HomeMy WebLinkAbout32708AMENDMENT TO AGREEMENT 1 2 THIS AMENDMENT I, hereinafter referred to as Amendment, is made and entered into 3 this ____ day of ________ , 2018, by and between the COUNTY OF 4 FRESNO, a Political Subdivision of the State of California, hereinafter referred to as 5 "COUNTY", and UPLIFT FAMILY SERVICES (Formerly FAMILIES FIRST, INC.), a 6 Private Non-Profit Corporation, whose address is 251 Llewellyn Avenue, Campbell, California 7 95008-1940, hereinafter referred to as "CONTRACTOR". 8 WHEREAS, the COUNTY and F AMILIESFIRST, INC. entered into that certain 9 Agreement, identified as COUNTY Agreement No. A-15-189, effective July 1, 2015, hereinafter 10 referred to as the "Agreement"; and 11 WHEREAS, F AMILIESFIRST,INC. changed its name to UPLIFT FAMILY SERVICES 12 effective March 22, 2016; and 13 WHEREAS, the COUNTY engaged the CONTRACTOR for the purpose of providing 14 Wraparound services and Therapeutic Foster Care services (TFC) to SB 163 eligible children and 15 their families involved in the Child Welfare System (CWS); and 16 WHEREAS, the tern1 of Agreement No. A-15-189 is set to end on June 30, 2018 and the 17 COUNTY has contracted with another vendor to provide these services beginning June I, 2018 18 and COUNTY has a need to extend the term of Agreement No. A-15-189 to provide for a smooth 19 transition of clients from CONTRACTOR to the new vendor; and 20 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below 21 and restate the Agreement in its entirety. 22 NOW, THEREFORE, in consideration of their mutual promises, covenants and conditions, 23 hereinafter set forth, the sufficiency of which is acknowledged, the paiiies agree as follows: 24 1. That the following text in the Agreement, Page One (1 ), beginning with Section 25 One (1 ), Line twenty-six (26) and ending on Page One (1 ), Line twenty-seven (27) with the word 26 "herein" be deleted and the following inserted in its place: 27 "A. CONTRACTOR shall perform all services and fulfill all responsibilities as 28 set forth in Revised Exhibit A, "Summary of Services," attached hereto and by this reference -1 -COUNTY OF FRESNO Fresno, CA 5thJuneAgreement No. 15-189-1
1 incorporated herein." 2 2. That the following text in the Agreement, Page Three (3), beginning with Section 3 Two (2), Line one (1) with the word "2. TERM" and ending on Page Three (3), Line Ten (10) 4 with the word "term." be deleted and the following inserted in its place: 5 "2. TERM 6 This Agreement shall become effective on the first day of July 2015 and shall 7 terminate on the 30th day of September 2018. 8 3. That the following text in the Agreement, Page Four ( 4), beginning with Section 9. Four (4), Line Six (6) with the word "4. COMPENSATION" and ending on Page Four (4), Line 10 Twenty (20) with the word "CONTRACTOR" be deleted and the following inserted in its place: 11 12 "4. COMPENSATION A. COUNTY agrees to pay CONTRACTOR and CONTRACTOR 13 Agrees to receive compensation in accordance with Revised Exhibit B, "Budget," attached hereto 14 and by this reference incorporated herein. Mandated travel shall be reimbursed based on actual 15 expenditures and mileage reimbursement shall be at CONTRACTOR's adopted rate per mile, not 16 to exceed the IRS published rate. In no event shall the administrative costs exceed the total 17 amounts identified in Revised Exhibit B. Payment shall be made upon certification or other proof 18 satisfactory to COUNTY's DSS that services have actually been performed by CONTRACTOR as 19 specified in this Agreement. 20 For each twelve (12) month period of this Agreement, in no event shall all 21 actual services performed under this Agreement be in excess of Four Million, Five Hundred 22 Thousand, and no/100 Dollars ($4,500,000). For the additional Three (3) month period of this 23 Agreement (July 1, 2018 through September 30, 2018), in no event shall all actual services 24 performed under this Agreement be in excess of Four Hundred Eighty-Nine Thousand Two 25 Hundred Seventy Dollars ($489,270). The cumulative total of this Agreement for the Three (3) 26 year and Three (3) month period for both specialty mental health Medi-Cal and Non-Medi-Cal 27 billable services shall not be in excess of Thirteen Million, Nine Hundred Eighty-Nine Thousand, 28 Two Hundred Seventy Dollars ($13,989,270). It is understood that all expenses incidental to -2 -COUNTY OF FRESNO Fresno, CA
1 CONTRACTOR's performance of services under this Agreement shall be borne by 2 CONTRACTOR." 3 4. That the following text in the Agreement, in Section Four (4) (COMPENSATION), 4 Subsection C (Non-MHP Mental Health Services and Other Wraparound Services), on Page Seven 5 (7), beginning with Line Three (3) with the word "In" and ending on Page Seven (7), Line Nine 6 (9) with the amount "($3,375,000.00)." be deleted and the following inserted in its place: 7 "In no event shall services performed by CONTRACTOR for Non-MHP 8 Mental Health Services and Other Wraparound Services be in excess of One Million, One Hundred 9 Twenty-Five Thousand, and No/100 Dollars ($1,125,000.00), for each Twelve (12) month period: 10 July 1, 2015 through June 30, 2016; July 1, 2016 through June 30, 2017; and July 1, 2017 through 11 June 30, 2018. 12 In no event shall services performed by CONTRACTOR for Non-MHP 13 Mental Health Services and Other Wraparound Services be in excess of One Hundred Twenty-14 Two Thousand, Three Hundred and Seventeen Dollars and No/100 Dollars ($122,317.00), for the 15 additional Three (3) month period of this Agreement (July 1, 2018 through September 30, 2018). 16 In no event shall the maximum reimbursements for Non-MHP Mental 17 Health Services and Other Wraparound Services from July 1, 2015 through September 30, 2018 18 exceed Three Million, Four Hundred Ninety-Seven Thousand, Three Hundred and Seventeen 19 Dollars and No/100 Dollars ($3,497,317.00)." 20 5. That all references in the Agreement to "Exhibit A" shall be changed to read 21 "Revised Exhibit A", which is attached hereto and incorporated herein by this reference. 22 6. That all references in the Agreement to "Exhibit B" shall be changed to read 23 "Revised Exhibit B", which is attached hereto and incorporated herein by this reference. 24 7. COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend 25 Agreement No. A-15-189, and that upon execution of this Amendment, the original Agreement, 26 and this Amendment, shall together be considered the Agreement. 27 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 28 covenants, conditions and promises contained in the Agreement and not amended herein shall remain - 3 -COUNTY OF FRESNO Fresno, CA
1 in full force and effect. This Amendment shall become effective upon execution on the day first 2 hereinabove written. 3 Ill 4 Ill 5 Ill 6 Ill 7 Ill 8 Ill 9 Ill 10 Ill 11 Ill 12 Ill 13 Ill 14 Ill 15 Ill 16 Ill 17 Ill 18 Ill 19 Ill 20 Ill 21 Ill 22 Ill 23 Ill 24 Ill 25 Ill 26 Ill 27 Ill 28 Ill -4-COUNTY OF FRESNO Fresno, CA
I IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first
2 hereinabove written.
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9 1-1-------------Title (Chairperson of the Board,
President or Vice-President) 10
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Title (Secretary of Corporation, or
Chief Financial Officer/Treasurer,
or any Assistant Secretary or
Treasurer)
Mailing Address
20 251 Llewellyn A venue
Camobell. CA 95008
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FOR ACCOUNTING USE ONLY:
Medi-Cal Billable Services
Fund/Subclass: 0001/10000
ORG No.: 56107870
Account No.: 7223
26 Non Medi-cal Billable Services
Fund/Subclass: 0001/10000
27 0RG No.: 56107663
28 Account No.: 7870
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COUNTY OF FRESNO
ATTEST:
o, C airperson of the Board of
f e County of Fresno
c:h J\• ·, ~ • -::i~.J..
Bernice E. seidelO
Clerk of the Board of Supervisors
County of Fresno, State of California
COUNTY OF FRESNO
Fresno, CA
Revised Exhibit A
Page 1 of 6
SUMMARY OF SERVICES
ORGANIZATION: Uplift Family Services, Inc., (Formerly Families First, Inc.)
SERVICES: Senate Bill 163 Wraparound and Therapeutic Foster Care Services
CONTRACT PERIOD: July 1, 2015 - September 30, 2018
AMOUNT: $4,500,000 (July 1, 2015 – June 30, 2016)
$4,500,000 (July 1, 2016 – June 30, 2017)
$4,500,000 (July 1, 2017 – June 30, 2018)
$489,270 (July 1, 2018 – September 30, 2018)
SUMMARY OF SERVICES: CONTRACTOR shall perform all Wraparound Approach Services
(Wraparound), including emergency mental health support services, and Therapeutic Foster
Care (TFC) services and fulfill all responsibilities identified in COUNTY's Request for Proposal
(RFP) No. 952-5322 dated January 5, 2015, the RFP Addendum dated January 22, 2015
(referred to as the Revised RFP), and CONTRACTOR's response to said Revised RFP dated
February 11, 2015 and all incorporated herein by reference and made part of this Agreement.
Services provided, at a slot capacity of 150 children at any given time, include specialty mental
health services, Wraparound Approach Services (Wraparound) and TFC, that emphasize the
strength of the child and the family. Services are highly coordinated, highly individualized and
unconditional, they address needs and achieve positive outcomes in the lives of enrolled
children and their families and may include, but are not limited to: mentoring, tutoring,
recreational activities, shadowing, community involvement, school-sponsored activities, faith-
based programs and activities, and volunteerism.
CONTRACTOR recognizes that the COUNTY operates its mental health programs under an
agreement with the State Department of Health Care Services (DHCS), and that under said
agreement the State imposes certain requirements on COUNTY and its subcontractors.
CONTRACTOR shall adhere and be responsible for compliance as of the effective date of each
Federal, State or local law or regulation specified. In the event any, regulation or policy referred
to in the Agreement, RFP or this Exhibit A is amended during the term of this Agreement, the
parties agree to comply with the amended provision as of the effective date of such amendment.
SCHEDULE OF SERVICES: CONTRACTOR office(s) shall be open Monday through Friday, 8
a.m. to 5 p.m. Staff can access the office outside of these hours should they need to provide
services on site after 5 p.m. or on weekends. The majority of services will be provided in the
community and are scheduled on days and times that are convenient to the families, including
evenings and weekends. Youth/families also have access to stand by a crisis support phone
line twenty-four (24) hours/day, seven (7) days/week. The stand-by worker, in consultation with
a supervisor, will determine the level of support needed to address the crisis, which ranges from
telephone support and coaching to immediate in person response by staff.
TARGET POPULATION: 1) An enrolled child who has been adjudicated as either a dependent
or ward of the juvenile court pursuant to the Welfare Institution Code, Section 300, 601, or 602
and who would be placed in a group home licensed by COUNTY's Department of Social
Services (DSS) at a rate classification level (RCL) of 10 or higher; 2) A child/youth who has
been adjudicated as either a dependent or ward and who has experienced three (3) or more
placement moves or psychiatric hospitalizations within the past twenty-four (24) months; 3) A
child/youth who is in an adoptive placement or has a finalized adoption who qualifies for
Revised Exhibit A
Page 2 of 6
Adoption Assistance Program (AAP) benefits and has an urgent and/or intensive mental health
need which causes impairment at school, home, and/or in the community; 4) A child/youth who
is at imminent risk of placement in a RCL 10 or above or currently placed in a RCL 10 or above
and is within sixty (60) days of returning to the community.
CONTRACTOR AGREES to provide all Wraparound, emergency medical supports and TFC
services identified in COUNTY's Revised RFP. The following are highlights and/or further
defined/updated responsibilities of said items.
CONTRACTOR SHALL:
1. Work collaboratively in an integrated service delivery model within the community,
region and state to obtain the outcomes, goals and strategies of the California
Partners for Permanency (CAPP) and Katie A. Core Practice Models, SB163 Service
Models and Therapeutic Foster Care Models.
2. Have the ability to comply with applicable Federal and State of California laws and
Regulations, including but not limited to the Business Associate requirements of the
Health Insurance Portability and Accountability Act (HIPAA). (45 CFR parts 160, 162
and 164); the Health Information Technology for Economic and Clinical Health Act
regarding the confidentiality and security of patient information; and the Genetic
Information Nondiscrimination Act (GINA) of 2008 regarding the confidentiality of
Genetic information.
3. Maintain responsibility to provide and appropriately bill for Katie A. Subclass members
if medically necessary and provided within the CAPP and Katie A. Core Practice
Model and in accordance with the "Medi-Cal Manual for Intensive Care Coordination
(ICC), Intensive Horne Based Services (IHBS) & Therapeutic Foster Care (TFC) for
Katie A. Subclass Members", incorporated herein by reference.
4. Hire racially and ethnically diverse staff, whenever possible, reflective of the target
population to provide or assist with culturally competent, client and family-driven
mental health and supportive services.
5. Recruit qualified subcontractors, as needed, to provide authorized Wraparound
services.
6. Work cooperatively and collaboratively with Child Welfare Service (CWS) staff, Child
Welfare Mental Health Program staff and all treatment providers, caregivers, Foster
Family Agencies (FFA) to achieve the individual and collective treatment goals and
support the CWS case plan, communicate/resolve barriers to care, provide
continuity and warm-handoffs whenever possible when clients transition from
higher-to-lower or lower-to-higher levels of care whether within or outside of Fresno
County.
7. Ensure clinical supervision of registered/waivered mental health clinicians, including
co-signing or reviewing documentation and claiming in Electronic Medical Records as
required by the Board of Behavioral Sciences (BBS) or COUNTY requirements. All
supervision shall be provided by licensed Clinical Supervisors. The Clinical
Supervisor shall be two (2) years post-licensure and have completed the required
Revised Exhibit A
Page 3 of 6
training in accordance with the BBS.
8. Arrange for and complete a mental health assessment, if needed, including clinical
analysis of the history and current status of a beneficiary's mental, emotional, or
behavioral disorder; relevant cultural issues and history; diagnosis; and use of testing
procedures.
9. Address the demographic make-up and population trends of the Target Population to
identify their cultural and linguistic needs in designing and planning for providing
appropriate behavioral health services.
10. Ensure employees attend Cultural Competency, Compliance, and Billing and
Documentation trainings provided by the COUNTY upon hire and annually thereafter
or as needed.
11. Assist with training COUNTY staff and the community in S8163 Wraparound Service
processes and service options.
12. Develop training curriculum, as COUNTY identifies a need.
13. Meet all requirements to become a Short-Doyle Medi-Cal organizational provider for
Specialty Mental Health Services in the Fresno County Mental Health Plan (MHP).
14. Maintain ongoing responsibility for Data and Reporting, including the following:
a. Send applicable information and reports to the following distribution list for
COUNTY staff: DSS Financial Analyst, DSS Contract Analyst, DSS Program
Manager, DSS Social Work Supervisor and DBH Contract Analyst (actual
names and email addresses to be provided at a later date).
b. Possess the administrative and fiscal capability to provide and manage the
proposed services and ensure a cost-effective service delivery and operational
structure with an audit trail that adheres to Generally Accepted Accounting
Principles.
c. Report on performance measures (utilizing the Monthly Activity Report, identified
in Exhibit H), outcomes, units of service for Medi-Cal and Non Medi-Cal billable
services, cost allocation reports, or other reports as established by COUNTY.
This Agreement will be closely monitored for performance and CONTRACTOR
will be required to report monthly outcomes and expenses.
d. All reports will be due to the County by the 20th of each month, and be
reviewed for accuracy. (If the 20th lands on a weekend or Holiday, reports will
be due the next business day). Reimbursement for monthly expenses may be
delayed in the event inaccurate reports are submitted.
e. Provide COUNTY with Outcome Reports every six (6) months. Outcome Report
formats will be established through COUNTY/CONTRACTOR collaboration.
Outcome Report measurements may change, based on requirement information
or measurements needed. Current Outcome measurements are listed as follows:
Revised Exhibit A
Page 4 of 6
1) Cost Effectiveness, 2) Family Functioning, 3) Prevention of Placements in
More Restrictive Environments, 4) Improvement of Emotional and Behavioral
Adjustment, 5) School Attendance, 6) Academic Performance, 7) Parent or
Caregiver Satisfaction, and 8) Improvement in Family Involvement, Family &
Child Goal Attainment
f. Provide COUNTY with various reports throughout the length of the child's
enrollment in the program; a few of which are standardized and included herein;
Exhibit P “Monthly Progress Report", Exhibit Q "Discharge Presentation", Exhibit
R "Individual Child and Family Plan Presentation Outline", and Exhibit S
"Individual Child and Family Plan (ICFP)"
g. Maintain electronic health records and supply their own personal computers,
Internet access, printers, signature pads and other network devices to meet
statistical reporting requirements, report client and program outcomes and any
State or County data requirements of the Katie A. Implementation Plan.
CONTRACTOR shall also maintain capability to enter electronic billing claiming
data into COUNTY's Avatar system. A computer with Internet access is required
for office and field-based staff.
15. Cooperate and participate with the COUNTY MHP in Quality Assurance/Improvement
and Utilization Review Programs and grievance procedures, and comply with all final
determinations rendered by COUNTY's Quality Assurance/Improvement and
Utilization Review Programs, unless the decision is reversed on appeal as set forth in
the COUNTY MHP Provider Manual, incorporated herein by this reference.
COUNTY's adverse decisions regarding CONTRACTOR services to clients may
result in the disallowance of payment for services rendered; or may result in additional
controls to the delivery of services; or may result in the termination of this Agreement.
COUNTY shall have sole discretion in the determination of Quality
Assurance/Improvement and Utilization Review outcomes, decisions and actions.
16. Establish criteria and protocols to insure referral to services are therapeutically
appropriate, benefits the client and caregiver, achieves the client's treatment goals
and supports the success of the CWS case plan and avoids any potential for
perceived or actual conflict of interest or self-referral.
17. Maintain responsibility for any court reports and/or necessary testimony:
a. Court Reports - Documented reports of assessment and evaluation findings,
progress in treatment, recommendations for treatment and service plans
regarding reunification, maintenance and termination of parental rights, and
justification for recommendations.
b. Court Testimony- On-site court testimony of assessment and evaluation
findings, treatment and service plan recommendations regarding reunification,
maintenance and termination of parental rights, and justification for
recommendations.
18. Obtain signatures, as required, regarding consent:
Revised Exhibit A
Page 5 of 6
a. Care provider can sign for day trips and other minor miscellaneous items.
b. Court Order should suffice for most other items.
19. Upon notification of a pending court hearing, CONTRACTOR agrees to complete and
submit to the COUNTY a "Periodic Review Report twenty-one (21) calendar days
prior to the court date or seven (7) calendar days after notification.
COUNTY SHALL BE RESPONSIBLE FOR THE FOLLOWING:
COUNTY shall:
1. Designate a contact person for CONTRACTOR to communicate with, when necessary.
2. Meet with CONTRACTOR monthly, or as often as needed, to exchange pertinent
information, resolve problems, and work collaboratively to coordinate services.
3. Include necessary items in initial referral packets, as agreed upon by both
CONTRACTOR and COUNTY. Referral Packets shall include the following:
a. A completed referral
b. Placement History
c. Current court orders - detention minute order (CHDP Medical/Dental)
d. Health and Education Passport (HEP)
e. Mental Health Assessment (including most recent, if available)
f. T earn Decision Meeting (TDM)/Staffing notes (if available)
g. Individualized Education Program (IEP) (if available/applicable)
h. JV220 (if applicable)
i. FFA/Group Home Quarterly Report
4. Facilitate Intensive Care Coordination (ICC) meetings initially, and no less than every
ninety (90) days, for a child/youth identified as a Katie A. Subclass client.
5. Organize teaming meetings in alignment with CAPP, SB 163 and Katie A. Core Practice
models for which CONTRACTOR will be required to participate, when appropriate.
6. Provide education and training on CWS, practice models and Medi-Cal licensing,
documentation and billing requirements, as needed.
7. Expedite court processes required to change placements.
8. Screen children and their families for enrollment of Wraparound program. Provide
medication evaluations, ongoing monitoring and comply with State and County
regulations related to the JV220 process or other court requirements, complete
Treatment Authorization Requests (TARs) when ordering psychotropic medications and
coordinate the client care with the therapist and treatment team.
9. Act as liaison between staff and/or representatives of the California Department of Social
Services (CDSS) and CONTRACTOR.
10. Manage the Wraparound Program trust funds.
Revised Exhibit A
Page 6 of 6
11. Monitor this Agreement for achievement of agreed upon outcomes and for compliance
with the specified terms and conditions herein.
12. Through the MHP utilization management and quality improvement process, may be
required to take action necessitating consultation with its Medical Director, or with other
physicians, prior to authorization of MHP Covered Services, or to terminate this
Agreement. In the interest of program integrity or the welfare of clients, COUNTY may
introduce additional utilization controls as may be necessary at any time and without
advance notice to CONTRACTOR. In the event of such change, COUNTY shall notify
CONTRACTOR in writing, and the change shall take effect upon the tenth (10th)
calendar day following the deposit of said notice, by COUNTY, into the United States
mail, postage prepaid, to the address set forth in Section 33 of this Agreement.
13. Notify the CONTRACTOR when court hearings are scheduled.
PERFORMANCE MEASUREMENTS: Under the Katie A. Settlement Agreement and
Implementation Plan, the DHCS and CDSS are working to adopt statewide use of a data-
informed system of performance oversight, accountability, and communication that efficiently
monitors, measures, and evaluates access, quality, satisfaction, effectiveness, costs, and
outcomes at the individual, program, and system levels.
Performance measurements developed by COUNTY will reflect the information required by
DHCS and CDSS. Outcome indicators for this Agreement will continue to be developed in
conjunction with CONTRACTOR and State departments.
RFP 952-5322 Page: 1 of 29 Revised Exhibit B Stffltt8 Biil 163 Wraparound and Thtrilpeutk: Fostar Care Services FamlllosFlrst. Inc. dba EMQ FamilleaFlmt .· .. Budget. July 1, 20111 to Juno 30, 2016 Budget Categories • Total Pr®osed Budget Non Direct Consumer Cost Direct Consumer Cost Meo1-1.;aI Non m=l•t.;61 Meu~ar NOOl'lleOl•wll line Item Description (Must be itemized} FTE% Billable Cost Billable Cost Billable Cost Billable Cost Total PERSONNEL SALARIES: 0001 Tille Associate Director 1.00 $61,870 $20,623 $82,493 0002 TiUe Clinician I 4.00 $144,093 $48,031 $192,124 0003 Tille CMnical Director 0.50 $34.147 $11.383 545.530 0004 TIile Community Development Spec (RCL) 1.00 $33,653 S33,653 0005 rrt1e Addiction Prevention Counselor 3.00 $77.222 $25,741 5102,963 0006 Title EducalionNocational Specialist 3.00 Si7,076 $25,692 $102,768 0007 TIiie Clinical Program Manager 4.00 $191,145 $63.715 $254,860 0008 Tille Facilitator 12.00 $350,118 5116,706 $466,824 0009 Title FamHy Partner (RCL) 4.00 $135,572 S135,572 0010 Title Family Specialist 22.00 $497,029 $165,677 $662,706 0011 Tille Family services Coordinator: Familv Finding 1.00 $30.007 S10.003 $40,010 0012 TIUe Family Service Coordinator 1.00 $30.007 $10,003 $40,010 0013 Title Program Supervisor 3.00 $115,976 $38,659 $154,635 0014 Tille Intake Coordinator 1.00 $29,087 $9.696 $38,783 0015 rrt1e Administrative Assistant II 1.00 $24,914 S8,305 $33,219 0016 Title Biding Specialist 1.00 S23,268 57,756 $31,024 0017 Title ED. Regional Executive Director 0.45 $39,089 $13,030 S52.119 0018 TIUe Health lofonna!ion Management 1.00 $25,596 $8,532 $34.128 0019 Title Learning Partners 1.00 $52.034 $17,345 $69,379 !0020 THle Outcomes & Evaluation 0.50 $17,400 $5,800 $23,200 0021 rt11e Quality Support 0.50 $28,721 $9,574 $38,295 SALARY TOTAL 65.95 S211,022 $70,342 $1,637,777 $715,154 $2,634.295 PAYROLL TAXES: 0030 OASDI old age survivor and disabliity $13,083 $4,361 $101,542 $44,339 $163,325 0031 FICA/MEDICARE $3.060 $1,020 $23,748 S10,370 $38.198 0032 u.r. S4,959 S1.653 $38,488 $16,806 $61.906 PAYROLL TAX TOTAL $21.102 $7,034 S163,778 $71.515 $263,429 EMPLOYEE BENEFITS: 0040 Rellrement 58,441 $2,814 $65,511 $28,606 $105,372 0041 Worilers Compensation $6,331 $2,110 $49,133 $21,455 $79,029 0042 Health Insurance (medical vision. life, dental) $23,351 $7,784 $181,235 $79.138 $291,508 EMPLOYEE BENEFITS TOTAL $38,123 $12,708 $295,879 $129,199 $475,909 SALARY & BENEFITS GRANO TOTAL $270,247 $90,084 $2,097.434 $915,868 $3,373.633 Meo1-va1 NonM8QM.,8I FACILITIES/EQUIPMENT EXPENSES: Billable Cost Billable Cost Tot.al 1010 Rent/Lease Building 37.917 12,639 S50,556 1011 Rent/Lease Equipment 3,122 1,041 $4,163 1014 Maintenance (facility) 3,342 1.114 $4,456 1017 Other• Depredation 4,218 f,<106 $5,624 FACILITY/EQUIPMENT TOTAL S48,599 $16,200 $64,799 OPERATING EXPENSES: 1060 Telephone $41,127 $13,709 $54,836 1062 Postage/Shipping/Printing 1,426 475 $1,901 1066 Office Supplies & Equipment 4,807 1,602 S6,409 1069 Program Supplies • Therapeutic 8,437 2.813 $11,250 1072 Staff Mijeage/vehlde maintenance 165,487 55,163 S220,650 1074 Staff Training/Registration 5,011 1,671 $6,682 1076 Other-Emergencv Flex Funds 63,000 563,000 OPERATING EXPENSES TOTAL S226,295 $138,433 $ 364,728 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping so 1081 External Audit 5,453 1,818 7,271 1082 llabmty Insurance 17,382 3.030 520.412 1083 Other• Administrative Overhead 485,488 161,829 6-47.317 FINANCIAL SERVICES TOTAL 508,323 166,677 $675.000 SPECIAL EXPENSES (Consullanl/Etc.): 1089 Medication Su00ons I 16,380 5,460 $21,840 SPECIAL EXPENSES TOTAL 16,380 5.460 I $21,840 TOTAL PROGRAM EXPENSES I $4,500,000
RFP 952-5322 Page: 2 of29 Revised Exhibit B SGruit& Bill 163 Wraparound and Tharapoutlc Foster care SGrvlees Fam Illes First, Inc. dba EMQ Famlllll$Fll'$t .. : . .. Budgot-July 1, 2015 to June 30, 2016 Vo11un11s 01 Mea1-1.;a1 NOil Me01-\;BI DIRECT SERVICE REVENUE: Svc Rafe Billable Cost 8inable Cost SAmt. 3000 Mental Health Services 94,515 $2.61 $246.684 $246,684 (Assessment, Plan of Caro, lndividua/JFamily/Group Therapy, Rehab) 3100 Case Management. Linkage/Brokerage 203,298 $2.02 $410,662 $410.662 3200 Crisis Intervention 6.nB $3.88 $26,291 $26.291 3300 Medication Support 13,553 $4.82 $65,325 $65,325 3400 Collateral 27,105 $2.61 $70.744 $70,744 3500 Court Documentation, Report. Appearance $0 3600 Psychological evaluallon so 3700 ICC-Case Management 135,527 $2.02 $273,765 $273.765 3800 IHBS-Rehab 874,149 $2.61 $2,281,529 $2,281,529 3800 S8 Non BIilabie Services 1,022,727 $1.10 $1,125,000 $1,125,000 DIRECT SERVICE REVENUE TOTAL 2,377,650 S 3,375.000 s 1,125,000 $4,500,000 OTHER REVENUE: 4000 Other so 4100 Other so 4200 Other so 4300 other so OTHER REVENUE TOTAL so TOT AL PROGRAM REVENUE $4,500,000 1.687,500 Modi-Cal Revenue 50% FFP 1,350,000 Medi.Cal Revenue 40%, EPSDT {2.011 Realignment} 337,500 Medi-Cal Revenue 10¾ County SB163 Trust Fund $ 3,375,000 Total Medi.Cal Revenue 1,354.923 Total Medi-Cal Units s 2.49 Medi-Cal cost per unit $1,125,000 Non Medi-Cal BIiiabie Service Cost 1.022.727 Total Non-Medi-Cal Billable units $ 1.10 Non Modi-Cal cost per unit Annualized Total SummaJV $Dollar Amoun %Percentage% Meol-!.;81 Billable Cost s 3,375.000 75% [Non Meo1-1.;a1 Billable Cost s 1,125,000 25% Total s 4.500.000
RFP 952-5322 Page: 3 of29 Revised Exhibit B ·. Senato 8111163 Wraparound and Therapeutic FO$Wr Care Services FamillesFlrst, Inc. dba EMQ FamfllasFlrst --· .. -·--· .. : Budget. July1,2016toJunG3&,2016 PROPOSED BUDGET DETAIL NARRATIVE BUDGET NARRATIVE 0001 Associate Director I Total Amount $ 82,493 l.O FTE at a salary of $82,493 = $82,493 Master's degree (MA/MS). Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision with three to ten years of experience in healthcare/psychology/behavloral/mental health. The Associate Director assists the clinical director with implementing strategies to accomplish the agency annual priorities at the program level. Directs and develops managers, ensures CPMS are competent and have all tools necessary to lead teams. 0002 Olnlclan I I Total Amo\JJlt $ 192,124 4.0 FTE at average salary of$48,031 = $192,124 Master's Degree (MA/MS} and at least two years of experience working with youth, young adults and families in a therapeutic environment is required. If unlicensed must be a registered intern with the Board of Behavioral Sciences and receiving appropriate clinical supervision. Provides psychotherapy' and psychotherapeutic support to children and families. 0003 Olnlcal Director I Total Amount $ 45,530 0.5 FTE at a salary of $91,060 = $45,530 Master's Degree (MA/MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a Licensed CllnicalSocialWorkeror Marriage family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Provide~ regional leadership and effectively manages, develops, maintains, monitors and ensures the clinical quality in multiple clinical programs. 0004 community Oevelopment Specialist {RCl) I Total Amount $ 33,653 1.0 FTE at a salary of $33,653 = $33,653 Bachelor's Degree (BA/ BS) in Marketing or related field preferred. The community development specialist develops resources that support the needs of young people and families receiving agency services. Inspires and ensures community engagement in therapeutic and strength based opportunities to enhance or create mental health programs. 0005 Addiction Prevention Counselor I Total Amount $ 102,963 3.0 FTE at an average salary of $34,321 = Sl02,963 Bachelor's degree (BA/ BS) or higher In Psychology, Counseling or Social Work; certified drug and alcohol counselor is preferred. Two to four years related experience or an equivalent combination of education and experience working with youth or young adults with co-occurring disorders. 0006 Educatlcn/Vocatlonal Specialist I Total Amount $ 102,768 3.0 FTE at an average salary of $34,256 = $102,768 Associate's Degree (AA/ AS) AND six (6) years related experience in a mental health/education/vocational setting required. • OR Bachelor's Degree (SA/BSI AND four (4) years related experience in a mental health/education/vocational setting required. • OR Master's Degree (MA/ MS} In a mental health related field AND two (2) years related experience in a mental health setting required.
RFP 952-5322 Page: 4of29 Revised Exhibit B .. •· ·. · ·.: S.nato Bill 161 Wraparound and Therapeutic Foster C11n:1 S&rvlees _;: ·';~.!; FamUlssFlrst, Inc. dba EMO FamillosFlrst : ,._:-:•· ........ •:•: Budget• July 1, 2016 to JUnG> 30, 2016 0007 Clnlcat Program Manager I Total Amount $ 254,860 4.0 FTE at an average salary of $63,715 = $254,860 M3ste(s degree (MA/MS) required in a related field; two to four years related experience. Must have appropriate license to practice as a licensed Oinlcal Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Hires, develops, trains, manages and retains clinical program staff. 0008 Facilitator I TotalAmount $ 466,824 12.0 FTE at an average salary of S38,902 = $466,824 Maste(s Degree (MS/ MA} in Psychology, Social Work, Counseling or related field required. Works in the family's home and a variety of community and/or treatment settings, coordinates services with an understanding of the complellity of each family while blending the clinical care of the youth with the facilitation of the life domain planning process. 0009 Family Partner (Rct) I Total Amount $ 13S,S72 4.0 FTE at an average salary of $33,893 = $13S,S72 High School Diploma or General Education Development (GED) required; some college education is preferred. Three years of experience as a parent or caregiver of child with special needs. Implements family friendly practices by providing a parent's perspective to the routine operations and developments of programs. 0010 Family Specialist I Total Amount $ 662,706 22.0 FTE at an average salary of $30,123 = S662, 706 Bachelor's degree (BA/BS) required; six months, one year, or two years of experience working with SEO children required, dependent upon connect, OR equivalent combination of education and experience. Develops a strength based relationship with youth and caregivers in order to intervene with maladaptive behaviors while developing the youths strengths and interests. 0011 Family Service Coordinator: Fam!ly Finding I Total Amount $ 40,010 1.0 FTE at a salary of $40,010 = $40,010 Associate's degree (AA/AS) and six years of experience or Bachelor's degree {BNBS) with four years of experience or Master's degree (MA/MS) with two years of experience in related field is required. Works independently in family homes and a variety of community and/or treatment settings directly with children and adults. ls responsible for developing and coordinating family-centered teams. 0012 Famllv Services Coordinator I Tota!Amount $ 40,010 1.0 FTE at an average salary of $40,010 = $40,010 Associate's degree (AA/AS} and she years of experience or Bachelor's degree (BA/BS) with four years of experience or Master's degree (MA/MS) with two years of experience in related field is required. Works independently in family homes and a variety of community and/or treatment settings directly with children and adults. ts responsible for developing and coordinating family-centered teams. 0013 Program Supervl$0r I Total Amount $ 154,635 3.0 FTE at an average salary of $51,545 = $154,635 Bachelor's Degree (BA/ BS) in Psychology, Social Work, Counseling, Education or related field. Minimum of three (3) years of experience in social or mental health services delivery, residential care supervision or education required. Hires, develops, trains and manages program staff. Coordinates and supervises daily program operations. 0014 Intake Coordinator I TotalAmount $ 38,783 1.0 mat a salary of $38,783 = $38,783 Bachelor's degree (BA) In social work, psychology, marriage, child and family counseling, counseling psychology; minimum of two years of experience working with dependent children is required. This position is responsible for placement of clients into the program.
!•, RFP 952-5322 . -. ., 0015 Administrative Assistant II 1.0 FTE at a salary of$33,219 = $33,219 Page: 5 of29 •: Senate Bllf 163 Wraparound and Thilrapoutle Foster Care S•rvlcet FamlllesFlrllt, Inc. dba EMQ FamlllosFlrst Budg&t. Jlilv 1, 2.01510 June 30, 2016 Revised Exhibit B I Total Amount $ 33,219 High school diploma, GEO or equivalent combination of education and experience required. The administrative assistant II provides administrative support to program staff; perfonns private insurance billing and handles all flex funds for the Wrap program. I Total Amount 0016 BHlfng Specialist $ 31,024 1.0 FTE at an average salary of$31,024 = $31,024 High school diploma, GED or equivalent combination of education and experience required. This position inputs the EPSOT blll!ng into Avatar along with reconciliation and preparation of claim certification and inputs the units and flex funds on S8163 invoice. 0017 ED, Regional Executive Director 0.45 m at a salary of S 115,818 = $52,119 I Total Amount $ 52,119 Master's Degree {MA/MS} in Psychology, Social Work, Marriage and Family Counseling. Administration, Business or related field is required. Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. This position provides leadership, strategic direction and operational oversight. This position provides leadership, strategic direction and operational oversight. I Total Amount 0018 Health lnfonnatfon Management $ 34,128 l.0 FTE at a salary of $34,12B = $34,128 Associates degree (M/AS) required with one year direct work experience. Database, Visual Basic, and/or Crystal Reports experience required. Basic knowledge oflegal issues regarding releases ofinformation and other medical records issues required. Technical training on report writing in a database environment required. I Total Amount 0019 Leaming Partners S 69,379 1.0 FTE at an average salary of $69,379 "$69,379 Bachelor's Degree (BA/BS) or equivalent experience in related field required. Two years o( experience in education/learning/training. Assesses learning needs, designs, develops and oresents leanini? actMties. I TotalAmount 0020 Outcomes Evaluation $ 23,200 0.5 FTE at a salary of $46,400 = $23,200 Bachelor's degree (BA/BS) required with Si)( years research experience with statistical analysis software, database development, management, merging of multiple databases. Four (4) years of related experience in literature review, program research, data collection, Intermediate-advanced evaluation, and advanced knowledge and usage of statistical software package. Minimum of one (1} year experience in training research activities and lead responsibilities in research projects. I Total Amount 0021 Quality Support $ 38,29S o.s FTE at a salary of $76,589 = $38,295 Master's Degree (MA/ MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Develops, maintains, and manages operational infrastructure functions that provide support to service delivery (intake, medical records), the assurance of quality {utilization review and quality and manages operational infrastructure functions that provide support to service delivery (intake, medical records), the assurance of quality (utilization review and quality assurance structures, training structures, outcomes evaluation structures, risk management oversight) for a distinct geographic region In compliance with agency standards. 0030OA501 Calculated at 6.2% of salaries. I TotalAmount $ 163,325 I TotalAmount
RFP 952-5322 Page: 6 of29 Revised Exhibit B .· ,. •• '.• • •: -;-:v.,;._,•~:.?•.,,.,•: •.· . ~ ; · Senaw sm 163 Wraparound and Th&r.apeuUc F0&tar care S&rvlce8 ... FamllknsFirst, Inc. dba EMQ FamliiesFlrst .' \: ... ··-. .:·~1~;~:.,: -~-' . . Budget• July 1, 2015 to Juno 30,201£ .·.-:. . .. . . . . 0031 FICA/MEDICARE Is 38,198 calculated at 1.45% of salaries. 0032UI I Total Amount $ 61,906 calculated at 2.35% of sala,les. 0040 Retirement I Total Amount $ 105,372 calculated at 4.0% of salaries. 0041 Workers Compensatlon I TotalAmount $ 79,029 Calculated at 3.0% of salaries. 0042 Health Insurance (medical, vision, life, dental) I TotalAmount $ 291,508 Calculated at approximatelv 11% of salaries. 1010 Rent/LHSE Building I Total Amount $ S0,556 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes building, storage and file storage unit rental payments and all the costs associated with storing and retrieving of client, personnel or other files or records. 1011 Rent/lease Equipment I TotalAmount $ 4,163 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes rental payments for equipment including leased copiers, faxes, postage machines, phone systems, laptops or other communication, office or facility equipment. 1014 Malntenilnce (facility) I Total Amount $ 4,456 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes common area maintenance on leased building charges, maintenance/building repair charges, HVAC maintenance and repair, landscaping, Janitorial services, confidential paper shredding services, in-house or outside equipment repair and labor. 1017 Other-Depredation I Toti! Amount $ 5,624 Depreciation includes deprecation on leasehold improvements, office furniture/fixtures and equipment meeting amortization thresholds. Costs are allocated between programs on the basis of payroll dolfars and have been estimated based on historical trends. 1060 Telephone I Total Amount $ 54,836 Cell phones, land Lines, DSL, fax charges, phone system; also wireless cards for laptop computers enabling us to maintain a fully functional mobile work force to deliver in-home services. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends.
RFP 952-5322 Page: 7 of29 Revised Exhibit B ;.-... :·.{;.;,. .!. ~-:~t.:'-•. -!'-. .... -~~.. .. .. :::• ... ,:-. .. '·-~ · ···s.lU\bil 8111.1&3 Wnlparound and Th&rapeutk: fostllr Care S11rvlc&a FamlllllsFlrst. Inc. dba EMQ famllle11Flrst ·~--.. Budget• July 1, 20Ul to June 30, 2016 .. 1062 Postage/Shipping/Printing I TotalAmount $ 1,901 Postage, printing, US malL GSO, Federal Express, UPS, postage machine refills, outside reproduction costs, program specific brochures and flvers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. Postage, printing. US mail, GSO, Federal Express, UPS, postage machine refills, outside reproduction costs, program specific brochures and flyers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. 1066 Office Supplies & Equipment I Total Amount $ 6,409 Office supplies and equipment indude, but are not limited to: paper, pens, files, staplers, break rooms supplies such as coffee, paper cups, plastic utensils are also included. Costs are allocated between programs on the basis of direct labor dollars and have been estimated based on historical trends. 1069 Program Supplies-Therapeutic I Total Amount $ 11,250 Includes those supplies utilized In the direct delivery of therapeutic services to clients. Cost ls estimated to be approximately $15.00 per dlrect care staff per month. Materials, cash payments, outing costs, etc. used to motivate or reinforce desired behavior. 1072 Staff Mileage/vehicle maintenance I TotalAmount $ 220,650 Primarily includes mileage reimbursement paid (at the current federal rate to staff supporting program or program related activities. In addition, a component of travel costs may include overnight travel by staff for training, meetings or conferences. This figure also takes into consideration that we anticipate that the majority of all program services will be delivered in the community. Also includes the transportation of clients. Costs are estimated to be approximately 9.38% of direct personnel costs prior to taxes and benefits. 1074 Staff Training/ Registration I Total Amount $ 6,682 Includes ongoing training in the Wraparound model of care, organizational tools, team/organizational psychology, philosophy of client based services, integration of roles/team dynamics, assessment and individualized treatment planning, general services, organized admissions, and individualized treatment planning associated with the Wraparound system of care. Also includes other mandatory trainings such as first aid and CPR. 1076 Other -Emergency Flex Funds I Total Amount $ 63,000 Cost of "whatever it takes• flexible funding for client needs to maintain growth, functioning and recovery. Flexible funds were budgeted at $35 per client per month. Requests above $300 are approved by the Wraparound Community Team. 1081 btemal Audit I Total Amount S 7,2.71 Includes annual audit Insuring all financial records are relevant and accurate and in compliance with state and federal laws and regulations. Audit costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical costs. 1082 Uabllity Insurance I Total Amount $ 20,412 Includes 11eneral business liablllty and orooerty coverage along with professional liability insurance.
RFP 952-5322 Page: 8 of29 Revised Exhibit B ·.•~ .. ., . -~.'-..: '·:··i:.._ ,. ·. --·;, ,: :,·,, ·, .. Sefiate Blll 1$3 Wraparound ~nd Therapel(flc FO$t.Gr Caro Services .. FamlllesFirat, Inc. dba EMQ Faml!ieeFltsl ... ·" .. . . .. Budget• July 1, 2015 to Jurio 30, 2016 1083 Other-Administrative overhead I Total Amount $ 647,317 Represents the indirect costs of the agency's general and administrative shared support services such as finance, accounting, billing, human resources, dinlcal administration, informatlon technology, quality assurance and outcomes/evaluation, insurance, professional fees, HIPAA compliance and clinical record audits, quality management oversight or Medi-Cal records, risl: management and program fidelity, recruiting and human resources support, MIS infrastructure & QI/UM department support and oversight as well as executive management. Costs that cannot be specifically charged to a program are allocated to programs on the basis of direct labor program costs prior to the addition of taxes and benefits. Indirect costs have been budgeted at 15¾ of program costs. 1089 Medication Supports I Total Amount $ 21.840 This is a contract position estimated at to cost $175 per hour. The psychiatrist will be required to provide 2.61 hours per week, or approximately 10.44 hours per month {$1,820 per month x 12 months= $21,840) and will provide medical oversighVsupervision of program services. 3000-3900 Medi-Cal Revenues I Total Amount $ 4,500,000 Medi-cal eligibility is estimated to be 90% of all clients served. For the purpose of a conservative revenue projection, only the clinicians, facilitators and family specialists were assumed to be billable positions. Blend of service and unit volume are based on EMQ FamiliesFirst's experience in delivering mental health services in its existing Wraparound program. This budget assumes full staff and full census on day one and projects Medi-Cal revenue generation of $3,375,000 for the initial 12 month period. These revenue figures are based on a case management rate of $2.02 per minute, a mental health rate of $2.61 per minute, a medication support rate of $4,82 per minute, a collateral rate of $2.61 per minute and a crisis intervention rate of $3.88 per minute. The blend of services is anticipated to be 7% case management, 15% mental health, 1% crisis intervention, 1% medication support, 2% collateral, 10% ICC-case management, 64% ISHS-rehab.
RFP 952-5322 .. ,: -.. ·.-·• .·· .. · .... Page: 9 of 29 ·Sonalilt BIii 163 Wraparound and Therapoutlc f:osl8r Caro Services FamillesFirst, Inc. dba EMQ Famllie11First Budget• July 1, 2016 to June 30, 2016 Revised Exhibit B It is recognized that overhead cost is part of every organizations cost of doing business to evaluate direct service cost versus overhead cost, please utilize this page to delineate whal makes up your agencies overhead. Below is an example of overhead cost components/categories. please feel free to adjust to best represent your agency Cost Catec:iories Accountirn:i/Finance Human Resources Information Tech. Executive Manac:iement Training /Quality/Compliance Total Amount Reouested Exolanalion Agency corporate general accounting and financial 129 463 services 129.463 194 195 97,098 97,098 647.317 Agency human resources and administration, including recruiling, training and employee development Agency network, communication, security, application development and maintenance Agency management and leadership and administration Agency corporate training, quality, and compliance requirements 1) Please provide your agency's total administrative overhead cost. $13,000,000 2} Please provide the percentage of your agency's total administrative overhead cost, as is ii relates to your total agency cost. 15% 3) Please indicate your agency's proposed total cost for this service component. $4,500,000 4) Please indicate the percentage of your agency's administrative overhead cost charge, as it relates lo the total cost proposed for this service component. 15% 5) Please indicate the percentage of the total agency's administrative overhead cost, charged under this service component as it relates to your agency's total administrative cost. 5%
RFP 952-5322 Page: 10 of 29 Revised Exhibit B •:.:· ..... . ' ... . ·. ~: ... :.·· 'Senato 8111163 Wraparound and Therap,autlc Foster Car& Servlce8 · FamUlesFlrnt, Inc. dba EMQ Famll!esFlrst :; . ;,; .: .:. .. · .. ::·, . .. Budget-July 1, %018 Co June 30, 2017 Budgec Categories -Total Proposed Budaet Non Direct Consumer Cost Direct Consumer Cost Mea1-t;a1 NOO M8Dl·v8I Mt:Ul·Ull NOnMeo1-1,.;a1 Line Item Description (Must be itemized) FTE% Billable Cost Billable Cost Billable Cost Billable Cost Total PERSONNEL SALARIES: 0001 Title Associate Director 1.00 $61,870 $20,623 S82,493 0002 Title Cfinician t 4.00 S144,093 S48,031 S192,124 0003 TIiie Clinical Director 0.50 $34,147 S11.383 $45,530 0004 Tille Community Development Spec (RCL) 1.00 $33,653 $33.653 0005 Tille Addiction Prevention Counselor 3.00 577.222 S25,741 S102,963 0006 Tttle EducationNocalionat Specialist 3.00 S77,076 525,692 $102,768 0007 Tille Clinlcal Program Manager 4.00 $191,145 $63,715 S254,860 0008 TiUe Facilitator 12.00 S350,118 $116,706 $466,824 0009 Title Family Pat1ner (RCLl 4.00 S135,572 $135,572 0010 Tille Family Specialist 22.00 $497,029 S165,677 $662,706 0011 Tille Family Services Coordinator: Family Finding 1.00 $30,007 S10,003 $40,010 0012 Title Family Service Coordinator 1.00 S30,007 S10.003 $40,010 0013 Titla Program Supervisor 3.00 $115,976 $38,659 $154,635 0014 TiUe Intake Coordinator 1.00 $29,087 $9,696 S38,783 0015 Tille Administrative Assistant II 1.00 $24,914 S8,305 $33,219 0016 Title BIiiing Specialist 1.00 $23.268 $7,756 $31,024 0017 Title ED. Regional Executive Director 0.45 S39,089 S13,030 $52,119 0018 TIiie Health lnfonnation Management 1.00 $25,596 $8,532 S34,128 0019 ntte Leaming Partners 1.00 S52.034 S17.345 S69,379 0020 Tille Outcomes & Evaluation 0.50 517,400 $5,800 S23,200 0021 TIiie QuaPly Support 0.50 S28,721 $9,574 S38.295 SALARY TOTAL 65.95 S211,022 S70,342 $1,637,777 S715,154 $2,634,295 PAYROLL TAXES: 0030 CASO! old age survivor and dlsablllty $13,083 S4,361 $101,542 S44,339 S163,325 0031 FICA/MEDICARE $3,060 $1,020 S23,748 S10,370 $38,198 0032 U.1. S4,959 $1,653 S38,488 516,806 S61,906 PAYROLL TAX TOTAL $21,102 $7,034 $163,778 $71,515 $263,429 EMPLOYEE BENEFITS: 0040 Retirement SB.441 $2,814 S65,511 S28,606 $105,372 0041 Worxers Compensation S6,331 $2,110 S49,133 $21,455 S79,029 0042 Health Insurance (medical vision, lire, dental) S23,351 $7,784 $181,235 $79,138 $291,508 EMPLOYEE BENEFITS TOTAL $38,123 S12,708 $295,879 $129,199 $475,909 SAlARY & BENEFITS GRAND TOTAL $270,247 $90.084 $2,097,434 $915,868 $3,373,633 Meo1-i.;a1 Non MeOH..a1 FACILITIES/EQUIPMENT EXPENSES: Billable Cost Billable Cost Total 1010 Rent/Lease Building 37,917 12,639 $50,556 1011 Rent/Lease Equipment 3,122 1,041 $4,163 1014 Maintenance {facility) 3,342 1,114 $4,456 1017 Other -Depreciation 4,218 1,406 $5,624 FACILITY/EQUIPMENT TOTAL S48,599 S16,200 $64,799 OPERATING EXPENSES: 1060 Telephone $41,127 $13,709 $54,836 1062 Postage/Shipplng/Prinling 1,426 475 $1,901 1066 Office Supplies & Equipment 4,807 1,602 S6,409 1069 Program Supplies -Therapeutic 8,437 2,813 $11,250 1072 Steff MIieage/vehicie maintenance 165,487 55,163 $220,650 1074 Slaff Training/Registration 5,011 1,671 S6,682 1076 Other• Emergency Flex Funds 63,000 $63,000 OPERATING EXPENSES TOTAL $226,295 $138,433 $ 384,728 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping so 1081 EXlernalAUdlt 5,453 1,818 7,271 1082 Liabltlty Insurance 17,382 3,030 $20,412 1083 Other -Administrative Overhead 485,488 161,829 647,317 FINANCIAL SERVICES TOTAL 508,323 166,677 $675,000 SPECIAL EXPENSES (Consultant/Etc.): 1089 Medication Supports I 16,380 I 5,460 I $21,840 SPECIAL EXPENSES TOTAL 16,380 5,460 I $21,840 TOT AL PROGRAM EXPENSES I $4,500,000
RFP 952-5322 Page: 11 of 29 Revised Exhibit B ·. _ . .:, ... • .. . .;...::;-. ...,._.. • ... -: ·-··. . ·s.nate am 163 Wraparound and Therapet.ltlc Foster Car& Services Famllie&Flrst, Inc. dba EMQ FamilfeaFirst :.:-,.•: ' Eludg&t • .,luly 1, 2016 Co .,lune 30, 2017 Vol/Units or r.ieo1-1..a1 NOn MeOl•\.:81 DIRECT SERVICE REVENUE: Svc Rate Billable Cost Billable Cost $Amt. 3000 Mental Health Se!Vices 94,515 $2.61 S246,684 $246,684 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab} 3100 Case Management, linkage/Brokerage 203,298 $2.02 S41Q.662 $410,662 3200 Crisis lnlervenilon 6,776 53.88 $26,291 $26,291 3300 Medication Support 13,553 $4,82 $65,325 S65.325 3400 Collateral 27,105 $2.61 $70,744 $70,744 3500 Court Documentation, Report. Appearance so 3600 Psychological evaluation $0 3700 ICC-Case Management 135,527 $2.02 $273,765 $273.765 3800 IHBS•Rehab 874,149 $2.61 $2,281.529 $2,261,529 3900 SB Non Billable Services 1,022,727 $1.10 $1,125,000 $1,125,000 DIRECT SERVICE REVENUE TOT AL 2,377.650 S 3,375,000 s 1,125,000 $4,500,000 OTHER REVENUE: 14000 Other so 4100 Olher so 4200 Other so 4300 Other so OTHER REVENUE TOTAL so TOTAL PROGRAM REVENUE $.f,500,000 1,667.500 Medi-Cal Revenue 50% FFP 1,350,000 Medi-Cal Revenue 40% EPSDT (2011 Realignment) 337,500 Medi.Cal Revenue 10% County S8163 Trust Fund $ 3,375,000 Total Medi-Cal Revenue 1,354,923 Total Medi-Cal Units $ 2.49 Medi.cal cost per unit $1,125.000 Non Medi.Cal Billable Service Coat 1.022.727 Total Non-Medi-Cal BIiiabie units $ 1.10 Non Modi-Cal cost per unit Annualized Total Summary $Dollar Amoun %Pen:entage% Mecu-1,;a1 Billable Casi $ 3,375,000 75% · Non Med1-1.,a1 Billable Cost s 1,125,000 25% Total $ 4,500.000
RFP 952-5322 Page: 12 of29 Revised Exhibit 8 .... ... . ;:·.~ . •' ·.:: ,·. · · Sonat& Biil 163 Wraparound and Thorapevtle Fosblr care Silrvle1111 FamlllesFinrt, Inc. dba EMQ FamillasFlrst .. ... , .-. ':, .. Budget-July 1, 201fi'to Juna 30, 2017 PROPOSED BUDGET DETAIL NARRATIVE BUDGET NARRATIVE 0001 Associate Director I Total Amount $ 82,493 1.0 FTE at a salary of S82,493 = $82,493 Master's degree (MA/MS}. Must have appropriate license to practice as a licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision with three to ten years of experience in healthcare/psychology/behavioral/mental health. The Associate Director assists the clinical director with implementing strategies to accomplish the agency annual priorities at the program level. Directs and develops managers, ensures CPMS are competent and have all tools necessary to lead teams. 0002 Clinician I I TotalAmount $ 192,124 4.0 FTE at average salary of $48,031 = $192,124 Master's Degree (MA/MS) and at least two years of EJ<perience working with youth, young adults and familles in a therapeutic environment is required. If unlicensed must be a registered Intern with the Board of Behavioral Sciences and receiving appropriate clinical supervision. Provides psychotherapy and psychotherapeutic support to children and families. 0003 CUnlcal Director I Total Amount $ 45,530 05 FTE at a salary of $91,060 = $45,530 Master's Degree (MA/MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a Ucensed Clinical Social Worker or Marriage family Therapist In the State of California. Must meet the BBS requirements to provide t;linical oversight and supervision. Provides regional leadership and effectively manages, develops, maintains, monitors and ensures the clinical quality in multiple clinical programs. 0004 Community Development Specialist (RCL) I Total Amount $ 33,653 1.0 FTE at a salary of $33,653 = $33,653 Bachelor's Degree (SA/ BS) In Marketing or related field preferred. The community development specialist develops resources that support the needs of young people and families receiving agency services. Inspires and ensures community engagement In therapeutic and strength based opportunities to enhance or create mental health programs. 0005 Addiction Prevention Counselor I Total Amount $ 102,963 3.0 FTE atan average salary of$34,321 = $102,963 Bachelor's degree (BA/ BS) or higher in Psychology, Counseling or Social Work; certified drug and alcohol counselor is preferred. Two to four years related experience or an equivalent combination of education and experience working with youth or young adults with co-occurring disorders. 0006 Education/Vocational Specialist I Total Amount $ 102,768 3.0 FTE atan average salary of $34,256 = $102,768 Associate's Degree (AA/ AS) AND six {6) years related experience in a mental health/education/vocational setting required. • OR Bachelor's Degree (BA/BSI AND four {4) years related experience In a mental health/education/vocatlonal setting required. • OR Master's Degree {MA/ MS) In a mental health related field ANO two (2) years related experience in a mental health setting required.
RFP 952-5322 Page: 13 of29 Revised Exhibit B ._ ~ ~ !, ,;. •· .. · S.nato 8111163 Wraparound and Thorapoutle Foster Caro 'Servk:ee FamlllesFlrst, Inc. dba EMQ FamlliosFln;t Budgqt • Jlrly 1, 2016 to Juoo 30, 2017 0007 Oinlcal Program Manager I Total Amount $ 254,860 4,0 FTE at an average salary of $63,715 = $254,860 Master's degree (MNMS) required in a related field; two to four years related experience. Must have appropriate license to practice as a licensed Oinlcal Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Hires, develops, trains, manages and retains dinical program staff. 000B Facilitator I Total Amount S 465,824 12.0 FTE at an average salary of $38,902 = $466,824 Master's Degree {MS/ MA) in Psychology, Social Work, Counseling or related field required. Works in the family's home and a variety of community and/or treatment settings, coordinates sen.ices with an understanding of the complexity of each family while blending the clinical care of the youth with the facilitation of the life domain planning process. 0009 famlly Partner {RCL) I Total Amount $ 13S,572 4.0 FTE at an average salary of $33,893 = $135,572 High School Diploma or General Education Development (GEO} required; some college education is preferred. Three years of experience as a parent or caregiver of child with special needs. Implements family friendly practices by providing a parent's perspective to the routine operations and developments of programs. 0010 Family Spedallst I TotalAmount $ 662,706 22.0 FTE at an average salary of $30,123 = $662,706 Bachelor's degree (BA/BS) required; she months, one year, or two years of experience working with SED children required, dependent upon connect, OR equivalent combination of education and experience. Develops a strength based relationship with youth and caregivers In order to intervene with maladaptive behaviors while developing the youths strengths and interests. 0011 Famllv Service tcordinator: Famlly Finding I Total Amount $ 40,010 1.0 FTE at a salary of $40,010 = $40,010 Assoclate's degree (M/ASJ and siK years of experience or Bachelor's degree (BA/BS) with four years of experience or Master's degree (MA/MS) with two years of experience in related field is required. Works independently in family homes and a variety of community and/or treatment settings directly with children and adults. is responsible for developing and coordinating family-centered teams. 0012 Family Services Coordinator I Total Amount $ 40,010 1.0 FTE at an average salary of $40,010 = $40,010 Assoclate's degree (AA/AS) and six years of experience or Bachelor's degree {llA/BSI with four years of experience or Master's degree {MNMSI with two years of experience in related field is required. works independently in family homes and a variety of community and/or treatment settings directly with children and adults. Is responsible for developing and coordinating family-centered teams. 0013 Program Supervisor I Total Amount $ 154,635 3.0 FTE at an average salary of $51,545 = $154,635 Bachelor's Degree {BA/ BS) in Psychology, Social Work, Counseling, Education or related field. Minimum of three (3) years of experience in social or mental health services delivery, residential care supervision or education required. Hires, develops, trains and manages program staff. Coordinates and supervises daily program operations. 0014 Intake COordlnator I Total Amount S 38,783 1.0 FTE at a salary of $38,783 = $38,783 Bachelor's degree (BA) in social work, psychology, marriage, child and family counseling, counseling psychology; minimum of two years of experience working with dependent children is required. This position is responsible for placement of clients Into the program.
RFP 952-5322 Page: 14 of 29 Revised Exhibit B .. .--·,:-. .. .. ..·:· . . Senato Biil 163 Wmparound and Tholl!peutlc FOSflllr Care Services FamlliesFlrst, Inc. dba EMQ FamlliesFln.t . ·.: -~: ... : . . ... Budgat-July 1, 2016 to June 30, 2017 . . 0015 Administrative Assistant II I TotalAmount $ 33,219 1.0 FTE at a salary of $33,219 "'$33,219 High school diploma, GED or equivalent combination of education and experience required. The administrative assistant II provides administrative support to program staff; performs private insurance billing and handles all flex funds for the Wrap program. 0016 BIiiing Specialist I Total Amount $ 31,024 1.0 FTE at an average salary of $31,024 = $31,024 High school diploma, GED or equivalent combination of education and e~erience required. This position inputs the EPSDT billing into Avatar along with reconciliation and preparation of claim certification and inputs the units and flex funds on SB163 invoice. ' 0017 ED, Regional Executive Director I Total Amount $ 52,119 0.45 FTE at a salary of$115,818= $52,119 Master's Degree (MA/MS) in Psychology, Social Work, Marriage and Family Counseling, Administration. Business or related field is required. Must have appropriate license to practice as a licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide cl!nical oversight and supeNision. This position provides leadership, strategic direction and operational oversight This position provides leadership, strateglc direction and operational oversight. 0018 Health Information Management I TotalAmount $ 34,128 1.0 FTE at a salary of $34,128 = $34,128 Associates degree {AA/AS) required with one year direct work experience. Database, Visual Basic, and/or Crystal Reports experience required. Basic knowledge of legal issues regarding releases of Information and other medical records issues required. Technical training on report writing in a database environment required. 0019 Leaming Partners I Total Amount $ 69,379 1.0 FTE at an average salary of $69,379 = $69,379 Bachelor's Degree {BNSSI or equivalent eKperience in related field required. Two years of eicperience in education/learning/training. Assesses learning needs, designs, develops and presents leaninll activities. 0020 Outcomes Evaluation I Total Amount $ 23,200 0.5 FTE at a salary of $46,400 = $23,200 Bachelor's degree (BA/BS} required with six years research experience with statistical analysis software, database development, management, merging of multiple databases. Four (4} years of related elCperience in literature review, program research, data collection, intermediate-advanced evaluation, and advanced knowledge and usage of statistical software package. Minimum of one Ill year experience in training research activities and lead responsibilities in research projects. 0021 Quality Support I TotalAmount $ 38,295 O.S FTE at a salary of $76,589 = $38,295 Master's Degree (MA/ MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supet'Vision. Develops, maintains, and manages operational infrastructure functions that provide support to service delivery flntake, medical records), the assurance of quality (utiliz.ation review and quality and manages operational infrastructure functions that provide support to service delivery {intake, medical reeords}, the assurance of quality (utilization review and quality assurance structures, training structures, outcomes evaluation structures, risk management oversight) for a distinct geographic region ln compliance with agency standards. 0030OASOI I Total Amount $ 163,325 calculated at 6.2% or salaries. I Total Amount
RFP 952-5322 Page: 15 of 29 Revised Exhibit B = ~· • ' _._ .. ... ~ .. • 'Senate em 163 Wraparound and Therapeutlc Fomrcare Setvlcea : .. FamlllesFlrst, Inc. dba EMQ FamlliasFlrst . .: . Budget• July 1, 2016 to June 30, 2017 . 0031 FICA/MEDICARE I$ 38,198 Calculated at 1.45% of salaries. 003201 I Total Amount $ 61,906 calculated at 2.35% of salaries. 0040 Retirement I Total Amount $ 105,372 Calculated at 4.0~ of salaries. 0041 Workers Compensation I Total Amount $ 79,029 Calculated at 3.0% of salaries. 0042 Health insurance (medical, vision, life, dental) I Total Amount $ 291,508 Calculated at approximatelv 11% of salaries. 1010 Rent/tease Buildlng I Total Amount $ 50,556 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes building, storage and file storage unit rental payments and all the costs associated with storing and retrieving of client, personnel or other files or records. 1011 Rent/lease Equipment I TotalAmount $ 4,163 All occupancy costs are allocated between programs on the basi5 of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes rental payments for equipment including lea5ed copiers, faxes, postage machines, phone systems, laptops or other commuriication, office or facility equipment. 1014 Maintenance (facility) I TotalAmount $ 4,456 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes common area maintenance on leased building charges, maintenance/building repair charges, HVAC maintenance and repair, landscaping, Janitorial services, confidential paper shredding services, in-house or outslde equipment repair and labor. 1017 Other-Depredation I Total Amount $ 5,624 Depreciation Includes deprecation on leasehold improvements, office furniture/fixtures and equipment meeting amortization thresholds. Costs .ire allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. 1060 Telephone I Total Amount $ 54,836 Cell phones, Land lines, DSL, fax charges, phone system; also wireless cards for laptop computers enabling us to maintain a fully functional mobile work force to deliver in-home services. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends.
RFP 952-5322 ~age: 16 of 29 Revised Exhibit B .. ••• -,1· ·-.. Senate Bill 163 Wraparound andTflel'llpeutlc fostorCam Sor,,Jces •·. FamlllosFlrst, Inc. dba EMQ Famlll!!SFlrst Budgot • July 1, 2016 to June 30, 2017 1062 Postage/Shipping/Printing I Total Amount $ 1,901 Postage, printing, US mail, GSO, federal Express, UPS, postage machine refills, outside reproduction costs, program specific brochures and flyers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historlcal trends. Postage, printing, US mail, GSO, Federal Express. UPS. postage machine refills, outside reproduction costs, program specific brochures and flyers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. 1066 Office Supplies & Equipment I Total Amount $ 6,409 Office supplies and equipment include, but are not limited to: paper, pens, flh,s, staplers, break rooms supplies such as coffee, paper cups, plastic utensils are also included. Costs are allocated between programs on the basis of direct labor dollars and have been estimated based on historical trends. 1069 Program Supplles•Therapeutk: I Total Amount $ 11,250 lndudes those suppfies utilized in the direct delivery of therapeutic services to clients. Cost is estimated to be approximately $15.00 per direct care staff per month. Materials, cash payments, outing costs, etc. used to motivate or reinforce desired behavior. 10n Staff MIieage/vehicle maintenance I Total Amount $ 220,650 Primarily indudes mileage reimbursement paid (at the current federal rate to staff supporting program or program related activities. In addition, a component of travel costs may indude overnight travel by staff for training, meetings or conferences. This figure also takes into consideration that we anticipate that the majority of all program services will be delivered in the community. Also includes the transportation of clients. Costs are estimated to be approximately 9.38% of direct personnel costs prior to taxes and benefits. 1074 Staff Training/ Registration I Total Amount $ 6,682 Includes ongoing training in the Wraparound model of care, organizational tools, team/organizational psychology, philosophy of dient based services, integration of roles/team dynamics, assessment and Individualized treatment planning, general services, organized admissions, and individualized treatment planning associated with the Wraparound system of care. Also includes other mandatory trainings such as first aid and CPR. 1076 Other -Emergency FleM Fund$ I 1otal Amount $ 63,000 Cost of-whatever it takes" flexible funding for client needs to maintain growth, functioning and recovery. Flexible funds were budgeted at $3S per client per month. Requests above $300 are approved by the Wraparound Community Team. 1081 External Audit I Total Amount $ 7,271 Includes annual audit insuring all financial records are relevant and accurate and in compliance with state and federal laws and regul~tions. Audit costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical costs. 1082 Uabllitv Insurance I Total Amount $ 20,412 Includes 11eneral business liability and property coverage along with professional liability insurance.
RFP 952-5322 Page: 17 of 29 Revised Exhibit B •,• < .. ,::---•·' -:SfJna1& BUI 163 Wraparound 12nd Thertpeutlc Foster Caro Sorvlces FamlllosFlrst. Inc. dba EMQ FamiliMFirst ' .. audgot-July 1, 2016 to June 30, 2017 1083 Other•Adminlstratlve overhead I TotalAmount $ 647,317 Represents the indirect costs of the agency's general and administrative shared support services such as finance, accounting, billing, human resources, clinical administration, information technology, quality assurance and outcomes/evaluation, insurance, professional fees, HIPAA compliance and dinlcal record audits, quality management oversight of Medi-cal records, risk management and program fidelity, recruiting and human resources suppon, MIS infrastructure & QI/UM department support and oversight as well as e>Cecutive management. Costs that cannot be specifically charged to a program are allocated to programs on the basis of direct labor program costs prior to the addition of taxes and benefits. Indirect costs have been budgeted at 1S% of program costs. 1089 Medication Supports I Total Amount $ 21,840 This is a contract position estimated at to cost $175 per hour. The psychiatrist will be required to provide 2.61 hours per week, or approKimately 10.44 hours per month ($1,820 per month x 12 months= $21,840) and will provide rMdical oversight/supervision of program services. 3000-3900 Medi-cal Revenues I Total Amount $ 4,500,000 Medi-cal eligibility is estimated to be 90% of all clients served. For the purpose of a conservative revenue projection, only the clinicians, facilitators and family specialists were assumed to be billable positions. Blend of service and unit volume are based on EMQ familiesFirst's experience in delivering mental health services in Its existing Wraparound program. This budget assumes full staff and full census on day one and projects Medi-Cal revenue generation of $3,375,000 for the initial 12 month period. These revenue figures are based on a case management rate of $2.02 per minute, a mental health rate of $2.61 per minute, a medication support rate of $4.82 per minute, a collateral rate of $2.61 per minute and a crisis intervention rate of $3.88 per minute. The blend of services is anticipated to be 7¾ case management, 1S% mental health, l¾ crisis intervention, 1% medication support, 2% collateral, 10% ICC-case management, 64% IBHS-rehab.
RFP 952-5322 "' .:.'.' Page: 18 of29 Seflato BRI 163 Wraparound and Thempoutfc fostllr Caro Sorvl<:0$ FamlllasFlrst, Inc. dba EMQ FamlllesFlrst Budget-July 1, 2016 to Jum, 30, 2017 Revised Exhibit B It is recognized that overhead cost is part of every organizations cost of doing business to evaluate direct service cost versus overhead cost, please utilize this page to delineate what makes up your agencies overhead. Below is an example of overhead cost components/categories, please feel free to adjust to best represent your agency Cost Cateaorias Accountino/Finance Human Resources Information Tech. Executive Manaaement Training /Quality/Compliance Total Amount Requested Exolanalion Agency corporate general accounting and financial 129,463 services 129,463 194.195 97,098 97,098 647.317 Agency human resources and administration, including recruiting, training and employee development Agency network, communication, security, application development and maintenance Agency management and leadership and administration Agency corporate training, quality, and compliance requirements 1) Please provide your agency's total administrative overhead cost. $13,000,000 2) Please provide the percentage of your agency's total administrative overhead cost, as is it relates to your total agency cost. 15% 3) Please indicate your agency's proposed total cost for this service component. $4,500,000 4) Please indicate the percentage of your agency's administrative overhead cost charge, as it relates to the total cost proposed for this service component. 15% 5) Please indicate the percentage of the total agency's administrative overhead cost, charged under this service component as ii relates to your agency's total administrative cost. 5%
RFP 952-5322 Page: 19 of 29 Revised Exhibit B .... -~ .. ·:·· , .. ' -.. ·-·· Sonate BIU 163 Wraparound and Thampeutle Fosl&r care Sorvlco~ FamntesFlrst, Inc. dba EMQ Famllle-sFlrst . •.: .. ·, ....... .. Budget-July 1, 21117 to Juno 30, 2018 Budget Categories • Total Proposed 8ud9el Non Direct Consumer Cost Direr::! Consumer Cost Me0M.;a · NOn MeCll-vaJ Medr•<val NOnM80M.;at Line Item Description (Must be Itemized) FTE% 8iUable Cost BiHab!e Cost BIiiabie Cost BiHable Cost Total PERSONNEL SAIARIES; 0001 Title Associate Director 1.00 $61.870 $20,623 $82,493 0002 TIiie Clinician I 4.00 $144.093 $48,031 $192,124 0003 Title Clinical Director 0.50 $34,147 S11,3S3 545,530 0004 TIile Community Development Spec (RCt l 1.00 $33,653 $33,653 0005 Tille Addiction Prevention Counselor 3.00 $77,222 $25,741 S102,963 0006 TIiie EducalionNocallonal Specialist 3.00 $77,076 $25.692 $102,766 0007 Title Clin!cal Program Manager 4.00 $191,145 $63,715 S254.860 0008 Title Facilllalor 12.00 S350,118 $116,706 $466,824 0009 TiUe Family Partner {RCL) 4.00 $135,572 $135,572 0010 TIile Family Specialist 22.00 S497,029 $165,677 5662.706 0011 TIiie Family Services Coordinator. Family Finding 1.00 $30,007 $10,003 $40,010 0012 TIHe Family Service Coordinator 1.00 S30,007 $10,003 S40,010 0013 Ttlkl Program Supervisor 3.00 $115,976 $38,659 $154,635 0014 Title Intake Coordinator 1.00 $29,087 $9,696 $38,783 0015 Title Administrative Assistant II 1.00 $24,914 $8,305 $33,219 0016 Title Billing Specialist 1.00 S23,268 $7,756 $31,024 0017 TIile ED, Regional Executive Director 0.45 $39,089 $13,030 S52,119 0018 Title Health Information Management 1.00 $25,596 $8,532 534,128 0019 Tille Leaming Partners 1.00 $52,034 $17,345 $69,379 0020 Tl1Je Outcomes & Evaluation 0.50 $17.400 SS.800 S23,200 0021 Tille Quality Support 0.50 $28,721 $9.574 $38,295 SALARY TOTAL 65.95 S211,022 $70.342 $1,637,777 $715,154 $2,634.295 PAYROLL TAXES: 0030 OASOI old age survivor and disability $13,083 S4,361 $101,542 $44,339 $163,325 0031 FICA/MEDICARE $3,060 $1,020 $23,748 $10,370 S38.198 0032 U.1. $4,959 S1.653 $36,488 $16,606 $61,906 PAYROLL TAXTOTAL $21,102 $7,034 $163,778 $71.515 $263,429 EMPLOYEE BENEFITS: 0040 Retirement $8,441 $2,814 $65,511 S28,606 $105,372 0041 Workers Compensation $6,331 $2,110 $49,133 $21,455 $79,029 0042 Health lnsuranca (medical vision. lire. dental) $23,351 $7,784 $181,235 $79,138 S291,508 EMPLOYEE BENEFITS TOTAL $38,123 $12,708 $295,879 $129,199 $475,909 SALARY & BENEFITS GRAND TOTAL $270,247 $90,084 $2.097,434 $915,668 $3,373,633 Meor-1..,at NOnMeOt-1 .. B1 FACILITIES/EQUIPMENT EXPENSES: Billable Cost BiUable Cost Total 1010 RenlJl.ease Building 37,917 12,639 $50,556 1011 RenlJl.ease Equipment 3,122 1,041 $-4,163 1014 Maintenance (facility) 3,342 1,114 $4,456 1017 Other• Oeprecialion -4,218 1,406 S5.62-4 FACILITY/EQUIPMENT TOTAL $48.599 S16,200 S64,799 OPERATING EXPENSES: 1060 Telephone $41,127 $13,709 S54,636 1062 Poslage/Shlpping/Plinling 1,-426 475 $1,901 1066 Ollice Supplies & Equipment 4,807 1.602 $6,-409 1069 Program Supplies• Therapeutic 8,437 2,813 $11,250 1072 Slaff Milea91!/11ahicle maintenance 165.-487 55.163 $220,650 1074 Staff Training/Registration 5,011 1.671 $6,682 1076 Other-Ememencv Flex Funds 63,000 $63,000 OPERATING EXPENSES TOTAL $226,295 $138,433 s 364,728 FINANCIAL SERVICES EXPENSES: 1080 AccounUng/Bookkeeping so 1081 External Audit 5,453 1,818 7,271 1082 liability Insurance 17,382 3,030 $20,412 1083 Olher • Administrative Overhead 485,488 161.829 647,317 FINANCIAL SERVICES TOTAL 508,323 166,677 S675.000 SPECIAL EXPENSES (Consullanl/Elc.): 1089 Medication Surmarts 16,380 I 5.460 I 521,840 SPECIAL EXPENSES TOTAL 16,380 5.-460 I $21,840 TOTAL PROGRAM EXPENSES I $4,500,000
RFP 952-5322 Page: 20 of 29 Revised Exhibit B .: ·· .. ; Senate BHI 163 Wraparound and TIIGrapeutlc Foster Caro Services FamlllosFlrst, Inc. dba EMO Families First Budget• July 1, ~17 to Juno 30, 2018 VOUUOIIS Of Mea1-....a1 Non Mea1-~a1 DIRECT SERVICE REVENUE: Svc Rate BIilabie Cost Billable Cost SAmt. 3000 Mental Health Services 94,515 $2.61 $246,664 $246,664 {Assessment, Plan of Care, lndividuaVFamily/Group Therapy, Rehab} 3100 Case Management, Linkage/Brokerage 203,298 s2.02 $410,662 $410,662 3200 Crisis Intervention 6,776 $3.88 $26,291 $26,291 3300 Medication Support 13,553 $4.82 $65,325 $65,325 3400 Collateral 27,105 $2,61 $70,7-44 $70,744 3500 Court Documentation, Report, Appearance $0 3600 Psychological evaluation $0 3700 ICC-Case Management 135,527 $2.02 $273,765 $273,765 3800 IHBS-Rehab 67-4,149 $2.61 $2,281,529 $2,281,529 3900 SB Non Billable Services 1,022,727 $1.10 $1,125,000 $1,125,000 DIRECT SERVICE REVENUE TOTAL 2,377,650 S 3,375,000 $ 1,125,000 $-4,500,000 OTHER REVENUE: 4000 Olher so 4100 Other so 4200 Other so 4300 Other $0 OTHER REVENUE TOTAL $0 TOTAL PROGRAM REVENUE $4,600,000 1,687,500 Modi-Cal Revenue 50¾ FFP 1,350,000 Medi-Cal Revanuo 40% EPSOT f2011 Reallgnment) 337,500 Medi-Cal Revenue 10% County S8163 Trust Fund S 3,375.000 Total Medl-Cal Revenue 1.354,923 Total Medi-Cal Units $ 2.49 Medi-Cal cost per unit S 1,125,000 Non Medi.Cal Billable Service Cost 1.022,727 Total Non-Medi.Cal amable units s 1.10 Non Medi-Cal cost per unit Annualized Total Summary soonar Amoun %Perc,,m=e% Mt:Ul·val Billable Cost $ 3,375,000 75% NOnMeoH;a, Billable Cost s 1,125.000 25% Total s 4,500.000
RFP 962-5322 Page: 21 of 29 Revised Exhibit B . ~ : . ' ~ . .. . . &matu Bill 163 Wraparound and Tll$,apoutlc Foator Care Sorvk:os ',-: -~>)1~·::t-~:1';;•\· :-:· Famlllesflrst, Inc. dba EMQ Famlllesflrst ... ·•,•. . ,.•-Bvdggt • July 1, 2017 to Juno 30, 2018 PROPOSED BUDGET DETAIL NARRATIVE BUDGET NARRATIVE 0001 Associate Director I Tatar Amovnt $ 82,493 1.0 FTE at a salary of S82,493 = $82.493 Master's degree (MA/MS). Must have appropriate license to practice as a licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision with three to ten years of experience in healthcare/psychology/behavioral/mental health. The A.Ssociate Director assists the clinical director with implementing strategies to accomplish the agency annual priorities at the program level. Directs and develops managers, ensures CPMS are competent and have all tools necessary to lead teams. 0002 Clinician I I Total Amount $ 192,124 4.0 FTE at average salary of $48,031 = $192,124 Master's Degree (MA/MS) and at least two years of experience working with youth, young adults and families in a therapeutic environment is required. If unlicensed must be a registered intern with the Board of Behavioral Sciences and receiving appropriate clinical supervision. Provides psychotherapy and psychotherapeutic support to children and famifies. 0003 Cllnleal Director I Tot.I Amount $ 45,S30 O.S FTE at a salary of $91,060 = $45,530 Master's Degree (MA/MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Provides regional leadership and effectively manages, develops, maintains, monitors and ensures the clinical quality in multiple clinical programs. 0004 Community Development Specialist (RCl) I TotalAmount S 33,653 1.0 FTE at a salary of $33,653 = $33,653 Bachelor's Degree (BA/ BS) in Marketing or related field preferred. The cornmunlty development specialist develops resources that support the needs of young people and families receiving agency services. Inspires and ensures community engagement in therapeutic and strength based opportunities to enhance or create mental health programs. 0005 Addlcllon Prevention Counselor I Total Amount $ 102,963 3.0 FTE at an average salary of $34,321 = $102,963 Bachelor's degree (BA/ BS) or higher in Psychology, Counseling or Social Work; certified drug and alcohol counselor is preferred. Two to four years related experience or an equivalent combination of education and experience working with youth or young adults with co-occurring disorders. 0006 Education/Vocational Specialist I Total Amount $ 102,768 3.0 FTE atan average salary of $34,256 = $102,768 Associate's Degree (AN AS) ANO six (6) years related experience in a mental health/education/vocational setting required. • OR Bachelor's Degree (BA/BS) ANO four (4} years related experience in a mental health/education/vocational setting required. • OR Master's Degree {MA/ MS) in a mental health related field AND two (2) years related experience in a mental health setting required.
RFP 952-5322 Page: 22 of 29 Revised Exhibit B :, SGnato 8111163 Wraparound and Th&mpoutlc Fostar caro Sarvk:&s :::_; :-.~ · .. -~~::\::·~ ~ . . .... Familiei1Firat, Inc. dba EMO FamlllesFlrst ' ... .. Budget-Juty 1, 2017 to June SO, 2018 ••'. 0007 Cllnlcal Program Manager 4.0 FTE at an average salary of $63,715 = $254,860 I TotalArnount $ 254,860 Master's degree (MA/MS) required in a related field; two to four years related experience. Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to provide clinical oversight and supervision. Hires, develops, trains, manages and retains clinical program staff. 0008 Facllltator I Total Amount $ 466,824 12.0 FTE at an average salary of $38,902 = $466,824 Master's Degree (MS/ MA) in Psychology, Social Work, Counseling or related field required. Works in the family's home and a variety of community and/or treatment settings, coordinates services with an understanding of the complexity or each family while blending the clinical care of the youth with the facilitation of the fife domain planning process. 0009 Family Partner (RCt) I Total Amount $ 135,512 4.0 FTE at an average salary of $33,893 = $135,572 High School Diploma or General Education Development (GED) required; some college education is preferred. Three years of experience as a parent or caregiver of child with special needs. Implements family friendly practices by providing a parent's perspective to the routine operations and developments of programs. 0010 Family Speclallst I TotalAmount $ 662,706 22.0 FTE at an average salary of $30,123 = $662,706 Bachelor's degree (BA/BSJ required; six months, one year, or two years of experience working with SEO children required, dependent upon connect, OR equivalent combination of education and experience. Develops a strength based relationship with youth and caregivers in order to intervene with maladaptive behaviors while developing the youths strengths and interests. 0011 Family Service Coordinator: Family Finding I Total Amount $ 40,010 l.O FTE at a salary of $40,010 = $40,010 Associate's degree !AA/AS) and six years of experience or Bachelor's degree (BA/BS} with four years of experience or Master's degree (MA/MS) with two years of experience in related field is required. Works independently in family homes and a variety of community and/or treatment settings directly with children and adults. Is responsible for developing and coordinating family-centered teams. 0012 Family Services Coordinator I TotalAmount $ 40,010 1.0 FTE at an average salary of $40,010 = $40,010 Associate's degree {AA/1>:5) and six years of experience or Bachelor's degree (BA/BS) with four years of experience or Master's degree (MA/MS) with two years of experience in related field is required. Works independently in family homes and a variety of community and/or treatment settings directly with children and adults. is responsible for developing and coordinating family-centered teams. 0013 Program Supervisor I TotalAmount $ 154,635 3.0 FTE at an average salary of $51,545 = $154,635 Bachelor's Degree (BA/ BS} in Ps.ychology, Social Work, Counseling, Education or related field. Minimum of three (31 years of experience in social or mental health services delivery, residential care supervision or education required. Hires, develops, trains and manages program staff. Coordinates and supervises daily program operations, 0014 Intake Coordinator I Total Amount $ 38,783 l.OFTE ata salaryof$38,783 = $38,783 Bachelor's degree (BA} in social work, psychology, marriage, child and family counseling, counseling psychology; minimum of two yea rs of experience working with dependent children Is required. This position is responsible for placement of clients into the program.
RFP 952-532.2 Page: 23 of 29 Revised Exhibit B ... : ; ·=. ~ .. ..... "Sonate BUI 163 Wraparound and Therapeutic Follmr Care Servlcas FamillesFlrat, Inc. dba EMQ FamiliesFll'$t • .. : :!:~:. .: t'':.;. ·:"'<· : ;· .. -: .••• ~::-. ··•·· .,_, ~--. -· .·~ Budget-July 1, 2017 .to June 30, 2018 0015 Administrative Assistant II I Total Amount $ 33,219 1.0 FTE at a salary of$33,219 = $33,219 High school diploma, GEO or equivalent combination of education and experience required. The administrative assistant II provides administrative support to program staff; performs private insurance billing and handles all flex funds for the Wrap program. 0016 Billln11: S11edallst I Total Amount S 31,024 1.0 FTE atan average salary of$3l,024 = $31,024 High school diploma, GEO or equivalent combination of education and experience required. This position inputs the EPSOT billing into Avatar along with reconciliation and preparation of claim certification and inputs the units and flex funds on SB163 invoice. 0017 ED, Regional Eicecutive Director I Total Amount $ 52,119 0.45 FTE at a salary of$ 115,818 = $52,119 Master's Degree {MA/MS) in Psychology, Social Work, Marriage and Family Counseling, Administration, Business or related field is required. Must have appropriate license to practice as a Licensed Clinical Social Worker or Marriage Family Therapist in the State of California. Must meet the BBS requirements to prOllide clinical oversight and supervision. This position provides leadership, strategic direction and operational oversight. This position provides leadership, strategic directio11 and operational oversight. 0018 Health Information Management I Total Amount $ 34,U8 1.0 FTE at a salary of $34,128 = $34,128 Associates deBree {AA/ASl required with one year direct work experience. Database, Visual Basic, and/or Crystal Reports experience required. Basic knowledge of legal Issues regarding releases of Information and other medical records issues required. Technical training on report writing in a database environment required. 0019 Learning Partners I TotalAmount $ 69,379 1.0 FTE at an average salary of$69,379 = $69,379 Bachelor's Degree (BA/BS) or equivalent experience in related field required. Two years of experience in education/learning/training. Assesses learning needs, designs, develops and presents leaning activities. 0020 Outcomes Evaluation I Total Amount $ 23,200 0.5 FTE at a salary of $46,400 = $23,200 Bachelor's degree (BA/BS) required with six years research experience with statistical analysis software, database development, management, merging of multiple databases. Four (4) years of related experience In literature review, program research, data collection, intermediate-advanced e\/illUation, and advanced knowledge and usage of statistical software package. Minimum of one (1) year experience In training research activities and lead responsibilities in research projects. 0021 QuaRty support I Total Amount $ 38,29S 05 FTE at a salary of $76,589 = $38,295 Master's Degree (MA/ MS) in Psychology, Social Work, Marriage and Family Counseling or related field required. Must have appropriate license to practice as a licensed Clinical Social Worker or Marriage Family Therapist in the State of Callfomla. Must meet the BBS requirements to provide clinical oversight and supervision. Develops, maintains, and manages operational infrastructure functions that provide support to service delivery {Intake, medical records), the assurance of quality (utilization review and quality and manages operational infrastructure functions that provide support to service delivery (Intake, medical records), the assurance of quality (utilization review and quality assurance structures, training structures, outcomes evaluation structures, risk management oversight) ror a distinct geographic region in compliance with agency standards. 00300ASOI I Total Amount $ 163,325 calculated at 6.2% of salaries. I Total Amount
RFP 952-5322 Page: 24 of 29 Revised Exhibit B .. ..... ;;':;'(•'•.,-=: :•:,,, ·...:·: . . . :·sonato BUI 163 Wraparound and lbe111J)4Wtlc Fos1nr Carv Servf<:es . :.:~;-~;;.~;:-.:':~:-~:~-:.~>_.s:~;~:::,.~:._;_. :· ·. ..,4 · .: ~ .. ~-...... Famil!esFirat, Inc. dba EMQ FamlllosFhst Budgot • July 1, 2017 to Juoo 30, 2018 0031 FICA/MEDICARE I $ 38,198 calculated at 1.4S% of salaries. I Total Amount 0032UI $ 61,906 Calculated at 2.35% of salaries. 0040 Retirement I Total Amount $ 105,372 Calculated at 4.0% of salaries. 0041 Workers Compensation I TotalAmount $ 79,029 Calculated at 3.0% of salaries. 0042 Health Insurance (medical, vision, l1fe, dental) I Total Amount $ 291,S!la Calculated at approximately 11% of salaries. 1010 Rent/Lease Bulkllng I Total Amount $ 50,556 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes building, storage and file storage unit rental payments and all the costs associated with storing and retrieving of client, personnel or other files or records. 1011 Rent/lease Equipment I TotalAmount $ 4,163 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes rental payments for equipment including leased copiers, faxes, postage machines, phone systems, laptops or other communication, office or facility equipment, 1014 Maintenance (facility} I Total Amount $ 4,456 All occupancy costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends and the utilization of the agency's existing office in Fresno. This includes common area maintenance on leased building charges, maintenance/building repair charges, HVAC maintenance and repair, landscaping, janitorial services, confidential paper shredding services, In-house or outside equipment repair and labor. 1017 Other-Depreciation I Total Amount $ 5,624 Depreciation includes deprecation on leasehold improvements, office furniture/fixtures and equipment meeting amortization thresholds. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. 1060 Telephone I Total Amount $ 54,836 Cell phones, Land Lines, DSL, fax charges, phone system; also wireless cards for laptop computers enabllng us to maintain a fully functional mobile work force to deliver in-home services. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends.
RFP 952-5322 Page; 25 of 29 Revised Exhibit B ;-;:· :,. :·~=.: • .• ·1=:·:-":. . ~: ··: .. ·• .. • :&mate 8111163 Wraparound and Therapeutic Foster care Sorvleos ... Ji:.,. ·.• .. FamlllesFlrst, Inc. dba EMQ FamlllesFirst ·.•'. ....... ~·:,,..-:-: .. Budget-July 1, 2017 to June ·30, 2018 1062 POS1age/Shlpplng/Prlnting I T~ta! Amount $ 1,901 Postage, printing. US mail, GSO, Federal Express, UPS, postage machine refills, outside reproduction costs, program specific brochures and flyers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. Postage, printing, US mail, GSO, Federal express, UPS, postage machine refills, outside reproduction costs, program specific brochures and flyers when reimbursable by the program. Costs are allocated between programs on the basis of payroll dollars and have been estimated based on historical trends. 1066 Office Supplies & Equipment / TotalAmount $ 6,409 Office supplies and equipment Include, but are not limited to: paper, pens, files, staplers, break rooms suppries such as coffee, paper cups, plastic utensils are also included. Costs are allocated between programs on the basis of direct labor dollars and have been estimated based on historical trends. 1069 Program Supclies-Therapeutic I TotalAmount $ 11,250 Includes those supplies utilized in the direct delivery of therapeutic services to clients. Cost ls estimated to be approximately $15.00 per direct care staff per month. Materials, cash payments, outing costs, etc. used to motivate or reinforce desired behavior. 1072 Staff MIieage/vehicle maintenance I Total Amount $ 220,650 Primarily includes mileage reimbursement paid {at the current federal rate to staff supporting program or program related activities. In addition, a component of travel costs may include overnight travel by staff for training, meetings or conferences. This figure also takes into consideration that we anticipate that the majority of all program services will be delivered In the community. Also includes the transportation of clients. Costs are estimated to be approximately 9.38% of direct personnel costs prior to taxes and benefits. 1074 Staff Training/ Registration I TotalAmount $ 6,682 Includes ongoing training in the Wraparound model of care, organizational tools, team/organizational psychology, philosophy of client based services, integration or roles/team dynamlcs, assessment and individualized treatment planning, geooral services, organized admissions, and individualized treatment planning associated with the Wraparound system of care. Also includes other mandatory trainings such as first aid and CPR. 1076 Other• Emergency Flex Funds I Total Amount $ 63,000 Cost of 'whatever it takesn flexible funding for client needs to maintain growth, functioning and recovery. Flexible funds were budgeted at $35 per client per month. Requests above $300 are approved by the Wraparound Community Team. 1081 External Audit I TotalAmount $ 7,271 Includes annual audit insuring all financial records are relevant and accurate and in compliance with state and federal laws and regulations. Audit costs are allocated between programs on the basis of pavroll dollars and have been estimated based on historical com. 1082 liability Insurance I Total Amount $ 20,412 Includes general business liability and property coveraRe along with professional liability insurance.
RFP 952-5322 Page: 26 of 29 Revised Exhibit B -,'\. .. :, ... --~::·· ... · r· . . •' ··· ... :-··· -~ ... ·•::--.._~: ·Senato Bill 163 Wraparound and Therapeutic Foswr care Serv!C8$ . ,.·.· ··~· *~~:-: .. · < .. FammesFirst, Inc. dba EMQ FomiliesFlrst ..... .. Budglrt-July 1, 2017 to June 30, 2018 1083 Other•Adminlstrative Overhead I Total Amount .$ 647,317 Represents the indirect costs of the agency's general and administrative shared support services such as finance, accounting, blltlng, human resources, cllnical administration, information technology, quality assurance and outcomes/evaluation, insurance, professional fees, HIPAA compliance and clinical record audits, quality management oversight of Medi-Cal records, risk management and program fidelity, recruiting and human resources support, MlS infrastructure & QI/UM department support and oversight as well as e~ecutive management. Costs that cannot be specifically charged to a program are allocated to programs on the basis of direct labor program costs prior to the addition of taxes and benefits. Indirect costs have been budgeted at 15% of program costs. 1089 Medk:at!on Supports I Total Amount $ 21,840 This is a contract position estimated at to cost $175 per hour. The psychiatrist will be required to provide 2.61 hours per week, or approximately 10.44 hours per month ($1,820 per month x 12 months= $21,640) and will provide medical oversight/supervision of program services. 3000-3900 Medi•tal Revenues 1 Total Amount $ 4,500,000 Medi-Cal eligibility is estimated to be 90% or all clients served. For the purpose of a conservative revenue projection, only the clinicians, focilitators and family specialists were assumed to be billable positions. Blend of service and unit volume are based on EMQ FamiliesFirst's experience in delivering mental health services in its existing Wraparound program. This budget assumes full staff and full census on day one and projects Medi.Cal revenue generation of S3,375,000 for the initial 12 month period. These revenue figures are based on a case management rate of $2.02 p<!r minute, a mental health rate of $2.61 per minute, a medication support rate of $4.82 per minute, a collateral rate of $2.61 per minute and a crisis intervention rate of $3.88 per minute. The blend of services is anticipated to be 7¾ case management, 15% mental health, l'Y. crisis Intervention, 1'11i medication support, 2% collateral, 10% ICC-case management, 64% IBHS-rehab.
RFP 952-5322 ·-:.· .:.,.~.--~· •:•;,_ .. Page: 27 of 29 · Sonat& B111163 Wraparound and Thorapoiltk: Fos~ can, S&f1r'lcN FamiflesFlrst, Inc. dba EMO FamlllesFirst Budget-July 1, 2017 to Jun. 30, 20f8 Revised Exhibit B .. ; It is recognized that overhead cost is part of every organizations cost of doing business to evaluate direct service cost versus overhead cost. please utilize this page to delineate what makes up your agencies overhead. Below is an example of overhead cost components/categories, please feel free to adjust to best represent your agency Cost Categories Accountino/Finance Human Resources Information Tech. Executive Manaoement Training /Quality/Compliance Total Amount Reouested 129,463 129,463 194,195 97,098 97,098 647,317 Explanation Agency corporate general accounting and financial services Agency human resources and administration, including recruiting, training and employee development Agency network, communication, security, application development and maintenance Agency management and leadership and administration Agency corporate training, quality, and compliance requirements 1) Please provide your agency's total administrative overhead cost. $13,000,000 2) Please provide the percentage of your agency's total administrative overhead cost. as is it relates to your total agency cost. 15% 3) Please indicate your agency's proposed total cost for this service component. $4,500,000 4) Please indicate the percentage of your agency's administrative overhead cost charge. as it relates to the total cost proposed for this service component. 15% 5) Please indicate the percentage of the total agency's administrative overhead cost, charged under this service component as it relates to your agency's total administrative cost. 5%
Revised 5-03-18
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Associate Director 1.00 $22,586 $22,586
0002 Clinical Program Manager 2.00 $12,928 $25,856
0003 Clinician I 2.00 $10,512 $21,024
0004 Facilitator I 1.00 $11,783 $11,783
0005 Family Specialist III 11.70 $5,712 $66,830
0006 Program Supervisor 2.00 $10,669 $21,338
0007 Education/Vocational Specialist 2.00 $6,434 $12,868
0008 Family Partner I 2.00 $7,750 $15,500
0009 Admin Assistant I 1.00 $8,827 $8,827
0010 Health Info Technician 1.00 $8,671 $8,671
0011 Shared Support Staff 0.92 $46,642 $42,911
0012 title $0
SALARY TOTAL 26.62 $258,194
PAYROLL TAXES:
0030 OASDI $16,009
0031 FICA/MEDICARE $3,743
0032 SUI $3,486
PAYROLL TAX TOTAL $23,238
EMPLOYEE BENEFITS:
0040 Retirement $8,993
0041 Workers Compensation $6,036
0042 Health Insurance (medical, vision, life, dental)$59,278
EMPLOYEE BENEFITS TOTAL $74,307
SALARY & BENEFITS GRAND TOTAL $355,739
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $14,529
1011 Rent/Lease Equipment $810
1013 Building Maintenance $438
FACILITY/EQUIPMENT TOTAL $15,777
OPERATING EXPENSES:
1060 Telephone $5,666
1062 Postage/Shipping/Printing $267
1066 Office Supplies & Equipment $1,564
1072 Staff Mileage/vehicle maintenance $19,618
1074 Staff Training/Registration $648
1076 Depreciation - Equipment $763
1077 Flex Fund $6,400
1078 IT- Application/Licenses $1,761
Line Item Description (Must be itemized)
COST PROPOSAL
FRESNO WRAPAROUND PROGRAM
JULY 1, 2018 thru SEPTEMBER 30, 2018 (3 Months Budget)
Budget Categories -Total Proposed Budget
Revised 5-03-18
OPERATING EXPENSES TOTAL $36,687
FINANCIAL SERVICES EXPENSES:
1081 External Audit $833
1082 Liability Insurance $5,213
1083 Administrative Overhead $73,401
FINANCIAL SERVICES TOTAL $79,447
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)
1091 Translation Services
1092 Contract Psychiatrist $1,620
SPECIAL EXPENSES TOTAL $1,620
FIXED ASSETS:
TOTAL PROGRAM EXPENSES $489,270
MEDI-CAL REVENUE:Units of Service Rate $ Amount
3000 Mental Health Services (Individual/Family/Group Therapy)1,933 $2.84 $5,490
3100 Rehabilitation 31,014 $2.84 $88,080
3200 Collateral 539 $2.84 $1,531
3300 Intensive Home-Based Services 30,827 $2.84 $87,549
3400 Assessment 2,925 $2.84 $8,307
3500 Plan Development 668 $2.84 $1,897
3600 Case Management 13,070 $2.21 $28,885
3700 Intensive Case Coordination 18,950 $2.21 $41,880
3800 Crisis Services 0 $4.17 $0
3900 Medication Support 230 $5.18 $1,191
DIRECT SERVICE REVENUE TOTAL 100,156 $264,809
OTHER REVENUE:
4000 Other - (SB Non Billable Services)$224,461
4100 Other - (Identify)
4200 Other - (Identify)
4300 Other - (Identify)
OTHER REVENUE TOTAL $224,461
TOTAL PROGRAM REVENUE $489,270
Medi-Cal Revenue 50% FFP $132,404
Medi-Cal Revenue 40% EPSDT $105,923
County SB163 Trust Fund 10%$26,481
Total Medi-Cal Revenue $264,809
Total Medi-Cal Units 100,156
Medi-Cal cost per unit $2.64
Non Medi-Cal Billable Service Cost $224,461
Revised 5-03-18
Total Non Medi-Cal Billable Units 25,039
Non Medi-Cal cost per unit $8.96I