HomeMy WebLinkAboutAmendment V to Master STRTP Agt 23-277 24-440 (2).pdf Agreement No. 24-440
1 AMENDMENT NO. 5 TO MASTER SERVICE AGREEMENT
2 This Amendment No. 5 to Master Service Agreement 23-277 ("Amendment No. 5") is
3 dated August 20, 2024 and is between each Contractor ("Contractor(s)") listed in
4 Revised Exhibit A-4, "List of Contractors", and the County of Fresno, a political subdivision of
5 the State of California ("County").
6 Recitals
7 A. On June 20, 2023, the County and the Contractor(s) entered into a Master Short-Term
8 Residential Therapeutic Program (STRTP) Service Agreement, which is County agreement
9 number 23-277 ("Agreement"), for the provision of specialty mental health services to youth and
10 non-minor dependents placed in the care of the Contractor(s).
11 B. On August 22, 2023, the County and the Contractor(s) entered into County Agreement
12 number 23-417 ("Amendment No. 1"), to add Elite Family Systems to the list of Contractors
13 providing specialty mental health services to Fresno County youth in their care.
14 C. On October 24, 2023, the County and the Contractor(s) entered into County Agreement
15 number 23-575 ("Amendment No. 2"), to add Brighter Horizons Group Homes to the list of
16 Contractors providing specialty mental health services to Fresno County youth in their care.
17 D. On April 9, 2024, the County and the Contractor(s) entered into County Agreement
18 number 24-152 ("Amendment No. 3"), to add Z.N.D. Residential, Inc. to the list of Contractors
19 providing specialty mental health services to Fresno County youth in their care.
20 E. One July 9, 2024, the County and the Contractor(s) entered into County Agreement
21 number 24-372 ("Amendment No. 4"), to add Center for Positive Changes, Changing Faces,
22 Inc., Hesed Christian Ministries, Inc., The Virtuous Woman, Inc., For the Future, Inc., Guiding
23 Our Youth, Kern Bridges Youth Homes, Scott's Social Services, and Humanistic Foundation,
24 Incorporated (dba Stockdale Boys Center) Center for Positive Changes to the list of Contractors
25 providing specialty mental health services to Fresno County youth in their care.
26 F. In July 2024, the following agencies were identified as STRTPs that meets the
27 requirements to be added to the list of Contractors providing specialty mental health services to
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1 Fresno County youth in their care: (1) Global Family Care Network, Inc (dba Daughter Project
2 Girls Home); and (2) New Start Youth Facility Inc;
3 G. The County and the Contractor now desire to amend the Agreement to add the above
4 mentioned STRTPs as a Contractor(s) included under this Master STRTP Agreement.
5 The parties therefore agree as follows:
6 1. All references to Revised Exhibit A-3 in the current Agreement shall be deemed
7 references to Revised Exhibit A-4, which is attached and incorporated by reference.
8 2. Exhibit B-23 and Exhibit B-24, all entitled "Scope of Services" shall be added to the
9 Master Agreement and considered included in all references to "Exhibit B-1, et. seq.".
10 3. The parties agree that upon execution of this Amendment No. 5, the Agreement is
11 further revised, updated, and amended to add Contractors: (1) Global Family Care Network, Inc
12 (dba Daughter Project Girls Home); and (2) New Start Youth Facility Inc.
13 4. When the parties have signed this Amendment No. 5, the Agreement, Amendment No.
14 1, Amendment No. 2, Amendment No. 3, Amendment No. 4, and this Amendment No. 5
15 together constitute the Agreement.
16 5. The Contractor represents and warrants to the County that:
17 a. The Contractor is duly authorized and empowered to sign and perform its obligations
18 under this Amendment.
19 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
20 to do so and his or her signature on this Amendment legally binds the Contractor to
21 the terms of this Amendment.
22 6. The parties agree that this Amendment may be executed by electronic signature as
23 provided in this section.
24 a. An "electronic signature" means any symbol or process intended by an individual
25 signing this Amendment to represent their signature, including but not limited to (1) a
26 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
27 electronically scanned and transmitted (for example by PDF document) version of an
28 original handwritten signature.
2
1 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
2 equivalent to a valid original handwritten signature of the person signing this
3 Amendment for all purposes, including but not limited to evidentiary proof in any
4 administrative or judicial proceeding, and (2) has the same force and effect as the
5 valid original handwritten signature of that person.
6 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
7 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
8 2, Title 2.5, beginning with section 1633.1).
9 d. Each party using a digital signature represents that it has undertaken and satisfied
10 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
11 through (5), and agrees that each other party may rely upon that representation.
12 e. This Amendment is not conditioned upon the parties conducting the transactions
13 under it by electronic means and either party may sign this Amendment with an
14 original handwritten signature.
15 7. This Amendment may be signed in counterparts, each of which is an original, and all of
16 which together constitute this Amendment.
17 8. The Agreement as amended by this Amendment No. 5 is ratified and continued. All
18 provisions of the Agreement and not amended by this Amendment No. 5 remain in full force and
19 effect.
20 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No. 5 on the date stated in the introductory
2 clause.
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See Signature Pages Attached County of Fresno
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6 Nathan Magsig, Chairman of the Board of
Supervisors of the County of Fresno
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Attest:
8 Bernice E. Seidel
Clerk of the Board of Supervisors
9 County of Fresno, State of California
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By:
11 Deputy
12 For accounting use only:
13 Org No.:56302232
Account No.:7295
14 Fund No.:0001
Subclass No.:10000
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1 The parties are executing this Amendment No. 5 to the Agreement No. 23-277 on the
2 date stated in the introductory clause.
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4 Global Family Care Network, Inc (dba Daughter Project Girls Home)
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6 Jennifer Jensen, Executive Director
7
8 Q"¢ � qu
JoeII6 Gutierrez, TRTP AdMinistrator
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10 12004 Valpredo Avenue
Bakersfield, CA 93313
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15 For accounting use only:
16 Org No.:56302232
Account No.:7295
17 Fund No.:0001
Subclass No.:10000
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27 Please see additional
28 signature page attached.
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1 The parties are executing this Amendment No. 5 to the Agreement No. 23-277 on the
2 date stated in the introductory clause.
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New Start Youth Facility Inc
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6 �Johnson,
CEO
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8 �-
9 Gin od o, Administrator
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11 2409 Belvedere Ave.
Bakersfield, CA 93304
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13 For accounting use only:
14 Org No.:56302232
Account No.:7295
15 Fund No.:0001
Subclass No.:10000
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Please see additional
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signature page attached.
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Revised Exhibit A-4
List of Contractors
1. PROMESA BEHAVIORAL HEALTH (Exhibit B-1)
7120 N. Marks Avenue, Suite 110
Fresno, CA 93711
Phone#: (559) 439-5437
Contact for Notices: Chief Executive Officer
2. CORE CONDITIONS, INC. (Exhibit B-2)
4460 W. Shaw Ave #595
Fresno, CA 93722
Phone#: (559) 261-5083
Contact for Notices: Executive Director
3. DIN ASSOCIATES RESIDENTIAL CARE (Exhibit B-3)
4460 W. Shaw Ave #595
Fresno, CA 93722
Phone#: (559) 261-5083
Contact for Notices: Executive Director
4. 2ND HOME, INC. (Exhibit B-4)
1797 San Jose Avenue
Clovis, CA 93611
Phone#: (559) 790-2271
Contact for Notices: Director
5. QUALITY GROUP HOMES, INC. (Exhibit B-5)
(dba QUALITY FAMILY SERVICES)
4928 E. Clinton Way, Suite 108
Fresno, CA 93727
Phone#: (559) 252-6844, ext. 222
Contact for Notices: Chief Executive Officer
6. HOPE FOR YOUTH, INC. (Exhibit B-6)
6790 W Browning Ave
Fresno, CA 93723
Phone#: (559) 681-1470
Contact for Notices: Executive Director
7. MICHIGAN HOUSE, INC. (Exhibit B-7)
2014 Tulare St., Suite #414
Fresno, CA 93721
Phone#: (559) 347-7527
Contact for Notices: Mental Health Director
A-1
Revised Exhibit A-4
8. MANUCH INC. (Exhibit B-8)
PO Box 26622
Fresno, CA 93729
Phone#: (559) 347-7627
Contact for Notices: Mental Health Director
9. FRESH START YOUTH CENTER, INC. (Exhibit B-9)
Address Confidential
Phone#:(559) 916-2813
Contact for Notices: Executive Director
10. FRESNO YOUTH CARE HOMES, INC. (Exhibit B-10)
1640 W. Shaw Ave Suite #100
Fresno, CA. 93711
Contact for Notices: Executive Director
11. ELITE FAMILY SYTEMS (Exhibit B-11)
2935 4t" Street
Ceres, CA 95307
Contact for Notices: Clinical Director
12. BRIGHTER HORIZONS GROUP HOMES, INC. (Exhibit B-12)
7849 Oceanus Drive
Los Angeles, CA 90046
Contact for Notices: Chief Operating Officer
13. Z.N.D. RESIDENTIAL, INC. (Exhibit B-13)
2514 N. Whittier Avenue
Fresno, CA 93727
Contact for Notices: Chief Operating Officer
14. CENTER FOR POSITIVE CHANGES (Exhibit B-14)
4950 Waring Road, Suite 4
San Diego, CA 92120
Contact for Notices: Executive Director
15. CHANGING FACES, INC (Exhibit B-15)
4124 Odie Lane
Santa Maria, CA 93455
Contact for Notices: Executive Administrator
A-2
Revised Exhibit A-4
16. HESED CHRISTIAN MINISTRIES, INC. (Exhibit B-16)
425 Mooncrest Street
Santa Maria, CA 93455
Contact for Notices: Executive Director
17. THE VIRTUOUS WOMAN, INC (Exhibit B-17)
1620 Centinela Avenue, Suite 207
Inglewood, CA 90302
Contact for Notices: Executive Director
18. FOR THE FUTURE, INC (Exhibit B-18)
9800 Topanga Canyon Boulevard, #309
Chatsworth, CA 91311
Contact for Notices: Chief Financial Officer
19. GUIDING OUR YOUTH (Exhibit B-19)
1197 E. Los Angeles Avenue, #338
Simi Valley, CA 93065
Contact for Notices: Chief Financial Officer
20. KERN BRIDGES YOUTH HOMES (Exhibit B-20)
1321 Stine Road
Bakersfield, CA 93309
Contact for Notices: Chief Executive Officer
21. SCOTT'S SOCIAL SERVICES (Exhibit B-21)
1780 Glenwood Drive
Bakersfield, CA 93306
Contact for Notices: Chief Executive Officer
22. HUMANISTIC FOUNDATION, INCORPORATED (dba STOCKDALE BOYS CENTER)
CENTER FOR POSITIVE CHANGES (Exhibit B-22)
5757 W. Century Boulevard, Suite 303
Los Angeles, CA 90045
Contact for Notices: Executive Director
23. GLOBAL FAMILY CARE NETWORK, INC (dba DAUGHTER PROJECT GIRLS HOME)
(EXHIBIT B-23)
12004 Valpredo Avenue
Bakersfield, CA 93313
Contact for Notices: Administrator
A-3
Revised Exhibit A-4
24. NEW START YOUTH FACILITY INC (Exhibit B-25)
2409 Belvedere Ave.
Bakersfield, CA 93304
Contact for Notices: STRTP Administrator
A-4
Exhibit B-23
Scope of Services
ORGANIZATION: Global Family Care Network, Inc. (dba Daughter Project Girls
Home)
ADDRESS: 12004 Valpredo Avenue
Bakersfield, CA 93313
TELEPHONE: (661) 800-8522
(661) 213-3380
CONTACT PERSON: Joellen Gutierrez, Administrator
CONTRACT PERIOD: Upon execution —June 30, 2025
SUMMARY OF SERVICES
Global Family Care Network, Inc., dba Daughter Project Girl's Home (DPGH), makes available
specialty mental health services (SMHS) including, but not limited to, assessment,plan
development, individual, group or family therapy, individual/group rehabilitation, collateral,
targeted case management, case consultation, intensive care coordination, intensive home-based
services, therapeutic behavioral services, crisis intervention, education support,psychiatrist
services, medication support services, and transition support services.
TARGET POPULATION
Female foster youth ages 12-17 who have history or are at-risk/suspected for CSEC behaviors.
SERVICE LOCATIONS
Daughter Project Girls Home
12004 Valpredo Ave.
Bakersfield, CA 93313
CONTRACTOR SHALL BE RESPONSIBLE FOR THE FOLLOWING SERVICES:
DPGH shall provide mental health treatment, including specialty mental health services, and
mental health supports, as appropriate to the needs of the child. All specialty mental health
services shall meet Medi-Cal standards. These services shall include all of the following:
B-23-1
Exhibit B-23
A. Mental Health Assessment:
i. A mental health assessment shall be completed by a licensed mental
health professional (LMHP) or waivered/registered associate within five
(5) calendar days of a youth's admission.
ii. A mental health assessment that was completed by an LMHP within sixty
(60) calendar days may also be used to meet this requirement.
B. Client Plan:
i. Each youth admitted to the STRTP shall have a Client Plan prepared,
reviewed and signed by an LMHP or the Head of Service (HOS) or any
other related discipline designated by the HOS within ten (10) calendar
days of admission.
ii. The Client Plan is reviewed by a member of the mental health program
staff at least every thirty (30) calendar days.
iii. Client Plan of each youth or non-minor dependent shall include:
a) anticipated length of stay;
b) specific behavioral goals;
c) specific mental health treatment services;
d) one or more transition goals that support the rapid and
successful transition of the youth back into the community;
e) the youth's participation and agreement; and
f) evidence of review by a member of the STRTP mental
health program staff.
C. Collaborating with the Child and Family Team (CFT), consistent with the Client
Plan.
D. Specialty Mental Health Treatment Services: STRTPs shall make available for
each youth structured specialty mental health treatment services during the day
and evening, seven (7) days per week, according to the youth's needs as
indicated on the youth's Client Plan. At minimum, the following mental health
treatment services (as defined in Title 9 of the California Code of Regulations)
shall be made available, as medically necessary:
i. Mental Health Services— individual or group therapies and interventions
that are designed to provide reduction of mental disability and restoration,
improvement, or maintenance of functioning consistent with the goals of
learning, development, independent living, and enhanced self-sufficiency.
Service activities may include assessment, plan development, therapy,
rehabilitation, and collateral services.
B-23-2
Exhibit B-23
a) Assessment - A clinical analysis of the history and current
status of a youth's mental, emotional, or behavioral
disorder to include relevant cultural and social issues,
history, diagnosis, and any recorded testing results.
b) Plan Development—The development of Client Plans, to
include the youth's needs and services, approval of client
plans, and monitoring of a youth's progress. Clients
participate in the development of the Client Plan which is a
comprehensive detail of the youth's needs, personal goals
and objectives for improvement and exiting from the
STRTP program. It also includes a treatment component
which is specific to mental health and behavioral
improvements the youth would like to work toward.
c) Collateral —This is any service activity to a significant
support person in a youth's life with the intent of improving
or maintaining the mental health status of the youth.
Collateral services include, but are not limited to, helping
significant support persons to understand and accept the
youth's condition and involving them in service planning
and implementation of the Client Plan. Family counseling
or therapy, which is provided on behalf of the youth, may
be considered collateral.
ii. Medication Support Services —shall be provided via a contracted
provider. DPGH will monitor that the following is adhered to by the
psychiatrist for these services:
a) Within the first thirty (30) days of the youth admission, the
psychiatrist shall examine each youth prior to prescribing any
psychotropic medication and include a screening to determine
whether there are potential medical complications that may
contribute to the youth's health condition. This examination shall
be noted in the youth's record.
b) The psychiatrist shall sign a written medication review for each
youth prescribed psychotropic medication as clinically appropriate,
but at least every six (6) weeks. This review shall be included in
the youth's record.
c) The psychiatrist shall review the course of treatment for all youth
who are not on psychotropic medication at least every ninety (90)
days and include the results of this review in a progress note
B-23-3
Exhibit B-23
signed by the prescribing physician at the time the review is
completed.
d) Psychotropic medications for a youth placed in an STRTP shall be
administered in accordance with all applicable State and Federal
laws, which include but are not limited to laws related to informed
consent, documentation of informed consent, and California
Welfare & Institutions (WIC) Code Sections 369.5 and 739.5.
e) STRTPs providing care supervision to children diagnosed by a
physician, psychologist, or licensed clinical social worker as
mentally disordered shall make provision for at least monthly
consultation from a psychiatrist, clinical psychologist, or licensed
clinical social worker regarding the program of services.
iii. Crisis Intervention — an emergency response that enables a youth to cope
with a crisis. Activities are intended to support, improve, or maintain the
youth's mental health status.
iv. Therapy—therapeutic intervention that focuses on symptom reduction in
order to improve identified functional impairments. This service may be
delivered to an individual or group and may also include family therapy.
Youth shall receive both individual and group therapy at least once per
week. The therapeutic modalities are Cognitive Behavioral Therapy
(CBT), Dialectical Behavior Therapy (DBT), and the Trauma Resiliency
Model (TRM). CBT is effective in treating children and adolescents who
have persistent behavioral reactions, DBT focuses on problem-solving
and acceptance-based strategies within a framework of dialectical
methods, and TRM focuses on the concept the biological basis of trauma.
v. Targeted Case Management—any service that assists the youth to
access the needed social, vocational, medical, educational, rehabilitative
or other community services. Services may include, but are not limited to,
communication, coordination and referral to available resources.
vi. Psychologist Services—services provided by licensed psychologists,
within their scope of practice, to diagnose or treat a mental illness or
condition.
vii. EPSDT Supplemental Specialty Mental Health Services— mental health
related diagnostic services and treatment available under the Medi-Cal
program only to persons under 21 years of age. These include but are
not limited to Intensive Care Coordination (ICC) and Intensive Home-
Based Services (IHBS) services in accordance with the "Medi-Cal Manual
B-23-4
Exhibit B-23
for Intensive Care Coordination (ICC), Intensive Home-Based Services
(IHBS), & Therapeutic Foster Care (TFC) for Medi-Cal Beneficiaries."
E. A licensed mental health professional shall perform a clinical review every ninety
(90) days of the youth's status and progress in treatment to determine whether
the youth should continue admission in the program or be transitioned to a
different level of care. The LMHP shall make this determination in consultation
with the placing agency. A report documenting this clinical review shall be
maintained in the youth's record.
F. Ensuring continuity of care, services, and treatment as a youth moves from his or
her STRTP placement to home-based family care or to a permanent living
situation through reunification, adoption, or guardianship, in accordance with the
youth's case plan or treatment plan.
G. Documenting the youth's ability to access mental health services identified in the
Client Plan, or efforts made by the STRTP to ensure access to identified mental
health services, including utilization of any existing grievance processes for
accessing services.
i. Progress notes shall be written to document a youth's participation and
responses to mental health treatment services. The progress notes shall
meet Medi-Cal requirements of documentation and shall be maintained in
the youth's record.
ii. On the same day as the mental health treatment service, the progress
notes shall be signed and dated by the direct service program staff
member(s) who provided the service.
iii. The STRTP shall ensure that documentation and recordkeeping
requirements are met.
H. The youth's record must include:
i. Mental health assessment;
ii. Admission statement, signed by the HOS within five (5) days of
youth's arrival;
iii. Client Plan;
iv. STRTP mental health program progress notes;
v. Clinical review report and transition determination;
vi. Physician's orders, medication examinations, medication reviews,
written informed consent for prescribed medications;
vii. Copy of court orders or judgements regarding physical or legal
custody;
B-23-5
Exhibit B-23
viii. Documentation indicating each date and names of individuals or
groups of individuals who have participated in the development of
the Client Plan; and
ix. A transition determination plan.
I. The STRTP shall ensure that American Indian youth receive specialty mental
health services in accordance with the Federal Indian Child Welfare Act (25
U.S.C. Sec 1901 et seq.).
STAFFING
A. All licensed, waivered, and registered mental health professionals providing services at
the STRTP shall meet all legal requirements for professional licensing, waiver, or
registration, as applicable.
B. Adequate numbers and qualifications of direct service program staff shall be employed,
present, awake, and on duty seven (7) days per week.
C. DPGH shall have at least one (1) full-time equivalent direct service program staff from
the following list employed for each six (6) children admitted to the program:
a) Physicians
b) Psychologists or psychologists who have received a waiver pursuant to WIC
Code 5751.2
c) Licensed Clinical Social Workers or registered professionals pursuant to WIC
Code 5751.2
d) Licensed Marriage, Family, and Child Therapists or registered professionals
pursuant to WIC Code 5751.2
e) Licensed Professional Clinical Counselors or registered professionals pursuant to
WIC Code 5751.2
f) Psychiatric Technicians
g) Mental Health Rehabilitation Specialists as defined in Section 630 of Title 9 CCR
D. Of the direct service program staff required above, DPGH will have one (1) half-time
equivalent LMHP employed for each six (6) children admitted to the program. A LMHP
who is employed to meet this requirement may also be the head of service, if employed
at least forty (40) hours per week.
E. DPGH shall have access to the psychiatrist twenty-four (24) hours per day.
PERFORMANCE MEASURES/PROGRAM OUTCOMES
DPGH shall provide all project monitoring and compliance protocols, procedures, data collection
methods, and reporting requirements requested by the County. DPGH utilizes performance and
B-23-6
Exhibit B-23
outcome measures for evaluating program and system effectiveness to ensure services and
service delivery strategies are positively impacting the youth in their care. Performance
outcome measures shall be reported to the County annually in accumulative reports for overall
program and contract evaluation.
DPGH will address each of the categories referenced below and may additionally propose
other performance and outcome measures that are deemed best to evaluate the services
provided and/or to evaluate overall program performance.
Category Indicator
Monthly Performance Indicators o Youth will demonstrate a 70% decrease in
AWOLs throughout their stay.
o Youth's incident reports will decrease by 65%
throughout their stay.
o Less than 10% of youth will experience injury.
o Less than 10% of youth will experience
psychiatric hospitalization.
o Less than 5% of youth will experience manual
restraint.
o Youth will engage in at least 70% of offered
services.
Permanency Indicators o 40% of youth will successfully discharge to a
lower level of care within 6-12 months.
Service Quality o 80% of youth surveyed will report satisfaction
with the program and extracurricular activities.
Client Indicators o 90% of youth will complete a stay of 6-9
months.
o Youth will engage in at least 70% of offered
services.
o Youth will engage in at least 75% of medical
health services.
o Youth will engage in social activities over 75%
of the time.
Trauma Informed Indicators o Reduce incidents of self-harm to less than 5%
if applicable.
o Overall reduction of identified symptoms of
trauma to less than 30%
Mental Health Indicators o Overall improvement and reduction of
identified mental health symptoms per the
treatment plan to less than 25%.
B-23-7
Exhibit B-23
The goal of DPGH is to provide each girl in our care with a safe, nurturing environment that
meets their basic needs, as well as their individual needs dependent on what led to placement
at an STRTP. DPGH works to identify and target these behaviors by providing a therapeutic
environment, specialty mental health services, and life skills. DPGH aims to support all youth
with reducing and/or eliminating the behaviors that led to STRTP placement so that each youth
can step down to a lower level of care, or transition into independent living.
DPGH understands that the County may adjust the performance and outcome measures
periodically throughout the duration of this Agreement, as needed, to best measure the
program. DPGH will utilize a computerized tracking system with which performance and
outcome measures and other relevant data, such as demographics, will be maintained.
B-23-8
Exhibit B-24
Scope of Services
ORGANIZATION: New Start Youth Facility Inc.
ADDRESS: 2409 Belvedere Ave
Bakersfield CA, 93304
TELEPHONE: 661-487-2158
CONTACT PERSON: Gina Sodaro, STRTP Administrator
CONTRACT PERIOD: Upon execution —June 30, 2025
SUMMARY OF SERVICES
New Start Youth Facility, Inc (NSYF) Short-Term Residential Therapeutic Program (STRTP)
where each youth is offered a series of intensive specialty mental health services by on-site,
full-time mental health staff consisting of a licensed therapist and rehabilitation specialist. Each
youth placed at the NSYF is monitored 24/7 and offered the following services: weekly group
therapy, weekly group psychosocial rehabilitation, individual therapy (2-3x per week), family
therapy (if deemed appropriate), individual psychosocial rehabilitation (2-4x per week), and
crisis intervention (as necessary). The youth will be linked to a local provider and complete an
initial Intensive Case Coordination (ICC)/Child and Family Team (CFT) meeting within 30 days
of placement to review the progress and behavior of the youth and begin to plan for their
transition to a lower level of care once the treatment plan goals are achieved. A psychiatric
evaluation will also be completed to determine the youth's need for medication. Additionally,
mental health staff completes referrals to community supports such as Kern Regional Center,
mentoring, social recreational programs, and TBS, as deemed appropriate.
TARGET POPULATION
NYSF accepts males, LGBTQ, CSEC, and transgendered youth, from probation and the child
welfare system, between the ages of 7 through 18, who are capable of functioning in an open
community setting. NSYF does not accept privately placed youth or non-minor dependents
(NMD).
SERVICE LOCATIONS
First Step New Start Youth Facility
6024 Friant Street 2409 Belvedere Ave.
Bakersfield, CA 93309 Bakersfield, CA 93304
B-24-1
Exhibit B-24
CONTRACTOR SHALL BE RESPONSIBLE FOR THE FOLLOWING SERVICES:
NSYF shall provide mental health treatment, including specialty mental health services, and
mental health supports, as appropriate to the needs of the child. All specialty mental health
services shall meet Medi-Cal standards. These services shall include all of the following:
A. Mental Health Assessment:
i. A mental health assessment shall be completed by a licensed mental
health professional (LMHP) or waivered/registered associate within five
(5) calendar days of a youth's admission.
ii. A mental health assessment that was completed by an LMHP within sixty
(60) calendar days may also be used to meet this requirement.
B. Client Plan:
i. Each youth admitted to the STRTP shall have a Client Plan prepared,
reviewed and signed by an LMHP or the Head of Service (HOS) or any
other related discipline designated by the HOS within ten (10) calendar
days of admission.
ii. The Client Plan is reviewed by a member of the mental health program
staff at least every thirty (30) calendar days.
iii. Client Plan of each youth or non-minor dependent shall include:
a) anticipated length of stay;
b) specific behavioral goals;
c) specific mental health treatment services;
d) one or more transition goals that support the rapid and
successful transition of the youth back into the community;
e) the youth's participation and agreement; and
f) evidence of review by a member of the STRTP mental
health program staff.
C. Collaborating with the Child and Family Team (CFT), consistent with the Client
Plan.
D. Specialty Mental Health Treatment Services: STRTPs shall make available for
each youth structured specialty mental health treatment services during the day
and evening, seven (7) days per week, according to the youth's needs as
indicated on the youth's Client Plan. At minimum, the following mental health
treatment services (as defined in Title 9 of the California Code of Regulations)
shall be made available, as medically necessary:
B-24-2
Exhibit B-24
i. Mental Health Services— individual or group therapies and interventions
that are designed to provide reduction of mental disability and restoration,
improvement, or maintenance of functioning consistent with the goals of
learning, development, independent living, and enhanced self-sufficiency.
Service activities may include assessment, plan development, therapy,
rehabilitation, and collateral services.
a) Assessment - A clinical analysis of the history and current
status of a youth's mental, emotional, or behavioral
disorder to include relevant cultural and social issues,
history, diagnosis, and any recorded testing results.
b) Plan Development—The development of Client Plans, to
include the youth's needs and services, approval of client
plans, and monitoring of a youth's progress. Clients
participate in the development of the Client Plan which is a
comprehensive detail of the youth's needs, personal goals
and objectives for improvement and exiting from the
STRTP program. It also includes a treatment component
which is specific to mental health and behavioral
improvements the youth would like to work toward.
c) Collateral —This is any service activity to a significant
support person in a youth's life with the intent of improving
or maintaining the mental health status of the youth.
Collateral services include, but are not limited to, helping
significant support persons to understand and accept the
youth's condition and involving them in service planning
and implementation of the Client Plan. Family counseling
or therapy, which is provided on behalf of the youth, may
be considered collateral.
ii. Medication Support Services — shall be provided via a contracted
psychiatrist. NSYF will monitor that the following is adhered to by the
psychiatrist for these services:
a) Within the first thirty (30) days of the youth admission, the
psychiatrist shall examine each youth prior to prescribing any
psychotropic medication and include a screening to determine
whether there are potential medical complications that may
contribute to the youth's health condition. This examination shall
be noted in the youth's record.
b) The psychiatrist shall sign a written medication review for each
youth prescribed psychotropic medication as clinically appropriate,
B-24-3
Exhibit B-24
but at least every six (6) weeks. This review shall be included in
the youth's record.
c) The psychiatrist shall review the course of treatment for all youth
who are not on psychotropic medication at least every ninety (90)
days and include the results of this review in a progress note
signed by the prescribing physician at the time the review is
completed.
d) Psychotropic medications for a youth placed in an STRTP shall be
administered in accordance with all applicable State and Federal
laws, which include but are not limited to laws related to informed
consent, documentation of informed consent, and California
Welfare & Institutions (WIC) Code Sections 369.5 and 739.5.
e) STRTPs providing care supervision to children diagnosed by a
physician, psychologist, or licensed clinical social worker as
mentally disordered shall make provision for at least monthly
consultation from a psychiatrist, clinical psychologist, or licensed
clinical social worker regarding the program of services.
iii. Crisis Intervention — an emergency response that enables a youth to cope
with a crisis. Activities are intended to support, improve, or maintain the
youth's mental health status.
iv. Therapy—therapeutic intervention that focuses on symptom reduction in
order to improve identified functional impairments. This service may be
delivered to an individual or group and may also include family therapy.
Youth shall receive both individual and group therapy at least once per
week. The therapeutic modalities are Cognitive Behavioral Therapy
(CBT), Dialectical Behavior Therapy (DBT), and the Trauma Resiliency
Model (TRM). CBT is effective in treating children and adolescents who
have persistent behavioral reactions, DBT focuses on problem-solving
and acceptance-based strategies within a framework of dialectical
methods, and TRM focuses on the concept the biological basis of trauma.
v. Targeted Case Management—any service that assists the youth to
access the needed social, vocational, medical, educational, rehabilitative
or other community services. Services may include, but are not limited to,
communication, coordination and referral to available resources.
vi. Psychologist Services—services provided by licensed psychologists,
within their scope of practice, to diagnose or treat a mental illness or
condition.
B-24-4
Exhibit B-24
vii. EPSDT Supplemental Specialty Mental Health Services— mental health
related diagnostic services and treatment available under the Medi-Cal
program only to persons under 21 years of age. These include but are
not limited to Intensive Care Coordination (ICC) and Intensive Home-
Based Services (IHBS) services in accordance with the "Medi-Cal Manual
for Intensive Care Coordination (ICC), Intensive Home-Based Services
(IHBS), & Therapeutic Foster Care (TFC) for Medi-Cal Beneficiaries."
E. A licensed mental health professional shall perform a clinical review every ninety
(90) days of the youth's status and progress in treatment to determine whether
the youth should continue admission in the program or be transitioned to a
different level of care. The LMHP shall make this determination in consultation
with the placing agency. A report documenting this clinical review shall be
maintained in the youth's record.
F. Ensuring continuity of care, services, and treatment as a youth moves from his or
her STRTP placement to home-based family care or to a permanent living
situation through reunification, adoption, or guardianship, in accordance with the
youth's case plan or treatment plan.
G. Documenting the youth's ability to access mental health services identified in the
Client Plan, or efforts made by the STRTP to ensure access to identified mental
health services, including utilization of any existing grievance processes for
accessing services.
i. Progress notes shall be written to document a youth's participation and
responses to mental health treatment services. The progress notes shall
meet Medi-Cal requirements of documentation and shall be maintained in
the youth's record.
ii. On the same day as the mental health treatment service, the progress
notes shall be signed and dated by the direct service program staff
member(s) who provided the service.
iii. The STRTP shall ensure that documentation and recordkeeping
requirements are met.
H. The youth's record must include:
i. Mental health assessment;
ii. Admission statement, signed by the HOS within five (5) days of
youth's arrival;
iii. Client Plan;
iv. STRTP mental health program progress notes;
B-24-5
Exhibit B-24
v. Clinical review report and transition determination;
vi. Physician's orders, medication examinations, medication reviews,
written informed consent for prescribed medications;
vii. Copy of court orders or judgements regarding physical or legal
custody;
viii. Documentation indicating each date and names of individuals or
groups of individuals who have participated in the development of
the Client Plan; and
ix. A transition determination plan.
I. The STRTP shall ensure that American Indian youth receive specialty mental
health services in accordance with the Federal Indian Child Welfare Act (25
U.S.C. Sec 1901 et seq.).
STAFFING
A. All licensed, waivered, and registered mental health professionals providing services at
the STRTP shall meet all legal requirements for professional licensing, waiver, or
registration, as applicable.
B. Adequate numbers and qualifications of direct service program staff shall be employed,
present, awake, and on duty seven (7) days per week.
C. NSYF shall have at least one (1) full-time equivalent direct service program staff from
the following list employed for each six (6) children admitted to the program:
a) Physicians
b) Psychologists or psychologists who have received a waiver pursuant to WIC
Code 5751.2
c) Licensed Clinical Social Workers or registered professionals pursuant to WIC
Code 5751.2
d) Licensed Marriage, Family, and Child Therapists or registered professionals
pursuant to WIC Code 5751.2
e) Licensed Professional Clinical Counselors or registered professionals pursuant to
WIC Code 5751.2
f) Psychiatric Technicians
g) Mental Health Rehabilitation Specialists as defined in Section 630 of Title 9 CCR
D. Of the direct service program staff required above, NSYF have one (1) half-time
equivalent LMHP employed for each six (6) children admitted to the program. A LMHP
who is employed to meet this requirement may also be the head of service, if employed
at least forty (40) hours per week.
E. NSYF shall have access to the psychiatrist twenty-four (24) hours per day.
B-24-6
Exhibit B-24
PERFORMANCE MEASURES/PROGRAM OUTCOMES
NSYF shall provide all project monitoring and compliance protocols, procedures, data collection
methods, and reporting requirements requested by the County. New Start Youth Facility Inc.
utilizes performance and outcome measures for evaluating program and system effectiveness
to ensure services and service delivery strategies are positively impacting the youth in their
care. Performance outcome measures shall be reported to the County annually in accumulative
reports for overall program and contract evaluation.
NSYF will address each of the categories referenced below and may additionally propose other
performance and outcome measures that are deemed best to evaluate the services provided
and/or to evaluate overall program performance.
A. Access to care: The ability of youth to receive the right service at the right time.
a) 100 % of youth will have an assessment completed by the head of service within
3 days of admission.
b) 100 % of youth will receive their first treatment service within 48 hours of
admission
B. Effectiveness: Objective results achieved through services.
a) Effectiveness of Treatment Interventions: Within 30 days of admission, and every
30 days after, the licensed clinician will review the services provided, treatment
plan and additional resources needed. Every 30 days, each youth will receive
100% of the recommended services within the treatment plan, which will be
reflective in the behavior reduction by 10%.
b) Effectiveness of Discharge Planning: Beginning at admission, and continuing
throughout 6 months of placement, the treatment team will provide intensive
mental health services to 100% of the youth, consisting of 4-7 services per week.
At the 6 months of admission, the treatment team will make recommendations
and advise on potential step-down for client based on client's performance and
additional stakeholder's input.
C. Efficiency: Demonstration of the relationship between results and the resources used to
achieve them.
a) 10% of youth will be successfully discharged within 6 months of placement.
D. Satisfaction and Compliance:
a) NSYF will maintain an 85% compliance rate, as evidenced by audits and other
performance and utilization reviews of health care services, surveys of persons
services, family members, health care providers, and other stakeholders.
B-24-7
Exhibit B-24
NSYF understands that the County may adjust the performance and outcome measures
periodically throughout the duration of this Agreement, as needed, to best measure the
program. NSYF will utilize a computerized tracking system with which performance and
outcome measures and other relevant data, such as demographics, will be maintained.
B-24-8