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Agreement between LCSO and Cascade Pacific Action Alliance BEFORE THE BOARD OF COUNTY COMMISSIONERS OF LEWIS COUNTY, WASHINGTON N RE ACCEPTANCE OF AN AGREEMENT ) Resolution No 19- 00' BETWEEN THE LEWIS COUNTY SHERIFF ) AND CASCADE PACIFIC ACTION ALLIANCE ) WHEREAS the Lewis County Shenff s Office has determined that the interests of the public are best served by accepting the agreement with Cascade Pacific Action Alliance, and WHEREAS there is no cost to the county, this agreement is for unanticipated revenue related to a Medication Assisted Treatment(MAT)program at the Lewis County Jail, and WHEREAS, it appears to be in the best public interest to authorize the execution of said agreements NOW THEREFORE BE IT RESOLVED that the Sheriff or, in his absence, the Undershenff or Corrections Chief, is authorized to sign the subjoined Agreement on behalf of Lewis County r DONE IN OPEN SESSION this a5 day of rCbf' U , 2019 REVIEWED AS TO FORM. I.? OF COUNTY COMMISSIONERS Jonathan Meyer, Prosecuting Attorney OUNTY, WASH GTON By Deputy Prosecuting Attorney Robe C Jackso , Chair ATTEST- Gary Sta per, Vice hair JJ Rieva Lester, Clerk of the B \ o,�'`/,is ee Edna J Fund, C. issioner o', / • • \ ry \�'o. ▪ SINCE k8 1845 ,L! z: • e e — 'co e.1'ee :�S1s`ee eeee DocuSign Envelope ID AO5BFDD1-6AC3-40C2-88E2-D3A7AB7222CB CASCADE PACIFIC) ACTION ALLIANCE Contract for Agency Services CPAA ACH LLC Contract No K2293-28 1217 4th Ave E., Suite 200 Olympia WA 98506 New Contract (360) 539 7576 Amendment/Modification No, Contractor INFORMATION Agency Name i Address Federal ID# Lewis County Sherriff 345 W Main Street, Chehalis, Department WA 98532 Contact Person Title Phone Number(s) Chris Sweet ) Contact's E-Mail Address Contact's Fax Number Contact's Phone Number (if different than above) CPAA INFORMATION Contract Title Medicaid Transformation Project Contact Person Title Contact Phone Number Christina Mitchell Program Director 360-539-7576 x 131 Contact E-Mail Address Contact's Fax Number mitchellc @crhn org 360-943-1164 CONTRACT INFORMATON Funding Source Funding Level Effective Dates HCA $ 79,900 Date of Execution to January 31, 2022 Reason for Amendment Amendment Amount (if opplicabte) (if upp1icable) Cascade Pacific Page 1 of 23 K2293-26 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-8BE2-D3A7AB7222CB CASCADE PACIFIC)) ArT!ON ALI!AN MEDICAID TRANSFORMATION PARTNERSHIP AGREEMENT BETWEEN CASCADE PACIFIC ACTION ALLIANCE(CPAA ACH LLC) AND LEWIS COUNTY SHERRIFF DEPARTMENT THIS"TRANSFORMATION PARTNERSHIP AGREEMENT"(Agreement)is made and entered Into by and between Cascade Pacific Action Alliance(CPAA)an Accountable Community of Health(ACH)at 1217 4th Avenue East, Suite 200 Olympia,WA 98506 And Lewis County Shernff Department,a Medicaid Transformation partnering provider(Partner)pursuant to Washington State s Medicaid Transformation Project(MTP) I RECITALS On January 9,2017 the Centers for Medicare& Medicaid Services(CMS)approved Washington State s request for a section 1115(a) Medicaid demonstration entitled Medicaid Transformation Demonstration project(Demonstration) Part of this Demonstration is a Delivery System Reform Incentive Payment (DSRIP)program through which the State will make performance-based funding available to regionally based ACH and their partnering providers In order to assure consistent management of an accounting for the distribution of DSRIP funds across ACHs, the Health Care Authority(HCA)has appointed Public Consulting Group(PCG)who is responsible for administering the funding distribution plan for the DSRIP program The tern"Partner"is specific to the contents of this Agreement and limited by the scope of the Demonstration as further defined in section 16 of this agreement 2 PURPOSE The purpose of this Agreement is to set forth each party s roles and responsibilities with respect to a specific Medicaid Transformation DSRIP project approved and selected for implementation as well the funding, project milestones,performance metrics and payment schedules for that project. 3 SCOPE OF WORK The Partner will furnish the necessary personnel,equipment material and,or service(s)and otherwise do all things necessary for or incidental to the performance of work set forth in Addendum 'B"attached and incorporated herein Cascade Pacific Page 2 of 23 K2293-28 Action Alliance DocuSign Envelope ID A05BFDD1-6AC3-40C2-88E2-03A7AB7222CB . , .. E PACIFIC)) ACTION ALLIANCE 4 PERIOD OF PERFORMANCE Subject to its other provisions the period of performance of this Agreement will commence on the date of final execution(signature),and be completed on January 31,2022,unless terminated sooner or extended,as provided herein 5 AGREEMENT CHANGES, MODIFICATIONS AND AMENDMENTS This Agreement may be changed,modified or amended only by written agreement executed by both parties with a 30-day notice 6 ASSIGNMENT The work to be provided by CPAA under this Agreement is supported by CHOICE Regional Health Network as per the legal agreement between both entities Work provided by the Partner and any claim arising thereunder,is not assignable or delegable m whole or in part,without the express prior written consent of CPAA,which consent will not be unreasonably withheld. 7 CONTRACT MANAGEMENT The program manager for each of the parties will be responsible for and will be the contact person for all communications and regarding the performance of this Agreement. a) The MTP programming contact for CPAA is Christina Mitchell 1217 4th Ave E Suite 200 Olympia. If":1 98506 phone 360.539 7576 ext. 131 b) The MTP financial contact for CPAA is Samantha Tatum 1217 4th Ave E Suite 200 Olympia W4 98506 phone 360.539.7576 ext. 118 c) The MTP contract Partner contact is Chris Sweet 34.1 WMain Street Chehalis WA 98532 Changes to contract management by either party will be made via email within 30 days of the effective change 8 DISTRIBUTION OF DSRIP FUNDS—GENERAL PRINCIPLES a) Basis for Payment to Partner The Partner will receive payment of DSRIP Funds from HCA's Financial Executor PCG as set forth by DSR1P guidelines only if and to the extent that CPAA has achieved the project milestones and performance measures specified in the CPAA Implementation Plan and the Partner s Change Plan Cascade Pacific Page 3 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-86E2-D3A7A87222C8 CASC DE PACIFIC) ACTION ALLIANCE Initial payment of DSRIP funds are based on the following: • Request for Proposal submission and selection as a partnering agency • Allocations for projects that qualifly for rural and health equity bonus pool allocations • A Signed contract Multiple project bonus pool allocations are based on • Multiple projects of four or more • Submission and review of the Partner s Change Plan o Multiple project bonus pool allocations will be processed after review of the Change Plan b) Payments Contingent on Partner Performance Payment of DSRIP Funds to the Partner is contingent on the Partner complying with the terms of this Agreement and the Partner s Change Plan, including timely submission of data to CPAA to meet the ACH's reporting obligations to the HCA, • Payment to eligible partners for multiple project bonus pool allocations will be processed upon submission and review of the Partner s Change Plan Multiple project bonus pool allocations are contingent upon four or more projects • Partner's performance on stated interventions project milestones and performance outcomes established in the Partner's Change Plan • Partner's timely quarterly reporting • Partner will show evidence for expansion or deepening of partnership projects, as this will be essential for the"scale"in DSRIP years • Other conditions and criteria as are set forth in the DSRIP guidelines • The Partner acknowledges in accordance with this section that it may not receive DSRIP funds,and that any such funds received may not cover all the costs or expenses related to Partner's participation in a DSRIP Project Plan. Payment Type Amount Payment Date Base Incentive $32,070 Upon Contract Execution Bonus Incentive. Attribution $15,870 Upon Contract Execution Equity Upon Contract Execution Rural Service $10,580 Upon Contract Execution Multiple Project Participation Submit Change Plan by 11/15/18 Performance Incentive $21,380 Submit Change Plan by 11/15/18 TOTAL Year 1 Funds Earned $79,900 c) Conclusion of Funds Payment of pay for performance DSRIP funds will conclude by second quarter 2023 Cascade Pacific Page 4 of 23 K2293-28 Action Alliance DocuSign Envelope ID'AO5BFDD1-6AC3-40C2-3BE2-D3A7AB7222C8 C.A5c DE PACIFiC:k ACTION ALLIANCE 9. DISALLOWED COSTS The Partner is responsible for any audit findings or disallowed costs incurred by its own organization or that of its Subcontractors 10. DATA SHARING AND PRIVACY a) Protected Health Information The Partner agrees and will acknowledge data sharing and pnvacy in accordance with the HIPAA Business Associate Agreement—Addendum A. b) Sharing Confidential Information The parties acknowledge that they may need to share Confidential Information other than PHI 'Confidential Information'means information of a party regardless of the form or media in which it is disclosed,which is identified in writing or other manner as confidential,restricted,or proprietary The parties will share Confidential Information in accordance with Section 7 of this Agreement c) Obligations of Confidentiality and Restrictions on Use A party receiving Confidential Information from the other party(the"Receiving Party")will not (a) use the Confidential Information of the Party making the disclosure(the"Disclosing Party") except as necessary to perform its obligations or exercise its rights under this Agreement,or disclose or otherwise allow access to the Confidential Information of the Disclosing Party to a third party.except as permitted in this Section The Receiving Party will protect the Confidential information of the Disclosing Party with at least the same level of care as it protects its own Confidential Information of similar nature,but not less than a reasonable level of care d) Disclosure of Confidential Information to Representatives The Receiving Party may disclose the Disclosing Party's Confidential Information to the Receiving Party s officers,directors,employees,professional advisors,and other agents and representatives to the extent such disclosure is necessary for the performance of their obligations under this Agreement; provided,however,that the Receiving Party will cause such Confidential Information to be held in confidence by any such recipient e) Compelled Disclosure If a Receiving Party is requested by a Federal or State court or other regulatory body to disclose Confidential Information in any legal or administrative proceeding or determines that a disclosure is affirmatively required by applicable laws,the Receiving Party will promptly notify the Disclosing Party of such request or determination so that the Disclosing Party may take,at its expense such steps as it may deem necessary to protect the Confidential Information If the Receiving Party is thereafter required to disclose the Confidential Information to the court or regulatory body compelling such disclosure or to which such disclosure is required to be made only the part of such Confidential Information as is required by applicable laws will be disclosed. Cascade Pacific Pace 5 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1.6AC3-4002-86E2•D3.A7AE37222CB . CASCADE PACIFIC,".; ACTION ALLIANCE if) Exceptions The obligations of confidentiality and restrictions on use as set forth to this Agreement will not apply to any Confidential Information that (a)is in the public domain or is otherwise publicly known, without any breach hereof;(b)was previously known prior to disclosure by the Disclosing Party to the Receiving Party free of any obligation to keep it confidential,(c) was rightfully received by the Receiving Party from a third party whose disclosure would not violate a confidentiality obligation owed by such third party to the Disclosing Party and which disclosure was not in breach of the Agreement;(d)was subsequently and Independently developed by the Receiving Party without reference to such Confidential Information disclosed under the Agreement, or(e)was expressly approved for release by written authorization of the Disclosing Party g) Obligations Upon Termination Upon expiration or termination of this Agreement for any reason each Party shall promptly return,or destroy in a secure manner,any Confidential information of the other Party and shall retain no copies thereof,except as required by law or to verify or document performance under this Agreement for audit purposes and to enforce Its rights and defend itself from any claims or causes of action related to this Agreement or the other Party Each Party shall extend the protections of this Agreement to any Confidential Information retained pursuant to this section and limit further uses and disclosures to those purposes permitted by this section 11 DISPU'T'E RESOLUTION a) In the event of any dispute arising under this Agreement the parties agree to meet and confer in good faith to resolve any such disputes before resorting to any other process identified herein Both parties will continue, without delay, to carry out their respective responsibilities under this Agreement that are not affected by the dispute b) If resolution under paragraph a)does not resolve the dispute within a reasonable period of time,any dispute arising out of,or in connection with,this Agreement shall first be subject to mediation for a sixty(60)day period This mediation time period starts when one party demands mediation Any dispute which cannot be amicably settled through mediation between the parties shall be finally settled by arbitration before a single arbitrator under the Rules of Commercial Arbitration of the American Arbitration Association except as modified herein, provided,however,that the parties do not intend by the use of such rules,that the American Arbitration Association('AAA')shall necessarily administer the arbitration The selected arbitrator must be a retired state or federal judge,magistrate who previously presided in the Thurston County Superior Court or a federal court located within the Western District of Washington In the event that the parties cannot agree upon an arbitrator within a seven (7)day time period after a demand for arbitration has been made, then each side shall submit to AAA a list of five (5) arbitrators,each of whom must possess the foregoing qualifications,and the AAA case administrator shall randomly draw the name of one of qualified candidates submitted to serve as the arbitrator(the random drawing method shall be determined by the AAA case administrator at his her discretion) Within thirty(30)days of the arbitrator s selection and receipt of payment in full by the AAA of all filing fees, the AAA case administrator shall schedule a preliminary hearing for the arbitrator and the parties, pursuant to Rule R 21 of the AAA Commercial Arbitration Rules to establish Cascade Pacific Page 6 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-88E2-D3A7AB7222CB f , .2. IE PACIFIC) ALLIANCE a plan for the parties exchange of information and a schedule for the remainder of the proceeding Each party shall initially bear its own costs and legal fees associated with such arbitration c) A demand for arbitration may be made as soon as it becomes apparent that the matter cannot be settled through mediation The mediation or arbitration shall take place in Olympia, Washington or such other location as mutually agreed by the parties hereto The resulting decision of the arbitrator shall be final and binding on the parties No request or demand for mediation or arbitration shall be made after the date on which the applicable statute of limitations would expire or as limited by this Agreement The award of the arbitrator or panel of arbitrators may, in the arbitrator s discretion include reasonable attorney's fees and expenses to the prevailing party and may be entered in any appropriate court.The decision of the arbitrator or arbitrators shall be rendered pursuant to a reasoned written legal opinion and final and binding upon the parties and judgment upon such decision may be entered in any court of competent jurisdiction d.) The Partner agrees that all disputes be resolved in Thurston County or in the county in which business is conducted 12 GOVERNANCE a) This Agreement is entered into pursuant to and under the authority granted by the laws of the state of Washington and any applicable federal laws The provisions of this Agreement will be construed to conform to those laws b) In the event of an inconsistency in the terms of this Agreement,or between its terms and any applicable statute or rule,the inconsistency will be resolved by giving precedence in the following order I. Applicable state and federal statutes and rules, 11 Scope of Work,Addendum B III Any other provisions of the Agreement,including materials incorporated by reference 13 INDEPENDENT CAPACITY The employees or agents of each party who are engaged in the performance of this Agreement will continue to be employees or agents of that party and will not be considered for any purpose to be employees or agents of the other party 14 RECORDS MAINTENANCE The parties to this Agreement will each maintain books,records,documents and other evidence which sufficiently and properly reflect all direct and indirect costs expended by either party in the performance of the services described herein These records will be subject to inspection,review or audit by personnel of both parties,other personnel duly authorized by either party,the Office of the State Auditor,and federal officials so authorized by law All books records documents and other material relevant to this Agreement will be retained for six years after expiration and the Office of the State Auditor.federal auditors, and any persons duly authorized by the parties will have full access and the right to examine any of these materials during this period. Cascade Pacific Page 7 of 23 K2293-28 Action Alliance DccuSign Envelope ID A05BFDD1-6AC3-4CC2-8BE2-D3A7AB7222CB CASCADE MOM)) • ,-" ` :-SON ALLIA`. Records and other documents in any medium, furnished by one party to this Agreement to the other party will remain the property of the furnishing party,unless otherwise agreed.The receiving party will not disclose or make available this material to any third parties without first giving notice to the furnishing party and giving it a reasonable opportunity to respond. Each party will utilize reasonable security procedures and protections to assure that records and documents provided by the other party are not erroneously disclosed to third parties 15. RECORD RETENTION AND AUDITING a) Retention of Records The Partner will retain all records ("Records")relating to its activities related to the DSRIP program for a period of not less than six years,or as otherwise required by applicable law and regulations b) Sufficiency of Records The Records will be sufficient to support confirmation that all data submitted by the Partner to CPAA for any and all reports required by CPAA or CMS is accurate and complete c) Audit All Records relating to the DSRIP program are subject at all reasonable times for inspection. review,or audit by CPAA and other state and federal officials so authorized by law rule regulation or agreement 16 \IISCELLANEOUS a) Independent Contractor The parties understand and agree that the parties Intend to act and perform their respective obligations under this Agreement as independent contractors and that neither is an employee partner or joint venture of the other b) Required Insurance Each Party will at its own cost and expense have in effect insurance coverage of such amounts and types usually maintained by entities such as the parties including but not limited to L &I insurance compensation, commercial general liability insurance,including contractual liability,of not less than SI million per claimiS2 million general aggregate,errors and omissions coverage of not less than S1 million per claim,'S2 million general aggregate c) Indemnity/Hold Harmless Provision The Partner shall defend. indemnify and hold CPAA ACH LLC,its officers,officials employees and volunteers harmless from any and all claims injuries damages losses or suits including attorney fees. arising out of or in connection with the performance of this Agreement, except for injuries and damages caused by the sole negligence of CPAA ACH LLC It is further specifically and expressly understood that the indemnification provided herein constitutes the Partner's waiver of immunity under Industrial Insurance Title 51 RCM/ solely for the purposes of this indemnification The provisions of this section shall survive the expiration or termination of this Agreement Cascade Pacific Page 8 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-88E2-D3A7AB7222CB CASCA AC r;.0^,; - 17 REPRESENTATIONS AND WARRANTIES a) The Partner represents and warrants that it is not presently debarred.suspended,proposed for debarment declared ineligible or voluntarily excluded in any Washington State or Federal department or agency from b) participating in transactions(debarred) The Partner must immediately notify CPAA if during the term of this Agreement,the Partner becomes debarred c) The Partner further agrees it will not commit a discriminatory act prohibited by state law on the basis of sex,race age creed,religion,color,national origin,disability,sexual orientation,or marital status,or engage in any discriminatory practices which are counterproductive to or place the project at risk. d) Each part represents and warrants that it is in compliance with,and will at all times hereafter comply with, all federal licensing,accreditation and registration requirements and standards necessary for the completion of the deliverables outlined in Addendum B e) The Partner further agrees it will not engage in any discriminatory practices which are counterproductive to or place the project at risk. I) Each party represents and warrants that it has all requisite corporate power and authority to execute and deliver this Agreement and to consummate the transactions contemplated herein,and to perform its obligations in accordance with the terms of this Agreement. 18. SEVERABILITY If any provision of this Agreement or any provision of any document incorporated by reference is determined invalid by a court of competent jurisdiction,such invalidity will not affect the other provisions of this Agreement,which can be given effect without the invalid provision if such remainder conforms to the requirements of applicable law and the fundamental purpose of this Agreement,and to this end the provisions of this Agreement are declared to be severable 19 TERMINATION FOR CAISE If for any cause,either party does not fulfill in a timely and proper manner its obligations under this Agreement, or if either party violates any of these terms and conditions,the aggrieved party will give the other party written notice of such failure or violation The responsible party will be given the opportunity to correct the violation or failure within(30)calendar days if failure or violation is not corrected,this Agreement may be terminated within thirty(30)calendar days by written notice of the aggrieved party to the other 20 TERM AND TERMINATION a) Term This Agreement will terminate on December 31 2021,unless terminated earlier in accordance with the provisions in this section or section 19 Termination for cause The distribution of pay for performance DSRIP funds will conclude by the end of second quarter 2023 Cascade Pacific Page 9 of 23 K2293-28 Action Alliance DocuSign Envelope ID A05BFDD1-6AC3-40C2-8BE2-D3A7AB7222CB CASCADE QAC{FIC,�.) ACTION A!L.. .'ICE b) Termination by Partner The Partner may terminate the Agreement with 30 days' written notice to CPAA DSRIP funds for completed project reporting up to the date of termination would be distributed per the DSRIP payment schedule c) Termination by CPAA CPAA may terminate this Agreement in the event that the Partner breaches a material term of this Agreement within thirty(30)calendar days after receiving written notice from CPAA regarding the breach(or such other longer cure period as CPAA deems reasonable under the circumstances) In addition,CPAA may terminate this Agreement upon twenty-four(24) hours' written notice to the Partner if any license,certification or government approval of the material relevant to its performance under this Agreement is suspended terminated,revoked, or surrendered. d) Termination for Withdrawal of Federal or State Funding In the event that the federal government cancels or modifies the Medicaid Transformation funding,or if the authority of CPAA to perform any of its duties is withdrawn,reduced,or limited in any way then CPAA may immediately terminate this Contract by providing written notice to the Partner The termination will be effective on the date specified m the termination notice CPAA agrees to notify- Partner of such withdrawal of authority at the earliest possible time No penalty will accrue to CPAA in the event the termination option in this section is exercised. e) Termination for Exclusion CPAA may terminate this Agreement immediately if the Partner or any of its employees,agents or contractors are excluded from the Medicare or Medicaid program or any other federal or state health care program and,where the exclusion applies to the Partner's employees,agents or contractors the Partner fails to terminate such employees agents or contractors within five(5) business days of becoming aware of the exclusion f) Termination for Uncured Breach Either party may terminate this Agreement upon the other party s material breach of its obligations hereunder which breach is uncured for a period of thirty(30)days after the non-breaching party has ,liven the breaching party notice of that breach and requested that the breaching party cure that breach provided that no opportunity to cure will be provided and termination will be immediate in the event of (a)a breach that cannot reasonably be cured within thirty(30)days,(b)repeated breaches of the same obligation or(c)a breach that would expose the non breaching party to civil or criminal liability or would otherwise cause a violation of applicable laws rules regulations or accreditation standards applicable to a non breaching party Termination of this Agreement by either Party will automatically terminate the Partner s participation in any MTP that is part of CPAA s Projects Plan Termination for an uncured breach may result in modification in DSRIP funds Cascade Pacific Page 10 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDDI-6AC3-40C2-88E2-D3A7A87222C8 CASCADE PACIFIC)) ACTION ALLIANCE 21 WAIVER A failure by either party to exercise its rights under this Agreement will not preclude that party from subsequent exercise of such rights and will not constitute a waiver of any other nghts under this Agreement unless stated to be such in a venting signed by an authorized representative of the party and attached to the original Agreement. 22 ALL WRITINGS CONTAINED HEREIN This Agreement contains all the terms and conditions agreed upon by the parties No other understandings oral or otherwise,regarding the subject matter of this Agreement will be deemed to exist or to bind any of the parties hereto 23 PUBLIC RECORDS ACT The parties acknowledge that this Agreement is a public record under RCW 42.56 IN WITNESS WTIEREOF,the parties have executed this Agreement CPAA ACH LLC Lewis Count. Sherriff Department Signature Signatire --.-17,t--le. ". -----c-= ‘ 0 1 ■ ij--c‘-:_,„ Title Date Title Date Cascade Pacific Page 11 of 23 K2293-28 Action Alliance DocuSign Envelope ID A05BFDD'-6AC3-4002-OBE2-D3A7A37222C8 CASCADE PAC, - ` ACTION ALUANCF Addendum A "Business Associate Agreement" HIPAA BUSINESS ASSOCIATE AGREEMENT This HIPAA Business Associate Agreement(this"Agreement")is made and entered on this day of , 2018,which supplements and is made an integral part of an underlying contract for certain services effective September 20,2018 (the"Contract") by and between CPAA ACH LLC("Covered Entity") and Lewis County Shemff Department(`'Business Associate") A During the term of the Contract,Business Associate may receive from Covered Entity,or may receive or create on behalf of Covered Entity, certain individual patient identified confidential health or medical information ("Protected Health Information" or "PHI") Protected Health Information is hereby defined to include Electronic Protected Health Information ("EPHI") as that term is defined in the regulations hereinafter referred to B By this Agreement,Covered Entity and Business Associate agree to protect the privacy and provide for the security of Protected Health Information disclosed to Business Associate pursuant to the Contract and as Required by Law in compliance with (i) the Health Insurance Portability and Accountability Act of 1996, Public Law 104 191 ("HIPAA") and regulations promulgated thereunder by the C S Department of Health and Human Services(the "HIPAA Regulations").Title 45 Parts 160 and 164. including the 'Privacy Rule' (Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and Part 164, Subparts A and E)and the 'Security Rule"(Security Standards for the Protection of Electronic Protected Health Information at 45 CFR Part 160 and Part 164, Subparts A and C)and the HITECH Regulations pertaining to the confidentiality.integrity and availability of EPHI,and other applicable laws, and (u)the Health Information Technology for Economic and Clinical Health Act("HITECH").passed as a part of the American Recovery and Reinvestment Act of 2009(ARRA), Public Law 111 5 and regulations including,but not limited to,45 C F R Parts 160 and 164(the"HITECH Regulations") references in this Agreement to HIPAA also includes any requirements contained in HITECH as the same may be amended from time to time C As part of the HIPAA Regulations the Privacy Rule requires Covered Entity to enter into a contract containing specific requirements with Business Associate as set forth in,but not limited to Title 45 Sections I64.502(e)and 164.504(e)of the Code of Federal Regulations("CFR")and contained in this Agreement D A Business Associate may be directly liable under the HiPAA Rules and subject to civil,and in some cases criminal penalties for making uses and disclosures of Protected Health Information that are not authorized by this Agreement or Required by Law A Business Associate also is directly liable and subject to civil penalties for failing to safeguard electronic protected health information in accordance with the HIPAA Security Rule In consideration of the mutual promises below and the exchange of information pursuant to this Agreement,the parties agree as follows Definitions All capitalized terms used herein but not otherwise defined in the preceding paragraphs shall have the meanings attributed to them to HIPAA and the HIPAA Regulations and HITECH and the HITECH Regulations Cascade Pacific Page 12 of 23 K2293-28 Action Alliance DocuSign Envelope ID A05BFDD1-6AC3-40C2-8BE2-D3A7AB7222C8 I.aY 2. Obligations of Business Associate. (a) Business Associate agrees to not use or disclose Protected Health Information other than as provided by the Agreement and as Required by Law Business Associate agrees to maintain and use appropriate safeguards,and to comply with the Security Rule with respect to EPH1,to prevent the use or disclosure of Protected Health Information other than as set forth in this Agreement (b) Business Associate shall assess potential risks and vulnerabilities to PHI including EPHI in its possession or under its control and develop,implement,and maintain commercially appropriate administrative, technical and physical safeguards to ensure that all Protected Health information obtained by or on behalf of Covered Entity is received,maintained, transmitted,and used or disclosed only as authorized by this Agreement and as permitted by the Privacy Rule and the Security Rule (c) Business Associate agrees to report to Covered Entity any use or disclosure of Protected Health information not provided for by this Agreement of which it becomes aware,including breaches of unsecured PHI as required by 45 CFR 164.410,and any Security Incident of which it becomes aware (d) Business Associate shall ensure that all its agents including subcontractors to whom it provides Protected Health Information received from Covered Entity.or created or received by Business Associate on behalf of Covered Entity,or who create,receive,maintain,or transmit PHI on behalf of Business Associate,agree in wilting to the same assurances,restrictions,requirements and conditions that apply to Business Associate with respect to such Protected Health Information If Business Associate receives EPHI Business Associate will ensure that any agent including a subcontractor to whom it provides such EPHI or who creates receives maintains or transmits PHI on behalf of Business Associate,specifically agrees in writing to implement reasonable and appropriate administrative, physical and technical safeguards to protect it (e) Business Associate shall, following the discovery of a Breach regarding PHI,notify the Privacy Officer of Covered Entity of the breach Notification shall be without unreasonable delay,and in no event later than 10(ten)business days after Discovery A Breach is"Discovered' on the first day it is known or, with the exercise of reasonable diligence, would have been known by any employee(other than the employee committing the Breach).officer or agent of the Business Associate Business Associate shall report such breaching use or disclosure even if Business Associate deems the use or disclosure to be in good faith,unintentional or inadvertent,and even if Business Associate deems the risk of harm posed to the Individuals involved to be insignificant The notification to the Privacy Officer shall include the information required pursuant to 45 CFR 164 404 and 164.410,including,but not limited to,the identity of the individual whose PHI has been breached,a brief description of what happened(including the date of the breach and the date of discovery), a description of the type of information accessed e.g., name, address date of birth Social Security Number,content of health care provided,steps the individual can take to protect him or herself from harm what the Business Associate is doing to investigate and mitigate the effects of the breach and to prevent future breaches, if any of this information is not available at the time of notification Business Associate shall provide it promptly if and when it becomes available in addition Business Associate shall provide to Covered Entity contact information, such as a toll free telephone number, email address, website or postal address where affected Individuals may request or receive information, and such other information as Covered Entity may reasonably request Business Associate shall cooperate with Covered Entity in investigating such use or disclosure and assist Covered Entity in determining whether such use or disclosure constitutes a Breach of Unsecured PHI In the event that Covered Entity determines that a Breach of Unsecured PHI has occurred, at Covered Entity s election Business Associate shall Cascade Pacific Page 13 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-8BE2-D3A7AB7222CB pil ACTION A__ (i) Prepare, subject to Covered Entity s right to review and approve, appropriate notifications of such Breach on behalf of Covered Entity pursuant to 45 CFR Sections 164 404 164 406 and 164 408, or provide Covered Entity with any information necessary for it to prepare appropriate and timely notifications of such Breach pursuant to 45 CFR Sections 164.404, 164.406, 164.408, and 164.410(c),and (ii) Subject to Covered Entity's right to elect to distribute such notifications itself distribute the appropriate notifications of such Breach in the time and manner that complies with 45 CFR Sections 164.404, 164.406 and 164.408 Notwithstanding the foregoing, a delay in the distribution in the appropriate notifications may be permitted,but only to the extent and subject to the conditions of 45 CFR Section 164 412 regarding certain law enforcement action (f) To the extent that Business Associate or its agents or subcontractors maintain PHI in a Designated Record Set, Business Associate shall,at the request of Covered Entity,make available PHI which is maintained in Designated Record Sets to Covered Entity or,as directed by Covered Entity, directly to individual to whom the PHI relates and in the tune and manner that meets the requirements of 45 CFR Section 164.524 (g) To the extent that Business Associate or its agents or subcontractors maintain PHi in a Designated Record Set,Business Associate shall make available PHI which is maintained in Designated Record Sets to Covered Entity for amendment pursuant to 45 CFR Section 164.526 Business Associate shall in a timely manner incorporate into the Designated Record Set any such amendment to enable Covered Entity to fulfill its obligations under the Privacy Rule If any Individual submits a request for an amendment of Protected Health Information directly to Business Associate or its agents or subcontractors,Business Associate must notify Covered Entity in writing within five(5) business days of the request. Any denial of amendment of an Individual s request to amend PHI maintained by Business Associate or its agents or subcontractors shall be solely the responsibility of Covered Entity (h) Business Associate shall implement a process that enables it to provide an accounting of disclosures of PHI sufficient so that Covered Entity can respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR Section 164.528 and Section 13405(c)of HITECH and the regulations promulgated thereunder At a minimum, the information to be documented in the log shall include- (i)the date of disclosure; (ii)the name of the entity or person who received PHI and,if known the address of the entity or person, (iii)a brief description of the PHI disclosed and(iv)a brief statement of the purpose of the disclosure that reasonably informs the Individual of the basis for the disclosure or a copy of the Individual s authorization,or a copy of the written request for disclosure Business Associate shall provide a copy of the log to Covered Entity annually upon request Within ten(10) business days of notice by Covered Entity of a request from an Individual for an accounting of disclosures of Protected Health Information,or within five(5) business days after a request for an accounting is delivered directly to Business Associate or its agents or subcontractors Business Associate shall make available to Covered Entity the information from the log required to provide an accounting of disclosures to enable Covered Entity to fulfill its Cascade Pacific Page 14 of 23 K2293-28 Action Alliance DocuSign Envelope ID A058FD01-6AC3-40C2-8EE2-D3A7AB7222CB CASCADE PACIFIC 1 i ACTION ALLIAN _r obligations under the Privacy Rule and HITECH including,but not limited to, 4i CFR 164.528 (i) Within fifteen(15) business days of a request by the Covered Entity,Business Associate agrees to comply with Covered Entity s request to accommodate an Individual s access to his/her Protected Health Information In the event that an Individual contacts the Business Associate directly about access to Protected Health Information Business Associate shall forward such request to Covered Entity within five(5)business days to Covered Entity,and shall respond pursuant to instructions from Covered Entity To the extent that PHI and communications are within the control of Business Associate, Covered Entity shall direct all requests for restrictions and confidential communications in connection with the disclosure of PHI under 45 CFR Section 164.522 to Business Associate for evaluation Business Associate shall respond directly to Individual if directed to do so by Covered Entity or if contacted directly by Individual and in the time and manner that complies with all the requirements of 45 CFR Section 164.522 and Section 13405(a) of HITECH (l) All documentation that is required by this Agreement, the Privacy Rule the Security Rule and HITECH shall be retained by Business Associate for a period of six (6) years from the date of creation or when it was last in effect, whichever is later After the expiration of such period, the Business Associate shall destroy the PHI and EPHI unless otherwise directed by Covered Entity (k) Business Associate agrees to make its internal practices,books and records relating to the use and disclosure of Protected Health Information available to the Secretary for purposes of determining Covered Entity s and-or Business Associate s compliance with the Privacy Rule and HITECH in a time and manner designated by the Secretary (I) Business Associate agrees to mitigate,to the extent practicable,any harmful effect that is known to Business Associate of a use or disclosure of Protected Health Information by Business Associate(or by any other person to whom Business Associate has disclosed PHI) in violation of the requirements of this Addendum In addition Business Associate shall cooperate with and implement any reasonable mitigation requests by the Business Associate or Covered Entity relating to any Breach or any attempted or successful Security Incident Upon request, Business Associate shall provide Covered Entity with a written report of its mitigation efforts (m) Business Associate represents and warrants that all personnel in its workforce and any agents or subcontractors,whose services may be used to fulfill obligations under this Agreement are or shall be appropriately informed of the terms of this Agreement and shall comply with all provisions of this Agreement 3 Permitted Uses and Disclosures by Business Associate, Sale and Marketing Prohibited (a) Business Associate shall not use or further disclose Protected Health Information, except as follows or as Required by Law (i) The Business Associate is permitted to access and use any and all Protected Health Information in the form of a 'limited data set' as defined in 45 CFR 164 514(e) and to provide this de-identified Protected Health Information to others for the purpose of research on public health issues and the effectiveness of care coordination, and in the development of new or improved Pathways Cascade Pacific Page 15 of 23 1(2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3.4002-8BE2-D3A7AB7222C8 Ii.ACTi✓r; (b) In any permitted use or disclosure of Protected Health Information to perform functions, activities,or services for, or on behalf of Covered Entity as specified in the Contract and this Agreement, Business Associate shall make reasonable efforts to limit protected health information used or disclosed to the minimum necessary to accomplish the intended purpose of the use disclosure or request Business Associate agrees that,to the extent practicable.it shall only request use and disclose PHI in the form of a Limited Data Set(as defined in 45 CFR Section 164.514(e)(2)),and that in all other cases it shall only request,use or disclose the Minimum Necessary amount of PHI necessary to accomplish the purpose of the request. use or disclosure (c) Business Associate may use PHI to the minimum extent necessary for the proper management and administration of Business Associate or to carry out the legal responsibilities of the Business Associate (d) Business Associate may disclose PHI for the proper management and administration of Business Associate,provided that disclosures are Required By Law,or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and be used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person,and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been Breached. (e) Business Associate may use PHI to report violations of law to appropriate Federal and State authorities consistent with 45 CFR 164.502 (f) Business Associate may use Protected Health Information to provide Data Aggregation Services to Covered Entity as permitted by 45 CFR Section 164.504(e)12)(i)(B) (g) The Business Associate is permitted to access and use any and all Protected Health Information in the form of a "limited data set' as defined in 45 CFR 164.514(e), and to provide this de identified Protected Health information to others, for the purpose of research on public health issues and the effectiveness of care coordination and in the development of new or improved Pathways (h) Prohibition on Sale of PHI and Marketing. Business Associate shall neither sell PHI nor use PHI in marketing unless permission is specifically requested in writing and Business Associate is permitted to do so by Covered Entity in writing, and such sale or marketing is permitted under the Privacy Rule and HITECH 4 Obligations of Covered Entity_ (a) Covered Entity shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of Protected Health Information, including EPHI, transmitted to Business Associate pursuant to the Contract and this Agreement, in accordance with the standards and requirements of the Privacy Rule and the Security Rule, until such Protected Health Information is received by Business Associate,and in accordance with any specifications set forth in the Contract (b) Covered Entity shall notify Business Associate of any limitation(s)in its notice of privacy Cascade Pacific Page 16 of 23 K2293-28 Acton Alliance DocuSign Envelope ID A058FDD1-6AC3-40C2-88E2-03A7AB7222C8 /Oft;,_ -.ON ALLIANCE practices of Covered Entity in accordance with 45 CFR 164.520, to the extent that such limitation may affect Business Associate's use or disclosure of Protected Health Information (c) Covered Entity shall notify Business Associate of any changes in,or revocation of,permission by Individual to use or disclose Protected Health Information, to the extent that such changes may affect Business Associate's use or disclosure of Protected Health Information (d) Covered Entity shall notify Business Associate of any restriction to the use or disclosure of Protected Health Information that Covered Entity has agreed to in accordance with 45 CFR 164 522 to the extent that such restriction may affect Business Associate's use or disclosure of Protected Health Information 5 Term This Agreement shall become effective immediately upon execution and,except as hereinafter provided,shall remain in force and effect until the last of the Protected Health Information is returned to Covered Entity or destroyed Notwithstanding the foregoing, the rights and obligations provided by Sections 2,7,8 and 9 of this Agreement shall survive indefinitely 6 Termination of Contract. Notwithstanding any provision in the Contract to the contrary regarding term or termination if Covered Entity determines in good faith that Business Associate has violated a material term of this Agreement Covered Entity shall either (a) If such violation can be cured within 30 days or a reasonable period of time, provide an opportunity for Business Associate to cure the breach or end the violation and if Business Associate does not cure the breach or end the violation within the time specified.terminate the Contract,or (b) If no cure is possible,immediately terminate the Contract if feasible or (c) If neither termination nor cure is feasible Covered Entity shall report the violation to the Secretary 7 Effect of Termination (a) Except as provided in paragraph(b)of this Section upon termination of the Contract for any reason Business Associate shall retain no copies of Protected Health Information and,as Instructed by Covered Entity,shall return or destroy all Protected Health Information received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity This provision,shall apply to Protected Health Information that is in the possession of subcontractors or agents of Business Associate (b) En the event that Business Associate determines that returning or destroying the Protected Health Information is not feasible or that the retention of some PHI is necessary for Business Associate s proper management and administration or to carry out its legal responsibilities, Business Cascade Pacific Page 17 of 23 K2293-28 Action Alliance DocuSign Envelope ID A058FDDI-6AC3-40C2-8BE2-D3A7AB7222CB . .)E RACIFIC,)) / ACTION ALLIANc::_ Associate shall continue to extend the protection of this Agreement to such Protected Health Information retained for those purposes that make the return or destruction infeasible,for so long as Business Associate maintains such Protected Health Information. (c) Upon termination, Business Associate shall retain and continue to make available to Covered Entity the accounting of disclosures required by paragraph 2(j) in accordance with the requirements of and for the time period required by HITECH 8 Indemnification. (a) Notwithstanding any provision in the Contract to the contrary regarding indemnification Business Associate agrees to indemnify,defend and hold Covered Entity harmless from any liability loss, claims or damages, including reasonable attorneys' fees, caused solely by a breach by Business Associate or any of its affiliates employees agents subcontractors or successors,of its obligations under this Agreement Business Associate further agrees to assist and defend Covered Entity in any investigation,litigation,adjudication, arbitration,or proceeding of any kind,whether brought by the Secretary, an Individual,or any other person or entity that may result or arise from any breach of the terms of the Contract or this Agreement (b) In the event that Covered Entity intends to rely on this indemnification obligation of Business Associate.Covered Entity will (i)provide prompt written notice to Business Associate of any claim action or demand for which indemnity is claimed, and(ii)provide such reasonable cooperation as Business Associate may request. 9 No Third Party Beneficiaries Nothing express or implied in this Contract is intended to confer,nor shall anything herein confer,upon any person other than Covered Entity, Business Associate and their respective successors or assigns, any rights,remedies.obligations or liabilities whatsoever 10 Miscellaneous. (a) A reference in this Agreement to a section in the Privacy Rule or in HITECH means the section as in effect or as hereafter amended. (b) The parties agree to take such action as is necessary to amend this Agreement from time to time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule HIPAA and HITECH (c) Except as specifically required to implement the purposes of this Agreement or to the extent inconsistent with this Agreement,all other terms of the Contract shall remain in force and effect (d) The provisions of this Agreement shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Agreement. This Agreement and the Contract shall be interpreted as broadly as necessary to implement and comply with HIPAA the Privacy Rule and HiTECH (or applicable state laws relating to security and privacy,if more stringent) The parties agree that any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is Cascade Pacific Page 18 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD'-6AC3-4002-8BE2-D3A7AB7222CB CASCADE PACIFIC)) ACTION ALLIANCE consistent with HIPAA, the Privacy Rule and HIl ECH (or applicable state laws relating to security and privacy,if more stringent) (e) Upon the effective date of any federal statute amending or expanding HIPAA or any guidance, temporary, interim final or final regulations promulgated under HIPAA or under any federal statute amending or expanding HIPAA(collectively, the"HIPAA Regulations") that are applicable to this Agreement or any amendments to the HIPAA Regulations, this Agreement shall be automatically amended,such that the obligations imposed on Covered Entity and Business Associate shall remain in compliance with such requirements,unless Covered Entity notifies Business Associate otherwise The parties agree to take such action as is necessary to expressly reflect such automatic amendments in this Agreement from time to time Except as provided otherwise in this Section 10(e) no waiver change modification,or amendment of any provision of this Agreement shall be made unless it is in writing and is signed by the parties hereto The failure of either party at any time to Insist upon strict performance of any condition.promise,agreement or understanding set forth herein shall not be construed as a waiver or relinquishment of the right to insist upon strict performance of the same condition, promise,agreement or understanding at a future time (f) This Agreement,together with the Contract,constitutes the entire agreement between Covered Entity and Business Associate with respect to the matters described herein No promises,terms, conditions or obligations,other than those contained in this Agreement or the Contract shall be valid or binding Any prior agreements,statements,promises,negotiations,inducements,or representations, either oral or written made by either party or agent of either party that are not contained in this Agreement or the Contract shall be of no force or effect. Cascade Pacific Page 19 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3.4()C2-8BE2-D3A7AB7222CB PACIFlCA ACTION ALLIANCE Addendum B "Scope of Work" I INTRODUCTION This Scope of Work(SOW) sets forth the basic agreement between CPAA and the Partner set forth above The SOW sets forth each party's responsibilities with respect to any DSRIP project(s) as well the funding, project milestones, performance metrics, and payment schedules for project(s)and signals the Partner's intent to participate in the Medicaid Transformation Demonstration. 2 SOW CONTACT INFORMATION For organizations that have a specific lead contact person for an individual project, indicate in the table below If your organization has one contact for the entire Medicaid Transformation Project, indicate as such by leaving the Project Lead Contact section blank CPAA ACH LLC Partner Lewis County Sherriff Department CPAA Project Lead Partner Contact. Christina Mitchell Chris Sweet Phone. 360-539-7576 ext. 131 Phone Email.mitchellcci:crhn.org j Email Project Area Partner Lead Contact(Person- Name, Title) Chris Sweet 3A-Opioid Response CPAA Manager. Sara Rainer Phone Phone. 360-539-7576 x 130 Email raisers crhn.org Email chri s sweet@lewi scountywa gov 3. BASIC ROLES AND RESPONSIBILITIES a) CPAA's ROLES AND RESPONSIBILITIES CPAA will have the following roles and responsibilities, in accordance with and subject to the MTP this Agreement,and applicable law 1 Establishing and maintaining a governance and organizational structure that complies with the terms of the Demonstration and the DSRIP Planning Protocol 11 Keeping partnering providers informed of all DSRIP related communications received by the ACH from the State and facilitating communication among the Partners regarding DSRIP matters Cascade Pacific Page 20 of 23 K2293-28 Action Alliance DocuSign Envelope ID AO5BFDD1-6AC3-40C2-88E2-03A7AB7222CB ACTION A!I-IA`.' '.. Iil CPAA will use the following key indicators to measure partnenng provider implementation progress Change Plan completion Utilization of data reporting formitool, Partner engagement in trairiings and shared learnings Partner engagement in committees and work groups IV Assist Partners,as necessary, in developing an organizational Change Plan as well as hosting virtual Town Hall-style webinars to publicly answer questions and walk organizations through the Change Plan process V CPAA will provide a reporting tool and provide reporting templates as necessary to the organization to use in completing and submitting reports no later than the 1'quarter of DY3 VI Monitor the progress of each Partner,providing consultation to help the Partner fulfill stated interventions and reach or improve required and selected measures to ensure milestone achievement and alignment with state MTP goals CPAA will assist to develop a plan of action with the organization to remedy any identified gaps or barriers VII Receive and evaluate quarterly reports from participating Partners,to track individual progress toward required and organization-specific measures Certify progress milestones,performance metrics,and other such reports as required by the DSRIP Planning Protocol VIII CPAA will provide a variety of statistical reports to Partners quarterly for evaluation purposes IX Provide fiscal reporting for DSRIP funds as needed X Distribute initial funds in a timely manner to participating partners in accordance with the state approved funding distribution plans payable within 60 days of receipt of the signed Agreement Funds are intended to supplement the time and resources committed to Transformation efforts XI Provide communication and instruction related to reporting and performance measures for additional payments beyond the initial funds XII. Submit scheduled reports to FICA on the actual distribution of transformation project payments fund balances and reconciliations as well as progress on the Partner s scope of work adherence to reporting requirements,metrics and the continuous improvement of such XIII CPAA will offer and facilitate a variety of collaborative forums such as an MTP kick-off celebration, project area work groups,planning committees,webinars, and conference calls, CPAA Board and Council meetings. XIV CPAA Program Managers will make themselves available and conduct regular check-ins and outreach calls and provide technical assistance as needed b) THE PARTNER ROLES AND RESPO\SIBITIES The Partner will have the following roles and responsibilities in accordance with and subject to this Agreement,and applicable law Cascade Pacific Page 21 of 23 K2293-28 Action Alliance DocuSign Envelope ID.A05BFDD1-6AC3-40C2-8BE2-D3A7AB7222CB CA5_ 'DE, PACi:'-; .) ACTION ALLIANCE I The Partner will collaborate with CPAA as needed to develop and submit a Change Plan for CPAA according to the number of projects the Partner was selected for II Partner will register in the Financial Executor Portal III The Partner will complete and submit any administrative forms required in order for the Partner to receive funds via the Medicaid Demonstration s Financial Portal and CPAA s Financial Executor Partners are required to report on pay for reporting measures quarterly by the end of the first month following every quarter Late reporting could impact receipt of allocated funds IV The Partner will comply with this Agreement s requirements, including but not limited to timely and accurate reporting to CPAA in accordance with the performance measures project milestones, and timelines specified in the Change Plan, and V The Partner will provide other information as reasonably requested by CPAA within 30 days VI The Partner will participate in Quality Improvement activities for each MTP Program area they are selected for VII The Partner will align and coordinate MTP activities with other CPAA selected partners VIII The Partner may request technical assistance from CPAA Program Managers as needed LX The Partner is encouraged to participate in CPAA s MTP kick-off celebration,project area work groups,planning committees, MTP task force,webinars,and conference calls CPAA Board Council meetings and local forums Active participation is linked to MTP incentives X The Partner will complete tasks and deliverables as set forth in the Change Plan and agrees to notify the CPAA Program Manager if timeline or deliverables will not be submitted as required Xl Partner will show evidence for expansion or deepening of partnerships projects as this will be essential for the"scale"in DSRIP years XII The Partner will incorporate Health Equity Considerations into the execution of their project XIII If Partner is implementing the Pathways Model as a Care Coordinating Agency. the Partner will complete additional documents i Care Coordination Service Agreement n Mutual Nondisclosure Agreement Cascade Pacific Page 22 of 23 K2293-28 Action Alliance DocuSign Envelope ID A65BFDD1-6AC3-40C2-8BE2-D3A7AB7222C13 PACiF IC) A',."r-I^r.i .n.LI_!ARlCF 4 PARTNER DELIVERABLES a Signed contract & HIPAA Business Associates Agreement no later than October 5, 2018 If an extension is needed, please email Chris Haywood at haywoodc @crhn.org. b. Submit first draft of a Change Plan to reporting%acpaawa.org no later than October 15 2018 and final draft of Change Plan no later than November 15,2018 c Update the Change Plan annually in quarter 4 d. Submit quarterly and semi-annual reports to CPAA e Submit quarterly reports to reporting(Acpaawa.org per the table below Quarter 1 (Jan-Mar) Quarter 2(Apr-Jun) Quarter 3(Jul-Sep) Quarter 4(Oct Dec) 1 Change Plan Progress 1 Change Plan Progress 1.Change Plan Progress 1 Change Plan Progress Report Report Report Report 2 Intervention Metrics 2 Intervention Metrics 3 Change Plan Update April 30,2019 July 31 2019 October 31 2019 January 31 2020 April 30, 2020 July 31 2020 October 31,2020 January 31,2021 April 30.2021 July 31 2021 October 31,2021 January 31 2022 *Si-Directional Integration of Care and Opioid Response projects require additional reporting semi-annually due to FICA requirements Cascade Pacific Page 23 of 23 K2293-28 Action Alliance • BOCC AGENDA ITEM SUMMARY Resolution BOCC Meeting Date Feb 25,2019 Suggested Wording for Agenda Item Agenda Type Consent Approve an agreement with Cascade Pacific Action Alliance for Medication Assisted Treatment Contact Chief Chris Sweet Phone 3607402714 Department: Sheriff Action Needed. Approve Resolution Description Approve an agreement with Cascade Pacific Action Alliance for Medication Assisted Treatment Cover Letter To Chief Chris Sweet Additional Copies Carrie Breen