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Contractor’s Name 15-92265 Page 1 Exhibit A Scope of Work 1. Service Overview On August 13, 2015, the Centers for Medicare & Medicaid Services (CMS) approved the Drug Medi-Cal Organized Delivery System amendment to the California Bridge to Reform Demonstration waiver (DMC-ODS Waiver). The DMC-ODS Waiver provides counties with the option to participate and tailor substance use disorder (SUD) services to meet the unique needs of the beneficiaries of each individual county. Counties that choose to participate in the DMC-ODS pilot program will offer Waiver services in one of five regional phases. Those counties may elect to individually provide the required DMC-ODS Waiver services, or may, upon Departmental approval, implement a regional model to provide the required services. As described in this Scope of Work, the Contractor shall perform the following Services: 1. Provide DMC-ODS Waiver trainings to counties that opt into the DMC-ODS Waiver, counties that receive approval to form a Regional Delivery System, and providers selected by counties to provide DMC-ODS Waiver services; 2. Provide Technical Assistance to counties and providers as required by DHCS; 3. Provide DHCS with Monthly Progress Reports; 4. Provide DHCS with Trainings up to once Quarterly; and 5. Provide DHCS with a Final Report. 2. Service Location The Contractor shall be available to perform the Services within any California county that opts into the DMC-ODS Waiver, any region that receives approval from DHCS to form a Regional Delivery System, and any SUD treatment providers within those counties and regions. 3. Service Hours The Contractor shall provide the Services during normal Contractor working days and hours, excluding national and State holidays. 4. Project Representatives A. The project representatives during the term of this Agreement will be: Department of Health Care Services Contractor’s Name Contract Manager: Ilana Rub Telephone: (916) 552-9690 Fax: (916) 440-5230 Email: [email protected] [Enter Name of Contract Manager] Telephone: (XXX) XXX-XXXX Fax: (XXX) XXX-XXXX Email: Xxxxxxxx@xxxxxxxx Contractor’s Name 15-92265 Page 2 Exhibit A Scope of Work B. Direct all inquiries to: Department of Health Care Services Contractor’s Name Narcotic Treatment Programs Attention: Ilana Rub Mail Station Code 2603 1501 Capitol Avenue P.O. Box 997413 Sacramento, CA, 95899-7413 Section or Unit Name (if applicable) Attention: [Enter name, if applicable] Street address & room number, if applicable P.O. Box Number (if applicable) City, State, Zip Code Telephone: (916) 552-9690 Fax: (916) 440-5230 Email: [email protected] Telephone: (XXX) XXX-XXXX Fax: (XXX) XXX-XXXX Email: Xxxxxxxx@xxxxxxxx C. Either party may make changes to the information in Section 4(A) and (B) above by giving written notice to the other party. Said changes shall not require an amendment to this Agreement. 5. Services to be Performed A. Trainings As described below, the Contractor shall provide DMC-ODS Waiver Trainings to those counties that opt into the DMC-ODS Waiver, those counties that receive approval from DHCS to form Regional Delivery Systems, those providers selected by counties to provide DMC-ODS Waiver services, and supplemental training for counties, regions, and providers to address specific issues that arise during the DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services. All costs associated with the trainings, including materials provided to training attendees, travel and accommodations for the trainers/instructors, compensation for trainers/instructors, and presentation devices (projectors, computers, visual aides, etc.) shall be provided, and paid for, by the Contractor. 1. Trainings a. Training Plan Outline The Contractor shall, within 30 days of the execution of this Contract, provide the DHCS Project Representative with a Training Plan Outline. The Training Plan Outline shall include a Training Schedule that sets forth the anticipated dates of all County/Regional and Provider Trainings to be held during the entire Contract period. The Training Schedule shall be evaluated annually by the DHCS Project Representative and the Contractor at the anniversary date of this Contract to address necessary modifications based on counties opting into the Waiver. Changes cannot be made to the Training Schedule prior to the annual evaluation date without prior written consent from the DHCS Project Representative. The Contractor must submit any proposed changes to the Training Schedule 30 days Contractor’s Name 15-92265 Page 3 Exhibit A Scope of Work prior to the scheduled training date. DHCS shall either approve or deny the request to amend the Training Schedule within 15 days of receiving the Contractor’s request. The Training Plan Outline shall include a County Training Template and Provider Training Template that identify and describe the specific curriculum topics to be covered, including those topics identified in Section 5(A)(1)(d). The Training Plan Outline shall also attach an evaluation form to be completed by the training participants (a sample evaluation form is attached as Exhibit I). Within 30 days of receiving the Contractor’s Training Plan Outline, the DHCS Project Representative shall either approve the Training Plan Outline as submitted by the Contractor or provide the Contractor with notice requiring modifications to the Training Outline Plan. Within 15 days of receiving notice of required modifications, the Contractor shall re-submit Training Plan Outline that addresses DHCS’ request for modifications. b. County/Regional Specific Training Plan The Contractor shall, 30 days prior to a County/Regional Training date, submit a County/Regional Specific Training Plan to the DHCS Project Representative. The County/Regional Specific Training Plan shall include the following: i. The training curriculum and materials; ii. The location(s) of the County/Regional Training; and iii. The names and resumes of all presenters/instructors. Within 10 days of receiving the Contractor’s County/Regional Specific Training Plan, the DHCS Project Representative shall either approve the plan as submitted by the Contractor or provide the Contractor with notice requiring modifications to the County/Regional Specific Training Plan. Within 10 days of receiving notice of required modifications, the Contractor shall re-submit the County/Regional Specific Training Plan that addresses DHCS’ request for modifications. c. Provider Specific Training Plan The Contractor shall, 30 days prior to a Provider Training date, submit a Provider Specific Training Plan to the DHCS Project Representative. The Provider Specific Training Plan shall include the following: i. The training curriculum and materials; ii. The location(s) of the Provider Training; and iii. The names and resumes of all presenters/instructors. Within 10 days of receiving the Contractor’s Provider Specific Training Plan, the DHCS Project Representative shall either approve the plan as submitted by the Contractor or provide the Contractor with notice requiring modifications to the Provider Specific Training Plan. Within 10 days of receiving notice of required modifications, the Contractor shall re-submit the Provider Specific Training Plan that addresses DHCS’ request for modifications. Contractor’s Name 15-92265 Page 4 Exhibit A Scope of Work d. Training Content The curriculum presented at a training must remain within the scope of the curriculum approved by DHCS. Additionally, only materials approved by DHCS may be distributed at a training. Instructors can only address or answer questions from training attendees that are within the scope of the approved training curriculum. All questions that deviate from the scope of the approved training curriculum shall be presented to the DHCS Project Representative in the Training Report, as described in Section 5(A)(1)(e) below. The training content shall include the following DMC-ODS Waiver subject matters: i. ii. iii. iv. v. vi. DMC-ODS Waiver Assessment of Modality Services: The Contractor shall assist counties in identifying the existing modalities for DMC-ODS Waiver services and the infrastructure needed to integrate additional modalities as required by the STCs. American Society of Addiction Medicine (ASAM) Criteria: The Contractor shall provide a general overview of ASAM as well as instruction related to the proper utilization of ASAM criteria for appropriate patient placement, and guidance for utilizing ASAM criteria to determine the appropriate treatment of patients based upon their level of care. Selective Contracting: The Contractor shall provide guidance to counties on how to draft a request for proposal (RFP) to ensure that the contracting requirements and selection criteria set forth in the DMC-ODS Waiver Standard Terms and Conditions (STCs) are clearly articulated. The Contractor shall also address with counties, and each county’s respective board of supervisors, the appropriate written policies and procedures for selection and retention of providers that are in compliance with the STCs. Quality Assurance Processes: The Contractor shall provide counties with instructions for drafting the quality assurance plans in a manner that complies with the Code of Federal Regulation section 438 requirements. The Contractor shall also provide counties with guidance on the practical application of the quality assurance plans and organizational structure and operation of the quality assurance committee. Medication-Assisted Treatment (MAT): The Contractor shall provide a general overview of the medications used in MAT that are available through the DMC-ODS Waiver. The overview shall address each specific medication, including the primary use for treatment and the relationship, if any, with other medications available for treatment. As part of the MAT training content, the Contractor shall educate counties on the theory of MAT and how MAT can be utilized to treat substance use disorders. Continuum of Care: The Contractor shall address, in detail, each ASAM level of care set forth in STCs. The Contractor shall specifically discuss the nature of services provided at each level of care and the appropriate interaction between providers when transitioning patients within the continuum of care to levels appropriate to meet their needs. Contractor’s Name 15-92265 Page 5 Exhibit A Scope of Work e. Training Reports Within 15 days of completing a County/Regional or Provider Training, the Contractor shall submit a Training Report to the DHCS Project Representative. The Training Report shall include: i. The date, time, and location of the training; ii. The number of attendees; iii. The attendees’ competed evaluation sheets; iv. The questions asked by participants at the trainings that were within the scope of the approved training curriculum and the responses provided by the Contractor; and v. The questions asked by participants that were outside the scope of the approved training curriculum, if applicable. Within 15 days of receiving a Training Report, DHCS shall provide the Contractor with responses to questions outside the scope of the approved training curriculum. 2. Supplemental Trainings a. Supplemental Training Plan The Contractor shall provide Supplemental Trainings at the direction of DHCS. Within 10 days of receiving a request for additional training services, the DHCS Project Representative shall notify the Contractor by providing the specific request from the county/region or provider. Within 15 days of receiving a Supplemental Training request, the Contractor shall provide the DHCS Project Representative with its Supplemental Training Plan to address the specific request. The Supplemental Training Plan shall include: i. ii. iii. iv. v. vi. A training schedule that will address the specific request from the county or region; The number of trainings; The locations of the trainings; The curriculum topic(s) to be provided at the trainings; The names and resumes of the trainers/instructors; and The evaluation form to be completed by the training attendees. Within 15 days of receiving the Contractor’s Supplemental Training Plan, DHCS shall either approve the plan as submitted by the Contractor or provide the Contractor with notice requiring modifications to the Supplemental Training Plan. Within 10 days of receiving notice of required modifications, the Contractor shall re-submit its Supplemental Training Plan that addresses the request for modifications. Changes cannot be made to the Supplemental Training Plan without prior written consent from the DHCS Project Representative. The Contractor must submit any proposed changes to the Supplemental Training Plan 15 days prior to the training date. DHCS will either approve or deny the request to amend the Supplemental Training Plan within 10 days of receiving the Contractor’s request. Contractor’s Name 15-92265 Page 6 Exhibit A Scope of Work b. Training Content The curriculum presented at a training must remain within the scope of the curriculum topic(s) approved by DHCS in the Supplemental Training Plan. Additionally, only materials approved by DHCS in the Supplemental Training Plan may be distributed at a training. Instructors can only address or answer questions from training attendees that are within the scope of the approved training curriculum. All questions that deviate from the scope of the approved training curriculum shall be presented to the DHCS Project Representative in the Training Report, as described in Section 5(A)(2)(b). c. Training Reports Within 15 days of completing a Supplemental Training, the Contractor shall submit a Training Report to the DHCS Project Representative. The Training Report shall include: i. ii. iii. iv. The date, time, and location of the training; The number of attendees; The attendees’ competed evaluation sheets; The questions asked by participants at the trainings that were within the scope of the approved training curriculum and the responses provided by the Contractor; and v. The questions asked by participants that were outside the scope of the approved training curriculum and the Contractor’s proposed responses, if applicable. Within 15 days of receiving a Training Report, DHCS shall provide the Contractor with responses to questions outside the scope of the approved training curriculum. B. Technical Assistance As counties/regions and selected providers implement the DMC-ODS Waiver, DHCS anticipates the need for Technical Assistance to address modality specific questions and implementation challenges. Furthermore, DHCS will oversee and monitor counties participating in the DMC-ODS Waiver to ensure compliance with standards, access, and delivery of quality care and services through an External Quality Review Organization. The participating counties will also monitor the contracted providers at least once per year to ensure compliance with standards, access, and delivery of quality care and services. If significant deficiencies or significant evidence of noncompliance with the DMC-ODS Waiver, the county implementation plan, or the state/county intergovernmental agreement are found, then the Contractor shall, at the direction of DHCS, engage the county to determine if the challenges can be addressed with technical assistance. 1. Direct Requests for Technical Assistance A county/region or provider may request Technical Assistance through DHCS or directly from the Contractor. Contractor’s Name 15-92265 Page 7 Exhibit A Scope of Work If a county/region or provider requests Technical Assistance through DHCS, within 10 days of receiving such request, the DHCS Project Representative shall notify the Contractor by providing the specific request from the county/region or provider. The Contractor shall provide the DHCS Project Representative with a Technical Assistance Plan within 15 days of receiving notice from DHCS. If a county/region or provider requests Technical Assistance directly from the Contractor, within 15 days of receiving such request, the Contractor shall provide the DHCS Project Representative with its Technical Assistance Plan. The Technical Assistance Plan shall include: 1. 2. 3. 4. The specific request; Any necessary documents and information; The proposed response to the request for Technical Assistance; and The timeframe in which the Contractor shall address the request for Technical Assistance. Within 10 days of receiving the Contractor’s Technical Assistance Plan, DHCS shall either approve the plan as submitted by the Contractor or provide the Contractor with notice requiring modifications to the Technical Assistance Plan. Within 5 days of receiving notice of required modifications, the Contractor shall re-submit its Technical Assistance Plan that addresses the request for modifications. The Contractor’s response to the request for Technical Assistance shall not deviate from the scope of the DHCS approved response. Within 15 day of closing a request for Technical Assistance, the Contractor shall submit a Technical Assistance Report to the DHCS Project Representative. The Technical Assistance Report shall include: 1. 2. 3. 4. The issue or question presented by the requestor; The response provided by the Contractor to the requestor; The method in which the Contractor delivered the response; and Any additional proposed follow up actions for the specific requestor. 2. Monitoring Deficiency Technical Assistance Upon determination by DHCS of a deficiency that requires Technical Assistance, as required by the Standard Terms of Conditions (STCs), DHCS shall notify the Contractor by providing: 1. The specific deficiency; 2. The DHCS approved Plan of Action to correct the specific deficiency; and 3. The timeframe in which the Contractor shall complete the Plan of Action. When addressing the specific deficiency, the Contractor shall not deviate from the DHCS approved Plan of Action. In working with the county or provider to address the specific deficiency, any questions regarding the Plan of Action must be directed to the DHCS Project Representative. Contractor’s Name 15-92265 Page 8 Exhibit A Scope of Work Within 15 days of completing the Plan of Action, the Contractor shall submit a Technical Assistance Report to the DHCS Project Representative. The Technical Assistance Report shall include: 1. The specific deficiency addressed by the Plan of Action; 2. The response provided by the Contractor to the county or provider; and 3. Any additional proposed follow up actions for the specific deficiency. C. DHCS Trainings DHCS employees shall have the right to attend any and all of the County/Regional and Provider Trainings presented by the Contractor without advanced notice or cost to DHCS. In addition to attending County/Regional and Provider Trainings, DHCS may request additional trainings from the Contractor up to once quarterly on any requested DMC-ODS Waiver specific subject matter. Contractor shall teach DHCS staff how to effectively utilize the procedures developed by the Contractor to successfully address typical issues encountered by counties, providers, and Regional Delivery Systems, if applicable, of varying size, population density, demographics, and geographic region. D. Monthly Reports On the final day of each month, the Contractor shall submit a Monthly Report to the DHCS Project Representative. The Monthly Report shall include: 1. A summary of all Trainings provided and Technical Assistance rendered during that month; 2. A summary of challenges encountered by counties categorized according to geographical size, population density, and geographical regions; 3. A summary of challenges encountered by Regional Delivery Systems, if applicable; 4. A summary of modality specific challenges encountered by counties; 5. A summary of modality specific challenges encountered by providers; and 6. A summary of successful strategies and procedures utilized by counties and Regional Deliver Systems, if applicable, during DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services. E. Invoices The Contractor shall submit invoices in conjunction with the Monthly Report and in accordance with the requirements of Exhibit B. Each invoice shall detail the number of hours worked on any of the following services: 1. 2. 3. 4. 5. Preparation of the Training Plan Outline; Preparation of any County/Regional Specific Training Plan; Preparation of any Provider Specific Training Plan; Performing any County/Regional or Provider training; Preparation of any Training Reports; Contractor’s Name 15-92265 Page 9 Exhibit A Scope of Work 6. 7. 8. 9. Performing Technical Assistance at the direction of DHCS; Preparing of any Technical Assistance Reports; Performing DHCS trainings, if requested, up to once a quarter; and Preparation of the Final Report. Invoices must include the dates associated with each of the hours of work specified above as well as a description of services performed. The DHCS Project Representative shall reserve the right to request additional information from the Contractor if he or she deems the invoice to be inadequate. F. Final Report On or before the expiration of the Contract, the Contractor shall submit a Final Report to the DHCS Project Representative. The Final Report shall include: 1. Templates, scripts, and materials for County Trainings categorized according to geographical size, population density, demographics, and geographical regions; 2. Templates, scripts, and materials for Provider Trainings categorized by modality and geographic location; 3. Templates, scripts, and materials for Regional Delivery Systems, if applicable; 4. A list of Frequently Asked Questions (FAQs) posed by counties during DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services and the Contractor’s responses to those FAQs; 5. A list of FAQs posed by providers during DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services and the Contractor’s responses to those FAQs; 6. A list of FAQs posed by Regional Delivery Systems during DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services and the Contractor’s responses to those FAQs, if applicable; 7. A summary of challenges encountered by counties grouped according to geographical size, population density, demographics, and geographical regions; 8. A summary of challenges encountered by Regional Delivery Systems, if applicable; 9. A summary of modality specific challenges encountered by counties; 10. A summary of modality specific challenges encountered by providers; and 11. A summary of successful strategies and procedures utilized by counties and Regional Delivery Systems, if applicable, during DMC-ODS Waiver implementation and continuance of DMC-ODS Waiver services.