220220 MCAO FELONY DIVERSION CONTRACT 2ND SIGNED 2-17-22.PDF
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CONTRACT MARICOPA COUNTY ATTORNEY’S OFFICE
FELONY DIVERSION PROGRAM 220220-CI
This contract is entered into this 23rd day of February 2022 between the Maricopa County, acting through
the Maricopa County Attorney’s Office (MCAO), and SAGE Counseling Inc. (Contractor), to govern the
Contractor’s participation in the Felony Diversion Program administered by MCAO.
1.0
CONTRACT TERM
1.1
This contract is for a term of one year and ten months, beginning on the 23rd day of
February 2022 and ending the 31st day of December 2024.
1.2
The County may, at its option and with the agreement of the Contractor, renew the term
of this contract for additional terms up to a maximum of one additional year. The County
shall notify the Contractor in writing of its intent to extend the contract term at least thirty
calendar days prior to the expiration of the original contract term, or any additional term
thereafter.
1.3
CONTRACT TERMINATION
Upon termination of this contract for any reason, the Contractor shall make all reasonable
efforts for an orderly transition of its duties and responsibilities to another provider and/or
to the County or MCAO. This may include, but is not limited to, preparation of a transition
plan and cooperation with the County or MCAO or other providers in the transition and
completion of services initiated but not completed prior to the date of termination. The
transition includes the transfer of all records and other data in the possession, custody, or
control of Contractor required to be provided to the County or MCAO either by the terms
of this agreement or as a matter of law. The provisions of this clause shall survive the
expiration or termination of this agreement.
2.0
FEE ADJUSTMENTS
2.1
Any request for a reasonable fee adjustment must be submitted not less than 60 calendar
days prior to the current contract expiration date. Any adjustment is only applicable once
a new contract year begins. Requests for adjustment must be supported by appropriate
documentation. If the County agrees to the adjusted fee, the County shall issue written
approval of the change which will be effective upon renewal or new contract. Requests
submitted after the 60-calendar day deadline will not be considered.
3.0
PAYMENTS
3.1
As consideration for performance of the duties described herein, County shall pay
Contractor the sum(s) stated in Exhibit “A.”
3.2
Payment shall be made upon the County’s receipt of a properly completed invoice.
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3.3
INVOICES
3.3.1
The Contractor shall submit one legible copy of their detailed invoice before
payment(s) will be made. Incomplete invoices will not be processed. At a
minimum, the invoice must provide the following information:
•
Company name, address, and contact information
•
County bill-to name and contact information
•
Contract serial number
•
County purchase order number
•
Invoice number and date
•
Payment terms
•
Date of service
•
Quantity (number of days or weeks or sessions)
•
Contract Item number(s)
•
Description of Purchase (services)
•
Extended price
•
Total Amount Due
3.3.2
Problems regarding billing or invoicing shall be directed to the department as
listed on the purchase order.
3.3.3
Payment shall only be made to the Contractor by Accounts Payable through the
Maricopa County Vendor Express Payment Program. This is an electronic funds
transfer (EFT) process. After contract award, the Contractor shall complete the
Vendor Registration Form accessible from the County Department of Finance
Vendor
Registration Web
Site
https://www.maricopa.gov/5169/Vendor-
Information.
3.3.4
Discounts offered in the contract shall be calculated based on the date a properly
completed invoice is received by the County.
3.3.5
EFT payments to the routing and account numbers designated by the Contractor
will include the details on the specific invoices that the payment covers. The
Contractor is required to discuss remittance delivery capabilities with their
designated financial institution for access to those details.
4.0
APPLICABLE TAXES
4.1
Payment of Taxes: The Contractor shall pay all applicable taxes.
4.2
Tax Indemnification: Contractor and all subcontractors shall pay all Federal, state, and
local taxes applicable to its operation and any persons employed by the Contractor.
Contractor shall require all subcontractors to hold MCAO and Maricopa County harmless
from any responsibility for taxes, damages and interest, if applicable, contributions
required under Federal, and/or state and local laws and regulations and any other costs
including transaction privilege taxes, unemployment compensation insurance, Social
Security and Worker’s Compensation.
5.0
AVAILABILITY OF FUNDS
5.1
The provisions of this contract relating to payment for services shall become effective
when funds assigned for the purpose of compensating the Contractor as herein provided
are actually available to County for disbursement. The County shall be the sole judge and
authority in determining the availability of funds under this contract. County shall keep the
Contractor fully informed as to the availability of funds.
5.2
If any action is taken by, any State agency, Federal department, or any other agency or
instrumentality to suspend, decrease, or terminate its fiscal obligations under, or in
SERIAL# 220220-CI
connection with, this contract, County may amend, suspend, decrease, or terminate its
obligations under, or in connection with, this contract. In the event of termination, County
shall be liable for payment only for services rendered prior to the effective date of the
termination, provided that such services are performed in accordance with the provisions
of this contract. County shall give written notice of the effective date of any suspension,
amendment, or termination under this section, at least 10 days in advance.
6.0
DUTIES
The Contractor shall perform all duties stated in Exhibit “B”, Scope of Work, or as otherwise agreed
to by the parties and directed in writing by MCAO.
7.0
TERMS and CONDITIONS
7.1
INDEMNIFICATION
INDEMNIFICATION. Each Party to this Agreement shall hold harmless, and indemnify
the other Party and its directors, officers, agents, sub-contractors, employees and
volunteers against any and all losses, liabilities, damages, injuries, claims, suits, demands
and legal proceedings including any direct, indirect or consequential loss, liability,
damage, or expense, but not including attorneys’ fees, unless awarded by a court of
competent jurisdiction, arising out of or in connection with the intentional, willful, wanton,
reckless or negligent conduct arising from or to the extent alleged to be in connection with
the Services to any Indemnified Party and any third party. However, neither Party shall be
indemnified hereunder for any loss, liability, damage, or expense resulting from its sole
negligence or willful misconduct. Any claim involving contributory negligence shall be
handled so that each party is responsible and liable for its share of the damages and
defense cost associated therewith, in proportion to its share of negligence.
7.1.1
The amount and type of insurance coverage requirements set forth herein will in
no way be construed as limiting the scope of the indemnity in this section.
7.2
INSURANCE
7.2.1
Contractor, at Contractor’s own expense, shall purchase and maintain, at a
minimum, the herein stipulated insurance from a company or companies duly
licensed by the State of Arizona and possessing a current AM Best, Inc. category
rating of B++. In lieu of State of Arizona licensing, the stipulated insurance may
be purchased from a company or companies, which are authorized to do business
in the State of Arizona, provided that said insurance companies meet the approval
of The County. The form of any insurance policies and forms must be acceptable
to the County.
7.2.2
All insurance required herein shall be maintained in full force and effect until all
work or service required to be performed under the terms of the contract is
satisfactorily completed and formally accepted. Failure to do so may, at the sole
discretion of the County, constitute a material breach of this contract.
7.2.3
In the event that the insurance required is written on a claims-made basis,
Contractor warrants that any retroactive date under the policy shall precede the
effective date of this contract and either continuous coverage will be maintained,
or an extended discovery period will be exercised for a period of two years
beginning at the time work under this contract is completed.
7.2.4
Contractor’s insurance shall be primary insurance as respects County, and any
insurance or self-insurance maintained by County shall not contribute to it.
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7.2.5
Any failure to comply with the claim reporting provisions of the insurance policies
or any breach of an insurance policy warranty shall not affect the County’s right
to coverage afforded under the insurance policies.
7.2.6
The insurance policies may provide coverage that contains deductibles or self-
insured retentions. Such deductible and/or self-insured retentions shall not be
applicable with respect to the coverage provided to the County under such
policies. Contractor shall be solely responsible for the deductible and/or self-
insured retention and County, at its option, may require Contractor to secure
payment of such deductibles or self-insured retentions by a surety bond or an
irrevocable and unconditional letter of credit.
7.2.7
The insurance policies required by this contract, except Workers’ Compensation
and Errors and Omissions, shall name County, its agents, representatives,
officers, directors, officials, and employees as additional insureds.
7.2.8
The policies required hereunder, except Workers’ Compensation and Errors and
Omissions, shall contain a waiver of transfer of rights of recovery (subrogation)
against County, its agents, representatives, officers, directors, officials, and
employees for any claims arising out of Contractor’s work or service.
7.2.9
If available, the insurance policies required by this contract may be combined with
Commercial Umbrella Insurance policies to meet the minimum limit requirements.
If a Commercial Umbrella insurance policy is utilized to meet insurance
requirements, the Certificate of Insurance shall indicate which lines the
Commercial Umbrella Insurance covers.
7.2.9.1 Commercial General Liability
Commercial General Liability (CGL) insurance and, if necessary,
Commercial Umbrella insurance with a limit of not less than $1,000,000
for each occurrence, $2,000,000 Products/Completed Operations
Aggregate, and $2,000,000 General Aggregate Limit. The policy shall
include coverage for premises liability, bodily injury, broad form property
damage, personal injury, products and completed operations and blanket
contractual coverage, and shall not contain any provisions which would
serve to limit third party action over claims. There shall be no
endorsement or modifications of the CGL limiting the scope of coverage
for liability arising from explosion, collapse, or underground property
damage.
7.2.9.2 Sexual molestation and physical abuse
When services involve working with these groups of individuals, the
insurance requirements in the contract need to be revised to include
coverage for "sexual molestation and physical abuse". Coverage for
this type of claim, or allegation, is excluded from standard general liability
policies. Therefore, contractors whose services include working with
and/or caring for children/elderly and disabled persons should have their
policies specifically endorsed to include this coverage.
7.2.9.3 Commercial General Liability – Occurrence Form
Policy shall include bodily injury, property damage and broad form
contractual liability coverage.
a. The policy shall be endorsed to include coverage for
physical/sexual abuse and molestation/criminal sexual
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misconduct, with limits of no less than $5,000,000 for each
claim (see 7.2.9.1)
b. The policy shall be endorsed to include the following additional
insured language: "Maricopa County, its subsidiary, parent,
associated and/or affiliated entities, successors, or assigns, its
elected officials, trustees, employees, agents, and volunteers shall
be named as additional insureds with respect to liability arising out
of the activities performed by, or on behalf of the Contractor".
7.2.9.4 Professional Liability
Professional Liability insurance and, if necessary, Commercial Umbrella
insurance, which will insure and provide coverage for Professional
Liability of the Contractor, with limits of no less than $5,000,000 for each
claim.
7.2.10 Certificates of Insurance
7.2.10.1 Prior to contract award, Contractor shall furnish the County with valid
and complete Certificates of Insurance, or formal endorsements as
required by the contract in the form provided by the County, issued by
Contractor’s insurer(s), as evidence that policies providing the required
coverage, conditions and limits required by this contract are in full force
and effect. Such certificates shall identify this contract number and title.
7.2.10.2 In the event any insurance policy(ies) required by this contract is (are)
written on a claims-made basis, coverage shall extend for two years past
completion and acceptance of Contractor’s work or services and as
evidenced by annual certificates of insurance.
7.2.10.3 If a policy does expire during the life of the contract, a renewal certificate
must be sent to the County 15 calendar days prior to the expiration date.
7.2.10.4 Certificates of Insurance shall identify Maricopa County as the additional
insured/certificate holder as follows:
Maricopa County
c/o Risk Management
301 W Jefferson St, Suite 910
Phoenix, AZ 85003
7.2.11 Cancellation and Expiration Notice
Applicable to all insurance policies required within the insurance requirements of
this contract, Contractor’s insurance shall not be permitted to expire, be
suspended, be canceled, or be materially changed for any reason without 30 days
prior written notice to Maricopa County. Contractor must provide to Maricopa
County, within two business days of receipt, if they receive notice of a policy that
has been or will be suspended, canceled, materially changed for any reason, has
expired, or will be expiring. Such notice shall be sent directly to Maricopa County
Office of Procurement Services and shall be mailed, or hand delivered to 160 S.
4th Avenue, Phoenix, AZ 85003, or emailed to the procurement officer noted in
solicitation.
7.3
INCIDENT REPORTING REQUIREMENT
The Contractor shall ensure incidents involving clients are reported according to this
Section.
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7.3.1
Definitions
7.3.1.1 “Incident” means an unusual or significant event involving client(s)
and/or staff, which requires notification to the designated authorities.
7.3.1.2 “Incident Report” means a report that is verbal or written communication
to the MCAO as described below.
7.3.2
Notification
7.3.2.1 The Contractor shall report incidents to the MCAO by telephone at 602-
372-7300 by 5:00 pm on the next business day after the incident occurs
or after becoming aware of the incident. The Contractor shall also submit
a written incident report as described in Section 7.3.5 below.
7.3.2.2 The Contractor shall report incidents to law enforcement as required by
law and according to the Contractor’s policies and procedures.
7.3.3
Health, Safety, and Welfare Incidents: The Contractor shall immediately report all
incidents impacting the health, safety, and welfare of clients served under this
contract to the MCAO. The Contractor shall notify MCAO of any death or
significant physical injury occurring at any SAGE facility. Health, safety, and
welfare incidents include the following when they occur while a client was in a
contract service and the event occurred on Contractor premises:
a.
Physical assault that requires medical treatment beyond first aid;
b.
Any medical treatment beyond first aid;
c.
Emergency room or urgent care visits;
d.
Request for emergency mental health stabilization provided by
first responders and/or crisis intervention teams;
e.
Use of seclusion and/or restraint;
f.
Actions which pose an immediate and serious threat directed
toward self, others, and/or individuals in the Contractor’s care
and/or Contractor’s staff;
g.
Acts of inappropriate discipline or sexual behavior (consensual
or not) between staff and clients;
h.
Any event that Contractor is aware of and is likely to have media
interest.
7.3.4
Significant Incidents: The Contractor shall report the following significant incidents
involving clients served under this contract:
a. Death of a client that occurs while client was in a contract service;
b. Weapons possession while in a contract service;
c. Acts by clients or staff where the Contractor involves law
enforcement;
d. Traffic accidents involving clients transported by the Contractor or its
personnel, non-employees or transport contractor.
7.3.5
Incident Report Form: The Contractor shall use the MCAO approved Incident
Report form to complete and submit incident reports. The Contractor must submit
a written report to the MCAO via email to mcaodiv@mcao.maricopa.gov not later
than three calendar days after the incident occurs or after becoming aware of the
incident. All reports must be legible and be signed by the staff who prepared the
report as well as by the staff who approved the report. The Contractor shall
maintain a file of written incident reports that are available for review under this
contract.
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7.3.6
Response to Incident Reports: All incident reports will be maintained by MCAO’s
Diversion Strategies Group as directed by the Director. Upon notification of an
incident the Director or his or her designee will do the following:
7.3.6.1 Review the information to determine if the incident requires further
investigation;
7.3.6.2 As necessary, request additional information and direct corrective action
to comply with this contract;
7.3.6.3 Refer the matter to any relevant authorities if necessary.
7.4
INSPECTION AND EVALUATION OF SERVICES/FACILITIES
7.4.1
The Contractor shall provide and maintain an inspection system that continuously
ensures the services under this contract. Complete records of all inspection work
performed by the Contractor shall be maintained and made available to MCAO
during contract performance and for as long afterwards as the contract requires.
7.4.2
MCAO has the right to inspect all services and facilities called for by the contract,
to the extent practicable at all times and places during the term of the contract.
MCAO shall perform inspections in a manner that will not unduly delay the work.
7.4.3
If any of the services or facilities do not conform to contract requirements, MCAO
may require the Contractor to perform the services again in conformity with
contract requirements, at no cost to the County or MCAO. When the defects in
services cannot be corrected by re-performance, the County or MCAO may:
7.4.3.1 require the Contractor to take necessary action to ensure that future
performance conforms to contract requirements.
7.4.4
If the Contractor fails to promptly perform the services again or to take the
necessary action to ensure future performance in conformity with contract
requirements, the County may terminate the contract for default.
7.4.5
MCAO may design and implement a system of program evaluation to use to
determine the Contractor’s performance as contemplated by this contract. Such
evaluations may, in MCAO’s sole discretion, be shared with the Contractor.
7.5
NO MINIMUM OR MAXIMUM PURCHASE OBLIGATION
This contract does not guarantee any minimum or maximum number of referrals of
offenders to be made by MCAO to Contractor.
7.6
BACKGROUND CHECK
Contractors need to be aware that there may be multiple background checks (Sheriff’s
Office, County Attorney's Office, Courts, as well as Maricopa County general government)
to determine if the Contractor’s employees or sub-contractors (including employees of
such sub-contractors) are acceptable to do business with the County or MCAO with
respect to providing the services contemplated by this contract. Contractor agrees to
cause such background checks to be completed and to forward the results to MCAO, as
requested. Contractor shall not allow any person who has not satisfactorily passed all
required background checks to provide the services contemplated by this contract. Failure
to meet these requirements may lead to termination of the contract.
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7.7
SUSPENSION OF WORK
The County may order the Contractor, in writing, to suspend, delay, or interrupt all or any
part of the work of this contract for the period of time that the County determines
appropriate for the convenience of the County.
7.8
STOP WORK ORDER
7.8.1
The County may, at any time, by written order to the Contractor, require the
Contractor to stop all, or any part, of the work called for by this contract. The order
shall be specifically identified as a stop work order issued under this clause. After
a stop-work is delivered to the Contractor, the County shall either—
7.8.1.1 cancel the stop-work order; or
7.8.1.2 terminate the work covered by the order as provided in the Termination
for Default or the Termination for Convenience, clause of this contract.
7.9
TERMINATION FOR CONVENIENCE
Maricopa County may terminate the resultant contract for convenience without further
obligation by providing 60 calendar day notice to the Contractor. The Contractor may
terminate the resultant contract for convenience without further obligation by providing a
six months’ notice to the County and MCAO.
7.10
TERMINATION FOR DEFAULT
7.10.1 The County may, by written Notice of Default to the Contractor, terminate this
contract in whole or in part if the Contractor fails to:
7.10.1.1 perform the services required in accordance with the terms of this
contract or any extension;
7.10.1.2 perform the services required within the time frame specified in this
contract or any extension;
7.10.1.3 perform any of the other provisions of this contract; or
7.10.1.4 if the Contractor should be adjudged bankrupt or should make a
general assignment for the benefits of its creditors, or if a receiver
should be appointed because of its insolvency.
7.10.2 The County’s right to terminate this contract under these subparagraphs may be
exercised if the Contractor does not cure such failure within 10 business days (or
more if authorized in writing by the County) after receipt of a Notice to Cure from
the procurement officer specifying the failure.
7.10.3 Upon termination under this paragraph, all goods, materials, documents, data
and reports prepared by the Contractor under the contract shall become the
property of and be delivered to the County on demand.
7.10.4 The County may, upon termination of this contract, procure, on terms and in
the manner that it deems appropriate, materials or services to replace those
under this contract. The Contractor shall be liable to the County for any excess
costs incurred by the County in procuring materials or services in substitution
for those due from the Contractor. Any claim for excess costs incurred arising
out of this paragraph shall be itemized with descriptive detail and submitted
to Contractor for review and acceptance. In any event no claim shall exceed
$10,000.
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7.10.5 The Contractor shall continue to perform, in accordance with the requirements
of the contract, up to the date of termination, or as directed in the termination
notice.
7.11
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST
Notice is given that, pursuant to A.R.S. § 38-511, the County may cancel any contract
without penalty or further obligation within three years after execution of the contract, if
any person significantly involved in initiating, negotiating, securing, drafting, or creating
the contract on behalf of the County is at any time while the contract or any extension of
the contract is in effect, an employee or agent of any other party to the contract in any
capacity or consultant to any other party of the contract with respect to the subject matter
of the contract. Additionally, pursuant to A.R.S. §38-511, the County may recoup any
fee or commission paid or due to any person significantly involved in initiating,
negotiation, securing, drafting, or creating the contract on behalf of the County from
any other party to the contract arising as the result of the contract.
7.12
CONTRACTOR LICENSE REQUIREMENT
The Contractor shall procure all permits, insurance, and licenses, and pay the charges
and fees necessary and incidental to the lawful conduct of his/her business, and as
necessary complete any requirements, by any and all governmental or non-governmental
entities as mandated to maintain compliance with and in good standing. The Contractor
shall keep fully informed of existing and future trade or industry requirements, Federal,
State, and local laws, ordinances, and regulations which in any manner affect the
fulfillment of a contract and shall comply with the same. Contractor shall immediately notify
both Office of Procurement Services and the department of any and all changes
concerning permits, insurance, or licenses.
7.13
OFFSET FOR DAMAGES
In addition to all other remedies at Law or Equity, the County may offset from any money
due to the Contractor any amounts Contractor owes to the County for damages resulting
from breach or deficiencies in performance of the contract.
7.14
SUBCONTRACTING
The Contractor may not assign to another Contractor or subcontract to another party for
performance of the terms and conditions hereof without the written consent of the County.
7.15
AMENDMENTS
All amendments to this contract shall be in writing and approved/signed by both parties.
Maricopa County Office of Procurement Services shall be responsible for approving all
amendments for Maricopa County.
7.16
ADDITIONS/DELETIONS OF REQUIREMENTS
The County reserves the right to add and/or delete services to a contract. If a service
requirement is deleted, payment to the Contractor will be reduced proportionately to the
amount of service reduced in accordance with the bid price. If additional services are
requested from a contract, prices for such additions will be negotiated between the
Contractor and the County.
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7.17
STRICT COMPLIANCE
Acceptance by County of a performance that is not in strict compliance with the terms of
the contract shall not be deemed to be a waiver of strict compliance with respect to all
other terms of the contract.
7.18
VALIDITY
The invalidity, in whole or in part, of any provision of this contract shall not void or affect
the validity of any other provision of the contract.
7.19
SEVERABILITY
The removal, in whole or in part, of any provision of this contract shall not void or affect
the validity of any other provision of this contract.
7.20
RIGHTS IN DATA
7.20.1 The County shall have the use of data and reports resulting from a contract
without additional cost or other restriction except as may be established by law or
applicable regulation. Each party shall supply to the other party, upon request,
any available information that is relevant to a contract and to the performance
thereunder.
7.20.2 Data, records, reports, and all other information generated for the County by a
third party as the result of a contract are the property of the County and shall be
provided in a format designated by the County or shall be and remain accessible
to the County into perpetuity.
7.21
NON-DISCRIMINATION
Contractor agrees to comply with all provisions and requirements of Arizona Executive
Order 2009-09, including flow down of all provisions and requirements to any
subcontractors. Executive Order 2009-09 supersedes Executive Order 99-4 and amends
Executive Order 75-5 and is hereby incorporated into this contract as if set forth in full
herein. During the performance of this contract, Contractor shall not discriminate against
any employee, client, or any other individual in any way because of that person’s age,
race, creed, color, religion, sex, disability, or national origin. (Arizona Executive Order
2009-09
can
be
downloaded
from
the
Arizona
Memory
Project
at
http://azmemory.azlibrary.gov/cdm/singleitem/collection/execorders/id/680/rec/1.)
7.22
WRITTEN CERTIFICATION PURSUANT to A.R.S. § 35-393.01
If vendor engages in for-profit activity and has 10 or more employees, and if this
agreement has a value of $100,000 or more, vendor certifies it is not currently engaged
in, and agrees for the duration of this agreement to not engage in, a boycott of goods or
services from Israel. This certification does not apply to a boycott prohibited by 50 U.S.C.
§ 4842 or a regulation issued pursuant to 50 U.S.C. § 4842.
7.23
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
7.23.1 The undersigned (authorized official signing for the Contractor) certifies to the
best of his or her knowledge and belief, that the Contractor, its current officers,
and directors:
7.23.1.1 are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from being awarded any
contract or grant by any United States department or agency or any
state, or local jurisdiction;
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7.23.1.2 have not within 3-year period preceding this contract:
7.23.1.2.1 been convicted of fraud or any criminal offense in
connection with obtaining, attempting to obtain, or as the
result of performing a government entity (Federal, State or
local) transaction or contract; or
7.23.1.2.2 been convicted of violation of any Federal or State antitrust
statutes or conviction for embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false
statements, or receiving stolen property regarding a
government entity transaction or contract;
7.23.1.3 are not presently indicted or criminally charged by a government entity
(Federal, State or local) with commission of any criminal offenses in
connection with obtaining, attempting to obtain, or as the result of
performing a government entity public (Federal, State or local)
transaction or contract;
7.23.1.4 are not presently facing any civil charges from any governmental entity
regarding obtaining, attempting to obtain, or from performing any
governmental entity contract or other transaction; and
7.23.1.4 have not within a three-year period preceding this contract any public
transaction (Federal, State or local) terminated for cause of default.
7.23.2 If any of the above circumstances described in the paragraph are applicable to
the entity submitting a bid for this requirement, include with your bid an
explanation of the matter including any final resolution.
7.23.3 The Contractor shall include, without modification, this clause in all lower tier
covered transactions (i.e. transactions with subcontractors or sub-subcontractors)
and in all solicitations for lower tier covered transactions related to this contract.
7.24
VERIFICATION REGARDING COMPLIANCE WITH ARIZONA REVISED STATUTES §
41-4401 AND FEDERAL IMMIGRATION LAWS AND REGULATIONS
7.24.1 By entering into the contract, the Contractor warrants compliance with the
Immigration and Nationality Act (INA using E-Verify) and all other Federal
immigration laws and regulations related to the immigration status of its employees
and A.R.S. § 23-214(A). The contractor shall obtain statements from its
subcontractors certifying compliance and shall furnish the statements to the
procurement officer upon request. These warranties shall remain in effect through
the term of the contract. The Contractor and its subcontractors shall also maintain
Employment Eligibility Verification forms (I-9) as required by the Immigration
Reform and Control Act of 1986, as amended from time to time, for all employees
performing work under the contract and verify employee compliance using the E-
Verify system and shall keep a record of the verification for the duration of the
employee’s employment or at least three years, whichever is longer. I-9 forms are
available for download at www.uscis.gov.
7.24.2 The County retains the legal right to inspect contractor and subcontractor employee
documents performing work under this contract to verify compliance with paragraph
7.24.1 of this section. Contractor and subcontractor shall be given reasonable
notice of the County’s intent to inspect and shall make the documents available at
the time and date specified. Should the County suspect or find that the Contractor
or any of its subcontractors are not in compliance, the County will consider this a
material breach of the contract and may pursue any and all remedies allowed by
SERIAL# 220220-CI
law, including, but not limited to: suspension of work, termination of the contract for
default, and suspension and/or debarment of the Contractor. All costs necessary
to verify compliance are the responsibility of the Contractor.
7.25
CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO
INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS
7.25.1 The parties agree that this contract and employees working on this contract will
be subject to the Contractor employee whistleblower protections established by
Title 41 U.S.C. § 4712 and Section 3.908 of the Federal Acquisition Regulation.
7.25.2 Contractor shall inform its employees in writing, in the predominant language of
the workforce, of employee whistleblower rights and protections under 41 U.S.C.
§ 4712, as described in Section 3.908 of the Federal Acquisition Regulation.
Documentation of such employee notification must be kept on file by Contractor
and copies provided to County upon request.
7.25.3 Contractor shall insert the substance of this clause, including this paragraph, in
all subcontracts over the simplified acquisition threshold ($250,000 as of fiscal
year 2018).
7.26
INFLUENCE
7.26.1 As prescribed in MC1-1203 of the Maricopa County Procurement Code, any effort
to influence an employee or agent to breach the Maricopa County or MCAO
Ethical Code of Conduct or any ethical conduct may be grounds for disbarment
or suspension under MC1-902.
7.26.2 An attempt to influence includes, but is not limited to:
7.26.2.1 A person offering or providing a gratuity, gift, tip, present, donation,
money, entertainment or educational passes or tickets, or any type of
valuable contribution or subsidy that is offered or given with the intent to
influence a decision, obtain a contract, garner favorable treatment, or
gain favorable consideration of any kind.
7.26.3 If a person attempts to influence any employee or agent of Maricopa County, the
chief procurement officer, or his designee, reserves the right to seek any remedy
provided by the Maricopa County Procurement code, any remedy in equity or in
the law, or any remedy provided by this contract.
7.27
ACCESS TO AND RETENTION OF RECORDS FOR THE PURPOSE OF AUDIT
AND/OR OTHER REVIEW
7.27.1 In accordance with Section MC1-373 of the Maricopa County Procurement Code,
Contractor agrees to retain all books, records, accounts, statements, reports,
files, and other records and back-up documentation relevant to this contract for
six years after final payment or until after the resolution of any audit questions
which could be more than six years, whichever is latest. The County, Federal or
State auditors and any other persons duly authorized by the department shall
have full access to, and the right to examine, copy, and make use of, any and all
said materials except those materials containing materials protected under
privacy laws.
7.27.2 If the Contractor’s books, records, accounts, statements, reports, files, and other
records and back-up documentation relevant to this contract are not sufficient to
support and document that requested services were provided, the Contractor
shall reimburse Maricopa County for the services not so adequately supported
and documented.
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7.28
CONFIDENTIAL INFORMATION
7.28.1 Any information obtained in the course of performing this contract may include
information that is proprietary or confidential to the County, MCAO or to the
person or persons who are the recipients of the services being provided by the
Contractor. This provision establishes the contractor’s obligation regarding such
information.
7.28.2 The Contractor shall establish and maintain procedures and controls that are
adequate to assure that no information contained in its records and/or obtained
from the County, MCAO or from others in carrying out its functions (services)
under the contract shall be used by or disclosed by it, its agents, officers, or
employees, except as required to efficiently perform duties under the contract.
The Contractor’s procedures and controls, at a minimum, must be the same
procedures and controls it uses to protect its own proprietary or confidential
information. If, at any time during the duration of the contract, the County or
MCAO determines that the procedures and controls in place are not adequate,
the Contractor shall institute any new and/or additional measures requested by
the County within 15 calendar days of the written request to do so.
7.28.3 Any requests to the Contractor for County or MCAO proprietary or confidential
information shall be referred to the County or the MCAO custodian of records for
review and approval, prior to any dissemination.
7.29
PUBLIC RECORDS
Under Arizona law, all offers submitted and opened are public records and must be
retained by the County at the Maricopa County Office of Procurement Services according
to retention polices. Offers shall be open to public inspection and copying after contract
award and execution, except for such offers or sections thereof determined to contain
proprietary or confidential information by the Office of Procurement Services. If an offeror
believes that information in its offer or any resulting contract should not be released in
response to a public record request under Arizona law, the offeror shall indicate the
specific information deemed confidential or proprietary and submit a statement with its
offer detailing the reasons that the information should not be disclosed. Such reasons
shall include the specific harm or prejudice which may arise from disclosure. The records
manager of the Office of Procurement Services shall determine whether the identified
information is confidential pursuant to the Maricopa County Procurement Code.
7.30
FEES
Contractor warrants that fees extended to the County under this contract are no higher
than those paid by any other customer for these services. Fees charged shall be
reasonable and are established at the beginning of the contract period. Any request for
an increase in fee shall be subject to approval by the County.
7.31
AUDIT DISALLOWANCES
If at any time, County determines that a cost for which payment has been made is a
disallowed cost, such as overpayment, the County shall notify the Contractor in
writing of the disallowance. County shall also state the means of correction, which
may be but shall not be limited to adjustment of any future claim submitted by the
Contractor by the amount of the disallowance, or to require repayment of the
disallowed amount by the Contractor.
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7.32
INTEGRATION
This contract represents the entire and integrated agreement between the parties and
supersedes all prior negotiations, proposals, communications, understandings,
representations, or agreements, whether oral or written, expressed, or implied.
7.33
RELATIONSHIPS
In the performance of the services described herein, the Contractor shall act solely as an
independent contractor, and nothing herein or implied herein shall at any time be
construed as to create the relationship of employer and employee, co-employee,
partnership, principal and agent, or joint venture between the County and the Contractor.
7.34
UNIFORM ADMINISTRATIVE REQUIREMENTS
By entering into this contract, the Contractor agrees to comply with all applicable
provisions of Title 2, Subtitle A, Chapter II, Part 200—UNIFORM ADMINISTRATIVE
REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL
AWARDS contained in Title 2 C.F.R. § 200 et seq.
7.35
GOVERNING LAW
This contract shall be governed by the laws of the state of Arizona. Venue for any actions
or lawsuits involving this contract will be in Maricopa County Superior Court, sitting in
Phoenix, Arizona
7.36
ORDER OF PRECEDENCE
In the event of a conflict in the provisions of this contract, scope of work, and request for
proposal, if applicable, the terms of this contract shall prevail.
7.37
DISPUTES
Any matter which cannot be resolved by the parties will be submitted for review to the
Maricopa County Attorney or designee. The decision of the Maricopa County Attorney or
designee is the final determination of the matter. The parties retain the right to pursue any
judicial remedies available under Arizona law.
7.38
INCORPORATION OF DOCUMENTS
The following are to be attached to and made part of this contract:
7.38.1 Exhibit A, Vendor Information and Fees;
7.38.2 Exhibit B, Scope of Work;
7.38.3 Exhibit C, MCAO Consent Form;
7.38.4 Exhibit D, SAGE Provider Application & Agreement (Third Party Administrator);
7.38.5 Exhibit E, MCAO Financial Agreement Form
NOTICES:
All notices given pursuant to the terms of this contract shall be addressed to MCAO with
a copy going to Office of Procurement Services:
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For MCAO:
Maricopa County Attorney’s Office
Administration Division
Grant and Contract Administrator
225 W Madison St, 6th Floor
Phoenix, Arizona 85003
For Office of Procurement Services:
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, Arizona 85003-1647
For Contractor:
SAGE Counseling, Inc.
1830 South Alma School Road, #104
Mesa, AZ 85210
SERIAL# 220220-CI
IN WITNESS WHEREOF, this Contract is executed on the date set forth above.
CONTRACTOR
________________________________________________
AUTHORIZED SIGNATURE
________________________________________________
PRINTED NAME AND TITLE
________________________________________________
ADDRESS
________________________________________________
DATE
MARICOPA COUNTY
CHAIRMAN, BOARD OF SUPERVISORS
DATE
ATTESTED:
CLERK OF THE BOARD
DATE
APPROVED AS TO FORM:
DEPUTY COUNTY ATTORNEY
DATE
Linda Cowan, COO
1830 South Alma School Rd., Mesa, AZ 85201
02/17/2022
2/17/2022
SERIAL# 220220-CI
EXHIBIT A
VENDOR INFORMATION AND FEES
SERIAL 220220-CI
NIGP CODE:
RESPONDENT'S NAME:
SAGE Counseling, Inc.
COUNTY VENDOR NUMBER:
VC0000008662
ADDRESS:
1830 S. Alma School Rd., Suite 101
Mesa, AZ 85210
P.O. ADDRESS:
TELEPHONE NUMBER:
480-649-3352
FACSIMILE NUMBER:
480-649-3358
WEB SITE:
www.sagecounseling.net
CONTACT (REPRESENTATIVE):
Stephen Grams
REPRESENTATIVE'S E-MAIL ADDRESS:
info@sagecounseling.net
PAYMENT TERMS:
Net 30
1.0 PRICING:
Fee/Rate Per
Class
Assessment Fees
$150.00
Assessment Update
$55.00
Assessment Rescheduling Fee
n/a
Group Fees
$40.00
IOP Group Fees
$50.00
Weekend Education (fee/day)
$110.00
Individual Sessions
$65.00
Case Coordination Fee (Out of State/Out of County) per Month
$80.00
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EXHIBIT B
SCOPE OF WORK
1.0
COUNTY ATTORNEY AUTHORITY AND REFERRALS; PURPOSE:
1.1
Pursuant to A.R.S. §§ 11-361 et seq., the Maricopa County Attorney (“County Attorney”) has
the authority, as an alternative to prosecution, to divert or defer, before a guilty plea or a trial,
the prosecution of an eligible person who is accused of committing a crime. Per this authority,
the County Attorney has established the MCAO Felony Diversion Program. The purpose of
this of Scope of Work (SOW) is for the Contractor to provide treatment services to eligible
adult felony offenders referred to the Contractor by the County Attorney after the filing of
charges for specific felony offenses.
1.2
The County Attorney is solely responsible for determining which offenders are eligible for the
MCAO Felony Diversion Program.
1.3
The MCAO Felony Diversion Program is available to eligible offenders only after charges are
filed in state court (post-file cases).
1.4
The Contractor, as further defined in this SOW, shall conduct a comprehensive validated
assessment of the referred offender and recommend and institute a treatment plan with the
goal that the offender successfully completes the program.
1.5
The County Attorney may rescind an offender’s participation in the MCAO Felony Diversion
Program at any time. If the County Attorney directs removal of any offender from MCAO
Felony Diversion Program, the Contractor shall promptly cease providing any further diversion
services to the offender and close the offender’s diversion file without making any
determination regarding the offender’s completion of the diversion program. In these cases,
the Contractor will be advised/directed by MCAO on how to discharge the case.
1.6
For those offenders who successfully complete the MCAO Felony Diversion Program, the
County Attorney will dismiss the charges with prejudice. If an offender fails to successfully
complete the MCAO Felony Diversion Program, MCAO will review the reasons for the
offender’s unsuccessful termination and will decide what action should be taken depending on
the circumstances presented. If it appears that the termination is solely due to an offender’s
non-payment of program costs and fees (including drug test fees, but not including restitution),
MCAO will consult with the Contractor to review the offender’s financial assessment application,
financial responsibility determination, and any other available information regarding the
offender’s financial circumstances. MCAO will determine whether to reinstate prosecution or
undertake alternatives thereto.
2.0
PROGRAM REQUIREMENTS:
The Contractor shall:
2.1
Upon receipt of referral to the MCAO Felony Diversion Program, administer a comprehensive
and validated assessment tool: the Ohio Risk Assessment System – Community Supervision
Tool (ORAS-CST) for offender assessment and rehabilitation. The ORAS-CST shall assess
the offender’s overall risk to reoffend, risk level score, and identify targeted criminogenic needs
and domains. It is the responsibility of the Contractor to have certified end users in the ORAS-
CST. The Contractor may use additional assessment tools in conjunction with the ORAS
pertinent to the offender’s specific needs.
2.2
Upon the ORAS’ determination of the offender’s overall risk to reoffend and targeted
criminogenic needs and domains, assign the offender to the appropriate “track” of treatment
per the MCAO Felony Diversion Program Flow Chart.
2.3
Develop an individualized treatment plan and goals relative to the targeted criminogenic needs
and domains so the service is beneficial and appropriate for the offender’s learning style,
motivation, abilities, and strengths.
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2.3.1
TRACK ONE – Overall Low Risk Offenders with a Moderate to High Substance
Abuse Criminogenic Need will be assigned to: Drug Treatment: Early Intervention
Substance Abuse Education/Treatment. The program shall consist of:
2.3.1.1 Two-hour group counseling sessions, one time per week for 10 sessions. All
sessions must be completed;
2.3.1.2 Case Management services may be offered as a voluntary service to the
offender when active, illicit drug use is suspected or confirmed, and deemed
to be medically necessary. Prior to Case Management service engagement,
the cost of this service shall be explained to the offender. Case Management
services shall not delay the offender’s timely discharge in the Felony
Diversion Program. Any Case Management services beyond two (2) hours
shall be approved by the MCAO Diversion Strategies Group Director or
designee prior to implementation.
2.3.1.3 Offenders shall complete a maximum of four (4) drug tests over the duration
of their treatment. “Completed” tests consists of the offender providing
adequate specimens that can be tested by the MCAO Contracted Laboratory.
If Case Management services are implemented per Section 2.3.1.2, the
Contractor may require the offender to complete up to four (4) additional drug
tests for a total of eight (8) tests over the duration of treatment. Notification
to offender shall be random and variable. Illegal substances tested must be
in a rotating and variable panel;
2.3.1.4 Curriculum: Group Treatment for Substance Abuse: A Stages of Change
Therapy Model; and
2.3.1.5 Offenders with an ORAS Overall Low/Moderate Risk score shall be placed
in Track One or Track Two starting at 15-20 weeks of treatment, depending
on their substance abuse history and prior treatment.
2.3.2
TRACK TWO – Overall Low Risk Offenders with a Moderate to High Substance
Abuse Criminogenic Need shall be assigned to: Drug Treatment: Lapse/Relapse
Prevention Program. The program shall consist of:
2.3.2.1 Geared towards those offenders who have had success in past substance
abuse education or treatment, but have returned to substance abuse;
2.3.2.2 Two-hour group counseling sessions, one time per week for 10 sessions. All
sessions must be completed;
2.3.2.3 Case Management services may be offered as a voluntary service to the
offender when active, illicit drug use is suspected or confirmed, and deemed
to be medically necessary. Prior to Case Management service engagement,
the cost of this service shall be explained to the offender. Case Management
services shall not delay the offender’s timely discharge in the Felony
Diversion Program. Any Case Management services beyond two (2) hours
shall be approved by the MCAO Diversion Strategies Group Director or
designee prior to implementation.
2.3.2.4 Offenders shall complete a maximum of four (4) drug tests over the duration
of their treatment. “Completed” tests consists of the offender providing
adequate specimens that can be tested by the MCAO Contracted Laboratory.
If Case Management services are implemented per Section 2.3.2.3, the
Contractor may require the offender to complete up to four (4) additional drug
tests for a total of eight (8) tests over the duration of treatment. Notification
to offender shall be random and variable. Illegal substances tested must be
in a rotating and variable panel;
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2.3.2.5 Curricula: Approved lessons of SAMHSA: Counselor’s Manual for Relapse
Prevention with Chemically Dependent Criminal Offenders and Hazelden’s
Living in Balance;
2.3.2.6 Offenders with an ORAS Overall Low/Moderate Risk score shall be placed
in Track One or Track Two starting at 15-20 weeks of treatment, depending
on their substance abuse history and prior treatment.
2.3.3
TRACK THREE – Overall Moderate Risk Offender with a Moderate to High
Substance Abuse Criminogenic Need shall be assigned to: Drug Treatment –
Standard Outpatient Program (SOP). The program shall consist of:
2.3.3.1 Two-hour group counseling sessions, twice per week for 20-34 sessions. All
sessions must be completed;
2.3.3.2 Required attendance in at least one (1) post-group case management
session;
2.3.3.3 Additional Case Management services may be offered as a voluntary service
to the offender when active, illicit drug use is suspected or confirmed, and
deemed to be medically necessary. Prior to Case Management service
engagement, the cost of this service shall be explained to the offender. Case
Management services shall not delay the offender’s timely discharge in the
Felony Diversion Program. Any Case Management services beyond two (2)
hours shall be approved by the MCAO Diversion Strategies Group Director
or designee prior to implementation.
2.3.3.4 Offenders shall complete a maximum of four (4) drug tests over the duration
of their treatment. “Completed” tests consists of the offender providing
adequate specimens that can be tested by the MCAO Contracted Laboratory.
If Case Management services are implemented per Section 2.3.3.3, the
Contractor may require the offender to complete up to four (4) additional drug
tests for a total of eight (8) tests over the duration of treatment. Notification
to offender shall be random and variable. Illegal substances tested must be
in a rotating and variable panel; and
2.3.3.5 Curriculum: Hazelden’s Living in Balance, with completion of the 12 Core
Sessions plus, at a minimum, eight (8) supplemental supportive sessions
based upon individual needs.
2.3.4
TRACK FOUR – Overall High/Very High Risk Offender with a Moderate to High
Substance Abuse Criminogenic Need shall be assigned to: Drug Treatment –
Intensive Outpatient (IOP). The program shall consist of:
2.3.4.1 Three-hour group counseling sessions, for a total of 50 sessions. Frequency
of groups shall be determined by phases and individual progress, beginning
with Phase I. Phase I: attendance shall be three times per week; Phase II:
attendance shall be twice per week; Phase III: one time per week. All
sessions must be completed;
2.3.4.2 Required attendance in 3-12 individual counseling sessions;
2.3.4.3 Case Management services may be offered as a voluntary service to the
offender when active, illicit drug use is suspected or confirmed, and deemed
to be medically necessary. Prior to Case Management service engagement,
the cost of this service shall be explained to the offender. Case Management
services shall not delay the offender’s timely discharge in the Felony
Diversion Program. Any Case Management services beyond two (2) hours
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shall be approved by the MCAO Diversion Strategies Group Director or
designee prior to implementation.
2.3.4.4 Offenders shall complete a maximum of four (4) drug tests over the duration
of their treatment. “Completed” tests consists of the offender providing
adequate specimens that can be tested by the MCAO Contracted Laboratory.
If Case Management services are implemented per Section 2.3.4.3, the
Contractor may require the offender to complete up to four (4) additional drug
tests for a total of eight (8) tests over the duration of treatment;
2.3.4.5 If needed, referrals to inpatient and other higher end services may be
possible; and
2.3.4.6 Curriculum: Criminal Conduct & Substance Abuse Treatment, Strategies for
Self-Improvement and Change, Pathways to Responsible Living.
2.3.5
TRACK FIVE – Overall Low Risk Offender with a Low to High Criminogenic Needs
(Primary Focus is not Substance Abuse) shall be assigned to: Cognitive Behavioral
Intervention: LOW). The program shall consist of:
2.3.5.1 2-hour group counseling sessions, one time per week, for a total of 12
sessions; must complete all sessions;
2.3.5.2 Drug testing is not required, but available if approved by the County Attorney
or the Director of the MCAO Diversion Strategies Group; and
2.3.5.3 Curriculum: Decision Points: five lessons and activities over 12 sessions.
2.3.6
TRACK SIX – Overall Moderate to High/Very High Risk Offender with Criminogenic
Needs (Primary Focus is not Substance Abuse) shall be assigned to Cognitive
Behavioral Intervention: MODERATE to VERY HIGH). The program shall consist of:
2.3.6.1 2-hour open group counseling sessions, twice per week, for a total of 25
sessions; must complete all sessions;
2.3.6.2 Drug testing is not required, but available if approved by the County Attorney
or the Director of the MCAO Diversion Strategies Group; and
2.3.6.3 Curriculum: Approved lessons in Decision Points and Texas Christian
University’s Unlock Your Thinking: Open Your Mind and Getting Motivated to
Change.
2.3.7
The ability for the Contractor to deliver certain curricula may require training or
certification. When applicable, the Contractor shall have certified and/or properly
trained end users in said curricula. The responsibility for future certification and
training expenses shall be with the Contractor.
2.3.8 Provide for random and variable offender urinalysis testing as determined by the
clinician and treatment plan, if approved by the County Attorney or the Director of the
MCAO Diversion Strategies Group. Any approved testing will be limited by the Track
maximum ranges. Approved urinalysis testing may be directly provided by the
Contractor. Or, if the Contractor cannot provide approved urinalysis testing onsite,
the Contractor shall refer offenders to a laboratory under contract with MCAO.
2.4
For offenders who do live near the Contractor’s site for services (those residing outside of
Maricopa County, Arizona):
2.4.1
If offered, the Contractor will provide telehealth/virtual services to an offender at the
approved fee schedule rate until program completion or termination without the
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offender being charged case coordination fees. These offenders shall be notified of
the ability to receive a financial discount application and instructions by the Contractor
for a determination of possible fee discounts.
2.4.2
If the Contractor does not offer telehealth/virtual services to a recently referred
offender, it shall be the responsibility of the offender to locate a Third-Party
Administrator (TPA) in their jurisdiction that can provide comparable treatment
services as required in the Felony Diversion Program.
2.4.3
Provided that the Contractor and the TPA enter into the SAGE Counseling Provider
Application and Agreement (attached as Exhibit D hereto without any amendments
or modifications thereto), the TPA shall be considered to be approved by the County
Attorney. The Application shall be executed prior to the commencement of any
services. An executed copy of the SAGE Counseling’s Provider Application and
Agreement shall be maintained in the offender’s file.
2.4.4
For offenders described in Section 2.4.2, the Contractor shall be allowed to charge
the offender the approved rate per month in Exhibit A for case coordination services
for the duration of treatment. All treatment fees associated with the TPA shall be the
responsibility of the offender.
2.4.5
For offenders described in Section 2.4.2, who are subject to drug testing while in the
Felony Diversion Program, the Contractor shall coordinate with MCAO’s approved
Contracting Laboratory to determine if there is a collection site operating within
approximately thirty (30) miles from their home or business address. If such collection
site exists, the Contracting Laboratory shall assist the Contractor of the Felony
Diversion Program to set up drug testing services.
2.4.6
For offenders described in Section 2.4.2 who are subject to drug testing while in the
Felony Diversion Program and are not able to test at the Contracting Laboratory, the
Contractor of the Felony Diversion Program shall notify MCAO Diversion Strategies
Group designee for further direction or an alternate method of drug testing.
2.5
For those offenders owing restitution, per the Consent Agreement signed by the offender and
filed in court, the collection of restitution payments from offenders is mandatory. Per the
Consent Agreement, the offender agreed to pay 50% of the restitution balance owed within
30 days following the first day of services as specified in the offender’s treatment plan in the
MCAO Felony Diversion Program. In the event the offender fails to pay 50% of the restitution
balance by the 30-day deadline established by the Consent Agreement, the Contractor must
notify MCAO. MCAO will determine if the Contractor needs to take any additional action at
that time. The remaining restitution balance owed can be paid in installment payments with
due date as determined by the Contractor. The Contractor shall notify MCAO if the offender
fails to make installments payments for the remaining restitution balance by the determined
due date(s). MCAO will determine whether any additional action needs to be taken at that
time by the Contractor. Per the Consent Agreement, the offender’s failure to pay restitution
as owed by the determined due date may result in an unsuccessful termination from the
program. No offender can be successfully discharged from the program until restitution is
paid in full.
2.6
Provide, at a minimum, one (1) designated Contractor staff to be assigned to specified Court
locations in Maricopa County to provide information and education to offenders and attorneys
about the MCAO Felony Diversion Program. This information is to include: a brief orientation,
completion of required forms, scheduling a future intake appointment and assessment(s),
verifying insurance status, and general components of the Program.
2.7
Provide services in a community-based setting at multiple locations throughout Maricopa
County.
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2.8
Service provisions such as: offender/group setting, gender specific and closed/open format as
prescribed by the Track curriculum, length and frequency of service, hours of operation
(including weeknights and weekend availability consideration), and the staff to offender ratio
shall safely and effectively meet the needs of offenders. Conduct classes and treatment
accordance with an established and published schedule.
2.9
Service delivery shall be culturally relevant and linguistically appropriate to the population
served and consistently delivered in a structured and supportive learning environment that
promotes attainment of treatment goals.
2.10
Preference is for an individual who holds a master’s degree in a human services-related field
and licensed to practice independently by the Arizona Board of Behavioral Health Examiners
or is exempt from licensure pursuant to A.R.S. Title 32, Chapter 33 to deliver services.
However, services may also be delivered by Behavioral Health Technicians under the
supervision of a master’s level clinician.
2.11
Attend workshops or training, at the Contractor’s expense, sponsored by the MCAO if required
by the County Attorney. Provide training at no additional cost to MCAO personnel as requested
by the Director of the MCAO Diversion Strategies Group, the County Attorney or her duly
authorized employees, agents, or assigns (“MCAO Authorized Persons”).
2.12
Designate and update as needed, one (1) point of contact at the staff level for purposes of
communication regarding MCAO Diversion cases.
2.13
All Contractor forms (to include informational flyers, brochures, working documents, etc.) used
and given to offenders for any MCAO diversion program shall be submitted to the County
Attorney in advance and approved by the County Attorney prior to implementation. The
Contractor shall not in any manner represent the County Attorney, MCAO Felony Diversion
Program or MCAO.
2.14
Establish reasonable treatment and non-treatment Contractor fees. Accept multiple forms of
payment such as: cash, debit cards, and credit cards as payment for services and/or the ability
to bill private insurance or AHCCCS to cover treatment or education costs.
2.15
Financial Assessment Process
2.15.1 The Contractor shall establish a financial assessment process and make financial
responsibility determinations based upon current Federal Poverty Guidelines (FPLs)
and a Sliding Scale established by the Contractor for all program service fees. Per
the financial assessment process, the Contractor shall make a financial responsibility
determination, so an offender's finances do not preclude the offender’s opportunity
to participate in the program per program requirements.
2.15.2 The Contractor shall establish a policy which outlines a standardized financial
assessment process. The Contractor shall provide a copy of this policy to the County
Attorney via the MCAO Diversion Strategies Group. The policy shall be approved by
the County Attorney.
2.15.3 The Contractor shall establish an offender financial assessment application and
instructions, a Contractor Sliding Scale (attached as Exhibit A hereto), and a listing of
fees. The Contractor shall provide a copy of these documents to the County Attorney
via the MCAO Diversion Strategies Group. The documents shall be approved by the
County Attorney.
2.15.4 The standardized financial assessment process and financial responsibility
determination, including written notification by the Contractor to the offender of the
offender’s financial responsibility for payment of program service fees, shall occur
prior to the commencement of any service to an offender who has notified the
Contractor that the offender is requesting financial assessment and financial
responsibility determination per the process described herein.
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2.15.5 Immediately following the court hearing and as prescribed in the filed Consent
Agreement filed with the court (see Exhibit C) wherein the offender agrees to
participate in the MCAO Felony Diversion Program, the offender shall meet with
designated Contractor staff to address questions, review initial referral paperwork,
and verify the offender’s contact information and insurance status. Or, if following the
court hearing and as prescribed in the filed Consent Agreement wherein the offender
agreed to participate in the MCAO Felony Diversion Program, the offender does not
meet with designated Contractor staff, within seven (7) business days of receiving
the referral from the MCAO, the Contractor shall contact the offender via email or
phone, review initial program information, and verify insurance status. If unable to
contact the offender after several outreach attempts, the Contractor shall
unsuccessfully discharge the offender from the program.
2.15.6 During the meeting referenced in Section 2.15.5, the Contractor shall ask the offender
whether he or she is insured with AHCCCS. Upon an offender’s claim that he or she
is insured with AHCCCS, the Contractor shall verify the accuracy of such claim by
obtaining AHCCCS’ documented response verifying current enrollment.
2.15.7 The Contractor shall not charge any program service fees for AHCCCS members for
any AHCCCS approved service. If any AHCCCS health plan denies coverage for the
diversion program treatment, the Contractor shall review the AHCCCS health plan
decision to determine if an appeal of the decision can be submitted. If the AHCCCS
health plan decision is not appealed or not reversed by appeal, the Contractor shall
implement in Exhibit A of this Scope of Work, the Sliding Scale tier for any uncovered
services for AHCCCS members.
2.15.8 An offender’s inability to provide an AHCCCS insurance card shall not disqualify the
offender from an AHCCCS waiver or discount of program service fees as may be
applicable under Section 2.15.7.
2.15.9 During the meeting referenced in Section 2.15.5 above, upon the offender’s claim that
he or she is not insured with AHCCCS, or upon verification that the offender is not
insured by AHCCCS, the Contractor shall provide to the offender a financial
assessment application and application instructions with a due date of seven (7)
business days from receipt. The Contractor shall explain the instructions and shall
assist the offender with the financial assessment application to further the offender’s
understanding and completion of the application, while emphasizing it is the sole
responsibility of the offender to complete the application and to provide necessary
supporting documentation (e.g.: tax returns, pay stubs, statements showing income
from Social Security, Medicaid, SNAP, pension, annuity, veterans’ benefits, alimony,
child support, military benefits, businesses, rent, interest, dividends, and any other
income) by the required deadline. The offender may submit the completed financial
assessment application and necessary supporting documentation to the Contractor
via email, physical mail, or personal delivery.
2.15.10 Full service fees (as described in Exhibit A and the Sliding Scale) shall be assessed
at the time of service if the offender fails to complete the financial assessment
application and/or fails to provide necessary supporting documentation within seven
(7) business days from the date of receipt of the application and instructions per
Section 2.15.9.
2.15.11 If the offender submits the completed financial assessment application and
necessary supporting documentation within the required seven (7) business days
deadline, the Contractor shall make a determination regarding the offender’s financial
responsibility within five (5) business days of receipt of the completed financial
assessment application and necessary supporting documentation. The Contractor
shall provide the offender with written notification of the financial responsibility
determination.
SERIAL# 220220-CI
2.15.12 Upon receiving written notice of the Contractor’s financial responsibility
determination, the offender may submit a written request, including supporting
documentation, to the Contractor, requesting re-assessment of financial
responsibility on the basis of factual error, such as incorrect salary amount, incorrect
number of members of household, as objectively demonstrated by supporting
documentation supplied by the offender. The offender shall submit such written
submittal and supporting documentation to the Contractor within 5 business days of
receipt of written notice of the Contractor’s financial responsibility determination. If
the offender does not submit such request within the required deadline, the
Contractor’s financial responsibility determination shall be final, absent the offender
completing the processes required for an intervening change of circumstances per
Section 2.16. If the offender does make such submittal within the required deadline,
the Contractor shall provide the offender with written notice regarding its decision on
the submittal’s request and to the extent applicable, provide written notice of any
correction to the financial responsibility determination, which shall be final.
2.15.13 Upon providing written notification to the offender regarding the financial
responsibility determination, the Contractor and the offender shall enter into a
Financial Responsibility Agreement in the form attached as Exhibit E. The Financial
Responsibility Agreement shall govern the offender’s fee payment obligations for
successful completion of the program, unless and until there may be a revised
financial responsibility determination resulting from the offender’s report of an
intervening change in circumstances per Section 2.16 hereto. In circumstances
where the offender fails to make the fee payments provided in the financial
responsibility determination and agreed in the Financial Responsibility Agreement,
and where there is not a revised financial responsibility determination resulting from
the offender’s report of an intervening change in circumstances per Section 2.16
hereto, the Contractor may refuse to provide services to the offender, may terminate
the offender’s program, and may return the offender to MCAO for determination
whether to reinstate prosecution. In no event shall the Contractor refuse to provide
services, terminate the offender’s program or return the offender to MCAO for
prosecution, solely because the offender failed to pay fees in excess of the fees
applicable to and agreed by the offender per the financial assessment process,
financial responsibility determination and Financial Responsibility Agreement. If it
appears that the termination is solely due to an offender’s non-payment of program
costs and fees (including drug test fees, but not including restitution), MCAO will consult
with the Contractor to review the offender’s financial assessment application, financial
responsibility determination, and any other available information regarding the
offender’s financial circumstances. MCAO will determine whether to reinstate
prosecution or undertake alternatives thereto.
2.15.14 If as a result of the financial assessment process, the Contractor determines the
offender may be AHCCCS eligible, the Contractor shall assist the offender in their
application to AHCCCS. If the AHCCCS eligible offender refuses to submit an
application to AHCCCS, the Contractor shall document such refusal in writing and
the Contractor is not obligated to waive or reduce program service fees.
2.15.15 If as a result of the financial assessment process, the Contractor determines the
offender is qualified for fee waiver per the applicable Sliding Scale, such waiver will
be applied retroactively to the 1st day of the month of the date of submittal of the
completed and approved financial assessment application. Any payments of fees
made on or after submittal of the completed application shall be refunded by the
Contractor to the offender. These refunds apply to any overpayment by the offender
due to their AHCCCS healthcare plan coverage or unless the offender loses their
AHCCCS coverage in the future.
2.15.16 If as a result of the financial assessment process, the Contractor determines the
offender is qualified for fee discount per the applicable Sliding Scale, such discount
will be applied retroactively to the to the date of submittal of the completed financial
SERIAL# 220220-CI
assessment application. Any overpayment of fees made on or after submittal of the
completed application shall be applied in the form of a credit towards future fees or
refunded to the offender, whichever is preferable to the Contractor.
2.15.17 Upon the completion of the financial assessment process and the Financial
Responsibility Agreement, the Contractor shall schedule the offender for an
appointment for an Intake/Assessment.
2.15.18 Completed financial assessment applications and supporting documentation, written
financial responsibility determinations, and Financial Responsibility Agreements shall
be maintained in the offender’s program file, and shall be made available to MCAO
upon request. Additionally, the following aggregated data/metrics shall be regularly
maintained by the Contractor and shall be made available in electronic format to
MCAO upon request:
2.15.18.1 Total number of offenders admitted to the Program.
2.15.18.2 Total number of offenders verified to be AHCCCS insureds or AHCCCS
eligible.
2.15.18.3 Total number of offenders who received financial assessment applications
and instructions.
2.15.18.4 Total number of offenders who submitted financial assessment applications
and supporting documentation per the required financial assessment
process.
2.15.18.5 Total number of offenders whose financial assessment applications and
supporting documentation were determined not to qualify for waiver
(AHCCCS) or discount of fees under the applicable Sliding Scale.
2.15.18.6 Total number of offenders whose financial assessment applications and
supporting documentation were determined to qualify for waiver (AHCCCS)
of fees under the applicable Sliding Scale.
2.15.18.7 Total number of offenders whose financial assessment applications and
supporting documentation were determined to qualify for discount of fees
under the applicable Sliding Scale, and for such offenders, total number of
offenders qualifying for discounts under each Sliding Scale tier.
2.15.19 The Contractor shall notify the Contracting Laboratory of: offender’s frequency of
substance abuse testing and financial responsibility while in treatment. The only
MCAO authorized method of any approved substance abuse testing and monitoring
shall be urinalysis and direct observation, respectfully; however, the Contractor may
seek approval from MCAO for other authorized methods due to offender’s exigent
circumstances on a case by case basis.
2.15.20 The Contractor shall require payment at the time of service based upon program
service fees as determined by the financial assessment process, financial
responsibility determination and Financial Responsibility Agreement.
2.16
Intervening Change in Circumstances:
2.16.1 If during the course of the program, the offender has an intervening loss of AHCCCS
eligibility, the Contractor shall assist the offender with re-enrollment into AHCCCS. If
such offender is determined by AHCCCS not to be AHCCCS-eligible, the Contractor
shall provide the financial assessment application and instructions to the offender per
Section 2.15.9. The offender must complete the application and provide necessary
supporting documentation (e.g.: tax returns, pay stubs, statements showing income
SERIAL# 220220-CI
from Social Security, Medicaid, SNAP, pension, annuity, veteran’s benefits, alimony,
child support, military benefits, businesses, rent, interest, dividends, and any other
income), no later than seven (7) business days after receipt. If such application and
documentation are received by the Contractor within the required deadline, the
Contractor shall make the financial responsibility determination within five (5)
business days of receipt and shall provide written notification to the offender regarding
the financial responsibility determination. The Contractor and the offender shall enter
into a Financial Responsibility Agreement with obligations, requirements and
processes per Section 2.15.13. The processes set forth in Section 2.15.12 shall
apply. If the offender does not complete such application and provide such
documentation within the required deadline, the Contractor shall notify the offender in
writing that the offender shall be financially responsible for payment of full fees.
2.16.2 If during the course of the program, the offender notifies the Contractor of alleged
diminishment of the offender’s financial circumstances, the Contractor shall provide
the financial assessment application and instructions to the offender per Section
2.15.9. offender must complete the application and provide necessary supporting
documentation (e.g.: tax returns, pay stubs, statements showing income from Social
Security, Medicaid, SNAP, pension, annuity, veteran’s benefits, alimony, child
support, military benefits, businesses, rent, interest, dividends, and any other
income), no later than seven (7) business days after receipt. If received by the
Contractor within the required deadline, the Contractor shall make the financial
responsibility determination within five (5) business days of receipt and shall provide
written notification to the offender regarding the financial responsibility determination.
The Contractor and the offender shall enter into a revised Financial Responsibility
Agreement with obligations, requirements and processes per Section 2.15.13. The
processes set forth in Section 2.15.12 shall apply. If the offender does not complete
such application and provide such documentation within the required deadline, the
Contractor shall notify the offender in writing that the offender shall continue to be
financially responsible for the same fee amounts established by the financial
assessment
process,
financial
responsibility
determination
and
Financial
Responsibility Agreement applicable at the time of the reported intervening change in
circumstances.
2.17
Should public monies become available to the MCAO for diversion programs, these funds may
at the discretion of the County Attorney be used in whole or part to offset discounts and waivers
provided by the Contractor to the offender for program service fees, based upon their approved
Sliding Scale under Section 2.15.1. The Contractor shall invoice MCAO on a monthly basis
for the preceding month for reimbursement. The invoice shall include: specific diversion
program, offender name, date of service, type of service, quantity of service(s), billed amount,
and offender payment. The use of public monies is subject to applicable legal requirements,
applicable approval processes/requirements, fiscal agent conditions and requirements,
expiration date, and available balance. Contractor reimbursement is contingent on the
availability of funds.
2.18
If applicable to the case, the offender shall make restitution payments via the MCAO Diversion
Payment Portal or mail payments directly to MCAO using the approved payment methods.
The Contractor shall ascertain if co-offenders were ordered to pay as joint and several liability
requirements and verify restitution payments via the MCAO Diversion Payment Portal prior to
discharging the offender from the Felony Diversion Program. Full restitution shall be paid for
a successful discharge. The total amount of restitution paid shall be documented on the
MCAO Discharge Report, whether successful or unsuccessful discharge.
2.19
Direct Service Standards:
2.19.1 Inform the offender of program rules, which includes but is not limited to confidentiality,
offender rights, and expected behavior; obtain their written consent for Release of
Information. Document in offender’s case file;
SERIAL# 220220-CI
2.19.2 Inform the offender of program requirements for successful completion of the MCAO
Felony Diversion Program so the offender understands expected performance and
criteria for successful completion. Document in offender’s case file;
2.19.3 Inform the offender of the financial obligations to participate in the program; to include:
programmatic fees or copays, methods of acceptable payment (AHCCCS, private
insurance, self-pay), and payment schedules and due dates for remittance of
payment. Document in the offender’s case file;
2.19.4 Use of the ORAS with identified criminogenic needs and domains targeted shall be
addressed throughout the course of the treatment and recorded in the offender’s case
file. Additionally, the ORAS tool and its supporting/collateral documentation (interview
notes, interview guide, self-report form, scoring guide) shall be retained in the
offender’s case file. Digital upload of ORAS documentation into Contractor’s case
management system shall suffice;
2.19.5 The treatment plan shall be updated as needed with information demonstrating
structured sessions occurred for a specific and authorized period that works toward
the attainment of treatment goals. Document offender progress and participation in
the offender’s case file; and
2.19.6 Identify community resources and natural supports for the offender upon successful
release from treatment. Document in offender’s case file.
2.20
Retain adequate accounting and case reconciliation records for review purposes by the
County Attorney and/or MCAO Authorized Persons.
3.0
CONTRACTOR QUALIFICATION REQUIREMENTS
3.1
The Contractor shall hold and maintain during the performance of this contract, a current,
applicable Arizona Department of Health Services license that is in good standing, for each
facility from which services shall be provided.
3.2
The Contractor shall be an AHCCCS provider. The Contractor shall maintain contracts with
all AHCCCS Complete Care Plans serving the Central Region Geographical Service Area.
4.0
CONTRACTOR REPORTING REQUIREMENTS: OFFENDER ENROLLMENT AND TERMINATION
4.1
The Contractor shall provide immediate notification to the County Attorney via the MCAO
Diversion Strategies Group when an offender is enrolled and when terminated: successfully
completes or unsuccessfully completes (defined as either meeting or not meeting program
requirements) the MCAO Felony Diversion Program. Immediate notification is defined by as
the next business day but no longer than three (3) business days after enrollment or
termination.
4.1.1.
Upon termination from the MCAO Felony Diversion Program, the Contractor shall
complete and provide to the County Attorney via the MCAO Diversion Strategies
Group:
4.1.1.1 The MCAO Discharge Report documenting: the ORAS overall risk level, the
ORAS top three (3) identified criminogenic needs and domains, treatment
goals, offender participation, financial obligation compliance (fees, copays,
and restitution if applicable, collected), if applicable, the reason for any case
management services, reasons for successful or unsuccessful completion,
and documented attempts by Contractor to engage the offender in the MCAO
Felony Diversion Program.
4.1.1.2 For unsuccessful discharges, the Contractor shall also document on the
MCAO Discharge Report whether the offender would be considered for future
reentry.
SERIAL# 220220-CI
4.1.1.2.1 If, at a later date the offender is allowed to reenter FDP, the
Contractor shall reassess the offender. In an effort to achieve a
more positive treatment outcome, assign the offender to a
higher/more intensive track to meet his/her clinical needs. This
assignment to a higher track option is only available for offenders
previously assigned to Tracks 1-3.
4.1.1.2.2 For offenders previously assigned to Track 4, upon reentry, the
Contractor may recommend an inpatient treatment program for
stabilization. If the offender does not enter an inpatient treatment
program, the offender shall repeat Track 4 with expected
qualitative differences during the required individual counseling
sessions to meet the offender’s higher level of need.
4.1.1.3 Provide offender-related urinalysis testing results upon successful or
unsuccessful termination from the MCAO Felony Diversion Program.
Documentation shall not be individual urinalysis reports, but a summary or
chart of the dates the offender tested and was required to test (including
failure or refusal to test) and results (positive, negative, or diluted and names
of substances tested).
4.2
Contractor shall have the capability to transmit updates regarding MCAO Felony Diversion
Program enrollment and discharge via one or more of the following: 1) Manual email to:
mcaodiv@mcao.maricopa.gov
2) Manual entry into the MCAO Diversion portal, 3)
Automatically via Extensible Markup Language (XML), or 4) Automatically or manually via a
delimited file. Contractor transmitting information using Options 3 or 4 must do so using a
schema/format to be provided by MCAO.
4.3
By the end of the fifth business day of each month, the Contractor shall provide to the County
Attorney via the MCAO Felony Diversion Program the following statistical information.
Contractor shall email information to: mcaodiv@mcao.maricopa.gov with “Monthly Stats” in
the subject line.
4.3.1
Number of new offenders enrolled (never been in the program before) in the MCAO
Felony Diversion Program for the prior month by Track;
4.3.2
Number of offenders enrolled in the MCAO Felony Diversion Program for the prior
month who had previously been enrolled in the Program one or more times by Track;
4.3.3
Total number of offenders and total enrolled in the MCAO Felony Diversion Program
by Track;
4.3.4
Number of offenders who were unsuccessfully terminated from the MCAO Felony
Diversion Program for the prior month by Track; and
4.3.5
Number of offenders who successfully completed the MCAO Felony Diversion
Program for the prior month by Track.
4.4
The Contractor shall provide annual (fiscal year: July 1-June 30) reports to MCAO with the
aggregate statistical information described in subsection 4.3; additional relevant data may
also be submitted with these reports.
4.5
The Contractor shall provide additional data and information to the County Attorney and MCAO
Authorized Persons, as requested.
5.0
CONTRACTOR PERFORMANCE REQUIREMENTS:
5.1
Service milestones shall be based on the needs of the offender; however, desired outcomes
are:
SERIAL# 220220-CI
5.1.1
Offender shall have exhibited progress on treatment goals as outlined in treatment
plan;
5.1.2
Offender shall have improved daily functioning, and
5.1.3
Identified community supports are part of the discharge plan that is put in place for the
offender to help maintain stability and resilience in the community.
5.2
At a minimum, all reasonable efforts are made to deliver services to the offender in a timely
manner to meet the needs of the offender.
5.3
All contacts between the Contractor, offenders, and MCAO employees, agents and assigns
shall be conducted with professionalism, fairness, respect, and dignity to the offender. The
offender shall not be discriminated against based on race, national origin, religion, gender,
sexual orientation, age, disability, marital status, diagnosis, or source of payment.
5.4
The Contractor shall comply with all professional and ethical obligations and code of conduct
of licensure and maintain good standing with the Arizona Bureau of Medical Facilities
Licensing (BMFL). Further, the Contractor shall protect information and records protected by
federal confidentiality rules (e.g., 42 CFR Part 2 and HIPAA Rules at 45 CFR Parts 160, 162,
and 164) and state confidentiality rules (e.g., A.R.S. §§ 12-2291 et seq.), and ensure that
Contractor and its employees and subcontractors comply with said rules and employ all
administrative and physical safeguards as may be required by law to protect confidential
information. The Contractor shall be responsible for ensuring the execution of any business
associate
agreements,
qualified
service
organization
agreements,
and
nondisclosure/confidentiality agreements that may be required under federal and state
confidentiality rules.
5.5
The MCAO Grants and Contract Administrator shall act as Contract Administrator.
5.6
Successful performance shall be determined by Contractor compliance with the terms of the
contract.
5.7
Contractor failure to comply with the terms of this contract may result in suspension of
work or termination of the contract at the discretion of Maricopa County or designee.
SERIAL# 220220-CI
EXHIBIT C
MCAO CONSENT FORM
IN THE SUPERIOR COURT OF THE STATE OF ARIZONA IN AND FOR THE COUNTY OF
MARICOPA
THE STATE OF ARIZONA,
CR______________________
Plaintiff,
DEFENDANT’S CONSENT TO PARTICIPATE
IN DEFERRED PROSECUTION PROGRAM
vs.
AND ACKNOWLEDGEMENT
Defendant.
I, ___________________, the Defendant in this case, agree to participate in the Felony Diversion
Program, a deferred prosecution program, and I give my consent to the Maricopa County Attorney’s
Office to apply to the Court for suspension of prosecution of this matter. I understand that my
participation in the program is contingent upon my acceptance. If accepted, I will adhere to the
regulations of the program and the directives of my case manager. Successful completion of the
program will be determined by SAGE Counseling Inc., and the Maricopa County Attorney’s Office. If I
successfully complete this program, I acknowledge that the criminal case currently pending against me
in the above referenced cause number will be dismissed with prejudice.
By agreeing to participate in this deferred prosecution program, I acknowledge and agree that:
___ 1. I have been given a description of the Felony Diversion Program that I am agreeing to enter, and
I understand and agree that it will consist of education and treatment as directed by the program
provider, SAGE Counseling Inc. I understand and agree that successful completion of this
program will require me to follow all the steps that will be outlined in my treatment plan that will
be developed specifically for me following my initial intake session.
___ 2. I agree to contact SAGE Counseling Inc. at 1616 East Indian School Road, #150, Phoenix,
Arizona. Five (5) days from today’s date, _____________, I will call SAGE Counseling at 480-
649-3352 to schedule an appointment date and time. I understand and agree that a failure to
contact SAGE Counseling Inc. or to complete my assessment on the date scheduled will be
considered unsuccessful completion of the program and the criminal prosecution will be
resumed. I will not call any sooner than five days with the understanding that SAGE
Counseling needs additional time to receive my referral.
___ 3. I understand and agree that this consent will, by necessity, cause a delay in the prosecution of
this case, and I waive my right to a speedy trial as guaranteed by the United States Constitution
and Rule 8 of the Arizona Rules of Criminal Procedure. Prosecution may be suspended for up to
two years.
___ 4. I promise to appear at any and all future court dates. If the prosecutor seeks to resume
prosecution against me, I will be notified of my next court date by mail. Because the Court will
issue a warrant for my arrest if I fail to appear at future court dates, I agree to notify SAGE
Counseling, my attorney, the prosecutor and the Court of my current address until this case is
completely resolved. My current correct best contact information is as follows:
Address: ______________________________________________
Street Address including Apt. number if applicable
_________________________________________
City
State
Zip
Email Address: ______________________________________________
SERIAL# 220220-CI
Cell number where I can receive text messages: ______________
___ 5. I do not contest my guilt in this matter. I admit that I committed the charged offenses as further
explained in the factual basis that I signed and provided to the State. I acknowledge and agree
that this admission of guilt and factual basis may be used against me if I do not successfully
complete the deferred prosecution program and I decide to have a trial in this matter.
___ 6. I have reviewed the following statements with my attorney and the each of the following
statements are true. I understand and agree that if any of these statements are not true, I am not
eligible for this deferred prosecution program and the prosecution against me will be resumed:
a. I have no prior conviction for a serious offense as defined in A.R.S. § 13-706.
b. I have no prior conviction for any offenses under A.R.S. Title 13, Chapter 14.
c. I have no prior conviction for any dangerous offense as defined in A.R.S. §13- 105.
d. I have no prior conviction for any dangerous crime against children as defined in A.R.S. §
13-705.
e. I have no felony convictions within the last five years, and I have no historical prior felony
convictions as defined in A.R.S. § 13-105 except an Aggravated DUI committed on DATE
and convicted in Case Number NUMBER
f. I do not have any other felony charges pending against me in any other jurisdiction.
g. I was not on felony probation or any type of release for any felony matter at the time of the
offense(s) charged in this case.
h. I have not completed any deferred prosecution or diversion program for any felony offense
within the last five years.
___ 7. I understand and agree that while the prosecution is suspended in this matter, I will be released
on my own recognizance under the conditions set by the court. I further understand and agree
that should I commit a new felony offense while released on my own recognizance that I may be
held without bond on the new offense.
___ 8. I will / will not need the services of an interpreter. I understand that there may be additional fees
associated with interpreter services and any such fees will be fully explained during my intake
session with SAGE Counseling Inc.
Language: __________________________
___ 9. I acknowledge and agree that to successfully complete this program, I must remain crime free.
Therefore, I understand and agree that I will not be in compliance with the requirements of this
Felony Diversion Program if I am subsequently arrested for or charged with a new offense
before a Motion and Order to Dismiss this case is filed and signed by the Court and, if that
occurs, MCAO may reinstate prosecution in this case.
__ 10 By signing this agreement, I authorize SAGE Counseling Inc., Avertest dba Averhealth
(Averhealth), Genotox Laboratories (Genotox), and RecoveryTrek to share confidential information
with the Maricopa County Attorney’s Office including but not limited to: information related to my
assessment, treatment recommendations, drug testing compliance and results, and participation
and compliance in the MCAO Felony Diversion Program. I further authorize and acknowledge that
this confidential information may contain information related to alcohol and/or drug abuse (Federal
Law references 42 U.S.C. 290 dd-3 –Federal Regulation reference CFR, Part 2) and the
information may be disclosed for purposes of case prosecution to defense attorneys, the Court,
and all other relevant parties.
SERIAL# 220220-CI
FINANCIAL OBLIGATIONS
__ 11. FOR DEFENDANTS OWING RESTITUTION:
I understand and agree that successful completion of this program requires me to pay full
restitution to any and all victims in this matter in a total amount of $_______ and that I am
required to pay 50% of that total, which is $________, within 30 days following the first day of
services as specified in the offender’s treatment plan. I understand and agree that if I fail to
make restitution payments by required deadlines, MCAO will decide what additional action may
be taken in respect to my program which may include reinstatement of the prosecution against
me. I also understand and agree that if I do not successfully complete the program that any
restitution paid belongs to the victim(s) and will not be returned to me, but any amounts paid will
be credited against any future restitution orders in this case. Restitution must be paid in full by
the completion of my treatment, which may be as short as ten (10) to twelve (12) weeks
depending upon the assigned treatment track. My treatment will not be extended for the purpose
of meeting my restitution obligation. I have considered this prior to agreeing to this Diversion
offer.
__ 12. In addition to any restitution, I understand and agree that I will be responsible for paying for the
education and treatment program. These fees and costs will be fully explained to me when the
treatment program is developed. I understand and agree that if I decide not to pay the fees and
costs for the program, I may voluntarily end my participation in the program and the criminal
prosecution in this matter will be resumed. In addition, I understand and agree that if I fail to pay
agreed fees and costs for the program I may be terminated unsuccessfully from the program and
criminal prosecution in this matter may be resumed. I understand and agree that any payments
made for program fees and costs will not be returned to me.
__ 13. Fees and costs for the program may be reduced through either AHCCCS coverage for provided
services or through a financial assessment and responsibility determination.
AHCCCS ELIGIBLE DEFENDANTS:
If I am eligible for AHCCCS coverage for program services, the fees and costs of the services
may be covered. If needed SAGE Counseling Inc. will assist me to help determine if I am
AHCCCS eligible, verify my AHCCCS coverage, and assist me with AHCCCS registration if
necessary. I understand and agree that some services may be required in this program that are
not covered by AHCCCS and in that event, I will be responsible for the fees and costs of those
services at a significantly reduced rate.
DEFENDANTS NOT ELIGIBLE FOR AHCCCS COVERAGE:
If I am not eligible for AHCCCS coverage for program services, I will be given the opportunity to
complete a financial assessment process to determine if I am eligible for reduced fees and costs
for services. I acknowledge and agree that although I am not required to disclose any financial
information unless I wish to do so, I am required to sign an attestation form with my defense
attorney to acknowledge I will be offered a financial assessment application and instructions by
SAGE Counseling. On the attestation form I must also indicate if I am interested in a financial
assessment for the purposes of determining a discount on program fees or if I am not interested
in completing the financial assessment application. This choice must be indicated on the
attestation form and signed by me. Failure to indicate my choice and sign the attestation form
will result in my case being returned to the Maricopa County Attorney’s Office for prosecution.
__ 14. PERTAINS TO CURRENT AND POSSIBLE FUTURE OUT OF STATE/OUT OF COUNTY
DEFENDANTS (MUST ACKNOWLEDGE ALL SECTIONS):
I acknowledge that treatment services for the Felony Diversion Program through SAGE
Counseling are delivered in Maricopa County, Arizona and despite residing outside of Maricopa
County, Arizona I have the option of attending treatment services in Maricopa County, Arizona
without incurring additional fees.
__ 15. I acknowledge that if I elect to attend treatment services outside of Maricopa County, Arizona,
now or in the future, I will incur additional fees to SAGE Counseling for monthly case
SERIAL# 220220-CI
coordination with a third-party behavioral health organization and if applicable, additional fees for
drug testing.
__ 16. I acknowledge that if I elect to attend treatment services outside of Maricopa County, Arizona,
now or in the future, I am responsible for contacting SAGE Counseling as required in paragraph
#2 to schedule my assessment appointment if not previously completed.
__ 17. I understand that upon completion of my assessment through SAGE Counseling, if now or in the
future I reside outside of Maricopa County, Arizona, I will be given my general assessment
information and I am responsible for locating a third-party behavioral health organization in my
jurisdiction that can provide comparable treatment services to the Felony Diversion Program.
Before beginning treatment services, SAGE Counseling must approve my participation in these
services with this third-party behavioral health organization.
__ 18. I understand that if I elect to use a third-party behavioral health organization outside of Maricopa
County, Arizona, I am responsible for all fees charged by the third-party behavioral health
organization for treatment.
__ 19. I understand that if I am required to submit to drug testing as determined by the assessment
administered by SAGE Counseling, I will be subject to random testing at an Averhealth testing
site if one is located with approximately 30 miles from my home or work address. I will pay
Averhealth for the drug tests at the time of service.
__ 20. I understand that if I am directed to submit to drug testing and Averhealth is not available, I will
be assigned to drug test through an approved drug testing provider: Genotox/RecoveryTrek. I
will be required to make a prepayment for Genotox home drug test kits within five (5) calendar
days from my assessment appointment and will receive additional instructions from SAGE
Counseling. Failure to pay within this time frame may result in no treatment services scheduled
and an unsuccessful discharge from the Felony Diversion Program. The cost of the prepayment
is $325.00. I am responsible for the cost of any additional drug testing ($100.00 each) as
directed.
If applicable, I authorize Genotox and RecoveryTrek to contact and assist me with my drug testing
obligations. This authorization includes scheduling appointments as necessary, notification of future drug
testing, and assistance with using their portal for the ordering and payment of drug testing kits as
required.
__ 21. My attorney has reviewed this entire agreement with me and has fully explained each and
every paragraph of this agreement including each statement in paragraph 6. I understand
that I am under no obligation to agree to this program. I freely and voluntarily agree to
participate in this deferred prosecution program.
_____________
__________________________________________________
Date
Signature
I have explained this Consent to Participate in Deferred Prosecution Program & Acknowledgement to the
Defendant.
_____________
__________________________________________________
Date
, # Defense Counsel
SERIAL# 220220-CI
EXHIBIT D
SAGE PROVIDER APPLICATION & AGREEMENT (THIRD-PARTY ADMINISTRATOR)
(see pdf document 220220-CI Exhibit D SAGE Provider App)
SERIAL# 220220-CI
EXHIBIT E
MCAO FINANCIAL AGREEMENT FORM
MCAO DIVERSION PROGRAM
FINANCIAL RESPONSIBILITY AGREEMENT
DATE: _______________
CLIENT NAME: ___________________________________
CLIENT PROGRAM ID: _____________
On __________, ______________________ (“Client”) received written notification of the Financial
Responsibility Determination applicable to Client’s participation in the MCAO Diversion Program
(“Client’s Financial Responsibility Determination”).
Client’s Financial Responsibility Determination is effective ________. Client understands and agrees
that Client’s Financial Responsibility Determination shall remain in full force and effect throughout
Client’s participation in the MCAO Diversion Program. Client understands and agrees that Client’s
Financial Responsibility Determination is not subject to amendment or modification other than through
completion of the applicable procedures for a revised Financial Responsibility Determination.
Client understands and agrees that Client shall pay costs and fees for services applicable to Client’s
treatment plan. Such costs and fees are identified in the applicable fee schedules previously provided to
Client, as Client acknowledged and agreed in Paragraphs 1, 12 and 13 of Defendant’s Consent to
Participate in Deferred Prosecution Program and Acknowledgement, filed in Client’s criminal case. Client
understands and agrees that the amount of costs and fees for services provided by SAGE Counseling,
Inc. (“SAGE Counseling”) shall be assessed per the applicable SAGE Counseling fee schedule in
conjunction with Client’s Financial Responsibility Determination. Client understands and agrees that the
amount of costs and fees for drug testing services shall be assessed per the applicable drug testing fee
schedule.
Client understands and agrees that Client’s failure to pay agreed costs and fees may result in Client
being precluded from obtaining services for which Client has not made the agreed payment, and/or
Client being terminated unsuccessfully from the MCAO Diversion Program and criminal prosecution in
Client’s criminal case may be resumed. Client understands and agrees that any payments made for
program fees and costs will not be returned to Client.
Client agrees that Client has full understanding of the terms and provisions of this Financial
Responsibility Agreement.
Client freely and voluntarily agrees and enters into this Financial Responsibility Agreement without any
degree of duress or compulsion whatsoever.
______________________________________________/DATE __________________
CLIENT SIGNATURE
______________________________________________/PROGRAM ID ___________
PRINTED CLIENT NAME
_______________________________________________/DATE _________________
SIGNATURE, AUTHORIZED REPRESENTATIVE OF SAGE COUNSELING INC.
__________________________________________________
PRINTED NAME, AUTHORIZED REPRESENTATIVE OF SAGE COUNSELING INC
SERIAL# 220220-CI
EXHIBIT F
MCAO FINANCIAL AGREEMENT FORM
(to be determined, if needed)