HomeMy WebLinkAbout32683COUNTY OF FRESNO
Fresno, CA
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AGREEMENT
THIS AGREEMENT is made and entered into this __________ day of ______________ 2018,
by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
hereinafter referred to as "COUNTY", and FRESNO COUNTY SUPERINTENDENT OF SCHOOLS., a
Political Subdivision of the State of California, whose address is 1111 Van Ness Avenue, Fresno, CA,
93721, hereinafter referred to as "CONTRACTOR".
W I T N E S S E T H:
WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), is looking to expand
mental health treatment and prevention and early intervention services for children and youth at school,
home, and community locations in Fresno County; and
WHEREAS, COUNTY, through its DBH, Mental Health Services Act (MHSA), Community
Service and Supports (CSS) and Prevention and Early Intervention (PEI) component, and through
input from the community stakeholder process, recognizes the need to provide school based mental
health treatment and PEI for both metropolitan and rural areas to children and youth enrolled in school
grades Kindergarten through High School, as specified in this Agreement and as part of Fresno
County’s approved State CSS and PEI Plans, to provide services related to mental well-being; and
WHEREAS, COUNTY, through its DBH, Mental Health Services Act (MHSA), Prevention and
Early Intervention (PEl) component, recognizes the need to provide Prevention and Early Intervention
School Based Programs (PEISBP) Kindergarten through Twelfth Grade, as specified in this
Agreement and as part of Fresno County's approved State PEI Plan, to help reduce stigma and
discrimination against mental illness and provide services related to mental well-being and mental
health services; and
WHEREAS, children/youth with Serious Emotional Disturbance (SED) who also experience co-
occurring mental health and alcohol/substance use disorders and/or discipline issues will be included
among those served; and
WHEREAS, CONTRACTOR’s school districts are public schools districts which also coordinate
their own mental health services within the jurisdictional boundaries specific to each school district; and
///
Agreement No. 18-308
5th June
COUNTY OF FRESNO
Fresno, CA
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WHEREAS, CONTRACTOR has similar goals of COUNTY to expand mental health treatment
and prevention and early intervention services for it students and families across the County of Fresno,
and to provide integrated student supports through a collaboration with the COUNTY’s DBH; and
WHEREAS, COUNTY, through its DBH, is a Mental Health Plan (MHP), as defined in Title 9 of
the California Code of Regulations (C.C.R.), Section 1810.226; and
WHEREAS, CONTRACTOR is qualified, has the staffing, facilities, support services and is
willing to provide said expanded mental health services at school, home and community locations
throughout Fresno County, pursuant to the terms and conditions of this Agreement.
NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
hereto agree as follows:
1. SERVICES
A. CONTRACTOR shall perform all services and fulfill all responsibilities as set forth
in Exhibit A-1, Exhibit A-2, and Exhibit A-3, “Specialty Mental Health Services Scope of Work, Prevention
and Early Intervention Services Scope of Work,” Continuum of Care Vision and Strategies, all attached
hereto and by this reference incorporated herein and made part of this Agreement.
B.CONTRACTOR shall align programs, services, and practices with the vision,
mission, and guiding principles of the County of Fresno, Department of Behavioral Health (DBH), as
further described in Exhibit B, “Fresno County Department of Behavioral Health Guiding Principles of
Care Delivery”, attached hereto and by this reference incorporated herein and made part of this
Agreement.
C.CONTRACTOR shall send to County’s DBH upon execution of this Agreement, a
detailed plan ensuring clinically appropriate leadership and supervision of their clinical program.
Recruitment and retaining clinical leadership with the clinical competencies to oversee services based on
the level of care and program design presented herein shall be included in this plan. A description and
monitoring of this plan shall be provided to the COUNTY’s DBH.
D. CONTRACTOR shall establish and maintain Medi-Cal certification, medi-cal site
certification, or become certified within ninety (90) days of the effective date of this Agreement through
the COUNTY to provide reimbursable services to Medi-Cal eligible clients. In addition, CONTRACTOR
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shall work with the COUNTY’s DBH Managed Care Division for credentialing of staff. CONTRACTOR
shall be required to become Medi-Cal certified prior to providing services to Medi-Cal eligible clients and
seeking reimbursement in COUNTY’s billing system. CONTRACTOR shall not be reimbursed by
COUNTY for any Medi-Cal services rendered prior to certification.
E. CONTRACTOR shall also provide tracking tools and measurements for access,
effectiveness, efficiency, and client satisfaction indicators as required by the Commission on
Accreditation of Rehabilitation Facilities (CARF) standards and as further detailed in Exhibits A-1 and A-
2, Scope of Work.
F. CONTRACTOR shall participate in utilizing and integrating the Reaching
Recovery tools and outcomes as applicable to CONTRACTOR and as directed by the COUNTY’s DBH.
G. It is acknowledged by all parties hereto that COUNTY’s DBH Contracts Division
unit shall monitor this program operated by CONTRACTOR, in accordance with Section Fourteen (14) of
this Agreement.
H. CONTRACTOR shall participate in monthly, or as needed, workgroup meetings
consisting of staff from COUNTY’s DBH to discuss service requirements, data reporting, training,
policies and procedures, overall program operations and any problems or foreseeable problems that
may arise. CONTRACTOR shall also participate in other COUNTY meetings, such as but not limited to
QI meetings, provider meetings, Behavioral Health Board meetings, etc.
I. CONTRACTOR shall maintain requirements as an organizational provider
throughout the term of this Agreement, as described in Section Seventeen (17) of this Agreement. If for
any reason, this status is not maintained, COUNTY may terminate this Agreement pursuant to Section
Three (3) of this Agreement.
J. CONTRACTOR agrees that prior to, and while providing services under the
terms and conditions of this Agreement, CONTRACTOR shall have staff hired and in place for program
services and operations or COUNTY may, in addition to other remedies it may have, suspend referrals
or terminate this Agreement, in accordance with Section Three (3) of this Agreement.
K. It is acknowledged by all parties hereto that the ramp up period shall commence
on July 1, 2018 and continue through December 2018. Each subsequent fiscal year and subsequent
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geographical location/hubs shall also have start up periods as further identified in the budget sheets
(Exhibit C). Due to the timing of staff hires, staff trainings completed, and other program related
factors, the dates of the ramp up period and initial operational period may be adjusted as needed with
the written approval of COUNTY’s DBH Director, or designee. Budgets amounts shall be prorated
accordingly from the start up budgets to operational budgets, without going over the annual contract
maximum.
L.It is acknowledged by all parties hereto that CONTRACTOR’s service school
sites shall be as identified in Exhibit A-4, attached hereto and incorporated herein by reference and
made part of this Agreement. Any change/addition/deletion to CONTRACTOR(S) location of the
service sites may be made only upon thirty (30) days advance written notification to COUNTY’s DBH
Director and upon written approval from COUNTY’s DBH Director, or designee.
M. CONTRACTOR may maintain its records in COUNTY’s Electronic Health Record
(EHR) system (Avatar) in accordance with Exhibit E, “Documentation Standards for Client Records,”
attached hereto and incorporated herein by reference and made part of this Agreement, beginning July
1, 2018. The client record shall begin with registration and intake and include client authorizations,
assessments, plans of care, and progress notes, as well as other documents as approved by the
County’s DBH. COUNTY shall be allowed to review records of services provided, including the goals
and objectives of the treatment plan, and how the therapy provided is achieving the
goals and objectives. If CONTRACTOR determines to maintain its records in AVATAR, it shall provide
COUNTY’s DBH Director, or designee, with a 30-day notice. If at any time CONTRACTOR chooses
not to maintain its records in AVATAR, it shall provide COUNTY’S DBH Director, or designee, with a
30-day notice and CONTRACTOR will be responsible for obtaining its own system, at its own cost, for
Electronic Health Records management. Disclaimer - COUNTY makes no warranty or representation
that information entered into the COUNTY’s EHR system by CONTRACTOR will be accurate, adequate
or satisfactory for CONTRACTOR’s own purposes or that any information in CONTRACTOR’s
possession or control, or transmitted or received by CONTRACTOR, is or will be secure from
unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely responsible for
client information entered by CONTRACTOR into the COUNTY’s EHR system. CONTRACTOR agrees
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that all Private Health Information (PHI) maintained by CONTRACTOR in COUNTY’s EHR system will
be maintained in conformance with all HIPAA laws, as stated in Section Nineteen (19), “Health
Insurance Portability and Accountability Act.
N.It is mutually agreed by all parties to this Agreement, that the program funded
under this Agreement shall be identified and subsequently named/branded through the review and
approval of the Director, Department of Behavioral Health or designee. All print or media materials,
including program branding and program references shall be reviewed and approved by the Director,
Department of Behavioral Health or designee. The program funded under this Agreement shall be
identified as a County of Fresno, Department of Behavioral Health funded program, and operated by
the CONTRACTOR under the terms and conditions of this Agreement.
2. TERM
The term of this Agreement shall be for a period of three (3) years, commencing on the
1st day of July, 2018 through and including June 30, 2021. This Agreement may be extended for two
(2) additional consecutive twelve (12) month periods upon written approval of both parties no later than
thirty (30) days prior to the first day of the next twelve (12) month extension period. The COUNTY’s
DBH Director, or designee, is authorized to execute such written approval on behalf of COUNTY based
on CONTRACTOR’s satisfactory performance.
3.TERMINATION
A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving CONTRACTOR sixty (60) days advance written notice.
B.Breach of Contract - COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of COUNTY there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to COUNTY;
4)Improperly performed service.
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In no event shall any payment by COUNTY constitute a waiver by COUNTY of
any breach of this Agreement or any default which may then exist on the part of CONTRACTOR.
Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the
breach or default. COUNTY shall have the right to demand of CONTRACTOR the repayment to
COUNTY of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of
COUNTY were not expended in accordance with the terms of this Agreement. CONTRACTOR shall
promptly refund any such funds upon demand, or at COUNTY’s option, such repayment shall be
deducted from future payments owing to CONTRACTOR under this Agreement.
C.Without Cause - Under circumstances other than those set forth above, this
Agreement may be terminated by CONTRACTOR or COUNTY or COUNTY’s DBH Director, or
designee, upon the giving of thirty (30) days advance written notice prior to close of the current
Agreement term.
4.COMPENSATION
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
compensation in accordance with the Budgets set forth in Exhibit C, attached hereto and by this
reference incorporated herein and made part of this Agreement.
A.Maximum Contract Amount
The maximum amount for the ramp up period (July 1, 2018 through December
31, 2018,) shall not exceed Two Million, Fifty-Seven Thousand, One Hundred Ninety-Three and No/100
Dollars ($2,057,193.00).
The maximum amount for the initial operational period of January 1, 2018
through June 30, 2019 shall not exceed Five Million, Seven Hundred-Fifty Thousand, Eight Hundred
Ninety-Three and No/100 Dollars ($5,750,893.00).
The maximum amount for the period of July 1, 2019 through June 30, 2020 shall
not exceed Seventeen Million, One Hundred Sixty-Eight and No/100 Dollars ($17,000,168.00).
The maximum amount for the period of July 1, 2020 through June 30, 2021 shall
not exceed Twenty-Two Million, Five Hundred Seventy-Nine Thousand, Six hundred and No/100
Dollars ($22,579,600.00).
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The maximum amount for the period of July 1, 2021 through June 30, 2022 shall
not exceed Twenty-Eight Million, Four Hundred Seventy-Five Thousand, Six Hundred Sixty-Four and
No/100 Dollars ($28,475,664.00).
The maximum amount for the period of July 1, 2022 through June 30, 2023 shall
not exceed Thirty-Five Million, Three Hundred Forty-Seven Thousand, Four Hundred Fifty-Nine and
No/100 Dollars ($35,347,459.00).
In no event shall the maximum contract amount for all the services provided by
the CONTRACTOR to COUNTY under the terms and conditions of this Agreement be in excess of One
Hundred Eleven Million, Two Hundred Ten Thousand, Nine Hundred Seventy-Seven and No/100
Dollars ($111,210,977.00) during the entire term of this Agreement. Funding amounts by fiscal year for
specialty mental health services and prevention and early intervention services are further detailed
below:
Specialty Mental Health Services:
Fiscal Year Total Contract MHSA Ramp CSS Medi-cal FFP
2018-19 $6,220,264 $2,057,193 $1,248,879 $2,914,192
2019-20 $13,709,938 $787,930 $3,757,205 $9,164,804
2020-21 $18,227,020 $667,271 $5,227,637 $12,332,112
2021-22 $23,027,015 $709,834 $6,924,876 $15,392,304
2022-23 $28,567,809 $646,147 $8,753,716 $19,167,946
Maximum Compensation All Five (5) Years: $89,752,046
Prevention and Early Intervention Services:
Fiscal Year Contract Maximum (MHSA PEI Funds)
2018-19 $1,587,822
2019-20 $3,290,230
2020-21 $4,352,581
2021-22 $5,448,649
2022-23 $6,779,650
Maximum Compensation All Five (5) Years: $21,458,932
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B.If CONTRACTOR fails to generate the Medi-Cal revenue and/or client fee
reimbursement amounts set forth in Exhibit C, the COUNTY shall not be obligated to pay the difference
between these estimated amounts and the actual amounts generated.
It is further understood by COUNTY and CONTRACTOR that any Medi-Cal
revenue and/or client fee reimbursements above the amounts stated herein will be used to directly offset
the COUNTY’s contribution of COUNTY funds identified in Exhibit C. The offset of funds will also be
clearly identified in monthly invoices received from CONTRACTOR as further described in Section Five
(5) of this Agreement.
Travel shall be reimbursed based on actual expenditures and mileage
reimbursement shall be at CONTRACTOR’s adopted rate per mile, not to exceed the Federal Internal
Revenue Services (IRS) published rate.
Payment shall be made upon certification or other proof satisfactory to COUNTY’s
DBH that services have actually been performed by CONTRACTOR as specified in this Agreement.
C.It is understood that all expenses incidental to CONTRACTOR’s performance of
services under this Agreement shall be borne by CONTRACTOR. If CONTRACTOR fails to comply with
any provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation.
D.Payments shall be made by COUNTY to CONTRACTOR in arrears, for services
provided during the preceding month, within forty-five (45) days after the date of receipt and approval by
COUNTY of the monthly invoicing as described in Section Five (5) herein. Payments shall be made
after receipt and verification of actual expenditures incurred by CONTRACTOR for monthly program
costs, as identified in the budget narratives and budgets identified in Exhibit C, in the performance of this
Agreement and shall be documented to COUNTY on a monthly basis by the tenth (10th) of the month
following the month of said expenditures. The parties acknowledge that the CONTRACTOR will be
performing hiring, training, credentialing of staff, configuring facilities and office space, and obtaining site
certification from the COUNTY’s Mental Health Plan (Mental Health Plan).
E. Yearly budget (s) beginning for FY 2019-20 to be provided herein shall be
submitted for review for each subsequent term of the Agreement to COUNTY's DBH Director or
designee for approval. Said budget(s) shall be submitted for review and requires the approval of
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COUNTY's DBH Director or designee prior to March 1st of each term of this Agreement. If said
budget is not received by the March 1st due date, the current budget will remain at the then current
funding level. The compensation amount of said approved budget(s) shall not exceed the maximum
compensation of the current Agreement term.
F.COUNTY shall not be obligated to make any payments under this Agreement if
the request for payment is received by COUNTY more than sixty (60) days after this Agreement has
terminated or expired.
All final invoices and/or any final budget modification requests shall be submitted
by CONTRACTOR within sixty (60) days following the final month of service for which payment is
claimed. No action shall be taken by COUNTY on claims submitted beyond the sixty (60) day closeout
period. Any compensation which is not expended by CONTRACTOR pursuant to the terms and
conditions of this Agreement shall automatically revert to COUNTY.
G. The services provided by CONTRACTOR under this Agreement are funded in
whole or in part by the State of California. In the event that funding for these services is delayed by the
State Controller, COUNTY may defer payments to CONTRACTOR. The amount of the deferred
payment shall not exceed the amount of funding delayed by the State Controller to the COUNTY. The
period of time of the deferral by COUNTY shall not exceed the period of time of the State Controller’s
delay of payment to COUNTY plus forty-five (45) days.
H.CONTRACTOR shall be held financially liable for any and all future
disallowances/audit exceptions due to CONTRACTOR’s deficiency discovered through the State audit
process and COUNTY utilization review during the course of this Agreement. At COUNTY’s election,
the disallowed amount will be remitted within forty-five (45) days to COUNTY upon notification or shall
be withheld from subsequent payments to CONTRACTOR. CONTRACTOR shall not receive
reimbursement for any units of services rendered that are disallowed or denied by the Fresno County
Mental Health Plan (Mental Health Plan) utilization review process or through the State of California
DHCS cost report audit settlement process for Medi-Cal eligible clients.
I. It is understood by CONTRACTOR and COUNTY that this Agreement is funded
with mental health funds to serve in part, individuals with SED, many of whom have co-occurring
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disorders. It is further understood by CONTRACTOR and COUNTY that funds shall be used to support
appropriately integrated services for co-occurring disorders in the target population, and that integrated
services can be documented in crisis assessments, interventions, and progress notes documenting
linkages.
5.INVOICING
A.CONTRACTOR shall invoice COUNTY in arrears by the tenth (10th) day of each
month for the prior month’s actual services rendered to DBHInvoices@co.fresno.ca.us. A separate
invoice shall be submitted for the start-up budget/costs. After CONTRACTOR renders service to
clients, CONTRACTOR will invoice COUNTY for payment, certify the expenditure, and submit
electronic claiming data into COUNTY’s electronic information system for all clients, including those
eligible for Medi-Cal as well as those that are not eligible for Medi-Cal, including contracted cost per
unit and actual cost per unit. COUNTY must pay CONTRACTOR before submitting a claim to DHCS
for Federal reimbursement for Medi-Cal eligible clients.
B.CONTRACTOR shall submit to the COUNTY by the tenth (10th) of each month a
detailed general ledger (GL), itemizing costs incurred in the previous month. Failure to submit GL
reports and supporting documentation, including cost invoices and receipts as required by the
COUNTY, shall be deemed sufficient cause for COUNTY to withhold payments until there is
compliance, as further described in Section Five (5) herein.
C.If CONTRACTOR chooses to utilize the COUNTY’s electronic health record
system (currently AVATAR, the preferred EHR system by DBH) method as their own full electronic health
records system, COUNTY’s DBH shall invoice CONTRACTOR in arrears by the fifth (5th) day of each
month for the prior month’s hosting fee for access to the COUNTY’s electronic information system in
accordance with the fee schedule as set forth in Exhibit D, “Electronic Health Records Software Charges”
attached hereto and incorporated herein by this reference and made part of this Agreement. COUNTY
shall invoice CONTRACTOR annually for the annual maintenance and licensing fee for access to the
COUNTY’s electronic information system in accordance with the fee schedule as set forth in Exhibit D.
COUNTY shall invoice CONTRACTOR annually for the Reaching Recovery fee, as applicable, for access
to the COUNTY’s electronic information system in accordance with the fee schedule as set forth in
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Exhibit D. CONTRACTOR shall provide payment for these expenditures to COUNTY’s Fresno County
Department of Behavioral Health, Accounts Receivable, P.O. Box 712, Fresno, CA 93717-0712,
Attention: Business Office, within forty-five (45) days after the date of receipt by CONTRACTOR of the
invoicing provided by COUNTY.
D.At the discretion of COUNTY’s DBH Director, or designee, if an invoice is
incorrect or is otherwise not in proper form or substance, COUNTY’s DBH Director, or designee, shall
have the right to withhold payment as to only that portion of the invoice that is incorrect or improper
after five (5) days prior notice to CONTRACTOR. CONTRACTOR agrees to continue to provide
services for a period of ninety (90) days after notification of an incorrect or improper invoice. If after the
ninety (90) day period, the invoice(s) is still not corrected to COUNTY DBH’s satisfaction, COUNTY’s
DBH Director, or designee, may elect to terminate this Agreement, pursuant to the termination
provisions stated in Section Three (3) of this Agreement. In addition, for invoices received sixty (60)
days after the expiration of each term of this Agreement or termination of this Agreement, at the
discretion of COUNTY’s DBH Director, or designee, COUNTY’s DBH shall have the right to deny
payment of any invoices received.
E.Monthly invoices shall include a client roster, identifying volume reported by
payer group clients served (including third party payer of services) by month and year-to-date, including
percentages.
F.CONTRACTOR shall submit monthly invoices and general ledgers that itemize
the line item charges for monthly program costs (per applicable budget, as identified in Exhibit C),
including the cost per unit calculation based on clients served within that month, and excluding
unallowable costs. Unallowable costs such as lobbying or political donations must be deducted from
the monthly invoice reimbursements. The invoices and general ledgers will serve as tracking tools to
determine if CONTRACTOR’s program costs are in accordance with its budgeted cost, and cost per
unit negotiated by service modes compared to actual cost per unit, as set forth in Exhibit C. The actual
cost per unit will be based upon total costs and total units of service. It will also serve for the COUNTY
to certify the public funds expended for purposes of claiming Federal and State reimbursement for the
cost of Medi-Cal services and activities.
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G. CONTRACTOR will remit annually within ninety (90) days from June 30, a
schedule to provide the required information on published charges for all authorized direct specialty
mental health services. The published charge listing will serve as a source document to determine the
CONTRACTOR’s usual and customary charge prevalent in the public mental health sector that is used
to bill the general public, insurers or other non-Medi-Cal third party payers during the course of
business operations.
H.CONTRACTOR shall submit monthly staffing reports that identify all direct
service and support staff, applicable licensure/certifications, ethnicity and language detail of staff, and
actual time of hours (FTE) worked to be used as a tracking tool to determine if CONTRACTOR’s
program is staffed according to the services provided under this Agreement. Monthly staffing reports
shall indicate if staff licenses are valid and current.
I.CONTRACTOR must maintain such financial records for a period of ten
(10)years or until any dispute, audit or inspection is resolved, whichever is later. CONTRACTOR will
be responsible for any disallowances related to inadequate documentation.
J.CONTRACTOR is responsible for collection and managing data in a
manner to be determined by State of California DHCS and the COUNTY’s Mental Health Plan in
accordance with applicable rules and regulations. COUNTY’s electronic billing system is a critical
source of information for purposes of monitoring service volume and obtaining reimbursement.
CONTRACTOR must attend COUNTY’s DBH’s Business Office training on equipment reporting for
assets, intangible and sensitive minor assets, COUNTY’s electronic information system; and related
cost reporting.
K. CONTRACTOR shall submit service data into COUNTY’s electronic information
system within ten (10) calendar days from the date services were rendered. Federal and State
reimbursement for Medi-Cal specialty mental health services is based on public expenditures certified
by the CONTRACTOR.
L. CONTRACTOR must provide all necessary data to allow the COUNTY to bill
Medi-Cal, and any other third-party source, for services and meet State and Federal reporting
requirements. The necessary data can be provided by a variety of means, including but not limited to:
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1) direct data entry into COUNTY’s electronic information system (currently AVATAR); 2) providing an
electronic file compatible with COUNTY’s electronic information system; or 3) integration between
COUNTY’s electronic information system and CONTRACTOR’s information system(s).
M. If a client has dual coverage, such as other health coverage (OHC) or Federal
Medicare, the CONTRACTOR will be responsible for billing the carrier and obtaining a
payment/denial or have validation of claiming with no response ninety (90) days after the claim was
mailed before the service can be entered into the COUNTY’s electronic information system.
CONTRACTOR must report all third party collections for Medicare, third party or client pay or private
pay in each monthly invoice and in the annual cost report that is required to be submitted. A copy of
explanation of benefits or CMS 1500 form is required as documentation. CONTRACTOR must report
all revenue collected from OHC, third-party, client-pay or private-pay in each monthly invoice and in
the cost report that is required to be submitted. CONTRACTOR shall submit monthly invoices for
reimbursement that equal the amount due CONTRACTOR less any funding sources not eligible for
Federal and State reimbursement. CONTRACTOR must comply with all laws and regulations
governing the Federal Medicare program, including, but not limited to: 1) the requirement of the
Medicare Act, 42 U.S.C. section 1395 et seq; and 2) the regulation and rules promulgated by the
Federal Centers for Medicare and Medicaid Services as they relate to participation, coverage and
claiming reimbursement. CONTRACTOR will be responsible for compliance as of the effective date
of each Federal, State or local law or regulation specified.
N.Data entry shall be the responsibility of the CONTRACTOR. The direct specialty
mental health services data must be reconciled by the CONTRACTOR to the monthly invoices
submitted for payment. COUNTY shall monitor the volume of services and cost of services entered into
the COUNTY’s electronic information system. Any and all audit exceptions resulting from the provision
and reporting of specialty mental health services by CONTRACTOR shall be the sole responsibility of
the CONTRACTOR. CONTRACTOR will comply with all applicable policies, procedures, directives and
guidelines regarding the use of COUNTY’s electronic information system. If CONTRACTOR elects to
use their own Electronic Health Record (EHR) system, the EHR must have CCHIT certification for
Security Access Control, Audit and Authentication. CONTRACTOR’s billers in the EHR system will
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need to sign an Electronic Signature Certification (ESR).
O. Medi-Cal Certification and Mental Health Plan Compliance
CONTRACTOR will establish and maintain Medi-Cal certification or become
certified (as required by the COUNTY’s Mental Health Plan) within ninety (90) days of the execution of
this Agreement for all sites/facilities that will provide specialty mental health billable services under this
Agreement through COUNTY to provide reimbursable services to Medi-Cal eligible clients. In addition,
CONTRACTOR shall work with the COUNTY’s DBH to execute the process if not currently certified by
COUNTY for credentialing of staff. During this process, the CONTRACTOR will obtain a legal entity
number established by the State of California DHCS, as this is a requirement for maintaining Mental
Health Plan organizational provider status throughout the term of this Agreement. CONTRACTOR will
be required to become Medi-Cal certified prior to providing direct specialty mental health services to
Medi-Cal eligible clients and seeking reimbursement from the COUNTY for costs associated with direct
specialty mental health services. CONTRACTOR will not be reimbursed by COUNTY for any direct
specialty mental health services rendered prior to certification.
CONTRACTOR shall provide specialty mental health services in accordance with
the COUNTY’s Mental Health Plan. CONTRACTOR must comply with the “Fresno County Mental
Health Plan Compliance Program and Code of Conduct” set forth in Exhibit F, attached hereto and
incorporated herein by reference and made part of this Agreement.
CONTRACTOR may provide direct specialty mental health services using
unlicensed staff as long as the individual is approved as a provider by the Mental Health Plan, is
supervised by licensed staff, works within his/her scope and only delivers allowable direct specialty
mental health services. It is understood that each service is subject to audit for compliance with Federal
and State regulations, and that COUNTY may be making payments in advance of said review. In the
event that a service is disapproved, COUNTY may, at its sole discretion, withhold compensation or set
off from other payments due the amount of said disapproved services. CONTRACTOR shall be
responsible for audit exceptions to ineligible dates of services or incorrect application of utilization
review requirements.
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6. INDEPENDENT CONTRACTOR
In performance of the work, duties, and obligations assumed by CONTRACTOR under
this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
CONTRACTOR's officers, agents, and employees will at all times be acting and performing as an
independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venturer, partner, or associate of COUNTY. Furthermore, COUNTY shall have no right
to control or supervise or direct the manner or method by which CONTRACTOR shall perform its work
and function. However, COUNTY shall retain the right to administer this Agreement so as to verify that
CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof.
CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the rules and
regulations, if any, of governmental authorities having jurisdiction over matters which are directly or
indirectly the subject of this Agreement.
Because of its status as an independent contractor, CONTRACTOR shall have
absolutely no right to employment rights and benefits available to COUNTY employees.
CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees all
legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and save
COUNTY harmless from all matters relating to payment of CONTRACTOR’s employees, including
compliance with Social Security, withholding, and all other regulations governing such matters. It is
acknowledged that during the term of this Agreement, CONTRACTOR may be providing services to
others unrelated to COUNTY or to this Agreement.
7.MODIFICATION
Any matters of this Agreement may be modified from time to time by the written consent
of all the parties without, in any way, affecting the remainder.
Notwithstanding the above, minor changes to services, staffing, and responsibilities of
the CONTRACTOR , as needed, and changes to accommodate changes in the laws relating to mental
health treatment, as set forth in Exhibit A-1 and A-2, may be made with the signed written approval of
COUNTY’s DBH Director, or designee, and CONTRACTOR through an amendment approved by
COUNTY’s Counsel and the COUNTY’s Auditor-Controller/Treasurer-Tax Collector’s Office.
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Changes to line items and expense category (i.e. Salary and Benefits,
Facilities/Equipment. Operating, Financial Services, Special Expenses, Fixed Assets, etc.) subtotals in
the budgets, as set forth in Exhibit C that do not exceed ten percent (10%) of the maximum
compensation payable to the CONTRACTOR, and changes to the volume of units of services/types of
service units, and changes to the service rates to be provided, as set forth in Exhibit C, and movement
of funds between each program budget that do not exceed ten percent (10%) of the maximum
compensation payable to the CONTRACTOR, and the earlier/later start up of various programs as
identified in Exhibits A-1 and A-2 and Exhibits C, may be made with the written approval of COUNTY’s
DBH Director, or designee, and CONTRACTOR. Changes to the line items and expense category
subtotals in the budgets, as set forth in Exhibit C, that exceed ten percent (10%) of the maximum
compensation payable to the CONTRACTOR and movement of funds between each program budgets
that exceed ten percent (10%) of the maximum compensation payable to the CONTRACTOR, may be
made with the signed written approval of COUNTY’s DBH Director, or designee, and CONTRACTOR
through an amendment approved by COUNTY’s Counsel and COUNTY’s Auditor-Controller/Treasurer-
Tax Collector’s Office.
Said modifications shall not result in any change to the annual maximum compensation
amount payable to CONTRACTOR, as stated in this Agreement.
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
compensation for annual administrative costs which are justifiable and reasonable, not to exceed a
maximum of fifteen percent (15%) of the total actual expenditures of each fiscal year.
8.ADDITIONS/DELETIONS OF SCHOOLS
COUNTY’s DBH Director, or designee, reserves the right at any time during the term of
this Agreement to add CONTRACTOR schools to Exhibit A-4 attached hereto. These same provisions
shall apply to the deletion of any CONTRACTOR schools contained in Exhibit A-4 attached hereto,
except that deletions shall be by mutual written agreement between COUNTY’s DBH Director and
CONTRACTOR to be deleted or shall be in accordance with the provisions of Section Four (4) of this
Agreement.
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In addition, specific schools within each CONTRACTOR school district to receive mental
health services are as listed in Exhibit A-4 attached hereto. The addition or deletion of specific
schools shall require written approval of COUNTY’s DBH Director, or designee.
9. NON-ASSIGNMENT
No party shall assign, transfer or subcontract this Agreement nor their rights or duties
under this Agreement without the prior written consent of COUNTY.
10. HOLD-HARMLESS
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
defend COUNTY, its officers, agents and employees from any and all costs and expenses, including,
without limitation, costs and fees of litigation, damages, liabilities, claims and losses occurring or
resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its
officers, agents or employees under this Agreement, and from any and all costs and expenses,
including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to
any person, firm or corporation who may be injured or damaged by the performance, or failure to
perform, of CONTRACTOR, their officers, agents or employees under this Agreement.
CONTRACTOR agrees to indemnify COUNTY for Federal and/or State of California
audit exceptions resulting from noncompliance herein on the part of CONTRACTOR.
11. INSURANCE
Without limiting COUNTY's right to obtain indemnification from CONTRACTOR or any
third parties, CONTRACTOR, at its sole expense, shall maintain in full force and affect the following
insurance policies throughout the term of this Agreement:
A.Commercial General Liability (CGL) or a Policy of Self Insurance
Commercial General Liability Insurance or a Policy of Self Insurance with limits of
not less than Two Million Dollars ($2,000,000) per occurrence and an annual
aggregate of Five Million Dollars ($5,000,000). This policy shall be issued on a
per occurrence basis. COUNTY may require specific coverage including
completed operations, product liability, contractual liability, Explosion, Collapse,
and Underground (XCU), fire legal liability or any other liability insurance deemed
necessary because of the nature of the Agreement.
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B. Automobile Liability
Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto),
or if CONTRACTOR has no owned autos, Code 8 (hired) and 9 (non-owned).with
limits for bodily injury of not less than One Million Dollars ($1,000,000) per
accident for bodily injury and property damage. Coverage should include owned,
non-owned, and hired vehicles used in connection with this Agreement.
C.Real and Property Insurance
CONTRACTOR shall maintain a policy of insurance for all risk personal property
coverage which shall be endorsed naming the County of Fresno as an additional
loss payee. The personal property coverage shall be in an amount that will cover
the total of the COUNTY purchase and owned property, at a minimum, as
discussed in Section Twenty (21) of this Agreement.
All Risk Property Insurance
CONTRACTOR will provide property coverage for the full replacement value of
the COUNTY’s personal property in possession of CONTRACTOR and/or used
in the execution of this Agreement. COUNTY will be identified on an appropriate
certificate of insurance as the certificate holder and will be named as an
Additional Loss Payee on the Property Insurance Policy.
D.Professional Liability
If CONTRACTOR employs licensed professional staff (e.g., Ph.D., R.N.,
L.C.S.W., M.F.T.) in providing services, Professional Liability Insurance with
limits of not less than One Million Dollars ($1,000,000) per occurrence, Three
Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees that it
shall maintain, at its sole expense, in full force and effect for a period of three (3)
years following the termination of this Agreement, one or more policies of
professional liability insurance with limits of coverage as specified herein.
E.Child Abuse/Molestation and Social Services Coverage
CONTRACTOR shall have either separate policies or an umbrella policy with
endorsements covering Child Abuse/Molestation and Social Services Liability
coverage or have a specific endorsement on their General Commercial liability
policy covering Child Abuse/Molestation and Social Services Liability. The policy
limits for these policies shall be One Million Dollars ($1,000,000) per occurrence
with a Two Million Dollars ($2,000,000) annual aggregate. The policies are to be
on a per occurrence basis.
F.Worker's Compensation
A policy of Worker's Compensation Insurance as may be required by the
California Labor Code.
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G. Cyber Liability
Insurance appropriate to the CONTRACTOR’s profession, with limits not less
than Two Million Dollars ($2,000,000) per occurrence or claim, Two Million
Dollars ($2,000,000) aggregate. Coverage shall be sufficiently broad to respond
to the duties and obligations as is undertaken by CONTRACTOR in this
agreement and shall include, but not be limited to, claims involving infringement
of intellectual property, including but not limited to infringement of copyright,
trademark, trade dress, invasion of privacy violations, information theft, damage
to or destruction of electronic information, release of private information,
alteration of electronic information, extortion and network security. The policy
shall provide coverage for breach response costs as well as regulatory fines and
penalties as well as credit monitoring expenses with limits sufficient to respond to
these obligations.
CONTRACTOR shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under CONTRACTOR’s policies herein. This
insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written
notice given to COUNTY. If the CONTRACTOR maintains broader coverage and/or higher limits than
the minimums shown above, the COUNTY requires and shall be entitled to the broader coverage
and/or higher limits maintained by the CONTRACTOR. Any available insurance proceeds in excess of
the specified minimum limits of insurance and coverage shall be available to the COUNTY.
Within thirty (30) days from the date CONTRACTOR signs this Agreement,
CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 3133
N. Millbrook Ave, Fresno, California, 93703, Attention: Contracts Division, stating that such insurance
coverages have been obtained and are in full force; that the County of Fresno, its officers, agents and
employees will not be responsible for any premiums on the policies; that such Commercial General
Liability insurance names the County of Fresno, its officers, agents and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned; that such coverage for additional insured shall apply as primary insurance and any other
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insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, shall be
excess only and not contributing with insurance provided under CONTRACTOR’s policies herein; and
that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance,
written notice given to COUNTY.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this
Agreement upon the occurrence of such event.
All policies shall be with admitted insurers licensed to do business in the State of
California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of
A FSC VII or better.
12. LICENSES/CERTIFICATES
Throughout each term of this Agreement, CONTRACTOR and CONTRACTOR’s staff
shall maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions
necessary for the provision of the services hereunder and required by the laws and regulations of the
United States of America, State of California, the County of Fresno, and any other applicable
governmental agencies. CONTRACTOR shall notify COUNTY immediately in writing of its inability to
obtain or maintain such licenses, permits, approvals, certificates, waivers and exemptions irrespective
of the pendency of any appeal related thereto. Additionally, CONTRACTOR and CONTRACTOR’s
staff shall comply with all applicable laws, rules or regulations, as may now exist or be hereafter
changed. CONTRACTOR shall provide COUNTY DBH, monthly staffing reports indicating staff licenses
are valid and current.
13. RECORDS
CONTRACTOR shall maintain records in accordance with Exhibit E, "Documentation
Standards for Client Records", as referenced in Section One (1) of this Agreement. During site visits,
COUNTY shall be allowed to review records of services provided, including the goals and objectives of
the treatment plan, and how the therapy provided is achieving the goals and objectives. All medical
records shall be maintained for a minimum of ten (10) years from the date of the end of this Agreement.
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14. REPORTS
A. Outcome Reports
CONTRACTOR shall submit to COUNTY’s DBH service outcome reports as
requested by COUNTY’s DBH. Outcome reports and outcome requirements are subject to change at
COUNTY’s DBH discretion. Outcome reports are further referenced in Exhibits A-1 and A-2.
B.Additional Reports
Monthly Reports - CONTRACTOR shall submit to COUNTY's DBH by the tenth
(10th) of each month all monthly activity and budget reports for the preceding month. CONTRACTOR
shall also furnish to COUNTY such statements, records, reports, data, and other information as
COUNTY’s DBH may request pertaining to matters covered by this Agreement. In the event that
CONTRACTOR fails to provide such reports or other information required hereunder, it shall be
deemed sufficient cause for COUNTY to withhold monthly payments until there is compliance. In
addition, CONTRACTOR shall provide written notification and explanation to COUNTY within five (5)
days of any funds received from another source to conduct the same services covered by this
Agreement.
Quarterly Report Progress Reports - CONTRACTOR shall complete Quarterly
Report Progress updates showing the total number of clients served versus the target number of clients
to be seen each quarter according to State DHCS Mental Health regulations in accordance with
"Quarterly Progress Goals and Report". All quarterly reporting is to be submitted to the DBH's
Contracted Services Unit within thirty (30) days of quarter ending for review by COUNTY's Contracted
Services unit.
C.Cost Report
CONTRACTOR agrees to submit a complete and accurate detailed cost report to
the COUNTY’s DBH on an annual basis for each fiscal year ending June 30th in the format prescribed
by the State DHCS for the purposes of Short Doyle Medi-Cal reimbursements and total costs for
programs. The cost report will be the source document for several phases of settlement with the State
DHCS for the purposes of Short Doyle Medi-Cal reimbursement. CONTRACTOR shall report costs
under their approved legal entity number established during the Medi-Cal certification process. The
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information provided applies to CONTRACTOR for program related costs for services rendered to
Medi-Cal and non Medi-Cal clients. The CONTRACTOR will remit a schedule to provide the required
information on published charges for all authorized services. The report will serve as a source
document to determine the CONTRACTOR’s usual and customary charge prevalent in the public
mental health sector that is used to bill the general public, insurers or other non-Medi-Cal third party
payors during the course of business operations. CONTRACTOR must report all collections for Medi-
Cal/Medicare services and collections. The CONTRACTOR shall also submit with the cost report a
copy of the CONTRACTOR’s general ledger that supports revenues and expenditures and reconciled
detailed report of reported total units of services rendered under this Agreement to the units of services
reported by CONTRACTOR to COUNTY’S electronic information system.
Each fiscal year ending June 30, CONTRACTOR shall remit a hard copy of their
annual cost report with a signed cover letter and requested support documents to County of Fresno,
Attention: DBH Cost Report Team, PO BOX 45003, Fresno CA 93718. In addition, CONTRACTOR
shall remit an electronic copy or any inquiries to DBHcostreportteam@co.fresno.ca.us. COUNTY shall
provide instructions of the cost report, cost report training, State DHCS cost report template
worksheets, and deadlines to submit the cost reports as determined by the State each fiscal year.
All Cost Reports must be prepared in accordance with General Accepted
Accounting Principles (GAAP) and Welfare and Institutions Code §§ 5651(a)(4), 5664(a), 5705(b)(3)
and 5718(c). Unallowable costs such as lobbying or political donations must be deducted on the cost
report and monthly invoice reimbursements.
If the CONTRACTOR does not submit the cost report by the deadline, including
any extension period granted by the COUNTY, the COUNTY may withhold payments of pending
invoicing under compensation until the cost report has been submitted and clears COUNTY desk audit
for completeness.
D. Settlements with State Department of Health Care Services (DHCS)
During the term of this Agreement and thereafter, COUNTY and CONTRACTOR
agree to settle dollar amounts disallowed or settled in accordance with DHCS audit settlement findings
related to the reimbursement provided under this Agreement. CONTRACTOR will participate in the
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several phases of settlements between COUNTY/CONTRACTOR and State DHCS. The phases of
initial cost reporting for settlement according to State reconciliation of records for paid Medi-Cal
services and audit settlement are: State DHCS audit 1) initial cost reporting - after an internal review by
COUNTY, the COUNTY files the cost report with State DHCS on behalf of the CONTRACTOR’s legal
entity for the fiscal year; 2) Settlement –State reconciliation of records for paid Medi-Cal services,
approximately 18 to 36 months following the State close of the fiscal year, State DHCS will send notice
for any settlement under this provision to the COUNTY; 3) Audit Settlement-State DHCS audit. After
final reconciliation and settlement, DHCS may conduct a review of medical records, cost report along
with support documents submitted to COUNTY in initial submission to determine accuracy and may
disallow costs and/or units of services reported on the CONTRACTOR’s legal entity cost report.
COUNTY may choose to appeal and therefore reserves the right to defer payback settlement with
CONTRACTOR until resolution of the appeal. State DHCS Audits will follow Federal Medicaid
procedures for managing overpayments. If at the end of the Audit Settlement, the COUNTY determines
that it overpaid the CONTRACTOR, it will require the CONTRACTOR to repay the Medi-Cal related
overpayment back to the COUNTY.
Funds owed to COUNTY will be due within forty-five (45) days of notification by
the COUNTY, or COUNTY shall withhold future payments until all excess funds have been recouped by
means of an offset against any payments then or thereafter owing to COUNTY under this or any other
Agreement between the COUNTY and CONTRACTOR.
15.MONITORING
CONTRACTOR agrees to extend to COUNTY’s staff, COUNTY’s DBH Director and the
State DHCS, or their designees, the right to review and monitor records, programs or procedures, at
any time, in regard to clients, as well as the overall operation of CONTRACTOR’s programs, in order to
ensure compliance with the terms and conditions of this Agreement.
16.REFERENCES TO LAWS AND RULES
In the event any law, regulation, or policy referred to in this Agreement is amended
during the term thereof, the parties hereto agree to comply with the amended provision as of the
effective date of such amendment.
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17. COMPLIANCE WITH MENTAL HEALTH PLAN COMPLIANCE PROGRAM, CODE OF
CONDUCT AND ETHICS
CONTRACTOR agrees to comply with the COUNTY’s Contractor Code of Conduct and
Ethics and the COUNTY’s Compliance Program in accordance with Exhibit F, attached hereto and
incorporated herein by reference and made part of this Agreement. Within thirty (30) days of entering
into this Agreement with the COUNTY, CONTRACTOR shall have all of CONTRACTOR’s employees,
agents and subcontractors providing services under this Agreement certify in writing, that he or she has
received, read, understood, and shall abide by the Contractor Code of Conduct and Ethics.
CONTRACTOR shall ensure that within thirty (30) days of hire, all new employees, agents and
subcontractors providing services under this Agreement shall certify in writing that he or she has
received, read, understood, and shall abide by the Contractor Code of Conduct and Ethics.
CONTRACTOR understands that the promotion of and adherence to the Code of Conduct is an
element in evaluating the performance of CONTRACTOR and its employees, agents and
subcontractors. Within thirty (30) days of entering into this Agreement, and annually thereafter, all
employees, agents and subcontractors providing services under this Agreement shall complete general
compliance training and appropriate employees, agents and subcontractors shall complete
documentation and billing or billing/reimbursement training. All new employees, agents and
subcontractors shall attend the appropriate training within thirty (30) days of hire. Each individual who
is required to attend training shall certify in writing that he or she has received the required training.
The certification shall specify the type of training received and the date received. The certification shall
be provided to the COUNTY’s Compliance Officer at 3133 N. Millbrook, Fresno, California 93703.
CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon
COUNTY by the Federal Government as a result of CONTRACTOR’s violation of the terms of this
Agreement.
18. COMPLIANCE WITH STATE MENTAL HEALTH REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its mental health programs
under an agreement with the State of California DHCS, and that under said agreement the State
imposes certain requirements on COUNTY and its subcontractors. CONTRACTOR shall adhere to all
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State requirements, including those identified in Exhibit G “State Mental Health Requirements”, attached
hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR
shall also file an incident report for all incidents involving clients/consumers, following the Protocol and
using the Worksheet identified in Exhibit H, attached hereto and by this reference incorporated herein
and made part of this Agreement.
19.COMPLIANCE WITH STATE MEDI-CAL REQUIREMENTS ORGANIZATIONAL
PROVIDER STANDARDS/CLIENT GRIEVANCE PROCESS/CONTRACTOR RESOLUTION AND
APPEALS PROCESS
CONTRACTOR shall be required to maintain organizational provider certification by
Fresno County. CONTRACTOR must meet Medi-Cal organization provider standards as listed in
Exhibit I, “Medi-Cal Organizational Provider Standards”, attached hereto and incorporated herein and
made part of this Agreement. It is acknowledged that all references to Organizational Provider and/or
Provider in Exhibit I shall refer to CONTRACTOR. In addition, CONTRACTOR shall inform every client
of their rights under the client grievance process and CONTRACTOR resolution process in COUNTY's
Mental Health Plan as described in Exhibit J, attached hereto and by this reference incorporated herein
and made part of this Agreement. CONTRACTOR shall also file an incident report for all incidents
involving clients, following the Protocol and using the Worksheet identified in Exhibit H, attached hereto
as identified in Section Eighteen (18) herein, or a protocol and worksheet presented by CONTRACTOR
that is accepted by COUNTY’s DBH Director, or designee.
20. CONFIDENTIALITY
All services performed by CONTRACTOR under this Agreement shall be in strict
conformance with all applicable Federal, State of California and/or local laws and regulations relating to
confidentiality.
21.HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
COUNTY and CONTRACTOR each consider and represent themselves as covered
entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law
104-191 (HIPAA) and agree to use and disclose Protected Health Information (PHI) as required by law.
COUNTY and CONTRACTOR acknowledge that the exchange of PHI between them is
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only for treatment, payment, and health care operations.
COUNTY and CONTRACTOR intend to protect the privacy and provide for the security
of PHI pursuant to the Agreement in compliance with HIPAA, the Health Information Technology for
Economic and Clinical Health Act, Public Law 111-005 (HITECH), and regulations promulgated
thereunder by the U.S. Department of Health and Human Services (HIPAA Regulations) and other
applicable laws.
As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require
CONTRACTOR to enter into a contract containing specific requirements prior to the disclosure of PHI,
as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504€ of the Code of
Federal Regulations.
22. DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent access,
viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of
COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter
into a contractual relationship with the COUNTY for the purpose of providing services under this
Agreement must employ adequate data security measures to protect the confidential information
provided to CONTRACTOR by the COUNTY, including but not limited to the following:
A.CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices
CONTRACTOR may not connect to COUNTY networks via personally-owned
mobile, wireless or handheld devices, unless the following conditions are met:
1) CONTRACTOR has received authorization by COUNTY for telecommuting
purposes;
2)Current virus protection software is in place;
3)Mobile device has the remote wipe feature enabled/ and
4)A secure connection is used.
B.CONTRACTOR-Owned Computers or Computer Peripherals
CONTRACTOR may not bring CONTRACTOR-owned computers or computer
peripherals into the COUNTY for use without prior authorization from the COUNTY’s Chief Information
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Officer, and/or designee(s), including but not limited to mobile storage devices. If data is approved to
be transferred, data must be stored on a secure server approved by the COUNTY and transferred by
means of a Virtual Private Network (VPN) connection, or another type of secure connection. Said data
must be encrypted.
C.COUNTY-Owned Computer Equipment
CONTRACTOR may not use COUNTY computers or computer peripherals on
non-COUNTY premises without prior authorization from the COUNTY’s Chief Information Officer,
and/or designee(s).
D. CONTRACTOR may not store COUNTY’s private, confidential or sensitive data
on any hard-disk drive, portable storage device, or remote storage installation unless encrypted.
E.CONTRACTOR shall be responsible to employ strict controls to ensure the
integrity and security of COUNTY’s confidential information and to prevent unauthorized access,
viewing, use or disclosure of data maintained in computer files, program documentation, data
processing systems, data files and data processing equipment which stores or processes COUNTY
data internally and externally.
F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128
BIT or higher. Additionally, a password or pass phrase must be utilized.
G. CONTRACTOR is responsible to immediately notify COUNTY of any violations,
breaches or potential breaches of security related to COUNTY’s confidential information, data
maintained in computer files, program documentation, data processing systems, data files and data
processing equipment which stores or processes COUNTY data internally or externally.
H.COUNTY shall provide oversight to CONTRACTOR’s response to all incidents
arising from a possible breach of security related to COUNTY’s confidential client information provided
to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected individuals
as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be
responsible for all costs incurred as a result of providing the required notification.
///
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23. PROPERTY OF COUNTY
A. COUNTY and CONTRACTOR recognizes that fixed assets are tangible and
intangible property obtained or controlled under COUNTY’s Mental Health Plan for use in operational
capacity and will benefit COUNTY for a period more than one year. Depreciation of the qualified items
will be on a straight-line basis.
For COUNTY purposes, fixed assets must fulfill three (2) qualifications:
1.Asset must have life span of over one (1) year.
2.The asset is not a repair part
3.The asset must be valued at or greater than the capitalization thresholds
for the asset type
Asset type Threshold
land $0
buildings and improvements $100,000
infrastructure $100,000
be tangible $5,000
o equipment
o vehicles
or intangible asset $100,000
o Internally generated software
o Purchased software
o Easements
o Patents
and capital lease $5,000
Qualified fixed asset equipment is to be reported and approved by COUNTY. If it
is approved and identified as an asset it will be tagged with a COUNTY program number. A Fixed
asset log, attached hereto as Exhibit K and Exhibit K-1, incorporated herein and made part of this
Agreement, will be maintained by COUNTY’s Asset Management System and annualy inventoried until
the asset is fully depreciated. During the terms of this Agreement, CONTRACTOR’s fixed assets may
be inventoried in comparison to COUNTY’s DBH Asset Inventory System.
B.Certain purchases less than Five Thousand and No/100 Dollars ($5,000.00) but
more than One Thousand and No/100 Dollars ($1,000.00), with over one (1) year life span, and are
mobile and high risk of theft or loss are sensitive assets. Such sensitive items are not limited to
computers, copiers, televisions, cameras and other sensitive items as determined by COUNTY’s DBH
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Director or designee. CONTRACTOR shall maintain a tracking system on the items and are not
required to be capitalize or depreciated. The items are subject to annual inventory for compliance.
C. Assets shall be retained by COUNTY, as COUNTY property, in the event this
Agreement is terminated or upon expiration of this Agreement. CONTRACTOR agrees to participate in
an annual inventory of all COUNTY fixed and inventoried assets. Upon termination or expiration of this
Agreement CONTRACTOR shall be physically present when fixed and inventoried assets are returned
to COUNTY possession. CONTRACTOR is responsible for returning to COUNTY all COUNTY owned
undepreciated fixed and inventoried assets, or the monetary value of said assets if unable to produce
the assets at the expiration or termination of this Agreement.
CONTRACTOR further agrees to the following:
1. To maintain all items of equipment in good working order and condition,
normal wear and tear is expected;
2. To label all items of equipment with COUNTY assigned program number,
to perform periodic inventories as required by COUNTY and to maintain an inventory list showing
where and how the equipment is being used, in accordance with procedures developed by COUNTY.
All such lists shall be submitted to COUNTY within ten (10) days of any request therefore; and
3.To report in writing to COUNTY immediately after discovery, the lost or
theft of any items of equipment. For stolen items, the local law enforcement agency must be contacted
and a copy of the police report submitted to COUNTY.
D.The purchase of any equipment by CONTRACTOR with funds provided
hereunder shall require the prior written approval of COUNTY’s DBH Director or designee, shall fulfill
the provisions of this Agreement as appropriate, and must be directly related to CONTRACTOR’s
services or activity under the terms of this Agreement. COUNTY’s DBH may refuse reimbursement for
any costs resulting from equipment purchased, which are incurred by CONTRACTOR, if prior written
approval has not been obtained from the COUNTY’s DBH Director or designee.
E. CONTRACTOR must obtain prior written approval from COUNTY’s DBH
whenever there is any modification or change in the use of any property acquired or improved, in whole
or in part, using funds under this Agreement. If any real or personal property acquired or improved with
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said funds identified herein is sold and/or is utilized by CONTRACTOR for a use which does not qualify
under this Agreement, CONTRACTOR shall reimburse COUNTY in an amount equal to the current fair
market value of the property, less any portion thereof attributable to expenditures of funds not provided
under this Agreement. These requirements shall continue in effect for the life of the property. In the
event this Agreement expires, or terminates, the requirements for this Section shall remain in effect for
activities or property funded with said funds, unless action is taken by the State government to relieve
COUNTY of these obligations.
24.NON-DISCRIMINATION
During the performance of this Agreement, CONTRACTOR and its subcontractors shall
not deny the contract’s benefits to any person on the basis of race, religious creed, color, national
origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital
status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran
status, nor shall they discriminate unlawfully against any employee or applicant for employment
because of race, religious creed, color, national origin, ancestry, physical disability, mental disability,
medical condition, genetic information, marital status, sex, gender, gender identity, gender expression,
age, sexual orientation, or military and veteran status. CONTRACTOR shall insure that the evaluation
and treatment of employees and applicants for employment are free of such discrimination.
CONTRACTOR and subcontractors shall comply with the provisions of the Fair Employment and
Housing Act (Gov. Code §12900 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit.
2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government
Code (Gov. Code §§11135-11139.5), and the regulations or standards adopted by the awarding state
agency to implement such article. Contractor shall permit access by representatives of the Department
of Fair Employment and Housing and the awarding state agency upon reasonable notice at any time
during the normal business hours, but in no case less than 24 hours’ notice, to such of its books,
records, accounts, and all other sources of information and its facilities as said Department or Agency
shall require to ascertain compliance with this clause. CONTRACTOR and its subcontractors shall
give written notice of their obligations under this clause to labor organizations with which they have a
collective bargaining or other agreement. (See Cal. Code Regs., tit. 2, §11105.) CONTRACTOR shall
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include the Non-Discrimination and compliance provisions of this clause in all subcontracts to perform
work under the Agreement.
25. CULTURAL COMPETENCY
As related to Cultural and Linguistic Competence, CONTRACTOR shall comply with:
A. Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d, and 45 C.F.R.
Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance
from discriminating against persons based on race, color, national origin, sex, disability or religion. This
is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access and
participation in federally funded programs through the provision of comprehensive and quality bilingual
services.
B.Policies and procedures for ensuring access and appropriate use of trained
interpreters and material translation services for all LEP consumers, including, but not limited to,
assessing the cultural and linguistic needs of its consumers, training of staff on the policies and
procedures, and monitoring its language assistance program. The CONTRACTOR’s procedures must
include ensuring compliance of any sub-contracted providers with these requirements.
C. CONTRACTOR shall not use minors as interpreters.
D. CONTRACTOR shall provide and pay for interpreting and translation services to
persons participating in CONTRACTOR’s services who have limited or no English language
proficiency, including services to persons who are deaf or blind. Interpreter and translation services
shall be provided as necessary to allow such participants meaningful access to the programs, services
and benefits provided by CONTRACTOR. Interpreter and translation services, including translation of
CONTRACTOR’s “vital documents” (those documents that contain information that is critical for
accessing CONTRACTOR’s services or are required by law) shall be provided to participants at no cost
to the participant. CONTRACTOR shall ensure that any employees, agents, subcontractors, or
partners who interpret or translate for a program participant, or who directly communicate with a
program participant in a language other than English, demonstrate proficiency in the participant's
language and can effectively communicate any specialized terms and concepts peculiar to
CONTRACTOR’s services.
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E. In compliance with the State mandated Culturally and Linguistically Appropriate
Services standards as published by the Office of Minority Health, CONTRACTOR must submit to
COUNTY for approval, within sixty (60) days from date of contract execution, CONTRACTOR’s plan to
address all fifteen national cultural competency standards as set forth in the “National Standards on
Culturally and Linguistically Appropriate Services (CLAS)”
(http://minorityhealth.hhs.gov/assets/pdf/checked/finalreport.pdf). COUNTY’s annual on-site review of
CONTRACTOR shall include collection of documentation to ensure all national standards are
implemented. As the national competency standards are updated, CONTRACTOR’s plan must be
updated accordingly. Cultural competency training for CONTRACTOR staff should be substantively
integrated into health professions education and training at all levels, both academic and functional,
including core curriculum, professional licensure, and continuing professional development programs.
CONTRACTOR on a monthly basis shall provide COUNTY DBH a monthly monitoring tool/report that
shows all CONTRACTOR staff cultural competency trainings completed.
F. CONTRACTOR shall be responsible for conducting an annual cultural
competency self-assessment and provide the results of said self-assessment to the COUNTY”S DBH.
The annual cultural competency self-assessment instruments shall be reviewed by the COUNTY and
revised as necessary to meet the approval of the COUNTY.
G. CONTRACTOR shall attend the County’s Cultural Diversity Committee monthly
meetings, maintain its own cultural competence oversight committee, and develop a cultural
competency plan to address and evaluate cultural competency issues
26.AMERICANS WITH DISABILITIES ACT
CONTRACTOR agrees to ensure that deliverables developed and produced, pursuant
to this Agreement shall comply with the accessibility requirements of Section 508 of the Rehabilitation
Act and the Americans with Disabilities Act of 1973 as amended (29 U.S.C. § 794 (d)), and regulations
implementing that Act as set forth in Part 1194 of Title 36 of the Code of Federal Regulations. In 1998,
Congress amended the Rehabilitation Act of 1973 to require Federal agencies to make their electronic
and information technology (EIT) accessible to people with disabilities. California Government Code
section 11135 codifies section 508 of the Act requiring accessibility of electronic and information
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technology.
27. TAX EQUITY AND FISCAL RESPONSIBILITY ACT
To the extent necessary to prevent disallowance of reimbursement under section
1861(v)(1) (I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four
(4) years after the furnishing of services under this Agreement, CONTRACTOR shall make available,
upon written request to the Secretary of the United States Department of Health and Human Services,
or upon request to the Comptroller General of the United States General Accounting Office, or any of
their duly authorized representatives, a copy of this Agreement and such books, documents, and
records as are necessary to certify the nature and extent of the costs of these services provided by
CONTRACTOR under this Agreement. CONTRACTOR further agrees that in the event
CONTRACTOR carries out any of its duties under this Agreement through a subcontract, with a value
or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12) month period,
with a related organization, such Agreement shall contain a clause to the effect that until the expiration
of four (4) years after the furnishing of such services pursuant to such subcontract, the related
organizations shall make available, upon written request to the Secretary of the United States
Department of Health and Human Services, or upon request to the Comptroller General of the United
States General Accounting Office, or any of their duly authorized representatives, a copy of such
subcontract and such books, documents, and records of such organization as are necessary to verify
the nature and extent of such costs.
28.SINGLE AUDIT CLAUSE
A. If CONTRACTOR expends Seven Hundred Fifty Thousand and No/100 Dollars
($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to conduct
an annual audit in accordance with the requirements of the Single Audit Standards as set forth in Office
of Management and Budget (OMB) 2 CFR 200. CONTRACTOR shall submit said audit and
management letter to COUNTY. The audit must include a statement of findings or a statement that
there were no findings. If there were negative findings, CONTRACTOR must include a corrective
action plan signed by an authorized individual. CONTRACTOR agrees to take action to correct any
material non-compliance or weakness found as a result of such audit. Such audit shall be delivered to
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COUNTY’s DBH Business Office, for review within nine (9) months of the end of any fiscal year in
which funds were expended and/or received for the program. Failure to perform the requisite audit
functions as required by this Agreement may result in COUNTY performing the necessary audit tasks,
or at COUNTY’s option, contracting with a public accountant to perform said audit, or, may result in the
inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this
Agreement are the sole responsibility of CONTRACTOR.
B.A single audit report is not applicable if CONTRACTOR’s Federal contracts do not
exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement or CONTRACTOR’s
only funding is through Drug related Medi-Cal. If a single audit is not applicable, a program audit must
be performed and a program audit report with management letter shall be submitted by CONTRACTOR
to COUNTY as a minimum requirement to attest to CONTRACTOR’s solvency. Said audit report shall
be delivered to COUNTY’s DBH Business Office, for review no later than nine (9) months after the
close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to
comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a
qualified accountant to perform said audit. All audit costs related to this Agreement are the sole
responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material
noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under
this paragraph shall be billed to the CONTRACTOR at COUNTY cost, as determined by COUNTY’s
Auditor-Controller/Treasurer-Tax Collector.
C.CONTRACTOR shall make available all records and accounts for inspection by
COUNTY, the State of California, if applicable, the Comptroller General of the United States, the
Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a
period of at least three (3) years following final payment under this Agreement or the closure of all other
pending matters, whichever is later.
29. ASSURANCES
In entering into this Agreement, CONTRACTOR certifies that it, nor any of its officers,
are not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal
Health Care Programs: that it, nor any of its officers, have not been convicted of a criminal offense
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related to the provision of health care items or services; nor has it, or any of its officers, been reinstated
to participate in the Federal Health Care Programs after a period of exclusion, suspension, debarment,
or ineligibility. If COUNTY learns, subsequent to entering into a contract, that CONTRACTOR is
ineligible on these grounds, COUNTY will remove CONTRACTOR from responsibility for, or
involvement with, COUNTY’s business operations related to the Federal Health Care Programs and
shall remove such CONTRACTOR from any position in which CONTRACTOR’s compensation, or the
items or services rendered, ordered or prescribed by CONTRACTOR may be paid in whole or part,
directly or indirectly, by Federal Health Care Programs or otherwise with Federal Funds at least until
such time as CONTRACTOR is reinstated into participation in the Federal Health Care Programs.
A. If COUNTY has notice that CONTRACTOR, or its officers, has been charged
with a criminal offense related to any Federal Health Care Program, or is proposed for exclusion during
the term of any contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the
accuracy of any claims submitted to any Federal Health Care Program. At its discretion given such
circumstances, COUNTY may request that CONTRACTOR cease providing services until resolution of
the charges or the proposed exclusion.
B.CONTRACTOR agrees that all potential new employees of CONTRACTOR or
subcontractors of CONTRACTOR who, in each case, are expected to perform professional services
under this Agreement, will be queried as to whether (1) they are now or ever have been excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2)
they have been convicted of a criminal offense related to the provision of health care items or services;
and or (3) they have been reinstated to participate in the Federal Health Care Programs after a period
of exclusion, suspension, debarment, or ineligibility.
1. In the event the potential employee or subcontractor informs
CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been
convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR
hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said
employee or subcontractor does no work, either directly or indirectly relating to services provided to
COUNTY.
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2. Notwithstanding the above, COUNTY at its discretion may terminate this
Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as
defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of
CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY.
Such demand for adequate assurance shall be effective upon a time frame to be determined by
COUNTY to protect the interests of COUNTY consumers.
C.CONTRACTOR shall verify (by asking the applicable employees and
subcontractors) that all current employees and existing subcontractors who, in each case, are expected
to perform professional services under this Agreement (1) are not currently excluded, suspended,
debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been
convicted of a criminal offense related to the provision of health care items or services; and (3) have not
been reinstated to participation in the Federal Health Care Program after a period of exclusion,
suspension, debarment, or ineligibility. In the event any existing employee or subcontractor informs
CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to participate in
the Federal Health Care Programs, or has been convicted of a criminal offense relating to the provision
of health care services, CONTRACTOR will ensure that said employee or subcontractor does no work,
either direct or indirect, relating to services provided to COUNTY.
1.CONTRACTOR agrees to notify COUNTY immediately during the term of
this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case,
is providing professional services under this Agreement is excluded, suspended, debarred or otherwise
ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense
relating to the provision of health care services.
2. Notwithstanding the above, COUNTY at its discretion may terminate this
Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as
defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of
CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY.
Such demand for adequate assurance shall be effective upon a time frame to be determined by
COUNTY to protect the interests of COUNTY consumers.
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D. CONTRACTOR agrees to cooperate fully with any reasonable requests for
information from COUNTY, which may be necessary to complete any internal or external audits relating
to CONTRACTOR’s compliance with the provisions of this Section.
E.CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty
imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’S violation of
CONTRACTOR’S obligations as described in this Section.
30. PUBLICITY PROHIBITION
None of the funds, materials, property or services provided directly or indirectly under
this Agreement shall be used for CONTRACTOR’s advertising, fundraising, or publicity (i.e., purchasing
of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. Notwithstanding the
above, publicity of the services described in Section One (1) of this Agreement shall be allowed as
necessary to raise public awareness about the availability of such specific services when approved in
advance by COUNTY’s DBH Director or designee and at a cost to be provided in Exhibit C, for such
items as written/printed materials, the use of media (i.e., radio, television, newspapers) and any other
related expense(s).
31. COMPLAINTS
CONTRACTOR shall log complaints and the disposition of all complaints from a client or
a client's family. CONTRACTOR shall provide a copy of the detailed complaint log entries concerning
COUNTY-sponsored clients to COUNTY at monthly intervals by the tenth (10th) day of the following
month, in a format that is mutually agreed upon. In addition, CONTRACTOR shall provide details and
attach documentation of each complaint with the log. CONTRACTOR shall post signs informing clients
of their right to file a complaint or grievance. CONTRACTOR shall notify COUNTY of all incidents
reportable to State licensing bodies that affect COUNTY clients within twenty-four (24) hours of receipt
of a complaint.
Within ten (10) days after each incident or complaint affecting COUNTY-sponsored
clients, CONTRACTOR shall provide COUNTY with information relevant to the complaint, investigative
details of the complaint, the complaint and CONTRACTOR's disposition of, or corrective action taken to
resolve the complaint. In addition, CONTRACTOR shall inform every client of their rights as set forth in
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Exhibit J. CONTRACTOR shall file an incident report for all incidents involving clients, following the
protocol and using the worksheet identified in Exhibit H.
32. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST INFORMATION
This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or
managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104,
and 455.106(a)(1),(2).
In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),(2),
the following information must be disclosed by CONTRACTOR by completing Exhibit L, “Disclosure of
Ownership and Control Interest Statement”, attached hereto and by this reference incorporated herein
and made part of this Agreement. CONTRACTOR shall submit this form to the COUNTY’s DBH within
thirty (30) days of the effective date of this Agreement. Additionally, CONTRACTOR shall report any
changes to this information within thirty-five (35) days of occurrence by completing Exhibit L,
“Disclosure of Ownership and Control Interest Statement.” CONTRACTOR is required to submit a set
of fingerprints for any person with a five percent (5%) or greater direct or indirect ownership interest in
CONTRACTOR. COUNTY may terminate this Agreement where any person with a five percent (5%)
or greater direct or indirect ownership interest in the CONTRACTOR and did not submit timely and
accurate information and cooperate with any screening method required in CFR, Title 42, Section
455.416. Submissions shall be scanned pdf copies and are to be sent via email to
DBHAdministration@co.fresno.ca.us, Attention: Contracts Administration. COUNTY may deny
enrollment or terminate this Agreement where any person with a five percent (5%) or greater direct or
indirect ownership interest in CONTRACTOR has been convicted of a criminal offense related to that
person’s involvement with the Medicare, Medicaid, or Title XXI program in the last ten (10) years.
33.DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS
CONTRACTOR is required to disclose if any of the following conditions apply to them,
their owners, officers, corporate managers and partners (hereinafter collectively referred to as
“CONTRACTOR”):
A. Within the three (3) year period preceding the Agreement award, they have been
convicted of, or had a civil judgment rendered against them for:
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1. Fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction;
2. Violation of a federal or state antitrust statute;
3.Embezzlement, theft, forgery, bribery, falsification, or destruction of records;
or
4.False statements or receipt of stolen property.
B.Within a three (3) year period preceding their Agreement award, they have had
a public transaction (federal, state, or local) terminated for cause or default.
Disclosure of the above information will not automatically eliminate
CONTRACTOR from further business consideration. The information will be considered as part of
the determination of whether to continue and/or renew this Agreement and any additional information
or explanation that a CONTRACTOR elects to submit with the disclosed information will be
considered. If it is later determined that the CONTRACTOR failed to disclose required information,
any contract awarded to such CONTRACTOR may be immediately voided and terminated for
material failure to comply with the terms and conditions of the award.
CONTRACTOR must sign a “Certification Regarding Debarment, Suspension,
and Other Responsibility Matters- Primary Covered Transactions” in the form set forth in Exhibit M,
attached hereto and by this reference incorporated herein and made part of this Agreement.
Additionally, CONTRACTOR must immediately advise the COUNTY’s DBH in writing if, during the term
of this Agreement: (1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for
participation in federal or state funded programs or from receiving federal funds as listed in the
excluded parties’ list system (http://www.epls.gov); or (2) any of the above listed conditions become
applicable to CONTRACTOR. CONTRACTOR shall indemnify, defend and hold the COUNTY
harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other
matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility
Matters.
///
COUNTY OF FRESNO
Fresno, CA
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34. DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the CONTRACTOR is operating as a corporation (a
for-profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR changes
its status to operate as a corporation.
Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing
transactions that they are a party to while CONTRACTOR is providing goods or performing services
under this Agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR
is a party and in which one or more of its directors has a material financial interest. Members of the
Board of Directors shall disclose any self-dealing transactions that they are a party to by completing
and signing a “Self-Dealing Transaction Disclosure Form”, attached hereto as Exhibit N and
incorporated herein by reference and made part of this Agreement, and submitting it to the COUNTY
prior to commencing with the self-dealing transaction or immediately thereafter.
35. SUBCONTRACTS
CONTRACTOR shall obtain written approval from COUNTY’s DBH Director, or
designee, before subcontracting any of the services delivered under this Agreement. COUNTY’s DBH
Director, or designee, retains the right to approve or reject any request for subcontracting services.
Any transferee, assignee, or subcontractor will be subject to all applicable provisions of this Agreement,
and all applicable State and Federal regulations. CONTRACTOR shall be held primarily responsible by
COUNTY for the performance of any transferee, assignee, or subcontractor unless otherwise expressly
agreed to in writing by COUNTY’s DBH Director, or designee. The use of subcontractors by
CONTRACTOR shall not entitle CONTRACTOR to any additional compensation that is provided for
under this Agreement.
36.AUDITS AND INSPECTIONS
The CONTRACTOR shall at any time during business hours, and as often as the
COUNTY may deem necessary, make available to the COUNTY for examination all of its records and
data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request
by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to
ensure CONTRACTOR’s compliance with the terms of this Agreement.
COUNTY OF FRESNO
Fresno, CA
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If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
CONTRACTOR shall be subject to the examination and audit of the State Auditor General for a period
of three (3) years after final payment under contract (California Government Code section 8546.7).
37.NOTICES
The persons having authority to give and receive notices under this Agreement and their
addresses include the following:
COUNTY CONTRACTOR
Director, Fresno County Superintendent
Department of Behavioral Health Fresno County Superintendent of Schools
3133 N. Millbrook Ave 1111 Van Ness Avenue
Fresno, CA 93702 Fresno, CA, 93712
Any and all notices between COUNTY and CONTRACTOR provided for or permitted
under this Agreement or by law shall be in writing and shall be deemed duly served when personally
delivered to one of the parties, or in lieu of such personal service, when deposited in the United States
Mail, postage prepaid, addressed to such party.
38.GOVERNING LAW
Venue for any action arising out of or related to the Agreement shall only be in Fresno
County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
39. SUPERSEDE
This Agreement shall supersede in its entirety and render null and void the Agreement
between the parties for the services identified in COUNTY Agreement No. 15-209, effective upon
execution of this Agreement.
40. ENTIRE AGREEMENT
This Agreement, including all Exhibits, constitutes the entire agreement between
CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous
agreement negotiations, proposals, commitments, writings, advertisements, publications, and
understandings of any nature whatsoever unless expressly included in this Agreement.
1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
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4 CONTRACTOR:
5 FRESNO COUNTY SUPERINTENDENT
OF SCHOOLS
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By:,.n::: ~-
Jim Yovino, Superintendent Print Name: _________ _
Title: ____________ _
11 Fresno County Superintendent of Schools
or Authorized Designee
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Fresno County Superintendent of Schools
2 2 1111 Van Ness Avenue
Fresno, CA, 93711
COUNTY OF FRESNO
C~:ii.~er·SICJI)_Qlil'Jhe Board of Supervisors of the
County of Fresno
Date: l g I 5 I "2.0(5?
ATTEST:
Bernice E. Seidel,
Clerk of the Board of Supervisors
County of Fresno, State of California
By: 'lb, Ju. '. ~
Deputy
2 3 Contact/Phone: Jim Yovino, Superintendent/559-265-3010, ext 3210
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FOR ACCOUNTING USE ONLY:
Fund/Subclass: 0001/10000
Account/Program: 7295/0
Organization/Cost Centers: 56304324/4325
FY 2018-19 $7,808,086, FY 2019-20 $17,000,168, FY 2020-21 $22,579,600
FY 2021-22 $28,475,664, FY 2022-23 $35,347,459
-42 -COUNTY OF FRESNO
Fresno, CA
Exhibit A-1
Page 1 of 12
School and Community Based
Specialty Mental Health Treatment Services to Children/Youth
Scope of Work
ORGANIZATION: Fresno County Superintendent of Schools
ADDRESS: 1111 Van Ness Avenue, Fresno, CA, 93712
SERVICES: School Aged Specialty Mental Health Treatment Services for Ages
0-22
PROGRAM NAME: All 4 Youth
CONTRACT TERM: July 1, 2018 - June 30, 2021
with options for two (2) additional twelve (12) month periods
CONTRACT SITES: See Exhibit A-4
CONTRACT AMOUNT: Fiscal Year Total Contract MHSA Ramp CSS Medi-cal FFP
2018-19 $6,220,264 $2,057,193 $1,248,879 $2,914,192
2019-20 $13,709,938 $787,930 $3,757,205 $9,164,804
2020-21 $18,227,020 $667,271 $5,227,637 $12,332,112
2021-22 $23,027,015 $709,834 $6,924,876 $15,392,304
2022-23 $28,567,809 $646,147 $8,753,716 $19,167,946
Maximum Compensation All Five (5) Years: $89,752,046
TELEPHONE: (559) 265-3010
CONTACT PERSON: Jim Yovino, Superintendent of Schools
I.SCHEDULE OF SERVICES:
Monday through Friday 7:00 AM to 7:00 PM. Public posted hours may differ (7:00 AM to 4:00 PM
school hours, but services provided at site after 4:00 PM). Operational hours will be flexible to meet
needs of families. Saturday and/or Sunday by appointment or as needed. Access to school sites during
summer as needed. Services during summer provided in-home as needed.
II.TARGET POPULATION:
CONTRACTOR shall provide specialty mental health medically necessary treatment services to
youth, ages 0-22, with serious emotional disturbance (SED) and their families.
These youth are characterized by having difficulty with social/emotional/behaviors, and such
difficulties are impacting their ability to cope with the school and/or home environment. These
characteristics may be impacting their relationships with others, their ability to make progress at
school and their overall health and well-being.
Target population: Medi-Cal beneficiaries with SED
Exhibit A-1
Page 2 of 12
Referral Sources: Referrals from school staff, County of Fresno, Department of Behavioral Health
(DBH) staff, self-referral, family member, community member, school employee or any agency
member in the community.
The target population shall include youth who are at-risk of involvement, or are currently involved in
the juvenile justice system, and have significant family conflict. Additionally, services shall be
provided to clients/families in rural/metro areas; clients/families that have no or limited means of
payment for services; clients/families who have traditionally been reluctant to seek services from
traditional mental health settings; and clients/families who are in danger of homelessness,
hospitalizations, out of home placements, and/or emergency room visits.
III.PROJECT DESCRIPTION:
CONTRACTOR shall provide one integrated system of behavioral health services and shall reduce
barriers to access. Services shall be readily accessible in a continuum of care. CONTRACTOR shall
effectively provide access to the full continuum of behavioral health services for all children and
families of Fresno County and institute a vision where all children's behavioral health needs are met
and all children and families will have access to a seamless system that promotes a positive healthy
environment in which to live and learn and to provide access for all children.
CONTRACTOR shall provide a full array of specialty mental health outpatient treatment services,
including intensive case management, Intensive Care Coordination (ICC), Intensive Home Based
Services (IHBS), rehabilitation, collateral, mental health therapy services, group therapy, crisis
services, medication support services, outreach and advocacy services.
CONTRACTOR shall provide specialty mental health services pursuant to and in accordance with the
COUNTY’s Managed Care Fresno County Mental Health Plan (FCMHP) Organizational Provider
Manual, the FCMHP Clinical Documentation and Billing Manual, and in accordance with the Medicaid
Managed care (MMC) Final Rule regulations, all referenced herein, and accessible via the following
website: http://www.co.fresno.ca.us/departments/behavioral-health/managed-care. CONTRACTOR
shall adhere to all of the documents and requirements as stated in the above manuals and
regulations.
It is the expectation of the COUNTY that CONTRACTOR provide timely access to services that meet
the State of California standards for care guidelines. Network adequacy standards for access to
services and time and distance requirements under the Managed Care Final Rule must be adhered
to. CONTRACTOR shall provide services in accordance with State of California MHSUDS Info Notice
No. 18-011. Services can be delivered in the school, home, community, or other community-based
settings. Telehealth, mobile services, and co-location in natural supports and gathering places for the
intended population are additional options.
It is hereby recognized that CONTRACTOR shall provide mental health services (non-urgent
services) within ten (10) business days from first request/referral of services to first appointment.
CONTRACTOR shall provide psychiatry services within fifteen (15) business days from first
request/referral to first appointment. CONTRACTOR shall provide urgent services within 48 hours or
as soon as needed based on each client’s needs. In addition, the location of services shall be within
45 miles or 75 minutes from the beneficiary /client’s place of residence.
CONTRACTOR shall track timeliness of services to clients and provide a monthly report showing the
monitoring or tracking tool that captures this data. COUNTY and CONTRACTOR shall meet to go
over this monitoring tool on a monthly basis as needed. COUNTY shall take corrective action if there
is a failure to comply by CONTRACTOR with the above timely access standards.
Exhibit A-1
Page 3 of 12
CONTRACTOR shall be expected to develop strategies to mitigate lengthy client wait lists should
service demand exceed program capacity. This would include the provision of services during non-
traditional hours of operation and weekends as noted in Exhibits A-1 and A-2, Scope of Work.
CONTRACTOR agrees to comply with any and all changes in the State of California, Federal, and/or
County guidelines and regulations as may occur during the term of this Agreement.
CONTRACTOR shall provide Intensive Care Coordination (ICC) and Intensive Home Based Services
(IHBS) services to clients/beneficiaries under age 21 who are eligible for the full scope of Medi-Cal
services and meet the medical necessity criteria for specialty mental health services as required by
State of California guidelines for services to children and youth. ICC and IHBS services shall be
provided in accordance with State of California MHSUDS Information Notice No.16-004. Services
shall be coordinated, comprehensive, and community-based for children and youth with more
intensive needs and client shall receive ICC and IHBS in their own home or in the most homelike
setting appropriate to their needs.
The State of California, Department of Health Care Services (DHCS) has selected the Pediatric
Symptom Checklist (PSC-35) and the California Child and Adolescents Needs and Strengths (CANS
50)tools to measure child and youth functioning, as intended by Welfare and Institutions Code
Section 14707.5. CONTRACTOR shall provide services and utilize the PSC-35 and CANS 50
outcomes measurement tools in accordance with State of California MHSUDS Info Notice No. 17-
052.The PSC-35 is a psychosocial screening tool designed to facilitate the recognition of cognitive,
emotional, and behavioral problems so appropriate interventions can be initiated as early as possible.
Parents/caregivers will complete PSC-35 (parent/caregiver version) for children and youth, ages 4 up
to age 18. The CANS 50 is a structured assessment used for identifying youth and family actionable
needs and useful strengths. It provides a framework for developing and communicating about a
shared vision and uses youth and family information to inform planning, support decisions, and
monitor outcomes. CONTRACTOR shall complete the CANS 50 through a collaborative process
which includes children and youth ages 6 up to age 17, and their caregivers (at a minimum). These
functional assessment tools need to be completed at the beginning of treatment, every six months
following the first administration, and at the end of treatment.
The determination of which services and supports are to be provided to each client/family shall be
made on the basis of the individual services and supports plan, or plan of care, which is created by
the client/family and the CONTRACTOR staff.
An individual services and supports plan is a plan developed to identify the client’s goals and
describe the array of services and supports necessary to advance these goals based on the client’s
needs and preferences and, when appropriate, the needs and preferences of the client’s family.
The concepts of wellness and recovery shall be embedded in this program through all interventions
that will focus on the strengths of the family and work toward the goal of enhancing those strengths
and self-sufficiency.
CONTRACTOR shall provide services that will encourage clients and families to achieve wellness
and recovery. As clients and families advance in the program they will be able to reach a level of
wellness and recovery that should allow them to successfully discharge from the program or move to
a lower level of service. CONTRACTOR shall make appropriate decisions that allow it to efficiently
serve enrolled clients and families and those that are on a waiting list for services.
Exhibit A-1
Page 4 of 12
Number of Clients to be Seen:
CONTRACTOR shall provide services to the following number (minimum number) of clients per year:
Year 1: 750 clients will be served
Year 2: 1680 clients will be served
Year 3: 2460 clients will be served
Year 4: 3240 clients will be served
Year 5: 4020 clients will be served
Staffing:
CONTRACTOR’s staffing is identified in CONTRACTOR’s budget and budget narratives in Exhibit C.
CONTRACTOR staff providing clinical direct behavioral health services will be required to have the
appropriate licensure or be internship/unlicensed/associates designated supervised by licensed staff.
The Behavioral Health Program Supervisor and Behavioral Health Clinician Supervisor are high-level
leadership positions that will be required to have the necessary licensure, excellent clinical
competencies, extensive knowledge of the Medi-Cal billing system and auditing requirements, and
knowledge and experience of the educational system.
Cultural brokers and family partner will also be hired with lived experience in each of
CONTRACTOR’s sites/hub. Services to be provided at school sites, at child’s home, or other
community settings.
Service Locations (Refer to Exhibit A-4 for school listings and sites):
FY 2018-2019-Phase 1
Hub locations:
Corporate office: 2440 Tulare St. Civic Center Square Suite 200 Fresno, CA 93721
Mendota Hub (address TBD): Satellite offices in Firebaugh, Golden Plains, Kerman
Population Hub - Birth to 5 years of age utilizing CONTRACTOR’s mobile health unit, corporate hub,
community opportunities and in the home.
FY 2019-2020-Phase 2 - in strategically placed geographic areas within Fresno County. Location of
Hub will occur in the South/Central Fresno County area and the districts located in the area include:
Washington, Selma, Fowler, Laton, Washington Colony, Orange Center, Fresno, Pacific Union,
Caruthers, Clay, Kingsburg High, Kingsburg Elementary, Alvina, Monroe, and Parlier, Laton, Raisin
City, West Park.
FY 2020-2021-Phase 3 - in strategically placed geographic areas within Fresno County. Location of
the Hub will occur in the North side of Fresno County and the districts located in this area include:
Central, Fresno, Clovis, and Sierra, Big Creek, and Pine Ridge.
FY 2021-2022-Phase 4 - in strategically placed geographic areas within Fresno County. Location of
the Hub will occur in the East side of Fresno County area and the districts located in this area
include: Kings Canyon, Sanger, and Sierra.
Exhibit A-1
Page 5 of 12
FY 2022-2023-Phase 5 - in strategically placed geographic areas within Fresno County. Location of
the Hub will occur in the Southern part of Fresno County area and the districts in this area include:
Coalinga-Huron, Westside Elementary, and Burrel, Riverdale.
Clinicians can be assigned to satellite sites not yet connected to a Hub location in the existing region
throughout the duration of this agreement.
Clinicians and other mental health staff located at a specific site or hub may serve students/clients in
other hubs/locations and other areas in the community as needed. Students/clients located in a
specific location/hub may access services in other sites/hubs as needed. CONTRACTOR shall work
with COUNTY’s DBH Director, or designee to ensure a smooth and efficient continuum of care for all
students/clients. CONTRACTOR shall work collaboratively with COUNTY’s DBH and the DBH’s
network of providers to ensure students/clients receive all needed linkages and services in a
seamless manner.
Hubs shall be strategically situated to provide coverage in all areas of Fresno County by Phase 5 and
to include coverage in the Fresno Metro area (Fresno Unified, Central Unified, Washington Unified),
Clovis, the southwest area (Coalinga, Westside, Laton etc.) the eastern side of the county (including
Dunlap, Pine Ridge, Kings Canyon, Parlier etc.) the west side (Mendota, Firebaugh, Kerman,
Tranquility etc.) and the south central (Selma, Monroe, Alvina, etc.)
Hub locations, start up periods, and school satellite sites may be adjusted during the term of this
agreement by the written approval of the COUNTY’s DBH Director, or designee, and CONTRACTOR.
Any new schools or sites may be added or deleted or further adjusted throughout the duration of this
Agreement with the written approval of the COUNTY’s DBH Director, or designee, and
CONTRACTOR. Services may be located at the school site, community based or be provided in the
in home.
MHSA – CCS Funds
Since part of the funding for this specialty mental health treatment services scope of work is based on
MHSA Community Services and Support Funds (CSS) funding, CONTRACTOR shall follow all
requirements of a CSS program under the Mental Health Services Act (MHSA) as defined in the
current MHSA CSS Regulations.
CONTRACTOR shall collect all data and fulfill all reporting requirements as specified in the
applicable MHSA CSS regulations related to the program type, strategies, and standards indicated
above or as indicated in MHSA regulations. CONTRACTOR shall will work with COUNTY to ensure
data, outcomes, and reports are included in all required MHSA reports, plans, and updates.
Current MHSA Regulations can be found at the following website:
http://mhsoac.ca.gov/laws-and-regulations
CONTRACTOR shall understand all MHSA CSS regulations to ensure they have the organizational
capacity to record, track, and report all required elements.
CONTRACTOR shall participate in monthly, or as needed, workgroup meetings consisting of staff
from COUNTY’s DBH to discuss MHSA requirements, data reporting, training, policies and
procedures, overall program operations and any problems or foreseeable problems that may arise.
Under MHSA CSS funding, the target population must meet requirements for SMI/SED diagnosis;
and must address reduction of specific ethnic disparities.
Exhibit A-1
Page 6 of 12
The target population will include individuals who are not currently served and who meet one or more
of the following criteria:
At risk of homelessness – such as youth aging out of foster care or persons coming out of jail
Involved in the criminal justice system – Jail/JJC (including families with child protection
issues)
Frequent users of hospital and emergency room services or are so underserved that they are
at risk of:
Homelessness – such as persons living in institutions or nursing homes
Institutionalization
Diagnoses that serve as criteria for inclusion in the target population will be based on definitions
found in 5600.3 California Welfare and Institutions code defining severe mental disorder. The
operational definition of “diagnosis” for programs serving the chronically homeless may also include:
co-occurring disorders, personality disorders, general anxiety/mood disorders, and Post Traumatic
Stress Disorder).
The Five (5) Core MHSA Concepts to be embedded in each program consist of:
Concept 1: Recovery/resiliency orientation:
Programs shall embody the values of recovery and resiliency (i.e., hope, personal responsibility, self-
advocacy, choice, respect) and the program principles of recovery and resiliency, including:
Client-driven goal setting and Individualized Services and Supports Plans
Providers are allies to the client’s recovery process.
A harm-reduction approach to substance abuse that encourages recovery and abstinence but
does not penalize consumers or withdraw help from them if they are using.
A built in understanding and expectation of setbacks as part of recovery.
Links to a range of services that are part of the consumers “pathway to wellness” (i.e.,
employment, health care, peer support, housing, medications, food and clothing)
Concept 2: Cultural Competence Orientation: The program’s structure, staffing and service delivery
values will reflect the cultural values and orientation of the program’s target populations.
The program will embody principals of cultural competence including:
Diverse staff, representative of the primary ethnic groups to be reached through the program
Staff trained regarding common access barriers for racial and ethnic groups targeted
(including the impact of housing discrimination)
Links to community-based organizations that share the healing beliefs and practices of ethnic
communities served by the Program.
CONTRACTOR’s program must also be able to deal with gender and sexual orientation diversity.
Training in sensitivity to gender and sexuality issues is a key component for staff on the Team.
Exhibit A-1
Page 7 of 12
Concept 3: Community Collaboration: Collaborations ensure that community resources are made
available to enrollees. These collaborations include subcontracts between the CONTRACTOR and
other agencies, memoranda of understanding with community non-profits and businesses regarding
providing services to clients, and informal relationships built between CONTRACTOR staff and
community stakeholders that result in improved access and decreased discrimination.
Concept 4: Client/Family Driven program: Integrated Services and Supports Plan (ISSP) is used by
adult clients and families of children and youth to identify their needs and preferences which lead to
the services and supports that will be most effective for them. Providers work in full partnership with
clients to develop these ISSPs. Their needs and preferences drive the policy and financing decisions
that affect them.
Concept 5: Integrated Service Experience: Programs were incorporated into the MHSA to ensure
that these dollars funded “integrated service experiences.” This means that services are “seamless”
to clients and that clients do not have to negotiate multiple agencies and funding sources to get
critical needs met and to move towards recovery and develop resiliency. Services are delivered, or at
a minimum, coordinated through a single agency or a system of care. The integrated service
experience centers on the individual/family, uses a strength-based approach, and includes multi-
agency programs and joint planning to best address the individual/family’s needs using the full range
of community-based treatment, case management, and interagency system components required by
children/transition age youth/adults/older adults.
IV.Cultural Competency:
A.CONTRACTOR shall provide the following as it relates to cultural competency services:
1.CONTRACTOR shall recruit and hire staff that have demonstrated experience working
with the Latino, African American, Southeast Asian, Native American, Punjabi, and other
minority populations and have knowledge about the culture of these targeted groups as
well as other diverse communities.
2. CONTRACTOR’s staff shall attend annual trainings on cultural competency, awareness,
and diversity as provided by CONTRACTOR. CONTRACTOR’s staff shall be appropriately
trained in providing services in a culturally sensitive manner.
3. CONTRACTOR’s staff shall attend civil rights training as provided by CONTRACTOR.
4.CONTRACTOR shall hire bilingual staff. At a minimum, CONTRACTOR shall hire staff
competent in Spanish and Hmong as these are the identified threshold languages in
Fresno County.
5.CONTRACTOR shall secure the services of trained translators/interpreters as may be
necessary. Translators/interpreters may prove invaluable for languages such as
Cambodian, Russian, Arabic, Armenian, Punjabi, and others. Translators/interpreters
shall be appropriately trained in providing services in a culturally sensitive manner.
6.CONTRACTOR shall provide services by placing importance on traditional values, beliefs
and family histories. Cultural values and traditions offer special strengths in treating
clients and this should help guide health care messages and wellness and recovery plans.
7.CONTRACTOR shall provide services within the most relevant and meaningful cultural,
gender-sensitive, and age-appropriate context for the target population.
8.CONTRACTOR shall develop plans to continually engage targeted populations.
Exhibit A-1
Page 8 of 12
9. CONTRACTOR shall recruit and hire client/family members. Regarding the recruitment of
client/family members, the CONTRACTOR will be able to consult with the COUNTY DBH.
10. CONTRACTOR shall distribute literature/informational brochures in appropriate languages
and request feedback as to how access to care could be improved for these culturally
diverse communities.
11. CONTRACTOR shall conduct an annual cultural competency self-assessment and provide
the results of said self-assessment to the COUNTY. The annual cultural competency self-
assessment instruments shall be reviewed by the COUNTY and revised as necessary to
meet the approval of the COUNTY. The CONTRACTOR can create their own cultural
competency self-assessment tools or utilize instruments to be provided by COUNTY.
12. CONTRACTOR shall provide services throughout Fresno County in the community and
home as needed, to increase the frequency of clients obtaining needed services as some
children/families are reluctant to seek services at school sites.
13. CONTRACTOR shall promote system of care accountability for performance outcomes
which enable children and their families to live independently, work, maintain community
supports, stay in good health, and avoid substance abuse and incarceration.
14. CONTRACTOR shall develop individual services and supports plans which are flexible
and open to meet the unique needs of the targeted populations.
15. CONTRACTOR shall provide family support and the creation of family partnerships
utilizing peer support for families and parenting support.
16. CONTRACTOR shall establish culturally specific multidisciplinary treatment teams
responsible for assuring and providing needed services.
17. CONTRACTOR shall provide parenting groups that are conducted in the preferred
language of the participant client/families.
18. CONTRACTOR’s staff will be trained to keep an open mind and maintain non-judgmental
interaction with clients/families.
19. CONTRACTOR, when developing program services and service delivery approaches,
shall seek to hire and train staff and community stakeholders (i.e., consumers, family
members, etc.) that are providing services to consumers and families on appropriate
methods and approaches to delivering gender and age specific services.
20. CONTRACTOR’s hiring and contracting practices shall be based on local data and reflect
the needs of the population to be served.
21. CONTRACTOR shall attend the COUNTY’s Cultural Diversity Committee monthly
meetings, maintain its own cultural competence oversight committee, and develop a
cultural competency plan to address and evaluate cultural competency issues.
22. COUNTY shall provide technical assistance and demographic data to CONTRACTOR in
relation to cultural competency planning.
23. CONTRACTOR shall train staff on best practice for utilizing interpreters to ensure effective
communication with monolingual consumers and families to assist in the delivery of
culturally/linguistically appropriate services.
Exhibit A-1
Page 9 of 12
V.COUNTY RESPONSIBILITIES:
COUNTY shall:
1.Provide oversight, through its DBH Director, or designee, and collaborate with
CONTRACTOR and other COUNTY Departments and community agencies to help
achieve State program goals and outcomes. In addition to contract monitoring of
program(s), oversight includes, but not limited to, coordination with the State Department
of Health Care Services in regard to program administration and outcomes.
2. Assist the CONTRACTOR in making linkages with the total behavioral health system.
This will be accomplished through regularly scheduled meetings as well as formal and
informal consultation.
3.Participate in evaluating the progress of the overall program and the efficiency of
collaboration with CONTRACTOR’s staff and will be available to the CONTRACTOR for
ongoing consultation.
4. Gather outcome information from CONTRACTOR throughout each term of this
Agreement. COUNTY DBH staff shall notify the CONTRACTOR when its participation is
required. The performance outcome measurement process will not be limited to survey
instruments but will also include, as appropriate, client and staff interviews, chart reviews,
and other methods of obtaining required information.
5. Assist the CONTRACTOR’s efforts towards cultural and linguistic competency by
providing the following to CONTRACTOR:
a.Technical assistance and training regarding cultural competency requirements.
b. Mandatory cultural competency training for CONTRACTOR personnel, at minimum
once per year.
c.Technical assistance for translating information into COUNTY’s threshold languages
(Spanish and Hmong). Translation services and costs associated will be the
responsibility of the CONTRACTOR.
6.Convene a routine collaborative governing leadership meeting between CONTRACTOR
and COUNTY designed to maintain the overarching goals and objectives of the
requirements of this Agreement.
VI.Performance Outcome Measures
CONTRACTOR shall be required to submit measureable outcomes on an annual basis, as
identified in the COUNTY DBH’s Policy and Procedure Guide (PPG) 1.2.7 Performance Outcomes
Measures, attached hereto and referenced herein as Exhibit A-5, attached hereto and incorporated
herein by reference and made part of this Agreement. Performance outcome measures must be
approved by the COUNTY’s DBH and satisfy all State and local mandates. The Department will
provide technical assistance and support in defining measureable outcomes. Performance outcome
measures shall be mutually agreed upon by CONTRACTOR and COUNTY’s DBH Director, or
designee, within ninety (90) days of the Agreement start date. All performance indicators will reflect the
four (4) domains identified by the Commission Accreditation of Rehabilitation Facilities (CARF).
The domains are Effectiveness, Efficiency, Access, and Satisfaction. These are defined and
listed below.
Exhibit A-1
Page 10 of 12
The COUNTY’s DBH collects data about the characteristics of the persons served and
measures service delivery performance indicators in each of the following CARF Domains: At
minimum, one (1) performance indicator will be identified for each of the four (4) CARF domains listed
below.
1.Effectiveness: A performance dimension that assesses the degree to which an intervention or
services have achieved the desired outcome/result/quality of care through measuring change
over time. The results achieved and outcomes observed are for persons served.
Examples of indicators include: Persons get a job with benefits, or receive supports needed to
live in the community, increased function, activities, or participation, and improvement of health,
employment/earnings, or plan of care goal attainment.
2.Efficiency: Relationship between results and resources used, such as time, money, and staff.
The demonstration of the relationship between results and the resources used to achieve them.
A performance dimension addressing the relationship between the outputs/results and the
resources used to deliver the service.
Examples of indicators include: Direct staff cost per person served, amount of time it takes to
achieve an outcome, gain in scores per days of service, service hours per person achieving
some positive outcome, total budget (actual cost) per person served, length of stay and direct
service hours of clinical and medical staff.
3.Access: Organizations’ capacity to provide services of those who desire or need services.
Barriers or lack thereof for persons obtaining services. The ability of clients to receive the right
service at the right time. A performance dimension addressing the degree to which a person
needing services is able to access those services.
Examples of indicators include: Timeliness of program entry (From 1st request for service to 1st
service), ongoing wait times/wait lists, minimizing barriers to getting services, and no-
show/cancellation rates.
4.Satisfaction: Satisfaction Measures are usually orientated towards consumers, family, staff,
and stakeholders. The degree to which clients, the COUNTY and other stakeholders are
satisfied with services. A performance dimension that describes reports or ratings from persons
served about services received from an organization.
Examples of indicators include: opinion of persons served or other key stakeholders in regards
to access, process, or outcome of services received, Consumer and/or Treatment Perception
Survey.
A.Data Collection
1.Data collection and evaluation methods may include, but are not limited to, staff,
participant, and family interviews; and case file reviews.
2. CONTRACTOR shall also conduct consumer satisfaction surveys to see if there is a
strong correlation of the efficacy of the evidence-based program with specific ethnicities
and languages as well as to identify gaps in meeting cultural needs of clients/families, if
any.
Exhibit A-1
Page 11 of 12
3. CONTRACTOR shall ensure all program clients/families participate in the semi-annual State
Consumer Perception Survey (CPS) survey. CPS’s will be distributed to all active
clients/families to fill out and return to CONTRACTOR.
4.CONTRACTOR shall collect data regarding the ethnicity and language of each
client/family receiving services as well as directing staff to follow-up with the culturally
diverse clients/families for suggestions on how to improve the programs and also how to
help make the programs more culturally relevant.
5.CONTRACTOR shall maintain all client data in permanent electronic case records.
CONTRACTOR shall have established policies and procedures for data collection and
client confidentiality.
B.Performance Goals
CONTRACTOR’s performance shall also be evaluated according to its scope of work goals and
effectiveness indicator’s.
Other goals that CONTRACTOR shall be evaluated on by COUNTY DBH utilizing the following
performance outcomes:
Goal/Objective 1: Increase the delivery of mental health treatment services to
unserved and underserved clients and families with limited or
no means of payment.
Goal/Objective 2: Identify and build upon individual and family strengths and
assets to help parents and children develop new skills to
enhance family cohesion.
Outcome 2: Clients will gain skills to reduce family conflict and the ability to
identify familial strengths.
Outcome 3: Clients will gain self-confidence, increased ability to handle
anger and manage difficult situations, and experience
improved individual functioning.
Outcome Indicator
3A:
85% of the clients that participate in the program will report
functional improvement measured by CANS (Child/Adolescent
Needs and Strengths) scores.
Outcome Indicator
3B:
50% of students/clients that are identified with behavioral
health problems will report a decrease in behavioral health
symptoms between the start of program and end of program.
Outcome Indicator
3C:
50% of the clients that are part of the program will report a
decrease in inpatient mental health crisis visits between start
of program and end of program.
Outcome Indicator
3D:
50% of the clients that complete the program will report a
decrease in recidivism into the Juvenile Justice System
between start of program and end of program.
Exhibit A-1
Page 12 of 12
Outcome Indicator
3E:
85% of the clients participating in the program that are
diagnosed with mental health disorders, e.g., conduct disorder,
oppositional defiant disorder, disruptive behavior disorder, etc.,
when they begin the program will report improvement after
successfully completing the program.
Outcome Indicator 4: At a minimum, 80% percent of clients/families will report their
satisfaction with program services on the CONTRACTOR’s
consumer satisfaction surveys, and the semi-annual State POQI
survey.
C.Reports
1.CONTRACTOR shall prepare an evaluation report annually and submit to the COUNTY’s
DBH, and make said reports available to partnering and interested local agencies and
organizations such as the project collaborators, other community agencies and mental heath
treatment providers. Each annual evaluation report will include the following information:
demographics of the target population served, services provided to each participant, number
of hospitalization, enrollment in school, results of data analysis compared to planned
process, output and outcome measures, barriers to program implementation and measures
taken to overcome those barriers, accomplishments of program participants, lessons
learned, and the final result of any and all satisfactory survey(s).
2.CONTRACTOR shall be expected to comply with all contract monitoring and compliance
protocols, procedures, data collection methods, and reporting requirements conducted by
the COUNTY.
3.Additional reports/outcomes may also be requested by the COUNTY’s DBH, based on
among other things, identification of client/family specific needs as well as State required
reports/outcomes as needed.
Exhibit A-2
Page 1 of 11
School and Community Based
Prevention and Early Intervention (PEI) Services to Children/Youth
Scope of Work
ORGANIZATION: Fresno County Superintendent of Schools
ADDRESS: 1111 Van Ness Avenue, Fresno, CA, 93712
SERVICES: PEI School Aged Prevention and Early Intervention Services –
Including Positive Behavioral Intervention and Supports (PBIS)
Services for Ages 0-22
PROGRAM NAME: All 4 Youth - PEI
CONTRACT TERM: July 1, 2018 - June 30, 2021
with options for two (2) additional twelve (12) month periods
CONTRACT SITES: See Exhibit A-4
CONTRACT AMOUNT: Fiscal Year Contract Maximum (PEI Funds)
2018-19 $1,587,822
2019-20 $3,290,230
2020-21 $4,352,581
2021-22 $5,448,649
2022-23 $6,779,650
Maximum Compensation All Five (5) Years: $21,458,932
TELEPHONE: (559) 265-3010
CONTACT PERSON: Jim Yovino, Superintendent of Schools
I.SCHEDULE OF SERVICES:
Monday through Friday 7:00 AM to 7:00 PM. Public posted hours may differ (7:00 AM to 4:00 PM
school hours, but services provided at site after 4:00 PM). Operational hours will be flexible to meet
needs of families. Saturday and/or Sunday by appointment or as needed. Access to school sites during
summer as needed. Services during summer provided in-home as needed.
II.TARGET POPULATION:
PEI programs will take place in a school setting, a preschool setting and in the home throughout
Fresno County. In particular, programs in the schools and preschools will be a mixture of school-
wide, classroom, and non-classroom or non-instructional settings. Professionals involved in various
aspects of these programs will include school administrators, teachers, and school
psychologist/therapist, rehabilitation specialists in addition to personnel from outside the particular
school, including CONTRACTOR’s behavioral health staff.
Exhibit A-2
Page 2 of 11
III.PROJECT DESCRIPTION:
Since the inception of the MHSA Positive Behavior Interventions and Supports (PBIS) program
implementation in 2011, 138 schools have been trained in PBIS through the three (3) year training
and coaching cycle. The adoption of a PBIS framework within the schools has had a positive effect
on decreasing problem behaviors, increasing school attendance, increasing social-emotional
supports in schools and improving school climate. The original PBIS scope of work was designed to
achieve these goals within the school setting. This revised PEI/PBIS scope of work will address: 1.
Expansion of the PBIS training to include trauma-informed practices in the current PBIS schools and
provide PBIS training for preschools; 2. Integration of mental health staff into the school-wide system;
and 3. The need for an access point to triage at-risk children and families in order to link to services
in the community in a timely manner.
This project proposes to enhance the existing PBIS framework by providing an additional one (1)
year training cycle to support schools with integrating trauma-informed practices, suicide prevention
practices and effectively incorporating mental health staff within the school system and culture.
This project further proposes to provide a two (2) year training cycle to preschools within Fresno
County on PBIS in order to incorporate the PBIS framework into preschool settings.
The intent of this project is to provide funds for positive behavioral supports and mental health
prevention and early intervention services in a school, preschool, community and home setting to
children and youth, ages 0 to 22. The purpose of the PEI component is to prevent mental illness and
reduce the long-term adverse impact on individuals and their families and reduce the impact of
untreated mental illness. Prevention in mental health involves reducing risk factors or stressors,
building protective factors and skills and increasing support. Prevention promotes positive cognitive,
social and emotional development and encourages a state of well-being that allows the individual to
function well in challenging circumstances.
In general, school based PEI programs will incorporate a positive behavioral PEI services reflecting
an Evidence Based Program (EBP) which must include a three-tiered integrated approach
emphasizing primary preventions, secondary preventions, and linking to tertiary interventions
(specialized/individualized systems for youth at risk of school failure, severe emotional and
behavioral problems, abuse, neglect, trauma resulting from co-occurring substance use disorder,
and/or risk of juvenile justice involvement).
PEI programs will also incorporate programs to support perinatal and early childhood wellness and
prevention strategies to address the needs of youth ages 0 to 5 years old to increase school
readiness and prevent mental illness. This structure is designed to mitigate school failure, juvenile
justice involvement and mental health crisis by addressing poor social skills and behavior problems
that are in the early stages and thus affect the child’s overall mental well-being.
The First Tier, Prevention – focuses on prevention which deters the development of new cases of
problem behavior by focusing on all youth, parents and staff, across all settings (school-wide,
classroom, and non-instructional settings). This primary tier will be designed to increase awareness
of warning signs and risk factors for potential mental health and behavioral issues. It will create
positive school social cultures and home environments that promote social and academic success
and thus building protective factors in the child to deal with social and emotional challenges. (See
Exhibit A-3)
The Second Tier, Early Intervention – focuses on reducing the number of existing cases of problem
behaviors, including emotional and behavioral problems, by establishing efficient and rapid
responses to problem behavior and emotional distress. The Secondary tier prevention is more
specialized group system for students with at risk behaviors and warning signs of mental illness. This
Exhibit A-2
Page 3 of 11
group setting will assist children and youth with improving behavioral and social skills and increase
coping strategies at home, school and other environments. Within the Secondary tier, an early
identification screening system will be implemented by a mental health clinician or a properly trained
school staff to allow for early delivery of timely intervention supports and programs to children,
schools, and their families. (See Exhibit A-3)
The Third Tier, Intervention – known as the tertiary tier is the stage at which MHSA Community
Services and Supports (CSS) interventions and intensive individualized supports are made available
through CONTRACTOR and COUNTY DBH Behavioral Health Partnership. Children and youth
requiring more intensive services will be assessed for appropriate services. (See Exhibit A-3)
Prevention and Early Intervention – MHSA
Since part of the funding for this PEI scope of work is based on MHSA PEI funding, the
CONTRACTOR shall follow all requirements of a PEI program under the Mental Health Services Act
(MHSA) as defined in the current MHSA PEI Regulations.
Prevention
Prevention in mental health involves reducing risk factors or stressors, building protective factors and
skills and increasing support. Prevention promotes positive cognitive, social and emotional
development and encourages a state of well-being that allows the individual to function well in
challenging circumstances.
Early Intervention
Early Intervention is directed toward individuals and families for whom a short-duration (up to one
year), relatively low-intensity intervention is appropriate to measurably improve a mental health
problem or concern very early in its manifestation, thereby avoiding the need for more extensive
mental health treatment or services; or to prevent a mental health problem from getting worse.
An early intervention program, as defined by MHSA PEI regulations, designed to utilize the following
strategies:
•Be designed and implemented to help create Access and Linkage to Treatment
•Be designed, implemented, and promoted in ways that Improve Timely Access to Mental
Health Services for Individuals and/or Families from Underserved Populations
•Be designed, implemented, and promoted using Strategies that are Non-Stigmatizing and
Non-Discriminatory
This program will use an effective method likely to bring about intended outcomes, based on one of
the following standards, or a combination of the following standards (as defined by current MHSA PEI
regulations):
•Evidence-based practice standard
•Promising practice standard
•Community and or practice-based evidence standard
CONTRACTOR shall collect all data and fulfill all reporting requirements as specified in the
applicable MHSA PEI regulations related to the program type, strategies, and standards indicated
Exhibit A-2
Page 4 of 11
above or as indicated in MHSA regulations. CONTRACTOR shall will work with COUNTY to ensure
data, outcomes, and reports are included in all required MHSA reports, plans, and updates.
Current MHSA Regulations can be found at the following website:
http://mhsoac.ca.gov/laws-and-regulations
CONTRACTOR shall understand all MHSA PEI regulations to ensure they have the organizational
capacity to record, track, and report all required elements.
Number of Clients to be Seen:
CONTRACTOR shall provide services to the following number (minimum number) of clients per year:
Year 1: 750 clients will be served
Year 2: 1680 clients will be served
Year 3: 2460 clients will be served
Year 4: 3240 clients will be served
Year 5: 4020 clients will be served
IV.Staffing:
Proposed staffing is reflected in the budget Exhibits (Exhibit C) and will include:
Trainer of trauma-informed PBIS and preschool PBIS
Trauma-informed/preschool PBIS consultant
PBIS Coaches
Behavioral Health Clinicians
Intensive Behavior Intervention Specialists
V.Service Start Dates:
FY 2018-19: Complete final year of current PBIS Program & prepare for trauma-informed and
preschool trainings
FY 2019-20: Train approximately ten (10) preschool cohorts and twenty (20) school cohorts
FY 2020-21: Train approximately ten (10) preschool cohorts and twenty (20) school cohorts
FY 2021-22: Train approximately ten (10) preschool cohorts and twenty (20) school cohorts
FY 2022-23: Train approximately ten (10) preschool cohorts and twenty (20) school cohorts
Exhibit A-2
Page 5 of 11
School sites are listed in Exhibit A-4.
Hub locations, start up periods, and school satellite sites may be adjusted during the term of this
agreement by the written approval of the COUNTY’s DBH Director, or designee, and CONTRACTOR.
Clinicians and other mental health staff located at a specific site or hub may serve students/clients in
other hubs/locations and other areas in the community as needed. Students/clients located in a
specific location/hub may access services in other sites/hubs as needed. CONTRACTOR shall work
with COUNTY’s DBH Director, or designee, to ensure a smooth and efficient continuum of care for all
students/clients
Any new schools or sites may be added throughout the duration of the contract with the written
approval of the COUNTY’s Director DBH, or designee, and Contractor. Services may be located at
the school site, community based or in home based services.
VI.Cultural Competency:
A.CONTRACTOR shall provide the following as it relates to cultural competency services:
1.CONTRACTOR shall recruit and hire staff that have demonstrated experience working
with the Latino, African American, Southeast Asian, Native American, Punjabi, and other
minority populations and have knowledge about the culture of these targeted groups as
well as other diverse communities.
2. CONTRACTOR’s staff shall attend annual trainings on cultural competency, awareness,
and diversity as provided by CONTRACTOR. CONTRACTOR’s staff shall be appropriately
trained in providing services in a culturally sensitive manner.
3. CONTRACTOR’s staff shall attend civil rights training as provided by CONTRACTOR.
4.CONTRACTOR shall hire bilingual staff. At a minimum, CONTRACTOR shall hire staff
competent in Spanish and Hmong as these are the identified threshold languages in
Fresno County.
5.CONTRACTOR shall secure the services of trained translators/interpreters as may be
necessary. Translators/interpreters may prove invaluable for languages such as
Cambodian, Russian, Arabic, Armenian, Punjabi, and others. Translators/interpreters
shall be appropriately trained in providing services in a culturally sensitive manner.
6.CONTRACTOR shall provide services by placing importance on traditional values, beliefs
and family histories. Cultural values and traditions offer special strengths in treating
clients and this should help guide health care messages and wellness and recovery plans.
7.CONTRACTOR shall provide services within the most relevant and meaningful cultural,
gender-sensitive, and age-appropriate context for the target population.
8.CONTRACTOR shall develop plans to continually engage targeted populations.
9. CONTRACTOR shall recruit and hire client/family members. Regarding the recruitment of
client/family members, the CONTRACTOR will be able to consult with the COUNTY DBH.
10.CONTRACTOR shall distribute literature/informational brochures in appropriate languages
and request feedback as to how access to care could be improved for these culturally
diverse communities.
Exhibit A-2
Page 6 of 11
11. CONTRACTOR shall conduct an annual cultural competency self-assessment and provide
the results of said self-assessment to the COUNTY. The annual cultural competency self-
assessment instruments shall be reviewed by the COUNTY and revised as necessary to
meet the approval of the COUNTY. The CONTRACTOR can create their own cultural
competency self-assessment tools or utilize instruments to be provided by COUNTY.
12. CONTRACTOR shall provide services throughout Fresno County in the community and
home as needed, to increase the frequency of clients obtaining needed services as some
children/families are reluctant to seek services at school sites.
13. CONTRACTOR shall promote system of care accountability for performance outcomes
which enable children and their families to live independently, work, maintain community
supports, stay in good health, and avoid substance abuse and incarceration.
14.CONTRACTOR shall develop individual services and supports plans which are flexible
and open to meet the unique needs of the targeted populations.
15. CONTRACTOR shall provide family support and the creation of family partnerships
utilizing peer support for families and parenting support.
16. CONTRACTOR shall establish culturally specific multidisciplinary treatment teams
responsible for assuring and providing needed services.
17. CONTRACTOR shall provide parenting groups that are conducted in the preferred
language of the participant client/families.
18. CONTRACTOR’s staff will be trained to keep an open mind and maintain non-judgmental
interaction with clients/families.
19. CONTRACTOR, when developing program services and service delivery approaches,
shall seek to hire and train staff and community stakeholders (i.e., consumers, family
members, etc.) that are providing services to consumers and families on appropriate
methods and approaches to delivering gender and age specific services.
20.CONTRACTOR’s hiring and contracting practices shall be based on local data and reflect
the needs of the population to be served.
21. CONTRACTOR shall attend the COUNTY’s Cultural Diversity Committee monthly
meetings, maintain its own cultural competence oversight committee, and develop a
cultural competency plan to address and evaluate cultural competency issues.
22. COUNTY shall provide technical assistance and demographic data to CONTRACTOR in
relation to cultural competency planning.
23. CONTRACTOR shall train staff on best practice for utilizing interpreters to ensure effective
communication with monolingual consumers and families to assist in the delivery of
culturally/linguistically appropriate services.
VII.COLLABORATION:
Through the PEI/PBIS site-based teams, local needs will be based on objective data. When the data
utilized by the PEI/PBIS teams indicates student and families may require more intensive supports,
the team will establish a coordinated seamless procedure for comprehensive service delivery through
Exhibit A-2
Page 7 of 11
CONTRACTOR’s specialty mental health treatment services as well as other existing local resources.
School staff is sometimes the first to identify barriers within the students' families. All too often, the
social and emotional barriers experienced by the family may affect the student's ability to access
education and quality mental health services. When the data indicates the need for intensive mental
health supports for the student and/or family, the PEI/PBIS team will be able to integrate
representatives from CONTRACTOR’s specialty mental health treatment services as well as outside
private and public providers who are working closely with the family/student to create a person-
centered action plan. Fresno County MHSA programs such as the Kings View Youth Empowerment
Centers and the Uplift Family Youth ACT programs are a few examples of local community supports
that can integrate within the teaming process as needed. CONTRACTOR is expected to understand
the process of navigating and connecting to public and private behavioral health providers and
various student/client insurance providers. CONTRACTOR shall work collaboratively with COUNTY’s
DBH and the DBH’s network of providers to ensure students/clients receive all needed linkages and
services in a seamless manner.
VIII. COUNTY RESPONSIBILITIES:
A.COUNTY shall:
1.Provide oversight, through its DBH Director, or designee, and collaborate with
CONTACTOR and other COUNTY Departments and community agencies to help achieve
State program goals and outcomes. In addition to contract monitoring of program(s),
oversight includes, but not limited to, coordination with the State Department of Health
Care Services in regard to program administration and outcomes.
2. Assist the CONTRACTOR in making linkages with the total mental health system. This
will be accomplished through regularly scheduled meetings as well as formal and informal
consultation.
3. Participate in evaluating the progress of the overall program and the efficiency of
collaboration with CONTRACTOR’s staff and will be available to the CONTRACTOR for
ongoing consultation.
4. Gather outcome information from CONTRACTOR throughout each term of this
Agreement. COUNTY DBH staff shall notify the CONTRACTOR when its participation is
required. The performance outcome measurement process will not be limited to survey
instruments but will also include, as appropriate, client and staff interviews, chart reviews,
and other methods of obtaining required information.
5. Assist the CONTRACTOR’s efforts towards cultural and linguistic competency by
providing the following to CONTRACTOR:
a.Technical assistance and training regarding cultural competency requirements.
b. Mandatory cultural competency training for CONTRACTOR personnel, at minimum
once per year.
c.Technical assistance for translating information into COUNTY’s threshold languages
(Spanish and Hmong). Translation services and costs associated will be the
responsibility of the CONTRACTOR.
6.Convene a routine collaborative governing leadership meeting between CONTRACTOR
and COUNTY designed to maintain the overarching goals and objectives of the
requirements of this Agreement.
Exhibit A-2
Page 8 of 11
IX. Performance Outcome Measures
CONTRACTOR shall be required to submit measureable outcomes on an annual basis, as
identified in the COUNTY DBH’s Policy and Procedure Guide (PPG) 1.2.7 Performance Outcomes
Measures, attached hereto and referenced herein as Exhibit A-5. Performance outcomes measures
must be approved by the Department and satisfy all State and local mandates. The Department will
provide technical assistance and support in defining measureable outcomes. Performance outcome
measures shall be mutually agreed upon by CONTRACTOR and COUNTY’s DBH Director, or
designee, within ninety (90) days of the Agreement start date. All performance indicators will reflect the
four (4) domains identified by the Commission Accreditation of Rehabilitation Facilities (CARF).
The domains are Effectiveness, Efficiency, Access, and Satisfaction. These are defined and
listed below.
The COUNTY’s DBH collects data about the characteristics of the persons served and
measures service delivery performance indicators in each of the following CARF Domains: At
minimum, one (1) performance indicator will be identified for each of the four (4) CARF domains listed
below.
1.Effectiveness: A performance dimension that assesses the degree to which an intervention or
services have achieved the desired outcome/result/quality of care through measuring change
over time. The results achieved and outcomes observed are for persons served.
Examples of indicators include: Persons get a job with benefits, or receive supports needed to
live in the community, increased function, activities, or participation, and improvement of health,
employment/earnings, or plan of care goal attainment.
Reduction in disciplinary interactions. Indicators - referrals, suspensions. Achievement of
treatment goals. Data sources: attendance, disciplinary data, GPA, PSC-35.
2.Efficiency: Relationship between results and resources used, such as time, money, and staff.
The demonstration of the relationship between results and the resources used to achieve them.
A performance dimension addressing the relationship between the outputs/results and the
resources used to deliver the service.
Examples of indicators include: Direct staff cost per person served, amount of time it takes to
achieve an outcome, gain in scores per days of service, service hours per person achieving
some positive outcome, total budget (actual cost) per person served, length of stay and direct
service hours of clinical and medical staff. Training modalities. Penetration rates.
3.Access: Organizations’ capacity to provide services of those who desire or need services.
Barriers or lack thereof for persons obtaining services. The ability of clients to receive the right
service at the right time. A performance dimension addressing the degree to which a person
needing services is able to access those services.
Examples of indicators include: Timeliness of program entry (From 1st request for service to 1st
service), ongoing wait times/wait lists, minimizing barriers to getting services, and no-
show/cancellation rates.
4.Satisfaction: Satisfaction Measures are usually orientated towards consumers, family, staff,
and stakeholders. The degree to which clients, the County and other stakeholders are satisfied
Exhibit A-2
Page 9 of 11
with services. A performance dimension that describes reports or ratings from persons served
about services received from an organization.
Examples of indicators include: opinion of persons served or other key stakeholders in regards
to access, process, or outcome of services received, Consumer and/or Treatment Perception
Survey. Consumer Perception Survey Pre and Post survey data for sub components.
A.Data Collection
1.Data collection and evaluation methods may include, but are not limited to, staff,
participant, and family interviews; and case file reviews.
2. CONTRACTOR shall also conduct consumer satisfaction surveys to see if there is a
strong correlation of the efficacy of the evidence-based program with specific ethnicities
and languages as well as to identify gaps in meeting cultural needs of clients/families, if
any.
3. CONTRACTOR shall ensure all program clients/families participate in the semi-annual State
Consumer Perception Survey (CPS) survey. CPS’s will be distributed to all active
clients/families to fill out and return to CONTRACTOR.
4.CONTRACTOR shall collect data regarding the ethnicity and language of each
client/family receiving services as well as directing staff to follow-up with the culturally
diverse clients/families for suggestions on how to improve the programs and also how to
help make the programs more culturally relevant.
5.CONTRACTOR shall maintain all client data in permanent electronic case records.
CONTRACTOR shall have established policies and procedures for data collection and
client confidentiality.
B.Goals and Outcomes:
CONTRACTOR’s performance will also be evaluated by COUNTY DBH utilizing the following
performance outcomes:
Individual:
•Increase number of school staff that are trained in recognition of early indicators of mental
illness and how to refer students for screening and intervention
•Decrease number of preschool suspensions & expulsions
•Reduction in symptoms
•Increase knowledge of risk, warning signs and protective factors
•Enhanced resilience
•Ensure cultural and linguistic competent services are provided to students of different cultures
and ethnicities
Exhibit A-2
Page 10 of 11
•Increase in mental health awareness, early-age attachment, social support, and academic
achievement
•Student increase in attendance and Grade Point Averages as well as increase in overall
satisfaction of the program for students and Parents/caregivers
•Student increase in mental well-being and self-report of positive environment
•Reduction in bullying and aggressive behaviors
•Reduction in 5150 referrals
•Reduction in discriminatory/prejudicial activities in the school
•Reduction in suspensions, expulsions, and detentions
System/Program/Community:
•Prevent development of new cases of problem behavior by focusing on all students and staff
•Efficient and rapid responses to problem behavior
•Successful integration of behavioral health staff into the school culture and system
•Provide emotional, and behavioral supports for youth
•Improve PEI supports for children and youth
•Increase access to mental health services for underserved and un-served children
•Increase competency with preschool staff with supporting social/emotional/behavioral needs
of youth
•Increased EBP’s for youth ages birth to 5
Proposed Methods/Measures of Success:
•Survey or focus groups to measure change in knowledge/attitudes about mental illness and
when/how to refer
•Records of students progress on individualized goals
•Consumer satisfaction surveys that assess client/family satisfaction and improvement in
presenting problems
•Quantitative analysis of identified referrals, frequency of contact, and associated reduction in
suspension/expulsion
Outcomes will be reviewed for input and are approved by the COUNTY’s DBH Outcome
Committee. The purpose is to ensure a comprehensive system wide approach to the evaluation
of programs through and effective outcome reporting process.
Exhibit A-2
Page 11 of 11
Through the COUNTY/CONTRACTOR Behavioral Health partnership, mental health clinicians
and other staff will provide services within the school and local community settings to support
prevention and intervention activities. CONTRACTOR staff will further collaborate with community
based organizations to ensure that families and children ages 0-22 are linked with appropriate
services to support youth and family needs beyond those that exist within the school setting.
C. Reports
1.CONTRACTOR shall prepare an evaluation report annually and submit to the COUNTY’s
DBH, and make said reports available to partnering and interested local agencies and
organizations such as the project collaborators, other community agencies and mental heath
treatment providers. Each annual evaluation report will include the following information:
demographics of the target population served, services provided to each participant, ,
enrollment in school, results of data analysis compared to planned process, output and
outcome measures, barriers to program implementation and measures taken to overcome
those barriers, accomplishments of program participants, lessons learned, and the final
result of any and all satisfactory survey(s).
2.CONTRACTOR shall be expected to comply with all contract monitoring and compliance
protocols, procedures, data collection methods, and reporting requirements conducted by
the COUNTY.
3.Additional reports/outcomes may also be requested by the COUNTY’s DBH, based on
among other things, identification of client/family specific needs as well as State required
reports/outcomes as needed.
Exhibit A-3, Page 1 of 1
Behavioral Health Partnership
Fresno County Superintendent of Schools and Department of Behavioral Health are partnering to address social,
emotional and behavioral needs of youth in all schools across Fresno County. Through this collaboration, together we
can provide access to all students who need services. Behavioral health services are for all youth ages Birth to 22
ranging in frequency and intensity depending upon the individual needs. This collaboration will be expanded to
include other community agencies in the future. In this service delivery model mental health clinicians will serve as
team members within a school‐wide multi‐tiered system of support that address the mental health needs of all youth.
Services and supports will be delivered at the school site, in the community and in the home where appropriate.
Training and education for school staff, caregivers and students will be provided. Care coordination, risk assessment
and suicide prevention will be embedded throughout this system of care so that all children in rural and urban areas
have access to mental health support within their community. All agency services will be integrated into the schools
to create a network of providers and service to reach all students. This collaborative model will provide students and
caregivers with one seamless system of care that will remove barriers and increase access to a positive healthy
environment in which youth can live and learn. Being prepared to learn is as important as the learning.
Universal: Crisis and Acute Care Services
Prevention Peri‐natal wellness
Mental Health First Aide
Parent training/support
Screening & Triage for crisis
Mental health awareness
Mindfulness
Bully prevention & awareness education
Suicide awareness education
Suicide prevention training
Positive Behavioral Intervention & Supports (PBIS)
Universal Screening
Early
Intervention
Mid‐level assessment
Parent training/support
Pediatric consultation
Agency linkage
Student Assistance Program (SAP)
Group counseling
Special Friends
Behavior consultation/support
Intervention Assessment (to identify underlying issues such as
Depression, Anxiety, etc..)
Therapy (Counseling, play therapy, Parent‐Child
Interaction Therapy (PCIT), Functional Family
Therapy, Evidenced‐based trauma‐informed
treatment, substance abuse treatment, Eating
Disorder treatment)
Medication management
Collateral
Case Management (Agency linkage)
Treatment Planning & Development
Psychiatric/Pediatric consultation
Rehabilitation
Family Behavioral Health Court
Behavior intervention
Intensive
Intervention
(Reflects higher frequency & duration of
service)
Care Coordination (managing placement &
transition between placements: non‐public
schools, hospital)
Case Management (Agency linkage)
Residential monitoring
Medication management
Psychiatric/pediatric consultation
Intensive Outpatient services
Behavior Intervention classrooms
Therapeutic Behavior Services (TBS)
Wraparound Services
Residential assessment
Page 1 of 12 Exhibit A-4
SCHOOL DIRECTORY
DISTRICT NAME SCHOOL NAME ADDRESS CITY ZIP CODE GRADES SERVED
Alvina Elementary
Alvina Elementary 295 W. Saginaw Caruthers 93609 K-8
Big Creek Elementary
Big Creek Elementary 55190 Point Road Big Creek 93605 K-8
Burrell Union Elementary
Burrel Union Elementary 16704 S. Jameson Avenue Riverdale 93656 K-8
Caruthers Unified
Caruthers Elementary 13369 S. Quince Street Caruthers 93609 K-8
Caruthers High School 2580 W. Tahoe Caruthers 93609 9th -12
MARC Continuation Adult 2580 W. Tahoe Caruthers 93609
Central Unified
Biola-Pershing 4885 N. Biola Avenue Fresno 93723 K-6
Harvest 6514 W. Gettysburg Fresno 93723 K-6
Herndon Barstow 6265 N. Grantland Fresno 93723 K-6
Houghton Kearney 8905 W. Kearney Fresno 93706 K-8
Liddell 5455 W. Alluvial Fresno 93722 K-6
Madison 330 S. Brawley Fresno 93706 K-6
McKinley 4444 W. McKinley Fresno 93722 K-6
Polk 2195 N. Polk Fresno 93722 K-6
River Bluff 6150 W. Palo Alto Fresno 93722 K-6
Roosevelt 2600 N. Garfield Fresno 93723 K-6
Saroyan 5650 W. Escalon Fresno 93722 K-6
Steinbeck 3550 N. Milburn Fresno 93722 K-6
Teague 4725 N. Polk Fresno 93722 K-6
Tilley, Hanh Phan 2280 N. Valentine Fresno 93722 K-6
El Capitan 4443 W. Weldon Fresno 93722 7th -8
Glacier Point 4055 N. Bryan Fresno 93723 7th -8
' Rio Vista 6240 W. Palo Alto Fresno 93722 7th -8
Central High East 3535 N. Cornelia Fresno 93722 9th -12
Central High West 2045 N. Dickenson Fresno 93723 9th -12
Central Unified Adult {C.L.A.S.S.) 2698 N. Brawley Fresno 93722
Central Unified Alternative (Ind. Study) 2698 N. Brawley Fresno 93722
Pathway Community Day School 11 S. Tielman Fresno 93706
Pershing Continuation 855 W. Nielsen Fresno 93706
Clay Joint Elementary
Clay Joint Elementary 12449 S. Smith Kingsburg 93631 K-8
Clovis Unified
Boris 7071 E. Clinton Fresno 93737 K-6
Page 2 of 12 Exhibit A-4
SCHOOL DIRECTORY
Bud Rank 3650 Powers Avenue Clovis 93619 K-6
Cedarwood 2851 Palo alto Clovis 93611 K-6
Century 965 N. Sunnyside Clovis 93611 K-6
Clovis 1100 Armstrong Clovis 93611 K-6
Cole 615 W. Stuart Clovis 93612 K-6
Copper Hills 1881 E. Plymouth Way Fresno 93720 K-6
Dry Creek 1273 N. Armstrong Clovis 93611 K-6
Fancher Creek 5978 E.Tulare Fresno 93727 K-6
Fort Washington 960 E. Teague Fresno 93727 K-6
Freedom 2955 Gettysburg Clovis 93611 K-6
Fugman 10825 N. Cedar Fresno 93730 K-6
Garfield 1315 N. Peach Clovis 93611 K-6
Gettysburg 2100 Gettysburg Clovis 93611 K-6
Jefferson 1880 Fowler Clovis 93611 K-6
Liberty 1250 E. Liberty Hill Drive Fresno 93720 K-6
Lincoln 774 E. Alluvial Fresno 93720 K-6
Maple Creek 2025 E. Teague Fresno 93720 K-6
Mickey Cox 2191 Sierra Clovis 93611 K-6
Miramonte 1590 Bellaire Clovis 93611 K-6
Mountain View 2002 E. Alluvial Fresno 93720 K-6
Nelson 1336 W. Spruce Pinedale 93650 K-6
Oraze 3468 N. Armstrong Fresno 93727 K-6
Pinedale 7171 N. Sugar Pine Pinedale 93650 K-6
Regan 8300 E. Ashlan Avenue Clovis 93619 K-6
Red Bank 1454 Locan Avenue Clovis 93611 K-6
Riverview 2491 E. Behymer Fresno 93730 K-6
Sierra Vista 510 Barstow Clovis 93612 K-6
Tarpey 2700 Minnewawa Clovis 93612 K-6
Temperance-Kutner 1448 N. Armstrong Fresno 93727 K-6
Valley Oak 465 E Champlain Fresno 93730 K-6
Weldon 150 DeWitt Clovis 93612 K-6
Woods 700 Teague Avenue Clovis 93619 K-6
Alta Sierra Intermediate 380 W. Teague Clovis 93611 7th -8
Clark Intermediate 902 Fifth Street Clovis 93612 7th -8
Granite Ridge 2770 E. International Avenue Fresno 93730 7th -8
Kastner Intermediate 7676 N. First Street Fresno 93720 7th -8
Reyburn Intermediate 4300 N. Dewolf Clovis 93611 7th -8
Buchanan 465 E Champlain Fresno 93730 9th -12
CART 150 DeWitt Clovis 93612 9th -12
Clovis East 4343 N. Leonard Clovis 93611 9th -12
Page 3 of 12 Exhibit A-4
SCHOOL DIRECTORY
Clovis High 1055 Fowler Clovis 93611 9th -12
Clovis North 2770 E. International Fresno 93730 9th -12
Clovis West 1070 E. Teague Fresno 93720 9th -12
Clovis Adult Education 1452 David E. Cook Way Clovis 93611
Clovis Community Day Elementary 1715 David E. Cook Way Clovis 93611
Clovis Community Day Secondary 1715 David E. Cook Way Clovis 93611
Enterprise High School 1655 David E. Cook Way Clovis 93611
Gateway 1550 Herndon Clovis 93611
Coalinga -Huron Unified
Henry F. Bishop 1501 Sunset Ave. Coalinga 93210 K-1
Annie E. Cheney Kindergarten 149 Adams Street Coalinga 93210 K
Nell Dawson 1303 Sunset Ave. Coalinga 93210 2nd -3
Huron 12th and N Streets Huron 93234 K-5
Sunset 958 Sunset Ave Coalinga 93210 4th -5
Coalinga Middle 265 Cambridge Ave. Coalinga 93210 6th -8
Huron Middle 16875 4th Street Huron 93234 6th -8
Coalinga High 750 Van Ness Ave. Coalinga 93210 9th -12
Cambridge High Continuation 516 Baker St. Coalinga 93210
Chestnut High Continuation 16673 Palmer Ave. Huron 93234
Community Day School 275 Cambridge Ave. Coalinga 93210
Firebaugh-Las Deltas Unified
Hazel M. Bailey 1691 Q Street Firebaugh 93622 K-3
Arthur E. Mills Intermediate 1191 P Street Firebaugh 93622 4th-5
Firebaugh Middle 1600 16th Street Firebaugh 93622 6th-8
Firebaugh High 1976 Morris Kyle Drive Firebaugh 93622 9th-12
El Puente High Continuation 1666 Saipan Firebaugh 93622
Firebaugh Adult Education 1976 Morris Kyle Drive Firebaugh 93622
Firebaugh Community Day 1976 Morris Kyle Drive Firebaugh 93622
Fowler Unified
James W. Marshall 142 N. Armstrong Avenue Fowler 93625 K-2
John C. Fremont 306 E. Tuolumne Street Fowler 93625 3rd -5
Malaga 3910 S. Ward Fresno 93725 K-5
John Sutter 701 E. Walter Avenue Fowler 93625 6th -8
Fowler High 701 E. Main Street Fowler 93625 9th -12
Fowler Academy Continuation 975 E. Adams Avenue Fowler 93625
Fowler Academy Community Day 975 E. Adams Avenue Fowler 93625
Fresno Unified
Adams 2117 W. McKinley Fresno 93728 K-6
Anthony 1542 E. Webster Fresno 93728 K-6
Ayer 5272 E. Lowe Fresno 93727 K-6
Page 4 of 12 Exhibit A-4
SCHOOL DIRECTORY
Aynesworh 4765 E. Burns Fresno 93727 K-6
Bakman 588 N. Helm Fresno 93727 K-6
Balderas 4625 E. Florence Fresno 93725 K-6
Birney 3034 E. Cornell Fresno 93703 K-6
Bullard Project Talent 4950 N. Harrison Fresno 93704 K-8
Burroughs 166 N. Sierra Vista Fresno 93702 K-6
Calwa 4303 E. Jensen Fresno 93725 K-6
Centennial 3803 E. Saginaw Way Fresno 93726 K-6
Columbia 1025 S. trinity Fresno 93706 K-6
Del Mar 4122 N. Del Mar Fresno 93704 K-6
Easterby 5211 E. Tulare Fresno 93727 K-6
Eaton 1451 E. Sierra Fresno 93710 K-6
Ericson 4774 E. Yale Fresno 93703 K-6
Ewing 4873 E. Olive Fresno 93727 K-6
Figarden 6235 M. Brawley Fresno 93722 K-6
Forkner 7120 N. Valentine Fresno 93711 K-6
Fremont 1005 W. Weldon Fresno 93705 K-6
Gibson 1266 W. Barstow Fresno 93705 K-6
Greenberg 5081 E. Lane Fresno 93727 K-6
Hamilton 102 E. Clinton Fresno 93704 K-6
Heaton 1533 N. San Pablo Fresno 93728 K-6
Hidalgo 3550 E. Thomas Fresno 93702 K-6
Holland 676 N. Fresno Fresno 93726 K-6
Homan 1602 W. Harvard Fresno 93705 K-6
Jackson 3750 E. Platt Fresno 93702 K-6
Jefferson 202 N. Mariposa Fresno 93701 K-6
King 1001 E. Florence Fresno 93706 K-6
Kirk 2000 E. Belgravia Fresno 93706 K-6
Kratt 650 W. Sierra Fresno 93704 K-6
Lane 4730 E. Lane Fresno 93702 K-6
Lawless 5255 N. Reese Fresno 93722 K-6
Leavenworth 4420 E. Thomas Fresno 93702 K-6
Lincoln 651 "B" Street Fresno 93706 K-6
Lowell 171 N. Poplar Fresno 93701 K-6
Malloch 2251 W. Morris Fresno 93705 K-6
Manchester GATE 2307 e. Dakota Fresno 93726 K-6
Mayfair 3305 E. Home Fresno 93703 K-6
Mccardle 577 E. Sierra Fresno 93710 K-6
Muir 109 E. Dennett Fresno 93728 K-6
Norseman 4636 E. Weldon Fresno 93703 K-6
Page 5 of 12 Exhibit A-4
SCHOOL DIRECTORY
Olmos 550 S. Garden Fresno 93727 K-6
Powers-Ginsberg 110 E. Swift Fresno 93704 K-6
Pyle 4140 N. Augusta Fresno 93726 K-6
Robinson 555 E. Browning Fresno 93710 K-6
Roeding 1225 W. Dakota Fresno 93705 K-6
Rowell 3460 E. McKenzie Fresno 93702 K-6
Slater 4472 E. Emerson Fresno 93705 K-6
Starr 1780 W. Sierra Avenue Fresno 93705 K-6
Storey 5250 E. Church Fresno 93725 K-6
Sunset 1755 S. Crystal Fresno 93706 K-6
Thomas 4444 N. Millbrook Fresno 93726 K-6
Turner 5218 E. Clay Fresno 93727 K-6
Vang Pao 5090 E. Church Fresno 93725 K-6
Viking 4251 N. Winery Fresno 93726 K-6
Vinland 4666 N. Maple Fresno 93726 K-6
Webster 930 N. Augusta Fresno 93701 K-6
Williams 525 W. Saginaw Fresno 93705 K-6
Wilson 2131 W. Ashlan Fresno 93705 K-6
Winchell 3722 E. Lowe Fresno 93702 K-6
Wishon 3857 E. Harvard Fresno 93703 K-6
Wolters 5174 N. First Fresno 93710 K-6
Yokomi 2323 E. McKenzie Fresno 93701 K-6
Ahwahnee 1127 E. Escalon Fresno 93710 7th -8
Baird 5500 N. Moroa Fresno 93704 7th -8
Computech 555 E. Belgravia Fresno 93706 7th -8
Cooper 2277 W. Bellaire Way Fresno 93705 7th -8
Fort Miller 1302 Dakota Fresno 93704 7th -8
Gaston 1100 E. Church Fresno 93706 7th -8
Hamilton 102 E. Clinton Fresno 93704 7th -8
Kings Canyon 5117 E. Tulare Fresno 93727 7th -8
Scandinavian 3232 N. Sierra Vista Fresno 93726 7th -8
Sequoia 4050 E. Hamilton Fresno 93702 7th -8
Tehipite 630 N. Augusta Fresno 93701 7th -8
Tenaya 1239 W. Mesa Fresno 93711 7th -8
Terronez 2300S. Willow Fresno 93725 7th -8
Tioga 3232 E. Fairmont Fresno 93726 7th -8
Wawona 45254 N. Thorne Fresno 93705 7th -8
Yosemite 1292 N. Ninth Fresno 93703 7th -8
Bullard 5445 N. Palm Fresno 93704 9th -12
CART 2555 Clovis Ave. Clovis 93612 9th -12
Page 6 of 12 Exhibit A-4
SCHOOL DIRECTORY
Duncan Polytechnical 4330 E. Garland Fresno 93726 9th -12
Edison 540 E. California Fresno 93706 9th -12
Fresno 1839 Echo Avenue Fresno 93704 9th -12
Hoover 5550 N. First Street Fresno 93710 9th -12
Mclane 2727 N. Cedar Fresno 93703 9th -12
Phillip J Patino School of Entrepreneurship 2000 E. Cambridge Avenue Fresno 93703 9th -12
Roosevelt 4250 E. Tulare Fresno 93702 9th -12
Sunnyside 1019 S. Peach Fresno 93727 9th -12
Cambridge Continuation 1001 Chestnut Fresno 93721
Cesar E. Chavez Adult Education Center 2500 Stanislaus Fresno 93721
Design Science High School 2004 E. Cambridge Avenue Fresno 93703
Dewolf Continuation 2021 N. Clark Fresno 93703
J.E. Young 822 N. Abby Fresno 93701
Phoenix Elementary Academy 3335 N. Authur Fresno 93705 .
Phoenix Secondary Academy 2445 W. Dakota Fresno 93705
Golden Plains Unified
Cantua 29288 W. Clarkson Ave. Cantua 93608 K-8
Helm 13883 S. Lassen Helm 93627 K-8
San Joaquin 8535 S. 9th Street San Joaquin 93660 K-3
Tranquility 6116 S. Daniels Tranquillity 93668 K-8
Tranquillity High 6052 S. Juanche Tranquillity 93668 9th-12
Alternative Education 13883 S. Lassen Ave. Helm 93627
Kerman Unified
Kerman-Floyd 14655 W. F Street Kerman 93630 TK-6
Sun Empire 2649 N. Modoc Kerman 93630 TK-6
Liberty 16001 W. E Street Kerman 93630 TK-6
Goldenrod 445 S. Goldenrod Ave. Kerman 93630 TK-6
Kerman Middle 601 S. First Street Kerman 93630 7th-8
Kerman High 205 S. First Street Kerman 93630 9th-12
Enterprise High 15405 W. Sunset Ave. Kerman 93630
Kings Canyon Unified
Alta 21771 E. Parlier Avenue Reedley 93654 TK-5
A. L. Conner 222 Fourth Street Orange Cove 93646 Pre, K-5
Dunlap 39667 Dunlap Road Dunlap 93621 Pre, TK-8
Great Western 5051 S. Frankwood Avenue Reedley 93654 K-5
Jefferson 1037 E. Duff Avenue Reedley 93654 Pre, TK-5
Lincoln 374 E. North Avenue Reedley 93654 TK-5
McCord 333 Center Street Orange Cove 93646 Pre, K-5
Riverview 8662 S. Lac Jae Parlier 93648 K-8
Sheridan 1001 9th Street Orange Cove 93646 TK-5
Page 7 of 12 Exhibit A-4
SCHOOL DIRECTORY
Silas Bartsch 2225 E. North Avenue Reedley 93654 K-8
T.l. Reed 1400 Frankwood Reedley 93654 K-8
Washington 1250 "K" Street Reedley 93654 Pre, K-5
Citrus 1400 Anchor Orange Cove 93646 6th -8
General Grant 360 N. East Avenue Reedley 93654 6th-8
Navelencia 22620 Wahtoke Avenue Reedley 93654 6th -8
Dunlap Leadership Academy 39500 Dunlap road Dunlap 93621 9th-12
Orange Cove High 1700 Anchor Avenue Orange Cove 93646 9th-12
Reedley High 740 W. North Avenue Reedley 93654 9th-12
Reedley Middle College High School 995 N. Reed Avenue Reedley 936S4 9th-12
Kings Canyon Adult 740 W. North Avenue Reedley 93654
Kings Canyon High Continuation 10026 S. Crawford Avenue Dinuba 93618
Mountain View School/Independent Study 877 E. North Avenue Reedley 93654
Kingsburg Elementary Charter School District
Central Valley Home School 1776 6th Avenue Drive Kingsburg 93631 K-8
Island Community Day School 1776 6th Avenue Drive Kingsburg 93631 4th-8
Lincoln 1900 Mariposa Avenue Kingsburg 93631 2nd-3
Reagan 1180 Diane Avenue Kingsburg 93631 4th-6
Roosevelt 1185 10th Street Kingsburg 93631 1st
Washington 1501 Ellis Street Kingsburg 93631 K
Rafer Johnson Jr. High 1300 Stroud Avenue Kingsburg 93631 7th-8
Kingsburg Joint Union High
Kingsburg High School 1900 18th Avenue Kingsburg 93631 9th-12
Kingsburg Adult School 2311 Sierra Street Kingsburg 93631
Laton Unified
Laton Elementary/Conejo 6065 Latonia Laton 93242 K-8
Laton High 6449 Dewoody Street Laton 93242 9th-12
Mendota Unified
Washington 1599 5th Street Mendota 93640 Pre-2
McCabe 250 S. Derrick Avenue Mendota 93640 2nd-6
Mendota 605 Bass Avenue Mendota 93640 K-6
Mendota Jr. High 1258 Belmont Avenue Mendota 93640 7th-8
Mendota High 1993 Belmont Avenue Mendota 93640 9th-12
Monroe Elementary
Monroe Elementary 11842 S. Chestnut Avenue Fresno 93725 K-8
Orange Center Elementary
Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706 Pre, TK-8
Pacific Union Elementary
Pacific Union Elementary 2065 E. Bowles Avenue Fresno 93725 K-8
Page 8 of 12 Exhibit A-4
SCHOOL DIRECTORY
Parlier Unified
S.Ben Benavidez 13900 Tuolumne Street Parlier 93648 K-6
Mathew J. Brletic 601 3rd Street Parlier 93648 K-6
Cesar E. Chavez 500 Tuolumne Street Parlier 93648 K-6
John C. Martinez 13174 E. Parlier Parlier 93648 K-6
Parlier Junior High 1200 E. Parlier Parlier 93648 7th -8
Parlier High 603 Third Street Parlier 93648 9th-12
San Joaquin Valley Continuation School 900 Newmark Avenue Parlier 93648
Pine Ridge Elementary
Pine Ridge Elementary 45828 Auberry Road Auberry 93602 K-8
Raisin City Elementary
Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652 Pre-8
Riverdale Unified
Central Valley Preschool 21320 S. Feland Riverdale 93656 Pre
Fipps Primary 21320 S. Feland Riverdale 93656 K-3
Riverdale Elementary 3700 Stathem Street Riverdale 93656 4th-8
Riverdale High 3086 W. Mt. Whitney Riverdale 93656 9th-12
Sanger Unified
Del Rey Preschool 10620 Morro Street Del Rey 93616 Pre
Jefferson Preschool 1110 Tucker Street Sanger 93657 Pre
Lincoln Preschool 1700 14th Street Sanger 93657 Pre
Wilson Preschool 504 Faller Sanger 93657 Pre
Centerville 48 S. Smith Avenue Sanger 93657 K-6
Del Rey 10620 Morro Street Del Rey 93616 K-6
Fairmont 3095 N. Greenwood Avenue Sanger 93657 K-8
Jackson 1810 Third Street Sanger 93657 K-5
Lincoln 1700 14th Street Sanger 93657 K-5
Lone Star 2617 S. Fowler Fresno 93725 K-6
Madison 2324 Cherry Street Sanger 93657 K-5
Reagan 1586 S. Indianola Avenue Sanger 93657 K-5
Sequoia 1820 S. Armstrong Avenue Fresno 93727 K-6
John S. Wash 6350 E. Lane Fresno 93727 K-6
Wilson 610 Faller Sanger 93657 K-5
Washington Academic 1705 Tenth Street Sanger 93657 6th-8
Sanger High 1045 Bethel Avenue Sanger 93657 9th -12
Community Day School 818 "L" Street Sanger 93657 7th-12
Education Center 1801 7th Street Sanger 93657
Sanger Adult Education 1045 Bethel Avenue Sanger 93657
Taft High (Ind. Study) 1801 7th Street Sanger 93657
Selma Unified
Page 9 of 12 Exhibit A-4
SCHOOL DIRECTORY
James A. Garfield 2535 "B" Street Selma 93662 K-6
Indianola 11524 E. Dinuba Selma 93662 K-6
Andrew Jackson 2220 Huntsman Selma 93662 K-6
Theodore Roosevelt 1802 Floral Avenue Selma 93662 K-6
Terry 12906 S. Fowler Selma 93662 K-6
George Washington 1420 2nd Street Selma 93662 K-6
Eric White 2001 Mitchell Selma 93662 K-6
Woodrow Wilson 1325 Stillman Selma 93662 K-6
Abraham Lincoln 1239 Nelson Blvd Selma 93662 7th-8
Selma High 3125 Wright Street Selma 93662 9th-12
Heartland Alternative/Selma Adult School 2269 Sylvia Street Selma 93662
Selma Adult School Facilitators 3125 Wright Street Selma 93662
Sierra Unified
Foothill Elementary 29147 Auberry Road Prather 93651 K-6
Lodge Pole 33467 Lodge Road Tollhouse 93667 K-8
Pole Corral 65265 Hall Meadow Shaver Lake 93664 K-8
Sierra Junior High 33326 Lodge Road Tollhouse 93667 7th-8
Sierra High 33326 Lodge Road Tollhouse 93667 9th-12
Black Mountain Adult Education 33461 Lodge Road Tollhouse 93667
Oak Meadow Community Day School 33411 Lodge Road Tollhouse 93667
Sandy Bluffs Alternative Education 33280 Lodge Road Tollhouse 93667
Washington Colony Elementary
Washington Colony Elementary 130 E. Lincoln Fresno 93706 K-8
Washington Unified
West Fresno Preschool 888 S. Ivy Fresno 93706 Pre
American Union Elementary 2801 W. Adams Avenue Fresno 93706 K-8
West Fresno Elementary 2910 S. Ivy Avenue Fresno 93706 K-5
West Fresno Middle School 2888 S. Ivy Avenue Fresno 93706 6th-8
Washington Union High School 6041 S. Elm Avenue Fresno 93706 9th-12
Easton High Continuation 5865 S. Clara Fresno 93706
Easton Community Day School 5865 S. Clara Fresno 93706
ELM High School Independent Study 5865 S. Clara Fresno 93706
West Park Elementary
West Park Elementary 2695 S. Valentine Fresno 93706 K-12
Westside Elementary
Westside Elementary 19191 W. Excelsior Five Points 93624 Pre, K-8
Page 10 of 12 Exhibit A-4
SCHOOL DIRECTORY
Page 11 of 12 Exhibit A-4
SCHOOL DIRECTORY
Page 12 of 12 Exhibit A-4
SCHOOL DIRECTORY
Page 1 of 2 Exhibit A-4 Phase 1
SCHOOL DIRECTORY
SCHOOL DISTRICT SCHOOL NAME ADDRESS CITY ZIP CODE GRADES SERVED
Mendota
Washington 1599 5th Street Mendota 93640 Pre-2
McCabe 250 S. Derrick Ave. Mendota 93640 2nd-6
Mendota 605 Bass Ave. Mendota 93640 K-6
Mendota Jr High 1258 Belmont Ave. Mendota 93640 7th-8
Mendota High 1993 Belmont Mendota 93640 9th-12
Golden Plains
Cantua 29288 W. Clarkson Ave. Cantua 93608 K-8
Helm 13883 S. Lassen Helm 93627 K-8
San Joaquin 8535 S. 9th Street San Joaquin 93660 K-3
Tranquillity 6116 S. Daniels Tranquillity 93668 K-8
Tranquillity High 6052 S. Juanche Tranquillity 93668 9th-12
Alternative Education 13883 S. Lassen Ave. Helm 93627
Kerman
Kerman-Floyd 14655 W. F Steet Kerman 93630 TK-6
Sun Empire 2649 N. Modoc Kerman 93630 TK-6
Liberty 16001 W. E Steet Kerman 93630 TK-6
Goldenrod 445 S. Goldenrod Ave. Kerman 93630 TK-6
Kerman Middle 601 S. First Street Kerman 93630 7th-8
Kerman High 205 S. First Street Kerman 93630 9th-12
Enterprise High 15405 W. Sunset Ave. Kerman 93630
Firebaugh-Las Deltas
Hazel M. Bailey 1691 Q. Street Firebaugh 93622 K-3
Arthur E. Mills Intermediate 1191 P. Street Firebaugh 93622 4th-5
Firebaugh Middle 1600 16th Street Firebaugh 93622 6th-8
Firebaugh High 1976 Morris Kyle Drive Firebaugh 93622 9th-12
El Puente High Continuation 1666 Saipan Firebaugh 93622
Firebaugh Adult Education 1976 Morris Kyle Drive Firebaugh 93622
Firebaugh Community Day 1976 Morris Kyle Drive Firebaugh 93622
PRESCHOOLS
Washington Elementary 1599 5th Street Mendota 93640
Page 2 of 2 Exhibit A-4 Phase 1
MIGRANT HEAD START
Biola 5022 Madera Avenue Kerman 93630
Firebaugh 1777ThomasConboy Firebaugh 93622
Mendota 435 Sorenson Mendota 93640
HEADSTARTS
CANTUA Cantua Elementary School 29228 W. Clarkson Avenue Cantua Creek 93608
SAN JOAQUIN San Joaquin Elementary Schc 8535 S. Ninth San Joaquin 93660
Page 1 of 8 Exhibit A-4 Phase 2
SCHOOL DIRECTORY
SCHOOL DISTRICT SCHOOL NAME ADDRESS CITY ZIP CODE GRADES SERVED
Mendota
Washington 1599 5th Street Mendota 93640 Pre-2
McCabe 250 S. Derrick Ave. Mendota 93640 2nd-6
Mendota 605 Bass Ave. Mendota 93640 K-6
Mendota Jr High 1258 Belmont Ave. Mendota 93640 7th-8
Mendota High 1993 Belmont Mendota 93640 9th-12
Golden Plains
Cantua 29288 W. Clarkson Ave. Cantua 93608 K-8
Helm 13883 S. Lassen Helm 93627 K-8
San Joaquin 8535 S. 9th Street San Joaquin 93660 K-3
Tranquillity 6116 S. Daniels Tranquillity 93668 K-8
Tranquillity High 6052 S. Juanche Tranquillity 93668 9th-12
Alternative Education 13883 S. Lassen Ave. Helm 93627
Kerman
Kerman-Floyd 14655 W. F Steet Kerman 93630 TK-6
Sun Empire 2649 N. Modoc Kerman 93630 TK-6
Liberty 16001 W. E Steet Kerman 93630 TK-6
Goldenrod 445 S. Goldenrod Ave. Kerman 93630 TK-6
Kerman Middle 601 S. First Street Kerman 93630 7th-8
Kerman High 205 S. First Street Kerman 93630 9th-12
Enterprise High 15405 W. Sunset Ave. Kerman 93630
Firebaugh-Las Deltas
Hazel M. Bailey 1691 Q. Street Firebaugh 93622 K-3
Arthur E. Mills Intermediate 1191 P. Street Firebaugh 93622 4th-5
Firebaugh Middle 1600 16th Street Firebaugh 93622 6th-8
Firebaugh High 1976 Morris Kyle Drive Firebaugh 93622 9th-12
El Puente High Continuation 1666 Saipan Firebaugh 93622
Firebaugh Adult Education 1976 Morris Kyle Drive Firebaugh 93622
End of Phase 1 Firebaugh Community Day 1976 Morris Kyle Drive Firebaugh 93622
Fresno Unified
Adams 2117 W. McKinley Fresno 93728 K-6
Page 2 of 8 Exhibit A-4 Phase 2
Anthony 1542 E. Webster Fresno 93728 K-6
Ayer 5272 E. Lowe Fresno 93727 K-6
Aynesworh 4765 E. Burns Fresno 93727 K-6
Bakman 588 N. Helm Fresno 93727 K-6
Balderas 4625 E. Florence Fresno 93725 K-6
Birney 3034 E. Cornell Fresno 93703 K-6
Bullard Project Talent 4950 N. Harrison Fresno 93704 K-8
Burroughs 166 N. Sierra Vista Fresno 93702 K-6
Calwa 4303 E. Jensen Fresno 93725 K-6
Centennial 3803 E. Saginaw Way Fresno 93726 K-6
Columbia 1025 S. trinity Fresno 93706 K-6
Del Mar 4122 N. Del Mar Fresno 93704 K-6
Easterby 5211 E. Tulare Fresno 93727 K-6
Eaton 1451 E. Sierra Fresno 93710 K-6
Ericson 4774 E. Yale Fresno 93703 K-6
Ewing 4873 E. Olive Fresno 93727 K-6
Figarden 6235 M. Brawley Fresno 93722 K-6
Forkner 7120 N. Valentine Fresno 93711 K-6
Fremont 1005 W. Weldon Fresno 93705 K-6
Gibson 1266 W. Barstow Fresno 93705 K-6
Greenberg 5081 E. Lane Fresno 93727 K-6
Hamilton 102 E. Clinton Fresno 93704 K-6
Heaton 1533 N. San Pablo Fresno 93728 K-6
Hidalgo 3550 E. Thomas Fresno 93702 K-6
Holland 676 N. Fresno Fresno 93726 K-6
Homan 1602 W. Harvard Fresno 93705 K-6
Jackson 3750 E. Platt Fresno 93702 K-6
Jefferson 202 N. Mariposa Fresno 93701 K-6
King 1001 E. Florence Fresno 93706 K-6
Kirk 2000 E. Belgravia Fresno 93706 K-6
Kratt 650 W. Sierra Fresno 93704 K-6
Lane 4730 E. Lane Fresno 93702 K-6
Lawless 5255 N. Reese Fresno 93722 K-6
Page 3 of 8 Exhibit A-4 Phase 2
Leavenworth 4420 E. Thomas Fresno 93702 K-6
Lincoln 651 "B" Street Fresno 93706 K-6
Lowell 171 N. Poplar Fresno 93701 K-6
Malloch 2251 W. Morris Fresno 93705 K-6
Manchester GATE 2307 e. Dakota Fresno 93726 K-6
Mayfair 3305 E. Home Fresno 93703 K-6
Mccardle 577 E. Sierra Fresno 93710 K-6
Muir 109 E. Dennett Fresno 93728 K-6
Norseman 4636 E. Weldon Fresno 93703 K-6
Olmos 550 S. Garden Fresno 93727 K-6
Powers-Ginsberg 110 E. Swift Fresno 93704 K-6
Pyle 4140 N. Augusta Fresno 93726 K-6
Robinson 555 E. Browning Fresno 93710 K-6
Roeding 1225 W. Dakota Fresno 93705 K-6
Rowell 3460 E. McKenzie Fresno 93702 K-6
Slater 4472 E. Emerson Fresno 93705 K-6
Starr 1780 W. Sierra Avenue Fresno 93705 K-6
Storey 5250 E. Church Fresno 93725 K-6
Sunset 1755 S. Crystal Fresno 93706 K-6
Thomas 4444 N. Millbrook Fresno 93726 K-6
Turner 5218 E. Clay Fresno 93727 K-6
Vang Pao 5090 E. Church Fresno 93725 K-6
Viking 4251 N. Winery Fresno 93726 K-6
Vinland 4666 N. Maple Fresno 93726 K-6
Webster 930 N. Augusta Fresno 93701 K-6
Williams 525 W. Saginaw Fresno 93705 K-6
Wilson 2131 W. Ashlan Fresno 93705 K-6
Winchell 3722 E. Lowe Fresno 93702 K-6
Wishon 3857 E. Harvard Fresno 93703 K-6
Wolters 5174 N. First Fresno 93710 K-6
Yokomi 2323 E. McKenzie Fresno 93701 K-6
Ahwahnee 1127 E. Escalon Fresno 93710 7th -8
Baird 5500 N. Maroa Fresno 93704 7th -8
Page 4 of 8 Exhibit A-4 Phase 2
Computech 555 E. Belgravia Fresno 93706 7th -8
Cooper 2277 W. Bellaire Way Fresno 93705 7th -8
Fort Miller 1302 Dakota Fresno 93704 7th -8
Gaston 1100 E. Church Fresno 93706 7th -8
Hamilton 102 E. Clinton Fresno 93704 7th -8
Kings Canyon 5117 E. Tulare Fresno 93727 7th -8
Scandinavian 3232 N. Sierra Vista Fresno 93726 7th -8
Sequoia 4050 E. Hamilton Fresno 93702 7th -8
Tehipite 630 N. Augusta Fresno 93701 7th -8
Tenaya 1239 W. Mesa Fresno 93711 7th -8
Terronez 2300 S. Willow Fresno 93725 7th -8
Tioga 3232 E. Fairmont Fresno 93726 7th -8
Wawona 45254 N. Thorne Fresno 93705 7th -8
Yosemite 1292 N. Ninth Fresno 93703 7th-8
Bullard 5445 N. Palm Fresno 93704 9th -12
CART 2555 Clovis Ave. Clovis 93612 9th -12
Duncan Polytechnical 4330 E. Garland Fresno 93726 9th -12
Edison 540 E. California Fresno 93706 9th -12
Fresno 1839 Echo Avenue Fresno 93704 9th -12
Hoover 5550 N. First Street Fresno 93710 9th -12
Mclane 2727 N. Cedar Fresno 93703 9th -12
Phillip J Patino School of Ent 2000 E. Cambridge Avenue Fresno 93703 9th -12
Roosevelt 4250 E. Tulare Fresno 93702 9th -12
Sunnyside 1019 S. Peach Fresno 93727 9th -12
Cambridge Continuation 1001 Chestnut Fresno 93721
Cesar E. Chavez Adult Educa 2500 Stanislaus Fresno 93721
Design Science High School 2004 E. Cambridge Avenue Fresno 93703
DeWolf Continuation 2021 N. Clark Fresno 93703
J.E. Young 822 N. Abby Fresno 93701
Phoenix Elementary Acaden 3335 N. Authur Fresno 93705
Phoenix Secondary Academ� 2445 W. Dakota Fresno 93705
Washington Colony Elementary
Page 5 of 8 Exhibit A-4 Phase 2
Washington Colony Element 130 E. Lincoln Fresno 93706 K-8
Washington Unified
West Fresno Preschool 888 S. Ivy Fresno 93706 Pre
American Union Elementary 2801 W. Adams Avenue Fresno 93706 K-8
West Fresno Elementary 2910 S. Ivy Avenue Fresno 93706 K-5
West Fresno Middle School 2888 S. Ivy Avenue Fresno 93706 6th-8
Washington Union High Schc 6041 S. Elm Avenue Fresno 93706 9th-12
Easton High Continuation 5865 S. Clara Fresno 93706
Easton Community Day Scho 5865 S. Clara Fresno 93706
ELM High School lndepender 5865 S. Clara Fresno 93706
West Park Elementary
West Park Elementary 2695 S. Valentine Fresno 93706 K-12
Selma Unified
James A. Garfield 253 5 11 811 Street Selma 93662 K-6
Indianola 11524 E. Dinuba Selma 93662 K-6
Andrew Jackson 2220 Huntsman Selma 93662 K-6
Theodore Roosevelt 1802 Floral Avenue Selma 93662 K-6
Terry 12906 S. Fowler Selma 93662 K-6
George Washington 1420 2nd Street Selma 93662 K-6
Eric White 2001 Mitchell Selma 93662 K-6
Woodrow Wilson 1325 Stillman Selma 93662 K-6
Abraham Lincoln 1239 Nelson Blvd Selma 93662 7th-8
Selma High 3125 Wright Street Selma 93662 9th-12
Heartland Alternative/Selma 2269 Sylvia Street Selma 93662
Selma Adult School Facilitate 3125 Wright Street Selma 93662
Fowler Unified
James W. Marshall 142 N. Armstrong Avenue Fowler 93625 K-2
John C. Fremont 306 E. Tuolumne Street Fowler 93625 3rd -5
Malaga 3910 S. Ward Fresno 93725 K-5
John Sutter 701 E. Walter Avenue Fowler 93625 6th -8
Fowler High 701 E. Main Street Fowler 93625 9th -12
Fowler Academy Continuatic 975 E. Adams Avenue Fowler 93625
Page 6 of 8 Exhibit A-4 Phase 2
Fowler Academy Communit 975 E. Adams Avenue Fowler 93625
Kingsburg Elementary Charter School District
Central Valley Home School 1776 6th Avenue Drive Kingsburg 93631 K-8
Island Community Day Schoc 1776 6th Avenue Drive Kingsburg 93631 4th-8
Lincoln 1900 Mariposa Avenue Kingsburg 93631 2nd-3
Reagan 1180 Diane Avenue Kingsburg 93631 4th-6
Roosevelt 1185 10th Street Kingsburg 93631 1st
Washington 1501 Ellis Street Kingsburg 93631 K
Rafer Johnson Jr. High 1300 Stroud Avenue Kingsburg 93631 7th-8
Kingsburg Joint Union High
Kingsburg High School 1900 18th Avenue Kingsburg 93631 9th-12
Kingsburg Adult School 2311 Sierra Street Kingsburg 93631
Laton Unified
Laton Elementary/Conejo 6065 Latonia Laton 93242 K-8
Laton High 6449 Dewoody Street Laton 93242 9th-12
Alvina Elementary
Alvina Elementary 295 W. Saginaw Caruthers 93609 K-8
Caruthers Unified
Caruthers Elementary 13369 S. Quince Street Caruthers 93609 K-8
Caruthers High School 2580 W. Tahoe Caruthers 93609 9th -12
MARC Continuation Adult 2580 W. Tahoe Caruthers 93609
Monroe Elementary
Monroe Elementary 11842 S. Chestnut Avenue Fresno 93725 K-8
Orange Center Elementary
Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706 Pre, TK-8
Pacific Union Elementary
Pacific Union Elementary 2065 E. Bowles Avenue Fresno 93725 K-8
Parlier Unified
S.Ben Benavidez 13900 Tuolumne Street Parlier 93648 K-6
Mathew J. Brletic 601 3rd Street Parlier 93648 K-6
Cesar E. Chavez 500 Tuolumne Street Parlier 93648 K-6
John C. Martinez 13174 E. Parlier Parlier 93648 K-6
Page 7 of 8 Exhibit A-4 Phase 2
Parlier Junior High 1200 E. Parlier Parlier 93648 7th -8
Parlier High 603 Third Street Parlier 93648 9th-12
San Joaquin Valley Continua 900 Newmark Avenue Parlier 93648
Raisin City Elementary
Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652 Pre-8
HEADSTARTS
Laton Unified Laton Unified Early Learning 6045 E. Mt. Whitney Laton 93242
Orange Center Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706
Raisin City Elementary Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652
Washington Unified West Fresno Preschool 888 S. Ivy Fresno 93706
AREA II Ted C. Wills Community Cen 770 N. San Pablo Fresno 93728
BROOKS Brooks 1504 N. Weber Fresno 93728
DAKOTA CIRCLE Dakota Circle 4156 E. Dakota Avenue Fresno 93726
ESTELLE DAILEY Community United Church o 5550 N. Fresno St Fresno 93710
MADISON Madison Elementary School 388 S. Brawley Fresno 93706
MAPLE VISTA Sierra Vista United Methodi� 4609 E. Illinois Fresno 93702
MOLLY NEVAREZ Central Community Church 4710 N. Polk Avenue Fresno 93722
MOSQUEDA Mosqueda Community Centi 4676 E. Butler Fresno 93702
RAMACHER RaMacher Educational Com1 710 N. Hughes Fresno 93728
ROMAIN Romain Neighborhood Centi 745 N. First Street Fresno 93702
SEQUOIA First Congregational Church 2121 N. Van Ness Fresno 93704
YOSEMITE Fresno Iglesia Del Nazareno 4718 E. Yale Fresno 93703
KINGSCANYON Kings Canyon 4995 E. Balch Fresno 93727
CED ARWOOD El Encino Baptist Church 2063 S. Cedar Fresno 93702
CARUTHERS Caruthers Elementry School 2420 W. Clemenceau Avem Caruthers 93609
FRANKLIN Franklin Head Sart 1189 Martin Street Fresno 93706
LA COLONIA La Colonia Community CentE 8770 S. Mendocino Parlier 93648
ROOSEVELT Roosevelt Elementary Schoo 1701 Alton Street Ste. A Selma 93662
SEQUOIA First Congregational Church 2121 N. Van Ness Fresno 93704
WASHINGTON Washington Elementary Sch1 1420 Second Street Selma 93662
WILSON Wilson Elementary School 1325 Stillman Selma 93662
Page 8 of 8 Exhibit A-4 Phase 2
MIGRANT HEADSTART
Parlier 900 Newmark Avenue Parlier 93648
Selma 12898 S. Fowler Avenue Selma 93662
Phase includes Phase 1
Page 1 of 11 Exhibit A-4 Phase 3
SCHOOL DIRECTORY
SCHOOL DISTRICT SCHOOL NAME ADDRESS CITY ZIP CODE GRADES SERVED
Mendota
Washington 1599 5th Street Mendota 93640 Pre-2
McCabe 250 S. Derrick Ave. Mendota 93640 2nd-6
Mendota 605 Bass Ave. Mendota 93640 K-6
Mendota Jr High 1258 Belmont Ave. Mendota 93640 7th-8
Mendota High 1993 Belmont Mendota 93640 9th-12
Golden Plains
Cantua 29288 W. Clarkson Ave. Cantua 93608 K-8
Helm 13883 S. Lassen Helm 93627 K-8
San Joaquin 8535 S. 9th Street San Joaquin 93660 K-3
Tranquillity 6116 S. Daniels Tranquillity 93668 K-8
Tranquillity High 6052 S. Juanche Tranquillity 93668 9th-12
Alternative Education 13883 S. Lassen Ave. Helm 93627
Kerman
Kerman-Floyd 14655 W. F Steet Kerman 93630 TK-6
Sun Empire 2649 N. Modoc Kerman 93630 TK-6
Liberty 16001 W. E Steet Kerman 93630 TK-6
Goldenrod 445 S. Goldenrod Ave. Kerman 93630 TK-6
Kerman Middle 601 S. First Street Kerman 93630 7th-8
Kerman High 205 S. First Street Kerman 93630 9th-12
Enterprise High 15405 W. Sunset Ave. Kerman 93630
Firebaugh-Las Deltas
Hazel M. Bailey 1691 Q. Street Firebaugh 93622 K-3
Arthur E. Mills Intermediate 1191 P. Street Firebaugh 93622 4th-5
Firebaugh Middle 1600 16th Street Firebaugh 93622 6th-8
Firebaugh High 1976 Morris Kyle Drive Firebaugh 93622 9th-12
El Puente High Continuation 1666 Saipan Firebaugh 93622
Firebaugh Adult Education 1976 Morris Kyle Drive Firebaugh 93622
END OF PHASEl Firebaugh Community Day 1976 Morris Kyle Drive Firebaugh 93622
Fresno Unified
Adams 2117 W. McKinley Fresno 93728 K-6
Page 2 of 11 Exhibit A-4 Phase 3
Anthony 1542 E. Webster Fresno 93728 K-6
Ayer 5272 E. Lowe Fresno 93727 K-6
Aynesworh 4765 E. Burns Fresno 93727 K-6
Bakman 588 N. Helm Fresno 93727 K-6
Balderas 4625 E. Florence Fresno 93725 K-6
Birney 3034 E. Cornell Fresno 93703 K-6
Bullard Project Talent 4950 N. Harrison Fresno 93704 K-8
Burroughs 166 N. Sierra Vista Fresno 93702 K-6
Calwa 4303 E. Jensen Fresno 93725 K-6
Centennial 3803 E. Saginaw Way Fresno 93726 K-6
Columbia 1025 S. trinity Fresno 93706 K-6
Del Mar 4122 N. Del Mar Fresno 93704 K-6
Easterby 5211 E. Tulare Fresno 93727 K-6
Eaton 1451 E. Sierra Fresno 93710 K-6
Ericson 4774 E. Yale Fresno 93703 K-6
Ewing 4873 E. Olive Fresno 93727 K-6
Figarden 6235 M. Brawley Fresno 93722 K-6
Forkner 7120 N. Valentine Fresno 93711 K-6
Fremont 1005 W. Weldon Fresno 93705 K-6
Gibson 1266 W. Barstow Fresno 93705 K-6
Greenberg 5081 E. Lane Fresno 93727 K-6
Hamilton 102 E. Clinton Fresno 93704 K-6
Heaton 1533 N. San Pablo Fresno 93728 K-6
Hidalgo 3550 E. Thomas Fresno 93702 K-6
Holland 676 N. Fresno Fresno 93726 K-6
Homan 1602 W. Harvard Fresno 93705 K-6
Jackson 3750 E. Platt Fresno 93702 K-6
Jefferson 202 N. Mariposa Fresno 93701 K-6
King 1001 E. Florence Fresno 93706 K-6
Kirk 2000 E. Belgravia Fresno 93706 K-6
Kratt 650 W. Sierra Fresno 93704 K-6
Lane 4730 E. Lane Fresno 93702 K-6
Lawless 5255 N. Reese Fresno 93722 K-6
Page 3 of 11 Exhibit A-4 Phase 3
Leavenworth 4420 E. Thomas Fresno 93702 K-6
Lincoln 651 "B" Street Fresno 93706 K-6
Lowell 171 N. Poplar Fresno 93701 K-6
Malloch 2251 W. Morris Fresno 93705 K-6
Manchester GATE 2307 e. Dakota Fresno 93726 K-6
Mayfair 3305 E. Home Fresno 93703 K-6
Mccardle 577 E. Sierra Fresno 93710 K-6
Muir 109 E. Dennett Fresno 93728 K-6
Norseman 4636 E. Weldon Fresno 93703 K-6
Olmos 550 S. Garden Fresno 93727 K-6
Powers-Ginsberg 110 E. Swift Fresno 93704 K-6
Pyle 4140 N. Augusta Fresno 93726 K-6
Robinson 555 E. Browning Fresno 93710 K-6
Roeding 1225 W. Dakota Fresno 93705 K-6
Rowell 3460 E. McKenzie Fresno 93702 K-6
Slater 4472 E. Emerson Fresno 93705 K-6
Starr 1780 W. Sierra Avenue Fresno 93705 K-6
Storey 5250 E. Church Fresno 93725 K-6
Sunset 1755 S. Crystal Fresno 93706 K-6
Thomas 4444 N. Millbrook Fresno 93726 K-6
Turner 5218 E. Clay Fresno 93727 K-6
Vang Pao 5090 E. Church Fresno 93725 K-6
Viking 4251 N. Winery Fresno 93726 K-6
Vinland 4666 N. Maple Fresno 93726 K-6
Webster 930 N. Augusta Fresno 93701 K-6
Williams 525 W. Saginaw Fresno 93705 K-6
Wilson 2131 W. Ashlan Fresno 93705 K-6
Winchell 3722 E. Lowe Fresno 93702 K-6
Wishon 3857 E. Harvard Fresno 93703 K-6
Wolters 5174 N. First Fresno 93710 K-6
Yokomi 2323 E. McKenzie Fresno 93701 K-6
Ahwahnee 1127 E. Escalon Fresno 93710 7th -8
Baird 5500 N. Moroa Fresno 93704 7th -8
Page 4 of 11 Exhibit A-4 Phase 3
Computech 555 E. Belgravia Fresno 93706 7th -8
Cooper 2277 W. Bellaire Way Fresno 93705 7th -8
Fort Miller 1302 Dakota Fresno 93704 7th -8
Gaston 1100 E. Church Fresno 93706 7th -8
Hamilton 102 E. Clinton Fresno 93704 7th -8
Kings Canyon 5117 E. Tulare Fresno 93727 7th -8
Scandinavian 3232 N. Sierra Vista Fresno 93726 7th -8
Sequoia 4050 E. Hamilton Fresno 93702 7th -8
Tehipite 630 N. Augusta Fresno 93701 7th -8
Tenaya 1239 W. Mesa Fresno 93711 7th -8
Terronez 2300 S. Willow Fresno 93725 7th -8
Tioga 3232 E. Fairmont Fresno 93726 7th -8
Wawona 45254 N. Thorne Fresno 93705 7th -8
Yosemite 1292 N. Ninth Fresno 93703 7th -8
Bullard 5445 N. Palm Fresno 93704 9th -12
CART 2555 Clovis Ave. Clovis 93612 9th -12
Duncan Polytechnical 4330 E. Garland Fresno 93726 9th -12
Edison 540 E. California Fresno 93706 9th -12
Fresno 1839 Echo Avenue Fresno 93704 9th -12
Hoover 5550 N. First Street Fresno 93710 9th -12
Mclane 2727 N. Cedar Fresno 93703 9th -12
Phillip J Patino School of Ent 2000 E. Cambridge Avenue Fresno 93703 9th -12
Roosevelt 4250 E. Tulare Fresno 93702 9th -12
Sunnyside 1019 S. Peach Fresno 93727 9th -12
Cambridge Continuation 1001 Chestnut Fresno 93721
Cesar E. Chavez Adult Educa1 2500 Stanislaus Fresno 93721
Design Science High School 2004 E. Cambridge Avenue Fresno 93703
DeWolf Continuation 2021 N. Clark Fresno 93703
J.E. Young 822 N. Abby Fresno 93701
Phoenix Elementary Acaden 3335 N. Authur Fresno 93705
Phoenix Secondary Academy 2445 W. Dakota Fresno 93705
Washington Colony Elementary
Page 5 of 11 Exhibit A-4 Phase 3
Washington Colony Element 130 E. Lincoln Fresno 93706 K-8
Washington Unified
West Fresno Preschool 888 $. Ivy Fresno 93706 Pre
American Union Elementary 2801 W. Adams Avenue Fresno 93706 K-8
West Fresno Elementary 2910 S. Ivy Avenue Fresno 93706 K-5
West Fresno Middle School 2888 S. Ivy Avenue Fresno 93706 6th-8
Washington Union High Schc 6041 S. Elm Avenue Fresno 93706 9th-12
Easton High Continuation 5865 S. Clara Fresno 93706
Easton Community Day Scho 5865 S. Clara Fresno 93706
ELM High School lndepende1 5865 S. Clara Fresno 93706
West Park Elementary
West Park Elementary 2695 S. Valentine Fresno 93706 K-12
Selma Unified
James A. Garfield 2535 "B" Street Selma 93662 K-6
Indianola 11524 E. Dinuba Selma 93662 K-6
Andrew Jackson 2220 Huntsman Selma 93662 K-6
Theodore Roosevelt 1802 Floral Avenue Selma 93662 K-6
Terry 12906 S. Fowler Selma 93662 K-6
George Washington 1420 2nd Street Selma 93662 K-6
Eric White 2001 Mitchell Selma 93662 K-6
Woodrow Wilson 1325 Stillman Selma 93662 K-6
Abraham Lincoln 1239 Nelson Blvd Selma 93662 7th-8
Selma High 3125 Wright Street Selma 93662 9th-12
Heartland Alternative/Selma 2269 Sylvia Street Selma 93662
Selma Adult School Facilitate 3125 Wright Street Selma 93662
Fowler Unified
James W. Marshall 142 N. Armstrong Avenue Fowler 93625 K-2
John C. Fremont 306 E. Tuolumne Street Fowler 93625 3rd -5
Malaga 3910 S. Ward Fresno 93725 K-5
John Sutter 701 E. Walter Avenue Fowler 93625 6th -8
Fowler High 701 E. Main Street Fowler 93625 9th -12
Fowler Academy Continuatic 975 E. Adams Avenue Fowler 93625
Page 6 of 11 Exhibit A-4 Phase 3
Fowler Academy Communit 975 E. Adams Avenue Fowler 93625
Kingsburg Elementary Charter School District
Central Valley Home School 1776 6th Avenue Drive Kingsburg 93631 K-8
Island Community Day Schoc 1776 6th Avenue Drive Kingsburg 93631 4th-8
Lincoln 1900 Mariposa Avenue Kingsburg 93631 2nd-3
Reagan 1180 Diane Avenue Kingsburg 93631 4th-6
Roosevelt 1185 10th Street Kingsburg 93631 1st
Washington 1501 Ellis Street Kingsburg 93631 K
Rafer Johnson Jr. High 1300 Stroud Avenue Kingsburg 93631 7th-8
Kingsburg Joint Union High
Kingsburg High School 1900 18th Avenue Kingsburg 93631 9th-12
Kingsburg Adult School 2311 Sierra Street Kingsburg 93631
Laton Unified
Laton Elementary/Conejo 6065 Latonia Laton 93242 K-8
Laton High 6449 Dewoody Street Laton 93242 9th-12
Alvina Elementary
Alvina Elementary 295 W. Saginaw Caruthers 93609 K-8
Caruthers Unified
Caruthers Elementary 13369 S. Quince Street Caruthers 93609 K-8
Caruthers High School 2580 W. Tahoe Caruthers 93609 9th -12
MARC Continuation Adult 2580 W. Tahoe Caruthers 93609
Monroe Elementary
Monroe Elementary 11842 S. Chestnut Avenue Fresno 93725 K-8
Orange Center Elementary
Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706 Pre, TK-8
Pacific Union Elementary
Pacific Union Elementary 2065 E. Bowles Avenue Fresno 93725 K-8
Parlier Unified
S.Ben Benavidez 13900 Tuolumne Street Parlier 93648 K-6
Mathew J. Brletic 601 3rd Street Parlier 93648 K-6
Cesar E. Chavez 500 Tuolumne Street Parlier 93648 K-6
John C. Martinez 13174 E. Parlier Parlier 93648 K-6
Page 7 of 11 Exhibit A-4 Phase 3
Parlier Junior High 1200 E. Parlier Parlier 93648 7th -8
Parlier High 603 Third Street Parlier 93648 9th-12
San Joaquin Valley Continua1 900 Newmark Avenue Parlier 93648
Raisin City Elementary
End of Phase 2 Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652 Pre-8
Clovis Unified
Boris 7071 E. Clinton Fresno 93737 K-6
Bud Rank 3650 Powers Avenue Clovis 93619 K-6
Cedarwood 2851 Palo alto Clovis 93611 K-6
Century 965 N. Sunnyside Clovis 93611 K-6
Clovis 1100 Armstrong Clovis 93611 K-6
Cole 615 W. Stuart Clovis 93612 K-6
Copper Hills 1881 E. Plymouth Way Fresno 93720 K-6
Dry Creek 1273 N. Armstrong Clovis 93611 K-6
Fancher Creek 5978 E.Tulare Fresno 93727 K-6
Fort Washington 960 E. Teague Fresno 93727 K-6
Freedom 2955 Gettysburg Clovis 93611 K-6
Fugman 10825 N. Cedar Fresno 93730 K-6
Garfield 1315 N. Peach Clovis 93611 K-6
Gettysburg 2100 Gettysburg Clovis 93611 K-6
Jefferson 1880 Fowler Clovis 93611 K-6
Liberty 1250 E. Liberty Hill Drive Fresno 93720 K-6
Lincoln 774 E. Alluvial Fresno 93720 K-6
Maple Creek 2025 E. Teague Fresno 93720 K-6
Mickey Cox 2191 Sierra Clovis 93611 K-6
Miramonte 1590 Bellaire Clovis 93611 K-6
Mountain View 2002 E. Alluvial Fresno 93720 K-6
Nelson 1336 W. Spruce Pinedale 93650 K-6
Oraze 3468 N. Armstrong Fresno 93727 K-6
Pinedale 7171 N. Sugar Pine Pinedale 93650 K-6
Regan 8300 E. Ashlan Avenue Clovis 93619 K-6
Red Bank 1454 Locan Avenue Clovis 93611 K-6
Page 8 of 11 Exhibit A-4 Phase 3
Riverview 2491 E. Behymer Fresno 93730 K-6
Sierra Vista 510 Barstow Clovis 93612 K-6
Tarpey 2700 Minnewawa Clovis 93612 K-6
Temperance-Kutner 1448 N. Armstrong Fresno 93727 K-6
Valley Oak 465 E Champlain Fresno 93730 K-6
Weldon 150 DeWitt Clovis 93612 K-6
Woods 700 Teague Avenue Clovis 93619 K-6
Alta Sierra Intermediate 380 W. Teague Clovis 93611 7th -8
Clark Intermediate 902 Fifth Street Clovis 93612 7th -8
Granite Ridge 2770 E. International Avenu Fresno 93730 7th -8
Kastner Intermediate 7676 N. First Street Fresno 93720 7th -8
Reyburn Intermediate 4300 N. Dewolf Clovis 93611 7th -8
Buchanan 465 E Champlain Fresno 93730 9th -12
CART 150 DeWitt Clovis 93612 9th -12
Clovis East 4343 N. Leonard Clovis 93611 9th -12
Clovis High 1055 Fowler Clovis 93611 9th -12
Clovis North 2770 E. International Fresno 93730 9th -12
Clovis West 1070 E. Teague Fresno 93720 9th -12
Clovis Adult Education 1452 David E. Cook Way Clovis 93611
Clovis Community Day ElemE 1715 David E. Cook Way Clovis 93611
Clovis Community Day Secor: 1715 David E. Cook Way Clovis 93611
Enterprise High School 1655 David E. Cook Way Clovis 93611
Gateway 1550 Herndon Clovis 93611
Central Unified
Biola-Pershing 4885 N. Biola Avenue Fresno 93723 K-6
Harvest 6514 W. Gettysburg Fresno 93723 K-6
Herndon Barstow 6265 N. Grantland Fresno 93723 K-6
Houghton Kearney 8905 W. Kearney Fresno 93706 K-8
Liddell 5455 W. Alluvial Fresno 93722 K-6
Madison 330 S. Brawley Fresno 93706 K-6
McKinley 4444 W. McKinley Fresno 93722 K-6
Polk 2195 N. Polk Fresno 93722 K-6
Page 9 of 11 Exhibit A-4 Phase 3
River Bluff 6150 W. Palo Alto Fresno 93722 K-6
Roosevelt 2600 N. Garfield Fresno 93723 K-6
Saroyan 5650 W. Escalon Fresno 93722 K-6
Steinbeck 3550 N. Milburn Fresno 93722 K-6
Teague 4725 N. Polk Fresno 93722 K-6
Tilley, Hanh Phan 2280 N. Valentine Fresno 93722 K-6
El Capitan 4443 W. Weldon Fresno 93722 7th -8
Glacier Point 4055 N. Bryan Fresno 93723 7th -8
Rio Vista 6240 W. Palo Alto Fresno 93722 7th -8
Central High East 3535 N. Cornelia Fresno 93722 9th -12
Central High West 2045 N. Dickenson Fresno 93723 9th -12
Central Unified Adult (C.L.A.� 2698 N. Brawley Fresno 93722
Central Unified Alternative (I 2698 N. Brawley Fresno 93722
Pathway Community Day Sci 11 S. Tielman Fresno 93706
Pershing Continuation 855 W. Nielsen Fresno 93706
Big Creek Elementary
Big Creek Elementary 55190 Point Road Big Creek 93605 K-8
Pine Ridge Elementary
Pine Ridge Elementary 45828 Auberry Road Auberry 93602 K-8
Sierra Unified
Foothill Elementary 29147 Auberry Road Prather 93651 K-6
Lodge Pole 33467 Lodge Road Tollhouse 93667 K-8
Pole Corral 65265 Hall Meadow Shaver Lake 93664 K-8
Sierra Junior High 33326 Lodge Road Tollhouse 93667 7th-8
Sierra High 33326 Lodge Road Tollhouse 93667 9th-12
Black Mountain Adult Educa 33461 Lodge Road Tollhouse 93667
Oak Meadow Community De 33411 Lodge Road Tollhouse 93667
Sandy Bluffs Alternative Edu 33280 Lodge Road Tollhouse 93667
PRESCHOOLS
Central Unified Biola Pershing Elementary S< 4885 N. Biola Fresno 93723
Page 10 of 11 Exhibit A-4 Phase 3
Hendon-Barstow Elementar, 6265 N. Grantland Fresno 93723
Madison Elementary School 330 S. Brawley Avenueq Fresno 93706
Teague Elementary School 4725 N. Polk Fresno 93722
Roosevelt Elementary Schoo 2600 N. Garfield Avenue Fresno 93723
Clovis Unified Boris 7071 E. Clinton Fresno 93737
Buchananan 465 E Champlain Fresno 93730
Century 965 N. Sunnyside Clovis 93611
Clovis 1100 Armstrong Clovis 93611
Cole 615 W. Stuart Clovis 93612
Copper Hills 1881 E. Plymouth Way Fresno 93720
Francher Creek 5978 E.Tulare Fresno 93727
Freedom 2955 Gettysburg Clovis 93611
Gettysburg 2100 Gettysburg Clovis 93611
Jefferson 1880 Fowler Clovis 93611
Lincoln 774 E. Alluvial Fresno 93720
Maple Creek 2025 E. Teague Fresno 93720
Mickey Cox 2191 Sierra Clovis 93611
Miramonte 1590 Bellaire Clovis 93611
Mountain View 2002 E. Alluvial Fresno 93720
Nelson 1336 W. Spruce Pinedale 93650
Oraze 3468 N. Armstrong Fresno 93727
Pinedale 7171 N. Sugar Pine Pinedale 93650
Reagan 8300 E. Ashlan Avenue Clovis 93619
Red Bank 1454 Locan Avenue Clovis 93611
Riverview 2491 E. Behymer Fresno 93730
Sierra Vista 510 Barstow Clovis 93612
Tarpey 2700 Minnewawa Clovis 93612
TK 1448 N. Armstrong Fresno 93727
Valley Oak 465 E. Champlain Fresno 93730
Weldon 150 DeWitt Clovis 93612
HEADSTARTS
CLOVIS Sierra Vista Elementary Scho 510 Barstow Clovis 93612
COLLEGE COMMUNITY College Community Church 2529 Willow Avenue Clovis 93612
I PINEDALE
Phase 3 include Phase 1 & 2
Page 11 of 11
!Pinedale Elementary School !7171 N. Sugarpine
Exhibit A-4 Phase 3
{Pinedale 936SOj
Page 1 of 12 Exhibit A-4 Phase 5
SCHOOL DIRECTORY
SCHOOL DISTRICT SCHOOL NAME ADDRESS CITY ZIP CODE GRADES SERVED
Mendota
Washington 1599 5th Street Mendota 93640 Pre-2
McCabe 250 S. Derrick Ave. Mendota 93640 2nd-6
Mendota 605 Bass Ave. Mendota 93640 K-6
Mendota Jr High 1258 Belmont Ave. Mendota 93640 7th-8
Mendota High 1993 Belmont Mendota 93640 9th-12
Golden Plains
Cantua 29288 W. Clarkson Ave. Cantua 93608 K-8
Helm 13883 S. Lassen Helm 93627 K-8
San Joaquin 8535 S. 9th Street San Joaquin 93660 K-3
Tranquillity 6116 S. Daniels Tranquillity 93668 K-8
Tranquillity High 6052 S. Juanche Tranquillity 93668 9th-12
Alternative Education 13883 S. Lassen Ave. Helm 93627
Kerman
Kerman-Floyd 14655 W. F Steet Kerman 93630 TK-6
Sun Empire 2649 N. Modoc Kerman 93630 TK-6
Liberty 16001 W. E Steet Kerman 93630 TK-6
Goldenrod 445 S. Goldenrod Ave. Kerman 93630 TK-6
Kerman Middle 601 S. First Street Kerman 93630 7th-8
Kerman High 205 S. First Street Kerman 93630 9th-12
Enterprise High 15405 W. Sunset Ave. Kerman 93630
Firebaugh-Las Deltas
Hazel M. Bailey 1691 Q. Street Firebaugh 93622 K-3
Arthur E. Mills Intermediate 1191 P. Street Firebaugh 93622 4th-5
Firebaugh Middle 1600 16th Street Firebaugh 93622 6th-8
Firebaugh High 1976 Morris Kyle Drive Firebaugh 93622 9th-12
El Puente High Continuation 1666 Saipan Firebaugh 93622
Firebaugh Adult Education 1976 Morris Kyle Drive Firebaugh 93622
Firebaugh Community Day 1976 Morris Kyle Drive Firebaugh 93622
Fresno Unified
Adams 2117 W. McKinley Fresno 93728 K-6
Page 2 of 12 Exhibit A-4 Phase 5
Anthony 1542 E. Webster Fresno 93728 K-6
Ayer 5272 E. Lowe Fresno 93727 K-6
Aynesworh 4765 E. Burns Fresno 93727 K-6
Bakman 588 N. Helm Fresno 93727 K-6
Balderas 4625 E. Florence Fresno 93725 K-6
Birney 3034 E. Cornell Fresno 93703 K-6
Bullard Project Talent 4950 N. Harrison Fresno 93704 K-8
Burroughs 166 N. Sierra Vista Fresno 93702 K-6
Calwa 4303 E. Jensen Fresno 93725 K-6
Centennial 3803 E. Saginaw Way Fresno 93726 K-6
Columbia 1025 S. trinity Fresno 93706 K-6
Del Mar 4122 N. Del Mar Fresno 93704 K-6
Easterby 5211 E. Tulare Fresno 93727 K-6
Eaton 1451 E. Sierra Fresno 93710 K-6
Ericson 4774 E. Yale Fresno 93703 K-6
Ewing 4873 E. Olive Fresno 93727 K-6
Figarden 6235 M. Brawley Fresno 93722 K-6
Forkner 7120 N. Valentine Fresno 93711 K-6
Fremont 1005 W. Weldon Fresno 93705 K-6
Gibson 1266 W. Barstow Fresno 93705 K-6
Greenberg 5081 E. Lane Fresno 93727 K-6
Hamilton 102 E. Clinton Fresno 93704 K-6
Heaton 1533 N. San Pablo Fresno 93728 K-6
Hidalgo 3550 E. Thomas Fresno 93702 K-6
Holland 676 N. Fresno Fresno 93726 K-6
Homan 1602 W. Harvard Fresno 93705 K-6
Jackson 3750 E. Platt Fresno 93702 K-6
Jefferson 202 N. Mariposa Fresno 93701 K-6
King 1001 E. Florence Fresno 93706 K-6
Kirk 2000 E. Belgravia Fresno 93706 K-6
Kratt 650 W. Sierra Fresno 93704 K-6
Lane 4730 E. Lane Fresno 93702 K-6
Lawless 5255 N. Reese Fresno 93722 K-6
Page 3 of 12 Exhibit A-4 Phase 5
Leavenworth 4420 E. Thomas Fresno 93702 K-6
Lincoln 651 "B" Street Fresno 93706 K-6
Lowell 171 N. Poplar Fresno 93701 K-6
Malloch 2251 W. Morris Fresno 93705 K-6
Manchester GATE 2307 e. Dakota Fresno 93726 K-6
Mayfair 3305 E. Home Fresno 93703 K-6
Mccardle 577 E. Sierra Fresno 93710 K-6
Muir 109 E. Dennett Fresno 93728 K-6
Norseman 4636 E. Weldon Fresno 93703 K-6
Olmos 550 S. Garden Fresno 93727 K-6
Powers-Ginsberg 110 E. Swift Fresno 93704 K-6
Pyle 4140 N. Augusta Fresno 93726 K-6
Robinson 555 E. Browning Fresno 93710 K-6
Roeding 1225 W. Dakota Fresno 93705 K-6
Rowell 3460 E. McKenzie Fresno 93702 K-6
Slater 4472 E. Emerson Fresno 93705 K-6
Starr 1780 W. Sierra Avenue Fresno 93705 K-6
Storey 5250 E. Church Fresno 93725 K-6
Sunset 1755 S. Crystal Fresno 93706 K-6
Thomas 4444 N. Millbrook Fresno 93726 K-6
Turner 5218 E. Clay Fresno 93727 K-6
Vang Pao 5090 E. Church Fresno 93725 K-6
Viking 4251 N. Winery Fresno 93726 K-6
Vinland 4666 N. Maple Fresno 93726 K-6
Webster 930 N. Augusta Fresno 93701 K-6
Williams 525 W. Saginaw Fresno 93705 K-6
Wilson 2131 W. Ashlan Fresno 93705 K-6
Winchell 3722 E. Lowe Fresno 93702 K-6
Wishon 3857 E. Harvard Fresno 93703 K-6
Wolters 5174 N. First Fresno 93710 K-6
Yokomi 2323 E. McKenzie Fresno 93701 K-6
Ahwahnee 1127 E. Escalon Fresno 93710 7th -8
Baird 5500 N. Moroa Fresno 93704 7th -8
Page 4 of 12 Exhibit A-4 Phase 5
Computech 555 E. Belgravia Fresno 93706 7th -8
Cooper 2277 W. Bellaire Way Fresno 93705 7th -8
Fort Miller 1302 Dakota Fresno 93704 7th -8
Gaston 1100 E. Church Fresno 93706 7th -8
Hamilton 102 E. Clinton Fresno 93704 7th -8
Kings Canyon 5117 E. Tulare Fresno 93727 7th -8
Scandinavian 3232 N. Sierra Vista Fresno 93726 7th -8
Sequoia 4050 E. Hamilton Fresno 93702 7th -8
Tehipite 630 N. Augusta Fresno 93701 7th -8
Tenaya 1239 W. Mesa Fresno 93711 7th -8
Terronez 2300 S. Willow Fresno 93725 7th -8
Tioga 3232 E. Fairmont Fresno 93726 7th -8
Wawona 45254 N. Thorne Fresno 93705 7th -8
Yosemite 1292 N. Ninth Fresno 93703 7th -8
Bullard 5445 N. Palm Fresno 93704 9th -12
CART 2555 Clovis Ave. Clovis 93612 9th -12
Duncan Polytechnical 4330 E. Garland Fresno 93726 9th -12
Edison 540 E. California Fresno 93706 9th -12
Fresno 1839 Echo Avenue Fresno 93704 9th -12
Hoover 5550 N. First Street Fresno 93710 9th -12
Mclane 2727 N. Cedar Fresno 93703 9th -12
Phillip J Patino School of Ent 2000 E. Cambridge Avenue Fresno 93703 9th -12
Roosevelt 4250 E. Tulare Fresno 93702 9th -12
Sunnyside 1019 S. Peach Fresno 93727 9th -12
Cambridge Continuation 1001 Chestnut Fresno 93721
Cesar E. Chavez Adult Educa 2500 Stanislaus Fresno 93721
Design Science High School 2004 E. Cambridge Avenue Fresno 93703
DeWolf Continuation 2021 N. Clark Fresno 93703
J.E. Young 822 N. Abby Fresno 93701
Phoenix Elementary Acaden 3335 N. Authur Fresno 93705
Phoenix Secondary Academ� 2445 W. Dakota Fresno 93705
Washington Colony Elementary
Page 5 of 12 Exhibit A-4 Phase 5
Washington Colony Element 130 E. Lincoln Fresno 93706 K-8
Washington Unified
West Fresno Preschool 888 S. Ivy Fresno 93706 Pre
American Union Elementary 2801 W. Adams Avenue Fresno 93706 K-8
West Fresno Elementary 2910 S. Ivy Avenue Fresno 93706 K-5
West Fresno Middle School 2888 S. Ivy Avenue Fresno 93706 Gth-8
Washington Union High Schc 6041 S. Elm Avenue Fresno 93706 9th-12
Easton High Continuation 5865 S. Clara Fresno 93706
Easton Community Day Scho 5865 S. Clara Fresno 93706
ELM High School lndepender 5865 S. Clara ' Fresno 93706
West Park Elementary
West Park Elementary 2695 S. Valentine Fresno 93706 K-12
Selma Unified
James A. Garfield 2535 11 8 11 Street Selma 93662 K-6
Indianola 11524 E. Dinuba Selma 93662 K-6
Andrew Jackson 2220 Huntsman Selma 93662 K-6
Theodore Roosevelt 1802 Floral Avenue Selma 93662 K-6
Terry 12906 S. Fowler Selma 93662 K-6
George Washington 1420 2nd Street Selma 93662 K-6
Eric White 2001 Mitchell Selma 93662 K-6
Woodrow Wilson 1325 Stillman Selma 93662 K-6
Abraham Lincoln 1239 Nelson Blvd Selma 93662 7th-8
Selma High 3125 Wright Street Selma 93662 9th-12
Heartland Alternative/Selma 2269 Sylvia Street Selma 93662
Selma Adult School Facilitate 3125 Wright Street Selma 93662
Fowler Unified
James W. Marshall 142 N. Armstrong Avenue Fowler 93625 K-2
John C. Fremont 306 E. Tuolumne Street Fowler 93625 3rd -5
Malaga 3910 S. Ward Fresno 93725 K-5
John Sutter 701 E. Walter Avenue Fowler 93625 6th -8
Fowler High 701 E. Main Street Fowler 93625 9th -12
Fowler Academy Continuatic 975 E. Adams Avenue Fowler 93625
Page 6 of 12 Exhibit A-4 Phase 5
Fowler Academy Communit 975 E. Adams Avenue Fowler 93625
Kingsburg Elementary Charter School District
Central Valley Home School 1776 6th Avenue Drive Kingsburg 93631 K-8
Island Community Day Schoc 1776 6th Avenue Drive Kingsburg 93631 4th-8
Lincoln 1900 Mariposa Avenue Kingsburg 93631 2nd-3
Reagan 1180 Diane Avenue Kingsburg 93631 4th-6
Roosevelt 1185 10th Street Kingsburg 93631 1st
Washington 1501 Ellis Street Kingsburg 93631 K
Rafer Johnson Jr. High 1300 Stroud Avenue Kingsburg 93631 7th-8
Kingsburg Joint Union High
Kingsburg High School 1900 18th Avenue Kingsburg 93631 9th-12
Kingsburg Adult School 2311 Sierra Street Kingsburg 93631
Laton Unified
Laton Elementary/Conejo 6065 Latonia Laton 93242 K-8
Laton High 6449 Dewoody Street Laton 93242 9th-12
Alvina Elementary
Alvina Elementary 295 W. Saginaw Caruthers 93609 K-8
Caruthers Unified
Caruthers Elementary 13369 S. Quince Street Caruthers 93609 K-8
Caruthers High School 2580 W. Tahoe Caruthers 93609 9th -12
MARC Continuation Adult 2580 W. Tahoe Caruthers 93609
Monroe Elementary
Monroe Elementary 11842 S. Chestnut Avenue Fresno 93725 K-8
Orange Center Elementary
Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706 Pre, TK-8
Pacific Union Elementary
Pacific Union Elementary 2065 E. Bowles Avenue Fresno 93725 K-8
Parlier Unified
S.Ben Benavidez 13900 Tuolumne Street Parlier 93648 K-6
Mathew J. Brletic 601 3rd Street Parlier 93648 K-6
Cesar E. Chavez 500 Tuolumne Street Parlier 93648 K-6
John C. Martinez 13174 E. Parlier Parlier 93648 K-6
Page 7 of 12 Exhibit A-4 Phase 5
Parlier Junior High 1200 E. Parlier Parlier 93648 7th -8
Parlier High 603 Third Street Parlier 93648 9th-12
San Joaquin Valley Continua" 900 Newmark Avenue Parlier 93648
Raisin City Elementary
Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652 Pre-8
Clovis Unified
Boris 7071 E. Clinton Fresno 93737 K-6
Bud Rank 3650 Powers Avenue Clovis 93619 K-6
Cedarwood 2851 Palo alto Clovis 93611 K-6
Century 965 N. Sunnyside Clovis 93611 K-6
Clovis 1100 Armstrong Clovis 93611 K-6
Cole 615 W. Stuart Clovis 93612 K-6
Copper Hills 1881 E. Plymouth Way Fresno 93720 K-6
Dry Creek 1273 N. Armstrong Clovis 93611 K-6
Fancher Creek 5978 E.Tulare Fresno 93727 K-6
Fort Washington 960 E. Teague Fresno 93727 K-6
Freedom 2955 Gettysburg Clovis 93611 K-6
Fugman 10825 N. Cedar Fresno 93730 K-6
Garfield 1315 N. Peach Clovis 93611 K-6
Gettysburg 2100 Gettysburg Clovis 93611 K-6
Jefferson 1880 Fowler Clovis 93611 K-6
Liberty 1250 E. Liberty Hill Drive Fresno 93720 K-6
Lincoln 774 E. Alluvial Fresno 93720 K-6
Maple Creek 2025 E. Teague Fresno 93720 K-6
Mickey Cox 2191 Sierra Clovis 93611 K-6
Miramonte 1590 Bellaire Clovis 93611 K-6
Mountain View 2002 E. Alluvial Fresno 93720 K-6
Nelson 1336 W. Spruce Pinedale 93650 K-6
Oraze 3468 N. Armstrong Fresno 93727 K-6
Pinedale 7171 N. Sugar Pine Pinedale 93650 K-6
Regan 8300 E. Ashlan Avenue Clovis 93619 K-6
Red Bank 1454 Locan Avenue Clovis 93611 K-6
Page 8 of 12 Exhibit A-4 Phase 5
Riverview 2491 E. Behymer Fresno 93730 K-6
Sierra Vista 510 Barstow Clovis 93612 K-6
Tarpey 2700 Minnewawa Clovis 93612 K-6
Temperance-Kutner 1448 N. Armstrong Fresno 93727 K-6
Valley Oak 465 E Champlain Fresno 93730 K-6
Weldon 150 DeWitt Clovis 93612 K-6
Woods 700 Teague Avenue Clovis 93619 K-6
Alta Sierra Intermediate 380 W. Teague Clovis 93611 7th -8
Clark Intermediate 902 Fifth Street Clovis 93612 7th -8
Granite Ridge 2770 E. International Avenu Fresno 93730 7th -8
Kastner Intermediate 7676 N. First Street Fresno 93720 7th -8
Reyburn Intermediate 4300 N. Dewolf Clovis 93611 7th -8
Buchanan 465 E Champlain Fresno 93730 9th -12
CART 150 DeWitt Clovis 93612 9th -12
Clovis East 4343 N. Leonard Clovis 93611 9th -12
Clovis High 1055 Fowler Clovis 93611 9th -12
Clovis North 2770 E. International Fresno 93730 9th -12
Clovis West 1070 E. Teague Fresno 93720 9th -12
Clovis Adult Education 1452 David E. Cook Way Clovis 93611
Clovis Community Day ElemE 1715 David E. Cook Way Clovis 93611
Clovis Community Day Secor 1715 David E. Cook Way Clovis 93611
Enterprise High School 1655 David E. Cook Way Clovis 93611
Gateway 1550 Herndon Clovis 93611
Central Unified
Biola-Pershing 4885 N. Biola Avenue Fresno 93723 K-6
Harvest 6514 W. Gettysburg Fresno 93723 K-6
Herndon Barstow 6265 N. Grantland Fresno 93723 K-6
Houghton Kearney 8905 W. Kearney Fresno 93706 K-8
Liddell 5455 W. Alluvial Fresno 93722 K-6
Madison 330 S. Brawley Fresno 93706 K-6
McKinley 4444 W. McKinley Fresno 93722 K-6
Polk 2195 N. Polk Fresno 93722 K-6
Page 9 of 12 Exhibit A-4 Phase 5
River Bluff 6150 W. Palo Alto Fresno 93722 K-6
Roosevelt 2600 N. Garfield Fresno 93723 K-6
Saroyan 5650 W. Escalon Fresno 93722 K-6
Steinbeck 3550 N. Milburn Fresno 93722 K-6
Teague 4725 N. Polk Fresno 93722 K-6
Tilley, Hanh Phan 2280 N. Valentine Fresno 93722 K-6
El Capitan 4443 W. Weldon Fresno 93722 7th -8
Glacier Point 4055 N. Bryan Fresno 93723 7th -8
Rio Vista 6240 W. Palo Alto Fresno 93722 7th -8
Central High East 3535 N. Cornelia Fresno 93722 9th -12
Central High West 2045 N. Dickenson Fresno 93723 9th -12
Central Unified Adult (C.L.A.c 2698 N. Brawley Fresno 93722
Central Unified Alternative (I 2698 N. Brawley Fresno 93722
Pathway Community Day Sci 11 S. Tielman Fresno 93706
Pershing Continuation 855 W. Nielsen Fresno 93706
Big Creek Elementary
Big Creek Elementary 55190 Point Road Big Creek 93605 K-8
Pine Ridge Elementary
Pine Ridge Elementary 45828 Auberry Road Auberry 93602 K-8
Sierra Unified
Foothill Elementary 29147 Auberry Road Prather 93651 K-6
Lodge Pole 33467 Lodge Road Tollhouse 93667 K-8
Pole Corral 65265 Hall Meadow Shaver Lake 93664 K-8
Sierra Junior High 33326 Lodge Road Tollhouse 93667 7th-8
Sierra High 33326 Lodge Road Tollhouse 93667 9th-12
Black Mountain Adult Educa 33461 Lodge Road Tollhouse 93667
Oak Meadow Community Da 33411 Lodge Road Tollhouse 93667
Sandy Bluffs Alternative Edu 33280 Lodge Road Tollhouse 93667
Kings Canyon Unified
Alta 21771 E. Parlier Avenue Reedley 93654 TK-5
A.L. Conner 222 Fourth Street Orange Cove 93646 Pre, K-5
Dunlap 39667 Dunlap Road Dunlap 93621 Pre, TK-8
Page 10 of 12 Exhibit A-4 Phase 5
Great Western 5051 S. Frankwood Avenue Reedley 93654 K-5
Jefferson 1037 E. Duff Avenue Reedley 93654 Pre, TK-5
Lincoln 374 E. North Avenue Reedley 93654 TK-5
McCord 333 Center Street Orange Cove 93646 Pre, K-5
Riverview 8662 S. Lac Jae Parlier 93648 K-8
Sheridan 1001 9th Street Orange Cove 93646 TK-5
Silas Bartsch 2225 E. North Avenue Reedley 93654 K-8
T.L. Reed 1400 Frankwood Reedley 93654 K-8
Washington 1250 "K" Street Reedley 93654 Pre, K-5
Citrus 1400 Anchor Orange Cove 93646 6th -8
General Grant 360 N. East Avenue Reedley 93654 6th -8
Navelencia 22620 Wahtoke Avenue Reedley 93654 6th -8
Dunlap Leadership Academy 39500 Dunlap road Dunlap 93621 9th-12
Orange Cove High 1700 Anchor Avenue Orange Cove 93646 9th-12
Reedley High 740 W. North Avenue Reedley 93654 9th-12
Reedley Middle College High 995 N. Reed Avenue Reedley 93654 9th-12
Kings Canyon Adult 740 W. North Avenue Reedley 93654
Kings Canyon High Continua1 10026 S. Crawford Avenue Dinuba 93618
Mountain View School/lnde1 877 E. North Avenue Reedley 93654
Sanger Unified
Del Rey Preschool 10620 Morro Street Del Rey 93616 Pre
Jefferson Preschool 1110 Tucker Street Sanger 93657 Pre
Lincoln Preschool 1700 14th Street Sanger 93657 Pre
Wilson Preschool 504 Faller Sanger 93657 Pre
Centerville 48 S. Smith Avenue Sanger 93657 K-6
Del Rey 10620 Morro Street Del Rey 93616 K-6
Fairmont 3095 N. Greenwood Avenue Sanger 93657 K-8
Jackson 1810 Third Street Sanger 93657 K-5
Lincoln 1700 14th Street Sanger 93657 K-5
Lone Star 2617 S. Fowler Fresno 93725 K-6
Madison 2324 Cherry Street Sanger 93657 K-5
Reagan 1586 S. Indianola Avenue Sanger 93657 K-5
Page 11 of 12 Exhibit A-4 Phase 5
Sequoia 1820 S. Armstrong Avenue Fresno 93727 K-6
John S. Wash 6350 E. Lane Fresno 93727 K-6
Wilson 610 Faller Sanger 93657 K-5
Washington Academic 1705 Tenth Street Sanger 93657 Gth-8
Sanger High 1045 Bethel Avenue Sanger 93657 9th -12
Community Day School 818 "L" Street Sanger 93657 7th-12
Education Center 1801 7th Street Sanger 93657
Sanger Adult Education 1045 Bethel Avenue Sanger 93657
End of Phase 4 Taft High (Ind. Study) 1801 7th Street Sanger 93657
Coalinga -Huron Unified
Henry F. Bishop 1501 Sunset Ave. Coalinga 93210 K-1
Annie E. Cheney Kindergarte 149 Adams Street Coalinga 93210 K
Nell Dawson 1303 Sunset Ave. Coalinga 93210 2nd - 3
Huron 12th and N Streets Huron 93234 K-5
Sunset 958 Sunset Ave Coalinga 93210 4th -5
Coalinga Middle 265 Cambridge Ave. Coalinga 93210 6th -8
Huron Middle 16875 4th Street Huron 93234 6th -8
Coalinga High 750 Van Ness Ave. Coalinga 93210 9th -12
Cambridge High Continuatio 516 Baker St. Coalinga 93210
Chestnut High Continuation 16673 Palmer Ave. Huron 93234
Community Day School 275 Cambridge Ave. Coalinga 93210
Westside Elementary
Westside Elementary 19191 W. Excelsior Five Points 93624 Pre, K-8
Burrell Union·Elementary
Burrel Union Elementary 16704 S. Jameson Avenue Riverdale 93656 K-8
Riverdale Unified
Central Valley Preschool 21320 S. Feland Riverdale 93656 Pre
Fipps Primary 21320 S. Feland Riverdale 93656 K-3
Riverdale Elementary 3700 Stathem Street Riverdale 93656 4th-8
Riverdale High 3086 W. Mt. Whitney Riverdale 93656 9th-12
PRESCHOOLS
Westside Elementary Westside Elementary 19191 W. Excelsior Five Points 93624
Page 12 of 12 Exhibit A-4 Phase 5
Riverdale Central Valley Preschool 21320 S. Feland Riverdale 93656
HEADSTARTS
HURON Huron Elementary School 16641 Palmer Street Huron 93234
MIGRANT HEADSTART
Five Points 18849 W. Excelsior Road Five Points 93624
Huron 16901 Toronado Huron 93234
Phase 5 Includes 1-4
Page 1 of 4 Exhibit A-4
PRESCHOOL/HEADSTART SITES
HEADSTARTS SCHOOL NAME ADDRESS CITY ZIP CODE
AREA II Ted C. Wills Community Center 770 N. San Pablo Fresno 93728
BROOKS Brooks 1504 N. Weber Fresno 93728
CANTUA Cantua Elementary School 29228 W. Clarkson Avenue Cantua Creek 93608
CARUTHERS Caruthers Elementry School 2420 W. Clemenceau Avenue Caruthers 93609
CEDARWOOD El Encino Baptist Church 2063 S. Cedar Fresno 93702
CITRUS A.L. Conner Elementry School 112 4th Street Orange Cove 93646
CLOVIS Sierra Vista Elementary School 510 Barstow Clovis 93612
COLLEGE COMMUNITY College Community Church 2529 Willow Avenue Clovis 93612
DAKOTA CIRCLE Dakota Circle 4156 E. Dakota Avenue Fresno 93726
ESTELLE DAILEY Community United Church of Christ 5550 N. Fresno St Fresno 93710
FRANKLIN Franklin Head Sart 1189 Martin Street Fresno 93706
HURON Huron Elementary School 16641 Palmer Street Huron 93234
IVY Mary Ella Brown Community Center 1350 E. Annadale Fresno 93706
JEFFERSON Jefferson Elementary School 1240 E. Washingon Street Reedley 93654
KINGSCANYON Kings Canyon 4995 E. Balch Fresno 93727
LA COLONIA La Colonia Community Center 8770 S. Mendocino Parlier 93648
MADISON Madison Elementary School 388 S. Brawley Fresno 93706
MAPLE VISTA Sierra Vista United Methodist 4609 E. Illinois Fresno 93702
MOLLY NEVAREZ Central Community Church 4710 N. Polk Avenue Fresno 93722
MOSQUEDA Mosqueda Community Center 4676 E. Butler Fresno 93702
PINEDALE Pinedale Elementary School 7171 N. Sugarpine Pinedale 93650
RAMACHER RaMacher Educational Complex 710 N. Hughes Fresno 93728
REEDLEY Reedley 144 S. Sunset Reedley 93654
ROMAIN Romain Neighborhood Center 745 N. First Street Fresno 93702
ROOSEVELT Roosevelt Elementary School 1701 Alton Street Ste. A Selma 93662
SAN JOAQUIN San Joaquin Elementary School 8535 S. Ninth San Joaquin 93660
SANGER lnglesia La Roca 3037 S. Orchid Sanger 93657
SEQUOIA First Congregational Church 2121 N. Van Ness Fresno 93704
WASHINGTON Washington Elementary School 1420 Second Street Selma 93662
Page 2 of 4 Exhibit A-4
WILSON Wilson Elementary School 1325 Stillman Selma 93662
YOSEMITE Fresno Iglesia Del Nazareno 4718 E. Yale Fresno 93703
MIGRANT HEAD STARTS Fresno Migrant & Seasonal Head Start
Biola 5022 Madera Avenue Kerman 93630
Firebaugh 1777 Thomas Conboy Firebaugh 93622
Five Points 18849 W. Excelsior Road Five Points 93624
Huron 16901 Toronado Huron 93234
Mendota 435 Sorenson Mendota 93640
Orange Cove 315 Adams Street Orange Cove 93646
Parlier 900 Newmark Avenue Parlier 93648
Orange Cove 315 Adams Street Orange Cove 93646
Selma 12898 S. Fowler Avenue Selma 93662
PRESCHOOLS
Central Unified Biola Pershing Elementary School 4885 N. Biola Fresno 93723
Hendon-Barstow Elementary School 6265 N. Grantland Fresno 93723
Madison Elementary School 330 S. Brawley Avenueq Fresno 93706
Teague Elementary School 4725 N. Polk Fresno 93722
Roosevelt Elementary School 2600 N. Garfield Avenue Fresno 93723
Clovis Unified Boris 7071 E. Clinton Fresno 93737
Buchananan 465 E Champlain Fresno 93730
Century 965 N. Sunnyside Clovis 93611
Clovis 1100 Armstrong Clovis 93611
Cole 615 W. Stuart Clovis 93612
Copper Hills 1881 E. Plymouth Way Fresno 93720
Francher Creek 5978 E.Tulare Fresno 93727
Freedom 2955 Gettysburg Clovis 93611
Gettysburg 2100 Gettysburg Clovis 93611
Jefferson 1880 Fowler Clovis 93611
Lincoln 774 E. Alluvial Fresno 93720
Maple Creek 2025 E. Teague Fresno 93720
Page 3 of 4 Exhibit A-4
Mickey Cox 2191 Sierra Clovis 93611
Miramonte 1590 Bellaire Clovis 93611
Mountain View 2002 E. Alluvial Fresno 93720
Nelson 1336 W. Spruce Pinedale 93650
Craze 3468 N. Armstrong Fresno 93727
Pinedale 7171 N. Sugar Pine Pinedale 93650
Reagan 8300 E. Ashlan Avenue Clovis 93619
Red Bank 1454 Locan Avenue Clovis 93611
Riverview 2491 E. Behymer Fresno 93730
Sierra Vista 510 Barstow Clovis 93612
Tarpey 2700 Minnewawa Clovis 93612
TK 1448 N. Armstrong Fresno 93727
Valley Oak 465 E. Champlain Fresno 93730
Weldon 150 DeWitt Clovis 93612
Fowler Fowler Early Education Center 142 N. Armstrong Fowler 93625
Kings Canyon Unified A.L. Conner 222 Fourth Street Orange Cove 93646
Dunlap 39667 Dunlap road Dunlap 93621
Jefferson 1037 E. Duff Avenue Reedley 93654
McCord 333 Center Street Orange Cove 93646
Washington 1250"K" Street Reedley 93654
Laton Unified Laton Unified Early Learning Center 6045 E. Mt. Whitney Laton 93242
Orange Center Orange Center Elementary 3530 S. Cherry Avenue Fresno 93706
Mendota Unified Washington Elementary 1599 5th Street Mendota 93640
Raisin City Elementary Raisin City Elementary 6425 W. Bowles Avenue Raisin City 93652
Riverdale Central Valley Preschool 21320 S. Feland Riverdale 93656
Sanger Unified Del Rey Preschool 10620 Morro Street Del Rey 93616
Jefferson Preschool 1110 tucker Street Sanger 93657
Lincoln Preschool 1700 14th Street Sanger 93657
Wilson Preschool 504 Faller Sanger 93657
Washington Unified West Fresno Preschool 888 S. Ivy Fresno 93706
Westside Elementary Westside Elementary 19191 W. Excelsior Five Points 93624
Charter Schools Edison-Bethune Charter Academy (K-6) 1616 S. Fruit Fresno 93706
Page 4 of 4 Exhibit A-4
I University High School I 2611 E. Matoiian M/S UH 134 {Fresno 937401
�co �� ii\ '6 �% 1s5�o/
PR"£;'
Section:
Effective Date:
Policy Title:
Department of Behavioral Health
Administration
os/30/2011
Performance Outcome Measures
Policy and Procedure Guide
PPG 1.2.7
Revised Date: os/30/2011
- ------· --- -------·· ------ -----·----···-·····-
Approved by: Dawan Utecht (Director of Behavioral Health), Francisco Escobedo (Sr. Staff Analyst - QA), Kannika
POLICY:
PURPOSE:
REFERENCE:
DEFINITIONS:
Toonnachat (Division Manager -Technology and Quality Management)
It is the policy of Fresno County Department of Behavioral Health and the
Fresno County Mental Health Plan (FCMHP) to ensure procedures for
developing performance measures which accurately reflect vital areas of
performance and provide for systematic, ongoing collection and analysis
of valid and reliable data. Data collection is not intended to be an
additional task for FCMHP programs/providers but rather embedded within
the various non-treatment, treatment and clinical documentation.
To determine the effectiveness and efficiency of services provided by
measuring performance outcomes/results achieved by the persons served
during service delivery or following service completion, delivery of service,
and of the individuals' satisfaction. This is a vital management tool used to
clarify goals, document the efforts toward achieving those goals, and thus
measure the benefit the service delivery to the persons served.
Performance measurement selection is part of the planning and
developing process design of the program. Performance measurement is
the ongoing monitoring and reporting of progress towards pre-established
objectives/goals.
California Code of Regulations, Title 9, Chapter 11, Section
1810.380(a)(1 ): State Oversight
DHCS Service, Administrative and Operational Requirements
Mental Health Services Act (MHSA}, California Code of Regulations, Title
9, Section 3320, 3200.050, and 3200.120
Commission on Accreditation of Rehabilitation Facilities (CARF)
1.Indicator: Qualitative or quantitative measure(s) that tell if the outcomes have been
accomplished. Indicators evaluate key performance in relation to objectives. It indicates
what the program is accomplishing and if the anticipated results are being achieved.
---�------·-------·----·-·--·---· ---· -·--------·---···--
MISSION STATEMENT
The Department of Behallioral Health Is dedicated to supporting the wellness of Individuals, families and communities In Fresno County who are affected by, or ore at risk
of, mental Illness and/or substance use disorders through cultivation of strengths toward promoting recollf!f)I In the least restrictive environment
Template Review Date 3/28/16
Exhibit A-5 Page 1 of 6
� co�-<V fi!' Department of Behavioral Health
� t> % 185��
Policy and Procedure Guide
PR�� Section: Administration Effective Date: 05/30/2017 PPG 1.2.7
Policy Title: Performance Outcome Measures
2.Intervention: A systematic plan of action consciously adapted in an attempt to address
and reduce the causes of failure or need to improve upon system.
3.Fresno County Mental Health Plan (FCMHP): Fresno County's contract with the State
Department of Health and Human Services that allows for the provision of specialty
mental health services. Services may be delivered by county-operated programs,
contracted organizational, or group providers.
4.Objective (Goal): Intended results or the impact of learning, programs, or activities.
5.Outcomes: Specific results or changes achieved as a consequence of the program or
intervention. Outcomes are connected to the objectives/goals identified by the program
or intervention.
PROCEDURE:
I.Each FCMHP program/provider shall engage in measurement of outcomes in order
to generate reliable and valid data on the effectiveness and efficiency of programs or
interventions. Programs/providers will establish/select objectives (goals), decide on
a methodology and timeline for the collection of data, and use an appropriate data
collection tool. This occurs during the program planning and development process.
Outcomes should be in alignment with the program/provider goals.
II.Outcomes should be measureable, obtainable, clear, accurately reflect the expected
result, and include specific time frames. Once the measures have been selected, it
is necessary to design a way to gather the information. For each service delivery
performance indicator, FCMHP program/provider shall determine: to whom the
indicator will be applied; who is responsible for collecting the data; the tool from
which data will be collected; and a performance target based on an industry
benchmark, or a benchmark set by the program/provider.
Ill. Performance measures are subject to review and approval by FCMHP
Administration.
IV.Performance measurement is the ongoing monitoring and reporting of progr ess
towards pre-established objectives/goals. Annually, each FCMHP program/provider
must measure service delivery performance in each of the areas/domains listed
below. Dependent on the program/provider service deliverables, exceptions must be
approved by the FCMHP Administration.
Exhibit A-5 Page 2 of 6
� � col<-<V-Department of Behavioral Health
�
� � Policy and Procedure Guide
� 185�0
�R£Y Section: Administration Effective Date: 05/30/2017 PPG 1.2.7
Policy Title: Performance Outcome Measures
a.Effectiveness of services -How well programs performed and the results
achieved. Effectiveness measures address the quality of care through
measuring change over time. Examples include but are not limited to: reduction
of hospitalization, reduction of symptoms, employment and housing status, and
reduction of recidivism rate and incidence of relapse.
b.Efficiency of services -The relationship between the outcomes and the
resources used. Examples include but are not limited to: service delivery cost per
service unit, length of stay, and direct service hours of clinical and medical staff.
c.Services access -Changes or improvements in the program/provider's capacity
and timeliness to provide services to those who request them. Examples include
but are not limited to: wait/length of time from first request/referral to first service
or subsequent appointment, convenience of service hours and locations, number
of clients served by program capacity, and no-show and cancellation rates.
d.Satisfaction and feedback from persons served and stakeholders-Changes or
increased positive/negative feedback regarding the experiences of the persons
served and others (families, referral sources, payors/guarantors, etc.).
Satisfaction measures are usually oriented toward clients, family members,
personnel, the community, and funding sources. Examples include but are not
limited to: did the organization/program focus on the recovery of the person
served, were grievances or concerns addressed, overall feelings of satisfa ction,
and satisfaction with physical facilities, fees, access, service effectiveness, and
efficiency.
V.Each FCMHP program/provider shall use the following templates to document the
defined goals, intervention(s), specific indicators, and outcomes.
1.FCMHP Outcome Report template (see Attachment A)
2.FCMHP Outcome Analysis template (see Attachment C)
Exhibit A-5 Page 3 of 6
Exhibit A-5 Page 4 of 6
Exhibit A-5 Page 5 of 6
Exhibit A-5 Page 6 of 6
Fresno County Department of Behavioral Health Exhibit B
Guiding Principles of Care Delivery
1
rev 01‐02‐2018
DBH VISION:
Health and well-being for our community.
DBH MISSION:
The Department of Behavioral Health is dedicated to supporting the wellness of individuals,
families and communities in Fresno County who are affected by, or are at risk of, mental illness
and/or substance use disorders through cultivation of strengths toward promoting recovery in the
least restrictive environment.
DBH GOALS:
Quadruple Aim
Deliver quality care
Maximize resources while focusing on efficiency
Provide an excellent care experience
Promote workforce well-being
GUIDING PRINCIPLES OF CARE DELIVERY:
The DBH 11 principles of care delivery define and guide a system that strives for excellence in the
provision of behavioral health services where the values of wellness, resiliency, and recovery are
central to the development of programs, services, and workforce. The principles provide the
clinical framework that influences decision-making on all aspects of care delivery including
program design and implementation, service delivery, training of the workforce, allocation of
resources, and measurement of outcomes.
1.Principle One - Timely Access & Integrated Services
o Individuals and families are connected with services in a manner that is streamlined,
effective, and seamless
o Collaborative care coordination occurs across agencies, plans for care are integrated,
and whole person care considers all life domains such as health, education,
employment, housing, and spirituality
o Barriers to access and treatment are identified and addressed
o Excellent customer service ensures individuals and families are transitioned from one
point of care to another without disruption of care
2.Principle Two - Strengths-based
o Positive change occurs within the context of genuine trusting relationships
o Individuals, families, and communities are resourceful and resilient in the way they
solve problems
o Hope and optimism is created through identification of, and focus on, the unique
abilities of individuals and families
Fresno County Department of Behavioral Health Exhibit B
Guiding Principles of Care Delivery
2
rev 01‐02‐2018
3.Principle Three - Person-driven and Family-driven
o Self-determination and self-direction are the foundations for recovery
o Individuals and families optimize their autonomy and independence by leading the
process, including the identification of strengths, needs, and preferences
o Providers contribute clinical expertise, provide options, and support individuals and
families in informed decision making, developing goals and objectives, and identifying
pathways to recovery
o Individuals and families partner with their provider in determining the services and
supports that would be most effective and helpful and they exercise choice in the
services and supports they receive
4.Principle Four - Inclusive of Natural Supports
o The person served identifies and defines family and other natural supports to be
included in care
o Individuals and families speak for themselves
o Natural support systems are vital to successful recovery and the maintaining of
ongoing wellness; these supports include personal associations and relationships
typically developed in the community that enhance a person’s quality of life
o Providers assist individuals and families in developing and utilizing natural supports.
5.Principle Five - Clinical Significance and Evidence Based Practices (EBP)
o Services are effective, resulting in a noticeable change in daily life that is measurable.
o Clinical practice is informed by best available research evidence, best clinical
expertise, and client values and preferences
o Other clinically significant interventions such as innovative, promising, and emerging
practices are embraced
6.Principle Six - Culturally Responsive
o Values, traditions, and beliefs specific to an individual’s or family’s culture(s) are
valued and referenced in the path of wellness, resilience, and recovery
o Services are culturally grounded, congruent, and personalized to reflect the unique
cultural experience of each individual and family
o Providers exhibit the highest level of cultural humility and sensitivity to the self-
identified culture(s) of the person or family served in striving to achieve the greatest
competency in care delivery
7.Principle Seven - Trauma-informed and Trauma-responsive
o The widespread impacts of all types of trauma are recognized and the various
potential paths for recovery from trauma are understood
Fresno County Department of Behavioral Health Exhibit B
Guiding Principles of Care Delivery
3
rev 01‐02‐2018
o Signs and symptoms of trauma in individuals, families, staff, and others are recognized
and persons receive trauma-informed responses
o Physical, psychological and emotional safety for individuals, families, and providers is
emphasized
8.Principle Eight - Co-occurring Capable
o Services are reflective of whole-person care; providers understand the influence of bio-
psycho-social factors and the interactions between physical health, mental health, and
substance use disorders
o Treatment of substance use disorders and mental health disorders are integrated; a
provider or team may deliver treatment for mental health and substance use disorders
at the same time
9.Principle Nine - Stages of Change, Motivation, and Harm Reduction
o Interventions are motivation-based and adapted to the client’s stage of change
o Progression though stages of change are supported through positive working
relationships and alliances that are motivating
o Providers support individuals and families to develop strategies aimed at reducing
negative outcomes of substance misuse though a harm reduction approach
o Each individual defines their own recovery and recovers at their own pace when
provided with sufficient time and support
10.Principle Ten - Continuous Quality Improvement and Outcomes-Driven
o Individual and program outcomes are collected and evaluated for quality and efficacy
o Strategies are implemented to achieve a system of continuous quality improvement
and improved performance outcomes
o Providers participate in ongoing professional development activities needed for
proficiency in practice and implementation of treatment models
11.Principle Eleven - Health and Wellness Promotion, Illness and Harm Prevention, and Stigma
Reduction
o The rights of all people are respected
o Behavioral health is recognized as integral to individual and community well-being
o Promotion of health and wellness is interwoven throughout all aspects of DBH services
o Specific strategies to prevent illness and harm are implemented at the individual,
family, program, and community levels
o Stigma is actively reduced by promoting awareness, accountability, and positive
change in attitudes, beliefs, practices, and policies within all systems
o The vision of health and well-being for our community is continually addressed through
collaborations between providers, individuals, families, and community members
BEHAVIORAL HEALTH CONTRACT
FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
FY 2018-2019
F TE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Director 0.20 $24,387 $24,387 0.40 $48,776 $48,776 0.40 $48,776 $48,776 1.00 $121,939 $121,939
0002 Administrative Assistant 0.17 $10,712 $10,712 0.40 $25,708 $25,708 0.27 $17,139 $17,139 0.83 $53,559 $53,559
0003 Behavioral Health Program Supervisor 0.17 $19,805 $19,805 0.40 $47,531 $47,531 0.27 $31,688 $31,688 0.83 $99,024 $99,024
0004 Program Assistant 0.33 $17,833 $17,833 0.80 $42,797 $42,797 0.53 $28,532 $28,532 1.67 $89,162 $89,162
0005 Behavioral Health Clinician Supervisor 0.17 $17,412 $17,412 0.40 $41,789 $41,789 0.27 $27,859 $27,859 0.83 $87,060 $87,060
0006 Behavioral Health Clinician (II)1.33 $124,076 $124,076 4.00 $372,226 $372,226 1.33 $124,076 $124,076 6.67 $620,378 $620,378
0007 Behavioral Health Clinician (I)2.93 $245,221 $245,221 8.80 $735,663 $735,663 2.93 $245,220 $245,220 14.67 $1,226,104 $1,226,104
0008 Psychologist 0.00 $0 $0 1.00 $101,869 $101,869 0.17 $16,978 $16,978 1.17 $118,847 $118,847
0009 Intensive Behavior Intrv Spec 1.33 $79,986 $79,986 4.00 $239,960 $239,960 1.33 $79,986 $79,986 6.67 $399,932 $399,932
0010 Office Assistant 0.17 $7,374 $7,374 0.40 $17,697 $17,697 0.13 $5,899 $5,899 0.70 $30,970 $30,970
0011 Department Automation Specialist 0.15 $9,249 $9,249 0.40 $24,664 $24,664 0.20 $12,332 $12,332 0.75 $46,245 $46,245
0012 Accountant 0.20 $14,148 $14,148 0.40 $28,296 $28,296 0.40 $28,296 $28,296 1.00 $70,740 $70,740
0013 Accounting Technician 0.12 $6,136 $6,136 0.40 $21,039 $21,039 0.13 $7,013 $7,013 0.65 $34,188 $34,188
0016 Nurse 0.00 $0 $0 1.00 $94,060 $94,060 0.33 $31,354 $31,354 1.33 $125,414 $125,414
0017 Psychiatrist 0.00 $0 $0 0.75 $159,658 $159,658 0.00 $0 $0 0.75 $159,658 $159,658
0020 Financial Officer 0.00 $0 $0 0.00 $0 $0 0.25 $31,583 $31,583 0.25 $31,583 $31,583
0021 Program Manager II 0.50 $56,147 $56,147 0.50 $56,147 $56,147 0.50 $56,147 $56,147 1.50 $168,441 $168,441
0022 PBIS Coaches 0.80 $74,445 $74,445 0.00 $0 $0 0.00 $0 $0 0.80 $74,445 $74,445
0023 Administrator 0.04 $6,140 $6,140 0.08 $12,281 $12,281 0.08 $12,281 $12,281 0.20 $30,702 $30,702
$0 $0 $0 $0 $0
$0 $0 $0 $0 $0
SALARY TOTAL 8.61 $0 $713,071 $713,071 24.13 $0 $2,070,161 $2,070,161 9.53 $0 $805,159 $805,159 42.27 $0 $3,588,391 $3,588,391
PAYROLL TAXES:
0030 OASDI $0 $0 $0 $0 $0 $0
0031 FICA/MEDICARE $47,948 $47,948 $142,322 $142,322 $50,419 $50,419 $240,690 $240,690
0032 SUI $357 $357 $1,035 $1,035 $403 $403 $1,794 $1,794
PAYROLL TAX TOTAL $0 $48,305 $48,305 $0 $143,357 $143,357 $0 $50,822 $50,822 $0 $242,484 $242,484
EMPLOYEE BENEFITS:
0040 Retirement $132,492 $132,492 $384,931 $384,931 $148,392 $148,392 $665,814 $665,814
0041 Workers Compensation $15,474 $15,474 $44,923 $44,923 $17,472 $17,472 $77,868 $77,868
0042 Health Insurance (medical, vision, life, dental)$121,721 $121,721 $342,086 $342,086 $134,993 $134,993 $598,800 $598,800
EMPLOYEE BENEFITS TOTAL $0 $269,687 $269,687 $0 $771,939 $771,939 $0 $300,856 $300,856 $0 $1,342,482 $1,342,482
SALARY & BENEFITS GRAND TOTAL $1,031,063 $2,985,457 $1,156,837 $5,173,357
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $105,600 $211,200 $211,200 $528,000
1011 Rent/Lease Equipment $0 $0 $0 $0
1012 Utilities $30,240 $60,480 $60,480 $151,200
1013 Building Maintenance $9,120 $18,240 $18,240 $45,600
1014 Equipment purchase $0 $12,500 $4,167 $16,667
FACILITY/EQUIPMENT TOTAL $144,960 $302,420 $294,087 $741,467
OPERATING EXPENSES:
1060 Telephone $11,740 $24,130 $24,380 $60,250
1061 Answering Service $0 $5,000 $0 $5,000
1062 Postage $600 $1,200 $1,500 $3,300
1063 Printing/Reproduction $15,849 $32,576 $65,826 $114,251
1064 Publications $500 $375 $125 $1,000
1065 Legal Notices/Advertising $0 $0 $0 $0
1066 Office Supplies & Equipment $51,852 $15,000 $86,143 $152,994
1067 Household Supplies $450 $1,200 $600 $2,250
1068 Food $4,500 $0 $0 $4,500
1069 Program Supplies - Therapeutic $11,250 $7,500 $3,750 $22,500
1070 Program Supplies - Medical $11,250 $7,500 $3,750 $22,500
1071 Transportation of Clients $10,800 $10,800 $0 $21,600
1072 Staff Mileage/vehicle maintenance $51,500 $102,500 $0 $154,000
1073 Staff Travel (Out of County)$0 $0 $39,618 $39,618
1074 Staff Training/Registration $13,120 $9,840 $4,920 $27,880
1075 Lodging $7,500 $7,500 $3,750 $18,750
1076 Other - Parking $1,500 $750 $250 $2,500
1077 Other - Recruitment $1,500 $750 $73,140 $75,390
1078 Other - Licenses $0 $0 $0 $0
OPERATING EXPENSES TOTAL $193,911 $226,621 $307,751 $728,282
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0 $0 $0 $0
1081 External Audit $0 $0 $0 $0
1082 Liability Insurance $0 $0 $0 $0
1083 Administrative Overhead $207,389 $543,573 $268,517 $1,019,479
1084 Payroll Services $0 $0 $0 $0
1085 Professional Liability Insurance $0 $0 $0 $0
FINANCIAL SERVICES TOTAL $207,389 $543,573 $268,517 $1,019,479
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$10,500 $0 $0 $10,500
1090.1 Legal Fees $0 $60,000 $0 $60,000
1091 Translation Services $0 $45,000 $30,000 $75,000
1092 Medication Supports $0 $0 $0 $0
SPECIAL EXPENSES TOTAL $10,500 $105,000 $30,000 $145,500
FIXED ASSETS:
1190 Computers & Software $0 $0 $0 $0
1191 Furniture & Fixtures $0 $0 $0 $0
1192 Other - (Identify)$0 $0 $0 $0
1193 Other - (Identify)$0 $0 $0 $0
FIXED ASSETS TOTAL $0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenditures (SFC 70)$0 $0 $0 $0
2001 Client Housing Operating Expenditures (SFC 71)$0 $0 $0 $0
2002.1 Clothing, Food & Hygiene (SFC 72)$0 $0 $0 $0
2002.2 Client Transportation & Support (SFC 72)$0 $0 $0 $0
2002.3 Education Support (SFC 72)$0 $0 $0 $0
2002.4 Employment Support (SFC 72)$0 $0 $0 $0
2002.5 Respite Care (SFC 72)$0 $0 $0 $0
2002.6 Household Items $0 $0 $0 $0
2002.7 Utility Vouchers (SFC 72)$0 $0 $0 $0
2002.8 Child Care (SFC 72)$0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0 $0 $0 $0
TOTAL PROGRAM EXPENSES $1,587,822 TOTAL PROGRAM EXPENSES $4,163,070 TOTAL PROGRAM EXPENSES $2,057,193 TOTAL PROGRAM EXPENSES $7,808,085
MEDI-CAL REVENUE:Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 586,042 $4.01 $2,351,022 0 $0.00 $0 586,042 $4.01 $2,351,022
3100 Case Management 0 $0.00 $0 140,714 $3.10 $436,894 0 $0.00 $0 140,714 $3.10 $436,894
3200 Crisis Services 0 $0.00 $0 42,747 $5.96 $254,930 0 $0.00 $0 42,747 $5.96 $254,930
3300 Medication Support 0 $0.00 $0 55,350 $7.41 $410,065 0 $0.00 $0 55,350 $7.41 $410,065
3400 Collateral 0 $0.00 $0 73,297 $4.01 $294,046 0 $0.00 $0 73,297 $4.01 $294,046
3500 Plan Development 0 $0.00 $0 69,392 $4.01 $278,378 0 $0.00 $0 69,392 $4.01 $278,378
3600 Assessment 0 $0.00 $0 26,855 $4.01 $107,734 0 $0.00 $0 26,855 $4.01 $107,734
3700 Rehabilitation 0 $0.00 $0 104,783 $4.01 $420,356 0 $0.00 $0 104,783 $4.01 $420,356
Estimated Specialty Mental Health Services Billing Totals 0 $0ng Totals 1,099,178 $4,553,425ng Totals 0 $0ng Totals 1,099,178 $4,553,425
Estimated % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%d % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $3,642,740 h Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $3,642,740
0.00%$0 80.00%$2,914,192 0.00%$0 80.00%$2,914,192
0.00%$0 0.00%$0 0.00%$0 0.00%$0
MEDI-CAL REVENUE TOTAL $0 $2,914,192 $0 $2,914,192
OTHER REVENUE:
4100 Other - (Identify)$0 $0 $0 $0
4200 Other - (Identify)$0 $0 $0 $0
4300 Other - (Identify)$0 $0 $0 $0
OTHER REVENUE TOTAL $0 $0 $0 $0
MENTAL HEALTH SERVICES ACT (MHSA) REVENUE:
5000 Prevention & Early Intervention (PEI) Funds $1,587,822 $0 $0 $1,587,822
5100 Community Services & Supports (CSS) Funds $0 $1,248,879 $2,057,193 $3,306,071
5200 Innovation (INN) Funds $0 $0 $0 $0
5300 Workforce Education & Training (WET) Funds $0 $0 $0 $0
MHSA FUNDS TOTAL $1,587,822 $1,248,879 $2,057,193 $4,893,894
TOTAL PROGRAM REVENUE $1,587,822 TOTAL PROGRAM REVENUE $4,163,070 TOTAL PROGRAM REVENUE $2,057,193 TOTAL PROGRAM REVENUE $7,808,086
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
CSS Budget Total Proposed Budget
Line Item Description (Must be itemized)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Ramp-Up CSS BudgetBudget Categories -PEI Budget
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Exhibit C, Page 1 of 21
Behavioral Health Contract
Budget Narrative
FY 2018-2019
PROGRAM EXPENSES
Personnel Salaries, Payroll Taxes & Employee Benefits – Line Items 0001-0042
0001 through 0042: These amounts reflect staff that are needed to perform the duties of
specialty mental health services and related activities. Full-time equivalent (FTE) is provided for
each position. Note that many positions in FY 2018-19 begin after the year begins, thereby
reducing their total FTE and their total annual cost for this year. Below is a list of staff, their FTE,
and the month the employee(s) starts in FY 2018-19:
Month 1
0.20 FTE Administrator at $153,501 per FTE
1.00 FTE Director at $121,939 per FTE
1.00 FTE Accountant at $70,741 per FTE
1.50 FTE Financial Officer $126,330 per FTE
1.50 FTE Program Manager II $112,295 per FTE
0.80 PBIS Coaches $93,057 per FTE
1.00 FTE Program Assistant $53,497 per FTE
Month 3
Staff
1.00 FTE Behavioral Health Program Supervisor $118,828 per FTE
1.00 FTE Administrative Assistant $53,497 per FTE
1.00 FTE Behavioral Health Clinician Supervisor $104, 472 per FTE
Month 4
1.00 FTE Department Automation Specialist $61,659 per FTE
2.00 FTE Program Assistant $53,497 per FTE
Month 5
10.00 FTE Behavioral Health Clinician II $93,057 per FTE
22.00 FTE Behavioral Health Clinician I $83,598 per FTE
10.00 FTE Intensive Behavior Intervention Specialist $59,990 per FTE
1.00 FTE Office Assistant $44,245 per FTE
1.00 FTE Accounting Technician $52,597 per FTE
2.00 FTE Nurse $94,061 per FTE
Month 6
2.00 FTE School Psychologists $101,870 per FTE
After 6 month ramp-up
Tele-psychiatrist
Exhibit C, Page 2 of 21
These staff include: 1.00 Director at $121,939 per FTE, 0.83 Administrative Assistant at $64,271
per FTE, 0.83 Behavioral Health Program Supervisor at $118,828 per FTE, 1.67 Program
Assistants at $53,497 per FTE, 0.83 Behavioral Health Clinical Supervisor at $104,472 per FTE,
6.67 Behavioral Health Clinicians II at $93,057 per FTE, 14.67 Behavioral Health Clinicians I at
$83,598 per FTE, 1.17 Psychologists at $101,870 per FTE, 6.67 Intensive Behavior
Intervention Specialists at $59,990 per FTE, 0.70 Office Assistant at $44,245 per FTE, 0.75
Department Automation Specialist at $61,659 per FTE, 1.00 Accountant at $70,741 per FTE,
0.65 Accounting Technician at $52,597 per FTE, 1.33 Nurses at $94,061 per FTE, 0.75
Psychiatrist at $212,876 per FTE, 0.25 Financial Officer at $126,332 per FTE, 1.50 Program
Managers at $112,295 per FTE, 0.80 PBIS Coaches at $93,057 per FTE, and 0.20 Administrator
at $153,501 per FTE. ($3,588,391)
PAYROLL TAXES will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools. ($242,484)
EMPLOYEE BENEFITS will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools ($1,342,482)
Facilities/Equipment Expenses – Line Items 1010-1014
Facilities and Equipment expenses include rent or lease of buildings and equipment, utilities,
building maintenance and equipment purchases.
1010 (Rent/Lease Building): This line item reflects 20,000 square feet office space and Hub
costs. The estimated amount is $2.20 per square foot per month. ($528,000)
1012 (Utilities): This includes cost for utilities such as PG&E, water/garbage, etc. ($151,200)
1013 (Building Maintenance): This includes building maintenance, security, and janitorial
services and damages to any of the building if caused by a client. ($45,600)
1014 (Equipment purchase): This reflects the cost of purchasing desks, couches, both
stationary and portable tables, chairs, bookcases, file cabinets, shredder, trash cans, shelves,
cell and landline phones, and other usual and customary office equipment. ($16,667)
Exhibit C, Page 3 of 21
Operating Expenses – Line Items 1060-1080
Operating costs include the following: communications including cell phones monthly charges
for program use, postage, lease of copier equipment, printing and reproduction costs due to
subscriptions, office supplies, client food, program supplies, staff mileage, vehicle leases,
insurance, gas, oil & tire, office maintenance, staff education and per diem when attending
trainings, licenses, taxes, building security.
1060 (Telephone): Cell phones and landline use. ($60,250)
1061 (Answering Service): After-hours answering service. ($5,000)
1062 (Postage): Postage in order to provide documents through mail service to schools and
community agencies relating to Specialty Mental Health. ($3,300)
1063 (Printing/Reproduction): Training materials provided for team trainings, therapy
documents, case notes, flyers, brochures, etc. A proportionate share of the copier lease will be
charged to this line. The estimate is calculated at $6.00 per person per day at 225 days.
Marketing and Infographics for brochures will be included in Ramp-Up. ($114,251)
1064 (Publications): Includes expenses for the publication of notices & reports. ($1,000)
1066 (Office Supplies & Equipment): Reflects office supplies that are generally used, such as
laptops, printers, desktops, iPad, scissors, tape, staplers, power strips, hole-punch, cutting
board, business cards, envelopes, paper clips, pencil sharpeners, wastebaskets, etc.
($152,994)
1067 (Household Supplies): Reflects cleaning supplies such as microfiber cloths, Windex,
Clorox wipes, dish-soap, sponges, hand sanitizer, Kleenex, etc. ($2,250)
1068 (Food): Reflects costs of providing food and beverages such as soft drinks and water for
trainings as well as for clients as needed such as granola bars and water. ($4,500)
1069 (Program Supplies-Therapeutic): Reflects costs for toys, assessment instruments,
protocols, crayons, play barn, etc. ($22,500)
1070 (Program Supplies-Medical): Reflects costs for gloves, vision and hearing
supplies/equipment, first aid supplies, AED devise, etc. ($22,500)
1071 (Transportation of Clients): Reflects cost of leasing three (3) vehicles to transport clients to
and from Hubs. The estimated cost is based upon $600 per month per vehicle. ($21,600)
1072 (Staff mileage and vehicle maintenance): Cost of staff mileage reimbursement per year
for traveling to schools, Hubs, parent homes or in the community (i.e. McDonalds) in order to
provide services. Transportation of clients to and from appointments, if needed. Mileage will be
reimbursed at the IRS established rate. The estimated cost is based upon $5,000 per FTE that is
expected to travel, such as Behavioral Health Clinicians. ($154,000)
1073 (Staff Travel-Out of County): Trainings that are Evidence-based practices (EBP) may be
subject to out of town travel. ($39,618)
1074 (Staff Training and Release Time): The cost is to assist the schools in releasing staff
and teachers in order to participate in the training. Trainings will include the following: Trauma-
informed CBT, Child Psychotherapy, Positive Discipline, NCI, etc. ($27,880)
1075 (Lodging): Trainings that are EBP and necessitate lodging. ($18,750)
Exhibit C, Page 4 of 21
1076 (Parking Validation): Cost reflects validation for parking for parents, PBIS coaches, or
teachers for each Hub. ($2,500)
1077 (Recruitment): Reflects cost to recruit staff. ($75,390)
Financial Services Expenses – Line Items 1080-1085
1083 (Administrative Overhead @ 15%): Indirect costs are those costs of general
management that are agency-wide. General management costs consist of expenditures for
administrative activities necessary for the general operation of the County Office of Education
(e.g., accounting, budgeting, payroll preparation, personnel management, purchasing, and
centralized data processing). The standardized method to recover indirect costs from programs
without having to time-account for the general administrative support provided to each program
is referred to as the indirect cost rate process. The indirect cost rate process in California is
based on the California Department of Education’s (CDE’s) federally approved indirect cost plan
for K-12 Local Education Agency’s (LEAs), which includes county offices of education.
California’s plan includes specific guideline on indirect cost components, including the indirect
cost pool, base costs, and the carry-forward adjustment. The United States Department of
Education has approved the fixed-with-carry-forward restricted rate methodology for calculating
indirect cost rates for California LEAs. CDE has been delegated authority to calculate and
approve indirect cost rates annually for LEAs. ($1,019,479)
Special Expenses – Line Items 1090-1201
1090 (Consultation – network & data management): This budget is for MOUs for Districts,
training (i.e. HIPAA, FERPA). Assisting with providing training for staff specifically related to
providing mental health services in schools. Also, help with the telemedicine treatments.
($10,500)
1090.1 (Legal Fees): This budget is for professional legal fees in the area of HIPAA, FERPA
related to Specialty Mental Health and Schools and Behavioral Health Positions; training for staff
that is specifically related to Mental Health Services in our Schools; MOUs between FCSS,
Mental Health and our districts, Psychiatry and pediatrician - Telemedicine Agreements.
($60,000)
1091 (Translation Services): Translation services will be provided as needed through an
outside contractor. We do have several languages spoken by our staff; however, we may need
translator for languages that are not spoken by staff, such as Hmong, Punjabi, or a client who is
deaf. ($75,000)
Total Program Expense: $7,808,085
Exhibit C, Page 5 of 21
BEHAVIORAL HEALTH CONTRACT
FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
FY 2019-2020
F TE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Director 0.20 $26,351 $26,351 0.80 $105,405 $105,405 0.00 $0 $0 1.00 $131,756 $131,756
0002 Administrative Assistant 0.20 $13,234 $13,234 0.80 $52,937 $52,937 0.00 $0 $0 1.00 $66,171 $66,171
0003 Behavioral Health Program Supervisor 0.40 $49,411 $49,411 1.60 $197,642 $197,642 0.00 $0 $0 2.00 $247,053 $247,053
0004 Program Assistant 0.60 $33,376 $33,376 2.40 $133,504 $133,504 0.00 $0 $0 3.00 $166,880 $166,880
0005 Behavioral Health Clinician Supervisor 0.40 $43,024 $43,024 1.47 $157,749 $157,749 0.13 $14,340 $14,340 2.00 $215,113 $215,113
0006 Behavioral Health Clinician (II)2.60 $249,089 $249,089 10.13 $970,807 $970,807 0.27 $25,548 $25,548 13.00 $1,245,444 $1,245,444
0007 Behavioral Health Clinician (I)4.80 $413,092 $413,092 18.80 $1,617,946 $1,617,946 0.40 $34,424 $34,424 24.00 $2,065,462 $2,065,462
0008 Psychologist 0.00 $0 $0 2.00 $209,762 $209,762 0.00 $0 $0 2.00 $209,762 $209,762
0009 Intensive Behavior Intrv Spec 8.00 $494,256 $494,256 28.00 $1,729,896 $1,729,896 4.00 $247,128 $247,128 40.00 $2,471,280 $2,471,280
0010 Office Assistant 0.60 $27,612 $27,612 2.40 $110,447 $110,447 0.00 $0 $0 3.00 $138,059 $138,059
0011 Department Automation Specialist 0.20 $12,824 $12,824 0.80 $51,297 $51,297 0.00 $0 $0 1.00 $64,121 $64,121
0012 Accountant 0.20 $14,712 $14,712 0.80 $58,848 $58,848 0.00 $0 $0 1.00 $73,560 $73,560
0013 Accounting Technician 0.20 $10,946 $10,946 0.80 $43,781 $43,781 0.00 $0 $0 1.00 $54,727 $54,727
0016 Nurse 0.00 $0 $0 2.83 $274,426 $274,426 0.17 $16,142 $16,142 3.00 $290,568 $290,568
0017 Psychiatrist 0.00 $0 $0 1.50 $328,800 $328,800 0.00 $0 $0 1.50 $328,800 $328,800
0020 Financial Officer 0.00 $0 $0 1.00 $130,087 $130,087 0.00 $0 $0 1.00 $130,087 $130,087
0021 Program Manager II 0.50 $58,366 $58,366 1.00 $116,732 $116,732 0.00 $0 $0 1.50 $175,098 $175,098
0022 PBIS Coaches 0.80 $76,642 $76,642 0.00 $0 $0 0.00 $0 $0 0.80 $76,642 $76,642
0023 Administrator 0.04 $6,323 $6,323 0.16 $25,290 $25,290 0.00 $0 $0 0.20 $31,613 $31,613
$0 $0 $0 $0 $0
$0 $0 $0 $0 $0
SALARY TOTAL 19.74 $0 $1,529,258 $1,529,258 77.29 $0 $6,315,356 $6,315,356 4.97 $0 $337,582 $337,582 102.00 $0 $8,182,196 $8,182,196
PAYROLL TAXES:
0030 OASDI $0 $0 $0 $0 $0 $0
0031 FICA/MEDICARE $108,280 $108,280 $438,516 $438,516 $24,824 $24,824 $571,620 $571,620
0032 SUI $765 $765 $3,158 $3,158 $169 $169 $4,091 $4,091
PAYROLL TAX TOTAL $0 $109,045 $109,045 $0 $441,674 $441,674 $0 $24,993 $24,993 $0 $575,712 $575,712
EMPLOYEE BENEFITS:
0040 Retirement $327,166 $327,166 $1,344,468 $1,344,468 $73,006 $73,006 $1,744,640 $1,744,640
0041 Workers Compensation $33,185 $33,185 $137,043 $137,043 $7,326 $7,326 $177,554 $177,554
0042 Health Insurance (medical, vision, life, dental)$293,113 $293,113 $1,150,602 $1,150,602 $73,585 $73,585 $1,517,300 $1,517,300
EMPLOYEE BENEFITS TOTAL $0 $653,464 $653,464 $0 $2,632,113 $2,632,113 $0 $153,916 $153,916 $0 $3,439,494 $3,439,494
SALARY & BENEFITS GRAND TOTAL $2,291,767 $9,389,143 $516,491 $12,197,401
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $105,600 $598,400 $35,200 $739,200
1011 Rent/Lease Equipment $0 $0 $0 $0
1012 Utilities $30,240 $171,360 $10,080 $211,680
1013 Building Maintenance $9,120 $51,680 $3,040 $63,840
1014 Equipment purchase $0 $45,833 $4,167 $50,000
FACILITY/EQUIPMENT TOTAL $144,960 $867,273 $52,487 $1,064,720
OPERATING EXPENSES:
1060 Telephone $19,740 $77,293 $4,967 $102,000
1061 Answering Service $0 $10,000 $0 $10,000
1062 Postage $1,000 $3,733 $333 $5,067
1063 Printing/Reproduction $26,649 $104,346 $13,410 $144,405
1064 Publications $1,250 $1,167 $83 $2,500
1065 Legal Notices/Advertising $0 $0 $0 $0
1066 Office Supplies & Equipment $104,622 $46,667 $26,323 $177,612
1067 Household Supplies $1,000 $3,733 $267 $5,000
1068 Food $15,000 $0 $0 $15,000
1069 Program Supplies - Therapeutic $25,000 $23,333 $1,667 $50,000
1070 Program Supplies - Medical $25,000 $23,333 $1,667 $50,000
1071 Transportation of Clients $36,000 $33,600 $2,400 $72,000
1072 Staff Mileage/vehicle maintenance $88,500 $333,167 $0 $421,667
1073 Staff Travel (Out of County)$0 $0 $16,142 $16,142
1074 Staff Training/Registration $32,800 $30,613 $2,187 $65,600
1075 Lodging $25,000 $23,333 $1,667 $50,000
1076 Other - Parking $2,500 $2,333 $167 $5,000
1077 Other - Recruitment $2,500 $2,333 $14,900 $19,733
1078 Other - Licenses $0 $0 $0 $0
OPERATING EXPENSES TOTAL $406,561 $718,986 $86,178 $1,211,725
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0 $0 $0 $0
1081 External Audit $0 $0 $0 $0
1082 Liability Insurance $0 $0 $0 $0
1083 Administrative Overhead $429,442 $1,686,606 $102,773 $2,218,822
1084 Payroll Services $0 $0 $0 $0
1085 Professional Liability Insurance $0 $0 $0 $0
FINANCIAL SERVICES TOTAL $429,442 $1,686,606 $102,773 $2,218,822
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$17,500 $0 $0 $17,500
1090.1 Legal Fees $0 $120,000 $0 $120,000
1091 Translation Services $0 $140,000 $30,000 $170,000
1092 Medication Supports $0 $0 $0 $0
SPECIAL EXPENSES TOTAL $17,500 $260,000 $30,000 $307,500
FIXED ASSETS:
1190 Computers & Software $0 $0 $0 $0
1191 Furniture & Fixtures $0 $0 $0 $0
1192 Other - (Identify)$0 $0 $0 $0
1193 Other - (Identify)$0 $0 $0 $0
FIXED ASSETS TOTAL $0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenditures (SFC 70)$0 $0 $0 $0
2001 Client Housing Operating Expenditures (SFC 71)$0 $0 $0 $0
2002.1 Clothing, Food & Hygiene (SFC 72)$0 $0 $0 $0
2002.2 Client Transportation & Support (SFC 72)$0 $0 $0 $0
2002.3 Education Support (SFC 72)$0 $0 $0 $0
2002.4 Employment Support (SFC 72)$0 $0 $0 $0
2002.5 Respite Care (SFC 72)$0 $0 $0 $0
2002.6 Household Items $0 $0 $0 $0
2002.7 Utility Vouchers (SFC 72)$0 $0 $0 $0
2002.8 Child Care (SFC 72)$0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0 $0 $0 $0
TOTAL PROGRAM EXPENSES $3,290,230 TOTAL PROGRAM EXPENSES $12,922,009 TOTAL PROGRAM EXPENSES $787,930 TOTAL PROGRAM EXPENSES $17,000,168
MEDI-CAL REVENUE:Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 1,562,314 $4.01 $6,267,530 0 $0.00 $0 1,562,314 $4.01 $6,267,530
3100 Case Management 0 $0.00 $0 688,975 $3.10 $2,139,157 0 $0.00 $0 688,975 $3.10 $2,139,157
3200 Crisis Services 0 $0.00 $0 114,069 $5.96 $680,277 0 $0.00 $0 114,069 $5.96 $680,277
3300 Medication Support 0 $0.00 $0 110,700 $7.41 $820,129 0 $0.00 $0 110,700 $7.41 $820,129
3400 Collateral 0 $0.00 $0 258,888 $4.01 $1,038,582 0 $0.00 $0 258,888 $4.01 $1,038,582
3500 Plan Development 0 $0.00 $0 177,068 $4.01 $710,344 0 $0.00 $0 177,068 $4.01 $710,344
3600 Assessment 0 $0.00 $0 63,571 $4.01 $255,027 0 $0.00 $0 63,571 $4.01 $255,027
3700 Rehabilitation 0 $0.00 $0 600,484 $4.01 $2,408,959 0 $0.00 $0 600,484 $4.01 $2,408,959
Estimated Specialty Mental Health Services Billing Totals 0 $0ng Totals 3,576,069 $14,320,006ng Totals 0 $0ng Totals 3,576,069 $14,320,006
Estimated % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%d % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $11,456,004 h Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $11,456,004
0.00%$0 80.00%$9,164,804 0.00%$0 80.00%$9,164,804
0.00%$0 0.00%$0 0.00%$0 0.00%$0
MEDI-CAL REVENUE TOTAL $0 $9,164,804 $0 $9,164,804
OTHER REVENUE:
4100 Other - (Identify)$0 $0 $0 $0
4200 Other - (Identify)$0 $0 $0 $0
4300 Other - (Identify)$0 $0 $0 $0
OTHER REVENUE TOTAL $0 $0 $0 $0
MENTAL HEALTH SERVICES ACT (MHSA) REVENUE:
5000 Prevention & Early Intervention (PEI) Funds $3,290,230 $0 $0 $3,290,230
5100 Community Services & Supports (CSS) Funds $0 $3,757,205 $787,930 $4,545,135
5200 Innovation (INN) Funds $0 $0 $0 $0
5300 Workforce Education & Training (WET) Funds $0 $0 $0 $0
MHSA FUNDS TOTAL $3,290,230 $3,757,205 $787,930 $7,835,365
TOTAL PROGRAM REVENUE $3,290,230 TOTAL PROGRAM REVENUE $12,922,009 TOTAL PROGRAM REVENUE $787,930 TOTAL PROGRAM REVENUE $17,000,168
Budget Categories -PEI Budget CSS Budget
Line Item Description (Must be itemized)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Ramp-Up CSS Budget Total Proposed Budget
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Exhibit C, Page 6 of 21
Behavioral Health Contract
Budget Narrative
FY 2019-2020
PROGRAM EXPENSES
Personnel Salaries, Payroll Taxes & Employee Benefits – Line Items 0001-0042
0001 through 0042: These amounts reflect staff that are needed to perform the duties of
specialty mental health services and related activities. Full-time equivalent (FTE) is provided for
each position.
These staff include: 1.00 Director at $131,756 per FTE, 1.00 Administrative Assistant at $66,171
per FTE, 2.00 Behavioral Health Program Supervisor at $123,526 per FTE, 3.00 Program
Assistants at $55,626 per FTE, 2.00 Behavioral Health Clinical Supervisor at $107,556 per FTE,
13.00 Behavioral Health Clinicians II at $95,803 per FTE, 24.00 Behavioral Health Clinicians I at
$86,061 per FTE, 2.00 Psychologists at $104,881 per FTE, 40.00 Intensive Behavior
Intervention Specialists at $61,782 per FTE, 3.00 Office Assistant at $46,020 per FTE, 1.00
Department Automation Specialist at $64,122 per FTE, 1.00 Accountant at $73,560 per FTE,
1.00 Accounting Technician at $54,726 per FTE, 3.00 Nurses at $96,856 per FTE, 1.50
Psychiatrist at $219,200 per FTE, 1.00 Financial Officer at $130,087 per FTE, 1.50 Program
Managers at $116,732 per FTE, 0.80 PBIS Coaches at $95,803 per FTE, and 0.20 Administrator
at $158,061 per FTE. ($8,182,196)
PAYROLL TAXES will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools. ($575,712)
EMPLOYEE BENEFITS will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools ($3,439,494)
Facilities/Equipment Expenses – Line Items 1010-1014
Facilities and Equipment expenses include rent or lease of buildings and equipment, utilities,
building maintenance and equipment purchases.
1010 (Rent/Lease Building): This line item reflects 28,000 square feet of office space and Hub
costs. The estimated amount is $2.20 per square foot per month. ($739,200)
1012 (Utilities): This includes cost for utilities such as PG&E, water/garbage, etc. ($211,680)
1013 (Building Maintenance): This includes building maintenance, security, and janitorial
services and damages to any of the building if caused by a client. ($63,840)
1014 (Equipment purchase): This reflects the cost of purchasing desks, couches, both
stationary and portable tables, chairs, bookcases, file cabinets, shredder, trash cans, shelves,
cell and landline phones, and other usual and customary office equipment. ($50,000)
Exhibit C, Page 7 of 21
Operating Expenses – Line Items 1060-1080
Operating costs include the following: communications including cell phones monthly charges
for program use, postage, lease of copier equipment, printing and reproduction costs due to
subscriptions, office supplies, client food, program supplies, staff mileage, vehicle leases,
insurance, gas, oil & tire, office maintenance, staff education and per diem when attending
trainings, licenses, taxes, building security.
1060 (Telephone): Cell phones and landline use. ($102,000)
1061 (Answering Service): After-hours answering service. ($10,000)
1062 (Postage): Postage in order to provide documents through mail service to schools and
community agencies relating to Specialty Mental Health. ($5,067)
1063 (Printing/Reproduction): Training materials provided for team trainings, therapy
documents, case notes, flyers, brochures, etc. A proportionate share of the copier lease will be
charged to this line. The estimate is calculated at $6.00 per person per day at 225 days.
Marketing and Infographics for brochures will be included in Ramp-Up. ($144,405)
1064 (Publications): Includes expenses for the publication of notices & reports. ($2,500)
1066 (Office Supplies & Equipment): Reflects office supplies that are generally used, such as
laptops, printers, desktops, iPad, scissors, tape, staplers, power strips, hole-punch, cutting
board, business cards, envelopes, paper clips, pencil sharpeners, wastebaskets, etc.
($177,612)
1067 (Household Supplies): Reflects cleaning supplies such as microfiber cloths, Windex,
Clorox wipes, dish-soap, sponges, hand sanitizer, Kleenex, etc. ($5,000)
1068 (Food): Reflects costs of providing food and beverages such as soft drinks and water for
trainings as well as for clients as needed such as granola bars and water. ($15,000)
1069 (Program Supplies-Therapeutic): Reflects costs for toys, assessment instruments,
protocols, crayons, play barn, etc. ($50,000)
1070 (Program Supplies-Medical): Reflects costs for gloves, vision and hearing
supplies/equipment, first aid supplies, AED devise, etc. ($50,000)
1071 (Transportation of Clients): Reflects cost of leasing ten (10) vehicles to transport clients to
and from Hubs. The estimated cost is based upon $600 per month per vehicle. ($72,000)
1072 (Staff mileage and vehicle maintenance): Cost of staff mileage reimbursement per year
for traveling to schools, Hubs, parent homes or in the community (i.e. McDonalds) in order to
provide services. Transportation of clients to and from appointments, if needed. Mileage will be
reimbursed at the IRS established rate. The estimated cost is based upon $5,000 per FTE that is
expected to travel, such as Behavioral Health Clinicians. ($421,667)
1073 (Staff Travel-Out of County): Trainings that are Evidence-based practices (EBP) may be
subject to out of town travel. ($16,142)
1074 (Staff Training and Release Time): The cost is to assist the schools in releasing staff
and teachers in order to participate in the training. Trainings will include the following: Trauma-
informed CBT, Child Psychotherapy, Positive Discipline, NCI, etc. ($65,600)
1075 (Lodging): Trainings that are EBP and necessitate lodging. ($50,000)
Exhibit C, Page 8 of 21
1076 (Parking Validation): Cost reflects validation for parking for parents, PBIS coaches, or
teachers needing to attend training at the downtown location. ($5,000)
1077 (Recruitment): Reflects cost to recruit staff. ($19,733)
Financial Services Expenses – Line Items 1080-1085
1083 (Administrative Overhead @ 15%): Indirect costs are those costs of general
management that are agency-wide. General management costs consist of expenditures for
administrative activities necessary for the general operation of the County Office of Education
(e.g., accounting, budgeting, payroll preparation, personnel management, purchasing, and
centralized data processing). The standardized method to recover indirect costs from programs
without having to time-account for the general administrative support provided to each program
is referred to as the indirect cost rate process. The indirect cost rate process in California is
based on the California Department of Education’s (CDE’s) federally approved indirect cost plan
for K-12 Local Education Agency’s (LEAs), which includes county offices of education.
California’s plan includes specific guideline on indirect cost components, including the indirect
cost pool, base costs, and the carry-forward adjustment. The United States Department of
Education has approved the fixed-with-carry-forward restricted rate methodology for calculating
indirect cost rates for California LEAs. CDE has been delegated authority to calculate and
approve indirect cost rates annually for LEAs. ($2,218,822)
Special Expenses – Line Items 1090-1201
1090 (Consultation – network & data management): This budget is for MOUs for Districts,
training (i.e. HIPAA, FERPA). Assisting with providing training for staff specifically related to
providing mental health services in schools. Also, help with the telemedicine treatments.
($17,500)
1090.1 (Legal Fees): This budget is for professional legal fees in the area of HIPAA, FERPA
related to Specialty Mental Health and Schools and Behavioral Health Positions; training for staff
that is specifically related to Mental Health Services in our Schools; MOUs between FCSS,
Mental Health and our districts, Psychiatry and pediatrician - Telemedicine Agreements.
($120,000)
1091 (Translation Services): Translation services will be provided as needed through an
outside contractor. We do have several languages spoken by our staff; however, we may need
translator for languages that are not spoken by staff, such as Hmong, Punjabi, or a client who is
deaf. ($170,000)
Total Program Expense: $17,000,168
Exhibit C, Page 9 of 21
BEHAVIORAL HEALTH CONTRACT
FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
FY 2020-2021
F TE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Director 0.20 $28,474 $28,474 0.80 $113,897 $113,897 0.00 $0 $0 1.00 $142,371 $142,371
0002 Administrative Assistant 0.20 $13,627 $13,627 0.80 $54,507 $54,507 0.00 $0 $0 1.00 $68,134 $68,134
0003 Behavioral Health Program Supervisor 0.40 $50,874 $50,874 1.60 $203,499 $203,499 0.00 $0 $0 2.00 $254,373 $254,373
0004 Program Assistant 0.80 $45,804 $45,804 3.20 $183,217 $183,217 0.00 $0 $0 4.00 $229,021 $229,021
0005 Behavioral Health Clinician Supervisor 0.60 $66,444 $66,444 2.27 $251,001 $251,001 0.13 $14,764 $14,764 3.00 $332,209 $332,209
0006 Behavioral Health Clinician (II)3.00 $295,896 $295,896 11.73 $1,157,288 $1,157,288 0.27 $26,302 $26,302 15.00 $1,479,486 $1,479,486
0007 Behavioral Health Clinician (I)5.60 $496,147 $496,147 21.87 $1,937,336 $1,937,336 0.53 $47,252 $47,252 28.00 $2,480,735 $2,480,735
0008 Psychologist 0.00 $0 $0 2.00 $215,965 $215,965 0.00 $0 $0 2.00 $215,965 $215,965
0009 Intensive Behavior Intrv Spec 12.00 $763,656 $763,656 45.33 $2,884,922 $2,884,922 2.67 $169,702 $169,702 60.00 $3,818,280 $3,818,280
0010 Office Assistant 0.80 $37,918 $37,918 3.20 $151,672 $151,672 0.00 $0 $0 4.00 $189,590 $189,590
0011 Department Automation Specialist 0.20 $13,209 $13,209 0.80 $52,835 $52,835 0.00 $0 $0 1.00 $66,044 $66,044
0012 Accountant 0.40 $30,310 $30,310 1.60 $121,237 $121,237 0.00 $0 $0 2.00 $151,547 $151,547
0013 Accounting Technician 0.20 $11,271 $11,271 0.80 $45,084 $45,084 0.00 $0 $0 1.00 $56,355 $56,355
0016 Nurse 0.00 $0 $0 3.83 $382,314 $382,314 0.17 $16,622 $16,622 4.00 $398,936 $398,936
0017 Psychiatrist 0.00 $0 $0 1.50 $338,569 $338,569 0.00 $0 $0 1.50 $338,569 $338,569
0020 Financial Officer 0.00 $0 $0 1.00 $133,966 $133,966 0.00 $0 $0 1.00 $133,966 $133,966
0021 Program Manager II 0.50 $60,094 $60,094 1.00 $120,189 $120,189 0.00 $0 $0 1.50 $180,283 $180,283
0022 PBIS Coaches 0.80 $78,906 $78,906 0.00 $0 $0 0.00 $0 $0 0.80 $78,906 $78,906
0023 Administrator 0.04 $6,607 $6,607 0.16 $26,425 $26,425 0.00 $0 $0 0.20 $33,032 $33,032
$0 $0 $0 $0 $0
$0 $0 $0 $0 $0
SALARY TOTAL 25.74 $0 $1,999,237 $1,999,237 103.49 $0 $8,373,923 $8,373,923 3.77 $0 $274,642 $274,642 133.00 $0 $10,647,802 $10,647,802
PAYROLL TAXES:
0030 OASDI $0 $0 $0 $0 $0 $0
0031 FICA/MEDICARE $143,886 $143,886 $588,133 $588,133 $19,980 $19,980 $751,999 $751,999
0032 SUI $1,000 $1,000 $4,187 $4,187 $137 $137 $5,324 $5,324
PAYROLL TAX TOTAL $0 $144,886 $144,886 $0 $592,320 $592,320 $0 $20,117 $20,117 $0 $757,323 $757,323
EMPLOYEE BENEFITS:
0040 Retirement $480,125 $480,125 $1,997,694 $1,997,694 $66,249 $66,249 $2,544,068 $2,544,068
0041 Workers Compensation $43,383 $43,383 $181,714 $181,714 $5,960 $5,960 $231,057 $231,057
0042 Health Insurance (medical, vision, life, dental)$401,198 $401,198 $1,616,765 $1,616,765 $58,737 $58,737 $2,076,700 $2,076,700
EMPLOYEE BENEFITS TOTAL $0 $924,707 $924,707 $0 $3,796,174 $3,796,174 $0 $130,945 $130,945 $0 $4,851,826 $4,851,826
SALARY & BENEFITS GRAND TOTAL $3,068,830 $12,762,417 $425,704 $16,256,951
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $105,600 $809,600 $35,200 $950,400
1011 Rent/Lease Equipment $0 $0 $0 $0
1012 Utilities $30,240 $231,840 $10,080 $272,160
1013 Building Maintenance $9,120 $69,920 $3,040 $82,080
1014 Equipment purchase $0 $91,667 $8,333 $100,000
FACILITY/EQUIPMENT TOTAL $144,960 $1,203,027 $56,653 $1,404,640
OPERATING EXPENSES:
1060 Telephone $25,740 $103,493 $3,767 $133,000
1061 Answering Service $0 $10,000 $0 $10,000
1062 Postage $1,400 $5,333 $333 $7,067
1063 Printing/Reproduction $34,749 $139,716 $10,170 $184,635
1064 Publications $1,750 $1,667 $83 $3,500
1065 Legal Notices/Advertising $0 $0 $0 $0
1066 Office Supplies & Equipment $136,422 $66,667 $19,963 $223,052
1067 Household Supplies $1,400 $5,333 $267 $7,000
1068 Food $21,000 $0 $0 $21,000
1069 Program Supplies - Therapeutic $35,000 $33,333 $1,667 $70,000
1070 Program Supplies - Medical $35,000 $33,333 $1,667 $70,000
1071 Transportation of Clients $50,400 $48,000 $2,400 $100,800
1072 Staff Mileage/vehicle maintenance $115,500 $452,167 $0 $567,667
1073 Staff Travel (Out of County)$0 $0 $12,242 $12,242
1074 Staff Training/Registration $45,920 $43,733 $2,187 $91,840
1075 Lodging $35,000 $33,333 $1,667 $70,000
1076 Other - Parking $3,500 $3,333 $167 $7,000
1077 Other - Recruitment $3,500 $3,333 $11,300 $18,133
1078 Other - Licenses $0 $0 $0 $0
OPERATING EXPENSES TOTAL $546,281 $982,776 $67,878 $1,596,935
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0 $0 $0 $0
1081 External Audit $0 $0 $0 $0
1082 Liability Insurance $0 $0 $0 $0
1083 Administrative Overhead $568,010 $2,291,529 $87,035 $2,946,574
1084 Payroll Services $0 $0 $0 $0
1085 Professional Liability Insurance $0 $0 $0 $0
FINANCIAL SERVICES TOTAL $568,010 $2,291,529 $87,035 $2,946,574
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$24,500 $0 $0 $24,500
1090.1 Legal Fees $0 $120,000 $0 $120,000
1091 Translation Services $0 $200,000 $30,000 $230,000
1092 Medication Supports $0 $0 $0 $0
SPECIAL EXPENSES TOTAL $24,500 $320,000 $30,000 $374,500
FIXED ASSETS:
1190 Computers & Software $0 $0 $0 $0
1191 Furniture & Fixtures $0 $0 $0 $0
1192 Other - (Identify)$0 $0 $0 $0
1193 Other - (Identify)$0 $0 $0 $0
FIXED ASSETS TOTAL $0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenditures (SFC 70)$0 $0 $0 $0
2001 Client Housing Operating Expenditures (SFC 71)$0 $0 $0 $0
2002.1 Clothing, Food & Hygiene (SFC 72)$0 $0 $0 $0
2002.2 Client Transportation & Support (SFC 72)$0 $0 $0 $0
2002.3 Education Support (SFC 72)$0 $0 $0 $0
2002.4 Employment Support (SFC 72)$0 $0 $0 $0
2002.5 Respite Care (SFC 72)$0 $0 $0 $0
2002.6 Household Items $0 $0 $0 $0
2002.7 Utility Vouchers (SFC 72)$0 $0 $0 $0
2002.8 Child Care (SFC 72)$0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0 $0 $0 $0
TOTAL PROGRAM EXPENSES $4,352,581 TOTAL PROGRAM EXPENSES $17,559,749 TOTAL PROGRAM EXPENSES $667,271 TOTAL PROGRAM EXPENSES $22,579,600
MEDI-CAL REVENUE:Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 1,971,622 $4.01 $7,909,553 0 $0.00 $0 1,971,622 $4.01 $7,909,553
3100 Case Management 0 $0.00 $0 1,051,109 $3.10 $3,263,523 0 $0.00 $0 1,051,109 $3.10 $3,263,523
3200 Crisis Services 0 $0.00 $0 143,575 $5.96 $856,243 0 $0.00 $0 143,575 $5.96 $856,243
3300 Medication Support 0 $0.00 $0 110,700 $7.41 $820,129 0 $0.00 $0 110,700 $7.41 $820,129
3400 Collateral 0 $0.00 $0 363,257 $4.01 $1,457,276 0 $0.00 $0 363,257 $4.01 $1,457,276
3500 Plan Development 0 $0.00 $0 219,303 $4.01 $879,776 0 $0.00 $0 219,303 $4.01 $879,776
3600 Assessment 0 $0.00 $0 76,044 $4.01 $305,064 0 $0.00 $0 76,044 $4.01 $305,064
3700 Rehabilitation 0 $0.00 $0 941,586 $4.01 $3,777,359 0 $0.00 $0 941,586 $4.01 $3,777,359
Estimated Specialty Mental Health Services Billing Totals 0 $0ng Totals 4,877,195 $19,268,924ng Totals 0 $0ng Totals 4,877,195 $19,268,924
Estimated % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%d % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $15,415,139 h Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $15,415,139
0.00%$0 80.00%$12,332,112 0.00%$0 80.00%$12,332,112
0.00%$0 0.00%$0 0.00%$0 0.00%$0
MEDI-CAL REVENUE TOTAL $0 $12,332,112 $0 $12,332,112
OTHER REVENUE:
4100 Other - (Identify)$0 $0 $0 $0
4200 Other - (Identify)$0 $0 $0 $0
4300 Other - (Identify)$0 $0 $0 $0
OTHER REVENUE TOTAL $0 $0 $0 $0
MENTAL HEALTH SERVICES ACT (MHSA) REVENUE:
5000 Prevention & Early Intervention (PEI) Funds $4,352,581 $0 $0 $4,352,581
5100 Community Services & Supports (CSS) Funds $0 $5,227,637 $667,271 $5,894,908
5200 Innovation (INN) Funds $0 $0 $0 $0
5300 Workforce Education & Training (WET) Funds $0 $0 $0 $0
MHSA FUNDS TOTAL $4,352,581 $5,227,637 $667,271 $10,247,489
TOTAL PROGRAM REVENUE $4,352,581 TOTAL PROGRAM REVENUE $17,559,749 TOTAL PROGRAM REVENUE $667,271 TOTAL PROGRAM REVENUE $22,579,600
Budget Categories -PEI Budget CSS Budget
Line Item Description (Must be itemized)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Ramp-Up CSS Budget Total Proposed Budget
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Exhibit C, Page 10 of 21
Behavioral Health Contract
Budget Narrative
FY 2020-2021
PROGRAM EXPENSES
Personnel Salaries, Payroll Taxes & Employee Benefits – Line Items 0001-0042
0001 through 0042: These amounts reflect staff that are needed to perform the duties of
specialty mental health services and related activities. Full-time equivalent (FTE) is provided for
each position.
These staff include: 1.00 Director at $142,372 per FTE, 1.00 Administrative Assistant at $68,134
per FTE, 2.00 Behavioral Health Program Supervisor at $127,187 per FTE, 4.00 Program
Assistants at $57,255 per FTE, 3.00 Behavioral Health Clinical Supervisor at $110,736 per FTE,
15.00 Behavioral Health Clinicians II at $98,632 per FTE, 28.00 Behavioral Health Clinicians I at
$88,598 per FTE, 2.00 Psychologists at $107,982 per FTE, 60.00 Intensive Behavior
Intervention Specialists at $63,638 per FTE, 4.00 Office Assistant at $47,398 per FTE, 1.00
Department Automation Specialist at $66,043 per FTE, 2.00 Accountant at $75,774 per FTE,
1.00 Accounting Technician at $56,355 per FTE, 4.00 Nurses at $99,734 per FTE, 1.50
Psychiatrist at $225,713 per FTE, 1.00 Financial Officer at $133,965 per FTE, 1.50 Program
Managers at $120,189 per FTE, 0.80 PBIS Coaches at $98,633 per FTE, and 0.20 Administrator
at $165,153 per FTE. ($10,647,802)
PAYROLL TAXES will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools. ($757,323)
EMPLOYEE BENEFITS will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools ($4,851,826)
Facilities/Equipment Expenses – Line Items 1010-1014
Facilities and Equipment expenses include rent or lease of buildings and equipment, utilities,
building maintenance and equipment purchases.
1010 (Rent/Lease Building): This line item reflects 36,000 square feet of office space and Hub
costs. The estimated amount is $2.20 per square foot per month. ($950,400)
1012 (Utilities): This includes cost for utilities such as PG&E, water/garbage, etc. ($272,160)
1013 (Building Maintenance): This includes building maintenance, security, and janitorial
services and damages to any of the building if caused by a client. ($82,080)
1014 (Equipment purchase): This reflects the cost of purchasing desks, couches, both
stationary and portable tables, chairs, bookcases, file cabinets, shredder, trash cans, shelves,
cell and landline phones, and other usual and customary office equipment. ($100,000)
Exhibit C, Page 11 of 21
Operating Expenses – Line Items 1060-1080
Operating costs include the following: communications including cell phones monthly charges
for program use, postage, lease of copier equipment, printing and reproduction costs due to
subscriptions, office supplies, client food, program supplies, staff mileage, vehicle leases,
insurance, gas, oil & tire, office maintenance, staff education and per diem when attending
trainings, licenses, taxes, building security.
1060 (Telephone): Cell phones and landline use. ($133,000)
1061 (Answering Service): After-hours answering service. ($10,000)
1062 (Postage): Postage in order to provide documents through mail service to schools and
community agencies relating to Specialty Mental Health. ($7,067)
1063 (Printing/Reproduction): Training materials provided for team trainings, therapy
documents, case notes, flyers, brochures, etc. A proportionate share of the copier lease will be
charged to this line. The estimate is calculated at $6.00 per person per day at 225 days.
Marketing and Infographics for brochures will be included in Ramp-Up. ($184,635)
1064 (Publications): Includes expenses for the publication of notices & reports. ($3,500)
1066 (Office Supplies & Equipment): Reflects office supplies that are generally used, such as
laptops, printers, desktops, iPad, scissors, tape, staplers, power strips, hole-punch, cutting
board, business cards, envelopes, paper clips, pencil sharpeners, wastebaskets, etc.
($223,052)
1067 (Household Supplies): Reflects cleaning supplies such as microfiber cloths, Windex,
Clorox wipes, dish-soap, sponges, hand sanitizer, Kleenex, etc. ($7,000)
1068 (Food): Reflects costs of providing food and beverages such as soft drinks and water for
trainings as well as for clients as needed such as granola bars and water. ($21,000)
1069 (Program Supplies-Therapeutic): Reflects costs for toys, assessment instruments,
protocols, crayons, play barn, etc. ($70,000)
1070 (Program Supplies-Medical): Reflects costs for gloves, vision and hearing
supplies/equipment, first aid supplies, AED devise, etc. ($70,000)
1071 (Transportation of Clients): Reflects cost of leasing fourteen (14) vehicles to transport clients
to and from Hubs. The estimated cost is based upon $600 per month per vehicle. ($100,800)
1072 (Staff mileage and vehicle maintenance): Cost of staff mileage reimbursement per year
for traveling to schools, Hubs, parent homes or in the community (i.e. McDonalds) in order to
provide services. Transportation of clients to and from appointments, if needed. Mileage will be
reimbursed at the IRS established rate. The estimated cost is based upon $5,000 per FTE that is
expected to travel, such as Behavioral Health Clinicians. ($567,667)
1073 (Staff Travel-Out of County): Trainings that are Evidence-based practices (EBP) may be
subject to out of town travel. ($12,242)
1074 (Staff Training and Release Time): The cost is to assist the schools in releasing staff
and teachers in order to participate in the training. Trainings will include the following: Trauma-
informed CBT, Child Psychotherapy, Positive Discipline, NCI, etc. ($91,840)
1075 (Lodging): Trainings that are EBP and necessitate lodging. ($70,000)
Exhibit C, Page 12 of 21
1076 (Parking Validation): Cost reflects validation for parking for parents, PBIS coaches, or
teachers needing to attend training at the downtown location. ($7,000)
1077 (Recruitment): Reflects cost to recruit staff. ($18,133)
Financial Services Expenses – Line Items 1080-1085
1083 (Administrative Overhead @ 15%): Indirect costs are those costs of general
management that are agency-wide. General management costs consist of expenditures for
administrative activities necessary for the general operation of the County Office of Education
(e.g., accounting, budgeting, payroll preparation, personnel management, purchasing, and
centralized data processing). The standardized method to recover indirect costs from programs
without having to time-account for the general administrative support provided to each program
is referred to as the indirect cost rate process. The indirect cost rate process in California is
based on the California Department of Education’s (CDE’s) federally approved indirect cost plan
for K-12 Local Education Agency’s (LEAs), which includes county offices of education.
California’s plan includes specific guideline on indirect cost components, including the indirect
cost pool, base costs, and the carry-forward adjustment. The United States Department of
Education has approved the fixed-with-carry-forward restricted rate methodology for calculating
indirect cost rates for California LEAs. CDE has been delegated authority to calculate and
approve indirect cost rates annually for LEAs. ($2,946,574)
Special Expenses – Line Items 1090-1201
1090 (Consultation – network & data management): This budget is for MOUs for Districts,
training (i.e. HIPAA, FERPA). Assisting with providing training for staff specifically related to
providing mental health services in schools. Also, help with the telemedicine treatments.
($24,500)
1090.1 (Legal Fees): This budget is for professional legal fees in the area of HIPAA, FERPA
related to Specialty Mental Health and Schools and Behavioral Health Positions; training for staff
that is specifically related to Mental Health Services in our Schools; MOUs between FCSS,
Mental Health and our districts, Psychiatry and pediatrician - Telemedicine Agreements.
($120,000)
1091 (Translation Services): Translation services will be provided as needed through an
outside contractor. We do have several languages spoken by our staff; however, we may need
translator for languages that are not spoken by staff, such as Hmong, Punjabi, or a client who is
deaf. ($230,000)
Total Program Expense: $22,579,600
Exhibit C, Page 13 of 21
BEHAVIORAL HEALTH CONTRACT
FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
FY 2021-2022
F TE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Director 0.20 $30,770 $30,770 0.80 $123,083 $123,083 0.00 $0 $0 1.00 $153,853 $153,853
0002 Administrative Assistant 0.20 $14,032 $14,032 0.80 $56,127 $56,127 0.00 $0 $0 1.00 $70,159 $70,159
0003 Behavioral Health Program Supervisor 0.40 $52,383 $52,383 1.60 $209,533 $209,533 0.00 $0 $0 2.00 $261,916 $261,916
0004 Program Assistant 1.00 $58,946 $58,946 4.00 $235,786 $235,786 0.00 $0 $0 5.00 $294,732 $294,732
0005 Behavioral Health Clinician Supervisor 0.80 $91,208 $91,208 3.07 $349,638 $349,638 0.13 $15,202 $15,202 4.00 $456,048 $456,048
0006 Behavioral Health Clinician (II)3.60 $365,566 $365,566 14.13 $1,435,190 $1,435,190 0.27 $27,080 $27,080 18.00 $1,827,836 $1,827,836
0007 Behavioral Health Clinician (I)6.00 $547,263 $547,263 23.47 $2,140,411 $2,140,411 0.53 $48,646 $48,646 30.00 $2,736,320 $2,736,320
0008 Psychologist 0.00 $0 $0 2.00 $222,354 $222,354 0.00 $0 $0 2.00 $222,354 $222,354
0009 Intensive Behavior Intrv Spec 16.00 $1,048,672 $1,048,672 61.33 $4,019,910 $4,019,910 2.67 $174,778 $174,778 80.00 $5,243,360 $5,243,360
0010 Office Assistant 0.80 $39,054 $39,054 3.20 $156,216 $156,216 0.00 $0 $0 4.00 $195,270 $195,270
0011 Department Automation Specialist 0.40 $27,211 $27,211 1.60 $108,843 $108,843 0.00 $0 $0 2.00 $136,054 $136,054
0012 Accountant 0.60 $46,817 $46,817 2.40 $187,269 $187,269 0.00 $0 $0 3.00 $234,086 $234,086
0013 Accounting Technician 0.40 $23,219 $23,219 1.60 $92,875 $92,875 0.00 $0 $0 2.00 $116,094 $116,094
0016 Nurse 0.00 $0 $0 4.83 $496,382 $496,382 0.17 $17,116 $17,116 5.00 $513,498 $513,498
0017 Psychiatrist 0.00 $0 $0 1.92 $445,474 $445,474 0.08 $19,368 $19,368 2.00 $464,842 $464,842
0020 Financial Officer 0.00 $0 $0 1.00 $137,953 $137,953 0.00 $0 $0 1.00 $137,953 $137,953
0021 Program Manager II 0.50 $61,874 $61,874 1.00 $123,749 $123,749 0.00 $0 $0 1.50 $185,623 $185,623
0022 PBIS Coaches 0.80 $81,238 $81,238 0.00 $0 $0 0.00 $0 $0 0.80 $81,238 $81,238
0023 Administrator 0.04 $6,803 $6,803 0.16 $27,210 $27,210 0.00 $0 $0 0.20 $34,013 $34,013
$0 $0 $0 $0 $0
$0 $0 $0 $0 $0
SALARY TOTAL 31.74 $0 $2,495,056 $2,495,056 128.91 $0 $10,568,003 $10,568,003 3.85 $0 $302,190 $302,190 164.50 $0 $13,365,249 $13,365,249
PAYROLL TAXES:
0030 OASDI $0 $0 $0 $0 $0 $0
0031 FICA/MEDICARE $181,459 $181,459 $747,695 $747,695 $22,056 $22,056 $951,209 $951,209
0032 SUI $1,247 $1,247 $5,284 $5,284 $151 $151 $6,683 $6,683
PAYROLL TAX TOTAL $0 $182,706 $182,706 $0 $752,979 $752,979 $0 $22,207 $22,207 $0 $957,892 $957,892
EMPLOYEE BENEFITS:
0040 Retirement $626,065 $626,065 $2,629,355 $2,629,355 $75,891 $75,891 $3,331,311 $3,331,311
0041 Workers Compensation $54,143 $54,143 $229,326 $229,326 $6,558 $6,558 $290,026 $290,026
0042 Health Insurance (medical, vision, life, dental)$518,243 $518,243 $2,109,449 $2,109,449 $62,933 $62,933 $2,690,625 $2,690,625
EMPLOYEE BENEFITS TOTAL $0 $1,198,451 $1,198,451 $0 $4,968,130 $4,968,130 $0 $145,381 $145,381 $0 $6,311,962 $6,311,962
SALARY & BENEFITS GRAND TOTAL $3,876,213 $16,289,112 $469,778 $20,635,103
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $105,600 $1,020,800 $35,200 $1,161,600
1011 Rent/Lease Equipment $0 $0 $0 $0
1012 Utilities $30,240 $292,320 $10,080 $332,640
1013 Building Maintenance $9,120 $88,160 $3,040 $100,320
1014 Equipment purchase $0 $100,000 $0 $100,000
FACILITY/EQUIPMENT TOTAL $144,960 $1,501,280 $48,320 $1,694,560
OPERATING EXPENSES:
1060 Telephone $31,740 $128,910 $3,850 $164,500
1061 Answering Service $0 $10,000 $0 $10,000
1062 Postage $1,800 $6,933 $333 $9,067
1063 Printing/Reproduction $42,849 $174,029 $10,395 $227,273
1064 Publications $2,250 $2,167 $83 $4,500
1065 Legal Notices/Advertising $0 $0 $0 $0
1066 Office Supplies & Equipment $168,222 $86,667 $20,405 $275,294
1067 Household Supplies $1,800 $6,933 $267 $9,000
1068 Food $27,000 $0 $0 $27,000
1069 Program Supplies - Therapeutic $45,000 $43,333 $1,667 $90,000
1070 Program Supplies - Medical $45,000 $43,333 $1,667 $90,000
1071 Transportation of Clients $64,800 $62,400 $2,400 $129,600
1072 Staff Mileage/vehicle maintenance $141,500 $561,167 $0 $702,667
1073 Staff Travel (Out of County)$0 $0 $12,513 $12,513
1074 Staff Training/Registration $59,040 $56,853 $2,187 $118,080
1075 Lodging $45,000 $43,333 $1,667 $90,000
1076 Other - Parking $4,500 $4,333 $167 $9,000
1077 Other - Recruitment $4,500 $4,333 $11,550 $20,383
1078 Other - Licenses $0 $0 $0 $0
OPERATING EXPENSES TOTAL $685,001 $1,234,725 $69,149 $1,988,875
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0 $0 $0 $0
1081 External Audit $0 $0 $0 $0
1082 Liability Insurance $0 $0 $0 $0
1083 Administrative Overhead $710,975 $2,912,064 $92,587 $3,715,626
1084 Payroll Services $0 $0 $0 $0
1085 Professional Liability Insurance $0 $0 $0 $0
FINANCIAL SERVICES TOTAL $710,975 $2,912,064 $92,587 $3,715,626
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$31,500 $0 $0 $31,500
1090.1 Legal Fees $0 $120,000 $0 $120,000
1091 Translation Services $0 $260,000 $30,000 $290,000
1092 Medication Supports $0 $0 $0 $0
SPECIAL EXPENSES TOTAL $31,500 $380,000 $30,000 $441,500
FIXED ASSETS:
1190 Computers & Software $0 $0 $0 $0
1191 Furniture & Fixtures $0 $0 $0 $0
1192 Other - (Identify)$0 $0 $0 $0
1193 Other - (Identify)$0 $0 $0 $0
FIXED ASSETS TOTAL $0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenditures (SFC 70)$0 $0 $0 $0
2001 Client Housing Operating Expenditures (SFC 71)$0 $0 $0 $0
2002.1 Clothing, Food & Hygiene (SFC 72)$0 $0 $0 $0
2002.2 Client Transportation & Support (SFC 72)$0 $0 $0 $0
2002.3 Education Support (SFC 72)$0 $0 $0 $0
2002.4 Employment Support (SFC 72)$0 $0 $0 $0
2002.5 Respite Care (SFC 72)$0 $0 $0 $0
2002.6 Household Items $0 $0 $0 $0
2002.7 Utility Vouchers (SFC 72)$0 $0 $0 $0
2002.8 Child Care (SFC 72)$0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0 $0 $0 $0
TOTAL PROGRAM EXPENSES $5,448,649 TOTAL PROGRAM EXPENSES $22,317,181 TOTAL PROGRAM EXPENSES $709,834 TOTAL PROGRAM EXPENSES $28,475,664
MEDI-CAL REVENUE:Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 2,339,610 $4.01 $9,385,806 0 $0.00 $0 2,339,610 $4.01 $9,385,806
3100 Case Management 0 $0.00 $0 1,386,545 $3.10 $4,304,999 0 $0.00 $0 1,386,545 $3.10 $4,304,999
3200 Crisis Services 0 $0.00 $0 170,565 $5.96 $1,017,207 0 $0.00 $0 170,565 $5.96 $1,017,207
3300 Medication Support 0 $0.00 $0 141,450 $7.41 $1,047,943 0 $0.00 $0 141,450 $7.41 $1,047,943
3400 Collateral 0 $0.00 $0 461,630 $4.01 $1,851,919 0 $0.00 $0 461,630 $4.01 $1,851,919
3500 Plan Development 0 $0.00 $0 257,925 $4.01 $1,034,716 0 $0.00 $0 257,925 $4.01 $1,034,716
3600 Assessment 0 $0.00 $0 90,940 $4.01 $364,824 0 $0.00 $0 90,940 $4.01 $364,824
3700 Rehabilitation 0 $0.00 $0 1,257,089 $4.01 $5,043,060 0 $0.00 $0 1,257,089 $4.01 $5,043,060
Estimated Specialty Mental Health Services Billing Totals 0 $0ng Totals 6,105,753 $24,050,476ng Totals 0 $0ng Totals 6,105,753 $24,050,476
Estimated % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%d % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $19,240,380 h Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $19,240,380
0.00%$0 80.00%$15,392,304 0.00%$0 80.00%$15,392,304
0.00%$0 0.00%$0 0.00%$0 0.00%$0
MEDI-CAL REVENUE TOTAL $0 $15,392,304 $0 $15,392,304
OTHER REVENUE:
4100 Other - (Identify)$0 $0 $0 $0
4200 Other - (Identify)$0 $0 $0 $0
4300 Other - (Identify)$0 $0 $0 $0
OTHER REVENUE TOTAL $0 $0 $0 $0
MENTAL HEALTH SERVICES ACT (MHSA) REVENUE:
5000 Prevention & Early Intervention (PEI) Funds $5,448,649 $0 $0 $5,448,649
5100 Community Services & Supports (CSS) Funds $0 $6,924,876 $709,834 $7,634,711
5200 Innovation (INN) Funds $0 $0 $0 $0
5300 Workforce Education & Training (WET) Funds $0 $0 $0 $0
MHSA FUNDS TOTAL $5,448,649 $6,924,876 $709,834 $13,083,360
TOTAL PROGRAM REVENUE $5,448,649 TOTAL PROGRAM REVENUE $22,317,181 TOTAL PROGRAM REVENUE $709,834 TOTAL PROGRAM REVENUE $28,475,664
Budget Categories -PEI Budget CSS Budget
Line Item Description (Must be itemized)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Ramp-Up CSS Budget Total Proposed Budget
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Exhibit C, Page 14 of 21
Behavioral Health Contract
Budget Narrative
FY 2021-2022
PROGRAM EXPENSES
Personnel Salaries, Payroll Taxes & Employee Benefits – Line Items 0001-0042
0001 through 0042: These amounts reflect staff that are needed to perform the duties of
specialty mental health services and related activities. Full-time equivalent (FTE) is provided for
each position.
These staff include: 1.00 Director at $153,853 per FTE, 1.00 Administrative Assistant at $70,159
per FTE, 2.00 Behavioral Health Program Supervisor at $130,958 per FTE, 5.00 Program
Assistants at $58,946 per FTE, 4.00 Behavioral Health Clinical Supervisor at $114,012 per FTE,
18.00 Behavioral Health Clinicians II at $101,546 per FTE, 30.00 Behavioral Health Clinicians I
at $91,211 per FTE, 2.00 Psychologists at $111,177 per FTE, 80.00 Intensive Behavior
Intervention Specialists at $65,542 per FTE, 4.00 Office Assistant at $48,817 per FTE, 2.00
Department Automation Specialist at $68,027 per FTE, 3.00 Accountant at $78,029 per FTE,
2.00 Accounting Technician at $58,046 per FTE, 5.00 Nurses at $102,700 per FTE, 2.00
Psychiatrist at $232,421 per FTE, 1.00 Financial Officer at $137,953 per FTE, 1.50 Program
Managers at $123,749 per FTE, 0.80 PBIS Coaches at $101,546 per FTE, and 0.20 Administrator
at $170,063 per FTE. ($13,365,249)
PAYROLL TAXES will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools. ($957,892)
EMPLOYEE BENEFITS will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools ($6,311,962)
Facilities/Equipment Expenses – Line Items 1010-1014
Facilities and Equipment expenses include rent or lease of buildings and equipment, utilities,
building maintenance and equipment purchases.
1010 (Rent/Lease Building): This line item reflects 44,000 square feet of office space and Hub
costs. The estimated amount is $2.20 per square foot per month. ($1,161,600)
1012 (Utilities): This includes cost for utilities such as PG&E, water/garbage, etc. ($332,640)
1013 (Building Maintenance): This includes building maintenance, security, and janitorial
services and damages to any of the building if caused by a client. ($100,320)
1014 (Equipment purchase): This reflects the cost of purchasing desks, couches, both
stationary and portable tables, chairs, bookcases, file cabinets, shredder, trash cans, shelves,
cell and landline phones, and other usual and customary office equipment. ($100,000)
Exhibit C, Page 15 of 21
Operating Expenses – Line Items 1060-1080
Operating costs include the following: communications including cell phones monthly charges
for program use, postage, lease of copier equipment, printing and reproduction costs due to
subscriptions, office supplies, client food, program supplies, staff mileage, vehicle leases,
insurance, gas, oil & tire, office maintenance, staff education and per diem when attending
trainings, licenses, taxes, building security.
1060 (Telephone): Cell phones and landline use. ($164,500)
1061 (Answering Service): After-hours answering service. ($10,000)
1062 (Postage): Postage in order to provide documents through mail service to schools and
community agencies relating to Specialty Mental Health. ($9,067)
1063 (Printing/Reproduction): Training materials provided for team trainings, therapy
documents, case notes, flyers, brochures, etc. A proportionate share of the copier lease will be
charged to this line. The estimate is calculated at $6.00 per person per day at 225 days.
Marketing and Infographics for brochures will be included in Ramp-Up. ($227,273)
1064 (Publications): Includes expenses for the publication of notices & reports. ($4,500)
1066 (Office Supplies & Equipment): Reflects office supplies that are generally used, such as
laptops, printers, desktops, iPad, scissors, tape, staplers, power strips, hole-punch, cutting
board, business cards, envelopes, paper clips, pencil sharpeners, wastebaskets, etc.
($275,294)
1067 (Household Supplies): Reflects cleaning supplies such as microfiber cloths, Windex,
Clorox wipes, dish-soap, sponges, hand sanitizer, Kleenex, etc. ($9,000)
1068 (Food): Reflects costs of providing food and beverages such as soft drinks and water for
trainings as well as for clients as needed such as granola bars and water. ($27,000)
1069 (Program Supplies-Therapeutic): Reflects costs for toys, assessment instruments,
protocols, crayons, play barn, etc. ($90,000)
1070 (Program Supplies-Medical): Reflects costs for gloves, vision and hearing
supplies/equipment, first aid supplies, AED devise, etc. ($90,000)
1071 (Transportation of Clients): Reflects of leasing eighteen (18) vehicles to transport clients to
and from Hubs. The estimated cost is based upon $600 per month per vehicle. ($129,600)
1072 (Staff mileage and vehicle maintenance): Cost of staff mileage reimbursement per year
for traveling to schools, Hubs, parent homes or in the community (i.e. McDonalds) in order to
provide services. Transportation of clients to and from appointments, if needed. Mileage will be
reimbursed at the IRS established rate. The estimated cost is based upon $5,000 per FTE that is
expected to travel, such as Behavioral Health Clinicians. ($702,667)
1073 (Staff Travel-Out of County): Trainings that are Evidence-based practices (EBP) may be
subject to out of town travel. ($12,513)
1074 (Staff Training and Release Time): The cost is to assist the schools in releasing staff
and teachers in order to participate in the training. Trainings will include the following: Trauma-
informed CBT, Child Psychotherapy, Positive Discipline, NCI, etc. ($118,080)
1075 (Lodging): Trainings that are EBP and necessitate lodging. ($90,000)
Exhibit C, Page 16 of 21
1076 (Parking Validation): Cost reflects validation for parking for parents, PBIS coaches, or
teachers needing to attend training at the downtown location. ($9,000)
1077 (Recruitment): Reflects cost to recruit staff. ($20,383)
Financial Services Expenses – Line Items 1080-1085
1083 (Administrative Overhead @ 15%): Indirect costs are those costs of general
management that are agency-wide. General management costs consist of expenditures for
administrative activities necessary for the general operation of the County Office of Education
(e.g., accounting, budgeting, payroll preparation, personnel management, purchasing, and
centralized data processing). The standardized method to recover indirect costs from programs
without having to time-account for the general administrative support provided to each program
is referred to as the indirect cost rate process. The indirect cost rate process in California is
based on the California Department of Education’s (CDE’s) federally approved indirect cost plan
for K-12 Local Education Agency’s (LEAs), which includes county offices of education.
California’s plan includes specific guideline on indirect cost components, including the indirect
cost pool, base costs, and the carry-forward adjustment. The United States Department of
Education has approved the fixed-with-carry-forward restricted rate methodology for calculating
indirect cost rates for California LEAs. CDE has been delegated authority to calculate and
approve indirect cost rates annually for LEAs. ($3,715,626)
Special Expenses – Line Items 1090-1201
1090 (Consultation – network & data management): This budget is for MOUs for Districts,
training (i.e. HIPAA, FERPA). Assisting with providing training for staff specifically related to
providing mental health services in schools. Also, help with the telemedicine treatments.
($31,500)
1090.1 (Legal Fees): This budget is for professional legal fees in the area of HIPAA, FERPA
related to Specialty Mental Health and Schools and Behavioral Health Positions; training for staff
that is specifically related to Mental Health Services in our Schools; MOUs between FCSS,
Mental Health and our districts, Psychiatry and pediatrician - Telemedicine Agreements.
($120,000)
1091 (Translation Services): Translation services will be provided as needed through an
outside contractor. We do have several languages spoken by our staff; however, we may need
translator for languages that are not spoken by staff, such as Hmong, Punjabi, or a client who is
deaf. ($290,000)
Total Program Expense: $28,475,664
Exhibit C, Page 17 of 21
BEHAVIORAL HEALTH CONTRACT
FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
FY 2022-2023
F TE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Director 0.20 $31,684 $31,684 0.80 $126,739 $126,739 0.00 $0 $0 1.00 $158,423 $158,423
0002 Administrative Assistant 0.20 $14,450 $14,450 0.80 $57,797 $57,797 0.00 $0 $0 1.00 $72,247 $72,247
0003 Behavioral Health Program Supervisor 0.40 $53,936 $53,936 1.60 $215,746 $215,746 0.00 $0 $0 2.00 $269,682 $269,682
0004 Program Assistant 1.20 $72,840 $72,840 4.80 $291,361 $291,361 0.00 $0 $0 6.00 $364,201 $364,201
0005 Behavioral Health Clinician Supervisor 1.00 $117,381 $117,381 3.87 $453,887 $453,887 0.13 $15,652 $15,652 5.00 $586,920 $586,920
0006 Behavioral Health Clinician (II)5.00 $522,743 $522,743 19.73 $2,063,077 $2,063,077 0.27 $27,880 $27,880 25.00 $2,613,700 $2,613,700
0007 Behavioral Health Clinician (I)7.00 $657,315 $657,315 27.73 $2,604,214 $2,604,214 0.27 $25,040 $25,040 35.00 $3,286,569 $3,286,569
0008 Psychologist 0.00 $0 $0 2.00 $228,934 $228,934 0.00 $0 $0 2.00 $228,934 $228,934
0009 Intensive Behavior Intrv Spec 20.00 $1,350,200 $1,350,200 77.33 $5,220,774 $5,220,774 2.67 $180,026 $180,026 100.00 $6,751,000 $6,751,000
0010 Office Assistant 0.80 $40,223 $40,223 3.20 $160,893 $160,893 0.00 $0 $0 4.00 $201,116 $201,116
0011 Department Automation Specialist 0.40 $28,021 $28,021 1.60 $112,084 $112,084 0.00 $0 $0 2.00 $140,105 $140,105
0012 Accountant 0.60 $48,220 $48,220 2.40 $192,881 $192,881 0.00 $0 $0 3.00 $241,101 $241,101
0013 Accounting Technician 0.40 $23,920 $23,920 1.60 $95,680 $95,680 0.00 $0 $0 2.00 $119,600 $119,600
0016 Nurse 0.00 $0 $0 5.83 $616,897 $616,897 0.17 $17,626 $17,626 6.00 $634,523 $634,523
0017 Psychiatrist 0.00 $0 $0 2.00 $478,662 $478,662 0.00 $0 $0 2.00 $478,662 $478,662
0020 Financial Officer 0.00 $0 $0 1.00 $142,061 $142,061 0.00 $0 $0 1.00 $142,061 $142,061
0021 Program Manager II 0.50 $63,709 $63,709 1.00 $127,417 $127,417 0.00 $0 $0 1.50 $191,126 $191,126
0022 PBIS Coaches 0.80 $83,639 $83,639 0.00 $0 $0 0.00 $0 $0 0.80 $83,639 $83,639
0023 Administrator 0.04 $7,005 $7,005 0.16 $28,019 $28,019 0.00 $0 $0 0.20 $35,024 $35,024
$0 $0 $0 $0 $0
$0 $0 $0 $0 $0
SALARY TOTAL 38.54 $0 $3,115,286 $3,115,286 157.46 $0 $13,217,123 $13,217,123 3.50 $0 $266,224 $266,224 199.50 $0 $16,598,633 $16,598,633
PAYROLL TAXES:
0030 OASDI $0 $0 $0 $0 $0 $0
0031 FICA/MEDICARE $228,627 $228,627 $941,991 $941,991 $19,273 $19,273 $1,189,891 $1,189,891
0032 SUI $1,558 $1,558 $6,609 $6,609 $133 $133 $8,299 $8,299
PAYROLL TAX TOTAL $0 $230,184 $230,184 $0 $948,600 $948,600 $0 $19,406 $19,406 $0 $1,198,190 $1,198,190
EMPLOYEE BENEFITS:
0040 Retirement $803,525 $803,525 $3,376,842 $3,376,842 $68,528 $68,528 $4,248,895 $4,248,895
0041 Workers Compensation $67,602 $67,602 $286,812 $286,812 $5,777 $5,777 $360,190 $360,190
0042 Health Insurance (medical, vision, life, dental)$658,168 $658,168 $2,694,632 $2,694,632 $59,800 $59,800 $3,412,600 $3,412,600
EMPLOYEE BENEFITS TOTAL $0 $1,529,295 $1,529,295 $0 $6,358,285 $6,358,285 $0 $134,105 $134,105 $0 $8,021,685 $8,021,685
SALARY & BENEFITS GRAND TOTAL $4,874,765 $20,524,008 $419,735 $25,818,508
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $105,600 $1,232,000 $35,200 $1,372,800
1011 Rent/Lease Equipment $0 $0 $0 $0
1012 Utilities $30,240 $352,800 $10,080 $393,120
1013 Building Maintenance $9,120 $106,400 $3,040 $118,560
1014 Equipment purchase $0 $100,000 $0 $100,000
FACILITY/EQUIPMENT TOTAL $144,960 $1,791,200 $48,320 $1,984,480
OPERATING EXPENSES:
1060 Telephone $38,540 $157,460 $3,500 $199,500
1061 Answering Service $0 $10,000 $0 $10,000
1062 Postage $2,200 $8,533 $333 $11,067
1063 Printing/Reproduction $52,029 $212,571 $9,450 $274,050
1064 Publications $2,750 $2,667 $83 $5,500
1065 Legal Notices/Advertising $0 $0 $0 $0
1066 Office Supplies & Equipment $204,262 $106,667 $18,550 $329,479
1067 Household Supplies $2,200 $8,533 $267 $11,000
1068 Food $33,000 $0 $0 $33,000
1069 Program Supplies - Therapeutic $55,000 $53,333 $1,667 $110,000
1070 Program Supplies - Medical $55,000 $53,333 $1,667 $110,000
1071 Transportation of Clients $79,200 $76,800 $2,400 $158,400
1072 Staff Mileage/vehicle maintenance $174,500 $699,500 $0 $874,000
1073 Staff Travel (Out of County)$0 $0 $11,375 $11,375
1074 Staff Training/Registration $72,160 $69,973 $2,187 $144,320
1075 Lodging $55,000 $53,333 $1,667 $110,000
1076 Other - Parking $5,500 $5,333 $167 $11,000
1077 Other - Recruitment $5,500 $5,333 $10,500 $21,333
1078 Other - Licenses $0 $0 $0 $0
OPERATING EXPENSES TOTAL $836,841 $1,523,371 $63,812 $2,424,024
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0 $0 $0 $0
1081 External Audit $0 $0 $0 $0
1082 Liability Insurance $0 $0 $0 $0
1083 Administrative Overhead $884,584 $3,643,083 $84,280 $4,611,947
1084 Payroll Services $0 $0 $0 $0
1085 Professional Liability Insurance $0 $0 $0 $0
FINANCIAL SERVICES TOTAL $884,584 $3,643,083 $84,280 $4,611,947
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$38,500 $0 $0 $38,500
1090.1 Legal Fees $0 $120,000 $0 $120,000
1091 Translation Services $0 $320,000 $30,000 $350,000
1092 Medication Supports $0 $0 $0 $0
SPECIAL EXPENSES TOTAL $38,500 $440,000 $30,000 $508,500
FIXED ASSETS:
1190 Computers & Software $0 $0 $0 $0
1191 Furniture & Fixtures $0 $0 $0 $0
1192 Other - (Identify)$0 $0 $0 $0
1193 Other - (Identify)$0 $0 $0 $0
FIXED ASSETS TOTAL $0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenditures (SFC 70)$0 $0 $0 $0
2001 Client Housing Operating Expenditures (SFC 71)$0 $0 $0 $0
2002.1 Clothing, Food & Hygiene (SFC 72)$0 $0 $0 $0
2002.2 Client Transportation & Support (SFC 72)$0 $0 $0 $0
2002.3 Education Support (SFC 72)$0 $0 $0 $0
2002.4 Employment Support (SFC 72)$0 $0 $0 $0
2002.5 Respite Care (SFC 72)$0 $0 $0 $0
2002.6 Household Items $0 $0 $0 $0
2002.7 Utility Vouchers (SFC 72)$0 $0 $0 $0
2002.8 Child Care (SFC 72)$0 $0 $0 $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0 $0 $0 $0
TOTAL PROGRAM EXPENSES $6,779,650 TOTAL PROGRAM EXPENSES $27,921,662 TOTAL PROGRAM EXPENSES $646,147 TOTAL PROGRAM EXPENSES $35,347,459
MEDI-CAL REVENUE:Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)0 $0.00 $0 2,953,549 $4.01 $11,848,745 0 $0.00 $0 2,953,549 $4.01 $11,848,745
3100 Case Management 0 $0.00 $0 1,732,913 $3.10 $5,380,416 0 $0.00 $0 1,732,913 $3.10 $5,380,416
3200 Crisis Services 0 $0.00 $0 213,624 $5.96 $1,274,002 0 $0.00 $0 213,624 $5.96 $1,274,002
3300 Medication Support 0 $0.00 $0 147,600 $7.41 $1,093,506 0 $0.00 $0 147,600 $7.41 $1,093,506
3400 Collateral 0 $0.00 $0 574,760 $4.01 $2,305,762 0 $0.00 $0 574,760 $4.01 $2,305,762
3500 Plan Development 0 $0.00 $0 323,547 $4.01 $1,297,972 0 $0.00 $0 323,547 $4.01 $1,297,972
3600 Assessment 0 $0.00 $0 109,867 $4.01 $440,753 0 $0.00 $0 109,867 $4.01 $440,753
3700 Rehabilitation 0 $0.00 $0 1,572,591 $4.01 $6,308,761 0 $0.00 $0 1,572,591 $4.01 $6,308,761
Estimated Specialty Mental Health Services Billing Totals 0 $0ng Totals 7,628,451 $29,949,915ng Totals 0 $0ng Totals 7,628,451 $29,949,915
Estimated % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%d % of Clients that are Medi-Cal Beneficiaries 0%d % of Clients that are Medi-Cal Beneficiaries 80%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $23,959,932 h Services Provided to Medi-Cal Beneficiaries $0 h Services Provided to Medi-Cal Beneficiaries $23,959,932
0.00%$0 80.00%$19,167,946 0.00%$0 80.00%$19,167,946
0.00%$0 0.00%$0 0.00%$0 0.00%$0
MEDI-CAL REVENUE TOTAL $0 $19,167,946 $0 $19,167,946
OTHER REVENUE:
4100 Other - (Identify)$0 $0 $0 $0
4200 Other - (Identify)$0 $0 $0 $0
4300 Other - (Identify)$0 $0 $0 $0
OTHER REVENUE TOTAL $0 $0 $0 $0
MENTAL HEALTH SERVICES ACT (MHSA) REVENUE:
5000 Prevention & Early Intervention (PEI) Funds $6,779,650 $0 $0 $6,779,650
5100 Community Services & Supports (CSS) Funds $0 $8,753,716 $646,147 $9,399,863
5200 Innovation (INN) Funds $0 $0 $0 $0
5300 Workforce Education & Training (WET) Funds $0 $0 $0 $0
MHSA FUNDS TOTAL $6,779,650 $8,753,716 $646,147 $16,179,513
TOTAL PROGRAM REVENUE $6,779,650 TOTAL PROGRAM REVENUE $27,921,662 TOTAL PROGRAM REVENUE $646,147 TOTAL PROGRAM REVENUE $35,347,459
Budget Categories -PEI Budget CSS Budget
Line Item Description (Must be itemized)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Ramp-Up CSS Budget Total Proposed Budget
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Federal M/Cal Share of Cost
% (Federal Financial
Participation-FFP)
Exhibit C, Page 18 of 21
Behavioral Health Contract
Budget Narrative
FY 2022-2023
PROGRAM EXPENSES
Personnel Salaries, Payroll Taxes & Employee Benefits – Line Items 0001-0042
0001 through 0042: These amounts reflect staff that are needed to perform the duties of
specialty mental health services and related activities. Full-time equivalent (FTE) is provided for
each position.
These staff include the following: 1.00 Director at $158,423 per FTE, 1.00 Administrative
Assistant at $72,247 per FTE, 2.00 Behavioral Health Program Supervisor at $134,842 per FTE,
6.00 Program Assistants at $60,700 per FTE, 5.00 Behavioral Health Clinical Supervisor at
$117,384 per FTE, 25.00 Behavioral Health Clinicians II at $104,548 per FTE, 35.00 Behavioral
Health Clinicians I at $93,902 per FTE, 2.00 Psychologists at $114,467 per FTE, 100.00
Intensive Behavior Intervention Specialists at $67,510 per FTE, 4.00 Office Assistant at $50,279
per FTE, 2.00 Department Automation Specialist at $70,052 per FTE, 3.00 Accountant at
$80,367 per FTE, 2.00 Accounting Technician at $59,800 per FTE, 6.00 Nurses at $105,754 per
FTE, 2.00 Psychiatrist at $239,331 per FTE, 1.00 Financial Officer at $142,062 per FTE, 1.50
Program Managers at $127,417 per FTE, 0.80 PBIS Coaches at $104,548 per FTE, and 0.20
Administrator at $175,120 per FTE. ($16,598,633)
PAYROLL TAXES will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools. ($1,198,190)
EMPLOYEE BENEFITS will be paid in a like manner as other employees of the Fresno County
Superintendent of Schools ($8,021,685)
Facilities/Equipment Expenses – Line Items 1010-1014
Facilities and Equipment expenses include rent or lease of buildings and equipment, utilities,
building maintenance and equipment purchases.
1010 (Rent/Lease Building): This line item reflects 52,000 square feet of office space and Hub
costs. The estimated amount is $2.20 per square foot per month. ($1,372,800)
1012 (Utilities): This includes cost for utilities such as PG&E, water/garbage, etc. ($393,120)
1013 (Building Maintenance): This includes building maintenance, security, and janitorial
services and damages to any of the building if caused by a client. ($118,560)
1014 (Equipment purchase): This reflects the cost of purchasing desks, couches, both
stationary and portable tables, chairs, bookcases, file cabinets, shredder, trash cans, shelves,
cell and landline phones, and other usual and customary office equipment. ($100,000)
Exhibit C, Page 19 of 21
Operating Expenses – Line Items 1060-1080
Operating costs include the following: communications including cell phones monthly charges
for program use, postage, lease of copier equipment, printing and reproduction costs due to
subscriptions, office supplies, client food, program supplies, staff mileage, vehicle leases,
insurance, gas, oil & tire, office maintenance, staff education and per diem when attending
trainings, licenses, taxes, building security.
1060 (Telephone): Cell phones and landline use. ($199,500)
1061 (Answering Service): After-hours answering service. ($10,000)
1062 (Postage): Postage in order to provide documents through mail service to schools and
community agencies relating to Specialty Mental Health. ($11,067)
1063 (Printing/Reproduction): Training materials provided for team trainings, therapy
documents, case notes, flyers, brochures, etc. A proportionate share of the copier lease will be
charged to this line. The estimate is calculated at $6.00 per person per day at 225 days.
Marketing and Infographics for brochures will be included in Ramp-Up. ($274,050)
1064 (Publications): Includes expenses for the publication of notices & reports. ($5,500)
1066 (Office Supplies & Equipment): Reflects office supplies that are generally used, such as
laptops, printers, desktops, iPad, scissors, tape, staplers, power strips, hole-punch, cutting
board, business cards, envelopes, paper clips, pencil sharpeners, wastebaskets, etc.
($329,479)
1067 (Household Supplies): Reflects cleaning supplies such as microfiber cloths, Windex,
Clorox wipes, dish-soap, sponges, hand sanitizer, Kleenex, etc. ($11,000)
1068 (Food): Reflects costs of providing food and beverages such as soft drinks and water for
trainings as well as for clients as needed such as granola bars and water. ($33,000)
1069 (Program Supplies-Therapeutic): Reflects costs for toys, assessment instruments,
protocols, crayons, play barn, etc. ($110,000)
1070 (Program Supplies-Medical): Reflects costs for gloves, vision and hearing
supplies/equipment, first aid supplies, AED devise, etc. ($110,000)
1071 (Transportation of Clients): Reflects cost of leasing twenty-two (22) vehicles to transport
clients to and from Hubs. The estimated cost is based upon $600 per month per vehicle.
($158,400)
1072 (Staff mileage and vehicle maintenance): Cost of staff mileage reimbursement per year
for traveling to schools, Hubs, parent homes or in the community (i.e. McDonalds) in order to
provide services. Transportation of clients to and from appointments, if needed. Mileage will be
reimbursed at the IRS established rate. The estimated cost is based upon $5,000 per FTE that is
expected to travel, such as Behavioral Health Clinicians. ($874,000)
1073 (Staff Travel-Out of County): Trainings that are Evidence-based practices (EBP) may be
subject to out of town travel. ($11,375)
1074 (Staff Training and Release Time): The cost is to assist the schools in releasing staff
and teachers in order to participate in the training. Trainings will include the following: Trauma-
informed CBT, Child Psychotherapy, Positive Discipline, NCI, etc. ($144,320)
1075 (Lodging): Trainings that are EBP and necessitate lodging. ($110,000)
Exhibit C, Page 20 of 21
1076 (Parking Validation): Cost reflects validation for parking for parents, PBIS coaches, or
teachers needing to attend training at the downtown location. ($11,000)
1077 (Recruitment): Reflects cost to recruit staff. ($21,333)
Financial Services Expenses – Line Items 1080-1085
1083 (Administrative Overhead @ 15%): Indirect costs are those costs of general
management that are agency-wide. General management costs consist of expenditures for
administrative activities necessary for the general operation of the County Office of Education
(e.g., accounting, budgeting, payroll preparation, personnel management, purchasing, and
centralized data processing). The standardized method to recover indirect costs from programs
without having to time-account for the general administrative support provided to each program
is referred to as the indirect cost rate process. The indirect cost rate process in California is
based on the California Department of Education’s (CDE’s) federally approved indirect cost plan
for K-12 Local Education Agency’s (LEAs), which includes county offices of education.
California’s plan includes specific guideline on indirect cost components, including the indirect
cost pool, base costs, and the carry-forward adjustment. The United States Department of
Education has approved the fixed-with-carry-forward restricted rate methodology for calculating
indirect cost rates for California LEAs. CDE has been delegated authority to calculate and
approve indirect cost rates annually for LEAs. ($4,611,947)
Special Expenses – Line Items 1090-1201
1090 (Consultation – network & data management): This budget is for MOUs for Districts,
training (i.e. HIPAA, FERPA). Assisting with providing training for staff specifically related to
providing mental health services in schools. Also, help with the telemedicine treatments.
($38,500)
1090.1 (Legal Fees): This budget is for professional legal fees in the area of HIPAA, FERPA
related to Specialty Mental Health and Schools and Behavioral Health Positions; training for staff
that is specifically related to Mental Health Services in our Schools; MOUs between FCSS,
Mental Health and our districts, Psychiatry and pediatrician - Telemedicine Agreements.
($120,000)
1091 (Translation Services): Translation services will be provided as needed through an
outside contractor. We do have several languages spoken by our staff; however, we may need
translator for languages that are not spoken by staff, such as Hmong, Punjabi, or a client who is
deaf. ($350,000)
Total Program Expense: $35,347,459
Exhibit C, Page 21 of 21
Exhibit D Page 1 of 1 Electronic Health Record Software Charges CONTRACTOR understand that COUNTY utilizes NetSmart’s Avatar for its Electronic Health Records Management. CONTRACTOR agree to reimburse COUNTY for all user license fees for accessing NetSmart’s Avatar, as set forth below. Description FY 2018-19 FY 2019-20 FY 2020-21 FY 2021-22 FY 2022-23 Fee Per User/License NetSmart Avatar Monthly Hosting Service (per active user per month) $ 37.00 $ 37.00 $ 37.00 $ 37.00 $ 37.00 NetSmart Avatar User Maintenance (per active user per month) $ 14.00 $ 14.00 $ 14.00 $ 14.00 $ 14.00 NetSmart Avatar User Hosting Perceptive (per active user per month) $ 4.66 $ 4.66 $ 4.66 $ 4.66 $ 4.66 NetSmart Avatar Annual Maintenance/License* (per named license per year) $ 249.95 $ 249.95 $ 249.95 $ 249.95 $ 249.95 OrderConnect License1 (per named license per year) $ 1,278.00 $ 1,278.00 $ 1,278.00 $ 1,278.00 $ 1,278.00 Reaching Recovery (per named user per year) $ 10.00 $ 10.00 $ 10.00 $ 10.00 $ 10.00 Rates and types of services stated above are subject to change throughout the term of the Agreement, with the approval of the Department of Behavioral Health Director or designee and CONTRACTOR. Should CONTRACTOR choose not to utilize NetSmart’s Avatar for its Electronic Health Records management, CONTRACTOR(S) will be responsible for obtaining its own system for Electronic Health Records management. _________________________________________________________________________________________________________ *Annual Maintenance increases by 3% each FY on July 1st. 1Includes 100 faxed pages per month. An additional fee of $0.20 per faxed page will apply thereafter.
Exhibit E
Page 1 of 3
Documentation Standards For Client Records
The documentation standards are described below under key topics related to client care. All
standards must be addressed in the client record; however, there is no requirement that the
record have a specific document or section addressing these topics. All medical records shall be
maintained for a minimum of 10 years from the date of the end of the Agreement.
A. Assessments
1. The following areas will be included as appropriate as a part of a comprehensive client
record.
Relevant physical health conditions reported by the client will be prominently identified
and updated as appropriate.
Presenting problems and relevant conditions affecting the client’s physical health and
mental health status will be documented, for example: living situation, daily activities,
and social support.
Documentation will describe client’s strengths in achieving client plan goals.
Special status situations that present a risk to clients or others will be prominently
documented and updated as appropriate.
Documentations will include medications that have been described by mental health plan
physicians, dosage of each medication, dates of initial prescriptions and refills, and
documentations of informed consent for medications.
Client self report of allergies and adverse reactions to medications, or lack of known
allergies/sensitivities will be clearly documented.
A mental health history will be documented, including: previous treatment dates,
providers, therapeutic interventions and responses, sources of clinical data, relevant
family information and relevant results of relevant lab tests and consultations reports.
For children and adolescents, pre-natal and perinatal events and complete
developmental history will be documented.
Documentations will include past and present use of tobacco, alcohol, and caffeine, as
well as illicit, prescribed and over-the-counter drugs.
A relevant mental status examination will be documented.
A DSM-5 diagnosis, or a diagnosis from the most current ICD, will be documented,
consistent with the presenting problems, history mental status evaluation and/or other
assessment data.
2. Timeliness/Frequency Standard for Assessment
An assessment will be completed at intake and updated as needed to document
changes in the client’s condition.
Client conditions will be assessed at least annually and, in most cases, at more frequent
intervals.
B. Client Plans
1. Client plans will:
have specific observable and/or specific quantifiable goals
Exhibit E
Page 2 of 3
identify the proposed type(s) of intervention
have a proposed duration of intervention(s)
be signed (or electronic equivalent) by:
the person providing the service(s), or
a person representing a team or program providing services, or
a person representing the MHP providing services
when the client plan is used to establish that the services are provided under the
direction of an approved category of staff, and if the below staff are not the approved
category,
a physician
a licensed/ “waivered” psychologist
a licensed/ “associate” social worker
a licensed/ registered/marriage and family therapist or
a registered nurse
In addition,
client plans will be consistent with the diagnosis, and the focus of intervention will be
consistent with the client plan goals, and there will be documentation of the client’s
participation in and agreement with the plan. Examples of the documentation include,
but are not limited to, reference to the client’s participation and agreement in the
body of the plan, client signature on the plan, or a description of the client’s
participation and agreement in progress notes.
client signature on the plan will be used as the means by which the
CONTRACTOR(S) documents the participation of the client
when the client’s signature is required on the client plan and the client refuses or is
unavailable for signature, the client plan will include a written explanation of the
refusal or unavailability.
The CONTRACTOR(S) will give a copy of the client plan to the client on request.
2. Timeliness/Frequency of Client Plan:
Will be updated at least annually
The CONTRACTOR(S) will establish standards for timeliness and frequency for the
individual elements of the client plan described in item 1.
C. Progress Notes
1. Items that must be contained in the client record related to the client’s progress in treatment
include:
The client record will provide timely documentation of relevant aspects of client care
Mental health staff/practitioners will use client records to document client encounters,
including relevant clinical decisions and interventions
All entries in the client record will include the signature of the person providing the
service (or electronic equivalent); the person’s professional degree, licensure or job title;
and the relevant identification number, if applicable
All entries will include the date services were provided
The record will be legible
The client record will document follow-up care, or as appropriate, a discharge summary
2. Timeliness/Frequency of Progress Notes:
Exhibit E
Page 3 of 3
Progress notes shall be documented at the frequency by type of service indicated below:
A. Every Service Contact
Mental Health Services
Medication Support Services
Crisis Intervention
Exhibit F
Page 1 of 3
FRESNO COUNTY MENTAL HEALTH COMPLIANCE PROGRAM
CONTRACTOR CODE OF CONDUCT AND ETHICS
Fresno County is firmly committed to full compliance with all applicable laws,
regulations, rules and guidelines that apply to the provision and payment of mental health services.
Mental health contractors and the manner in which they conduct themselves are a vital part of this
commitment.
Fresno County has established this Contractor Code of Conduct and Ethics with which
contractor and its employees, associates, and subcontractors shall comply. Contractor shall require
its employees, associates, and subcontractors to attend a compliance training that will be provided
by Fresno County. After completion of this training, each contractor, contractor’s employee,
associate, and subcontractor must sign the Contractor Acknowledgment and Agreement form and
return this form to the Compliance officer or designee.
Contractor and its employees and subcontractor shall:
1. Comply with all applicable laws, regulations, rules or guidelines when providing and billing for
mental health services.
2. Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their
professional dealing related to their contract with the County and avoid any conduct that could
reasonably be expected to reflect adversely upon the integrity of the County.
3. Treat County employees, consumers, and other mental health contractors fairly and with
respect.
4. NOT engage in any activity in violation of the County’s Compliance Program, nor engage in
any other conduct which violates any applicable law, regulation, rule or guideline
5. Take precautions to ensure that claims are prepared and submitted accurately, timely and are
consistent with all applicable laws, regulations, rules or guidelines.
6. Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement
of any kind are submitted.
7. Bill only for eligible services actually rendered and fully documented. Use billing codes that
accurately describe the services provided.
Exhibit F
Page 2 of 3
8. Act promptly to investigate and correct problems if errors in claims or billing are discovered.
9. Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct
and Ethics by County employees or other mental health contractors, or report any activity that
they believe may violate the standards of the Compliance Program, or any other applicable
law, regulation, rule or guideline. Fresno County prohibits retaliation against any person
making a report. Any person engaging in any form of retaliation will be subject to disciplinary
or other appropriate action by the County. Contractor may report anonymously.
10. Consult with the Compliance Officer if you have any questions or are uncertain of any
Compliance Program standard or any other applicable law, regulation, rule or guideline.
11. Immediately notify the Compliance Officer if they become or may become an Ineligible person
and therefore excluded from participation in the Federal Health Care Programs.
Exhibit F
Page 3 of 3
Fresno County Mental Health Compliance Program
Contractor Acknowledgment and Agreement
I hereby acknowledge that I have received, read and understand the Contractor Code of Conduct and
Ethics. I herby acknowledge that I have received training and information on the Fresno County Mental
Health Compliance Program and understand the contents thereof. I further agree to abide by the
Contractor Code of Conduct and Ethics, and all Compliance Program requirements as they apply to my
responsibilities as a mental health contractor for Fresno County.
I understand and accept my responsibilities under this Agreement. I further understand that any
violation of the Contractor Code of Conduct and Ethics or the Compliance Program is a violation of
County policy and may also be a violation of applicable laws, regulations, rules or guidelines. I further
understand that violation of the Contractor Code of Conduct and Ethics or the Compliance Program
may result in termination of my agreement with Fresno County. I further understand that Fresno
County will report me to the appropriate Federal or State agency.
For Individual Providers
Name (print): _____________________________________
Discipline: Psychiatrist Psychologist LCSW LMFT
Other:___________________________________________
Signature :________________________________ Date : ___/____/___
For Group or Organizational Providers
Group/Org. Name (print): _______________________________________
Employee Name (print): ________________________________________
Discipline: Psychiatrist Psychologist LCSW LMFT
Other:___________________________________________
Job Title (if different from Discipline): ___________________________
Signature: _________________________________ Date: ____/___/____
Exhibit G
Page 1 of 6
STATE MENTAL HEALTH REQUIREMENTS
1. CONTROL REQUIREMENTS
The COUNTY and its subcontractors shall provide services in accordance with all
applicable Federal and State statutes and regulations.
2. PROFESSIONAL LICENSURE
All (professional level) persons employed by the COUNTY Mental Health
Program (directly or through contract) providing Short-Doyle/Medi-Cal services
have met applicable professional licensure requirements pursuant to Business
and Professions and Welfare and Institutions Codes.
3. CONFIDENTIALITY
CONTRACTOR shall conform to and COUNTY shall monitor compliance with all
State of California and Federal statutes and regulations regarding confidentiality,
including but not limited to confidentiality of information requirements at 42, Code
of Federal Regulations sections 2.1 et seq; California Welfare and Institutions
Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the
California Health and Safety Code; Title 22, California Code of Regulations,
section 51009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code.
4. NON-DISCRIMINATION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY and to the
public all eligibility requirements to participate in the program plan set
forth in the Agreement. No person shall, because of ethnic group
identification, age, gender, color, disability, medical condition, national
origin, race, ancestry, marital status, religion, religious creed, political
belief or sexual preference be excluded from participation, be denied
benefits of, or be subject to discrimination under any program or activity
receiving Federal or State of California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the Equal
Employment Opportunity Commission guidelines, which forbids
discrimination against any person on the grounds of race, color, national
origin, sex, religion, age, disability status, or sexual preference in
employment practices. Such practices include retirement, recruitment
advertising, hiring, layoff, termination, upgrading, demotion, transfer, rates
of pay or other forms of compensation, use of facilities, and other terms
and conditions of employment.
Exhibit G
Page 2 of 6
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold all further
funds, until CONTRACTOR can show clear and convincing evidence to
the satisfaction of COUNTY that funds provided under this Agreement
were not used in connection with the alleged discrimination.
D. Nepotism
Except by consent of COUNTY’s Department of Behavioral Health
Director, or designee, no person shall be employed by CONTRACTOR
who is related by blood or marriage to, or who is a member of the Board
of Directors or an officer of CONTRACTOR.
5. PATIENTS' RIGHTS
CONTRACTOR shall comply with applicable laws and regulations, including but
not limited to, laws, regulations, and State policies relating to patients' rights.
STATE CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the
non-discrimination program requirements. (Gov. Code§ 12990 (a-f) and CCR, Title 2,
Section 111 02) (Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free workplace;
3) any available counseling, rehabilitation and employee assistance programs;
and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of
employment on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
Exhibit G
Page 3 of 6
certification by failing to carry out the requirements as noted above. (Gov. Code §8350
et seq.)
3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that
no more than one (1) final unappealable finding of contempt of court by a Federal court
has been issued against Contractor within the immediately preceding two-year period
because of Contractor's failure to comply with an order of a Federal court, which orders
Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract
Code §10296) (Not applicable to public entities.)
4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO
REQUIREMENT: Contractor hereby certifies that Contractor will comply with the
requirements of Section 6072 of the Business and Professions Code, effective January
1, 2003.
Contractor agrees to make a good faith effort to provide a minimum number of hours of
pro bono legal services during each year of the contract equal to the lessor of 30
multiplied by the number of full time attorneys in the firm’s offices in the State, with the
number of hours prorated on an actual day basis for any contract period of less than a
full year or 10% of its contract with the State.
Failure to make a good faith effort may be cause for non-renewal of a state contract for
legal services, and may be taken into account when determining the award of future
contracts with the State for legal services.
5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an
expatriate corporation or subsidiary of an expatriate corporation within the meaning of
Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the
State of California.
6. SWEATFREE CODE OF CONDUCT:
a. All Contractors contracting for the procurement or laundering of apparel, garments or
corresponding accessories, or the procurement of equipment, materials, or supplies,
other than procurement related to a public works contract, declare under penalty of
perjury that no apparel, garments or corresponding accessories, equipment, materials,
or supplies furnished to the state pursuant to the contract have been laundered or
produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured
labor under penal sanction, abusive forms of child labor or exploitation of children in
sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor,
indentured labor under penal sanction, abusive forms of child labor or exploitation of
children in sweatshop labor. The contractor further declares under penalty of perjury
that they adhere to the Sweatfree Code of Conduct as set forth on the California
Department of Industrial Relations website located at www.dir.ca.gov, and Public
Contract Code Section 6108.
b. The contractor agrees to cooperate fully in providing reasonable access to the
contractor’s records, documents, agents or employees, or premises if reasonably
required by authorized officials of the contracting agency, the Department of Industrial
Relations, or the Department of Justice to determine the contractor’s compliance with
the requirements under paragraph (a).
Exhibit G
Page 4 of 6
7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies that
Contractor is in compliance with Public Contract Code section 10295.3.
8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that
Contractor is in compliance with Public Contract Code section 10295.35.
DOING BUSINESS WITH THE STATE OF CALIFORNIA
The following laws apply to persons or entities doing business with the State of
California.
1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions
regarding current or former state employees. If Contractor has any questions on the
status of any person rendering services or involved with the Agreement, the awarding
agency must be contacted immediately for clarification.
Current State Employees (Pub. Contract Code §10410):
1). No officer or employee shall engage in any employment, activity or enterprise from
which the officer or employee receives compensation or has a financial interest and
which is sponsored or funded by any state agency, unless the employment, activity or
enterprise is required as a condition of regular state employment.
2). No officer or employee shall contract on his or her own behalf as an independent
contractor with any state agency to provide goods or services.
Former State Employees (Pub. Contract Code §10411):
1). For the two-year period from the date he or she left state employment, no former
state officer or employee may enter into a contract in which he or she engaged in any of
the negotiations, transactions, planning, arrangements or any part of the decision-
making process relevant to the contract while employed in any capacity by any state
agency.
2). For the twelve-month period from the date he or she left state employment, no former
state officer or employee may enter into a contract with any state agency if he or she
was employed by that state agency in a policy-making position in the same general
subject area as the proposed contract within the 12-month period prior to his or her
leaving state service.
If Contractor violates any provisions of above paragraphs, such action by Contractor
shall render this Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they do not receive
payment other than payment of each meeting of the board or commission, payment for
preparatory time and payment for per diem. (Pub. Contract Code §10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the
provisions which require every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions, and
Exhibit G
Page 5 of 6
Contractor affirms to comply with such provisions before commencing the performance
of the work of this Agreement. (Labor Code Section 3700)
3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies
with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on
the basis of disability, as well as all applicable regulations and guidelines issued
pursuant to the ADA. (42 U.S.C. 12101 et seq.)
4. CONTRACTOR NAME CHANGE: An amendment is required to change the
Contractor's name as listed on this Agreement. Upon receipt of legal documentation of
the name change the State will process the amendment. Payment of invoices presented
with a new name cannot be paid prior to approval of said amendment.
5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:
a. When agreements are to be performed in the state by corporations, the contracting
agencies will be verifying that the contractor is currently qualified to do business in
California in order to ensure that all obligations due to the state are fulfilled.
b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any
transaction for the purpose of financial or pecuniary gain or profit. Although there are
some statutory exceptions to taxation, rarely will a corporate contractor performing within
the state not be subject to the franchise tax.
c. Both domestic and foreign corporations (those incorporated outside of California) must
be in good standing in order to be qualified to do business in California. Agencies will
determine whether a corporation is in good standing by calling the Office of the
Secretary of State.
6. RESOLUTION: A county, city, district, or other local public body must provide the
State with a copy of a resolution, order, motion, or ordinance of the local governing body
which by law has authority to enter into an agreement, authorizing execution of the
agreement.
7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall
not be: (1) in violation of any order or resolution not subject to review promulgated by the
State Air Resources Board or an air pollution control district; (2) subject to cease and
desist order not subject to review issued pursuant to Section 13301 of the Water Code
for violation of waste discharge requirements or discharge prohibitions; or (3) finally
determined to be in violation of provisions of federal law relating to air or water pollution.
8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all
contractors that are not another state agency or other governmental entity.
9. INSPECTION and Audit of Records and access to Facilities.
The State, CMS, the Office of the Inspector General, the Comptroller General, and their
designees may, at any time, inspect and audit any records or documents of
CONTRACTOR or its subcontractors, and may, at any time, inspect the premises,
physical facilities, and equipment where Medicaid-related activities or work is conducted.
Exhibit G
Page 6 of 6
The right to audit under this section exists for 10 years from the final date of the contract
period or from the date of completion of any audit, whichever is later.
Federal database checks. Consistent with the requirements at § 455.436 of this chapter,
the State must confirm the identity and determine the exclusion status of
CONTRACTOR, any subcontractor, as well as any person with an ownership or control
interest, or who is an agent or managing employee of CONTRACTOR through routine
checks of Federal databases. This includes the Social Security Administration's Death
Master File, the National Plan and Provider Enumeration System (NPPES), the List of
Excluded Individuals/Entities (LEIE), the System for Award Management (SAM), and any
other databases as the State or Secretary may prescribe. These databases must be
consulted upon contracting and no less frequently than monthly thereafter. If the State
finds a party that is excluded, it must promptly notify the CONTRACTOR and take action
consistent with § 438.610(c).
The State must ensure that CONTRACTOR with which the State contracts under this
part is not located outside of the United States and that no claims paid by a
CONTRACTOR to a network provider, out-of-network provider, subcontractor or financial
institution located outside of the U.S. are considered in the development of actuarially
sound capitation rates.
Exhibit H
Page 1 of 3
FFRREESSNNOO CCOOUUNNTTYY MMEENNTTAALL HHEEAALLTTHH PPLLAANN
IINNCCIIDDEENNTT RREEPPOORRTTIINNGG
PPRROOTTOOCCOOLL FFOORR CCOOMMPPLLEETTIIOONN OOFF IINNCCIIDDEENNTT RREEPPOORRTT
The Incident Report must be completed for all incidents involving clients. The staff person
who becomes aware of the incident completes this form, and the supervisor co-signs it.
When more than one client is involved in an incident, a separate form must be completed
for each client.
Where the forms should be sent - within 24 hours from the time of the incident
Incident Report should be sent to:
Managed Care Division Manager
Fresno County Mental Health Plan
P.O. Box 45003
Fresno, CA 93718-9886
Exhibit H
Page 2 of 3
INCIDENT REPORT WORKSHEET
When did this happen?
(date/time)
Where did this
happen?
Name/DMH #
1. Background information of the incident:
2. Method of investigation: (chart review, face-to-face interview, etc.)
Who was affected? (If other than
consumer)
List key people involved. (witnesses, visitors, physicians, employees)
3. Preliminary findings: How did it happen? Sequence of events. Be specific. If attachments
are needed write comments on an 8 1/2 sheet of paper and attach to worksheet.
Outcome
severity:
Nonexist
ent inconsequ
ential conseque
ntial dea
th
not
applicabl
e
unkno
wn
4. Response: a) corrective action, b) Plan of Action, c) other
Completed by (print
name)
Completed by
(signature)
Date
completed
Reviewed by Supervisor (print
name)
Exhibit H
Page 3 of 3
Supervisor
Signature Date
Exhibit I
Page 1 of 2
Medi-Cal Provider Standards
1. The Medi-Cal Provider possesses the necessary license to operate, if applicable, and
any required certification.
2. The space owned, leased or operated by the Provider and used for services or staff
meets local fire codes.
3. The physical plant of any site owned, leased, or operated by the Provider and used for
services or staff is clean, sanitary and in good repair.
4. The Medi-Cal Provider maintains client records in a manner that meets applicable state
and federal standards.
5. The Medi-Cal Provider has staffing adequate to allow the County to claim federal
financial participation for the services the Provider delivers to beneficiaries, as described
in Division 1, Chapter 11, Subchapter 4 of Title 9, CCR, when applicable.
6. The Medi-Cal Provider that provides or stores medications, the Provider stores and
dispenses medications in compliance with all pertinent state and federal standards. In
particular:
A. All drugs obtained by prescription are labeled in compliance with federal and
state laws. Prescription labels are altered only by persons legally authorized to
do so.
B. Drugs intended for external use only or food stuffs are stored separately from
drugs for internal use.
C. All drugs are stored at proper temperatures, room temperature drugs at 59-86
degrees F and refrigerated drugs at 36-46 degrees F.
D. Drugs are stored in a locked area with access limited to those medical personnel
authorized to prescribe, dispense or administer medication.
E. Drugs are not retained after the expiration date. IM multi-dose vials are dated
and initialed when opened.
F. A drug log is maintained to ensure the Provider disposes of expired,
contaminated, deteriorated and abandoned drugs in a manner consistent with
state and federal laws.
G. Policies and procedures are in place for dispensing, administering and storing
medications.
7. The Medi-Cal Provider that provides day treatment intensive or day rehabilitation, the
Provider must have a written description of the day treatment intensive and/or day
treatment rehabilitation program that complies with State Department of Health Care
Exhibit I
Page 2 of 2
Services’ day treatment requirements. The COUNTY shall review the Provider’s written
program description for compliance with the State Department of Health Care Services’
day treatment requirements.
8. The COUNTY may accept the host county’s site certification and reserves the right to
conduct an on-site certification review at least every three (3) years. The COUNTY may
also conduct additional certification reviews when:
A. The Provider makes major staffing changes.
B. The Provider makes organizational and/or corporate structure changes (example:
conversion from a non-profit status).
C. The Provider adds day treatment or medication support services when
medications shall be administered or dispensed from the Provider site.
D. There are significant changes in the physical plant of the Provider site (some
physical plant changes could require a new fire clearance).
E. There is change of ownership or location.
F. There are complaints against the Provider.
G. There are unusual events, accidents, or injuries requiring medical treatment for
clients, staff or members of the community.
Exhibit J
Page 1 of 2
Fresno County Mental Health Plan
Grievances
Fresno County Mental Health Plan (MHP) provides beneficiaries with a grievance and
appeal process and an expedited appeal process to resolve grievances and disputes at
the earliest and the lowest possible level.
Title 9 of the California Code of Regulations requires that the MHP and its fee-for-service
providers give verbal and written information to Medi-Cal beneficiaries regarding the
following:
How to access specialty mental health services
How to file a grievance about services
How to file for a State Fair Hearing
The MHP has developed a Consumer Guide, a beneficiary rights poster, a grievance
form, an appeal form, and Request for Change of Provider Form. All of these
beneficiary materials must be posted in prominent locations where Medi-Cal
beneficiaries receive outpatient specialty mental health services, including the waiting
rooms of providers’ offices of service.
Please note that all fee-for-service providers and contract agencies are required to give
their clients copies of all current beneficiary information annually at the time their
treatment plans are updated and at intake.
Beneficiaries have the right to use the grievance and/or appeal process without any
penalty, change in mental health services, or any form of retaliation. All Medi-Cal
beneficiaries can file an appeal or state hearing.
Grievances and appeals forms and self addressed envelopes must be available for
beneficiaries to pick up at all provider sites without having to make a verbal or written
request. Forms can be sent to the following address:
Fresno County Mental Health Plan
P.O. Box 45003
Fresno, CA 93718-9886
(800) 654-3937 (for more information)
(559) 488-3055 (TTY)
Provider Problem Resolution and Appeals Process
The MHP uses a simple, informal procedure in identifying and resolving provider
concerns and problems regarding payment authorization issues, other complaints and
concerns.
Informal provider problem resolution process – the provider may first speak to a Provider
Relations Specialist (PRS) regarding his or her complaint or concern.
Exhibit J
Page 2 of 2
The PRS will attempt to settle the complaint or concern with the provider. If the attempt
is unsuccessful and the provider chooses to forego the informal grievance process, the
provider will be advised to file a written complaint to the MHP address (listed above).
Formal provider appeal process – the provider has the right to access the provider
appeal process at any time before, during, or after the provider problem resolution
process has begun, when the complaint concerns a denied or modified request for MHP
payment authorization, or the process or payment of a provider’s claim to the MHP.
Payment authorization issues – the provider may appeal a denied or modified request
for payment authorization or a dispute with the MHP regarding the processing or
payment of a provider’s claim to the MHP. The written appeal must be submitted to the
MHP within 90 calendar days of the date of the receipt of the non-approval of payment.
The MHP shall have 60 calendar days from its receipt of the appeal to inform the
provider in writing of the decision, including a statement of the reasons for the decision
that addresses each issue raised by the provider, and any action required by the
provider to implement the decision.
If the appeal concerns a denial or modification of payment authorization request, the
MHP utilizes a Managed Care staff who was not involved in the initial denial or
modification decision to determine the appeal decision.
If the Managed Care staff reverses the appealed decision, the provider will be asked to
submit a revised request for payment within 30 calendar days of receipt of the decision
Other complaints – if there are other issues or complaints, which are not related to
payment authorization issues, providers are encouraged to send a letter of complaint to
the MHP. The provider will receive a written response from the MHP within 60 calendar
days of receipt of the complaint. The decision rendered buy the MHP is final.
Exhibit KVendor: Contract# Contact Person Contact#Item Make/Brand Model Serial #Fixed AssetSensitive ItemDate Requested (If Fixed Asset)Date Approved ( If Fixed Assset)Purchase DateLocation ConditionFresno County Inventory NumberCostExampleCopier Canon 27CRT 9YHJY65R x 3/27/2008 4/1/2008 4/10/2008 Heritage New $6,500.00ExampleDVD Player Sony DV2230 PXC4356A x n/a n/a 4/1/2008 Heritage New $450.00Date Prepared:12345678910111213141516171819202122Fixed Asset and Sensitive Item Tracking
Exhibit K232425Date Received:
Exhibit K-1Field Number Field DescriptionInstruction or Comments Required or ConditionalHeader VendorIndicate the legal name of the agency contracted to provide services.RequiredHeader ProgramIndicate the title of the project as described in the contract with the County.RequiredHeader Contract #Indicate the assigned County contract number. If not known, County staff can provide.RequiredHeader Contact PersonIndicate the first and last name of the primary agency contact for the contract.RequiredHeader Contact #Indicate the most appropriate telephone number of the primary agency contact for the contract.RequiredHeader Date PreparedIndicate the most current date that the tracking form was completed by the vendor.Requireda ItemIdentify the item by providing a commonly recognized description of the item.Requiredb Make/Brand Identify the company that manufactured the item.Requiredc Model Identify the model number for the item, if applicable. Conditionald Serial # Identify the serial number for the item, if applicable. Conditionale Fixed AssetMark the box with an "X" if the cost of the item is $5,000 or more to indicate that the item is a fixed asset.Conditionalf Sensitive ItemMark the box with an "X" if the item meets the criteria of a sensitive item as defined by the County.Conditionalg Date RequestedIndicate the date that the agency submitted a request to the County to purchase the item.Requiredh Date ApprovedIndicate the date that the County approved the request to purchase the item.Requiredi Purchase Date Indicate the date the agency purchased the item.Requiredj Location Indicate the physical location of the item Requiredk ConditionIndicate the general condition of the item (New, Good, Worn, Bad).RequiredlFresno County Inventory NumberIndicate the FR # provided by the County for the item. Conditionalm CostIndicate the total purchase price of the item including sales tax and other costs, such as shipping.RequiredFIXED ASSET AND SENSITIVE ITEM TRACKING
Exhibit L
Page 1 of 2
DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT
I. Identifying Information
Name of entity D/B/A
Address (number, street) City State ZIP code
CLIA number Taxpayer ID number (EIN) Telephone number
( )
II. Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and
addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued.
A. Are there any individuals or organizations having a direct or indirect ownership or control interest
of five percent or more in the institution, organizations, or agency that have been convicted of a criminal
offense related to the involvement of such persons or organizations in any of the programs established
YES NO
by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒
B. Are there any directors, officers, agents, or managing employees of the institution, agency, or
organization who have ever been convicted of a criminal offense related to their involvement in such
programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒
C. Are there any individuals currently employed by the institution, agency, or organization in a managerial,
accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or
agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒
III. A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling
interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names
and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are
related to each other, this must be reported under “Remarks.”
NAME ADDRESS EIN
B. Type of entity: ❒ Sole proprietorship ❒ Partnership ❒ Corporation
❒ Unincorporated Associations ❒ Other (specify)
C. If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations
under “Remarks.”
D. Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities?
(Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses
of individuals, and provider numbers. .......................................................................................................... ❒ ❒
NAME ADDRESS PROVIDER NUMBER
Exhibit L
Page 2 of 2
YES NO
IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒
If yes, give date.
B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒
If yes, when?
C. Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒
If yes, when?
V. Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒
If yes, give date of change in operations.
VI. Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒
VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
B. If the answer to question VII.A. is NO, was the facility ever affiliated with a chain?
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be
prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the
information requested may result in denial of a request to participate or where the entity already participates, a termination of
its agreement or contract with the agency, as appropriate.
Name of authorized representative (typed) Title
Signature Date
Remarks
Exhibit M
1 of 2
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is
providing the certification set out below.
2. The inability of a person to provide the certification required below will not
necessarily result in denial of participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the certification set out
below. The certification or explanation will be considered in connection with the
department or agency's determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a certification or an explanation
shall disqualify such person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which
reliance was placed when the department or agency determined to enter into this
transaction. If it is later determined that the prospective primary participant knowingly
rendered an erroneous certification, in addition to other remedies available to the
Federal Government, the department or agency may terminate this transaction for
cause or default.
4. The prospective primary participant shall provide immediate written notice to
the department or agency to which this proposal is submitted if at any time the
prospective primary participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, participant,
person, primary covered transaction, principal, proposal, and voluntarily excluded, as
used in this clause, have the meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549. You may contact the
department or agency to which this proposal is being submitted for assistance in
obtaining a copy of those regulations.
6. Nothing contained in the foregoing shall be construed to require establishment
of a system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
Exhibit M
2 of 2
CERTIFICATION
(1) The prospective primary participant certifies to the best of its knowledge and belief,
that it, its owners, officers, corporate managers and partners:
(a) Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency;
(b) Have not within a three-year period preceding this proposal been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal
offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State or local) transaction or contract under a public transaction; violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or receiving
stolen property;
(c) (d) Have not within a three-year period preceding this application/proposal
had one or more public transactions (Federal, State or local) terminated for cause or
default.
(2) Where the prospective primary participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an explanation
to this proposal.
Signature: Date:
(Printed Name & Title) (Name of Agency or
Company)
Exhibit N
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”),
must disclose any self-dealing transactions that they are a party to while providing goods,
performing services, or both for the County. A self-dealing transaction is defined below:
“A self-dealing transaction means a transaction to which the corporation is a party and in
which one or more of its directors has a material financial interest”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member’s name, job title (if applicable), and date this disclosure is being
made.
(2) Enter the board member’s company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to
the County. At a minimum, include a description of the following:
a. The name of the agency/company with which the corporation has the
transaction; and
b. The nature of the material financial interest in the Corporation’s transaction that
the board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing
transaction described in Sections (3) and (4).
Exhibit N
Page 2 of 2
(1) Company Board Member Information:
Name: Date:
Job Title:
(2) Company/Agency Name and Address:
(3) Disclosure (Please describe the nature of the self-dealing transaction you are a party
to)
(4) Explain why this self-dealing transaction is consistent with the requirements of
Corporations Code 5233 (a)
(5) Authorized Signature
Signatur
e:
Date: