User ID - Rutgers University



New Jersey Department of Human Services,

Division of Mental Health and Addiction Services

Electronic Signature Policy and

Provider Agency Agreement to Comply with the Policy

I. Purpose

The New Jersey Department of Human Services, Division of Mental Health and Addiction Services (DMHAS) has developed a web-based, paperless contracting system, the Contract Information Management System (CIMS). DMHAS designed CIMS to improve the transparency, accountability and efficiency of contract processing. In order for CIMS to be fully operational as a paperless contracting system, Provider Agencies must agree to submit and approve contract documents electronically.

II Definitions

All terms shall have the same definitions as provided in the State Contract Manuals and Standard Language Document.

III. Program Design

In lieu of receiving contract documents by mail, DMHAS and the provider agency shall send and receive and execute contract documents electronically through the CIMS web site. In order to do so, the provider agency will need to agree to be bound by electronic signature, use the DMHAS CIMS web site and need to receive user codes and passwords to do so. The process for managing the CIMS web site is as follows:

A. DMHAS shall the send the Executive Director (ED) or Agency Designee (AD) of a Provider Agency email(s) from DMHAS containing the following information to allow them to make the required electronic submissions:

1. CIMS User ID and Password for that ED or AD; and

2. Two codes, each for use by the ED/AD for submission a different portion of the required Electronic submission, specifically,

a. Authorization codes for submission of Annex B and Report of Expenditures (one code per agency).

b. Authorization code for approval of Standard Language Document, P1.10 Contract Modification Form and any other documents requiring ED signature (one code).

B. DMHAS shall send the Chairperson of the Board of Directors email(s) containing the following information:

1. CIMS User ID and Password for the Chairperson of the Board of Directors

2. Electronic signature authorization code for completion of the DHS Board Resolution Form Approving Contract and any other contract documents requiring Chairperson’s signature (one code).

3. The Electronic signature authorization code shall not be used by anyone other than the Chairperson.

C. Using the CIMS Administrator module, the Provider Agency ED/AD may assign user rights to as many agency personnel as necessary for the following actions:

1. Annex B - all actions including electronic signature

2. Report of Expenditures – all actions including electronic signature

3. Standard Language Document - all actions except electronic signature

4. Contract Modification - all actions except electronic signature

5. Other Contract Agreements and Actions - all actions except electronic signature

6. Annex A- all actions including approval

7. Programmatic Requirements- all actions including approval

D. A contract shall not be considered to have been executed without completion of all of these steps. Execution of a contract will be accomplished by:

1. Provider agency completion of all active CIMS Contract Application Steps 1-5 set forth below; and

2. Director of DMHAS shall electronically sign the SLD or P1.10 form

IV. Provider Agency Responsibilities

The Provider Agency:

A. shall maintain all CIMS User codes and passwords as confidential

B. shall complete, execute and submit contract documents as appropriate through CIMS.

C. shall complete, approve and, using the codes provided by DMHAS, submit all active steps on the CIMS “Contract Application Steps” screen, or any subsequent electronic contract system. At present, these steps are as follows:

1. Step #1- review and electronicially approve Annex A

2. Step #2- complete and electronically approve programmatic requirements in application

3. Step #3- complete and electronically sign Annex B

4. Step #4- complete online, electronically sign and/or forward all documents required by DHS contract policy as applicable, including electronically signed Board Resolution approving contract

5. Step #5- ED or designee electronically signs the Standard Language Document

6. Step #6- Submit contract package to DMHAS

D. shall require the agency Chairperson, Board of Directors to sign off on Electronic Signature Agreement. The Chair may not delegate this authority to the ED/AD

E. may allow the ED/AD to assign CIMS user rights to agency staff members and prevent unauthorized access.

F. within 3 business days of a change, notify DMHAS Contract Administrator of a change in Chairperson, ED or AD, so that DMHAS may terminate the CIMS User ID and Password.

G. within 1 business day, terminate the user rights of any provider agency personnel no longer employed or authorized to access CIMS.

H. within 3 business days of any change, inform the DMHAS Contract Administrator if email address for ED/AD or Chairperson, Board of Directors changes from address entered on original Electronic Signature Agreement.

I. shall obtain and maintain on file, a Board resolution agreeing to the following:

1. We accord       (Name Executive Director or Agency Designee)       (Title Agency Designee) all necessary authority to execute and assign authorization rights for all contract related matters between our agency and the Division of Addiction Services except for board resolutions.

2. We agree that all contracts entered by ______________________ (Provider Agency) shall, from the date of this Resolution forward shall be entered electronically pursuant to the New Jersey Department of Human Services, Division of Mental Health and Addiction Services, Electronic Signature Policy.

3. We agree to abide by all Provider Responsibilities set for in New Jersey Department of Human Services, Division of Mental Health and Addiction Services, Electronic Signature Policy.

4. We agree that all CIMS electronic signatures and authorization codes entered by the Chairperson of the Board, the Executive Director and the Agency Designee shall be legally binding on ________________ (Provider Agency) as if they were authorized signatures.

5. We agree that we shall not make any claims or seek damages, costs, judgments, or expenses in connection with or on account of the utilization of the New Jersey Department of Human Services, Division of Mental Health and Addiction Services Contract Information Management System (or any successor electronic contract) web site.

J. shall notify DMHAS within 3 business days in the event that a Board Resolution rescinding all or part of the resolution required by Section IV (I) or that has the effect of rescinding all or part of the resolution required by Section IV (I). Any such resolution shall be a basis for DMHAS to suspend or terminate the provider agency’s current contract(s) and bar it from receipt of any future contracts from the Division of Mental Health and Addiction Services.

By the signatures below, the Provider Agency agrees to comply with all aspects of this policy, as part of this agreement, and as part of its contractual responsibilities under any and all contracts in effect now and in the future, with the Division of Mental Health and Addiction Services.

           

Name Chairperson, Board of Directors Name, Agency Designee

           

Email Chairperson- Board of Directors Email - Agency Designee

Signature Signature

Chairperson, Board of Directors Agency Designee

Date Date

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