HomeMy WebLinkAbout27- Fire CITY OF SAN BERNARDINO-REQUEST FOR COUNCIL ACTIO O R I G I N>A!
From: Michael J. Conrad, Fire Chief Subject: Resolution authorizing the City of San Bernardino
to enter into a new standard agreement with the
Department of Mental Health-Patton State Hospital.
Dept: Fire
Date: April 5, 2010 MC/C Meeting Date: May 3,2010
Synopsis of Previous Council Action:
07/07/08 Resolution #2008-262 authorizing the City of San Bernardino to enter into standard agreements
with the Department of Mental Health-Patton State Hospital.
07/24/06 Resolution #2006-266 authorizing the City of San Bernardino to enter into standard agreements
with the Department of Mental Health-Patton State Hospital.
RECOMMENDATION:
Adopt resolution.
Signature
Contact Person: Mat Fratus Deputy Chief Phone: (909) 384-5286
Supporting data attached: Staff Report,Resolution,and Agreement Ward: City Wide
FUNDING REQUIREMENTS: Amount:
Source: (Acct No.)
(Acct Descriution)
Finance:
Council Notes:
KESO zolo- /Z Z-
Agenda Item No A-
STAFF REPORT
SUBJECT
Resolution authorizing the City of San Bernardino to enter into a new standard agreement
with the Department of Mental Health-Patton State Hospital.
BACKGROUND
The Fire Department responds to emergency medical incidents and renders emergency
medical care and lifesaving measures in accordance with emergency medical standards
established by the San Bernardino County Health Officer. For EMS services rendered, the
City charges a user fee. The City of San Bernardino Municipal Code Chapter 3.72
authorizes the city to charge the EMS user fee to recover costs associated with the delivery
of paramedic services for basic and advanced life support services.
The California Department of Mental Health requires that state mental hospitals enter into
agreements to reimburse local agencies for services provided to patients. The current
agreement expires on June 30, 2010. Therefore, Patton State Hospital, the local care and
treatment facility within our community is required to establish a new agreement with the
City. The agreement will allow Patton State Hospital to reimburse the City for emergency
medical services rendered.
The Fire Department is requesting authorization to enter into a new standard agreement
with the Department of Mental Health-Patton State Hospital to compensate the City for
billable EMS services at their facility. The agreement requires action for the City to receive
compensation for services provided to Patton State Hospital from July 1, 2010 through
June 30, 2012 (attachment A). The agreement outlines mutual expectations, rights and
responsibilities of the Department of Mental Health-Patton State Hospital and the Fire
Department.
FINANCIAL IMPACT
There is no cost to the City to enter into this new standard agreement with the Department
of Mental Health-Patton State Hospital. This will allow Patton State Hospital to
compensate the City for all emergency medical services rendered to their patients. Patton
State Hospital is being billed the current Emergency Medical Service User fee of$200 per
response. This agreement allows Patton State Hospital to reimburse the City the EMS user
fee.
All approved invoices by Patton State Hospital will compensate the City for EMS services
and funds will be deposited into the City's revenue account number 001-000-4880 (EMS
user fee). Agreement number 10-30099 will allow us to receive compensation for billable
services in the amount not-to-exceed$49,999.99 over the 2 year period.
RECOMMENDATION
Adopt resolution.
t
RESOLUTION NO.
1 V
2 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
3 BERNARDINO AUTHORIZING THE CITY OF SAN BERNARDINO TO ENTER
INTO A NEW STANDARD AGREEMENT WITH THE DEPARTMENT OF MENTAL
4 HEALTH-PATTON STATE HOSPITAL.
5 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
6
7 SECTION 1. The City of San Bernardino and the Department of Mental Health-Patton
8 State Hospital wish to enter into a new standard agreement for emergency medical services
9 reimbursement to the City of San Bernardino;
10 SECTION 2. The City Manager or his designee is hereby authorized and directed to
11 execute said agreement, a copy of which is attached and incorporated herein as Attachment A;
12
SECTION 3. The term of the Standard Agreement is from July 1, 2010 through June
13
14 30, 2012;
15 SECTION 4. The authorization to execute the above referenced Agreement is
16 rescinded if it is not executed within one hundred twenty (120) days of the passage of this
17 resolution.
18
19
20
21
22
23
24
25
26
27
28
S-f7- I D
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AUTHORIZING THE CITY OF SAN BERNARDINO TO ENTER
1 INTO A NEW STANDARD AGREEMENT WITH THE DEPARTMENT OF MENTAL
HEALTH-PATTON STATE HOSPITAL.
2
3 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
4
and Common Council of the City of San Bernardino at a meeting thereof,
5
held on the day of , 2010,by the following vote,to wit:
6
7
8 COUNCIL MEMBERS: AYES NAYS ABSTAIN ABSENT
9
10 MARQUEZ
11 DESJARDINS
12 BRINKER
13 SHORETT
14 KELLEY
15 JOHNSON
16
MCCAMMACK
17
18 Rachel G. Clark,City Clerk
19 - City of San Bernardino
20
The foregoing Resolution is hereby approved this day of , 2010.
21
22
23 Patrick J. Morris, Mayor
City of San Bernardino
24
25 Approved as to form:
26 JAMES F. PENMAN,7C'ZtAttomey
27 B
28
2
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213(Rev 06/03) AGREEMENT NUMBER
10-30099
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below.
STATE AGENCYs HOME
California Department of Mental Health—Patton State Hospital
cci,n TIXYe NNME
City of San Bernardino Fire Department
2. The term of this July 1, 2010, or upon PSH approval(whichever occurs later),through June 30, 2012
Agreement is:
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 1 page
Exhibit C—General Terms and Conditions 3 pages
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions(Attached hereto as part of this agreement) 5 pages
❑ Exhibit-D'Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F—Insurance Requirements N/A
Items shown with an Asterisk('),are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at omvw.ols.dgs.ca.gov/Standard+Language
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
CONTRACTOR Calif imia Department of General
Services Use Only
CONTRACTOR'S NAME(if other Nan an indivdual siaf whel/rera core Wn,prtn qi,,et.)
City of San Bernardino Fire Department
BY(AUthadzed Stgplara) DATE SIGNIa)(DO„or yy.l
A5 1
pq@QEQNAMEAND TITLE OF PERSON SIGNING
ADDRESS
200 E.Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCY NAME
California Department of Mental Health—Patton State Hospital
BY(AuNOnzed Stgnature) E SIGNED(Do.,0,)
DAT
AK PRINTED NAME AND TITLE OF PERSON SIGNING ®Exempt per: SCM 94.04.5.b
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
Approved as to Form
James F.Penman,City Attorney
By: f
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213(Rev 06103) AGREEMENT NUMBER
10-30099
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below.
at,ATE AGENCY'S HOME
California Department of Mental Health—Patton State Hospital
C0NTRA70R'S NAME
City of San Bernardino Fire Department
2. The term of this July 1, 2010, or upon PSH approval(whichever occurs later), through June 30, 2012
Agreement is:
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 1 page
Exhibit C—General Terms and Conditions 3 pages
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions(Attached hereto as part of this agreement) 5 pages
❑ Exhibit-D'Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F—Insurance Requirements NIA
Items shown with an Asterisk(), are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at www.ols.dgs.ce.gov/Standard+Language
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
CONTRACTOR California Department of General
Services Use Only
CONTRACTORS NAME(i/oerer Alan an inEnitivdl,state wnelhera corporation,partnership.etc)
City of San Bernardino Fire Department
aY fAulhorizerl Sgna" DATE StGNEDtno....r gyri
AK I
PRINTED NAME AND TITLE OF PERSON SIGNING
ADDRESS
200 E. Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCY NAME
California Department of Mental Health—Patton State Hospital
BY(Aulhmzed Signature) DATE SIGNED(O mttYPe)
PRINTED NAME AND TITLE OF PERSON SIGNING ®Exempt per: SCM 04.04.5.b
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
Approved as to Form
Q
James F.Penman,City Attorney
By:
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213(Rev 06/03) AGREEMENT NUMBER
10-30099
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below.
STATE AGENLYS NOME
California Department of Mental Health—Patton State Hospital
CONTRA ms NAME
City of San Bernardino Fire Department
2. The term of this July 1, 2010, or upon FISH approval(whichever occurs later),through June 30, 2012
Agreement is
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement. -
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 1 page
Exhibit C—General Terms and Conditions 3 pages
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions (Attached hereto as part of this agreement) 5 pages
❑ Exhibit-D'Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F—Insurance Requirements NIA
Items shown with an Asterisk('), are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at www.o1S.dgs.ce gov/Standard+Language
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
CONTRACTOR Callfomla Department of General
Services Use Only
CONTRACTOR'S NAME(itother Man an IndMYual,state wme r. x,,orewn,p nxrie at,)
City of San Bernardino Fire Department
BY(AiA,oraed Sigratim) OATESIGNEDTD--,w)
PRIMED NAME ANO TITLE OF PERSON SIGNING
ADDRESS
200 E. Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCYNAME
California Department of Mental Health—Patton State Hospital
BY(AUMgdred SIgraere) DATE SIGNFD(Do mr ypsl
PRINTED NAME AND TITLE OF PERSON SIGNING ®Exempt per: SCM$4.04.5.b
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
Approved as to Form
James F.Penman,City Attorney
By:
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213(Rev 06103) AGREEMENT NUMBER
1a3oos9
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below.
STATE AGENCYS NAME
California Department of Mental Health—Patton State Hospital
=(TRACTOR'S NAME
City of San Bernardino Fire Department
2. The term of this July 1, 2010, or upon PSH approval(whichever occurs later),through June 30, 2012
Agreement is:
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 1 page
Exhibit C—General Terms and Conditions 3 pages
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions(Attached hereto as part of this agreement) 5 pages
❑ Exhibit-D'Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F—Insurance Requirements N/A
C Items shown with an Asterisk(),are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at www.ols.dgs.cagov/Standard+Language
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
CONTRACTOR California Department of General
Services Use Only
CONTRACTOR'S NAME(ifa'her Nan an individual stale wheltxV-cmrpdaf Periners P,ee.)
City of San Bernardino Fire Department
BY(Aulhwzed Signature) DATE SIGNEDlDo notrypel
A5
W4NIED NAME AND TITLE OF PERSON SIGNING
ADDRESS
200 E. Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCY NAME
California Department of Mental Health—Patton State Hospital
BY(Auth.l Sigtrdfwe) E SIGNED(D mt NW)
JK DAT
PRINTED NAME ANDTITLE OF PERSON SIGNING ®Exempt par: SCM 04.04.51
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
Approved as to Form
James F Penman,City Attorney
By:
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213(Rev 06/03) AGREEMENT NUMBER
10-30099
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below.
arATE AGSNCYS NAME
California Department of Mental Health—Patton State Hospital
CONTRACTOas NAME
City of San Bernardino Fire Department
2. The term of this July 1, 2010, or upon PSH approval (whichever occurs later), through June 30, 2012
Agreement is
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 1 page
Exhibit C—General Terms and Conditions 3 pages
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions(Attached hereto as part of this agreement) 5 pages
❑ Exhibit-D'Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F—Insurance Requirements N/A
Items shown with an Asterisk(*), are hereby incorporated by reference and made pert o/this agreement as if attached hereto.
These documents can be viewed at w .ols.dgs.ce.gov/Standard+Language
IN WITNESS WHEREOF,this Agreementhas been executed bythe parties hereto.
CONTRACTOR California Department of General
Services Use Only
CONTRACTOR'S NAME(ifoeror Man an I ew4 al,state wmimrs corporation,pannership,ek.)
City of San Bernardino Fire Department
BY(Auth.mdSignature) DAIESIGNIEwoaottyp.)
E
PRIMED NAME AND TITLE OF PERSON SIGNING
ADDRESS
200 E. Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCYNAME
California Department of Mental Health—Patton State Hospital
BY(Autorned Signature) DATE SIGNED/).rot ryp,/
1K I
PRINTED NAME AND TITLE OF PERSON SIGNING
Exempt per. SCM*4 04,51
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
Approved as to Forth
James . Penman,City Attorney
By:
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number.Page 1 of
EXHIBIT A
SCOPE OF WORK
Important Disclaimer: This contract shall be of no force or effect pending signature by both parties (State
Agency and Contractor). The Contractor is not to begin work until a contract has been made, all approvals
have been obtained, and the contract has been fully executed. Should work begin before all approvals are
obtained,services will be considered voluntary.
1. City of San Bernardino Fire Department, hereafter referred to as the Contractor, agrees to provide to Patton
State Hospital (PSH) paramedic and Emergency Medical Technician (EMT-1)services.
2. The services shall be performed for Patton State Hospital, 3102 E. Highland Avenue, Patton, CA 92389.
3. The Contractor's professional, technical, and administrative personnel shall provide the necessary covered
services(on-call),twenty-four(24)hours per day,seven(7)days per week
4. The project representative during the term of this agreement will be:
City of San Bernardino
State Agency: Patton State Hospital Contractor: Fire Department
Name: Darryl Brown MSA Name: Bernie Horak
Phone: (909)425-7960 Phone: (909)384-5530
Fax: (909)425-6589 Fax (909)3845281
Direct All Inquiries To:
City of San Bernardino
State Agency: Patton State Hospital Contractor: Fire Department
Section/Unit Contracts Office SectionlUnit: EMS Coordinator
Attention: Annette Calderon Attention: Bernie Horak
3102 E. Highland Avenue 200 E. Third Street
Address: Patton, CA 92369 Address: San Bernardino CA 92410
Phone: (909)425-6888 Phone: (909)3845530
Fax: (909)425-6243 Fax: (909)3845281
5. Contractor shall supply all personnel, labor, tools, supplies, materials, equipment, licenses, permits, insurance,
and a properly equipped service vehicle to provide paramedic and EMT-1 services, on as-needed basis.
A. Contractor shall assist the PSH Medical Staff in providing the highest quality of medical care reasonable
and consistent with available resources.
B. Contractor shall assure that evaluations and documentation meet the requirements and standards set by
Licensing (Title 22) and Joint Commission on Accreditation of Health care Organizations (Joint
Commission)or American Osteopathic Association(AOA) accreditation.
C. Contractor shall assure that qualified personnel will provide paramedic and EMT-1 service. Contractor's
vehicle will arrive with the Advanced Cardiac Life Support (ACLS) and other equipment needed for life-
saving measures.
D. Paramedic services shall be for emergency care to stabilize the patient(Individual)on-site at PSH.
City of San Bernardino Fire Department
California Department of Mental Health Agreement Number: 10-30099
Patton State Hospital Page 2 of 3
E. Upon arrival at a PSH medical emergency, if a PSH physician is already attending and directing emergency
pre, the paramedic shall acquire authorization from the attending physician (on-site) to commence
emergency procedures.
F. The PSH attending physician shall transfer control to Contractor's paramedic at an appropriate point of
care. If there is no PSH physician on-site directing emergency pre when the Contractor's paramedic
reaches the patient (Individual), the Contractor's paramedic shall assume control immediately. PSH staff
shall supply relevant patient medical information to paramedic and EMT-1, as available.
G. Exchange of monitoring equipment(from PSH to Contractor)shall be done at an appropriate time that does
not interfere with medical treatment in progress.
H. Contractor shall respond in a timely manner, to PSH calls, for emergency or non-emergency calls, as
requested and/or as appropriate.
I. Contractor shall provide a liaison for discussion of questions or problems related to cases in which the
Contractor is involved. PSH liaison shall be the Chief Physician and Surgeon or designee.
J. PSH shall provide opportunities for Contractor to participate in drills or practice/mock runs on the hospital's
property, upon Contractor's request or voluntarily if invited by PSH, to enhance readiness for emergency or
disaster response.
K. Contractor shall provide copy of run sheets with invoices, or earlier upon request by PSH, to facilitate a
clinical case review.
L. Mutual Indemnification—Each party, to this contract, shall defend, indemnify, hold free and harmless the
other party, its elected officials, its officers and employees, from and against any and all liability, claims,
losses and demands, including attorney's fees and other reasonable costs incurred in defending any such
claim, whether resulting from court action or otherwise, arising out of the acts, errors or omissions of the
indemnifying party, its employees and/or authorized subcontractors, whether intentional or negligent, in the
performance of this Agreement
M. Self-Insured Status — Contractor is self-insured through the Big Independent Cities Excess Pool Joint
Powers Authority("BICEP") pursuant to Government Code sections 990.8 and 6500, et seq.
N. Contractor shall maintain in effect at all times, during the term of the Agreement, current licenses,
certifications, and permits in accordance with Federal, State, and local government requirements.
O. Contractor shall cooperate with PSH security procedures.
P. Contractor and/or Representatives must present a valid picture identification (e.g., DMV license, CA I.D.
issued by DMV, military card, etc.) in order to be admitted into secured compounds. Contractor and/or
Representative must be in possession of a valid ID at all times while in Secured Compounds.
Q. Contractor and/or Contractors service staff must be prepared to display a list of tools in their possession,
when entering and exiting locked compounds.
R. Contractor is advised that tan, brown, and khaki clothing may prevent entry to patient(Individual) areas of
the hospital.
S. All work shall be coordinated and approved by the Project Coordinator or designee. In the event additional
work is required, Contractor shall provide the Project Coordinator or designee with a written estimate for
review and approval prior to commencing the work.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number 10-30099
Page 1 of 1
EXHIBIT B
BUDGET DETAIL AND PAYMENT PROVISIONS
1. Invoicing and Payment
A. This Agreement must be fully executed and approved by the State before any payments for services can
be made.
B. For services satisfactorily rendered as specified in EXHIBIT 'A', Scope of Work, and upon receipt and
approval of the invoices, the State agrees to compensate the Contractor for actual expenditures incurred in
accordance with the rates specified to Exhibit B, Item 3.
C. Invoices for services to be paid by Patton State Hospital (PSH) must be submitted in duplicate, as specified
in Paragraph B, within forty-five (45) days after services were performed and shall include the PSH
Agreement Number, Patient Name, Date of Services Performed, Description of Services/Procedures
Provided, the Usual and Customary Rate, Itemization of Costs, related CPT codes associated with
services, and Total Amount Due. Invoice(s)shall be submitted in arrears to
Patton State Hospital
ATTN: ACCOUNTING/Accounts Payable
3102 E. Highland Avenue
Patton, CA 92369-0999
D. Prior to invoicing Patton State Hospital, Contractor shall bill Medicare or other third-party insurance within
the specified time frames set by Medicare or other third-party insurance for reimbursement. Statements
and Medicare Explanation of Benefits, which reflect MEDICARE and/or third party payments or denials,
must be submitted with original invoice for payment when invoicing Patton State Hospital for the difference
andlor the remaining balance which is not covered by Medicare.
>.s E. Payment will be made in accordance with, and within the time specified in Government Code Chapter 4.5,
commencing with Section 927.
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under
this Agreement does not appropriate sufficient funds for the program,this Agreement shall be invalid and of
no further force and effect. In this event, the State shall give notice thereof to Contractor, and shall have no
further liability to pay any funds whatsoever to the Contractor or to furnish any other considerations under
this Agreement except for services already performed, and the Contractor shall not be obligated to perform
any provisions of this Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State
shall have the option to either cancel this Agreement with no liability accruing to the State, except for
payment for services already completed, or offer an agreement amendment to the Contractor to reflect the
reduced amount.
3. Budget Detail
DESCRIPTION RATE PER CALL
Fire Engine First Responder $200.00
California Department of Mental Health City of San Bernardino Fire Department
Agreement Number: 10-30099
Patton State Hospital
THIS PAGE HAS BEEN INTENTIONALLY BLANK
California Department of Mental Health City of San Bemardino Fire Department
P Agreement Number Page 1 of 9
Patton State Hospital
Page 1 of 3
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1. APPROVAL: This Agreement is of no force or effect until signed by both parties and approved by the
Department of General Services, if required. Contractor may not commence performance until such approval
has been obtained.
2. AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid unless made in writing,
signed by the parties and approved as required. No oral understanding or Agreement not incorporated in the
Agreement is binding on any of the parties.
3. ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in part, without the
consent of the State in the form of a formal written amendment.
4. AUDIT: Contractor agrees that the awarding department, the Department of General Services, the Bureau of
State Audits, or their designated representative shall have the right to review and to copy any records and
supporting documentation pertaining to the performance of this Agreement. Contractor agrees to maintain such
records for possible audit for a minimum of three(3)years after final payment, unless a longer period of records
retention is stipulated. Contractor agrees to allow the auditor(s) access to such records during normal business
hours and to allow interviews of any employees who might reasonably have information related to such
records. Further, Contractor agrees to include a similar right of the State to audit records and interview staff in
any subcontract related to performance of this Agreement. (Gov. Code§8546.7, Pub. Contract Code§10115 et
seq., CCR Title 2, Section 1896).
5. DISPUTES: Contractor shall continue with the responsibilities under this Agreement during any dispute.
6. TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of any payments
should the Contractor fail to perform the requirements of this Agreement at the time and in the manner herein
provided. In the event of such termination the State may proceed with the work in any manner deemed proper
by the State. All costs to the State shall be deducted from any sum due the Contractor under this Agreement
and the balance, if any, shall be paid to the Contractor upon demand.
7. INDEPENDENT CONTRACTOR:Contractor, and the agents and employees of Contractor, in the performance
of this Agreement, shall act in an independent capacity and not as officers or employees or agents of the State.
8. NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, Contractor and its
subcontractors shall not unlawfully discriminate, harass, or allow harassment against any employee or
applicant for employment because of sex, race, color, ancestry, religious creed, national origin, physical
disability (including HIV and AIDS), mental disability, medical condition (cancer), age (over 40), marital status,
and denial of family pre leave. Contractor and subcontractors shall insure that the evaluation and treatment of
their employees and applicants for employment are free from such discrimination and harassment. Contractor
and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code
§12990 (a-f) et seq.) and the applicable regulations promulgated there under (California Code of Regulations,
Title 2, Section 7285 at seq.). The applicable regulations of the Fair Employment and Housing Commission
implementing Govemment Code Section 12990 (a-f), set forth in Chapter 5 of Division 4 of Title 2 of the
California Code of Regulations, are incorporated into this Agreement by reference and made a part hereof as if
set forth in full. Contractor and its subcontractors shall give written notice of their obligations under this clause
to labor organizations with which they have a collective bargaining or other Agreement.
Contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to
perform work under the Agreement.
9. CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES contained in the document
CCC 307 are hereby incorporated by reference and made a part of this Agreement by this reference as it
attached hereto.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 2 of 3
% TIMELINESS: Time is of the essence in this Agreement.
11. COMPENSATION: The consideration to be paid Contractor, as provided herein, shall be in compensation for all
of Contractor's expenses incurred in the performance hereof, including travel, per diem, and taxes, unless
otherwise expressly so provided.
12. GOVERNING LAW: This contract is governed by and shall be interpreted in accordance with the laws of the
State of California.
13, ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if these services or goods
are obtained by means of a competitive bid, the Contractor shall comply with the requirements of the
Government Codes Sections set out below.
A. The Government Code Chapter on Antitrust claims contains the following definitions:
i. "Public purchase' means a purchase by means of competitive bids of goods, services, or materials
by the State or any of its political subdivisions or public agencies on whose behalf the Attorney
General may bring an action pursuant to subdivision (c) of Section 16750 of the Business and
Professions Code.
ii. "Public purchasing body" means the State or the subdivision or agency making a public purchase.
Government Code Section 4550.
B. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it
will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have
under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2
(commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising
from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to
the bid. Such assignment shall be made and become effective at the time the purchasing body tenders
final payment to the bidder. Government Code Section 4552.
C. If an awarding body or public purchasing body receives, either through judgment or settlement, a
monetary recovery for a cause of action assigned under this chapter, the assignor shall be entitled to
receive reimbursement for actual legal costs incurred and may, upon demand, recover from the public
body any portion of the recovery, including treble damages, attributable to overcharges that were paid by
the assignor but were not paid by the public body as part of the bid price, less the expenses incurred in
obtaining that portion of the recovery. Government Code Section 4553.
D. Upon demand in writing by the assignor, the assignee shall, within one year from such demand, reassign
the cause of action assigned under this part if the assignor has been or may have been injured by the
violation of law for which the cause of action arose and (a)the assignee has not been injured thereby, or
(b) the assignee declines to file a court action for the cause of action. See Government Code Section
4554.
14. CHILD SUPPORT COMPLIANCE ACT: 'For any Agreement in excess of $100,000, the contractor
acknowledges in accordance with Pudic Contract Code 7110,that.
A. The contractor recognizes the importance of child and family support obligations and shall fully comply
with all applicable state and federal laws relating to child and family support enforcement, including, but
not limited to, disclosure of information and compliance with earnings assignment orders, as provided in
Chapter 8(commencing with section 5200)of Part 5 of Division 9 of the Family Code. and
B. The contractor, to the best of its knowledge is fully complying with the earnings assignment orders of all
employees and is providing the names of all new employees to the New Hire Registry maintained by the
California Employment Development Department."
f"`
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Patton State Hospital Agreement Number. 10-30099
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15. UNENFORCEABLE PROVISION. In the event that any provision of this Agreement is unenforceable or held to
be unenforceable, then the parties agree that all other provisions of this Agreement have force and effect and
shall not be affected thereby.
16. PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of $200,000, the
Contractor shall give priority consideration in filling vacancies in positions funded by the Contract to qualified
recipients of aid under Welfare and Institutions Code Section 11200 in accordance with Pub. Contract Code
§10353.
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EXHIBIT D
SPECIAL TERMS AND CONDITIONS
1. SUBCONTRACTS
Except for subcontracts identified in the proposal in accordance with the Request for Proposal or Invitation for
bid, Contractor shall submit any subcontracts which are proposed to be entered into in connection with this
Contract to the State Agency (State)for its prior written approval before entering into the same. No work shall
be subcontracted without the prior written approval of the State. Upon the termination of any subcontract, State
shall be notified immediately. Any subcontract shall include all the terms and conditions of this Contract and its
attachments.
2. PUBLICATIONS AND REPORTS
A. The State reserves the right to use and reproduce all publications, reports, and data produced and
delivered pursuant to this Contract. State further reserves the right to authorize others to use or reproduce
such materials, provided the author of the report is acknowledged in any such use or reproduction.
B. If the publication and/or report are prepared by non-employees of the State, and the total cost for such
preparation exceeds$5,000, the publication and/or report shall contain the numbers and dollar amounts of
all contracts and subcontracts relating to the preparation of the publication and report in a separate section
of the report(Government Code Section 7550).
3. PROGRESS REPORTS
If progress reports are required by the Contract, Contractor shall provide a progress report in writing, or orally if
approved by the State Contract Manager, at least once a month to the State Contract Manager. This progress
report shall include, but not limited to, a statement that the Contractor is or is not on schedule, any pertinent
reports, or interim findings. Contractor shall cooperate with and shall be available to meet with the State to
discuss any difficulties, or special problems, so that solutions or remedies can be developed as soon as
possible.
4. PRESENTATION
Upon request, Contractor shall meet with the State to present any findings, conclusions, and recommendations
required by the Contract for approval. If set forth in the Contract, Contractor shall submit a comprehensive final
report for approval. Both the final meeting and the final report shall be completed on or before the date
indicated in the Contract.
5. DEPARTMENT OF MENTAL HEALTH STAFF
Department of Mental Health staff shall be permitted to work side by side with Contractors staff to the extent
and under conditions as directed by the State Contract Manager. In this connection, Department of Mental
Health staff shall be given access to all data, working papers, etc., which Contractor seeks to utilize.
6. CONFIDENTIALITY OF DATA AND DOCUMENTS
A. Contractor shall not disclose data or documents or disseminate the contents of the final or any preliminary
report without written permission of the State Contract Manager. However, all public entities shall comply
with California Public Records Act (Government Code Sections 6250 et seq.) and the Freedom of
Information Act(Title 5 of the United States Code Section 552), as applicable.
B. Permission to disclose information or documents on one occasion shall not authorize Contractor to further
disclose such information or documents on any other occasions except as otherwise provided in the
Contract or required by law.
C. Contractor shall not comment publicly to the press or any other media regarding the data or documents
generated, collected, or produced in connection with this contract, or the State's actions on the same,
except to the Department of Mental Health staff, Contractors own personnel involved in the performance of
`p this Contract, or as required by law.
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f" D. If requested by State, Contractor shall require each of its employees or officers who will be involved in the
performance of this Contract to agree to the above terms in a form to be approved by State and shall
supply State with evidence thereof.
E. Each subcontract shall contain the foregoing provisions related to the confidentiality of data and
nondisclosure.
F. After any data or documents submitted has become a part of the public records of the State, Contractor
may at its own expense and upon written approval by the State Contract Manager, publish or utilize the
same data or documents but shall include the following Notice:
LEGAL NOTICE
This report was prepared as an account of work sponsored by the Department of Mental Health
(Department), but does not necessarily represent the views of the Department or any of its employees
except to the extent, if any, that it has formally been approved by the Department. For information
regarding any such action, communicate directly with the Department at P.O. Box 952050, Sacramento,
California, 94252-2050. Neither said Department nor the State of California, nor any officer or employee
thereof, or any of its contractors or subcontractors makes any warranty, express or implied, or assumes
any legal liability whatsoever for the contents of this document. Nor does any party represent that use of
the data contained herein, would not infringe upon privately owned rights without obtaining permission or
authorization from any party who has any rights in connection with the data.
7. PROVISIONS RELATING TO DATA
A. "Data" as used in this Contract means recorded information, regardless of form or characteristics, of a
scientific or technical nature. It may, for example, document research, experimental, developmental or
engineering work or be usable or be used to define a design or process; or support a premise or
conclusion asserted in any deliverable document called for by this Contract. The data may be graphic or
pictorial delineations in media, such as drawings or photographs, charts, tables, mathematical modes,
collections or extrapolations of data or information, etc. It may be in machine form, as punched cards,
magnetic tape, computer printouts, or may be retained in computer memory.
B. "Generated data' is that data, which a Contractor has collected, collated, recorded, deduced, read out or
postulated for utilization in the performance of this Contract. Any electronic data processing program,
model or software system developed or substantially modified by the Contractor in the performance of this
Contract at State expense, together with complete documentation thereof, shall be treated in the same
manner as generated data.
C. 'Deliverable data" is that data which under terms of this Contract is required to be delivered to the State.
Such data shall be property of the State.
D. Prior to the expiration of any legally required retention period and before destroying any data, Contractor
shall notify the State of any such contemplated action; and State may within 30 days of said notification
determine whether or not this data shall be further preserved. The State shall pay the expense of further
preserving this data. State shall have unrestricted reasonable access to the data that is preserved in
accordance with this Contract.
E. Contractor shall use best efforts to furnish competent witnesses to identify such competent witnesses to
testify in any court of law regarding data used in or generated under the performance of this Contract.
8. APPROVAL OF PRODUCT
Each product to be approved under this Contract shall be approved by the Contract Manager. The State's
determination as to satisfactory work shall be final absent fraud or mistake.
9. SUBSTITUTIONS
Contractor's key personnel as indicated in its proposal may not be substituted without Contract Manager's prior
written approval.
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Agreement Number. 10-30099
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10. NOTICE
Notice to either party shall be given by first class mail properly addressed, postage fully prepaid,to the address
beneath the name of each respective party. Such notice shall be effective when received as indicated by post
office records or if deemed undeliverable by post office, such notice shall be effective nevertheless 15 days
after mailing. Alternatively, notice may be given by personal delivery by any means whatsoever to the party,
and such notice shall be deemed effective when delivered.
11. WAIVER
No waiver of any breach of this Contract shall be held to be a waiver of any other or subsequent breach. All
remedies afforded in this Contract shall be taken and construed as cumulative,that is, in addition to every other
remedy provided therein or by law. The failure of State to enforce at any time the provisions of this Contract, or
to require at any time performance by the Contractor of any of the provisions, shall in no way be construed to
be a waiver of such provisions not to affect the validity of this Contract or the right of State to enforce said
provisions.
12. GRATUITIES AND CONTINGENCY FEES
The State, by written notice to the Contractor, may terminate the right of Contractor to proceed under this
Contract if it is found, after notice and hearing by the State, that gratuities were offered or given by the
Contractor or any agent or representative of the Contractor to any officer or employee of the State with a view
toward securing a contract or securing favorable treatment with respect to the awarding, amending, or
performing of such contract.
In the event this Contract is terminated as provided in the paragraph above, State shall be entitled (a)to pursue
the same remedies against Contractor as it could pursue in the event of the breach of the Contract by the
Contractor, and (b) as a predetermined amount of liquidated damages, to exemplary damages in an amount
which shall not be less than three times the cost incurred by the Contractor in providing any such gratuities to
any such officer or employee.
The rights and remedies of the State provided in this clause shall not be exclusive and are in addition to any
other rights and remedies provided by law or under this Contract.
The Contractor warrants by execution of this Contract that no person or selling agency has been employed or
retained to solicit or secure this Contract for a commission, percentage, brokerage or contingent fee, excepting
bona fide employees of Contractor, for the purpose of securing business. For breach or violation of this
warranty, the State shall have the right to annul this Contract without liability, paying only for the values of the
work actually returned, or in its discretion to deduct from the contract price or consideration, or otherwise
recover, the full amount of such commission, percentage, brokerage, or contingent fee.
13. INSURANCE
Contractor hereby warrants that they are legally self insured for Workers Compensation and Public Liability.
14. CONTRACT IS COMPLETE
Other than as specified herein, no document or communication passing between the parties hereto shall be
deemed a part of this Contract.
15. CAPTIONS
The clause headings appearing in this Contract have been inserted for the purpose of convenience and ready
reference. They do not purport to and shall not be deemed to define, limit or extend the scope or intent of the
clauses to which they pertain.
16. PUBLIC HEARINGS
If public hearings on the subject matter dealt with in this Contract are held within one year from the contract
expiration date, Contractor shall make available to testify the personnel assigned to this Contract at the hourly
rates specified in the Contractor's proposed budget. State shall reimburse Contractor for travel of said
personnel at the contract rates for such testimony as may be requested by State.
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17. DVBE
Unless specifically waived by the Deputy Director of Administrative Services of the Department, Contractor
shall comply with the Disabled Veteran Business Enterprises participation goal in accordance with the
provisions of Public Contract Code Section 10115 et seq.
18. FORCE MAJEURE
Neither the State nor the Contractor shall be deemed to be in default in the performance of the terms of this
Contract if either party is prevented from performing the terms of this Contract by causes beyond its control,
including without being limited to acts of God; interference, rulings or decision by municipal, Federal, State or
other governmental agencies, boards or commissions; any laws and/or regulations of such municipal, State,
Federal, or other governmental bodies; or any catastrophe resulting from flood, fire, explosion, or other causes
beyond the control of the defaulting party. If any of the stated contingencies occur, the party delayed by force
majeure shall immediately give the other party written notice of the cause of delay. The party delayed by force
majeure shall use reasonable diligence to correct the cause of the delay, if correctable.
19. PERMITS AND LICENSES
The Contractor shall procure and keep in full force and effect during the term of this Contract all permits,
registrations and licenses necessary to accomplish the work specified in this Contract, and give all notices
necessary and incident to the lawful prosecution of the work.
The Contractor shall keep informed of, observe, comply with, and cause all of its agents and employees to
observe and to comply with all prevailing Federal, State, and local laws, and rules and regulations made
pursuant to said Federal, State, and local laws, which in any way affect the conduct of the work of this Contract
If any conflict arises between provisions of the plans and specifications and any such law above referred to,
then the Contractor shall immediately notify the State in writing.
20. LITIGATION
The State, promptly after receiving notice thereof, shall notify the Contractor in writing of the commencement of
any claim, suit, or action against the State or its officers or employees for which the contractor must provide
indemnification under this Contract. The failure of the State to give such notice, information, authorization or
�- assistance shall not relieve the Contractor of its indemnification obligations. The Contractor shall immediately
notify the State of any claim or action against it which affects, or may affect, this Contract, the terms and
conditions hereunder, or the State, and shall take such action with respect to said claim or action which is
consistent with the terms of this Contract and the interest of the State.
21. DISPUTES
Contractor shall first discuss and attempt to resolve any dispute arising under or relating to the performance of
this Contract, which is not disposed of by the Contract, informally with the State Contract Manager. If the
dispute cannot be disposed of at this level, then the dispute shall be decided by the Department of Mental
Health's Deputy Director of Administration. All issues pertaining to this dispute shall be submitted in written
statements and addressed to the Deputy Director of Administration, Department of Mental Health, 1600 9th
Street, Room 101, Sacramento, California 95814. Such written notice must contain the Contract Number. The
decision of the Deputy Director of Administrative Services shall be final and binding to all parties. Within ten
days of receipt of the written grievance report from the Contractor, the Deputy Director of Administration
Director of Administration or his/her designee, the Contractor shall proceed diligently with the performance of
the Contract. Neither the pendency of a dispute, nor its consideration by the Deputy Director of Administration,
shall excuse the Contractor from full and timely performance of the services required in accordance with the
terms of the contract.
22. EVALUATION OF CONTRACTOR'S PERFORMANCE
The Contractors performance under this Contract shall be evaluated by the State after completion of the
contract. A copy of the written evaluation shall be maintained in the contract file and may be submitted to the
Office of Legal Services, Department of General Services.
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Patton State Hospital Agreement Number. 10-30099
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23. CONFIDENTIALITY AND INFORMATION SECURITY PROVISIONS
A. The Contractor shall comply with applicable laws and regulations, including but not limited to Sections
14100.2 and 5328 et seq. of the Welfare and Institutions Code, Section 431.300 et seq. of Title 42, Code of
Federal Regulations, and the Health Insurance Portability and Accountability Act (HIPAA), and its
implementing regulations (including but not limited to Title 45, CFR, Parts 160, 162 and 164) regarding the
confidentiality and security of individually identifiable health information(IIHI).
B. Nondisclosure. Contractor shall not use or disclose confidential, individually identifiable, or sensitive
information other than as permitted or required by the Contract and as permitted or required by law.
24. AUDITS, INSPECTION AND ENFORCEMENT
A. From time to time, the State may inspect the facilities, systems, books and records of Contractor to monitor
compliance with the Contract.
B. Contractor shall promptly remedy any violation of any provision of the Contract and shall certify the same to
the Department Information Security Officer in writing.
C. The fact that the State inspects, or fails to inspect, or has the right to inspect Contractor's facilities,
systems, and procedures does not relieve Contractor of its responsibility to comply with the Contract.
D. The State's failure to detect or the State's detection of any unsatisfactory practices, but failure to notify
Contractor or require Contractors remediation of the unsatisfactory practices does not constitute
acceptance of such practice or a waiver of the State's enforcement rights under the Contract.
25. USE OF STATE FUNDS
Contractor, including its officers and members, shall not use funds received from the Department pursuant to
this contract to support or pay for costs or expenses related to the following:
A. Campaigning or other partisan activities to advocate for either the election or defeat of any candidate for
elective office, or for or against the passage of any proposition or ballot measure, or,
B. Lobbying for either the passage or defeat of any legislation.
This provision is not intended and shall not be construed to limit any expression of a view, opinion, or position
of any member of Contractor as an individual or private citizens, as long as state funds are not used; nor does
this provision limit Contractor from merely reporting the results of a poll or survey of its membership.
Revised:April 2010
California ity of San Bernardino Fire Department
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EXHIBIT E
CONFIDENTIALITY AND INFORMATION SECURITY PROVISIONS
1. Confidentiality and Information Security Provisions
A. The Contractor shall comply with applicable laws and regulations, including but not limited to Sections
14100.2 and 5328 et seq. of the Welfare and Institutions Code, Section 431.300 et seq. of Title 42, Code of
Federal Regulations (CFR), and the Health Insurance Portability and Accountability Act(HIPAA), including
but not limited to Section 1320 d et seq, of Title 42, United States Code and it's implementing regulations
(including but not limited to Title 45, CFR, Parts 160, 162 and 164) regarding the confidentiality and
security of Individually Identifiable Health Information(IIHI).
B. Permitted Uses and Disclosures of IIHI by the Contractor
i. Permitted Uses and Disclosures
Except as otherwise provided in this Agreement, the Contractor, may use or disclose IIHI to perform
functions, activities or services identified in this Agreement provided that such use or disclosure would
not violate federal or state laws or regulations.
ii. Specific Uses and Disclosures Provisions
Except as otherwise indicated in the Agreement, the Contractor may:
a. Use and disclose IIHI for the proper management and administration of the Contractor or to carry
out the legal responsibilities of the Contractor, provided that such use and disclosures are
permitted by law.
b. Use IIHI to provide data aggregation services to DMH. Data aggregation means the combining of
IIHI created or received by the Contractor for the purposes of this contract with IIHI received by
the Contractor in its capacity as the Contractor of another HIPAA covered entity, to permit data
analyses that relate to the health pre operations of DMH.
C. Safeguards
Contractor shall develop and maintain an information privacy and security program that includes the
implementation of administrative, technical, and physical safeguards appropriate to the size and complexity
of the Contractor's operations and the nature and scope of its activities. The information privacy and
security program shall reasonably and appropriately protect the confidentiality, integrity, and availability of
the IIHI that it creates, receives, maintains, or transmits; and prevent the use or disclosure of IIHI other than
as provided for by this Agreement. The Contractor shall provide DMH with information concerning such
safeguards as DMH may reasonably request from time to time.
The Contractor shall implement administrative, technical, and physical safeguards to ensure the security of
DMH information on portable electronic media (e.g., floppy disks and CD-Rom) and in paper files.
Administrative safeguards to be implemented shall include, but are not limited to training, instructions to
employees, and policies and procedures regarding the HIPAA Privacy Rule. Technical safeguards to be
implemented shall include, but are not limited to, role-based access, computer passwords, timing out of
screens, storing laptop computers in a secure location (never leaving the equipment unattended at
workplace, home or in a vehicle)and encryption. Physical safeguards to be implemented shall include, but
are not limited to, locks on file cabinets, door locks, partitions, shredders, and confidential destruct.
0. The Contractor shall implement appropriate authentication methods to ensure information system access to
confidential, personal (e.g., IIHI) or sensitive data is only granted to properly authenticated and authorized
persons. If passwords are used in user authentication (e.g., username/password combination), the
Contractor shall implement strong password controls on all compatible computing systems that are
consistent with the National Institute of Standards and Technology (NIST) Special Publication 80088 and
Cthe SANS Institute Password Protection Policy. The Contractor shall:
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
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L Implement the following security controls on each server, workstation, or portable (e.g., laptop
computer)computing device that processes or stores confidential, personal, or sensitive data:
a. Network-based frewall and/or personal firewall
b. Continuously updated anti-virus software
c. Patch-management process including installation of all operating system/software vendor security
patches
ii. Encrypt all confidential, personal, or sensitive data stored on portable electronic media (including, but
not limited to, CDs and thumb drives) and on portable computing devices(including, but not limited to,
laptop computers, smart phones and PDAs) with a solution that uses proven industry standard
algorithms.
iii. Prior to disposal, sanitize all DMH confidential data contained in hard drives, memory devices,
portable electronic storage devices, mobile computing devices, and networking equipment in a
manner consistent with the National Institute of Standards and Technology (NIST) Special Publication
800-88.
The Contractor shall not transmit confidential, personal, or sensitive data via e-mail or other Internet
transport protocol over a public network unless, at minimum, a 128-bit encryption method (for
example AES, 3DES, or RC4) is used to secure the data.
E. Mitigation of Harmful Effects
Contractor shall mitigate, to the extent practicable, any harmful effect that is known to Contractor of a use
or disclosure of IIHI by Contractor or its subcontractors in violation of the requirements of this Agreement.
F. Notification of Breach
During the term of this Agreement:
I. Discovery of Breach. Contractor shall immediately notify the DMH Information Security Officer by
telephone call plus e-mail upon the discovery of breach of security of IIHI in all forms (paper,
electronic, or oral) if the IIHI was, or is reasonably believed to have been, acquired by an
unauthorized person, or within 24 hours by email or fax of the discovery of any suspected security
incident, intrusion or unauthorized use or disclosure of IIHI in violatiorr of this Agreement, or potential
loss of confidential data affecting this Agreement. If the incident occurs after business hours or on a
weekend or holiday and involves IHII, notification shall be provided by calling the DMH Information
Security Officer. Contractor shall take:
a. Prompt corrective action to mitigate any risks or damages involved with the breach and to protect
the operating environment; and
b. Any action pertaining to such unauthorized disclosure required by applicable Federal and State
laws and regulations.
ii. Investigation of Breach. Contractor shall immediately investigate such security incident, breach, or
unauthorized use or disclosure of IHII or confidential data. Within 72 hours of discovery (of the
breach), Contractor shall notify the DMH Information Security Officer of.
a. What data elements were involved and the extent of the data involved in the breach,
b. A description of the unauthorized persons known or reasonably believed to have improperly used
or disclosed IIHI or confidential data,
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c. A description of where the IIHI or confidential data is believed to have been improperly
transmitted, sent, or utilized,
d. A description of the probable causes of the improper use or disclosure; and
e. Whether Civil Code sections 1798.29 or 1798.82 or any other federal or state laws requiring
individual notifications of breaches are triggered
iii. Written Report
Contractor shall provide a written report of the investigation to the DMH Information Security Officer
within ten (10) working days of the discovery of the breach or unauthorized use or disclosure. The
report shall include, but not be limited to, the information specified above, an estimation of cost for
remediation, as well as a full, detailed corrective action plan, including information on measures that
were taken to halt and/or contain the improper use or disclosure.
iv. Notification of Individuals
Contractor shall notify individuals of the breach or unauthorized use or disclosure when notification is
required under state or federal law and to pay any costs of such notifications, as well as any costs
associated with the breach. Notification shall be made in the most expedient time possible without
reasonable delay. The DMH Information Security Officer shall approve the time, manner and content
of any such notifications.
v. DMH Contact Information
Contractor shall direct communications to the DMH Information Security Officer and the Contractor
shall initiate contact as indicated herein. DMH reserves the right to make changes to the contact
information below by giving written notice to the Contractor. Said changes shall not require an
amendment to this Agreement to which it is incorporated.
Information Security Officer
California Department of Mental Health
1600 9th Street, Room 433
Sacramento, CA 95814
Phone: (916)651-6776
E-mail: ISO @dmh.ca.gov
G. Agents and Subcontractors of the Contractor
Contractor shall ensure that any agent, including a subcontractor to which the Contractor provides IIHI
received from, or created or received by the Contractor under this Agreement, shall comply with the same
restrictions and conditions that apply through this Agreement to the Contractor with respect to such
information.
H. Internal Practices
Contractor shall make Contractors internal practices, books and records relating to the use and disclose of
IIHI received from DMH, or created or received by the Contractor under this Agreement, available to DMH
or to the Secretary of the U.S. Department of Health and Human Services in a time and manner designated
by DMH or by the Secretary, for purposes of determining DMH's compliance with the HIPAA regulations.
I. Employee Training and Discipline
Contractor shall train and use reasonable measures to ensure compliance with the requirements of this
Agreement by employees who assist in the performance of functions or activities under this Agreement and
use or disclose IIHI; and discipline such employees who intentionally violate any provisions of this
Agreement, including by termination of employment.
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J. Effect of Termination
Upon termination or expiration of this Agreement for any reason, Contractor shall return or destroy all IIHI
received from DMH (or created or received by Contractor under this Agreement that Contractor still
maintains in any form, and shall retain no copies of such IIHI or, if return or destruction is not feasible, it
shall continue to extend the protections of this Agreement to such information, and limit further use of such
IIHI to those purposes that make the return or destruction of such IIHI infeasible. This provision shall apply
to IIHI that is in the possession of subcontractors or agents of the Contractor.
K. Miscellaneous Provisions
i. Disclaimer
DMH makes no warranty or representation that compliance by Contractor with this Agreement, HIPAA
or the HIPAA regulations shall be adequate or satisfactory for Contractors own purposes or that any
information in the Contractors possession or control, or transmitted or received by the Contractor, is
or shall be secure from unauthorized use or disclosure. Contractor is solely responsible for all
decisions made by Contractor regarding the safeguarding of IIHI.
ii. Assistance in Litigation or Administrative Proceedings
Each party shall make and use its best efforts to make any subcontractors, employees or agents
assisting the party in the performance of its obligations under this Agreement, available at no cost to
testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being
commenced for claimed violation of HIPAA, the HIPAA regulations or other laws relating to security
and privacy based upon actions or inactions of the party and/or its subcontractor, employee, or agent,
except where the party or its subcontractor, employee, or agent is a named adverse party.
a. No Third-Party Beneficiaries
Nothing expressed or implied in the terms and conditions of this Agreement is intended to
confer, nor shall anything herein confer, upon any person other than DMH or Contractor and
their respective successors or assignees, any rights remedies, obligations or liabilities
whatsoever.
b. Interpretation
The terms and conditions in this Agreement shall be interpreted as broadly as necessary to
implement and comply with HIPAA, the HIPAA regulations and applicable State laws. The
parties agree that any ambiguity in the terms and conditions of this Agreement shall be
resolved in favor of a meaning that complies and is consistent with state and federal law,
including HIPAA and the HIPAA regulations.
c. Regulatory References
A reference in the terms and conditions of this Agreement to a section in the HIPAA regulations
means the section as in effect or as amended.
d. Survival
The respective rights and obligations of Contractor under this Agreement shall survive the
termination or expiration of this Agreement.
2. Violations reported to U.S. Department of Health and Human Services. Upon DMH's knowledge of a material
breach of this Agreement by Contractor, that has not been cured or for which termination of the Agreement is
not feasible, the DMH Information Security Officer shall report the violation to the Secretary of the U.S.
Department of Health and Human Services.
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Patton State Hospital Agreement Number: 10-30099
Page 5 of 5
3. Judicial or Administrative Proceedings. DMH may terminate this Agreement, effective immediately, if (i)
Contractor is found liable in a civil or criminal proceeding for a violation of the HIPAA Privacy or Security Rule
or (ii) a finding or stipulation that the Contractor has violated a privacy or security standard or requirement of
HIPAA, or other security or privacy laws is made in an administrative or civil proceeding in which the Contractor
is a party.
Revised:Mardi 2009
RESOLUTION NO.
1
2 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
3 BERNARDINO AUTHORIZING THE CITY OF SAN BERNARDINO TO ENTER
INTO A NEW STANDARD AGREEMENT WITH THE DEPARTMENT OF MENTAL
4 HEALTH-PATTON STATE HOSPITAL.
5 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
6
7 SECTION 1. The City of San Bernardino and the Department of Mental Health-Patton
g State Hospital wish to enter into a new standard agreement for emergency medical services
9 reimbursement to the City of San Bernardino;
10 SECTION 2. The City Manager or his designee is hereby authorized and directed to
11 execute said agreement, a copy of which is attached and incorporated herein as Attachment A;
12
SECTION 3. The term of the Standard Agreement is from July 1, 2010 through June
13
14 30, 2012;
15 SECTION 4. The authorization to execute the above referenced Agreement is
16 rescinded if it is not executed within one hundred twenty (120) days of the passage of this
17 resolution.
18
19
20
21
22
23
24
25
26
27
28
i
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO AUTHORIZING THE CITY OF SAN BERNARDINO TO ENTER
1 INTO A NEW STANDARD AGREEMENT WITH THE DEPARTMENT OF MENTAL
HEALTH-PATTON STATE HOSPITAL.
2
3 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
4
and Common Council of the City of San Bernardino at a meeting thereof,
5
6 held on the day of , 2010,by the following vote,to wit:
7
8 COUNCIL MEMBERS: AYES NAYS ABSTAIN ABSENT
9
10 MARQUEZ
11 DESJARDINS
12 BRINKER
13 SHORETT
14 KELLEY
15 JOHNSON
16
MCCAMMACK
17
18 Rachel G. Clark, City Clerk
19 City of San Bernardino
20
21 The foregoing Resolution is hereby approved this day of 2010.
22
23 Patrick J. Moms, Mayor
City of San Bernardino
24
25 Approved as to form:
26 JAMES F. PENMAN, City Attorney
27 By.
28
I 2 i
STATE OF CALIFORNIA
STANDARD AGREEMENT _
STD 213(Rev 06/03) AGREEMENT NUMBER
10-30099
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCYS NAME
Department of Mental Health-Patton State Hospital (PSH)
CONTRACTOR'S NAME
City of San Bemardino Fire Department
2. The term of this July 1, 2010, or upon PSH approval, through June 30, 2012
Agreement is:
3. The maximum amount $49,999.99
of this Agreement is: (Forty Nine Thousand, Nine Hundred Ninety Nine Dollars and Ninety Nine Cents)
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A—Scope of Work 3 pages
Exhibit B—Budget Detail and Payment Provisions 2 pages
Exhibit C'—General Terms and Conditions GTC 307
Check mark one item below as Exhibit D:
® Exhibit-D Special Terms and Conditions(Attached hereto as part of this agreement) 6 pages
❑ Exhibit-D`Special Terms and Conditions
Exhibit E—Confidentiality and Information Security Provisions 5 pages
Exhibit F— Insurance Requirements N/A
Exhibit G—Security Regulations 6 pages
Items shown with an Asterisk(), are hereby incorporated by reference and made part of this agreement as IF attached hereto.
These documents can be viewed at w ..ols.dps.ca.pov/Standard+Lanpuape
IN WITNESS WHEREOF,this Agreement has been executed by the parties hereto.
CONTRACTOR California Department of General
Services Use Only
CONTRACTOR'S NAME(F other Man an individual,Nate whether a corporation,partnership,etc.)
City of San Bernardino Fire Department
BY(Authonxd Signal") DATE SIGNED(D,,nor type)
PRINTED NAME AND TITLE OF PERSON SIGNING
ADDRESS
200 E.Third Street
San Bernardino, CA 92410
STATE OF CALIFORNIA
AGENCY NAME
Department of Mental Health-Patton State Hospital
BY(Authorized Signature) DATE SIGNED(Do not type)
AK I
PRINTED NAME AND TILE OF PERSON SIGNING ® Exempt per. SCM#4.04.5.b
Octavio C. Luna, Executive Director
ADDRESS
3102 East Highland Avenue
Patton, CA 92369-0999
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number-, 10-30099
Page 1 of 3
EXHIBIT A
SCOPE OF WORK
Important Disclaimer: This contract shall be of no force or effect pending signature by both parties (State
Agency and Contractor). The Contractor is not to begin work until a contract has been made, all approvals
have been obtained, and the contract has been fully executed. Should work begin before all approvals are
obtained, services will be considered voluntary.
1. City of San Bernardino Fire Department, hereafter referred to as the Contractor, agrees to provide to Patton
State Hospital (PSH)paramedic and Emergency Medical Technician (EMT-1)services as described herein:
2. The services shall be performed for Patton State Hospital, 3102 E. Highland Avenue, Patton, CA 92369.
3. The Contractor's professional, technical, and administrative personnel shall provide the necessary covered
services(on-call),twenty-four(24)hours per day, seven(7)days per week.
4. The project representative during the term of this agreement will be:
City of San Bernardino
State Agency: Patton State Hospital Contractor: Fire Department
Darryl Brown,
Medical Services
Name: Administrator Name: Bernie Horak
Phone: (909)425-7960 Phone: (909) 384-5530
Fax: (909)425-6589 Fax: (909)3845281
Direct All Inquiries To:
City of San Bernardino
State Agency: Patton State Hospital Contractor: Fire Department
Section/Unit Contracts Office Section/Unit: EMS Coordinator
Attention: Annette Calderon Attention: Bernie Horak
Address: 3102 E. Highland Avenue Address: 200 E.Third Street
Patton CA 92369-0999 San Bernardino, CA 92410
Phone: (909)425-6888 Phone: (909) 3845530
Fax: (909)425-6243 Fax: (909) 384-5281
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Scone of Work(continued)
Page 2 of 3
5. Contractor shall supply all personnel, labor, tools, supplies, materials, equipment, licenses, permits, insurance,
and a properly equipped service vehicle to provide paramedic and EMT-1 services, on as-needed basis.
A. Contractor shall assist the PSH Medical Staff in providing the highest quality of medical care reasonable
and consistent with available resources.
B. Contractor shall assure that evaluations and documentation meet the requirements and standards set by
Licensing (Title 22) and Joint Commission on Accreditation of Health care Organizations (Joint
Commission)or American Osteopathic Association (AOA)accreditation.
C. Contractor shall assure that qualified personnel will provide paramedic and EMT-1 service. Contractor's
vehicle will arrive with the Advanced Cardiac Life Support (ACLS) and other equipment needed for life-
saving measures.
D. Paramedic services shall be for emergency care to stabilize the PatienUlndividual on-site at PSH.
E. Upon arrival at a PSH medical emergency, if a PSH physician is already attending and directing emergency
care, the paramedic shall acquire authorization from the attending physician (on-site) to commence
emergency procedures.
F. The PSH attending physician shall transfer control to Contractor's paramedic at an appropriate point of
care. If there is no PSH physician on-site directing emergency care when the Contractor's paramedic
reaches the Patient/individual, the Contractor's paramedic shall assume control immediately. PSH staff
shall supply relevant patient medical information to paramedic and EMT-1, as available.
G. Exchange of monitoring equipment (from PSH to Contractor)shall be done at an appropriate time that does
not interfere with medical treatment in progress.
H. Contractor shall respond in a timely manner, to PSH calls, for emergency or non-emergency calls, as
requested and/or as appropriate.
I. Contractor shall provide a liaison for discussion of questions or problems related to cases in which the
Contractor is involved. PSH liaison shall be the Chief Physician and Surgeon or designee.
J. PSH shall provide opportunities for Contractor to participate in drills or practice/mock runs on the hospital's
property, upon Contractor's request or voluntarily if invited by PSH, to enhance readiness for emergency or
disaster response.
K. Contractor shall provide copy of run sheets with invoices, or earlier upon request by PSH, to facilitate a
clinical case review.
L. Mutual Indemnification — Each party, to this contract, shall defend, indemnify, hold free and harmless the
other party, its elected officials, its officers and employees, from and against any and all liability, claims,
losses and demands, including attorney's fees and other reasonable costs incurred in defending any such
claim, whether resulting from court action or otherwise, arising out of the acts, errors or omissions of the
indemnifying party, its employees and/or authorized subcontractors, whether intentional or negligent, in the
performance of this Agreement.
M. Self-Insured Status — Contractor is self-insured through the Big Independent Cities Excess Pool Joint
Powers Authority ("BICEP")pursuant to Government Code sections 990.8 and 6500, at seq.
N. Contractor shall maintain in effect at all times, during the term of the Agreement, current licenses,
certifications, and permits in accordance with Federal, State, and local government requirements.
O. Contractor shall cooperate with PSH security procedures.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 3 of 3
S000e of Work(continued)
P. Contractor and/or Representatives must present a valid picture identification (e.g., DMV license, CA I.D.
issued by DMV, military card, etc.) in order to be admitted into secured compounds. Contractor and/or
Representative must be in possession of a valid ID at all times while in Secured Compounds.
0. Contractor and/or Contractor's service staff must be prepared to display a list of tools in their possession,
when entering locked compounds.
R. Contractor is advised that tan, brown, and khaki clothing may prevent entry to Patient/Individual areas of
the hospital.
S. All work shall be coordinated and approved by the Project Coordinator or designee. In the event additional
work is required, Contractor shall provide the Project Coordinator or designee with a written estimate for
review and approval prior to commencing the work.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
THIS PAGE IS INTENTIONALLY BLANK
Caltfornia Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 1 of 2
EXHIBIT B
BUDGET DETAIL AND PAYMENT PROVISIONS
1. Invoicino and Payment
A. This Agreement must be fully executed and approved by the State before any payments for services can
be made.
B. For services satisfactorily rendered as specified in EXHIBIT "A", Scope of Work, and upon receipt and
approval of the invoices, the State agrees to compensate the Contractor for actual expenditures incurred in
accordance with the rates specified to Exhibit B, Item 3.
C. Invoices for services to be paid by Patton State Hospital (PSH)must be submitted in duplicate, as specified
in Paragraph B, within forty-five (45) days after services were performed and shall include the PSH
Agreement Number, Patient Name, Date of Services Performed, Description of Services/Procedures
Provided, the Usual and Customary Rate, Itemization of Costs, related CPT codes associated with
services, and Total Amount Due. Invoice(s)shall be submitted in arrears to:
Patton State Hospital
ATTN: ACCOUNTING/Accounts Payable
3102 E. Highland Avenue
Patton, CA 92369-0999
D. Prior to invoicing Patton State Hospital, Contractor shall bill Medicare or other third-party insurance within
the specified time frames set by Medicare or other third-party insurance for reimbursement. Statements
and Medicare Explanation of Benefits, which reflect MEDICARE and/or third party payments or denials,
must be submitted with original invoice for payment when invoicing Patton State Hospital for the difference
and/or the remaining balance which is not covered by Medicare.
E. Payment will be made in accordance with, and within the time specified in Government Code Chapter 4.5,
commencing with Section 927.
F. Amounts to be encumbered for the fiscal years covered by this contract are as follows:
$24,999.99 in FY 2010/11 (07/01/10 to 06/30/11)
$25,000.00 in FY 2011/12(07/01/11 to 06/30112)
G. The above amounts may be adjusted between the fiscal years to cover services rendered for a particular
fiscal year at the sole discretion of the Fiscal Officer at PSH as long as the total amount specified on Page
1, Item#3, is not exceeded.
2. Budget Contingency Clause
A. It'is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under
this Agreement does not appropriate sufficient funds for the program, this Agreement shall be invalid and of
no further force and effect. In this event, the State shall give notice thereof to Contractor, and shall have no
further liability to pay any funds whatsoever to the Contractor or to furnish any other considerations under
this Agreement except for services already performed, and the Contractor shall not be obligated to perform
any provisions of this Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State
shall have the option to either cancel this Agreement with no liability accruing to the State, except for
payment for services already completed, or offer an agreement amendment to the Contractor to reflect the
reduced amount.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
3. Budget Detail Page 2 of 2
DESCRIPTION RATE PER CALL
Fire Engine First Responder $200.00
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 1 of 6
EXHIBIT D
SPECIAL TERMS AND CONDITIONS
1. SUBCONTRACTS: Except for subcontracts Identified in the proposal in accordance with the Request for
Proposal or Invitation for bid, Contractor shall submit any subcontracts which are proposed to be entered into in
connection with this Contract to the State Agency (State) for its prior written approval before entering into the
same. No work shall be subcontracted without the prior written approval of the State. Upon the termination of
any subcontract, State shall be noted immediately. Any subcontract shall include all the terms and conditions
of this Contract and its attachments.
2. PUBLICATIONS AND REPORTS:
A. If a publication and/or report is required under this Contract, Contractor shall:
I. Incorporate any comments or revisions required by the State into any publication or report and shall
not publish any material until it receives final State approval.
ii. Furnish two copies of each publication and report required plus one reproducible original.
iii. Prepare all illustrations, maps and graphs in a manner which allows the complete illustration to be
contained on a single 8-112 by 11 page unless specific written approval is given to the contrary.
iv. Print all graphs, illustrations and printed materials in a single color throughout each publication unless
prior State approval is granted.
v. Place the Contractor's name only on the cover and title page of publications and reports and
summaries. Covers and title pages shall read as follows:
DEPARTMENT OF MENTAL HEALTH
TITLE
By(Contractor)
B. The State reserves the right to use and reproduce all publications, reports, and data produced and
delivered pursuant to this Contract. State further reserves the right to authorize others to use or reproduce
such materials, provided the author of the report is acknowledged in any such use or reproduction.
C. If the publication and/or report are prepared by non-employees of the State, and the total cost for such
preparation exceeds$5,000, the publication and/or report shall contain the numbers and dollar amounts of
all contracts and subcontracts relating to the preparation of the publication and report in a separate section
of the report(Government Code Section 7550).
3. PROGRESS REPORTS: If progress reports are required by the Contract, Contractor shall provide a progress
report in writing, or orally if approved by the State Contract Manager, at least once a month to the State
Contract Manager. This progress report shall include, but not limited to, a statement that the Contractor is or is
not on schedule, any pertinent reports, or interim findings. Contractor shall cooperate with and shall be
available to meet with the State to discuss any difficulties, or special problems, so that solutions or remedies
can be developed as soon as possible.
4. PRESENTATION: Upon request, Contractor shall meet with the State to present any findings, conclusions, and
recommendations required by the Contract for approval. If set forth in the Contract, Contractor shall submit a
comprehensive final report for approval. Both the final meeting and the final report shall be completed on or
before the date indicated in the Contract.
5. DEPARTMENT OF MENTAL HEALTH STAFF: Department of Mental Health staff shall be permitted to work
side by side with Contractor's staff to the extent and under conditions as directed by the State Contract
Manager. In this connection, Department of Mental Health staff shall be given access to all data, working
papers, etc.,which Contractor seeks to utilize.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number. 10-30099
Page 2 of 6
6. CONFIDENTIALITY OF DATA AND DOCUMENTS:
A. Contractor shall not disclose data or documents or disseminate the contents of the final or any preliminary
report without written permission of the State Contract Manager. However, all public entities shall comply
with California Public Records Act (Government Code Sections 6250 at seq.) and the Freedom of
Information Act(Title 5 of the United States Code Section 552), as applicable.
B. Permission to disclose information or documents on one occasion shall not authorize Contractor to further
disclose such information or documents on any other occasions except as otherwise provided in the
Contract or required by law.
C. Contractor shall not comment publicly to the press or any other media regarding the data or documents
generated, collected, or produced in connection with this contract, or the State's actions on the same,
except to the Department of Mental Health staff, Contractor's own personnel involved in the performance of
this Contract, or as required by law.
D. If requested by State, Contractor shall require each of its employees or officers who will be involved in the
performance of this Contract to agree to the above terms in a form to be approved by State and shall
supply State with evidence thereof.
E. Each subcontract shall contain the foregoing provisions related to the confidentiality of data and
nondisclosure.
F. After any data or documents submitted has become a part of the public records of the State, Contractor
may at its own expense and upon written approval by the State Contract Manager, publish or utilize the
same data or documents but shall include the following Notice:
LEGAL NOTICE
This report was prepared as an account of work sponsored by the Department of Mental Health
(Department), but does not necessarily represent the views of the Department or any of its employees
except to the extent, if any, that it has formally been approved by the Department. For information
regarding any such action, communicate directly with the Department at P.O. Box 952050, Sacramento,
California, 94252-2050. Neither said Department nor the State of California, nor any officer or employee
thereof, or any of its contractors or subcontractors makes any warranty, express or implied, or assumes
any legal liability whatsoever for the contents of this document. Nor does any party represent that use of
the data contained herein, would not infringe upon privately owned rights without obtaining permission or
authorization from any party who has any rights in connection with the data.
7. PROVISIONS RELATING TO DATA:
A. "Data" as used in this Contract means recorded information, regardless of form or characteristics, of a
scientific or technical nature. It may, for example, document research, experimental, developmental or
engineering work; or be usable or be used to define a design or process; or support a premise or
conclusion asserted in any deliverable document called for by this Contract. The data may be graphic or
pictorial delineations in media, such as drawings or photographs, charts, tables, mathematical modes,
collections or extrapolations of data or information, etc. It may be in machine form, as punched cards,
magnetic tape, computer printouts, or may be retained in computer memory.
B. "Generated data" is that data, which a Contractor has collected, collated, recorded, deduced, read out or
postulated for utilization in the performance of this Contract. Any electronic data processing program,
model or software system developed or substantially modified by the Contractor in the performance of this
Contract at State expense, together with complete documentation thereof, shall be treated in the same
manner as generated data.
C. "Deliverable data" is that data which under terms of this Contract is required to be delivered to the State.
Such data shall be property of the State.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 3 of 6
D. Prior to the expiration of any legally required retention period and before destroying any data, Contractor
shall notify the State of any such contemplated action; and State may within 30 days of said notification
determine whether or not this data shall be further preserved. The State shall pay the expense of further
preserving this data. State shall have unrestricted reasonable access to the data that is preserved in
accordance with this Contract.
E. Contractor shall use best efforts to furnish competent witnesses to identify such competent witnesses to
testify in any court of law regarding data used in or generated under the performance of this Contract.
8. APPROVAL OF PRODUCT: Each product to be approved under this Contract shall be approved by the
Contract Manager. The State's determination as to satisfactory work shall be final absent fraud or mistake.
9. SUBSTITUTIONS: Contractor's key personnel as indicated in its proposal may not be substituted without
Contract Manager's prior written approval.
10. NOTICE: Notice to either party shall be given by first class mail properly addressed, postage fully prepaid, to
the address beneath the name of each respective party. Such notice shall be effective when received as
indicated by post office records or if deemed undeliverable by post office, such notice shall be effective
nevertheless 15 days after mailing. Alternatively, notice may be given by personal delivery by any means
whatsoever to the party, and such notice shall be deemed effective when delivered.
11. WAIVER: No waiver of any breach of this Contract shall be held to be a waiver of any other or subsequent
breach. All remedies afforded in this Contract shall be taken and construed as cumulative;that is, in addition to
every other remedy provided therein or by law. The failure of State to enforce at any time the provisions of this
Contract, or to require at any time performance by the Contractor of any of the provisions, shall in no way be
construed to be a waiver of such provisions not to affect the validity of this Contract or the right of State to
enforce said provisions.
12. GRATUITIES AND CONTINGENCY FEES: The State, by written notice to the Contractor, may terminate the
right of Contractor to proceed under this Contract if it is found, after notice and hearing by the State, that
gratuities were offered or given by the Contractor or any agent or representative of the Contractor to any officer
or employee of the State with a view toward securing a contract or securing favorable treatment with respect to
the awarding, amending, or performing of such contract.
In the event this Contract is terminated as provided in the paragraph above, State shall be entitled (a)to pursue
the same remedies against Contractor as it could pursue in the event of the breach of the Contract by the
Contractor, and (b) as a predetermined amount of liquidated damages, to exemplary damages in an amount
which shall not be less than three times the cost incurred by the Contractor in providing any such gratuities to
any such officer or employee.
The rights and remedies of the State provided in this clause shall not be exclusive and are in addition to any
other rights and remedies provided by law or under this Contract.
The Contractor warrants by execution of this Contract that no person or selling agency has been employed or
retained to solicit or secure this Contract upon a Contract or understanding for a commission, percentage,
brokerage or contingent fee, excepting bona fide employees of Contractor, for the purpose of securing
business. For breach or violation of this warranty, the State shall have the right to annul this Contract without
liability, paying only for the values of the work actually returned, or in its discretion to deduct from the contract
price or consideration, or otherwise recover, the full amount of such commission, percentage, brokerage, or
contingent fee.
13. INSURANCE: Contractor hereby warrants that it carries and shall maintain in full force and effect during the full
term of this contract and any extensions to said term:
Sufficient and adequate Worker's Compensation Insurance for all of its employees who shall be engaged in the
performance of this Contract and agrees to furnish to State satisfactory evidence thereof at any time the State
may request the same; and
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital - Agreement Number: 10-30099
Page 4 of 6
Sufficient and adequate Liability Insurance to cover any and all potential liabilities and agrees to furnish to State
satisfactory evidence thereof upon request by State.
14. CONTRACT IS COMPLETE: Other than as specified herein, no document or communication passing between
the parties hereto shall be deemed a part of this Contract.
15. CAPTIONS: The clause headings appearing in this Contract have been inserted for the purpose of
convenience and ready reference. They do not purport to and shall not be deemed to define, limit or extend the
scope or intent of the clauses to which they pertain.
16. PUBLIC HEARINGS: If public hearings on the subject matter dealt with in this Contract are held within one year
from the contract expiration date, Contractor shall make available to testify the personnel assigned to this
Contract at the hourly rates specified in the Contractor's proposed budget. State shall reimburse Contractor for
travel of said personnel at the contract rates for such testimony as may be requested by State.
17. DVBE: Unless specifically waived by the Deputy Director of Administrative Services of the Department,
Contractor shall comply with the Disabled Veteran Business Enterprises participation goal in accordance with
the provisions of Public Contract Code Section 10115 at seq.
18. FORCE MAJEURE: Neither the State nor the Contractor shall be deemed to be in default in the performance
of the terms of this Contract if either party is prevented from performing the terms of this Contract by causes
beyond its control, including without being limited to: acts of God; interference, rulings or decision by municipal,
Federal, State or other governmental agencies, boards or commissions; any laws and/or regulations of such
municipal, State, Federal, or other governmental bodies;or any catastrophe resulting from flood,fire, explosion,
or other causes beyond the control of the defaulting party. If any of the stated contingencies occur, the party
delayed by force majeure shall immediately give the other party written notice of the cause of delay. The party
delayed by force majeure shall use reasonable diligence to correct the cause of the delay, if correctable.
19. PERMITS AND LICENSES: The Contractor shall procure and keep in full force and effect during the term of
this Contract all permits, registrations and licenses necessary to accomplish the work specified in this Contract,
and give all notices necessary and incident to the lawful prosecution of the work.
The Contractor shall keep informed of, observe, comply with, and cause all of its agents and employees to
observe and to comply with all prevailing Federal, State, and local laws, and rules and regulations made
pursuant to said Federal, State, and local laws,which in any way affect the conduct of the work of this Contract.
If any conflict arises between provisions of the plans and specifications and any such law above referred to,
then the Contractor shall immediately notify the State in writing.
20. LITIGATION: The State, promptly after receiving notice thereof, shall notify the Contractor in writing of the
commencement of any claim, suit, or action against the State or its officers or employees for which the
contractor must provide indemnification under this Contract. The failure of the State to give such notice,
information, authorization or assistance shall not relieve the Contractor of its indemnification obligations. The
Contractor shall immediately notify the State of any claim or action against it which affects, or may affect, this
Contract,the terms and conditions hereunder, or the State, and shall take such action with respect to said claim
or action which is consistent with the terms of this Contract and the interest of the State.
21. DISPUTES: Contractor shall first discuss and attempt to resolve any dispute arising under or relating to the
performance of this Contract, which is not disposed of by the Contract, informally with the State Contract
Manager. If the dispute cannot be disposed of at this level, then the dispute shall be decided by the
Department of Mental Health's Deputy Director of Administration. All issues pertaining to this dispute shall be
submitted in written statements and addressed to the Deputy Director of Administration, Department of Mental
Health, 1600 9th Street, Room 150, Sacramento, California 95814. Such written notice must contain the
Contract Number. The decision of the Deputy Director of Administrative Services shall be final and binding to
all parties. Within ten days of receipt of the written grievance report from the Contractor, the Deputy Director of
Administration Director of Administration or his/her designee, the Contractor shall proceed diligently with the
performance of the Contract. Neither the pendency of a dispute, nor its consideration by the Deputy Director of
Administration, shall excuse the Contractor from full and timely performance of the services required in
accordance with the terms of the contract.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 5 of 6
Notwithstanding any other provisions of this Contract, after recourse to the procedure set forth in the paragraph
above, any controversy or claim arising out of or relating to this Contract or breach thereof shall be settled by
arbitration at the election of either party in accordance with California Public Contract Code Section 10240 et.
seq. and judgment upon the award rendered by the arbitration may be entered in any court having jurisdiction
thereof.
22. EVALUATION OF CONTRACTOR'S PERFORMANCE: The Contractor's performance under this Contract shall
be evaluated by the State after completion of the contract. A copy of the written evaluation shall be maintained
in the contract file and may be submitted to the Office of Legal Services, Department of General Services.
23. TRAVEL: Contractor's headquarters for purposes of payment of travel shall be the city designated in the
signature block unless otherwise specified in the contract.
For travel necessary to the performance of this Contract, contractor shall use and submit travel reimbursement
forms provided by the Department. All reimbursements shall be made in accordance with, and shall not exceed
the rates authorized by, the State Administrative Manual and the Policies and Procedures of the Department.
All requests to exceed any base reimbursement rate established in the State Administrative Manual or the
Policies and Procedures of the Department must be made and approved prior to the date of travel and must be
submitted in writing to the State's Contract Manager.
24. TERMINATION: The Department may terminate this contract by giving 30 days written notice to the contractor.
The notice of termination shall specify the effective date of termination.
Upon the Contractor's receipt of notice of termination from the State, and except as otherwise directed in the
notice,the Contractor shall:
A. Stop work on the date specified in the notice.
B. Place no further orders or enter into any further subcontracts for materials, services or facilities except as
necessary to complete work under the Contract up to effective date of termination.
C. Terminate all orders and subcontracts;
D. Promptly take all other reasonable and feasible steps to minimize any additional cost, loss, or expenditure
associated with work terminated, including, but not limited to reasonable settlement of all outstanding
liability and claims arising out of termination of orders and subcontracts;
E. Deliver or make available to the Department all data, drawings, specifications, reports, estimates,
summaries, and such other information and materials as may have been accumulated by the Contractor
under this Contract, whether completed, partially completed, or in progress. _
In the event of termination, an equitable adjustment in the price provided for this Contract shall be made.
Such adjustment shall include reasonable compensation for all services rendered, materials supplies, and
expenses incurred pursuant to this Contract prior to the effective date of termination.
25. CONFIDENTIALITY AND INFORMATION SECURITY PROVISIONS:
A. The Contractor shall comply with applicable laws and regulations, including but not limited to Sections
14100.2 and 5328 at seq. of the Welfare and Institutions Code, Section 431.300 at seq. of Title 42, Code of
Federal Regulations, and the Health Insurance Portability and Accountability Act (HIPAA), and it's
implementing regulations (including but not limited to Title 45, CFR, Parts 160, 162 and 164) regarding the
confidentiality and security of individually identifiable health information (IIHI).
B. Nondisclosure
Contractor shall not use or disclose confidential, individually identifiable, or sensitive information other than
as permitted or required by the Contract and as required by law.
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Patton State Hospital Agreement Number: 10-30099
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26. AUDITS, INSPECTION AND ENFORCEMENT:
A. From time to time, the State may inspect the facilities, systems, books and records of Contractor to monitor
compliance with the Contract.
B. Contractor shall promptly remedy any violation of any provision of the Contract and shall certify the same to
the Department Information Security Officer in writing.
C. The fact that the State inspects, or fails to inspect, or has the right to inspect Contractor's facilities,
systems, and procedures does not relieve Contractor of its responsibility to comply with the Contract.
D. The State's failure to detect or the State's detection of any unsatisfactory practices, but failure to notify
Contractor or require Contractor's remediation of the unsatisfactory practices does not constitute
acceptance of such practice or a waiver of the State's enforcement rights under the Contract.
27. USE OF STATE FUNDS: Contractor, including its officers and members, shall not use funds received from the
Department pursuant to this contract to support or pay for costs or expenses related to the following:
A. Campaigning or other partisan activities to advocate for either the election or defeat of any candidate for
elective office, or for or against the passage of any proposition or ballot measure; or,
B. Lobbying for either the passage or defeat of any legislation.
This provision is not intended and shall not be construed to limit any expression of a view, opinion, or
position of any member of Contractor as an individual or private citizens, as long as state funds are not
used; nor does this provision limit Contractor from merely reporting the results of a poll or survey of its
membership.
28. DRUG-FREE WORKPLACE CERTIFICATION: Contractor shall comply with the requirements of the Drug-Free
Workplace Act of 1990(Government Code Section 8350 at seq.)and shall provide a dug-free workplace.
29. CONFLICT OF INTEREST CERTIFICATION: In accordance with State laws and Departmental policy, no
employees (including contractors) shall participate in incompatible activities, which are in conflict with their job
duties. In addition, State law requires employees whose positions are designated in the Department's Conflict
of Interest Code to file statements of economic interest. Employees whose positions have been designated will
be notified by the Department if a statement is required.
In signing this contract, I certify that I have read and understand GOVERNMENT CODE 19990.
Revised:January 2010
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
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EXHIBIT E
CONFIDENTIALITY AND INFORMATION SECURITY PROVISIONS
1. Confidentiality and Information Security Provisions
A. The Contractor shall comply with applicable laws and regulations, including but not limited to Sections
14100.2 and 5328 et seq. of the Welfare and Institutions Code, Section 431.300 et seq. of Title 42, Code of
Federal Regulations (CFR), and the Health Insurance Portability and Accountability Act (HIPAA), including
but not limited to Section 1320 d et seq, of Title 42, United States Code and it's implementing regulations
(including but not limited to Title 45, CFR, Parts 160, 162 and 164) regarding the confidentiality and
security of Individually Identifiable Health Information (IIHI).
B. Permitted Uses and Disclosures of IIHI by the Contractor
i. Permitted Uses and Disclosures
Except as otherwise provided in this Agreement, the Contractor, may use or disclose IIHI to perform
functions, activities or services identified in this Agreement provided that such use or disclosure would
not violate federal or state laws or regulations.
ii. Specific Uses and Disclosures Provisions
Except as otherwise indicated in the Agreement, the Contractor may:
a. Use and disclose IIHI for the proper management and administration of the Contractor or to carry
out the legal responsibilities of the Contractor, provided that such use and disclosures are
permitted by law.
b. Use IIHI to provide data aggregation services to DMH. Data aggregation means the combining of
IIHI created or received by the Contractor for the purposes of this contract with IIHI received by
the Contractor in its capacity as the Contractor of another HIPAA covered entity, to permit data
analyses that relate to the health care operations of DMH.
C. Safeguards
Contractor shall develop and maintain an information privacy and security program that includes the
implementation of administrative, technical, and physical safeguards appropriate to the size and complexity
of the Contractor's operations and the nature and scope of its activities. The information privacy and
security program shall reasonably and appropriately protect the confidentiality, integrity, and availability of
the IIHI that it creates, receives, maintains, or transmits; and prevent the use or disclosure of IIHI other than
as provided for by this Agreement. The Contractor shall provide DMH with information concerning such
safeguards as DMH may reasonably request from time to time.
The Contractor shall implement administrative, technical, and physical safeguards to ensure the security of
DMH information on portable electronic media (e.g., floppy disks and CD-Rom) and in paper files.
Administrative safeguards to be implemented shall include, but are not limited to training, instructions to
employees, and policies and procedures regarding the HIPAA Privacy Rule. Technical safeguards to be
implemented shall include, but are not limited to, role-based access, computer passwords, timing out of
screens, storing laptop computers in a secure location (never leaving the equipment unattended at
workplace, home or in a vehicle)and encryption. Physical safeguards to be implemented shall include, but
are not limited to, locks on file cabinets, door locks, partitions, shredders, and confidential destruct.
D. The Contractor shall implement appropriate authentication methods to ensure information system access to
confidential, personal (e.g., IIHI) or sensitive data is only granted to properly authenticated and authorized
persons. If passwords are used in user authentication (e.g., usemame/password combination), the
Contractor shall implement strong password controls on all compatible computing systems that are
consistent with the National Institute of Standards and Technology (NIST) Special Publication 800-68 and
the SANS Institute Password Protection Policy. The Contractor shall:
California Department of Mental Health City of San Bernardino Fire Department'
Patton State Hospital Agreement Number: 10-30099
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L Implement the following security controls on each server, workstation, or portable (e.g., laptop
computer)computing device that processes or stores confidential, personal, or sensitive data:
a. Network-based firewall and/or personal firewall
b. Continuously updated anti-virus software
c. Patch-management process including installation of all operating system/software vendor security
patches
ii. Encrypt all confidential, personal, or sensitive data stored on portable electronic media (including, but
not limited to, CDs and thumb drives)and on portable computing devices(including, but not limited to,
laptop computers, smart phones and PDAs) with a solution that uses proven industry standard
algorithms.
iii. Prior to disposal, sanitize all DMH confidential data contained in hard drives, memory devices,
portable electronic storage devices, mobile computing devices, and networking equipment in a
manner consistent with the National Institute of Standards and Technology(NIST)Special Publication
800-88.
The Contractor shall not transmit confidential, personal, or sensitive data via e-mail or other Internet
transport protocol over a public network unless, at minimum, a 128-bit encryption method (for
example AES, 3DES, or RC4) is used to secure the data.
E. Mitigation of Harmful Effects
Contractor shall mitigate, to the extent practicable, any harmful effect that is known to Contractor of a use
or disclosure of IIHI by Contractor or its subcontractors in violation of the requirements of this Agreement.
F. Notification of Breach
During the term of this Agreement:
L Discovery of Breach. Contractor shall immediately notify the DMH Information Security Officer by
telephone call plus e-mail upon the discovery of breach of security of IIHI in all forms (paper,
electronic, or oral) if the IIHI was, or is reasonably believed to have been, acquired by an
unauthorized person, or within 24 hours by email or fax of the discovery of any suspected security
incident, intrusion or unauthorized use or disclosure of IIHI in violation of this Agreement, or potential
loss of confidential data affecting this Agreement. If the incident occurs after business hours or on a
weekend or holiday and involves IHII, notification shall be provided by calling the DMH Information
Security Officer. Contractor shall take:
a. Prompt corrective action to mitigate any risks or damages involved with the breach and to protect
the operating environment; and
b. Any action pertaining to such unauthorized disclosure required by applicable Federal and State
laws and regulations.
ii. Investigation of Breach. Contractor shall immediately investigate such security incident, breach, or
unauthorized use or disclosure of IHII or confidential data. Within 72 hours of discovery (of the
breach), Contractor shall notify the DMH Information Security Officer of:
a. What data elements were involved and the extent of the data involved in the breach,
b. A description of the unauthorized persons known or reasonably believed to have improperly used
or disclosed IIHI or confidential data,
California Department of Mental Health City of San Bernardino Fire Department
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c. A description of where the IIHI or confidential data is believed to have been improperly
transmitted, sent, or utilized,
d. A description of the probable causes of the improper use or disclosure; and
e. Whether Civil Code sections 1798.29 or 1798.82 or any other federal or state laws requiring
individual notifications of breaches are triggered
iii. Written Report
Contractor shall provide a written report of the investigation to the DMH Information Security Officer
within ten (10) working days of the discovery of the breach or unauthorized use or disclosure. The
report shall include, but not be limited to, the information specified above, an estimation of cost for
remediation, as well as a full, detailed corrective action plan, including information on measures that
were taken to halt and/or contain the improper use or disclosure.
iv. Notification of Individuals
Contractor shall notify individuals of the breach or unauthorized use or disclosure when notification is
required under state or federal law and to pay any costs of such notifications, as well as any costs
associated with the breach. Notification shall be made in the most expedient time possible without
reasonable delay. The DMH Information Security Officer shall approve the time, manner and content
of any such notifications.
v. DMH Contact Information
Contractor shall direct communications to the DMH Information Security Officer and the Contractor
shall initiate contact as indicated herein. DMH reserves the right to make changes to the contact
information below by giving written notice to the Contractor. Said changes shall not require an
amendment to this Agreement to which it is incorporated.
Information Security Officer
California Department of Mental Health
1600 9th Street, Room 433
Sacramento, CA 95814
Phone: (916)651-6776
E-mail: ISO @dmh.ca.gov
G. Agents and Subcontractors of the Contractor
Contractor shall ensure that any agent, including a subcontractor to which the Contractor provides IIHI
received from, or created or received by the Contractor under this Agreement, shall comply with the same
restrictions and conditions that apply through this Agreement to the Contractor with respect to such
information.
H. Internal Practices
Contractor shall make Contractor's internal practices, books and records relating to the use and disclose of
IIHI received from DMH, or created or received by the Contractor under this Agreement, available to DMH
or to the Secretary of the U.S. Department of Health and Human Services in a time and manner designated
by DMH or by the Secretary,for purposes of determining DMH's compliance with the HIPAA regulations.
I. Employee Training and Discipline
Contractor shall train and use reasonable measures to ensure compliance with the requirements of this
Agreement by employees who assist in the performance of functions or activities under this Agreement and
use or disclose IIHI; and discipline such employees who intentionally violate any provisions of this
Agreement, including by termination of employment.
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Patton State Hospital Agreement Number: 10-30099
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J. Effect of Termination
Upon termination or expiration of this Agreement for any reason, Contractor shall return or destroy all IIHI
received from DMH (or created or received by Contractor under this Agreement that Contractor still
maintains in any form, and shall retain no copies of such IIHI or, If return or destruction is not feasible, it
shall continue to extend the protections of this Agreement to such information, and limit further use of such
IIHI to those purposes that make the return or destruction of such IIHI infeasible. This provision shall apply
to IIHI that is in the possession of subcontractors or agents of the Contractor.
K. Miscellaneous Provisions
I. Disclaimer
DMH makes no warranty or representation that compliance by Contractor with this Agreement, HIPAA
or the HIPAA regulations shall be adequate or satisfactory for Contractor's own purposes or that any
information in the Contractor's possession or control, or transmitted or received by the Contractor, is
or shall be secure from unauthorized use or disclosure. Contractor is solely responsible for all
decisions made by Contractor regarding the safeguarding of IIHI.
ii. Assistance in Litigation or Administrative Proceedings
Contractor shall make itself,and use its best efforts to make any subcontractors, employees or agents
assisting Contractor in the performance of its obligations under this Agreement, available to DMH at
no cost to DMH to testify as witnesses, or otherwise, in the event of litigation or administrative
proceedings being commenced against DMH, its directors, officers or employees for claimed violation
of HIPAA, the HIPAA regulations or other laws relating to security and privacy based upon actions or
inactions of the Contractor and/or its subcontractor, employee, or agent, except where Contractor or
its subcontractor, employee, or agent is a named adverse party.
a-. No Third-Party Beneficiaries
Nothing expressed or implied in the terms and conditions of this Agreement is intended to confer,
nor shall anything herein confer, upon any person other than DMH or Contractor and their
respective successors or assignees, any rights remedies, obligations or liabilities whatsoever.
b. Interpretation
The terms and conditions in this Agreement shall be interpreted as broadly as necessary to
implement and comply with HIPAA, the HIPAA regulations and applicable State laws. The parties
agree that any ambiguity in the terms and conditions of this Agreement shall be resolved in favor
of a meaning that complies and is consistent with state and federal law, including HIPAA and the
HIPAA regulations.
c. Regulatory References
A reference in the terms and conditions of this Agreement to a section in the HIPAA regulations
means the section as in effect or as amended.
d. Survival
The respective rights and obligations of Contractor under this Agreement shall survive the
termination or expiration of this Agreement.
2. Violations reported to U.S. Department of Health and Human Services. Upon DMH's knowledge of a material
breach of this Agreement by Contractor, that has not been cured or for which termination of the Agreement is
not feasible, the DMH Information Security Officer shall report the violation to the Secretary of the U.S.
Department of Health and Human Services.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
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3. Judicial or Administrative Proceedings. DMH may terminate this Agreement, effective immediately, if (i)
Contractor is found liable in a civil or criminal proceeding for a violation of the HIPAA Privacy or Security Rule
or (ii) a finding or stipulation that the Contractor has violated a privacy or security standard or requirement of
HIPAA, or other security or privacy laws is made in an administrative or civil proceeding in which the Contractor
is a party.
Revised:March 2009
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
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California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 1 of 6
EXHIBIT G
SECURITY REGULATIONS
TO: Independent Service Providers
Contractors
Vendors
FROM: Ed Halsell, Chief of Plant Operations III
The following items are of great importance to Patton State Hospital(PSH)and are summarized for your convenience.
Patton State Hospital has abnormal site conditions and these administrative directives(A.D.'s)must be strictly adhered
to.
The following, A.D. # 4.26 "Clothing and Grooming Standards", should be in the same paragraph that contains
information about the Mandatory Site Inspection, as it describes the type of clothing that shall not be worn, if a
contractor/vendor/or visitor is to visit behind the secured compound. In this scenario,the contractors/vendors will have to
go behind the secured compounds.
Another A.D. that must be in the same paragraph as the information about the Mandatory Site Inspection is #6.08
"Access Control". Anyone going behind the secured compound must have legal picture identification, such as driver's
license, military card, state identification, etc.
Should you have any questions or would like detailed copies of the Patton State Hospital Administrative Directives,
please contact the Patton's Contract Office at(909)4257931.
1. A.D. 1.08—Administrative Rules for Employees
PSH does not allow cellular telephones with camera capabilities.These types of phones are considered cameras,
which are not allowed on the hospital grounds without the Executive Director and/or designee's approval.
2. A.D. 1.16—Code of Ethics
The Hospital's mission and ultimate objective is to help its patients"to get better faster,"by means of clinical and
forensic evaluation,treatment, and protection. This administrative directive describes the Hospital's philosophy,
values, and mission, which supports the Professional Code of Ethics.
3. A.D. 3.05—Sexual Harassment
PSH will not tolerate sexual harassment of employees or non-employees who engage in sexual harassment of
employees/non-employees in the workplace. PSH will take reasonable measures to prevent/correct violation of
this policy.
The purpose of this administrative directive is to provide a work environment that is free from any form of sexual
harassment. All sexual harassment is unprofessional and discourteous and may lead to interruption or damage to
careers or harm to the well-being of employees/non-employees. All employees//non-employees have the right to
work in an environment that is free from all forms of discrimination, including sexual harassment.
4. A.D.4.08—Employee Clinic Services
Visitors or volunteers who become injured or acutely ill will be given first aid.They will be promptly evaluated and
referred to the appropriate primary care provider outside of the Hospital.
5. A.D.4.13—Smoke/Tobacco Free Policy
Patton State Hospital is a "Smokefrobacco Free"facility. It is the hospital's policy to provide an environment,
which is free of tobacco smoke and its undesirable effects. Therefore, smoking shall be prohibited in all areas of
the hospital. There will be no exceptions made in regards to smoking anywhere on the grounds(includes inside of
buildings)or in state vehicles.
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Patton State Hospital Agreement Number: 10-30099
Page 2 of 6
Cigarettes and/or any other smoking/tobacco products and lighters are considered contraband items and are
prohibited from secured compounds. Any of these items brought onto hospital grounds by employees or visitors
should be kept locked in personal vehicles.
6. A.D.4.22—Staff/Patient Relationships
The purpose of this directive is to define the standards for patient/staff relationships. Contractors are not to
engage in conversation with Hospital patients. If Contractor encounters a patient who tries to promote
conversation or contact, contact the PSH Job Manager/Inspector at once.PSH Job Manager/Inspector will notify
staff and/or Grounds Presence Staff immediately.
7. A.D.4.26—Clothing and Grooming Standards
Because the Penal Code patients wear a specific uniform, persons/or your employees are not to wear a
combination of clothing, which might be mistaken for a patient's uniform. Patient uniform clothing is as follows:
MALE PATIENT clothing consists of khaki shirt and trousers; FEMALE PATIENT clothing consists of khaki shirt
and brown slacks.
8. A.D. 6.01 —Security of Grounds(Laws, Rules, & Regulations)
Correctional Officers/Highway Patrol shall enforce vehicle speed and parking regulations, and issue citations
answerable to the San Bernardino Municipal Court. Employees and visitors shall not bring upon the grounds of
PSH any intoxicating liquor, narcotic, medicine, or drug for the purpose of furnishing same to a patient. Firearms
and ammunition, cameras, aluminum cans, glass bottles, or printed publications which are also prohibited.
9. A.D. 6.02—Traffic and Parking Control
The California Highway Patrol, By Agreement, is responsible for the enforcement of traffic laws at PSH.
PSH/Dept.of Corrections, under W.I.C., Div.4, Part I, Chapter 2, Article 3,commencing with Section 4300, has
the authority to regulate vehicle traffic upon PSH with respect to speed, place of parking, types of vehicles
permitted to enter, and to enforce the regulations enacted. The State reserves the right for its authorized officers
to inspect any person or vehicle entering or leaving PSH to determine whether articles detrimental to the welfare of
the patients are being taken into the grounds or state property is being illegally removed.
The Hospital speed limit is 11 m.p.h.within secured compounds and 15 m.p.h.outside the secured compounds.
All vehicles must be kept locked.
10. A.D. 6.03—Key Control
A set of loaner keys can be obtained by the Contractor, strictly on a daily basis and must be returned to Plant
Operations by 4:00 p.m.for the express purpose of access to their work area only.
Patients are expressly prohibited from having hospital keys in their possession. At no time, under any
circumstances, shall the Contractor permit a patient to have official keys in his/her possession.
Should a Contractor or their employees lose any keys inside of the security compounds they are to notify Plant
Operations immediately at Extension 7578 and the Department of Corrections at Extension 7780. Plant
Operations will take immediate steps to secure the area and initiate a search.
11. A.D. 6.04—Security Procedures within Compounds
The Department of Corrections staff at PSH is responsible for processing all staff going in/out of the Sallyports.
Conversations with patients and visitors or passing objects through or over any fence are not permitted.
("Use of Vehicles Behind Fenced Areas")
Vehicles with loose/unguarded/unsecured materials or tools will not be allowed to enter. All unneeded tools or
equipment will be left between the Sallyport gates.
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Patton State Hospital Agreement Number: 10-30099
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Procedures for inspection of vehicles entering/exiting the PC compounds are as follows: All entering and exiting
vehicles will be entered in the Sallyport Log Books. All drivers are to stop the engine,exit the vehicle, and open
the hood. A Correctional Officer will inspect the vehicle prior to entering/departure of the compounds. The
Sallyport Gate Officer will not open the outermost gate until the Searching Officer gives his/her approval that the
vehicle has been thoroughly searched. Vehicles are subject to a thorough physical inspection on a random basis
or because of suspicious circumstances.
12. A.D.6.08—Access Control (Passes and Badges)
Identification(ID)cards must be visibly worn at all times and must be attached to the upper torso of that person.
PSH Identification cards will be blue, no photo. Persons wearing identification cards must at all time carry proper
I.D. with photo (e.g., DMV license, CA I.D. issued by DMV, etc.). There are four (4)types of Official Hospital
Badges:
White with Photo: Permanent employees, retired annuitants, permanent intermittent, CNS Registry staff and
PSH CDC Staff.
White without Photo:Temporary badge issued for on-shift only, to employees who forgot their badges and to
those employees who have lost their badge.
Grey with Photo: Independent Service Provides (ISP's), students, interns, court appointees, contractors,
volunteers, and summer youth employees, etc.
Grey without Photo:Alcoholics/Narcotic Anonymous Volunteers and/or Visitors.
Identification cards shall be returned to the Sallyport Gate Officer upon departure.
Loss of identification cards shall be reported immediately to a Hospital Supervisor. Corrections shall be alerted at
Extension 7781 and a search conducted. If I.D.card is not found,the person who lost the I.D.shall be escorted to
the Sallyport by someone who is familiar to him/her. A replacement card will cost $10.00 (payable at the
Accounting Office and $25.00 thereafter for each occurrence).
13. A.D. 6.09—Tool Control
It is the intent of this policy to restrict items from the Hospital grounds which present a serious threat to the health
and safety of patients, employees, visitors, volunteers, students, and all other persons conducting business on
Hospital grounds.
All tools,equipment,and materials used in the project shall be controlled.The Contractorwill provide a storage bin
to secure his/her tools, equipment,and materials, which is to be locked at the end of each working day.
15. A.D. 6.11 — Individual Served Committed Offenses
The purpose of this directive is to ensure that all employees/visitors understand their responsibility with regards to
handling assaults and to delineate reporting and investigative responsibilities in the event of such an incident.
16. A.D. 6.14—Closure of Hospital Security Compounds
This directive sets forth the policy and procedures for the closure of the Hospital grounds from patient activities.
17. A.D. 10.08—Infection Control Practices
Patton State Hospital has implemented this directive to control the transmission of infections among personnel,
patients, and visitors.
18. A.D. 10.25—Medical Emergency Response System
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Patton State Hospital Agreement Number: 10-30099
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All physicians and nursing stall shall immediately respond to medical emergencies upon notification, whether
involving a patient, employee, or visitor. Medical emergencies are defined as conditions requiring immediate
medical attention to prevent death, disability, serious illness, injury or complications, or to alleviate pain or
suffering.
For Contractor Information:The closest Hospital that treats urgent care is St.Bernardine's Hospital located at the
corner of Highland and Waterman Avenues in San Bernardino.
When an employee or visitor refuses emergency medical care during routine business hours, he/she should be
escorted to the Employee Clinic for observation. Nursing staff shall obtain a signed statement refusing medical
treatment. The ACNS and MOD shall record their observations.
19. A.D. 15.16—Allowable Items/Contraband
The purpose of this directive is to identify the controls on contraband and property.
20. A.D. 15.22—Grounds Presence
Grounds presence will be provided by nursing level-of-care staff who will enforce rules and regulations as they
apply to patients on grounds. This directive will provide increased safety and security for all staff, patients, and
visitors.
21. A.D. 18.01 —Fire Rules and Regulations
This directive outlines the responsibilities of staff and to define their actions in fire prevention, fire emergencies,
and fire reporting.
An up-to-date Fire Plan shall be prominently displayed in every unit and work area of the institution. The Fire Plan
shall consist of a current floor plan of the unit, work area with emergency escape routes, exits, fire alarms, fire
alarm panels, fire extinguishers and locations, and fire control and first aid stations clearly indicated with all
pertinent information available.
22. A.D. 18.02—Fire Watch Procedures
Avoid accumulation of combustibles. All trash must be placed in metal containers with tight fitting covers or
approved Rubbermaid trash containers with lids. NO SMOKING signs or painted stencils shall be posted in all
areas where combustibles are stored.
The Contractor will store building/combustible materials in designated areas and will provide a portable early fire
detection device in each enclosed storage area. The Contractor shall be responsible to keep the premises free of
debris and trash and shall "police the area" and make proper disposal of all debris at the completion of each
working day. Necessity for additional fire fighting equipment will be assessed by the Fire Protection Officer and
staff will be trained as to location and use, if additional equipment is provided.
The Department of Corrections staff will patrol grounds on continuous surveillance and will be especially alert to
early signs of fire.
23. A.D. 18.03—Safety Program
The Safety Program establishes, supports, and maintains a safety management program that is based on
monitoring and evaluating organizational experience, applicable laws and regulations,and acceptable practices.
In addition,this directive establishes a risk assessment program that proactively evaluates the impact on patient
and public safety of the buildings, grounds, equipment, occupants, and internal physical systems.
25. A.D. 18.05—Safety Program— Footwear
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number. 10-30099
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It is the policy of PSH that all employees(including vendors/contractors)who work within the security compounds
and those exposed to foot injuries from hot, corrosive poisonous substances, falling objects, crushing or
penetrating actions, which may cause abnormal wet conditions must wear appropriate foot protection.
Footwear,which is defective or inappropriate to the extent that its ordinary use creates the possibility of foot injury,
shall not be worn. The following types of footwear shall not be worn: zories/flip flops or other type of shower
shoes; shoes with steel taps on heels.
26. A.D. 18.06—LockoutlBlockout Procedures
It is the policy of PSH to use practices,means methods,operations,and processes which are reasonably adequate
to render a safe,healthful place of employment. The purpose of this directive is to establish uniform procedures to
provide a safe environment for patients and employees during construction, servicing, and equipment repairs.
Every prime mover or power driven machine equipped with lockable controls or readily adaptable to lockable
controls shall be locked or positively sealed in the "OFF' position during repair work and setting-up operations.
Those not equipped with lockable controls or readily adaptable to lockable controls shall be de-energized for
disconnected from their power source to prevent the prime mover or machine from being started.
Caution signs or tags with adequate wording("Caution-Working on Machines-Do Not Start,"or equivalent)shall
be placed on the controls of the machines and prime movers during repair work. Signs shall be equipped with a
permanently attached means(string,wire,or adhesive)which can be readily attached to the control. This shall be
signed and dated by the person performing repairs.
27. A.D. 18.08—Emergency Management Plan
PSH shall have an emergency preparedness plan(meeting the requirements of the Department of Mental Health,
Joint Commission on Accreditation of Health Care Organizations, and Title 22)designed to provide for effective
management and utilization of resources should a disaster or emergency occur to such an extent that normal
operations of the Hospital would be severely disrupted.
28. A.D. 18.09—Emergency Alarm Systems Operation
To report a fire, dial 7311. The call is answered by the San Bernardino City Fire Dispatcher and is monitored by
the Hospital Telephone Office. Every Contractor and his/her employees shall be instructed as to the location and
operation of fire alarm and protection systems in the designated work area. All efforts shall be taken to avoid
setting off a false alarm.
The operating procedures for the alarm system will be posted adjacent to each alarm system device.All responses
to alarms shall be done in such a manner as to prevent injury or incidents resulting from response.
29. A.D. 18.10—Protective Equipment for Hazardous Substance
It is the policy of PSH that protective equipment including personal protective equipment(PPE)for eyes, face,
head, and extremities, protective clothing respiratory devices, protective shields, and barriers shall be provided,
used, and maintained in a sanitary and reliable condition wherever it is necessary by reason of hazards of
processes or environment, chemical hazards, radiological hazards, or mechanical irritants encountered in a
manner capable of causing injury or impairment in the function of any part of the body through absorption,
inhalation, or physical contact.
The purpose of PPE is to assist in protecting the individual from harmful exposures.
30. A.D. 18.11 —Hazardous Substance Handling Storage and Disposal
It is the policy of PSH to assure that all hazardous materials be managed in accordance with all applicable laws,
rules, and regulations, and in a manner that protects the health of patients, employees, and visitors, and
safeguards the environment of the community. All hazardous materials and hazardous waste shall be handled,
transported, and stored in accordance with prevailing regulations.
California Department of Mental Health City of San Bernardino Fire Department
Patton State Hospital Agreement Number: 10-30099
Page 6 of 6
Material Safety Data Sheets describing the use and character of hazardous substance shall be maintained in
accessible locations to employees/Contractor and staff who handle hazardous substances. Employees of
PSH/Contractor and staff shall have knowledge of hazardous materials ingredients, physical data, fire and
explosive data, first aid and health hazard data, spill or leak procedures, Hazard Communication Act, Right-To-
Know, and use of protective equipment.
A record of all hazardous substances shall be maintained at all storage sites. This will include the name of the
hazardous substance, amount of each hazardous substance on hand and the location where the hazardous
substance was used. These hazardous substance containers must be labeled with one of the following hazard
codes: Corrosive, Explosive, Combustible, Flammable, or Ignitable.
The Safety Committee shall review and analyze statistics on the incidences and/or causes of accidents and injuries
to employees,patients,visitors,and Contractor and staff,and damage to property,and make recommendations for
prevention and corrective action. The Health and Safety Officer, who is a member of the Safety Committee, is
responsible for carrying out the functions of the Safety Management Program, including administration and
implementation of safety policies and the decisions of the Safety Committee,and all their functions designated in
this directive, as assigned by the Executive Director.
Whenever hazardous conditions exist that poses an immediate threat to life, health,equipment,or buildings, the
Health and Safety Officer shall have the authority to take appropriate action as needed and to order intervention
and shall immediately report the intervention to the Executive Director or designee.
Contracting is responsible for reading,understanding,and following instructions for handling chemical substances
or hazardous materials, including the wearing of protective clothing or gear when appropriate.
32. A.D. 18.13—Interim Fire, Life, Safety Measures
As part of PSH's Life Safety Management Program,it is necessary to provide for adequate fire protection,as well
as environment and grounds safety at all times. During times of construction/renovation in buildings and grounds,
extraordinary measures must be taken to compensate for hazards posed by any existing life safety deficiencies
that will be diminished by construction. Responsibility for the assessment, development, and implementations of
any interim,fire,life,safety measures that might be necessary that are of the Hospital Health and Safety Officer,in
conjunction with the Chief of Plant Operations, Fire Chief and others as needed.
The Chief of Plant Operations/designee will notify the Health and Safety Officer of proposed
construction/renovation projects and will assist in providing information such as pertinent codes and regulations,
site visits,impact on patient care,documents on the specifics of the project,the scope and duration of the project
to assess the project for any interim life safety measures that might be necessary. The Health and Safety Officer
will attend the Start Meeting to assure that the Contractor and project coordinators are aware of,and assist in the
implementation of all interim safety measures designated for the project.
Revised December 2008
t
AC A L I F 0 N N I A P E P A N T N E N T OF
Mental Health
Patton State Hospital
3102 East Highland Avmue,Patton,CA 92369
(909)425-7000
June 29,2010
City of San Bernardino Fire Department
Attn: Charles McNeely, City Manager
200 E. Third Street
San Bernardino, CA 92410
Subject: Contract# 10-30099 Paramedic and EMT Services
Dear Contractor,
Enclosed, for your records, you will find the approved agreement for the above mentioned
services. Should you have questions or concerns regarding this contract, your contacts are as
follows:
• Project Coordinator(technical questions): Darryl Brown—(909)425-7960
• Accounting(payment questions): Linda Borrego—(909)425-7169
• Contracts Analyst(contract questions): Annette Calderon—(909)425-6888
We look forward to working with you; should you need assistance,please don't hesitate to call.
Sincerely,
ette Calderon AGPA
Contract Analyst
Received
/enclosure JUN 3 0 2010
San Bemardino City
Fire llepartment