HomeMy WebLinkAboutM-25-665 FY 25-26 InterDept MOU for JJC Med-BH Svcs.pdf M-25-665
1 INTER-DEPARTMENTAL AGREEMENT
2 This Inter-Departmental Agreement ("Agreement") is dated January 13, 2026 and
3 is between the County of Fresno Probation Department ("Probation"), County of Fresno
4 Department of Public Health ("DPH"), and County of Fresno Department of Behavioral Health
5 ("DBH").
6 Recitals
7 A. Probation is required to provide necessary medical and behavioral health care services
8 to youth who are in the custody of Probation at the Fresno County Juvenile Justice Campus
9 ("JJC").
10 B. DPH and DBH are willing and able to support Probation to provide the necessary
11 medical and behavioral health care services for youth in the custody of Probation, in a manner
12 consistent with all applicable standards of medical and behavioral health care, and in
13 compliance with all applicable laws including Title 15 of the California Code of Regulations (Title
14 15), and all applicable State of California and Federal Court Orders.
15 C. On June 18, 2024, County of Fresno entered into Agreement No. 24-312 with California
16 Forensic Medical Group, Inc., also known as Wellpath ("Contractor"), effective July 1, 2024 to
17 provide comprehensive medical and behavioral health care services, including substance use
18 disorder ("SUD") services, to youth in the custody of Probation.
19 The parties therefore agree as follows:
20 Article 1
21 Responsibilities
22 1.1 Probation Responsibilities. Probation shall:
23 (A) Be responsible for administration of Agreement No. 24-312 in close coordination
24 with DPH and DBH.
25 (B) Supply Contractor with space to conduct all medical and behavioral health care
26 examinations, encounters and treatment, including sufficient office space for
27 administrative duties.
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1 (C) Supply DBH with sufficient space at JJC to conduct oversight of behavioral
2 health care service delivery, and to provide service and care coordination for youth who
3 have or potentially have a serious emotional disorder (SED) or serious mental illness
4 (SMI) who are in Collaborative Treatment Courts.
5 (D) Support and facilitate, when appropriate, medical decisions made by Contractor,
6 including providing all therapeutic diets for youths ordered by Contractor.
7 (E) Oversee medical and behavioral health programs at the direction of a Deputy
8 Chief Probation Administrative Officer or Deputy Chief Probation Officer and in close
9 coordination with an interdisciplinary team including DPH, and DBH, as applicable.
10 (F) Have the Deputy Chief Probation Administrative Officer or designee coordinate
11 and process payment with Contractor, reviewing the monthly Staffing Report, Cost
12 Report and average daily population (ADP) as related to the monthly invoice.
13 (G) In consultation with DPH and DBH, have the Deputy Chief Probation Officer or
14 designee confirm Contractor provides all staffing, medical and clerical equipment,
15 services, supplies and prescription medication necessary to provide adequate and timely
16 medical and related clerical services to the JJC youth.
17 (H)Work with Contractor to establish standardized procedures for:
18 (1) Medication administration: Probation will assist Contractor staff when
19 necessary to ensure the youth interacts appropriately with Contractor staff. This may
20 include verifying youth consume medication properly (i.e. swallows medication, does
21 not pretend to swallow or `cheek' the medication, etc.). For proper medication
22 administration, youth cells and pods must be well lit so Contractor staff can ensure
23 the youth has taken the medication. Lights in pods must be turned on when
24 Contractor is present for optimal observation and safety. An announcement will be
25 made by Probation alerting the youth when medication pass will commence.
26 (2) Access to care (health service requests): Youth shall have access to blank
27 health service request forms. Probation will provide for privacy for youth during the
28 health service request submittal and collection process.
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1 (1) Provide sufficient assistance, as necessary, to Contractor including, but not
2 limited to, providing for the safety of Contractor medical and behavioral health care staff
3 working at the JJC whenever youth has access to said staff.
4 (J) Provide oversight of other arresting agency staff that bring youth into JJC for
5 booking.
6 (K) Provide all laundry services as normally provided for youth.
7 (L) Provide for routine facility maintenance and repair of the medical/behavioral
8 health service areas including but not limited to electrical, plumbing, mechanical and
9 structural.
10 (M)Assist in compliance with medical and behavioral health care for detention facility
11 youth in accordance with Title 15 and all applicable State and Federal Court Orders,
12 laws, rules, and regulations.
13 (N) Respond in a timely fashion to all inquiries by DPH, DBH and/or Contractor
14 regarding incidents related to youth care, or to any provision of this Agreement.
15 (0)Provide Contractor access to Probation's JJC Policy and Procedure Manual, by
16 this reference incorporated herein.
17 (P) Comply with all Prison Rape Elimination Act (PREA) standards for juvenile
18 facilities and provide training to Contractor staff, as necessary.
19 (Q)Participate in training provided by Contractor to conduct non-health care provider
20 intake screening during non-clinic hours.
21 (R) Provide Contractor with County INTRA ID and access to the Probation's
22 electronic case management system, currently "PRI MS".
23 (S) Provide all telephone equipment and related telephone service costs up to
24 $10,000 annually.
25 (T) Provide telephone, fax and data support for Contractor through the County's
26 Information Technology Services Department and related charges for usage.
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1 (U) Coordinate development and implementation of California Advancing and
2 Innovating Medi-Cal Justice-Involved Initiative for detained youth at JJC with DPH, DBH
3 and Contractor.
4 1.2 DPH Responsibilities. DPH shall:
5 (A) Assign a Registered Nurse (RN) Auditor as needed to work at the direction of
6 Probation's JJC Administration ("JJC Administration") to provide oversight and
7 compliance auditing of Contractor. RN Auditor shall do the following:
8 (1) Conduct ongoing evaluation of Contractor performance.
9 (2) Provide reports to JJC Administration of ongoing compliance.
10 (3) Conduct oversight of medical, dental, and behavioral health grievance
11 process and conduct review of appeals.
12 (B) Administer State Medi-Cal County Inmate Program (MCIP) in coordination with
13 Contractor.
14 (C) Coordinate with Contractor and Probation to address communicable disease
15 investigations (including TB and syphilis) needing to occur in the JJC.
16 (D) Provide technical assistance, including consultation from the County Health
17 Officer, to Probation at the request of the JJC Administration.
18 (E) Participate in administrative meetings.
19 (F) Annually arrange and coordinate Title 15 inspections required of the County
20 Health Officer.
21 (G)Work with Probation to conduct a comprehensive staffing audit prior to July 1 st of
22 each year, as applicable.
23 1.3 DBH Responsibilities. DBH shall:
24 (A) Assign up to 0.20 full-time equivalent (FTE) Utilization Review Specialist (URS).
25 The URS qualifications include, but are not limited to, being a licensed mental health
26 professional. The URS will maintain responsibility to assist with oversight and
27 compliance auditing of Contractor at JJC in collaboration with Probation and DPH. The
28 remaining 0.80 FTE will be dedicated to assisting with oversight and compliance auditing
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1 of Contractor at Adult Jail working in coordination with Jail Administration and DPH. The
2 URS shall perform the following:
3 (1) Conduct ongoing evaluation of Contractor's performance in implementing and
4 maintaining mental health and SUD programs and services.
5 (2) Provide reports to Probation on County Agreement compliance monitoring,
6 including but not limited to:
7 a. Discharge planning and linkage;
8 b. Group/individual therapy;
9 c. Release of information (ROI), verification of medication on intake,
10 prescription bridging, and psychiatric referrals (including compliance to
11 timeliness standards);
12 d. Suicide risk assessment, monitoring, and prevention; and
13 e. SUD services.
14 (3) Liaison with other DBH-contracted providers of inpatient/direct mental health
15 and SUD services (e.g., crisis stabilization centers, acute inpatient psychiatric health
16 facilities and Community Regional Medical Center).
17 (4) Attend appropriate administrative and coordination meetings with Probation,
18 DPH and/or Contractor, including but not limited to, monthly administrative meetings,
19 suicide prevention discussions, quality assurance meetings, and mortality reviews,
20 as deemed necessary.
21 (5) Conduct audits of Contractor's mental health charts, at a minimum annually,
22 and review annual SUD charts as conducted by DBH, to ensure compliance to
23 County Agreements and community standards as applicable.
24 If such URS position is unfilled at any time, another DBH URS will assist in this role
25 as a consultant to Probation.
26 (B) Ensure Contractor maintains compliance with the standards of behavioral health
27 care for youth in accordance with the California Medical Association Guidelines,
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1 including the applicable provisions of Title 15 of the California Code of Regulations and
2 all applicable State of California and Federal Court Orders.
3 (C) Maintain full responsibility for ensuring Contractor is providing, planning,
4 coordinating, and evaluating timely and adequate behavioral health care services to
5 appropriate youth, based on written and approved policies and procedures.
6 (D) Ensure that Contractor maintains all behavioral health care records on all youth
7 seen by Contractor behavioral health care staff.
8 (E) Confirm Contractor provides appropriate staffing, supplies and equipment
9 necessary for providing timely and adequate behavioral health, clerical, and related
10 care/services, to the youth within the JJC facility. These services and equipment shall
11 include, but are not limited to, personnel, telephones and copy/fax machine. In addition,
12 Contractor psychiatric/medical staff shall provide consultation, medication monitoring
13 and written prescription for minors deemed appropriate for psychotropic medication, in
14 accordance with Medical Board Regulations, parental consents/JV220/Court Orders,
15 local, State and Federal laws, minors' knowledge and all applicable laws. The
16 administration of these medications shall be in collaboration among the medical and
17 behavioral health care staff of the Contractor and shall follow all applicable laws. All such
18 costs for operating the JJC's behavioral health program are to be incurred and budgeted
19 for in the DBH budget.
20 (F) Ensure Contractor provides necessary staffing levels including: psychiatrists,
21 mid-level practitioners, licensed vocational nurses, licensed clinicians,
22 waivered/unlicensed clinicians, case managers, SUD counselors, and clerical staff, as
23 deemed appropriate. These staff shall be available to provide adequate and timely
24 mental health and SUD services to the youth housed in the JJC facility. Work schedules
25 for those Contractor employees assigned to the JJC will be established by Contractor
26 management.
27 (G)Ensure Contractor shall provide the following behavioral health care services:
28 (1) Screen youth offenders appearing to require behavioral health care services.
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1 (2) Assess treatment needs of those youth screened and/or identified.
2 (3) Provide crisis intervention as necessary.
3 (4) Assess for suicide risk.
4 (5) Provide short-term therapeutic services.
5 (6) Participate in protocol to assess and determine youth's capability to regain
6 competency in order to stand trial per California WIC §709.
7 (7) Evaluate youth's need for involuntary hospitalization per California WIC
8 §5150.
9 (8) As practical, provide pre-release planning and referral of youth who need or
10 request psychiatric treatment after release from custody.
11 (9) When deemed medically necessary, shall provide appropriate behavioral
12 health care service(s) to youth in custody as well as those awaiting placement, which
13 Contractor staff will verify through adjudication status.
14 (10) Ensure timely response by Contractor to all inquiries by Probation or the
15 Courts regarding incidents related to youth behavioral health care, or to provisions of
16 this Inter-Departmental Agreement.
17 (H) Shall comply with all Prison Rape Elimination Act (PREA) standards for youth
18 facilities. Training will be provided by Probation to Contractor staff, as necessary.
19 (1) Provide any behavioral health care service data as may be required by Probation
20 for its Performance-Based Standards measures.
21 1.4 DPH and DBH Responsibilities. DPH and DBH shall ensure Contractor has a plan
22 in place for emergency medical and/or behavioral health care services for ALL youth housed
23 within the JJC. Services provided shall cover all medical and/or behavioral health care services
24 that are the result of a crisis and/or emergency 24-hours a day, 7-days a week. When
25 Contractor does not have the appropriate equipment for accurate diagnosis or is not capable of
26 providing emergency medical or behavioral health care services within the JJC facility,
27 Contractor may coordinate with area hospitals to make such services available. When
28 Contractor's intervention efforts are unsuccessful and crisis stabilization services are deemed to
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1 be underserving the youth's needs while experiencing a mental health crisis and therefore a
2 determination is made that acute inpatient psychiatric services are required, the Contractor shall
3 coordinate with the DBH-contracted youth psychiatric health facility or an out-of-county facility to
4 facilitate admission and arrange for transport. Where time is critical, Probation staff and/or
5 Contractor staff may also call 911 for emergencies, as deemed appropriate.
6 1.5 Representation. Probation, DPH and DBH represent that they are qualified, ready,
7 willing, and able to perform all of the services provided in this Agreement.
8 1.6 Compliance with Laws. Probation, DPH and DBH shall, at their own cost, comply
9 with all applicable federal, state, and local laws and regulations in the performance of their
10 obligations under this Agreement, including but not limited to workers compensation, labor, and
11 confidentiality laws and regulations. Probation, DPH and DBH shall provide services in
12 conformance with all applicable State and Federal statutes, regulations and subregulatory
13 guidance, as from time to time amended, including but not limited to:
14 (A) California Code of Regulations, Title 15, Minimum Standards for Local Detention
15 Facilities;
16 (B) California Welfare & Institutions Code Section 5150, et seq. and 5600.4;
17 (C) California Penal Code Section 4011.6;
18 (D) California Education Code;
19 (E) California Code of Regulations, Title 9;
20 (F) California Code of Regulations, Title 22;
21 (G)California Welfare and Institutions Code, Division 5;
22 (H) United States Code of Federal Regulations, Title 42, including but not limited to
23 Parts 438 and 455;
24 (1) United States Code of Federal Regulations, Title 45;
25 (J) United States Code, Title 42 (The Public Health and Welfare), as applicable;
26 (K) Balanced Budget Act of 1997;
27 (L) Health Insurance Portability and Accountability Act (HIPAA); and
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1 (M)Applicable Medi-Cal laws and regulations, including applicable sub-regulatory
2 guidance, such as Behavioral Health Information Notices (BHINs), Mental Health and
3 Substance Use Disorder Services Information Notices (MHSUDS INs), and provisions of
4 County, state or federal contracts governing services for persons served as applicable to
5 county correctional facilities.
6 In the event any law, regulation, or guidance referred to in this section 1.6 is amended during
7 the term of this Agreement, the parties agree to comply with the amended authority as of the
8 effective date of such amendment without amending this Agreement.
9 Article 2
10 Compensation, Invoices, and Payments
11 2.1 Probation, DPH and DBH provide funding for subcontracted program costs (staffing,
12 supplies, etc.) to operate the medical and behavioral health care programs at the JJC as
13 identified in Agreement No. A-24-312.
14 2.2 Probation, DPH and DBH shall provide funding to compensate for services provided
15 by the Contractor as identified in Exhibit A.
16 2.3 Invoices. Probation shall process the Contractor's monthly invoice for payment at
17 such time the invoice and backup documentation is received from the Contractor. Probation
18 shall then provide DPH and DBH with a monthly invoice for their funding portion of the
19 Contractor's monthly invoice according to their total percent contribution in Exhibit A.
20 Probation's invoicing to DPH and DBH shall include the following:
21 (A) Reference shall be made to the appropriate Contractor invoice billing cycle.
22 (B) Copy of the Contractor's invoice, monthly ADP, shift penalty credit memo, and
23 the monthly Cost Report shall accompany Probation's invoice to DPH and DBH.
24 2.4 Payment. Once Probation's invoice has been reviewed and approved for payment
25 by DPH and DBH through email, DPH and DBH shall process a journal voucher for
26 reimbursement to Probation. DPH and DBH shall email a copy of the journal voucher to
27 Probation. The journal vouchers shall be subject to County, State and Federal audits.
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1 2.5 Incidental Expenses. DPH and DBH are solely responsible for all of their costs and
2 expenses that are not specified as payable by Probation under this Agreement.
3 Article 3
4 Term of Agreement
5 3.1 Term. This Agreement is retroactively effective on July 1, 2025 and terminates on
6 June 30, 2026, except as provided in Article 4, "Termination and Suspension". Probation shall
7 initiate negotiations for renewal of responsibilities between all parties on or about April 1, 2026.
8 Article 4
9 Termination and Suspension
10 4.1 Termination for Non-Allocation of Funds. The terms of this Agreement are
11 contingent on the approval of funds by the appropriating government agency. If sufficient funds
12 are not allocated, then any party upon at least 60 days' advance written notice to all parties,
13 may:
14 (A) Modify the services provided by the party under this Agreement; or
15 (B) Terminate this Agreement.
16 4.2 Termination without Cause. In circumstances other than those set forth above, any
17 party may terminate this Agreement by giving at least 60 days advance written notice to all
18 parties. However, termination of this Agreement shall not affect any pending activities which
19 shall be handled to their conclusion by the parties.
20 4.3 No Penalty or Further Obligation. Any termination of this Agreement by any party
21 under this Article 4 is without penalty to or further obligation of all parties.
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23 Article 5
24 Inspections, Audits, and Public Records
25 5.1 Inspection of Documents. Any party shall make available to the parties, and the
26 parties may examine at any time during business hours and as often as the parties deem
27 necessary, all of any party's records and data with respect to the matters covered by this
28 Agreement, excluding attorney-client privileged communications. Any party shall, upon request
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1 by the parties, permit the parties to audit and inspect all of such records and data to ensure any
2 party's compliance with the terms of this Agreement.
3 Article 6
4 General Terms
5 6.1 Modification. Except as provided in Article 4, "Termination and Suspension," this
6 Agreement may not be modified, and no waiver is effective, except by written agreement signed
7 by the parties. The parties acknowledges that its employees have no authority to modify this
8 Agreement except as expressly provided in this Agreement.
9 6.2 Non-Assignment. No parties may assign its rights or delegate its obligations under
10 this Agreement without the prior written consent of all parties.
11 6.3 Governing Law. The laws of the State of California govern all matters arising from
12 or related to this Agreement.
13 6.4 Jurisdiction and Venue. This Agreement is signed and performed in Fresno
14 County, California. The parties consent to California jurisdiction for actions arising from or
15 related to this Agreement, and, subject to the Government Claims Act, all such actions must be
16 brought and maintained in Fresno County.
17 6.5 Construction. The final form of this Agreement is the result of the parties' combined
18 efforts. If anything in this Agreement is found by a court of competent jurisdiction to be
19 ambiguous, that ambiguity shall not be resolved by construing the terms of this Agreement
20 against either party.
21 6.6 Days. Unless otherwise specified, "days" means calendar days.
22 6.7 Headings. The headings and section titles in this Agreement are for convenience
23 only and are not part of this Agreement.
24 6.8 Severability. If anything in this Agreement is found by a court of competent
25 jurisdiction to be unlawful or otherwise unenforceable, the balance of this Agreement remains in
26 effect, and the parties shall make best efforts to replace the unlawful or unenforceable part of
27 this Agreement with lawful and enforceable terms intended to accomplish the parties' original
28 intent.
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1 6.9 Nondiscrimination. During the performance of this Agreement, the parties shall not
2 unlawfully discriminate against any employee or applicant for employment, or recipient of
3 services, because of race, religious creed, color, national origin, ancestry, physical disability,
4 mental disability, medical condition, genetic information, marital status, sex, gender, gender
5 identity, gender expression, age, sexual orientation, military status or veteran status pursuant to
6 all applicable State of California and federal statutes and regulation.
7 6.10 No Waiver. Payment, waiver, or discharge by the parties of any liability or obligation
8 of the parties under this Agreement on any one or more occasions is not a waiver of
9 performance of any continuing or other obligation of the parties and does not prohibit
10 enforcement by the parties of any obligation on any other occasion.
11 6.11 Differences Arising from Interpretation of Agreement. Every effort shall be made
12 by all parties concerned to amicably resolve differences in the interpretation of this Agreement.
13 If differences cannot be resolved informally at a Division/Program Manager level, they be
14 referred to the Chief Probation Officer, DPH Director and/or DBH Director, or respective
15 designees, for resolution.
16 6.12 Entire Agreement. This Agreement, including its exhibits, is the entire agreement
17 between Probation, DPH and DBH with respect to the subject matter of this Agreement, and it
18 supersedes all previous negotiations, proposals, commitments, writings, advertisements,
19 publications, and understandings of any nature unless those things are expressly included in
20 this Agreement. If there is any inconsistency between the terms of this Agreement without its
21 exhibits and the terms of the exhibits, then the inconsistency will be resolved by giving
22 precedence first to the terms of this Agreement without its exhibits, and then to the terms of the
23 exhibits.
24 6.13 No Third-Party Beneficiaries. This Agreement does not and is not intended to
25 create any rights or obligations for any person or entity except for the parties.
26 6.14 Authorized Signature. Probation, DPH and DBH represent and warrant that:
27 (A) Probation, DPH and DBH are duly authorized and empowered to sign and
28 perform their obligations under this Agreement.
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1 (B) The individual signing this Agreement on behalf of Probation, DPH and DBH is
2 duly authorized to do so and his or her signature on this Agreement legally binds
3 Probation, DPH and DBH to the terms of this Agreement.
4 6.15 Electronic Signatures. The parties agree that this Agreement may be executed by
5 electronic signature as provided in this section.
6 (A) An "electronic signature" means any symbol or process intended by an individual
7 signing this Agreement to represent their signature, including but not limited to (1) a
8 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
9 electronically scanned and transmitted (for example by PDF document) version of an
10 original handwritten signature.
11 (B) Each electronic signature affixed or attached to this Agreement (1) is deemed
12 equivalent to a valid original handwritten signature of the person signing this Agreement
13 for all purposes, including but not limited to evidentiary proof in any administrative or
14 judicial proceeding, and (2) has the same force and effect as the valid original
15 handwritten signature of that person.
16 (C)The provisions of this section satisfy the requirements of Civil Code section
17 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3,
18 Part 2, Title 2.5, beginning with section 1633.1).
19 (D) Each party using a digital signature represents that it has undertaken and
20 satisfied the requirements of Government Code section 16.5, subdivision (a),
21 paragraphs (1) through (5), and agrees that each other party may rely upon that
22 representation.
23 (E) This Agreement is not conditioned upon the parties conducting the transactions
24 under it by electronic means and either party may sign this Agreement with an original
25 handwritten signature.
26 6.16 Counterparts. This Agreement may be signed in counterparts, each of which is an
27 original, and all of which together constitute this Agreement.
28 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Agreement on the date stated in the introductory clause.
2
Probation Department Department of Public Health
3
4
5 Kirk Hayne's', 01hief Probation Officer Joe rado, Director
6 Date: 12/2/2025
Date:
7
8
9 Department of Behavioral Health
10 jaw
11 Susan Holt(Jan 13,2026 08:47:22 PST)
Susan L. Holt, LMFT, Director
12
13 Date: Jan 13,2026
14
15
For accounting use only:
16
Probation
17 Org No.: 34409999
Account No.: 5957
18 Fund No.: 0001
19 Subclass No.: 10000
20 DPH
Org No.: 56201684
21 Account No.: 7910
Fund No.: 0001
22 Subclass No.: 10000
23 DBH
24 Org No.: 56302125
Account No.: 7295
25 Fund No.: 0001
Subclass No.: 10000
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Exhibit A
Inter-Departmental Agreement-Probation,DPH and DBH
Wellpath JJC A-24-312 Budget
FY 2025-26
JJC Probation to Budget %of Total
Contract Professional&Specialized $ 4,150,531.13 100.00%
TOTAL Appropriations $ 4,150,531.13 100.00%
DPH Health Realignment $ 1,921,829.00 46.30%
DBH Mental Health Realignment $ 1,655,429.00 39.88%
Probation $ 573,273.13 13.81%
TOTAL Revenues $ 4,150,531.13 100.00%
A-1