HomeMy WebLinkAboutAgreement A-15-594-2 with Exodus Recovery Inc..pdf- 1 -
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AMENDMENT II
THIS SECOND AMENDMENT TO AGREEMENT (hereinafter “Amendment II”) 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 EXODUS
RECOVERY, INC, a for-profit California corporation, whose address is 9800 Venice Blvd, Suite 700,
Culver City, CA 90232 (hereinafter “CONTRACTOR”).
WITNESSETH:
WHEREAS, COUNTY and CONTRACTOR entered into COUNTY Agreement number 15-594,
dated November 17, 2015, as amended by COUNTY Amendment No. 15-594-1, dated June 18, 2019
(hereinafter collectively referred to as “COUNTY Agreement No. A-15-594”), whereby CONTRACTOR
agreed to operate an adult sixteen (16) bed acute inpatient psychiatric health facility (PHF) to provide
psychiatric services to adult clients (ages eighteen and older) who may be admitted on a voluntary
basis or involuntary basis and may include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal
beneficiaries, indigent/uninsured clients, and jail inmates (who are referred by the current
subcontractor of Behavioral Health services within the Jail), DBH contracted providers, hospital
emergency rooms, other COUNTY departments, and other agencies. In addition, conservatees of the
COUNTY that are placed in other residential settings and attending court in Fresno County will be
temporarily placed at the PHF operated by CONTRACTOR until each such conservatee’s court
proceeding is completed; 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.That all references in the COUNTY Agreement No. A-15-594 to “Exhibit A” be changed
to read “Revised Exhibit A”, attached hereto and incorporated herein by this reference.
2.That all references in the COUNTY Agreement No. A-15-594 to “Revised Exhibit B” be
changed to read “Revised Exhibit B-1”, attached hereto and incorporated herein by this reference.
3. That COUNTY Agreement No. 15-594, Section Two (2) “TERM”, shall be revised by
Agreement No. 15-594-2
22nd June
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adding the following at Page Three (3), Paragraph Four (4), Line Twenty-Two (22), after the word
“term”:
"The term of this Agreement shall be extended for a period of one (1) year beginning
July 1, 2021 through June 30, 2022."
4. That COUNTY Agreement No. 15-594, as set forth in Amendment I (COUNTY
Amendment No. 15-594-1) , Page Three (3), beginning with Line Twenty-Five (25), with the word “The”
and ending on Page Four (4) Line Three (3) with the word “Agreement” be deleted and the following
inserted in its place:
“The maximum amount for the fifth period of renewal (July 1, 2020 through June 30,
2021) shall not exceed Four Million, Nine Hundred Two Thousand, Nine Hundred Fifty Four and
No/100 Dollars ($4,902,954.00).
The maximum amount for the sixth period of renewal (July 1, 2021 through June 30,
2022) shall not exceed Four Million, Nine Hundred Twenty-Five Thousand, One Hundred Twenty and
No/100 Dollars ($4,925,120.00).
In no event shall the maximum contract amount for the services provided by
CONTRACTOR to COUNTY under the terms and conditions of this Agreement be in excess of
Twenty-Eight Million, Seventy Five Thousand, Two Hundred Thirty Seven and No/100 Dollars
($28,075,237) during the total six (6) year, nine month (9) term of this Agreement."
5.That COUNTY Agreement No. 15-594, Section Ten (10), “Insurance”, Page Thirteen
(13), Line Nine (9), beginning with the number “10” and ending on Page Fifteen, Line Thirteen (13)
with the word “better” be deleted and the following inserted in its place:
“10. INSURANCE
Without limiting COUNTY’s right to obtain indemnification from CONTRACTOR or any
third parties, CONTRACTOR, at its sole expense, shall maintain in full force and affect the following
insurance policies throughout the term of this Agreement:
A.Commercial General Liability
Commercial General Liability Insurance with limits of not less than Two
Million Dollars ($2,000,000) per occurrence and an annual aggregate of Five
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Million Dollars ($5,000,000). This policy shall be issued on a per occurrence
basis. COUNTY may require specific coverage including completed
operations, product liability, contractual liability, Explosion, Collapse, and
Underground (XCU), fire legal liability or any other liability insurance deemed
necessary because of the nature of the Agreement.
B.Automobile Liability
Comprehensive Automobile Liability Insurance with limits of not less than
One Million Dollars ($1,000,000.00) per accident for bodily injury and for
property damages. Coverage should include any auto used in connection
with this Agreement.
C.Real and Property Insurance
CONTRACTOR shall maintain a policy of insurance for all risk real and
personal property coverage which shall be endorsed naming the County of
Fresno as an additional loss payee. The real and personal property
coverage shall be in an amount that will cover the total of the COUNTY
purchase and owned property, at a minimum, as discussed in Section
Twenty (21) of this Agreement.
All Risk Property Insurance
CONTRACTOR will provide property coverage for the full replacement value
of the COUNTY’S personal property in possession of CONTRACTOR and/or
used in the execution of this Agreement. COUNTY will be identified on an
appropriate certificate of insurance as the certificate holder and will be
named as an Additional Loss Payee on the Property Insurance Policy.
D.Professional Liability
If CONTRACTOR employs licensed professional staff (e.g. Ph.D., R.N.,
L.C.S.W., M.F.T.) in providing services, Professional Liability Insurance with
limits of not less than One Million Dollars ($1,000,000) per occurrence,
Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR
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agrees that it shall maintain, at its sole expense, in full force and effect for a
period of three (3) years following the termination of this Agreement, one or
more policies of professional liability insurance with limits of coverage as
specified herein.
E.Worker’s Compensation
A policy of Worker’s Compensation Insurance as may be required by the
California Labor Code.
F. Molestation
Sexual abuse / molestation liability insurance with limits of not less than One
Million Dollars ($1,000,000.00) per occurrence, Two Million Dollars
($2,000,000.00) annual aggregate. This policy shall be issued on a per
occurrence basis.
G.Cyber Liability
Cyber liability Insurance with limits not less than $2,000,000 per occurrence
or claim, $2,000,000 aggregate. Coverage shall be sufficiently broad to
respond to the duties and obligations as is undertaken by Vendor in this
agreement and shall include, but not be limited to, claims involving
infringement of intellectual property, including but not limited to infringement
of copyright, trademark, trade dress, invasion of privacy violations,
information theft, damage to or destruction of electronic information, release
of private information, alteration of electronic information, extortion and
network security. The policy shall provide coverage for breach response
costs as well as regulatory fines and penalties as well as credit monitoring
expenses with limits sufficient to respond to these obligations.
CONTRACTOR shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
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insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under CONTRACTOR’s policies herein. This
insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written
notice given to COUNTY.
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.
Within thirty (30) days from the date CONTRACTOR signs this Agreement,
CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 3133
N.Millbrook Ave, Fresno, California, 93703, Attention: Contracted Services Division, stating that such
insurance coverages have been obtained and are in full force; that the County of Fresno, its officers,
agents and employees will not be responsible for any premiums on the policies; that such Commercial
General Liability insurance names the County of Fresno, its officers, agents and employees,
individually and collectively, as additional insured, but only insofar as the operations under this
Agreement are concerned; that such coverage for additional insured shall apply as primary insurance
and any other insurance, or self-insurance, maintained by COUNTY, its officers, agents and
employees, shall be excess only and not contributing with insurance provided under CONTRACTOR’s
policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty
(30)days advance, written notice given to COUNTY.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this
Agreement upon the occurrence of such event.
All policies shall be with admitted insurers licensed to do business in the State of
California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of
A FSC VII or better.”
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6. 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 (II) 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
handwritten signature
7. COUNTY and CONTRACTOR agree that this Amendment II is sufficient to amend the
Agreement and, that upon execution of this Amendment II, the Agreement, Amendment I and this
Amendment II together shall be considered the Agreement.
8. 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. This Amendment II shall be effective retroactive to July 1, 2020.
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1 IN WITNESS WHEREOF , the parties hereto have executed this Amendment II as of the day and year
2 first hereinabove written .
3
4 CONTRACTOR
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Luana Murphy, PresidenUCEO
8 Print Name & Title
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(Authorized Signature)
LeeAnn Skorohod, Secretary/COO
Print Name & Title
MAILING ADDRESS:
Exodus Recovery, Inc.
9808 Venice Boulevard, Suite 700
Cu lver City , CA 90232
Contact: Luana Murphy, President/CEO
(310) 945-3350
20 FOR ACCOUNTING USE ONLY:
Fund :0001
21 Subclass : 10000
Org : 56302490
22 Account: 7295
Fiscal Year
FY 2015-16
FY 2016-17
FY 2017-18
FY 2018-19
FY 2019-20
FY 2020-21
FY 2021-22
$2,048,296
$3,698,759
$3,810,886
$4,291 ,345
$4,397,877
$4 ,902,954
$4,925,120
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Total : $28 ,075,237
Steve Branda , 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: -~cl,A\,..,,,:\Qi.,.. ,L_l ..i...C ..... ,~4&~----
De ~
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REVISED EXHIBIT A
Page 1 of 11
ACUTE INPATIENT PSYCHIATRIC HEALTH FACILITY (PHF)
SCOPE OF WORK
ORGANIZATION: Exodus Recovery, Inc.
ADDRESS: 9808 Venice Blvd Suite 700 Culver City, CA 90232
SITE ADDRESS: 4411 E Kings Canyon Rd Fresno, CA 93702, Bldg 319
SERVICES: Acute Inpatient Psychiatric Services
CONTACT: Luana Murphy, President/CEO
PHONE NUMBER: (310) 945-3350
CONTRACT PERIOD: October 1, 2015 – June 30, 2016, (start up and implementation
period) followed by a three (3) year base contract and an option for two (2) twelve (12)
month renewals and an additional one year renewal
CONTRACT AMOUNT: $2,048,296 October 1, 2015 through June 30, 2016
$3,698,759 FY 2016-17
$3,810,886 FY 2017-18
$4,291,345 FY 2018-19
$4,397,877 FY 2019-20
$4,902,954 FY 2020-21
$4,925,120 FY 2021-22
I. SCHEDULE OF SERVICES:
CONTRACTOR shall operate the Psychiatric Health Facility (PHF) twenty-four
(24) hours per day, seven (7) days per week.
II. TARGET POPULATION:
The target population will include male and female clients, who are eighteen (18)
years and older, who may be admitted on a voluntary or involuntary basis. These clients
will include Medi-Cal beneficiaries; Medicare and Medicare/Medi-Cal beneficiaries;
indigent/uninsured clients’ and jail inmates who are referred by the Department of
Behavioral Health (DBH), a contract provider with the DBH, hospital emergency
departments, other COUNTY departments and other agencies to the PHF. Jail inmates
brought to the PHF will continue to be transported and supervised by the Sheriff’s
correctional staff.
In addition, Conservatees of the COUNTY that are placed in other residential settings
and attending court in Fresno County will be temporarily placed at the PHF operated by
REVISED EXHIBIT A
Page 2 of 11
CONTRACTOR until each such Conservatee’s court proceeding is completed.
CONTRACTOR shall work with the DBH Client Placement Team to execute placement
of COUNTY Conservatees that are being discharged from the PHF operated by the
CONTRACTOR.
Medical clearance in keeping with community standards of care will be required for
referred clients where there are indicators of an acute medical condition as determined
by a medical screening. However, in the event a referred client is known to possess a
contagious medical condition, said client shall be medically cleared by a local hospital
prior to admission to the PHF operated by CONTRACTOR.
CONTRACTOR shall accept direct admissions to the PHF from COUNTY DBH
programs or its contracted providers when PHF beds are available. Said direct admits
shall have medical clearance in keeping with community standards.
III. CONTRACTOR’S RESPONSIBILITIES:
CONTRACTOR shall provide the following:
1. Management of clients’ acute psychiatric disorders and prepare clients to
successfully use a less restrictive level of care.
2. A clinical program which has appropriate professional staffing on a twenty-four (24)
hours/seven (7) days a week (24/7) basis.
3. In general, client admissions are executed any time during operating hours (24/7)
when there are PHF beds available. Discharges are generally executed before
9:00pm each day of the week.
4. Provide a safe, secure environment for clients that encourage wellness and
recovery.
5. Provides for a comprehensive multi-disciplinary evaluation and treatment plan.
6. Provides dietary services.
7. Admission procedures for clients, who may be admitted on a voluntary or involuntary
basis. Individuals who are on involuntary holds in accordance with Welfare and
Institutions Code 5150 may be referred from hospital emergency departments or by
local law enforcement agencies or by licensed medical/mental health professionals
certified by the County as 5150 Initial Evaluators.
REVISED EXHIBIT A
Page 3 of 11
8. Treatment Planning - CONTRACTOR shall provide the following services:
a. Mental Status Examination
b. Medical Evaluation
c. Psycho-Social Assessment
d. Nursing Assessment
e. Multi-Disciplinary Milieu Treatment Program
f. Individualized Focused Treatment Planning
g. Aftercare planning including care coordination with current and/or identified
post discharge providers including sharing of records.
h. Appropriate prescriptions to clients at discharge as well as make any other
necessary arrangements to ensure the client’s well-being.
9. Provide an intensive treatment program which has individualized treatment plans.
10. Stabilize clients as soon as possible in order to assist them in their recovery from
mental illness.
11. Effectively partner with other programs in accepting COUNTY clients for admission
for acute inpatient psychiatric services and also to work collaboratively in discharge
planning to insure appropriate ongoing outpatient specialty mental health treatment
services are provided.
12. Identify COUNTY clients with frequent admissions during the fiscal year and develop
strategies with other COUNTY and community agencies to reduce readmissions.
13. Effectively interact with community agencies, other mental health programs and
providers, natural support systems and families to assist clients to be discharged to
the most appropriate level of care.
14. Work effectively with the legal system to provide temporary conservatorship if
necessary and appropriate for clients who require additional inpatient care.
15. Ancillary Services – CONTRACTOR shall provide the following:
a. Provide services to clients who are designated to be incompetent to stand
trial in order to allow clients to stand trial.
b. CONTRACTOR’s psychiatrist staff shall provide court testimony, written
reports, and documentation relevant to the PHF clients when required.
REVISED EXHIBIT A
Page 4 of 11
16. Comply with the requirements of the Fresno County Mental Health Plan (FCMHP)
and must complete and submit a Treatment Authorization Request (TAR) and the
supporting documentation for all Medi-Cal, Medi-cal/Medicare, and UMDAP
admissions to the FCMHP. The FCMHP will perform a utilization review of all
admissions to determine that the documentation demonstrates that medical
necessity criteria as defined by the California Department of Health Care Services
(DHCS) was met for each day of the hospitalization, except for the day of discharge.
17. Enter all client service information, admission data and billing information into the
COUNTY’s electronic information system and will be responsible for any and all
audit exceptions pertaining to the delivery of services. The CONTRACTOR will also
be responsible for the mandated reporting of patient information and
admission/discharge data and other required reports to the Office of State Health
Planning and Development (OSHPD), DHCS, and meet the submission deadlines
each calendar year.
18. Staffing
CONTRACTOR shall provide the appropriate type and level of staffing to provide for
a clinically effective program design.
a. The staffing pattern for the PHF shall meet all State licensing and regulatory
requirements including medical staff standards, nursing staff standards, social
work and rehabilitation staff requirements pursuant to Title 22, Division 5,
Chapter 9, Article 3, Section 77061 of the California Code of Regulations for
PHF’s. There shall be an appropriate level of supervisory staff as required by
regulation or statute. All staff, which requires State licensure or certification,
will be required to be licensed or certified in the State of California and be in
good standing with the State licensing or certification board.
b. All facility staff, who provide direct client care or perform coding/billing
functions, must meet the requirements of the FCMHP Compliance Program.
This includes the screening for excluded persons and entities by accessing or
querying the applicable licensing board(s), the National Practitioner Data
Bank (NPDB), Office of Inspector General's List of Excluded Individuals/
Entities (LEIE), Excluded Parties List System (EPLS) and Medi-Cal
Suspended and Ineligible List prior to hire and monthly thereafter. In addition,
all licensed/registered/waivered staff must complete a FCMHP Provider
Application and be credentialed by the FCMHP’s Credentialing Committee. All
licensed staff shall have Department of Justice (DOJ), Federal Bureau of
Investigation (FBI), and Sheriff fingerprinting (Lives can) executed.
REVISED EXHIBIT A
Page 5 of 11
c. Peer and/or family support staff will be utilized on the treatment team to
provide Peer/Family specific services to enhance the services provided by
professional staff.
d. Organized Clinical Staff - The organized clinical staff of CONTRACTOR shall
be composed of all licensed mental health professionals as included in Title
22, Division 5, Chapter 9, Article 4, Section 77083 (Organized Clinical Staff)
of the California Code of Regulations.
e. Organized Medical Staff - CONTRACTOR shall meet the requirement for an
organized medical staff pursuant to Title 22, Division 5, Chapter 9, Article 3,
Section 77061 (Staffing) of the California Code of Regulations.
19. Medical Records and Mandated Reporting to the Office of State Health Planning and
Development
a. The CONTRACTOR shall develop and implement a medical record system
which meets all State and Federal requirement and clearly documents
medical necessity for both treatment and billing services. Medical records
shall be kept in such a manner as to comply with the Fresno County Quality
Improvement standards and Federal and State quality standards. Fresno
County has an electronic medical record system and the expectation is that
the CONTRACTOR will participate in this record keeping system.
b. CONTRACTOR will be responsible for accommodating appropriate and legal
“release of information” requests for the facility and shall adhere to applicable
Federal and State regulations in providing protected health information per
such requests.
c. CONTRACTOR will be required to provide mandated reporting of client
information and admission/discharge data to the OSHPD and meet the
submission deadlines on June 30 and December 31 each calendar year.
20. Pharmaceutical Services- CONTRACTOR must provide for the level of
pharmaceutical services as a PHF pursuant to Title 22, Section 5, Chapter 9, Article
3, 77079.13 of the California Code of Regulations. If CONTRACTOR intends to
utilize any type of automated dispensing system, the cost of that system and
pharmacy consultants shall be included as part of the CONTRACTOR’s budget.
21. Physical Health Care - CONTRACTOR shall provide admission history and physical
examination, will order and receive ancillary health exams which are considered
community standards of care, provide dietary services and maintain a written
agreement for medical services with one or more general acute care hospitals.
REVISED EXHIBIT A
Page 6 of 11
22. Schedule of Active Therapies - CONTRACTOR shall provide active therapies that
will be provided as part of the clinical treatment program. The schedule shall include
group therapies, skill development and client education activities, wellness and
recovery focused treatment, family therapy, scheduled community meetings,
recreational and exercise programs. The treatment team is expected to schedule
client’s participation activities tailored to each client’s individual needs.
23. CONTRACTOR shall provide a safe and secure environment to provide for clinical
and medical assessment, diagnostic formulation, crisis intervention, medication
management and clinical treatment for mental health clients with an acute
psychiatric disorder. CONTRACTOR shall utilize cost containment strategies for the
provision of stock and prescription medications to clients (i.e., use of prescription
assistance program, contracting with a pharmaceutical benefits management
company, etc.).
24. CONTRACTOR shall use the Department’s current medication formulary for
consistency purposes in the event that clients are discharged from the PHF and
potentially linked to other outpatient programs within the Department. In addition, the
CONTRACTOR shall execute a contract with a pharmaceutical benefit management
(PBM) company or pharmacy. The CONTRACTOR will not use, or be a part of, the
Department’s current agreement for PBM services. The injectables currently utilized
are Haldol and Prolixin.
25. CONTRACTOR shall integrate mental health and substance use disorder services
through comprehensive continuous integrated systems of care for the life span of
those served and to work as partners with a shared vision: to create a coordinated
and comprehensive system of service delivery. CONTRACTOR shall develop a
formal written Continuous Quality Improvement (CQI) action plan to identify
measurable objectives toward the achievement of Co-Occurring Disorders (COD)
capability that will be addressed by the program during the contract period. These
objectives should be achievable and realistic for the program, based on the self-
assessment and the program priorities, but need to include attention to making
progress on the following issues, at minimum:
a. Welcoming policies, practices, and procedures related to the engagement of
individuals with co-occurring issues and disorders;
b. Removal or reduction of access barriers to admission based on co-occurring
diagnosis or medication;
c. Improvement in routine integrated screening, and identification in the
County’s electronic information system of how many clients served have co-
occurring issues;
REVISED EXHIBIT A
Page 7 of 11
d. Developing the goal of basic co-occurring competency for all treatment staff,
regardless of licensure or certification; and
e. Documentation of coordination of care with collaborative mental health and/or
substance use disorder providers for each client.
IV. CULTURAL AND LINGUISTIC COMPETENCE REQUIREMENTS:
CONTRACTOR shall:
1. Ensure compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section
2000d, and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which prohibits
recipients of Federal financial assistance from discriminating against persons based
on race, color, national origin, sex, disability or religion. This is interpreted to mean
that a limited English proficient (LEP) individual is entitled to equal access and
participation in federally funded programs through the provision of comprehensive
and quality bilingual services.
2. Create and maintain policies and procedures for ensuring access and appropriate
use of trained interpreters and material translation services for all LEP consumers,
including, but not limited to, assessing the cultural and linguistic needs of its clients,
training of staff on the policies and procedures, and monitoring its language
assistance program. The CONTRACTOR's procedures must include ensuring
compliance of any sub-contracted providers with these requirements.
3. Ensure that minors shall not be used as interpreters.
4. Conduct and submit to COUNTY an annual cultural and linguistic needs assessment
to promote the provision and utilization of appropriate services for its diverse client
population. The needs assessment report shall include findings and a plan outlining
the proposed services to be improved or implemented as a result of the assessment
findings, with special attention to addressing cultural and linguistic barriers and
reducing racial, ethnic, language, abilities, gender, and age disparities.
5. Develop internal systems to meet the cultural and linguistic needs of the
CONTRACTOR's client census including the incorporation of cultural competency in
the CONTRACTOR's mission; establishing and maintaining a process to evaluate
and determine the need for special - administrative, clinical, welcoming, billing, etc. -
initiatives related to cultural competency.
6. Develop recruitment and retention initiatives to establish contracted program staffing
that is reflective and responsive to the needs of the program and target population.
REVISED EXHIBIT A
Page 8 of 11
7. Establish designated staff person to coordinate and facilitate the integration of
cultural competency guidelines and attend the COUNTY DBH Cultural Competency
Committee monthly meetings. The designated person will provide an array of
communication tools to distribute information to staff relating to cultural competency
issues.
8. Keep abreast of evidence-based and best practices in cultural competency in mental
health care and treatment to ensure that the CONTRACTOR maintains current
information and an external perspective in its policies. The CONTRACTOR shall
evaluate the effectiveness of strategies and programs in improving the health status
of cultural-defined populations.
9. Ensure that an assessment of a client’s sexual orientation is included in the bio-
psychosocial intake process. CONTRACTOR's staff shall assume that the
population served may not be in heterosexual relationships. Gender sensitivity and
sexual orientation must be covered in annual training.
10. Utilize existing community supports, referrals to transgender support groups, etc.,
when appropriate.
11. Report its efforts to evaluate cultural and linguistic activities as part of the
CONTRACTOR's ongoing quality improvement efforts in the monthly activities
report. Reported information may include clients’ complaints and grievances, results
from client satisfaction surveys, and utilization and other clinical data that may reveal
health disparities as a result of cultural and linguistic barriers.
V. TRAINING REQUIREMENTS:
CONTRACTOR shall:
1. Attend annual Cultural Competence training.
2. Attend annual Compliance, Billing and Documentation training.
3. Attend County’s 5150 certification training.
4. Attend other required trainings provided by the COUNTY.
VI. PROGRAM OUTCOMES:
The COUNTY DBH is dedicated to supporting the wellness of individuals, families
and communities in Fresno County who are affected by, or at risk of, mental illness
and/or substance use disorders through cultivation of strengths toward promoting
REVISED EXHIBIT A
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recovery in the least restrictive environment (note - the 1st five (5) items listed below will
be utilized to support this DBH Mission). The following items listed below represent
program goals to be achieved by CONTRACTOR in addition to CONTRACTOR-
developed outcomes. The program’s success will be based on the number of goals it
can achieve, resulting from performance outcomes. The CONTRACTOR will utilize
computerize tracking system with which outcome measure and other relevant client
data, such as demographics, will be maintained.
1. Behavioral Health Integrated Access – The time between client arrival and
admission to the PHF, until assessment.
2. Wellness, Recovery and Resiliency Supports – program, services or philosophical
approaches which support the concept of wellness, recovery and resiliency in our
clients. Client levels of care, peer support, family advocacy, education and
employment, housing
3. Cultural/Community Defined Practices – programs, services or philosophical
practices which support the unique cultural specific needs of individuals receiving
care. Suggested penetration rate for particular groups can possibly be used to
measure.
4. Behavioral Health Clinical Care – programs, services where direct therapeutic
treatment is provided. Included in the frame work of ‘Levels’ of care where a client’s
needs, as identified through assessment/screening, are matched with a complexity
and intensity of services to meet those needs. Recovery 360 – Levels of Care and
fidelity of the program are examples.
5. Infrastructure Supports –includes all personnel, equipment, program and facilities
which exist to support the delivery of care to the clients we serve. Includes safety,
quality and regulatory compliance functions, along with outcome assessments/
program evaluation, training and technology (i.e., cost effectiveness of services,
Staff Training and development, Quality Improvement, Program evaluation,
regularity compliance efforts, personnel recruitment).
6. Effectiveness of discharge planning as demonstrated by the referral and linkage to
the COUNTY DBH programs, community providers and other community resources.
7. Collaborative approach and treatment strategies to reduce readmission of clients
with frequent readmissions to the facility.
8. Denial rate for PHF days that do not meet Medi-Cal medical necessity criteria as
determined by the utilization review performed by the FCMHP.
9. Initial Screening- Percent of patients discharged that were screened by the third day
post admission for all of the following: risk of violence to self, risk of violence to
others, substance use, psychological trauma history, and patient strengths.
10. Hours of Physical Restraint Use - Total hours all patients spent in physical restraint
as a proportion of total inpatient hours. Restraint is defined as mechanical and
manual devises that restrict freedom of movement of the body.
REVISED EXHIBIT A
Page 10 of 11
11. Hours of Seclusion Use - Total hours all patients spent in seclusion as a proportion
of total inpatient hours. Seclusion is defined as restricted alone to a room or area
where the patient is not allowed to leave without the permission of staff.
12. Discharge on Multiple Antipsychotic Medications - Percent of patients discharged on
two or more antipsychotic medications as a proportion of patients discharged on one
or more antipsychotic medications. Antipsychotic medications include regularly
scheduled oral doses and long-acting injectable forms, regardless of diagnosis.
13. Discharge on Multiple Antipsychotic Medications with Appropriate Justification.
Percent of patients discharged on multiple antipsychotic medications with
appropriate justification as a proportion of patients discharged on two or more
antipsychotic medications. Appropriate justifications are limited to augmentation of
clozapine, tapering to monotherapy, and history of at least three failed trials of
monotherapy.
14. Continuing Care Plan Created - Percent of patients discharged with a continuing
care plan created that includes all of the following: reason for hospitalization,
discharge diagnosis, discharge medications, and next level of care
recommendations. Minimum information for all discharge medications includes
medication name, dose, and indications for use.
15. Continuing Care Plan Transmitted. Percent of patients discharged with a complete
continuing care plan (defined in #14) that is transmitted to next level of care provider
by the fifth day post discharge.
16. CONTRACTOR shall also propose their own outcomes measures that are deemed
to best evaluate the success of the clients and program.
17. COUNTY DBH may adjust the outcome measurements needed under this program
periodically, so as to best measure the success of clients and program as
determined by COUNTY.
VII. COUNTY RESPONSIBILITIES:
COUNTY shall:
1. Perform a utilization review (through its FCMHP) of all Medi-Cal, Medi-Cal/Medicare,
and UMDAP admissions, to determine that the documentation demonstrates that
medical necessity criteria as defined by the DHCS was met for each day of the
hospitalization, except for the day of discharge.
2. Provide oversight (through the COUNTY DBH) of the CONTRACTOR'S PHF
program. In addition to contract monitoring of program(s), oversight includes, but not
limited to, coordination with the DHCS in regard to program administration and
outcomes.
REVISED EXHIBIT A
Page 11 of 11
3. Assist the CONTRACTOR in making linkages with the total behavioral health
system. This will be accomplished through regularly scheduled meetings as well as
formal and informal consultation
4. Participate in evaluating the progress of the overall program and the efficiency of
collaboration with the vendor staff and will be available to the contractor for ongoing
consultation.
5. Receive and analyze statistical data outcome information from CONTRACTOR
throughout the term of contract on a monthly basis. DBH will notify the vendor when
additional participation is required. The performance outcome measurement process
will not be limited to survey instruments but will also include, as appropriate, client
and staff interviews, chart reviews, and other methods of obtaining required
information.
6. Recognize that cultural competence is a goal toward which professionals, agencies,
and systems should strive. Becoming culturally competent is a developmental
process and incorporates at all levels the importance of culture, the assessment of
cross-cultural relations, vigilance towards the dynamics that result from cultural
differences, the expansion of cultural knowledge, and the adaptation of services to
meet culturally-unique needs. Offering those services in a manner that fails to
achieve its intended result due to cultural and linguistic barriers is not cost effective.
To assist the CONTRACTOR'S efforts towards cultural and linguistic competency,
DBH shall provide the following at no cost to vendor(s):
a. Technical assistance to CONTRACTOR regarding cultural competency
requirements and sexual orientation training.
b. Technical assistance for CONTRACTOR in translating behavioral health and
substance use disorder services information into DBH's threshold languages
(English, Spanish, and Hmong). Translation services and costs associated
will be the responsibility of the CONTRACTOR.
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Program Director/Quality Improvement 1.00 106,508$ -$ 106,508$
1102 Program Support Assistant 1.00 51,002 - 51,002
1103 Program Nurse (LVN, LPT)9.00 - 524,160 524,160
1104 Program Nurse (RN)4.05 - 401,488 401,488
1105 LMFT 1.00 - 81,120 81,120
1106 Mental Health Worker 21.55 - 859,276 859,276
1107 Recreational Therapist 1.00 - 70,221 70,221
1108 Senior Data Specialist 0.51 20,357 - 20,357
1109 Social Services Coordinator 1.15 70,540 - 70,540
1110 Administrator 0.10 16,034 - 16,034
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 40.36 264,440$ 1,936,265$ 2,200,705$
Employee Benefits
Acct #Admin Direct Total
1201 98,789$ -$ 98,789$
1202 141,740 - 141,740
1203 188,987 - 188,987
1204 - - -
1205 - - -
1206 - - -
429,516$ -$ 429,516$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 17,319$ -$ 17,319$
1302 157,791 - 157,791
1303 17,319 - 17,319
1304 - - -
1305 - - -
1306 - - -
192,428$ -$ 192,428$
886,384$ 1,936,265$ 2,822,649$
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)
Adult Inpatient Psychiatric Health Facility (PHF)
Exodus Recovery, Inc.
Fiscal Year (FY 2020-21)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 1 of 14
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 22,546
2009 18,414
2010 -
2011 20,935
2012 295,167
2013
2014 -
2015 -
2016 -
357,062$
3000: OPERATING EXPENSES
Acct #Amount
3001 25,464$
3002 500
3003 68,396
3004 -
3005 6,797
3006 200
3007 -
3008 -
3009 3,623
3010 -
3011 -
3012 -
104,979$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 10,000$
4002 -
4003 256
4004 -
4005 153,197
4006 60,000
4007 75,506
4008 199
4009 -
4010 -
299,158$
5000: SPECIAL EXPENSES
FACILITIES/EQUIPMENT TOTAL:
Other - Janitorial
Other - Business Taxes/License/Permits
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Security
Utilities
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Staff Orientation/Recruitment
Other - Staff Orientation/Recruitment
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing and Postage
Office, Household, and Program Supplies
Advertising
Staff Development and Training
Staff Mileage/Vehicle Mainteanance
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 - Program Supplies - Therapeutic
Other - Food Service
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 2 of 14
Acct #Amount
5001 16,715$
5002 -
5003 583,183
5004 3,389
5005 29,757
5006 14,198
5007 1,768
5008 -
649,010$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 639,607$
6002 10,000
6003 -
6004 -
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
649,607$
7000: FIXED ASSETS
Acct #Amount
7001 17,982$
7002 -
7003 2,507
7004 -
7005 -
7006 -
7007 -
7008 -
20,489$ FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 4,902,954$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Insurance (Specify):
Line Item Description
Other - Laundry Service
Other - Medical Waste Disposal
Other - X-Ray and EKG Services
Other (Specify)
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services - Personnel related (Registry, Parking, Relocation, etc.)
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 3 of 14
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
8009 Psychiatric Health Facility Services 6,596 743.34 4,902,954
6,596 4,902,954$
80%
3,941,975
50%1,970,987
1,970,987$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 1,970,987$
1,970,987$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports -$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
-$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance 343,206
8403 -
8404 617,774
8405 -
960,980$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:4,902,954$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Uninsured
Other (Specify)
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
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 4 of 14
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 2,822,649
Employee Salaries 2,200,705
1101 Program Director/Quality Improvement 106,508 Program Director 1.00 FTE, Administrative Services
1102 Program Support Assistant 51,002 Program Support Assistant 1.00 FTE, Administrative Services
1103 Program Nurse (LVN, LPT)524,160 Program Nurse (LVN, LPT) 9.00 FTE, Direct Services
1104 Program Nurse (RN)401,488 Program Nurse (RN) 4.05 FTE Direct Services
1105 LMFT 81,120 LMFT 1.00 FTE Direct Services
1106 Mental Health Worker 859,276 Mental Health Worker 21.5 FTE Direct Services
1107 Recreational Therapist 70,221 Recreational Therapist 1.00 FTE Direct Services
1108 Senior Data Specialist 20,357 Senior Data Specialist 0.51 FTE Admin Services
1109 Social Services Coordinator 70,540 Social Services Coordinator 1.15 FTE Admin Services
1110 Administrator 16,034 Administrator 0.10 FTE Admin Services
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 429,516
1201 Retirement 98,789 Employer contributions to a pool of funds set aside for employees future benefit
1202 Worker's Compensation 141,740 Business Insurance that provides beenfits to employees who suffer work-related
injuries
1203 Health Insurance 188,987 Employer covered health insurance plan
1204 Other (Specify)-
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:192,428
1301 OASDI 17,319 Old-Age, Survivors, and Disability Insurance Program
1302 FICA/MEDICARE 157,791 Federal Payroll Tax
1303 SUI 17,319 State Unemploymet Insurance
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT 357,062
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports 22,546 Medication Cost for clients
2009 Program Supplies - Medical 18,414 Medical Supplies for Clients
2010 Utility Vouchers -
2011 Other - Program Supplies - Therapeutic 20,935 Therapeutic Supplies for Clients
2012 Other - Food Service 295,167 Food services cost for clients
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 104,979
3001 Telecommunications 25,464 Phone and Internet usage
Adult Inpatient Psychiatric Health Facility (PHF)
Exodus Recovery, Inc.
Fiscal Year (FY 2020-21)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 5 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3002 Printing and Postage 500 Program related postage and delivery
3003 Office, Household, and Program Supplies 68,396 Office Supplies (pens, paper, binders, staples, paper clips, desk organizers etc.) and
Office Equipment
3004 Advertising -
3005 Staff Development and Training 6,797 On-going staff training
3006 Staff Mileage/Vehicle Mainteanance 200 Mileage, parking, travel expenses etc.
3007 Subscriptions & Memberships -
3008 Staff Orientation/Recruitment -
3009 Other - Staff Orientation/Recruitment 3,623 On-going staff orientation/recruitment
3010 Other (Specify)-
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 299,158
4001 Building Maintenance 10,000 Maintenance and Repairs
4002 Rent/Lease Building -
4003 Rent/Lease Equipment 256 Leased computers, printers, copiers and faxes
4004 Rent/Lease Vehicles -
4005 Security 153,197 Program Security Personnel
4006 Utilities 60,000 Program Utilities
4007 Other - Janitorial 75,506 Program Cleaning Services
4008 Other - Business Taxes/License/Permits 199 Program business taxes, licenses and permits
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 649,010
5001 Consultant (Network & Data Management)16,715 Network & Data management, Cost for consultant IT firm support, network
monitoring and off-site back-up for IT system
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services - Personnel
related (Registry, Parking, Relocation, etc.)
583,183 Personnel related services including registry as needed, parking, relocation etc.
5004 Translation Services 3,389 Translation Services for the program
5005 Other - Laundry Service 29,757 Linen service for program
5006 Other - Medical Waste Disposal 14,198 Client medical waste disposal
5007 Other - X-Ray and EKG Services 1,768 X-Ray and EKG serivces
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 649,607
6001 Administrative Overhead 639,607 Administrative Overhead fee at 15% of program expenses
6002 Professional Liability Insurance 10,000 Liability, Business and Vehicle Insurance
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify):-
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS 20,489
7001 Computer Equipment & Software 17,982 Computers replacementor repair and software for program
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures 2,507 Furniture & fixtures replacement or repair
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 6 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:4,902,954
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:4,902,954
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 7 of 14
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Program Director/Quality Improvement 1.00 109,703$ -$ 109,703$
1102 Program Support Assistant 1.00 52,532 - 52,532
1103 Program Nurse (LVN, LPT)9.00 - 539,885 539,885
1104 Program Nurse (RN)4.05 - 413,532 413,532
1105 LMFT 1.00 - 83,554 83,554
1106 Mental Health Worker 21.55 - 885,054 885,054
1107 Recreational Therapist 1.00 - 72,327 72,327
1108 Senior Data Specialist 0.51 20,967 - 20,967
1109 Social Services Coordinator 1.15 72,656 - 72,656
1110 Administrator 0.10 16,515 - 16,515
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 40.36 272,373$ 1,994,353$ 2,266,726$
Employee Benefits
Acct #Admin Direct Total
1201 101,752$ -$ 101,752$
1202 145,992 - 145,992
1203 194,657 - 194,657
1204 - - -
1205 - - -
1206 - - -
442,401$ -$ 442,401$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 17,838$ -$ 17,838$
1302 162,525 - 162,525
1303 17,838 - 17,838
1304 - - -
1305 - - -
1306 - - -
198,201$ -$ 198,201$
912,975$ 1,994,353$ 2,907,328$
2000: CLIENT SUPPORT
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)
Adult Inpatient Psychiatric Health Facility (PHF)
Exodus Recovery, Inc.
Fiscal Year (FY 2021-22)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 8 of 14
Acct #Amount
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 23,222
2009 18,966
2010 -
2011 21,563
2012 295,167
2013 -
2014 -
2015 -
2016 -
358,918$
3000: OPERATING EXPENSES
Acct #Amount
3001 26,228$
3002 500
3003 68,488
3004 -
3005 7,001
3006 206
3007 -
3008 -
3009 3,623
3010 -
3011 -
3012 -
106,045$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 10,000$
4002 -
4003 264
4004 -
4005 160,129
4006 60,000
4007 75,506
4008 199
4009 -
4010 -
306,097$
5000: SPECIAL EXPENSES
Acct #Amount
5001 16,715$
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
Security
Utilities
Other - Janitorial
Other - Business Taxes/License/Permits
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Staff Orientation/Recruitment
Other - Staff Orientation/Recruitment
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing and Postage
Office, Household, and Program Supplies
Advertising
Staff Development and Training
Staff Mileage/Vehicle Mainteanance
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 - Program Supplies - Therapeutic
Other - Food Service
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Line Item Description
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 9 of 14
5002 -
5003 521,078
5004 3,491
5005 30,650
5006 14,624
5007 1,768
5008
588,326$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 642,407$
6002 10,000
6003 -
6004 -
6005 -
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
652,407$
7000: FIXED ASSETS
Acct #Amount
7001 3,000$
7002 -
7003 3,000
7004 -
7005 -
7006 -
7007 -
7008 -
6,000$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
8009 Psychiatric Health Facility Services 6,626 743.34 4,925,120
6,626 4,925,120$
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 4,925,120$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other - Laundry Service
Other - Medical Waste Disposal
Other - X-Ray and EKG Services
Other (Specify)
Insurance (Specify):
HMIS (Health Management Information System)
Contractual/Consulting Services - Personnel related (Registry, Parking, Relocation, etc.)
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 10 of 14
80%
3,959,796
50%1,979,898
1,979,898$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 1,979,898$
1,979,898$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports -$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
-$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance 344,758
8403 -
8404 620,566
8405 -
965,324$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:4,925,120$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Uninsured
Other (Specify)
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
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit B-1
Page 11 of 14
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 2,907,328
Employee Salaries 2,266,726
1101 Program Director/Quality Improvement 109,703 Program Director 1.00 FTE, Administrative Services
1102 Program Support Assistant 52,532 Program Support Assistant 1.00 FTE, Administrative Services
1103 Program Nurse (LVN, LPT)539,885 Program Nurse (LVN, LPT) 9.00 FTE, Direct Services
1104 Program Nurse (RN)413,532 Program Nurse (RN) 4.05 FTE Direct Services
1105 LMFT 83,554 LMFT 1.00 FTE Direct Services
1106 Mental Health Worker 885,054 Mental Health Worker 21.5 FTE Direct Services
1107 Recreational Therapist 72,327 Recreational Therapist 1.00 FTE Direct Services
1108 Senior Data Specialist 20,967 Senior Data Specialist 0.51 FTE Admin Services
1109 Social Services Coordinator 72,656 Social Services Coordinator 1.15 FTE Admin Services
1110 Administrator 16,515 Administrator 0.10 FTE Admin Services
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 442,401
1201 Retirement 101,752 Employer contributions to a pool of funds set aside for employees future benefit
1202 Worker's Compensation 145,992 Business Insurance that provides beenfits to employees who suffer work-related
injuries
1203 Health Insurance 194,657 Employer covered health insurance plan
1204 Other (Specify)-
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:198,201
1301 OASDI 17,838 Old-Age, Survivors, and Disability Insurance Program
1302 FICA/MEDICARE 162,525 Federal Payroll Tax
1303 SUI 17,838 State Unemploymet Insurance
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT 358,918
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports 23,222 Medication Cost for clients
2009 Program Supplies - Medical 18,966 Medical Supplies for Clients
2010 Utility Vouchers -
2011 Other - Program Supplies - Therapeutic 21,563 Therapeutic Supplies for Clients
2012 Other - Food Service 295,167 Food services cost for clients
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 106,045
3001 Telecommunications 26,228 Phone and Internet usage
Adult Inpatient Psychiatric Health Facility (PHF)
Exodus Recovery, Inc.
Fiscal Year (FY 2021-22)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 12 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3002 Printing and Postage 500 Program related postage and delivery
3003 Office, Household, and Program Supplies 68,488 Office Supplies (pens, paper, binders, staples, paper clips, desk organizers etc.) and
Office Equipment
3004 Advertising -
3005 Staff Development and Training 7,001 On-going staff training
3006 Staff Mileage/Vehicle Mainteanance 206 Mileage, parking, travel expenses etc.
3007 Subscriptions & Memberships -
3008 Staff Orientation/Recruitment -
3009 Other - Staff Orientation/Recruitment 3,623 On-going staff orientation/recruitment
3010 Other (Specify)-
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 306,097
4001 Building Maintenance 10,000 Maintenance and Repairs
4002 Rent/Lease Building -
4003 Rent/Lease Equipment 264 Leased computers, printers, copiers and faxes
4004 Rent/Lease Vehicles -
4005 Security 160,129 Program Security Personnel
4006 Utilities 60,000 Program Utilities
4007 Other - Janitorial 75,506 Program Cleaning Services
4008 Other - Business Taxes/License/Permits 199 Program business taxes, licenses and permits
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 588,326
5001 Consultant (Network & Data Management)16,715 Network & Data management, Cost for consultant IT firm support, network
monitoring and off-site back-up for IT system
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services - Personnel
related (Registry, Parking, Relocation, etc.)
521,078 Personnel related services including registry as needed, parking, relocation etc.
5004 Translation Services 3,491 Translation Services for the program
5005 Other - Laundry Service 30,650 Linen service for program
5006 Other - Medical Waste Disposal 14,624 Client medical waste disposal
5007 Other - X-Ray and EKG Services 1,768 X-Ray and EKG serivces
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 652,407
6001 Administrative Overhead 642,407 Administrative Overhead fee at 15% of program expenses
6002 Professional Liability Insurance 10,000 Liability, Business and Vehicle Insurance
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify):-
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS 6,000
7001 Computer Equipment & Software 3,000 Computers replacementor repair and software for program
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures 3,000 Furniture & fixtures replacement or repair
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 13 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:4,925,120
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:4,925,120
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit B-1
Page 14 of 14