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45. Advance Directives and POLST. Facility shall ensure that whether a Member has <br />executed an advance directive or POLST shall be indicated in a prominent part of such <br />Member's medical records, and Facility shall not provision care or otherwise discriminate <br />against a Member based on whether the Member has executed an advance directive or POLST. <br />46. Mental Health Advance Directives. Facility shall comply with Chapter 71.32 RCW <br />(Mental Health Advance Directives). <br />47. Behavioral Health Services. If Facility provides behavioral health services, Facility <br />must use GAIN -SS and assessment process that includes use of the quadrant placement. Failure <br />to implement and maintain the Integrated Co -Occurring Disorder Screening and Assessment <br />process will result in corrective action. <br />4& Behavioral Health Organization (BHO) Coordination. Facility shall coordinate with <br />BHO providers in accordance with the State Contract and as required by CHPW. <br />49. Health Home Surely Bond. If Facility is a home health agency, Facility represents and <br />warrants that it is in compliance with the surety bond requirements of federal law (Section <br />4708(d) of the Balanced Budget Act of 1997 and 42 C.F.R. § 441.16). <br />50. Physician Incentive Plan. If Facility is at financial risk, as defined in the Substantial <br />Financial Risk or Risk provisions in the State Contract, Facility shall be subject to solvency <br />requirements that provide assurance of Facility's ability to meet its obligations. Such <br />requirements shall be regularly monitored and enforced. <br />If Facility makes payment to any physician under a Physician Incentive Plan, such plan shall meet <br />all applicable requirements under the State Contract, including but not limited to disclosure <br />requirements and stop -loss protection. No payment to Facility, or by Facility to a provider, under <br />a Physician Incentive Plan shall, directly or indirectly, be an inducement to reduce or limit <br />Medically Necessary Services provided to an individual Member. <br />51. Information on Ownership and Control. Failure to comply with the terms of this <br />Section shall be deemed a material breach of the Agreement. <br />51.1 If Facility is not an individual practitioner or a group of practitioners, Facility <br />shall disclose the following information to CHPW upon Agreement execution, upon request <br />during the re -validation of enrollment process under 42 C.F.R. § 455.414, and within thirty-five <br />(35) business days after any change in ownership of Facility: <br />51.1.1 The name and address of any person (individual or corporation) with an <br />ownership or control interest in Facility; <br />51.1.2 If Facility is a corporate entity, the primary business address, every <br />business location, and P.O. Box address; <br />51.1.3 If Facility has corporate ownership, the tax identification number of the <br />corporate owner(s); <br />51.1.4 If Facility is an individual, date of birth and Social Security Number; <br />2020 Facility Ex6 Bl B - McaidProv Page 39 of 51 Contract #{Contract #}-1PRC Agreement To <br />