Common use of REPORTING AND SUBMISSION REQUIREMENTS Clause in Contracts

REPORTING AND SUBMISSION REQUIREMENTS. 1. Grantee shall submit required reports of monitoring activities to System Agency by the applicable due date outlined below. The following reports must be submitted to System Agency through Globalscape EFT (▇▇▇▇▇://▇▇▇▇.▇▇▇.▇▇▇▇▇.▇▇▇/) by the required due date in Table 1 (“Submission Requirements”) below: a. Grantee shall submit all documents listed in Table 1 by the due date stated; b. Grantee will note that if the due date is on a weekend or holiday, the due date is the following business day; c. Grantee shall submit monthly claims in Clinical Management for Behavioral Health Services (CMBHS) by the 15th of the following month; d. Grantee shall submit annual Contract Closeout documentation each fiscal year with a final contract closeout due October 15 of the final contract year; e. Grantee shall submit a CMBHS Security Attestation Form electronically within 15 days of contract execution and then on or before September 15 and March 15 in each successive fiscal year to the designated folder in Globalscape EFT; and f. ▇▇▇▇▇▇▇’s duty to submit documents will survive the termination or expiration of this Contract. 2. HHSC will monitor ▇▇▇▇▇▇▇’s performance of the requirements in “Attachment A,” as well as compliance with all of the Contract’s terms and conditions. Table 1: Submission Requirements Report Frequency Due Date Delivery Method Claims in CMBHS: Monthly All claims must be entered by the 15th day of the month following the end of each calendar month. CMBHS CMBHS Security Attestation Form: Semi-annually. Initial form due 15 days from the date the Contract commences. August 15th in base year; September 15th and March 15th in each successive fiscal year. Globalscape Quality Management and Oversight Monitoring Schedule: Quarterly. 5th business day following the end of each quarter of the Contract term. Globalscape Report Frequency Due Date Delivery Method Quality Management and OversightMonitoring Activity Report Quarterly. 30 days following the end of the quarter of the Contract term. Globalscape Annual Closeout Documents. 45 days from the end of each fiscal year. October 15th. Globalscape

REPORTING AND SUBMISSION REQUIREMENTS. 1. Grantee A. Local Government shall submit required reports of monitoring activities to System Agency by the applicable due date outlined below. The following reports must be submitted to System Agency through Globalscape EFT (CMBHS, another System Agency submission system, or by email to SUD Mailbox, ▇▇▇.▇▇▇▇▇://▇▇▇▇.@▇▇▇.▇▇▇▇▇.▇▇▇/) ., by the required due date and report name described in Table 1 (“1: Submission Requirements”) below:. a. Grantee shall submit all documents listed in Table 1 by B. Local Government is required to maintain access to CMBHS for the due date stated;term of this contract. b. Grantee C. All reports submitted to the SUD Mailbox require the email subject line to use the following naming convention: [FY of Report] Report [Name of Report] SA/TRF [Contract No.] D. Local Government will note that if the due date is on a weekend or holiday, the due date is the following business day;. c. Grantee shall submit monthly claims in Clinical Management for Behavioral Health Services (CMBHS) by the 15th of the following month; d. Grantee E. Local Government shall submit annual Contract Closeout documentation each fiscal year with a by October 15th. The final contract closeout due October 15 of the final shall be received by 45 days from contract year;end date. e. Grantee F. Local Government shall submit a CMBHS Security Attestation Form electronically within 15 days of contract execution and then on or before September 15 15th and March 15 in 15th, each successive fiscal year to the designated folder in Globalscape EFT; andyear. f. ▇▇▇▇▇▇▇’s duty to submit documents will G. Local Government survive the termination or expiration of this Contract. 2. HHSC H. System Agency will monitor Local Government Attachment conditions. Section IV FY Closeout documents Each FY: October 15th SUD Mailbox: ▇▇▇.▇▇▇▇▇▇▇’s performance of the requirements in “Attachment A,” as well as compliance with all of the Contract’s terms and conditions. Table 1▇▇@▇▇▇.▇▇▇▇▇.▇▇▇ Section IV Final Closeout documents By 45 days after contract end date SUD Mailbox: Submission Requirements Report Frequency Due Date Delivery Method Claims in CMBHS: Monthly All claims must be entered by the 15th day of the month following the end of each calendar month. CMBHS ▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇▇▇.▇▇▇ Section IV CMBHS Security Attestation FormForm and list of authorized users Each FY: Semi-annually. Initial form due 15 days from the date the Contract commences. August 15th in base year; September 15th and & March 15th SUD Mailbox: ▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇▇▇.▇▇▇ SECTION VII: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS A. All CMBHS requirements for the TRF program are detailed in each successive fiscal year. Globalscape Quality Management and Oversight Monitoring Schedule: Quarterly. 5th business day following the end Section V, System of each quarter Record of the Contract termProgram Guide, which includes the following references: 1. Globalscape Report Frequency Due Date Delivery Method Quality Management Designation of Security Administrator and OversightMonitoring Activity Report Quarterlybackup Security Administrator 2. 30 Establishment of Security Policy 3. Notifications to CMBHS Help-desk within 10 business days following the end of the quarter any changes to Security Administrator 4. CMBHS user access, including removal of the Contract term. Globalscape Annual Closeout Documents. 45 days from the end of each fiscal year. October 15th. Globalscapeuser access within 24 hours for those who are no longer authorized to have access to secure data.

REPORTING AND SUBMISSION REQUIREMENTS. 1. Grantee shall submit required reports of monitoring activities to System Agency by the applicable due date outlined below. The following reports must be submitted to System Agency through Globalscape GlobalScape EFT (▇▇▇▇▇://▇▇▇▇.▇▇▇.▇▇▇▇▇.▇▇▇/) or CMBHS by the required due date and report name described in Table 1 (“1: Submission Requirements”) below: a. Grantee shall submit all documents listed in Table 1 by the due date stated;. b. Grantee will note that if the due date is on a weekend or holiday, the due date is the following business day;. c. Grantee shall submit monthly claims clams in Clinical Management for Behavioral Health Services (CMBHS) by the 15th of the following month;. d. Grantee shall submit annual Contract Closeout documentation each fiscal year with a final contract closeout Contract Closeout due October 15 of the final contract Contract year;. e. Grantee shall submit a CMBHS Security Attestation Form electronically within 15 days of contract execution and then on or before September 15 15th and March 15 in each successive fiscal year 15th to the designated folder in Globalscape GlobalScape EFT; and. f. ▇▇▇▇▇▇▇’s duty to submit documents will survive the termination or expiration of this Contract. 2. HHSC System Agency will monitor ▇▇▇▇▇▇▇’s performance of the requirements in “Attachment A,” as well as A and compliance with all of the Contract’s terms and conditions. Table SECTION V: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee Shall: 1: Submission Requirements Report Frequency Due Date Delivery Method Claims in CMBHS: Monthly All claims must . Designate a Security Administrator and a back-up Security Administrator. The Security Administrator is required to implement and maintain a system for management of user accounts/user roles to ensure that all the CMBHS user accounts are current. 2. Establish and maintain a security policy that ensures adequate system security and protection of confidential information. 3. Notify the CMBHS Help-desk within ten (10) business days of any change to the designated Security Administrator or the back-up Security Administrator. 4. Ensure that access to CMBHS is restricted to only authorized users. Grantee shall, within 24 hours, remove access to users who are no longer authorized to have access to secure data. 5. In addition to CMBHS Helpdesk notification, Grantee shall submit a signed CMBHS Security Attestation Form and a list of Grantee’s employees, contracted laborers and subcontractors Grantee has authorized to have access to secure data. The CMBHS Security Attestation Form shall be entered by submitted electronically on or before the 15th day of the month following the end of each calendar month. CMBHS CMBHS Security Attestation Form: Semi-annually. Initial form due 15 days from the date the Contract commences. August 15th in base year; September 15th and March 15th 15th, to the designated folder in each successive fiscal yearGlobalscape EFT. a. Administrative Note to document any other activities (as needed). 6. Attend System Agency training on CMBHS documentation. 7. System Agency requires all deliverables excluding the CMBHS deliverables be submitted within Globalscape Quality Management and Oversight Monitoring ScheduleEFT. Grantee is required to maintain access to Globalscape EFT for the term of this Contract. A. CONTRACT INFORMATION Vendor ID: Quarterly. 5th business day following the end of each quarter of the 17528112685 Grantee Name: North Texas Behavioral Health Authority Contract term. Globalscape Report Frequency Due Date Delivery Method Quality Management and OversightMonitoring Activity Report Quarterly. 30 days following the end of the quarter of the Number: HHS000779800004 Contract term. Globalscape Annual Closeout Documents. 45 days from the end of each fiscal year. October 15th. GlobalscapeType Treatment Payment Method: Fee-for-Service DUNS Number: 011556147 Federal Award Identification Number (▇▇▇▇) B08TI083054-01

REPORTING AND SUBMISSION REQUIREMENTS. A. Grantee shall ensure compliance to the following requirements: 1. Grantee shall submit the required reports of monitoring activities deliverables for this agreement to System Agency by the applicable due date outlined in the deliverable table in item (C) below. The following reports must be submitted deliverable table documents the submission system Grantee is required to System Agency through Globalscape EFT (▇▇▇▇▇://▇▇▇▇.▇▇▇.▇▇▇▇▇.▇▇▇/) by the submit each deliverable. Grantee is required due date in Table 1 (“Submission Requirements”) below: a. Grantee shall submit all documents listed in Table 1 by the due date stated; b. Grantee will note that if the due date is on a weekend or holiday, the due date is the following business day; c. Grantee shall submit monthly claims in Clinical Management for Behavioral Health Services (CMBHS) by the 15th of the following month; d. Grantee shall submit annual Contract Closeout documentation each fiscal year with a final contract closeout due October 15 of the final contract year; e. Grantee shall submit a CMBHS Security Attestation Form electronically within 15 days of contract execution and then on or before September 15 and March 15 in each successive fiscal year to maintain access to the designated folder in Globalscape EFT; andGlobalScape EFT and CMBHS for the term of this agreement. f. 2. ▇▇▇▇▇▇▇’s duty to submit documents the deliverables will survive the termination or expiration of this Contract. 23. HHSC System Agency will monitor ▇▇▇▇▇▇▇’s performance of the requirements in “Attachment A,” as well as this agreement and compliance with all of the Contract’s terms and conditionsconditions through the required deliverables. 4. Table 1System Agency may request additional deliverables to support data request by the Federal funding partner, U.S Health and Human Services, Substance Abuse and Mental Health Services Administration. Grantee shall provide additional requested deliverables, as applicable. 5. Grantee is required to submit a monthly invoice in CMBHS, the invoice will serve as ▇▇▇▇▇▇▇’s request for reimbursement for the previous month’s activities. 6. Grantee is required to submit a quarterly Financial Status Report (FSR) in CMBHS, the FSR will report how the funding paid was utilized, per the cost reimbursement categories. 7. Grantee is required to submit ▇▇▇▇▇▇▇’s General Ledger as supportive documentation to support the data reported in the FSR’s. 8. Each fiscal year, Grantee is required to complete a System Agency Close-out packet, and return the packet to System Agency by the deadline. 9. The required deliverables documented in this agreement, shall be submitted as follows: Submission Requirements Item Deliverable (Report Frequency Name) Due Date Delivery Method Claims in CMBHS: Monthly All claims must be entered by the 15th day of the month following the end of each calendar month. CMBHS CMBHS Security Attestation Form: Semi-annually. Initial form due 15 days from the date the Contract commences. August 15th in base year; September 15th and March 15th in each successive fiscal year. Globalscape Quality Management and Oversight Monitoring Schedule: Quarterly. 5th business day following the end of each quarter of the Contract term. Globalscape Report Frequency Due Date Delivery Method Quality Management and OversightMonitoring Activity Report Quarterly. Submission System Section V (A) (3) Institutional Review Board Submission (if necessary) Within 30 days following the end of the quarter receipt of the Contract term. documentation of determination Globalscape Annual Closeout Documents. 45 Section V (A) (2) Implementation Plan Within 60 days from the end of contract execution GlobalScape Section V (A) (3) (a) Data Collection and Evaluation Plan Within 90 days of contract execution GlobalScape Section V (A) (3) (c) Program Outcome Measures Menu Within 60 days of contract execution GlobalScape Section V (A) (4) (a) Mid-year Evaluation Reports March 31th of each fiscal year. October 15th. Globalscapeyear GlobalScape