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DocuSign Envelope ID:69D59989-52CF-4A22-A158-77969288A018
Agreement No. 24-041
1 AMENDMENT NO. 2 TO LICENSE AGREEMENT
2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated
3 January 23, 2024 and is between Kings View, a California non-profit corporation
4 ("Licensee"), and the County of Fresno, a political subdivision of the State of California
5 ("Licensor").
6 Recitals
7 A. On December 23, 2021, the Licensor and the Licensee entered into County agreement
8 number D-21-560 (License Agreement), to co-locate in the building located at 1925 East Dakota
9 Avenue, Fresno, CA 93726, and provide behavioral health Crisis Intervention Team (CIT)
10 services.
11 B. On June 20, 2023, the Licensor and the Licensee entered into Amendment No. 1 to
12 License Agreement to increase the term of the License Agreement, not to extend past June 30,
13 2025, such that the Licensee may be able to continue providing necessary services.
14 C. The Department of Behavioral Health (DBH) receives funding from Federal Financial
15 Participation (FFP) Medi-Cal revenue, and Mental Health Services Act (MHSA) Prevention and
16 Early Intervention (PEI) funds).
17 D. There is a significant population of individuals in the Fresno metro area who are actively
18 experiencing a behavioral health crisis and experience the negative consequences of lacking
19 access to appropriate crisis intervention services.
20 E. The Licensee provides CIT services to individuals experiencing an acute behavioral
21 health crisis in the Fresno metro area utilizing a co-response model with law enforcement
22 agencies, pursuant to County agreement No. A-22-421.
23 F. On June 19, 2023, pursuant to Welfare and Institutions Code (W&I) Section 14132.57,
24 the California Department of Health Care Services (DHCS) released guidance through
25 Behavioral Health Information Notice 23-025 requiring implementation of the Medi-Cal
26 Community-Based Mobile Crisis Intervention Services benefit by county mental health plans
27 (MHPs) and Drug-Med-Cal Organized Delivery System (DMC-ODS) by December 31, 2023.
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DocuSign Envelope ID:69D59989-52CF-4A22-A158-77969288A018
1 G. The Licensor and the Licensee now desire to further amend the License Agreement to
2 comply with state mandates and be able to provide 24/7/365 CIT services.
3 The parties therefore agree as follows:
4 1. A portion of Section 6 of the Agreement, located on page 2, lines 21 through 24, is
5 deleted and replaced with the following:
6 "USE - Licensee shall have use of the Premises 24 hours a day, 7 days a week,
7 365 days a year, to provide the services as described in Exhibit B and Exhibit B-
8 1, attached and incorporated by this reference. Licensee agrees that its use of
9 the Premises shall, at all times, be consistent with providing these services."
10 2. Section 26 of the Agreement, located on page 12, lines 8 through 11, as previously
11 amended, is deleted and replaced with the following:
12 "This Agreement constitutes the entire Agreement between the Licensee and the
13 Licensor with respect to the subject matter hereof and supersedes all previous
14 Agreement negotiations, proposals, commitments, writings, advertisements,
15 publications, and understandings of any nature whatsoever unless expressly
16 included in this Agreement. In the event of any inconsistency in interpreting the
17 documents which constitute this Agreement, the inconsistency shall be resolved
18 by giving precedence in the following order of priority: (1) the text of this
19 Amendment No. 2; (2) Amendment No. 1; (3) the Agreement without Exhibits A
20 and B; and (4) Exhibits A through B-1."
21 3. When both parties have signed this Amendment No. 2, the Agreement, Amendment No.
22 1, and this Amendment No. 2 together constitute the Agreement.
23 4. The Licensee represents and warrants to the Licensor that:
24 a. The Licensee is duly authorized and empowered to sign and perform its obligations
25 under this Amendment No. 2.
26 b. The individual signing this Amendment No. 2 on behalf of the Licensee is duly
27 authorized to do so and his or her signature on this Amendment No. 2 legally binds
28 the Licensee to the terms of this Amendment No. 2.
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DocuSign Envelope ID:69D59989-52CF-4A22-A158-77969288A018
1 5. This Amendment No. 2 may be signed in counterparts, each of which is an original, and
2 all of which together constitute this Amendment No. 2.
3 6. The Agreement as previously amended and as amended by this Amendment No. 2 is
4 ratified and continued. All provisions of the as previously amended and not amended by this
5 Amendment No. 2 remain in full force and effect.
6 [SIGNATURE PAGE FOLLOWS]
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DocuSign Envelope ID:69D59989-52CF-4A22-A158-77969288Ao18
1 The parties are signing this Amendment No. 2 on the date stated in the introductory
2 clause.
3
KINGS VIEW COUNTY OF FRESNO
4
...
DocuSigned by:
5 FA^o^AA^ �vV� vine
6 Aman a ugent Divine, CEO Nathan Magsig, Chairman of the Board of
7 1396 W. Herndon Ave. Supervisors of the County of Fresno
Fresno, CA 93711 Attest:
8 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
10
By: _
11 deputy
12 For accounting use only:
13 Org No.: 56304763
Account No.: 7295
14 Fund No.: 0001
Subclass No.: 10000
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DocuSign Envelope ID:69D59989-52CF-4A22-A158-77969288A018
Exhibit B-1
Medi-Cal Mobile Crisis Benefit Response Team
SCOPE OF WORK
CONTRACTOR: Kings View
PROGRAMS: Metropolitan Crisis Intervention Team (Metro CIT)
LOCATION OF SERVICES: 1925 E. Dakota Ave., Suite Q, Fresno, CA 93726
I. BACKGROUND
Pursuant to Section 14132.57 of the Welfare and Institutions Code (W&I), Department of Health
Care Services (DHCS) sought all necessary federal approvals to provide qualifying community-
based mobile crisis intervention services to eligible Medi-Cal beneficiaries experiencing a mental
health and/or substance use disorder (SUD) crisis. Accordingly, DHCS submitted to the Centers for
Medicare and Medicaid Services (CMS) State Plan Amendment (SPA) 22-0043 that establishes
mobile crisis services as a new benefit in the Medi-Cal program. DHCS is not making any changes
to the existing crisis intervention services and SUD crisis intervention services benefits covered
under the Specialty Mental Health Services (SMHS), DMC and DMC-ODS delivery systems. Medi-
Cal behavioral health delivery systems shall continue covering these services in accordance with
existing federal and state, and contractual requirements.
Upon receiving approval from DHCS of its Medi-Cal mobile crisis implementation plan, Fresno
County shall provide, or arrange for the provision of, qualifying mobile crisis services in accordance
with the requirements set forth in BHIN 23-025. Mobile crisis services are an integral part of
California's efforts to strengthen the continuum of community-based care for individuals who
experience behavioral health crises.
II. SERVICES START DATE
The Contractor shall start services on January 9, 2024. In order to meet this start date, Contractor
will be using existing Medi-Cal site certification and DMC-ODS site certification. It is not the
expectation that the Contractor be fully staffed at the start of the services, but will be utilizing
existing staff for these services and hiring and training staff as appropriate.
III. TARGET POPULATION
The target population to be served by this program are individuals currently experiencing an acute
behavioral health crisis, including any behavioral health signs and symptoms, requiring immediate
crisis intervention, de-escalation, but not requiring law enforcement or first responders, within the
Fresno metropolitan (metro) area.
IV. LOCATION OF SERVICES
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Exhibit B-1
With the exception of the settings listed in the next paragraph, the mobile crisis response shall be
provided where the person served is in crisis, or at an alternate location of the individual's
choosing. Examples of settings include, but are not limited to:
• Houses and multi-unit housing;
• Workplaces;
• Public libraries;
• Parks;
• Schools;
• Homeless shelters;
• Outpatient clinics;
• Assisted living facilities; and
• Primary care provider settings.
Mobile crisis services shall not be provided in the following settings due to restrictions in federal
law and/or because these facilities and settings are already required to provide other crisis
services:
• Inpatient Hospital;
• Inpatient Psychiatric Hospital;
• Emergency Department;
• Residential SUD treatment and withdrawal management facility;
• Mental Health Rehabilitation Center;
• PHF;
• Special Treatment Program;
• Skilled Nursing Facility;
• Intermediate Care Facility;
• Settings subject to the inmate exclusion such as jails, prisons, and juvenile 21 detention
facilities;• Other crisis stabilization and receiving facilities (e.g., sobering centers, crisis
respite, crisis stabilization units, psychiatric health facilities, psychiatric inpatient hospitals,
crisis residential treatment programs, etc.).
Should the Contractor have any questions about which facilities are not considered part of
community response, they must immediately request such clarification from DBH and approval
prior to providing services.
Mobile crisis teams shall arrive at the community-based location where a crisis occurs in a timely
manner. Specifically, mobile crisis teams shall arrive within 60 minutes of the person served being
determined to require mobile crisis services in the metro area.
Post-crisis follow-up services are to be provided face-to-face, over the phone, using video or via
United States mail as appropriate and in accordance with DBH's Guiding Principles of Care
Delivery.
V. HOURS OF OPERATION
Contractor is required to be available to provide services 24 hours a day, 7 days a week, and 365
days a year.
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Exhibit B-1
VI. DESCRIPTION OF SERVICES
The mobile crisis response team (MCRT) will establish a rapid response, individual assessment
and community-based stabilization to persons served who are experiencing a behavioral health
crisis. MCRT services shall be designed to provide relief to persons served experiencing a
behavioral health crisis, including through de-escalation and stabilization techniques; reduce the
immediate risk of danger and subsequent harm; and avoid unnecessary emergency department
care, psychiatric inpatient hospitalizations, and law enforcement involvement. While mobile crisis
services are intended to support an integrated approach to responding to both mental and
substance use related crises, and mobile crisis teams will be carrying, trained, and able to
administer naloxone, this team is not intended to replace emergency medical services for
medical emergencies.
1. Dispatch
The telephone number 559-600-6000 will serve as the crisis services hotline connected to the
dispatch of mobile crisis teams to receive and triage calls from the community. The county's
24/7 Access Line, community partners, and other crisis lines such as the 988 Suicide and
Crisis Lifeline, local law enforcement and 911 systems, and the Family Urgent Response
System (FURS) will be able to refer calls to the county crisis service hotline.
Contractor is inclusive of the hotline operators who shall use a standardized dispatch tool and
procedures to determine when to dispatch a mobile crisis team, versus determine when the
person served needs can be addressed via alternative means. These means include, but are
not limited to, de-escalation by the hotline operator or connection to other services. The
hotline operator may also determine that the call needs to be routed to emergency services if
the situation has developed into a safety risk.
The hotline operators shall be live staff to receive and respond to all calls from the mobile
crisis service hotline. Hotline operators shall follow procedures identifying how mobile crisis
teams will respond to dispatch requests. When screened directly or through the individual
calling on their behalf to request assistance, and the standardized dispatch tool has been
used to determine mobile crisis services need, a mobile crisis team will be dispatched. The
mobile crisis team shall meet the person served who is experiencing the behavioral health
crisis in the location where the crisis occurs unless the person served requests to be met in
an alternative location in the community or cannot be located.
2. Crisis Response & Follow-up
The mobile crisis response teams will not respond with a law enforcement presence unless it
is determined to be required. The goal of the MCRT program is to provide more efficient
access to crisis services to person served, with the main goal of deescalating the situation to
avoid an emergency room visit and/or placement within an inpatient facility.
MCRT services shall include the following services:
- Warm handoffs to appropriate settings and providers when the person served requires
additional stabilization and/or treatment services;
- Coordination with and referrals to appropriate health, social and other services and
supports, as needed;
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- And short-term follow-up support to help ensure the crisis is resolved and the person
served is connected to ongoing care.
MCRT services are directed toward the person served in crisis but may include contact with a
family member(s) or other significant support collateral(s) if the purpose of the collateral's
participation is to assist the person served in addressing their behavioral health crisis and
restoring the person served to the highest possible functional level. For children and youth, in
particular, mobile crisis teams shall work extensively with parents, caretakers and guardians,
as appropriate and in a manner that is consistent with all federal and state laws related to
minor consent, privacy and confidentiality.
Contractor shall ensure that persons served receive a follow-up check-in within 72 hours of
the initial mobile crisis response. The purpose of the follow-up check-in is to support
continued resolution of the crisis, as appropriate, and should include the creation of or
updates to the person's served crisis safety plan, or additional referrals to ongoing supports,
as needed. If the person served received a referral to ongoing supports during the initial
mobile crisis response, as part of follow-up the mobile crisis team shall check on the status of
appointments and continue to support scheduling, arrange for transportation, and provide
reminders as needed.
Follow-up may be conducted by any mobile crisis team member who meets DHCS' core
training requirements and may be conducted in-person or via telehealth, which includes both
synchronous audio-only (e.g., telephone) and video interactions. Follow-up may be
conducted by a mobile crisis team member that did not participate in the initial mobile crisis
response. If the mobile crisis team member conducting follow-up is not part of the mobile
crisis team that provided the initial crisis response, the individual providing follow-up shall
coordinate with the team members that participated in the initial mobile crisis response to
gather information on the recent crisis and any other relevant information about the person
served. There may be times when the mobile crisis team is unable to engage the person
served in follow-up. Examples include but are not limited to the person served is in inpatient
treatment, otherwise incapacitated, unwilling to engage, or cannot be reached despite
reasonably diligent efforts. The mobile crisis team shall document those instances where the
person served cannot be engaged for follow-up.
These services will be continuously evaluated by the County and Contractor. The Contractor
must adapt to meet the geographically dispersed needs of those living in metropolitan Fresno
County, the communities' needs as crisis services and demands fluctuate, and as Fresno
County identifies more appropriate CIT models that improve service delivery.
3. Responding to the Needs of Children and Youth
Mobile crisis teams shall work with parents, caregivers, and guardians in a manner consistent
with state and federal privacy and confidentiality laws. These teams prioritize the well-being
and safety of individuals experiencing a crisis while also respecting the privacy and rights of
those involved.
• Assessment and initial contact: When a mobile crisis team responds to a crisis situation
involving a child or youth, they will conduct the standardized assessment tool to gather
relevant information about the situation. This may involve speaking with parents,
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caregivers, or guardians to understand the background, triggers, and any immediate
concerns.
• Collaboration and information sharing: The mobile crisis team will work collaboratively
with parents, caregivers, and guardians to develop a comprehensive understanding of the
needs and preferences of the child or youth involved. They may seek consent to
exchange information with relevant professionals, such as primary care providers or
therapists, to ensure comprehensive care.
• Privacy and confidentiality: Mobile crisis teams adhere to state and federal privacy laws,
such as the Health Insurance Portability and Accountability Act (HIPAA) in the United
States. This means they protect the privacy and confidentiality of individuals involved,
unless there is a legal requirement or serious safety concern that necessitates sharing
information with appropriate authorities or professionals.
• Informed consent: Mobile crisis teams will inform parents, caregivers, or guardians about
the purpose of their involvement, the services they can provide, and the limits of
confidentiality. The team will obtain informed consent before initiating any services or
sharing information, ensuring that everyone involved is aware of their rights and
responsibilities.
• Collaboration and support: Throughout the crisis intervention process, mobile crisis teams
will engage parents, caregivers, and guardians in developing a crisis response plan. They
will provide support, education, and resources to enhance the family's ability to manage
crises and promote the well-being of the child or youth.
4. Coordination with Other Delivery Systems
A mobile crisis response is a powerful indicator that an individual needs additional
services or that something is not working well with their current array of services; it
warrants an alert to other providers who are involved in the individual's care and
coordinated follow-up.
Contractor shall establish policies and procedures to ensure mobile crisis services are
integrated into a whole person approach to care. Policies and procedures may include,
but are not limited to:
- Contractor shall alert the person's served Medi-Cal behavioral health delivery
system within 48 hours of a mobile crisis response and provide basic information
about the encounter (e.g., disposition of the mobile crisis call);
- The Medi-Cal behavioral health delivery system shall inform the Contractor if they
are aware if the person served is receiving care management through targeted
case management, ICC, ECM, or any other benefit including non-Medi-Cal
benefits such as Full-Service Partnership;
- Contractor shall alert the person's served MCP, if known, of the behavioral health
crisis; and
- If a mobile crisis team receives information that a person served is receiving
services from a care manager, it shall alert the person's served care manager(s) of
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the behavioral health crisis, as applicable, and coordinate referrals and follow-up
consistent with privacy and confidentiality requirements.
- Mobile crisis teams shall ensure that they have the person's served consent for
these disclosures in cases where consent is required by applicable law.
5. Collaboration with Law Enforcement
The Contractor shall establish and maintain collaborative relationships with the Fresno
County Police Departments. The Contractor shall be willing to provide information on the
program services through trainings and infographics to our community and law enforcement
partners.
6. Collaboration with EMS
As a Central California Emergency Medical Services Agency, Fresno County through its
Department of Public Health obtained approval for paramedic triage to alternate destination
(PAD) services Under PAD, local EMS responds via 911 emergency services dispatch or call
from behavioral health provider to a community-based behavioral health crisis where an
involuntary hold has been placed and provides transportation to the county's crisis
stabilization center and no medical emergency is present. The Contractor shall establish and
maintain collaborative relationships with local EMS services as EMS will continue to provide
transportation services for person served.
7. Collaboration with FURS
The local FURS services are coordinated through the Department of Social Services,
Probation Department, and a county contracted provider of behavioral health services for
24/7 in-home/community mobile response within prescribed timeframes for current and
former foster youth, including foster youth currently or formerly involved with Probation
Department. The contracted FURS mobile response team provides services such as de-
escalation, crisis stabilization and reconnection to social services or mental health services.
As with current contracted crisis co-response services, when it is determined that the person
served is eligible for FURS, the mobile crisis hotline and/or team will coordinate services by
informing the individual of FURS as a resource and provide linkage to Child Welfare Services
partners. If appropriate, the mobile crisis hotline may dispose the call to the local FURS
services.
The local FURS services may also refer to the mobile crisis hotline if the youth is determined
to need higher level of care. FURS mobile response team members who are clinical staff are
not delegated authority under the MHP to evaluate for involuntary holds. In the event that the
FURS team is unable to de-escalate a youth that is in crisis, mobile crisis teams may be
dispatched to the location if appropriate.
To ensure effective engagement with FURS and County Social Services so that the most
appropriate system is providing crisis response, interagency collaboration will be needed to
share information, streamline processes and coordinate services effectively. The Contractor
shall establish and maintain collaborative relationships with local FURS services.
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8. Documentation and Billing
• Contractor will use Fresno County DBH's electronic health record (EHR) and billing system,
and business management platform to conduct data analysis.
• Contractor must complete all documentation within 24 hours of service delivery, including
but not limited to: access forms, client referral forms and progress notes. In addition, all
related documents need to be uploaded within the same timeframe.
• Contractor must adhere to the documentation standards established in DHCS's CalAIM
Documentation Manuals as well as any future amendments to these documents on the
CaIMHSA website.
• Contractor shall utilize collaborative documentation with the person served whenever it is
clinically indicated. Staff must adhere to DBH's collaborative documentation standards,
which may include training courses offered by DBH.
9. Care Coordination and Community Collaboration
• Contractor shall participate in care coordination activities with DBH, law enforcement and
other community agencies.
• Contractor agrees to coordinate with the Family Urgent Response System in Fresno County
and utilize this program as a resource for qualified individuals.
• Comprehensive knowledge of community resources is essential for case management staff
to refer persons served to appropriate services. Contractor must make all attempts to
ensure program staff are aware of applicable community resources and how to refer to
these programs.
• If the person served is linked to a DBH program, Contractor will notify the service provider
as soon as practicable.
VII. STAFFING
Contractor shall provide a staffing plan that is clear and concise and allows for full implementation
of all services described in the program. Staff shall be qualified in education experience, clinical,
and cultural competencies according to MHP provider manual requirements.
The CIT crisis co-response programs are currently staffed with Licensed or Associate-Level Mental
Health Professionals (LMHP), Licensed or Associate-Level Practitioners of the Healing Arts (LPHA)
and Other Qualified Providers, specifically case managers. The MCRT program shall use these
provider types in teams of two with at least one team member being a licensed or associate level
clinician. This will allow for the clinical support and expertise needed to determine if the person
served requires further treatment at a higher level of care and authority to take the person served
into custody for a 72-hour involuntary hold (5150 hold) under Welfare and Institutions (W&I) 5150.
Contractor shall follow best practice and have the two providers be physically present onsite during
the initial mobile crisis response. At least one onsite team member will conduct the crisis
assessment. At least one onsite team member will be carrying, trained and able to administer
naloxone.
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Contractor shall provide robust, comprehensive, and ongoing training and mentoring
to staff in evidence-based practices (EBP) of the program to ensure fidelity and to build
competency and expertise of their staff. In addition to EBPs, Contractor shall provide
training to on co-occurring and trauma informed practice.
All mobile crisis team staff, including hotline operators and mobile crisis responders, shall complete
the DHCS' core training requirements made available on the County's e-learning website. Training
may include, but is not limited to, delivering culturally responsive care, particularly when working
with children, youth and young adults who are LGBTQ+, Black, Indigenous, and People of Color,
involved in the child welfare system, or living with intellectual and/or Developmental Disabilities
(I/DD). Mobile crisis teams shall abide by all state and federal minor consent laws. Required
training shall also include an overview of existing minor consent obligations and appropriate
protocols for communicating with parents, guardians and other responsible adults who may or may
not be present at the time of the crisis. In order to ensure the most appropriate systems are
responding to a crisis, the mobile crisis hotline operator and mobile crisis team will be familiar with
FURS, Regional Centers and other dispatch lines to be able to coordinate referrals as appropriate.
Contractor shall demonstrate staff proficiency (training and certification) in suicide and crisis
intervention procedures and other training subjects that would benefit the individuals in their
wellness goals.
Contractor shall ensure clinical supervisor(s) will oversee the work of the clinicians, including
approving documentation and claiming in the electronic medical records as required. The clinical
supervisor(s) shall be able to provide Board of Behavioral Sciences (BBS) supervision.
All staff, who provide direct care or perform coding/billing functions, must meet the requirements of
the Fresno County Mental Health Plan (FCMHP) Compliance Program. This includes the screening
for excluded persons and entities by accessing or querying the applicable licensing board(s), the
National Provide Data Bank (NPDB), Office of Inspector General's List of Excluded
Individuals/Entities (LEIE), Excluded Parties List System (EPLS) and Medi-Cal Suspended and
Ineligible List prior to hire and monthly thereafter. In addition, all licensed/registered/waivered staff
must complete a FCMHP Provider Application and be credentialed by the FCMHP's Credentialing
Committee. All licensed staff shall have Department of Justice (DOJ), Federal Bureau of
Investigation (FBI), and Sherriff fingerprinting (Live scan) executed.
VIII. REPORTING
Contractor shall comply with the following reporting requirements:
1. DHCS Reporting:
a. Contractor shall provide data necessary for all reports mandated by DHCS.
2. CSI Reporting
a. Contractor shall work with DBH to capture and enter all Client Service Information (CSI),
admission data, and billing information into DBH's data system for the purposes of
effective care coordination and State reporting. Contractor shall provide all necessary
data to allow DBH to capture all CSI data for services provided and to meet all State and
Federal reporting requirements. Methods of providing such information include, but not
limited to, the following:
i. Direct data entry in DBH's electronic information system; or
ii. Provide an electronic file compatible with DBH's electronic information system.
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3. Contractor shall comply with all reporting requests made by DBH. Reporting requirements are
subject to change as the program develops.
IX. PERFORMANCE AND OUTCOME MEASUREMENTS
Contractor shall comply with all project monitoring and compliance protocols, procedures, data
collection methods, and reporting requirements requested by the County. County and Contractor
shall use performance outcome measures for evaluating program and system effectiveness to
ensure services and service delivery strategies are positively impacting the service population.
In addition, these measures shall be used to ensure the program is in alignment with MHSA
guiding principles which are inclusive of: an integrated service experience; community
collaboration; cultural competence; individual/family driven service; and wellness, resilience, and
recovery-focused services.
Performance outcome measures shall be tracked on an ongoing basis and used to update the
County monthly. In addition, performance outcome measures are reported to the County annually
in accumulative reports for overall program and contract evaluation. Forms and tools used to
gather, and report data reflecting services provided, populations served, and impact of those
services are to be developed by the County and Contractor. Contractor will work closely with the
County to analyze the data and make necessary adjustments to service delivery and reporting
requirements before the start of each new fiscal year and at appropriate intervals during the fiscal
year.
Measurable outcomes may be reviewed for input and approval by a designated DBH work group
upon contract execution and adjusted as needed each new fiscal year. The purpose of this
review process is to ensure a comprehensive system-wide approach to the evaluation of
programs through an effective outcome reporting process.
The following items listed below represent program goals to be achieved by Contractor. The
program's success will be based on the number of goals it can achieve, resulting from performance
outcomes. Contractor will utilize a computerized tracking system with which outcome measures
and other relevant individual data, such as demographics, will be maintained.
Contractor will collect data about the characteristics of the individuals served and measure service
delivery performance indicators in the four Commission on Accreditation of Rehabilitation Facilities
(CARF) domains listed below, with at least one performance indicator for each of the four domains.
Contractor shall submit annual outcomes on a report template to be provided by the County for
each level of care provided.
1. Effectiveness
2. Efficiency
3. Access
4. Satisfaction & Feedback of Persons Served & Stakeholders
Additional Reporting Requirements
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Contractor will be responsible for meeting with DBH on a monthly basis, or more often as agreed
upon between DBH and Contractor, for contract and performance monitoring. Contractor will be
required to submit monthly reports to the County that will include, but not be limited to: dollars
billed for Medi-Cal, CCMU, and MHSA (non-Medi-Cal or non-Medi-Cal services); persons served;
actual expenses; the number of persons served/anticipated to be served; wait lists; utilization of
services by persons served; and staff composition. These reports will be due within 30 days
after the last day of the previous month or payments may be delayed.
DBH requires the following data reporting, which must be submitted to the Department by the 101" of
each month, unless otherwise indicated. The reporting period is typically the prior month in which
services were provided. The following funding, staffing, services and data must be collected,
maintained and reported by the established deadlines. Reporting templates and requirements are
subject to change based on State and Federal regulations, funding guidelines and efforts to improve
service delivery.
A. Invoices must be submitted each month and shall include expenses and revenues from the
prior month.
B. The Monthly Staffing Report shall be submitted each month and must include each program
staff member, their title, full-time equivalent, salary and other information as deemed
appropriate by DBH.
C. CCMU grant reports must be submitted at least quarterly, but more frequently as needed.
D. Annual Performance Outcome Measures reports shall be completed at least annually and
submitted to DBH as requested. County staff will notify the awarded vendor when its
agency's participation is required. The performance outcome measurement report process
will include survey instruments, person served and staff interviews, chart reviews, and other
methods of obtaining necessary information as appropriate.
The Contractor will be required to provide culturally and linguistically appropriate services that
align with the National Standards for Culturally and Linguistically Appropriate Services and DBH
PPG 1.5.1 Culturally and Linguistically Appropriate Services as well as any updates to these
standards. The program will be required to report staff training related to cultural competency as
requested by DBH.
B-1-10