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HomeMy WebLinkAboutContracts & Agreements_203-2018RW 7-12-10 REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS OF SAN BERNARDINO COUNTY, CALIFORNIA AND RECORD OF ACTION December 18, 2018 FROM. VERONICA KELLEY, Director Department of Behavioral Health SUBJECT. NON-FINANCIAL MEMORANDA OF UNDERSTANDING FOR DEDICATED OFFICE SPACE Approve non-financial Memoranda of Understanding with the following agencies for dedicated office space for the Department of Behavioral Health staff to provide crisis services, for the period of January 1, 2019 through December 31, 2023 1. Desert Valley Hospital Agreement No 18-883 2 Redlands Police Department Agreement No 18-884 3. San Bernardino Police Department Agreement No. 18-885 4 Victor Valley College Agreement No 18-886 (Presenter Veronica Kelley, Director, 388-0801) Provide for the Safety, Health and Social Service Needs of County Residents Pursue County Goals and Objectives by Working with Other Agencies This item does not Impact Discretionary General Funding (Net County Cost) The non-financial Memoranda of Understanding (MOU) allows the Department of Behavioral Health (DBH) to utilize office space located within the agencies in the Recommendation at no cost to the County in order for DBH to provide crisis services through the Triage, Engagement and Support Team (TEST) program Since 2015, DBH has partnered with various key agencies, for no cost office space to place DBH crisis triage staff In Underserved areas throughout San Bernardino County. DBH-selected agencies, known as 'points of access' such as law enforcement, hospital emergency departments, colleges, and agencies within the judicial court system, to assist consumers experiencing a mental health crisis The TEST team's co -located program allows immediate access to crisis triage by a mental health specialist, which has resulted in thousands of cc DBH - Forthun w/ agreements Contractor c/o DI3H w/ agreement DBH - Kelley DBH - Hoatsdn CAO - Lange File - w/ agreement mr 12/27/2018 MOTION ILA IBY ITEM 22 DATED: Record of AP Page 1 of 2 Supervisors NNENDAR) O OVE AYE 4 3 NON-FINANCIAL MEMORANDA OF UNDERSTANDING FOR DEDICATED OFFICE SPACE DECEMBER 18, 2018 PAGE 2OF2 successful outcomes In 2017-18, there were 3,840 encounters with co -located DBH TEST staff that many resulted in crisis stabilization versus unnecessary incarcerations and/or hospitalizations Crisis stabilization with case management and linkage to appropriate services reduce expenditures for law enforcement resources and hospital emergency departments The non-financial MOUs outline the use of office space for the TEST service team to provide these services Desert Valley Hospital, Redlands Police Department, and Victor Valley College are new collaborating partners San Bernardino Police Department has collaborated with DBH on crisis services since 2015 The recommended non-financial MOUs will allow DBH to utilize dedicated office space through December 31, 2023, and may be terminated by either party without cause The MOUs reaffirm DBH's commitment to provide access to crisis services for underserved populations at a variety of collaborated sites throughout San Bernardino County PROCUREMENT N/A REVIEW BY OTHERS This item has been reviewed by Behavioral Health Contracts (Ellayna Hoatson, Contract Supervisor 388-0858) on November 15, 2018, County Counsel (Frank Salazar, Deputy County Counsel, 387-5455) November 20, 2018, Finance (Christopher Lange, Administrative Analyst, 386-8392) on November 28, 2018, and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on November 29, 2018 1211$12018 #22 NO Y Behavioral Health Department Contract Representative Telephone Number Contractor Contractor Representative Telephone Number Contract Term Original Contract Amount Amendment Amount Total Contract Amount Cost Center . ►frt umber SAP Number NIA Debbie Forthun Kitchen 909-388-0862 City of Redlands Lieutenant Stephen Crane 909-335-4794 01/01/2019 — 12/31/2023 Non-financial Briefly describe the general nature of the contract This non-financial Memorandum of Understanding (MOU) serves to identify areas of agreement and responsibility between the County of San Bernardino Department of Behavioral Health (DSH) and the above named City regarding utilization of a no cost, designated office space within the City by DBH Triage, Engagement, and Support Teams (TEST) to provide community crisis triage services for City referred clients FOR COUNTY USE ONLY Approved as to Legal Fo ■ Frank Salazar, De County /}Counsel Date — Revi d for Contract Compliance Natalie Kes a nt4,ccts a ger Date k Z` 5 ■ Date Non -Standard Contract Coversheet Revised 10/18/17 MEMORANDUM OF UNDERSTANDING Between Department of Behavioral Health And The City of Redlands For Dedicated Office Space January 1, 2099 WHEREAS, the San Bernardino County (County), Department of Behavioral Health hereinafter referred to as DBH, and the City of Redlands (City), and WHEREAS, DBH desires to expand consumer rapid access to mental health crisis care through community Triage, Engagement and Support Teams (TEST) and have community office space available for the mobile Community Crisis Response Teams (CCRT) DBH will do so by collaborating for dedicated office space, at no cost, within agencies that have the highest contact with consumers experiencing a psychiatric emergency These agencies, named 'points of access' are law enforcement, hospital emergency rooms, schools and court related agencies, and WHEREAS, DBH has been allocated funds by the Mental Health Services Act (MRSA) to provide such services, and WHEREAS, City is willing and able to provide adequate, non-financial, dedicated office space located in the City's Police Department, specifically for DBH services provided by co -located TEST staff, and CCRT mobile field staff to assist/link consumers, and NOW THEREFORE, in consideration of the mutual promises contained herein, DBH and City agree as follows Page 1 of 10 TABLE OF CONTENTS I PURPOSE 3 II DEFINITIONS 3 III COLLABORATING CITY FACILITY REQUIREMENTS 4 1V CITY GENERAL RESPONSIBILITIES 4 V DBH GENERAL RESPONSIBILITIES 5 VI MUTUAL RESPONSIBILITIES 6 VII RIGHT TO MONITOR AND AUDIT 8 VIII TERM 9 IX EARLY TERMINATION 9 X GENERAL PROVISIONS 9 XI CONCLUSION 10 Attachment Exhibit A — Description of Triage, Engagement and Support Teams (TEST) Services Page 2 of 10 PURPOSE This Memorandum of Understanding (MOU) serves to identify areas of agreement and responsibility between City and the Department of Behavioral Health (DBH), regarding the use of dedicated office space within City's Police Department for co -locating DBH TEST program staff and DBH's mobile field staff to assist/link consumers with community services DBH will assign the TEST staff that will utilize office space within City location here Redlands Police Department 30 Cajon Street Redlands, CA 92373 (909)335-4744 The MOU is a joint effort to bring responsive access to mental health crisis services to the Redlands community, at no charge, for a consumer in need In exchange for City's space and responsibilities hereunder, the TEST staff shall provide crisis assessments, intervention, and intensive case management with linkage to community resources DBH mobile -field staff will also be utilizing the dedicated office space as outlined in attached Exhibit A II. DEFINITIONS A The terms consumer, resident, individual, client or participant are used interchangeably throughout this MOU referring to the individual inquiring, accessing and/or receiving services B Authorization for Release of Protected Health Information (PHI)- A HIPAA compliant authorization signed by the client or client's legal representative, authorizing DBH to release the client's information to a designated recipient This form must be completed thoroughly with specified records to be shared, a designated time frame and expiration date, as well as a signature by the DBH client or his/her legal representative If the form is signed by a legal representative, proof from the court system designating legal representation must accompany the request C Department of Behavioral Health (DBH) The San Bernardino County Department of Behavioral Health, under state law, provides mental health and substance use disorder treatment services to County residents In order to maintain a continuum of care, DBH operates or contracts for the provision of prevention and early intervention services, 24-hour care, day treatment outpatient services, case management, and crisis and referral services Community services are provided in all major County metropolitan areas and are readily accessible to County residents D Health Insurance Portability and Accountability Act (HIPAA)• A federal law designed to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes E Mental Health Services Act (MHSA)• Mental Health Services Act, also known as Proposition 63, imposes a 1% tax on adjusted annual income over $1,000,000 In November 2004, California voters passed Proposition 63 to adopt the MHSA According to the MRSA, the intent of the funding is to reduce the long term adverse impact on individuals, families, and State and local budgets resulting from untreated serious mental illness Page 3 of 10 F Personally Identifiable Information (PII) PII is information that can be used alone or in conjunction with other personal or identifying information, which is linked or linkable to a specific individual This includes name, social security number, date of birth, address, driver's license, photo identification, other identifying number (case number, client index number, SIMON number/medical record number, etc ) G Protected Health Information (PHI) PHI is individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper or oral individually identifiable information is information, including demographic data, that relates to the individual's past, present or future physical or mental health or condition, the provision of health care to the individual, or the past, present, or future payment for the provision of health care to the individual, and identifies the individual or for which there is reasonable basis to believe it can be used to identify the individual PHI excludes individually identifiable health information in education records covered by the Family Educational Rights and Privacy Act, as amended, 20 U S C 1232g, in records described at 20 U S C1232g(a)(4)(B)(iv), in employment records held by a covered entity in its role as employer, and regarding a person who has been deceased for more than fifty (50) years H Triage, Engagement and Support Teams (TEST)- Triage teams specializing in crisis intervention, continuum of care, and intensive case management for individuals experiencing an urgent psychiatric health condition with up to 59 days of individualized linkage and follow up services The goal is to improve consumer experience by improving access to mental health services with local staff and rapid response times, allowing the consumer to possibly stay within their own community and strengthening their opportunity for recovery and wellness while reducing involvement with the criminal justice system, reducing frequencies of emergency room visits and/or unnecessary hospitalization III COLLABORATING CITY FACILITY REQUIREMENTS City will A Provide adequate workspace for DBH staff within City facilities Adequate workspace shall include a personal work area with a desk, chairs and secure document storage B Provide a designated area for consultation of consumers as required C Provide a parking space for a County or DBH staff vehicle D Provide access to a desk phone, fax machine and photocopier E Provide DBH staff access to staff restrooms and breakroom F Maintain and relay safety/security procedures related to DBH staff assigned to City G Assign building passes and office keys as needed to TEST staff, and/or DBH employees regularly assigned to City IV CITY GENERAL RESPONSIBILITIES A City will not assign this MOU, either in whole or in part, without the prior written consent of DBH B City shall make available to the DBH Program Manager (PM) copies of all administrative policies and procedures utilized and developed for this service location(s) and shall maintain ongoing communication with the DBH PM regarding those policies and procedures Page 4 of 10 C City is aware that DBH is required by regulation to guard Personally Identifiable Information (PII) and Protected Health Information (PHI) from unauthorized use or disclosure such as names and other identifying information concerning persons receiving services pursuant to this MOU D Information obtained by DBH for participants is PHI and any DBH documents stored at City are highly sensitive and confidential, therefore, City shall provide DBH with secure document storage and use the same physical safeguards related to such document storage that City uses to safeguard its own lawfully protected information E Should City find the need to obtain PHI about a consumer, City shall request the consumer complete the DBH Authorization for Release of Protected Health Information (COM001) form prior to any discussion or release regarding consumer PHI, including but not limited to diagnosis treatment, and/or outcomes The form must state DBH can share consumer's PHI with City personnel, with specified time frames including expiration date This provision will remain in force even after the termination of the MOU F City acknowledges DBH must track/report specified data required by Mental Health Services Act (MHSA) in a format approved by DBH Part of the necessary information measures the referrals and linkage to appropriate services designed to address the particular behavioral health issues being presented to law enforcement Qustice system), reduction of the time individuals needing mental health services spend within the justice system, reduced number of visits to assist the same consumer for behavioral health-related concerns post TEST involvement, and to facilitate assessments of individuals experiencing a mental health crisis that could result in inpatient hospitalization City further acknowledges that these tracking/reporting requirements may change per the County and/or the State V. DBH GENERAL RESPONSIBILITIES DBH will A In the least restrictive environment possible, provide crisis intervention designed to divert seriously mentally ill consumers from law enforcement encounters The primary usage of this office space is to 1 Provide crisis intervention services for consumers in surrounding community 2 Provide intensive case management for local consumers participating in TEST 3 Be the central location for TEST staff to link consumers to the appropriate public and/or private community resources for up to 59 days 4 Be an in-house asset to City in improving outcomes for consumers with behavioral health issues B Assign staff for a minimum of 40 hours a week to City This may include any combination of the following Social Worker II, Alcohol and Drug Counselor, and Clinical Therapist, for the purpose of providing crisis response services within the dedicated office space and in the field (exact service hours will be agreed upon between DBH Program Manager and City) C Adhere to City's required clearance protocols for assigned DBH staff prior to staff person utilizing dedicated office space D Occasionally utilize the space for the Community Crisis Response Team (CCRT) mobile staff Page 5 of 10 E Monitor and coordinate staff work schedules, as staff work hours may vary F Assign computers and cell phones to TEST staff ALL correspondence with TEST staff must be sent through the DBH email system No other City email is to be allocated to the TEST staff DBH staff shall adhere to the DBH Electronic Mail Policy G Provide administrative supervision to all DBH staff located or utilizing the City offices Any concerns or suggestions regarding any type of matters shall be taken to the DBH Program Manager, supervisory staff or his/her designee H Communicate with the appropriate City supervisory staff or his/her designee with any concerns and/or suggestions for overcoming problem areas and/or changing procedures related to facility usage or supervision Maintain authority and responsibility for the assignment and/or reassignment of all TEST staff J Address the MHSA goals, measure and report outcomes in collaboration with City by increasing access to mental health services, reducing criminal and juvenile justice involvement while also reducing frequency of emergency room visits and unnecessary hospitalizations within the local community K Maintain consumer records in compliance with all regulations set forth by the State and provide access to clinical records by DBH staff L Pursuant to HIPAA, implement administrative, physical, and technical safeguards to protect the confidentiality, integrity, and availability of health information that is transmitted or maintained in any form or medium M Obtain HIPAA compliant Authorization for Release of PHI for each consumer prior to any discussions/sharing with City regarding any consumer's PHI, including, but not limited to, diagnosis, treatment, and/or outcomes in the performance of required services VI MUTUAL RESPONSIBILITIES A DBH TEST staff will coordinate with City staff for the purpose of providing crisis intervention services and intensive case management and linkage for referred consumers B City and DBH agree to develop a program unique to City needs and internal procedures for optimal utilization of TEST services and fulfilment of consumer needs as outlined in Exhibit A of this MOU C The Parties must comply with relevant regulations for any release of information City and DBH agree they will establish mutually satisfactory methods for the exchange of such information as may be necessary in order that each party may perform its duties and functions under this MOU Both parties will develop appropriate procedures to ensure all information is safeguarded from unauthorized disclosure in accordance with applicable State and Federal laws and regulations, and as referred herein D City and DBH agree they will establish mutually satisfactory methods for problem resolution at the lowest possible level as the optimum, with a procedure to mobilize problem resolution up through the City and DBH mutual chain of command, as deemed necessary E City and DBH agree to develop and implement procedures and forms necessary to administer and document each program referral, participation, compliance and effectiveness Page 6 of 10 F City and DBH agree to develop internal procedures for resolving grievances including the specific steps a consumer must follow, and the time limits for resolution G City and DBH agree to comply with all applicable local, State, and Federal laws H City and DBH shall not charge each other for any of the items or services provided hereunder Indemnification and Insurance Requirements 1 City agrees to defend, indemnify and hold harmless the County, it's officers, staff, agents, and volunteers for any and all claims, losses, actions, damages and/or liability resulting from this agreement/contract from any cause whatsoever, including any costs or expenses incurred by County, except as prohibited by law, arising out of the City or City Police Department's negligent or wrongful acts or omissions in connection with its performance under the herein agreement 2 The County agrees to defend, indemnify and hold harmless the City, it's officers, staff, agents, and volunteers for any and all claims, losses, actions, damages and/or liability arising out of this agreement/contract from any cause whatsoever, including any costs or expenses incurred by the City, except as prohibited by law, arising out of County's or DBH's negligent or wrongful acts or omissions in connection with its performance under the herein agreement 3 In the event that the County and/or the City are determined to be comparatively at fault for any claim, action, loss or damage which results from their respective obligations under this agreement, the County and/or the City shall indemnify the other to the extent of its comparative fault 4 The County and the City are authorized self-insured entities for purposes of General Liability, Automobile Liability, Workers' Compensation, and Professional Liability coverage and warrants that through its program of self-insurance, it has adequate coverage or resources to protect against liabilities arising out of the terms, conditions and obligations of this agreement J Privacy and Security 1 City and DBH shall adhere to any County applicable privacy -related policies pertaining to PHI DBH has a specific responsibility to comply with all applicable State and Federal regulations pertaining to privacy and secunty of consumer PHI and strictly maintain the confidentiality of behavioral health records, and City shall assist DBH in upholding said confidentiality by applying safeguards as discussed herein Regulations have been promulgated governing the privacy and security of individually identifiable health information (IIHI) PHI or electronic Protected Health Information (ePHI) 2 In addition to the aforementioned protection of IIHI, PHI, and a -PH, both parties shall adhere to the protection of PII and Medi -Cal PII PII includes any information that can be used to search for or identify individuals such as but not limited to name, social security number or date of birth Whereas Medi -Cal PII is the information that is directly obtained in the course of performing an administrative function on behalf of Medi -Cal, such as determining eligibility that can be used alone in conjunction with any other information to identify an individual Page 7 of 10 3 Reporting Improper Access, Use, Disclosure, or Breach Upon discovery of any unauthorized use, access or disclosure of PHI or any other security incident with regards to PHI or PII, City agrees to report to DBH no later than one (1) business day upon the discovery of a potential breach City shall cooperate and provide information to DBH to assist with appropriate reporting requirements to the DBH Office of Compliance K City and DBH will ensure any DBH consumer PHI that is stored on City premises will be locked and secure in adherence to IIH1 and PHI privacy requirements L City and DBH shall protect from unauthorized use or disclosure names and other identifying information concerning persons receiving services pursuant to this MOU, except for statistical information not identifying any consumer DBH and City shall not use or disclose any identifying information for any other purpose other than carrying out the obligations under this MOU, except as may be otherwise permitted or required by law This provision will remain in force even after the termination of the MOU M City and DBH agree they will collaborate in providing in-service training to City staff on the services offered under this MOU and any relevant policies/procedures, including the Authorization to Release of Protected Health Information Policy and Procedure VII RIGHT TO MONITOR AND AUDIT A City will collaborate with DBH in the implementation, monitoring and evaluation of this MOU and share information as needed B City shall provide all reasonable facilities and assistance for the safety and convenience of DBH's representative in the performance of monitoring or auditing duties Any supervisory or administrative inspections and evaluations shall be performed in such a manner as will not unduly delay the work of City staff C City and DBH agree to work together to develop a tracking system of calls that TEST staff respond to for the purpose of productivity measures and staff accountability D A review of productivity at the City location for TEST services shall be conducted after the end of each fiscal year E City and DBH will participate in evaluating the progress of the overall program in regard to responding to the mental health needs of local communities F City and DBH will work jointly to monitor outcome measures City and DBH shall comply with all local, State and Federal regulations regarding local, State and Federal performance outcomes measurements requirements and participate in the outcomes measurement process, as required by the State and/or DBH For MHSA programs, City agrees to meet the goals and intention of the program as indicated in the related MHSA Component Plan and most recent up dates VIII TERM This Memorandum of Understanding (MOU) is effective as of January 1, 2019 to December 31, 2023, and may be terminated earlier in accordance with provisions of Section IX of this MOU Page 8 of 10 IX EARLY TERMINATION This MOU may be terminated without cause upon thirty (30) days written notice by either party DBH's Director is authorized to exercise DBH's rights with respect to any termination of this MOU The City's Chief of Police, or his/her appointed designee, has authority to terminate this MOU on behalf of City X. GENERAL PROVISIONS A DBH staff vacancies or changes in staffing plan shall be submitted to the appropriate City's contact person within 48 hours of DBH's knowledge of such occurrence Such notice shall include a pian of action to address the vacancy or a justification for the staffing plan change B No waiver of any of the provisions of the MOU documents shall be effective unless it is made in a writing which refers to provisions so waived and which is executed by the parties No course of dealing and no delay or failure of a party in exercising any right under any MOU document shall affect any other or future exercise of that right or any exercise of any other right A party shall not be precluded from exercising a right by its having partially exercised that right or its having previously abandoned or discontinued steps to enforce that right C Any alterations, variations, modifications, or waivers of provisions of the MOU, unless specifically allowed in the MOU, shall be valid only when they have been reduced to writing, duly signed and approved by the authorized representatives of both parties as an amendment to this MOU No oral understanding or agreement not incorporated herein shall be binding on any of the parties hereto Page 9 of 10 XI CONCLUSION A This MOU, consisting of ten pages (10), is the full and complete document describing services to be rendered by City to DBH including all covenants, conditions and benefits B The signatures of the parties affixed to this MOU affirm that they are duly authorized to commit and bind their respective departments to the terms and conditions set forth in this document COUNTY OF SAN BERNARDINO City of Redlands Department of Behavioral Health Redlands Police Department Name 11 ) Kelley Title Director Address 303 E Vanderbilt Way San Bernardino, CA 92415 Date COUNTY OF SAN BERNARDINO p �i�r�loCn�«�6sry Robert A Lovingood, Chairman, Board of Supervisors Dated MC—jr ?Jy s SIGNED AND CERTIFIED THAT A COPY OF THIS DOCUMENT HAS BEEN DELIVERED TO THE CHAIRMAN O Lau IldiilFfRiPPINGi; CI isors ^o By 12 A I TIVWW!,, IC Name Paul W Foster Title Mayor Address 35 Capon Street P O Box 3005, Redlands, CA 92374 Date 1 Z-+ Attest Page 10 of 10 EXHIBIT A Description of Triage, Engagement and Support Teams (TEST) Services Available And Co -location Specific Considerations FOR Redlands Police Department 30 Capon Street Redlands, CA 92373 Department of Behavioral Health (DBH) has community based, behavioral health, crisis teams that respond throughout San Bernardino County for consumers having a mental health emergency and is in need of crisis triage The success of the Triage, Engagement, and Support Teams (TEST) program has grown with Agency collaborations throughout San Bernardino County DBH funds • Triage, Engagement and Support Team (TEST) Program Manager II Vivian Bermudez (909) 421-9456 Number of Locations Approximately 26 community office spaces Base Location Co -located within participating community agency Specialty Crisis triage for consumers referred by Agency • Community Crisis Response Team (CCRT) Program Manager II Julie Hale (909) 873-4480 Number of Units Three DBH mobile units Service Area Countywide (909) 421-9233 Base Locations Ontario (Vilest Valley *Pager (909) 535-1316), Rialto (East Valley *Pager (909) 420-0560), and Victorville (High Desert *pager (760) 734-8093) Specialty Crisis triage for consumers/agencies (after hours) that call direct to CCRT office/pagers TEST and CCRT work with consumers experiencing a mental health crisis to develop and maintain a level of stability that reduces the need for emergency services and minimizes incarcerations and hospitalizations, freeing law enforcement and medical facilities resources Agencies requesting to locate a TEST team participate collaboratively with DBH The Agency provides no cost office space and refers local consumers that may need TEST's specialized services The referred consumer receives expedited access to mental health crisis triage from TEST staff located in the Agency offices Consumers are given the opportunity to de-escalate and focus on their present needs and learn how TEST can assist them by linking them to appropriate services resulting in better consumer outcomes Exhibit I is attached to the MOU as an overview of the TEST program, specifies considerations unique to the Agency, defines the specific seances available through the TEST program, and shares the State mandated reporting requirement Overview of TEST Current Successes and Examples A Since the inception of TEST in 2014, the purpose was to improve consumer access to specialized behavioral health services during a mental health crisis Page 1 of 6 EXHIBIT A and to minimize negative outcomes such as incarcerations and hospitalizations In FY 2017118, there were a total of 3,840 TEST encounters with co -located TEST staff in San Bernardino County B The following results can be highlighted By DBH co -locating meatal health crisis triage staff where consumers live and work the access to specialty mental health services for underserved consumers has increased • Consumers receiving crisis triage followed by immediate linkage to appropriate services has improved consumer outcomes • Decreased costs for law enforcement agencies and emergency room services as resources to assist consumers in crisis are diverted to TEST staff and appropriate linked services • Increased number of consumers experiencing a mental health crisis diverted from the justice system, hospitals and/or hospitalization C TEST within your City TEST's Program Manager (PM) or designee will select the appropriate staff for your facility The PM continually evaluates TEST locations on their successes for providing services/referrals/linkage for consumers in crisis In the office space provided each TEST encounter will focus on individual consumer needs, and provide community based crisis triage combined with linkage to quality mental health services to improve consumer outcomes TEST Commitment to City TEST Provides To ensure 100% of City's TEST staff provides immediate access referrals, consumers experiencing to Specialty Mental Health Services for a mental health crisis, are seen in consumers in a mental health crisis. a timely fashion, initiating links/provides referrals to appropriate improved consumer outcomes services D Most Agencies Frequently Referred Consumers. DBH shall screen consumers generated and referred by the City, shall develop policies and procedures regarding those persons who are eligible for services, and shall provide a linkage plan for all consumer interventions that aid in the maintenance of a stable level of functioning Most Frequent Referrals TESTSpecific Focus Consumer in crisis, coming in When TEST staff identifies consumers contact with host City, having co- with co-occurring mental health and occurring mental health and substance use disorders staff substance use disorders links/provides referrals to appropriate services Consumers in crisis who may TEST staff arranges access to peer respond well to peer support and support and self-help groups self-help groups Page 2 of 6 EXHIBIT A Consumers in crisis who are part TEST serves uninsured consumers and of the 25% of statistical uninsured links them with services and applying for consumers or utilizing current insurance coverage Consumers in crisis needing more TEST will provide up to 59 days of case than day one of crisis intervention management services, TEST will provide Usually needing an assisted period linkage to all community resources and of stabilization with regular follow services accessible to DBH that could be up such as several weeks of beneficial to each unique consumer with guidance and/or more intensive a focus on long term stabilization, level of assistance minimized use of emergency room services as well as reduced psychiatric hospital admissions II Participating City Considerations A General Considerations • Allow DBH staff from the field-based, mobile, Community Crisis Response Team (CCRT) with prior notification to the Station Commander, to utilize the same office space when working with local consumers to assist and/or link to local services as needed • Provide TEST staff access to data to track/report necessary information that measures reduced time law enforcement spends with individuals needing mental health services, reduced number of encounters between consumer and law enforcement, reduced number of crisis referrals that result in arrests and tail time, and reductions in crisis referred consumers that do not need emergency services and hospitalization Work collaboratively with DBH, as necessary B Considerations Applicable to Law Enforcement • At the Station Commander's discretion and with his/her approval o Provide TEST staff with a hand-held radio after the appropriate C L E T S testing has been taken and a statement of confidentiality has been signed and received by the City o Provide training to TEST staff for radio use with provided call signs o Provide TEST staff an unmarked safety vehicle to facilitate services III Detailed Description of Available Services TEST Staff May Provide A The behavioral health service provided comes at no cost to the City and is provided by the TEST program as an expedient link to behavioral health services for the community served Initial services shall be directed toward achieving crisis intervention, diversion, and stabilization B TEST staff is called to assist City staff when a possible consumer is exhibiting symptoms of psychiatric crisis TEST will immediately respond starting with triage to engage and support the consumer in crisis TEST staff will provide crisis intervention with assessment and evaluation including collateral to help identify Page 3 of 6 EXHIBIT A the needs for behavioral health services The goal of intensive case management is to stabilize and successfully link consumers to DBH services and other community resources The following are services provided by TEST staff Crisis Intervention is a quick emergency response service enabling the individual to cope with a crisis, while maintaining his/her status as a functioning community member to the greatest extent possible A crisis is an unplanned event that results in the individual's need for immediate service intervention The response modality must allow for the resolution of the consumer's crisis Crisis Intervention services are limited to stabilization of the presenting emergency Service activities include but are not limited to assessment, evaluation, and collateral a Assessment is an analysis of the history and current status of the individual's mental, emotional, or behavioral disorder Relevant cultural factors and history may be included where appropriate Assessments will include consumer level of acuity and risk b Evaluation is an appraisal of the individual's community functioning in several areas including living situation, daily activities, social support systems and health status Cultural issues may be addressed where appropriate c Collateral is contact with one or more significant support persons in the life of the individual to assist the consumer in crisis as quickly as possible 2 Intensive Case Management provided by TEST staff for up to 59 days to link the consumer with appropriate DBH and community resources for continued stability C Consumer interventions conclude following completion of services or consumer is at an acceptable level of stability and/or linkage with supportive resources IV TEST Staff All TEST staff shall be employed by DBH The staff described will work the designated number of hours per week in full time equivalents (FTE's), and perform the fob functions specified Clinical staff providing TEST services shall be licensed or waivered by viable internship by the State, if applicable A The staffing will consist of the following An intensive case management treatment model will be used and will employ staff members that may include any combination of the following Social Worker Il, Alcohol and Drug Counselor, Mental Health Specialist, and/or Clinical Therapist, for the purpose of providing crisis intervention services, intensive case management and linkage within the dedicated office space, and in the field Page 4of6 EXHIBIT A B Staff Responsibilities 1 Provide crisis triage/response/intervention 2 Provide interagency coordination of crisis services 3 Conduct case management needs assessment for possible intensive case management for consumers, identified and referred by the City, for referrals/linkage to DBH services and/or other community services 4 Identify individuals with potential Substance Use Disorder and Recovery Services (SUDRS) needs and refer to community SUDRS services 5 Provide short-term follow-up case management services (up to 59 days) while consumers are appropriately linked to DBH services and/or other community services 6 Collaborate with City staff, community agencies, family, and other support persons to avoid psychiatric hospitalizations or law enforcement escalations and to improve consumers daily functioning 7 Maintain appropriate and timely documentation, according to DBH policies and standards 8 Attend co -location meetings such as, briefings, staff meetings, and/or other team/community meetings, as appropriate C Welfare and Institutions Code (WIC) 5150 Adults/5585 Children - Involuntary Psychiatric Hold • Most TEST Paraprofessional staff are not aole to write WIC 5150 or 5585 holds, but can assist law enforcement during WIC 5150 or 5585 evaluations by providing support to the officers writing the holds • The exception occurs when a DBH Clinical Therapist is available and law enforcement is NOT available to do the WIC 5150/5585 evaluations After an evaluation, if appropriate, DBH Clinical Therapist will write the needed hold D Transporting WIC 5150 or 5585 holds to appropriate psychiatric facility • TEST staff can follow law enforcement to the hospital and sit with the consumer • TEST staff is able to transport consumers that do not present as violent or a flight risk with appropriate City vehicle without a law enforcement officer This method frees up law enforcement to return to the community instead of transporting the consumer and waiting at the hospital V Data Reporting and Outcome Measures Requirements A The assigned DBH Program Manager is responsible for reporting MHSA goals and outcome measures to the MHSA Coordinator, as appropriate The outcomes -based criteria which shall be measured are as follows Page 5 of 6 EXHIBIT A GOALS KEY OUTCOMES Reduce . Increased use of alternative crisis interventions (e g , unnecessary CWIC, CCRT, CSU) psychiatric . Increase in number of individuals diverted from hospitalizations hospitalization • Increase access to and use of existing community resources (e g , housing, mental health services, alcohol and drug services, medical treatment, education services, etc B DBH shall be responsible for collecting and entering data via the data collection instrument developed by the County and the State on all clients referred by the City DBH shall ensure the data is entered electronically at encrypted network sites and downloaded at the County centralized database (Integrated System) In addition to the below performance-based criteria, data collection shall include demographic data, the number of case openings, the number of case closings, and the services provided DBH may base future extensions of this program upon positive performance outcomes, which DBH will monitor throughout the year TEST staff, in collaboration with host City, shall collect data in a timely manner and submit it to the DBH MHSA coordinator VI DBH Considerations and Special Provisions A Program Manager shall monitor TEST staff and provide oversight on a regular basis in regard to compliance with all of the above requirements B It is further expected that the consumer population will be reflective of the social, economic and ethnic characteristics of the communities served by the City C DBH CCRT team is a field based mobile mental health and crisis intervention team that, on occasion, may need local office space to contact a local consumer not referred by this City This DBH staff will temporarily utilize the same office space allocated to the TEST team for small tasks Page 6 of 6