HomeMy WebLinkAboutAgreement A-25-051 with DHCS MHBG.pdf Agreement No. 25-051
Biennial 2024-26 MHBG County Application Enclosure 1
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Community Mental Health Services Block Grant (MHBG)
Biennial Funding Allocation
State Fiscal Years 2024-25 and 2025-26
Fresno County 06/28/2024
County Name Date
RUJLPIK3WWK9 Entity Data Detail.pdf document included ❑
SFY 2024-25 SFY 2025-26
Proposed Total Allocation $2,381,212 $2,381,212
Base Allocation $1,962,313 $1,962,313
Dual Diagnosis Set-Aside $418,899 $418,899
First Episode Psychosis Set-Aside $0 $0
Children's System of Care Set-Aside $0 $0
Integrated Services Agency Set-Aside $0 $0
The County requests continuation of the MHBG. These funds will be used in accordance
with Public Law 102-321 (42 U.S.C., Sections 300x through 300x-13), and Public Law
(PL) 106-310, and will be used as stated in the enclosed MHBG Funding Agreements
with Federal Requirements on Use of Allotments, and the Certification Statements.
These estimates are the proposed total allocations for State Fiscal Year (SFY) 2024-25
and 2025-26 and are subject to change based on the level of appropriation approved in
the State Budget Act of 2024 and State Budget Act of 2025. In addition, this amount is
subject to adjustments for a net reimbursable amount to the county. The adjustments
include, but are not limited to, Gramm-Rudmann-Hollings (Federal Deficit Reduction Act)
reductions, prior year audit recoveries, federal legislative mandates applicable to
categorical funding, augmentations, etc. The net amount reimbursable will be reflected in
reimbursable payments as the specific dollar amounts of adjustments become known for
each county.
The County will use this estimate to build the County's SFY 2024-25 and SFY 2025-26
budget for the provision of mental health services for adults with serious mental illness
(SMI) and children with serious emotional disturbance (SED).
a - -o2oa5
Behavioral Health Direct or Authorized Signer Signature Date
Ernest Buddy Mendes,Chairman of the Board of Supervisors of the County of Fresno
Print Name ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
(Rev. 05/2024) County of Fresno,State of C lifornia
By Deputy
Biennial 2024-26 MHBG County Application Enclosure 4
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Community Mental Health Services Block Grant Funding Agreements
Public Law 106-310 (Children's Health Act of 2000)
Public Law 102-321; Title II-Block Grants to States Regarding
Mental Health & Substance Abuse
Part B of Title XIX of the Public Health Service Act [42 U.S.C. 300x-1 et seq.]
The county, as recipient of grant funds, acknowledges and agrees that the county and
its subcontractors shall provide services in accordance with all applicable federal and
state statutes and regulations including the following:
Section 1911
Subject to Section 1916, the State/County involved will expend the grant only for
the purpose of:
(1) Carrying out the plan submitted under Section 1912(a) [State Plan for
Comprehensive Community Mental Health Services] by the State for the fiscal
year involved;
(2) Evaluating programs and services carried out under the plan; and
(3) Planning, administration, and educational activities related to providing
services under the plan.
Section 1912
(c)(1) & (2) [As a funding agreement for a grant under Section 1911 of this title the
Secretary establishes and disseminates definitions for the terms "adult with a
serious mental illness" and "children with a serious emotional disturbance" and the
State/County will utilize such methods [standardized methods, established by the
Secretary] in making estimates [of the incidence and prevalence in the County of
serious mental illness among adults and serious emotional disturbance among
children].
Section 1913
(a)(1)(C) the County will expend for such system [of integrated services described
in Section 1912(b)(3)] not less than an amount equal to the amount expended by
the County for fiscal year 1994.
[A system of integrated social services, educational services, juvenile services, and
substance abuse services that, together with health and mental health services,
will be provided in order for such children to receive care appropriate for their
multiple needs (which includes services provided under the Individuals with
Disabilities Education Act)].
(b)(1) The County will provide services under the plan only through appropriate
qualified community programs (which may include community mental health
centers, child mental health programs, psychosocial rehabilitation programs,
mental health peer-support programs, and mental health primary consumer-
directed programs).
Biennial 2024-26 MHBG County Application Enclosure 4
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(b)(2) The State agrees that services under the plan will be provided through
community mental health centers only if the centers meet the criteria specified in
subsection (c).
(c)(1) With respect to mental health services, the centers provide services as
follows:
(A) Services principally to individuals residing in a defined geographic
area (hereafter in the subsection referred to as a "service area").
(B) Outpatient services, including specialized outpatient services for
children, the elderly, individuals with a serious mental illness, and
residents of the service areas of the centers who have been
discharged from inpatient treatment at a mental health facility.
(C) 24-hour-a-day emergency care services.
(D) Day treatment or other partial hospitalization services, or
psychosocial rehabilitation services.
(E) Screening for patients being considered for admission to state
mental health facilities to determine the appropriateness of such
admission.
(2) The mental health services of the centers are provided, within the limits of
the capacities of the centers, to any individual residing or employed within
the service area of the center regardless of ability to pay for such services.
(3) The mental health services of the centers are available and accessible
promptly, as appropriate and in a manner which preserves human dignity
and assures continuity and high quality care.
Section 1916
(a) The County involved will not expend the grant-
(1) to provide inpatient services;
(2) to make cash payments to intended recipients of health services;
(3) to purchase or improve land, purchase, construct, or permanently improve
(other than minor remodeling) any building or other facility, or purchase
major medical equipment;
(4) to satisfy any requirement for the expenditure of non-federal funds as a
condition for the receipt of federal funds; or
(5) to provide financial assistance to any entity other than a public or nonprofit
private entity.
(b) The County involved will not expend more than ten percent of the grant for
administrative expenses with respect to the grant.
Biennial 2024-26 MHBG County Application Enclosure 4
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Section 1946 PROHIBITIONS REGARDING RECEIPT OF FUNDS
(a) Establishment-
(1) Certain false statements and representation - A person shall not knowingly
and willfully make or cause to be made any false statement or
representation of a material fact in connection with the furnishing of items
or services for which payments may be made by a State from a grant
made to the State under Section 1911 or 1921.
(2) Concealing or failing to disclose certain events - A person with knowledge
of the occurrence of any event affecting the initial or continued right of the
person to receive any payments from a grant made to a State under
Section 1911 or 1921 shall not conceal or fail to disclose any such event
with an intent fraudulently to secure such payment either in a greater
amount than is due or when no such amount is due.
(b) Criminal Penalty for Violation of Prohibition - Any person who violates any
prohibition established in subsection (a) shall for each violation be fined in
accordance with Title 18, United States Code, or imprisoned for not more than
five years, or both.
Section 1947 NONDISCRIMINATION
(a) In General-
(1) Rule of construction regarding certain civil rights laws - For the purpose of
applying the prohibitions against discrimination on the basis of age under
the Age Discrimination Act of 1975, on the basis of handicap under
Section 504 of the Rehabilitation Act of 1973, on the basis of sex under
Title IX of the Education Amendments of 1972, or on the basis of race,
color, or national origin under Title VI of the Civil Rights Act of 1964,
programs and activities funded in whole or in part with funds made
available under Section 1911 or 1921 shall be considered to be programs
and activities receiving federal financial assistance.
(2) Prohibition- No person shall on the grounds of sex (including, in the case
of a woman, on the grounds that the woman is pregnant), or on the
grounds of religion, be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under, any program or
activity funded in whole or in part with funds made available under Section
1911 or 1921.
(b) Enforcement-
(1) Referrals to Attorney General after notice: Whenever the Secretary finds
that a state, or an entity that has received a payment pursuant to Section
1911 or 1921, has failed to comply with a provision of law referred to in
Biennial 2024-26 MHBG County Application Enclosure 4
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subsection (a)(1), with subsection (a)(2), or with and applicable regulation
(including one prescribed to carry out subsection (a)(2), the Secretary
shall notify the Chief Executive Officer of the state and shall request the
Chief Executive Officer to secure compliance. If within a reasonable period
of time, not to exceed 60 days, the Chief Executive Officer fails or refuses
to secure compliance, the Secretary may--
(1)(A) refer the matter to the Attorney General with a recommendation that
an appropriate civil action be instituted;
(1)(B) exercise the powers and functions provided by the Age
Discrimination Act of 1975, Section 504 of the Rehabilitation Act of
1973, Title IX of the Education Amendment of 1972, or Title VI of the
Civil Rights Act of 1964, as may be applicable; or
(1)(C) take such other actions as may be authorized by law.
(2) Authority of Attorney General - When a matter is referred to the Attorney
General pursuant to paragraph (1)(A), or whenever the Attorney General
has reason to believe that a State or an entity is engaged in a pattern or
practice in violation of a provision of law referred to in subsection (a)(1) or
in violation of subsection (a)(2), the Attorney General may bring a civil
action in any appropriate district court of the United States for such relief
as may be appropriate, including injunctive relief.
E..-Y .2 -/l ozoa s
Behavioral Health Direc or Authorized Signer Signature Date
Ernest Buddy Mendes, Chairman of the Board of Supervisors Fresno
Print Name/Title County
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By_ Deputy
Biennial 2024-26 MHBG County Application Enclosure 5
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Certifications
CERTIFICATION REGARDING LOBBYING
1) No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the
awarding of any federal contract, the making of any federal grant, the making of any
federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal contract, grant,
loan, or cooperative agreement.
2) If any funds other than federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions.
3) The undersigned shall require that the language of this certification be included in
the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans, and cooperative agreements) and that
all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is
prerequisite for making or entering into this transaction imposed by Section 1352, Title
31, and U.S. Code. Any person who fails to file the required certification shall be subject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
SALARY CAP
The undersigned certifies that no part of any federal funds provided under this Contract
shall be used by the County or its subcontractors to pay the salary and wages of an
individual at a rate in excess of Level II of the Executive Schedule, as found online at:
https://grants.nih.gov/grants/policy/salcap summary.htm
DRUG FREE WORK ENVIRONMENT
The undersigned certifies that reasonable efforts are made to maintain a drug-free work
place in all programs supported by the Federal Block Grant funds.
Biennial 2024-26 MHBG County Application Enclosure 5
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CERTIFICATION REGARDING DEBARMENT, SUSPENSION INELIGIBILITY AND
VOLUNTARY EXCLUSION - LOWER TIER COVERED TRANSACTIONS
1) The prospective lower tier participant certified, by submission of this proposal, that
neither it nor its principals or contracted providers is presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency.
2) Where the prospective lower tier participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an
explanation to this proposal/application.
CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE
Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that
smoking not be permitted in any portion of any indoor facility owned or leased or
contracted for by an entity and used routinely or regularly for the provision of health, day
care, early childhood development services, education or library services to children
under the age of 18, if the services are funded by Federal programs either directly or
through State or local governments, by Federal grant, contract, loan, or loan guarantee.
The law also applies to children's services that are provided in indoor facilities that are
constructed, operated or maintained with such federal funds. The law does not apply to
children's services provided in private residences; portions of facilities used for inpatient
drug or alcohol treatment; service providers whose sole source of applicable Federal
funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure
to comply with the provisions of the law may result in the imposition of a civil monetary
penalty of up to $1,000 for each violation and/or the imposition of an administrative
compliance order on the responsible entity.
By signing this certification, the offer or contractor (for acquisitions) or applicant/grantee
(for grants) certifies that the submitting organization will comply with the requirements of
the Act and will not allow smoking within any portion of any indoor facility used for the
provision of services for children as defined by the Act.
The submitting organization agrees that it will require that the language of this
certification be included in any subawards which contain provisions for children's
services and that all subrecipients shall certify accordingly.
--..�..-�� 'Ix2 -/l -boa S
Behavioral Health Dire or or Authorized Signer Signature Date
Ernest Buddy Mendes, Chairman of the Board of Supervisors Fresno
Print Name/Title County
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By_ Deputy
1
State of California - Health and Human Services Agency Department of Health Care Services
Enclosure 6
2024-25
MHBG Program Data Sheet
Complete one sheet for each MHBG funded program that supports transformation activities (as budgeted).
County: FRESNO
Program Title: Specialized Supplemental Board and Care Home Services
Program Contact: Jon Rogers
Email: jrogers@fresnocountyca.gov
Phone Number: 559-600-4647
MHBG Funding Level: 1 $2,381,212.00
Target Population(s): (Estimated number of consumers to be served in the year with MHBG funds)
Ages 0-5 0 Age 21-24: 5 Age 65-74: 31
Age 6-17 0 Age 25-44: 108 Age 75+: 6
Age 18-20: 0 Age 45-64: 115 Age Not Available: 0
Types of Transformational Service(s) Provided
• Check all categories that are applicable
• Please elaborate in the narrative portion of the application
Transformational Categories Is MHBG funding used to support this goal?
Please check one.
Americans Understand that Mental Health is Essential to Overall Health 0 YES ❑ No
Mental Health Care is Consumer and Family Driven [21 YES ❑ No
Disparities in Mental Health Services are Eliminated 0 YES ❑ No
Early Mental Health Screening, Assessment, and Referral to Services are Common Practices 0 YES ❑ No
Excellent Mental Health Care is Delivered and Research is Accelerated 0 YES ❑ No
Technology is Used to Access Mental Health Care and Information 0 YES ❑ No
Additional Comments:
State of California - Health and Human Services Agency Department of Health Care Services
Version 1.7
Enclosure 7 Current ICR 10.00%
Detailed Program Budget
TYPE OF GRANT lCommunity Mental Health Services Block Grant ISFY 2024-25
COUNTY IFRESNO ISubmission Date 6/28/2024
DHCS Approval (For DHCS Staff Only)
Analyst Michelle Aulisio Date Approval 7/29/2024
Funding Source
Base Allocation 1 $ 1,962,313.00
Dual Diagnosis I $ 418,899.00
Program Name ISpecialized Supplemental Board and Care Home Services
Summary
Category Amount
Staff Expenses $ -
Consultant/Contract Costs $ 2,164,738.20
Equipment $ -
Supplies $ -
Travel $ -
Other Expenses $ -
Program Maximum Allowable Indirect Costs $ 216,473.82
Indirect Costs $ -
Program Maximum Allowable Support Administrative Direct Costs $ 216,473.82
County Support Administrative Direct Costs $ 216,473.80
Net Program Expenses $ 2,381,212.00
Other Funding Sources: Federal $ -
Other Funding Sources: Non-Federal Funds $ 2,618,788.00
Total Other Funding Sources $ 2,618,788.00
Gross Cost of Program $ 5,000,000.00
I. Staffing Itemized Detail
Category Detail Annual Salary Grant FTE Total Not to
Exceed
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ o.000 $
1
Detailed Program Budget
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
Staff Expenses $ 0.000 $ -
2
Detailed Program Budget
II. Itemized Detail
Category Detail Amount Total
Indirect Costs $ - $ -
Consultant/Contract Costs Services are provided through all-inclusive daily rate set by individual contractors in Appendix A $ 2,164,738.20 $ 2,164,738.20
County Support Administra County overhead and Administrative Support $ 216,473.80 $ 216,473.80
Other Funding Sources:N Realignment $ 2,618,788.00 $ 2,618,788.00
3
1
State of California - Health and Human Services Agency Department of Health Care Services
Enclosure 6
2025-26
MHBG Program Data Sheet
Complete one sheet for each MHBG funded program that supports transformation activities (as budgeted).
County: FRESNO
Program Title: Specialized Supplemental Board and Care Home Services
Program Contact: Jon Rogers
Email: jrogers@fresnocountyca.gov
Phone Number: 559-600-4647
MHBG Funding Level: 1 $2,381,212.00
Target Population(s): (Estimated number of consumers to be served in the year with MHBG funds)
Ages 0-5 0 Age 21-24: 5 Age 65-74: 31
Age 6-17 0 Age 25-44: 108 Age 75+: 6
Age 18-20: 0 Age 45-64: 115 Age Not Available: 0
Types of Transformational Service(s) Provided
• Check all categories that are applicable
• Please elaborate in the narrative portion of the application
Transformational Categories Is MHBG funding used to support this goal?
Please check one.
Americans Understand that Mental Health is Essential to Overall Health 0 YES ❑ No
Mental Health Care is Consumer and Family Driven [21 YES ❑ No
Disparities in Mental Health Services are Eliminated 0 YES ❑ No
Early Mental Health Screening, Assessment, and Referral to Services are Common Practices 0 YES ❑ No
Excellent Mental Health Care is Delivered and Research is Accelerated 0 YES ❑ No
Technology is Used to Access Mental Health Care and Information 0 YES ❑ No
Additional Comments:
State of California - Health and Human Services Agency Department of Health Care Services
Version 1.7
Enclosure 7 Current ICR 10.00%
Detailed Program Budget
TYPE OF GRANT lCommunity Mental Health Services Block Grant ISFY 2025-26
COUNTY IFRESNO ISubmission Date 6/28/2024
DHCS Approval (For DHCS Staff Only)
Analyst Michelle Aulisio Date Approval 7/29/2024
Funding Source
Base Allocation 1 $ 1,962,313.00
Dual Diagnosis I $ 418,899.00
Program Name ISpecialized Supplemental Board and Care Home Services
Summary
Category Amount
Staff Expenses $ -
Consultant/Contract Costs $ 2,164,738.20
Equipment $ -
Supplies $ -
Travel $ -
Other Expenses $ -
Program Maximum Allowable Indirect Costs $ 216,473.82
Indirect Costs $ -
Program Maximum Allowable Support Administrative Direct Costs $ 216,473.82
County Support Administrative Direct Costs $ 216,473.80
Net Program Expenses $ 2,381,212.00
Other Funding Sources: Federal $ -
Other Funding Sources: Non-Federal Funds $ 2,618,788.00
Total Other Funding Sources $ 2,618,788.00
Gross Cost of Program $ 5,000,000.00
I. Staffing Itemized Detail
Category Detail Annual Salary Grant FTE Total Not to
Exceed
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ o.000 $
1
Detailed Program Budget
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $ -
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $
$ 0.000 $ -
Staff Expenses $ 0.000 $ -
2
Detailed Program Budget
II. Itemized Detail
Category Detail Amount Total
Indirect Costs $ - $ -
Consultant/Contract Costs Services are provided through all-inclusive daily rate set by individual contractors in Appendix A $ 2,164,738.20 $ 2,164,738.20
County Support Administra County Overhead and Administrative Support $ 216,473.80 $ 216,473.80
Other Funding Sources:N Realignment $ 2,618,788.00 $ 2,618,788.00
3
Fresno County
Community Mental Health Services Block Grant (MHBG)
State Fiscal Year (SFY) 2024-26 Program Narrative
Instructions: Complete one Program Narrative for each proposed program. The Program
Narrative should span the entire application period from July 1, 2024, to June 30, 2026. Each
Program Narrative must have a corresponding Detailed Budget. Each Program Narrative must
be completed on this template and the template may not be altered. The Program Narrative
should be comprehensive and detail the activities for both SFYs. Each SFY should not have
its own Program Narrative. Please enter responses to each question within the provided gray
comment box — the boxes have a 6000-character limit.
Program Name: Insert the Program Name below in the gray box below and ensure it
matches the Program Name on the Detailed Budget.
Specialized Supplemental Board and Care Home Services
Check Is this Program County-Run
Set-Aside(s) Utilized for Program Appropriate
or Subcontracted?
Box(es)
Base Allocation County-Run ❑
❑x Subcontracted ❑x
Both ❑
Dual-Diagnosis County-Run ❑
❑x Subcontracted ❑x
Both ❑
First Episode Psychosis County-Run ❑
❑ Subcontracted ❑
Both ❑
Children's System of Care County-Run ❑
❑ Subcontracted ❑
Both ❑
Integrated Services Agency County-Run ❑
❑ Subcontracted ❑
Both ❑
A. Statement of Purpose: Please describe how the program will provide comprehensive,
community-based mental health services to adults with serious mental illnesses and/or
to children with serious emotional disturbances and to monitor progress in implementing
a comprehensive, community-based mental health system. Specify how the program
works/will work with other departments and agencies that serve the same population(s).
The Fresno County Department of Behavioral Health (DBH), in partnership with our
diverse community, is dedicated to providing quality, culturally responsive behavioral
health services to promote wellness, recovery, and resiliency for individuals and families
in our community. Fresno County DBH has identified four primary goals, which we call
our Quadruple Aim. These goals are: 1) Deliver quality services; 2) Maximize resources
while focusing on efficiency; 3) Provide an excellent care experience; and 4) Promote
workforce well-being. Additionally, Fresno County DBH has developed Guiding
Principles of Care Delivery that define and guide the behavioral health system of care
toward excellence in the provision of services where the values of wellness, resiliency
and recovery are central to the development of programs, services and workforce.
Pursuant to Welfare and Institutions Code Section 5801 and the California Code of
Regulations Title 22, Fresno County DBH provides placements for adults with serious
mental illness (SMI) in secured, certified or licensed facilities with the appropriate level
of care and services. Historically, SMI adults with Lanterman-Petris-Short (LPS)
conservatorship status have been classified as hard to place. Placement have resulted
in many persons served being placed at higher and secured levels of care that can
include State Hospitals, Institutions of Mental Disease (IMD), Mental Health
Rehabilitation Centers (MHRC) or Skilled Nursing Facilities (SNF). Many of these
higher-level facilities are located outside of Fresno County. The transition from locked
and/or higher-level of care institutions to less restrictive facilities as determined by DBH
clinical staff, through Specialized Supplemental Board and Care Home services allows
for integrative approaches in collaboration with local medical health, substance use
disorder service providers, spiritual organizations, educational institutions, cultural
brokers, and other mental health partners to provide an integrated care experience.
Placements at appropriate service levels and collaboration of DBH with facility staff
ensures persons served are progressing in treatment toward the goal of independence
from LIPS conservatorship status, thus restoring capacity for person's served to care for
their basic needs with increased stabilization of mental health symptoms and increased
wellness. Continuity of care is well established while the person served receives
treatment services during placement in the local community.
Specialized Supplemental Board and Care Homes are licensed by Community Care
Licensing and provide structured supportive and therapeutic housing that supports a
seamless transition in preparing person's served to return to independence in the
community free of institutional restrictions that are aligned with successful transitions.
The range of services focus on the person's served wellness and recovery, working to
facilitate returning or continuing to live in the community, and including medication
management/education and self-care. Some specialized facilities possess care
exemptions from Community Care Licensing (CCL), which allows them to provide
services to persons served with mental health disorders and a wide variety of
specialized medical and behavioral needs.
B. Program Description: Specify the activities/services that will be paid with MHBG
funds. The description must include activities/services offered, types of settings, and/or
planned community outreach, as applicable. In addition, itemize and explain the budget
line items within the program's Detailed Budget.
Placement of Conservatees at facilities licensed to provide Specialized Supplemental
Board and Care Home services must be authorized by the DBH Recovery with
Inspiration, Support and Empowerment (RISE) Conservatorship Team. The DBH RISE
Team places conseved persons is facilities based on the need of the person. Facilities
are identified by DBH according to which services they provide. Services at licensed
facilities may include:
Provide three (3) meals and three (3) snacks per day (Title 22 87555)
Medication Management (assistance with taking, cheeking, and documentation of
consumption) (Title 22 80075)
Provide enough forks, glasses, and plates for each person (Title 22 80076)
Doctor visits - transport to and return safely from doctor visits (Title 22 80075, 87465)
Clearly defined menu, for thirty (30) days for all three (3) meals, and adherence to menu
(Title 22 80076)
Assistance with grooming (e.g. hair cut/trim, etc.)
Logging showers
Documentation for court - Psychiatrist notes, discharge papers, behavior notes must be
returned to DBH three (3) weeks prior to court date
Maintain a staff/person served ratio as defined in CCL regs (Title 22 85065.5).
There shall be at least one person capable of and responsible for communicating with
emergency personnel in the facility at all times.
Staff in milieu not just on site (staff available for care and supervision of person served)
Maintaining person served records such as progress notes and financial records (Title
22 80070)
Basic safe and healthful (clean) living accommodations and services (Title 22 87307)
Personal assistance and care as needed by the person served and as indicated in the
pre-admission appraisal, with those activities of daily living such as dressing, eating,
bathing, toileting, and assistance with taking prescribed medications, as specified in
Section 87608, Postural Supports.
Regular observation, documentation, and reporting of the person's served physical and
mental condition, as specified in Section 87466, Includes observation of the person
served and change in person served status
A planned activities program which includes social and recreational activities
appropriate to the interests and capabilities of the resident, as specified in Section
87219, Planned Activities
Support for ASL/non-English — provide interpreter
Support for ASL/non-English — direct communication
Enhancement of independent living skills other than care and supervision
Higher frequency medical transporting
Mobility assistance (Ambulation, etc.) with person served cooperation
Mitigating arsonist tendencies (redirection and risk management)
Managing verbal aggression
Multiple 9-1-1 calls/false reporting behavioral issues
Advanced medical needs with hospice
Transportation for other than medical reasons and care and supervision (e.g., visiting
family, outings, etc.)
Group — Biweekly activities/hobbies (Fun)
Security or controlled access (in and out of facility)
Medical supports requiring license professional (active dressing changes/wound care) —
In-house
Using AOD/toxicology screening/intervention support
Destruction of property
Multiple 9-1-1 calls/false reporting due to mental health symptoms
Preventative measures of elopement (cognitive or behavioral)
Efforts to locate an eloped person served
Certified Service Animal/Pet Therapy
Mitigating instigative behaviors
Emotional support/behavioral management for person served — Documented
Group — AA/12 Step/Rehab/SUD
Higher staffing ratio - staffing higher than one direct care staff to three persons served
Mobility assistance without person served cooperation all needs
Dealing with inappropriate physical/sexual touching
Acceptances of person served with multiple failed placements/evictions
Advanced medical needs without hospice
Cultural needs — Age/LGBTQIA+/Ethnicity/Language Barriers
Specialized trainings for staff for emotional/behavioral support for SMI/AOD
Equine Therapy
Hygiene related to encopresis/enuresis — Grooming: Soiled clothing/bedding
Services may also include intensive support and rehabilitation to persons served as an
alternative to State hospitalization or placement in other 24-hour care facilities and are
aimed at helping persons served to develop skills to become self-sufficient and increase
their levels of independent functioning.
Services are provided in a residential setting. Facilties are paid a daily rate dependant
on the services from the list above that they provide.
C. Evidence-Based Practices: List the Evidence-Based Practices (i.e., Coordinated
Specialty Care [CSC], NAVIGATE, Early Diagnosis and Preventative Treatment
[EDAPT], etc.) that will be used in this program. Provide a description of how each one
is used in the program.
Evidence Based Practices provided to conserved persons placed in Specialized
Supplemental Board and Care Homes are:
Cognitive Behavioral Therapy for Psychosis (CBTp) is a treatment approach that helps
persons with psychotic disorders cope with their symptoms and improve their
functioning. CBTp involves learning how to understand, normalize, and accept psychotic
symptoms, such as hallucinations, delusions, and negative thoughts.
Motivational Interviewing is used most frequently in individual sessions as a way to
emphasize change.
Wellness Recovery Action Plan (WRAP) guides participants through the process of
identifying and understanding their personal wellness resources ("wellness tools") and
then helps them develop an individualized plan to use these resources on a daily basis
to manage their mental illness.
Dialectical behavior therapy (DBT) is a modified type of cognitive behavioral therapy
(CBT). Its main goals are to teach people how to live in the moment, develop healthy
ways to cope with stress, regulate their emotions, and improve their relationships with
others
Eye Movement Desensitization and Reprocessing (EMDR) therapy is a form of
psychotherapy that uses eye movements or other forms of bilateral stimulation to help
persons process and release traumatic memories.
Trauma Informed therapy addresses the symptoms and behaviors resulting from trauma
and empowers persons with long-term healing and resilience.
Harm reduction is an approach to treating substance-use problems that respect
person's goals and choices and uses practical strategies to reduce harm.
D. Measurable Outcome Objectives: Identify a minimum of three (3) measurable
outcome objectives that demonstrate progress toward stated purposes and/or goals of
the program. Please also provide a statement reflecting the progress made toward
achieving the county's objectives from the previous SFY 2022-24 application cycle.
1. 50% of all conservatees will be in the least restrictive environment in licensed
specialized supplemental board and care home levels with intensive treatment services.
2. 90% of conservatees will have monthly psychiatric appointments for progress and
response to medication.
3. 75% of conservatees will maintain medication participation and adherance for six
consecutive weeks.
4. 90% of local conservatees in a Specialized Supplemental Board and Care Home
settings will receive in-person treatment services at least once a week.
5.
Progress Statement:
The following outcomes were discussed in the FY 22-23 and FY 23-24 MHBG
Application. Since the submission of the FY 22-23 and 23-24 MHBG, DBH is working
toward specific, measurable, achievable, relevant, and time bound goals that can be
tracked, analyzed and reported which are state above. Below please find the outcomes
and progress made since the last bi-annual submission:
1. Place 60% or at least 300 adults locally at Specialized Supplemental Board and Care
Home facilities, allowing these persons served to remain closer to families and
community that impact recovery success, while they receive services.
Outcome #1: 272 adults were placed locally at Specialized Supplemental Board and
Care Home facilities.
2. Provide high intensity community/telehealth services, while at placement to support
maintenance of placement and management of symptoms in preparation for a lower
level of care.
Outcome #2: Eight staff on the Community Conservatorship Team have the goal of
providing in-person high intensity treatment services to support maintenance of
placement, symptom management, and progress toward no longer being gravely
disabled at minimum 3-4 times per month. Staff consult regularly with treating
psychiatrists and forensic psychologists for Grave Disability determinations.
Additionally, staff monitor conserved persons regularly for Grave Disability. The
Community Conservator Team staff caseload fluctuates and is approximately 25-30
conserved persons at any time and these check ins are administered as often as
possible based on staffing fluctuation and individual increased person's needs.
3. Maintain an information system to track the number of special incidents, that include
crisis for conserved adults served at the specialized supplemental board and care home
program level.
Outcome #3: Of the 272 adults placed at Specialized Supplemental Board and Care
Home facilities, approximately 6% were hospitalized and 1% received inpatient crisis
stabilization services at least once after placement. This is tracked through incident
reports and movement notices.
4. Continue to monitor co-occurring issues of substance use and track through the
diagnosis reports, via Avatar.
Outcome #4: An estimated 80% of all adults placed at Specialized Supplemental Board
and Care Home facilities show a co-occurring disorder of substance use.
E. Cultural Competency: Describe how the program provides culturally appropriate and
responsive services in the county. Identify advances made to promote and sustain a
culturally competent system.
DBH works to support cultural traditions and social practices for each person served
and acknowledges the impact that this may have on each person's ability to socially
regulate and express themselves with their mental health. Each person's served
treatment is guided by the culture the person identifies with. Staff research, consult and
collaborate with various partners, including cultural brokers, to support this value and as
a resource in the recovery process. DBH clinicians embrace the idea that culture and
mind are inseparable and are trained to provide psychosocial assessments from a
developmental, social and cognitive perspective that include cultural differences that
may go beyond traditional theoretical approaches.
Specialized Supplemental Board and Care Home program staff recognize and accept
persons' served cultural and ethnic differences. Staff encourage observations of
culturally appropriate holidays, events, and traditions, in accordance with the cultural
identity, history or preferences of persons served. This may include, but not be limited
to, offering activities, foods, and decorations appropriate to the person served.
Contracted Specialized Supplemental Board and Care Home facilities ensure all
persons served have equal access to quality care by adopting the Federal Office of
Minority Health Culturally and Linguistically Appropriate Services (CLAS) national
standards.
DBH has convened a Diversity, Equity and Inclusion (DEI) Committee which meets
monthly. Participation from community-based substance use and mental health
providers is essential to the efforts of this committee. The focus of the DEIC is to reduce
or eliminate disparities by improving access to culturally and linguistically sensitive
behavioral health services. DBH makes annual trainings available to providers to build
upon their culturally responsive skills.
F. Target Population / Service Areas: Specify the target population(s), any sub-
population, and/or service areas the county's MHBG-funded program serves. Federal
statutes require that the target population include adults and older adults with a Serious
Mental Illness (SMI) and/or children with a Serious Emotional Disturbance (SED).
The Center for Mental Health Services Definitions of adults with a SMI and children with
a SED (Enclosure 2), as published in the Federal Register in 1992, is enclosed. In
addition, there may be discrete programs serving specific sub-populations such as
dually diagnosed, those that have experienced first episode psychosis (FEP), homeless,
forensic, minorities, consumer operated, and transitional age youth. The Dual Diagnosis
(DDX) set-aside must continue to be used for individuals with a dual diagnosis and must
be addressed in the description. The FEP set-aside must be used for individuals who
have early serious mental illness (ESMI), including a FEP, regardless of the individual's
age at onset, and must also be addressed in the description. Counties cannot use
MHBG funds for prodromal symptoms (specific group of symptoms that may precede
the onset and diagnosis of a mental illness) and/or those who are not diagnosed with an
SMI. Screening and assessment of SMI/SED/FEP is allowable, but a prodromal
diagnosis does not constitute ESMI or FEP, and MHBG funds cannot support
prevention, early intervention, or treatment of prodromal clients.)
❑x Adults and Older Adults With SMI ❑ Children With SED
❑ Other
Description:
Describe how this program is targeting individuals in marginalized communities.
The target population are adults and older adults diagnosed with SMI, who are
stepping down from out of county locked 24-hour supervised IMD/MHRC facilities or
stepped down from inpatient facilities to a less restricted and supervised environment,
LPS conserved adults and older adults, or adults and older adults recently released but
identified as high-risk for receding to LPS Conservatorship. A LPS conserved adult is
identified as unable to provide a plan for self-care including meals, clothing, and shelter
due to their behavioral health symptoms. The population includes person served with a
dual diagnosis. This funding is not used for inpatient facilities.
G. Staffing: Detailed information regarding subcontractor staffing is not required. However,
detailed information regarding county program staff funded by MHGB is required.
Is this program fully subcontracted with no support from county-funded positions?
❑x Yes ❑ No — if this box is checked, fill out the table below.
County program staff positions funded by MHBG must be listed in the table below. First,
identify the county staff position title. Second, list the grant-specific duties this position
will perform. Third, identify the percentage of Full-Time Employment (FTE) which will be
funded by MHBG funds (in decimals, and no greater than 1.0). Finally, list the number of
positions associated with this position title, grant-specific duty summary, and FTE. This
information must match the Detailed Budget document, including FTE.
Restrictions on salaries are as follows: The county agrees that no part of any federal
funds provided under this Contract shall be used by the county or its subcontractors to
pay the salary and wages of an individual at a rate in excess of Level II of the Executive
Schedule, as found online at: https://grants.nih.gov/grants/policy/salcap summary.htm
FTE Number
Position Title Grant-Specific Duties Summary (No greater of
than 1.0) Positions
Example: Example: Example: Example:
Nurse Practitioner Outreach, Service Coordination, 0.75 5
Peer Support, etc.
N/A N/A N/A N/A
Please provide any additional information regarding county staffing below:
County staff are not funded with MHBG.
H. Implementation Plan: Specify the approximate implementation dates for each phase
of the program or state that the "program is fully implemented."
The program is fully implemented. Specialized Supplemental Board and Care Home
services have been provided by contracted facilities since 2008. Current Fresno County
Agreement No. 22-230 was executed effective July 1, 2022 as a master agreement.
Throughout the contract term additional contractors have been and continually are
added as determined appropriate to provide this level of care. The current list of
contractors include:
AK's Home of Blessing and Joy, Inc.
AK's Home of Care, LLC
Anjaleoni Enterprise dba Leonie House
ASC Treatment Group dba Anne Sippi Clinic (Bakersfield and Los Angeles)
Benevolent Residential Care Service dba Dailey's Haven
BK House of Grace, LLC
Bonavente Home for the Elderly I I
The Chimes Home
Garden Manor, Inc.
Goldridge Home, LLC
Donald Haskins dba Haskins Residential Care
Jan-Roy Place of Fresno (2 locations)
Marian Homes, Inc. (2 locations)
Mark A Gisler dba Ruby's Valley Care Home
Modesto Residential Living Center
Providian Residential Care Services, Inc. dba Fillmore Christian Gardens
Royal Board and Care for the Elderly
Sierra Meadows Senior Care, Inc. dba River Bluffs Memory Care
Sunshine Board and Care II
Valley Comfort Home, Inc.
Contractors may modify their daily service rate annually with approval of the DBH
Director, as long as the modification does not result in changes to the contract
maximum compensation. Additionally, contractors may add new services to serve
higher need populations which will be monitored annually.
I. Program Evaluation Plan: Describe how the county monitors progress toward meeting
the program's objectives.
Frequency and type of internal review:
Annually DBH will complete a site review of all facilities to ensure that identified services
from the list above in the Program Description per facility are occuring. The environment
and ambience of each home will be conducive to a safe, comfortable and healing place
for community integration, per the integration mandate. Any needed documentation to
illustrate complaince will be collected, such as meal menus, medication logs,
appropriate thermostat settings, comfortable seating in the milieu, a designated eating
area, access to personal property and a place for physical activitiy indoors or
outdoors.etc.
All incidents compromising the health and safety of persons served that occur in the
facility will be reported to the appropriate reporting agency including DBH, CCL, APS,
California State Board of Pharmacy, the Medical Board of California or other reporting
agencies within 24 hours of the occurence. Additionally any issues that arise that are
brought to the Community or the RISE Conservatorship Team will be communicated to
CCL for review or investigation.
Frequency of data collection and analysis:
Annually
Type of data collection and analysis:
Mental health service review, review of incidents, reporting to CCL, review of frequency
of intensive community based services.
Identification of problems or barriers encountered for ongoing programs:
Problems or barriers are identified by the Community and RISE Team Case Managers
and Deputy Conservators are brought to the attention of the Medical Director, Supervising
Clinical Supervisor, County Counsel or the Contracts Analyst.
Identify the county's corrective action process (i.e., how the county corrects and
resolves identified problems):
The corrective action process includes each home required to cooperate and respond to
the open investigation of the identified agency. A written plan to correct, the execution
and/or plan to do so and by what date.
Identify the county's corrective action process timeline (i.e., what is the county's
established length of time for the correction and resolution of identified problems).
DBH does not have an established corrective action process timeline as these facilities
do not provide Specialty Mental Health Services. Any issue discovered is handled immediately
as issues are affecting conserved persons. Any issues identified, DBH will notify the licensing
entity to report. CCL has their own timelines they follow for investigations.
Does the corrective action plan timeline meet timely access standards?
This is not for Speciality Mental Health Services. Corrective Action is required
immediately for facilities providing services to LPS conserved adults.
J. Olmstead Mandate and the MHBG:
In 1999 The Supreme Court issued its decision in Olmstead vs L.C. promulgating the
enforcement of states to provide services in the most integrated setting appropriate to
individuals and prohibit needless institutionalization and segregation in work, living and
other settings. Describe the county's efforts on how the MHBG addresses the
Americans with Disabilities Act (ADA) community integration mandate required by the
Olmstead decision of 1999 in the following areas:
Housing services:
LPS conservatees that are appropriate for an unlocked setting with a high structure are
provided a place to live and receive mental health care, with consistent and
collaborative care between Specialized Supplemental Board and Care Home
owners/staff, the treating practitioner, the deputy conservator and a psychiatrist.
Home and community-based services and peer support services:
The wellness of each person is supported with intensive community-based treatment
services that are aprpropriate to the needs of the person served and in a setting that
benfits the person with consideration to cultural preferences and supports. The milieu is
integrated with all residents and a sense of community is encouraged and supported
through group activities. A collaborative and strength-based approach to support
increasing independence, stability and management of symptoms, and to make use of
food, clothing and shelter with wellness is maintained with the Community
Conservatorship treatment team. Services may include, but are not limited to:
• Rehabilitation services that include psychoeducation, skills building, symptom
management, arts, talk circles and community updates
• Psychotherapy services
• Case management for linkage to services, resources, and benefits
• Medication management and services with psychiatrist
• Psychiatric evaluations to determine ongoing need for LPS status
• Community based intensive services
• Fiduciary services to manage finances, income, and benefits
• Personal property management
• Support to engage, receive, or practice in cultural traditions or faith-based activities
• Peer facilitated storytelling
• Peer facilitated chair and walking exercise activity
Employment services:
DBH is contracted with Dream Catchers program. This program provides persons
served with the opportunity to be employed with accommodations for mental and
physical capacity, in addition to mental health needs.
Transition from hospitals to community settings:
Adult persons served with SMI are transitioned from locked and/or higher-level of care
institutions to less restrictive facilities as determined by Fresno County clinical staff.
Once hospital staff deem the person "medically" or "psychiatrically cleared," the Deputy
Conservator approves of the placement upon confirmation of person's readiness for
placement in the community by consulting with mental health/medical treating team at
the hospital and the assigned treating community provider. Planning and coordination of
the transition is completed prior to a move date. Conservatees may arrive with at least
two weeks of medication with a scheduled appointment to meet with their assigned
psychiatrist within ten days. The assigned clinical treating provider meets with the
conservatee in their new home environment to discuss plans, goals and adjustments to
the new living conditions. Weekly in-person contacts are made by clinical treating
provider to support the maintenance and stability of placement in the least restrictive
environment.
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CONTRACTORS/FACILITIES Daily Rate 2 $ o _ - E _ _ - o _
AK's Home of Blessing and Joy,Inc. $98.96 Y Y Y Y y Y - - - - Y y - n Y Y Y - - - Y Y - Y Y - Y Y Y Y - Y Y - Y Y Y - Y Y Y Y - Y - - - -
AK's Home of Care,LLC $70.69 Y Y Y Y Y Y - - - - Y Y - Y Y Y - - - Y Y - Y Y - Y Y Y y - Y y - Y Y y - Y Y Y Y - y - - - -
Anlaleom Enterprises,Inc.-dba Leome House $128.52 Y Y Y Y Y Y Y I Y I Y - Y V Y Y - - - - - - Y - - - - Y Y Y Y - - y - - Y Y - Y y - Y Y - - - - Y
ASC Treatment Group-dba Anne Sippi Clmm(Bakersfield) $187.43 Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y - Y - Y - - Y Y Y Y Y Y Y Y Y Y - - Y Y - - Y
ASC Treatment(Los
An gelesla ippi Clinic $18743 Y y y y y Y Y Y y y y V Y Y Y Y y y Y Y Y Y Y y - Y - Y - - Y Y Y Y Y Y Y Y Y Y - - Y y - - Y
enevoent a enba a vmes $13388 Y Y Y y Y Y - - Y Y y Y Y Y Y Y - - Y y Y - Y - - - y Y - - Y y - - Y Y Y Y Y - - - Y - - - Y
BK House of Grace,LLC $97.57 Y Y v y y - Y - Y v y Y Y Y Y - - - - - - - - - - - - Y Y - y y - y Y y - - Y Y - - Y - - - -
Bonavente Home for the Elderly 11 $10190 Y Y Y y y y Y y Y Y y y y Y y - - - Y - Y - Y - - - - Y - - y y - Y Y y - y y y Y - Y - - - y
The Chimes Home $119.95 Y V V Y Y - Y - V y - Y Y Y Y - - - - - - - - - - - - Y Y - Y Y - Y Y Y - - Y V - - - - - - -
Garden Manor $126.21 Y V y y y Y Y Y V y y Y V Y Y V - - y Y Y Y Y y y V - Y - - y y y Y Y V y y y y Y - V - - - Y
Goldridge Home,LLC $143.82 Y y y Y Y Y Y Y Y Y Y Y Y Y Y Y - - Y Y Y - Y Y y Y Y Y - - y Y - Y Y y - Y Y - - - y y - - Y
Donald Haskms $194.04 Y V y y Y Y Y Y y y y Y Y Y Y y - - Y Y Y - y y y - Y - - - y Y Y Y Y V y y Y - - - Y - - - Y
Jan-Roy Place of Fresno,Inc. $128.52 Y Y y y Y - Y - Y y y Y Y Y Y - - - - - - - - - - - - Y Y - y y - Y Y Y y - Y - - - - - - - Y
Jan Roy Place of Fresno 2 $128.52 Y y y Y Y - Y - y y Y Y Y Y Y - - - - - - - - - - - - Y Y - Y Y - Y Y y y - Y - - - - - - - Y
Marian Homes,Inc.-dba Sierra Villa Rest Home $128.52 Y Y y y y Y Y Y Y y y V Y Y Y Y - - - Y Y - Y y Y - Y Y Y - - - - - Y Y - y y Y Y - - - - - Y
Marian Homes,Inc.-dba Marian Homes 3 $128.52 Y y Y y Y Y Y Y y Y - Y Y Y - - - - - - Y - - - Y - Y Y - - - y - - - - - y Y - - - - - - - Y
Modesto Residential Living Center,Inc. $86.70 Y y y y Y Y Y Y y y y Y Y Y Y Y - - - - - - Y - y - Y Y Y - y y - Y Y Y - - V Y - - y y - - -
r enna aInc. $133.88 Y y Y Y Y Y Y - Y - - y Y Y Y - - - - - Y - Y - - Y - - - - Y Y - Y Y y - Y Y Y - - Y - - - -
$25067 Y y y y y Y Y Y - y y y Y Y Y Y - - Y Y Y - Y y y y Y Y Y Y y y - Y Y Y Y y - Y Y Y Y y - - Y
Royal Board and Care Homeforthe Elderly $94.10 Y Y Y y Y - y - - Y y Y y Y - - - - - - Y - - - - - - - - - - y - - Y Y - - y Y - - Y - - - -
MarkAGisler-dba Ruby's Valley Care Home $16503 Y Y Y Y Y V Y Y Y Y Y Y Y Y Y Y - - y Y Y Y y Y y y Y - - y Y y y Y Y y y y Y y - - y Y y y Y
Sunshine Board and Care 11 $94.86 Y Y Y Y Y - Y - - - Y Y Y Y - - - - - - Y - - - - - - - - - - y - - Y y - - y y - - Y - - - -
Valley Comfort Home,Inc. $118.59 Y Y Y Y Y - - - V Y Y Y Y Y Y V - - - Y Y - Y Y - Y Y Y - - y Y - Y Y Y - Y Y Y - - V
Biennial 2024-26 MHBG County Application Enclosure 2
Page 1 of 9
CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES
Community Mental Health Services Block Grant (MHBG)
Biennial Application Instructions
State Fiscal Years (SFY) 2024-25 and 2025-26
Application Deadline: Applications must be received electronically by the California
Department of Health Care Services, Federal Grants Branch, at MHBG@dhcs.ca.gov,
no later than 5:00 pm on Friday, June 28, 2024.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 2 of 9
Table of Contents
INTRODUCTION..................................................................................................................................... 3
History & Background .......................................................................................................................... 3
PROGRAM INFORMATION.................................................................................................................... 3
TargetPopulation................................................................................................................................. 3
Definitions............................................................................................................................................4
MarijuanaRestriction ........................................................................................................................... 6
APPLICATION REQUIREMENTS........................................................................................................... 7
GeneralGuidelines.............................................................................................................................. 7
SubmissionInstructions....................................................................................................................... 7
COUNTY APPLICATION CONTENT...................................................................................................... 8
CountyInformation............................................................................................................................... 8
UniqueEntity Data Detail..................................................................................................................... 8
Biennial 2024-26 MHBG County Application Enclosure 2
Page 3of9
MHBG INSTRUCTIONS
INTRODUCTION
History & Background
The MHBG was established in 1981 and administered by The Substance Abuse and Mental
Health Services Administration (SAMHSA) under the funding of the Center for Mental Health
Services (CMHS) as one of the largest, federally noncompetitive formula grants dedicated to
mental health services. Under President Reagan's Administration, as part of the "New
Federalism" initiative, states and territories were encouraged to establish or expand innovative
community-based programs and services of care for providing Title XIX mental health services
to children with Serious Emotional Disturbances (SED) and adults with Serious Mental Illness
(SMI). Authorized by Part B, Subparts I and III of Title XIX of the Public Health Service (PHS)
Act, the California State Department of Health Care Services (DHCS) serves as the liaison in
the allocation of funds. At the same time, Mental Health Partners and their contracted
providers deliver a broad array of treatment and support services supported by the block grant
that must comply with implementation regulations.
PROGRAM INFORMATION
Target Population
The MHBG program targets the following populations and service areas:
Adults with a Serious Mental Illness (SMI):
o Pursuant to Section 1912(c) of the Public Health Service Act, as amended by Public
Law 102-321, "adults with a serious mental illness" are persons: (1) age 18 and over
and (2) who currently meet or at any time during the past year has met criteria for a
mental disorder— including within developmental and cultural contexts — as specified
within a recognized diagnostic classification system (e.g., most recent editions of
Diagnostic and Statistical Manual (DSM), International Classification of Diseases (ICD),
etc.), and (3) who displays functional impairment, as determined by a standardized
measure, which impedes progress towards recovery and substantially interferes with or
limits the person's role or functioning in family, school, employment, relationships, or
community activities.
Children & Adolescents with Serious Emotional Disturbances (SED):
o Pursuant to Section 1911(c) of the Public Health Service Act, "children with a serious
emotional disturbance" are (1) from birth up to age 18 and (2) who meet or at any time
during the past year have met criteria for a mental disorder— including within
developmental and cultural contexts — as specified within a recognized diagnostic
classification system (e.g., most recent editions of DSM, ICD, etc.), and (3) who
displays functional impairment, as determined by a standardized measure, which
impedes progress towards recovery and substantially interferes with or limits the
person's role or functioning in family, school, employment, relationships, or community
activities.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 4 of 9
Early Serious Mental Illness (ESMI):
o An early serious mental illness or ESMI is a condition that affects an individual
regardless of their age and that is a diagnosable mental, behavioral, or emotional
disorder of sufficient duration to meet diagnostic criteria specified within DSM-5 (APA,
2013). For a significant portion of the time since the onset of the disturbance, the
individual has not achieved or is at risk of not achieving the expected level of
interpersonal, academic, or occupational functioning. This definition is not intended to
include conditions that are attributable to the physiologic effects of a substance use
disorder, are attributable to an intellectual/developmental disorder, or are attributable to
another medical condition. The term ESMI is intended for the initial period of onset.
Definitions
The following are California's definitions as they pertain to the MHBG and data collection.
Uniformity of definitions by all MHBG programs is essential in developing and reporting
consistent information on services and programs. The MHBG program is subject to U.S.
Department of Health and Human Services (HHS) Uniform Administrative Requirements, Cost
Principles, and Audit Requirements found in 45 CFR Part 75.
MHBG funds are allocated to counties to provide program funding for specific areas of need
under five categories called "Set-Asides." These set-asides include allowable and
recommended funding activities, as outlined below:
o Base Allocation
o Dual Diagnosis Set-Aside
o First Episode Psychosis Set-Aside
o Children's System of Care Set-Aside
o Integrated Services Agency Set-Aside
Set-Aside
Set-aside specifically refers to the practice of reserving a certain portion of funds for a
particular purpose or program. Set-Asides ensure that a portion of funds are earmarked for
specific programs/projects and must fall within the specified set-aside requirement. Set-aside
can also be portions of base allocation funds that are set-aside to fulfill a specific funding
requirement.
Base Allocation
A portion of the overall allocation that is set aside for a specific purpose or expense that is
allowable, necessary, and reasonable for the performance of the program. Base allocation
funds can be used as other set-aside funds, but additional set-aside funds cannot be used as
base allocation funds.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 5 of 9
Dual Diagnosis Set-Aside
States may use MHBG funds available for treatment under Public Law 102-321 (42 U.S.C.,
Sections 300x through 300x-13) to treat persons and provide screening and diagnosis for
children, transitional age youth, and adults meeting the Federal definition of SMI or SED and
who also have a diagnosis of:
o Substance abuse problem
o Treatment planning
o Assertive case management
o Individual or group psychotherapy
o Supported employment and education services
o Family education and support
o Antipsychotic agents and medication management
o Primary care coordination
o Peer support
o Outreach with co-occurring substance abuse and mental disorders
Counties are encouraged to provide services or work toward providing services as long as
funds available under such sections are used for the purposes they were authorized by law
and can be tracked for accounting purposes.
First Episode Psychosis (FEP) Set-Aside
SAMHSA is directed by Congress through its FY 2016 Omnibus bill, Public Law 114-113, to
require that states set aside 10 percent of their MHBG allocation to support evidence-based
programs (EBP) that provide treatment for those with SMI and FEP. The law specifically
requires the 10% set-aside to fund only those EBPs that target FEP. FEP refers to a condition
that makes it difficult for an individual to differentiate between what is real and what is not.
When people experience psychosis, their thoughts and perceptions are disrupted. They may
perceive things that others do not or hold strong beliefs about things that are not true.
Although psychosis can be experienced at any age, symptoms most commonly begin between
the ages of 16 and 30. FEP is generally regarded as the early period (up to five years) after
the onset of psychotic symptoms. In many cases, first episode psychosis impacts young
people just at the time when they are preparing for and establishing autonomy as adults.
Psychosis is a condition that disrupts a person's thoughts and perceptions and makes it
difficult for an individual to differentiate between what is real and what is not.
Symptoms of psychosis may include:
o Delusions (false beliefs);
o Hallucinations (seeing or hearing things that others do not see or hear);
o Incoherent speech;
o Memory problems;
o Trouble thinking clearly or concentrating;
o Disturbed thoughts or perceptions;
o Difficulty understanding what is real;
o Poor executive functioning (the ability to use information to make decisions);
o Behavior that is inappropriate for the situation
Counties are encouraged to provide services or work toward providing services, consistent
with the Coordinated Specialty Care (CSC) model, a team-based program providing an array
of evidence-based interventions for recent onset/first episode psychosis.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 6 of 9
DHCS requires counties to report, within the FEP Budget Narrative and Enclosure 8, the total
number of individual FEP programs (by site location) within the county regardless of funding
source, as well as the number of individual FEP programs (by site location) funded by the SFY
2024-25 and 2025-26 MHBG Award.
Integrated Services Agency Set-Aside
The integrated services agency (ISA) provides an adult with SMI or a co-occurring disorder
access to a full range of services provided by multiple agencies, programs, and funding
sources in a comprehensive and coordinated manner. These services can include
psychosocial, rehabilitation, and recovery-oriented services. ISA ultimately strives to provide
mental health services to enhance the quality of life by empowering individuals to take charge
of their own lives by promoting self-care and independence.
Children's System of Care Set-Aside
The United States Code, Section 300x-2, requires states to spend at least the amount it spent
in 1994 on systems of integrated services to promote the coordination of the often-fragmented
systems that serve children and youth diagnosed with a serious emotional disturbance and
their families.
The system of care approach offers a pathway to better outcomes for children who have
serious mental health conditions, including improved functioning at home, at school, and in the
community. These improvements are based on the philosophy that services should be:
o Family-driven;
o Based on service plans that are individualized, strengths-based, and evidence-
informed;
o Youth guided; culturally and linguistically competent;
o Provided in the least restrictive environment possible;
o Community-based;
o Accessible; and
o Collaborative and coordinated through an interagency network.
Marijuana Restriction
Grant funds may not be used, directly or indirectly, to purchase, prescribe, or provide
marijuana or treatment using marijuana. Treatment in this context includes the treatment of
opioid use disorder. Grant funds also cannot be provided to any individual or organization that
provides or permits marijuana use for the purposes of treating substance use or mental
disorders. See, e.g., 45 C.F.R. § 75.300(a) (requiring HHS to "ensure that Federal funding is
expended . . . in full accordance with U.S. statutory . . . requirements."); 21 U.S.C. §§ 812(c)
(10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of
marijuana). This prohibition does not apply to those providing such treatment in the context of
clinical research permitted by the Drug Enforcement Administration (DEA) and under a Food
and Drug Administration-approved investigational new drug application where the article
being.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 7of9
APPLICATION REQUIREMENTS
General Guidelines
Prior to the implementation and delivery of services, an application package is required to be
submitted and approved by DHCS. To enable DHCS to comply with Federal requirements, it is
imperative that information submitted from counties be submitted in accordance with the
specified guidelines.
Incomplete applications or those that are resubmissions of applications from prior years will be
returned to the county for revision and resubmission. This could delay funding. You may use
the information contained in your last application when appropriate, but the new application
must conform to the instructions below and contain current information and data.
Applications will be approved when all items in the application have been received and
determined to meet the requirements. Should either budget introduce additional constraints
upon the MHBG program, it may be necessary to require program changes, budget changes,
or both.
Submission Instructions
The MHBG County Application packages must be submitted electronically. Please submit
program budgets in Excel format and the corresponding narrative(s) in Word, utilizing the
provided template, to MHBG(a)dhcs.ca.gov no later than the close of business on June 28,
2024.
All documents requiring signatures, including the Funding Allocation, Funding Agreements,
and Certifications, must be electronically signed and submitted no later than June 28, 2024, to
MHBGC@dhcs.ca.gov.
Note: All documents must remain in their original format and should NOT be combined
into one file. Late submissions may delay funding.
The MHBG Application must address all programs funded by the MHBG. The MHBG County
Application package (Enclosures and Forms) will be sent by email in a zip file.
Upon submittal, the electronic MHBG County Application must include the following:
o Enclosure 1 — MHBG Funding Allocation worksheet
o Enclosure 4 — Federal Assurances- Non-Construction
o Enclosure 5 — Signed Certification
o Enclosure 6, 7, 8 — MHBG Program Data Sheet
o MHBG Federal Grant Detailed Program Budget
o MHBG First Episode Psychosis (FEP) Program Data Sheet
o Program Narrative — Complete one for each proposed program
Biennial 2024-26 MHBG County Application Enclosure 2
Page 8of9
COUNTY APPLICATION CONTENT
County Information
1) Enclosure 1: Signed Funding Allocation — To be signed by the Behavioral Health
Director or Authorized Signer. This document must be scanned and submitted
electronically.
2) Enclosure 2: Application Instructions — Provides comprehensive information regarding
application submission instructions, key definitions, and deadlines.
3) Enclosure 3: Accounting and Special Program Guidelines — Details the submission of a
quarterly and year-end cost report that will be completed, and records maintained in a
manner consistent with the associated regulations, laws, guidelines, and policies.
4) Enclosure 4: Funding Agreements — To be signed by the Behavioral Health Director or
Authorized Signer. This document must be scanned and submitted electronically.
5) Enclosure 5: Signed Certifications — To be signed by the Behavioral Health Director or
Authorized Signer. This document must be scanned and submitted electronically.
6) Enclosure 6: MHBG Program Data Sheet— Please complete one per program, and it
must indicate any transformational services provided.
7) Enclosure 7: MHBG Federal Grant Detailed Program Budget — Please complete one per
program. If your county has more than one MHBG-funded program, submit the budgets
in one Excel workbook.
8) Enclosure 8: MHBG First Episode Psychosis (FEP) Program Data Sheet — Report the
actual numbers served and the description of the evidence-based practice(s)
implemented in the program.
9) Program Narrative Template — Complete one Program Narrative for each proposed
program. Each Program Narrative must have a corresponding Detailed Budget. Each
Program Narrative must be completed on this template and the template may not be
altered.
10)Program Narrative Example — Serves as a reference on how to complete the Program
Narrative Template.
Unique Entity Data Detail
On April 4, 2022, the unique entity identifier used across the federal government changed from
the DUNS Number to the Unique Entity ID (UEI). The UEI is a 12-character alphanumeric ID
assigned to an entity that is registered and active by the System for Award Management
(SAM.gov). Please note that counties applying for MHBG funding are required to provide their
SAM UEI created on SAM.gov to DHCS.
The County must ensure the downloadable "Entity Data Detail.pdf" form obtained from the
SAM.gov website is included with all other required application documents.
Biennial 2024-26 MHBG County Application Enclosure 2
Page 9 of 9
Applications will not be reviewed until a valid and current "Entity Data Detail.pdf' has been
received from the County. Counties may complete the entity validation process on the
SAM.gov website to renew or update entity information.
Please email MHBG(o)dhcs.ca.gov if your county requires additional assistance in
downloading the "Entity Data Detail.pdf."
Last updated by Sean Patterson on Mar 01,2024 at 02.-39 PM COUNTY OF FRESNO
III
,
COUNTY OF FRESNO
Unique Entity ID CAGE/NCAGE Purpose of Registration
RUJLP1K3WWK9 7JJ15 All Awards
Registration Status Expiration Date
Active Registration Mar 1,2025
Physical Address Mailing Address
4417 E Inyo ST 1925 E Dakota AVE
Bldg 333 Fresno,California 93726-4821
Fresno,California 93702-2977 United States
United States
Doing Business as Division Name Division Number
DEPARTMENT OF BEHAVIORAL HEALTH Behavioral Health (blank)
Congressional District State/Country of Incorporation URL
California 21 (blank)/(blank) https://www.co.fresno.ca.us/departments/behavior
al-health
Registration Dates
Activation Date Submission Date Initial Registration Date
Mar 5,2024 Mar 1,2024 Jan 13,2016
Entity Dates
Entity Start Date Fiscal Year End Close Date
Apr 19,1856 Jun 30
Immediate Owner
CAGE Legal Business Name
(blank) (blank)
Highest Level Owner
CAGE Legal Business Name
(blank) (blank)
Executive Compensation
In your business or organization's preceding completed fiscal year,did your business or organization(the legal entity to which this specific SAM record,
represented by a Unique Entity ID,belongs)receive both of the following: 1.80 percent or more of your annual gross revenues in U.S.federal contracts,
subcontracts,loans,grants,subgrants,and/or cooperative agreements and 2.$25,000,000 or more in annual gross revenues from U.S.federal contracts,
subcontracts,loans,grants,subgrants,and/or cooperative agreements?
No
Does the public have access to information about the compensation of the senior executives in your business or organization(the legal entity to which this
specific SAM record,represented by a Unique Entity ID,belongs)through periodic reports filed under section 13(a)or 15(d)of the Securities Exchange Act
of 1934(15 U.S.C.78m(a),78o(d))or section 6104 of the Internal Revenue Code of 1986?
Not Selected
Proceedings Questions
Is your business or organization,as represented by the Unique Entity ID on this entity registration,responding to a Federal procurement opportunity that
contains the provision at FAR 52.209-7,subject to the clause in FAR 52.209-9 in a current Federal contract,or applying for a Federal grant opportunity
which contains the award term and condition described in 2 C.F.R.200 Appendix XII?
No
Does your business or organization,as represented by the Unique Entity ID on this specific SAM record, have current active Federal contracts and/or
grants with total value(including any exercised/unexercised options)greater than$10,000,000?
Not Selected
Within the last five years,had the business or organization(represented by the Unique Entity ID on this specific SAM record)and/or any of its principals, in
connection with the award to or performance by the business or organization of a Federal contract or grant,been the subject of a Federal or State(1)
criminal proceeding resulting in a conviction or other acknowledgment of fault;(2)civil proceeding resulting in a finding of fault with a monetary fine,penalty,
reimbursement,restitution,and/or damages greater than$5,000,or other acknowledgment of fault;and/or(3)administrative proceeding resulting in a
finding of fault with either a monetary fine or penalty greater than$5,000 or reimbursement,restitution,or damages greater than$100,000,or other
acknowledgment of fault?
May 24,2024 06:44:03 PM GMT
https:ll,sam.govlentitylRUJLPIK3WWK91coreData?status=null Pagel of3
Last updated by Sean Patterson on Mar 01,2024 at 02.-39 PM COUNTY OF FRESNO
Not Selected
Active Exclusions Records?
No
I authorize my entity's non-sensitive information to be displayed in SAM public search results:
Yes
Entity Types
Business Types
Entity Structure Entity Type Organization Factors
U.S.Government Entity US Local Government (blank)
Profit Structure
(blank)
Socio-Economic Types
Check the registrant's Reps&Certs, if present,under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small
business concern.Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the
SBA supplemental pages during registration.
Government Types
U.S.Local Government
County
1W
Accepts Credit Card Payments Debt Subject To Offset
Yes No
EFT Indicator CAGE Code
0000 7JJ15
Electronic Funds Transfer
Account Type Routing Number Lock Box Number
Checking *******82 (blank)
Financial Institution Account Number
BMO BANK NA *******70
Automated Clearing House
Phone(U.S.) Email Phone(non-U.S.)
5596003487 (blank) (blank)
Fax
(blank)
Remittance Address
Fresno County Behavioral Health
1925 E Dakota AVE
Fresno,California 93726
United States
Taxpayer Info rn tion
EIN Type of Tax Taxpayer Name
*****0512 Applicable Federal Tax COUNTY OF FRESNO
Tax Year(Most Recent Tax Year) Name/Title of Individual Executing Consent TIN Consent Date
2020 Behavioral Health Business Manager Mar 1,2024
Address Signature
P.O.Box 1247 SEAN PATTERSON
Fresno,California 93715
Points of Contact
May 24,2024 06:44:03 PM GMT
https://sam.govlentitylRUJLPIK3WWK91coreData?status=null Page 2 of 3
Last updated by Sean Patterson on Mar 01,2024 at 02.-39 PM COUNTY OF FRESNO
Accounts Receivable POC
0
Sean Patterson,Behavioral Health Division
Manager
spatterson@fresnocountyca.gov
5596004601
Electronic Business
1925 E Dakota AVE
Sean Patterson Fresno,California 93726
spatterson@fresnocountyca.gov United States
5596004601
Government Business
1925 E Dakota AVE
Sean Patterson,Behavioral Health Division Fresno,California 93726
Manager United States
spatterson@fresnocountyca.gov
5596004601
NAICS Codes
Primary NAICS Codes NAICS Title
Yes 621420 Outpatient Mental Health And Substance Abuse Centers
621330 Offices Of Mental Health Practitioners(Except Physicians)
623220 Residential Mental Health And Substance Abuse Facilities
624190 Other Individual And Family Services
921190 Other General Government Support.
IGT Size Metrics
Annual Revenue(from all IGTs)
(blank)
Worldwide
Annual Receipts(in accordance with 13 CFR Number of Employees(in accordance with 13 CFR
121) 121)
$335,295,532.00 756
Location
Annual Receipts(in accordance with 13 CFR Number of Employees(in accordance with 13 CFR
121) 121)
(blank) (blank)
Industry-Specific
Barrels Capacity Megawatt Hours Total Assets
(blank) (blank) (blank)
This entity did not enter the EDI information
This entity does not appear in the disaster response registry.
May 24,2024 06:44:03 PM GMT
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X!l SAM.GOV'
Entity Workspace Results 1 Total Results
COUNTY OF FRESNO
Unique Entity ID: RUJLPIK3WWK9 Doing Business As: DEPARTMENT OF Expiration Date:
CAGE/NCAGE:7JJ15 BEHAVIORAL HEALTH Mar 01,2025
Entity Status:Active Registration Physical Address: Purpose of Registration:
4417 E INYO ST BLDG 333 All Awards
FRESNO,CA
93702-2977 USA
May 24,2024 06:45:10 PM GMT 1
1 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) COUNTY
COMMUNITY MENTAL HEALTH BLOCK GRANT (MHBG) RENEWAL APPLICATION
2 FY 2024-25 and 2025-26
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21 FOR ACCOUNTING USE ONLY:
22 Fund/Subclass: 0001/10000
ORG No.: 5630
23 Account No.: 4380
24
25
26
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1 - COUNTY OF FRESNO
Fresno, CA