HomeMy WebLinkAboutInter-Dept DPH & DBH-Perinatal Prevention & Early Intervention for Pregnant Parenting Women & Thier Infants_D-20-067.pdf
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INTER-DEPARTMENTAL AGREEMENT
THIS INTER-DEPARTMENTAL AGREEMENT is made and entered into this 10th day of
January, 2020, by and between the COUNTY OF FRESNO, DEPARTMENT OF BEHAVIORAL
HEALTH, hereinafter referred to as "DBH", and the COUNTY OF FRESNO, DEPARTMENT OF
PUBLIC HEALTH, hereinafter referred to as "DPH".
W I T N E S S E T H:
WHEREAS, the County of Fresno, Department of Behavioral Health (DBH), is in need of
qualified public health nursing staff to provide medical case management services to pregnant and/or
postpartum mothers and their infants in a variety of sites including homes, primary health clinics,
OB/GYN providers, community centers, other clinics and treatment centers; and
WHEREAS, the County of Fresno, Department of Public Health (DPH) has the facilities,
equipment and personnel skilled in the provision of such services; and
WHEREAS, the Department of Public Health (DPH) is qualified and is willing to provide such
services, pursuant to the terms and conditions of this Agreement.
NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
hereto agree as follows:
1. SERVICES
A. DPH shall perform all services and responsibilities identified in Exhibit A, Public
Health Summary of Services, incorporated herein by reference and made part of this Inter-
Departmental Agreement. In addition, DPH will provide services in accordance to the Prevention and
Early Intervention State approved work plan and specifically in reference to the Perinatal Prevention
and Early Intervention for Pregnant/Parenting Women and Their Infants.
B. DPH shall provide all services in accordance with the County’s Mental Health
Plan. DBH may request additional services from DPH which are not otherwise provided for in this
Inter-Departmental Agreement, which DPH, at its sole discretion, may provide. If DPH is unable to
provide additional services to DBH when requested, DPH shall notify DBH immediately.
Compensation for any such additional services shall be based on actual expenditures incurred by DPH
and in accordance to the budget identified in Exhibit B, DPH Budget Summary, attached hereto and by
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this reference incorporated herein and made a part of this Inter-Departmental Agreement, unless the
DBH Director and DPH Director, or their designees, agree otherwise mutually, in writing.
C. DBH Contracts Administration shall be responsible for providing any necessary
oversight to ensure appropriate accounting of the delivery of services.
2. TERM
This Agreement shall become effective on the 1st day of July, 2018 and shall terminate
on the 30th day of June, 2021.
This Inter-Departmental Agreement, subject to State funding each year, shall
automatically be extended for two (2) additional twelve (12) month periods upon the same terms and
conditions herein set forth, unless written notice is given by either DBH Director, or designee, or DPH
Director, or designee, not later than sixty (60) days prior to the close of the current Inter-Departmental
Agreement term.
3. TERMINATION
A. Non-Allocation of Funds - The terms of this Inter-Departmental Agreement, and
the services to be provided thereunder, is contingent on the approval of funds by the appropriating
government agency. Should sufficient funds not be allocated, the services provided may be modified,
or this Inter-Departmental Agreement terminated at any time by DBH providing DPH sixty (60) days
advance written notice.
B. Breach of Contract - DBH may immediately suspend or terminate this Inter-
Departmental Agreement in whole or in part, wherein the determination of DBH there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to DBH;
4) Improperly performed service.
In no event shall any payment by DBH constitute a waiver by DBH of any breach of this
Inter-Departmental Agreement or any default which may then exist on the part of DPH. Neither shall
such payment impair or prejudice any remedy available to DBH with respect to the breach or default.
DBH shall have the right to demand of DPH the repayment to DBH of any funds disbursed to DPH
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under this Inter-Departmental Agreement, which in the judgment of DBH were not expended in
accordance with the terms of this Inter-Departmental Agreement. DPH shall promptly refund any
funds upon demand or, at DBH’s option such repayment shall be deducted from future payments
owing to DPH under this Agreement.
C. Without Cause - Under circumstances other than those set forth above, this
Inter-Departmental Agreement may be terminated by either party upon the giving of thirty (30) days
advance written notice of an intention to terminate. However, termination of this Inter-Departmental
Agreement shall not affect any pending activities, which shall be handled to their conclusion by DPH.
4. COMPENSATION
DBH agrees to pay DPH and DPH agrees to receive compensation as follows:
Payment shall be made upon certification or other proof satisfactory to DBH, that services have been
performed by DPH as specified in this Inter-Departmental Agreement. Allowable expenditures under
this Inter-Departmental Agreement are specifically established and identified in Exhibit B. The
maximum amount under this Inter-Departmental Agreement for the initial term, July 1, 2018 through
June 30, 2019, shall not exceed Two Hundred Seventy-Two Thousand, Five Hundred Thirty-One and
No/100 Dollars ($272,531.00).
The maximum amount for period from July 1, 2019 through June 30, 2020 shall not
exceed Two Hundred Seventy-Four Thousand, Seven Hundred Eight and No/100 Dollars
($274,708.00).
The maximum amount for the period from July 1, 2020 through June 30, 2021 shall not
exceed Two Hundred Seventy-Six Thousand, Nine Hundred Forty-Nine and No/100 Dollars
($276,949.00).
The maximum amount for the period from July 1, 2021 through June 30, 2022 shall not
exceed Two Hundred Seventy-Nine Thousand, Two Hundred Fifty-Eight and No/100 Dollars
($279,258.00).
The maximum amount for the period from July 1, 2022 through June 30, 2023 shall not
exceed Two Hundred Eighty-One Thousand, Six Hundred Thirty-Seven and No/100 Dollars
($281,637.00).
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The total maximum compensation amount of this Inter-Departmental Agreement for the
entire contract term shall not exceed One Million, Three Hundred Eighty-Five Thousand, Eighty-Three
and No/100 Dollars ($1,385,083.00).
Payment by DBH shall be in arrears, for services provided during the preceding month,
within forty-five (45) days after receipt and verification of DPH invoices by DBH. If DPH should fail to
comply with any provision of this Inter-Departmental Agreement, DBH shall be relieved of its obligation
for further compensation. All final claims and/or any final budget modification requests shall be
submitted by DPH within sixty (60) days following the final month of service for which payment is
claimed. No action shall be taken by DBH on claims submitted beyond sixty (60) day closeout period.
Any compensation which is not expended by DPH pursuant to the terms and conditions of this Inter-
Departmental Agreement shall automatically revert to DBH.
5. INVOICING
A. Department of Public Health Business Office shall prepare Inter-Departmental
Journal Vouchers Quarterly for services provided by DPH pursuant to the terms and conditions of this
Inter-Departmental Agreement. Journal vouchers shall include applicable supporting documentation
in detail such as dates of services, hours, and amount (s) charged. Documentation will include
Support Staff Time Report (DFA-7). Journal vouchers shall be subject to County, State of California,
and Federal audits. Journal vouchers to be received and reviewed by DBH Mental Health Contracts
Staff Analyst.
B. No reimbursement for actual services rendered under this Inter-Departmental
Agreement shall be made until Inter-Departmental Journal Vouchers, as identified above, are received
and reviewed by DBH. DBH agrees to reimburse DPH quarterly, in arrears, within forty-five (45) days
after receipt and verification of DPH’s Journal Vouchers. If journal vouchers or activity reports are
incorrect or are otherwise not in proper form or substance, DBH shall have the right to withhold
payment as to only that portion of the journal voucher or activity report that is incorrect or improper.
C. The journal voucher and all supporting documentation shall be sent to the
Department of Behavioral Health, 3133 N. Millbrook Ave, Fresno, CA 93703, Attention: Mental Health
Contracts Division, Staff Analyst via inter-office mail (Stop No. 100) or forwarded via email.
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6. MODIFICATION
A. Any matters of this Inter-Departmental Agreement may be modified from time to
time by the written consent of DBH and DPH without, in any way, affecting the remainder.
B. DPH hereby agrees to any amendments in funding to reflect a reduction in funds
from State and Federal sources. In addition, this Inter-Departmental Agreement is subject to any
restrictions, limitations, or enactments of all legislative bodies which affect the provisions, term or
funding of this Inter-Departmental Agreement in any manner.
7. CONFIDENTIALITY
All services performed by DPH under this Inter-Departmental Agreement shall be in
strict conformance with all applicable Federal, State of California and/or local laws and regulations
relating to confidentiality.
8. LICENSES/CERTIFICATES
Throughout each term of this Inter-Departmental Agreement, DPH staff shall maintain
all necessary licenses, permits, approvals, certificates, waivers and exemptions necessary for the
provision of the services hereunder and required by the laws and regulations of the United States of
America, State of California, the County of Fresno, and any other applicable governmental agencies.
DPH shall notify DBH immediately in writing of its inability to obtain or maintain such licenses, permits,
approvals, certificates, waivers and exemptions irrespective of the pendency of any appeal related
thereto. Additionally, DPH staff shall comply with all applicable laws, rules or regulations, as may now
exist or be hereafter changed.
9. COMPLIANCE WITH STATE REQUIREMENTS
DPH recognizes that DBH operates its mental health programs under an agreement
4with the State of California Department of Health Care Services, and that under said agreement the
State imposes certain requirements on DBH mental health. DPH shall adhere to all State
requirements.
DPH recognizes that DBH operates its mental health programs under an agreement
with the State of California Department of Mental Health, and that under said agreement the State
imposes certain requirements on DBH and its subcontractors. DPH shall adhere to all State
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requirements, including those identified in Exhibit C “State Mental Health Requirements”, attached
hereto and by this reference incorporated herein.
10. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
A. The parties to this Inter-Departmental Agreement shall comply with applicable
laws and regulations, including but not limited to Sections 14100.2 and 5328 et seq. of the Welfare
and Institutions Code, Section 431.300 et seq. of Title 42, Code of Federal Regulations, and the
Health Insurance Portability and Accountability Act (HIPAA), including but not limited to Section 1320
D et seq, of Title 42, United States Code and it’s implementing regulations (including, but not limited to
Title 45, CFR, Parts 142,160, 162, and 164) regarding the confidentiality and security of patient
information.
B. DPH shall protect, from unauthorized disclosure, names and other identifying
information concerning persons receiving services pursuant to this contract, except for statistical
information. This pertains to any and all persons receiving services pursuant to a County funded
program. DPH shall not use such identifying information for any purpose other than carrying out DPH
obligations under this contract.
C. DPH shall not disclose, except as otherwise specifically permitted by this Inter-
Departmental Agreement, authorized by law or authorized by the client/patient, any such identifying
information to anyone other than the State without prior written authorization from the State in
accordance with State and Federal Laws.
D. For purposes of the above sections, identifying information shall include, but not
be limited to, name, identifying number, symbol, or other identifying particular assigned to the
individual, such as finger or voice print, or a photograph.
E. Notification of Electronic Breach or Improper Disclosure: During the term of this
Inter-Departmental Agreement, DPH shall notify DBH, immediately upon discovery of any breach of
Medi-Cal Protected Health Information (PHI) and/or data, where the information and/or data is
reasonably believed to have been acquired by an unauthorized person. Immediate notification shall
be made to County’s Information Security Officer, within two business days of discovery, at (559) 600-
5800. DPH shall take prompt corrective action to cure any deficiencies and any action pertaining to
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such unauthorized disclosure required by applicable Federal and State Laws and regulations. DPH
shall investigate such breach and provide a written report of the investigation to the County
Information Security Officer, postmarked within the thirty (30) working days of the discovery of the
breach to the address below:
County of Fresno
Information Security Officer
2048 N. Fine Street
Fresno, CA 93727
F. Safeguards. DPH shall implement administrative, physical, and technical
safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the
protected health information, including electronic PHI, that it creates, receives, maintains or transmits
on behalf of County; and to prevent use or disclosure of PHI other than as provided for by this
agreement, DPH shall develop and maintain a written information privacy and security program that
includes administrative, technical and physical safeguards appropriate to the size and complexity of
program operations and the nature and scope of its activities. DPH will provide DBH with information
concerning such safeguards as DBH may reasonably request from time to time.
DPH will implement strong access controls and other security safeguards and
precautions as noted in the following to restrict logical and physical access to confidential, personal
(e.g., PHI) or sensitive data to authorized users only.
DPH will enforce the following administrative and technical password
Controls on all systems used to process or store confidential, personal, or sensitive data:
1. Passwords must not be:
a. Shared or written down where they are accessible or
recognizable by anyone else; such as taped to computer screens, stored under keyboards, or visible
in a work area;
b. A dictionary word; and
c. Stored in clear text.
2. Passwords must be:
a. Eight (8) characters or more in length;
b. Changed every ninety (90) days;
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c. Changed immediately if revealed or compromised; and
d. Composed of characters from at least three (3) of the following
four (4) groups from the standard keyboard:
1) Upper case letters (A-Z);
2) Lowercase letters (a-z);
3) Arabic numerals (0 through 9); and
4) Non-alphanumeric characters (punctuation symbols).
DPH will implement the following security controls on each workstation or
portable computing device (e.g., laptop computer) containing confidential, personal, or sensitive data:
1. Network-based firewall and/or personal firewall;
2. Continuously updated anti-virus software; and
3. Patch management process including installation of all operating
system/software vendor security patches.
DPH will utilize a commercial encryption solution that has received FIPS 140-2
validation to encrypt all confidential, personal, or sensitive data stored on portable electronic media
(including, but not limited to, CDs and thumb drives) and on portable computing devices (including, but
not limited to, laptop and notebook computers).
DPH will not transmit confidential, personal, or sensitive data via e-mail or other
internet transport protocol unless the data is encrypted by a solution that has been validated by the
National Institute of Standards and Technology (NIST) as conforming to the Advanced Encryption
Standard (AES) Algorithm.
G. Mitigation of Harmful Effects. DPH shall mitigate, to the extent practicable, any
harmful effect that is known to DPH of a use or disclosure of PHI by DPH or its subcontractors in
violation of the requirements of these Provisions.
H. Contractor’s Contractors. DPH shall ensure that any contractors, including
subcontractors, to whom DPH provides PHI received from or created or received by DPH on behalf of
County, agree to the same restrictions and conditions that apply to DPH with respect to such PHI; and
to incorporate, when applicable, the relevant provisions of these Provisions into each subcontract or
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sub award to such agents or subcontractors.
I. Employee Training and Discipline. DPH shall train and use reasonable
measures to ensure compliance with the requirements of these Provisions by employees who assist in
the performance of functions or activities on behalf of County under this Agreement and use or
disclose PHI; and discipline such employees who intentionally violate any provisions of these
Provisions, including termination of employment.
J. Termination for Cause. Upon County’s knowledge of a material breach of these
Provisions by DPH, County shall either:
1. Provide an opportunity for DPH to cure the breach or end the violation
and terminate this Inter-Departmental Agreement if DPH does not cure the breach or end the violation
within the time specified by County; or
2. Immediately terminate this Agreement if DPH has breached a material
term of these Provisions and cure is not possible.
3. If neither cure nor termination is feasible, the County Privacy Officer shall
report the violation to the Secretary of the U.S. Department of Health and Human Services.
K. Judicial or Administrative Proceedings. County may terminate this Inter-
Departmental Agreement in accordance with Section Three (3) of this Inter-Departmental Agreement,
if (1) DPH is found guilty in a criminal proceeding for a violation of the HIPAA Privacy or Security Rule
or (2) a finding or stipulation that the DPH has violated a privacy or security standard or requirement of
HIPAA; or other security or privacy laws in an administrative or civil proceeding in which the DPH is a
party.
L. Effect of Termination. Upon termination or expiration of this Inter-Departmental
Agreement for any reason, DPH shall return or destroy all PHI received from County (or created or
received by DPH on behalf of County) that DPH still maintains in any form, and shall retain no copies
of such PHI or, if return or destruction is not feasible, it shall continue to extend the protections of
these Provisions to such information, and limit further use of such PHI to those purposes that make
the return or destruction of such PHI infeasible. This provision shall apply to PHI that is in the
possession of subcontractors or agents of DPH.
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M. Disclaimer. DPH makes no warranty or representation that compliance by DPH
with these Provisions, HIPAA or the HIPAA regulations will be adequate or satisfactory for DPH’s own
purposes or that any information in DPH’s possession or control, or transmitted or received by DPH, is
or will be secure from unauthorized use or disclosure. DPH is solely responsible for all decisions
made by DPH regarding the safeguarding of PHI.
N. Amendment. The parties acknowledge that Federal and State laws relating to
electronic data security and privacy are rapidly evolving and that amendment of these Provisions may
be required to provide for procedures to ensure compliance with such developments. The parties
specifically agree to take such action as is necessary to implement the standards and requirements of
HIPAA, the HIPAA regulations and other applicable laws relating to the security or privacy of PHI.
Upon County’s request, DPH agrees to promptly enter into negotiations with County concerning an
amendment to these Provisions embodying written assurances consistent with the standards and
requirements of HIPAA, the HIPAA regulations or other applicable laws. County may terminate this
Agreement upon thirty (30) days written notice in the event (i) DPH does not promptly enter into
negotiations to amend these Provisions when requested by County pursuant to this Section or (ii) DPH
does not enter into an amendment providing assurances regarding the safeguarding of PHI that
County in its sole discretion, deems sufficient to satisfy the standards and requirements of HIPAA and
the HIPAA regulations.
O. No Third-Party Beneficiaries. Nothing express or implied in the terms and
conditions of these provisions is intended to confer, nor shall anything herein confer, upon any person
other than County or DPH and their respective successors or assignees, any rights, remedies,
obligations or liabilities whatsoever.
P. Interpretation. The terms and conditions in these Provisions shall be
interpreted as broadly as necessary to implement and comply with HIPAA, the HIPAA regulations and
applicable State laws. The parties agree that any ambiguity in the terms and conditions of these
Provisions shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the
HIPAA regulations.
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Q. Regulatory References. A reference in the terms and conditions of these
Provisions to a section in the HIPAA regulations means the section as in effect or as amended.
R. Survival. The respective rights and obligations of DPH as stated in this Section
shall survive the termination or expiration of this Inter-Departmental Agreement.
S. No Waiver of Obligations. No change, waiver or discharge of any liability or
obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any
continuing or other obligation, or shall prohibit enforcement of any obligation on any other occasion.
11. AUDITS AND INSPECTIONS
DPH shall at any time during business hours, and as often as DBH may deem
necessary, make available to DBH for examination all of its records and data with respect to the
matters covered by this Inter-Department Agreement. DPH shall, upon request by DBH, permit DBH
to audit and inspect all such records and data necessary to ensure DPH compliance with the terms of
this Inter-Departmental Agreement.
Notwithstanding any other provision of law, every contract involving the expenditure of
public funds in excess of ten thousand dollars ($10,000) entered into by any state agency, board,
commission, or department or by any other public entity, including a city, county, city and county, or
district, shall be subject to the examination and audit of the California State Auditor, at the request of
the public entity or as part of any audit of the public entity, for a period of three years after final
payment under the contract in accordance with Government Code 8546.7.
12. NON-ASSIGNMENT
Neither party shall assign, transfer or subcontract this Inter-Departmental Agreement
nor their rights or duties under this Inter-Departmental Agreement without the prior written consent of
the other party.
13. RECORDS
DPH shall assume responsibility for maintaining detailed records to support its invoices
to DBH for services provided under this Inter-Departmental Agreement. DPH shall provide DBH with
access to said records for audit purposes. Furthermore DPH shall retain said records for a minimum
of ten (10) years following the expiration of this Inter-Departmental Agreement. In the event of any
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outstanding State of California or Federal audits or exceptions, DPH agrees to retain its records until
such audits and exceptions are finalized.
14. RELATIONSHIP OF PARTIES
It is understood that this is an Inter-Departmental Agreement by and between two (2)
separate departments of the County of Fresno and is not intended to and shall not be construed to
create a relationship of agent, servant, employee, partnership, joint venture or association.
15. NON-DISCRIMINATION
During the performance of this Agreement, DPH and DBH shall not unlawfully
discriminate against any employee or applicant for employment, or recipient of services, because of
race, religion, color, national origin, ancestry, physical handicap, medical condition, marital status, age
or sex, pursuant to all applicable State and Federal statutes and regulations.
16. GOVERNING LAW
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by all Federal, State and local statutes and regulations.
17. ENTIRE AGREEMENT
This Inter-Departmental Agreement, including all Exhibits, constitutes the entire Inter-
Departmental Agreement between DBH and DPH with respect to the subject matter hereof and
supersedes all previous agreement negotiations, proposals, commitments, writings, advertisements,
publications and understandings of any nature whatsoever unless expressly included in this Inter-
Departmental Agreement.
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Exhibit A
Page 1 of 7
DEPARTMENT OF PUBLIC HEALTH
SUMMARY OF SERVICES
ORGANIZATION: Department of Public Health
ADDRESS: 1221 Fulton Street, 4th floor, Fresno, CA 93721
TELEPHONE: (559) 600-1021 FAX: (559) 600-1132
SERVICE LOCATION: West Fresno Regional Service Center
142 East California Ave
Fresno, CA 93706
CONTACT PERSON: Lillarose Bangs
Supervising Public Health Nurse
Department of Public Health
CONTRACT PERIOD: July 1, 2018 – June 30, 2023
CONTRACT AMOUNT: FY 2018-19 $ 272,531.00
FY 2019-20 $ 274,708.00
FY 2020-21 $ 276,949.00
FY 2021-22 $ 279,258.00
FY 2022-23 $ 281,637.00
SUMMARY OF SERVICES:
The Fresno County Department of Behavioral Health (DBH) and the Department of Public Health
(DPH) will establish parameters for the DBH Mental Health Services Act – Perinatal Prevention and
Early Intervention (PEI) Perinatal Wellness Center. Services provided through this center will target
clients who experience their first episode of mental illness during pregnancy and/or postpartum, as
well as clients with an acute/chronic history of mental illness during pregnancy and/or postpartum.
Perinatal is defined as the period during pregnancy and up to one year after childbirth. Three (3)
Public Health Nurses (PHNs) within the Perinatal Wellness Center will provide case management
services to pregnant and/or parenting women and their infants in their homes. Liaison activities with
clients and providers may be conducted at primary clinics, OB/GYN offices, community centers,
clinics, and treatment centers. The PHNs will provide health assessment and screening for pregnant
and postpartum women, which will include screening for symptoms of perinatal mood disorders.
Additionally, PHNs will identify women requiring further evaluation and provide referral and linkage to
needed services and promote client retention in treatment services. PHNs will also maintain
communication with clinicians to facilitate successful interventions and optimal infant birth outcomes.
TARGET POPULATION:
The program’s intended target population is high-risk perinatal clients and their infants in un-
served/underserved cultural populations and geographic areas within the County of Fresno. Each
Exhibit A
Page 2 of 7
Department‘s specific needs and services are detailed below.
I. DPH SHALL PROVIDE THE FOLLOWING SERVICES TO DBH:
1. Provide three (3) Public Health Nurses for the Perinatal Wellness Center.
2. Accept and process client referrals received from community medical providers.
3. Provide case management services to the DBH perinatal clients and their infants, which
include health screening, assessment, identification of services needed, providing nursing
services needed, referral, and linkage to needed services.
4. When requested, conduct joint home visits with mental health clinicians to facilitate client
intake and assessment.
5. Provide consultation to perinatal mental health clinical staff regarding medical conditions
affecting clients.
6. Act as a liaison between community medical providers identifying clients in need of services
and clinicians providing treatment services to perinatal clients.
7. Maintain an up-to-date listing of community mental health services available to perinatal clients
and their infants.
8. Participate in education and training to enhance the PHN’s knowledge and skills in screening,
identification, and treatment of perinatal depression and maternal/infant attachment disorders.
9. Attend medical training to build/enhance skills in other areas, such as, but not limited to:
substance use disorder, tobacco, domestic violence prevention, breastfeeding, gestational
diabetes, Sudden Infant Death Syndrome (SIDS), perinatal and child development trainings.
10. Participate in multidisciplinary team meetings to facilitate inter-department communication and
coordination of client referrals and treatment services.
11. Identify gaps in the perinatal health care system and develop solutions and recommendations
to problems identified.
12. Maintain a database and make available reports as requested by DBH for the Perinatal
Wellness Center program.
13. DPH shall provide services as identified in the Prevention & Early Intervention Work Plan
approved by the State as it relates to DPH nursing services.
14. Provide comprehensive case management during the PHN home visit through skilled nursing
assessment and nursing intervention, and care coordination of at-risk pregnant and
postpartum women and their infants, children and their families.
15. Prioritize and triage referrals for medically and/or psychosocially difficult and/or challenging
cases involving high-risk women, infants/children, their families, and pregnant/parenting teens.
Identify appropriate interventions and medically necessary services.
Exhibit A
Page 3 of 7
16. Provide screening, assessment, referral and linkage to health care providers and community
agencies and coordinate linkage of clients and families to services identified in the
treatment/care plan.
17. Provide nurse case management involving high-risk infants/children, their families and high-
risk pregnant/parenting teens to identify appropriate medically-necessary services, provide
referral and linkage to health care providers and assess the progress in meeting the infant,
child and pregnant/parenting teen’s identified service care plan.
18. Promote client retention in treatment services, maintaining communication with clinicians to
facilitate successful interventions and optimal infant birth outcomes.
19. Consult and collaborate with the client’s prenatal care provider and other agencies to develop
and coordinate the client’s plan of care.
20. Participate in quality improvement activities, such as case conferences with peers, multi-
disciplinary professionals or other agencies to problem-solve and coordinate services, which
will improve access to medical/mental health/dental care for clients.
21. Assist clients in referring and linking clients to resources providing food, clothing, and needed
services identified through ongoing assessment during home visits.
22. Screen, assess, and provide education/information on the dangers of tobacco, alcohol and
other drugs and refer to community-based programs as needed.
23. Provide consultation to professional staff in other agencies about specific medical conditions
within their client population.
24. Coordinate with the client’s physician on client’s progress in meeting treatment goals.
25. Assist clients and their children in accessing Medi-Cal services and other medically related
appointments including obtaining a referral to a specialist.
26. Provide annual client statistical reports involving but not limited to: high-risk infants/children,
high-risk pregnant/parenting teens, substance use disorder, and/or Sudden Infant Death
Syndrome (SIDS), as requested.
II. DBH SHALL PROVIDE THE FOLLOWING SERVICES TO DPH:
1. Provide oversight, through its MHSA Coordinator and/or Mental Health Contracts Staff
Analyst, or their designees, and collaborate with DPH and other community agencies to help
achieve State program goals and outcomes. In addition to contract monitoring of the
program, oversight includes, but is not limited to, coordination with the State Department of
Health Care Services in regard to program administration and outcomes.
2. DBH shall assist DPH in making linkages with the mental health system. This will be
accomplished through regularly scheduled meetings as well as formal and informal
consultation.
3. Participate in evaluating the progress of the overall program and the efficiency of
collaboration with DBH staff and will be available to DPH for ongoing consultation.
Exhibit A
Page 4 of 7
4. Gather outcome information from target client group(s) and DPH throughout each term of
contract.
5. DBH will work with DPH in developing outcome performance measures to identify program
and client success.
6. To assist DPH efforts towards cultural and linguistic competency, DBH shall provide the
following at no cost to DPH:
A. Mandatory comprehensive cultural competency training shall be offered to nursing
staff assigned to the Perinatal Wellness Center, at a minimum once per year. County
may provide technical assistance regarding mandatory trainings about the special
needs of diverse populations and will be included in the cultural competency
training(s).
B. Technical assistance for translating behavioral health and substance use disorder
services information into DBH’s threshold languages (Spanish and Hmong).
Translation services and costs associated will be the responsibility of DPH.
III. PERFORMANCE OUTCOMES AND MEASURES:
Per Title 9 California Code of Regulations, Division 1, Chapter 14 MHSA, all programs funded through
the Prevention and Early Intervention (PEI) component of the Mental Health Services Act (MHSA) are
required to have outcome and performance reporting requirements. Some reporting requirements are
standard for any and all PEI programs (such as demographic data), and others are dependent on
which of the six PEI strategies the program is classified within.
The following outcomes and data shall be submitted quarterly to DBH, so that the Department can
successfully complete its required annual and three-year reporting requirements to the DHCS and the
Mental Health Services Oversight and Accountability Commission (MHSOAC).
The Perinatal Wellness Center is classified as an Early Intervention PEI Strategy (see Section 3710
Early Intervention Program for specific definitions and regulatory requirements). These are
mandatory requirements of any provider receiving funding for PEI Services from Fresno County DBH
and will go into effect July 1, 2019.
Requirements:
Program shall collect and report information on the following:
Total number of unduplicated individuals served. If program serves families the total number
of individual family members served shall be reported.
Prevention activities performed separately, as the focus is early intervention.
Total number of specific services received by each individual
Types of and the number of individuals served.
Timely access to care -- including but not limited to, timeframe from referral to date of first
service.
Linkage to services -- including but not limited to, timeframe from onset of linkage to date of
warm hand-off and type of linkage.
Progress of the client’s symptoms and overall wellness and recovery.
Exhibit A
Page 5 of 7
Number of hospitalizations (including Emergency Department utilization/visits) for each client.
Participant engagement in services.
Client engagement.
Number of cases involved with Child Welfare
Program shall provide, as part of its reports, what tools/assessments/rubrics it is using to measure
outcomes such as number screened, numbers enrolled, improved wellness within participants, and
measuring the number of individuals remaining in care through participation in this program. Program
shall identify the types of activities it uses to improve wellness, reduce stress, etc.
Demographic Data:
Additionally, the program will report the following demographic data of its clients:
1) AGE
0-15 Children/Youth
16-25 Transition Age Youth (TAY)
26-59 Adult
Ages 60+ (Older Adult).
2) RACE BY THE FOLLOWING CATEGORIES:
American Indian/Alaska Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Other
More than one race
Number of clients who declined to state
3) ETHNICITY BY THE FOLLOWING CATEGORIES:
Hispanic or Latino as follows:
o Caribbean
o Central American
o Mexican/Mexican American/Chicano
o Puerto Rican
o South American
o Other
o Number of clients who declined to state
Non-Hispanic or Non-Latinos as follows:
o African
o Asian Indian/South Asian
o Cambodian
o Chinese
Exhibit A
Page 6 of 7
o Eastern European
o Filipino
o Japanese’s
o Korean
o Middle Eastern
o Vietnamese
o Other
o Number of clients who declined to state
More than one ethnicity
Number of clients who declined to state
4) PRIMARY LANGUAGE USED LISTED BY THRESHOLD LANGUAGES FOR INDIVIDUAL
COUNTY
English
Spanish
Hmong
Other (specify)
Unknown
Number of clients who declined to state
5) SEXUAL ORIENTATION
Gay or Lesbian
Heterosexual or Straight
Bisexual
Questioning or unsure of sexual orientation
Queer
Another Sexual Orientation
Number of clients who declined to state
6) DISABILITIES (Defined as physical or mental impairment or medical condition lasting at least
six months that substantially limits major life activity, which is not the result of a severe mental
illness).
Yes, report the number that apply in each domain of disability(ies)
o Communication domain separated by each of the following;
Difficulty Seeking
Difficulty hearing, or having speech understood
Other (specify)
o Mental domain, not including mental illness (including but not limited to a
learning disability, developmental disability, dementia)
o Physical/mobility domain
o Chronic health condition (including but not limited to, chronic pain)
o Other (specific)
No
Number of clients who declined to state
Exhibit A
Page 7 of 7
7) VETERAN STATUS
Yes
No
Number of clients who declined to state
8) GENDER
Assigned sex at birth
o Male
o Female
o Number of clients who declined to state
Current gender identity
o Male
o Female
o Transgender
o Genderqueer
o Questioning or unsure of gender identity
o Another gender identity
o Number of clients who decline to state
Exception to the demographic data collection is for a program serving children and youth younger
than 18 yrs. age shall be reported to the extent permissible by California Education Code, Family
Educational Rights and Privacy Act (FERPA), Heath Insurance Portability and Accountably Act of
1996 (HIPAA), California Information Practices Act, and other applicable state and federal privacy
laws. In such instances the program shall provide written explanation on the attempts and challenges
in obtaining demographic data in these settings.
Except for sexual orientation, current gender identity, and veteran status, program shall collect all the
demographic information required from a minor younger than 12yrs of age.
REPORTS:
Beginning in fiscal year (FY) 2019-2020 reports shall be submitted quarterly to contractor’s assigned
Fresno County DBH Staff Analyst via email and to the MHSA Coordinator via the
MHSA@fresnocountyca.gov. Late reports shall be documented and shall reflect on provider’s ability
to adhere to contract requirements.
Reports shall provide an update for the program, progress and measure on outcome and goals, and
demographic information on new/unduplicated persons served each quarter.
Departments of Behavioral Health/Public Health MOUFY 2018-19Exhibit BDBH/ DPH MOUFY 2018-19FundingAccounts 6100 6350 6400 6500 6600 Benefits Total Total FFP DBH 1.00FY 2018-19MHSAPercent Yearly 6350 6400 6500 6600 Benefits Total Total FFP 51% DBH 49% DBHJCNPositionTimeSalaryUnemploy.RetirementOASDI/MedicareHealth Ins.Life Ins.Admin.BenefitsS & BS & BS & BMonthly1346 5620PH Nurse II100%$99,309 $159 $61,959 7,597 $7,921 $0 $160 $77,796 $177,106 $90,324 $86,782 $7,2321346 5620PH Nurse II100%$82,576 $132 $40,091 6,317 $10,787 $0 $160 $57,487 $140,064 $71,433 $68,631 $5,7191346 5620PH Nurse II100%$99,309 $159 $49,823 7,597 $10,787 $0 $160 $68,526 $167,836 $85,597 $82,240 $6,853$247,353 $237,653$19,804Overhead Rate DBH-MHSA (14.676%)$36,302 $34,878 $2,906Total$283,655 $272,531 $22,711Journal Vouchers billed to DBH to provide detailed information and breakout of cost by Cost Center
Departments of Behavioral Health/Public Health MOUFY 2019-20Exhibit BDBH/ DPH MOUFY 2019-20FundingAccounts 6100 6350 6400 6500 6600 Benefits Total Total FFP DBH 1.00FY 2018-19MHSAPercent Yearly 6350 6400 6500 6600 Benefits Total Total FFP 51% DBH 49% DBHJCNPositionTimeSalaryUnemploy.RetirementOASDI/MedicareHealth Ins.Life Ins.Admin.BenefitsS & BS & BS & BMonthly1346 5620PH Nurse II100%$99,309 $159 $61,959 7,597 $7,921 $0 $160 $77,796 $177,106 $90,324 $86,782 $7,2321346 5620PH Nurse II100%$85,053 $136 $41,293 6,507 $10,787 $0 $160 $58,883 $143,937 $73,408 $70,529 $5,8771346 5620PH Nurse II100%$99,309 $159 $49,823 7,597 $10,787 $0 $160 $68,526 $167,836 $85,597 $82,240 $6,853$249,329 $239,551$19,963Overhead Rate DBH-MHSA (14.676%)$36,591 $35,157 $2,930Total$285,920 $274,708 $22,892Journal Vouchers billed to DBH to provide detailed information and breakout of cost by Cost Center
Departments of Behavioral Health/Public Health MOUFY 2020-21Exhibit BDBH/ DPH MOUFY 2020-21FundingAccounts 6100 6350 6400 6500 6600 Benefits Total Total FFP DBH 1.00FY 2018-19MHSAPercent Yearly 6350 6400 6500 6600 Benefits Total Total FFP 51% DBH 49% DBHJCNPositionTimeSalaryUnemploy.RetirementOASDI/MedicareHealth Ins.Life Ins.Admin.BenefitsS & BS & BS & BMonthly1346 5620PH Nurse II100%$99,309 $159 $61,959 7,597 $7,921 $0 $160 $77,796 $177,106 $90,324 $86,782 $7,2321346 5620PH Nurse II100%$87,605 $140 $42,532 6,702 $10,787 $0 $160 $60,321 $147,927 $75,443 $72,484 $6,0401346 5620PH Nurse II100%$99,309 $159 $49,823 7,597 $10,787 $0 $160 $68,526 $167,836 $85,597 $82,240 $6,853$251,363 $241,506$20,125Overhead Rate DBH-MHSA (14.676%)$36,890 $35,443 $2,954Total$288,253 $276,949 $23,079Journal Vouchers billed to DBH to provide detailed information and breakout of cost by Cost Center
Departments of Behavioral Health/Public Health MOUFY 2021-22Exhibit BDBH/ DPH MOUFY 2021-22FundingAccounts 6100 6350 6400 6500 6600 Benefits Total Total FFP DBH 1.00FY 2018-19MHSAPercent Yearly 6350 6400 6500 6600 Benefits Total Total FFP 51% DBH 49% DBHJCNPositionTimeSalaryUnemploy.RetirementOASDI/MedicareHealth Ins.Life Ins.Admin.BenefitsS & BS & BS & BMonthly1346 5620PH Nurse II100%$99,309 $159 $61,959 7,597 $7,921 $0 $160 $77,796 $177,106 $90,324 $86,782 $7,2321346 5620PH Nurse II100%$90,233 $144 $43,808 6,903 $10,787 $0 $160 $61,802 $152,036 $77,539 $74,498 $6,2081346 5620PH Nurse II100%$99,309 $159 $49,823 7,597 $10,787 $0 $160 $68,526 $167,836 $85,597 $82,240 $6,853$253,459 $243,520$20,293Overhead Rate DBH-MHSA (14.676%)$37,198 $35,739 $2,978Total$290,657 $279,258 $23,272Journal Vouchers billed to DBH to provide detailed information and breakout of cost by Cost Center
Departments of Behavioral Health/Public Health MOUFY 2022-23Exhibit BDBH/ DPH MOUFY 2022-23FundingAccounts 6100 6350 6400 6500 6600 Benefits Total Total FFP DBH 1.00FY 2018-19MHSAPercent Yearly 6350 6400 6500 6600 Benefits Total Total FFP 51% DBH 49% DBHJCNPositionTimeSalaryUnemploy.RetirementOASDI/MedicareHealth Ins.Life Ins.Admin.BenefitsS & BS & BS & BMonthly1346 5620PH Nurse II100%$99,309 $159 $61,959 7,597 $7,921 $0 $160 $77,796 $177,106 $90,324 $86,782 $7,2321346 5620PH Nurse II100%$92,940 $149 $45,122 7,110 $10,787 $0 $160 $63,328 $156,269 $79,697 $76,572 $6,3811346 5620PH Nurse II100%$99,309 $159 $49,823 7,597 $10,787 $0 $160 $68,526 $167,836 $85,597 $82,240 $6,853$255,618 $245,594$20,466Overhead Rate DBH-MHSA (14.676%)$37,514 $36,043 $3,004Total$293,132 $281,637 $23,470Journal Vouchers billed to DBH to provide detailed information and breakout of cost by Cost Center