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 (xxxxx://xxxx.xxx.xxxxx.xxx/) or CMBHS by the required due date and report name described in Table 1: Submission Requirements: 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 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 due October 15 of the final Contract year. e. Grantee shall submit a CMBHS Security Attestation Form electronically on or before September 15th and March 15th to the designated folder in GlobalScape EFT. f. Xxxxxxx’s duty to submit documents will survive the termination or expiration of this Contract. 2. System Agency will monitor Xxxxxxx’s performance of the requirements in Attachment A and compliance with the Contract’s terms and conditions. SECTION V: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee Shall: 1. 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 submitted electronically on or before the 15th day of September and March 15th, to the designated folder in Globalscape 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 EFT. Grantee is required to maintain access to Globalscape EFT for the term of this Contract. A. CONTRACT INFORMATION Vendor ID: 17528112685 Grantee Name: North Texas Behavioral Health Authority Contract Number: HHS000779800004 Contract Type Treatment Payment Method: Fee-for-Service DUNS Number: 011556147 Federal Award Identification Number (XXXX) 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 submit each deliverable. Grantee is required to maintain access to the GlobalScape EFT (xxxxx://xxxx.xxx.xxxxx.xxx/) or and CMBHS by for the required due date and report name described in Table 1: Submission Requirements: a. Grantee shall submit all documents listed in Table 1 by the due date statedterm of this agreement. 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 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 due October 15 of the final Contract year. e. Grantee shall submit a CMBHS Security Attestation Form electronically on or before September 15th and March 15th to the designated folder in GlobalScape EFT. f. 2. Xxxxxxx’s duty to submit documents the deliverables will survive the termination or expiration of this Contract. 23. System Agency will monitor Xxxxxxx’s performance of the requirements in Attachment A this agreement and compliance with the Contract’s terms and conditions. SECTION V: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee Shall: 1. Designate a Security Administrator and a back-up Security Administrator. The Security Administrator is conditions through the 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 Administratordeliverables. 4. Ensure that access System Agency may request additional deliverables to CMBHS is restricted to only authorized userssupport data request by the Federal funding partner, U.S Health and Human Services, Substance Abuse and Mental Health Services Administration. Grantee shallshall provide additional requested deliverables, within 24 hours, remove access to users who are no longer authorized to have access to secure dataas applicable. 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 submitted electronically on or before the 15th day of September and March 15th, to the designated folder in Globalscape 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 EFT. Grantee is required to maintain access to Globalscape EFT submit a monthly invoice in CMBHS, the invoice will serve as Xxxxxxx’s request for reimbursement for the term of this Contractprevious month’s activities. A. CONTRACT INFORMATION Vendor ID6. 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 Xxxxxxx’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: 17528112685 Grantee Item Deliverable (Report Name: North Texas Behavioral Health Authority Contract Number: HHS000779800004 Contract Type Treatment Payment Method: Fee) Due Date Submission System Section V (A) (3) Institutional Review Board Submission (if necessary) Within 30 days of receipt of documentation of determination Globalscape Section V (A) (2) Implementation Plan Within 60 days 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-for-Service DUNS Number: 011556147 Federal Award Identification Number (XXXX) B08TI083054-01year Evaluation Reports March 31th of each fiscal year GlobalScape

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 (xxxxx://xxxx.xxx.xxxxx.xxx/) 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 clams 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 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 15th 15 and March 15th 15 in each successive fiscal year to the designated folder in GlobalScape Globalscape EFT.; and f. Xxxxxxx’s duty to submit documents will survive the termination or expiration of this Contract. 2. System Agency HHSC will monitor Xxxxxxx’s performance of the requirements in “Attachment A and A,” as well as compliance with all of the Contract’s terms and conditions. SECTION VTable 1: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (Submission Requirements Report Frequency Due Date Delivery Method Claims in CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee Shall: 1. 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 : Monthly All claims must be submitted electronically on or before 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, to the designated folder in Globalscape 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 EFT. Grantee is required to maintain access to Globalscape EFT for the term of this Contract. A. CONTRACT INFORMATION Vendor ID: 17528112685 Grantee Name: North Texas Behavioral Health Authority Contract Number: HHS000779800004 Contract Type Treatment Payment Method: Fee-for-Service DUNS Number: 011556147 Federal Award Identification Number (XXXX) B08TI083054-01Globalscape

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 (xxxxx://xxxx.xxx.xxxxx.xxx/) CMBHS, another System Agency submission system, or CMBHS by email to SUD Mailbox, XXX.Xxxxxxxxx@xxx.xxxxx.xx., by the required due date and report name described in Table 1: Submission Requirements: a. Grantee shall submit all documents listed in Table 1 by the due date stated. b. Grantee B. Local Government is required to maintain access to CMBHS for the term of this contract. 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 clams 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 Contract yearcontract closeout shall be received by 45 days from contract end date. e. Grantee F. Local Government shall submit a CMBHS Security Attestation Form electronically on or before September 15th and March 15th to the designated folder in GlobalScape EFT15th, each fiscal year. f. Xxxxxxx’s duty to submit documents will G. Local Government survive the termination or expiration of this Contract. 2. H. System Agency will monitor Xxxxxxx’s performance of the requirements in Local Government Attachment A and compliance with the Contract’s terms and conditions. Section IV FY Closeout documents Each FY: October 15th SUD Mailbox: XXX.Xxxxxxxxx@xxx.xxxxx.xxx Section IV Final Closeout documents By 45 days after contract end date SUD Mailbox: XXX.Xxxxxxxxx@xxx.xxxxx.xxx Section IV CMBHS Security Attestation Form and list of authorized users Each FY: September 15th & March 15th SUD Mailbox: XXX.Xxxxxxxxx@xxx.xxxxx.xxx SECTION VVII: CLINICAL MANAGEMENT FOR BEHAVIORAL HEALTH SERVICES (CMBHS) SYSTEM MINIMUM REQUIREMENTS Grantee ShallA. All CMBHS requirements for the TRF program are detailed in Section V, System of Record of the Program Guide, which includes the following references: 1. Designate a Designation of Security Administrator and a back-up backup 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 Establishment of confidential information.Security Policy 3. Notify the Notifications to CMBHS Help-desk within ten (10) 10 business days of any change changes to the designated Security Administrator or the back-up Security Administrator. 4. Ensure that CMBHS user access, including removal of user access to CMBHS is restricted to only authorized users. Grantee shall, within 24 hours, remove access to users hours for those 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 submitted electronically on or before the 15th day of September and March 15th, to the designated folder in Globalscape 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 EFT. Grantee is required to maintain access to Globalscape EFT for the term of this Contract. A. CONTRACT INFORMATION Vendor ID: 17528112685 Grantee Name: North Texas Behavioral Health Authority Contract Number: HHS000779800004 Contract Type Treatment Payment Method: Fee-for-Service DUNS Number: 011556147 Federal Award Identification Number (XXXX) B08TI083054-01