HomeMy WebLinkAboutExecuted MHBG Application.pdf Agreement No. 22-409
Community Mental Health Block Grant
Application (MHBG)
FY 2022-23 and FY 2023-24
Presented to:
State of California
Department of Health Care Services
CO
O 1$5�0
� FRCS
Susan L Holt, Director
Department of Behavioral Health
June 21 2022
Table of Contents
Signed MHBG Biennial Funding Allocation (Enclosure 1).............................................................................3
Signed MHBG Funding Agreements(Enclosure 4)........................................................................................4
Signed Certifications (Enclosure 5)...............................................................................................................8
Completed MHBG Per Program Data Sheet FY 2022-23, DHCS 1751 (Enclosure 6)...................................10
Completed MHBG Per Program Data Sheet FY 2023-24, DHCS 1751 (Enclosure 6)...................................11
Federal Grant Detailed Per Program Budget FY 2022-23, DHCS 1779(Enclosure 7) .................................12
Federal Grant Detailed Per Program Budget FY 2023-24, DHCS 1779 (Enclosure 7) .................................15
Program Narrative,Specialized Supplemental Board and Care Home.......................................................18
AppendixA..................................................................................................................................................28
MHBG Biannual Appliaction Instructions....................................................................................................29
EntityData Detail Form...............................................................................................................................32
Biennial 2022-24 MHBG County Application Enclosure 1
Page 1 of 1
Community Mental Health Services Block Grant (MHBG)
Biennial Funding Allocation
State Fiscal Years 2022-23 and 2023-24
Fresno 05/02/2022
County Name Date
RUJLP1 K3WWK9 I Entity Data Detail.pdf document included
*See Unique Entity Identifier Update below for new SAM requirement.
SFY 2022-23 SFY 2023-24
Proposed Total Allocation $ 2,381,212 $ 2,381,212
Base Allocation $ 1,962,313 $ 1,962,313
Dual Diagnosis Set-Aside $ 418,899 $ 418,899
First Episode Psychosis Set-Aside $ 0 $ 0
Children's System of Care Set-aside $ 0 $ 0
Integrated Services Agency Set-Aside $ 0 $ 0
The County requests continuation of the MHBG. These funds will be used in accordance
with Public Law 102-321 (42 U.S.C., Sections 300x through 300x-13), and Public Law
(PL) 106-310, and will be used as stated in the enclosed MHBG Funding Agreements
with Federal Requirements on Use of Allotments, and the Certification Statements.
These estimates are the proposed total allocations for State Fiscal Year (SFY) 2022-23
and 2023-24 and are subject to change based on the level of appropriation approved in
the State Budget Act of 2022 and State Budget Act of 2023. In addition, this amount is
subject to adjustments for a net reimbursable amount to the county. The adjustments
include, but are not limited to, Gramm-Rud man n-Hollings (Federal Deficit Reduction Act)
reductions, prior year audit recoveries, federal legislative mandates applicable to
categorical funding, augmentations, etc. The net amount reimbursable will be reflected in
reimbursable payments as the specific dollar amounts of adjustments become known for
each county.
The County will use this estimate to build the County's SFY 2022-23 and SFY 2023-24
budget for the provision of mental health services for adults with serious mental illness
(SMI) and children with serious emotional disturbance (SED).
L 0J, y-4-ada�
Signature of Official Authorized to Sign Application Date
Brian Pacheco, Chairman of the Board of Supervisors of the County of Fresno
Print Name Attest:
(3/22) Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
By:- 7 y
Biennial 2022-24 MHBG County Application Enclosure 4
Page 1 of 4
Community Mental Health Services Block Grant Funding Agreements
Public Law 106-310 (Children's Health Act of 2000)
Public Law 102-321; Title II-Block Grants to States Regarding
Mental Health & Substance Abuse
Part B of Title XIX of the Public Health Service Act [42 U.S.C. 300x-1 et seq.]
The county, as recipient of grant funds, acknowledges and agrees that the county and its
subcontractors shall provide services in accordance with all applicable federal and state
statutes and regulations including the following:
Section 1911
Subject to Section 1916, the State/County involved will expend the grant only for the
purpose of:
(1) Carrying out the plan submitted under Section 1912(a) [State Plan for
Comprehensive Community Mental Health Services] by the State for the fiscal
year involved;
(2) Evaluating programs and services carried out under the plan; and
(3) Planning, administration, and educational activities related to providing services
under the plan.
Section 1912
(c)(1) & (2) [As a funding agreement for a grant under Section 1911 of this title the
Secretary establishes and disseminates definitions for the terms "adult with a serious
mental illness" and "children with a serious emotional disturbance" and the
State/County will utilize such methods [standardized methods, established by the
Secretary] in making estimates [of the incidence and prevalence in the County of
serious mental illness among adults and serious emotional disturbance among
children].
Section 1913
(a)(1)(C) the County will expend for such system [of integrated services described in
Section 1912(b)(3)] not less than an amount equal to the amount expended by the
County for fiscal year 1994.
[A system of integrated social services, educational services,juvenile services, and
substance abuse services that, together with health and mental health services, will
be provided in order for such children to receive care appropriate for their multiple
needs (which includes services provided under the Individuals with Disabilities
Education Act)].
(b)(1) The County will provide services under the plan only through appropriate
qualified community programs (which may include community mental health centers,
child mental health programs, psychosocial rehabilitation programs, mental health
peer-support programs, and mental health primary consumer-directed programs).
Biennial 2022-24 MHBG County Application Enclosure 4
Page 2 of 4
(b)(2) The State agrees that services under the plan will be provided through
community mental health centers only if the centers meet the criteria specified in
subsection (c).
(c)(1) With respect to mental health services, the centers provide services as
follows:
(A) Services principally to individuals residing in a defined geographic area
(hereafter in the subsection referred to as a "service area").
(B) Outpatient services, including specialized outpatient services for
children, the elderly, individuals with a serious mental illness, and
residents of the service areas of the centers who have been
discharged from inpatient treatment at a mental health facility.
(C) 24-hour-a-day emergency care services.
(D) Day treatment or other partial hospitalization services, or
psychosocial rehabilitation services.
(E) Screening for patients being considered for admission to state mental
health facilities to determine the appropriateness of such admission.
(2) The mental health services of the centers are provided, within the limits of the
capacities of the centers, to any individual residing or employed within the
service area of the center regardless of ability to pay for such services.
(3) The mental health services of the centers are available and accessible
promptly, as appropriate and in a manner which preserves human dignity and
assures continuity and high quality care.
Section 1916
(a) The County involved will not expend the grant-
(1) to provide inpatient services;
(2) to make cash payments to intended recipients of health services;
(3) to purchase or improve land, purchase, construct, or permanently improve
(other than minor remodeling) any building or other facility, or purchase
major medical equipment;
(4) to satisfy any requirement for the expenditure of non-federal funds as a
condition for the receipt of federal funds; or
(5) to provide financial assistance to any entity other than a public or nonprofit
private entity.
(b) The County involved will not expend more than ten percent of the grant for
administrative expenses with respect to the grant.
Section 1946 PROHIBITIONS REGARDING RECEIPT OF FUNDS
(a) Establishment-
Biennial 2022-24 MHBG County Application Enclosure 4
Page 3 of 4
(1) Certain false statements and representation -A person shall not knowingly
and willfully make or cause to be made any false statement or
representation of a material fact in connection with the furnishing of items or
services for which payments may be made by a State from a grant made to
the State under Section 1911 or 1921.
(2) Concealing or failing to disclose certain events -A person with knowledge of
the occurrence of any event affecting the initial or continued right of the
person to receive any payments from a grant made to a State under Section
1911 or 1921 shall not conceal or fail to disclose any such event with an
intent fraudulently to secure such payment either in a greater amount than is
due or when no such amount is due.
(b) Criminal Penalty for Violation of Prohibition -Any person who violates any
prohibition established in subsection (a) shall for each violation be fined in
accordance with Title 18, United States Code, or imprisoned for not more than
five years, or both.
Section 1947 NONDISCRIMINATION
(a) In General-
(1) Rule of construction regarding certain civil rights laws - For the purpose of
applying the prohibitions against discrimination on the basis of age under the
Age Discrimination Act of 1975, on the basis of handicap under Section 504
of the Rehabilitation Act of 1973, on the basis of sex under Title IX of the
Education Amendments of 1972, or on the basis of race, color, or national
origin under Title VI of the Civil Rights Act of 1964, programs and activities
funded in whole or in part with funds made available under Section 1911 or
1921 shall be considered to be programs and activities receiving federal
financial assistance.
(2) Prohibition- No person shall on the grounds of sex(including, in the case of a
woman, on the grounds that the woman is pregnant), or on the grounds of
religion, be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under, any program or activity funded in whole or
in part with funds made available under Section 1911 or 1921.
(b) Enforcement-
(1) Referrals to Attorney General after notice: Whenever the Secretary finds that
a state, or an entity that has received a payment pursuant to Section 1911 or
1921, has failed to comply with a provision of law referred to in subsection
(a)(1), with subsection (a)(2), or with and applicable regulation (including one
prescribed to carry out subsection (a)(2), the Secretary shall notify the Chief
Executive Officer of the state and shall request the Chief Executive Officer to
secure compliance. If within a reasonable period of time, not to exceed 60
Biennial 2022-24 MHBG County Application Enclosure 4
Page 4 of 4
days, the Chief Executive Officer fails or refuses to secure compliance, the
Secretary may--
(1)(A) refer the matter to the Attorney General with a recommendation that an
appropriate civil action be instituted;
(1)(B) exercise the powers and functions provided by the Age Discrimination
Act of 1975, Section 504 of the Rehabilitation Act of 1973, Title IX of
the Education Amendment of 1972, or Title VI of the Civil Rights Act of
1964, as may be applicable; or
(1)(C) take such other actions as may be authorized by law.
(2) Authority of Attorney General - When a matter is referred to the Attorney
General pursuant to paragraph (1)(A), or whenever the Attorney General has
reason to believe that a State or an entity is engaged in a pattern or practice
in violation of a provision of law referred to in subsection (a)(1) or in violation
of subsection (a)(2), the Attorney General may bring a civil action in any
appropriate district court of the United States for such relief as may be
appropriate, including injunctive relief.
L t
Signature of Official Authorized to Sign Application Date
Brian Pacheco, Chairman of the Board of Supervisors Fresno
Print Name/Title County
Attest:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State f California
By: —/7`L� _,-a iDU�'y
Biennial 2022-24 MHBG County Application Enclosure 5
Page 1 of 2
Certifications
CERTIFICATION REGARDING LOBBYING
1) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
federal contract, the making of any federal grant, the making of any federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
2) If any funds other than federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency,
a member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
3) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients
shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is prerequisite
for making or entering into this transaction imposed by Section 1352, Title 31, and U.S.
Code. Any person who fails to file the required certification shall be subject to a civil penalty
of not less than $10,000 and not more than $100,000 for each such failure.
SALARY CAP
The undersigned certifies that no part of any federal funds provided under this Contract
shall be used by the County or its subcontractors to pay the salary and wages of an
individual at a rate in excess of Level II of the Executive Schedule, as found online at:
https:Hgrants.nih.gov/qrants/policV/salcap summarV.htm
DRUG FREE WORK ENVIRONMENT
The undersigned certifies that reasonable efforts are made to maintain a drug-free work
place in all programs supported by the Federal Block Grant funds.
Biennial 2022-24 MHBG County Application Enclosure 5
Page 2of2
CERTIFICATION REGARDING DEBARMENT, SUSPENSION INELIGIBILMY AND
VOLUNTARY EXCLUSION - LOWER TIER COVERED TRANSACTIONS
1) The prospective lower tier participant certified, by submission of this proposal, that
neither it nor its principals or contracted providers is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in
this transaction by any Federal department or agency.
2) Where the prospective lower tier participant is unable to certify to any of the statements
in this certification, such prospective participant shall attach an explanation to this
proposal/application.
CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE
Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that
smoking not be permitted in any portion of any indoor facility owned or leased or
contracted for by an entity and used routinely or regularly for the provision of health, day
care, early childhood development services, education or library services to children under
the age of 18, if the services are funded by Federal programs either directly or through
State or local governments, by Federal grant, contract, loan, or loan guarantee. The law
also applies to children's services that are provided in indoor facilities that are constructed,
operated or maintained with such federal funds. The law does not apply to children's
services provided in private residences; portions of facilities used for inpatient drug or
alcohol treatment; service providers whose sole source of applicable Federal funds is
Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure to comply
with the provisions of the law may result in the imposition of a civil monetary penalty of up
to $1,000 for each violation and/or the imposition of an administrative compliance order on
the responsible entity.
By signing this certification, the offer or contractor (for acquisitions) or applicant/grantee
(for grants) certifies that the submitting organization will comply with the requirements of
the Act and will not allow smoking within any portion of any indoor facility used for the
provision of services for children as defined by the Act.
The submitting organization agrees that it will require that the language of this certification
be included in any subawards which contain provisions for children's services and that all
subrecipients shall certify accordingly.
G -aoa
Signature of Official Authorized to Sign Application Date
Brian Pacheco, Chairman of the Board of Supervisors Fresno
Print Name/Title County
Attest:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State f California
By:_ QewAj
State of California-Health and Human Services Agency Department of Health Care Services
Enclosure 6
SFY 2022-2023
MHBG Program Data Sheet
Complete one sheet for each MHBG funded program that supports transformation activities (as budgeted).
County: Fresno
Program Title: Specialized Supplemental Board and Care Home
Program Contact: Rita Mehia
Email: rmehia@fresnocountyca.gov
Phone: 559-600-6688
MHBG Funding Level: $ 2,381,212.00
Target Population(s): (Estimated number of consumers to be served in the year with MHBG funds)
SMI Adult(18-59) 225
SMI Older Adult(60+) 65
SED Child (0-17)
Types of Transformational Service(s) Provided
• Check all categories that are applicable
• Please elaborate in the narrative portion of the application
Transformational Categories Is MHBG funding used to
support this goal?Please
check one.
Americans Understand that Mental Health is Essential to Overall Health El YES ❑No
Mental Health Care is Consumer and Family Driven 0 YES ❑No
Disparities in Mental Health Services are Eliminated 171 YES ❑No
Early Mental Health Screening, Assessment, and Referral to Services are El YES ❑No
Common Practices
Excellent Mental Health Care is Delivered and Research is Accelerated El YES ❑No
Technology is Used to Access Mental Health Care and Information El YES ❑No
Additional Comments:
State of California-Health and Human Services Agency Department of Health Care Services
Enclosure 6
SFY 2023-2024
MHBG Program Data Sheet
Complete one sheet for each MHBG funded program that supports transformation activities (as budgeted).
County: Fresno
Program Title: Specialized Supplemental Board and Care Home
Program Contact: Rita Mehia
Email: rmehia@fresnocountyca.gov
Phone: 559-600-6688
MHBG Funding Level: $ 2,381,212.00
Target Population(s): (Estimated number of consumers to be served in the year with MHBG funds)
SMI Adult(18-59) 239
SMI Older Adult(60+) 69
SED Child (0-17)
Types of Transformational Service(s) Provided
• Check all categories that are applicable
• Please elaborate in the narrative portion of the application
Transformational Categories Is MHBG funding used to
support this goal?Please
check one.
Americans Understand that Mental Health is Essential to Overall Health D YES ❑No
Mental Health Care is Consumer and Family Driven 0 YES ❑No
Disparities in Mental Health Services are Eliminated E YES ❑No
Early Mental Health Screening, Assessment, and Referral to Services are O YES ❑No
Common Practices
Excellent Mental Health Care is Delivered and Research is Accelerated El YES ❑No
Technology is Used to Access Mental Health Care and Information FJI YES ❑No
Additional Comments:
State of California - Health and Human Services Agency Department of Health Care Services
Version 1.4
Current ICR 1o.0o% Enclosure 7
Federal Grant Detailed Program Budget
TYPE OF GRANT I Mental Health Block Grant ISFY 2022-23
COUNTY I Fresno ISubmission Date 6/1/2022
Fiscal Contact I Kim Pho I Phone 559-600-7946
Email Address kpho@fresnocountyca.gov
Program Contact I Rita Mehia I Phone 559-600-6688
Email Address I mehia@fresnocountyca.gov
Program Name Tpecialized Supplemental Board and Care Home
Summary
Category Amount
Staff Expenses $
Consultant/Contract Costs $ 2,164,738.20
Equipment $
Supplies $
Travel $
Other Expenses $ -
Program Maximum Allowable Indirect Costs $ 216,473.82
Indirect Costs $ -
Program Maximum Allowable Support Administrative Direct Costs $ 216,473.82
County Support Administrative Direct Costs $ 216,473.80
Net Program Expenses $ 2,381,212.00
Other Funding Sources: Federal $
Other Funding Sources: Non-Federal Funds $ 2,618,788.00
Total Other Funding Sources $ 2,618,788.00
Gross Cost of Program $ 5,000,000.00
I. Staffing Itemized Detail
Category Detail Annual Salary Grant FTE Total Not to
Exceed
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 1 0.000 $
1
Federal Grant Detailed Program Budget
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 1 0.000 $
Staff Expenses Benefits I $ 1.000 $
2
Federal Grant Detailed Program Budget
II. Itemized Detail
Category Detail Amount Total
Consultant/Contract Costs Contractors under Agreement 17-377(DDX) $ 2,164,738.20 $ 2,164,738.20
Specialized Supplemental Board and Care Home services are provided through $ $
all-inclusive daily rates set by individual contractors in Appendix A $ $ -
County Support Administra County overhead and administrative support $ 216,473.80 $ 216,473.80
Other Funding Sources:N Realignment $ 2,618,788.00 $ 2,618,788.00
Indirect Costs Indirect costs funded with realignment $ $
DHCS Approval By:
Date:
3
State of California - Health and Human Services Agency Department of Health Care Services
Version 1.4
Current ICR 1o.0o% Enclosure 7
Federal Grant Detailed Program Budget
TYPE OF GRANT I Mental Health Block Grant ISFY 2023-24
COUNTY I Fresno ISubmission Date 6/1/2022
Fiscal Contact I Kim Pho I Phone 559-600-7946
Email Address kpho@fresnocountyca.gov
Program Contact I Rita Mehia I Phone 559-600-6688
Email Address I mehia@fresnocountyca.gov
Program Name
Summary
Category Amount
Staff Expenses $
Consultant/Contract Costs $ 2,164,738.20
Equipment $
Supplies $
Travel $
Other Expenses $ -
Program Maximum Allowable Indirect Costs $ 216,473.82
Indirect Costs $ -
Program Maximum Allowable Support Administrative Direct Costs $ 216,473.82
County Support Administrative Direct Costs $ 216,473.80
Net Program Expenses $ 2,381,212.00
Other Funding Sources: Federal $
Other Funding Sources: Non-Federal Funds $ 2,618,788.00
Total Other Funding Sources $ 2,618,788.00
Gross Cost of Program $ 5,000,000.00
I. Staffing Itemized Detail
Category Detail Annual Salary Grant FTE Total Not to
Exceed
Staff Expenses $ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 1 0.000 $
1
Federal Grant Detailed Program Budget
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 1 0.000 $
Staff Expenses Benefits I $ 1.000 $
2
Federal Grant Detailed Program Budget
II. Itemized Detail
Category Detail Amount Total
Consultant/Contract Costs Contractors under Agreement 17-377(DDX) $ 2,164,738.20 $ 2,164,738.20
Specialized Supplemental Board and Care Home services are provided through all-inclusive $ $
daily rates set by individual contractors in Appendix A $ $ -
County Support Administra County overhead and administrative support. $ 216,473.80 $ 216,473.80
Other Funding Sources:N Reallignment $ 2,618,788.00 $ 2,618,788.00
Indirect Costs Indirect costs funded with realignment $ $
DHCS Approval By:
Date:
3
Biennial 2022-24 MHBG County Application Narrative Page 1
Fresno County
Community Mental Health Services Block Grant (MHBG)
SFY 2022-23 and 2023-24 Specialized Supplemental Board and Care Home Services Narrative
Program Name: Specialized Supplemental Board and Care Home Services
A. Statement of Purpose:
Pursuant to Welfare and Institutions Code Section 5801 and the California Code of Regulations
Title 22, Fresno County Department of Behavioral Health (DBH) provides placements for adults with
serious mental illness (SMI) in secured, certified or licensed facilities with the appropriate level of
care and services. Historically, SMI adults with Lanterman-Petris-Short (LPS) conservatorship
status have been classified as to place. Placement have resulted in many persons served being
placed at higher and secured levels of care that can include State Hospitals, Institutions of Mental
Disease (IMD), Mental Health Rehabilitation Centers (MHRC) or Skilled Nursing Facilities (SNF).
Many of these facilities are located out of Fresno County. The transition from locked and/or higher-
level of care institutions to less restrictive facilities as determined by DBH clinical staff, through
specialized supplemental board and care home services allows for integrative approaches in
collaboration with local medical health, substance use disorder service providers, spiritual
organizations, educational institutions, cultural brokers, and other mental health partners to provide
an integrated care experience. Placements at appropriate service levels and collaboration of DBH
with facility staff ensures persons served are progressing in treatment toward the goal of
independence from LPS conservatorship status, thus restoring capacity for Person's Served to care
for their basic needs with increased stabilization of mental health symptoms and increased
wellness. Continuity of care is well established while the Person Served receives treatment services
during placement in the local community.
Specialized Supplemental facilities licensed by Community Care Licensing provide structured
supportive and therapeutic housing that supports a seamless transition in preparing Person's
Served to return to independence in the community free of institutional restrictions that are aligned
with successful transitions. The range of services focus on the person's served wellness and
recovery, working to facilitate returning or continuing to live in the community, and including
medication management/education and self-care. Some more specialized facilities possess care
exemptions from Community Care Licensing (CCL), which allows them to provide services to
persons served with mental health disorders and a wide variety of specialized medical and
behavioral needs.
B. Measurable Outcome Objectives:
Persons Served at the Specialized Supplemental Board and Care Home level of care have
experienced improved client-centered outcomes with reduced risk of symptom exacerbation;
successfully preventing renewed need for an LPS Conservatorship. This level of care proves
increased opportunities for DBH monitoring, as well as unburdened family support and
structured community engagement. Due to demonstrated successes, Fresno County DBH has
Biennial 2022-24 MHBG County Application Narrative Page 2
seen a year/year utilization of Specialized Supplemental Board and Care Homes increase in a
range of 8%-16% since 2019. Starting FY 2022-2023, Persons Served will have expanded
options for treatment that will now include Telehealth service.
FY 2022-23 and FY 2023-24 Objectives:
1. Place 60% or at least 300 adults locally at Specialized Supplemental Board and Care
Home facilities, allowing these persons served to remain closer to families and
community that impact recovery success, while they receive services.
2. Provide high intensity community/telehealth services, while at placement to support
maintenance of placement and management of symptoms in preparation for a lower
level of care.
3. Maintain an information system to track the number of special incidents, that include
crisis for conserved adults served at the specialized supplemental board and care home
program level. Data can be tracked through Special Incident Reporting.
4. Continue to monitor co-occurring issues of substance use and track through the
diagnosis reports, via Avatar.
FY 2022-23 and FY 2023-24 Outcomes:
The following data was tracked in the County's conservatorship database and the electronic
health record system, Avatar.
1. Up to this point in fiscal year 2021-22 there were 273 adults placed locally at Specialized
Supplemental Board and Care Home facilities, allowing these persons served to remain
closer to families while they receive services. This number will exclude persons served
place in June 2022. These numbers continue to go up year after year and DBH has
increased funding to support these contractors in providing these services to person
served.
2. Up to this point in fiscal year 2021-22, of the 273 adults placed at Specialized
Supplemental Board and Care Home facilities, approximately 1.5% were hospitalized
and 23% received inpatient crisis stabilization services at least once after placement.
3. An estimated 80% of all adults placed at Specialized Supplemental Board and Care
Home facilities show a co-occurring disorder of substance use.
The Fresno County Department of Behavioral Health continually monitors the placement of
persons served. This level of care has been a success in preventing persons served at risk of
becoming conserved from ultimately becoming conserved with the State of California. Year after
year Fresno County DBH has seen an increase in the number of persons served placed in
Specialized Supplemental Board and Care Homes allowing them to be near DBH for monitoring
as well as their families. Each year the percent increase of persons served placed has
increased between 8% to 16% from 2019-present. DBH has included the use of telehealth in the
renewed contract beginning FY 2022-23 to serve persons served more efficiently.
Biennial 2022-24 MHBG County Application Narrative Page 3
C. Program Description:
Placement to Specialized Supplemental Board and Care Home services must be authorized by
the DBH Recovery with Inspiration, Support and Empowerment(RISE) Conservatorship Team.
Services may range from basic services, which include reasonable access to required medical
treatment, up-to-date psychopharmacology and transportation to needed off-site services, and
bilingual/bicultural programming as appropriate for persons served who have a chronic
psychiatric impairment and whose adaptive functioning is moderately impaired, to enhanced
services, which are designed to service persons served who have subacute psychiatric
impairment and/or whose adaptive functioning is severely impaired. Services may also include
intensive support and rehabilitation to persons served as an alternative to State hospitalization
or placement in other 24-hour care facilities and are aimed at helping persons served to develop
skills to become self-sufficient and increase their levels of independent functioning.
Each Specialized Supplemental Board and Care Home facility has a written Program Design
(Title 22, Plan of Operation) approved by DBH, which contains a statement of purpose, a
statement of goals, a description of program methods and a staff training plan. The activities
and opportunities provided to each person served are consistent with the written Program
Design. The facility administrator, person served, and agency referral person/authorized
representatives are involved in the development of the person's served "Appraisal/Needs and
Services Plan". Staff communicate and participate with other agencies in case conferences and
in the development of a plan of care or educational plan to ensure continuity in each person's
served planned activities. The supervision and training provided to each person served follows
the objectives and plans written in the "Appraisal/Needs and Services Plan". The facility
provides supervision and training seven days per week with a staff ratio adequate to implement
the "Appraisal/Needs and Services Plan".
A written monthly Activity Schedule is posted for all hours that persons served are awake and
under the supervision of the facility, seven days per week. The Activity Schedule reflects the
time and place of usual person served activities, with at least one recreational activity each day
and at least one activity in the community each week. The facility teaches and enables persons
served to practice skills and behaviors that are necessary for attaining greater independence in
the home and in the community in accordance with the "Appraisal/Needs and Services Plan".
Use of leisure time in a constructive manner is encouraged. Daily activities are age appropriate
and natural environments and materials are used in teaching skills to persons served. Training
techniques are also individualized in accordance with the "Appraisal/Needs and Services Plan"
and are consistent with the principles of least restrictive method. All staff persons responsible
for carrying out an person's served "Training/Treatment" are familiar with its objectives and
methods of implementation. There is a continuity, through staff changes, in training provided to
persons served, as evidenced by either oral or written communications between staff on
different shifts.
Every twelve months the "Appraisal/Needs and Services Plan" is reviewed by the case
manager/authorized representative, person served and facility staff to measure and document
progress of set objectives and/or the need to modify. Every six months the person served is
assessed by the case manager with input from facility staff. When the "Appraisal/Needs and
Services Plan" needs to be updated, facility staff bring this to the attention of the case manager.
The facility staff, case manager and person served participate in the revision, as appropriate.
Biennial 2022-24 MHBG County Application Narrative Page 4
In lieu of community outreach referrals to these homes come from the RISE Team within DBH.
Persons served placed are primarily LPS Conservatees. As a form of outreach, DBH Contracts
makes sure as many facilities are added to the existing Master Agreement and that the RISE
Team is aware of facilities on contract in order to place persons served in the most appropriate
facility based on their needs and culture.
COMMUNITY INTEGRATION
Facilities located in residential neighborhoods must be physically compatible with residences in
that neighborhood. Person Served have access to resources available to other members of the
local community and are given regular opportunities to use those resources and to practice
community and independent living skills in their local community. The facility provides group
activities which include activities involving six or fewer persons served. At least one recreational
activity a week will be offered in the community appropriate to the interests or development of
interests of the persons served.
SOCIAL - PSYCHOLOGICAL ENVIRONMENT
The physical aspects of each facility must be appropriate to the age and physical abilities of the
person served. Persons served eat in the dining room or eating areas typically used by family
and/or staff members. Each person served have appropriate clothing for their size, culture, and
climate. Each person served wears his/her/they personal clothing.
Staff and Persons Served maintain an environment of respecting the inherent dignity and worth
of each person. Staff continue to receive support in therapeutic approaches to communication
and engage in establishing positive relationships with family and friends of Persons Served.
Team decision making and a wraparound approach to serving each person will contribute to the
Person's Served recovery. Awareness, respect and sensitivity to cultural differences are
practiced, with care for the LGBTQ/BIPOC community needs. Traditions that may include
meals, spiritual/religious practices are honored, provided space to practice and honored.
Additionally, Person's Served may be provided transportation to culturally appropriate services
to celebrate individual traditions and practices to support each individual.
Each facility is furnished, decorated, and arranged to provide a home-like, non-institutional
atmosphere and maintain a hygiene aligned with standards from CCL. Bathroom facilities are
designed and equipped to afford privacy and physical disabilities, as appropriate. No more than
two persons served shall share a bedroom. Bedrooms are not used as passageways to other
rooms. Persons served are allowed to use bedrooms as places to be alone. Persons served
have access to all common areas of the residence, except controlled storage areas and staff
designated areas. Medications shall be dispensed per doctor's orders, tracked for times
medications are administered, refused, or"cheeked,"when a Person Served attempts to hide
medications in mouth.
Specialized Supplemental Board and Care Home services may consist of, but are not limited to,
all of the components listed above. They are to be provided to each person served as specified
in their"Appraisal/Needs and Services Plan,"or as the need arises. Contractors of Specialized
Supplemental Board and Care Home services are paid at an all-inclusive daily rate for services.
In the event persons served also fall under more than one enhanced category as set forth
below, County shall pay only one all-inclusive rate, which is to be mutually agreed upon by
Biennial 2022-24 MHBG County Application Narrative Page 5
County and Contractor. Possession of care exemptions approved by CCL will be required to
provide services to persons served with specialized medical needs. Appendix A provides a full
list of existing Contractors and the daily rates for their services.
ENHANCED INDIVIDUAL CATEGORIES
CHRONIC INEBRIATES: Dual diagnosis persons served needing controlled community access.
Services provided will include:
• 15-minute visuals, 24/7, 365 days
• In-house psychiatrist with assessments done on site may be provided
• On call 24/7 psychiatrist with standing orders for PRN & injectables
• Prevocational job training on site with a community re-entry-based philosophy
• On-site Drug &Alcohol counselors
• Day Treatment, Recovery models, DBT groups and WRAP & Wellness
• On-site dietician to provide healthy diets
SPECIAL NEEDS:
• Diabetic—trained staff(incl. LVN, dietary) available to meet CCL Title 22 Section
80092.8. Services provided will include:
o Insulin shots
o Diabetes maintenance including, but not limited to insulin injections and blood
sugar monitoring
o On-site dietician to provide special diet(sugar free menu)
o Blood sugar monitoring by licensed, qualified staff
0 50% of staff shall be certified Medical Assistants
0 15-minute visuals, 24/7, 365 days a year
o On call 24/7 psychiatrist with standing orders for PRN & injectables
o Prevocational job training on site with a community re-entry-based philosophy
o Day Treatment, Recovery models, and WRAP & Wellness
• Conditions of Life—facility upgrades &trained staff available to meet CCL Title 22
Section 80077.2-3, 80001 d.(2)for persons served who rely on others to assist with most
activities of daily living (ADLs), persons served with lack of hazard awareness/impulse
control or persons served with medical conditions for which they need
assistance/observation. Services provided will include:
0 15-minute visuals 24/7, 365 days a year
o On-site dietician to provide special diets, as required
0 50% staff are certified Medical Assistants to monitor health conditions
o On call 24/7 Psychiatrist with standing orders for PRN & injectables
o Prevocational job training on-site with a community re-entry-based philosophy
o Day Treatment, Recovery models, and WRAP & Wellness
o CCL waiver for persons served needing oxygen
• Non-Ambulatory: all the above facility services shall be available to non-ambulatory
persons served. In addition to diabetic, dual-diagnosis and other conditions of life
services, the facility shall provide:
o Trained staff available to assist non-ambulatory persons served with ADL's.
Facility-wide training shall be rendered to ensure the safety of non-ambulatory
persons served with regards to egress, mobility and emergency procedures.
Biennial 2022-24 MHBG County Application Narrative Page 6
o Transportation to allow non-ambulatory persons served to participate in
community outings.
• Ambulatory Issues -trained staff(incl. LVN, dietary) available to meet CCL Title 22
Section 80010:
o Amputee
o Wheelchair dependent (for mobility)
o Walkers/Other Walking Assistance Devices
o Visual Impairment/including Legal Blindness
• Medical —trained staff to provide care for persons served who have any of the following
restricted health conditions, or who require any of the following health services:
o Colostomy bags—as specified in CCL Title 22, Section 87621
o Oxygen dependent individuals -as specified in CCL Title 22, Section 87618
o Catheter services -as specified in CCL Title 22, Section 87623
Contractors have trained staff available to provide care within a facility intended for persons
served with mental health disorders, specific characteristics, and a history of additional
behaviors/legal status including, but not limited to the following behavioral/legal status:
• LPS Conservatorship—Person served moving from locked and out of county (possible)
IMD or acute inpatient psychiatric facilities
• Aggressive Behaviors - Recent physical aggressive episode toward a person (general)
or history of physical assault on a staff
• Fire Setting
• Elopement- Elopement is considered not returning by curfew
• Sexual Assault or Sex Offender Status
• Young Adults -Young adults considered to be between the ages of 18-24 years old
• Individuals with Mild Developmental Delays -"Mild developmental delay" defined as
borderline intellectual functioning with an IQ of just below 80
D. Cultural Competency:
The Department of Behavioral Health works to support cultural traditions and social practices for
each person served and acknowledges the impact that this may have on each person's ability to
socially regulate and express themselves with their mental health. Each person's served
treatment is guided by the culture the person identifies with. Staff research, consult and
collaborate with various partners, including cultural brokers, to support this value and as a
resource in the recovery process. DBH clinicians embrace the idea that culture and mind are
inseparable and are trained to provide psychosocial assessments from a developmental, social
and cognitive perspective that include cultural differences that may go beyond traditional
theoretical approaches.
Specialized Supplemental Board and Care Home program staff recognize and accept persons'
served cultural and ethnic differences. Staff encourage observations of culturally appropriate
holidays, events, and traditions, in accordance with the cultural identity, history or preferences of
persons served. This may include, but not be limited to, offering activities, foods, and
decorations appropriate to the person served.
County-contracted Specialized Supplemental Board and Care Home providers ensure all
persons served have equal access to quality care by adopting the Federal Office of Minority
Biennial 2022-24 MHBG County Application Narrative Page 7
Health Culturally and Linguistically Appropriate Services (CLAS) national standards. Each year
contracted providers submit an updated CLAS plan describing the actions they've taken to meet
the 15 CLAS standards.
DBH has convened a Cultural Humility Committee (CHC)which meets monthly. Participation
from community-based behavioral health providers is essential to the efforts of this committee.
The focus of the CHC is to reduce or eliminate disparity by improving access to culturally and
linguistically sensitive behavioral health services. The DBH makes annual trainings available to
providers to build upon their culturally responsive skills.
E. Target Population /Service Areas:
The target population are adults and older adults diagnosed with SMI, who are stepping down
from out of county locked 24-hour supervised IMD/MHRC facilities or from inpatient facilities to a
less restricted and supervised environment, LPS Conserved adults and older adults, or adults
and older adults recently released but identified as high-risk for receding to LPS
Conservatorship. A LPS Conserved adult is identified as unable to provide a plan for self-care
including meals, clothing, and shelter due to their behavioral health symptoms. The population
includes person served with a dual diagnosis.
F. Staffing:
MHBG will not directly fund program staffing. Contractors are paid at their all-inclusive daily rate
and are expected to staff accordingly to their Program Design. Fresno County is not requesting
new positions to be funded through the MHBG at this time due to the uncertainty of MHBG
funding on a continuing basis for this program and the sustainability of hiring new staff by DBH.
G. Implementation Plan:
The program is fully implemented. Specialized Supplemental Board and Care Home services
have been provided by Contractors since 2008. Current Fresno County Agreement No. 17-377
was approved in July 2017 as a master agreement and Fresno County will be continuing the
funding of these services by renewing this expiring agreement effective July 1, 2022.
Throughout the contract term additional contractors have been and continually are added as
determined appropriate to provide this level of care. The current list of contractors include AK's
Home of Blessing and Joy, AK's Home of Care, Anjaleoni Enterprise (Leonie House),
Benevolent Residential Care Service (Dailey's Haven), BK House of Grace, Bonavente Home
for the Elderly ll, The Chimes Home, Garden Manor, Garem Assisted Living, Haskins
Residential Care, Jan-Roy Place of Fresno, Marian Homes (Sierra Villa Rest Home), Mark A
Gisler (Ruby's Valley Care Home) Modesto Residential Living Center, Providian Residential
Care Services (Fillmore Christian Gardens), Royal Board and Care for the Elderly, Sunshine
Board and Care II, and Valley Comfort. Contractors may modify their daily service rate annually
with approval of the DBH Director, as long as the modification does not result in changes to the
contract maximum compensation.
Biennial 2022-24 MHBG County Application Narrative Page 8
H. Program Evaluation Plan:
Each facility must meet quality assurance standards for licensed residential care facilities.
Facilities eligible to be certified for payment for Specialized Supplemental Board and Care
Home services from Fresno County DBH shall be a licensed Adult Residential Care Facility or
licensed Residential Care Facility for the Elderly, authorized by the California Department of
Social Services (CDSS), Community Care Licensing (CCL) Division, to provide care and
supervision to SMI adults and older adults. The facility administrator shall complete 20 hours
per year of the continuing education or in-service training in mental health issues or related
topics, in accordance with the education or training specifications of the CDSS CCL Division.
Direct care staff, employed by the facility, participates in the training activities specified in the
"Fresno County Department of Behavioral Health, Quality Assurance Standards for Licensed
Adult Residential Care Facilities, and Residential Care Facilities: Section 9". Contractors
provide information for monthly billing and other data, as required by the County's management
information system, and a monthly statement of all persons served living in the facility.
Additionally, facilities shall be certified for participation by Fresno County and services shall be
provided through written agreement, including but not limited to:
1. Cooperate with County staff, subsequent to referral and with authorization by the
County, in completing the "Appraisal/Needs and Services Plan," as indicated by the
CDSS, Adult Residential Facilities, Division 6, Chapter 1, Section 80068.2, to meet the
goals, objectives, and activities appropriate to the person served. This plan shall be
completed and placed in the person's served record on or before the first day of
placement and kept current.
2. Complete a "Facility Service Plan" indicating the specific services to be provided to
address the needs identified in the "Appraisal/Needs and Services Plan". This plan shall
be completed and placed in the person's served record on or before the first day of
placement.
3. Maintain persons served records, on the premises, in accordance with "Fresno County
Department of Behavioral Health, Quality Assurance Standards for Licensed Adult
Residential Care Facilities and Residential Care Facilities, Section 8 - Individual
Records" to promote the services to each person served. These records shall include:
a. The "Appraisal/Needs and Services Plan" specifying the needs to be addressed.
b. Weekly notes shall:
i. Address all needs, objectives, and services provided by facility staff to
implement the "Facility Service Plan"for each person served;
ii. Address significant occurrences affecting the person served (incidents,
illness, exacerbation of symptoms, signs of improved functioning, etc.), as
appropriate;
iii. Describe behavioral observations and symptoms; and
iv. Be written by staff having direct supervision/observation of the person
served.
c. Monthly summary notes shall reflect all needs and services addressed in the
"Appraisal/Needs and Services Plan." (Refer to "Fresno County Department of
Behavioral Health, Quality Assurance Standards for Licensed Adult Residential
Care Facilities and Residential Care Facilities: Section 8 - Individual Records".)
d. All other documents/information as required by CDSS CCL Division.
Biennial 2022-24 MHBG County Application Narrative Page 9
4. Allow access to the facility, to the extent authorized by law, by County and State staff for
assessment of person(s) served, monitoring of the contract, record review, consultation
with staff, and evaluation of the facility and services.
5. Maintain the capability to provide the services required to meet the specialized needs of
persons served, as identified in the persons' served "Appraisal/Needs and Services
Plans".
6. Cooperate and consult with County staff to improve/enhance/modify program services to
meet the need of persons served as indicated in their"Appraisal/Needs and Services
Plans."
7. Inform DBH Case Manager and Coordinator immediately and provide a written report
within 24 hours of all incidents necessitating an incident report to CDSS CCL Division.
Incidents to be reported include, but are not limited to, death, accident/injury, abuse, and
absence without leave (AWOL).
8. Inform the Coordinator within 24 hours of all persons served movements (i.e. admissions
to a general hospital, acute psychiatric facility, and/or AWOL).
9. Encourage persons served to take increased responsibility for own treatment by setting
self-established goals.
10. Provide scheduled and posted activities to encourage the development of activities
satisfying to persons served, as specified in their"Appraisal/Needs and Services Plans".
The posted monthly schedules shall reflect the interests of persons served, expose them
to and develop a variety of leisure interests, and develop interpersonal skills and
relationships.
Contractors are encouraged to engage in all quality improvement activities to provide a
welcoming environment, and to continue developing co-occurring substance use and mental
health treatment capability for persons served and their families.
I. Olmstead Mandate and the MHBG:
In 1999 The Supreme Court issued its decision in Olmstead vs L.C. promulgating the
enforcement of states to provide services in the most integrated setting appropriate to
individuals and prohibit needless institutionalization and segregation in work, living and other
settings. Describe the county's efforts on how the MHBG addresses the ADA community
integration mandate required by the Olmstead decision of 1999 in the following areas.
i. Housing Services
ii. Home and community-based services and peer support services
iii. Employment services
iv. Transition from hospitals to community settings
Fresno County DBH looks towards all funding sources, including MHBG, and the full spectrum
of services to create a complete continuum of care for persons served, through integration of all
available services. In particular, adult persons served with SMI are transitioned from locked
and/or higher-level of care institutions to less restrictive facilities as determined by Fresno
County clinical staff. These facilities are Specialized Supplemental Board and Care Home
services and/or other certified/licensed facilities with a residential setting in the community. The
range of services provides for the person's served recovery while working to facilitate returning
to live in the community. Services include on-the-job skills training. DBH is dedicated to
Biennial 2022-24 MHBG County Application Narrative Page 10
providing treatment at appropriate levels of care and while in the least restrictive environment
for all persons served and their families, to promote their wellness, recovery and resiliency.
All contracted providers have the ability to house and assist persons served with disabilities.
These providers specialize in this population and are equipped to assist persons living in
facilities in their daily activities as well as care and supervision of these persons. When persons
served are transitioned from hospitals to Specialized Supplemental Board and Care Homes
contractors assist person served in the transition and assist them in activities to acclimate the
person served during this process. Each contractor is required to allow and assist persons
served regardless of disability to attend one recreational activity each day as well as attend one
activity in the community each week.
SERVICES
N > m U T K C
C ti
V n T
a O pp G > <
° E
E a
'E = v E v
a o
aci 19 > o oU rco
a
E v c v E m ID
N v > a — v `° oaf s r U
to N `° i E ov
G �Cp C n 'D ILL al T Ol E
a E .on E `° u w w f0 v E -
- o
i H H o - E v
E w o n. M N .� .� > E E to c u
a c o Y `m y o M > E m m
c >a c v m x x v P O c L
0 0. L v o v c ? v m c n o. c aci
v mlu L ro c — ro a, m E c
o. a v u o °o. o N E 'm c ,.. v v
m c c n v o v o N E a
O O O Ul O G T n L
m NOO O
23 E ° ° O ry LO
LvFY 22 Cvv v :E
o_ v w u n
Daily o�u w 'm E N v n Y o u Z a > N 3 o a
E L a `° o a v o `� x v v a v `�' o c 2 M t
CONTRACTORS/FACILITIES Rate m w a E o 0 n w _ E G p a G
AK's House of Blessing $89.00 x X x X X X X x X
AK's Home and Care $66.00 x x x x x x x x x
Anjaleoni Enterprise,Inc dba Leonie House $120.00 x x x x x x x x
Benevolent Residential Care Service dba $150.00 x x x x
Dailey's Haven
BK House of Grace $91.10 x x x x x x x
Bonavente Home for the Elderly II $89.95 x x x x x x x
The Chimes Home $107.00 x x x x x x x x
Garden Manor $83.54 x x x x x x
Garem Assisted Living $110.00 x x x x x x x x x x x
Haskins Residential Care $190.24 x x x x x x x x x x x
Jan-Roy Place of Fresno $120.00 x x x x x x x x x x x
Marian Homes Inc.dba Sierra Villa $120.00 x x x x x x x x
Mark A.Gisler dba Ruby's Valley Care Home $154.11 x x x x x x x
Modesto Residential Living Center $70.00 x x x x
Providian Residential Care Services(Fillmore $11000 x x x x x x
Christian Gardens) .
Royal Board and Care for the Elderly $90.00 x x x x x x x x
Sunshine Board and Care II $90.00 x x x x x x x x
Valley Comfort $92.00 x x x x x
Biennial 2022-24 MHBG County Application Enclosure 2
Page 1 of 3
Community Mental Health Services Block Grant (MHBG)
Biennial Application Instructions
State Fiscal Years 2022-23 and 2023-24
The MHBG Application must address all programs funded with the MHBG. The MHBG
County Application package contents (Enclosures and Forms)will be sent by email in a zip
file.
Upon submittal, the MHBG County Application must include the following:
1. Signed Funding Allocation.
2. Signed Agreements.
3. Signed Certifications.
4. Completed MHBG Program Data Sheet. Please complete one per program and it must
indicate any transformational services provided.
5. Federal Grant Detailed Program Budget. Please complete one per program. If your
county has more than one MHBG funded program, submit the budgets in one excel
workbook.
6. Completed MHBG First Episode Psychosis (FEP) Program Data Sheet. Report the actual
numbers served and description of the evidence-based practice(s) implemented in the
program.
7. A separate Program Narrative is required for each program funded with the base
allocation, dual diagnosis (DDX) set-aside, FEP set-aside, Children System of Care
(CSOC)set-aside, and Integrated Services Agency (ISA) set-aside. Multiple programs
and/or subcontractor expenses including DDX, CSOC, ISA and FEP set-aside programs
must be detailed on separate forms. Please ensure that all programs titled in the narrative
correspond to the program name on each MHBG Program Data Sheet and each Federal
Grant Detailed Program Budget.
Please use the attached DHCS narrative template to complete each Program Narrative.
Each Program Narrative should be no longer than 10 pages and must span the entire
application period from July 1, 2022 through June 30, 2024. Each Program Narrative
must identify and specify the activities to occur within each SFY (2022-23 and 2023-24) of
the biennial period, and counties should not submit separate Program Narratives for each
SFY. Each narrative must include the following sections lettered and in the same order as
below in bold:
a. Statement of Purpose: reflects the principles on which the program is being
implemented. MHBG programs are required to implement the principles of integrated
systems of care. Specify how the program works with other departments and agencies
that serve the same population.
b. Measurable Outcome Objectives: includes any measurable outcome objectives that
demonstrate progress toward stated purpose(s) or goal(s) of the program, along with a
statement reflecting the progress made toward achieving last year's objectives. List a
minimum of three objectives.
Biennial 2022-24 MHBG County Application Enclosure 2
Page 2 of 3
c. Program Description: specifies what is actually being paid for by the block grant
funds. The description must include services to be offered, type of setting, and planned
community outreach, as applicable. The budget line items within the Federal Grant
Detailed Program Budget, must be explained in the program description.
d. Cultural Competency: describes how the program is providing culturally appropriate
and responsive services in the county; also report on advances made to promote and
sustain a culturally competent system.
e. Target Population: specifies the population that your MHBG funded programs are
serving. Each narrative in the MHBG County Application must include a brief
description of the target population including any sub-population served with the MHBG
funds. Federal statutes require that the target population must include adults and older
adults with a serious mental illness (SMI) and/or children with a serious emotional
disturbance (SED). The Center for Mental Health Services Definitions of Adults with a
Serious Mental Illness and Children with a Serious Emotional Disturbance (Enclosure
8) as published in the Federal Register in 1992, is enclosed. There may be discrete
programs serving specific sub-populations such as dually diagnosed, those that have
experienced first episode psychosis, homeless, forensic, minorities, consumer
operated, and transitional age youth. The DDX set-aside must continue to be used for
individuals with a dual diagnosis and must be addressed in your description. The FEP
set-aside must be used for individuals who have early serious mental illness (ESMI),
including a FEP, regardless of the age of the individual at onset and must be
addressed in your description. Counties cannot use MHBG funds for prodromal
symptoms (specific group of symptoms that may precede the onset and diagnosis of a
mental illness) and/or those who are not diagnosed with a SMI. Screening and
assessment of SMVSED/FEP is allowable, but a prodromal diagnosis does not
constitute ESMI or FEP, and MHBG funds cannot support prevention, early
intervention, or treatment of prodromal clients.
f. Staffing: specifies MHBG-funded positions, which must match the submitted budgets.
Restrictions on Salaries
County agrees that no part of any federal funds provided under this Contract shall be
used by the County or its subcontractors to pay the salary and wages of an individual at
a rate in excess of Level II of the Executive Schedule, as found online at:
https:Hgrants.nih.gov/grants/policy/salcap summary.htm
g. Implementation Plan: specifies dates by which each phase of the program will be
implemented or state that the "program is fully implemented".
h. Program Evaluation Plan: describes monitoring progress toward meeting the
program's objectives, including frequency and type of internal review, data collection
and analysis, identification of problems or barriers encountered for ongoing programs,
and a plan for monitoring, correcting, and resolving identified problems.
i. Olmstead Mandate and the MHBG: In 1999 The Supreme Court issued its decision in
Olmstead vs L.C. promulgating the enforcement of states to provide services in the
most integrated setting appropriate to individuals and prohibit needless
institutionalization and segregation in work, living and other settings. Describe the
Biennial 2022-24 MHBG County Application Enclosure 2
Page 3 of 3
county's efforts on how the MHBG addresses the ADA community integration mandate
required by the Olmstead decision of 1999 in the following areas.
i. Housing Services
ii. Home and community-based services and peer support services
iii. Employment services
iv. Transition from hospitals to community settings
The MHBG County Application packages must be submitted electronically. Please submit
program budgets in Excel format, and the corresponding narrative(s) in Word, utilizing the
provided template, to MHBG(a-)_dhcs.ca.gov no later than close of business on June 2, 2022.
All documents requiring signatures, including the Funding Allocation, Funding Agreements,
and Certifications, must be electronically signed and submitted no later than June 2, 2022 to
MHBG(ab-dhcs.ca.gov.
Unique Entity Identifier(UEI) Update
The System for Award Management (SAM) website generated UEI has become the new
official identifier as of April 4, 2022, at which point the Federal government stopped using the
DUNS number to uniquely identify entities.
Please note that counties applying for MHBG funding are required to provide their SAM UEI.
Your county's SAM UEI number must also be registered and active on the sam.gov website,
and updated annually. More information and guidance regarding this transition can be found
online at: https://sam.gov/content/duns-uei
The County must ensure the downloadable "Entity Data Detail.pdf" form obtained
from the SAM.gov website is included with all other required application
documents. Applications will not be reviewed until a valid and current "Entity Data
Detail.pdf' has been received from the County. Please check the box on top of page one
to verify "Entity Data Detail.pdF is included with required application documents.
Please email MHBG(a-)dhcs.ca.gov if your county requires additional assistance in
downloading the "Entity Data Detail.pdf."
o.�SAM.00v
Entity Workspace Results 1 Total Results
Fresno,County of
DUNS Unique Entity ID:080055902 Physical Address: Expiration Date:
4417 E Inyo Ave Bldg 333 Mar 28,2023
L SAM 1 Unique Entity ID:RUJLPIK3WWK9 Fresno,CA
Purpose of Registration:
CAGE/NCAGE:7JJ15 93702-2977 USA All Awards
Entity Status:Active
KA—In )m,)1 o•nn•n7 onn i
1 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) COUNTY
COMMUNITY MENTAL HEALTH BLOCK GRANT (MHBG) RENEWAL APPLICATION
2 FY 2022-23 and 2023-24
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21 FOR ACCOUNTING USE ONLY:
22 Fund/Subclass: 0001/10000
ORG No.: 5630
23 Account No.: 4380
24
25
26
27
28
1 - COUNTY OF FRESNO
Fresno, CA