Common use of Superseding MOU Clause in Contracts

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By Name: Xxxxxxx Xxxxxxxx Title: Board Chair, Board of Supervisors Notice Address: Name: Xxxxxxx Xxxxxxxx Title: CEO Notice Address: 0000 Xxxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx Xxxxxx, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: Xxxxxxx X. Xxxxxxxx Title: Deputy County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT B DMC-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, Behavioral Health and Recovery Services Director DMC-ODS LIASION: Xxxxxxxx Xxxx, Behavioral Health and Recovery Services, Assistant Director EXHIBIT C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis services

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. (Remainder of this page intentionally left blank) The Parties represent that they have the authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective date of final signature. Xxxxxx Foundation Health Plan, Inc. (MCP) County of Marin – HHS – Behavioral Health and Recovery Services Signature: Signature: Date. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By : Date: Name: Xxxxxxx Xxxxx Xxxxxxxx Name: Xxxxxx Xxxxxx Title: Board ChairExecutive Director, Medicaid Care Delivery and Operations Title: President, Board of Supervisors Notice Address: Name000 X. Xxxxxx Xx., Xxxxxxxx, XX 00000 Electronic Notice Delivery: Xxxxxxx Xxxxxxxx Title: CEO XXXXX@xx.xxx Notice Address: 0000 Attn: BHRS Director 00 X. Xxx Xxxxx Xxxxx XxxxXx. San Rafael, Xxxxx 000CA 94903 MCP-Agency Liaisons Exhibit A Liaisons Contact Information MCP Responsible Person Xxxxxxx Xxxxxxxx, Xxxxxx XxxxxxMOU Coordinator, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: XXXXX@xx.xxx MCP Agency Liaison Xxxxxxx X. Xxxxxxxx Title: Deputy Xxxxxxxxxx, MOU Liaison, XXXXX@xx.xxx Exhibit B Marin County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT B DMC-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, HHS – Behavioral Health and Recovery Services Director services MHP/DMC-ODS LIASIONResponsible Person: Xxxxxxxx XxxxXxxxx Xxxxx, Behavioral Health and Recovery ServicesLMFT BHRS Quality Management Director 00 X. Xxx Xxxxx Xx. San Rafael, Assistant CA 94903 Xxxxx.Xxxxx@XxxxxXxxxxx.xxx (000)000-0000 MHP/DMC-ODS Liaison: Xxxxx Xxxxx, LMFT BHRS Quality Management Director EXHIBIT 00 X. Xxx Xxxxx Xx. San Rafael, CA 94903 Xxxxx.Xxxxx@XxxxxXxxxxx.xxx (000)000-0000 Exhibit C – Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis servicesElements

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. (Remainder of this page intentionally left blank) The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By Name: Xxxxxxx Xxxxxxxx Title: Board Chair, Board of Supervisors Notice AddressSignature: Name: Xxxxxxx Xxxxxxxx Xxxxx Xxxxxx Title: CEO Plan President Notice AddressAddress:000 Xxxxxxxxx Xxx 000 Xxxx Xxxxx, XX 00000 Regional Center Kot ' ~r l. Signature: 0000 Xxxxx Xxxxx XxxxName: Xxxx Xxxxxxx Title: Executive Director Notice Address:0000 Xxxxxxx Xxxxxx, Xxxxx Xxx 000, Xxxxxxxxxx, XX 00000 Exhibit A Xxxxxx Responsible Person (Oversight and Compliance) Xxxxxx Address Telephone Director, Case Management 000 Xxxxxxxxx Xxxx Xxxxx, XX 00000 562-485-4966 Xxxxxx-Regional Center Liaison (Point of Contact between Xxxxxx and Regional Center) Xxxxxx Address Telephone Director, Case Management 000 Xxxxxxxxx Xxxx Xxxxx, XX 00000 562-485-4966 Xxxxxx Address Telephone Supervisor, Case Management 000 Xxxxxxxxx Xxxx Xxxxx, XX 00000 562-542-1517 ExhibitB Regional Center Responsible Person (Oversight and Compliance) Ai at6at . - - - - I Director of Intake and Clinical Services and Director of Client Services 0000 Xxxxxxx Xxxxxx, XX 00000Xxx. 000 Xxxxxxxxxx XX, 00000 916-978-6400 - '• Regional Center Liaison . A44, g u l f au Ta' . Director of Intake and Clinical Services and Director of Client Services 0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: Xxxxxxx X. Xxxxxxxx Title: Deputy County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx XxxxxxXxx. 000 Xxxxxxxxxx XX, Behavioral Health Program Manager EXHIBIT B DMC00000 916-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, Behavioral Health and Recovery Services Director DMC978-ODS LIASION: Xxxxxxxx Xxxx, Behavioral Health and Recovery Services, Assistant Director EXHIBIT 6400 Exhibit C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis servicesElements‌

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSIONCentral California Alliance for Health SUBCONTRACTORCarelon Behavioral Health of California, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By NameInc. Signature: Xxxxxxx Xxxxxxxx Title: Board Chair, Board of Supervisors Notice AddressSignature: Name: Xxxxxxx Xxxxxxxx Name: Xxxxxx Xxxxx Title: CEO Notice Address: 0000 Xxxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx Xxxxxx, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Title: Subcontractor Notice Address: MHP County of Mariposa Signature: Name: Xxxxx Xxxxxxxx, Chair Title: Board of Supervisors MHP County of Mariposa COUNTERSIGNED: (Government Code §25103) Signature: Name: Xxxxxxxx Xxxxxxx Title: Clerk of the Board MHPCounty of Mariposa APPROVED AT TO FORM: Signature:Name: Xxxxxx X. Xxxxxxxx Xxxxxx Title: County Counsel Exhibit A MCP Responsible Party - Name: Xxxxxx Xxxxxx Title: Behavioral Health Director Contact: xxxxxxx@xxxx-xxxxxxxx.xxx MCP Liaison - Name: Xxxxx Xxxxxx Title: Behavioral Health Program Contact: xxxxxxx@xxxx-xxxxxxxx.xxx Exhibit B MHP Responsible Party - Name: Xxxxxx Xxxxx Title: Deputy County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT B DMC-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, of Behavioral Health and Recovery Services & Local Mental Health Director DMC-ODS LIASIONContact: Xxxxxxxx Xxxx, Behavioral xxxxxx@xxxxxxxxxxxxxx.xxx MHP Liaison - Name: Xxxxx Xxxxx Title: Administrative Analyst – Mental Health and Recovery Services, Assistant Director EXHIBIT Quality Assurance Supervisor Contact: xxxxxx@xxxxxxxxxxxxxx.xxx Exhibit C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis services

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. (Remainder of this page intentionally left blank) The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Datedate of final signature. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By Partnership HealthPlan of California Signature: Name: Xxxxxxxxx Xxxxxxx Xxxxxxxx Title: Board ChairActing CEO/ Chief Health Services Officer Notice Address: 0000 Xxxxxxxx Xxxxxx Xx. Fairfield, CA 94534 County of Marin – HHS-Behavioral Health and Recovery Services Signature: Name: Xxxxxx Xxxxxx Title: President, Board of Supervisors Notice Address: NameAttn: Xxxxxxx BHRS Director Date: 8/8/2024 00 X. Xxx Xxxxx Xx. San Rafael, CA 94903 Date: Exhibit A Xxxx Xxxxxxxxx Partnership HealthPlan Behavioral Health Administrator/ or Designee xxxxxxxxxx@xxxxxxxxxxxxx.xxx 000-000-0000 0000 Xxxxxxxx Title: CEO Notice Address: 0000 Xxxxxx Xxxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx XxxxxxXxxxxxxxx, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: Xxxxxxx X. Xxxxxxxx Title: Deputy 00000 Exhibit B Marin County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT B DMC-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, HHS – Behavioral Health and Recovery Services Director services MHP/DMC-ODS LIASIONResponsible Person: Xxxxxxxx XxxxXxxxx Xxxxx, Behavioral LMFT BHRS Quality Management Director 00 X. Xxx Xxxxx Xx. San Rafael, CA 94903 Xxxxx.Xxxxx@XxxxxXxxxxx.xxx (000)000-0000 MHP/DMC-ODS Liaison: Xxxxx Xxxxx, LMFT BHRS Quality Management Director 00 X. Xxx Xxxxx Xx. San Rafael, CA 94903 Xxxxx.Xxxxx@XxxxxXxxxxx.xxx (000)000-0000 Exhibit C – Data Elements Through the joint participation in a Health Information Exchange (HIE), the following data will be exchanged between the County Mental Health Plan and Managed Care Plan. When necessary, patient/member consent will be obtained prior to exchanging the following data as dictated by federal and state privacy rules. # From County Data Elements From PHC Data Fields Member Demographics 1 Member Client Identification Number (CIN) Member Client Identification Number (CIN) 2 County County 3 First Name Member First Name 4 Middle Name Member Middle Name 5 Last Name Member Last Name 6 Social Security Number Social Security Number 7 Date of Birth Date of Birth 8 Race/Ethnicity Race/Ethnicity 10 ECM Provider PCP 11 N/A PCP Name 12 N/A NPI number 13 N/A Address 14 N/A Taxonomy Visit Details, all types 15 Rendering/attending provider for encounter below - only for outpatient Rendering/attending provider 16 Rendering/attending provider NPI number - NPI for org Rendering/attending provider NPI number 18 Rendering/attending phone number Rendering/attending phone number 19 Rendering/attending provider specialty - outpatient Rendering/attending provider specialty: Mental Health and Recovery Services, Assistant Director EXHIBIT C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • ReferralsPCP SUD or MH outpatient visits from County BH Medical Outpatient Visits 20 OP MH or SUD-Date of Outpatient Visit Outpatient-Date of Visit 21 Outpatient-Office ID Outpatient-Office ID 22 Outpatient-Office Name of Site Outpatient-Office Name of Site 23 Outpatient-Office NPI Outpatient-Office NPI 24 Outpatient-diagnosis codes Outpatient-diagnosis codes 25 Outpatient-Procedure codes Outpatient-Procedure codes ED Visits 26 N/discharges toA ED-Date of ED visit 27 N/from inpatient or crisis servicesA ED-Hospital name 28 N/A ED-NPI number 29 N/A ED-All Diagnosis code 30 N/A ED-Principle Diagnosis Codes 31 N/A ED-Main visit procedure codes 32 N/A ED-CPT code MH/SUD Inpatient Admissions Inpatient Admissions 34 IP-NPI number IP-NPI number 35 IP-Date of admission IP-Date of admission 37 IP-Admission Diagnosis Codes IP-Admission Diagnosis Codes 38 IP-Discharge Diagnosis IP-Discharge Diagnosis County Enrollment Status PHC Enrollment status 39 Enrollment date for SUD PHC enrollment date (most recent date begun versus detail going back 1 year?)

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMC-ODS MHP COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By Name: Xxxxxxx Xxxxxxxx Title: Board Chair, Board of Supervisors Notice Address: Name: Xxxxxxx Xxxxxxxx Title: CEO Notice Address: 0000 Xxxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx Xxxxxx, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: Xxxxxxx X. Xxxxxxxx Title: Deputy County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT Exhibit A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT Exhibit B DMC-ODS MHP RESPONSIBLE PERSON: Xxxxxx Xxxx, Behavioral Health and Recovery Services Director DMC-ODS MHP LIASION: Xxxxxxxx Xxxx, Behavioral Health and Recovery Services, Assistant Director EXHIBIT Exhibit C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis services

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. (Remainder of this page intentionally left blank) DocuSign Envelope ID: C977AC65-61FC-46C9-BACA-08CFF903E6C6 The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMCMCP MHP Santa Xxxx-ODS COUNTY OF MERCED MCP SANTA XXXXMonterey-MONTEREYMerced-MERCED- SAN XXXXXXSan County of Monterey Behavioral Health Xxxxxx-MARIPOSA MANAGED MEDICAL CARE COMMISSIONMariposa Managed Medical Care Commission, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR HEALTH By By operating as Central California Alliance for Health Signature: Signature: Name: Title: Xxxxxxx Xxxxxxxx Chief Executive Officer Name: Title: Board Chair, Board of Supervisors Notice Address: Name: Xxxxxxx Xxxxxxxx Title: CEO Notice Address: 0000 Xxxxx Xxxxx Xxxx, Xxxxx 000#101 0000 Xxxxxxxxx Xxxx Scotts Valley, Xxxxxx XxxxxxCA 95066-4981 Salinas, XX 00000-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By NameCA 93906 Subcontractor Carelon Behavioral Health of California, Inc. Signature: Xxxxxxx X. Xxxxxxxx Title: Deputy County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Xxxxxx Xxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Xxxxxx Xxxxx Market President Notice Address: Date EXHIBIT 00000 XXXXX XXXXXX XXXXX XXXXXXXX, XX 00000 DocuSign Envelope ID: C977AC65-61FC-46C9-BACA-08CFF903E6C6 Exhibits A & B Placeholder for exhibits to contain MCP-MHP and MHP Liaisons as referenced in Sections 4.b and 5.b of this MOU MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, Behavioral Health Director MCP LIASON: Xxxxx Xxxxxx, Behavioral Health Program Manager EXHIBIT B DMC-ODS MHP RESPONSIBLE PERSON: Xxxxxx XxxxXxxxxxx X’Xxxxx, Behavioral Health and Recovery Services Deputy Director DMC-ODS of Quality MHP LIASION: Xxxxxxxx XxxxXxxxxxx X’Xxxxx, Behavioral Health and Recovery Services, Assistant Deputy Director EXHIBIT of Quality DocuSign Envelope ID: C977AC65-61FC-46C9-BACA-08CFF903E6C6 Exhibit C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis servicesservices • Known changes in condition that may adversely impact the Member’s health and/or welfare

Superseding MOU. This MOU constitutes the final and entire agreement between the Parties and supersedes any and all prior oral or written agreements, negotiations, or understandings between the Parties that conflict with the provisions set forth in this MOU. It is expressly understood and agreed that any prior written or oral agreement between the Parties pertaining to the subject matter herein is hereby terminated by mutual agreement of the Parties. (Remainder of this page intentionally left blank) The Parties represent that they have authority to enter into this MOU on behalf of their respective entities and have executed this MOU as of the Effective Date. DMC-ODS COUNTY OF MERCED MCP SANTA XXXX-MONTEREY-MERCED- SAN XXXXXX-MARIPOSA MANAGED MEDICAL CARE COMMISSION, OPERATING AS CENTRAL CALIFORNIA ALLIANCE FOR INLAND EMPIRE HEALTH By By NamePLAN RIVERSIDE UNIVERSITY HEALTH SYSTEM – BEHAVIORAL HEALTH By: Xxxxxxx Xxxxxxxx TitleXxxx, MD, MPH Chief Medical officer for: Board ChairXxxxxx XxXxxxxxxx, Board of Supervisors MBA, FACHE Chief Executive Officer 6/3/2024 Notice Address: NameInland Empire Health Plan 00000 0xx Xxxxxx Rancho Cucamonga, CA 91730 By: Xxxxxxx Xxxxxxxx Title: CEO Xxxxx, MD Behavioral Health Director Notice Address: Riverside University Health System - Behavioral Health 0000 Xxxxxx Xxxxxx Xxxxx Xxxxx Xxxx, Xxxxx 000, Xxxxxx XxxxxxXxxxxxxxx, XX 0000000000 By: Chair, IEHP Governing Board Date: 6/3/2024 Attest: Secretary, IEHP Governing Board 6/3/2024 Date: Approved as to Form By: Xxxx X. Xxxx Vice President, General Counsel Inland Empire Health Plan Date: 6/3/2024 By: County Counsel, County of Riverside Date: Exhibit A Inland Empire Health Plan Compliance and Oversight Responsibilities MCP-0000 Date Date APPROVED AS TO LEGAL FORM MERCED COUNTY COUNSEL By Name: Xxxxxxx X. Xxxxxxxx Title: Deputy IEHP Address Telephone Director, Integrated Care 00000 0xx Xxxxxx Xxxxxx Xxxxxxxxx, XX 00000 909-890-2000 MCP-IEHP Address Telephone County Counsel Date BEHAVIORAL HEALTH AND RECOVERY SERVICES By Name: Programs Liaison 00000 0xx Xxxxxx XxxxXxxxxx Xxxxxxxxx, DSW, LCSW Title: Director Date SUBCONTRACTOR CARELON BEHAVIORAL HEALTH OF CALIFORNIA By Name: Title: Notice Address: Date EXHIBIT A MCP RESPONSIBLE PERSON: Xxxxxx Xxxxxx, XX 00000 909-890-2000 Exhibit B Riverside University Health System – Behavioral Health Compliance and Oversight Responsibilities MHP-RUHS – Behavioral Health Address Telephone Behavioral Health Director MCP LIASON: 0000 Xxxxxx Xxxxxx Xxxxx XxxxxxXxxxxxxxx, Behavioral Health Program Manager EXHIBIT B DMCXX 00000 951-ODS RESPONSIBLE PERSON: Xxxxxx Xxxx, Behavioral Health and Recovery Services Director DMC358-ODS LIASION: Xxxxxxxx Xxxx, Behavioral Health and Recovery Services, Assistant Director EXHIBIT C Data Elements To the extent permitted under applicable law, the Parties must share, at a minimum: • Member demographic information • Behavioral and physical health information • Diagnoses • Assessments • Medications prescribed • Laboratory results • Referrals/discharges to/from inpatient or crisis services4501 MCP-IEHP Address Telephone