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HomeMy WebLinkAboutAgreement A-24-617 Amendment VI to Master Agreement No. 23-277.pdf Agreement No. 24-617 1 AMENDMENT NO. 6 TO MASTER SERVICE AGREEMENT 2 This Amendment No. 6 to Master Service Agreement 23-277 ("Amendment No. 6") is 3 dated December 3, 2024 and is between each Contractor ("Contractor(s)") listed in 4 Revised Exhibit A-5, "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. On 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. On August 20, 2024, the County and the Contractor(s) entered into County Agreement 27 number 24-440 ("Amendment No. 5"), to add Global Family Care Network, Inc. (dba Daughter 28 1 1 Project Girls Home) and New Start Youth Facility Inc to the list of Contractors providing 2 specialty mental health services to the Fresno County Youth in their care. 3 G. In October 2024, the Fresno County Department of Behavioral Health (DBH) identified 4 the need to remove Fresh Start Youth Center, Inc. from the list of Contractors as this Contractor 5 no longer met the requirements of the Agreement. Contractor Fresh Start Youth Center, Inc. is 6 being removed from the Agreement; and 7 H. In October 2024, Fresno County DBH identified the need to update Exhibit B-12 to 8 revise the location sites of the STRTPs program for Contractor Brighter Horizons Group Homes, 9 Inc. 10 I. The County and the Contractor now desire to amend the Agreement to make the above 11 mentioned changes to Revised Exhibit A-4 and Exhibit B-12 of this Master STRTP Agreement. 12 The parties therefore agree as follows: 13 1. All references to Revised Exhibit A-4 in the current Agreement shall be deemed 14 references to Revised Exhibit A-5, which is attached and incorporated by reference. 15 2. All references to Exhibit B-12 in the current Agreement shall be deemed references to 16 Revised Exhibit B-12, which is attached and incorporated by reference. 17 3. The parties agree that upon execution of this Amendment No. 6, the Agreement, 18 Amendment No. 1, Amendment No. 2, Amendment No. 3, Amendment No. 4, and Amendment 19 No. 5 are further revised, updated, and amended to include the above-mentioned changes. 20 4. When both parties have signed this Amendment No. 6, the Agreement, Amendment No. 21 1, Amendment No. 2, Amendment No. 3, Amendment No. 4, Amendment No. 5, and this 22 Amendment No. 6 together constitute the Agreement. 23 5. The Contractor represents and warrants to the County that: 24 a. The Contractor is duly authorized and empowered to sign and perform its obligations 25 under this Amendment. 26 b. The individual signing this Amendment on behalf of the Contractor is duly authorized 27 to do so and his or her signature on this Amendment legally binds the Contractor to 28 the terms of this Amendment. 2 1 6. The parties agree that this Amendment may be executed by electronic signature as 2 provided in this section. 3 a. An "electronic signature" means any symbol or process intended by an individual 4 signing this Amendment to represent their signature, including but not limited to (1) a 5 digital signature; (2) a faxed version of an original handwritten signature; or (3) an 6 electronically scanned and transmitted (for example by PDF document) version of an 7 original handwritten signature. 8 b. Each electronic signature affixed or attached to this Amendment (1) is deemed 9 equivalent to a valid original handwritten signature of the person signing this 10 Amendment for all purposes, including but not limited to evidentiary proof in any 11 administrative or judicial proceeding, and (2) has the same force and effect as the 12 valid original handwritten signature of that person. 13 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5, 14 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 15 2, Title 2.5, beginning with section 1633.1). 16 d. Each party using a digital signature represents that it has undertaken and satisfied 17 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) 18 through (5), and agrees that each other party may rely upon that representation. 19 e. This Amendment is not conditioned upon the parties conducting the transactions 20 under it by electronic means and either party may sign this Amendment with an 21 original handwritten signature. 22 7. This Amendment may be signed in counterparts, each of which is an original, and all of 23 which together constitute this Amendment. 24 8. The Agreement as amended by this Amendment No. 6 is ratified and continued. All 25 provisions of the Agreement and not amended by this Amendment No. 6 remain in full force and 26 effect. 27 [SIGNATURE PAGE FOLLOWS] 28 3 1 The parties are signing this Amendment No. 6 on the date stated in the introductory 2 clause. 3 BRIGHTER HORIZONS GROUP HOMES, COUNTY OF FRESNO 4 INC. 5 /�- 6 David Vayntrub, CEO `'' Nathan Magsig, Chairmen-MTT TMe Board of Supervisors of the County of Fresno 7Attest: g " Bernice E. Seidel Irina Vayntrub, Secretary Clerk of the Board of Supervisors 9 County of Fresno, State of California 10 7849 Oceanus Drive ' Los Angeles, CA 90046 By: ��- 11 Deputy 12 For accounting use only: 13 Org No.:56302232 Account No.:7295 14 Fund No.:0001 Subclass No.:10000 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4 Revised Exhibit A-5 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-5 8. MANUCH INC. (Exhibit B-8) PO Box 26622 Fresno, CA 93729 Phone#: (559) 347-7627 Contact for Notices: Mental Health Director 9. FRESNO YOUTH CARE HOMES, INC. (Exhibit B-10) 1640 W. Shaw Ave Suite #100 Fresno, CA. 93711 Contact for Notices: Executive Director 10. ELITE FAMILY SYSTEMS (Exhibit B-11) 2935 4t" Street Ceres, CA 95307 Contact for Notices: Clinical Director 11. BRIGHTER HORIZONS GROUP HOMES, INC. (Revised Exhibit B-12) 7849 Oceanus Drive Los Angeles, CA 90046 Contact for Notices: Chief Operating Officer 12. Z.N.D. RESIDENTIAL, INC. (Exhibit B-13) 2514 N. Whittier Avenue Fresno, CA 93727 Contact for Notices: Chief Operating Officer 13. CENTER FOR POSITIVE CHANGES (Exhibit B-14) 4950 Waring Road, Suite 4 San Diego, CA 92120 Contact for Notices: Executive Director 14. CHANGING FACES, INC (Exhibit B-15) 4124 Odie Lane Santa Maria, CA 93455 Contact for Notices: Executive Administrator 15. HESED CHRISTIAN MINISTRIES, INC. (Exhibit B-16) 425 Mooncrest Street Santa Maria, CA 93455 Contact for Notices: Executive Director A-2 Revised Exhibit A-5 16. THE VIRTUOUS WOMAN, INC (Exhibit B-17) 1620 Centinela Avenue, Suite 207 Inglewood, CA 90302 Contact for Notices: Executive Director 17. FOR THE FUTURE, INC (Exhibit B-18) 9800 Topanga Canyon Boulevard, #309 Chatsworth, CA 91311 Contact for Notices: Chief Financial Officer 18. GUIDING OUR YOUTH (Exhibit B-19) 1197 E. Los Angeles Avenue, #338 Simi Valley, CA 93065 Contact for Notices: Chief Financial Officer 19. KERN BRIDGES YOUTH HOMES (Exhibit B-20) 1321 Stine Road Bakersfield, CA 93309 Contact for Notices: Chief Executive Officer 20. SCOTT'S SOCIAL SERVICES (Exhibit B-21) 1780 Glenwood Drive Bakersfield, CA 93306 Contact for Notices: Chief Executive Officer 21. 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 22. GLOBAL FAMILY CARE NETWORK, INC (dba DAUGHTER PROJECT GIRLS HOME) (EXHIBIT B-23) 12004 Valpredo Avenue Bakersfield, CA 93313 Contact for Notices: Administrator 23. NEW START YOUTH FACILITY INC (Exhibit B-24) 2409 Belvedere Ave. Bakersfield, CA 93304 Contact for Notices: STRTP Administrator A-3 Revised Exhibit B-12 Scope of Services ORGANIZATION: Brighter Horizon Group Homes, Inc. dba Brighter Horizon Treatment Centers (BHTC) ADDRESS: 7849 Oceanus Drive Los Angeles, CA 90046 TELEPHONE: (310) 909-3817 CONTACT PERSON: Irina Vayntrub, COO CONTRACT PERIOD: Upon execution —June 30, 2024 with one (1) optional twelve (12) month renewal SUMMARY OF SERVICES Brighter Horizon Treatment Centers (BHTC)will provide support to male and female youth ages 10-17, and their families, whose special needs can be met through services delivered, supervised, and supported by professional agency staff. BHTC's mission is to provide residential treatment, foster care, adoption, counseling, and supportive family services to youth meeting medical necessity criteria utilizing a unique integrated comprehensive service delivery model by providing interventions and support for service area youth and their families. BHTC's services are provided in-house, and our youth receive individual/group counseling, substance abuse treatment, anger management treatment, psychiatric services, independent living skills, recreational services, educational services, and job training. This includes therapy, training, familiarizing the youth with community resources providing these individuals with their basic needs, reunifying family systems, creating new foster family units, rehabilitating juvenile offenders, supporting pregnant and parenting teens, and developing a support system for all youth. BHTC is a bi-lingual, multi- cultural organization who has serviced multiple counties. BHTC provides placing counties with an assessment and treatment-oriented alternative for emotionally and behaviorally disordered children who would otherwise be in settings more restrictive than necessary. BHTC strives to stabilize referred youths and to reduce each referred child's particular psychiatric symptoms and dysfunctional behaviors through comprehensive interdisciplinary evaluation and Treatment Planning with a focus on a length of stay between 6 and 9 months, and to avoid/prevent inappropriate acute hospitalization. BHTC facilities provide a safe, protective, and nurturing environment which maximizes the opportunity for the child and their family to resolve psychopathology and resume reasonable age-appropriate pursuit of developmental tasks. TARGET POPULATION B-12-1 Revised Exhibit B-12 Youth between the ages of 10-17 who meet medical necessity for the STRTP program, and that are referred by either child welfare or probation systems. Our residential treatment programs will also provide youth who meet criteria for Serious Emotional Disturbance (SED) with an array of core therapeutic services that are trauma informed, culturally relevant, and individualized based on their treatment needs and development, to improve their mental health functioning. REFERRALS Fresno County youth shall retain priority placement within the STRTP. County-of-origin of placed youth will be monitored and, if the STRTP is found to have a low percentage of Fresno County placements overall, a meeting with County and the STRTP shall convene to discuss potential remedies and/or penalties. SERVICE LOCATIONS BHTC, Elm BHTC, Cottonwood 2747 Redda Road 7133 E. Cornell Ave Fresno, CA 93737 Fresno, CA 93737 CONTRACTOR SHALL BE RESPONSIBLE FOR THE FOLLOWING SERVICES: BHTC shall provide mental health treatment, including specialty mental health services, and mental health supports, as appropriate to the needs of the child. All specialty mental health services shall meet Medi-Cal standards. These services shall include all 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. B-12-2 Revised Exhibit B-12 iii. Client Plan of each youth or non-minor dependent shall include: a) anticipated length of stay; b) specific behavioral goals; c) specific mental health treatment services; d) one or more transition goals that support the rapid and successful transition of the youth back into the community; e) the youth's participation and agreement; and f) evidence of review by a member of the STRTP mental health program staff. C. Collaborating with the Child and Family Team (CFT), consistent with the Client Plan. D. Specialty Mental Health Treatment Services: STRTPs shall make available for each youth structured specialty mental health treatment services during the day and evening, seven (7) days per week, according to the youth's needs as indicated on the youth's Client Plan. At minimum, the following mental health treatment services (as defined in Title 9 of the California Code of Regulations) shall be made available, as medically necessary: i. Mental Health Services— individual or group therapies and interventions that are designed to provide reduction of mental disability and restoration, improvement, or maintenance of functioning consistent with the goals of learning, development, independent living, and enhanced self-sufficiency. Service activities may include assessment, plan development, therapy, rehabilitation, and collateral services. a) Assessment - A clinical analysis of the history and 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. B-12-3 Revised Exhibit B-12 Collateral services include, but are not limited to, helping significant support persons to understand and accept the youth's condition and involving them in service planning and implementation of the Client Plan. Family counseling or therapy, which is provided on behalf of the youth, may be considered collateral. ii. Medication Support Services —shall be provided via referral to Fresno County Behavioral Health. BHTC will monitor that the following is adhered to by the psychiatrist for these services: a) Within the first thirty (30) days of the youth admission, the psychiatrist shall examine each youth prior to prescribing any psychotropic medication and include a screening to determine whether there are potential medical complications that may contribute to the youth's health condition. This examination shall be noted in the youth's record. b) The psychiatrist shall sign a written medication review for each youth prescribed psychotropic medication as clinically appropriate, but at least every six (6) weeks. This review shall be included in the youth's record. c) The psychiatrist shall review the course of treatment for all youth who are not on psychotropic medication at least every ninety (90) days and include the results of this review in a progress note signed by the prescribing physician at the time the review is completed. d) Psychotropic medications for a youth placed in an STRTP shall be administered in accordance with all applicable State and Federal laws, which include but are not limited to laws related to informed consent, documentation of informed consent, and California Welfare & Institutions (WIC) Code Sections 369.5 and 739.5. e) STRTPs providing care supervision to children diagnosed by a physician, psychologist, or licensed 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. B-12-4 Revised Exhibit B-12 iv. Therapy—therapeutic intervention that focuses on symptom reduction in order to improve identified functional impairments. This service may be delivered to an individual or group and may also include family therapy. Youth shall receive both individual and group therapy at least once per week. The therapeutic modalities are Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and the Trauma Resiliency Model (TRM). CBT is effective in treating children and adolescents who have persistent behavioral reactions, DBT focuses on problem-solving and acceptance-based strategies within a framework of dialectical methods, and TRM focuses on the concept the biological basis of trauma. v. Targeted Case Management—any service that assists the youth to access the needed social, vocational, medical, educational, rehabilitative or other community services. Services may include, but are not limited to, communication, coordination and referral to available resources. vi. Psychologist Services—services provided by licensed psychologists, within their scope of practice, to diagnose or treat a mental illness or condition. vii. EPSDT Supplemental Specialty Mental Health Services— mental health related diagnostic services and treatment available under the Medi-Cal program only to persons under 21 years of age. These include but are not limited to Intensive Care Coordination (ICC) and Intensive Home- Based Services (IHBS) services in accordance with the "Medi-Cal Manual for Intensive Care Coordination (ICC), Intensive Home-Based Services (IHBS), & Therapeutic Foster Care (TFC) for Medi-Cal Beneficiaries." E. A licensed mental health professional shall perform a clinical review every ninety (90) days of the youth's status and progress in treatment to determine whether the youth should continue admission in the program or be transitioned to a different level of care. The LMHP shall make this determination in consultation with the placing agency. A report documenting this clinical review shall be maintained in the youth's record. F. Ensuring continuity of care, services, and treatment as a youth moves from his or her STRTP placement to home-based family care or to a permanent living situation through reunification, adoption, or guardianship, in accordance with the youth's case plan or treatment plan. 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 B-12-5 Revised Exhibit B-12 health services, including utilization of any existing grievance processes for accessing services. i. Progress notes shall be written to document a youth's participation and responses to mental health treatment services. The progress notes shall meet Medi-Cal requirements of documentation and shall be maintained in the youth's record. ii. On the same day as the mental health treatment service, the progress notes shall be signed and dated by the direct service program staff member(s) who provided the service. iii. The STRTP shall ensure that documentation and recordkeeping requirements are met. H. The youth's record must include: i. Mental health assessment; ii. Admission statement, signed by the HOS within five (5) days of youth's arrival; iii. Client Plan; iv. STRTP mental health program progress notes; v. Clinical review report and transition determination; vi. Physician's orders, medication examinations, medication reviews, written informed consent for prescribed medications; vii. Copy of court orders or judgements regarding physical or legal custody; viii. Documentation indicating each date and names of individuals or groups of individuals who have participated in the development of the Client Plan; and ix. A transition determination plan. I. The STRTP shall ensure that American Indian youth receive specialty mental health services in accordance with the Federal Indian Child Welfare Act (25 U.S.C. Sec 1901 et seq.). 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. B-12-6 Revised Exhibit B-12 C. BHTC shall have at least one (1) full-time equivalent direct service program staff from the following list employed for each six (6) children admitted to the program: a) Physicians b) Psychologists or psychologists who have received a waiver pursuant to WIC Code 5751.2 c) Licensed Clinical Social Workers or registered professionals pursuant to WIC Code 5751.2 d) Licensed Marriage, Family, and Child Therapists or registered professionals pursuant to WIC Code 5751.2 e) Licensed Professional Clinical Counselors or registered professionals pursuant to WIC Code 5751.2 f) Psychiatric Technicians g) Mental Health Rehabilitation Specialists as defined in Section 630 of Title 9 CCR D. Of the direct service program staff required above, BHTC 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. BHTC shall have access to the psychiatrist twenty-four (24) hours per day. PERFORMANCE MEASURES/PROGRAM OUTCOMES BHTC shall provide all project monitoring and compliance protocols, procedures, data collection methods, and reporting requirements requested by the County. BHTC utilizes performance and outcome measures for evaluating program and system effectiveness to ensure services and service delivery strategies are positively impacting the youth in their care. Performance outcome measures shall be reported to the County annually in accumulative reports for overall program and contract evaluation. BHTC will address each of the categories referenced below and may additionally propose other performance and outcome measures that are deemed best to evaluate the services provided and/or to evaluate overall program performance. A. Access to care: The ability of youth to receive the right service at the right time. a) Timeliness between referral to assessment and completion of assessment; assessment to first treatment service; and first treatment service to subsequent follow-up visit B. Effectiveness: Objective results achieved through services. a) Effectiveness of treatment interventions b) Effectiveness of discharge planning (e.g. percentage of youth successfully linked to lower levels of care) B-12-7 Revised Exhibit B-12 C. Efficiency: Demonstration of the relationship between results and the resources used to achieve them. a) Length of youth stay in program b) Number of units of service per youth c) Cost per youth D. Satisfaction and Compliance: The degree to which persons served, County, and other stakeholders are satisfied with the services. a) Audits and other performance and utilization reviews of health care services and compliance with agreement terms and conditions b) Surveys of persons serviced, family members, other health care providers, and other stakeholders ACCESS TO CARE # Objective Indicator Who Time of Data Source Performance Target A lied Measure 1 Time between BHTC Within 5 EMR** 80% of placed youth youth's STRTP days of the Extended will have assessments admission date Youth youth's Reach — completed within 10 and the arrival, their Completion days of admission. completion of assessments dates of each their will be assessment assessments*. completed. documentation. 2 Time between BHTC Within 7 EMR Extended 85% of youth will have BHTC the completion STRTP days of the Reach — their first treatment STRTP of assessments Youth completion Completion service completed youth and the youth's of a youth's date of within 7 days after receive the first Specialty assessment, assessment admission. right Mental Health their first documentation service at Service (SMHS). treatment and youth's the right service will first SMHS. time be held. . 3 Timeliness of BHTC After EMR Extended 80% of youth will have youth's first STRTP completion Reach — a subsequent follow- treatment Youth of first Completion up visit within 48 service to follow- SMHS, date of first hours of their first up visit. youth's SMHS and SMHS. subsequent date of follow-up subsequent visit occurs follow-up visit. within 48 hours. B-12-8 Revised Exhibit B-12 *Assessments includes Admission Statement, Mental Health Assessment, CANS, PSC-35, Treatment Plan and Medication Referral as required. **EMR = Electronic Medical Record will be the data source used- either BHTC'Extended Reach or Fresno County Avatar as indicated. EFFECTIVENESS # Objective Indicator Who Time of Data Source Performance Target A lied Measure 1 Treatment CANS BHTC Intake CANS EMR: Avatar— 65% of youth will interventions assessment STRTP scoare and Admission and have a positive used will scores Youth discharge discharge change in their CANS improve CANS score. CANS score scores at discharge. youth's data collected. quality of life CANS completed at 3 months 2 BHTC will Percentage of BHTC Youth are EMR: 50% of youth will step link STRTP youth STRTP discharged Extended down to a lower level youth to a successfully Youth to Home, Reach of care. lower level stepped down to Relative, Discharge data of care upon a lower level of Foster Care, will be discharge. care. Independent collected. Living Program, etc. EFFICIENCY # Objective Indicator Who Time of Data Source Performance A lied Measure Target 1 Youth will be BHTC STRTP BHTC Data EMR: 60% of youth will discahrged youth's actual STRTP gathered at Extended be discharged within the length of stay Youth youth Reach — within the timeframe discharge Youth's total timeframe identified in and/or Days of Care identified in their their collated for treatment plan. treatment the fiscal plan. year by June 30 2 Youth Number of units BHTC Data Youth's total The number of receives of service per STRTP gathered at units of service units of service mental youth and cost Youth youth and costs per provided to health per individual discharge individual srved achieve youth's services served and/or treatment plan according to collated for goals will be their the fiscal proportional to the treatment year by costs per plan June 30 individual served. B-12-9 Revised Exhibit B-12 SATISFACTION AND COMPLIANCE # Objective Indicator Who Time of Data Source Performance Applied Measure Target 1 Youth will be Client BHTC After intake Electronic or 65% of youth at satisfied with Satisfaction STRTP and before Paper Survey discharge will be services Surveys & Youth planned Results satisfied with the received Communication discharge services received Hour Communication discussions Hour Meeting Notes. 2 Stakeholders Stakeholder BHTC Two times Electronic or 85% of will be Satisfaction Stakeholders a year Paper Survey stakeholdres will satisfied with Surveys Results be satisfied with the services (Virtual the services provided to Informal meetings, Notes from provided to their youth Discussions phone informal STRTP youth calls, etc.) discussions BHTC understands that the County may adjust the performance and outcome measures periodically throughout the duration of this Agreement, as needed, to best measure the program. BHTC will utilize a computerized tracking system with which performance and outcome measures and other relevant data, such as demographics, will be maintained. B-12-10