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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 28 a 1 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 2 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; 28 3 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 5 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 28 6 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] 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 7 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 15 16 17 18 19 20 21 22 23 24 25 26 27 28 8 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date 2 stated in the introductory clause. 3 4 Provider: COMPREHENSIVE ADDICTION PROGRAMS, INC. 5 6 By 7 8 Print r4ame: 9 10 Title: Chairman of the Board, President, or Vice President 11 /1 12 Date: 70 13 14 15 By 16 -44pV, ryl,All Print Name: 17 18 Title: 19 Secretary (of Corpor# t 6n), Assistant Secretary, Chief Financial Officer, or Assistant Treasurer 20 21 Date: 22 23 24 25 26 27 28 9 1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date 2 stated in the introductory clause. 3 4 Provider: FRESNO COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG 5 ABUSE SERVICES,INC. 6 7 8 By / 9 Print Name: Alfredo C.Vasquez 10 11 Title: Chairman 12 Chairman of the Board, President,or Vice President 13 Date: April 30,2024 14 15 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 21 22 Date: 4 /3 U �2 4 23 24 25 26 27 28 10 1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date 2 stated in the introductory clause. 3 4 Provider: MENTAL HEALTH SYSTEMS, INC. 5 6 'an�es C Callag;�an By 7 g Print Name: James C. Callaghan Jr. 9 10 Title: CEO/President Chairman of the Board. President, or Vice President 11 12 Date: 05/01/24 13 14 �.�l�id Tamer 15 By 16 Print Name: David Tanner 17 18 Title: VP of Corporate Finance 19 Secretary (of Corporation), Assistant Secretary, Chief Financial Officer, or Assistant Treasurer 20 21 Date: 05/01/24 22 23 24 25 26 27 28 11 1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date 2 stated in the introductory clause. 3 4 Provider: TURNING POINT OF CENTRAL CALIFORNIA, INC. 5 6 7 By 8 Print Name: !� a 9 10 Title: CIE 0 Chairman of the Board, President, or Vice President 11 12 Date: 13 14 22 15 By 16 _ 17 Print Name: 18 Title: ,1:, ,:., Gr o 19 Secretary (of Corporation), Assistant Secretary, Chief Financial Officer, or Assistant Treasurer 20 21 Date /3� 26 z 4L 22 23 24 25 26 27 28 12 1 The parties are executing this Amendment No. 1 to Agreement No. 23-292 on the date 2 stated in the introductory clause. 3 4 5 Provider: WESTCARE CALIFORNIA, INC. 6 7 Byc�- 8 9 Print Name:'& wo ri�.%"S 10 Title: C—C30 11 Chairman of the Board, President, or Vice President 12 5/2/24 Date: 13 14 w LLA 20 L-4-(1) 15 By 16 17 N r.i N 18 19 Title: Secretary (of Corporation), Assi--.Wnt Secretary, 20 Chief Financial Officer, or Assistant Treasurer 21 Date: O� CU 22 23 24 25 26 27 28 13 1 2 3 4 5 THIS PAGE INTENTIONALLY LEFT BLANK 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 14 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