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Home My WebLink AboutAgreement A-17-006-1 Master Agreement.pdf1 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, hereinafter referred to as Amendment I, is made and entered into this _____ day of ______________, 2021, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as “COUNTY”, and each CONTRACTOR to be listed in Revised Exhibit A “List of Contractors” attached hereto and incorporated herein by reference, and collectively hereinafter referred to as “CONTRACTOR(S)”. Reference in this Agreement to party or “parties” shall be understood to refer to COUNTY and each individual CONTRACTOR(S), unless otherwise specified. WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement No. 17-006, effective January 10, 2017, whereby CONTRACTORS agreed to operate Multi-Agency Access Program (MAP) Points to provide an integrated screening process connecting individuals and families facing mental health, substance use disorder, physical health, housing/homelessness, social service, and other related challenges to supportive service agencies, to COUNTY’s Department of Behavioral Health (DBH); and WHEREAS, the parties 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, the parties agree as follows: 1.That the following be added to existing COUNTY Agreement No. 17-006, Section Two (2) “Term”, on Page Three (3), Line Fourteen (14) after the word “appropriate”. “The term of this Agreement shall be extended for an additional twelve (12) month period beginning on July 1, 2021 and shall terminate on June 30, 2022.” 2.That the existing County Agreement No. 17-006, Section Four (4) “Compensation and Payments”, Subsection A “Maximum Contract Amount”, on Page Four (4), beginning on Line Thirteen (13) with the word “The” and ending on Page Five (5), Line One (1) with the word “combined” be replaced in its entirety as follows: “The maximum compensation amount under this agreement for January 10, 2017 through June 30, 2017 and each Fiscal Year of: July 1, 2017 through June 30, 2018; July 1, 2018 through Agreement No. 17-006-1 22nd June 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 June 30, 2019; July 1, 2019 through June 30, 2020; and July 1, 2020 through June 30, 2021; shall not exceed One Million Five Hundred Thousand and No/100 Dollars ($1,500,000.00) for all CONTRACTORS combined. The maximum compensation amount under this agreement for Fiscal Year July 1, 2021 through June 30, 2022 shall not exceed One Million and No/100 Dollars ($1,000,000.00) for all CONTRACTORS combined. The maximum amounts paid to each CONTRACTORS identified in this Agreement shall be as stated in the individual CONTRACTOR(S)’s “Budget” documents approved by COUNTY’s DBH Director or designee, and attached hereto as Exhibit C-1, Exhibit C-2, and Revised Exhibit C. and incorporated herein by this reference. The maximum contract amount under this Agreement for the Start Up period (January 10, 2017 through March 10, 2017), of CONTRACTOR(S) identified in Exhibit A-1, shall not exceed Seventy One Thousand Six Hundred Sixty Eight and No/100 Dollars ($71,668.00), as identified in Exhibit C-1. In no event shall the maximum compensation amount under this Agreement for January 10, 2017 through June 30, 2017 and Fiscal Year 2017-18 through Fiscal Year 2021-22 exceed Eight Million Five Hundred and No/100 Dollars ($8,500,000.00) or proration thereof for all CONTRACTOR(S) combined.” 3.That the existing COUNTY Agreement No. 17-006, Section Seven (7) “Modification”, on Page Eight (8), Line Ten (10) beginning with the word “Changes” and ending on Page Eight (8), Line Nineteen (19) with the word “herein” be replaced in its entirety as follows: “In addition, changes to expense category (i.e., Salary & Benefits, Client Support, Facilities/Equipment, Operating Expenses, Administrative Expenses, Special Expenses, Fixed Assets, etc.) subtotals in the budgets as set forth in Revised Exhibit C that do not exceed ten percent (10%) of the maximum compensation payable to the individual CONTRACTOR may be made with the written approval of COUNTY’s DBH Director, or designee. Said modifications shall not result in any change to the annual maximum compensation amount payable to the individual CONTRACTOR(S)’ program maximum compensation amount payable to CONTRACTOR(S), as stated in this Agreement.” 4.That the existing COUNTY Agreement No. 17-006, Section Ten (10) “Insurance”, on Page 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 Nine (9), Line Eight (8) beginning with the word “Without” and ending on Page Eleven (11), Line Twelve (12) with the word “better” be replaced in its entirety as follows: “Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the following insurance policies or a program of self-insurance, including but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the term of the Agreement: A.Commercial General Liability Commercial General Liability Insurance with limits of not less than Two Million Dollars ($2,000,000.00) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000.00). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including completed operations, products liability, contractual liability, Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. 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.Professional Liability If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W., M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) annual aggregate. D.Real and Property Insurance CONTRACTOR shall maintain a policy of insurance for all risk personal property coverage which shall be endorsed naming the County of Fresno as an additional loss payee. The personal property coverage shall be in an amount that will cover 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 the total of COUNTY purchase and owned property, at a minimum, as discussed in Section Nineteen (19) of this Agreement. E.All Risk Property Insurance As applicable, 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. F.Worker's Compensation A policy of Worker's Compensation insurance as may be required by the California Labor Code. G.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. H. Cyber Liability Cyber Liability Insurance, with limits not less than Two Million Dollars ($2,000,000) per occurrence or claim, Two Million Dollars ($2,000,000) aggregate. Coverage shall be sufficiently broad to respond to duties and obligations undertaken by CONTRACTOR in this agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations. /// 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 Additional Requirements Relating to Insurance CONTRACTOR shall obtain endorsements to the Commercial General Liability insurance naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be excess only and not contributing with insurance provided under CONTRACTOR's policies herein. This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written notice given to COUNTY. 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 and executes this Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, Contracted Services Division, 3133 N. Millbrook Avenue, Fresno, California, 93703 and DBHContractedServicesDivision@fresnocountyca.gov, stating that such insurance coverage 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 for such worker’s compensation insurance the CONTRACTOR has waived its right to recover from the COUNTY, its officers, agents, and employees any amounts paid under the insurance policy and that waiver does not invalidate the insurance policy; 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, 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 written notice given to COUNTY. In the event CONTRACTOR fails to keep in effect at all times insurance coverage as herein provided, the 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 issued by admitted insurers licensed to do business in the State of California, and such insurance shall be purchased from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better.” 5.That all references in existing COUNTY Agreement No. 17-006 to “Exhibit A” shall be changed to read “Revised Exhibit A”, which is attached hereto and incorporated herein by this reference. 6.That all references in existing COUNTY Agreement No. 17-006 to “Exhibit B” shall be changed to read “Revised Exhibit B”, which is attached hereto and incorporated herein by this reference. 7.That all references in existing COUNTY Agreement No. 17-006 to Exhibit B-1 shall be changed to read “Revised Exhibit B-1”, which is attached hereto and incorporated herein by this reference. 8.That Revised Exhibit C is attached hereto and incorporated herein by this reference. 9.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 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 I, the Agreement electronic means and either party may sign this Amendment with an original handwritten signature. 10.The parties agree that this Agreement I is sufficient to amend the Agreement; and that upon execution of this Amendment and 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. This Amendment I shall be effective July 1, 2021. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 1 IN WITNESS WHEREOF , the parties hereto have executed this Amendment I to 2 Agreement as of the date first above set forth . 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 [INSERT CONTRACTOR NAME] Please see attached signatures FOR ACCOUNTING USE ONLY: Fund/Subclass: 0001/10000 ORG No.: 56304768 Account No.: 7295/0 8 COUNTY OF FRESNO SteveB J k 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 4-15-2021 Revised Exhibit A Page 1 of 1 MULTI-AGENCY ACCESS PROGRAM (MAP) POINT OPERATORS LIST OF CONTRACTORS 1.Kings View (lead) 7170 N. Financial Dr., Suite 110 Fresno, CA, 93720 (559)256-0100 Contacts: Amanda Nugent Divine, Chief Executive Officer Virginia Sparks, Regional Director 2.Poverello House 412 F Street Fresno, CA 93706 (559) 498-6988 Contact:Zachary D. Darrah, Chief Executive Officer Sara Mirhadi, Chief Program Officer 3.Centro La Familia Advocacy Services, Inc. 302 Fresno St., Suite 102 Fresno, CA 93706 (559) 237-2961 Contact:Margarita A. Rocha, Executive Director Ilse Gallardo, Program Manager Revised Exhibit B Page 1 of 7 MENTAL HEALTH SERVICES ACT PREVENTION AND EARLY INTERVENTION MULTI-AGENCY ACCESS PROGRAM POINT Program Overview CONTRACT SERVICES: Operation of Multi-Agency Access Program (MAP) Points CONTRACT TERM: January 10, 2016 – June 30, 2019 (Base); July 1, 2019 – June 30, 2020 (Optional Renewal); July 1, 2020 – June 30, 2021 (Optional Renewal); and July 1, 2021 – June 30, 2022 (Extension) CONTRACTORS: See Revised Exhibit A CONTRACT MAXIMUM: $7,500,000 FY 2016-21 $1,000,000 FY 2021-22 CONTRACTOR AWARDS: See Exhibits C-1, et seq. for individual Provider Awards SERVICE POPULATIONS: Underserved and unserved groups within Fresno County I. MAP POINT PROGRAM OVERVIEW County of Fresno on behalf of the Department of Behavioral Health (DBH), Mental Health Services Act (MHSA), Prevention and Early Intervention (PEI), has developed a Master Agreement for the operation of Multi-Agency Access Program (MAP) Point services for underserved and unserved culturally diverse populations in Fresno County. PEI Program Intent and Goals - The intent of the PEI program is to provide funds for MAP Point services to be delivered in community settings to all age groups in a culturally, linguistically and age- appropriate manner. The goals of the PEI component of the MHSA shall be integrated into the MAP Point program and shall be promoted through: community collaboration; cultural and linguistic competency; and services that are individual/family driven, wellness and recovery focused, integrated and performance outcomes based. MAP Point Program Intent and Goals – DBH seeks to streamline access processes to ensure that all individuals in need of behavioral health care have a timely, personal, relevant, clear and understandable path to care. By integrating behavioral health into other systems such as physical health settings, justice settings including courts and probation, schools, and other service delivery Revised Exhibit B Page 2 of 7 organizations, DBH can significantly increase access to care and improve the total health and wellness in the community. A MAP provides an integrated screening process which connects individuals facing mental health, substance use disorder, physical health, or housing challenges to supportive services matching individuals and families to the right resources at the right time in the right location. This is accomplished through an established and formalized screening process, collaboration of service providers, leveraging existing community resources, eliminating barriers and assisting clients’ access to supportive services. The purpose of this program is to provide multiple MAP Points at optimal strategic and geographic locations that have dense client flow to target underserved and unserved populations with critical access needs. Each MAP Point Provider will be an access point and use a common screening process to serve individuals where they are. Each Provider will work within a centralized or coordinated system for linkages to further assessments and/or services for all persons who participate in the screening. Goals of the program include less utilization of more costly crisis services, and minimization or avoidance of more severe outcomes such as substance use disorder, hospitalization or incarceration. Funding Use – PEI guidelines stipulated by the California Department of Health Care Services specifically limit how PEI funds may be used. The funding for MAP Point services is to provide for salaries and benefits of staff, training, consumer incentives, planning and operational costs, lease space, technology, transportation needs, and other acceptable expenses that carry out the intent of this project. Providers’ individual funding allocations are identified and detailed in Exhibits C-1 et seq. Prevention in mental health involves reducing risk factors or stressors, building protective factors and skills and increasing support. Prevention promotes positive cognitive, social and emotional development and encourages a state of well being that allows the individual to function well in challenging circumstances. MAP Points will assist the clients in reducing negative outcomes that may serve as a risk factor to developing potentially serious mental illness by screening for biological, behavioral and socio-economic needs and linking to appropriate service providers. Early intervention is directed toward individuals and families for whom a short-duration (up to one year), relatively low-intensity intervention is appropriate to measurably improve a mental health problem or concern very early in its manifestation, thereby avoiding the need for more extensive Revised Exhibit B Page 3 of 7 mental health treatment or services; or prevent a mental health problem from getting worse. MAP Points will not be providing direct treatment services, but will track any linkages to early intervention programs. MAP Points will be primarily a program to improve timely access to mental health services to underserved populations with inherent strategies to provide prevention, outreach, access and linkage, and stigma and discrimination reduction. Target populations are underserved and unserved, who lack protective factors such as knowledge of the system of care and access to mental health services or have stigma associated with reaching out for mental health services. Outreach for Increasing Recognition of Early Signs of Mental Illness – Outreach serves to introduce and educate the community on mental health and related services available within the community, and in Fresno County in general. Connections made shall help to build a trusted presence within the community and thereby encourage future contacts, follow-ups, and linkages to service information and/or delivery. MAP Points will be located in settings where service populations are, whether in their own communities, places they frequent or have a connection. These settings as well as the mental health domain of the screening tool will provide opportunity to identify early signs of mental illness. Access and Linkage – The MAP integrated screening process will be able to screen clients for mental health needs and link to further assessment to determine appropriate care and/or treatment. Stigma and Discrimination Reduction - MAP Points will provide culturally-competent services. Staff with same cultural and linguistic make up of clients will make it easier for clients to feel welcomed and comfortable in seeking mental health services and continue to receive needed services. Services and Performance Measures - Under the provision of the MHSA PEI component, the County’s Department of Behavioral Health receives funding to expand, develop and create successful PEI programs for children, transitional aged youth, adults, and older adults in a culturally, ethically, and linguistically competent approach for underserved and unserved populations. MAP Point Program Providers’ culturally specific approaches to these services, and their performance measures and outcome goals are identified and detailed in Exhibits B-1 et seq. Performance measures are further addressed in Section Four (4) of this document. Service Populations - Target areas include optimal strategic and geographic locations that have a high volume of client flow/interaction that can target underserved and un-served populations with critical access needs. These areas can be in metropolitan and rural locations, law enforcement Revised Exhibit B Page 4 of 7 agencies, critical access points such as hospitals, service agencies, educational settings, or any other location that meets the intent of MAP Point project. Target populations include unserved or underserved groups within Fresno County; examples include, but are not limited to, cultural populations, lesbian/gay/bi-sexual/transgender/questioning (LGBTQ) community, Veterans, homeless and geographically isolated groups. MAP Point services, while targeting specific unserved and underserved groups, must extend services to all age groups, populations, cultures and must be able to link to all appropriate services as needed. There should be no exclusion criteria. Service populations are identified for each MAP Point Provider in Exhibit A and Exhibits B-1 et seq. Collaborations – MAP Point Providers shall work in collaboration with existing partners, including but not limited to the existing MAP Point at Pov, local schools and district offices, faith-based organizations, primary care centers, various health offices, natural gathering sites, social services offices and local law enforcement offices. In addition, collaborations and partnerships shall be encouraged with all other community stakeholders and service providers, including but not limited to: private, profit/non-profit, government, faith-based, cultural-specific community resource/service providers, and advisory boards and commissions. Providers will be required to participate in MAP Community Work Groups and encouraged to participate in Community Conversations, Fresno-Madera Continuum of Care and other local planning organizations, initiatives, activities and assessments. Master Agreement Additions - Organizations seeking to be included in this Master Agreement, or seeking to provide additional services to underserved and un-served target/service populations, funded through MHSA PEI, must submit a written proposal to Fresno County Department of Behavioral Health, Attention: MAP Point Contract Analyst, 3133 N. Millbrook Avenue, Fresno, CA 93703. The proposal must be prepared and submitted for review and approval in accordance to, and in proper response to, the Request for Proposal (RFP) #952-5468 issued by Fresno County Purchasing Division on April 8, 2016. Proposals received must be approved by DBH Director and/or designee for addition to Master Agreement. II. MAP POINT SERVICES A. Provide screening for each client in order to understand their individual needs and motivation to be linked with services. Specific services shall include: Revised Exhibit B Page 5 of 7 • Use Motivational Interviewing (MI) to identify client’s fundamental values and goals to stimulate change. • Develop a service or linkage plan for the client or family and monitor their success in connecting to assessments or services identified in the screening. • Meet individually with client or family when necessary to provide support and assistance towards achieving service or linkage plan goals. • Make linkages and appointments with appropriate service providers. A linkage is considered achieved when a client is confirmed to be connected with a service provider, not simply referred. • Maintain client files. • Transportation of clients to identified resource agencies and/or to initial scheduled appointment with identified service providers, as necessary. B. Assist clients in obtaining necessary documents such as State Identification Card, Social Security Card, Birth Certificate, etc. needed to link to appropriate services and support clients in developing an understanding how to utilize community supports in an ongoing fashion (such as public transportation system, community food banks, etc.). C. Be responsible for linking clients to the appropriate services based upon initial screening and linkage plan. Services to which clients may be linked range from mental health, substance use disorder, physical health, housing, social and/or other services. Methods for service coordination and communication between program and other service providers shall be developed and implemented consistent with Fresno County Mental Health Plan (MHP) confidentiality rules. • Should read-only access to the County’s electronic health record system (currently Avatar) be provided in order to assist in determining client’s prior involvement in the County’s Mental Health Plan system of services and ensure continuum of care, understand that fees for access may apply and are expected to become part of the Provider’s operational costs as identified and detailed in Exhibits C-1 et seq. D. Work collaboratively with the MAP Community Coordinator and other service providers to monitor client success, areas for growth and challenges with program linkage. Ensure a warm handoff between client and service providers. E. Maintain relationships with referring and supporting agencies and represent agencies at various community meetings as requested. Participate in all scheduled MAP Point community meetings. Attend scheduled meetings and presentations with referral agencies. Revised Exhibit B Page 6 of 7 F. Utilize evidence based practices in screening and serving clients. Ensure on-going training of staff regarding evidence based practices and knowledge of relevant mental health/illness topics. G. Utilize the standardized MAP Community Screening Tool and stay current in practice with any future revisions to this tool and provide appropriate feedback. Participate in training needed on the tool itself or supporting data systems used. • Any costs associated with use of data systems supporting the MAP Community Screening Tool or VI-SPDAT or other systems as required and/or developed by the MAP Community Group are to become part of Provider’s operational costs as identified and detailed in Exhibits C-1 et seq. • Entry of data and case relevant information into MAP Community Screening Tool data system and/or other required systems. III. STAFFING The staffing plan should be clear and concise and allow for full implementation of all items described in the program. It is expected that MAP Point Navigator(s) shall complete the services and linkages as identified above. In addition, the Navigator shall work collaboratively with other service components and programs in the MAP system. Navigators shall be knowledgeable of cultural sensitivity/competency and well versed in community resources. Staff work schedules shall be responsive to client needs and shall permit staff to be available at times/locations that are convenient for the client and/or respond to family members’ concerns. There is no mental health treatment currently offered or anticipated at MAP Points. As such, specific licensures related to behavioral health are not required. The staffing plan should include MAP Point Navigators, supervision of MAP Point Navigators, and additional positions as needed to ensure full implementation of the program. IV. PERFORMANCE OUTCOME MEASURES All Providers shall comply with all project monitoring and compliance protocols, procedures, data collection methods, and reporting requirements requested by the County. Providers shall use performance outcome measures for evaluating program and system effectiveness to ensure services and service delivery strategies are positively impacting the service population. Revised Exhibit B Page 7 of 7 In addition, these measures shall be used to ensure MAP Point services are in alignment with MHSA guiding principles which are inclusive of: an integrated service experience; community collaboration; cultural competence; client/family driven service; and wellness, resilience, and recovery focused services. MHSA PEI reporting requirements include but are not limited to the following: number of referrals/linkages of members of underserved populations to a prevention program, early intervention program, and/or treatment beyond early onset; number of persons who followed through on the referral and engaged in services (linkage may be defined as having participated at least once in the program to which person was referred); and timeliness of care, the interval between referral and engagement in services. Performance outcome measures shall be tracked on an ongoing basis and used to update the County monthly (by the 10th of the month following the report period) regarding MAP Point services. In addition, performance outcome measures are reported to the County annually in accumulative reports for overall program and contract evaluation. Providers will utilize standardized forms and tools so that data shall be collected in the same way for each MAP Point location and population it may serve. Forms and tools used to gather and report data reflecting services provided, populations served, and impact of those services are to be developed by the County and Providers. Providers will work closely with the County to analyze the data and make necessary adjustments to service delivery and reporting requirements before the start of each new fiscal year. Providers’ specific performance measures and outcome goals are identified and detailed in Exhibit B-1 et seq. Measurable outcomes may be reviewed for input and approval by a designated Department of Behavioral Health work group upon contract execution and adjusted as needed each new fiscal year. The purpose of this review process is to ensure a comprehensive system wide approach to the evaluation of programs through an effective outcome reporting process. Revised Exhibit B-1 Page 1 of 9 MAP POINT COLLABORATIVE (KINGS VIEW, POVERELLO HOUSE AND CENTRO LA FAMILIA) SCOPE OF WORK CONTRACT SERVICES: CONTRACT TERM: CONTRACT MAXIMUM: Operation of Multi-Agency Access Program (MAP) Points January 10, 2017 – June 30, 2019 Two (2) Twelve-Month Renewal Options One (1) Twelve-Month Extension $1,000,000 Per Fiscal Year NOTE: The information, expectations and requirements contained in this Exhibit B-1 are specific to the MAP Point Collaborative and shall be considered in addition to Exhibit B and the Kings View proposal submitted in response to Request for Proposal No. 952-5468. I. PROGRAM OVERVIEW Kings View and its partners Centro La Familia Advocacy Services and Poverello House (collectively known as the MAP Point Collaborative) propose to provide clients with a MAP single point of entry for residents of Fresno County to access linkage to multiple behavioral, social and health services to promote their wellness and recovery. Although additional sites may be added, the present proposal includes eight MAP sites in the collaborative plus a mobile food truck that will serve clients as well. The MAP Point Collaborative will use Motivational Interviewing and evidence-based practices to engage the client in completing the Community Screening Tool and develop linkage plan goals. All services will be provided with a respectful approach to each client’s ethnicity, gender and belief system. The MAP Point Collaborative is an experienced team of three partners: Kings View, Centro La Familia Advocacy Services (CLFA), and Poverello House. Community Regional Medical Center (CRMC) is a project participant, and will provide a MAP site at its Ambulatory Care Center, but is not a formal, funded partner. Together this team has developed a proposal to serve Fresno County through eight fixed sites and a mobile truck. The project includes three sites in urban Fresno and five rural sites, plus mobile unit stops. The project plan draws upon the experience of the Poverello House at its current MAP Point at Pov program, enhanced by the experience of Kings View, and Centro La Familia Advocacy Services in serving the target populations. The MAP Point Collaborative proposes to serve all clients who come to one of the MAP points, and to leverage partner resources to create community awareness of MAP services. Partners developed conservative estimates of initial duplicated contacts based on their experience at each of these sites. •Poverello House, 412 F Street, Fresno •Mobile Unit/Food Truck (initially operating 4 days/week); initial stops include Mendota, Firebaugh, Huron, Orange Cove, San Joaquin, Calwa, Parlier, Del Ray, Riverdale, and Sanger •Kings View, 2045 Grant Street, Selma Revised Exhibit B-1 Page 2 of 9 •Centro La Familia Advocacy Services o Main CLFA office: 302 Fresno Street, Fresno o Mendota Community Center: 195 Smoot Ave, Mendota o Carmen Meza Center: 838 O St, Firebaugh o Huron Family Learning Center: 36602 Central Ave, Huron o EDA Community Center: 633 Sixth Street, Orange Cove •Community Regional Medical Center, Ambulatory Care Center: 290 N. Wayte Lane, Fresno 93701 Kings View, Centro La Familia Advocacy Services, and Poverello House will draw upon shared and unique resources to provide a continuum of services and connections to MAP clients at each of the MAP locations. For example, substance abuse treatment will be provided by Kings View or other appropriate community partners, including West Care. Clients needing mental health treatment will be linked to Kings View, or other appropriate community resources. Poverello House will link and provide services including emergency services (e.g., food, shelter, clothing) and limited medical services. Domestic violence intervention will be addressed by Poverello or Centro La Familia Advocacy Services; all organizations will assist clients in health insurance, food stamps, and other enrollments they are equipped to provide. The MAP partners all have stable and sustained organizational histories in the San Joaquin Valley, which allows them to leverage resources as a group under a single Collaborative Program Manager who will coordinate services and connections. In addition, the MAP Resource Coordinator will actively seek appropriate resources throughout Fresno County and share this information with all MAP partners to ensure that all sites have complete and current service provider information. The chart below shows services currently provided and to be leveraged by each of the partner agencies and by Community Regional Medical Center’s Ambulatory Care Center. Services Poverello Kings View CLFA CRMC Ambulatory Care MAP Program administration X Emergency shelter X Housing services X Substance abuse treatment X X X Medical services X X Employment services X X Mental health treatment X (DBH on site) X X X Legal services (Immigration) X Meal service X Food resource X Domestic violence intervention X X General assistance X X X Health insurance enrollment X X X X Parent education X Youth skills X Dental X Revised Exhibit B-1 Page 3 of 9 Kings View will hire a MAP Collaborative Program Manager to provide administrative and operational oversight and support, and a Resource Coordinator to identify and develop community resources for client linkage. Navigators at each site will screen clients using the Community Screening Tool and other relevant tools (e.g., the VI-SPDAT) and link or facilitate client linkage following the warm hand-off model. Transporters will drive clients to services via eight-passenger vans or automobiles to be leased for this project. Materials will be available in all three Fresno County threshold languages (English, Spanish and Hmong), and all sites will provide access to interpreters for clients and families. If an interpreter is not available, Language Line will be used to provide interpretation. The project will develop a data system designed to facilitate the data collection and reporting requirements of this project. The system will be designed with the assistance of Bitwise Industries leveraging the experience of that company with Fresno County data system design. II. SERVICES A.Screening provided MAP Point Collaborative partner navigators will provide a screening for each client to document and understand their individual needs and motivation to be linked with services. Navigators will: •Use Motivational Interviewing (MI) to identify and understand the client’s fundamental needs, values and goals to stimulate change. •Develop a service or linkage plan for the client or family and monitor success in connecting to assessments or services identified in the screening. •Meet individually with the client or family when necessary to provide support and assistance towards achieving service and/or linkage plan goals. •Make linkages and appointments with appropriate service providers including housing, mental health and social services. Clients will be considered linked with a referral service when connection with that service provider is confirmed. •Maintain client files through use of a database to be developed by technology firm Bitwise Industries, in coordination with Kings View IT staff and based on program requirements. •Provide transportation for clients to identified resource agencies and/or to initial scheduled appointment with identified service providers, as necessary. Transportation will be provided through tokens for public transport or by two MAP transporters in leased vans, as reflected in the project budget. B.Client assistance in obtaining documents MAP Point Collaborative Navigators will assist clients at all sites in obtaining necessary documents such as state identification card, social security card, birth certificate, immigration- related documents (passport, green card), and others that are needed to link to appropriate services such as public benefits, housing, and/or health insurance enrollment. MAP Navigators will provide clients information on how to obtain additional resources such as transportation, food and any immediate medical resources. Revised Exhibit B-1 Page 4 of 9 C.Linking clients to appropriate services based on initial screening The MAP Point Collaborative Navigators at all sites will be responsible for linking clients to the appropriate services based on their screening and linkage plan. MAP Navigators will provide information to clients about necessary documents, and assist in completing applications that are available to the MAP staff, and provide transportation as needed to county services such CalFresh, CalW ORKs, and TANF, as well as to services that fit into each agency’s relevant programs. Navigators will also assist clients in linking clients in the same way to low-income housing options, landlords, primary medical care, faith-based support systems, and in some cases with their families. In many cases, the MAP partners will directly provide those services, consistent with each agency’s mission. Methods for service coordination and communication between program and other service providers will be developed and implemented in alignment with Fresno County Mental Health Plan (MHP) confidentiality rules. Coordination is crucial in Fresno County’s large catchment area because services are spread out and low-income residents of rural communities have very little access to services without necessary transportation. D.Service provider coordination/collaboration The MAP Point Collaborative Navigators at all sites will work collaboratively with the Program Manager and other service providers to monitor client success, identify areas for growth and challenges with program linkage, and will ultimately ensure a warm hand-off between client and service providers. The MAP Collaborative Program Manager will provide overall program coordination and monitoring; a MAP Resource Coordinator will develop and manage linkage resources to meet the needs of clients. Potential resources include government agencies such as Department of Behavioral Health, Department of Social Services, Department of Motor Vehicles, Housing Authority, and community-based organization programs. E.Maintaining agency relationships The MAP Point Collaborative Program Manager, MAP Resource Coordinator, and other staff as appropriate will maintain relationships with referring and supporting agencies and represent agencies at various community meetings as requested. The purpose of this position is to coordinate and develop resources appropriate to the needs identified through the project. In addition to the MAP Collaborative Program Manager’s role of program oversight and contract compliance, the Program Manager will also establish regular collaborative meetings, and facilitate those meetings to support the collaborative and community relationships. Each of the participating agencies is already fully engaged in relevant agency relationships F.Evidence based practices in screening and serving clients The MAP Point Collaborative will use evidence-based practices in screening and serving clients. The use of proven methodologies, with an evidence basis, allows for interactions with the clients to be more complete and productive. There are numerous evidence-based methodologies for these purposes that can be incorporated into the process depending on the situation and need. Some of the key evidence-based practices that will be used are described below. Revised Exhibit B-1 Page 5 of 9 •Collaborative Navigators will use the evidence-based practice of Motivational Interviewing, a clinical approach that helps people with mental health and substance-use disorders and other chronic conditions such as diabetes, cardiovascular conditions, and asthma make positive behavioral changes to support better health. The approach upholds four principles— expressing empathy and avoiding arguing, developing discrepancy, rolling with resistance, and supporting self-efficacy (a client’s belief s/he can successfully make a change). Kings View staff are already trained in Motivational Interviewing. For project staff who are not yet trained, Motivational Interviewing classes are available online. All MAP staff will be trained in Motivational Interviewing, with support provided by collaborative partners. •Another evidence-based practice to be used by the MAP Point Collaborative is the Wellness Recovery Action Plan or WRAP®, a self-designed prevention and wellness process used extensively by health care and mental health systems to address physical, mental health and life issues, and will be used at MAP Point Collaborative sites to engage the client in completing the Community Screening Tool and develop linkage plan goals. WRAP has been studied extensively in rigorous research projects and is listed in the National Registry of Evidence-based Programs and Practices. All MAP services will be provided with a respectful approach to each client’s ethnicity, gender and belief system. G.Utilizing standardized MAP Point Community Screening Tool MAP Point Collaborative staff will use the standardized MAP Point Community Screening Tool and stay current with any future revisions to this tool. In addition, the MAP Point Program Manager and Navigators will participate in future development of screening tools as requested. While primary screening staff will be the Navigators, training will be provided to all appropriate staff. III.STAFFING To allow for full implementation of all items described in the program, the staffing plan proposed for the Map Point Collaborative sites will be as follows: •1.0 FTE M AP Collaborative Program Manager will oversee the Multi-Agency Access Program locations to ensure operations are running smoothly and in compliance with contract requirements including records management, security, communications, transportation services and staff sharing. Qualifications include a Master’s Degree in behavioral health or related field or equivalent with at least two years of experience as a manager in a case management environment, while working with the severely mentally ill (SMI), and/or co-occurring clients as well as experience in developing linkages for a wide variety of needs and coordinating case management type services for the homeless and indigent populations. •1.0 FTE M AP Resource Coordinator will be responsible for cultivating resources and linkages for MAP personnel to ensure clients are linked to the “right services, the first time.” Linkages to include: housing resources, physical and mental health services, substance abuse treatment services, domestic violence education and support groups, immigration services for undocumented clients, vocational assessment, education and training, Revised Exhibit B-1 Page 6 of 9 parenting, school based counseling and support groups, wellness and recovery activities. Qualifications include Bachelor’s Degree in related field. •9.0 FTE Navigators among eight fixed sites and one mobile unit (see program budget for specific assignments) will administer the Community Screening Tool and/or VI-SPDAT to the client and facilitate linkages to indicated services and faith-based supports. Navigators will work collaboratively with other service components and programs in the MAP system. Navigators will be knowledgeable of cultural sensitivity/competency and well versed in community resources. Navigators will be responsible for case management to ensure proper linkages occur. The Navigators will be placed at the main MAP site at Poverello House, the Kings View site in Selma as well as the Centro La Familia sites at 302 Fresno Street, Community Regional Medical Center, and in the cities of Mendota, Firebaugh, Huron and Orange Cove. Navigators are required to have a Bachelor’s Degree in a related field. •2.0 FTE Transporters, using program vehicles, will transport clients to appointments, designated treatment programs, health care services, social services, government offices and faith-based services in the community as necessary to fulfill the clients’ linkage plan goals. Transporters are required to have and Associate's degree or equivalent with experience working with severely mentally ill and/or co-occurring environment. Transporters must also have a basic knowledge of common mental health diagnoses. Additional training may be provided, for example Mental Health First Aid training, which is offered by Fresno County as well as American Ambulance. Kings View will employ the MAP Collaborative Program Manager and Navigators for the Selma site. Poverello House will employ the Resource Coordinator. Each partner will directly employ Navigators for its sites. Although the core elements of job duties are consistent among all program staff, each agency may add expectations specific to their agency. Staff work schedules will be responsive to client needs and permit staff to be available at times and locations that are convenient for the client and respond to family members’ concerns. The MAP Point Collaborative has identified sites for the MAP points that are well known to the community, used by the target population, and are already trusted sources of assistance. MAP Point Collaborative staff will be bilingual, multi-culturally aware and sensitive to gender differences so that a trust and respect can be established with clients. All MAP Point Collaborative staff will receive initial cultural humility training and then once per year thereafter. All partners are fully committed to providing culturally competent services, and acknowledge the California Department of Mental Health’s Cultural Competence Plan CCPR Modification (2010), which serves to operationalize cultural competence at the contractor level. Whenever feasible, MAP staff will be hired from the cultural, linguistic and ethnic backgrounds of the target population. In addition, Kings View reaches out to members of the community who might not know how to engage in the treatment of mental health issues. Unserved and underserved clients may not understand how to seek services and/or they may have stigma associated with reaching out for mental health services. Having staff who are the same cultural and linguistic make up as the clients makes it easier for clients to feel welcomed and comfortable in seeking mental health services and continue to receive needed services. All partners regularly attend cultural competency trainings, including those sponsored by the County of Fresno. All MAP Point Collaborative staff will also be trained in Mental Health First Aid. Revised Exhibit B-1 Page 7 of 9 IV.PERFORMANCE MEASURES/PROGRAM OUTCOMES A. Goals and objectives, projected number of clients The overall goals of the MAP Point project are as follows: 1.Provide clients with a single point of entry in urban and rural communities where people may access health and social services that promote their health, financial and social well-being in the community. 2.Support the client’s resiliency and sustainability through appropriate linkages. 3.Using best practices, engage the client in completing the Community Screening Tool and other appropriate tools to assist in development of their linkage plan goals. 4.Respect each client’s ethnicity, gender and belief system by utilizing cultural humility in all interactions. The estimates below were developed using some base assumptions: 1) the same individuals may come to a MAP point more than once, and will be reflected in the number of duplicated contacts; 2) the linkage needs for individuals may change over time; and 3) information on survey tools may change or become more complete over time as clients provide additional information or their situation changes. Using the duplicated contacts as a starting point, the following methodology was used to project the number of unique clients, number of surveys completed, and the number of linkages made. Please note that although these are conservative estimates, they are based on the experience of MAP Point at Pov. One of the lessons learned at MAP Point at Pov is that it is important to develop a rapport/trust with a client to obtain accurate answers to survey questions. This might be achieved in one visit or at a second visit at MAP Point at Pov, which found that 74% of clients return for follow-up visits and that completion of the VI-DSPAT (a shorter assessment than the draft Community Screening Tool) requires between 15 and 30 minutes, depending on the experience of the interviewer and the individual. Another lesson learned is that often a client comes in for one need but may have an emergency situation that takes priority. For example, a client may come in for housing assistance but need immediate referral to mental health services and/or medical services. At times a client has to be stabilized before they can complete an assessment. These factors are especially true if a client and/or a family have been homeless for a while. The Collaborative recognizes while many clients served will not be homeless, similar factors may influence the number of surveys completed. Based on the current experience of MAP Point at Pov, the collaborative determined that a conservative estimate was most appropriate at this time. 1.Unique clients are estimated to represent 40% of the duplicated contacts. 2.Survey completion in Year 1 is projected at 60% of unique clients, 65% in Year 2 and 70% for Years 3-5. 3.Successful linkage will be completed for 60% of initial contacts. 4.Services will increase by 10% each year. Revised Exhibit B-1 Page 8 of 9 Contacts (Duplicated) Unique clients Survey completion (of unique clients) Linkage (of contacts) Year 1 22,800 9,120 5,472 13,680 Year 2 25,080 10,032 6,019 15,048 Year 3 27,588 11,036 6,622 16,553 Year 4 30,346 12,138 7,283 18,208 Year 5 33,381 13,354 8,019 20,029 TOTAL 139,195 55,680 33,415 83,518 B. Performance outcome measurement tools The table above delineates the conservatively-projected service numbers for all five years of the MAP. These data will be collected, analyzed and reported through the system to be developed by Kings View’s IT and CFO, in consultation with Bitwise Industries. This collaboration is already being discussed, and work will begin immediately upon award. While it is hoped that electronic data collection will begin upon program launch (anticipated two months post-award notice), if the instrument is not completed, partners will manually track all data based on information to be collected. In addition to the outcomes measuring tool, the Community Screening Tool, the VI-SPDAT and other appropriate tools will be used to assess client needs. C. Measure of effectiveness The MAP Point Collaborative has identified potential outcomes and analyses in its Work Plan. Specific outcomes are proposed, but should not be considered comprehensive or complete. It is anticipated that measures will be adjusted in coordination with the County upon contract execution. Preliminary measures include the following: Key Performance Indicators Unique Client Contacts Total Clients Contacts Number of Survey Completed Number of Linkages Provided Linkage Types Emergency Room Visits Number of Client Transports Number of Client Housing Linkages Number of referrals to PEI Wellness Programs Other linkage types to be determined Other Indicators Number of Men Served Number of Women Served Number of Children Served Linkages by Urban Location Linkages by Rural Location Number Vehicle Miles Driven Number of Outreach Events Other indicators to be determined Total Client Linkages by Zip Code As noted, the MAP Point Collaborative will work with Bitwise Industries to develop an appropriate data tool for this MAP project. The tool will be designed to collect all data specified above, including number of client contacts, number of screening tools completed, number of unique/unduplicated clients, number of clients with multiple contacts, average number of contacts per client within the time period (year), number of clients with multiple referrals/linkage to same or same type of agency, referrals/linkages by agency and agency type. Numbers reflect: Revised Exhibit B-1 Page 9 of 9 •10% increase in clients and services each year •60% rate of successful linkages per client visit •60% of unique clients will complete the survey in Year 1; 65% of clients will complete the survey in Year 2; 70% of clients will complete the survey in Years 3 through 5 A client satisfaction survey appropriate for the MAP services will be developed, and the survey distributed to clients with responses recorded in the database for analysis. Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Oversight 0.10 -$ 12,150$ 12,150$ 1102 Map Point Services Manager 1.00 - 68,037 68,037 1103 Navigators 2.00 - 72,897 72,897 1104 - - - 1105 - - - 1106 - - - 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - 1112 - - 1113 - - 1114 - - 1115 - - 1116 - - 1117 - - 1118 - - 1119 - - 1120 - - 1121 - - - 1122 - - - 1123 - - - 1124 - - - 1125 - - - 1126 - - - 1127 - - - 1128 - - - 1129 - - - 1130 - - - 1131 - - - 1132 - - - 1133 - - - 1134 - - - 1135 - - - Personnel Salaries Subtotal 3.10 -$ 153,084$ 153,084$ Employee Benefits Acct #Admin Direct Total 1201 -$ -$ -$ 1202 - - - 1203 - 27,199 27,199 1204 - - - 1205 - - - 1206 - - - -$ 27,199$ 27,199$ Employee Benefits Subtotal: Retirement Worker's Compensation Health Insurance Other (specify) Other (specify) Multi-Agency Access Program (MAP) Kings View Fiscal Year (FY) 2021-22 Description Other (specify) PROGRAM EXPENSES 1000: SALARIES & BENEFITS Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 Revised Exhibit C Page 1 of 21 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 - 11,711 11,711 1303 - 1,531 1,531 1304 - 2,648 2,648 1305 - - - 1306 - - - -$ 15,890$ 15,890$ -$ 196,173$ 196,173$ 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 2,880$ 3002 1,680 3003 3,090 3004 - 3005 - 3006 16,590 3007 - 3008 - 3009 3,515 3010 - 3011 - 3012 - 27,755$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 1,500$ 4002 12,000 4003 3,300 4004 20,960 Other (specify) Other (Program Supplies) Staff Mileage/Vehicle Maintenance/Fuel Subscriptions & Memberships Other (specify) Other (specify) Rent/Lease Equipment Rent/Lease Building Staff Development & Training Vehicle Maintenance Other (specify) Office Supplies Cell Phone Services Data Lines/Mi-Fi Services Rent/Lease Vehicles Client Transportation & Support Client Housing Support Child Care Other (specify) Other (specify) Other (specify) Description Clothing, Food, & Hygiene Education Support Household Items for Clients Employment Support OASDI FICA/MEDICARE SUI Other (Workers Compensation) Utility Vouchers Program Supplies - Medical Medication Supports OPERATING EXPENSES TOTAL: Building Maintenance Payroll Taxes & Expenses Subtotal: Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Other (specify) Other (specify) EMPLOYEE SALARIES & BENEFITS TOTAL: Other (specify) Advertising Other (specify) Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 Revised Exhibit C Page 2 of 21 4005 - 4006 2,472 4007 - 4008 - 4009 - 4010 - 40,232$ 5000: SPECIAL EXPENSES Acct #Amount 5001 25,000$ 5002 - 5003 - 5004 - 5005 - 5006 - 5007 - 5008 - 25,000$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 21,666$ 6002 4,500 6003 17,488 6004 - 6005 Insurance (Property/Auto/Other):- 6006 Payroll Services - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 43,654$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ Acct #Service Units Rate Amount Other (specify) Other (specify) Other (specify) Other (specify) Other (specify) HMIS (Homeless Management Information System) General & Administration (G&A) Other (specify) Other (specify) Depreciation (Provider-Owned Equipment to be Used for Program Purposes) Line Item Description Security External Audit SPECIAL EXPENSES TOTAL: Line Item Description Contractual/Consulting Services (Specify) Other (specify) Other (specify) Other (specify) Translation Services Other (specify) Utilities Consultant (Network & Data Management) Other (specify) Other (specify) Line Item Description Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Other (specify) Leasehold/Tenant/Building Improvements Furniture & Fixtures PROGRAM FUNDING SOURCES 332,814$ TOTAL PROGRAM EXPENSES Other Assets over $500 with Lifespan of 2 Years + Other (specify) Assets over $5,000/unit (Specify) FIXED ASSETS EXPENSES TOTAL 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Line Item Description Insurance (Liability, Auto, Professional) Contract Administration FACILITIES/EQUIPMENT TOTAL: ADMINISTRATIVE EXPENSES TOTAL Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 Revised Exhibit C Page 3 of 21 8001 Mental Health Services 0 - -$ 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 0 - - 8010 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention 332,814 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 332,814$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ MEDI-CAL FFP TOTAL MHSA TOTAL Line Item Description 8100 - SUBSTANCE USE DISORDER FUNDS 8300 - MENTAL HEALTH SERVICE ACT (MHSA) Line Item Description REALIGNMENT TOTAL 8200 - REALIGNMENT Other (Specify) Other (Specify) NET PROGRAM COST: 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:332,814$ -$ SUBSTANCE USE DISORDER FUNDS TOTAL OTHER REVENUE TOTAL MHSA Program Name Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 Revised Exhibit C Page 4 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 196,173 Employee Salaries 153,084 1101 Program Oversight 12,150 These positions will provide agency specific staff oversight and represent and maintain the collaborative relationship between the three agencies. The FYT may be filled by multiple individuals in each agency. 1102 Map Point Services Manager 68,037 This position will oversee the Multi Agency Access Program locations to ensure operations are running smoothly and in compliance with the contract requirements. This position is budgeted for 12 months in year one. 1103 Navigators 72,897 Individuals in this position will administer the Community Screening Tool and the VI- SPDAT to the client and assist with linkages. These positions are budgeted for 11 months in year one. 1104 0 - 1105 0 - 1106 0 - 1107 0 - 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - 1121 0 - 1122 0 - 1123 0 - 1124 0 - 1125 0 - 1126 0 - 1127 0 - 1128 0 - 1129 0 - 1130 0 - 1131 0 - 1132 0 - 1133 0 - 1134 0 - 1135 0 - Employee Benefits 27,199 1201 Retirement - 0 1202 Worker's Compensation - 0 1203 Health Insurance 27,199 Medical, Dental, Vision, Life, Retirement - Employer share 1204 Other (specify)- 1205 Other (specify)- 1206 Other (specify)- Payroll Taxes & Expenses:15,890 1301 OASDI - 1302 FICA/MEDICARE 11,711 FICA/MEDICARE - Employer share 1303 SUI 1,531 SUI 1304 Other (Workers Compensation)2,648 Workers Compensation 1305 Other (specify)- 1306 Other (specify)- 2000: CLIENT SUPPORT - Multi-Agency Access Program (MAP) Kings View Fiscal Year (FY) 2021-22 Budget Narrative PROGRAM EXPENSE Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C Page 5 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 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 - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (specify)- 2012 Other (specify)- 2013 Other (specify)- 2014 Other (specify)- 2015 Other (specify)- 2016 Other (specify)- 3000: OPERATING EXPENSES 27,755 3001 Cell Phone Services 2,880 The annual cost for cell phone services. 3002 Data Lines/Mi-Fi Services 1,680 The annual cost for data connectivity to networks and the internet. 3003 Office Supplies 3,090 This includes all supplies used by staff in the course of providing MAP Point services. 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage/Vehicle Maintenance/Fuel 16,590 This includes vehicle maintenance costs, fuel costs and staff reimbursement for using a personal vehicle paid at the current IRS rate. 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (Program Supplies)3,515 Supplies provided to clients or necessary for client related services. Includes outreach items. 3010 Other (specify)- 3011 Other (specify)- 3012 Other (specify)- 4000: FACILITIES & EQUIPMENT 40,232 4001 Building Maintenance 1,500 The annual cost of janitorial services and minor building repairs. 4002 Rent/Lease Building 12,000 Building space in Selma. Kings View staff will operate at sites provided free of charge such as churches in rural communities. 4003 Rent/Lease Equipment 3,300 This is for copier leases. 4004 Rent/Lease Vehicles 20,960 The annual cost to lease 2 vans and 2 cars. The vehicles will be shared by all 3 agencies. There is concern that leased vehicles will soon exceed the mileage caps put in place by leasing agencies. The plan is to have Kings View Foundation, an subsidiary affiliate of Kings View Corporation purchase the vehicles and lease them to the program at cost so as to avoid any issues of excessive mileage charges. 4005 Security - 4006 Utilities 2,472 The annual cost of gas and electric costs. May include reimbursement of utilities for sites providing space free of charge. 4007 Other (specify)- 4008 Other (specify)- 4009 Other (specify)- 4010 Other (specify)- 5000: SPECIAL EXPENSES 25,000 5001 Consultant (Network & Data Management)25,000 Kings View Information Technology Department (KVIT) will provide hardware and software support for successful data collection. A database will be designed for this program. KVIT will procure equipment, software & other services from approved & authorized vendors. Provide online, onsite, or phone-based emergency support- 24/7 from the KVIT Help Desk. These services will be provided to all 3 agencies. 5002 HMIS (Homeless Management Information System) - 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C Page 6 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 5005 Other (specify)- 5006 Other (specify)- 5007 Other (specify)- 5008 Other (specify)- 6000: ADMINISTRATIVE EXPENSES 43,654 6001 General & Administration (G&A)21,666 This is overhead costs such as AP, HR and other administrative costs. 6002 Insurance (Liability, Auto, Professional)4,500 Includes general liability, professional liability and auto insurance. 6003 Contract Administration 17,488 Kings View Corporation as the lead agency will provide contract administrative functions including providing monthly consolidated outcome reports for all agencies. Coordinate program start-up, obtaining competitive bids 6004 External Audit - 6005 Insurance (Property/Auto/Other):- 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 - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (specify)- 7008 Other (specify)- ACCT # PROVIDE DETAILS OF METHODOLOGY(IES) USED IN DETERMINING MEDI-CAL SERVICE RATES AND/OR SERVICE UNITS, IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 8002 8003 8004 8005 8006 8007 8008 8009 8010 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:332,814 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:332,814 BUDGET CHECK:- Other (Specify) 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Plan Development Assessment Rehabilitation Other (Specify) PROGRAM FUNDING SOURCES Collateral LINE ITEM Mental Health Services Case Management Crisis Services Medication Support Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C Page 7 of 21 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Program Oversight-Chief Programs Officer 0.15 18,224$ -$ 18,224$ 1102 Transporter 1.00 - 33,280 33,280 1103 Transporter 1.00 - 33,280 33,280 1104 Map Point Resource Coordinator 1.00 - 50,960 50,960 1105 Navigator 1.00 - 37,440 37,440 1106 Navigator 1.00 - 37,440 37,440 1107 Rural Navigator 1.00 - 37,440 37,440 1108 Navigator 1.00 - 37,440 37,440 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - 1121 - - - 1122 - - - 1123 - - - 1124 - - - 1125 - - - 1126 - - - 1127 - - - 1128 - - - 1129 - - - 1130 - - - 1131 - - - 1132 - - - 1133 - - - 1134 - - - 1135 - - - Personnel Salaries Subtotal 7.15 18,224$ 267,280$ 285,504$ Employee Benefits Acct #Admin Direct Total 1201 547$ 4,014$ 4,561$ 1202 182 2,672 2,854 1203 900 42,000 42,900 1204 - - - 1205 - - - 1206 - - - 1,629$ 48,686$ 50,315$ Multi-Agency Access Program (MAP) Poverello House Fiscal Year (FY) 2021-22 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Revised Exhibit C Page 8 of 21 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 1,394 20,446 21,840 1303 182 2,672 2,854 1304 - - - 1305 - - 1306 - - 1,576$ 23,118$ 24,694$ 21,429$ 339,084$ 360,513$ 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 5,000 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 5,000$ 3000: OPERATING EXPENSES Acct #Amount 3001 8,000$ 3002 - 3003 7,715 3004 - 3005 - 3006 2,000 3007 - 3008 - 3009 - 3010 - 3011 - 3012 - 17,715$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 2,100$ 4002 6,000 4003 2,400 4004 - Description OASDI FICA/MEDICARE SUI Child Care Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: 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 Other (Specify) Other (Specify) Subscriptions & Memberships Vehicle Maintenance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Revised Exhibit C Page 9 of 21 4005 - 4006 8,000 4007 - 4008 - 4009 - 4010 - 18,500$ 5000: SPECIAL EXPENSES Acct #Amount 5001 -$ 5002 - 5003 - 5004 - 5005 - 5006 - 5007 - 5008 - -$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 17,179$ 6002 1,200 6003 2,400 6004 - 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 20,779$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ Acct #Service Units Rate Amount Security Utilities Other (Specify) Other (Specify) Other (Specify) Other (Specify) SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): FACILITIES/EQUIPMENT TOTAL: Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) 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 $500 with Lifespan of 2 Years + PROGRAM FUNDING SOURCES 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 422,507$ Revised Exhibit C Page 10 of 21 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 0 - - 8010 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention 422,507 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 422,507$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 8404 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:422,507$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C Page 11 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 360,513 Employee Salaries 285,504 1101 Program Oversight-Chief Programs Officer 18,224 Oversee the program staff and make sure program objectives are met. 1102 Transporter 33,280 Transport clients to and from Poverello House to receive services and to other appts. 1103 Transporter 33,280 Transport clients to and from Poverello House to receive services and to other appts. 1104 Map Point Resource Coordinator 50,960 Secure additional resources for all Map Points and oversee Map Point operations at Poverello House 1105 Navigator 37,440 Will administer the Community Screening Tool to the client and develop a linkage plan. 1106 Navigator 37,440 Will administer the Community Screening Tool to the client and develop a linkage plan. 1107 Rural Navigator 37,440 Will administer the Community Screening Tool to the client and develop a linkage plan. 1108 Navigator 37,440 Will administer the Community Screening Tool to the client and develop a linkage plan. 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - 1121 0 - 1122 0 - 1123 0 - 1124 0 - 1125 0 - 1126 0 - 1127 0 - 1128 0 - 1129 0 - 1130 0 - 1131 0 - 1132 0 - 1133 0 - 1134 0 - 1135 0 - Employee Benefits 50,315 1201 Retirement 4,561 3% of total gross wages with 50% participation 1202 Worker's Compensation 2,854 1% of total gross wages 1203 Health Insurance 42,900 Average of $500 per FTE x 12 months 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- Payroll Taxes & Expenses:24,694 1301 OASDI - 1302 FICA/MEDICARE 21,840 7.65% x gross wages 1303 SUI 2,854 1% x gross wages 1304 Other (Specify)- 1305 Other (Specify)- 1306 Other (Specify)- 2000: CLIENT SUPPORT 5,000 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support 5,000 Bus Tokens for client transportation Multi-Agency Access Program (MAP) Poverello House Fiscal Year (FY) 2021-22 Budget Narrative PROGRAM EXPENSE Revised Exhibit C Page 12 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES 17,715 3001 Telecommunications 8,000 $3600 for land lines, $2,400 for cell phones for mappoint staff, $2,000 for Data Lines/Mi- Fi services 3002 Printing/Postage - 3003 Office, Household & Program Supplies 7,715 Office supplies $3600, Program supplies $4115 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage 2,000 Mileage for staff and vehicle maintenance for Poverello House Vans used for client transportation. 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (Specify)- 3010 Other (Specify)- 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 18,500 4001 Building Maintenance 2,100 General maintenance on Mappoint building. 4002 Rent/Lease Building 6,000 Depreciation on Client Services building where Mappoint services are provided. 4003 Rent/Lease Equipment 2,400 Copier lease for copy machine used by mappoint staff 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities 8,000 Utilities allocated to Mappoint services building. 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES - 5001 Consultant (Network & Data Management)- 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services - 5005 Other (Specify)- 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES 20,779 6001 Administrative Overhead 17,179 Administrative overhead such as CEO and Executive time and other administrative expenses not covered in direct costs that should be allocated to the program. 6002 Professional Liability Insurance 1,200 Liability insurance allocated to mappoint program for mappoint staff. 6003 Accounting/Bookkeeping 2,400 Accounting bookkeeping allocated to mappoint program for mappoint staff. 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)- Revised Exhibit C Page 13 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 6011 Other (Specify)- 6012 Other (Specify)- 7000: FIXED ASSETS - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- ACCT # PROVIDE DETAILS OF METHODOLOGY(IES) USED IN DETERMINING MEDI-CAL SERVICE RATES AND/OR SERVICE UNITS, IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 8002 8003 8004 8005 8006 8007 8008 8009 8010 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:422,507 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:422,507 BUDGET CHECK:- Mental Health Services Case Management Crisis Services Medication Support LINE ITEM PROGRAM FUNDING SOURCES 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Other (Specify) Collateral Plan Development Assessment Rehabilitation Other (Specify) Revised Exhibit C Page 14 of 21 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Department Manager 0.25 - 14,850$ 14,850$ 1102 Navigator 1.00 - 37,500 37,500 1103 Navigator 1.00 - 36,000 36,000 1104 Navigator 1.00 - 36,000 36,000 1105 Navigator 1.00 - 36,000 36,000 1106 - - - 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - 1121 - - - 1122 - - - 1123 - - - 1124 - - - 1125 - - - 1126 - - - 1127 - - - 1128 - - - 1129 - - - 1130 - - - 1131 - - - 1132 - - - 1133 - - - 1134 - - - 1135 - - - Personnel Salaries Subtotal 4.25 -$ 160,350$ 160,350$ Employee Benefits Acct #Admin Direct Total 1201 -$ 5,805$ 5,805$ 1202 - 2,845 2,845 1203 - 17,850 17,850 1204 - - - 1205 - - - 1206 - - - -$ 26,500$ 26,500$ Multi-Agency Access Program (MAP) Centro La Familia Advocacy Services (CLFA) Fiscal Year (FY) 2021-22 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Employee Benefits Subtotal: Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Revised Exhibit C Page 15 of 21 Payroll Taxes & Expenses: Acct #Admin Direct Total 1301 -$ -$ -$ 1302 - 14,803 14,803 1303 - 2,170 2,170 1304 - - - 1305 - - 1306 - - -$ 16,973$ 16,973$ -$ 203,823$ 203,823$ 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 1,040 2004 3,000 2005 - 2006 - 2007 1,019 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - 5,059$ 3000: OPERATING EXPENSES Acct #Amount 3001 4,240$ 3002 - 3003 2,400 3004 - 3005 - 3006 6,048 3007 - 3008 - 3009 60 3010 3011 3012 12,748$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 -$ 4002 3,000 4003 1,200 4004 - Description OASDI FICA/MEDICARE SUI Child Care Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: 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 Other (Specify) Other (Specify) Subscriptions & Memberships Vehicle Maintenance Other (Specify): Background Check Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Revised Exhibit C Page 16 of 21 4005 - 4006 2,400 4007 - 4008 - 4009 - 4010 - 6,600$ 5000: SPECIAL EXPENSES Acct #Amount 5001 -$ 5002 - 5003 - 5004 250 5005 - 5006 - 5007 - 5008 - 250$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 15,000$ 6002 1,200 6003 - 6004 - 6005 - 6006 - 6007 - 6008 - 6009 - 6010 - 6011 - 6012 - 16,200$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 - 7007 - 7008 - -$ Acct #Service Units Rate Amount Security Utilities Other (Specify) Other (Specify) Other (Specify) Other (Specify) SPECIAL EXPENSES TOTAL: Line Item Description Other (Specify) Other (Specify) Other (Specify) Other (Specify) Insurance (Specify): FACILITIES/EQUIPMENT TOTAL: Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) 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 $500 with Lifespan of 2 Years + PROGRAM FUNDING SOURCES 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Line Item Description FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 244,680$ Revised Exhibit C Page 17 of 21 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 0 - - 8010 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention 244,680 8303 INN - Innovations - 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 244,680$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 - 8404 - 8405 - -$ 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 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 OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:244,680$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Grants (Specify) Other (Specify) Other (Specify) Revised Exhibit C Page 18 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 203,823 Employee Salaries 160,350 1101 Department Manager 14,850 Will provide staff and program oversight. Wil represent and maintain the collaborative relationship between the three agencies. Calculated at .25 of yearly income. 1102 Navigator 37,500 Assist clients with MAP Point Services, administer the Community Screening Tool and the VI-SPDAT to clients and assist with linkages. Calculated at $3,125 per month x 12 months 1103 Navigator 36,000 Assist clients with MAP Point Services, administer the Community Screening Tool and the VI-SPDAT to clients and assist with linkages. Calculated at $3,000 per month x 12 months 1104 Navigator 36,000 Assist clients with MAP Point Services, administer the Community Screening Tool and the VI-SPDAT to clients and assist with linkages. Calculated at $3,000 per month x 12 months 1105 Navigator 36,000 Assist clients with MAP Point Services, administer the Community Screening Tool and the VI-SPDAT to clients and assist with linkages. Calculated at $3,000 per month x 12 months 1106 0 - 1107 0 - 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - 1121 0 - 1122 0 - 1123 0 - 1124 0 - 1125 0 - 1126 0 - 1127 0 - 1128 0 - 1129 0 - 1130 0 - 1131 0 - 1132 0 - 1133 0 - 1134 0 - 1135 0 - Employee Benefits 26,500 1201 Retirement 5,805 Calculated at 4.25 FTE at 3% of salary rates 1202 Worker's Compensation 2,845 Budgeted based on current salary expenses. 1203 Health Insurance 17,850 Calculated at 4.25 FTE at $350 per month x 12 months 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- Payroll Taxes & Expenses:16,973 1301 OASDI - 1302 FICA/MEDICARE 14,803 Calculated at 0.0765% per salary dollar. 1303 SUI 2,170 Budgeted based on current salary expenses. 1304 Other (Specify)- 1305 Other (Specify)- 1306 Other (Specify)- Multi-Agency Access Program (MAP) Centro La Familia Advocacy Services (CLFA) Fiscal Year (FY) 2021-22 Budget Narrative PROGRAM EXPENSE Revised Exhibit C Page 19 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 2000: CLIENT SUPPORT 5,059 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support 1,040 Bus Tokens for clients to attend appointments. Calculated at 832 ride share cards x 1.25 cost for card 2004 Clothing, Food, & Hygiene 3,000 Supplies provided to clients in need of clothing, food and hygiene products. Budgetd for $50.00 per client. 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 1,019 Supplies provided to clients in need of household items. Budgetd at $40.76 per client. 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES 12,748 3001 Telecommunications 4,240 Landline service for staff to conduct client work. Calculated $83.33 per month for 4.25 FTE staff. Calculated at $40 per month for 4.25 FTE staff for cell phones. Calculated at $100 per month for 4.25 FTE staff for Data/WiFi. 3002 Printing/Postage - 3003 Office, Household & Program Supplies 2,400 Office Supplies such as desktop items, ink and paper calcuated at $200 per month 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage 6,048 Calculated at .56 Federal Milage Rate x 450 miles per month x 2 staff members x 12 months 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (Specify): Background Check 60 Calculated at $40 per month for 4.25 FTE staff 3010 Other (Specify)- 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 6,600 4001 Building Maintenance - 4002 Rent/Lease Building 3,000 Calculated at .85 per square foot for 4.25 FTE staff x 12 months 4003 Rent/Lease Equipment 1,200 Calculated at$100 per month x 12 months 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities 2,400 Calculated at$200 per month for 4.25 FTE staff x 12 months 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES 250 5001 Consultant (Network & Data Management)- 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services 250 Cost for interpretation services such as usage of a Language Line and translating documents to the threshold languages. 5005 Other (Specify)- 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES 16,200 6001 Administrative Overhead 15,000 Calculated at 6% of overall budget to support Direct Expenses = Personnel + Non- Personnel 6002 Professional Liability Insurance 1,200 Includes general liability, professional liability and auto insurance. Revised Exhibit C Page 20 of 21 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE PROGRAM EXPENSE 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 - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 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)- ACCT # PROVIDE DETAILS OF METHODOLOGY(IES) USED IN DETERMINING MEDI-CAL SERVICE RATES AND/OR SERVICE UNITS, IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 8002 8003 8004 8005 8006 8007 8008 8009 8010 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:244,680 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:244,680 BUDGET CHECK:- Medication Support 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) LINE ITEM Mental Health Services Case Management Crisis Services PROGRAM FUNDING SOURCES Other (Specify) Collateral Plan Development Assessment Rehabilitation Other (Specify) Revised Exhibit C Page 21 of 21