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HomeMy WebLinkAboutAgreement A-18-366-1 Comprehensive Youth Services.pdf- 1 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AMENDMENT I TO AGREEMENT THIS AMENDMENT I TO AGREEMENT 18-366 (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 each provider listed in Exhibit A “Provider List”, attached hereto and by this reference incorporated herein and made part of this Agreement, and collectively referred to hereinafter as “CONTRACTORS”. Reference in this Amendment to “party” or “parties” shall be understood to refer to COUNTY and each individual CONTRACT, unless otherwise specified WITNESSETH: WHEREAS, COUNTY and CONTRACTOR entered into Agreement number 18-366, dated 10th July, 2018 (hereinafter “Agreement”), pursuant to which CONTRACTOR agreed to operate a Mental Health Services Act (MHSA) funded Children’s Full Service Partnership (FSP) program for underserved or unserved high-risk children between the ages of 0-10 years with Serious Emotional Disturbance (SED) and their families, 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 C shall be replaced to read Revised Exhibit C.Revised Exhibit C 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 Fifteen (15) with the word “The”, and ending on Page Six (6), Line Fifteen (15) with the word “Agreement” shall be deleted in its entirety and replaced with the following: "The maximum amount payable to CONTRACTORS for the period of July 1, 2018 through June 30, 2019 shall not exceed Five Million Five Hundred Eighteen Thousand Four Hundred Nineteen and No/100 Dollars ($5,518,419.00). It is understood by CONTRACTORS and COUNTY that the cumulative total of Mental Health Services Act (MHSA) Community Services and Supports (CSS) funds payable under this Agreement to CONTRACTORS shall 8th June Agreement No. 18-366-1 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 not exceed Two Million Ninety-Seven Thousand Three Hundred Fifty-Three and No/100 Dollars ($2,097,353.00). It is also understood by CONTRACTORS and COUNTY that CONTRACTORS estimate to generate a cumulative total of Three Million Four Hundred Twenty-One Thousand Sixty-Six and No/100 Dollars ($3,421,066.00) in Medi-Cal Federal Financial Participation (FFP) for SED services under this Agreement to offset CONTRACTORS’ program costs as set forth in Revised Exhibit C. The maximum amount payable to CONTRACTORS for the period of July 1, 2019 through June 30, 2020 shall not exceed Five Million Six Hundred Fifty-Three Thousand One Hundred Twenty and No/100 Dollars ($5,653,120.00). It is understood by CONTRACTORS and COUNTY that the cumulative total of MHSA CSS funds payable under this Agreement to CONTRACTORS shall not exceed Two Million Ninety-Seven Thousand Three Hundred Fifty- Three and No/100 Dollars ($2,097,353.00). It is also understood by CONTRACTORS and COUNTY that CONTRACTORS estimate to generate a cumulative total of Three Million Five Hundred Fifty-Five Thousand Seven Hundred Sixty-Seven and No/100 Dollars ($3,555,767.00) in Medi-Cal Federal FFP for SED services under this Agreement to offset CONTRACTORS’ program costs as set forth in Revised Exhibit C. The maximum amount payable to CONTRACTORS for the period of July 1, 2020 through June 30, 2021 shall not exceed Six Million Eight Hundred Twenty Thousand Ninety- One and No/100 Dollars ($6,820,091.00). It is understood by CONTRACTORS and COUNTY that the cumulative total of MHSA CSS funds payable under this Agreement to CONTRACTORS shall not exceed Two Million Ninety-Seven Thousand Three Hundred Fifty- Three and No/100 Dollars ($2,097,353.00). It is also understood by CONTRACTORS and COUNTY that CONTRACTORS estimate to generate a cumulative total of Four Million Seven Hundred Twenty Two Thousand Seven Hundred Thirty Eight and No/100 Dollars ($4,722,738.00) in Medi-Cal Federal FFP for SED services under this Agreement to offset CONTRACTORS’ program costs as set forth in Revised Exhibit C. The maximum amount payable to CONTRACTORS for the period of July 1, 2021 through June 30, 2022 shall not exceed Seven Million Two Hundred Thousand Seven Hundred - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Sixty-Two and No/100 Dollars ($7,200,762.00). It is understood by CONTRACTORS and COUNTY that the cumulative total of MHSA CSS funds payable under this Agreement to CONTRACTORS shall not exceed Two Million Ninety-Seven Thousand Three Hundred Fifty- Three and No/100 Dollars ($2,097,353.00). It is also understood by CONTRACTORS and COUNTY that CONTRACTORS estimate to generate a cumulative total of Five Million One Hundred Three Thousand Four Hundred Nine and No/100 Dollars ($5,103,409.00) in Medi-Cal Federal FFP for SED services under this Agreement to offset CONTRACTORS’ program costs as set forth in Revised Exhibit C. The maximum amount payable to CONTRACTORS for the period of July 1, 2022 through June 30, 2023 shall not exceed Seven Million Four Hundred Eight Thousand Twenty- Three and No/100 Dollars ($7,408,023). It is understood by CONTRACTORS and COUNTY that the cumulative total of MHSA CSS funds payable under this Agreement to CONTRACTORS shall not exceed Two Million Ninety-Seven Thousand Three Hundred Fifty- Three and No/100 Dollars ($2,097,353.00). It is also understood by CONTRACTORS and COUNTY that CONTRACTORS estimate to generate a cumulative total of Five Million Three Hundred Ten Thousand Six Hundred Seventy and No/100 Dollars ($5,310,670.00) in Medi-Cal Federal FFP for SED services under this Agreement to offset CONTRACTORS’ program costs as set forth in Revised Exhibit C. In no event shall the maximum contract amount, for the full contract term of July 1, 2018 through June 30, 2023, for all the services provided by CONTRACTORS to COUNTY under the terms and conditions of this Agreement be in excess of Thirty Two Million Six Hundred Thousand Four Hundred Fifteen and No/100 Dollars ($32,600,415.00) during the total term of this Agreement. The maximum amount of MHSA CSS funds payable to CONTRACTORS for all services provided under this Agreement shall not exceed Ten Million Four Hundred Eighty- Six Thousand Seven Hundred Sixty-Five and No/100 Dollars ($10,486,765.00). The total revenue estimated to be generated by CONTRACTORS under this Agreement is Twenty Two Million One Hundred Thirteen Thousand Six Hundred Fifty and No/100 Dollars ($22,113,650.00). - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 Ten (10) – Insurance - Section I – Waiver of Subrogation - of the Agreement, on Page Fifteen (15), beginning on Line Five (5) with the letter “I”, and ending on Page Fifteen (15), Line Eight (8) 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 effective whether or not CONTRACTOR obtains such an endorsement.” 4.The parties agree that this Amendment may be executed by electronic signature as provided in this section. An “electronic signature” means any symbol or process intended by an individual signing this Amendment to represent their signature, including but not limited to (1) a digital signature; (2) a faxed version of an original handwritten signature; or (3) an electronically scanned and transmitted (for example by PDF document) of a handwritten signature. Each electronic signature affixed or attached to this Amendment (1) is deemed equivalent to a valid original handwritten signature of the person signing this Amendment for all purposes, including but not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. The provisions of this section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). Each party using a digital signature represents that it has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) through (5), and agrees that each other party may rely upon that representation. This Amendment is not conditioned upon the parties conducting the transactions under it by electronic means and either party may sign this Amendment with an original - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 handwritten signature. 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 I 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. // // // // // // // // // // // // // // // // // // // // // 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment I as of the day and 2 year first hereinabove written . 3 4 CONTRACTOR 5 SEE ATTACHED SIGNATURE PAGES 6 7 8 9 10 11 12 13 14 15 16 17 18 FOR ACCOUNTING USE ONLY : 19 Fund : 0001 20 Subclass : 10000 21 ORG : 5630 22 Account:7295 23 24 25 26 27 28 Steven 1-anEau, 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: ~ct~~~•~c..A,,A,+ ~....,.._ __ _ Dep t) -6 - 1 2 3 4 PARENTS UNLIMITED, rized Signatw- // T �s C[o 5 1+----""--""-"""--=:..!...C------'::...._-=-.:......::...::.......,ic........:=--.:::::...._ ___ _ Print Name & Title 6 5". !� t-/ 1-1--------'--�C....,,..-------'--------- 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Date Mailing Address: 4440 N. First Street Fresno, CA 93726 -8 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 COMPREHENSIVE YOUTH SERVICES By� � Print Name: /jj C /J4 v'ci dr, dJ 71 Title�0�Chairman of the Board, or President, or any Vice President slJ{b�11fa= Print Name t..AOiL'z:(e, '-j� Title: Sec :\-C.\. Secretary (of Corp ation), or any Assistant Sec etary, or Chief Financial Of ficer, or any Assistant Treasurer Date 5 \ II ) 2-DZJ. 2 4 Mailing Address: 4545 N. West Ave 2 s Fresno, CA 93705 Phone No.: (559) 229-3561 2 6 Contact: Executive Director 27 28 - 7 -COUNTY Of FRESNO Fresno, CA Employee Salaries Acct #Position FTE Admin Direct Total 1101 Clinician I 5.00 -$ 270,392$ 270,392$ 1102 Clinician II 1.00 - 62,307 62,307 1103 Facilitator I 10.00 - 487,606 487,606 1104 Facilitator II 1.00 - 58,171 58,171 1105 Family Partner I 2.00 - 64,929 64,929 1106 Family Specialist I 2.00 - 65,635 65,635 1107 Clinical Program Coordinator 3.33 - 237,178 237,178 1108 Support Service Coordinator 0.50 - 23,807 23,807 1109 Clinical Director 0.33 - 27,932 27,932 1110 Program Support Staff 4.49 - 280,360 280,360 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 29.65 -$ 1,578,317$ 1,578,317$ Employee Benefits Acct #Admin Direct Total 1201 -$ 56,291$ 56,291$ 1202 - 37,795 37,795 1203 - 375,822 375,822 1204 - - - 1205 - - - 1206 - - - -$ 469,908$ 469,908$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ 99,716$ 99,716$ 1302 - 23,321 23,321 1303 - 16,083 16,083 1304 - - - 1305 - - - 1306 - - - -$ 139,120$ 139,120$ -$ 2,187,345$ 2,187,345$ BRIGHT BEGINNINGS FOR FAMILIES UPLIFT FAMILY SERVICES Fiscal Year (FY) 2018-2019 Description Payroll Taxes & Expenses Subtotal: Other (specify) Other (specify) EMPLOYEE SALARIES & BENEFITS TOTAL: PROGRAM EXPENSES 1000: SALARIES & BENEFITS Other (specify) Employee Benefits Subtotal: Description Retirement Worker's Compensation Health Insurance Other (specify) Other (specify) OASDI FICA/MEDICARE SUI Other (specify) Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 778 2003 1,252 2004 4,530 2005 192 2006 - 2007 1,156 2008 - 2009 - 2010 578 2011 1,155 2012 - 2013 - 2014 - 2015 - 2016 - 9,641$ 3000: OPERATING EXPENSES Acct #Amount 3001 37,870$ 3002 - 3003 26,438 3004 - 3005 17,836 3006 50,533 3007 - 3008 - 3009 7,000 3010 5,550 3011 - 3012 - 145,227$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 4,500$ 4002 105,203 4003 17,050 4004 - 4005 - 4006 - 4007 13,256 4008 - 4009 - 4010 - 140,009$ 5000: SPECIAL EXPENSES Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Other (specify) Client Housing Operating Expenditures Advertising FACILITIES/EQUIPMENT TOTAL: Depreciation OPERATING EXPENSES TOTAL: Equipment Purchase Other (specify) Other (specify) Building Maintenance 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 Rent/Lease Vehicles Security Other (specify) Utilities Other (specify) Program Supplies - Therapeutic Staff Travel/Mileage Subscriptions & Memberships Other (specify) Other (specify) Rent/Lease Equipment Rent/Lease Building Staff Development & Training Vehicle Maintenance Other (specify) Office, Household & Program Supplies Telecommunications Printing/Postage Revised Exhibit C Acct #Amount 5001 -$ 5002 - 5003 44,601 5004 - 5005 - 5006 - 5007 - 5008 - 44,601$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 451,830$ 6002 30,622 6003 - 6004 2,330 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 484,782$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ Line Item Description Professional Liability Insurance Accounting/Bookkeeping ADMINISTRATIVE EXPENSES TOTAL 3,011,605$ TOTAL PROGRAM EXPENSES Other Assets over $500 with Lifespan of 2 Years + Other (specify) Assets over $5,000/unit (Specify) FIXED ASSETS EXPENSES TOTAL SPECIAL EXPENSES TOTAL: Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Other (specify) Contract Psychiatrist Translation Services Leasehold/Tenant/Building Improvements Payroll Services Line Item Description External Audit Other (specify) Other (specify) Other (specify) Insurance (Specify): Other (specify) Other (specify) Other (specify) Other (specify) Furniture & Fixtures Line Item Description HMIS (Health Management Information System) Administrative Overhead Other (specify) Other (specify) Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Consultant (Network & Data Management) Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 395,077 2.84 1,122,019$ 8002 Case Management 290,001 2.21 640,902 8003 Crisis Services 9,667 4.17 40,311 8004 Medication Support 19,333 5.18 100,145 8005 Collateral 38,860 2.84 110,362 8006 Plan Development 6,477 2.84 18,395 8007 Assessment 45,337 2.84 128,757 8008 Rehabilitation 161,917 2.84 459,844 966,669 2,620,736$ 80% 2,096,589 100%2,096,589 2,096,589$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment 0$ 0$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 915,016$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 915,016$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) 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:3,011,605$ -$ SUBSTANCE USE DISORDER FUNDS TOTAL 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 Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Clinician I 5.00 -$ 278,504$ 278,504$ 1102 Clinician II 1.00 - 64,176 64,176 1103 Facilitator I 10.00 - 520,076 520,076 1104 Facilitator II 1.00 - 59,916 59,916 1105 Family Partner I 2.00 - 66,877 66,877 1106 Family Specialist I 2.00 - 67,604 67,604 1107 Clinical Program Manager 3.33 - 244,293 244,293 1108 Support Service Coordinator 0.50 - 24,521 24,521 1109 Clinical Director 0.33 - 28,770 28,770 1110 Doctors Assistant 0.30 - 4,586 4,586 1111 Program Support Staff 4.19 - 288,771 288,771 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 29.65 -$ 1,648,094$ 1,648,094$ Employee Benefits Acct #Admin Direct Total 1201 -$ 32,899$ 32,899$ 1202 - 29,812 29,812 1203 - 387,097 387,097 1204 - - - 1205 - - - 1206 - - - -$ 449,808$ 449,808$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ 93,341$ 93,341$ 1302 - 24,020 24,020 1303 - 12,024 12,024 1304 - - - 1305 - - 1306 - - -$ 129,385$ 129,385$ -$ 2,227,287$ 2,227,287$ BRIGHT BEGINNINGS FOR FAMILIES UPLIFT FAMILY SERVICES Fiscal Year (FY) 2019-2020 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 778 2003 1,252 2004 807 2005 192 2006 - 2007 1,156 2008 - 2009 - 2010 578 2011 1,155 2012 - 2013 - 2014 - 2015 - 2016 - 5,918$ 3000: OPERATING EXPENSES Acct #Amount 3001 37,870$ 3002 - 3003 10,438 3004 - 3005 41,934 3006 63,953 3007 - 3008 - 3009 5,550 3010 - 3011 - 3012 - 159,745$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 4,500$ 4002 125,329 4003 17,050 4004 - 4005 - 4006 - 4007 13,256 4008 - 4009 - 4010 - 160,135$ 5000: SPECIAL EXPENSES Child Care Client Housing Support Expenditures Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description 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) Subscriptions & Memberships Vehicle Maintenance Depreciation Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Travel/Mileage 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 FACILITIES/EQUIPMENT TOTAL: Revised Exhibit C Acct #Amount 5001 4,242$ 5002 - 5003 37,601 5004 - 5005 - 5006 - 5007 - 5008 - 41,843$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 464,661$ 6002 35,215 6003 - 6004 2,330 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 502,206$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ 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 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 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 $500 with Lifespan of 2 Years + FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 3,097,134$ Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 411,195 2.84 1,167,794$ 8002 Case Management 301,832 2.21 667,049 8003 Crisis Services 10,061 4.17 41,954 8004 Medication Support 20,122 5.18 104,232 8005 Collateral 40,445 2.84 114,864 8006 Plan Development 6,741 2.84 19,144 8007 Assessment 47,186 2.84 134,008 8008 Rehabilitation 168,522 2.84 478,602 1,006,104 2,727,648$ 80% 2,182,118 100%2,182,118 2,182,118$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment (0)$ (0)$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 915,016$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 915,016$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 8404 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:3,097,134$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Clinician I 5.00 -$ 395,705$ 395,705$ 1102 Clinician II 1.00 - 87,935 87,935 1103 Facilitator I 8.00 - 633,128 633,128 1104 Facilitator II 2.00 - 175,870 175,870 1105 Family Partner I 2.00 - 70,614 70,614 1106 Family Specialist I 3.00 - 101,689 101,689 1107 Clinical Program Manager 3.20 - 323,200 323,200 1108 Support Service Coordinator 0.50 - 25,191 25,191 1109 Clinical Director 0.50 - 72,050 72,050 1110 Doctors Assistant 0.30 - 11,462 11,462 1111 Program Support Staff 2.55 177,459 - 177,459 1112 Regional Director 0.28 47,586 - 47,586 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 28.33 225,045$ 1,896,844$ 2,121,889$ Employee Benefits Acct #Admin Direct Total 1201 6,211$ 68,055$ 74,266$ 1202 4,170 45,694 49,864 1203 41,468 454,363 495,831 1204 - - - 1205 - - - 1206 - - - 51,849$ 568,112$ 619,961$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 11,002$ 120,554$ 131,556$ 1302 2,573 28,195 30,768 1303 1,775 19,443 21,218 1304 - - - 1305 - - 1306 - - 15,350$ 168,192$ 183,542$ 292,244$ 2,633,148$ 2,925,392$ BRIGHT BEGINNINGS FOR FAMILIES UPLIFT FAMILY SERVICES Fiscal Year (FY) 2020-2021 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 250 2003 1,252 2004 500 2005 192 2006 - 2007 500 2008 - 2009 - 2010 250 2011 250 2012 - 2013 - 2014 - 2015 - 2016 - 3,194$ 3000: OPERATING EXPENSES Acct #Amount 3001 37,870$ 3002 - 3003 10,438 3004 - 3005 27,836 3006 13,000 3007 - 3008 - 3009 5,550 3010 - 3011 - 3012 - 94,694$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 4,500$ 4002 147,095 4003 17,050 4004 - 4005 - 4006 - 4007 13,256 4008 - 4009 - 4010 - 181,901$ 5000: SPECIAL EXPENSES Child Care Client Housing Support Expenditures Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description 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) Subscriptions & Memberships Vehicle Maintenance Depreciation Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Travel/Mileage 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 FACILITIES/EQUIPMENT TOTAL: Revised Exhibit C Acct #Amount 5001 5,082$ 5002 - 5003 83,721 5004 - 5005 - 5006 - 5007 - 5008 - 88,803$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 590,380$ 6002 48,803 6003 - 6004 2,697 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 641,880$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ 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 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 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 $500 with Lifespan of 2 Years + FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 3,935,864$ Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 427,815 3.78 1,616,640$ 8002 Case Management 314,037 2.94 923,447 8003 Crisis Services 10,468 5.55 58,082 8004 Medication Support 20,936 6.89 144,299 8005 Collateral 42,080 3.78 159,013 8006 Plan Development 7,013 3.78 26,501 8007 Assessment 49,094 3.78 185,518 8008 Rehabilitation 175,335 3.78 662,561 1,046,778 3,776,060$ 80% 3,020,848 100%3,020,848 3,020,848$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 915,016$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 915,016$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:3,935,864$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Clinician I 5.00 -$ 407,576$ 407,576$ 1102 Clinician II 1.00 - 90,573 90,573 1103 Facilitator I 8.00 - 652,122 652,122 1104 Facilitator II 2.00 - 181,146 181,146 1105 Family Partner I 2.00 - 72,732 72,732 1106 Family Specialist I 3.00 - 104,740 104,740 1107 Clinical Program Manager 3.20 - 332,896 332,896 1108 Support Service Coordinator 0.50 - 25,947 25,947 1109 Clinical Director 0.50 - 74,212 74,212 1110 Doctors Assistant 0.30 - 11,806 11,806 1111 Program Support Staff 2.55 182,782 - 182,782 1112 Regional Director 0.28 49,014 - 49,014 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 28.33 231,796$ 1,953,750$ 2,185,546$ Employee Benefits Acct #Admin Direct Total 1201 6,397$ 70,097$ 76,494$ 1202 4,295 47,065 51,360 1203 42,712 467,994 510,706 1204 - - - 1205 - - - 1206 - - - 53,404$ 585,156$ 638,560$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 11,332$ 124,170$ 135,502$ 1302 2,650 29,041 31,691 1303 1,828 20,027 21,855 1304 - - - 1305 - - - 1306 - - - 15,810$ 173,238$ 189,048$ 301,010$ 2,712,144$ 3,013,154$ BRIGHT BEGINNINGS FOR FAMILIES UPLIFT FAMILY SERVICES Fiscal Year (FY) 2021-2022 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 778 2003 1,252 2004 4,530 2005 192 2006 - 2007 1,156 2008 - 2009 - 2010 578 2011 1,155 2012 - 2013 - 2014 - 2015 - 2016 - 9,641$ 3000: OPERATING EXPENSES Acct #Amount 3001 39,006$ 3002 - 3003 10,438 3004 - 3005 49,810 3006 102,736 3007 - 3008 - 3009 5,550 3010 - 3011 - 3012 - 207,540$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 4,725$ 4002 147,095 4003 17,903 4004 - 4005 - 4006 - 4007 13,256 4008 - 4009 - 4010 - 182,979$ 5000: SPECIAL EXPENSES Child Care Client Housing Support Expenditures Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description 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) Subscriptions & Memberships Vehicle Maintenance Depreciation Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Travel/Mileage 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 FACILITIES/EQUIPMENT TOTAL: Revised Exhibit C Acct #Amount 5001 5,800$ 5002 - 5003 86,233 5004 - 5005 - 5006 - 5007 - 5008 - 92,033$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 627,990$ 6002 50,268 6003 - 6004 2,967 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 681,225$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ 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 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 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 $500 with Lifespan of 2 Years + FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 4,186,572$ Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 444,965 3.93 1,750,819$ 8002 Case Management 326,620 3.06 1,000,074 8003 Crisis Services 10,887 5.78 62,899 8004 Medication Support 21,775 7.18 156,273 8005 Collateral 43,767 3.93 172,211 8006 Plan Development 7,295 3.93 28,704 8007 Assessment 51,062 3.93 200,915 8008 Rehabilitation 182,363 3.93 717,550 1,088,734 4,089,445$ 80% 3,271,556 100%3,271,556 3,271,556$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 915,016$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 915,016$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:4,186,572$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Clinician I 5.00 -$ 419,803$ 419,803$ 1102 Clinician II 1.00 - 93,290 93,290 1103 Facilitator I 8.00 - 671,686 671,686 1104 Facilitator II 2.00 - 186,580 186,580 1105 Family Partner I 2.00 - 74,914 74,914 1106 Family Specialist I 3.00 - 107,882 107,882 1107 Clinical Program Manager 3.20 - 342,883 342,883 1108 Support Service Coordinator 0.50 - 26,725 26,725 1109 Clinical Director 0.50 - 76,438 76,438 1110 Doctors Assistant 0.30 - 12,160 12,160 1111 Program Support Staff 2.55 188,266 - 188,266 1112 Regional Director 0.28 50,484 - 50,484 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 28.33 238,750$ 2,012,361$ 2,251,111$ Employee Benefits Acct #Admin Direct Total 1201 6,589$ 72,200$ 78,789$ 1202 4,424 48,477 52,901 1203 43,993 482,034 526,027 1204 - - - 1205 - - - 1206 - - - 55,006$ 602,711$ 657,717$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 11,672$ 127,895$ 139,567$ 1302 2,730 29,911 32,641 1303 1,883 20,627 22,510 1304 - - - 1305 - - 1306 - - 16,285$ 178,433$ 194,718$ 310,041$ 2,793,505$ 3,103,546$ BRIGHT BEGINNINGS FOR FAMILIES UPLIFT FAMILY SERVICES Fiscal Year (FY) 2022-2023 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 778 2003 1,252 2004 4,530 2005 192 2006 - 2007 1,156 2008 - 2009 - 2010 578 2011 1,155 2012 - 2013 - 2014 - 2015 - 2016 - 9,641$ 3000: OPERATING EXPENSES Acct #Amount 3001 40,176$ 3002 - 3003 10,438 3004 - 3005 49,810 3006 105,818 3007 - 3008 - 3009 5,550 3010 - 3011 - 3012 - 211,792$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 4,961$ 4002 147,095 4003 18,798 4004 - 4005 - 4006 - 4007 23,256 4008 - 4009 - 4010 - 194,110$ 5000: SPECIAL EXPENSES Child Care Client Housing Support Expenditures Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description 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) Subscriptions & Memberships Vehicle Maintenance Depreciation Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Travel/Mileage 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 FACILITIES/EQUIPMENT TOTAL: Revised Exhibit C Acct #Amount 5001 5,800$ 5002 - 5003 88,820 5004 - 5005 - 5006 - 5007 - 5008 - 94,620$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 647,430$ 6002 51,776 6003 - 6004 3,264 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 702,470$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ 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 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 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 $500 with Lifespan of 2 Years + FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 4,316,179$ Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 462,655 3.93 1,820,191$ 8002 Case Management 339,602 3.06 1,039,690 8003 Crisis Services 11,320 5.78 65,392 8004 Medication Support 22,640 7.18 162,460 8005 Collateral 45,507 3.93 179,035 8006 Plan Development 7,584 3.93 29,837 8007 Assessment 53,091 3.93 208,872 8008 Rehabilitation 189,612 3.93 745,977 1,132,011 4,251,454$ 80% 3,401,163 100%3,401,163 3,401,163$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment (0)$ (0)$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 915,016$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 915,016$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:4,316,179$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 Senior Mental Health Clinician 1.80 $167,400 $167,400 0002 Licensed Mental Health Clinician 1.00 $70,000 $70,000 0003 Mental Health Clinician 2.00 $110,560 $110,560 0004 Children's Services Coordinator II 5.00 $192,587 $192,587 0005 Children's Services Coordinator III 2.00 $94,057 $94,057 0006 Suport Services Supervisor 0.30 $13,308 $13,308 0007 Children's Services Assistant 1.70 $46,053 $46,053 0008 Administrative Assistant 0.70 $23,285 $23,285 0009 Billing Specialist 0.45 $17,225 $17,225 0010 Billing Assistant 1.00 $30,012 $30,012 0011 Data Management Assistant 1.00 $30,710 $30,710 0012 Facilities Manager 0.05 $2,424 $2,424 0013 Program & Operations Manager-ACC 0.50 $44,000 $44,000 SALARY TOTAL 17.50 $147,656 $693,965 $841,621 PAYROLL TAXES: 0030 OASDI $9,155 $43,026 $52,181 0031 FICA/MEDICARE $2,141 $10,062 $12,203 0032 SUI $623 $2,322 $2,945 PAYROLL TAX TOTAL $11,919 $55,410 $67,329 EMPLOYEE BENEFITS: 0040 Retirement $5,906 $27,759 $33,665 0041 Workers Compensation $2,067 $9,716 $11,783 0042 Health Insurance (medical, vision, life, dental)$15,652 $73,560 $89,212 EMPLOYEE BENEFITS TOTAL $23,625 $111,035 $134,660 SALARY & BENEFITS GRAND TOTAL $1,043,610 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $67,190 1011 Rent/Lease Equipment $16,800 1012 Utilities $9,000 1013 Building Maintenance $11,880 1014 Equipment purchase $3,000 FACILITY/EQUIPMENT TOTAL $107,870 Line Item Description (Must be itemized) BRIGHT BEGINNINGS FOR FAMILIES CHILDREN'S FSP - AGES 0-10 YEARS EXCEPTIONAL PARENTS UNLIMITED, INC FY 2018-2019 Budget Categories -Total Proposed Budget Revised Exhibit C OPERATING EXPENSES: 1060 Telephone $7,500 1061 Answering Service $0 1062 Postage $1,800 1063 Printing/Reproduction $1,500 1064 Publications $0 1065 Legal Notices/Advertising $0 1066 Office Supplies & Equipment $14,400 1067 Household Supplies $0 1068 Food $500 1069 Program Supplies - Therapeutic $5,500 1070 Program Supplies - Medical $0 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $5,500 1073 Staff Travel (Out of County)$2,150 1074 Staff Training/Registration $18,000 1075 Lodging $0 1076 Other - (Identify)$0 1077 Other - (Identify)$0 OPERATING EXPENSES TOTAL $56,850 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $3,600 1082 Liability Insurance $8,400 1083 Administrative Overhead $181,687 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $193,687 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (network & data management)$9,135 1091 Translation Services $900 1092 Billing System Support $2,400 1092 Contract Psychologist $60,000 SPECIAL EXPENSES TOTAL $72,435 FIXED ASSETS: 1190 Computers & Software $0 1191 Furniture & Fixtures $0 1192 Other - (Identify)$0 1193 Other - (Identify)$0 FIXED ASSETS TOTAL $0 Revised Exhibit C NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$900 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$700 2002.2 Client Transportation & Support (SFC 72)$700 2002.3 Education Support (SFC 72)$700 2002.4 Employment Support (SFC 72)$500 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $750 2002.7 Utility Vouchers (SFC 72)$750 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $5,000 TOTAL PROGRAM EXPENSES $1,479,452 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)49,900 $2.84 $141,716 3100 Case Management 20,376 $2.21 $45,031 3200 Crisis Services 1,000 $4.17 $4,170 3300 Medication Support 0 $0.00 $0 3400 Collateral 72,672 $2.84 $206,388 3500 Plan Development 6,525 $2.84 $18,531 3600 Assessment 32,467 $2.84 $92,206 3700 Rehabilitation 60,112 $2.84 $170,718 Estimated Specialty Mental Health Services Billing Totals 243,052 $678,761 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $678,761 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP) 0.00%$0 State M/Cal Share of Cost % (BH Realignment/EPSDT) 0.00%$0 MEDI-CAL REVENUE TOTAL $678,761 OTHER REVENUE: 4100 Other - (Identify)$0 4200 Other - (Identify)$0 4300 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $800,691 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $800,691 TOTAL PROGRAM REVENUE $1,479,452 Revised Exhibit C FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 Senior Mental Health Clinician 1.80 $169,911 $169,911 0002 Licensed Mental Health Clinician 3.00 $186,610 $186,610 0003 Children's Services Coordinator II 5.00 $195,476 $195,476 0004 Children's Services Coordinator III 2.00 $95,469 $95,469 0005 Support Services Supervisor 0.30 $13,508 $13,508 0006 Children's Services Assistant 1.70 $46,744 $46,744 0007 Administrative Assistant 0.70 $23,634 $23,634 0008 Billing Specialist 0.45 $17,481 $17,481 0009 Billing Assistant 1.00 $30,462 $30,462 0010 Data Management Assistant 1.00 $30,970 $30,970 0011 Facilities Manager 0.05 $2,462 $2,462 0012 Program & Operations Manager-ACC 0.50 $44,000 $44,000 SALARY TOTAL 17.50 $149,009 $707,718 $856,727 PAYROLL TAXES: 0030 OASDI $9,239 $43,879 $53,117 0031 FICA/MEDICARE $2,161 $10,262 $12,423 0032 SUI $634 $2,364 $2,998 PAYROLL TAX TOTAL $12,033 $56,504 $68,538 EMPLOYEE BENEFITS: 0040 Retirement $5,960 $28,309 $34,269 0041 Workers Compensation $2,086 $9,908 $11,994 0042 Health Insurance (medical, vision, life, dental)$15,795 $75,018 $90,813 EMPLOYEE BENEFITS TOTAL $23,841 $113,235 $137,076 SALARY & BENEFITS GRAND TOTAL $1,062,341 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $67,190 1011 Rent/Lease Equipment $16,800 1012 Utilities $9,000 1013 Building Maintenance $11,880 1014 Equipment purchase $1,000 FACILITY/EQUIPMENT TOTAL $105,870 Line Item Description (Must be itemized) BRIGHT BEGINNINGS FOR FAMILIES CHILDREN'S FSP - AGES 0-10 YEARS EXCEPTIONAL PARENTS UNLIMITED, INC FY 2019-2020 Budget Categories -Total Proposed Budget Revised Exhibit C OPERATING EXPENSES: 1060 Telephone $7,500 1061 Answering Service $0 1062 Postage $1,800 1063 Printing/Reproduction $1,500 1064 Publications $0 1065 Legal Notices/Advertising $0 1066 Office Supplies & Equipment $14,400 1067 Household Supplies $0 1068 Food $400 1069 Program Supplies - Therapeutic $5,600 1070 Program Supplies - Medical $0 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $5,500 1073 Staff Travel (Out of County)$1,540 1074 Staff Training/Registration $6,000 1075 Lodging $0 1076 Other - (Identify)$0 1077 Other - (Identify)$0 OPERATING EXPENSES TOTAL $44,240 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $3,600 1082 Liability Insurance $8,400 1083 Administrative Overhead $182,267 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $194,267 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (network & data management)$9,160 1091 Translation Services $900 1092 Billing System Support $2,400 1092 Contract Psychologist $60,000 SPECIAL EXPENSES TOTAL $72,460 FIXED ASSETS: 1190 Computers & Software $0 1191 Furniture & Fixtures $0 1192 Other - (Identify)$0 1193 Other - (Identify)$0 FIXED ASSETS TOTAL $0 Revised Exhibit C NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$900 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$700 2002.2 Client Transportation & Support (SFC 72)$700 2002.3 Education Support (SFC 72)$700 2002.4 Employment Support (SFC 72)$500 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $750 2002.7 Utility Vouchers (SFC 72)$750 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $5,000 TOTAL PROGRAM EXPENSES $1,484,178 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)50,250 $2.84 $142,710 3100 Case Management 20,492 $2.21 $45,287 3200 Crisis Services 1,000 $4.17 $4,170 3300 Medication Support 0 $0.00 $0 3400 Collateral 73,187 $2.84 $207,851 3500 Plan Development 6,568 $2.84 $18,653 3600 Assessment 32,700 $2.84 $92,868 3700 Rehabilitation 60,545 $2.84 $171,948 Estimated Specialty Mental Health Services Billing Totals 244,742 $683,487 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $683,487 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP) 0.00%$0 State M/Cal Share of Cost % (BH Realignment/EPSDT) 0.00%$0 MEDI-CAL REVENUE TOTAL $683,487 OTHER REVENUE: 4100 Other - (Identify)$0 4200 Other - (Identify)$0 4300 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $800,691 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $800,691 TOTAL PROGRAM REVENUE $1,484,178 Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Manager of Clinical Services 1.00 98,665$ 98,665$ 1102 Senior Mental Health Clinician 1.00 - 81,000 81,000 1103 Licensed Mental Health Clinician 3.00 - 211,400 211,400 1104 Case Manager - Facilitator 6.00 - 240,000 240,000 1105 Support Services Supervisor 1.00 - 58,240 58,240 1106 Program Assistant 1.80 - 58,610 58,610 1107 Billing Specialist 1.00 41,875 - 41,875 1108 Billing Assistant 1.00 31,825 - 31,825 1109 Facilities Manager 0.05 2,835 - 2,835 1110 Program & Operations Manager - ACC 0.50 46,895 - 46,895 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 16.35 123,430$ 747,915$ 871,345$ Employee Benefits Acct #Admin Direct Total 1201 4,937$ 29,917$ 34,854$ 1202 1,728 10,471 12,199 1203 15,400 83,343 98,743 1204 - - - 1205 - - - 1206 - - - 22,065$ 123,731$ 145,796$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 7,652$ 46,371$ 54,023$ 1302 1,790 10,845 12,635 1303 803 4,347 5,150 1304 - - - 1305 - - - 1306 - - - 10,245$ 61,563$ 71,808$ 155,740$ 933,209$ 1,088,949$ Retirement Worker's Compensation Health Insurance Other (specify) Other (specify) OASDI FICA/MEDICARE SUI Other (specify) Other (specify) Employee Benefits Subtotal: Description BRIGHT BEGINNINGS FOR FAMILIES EXCEPTIONAL PARENTS UNLIMITED, INC Fiscal Year (FY) 2020-2021 Description Payroll Taxes & Expenses Subtotal: Other (specify) Other (specify) EMPLOYEE SALARIES & BENEFITS TOTAL: PROGRAM EXPENSES 1000: SALARIES & BENEFITS Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 1,800 2003 1,000 2004 1,000 2005 900 2006 900 2007 1,200 2008 - 2009 - 2010 1,200 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 8,000$ 3000: OPERATING EXPENSES Acct #Amount 3001 6,600$ 3002 2,800 3003 14,800 3004 - 3005 21,640 3006 1,400 3007 - 3008 3,600 3009 6,500 3010 500 3011 - 3012 - 57,840$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 13,880$ 4002 81,470 4003 17,800 4004 12,500 4005 - 4006 4007 4008 - 4009 - 4010 - 125,650$ 5000: SPECIAL EXPENSES Other (specify) Program Supplies - Therapeutic Staff Mileage Subscriptions & Memberships Other (specify) Other (specify) Rent/Lease Equipment Rent/Lease Building Staff Development & Training Vehicle Maintenance Other (specify) Office Supplies & Equipment Telecommunications Printing/Postage Utilities Equipment Purchase Other (specify) Other (specify) Client Transportation & Support Client Housing Support 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: Other (specify) Other (specify) Other (specify) Building Maintenance Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Other (specify) Other (specify) Advertising FACILITIES/EQUIPMENT TOTAL: Food Revised Exhibit C Acct #Amount 5001 7,500$ 5002 3,600 5003 40,000 5004 4,000 5005 - 5006 - 5007 - 5008 - 55,100$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 189,074$ 6002 - 6003 - 6004 3,600 6005 9,500 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 202,174$ 7000: FIXED ASSETS Acct #Amount 7001 1,000$ 7002 890 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - 1,890$ 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) Contractual/Consulting Services (Specify) Translation Services 1,539,603$ TOTAL PROGRAM EXPENSES Other Assets over $500 with Lifespan of 2 Years + Other (specify) Assets over $5,000/unit (Specify) FIXED ASSETS EXPENSES TOTAL Line Item Description Professional Liability Insurance Accounting/Bookkeeping ADMINISTRATIVE EXPENSES TOTAL Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 43,000 3.78 162,540$ 8002 Case Management 35,000 2.94 102,900 8003 Crisis Services 1,000 5.55 5,550 8004 Medication Support 0 - - 8005 Collateral 60,000 3.78 226,800 8006 Plan Development 6,000 3.78 22,680 8007 Assessment 30,000 3.78 113,400 8008 Rehabilitation 27,789 3.78 105,042 202,789 738,912$ 100% 738,912 100%738,912 738,912$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment (0)$ (0)$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 800,691$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 800,691$ 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:1,539,603$ -$ SUBSTANCE USE DISORDER FUNDS TOTAL 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Manager of Clinical Services 1.00 -$ 101,625$ 101,625$ 1102 Senior Mental Health Clinician 1.00 - 83,430 83,430 1103 Mental Health Clinician 4.00 - 306,000 306,000 1104 Case Manager-Facilitator 5.00 - 208,000 208,000 1105 Support Services Supervisor 1.00 - 60,320 60,320 1106 Program Assistant 1.80 - 60,320 60,320 1107 Billing Specialist 1.00 43,130 - 43,130 1108 Billing Assistant 1.00 32,780 - 32,780 1109 Facilities Manager 0.05 3,015 - 3,015 1110 Program & Operations Manager-ACC 0.50 48,300 - 48,300 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 16.35 127,225$ 819,695$ 946,920$ Employee Benefits Acct #Admin Direct Total 1201 5,089$ 32,788$ 37,877$ 1202 1,781 11,476 13,257 1203 15,912 86,112 102,024 1204 - - - 1205 - - - 1206 - - - 22,782$ 130,376$ 153,158$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 7,888$ 50,821$ 58,709$ 1302 1,845 11,885 13,730 1303 803 4,347 5,150 1304 - - - 1305 - - 1306 - - 10,536$ 67,053$ 77,589$ 160,543$ 1,017,124$ 1,177,667$ 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) BRIGHT BEGINNINGS FOR FAMILIES EXCEPTIONAL PARENTS UNLIMITED, INC Fiscal Year (FY) 2021-2022 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 1,800 2003 1,000 2004 1,000 2005 900 2006 900 2007 1,200 2008 - 2009 - 2010 1,200 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 8,000$ 3000: OPERATING EXPENSES Acct #Amount 3001 7,680$ 3002 2,700 3003 14,800 3004 - 3005 15,750 3006 1,680 3007 - 3008 3,600 3009 7,000 3010 500 3011 - 3012 - 53,710$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 13,245$ 4002 73,800 4003 17,800 4004 4005 12,000 4006 - 4007 - 4008 - 4009 - 4010 - 116,845$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Utilities Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Equipment Purchase Subscriptions & Memberships Vehicle Maintenance Program Supplies - Therapeutic Food Other (Specify) Other (Specify) Telecommunications Printing/Postage Office Supplies & Euipment Advertising Staff Development & Training Staff 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 Other (Specify) Other (Specify) Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Child Care Revised Exhibit C Acct #Amount 5001 6,300$ 5002 3,600 5003 40,000 5004 5,200 5005 - 5006 - 5007 - 5008 - 55,100$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 200,119$ 6002 - 6003 - 6004 3,600 6005 9,500 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 213,219$ 7000: FIXED ASSETS Acct #Amount 7001 3,000$ 7002 - 7003 2,000 7004 - 7005 - 7006 - 7007 - 7008 - 5,000$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 1,629,541$ 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 $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Payroll Services SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) Translation Services Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 52,000 3.78 196,560$ 8002 Case Management 35,000 2.94 102,900 8003 Crisis Services 1,000 5.55 5,550 8004 Medication Support 0 - - 8005 Collateral 70,000 3.78 264,600 8006 Plan Development 6,525 3.78 24,665 8007 Assessment 30,000 3.78 113,400 8008 Rehabilitation 32,057 3.78 121,175 226,582 828,850$ 100% 828,850 100%828,850 828,850$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment 0$ 0$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 800,691$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 800,691$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 8404 8405 - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:1,629,541$ 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 Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Manager of Clinical Services 1.00 -$ 104,675$ 104,675$ 1102 Senior Mental Health Clinician 1.00 - 85,935 85,935 1103 Licensed Mental Health Clinician 4.00 - 316,710 316,710 1104 Case Manager-Facilitator 5.00 - 214,240 214,240 1105 Support Services Supervisor 1.00 - 62,130 62,130 1106 Program Assistant 1.80 - 62,130 62,130 1107 Billing Specialist 1.00 44,425 - 44,425 1108 Billing Assistant 1.00 33,764 - 33,764 1109 Facilities Manager 0.05 3,105 - 3,105 1110 Program & Operations Manager - ACC 0.50 49,750 - 49,750 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 16.35 131,044$ 845,820$ 976,864$ Employee Benefits Acct #Admin Direct Total 1201 5,242$ 33,833$ 39,075$ 1202 1,835 11,841 13,676 1203 16,677 90,252 106,929 1204 - - - 1205 - - - 1206 - - - 23,754$ 135,926$ 159,680$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 8,125$ 52,441$ 60,566$ 1302 1,900 12,264 14,164 1303 803 4,347 5,150 1304 - - - 1305 - - 1306 - - 10,828$ 69,052$ 79,880$ 165,626$ 1,050,798$ 1,216,424$ 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) BRIGHT BEGINNINGS FOR FAMILIES EXCEPTIONAL PARENTS UNLIMITED, INC Fiscal Year (FY) 2022-2023 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 1,800 2003 1,000 2004 1,000 2005 900 2006 900 2007 1,200 2008 - 2009 - 2010 1,200 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 8,000$ 3000: OPERATING EXPENSES Acct #Amount 3001 7,680$ 3002 2,700 3003 11,200 3004 - 3005 10,750 3006 1,680 3007 - 3008 3,600 3009 7,000 3010 500 3011 - 3012 - 45,110$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 13,200$ 4002 73,800 4003 17,800 4004 - 4005 12,000 4006 - 4007 - 4008 - 4009 - 4010 - 116,800$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Utilities Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Equipment Purchase Subscriptions & Memberships Vehicle Maintenance Program Supplies - Therapeutic Food Other (Specify) Other (Specify) Telecommunications Printing/Postage Office Supplies & Equipment Advertising Staff Development & Training Staff 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 Other (Specify) Other (Specify) Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Child Care Revised Exhibit C Acct #Amount 5001 6,400$ 5002 10,800 5003 40,000 5004 5,200 5005 - 5006 - 5007 - 5008 - 62,400$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 205,077$ 6002 - 6003 - 6004 3,600 6005 9,500 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 218,177$ 7000: FIXED ASSETS Acct #Amount 7001 3,000$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - 3,000$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 1,669,911$ 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 $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Payroll Services SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) Translation Services Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 52,000 3.78 196,560$ 8002 Case Management 35,000 2.94 102,900 8003 Crisis Services 1,000 5.55 5,550 8004 Medication Support 0 - - 8005 Collateral 73,000 3.78 275,940 8006 Plan Development 6,525 3.78 24,665 8007 Assessment 30,500 3.78 115,290 8008 Rehabilitation 39,237 3.78 148,316 237,262 869,220$ 100% 869,220 100%869,220 869,220$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment (0)$ (0)$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 800,691$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 800,691$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:1,669,911$ 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 Revised Exhibit C FTE %Admin Direct Total 0001 Program Manager 0.75 -$ 76,897$ 76,897$ 0002 Clinical Director 0.10 -$ 11,308$ 11,308$ 0003 Clinical Oversight/Peer Review 0.55 -$ 49,798$ 49,798$ 0004 PCIT Clinicians/Lead Therapists 6.00 -$ 305,612$ 305,612$ 0005 Case Managers 4.00 -$ 144,565$ 144,565$ 0006 Finance Dir/HR Mgr/Finance & Clerical Support Varies 41,680$ 47,892$ 89,572$ SALARY TOTAL 41,680$ 636,072$ 677,752$ 0030 OASDI -$ -$ -$ 0031 FICA/MEDICARE 3,188$ 48,662$ 51,850$ 0032 SUI 329$ 7,923$ 8,252$ PAYROLL TAX TOTAL 3,517$ 56,585$ 60,102$ 0040 Retirement 2,086$ 31,812$ 33,898$ 0041 Workers Compensation 423$ 6,780$ 7,203$ 0042 4,337$ 82,473$ 86,810$ EMPLOYEE BENEFITS TOTAL 6,846$ 121,065$ 127,911$ 865,765$ 1010 Rent/Lease Building 55,164$ 1011 Rent/Lease Equipment 10,921$ 1012 Utilities 8,792$ 1013 Building Maintenance 5,420$ 1014 Equipment purchase 4,000$ FACILITY/EQUIPMENT TOTAL 84,297$ PERSONNEL SALARIES: PAYROLL TAXES: EMPLOYEE BENEFITS: Health Insurance (medical, vision, life, dental) SALARY & BENEFITS GRAND TOTAL FACILITIES/EQUIPMENT EXPENSES: Line Item Description (Must be itemized) BRIGHT BEGINNINGS FOR FAMILIES CHILDREN'S FSP - AGES 0-10 YEARS COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. FY 2018 - 2019 Budget Categories -Total Proposed Budget Revised Exhibit C 1060 Telephone 11,421$ 1061 Answering Service -$ 1062 Postage -$ 1063 Printing/Reproduction 300$ 1064 Publications -$ 1065 Legal Notices/Advertising -$ 1066 Office Supplies & Equipment 5,846$ 1067 Household Supplies -$ 1068 Food -$ 1069 Program Supplies - Therapeutic 4,800$ 1070 Program Supplies - Medical -$ 1071 Transportation of Clients 4,500$ 1072 Staff Mileage/Vehicle Maintenance 4,210$ 1073 Staff Travel (Out of County)1,840$ 1074 Staff Training/Registration 11,038$ 1075 Lodging 1,200$ 1076 Other - (Identify)-$ 1077 Other - (Identify)-$ OPERATING EXPENSES TOTAL 45,155$ 1080 Accounting/Bookkeeping -$ 1081 External Audit 3,132$ 1082 Liability Insurance -$ 1083 Administrative Overhead 4,101$ 1084 Payroll Services 2,151$ 1085 Professional Liability Insurance 5,978$ FINANCIAL SERVICES TOTAL 15,362$ 1090 Consultant 2,333$ 1091 Translation Services 2,000$ 1092 Medication Supports 250$ SPECIAL EXPENSES TOTAL 4,583$ 1190 Computers & Software -$ 1191 Furniture & Fixtures -$ 1192 Other - Leased Automobile 7,200$ FIXED ASSETS TOTAL 7,200$ OPERATING EXPENSES: FINANCIAL SERVICES EXPENSES: SPECIAL EXPENSES (Consultant/Etc.): FIXED ASSETS: Revised Exhibit C 2000 Client Housing Support Expenditures (SFC 70)-$ 2001 Client Housing Operating Expenditures (SFC 71)-$ 2002.1 Clothing, Food & Hygiene (SFC 72)2,500$ 2002.2 Client Transportation & Support (SFC 72)2,000$ 2002.3 Education Support (SFC 72)300$ 2002.4 Employment Support (SFC 72)200$ 2002.5 Respite Care (SFC 72)-$ 2002.6 Household Items -$ 2002.7 Utility Vouchers (SFC 72)-$ 2002.8 Child Care (SFC 72)-$ 5,000$ TOTAL PROGRAM EXPENSES 1,027,362$ Units of Service Rate $ Amount 3000 49,917 $2.84 141,764$ 3100 Case Management 26,447 $2.21 58,448$ 3200 Crisis Services 126 $4.23 533$ 3300 Medication Support - $4.82 -$ 3400 Collateral 109,868 $2.84 312,025$ 3500 Plan Development 994 $2.84 2,823$ 3600 Assessment 19,210 $2.84 54,556$ 3700 Rehabilitation 26,608 $2.84 75,567$ 233,170 645,716$ Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 645,716$ Federal M/Cal Share of Cost % (Federal Financial Participation-FFP) 50.00%322,858$ State M/Cal Share of Cost % (BH Realignment/EPSDT) 50.00%322,858$ MEDI-CAL REVENUE TOTAL 645,716$ 4100 Other - (Identify)-$ 4200 Other - (Identify)-$ 4300 Other - (Identify)-$ OTHER REVENUE TOTAL -$ 5000 Prevention & Early Intervention (PEI) Funds -$ 5100 Community Services & Supports (CSS) Funds 381,646$ 5200 Innovation (INN) Funds -$ 5300 Workforce Education & Training (WET) Funds -$ MHSA FUNDS TOTAL 381,646$ 1,027,362$ OTHER REVENUE: MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: TOTAL PROGRAM REVENUE NON MEDI-CAL CLIENT SUPPORT EXPENSES: NON MEDI-CAL CLIENT SUPPORT TOTAL MEDI-CAL REVENUE: Mental Health Services (Individual/Family/Group Therapy) Estimated Specialty Mental Health Services Billing Totals Revised Exhibit C FTE %Admin Direct Total 0001 Program Manager 0.75 -$ 81,955$ 81,955$ 0002 Clinical Director 0.10 -$ 12,005$ 12,005$ 0003 Clinical Oversight/Peer Review 0.55 -$ 52,870$ 52,870$ 0004 PCIT Clinicians/Lead Therapists 6.00 -$ 324,571$ 324,571$ 0005 Case Managers 4.00 -$ 153,335$ 153,335$ 0006 Finance Dir/HR Mgr/Finance & Clerical Support Varies 44,404$ 51,025$ 95,429$ SALARY TOTAL 44,404$ 675,761$ 720,165$ 0030 OASDI -$ -$ -$ 0031 FICA/MEDICARE 3,397$ 51,695$ 55,092$ 0032 SUI 276$ 6,605$ 6,881$ PAYROLL TAX TOTAL 3,673$ 58,300$ 61,973$ 0040 Retirement 2,224$ 33,801$ 36,025$ 0041 Workers Compensation 452$ 7,202$ 7,654$ 0042 4,632$ 88,091$ 92,723$ EMPLOYEE BENEFITS TOTAL 7,308$ 129,094$ 136,402$ 918,540$ 1010 Rent/Lease Building 56,684$ 1011 Rent/Lease Equipment 11,102$ 1012 Utilities 9,056$ 1013 Building Maintenance 5,602$ 1014 Equipment purchase -$ FACILITY/EQUIPMENT TOTAL 82,444$ FACILITIES/EQUIPMENT EXPENSES: BRIGHT BEGINNINGS FOR FAMILIES CHILDREN'S FSP - AGES 0-10 YEARS COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. FY 2019 - 2020 Budget Categories -Total Proposed Budget Line Item Description (Must be itemized) PERSONNEL SALARIES: PAYROLL TAXES: EMPLOYEE BENEFITS: Health Insurance (medical, vision, life, dental) SALARY & BENEFITS GRAND TOTAL Revised Exhibit C 1060 Telephone 11,566$ 1061 Answering Service -$ 1062 Postage -$ 1063 Printing/Reproduction 300$ 1064 Publications -$ 1065 Legal Notices/Advertising -$ 1066 Office Supplies & Equipment 5,866$ 1067 Household Supplies -$ 1068 Food -$ 1069 Program Supplies - Therapeutic 4,800$ 1070 Program Supplies - Medical -$ 1071 Transportation of Clients 4,500$ 1072 Staff Mileage/Vehicle Maintenance 4,212$ 1073 Staff Travel (Out of County)1,840$ 1074 Staff Training/Registration 4,050$ 1075 Lodging 1,200$ 1076 Other - (Identify)-$ 1077 Other - (Identify)-$ OPERATING EXPENSES TOTAL 38,334$ 1080 Accounting/Bookkeeping -$ 1081 External Audit 3,226$ 1082 Liability Insurance -$ 1083 Administrative Overhead 4,161$ 1084 Payroll Services 2,215$ 1085 Professional Liability Insurance 6,080$ FINANCIAL SERVICES TOTAL 15,682$ 1090 Consultant 2,358$ 1091 Translation Services 2,000$ 1092 Medication Supports 250$ SPECIAL EXPENSES TOTAL 4,608$ 1190 Computers & Software -$ 1191 Furniture & Fixtures -$ 1192 Other - Leased Automobile 7,200$ FIXED ASSETS TOTAL 7,200$ OPERATING EXPENSES: FINANCIAL SERVICES EXPENSES: SPECIAL EXPENSES (Consultant/Etc.): FIXED ASSETS: Revised Exhibit C 2000 Client Housing Support Expenditures (SFC 70)-$ 2001 Client Housing Operating Expenditures (SFC 71)-$ 2002.1 Clothing, Food & Hygiene (SFC 72)2,500$ 2002.2 Client Transportation & Support (SFC 72)2,000$ 2002.3 Education Support (SFC 72)300$ 2002.4 Employment Support (SFC 72)200$ 2002.5 Respite Care (SFC 72)-$ 2002.6 Household Items -$ 2002.7 Utility Vouchers (SFC 72)-$ 2002.8 Child Care (SFC 72)-$ 5,000$ TOTAL PROGRAM EXPENSES 1,071,808$ Units of Service Rate $ Amount 3000 53,353 $2.84 151,523$ 3100 Case Management 28,267 $2.21 62,470$ 3200 Crisis Services 135 $4.23 571$ 3300 Medication Support - $4.82 -$ 3400 Collateral 117,430 $2.84 333,501$ 3500 Plan Development 1,063 $2.84 3,019$ 3600 Assessment 20,532 $2.84 58,311$ 3700 Rehabilitation 28,439 $2.84 80,767$ 249,219 690,162$ Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 690,162$ Federal M/Cal Share of Cost % (Federal Financial Participation-FFP) 50.00%345,081$ State M/Cal Share of Cost % (BH Realignment/EPSDT) 50.00%345,081$ MEDI-CAL REVENUE TOTAL 690,162$ 4100 Other - (Identify)-$ 4200 Other - (Identify)-$ 4300 Other - (Identify)-$ OTHER REVENUE TOTAL -$ 5000 Prevention & Early Intervention (PEI) Funds -$ 5100 Community Services & Supports (CSS) Funds 381,646$ 5200 Innovation (INN) Funds -$ 5300 Workforce Education & Training (WET) Funds -$ MHSA FUNDS TOTAL 381,646$ 1,071,808$ TOTAL PROGRAM REVENUE NON MEDI-CAL CLIENT SUPPORT EXPENSES: NON MEDI-CAL CLIENT SUPPORT TOTAL MEDI-CAL REVENUE: Mental Health Services (Individual/Family/Group Therapy) Estimated Specialty Mental Health Services Billing Totals OTHER REVENUE: MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.75 -$ 93,399$ 93,399$ 1102 Clinical Director 0.10 - 14,182 14,182 1103 Clinical Oversight/Peer Review 0.55 - 55,533 55,533 1104 PCIT Clinicians/Lead Therapists 6.00 - 493,824 493,824 1105 Case Managers 4.00 - 190,636 190,636 1106 Finance Dir/HR Mgr/Finance & Clerical 1.25 50,601 58,131 108,732 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 12.65 50,601$ 905,705$ 956,306$ Employee Benefits Acct #Admin Direct Total 1201 2,533$ 45,295$ 47,828$ 1202 515 9,616 10,131 1203 4,789 91,069 95,858 1204 - - - 1205 - - - 1206 - - - 7,837$ 145,980$ 153,817$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 3,872 69,286 73,158 1303 241 5,806 6,047 1304 - - - 1305 - - 1306 - - 4,113$ 75,092$ 79,205$ 62,551$ 1,126,777$ 1,189,328$ 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'S FULL SERVICE PARTNERSHIP PROGRAM COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. Fiscal Year (FY) 2020-2021 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 2,000 2004 2,500 2005 300 2006 200 2007 - 2008 250 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 5,250$ 3000: OPERATING EXPENSES Acct #Amount 3001 11,717$ 3002 300 3003 10,718 3004 - 3005 4,062 3006 4,215 3007 - 3008 - 3009 4,500 3010 1,840 3011 1,200 3012 - 38,552$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 5,033$ 4002 58,250 4003 11,289 4004 7,200 4005 - 4006 9,328 4007 - 4008 - 4009 - 4010 - 91,100$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Security Utilities Other (Specify) 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 Other (Specify): Transportation of Clients Other (Specify): Staff Travel (Out of County) Other (Specify): Lodging Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage/Vehicle Maintenance 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 Other (Specify) Other (Specify) Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Child Care Revised Exhibit C Acct #Amount 5001 -$ 5002 - 5003 2,383 5004 2,000 5005 - 5006 - 5007 - 5008 - 4,383$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 4,222$ 6002 6,184 6003 - 6004 3,323 6005 - 6006 2,282 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 16,011$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 1,344,624$ 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 $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Payroll Services SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify): Human Resources, HIPAA, Program Oversight Translation Services Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 55,936 3.78 211,438$ 8002 Case Management 29,635 2.94 87,127 8003 Crisis Services 140 5.55 777 8004 Medication Support 0 6.89 - 8005 Collateral 123,111 3.78 465,360 8006 Plan Development 1,114 3.78 4,211 8007 Assessment 21,525 3.78 81,365 8008 Rehabilitation 29,815 3.78 112,701 261,276 962,978$ 100% 962,978 100%962,978 962,978$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment 0$ 0$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 381,646$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 381,646$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:1,344,624$ 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 Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.75 -$ 99,088$ 99,088$ 1102 Clinical Director 0.10 - 14,915 14,915 1103 Clinical Oversight/Peer Review 0.55 - 59,411 59,411 1104 PCIT Clinicians/Lead Therapists 6.00 - 534,120 534,120 1105 Case Managers 4.00 - 170,028 170,028 1106 Finance Dir/HR Mgr/Finance & Clerical 1.25 47,860 55,005 102,865 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 12.65 47,860$ 932,567$ 980,427$ Employee Benefits Acct #Admin Direct Total 1201 2,395$ 46,636$ 49,031$ 1202 486 9,839 10,325 1203 5,007 95,207 100,214 1204 - - - 1205 - - - 1206 - - - 7,888$ 151,682$ 159,570$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 3,662 71,341 75,003 1303 296 7,127 7,423 1304 - - - 1305 - - - 1306 - - - 3,958$ 78,468$ 82,426$ 59,706$ 1,162,717$ 1,222,423$ 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'S FULL SERVICE PARTNERSHIP PROGRAM COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. Fiscal Year (FY) 2021-2022 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 2,000 2004 2,500 2005 300 2006 200 2007 - 2008 250 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 5,250$ 3000: OPERATING EXPENSES Acct #Amount 3001 11,871$ 3002 300 3003 10,922 3004 - 3005 4,075 3006 4,217 3007 - 3008 - 3009 4,500 3010 1,840 3011 1,200 3012 - 38,925$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 5,140$ 4002 59,862 4003 11,482 4004 7,200 4005 - 4006 9,607 4007 4,000 4008 - 4009 - 4010 - 97,291$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Security Utilities Other (Specify): 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 Other (Specify): Transportation of Clients Other (Specify): Staff Travel (Out of County) Other (Specify): Lodging Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage/Vehicle Maintenance 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 Other (Specify) Other (Specify) Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Child Care Revised Exhibit C Acct #Amount 5001 -$ 5002 - 5003 2,410 5004 2,000 5005 - 5006 - 5007 - 5008 - 4,410$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 4,285$ 6002 6,292 6003 - 6004 3,423 6005 - 6006 2,350 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 16,350$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 1,384,649$ 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 $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Payroll Services SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify): Human Resources, HIPAA, Program Oversight Translation Services Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 58,259 3.78 220,219$ 8002 Case Management 30,869 2.94 90,755 8003 Crisis Services 146 5.55 810 8004 Medication Support 0 6.89 - 8005 Collateral 128,228 3.78 484,702 8006 Plan Development 1,160 3.78 4,385 8007 Assessment 22,420 3.78 84,748 8008 Rehabilitation 31,054 3.78 117,384 272,136 1,003,003$ 100% 1,003,003 100%1,003,003 1,003,003$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment 0$ 0$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 381,646$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 381,646$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:1,384,649$ 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 Revised Exhibit C Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Manager 0.75 -$ 103,089$ 103,089$ 1102 Clinical Director 0.10 - 15,044 15,044 1103 Clinical Oversight/Peer Review 0.55 - 66,261 66,261 1104 PCIT Clinicians/Lead Therapists 6.00 - 553,698 553,698 1105 Case Managers 4.00 - 168,529 168,529 1106 Finance Dir/HR Mgr/Finance & Clerical 1.25 48,808 56,108 104,916 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 12.65 48,808$ 962,729$ 1,011,537$ Employee Benefits Acct #Admin Direct Total 1201 2,443$ 48,148$ 50,591$ 1202 495 10,139 10,634 1203 5,182 98,518 103,700 1204 - - - 1205 - - - 1206 - - - 8,120$ 156,805$ 164,925$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 3,734 73,651 77,385 1303 251 6,072 6,323 1304 - - - 1305 - - 1306 - - 3,985$ 79,723$ 83,708$ 60,913$ 1,199,257$ 1,260,170$ 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'S FULL SERVICE PARTNERSHIP PROGRAM COMPREHENSIVE YOUTH SERVICES OF FRESNO, INC. Fiscal Year (FY) 2022-2023 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Description OASDI Revised Exhibit C 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 2,000 2004 2,500 2005 300 2006 200 2007 - 2008 250 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 5,250$ 3000: OPERATING EXPENSES Acct #Amount 3001 12,031$ 3002 300 3003 10,902 3004 - 3005 4,088 3006 4,220 3007 - 3008 - 3009 4,500 3010 1,840 3011 1,200 3012 - 39,081$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 5,997$ 4002 61,523 4003 11,680 4004 7,200 4005 - 4006 9,895 4007 - 4008 - 4009 - 4010 - 96,295$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Security Utilities Other (Specify) 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 Other (Specify): Transportation of Clients Other (Specify): Staff Travel (Out of County) Other (Specify): Lodging Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage/Vehicle Maintenance 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 Other (Specify) Other (Specify) Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Child Care Revised Exhibit C Acct #Amount 5001 -$ 5002 - 5003 2,437 5004 2,000 5005 - 5006 - 5007 - 5008 - 4,437$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 4,352$ 6002 6,402 6003 - 6004 3,525 6005 - 6006 2,421 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 16,700$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 1,421,933$ Assets over $5,000/unit (Specify) Other (Specify): Leased Automobile 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 $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Other (Specify) Other (Specify) Other (Specify) Other (Specify) Other (Specify) Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Payroll Services SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify): Human Resources, HIPAA, Program Oversight Translation Services Revised Exhibit C Acct #Service Units Rate Amount 8001 Mental Health Services 60,421 3.78 228,391$ 8002 Case Management 32,019 2.94 94,136 8003 Crisis Services 153 5.55 849 8004 Medication Support 0 6.89 - 8005 Collateral 132,995 3.78 502,721 8006 Plan Development 1,203 3.78 4,547 8007 Assessment 23,253 3.78 87,896 8008 Rehabilitation 32,208 3.78 121,746 282,252 1,040,287$ 100% 1,040,287 100%1,040,287 1,040,287$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment (0)$ (0)$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports 381,646$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 381,646$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:1,421,933$ 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 Revised Exhibit C