HomeMy WebLinkAboutAgreement A-24-262 Amendment I to Master Agreement No. 23-292.pdf Agreement No. 24-262
1 AMENDMENT NO. 1 TO SERVICE AGREEMENT
2 This Amendment No. 1 to Service Agreement ("Amendment No. 1") is dated
3 June 4, 2024 and is between each contractor listed in Exhibit A-1 "Residential-
4 Withdrawal Management Room and Board Vendor List," (each a "Contractor" and collectively
5 referred to as "Contractors"), and the County of Fresno, a political subdivision of the State of
6 California ("County").
7 Recitals
8 A. County is authorized through its Substance Use Prevention, Treatment and Recovery
9 Services Block Grant (SUBG) Application with the California Department of Health Care
10 Services ("DHCS" or"State") to subcontract for Room and Board for Residential and Withdrawal
11 Management Substance Use Disorder (SUD) treatment services in Fresno County.
12 B. County is authorized to contract with privately operated agencies for the provision of
13 alcohol and other drug treatment services, pursuant to Title 9, Division 4 of the California Code
14 of Regulations and Division 10.5 (commencing with Section 11750) of the California Health and
15 Safety Code.
16 C. Contractors are certified by the State to provide services required by the County.
17 D. On June 20, 2023, the County and the Contractor entered into Non-DMC Room and
18 Board Master Agreement, which is County Agreement No. 23-292 ("Agreement"), for the
19 provision of Room and Board for residential and withdrawal management SUD treatment
20 services in Fresno County.
21 E. The County and Contractors now desire to amend various subsections of the Agreement
22 to update provider reporting requirements to align with California Advancing and Innovating
23 Medi-Cal (CaIAIM) initiatives and the new Electronic Health Records system and add Contractor
24 participation requirements for State efforts to improve culturally responsive care delivery;
25 F. The County and Contractors now desire to revise various exhibits, including Exhibit A,
26 Residential and Withdrawal Management Room and Board Vendor List to amend maximum
27 compensation for Mental Health Systems, Inc.; and Exhibit C to include the current Guiding
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a
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1 Principles of Care Delivery and to revise Exhibit J to amend WestCare California, Inc. residential
2 rates effective July 1, 2024.
3 The parties therefore agree as follows:
4 1. All references in the Agreement to "Exhibit A" shall be deemed references to Exhibit A-1.
5 Exhibit A-1 is attached and incorporated by this reference.
6 2. All references in the Agreement to "Exhibit C" shall be deemed references to Exhibit C-1.
7 Exhibit C-1 is attached and incorporated by this reference.
8 3. All references in the Agreement to "Exhibit H" shall be deemed references to Exhibit H-1.
9 Exhibit H-1 is attached and incorporated by this reference.
10 4. All references in the Agreement to "Exhibit X shall be deemed references to Exhibit J-1.
11 Exhibit J-1 is attached and incorporated by this reference.
12 5. That Article 1, Section 1.23 of the Agreement located at page 10, beginning at line 16
13 through page 13, line 21 is deleted in its entirety and replaced with the following:
14 "1.23 Reports. Contractors shall submit all information and data required by County
15 and State in accordance with Exhibit H-1 — Provider Reporting Requirements, incorporated in
16 this Agreement and also available on the DBH webpage at:
17 https://www.fresnocountVca.gov/Departments/Behavioral-Health/Providers/Contract-Provider-
18 Resources/Substance-Use-Disorder-Provider-. Reporting requirements may be revised
19 periodically to reflect changes to State-mandated reporting. Contractors that are not in
20 compliance with reporting deadlines are subject to payment withholding until reporting
21 compliance is achieved. Reporting requirements include, but are not limited to, the following:
22 (A) Drug and Alcohol Treatment Access Report (DATAR) in an electronic format
23 provided by the State and due no later than five (5) days after the preceding month;
24 (B) Ca1OMS Treatment— Submit Ca1OMS treatment admission, discharge, annual
25 update, and "provider activity report" record in an electronic format through County's EHR, and
26 on a schedule as determined by the County which complies with State requirements for data
27 content, data quality, reporting frequency, reporting deadlines, and report method and due no
28 later than five (5) days after the preceding month. All Ca1OMS admissions, discharges and
Q
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1 annual updates must be entered into the County's CalOMS system within twenty-four (24) hours
2 of occurrence;
3 (C) ASAM Level of Care (LOC) — Submit ASAM LOC data in a format determined by
4 DBH, on a schedule as determined by the County which complies with State requirements;
5 (D) DMC Outpatient Timeliness and/or DMC Opioid Timeliness— Contractor shall
6 enter access information into County's EHR at time of first contact with person served;
7 (E) Ineligible Person Screening Report— Format provided by County DBH and due
8 by the fifteenth (151h) day of each month to comply with State requirements;
9 (F) LogicManager Incident Reporting —As needed, when incidents occur and as
10 instructed in Exhibit I, Protocol for Completion of Incident Report;
11 (G) Monthly Status Report— Format provided by County DBH and due by the fifteen
12 (15th) day of each month;
13 (H) Wait list— Required by residential providers only and due by the fifteen (15th) day
14 of each month;
15 (1) Grievance Log — Due by the fifteen (151h) day of each month;
16 (J) Missed Appointments —Contractor shall maintain missed appointment
17 information until such time that DBH is able to collect that information in its Electronic Health
18 Record or other database;
19 (K) Cultural Competency Survey— Completed semi-annually in a format to be
20 determined by DBH;
21 (L) Americans with Disabilities (ADA)—Annually, upon request by County DBH,
22 Contractor shall complete an ADA Accessibility Certification and Self-Assessment, including
23 Implementation Plan, for each service location;
24 (M) Culturally and Linguistically Appropriate Services (CLAS) —Annually, upon
25 request by County DBH, Contractor shall complete an agency CLAS survey in a format
26 determined by County DBH and shall submit a CLAS Self-Assessment, including an
27 Implementation Plan;
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1 (N) Risk Assessment—Annually, upon request by County DBH, Contractor shall
2 submit a Risk Assessment on a form and in a format to be provided by DBH. The Assessment
3 must be submitted to the County in hard copy as well as electronically by the due date set by
4 County;
5 (0) Network Adequacy Certification Tool (NACT)—Annually, upon request,
6 Contractor shall submit NACT data as requested by County DBH;
7 (P) DMC-ODS 274 Provider Network Data Reporting — Due monthly by the twenty-
8 fifth (25th) day of each month and in a format provided by County DBH. Additionally, Contractors
9 are required to participate in 274 workgroup meetings with potential corrective actions or
10 sanctions, including withholding payment, for non-compliance.
11 (Q) Cost Reports—On an annual basis for each fiscal year ending June 301h non-
12 DMC Contractor shall submit a complete and accurate detailed cost report. Cost reports must
13 be submitted to the County as a hard copy with a signed cover letter and an electronic copy by
14 the due date. Submittal must also include any requested support documents such as general
15 ledgers and detailed electronic (e.g. Excel) schedules demonstrating how costs were allocated
16 both within programs, if provider has multiple funding sources (e.g. DMC and SUBG), and
17 between programs, if Contractor provides multiple SUD treatment modalities.
18 Contractor shall maintain general ledgers that reflect the original transaction
19 amounts where each entry in their accounting records represents one-hundred percent (100%)
20 of the total transaction cost and can be supported with the original source documentation (i.e.
21 receipts, bills, invoices, payroll registers, etc.). Bank statements reflecting purchases are not
22 original source documents and will not be accepted as such. All costs found to not be supported
23 by original source documentation will be disallowed. Total unallowable costs shall be allocated
24 their percentage share of the indirect Costs along with the Contractor's direct costs. All reports
25 submitted by Contractor to County must be typewritten.
26 County will issue instructions for completion and submittal of the annual cost
27 report, including the relevant cost report template(s) and due dates within forty-five (45) days of
28 each fiscal year end. All cost reports must be prepared in accordance with Generally Accepted
4
1 Accounting Principles. Unallowable costs such as those denoted in 2 CFR 200 Subpart E, Cost
2 Principles, 41 U.S.C. 4304, and the Center for Medicare and Medicaid Studies (CMS) Provider
3 Reimbursement Manual (PRM) 15-1, must not be included as an allowable cost on the cost
4 report and all invoices. Unallowable costs must be kept in the provider's General Ledger in
5 accounts entitled Unallowable followed by name of the account (e.g. Unallowable — Food) or in
6 some other appropriate form of segregation in the provider's accounting records. For further
7 information on unallowable costs refer to regulations provided above. Once the cost reports
8 have been approved by the County, originally-executed signed certification pages attesting to
9 the accuracy of the information contained in cost reports shall be submitted to the County.
10 Contractors with multiple agreements for the same service provided at the same
11 location where at least one of the Agreements is funded through DMC and the other funding is
12 other federal or county realignment funding will be required to complete cost reports for the non-
13 DMC agreement. Such Agreements will be settled for actual allowable costs in accordance with
14 Medicaid reimbursement requirements as specified in Title XIX or Title XXI of the Social
15 Security Act; Title 22, and the State's Medicaid Plan not to exceed the lesser of actual costs or
16 contract maximum. Within forty-five (45) days of the reconciliation by County, Contractor shall
17 make payment to County or County shall reimburse Contractor as appropriate.
18 During the term of this Agreement and thereafter, County and Contractor agree
19 to settle dollar amounts disallowed or settled in accordance with DHCS and County audit
20 settlement findings.
21 In the event that Contractor fails to provide such reports or other information
22 required hereunder, it shall be deemed sufficient cause for the County to withhold monthly
23 payments until there is compliance. In addition, the Contractor shall provide written notification
24 and explanation to the County within fifteen (15) days of any funds received from another
25 source to conduct the same services covered by this Agreement."
26 6. That a new Section 9.1.1 shall be added to the agreement, located on page 30,
27 beginning on line 13 as follows:
28
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1 "9.1.1 Participation Requirements. The Contractor shall participate in the State's
2 efforts to promote the delivery of services in a culturally competent manner to all persons
3 served, including those with limited English proficiency and diverse cultural and ethnic
4 backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity. (42
5 CFR §438.206(c)(2).)"
6 7. The Contractor represents and warrants to the County that:
7 a. The Contractor is duly authorized and empowered to sign and perform its obligations
8 under this Amendment.
9 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
10 to do so and his or her signature on this Amendment legally binds the Contractor to
11 the terms of this Amendment.
12 8. The parties agree that this Amendment may be executed by electronic signature as
13 provided in this section.
14 a. An "electronic signature" means any symbol or process intended by an individual
15 signing this Amendment to represent their signature, including but not limited to (1) a
16 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
17 electronically scanned and transmitted (for example by PDF document) version of an
18 original handwritten signature.
19 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
20 equivalent to a valid original handwritten signature of the person signing this
21 Amendment for all purposes, including but not limited to evidentiary proof in any
22 administrative or judicial proceeding, and (2) has the same force and effect as the
23 valid original handwritten signature of that person.
24 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
25 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
26 2, Title 2.5, beginning with section 1633.1).
27
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1 d. Each party using a digital signature represents that it has undertaken and satisfied
2 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
3 through (5), and agrees that each other party may rely upon that representation.
4 e. This Amendment is not conditioned upon the parties conducting the transactions
5 under it by electronic means and either party may sign this Amendment with an
6 original handwritten signature.
7 9. This Amendment may be signed in counterparts, each of which is an original, and all of
8 which together constitute this Amendment.
9 10. The Agreements amended by this Amendment No. 1 is ratified and continued. All
10 provisions of the Agreement and not amended by this Amendment No. 1 remain in full force and
11 effect.
12 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No.1 on the date stated in the introductory
2 clause.
3
CONTRACTORS COUNTY OFFRESNO
4
SEE FOLLOWING SIGNATURE PAGES ,�-
5
6 Nathan Magsig, Chairman of the Board of
Supervisors of the County of Fresno
7
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.: 56302081
Account No.: 7295/0
14 Fund No.: 0001
Subclass No.: 1000
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The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date
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stated in the introductory clause.
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Provider: COMPREHENSIVE ADDICTION PROGRAMS, INC.
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By
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Print r4ame:
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10 Title:
Chairman of the Board, President, or Vice President
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12 Date: 70
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15 By
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-44pV, ryl,All
Print Name:
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Title:
19 Secretary (of Corpor# t 6n), Assistant Secretary,
Chief Financial Officer, or Assistant Treasurer
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1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date
2 stated in the introductory clause.
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Provider: FRESNO COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG
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ABUSE SERVICES,INC.
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By /
9 Print Name: Alfredo C.Vasquez
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11 Title: Chairman
12 Chairman of the Board, President,or Vice President
13 Date: April 30,2024
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16 By
17 -
18 Print Name: I UJa
19 Title: CG�71 tr� C 7 C✓
20 Secretary(of Corporation),Assistant Secretary,
Chief Financial Officer, or Assistant Treasurer
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22 Date: 4 /3 U �2 4
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The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date
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stated in the introductory clause.
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Provider: MENTAL HEALTH SYSTEMS, INC.
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6 'an�es C Callag;�an
By
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g Print Name: James C. Callaghan Jr.
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Title: CEO/President
Chairman of the Board. President, or Vice President
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12 Date: 05/01/24
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14 �.�l�id Tamer
15 By
16 Print Name: David Tanner
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18 Title: VP of Corporate Finance
19 Secretary (of Corporation), Assistant Secretary,
Chief Financial Officer, or Assistant Treasurer
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21 Date:
05/01/24
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The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date
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stated in the introductory clause.
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Provider: TURNING POINT OF CENTRAL CALIFORNIA, INC.
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7 By
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Print Name: !� a
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10 Title: CIE 0
Chairman of the Board, President, or Vice President
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12 Date:
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15 By
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Print Name:
18 Title: ,1:, ,:., Gr o
19 Secretary (of Corporation), Assistant Secretary,
Chief Financial Officer, or Assistant Treasurer
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21 Date /3� 26 z 4L
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1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date
2 stated in the introductory clause.
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5 Provider: WESTCARE CALIFORNIA, INC.
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7 Byc�-
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9 Print Name:'& wo ri�.%"S
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Title: C—C30
11 Chairman of the Board, President, or Vice President
12 5/2/24
Date:
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w LLA 20 L-4-(1)
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By
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17 N r.i N
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19 Title:
Secretary (of Corporation), Assi--.Wnt Secretary,
20 Chief Financial Officer, or Assistant Treasurer
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Date: O� CU
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Fresno County Department of Behavioral Health Exhibit A-i
Provider Maximum Annual Allocation
Residential-Withdrawal Management Room and Board Vendor List
PHONE NUMBER/ Contract Max Contract Max Contract Max Contract Max
VENDOR CONTACT FAX EMAIL TYPE OF BUSINESS FY 2023-24 FY 2024-25 FY 2025-26 FY 2026-27
Comprehensive Addiction Programs Inc.
Remit to: Executive Director (559)492-1373 information@capfresno.org 501(c)3 Non-Profit Corporation $1,610,000 $1,610,100 $1,610,100 $1,610,100
2445 W.Whitesbridge Ave. Fax:(559)223-2898
Fresno,Ca 93706
Fresno County Hispanic Commission on
Alcohol and Drug Abuse Services,Inc.
Remit to: Executive Director (559)268-6480 info@hispaniccommission.org 501(c)3 Non-Profit Corporation $300,000 $300,000 $300,000 $300,000
1414 W Kearney Blvd
Fresno,Ca 93706
Mental Health Systems,Inc.
Remit to: CEO (858)573-2600 contact@turnbhs.org 501(c)3 Non-profit Corporation $1,540,000 $1,540,000 $1,540,000 $1,540,000
9465 Farnham St. CFO
San Diego,CA 92123
Turning Point of Central California,Inc.
Remit to: Chief Executive Officer (559)732-8086 info@tpocc.org 501(c)3 Non-profit Corporation $550,000 $550,000 $550,000 $550,000
P.O.Box 7447
Visalia,Ca 93290
WestCare California,Inc.
Remit to: Chief Operating Officer (559)251-4800 infoca@westcare.com 501(c)3 Non-profit Corporation $2,150,000 $2,150,000 $2,150,000 $2,150,000
1900 N.Gateway Blvd Fax:(559)453-7827
Fresno,CA 93727
Non-DMC Withdrawal Management Room and Board Vendor List
VENDOR PHONE NUMBER TYPE OF BUSINESS Contract Max Contract Max Contract Max Contract Max
FY 2023-24 FY 2024-25 FY 2025-26 FY 2026-27
Comprehensive Addiction Programs Inc.
Remit to: Executive Director (559)492-1373 information@capfresno.org 501(c)3 Non-profit Corporation See Above See Above See Above See Above
2445 W.Whitesbridge Ave. Fax:(559)223-2898
Fresno,Ca 93706
Mental Health Systems,Inc.
Remit to: CEO (858)573-2600 contact@turnbhs.org 501(c)3 Non-profit Corporation See Above See Above See Above See Above
9465 Farnham St. CFO
San Diego,CA 92123
WestCare California,Inc.
Remit to: Chief Operating Officer (559)251-4800 infoca@westcare.com 501(c)3 Non-profit Corporation See Above See Above See Above See Above
1900 N.Gateway Blvd Fax:(559)453-7827
Fresno,CA 93727
$6,150,000 $6,150,100 $6,150,100 $6,150,100
**A list of current provider sites can be found at:
https://www.co.fresno.ca.us/departments/behavio ra I-health/substance-use-disorder-services
Revised 04/04/2024
Exhibit C-1
COtf��.c.
$ Department of
Sao Behavioral Health
FRE"' PPG 1.3.14 V#: 2
Section: DBH Policies & Procedures, Mental Health, Substance Use Disorder
Effective Date: 07/09/2021 Revised Date: 01/10/2024
Policy Title: Guiding Principles of Care Delivery
Approved by:Joseph Rangel (Behavioral Health Division Manager), Lesby Flores (Licensed Deputy Director of
Behavioral Health), Stacy VanBruggen (Licensed Behavioral Health Division Manager), Susan Holt(Director of
Behavioral Health)
POLICY: The DBH Guiding Principles of Care Delivery define and guide our
Behavioral Health System of Care. We expect excellence in the provision
of behavioral health services where the values of wellness, resiliency, and
recovery are central to the development of programs, services, and
workforce.
PURPOSE: The principles provide the clinical framework that influences decision-
making in all aspects of care delivery including program design and
implementation, service delivery, training of the workforce, allocation of
resources, and measurement of outcomes.
REFERENCE: N/A
DEFINITIONS: Quadruple Aim — (1) deliver quality care, (2) maximize resources while
focusing on efficiency, (3) provide an excellent care experience, and (4)
promote workforce well-being.
PROCEDURE:
I. Principle One — Timely Access & Integrated Services
A. Persons-served are connected with services in a manner that is efficient and
effective.
B. Collaborative care coordination occurs across agencies, plans for care are
integrated, and whole person care considers all life domains such as physical
health, education,employment, housing, spirituality and other social determinant
of health.
C. Barriers to access and treatment are identified and addressed.
D. Excellent customer service ensures persons served are transitioned from one
point of care to another without disruption of care.
II. Principle Two — Strengths-Based
A. Positive change occurs within the context of genuine trusting relationships.
MISSION STATEMENT
DBH,in partnership with our diverse communities,is dedicated to providing quality,culturally responsive,behavioral health services to promote
wellness,recovery,and resiliency for individuals and families in our community.
0812021
Exhibit C-1
Section: DBH Policies& Procedures, Mental Health,Substance Use
Disorder
PPG 1.3.14 V#:2
Policy Title: Guiding Principles of Care Delivery
B. Individuals, families, and communities are resourceful and resilient in the way
they solve problems.
C. Hope and optimism are created through the identification of, and focus on, the
unique abilities of persons served.
III. Principle Three — Person-Driven and Family-Driven
A. Self-determination and self-direction are the foundations for recovery.
B. Persons served optimize their autonomy and independence by leading the
process, including the identification of strengths, needs, and preferences.
C. Providers contribute clinical expertise, provide options, and support persons
served in informed decision making, developing goals and objectives, and
identifying pathways to recovery.
D. Persons served partner with their provider(s) in determining the services and
supports that would be most effective and helpful and they exercise choice in the
services and supports they receive.
IV. Principle Four— Inclusive of Natural Supports
A. The person served identifies and defines family and other natural supports to be
included in care.
B. Persons served speak for themselves.
C. Natural support systems are vital to successful recovery and the maintaining of
ongoing wellness;these supports include personal associations and relationships
typically developed in the community that enhance a person's quality of life.
D. Providers assist persons served in developing and utilizing natural supports.
V. Principle Five — Clinical Significance and Evidence Based Practices (EBP)
A. Services are effective, resulting in a noticeable, measurable change in daily life.
B. Clinical practice is informed by best available research evidence, best clinical
expertise, and the values and preferences of those we serve.
C. Other clinically and culturally significant interventions such as innovative,
promising, and emerging practices are embraced.
VI. Principle Six — Culturally Responsive
A. Values, traditions, and beliefs specific to a person served's culture(s) are valued
and leveraged to support the theirwellness, resilience, and recovery.
B. Services are culturally grounded, congruent, and personalized to reflect the
unique cultural experience of each person served.
2 1 P a g e
Exhibit C-1
Section: DBH Policies& Procedures, Mental Health,Substance Use
Disorder
PPG 1.3.14 V#:2
Policy Title: Guiding Principles of Care Delivery
C. Providers exhibit the highest level of cultural humility and responsiveness to the
self-identified culture(s) of the person orfamily served in striving to achieve the
greatest equity in care delivery.
VII. Principle Seven — Trauma-informed and Trauma-Responsive
A. The widespread impacts of all types of trauma are recognized and the various
potential paths for recovery from trauma are understood.
B. Signs and symptoms of trauma in persons served, team members, and others
are recognized and persons served receive trauma-informed responses.
C. Physical, psychological, and emotional safety for persons served and treatment
team members is emphasized.
Vill. Principle Eight— Co-Occurring Capable
A. Services are reflective of whole-person care; providers understand the influence
of bio-psycho-social factors and the interactions between physical health, mental
health, and substance use disorders.
B. Treatment of mental health and substance use disorders are integrated. A
provider or team may deliver treatment for mental health and substance use
disorders at the same time.
IX. Principle Nine — Stages of Change, Motivation, and Harm Reduction
A. Interventions are motivation-based and adapted to the person served's stage of
change.
B. Progression through stages of change is supported through positive working
relationships and alliances that are motivating.
C. Providers support persons served to develop strategies aimed at reducing
negative outcomes of substance misuse through a harm reduction approach.
D. Each person served defines their own recovery and recovers at their own pace
when provided with sufficient dignity, time, and support.
X. Principle Ten — Continuous Quality Improvement and Outcomes-Driven
A. Individual and program outcomes are collected and evaluated for quality and
efficacy.
B. Strategies are implemented to achieve a system of continuous quality
improvement and improved performance outcomes.
C. Providers participate in ongoing professional development activities needed for
proficiency in practice and implementation of treatment models.
XI. Principle Eleven — Health and Wellness Promotion, Illness and Harm Prevention,
and Stigma Reduction
3 1 P a g e
Exhibit C-I
Section: DBH Policies& Procedures, Mental Health,Substance Use
Disorder
PPG 1.3.14 V#:2
Policy Title: Guiding Principles of Care Delivery
A. The rights of all persons served are respected and persons served are treated
with dignity.
B. Behavioral health is recognized as essential for person served and community
well-being.
C. Promotion of health and wellness is interwoven throughout all aspects of DBH
services.
D. Specific strategies to prevent illness and harm are implemented at the individual,
family, program, and community levels.
E. Stigma is actively reduced by promoting awareness and accountability through
creating positive change in attitudes, beliefs, practices, and policies within all
systems.
F. The vision of health and well-being for our community is continually addressed
through collaborations between providers, persons served, families, and
community members.
4 1 P a g e
PROVIDER REPORTS Fresno County Substance Use Disorder Services
Department of Behavioral Health EXHIBIT H-1
Report Purpose Submit to Notes Weekly Monthly Annual As
Needed
Tracks level of care determined at sas@
ASAM Level of Care screening,assessment,and reassessment fresnocountyca. Reports are provided monthly using excel 20t"of the
(LOC) template provided by DBH. month
and actual LOC referred to. gov
Provides capacity and utilization 5th of
DATAR information on publicly funded SUD DHCS Webpage following
programs. month
24 hours of
occurrence
and
Captures comprehensive client intake, Smartcare/ DBH submitted
CaIOMS Treatment treatment, and outcomes for statewide CalOMS includes admission, discharge, and no later than
Data analysis. EHR annual update information. five days
after the
preceding
month
Template provided by DBH.
• Provider shall enter information per
modality. If provider offers multiple
levelsof care within a modality,
Managed care requirement. Used to provider is to use the program ID t"
sas@ with the lowest LOC e. 15 of
Monthly Status Report monitor network adequacy standards. ( g.,for following
(MSR) Provides status on DMC programs and is fresnocountyca.gov residential, enter info under 3.1 month
used to update provider directory. instead of 3.5).
• Providers are asked to report
departing counselors via MSR as soon
asthey become aware of the
upcoming change.
Provides information on length of waittime sas@ 15th of
Wait List* for admission into a residential program. fresnocountyca.gov Applicable to residential providers only. following
month
03-05-2024
Page 1
PROVIDER REPORTS Fresno County Substance Use Disorder Services
Department of Behavioral Health EXHIBIT H-1
Report Purpose Submit to Notes weekly Monthly Annual As
Needed
Ineligible Persons Checks for clinicians'eligibility to provide sas@ 15th of
Screening services based on sanctions or exclusion fresnocountyca.gov Template provided by DBH. current
status. month
Providers are expected to maintain missed
appointment information until such time 15th of
Missed Appointments Collects missed appointment data. N/A that DBH is able to collect that information following
in its Electronic Health Record or other month
database.
DHCS requirement.Collects grievances at mcare@ 15th in
of
Grievance Log Template provided b DBH following
SUD programs. fresnocountyca.gov p p Y
month
Network Adequacy Used to monitor network adequacy sas@ Template provided by DBH. Submission Feb 1
Certification Tool (NACT) standards. fresnocountyca.gov dates may be subject to change.
DMC Outpatient Timely data submission on client access to Entered at the time of first contact with the
Timeliness and/or DMC Smart Care/ DBH As
services, measuring performance against EHR person served. Instructions for completion to needed
Opioid Timeliness established benchmarks for promptness. be provided by DBH.
03-05-2024
Page 2
PROVIDER REPORTS Fresno County Substance Use Disorder Services
Department of Behavioral Health EXHIBIT H-I
Report Purpose Submit to Notes weekly Monthly Annual As
Needed
DMC-ODS plans must submit detailed
provider network data for various service
levels using the X12 274 standard.This
includes data for outpatient, intensive
outpatient, residential, and opioid
treatment programs, covering county- 25t"of
DMC-ODS 274 Provider sas@ Network Data Reporting operated and contracted providers.The fresnocountyca.gov Template provided by DBH. following
submission must meet specific format and Month
compliance standards.Additionally, plans
are required to participate in 274
workgroup meetings,with potential
corrective actions or sanctions for non-
compliance
Culturally and
Linguistically Used to monitor adherence to the National
Appropriate Services CLAS Standards which are intended to sas@ late provided b TBD
Template(CLAS) self-assessment advance health equity, improve quality, fresnocountyca.gov p p y DBH.
and CLAS plan and help eliminatehealth care disparities.
Americans with Used to monitor compliance with sas@
Disabilities Act(ADA)Self- legislation that prohibits discrimination fresnocountyca.gov Template provided by DBH TBD
Assessment against people with disabilities.
03-05-2024
Page 3
PROVIDER REPORTS Fresno County Substance Use Disorder Services
Department of Behavioral Health EXHIBIT H-I
Additional Reports
Report Purpose Submit to Notes Weekly Monthly Annual As
Needed
Cultural Competency Surveys assessing provider cultural sas@ Complet
p y competency,guiding training, and Template provided by DBH.Completed ed semi-
Survey fresnocountyca.gov semi-annually or as determined by DBH. annually
policy adjustments Y
• Providers are required to
complete an online report of any
Documentation of any incidents incidents that compromise the
LogicManager Incident within treatment settings, Logic Manager health and safety of clients, X
Reporting supporting risk management and Website employees or community
quality improvement efforts members.
• Reports must be submitted within
48 hours of an incident.
• Timeframes vary. Refer to MHSUDS
IN #18-010E:
https://www.dhcs.ca.gov/forms
andpubs/Pages/Behavioral Heal
Notice of Adverse Managed Care requirement. NOABD letters th Information Notice.aspx
Benefit provide information to Medi-Cal persons mcare@fresnocount
• Templates provided by DBH, X
Determination served about their appeal rights and other yca.gov available at the Provider page:
(NOABD) rights under the Medi-Cal program. https://www.co.fresno.ca.us/depar
tments/behavioralhealth/
home/forproviders/
contractproviders/
substance-use-disorderproviders
03-05-2024
Page 4
Fresno County Department of Behavioral Health Exhibit!-1
Residential/Withdrawal Management Room and Board Compensation
Approved Rates by Modality/Provider
Rates Effective 7.01.2023 (Unless Otherwise Noted) Rates Effective 7.01.2023-6.30.2024
Day Rate Day Rate
Withdrawal Management 3.2 Residential 3.1
Comprehensive Addiction Programs 48.54 WestCare Fresno-Mens 56.91
Mental Health Systems 74.61 WestCare Fresno-Womens 53.82
WestCare Fresno- Mens 54.58 WestCare Fresno-Perinatal 51.97
WestCare Fresno-Womens 54.58 Residential 3.5
WestCare Fresno-Perinatal 54.58 WestCare Fresno-Mens 54.07
Residential 3.1 WestCare Fresno-Perinatal 55.24
Comprehensive Addiction Programs 53.25 WestCare Fresno-Womens 57.94
Fresno County Hispanic Commission 87.67
Mental Health Systems 82.95
Turning Point-Quest House 102.56
WestCare-Bakersfield 29.76
RATE
WestCare Fresno 55.38
EFFECTIVE
Residential 3.3 7.01.2024
WestCare Fresno 55.75
Residential 3.5
Comprehensive Addiction Programs 52.01
Mental Health Systems 82.95
Turning Point-Quest House 99.44
WestCare-Bakersfield 32.20
RATE
WestCare Fresno 55.36
EFFECTIVE
7.01.2024
Revised 06/04/2024 1 of 1