or received by the Business Associate, from or on behalf of the Covered Entity, will be handled between the Business Associate and the Covered Entity, and further with third parties during the term of the Master Agreement and after its termination. The Parties agree as follows: Covered Entity will make available to Business Associate certain information (e.g., medical records, patient information that is confidential and must be afforded special treatment and protection) in connection with Services provided by Business Associate to Covered Entity pursuant to the Master Agreement. Business Associate will have access to andlor receive from Covered Entity certain Information that can be used or disclosed only in accordance with this Agreement, the Master Agreement and the Department of Health and Human Service Privacy Regulations. Covered Entity and Business Associate agree as follows: 1. Business Associate shall not use or disclose Protected Health Information except as provided in this Agreement, the Master Agreement or required by law. A) The City of Lubbock agrees to provide Business Associate with a list of employees who are authorized to request retrieval of government documents. The City of Lubbock will be responsible for ensuring the fax machine is in a secured area for the receipt of confidential information. B) The City of Lubbock will fax to Business Associate a written, signed, and dated release of information request to Business Associate at: (� - . Business Associate will verify the name of the requestor and the incoming fax number prior to retrieving the requested document(s). Business Associate will verbally contact the original requestor prior to faxing or physically returning the documents and confirm request, verify documents, fax number andlor ship to address. C) Business Associate will return requested documents per City of Lubbock instructions. Fax requested returns will be to the authorized requestor's Business Associate Agreement — City of Lubbock Page 1 of 3 attention at (806)775-2164. Physical return of documents will be to the authorized requestor's attention at: The City of Lubbock, Citizens Tower, 1314 Avenue K, 9'h Floor, Lubbock, TX 79401 D) Business Associate will document method of return and original written authorization of release. Business Associate will maintain all release information for a period of six (6) years. 2. Business Associate shall implement and maintain appropriate safeguards to prevent the use or disclosure of Protected Health Information other than as provided herein. 3. Business Associate shall report to Covered Entity any use or disclosure of Protected Health Information in violation of this Agreement or the Master Agreement in which Business Associate becomes aware. 4. Business Associate agrees that anytime information is provided to or made available to any subcontractors or agents, Business Associate shall enter into a subcontract with the subcontractor or agent that contains the same terms, conditions and restrictions on the use and disclosure of information as contained in this Contract. 5. Business Associate shall make Protected Health Information available through and upon written request of the Covered Entity, to the individual subjects of such information. 6. Business Associate shall incorporate into this Agreement any amendments or corrections to Protected Health Information when notified by Covered Entity. 7. Business Associate shall provide for an accounting of uses and disclosures of Protected Health Information as requested by Covered Entity. 8. Business Associate shall make its internal practices, books and records relating to the use and disclosure of Protected Health Information available to the Secretary of the Department of Health and Human Services (HHS) as necessary for purposes of determining Covered Entity's compliance with the HIPAA Privacy Rule. 9. At termination of this Agreement Business Associate agrees to return or destroy all information received from, or created or received by Business Associate on behalf of Covered Entity. Business Associate agrees not to retain any copies of the information after termination of this contract. If return or destruction of the information is not feasible, Business Associate agrees to extend the protections of this Agreement for as long as necessary to protect the information after the termination of this Contract. 10. Covered Entity may terminate this agreement if it determines that Business Associate has violated a material term of this agreement after first providing written notice of such breach to Business Associate. Business Associate will then Business Associate Agreement — City of Lubbock Page 2 of 3 have seventy-two (72) hours to rectify said breach and notify Covered Entity of the resolution. 11. If termination of the contract is not feasible, then Covered Entity must report this violation to the Secretary of HHS. 12. The information shall be and remain the property of Covered Entity. Business Associate agrees that it acquires no title or rights to the information, including any de-identified information, as a result of this Contract. In witness whereof, Business Associate and City have caused this Contract to be signed and delivered by their duly authorized representatives, as of the date set forth above. The Ci BY; Print �rie: Tray Payne Title: Mayor Contractor By: Print Name: y15�'�✓1Ge D SP� � V Title: � W V1 � . Business Associate Agreement — City of Lubbock Page 3 of 3 Exhibit D 32. INSURANCE REQUIREMENTS 32.1. Prior to the approval of this contract by the City, the Contractor shall furnish a completed Insurance Certificate to the City, which shall be completed by an agent authorized to bind the named underwriter(s) to the coverages, limits, and termination provisions shown thereon, and which shall furnish and contain all required information referenced or indicated thereon. THE CITY SHALL HAVE NO DUTY TO PAY OR PERFORM UNDER THIS CONTRACT UNTIL SUCH CERTIFICATE SHALL HAVE BEEN DELIVERED TO THE CITY. 32.2. The City reserves the right to review the insurance requirements of this section during the effective period of the contract and to require adjustment of insurance coverages and their limits when deemed necessary and prudent by the City based upon changes in statutory law, court decisions, or the claims history of the industry as well as the Contractor. 32.3. Subject to the Contractor's right to maintain reasonable deductibles in such amounts as are approved by the City, the Contractor shall obtain and maintain in full force and effect for the duration of this contract, and any extension hereof, at Contractor's sole expense, insurance coverage written by companies approved by the State of Texas and acceptable to the City, in the following type(s) and amount(s): Commercial General Liabilitv ReQuirements: $1M occurrencel$2M aggregate (can be combined with an Excess Liability to meet requirement). Commercial General Liability to include Products -Completion/OP, Personal and Advertising Injury, Contractual Liability, Fire Damage (any one fire), and Medical Expenses (any one person). Auto Liabilitv Reauirements: $1 Mloccurrence is needed. Professional Liabilitv Requirements: $1 M occurrence/$2M aggregate. Workers Compensation Requirements• Statutory. If the vendor is an independent contractor with no employees and are exempt from providing Workers' Compensation coverage, they must sign a waiver (obtained from COL Purchasing) and include a copy of their driver's license. Employer Liability ($1 M) is required with Workers Compensation. * The City of Lubbock (including its officials, employees and volunteers) shall be afforded additional insured status on a primary and non-contributory basis on all liability policies except professional liabilities and workers' comp. * Waivers of Subrogation are required for COL, AL, and WC. * To Include Products of Completed Operations endorsement. * Carrier will provide a 30-day written notice of cancellation, 10-day written notice for non-payment. * Carriers must meet a A.M. Best rating of A- or better. * Subcontractors must carry same limits as listed above. IMPORTANT: POLICY ENDORSEMENTS The Contractor will provide copies of the policies without expense, to the City and all endorsements thereto and may make any reasonable request for deletion, revision, or modification of particular policy terms, conditions, limitations, or exclusions (except where policy provisions are established by law or regulation binding upon either of the parties hereto or the underwriter of any of such policies). Upon such request by the City, the Contractor shall exercise reasonable efforts to accomplish such changes in policy coverages, and shall pay the cost thereof. Any costs will be paid by the Contractor. REQUIRED PROVISIONS The Contractor agrees that with respect to the above required insurance, all insurance contracts and certificate(s) of insurance will contain and state, in writing, on the certificate or its attachment, the following required provisions: a. Name the City of Lubbock and its officers, employees, and elected representatives as additional insureds, (as the interest of each insured may appear) as to all applicable coverage; b. Provide for 30 days notice to the City for cancellation, nonrenewal, or material change; c. Provide for notice to the City at the address shown below by registered mail; d. The Contractor agrees to waive subrogation against the City of Lubbock, its officers, employees, and elected representatives for injuries, including death, property damage, or any other loss to the extent same may be covered by the proceeds of insurance; e. Provide that all provisions of this contract concerning liability, duty, and standard of care together with the indemnification provision, shall be underwritten by contractual liability coverage sufficient to include such obligations within applicable policies. NOTICES The Contractor shall notify the City in the event of any change in coverage and shall give such notices not less than 30 days prior the change, which notice must be accompanied by a replacement CERTIFICATE OF INSURANCE. All notices shall be given to the City at the following address: Marta Alvarez, Director of Purchasing & Contract Management City of Lubbock 1314Avenue K, 9�h Floor Lubbock, Texas 79401 Approval, disapproval, or failure to act by the City regarding any insurance supplied by the Contractor shall not relieve the Contractor of full responsibility or liability for damages and accidents as set forth in the contract documents. Neither shall the bankruptcy, insolvency, or denial of liability by the insurance company exonerate the Contractor from liability. CERTIFICATE OF INTERESTED PARTIES FORnn 1295 lofl Complete Nos.1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and s if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form� and the city, state and couniry of the business entity's place Certificate Number: of business. 2023-1038781 Mindfulness Behavioral Health Services LLC Fulshear, TX United States Date Filed: 2 Name o governmen enCtty or state agency that is a party to e contract r w c e form is 06/26/2023 being filed. City of LubboCk Date Acknowledged: g Provide the idenYfication number used by the govemmentai entity or state agency to track or idenMy the contract, and provide a description of the services, goods, or other property to be provided under the contracG 17194 Substance Abuse Therapy. Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check appiicable) Controlling Intermediary 5 Check only if there is NO Interested Party. � X 6 UNSWORN DECLARATION My name is �t'f ii '+'Q (1(� �,tl J�� , and my date of birth is � � My address is R��laarina,� ► r1 , ��ES �Ql.l r , �, � , V.�7 • � (sUeet) (aty) (state) (zip code) (country) I declare under penalry of pery'ury that the foregoing is Vue and correct. Executed in f'"�'W� C� Q.� � Counry, State of �'eX� s, on the �day of ta r1 , 20�,. (month) (year) Signature of authorized a t of contracting business entiry (Declarant) Forms orovided bv Texas Ethics Commission www.ethics.state.bc.us Version V3.5.1.a18ea2ca CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. i- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. l, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entiry filing form, and the city, state and country of the business entity's place Certificate Number: of business. 2023-1038781 Mindfulness Behavioral Health Services LLC Fulshear, TX United States nate Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/26/2023 being filed. Clty of Lubbock Date Acknowledged: 06/28/2023 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other properry to be provided under the contract. 17194 Substance Abuse Therapy. Nature of interest 4 Name of Interested P Ci State, Count lace of business check a licable �Y tY� rY (P ) ( PP ) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is , and my date of birth is My address is � . . (street) (ciry) (state) (zip code) (country) I declare under penalry of perjury that the foregoing is true and correct. F�cecuted in Counry, State of , on the day of , 20 (month) (year) Signature of authorized agent of contracting business entiry (Declarant) Forms arovided bv Texas Ethics Commission www.ethics.state.bc.us Version V3.5.1.a18ea2ca