HomeMy WebLinkAboutAgreement A-18-689-1 Assertive Community Treatment Program.pdf- 1 -
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AMENDMENT I TO AGREEMENT
THIS AMENDMENT I TO AGREEMENT 18-689 (hereinafter “Amendment”) is made and
entered into this ____ day of _____________, 2021, by and between COUNTY OF FRESNO, a
Political Subdivision of the State of California, Fresno, California (hereinafter “COUNTY”), and UPLIFT
FAMILY SERVICES, INC., a California Non-profit, 501 (c)(3), Corporation, whose address is 251
Llewellyn Ave, Campbell, CA 95008 (hereinafter “CONTRACTOR”).
WITNESSETH:
WHEREAS, COUNTY and CONTRACTOR entered into Agreement number 18-689, dated the
11th of December, 2018 (hereinafter “Agreement”), pursuant to which CONTRACTOR agreed to
operate a Mental Health Services ACT (MHSA) funded Children/Youth Assertive Community
Treatment Program and provide integrated mental health and community support services to youth
ages 10-18 with serious emotional disturbance (SED) and at least one diagnosis from the current
Diagnostic and Statistical Manual of Mental Disorder (DSM) to COUNTY; and
WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement regarding
changes as stated below and restate the Agreement in its entirety.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
1.All references in the Agreement to Exhibit B shall be replaced to read Revised Exhibit
B.Revised Exhibit B is attached hereto and incorporated herein by this reference.
2. That Paragraph Four (4) – Compensation - of the Agreement, on Page Four (4),
beginning on Line Ten (10) with the word “The”, and ending on Page Six (6), Line One (1) with the
word “Agreement.” shall be deleted in its entirety and replaced with the following:
"The maximum amount payable to CONTRACTOR for the period of January 1, 2019
through June 30, 2019 shall not exceed One Million Three Hundred Fifty-Nine Thousand Two
Hundred Fifty-Nine and No/100 Dollars ($1,359,259.00). It is understood by CONTRACTOR
and COUNTY that the total of MHSA funds payable under this Agreement to CONTRACTOR
shall not exceed Four Hundred Eighty-Five Thousand Nine Hundred Sixty-One and No/100
Dollars ($485,961.00). It is also understood by CONTRACTOR and COUNTY that
Agreement No. 18-689-1
8th June
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CONTRACTOR estimates generating a total of Eight Hundred Seventy Three Thousand Two
Hundred Ninety Eight and No/100 Dollars ($873,298.00) in Medi-Cal Federal Financial
Participation (FFP) revenue under this Agreement to offset CONTRACTOR program costs as
set forth in Revised Exhibit B.
The maximum amount payable to CONTRACTOR for the period of July 1, 2019
through June 30, 2020 shall not exceed Two Million Seven Hundred Ninety-Two Thousand
Five Hundred Seventy-One and No/100 Dollars ($2,792,571.00). It is understood by
CONTRACTOR and COUNTY that the total of MHSA funds payable under this Agreement to
CONTRACTOR shall not exceed Nine Hundred Eighty-One Thousand Nine Hundred Twenty-
One and No/100 Dollars ($981,921.00). It is also understood by CONTRACTOR and COUNTY
that CONTRACTOR estimates generating a total of One Million Eight Hundred Ten Thousand
Six Hundred Fifty and No/100 ($1,810,650.00) in Medi-Cal Federal FFP under this Agreement
to offset CONTRACTOR program costs as set forth in Revised Exhibit B.
The maximum amount payable to CONTRACTOR for the period of July 1, 2020 through
June 30, 2021 shall not exceed Three Million Two Hundred Eighty-One Thousand Six Hundred
Forty-Five and No/100 Dollars ($3,281,645.00). It is understood by CONTRACTOR and
COUNTY that the total of MHSA funds payable under this Agreement to CONTRACTOR shall
not exceed Nine Hundred Eight-One Thousand Nine Hundred Twenty-One and No/100 Dollars
($981,921.00). It is also understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates generating a total of Two Million Two Hundred Ninety Nine Thousand Seven
Hundred Twenty Four and No/100 Dollars ($2,299,724.00) in Medi-Cal Federal FFP under this
Agreement to offset CONTRACTOR program costs as set forth in Revised Exhibit B.
The maximum amount payable to CONTRACTOR for the period of July 1, 2021 through
June 30, 2022 shall not exceed Three Million Six Hundred Twenty-Eight Thousand Four
Hundred Sixty-Two and No/100 Dollars ($3,628,462.00). It is understood by CONTRACTOR
and COUNTY that the total of MHSA funds payable under this Agreement to CONTRACTOR
shall not exceed Nine Hundred Eight-One Thousand Nine Hundred Twenty-One and No/100
Dollars ($981,921.00). It is also understood by CONTRACTOR and COUNTY that
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CONTRACTOR estimates generating a total of Two Million Six Hundred Forty Six Thousand
Five Hundred Forty One and No/100 Dollars ($2,646,541.00) in Medi-Cal Federal FFP under
this Agreement to offset CONTRACTOR program costs as set forth in Revised Exhibit B.
The maximum amount payable to CONTRACTOR for the period of July 1, 2022 through
June 30, 2023 shall not exceed Three Million, Seven Hundred Forty-One Thousand, Two
Hundred Seventy-Eight and No/100 Dollars ($3,741,278.00). It is understood by
CONTRACTOR and COUNTY that the total of MHSA funds payable under this Agreement to
CONTRACTOR shall not exceed Nine Hundred Eight-One Thousand Nine Hundred Twenty-
One and No/100 Dollars ($981,921.00). It is also understood by CONTRACTOR and COUNTY
that CONTRACTOR estimates generating a total of Two Million Seven Hundred Fifty Nine
Thousand Three Hundred Fifty Six and No/100 Dollars ($2,759,356.00) in Medi-Cal Federal
FFP under this Agreement to offset CONTRACTOR program costs as set forth in Revised
Exhibit B.
In no event shall the maximum contract amount, for the full contract term of January 1,
2019 through June 30, 2023, for all the services provided by CONTRACTOR to COUNTY
under the terms and conditions of this Agreement be in excess of Fourteen Million Eight
Hundred Three Thousand Two Hundred Fifteen and No/100 Dollars ($14,803,215.00) during
the total term of the Agreement. The maximum amount of MHSA CSS funds payable to
CONTRACTOR for all services provided under this Agreement shall not exceed Four Million
Four Hundred Thirteen Thousand Six Hundred Forty-Five and No/100 Dollars ($4,413,645.00).
The total revenue estimated to be generated by CONTRACTOR under this Agreement is Ten
Million Three Hundred Eighty Nine Thousand Five Hundred Seventy and No/100 Dollars
($10,389,570.00).
Payment shall be made upon certification or other proof satisfactory to COUNTY’s DBH
that services have actually been performed by CONTRACTOR as specified in this Agreement."
3. That Paragraph Nine (9) – Hold-Harmless - of the Agreement, on Page Twelve (12),
beginning on Line Seventeen (17), and ending on Page Twelve (12), Line Twenty-Six (26) shall be
deleted in its entirety and replaced with the following:
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“9. HOLD HARMLESS
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY'S request,
defend the COUNTY, its officers, agents, and employees from any and all costs and
expenses (including attorney’s fees and costs), damages, liabilities, claims, and losses
occurring or resulting to COUNTY in connection with the performance, or failure to
perform, by CONTRACTOR, its officers, agents, or employees under this Agreement,
and from any and all costs and expenses (including attorney’s fees and costs),
damages, liabilities, claims, and losses occurring or resulting to any person, firm, or
corporation who may be injured or damaged by the performance, or failure to
perform, of CONTRACTOR, its officers, agents, or employees under this Agreement.”
4.That Paragraph Ten (10) – Insurance - Section B – Automobile Liability - of the
Agreement, on Page Thirteen (13), beginning on Line Nine (9) with the letter “B”, and ending on Page
Thirteen (13), Line Twelve (12) with the word “Agreement” shall be deleted in its entirety and replaced
with the following:
“B. Automobile Liability
Comprehensive Automobile Liability Insurance with limits of not less than One Million
Dollars ($1,000,000.00) per accident for bodily injury and for property damages.
Coverage should include any auto used in connection with this Agreement.”
5. That Paragraph Ten (10) – Insurance - Section I – Waiver of Subrogation - of the
Agreement, on Page Fourteen (14), beginning on Line Sixteen (16) with the letter “I”, and ending on
Page Fourteen (14), Line Nineteen (19) with the word “insurer” shall be deleted in its entirety and
replaced with the following:
“I. Additional Requirements Relating to Insurance
CONTRACTOR hereby waives its right to recover from COUNTY, its officers, agents,
and employees any amounts paid by the policy of worker’s compensation insurance
required by this Agreement. CONTRACTOR is solely responsible to obtain any
endorsement to such policy that may be necessary to accomplish such waiver of
subrogation, but CONTRACTOR’s waiver of subrogation under this paragraph is
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effective whether or not CONTRACTOR obtains such an endorsement.”
COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend the
Agreement and, that upon execution of this Amendment, the Agreement and this Amendment together
shall be considered the Agreement.
The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
covenants, conditions and promises contained in the Agreement and not amended herein shall remain
in full force and effect.
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1 IN WITNESS WHEREOF , the parties hereto have executed th is Amendment I as of the day and
2 year first hereinabove written .
3
4 ' IL Y SERVICES INC.
5 li:.::4-~~'..:.::::::=====-----
6
7 (.:. rdcn Rte
Print Name & Title
8
0 .13.2..
9 Date
Mailing Address :
251 Llewellyn Ave
Campbell, CA 95008
d::,:.__n V p ~ ,,
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FOR ACCOUNTING USE ONLY :
19 Fund : 000 1
20 Subclass :1 0000
21 ORG : 5630
22 Accoun t: 7295
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Steven Brandau,
Chairman of the Board of Supervisors of
the County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
By : _ _.::,~~-· .;__~-De_,_u~t .___ __ _
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Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Clinician I 6.00 -$ 154,680$ 154,680$
1102 Clinician II 3.00 - 91,818 91,818
1103 Family Specialist I 4.00 - 65,529 65,529
1104 Family Partner I 1.00 - 18,160 18,160
1105 Education/Vocation Specialist 3.00 - 59,925 59,925
1106 Addiction Prevention Counselor II 2.00 - 37,492 37,492
1107 Addiction Prevention Counselor III 1.00 - 27,627 27,627
1108 Clinical Program Manager 2.33 - 81,837 81,837
1109 Support Services Coordinator 0.50 - 11,841 11,841
1110 Associate Director 0.33 - 13,899 13,899
1111 Program Support Staff 4.33 - 130,137 130,137
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 27.49 -$ 692,945$ 692,945$
Employee Benefits
Acct #Admin Direct Total
1201 -$ 24,111$ 24,111$
1202 - 16,188 16,188
1203 - 161,875 161,875
1204 - - -
1205 - - -
1206 - - -
-$ 202,174$ 202,174$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 -$ 42,707$ 42,707$
1302 - 9,988 9,988
1303 - 6,889 6,889
1304 - - -
1305 - - -
1306 - - -
-$ 59,584$ 59,584$
-$ 954,703$ 954,703$
Retirement
Worker's Compensation
Health Insurance
Other (specify)
Other (specify)
OASDI
FICA/MEDICARE
SUI
Other (specify)
Other (specify)
Employee Benefits Subtotal:
Description
CHILDREN/YOUTH ASSERTIVE COMMUNITY TREATMENT (ACT)
UPLIFT FAMILY SERVICES
Fiscal Year (FY) 2018-19 Six Months (Jan 1, 2019- Jun 30, 2019)
Description
Payroll Taxes & Expenses Subtotal:
Other (specify)
Other (specify)
EMPLOYEE SALARIES & BENEFITS TOTAL:
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Revised Exhibit B
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 533
2003 857
2004 101
2005 131
2006 -
2007 791
2008 -
2009 -
2010 395
2011 791
2012 -
2013 -
2014 -
2015 -
2016 -
3,599$
3000: OPERATING EXPENSES
Acct #Amount
3001 18,540$
3002 -
3003 18,192
3004 -
3005 13,535
3006 54,910
3007 -
3008 -
3009 2,495
3010 -
3011 -
3012 -
107,672$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 1,426$
4002 47,541
4003 2,651
4004 -
4005 -
4006 -
4007 25,760
4008 -
4009 -
4010 -
77,378$
5000: SPECIAL EXPENSES
Other (specify)
Depreciation
Staff Travel/Mileage
Subscriptions & Memberships
Other (specify)
Other (specify)
Rent/Lease Equipment
Rent/Lease Building
Staff Development & Training
Vehicle Maintenance
Other (specify)
General Office Expenditures
Telecommunications
Printing/Postage
Rent/Lease Vehicles
Security
Other (specify)
Utilities
Client Transportation & Support
Client Housing Support Expenditures
Child Care
Other (specify)
Other (specify)
Clothing, Food, & Hygiene
Education Support
Household Items for Clients
Employment Support
Utility Vouchers
Program Supplies - Medical
Medication Supports
OPERATING EXPENSES TOTAL:
Equipment Purchase
Other (specify)
Other (specify)
Building Maintenance
Line Item Description
Line Item Description
Line Item Description
DIRECT CLIENT CARE TOTAL
Other (specify)
Client Housing Operating Expenditures
Advertising
FACILITIES/EQUIPMENT TOTAL:
Other (specify)
Revised Exhibit B
Acct #Amount
5001 -$
5002 -
5003 27,720
5004 -
5005 -
5006 -
5007 -
5008 -
27,720$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 172,399$
6002 14,532
6003 -
6004 1,256
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
188,187$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Leasehold/Tenant/Building Improvements
Payroll Services
Line Item Description
External Audit
Other (specify)
Other (specify)
Other (specify)
Insurance (Specify):
Other (specify)
Other (specify)
Other (specify)
Other (specify)
Furniture & Fixtures
Line Item Description
HMIS (Health Management Information System)
Administrative Overhead
Other (specify)
Other (specify)
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
Consultant (Network & Data Management)
SPECIAL EXPENSES TOTAL:
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Other (specify)
Contract Psychiatrist
Translation Services
1,359,259$ TOTAL PROGRAM EXPENSES
Other Assets over $500 with Lifespan of 2 Years +
Other (specify)
Assets over $5,000/unit (Specify)
FIXED ASSETS EXPENSES TOTAL
Line Item Description
Professional Liability Insurance
Accounting/Bookkeeping
ADMINISTRATIVE EXPENSES TOTAL
Revised Exhibit B
Acct #Service Units Rate Amount
8001 Mental Health Services 221,355 2.84 628,648$
8002 Case Management 36,147 2.21 79,885
8003 Crisis Services 3,859 4.17 16,092
8004 Medication Support 6,082 5.18 31,505
8005 Collateral 19,366 2.84 54,999
8006 Plan Development 5,809 2.84 16,498
8007 Assessment 23,239 2.84 65,999
8008 Rehabilitation 69,717 2.84 197,996
385,574 1,091,622$
80%
873,298
100%873,298
873,298$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 0$
0$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 485,961$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
485,961$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
MEDI-CAL FFP TOTAL
MHSA TOTAL
Line Item Description
Line Item Description
8100 - SUBSTANCE USE DISORDER FUNDS
OTHER REVENUE TOTAL
MHSA Program Name
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
Line Item Description
REALIGNMENT TOTAL
8200 - REALIGNMENT
NET PROGRAM COST:
PROGRAM FUNDING SOURCES
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Federal Financial Participation (FFP) %
Grants (Specify)
Other (Specify)
Other (Specify)
Line Item Description
8400 - OTHER REVENUE
TOTAL PROGRAM FUNDING SOURCES:1,359,259$
-$
SUBSTANCE USE DISORDER FUNDS TOTAL
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Revised Exhibit B
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Clinician I 6.00 -$ 268,457$ 268,457$
1102 Clinician II 3.00 - 174,145 174,145
1103 Family Specialist I 4.00 - 134,991 134,991
1104 Family Partner I 1.00 - 123,447 123,447
1105 Education/Vocation Specialist 3.00 - 77,234 77,234
1106 Addiction Prevention Counselor II 2.00 - 56,912 56,912
1107 Addiction Prevention Counselor III 1.00 - 168,584 168,584
1108 Clinical Program Manager 2.33 - 24,392 24,392
1109 Support Services Coordinator 0.50 - 37,407 37,407
1110 Clinical Director 0.33 - 28,631 28,631
1111 Program Supervisor 1.00 - 59,424 59,424
1112 Doctors Assistant 0.30 - 5,000 5,000
1113 Program Support Staff 4.03 - 233,083 233,083
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 28.49 -$ 1,391,707$ 1,391,707$
Employee Benefits
Acct #Admin Direct Total
1201 -$ 29,273$ 29,273$
1202 - 33,347 33,347
1203 - 287,576 287,576
1204 - - -
1205 - - -
1206 - - -
-$ 350,196$ 350,196$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 -$ 87,979$ 87,979$
1302 - 20,575 20,575
1303 - 14,190 14,190
1304 - - -
1305 - -
1306 - -
-$ 122,744$ 122,744$
-$ 1,864,647$ 1,864,647$
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
Other (Specify)
CHILDREN/YOUTH ASSERTIVE COMMUNITY TREATMENT (ACT)
UPLIFT FAMILY SERVICES
Fiscal Year (FY) 2019-2020
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Revised Exhibit B
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 1,065
2003 21,714
2004 6,203
2005 263
2006 -
2007 1,583
2008 -
2009 -
2010 791
2011 1,581
2012 -
2013 -
2014 -
2015 -
2016 -
33,200$
3000: OPERATING EXPENSES
Acct #Amount
3001 37,079$
3002 -
3003 15,383
3004 -
3005 39,031
3006 77,820
3007 -
3008 -
3009 4,990
3010 -
3011 -
3012 -
174,303$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 2,852$
4002 117,023
4003 5,302
4004 -
4005 -
4006 -
4007 11,519
4008 -
4009 -
4010 -
136,696$
5000: SPECIAL EXPENSES
FACILITIES/EQUIPMENT TOTAL:
Security
Utilities
Equipment Purchase
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Depreciation
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
General Office Expenditures
Advertising
Staff Development & Training
Staff Travel/Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Client Housing Operating Expenditures
Other (Specify)
Client Housing Support Expenditures
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Amount
5001 -$
5002 -
5003 134,160
5004 -
5005 -
5006 -
5007 -
5008 -
134,160$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 417,117$
6002 29,936
6003 -
6004 2,512
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
449,565$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$ FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 2,792,571$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
Payroll Services
SPECIAL EXPENSES TOTAL:
Line Item Description
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify):
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contract Psychiatrist
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Service Units Rate Amount
8001 Mental Health Services 458,950 2.84 1,303,418$
8002 Case Management 74,897 2.21 165,522
8003 Crisis Services 8,007 4.17 33,389
8004 Medication Support 12,622 5.18 65,382
8005 Collateral 40,153 2.84 114,035
8006 Plan Development 12,045 2.84 34,208
8007 Assessment 48,183 2.84 136,840
8008 Rehabilitation 144,549 2.84 410,519
799,406 2,263,313$
80%
1,810,650
100%1,810,650
1,810,650$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment (0)$
(0)$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 981,921$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
981,921$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403
8404
8405 -
-$ OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:2,792,571$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Grants (Specify)
Other (Specify)
Other (Specify)
Line Item Description
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Clinician I 5.00 -$ 395,705$ 395,705$
1102 Clinician II 3.00 - 263,805 263,805
1103 Family Specialist I 4.00 - 133,490 133,490
1104 Family Partner I 1.00 - 37,041 37,041
1105 Education/Vocation Specialist 3.00 - 124,966 124,966
1106 Addiction Prevention Counselor II 2.00 - 83,300 83,300
1107 Addiction Prevention Counselor III 1.00 - 58,824 58,824
1108 Clinical Program Manager 2.33 - 235,583 235,583
1109 Support Services Coordinator 0.50 - 25,191 25,191
1110 Clinical Director 0.50 - 72,050 72,050
1111 Program Supervisor 1.00 - 79,141 79,141
1112 Doctors Assistant 0.30 - 11,462 11,462
1113 Program Support Staff 2.17 144,278 - 144,278
1114 Regional Director 0.24 40,788 - 40,788
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - -
Personnel Salaries Subtotal 26.04 185,066$ 1,520,558$ 1,705,624$
Employee Benefits
Acct #Admin Direct Total
1201 5,020$ 54,326$ 59,346$
1202 3,371 36,475 39,846
1203 33,704 364,739 398,443
1204 - - -
1205 - - -
1206 - - -
42,095$ 455,540$ 497,635$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 8,892$ 96,230$ 105,122$
1302 2,080 22,505 24,585
1303 1,434 15,521 16,955
1304 - - -
1305 - -
1306 - -
12,406$ 134,256$ 146,662$
239,567$ 2,110,354$ 2,349,921$
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
Other (Specify)
CHILDREN/YOUTH ASSERTIVE COMMUNITY TREATMENT (ACT)
UPLIFT FAMILY SERVICES
Fiscal Year (FY) 2020-2021
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 250
2003 3,714
2004 500
2005 263
2006 -
2007 500
2008 -
2009 -
2010 250
2011 250
2012 -
2013 -
2014 -
2015 -
2016 -
5,727$
3000: OPERATING EXPENSES
Acct #Amount
3001 37,079$
3002 -
3003 15,383
3004 -
3005 31,991
3006 37,820
3007 -
3008 -
3009 4,990
3010 -
3011 -
3012 -
127,263$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 2,852$
4002 132,550
4003 5,302
4004 -
4005 -
4006 -
4007 16,519
4008 -
4009 -
4010 -
157,223$
5000: SPECIAL EXPENSES
FACILITIES/EQUIPMENT TOTAL:
Security
Utilities
Equipment Purchase
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Depreciation
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
General Office Expenditures
Advertising
Staff Development & Training
Staff Travel/Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Client Housing Operating Expenditures
Other (Specify)
Client Housing Support Expenditures
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Amount
5001 5,082$
5002 -
5003 102,438
5004 -
5005 -
5006 -
5007 -
5008 -
107,520$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 492,250$
6002 39,229
6003 -
6004 2,512
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
533,991$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$ FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 3,281,645$
Other (Specify)
Other (Specify)
Assets over $5,000/unit (Specify)
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
Payroll Services
SPECIAL EXPENSES TOTAL:
Line Item Description
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify):
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contract Psychiatrist
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Service Units Rate Amount
8001 Mental Health Services 478,301 3.46 1,655,487$
8002 Case Management 78,053 2.69 210,227
8003 Crisis Services 8,345 5.08 42,410
8004 Medication Support 13,155 6.31 83,048
8005 Collateral 41,846 3.46 144,837
8006 Plan Development 12,552 3.46 43,445
8007 Assessment 50,214 3.46 173,800
8008 Rehabilitation 150,643 3.46 521,403
833,109 2,874,655$
80%
2,299,724
100%2,299,724
2,299,724$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment -$
-$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 981,921$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
981,921$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$ OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:3,281,645$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Grants (Specify)
Other (Specify)
Other (Specify)
Line Item Description
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Clinician I 6.00 -$ 489,091$ 489,091$
1102 Clinician II 3.00 - 271,719 271,719
1103 Family Specialist I 4.00 - 137,495 137,495
1104 Family Partner I 1.00 - 38,152 38,152
1105 Education/Vocation Specialist 3.00 - 128,715 128,715
1106 Addiction Prevention Counselor II 2.00 - 85,799 85,799
1107 Addiction Prevention Counselor III 1.00 - 60,589 60,589
1108 Clinical Program Manager 2.33 - 242,650 242,650
1109 Support Services Coordinator 0.50 - 25,947 25,947
1110 Clinical Director 0.50 - 74,212 74,212
1111 Program Supervisor 1.00 - 81,515 81,515
1112 Doctors Assistant 0.30 - 11,806 11,806
1113 Program Support Staff 2.17 148,606 - 148,606
1114 Regional Director 0.24 42,012 - 42,012
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - -
Personnel Salaries Subtotal 27.04 190,618$ 1,647,690$ 1,838,308$
Employee Benefits
Acct #Admin Direct Total
1201 5,171$ 58,792$ 63,963$
1202 3,472 39,473 42,945
1203 34,715 394,724 429,439
1204 - - -
1205 - - -
1206 - - -
43,358$ 492,989$ 536,347$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 9,159$ 104,141$ 113,300$
1302 2,142 24,356 26,498
1303 1,477 16,797 18,274
1304 - - -
1305 - - -
1306 - - -
12,778$ 145,294$ 158,072$
246,754$ 2,285,973$ 2,532,727$
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
Other (Specify)
CHILDREN/YOUTH ASSERTIVE COMMUNITY TREATMENT (ACT)
UPLIFT FAMILY SERVICES
Fiscal Year (FY) 2021-2022
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 1,065
2003 3,714
2004 3,003
2005 263
2006 -
2007 1,583
2008 -
2009 -
2010 791
2011 1,581
2012 -
2013 -
2014 -
2015 -
2016 -
12,000$
3000: OPERATING EXPENSES
Acct #Amount
3001 38,191$
3002 -
3003 15,383
3004 -
3005 51,068
3006 116,382
3007 -
3008 -
3009 4,990
3010 -
3011 -
3012 -
226,014$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 2,995$
4002 132,550
4003 5,567
4004 -
4005 -
4006 -
4007 16,519
4008 -
4009 -
4010 -
157,631$
5000: SPECIAL EXPENSES
FACILITIES/EQUIPMENT TOTAL:
Security
Utilities
Equipment Purchase
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Depreciation
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
General Office Expenditures
Advertising
Staff Development & Training
Staff Travel/Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Client Housing Operating Expenditures
Other (Specify)
Client Housing Support Expenditures
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Amount
5001 5,800$
5002 -
5003 104,946
5004 -
5005 -
5006 -
5007 -
5008 -
110,746$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 544,300$
6002 42,281
6003 -
6004 2,763
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
589,344$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$ FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 3,628,462$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
Payroll Services
SPECIAL EXPENSES TOTAL:
Line Item Description
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify):
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contract Psychiatrist
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Service Units Rate Amount
8001 Mental Health Services 498,262 3.82 1,905,142$
8002 Case Management 81,311 2.98 241,932
8003 Crisis Services 8,693 5.61 48,804
8004 Medication Support 13,704 6.97 95,572
8005 Collateral 43,593 3.82 166,681
8006 Plan Development 13,076 3.82 49,997
8007 Assessment 52,310 3.82 200,011
8008 Rehabilitation 156,931 3.82 600,038
867,880 3,308,177$
80%
2,646,542
100%2,646,542
2,646,542$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment (0)$
(0)$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 981,921$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
981,921$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$ OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:3,628,462$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Grants (Specify)
Other (Specify)
Other (Specify)
Line Item Description
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Clinician I 6.00 -$ 503,764$ 503,764$
1102 Clinician II 3.00 - 279,871 279,871
1103 Family Specialist I 4.00 - 141,620 141,620
1104 Family Partner I 1.00 - 39,297 39,297
1105 Education/Vocation Specialist 3.00 - 132,576 132,576
1106 Addiction Prevention Counselor II 2.00 - 88,373 88,373
1107 Addiction Prevention Counselor III 1.00 - 62,407 62,407
1108 Clinical Program Manager 2.33 - 249,930 249,930
1109 Support Services Coordinator 0.50 - 26,725 26,725
1110 Clinical Director 0.50 - 76,438 76,438
1111 Program Supervisor 1.00 - 83,960 83,960
1112 Doctors Assistant 0.30 - 12,160 12,160
1113 Program Support Staff 2.17 153,065 - 153,065
1114 Regional Director 0.24 43,272 - 43,272
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 27.04 196,337$ 1,697,121$ 1,893,458$
Employee Benefits
Acct #Admin Direct Total
1201 5,326$ 60,556$ 65,882$
1202 3,576 40,658 44,234
1203 35,757 406,565 442,322
1204 - - -
1205 - - -
1206 - - -
44,659$ 507,779$ 552,438$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 9,434$ 107,265$ 116,699$
1302 2,206 25,087 27,293
1303 1,522 17,301 18,823
1304 - - -
1305 - -
1306 - -
13,162$ 149,653$ 162,815$
254,158$ 2,354,553$ 2,608,711$
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
Other (Specify)
CHILDREN/YOUTH ASSERTIVE COMMUNITY TREATMENT (ACT)
UPLIFT FAMILY SERVICES
Fiscal Year (FY) 2022-2023
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 1,065
2003 3,714
2004 3,003
2005 263
2006 -
2007 1,583
2008 -
2009 -
2010 791
2011 1,581
2012 -
2013 -
2014 -
2015 -
2016 -
12,000$
3000: OPERATING EXPENSES
Acct #Amount
3001 39,337$
3002 -
3003 15,383
3004 -
3005 51,068
3006 119,873
3007 -
3008 -
3009 4,990
3010 -
3011 -
3012 -
230,651$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 3,145$
4002 132,550
4003 5,845
4004 -
4005 -
4006 -
4007 26,519
4008 -
4009 -
4010 -
168,059$
5000: SPECIAL EXPENSES
FACILITIES/EQUIPMENT TOTAL:
Security
Utilities
Equipment Purchase
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Depreciation
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
General Office Expenditures
Advertising
Staff Development & Training
Staff Travel/Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Client Housing Operating Expenditures
Other (Specify)
Client Housing Support Expenditures
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Amount
5001 5,800$
5002 -
5003 108,268
5004 -
5005 -
5006 -
5007 -
5008 -
114,068$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 561,200$
6002 43,550
6003 -
6004 3,039
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
607,789$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$ FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 3,741,278$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
Payroll Services
SPECIAL EXPENSES TOTAL:
Line Item Description
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify):
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contract Psychiatrist
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B
Acct #Service Units Rate Amount
8001 Mental Health Services 518,853 3.83 1,986,353$
8002 Case Management 84,673 2.98 252,250
8003 Crisis Services 9,052 5.62 50,883
8004 Medication Support 14,270 6.98 99,643
8005 Collateral 45,394 3.83 173,784
8006 Plan Development 13,617 3.83 52,131
8007 Assessment 54,472 3.83 208,538
8008 Rehabilitation 163,416 3.83 625,614
903,747 3,449,195$
80%
2,759,356
100%2,759,356
2,759,356$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 1$
1$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 981,921$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
981,921$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$ OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:3,741,278$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Grants (Specify)
Other (Specify)
Other (Specify)
Line Item Description
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B