HomeMy WebLinkAbout32253State of California--Health and Human Services Agency
Agreement No. 14-407-1
Department of Health Care Services
ENCLOSURE 1
COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT (MHBG)
ALLOCATION WORKSHEET
STATE FISCAL YEAR 2014-15 FEDERAL CATALOG NO. __ _,9:_::3:.:-.9:::_58=---
COUNTY FRESNO REVISION NUMBER 1 ------'-----
The California State Department of Health Care Services (DHCS), under provisions of
42 United States Code, Sections 300x et. seq., Public Law 106-310, and the State
Budget Act of 2015 (Chapter 25, Statutes of 2015), is authorized to allocate the
mental health portion of the Federal MHBG funds to counties for State Fiscal Year
(SFY) 2014-15. Please note that these allocation amounts are subject to further
adjustments, as amounts are identified, which include, but are not limited to,
Gramm-Rudman reductions, prior years' audit recoveries and retained unexpended
amounts. Your allocation is identified below.
I. GROSS EXPENDITURE LEVEL
A MHBG Funding Base
B. Dual Diagnosis Set-Aside
C. First Episode Psychosis Set-Aside
D. Total Authorized Gross Expenditure Level
II. NET ALLOCATION REIMBURSABLE
$1,345,094
$418,899
$75,163
$1,839,156
$1,839,156
***********************************************************************************************************************
PURPOSE: Initial Allocation DATE: July 25, 2014
***********************************************************************************************************************
I, the undersigned, have accepted the Federal MHBG funds for the county under those conditions
established by governing federal and state laws, policies, regulations, and guidelines as well as the
specific conditions included i . he County Application.
Deborah A. Poochigian, Chairman, Boar
Printed Name
DHCS 1772A Rev (04/13)
-.
ATIEST:
BERNICE E. SEIDEL, Cieri<
Board of Supervisors
By ~ ~.sho::p
Deputy
Ott oi~Lex= 13 , JJJ /..5
DATE I
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State of California--Health and Human Services Agency Department of Health Care Services
ENCLOSURE 1
COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT (MHBG)
ALLOCATION WORKSHEET
STATE FISCAL YEAR 2014-15 FEDERAL CATALOG NO. __ ___:::93::.:·.::::95:::.:8::...._ __
COUNTY FRESNO REVISION NUMBER ___ __:2:__ __ _
The California State Department of Health Care Services (DHCS), under provisions of
42 United States Code, Sections 300x et. seq., Public Law 106-310, and the State
Budget Act of 2015 (Chapter 25, Statutes of 2015), is authorized to allocate the
mental health portion of the Federal MHBG funds to counties for State Fiscal Year
(SFY) 2014-15. Please note that these allocation amounts are subject to further
adjustments, as amounts are identified, which include, but are not limited to,
Gramm-Rudman reductions, prior years' audit recoveries and retained unexpended
amounts. Your allocation is identified below.
I. GROSS EXPENDITURE LEVEL
A. MHBG Funding Base
B. Dual Diagnosis Set-Aside
C. First Episode Psychosis Set-Aside
D. Total Authorized Gross Expenditure Level
II. NET ALLOCATION REIMBURSABLE
$1,345,966
$418,899
$90,518
$1,855,383
$1,855,383
***********************************************************************************************************************
PURPOSE: Revised Allocation DATE: May 18, 2015
***********************************************************************************************************************
I, the undersigned, have accepted the Federal MHBG funds for the county under those conditions
established by governing federal and state laws, policies, regulations, and guidelines as well as the
specific conditions include ·n the County Application.
Printed Name
DHCS 1772A Rev (04/13)
ATIEST:
BERNICE E. SEIDEL, Clerk
Board of Supervisors
By .3ust\N), &sbq-p
Deputy
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11
1
13
14
15
16
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18
19
20
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23
24
25
26
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30
31
32
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31
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38
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State of California -Health and Human Services Agency
FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPE OF GRANT: MHBG
COUNTY: FRESNO
FISCAL CONTACT: Jeannie Hurtado, Business Manager
TELEPHONE NUMBER: 559-600-4601
EMAIL ADDRESS: jhurtado@co.fresno.ca.us
PROGRAM NAME: SUMMARY ALL PROGRAMS
::;
IANNIIAI
TITLE OF POSITION I ~ALARY
(TOTAl:::; I At-~ (sum lines 1 thru $ -
fT :Costs
loooHoo SED Dual : Prog.-L
J8lf : Svcs. Proq. -C : Corizon Health, Inc.
IFEPT Aqe Youth and First Onset·
:(Where , lease or rent) (I
;(
11 ravel :per-diem, , & vc,.ovoc ""
Other
CO~~ AUMINI::> (Rfo.TIVE vU<:>I<:> (10%
fNET ~ (sum lines 12 thru 37)
THt:K FUNDING ~nl I Funds
I Funds ~FU CES (sum lines 39 & 40)
fCOSTOF I (sum lines 38 and 41)
DHCS 1779 (04/13)
G~~T
0.0~
Department of Health Care Services
Enclosure 7
Page 1
STATE FISCAL YEAR: 2014-2015
1 2 3
LAS~UDGET VEl) ~ ... ,!!~OR ( TOTAL
I$ -
I$ -
-
-
-
-
-
-
---
I$ . $ . .
-
$ 34Q.OOO -~'" nnn
$ 1, lOO'> 872 1,.<?£ ~'"
$ 75,163 15~5-90.518
-
-
-
-.
-
-
-
-
-
-
-.
-.
-
-
-
-
-
1$ 1,839;i56 [$ 16,227 1 ~~~ ~R~
I$ . $ .
I$ 1,839,156 I$ 16,227 $
DHCS APPROVAL BY:
TELEPHONE:
DATE:
State of California -Health and Human Services Agency
FEDERAL GRANT DETAILED PROGRAM BUDGET
Department of Health Care Services
Enclosure 7
Page 3
STATE FISCAL YEAR: 2014-2015
TYPE OF GRANT: MHBG
COUNTY: FRESNO SUBMISSION DATE: Revised August 11,2015
FISCAL CONTACT: Jennifer Pardo PROGRAM CONTACT: Jennifer Pardo
TELEPHONE NUMBER: (559) 600-6437 TELEPHONE NUMBER: (559) 600-6437
EMAIL ADDRESS: jpardo@co.fresno.ca.us EMAIL ADDRESS: jpardo@co.fresno.ca.us
PROGRAM NAME: Jail Psychiatric Svcs Pros. -Contract Corizon Health, Inc.
3 I
4
8~
~TITLE OF POSITION
~I
I Mental Health
fMentarHeailh
~
Men . Health :1 DDX
r-DDX
ANNUAL I GRANT
SALA~ FTE
$181,2!!!: 0.83
i96,300 0.96
;ac :t20 0.96
1
LAST APPROVED
BUDGET
92,743
78,123
2' •7
1:
2 3
TOTAL
150,645
92,809
1
E
o I r-DDX i]55 41 14
1n .1 ~o.J...;----~+;.--~2::::;;6:-l
11 .3:!3 10,330
12fiiJUrSei' i 677.532 1.9 74,6118 53 74,721
13 IT $76.256 76,207 49 76,256
141Benfits DDX $137,474 ~ 79 137,474
15 (TOT'ALSTAFF >{sum lines 1 thru 13) 1 $ 1 14.76 s ~ttt!:s:::::::!)778~st::~!ti~
'" iT( Costs I -
~~~~-------------------+----4------Hr---__,:
21~--------------------------------------------~----------+-----------~~-------~-22 -
24 -
n i •
26 -
27~--------------------------------~--------+-------~~----~-28 -
29 -
~rriTffiVEraverii-~Perrdidi'erTI.em,Mile;Qe0,&rVE~~~'~Remer~~~e------------lr--------t---------t~------~l
n -
34~--------------------------------~--------+-------~~----~-35 -
3E -
::~----------------------------------+------+--------~-----~:
3! -
~T'{A lTRATIVEGO::il (10% If 142,399 I $ 87
4'INEI 1-'KUuKAIVI nsumTines 15 tnru 3!1) I IT 1 1 $ 872 $
:F 1 I Funds
~es4'1&~ I$ ~~tt-1!:$::::::~~-j:$::~~~~-~~~~~~ a.~rncl::; 4J3::bl======d.-.:b$=~1.~993 I :!> t I~ I :>
State of California -Health and Human Services Agency
FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPE OF GRANT: MHBG
STAFFING
ANNUAL GRANT
TITLE OF POSITION SALARY FTE
1
2
3
4l'OTA[1lTAFF fTsum lines 1 thru 11T $ -0.00
5 Consultant I Contract Costslltemizel:
6 Felton Ins!.: Coonitive Behavioral ThO.T6 staff IOJ $1,500 each; 2 supervisors @ $2
7 Summarv: Psvchosis Trainina
s STARS Trainina-AcaderiiV: Traininafor Peer Sucoortl11 staff@ $4,839.33 eactif
s Summarv: TIP ModefTTransition to lndeoendence Process
o Coordinated Soecialtv Care CSC Model Consultant-Train ina PackaQe for 12 st
1 Summary: Evidence-Based Treatments for First Episode Psychosis Training
2 Eaui ment (Where feasible lease or rent Itemize):
3
4
5
6
7
B
9
0
1 SUnnlies fltemiz~
2
3
4
5
6 Travel -Per diem, Mileaoe, & Vehicle Rental/Lease
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
4
4
4
7
a Other Exnenses Itemize\:
9
0
1
2
3
4
5
6
7 COUNTY ADMINISTRATIVE COSTS (1% MHBG)
s NET PROGRAM EXPENSES (sum lines 12 thru 37)
9 OTHER FUNDING SOURCES: Federal Funds
0 Non-Federal Funds
1 TOTAL OTHER FUNDING SOURCESisum lines 39 & 40
2 GROSS COST OF PROGRAMisum lines 38 and 41l
DHCS 1779 (04/13)
I
Department of Health Care Services
Enclosure 3
Page4
STATE FISCAL YEAR: 2014-2015
SUBMISSION DATE: Revised August 17,2015
E-MAIL ADDRESS: javery@co.fresno.ca.us
1 2 3
LAST APPROVED REQUESTOR
BUDGET CHANGE TOTAL
$ -
$ -
$ -
$ -$ -$ -
$ -
$ 26,000 $ (12,000 $ 14,000
$ -
$ 29,036 $ 24,197 $ 53,233
$ -
$ 20,000 $ 2,029 $ 22,029
$ -
$ -
$ 127 $ 1,129 $ 1,256
$ 75,163 $ 15,355 $ 90,518
$ -$ -$ -
$ 75,163 $ 15,355 $ 90,518
DHCS APPROVAL BY:
TELEPHONE:
DATE:
II
State of California -Health and Human Services Agency
2014-2015
Department of Health Care Services
Enclosure 2
MHBG PROGRAM DATA SHEET
Complete one sheet for each MHBG funded program that supports transformation activities (as budgeted).
COUNTY: Fresno
PROGRAM TITLE: Transition Aged Youth and First Onset-Psychosis
PROGRAM CONTACT/TITLE: Jeffrey Avery. LMFT. Clinical Supervisor
Phone#: (559) 600-4681 FAX: (559) 600-4665 E-Mail: javery@co.fresno.ca.us
MHBG FUNDING LEVEL: (Grant Detailed Program Budget, DHCS 1779, Line 38, Net Cost) $90,518
TARGET POPULATION(S): (ESTIMATED NUMBER OF CONSUMERS TO BE SERVED IN THE YEAR WITH MHBG FUNDS)
SMI ADULT _,:=.30""-,35"---SMI OLDER ADULT SED CHILD -~1 O>L·:..;20!!0'---
TYPES OF TRANSFORMATIONAL SERVICE(S) PROVIDED
• Check all categories that are applicable
• Please elaborate in the narrative portion of the application
Is MHBG funding used
Transformational Categories to support this goal?
If yes, Please check ('/)
Americans Understand that Mental Health is Essential to Overall Health v
Mental Health Care is Consumer and Family Driven v
Disparities in Mental Health Services are Eliminated v
Early Mental Health Screening, Assessment, and Referral to Services are Common Practice v
Excellent Mental Health Care is Delivered and Research is Accelerated v
Technology is Used to Access Mental Health Care and Information v
ADDITIONAL COMMENTS:
Revised 7/28/15
DHCS 1751 (04/14)
II
Community Mental Health Services Block Grant {MHBG)
First Episode Psychosis {FEP) Set-Aside-Program Narrative
County of Fresno Department of Behavioral Health
A. STATEMENT OF PURPOSE: reflects the values and principles that guide program implementation
and how the county ensures team members acquire and maintain those values and principles.
Those values and principles should include a focus on recovery, shared decision-making that is
client-centered, and maintenance of an optimistic therapeutic perspective at all times.
In servicing clients of Fresno County's existing program for first episode psychosis (FEP),
Transitional Age Youth (TAY) and First Onset-Psychosis (FOT), Fresno County Behavioral Health will
continue to employ a community-based, multi-dimensional team approach that incorporates the
evidence-based practices of Transition to Independence Process (TIP) model and Cognitive
Behavioral Therapy-Psychosis (CBTp) to further the unification of our current program components
of client-centered, strengths-based case management, psychiatry, therapy, family involvement, and
supportive education/employment into the cohesive framework of the Coordinated Specialty Care
(CSC) model and elevate the quality of care through the use of a high-fidelity model. These services
are partially funded through Mental Health Services Act (MHSA) Prevention and Early Intervention
(PEl) funds and are aligned with the MHSA guiding principles of community collaboration, cultural
competence, client/family-driven system of care, a focus on well ness and recovery, and the
provision of an integrated service experience. Our Department shall ensure that these values and
principles are acquired and maintained by our service providers through the provision of ongoing
and follow-up fidelity training and education based upon annual program review. The FEP funding
will be used during Fiscal Year (FY) 2014-2015 for training and consultation.
B. TARGET POPULATION: Identify the age range of the population that will be served with these
funds and the specific FEP disorders (e.g., schizophrenia, bipolar disorder) that will be targeted
with these funds.
The age range for the FEP disorders target population is 16-28 years of age and will consist of
individuals who are experiencing their first onset of psychosis. FEP disorders that will be targeted
include: psychotic disorder NOS, the entire spectrum of schizophrenia disorders, and major
depression with psychosis, bipolar with psychosis, along with delusional and brief psychotic
disorders.
Provide an explanation of why this population wos chosen.
The population's age range and spectrum of diagnosis was chosen by Fresno County in response
to our findings in our community over the past five years. Findings in Fresno County are supported
by a growing body of research that sites psychotic disorders, not just schizophrenia, as presenting
onset and maximum impact in late adolescence and early adult life. Furthermore, according to
Vancouver/Richmond Early Psychosis Intervention, several studies have shown that delays between
onset of psychotic symptoms and commencement of appropriate treatment can cause significant
disruption at a critical developmental stage and cause significant secondary problems. The longer
the period of untreated illness, the greater the risk for psychological and social disruption and
secondary morbidity, such as major depression, for the person and their family. Psychotic episodes
Rev 8/14/15 1
often result in isolation from others and cause difficulties in familial and social relationships.
Difficulties can be seen in school and work, and the consequences often include unemployment,
substance abuse, depression, conflict with law enforcement, and self-harm or suicide. Some studies
also show that long delays in treatment may cause the illness to become less responsive to
treatment.
Identify the number of individuals within the identified target population who are currently being
served in the program.
During FY 2013-2014, the TAY/FOT programs served a total of 300 unique clients who received a
diagnosis of one of identified psychotic disorders. Presently, the program caseloads contain 156
clients who meet the FEP criteria.
Identify the additional number of people who will be served as a result of receiving additional
funding.
The program enhancements, in addition to training and education of the treatment team
members on the evidence-based models as previously mentioned, will be focused on formalizing
partnerships with our new youth crisis stabilization center, psychiatric health facilities and other
referring providers (local hospitals, emergency departments (ED) and contracted providers) that
may serve as triage opportunities. This effort would result in a larger number of clients being served
by way of early detection through education and co-location of services and resources at an
estimated rate of 30-35 adult and 10-20 children in the identified target population.
An accurate projection of the number of clients that can be served resulting from this
collaboration requires an efficient and reliable inpatient hospitalization notification/reporting
system which we are in the process of developing with the local hospitals and EDs and incorporating
into our electronic health records system (Avatar). Furthermore, the program augmentations are
heavily geared towards improving client outcomes through better quality of care in addition to
strengthening relationships with referring organizations to bypass system barriers to accessing
appropriate services in a timely manner for individuals in the target population.
C. PROGRAM DESCRIPTION: Describe the existing program and describe how that program will be
expanded to serve more people, extend early identification, or how community outreach will be
extended to develop new referral relationships.
Fresno County is currently expanding the existing adult crisis stabilization center to serve both
youth and adolescents as well as constructing a state-licensed 16-bed Child-Adolescent Psychiatric
Health Facility (PHF) for youth ages 7-18 on our main mental health campus that will fill a void in
inpatient psychiatric services for youth placement within the county. We will be able to create a
seamless system of care targeting early intervention for our transition aged youth experiencing
psychosis by partnering closely with these programs. Our new program will be able to interface
with the Child-Adolescent esc and youth PHF, preventing hospitalization when appropriate,
providing immediate same day access to outpatient follow-up care, and providing seamless step-
down from hospitalization.
Rev 8/14/15 2
The FEP set-aside funding allocation available to Fresno County will be partially used to launch
professional training and education on three evidence-based models to the TAY/FOT clinical team
currently serving clients in the target population. The trainings include CBTp (Felton Institute), the
TIP model (STARS Behavioral Health Group-STARS Training Academy), and the esc model (Lisa
Dixon, MD MPH, Professor of Psychiatry, Columbia University Medical Center).
Describe the client and family engagement process.
Outreach to clients and their families would begin at the time of admission and continue
throughout treatment until discharge. Part of the discharge plan would include same day access to
their outpatient mental health services only a few yards from the PHF. Parents and caregivers would
be engaged throughout the hospital stay and encouraged to immediately attend our Family Group
for those with FEP. Providing this level of integrated care would allow for another expansion of an
evidenced-based practice of family group for clients and families experiencing FEP.
Describe the members af the treatment team.
The current staffing for the programs includes one Clinical Supervisor, four Mental Health
Clinicians, five Community Mental Health Specialists (also known as case managers), one part -time
(0.50 FTE) Psychiatrist, and one Peer Support Specialists. There are also ten vacancies and two
stipend positions we are working to fill to be at full capacity (five clinicians, three case managers,
one Psychiatrist, one peer provider, and two peer mentors). FEP set-aside funds will not be utilized
during SFY 2014-15 to fund staff positions.
Describe the role(s) of each team member.
Role of Clinical Supervisor:
The Clinical Supervisor has full supervisory responsibilities over clinical and support staff. These
responsibilities include interviewing, selecting, training, assigning, directing, monitoring, and
evaluating staff. The Clinical Supervisor consults with a Division Manager regarding program goals,
activities, policies, procedures, and communicates and interprets program goals, policies, and
procedures to staff, community agencies, clients, and the public. The Clinical Supervisor assures that
county, department, and program policies are properly implemented. He/she develops and
implements work schedules to assure proper program coverage. He/she ensures staff proficiency in
behavioral health information and other information system utilized by the particular program,
reviews case files to assure compliance with departmental and state policies, procedures and billing
requirements, as well as assists management staff in the development and monitoring of program
budgets.
Role of Mental Health Clinician:
The Mental Health Clinician classification series is utilized to provide professional mental health
services and individual, group, marital, and family therapy and counseling to mentally ill or
emotionally-disturbed children and adults. The Mental Health Clinician evaluates client psychosocial
dysfunction and formulates a behavioral health well ness and recovery service plan. The Clinician
conducts individual, group, marital, family therapy, case management, rehabilitation, and counseling
sessions as part of a behavioral health well ness and recovery service plan. He/she provides crisis
Rev 8/14/15 3
intervention services to clients as well as behavioral health consultative services to professional
personnel of other agencies to help them better serve their clients and families. Clinicians speak to
community lay and professional groups to promote behavioral health, well ness and recovery and
anti-stigma practices. He/she participates in staff development programs and in staff conferences
regarding clients' well ness and recovery and professional behavioral health approaches. The
Clinician counsels and consults with clients, families, other professional staff and community
agencies regarding recommendations for well ness and recovery service planning.
Role of Community Mental Health Specialist:
The Community Mental Health Specialist {CMHS) is responsible for providing case management
and supportive services to adults with chronic mental illness or co-occurring disorders and/or
emotionally disturbed children and youth. Incumbents receive training, close supervision, and
direction in the performance of assignments. The CMHS interviews clients, individually or in group
settings, to determine their barriers to recovery and related needs concerning the necessities of
day-to-day living such as housing, employment, and home budgeting. Under clinical direction, the
CMHS develops and implements a treatment plan to help the client reduce barriers to recovery and
address their needs concerning the necessities of day-today living. The CMHS also assists clients
toward achievement of recovery goals through implementation of both individual and group
interventions aimed at increasing skills and decreasing symptoms. The CMHS documents
interventions and client's progress in treatment.
Role of Peer Support Specialists:
Under immediate supervision, a Peer Support Specialist {PSS) provides information, support,
assistance, advocacy, and service effectiveness review for clients or family members/caregivers of
clients of the behavioral health system. The Peer Support Specialist classification is responsible for
monitoring, informing, supporting, assisting and empowering clients and their family/caregivers who
directly or indirectly receive behavioral health services. The Peer Support Specialist is also
responsible for developing and coordinating activities, programs and resources which directly
support clients and family/caregivers in achieving wellness and recovery-oriented goals; facilitating
peer-to-peer assistance as a part of a team setting; conducting outreach to clients,
families/caregivers and the community; and acting in a liaison role between clients,
families/caregivers and community service providers. He/she provides peer support and self-help
services to behavioral health clients or family members/caregivers of clients as appropriate. The PSS
assists clients to develop self-advocacy, communication and empowerment skills. He/she assists
clients in obtaining benefits, {i.e., SSI, General Relief, Medi-Cal/MediCare, Section 8, and/or
identification cards). Under immediate supervision, a PSS participates in resolving client concerns as
required.
Role of Psychiatrist:
The Psychiatrist responsibilities include providing complete psychiatric assessments which may
include physical assessments and examinations, psychiatric diagnosis, and treatments of both
chronic and episodic psychiatric disorders. The Psychiatrist interviews patients to obtain complete
psychiatric and medical histories and may perform limited physical examinations. The Psychiatrist
counsels patients regarding matters pertaining to their physical and mental health, arranges for
hospital admission of patients, and facilitates the referral of patients to appropriate health facilities,
agencies, and resources. He/she orders and interprets a variety of routine tests which may include
Rev 8/14/15 4
blood counts, chemistry panels, lipid panels, liver function tests, medication levels, EKG, etc. The
Psychiatrist provides direct and indirect clinical services to patients. He/she records findings of
mental and/or developmental assessments.
Role of Peer Mentor:
The Peer Mentor's primary duties include but are not limited to the following activities for
individuals in the target population; planning recreational activities, coordinating outings and
awards ceremonies, provision of ongoing after-care and support, advocacy, outreach and training,
recruitment of potential peer mentors.
Under immediate supervision, a Peer Mentor utilizes a peer-to-peer approach in working with
clients being served in the Transition Age Youth program. The role of the peer mentors is to support
TAY clients in increasing their independence, to increase their self-awareness, to encourage clients
in meeting their treatment goals, identify and link to resources in the community, to encourage and
facilitate community involvement, conduct outreach, and to participate in the program planning
process.
Specifically, the role of a peer mentor as an advocate is to coach and model for clients to
develop their self-advocacy skills, communication skills and to empower them towards their
recovery. Peer Mentors are supported in their role as a models and advocates for clients as
evidenced by their participation in the TAY subcommittee that was developed as part of the Quality
Assurance Committee for the Department of Behavioral Health. Their presence and input is
considered just as any other member of the committee that includes Clinical Supervisors and
Clinicians.
The role of Peer Mentor allows for in-vivo work experience that equips them to support and
encourage clients towards gainful employment versus relying on disability benefits. Mentors can
further assist clients by walking them through and supporting them in our on campus Supportive
Education and Employment Services program. This role is a means to assist clients to spring board
towards furthering their education and /or to gain employment to increase the client's
independence.
Describe the core services provided to the target population.
Currently the Fresno County Department of Behavioral Health utilizes Cognitive Behavioral
Therapy for Psychosis (CBTp) and Transition to Independence Process (TIP) Model to serve
individuals who are experiencing a first episode of psychosis.
Specific goals for implementation of the CBTp model will target the reduction of distress
associated with positive symptoms, functional impairments associated with negative symptoms and
well ness planning for relapse reduction with the overall aim of increasing functioning for these
individuals.
The TIP model utilizes an individualized process, engaging youth and young adults in a process of
futures planning concurrent with the provision of supports and services that are accessible,
coordinated, appealing, non-stigmatizing, trauma-informed, and developmentally-appropriate, and
Rev 8/14/15 5
that build on their own strengths. The TIP model involves youth and young adults, their families, and
other informal key players in a process that facilitates the youths' movement towards enhanced
self-sufficiency and successful achievement of personal goals. Young people are encouraged by case
managers and therapists to explore their interests and to envision a future that relates to
conventional transition domains of employment and career, education, living situation, personal
effectiveness/wellbeing, and community-life functioning.
Describe the process by which individuals are transitioned out of the Coordinated Specialty Care
{CSC} program.
Individuals are transitioned out of the Coordinated Specialty Care (CSC) program upon
completion of their goals. It is determined that clients have met their goals as evidenced by the
following: (1) meeting and sustaining their treatment plan goals, (2) success as measured by
outcome instruments, and (3) client and multidisciplinary input. Transition out of the CSC program
can appear different for each client dependent upon such factors as Stage of Change, level of
functioning, recovery needs, and necessary resources.
The target goal for completion of the program is 1-2 years. Transition would include a
multidisciplinary case staffing including the client and caregiver, if appropriate. The clients existing
Futures Plan would be reviewed as a means for staff and client to evaluate the next logical step to
support the client in his or her ongoing recovery. This transition plan could include a step-down to a
lower level of care such as our Metro Outpatient division or to a contracted private provider in the
community. Transitions may or may not include ongoing clinical services depending on the client's
needs, successful independence, and well-being. For instance some clients who have successfully
achieved a high degree of recovery may be stable and thriving as evidenced by independent living,
employment, involvement with community resources, volunteering, or completing their education
as a step towards initial or a step up in their careers. In the instance that a client is not achieving
their goals in the esc program then a multidisciplinary case staffing would occur, including the client
and caregiver, if appropriate to determine a higher level of care such as a Full Service Partnership
TAY program, inpatient co-occurring treatment, or consideration for conservatorship.
Describe how community outreach will be extended to develop new referral relationships.
The enhanced program will be able to interface with the Child-Adolescent esc and Youth PHF
preventing hospitalization and when appropriate, providing immediate same day access to
outpatient follow-up care, and providing seamless step-down from hospitalization. Additional new
referral relationships will be established by partnering with the National Association for the
Mentally Ill, local state and community colleges, local hospitals and law enforcement.
D. STAFF ROSTER: Specifies position title, toto/ full time equivalency (FTE) for the program; and the
total MHBG dollars paid for by the FEP Set-Aside. MHBG positions must be listed in this section
and must match the submitted budget(s).
Fresno County is not requesting new positions to be funded through the FEP Set-Aside allocation
at this time due to the uncertainty of the available FEP funding on a continuing basis and the
sustainability of hiring new staff by the Department.
Rev 8/14/15 6
1
2
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AMENDMENT TO SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION (SAMSHA) COUNTY COMMUNITY MENTAL HEALTH BLOCK GRANT
(MHBG) RENEWAL APPLICATION FY 2014-15
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BERNICE E. SEIDEL, Clerk
Board of Supervisors l
By Ju~ ~sbo-p
~
PLEASE SEE ADDITIONAL
SIGNATURE PAGE ATTACHED
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COUNTY OF FRESNO
Fresno, CA
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APPROVED AS TO LEGAL FORM:
DANIEL C. CEDERBORG, COUNTY COUNSEL
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
A~-{1 ..
By ________ ~~~~~---------
REVIEWED AND RECOMMENDED FOR
APPROVAL:
By___.,&-::o....:..:::..~--.:=.!.::....~~'--~-
Dawan Utecht
Director, Department of Behavioral Health
By ~~~&dr
David Pomaville
Director, Department of Public Health
Fund/Subclass: 0001/1 0000
Organization: 5630 ($430,518); 5620 ($1 ,469, 71 0)
Account/Program: 4380
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Date: _1Lj/!...!:2-~t-l-/~(..lc_-__
Date:
Date: _..Lq..!..:/a:2.t..'..!/1-'='!5~_
Date: rfo I I I£"
COUNTY OF FRESNO
Fresno, CA