EXHIBIT 1 APPENDIX C - SOW Technical Exhibits TERMS AND DEFINITIONS CONTINUED DMH Electronic Prescribing System – A computer e-Prescribing system that electronically transmits prescriptions and stores medication information. OrderConnect is a secure, HIPAA compliant, web-based electronic prescription software solution that is integrated with IBHIS. Electronic Health Record (EHR) – An electronic health record provides secure, patient-centric information to aid clinical decision-making by providing access to a patient’s health information at the point of care. Electronically Placed Order – Laboratory Orders entered by the physician or qualified clinician using the LACDMH electronic ordering system and transmitted to the Contractor for drawing of the specimen. Homebound - An individual who the assistance of another person or medical equipment (walker or wheelchair) to leave their home and/or their doctor believes their health or illness could get worse if they leave home. Integrated Behavioral Health Information System – The electronic health record for LACDMH that provides secure, real-time, patient-centric information to aid clinical decision-making by providing access to a patient’s health information at the point of care. IBHIS Number – The “Client ID” number, as referred to by IBHIS. Invoice – A compiled list of the lab tests ordered at a clinic with agreed upon prices submitted for payment. Laboratory Request - A request for clinical laboratory services comprised of one or more orders. Laboratory Services Provider (LSP) – The laboratory services provider for Department of Mental Health. Los Angeles County Department of Mental Health (LACDMH or Department) The Los Angeles County Department of Mental Health as whole, including all of its clinics/programs. Page 2 of 4 EXHIBIT 1
APPENDIX C - SOW Technical Exhibits Performance Requirements Summary PERFORMANCE REQUIREMENTS METHOD OF MONITORING ACTIONS TAKEN IN LIEU OF NONCOMPLIANCE Only County funded patients will be invoiced to LACDMH. 100% of laboratory orders are for uninsured clients. LACDMH Accounts Payable will review a sampling of invoices and lab orders for alternate eligibility. LACDMH will track all occurrences of improper billing. The frequency of inappropriate billing is expected to decrease during course of contract. Non-reimbursement by County for claims billable to alternate payor source. Notification to LSP of unsatisfactory billing practices. LSP shall be given the opportunity to propose a corrective action plan to ensure billing accuracy. LACDMH may require LSP to provide eligibility inquiry information on a regular basis or take other corrective measures should frequency of inappropriate billing continue. Ordered laboratory tests results will be delivered within the next business day. 90% of routine ordered labs and 99.1% of STAT and critical labs will be delivered within the required timeframes specified in the SOW. DMH clinicians are instructed to contact the Office of the Medical Director when requested laboratory results are not returned or deemed unsatisfactory. The Office of the Medical Director will review. Possible non-reimbursement of claim. LSP does not process unauthorized laboratory tests. DMH will develop a report. Non-reimbursement of claim or reimbursement only for “deemed ordered” test. DMH may review order acceptance practices with management and propose additional solutions to prevent occurrence of improper processing. Laboratory samples obtained and handled appropriately by LSP’s courier or delivery personnel. 100% of laboratory samples will be labeled properly. The designated laboratory shall be cleaned and all waste disposed after every shift. LSP shall provide a quarterly report of lost, mishandled, or otherwise unusable samples. LACDMH will review frequency of cases and nature of specimens lost. LACDMH may conduct root cause analysis with LSP and develop a corrective action plan to reduce frequency of such events. LSP may be penalized or may be required to provide replacement sample acquisition services free of charge. EXHIBIT 4
EXHIBIT 5 APPENDIX C - SOW Technical Exhibits PAGE 3 OF 6 Services Areas ORDERING CLINICS AND LABORATORY SERVICES SCHEDULE SA LOCATION ON-SITE LAB HOURS 3 Arcadia MHC FSP Program 2620 California Ave. Monrovia, CA 91016 Phone: (626) 821-5844 Fax: (626)256-8327 Laboratory services provided at Patient Services Center 3 East San Gabriel Valley MHC 1359 North Grand Avenue Covina, CA 91724 Phone: (626) 430-2900 Fax: (626) 331-0035 Laboratory services provided at Patient Services Center 4 Downtown MHC 529 S. Maple Ave Los Angeles, CA 90013 Phone: (213) 629-6200 Fax: (213) 895-6263 Mon - P.M. Fri - A.M. 4 Hollywood MHC 1224 N. Vine St. Los Angeles, Ca 90038 Phone: (323) 769-6100 Fax: (323) 467-2647 Tu, Wed - A.M. 4 Northeast MHC 5321 Via Marisol Los Angeles, CA 90042 Phone: (323) 478-8200 Fax: (323) 344-8829 Fri - A.M. 4 Northeast Welllness Center 5564 N. Figueroa St. Los Angeles, CA 90020 Phone: (323) 478-8200 Fax: (323) 254-3950 Fri - A.M.
EXHIBIT 5 APPENDIX C - SOW Technical Exhibits PAGE 4 OF 6 Services Areas ORDERING CLINICS AND LABORATORY SERVICES SCHEDULE SA LOCATION ON-SITE LAB HOURS 4 Genesis 550 S. Vermont Ave 6th flr. Los Angeles, CA 90020 Phone: (213) 351-7284 Fax: (213) 427-6161 Clients are homebound, seeking phlebotomy services 5 Edelman MHC 11080 W. Olympic Blvd. Los Angeles, CA 90064 Phone: (310) 966-6500 Fax: (310) 915-8579 Tu, Wed, Th - A.M. 5 Edelman Wellness Center 11303 W. Washington Blvd. Ste 200 Los Angeles, CA 90064 Phone: (310) 482-3200 Fax: (310) 915-8579 Laboratory services are provided at Edelman MHC 6 Augustus F. Hawkins MHC 1720 E. 120th St. Los Angeles, CA 90059 Phone: (310) 915-8579 Fax: (310) 915-8579 Mon, Wed, Th - A.M. 6 Compton Family MHC 921 E. Compton Blvd. Compton, CA 90221 Phone: (310) 668-6800 Fax: (310) 223-0694 Tu, Wed - P.M. 6 West Central Family MHC 3751 Stocker St. Los Angeles, CA 90008 Phone: (323) 298-3680 Fax: (323) 296-4079 Mon - A.M. 6 Women's Community Integration 8300 S. Vermont Ave. Los Angeles, CA 90044 Phone: (323) 252-6400 Th - A.M.
EXHIBIT 5 APPENDIX C - SOW Technical Exhibits PAGE 5 OF 6 Services Areas ORDERING CLINICS AND LABORATORY SERVICES SCHEDULE SA LOCATION ON-SITE LAB HOURS 7 Rio Hondo Community MHC 17707 S. Studebaker Road Cerritos, CA 90703 Phone: (562) 402-0688 Fax: (562) 809-0185 Mon, Th - A.M. 7 Rio Hondo Centro de Bienestar 2677 Zoe Avenue Ste 301 Huntington Park, CA 90255 Phone: (323) 277-7862 Fax: (323) 277-7862 Laboratory services are provided at Rio Hondo Community MHC 7 Roybal Family MHC 4701 Cesar Chavez Av. Rm 222 Los Angeles, CA 90022 Phone: (323) 267-3400 Fax: (323) 260-5200 Laboratory services are provided at Patient Services Center 7 San Antonio MHC 2629 Clarendon Ave. Huntington Park, CA 90255 Phone: (323)584-3721 Fax: (323)277-4674 Laboratory services are provided at Patient Services Center 8 Central API MHC 14112 S. Kingsley Dr. Gardena, CA 90249 Phone: (310) 352-3111 Wed - A.M. 8 Harbor-UCLA Medical Center 1000 W. Carson St. Bldg. D5 Torrance, CA Phone: (310) 222-3151 Fax: (310) 328-7217 Tu - P.M. Thu - A.M.