HomeMy WebLinkAboutInter-Dept DPH DBH Sheriff Wellpath_D-22-467 .pdf DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
D-22-467
1 INTER-DEPARTMENTAL AGREEMENT
2 THIS INTER-DEPARTMENTAL AGREEMENT is made and entered into this 5th day of
3 October 2022,by and between the COUNTY OF FRESNO DEPARTMENT OF PUBLIC
4 HEALTH,hereinafter referred to as"DPH", COUNTY OF FRESNO DEPARTMENT OF
5 BEHAVIORAL HEALTH, hereinafter referred to as "DBH", COUNTY OF FRESNO, SHERIFF-
6 CORONER-PUBLIC ADMINISTRATOR'S OFFICE,hereinafter referred to as "SHERIFF" and
7 acknowledged CALIFORNIA FORENSIC MEDICAL GROUP (CFMG)/WELLPATH LLC, whose
8 business address is 3340 Perimeter Hill Dr.,Nashville,Tennessee,37211,hereinafter referred to as
9 "CFMG/WELLPATH" or "CONTRACTOR"(collectively"the parties").
10 WITNESSETH:
11 WHEREAS, SHERIFF is required to provide necessary medical and behavioral health services
12 to adult inmates in need thereof,who are in the custody of SHERIFF at all Fresno County Detention
13 Facilities,hereinafter collectively referred to as the"JAIL";and
14 WHEREAS,DPH, and DBH are willing and able to support SHERIFF to provide the necessary
15 medical and behavioral health services for JAIL inmates in custody of the SHERIFF, in a manner
16 consistent with all applicable standards of medical and behavioral health care, and in compliance with
17 all applicable laws including Title 15 of the California Code of Regulations (Title 15), and all
18 applicable State of California and Federal Court Orders;and
19 WHEREAS,the County of Fresno (COUNTY)entered into Agreement No.A-18-169,as
20 amended (as applicable) with CONTRACTOR,effective April 3,2018, to provide comprehensive
21 medical and behavioral health care services to adult inmates in custody of the SHERIFF; and
22 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
23 hereto agree as follows:
24 1. SHERIFF RESPONSIBILITIES
25 SHERIFF shall:
26 A. Supply CONTRACTOR with space to conduct all medical and behavioral health
27 examinations/encounters, operating an outpatient housing unit(OHU), and reasonable space for
28 maintaining records. This will include adequate space so that health care,dental care, mental health
1 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 and substance use disorder services can be provided and include space for clinical areas,programming
2 areas, medical support areas and administrative areas.
3 B. Ensure the OI-IU is used primarily for medical needs; only use the OHU for non-
4 medical related custody housing if the space is not at the time being utilized for medical housing. Jail
5 Population Management will coordinate with CONTRACTOR if this space is to be utilized for
6 alternative housing on a case-by-case basis. CONTRACTOR will determine medical and/or
7 behavioral health admissions to the OHU. Any inmate assigned to the OPHU will be medically
8 admitted to the housing unit by CONTRACTOR.
9 C. Provide an intake medical screening area with sufficient lighting with adequate
10 space for clinical examination and medical equipment. Said area must maintain suitable privacy for
11 the inmate as well as the inmate's protected health information. The intake medical screening area
12 must have access to hand washing facilities.
13 D. Support and facilitate, as possible,medical decisions made by CONTRACTOR,
14 including providing all therapeutic or specialized medical diets for JAIL imnates ordered by
15 CONTRACTOR.
16 E. Work with CONTRACTOR to establish standardized procedures for:
17 1) Medication administration: SHERIFF will collaborate and assist
18 CONTRACTOR staff when necessary to ensure the inmate interacts appropriately with
19 CONTRACTOR staff. This may include verifying that the inmate took the medication properly(i.e.,
20 swallows medication, does not pretend to swallow or`cheek' the medication, etc.). For proper
21 medication administration, innate cells and pods must be well lit so CONTRACTOR staff can ensure
22 the innate has taken the medication. Lights in pods must be turned on when CONTRACTOR is
23 present for optimal observation and safety. An announcement will be made by SHERIFF alerting the
24 inmates when medication pass will commence.
25 2) Access to care(health service requests): JAIL inmates shall have access
26 to blank health service requests. SHERIFF will provide for the privacy of the submittal and collection
27 of health service requests from JAIL inmates.
28 3) SHERIFF shall work in cooperation with DPH, DBH, and
2 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 CONTRACTOR and/or other COUNTY Departments to implement appropriate and adequate plans,
2 policies,and practices to ensure compliance as identified in Exhibit A, "REMEDIAL PLAN", available
3 upon request from the Sheriff's Office.
4 F. Provide access to inmates and ensure that inmates are appropriately moved for
5 all scheduled medical appointments including clinical appointments, tests, treatments, both onsite and
6 offsite.
7 G. Provide sufficient privacy during clinical encounters.
8 H. Provide access to inmates during lockdowns for their health care needs.
9 I. Permit use of aids to impairments(canes,crutches, devices,etc.) as needed for
10 their medical needs.
11 J. Provide sufficient assistance,as necessary,to CONTRACTOR including,
12 but not limited to,providing for the safety of CONTRACTOR medical and behavioral health staff
13 working at the JAIL whenever inmates have access to said staff.
14 K. Provide oversight of other arresting agency staff that bring inmates into JAIL for
15 booking.
16 L. Provide laundry services as normally provided for all JAIL inmates.
17 M. Provide for routine facility maintenance and repair of the medical and behavioral
18 health service areas including, but not limited to, electrical,plumbing, mechanical,and structural.
19 N. Assist in compliance with medical and behavioral health care standards for JAIL
20 inmates in accordance with Title 15 and all applicable State and Federal Court Orders.
21 O. Respond in a timely manner to all inquiries by DPH, DBH,and/or
22 CONTRACTOR regarding incidents related to inmate care or to provisions of this Inter-Departmental
23 Agreement.
24 P. Oversee medical and behavioral health programs at the direction of a Jail Captain
25 or Jail Administration and in close coordination with an interdisciplinary team from SHERIFF, DPH,
26 and DBH, as applicable.
27 Q. Coordinate with DPH and DBH to develop notices of deficiency to
28 CONTRACTOR.
- 3 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 R. Review and approve invoices for services under COUNTY Agreement No. A-
2 18-169, as amended(as applicable),and coordinate payment of CONTRACTOR.
3 2. CONTRACTOR RESPONSIBILITIES
4 CONTRACTOR shall:
5 A. Ensure compliance with all applicable laws and regulations, including the
6 applicable provisions of Title 15 and all applicable State and Federal Court Orders in effect at the date
7 this Inter-Departmental Agreement becomes effective.
8 B. Work in cooperation with SHERIFF, and/or other COUNTY Departments to
9 implement appropriate and adequate plans,policies,and practices to ensure compliance as identified in
10 Exhibit A.
11 C. Maintain responsibility for providing,planning, coordinating, and evaluating
12 medical and behavioral health services to inmates,based on written and published policies and
13 procedures.
14 D. Work with SHERIFF to establish legally and medically acceptable standardized
15 procedures for medication administration and access to care through health service requests.
16 E. Provide a Registered Nurse(RN)to triage health service requests within 24
17 hours and provide face-to-face triage no later than 72 hours after submittal.
18 F. Provide a thorough medical intake screening of JAIL inmates to include vital
19 signs, capillary blood glucose testing for inmates with diabetes,peak expiratory flow rate for inmates
20 with asthma, TB (tuberculosis) testing,and oxygen saturation for inmates with emphysema.
21 G. Provide SHERIFF continued access to medical and behavioral health
22 information for JAIL inmates in order to maintain a safe environment for inmates, staff, and visitors.
23 1) Promptly notify SHERIFF of persons with communicable disease that
24 may pose a threat to other inmates or staff and assist SHERIFF with determining appropriate housing
25 (e.g. for tuberculosis, influenza like illness [ILI], ectoparasites, MRSA, or meningococcal meningitis
26 as examples),
27
28
4 — COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 2) Direct communication and/or written reports will address innate
2 information including communicable diseases, dietary restrictions, behavioral health,psychological
3 disorders,physical restrictions, etc.
4 H. Evaluate health status of inmates in segregation or"safety cells"and determine
5 whether health needs require special accommodation or contraindicate the placement.
6 I. Ensure that inmates coming into intake receive a health assessment as soon as is
7 necessary based on the acuity of their illness and in any case no later than 14 days.
8 J. Ensure that inmates coming into the jail are assigned to housing in an appropriate
9 housing unit that meets their health needs.
10 K. Provide necessary reports, documents, or information necessary to comply with
11 all consent agreements and Court orders.
12 L. Collaborate with public health authorities to conduct outbreak investigations for
13 facility contagious disease outbreaks.
14 M. Coordinate and supervise the Title 15 medical and behavioral health, nutritional
15 and environmental health inspections of the JAIL to comply with Title 15 requirements and other
16 specific regulations specified in the COUNTY Agreement No. A-18-169.
17 N. Maintain medical and behavioral health records on all JAIL inmates seen by the
18 CONTRACTOR medical or behavioral health staff.
19 O. Provide all necessary staffing, supplies,and medical and/or behavioral health and
20 clerical equipment, and prescription medication necessary to provide timely and adequate medical
21 and/or behavioral health and related clerical(i.e., paperwork, documentation,scheduling,billing, etc.)
22 services to JAIL inmates. All such charges for operating the JAIL medical and behavioral health
23 programs are to be incurred and budgeted in the SHERIFF,DPH and DBH budgets.
24 P. Provide necessary CONTRACTOR staffing at the JAIL:
25 1) Medical program staff consisting of, but not limited to,physicians, mid-
2 6 level practitioners, registered nurses, licensed vocational nurses,psychiatric registered nurses, and
27 related clerical staff, as appropriate.
28 2) Behavioral health program staff consisting of, but not Limited to,
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Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 psychiatrists,mid-level practitioners/licensed mental health professionals, licensed psychiatric
2 technicians,substance use disorder counselors, case managers, and related clerical staff, as
3 appropriate.
4 3) To adequately maintain compliance with all applicable Title 15 and State
5 and Federal Court Order requirements related to medical, behavioral health, and dental care including
6 timely response to provide constitutionally required minimal care.
7 4) To adequately maintain compliance with SHERIFF set standards to
8 respond to original inmate grievances within 14 days of receipt by CONTRACTOR staff.
9 5) To adequately maintain compliance with SHERIFF set standards to
10 inmate grievance appeals.
11 6) Every effort shall be made to minimize the number of inmates being
12 transported out of the JAIL for specialty care treatment.
13 Q. Provide the following behavioral health services:
14 1) Screen, identify, and assess the imnates' treatment needs.
15 2) Provide crisis intervention,as necessary.
16 3) Assess suicide risk of inmates or of persons being processed into custody.
17 4) Provide short-term counseling and reassessment of inmates based on
18 acuity for recommendation of housing.
19 5) Evaluate imnate's need for involuntary hospitalization per California
20 Welfare and Institutions Code(WIC), Section(§) 5150.
21 6) Complete discharge or release planning and referral of inmates with a
22 serious mental illness(SMI).
23 R. Provide routine janitorial services, and biohazard services for the clinic areas in
24 the JAIL.
25 S. Comply with all applicable policies and procedures in SHERIFF's Jail Division
26 Policy and Procedure Manual,by this reference incorporated herein.
27 T. Respond in a timely manner to all inquiries by SHERIFF, or the Courts,
28 regarding incidents related to inmate medical or behavioral health care or to provisions of this Inter-
- 6 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 Departmental Agreement.
2 U. Submit all WIC §5150 holds written to DBH Managed Care Division monthly.
3 3. DPH RESPONSIBILITIES
4 DPH shall:
5 A. Assign, at a minimum, a .20 full-time equivalent Registered Nurse(RN)Auditor
6 to work at the direction of Jail Administration Captain to provide oversight and compliance auditing
7 of CONTRACTOR.
8 B. Collaborate in the Administration of the State Medi-Cal County Inmate Program
9 (MCIP) in coordination with CONTRACTOR.
10 C. Coordinate with CONTRACTOR and SHERIFF to address communicable
11 disease investigations(including TB and syphilis)needing to occur in the JAIL.
12 D. Provide technical assistance, including consultation from the COUNTY Health
13 Officer to SHERIFF at the request of the Jail Captain or Jail Administration.
14 E. Participate in administrative meetings.
15 F. Arrange for and conduct Title 15 inspections required of the COUNTY Health
16 Officer.
17 4. DBH RESPONSIBILITIES
18 DBH shall:
19 A. Assign,or provide monetary consideration for,up to 0.80 full-time equivalent
20 Utilization Review Specialist(URS). URS qualifications include,but are not limited to, being a
21 licensed mental health professional. The URS shall assist with oversight and compliance auditing of
22 CONTRACTOR at the JAIL in collaboration with the Jail Captain or Jail Administration and DPH..
23 B. The URS shall perform the following:
24 1) Conduct ongoing evaluation of CONTRACTOR's performance
25 implementing behavioral health programs and services.
26 2) Provide reports to Jail Captain or Jail Administration on ongoing
27 Remedial Plan and COUNTY Agreement as amended(as applicable)
28 compliance monitoring, including but not limited to:
- 7 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 a) Discharge planning and linkage;
2 b) Group/individual therapy;
3 c) Release of information(ROI),verification of medication on
4 intake,prescription bridging, and psychiatric referrals (including
5 compliance to timeliness standards);
6 d) Suicide risk assessment, monitoring, and prevention; and
7 e) Substance use disorder services.
8 3) Liaison with other DBH-contracted providers of inpatient/direct-
9 behavioral health services(e.g.,crisis stabilization centers,acute inpatient
10 psychiatric health facilities,and Community Regional Medical Center).
11 4) Attend appropriate administrative and coordination meetings with DPH,
12 DBH, SHERIFF, and/or CONTRACTOR,including but not limited to,
13 seriously mentally ill(SMI)inmates in administration segregation(AD-
14 SEG)biweekly meetings,monthly administrative meetings, monthly
15 quality assurance meetings,Prison Law Office visits and exit interviews,
16 and mortality reviews, as deemed necessary.
17 5) Conduct audits of CONTRACTOR's mental health and substance use
18 disorder charts, at a minimum annually, to ensure compliance to the
19 Remedial Plan, COUNTY Agreement No. A-18-169 as amended (as
20 applicable), and local community standards of the Fresno County Mental
21 Health Plan and Drug Medi-Cal-Organized Delivery System Plan as
22 applicable,
23 If such URS position is unfilled at any time, another DBH.URS will assist in this role as
24 a consultant to the Jail Captain or Jail Administration.
25 C. Provide consultative assistance and monitoring to SHERIFF via additional
26 staffing support from a DBH Staff Analyst and/or Senior Staff Analyst, as needed. Requests for
27 project assistance shall be sent to the DBH Deputy Director of Clinical Operations for review and
28 assigmnent.
a - COUNTY OF FR.ESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 D. Credential all mental health and substance use disorder professionals hired by
2 CONTRACTOR to provide behavioral health services in the JAIL through the DBH Managed Care
3 Division.
4 E. Provide mandatory WIC, §5150 training and credentialing to all of
5 CONTRACTOR's mental health professionals through the DBH Managed Care Division. Certified
6 CONTRACTOR's staff may write §5150 holds as a part of their behavioral health responsibilities.
7 4. OUTPATIENT SERVICES
8 All non-emergency outpatient services and/or procedures shall have the prior
9 authorization of the CONTRACTOR's Medical Director and pre-arranged review,coordination,and
10 completion of a threat assessment by SHERIFF.
11 5. ADMINISTRATIVE MEETINGS
12 DPH, DBH, and/or CONTRACTOR and SHERIFF will schedule an administrative
13 meeting monthly, at a minimum or as often as necessary, to address any issues or concerns related to
14 medical and behavioral health services provided at the JAIL. CONTRACTOR shall prepare an
15 agenda for each meeting and take minutes to be distributed to all parties.
16 6. MEDICAL AND BEHAVIORAL HEALTH PROGRAM FUNDING
17 Funding for the medical and behavioral health program for FY 2022-23 will be
18 administered by SHERIFF through Org 56201683 and SHERIFF Org 31114000. This Org funds the
19 JAIL Program. Sources of funding are identified in the County of Fresno's Agreement No. A-18-169.
20 Parties acknowledge that FY 2022-23 funding will remain approximately the same as FY 2021-22,
21 subject to review by the COUNTY Administrative Office(CAO)and approval by the COUNTY
22 Board of Supervisors.
23 7. TERM
24 This Inter-Departmental Agreement shall become effective upon execution and shall be
25 reviewed every three (years), effective July 1—, 2022 by all parties for continuity. Negotiations
26 between DPH,DBH, and SHERIFF, with additional input from CONTRACTOR, as applicable,
27 should begin by March 3 1" of each fiscal year thereafter, and be finalized no later than July 151.
28
- 9 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 8. NO MONETARY CONSIDERATION
2 This Inter-Departmental Agreement,pursuant to the terms and conditions herein, shall
3 be performed without the payment of any monetary consideration by DPH, DBH, and/or SHERIFF,
4 one to another party,unless otherwise specified within this Inter-Departmental Agreement.
5 9. MODIFICATION
6 Any matters of this Inter-Departmental Agreement may be modified by the written
7 consent of all parties,without, in any way, affecting the remainder.
8 10. CONFIDENTIALITY
9 All services performed by SHERIFF,DPH, and DBH under this Inter-Departmental
10 Agreement shall be in strict conformance with all applicable Federal, State, and/or local laws and
11 regulations relating to confidentiality of protected health infonnation.
12 11.DIFFERENCES ARISING FROM AGREEMENT INTERPRETATION
13 Every effort shall be made by all parties concerned to amicably resolve differences in
14 the interpretation and application of this Inter-Departmental Agreement. If differences cannot be
15 resolved informally at a lower Division Manager level, they may be referred to the DPH Director,
16 DBH Director, and/or the Fresno County Sheriff for resolution.
17 12.RELATIONSHIP OF PARTIES
18 It is understood that this is an Inter-Departmental Agreement by and between three(3)
19 separate Departments of the COUNTY and is not intended to and shall not be construed to create a
20 relationship of agent, servant, employee,partnership,joint venture, or association.
21 13.ENTIRE AGREEMENT
22 This Inter-Departmental Agreement, including Exhibit A and Exhibit B, constitute the
23 entire Inter-Departmental Agreement between SHERIFF, DPH, and DBH, as well as review and
24 acknowledgment by CONTRACTOR with respect to the subject matter hereof and supersedes all
25 previous agreement negotiations,proposals, commitments,writings, advertisements,publications,and
26 understandings of any nature whatsoever unless expressly included in this Inter-Departmental
27 Agreement. Notwithstanding the foregoing,the parties agree this Inter-Departmental Agreement does
28
10 - COUNTY OF FRESNO
Fresno,CA
DocuSign Envelope ID:69148824-058F-4F6A-8F46-E10BD95C8100
1 not supersede nor otherwise alter the terms of the COUNTY Agreement No. A-18-169, as amended
2 (as applicable), with CFMG/WELLPATH.
3 IN WITNESS WHEREOF the parties hereto have caused this Inter-Departmental Agreement to
4 be executed as of the day and year first hereinabove written.
5
6
7
8 HI
9 ///
10 REVIEWED AND RECOMMENDED REVIEWED AND RECOMMENDED
FOR APPROVAL: FOR APPROVAL:
11
12 DEPARTMENT OF BEHAVIORAL SHERIFF-CORONER'S OFFICE
13 HEALTH
14 By: By'
Susan L. Holt, LMFT,Director Marg M Oiff,
15
16 Date: August 26, 2022 Date: .
17
18 DEPARTMENT OF PUBLIC HEALTH
19 By:
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20 L� -
21 3U 2 ZZ
Date:
22
23
24
REVIEWED AND ACKNOWLEDGED BY:
25
CONTRACTOR:
26 CALIFORNIA FORENSIC MEDICAL
27 GROUP, INC.
2 DocuSigned by:
By:
Dale: 10/5/2022
11 - COUNTY OF FRESNO
Fresno,CA