HomeMy WebLinkAboutAgreement A-19-113 with CalMHSA.pdfAgreement No . 19-113
Agreement No . 421-2018-PT-FC
03/12/2019
1.
CALIFORNIA MENTAL HEALTH SERVICES AUTHORITY
PARTICIPATION AGREEMENT
COVER SHEET
Fresno County ("Participant") desires to participate in the Program identified below .
Name of Services : Inter-Member Transfer(s)
2. California Mental Health Services Authority ("CalMHSA ") and Member Participants' acknowledge
that the services will be governed by CalMHSA's Joint Powers Agreement and its Bylaws, and by
this Participation Agreement . The following exhibits are intended to clarify how the provisions of
those documents will be applied to this Program .
Exhibit A Program Services Descript ion
Exhib it B General Terms and Cond ition s
Exhib it C Member County-Specific Scope and Funding
3. Term of Services : This Agreement shall become effective upon execution and shall terminate on
the 30th of June 2022.
4. Deposit: The initial deposit payable by Participant is Seventy Eight Thousand Five Hundred Sixty
and No/100 Dollars ($78,560) plus an administrative fee that is not to exceed five percent (5 %),
payable within 45 days upon execution of this Agreement .
5. The maximum amount payable under this Agreement is Six Hundred Thousand and No/100
Dollars ($600,000). Any additional funding required in order to process transfer requests , shall be
by mutual agreement of the parties followed by executing an Agreement Amendment .
6 . Authorized Signatures:
CalMHSA
Signed : ____________ Name (Printed): John E. Chaquica, CPA, MBA, ARM
Title : _....;C=h=ie=f:....O::a..c.pe=r;...;::a=ti'""n""g'-'O:;;,.;ff"'"i=c=e:....r _____ _ Date : _________ _
Participant: Fresno County
Signed : See Attached Signature Page Name (Printed): __________ _
Title : ________________ _ Date: _________ _
Fresno County Participation Agreement
Agreement No. 421-2018-PT-FC
03/12/2019
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year
first hereinabove written .
CONTRACTOR:
See Previous Signature Page
(Authorized Signature)
Print Name & Title
Mailing Address
FOR ACCOUNTING USE ONLY:
ORG No.: 56302666
Account No.:7223
COUNTY OF FRESNO
Nathan Magsig,
Chairman of the Board of Supervisors
of the County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
Fresno County Participation Agreement -Exhibit A -Program Description and Funding
Page 2 of B
Agreement No. 421-2018-PT-FC
03/12/2019
Fresno County Participation Agreement – Exhibit A - Program Description and Funding
Page 3 of 8
EXHIBIT A
PROGRAM SERVICES DESCRIPTION
I. Name of Program –Inter-Member Transfer(s)
II. Program Overview
Under the Welfare and Institution Code § 14717.1, responsibility for providing or arranging for
specialty mental health services shall promptly transfer from the county of original jurisdiction to
the county in which a foster child resides, subject to any exceptions established pursuant to that
section. This is known as “presumptive transfer.” Counties have agreed that the county of original
jurisdiction (sending county) remains responsible for reimbursing the receiving county for
specialty mental health services provided or arranged by the receiving county. Under this
program, CalMHSA acts as a fiscal agent for participating counties to make and receive transfer
payments of county match dollars.
III Program Process
A. A funding structure shall be developed based on funding by each participant, as well as timing.
It is deemed that an annual funding mechanism would be ideal, especially if through the State
Controllers Officer. However, it may be such that quarterly transfers from the counties’,
would be the initial process.
B. All members shall have funding on deposit, no matter what the net expected funding level is
anticipated. As such a minimum annual amount to be funded by any member shall be
defined.
C. Triggers shall be defined for the initiation of the funding process. With this trigger, processes
shall be in place to discern the amount of payment and by such date.
D. The mechanics of transferring funds shall be the same for each receiving and paying member.
Agreement No. 421-2018-PT-FC
03/12/2019
Fresno County Participation Agreement – Exhibit B – General Terms & Conditions
Page 4 of 8
EXHIBIT B
GENERAL TERMS AND CONDITIONS
I. Definitions
The following words as used throughout this Participation Agreement shall be construed to have
the following meaning, unless otherwise apparent from the context in which they are used:
A. CalMHSA – California Mental Health Services Authority, a Joint Powers Authority (JPA)
created by counties in 2009 at the instigation of the California Mental Health Directors
Association to jointly develop and fund mental health services and education programs.
B. County (Sending) – A Sending County, is one that is transferring foster youth to facility
located outside of its jurisdiction.
C. County (Receiving) – A Receiving County is one in which a foster youth is being placed in
a facility located within their county jurisdiction.
D. Member – A County, City or JPA of two or more Counties, that has joined CalMHSA and
executed the CalMHSA Joint Powers Agreement.
E. Participant – Any Member participating in the Program and a member of CalMHSA
F. Program Services – The program identified in Exhibit A.
G. Vendor – Vendor or supplier providing specialty mental health services to foster youth.
H. Child – Foster youth receiving specialty mental health services.
I. HIPAA – The Health Insurance Portability and Accountability Act which:
Provides the ability to transfer and continue health insurance coverage for
millions of American Workers and their families when they change or lose their
jobs;
Mandates industry-wide standards for health care information on electronic
billing and other processes;
Requires the protection and confidential handling of protected health
information.
II. Responsibilities
A. Responsibilities of CalMHSA:
1. Act solely as the fiscal and administrative agent to facilitate transfer of funds
between Participants in compliance with instructions from and authorization by
Participants, without any responsibility for validation or control over the funded
services or activities.
2. Establish a banking pool that includes an individual interest-bearing account for
each county. Any interest accrued will be credited to the county. All transactions
in and out of the account will be provided regularly to each county.
3. Establish written internal control procedures to ensure understanding and sound
accounting controls, including items such as defining a trigger for a transaction,
the rate of payment, timing of payment, depositing of funds and reporting.
Agreement No. 421-2018-PT-FC
03/12/2019
Fresno County Participation Agreement – Exhibit B – General Terms & Conditions
Page 5 of 8
4. Management of and accounting for funds received consistent with the
requirements of any applicable laws, regulations, guidelines and/or contractual
obligations.
5. Keep all necessary records and provide regular fiscal reports to Participants
and/or other public agencies with a right to such reports.
6. Compliance with CalMHSA’s Joint Powers Agreement and Bylaws.
7. HIPAA/PHI – To the extent there is privileged information shared between
agencies, which is subject to protection under the HIPAA/PHI Act, CalMHSA shall
implement all necessary measures in compliance with the Act.
B. Responsibilities of Participant:
1. Transfer of funds for the Program as specified in Exhibit C, County-Specific Scope
and Funding, including administrative fee.
2. Participants are required to provide a timely, continuous contribution based on
actual usage, in order to comply with the all contractual obligations. Due to the
nature of the program and the specialty of services being provided to youth,
contributions are due fifteen (15) days from date of notice to replenish.
3. Identification of a representative authorized to act for Participant and receive
notices on behalf of Participant with regard to the Program.
4. Cooperate by providing CalMHSA and the other participating counties (and any
other parties deemed necessary) with requested information and assistance in
order to fulfill the purpose of the Program.
5. Any and all assessments, creation of individual case plans, and providing or
arranging services.
6. Compliance with applicable laws, regulations, guidelines, contractual
agreements, CalMHSA’s JPA Agreement, and Bylaws.
7. Instructions for and authorization of transfers to be made by CalMHSA.
8. Indemnification as described in Section VI.
9. HIPAA/PHI – To the extent there is privileged information shared between
agencies, which is subject to protection under the HIPAA/PHI Act,
County/Member shall implement all necessary measures in compliance with the
Act.
III. Duration, Term and Amendment
A. The Program is of indefinite duration, and will continue as long as Participants wish to act
together to conduct the Program. However, the obligation of any Member to pay funds
is limited to the periods and amounts stated in Exhibit C, County-Specific Scope and
Funding.
Agreement No. 421-2018-PT-FC
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Fresno County Participation Agreement – Exhibit B – General Terms & Conditions
Page 6 of 8
B. This Agreement may be supplemented, amended or modified only by the mutual
agreement of CalMHSA and the Participant, expressed in writing and signed by authorized
representatives of both parties.
C. Any Participant may withdraw from the Program upon six (6) months' written notice.
Notice shall be deemed served on the date of mailing.
IV. Withdrawal, Cancellation and Termination
A. The withdrawal of a Participant from the Program shall not automatically terminate its
responsibility for its share of the expenses and liabilities of the Program. The contributions
of current and past Participants are chargeable for their respective share of unavoidable
expenses and liabilities arising during the period of their participation
B. Upon cancellation, termination or other conclusion of the Program, any funds remaining
undisbursed after CalMHSA satisfies all obligations arising from the operation of the
Program shall be distributed back to the participating counties proportionally based on
the amount by which deposits made to the account of the Participant exceed the
payments disbursed from the account of the Participant.
V. Fiscal Provisions
A. Participants will share in the costs of planning, administration and evaluation in the same
proportions as their overall contributions, which are included in the amount stated on
first page of this Agreement.
B. Fees for the cost of performing these services will be based on the time extended to
perform the core services that are applicable to all Participants, no matter how frequent
or the amount of transfers. These services include, reporting, reconciling, investing,
banking, communication, and overall program management. The cost for the
transactional services—processing and recording of payments—will be based on
frequency. The same transactional cost is applicable to both the paying and receiving
participants.
C. The total fees will be based on the above and the number of participants. An allocation
formula will be developed to incorporate the two types of costs—core and transactional.
D. Participants are required to provide a timely, continuous contribution based on actual
usage, in order to comply with the all contractual obligations. Due to the nature of the
program and the specialty of services being provided to youth, contributions are due
fifteen (15) days from date of notice to replenish.
VI. Limitation of Liability and Indemnification
A. CalMHSA is responsible only for transfer of funds between county accounts as instructed
and authorized by Participants. CalMHSA is not liable for damages beyond the amount of
any funds which it transfers without authorization or contrary to Participant’s
instructions.
Agreement No. 421-2018-PT-FC
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Fresno County Participation Agreement – Exhibit B – General Terms & Conditions
Page 7 of 8
B. CalMHSA is not undertaking responsibility for assessments, creation of case or treatment
plans, providing or arranging services, and/or selecting, contracting with, or supervising
providers (collectively, “mental health services”). To the fullest extent permitted by law,
each party shall hold harmless, defend and indemnify the other party, including its
governing board, employees and agents from and against any and all claims, losses,
damages, liabilities, disallowances, recoupments, and expenses, including but not limited
to reasonable attorney’s fees, arising out of or resulting from other’s negligence in the
performance of its obligations under this Agreement, including the performance of the
other’s subcontractors, except that each party shall have no obligation to indemnify the
other for damages to the extent resulting from the negligence or willful misconduct of
any indemnitee. Each party may participate in the defense of any such claim without
relieving the other of any obligation hereunder.
This Participation Agreement does not anticipate CalMHSA performing any validation or verification of
the accuracy of the data supplied. Those services may be appended if deemed necessary.
Agreement No. 421-2018-PT-FC
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Fresno County Participation Agreement – Exhibit C – Scope and Funding Page 8 of 8
EXHIBIT C
SCOPE AND FUNDING
CalMHSA will be contracted to perform fund transfers on behalf of counties in order to allow foster
children who are placed outside of their county of original jurisdiction to access specialty mental health
services in a timely manner. The defined process is “presumptive transfer,” which means a prompt transfer
of the responsibility for the provision of, or arranging and payment for SMHS from the county of original
jurisdiction (sending county) to the county in which the foster child resides (receiving county), as provided
for by Welfare and Institution Code § 14717.1.
PROGRAM ACTIVITIES AND PROCESS:
To fulfill the Participant’s obligations under Welfare and Institution Code § 14717.1, the Parties will
undertake the following responsibilities.
A. CalMHSA will create a banking pool that includes a ledger for each participating county that
identifies and tracks all transactions.
B. Counties provide an estimated annual (or quarterly) payment (which includes an administrative
fee) to CalMHSA, of the non-Federal Financial Participation (FFP) portion of cost of services
anticipated for SMHS, for their youth in foster care outside of their county. (Administrative Fee to
be determined by CalMHSA)
C. County with the youth placement and SMHS organizations (Receiving County):
1. Receives a presumptive transfer and is required by statute to provide or arrange
appropriate treatment services;
2. Receives an assessment from the sending county and/or assesses the youth itself;
3. Provides or contracts with organizations to provide SMHS to foster youth in their county
D. Receiving county receives provider statement for services rendered, or prepares statement for
services provided directly.
E. Receiving county bills Medi-Cal.
F. Receiving county obtains approval from Sending county for payment, upon receipt of approval
this triggers invoice to CalMHSA with proof of services billed (Form 835), from sending county
account, for the services provided by contract or by the receiving county.
G. Receiving county reimburses the provider timely for services provided.
H. CalMHSA reimburses receiving county with non-FFP match from sending county funds for services
rendered.
INIITIAL FUNDING AMOUNT
$_78,560_______________