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ii. Date of birth <br />iii. Provider One #, SSN or another unique identifier <br />iv. Date of booking <br />v. Date MOUD started: continued or induction? <br />vi. Date of release if applicable <br />vii. Schedule first MOUD appointment upon release <br />viii. Which MOUD provided upon release <br />c. Information will be collected via the Managed File Transfer (MFT). It may be shared with <br />Research Data and Analysis (RDA) for evaluation purposes. <br />5. Contract Management/Accounting. <br />a. Ensure specific tools, such as job descriptions, policies and procedures, and statements of work, <br />are developed, and staff are adequately trained on these tools, to ensure consistent and <br />appropriate practice. <br />b. Attend required monthly meetings with HCA DBHR program administrator to discuss project <br />contract requirements, compliance, problem -solving and attend trainings. Attend additional <br />meetings as required or deemed necessary by the HCA DBHR program administrator. <br />c. Contractor will cooperate with periodic site visits by the HCA DBHR program administrator or <br />designee and make all relevant records and personnel available. <br />d. Submit a monthly report and a data spreadsheet through the Managed File Transfer portal (MFT) <br />as detailed in the deliverables table with the A-19 invoice. <br />FY2024 Contract Deliverables Table <br />Activity <br />Description <br />Due Date <br />Payment <br />Monthly <br />Report must include how funding is <br />Monthly: <br />progress <br />being spent, status of hiring staff, status <br />Reports due on <br />$114,870.00 <br />reports <br />of MOUD purchases and other <br />the 10th of every <br />supplies. Program details and how the <br />month beginning <br />($9,572.50 x 12) <br />standard of care, core components <br />with August 10, <br />(Section 2) are being met, barriers and <br />2023. <br />successes, technical assistance and <br />training participation, staff changes and <br />additional information as needed. <br />Monthly <br />Data spreadsheet filled out completely <br />Monthly: <br />Data <br />with section 4.b. above following <br />Due on the 101h <br />$114,870.00 <br />Collection <br />template provided by HCA and shared <br />of every month <br />spreadsheet <br />via MFT. <br />beginning with <br />($9,572.50 x 12) <br />August 10, 2023. <br />Amendment Total <br />$229,740.00 <br />6. Billing and Payment. <br />a. This amendment total is for $229,740.00. <br />b. Invoice System. The Contractor shall submit invoices using State Form A-19 Invoice Voucher, or <br />such other form as designated by HCA. Consideration for services rendered shall be payable <br />HCA Contract No. K5885-02 Page 6 of 7 <br />