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HomeMy WebLinkAboutAgreement A-23-079 Amendment I to Agreement with MHPRA.pdf Agreement No. 23-079 1 AMENDMENT I TO AGREEMENT NO. 19-586 2 This First Amendment to Agreement (AGT# 19-586) ("Amendment I") is made and 3 entered into this 28th day of February , 2023 ("Effective Date"), by and between the 4 COUNTY OF FRESNO, a political subdivision of the State of California ("COUNTY"), and 5 MENTAL HEALTH PATIENT'S RIGHTS ADVOCATE PROGRAM, a Sole Proprietorship 6 whose address is 1357 W. Shaw Ave. Suite 101, Fresno, CA 93711, hereinafter referred to 7 as "CONTRACTOR". 8 WITNESSETH 9 WHEREAS, the Parties entered into that certain Agreement, identified as COUNTY 10 Agreement No. 19-586, effective November 19, 2019, hereinafter referred to as "Agreement", 11 wherein CONTRACTOR agreed to represent individuals admitted to County operated and 12 County contracted acute inpatient psychiatric facilities by providing advisements and 13 representation in certification review hearings. CONTRACTOR also agreed to receive and 14 investigate grievances or complaints as well as coordinate County-approved advocacy 15 activities; and 16 WHEREAS, Assembly Bill 2275 has made significant changes to W&I Code, sections 17 5150, 5151, 5256, 5275, 5350, 5354 and 5585.20, requiring certification hearings and due 18 process for individuals placed on an involuntary hold within seven (7) days of the date the 19 person was initially detained pursuant to W&I Code, section 5150; and, 20 WHEREAS, CONTRACTOR is willing to provide additional services for individuals 21 required by Assembly Bill 2275; and 22 WHEREAS, COUNTY and CONTRACTOR now desire to modify the Scope of Work to 23 reflect the changes in the law; and 24 NOW, THEREFORE, the Parties agree to amend the Agreement as follows: 25 1. All references in the Agreement to "Exhibit A" shall be deemed references to "Revised 26 Exhibit A". "Exhibit A" of the Agreement is deleted in its entirety and replaced with "Revised 27 Exhibit A", attached and incorporated by this reference. 28 2. The Parties agree that this Amendment I is sufficient to amend the Agreement, and COUNTY OF FRESNO Fresno,California 1 1 that upon execution of this Amendment I, the Agreement and this Amendment I together, 2 shall be considered the Agreement. 3 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 4 covenants, conditions, and promises contained in the Agreement that are not amended 5 herein, shall remain unchanged and in full force and effect. This Amendment I shall become 6 effective upon execution. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 COUNTY OF FRESNO Fresno,California 2 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment I as of 2 the day and year hereinabove written. 3 CONTRACTOR: COUNTY: 4 MENTAL HEALTH PATIENT'S RIGHTS ADVOCATE PROGRAM COUNTY OFFRESNO 5 6 By. 7 Stan Lum S Qu to o, Mental Health Patient's Rights Advocate Ch an of the Board of Supervisors of the 8 Program County of Fresno 9 10 11 Mailing Address: 12 Mental Health Patient's Rights Advocate Program 13 1357 W. Shaw Ave, Suite 101 Fresno, CA 93711 ATTEST: �J 14 Contact: Stan Lum, Sole Proprietor Phone: (559)470-7087 15 Bernice E. Seidel Clerk of the Board of Supervisors 16 County of Fresno, State of California 17 18 By: i 19 20 21 22 23 24 25 26 27 28 COUNTY OFFRE8NO 3 Fresno,Calllomla Revised Exhibit A Page 1 of 7 SCOPE OF WORK Patients' Rights Advocate The Local Mental Health Director is responsible for the provision of Patients' Rights Advocate (PRA) services in Fresno County, as indicated in the Welfare and Institutions (W&I) Code Division 5, Part 1, Chapter 6.2, Article 3, § 5000 et seq. The County's goals and objectives for the patients' rights advocacy program include: A. Develop/maintain a comprehensive, high quality Patients' Rights Advocate program which assures the rights and dignity of individuals receiving mental health services. B. Provide sound policy consultation to the Department of Behavioral Health administration. C. Report to and work with the Director of the Department of Behavioral Health or designee to ensure local compliance with state law regarding rights of individuals receiving psychiatric services (monthly or as requested). D. It is important that vendor advocates recognize that the rights and desires of the client are being represented and not those of the advocates. I. GENERAL REQUIREMENTS A. Patients' Rights Advocacy (PRA) program will encompass two components; receiving and investigating grievances and other duties and the Patients' Rights Advocate shall have the PRA function as the individual's representative in all certification review hearings. The PRA shall provide the notification of rights to the individual and shall represent the individual at the certification review hearings. Component 1: Advisements and Hearings; Component 2: Receive and Investigate Grievances/Complaints and Coordinate County-approved Advocacy Activities B. Provide relief/backup coverage for advocate staff in the event of illness and vacation. C. Provide training and education about mental health law and patients' rights to mental health providers. PRA must provide mental health law trainings, to licensed health and community care facilities staff, at minimum 13 per year, or requested by County. Trainings will be conducted at health and community care facilities. D. Ensure that recipients of mental health services in all licensed health and community care facilities are notified of their rights. Revised Exhibit A Page 2 of 7 E. Exchange information and cooperate with the State Patients' Rights Office. F. Provide monthly and quarterly reports detailing accomplished work, or as requested, written documentation of activities in all the above areas, and prepare such written reports relating to the responsibilities and activities of the Patients' Rights Advocate as may be necessary or required by the County Plan, the Department of Behavioral Health, the Behavioral Health Board, the State Patients' Rights Office, or State directive or mandate. G. Ensure flexible or adjustable hours of operation to meet accessibility needs of individuals and/or family members. H. Have a working knowledge of the Lanterman Petris Short (LPS) Act. I. Strictly adhere with all applicable Federal (including HIPAA laws), State of California and/or local laws and regulations relating to confidentiality and protected health information. J. Submit monthly invoices to include the time period services were provided and the programs, departments/agencies and exact facilities services were provided. Invoice must also be accompanied by all required reports requested by the Local Mental Health Director, or designee (see Estimates of Service Section, IV of this RFP). K. Report to and work with the Director of the Department of Behavioral Health or their designee to ensure local compliance with state law regarding rights of individuals receiving psychiatric services, including but not limited to services outlined in this Scope of Work. L. Be in full compliance with Title VI of the Civil Rights Act of 1964. PRA must guarantee that services provided will be performed in compliance with all applicable State and Federal laws and regulations pertinent to this Agreement and shall execute the agreement in full compliance with Title VI of the Civil Rights Act of 1964. M. Provide/demonstrate ability to access competent and appropriate linguistic services in the identified individual's language of choice and have a working knowledge of accessing and utilizing qualified staff/third-party interpreters or language lines during advisement and hearing certification processes, complaints/grievances and investigations or other related services. Interpretation services will be at the cost of the PRA. N. Assist with the review and revision of policies and procedures which are critical components of effective advocacy. Establishing good policies and procedures sets the ground work for improving facility operations: good policy and procedures promote good practice. O. Provide advocates who are aware of the cultural differences in the treatment of mental health. It is essential that the advocate, in doing their job, is aware of the dynamic that culture plays in competent service representation. In representing and promoting the rights and interests of an individual, the advocate must be aware that it is the Revised Exhibit A Page 3 of 7 individual's voice that is being heard and represented and that sensitivity to the cultural context of the individual is recognized. This will require an ongoing commitment by patients' right advocates being knowledgeable of and promoting cultural understanding and self-awareness. Patients' Rights Advocate shall be required to adhere to the Department's Cultural Competency requirement (Exhibit K). P. Collaborate with County Mental Health Services Act (MHSA) program providers promoting and educating awareness of the PRA and available services. Q. Comply with the County's Contractor Code of Conduct and Ethics, and the County's Compliance Program in accordance with Exhibit C. R. Comply with all state and federal regulations pertaining to Health Insurance Portability and Accountability Act (HIPAA). II. SPECIFIC REQUIREMENTS The County would like to delineate the two components of the Patients' Rights Advocate program as follows: 1. Advisements and Hearings 2. Receive/Investigate Grievances and Coordinate County-approved Advocacy Activities A. COMPONENT 1: ADVISEMENTS AND HEARINGS The duties of the contracted Patients' Rights Advocate shall include, but not be limited to the following: 1. The Patients' Rights Advocate (PRA) shall function as the individual's representative in all certification review hearings. The PRA shall provide the notification and advisement of rights to those individuals admitted to County- operated, County-contracted acute inpatient psychiatric facilities, and non designated facilities, as required by Welfare and Institutions Code Sections 5150, 5250, 5260 and 5270, prior to the certification review hearing. The PRA may be directed by the Local Mental Health Director to provide similar services at other mental health facilities in the County of Fresno based on requirements of the W&I Code. 2. As the person designated by the County, the PRA shall inform the detained person of their rights with respect to certification hearings when in a non-designated facility pursuant to WIC 5256(b). 3. Function as the individual's representative in all certification review hearings held in Fresno County. Hearing activity and outcome shall be logged and provided in a secure electronic format to the Department Director and/or designee on a monthly basis by the 101" of each month. Report of notification and hearing activity must include, but not be limited to: a) Documentation of notification of rights for each individual served. b) Date, start/end time of hearing, location, outcome of hearing for each Revised Exhibit A Page 4 of 7 individual served. c) Identification of family/support system present at hearing. 3. Patients' Rights Advocate(s) must be knowledgeable of the LPS Act. The LPS Act, in shifting the emphasis of mental health treatment away from involuntary treatment to a commitment to community-based voluntary treatment narrowed the criteria under which a person can be detained involuntarily. B. COMPONENT 2: RECEIVE/ INVESTIGATE GRIEVANCES/COMPLAINTS AND COORDINATE COUNTY-APPROVED ADVOCACY ACTIVITIES The duties of the contracted Patients' Rights Advocate shall include, but not be limited to the following: 1. Under contract supervision, plans, directs, and coordinates advocacy services on behalf of individuals receiving mental health services and their families and performs related tasks as required that will promote and support the transformative components of Mental Health Services Act (Vision and Values). 2. Deliver advocate services to provide both information/referral and grievance resolution services to clients and family members. Information and referral may involve a brief explanation of legal rights and available services. Grievance resolution activities are the services provided when an individual or family member alleges a violation of her/his rights. Grievance resolution can range from a simple phone call to a provider to multiple interviews, record reviews and written correspondence. Every effort should be made to resolve complaints at the lowest level. Receive and investigate complaints from or concerning recipients of mental health services residing in licensed health or community care facilities regarding abuse, unreasonable denial, or punitive withholding of rights guaranteed under the provisions of Division 5 (commencing with Section 5000) of the Welfare and Institutions Code. Contractor shall respond to each grievance within forty-eight (48) hours. Under the provision of the Mental Health Services Act (MHSA), also known as Proposition 63, the provision of these client advocacy services will assist in transforming the mental health system to ensure that services are client focused and family centered and that it addresses the issue of underutilization and under representation on the part of populations of cultural/ethnic decent. 3. To receive and investigate grievances from or concerning recipients of mental health services residing in licensed health or community care facilities regarding abuse, unreasonable denials or punitive withholding of rights guaranteed under the provisions of the Welfare and Institutions Code: A. Develop and implement a format for the recording of patients' rights grievances and the disposition of each grievance. Such a format shall indicate both the level of care provided to the individual, conservatorship Revised Exhibit A Page 5 of 7 status, voluntary or involuntary treatment status, facility, nature of the grievance, validity of the grievance, disposition of the grievance, and any other information deemed necessary by the Local Mental Health Director. Written documentation of the investigation of each grievance, including the disposition of each grievance, shall be prepared and forwarded to Local Mental Health Director at the office of the Director of Behavioral Health. B. Report significant patients' rights grievances to the Local Mental Health Director, or designee, as soon as possible, verbally and in writing no later than five (5) days after receipt of grievance in the event of facility violation, harm/death to client or other significant event requiring immediate notification and action. Monthly reports of patients' rights complaints shall be prepared for the Director or designee, including verbal and written response when required. Monthly and quarterly reports detailing the work accomplished during the reporting period and problems, existing or anticipated, shall be brought to the attention of respective Director of the Department of Behavioral Health or designee. C. Make available the files maintained by the Patients' Rights Advocate to authorized representative from the Department of Behavioral Health (DBH) upon request. Contractor shall meet with DBH officials to determine authorized representative. D. All reports related to complaints and investigations should be sent to the Local Mental Health Director/designee. . 4. To monitor mental health facilities, services and programs for compliance with statutory and regulatory patient's rights provisions. Monitor mental health facilities services and programs for compliance with statutory and regulatory patients' rights provisions. Each mental health facility shall be visited at least once every three (3) months. Monitoring is the systemic observation of a mental health facility, its staff, its clients and/or its records. Monitoring is important because it provides information about the ways an institution functions, and why. An Advocate identifies institutional policies and practices, reviews how they affect clients, and identifies if goals toward wellness and recovery, client-focused, and culturally/linguistically accessible services are being provided. Monitoring usually focuses on finding patterns as opposed to one- time occurrence, looking at patients' problems in the aggregate rather than individually. Although the process may be initiated by an individual grievance or informal observation, monitoring focuses on the institution and institutional change. Monitoring should have a high degree of organization, formality and objectivity in the investigation, documentation and use of information and specifically gauge policy and practice to the Mental Health Services Act guiding principles as outlined under definitions. 5. To provide training and education about mental health law and patients' rights to mental health providers as requested and scheduled through County designee. Training is to be arranged to take place at least quarterly. Revised Exhibit A Page 6 of 7 6. To ensure that recipients of mental health services in all licensed health and community care facilities are notified of their rights. 7. To act as a liaison, to exchange information and cooperate with the State Department of Health Care Services Mental Health Patients' Rights Office. 8. Ensure that patients' rights are posted in all facilities where posting is required pursuant to Section 860 the Title 9 of the California Code of Regulations. 9. To act as advocate on behalf of individuals who are unable to register a grievance because of their mental or physical condition. 10. To act as the local consultant in the area of clients' rights. 11. To confer and meet with DBH administration regarding programs, policies, procedures, and operational issues regarding the advocacy program. 12. Act as a liaison between the DBH and individual or family members, the community, county and state agencies and the Behavioral Health Advisory Board. 13. Act as the Departmental liaison in providing leadership, technical assistance and program guidance on individual and family driven services. 14. Participate in the orientation activities for new DBH staff to ensure they have an appropriate perspective in the delivery of services. 15. Assist in developing, monitoring and evaluating mental health projects and programs. 16. Develop various techniques and tools to systematically analyze and report on specific client focused performance outcome measures. 17. Assist in the oversight of culturally efficient, co-occurring capable services to ethnically diverse individuals receiving mental health services. 18. Develop means of direct communication with individuals such as the development of a newsletter, client specific focus groups, and the administration of client satisfaction survey. IV. ESTIMATE OF SERVICES EXPECTED TO BE PROVIDED: I. The following is an estimate of the volume of the various activities the Advocate will be involved as defined in Component 1: • 14-day Certification: average 80 per quarter • Advisement to Clients: average 80 per quarter • Hearings Attendance: average 313 per quarter Revised Exhibit A Page 7 of 7 • 14-Day Post Certification (5260); average 1 per quarter • 30-Day Post Certification (5270): average 16 per quarter II. The following is an estimate of the volume of the various activities the Advocate will be involved as defined in Component 2: • Telephone Contacts: average 315 per quarter • Number of Complaints/Grievances average 49 per quarter • Number of Visits to County—designated facilities*: average 52 per quarter • Participation on committees: average 6 meetings per quarter • Monitoring of Records: average 270 records per quarter *County-designated facilities include, but are not limited to: Community Behavioral Health Center (CBHC), Fresno County Adult Psychiatric Health Facility (PHF), Veterans Affairs Central California Health Care Systems, Exodus Recovery Fresno Crisis Stabilization Center, Fresno County Adolescent Psychiatric Health Facility (PHF), and the Fresno County Adolescent Crisis Stabilization Unit (CSU). These designated facilities are subject to change and will be communicated to selected vendor for service provision.