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HomeMy WebLinkAbout32683COUNTY OF FRESNO Fresno, CA - 1 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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). COUNTY OF FRESNO Fresno, CA - 7 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 8 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 9 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 10 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 11 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 12 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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: COUNTY OF FRESNO Fresno, CA - 13 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 14 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 15 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 16 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 17 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 18 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 19 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 20 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 21 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 22 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 23 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 24 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 25 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 26 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 27 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. /// COUNTY OF FRESNO Fresno, CA - 28 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 29 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 30 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 31 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 32 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 33 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 34 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 35 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 36 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. COUNTY OF FRESNO Fresno, CA - 37 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 COUNTY OF FRESNO Fresno, CA - 38 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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: COUNTY OF FRESNO Fresno, CA - 39 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 - 40 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 - 41 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. 3 4 CONTRACTOR: 5 FRESNO COUNTY SUPERINTENDENT OF SCHOOLS 6 7 8 9 10 By:,.n::: ~- Jim Yovino, Superintendent Print Name: _________ _ Title: ____________ _ 11 Fresno County Superintendent of Schools or Authorized Designee 12 13 14 15 16 17 18 19 20 21 Mailing Address: 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 24 25 26 27 28 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: