Agenda 01/13/2015 Item #16D14 1/13/2015 16.D.14.
E�TIYT.SiTtVIMARY
Recommendation to approve Fourth Amendment to the agreement with the David Lawrence
Mental Health Center, Inc. for mental health and substance abuse services tol conform to the most
recently approved Agency for Healthcare Administration Low Income Pool Program.
OBJECTIVE,: To provide mental health and substance abuse services to the Collier County
community.
CONSIDERATION: On December 11, 2012, the Board approved a contract with the David
Lawrence Center Mental Health, Inc. The contract with David Lawrence Center is part of the
Low Income Pool (LIP) arrangement with the Agency for Healthcare Administration, Naples
Community Hospital, and Physicians Regional Medical Center, an update to which was
approved by the Board on September 23, 2014 (Agenda item 16D23). Section 394.76, Florida
Statutes, requires Collier County to participate in the funding of alcohol and mental health
services. The current contract allows for three one-year renewals, and this is the third contract
renewal with an effective date of October 1, 2014 through September 30, 2015.
This amendment provides for total compensation of$149,566 through the LIP arrangement to
support three Program Areas: 1) Adult Mental Health, 2) Adult Substance Abuse, and 3)
Children's Mental Health.
The following changes are being made to align with overarching changes in the LIP agreement
previously approved by the Board.
1. Exhibit 1, Payment Request, is amended to require invoice submission annually rather
than quarterly.
2. Exhibit 1A,Unit Report, is added.
3. Exhibit 3A,Performance Outcome Report FY 13/14,is deleted and replaced with
Performance Outcome Report FY 14/15.
4. Exhibit 5A,Program Area Unit Cost for FY 13/14, is deleted and replaced with Program
Area Unit Cost for FY 14/15.
5. Article III, contract language is changed from"quarterly reimbursement basis to Naples
Community Hospital"to "one annual payment and unit reporting for each quarter."
FISCAL IMPACT: In accordance with the LIP agreement update previously approved the
Board, the total funds DLC will receive for the mandated services are $1,385,040. Under this
amendment, the County will submit one payment of$149,566 to Naples Community Hospital,
who in turn will pay DLC. The remainder of the payments in the amount of$1,235,474 will be
made by Physicians Regional Hospital directly to DLC. Funds for the County commitment are
budgeted in the appropriate cost center in the Community and Human Services allocation of the
General Fund (001).
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated
with this Executive Summary.
/"1 LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a
majority vote for Board approval. -JAB
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RECOMMENDATION: That the Board of County Commissioners approves Fourth
Amendment to the agreement with the David Lawrence Mental Health Center, Inc. for mental
health.sod stance abuse services to conform to the most recently approved AHCA/Low
Income Pool program.
Prepared by: Leslie Hayes, Grants Coordinator, Community and Human Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.D.16.D.14.
Item Summary: Recommendation to approve Amendment Number 4 to the agreement
with the David Lawrence Mental Health Center, Inc. for mental health and substance abuse
services to conform with the most recently approved AHCA/Low Income Pool program.
Meeting Date: 1/13/2015
Prepared By
Name: HayesLeslie
Title: VALUE MISSING
11/25/2014 1:58:53 PM
Submitted by
Title: VALUE MISSING
Name: HayesLeslie
11/25/2014 1:58:54 PM
Approved By
Name: GrantKimberley
Title: Director-Housing,Human and Veteran S, Community &Human Services
Date: 12/16/2014 9:24:32 AM
Name: TownsendAmanda
Title: Director-Operations Support, Public Services Division
Date: 12/16/2014 3:20:22 PM
Name: SonntagKristi
Title:Manager-Federal/State Grants Operation, Community&Human Services
Date: 12/17/2014 8:30:07 AM
Name: AlonsoHailey
Title: Operations Analyst,Public Services Division
Date: 12/17/2014 4:57:48 PM
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Name: Bendisa Marku
Title: Supervisor-Accounting, Community&Human Services
Date: 12/19/2014 12:10:14 PM
Name: RobinsonErica
Title: Accountant, Senior,Grants Management Office
Date: 12/19/2014 4:27:46 PM
Name: CarnellSteve
Title: Administrator-Public Services, Public Services Division
Date: 12/22/2014 3:48:37 PM
Name: BelpedioJennifer
Title: Assistant County Attorney, CAO General Services
Date: 12/22/2014 3:49:09 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 1/2/2015 8:23:18 AM
Name: StanleyTherese
Title: Manager-Grants Compliance, Grants Management Office
Date: 1/5/2015 1:39:58 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 1/6/2015 8:52:47 AM
Name: DurhamTim
Title: Executive Manager of Corp Business Ops,
Date: 1/6/2015 9:20:46 AM
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FOURTH AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
DAVID LAWRENCE MENTAL HEALTH CENTER, INC.
This Amendment, is entered into this day of , 2014, by and
between David Lawrence Mental Health Center, Inc. a private not-for-profit corporation existing
under the laws of the State of Florida, herein after referred to as David Lawrence Center and
Collier County, Florida, herein after to be referred to as "COUNTY," collectively stated as the
"Parties."
WHEREAS, on December 11, 2012, the County entered into an agreement with David
Lawrence Center to provide substance abuse and mental health services to Collier County
residents (hereinafter referred to as the"Agreement"); and
WHEREAS, the Parties desire to amend the Agreement by modifying the language in
Article III, Compensation and Reports, Article IV Audits, Monitoring and Records, and Exhibits 1,
1A, 3A and 5A.
WHEREAS, this Agreement is funded by local funds matched with Federal funds as
provided in the October 23, 2012 Letter of Agreement between COUNTY and Agency for
Healthcare Care Administration that allows County participation in an
intergovernmental transfer program.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged,
the Parties agree to amend the Agreement as follows:
1. All references to Housing, Human and Veteran Services (HHVS) shall be replaced
by Community and Human Services (CHS) throughout the agreement.
2. Amend Article III Compensation and Reports, A. Contract Payment, B. Deferred
Payments and C. Contract Deliverables:
ARTICLE III COMPENSATION AND REPORTS
A. Contract Payment
Once invoiced by the DAVID LAWRENCE CENTER and validated, the
COUNTY will submit payments one payment on a quarterly reimbursenient
oasts in the first quarter of each county fiscal year to on a quarterly
reimbursement basis to the County's community hcvlth partner Naples
Community Hospital for $149,566.00 for Mental Health and Substance Abuse
services units delivered in accordance with Exhibit 5 and 5A. The DAVID
LAWRENCE CENTER agrees to accept as full compensation the total annual
amount not to exceed 5.14-541-2.00700 $149,566.00 from Naples Community
Hospital as committed to by the County and total compensation through the
Dor,rn 1
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matching program of $4,385,01-8O8. Payments will be authe '
work completed and/or .)crviccs for units delivered during the term of the
contract as stated in ARTICLE II: TERM OF CONTRACT and prior to the
payment request date. Documentation of eligible expenses units will be
provided as stated in Article III C. Contract Deliverables. Payment is subject to
the provisions of Article III B Deferred Payment/Return of Funds and Article IX,
Suspension/Termination. All requests for payment shall be submitted in
accordance with Exhibit 1 and be accompanied by the required supporting
documentation as outlined in the payment/deliverable performance table below.
Funding is contingent upon the availability of funds.
SALES TAX. The DAVID LAWRENCE CENTER shall pay all sales, consumer,
use and other similar taxes associated with the Work or portions thereof, which
are applicable during the performance of the work.
All payments are contingent upon the payment/deliverable performance table below:
Quarter 1 $149,566.00 Performance data Due Date:
October 1- Exhibit 1 Exhibit 3A and Unit January 30,2015
December 31 Data Exhibit 1A
Quarter 2 N/A Performance data Due Date:
January 1- March Exhibit 3A and April 30,2015
30 Unit Data Exhibit 1A
Quarter 3 April N/A Performance data. Due Date:
1 - June 30 Exhibit 3A and July 30,2015
Unit Data Exhibit 1A
Quarter 4 July N/A Performance data Due Date:
1 - September Exhibit 3A and October 30,2015
30 Unit Data Exhibit 1A
The County has agreed to purchase the units cervices) listed in Article I. For it
service at the fixed unit rate, as detailed in Exhibit S.
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Approved Minimum Unit By-
Bir Unit Program Area
Program Area Category and AHCk Tet-a-l-Pfetram-Afear
ar
Wig
k}ieeatienk
Adult Mental (a) Emergency $563,000 $1,030,000
Health Services 2,803 units
(b)Medical Services $363,000
(c)Immokaiee
Medical $25,000
(d)Immokalee $887899
Outpatient
Adult Substance (a) Detox $1-00,000 $230,090
Abuse 921 units
(b) Outpatient $60,000
(c)Drug Court $70,000
Children's Mental (a) Medical $58,010 $116,010
Health 314 units
(b) Urgent Care $58,000
Modifications to Article I may only be made if approved in advance by the Grant Coordinator,
Unit shifts among program areas shall not be more than 10% and does not signify a change in
scope. Fund shifts that exceed 10% of a program area shall only be made with board approval,
B. Deferred Payment/Return of Funds
The COUNTY may defer payment to the /DAVID f AWRENCE CENTER
Naples Community Hospital and Physician's Regional Hospital paid on
behalf of DAVID LAWRENCE CENTER for noncompliance with contract
deliverables or program requirements.
If, as a result of monitoring or audit, units of service provided are not
properly documented, a payment may be deferred. If units are found to
be unallowable, no future payments will be made until the full amount
of overpayment is remitted to the COUNTY or a repayment agreement
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is accepted by the COUNTY. If the monitoring or audit occurs after the
term of this contract, the DAVID LAWRENCE CENTER will be required
to remit funds to the COUNTY in accordance with the repayment
conditions below.
The DAVID LAWRENCE CENTER agrees to return to the COUNTY any
overpayments due to funds disallowed pursuant to the terms of this
Contract and/or COUNTY, State or Federal requirements. The DAVID
LAWRENCE CENTER will be required to reimburse the COUNTY for
any acts of non-compliance resulting in disallowed costs or fines.
C. Contract Deliverables
1. Required Reports (checked boxes are applicable)
Q EXHIBIT 1- Payment Request - Due: t4' The first quarter
of the County Fiscal year by the 30th of the following month. The first quarter
Ati payments will be reimbursement for e er3scs/scrviccs units and quarter two-four
shall be $0 invoices accompanied by performance and unit report for units rendered
during the contract term. •-= - - • '- -''� `•
in the Contract Closeout Sectien (Article III 2 D).•Copies of supporting unit documentation
is are required as part of the Quarterly Payment Request for review before payment will be
Lade authorized by -- - -- - - - --• - Community and Human Services.
Reimbursement for eligible units .eEpe eses Authorization will be made after review
and authorization of a correct and complete Exhibit 1 and all required performance and
unit data documentation :. != • ---`- Eligible units expcnsca are defined
as uncompensated expenses/services units delivered during the term of the contract
and paid prior to final payment request due date as indicated in the Contract Closeout
Section (Article III 2 D).
- • _ - -. - . . . - - - 'ce logs, other
fundcr invoices, expenditure -spreadsheets or other original
documor atien, as well as a ce- y-ef t-he AVID LAWR-ENCE CENTER
check issued with authorized signature. Two sided -copies of back up
ARTICLE IV AUDITS, MONITORING, AND RECORDS
A. Monitoring
The DAVID LAWRENCE CENTER agrees to permit persons duly authorized by
the COUNTY to inspect all records, papers, documents, facility's goods and
services of the DAVID LAWRENCE CENTER and/or interview any clients and
employees of the DAVID LAWRENCE CENTER to be assured of service
delivery and performance of the terms and conditions of this contract to the
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extent permitted by the law after giving the DAVID LAWRENCE CENTER
reasonable notice. The monitoring is a limited scope review of the contract and
agency management and does not relieve the DAVID LAWRENCE CENTER of
its obligation to manage in accordance with applicable rules and sound
management practices.
Following such monitoring the COUNTY will deliver to the DAVID LAWRENCE
CENTER a written report regarding the manner in which services are being
provided. The DAVID LAWRENCE CENTER will be requested to respond and
rectify all noted deficiencies within the specified period of time indicated in the
monitoring report or provide the COUNTY with a reasonable and acceptable
justification for not correcting the noted shortcomings. The DAVID
LAWRENCE CENTER'S failure to correct or justify the deficiencies within the
time specified by the COUNTY may result in the withholding of payments,
being deemed in breach or default, or termination of this Contract.
The County will conduct an annual financial and programmatic review. The Provider
agrees that Community and Human Services Department will carry out no less
than one (1) annual on-site monitoring visit and evaluation activities as determined
necessary. At the County's discretion, a desk top review of the activities may be
conducted in lieu of an on-site visit.
The continuation of this Agreement is dependent upon satisfactory evaluations. The
Provider shall, upon the request of Community and Human Services Department,
submit information and status reports required by Community and Human Services
Department to enable Community and Human Services Department to evaluate
said progress and to allow for completion of reports required. The Provider shall allow
Community and Human Services Department to monitor the Provider on site. Such
site visits may be scheduled or unscheduled as determined by Community and
Human Services Department. The County will monitor the performance of the
Provider based on performance standards as stated with all other applicable federal,
state and local laws, regulations, and policies governing the funds provided under this
contract. Substandard performance as determined by the County will constitute
noncompliance with this Agreement. If corrective action is not taken by the Provider
within a reasonable period of time after being notified by the County, contract
suspension or termination procedures will be initiated. Provider agrees to provide the
County's internal auditor(s) access to all records related to performance measures under
this agreement.
* * *
3. Amend Exhibit 1, Payment request, Attached.
4. Add Exhibit 1A, Unit Report, Attached
5. Add Exhibit 3A, Performance Outcome Report, Attached.
6. Add Exhibit 5A, Program Area Unit Cost for Fiscal Year 2014-2015, Attached.
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7. All other terms and conditions of the Agreement remain in full force and effect. This
Amendment merges any prior written and oral understanding and agreements, if any,
between the parties with respect to the matters set forth herein,
DAVID LAWRENCE CENTER: BOARD OF COUNTY COlviN/SSIONERS
OF COLLIER COUNTY, FLORIDA
By: Scott Burgess
Name (pr'rit)
By:
( *gnalture o iorized officer) TOM HENNING, CHAIRMAN
Chief Executive Officer
Title
Date
December 17,2014
Date Approved for form and legality:
Jennifer A. Belpedio
A I I EST: Assistant County Attorney
DWIGHT E. BROCK, CLERK
\‘.
By:
, DEPUTY CLERK
Page 6
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EXHIBIT I
PAYMENT REQUEST
Line Item Contract
t, ..n i• .r,... _ .. Coneant* Agency Coed Lawrence Center
cTP•' ' ' a,tra,tr..yf.ayh htalingAddress:
I:aNto:COMMA Wand Hunan SeraOea Expenderred for period: Pbnne:
ATTH:Laalie Heiea _i_'_ • ! FM:
pr,,.e•+s,2 -.. '9 Check appwpnste Ur. E-msA:
FAX.: __Register Reimbursement
E.1rig,lss ,F{ayea4Iiw0l2oynel _Final fterbursewest
Fr al Pay*nent
Report/reds*bythe twentieth calendar dayatwr Iha end or the rowing period.
C P'' '.n c..n,.,..r.^4.- I).TotaI Paid F
`6i11et�eeaiSiE•M,i;lfe•;fa.NS`i ::f:::: :'::8 tllsuutt}]l:;j, oLpdacmas4 Expenditures for
Reporting Period
it` ,iLl(C=3S�1i' is
i
S i i i i if c"i i.'i i v'i'i i i2'�':`,'i?i'i i i i i' :'.v;.;:!•...r-•
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f
P re 'io-• ilyegerpg telwc.i ne iffy drat tie•norkard.•or aerrtoes provdea ar ---FOR COLLIERCOUHTY USE ONLY-
reported in Exhibit I.are for anmmpensir5 e>•y_asesianlh,and have teen By sighting below,I certify thattothe best of my
coup lead anZ+or dehisce/lo the lust of niyknowled}e. I bather atilt that knowledge and abilities,[te work andror cervices
payment has bean made in sa»rdar ce waived applicable armies,tegutadors provided have been Inspected m ondored or reviewed
and approve/County welted. I undws tma thet know i illy providing False and appear to be In compile nos with all applicable
mfonnaton opal/mutt ib tiw P all5r,and treseWtien. skal,aec innhllith em and anncenead Cnnnty rmlriII
Skjnattrt
O Der
Aodtorde WHORE Official:
APPROVEDAl OIX4T: a
01111 Anmrtnid: DATE APPROVED:
-_.... __-____ --- Page?
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DAVID LAWRENCE CENTER Reporting Period: October 1,2013-September 30,2014
DEMOGRAPHICS OF CLIENTS SERVED Exhibit IA
UNDUPLICATED CLIENT Adult Mental Adult/Substance Child/Mental Child/Adolesc.
CHARACTERISTICS Health Abuse Health Substance Abuse
Total 5328 1816 2191 324
AGE^ ROL4Y-t M1� a_r
5 and Under -._,., .r.4�ar 1... i ` r. 87' 0
6•12years 5 -:4 .- . ' t 4' 881 7
13-17 years ,.. 3 1223 317
18-30 years 1487' 886 l x .
3 I-50 years 2017 676; _ }:�;
mn
51-61 years 1060 181
62 and over 757 73 r ;`,; .:,
Not Collected 7 0 0 0
TOTAL 5328 1816 2191 324
GENDER ... .:'e :. r. ,,.. ..
Male 2411 1078 1300 239
Female 2889 736 886 85
Not Collected 28 2 5 0
TOTAL 5328 1816 2191 324
-
American Indian or Alaska Native 2 1 12 I I 0
Asian - 28 5 II I
Black or African American - 349 88 190 45
Native Hawaiian or Pacific Islander 20 3. 9 2
While 4156, 1 527 1442 206
Multi-Racial 670 176 513 69
Other 0 0 0 0
Not Collected 84 5 - 15 I
TOTAL 5328, 1816 2191 324
Hisnanic or Latino 1277 373 948 131
Not Hispanic or Latino 3967 1438, 1228 192
_ Not Collected 84 5 15 1
TOTAL 5328 1816 2191 324
G I.RRSIDENCE AT-RFT RRAi- ;'
Goodland 34140,34145,34146* 102 37 44 17
lmmokalee 34142,34143 262 80 261 27
Lely 34113 * 233 93 87 24
Marco Island 34140,34145(*included Goodland) :"
Naples 34102,34103,34104,34105,34112 1245 383 404 72
Naples Manor 34113(4 included Lely)
Naples Park 34108* 162 45 53 14
Orangetree 34120 342 115 196 33
Pelican Bay 34108(*included Naples Park)
Pelican Ridge 34108(*included Naples Park) .
Plantation Island 34139,34141 4 5 3 0
Vineyards 34116,34119 835 285 434 59
Out of County 526 214 259 8,
Other County Not Incudcd Above 1136, 359 429 70
Not Collected 58 7 12 0
Homeless 423 193 9 0
TOTAL 5328 1816 2191 324
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Adult Mental ,. •lth Crisis u •rt mer.enc Services
Section 1 ONLYto be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract
due October 31,2015 for time period
10/01/14-9/30115
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 1:,
Adult Mental Health Crisis
Supnort/Emereencv Services
1. Outcome Statement including#or%: 350 distinct individuals that do not have
Medicaid, Medicare or other funding sources will be served each quarter in Adult
Mental Health Crisis Support/Emergency Services programs.
2, List the Activities or Services provided by this program. Adult Mental Health Crisis
Support and Emergency Services provides triage and admission services that
includes Clinical Assessments, Psychiatric Evaluations and crisis intervention for
individuals or adults who in crisis. Many assessments are completed within the
scope of the Baker Act.
3. How is outcome measured? List the tools/approaches/methods used to track or
measure this outcome. Outcome information is tracked via electronic medical
record and presented quarterly via internal reports capturing numbers and
characteristics qfpersons served.
END OF SECTION ONE
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Crisis Support/Emergencv Services.
SECTION TWO
Reporting Period: Contract year—October 1,2014—.September 30,2015
Due: QUARTERLY .
Can be submitted by mail, email or fax
OUTCOME 141:
Adult Mental Health Crisis Support/Emergency Services
I. Outcome Statement including #or%: 350 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Mental Health Crisis Support/Emergency
services programs.
2. From data collected during the term of the contract, provide the following information,:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a '/z page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
r•.
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Medical Services
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME #2:
Adult Mental Health Medical Services
1. Outcome Statement including# or%: 500 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Mental Health Medical Services program.
2. List the Activities or Services provided by this program.Adult Mental Health Medical Services include
Psychiatric Evaluations and Medication Management for persons who are experiencing
mental health problems ranging from acute to more long term treatment for a persistent
mental illness. Services also include nursing services in addition to coordination with
primary care physician.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.,
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
1 END OF SECTION ONE
---^_------_ ----- _____—._
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Medical Services,
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30,2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME#2:
Adult Mental Health Medical Services
1. Outcome Statement including#or %: 500 distinct individuals that do not have Medicaid, Medicare or
other funding sources t+'ill be served each quarter in Adult Mental Health programs.
2. From data collected during the term of the contract,provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a '/z page narrative explanation, This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process,
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Comorehensiv$ Community Service Team
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full terns of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME #3:
Adult Community Programs
1, Outcome Statement including#or%: Ladistinct individuals that do not have Medicaid,
Medicare or other funding sources will be served each quarter in Adult Mental
Comprehensive Community Service Team programs.
2. List the Activities or Services provided by this program. Adult Community Service are community
based mental health programs that include Case Management (care coordination, linking
and advocating for clients experiencing serious mental health disorders), Supported
employment, and Forensic Services for individuals within the legal system who have been
found incompetent to proceed or not guilty by insanity to proceed due to their mental
condition. Adult community services promote a recovery lifestyle that maximizes individual's
ability for independent functioning in the least restrictive setting based on their ability and individualized
need.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Comprehensive Community Service Team
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME # 3:
Adult Community Programs
1. Outcome Statement including # or%: J50 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Community programs.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a ''/z page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Outpatient
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31,2015
for time period 10/01/14-9/30115
SECTION ONE
To Be Completed and returned with contract
OUTCOME#4:
Adult Mental Health Outpatient
1, Outcome Statement including#or%: •200 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Mental Health Outpatient program.
2, List the Activities or Services provided by this program. Adult Mental Health Mental Health Outpatient
Services include individual, group and family therapy according to clinical recommendations based on the
�-o Assessment and Treatment Planning Process.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
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Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program;Adult Mental Health Outpatient
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30, 2015
Due: QUARTERLY
Can be submitted by mail,email or fax
OUTCOME 4 4:
Adult Mental Health Outpatient
1. Outcome Statement including# or%: 2911distincl individuals that do not have Medicaid, Medicare or
other f funding sources will be served each quarter in Adult Mental Health Outpatient program.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a 4 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
__-.-------___.-.- -— -- Packet Page-1689-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental_Health Crisis Stabilization Unit/CSU,
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31,2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# :
Adult Mental Health Crisis Stabilization Unit/CSU
1. Outcome Statement including# or%: Ladistinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in the Adult Mental Health Crisis
Stabilization Unit/CSU program.
2. List the Activities or Services provided by this program. Adult Mental Health Programs include the
Crisis Stabilization Unit that provides short term, inpatient crisis stabilization and support
for individuals or adults who are either at risk of harming themselves or others due to a
mental health crisis. David Lawrence Center manages the only Baker Act receiving facility for
Collier County.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics ofpersons served.
END OF SECTION ONE I
Page - -- -
Packet Page -1690-_��
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Mental Health Crisis Stabilization Unit i CSU.
SECTION TWO
Reporting Period: Contract year-October 1, 2014-September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 5:
Adult Mental Health Crisis Stabilization Unit/CSU
1. Outcome Statement including#or%: 150 distinct individuals that do not have Medicaid, Medicare
or other funding sources will be served each quarter in the Adult Mental Health Crisis
Stabilization Unit/ CSU program.
2. From data collected during the term of the contract,provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO 1
Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
- — ___ — — —
— - Packet Page-1691--
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Adult Mental Health I Crijiz,Stabilization Unit/CSU
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31,2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME#6:
Crisis Stabilization Unit
L Outcome Statement including%: 85% or more of individuals discharged from the Crisis
Stabilization Unit (CSU) will not be readmitted during the 30 days following discharge.
2. List the Activities or Services provided by this program. The Adult Crisis Stabilization Unit provides
short term, inpatient crisis stabilization and support for persons who are either at risk of
harming themselves or others due to a mental health crisis. The CSU is the only Baker Act
receiving facility for Collier County.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome,
Outcome information is tracked via electronic medical record database and presented quarterly via
internal reports capturing numbers and percentages of people re-admitted within 30 days.
END OF SECTION ONE
Page
Packet Page-1692-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program: Adult Mental Health I Crisis Stabilization Unit I CSU
.m.
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30,2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME#6:
Crisis Stabilization Unit
1. Outcome Statement including%: 85% or more of individuals discharged from the Crisis
Stabilization Unit (CSU) will not be readmitted during the 30 days following discharge.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients did the CSU admit during the specified time period?
B. How many unduplicated clients were measured for this outcome during the time period?
C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)?
D. How many of the unduplicated clients from B achieved the outcome during the time period?
E. Outcome percentage (D divided by B):
END OF SECTION TWO
Agencies are welcome to submit a 1/4 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page -- -- - - ---- - ,�
Packet Page -1693-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Adult Substance Abuse Outpatient
Section 1 ONLI'to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31,2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME #7:
Adult Substance Abuse Outpatient
1. Outcome Statement including#or%: 120 distinct individuals that do not have Medicai4 Medicare or
other funding sources will be served each quarter in Adult Substance Abuse Outpatient programs.
2. List the Activities or Services provided by this program.Adult Substance Abuse Outpatient Services include
'dividual, group and family therapy according to clinical recommendations based on the Assessment
id Treatment Planning Process. Outpatient Services also include the Drug Court program and
Intensive Outpatient Service program. Different levels of group therapy are available based on the
intensity of the substance abuse or dependency. Treatment focuses on helping the individual accept
his/her addiction and support the individual in establishing a recovery lifestyle. The Drug Court
program diverts offenders with substance abuse and drug related criminal activity from the criminal
justice system by offering them an opportunity to proactively deal with their dependence rather than
face punitive alternatives.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
L END OF SECTION ONE ,J
Page _ -- —–
Packet Page-1694-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Adult.Substance Abuse Outpatient
• SECTION TWO.
Reporting Period: Contract year--October I,2014—September 30,2015
Due: QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 7:
Adult Substance Abuse Outpatient
1. Outcome Statement including# or%: 120 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Substance Abuse programs.
2. From data collected during the term of the contract,provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a 4 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
—
�— Packet Page -1695-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Detox
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME#8:
Adult Substance Abuse Detox
1. -Outcome Statement including# or%: 80 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in the Adult Substance Abuse Detox program.
2. List the Activities or Services provided by t:hisprogram. Adult Substance Abuse Programs include the
Detox program which is a voluntary, medically- managed program for individuals who are in need of
detoxification services.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
Page __—__
--------
—� — Packet Page -1696-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Detox
SECTION TWO
Reporting Period: Contract year—October 1, 2014 —September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME#8:
Adult Substance Abuse Detox
1. Outcome Statement including# or%: 80 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in.the Adult Substance Abuse Detox program.
2, From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a 1/2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
Packet Page -1697-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Residential Level 1
Section I ONLY to be completed at time of contract execution.
Section 2 to be completed quarterly for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME#9:
Adult Substance Abuse Residential Level I.
1. Outcome Statement including#or%: Z.distinct individuals that do not have Medicaid,
Medicare or other funding sources will be served each quarter in the Adult Substance
Abuse residential program.
2. • I " , .; :� ,_ _ ,► •c , , i , , ,• , .r: A. Adult Substance Abuse Programs include
the Residential Program, Crossroads, which is a licensed Level I residential facility.
Services are structured and individualized with focus on therapeutic rehabilitation
provided to those suffering from alcohol or chemical dependency that need residential
level of care.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal
reports capturing numbers and characteristics of persons served.
END OF SECTION ONE
-
Page — 'l
�__ _ Packet Page-1698-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Residential Level I
SECTION TWO . ,. .
Reporting Period: Contract year—October 1,2014—September 30, 2015
Due.: QUARTERLY •
Can be submitted by mail, email or fax
OUTCOME##9:
Adult Substance Abuse Residential Level T
1. Outcome Statement including#or%: 25 distinct individuals that do not have Medicaid, Medicare or
other.funding sources will be served each quarter in the Adult Substance Abuse residential program.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page Packet Page -1699-^—
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Crisis S Wort/ meraency is
Section 1 ONLYto be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31,2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 10;
Adult Substance Abuse Crisis Supnort/Emergency Services
1. Outcome Statement including#or%: ,Jdistinct individuals that do not have Medicaid,
Medicare or other funding sources will be served each quarter in Adult Substance
Abuse Crisis Support/ Emergency Service programs.
2. List the Activities or Services provided by this program. Adult Substance Abuse Programs
include Crisis Support and Emergency Services that provide triage and admission
services. These services include Clinical Assessments and crisis intervention for adults
who present initially for substance abuse services or are in crisis relating to substance
use.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal
reports capturing numbers and characteristics of persons served
END OF SECTION ONE 1
Page
Packet Page-1700-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Crisis Support I Emergency Services
SECTION TWO
Reporting Period: Contract year—October 1,2014-September 30, 2015
Due: QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 10:
Adult Substance Abuse Crisis Support/Emergency Services
1. Outcome Statement including#or%: 100 distinct individuals that do not have Medicaid, Medicare
or other funding sources will be served each quarter in Adult Substance Abuse Crisis
Support/ Emergency Services programs.
2. From data collected during the term of the contract, provide the following information:
1. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a ''/2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
-- ---– – - —
Page
—-- - ___ —
Packet Page -1701-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Adult Substance Abuse Case Manaagement
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME # 11:
Adult Substance Abuse Case Management
1. Outcome Statement including#or%: SD distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Substance Abuse Case Management
Services.
2. List the Activities or Services provided by this program.Adult Substance Abuse Programs include Case
Management Services which are outreach, screening, referral, linking and monitoring services provides
to those families and children that are at risk due to substance us.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal
reports capturing numbers and characteristics of persons served.
END OF SECTION ONE
Page
Packet Page -1702-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program: Adult Substance Abuse Case Management
SECTION TWO
Reporting Period: Contract year—October 1,2014—.September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 11:
Adult Substance Abuse Case Management
1. Outcome Statement including# or%: 50 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Adult Substance Abuse Case Management
Services.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the
time period?
END OF SECTION TWO
Agencies are welcome to submit a V2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
ti'}4 r
Pags
Packet Page-1703- ___ --------_—_-___---
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Childrens Mental Health Medical Services
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31,2015.
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 12:
Childress Mental Medical Health Medical Services
I. Outcome Statement including#or%: 2Ldistinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Medical Services,
2, List the Activities or Services provided by this program. Childress Mental Health Programs include
Children's Medical Services that include Psychiatric Evaluations and Medication Management
for children who are experiencing mental health problems ranging from acute to more long
term treatment for a persistent mental illness. Services also include nursing services in
addition to coordination with primary care physician.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome informationn is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served
END OF SECTION ONE
Page
Packet Page -1704-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Childrens Mental Health Medical Services,
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 12:
Childrens Mental Health Medical Services.
1. Outcome Statement including#or°A°: 25 distinct individuals that do not have_Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Medical Services.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a AZ page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
Packet Page -1705-.._...—_
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Children's Mental Health Crisis Support i Emergency Services
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31,2915
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 13:
Children's Mental Crisis Support/Emergency Services
I. Outcome Statement including# or%: ,distinct individuals that do not have Medicaid, Medicare or other
funding sources will be served each quarter in Children's Mental Health Crisis Support/Emergency
Services programs.
2. List the Activities or Services provided by this program. Children's Mental Health Programs include
Children's Crisis Support and Emergency Services that provide triage and admission services
including Clinical Assessments, Psychiatric Evaluations and crisis intervention for children
who in crisis. Many assessments are completed within the scope of the Baker Act.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics ofpersons served.
END OF SECTION ONE
Page
Packet Page -1706-
1/13/2015 16:D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program: Children's Mental Health Crisis SuoDOrt 1 Emergency Service
SECTION TWO
Reporting Period: Contract year—October 1,2014--September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 13:
Children's Mental Heal h Crisis Su ort f Emer.encv Services
1. Outcome Statement including 1 or%:35 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Crisis Support/
Emergency Services programs.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO 1
Agencies are welcome to submit a 1/4 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
r-�
Page
Packet Page -1707-_____
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program: Children's Community Programs,
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# l4:
Children's Comrnunitv_Programs
1. Outcome Statement including#or%: 25 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Community programs.
2. List the Activities or Services provided by this program, Children's Community Programs are mental health
,cervices consisting of Case Management (care coordination, linking and advocating for clients
eriencing serious mental health disorders), and community based services provided in the home,
at school and other locations in the community. Children's Community Services promote family
involvement in the Child's treatment and recovery.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
Page
Packet Page-1708-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Children's Community Programs
SECTION TWO
Reporting Period: Contract year-October 1, 2014-September 30,2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 14;
Children's Community Programs
1. Outcome Statement including# or%: 25 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Community Programs,
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a .4 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page ----- _.- --__ . _..___- __
Packet Page-1709-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Children's Mental Health Outpatient
Section 1 ONLY to be completed at time of contract execution,
Section 2 to be completed for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 15:,
Children's Mental Health Outpatient
1. Outcome Statement including#or%: ILdistinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Outpatient program.
2. List the Activities or Services provided by this program. Children's Mental Health Programs include
Children's Mental Health Outpatient Services that provide individual, group and family therapy
-according to clinical recommendations based on the Assessment and Treatment Planning Process.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
Page ---- ---___
�� ---�-- Packet Page-1710- —
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Provider Name: David Lawrence Center
Program: Children's Mental Health Outpatient
SECTION TWO
Reporting Period: Contract year—October 1, 2014— September 30, 2015
Due : QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 15:
Children's Mental Health Outpatient
1. Outcome Statement including#or%: 30 distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Outpatient
program.
2, From data collected during the term of the contract,provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
END OF SECTION TWO
Agencies are welcome to submit a V2 page narrative explanation. This could include explanation regarding your actual versus
target percentage and any comments about the outcome results or the outcome process.
Page
Packet Page -1711-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program:Children's Mental Health Crisis Stabilization 'CSU,
Section 1 ONLY to be completed at time of contract execution.
Section 2 to be completed for full term of the contract due October 31, 2015
for time period 10/01/14-9/30/15
SECTION ONE
To Be Completed and returned with contract
OUTCOME# 16:.
Children's Mental Health Crisis Stabilization /CSU
I. Outcome Statement including#or%: Edistinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Crisis
Stabilization /CSU program,
2. List the Activities or Services provided by this program. Children's Mental Health Programs include the
Crisis Stabilization Unit that provides short term, inpatient crisis stabilization and support
for children who are either at risk of harming themselves or others due to a mental
health crisis. David Lawrence Center manages the only Baker Act receiving facility for
Collier County.
3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome.
Outcome information is tracked via electronic medical record and presented quarterly via internal reports
capturing numbers and characteristics of persons served.
END OF SECTION ONE
Page -.�—
Packet Page-1712-
1/13/2015 16.D.14.
Exhibit 3A
PERFORMANCE OUTCOME REPORT
Program: Children's Mental Health Crisis Stabilization/CSU
SECTION TWO
Reporting Period: Contract year—October 1,2014—September 30, 2015
Due: QUARTERLY
Can be submitted by mail, email or fax
OUTCOME# 16:
Children's Mental Health Crisis Stabilization /CSU,
1. Outcome Statement including# or%: B distinct individuals that do not have Medicaid, Medicare or
other funding sources will be served each quarter in Children's Mental Health Crisis Stabilization / CSU
program.
2. From data collected during the term of the contract, provide the following information:
A. How many unduplicated clients were served and were measured for this outcome during the time
period?
L_ END OF SECTION TWO
Agencies are welcome to submit a Yz page narrative explanation. This could include explanation regarding your actual
versus target percentage and any comments about the outcome results or the outcome process.
40
Packet Page-1713-
1/13/2015 16.D.14.
Exhibit 5A update for 2014-2015
DAVID LAWRENCE MENTAL HEALTH CENTER, INC.
For all programs Collier County purchases services and assists with the costs that are in
addition to funding by Central Florida Behavioral Health Network (CFBHN), the managing
entity for substance abuse and mental health funding for the Florida Department of
Children and Families.
• ADULT MENTAL HEALTH
Pro' ram Areas:
.'('/'.�.^' r►_�1ci5 S�Ip�7oxt/Eitter�eracy �YI;Y�C��.::. L tFJ + x - � _:
1) DLC Projected Cost to provide a unit of service = $42.71
2) DLC county Unit Rate = $42.71
3) State Maximum Rate = $42.71
4) CFBHN Contract Rate = $42.71
5) Hours, days, location of operation:,
24 hours a day / 7 days a week
6075 Bathey Lane Naples, Florida
6) Activities/Services provided Services include Crisis Assessment, Risk
Assessment, Crisis Intervention, Crisis Support referral for Urgent Care
Services or other appropriate service(s) within or outside the agency,
and/or referral for Admission to an appropriate Acute Care Unit. The
Emergency Services Assessment team works collaboratively with the
Acute Care team, where ongoing clinical triage/assessment occurs off
hours and on weekends.
7) Target population: Adults experiencing acute and serious mental health or
substance abuse problems.
1) DLC Projected Cost to provide a unit of service = $370.69
2) DLC county Unit Rate = $370.69
3) State Maximum Rate = $369.55
4) CFBHN Contract Rate = $369.55
5) Hours, days, location of operation:
8:00-5:00 Monday thru Thursday; 8:00-3:00 Friday
6075 Bathey Lane Naples, Florida
6) Activities/Services provided: Psychiatric evaluation, medication
management and nursing services.
7) Target Population: Adults experiencing mental health problems or severe
and persistent mental illness.
41
Packet Page-1714-
1/13/2015 16.D.14.
#3 _A►duJf Target d case Management _. i_ _,:...£.ti_- i
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State Maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: Provides an array of services to individuals in their natural
environment, which range from assessing one's living arrangements and mental status
to accompanying an individual to psychiatric, social service, and other appointments.
Additionally, an Adult Case Manager will plan and coordinate an individual's discharge
from all inpatient treatment facilities by linking the individual with recommended
services and basic needs to ensure successful transition into the community at large.
The Case Managers will ensure continuity of care via regular and ongoing
communication with other service providers, family members, and other natural
supports with regard to the served individual's needs and progress. Case Managers
make comprehensive efforts to facilitate clients in achieving an optimal level of
independence by linking them to internal and community resources. Case Managers
assist the individual to identify their needs on a holistic basis and seek to link them to
all potentially beneficial resources.
7) Target population: Adults experiencing mental health problems.
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State Maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: Forensics is a service provided to consumers within the
legal system who have been found incompetent to proceed or not guilty by reason of
insanity due to their mental condition but who have been charged with a felony. They
receive advocacy, support, monitoring, technical assistance and facilitation of
movement through the criminal justice system.
7) Target population: Adults experiencing mental health problems.
42
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#S-1.1-ehtai:Heai D rt � '�� :V - r° . � �. .,.,. -, r w*.... _.- .
th.,C U.a-. .
_. .. � -..... 3 ter . .._
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State Maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: Mental Health Court Program represents an effort to
increase cooperation between the criminal justice system and the mental health
treatment system. The intent of the program is to assist select defendants struggling
with a mental illness who have committed a non-violent crime with numerous services
in order for the person to become stable. Referrals may originate from legal services,
family members, or community providers that have concerns regarding the individual
mental health status.
7) Target population: Adults experiencing mental health problems.
4t.5:-..$1,1 Orted PEmphymerit '.,, , . z
1) DLC Projected Cost to provide a unit of service = $71.14
2) DLC county Unit Rate = $71.14
3) State Maximum Rate = $51.99
4) CFBHN Contract Rate = $51.99
5) Hours, days, location of operation:
8:00-5:00 Monday thru Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: These services, offered to adults 18 years or older,
provide resources to assist clients with entering the workforce and maintaining strong
employment relationships. On the job assistance is included in these services along
with unlimited ongoing support.
7) Target population: Adults experiencing mental health problems.
#J rifiiid kieWiS ttance iikT1 6:11 o1i iii:02Hometdsness 1011/:- ._
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State Maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Friday
2806 S. Horseshoe Dr. Naples, Florida
43
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1/13/2015 16.D.14.
6) Activities/Services provided: Project for Assistance in Transition from Homelessness
(PATH) is a Homeless Outreach program designed to identify homeless individuals in
the community and link them to appropriate services such as housing, medical,
substance abuse and mental health services. Case management, supported living,
housing and vocational services are provided as needed.
7) Target population: Adults experiencing mental health problems.
•
*A Adu t__t0.a4.t fW4ifi ft)u j atien't. ` 'gg ... n,, ....,. .... , .. . 4 ,W... ..;
1) DLC Projected Cost to provide a unit of service = $93.82
2) DLC county Unit Rate = $93.82
3) State Maximum Rate = $91.09
• 4) CFBHN Contract Rate = $91.09
5) Hours, days, location of operation:
8:00-6:00 Monday-Thursday; 8:00-3:00 Friday
6075 Bathey Lane Naples, Florida
6) Activities/services provided: Outpatient Services include integrated mental health and
co-occurring services following a brief treatment model of intervention. Services
include individual, marital, family, and group counseling services; educational
components within the provision of treatment services; treatment planning; linking
and referral services; and clinical care management. Counseling groups are created
based on assessed client needs and demand.
7) Target population: Adult individuals experiencing primary mental health problems. .
7Adutt Mer tali.t :ealth=PGrisi O Sitabjijzation,KO ` 4 ' - ' `:
1) DLC Projected Cost to provide a unit of service = $380.56
2) DLC county Unit Rate = $380.56
3) State Maximum Rate = $291.24
4) CFBHN Contract Rate = $380.72
5) Hours, days, location of operation:
24 hours day/ 7 days a week
6075 Bathey Lane Naples
6) Activities/services provided: Short term crisis stabilization and support for individuals
who are either at risk of harming themselves or others due to a mental health crisis.
Individuals may receive voluntary or involuntary services within the scope of the
Florida Baker Act. David Lawrence Center is the only Baker Act receiving facility in
Collier County.
7) Target population: Adults experiencing acute and serious mental health problems.
44
Packet Page-1717-
1/13/2015 16.D.14.
. 3 trisRS stabilizatioitPer, ex to a . 11iire._igiff .a;rate a 11 is sifike ,.,;=
No Rates
• ADULT SUBSTANCE ABUSE
Program Areas:
(.# .t Ad apt S.ufista i6ecAbii;ielOtitii ttent ,, t, ;;,< ,„ ,:.= L :A
1) DLC Projected Cost to provide a unit of service = $93.82
2) DLC county Unit Rate = $93.82
3) State Maximum Rate = $91.09
4) CFBHN Contract Rate = $91.09
5) Hours, days, location of operation:
8:00-6:00 Monday-Thursday; 8:00-3:00 Friday
6075 Bathey Lane Naples, Florida
6) Activities/services provided: Outpatient Services include integrated substance abuse
and co-occurring services following a brief treatment model of intervention. Services
include individual, marital, family, and group counseling services; educational
components within the provision of treatment services; treatment planning; linking
and referral services; and clinical care management. Counseling groups are created
based on assessed client needs and demand. Each client's length of stay is determined
by individual need and the appropriateness of the intervention
7) Target population: Adult individuals experiencing primary substance abuse or
dependency problems
t� P!{u iyi 4y',�Lra,1 lIZ .. < y �, Y. k t +: 0t : i - `�
,113 #OX_..,..,._ -_.-.._ . ,::; _._. .._.:: ... .:.. .....<.._ -,.
1) DLC Projected Cost to provide a unit of service = $249.79
2) DLC county Unit Rate = $249.79
3) State Maximum Rate = $204.94
4) CFBHN Contract Rate = $204.94
5) Hours, days, location of operation:
24 hours a day/ 7 days a week
6075 Bathey Lane Naples, Florida
6) Activities/services provided: Medically managed detoxification program.
7) Target population: Adults presenting with symptoms of alcohol or substance
withdrawal or signs that withdrawal syndrome is imminent.
1) DLC Projected Cost to provide a unit of service = $229.69
2) DLC county Unit Rate = $229.69
45
Packet Page-1718-
1/13/201516.D.14.
3) State maximum Rate = $241.10
4) CFHBN Contract Rate = $229.69
5) Hours, days, location of operation:
24 hours a day/ 7 days a week
6075 Bathey Lane Naples, Florida
6) Activities/Services provided: Services are structured and individualized with focus on
therapeutic rehabilitation provided to those suffering from alcohol or chemical
dependency that need residential level of care.
7) Target population: Adult individuals experiencing substance abuse or dependency
problems that need residential care.
43,4; Cris:is-Sapporo hirer .6-0.SerY ke:§U. ...:yEag_= aVag " R
1) DLC Projected Cost to provide a unit of service = $42.71
2) DLC county Unit Rate = $42.71
3) State Maximum Rate = $42.71
4) CFBHN Contract Rate = $42.71
5) Hours, days, location of operation:
24 hours a day / 7 days a week
6075 Bathey Lane Naples, Florida
6) Activities/Services: Evaluations, assessments or crisis intervention counseling for
individuals in crisis. Individuals may receive voluntary or involuntary services within .-.
the scope of the Florida Baker Act. David Lawrence Center is the only Baker Act
receiving facility in Collier County.
7) Target Population: Adults experiencing acute and serious mental health or substance
abuse problems.
#i$7Cae Manag±am;erit i ,. -
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Thursday; 8:00-3:00 Friday
All locations
6) Activities/Services provided: Services which are outreach, screening, referral, linking
and monitoring services provided to those families and children that are at risk due to
substance abuse.
7) Target Population: Adult individuals experiencing substance abuse or dependency
problems.
46
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1/13/2015 16.D.14.
• CHILDREN'S MENTAL in
Program Areas:
10 thifitre ii$4dial'Bervices a._:r A _ ...
1) DLC Projected Cost to provide a unit of service = $370.69
2) DLC county Unit Rate = $370.69
3) State Maximum Rate = $369.55
4) CFBHN Contract Rate = $369.55
5) Hours, days, location of operation:
8:00-5:00 Monday thru Thursday; 8:00-3:00 Friday
6075 Bathey Lane Naples, Florida
6) Activities/Services provided: Community based programs that include Case
Management (care coordination, linking and advocating for clients experiencing serious
mental health disorders), and community based services provided in the home, at
school and other locations in the community. Children's Community Services promote
family involvement in the Child's treatment and recovery.
7) Target population: Children experiencing mental health problems.
#.�7,�r�5is�iLpport�finerger��:y,.Seruices;` .�,t„, ,
1) DLC Projected Cost to provide a unit of service = $42.71
2) DLC county Unit Rate = $42.71
3) State Maximum Rate = $42.71
4) CFBHN Contract Rate = $42.71
5) Hours, days, location of operation:
24 hours a day / 7 days a week
6075 Bathey Lane Naples, Florida
6) Activities/Services provided: Services include Crisis Assessment, Risk Assessment,
Crisis Intervention, Crisis Support referral for Urgent Care Services or other
appropriate service(s) within or outside the agency, and/or referral for Admission to an
appropriate Acute Care Unit. The Emergency Services Assessment team works
collaboratively with the Acute Care team, where ongoing clinical triage/assessment
occurs off hours and on weekends.
7) Target population: Children experiencing acute and serious mental health or substance
abuse problems.
#1$`-.Therap. u �c Behavioral O;i .S�t&Servtces;(TBit?;SS� :l
1) DLC Projected Cost to provide a unit of service = $102.75
2) DLC county Unit Rate = $102.75
3) State Maximum Rate = $70.20
47
( )
Packet Page-1720-
1/13/2015 16.D.14.
4) CFBHN Contract Rate = $70.20
5) Hours, days, location of operation:
8:00-5:00 Monday thru Thursday; 8:00-3:00 Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: Provides individualized therapeutic services to children
and adolescents in community settings including: home, daycare, school, and work
with the goal of strengthening family systems and increasing protective factors
resulting in youth living at home and living successfully in their community. The child
must meet specific criteria based on the Community Behavioral On-site Coverage and
Limitations Handbook and/or as specified in the Center's Utilization Management
Program. Youth may be at risk for residential placement or in the process of being
stepped down from a residential program.
7) Target population: Children experiencing mental health problems.
1) DLC Projected Cost to provide a unit of service = $76.64
2) DLC county Unit Rate = $76.64
3) State Maximum Rate = $63.21
4) CFBHN Contract Rate = $63.21
5) Hours, days, location of operation:
8:00-5:00 Monday thru Thursday; 8:00-3:00 Friday
2806 S. Horseshoe Dr. Naples, Florida
6) Activities/Services provided: Services consist of an assessment aimed at identifying
an individual's complex needs, advocating and coordinating access to various service
systems; monitoring and evaluating service delivery to ensure the unique needs of the
individual are met; and coordinating the various service and system components to
optimize individual functioning.
7) Target population: Children experiencing mental health problems.
144-20_400d i':.6ii-S IijiL ai Mealth 3:iitiiitierit
1) DLC Projected Cost to provide a unit of service = $93.82
2) DLC county Unit Rate = $93.82
3) State Maximum Rate = $91.09
4) CFBHN Contract Rate = $91.09
5) Hours, days, location of operation: 8:00-5:00 Monday & Thursday; 8:00-7:00 Tuesday
& Wednesday; 8:00-3:00 Friday
6075 Bathey Lane Naples, Florida
6) Activities/services provided: Outpatient Services include integrated mental health and
co-occurring following a brief treatment model of intervention. Services include
individual, family, and group counseling services; educational components within the
provision of treatment services; treatment planning; linking and referral services; and
clinical care management.
48
k0' 't
Packet Page -1721-
1/13/2015 16.D.14.
7) Target population: Individuals experiencing primary mental health problems and/or a
combination of mental health and substance abuse or dependency problems.
1) DLC Projected Cost to provide a unit of service = $380.56
2) DLC county Unit Rate = $380.56
3) State Maximum Rate = $291.24
4) CFBHN Contract Rate = $380.72
5) Hours, days, location of operation:
24 hours day/ 7 days a week
6075 Bathey Lane Naples
6) Activities/Services provided: Short term crisis stabilization and support for individuals
who are either at risk of harming themselves or others due to a mental health crisis.
Individuals may receive voluntary or involuntary services within the scope of the
Florida Baker Act. David Lawrence Center is the only Baker Act receiving facility in
Collier County.
7) Target population: Children experiencing acute and serious mental health problems.
49
Packet Page -1722-