Loading...
HomeMy WebLinkAboutMINUTES - 01191999 - C78-C82 TO: BOARD OF SUPERVISORS elf William Walker, M.D. , Health Services Director FROM: By: Ginger Marieiro, Contracts Administrator Contra Costa DATE: December 29, 1998 CCUs ty SUBJECT. Approval of Contract #22-705 with Yvonne Dufala, CPRE, dba Fund Raising Solutions SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECgM ENDAT10N(S) Approve and authorize the Health Services Director, or his designee (Wendel Brunner, M.D. ) to execute on behalf of the County, Contract #22-705 with Yvonne Dufala, CPRE, dba Fund Raising Solutions, in the amount of $40, 000, for the period from January 1, 1999 through December 31, 1999, to provide consultation and technical assistance for County' s Meals on Wheels Program. FISCALIMPACT County funds ('GRIP Grant from the County Administrator' s Office, awarded for this purpose) . BACgG QUNID/REAS#3NVS) FOR RECMAXENDATIbN(S) Under Contract #22-705, Yvonne Dufala, CFRE, dba Fund Raising Solutions, will provide resource development services for the County' s Meals on Wheels Program to establish renewable financial support for the nutrition program. CONTINUED ON ATTACHMENT: SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGINATURE(S) el ACTION OF BOARD ON APPROVED AS RECOMMENDED iE VOTE OF SUPERVISORS UNANIMOUS (ABSENT odd--le— ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES. AND CORRECT COPY OF AN ACTION TAKEN ABSENT: _-__- ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD CbriCact. Wendel. Brunner, M.D. (313-6712?F 7 F SUPE/- Risk ON THE DATE SHOWN. CC: Health Services (Contracts) ATTESTE Management emr', of the Gard 0f Auditor-Controller uperosors and County Administrator Contractor M382/7-83 F3Y�r , DEPUTY TO: BOARD OF SUPERVISORS William Walker, M.D. , Health Services Director FROM: By: Ginger Marieiro, Contracts Administrator , Centra DATE: DecemberDecember29r 1998 Costa County SUBJECT: Approval of Contract #22-336-13 with Sandra J. Hollenbeck SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECC? MENDED ACTION: Approve and authorize the Health Services Director to execute on behalf', of the County, Contract ##22-336-13 with Sandra J. Hallenbeck, for the period from January 1, 1999 through December 31, 1999, with a payment limit of $28, 352, for consultation and technical assistance to the Department with regard to risk management and prevention programs for facilities handling acutely hazardous materials. FIRANCIAL IMPACT This Contract is funded by AB 3777 (RMPP Fees) revenues included in the Health Services Departments Budget. REASONS FOR RECOMMENDATIONS/F3ACKGROUND: On December 9, 1997, the Board of Supervisors approved Contract #22- 336-12 with Sandra J. Hollenbeck for consultation and technical assistance to the Department with regard to risk management and prevention programs for petroleum refining and chemical manufacturing businesses which handle acutely hazardous materials. The Contractor has been providing guidance in developing risk management and prevention programs mandated by the California Health and Safety Code. Pursuant to the passage of AB 1889 (effective January 1, 1997) , these programs have expanded to include the federal Risk Management Program as well. Approval of Contract #22-336-13 will allow the Contractor to continue to provide services through December 31, 1999. CONTINUED ON ATTACHMENT: S SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIG'NATURE(S) lw&orog, Q4 ACTION OF BOARD ON APPROVED AS RECOMMENDED VOTE OF SUPERVISORS UNANIMOUS {ABSENT &061 _`) 1 HEREBY CERTIFY THAT THIS IS A TRUE AYES; NOES; - AND CORRECT COPY O1= AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD COT1tSCt William Walker, M.D. (370-5010) OF SUPERVISOR ON THE DATE SHOWN. CC: Health Services (Contracts) ATTESTED Risk Management , Of t1wgoard Of Auditor-Controller upervisr)rs and Ccun#yRmtnifratnr Contractor M392/7•83 B /. J C "'".� DEPUTY TO: BOARDOF SUPERVISORS FOMWilliam Walker, M.D. , Health Services Director RBy: Ginger Marieiro, Contracts Administrator •' Contra December 29, 1998 Costa DATE: December SUBJECT: Approval of Contract Amendment Agreement #23-162-•7 with TMP Worldwide SPECIFIC REQUESTtS)OR 1~tECOMMEN#}ATION(S)&BACKGROUND AND JUSTIFICATION RLQOMM1NDAT1QN E B 1 : Approve and authorize the Health Services Director to execute on behalf of the ,County, Contract Amendment Agreement #23-.162--7 with TMP Worldwide (formerly: Garcia Advertising & Communications) effective December 31, 1998, to amend Contract #23-162-4 (as amended by Contract Amendment Agreements #23--162-5 and #24-162--6) to increase the contract payment limit by $60,000, from $250,000 to a new total payment limit of $310,000, and to extend the term' of Contract through February 28, 1999. $CAS I24PACT` The Contract is included in the Health Services Department's budget. SACK R LAN S o SCE} T N : On June 17, 1997, the Board of Supervisors approved Contract' #23-162--4 (as amended by Contract Amendment Agreements #23-162-5 and #24"162--6) with TMP Worldwide, for the period from July 1, 1997 through December 31, 1998, to provide advertising services for recruitment of qualified individuals for the Health Services Department's vacant positions, particularly in the area of direct' patient care. Approval of Contract Amendment Agreement #23-162-7 will allow the Contractor to provide additional advertising services to the Department through February 28, 1999. CONTINUED RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER ACTION OF BOARD ON APPROVED AS RECOMMENDED .110011& 61 VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED 10 HiL BATCHI ,CLER 'OF THE BOARD OF William Walker, M.D. (370-5010) SUPERVISORS ND COUNTY ADMINISTRATOR Contact Person: CC: Health Services(Contract) Auditor-Controller Risk Management BY , DEPUTY Contractor ......... ......... ......... ......... ......... ..........._...111.1. .. - _.. ........_. ......... ......... ......... ......... ......... ._....... ......... ......... ......... ......... ......._. __. ......... ......... ......... ......... ......... TO: BOAR©OF SUPERVISORS William Walker, M.D. , Health Services Director FROM By: Ginger MArieiro, Contracts Administrator 1' Contra DATE: December 23, 19 98 Costa County SUBJECT: Approval of Intercounty Agreement #24-658-2 with Napa County SPECIFIC REQUEST(S)OR RECOMMENDATIONS)3 BACKGROUND AND JUSTIFICATION RECOMMENDATION(B) : Approve and authorize the Chair, Board of Supervisors, to execute on behalf of the County, Intercounty Agreement #24-658-2 with Napa County, for the period from July 1, 1998 through June 30, 1999, . with a :payment limit of $63,940, for provision of transitional residential treatment services for severely and persistently mentally ill County residents. FISCAL IMPACT: This Contract is 100% Funded by County Mental Health Realignment, and is included in the Health Services Department's budget. BACKGROUNDLEASON(8) FOR REQQM__X NDATTON(8) : Napa County operates a facility known as "The Avenues" to provide transitional residential treatment services to prepare severely and persistently mentally ill individuals for their return to the community. This Contract is part of the Department's cost saving plan to reduce the number of high-cost State Hospital beds by developing alternative placements. On March 17, 1998, the Berard of Supervisors approved Intercounty Agreement #24-658-1 with Napa County for the period from July 1, 1997 through June 30, 1998. Approval of Intercounty Agreement #24-658-2 will allow County to continue placing severely and persistently mentally ill County residents at The Avenues through June 30, 1999 The Board Chair should sign seven copies of the agreement. six signed copies of the agreement and six sealed/certified copies of this Board Order should be returned to the Contracts and Grants Unit. C soATURE 2L RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE —OTHER SIGN LIRE(S): A�E s ' ACTION OF BOARD ON APPROVED AS RECOMMENDED _ /1. 4ppMw VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS (AII SENT AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED IL 9ATCHELd LERK F THE BUARD OF Donna Wigand, L.C.S.W. (313-6411) UPERVISO Contact Person: RS AND COUNTY ADMINISTRATOR CC: Health Services(Contract) Audltor-Controller Risk Management BY Contractor EPUTY r/r`2� -� .99 24 - 658 _ 2 NAPA COUNTY NO. 4441 INTERCOUNTY AGREEMENT CONBIUNITY MENTAL HEALTH SERVICES This contract is made and entered into on the dates recited herein, by and between two political subdivisions of the State of California: the COUNTY OF NAPA, hereinafter referred to as NAPA, and the COUNTY OF CONTRA COSTA, hereinafter referred to as CONTRA COSTA. WITNESSETH : WHEREAS, CONTRA COSTA desires to extend to its residents certain mental health services established under the California Welfare and Institutions Code and other enabling legislation, and programs and projects administered by the State Department of Mental Health (hereinafter referred to as "Department") or by counties through the Mental Health System, and WHEREAS, NAPA has entered into a contract with a qualified provider of mental health services, under which contract services will be provided to clients of CONTRA COSTA's Mental Health service by virtue of this Agreement, in a program known as "The Avenue", located within NAPA, and WHEREAS, parts of the California Code of Regulations and the Welfare and Institutions Code provide a set of definitions, standards, procedures and regulations by and pursuant to which CONTRA COSTA and NAPA may lawfully contract for such services as are described in the Service Description incorporated in this Agreement as Exhibit "A" NOW, THEREFORE, IT IS MUTUALLY AGREED between the parties as follows: 1. CONTRA COSTA agrees to: a) Designate the Adult Services Coordinator, or other appropriate staff of its Mental Health Services, to act as program liaison. Said program liaison shall be responsible for coordinating placements of CONTRA COSTA's clients at The Avenue, and in the development of policies and procedures made by NAPA, CONTRA COSTA, and the provider operating The Avenue. b) Identify appropriate placements for The Avenue program and cooperate with the provider in effecting placements and discharges. C) Place a maximum of two (2) CONTRA COSTA clients in The Avenue at any one time, subject to the provisions of Paragraphs 3(b) and 3(d). d) Retain responsibility for the collection of Supplemental Security Income (SSI) for its clients placed at The Avenue. -1- INTERCOUNTY AGREEMENT #3570 COMMUNITY MENTAL HEALTH SERVICES e) 1) Pay to NAPA the amount of Fifty-Eight Thousand, One Hundred Twenty-Seven Dollars and Fifty Cents ($58,127.50). This amount represents that proportion of the gross cost of provision of services, plus a five percent (5%) charge for program and fiscal administration by NAPA, less Medi-Cal reimbursement claimed by and paid to NAPA; apportioned in the same proportion which client placement slots, dedicated for use by CONTRA COSTA, bear to the total number of client placement slots (2/6). Components are displayed in Exhibit "B" 2) Pay to NAPA that portion of Medi-Cal reimbursement, as defined in Exhibit "B" attached, which may not be paid to NAPA due to the non-eligibility of the placed client for such reimbursement. For the purposes of this agreement, a client shall be determined "eligible" for Medi-Cal reimbursement at placement in the Avenue program only if such eligibility has been determined, and a Medi-Cal card or other eligibility certification issues, upon which NAPA may base a claim for services provided under this Agreement. For the purposes of this section, clients placed with pending application or pending determination for Medi-Cal eligibility shall be defined as "non-eligible" unless and until such eligibility is determined. It shall be the responsibility of CONTRA COSTA to ensure eligibility of the client for such reimbursement. NAPA shall bill CONTRA COSTA monthly for these charges in accordance with the rate schedule described in Exhibit "B" attached. Upon determination that the placed client is eligible for Medi-Cal, and receipt by NAPA of said reimbursement, NAPA shall return to CONTRA COSTA all funds paid by CONTRA COSTA, which have subsequently been reimbursed by Medi-Cal. The maximum amount payable by CONTRA COSTA under subsection 2) above shall be Five Thousand, Eight Hundred Twelve Dollars ($5,812.04) for the term of this agreement, billed on a fee-for-service basis. CONTRA COSTA and NAPA acknowledge that this amount is an estimate of the annual amount which may be incurred by CONTRA COSTA during the term; should this amount be exhausted during the term of this agreement, the parties agree to process an amendment to this agreement which increases said maximum to conform with the revised estimate. f) Cooperate in provision of patient history and fiscal records including those necessary to enable NAPA to complete its duties. 2. NAPA agrees to: a) Designate the Adult Services Coordinator, or other appropriate staff of its Mental Health Services, to act as program liaison. Said program liaison shall perform the same duties as are enumerated in paragraph 1(a). -2- INTERCOUNTY AGREEMENT #3570 COMMUNITY MENTAL HEALTH SERVICES b) Provide contract management and administration, including the receipt and payment of all claims by the contract provider operating The Avenue, and also including general contract liaison. C) Assume responsibility for collection and retention of all charges to Medi- Cal and Medicare for services provided by the contractor operating The Avenue. This shall include billing, record keeping, and quality assurance. d) Act as lessee under the terms of the lease of the premises on which The Avenue program will be conducted, including payment of lease costs and liaison with the contractor operating The Avenue on lease matters. e) Maintain all records required, including those provided by the contractor. 3. BOTH CONTRA COSTA AND NAPA agree: a) That both NAPA and CONTRA COSTA are included in a group of three California Counties which have agreed to place clients at The Avenue, that;the remaining County is the County of Marin, and that Marin, and CONTRA COSTA are each engaged in intercounty agreements with NAPA which recite their respective duties regarding The Avenue. b) That, should circumstances require a change in 'CONTRA COSTA's maximum number of client placements hereunder, CONTRA COSTA may discuss the temporary increase or decrease with any other participating County, provided that no alteration in any obligation of CONTRA COSTA to NAPA be made, except as provided in Paragraph 3(d) herein, and further provided that no agreement shall be made with any other County or entity which is not recited in paragraph 3(a) regarding use of or placement in The Avenue, absent the prior approval of the three recited Counties. c) Each party shall defend, indemnify, and save harmless the other, from and against any and all claims and losses whatsoever for damage, injury, or death arising out of or connected with the performance of this agreement, or resulting from any act or omission of that party's employees, officers, or agents. Each party shall maintain liability insurance or self- insurance of the scope and nature required of the operations undertaken by virtue of this agreement, including, as applicable, vehicular liability, professional liability, premises liability, and workers' compensation insurance for all persons as are required by state law to be covered. -3- INTERCOUNTY AGREEMENT #3570 COMMUNITY MENTAL HEALTH SERVICES d) No modification or variation of the terms of this contract shall be valid unless made in writing and signed by the parties hereto, and no oral understanding or agreement not incorporated herein shall be binding on any of the parties hereto. This writing is intended both as the final expression of the Agreement between the parties hereto with respect to the included terms and as complete and exclusive statement of the terms of the Agreement, pursuant to C.C.P. Section 1856. The parties expressly recognize that their personnel are without authorization to either order extra or changed work or waive contract requirements. Failure of either to secure authorization of Board of Supervisors of both parties, for such work shall constitute a waiver of any and all right to adjustment in the contract price or contract time due to such unauthorized work. e) TERM: The term of this contract shall begin July 1, 1998, and shall terminated on June 30, 1999, unless terminated as hereinafter provided.', This agreement may be terminated by either party by giving sixty (60) days written notice of intention to terminate. For the purposes of this Agreement, notice shall be deemed effective upon mailing by first class mail to the following addresses: For CONTRA COSTA Director, Mental Health Division Contra Costa County Health Services Department 595 Center Avenue, Suite 200 Martinez, CA 94553 For NAPA Larry Mowinckel, Contracts Specialist Napa County Health and Human Services Agency 2261 Elm Street Napa CA 94559-3721 This contract is made for a specific term. Nothing in this contract shall imply the renewal of this contract, or of any contract for similar or differing services between the parties hereto. Nothing herein shall imply or guarantee continuance of this contract of funding of any position or service by CONTRA COSTA to NAPA. -4- _ _........ ......... ......... .. ........ ............. ..............._.........._........._... ......... .. ....... ... _.. _. .......__... ...__._ ..._ ................................... ..................................... INTERCOUNTY AGREEMENT #3570 CONEWUNITY MENTAL HEALTH SERVICES IN WITNESS WHEREOF, the parties hereto have executed this contract the day and year hereinabove written. ATTEST: CLERK. OF THE BOARD COUNTY OF NAPA, a political subdivision of the State'of California By: By: FEB Date: Date: _ —�`ey AT71EST: CLERK OF THE BOARD COUNT' OF CONTRA'COSTA, a politica) subdivision of the State of California By: By: e: at A as€.h Date: Date: G:tCdNT98-91CQC0#4041 C,fir_,.J '11"41 S T 5�.�./ �`` rr`.'A < '" R O FEB 0 9 1999 G : of ✓runty/ FOARD QE SUPERVISOR By: COUNTY Of NARA Date: v f R:IM APPROVED 3ti iias�.r -5- el Al BUCKELEW PROGM45 $X!lINT •A•`M`�`��� page 1 of I0 THE AVENUE Description of Services I. General Service Approach and Contractor-Philosophy_ Buckelew, Programs' vision is to provide duality services for our +clients, enabling them to develop to fullest potential and to participate in the commun- ity. This philosophy is further enunciated by these three Xey Goals.- To oals;To provide high quality, cost effective programs that maximize the development of the individual. ° To offer programs responsive to and driven by clients' needs. To increase social responsibility by educating the community toward greater acceptance, Integra tion and support of the mentally ill and mentally disabled. 2. outline of Services The Avenue will provide the following services: A. General Services: 1. Lodging, 2. Adequate daily food supplies for three nutritious meals and assistance with preparation as needed; 3. Special diet as needed; 4. Snacks, S. Laundry facilities and linen and assistance in use as needed. b. Cleaning materials and equipment and assistance in use as needed; T. Assistance in planning for and using transportation; S. Assistance in planning and accessing recreational activities. 1 BUCKELEW PROGRAMS/The Avenue i 11t'af�Il# B. Health Services: 1. Daily observation of the resident's general health, 2. Assistance with obtaining a doctor and dentist as needed and accessing medical and dental care; 3. Assistance in obtaining bedside care for minor temporary illnesses. C. Rehabilitation and Treatment Services. . 1. Cay Program including education and practice in life skills, pre-vocational skills, exploration of community resources', and interpersonal relationships, 2. Afternoon, Evening and weekend Program including social and recreational activities; 3. Individual and group supportive counseling, 4. Assistance with developing a community support system utilizing non-mental health resources; 5. Family involvement where indicated in the 'resident's treatment plan; 5. 24 hour crisis intervention; 7. 24 hour supervision. The Avenue will be a transitional program as defined'; by the Social Rehabilitation criteria. Special attention will be paid to transitions and to the stressors involved in order to provide additional supports at those times. It is well documented that persons with a mental illness are especially susceptible to stress. The contractor's experience shows that many persistently and seriously mentally ill residents prefer to be minimally involved in format programs; nevertheless, they experience a slow but gradual improvement in skills and functioning as they involve themselves at their own pace, with minimal use of crisis services or rehospitalization. 2 SUCKECEK PROGRAMS/Tht Avenue EXHIOLT -A- page 3 of 20 /' It is important to balance consistency and structure carefully with the needs of individuals and with the needs `f the resident .gaup as a whole. For some clients, a broader definition of structure will be necessary to avoid too high a stress level which might trigger a decompensation . The overall treatment approach will be supportive and psycho-educational in nature, enabling the residents to learn and develop the tools to manage their illness and increase the quality of their lives in concert with their awn priorities and goals. Expectations for individuals residing in The Avenue will be within the context :)f membersnip in their household. As members who share the common goal of preparing for the eventual return to their own coasnunities, each resident should expect to participate in the functioning of the household to the extent he or she is able. When residents are newly arrived, it is likely that staff will need to be highly involved in the daily tasks, to assure a sense of consistency and security as residents are becoming adjusted to the recent transition and need time to settle in to their new location. Part of the initial assessment and intake process will include a discussion of skills and interests of each individual . 7o ensure early success and an increase in self esteem, the resident will be invited to participate in those tasks which he or she is most interested and comfortable . Thus, the early schedule will be tailored to each person's strengths , and early involvement can be somewhat minimal with a great deal of staff assistance as needed. Once new members are settled in, a part of the life skills focus for residents and staff will be to involve each person in the division of tasks. The schedule includes increasing resident participation with staff help in teaching and/or participatic to the degree needed to facilitate the smooth running of the house and program. 3 ;fir-a BUCKELEW PROGRAMSIThe Avenue FSP 4 Cf 10 Residents and staff alike will be expected to treat one mother with dignity and respect. This includes respect for individual differences, feelings, the need for privacy, safety, inclusion, and respect for one another's property. These issues and appropriate behaviors will be addressed throughout the program milieu. There will be times when staff need to set firm limits on certain behaviors to assure that people are safe and rights are resp*ctetd. This should always be done in a manner that conveys respect, .and with a rationale that is gm*led in a Concern for safety and fairness. The way in which staff set limits is important rote modeling for residents which they can learn and apply with one another. Whenever the situation allows, the rationale will be shared with the resident(s) involved. If it cannot be addressed in the moment, it will be discussed later. Since behavior that Jeopardizes the safety or rights of others constitutes a barrier toward the achievement of the goal of community living, alternatives will be discussed and become a part of the individual's service plan. At times, issues that are common to several residents may be the trigger for a focus group series or an invited speaker, e.g. , conflict resolution, fire safety, alternatives to physical aggression, etc. .3. Anticipated Treatment Barriers and Approaches a. Alcohol and drUS abuse gither on or gff site. The Avenue will provide educational information and support for a clean and sober lifestyle and culture with support and recommendations for active involvement in a Chemical Dependency Program for dually diagnosed people', and membership in AA or a 12 Step program, with a signed attendance form. b. Smoking -The Avenue homes will be smoke-free environments. Clear statements of this rule and information regarding smoking areas will be conveyed to residents. Education regarding personal health and safety will be part of the ongoing program. Positive feedback will be given. 4 .r BUCKELEW `RQLMAJ/That Avenue Page ge S of 1 't PlO c—____Money Management, Sorrowing, Be in , Stealing Staff will work directly with clients around the 'issues involved in these barriers. This will include encouragement for individuals in life skills groups to utilize alternative ways to interact with peers and in the community. Attention will be given not only to assist those clients who beg, borrow or steal in adopting more socially acceptable behavior patterns, but also to assist those clients whose skills in assertiveness and limit setting with others require encouragement and development. d. steal or Potential Assaultive Behavior, Threats, Verbal Intimidation Evidence of potential behavior of this nature will be addressed. during the assessment and intake process, with- clear expectations being conveyed regarding the unacceptability of such behavior, at The Avenue. Program staff will ascertain known predictors of such behavior with the individual client, in order to plan for early interventionand treatment. e. Medication noncompliance Staff will actively negotiate medication compliance, as part of the client's individual Service Plan, and as a clearly understood support to the attainment of community placement. Medication Management and Symptom Management classes will be recommended to all residents, to enable them to be knowledgeable regarding their symptoms and the appropriate medications. Staff will advocate for alterations in medication regimen in cases in which the existing -regimen is not facilitating client progress. f; Excessive Fear, Paranoia, including Unvoiced Fears Staff will make every effort to learn the history of each individual client, in order to anticipate the unvoiced concerns, their triggers, and predictor behaviors. Knowledgeable staff will thus be empowered to assist clients and initiate appropriate interventions at early indications of this behavior. The maintenance of a safe, caring, belonging site will enhance this. 5 _.._._. ......... ......... .............. . ........ .............. ....._._.. ........._.. . ..._...._................ ......... ......... ......... ................ _. _....... ......... ......... ......... 4 BUCKELE1i PROGRAMS/The Avenue EXHISIPage 6T f 10 *V g. Excessive Dependency Staff will be attuned to the potential for transitional clients to maintain a dependent behavior. Individualized attention to clients , focusing on increasing the individual 's self reliance at the individual client's pace and ability to take on this responsibility, will be a focus of staff interaction with the client. Joint work activities, with shifting degrees of responsibility, will be a method in which independent skills may be imparted. h. Behavior Actually Disturbing to Normal Program Activity Such behavior includes Sexual Acting Out, Inability to Live in Shared Room, Exaggerated Or Loud Outbursts, Gross Inactivity Or Refusal to Engage In Activity, and even Reversed Sleep Patterns. Each type of behavior must be' assessed in terms of the individual and the effect which such activity may have on the program and progress of the client population. Behaviors such as Sexual Acting Out need to be addressed as part of the living skills which the client will require for community living. Groups and educational programs will address the aspects of human sexuality. Similar information and imparting of living skills will focus on other behavior patterns , such as Exaggerated Outbursts or Inability to Share Room. Staff will be aware of the history of specific clients which results in Gross Inactivity, encouragement and invitation to participate',without pressure should be the rule. Finally, a Reversed Sleep Pattern must be assessed in. terms of the underlying motivation to the client. Such a pattern is not in and of itself a barrier to treatment, provided the client is able to learn the skills which avoid disruption of others in the program. 4. Detail Of Residential Programming a. Life Skills Subject areas include basic independent living skii1s, interpersonal relationships and conflict resolution, medication management, and other subjects of crucial importance in developing skills necessary for community living. b �l t SUCKELEW PROGRAMS/The Avenue EXHIBIT W Page 7 of IO• b. Other Programming This will include Afternoon Programs in community exploration, planning for activities, and individual meetings with the client's service coordinator; Evening Programs which will include art club, evening walks, 12-step meetings, and other recreational activities in modes which facilitate sleep; and Weekend Programs which will include recreational outings and time for family visits. c. Specialized Programming. Medication Management and Symptom Management courses will be given in eight week segments. Staff will strongly recommend client participation in these courses. The Medication Management course will utilize the UCLA nodule; Symptom Management will use a syllabus developed and utilized by the contractor. Other programs, including establishment of appropriate 12-step groups, will be driven by client needs and aspirations as expressed in regular, ongoing meetings of the Resident Advisory Committee. 5. Policies and Procedures a. Admission and Intake The Program Director will establish ongoing linkages with Institutions for Mental Disease (IMDs) in which potential clients are placed. Regular visits will be made to IMDs to provide information to clients about The Avenue. Pre- intake, informal contacts will be maintained to develop a level of comfort for potential residents. Once formal referral is proposed by ;the client`s Case Manager, contractor staff will gather information leading to a formal assessment of the appropriateness of the referral . During this phase staff visits to the client will continue as needed to develop a positive relationship with the client. This will include one or a series of visits to The Avenue when feasible. The forma' assessment will be based on the criteria in the MlediCal Rehab Option and a Strength perspective. If the client decides to accept residency and all parties agree, the 7 '�/rte BUCKELEK PROGRAMS/The Avenue EXHIBIT .X. P4908o'f 10 client's Case Manager and the IMD will coordinate the move, with appropria tes assistance from staff of the contractor. The contractor will communicate any necessary requirements to the IMM or Case Manager, as appropriate. Should the referral be deemed inappropriate for The Avenue, this decision and the rationale will be communicated to the Case Manager and to the client. The contractor reserves the right to make this final decision. b. Evaluation and Treatment Planning Ongoing assessment will take place within the framework of an Individual Service Plan, developed by the client's assigned service coordinator in concert with the client, staff members assigned to the client's in house treatment team, the client's extra-program caregivers (e.g. psychiatrist,; Case Manager), and the client's family or significant others, at the client's desire. The ISP will be reviewed on an informal , weekly basis , and formally to comport with MediCal/Medicare compliance. No major changes will be made in the ISP without the knowledge and involvement of the client. In addition, the client will be a participant in evaluation of the program and services , through the Resident Advisory Committee, The assessment process will always strive to maximize personal , client wishes in treatment team selection and involvement of the client and family in the process. C. Emergency Services Staff of The Avenue will be trained in crisis intervention skills and techniques. An important component of early intervention will be staff immer- sion in the history and predictor behavior of resident clients, enabling quick and responsive, appropriate action. Emergencies which develop requiring phy- sical restraint of the client will involve outside assistance, incorporating action protocols developed by contractor with the host County and other refer- ring counties. Crisis episodes will trigger contact and involvement with the client's Case Manager and other extra-program caregivers as appropriate. Interventions will always be governed by the health and safety of the person, . 8 fl SUCKELEW PROGRAMS/Th* Avenue EXHIBIT *A* Pale 9 of 10 other client residents and staff of The Avenue. ,/--41Z_, Advance planning for emergency services , including physical medical services, will be made to ensure quick response in any emergency situation. d. Residential Service Groups Client residents will be encouraged and recommended to attend groups which are deemed most helpful and appropriate to the individual client, as described in the Individualized Service Plan (ISP). While attendance will be encouraged and nurtured, each client will expand attendance at their own pace. Groups will fall into the following six types. Support Groups, designed to give support and encouragement to the client in one-on-one meetings with staff and a weekly group; Educational Classes , such as the Life Skills program, Symptom and Medication :ianagement, and other classes in various living skills; Task Groups, whose function is to facilitate actual operations of the residences (e.g. food preparation, activities, transportation); a weekly House Meeting with once a month meeting of the entire Avenue staff and client group, Recreational/Social Activities as designed by staff and client members; and various meetings including Individual . Family, and Resident Advisory Meetings which cover topics germane to the meeting membership. e. Medical Services and Referrals; Medication Management Appropriate Medical Services and Referrals for the resident will be °Fa ct0 s of a pre-admission physical examination performed prior to acceptance of the resident by the contractor, and on a detailed medical history, including current caregivers, to enable contractor staff to providefamiliar, routine medical care to the extent possible. Emergency medical services will be established by agreement between the contractor and the closest medical facility, and in accordance with the guidelines established with the referring county. Medication Management will be performed by contractor staff with the goal of enabling client residents to assume the greatest possible responsibility 9 BUC1C£l£N PROGRAMS/The Avenue EXHIBIT "A" Page IO of IG for their own medication. Medications will be prescribed by the resident's Psychiatrist or by personal physician or other treating physician/psychiatrist. They will be centrally. stored and accounted for according to state law and licensing regulations. Staff role will be to assist clients in administering their own medication and in taking increased responsibility for the medication regimen as prescribed. P.R.N. medication will be similarly managed in accordance with prescription, and client reaction to medication will; be observed and noted by staff. The Avenue will maintain individual locked mailboxed, in which clients may secure their own medications (as well as money and other valuables) as their ability to self manage medication increases. Medication Management and Symptom Management Classes will encourage and reinforce the importance of medication regimen and achievement of individual responsibility. f. Discharge Planning The client's individual service counselor has the lead responsiblity in planning for discharge, in coordination with the client and with the treatment team, including the Case Manager. This planning will focus on the strengths and needs of the client. Contractor staff will assist with the transition from The Avenue to the new living situation. Aftercare and followup are the respon- sibility of the client's designated Case Manager, with consultation and appro- priate assistance from staff of The Avenue. Unplanned discharges must be anticipated and planned for. To the extent possible, the Case Manager, caregivers', and supporting persons of a client at risk of an unplanned discharge will be alerted and involved in creating the best possible plan for the individual client's needs. As with planned dis- charges, primary responsibility for aftercare and followup will lie with the client's Case Manager, with consultation and appropriate assistance from staff of The Avenue. g. Performance Objectives are recited in the Addendum attached to this Exhibit. 10 _........._......._......................................................................................................................................................... .......... ........._.. .__...... ............_........ ...._..._.. . _........ ......_.. _.......... ......... ....__..........._.. 3UCKELEW 73559 (The Avenue) EXHIBIT "A" Addendum 914 Mission Avenue Buckelew Programs San Rafael, California 9490 Telephone: (415)''457-6964 Fax: (415) 721-0281 The Avenue Performance Objectives FY98/99 1. Within 18 months of admission, 60%of the participants will return to their own community to live. 2. Annually, 70%of the participants will show new or improved community and/or daily living skills. 3. Client Satisfaction/Program Evaluation Surveys will be distributed annually in the month of March to attain feedback to utilize in service enhancement and program development.. ......... ......... ..................... ............. _........ ......... ......... ._....... ......... ......... _ _..._.. ......... ......... ......... ......... .. .................................................................... EXHIBIT"B" AVENUES PROJECT BUDGET COUNTY APPORTIONMENT: CONTRA COSTA PY98-9 PERIOD BEDS DAYS RATE COST 7/1/98-6/30/99 2 734 79.627 $58,127.50 g:icont8.9iexb#4041 TO. BOARD OF SUPERVISORS . FROM:: C antra Arthur C. Miner Executive Director ector Costa Contra Costa County Private Industry Council # r DATE: i December 24, 1998 U SUBJECT: Authorize Execution of 1999 JTPA Title IIB Contract with the Contra Costa.County Office of Education(#19-1259-0) SPECIFIC REQUEST($)OR RECOMMENDATION(S)S BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION. Authorize the Executive Director, Contra Costa County Private Industry Council, to execute on behalf of the County a standard form Job Training Partnership Act (DTPA) contract for the Summer Youth Employment Training Program(SYETP) under Title IIB with the Contra Costa County Office of Education (#19-1259-0) for the term beginning January 1, 1999 and ending September 30, 1999 with a maximum payment limit of $1,414,188, subject to approval by County Counsel as to legal form. Ii. FINANCIAL IMPACT-- None, MPACT:None, one hundred percent federal funds. III. CHILDREN IMPACT STATEMENT: This contract addresses the second goal: Children and Youth Healthy and Preparing for Productive Adulthood. W. REASONS FOR RECOMMENDATION: At its meeting of December 21, 1998, the Private Industry Council designated the County Office of Education as the 1998 JTPA Title IIB service provider for the period January 1, 1998 through September 30, 1999. CONTINUED ON ATTACHMENT: SIGNATURE: ±RECOMMENDATION OF COUNTY ADMINISTRATOR --- RECOMMENDATION OF BOARD COMMITTEE APPROVE _ OTHER SIGNATURES ACTION OF BOARD ON r APPROVED AS RECOMMENDED O . VOTE OF SUPERVISORS f HEREBY CERTIFY THAT THIS IS A TRUE - UNANIMOUS(ABSENT LM,s _ _. AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ASSENT: ABSTAIN: OF SUPERVISOR N THE DATE SHOWN. Contact: Bob Whatford(646-5373) ATTESTED Private Industry Council IL BATCHELO . LERK Oi THE BOARD OF CC: Sarah Hoffman,CAO SUPERVISORS AND COUNTY ADMINISTRATOR John Cullen,social Services County Administrator County Auditor-Controller BY — DEPUTY Contractor y:ipicoffiiceldiskettelbdorders\#19-1259-t?Cary of Pittsburg