STATE OF GEORGIA



DEPARTMENT OF HUMAN SERVICES

CONTRACT for Room, Board and Watchful oversight (RBWO) Services

COUNTY DEPARTMENT ADMINISTRATIVE INFORMATION:

Expense X County Department Contract #42700-040C-     

(required)

Contractor’s TAX ID#:      

Total Obligation: $0.00 (required)

Contractor’s FY End Date: 12/31/2013

Contractor’s Entity Type: Profit Nonprofit Public Individual

NIGP Code(s): 95237

Sub-recipient: N (y/n) duns #: N/A

Vendor: Y (Y/N)

CFDA #: 93.658

CFDA #: 93.778

SECTION I GENERAL CONTRACT PROVISIONS:

PARA #101 CONTRACT BETWEEN:

This contract is made and entered into by and between Department of Human Services, Division of Family and Children Services (DFCS), Office of Provider Management (hereinafter called DHS), an agency of the State of Georgia legally empowered to contract pursuant to the Official Code of Georgia Annotated, Section 49-2-1 and hereinafter referred to as the County Department. Responsibilities and obligations pursuant to this contract will be performed by the DFCS office identified above and by the individual or entity identified below:

Who is legally empowered to contract pursuant to the Georgia Nonprofit Corporation Code, and hereinafter referred to as CONTRACTOR.

This contract is deemed to be made under and shall be construed and enforced in every respect according to the laws of the State of Georgia. Any lawsuit or other action based on a claim arising from this Contract shall be brought in a court or other forum of competent jurisdiction within Fulton County, State of Georgia.

It is the policy of the State of Georgia that minority business enterprises shall have the maximum opportunity to participate in the State purchasing and contracting process. Therefore, the State of Georgia encourages all minority business enterprises to compete for contracts for goods, services, and construction. Also, the State encourages all companies to sub-contract portions of any State contract to minority business enterprises. Contractors who utilize qualified minority subcontractors may qualify for a Georgia state income tax deduction for qualified payments made to minority subcontractors. See O.C.G.A. Section 48-7-38.

Nothing contained in this contract shall be construed to designate Contractor or any of its employees, agents, or subcontractors as a partner, employee, or agent of the County Department, nor shall either party to this contract have any authority to bind the other in any respect, it being intended that each shall remain an independent contractor.

The execution of this contract preempts any prior contracts or agreements that have been executed by DHS/DFCS and the Contractor for same or similar services.

PARA #102 PERIOD OF CONTRACT:

This contract has an effective beginning date of the 1st day of October July, 2013 and shall terminate on the 30th day of June, 2014, unless terminated earlier under other provisions of this contract.

PARA #103 COUNTY DFCS AND CONTRACTOR CONTACT INFORMATION:

A. Mailing Addresses:

The mailing addresses, telephone numbers, and contact persons listed below for DHS and the Contractor may be changed during the term of this contract by written notification to the other party by DHS or office representatives or by the Contractor.

1. Programmatic Fiscal Officer

Georgia Department of Human Services Georgia Department of Human Services

Division of Family and Children Services Division of Family and Children Services

Office of Provider Management Fiscal Services Section

Attn: Dianne Yearby Attn: David Teubl

Two Peachtree Street, N.W., 18th Floor Two Peachtree Street, N.W., 18th Floor

Atlanta, Georgia 30303-3142 Atlanta, Georgia 30303-3142

Telephone #: 404/657-3572 Telephone #: 404/463-7275

2. The Contractor's mailing address and telephone number for correspondence, reports, and other matters relative to this

contract are:

Attn:      

Address:     

     

Telephone #:      

Email:      

B. Mailing Address for Contract Payments:

Contractor's mailing address for all contract payment checks or remittance advice (for electronic funds transfer only) is:

     

PARA #104 NONDISCRIMINATION BY CONTRACTORS AND SUBCONTRACTORS:

A. NONDISCRIMINATION IN EMPLOYMENT PRACTICES: Contractor agrees to comply with all federal and state laws, rules and regulations, and the policy of DHS and the Division of Family and Children Services relative to nondiscrimination in employment practices because of political affiliation, religion, race, color, sex, handicap, age, creed, veteran status or national origin. Nondiscrimination in employment practices is applicable to employees, applicants for employment, promotions, demotions, dismissal, and other elements affecting employment/employees.

B. NONDISCRIMINATION IN SERVICE PRACTICES: Contractor agrees to comply with federal and state laws, rules and regulations, and the policy of DHS and the Division of Family and Children Services relative to nondiscrimination in consumer/customer/client and consumer/customer/client service practices because of political affiliation, religion, race, color, sex, handicap, age, creed, veteran status or national origin. Neither shall any individual be excluded from participation in, denied the benefits of, or otherwise be subjected to illegal discrimination under any program or activity conducted or supported by DHS or the Division of Family and Children Services.

C. COMPLIANCE WITH APPLICABLE PROVISIONS OF THE AMERICANS WITH DISABILITIES ACT: Contractor agrees to comply with all applicable provisions of the Americans with Disabilities Act (ADA) and any relevant federal and state laws, rules and regulations regarding employment practices toward individuals with disabilities and the availability/accessibility of programs, activities, or services for consumers/customers/clients with disabilities.

D. Contractor agrees to require any subcontractor performing services funded through this contract to comply with all provisions of the federal and state laws, rules, regulations and policies described in this paragraph.

PARA #105 GOVERNMENT-FUNDED RELIGIOUS ACTIVITIES: (UMCH) 9/29/03*

The Contractor agrees that it shall not engage in religious activities including religious worship, instruction, proselytization, or promotion, funded in whole or in part with, or supported by government monies. However, children in state custody have a right to voluntarily participate in religious activities and to follow their own religious beliefs, such as attendance at worship, religious observance, and religious study. Children who voluntarily choose to participate in religious activities shall be afforded reasonable opportunities to do so. Under no circumstances shall participation in religious activities be required in any way or be a condition of involvement in the Contractor’s services or programs. See Annex A entitled Government Funded Religious Activities Clarification.

PARA #106 CONFIDENTIALITY OF INDIVIDUAL INFORMATION:

The Contractor agrees to abide by all state and federal laws, rules, regulations, and DHS policy and procedures respecting confidentiality of an individual's records. The Contractor will not disclose any confidential or protected information obtained in any way from DHS without the express written authorization from DHS. The Contractor agrees to notify DHS within one (1) calendar day of receipt of a request for records under the Georgia Open Records Act, a subpoena, court order, or request for production of documents seeking confidential information concerning DHS customers or clients.

PARA #107 CONFLICT OF INTEREST:

Contractor and the County Department certify that the provisions of the Official Code of Georgia Annotated, Section 45-10-20 through 45-10-28, as amended, which prohibit and regulate certain transactions between certain state officials or employees and the State of Georgia, have not been violated and will not be violated in any respect.

PARA #108 CONTRACT MODIFICATION/ALTERATION:

A. No modification or alteration of this agreement, except for budget revisions which do not increase or decrease the total dollar value of the contract (except for the addition of an equipment line item or real estate rental), which has been approved in advance by the County Department, will be valid or effective unless such modification is made in writing and signed by both parties and affixed to this contract as an amendment indicating the County Department contract number involved, the original contracting parties and the original effective date of the contract and the paragraph(s) being modified or superseded, except as stated in subparagraph B immediately below.

B. In the event that either of the sources of reimbursement for services under this contract (appropriations from the General Assembly of the State of Georgia, or the Congress of the United States of America) are reduced during the term of this contract, the County Department has the absolute right to make financial and other adjustments to this contract and to notify the Contractor accordingly. Such adjustment(s) may require a contract amendment including, but not limited to, a termination of the contract. The certification by the Director of the Division of Family and Children Services of the occurrence of either of the reductions stated above shall be conclusive.

PARA #109 COUNTY DEPARTMENT’S RIGHT TO SUSPEND CONTRACT:

The County Department reserves the right to suspend the contract/subgrant in whole or in part under this contract provision if it appears to the County Department that the Contractor is failing to substantially comply with the quality of service or the specified completion schedule of its duties required under this contract. The County Department may require additional proof of reimbursable expenses prior to payment thereof; the County Department also may require Contractor to provide proof of its programmatic performance or service delivery, at the discretion of the County Department before the contract is resumed.

PARA #110 SEVERABILITY:

Any section, subsection, paragraph, term, condition, provision or other part (hereinafter collectively referred to as “part”) of this Contract that is judged, held, found, or declared to be voidable, void, invalid, illegal or otherwise not fully enforceable shall not affect any other part of this Contract, and the remainder of this Contract shall continue to be of full force and effect. Any agreement of the parties to amend, modify, eliminate, or otherwise change any part of this Contract shall not affect any other part of this Contract, and the remainder of this Contract shall continue to be of full force and effect.

PARA #111 TERMINATION:

A. Due to non-availability of funds. Notwithstanding any other provision of this contract, in the event that either of the sources of reimbursement for services under this contract (appropriations from the General Assembly of the State of Georgia or the Congress of the United States of America) no longer exist or in the event the sum of all obligations of the County DFCS incurred under this and all other contracts entered into for this program exceeds the balance of such contract sources, then this contract shall immediately terminate without further obligation of the County Department as of that moment. The certification by the Director of the Division of Family and Children Services of the occurrence of either of the events stated above shall be conclusive.

B. Due to default or for cause. This contract may be terminated for cause, in whole or in part, at any time by the County Department for failure of the Contractor to perform any of the provisions hereof. Should the County Department exercise its right to terminate this contract under the provisions of this paragraph, the termination shall be accomplished in writing and specify the reason and termination date. The Contractor will be required to submit the final contract expenditure report not later than 45 days after the effective date of written notice of termination. Upon termination of this contract, the Contractor shall not incur any new obligations after the effective date of the termination and shall cancel as many outstanding obligations as possible. The above remedies are in addition to any other remedies provided by law or the terms of this contract.

C. For Convenience. This contract may be cancelled or terminated by either of the parties without cause. This Contract may be terminated by Contractor for any reason upon 60 days prior written notice to the County Department. This Contract may be terminated by the County Department for any reason upon 30 60 days prior written notice to the Contractor.

D. Notwithstanding any other provision of this paragraph, this contract may be immediately terminated without any opportunity to cure, if any of the following events occurs:

1. Contractor becomes insolvent or liquidation or dissolution or a sale of Contractor’s assets begins.

2. Contractor or any subcontractor violates or fails to comply with any applicable provision of federal or state law or regulation.

3. Contractor or any subcontractor knowingly provides fraudulent, misleading or misrepresentative information to any consumer/customer/client of the County Department or DHS or any of its Offices or Divisions.

4. Contractor has exhibited an inability to meet its financial or services obligations under this contract.

5. A voluntary or involuntary bankruptcy petition is filed by or against the Contractor under the U.S. Bankruptcy Code or any similar petition under any state insolvency law.

6. An assignment is made by the Contractor for the benefit of creditors.

7. A proceeding for the appointment of a receiver, custodian, trustee, or similar agent is initiated with respect to the Contractor.

8. The County Department deems that such termination is necessary if the Contractor or any subcontractor fails to protect or potentially threatens the health or safety of any consumer/customer/client and/or to prevent or protect against fraud or otherwise protect the State of Georgia’s personnel, consumers/customers/clients, facilities, or services.

9. Contractor is debarred or suspended from performing services on any public contracts and/or subject to exclusion from participation in the Medicaid or Medicare programs.

10. Contractor loses or has any license, certification or accreditation sanctioned that is required by this Contract or state and federal laws.

PARA #112 COOPERATION IN TRANSITION OF SERVICES:

Contractor agrees upon termination of this contract, in whole or in part, for any reason that it will cooperate as requested by the County Department to effectuate the smooth and reasonable transition of the care and services for consumers/customers/clients as directed by the County Department. This will include, but not be limited to, the transfer of the consumer/customer/client records, personal belongings, and funds of all consumers/customers/clients as directed by the County Department. Contractor further agrees that should it go out of business and/or cease to operate, all records of consumers/customers/clients served pursuant to this contract shall be transferred by the Contractor to the County Department immediately and shall become the property of the County Department.

PARA #113 FORCE MAJEURE:

Each party will be excused from performance under this contract to the extent that it is prevented from performing, in whole or in substantial part, due to delays caused by an act of God, civil disturbance, civil or military authority, war, court order, acts of public enemy, and such nonperformance will not be a default under this contract nor a basis for termination for cause. Nothing in this paragraph shall be deemed to relieve Contractor from its liability for work performed by any subcontractor. If the services to be provided to the County Department are interrupted by a force majeure event, the County Department will be entitled to an equitable adjustment to the fees and other payments due under this contract.

PARA #114 ACCESS TO RECORDS AND INVESTIGATION:

A. The state and federal government and the County Department shall have full and complete access to all consumer/customer/client records, administrative records, financial records, pertinent books, documents, papers, correspondence, including e-mails, management reports, memoranda, and any other records of Contractor and subcontractor for the purpose of conducting or reviewing audit examinations, excerpts, and transcripts. Contractor and subcontractor record retention requirements are seven years from submission of final expenditure report. If any litigation, claim, or audit is started before the expiration of the seven-year period, the records shall be retained until all litigations, claims, or audit findings involving the records have been resolved.

B. Contractor agrees that the DHS Office of Inspector General, upon the request of the Commissioner of DHS or her/his designee, has full authority to investigate any allegation of misconduct in performance of duties arising from this contract made against an employee of the Contractor. The Contractor agrees to cooperate fully in such investigations by providing the Office of Inspector General full access to its records and by allowing its employees to be interviewed during such investigations.

C. The County Department shall have the right to monitor and inspect the operations of Contractor and any subcontractor for compliance with the provisions of this Contract and all applicable federal and state laws and regulations, with or without notice, at anytime during the term of this Contract. Contractor agrees to cooperate fully with these monitoring and inspection activities. Such monitoring and inspection activities may include, without limitation, on-site health and safety inspections, financial and behavioral health/clinical audits, review of any records developed directly or indirectly as a result of this Contract, review of management systems, policies and procedures, review of service authorization and utilization activities, and review of any other areas, activities or materials relevant to or pertaining to this Contract. The County Department will provide the Contractor with a report of any findings and recommendations and may require the Contractor to develop corrective action plans as appropriate. Such corrective action plans may include requiring the Contractor to make changes in service authorization, utilization practices, and/or any activity deemed necessary by the County Department.

PARA #115 COLLECTION OF AUDIT EXCEPTIONS:

The Contractor agrees that the County Department may withhold net payments (voucher deduction) equal to the amount which has been identified by an audit exception as being owed to the County Department or DHS by Contractor, notwithstanding the fact that such audit exception is made against a prior or current contract or subcontract. The Contractor may also repay the County Department for the total exception in a form specified by DHS.

PARA #116 SUBCONTRACTS:

Any subcontracts or delegation of the authority herein will be submitted to DHS for approval prior to execution. Contractor specifically agrees to be responsible for the performance of any subcontractor or other duties delegated under all provisions of this contract. Contractor will ensure that the subcontractor both understands and abides by all pertinent provisions of the contract and regulations applicable to the subcontractor. Contractor agrees to reimburse the County Department for any federal or state audit disallowances arising from the subcontractor's performance or non-performance of duties under this contract which are delegated to the subcontractor.

PARA #117 CONSULTANT/STUDY CONTRACT:

A. The Contractor agrees not to release any information, findings, research, reports, recommendations, or other material developed or utilized during or as a result of this contract until such time as the information has been provided to the County Department., appropriately presented to DHS for proper consideration, and made a matter of public record.

B. The Contractor further agrees that any research, study, review, or analysis of the consumers/customers/clients served under this contract by any outside individual or organization must be conducted in conformance with DHS procedures and Department of Human Services Policy 7901, Protection of Human Subjects.

C. All products developed/collected including raw data, databases, including code specifications, shall be the property of DHS and may be subject to review and validation by the County Department and DHS prior to completion of study.

PARA #118 CONTRACTOR/SUBCONTRACTOR LICENSE REQUIREMENTS:

A. Contractor agrees to maintain any required city, county and state business licenses and any other special licenses required, prior to and during the performance of this contract.

B. Contractor is responsible to ensure that subcontractors are appropriately licensed.

C. Contractor agrees to notify DHS in writing within one (1) business day of the loss or sanction of any license, certification, or accreditation required by this Contract, or by state or federal laws. Contractor agrees that if it loses or is sanctioned with regard to any license, certification or accreditation required by this Contract or state and federal laws, that this contract may be terminated immediately in whole or in part.

PARA #119 INDEPENDENT CONTRACTOR RELATIONSHIP: (130) 05/01/12

In its relationship with DHS and the state and for purposes of performing any services assigned under this Contract, Contractor warrants that Contractor is an independent contractor. Contractor shall therefore be responsible for compliance with all laws, rules, and regulations involving its employees and any subcontractor(s), including but not limited to employment of labor, hours of labor, health and safety, working conditions, workers' compensation insurance, and payment of wages. Neither Contractor nor any of Contractor's agents, servants, employees, subcontractors or suppliers shall become or be deemed to become agents, servants, or employees of the DHS or the state. This Contract shall not be construed so as to create a partnership or joint venture between Contractor and the state or any of its agencies.

PARA #120 PUBLICITY:

Contractors must ensure that any publicity given to the program or services provided herein identifies DHS/DFCS as a sponsoring agency. Publicity includes, but is not limited to, signs, notices, information pamphlets, press releases, brochures, radio or television announcements, or similar information prepared by or for Contractor. Prior approval for the materials must be received from the County Department’s managing programmatic division/office. All media and public information materials must also be approved by the Commissioner’s Office of Legislative Affairs and Communications. In addition, the Contractor shall not display the DHS’s name or logo in any manner, including, but not limited to, display on Contractor’s letterhead or physical plant, without the prior written authorization of the Commissioner of DHS.

PARA #121 INVENTIONS, PATENTS, COPYRIGHTS, INTANGIBLE PROPERTY AND PUBLICATIONS:

Any documents or other material prepared or in the process of being prepared by Contractor in connection with Contractor's performance of services under this Contract shall be deemed property of DHS and all right, title, and ownership interest in any such documents shall vest in DHS immediately upon their creation and Contractor further agrees to execute any and all documents or to take any additional actions that may be necessary in the future to fully effectuate this provision.

A. Inventions and patents. The Contractor agrees if patentable items, patent rights, processes, or inventions are produced in the course of work supported and funded by this contract, to report such facts in writing promptly and fully to the County Department. The federal agency and DHS shall determine whether protection of the invention or discovery shall be sought. The federal agency and DHS will also determine how the rights to the invention or discovery, including rights under any patent issued thereon, shall be allocated and administered in order to protect the public interest consistent with Government Patent Policy.

B. Copyrights. Except as otherwise provided in the terms and conditions of this contract, the author or DHS is free to copyright any books, publications, or other copyrightable materials developed in the course of, or under this contract. Should any copyright materials be produced as a result of this contract, the federal agency and DHS shall reserve a royalty-free nonexclusive and irrevocable right to reproduce, modify, publish, or otherwise use and to authorize others to use the work for government and purposes.

C. Publications: All publications, including pamphlets, art work, and reports shall be submitted to the County Department on disk or electronically.

PARA #122 (A) DRUG-FREE WORKPLACE:

A. If Contractor is an individual, he or she hereby certifies that he or she will not engage in the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana during the performance of this contract.

B. If Contractor is an entity other than an individual, it hereby certifies that it will comply with the Drug-Free Workplace Act of 1988 (Public Law 100-690, Title V, Subtitle D; 41 U.S.C. 701 et seq.) and that:

1. A drug-free workplace will be provided for Contractor's employees during the performance of this contract; and

2. It will secure from any subcontractor hired to work in a drug-free workplace the following written certification: “As part of the subcontracting agreement with (Contractor's Name), (Subcontractor's Name) certifies to the Contractor that a drug-free workplace will be provided for the subcontractor's employees during the performance of this contract pursuant to paragraph 7 of subsection B of Official Code of Georgia Annotated Section 50-24-3".

C. Contractor may be suspended, terminated, or debarred if it is determined that:

1. Contractor has made false certification herein above; or

2. Contractor has violated such certification by failure to carry out the requirements of Official Code of Georgia Annotated Section 50-24-3.

PARA #122 (B) FIRE ARMS-FREE WORKPLACE:

A. Contractor will have policy to maintain a firearms free workplace and prohibit the possession of firearms regardless of any license or permit that an individual may have which would otherwise authorize the individual to carry a firearm.

PARA #123 FEDERAL AND STATE PROHIBITIONS RELATED TO LOBBYING:

A. Pursuant to Section 1352 of Public Law 101-121, Contractor agrees that:

1. No federally appropriated funds have been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

2. As a condition of receipt of any federal contract, grant, loan, or cooperative agreement exceeding $100,000, Contractor shall file with the County Department a signed "Certification Regarding Lobbying," attached hereto as Annex B.

3. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the Contractor shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions, copies of which may be obtained from the County Department

4. A disclosure form will be filed at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by Contractor under subparagraphs (b) or (c) of this paragraph. An event that materially affects the accuracy of the information reported includes:

a. A cumulative increase of $25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered federal action; or

b. A change in the person(s) or individual(s) influencing or attempting to influence a covered federal action; or

c. A change in the officer(s), employee(s), or member(s) contacted to influence or attempt to influence a covered federal action.

Contractor shall require that the prohibitions and requirements of this paragraph be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

B. Contractor further agrees that in accordance with the federal appropriations act:

1. No part of any federal funds contained in this contract shall be used, other than for normal and recognized executive-legislative relationships, for publicity or propaganda purposes, for the preparation, distribution or use of any kit, pamphlet, booklet, publication, radio, television, or video presentation designed to support or defeat legislation pending before the Congress or any State legislature, except in presentation to the Congress or any State legislature itself.

2. No part of any federal funds contained in this contract shall be used to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence legislation or appropriations pending before the Congress or any State legislature.

C. Contractor further agrees that no part of state funds contained in this contract shall be used for the preparation, distribution or use of any kit, pamphlet, booklet, publication, radio, television, Internet, or video presentation designed to support or defeat legislation pending before the General Assembly or any committee thereof, or the approval or veto of legislation by the Governor or for any other related purposes.

PARA #124 CRIMINAL RECORDS INVESTIGATIONS:

(USED FOR DHS/DFCS CONTRACTS WHEN CLIENTS ARE SERVED)

A. The Contractor agrees that, for the filling of positions or classes of positions having direct care/treatment/custodial

responsibilities for services rendered under this contract, applicants selected for such positions shall undergo a criminal history

investigation which shall include a fingerprint record check pursuant to the provisions of Section 49-2-14 of the Official Code of

Georgia, Annotated (O.C.G.A.). New staff/sub-contractors must have a successful criminal records fingerprint background check

prior to service provision. Existing staff must have a successful criminal records fingerprint background check every five (5) years from the initial criminal background check. Fingerprint record checks shall be submitted via Live Scan electronic fingerprint technology.

Contractor must register with the Georgia Applicant Processing Services (GAPS) at ga. and follow the instructions provided at that website.

B. Pursuant to O.C.G.A. § 49-2-14, after receiving and reviewing the criminal history report generated through the Cogent-GAPS process, DHS will advise the Contractor if the applicant is eligible or not eligible to provide services to DHS . Said advisement will be accomplished through a fitness determination letter issued by the DHS’s Office of Inspector General Background Investigations Unit (OIG BIU) within fifteen (15) days of receiving the criminal history record. Circumstances may extend said fifteen (15) days if OIG BIU determines that the applicant’s criminal history record needs further review. If it is determined that the applicant is not eligible to provide services to DHS, said applicant will not be eligible to provide services to DHS under any circumstances.

C. Contractor further agrees to complete a criminal history fingerprint National Crime Information Center (NCIC) background report of all foster parents, residential and group home staff. Contractor must obtain satisfactory results of criminal history report before the placement of a child. If Contractor’s foster parent fails to successfully pass the criminal history fingerprint check, such individual will not be qualified to perform any services under this contract. Further, Contractor agrees that if a child is placed in a foster home with foster parents for whom Contractor has not received a satisfactory criminal history report, Contractor will repay all amounts paid to Contractor for the Room, Board and Watchful Oversight of the child during any such period when Contractor had not received a satisfactory criminal history report for the foster parents and DHS may, in its discretion, withhold payments owed to Contractor under this or any other Contract to recoup the amount paid to the contractor during such period.

Any adult (age 18 and over) with the exception of foster children,residing permanently or temporarily in the home and having access to children must inform the approving agency of any criminal indictments or convictions. A criminal records check including GCIC and NCIC finger printing must be performed and the outcomes documented. Repeat criminal records check, including fingerprinting, is required at least every (5) years at the time of the Annual Re-evaluation for all current foster parents and adults (age 18 and over) residing in the home.

D. Provisions of this paragraph of the contract shall not apply to persons employed in day-care centers, group day-care homes, family day-care homes, or child care learning centers which are required to be licensed, registered, or commissioned by DHS or by the Georgia Department of Early Care and Learning, or to personal care homes required to be licensed, permitted, or registered by the Department of Community Health.

PARA #125 AIDS POLICY:

Contractor agrees, as a condition to provision of services to the County Department’s consumers/customers/clients/patients, not to discriminate against any consumer/customer/client/patient who may have AIDS or be infected with Human Immunodeficiency Virus (HIV). The Contractor is encouraged to provide or cause to be provided appropriate AIDS training to its employees and to seek AIDS technical advice and assistance from the appropriate County Department office, as the Contractor deems necessary. The Contractor further agrees to refer those consumers/customers/clients/patients requesting additional AIDS related services or information to the appropriate county health department.

PARA #126 INDEMNIFICATION:

(NOT APPLICABLE TO STATE ENTITIES/BOARD OF REGENTS INSTITUTIONS/BOARDS OF HEALTH)

Contractor hereby waives, releases, relinquishes, discharges and agrees to indemnify, protect and save harmless the State of Georgia (including the State Tort Claims Trust Fund), DHS, DOAS, their officers and employees (collectively "indemnitees") of and from any and all claims, demands, liabilities, losses, costs or expenses and attorneys' fees caused by, growing out of, or otherwise happening in connection with this Contract due to any act or omission on the part of Contractor, its agents, employees, subcontractors, or others working at the direction of Contractor or on Contractor's behalf, due to the application or violation of any pertinent federal, state or local law, rule or regulation, or due to any breach of this Contract by contractor (collectively, the "Indemnity Claims").

This indemnification extends to the successors and assigns of the Contractor, and this indemnification and release survives the termination of this Contract and the dissolution or, to the extent allowed by law, the bankruptcy of the Contractor.

If and to the extent such damage or loss as covered by this indemnification is covered by the State Tort Claims Fund or any other self-insurance funds maintained by DOAS (collectively, the "funds"), the Contractor agrees to reimburse the Funds for such funds paid out by the Funds. To the full extent permitted by the Constitution and the laws of the State of Georgia and the terms of the Funds, the Contractor and its insurers waive any right of subrogation against the State of Georgia, the Indemnitees, and the Funds and insurers participating thereunder, to the full extent of this indemnification.

Contractor shall, at its expense, be entitled to and shall have the duty to participate in the defense of any suit against the Indemnitees. No settlement or compromise of any claim, loss or damage asserted against Indemnitees shall be binding upon Indemnitees unless expressly approved by the Indemnitees.

PARA #127 DEBARMENT:

In accordance with Executive Order 12549, Debarment and Suspension, and implemented at 45 CFR Part 76, 100-510, Contractor certifies by signing Annex C that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract by any federal department or agency. Contractor further agrees that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion -- Lower Tier Covered Transaction," without modification, in all lower tier transactions and in all solicitations for lower tier covered transactions.

PARA #128 NONSMOKING POLICY FOR CHILDREN’S SERVICES:

The Contractor agrees to comply with Public Law 103-227, also known as the Pro-Children Act of 1994, which requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by the Contractor and used routinely or regularly for the provision of health care, day care, early childhood development services, education or library services to children under the age of 18. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty up to $1,000.00 for each violation and/or the imposition of an administrative compliance order on the Contractor.

PARA #129 INSURANCE:

(NOT APPLICABLE TO STATE ENTITIES/BOARD OF REGENTS INSTITUTIONS/BOARDS OF HEALTH)

The following requirements shall be adhered to by Contractors throughout the duration of the Contract, and as may otherwise be specified herein. Contractor shall procure and maintain insurance that shall protect the Contractor and DHS from any claims for bodily injury, property damage, or personal injury that may arise out of operations under the Contract. Contractor shall procure the insurance policies at its own expense and shall furnish DHS an insurance certificate of the coverage required in this section listing DHS as certificate holder. In addition, the insurance certificate must provide the name and address of the insured, name, address, telephone number and signature of the authorized agent; the name of the insurance company (licensed to operate in Georgia); a description of the coverage in detailed standard terminology (including policy period and limits of liability); and, an acknowledgment that notice of cancellation is required to be given to DHS. Contractor is required to obtain and maintain the following types of insurance coverage for the duration of the Contract:

A. Workers Compensation Insurance (Occurrence) in the amounts of the statutory limits established by the General Assembly of the State of Georgia in Title 34, Chapter 9 of the O.C.G.A. (A self-insurer must submit a certificate from the Georgia Board of Workers Compensation stating that Contractor qualifies to pay its own workers compensation claims). Contractor shall require all subcontractors that are required by statute to hold workers compensation insurance and that occupy the premises or perform work under this Contract to obtain an insurance certificate showing proof of Workers Compensation Coverage.

B. Commercial General Liability Policy (Occurrence) to include contractual liability. $1 million per occurrence/$3 million dollar aggregate policy limits.

C. Business Auto Policy (Occurrence) to include but not be limited to liability coverage on any owned, non-owned and hired vehicle used by Contractor or Contractor’s personnel in the performance of this Contract. $1 million per occurrence/$3 million dollar aggregate policy limits.

D. Malpractice/Professional Liability Policy (Claims Based) with Errors and Omissions Coverage. $1 million per occurrence/$3 million aggregate policy limits.

E. Commercial Umbrella Policy (Occurrence). An umbrella policy may cover the aggregate policy limits required herein. There must be no gap between the $1 million and $3 million dollar policy limits and the umbrella policy must follow the form of the underlying $1 million primary policy.

The Contractor’s policy containing coverage amounts with higher limits than stated above will satisfy the requirements of this paragraph.

The foregoing policies shall contain a provision that coverage afforded under the policies will not be canceled, or not renewed or allowed to lapse for any reason until at least 10 days prior written notice has been given to DHS . Certificates of Insurance showing such coverage to be in force shall be filed with DHS prior to commencement of any work under this Contract. The foregoing policies shall be obtained from insurance companies licensed to do business in Georgia and shall be with companies acceptable to DHS. All such coverage shall remain in full force and effect during the initial term of the Contract and any renewal or extension thereof. At all times, coverage shall be within limits acceptable to DHS.

SECTION II SPECIAL TERMS AND CONDITIONS: SECTION IIA

PARA #201 DHS AND CONTRACTOR AGREEMENTS: (201) 3/17/03

WITNESSETH:

WHEREAS, DHS has a need for and desires Room, Board and Watchful Oversight (R.B.W.O.) services for children in DFCS custody.

AND

WHEREAS, the Contractor has represented to DHS its willingness and ability to provide the services and/or products identified herein.

NOW, THEREFORE, in consideration of the mutual covenants herein set forth, it is agreed by and between the parties hereto as follows:

A. The Contractor agrees:

1. That the Contractor’s provider application, which was approved by DHS, is made a part of this contract and is incorporated herein by reference. The Contractor’s provider application is on file with DHS’s, Division of Family and Children Services (DFCS), Office of Provider Management unit.

2. That this is a Performance Based Placement (PBP) and all performance scores will be published by DHS and used to facilitate placement decisions made by DHS. A detailed explanation of how scores will be determined is reflected in the R.B.W.O. Performance Based Placement Measurements and Standards Guide posted on the GA+SCORE website at and by reference, incorporated into this contract.

3. To fully comply with the FY 2014 R.B.W.O. Performance Based Placement (PBP) Measurements and Standards Guide, which contains all PBP requirements. The guide can be accessed on the GA+SCORE website at . The Contractor agrees to also fully comply with the FY 2013 R.B.W.O. Minimum Standards posted on the GA+SCORE website at . The Contractor agrees to abide by any changes made to the R.B.W.O. Minimum Standards.

4. That prior to commencing services under this contract, individuals in positions or classes of positions having direct care, treatment, or custodial access to confidential information of clients or any combination thereof shall undergo a criminal history investigation which shall include a fingerprint record check pursuant to the provisions of Section 49-2-14 of the Official Code of Georgia, Annotated (O.C.G.A.). Contractor shall, upon request, provide DHS with evidence of a satisfactory criminal record check of any members of its staff or a subcontractor’s staff assigned to or proposed to be assigned to any aspect of the performance of this contract. Contractor staff must have a satisfactory criminal records background check every five (5) years from the date of the initial criminal background check. Fingerprint record checks shall be submitted via Live Scan electronic fingerprint technology. Contractor must utilize the following method to comply with this requirement: Contractor will register with the Georgia Applicant Processing Services (GAPS) at ga. and follow the instructions provided at that website.

5. To provide an acknowledgement to DHS via the GA+SCORE System at confirming that they have reviewed the entire FY 2014 R.B.W.O. Performance Based Placement Measurements and Standards Guide and the FY 2014 R.B.W.O. Minimum Standards for the current fiscal year.

6. To participate fully in Performance Based Placement goals, and to provide regular and timely documentation by the 10th of the following month into GA+SCORE and the Georgia SHINES portal. The Performance Based Placement goals can be accessed on the GA+SCORE website at ww.. Scores will be provided quarterly. Goals and measures may be changed or modified throughout the contract year with a minimum of 90 days written notice to providers. The Contractor further agrees to abide by any changes made to the R.B.W.O. Performance Based Placement Measurements and Standards Guide.

7. To ensure the GA+SCORE System, at , is updated within 72 hours of an event, to include all admissions, and service delivery updates. Staff and administrative information, as well as a minimum of two different contact phone numbers and email addresses will be provided and updated within 72 hours of any change. Contact information must designate “after hours” and weekend referrals. Significant events relating to the provider’s operation or to the care or protection of children in its care must be reported in the GA + SCORE System, as soon as possible but no later than one business day.

8. To provide the services delineated in this contract in a manner that supports, and is consistent with, DHS’s values and principles (Annex E).

9. To maintain an admissions protocol that includes a process for accepting children for placement 24 hours per day and seven days per week.

10. To utilize a standard referral application form, once provided by DHS, for all RBWO placements and to document all referrals, including reasons for accepting or declining admissions, via the GA+SCORE system. Providers will have at least 90 days to implement use of the referral form once it is provided by DHS.

11. To comply with all applicable rules and regulations of the Department of Residential Child Care (RCC). Should the Contractor have an allegation of non-compliance with RCC rules and regulations, DHS, in its discretion, may suspend referrals to the Contractor or terminate the contract.

12. To provide DHS with an annual cost report, which shall include the contractor’s annual independent audit report. A complete and accurate cost report shall be submitted to DHS no later than ninety (90) days after the contractor’s fiscal year end closing. The Contractor further agrees to assist DHS in its efforts to obtain payments, or recover costs of any service provided under this contract from third parties. These obligations are in addition to the contractor’s obligations under Paragraph 115.

13. If the RBWO provider is a non-profit organization and RBWO revenues exceed RBWO expenses, the excess must be reinvested into the RBWO program and may not be used to subsidize other programs/books of business. As applicable, annual financial audits must contain a specific line item noting the excess RBWO operating revenues set aside for reinvestment into the RBWO program.

14. To accept children only within their approved program designations (Annex D) and contractual capacity. The contractor further agrees that all per diems will be paid in accordance with contracted program designations and associated per diems.

15. Child Placing Agencies are financially responsible for any per diem expectations established with a foster parent prior to an approved Departmental per diem waiver. The provider cannot recoup retroactive agency or foster home payments for greater than 60 180 days.

16. That admissions may be suspended in order to address any identified issues related to safety, risk or well-being. DHS will immediately notify the Contractor of the suspension and any required steps to be completed for the reinstatement of admissions.

17. Private provider agencies with whom DFCS contracts for the provision of placements for children in DFCS custody shall be required, through contract provisions, to certify that employees providing case management or supervisory services for DFCS have met the following criteria (unless waived by the Director of the Office of Provider Management):

a. Have an undergraduate degree from an accredited college or university:

b. If operating in the role of Human Service Professional, Case Support Worker, or Case Support Supervisor, complete RBWO Foundations course which consists of three (3) weeks of e-learning / field practice experience and one (1) week of classroom instruction for a total of four (4) weeks of instruction. The classroom component of Foundations culminates with a knowledge-based competency test based on the materials covered during the 5-day classroom experience. The test which consists of objective questions (multiple choice, true-false etc) must be passed with a score of at least 80% in order to earn credit for the classroom component. Please note that all or part of RBWO Foundations can be waived based on education and work experience. The RBWO Foundations Standards are posted on and by reference are incorporated into this contract.

c. Have 24 hours of job related ongoing professional development annually.

AND

B. DHS will:

1. Provide the Contractor with all necessary and available information about a child ,placed with the Contractor pursuant

to the terms of this contract, which shall include all supplemental documentation as it impacts the permanency goals

of each child.

2. Provide training to the Contractor regarding the Cost Reporting and other documentation required pursuant to this Contract.

3. Provide the Contractor with timely notification of any procedural or policy change impacting service delivery, case documentation or reporting.

4. Provide service authorization documentation for each child placed with Contractor, at the time of placement.

5. Make placement decisions that:

A. Locate the child near his/her residence whenever possible and/or appropriate

B. Maintain the child in school of origin whenever possible and/or appropriate

C. Keep siblings placed together

D. Reduce the length of time the child is in an emergency shelter

E. Expedite safe permanency for the child and minimizingminimizing time spent in out of home care, particularly more restrictive non-family like settings

6. Monitor the delivery and documentation of service by Contractor and issue reports to Contractor about the results of that monitoring.

7. Work with the Contractor to develop baseline data, performance measures and outcomes

supported by a rate structure to reach the defined outcomes, at a reasonable cost.

8. Ensure and make available to the Contractor, at the time of each referral, local DFCS case management telephone access

numbers for contact 24-hours per day, and 7 days a week,, via telephone, facsimile, and e-mail addresses.

9. Notify the contractor a minimum of five (5) business days prior to of any family team meetings, staffing sessions, court hearings or any other collaborative meeting

regarding a child and/or family.

10. Reimburse the contractor in a timely manner within 30 days for services provided under this contract.

11. Review Contractor’s performance reports generated by GA+SCORE.

12. Conduct site visits and randomly review file documents related to outcome measurements.

13. Make random requests for documentation to support information reported by the Contractor in GA+SCORE.

14. Collect and review data related to the Contractor’s performance on goals and outcome measurements, which measure

the quality of an agency’s service provision.

15. Commit to working closely with providers to implement the new training requirement (RBWO Foundations course).

Providers will receive advance notice regarding policies, training schedules and procedures developed to support

implementation, where applicable. Provider staff will be provided with ample training schedule options once the course(s) is

(are) available.

16. Remove child from placement within 24 hours of determining that child’s level of care has been incorrectly identified

SECTION III CONTRACT PAYMENT PROVISIONS

PARA #301 COUNTY DEPARTMENT PAYMENT TO CONTRACTOR: RBWO (301E) 2/23/84*

DHS will pay the Contractor at the rates as described in Annex D, for all children referred by DHS. The Contractor must submit individual premium/waiver requests to DHS if a payment premium/waiver is to be requested. The rate paid is to be claimed only if a child is placed by DHS and is in residence with the Contractor’s facility. In the event a child is transferred between Contractors , only the claim made by the Contractor where the child slept overnight will be honored for that date. The Contractor agrees to accept DHS’s payment rates and conditions for the services specified in this contract for the identified population. The Contractor agrees and is required to pursue reimbursement from other insurers and payers from which coverage for the consumers' services may be provided. The Contractor has the right and obligation to collect payment from eligible consumers for non-covered services, co-payments, and deductibles as well as collecting payment from third party sources for services. This paragraph is not intended to prohibit the Contractor from billing other local, state or federal agencies for reimbursable expenses that are not covered by the rate. Local DFCS will pay provider directly or through one of its local operating offices within 30 days of properly completed forms necessary to effect payment. The Contractor further agrees to comply with all reporting requirements as stipulated in the Contractor’s Provider Application.

PARA #302 PRE-BILL SUBMISSION: RBWO (306B) 4/8/98*

The Contractor agrees to return the Pre-Bill to the Division of Family and Children Services Payment Center during the term of this contract within 10 days of the receipt of the Pre-Bill for service. Any invoice submitted more than 10 days following the contract end date will not be paid by DHS.

If the Contractor is a Child Placing Agency (CPA), the Contractor will document separately that portion of the rate provided to the contracted community foster home for the room, board or watchful oversight of any child placed by DHS and that portion of the rate which is retained by the agency (Administrative Cost). The Pre-Bill to be used is attached hereto as Annex F.

SECTION IV COMPLIANCE WITH STATE AND FEDERAL LAWS, RULES, REGULATIONS AND STANDARDS:

PARA #401 STATE AND FEDERAL LAWS, RULES, REGULATIONS AND STANDARDS:

Contractor agrees that all work done as part of this contract will comply fully with all administrative and other requirements established by applicable federal and state laws, rules and regulations, and assumes responsibility for full compliance with all such laws, rules and regulations, and agrees to fully reimburse DHS for any loss of funds or resources resulting from non-compliance by Contractor, its staff, agents, or subcontractor as revealed in any subsequent audits. Contractor understands that the following items specifically apply to this contract, but do not exclude any other applicable federal or state laws or requirements.

A. Compliance with Health Insurance Portability and Accountability Act (HIPAA):

It is understood and agreed that DHS/DFCS is a “covered entity” as defined by HIPAA of 1996 and the federal “Standards for Privacy of Individually Identifiable Health Information” promulgated hereunder at 45 CFR Parts 160 and 164. Further, it is agreed that as a business associate of DHS/DFCS that its use or disclosure of any person’s protected health information received from or on behalf of DFCS will be governed by the Business Associate Agreement, attached hereto as Annex G which Contractor agrees to by signing this contract. Such Business Associate Agreement is executed and is effective simultaneously with this contract/amendment. However, the Business Associate Agreement will survive this contract/amendment pursuant to Section 4.3 d of the Business Associate Agreement.

B. Compliance with Security Management Process:

Contractor agrees to provide to the DHS of Information Technology (OIT) a secure network connection allowing electronic access to all contractors’ facilities that receive, transmit, store or process DHS electronic data. Contractor agrees to provide such connection within five (5) business days of a request from DHS OIT in order for DHS to conduct ongoing risk analysis, risk management and information system activity reviews with regard to security of DHS’s electronic data, as defined in the HIPAA Security Rule, 45 CFR § 164.308 (a)(1).

C. 45 CFR Part 74; as used in this contract, the word Contractor is synonymous with the word Sub-grantee as used in this Code of Federal Regulations.

D. Compliance with Executive Orders Concerning Ethics and Lobbyist Registration:

Contractor agrees to comply in all applicable respects with the Governor’s Executive Orders concerning ethics matters, including, but not limited to Executive Order dated January 10, 2011 (Establishing Code of Ethics for Executive Branch Officers and Employees, including provisions governing former officers and employees) and Executive Order dated October 1, 2003 (Providing for the Registration and Disclosure of Lobbyists Employed or Retained by Vendors to State Agencies). In this regard, Contractor certifies that any lobbyist engaged to provide services has both registered and made the disclosures required by the Executive Orders.

E. Fair Labor Standards Act of 1938, as amended.

F. OMB Circular A-133 Subpart D--Federal Agencies and Pass-Through Entities §_.400(c): Subrecipient Federal Grant Award Information, Annex J, which is applicable if federal funds are the source of the grant award to the subrecipient. Notwithstanding Paragraph 107 of this contract, this Annex may be updated by DHS from time to time which shall not be considered a contract modification/alteration requiring execution by the parties.

G. Compliance with Federal and State Immigration Laws: Contractor agrees that Contractor complies with O.C.G.A. Sec. 13-10-90 et seq. regarding security and immigration compliance, and that Contractor has registered with, is authorized to use, uses, and will continue to use the federal work authorization program. Contractor also agrees that throughout the performance of this Contract, including renewal options, if any, exercised by the Department, Contractor will remain in full compliance with all federal and state immigration laws, including but not limited to O.C.G.A. §13-10-91.

Contractor certifies by signing and providing the sworn affidavit in Annex K that Contractor will comply with O.C.G.A. Sec. §13-10-90 et seq., and will certify the same upon the exercise of each renewal option, if any, by the Department. Furthermore, Contractor agrees to include the provisions contained in the foregoing paragraph in each subcontract and sub-subcontract for services hereunder, require and obtain a sworn affidavit in the applicable format set forth in Annex K at the initiation of and throughout the contract period, and retain the affidavit(s) in accordance with the record retention requirements of this Contract.

PARA #402 AUDITS AND FINANCIAL REPORTING REQUIREMENTS: (402A) 04/01/13

Contractors that expend $500,000 or more in Federal funds during their fiscal year agree to have a single entity-wide audit conducted for that year in accordance with the provisions of the Single Audit Act Amendments of 1996 (Public Law 104-156) and their implementing regulation, OMB Circular A-133 entitled, “Audits of States, Local Governments, and Nonprofit Organizations.” The audit reporting package shall include the documents listed in the Department of Human Services On-line Directives Information System POL 1244, External Entities Audit Standards and Sanctions.

Contractors expending $100,000 or more in State funds during their fiscal year agree to have an entity-wide audit conducted for that year in accordance with Generally Accepted Auditing Standards issued by the American Institute of Certified Public Accountants. The audit reporting package shall include the documents listed in the Department of Human Services On-line Directives Information System POL 1244, External Entities Audit Standards and Sanctions.

Contractors expending at least $25,000 but less than $100,000 in State funds during their fiscal year agree to prepare unaudited entity-wide financial statements for that year. Assertions concerning the basis of financial statement preparation must be made by the president or other corporate official as described in the Department of Human Services On-line Directives Information System POL 1244, External Entities Audit Standards and Sanctions.

Contractor further agrees to submit the required audit or financial statements in the quantities set forth below within 180 days after the close of the Contractor’s fiscal year:

One (1) copy to: One (1) copy to:

Director, Internal Audits Georgia Department of Audits and Accounts

DHS Office of the Inspector General, Suite 30-450 Nonprofit and Local Government Audits Division

Two Peachtree Street, N.W. 270 Washington Street, S.W., Suite 1-156

Atlanta, Georgia 30303-3142 Atlanta, Georgia 30334-8400

Or email to Audits@dhr.state.ga.us

Contractor acknowledges that annual cost reports are subject to audit. Any non-allowable costs may impact contracted per diems. All expenses included in the annual cost report must be fully supported by authentic, verifiable documentation. Supporting documentation includes any and all working documents related to expense and subject allocation bases. Documentation must be readily available for a period not less than seven (7) years.

Contractor understands that according to the provisions of this contract and as described in the Department of Human Services On-line Directives Information System POL 1244, External Entities Audit Standards and Sanctions, failure to comply with the above audit and financial reporting requirements could be cause DHS to suspend payments, to terminate this contract, to require a refund of all monies received under this contract and to prohibit the Contractor from receiving funds from any state organization for a period of twelve (12) months from the date of notification by DHS or the Georgia Department of Audits and Accounts.

PARA #403 CRITICAL INCIDENT REPORTING:

Contractor has the responsibility for ensuring the health and safety of Departmental clients/consumers/customers served under this contract is not placed in any jeopardy. Therefore, Contractor shall have an effective response system when critical incidents occur. This responsibility includes, but is not limited to, any and all subcontractors employed by Contractor to provide services pursuant to this contract.

A. In the case of an emergency, Contractor shall call the appropriate local emergency medical services, police, or fire services (i.e., 9-1-1).

B. Contractor shall have a formal written critical incident reporting procedure that is approved by the licensing or certification authority, if applicable, and by DFCS.

C. Contractor is responsible for taking necessary actions to protect Departmental clients from any possibility of harm. In doing this, Contractor should preserve possible evidence for an investigation if one is to be conducted.

D. Contractor must notify the appropriate Departmental staff of the critical incident and results of any immediate action taken. Contractor is expected to notify local law enforcement authorities in any situation where there is a potential violation of criminal law.

E. DFCS will determine whether the Contractor’s actions were appropriate and sufficient, and/or whether additional corrective actions are warranted. In investigating a Critical Incident, DHS will determine:

1. Whether or not client’s health, safety and welfare are adequately protected;

2. That the response to the situation and event was reasonable and appropriate;

3. That the Contractor’s procedures and system for responding to such incidents were adequate; and that relevant steps to prevent similar incidents were taken;

4. That Contractor and/or its staff or subcontractors involved in the incident appear to be adequately trained or that additional training needed is to be provided pursuant to the Critical Incident Report.

F. Contractor agrees to cooperate with DHS in its investigation of all Critical Incidents, and implement all corrective actions necessary to ensure the safety and well-being of the individuals served under this contract

G. Each Contractor shall post a “Notice Concerning Critical Incident Reporting.” The signage shall be produced by the Contractor and shall conform in content to the sample Annex H which is attached to this contract. The Notice must be posted in a conspicuous, common area accessible to clients/consumers, and the general public.

All other required reporting procedures (i.e., child abuse reporting, etc.) and the timelines of other required reports will remain in force and are not replaced or superseded by the CIR process.

Contractor shall not use or disclose any information received during the investigation of a critical incident for any purpose not connected with the administration of Contractor’s or the DHS ’s responsibilities under this contract, except with the informed, written consent of the client or the client’s legal guardian, as required by law.

PARA #404 ENTIRE UNDERSTANDING:

This contract, together with the annexes and all other documents incorporated by reference, represents the complete and final understanding of the parties to this contract. No other understanding, oral or written regarding the subject matter of this contract, may be deemed to exist or to bind the parties at the time of execution.

SECTION V:

PARA #501 CONTRACT ANNEX INCLUSION:

This contract includes annexes as listed below, which are hereto attached:

Annex A Government Funded Religious Activities Clarification

Annex B Certification Regarding Lobbying

Annex C Debarment Certification

Annex D Rate Schedule

Annex E DFCS Value Statement

Annex F Pre-Bill

Annex G HIPAA Business Associate Agreement

Annex H Notice Concerning Critical Incident Reporting

Annex I Resolution to Contract for Corporations

Annex J Subrecipient Federal Grant Award Information (applicable if federal funds are awarded to a subrecipient)

Annex K Security and Immigration Compliance Affidavits

SIGNATURES TO CONTRACT BETWEEN THE DEPARTMENT OF HUMAN SERVICES

AND

     

CONTRACTS WITH NONPROFIT CORPORATIONS

IN WITNESS WHEREOF, the parties have hereunto affixed their signatures on the dates indicated.

The contractor certifies by signature hereon that the named corporation is registered with the Georgia Secretary of State to do business in the State of Georgia and that all required reports have been filed with that office, so as to ensure that the corporation is in good standing with the Georgia Secretary of State.

CONTRACTOR EXECUTION DEPARTMENTAL EXECUTION:

By:

*As of the Department of Human Services

Corporation

______________________________

Date signed by Contractor

________________________________

______________________________ Keith Horton

Name of Corporation Commissioner

________________________________

Print Name of Person Signing Date signed by DHS

CONTRACTOR ATTESTED:

Division/Office Director

By:

As of

the Corporation ________________________________

Signature

________________________________

Attestor's printed name Date signed by DHS

___________________________________

**Must be in accordance with the corporate resolution.

Attach to this contract marked Annex I a corporate resolution pertaining to and permitting this contract and authorizing and directing the above corporate officers to execute this contract for and on behalf of the corporation. When the corporate resolution is attached hereto, the same is hereby incorporated in and by reference made a part of this contract.

Annex A Page 1 of 2

GOVERNMENT FUNDED RELIGIOUS ACTIVITIES CLARIFICATION

1. DHS shall defer to the Contractor’s designation of positions serving a primarily spiritual, ministerial, or religious purpose. (Para. 104.A.)

2. The Contractor shall be deemed to be in compliance with the restrictions on the use of government monies in Paragraphs 104.A. and 105 if it segregates such funds into a separate account and refrains from using those funds to sponsor religious activities or to pay compensation or benefits to persons in non-secular positions. (Paras. 104.A. and 105.)

3. Without changing the requirements of Paragraph 104A, the Contractor maintains the right to employ personnel who can accept and support the Contractor’s mission statement and who can effectively support and relate to foster parents for whom religious beliefs are important. Employee personnel other than those in non-secular positions who only incidentally interact with spiritual, ministerial or religious programs may nevertheless be evaluated on their ability to fulfill the functions of these positions, which evaluation may include the ability to interact and communicate with those in non-secular positions and consideration of all other relevant factors. However, such incidental interaction with spiritual, ministerial or religious programs or personnel on the part of such employee personnel shall not be construed to constitute impermissible funding or support of such programs or personnel. The inability or unwillingness of an employee or prospective employee to work well with and be supportive of the Contractor’s other personnel, including its non-secular employees, may be considered by the Contractor. (Para. 104.A.)

4. The Contractor shall make available for inspection by DHS all non-privileged legally producible records required by this Contract; provided, however, that the private, confidential employment records of individual employees or prospective employees shall be treated as confidential by DHS and its personnel and shall not be disclosed to any third party without the consent of such employee or prospective employee, and if such records contain the mental impressions of Contractor agents, the consent of the Contractor. (Para. 104.A.) However, it is understood that DHS is subject to the provisions of the Georgia Open Records Act found at O.C.G.A. §§ 50-18-70 et seq. with regard to records coming into its possession in the normal course of business.

5. The phrases “consumer/customer/client,” “any person,” and “any individual” as used in Paragraph 104.B. refer only to children in state custody, and shall not be construed to include the potential and actual foster families with whom the Contractor places children. (Para. 104.B.)

6. The word “harassment” as used in Paragraph 104.B. shall be given its customary and ordinary meaning in law. (Para. 104.B.)

7. The term "government monies" as used in paragraphs 104 and 105 means only funds received by the Contractor directly from DHS.

8. DHS recognizes that as a religiously-based service provider, Contractor may from time to time engage in religious activities in its services and programs, including religious worship, instruction, proselytization, or promotion, and that no provision of Paragraph 105 shall be construed to prohibit said activities. DHS clarifies that incidental participation in such activities by employees other than those in non-secular positions shall not be construed to constitute impermissible funding or support of such

Annex A Page 2 of 2

activities in violation of this paragraph, but significant levels of participation in such activities will require payment from segregated funds or other means of pro-ration to assure that the employee's participation is not government funded. DHS further clarifies that residential programs may exert reasonable efforts to afford opportunities for religious activities for foster children or to excuse foster children from required religious activities in accordance with this paragraph. DHS will work with the Contractor to meet or accommodate the spiritual needs of a child when the child’s worship service, religious study, or religious observance is not attended by the majority of the children for whom the Contractor is providing care, or the Contractor does not have the resources to meet the child’s religious needs. (Para. 105)

9. Contractor will determine the nature of Contractor's relationship with foster parents. Should Contractor enter into subcontracts with foster parents, all subcontractor requirements of Paragraph 116 under the contract will apply. Subcontractor requirements will not apply to foster parents considered as agents, volunteers, or compensated or uncompensated staff members of Contractor, but the anti-discrimination clauses as herein clarified will apply.

10. DHS recognizes that compliance with paragraphs 104 and 105 may require Contractor to engage in substantial revisions of its operating policies and procedures. Accordingly, while Contractor is expected to make best efforts to come into compliance as soon as possible, full compliance shall not be required until October 3, 2004, provided the Contractor commences its good faith compliance efforts with reasonable promptness.

11. All services provided by parties contracting with, funded in whole or in part by, or acting on behalf of DHS or its divisions, including individual foster parents, child welfare agencies, child caring institutions and child-placing institutions as defined in O.C.G.A. § 49-5-3, shall be performed without discrimination or harassment based upon a child’s religion, religious beliefs, race, color, national origin, age, disability, creed, political affiliation, gender, sexual orientation, or HIV/AIDS status. This provision, and contractual terms related to this provision, are intended to acknowledge DHS’s commitment to see that no child in its custody is taunted, verbally or physically assaulted, or otherwise ridiculed for reasons based on sexual orientation or for any other reason. Nothing in this provision or in the contractual terms related to this provision is intended to create or recognize sexual orientation as a new protected class or to confer rights and privileges based on sexual orientation beyond what is required by law.

12. It is understood that should controlling provisions of the federal or state constitutions be subjected to narrowing interpretation by decisions of the United States Supreme Court or Georgia Supreme Court issued hereafter that the provisions of the RBWO contract shall be revised to be consistent with then existing law.

13. Nothing in this contract shall be interpreted or applied in a manner that violates the constitutional rights of the Contractor, its employees agents or subcontractors including the foster families with whom it places children in state custody or to cause DHS to violate any legally binding constitutional or statutory provisions, including the Open Records Act.

ANNEX B

CERTIFICATION REGARDING LOBBYING

Certification for Contracts, Grants, Loans, and Cooperative Agreements

The undersigned certifies, to the best of his or her knowledge and belief, that:

1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

By Date_________________________________

(Signature of Official Authorized to Sign)

________________________________________

________________________________________

ANNEX C

CERTIFICATION REGARDING

DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION

LOWER TIER COVERED TRANSACTION

(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

(2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective

participant shall attach an explanation to this proposal.

____________________________________________ _________________________________ _______________________

Name and Title of Authorized Representative Signature Date

======================================================================================================

INSTRUCTIONS FOR CERTIFICATION

1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below.

2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

3. The prospective lower tier participant shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations.

5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -- Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List (Telephone 202/245-0729).

8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

ANNEX E

DFCS VALUES STATEMENT

The Division of Family and Children Services is committed to help children, and families in Georgia achieve safe, stable, and healthy lives. The Division’s child welfare practice seeks to achieve their primary outcomes for children and families: increased safety, permanency, and well-being. These outcomes are based on what the professional research supports as the most critical outcomes for our work and include the seven outcomes for which the federal Child and Family Services Review (CFSR) holds us accountable.

|Better results for child |Child and Family Services Review |

|Safety for Children |Children are, first and foremost, protected from abuse and neglect. |

| |Children are safely maintained in their homes whenever possible and appropriate. |

|Permanency |Children have permanency and stability in their living situations. |

| |The continuity of family relationships is preserved for children. |

|Well-Being |Families have enhanced capacity to provide for their children’s needs. |

| |Children receive adequate services to meet their physical and mental health needs. |

| |Children receive appropriate services to meet their educational needs. |

DFCS Values and Principles

The foundation of a case practice model is a clear understanding of the values and principles we hold and that we expect to be reflected in day-to-day practice:

Core Values

• Children need and deserve to grow-up safe, free, and protected from abuse and neglect.

• Children do best when they have strong families, preferably their own and when that is not possible, a stable relative, foster or adoptive family.

• All families need community support and genuine connections to people and resources.

• Families have the capacity to change with the support of individualized service responses.

• Government cannot do the job alone; community partnerships are essential to ensure child safety and build strong families.

Principles

• In making determinations about plans and services, we consider the child’s safety and health paramount.

• We must provide relevant services with respect for an understanding of children’s needs and children’s and families’ culture.

• No child or family will be denied a needed service or placement because of race, ethnicity, sexual orientation, physical or emotional handicap, religion, or special language needs.

• Where appropriate, families will be provided with the services they need in order to keep their children safe and at home in order to avoid the trauma of removal.

• Understanding the disproportionate representation of children and families of color among those supervised by DFCS, we will continually assess our tools, services and strategies to prevent racial and ethnic bias.

• Foster care will be as temporary an arrangement as possible.

• If at all possible, children in out-of-home placements will be safely reunified with their families within 12 months. Families will be provided with the services they need to allow for safe reunification whenever possible.

• If a child cannot be safely reunified within time frames established under federal and state law, DFCS will find a permanent home for the child, using child-specific recruitment plans when necessary, preferably with an appropriate relative or an adoptive family.

• We must work to ensure children in out-of-home placement have

o Stable placements that promote the continuity of critical relationships, including with their parents, siblings and capable relative, to achieve a sustainable permanent family setting.

o Placements in settings that are the least restrictive and meet their individual needs.

o Decision-making that is informed by a long-term view of the child’s needs, informed by the family team and is consistent with federal and state time lines about achieving an exit from care to a sustainable, safe permanent home.

Annex F

| |

GEORGIA DEPARTMENT OF HUMAN SERVICES

DIVISION OF FAMILY AND CHILDREN SERVICES

Pay Center Address

Pay Center City, State, Zip

PRE-BILL – Service Month Year

Per Parental Admin

SMID # Cust Child Name UAS Days Diem Subtotal Other Pay(-) Total Cost Comments

______________________________________________________________________________________________________________________________

000000000000|D|LAST NAME,FIRST NAME |506| | 31| 81.00| 2,511.00 | | | | |

____________|_|_______________________|___|___|___|_______|___________|_________|_________|_________|_________|_______________

Vendor #: ###### Agency Type:

VENDOR NAME

VENDOR ADDRESS LINE 1

VENDOR ADDRESS LINE 2

VENDOR CITY, STATE, ZIP

PHONE NUMBER

>>> DATE OF DISCHARGE (DOD) equals last night in facility. > DATE OF DISCHARGE (DOD) equals last night in facility. ................
................

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