HomeMy WebLinkAboutAgreement A-16-359-1 for CBANS.pdfAgreement No. 16-359-1
1 AMENDMENT I TO AGREEMENT
2 THIS AMENDMENT, hereinafter referred to as "Amendment I", is made and entered into this
3 28th day of March , 2017, by and between the COUNTY OF FRESNO, a Political Subdivision
4 of the State of California, hereinafter referred to as "COUNTY", and each CONTRACTOR listed in
5 Revised Exhibit A "LIST OF CONTRACTORS", attached hereto and by this reference incorporated
6 herein, and collectively hereinafter referred to as "CONTRACTORS".
7 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
8 No. 16-359, effective July 1, 2016, hereinafter referred to as "Agreement", whereby CONTRACTORS
9 agreed to provide Mental Health Services Act (MHSA) funded Prevention and Early Intervention
10 (PEl) Cultural Based Access Navigation and Peer Support (CBANS) services, as specified in this
11 Agreement and as part of Fresno County's approved State PEl Plan, to help reduce stigma and
12 discrimination against mental illness and provide services related to mental well being; and
13 WHEREAS, the parties now desire to amend the Agreement regarding changes as stated below
14 and restate the Agreement in its entirety.
15 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
16 is hereby acknowledged, the parties agree as follows:
17 I. That in the existing COUNTY Agreement No. 16-359, all text in reference to
18 "Exhibit A" shall be replaced with the text "Revised Exhibit A";
19 2. That in the existing COUNTY Agreement No. 16-359, all text in reference to
20 "Exhibit B" shall be replaced with the text "Revised Exhibit B";
21 3. That in the existing COUNTY Agreement No. 16-359, all text in reference to
22 "Exhibits B-1 et seq" shall be replaced with the text "Exhibits B-1 et seq. or Revised Exhibits B-1 et
23 seq . where appropriate";
24 4 . That in the existing COUNTY Agreement No. 16-359, all text in reference to
25 "Exhibits C-1 et seq" shall be replaced with the text "Exhibits C-1 et seq . or Revised Exhibits C-1 et
26 seq. where appropriate";
27 5 . That the existing COUNTY Agreement No . 16-359, Section Seven (7)
28 "MODIFICATION", Page Seven (7), Line Five (5) beginning with the word "Changes" and ending
-1 -COUNT Y OF FRESNO
Fresno . CA
12345678910111213141516171819202122232425262728onlineTen(10)withtheword“herein.”bedeletedandthefollowinginsertedinitsplace:“Changestothelineitemsinthebudgetthatexceed10%ofthemaximumcompensationpayabletotheCONTRACTOR(S),orchangesthatexceedthemaximumamountpayabletotheindividualCONTRACTOR(S),maybemadewiththesignedwrittenapprovalofCOUNTY’SDBHDirector,orhisorherdesigneethroughanamendmentapprovedbyCountycounselandAuditor.Saidbudgetlineitemchanges,and/orchangestoindividualCONTRACTOR’(S)maximumamountpayableshallnotresultinanychangetothetotalmaximumcontractamount.”COUNTYandCONTRACTORagreethatthisAmendmentIissufficienttoamendtheAgreement;andthatuponexecutionofthisAmendmentI,theAgreementandAmendment1togethershallbeconsideredtheAgreement.TheAgreement,asherebyamended,isratifiedandcontinued.Allprovisions,terms,covenants,conditionsandpromisescontainedintheAgreementandnotamendedhereinshallremaininfullforceandeffect.ThisAmendmentIshallbecomeeffectiveFebruary1,2017.IllIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII-2-COUNTYOFFRESNOFresno.CA
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IN WITNESS WHEREOF, the parties here to h ave executed this Agreement as of the day and year
first hereinabove written.
ATTEST:
COUNTY OF FRESNO
By IL~~
Chairman, Board of Supervisors
Date : J -c?-.1?-17
BERNICE E. SEIDEL, Clerk
Board of Supervisors
Date: 3 -d-.<?~ 0
PLEASE SEE ADDITIONAL
SIGNATURE PAGES ATTACHED
. 3 . COUNTY OF FRESNO
Fresno. CA
12345678910111213141516171819202122232425262728APPROVEDASTOLEGALFORM:KEVINBRIGGS,COUNTYCOUNSELBy.cxAPPROVEDASTOACCOUNTINGFORM:OSCARJ.GARCIA,CPA,AUDITOR-CONTROLLER/TREASURER-TAXCOLLECTORBy.CA'rC.eREVIEWEDANDRECOMMENDEDFORAPPROVAL:ByDawanUtecht,DirectorDepartmentofBehavioralHealthFund/Subclass:0001/10000Organization:56304764Account/Program:7294/0PLEASESEEADDITIONALSIGNATUREPAGESATTACHED-4-COUNTYOFFRESNOFresno.CA
12345678910111213141516171819202122232425262728FRESNOAMERICANINDIANHEALTHPROJECT(FAIHP)Byi>PrintName:(y&VIKin-Title:V[Q-tCj{aAfChairmanoftheBoard,orPresidentoranyVicePresidentBPrintrame:jPI'lV)\\MvV\UTitle:QlMbflfartyKWExecutiveDirectorMailingAddress:1551E.ShawAvenue,Suite139Fresno,CA93710PhoneNo.:(559)320-0490Contact:JenniferRuiz,ExecutiveDirectorPLEASESEEADDITIONALSIGNATUREPAGEATTACHED5COUNTYOFFRESNOFresno,CA
12345678910111213141516171819202122232425262728CENTROLAFAMILIAADVOCACYSERVICES,Inc.(CLFAS)l1CPrintName:Tite:ChairmanoftheBoard,orPresidentoranyVicePresidentPrintName:A-Title:FlxecUASYEXECUTIVEDirectorMailingAddress:302FresnoStreet,Suite102Fresno,CA93706PhoneNo.:(559)237-2961Contact:MargaritaRocha,ExecutiveDirectorPLEASESEEADDITIONALSIGNATUREPAGEATTACHED-6-COUNTYOFFRESNOFresno,CA
12345678910111213141516171819202122232425262728FRESNOINTERDENOMINATIONALREFUGEESERVICES(FIRM)ByPAu(PrintName:C*/Uiv,f/Title:f'ij/,•rr^c„trf-—ifZ^OcuChairmanoftheBoard,orPresidentoranyVicePresidentPrintName:>b.Title:&Xifl-ExecutiveDirectorMailingAddress:1940N.FresnoStreetFresno,CA93703PhoneNo.:(559)487-1509PLEASESEEADDITIONALContact:ZacharyDarrah,ExecutiveDirectorSIGNATUREPAGE7COUNTYOFFRESNOFresno,CA
12345678910111213141516171819202122232425262728WESTFRESNOFAMILYRESOURCECENTER(WFFRC)17^/PrintName:£_STitle:ChairmanoftheBoard,orPresidentoranyVicePresidentB+JIMIkALPriktNameViT)Vlfl/jfj.fe?TitleecutiveDirectorMailingAddress:1802E.CaliforniaFresno,CA93706PhoneNo.:(559)621-2967Contact:YolandaRandles,ExecutiveDirectorPLEASESEEADDITIONALSIGNATUREPAGEATTACHED8COUNTYOFFRESNOFresno,CA
12345678910111213141516171819202122232425262728SARBATBHALA,Inc.(SBI)ChairmanoftheBoard,orPresidentoranyVicePresidentExecutiveDirectorMailingAddress:4250LincolnAvenueFresno,CA93725PhoneNo.:(559)360-1398Contact:AmandipGill,Director9COUNTYOFFRESNOFresno,CA
RevisedExhibitACULTURALBASEDACCESSNAVIGATIONSPECIALISTSLISTOFCONTRACTORSI.FresnoAmericanIndianHealthProject-(AmericanIndian/AlaskaNative)1551E.ShawAvenue,Suite139Fresno,CA,93710(559)320-0490Contact:JenniferRuiz,ExecutiveDirectorII.CentroLaFamiliaAdvocacyServices,Inc.-(Latino/Hispanic)302FresnoStreet,Suite102Fresno,CA,93706(559)237-2961Contact:MargaritaRocha,ExecutiveDirectorIII.FresnoInterdenominationalRefugeeMinistries-(SouthEastAsianHmong,Laotian,CambodianandSyrian)1940N.FresnoStreetFresno,CA93703(559)487-1509Contact:ZacharyDarrah,ExecutiveDirectorIV.WestFresnoFamilyResourceCenter-(AfricanAmerican)1802E.CaliforniaFresno,CA,93706(559)621-2967Contact:YolandaRandles,ExecutiveDirectorV.SarbatBhala-(Punjabi)4250E.LincolnAvenueFresno,CA93725(559)360-1398Contact:AmandipGill,Director
REVISEDEXHIBITBPage1of7MENTALHEALTHSERVICESACTPREVENTIONANDEARLYINTERVENTIONCULTURALBASEDACCESSNAVIGATIONANDPEERSUPPORT(CBANS)CBANSProgramOverviewCONTRACTSERVICES:CulturalBasedAccessNavigation&PeerSupportCONTRACTTERM:July1,2016-June30,2019;andTwo(2)Twelve-MonthRenewalOptionsCONTRACTORS:SeeRevisedExhibitACONTRACTMAXIMUM:$551,633perFiscalYearCONTRACTORAWARDS:$501,217FiscalYear(FY)2016-17-allProviderscombined$550,762FYs17-18,18-19,19-20,20-21-allProviderscombinedSeeExhibitsC-1etseq.andRevisedExhibitsC-1etseq.asappropriateforindividualProviderAwardsSERVICEPOPULATIONS:AmericanIndian/AlaskaNative,Hispanic/Latino,Hmong,Laotian,Cambodian,AfricanAmerican,Punjabi,andSyrian(effective2/1/17);eachservicepopulationincludesLGBTQ,Veteransandhomelessasneeded.CBANSPROGRAMOVERVIEWCountyofFresnoonbehalfoftheDepartmentofBehavioralHealth(DBH),MentalHealthServicesAct(MHSA)hasdevelopedaMasterAgreementfortheprovisionofCultural-BasedAccess-NavigationandPeer/FamilySupport(CBANS)servicestounderservedandun-servedculturallydiversepopulationsinFresnoCounty.PEIProgramIntentandGoals-TheintentofthePEIprogramistoprovidefundsforaCBANSserviceprogramtobedeliveredincommunitysettingstoallagegroupsinaculturally,linguisticallyandage-appropriatemanner.ThegoalsofthePEIcomponentoftheMHSAshallbeintegratedintotheCBANSprogramandshallbepromotedthroughcommunitycollaboration,culturalandlinguisticcompetency,individual/familydriven,wellness/recoveryfocused,integratedservices,andperformanceoutcomesbased.CBANSProgramIntentandGoals-TheCBANSProgramisaninstrumentalcomponentofprovidingwrap-aroundserviceinterventionutilizingaholisticandculturallyrelevantapproach,anddeliveredin
REVISEDEXHIBITBPage2of7anaturalcommunitysetting.ThepurposeandgoalsofthisProgramaretobuildontheskillsorinterestsoftheclientinordertomaximize:emotionalandphysicalindependence,self-careanddailylivingabilities,positivestressandsymptomcopingskills,andsocialandinterpersonalinteractions.Bydevelopingtheseskills,theclientshalllearntodependlessonmorecostlycrisisservices,andshallminimizeoravoidmoresevereoutcomessuchassubstanceabuse,hospitalizationorincarceration.FundingUse-PreventionandEarlyIntervention(PEI)fundingguidelinesstipulatedbyCaliforniaHealthCareServicesspecificallylimithowPEIfundsmaybeused.ThefundingforPEIservicesistoprovideforsalariesandstipendsforCommunityHealthWorkers(CHW)andPeerSupportstaffing(PSS),training,consumerincentives,outreachplanningandoperationalcosts.CBANSProgramProvidersindividualfundingallocationsareidentifiedanddetailedinExhibitsC-1etseq.Preventioninmentalhealthinvolvesreducingriskfactorsorstressors,buildingprotectivefactorsandskillsandincreasingsupport.Preventionpromotespositivecognitive,socialandemotionaldevelopmentandencouragesastateofwellbeingthatallowstheindividualtofunctionwellinchallengingcircumstances.Earlyinterventionisdirectedtowardindividualsandfamiliesforwhomashort-duration(uptooneyear),relativelylow-intensityinterventionisappropriatetomeasurablyimproveamentalhealthproblemorconcernveryearlyinitsmanifestation,therebyavoidingtheneedformoreextensivementalhealthtreatmentorservices;orpreventamentalhealthproblemfromgettingworse.ServicesandPerformanceMeasures-UndertheprovisionoftheMHSA,PEIcomponenttheCounty’sDepartmentofBehavioralHealthreceivesfundingtoexpand,developandcreatesuccessfulPEIprogramsforchildren,transitionalagedyouth,adults,andolderadultsinaculturally,ethically,andlinguisticallycompetentapproachforunderservedandun-servedpopulation.CBANSProgramProviders'culturallyspecificapproachestotheseservices,andtheirperformancemeasuresandoutcomegoalsareidentifiedanddetailedinExhibitsB-1etseq.PerformanceMeasuresarefurtheraddressedinthisdocumentonPagesix(6).ServicePopulations-CBANSProgramservicepopulationsinclude,butarenotlimitedto:AmericanIndian/AlaskaNative,Hispanic/Latino,Hmong,Laotian,Cambodian,AfricanAmerican,Punjabi,andSyrian.Inaddition,eachservicepopulationincludeslesbian/gay/bi-sexual/transgender/questioning(LGBTQ),Veteransandhomelessasneeded.CBANSservices,whiletargetingspecificculturalgroups,shallnotdenyservicesbasedonculture.ServicepopulationsareidentifiedforeachCBANSProviderinExhibitAandExhibitsB-1etseq.
REVISEDEXHIBITBPage3of7Collaborations-CBANSProvidersshallworkincollaborationwithotherCBANSpartners,includingbutnotlimitedto:FresnoAmericanIndianHealthProject(FAIHP),CentroLaFamiliaAdvocacyServices,FresnoInterdenominationalRefugeeMinistries(FIRM),WestFresnoFamilyResourceCenter(WFFRC),andSarbatBhala,Inc.Inaddition,collaborationsandpartnershipsshallbeencouragedwithallothercommunitystakeholdersandserviceproviders,includingbutnotlimitedto:private,profit/non-profit,government,faith-based,cultural-specificcommunityresource/serviceproviders,andadvisoryboardsandcommissions.MasterAgreementAdditions-OrganizationsseekingtobeincludedinthisMasterAgreement,orseekingtoprovideadditionalculturalservicestounderservedandun-servedtarget/servicepopulations,fundedthroughMHSA,mustsubmitawrittenproposaltoFresnoCountyDepartmentofBehavioralHealth,Attention:CBANSContractAnalyst,3133N.MillbrookAvenue,Fresno,CA93703.Theproposalmustbepreparedandsubmittedforreviewandapprovalinaccordanceto,andinproperresponseto,theRequestForProposal(RFP)#952-5412issuedbyFresnoCountyPurchasingDivisiononJanuary14,2016.ProposalsreceivedmustbeapprovedbyDBHDirectorand/ordesigneeforadditiontoMasterAgreement.CBANSSERVICESTheCBANSProgramshallhelpreducethestigmathatgroupsand/orindividualshaveaboutmentalillnessanditsservices,andthusimproveindividuals’knowledgeofmentalhealthandavailabilityofservicesdesignedtomeettheirpsychologicalandemotionalneeds.TheCBANS'sstaffshallprovidepeer/familyandeducationalservicestothecommunityinordertoprovideapersonalcontactorliaisontomentalhealthresourcesandprogramswithinthecommunitysothatindividualsshallnothavetovisitatraditionalmentalhealthtreatmentsite.TheCBANSprogramshallalsoassistindevelopingpeerandfamilysupportgroupstohelpindividualswithmentalhealthconcernsreceiveshorttermservicesearlyinthemanifestationofamentalhealthconcerninnaturalcommunitysettingsthatareculturallysensitiveandlinguisticallyappropriate.TheCBANS’sprogramshallactivelypursuethefeedbackofcommunityandconsumersthroughsurveysdistributedatallactivities,monitorthenumberofservicecontactsthroughsign-inprocedures,andevaluatetheeffectivenessofcontacts/presentationsthroughpre-andpost-feedbackworksheets.TheCBANSprogramismodeledsignificantlyonevidence-basedcommunity-basedhealthmodels,utilizingcommunityhealthcarepeersupportoutreachworkersemployedbycommunityorganizations.TheCBANS’smodelisusedbecauseCHWandPSSareeffectivedisseminatorsofinformation,andactasthebridgeorliaisonbetweengovernmentalandnon-governmentalsystems
REVISEDEXHIBITBPage4of7andthecommunitiestheyserve.Communityhealthworkersalsoactaschangeagentswithintheirnaturallyoccurringsocialnetworks.Direct,localinvolvementcangeneratecreativeanddynamiceffortstoaddressdisparitiestomentalhealthservicesintheseareasandforthesegroups.Theprogramshallfeatureapeer/familysupportcomponentwhichisculture-specificandtailoredtohelpbridgeculturalandlanguagedividesthroughadvocacy,education,andshorttermpeer-supportfornon-SMI/SEDinterventionforindividualsandfamiliesdealingwitheconomicandotherrelatedchallengesinade-stigmatizingandculturallyappropriatemanner.ThePromotoresmodelofCHWsservingtheLatinocommunitiesisagoodexampleofhowtheCBANSprogramshallserveeachunderservedcultural,ethnic,andracialcommunity.TheCountyenvisionsthatindividualsofrelativelyhighimportanceforagivenculturalcommunitymayactastheCHW(includingHmongShamanandNativeAmericanSpiritualLeaders).CHWservicesaredelivered,forthemostpart,throughcommunitysettings(wherepeoplecongregate),homevisitsandgrouppresentations,andalsospecificallyincludementalhealthpromotionstrategiesthatimpactknowledge,attitudes,andpracticesonacommunitylevel.Communitysettingscanincludebutarenotlimitedtoeventssuchas:healthfairs,churchandneighborhoodmeetings,factories,laundromats,gasstations,andgrocerystores,amongotherlocations.Trustedexpertsfromwithineachoftheunderservedandun-servedcommunitiesofFresnoCountyshallprovideinformationaboutresourcesandlinkagesforthosecommunitiesthroughadvocacy,engagement,education,andknowledgeaboutmentalhealthservices,includingthearrayofpreventionandearlyinterventionactivitiesinthecommunity.IntheprovisionofCBANSservices,CONTRACTORSshallinclude,butarenotlimitedto:1.CulturallyandLinguisticallyAppropriateStaffinga)One(1)identifiedCHWfromeachidentifiedservicepopulationCommunityHealthWorkersshallactaschangeagentswithintheirnaturallyoccurringsocialnetworktoaddressdisparitiestomentalhealthforspecificgroups.b)Uptothree(3)PSSsasneededfromeachidentifiedservicepopulationPeerSupportSpecialistshallassistinbridgingtheculturalandlinguisticdividesthroughadvocacy,education,andshorttermpeersupportfornon-SMI/SEDinterventionforindividualsandfamiliesdealingwitheconomicandimmigration-relatedchallengesinade-stigmatizingandculturalappropriatemanner.
REVISEDEXHIBITBPage5of7CHWandPeerSupportpersonsmustbecarefullyrecruitedforculturalandlinguisticcompetencyinordertoparticipateintheprogram.Staffshouldbefromwithinthevariouscultural,linguistic,ethnic,and/orracialcommunities,andshouldbelinguisticallyandculturallycompetentofthosecultures,ethnicities,valuesandthelanguageofthecommunity.BoththeCHWandPSSshallbeknowledgeableofmentalillness,symptoms,medication,culturalsensitivity,communityresourcesandPreventionandEarlyInterventionservices.CHWandPSSstaffshallclearlyunderstandtheirrolesandutilizetheirskillsasliaisonsbetweentheunserved/underservedculturalcommunitiestheyserveandtheDepartmentofBehavioralHealth,aswellasotherresourcesandserviceprovidersintheCounty.Liaisonsserveastrustedcommunityleaderswhohelpunserved/underservedindividualsandfamiliesnavigatethesystemsofcareandresourcesavailablewithinFresnoCounty,uptoandincludingwarmhand-offreferralsandlinkages.2.OngoingTraining/EducationforCHW&PSSStaffEachCHWshallreceiveextensivetrainingdirectedtowardsincreasedknowledgeofrelevantmentalhealth/illnesstopics.Staffshallbetrainedtoidentifyandrecognizeearlysignsandsymptomsofsubstanceabuseandmentalillnessdisorders,deliverPEIpsycho¬socialeducationalprograms,developmentofculturallyrelevantmaterials,andassistinensuringservicesaredeliveredinaculturallysensitivemanner.Staffshallalsobetrainedinwaystheycanparticipateinmentalhealthcoalitionbuildingtostrengthentheircommunities’capacitytoincreaseresilienceandwellness.TrainingshallbeprovidedbyeachrespectiveorganizationeitherthroughtheCounty,orotheravailablementalhealthcommunityresources.3.CommunityOutreachOutreachshallbeconductedatcommunityeventsorviaculturallyspecificmediaoutlets(e.g.:SpanishTVUnivisionChannel21,HmongRadioKBIF900AM,etc.)frequentedbyservicepopulations,suchas:fairs,culturalcelebrations,placesofworship,blockparties,andmentalhealthawarenessevents(e.g.:NAMIWalk,SOSLRun,etc.).Outreachservestointroduceandeducatethecommunityonmentalhealthandrelatedservicesavailablewithinthecommunity,andinFresnoCountyingeneral.Connectionsmadeshallhelptobuildatrustedpresencewithinthecommunityandtherebyencouragefuturecontacts,follow-ups,andlinkagestoserviceinformationand/ordelivery.
REVISEDEXHIBITBPage6of74.Peer/FamilySupport&Educationa)Peerandfamilysupportservicesshallbeappropriatelytailoredtothecultureandcommunityserved.Peerandfamilysupportshallbeinclusiveofgroupandeducationalsessions/presentationsregardingmentalillness,symptoms,medication,culturalsensitivity,andawarenessbasedoncommunityneeds.Providersshall,atminimum,facilitateVfchoursessionstoassistfamiliestoimprovetheirqualityoflifewithinthecommunity.Servicesshallincludelinkagetoothercommunityresources,transportation,problemsolving,andeducationinareasoflifeskills,suchasmoneymanagement,hygiene,independentliving,cooking,cleaning,andothersupportservicesidentifiedasneededthroughcontactswithconsumersandfamilymembers.b)Educationalsessionsshallbeprovidedinnaturalenvironmentalculturalsettingswithintheservicecommunity.IncollaborationwithCountymentalhealth,andasappropriate,CHW’sandPSSshallprovidetraininginmentalillness,signsandsymptoms,featuresofmedication,sensitivity,suicideprevention,mentalhealth/suicidestigma,Countymentalhealthresources,communityandfaith-basedorganizations,andprivateproviders/agencies.Educationalservicesshallbeprovidedtohelpsolidifyrelationshipbuilding,communitynetworking,andpersonalproblem-solving,whichshallallowforanatmosphereofhopeandcooperation.Educationalservices,informationalsessions,andpeersupportshallinclude,butnotbelimitedto:recognizingsignsandsymptomsofmentalillness,mentalillnessmanagement,waystoreducetensionandstresswithinthefamily;howtofindandprovidesocialsupportandencouragementtoothers,andothertopicstoassistfamiliesandconsumersindevelopingresiliencyandmaintainingrecovery.5.CommunityCollaborationThroughtheCBANSprogram,Providersshallcollaboratewithexistingpartners,suchaslocalschoolsanddistrictoffices,faith-basedorganizations,primarycarecenters,varioushealthoffices,naturalgatheringsites,socialservicesofficesandlocallawenforcementoffices.Additionaleffortsshallbemadetoreachandpartnerwithcommunitybasedorganizationsinunderserved/un-servedpopulationstoincludecommunity/familyresourcecenters,privateandpublicemploymentoffices,collaborationwithlocalmediaoutletsthroughoutFresnoCounty.TheProviders’organizationalmodelshallleveragecommunity
REVISEDEXHIBITBPage7of7volunteerswhocanbetrainedtoworkwithprofessionalsandpara-professionalsinthedeliveryofservices.TheProvidersshalldevelopnewpartnershipsanddeliverservicesinfaith-basedcenters,inhomesandothernaturalsettingsthatareculturallysensitive,linguisticallyappropriateandnon-threatening/non-stigmatizinglocationsforparticipants6.ClientandCommunityFeedbackProvidersshallactivelypursuethefeedbackofclientsandcommunitythroughsurveysdistributedatallactivities;monitorthenumberandtypesofservicecontactsthroughsign-inproceduresandotheravailabledatacollectiontools;andevaluatetheeffectivenessofcontacts/presentationsthroughpre-andpost-feedbackworksheetsandotheravailabletools.PERFORMANCEOUTCOMEMEASURESAllProvidersshallcomplywithallprojectmonitoringandcomplianceprotocols,procedures,datacollectionmethods,andreportingrequirementsrequestedbytheCounty.Providersshalluseperformanceoutcomemeasuresforevaluatingprogramandsystemeffectivenesstoensureservicesandservicedeliverystrategiesarepositivelyimpactingtheservicepopulation.Inaddition,thesemeasuresshallbeusedtoensureCBANSservicesareinalignmentwithMHSAguidingprincipleswhichareinclusiveof:anintegratedserviceexperience;communitycollaboration;culturalcompetence;client/familydrivenservice;andwellness,resilience,andrecoveryfocusedservices.PerformanceoutcomemeasuresshallbetrackedonanongoingbasisandusedtoupdatetheCountymonthly(bythe10thofthemonthfollowingthereportperiod)regardingCBANSservices.Inaddition,performanceoutcomemeasuresarereportedtotheCountyannuallyinaccumulativereportsforoverallprogramandcontractevaluation.CBANSPartnersutilizestandardizedformsandtoolssothatdatashallbecollectedinthesamewayforeachculturalgroup.TheCBANS“WellnessSurvey",“Needs/StressorsForm",andthe“CopingStrategies&ProtectiveFactorsForm”areexamplesoftoolsusedtogatherandreportdatareflectingservicesprovided,populationsserved,andimpactofthoseservices.CBANSProgramProviders’specificperformancemeasuresandoutcomegoalsareidentifiedanddetailedinExhibitsB-1etseq.MeasurableoutcomesmaybereviewedforinputandapprovalbyadesignatedDepartmentofBehavioralHealthworkgroupuponcontractexecution.Thepurposeofthisreviewprocessistoensureacomprehensivesystemwideapproachtotheevaluationofprogramsthroughaneffectiveoutcomereportingprocess.
REVISEDEXHIBITB-3Page1of6FRESNOINTERDENOMINATIONALREFUGEEMINISTRIES(FIRM)CULTURAL-BASEDACCESSNAVIGATIONANDPEER/FAMILYSUPPORTSCOPEOFWORKCONTRACTSERVICES:CulturalBasedAccessNavigationandPeer/FamilySupportServicesCONTRACTTERM:July1,2016-June30,2019,andTwo(2)Twelve-MonthRenewalOptionsSERVICEPOPULATIONS:SoutheastAsian(Hmong,Laotian,andCambodian),including:LGBTQ,VeteransandHomelesswithintheservicepopulations.ServicesforSyrianrefugeesareaddedeffectiveFebruary1,2017.CONTRACTMAXIMUM:$120,393FiscalYear2016-17EffectiveJuly1,2016-January31,2017$155,604FiscalYear2016-17EffectiveFebruary1,2017$205,149FiscalYears2017-18,2018-19,2019-20,2020-21(SeeAmendment1-ExhibitC-3forlineitembudgetdetails)NOTE:Theinformation,expectationsandrequirementscontainedinthisAmendment1-ExhibitB-3arespecifictoFresnoInterdenominationalRefugeeMinistries(FIRM)andshallbeconsideredinadditiontoExhibitB,theFresnoInterdenominationalRefugeeMinistriesproposalsubmittedinresponsetoRequestForProposal952-4512,andtheFresnoInterdenominationalRefugeeMinistriesproposalsubmittedonJanuary30,2017,toservetheSyrianrefugeepopulationeffectiveFebruary1,2017.FIRMPROGRAMOVERVIEWTheFresnoInterdenominationalRefugeeMinistries(FIRM)Cultural-BasedAccessNavigationandPeer/FamilySupportServices(CBANS)Programshallbeadministeredaspartofacomprehensivewellnessprogramservingtheunderservedandun-servedFresnoCountyHmong,Laotian,Cambodian,andSyrianrefugeecommunities,andinclusiveofLesbian/Gay/Bi-Sexual/Transgender/Questioning(LGBTQ),veterans,andhomelessmemberswithintheservicepopulations.TheFIRMCBANSprogramshallprovidementalhealthpreventionandearlyinterventionservicestohelpreducestigmaaboutmentalhealthandimproveindividuals’knowledgeof,availabilityof,andaccesstomentalhealthservicesinthecommunity.PromotoresModel:FIRMshallusethePromotoresmodelofCommunityHealthWorkers(CHW),adaptingthemodeltofittheirtargetpopulations.UtilizingCHWsandPeerSupportSpecialists(PSS)supportsanevidence-based,communitybasedhealthmodelwithFIRMstaffactingaseffectivedisseminatorsofinformationtotheirservicespopulations.Inaddition,wherethereisgreatmistrustwiththisservicepopulationofgovernmententities,staffshallbridgethegapbetweentheservicecommunityandservice
REVISEDEXHIBITB-3Page2of6providers.Duetolanguagebarriers,staffshallassistclientswithlifeskillsandservicenavigationonadailybasis.FIRMshallutilizeafamilycentered,wellnessapproach,emphasizingthestrengthsoftheindividualandfamilytohelpcopewiththestressorsandareasofneed.SBIRT:FIRMshallcontinuethepracticeofScreening,BriefInterventionandReferraltoTreatment(SBIRT)foreachclient/familyservedinordertoensureastreamlinedapproachtoaccessingappropriateservices.Aseachclientiscasemanaged,itistheresponsibilityoftheCBANSstafftoreferclients/familiestoadditionalresourcesasneeded.Aclientorfamily’sneedsaredeterminedbasedonresultsofavarietyoftoolsusedasidentifiedonPagefive(5)withinthisExhibitB-2.ServiceProviderComponent:FIRMshallimplementaServiceProviderComponentthatincludesstaffworkingwithcommunitymembersandserviceproviderstodevelopalistoftrustedcommunityserviceproviderswhoarebestequippedtoworkwiththeSoutheastAsianpopulations.Thisshallincludeworkingwith,andeducatingserviceproviderstodeveloppracticesandmethodsofimprovingculturalandlinguisticrelevance.PathwaystoWellness:ThiscomponenttoFIRM’SCBANScasemanagementprogramwilltrackadesignedanddevelopedpathwayforclientsinthepursuitofwellness.ThisshallbeutilizedforcasemanagedclientsandwillallowforbettertrackingofwhatCBANSclientsareactuallydoingtosecureandmanagetheirwellness/mentalhealth.“Wellness”isthebestwordculturallytodescribementalhealthandshallbeusedinthistool.
REVISEDEXHIBITB-3Page3of6FIRMProgramOverview:PREVENTIONLevel1LinkaaesFOIIOW-UDSI.DropInHoursatCBOa.Info/Materialsb.Screeningc.PeerSupportII.CommunityOutreachIII.EthnicMediaOutreachIV.Workshops/EducationSessionsV.CulturalCommunityEventsA.ReferralsmadetoCBO/CommunityResources3.ReferralsmadetoCBANSPartners.C.ReferralsmadetoCountyprimaryandoehavioralhealthservicesD.ConsumerAdvocacyasneeded=3.Follow-upwith-eferralprovidertoensuresuccessi.Follow-upwithclienttoensurethat1clientisnotinneedfurtherservicesatthattimeii.Surveyclientastomprovedwellness/mentalhealthEARLYINTERVENTIONLevelIILinkagesFollow-UpsVi.FormalizedSBiRTA.Linkagesiomeniaii.CasemanagementofVII.CompleteInitialhealthtreatmentclientuntil“PathwaytoWellnessSurveys/B.LinkagesmadetoWellness/MentalPHQ-9substanceabuseHealth"completedVIII.ClientCaseKtreatmentKii.Follow-upwithManagement\C.Linkagestocrisis/linkagestoensurethatIX.Create“Pathwayto/interventionservices/serviceswereprovidedWellness/Mental/D.IntensiveconsumerViii.Follow-upwithHealth”advocacyasLevelIIclientsandevaluationX.PeerSupportLinkagesarenavigatedastoprogressonaGroupswithclientquarterlybasisorasneededSTAFFINGAtaminimum,FIRMshallmaintainFullTimeEmployees(FTE)asfollow:0.75FTECommunityHealthWorker(Lao)1.50FTEPeerSupportSpecialist(HmongandCambodian)1.00FTECommunityHealthWorker(Syrian/ArabiceffectiveFebruary1,2017)0.75FTEPeerSupportSpecialist(SyrianeffectiveFebruary1,2017)0.05FTESupervisor(0.09EffectiveJuly1.2017)4.05FTETotal(4.09EffectiveJuly1,2017)TRAININGANDEDUCATIONStaff-Trainingforstaffmembersshallinclude,butisnotlimitedto:monthlyinternaltrainingonmentalhealth,focusingonitemsthatarespecifictotheSoutheastAsiancommunity;culturalcompetency;holisticapproachestomentalhealthservicedelivery;FacilitationofSupportGroupsusingCulturalCompetencyapproaches;suicideprevention/Question,Persuade,Refer(QPR)andothertrainingsasavailable.FIRM
REVISEDEXHIBITB-3Page4of6staffshallalsoparticipateinrequiredandvolunteertrainingsfacilitatedbyDBHasneededandrelevant.Inaddition,themonthlyPEIStaffMeetingincludesculturaland/orservicerelatedtraining.Staffshallalsoparticipatein,andfacilitateKnowtheSigns,Train-The-Trainer,WellnessRecoveryActionPlan(WRAP),andMentalHealthFirstAidasappropriate.Staffshallbeprovidedaregularcalendaroftrainingsdistributedtostaffonaquarterlybasis.Community-FIRMprovidestrainingonvariousmentalhealthtopicsthroughitsmonthlyworkshopsspecificforthecommunitiesserved,includingHmong,Lao,CambodianandSyrian.Topicsinclude:suicidepreventionandeducation(KnowtheSigns&QPR),stressreductiontechniques,thebenefitsofphysicalactivityforoverallwellnessandmuchmore.FIRMshallregularlydisseminateinformationaboutmentalhealthbyutilizingethnicmediaoutletssuchasHmongtelevisionandradio,andLaotianradio.EducationalmessagesandmaterialsshallalsobeprovidedduringvariousoutreacheventsthatFIRMstaffparticipateinmonthly.Inaddition,aspartofFIRM’SSen/iceProviderComponentasdescribedabove,staffshallworkwith,andprovideeducationalopportunitieswithserviceproviderstoimproveprovider’sculturalandlinguisticappropriatenessintheirdeliveryofservices.Facilitators-FIRMshallusevarietyofresourcesfortraining,suchas:knowledgeable/professionalstaffandcommunitypartnerresourcesandCBANSpartnerresources.Someofthesecollaboratingagenciesinclude:DepartmentofBehavioralHealth(e.g.:LunchandLearnMini-Series);CaliforniaStateUniversityFresno;NationalAllianceonMentalIllness(NAMI),FresnoCenterForNewAmericans,DepartmentofSocialServices;andothers.Examplesoftrainingtopicsinclude,butarenotlimitedto:culturalcompetency,confidentiality,andcasemanagement.CommunityEngagement-FIRMstaffshallusetheirPICOCommunityOrganizingModeltrainingandexpertiseascommunityorganizerstoimplementafour-foldapproachtoengagetheirservicepopulations.Thisincludes:1)door-to-doorengagements;ethnicmediaoutreach;3)walk-inclientoutreach;and4)communityoutreach.Trainingsandeducationalhealth-relatedmessagesshallbepublished/postedasappropriateusing:socialmediasites(Facebook,Twitter,Instagram,andPinterest);DBHWeeklyCommunityEventCalendar;PEIproviderpartners;ethnicmediaoutlets,including,butnotlimitedtoHmongtelevisionandradio,andLaotianradio;andatcommunityevents,suchashealthfairs,culturalcelebrations,andothersocialgatherings.Feedback-Shortpost-trainingsatisfactionsurveysareusedtodeterminewhetherthetrainingsarerelevantandsuccessful.Otherdatacollectedshallincludedemographicsand#sinattendance.
REVISEDEXHIBITB-3Page5of6FUNDINGFIRMshallutilizefundingprovidedbyFresnoCountyDepartmentofBehavioralHealthDepartmenttooperatetheCBANSprogramwithintheestablishedguidelinessetforPEIprogramsintheStateofCalifornia.ThiswouldincludesalariesoftheCHWandPSS,employeebenefits,training,consumerincentivesandtransportation,andoperationalcosts.FIRMshallproduceandmaintainabudgetandbudgetnarrativefiledwithandapprovedbytheCounty.FIRM’SdetailedbudgetallocationsmaybefoundinAmendment1-ExhibitC-3.PERFORMANCEGOALSFIRMshalladheretothebelowsetofannualperformancegoalsandoutcomemeasurestodemonstratetheon-goingeffectivenessoftheCBANSprogramandthepositiveimpactthattheserviceshaveforthetargetpopulation.FIRMshallfacilitateand/orparticipateinthefollowingactivitiesandservicesresultinginaminimumof2,712individualsdirectly(notcountingthosepotentiallyreachedthroughethnicmediaeventsandspecialculturalevents)reachedand/orservedannually:•Workshops/EducationSessions:72annualworkshops(3permonthwithoneineach:Khmer(Cambodian),Laotian,andHmong)servingaminimumof1,080individuals;andone(1)workshoppermonthwiththeSyriancommunityservinganaverageof25totalindividuals/10uniqueindividualspersession.•EthnicOutreach/EducationMediaEvents:5,000to10,000viewers/listenersperevent;potentiallyreachingaminimumof135,000individualsannually.ThisincludesTV,radioandprint.•One-on-OneWalk-InServices:Serving100permonth;servingaminimumof1,200individualsannually•ClientCases(Assessment,Linkage,Referrals):15newcasespermonth;servingaminimumof180annually;andSyrianrefugeefamilieswillbeevaluatedfor,andreceiveassessment,linkageandreferralservicesasneeded.•PeerSupportGroups:3permonth;servingaminimumof252individualsannually;andtwo(2)permonthfortheSyriancommunityservinganaverageof8individualspergroup.•SpecialCulturalEvents:Aminimumof6annuallyreachingaminimumof2,500individualsannually.Eventsidentifiedaboveshallresultinthefollowingannualminimums:•120Linkagesforhigherlevelmentalhealthservicesannuallytobetrackedbynumbersandforeffectiveness.•300Referralsannuallytocommunityresourcestobetrackedbynumbersandtypesofreferrals.•360Transportstoneededcommunityresourcestobetrackedbynumbersandresourceproviders.
REVISEDEXHIBITB-3Page6of6ThefollowingtablerepresentsFIRMoutcomes,goalsandsomedatasources/tools.OverallOutcomesSMARTObjectiveGoalsDataSource/Tool1Reducesocialandenvironmentalstressorsa)Reducethenumberofself-reportedstressorsfor75%ofclientswithinasixmonthtimeframe.b)Atleast75%ofclientswillreportpositivechangesinself-reportedstresslevelwithinatwelvemonthtimeframe.•Pre/PostCBANSNeeds/StressorsForm•Pre/PostCBANSWellnessSurvey2Improveattitudes&outlooka)Atleast85%ofclientswillreportanincreasedsenseofhopewithinasixmonthtimeframe.•Pre/PostHERTHHopeIndexTool3Increasehealthybehaviorsamongserviceparticipantsa)100%ofclientswillbescreenedfordepressionduringtheirintake(newclients)orwithinsixmonths(establishedclients).b)75%ofclientswithminimalormilddepression(score1-9accordingtoPHQ-9scale)willreportincreasedutilizationofcopingstrategiesandprotectivefactors.c)100%ofclientsthatscorea10orhigheronthePHQ-9assessmentwillbereferredtoappropriatecommunitybehavioralhealthservices.•PHQ-9AssessmentTool•CBANSCopingStrategies&ProtectiveFactorsFormPERFORMANCETRACKINGANDREPORTINGFIRMshallutilizeavarietyoftoolsforperformancetrackingandreportingasidentifiedbelow.•WellnessSurvey-usedtoassessclient’swellbeing,stresslevel,knowledgeofresourcesinthecommunity,confidencelevel,andoverallwellness.•Needs(Stressors)Survey-usedtoassessbasicdailylivingneedstodeterminethebestresources/servicestoassistthem.•PatientHealthQuestionnaire(PHQ9)-usedbystafftodetermineaclient’slevelofdepression,notfordiagnosing,buttoassiststaffindeterminingtheurgencyofneedandappropriatereferrals.•ClientFeedbackTool/SatisfactionSurvey•QuarterlyProgramAudits(internal)•ReferralsandLinkageForms•EventLogandSigninSheets•CalendarofEvents•OutcomesComparison/TrackingSpreadsheet•StaffingReports•AndotherreporttoolsasrequestedbyDBH•Warmhand-offsandclientfollow-upshallbestandardpracticetoallowstafftoidentifyifservicereferralsandlinkagesresultinappropriateservicedeliveryandpositiveoutcomes.
RevisedExhibitC-3CulturalBasedAccessNavigation&PeerSupportServicesFresnoInterdenominationalRefugeeMinistries(FIRM)FiscalYear2016-17BudgetCategories-TotalProposedBudgetLineItemDescription(Mustbeitemized)FTE%Admin.DirectTotalPERSONNELSALARIES:0001CommunityHealthWorker(Lao)0.75$23,400$23,4000002PeerSupportSpecialist(1Hmong&.5Cambodian)1.50$43,680$43,6800003Supervisor0.05$3,100$0$3,1000004CommunityHealthWorker(Arabic)1.00$13,200$13,2000005PeerSupportSpecialist(Arabic)0.75$9,240$9,240SALARYTOTAL4.05$3,100$89,520$92,620PAYROLLTAXES:0030OASDI$00031FICA/MEDICARE$272$6,848$7,1200032SUI$25$1,845$1,870PAYROLLTAXTOTAL$297$8,693$8,990EMPLOYEEBENEFITS:0040Retirement$00041WorkersCompensation$1,0230042HealthInsurance(medical,vision,life,dental)$15,040EMPLOYEEBENEFITSTOTAL$0$0$16,063SALARY&BENEFITSGRANDTOTAL$117,673FACILITIES/EQUIPMENTEXPENSES:1010Rent/LeaseBuilding$1,9001011Rent/LeaseEquipment$4001012Utilities$8501013BuildingMaintenance$400FACILITY/EQUIPMENTTOTAL$3,550OPERATINGEXPENSES:1060Telephone$9001061Printing/Reproduction$5001062OfficeSupplies&Equipment$1501063Food$4,1001064ProgramSupplies-Therapeutic$7501065TransportationofClients$6,5001066StaffMileage/vehiclemaintenance$1,7351067StaffTraining/Registration$5001068IncentivesforPeerMeetings/SupportGroups$2,100OPERATINGEXPENSESTOTAL$17,235FINANCIALSERVICESEXPENSES:1080Accounting/Bookkeeping$1,2601081ExternalAudit$1,4001082LiabilityInsurance$1051083AdministrativeOverhead$14,381FINANCIALSERVICESTOTAL$17,146TOTALPROGRAMEXPENSES$155,604MHSAFUNDS:5000Prevention&EarlyInterventionFunds$155,604MHSAFUNDSTOTAL$155,604TOTALPROGRAMREVENUE$155,604Page1of2
RevisedExhibitC-3CulturalBasedAccessNavigation&PeerSupportServicesFresnoInterdenominationalRefugeeMinistries(FIRM)FiscalYears2017-18,2018-19,2019-20,2020-21BudgetCategories-TotalProposedBudgetLineItemDescription(Mustbeitemized)FTE%Admin.DirectTotalPERSONNELSALARIES:0001CommunityHealthWorker(Lao)0.75$23,400$23,4000002PeerSupportSpecialist(1Hmong&.5Cambodian)1.50$43,680$43,6800003Supervisor0.09$5,580$0$5,5800004CommunityHealthWorker(Arabic)1.00$31,200$31,2000005PeerSupportSpecialist(Arabic)0.75$21,840$21,840SALARYTOTAL4.09$5,580$120,120$125,700PAYROLLTAXES:0030OASDI$00031FICA/MEDICARE$416$9,016$9,4320032SUI$39$1,714$1,753PAYROLLTAXTOTAL$455$10,730$11,185EMPLOYEEBENEFITS:0040Retirement$00041WorkersCompensation$1,5660042HealthInsurance(medical,vision,life,dental)$19,395EMPLOYEEBENEFITSTOTAL$0$0$20,961SALARY&BENEFITSGRANDTOTAL$157,846FACILITIES/EQUIPMENTEXPENSES:1010Rent/LeaseBuilding$4,3501011Rent/LeaseEquipment$4001012Utilities$1,2001013BuildingMaintenance$400FACILITY/EQUIPMENTTOTAL$6,350OPERATINGEXPENSES:1060Telephone$1,3201061Printing/Reproduction$5001062OfficeSupplies&Equipment$3861063Food$4,8001064ProgramSupplies-Therapeutic$7501065TransportationofClients$6,5001066StaffMileage/vehiclemaintenance$2,4841067StaffTraining/Registration$5001068IncentivesforPeerMeetings/SupportGroups$2,520OPERATINGEXPENSESTOTAL$19,760FINANCIALSERVICESEXPENSES:1080Accounting/Bookkeeping$1,2601081ExternalAudit$1,4001082LiabilityInsurance$1051083AdministrativeOverhead$18,428FINANCIALSERVICESTOTAL$21,193TOTALPROGRAMEXPENSES$205,149MHSAFUNDS:5000Prevention&EarlyInterventionFunds$205,149MHSAFUNDSTOTAL$205,149TOTALPROGRAMREVENUE$205,149Page2of2