HomeMy WebLinkAboutAmendment II to Master STRTP Agt 23-277 23-575.pdf Agreement No. 23-575
1 AMENDMENT NO. 2 TO MASTER SERVICE AGREEMENT
2 This Amendment No. 2 to Master Service Agreement 23-417 ("Amendment No. 2") is
3 dated October 24, 2023 and is between each Contractor ("Contractor(s)") listed in
4 Revised Exhibit A, "List of Contractors", and the County of Fresno, a political subdivision of the
5 State of California ("County").
6 Recitals
7 A. On June 20, 2023, the County and the Contractor(s) entered into a Master Short-Term
8 Residential Therapeutic Program (STRTP) Service Agreement, which is County agreement
9 number 23-277 ("Agreement"), for the provision of specialty mental health services to youth and
10 non-minor dependents placed in the care of the Contractor(s).
11 B. On August 22, 2023, the County and the Contractor(s) entered into County agreement
12 number 23-417 ("Amendment No. 1"), to add Brighter Horizon Group Homes, Inc. to the list of
13 Contractors providing specialty mental health services to Fresno County youth in their care.
14 C. In September 2023, Brighter Horizon Group Homes, Inc., was identified as an STRTP
15 that meets the requirements to be added to the list of Contractors providing specialty mental
16 health services to Fresno County youth in their care.
17 D. The County and the Contractor now desire to amend the Agreement to add Brighter
18 Horizon Group Homes, Inc. to Revised Exhibit A as a Contractor included under this Master
19 STRTP Agreement.
20 The parties therefore agree as follows:
21 1. All references to Revised Exhibit A in the current Agreement shall be deemed references
22 to Revised Exhibit A-1, which is attached and incorporated by reference.
23 2. Exhibit B-12, "Scope of Services" for Brighter Horizon Group Homes, Inc. shall be added
24 to the Master Agreement and considered included in all references to "Exhibit B-1, et. seq.".
25 3. The parties agree that upon execution of this Amendment No. 2, the Agreement and
26 Amendment No. 1 are further revised, updated, and amended to add Contractor(s): Brighter
27 Horizon Group Homes, Inc.
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1 4. When both parties have signed this Amendment No. 2, the Agreement, Amendment No.
2 1, and this Amendment No. 2 together constitute the Agreement.
3 5. The Contractor represents and warrants to the County that:
4 a. The Contractor is duly authorized and empowered to sign and perform its obligations
5 under this Amendment.
6 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
7 to do so and his or her signature on this Amendment legally binds the Contractor to
8 the terms of this Amendment.
9 6. The parties agree that this Amendment may be executed by electronic signature as
10 provided in this section.
11 a. An "electronic signature" means any symbol or process intended by an individual
12 signing this Amendment to represent their signature, including but not limited to (1) a
13 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
14 electronically scanned and transmitted (for example by PDF document) version of an
15 original handwritten signature.
16 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
17 equivalent to a valid original handwritten signature of the person signing this
18 Amendment for all purposes, including but not limited to evidentiary proof in any
19 administrative or judicial proceeding, and (2) has the same force and effect as the
20 valid original handwritten signature of that person.
21 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
22 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
23 2, Title 2.5, beginning with section 1633.1).
24 d. Each party using a digital signature represents that it has undertaken and satisfied
25 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
26 through (5), and agrees that each other party may rely upon that representation.
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1 e. This Amendment is not conditioned upon the parties conducting the transactions
2 under it by electronic means and either party may sign this Amendment with an
3 original handwritten signature.
4 7. This Amendment may be signed in counterparts, each of which is an original, and all of
5 which together constitute this Amendment.
6 8. The Agreement as amended by this Amendment No. 2 is ratified and continued. All
7 provisions of the Agreement and not amended by this Amendment No. 2 remain in full force and
8 effect.
9 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No. 1 on the date stated in the introductory clause.
2
BRIGHTER HORIZON GROUP HOMES, COUNTY OF FRESNO
3 INC.
5 David Vayntrub, CEO S Qu ro, Vhairman of the Board of
QJPeKis the County of Fresno
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Attest:
7 Bernice Seidel
Clerk of the Board of Supervisors
8 County of Fresno, State of California
By:_
10 Irina Vayntrub, Secretary Deputy
11
7849 Oceanus Drive
12 Los Angeles, CA 90046
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14 For accounting use only:
Org No.:56302232
15 Account No.:7295
Fund No.:0001
16 Subclass No.:10000
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Revised Exhibit A-1
List of Contractors
1. PROMESA BEHAVIORAL HEALTH (Exhibit B-1)
7120 N. Marks Avenue, Suite 110
Fresno, CA 93711
Phone#: (559) 439-5437
Contact for Notices: Chief Executive Officer
2. CORE CONDITIONS, INC. (Exhibit B-2)
4460 W. Shaw Ave #595
Fresno, CA 93722
Phone#: (559) 261-5083
Contact for Notices: Executive Director
3. DN ASSOCIATES RESIDENTIAL CARE (Exhibit B-3)
4460 W. Shaw Ave #595
Fresno, CA 93722
Phone#: (559) 261-5083
Contact for Notices: Executive Director
4. 2ND HOME, INC. (Exhibit B-4)
1797 San Jose Avenue
Clovis, CA 93611
Phone#: (559) 790-2271
Contact for Notices: Director
5. QUALITY GROUP HOMES, INC. (Exhibit B-5)
(dba QUALITY FAMILY SERVICES)
4928 E. Clinton Way, Suite 108
Fresno, CA 93727
Phone#: (559) 252-6844, ext. 222
Contact for Notices: Chief Executive Officer
6. HOPE FOR YOUTH, INC. (Exhibit B-6)
6790 W Browning Ave
Fresno, CA 93723
Phone#: (559) 681-1470
Contact for Notices: Executive Director
7. MICHIGAN HOUSE, INC. (Exhibit B-7)
2014 Tulare St., Suite #414
Fresno, CA 93721
Phone#: (559) 347-7527
A-1
Revised Exhibit A-1
Contact for Notices: Mental Health Director
8. MANUCH INC. (Exhibit B-8)
PO Box 26622
Fresno, CA 93729
Phone#: (559) 347-7627
Contact for Notices: Mental Health Director
9. FRESH START YOUTH CENTER, INC. (Exhibit B-9)
Address Confidential
Phone#:(559) 916-2813
Contact for Notices: Executive Director
10. FRESNO YOUTH CARE HOMES, INC. (Exhibit B-10)
1640 W. Shaw Ave Suite #100
Fresno, CA. 93711
Contact for Notices: Executive Director
11. ELITE FAMILY SYTEMS (Exhibit B-11)
2935 41" Street
Ceres, CA 95307
Contact for Notices: Clinical Director
12. BRIGHTER HORIZON GROUP HOMES, INC. (Exhibit B-12)
7849 Oceanus Drive
Los Angeles, CA 90046
Contact for Notices: Chief Operating Officer
A-2
Exhibit B-12
Scope of Services
ORGANIZATION: Brighter Horizon Group Homes, Inc. dba Brighter Horizon
Treatment Centers (BHTC)
ADDRESS: 7849 Oceanus Drive
Los Angeles, CA 90046
TELEPHONE: (310) 909-3817
CONTACT PERSON: Irina Vayntrub, COO
CONTRACT PERIOD: Upon execution —June 30, 2024
with one (1) optional twelve (12) month renewal
SUMMARY OF SERVICES
Brighter Horizon Treatment Centers (BHTC) will provide support to male and female youth ages
10-17, and their families, whose special needs can be met through services delivered,
supervised, and supported by professional agency staff. BHTC's mission is to provide
residential treatment, foster care, adoption, counseling, and supportive family services to youth
meeting medical necessity criteria utilizing a unique integrated comprehensive service delivery
model by providing interventions and support for service area youth and their families. BHTC's
services are provided in-house, and our youth receive individual/group counseling, substance
abuse treatment, anger management treatment, psychiatric services, independent living skills,
recreational services, educational services, and job training. This includes therapy, training,
familiarizing the youth with community resources providing these individuals with their basic
needs, reunifying family systems, creating new foster family units, rehabilitating juvenile
offenders, supporting pregnant and parenting teens, and developing a support system for all
youth. BHTC is a bi-lingual, multi-cultural organization who has serviced multiple counties.
BHTC provides placing counties with an assessment and treatment-oriented alternative for
emotionally and behaviorally disordered children who would otherwise be in settings more
restrictive than necessary. BHTC strives to stabilize referred youths and to reduce each referred
child's particular psychiatric symptoms and dysfunctional behaviors through comprehensive
interdisciplinary evaluation and Treatment Planning with a focus on a length of stay between 6
and 9 months, and to avoid/prevent inappropriate acute hospitalization. BHTC facilities provide
a safe, protective, and nurturing environment which maximizes the opportunity for the child and
their family to resolve psychopathology and resume reasonable age-appropriate pursuit of
developmental tasks.
B-12-1
Exhibit B-12
TARGET POPULATION
Youth between the ages of 10-17 who meet medical necessity for the STRTP program, and that
are referred by either child welfare or probation systems. Our residential treatment programs will
also provide youth who meet criteria for Serious Emotional Disturbance (SED) with an array of
core therapeutic services that are trauma informed, culturally relevant, and individualized based
on their treatment needs and development, to improve their mental health functioning.
REFERRALS
Fresno County youth shall retain priority placement within the STRTP. County-of-origin of
placed youth will be monitored and, if the STRTP is found to have a low percentage of Fresno
County placements overall, a meeting with County and the STRTP shall convene to discuss
potential remedies and/or penalties.
SERVICE LOCATIONS
BHTC, Elm BHTC, Cottonwood
3937 Griffith Avenue 3726 Graystoke Way
Clovis, CA 93619 Clovis, CA 93619
CONTRACTOR SHALL BE RESPONSIBLE FOR THE FOLLOWING SERVICES:
BHTC shall provide mental health treatment, including specialty mental health services, and
mental health supports, as appropriate to the needs of the child. All specialty mental health
services shall meet Medi-Cal standards. These services shall include all the following:
A. Mental Health Assessment:
i. A mental health assessment shall be completed by a licensed mental
health professional (LMHP) or waivered/registered associate within five
(5) calendar days of a youth's admission.
ii. A mental health assessment that was completed by an LMHP within sixty
(60) calendar days may also be used to meet this requirement.
B. Client Plan:
i. Each youth admitted to the STRTP shall have a Client Plan prepared,
reviewed and signed by an LMHP or the Head of Service (HOS) or any
other related discipline designated by the HOS within ten (10) calendar
days of admission.
ii. The Client Plan is reviewed by a member of the mental health program
staff at least every thirty (30) calendar days.
B-12-2
Exhibit B-12
iii. Client Plan of each youth or non-minor dependent shall include:
a) anticipated length of stay;
b) specific behavioral goals;
c) specific mental health treatment services;
d) one or more transition goals that support the rapid and
successful transition of the youth back into the community;
e) the youth's participation and agreement; and
f) evidence of review by a member of the STRTP mental
health program staff.
C. Collaborating with the Child and Family Team (CFT), consistent with the Client
Plan.
D. Specialty Mental Health Treatment Services: STRTPs shall make available for
each youth structured specialty mental health treatment services during the day
and evening, seven (7) days per week, according to the youth's needs as
indicated on the youth's Client Plan. At minimum, the following mental health
treatment services (as defined in Title 9 of the California Code of Regulations)
shall be made available, as medically necessary:
i. Mental Health Services— individual or group therapies and interventions
that are designed to provide reduction of mental disability and restoration,
improvement, or maintenance of functioning consistent with the goals of
learning, development, independent living, and enhanced self-sufficiency.
Service activities may include assessment, plan development, therapy,
rehabilitation, and collateral services.
a) Assessment - A clinical analysis of the history and status of
a youth's mental, emotional, or behavioral disorder to
include relevant cultural and social issues, history,
diagnosis, and any recorded testing results.
b) Plan Development—The development of Client Plans, to
include the youth's needs and services, approval of client
plans, and monitoring of a youth's progress. Clients
participate in the development of the Client Plan which is a
comprehensive detail of the youth's needs, personal goals
and objectives for improvement and exiting from the
STRTP program. It also includes a treatment component
which is specific to mental health and behavioral
improvements the youth would like to work toward.
c) Collateral —This is any service activity to a significant
support person in a youth's life with the intent of improving
B-12-3
Exhibit B-12
or maintaining the mental health status of the youth.
Collateral services include, but are not limited to, helping
significant support persons to understand and accept the
youth's condition and involving them in service planning
and implementation of the Client Plan. Family counseling
or therapy, which is provided on behalf of the youth, may
be considered collateral.
ii. Medication Support Services —shall be provided via referral to Fresno
County Behavioral Health. BHTC will monitor that the following is
adhered to by the psychiatrist for these services:
a) Within the first thirty (30) days of the youth admission, the
psychiatrist shall examine each youth prior to prescribing any
psychotropic medication and include a screening to determine
whether there are potential medical complications that may
contribute to the youth's health condition. This examination shall
be noted in the youth's record.
b) The psychiatrist shall sign a written medication review for each
youth prescribed psychotropic medication as clinically appropriate,
but at least every six (6) weeks. This review shall be included in
the youth's record.
c) The psychiatrist shall review the course of treatment for all youth
who are not on psychotropic medication at least every ninety (90)
days and include the results of this review in a progress note
signed by the prescribing physician at the time the review is
completed.
d) Psychotropic medications for a youth placed in an STRTP shall be
administered in accordance with all applicable State and Federal
laws, which include but are not limited to laws related to informed
consent, documentation of informed consent, and California
Welfare & Institutions (WIC) Code Sections 369.5 and 739.5.
e) STRTPs providing care supervision to children diagnosed by a
physician, psychologist, or licensed clinician social worker as
mentally disordered shall make provision for at least monthly
consultation from a psychiatrist, clinical psychologist, or licensed
clinical social worker regarding the program of services.
B-12-4
Exhibit B-12
iii. Crisis Intervention — an emergency response that enables a youth to cope
with a crisis. Activities are intended to support, improve, or maintain the
youth's mental health status.
iv. Therapy—therapeutic intervention that focuses on symptom reduction in
order to improve identified functional impairments. This service may be
delivered to an individual or group and may also include family therapy.
Youth shall receive both individual and group therapy at least once per
week. The therapeutic modalities are Cognitive Behavioral Therapy
(CBT), Dialectical Behavior Therapy (DBT), and the Trauma Resiliency
Model (TRM). CBT is effective in treating children and adolescents who
have persistent behavioral reactions, DBT focuses on problem-solving
and acceptance-based strategies within a framework of dialectical
methods, and TRM focuses on the concept the biological basis of trauma.
v. Targeted Case Management—any service that assists the youth to
access the needed social, vocational, medical, educational, rehabilitative
or other community services. Services may include, but are not limited to,
communication, coordination and referral to available resources.
vi. Psychologist Services—services provided by licensed psychologists,
within their scope of practice, to diagnose or treat a mental illness or
condition.
vii. EPSDT Supplemental Specialty Mental Health Services— mental health
related diagnostic services and treatment available under the Medi-Cal
program only to persons under 21 years of age. These include but are
not limited to Intensive Care Coordination (ICC) and Intensive Home-
Based Services (IHBS) services in accordance with the "Medi-Cal Manual
for Intensive Care Coordination (ICC), Intensive Home-Based Services
(IHBS), & Therapeutic Foster Care (TFC) for Medi-Cal Beneficiaries."
E. A licensed mental health professional shall perform a clinical review every ninety
(90) days of the youth's status and progress in treatment to determine whether
the youth should continue admission in the program or be transitioned to a
different level of care. The LMHP shall make this determination in consultation
with the placing agency. A report documenting this clinical review shall be
maintained in the youth's record.
F. Ensuring continuity of care, services, and treatment as a youth moves from his or
her STRTP placement to home-based family care or to a permanent living
situation through reunification, adoption, or guardianship, in accordance with the
youth's case plan or treatment plan.
B-12-5
Exhibit B-12
G. Documenting the youth's ability to access mental health services identified in the
Client Plan, or efforts made by the STRTP to ensure access to identified mental
health services, including utilization of any existing grievance processes for
accessing services.
i. Progress notes shall be written to document a youth's participation and
responses to mental health treatment services. The progress notes shall
meet Medi-Cal requirements of documentation and shall be maintained in
the youth's record.
ii. On the same day as the mental health treatment service, the progress
notes shall be signed and dated by the direct service program staff
member(s) who provided the service.
iii. The STRTP shall ensure that documentation and recordkeeping
requirements are met.
H. The youth's record must include:
i. Mental health assessment;
ii. Admission statement, signed by the HOS within five (5) days of
youth's arrival;
iii. Client Plan;
iv. STRTP mental health program progress notes;
v. Clinical review report and transition determination;
vi. Physician's orders, medication examinations, medication reviews,
written informed consent for prescribed medications;
vii. Copy of court orders or judgements regarding physical or legal
custody;
viii. Documentation indicating each date and names of individuals or
groups of individuals who have participated in the development of
the Client Plan; and
ix. A transition determination plan.
I. The STRTP shall ensure that American Indian youth receive specialty mental
health services in accordance with the Federal Indian Child Welfare Act (25
U.S.C. Sec 1901 et seq.).
B-12-6
Exhibit B-12
STAFFING
A. All licensed, waivered, and registered mental health professionals providing services at
the STRTP shall meet all legal requirements for professional licensing, waiver, or
registration, as applicable.
B. Adequate numbers and qualifications of direct service program staff shall be employed,
present, awake, and on duty seven (7) days per week.
C. BHTC shall have at least one (1) full-time equivalent direct service program staff from
the following list employed for each six (6) children admitted to the program:
a) Physicians
b) Psychologists or psychologists who have received a waiver pursuant to WIC
Code 5751.2
c) Licensed Clinical Social Workers or registered professionals pursuant to WIC
Code 5751.2
d) Licensed Marriage, Family, and Child Therapists or registered professionals
pursuant to WIC Code 5751.2
e) Licensed Professional Clinical Counselors or registered professionals pursuant to
WIC Code 5751.2
f) Psychiatric Technicians
g) Mental Health Rehabilitation Specialists as defined in Section 630 of Title 9 CCR
D. Of the direct service program staff required above, BHTC have one (1) half-time
equivalent LMHP employed for each six (6) children admitted to the program. A LMHP
who is employed to meet this requirement may also be the head of service, if employed
at least forty (40) hours per week.
E. BHTC shall have access to the psychiatrist twenty-four (24) hours per day.
PERFORMANCE MEASURES/PROGRAM OUTCOMES
BHTC shall provide all project monitoring and compliance protocols, procedures, data collection
methods, and reporting requirements requested by the County. BHTC utilizes performance and
outcome measures for evaluating program and system effectiveness to ensure services and
service delivery strategies are positively impacting the youth in their care. Performance
outcome measures shall be reported to the County annually in accumulative reports for overall
program and contract evaluation.
BHTC will address each of the categories referenced below and may additionally propose other
performance and outcome measures that are deemed best to evaluate the services provided
and/or to evaluate overall program performance.
B-12-7
Exhibit B-12
A. Access to care: The ability of youth to receive the right service at the right time.
a) Timeliness between referral to assessment and completion of assessment;
assessment to first treatment service; and first treatment service to subsequent
follow-up visit
B. Effectiveness: Objective results achieved through services.
a) Effectiveness of treatment interventions
b) Effectiveness of discharge planning (e.g. percentage of youth successfully linked
to lower levels of care)
C. Efficiency: Demonstration of the relationship between results and the resources used to
achieve them.
a) Length of youth stay in program
b) Number of units of service per youth
c) Cost per youth
D. Satisfaction and Compliance: The degree to which persons served, County, and other
stakeholders are satisfied with the services.
a) Audits and other performance and utilization reviews of health care services and
compliance with agreement terms and conditions
b) Surveys of persons serviced, family members, other health care providers, and
other stakeholders
ACCESS TO CARE
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
1 Time between BHTC Within 5 days EMR** 85% of placed youth will have
youth's STRTP of the youth's Extended assessments completed within 10
admission date Youth arrival, their Reach— days of admission.
and the assessments Completion
completion of will be dates of each
their completed. assessment
assessments*. documentation.
BHTC
2 STRTP Time between BHTC Within 7 days EMR Extended 85% of youth will have their first
youth the completion STRTP of the Reach— treatment service completed
receive the of assessments Youth completion of Completion within 7 days after assessment.
right and the youth's a youth's date of
service at first Specialty assessment, assessment
the right Mental Health their first documentation
time. Service treatment and youth's
(SMHS). service will be first SMHS.
held.
3 Timeliness of BHTC After EMR: 80% of youth will have
youth's first STRTP completion of Extended subsequent follow-up visit within
treatment Youth first SMHS, Reach— 48 hours of their first SMHS.
B-12-8
Exhibit B-12
ACCESS TO CARE
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
service to youth's Completion
subsequent subsequent date of first
follow-up visit. follow-up visit SMHS and
occurs within date of
48 hours. subsequent
follow-up visit.
*Assessments includes Admission Statement, Mental Health Assessment, CANS, PSC-35, Treatment
Plan and Medication Referral as required.
**EMR = Electronic Medical Record will be the data source used- either BHTC'Extended Reach or
Fresno County Avatar as indicated.
EFFECTIVENESS
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
1 Treatment CANS BHTC Intake CANS EMR: Avatar- 65% of youth will have a positive
interventions assessment STRTP score and Admission and change in their CANS scores at
used will scores Youth discharge discharge discharge.
improve CANS score CANS score
youth's quality data collected.
of life CANS
completed at
3 months
2 BHTC will link Percentage of BHTC Youth are EMR: 50% of youth will step down to a
STRTP youth youth STRTP discharged to Extended lower level of care
to a lower successfully Youth Home, Reach
level of care stepped down Relative, Discharge
upon to a lower Foster Care, data will be
discharge. level of care. Independent collected
Living
Program, etc.
EFFICIENCY
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
1 Youth will be BHTC STRTP BHTC Data gathered EMR: 60% of youth will be discharged
discharged youth's actual STRTP at youth Extended within the timeframe identified in
within the length of stay Youth discharge Reach— their treatment plan.
timeframe and/or Youth's total
identified in collated for Days of Care
their the fiscal year
treatment by June 30
plan
2 Youth Number of BHTC Data gathered EMR: Avatar— The number of units of service
B-12-9
Exhibit B-12
EFFICIENCY
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
receives units of STRTP at youth Youth's total provided to achieve youth's
mental health service per Youth discharge units of service treatment plan goals will be
services youth and and/or and costs per proportional to the costs per
according to cost per collated for individual individual served
their individual the fiscal year served
treatment served by June 30
plan
SATISFACTION AND COMPLIANCE
# Objective Indicator Who Time of Data Source Performance Target
Applied Measure
1 Youth will be Client BHTC After intake Electronic or 65% of youth at discharge will
satisfied with Satisfaction STRTP and before Paper Survey be satisfied with the services
services Surveys & Youth planned Results received
received Communication discharge
Hour Communication
discussions. Hour Meeting
Notes.
2 Stakeholders Stakeholder BHTC Two times a Electronic or 85% of stakeholders will be
will be Satisfaction Stakeholders year Paper satisfied with the services
satisfied with Surveys Survey Results provided to STRTP youth
the services (Virtual
provided to Informal meetings, Nots from
their youth Discussions phone calls, informal
etc.) discussions
BHTC understands that the County may adjust the performance and outcome measures
periodically throughout the duration of this Agreement, as needed, to best measure the
program. CHTC will utilize a computerized tracking system with which performance and
outcome measures and other relevant data, such as demographics, will be maintained.
B-12-10