HomeMy WebLinkAboutAgreement A-12-232-3 with WestCare California, Inc..pdfAgreement No. 12-232-3
AMENDMENT Ill TO AGREEMENT 1
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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
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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.
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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.
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11\J WfFNESS' WHEREOF, the:'parties hereto have. executed this Amendment Ill to Agreement
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.00.UNTY OF F~J:SNO
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1nc,r.~ot-l~""1 ... ~•Coynty of Fresno
ATTEST:
B~rriid~'E. Seidel
.c1erk;JjfttieBoard. of supervisors
Coi.inWof: Fresno, state:of California
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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