HomeMy WebLinkAboutAmendment III to Master STRTP Agt 23-277 24-152.pdf Agreement No. 24-152
1 AMENDMENT NO. 3 TO MASTER SERVICE AGREEMENT
2 This Amendment No. 3 to Master Service Agreement 23-277 ("Amendment No. 3") is
3 dated April 9, 2024 and is between each Contractor ("Contractor(s)") listed in
4 Revised Exhibit A-2, "List of Contractors", and the County of Fresno, a political subdivision of
5 the 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 Elite Family Systems to the list of Contractors
13 providing specialty mental health services to Fresno County youth in their care.
14 C. On October 24, 2023, the County and the Contractor(s) entered into County Agreement
15 number 23-575 ("Amendment No. 2"), to add Brighter Horizons Group Homes to the list of
16 Contractors providing specialty mental health services to Fresno County youth in their care.
17 D. In January 2024, Z.N.D. Residential, Inc., was identified as an STRTP that meets the
18 requirements to be added to the list of Contractors providing specialty mental health services to
19 Fresno County youth in their care.
20 E. The County and the Contractor now desire to amend the Agreement to add Z.N.D.
21 Residential, Inc. as a Contractor under this Master STRTP Agreement.
22 The parties therefore agree as follows:
23 1. All references to Revised Exhibit A-1 in the current Agreement shall be deemed
24 references to Revised Exhibit A-2, which is attached and incorporated by reference.
25 2. Exhibit B-13, "Scope of Services" for Z.N.D. Residential, Inc shall be added to the
26 Master Agreement and considered included in all references to "Exhibit B-1, et. seq.".
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1 3. The parties agree that upon execution of this Amendment No. 3, the Agreement,
2 Amendment No. 1, and Amendment No. 2 are further revised, updated, and amended to add
3 Contractor(s): Z.N.D. Residential, Inc..
4 4. When both parties have signed this Amendment No. 3, the Agreement, Amendment No.
5 1, Amendment No. 2, and this Amendment No. 3 together constitute the Agreement.
6 5. 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 6. 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).
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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 7. This Amendment may be signed in counterparts, each of which is an original, and all of
8 which together constitute this Amendment.
9 8. The Agreement as amended by this Amendment No. 3 is ratified and continued. All
10 provisions of the Agreement and not amended by this Amendment No. 3 remain in full force and
11 effect.
12 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No. 3 on the date stated in the introductory
2 clause.
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Z.N.D. RESIDENTIAL., INC. COUNTY OF FRESNO
5 '�''�•
Graves, CEO Nathan Ma si Chairman of the Board of
9 9�
6 2514 N. Whittier Avenue Supervisors of the County of Fresno
Fresno, CA 93727
7 Attest:
Bernice Seidel
8 Clerk of the Board of Supervisors
County of Fresno, State of California
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10 By:
Deputy
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For accounting use only:
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Org No.:56302232
13 Account No.:7295
Fund No.:0001
14 Subclass No.:10000
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Revised Exhibit A-2
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. DIN 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
Contact for Notices: Mental Health Director
A-1
Revised Exhibit A-2
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 4t" Street
Ceres, CA 95307
Contact for Notices: Clinical Director
12. BRIGHTER HORIZONS GROUP HOMES, INC. (Exhibit B-12)
7849 Oceanus Drive
Los Angeles, CA 90046
Contact for Notices: Chief Operating Officer
13. Z.N.D. RESIDENTIAL, INC. (Exhibit B-13)
2514 N. Whittier Avenue
Fresno, CA 93727
Contact for Notices: Chief Operating Officer
A-2
Exhibit B-13
Scope of Services
ORGANIZATION: Z.N.D. RESIDENTIAL, INC. (Z.N.D.)
ADDRESS: 2514 N. Whittier Ave.
Fresno, CA 93727
TELEPHONE: (559) 554-9703
CONTACT PERSON: Zeb K Graves
CONTRACT PERIOD: Upon Execution —June 30, 2024 with one (1)
optional twelve (12) month renewal
SUMMARY OF SERVICES
Z.N.D. Residential, Inc. (Z.N.D.) is a community-based organization that works towards creating and
maintaining an environment that is culturally competent, relevant, and sensitive to at-risk youth
through therapeutic, safe, and trauma-informed care principles, objectives, and training.
The purpose of this facility is to provide Children and Non-Minor Dependents (NMD), as described by
Health and Safety Code section 1502.4, who live here with a stable, secure, safe, consistent, and
supportive home. Z.N.D. recognizes that each program participant is different, which is why the
Behavioral Health & Mental Health based program offers individual, specialized, intensive services,
supports, treatments, and 24-hour care and supervision that is culturally relevant, trauma-informed,
and age and developmentally appropriate to meet the needs of each child and NMD in Z.N.D.'s care
and ensure long-lasting recovery. Z.N.D. strives in delivering comprehensive services to program
participants through identification of individualized needs and services that will also facilitate long-
term stabilization in the least restrictive setting possible, which may include family reunification,
adoption, foster-care, or independent living.
Z.N.D. understands that each program participant placed in Z.N.D.'s care will have faced different
obstacles, crises, and traumas ranging in severity that have created negative impairments within their
lives. Identification of individual needs will vary based upon the participant history, assessment of
needs, and transition plan. Collaboration and empowerment of the participant is crucial in developing
rapport to identify strategies, interventions, and strengths that will aid in successful transition and
reunification with family (if applicable). Identification of the program participant needs will be ongoing
and assessed to ensure that appropriate resources, linkages, and collaborations are provided for
participants.
A committed and caring team of mental health case managers, therapist, facility staff, and life skills
coordinators will work in tandem with community professionals and program participants to provide
wide-ranging services based upon their individual, identified needs. Through utilization of Trauma-
Informed Care and principles, Z.N.D. is cognizant of the importance of providing participants an
opportunity to develop, foster, and implement positive coping skills that will provide big dividends for
their future. We will work with our participants, community partners, and identified people of support
to assist the participants in healing, reunification, independence, and stability.
B-13-1
Exhibit B-13
TARGET POPULATION
The target population served is male youth, 10-17 years of age, and NMD males, 18-21 years of age,
who are under the supervision of Social Work Staff and Probation Officers, from the Fresno County
Department of Social Services or Probation Department. These youth and NMD are classified as
WIC 300 & 600. Program participants enrolled in the program will participate in individualized services
that are trauma informed and specific to the needs of the participants.
Z.N.D also works with NMD and authorized county representatives to assist with transition to a lower
level of care e.g., Assembly Bill 12 (AB12) or Transitional Housing Placement (THP). NMD persons
served may remain in the care of Z.N.D. until they have been discharged or have completed their
transitional plan, as identified within the CFT. The anticipated length of stay will be individualized and
based upon approval from the NMD person served's county of origin.
REFERRALS
Fresno County youth and NMD shall retain priority placement within the STRTP. County-of-
origin of placed youth and NMD 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
Z.N.D. RESIDENTIAL, INC.
2514 N. Whittier Ave
Fresno, CA 93727
559-554-9703
CONTRACTOR SHALL BE RESPONSIBLE FOR THE FOLLOWING SERVICES:
Z.N.D. shall provide mental health treatment, including specialty mental health services, and mental
health supports, as appropriate to the needs of the program participants or Non-Minor Dependent
(NMD) in Z.N.D.'s care. All specialty mental health services shall meet Medi-Cal standards. These
services shall include all of the following:
A. Mental Health Assessment:
i. A mental health assessment shall be completed and signed by a licensed
mental health professional (LMHP) or waivered/registered associate
within five (5) calendar days of a person served'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:
B-13-2
Exhibit B-13
i. Each person served admitted to the STRTP shall have a Client Plan
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.
iii. Client Plan of each person served 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 person served back into the
community;
e. evidence of the person served'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 case
plan.
D. Specialty Mental Health Treatment Services: STRTPs shall make available for
each person served structured specialty mental health treatment services during
the day and evening, seven (7) days per week, according to the person served's
needs as indicated on the person served'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.
ii. Medication Support Services —Z.N.D. will be referring persons served to
Fresno County DBH for the provision of one or more of the following
services: prescribing, administering, dispensing and monitoring drug
interactions and contraindications of psychiatric medications or biologicals
that are necessary to alleviate the suffering and symptoms of mental
illness.
B-13-3
Exhibit B-13
STRTP shall ensure monitor that the following is taking place:
a. A prescribing physician shall examine each person served prior
to prescribing any psychotropic medication and include a
screening to determine whether there are potential medical
complications that may contribute to the person served's health
condition. This examination shall be noted in the person
served's record.
b. The prescribing physician shall sign a written medication review
for each person served prescribed psychotropic medication as
clinically appropriate, but at least every six (6) weeks. This
review shall be included in the person served's record.
C. A psychiatrist shall review the course of treatment for all persons
served 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 psychiatrist at the time the review is
completed.
d. Psychotropic medications for a person served 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 persons served
diagnosed by a physician, psychologist, or licensed clinical
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.
iii. Crisis Intervention — an emergency response service enabling a person
served to cope with a crisis; requires a timelier response than a regularly
scheduled visit.
iv. Therapy—a service activity that is a therapeutic intervention that focuses
primarily on symptom reduction as a means to improve functional
impairments. May be delivered to an individual or group and may include
family therapy if the person served is present.
B-13-4
Exhibit B-13
V. Targeted Case Management— services that assist a person served in
accessing needed medical, education, social, prevocational, vocational,
rehabilitative, or other community services.
vi. Psychiatrist Services—services provided by licensed physicians, who
have indicated a psychiatrist specialty, who have contracted with the
(MHP) to provide specialty mental services to diagnose or treat a mental
illness or condition. Z.N.D. will utilize psychiatry services via Fresno
County Department of Behavioral Health (DBH).
vii. Psychologist Services—services provided by licensed psychologists,
within their scope of practice, to diagnose or treat a mental illness or
condition. Program participants that need a psychological assessment will
be referred to a psychologist via the Department of Behavioral Health as
identified in their Plan of Care and medical necessity.
viii. 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 person served's status and progress in treatment to determine
whether the person served 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 person served's record.
F. Ensuring continuity of care, services, and treatment as a person served 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 person served's case plan or treatment plan.
G. Documenting the person served'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 person served's
participation and responses to mental health treatment services. The
B-13-5
Exhibit B-13
progress notes shall meet Medi-Cal requirements of documentation and
shall be maintained in the person served'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 person served's record must include:
i. Mental health assessment;
ii. Admission statement, signed by the HOS within five (5) days of person
served'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 children receive specialty mental
health services in accordance with the Federal Indian Child Welfare Act (25
U.S.C. Sec 1901 et seq.).
STAFFING
A. All licensed, waivered, and registered mental health professional providing
services in an 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. A STRTP shall have at least one (1) full-time equivalent direct service program
staff from the following list employed for each six (6) persons served admitted to
the program:
B-13-6
Exhibit B-13
a. Psychologists or psychologists who have received a waiver pursuant to
WIC Code 5751.2
b. Licensed Clinical Social Workers or registered professionals pursuant to
WIC Code 5751.2
C. Licensed Marriage, Family, and Child Therapists or registered
professionals pursuant to WIC Code 5751.2
d. Licensed Professional Clinical Counselors or registered professionals
pursuant to WIC Code 5751.2
e. Licensed Vocational Nurses
f. Occupational Therapists
g. Mental Health Rehabilitation Specialists as defined in Section 630 of Title
9 CCR
D. Of the direct service program staff required above, a STRTP shall have one (1)
half-time equivalent LMHP employed for each six (6) persons served 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. The STRTP shall have access to a psychiatrist to provide medication support
services.
PERFORMANCE MEASURES/PROGRAM OUTCOMES
Z.N.D. shall provide all project monitoring and compliance protocols, procedures, data collection
methods, and reporting requirements requested by the County. Z.N.D. shall utilize performance
and outcome measures for evaluating program and system effectiveness to ensure services
and service delivery strategies are positively impacting the persons served in their care.
Performance outcome measures shall be reported to the County annually in accumulative
reports for overall program and contract evaluation.
Z.N.D. 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.
A. Access To Care: The ability of participants to receive the right service at the right time.
1. Timeliness between referral to assessment and completion of assessment; assessment to
first treatment service; and first treatment service to subsequent follow-up visit.
• 90% of program participants will receive a mental health assessment within five (5)
calendar days of placement in the (STRTP) unless a valid Mental Health assessment
has been completed within 60 days prior to placement at Z.N.D.
• 100% of program participants whose assessment demonstrates the need for specialty
mental health services will have a mental health treatment plan completed within 10
calendar days of placement in Z.N.D.
B-13-7
Exhibit B-13
• 80% of program participants with a Mental Health treatment plan will access services per
the treatment plan.
B. Effectiveness: Objective results achieved through services.
1. Effectiveness of treatment interventions
• 75% of program participants will demonstrate progress towards achieving their
individualized goals.
2. Effectiveness of discharge planning (e.g., percentage of participants successfully linked to
lower levels of care)
• 70% of program participants will complete Z.N.D.'s program within the targeted time
frame identified in the treatment plan.
• 100% of program participants will complete a transition/discharge plan.
70% of program participants will transition to a lower level of care.
C. Efficiency: Demonstration of the relationship between results and the resources used to
achieve them.
1. Length of anticipated stay in program
• 70% of program participants will complete Z.N.D.'s program within the targeted time
frame identified in the treatment plan.
2. Number of units of service per program participant
• 75% of program participants will utilize services identified in their treatment plan, as
measured by units of service (UOS).
3. Cost per program participants
• Z.N.D. will monitor the cost per participant as measured by reconciling monthly service
invoices via Fresno County DBH and estimated UOS.
D. Satisfaction and Compliance: The degree to which participants, County, and other
stakeholders are satisfied with the services.
1. Audits and other performance and utilization reviews of health care services and compliance
with agreement terms and conditions
• Z.N.D. will implement a compliance protocol for the MH department and will utilize
reporting methods to monitor compliance.
• 100% of program participants charts will be reviewed for compliance, which will include
service delivery and record keeping at least every 90 days.
B-13-8
Exhibit B-13
• Z.N.D. will designate clinical and admin staff to attend monthly contract meetings 100%
of the time.
• 100% of the time Z.N.D. will submit required documentation to Fresno County DBH
• Leadership will perform a formal evaluation of program participants and operational
performance annually.
- A Corrective Action Plan (CAP) will be completed to address performance
deficiencies.
2. Surveys of persons serviced, family members, other health care providers, and other stakeholders.
• 75% of program participants will complete a satisfaction survey that notates their treatment
needs being met.
70% of family members, stakeholders, and community partners will express satisfaction with
Z.N.D. as evidenced by satisfaction surveys.
Z.N.D. 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. Z.N.D. will
utilize a computerized tracking system with which performance and outcome measures and other
relevant data, such as demographics, will be maintained.
B-13-9