HomeMy WebLinkAboutAgreement A-23-054 Amendment to Agreement with DSH.pdf Agreement No. 23-054
STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES SCO ID:4440-2176003008-Al
STANDARD AGREEMENT-AMENDMENT
STD 213A(Rev.412020) AGREEMENT NUMBER AMENDMENT NUMBER Purchasing Authority Number
® CHECK HERE If ADDITIONAL PAGES ARE ATTACHED 5 PAGES I 21-76W3-008 i Al DSH-4440
1,This Agreement is entered into between the Contracting Agency and the Contractor named below:
CONTRACTING AGENCY NAME
Department of State Hospitals
CONTRACTOR NAME
Fresno County Sheriff's Office
2 The term of this Agreement is:
START DATE
July 1.2021
THROUGH END DATE
June 30.2024
3.The maximum amount of this Agreement after this Amendment is:
$360,000.00
Three Hundred Sixty Thousand Dollars and Zero Cents
4.The parties mutually agree to this amendment as follows.All actions noted below are by this reference made a part of the Agreement and
incorporated herein:
A. This amendment adds$180,000.00 to the original agreement of$180.000.00 for a new maximum agreement of$360,000,00.
B.Exhibit B,"Budget Detail and Payment Provisions"is attached hereto,Deletions are in strike-through and additions are in bold.
All other terms and conditions shall remain the same.
W WITNESS WHEREOF THISAGREEMENT HAS BEEN EXECUTED BY THEPARTIES HERETO.
CONTRACTOR
CONTRACTOR NAME(if other than an individual,state whether a corporation,partnership.etc.)
Fresno County Sheriffs Office
CONTRACTOR BUSINESS ADDRESS CITY STATE ZIP
2200 Fresno Street ATTEST: Fresno CA 193721
PRINTED NAM Or PERSON SIGNING BERNICE E.SEIDEL TITLE
Sal Quintero Clerk of the Board of Supervisors Chairman of the Board of Supervisors
Cou iy of Fres o,State of California
CONTRACTOR AUTHORIZED SIGNATURE DATE SIGNED
_ Bv / —_Deputy
A\AA- .� ��/:�/�-' 3
STATE OF CALIFORNIA
CONTRACTING AGENCY NAME
Department of State Haspital,
CONTRACTING AGENCY ADDRESS CITY STATE ZIP
1215 0 Street.MS-1 Sacramento CA 95814
PRINTED NAME OF PERSON SIGNING TITLE
Section Manager,PCSS
Enoth Hiatt
DATE SIGNED
CONTRACTING AGENCY AUTHORIZED SIGNATURE
02/24/2023
EXEMPTION(if Applicable)
CALIFORNIA DEPARTMENT OF GENERAL SERVICES +N&t code 4335.2(0
APPROVAL
Page 1 of 1
Department of State Hospitals Fresno County Sheriff's Office
Agreement Number 21-76003-008
Exhibit A, Scope of Work
EXHIBIT A
SCOPE OF WORK
1. CONTRACTED PARTIES:
A. This Agreement is made and entered into by and between. the Department of State Hospitals
(DSH) and Fresno County Sheriff's Office, hereafter referred to as Contractor, to provide DSH with
relevant inmate medical records, including mental health and behavioral health records, and
coordinate telehealth video interviews of defendants who have been committed to DSH as
Incompetent to Stand Trial (IST) on a felony charge, and are awaiting admission to a DSH facility.
Services are to be provided in accordance with Welfare and Institutions Code (WIC) section 4335.2
and are identified as IST Re-Evaluation services herein. IST Re-Evaluation Services performed by
DSH will be for the purposes of re-evaluating competency status, psychotropic medication status,
and assessment for placement in an alternative community based programs including but not
limited to mental health diversion or community based restoration.
2. SERVICE LOCATIONS:
A. These services will be performed primarily through remote telehealth, video conferencing and other
technologies facilitated by the county jail or other county locations housing felony IST defendants
and in coordination with the DSH
3. SERVICE HOURS:
A The services shall be provided upon request during the hours of operation of the locations where
services are required. DSH shall make every effort to assign work to be performed Monday through
Friday, during core hours of 7:00 am to 7:00 pm.
4. PROJECT REPRESENTATIVES:
A. The project representatives during the term of this Agreement will be.
Contract Manager
Department of State Hospitals: Contractor
Section/Unit: Section/Unit:
Forensic Services Division Fresno County Sheriffs Office
Attention: Attention:
Gilbert Jackson, SSM I Steve McComas, Assistant Sheriff
Address: Address:
1215 0 Street, MS-9 2200 Fresno Street
Sacramento, CA 95814 Fresno CA 93721
Phone: Fax: Phone: Fax:
(916) 562-2810 (916) 653-2257 (559)-600-8145 N/A
Email Email:
Gilbert.Jackson@dsh.ca.gov Stephen.McComas fresnosheriff.or
Page 1 of 4
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number: 21-76003-008
Exhibit A, Scope of Work
Administrative Contacts all administrative in uiries should be directed to):
Department of State Hospitals: Contractor: Insert Contractor's Name,
Section/Unit: Section/Unit:
Forensic Services Division Fresno County Sheriffs Office
Attention: Attention:
Kecia Aldridge-Hall Steve McComas, Assistant Sheriff
Address Address:
1215 0 Street, MS-9 2200 Fresno Street
Sacramento, CA 95814 Fresno, CA 93721
Phone: Fax Phone: Fax.
916 562-3022 916 653-2257 559 -600-8145 N/A
Email: Email:
Kecia.Aldrid e dsh.ca. ov Stephen.McComas fresnosheriff.or
Either party may make changes to the contact names or information above by giving written notice
to the other party. Said changes shall not require an amendment to this Agreement.
5. SUMMARY OF WORK TO BE PERFORMED:
A. The Contractor shall provide DSH with relevant and updated records of IST defendants who have
been selected by DSH to participate in this program.
B. The Contractor shall coordinate with DSH for the scheduling of interviews of those IST defendants
selected to participate in primarily telehealth video interviews.
C The Contractor shall provide the necessary secure setting, technology, and security for these
evaluations.
D. The DSH makes no representation as to the minimum amount of services required under this
Agreement.
E WIC section 4335.2, subdivision (c) provides, DSH shall have the authority and sole discretion to
consider and conduct reevaluations, which will occur primarily through video telehealth
6. CONTRACTOR RESPONSIBILITIES:
A. The Contractor agrees to provide support services to DSH that shall include but not be limited to:
i. Securing and maintaining all necessary equipment such as a laptop or electronic tablets
installed with appropriate software and having access to a secured internet connection
required to facilitate telehealth video interviews with the DSH-assigned forensic evaluators.
DSH shall reserve the right to approve the software application that will be utilized for tele-
health video interviews of IST defendants.
ii. Coordinating with DSH forensic evaluators and other assigned staff in the scheduling of tele-
health interviews within 24 hours of DSH contact
iii. Providing DSH with all relevant and updated inmate medical records which include, but are
not limited to, general medical records, mental health records, behavioral health records, and
custodial records, upon request by DSH and, at a maximum of 24 hours from the initial
request.
Page 2 of 4
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number: 21-76003-008
Exhibit A, Scope of Work
iv. Providing DSH with a contact to facilitate any DSH Evaluator requested collateral contacts
with jail and/or medical staff.
V. Providing the necessary logistics to facilitate the scheduled tele-health interview with the IST
defendant. Logistics shall include, but not be limited to, escorting the IST defendant from the
individual's cell to the interview room where the telehealth video interview will take place and
providing securby and monitoring of the IST defendant as necessary.
vi. Providing DSH and evaluators with a contact for technical assistance, and an emergency
contact to report any incidents that may arise during the interviews.
vii. Providing evaluators with access and security for any in-person interviews, which may occur
at the sole discretion of DSH.
viii. If services are provided on DSH grounds, then the Contractor shall participate in any of the
DSH workplace violence prevention, infection control-illness prevention, and workplace safety
measures or programs as may be required by DSH. This responsibility includes compliance
with infection control measures, use of Personal Protective Equipment (PPE) as prescribed by
DSH, attending any and all related training or orientation to such measures or programs as
may be required and scheduled by the DSH. DSH will provide the Contractor with electronic
versions of the DSH's current Illness and Injury Prevention Plan (IIPP), Workplace Violence
Prevention Plan (WVPP), DSH Code of Safe Practices, and other appropriate documents to
support worksite safety and infection control.
7. THE DSH RESPONSIBILITIES:
A. The DSH will provide the Contractor access to the DSH document management platform.
B. The DSH will provide the Contractor one-time start-up funds, based on a flat rate set by DSH, for
reimbursement of information technology support, equipment and software necessary to facilitate
telehealth interviews such as laptops or tablets, internet and the associated licensing for necessary
software in coordination with DSH.
C The DSH will reimburse Contractor for a portion of staff time utilized to facilitate video telehealth
interviews for each telehealth evaluation conducted Refusals will only be paid when Defendant
declines to be interviewed to the evaluator, when the evaluator has the opportunity to speak to, see,
and observe the defendant. Reimbursement will be based on a flat rate set by DSH
D. The DSH will coordinate with the Contractor regarding scheduling interviews, records requests,
and collateral interview contacts for IST defendants
E. The DSH will provide Contractor with the most current approved IST invoice template. Contractor
will be paid on a quarterly basis in arrears following the conclusion of the telehealth evaluations.
Page 3 of 4
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number: 21-76003-008
Exhibit A, Scope of Work
8. PERFORMANCE MEASURES:
A. Complete and Timely Provision of Services
i. Expectations: Contractor is expected to provide all services which include, but are not limited
to, providing DSH with collateral contacts, relevant records and scheduling interviews, in a
timely manner—in accordance with timelines established by DSH
9. AMENDMENTS:
A. The parties reserve the right to amend this Agreement by extending the term for up to one (1) one-
year renewal and to add funding sufficient for that period at the same rates. This right to amend is in
addition to the right to amend for other reasons contained in this Agreement. Any amendments shall
be in writing and signed by both parties, and be approved by the Department of General Services if
such approval is required.
Page 4 of 4
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number 21-76003-008 Al
Exhibit B,Budget Detail and Payment Provisions
EXHIBIT B
BUDGET DETAIL AND PAYMENT PROVISIONS
1. INVOICING AND PAYMENT:
A Contractor shall submit all invoices not more frequently than monthly in arrears
B Invoices should be sent no later than 90-days past the month the evaluation was conducted g
- "(e.g., April 2023 invoice
packet must be submitted no later than July 1, 2023)."
C The invoice shall identify all IST Defendants for whom DSH was provided with relevant updated
inmate medical records and has completed an interview. Refusals will only be paid when Defendant
declines to be interviewed to the evaluator. when the evaluator has the opportunity to speak to. see,
and observe the defendant
D For services satisfactorily rendered. and upon receipt and approval of invoices submitted as
described herein, the DSH agrees to compensate Contractor in accordance with the rates specified
in section 5. Budget Detail
E The DSH is not responsible for services performed by Contractor outside of this agreement. nor for
services performed other than as outlined in Exhibit A. Scope of Work
F The DSH makes no guarantee. either written or implied, as to the actual amount of funds that will
be expended under this Agreement
2. INSTRUCTIONS TO CONTRACTOR:
A To expedite the processing of invoices submitted to the DSH for payment, all invoice(s) shall be
submitted to the DSH for review and approval at either
Department of State Hospitals
Attn: Accounts Payable
1215 O Street. MS-2
Sacramento, CA 95814
OR
E-Mail DSHSac AccountsPayable(a-)dsh ca gov
B Contractor shall submit one original and one (1) copy of each invoice. unless emailed
C Contractor must utilize the most current DSH approved IST invoice template provided by DSH The
Contractor shall type. not handwrite, each invoice. Step by step instructions to complete the invoice
will be provided by DSH.
D DSH Administrators will provide the Contractor with the most current approved IST Invoice template
and detailed Invoice instructions
Page 1 of 5
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number 21-76003-008 Al
Exhibit B,Budget Detail and Payment Provisions
E Contractor shall clearly note Contractor's name and address on each invoice. The name on the
invoice must match the Payee Data Record (Std. 204) and the name listed on this Agreement.
F Contractor shall list and itemize in accordance with section 5. Budget Detail. all services or
deliverables provided on each invoice
G Contractor shall include the following on each submitted invoice
i. Date(s) during which the services or deliverables were provided and the date in which the
invoice was generated.
ii. Agreement number, which can be found on the Standard Agreement Form (Std. 213):
iii. First initial and last name of IST Defendant evaluated,
iv. Invoice total.
v. Written proof of DSH s approval as required by this Agreement for those services requiring pre-
approval
3. BUDGET CONTINGENCY CLAUSE:
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered
under this Agreement does not appropriate sufficient funds for the program, this Agreement shall no
longer be in full force and effect In this event. the State shall have no liability to pay any funds
whatsoever to Contractor or to furnish any other considerations under this Agreement and
Contractor shall not be obligated to perform any provisions of this Agreement.
B. If funding for any Fiscal Year (FY) is reduced or deleted by the Budget Act for purposes of this
program, the State shall have the option to either cancel this Agreement with no liability occurring to
the State. or offer an Agreement amendment to Contractor to reflect the reduced amount.
C If this Agreement overlaps Federal and State FYs. should funds not be appropriated by Congress or
approved by the Legislature for the FY in which the Agreement was entered into, and/or any
subsequent years covered under this Agreement. the State may exercise its option to cancel this
Agreement
D In addition. this Agreement is subject to any additional restrictions. limitations, or conditions enacted
by Congress or the Legislature which may affect the provisions or terms of funding of this
Agreement in any manner.
4. PROMPT PAYMENT CLAUSE:
A Payment will be made in accordance with. and within the time specified in. Government Code
section 927. et seq.
Page 2 of 5
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number 21-76003-008 Al
Exhibit B.Budget Detail and Payment Provisions
5. BUDGET DETAIL:
A. Contractor shall be compensated in accordance with the following
Rate Sheet
Jail Support Cost Rate
One-time start-up Cost Reimbursement per County (laptops/software $5,000.00
etc )
Sheriff Logistics and Coordination of re-evaluation (portion of jail $500.00 Flat Rate
staff time to provide support, escort. security and monitoring of Per IST Evaluation
the IST defendant) Rate applies to services performed prior
to July 1, 2022.
Sheriff Logistics and Coordination of re-evaluation (portion of $1,000.00 Flat Rate
jail staff time to provide support, escort, security and monitoring Per IST Evaluation
of the IST defendant) Rate applies to services performed after to
June 30, 2022.
i. The portion of staff time utilized to facilitate telehelath interviews and evaluation of felony IST
defendants in the)ail will be compensated within the all-inclusive flat rate fee per each IST
evaluation completed or refusal following articulated protocols referenced above
ii. Each IST evaluation consist of a completed interview and updated records which include. but
are not limited to. general medical records, mental health records, behavioral health records,
and custodial records.
iii. If the IST Defendant declines to be interviewed to the evaluator. when the evaluator has the
opportunity to speak to. see. and observe the defendant. the completed interview criteria will be
met
B The DSH does not expressly or by implication agree that the actual amount of work will correspond
with any estimation provided in this Agreement. and reserves the right to omit portions of the
estimated amount of work as may be deemed necessary or advisable by the DSH The estimates
listed above are a good faith estimate and are not a guarantee of business and is subject to change
depending on fluctuation in IST defendant referrals The amounts indicated above/below will be
used solely for the purposes of encumbering funds. The DSH makes no guarantee. expressed or
implied for actual amount of work to be performed
C. At the sole discretion of the DSH and for the purposes of accounting. the DSH may adjust the total
proposed expenditure for each fiscal year as needed to reflect work validated for completion. In no
event will this change the contract price for the services actually rendered
D. Contractor must submit each invoice within ninety (90) days from the last day of the month in which
services were rendered: unless Contractor has pre-approval. in writing, from the DSH. If Contractor
fails to provide invoices within this timeframe. the DSH may elect to reject the invoices for payment
as untimely and Contractor will be deemed to have waived any right to payment of the late invoices.
Page 3 of 5
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number 21-76003-008 Al
Exhibit B.Budget Detail and Payment Provisions
INVOICE TEMPLATE:
IST INVOICE
Month.
Year:
Is this Invoice the original or a Original
supplemental(additional) Supplemental
submission? (Additional)
FSD USE ONLY
Invoice Number:
Dispute Information:
Disputed Date
Resolved Date:
CONTRACT INFORMATION: TO:
Business/Contract Name California Department of State Hospitals
Contracted Street Address Attn:Accounts Payable,MS-2
1215 O Street
Contracted City, State,Z� Sacramento,CA9581d
Contract Phone Number DSHSAC.AccountsPayable@dsh.ca.gov
Current Contract Number
STOP'
Please read!
The totals will appear
once your contractor
infromation is complete.
Invoice Summary
Evaluations:
Total Invoicel $ -
DATE SIGNED:
CONTRACTOR SIGNATURE:
Smsll Business Certification Number' (1fappbcable)
S—W Buatnesa r-WWmataxt Starry Date to DISH A.—".p St:...t
Page 4 of 5
Department of State Hospitals Fresno County Sheriffs Office
Agreement Number 21-76003-008 Al
Exhibit B.Budget Detail and Payment Provisions
I ST DOCUMENTATION FOR EVALUATION FORM
Irttttt me�r Dade ! 1ST D�hrxtant Evaluator now I'nitJals_ _; Quantity Ta41
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Ono Tim•Start Up ExpWas
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Technology Start Up S 5.000 I SO
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Evaluation Total: 10 Service Total: ISO 00 1 Stan-Up Total: ISOOO Total: JSO.00
P ezw re, 'e os The crocument a Wotecred, only provrdF urformation rrr the avae/aete meat.
The Total will appear only it Interview Date IST Defendant Initials and Evaluartor information above
is complete
Page 5 of 5
FOR ACCOUNTING USE ONLY:
Fund:0001
Subclass:10000
ORG:31114000
Revenue Account: 3575