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HomeMy WebLinkAboutAgreement A-12-232-3 with WestCare California, Inc..pdfAgreement No. 12-232-3 AMENDMENT Ill TO AGREEMENT 1 2 3 THIS AMENDMENT, hereinafter referred to as Amendment 111, is made and entered into this 12th day of _ ___,.J..,,.un_,_,e'----' 2018, by and between COUNTY OF FRESNO, a Political Subdivision 4 of the State of California, hereinafter referred to as "COUNTY", and WESTCARE CALIFORNIA, INC., a 5 California non-profit Corporation, whose business address is P.O. Box 12107, Fresno, CA 93776, 6 hereinafter referred to as "CONTRACTOR" (collectively the "parties"). 7 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement 8 No. 12-232, effective May 22, 2012, COUNTY Amendment No. 12-232-1, effective November 4, 2014, 9 and COUNTY Amendment No. 12-232-2, effective June 20, 2018, herein collectively referred to as 10 COUNTY Agreement No. 12-232, whereby, CONTRACTOR agreed to provide overnight stay facility 11 services for eligible clients discharged from hospital emergency departments (ED)/designated 5150 12 facilities, as specified in Agreement No. 12-232 to help reduce consumer ED stays as well as reduce 13 recidivism rates for hospital stays; and 14 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below and 15 restate the Agreement in its entirety. 16 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is 17 hereby acknowledged, COUNTY and CONTRACTOR agree as follows: 18 1. That the existing COUNTYAgreement No. 12-232, Section two (2) "TERM", shall be 19 revised by adding the following at Page Two (2), Line Eleven (11) after the word "term": 20 "This Agreement shall be extended for an additional six (6) month period beginning July 21 1, 2018 through December 31, 2018." 22 2. That the existing COUNTY Agreement No. 12-232, beginning on Page Four (4), Line 23 Nine (9) with the word "The" and ending on Page Four (4), Line Eighteen (18) with the word 24 "Agreement" be deleted and the following inserted in its place: 25 "The maximum amounts to be paid to CONTRACTOR identified in this Agreement are 26 stated in Revised Exhibit 8:.1, attached hereto and incorporated herein to this Agreement. For the 27 period May 22, 2012 through June 30, 2013, the maximum amount of compensation for services 28 rendered under this Agreement shall not exceed Eight Hundred Twenty-Eight Thousand, Nine Hundred 1 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Fifty-Four and No/100 Dollars ($828,954.00). The maximum compensation under this Agreement for the period of July 1, 2013 through June 30, 2014, shall not exceed Six Hundred Eighty One Thousand, Seven Hundred Thirty- Five and No/100 Dollars ($681,735.00). The maximum compensation under this Agreement for the period of July 1, 2014 through June 30, 2015 shall not exceed Seven Hundred Seventy-Eight Thousand, Five Hundred Fifty and No/100 Dollars ($778,550.00). The maximum compensation under this Agreement for the period of July 1, 2015 through June 30, 2016 shall not exceed Eight Hundred Nineteen Thousand, Ninety and No/100 Dollars ($819,090.00). The maximum compensation under this Agreement for the period of July 1, 2016 through June 30, 2017 shall not exceed Eight Hundred Nineteen Thousand, Ninety and No/100 Dollars ($819,090.00). The maximum compensation under this Agreement for the period of July 1, 2017 through June 30, 2018 shall not exceed Eight Hundred Nineteen Thousand, Ninety and No/100 Dollars ($819,090.00). The maximum compensation under this Agreement for the period of July 1, 2018 through December 31, 2018 shall not exceed Four Hundred Twenty-Four Thousand, Eight Hundred Eight and No/Dollars ($424,808.00). The total maximum compensation to be paid by COUNTY to CONTRACTOR upon execution through December 31, 2018 shall not exceed Five Million, One Hundred Seventy-One Thousand, Three Hundred Seventeen and No/Dollars ($5,171,317.00).” 3. That, effective July 1, 2018, all references in existing COUNTY Agreement No. 12-232 to “Exhibit A,” shall be changed to read “Revised Exhibit A-1,” attached hereto and incorporated herein by reference. 4. That, effective July 1, 2018, all references in existing COUNTY Agreement No. 12-232 to “Exhibit B,” shall be changed to read “Revised Exhibit B-1,” attached hereto and incorporated herein by reference. 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 5. COUNTY and CONTRACTOR agree that this Amendment III is sufficient to amend the Agreement; and that upon execution of this Amendment III, the Agreement, Amendment I, Amendment II and Amendment III together shall be considered the Agreement. The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants, conditions and promises contained in the Agreement and not amended herein shall remain in full force and effect. This Amendment III shall become effective upon execution by all parties. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 11\J WfFNESS' WHEREOF, the:'parties hereto have. executed this Amendment Ill to Agreement 3 4 t:.dNTRAGfbR: '· .. ~·--~ . . •.-•; · .. ; ... :, . •.·-"· ~ 5 ' WesteAREiCALiFORNIA INC • . '-''.""•"'•( •'~':·'··: .•.•., -. ' -·· ,,;.••-:,.,:-~;•' .. -~•-··' ;1"(.:•''• 6 7 8 9 . 14 . PrinfName ·· · · · · · .00.UNTY OF F~J:SNO ·~Jrite.rs!m r:>(the. S,oardof 1nc,r.~ot-l~""1 ... ~•Coynty of Fresno ATTEST: B~rriid~'E. Seidel .c1erk;JjfttieBoard. of supervisors Coi.inWof: Fresno, state:of California 15 ~~J~~:bm~'at~t;~Hilltr° cq_~~, 16 Fin1;1ffc;i~I-QffiG~rJtre~~1,1r~r. 9r ~ny 17 Assistant-SecrE!tai:y.·otfre,al3Ur~r) 18 19 20 MAl.~f.NG. APO.RESS:. p;o. Ba:irt21.o.1 2·1 Fres'hb; .CA 93'776 22 Phone Nb.: (55!:1)251'-4800 23 24 FORAcG.oUNT-iNG vs:1;· oNt.. r: 25 Organization: FuhdiSubciass: 26 ,AccollnVPfogr~m: 27 28 $(33.qfW?.. 0001/.1'00:00 ·1-295j() .. · ...... ,, 4 Revised Exhibit A-1 Page 1 of 5 Mental Health Services Act (MHSA) Overnight Stay Facility Scope of Work ORGANIZATION: ADDRESS: SITE ADDRESS: SERVICES: CONTRACT PERIOD: CONTRACT AMOUNT: WestCare California, Inc. 1505 N. Chestnut, Fresno, CA 93776 2772 S. Martin Luther King Blvd, Fresno, CA 93706 Overnight stay services, clinical response services, peer support services, discharge services, transportation and linkage to appropriate mental health programs. Upon execution through December 31, 2018 July 1, 2018 - December 31, 2018 SCHEDULE OF SERVICES: CONTRACTOR'S staff shall be available to provide Overnight Stay Facility services to consumers seven days a week, 24 hours a day Contractor(s) shall provide services on eleven (11) County observed holidays in each calendar year as follows: New Year's Day Martin Luther King, Jr. Holiday President's Day Cesar Chavez Day Memorial Day Independence Day Labor Day Veterans Day Thanksgiving Day Day after Thanksgiving Day Christmas Day TARGET POPULATION: Adult and older adult consumers receiving services from Fresno County emergency departments (ED)/designated 5150 facilities who are discharged to the Overnight Stay Facility upon the ED/designated 5150 facility determination that a higher level of care is not necessary and linkage to outpatient and related services are required. Some consumers may be referred for post hospitalization case management from acute care psychiatric facilities when there is no identified plan for linkage. PROJECT DESCRIPTION: The Overnight Stay Facility program will provide 24 hour-7 days per week overnight stay services, clinical response services, peer support services, discharge services, transportation and linkage to appropriate mental health programs to adults and older adults who are deemed appropriate for the Overnight Stay Facility pursuant to discharge from designated hospital emergency departments' designated 5150 facilities and/or psychiatric facilities. Revised Exhibit A-1 Page 2 of 5 The CONTRACTOR'S Overnight Stay Facility will provide the services described below. CONTRACTOR will provide services to approximately 1,200 consumers annually during the term of the contract. Extended consumer stays will be allowed for homeless consumers that utilize the overnight stay program on nights when linkages to services are not available. Contractors case management staff will follow-up the following morning with extended stay/homeless consumers to provide the necessary linkages to services. CONTRACTOR'S RESPONSIBILITIES: CONTRACTOR shall: 1. Provide services to consumers discharged from local hospital Emergency Department's (ED)/designated 5150 facilities as requested by the County. The CONTRACTOR may expand to provide services to other agencies in the County of Fresno as needed or if requested to do so by COUNTY, Department of Behavioral Health (DB-I). 2. Provide transportation of consumers from ED to Overnight Stay Facility. CONTRACTOR shall arrive at ED/designated 5150 facility on average within thirty minutes of ED/designated 5150 facility request. CONTRACTOR shall then meet with appropriate ED/ designated 5150 facility or Crisis Psychiatric Response Services (CPRS) staff and greet consumer. CONTRACTOR shall learn the consumers discharge plan from the ED staff at the designated 5150 facility and assist the consumer in the appropriate linkage to services the following morning. 3. Provide supervision of consumers who are being discharged from the emergency department /designated 5150 facility. Provide for the basic care of consumers i.e.: food, bedding, shower/bath, medication supervision, etc. 4. Provide direct assistance with needed linkages including transportation or follow up care as prescribed by the discharging ED's designated 5150 facility. Linkages will occur as close as possible to the next business day. 5. Maintain staffing including, but not be limited to: program supervisor, clinician for emergency consultations, facility staffing ratio as State and Federal regulations require that will provide the needed supervision of consumers in the overnight sleeping arrangement. Staffing must include peer/family support and linkage specialists for the purpose of assisting the consumer to treatment/intervention during business hours. 6. Ensure that the safety of the community, consumer and staff are a priority. 7. Have a process in place for each consumer who utilizes the overnight-stay facility to ensure consumer is actively participating in services. CONTRACTOR will make telephone contacts with each participant's service provider once a week for up to 45 days. Consumers who are not keeping appointments or following through on referrals will be contacted directly, twice weekly at a minimum. Consumers who drop out will be located and motivational interviewing techniques will be used to encourage their return to their treatment program. CONTRACTOR will contact participants at least once a month until the individual has consistently participated in an outpatient program for 3 months and is functioning at a lower level of care 8. Ensure service delivery is culturally sensitive and appropriate for consumer and consumer's family. 9. Provide family support services through Peer Support Specialists and Linkage Specialists to aid in the recovery of the consumer as well as to educate and engage the whole family. 10. Maintain the procedures needed to handle overflow consumers. Maintain adequate space to handle any overflow of consumers into the facility. If the number of consumers exceeds the 1:6 staff to consumer ratio, an on-call Peer Support Specialist will be notified to report to work. Revised Exhibit A-1 Page 3 of 5 11. Extended consumer stays will be allowed for homeless consumers that utilize the overnight stay program on nights when linkages to services are not available. CONTRACTOR'S case management staff will follow-up the following morning with extended stay/homeless consumers to provide the necessary linkages to services. 12. The Overnight Stay facility program will provide 24-hour, 7-days-per-week overnight services, clinical response services, peer support services, discharge services, transportation and linkage to appropriate mental health programs to adults and older adults who are deemed appropriate for the Overnight Stay Facility pursuant to discharge from designated hospital emergency departments/designated 5150 facilities. COUNTY RESPONSIBILITIES: COUNTY shall: 1. Provide program and budget oversight through the County Department of Behavioral Health (DBH), Contracted Services Division to the CONTRACTOR'S Overnight Stay Facility. In addition to contract monitoring of the program, oversight includes, but not limited to, coordination with the State Department of Mental Health, Mental Health Services Act in regard to program administration and outcomes. 2. Participate in evaluating the progress of the overall program and the efficiency of collaboration with the CONTRACTOR staff and be available to the CONTRACTOR for ongoing consultation. 3. Receive and analyze statistical data outcome information from vendor throughout the term of contract on a monthly basis. DBH will notify the vendor when additional participation is required. The performance outcome measurement process will not be limited to survey instruments but may also include, as appropriate, consumer and staff interviews, chart reviews, and other methods of obtaining required information. 4. Recognize that cultural competency is a goal toward which professionals, agencies, and systems should strive. Becoming culturally competent is a developmental process and incorporates at all levels the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally-unique needs. Offering those services in a manner that fails to achieve its intended result due to cultural and linguistic barriers is not cost effective. To assist the vendor efforts towards cultural and linguistic competency, DBH shall provide the following at no cost to CONTRACTOR): A. Technical assistance and mandatory cultural competency training including sexual orientation and sensitivity training for vendor personnel, at minimum once per year. County will provide mandatory training regarding the special needs of this diverse population. Sexual orientation and sensitivity to gender differences is a basic cultural competence principle and shall be included in the cultural competency training. Literature suggests that the mental health needs of lesbian, gay, bisexual, transgender (LGBT) individuals may be at increased risk for mental disorders and mental health problems due to exposure to societal stressors such as stigmatization, prejudice, and anti-gay violence. Social support may be critical for this population. Access to care may be limited due to concerns about providers' sensitivity to differences in sexual orientation. B. Technical assistance for vendor in translating behavioral health and substance abuse services information into DBH's threshold languages (Spanish, Laotian, Cambodian and Hmong). Translation services and costs associated will be the responsibility of the vendor. Revised Exhibit A-1 Page 4 of 5 PROGRAM OUTCOMES The following items listed below represent program outcomes to be tracked by the vendor during the term of the Agreement: • CONTRACTOR shall track response time to emergency departments/ designated 5150 facility by Overnight Stay Facility team members. • CONTRACTOR shall track the amount of time it takes to place consumers from the emergency departments/designated 5150 facility to the Overnight Stay Facility. • CONTRACTOR shall track referral source. • CONTRACTOR shall track consumers with behavioral health disorders who are frequent users of hospital emergency departments/designated 5150 facility and monitor the recidivism rate of those consumers. • CONTRACTOR shall monitor, report and track appropriate linkage successes and challenges • CONTRACTOR shall track, report, and monitor follow up contacts with consumers. • CONTRACTOR shall track clinical outcomes by discharge placement. • CONTRACTOR shall track total discharges and discharge reasons • CONTRACTOR will develop a satisfaction survey, approved by DBH that complies with the mandated State performance outcome and quality improvement reports/outcomes. At a minimum, eighty percent (80%) of consumers will report satisfaction with the program services. • CONTRACTOR will identify services provided to each consumer on a monthly basis. CULTURAL & LINGUISTIC COMPETENCE: As related to Cultural and Linguistic Competence, the CONTRACTOR: A. Shall be required to ensure compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d, and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance from discriminating against persons based on race, color, national origin, sex, disability or religion. This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access and participation in federally funded programs through the provision of comprehensive and quality bilingual services. B. Shall develop and implement policies and procedures for ensuring access and appropriate use of trained interpreters and material translation services for all LEP consumers, including, but not limited to, assessing the cultural and linguistic needs of its consumers, training of staff on the policies and procedures, and monitoring it language assistance program. CONTRACTOR'S procedures must include ensuring compliance of any sub-contracted providers with these requirements. C. Agree that minors shall not be used as interpreters. D. Shall be required to conduct and submit to County an annual cultural and linguistic needs assessment to promote the provision and utilization of appropriate services for its diverse consumer population. The needs assessment report shall include findings and a plan outlining the proposed Revised Exhibit A-1 Page 5 of 5 services to be improved or implemented as a result of the assessment findings, with special attention to addressing cultural and linguistic barriers and reducing racial, ethnic, language, abilities, and gender and age disparities. E. Shall develop internal systems to meet the cultural and linguistic needs of the vendor's consumer census including the incorporation cultural competency in the vendor's mission; establishing and maintaining a process to evaluate and determine the need for special- administrative, clinical, welcoming, billing, etc. - initiatives related to cultural competency F. Shall develop recruitment and retention initiatives to establish contracted program staffing that is reflective and responsive to the needs of the program and target population. CONTRACTOR shall establish designated staff person to coordinate and facilitate the integration of cultural competency. The designated person will provide an array of communication tools to distribute information to staff relating to cultural competency issues G. Shall keep abreast of evidence-based and best practices in cultural competency in mental health care and treatment to ensure that the vendor (s) maintains current information and an external perspective in its policies. The CONTRACTOR will evaluate the effectiveness of strategies and programs in improving the health status of cultural-defined populations. CONTRACTOR shall communicate their policies to COUNTY for review of adherence with said evidenced-based practices and best practices in cultural competency in mental health care and treatment. CONTRACTOR shall provide translation services for program services in accordance with the requirements noted in Paragraph 30 of this Agreement. H. CONTRACTOR'S staff will assume that the population served may not be in heterosexual relationships. Gender sensitivity and sexual orientation must be covered in annual training. I. Will utilize existing community supports, referrals to transgender support groups, etc., when appropriate. J. Shall deliver services in the consumer's home community, drawing on formal and informal resources to promote the consumer's successful participation in the community. Community resources include not only mental health and co-occurring disorders professionals and provider agencies, but also social, religious and cultural organizations and other natural community support networks. K. Shall be required to annually attend the Cultural Competence as well as the Compliance training provided by DBH. L. Will report its efforts to evaluate cultural and linguistic activities as part of the vendor's ongoing quality improvement efforts in the monthly activities report. Reported information may include consumers' complaints and grievances, results from consumer satisfaction surveys, and utilization and other clinical data that may reveal health disparities as a result of cultural and linguistic barriers. M. Shall recruit and hire staff that have demonstrated experience working with culturally and linguistically underserved minority populations and have knowledge about the culture and languages of these intended groups as well as other diverse communities. *** Revised Exhibit B-1 Page 1 of 3 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 Program Supervisor 1.00 $27,500 $27,500 0002 Case Manager 3.00 $60,000 $60,000 0003 Peer Support Specialists/Driver 5.00 $70,200 $70,200 0004 Personal Service Coordinators 4.00 $60,320 $60,320 0005 Data/Program Assistant 1.00 $14,560 $14,560 0006 Medical Director 0.17 $16,635 $16,635 0007 LCSW 1.00 $27,500 $27,500 0008 Temp Help/Overtime $1,250 $1,250 0009 Title 0.00 $0 0010 Title 0.00 $0 0011 Title 0.00 $0 0012 Title 0.00 $0 SALARY TOTAL 15.17 $0 $277,965 $277,965 PAYROLL TAXES: 0030 OASDI $0 0031 FICA/MEDICARE 0.0654 $18,179 $18,179 0032 SUI 0.017 $4,725 $4,725 PAYROLL TAX TOTAL $0 $22,904 $22,904 EMPLOYEE BENEFITS: 0040 Retirement 0.03 $8,339 $8,339 0041 Workers Compensation 0.0206 $5,726 $5,726 0042 Health Insurance (medical, vision, life, dental)0.067 $18,624 $18,624 EMPLOYEE BENEFITS TOTAL $0 $32,689 $32,689 SALARY & BENEFITS GRAND TOTAL $333,558 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $8,450 1011 Rent/Lease Equipment $7,540 1012 Utilities $5,040 1013 Building Maintenance $1,020 1014 Equipment purchase $0 FACILITY/EQUIPMENT TOTAL $22,050 Line Item Description (Must be itemized) SUPERVISED OVERNIGHT STAY SERVICES WESTCARE CALIFORNIA, INC. FY 2018-2019 Budget Categories - Total Proposed Budget Revised Exhibit B-1 Page 2 of 3OPERATING EXPENSES: 1060 Telephone $1,930 1061 Answering Service $0 1062 Postage $0 1063 Printing/Reproduction $20 1064 Publications $0 1065 Legal Notices/Advertising $0 1066 Office Supplies & Equipment $1,080 1067 Household Supplies $1,140 1068 Food $0 1069 Program Supplies - Therapeutic $0 1070 Program Supplies - Medical $0 1071 Transportation of Clients $0 1072 Staff Mileage/vehicle maintenance $1,990 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $430 1075 Lodging $0 1076 Other - (Identify)$0 1077 Other - (Identify)$0 OPERATING EXPENSES TOTAL $6,590 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $0 1082 Liability Insurance $0 1083 Administrative Overhead $54,510 1084 Payroll Services $0 1085 Professional Liability Insurance $1,200 FINANCIAL SERVICES TOTAL $55,710 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (network & data management)$0 1091 Translation Services $0 1092 Medication Supports $0 SPECIAL EXPENSES TOTAL $0 FIXED ASSETS: 1190 Computers & Software $0 1191 Furniture & Fixtures $0 1192 Other - (Identify)$0 1193 Other - (Identify)$0 FIXED ASSETS TOTAL $0 Revised Exhibit B-1 Page 3 of 3NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$0 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$5,150 2002.2 Client Transportation & Support (SFC 72)$1,750 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $6,900 TOTAL PROGRAM EXPENSES $424,808 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 3100 Case Management 0 $0.00 $0 3200 Crisis Services 0 $0.00 $0 3300 Medication Support 0 $0.00 $0 3400 Collateral 0 $0.00 $0 3500 Plan Development 0 $0.00 $0 3600 Assessment 0 $0.00 $0 3700 Rehabilitation 0 $0.00 $0 Estimated Specialty Mental Health Services Billing Totals 0 $0 Estimated % of Clients that are Medi-Cal Beneficiaries 0% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP) 0.00%$0 State M/Cal Share of Cost % (BH Realignment/EPSDT) 0.00%$0 MEDI-CAL REVENUE TOTAL $0 OTHER REVENUE: 4100 Other - (Identify)$0 4200 Other - (Identify)$0 4300 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $424,808 5100 Community Services & Supports (CSS) Funds $0 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $424,808 TOTAL PROGRAM REVENUE $424,808