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HomeMy WebLinkAbout328311 2 AGREEMENT THIS AGREEMENT is made and entered into this 12th Agreement No. 18-327 day of _ ___...J,...un ...... e.__ _ _,, 2018, by 3 and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter 4 referred to as "COUNTY", and, Turning Point of Central California, Inc., a private, non-profit, 501 (c) (3), 5 corporation, whose address is P.O. Box 7447, Visalia, CA, 93290, hereinafter referred to as 6 "CONTRACTOR," collectively, "the parties." 7 WIT N ES S ET H: 8 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), is in need of a qualified 9 agency to operate a Rural Full Service Partnership (FSP) program, an Intensive Case Management (ICM) 10 program, and an Outpatient (OP) mental health program for children, adult and older adult clients who 11 have serious emotional disturbance and/or serious and persistent mental illness in Pinedale, Sanger, 12 Reedley, Selma, Kerman, and Coalinga and other rural sites as may be needed; 13 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), is a Mental Health Plan 14 (MHP) as defined in Title 9 of the California Code of Regulations (C.C.R.), section 1810.226; and 15 WHEREAS, CONTRACTOR is qualified and willing to operate said Rural FSP program, Rural ICM 16 Program, and Rural OP mental health Program pursuant to the terms and conditions of this Agreement. 17 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties hereto 18 agree as follows: 19 20 1. SERVICES A. CONTRACTOR shall perform all services and fulfill all responsibilities as set forth in 21 Exhibit A, attached hereto and by this reference incorporated herein and made part of this Agreement. 22 B. CONTRACTOR shall also perform all services and fulfill all responsibilities as 23 specified in COUNTY's Request for Proposal (RFP) No. 18-034 dated March 14, 2018, and Addendum 24 No. One (1) to COUNTY's RFP No. 18-034 dated April 3, 2018, and CONTRACTOR's response to said 25 Revised RFP dated April 12, 2018 all incorporated herein by reference and made part of this Agreement. 26 In the event of any inconsistency among these documents, the inconsistency shall be resolved by giving 27 precedence in the following order of priority: 1) to this Agreement, including all Exhibits; 2) to the Revised 28 RFP; and 3) to the Response to the Revised RFP. A copy of COUNTY's Revised RFP No. 18-034 and 1 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTRACTOR’s response thereto shall be retained and made available during the term of this Agreement by COUNTY’s DBH Contracts Division. C. It is acknowledged by all parties hereto that COUNTY's DBH shall monitor the services provided by CONTRACTOR, in accordance with Section Fourteen (14) of this Agreement. D. CONTRACTOR shall participate in monthly, or as needed, workgroup meetings consisting of staff from COUNTY's DBH to discuss service requirements, data reporting, training, policies and procedures, overall program operations and any problems or foreseeable problems that may arise. E. CONTRACTOR shall perform all FSP services as set forth in Exhibit A, in accordance with the Full Service Partnership Service Delivery Model - Exhibit C, attached hereto and incorporated herein by reference. 2. TERM This Agreement shall become effective on the 1st day of July 2018 and shall terminate on the 30th day of June 2021. This Agreement may be extended for two (2) additional twelve (12) month periods upon the written approval of both parties not later than sixty (60) days prior to the close of the then current Agreement term. The COUNTY’s DBH Director or his or her designee is authorized to execute such written approval on behalf of COUNTY based on CONTRCTOR’s satisfactory performance. 3. TERMINATION A. Non-Allocation of Funds - The terms of this Agreement, and the services to be provided thereunder, are contingent on the approval of funds by the appropriating government agency. Should sufficient funds not be allocated, the services provided may be modified, or this Agreement terminated at any time by giving CONTRACTOR thirty (30) days advance written notice. B. Breach of Contract - COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of COUNTY there is: 1) An illegal or improper use of funds; 2) A failure to comply with any term of this Agreement; 3) A substantially incorrect or incomplete report submitted to COUNTY; 4) Improperly performed service. 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 In no event shall any payment by COUNTY constitute a waiver by COUNTY of any breach of this Agreement or any default which may then exist on the part of CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of the CONTRACTOR the repayment to the COUNTY of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of COUNTY were not expended in accordance with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon demand or at COUNTY’s option such repayment shall be deducted from future payments owing to CONTRACTOR under this Agreement. C. Without Cause - Under circumstances other than those set forth above, this Agreement may be terminated by COUNTY upon the giving of sixty (60) days advance written notice of an intention to terminate to CONTRACTOR. D. CONTRACTOR may terminate this Agreement. If terminated by CONTRACTOR, termination shall require sixty (60) days advance written notice of intent to terminate (with allowance for appropriate clinical transition of clients prior to termination of services), transmitted by CONTRACTOR to COUNTY by Certified or Registered U.S. Mail, Return Receipt Requested, addressed to the office of COUNTY as follows: Director (or his or her designee) Department of Behavioral Health 3133 N. Millbrook Fresno, CA 93703 4. COMPENSATION COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation in accordance with the budget set forth in Exhibit B, attached hereto and by this reference incorporated herein and made part of this Agreement. A. Maximum Contract Amount The maximum amount payable to CONTRACTOR for the period of July 1, 2018 through June 30, 2019 shall not exceed Eleven Million Six Hundred Ninety-Six Thousand Five Hundred Twenty-Five and No/100 Dollars ($11,696,525.00). The maximum amount payable to CONTRACTOR for the period of July 1, 2019 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 through June 30, 2020 shall not exceed Twelve Million Two Hundred Two Thousand Nine Hundred Forty- Eight and No/100 Dollars ($12,202,948.00). The maximum amount payable to CONTRACTOR for the period of July 1, 2020 through June 30, 2021 shall not exceed Twelve Million Six Hundred Ninety-Nine Thousand Two Hundred Eighteen and No/100 Dollars ($12,699,218.00). The maximum amount payable to CONTRACTOR for the period of July 1, 2021 through June 30, 2022 shall not exceed Thirteen Million One Hundred Sixty-Seven Thousand Four Hundred Sixty-Seven and No/100 Dollars ($13,167,467.00). The maximum amount payable to CONTRACTOR for the period of July 1, 2022 through June 30, 2023 shall not exceed Thirteen Million Six Hundred Thirty-Seven Thousand Four Hundred Twenty-Seven and No/100 Dollars ($13,637,427.00). In no event shall the maximum contract amount for all the services provided by the CONTRACTOR to COUNTY under the terms and conditions of this Agreement be in excess of Sixty-Three Million Four Hundred Three Thousand Five Hundred Eighty-Five and No/100 Dollars ($63,403,585.00) during the total term of this Agreement. Payment shall be made upon certification or other proof satisfactory to COUNTY’s DBH that services have actually been performed by CONTRACTOR as specified in this Agreement. B. If CONTRACTOR fails to generate the Medi-Cal revenue and/or client fee reimbursement amounts set forth in Exhibit B, the COUNTY shall not be obligated to pay the difference between these estimated amounts and the actual amounts generated. It is further understood by COUNTY and CONTRACTOR that any Medi-Cal revenue and/or client fee reimbursements above the amounts stated herein will be used to directly offset the COUNTY’s contribution of COUNTY funds identified in Exhibit B. The offset of funds will also be clearly identified in monthly invoices received from CONTRACTOR as further described in Section Five (5) of this Agreement. Travel shall be reimbursed based on actual expenditures and mileage reimbursement shall be at CONTRACTOR’s adopted rate per mile, not to exceed the Federal Internal Revenue Services (IRS) published rate. 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 C. It is understood that all expenses incidental to CONTRACTOR’s performance of services under this Agreement shall be borne by CONTRACTOR. If CONTRACTOR fails to comply with any provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation. D. Payments shall be made by COUNTY to CONTRACTOR in arrears, for services provided during the preceding month, within forty-five (45) days after the date of receipt and approval by COUNTY of the monthly invoicing as described in Section Five (5) herein. Payments shall be made after receipt and verification of actual expenditures incurred by CONTRACTOR for monthly program costs, as identified in Exhibit B, in the performance of this Agreement and shall be documented to COUNTY on a monthly basis by the tenth (10th) of the month following the month of said expenditures. The parties acknowledge that the CONTRACTOR will be performing hiring, training, and credentialing of staff, and the COUNTY will be performing additional staff credentialing to ensure compliance with State and Federal regulations. E. COUNTY shall not be obligated to make any payments under this Agreement if the request for payment is received by COUNTY more than sixty (60) days after this Agreement has terminated or expired. All final invoices shall be submitted by CONTRACTOR within sixty (60) days following the final month of service for which payment is claimed. No action shall be taken by COUNTY on invoices submitted beyond the sixty (60) day closeout period. Any compensation which is not expended by CONTRACTOR pursuant to the terms and conditions of this Agreement shall automatically revert to COUNTY. F. The services provided by CONTRACTOR under this Agreement are funded in whole or in part by the State of California. In the event that funding for these services is delayed by the State Controller, COUNTY may defer payments to CONTRACTOR. The amount of the deferred payment shall not exceed the amount of funding delayed by the State Controller to the COUNTY. The period of time of the deferral by COUNTY shall not exceed the period of time of the State Controller’s delay of payment to COUNTY plus forty-five (45) days. G. CONTRACTOR shall be held financially liable for any and all future disallowances/audit exceptions due to CONTRACTOR’s deficiency discovered through the State audit 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 process and COUNTY utilization review during the course of this Agreement. At COUNTY’s election, the disallowed amount will be remitted within forty-five (45) days to COUNTY upon notification or shall be withheld from subsequent payments to CONTRACTOR. CONTRACTOR shall not receive reimbursement for any units of services rendered that are disallowed or denied by the Fresno County Mental Health Plan (Mental Health Plan) utilization review process or through the State Department of Health Care Services (DHCS) cost report audit settlement process for Medi-Cal eligible clients. Notwithstanding the above, COUNTY must notify CONTRACTOR prior to any State audit process and/or COUNTY utilization review. To the extent allowable by law, CONTRACTOR shall have the right to be present during each phase of any State audit process and/or COUNTY utilization review and shall be provided all documentation related to each phase of any State audit process and/or COUNTY utilization review. Additionally, prior to any disallowances/audit exceptions becoming final, CONTRACTOR shall be given at least 10 business days to respond to such proposed disallowances/audit exceptions. H. It is understood by CONTRACTOR and COUNTY that this Agreement is funded with mental health funds to serve adult individuals with Severely Mentally Ill (SMI) disorders and children/youth with Seriously Emotionally Disturbed (SED) disorders, many of whom have co-occurring substance use disorders. It is further understood by CONTRACTOR and COUNTY that funds shall be used to support appropriately integrated and documented treatment services for co-occurring mental health and substance use disorders. 5. INVOICING A. CONTRACTOR shall invoice COUNTY in arrears by the tenth (10th) day of each month for the prior month’s actual services rendered to DBH-Invoices@co.fresno.ca.us. After CONTRACTOR renders service to referred clients, CONTRACTOR will invoice COUNTY for payment, certify the expenditure, and submit electronic claiming data into COUNTY’s electronic information system for all clients, including those eligible for Medi-Cal as well as those that are not eligible for Medi-Cal, including contracted cost per unit and actual cost per unit. COUNTY must pay CONTRACTOR before submitting a claim to DHCS for Federal reimbursement for Medi-Cal eligible clients. B. At the discretion of COUNTY’s DBH Director, or his or her designee, if an invoice is incorrect or is otherwise not in proper form or substance, COUNTY’s DBH Director, or his or her designee, 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 shall have the right to withhold payment as to only that portion of the invoice that is incorrect or improper after five (5) days prior notice to CONTRACTOR. CONTRACTOR agrees to continue to provide services for a period of ninety (90) days after notification of an incorrect or improper invoice. If after the ninety (90) day period, the invoice(s) is still not corrected to COUNTY DBH’s satisfaction, COUNTY’s DBH Director, or his or her designee, may elect to terminate this Agreement, pursuant to the termination provisions stated in Section Three (3) of this Agreement. In addition, for invoices received ninety (90) days after the expiration of each term of this Agreement or termination of this Agreement, at the discretion of COUNTY’s DBH Director, or his or her designee, COUNTY’s DBH shall have the right to deny payment of any additional invoices received. C. Monthly invoices shall include a client roster, identifying volume reported by payer group clients served (including third party payer of services) by month and year-to-date, including percentages. D. CONTRACTOR shall submit to the COUNTY by the tenth (10th) of each month a detailed general ledger (GL), itemizing costs incurred in the previous month. Failure to submit GL reports and supporting documentation shall be deemed sufficient cause for COUNTY to withhold payments until there is compliance, as further described in Section Five (5) herein. E. CONTRACTOR will remit annually within ninety (90) days from June 30, a schedule to provide the required information on published charges for all authorized direct specialty mental health services. The published charge listing will serve as a source document to determine the CONTRACTOR’s usual and customary charge prevalent in the public mental health sector that is used to bill the general public, insurers or other non-Medi-Cal third party payers during the course of business operations. F. CONTRACTOR shall submit monthly staffing reports that identify all direct service and support staff, applicable licensure/certifications, and full time hours worked to be used as a tracking tool to determine if CONTRACTOR’s program is staffed according to the services provided under this Agreement. G. If CONTRACTOR chooses to utilize the COUNTY’s electronic health record system as their own full electronic health records system, COUNTY’s DBH shall invoice CONTRACTOR in arrears by the fifth (5th day of each month for the prior month’s hosting fee for access to the COUNTY’s electronic 8 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 information system in accordance with the fee schedule as set forth in Exhibit D, “Electronic Health Records Software Charges” attached hereto and incorporated herein by reference. COUNTY shall invoice CONTRACTOR annually for the annual maintenance and licensing fee for access to the COUNTY’s electronic information system in accordance with the fee schedule as set forth in Exhibit D. COUNTY shall invoice CONTRACTOR annually for the Reaching Recovery fee for access to the COUNTY’s electronic information system in accordance with the fee schedule as set forth in Exhibit D. CONTRACTOR shall provide payment for these expenditures to COUNTY’s Fresno County Department of Behavioral Health, Accounts Receivable, P.O. Box 712, Fresno, CA 93717-0712, Attention: Business Office, within forty-five (45) days after the date of receipt by CONTRACTOR of the invoicing provided by COUNTY. H. CONTRACTOR must maintain financial records for a period of ten (10) years or until any dispute, audit or inspection is resolved, whichever is later. CONTRACTOR will be responsible for any disallowances related to inadequate documentation. I. CONTRACTOR is responsible for collection and managing of data in a manner to be determined by DHCS and the COUNTY’s Mental Health Plan in accordance with applicable rules and regulations. COUNTY’s electronic information system is a critical source of information for purposes of monitoring service volume and obtaining reimbursement. J. CONTRACTOR shall submit service data into COUNTY’s electronic information system according to COUNTY’s DBH documentation standards to allow the COUNTY to bill Medi-Cal, and any other third-party source, for services and meet State and Federal reporting requirements. K. CONTRACTOR must comply with all laws and regulations governing the Federal Medicare program, including, but not limited to: 1) the requirement of the Medicare Act, 42 U.S.C. section 1395 et seq; and 2) the regulations and rules promulgated by the Federal Centers for Medicare and Medicaid Services as they relate to participation, coverage and claiming reimbursement. CONTRACTOR will be responsible for compliance as of the effective date of each Federal, State or local law or regulation specified. L. If a client has dual coverage, such as other health coverage (OHC) or Federal Medicare, the CONTRACTOR will be responsible for billing the carrier and obtaining a payment/denial or 9 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 have validation of claiming with no response ninety (90) days after the claim was mailed before the service can be entered into the COUNTY’s electronic information system. CONTRACTOR must report all third party collections for Medicare, third party or client pay or private pay in each monthly invoice and in the annual cost report that is required to be submitted. A copy of explanation of benefits or CMS 1500 form is required as documentation. CONTRACTOR must report all revenue collected from OHC, third-party, client-pay or private-pay in each monthly invoice and in the cost report that is required to be submitted. CONTRACTOR shall submit monthly invoices for reimbursement that equal the amount due CONTRACTOR less any funding sources not eligible for Federal and State reimbursement. CONTRACTOR must comply with all laws and regulations governing the Federal Medicare program, including, but not limited to: 1) the requirement of the Medicare Act, 42 U.S.C. section 1395 et seq; and 2) the regulation and rules promulgated by the Federal Centers for Medicare and Medicaid Services as they relate to participation, coverage and claiming reimbursement. CONTRACTOR will be responsible for compliance as of the effective date of each Federal, State or local law or regulation specified. M. Data entry shall be the responsibility of the CONTRACTOR. COUNTY shall monitor the volume of services and cost of services entered into the COUNTY’s electronic information system. Any and all audit exceptions resulting from the provision and reporting of specialty mental health services by CONTRACTOR shall be the sole responsibility of the CONTRACTOR. CONTRACTOR will comply with all applicable policies, procedures, directives and guidelines regarding the use of COUNTY’s electronic information system. N. Medi-Cal Certification and Mental Health Plan Compliance CONTRACTOR shall comply with any and all requests and directives associated with COUNTY maintaining State Medi-Cal site certification. CONTRACTOR shall provide specialty mental health services in accordance with the COUNTY’s Mental Health Plan. CONTRACTOR must comply with the “Fresno County Mental Health Plan Compliance Program and Code of Conduct” set forth in Exhibit E, attached hereto and incorporated herein by reference and made part of this Agreement. CONTRACTOR shall comply with any and all requests associated with any State/Federal reviews or audits. CONTRACTOR may provide direct specialty mental health services using pre- licensed staff as long as the individual is approved as a provider by the Mental Health Plan, is supervised 10 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 by licensed staff, works within his/her scope and only delivers allowable direct specialty mental health services. It is understood that each service is subject to audit for compliance with Federal and State regulations, and that COUNTY may be making payments in advance of said review. In the event that a service is disapproved, COUNTY may, at its sole discretion, withhold compensation or set off from other payments due the amount of said disapproved services. CONTRACTOR shall be responsible for audit exceptions to ineligible dates of services or incorrect application of utilization review requirements. 6. INDEPENDENT CONTRACTOR In performance of the work, duties, and obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of CONTRACTOR’s officers, agents, and employees will at all times be acting and performing as an independent CONTRACTOR, and shall act in an independent capacity and not as an officer, agent, servant, employee, joint venturer, partner, or associate of COUNTY. Furthermore, COUNTY shall have no right to control or supervise or direct the manner or method by which CONTRACTOR shall perform its work and function. However, COUNTY shall retain the right to administer this Agreement so as to verify that CONTRACTOR is performing their obligations in accordance with the terms and conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof. Because of its status as an independent contractor, CONTRACTOR shall have absolutely no right to employment rights and benefits available to COUNTY employees. CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and save COUNTY harmless from all matters relating to payment of CONTRACTOR’s employees, including compliance with Social Security, withholding, and all other regulations governing such matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be providing services to others unrelated to COUNTY or to this Agreement. 7. MODIFICATION Any matters of this Agreement may be modified from time to time by the written consent of 11 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 all the parties without, in any way, affecting the remainder. Notwithstanding the above, changes to services, staffing, and responsibilities of the CONTRACTOR, as needed, to accommodate changes in the laws relating to mental health treatment, as set forth in Exhibit A, may be made with the signed written approval of COUNTY’s DBH Director or his or her designee and CONTRACTOR through an amendment approved by COUNTY’s County Counsel and the COUNTY’s Auditor-Controller’s Office. In addition, changes to expense category (i.e., Salary & Benefits, Facilities/Equipment, Operating, Financial Services, Special Expenses, Fixed Assets, etc.) subtotals in the budgets, and changes to the volume of units of services/types of service units to be provided as set forth in Exhibit B, that do not exceed 10% of the maximum compensation payable to the CONTRACTOR may be made with the written approval of COUNTY’s DBH Director, or his or her designee. Changes to the expense categories in the budget that exceed ten percent (10%) of the maximum compensation payable to the CONTRACTOR, may be made with the signed written approval of COUNTY’s DBH Director, or his or her designee through an amendment approved by COUNTY’s Counsel and COUNTY’s Auditor-Controller’s Office. Changes to the fee scheduled identified in Exhibit C, “Electronic Health Records Software Charges,” may be made with the written approval of COUNTY’s DBH Director, or his or her designee. Said modifications shall not result in any change to the annual maximum compensation amount payable to CONTRACTOR, as stated in this Agreement. 8. NON-ASSIGNMENT No party shall assign, transfer or subcontract this Agreement nor their rights or duties under this Agreement without the prior written consent of COUNTY. 9. HOLD-HARMLESS CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request, defend COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any person, firm or 12 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 corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, their officers, agents or employees under this Agreement. CONTRACTOR agrees to indemnify COUNTY for Federal and/or State of California audit exceptions resulting from noncompliance herein on the part of CONTRACTOR. 10. INSURANCE Without limiting COUNTY's right to obtain indemnification from CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and affect the following insurance policies throughout the term of this Agreement: A. Commercial General Liability Commercial General Liability Insurance with limits of not less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of Five Million Dollars ($5,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverage including completed operations, product liability, contractual liability, Explosion, Collapse, and Underground (XCU), fire legal liability or any other liability insurance deemed necessary because of the nature of the Agreement. B. Automobile Liability Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non-owned).with limits of not less than) One Million Dollars ($1,000,000) per accident for bodily injury and property damage. C. 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 the total of the COUNTY purchase and owned property, at a minimum, as discussed in Section Twenty (21) of this Agreement. All Risk Property Insurance CONTRACTOR will provide property coverage for the full replacement value of the COUNTY’S personal property in possession of CONTRACTOR and/or used in the execution of this Agreement. COUNTY will be identified on an appropriate certificate of insurance as the certificate holder and will be named as an Additional Loss Payee on the Property Insurance Policy. D. Professional Liability 13 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 Professional Liability Insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence, Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees that it shall maintain, at its sole expense, in full force and effect for a period of three (3) years following the termination of this Agreement, one or more policies of professional liability insurance with limits of coverage as specified herein. E. Child Abuse/Molestation and Social Services Coverage CONTRACTOR shall have either separate policies or an umbrella policy with endorsements covering Child Abuse/Molestation and Social Services Liability coverage or have a specific endorsement on their General Commercial liability policy covering Child Abuse/Molestation and Social Services Liability. The policy limits for these policies shall be One Million Dollars ($1,000,000) per occurrence with a Two Million Dollars ($2,000,000) annual aggregate. The policies are to be on a per occurrence basis. F. Worker's Compensation A policy of Worker's Compensation Insurance as may be required by the California Labor Code. G. Cyber Liability Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to 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. H. Waiver of Subrogation CONTRACTOR hereby grants to COUNTY a waiver of any right to subrogation which any insurer of said CONTRACTOR may acquire against the COUNTY by virtue of the payment of any loss under insurance. CONTRACTOR agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the COUNTY has received a waiver of subrogation endorsement from the insurer. 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, 14 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 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. Within thirty (30) days from the date CONTRACTOR signs this Agreement, CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 3133 N. Millbrook Ave, Fresno, California, 93703, Attention: Contracts Division, stating that such insurance coverages have been obtained and are in full force; that the County of Fresno, its officers, agents and employees will not be responsible for any premiums on the policies; that such Commercial General Liability insurance names the County of Fresno, its officers, agents and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned; that such coverage for additional insured shall apply as primary insurance and any other insurance, or self- insurance, maintained by COUNTY, its officers, agents and employees, shall be excess only and not contributing with insurance provided under CONTRACTOR’s policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written notice given to COUNTY. In the event CONTRACTOR fails to keep in effect at all times insurance coverage as herein provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this Agreement upon the occurrence of such event. All policies shall be with admitted insurers licensed to do business in the State of California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. 11. LICENSES/CERTIFICATES Throughout each term of this Agreement, CONTRACTOR and CONTRACTOR’s staff shall maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States of America, State of California, the County of Fresno, and any other applicable governmental agencies. CONTRACTOR shall notify COUNTY immediately in writing of its inability to obtain or maintain such 15 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 licenses, permits, approvals, certificates, waivers and exemptions irrespective of the pendency of any appeal related thereto. Additionally, CONTRACTOR and CONTRACTOR’s staff shall comply with all applicable laws, rules or regulations, as may now exist or be hereafter changed. 12. RECORDS CONTRACTOR shall maintain records in accordance with Exhibit F, "Documentation Standards for Client Records", attached hereto and by this reference incorporated herein and made part of this Agreement. COUNTY shall be allowed to review all records of services provided, including the goals and objectives of the treatment plan, and how the therapy provided is achieving the goals and objectives. 13. REPORTS 1. Outcome Reports CONTRACTOR shall submit to COUNTY’s DBH service outcome reports as reasonably requested by COUNTY’s DBH. Outcome reports and outcome requirements are subject to change at COUNTY’s DBH discretion. 2. Additional Reports CONTRACTOR shall also furnish to COUNTY such statements, records, reports, data, and other information as COUNTY’s DBH may reasonably request pertaining to matters covered by this Agreement. In the event that CONTRACTOR fails to provide such reports or other information required hereunder, it shall be deemed sufficient cause for COUNTY to withhold monthly payments until there is compliance. In addition, CONTRACTOR shall provide written notification and explanation to COUNTY within five (5) days of any funds received from another source to conduct the same services covered by this Agreement. 3. Cost Report CONTRACTOR shall provide financial data to identify all direct and indirect costs incurred by the CONTRACTOR for all services delivered under this Agreement. All Cost Reports must be prepared in accordance with Generally Accepted Accounting Principles (GAAP) and Welfare and Institutions Code §§ 5651(a)(4), 5664(a), 5705(b)(3) and 5718(c). Unallowable costs such as lobbying or political donations must be deducted on the cost report and monthly invoice reimbursements. 4. Settlements with State Department of Health Care Services (DHCS) 16 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 During the term of this Agreement and thereafter, COUNTY and CONTRACTOR agree to settle dollar amounts disallowed or settled in accordance with DHCS audit settlement findings related to the reimbursement provided under this Agreement. CONTRACTOR will participate in the several phases of settlements between COUNTY/CONTRACTOR and DHCS. The phases of initial cost reporting for settlement according to State reconciliation of records for paid Medi-Cal services and audit settlement are: State DHCS audit 1) initial cost reporting - after an internal review by COUNTY, the COUNTY files the cost report with State DHCS on behalf of the CONTRACTOR’s legal entity for the fiscal year; 2) Settlement –State reconciliation of records for paid Medi-Cal services, approximately 18 to 36 months following the State close of the fiscal year, DHCS will send notice for any settlement under this provision to the COUNTY; 3) Audit Settlement-State DHCS audit. After final reconciliation and settlement DHCS may conduct a review of medical records, cost report along with support documents submitted to COUNTY in initial submission to determine accuracy and may disallow costs and/or units of services. COUNTY may choose to appeal and therefore reserves the right to defer payback settlement with CONTRACTOR until resolution of the appeal. DHCS Audits will follow Federal Medicaid procedures for managing overpayments. If at the end of the Audit Settlement, the COUNTY determines that it overpaid the CONTRACTOR, it will require the CONTRACTOR to repay the Medi-Cal related overpayment back to the COUNTY. Funds owed to COUNTY will be due within forty-five (45) days of notification by the COUNTY, or COUNTY shall withhold future payments until all excess funds have been recouped by means of an offset against any payments then or thereafter owing to COUNTY under this or any other Agreement between the COUNTY and CONTRACTOR. 14. MONITORING CONTRACTOR agrees to extend to COUNTY’s staff, COUNTY’s DBH Director and the State Department of Health Care Services, or their designees, the right to review and monitor records, services or procedures, at any time, in regard to clients, as well as the overall operation of CONTRACTOR’s performance, in order to ensure compliance with the terms and conditions of this Agreement. 15. REFERENCES TO LAWS AND RULES 17 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 In the event any law, regulation, or policy referred to in this Agreement is amended during the term thereof, the parties hereto agree to comply with the amended provision as of the effective date of such amendment. 16. COMPLIANCE WITH STATE REQUIREMENTS CONTRACTOR recognizes that COUNTY operates its mental health programs under an agreement with the State of California Department Health Care Services, and that under said agreement the State imposes certain requirements on COUNTY and its subcontractors. CONTRACTOR shall adhere to all State requirements, including those identified in Exhibit G “State Mental Health Requirements”, attached hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR shall also file an incident report for all incidents involving clients, following the Protocol and using the W orksheet identified in Exhibit H, attached hereto and by this reference incorporated herein and made part of this Agreement or a protocol and worksheet presented by CONTRACTOR that is accepted by COUNTY’s DBH Director or his or her designee. 17. COMPLIANCE WITH STATE MEDI-CAL REQUIREMENTS CONTRACTOR shall inform every client of their rights under the COUNTY's Mental Health Plan as described in Exhibit I, attached hereto and by this reference incorporated herein and made part of this Agreement. 18. CONFIDENTIALITY All services performed by CONTRACTOR under this Agreement shall be in strict conformance with all applicable Federal, State of California and/or local laws and regulations relating to confidentiality. 19. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT COUNTY and CONTRACTOR each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104- 191 (HIPAA) and agree to use and disclose Protected Health Information (PHI) as required by law. COUNTY and CONTRACTOR acknowledge that the exchange of PHI between them is only for treatment, payment, and health care operations. COUNTY and CONTRACTOR intend to protect the privacy and provide for the security of 18 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 PHI pursuant to the Agreement in compliance with HIPAA, the Health Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA Regulations) and other applicable laws. As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require CONTRACTOR to enter into a contract containing specific requirements prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504€ of the Code of Federal Regulations. 20. DATA SECURITY For the purpose of preventing the potential loss, misappropriation or inadvertent access, viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter into a contractual relationship with the COUNTY for the purpose of providing services under this Agreement must employ adequate data security measures to protect the confidential information provided to CONTRACTOR by the COUNTY, including but not limited to the following: A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices CONTRACTOR may not connect to COUNTY networks via personally-owned mobile, wireless or handheld devices, unless the following conditions are met: 1) CONTRACTOR has received authorization by COUNTY for telecommuting purposes; 2) Current virus protection software is in place; 3) Mobile device has the remote wipe feature enabled; and 4) A secure connection is used. B. CONTRACTOR-Owned Computers or Computer Peripherals CONTRACTOR may not bring CONTRACTOR-owned computers or computer peripherals into the COUNTY for use without prior authorization from the COUNTY’s Chief Information Officer, and/or his or her designee(s), including but not limited to mobile storage devices. If data is approved to be transferred, data must be stored on a secure server approved by the COUNTY and transferred by means of a Virtual Private Network (VPN) connection, or another type of secure connection. 19 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 Said data must be encrypted. C. COUNTY-Owned Computer Equipment CONTRACTOR may not use COUNTY computers or computer peripherals on non- COUNTY premises without prior authorization from the COUNTY’s Chief Information Officer, and/or his or her designee(s). D. CONTRACTOR may not store COUNTY’s private, confidential or sensitive data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted. E. CONTRACTOR shall be responsible to employ strict controls to ensure the integrity and security of COUNTY’s confidential information and to prevent unauthorized access, viewing, use or disclosure of data maintained in computer files, program documentation, data processing systems, data files and data processing equipment which stores or processes COUNTY data internally and externally. F. Confidential client information transmitted to one party by the other by means of electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128 BIT or higher. Additionally, a password or pass phrase must be utilized. G. CONTRACTOR is responsible to immediately notify COUNTY of any violations, breaches or potential breaches of security related to COUNTY’s confidential information, data maintained in computer files, program documentation, data processing systems, data files and data processing equipment which stores or processes COUNTY data internally or externally. H. COUNTY shall provide oversight to CONTRACTOR’s response to all incidents arising from a possible breach of security related to COUNTY’s confidential client information provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected individuals as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be responsible for all costs incurred as a result of providing the required notification. 21. PROPERTY OF COUNTY A. COUNTY and CONTRACTOR recognize that fixed assets are tangible and intangible property obtained or controlled under COUNTY’s Mental Health Plan for use in operational capacity and will benefit COUNTY for a period more than one year. Depreciation of the qualified items will be on a straight-line basis. 20 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 For COUNTY purposes, fixed assets must fulfill three qualifications: 1. Asset must have life span of over one year. 2. The asset is not a repair part 3. The asset must be valued at or greater than the capitalization thresholds for the asset type Asset type Threshold • land $0 • buildings and improvements $100,000 • infrastructure $100,000 • be tangible $5,000 o equipment o vehicles • or intangible asset $100,000 o Internally generated software o Purchased software o Easements o Patents • and capital lease $5,000 Qualified fixed asset equipment is to be reported and approved by COUNTY. If it is approved and identified as an asset it will be tagged with a COUNTY program number. A Fixed asset log will be maintained by COUNTY’s Asset Management System and annual inventoried until the asset is fully depreciated. During the terms of this Agreement, CONTRACTOR’s fixed assets may be inventoried in comparison to COUNTY’s DBH Asset Inventory System. B. Certain purchases less than Five Thousand and No/100 Dollars ($5,000.00) but more than $1,000, with over one year life span, and are mobile and high risk of theft or loss are sensitive assets. Such sensitive items are not limited to computers, copiers, televisions, cameras and other sensitive items as determined by COUNTY’s DBH Director or his or her designee. CONTRACTOR maintains a tracking system on the items and are not required to be capitalize or depreciated. The items are subject to annual inventory for compliance. C. Assets shall be retained by COUNTY, as COUNTY property, in the event this Agreement is terminated or upon expiration of this Agreement. CONTRACTOR agrees to participate in an 21 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 annual inventory of all COUNTY fixed and inventoried assets. Upon termination or expiration of this Agreement CONTRACTOR shall be physically present when fixed and inventoried assets are returned to COUNTY possession. CONTRACTOR is responsible for returning to COUNTY all COUNTY owned undepreciated fixed and inventoried assets, or the monetary value of said assets if unable to produce the assets at the expiration or termination of this Agreement. CONTRACTOR further agrees to the following: 1. To maintain all items of equipment in good working order and condition, normal wear and tear is expected; 2. To label all items of equipment with COUNTY assigned program number, to perform periodic inventories as required by COUNTY and to maintain an inventory list showing where and how the equipment is being used, in accordance with procedures developed by COUNTY. All such lists shall be submitted to COUNTY within ten (10) days of any request therefore; and 3. To report in writing to COUNTY immediately after discovery, the lost or theft of any items of equipment. For stolen items, the local law enforcement agency must be contacted and a copy of the police report submitted to COUNTY. D. The purchase of any equipment by CONTRACTOR with funds provided hereunder shall require the prior written approval of COUNTY’s DBH, shall fulfill the provisions of this Agreement as appropriate, and must be directly related to CONTRACTOR’s services or activity under the terms of this Agreement. COUNTY’s DBH may refuse reimbursement for any costs resulting from equipment purchased, which are incurred by CONTRACTOR, if prior written approval has not been obtained from COUNTY. E. CONTRACTOR must obtain prior written approval from COUNTY’s DBH whenever there is any modification or change in the use of any property acquired or improved, in whole or in part, using funds under this Agreement. If any real or personal property acquired or improved with said funds identified herein is sold and/or is utilized by CONTRACTOR for a use which does not qualify under this Agreement, CONTRACTOR shall reimburse COUNTY in an amount equal to the current fair market value of the property, less any portion thereof attributable to expenditures of funds not provided under this Agreement. These requirements shall continue in effect for the life of the property. In the event this 22 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 Agreement expires, or terminates, the requirements for this Section shall remain in effect for activities or property funded with said funds, unless action is taken by the State government to relieve COUNTY of these obligations 22. NON-DISCRIMINATION During the performance of this Agreement, CONTRACTOR shall not unlawfully discriminate against any employee or applicant for employment, or recipient of services, because of race, religion, color, national origin, ancestry, physical handicap, medical condition, marital status, age or gender, pursuant to all applicable State and Federal statutes and regulations. 23. CULTURAL COMPETENCY As related to Cultural and Linguistic Competence, CONTRACTOR shall comply with: A. Title 6 of the Civil Rights Act of 1964 (42 U.S.C. section 2000d, and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance from discriminating against persons based on race, color, national origin, sex, disability or religion. This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access and participation in federally funded programs through the provision of comprehensive and quality bilingual services. B. Policies and procedures for ensuring access and appropriate use of trained interpreters and material translation services for all LEP clients, including, but not limited to, assessing the cultural and linguistic needs of its clients, training of staff on the policies and procedures, and monitoring its language assistance program. The CONTRACTOR’s procedures must include ensuring compliance of any sub-contracted providers with these requirements. C. CONTRACTOR shall not use minors as interpreters. D. CONTRACTOR shall provide and pay for interpreting and translation services to persons participating in CONTRACTOR’s services who have limited or no English language proficiency, including services to persons who are deaf or blind. Interpreter and translation services shall be provided as necessary to allow such participants meaningful access to the programs, services and benefits provided by CONTRACTOR. Interpreter and translation services, including translation of CONTRACTOR’s “vital documents” (those documents that contain information that is critical for accessing CONTRACTOR’s 23 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 services or are required by law) shall be provided to participants at no cost to the participant. CONTRACTOR shall ensure that any employees, agents, subcontractors, or partners who interpret or translate for a program participant, or who directly communicate with a program participant in a language other than English, demonstrate proficiency in the participant's language and can effectively communicate any specialized terms and concepts peculiar to CONTRACTOR’s services. E. In compliance with the State mandated Culturally and Linguistically Appropriate standards as published by the Office of Minority Health, CONTRACTOR must submit to COUNTY for approval, within sixty (60) days from date of contract execution, CONTRACTOR’s plan to address all fifteen (15) national cultural competency standards as set forth in the “National Standards on Culturally and Linguistically Appropriate Services (CLAS)”. COUNTY’s annual on-site review of CONTRACTOR shall include collection of documentation to ensure all national standards are implemented. As the national competency standards are updated, CONTRACTOR’s plan must be updated accordingly. Cultural competency training for CONTRACTOR’s staff should be substantively integrated into health professions education and training at all levels, both academic and functional, including core curriculum, professional licensure, and continuing professional development programs. CONTRACTOR on a monthly basis shall provide COUNTY DBH a monthly monitoring tool/report that shows all CONTRACTOR’s staff cultural competency trainings completed. 24. AMERICANS WITH DISABILITIES ACT CONTRACTOR agrees to ensure that deliverables developed and produced, pursuant to this Agreement shall comply with the accessibility requirements of Section 508 of the Rehabilitation Act and the Americans with Disabilities Act of 1973 as amended (29 U.S.C. § 794 (d)), and regulations implementing that Act as set forth in Part 1194 of Title 36 of the Code of Federal Regulations. In 1998, Congress amended the Rehabilitation Act of 1973 to require Federal agencies to make their electronic and information technology (EIT) accessible to people with disabilities. California Government Code section 11135 codifies section 508 of the Act requiring accessibility of electronic and information technology. 25. TAX EQUITY AND FISCAL RESPONSIBILITY ACT To the extent necessary to prevent disallowance of reimbursement under section 1861(v)(1) (I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four (4) 24 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 years after the furnishing of services under this Agreement, CONTRACTOR shall make available, upon written request to the Secretary of the United States Department of Health and Human Services, or upon request to the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of this Agreement and such books, documents, and records as are necessary to certify the nature and extent of the costs of these services provided by CONTRACTOR under this Agreement. CONTRACTOR further agrees that in the event CONTRACTOR carries out any of its duties under this Agreement through a subcontract, with a value or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12) month period, with a related organization, such Agreement shall contain a clause to the effect that until the expiration of four (4) years after the furnishing of such services pursuant to such subcontract, the related organizations shall make available, upon written request to the Secretary of the United States Department of Health and Human Services, or upon request to the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of such subcontract and such books, documents, and records of such organization as are necessary to verify the nature and extent of such costs. 26. SINGLE AUDIT CLAUSE A. If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to conduct an annual audit in accordance with the requirements of the Single Audit Standards as set forth in Office of Management and Budget (OMB) Circular A-133. CONTRACTOR shall submit said audit and management letter to COUNTY. The audit must include a statement of findings or a statement that there were no findings. If there were negative findings, CONTRACTOR must include a corrective action plan signed by an authorized individual. CONTRACTOR agrees to take action to correct any material non-compliance or weakness found as a result of such audit. Such audit shall be delivered to COUNTY’s DBH Business Office, for review within nine (9) months of the end of any fiscal year in which funds were expended and/or received for the program. Failure to perform the requisite audit functions as required by this Agreement may result in COUNTY performing the necessary audit tasks, or at COUNTY’s option, contracting with a public accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this Agreement are the sole responsibility of 25 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 CONTRACTOR. B. A single audit report is not applicable if CONTRACTOR’s Federal contracts do not exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement or CONTRACTOR’s only funding is through Drug related Medi-Cal. If a single audit is not applicable, a program audit must be performed and a program audit report with management letter shall be submitted by CONTRACTOR to COUNTY as a minimum requirement to attest to CONTRACTOR’s solvency. Said audit report shall be delivered to COUNTY’s DBH Business Office, for review no later than nine (9) months after the close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a qualified accountant to perform said audit. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this paragraph shall be billed to the CONTRACTOR at COUNTY cost, as determined by COUNTY’s Auditor- Controller/Treasurer-Tax Collector. C. CONTRACTOR shall make available all records and accounts for inspection by COUNTY, the State of California, if applicable, the Comptroller General of the United States, the Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a period of at least three (3) years following final payment under this Agreement or the closure of all other pending matters, whichever is later. 27. COMPLIANCE CONTRACTOR agrees to comply with the COUNTY’s Contractor Code of Conduct and Ethics and the COUNTY’s Compliance Program in accordance with Exhibit E, attached hereto and incorporated herein by reference and made part of this Agreement. Within thirty (30) days of entering into this Agreement with the COUNTY, CONTRACTOR shall have all of CONTRACTOR’s employees, agents and subcontractors providing services under this Agreement certify in writing, that he or she has received, read, understood, and shall abide by the Contractor Code of Conduct and Ethics. CONTRACTOR shall ensure that within thirty (30) days of hire, all new employees, agents and subcontractors providing services under this Agreement shall certify in writing that he or she has received, read, understood, and shall abide 26 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 by the Contractor Code of Conduct and Ethics. CONTRACTOR understands that the promotion of and adherence to the Code of Conduct is an element in evaluating the performance of CONTRACTOR and its employees, agents and subcontractors. Within thirty (30) days of entering into this Agreement, and annually thereafter, all employees, agents and subcontractors providing services under this Agreement shall complete general compliance training and appropriate employees, agents and subcontractors shall complete documentation and billing or billing/reimbursement training. All new employees, agents and subcontractors shall attend the appropriate training within 30 days of hire. Each individual who is required to attend training shall certify in writing that he or she has received the required training. The certification shall specify the type of training received and the date received. The certification shall be provided to the COUNTY’s Compliance Officer at 3133 N. Millbrook, Fresno, California 93703. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of the terms of this Agreement. 28. ASSURANCES In entering into this Agreement, CONTRACTOR certifies that neither it, nor any of its officers, are currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; that neither it, nor any of its officers, have been convicted of a criminal offense related to the provision of health care items or services; nor has it, or any of its officers, been reinstated to participate in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTOR from responsibility for, or involvement with, COUNTY’s business operations related to the Federal Health Care Programs and shall remove such CONTRACTOR from any position in which CONTRACTOR’s compensation, or the items or services rendered, ordered or prescribed by CONTRACTOR may be paid in whole or part, directly or indirectly, by Federal Health Care Programs or otherwise with Federal Funds at least until such time as CONTRACTOR is reinstated into participation in the Federal Health Care Programs. A. If COUNTY has notice that either CONTRACTOR, or its officers, has been charged with a criminal offense related to any Federal Health Care Program, or is proposed for exclusion during the 27 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 term of any contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy of any claims submitted to any Federal Health Care Program. At its discretion given such circumstances, COUNTY may request that CONTRACTOR cease providing services until resolution of the charges or the proposed exclusion. B. CONTRACTOR agrees that all potential new employees of CONTRACTOR or subcontractors of CONTRACTOR who, in each case, are expected to perform professional services under this Agreement, will be queried as to whether (1) they are now or ever have been excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) they have been convicted of a criminal offense related to the provision of health care items or services; and or (3) they have been reinstated to participate in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. 1. In the event the potential employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said employee or subcontractor does no work, either directly or indirectly relating to services provided to COUNTY. 2. Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a time frame to be determined by COUNTY to protect the interests of COUNTY consumers. C. CONTRACTOR shall verify (by asking the applicable employees and subcontractors) that all current employees and existing subcontractors who, in each case, are expected to perform professional services under this Agreement (1) are not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been convicted of a criminal offense related to the provision of health care items or services; and (3) have not been reinstated to participate in the Federal Health Care Program after a period of exclusion, suspension, debarment, or 28 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 ineligibility. In the event any existing employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or has been convicted of a criminal offense relating to the provision of health care services, CONTRACTOR will ensure that said employee or subcontractor does no work, either direct or indirect, relating to services provided to COUNTY. 1. CONTRACTOR agrees to notify COUNTY immediately during the term of this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case, is providing professional services under this Agreement is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense relating to the provision of health care services. 2. Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section 3 of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a time frame to be determined by COUNTY to protect the interests of COUNTY consumers. D. CONTRACTOR agrees to cooperate fully with any reasonable requests for information from COUNTY which may be necessary to complete any internal or external audits relating to CONTRACTOR’s compliance with the provisions of this Section. E. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of CONTRACTOR’s obligations as described in this Section. 29. PUBLICITY PROHIBITION None of the funds, materials, property or services provided directly or indirectly under this Agreement shall be used for CONTRACTOR’s advertising, fundraising, or publicity (i.e., purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. Notwithstanding the above, publicity of the services described in Section One (1) of this Agreement shall be allowed as necessary to raise public awareness about the availability of such specific services when approved in advance by 29 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 COUNTY’s DBH Director or his or her designee and at a cost to be provided in Exhibit B for such items as written/printed materials, the use of media (i.e., radio, television, newspapers) and any other related expense(s). 30. COMPLAINTS CONTRACTOR shall log complaints and the disposition of all complaints from a client or a client's family. CONTRACTOR shall provide a copy of the detailed complaint log entries concerning COUNTY-sponsored clients to COUNTY at monthly intervals by the tenth (l 0th) day of the following month, in a format that is mutually agreed upon. In addition, CONTRACTOR shall provide details and attach documentation of each complaint with the log. CONTRACTOR shall post signs informing clients of their right to file a complaint or grievance. CONTRACTOR shall notify COUNTY of all incidents reportable to State licensing bodies that affect COUNTY clients within twenty-four (24) hours of receipt of a complaint. Within ten (10) days after each incident or complaint affecting COUNTY clients, CONTRACTOR shall provide COUNTY with information relevant to the complaint, investigative details of the complaint, the complaint and CONTRACTOR's disposition of, or corrective action taken to resolve the complaint. In addition, CONTRACTOR shall inform every client of their rights as set forth in Exhibit I. CONTRACTOR shall file an incident report for all incidents involving clients, following the protocol and using the worksheet identified in Exhibit H and incorporated herein by reference and made part of this Agreement. 31. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST INFORMATION This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104, and 455.106(a)(1),(2). In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),(2), the following information must be disclosed by CONTRACTOR by completing Exhibit J, “Disclosure of Ownership and Control Interest Statement”, attached hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR shall submit this form to the COUNTY’s DBH within thirty (30) days of the effective date of this Agreement. Additionally, CONTRACTOR shall report any changes to this information within thirty-five (35) days of occurrence by completing Exhibit J, “Disclosure of Ownership 30 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 and Control Interest Statement.” Submissions shall be scanned pdf copies and are to be sent via email to DBHAdministration@co.fresno.ca.us attention: Contracts Administration. 32. DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS CONTRACTOR is required to disclose if any of the following conditions apply to them, their owners, officers, corporate managers and partners (hereinafter collectively referred to as “CONTRACTOR”): A. Within the three-year period preceding the Agreement award, they have been convicted of, or had a civil judgment rendered against them for: 1. Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; 2. Violation of a federal or state antitrust statute; 3. Embezzlement, theft, forgery, bribery, falsification, or destruction of records; or 4. False statements or receipt of stolen property. B. Within a three-year period preceding their Agreement award, they have had a public transaction (federal, state, or local) terminated for cause or default. Disclosure of the above information will not automatically eliminate CONTRACTOR from further business consideration. The information will be considered as part of the determination of whether to continue and/or renew this Agreement and any additional information or explanation that a CONTRACTOR elects to submit with the disclosed information will be considered. If it is later determined that the CONTRACTOR failed to disclose required information, any contract awarded to such CONTRACTOR may be immediately voided and terminated for material failure to comply with the terms and conditions of the award. CONTRACTOR must sign a “Certification Regarding Debarment, Suspension, and Other Responsibility Matters- Primary Covered Transactions” in the form set forth in Exhibit K, attached hereto and by this reference incorporated herein and made part of this Agreement. Additionally, CONTRACTOR must immediately advise the COUNTY’s DBH in writing if, during the term of this Agreement: (1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for participation in federal or state 31 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 funded programs or from receiving federal funds as listed in the excluded parties’ list system (http://www.epls.gov); or (2) any of the above listed conditions become applicable to CONTRACTOR. CONTRACTOR shall indemnify, defend and hold the COUNTY harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility Matters. 33. DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTOR is operating as a corporation (a for- profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR changes its status to operate as a corporation. Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing transactions that they are a party to while CONTRACTOR is providing goods or performing services under this Agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR is a party and in which one or more of its directors has a material financial interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are a party to by completing and signing a Self-Dealing Transaction Disclosure Form, attached hereto as Exhibit L and incorporated herein by reference and made part of this Agreement, and submitting it to the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter. 34. AUDITS AND INSPECTIONS The CONTRACTOR shall at any time during business hours, and as often as the COUNTY may deem necessary, make available to the COUNTY for examination all of its records and data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to ensure CONTRACTOR’s compliance with the terms of this Agreement. If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), CONTRACTOR shall be subject to the examination and audit of the State Auditor General for a period of three (3) years after final payment under contract (California Government Code section 8546.7). 35. NOTICES The persons having authority to give and receive notices under this Agreement and their 32 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 addresses include the following: COUNTY CONTRACTOR Director, Fresno County Chief Executive Officer Department of Behavioral Health Turning Point of Central California 3133 N. Millbrook Ave P.O. Box 7447 Fresno, CA 93702 Visalia, CA 93290-7447 All notices between the COUNTY and CONTRACTOR provided for or permitted under this Agreement must be in writing and delivered either by personal service, by first-class United States mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by personal service is effective upon service to the recipient. A notice delivered by first-class United States mail is effective three COUNTY business days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the sender maintains a machine record of the completed transmission. For all claims arising out of or related to this Agreement, nothing in this section establishes, waives, or modifies any claims presentation requirements or procedures provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section 810). 36. GOVERNING LAW Venue for any action arising out of or related to the Agreement shall only be in Fresno County, California. The rights and obligations of the parties and all interpretation and performance of this Agreement shall be governed in all respects by the laws of the State of California. 37. ENTIRE AGREEMENT This Agreement, including all Exhibits, constitutes the entire agreement between CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous 33 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 agreement negotiations, proposals, commitments, writings, advertisements, publications, and understandings of any nature whatsoever unless expressly included in this Agreement. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 1 IN WITNESS WHEREOF, the parties hereto have .executed this Agreement as of the day and year 2 first hereinabove written. 3 4 5 TURNING POINT OF CENTRAL CALIFORNIA, INC. 6 7 8 9 COUNTY OF FRESNO ATTEST: Bernice E . Seidel Clerk of the Board of Supervisors County of Fresno , State of California 10 11 12 13 14 15 16 17 18 19 20 21 By: .SU.SU'vv\ ~s)yo·i) Deputy FOR ACCOUNTING USE ONLY : Org No .: 22 Account No.: 23 24 25 26 27 28 56304528 (ICM/OP: $52,694,620) 56304529 (FSP: $10,708 ,965) 7295 34 Exhibit A Page 1 of 8 0302adbh Mental Health Services Act (MHSA) Rural Mental Health Services Program Scope of Work ORGANIZATION: Turning Point of Central California, Inc. CORPORATE ADDRESS: P.O. Box 7447, Visalia Ca 93290 SERVICE ADDRESSES: Pinedale: 34 & 40 East Minarets, Pinedale, CA 93650 Reedley: 1131 I Street, Reedley, CA 93654 Sanger: 225 Academy, Sanger, CA 93657 Selma: 3800 & 3810 McCall Avenue, Selma, CA 93662 Kerman: 275 S. Madera Street, Suite 404, Kerman, CA 93630 Coalinga: 311 Coalinga Plaza, Coalinga, CA 93210 PROGRAM DIRECTOR: David Tan; (559) 476-2176 CONTRACT PERIOD: July 1, 2018 – June 30, 2021, with an option for two (2) twelve (12) month renewal terms BACKGROUND: The Rural Mental Health Services program includes three distinct levels of care - Full Service Partnership (FSP), Intensive Case Management (ICM), and Outpatient (OP) services. These programs are designed to serve clients within Fresno County rural areas that have a severe mental illness (schizophrenia, major depression with psychotic features or bi-polar disorder) and are in need of on-going community based services. The CONTRACTOR’S rural mental health services program will provide the services described below. TARGET POPULATION: The Full Service Partnership (FSP) program will serve an estimated 84 un-duplicated clients at any given point and time, and 176 un-duplicated clients on an annual basis. FSP services will be provided with a focus on recovery, resiliency and wellness. The target population includes adults and children that live in rural Fresno County and have been assessed and determined to be in need of Full Service Partnership (FSP) level of mental health services. This population includes adults with severe mental illness (schizophrenia, major depression with psychotic features or bi-polar disorders), children with serious emotional disturbance, and those adults and/or children who have had recent admissions to the county’s crisis intervention services (CIS), acute inpatient or have been incarcerated. The ICM and OP programs combined will serve approximately 3,200 clients on an annual basis. The Outpatient population includes those who are Medi-Cal eligible and meet the State Department of Mental Health’s medical necessity criteria. CONTRACTOR will provide office based outpatient mental services to include individual, group and family therapy and medication support services. The outpatient mental health services will be accessed through the County’s managed care program and will require prior authorization for services. The vendor staff will provide short-term psychotherapy and medication support services. For individuals who need medications only and do not require mental health specialty services, the vendor will work with United Health Center or other like agencies to develop a collaborative agreement for the provision of primary care services. The Intensive Case Management population includes adults with severe mental illness (schizophrenia, major depression with psychotic features or bi-polar disorders) and children with serious emotional disturbance who are in Exhibit A Page 2 of 8 0302adbh need of on-going community based services. For those clients who have been assessed and determined in need of Rural Mental Health services, services will be provided at six established rural service sites including: Reedley, Pinedale, Sanger, Selma, Kerman, and Coalinga. In addition, those rural clients that do not reside in one of the rural service cities identified will be sought for delivery of services and/or for transportation to services at one of the established rural sites. LOCATION OF SERVICES: CONTRACTOR shall provide FSP, ICM, and OP services at the following established sites: Coalinga, Kerman, Pinedale, Reedley, Selma, and Sanger. Additionally, CONTRACTOR has identified two locations to develop additional program sites; in Mendota and Huron. CONTRACTOR has identified these two locations as a way to provide easier access to services, further increase penetration rates in rural areas, and reducing wait times in nearby communities such as Coalinga and Kerman. DESCRIPTION OF SERVICES: Full Service Partnership CONTRACTOR shall provide case management and crisis outreach services will be available 24 hours a day/7 days a week both telephonically and in person. There shall be a minimum of providing 3 person to person contacts a week with each client. Services include, but may not be limited to: case management, crisis services, medication support, collateral, plan development, assessment, and rehabilitation services as needed. CONTRACTOR shall provide the following specific Full Service Partnership services as it relates to mental health: 1. Provide the following: • Staffing ratio of not more than 1 staff to 15 clients. • Assist clients in accessing all entitlements or benefits for which they are eligible (i.e. Medi-Cal, SSI, Section 8 vouchers etc.). • Develop family support and involvement whenever possible • Develop and maintenance access to supported education and employment opportunities. • Develop and maintain a “representative payee” service to those clients who could benefit from this service. • Develop and provide transportation to enable clients to access health care, mental health services and education, recreational or peer support services in the community. 2. Provide Medication Evaluation either in person or via tele-psychiatry. 3. Provide Peer Support services. 4. Provide Supported Independent Permanent Housing (including locating residences and assisting clients to successfully live in the community). 5. Provide services for Co-Occurring substance abuse disorders. • Identify alcohol, tobacco and drug abuse effects and patterns. Exhibit A Page 3 of 8 0302adbh • Education regarding the interaction of alcohol, tobacco and drug use with psychiatric symptoms and medications. • Developing motivation for deceasing alcohol, tobacco and drug use. • Achieving periods of abstinence and stability. • Use of clinical interventions and peer support recovery groups and activities. • Assisting clients to achieve an alcohol, tobacco and drug free life style. • Education regarding relapse prevention. 6. Develop client self-directed plan of care/wellness and recovery plan. 7. Provide Education and training in independent living skills to include. • Carry out personal hygiene tasks. • Perform household chores, including cooking, laundry and shopping. • Development of money management skills. • Use of community transportation. 8. Transport clients to and from rural service sites as needed. 9. Collaborate with local communities to provide additional services at their locations, as well as establishing new rural sites as circumstances and needs warrant. 10. Outreach to rural clients who are un-served and/or underserved to improve rural penetration rates, with an emphasis on the penetration rates of rural Hispanics. Penetration rates should improve by a minimum of 20% in the first term, and by at least 10% per subsequent term. Intensive Case Management CONTRACTOR shall provide case management and community-based crisis intervention services and shall be available 8 hours a day/ 5 days a week. There shall be a minimum of 1 person to person contact a week with clients. Services include, but may not be limited to: case management, crisis services, medication support, collateral, plan development, assessment, and rehabilitation services as needed. CONTRACTOR shall provide the following specific Intensive Case Management services as it relates to mental health: 1. Provide the following: • Assist clients with accessing all entitlements or benefits for which they are eligible (i.e. Medi-Cal, SSI, Section 8 vouchers etc.). • Develop family support and involvement whenever possible. • Refer clients to supported education and employment opportunities. • Provide transportation service when it is critical to initially access a support service or gain entitlements or benefits. • Provide and services to enable clients to access peer support activities. Exhibit A Page 4 of 8 0302adbh 2. Provide Medication Evaluation either in person or via tele-psychiatry. 3. Assist clients to locate appropriate housing in the community. 4. Refer or provide peer support activities. 5. Provide services for Co-Occurring substance abuse disorders. • Identify alcohol, tobacco and drug abuse effects and patterns. • Education regarding the interaction of alcohol, tobacco and drug use with psychiatric symptoms and medications. • Developing motivation for deceasing alcohol, tobacco and drug use. • Achieving periods of abstinence and stability. • Use of clinical interventions and peer support recovery groups and activities. • Assisting clients to achieve an alcohol, tobacco and drug free life style. • Education regarding relapse prevention. 6. Develop client self-directed plan of care. 7. Transport clients to and from rural service sites as needed. 8. Collaborate with local communities to provide additional services at their locations, as well as establishing new rural sites as circumstances and needs warrant. 9. Outreach to rural clients who are un-served and/or underserved to improve rural penetration rates, with an emphasis on the penetration rates of rural Hispanics. Penetration rates should improve by a minimum of 20% in the first term, and by at least 10% per subsequent term. Outpatient CONTRACTOR shall provide mental health outpatient services (individual, group and family therapy, and medication support) to adult clients. Services include, but may not be limited to: case management, crisis services, medication support, collateral, plan development, assessment, and rehabilitation services as needed. CONTRACTOR shall provide the following specific Full Service Partnership services as it relates to mental health: 1. Ensure CONTRACTOR staff provides appropriate age, culture, gender and language services and accommodations for physical disability(ies) to clients. 2. Make appropriate referrals and linkages to addiction services that are beyond that of the Rural Outpatient Mental Health services program to individuals with coexisting alcohol, tobacco and drug abuse and other addictive symptoms. 3. Provide support to the client’s family and other members of the client’s social network to help them manage the symptoms and illness of the client and reduce the level of family and social stress associated with the illness. 4. Coordinate services with other community mental health and non-mental health providers, as well as other medical professionals. Methods for service coordination and communication between vendor and other service providers serving the same clients shall be developed and implemented consistent with Fresno County confidentiality rules. Exhibit A Page 5 of 8 0302adbh 5. Selected Vendor shall maintain an up to date caseload record of all clients enrolled in services, and provide client, programmatic, and other demographic information to the County. Reports are to be submitted to the DBH Mental Health Services Act Division Manager or MHSA Staff Analyst on a monthly basis. 6. Selected bidder(s) shall compile quarterly reports indicating the total number of clients served in a particular Fiscal Year. 7. Ensure billable Mental Health Specialty Services meet any/all County, State, Federal regulations including any utilization review and quality assurance standards. Provide all pertinent and appropriate information in a timely manner to County to bill Medi-Cal for services rendered. 8. Transport clients to and from rural service sites as needed. 9. Collaborate with local communities to provide additional services at their locations, as well as establishing new rural sites as circumstances and needs warrant. 10. Outreach to rural clients who are un-served and/or underserved to improve rural penetration rates, with an emphasis on the penetration rates of rural Hispanics. Penetration rates should improve by a minimum of 20% in the first term, and by at least 10% per subsequent term. STAFFING: CONTRACTOR’s staff shall be trained in the purpose, mission, philosophy, and method of the FSP Program during their new hire orientation and annually throughout the course of their employment. Ongoing training shall include topics such as clinical, administrative, operational, human resource, cultural, and information technology areas. Additionally, cultural competency, motivational interviewing, W RAP skills, Criminogenic Risk Factors, and specialized clinical training shall also be utilized. Specific FSP service delivery training shall include: • Trauma Informed and Trauma Responsive Methods and Processes • Cultural Awareness and Responsiveness • Strength Based, Person Driven Plan Development and Natural Support Inclusion • Health and Wellness Promotion, Illness and Harm Prevention, and Stigma Reduction HOURS OF OPERATION: CONTRACTOR shall provide direct service appointments at all rural locations within the following schedule: Monday - Friday: 8:00AM – 5:00PM Additionally, CONTRACTOR shall provide operational and clinical services in the field as needed, and temporarily extend office hours in order to accommodate and increase timeliness of services. CONTRACTOR staff shall be available to provide crisis services to clients 24 hours per day, seven (7) days per week. CONTRACTOR shall respond within 1 hour of initial inquiry from clients. AVERAGE CLIENT LEGNTH OF STAY: The average length of stay for clients is 2.5 years for the FSP Program, 0.5 years for the ICM Program, and 2 years for the OP Program. Exhibit A Page 6 of 8 0302adbh COUNTY RESPONSIBILITIES: COUNTY shall: 1. Provide oversight (through the County Department of Behavioral Health (DBH), Adult System of Care, and the Mental Health Services Act, Division Managers or designees) of the CONTRACTOR’S Rural FSP program. In addition to contract monitoring of program, oversight includes, but not limited to, coordination with the State Department of Mental Health, Mental Health Services Act in regard to program administration and outcomes. 2. Assist the CONTRACTOR in making linkages with the total mental health system. This will be accomplished through regularly scheduled meetings as well as formal and informal consultation, 3. Participate in evaluating the progress of the overall program and the efficiency of collaboration with the vendor staff and will be available to the contractor for ongoing consultation. 4. Receive and analyze statistical data outcome information from vendor throughout the term of contract on a monthly basis. DBH will notify the vendor when additional participation is required. The performance outcome measurement process will not be limited to survey instruments but will also include, as appropriate, client and staff interviews, chart reviews, and other methods of obtaining required information. 5. Recognize that cultural competence is a goal toward which professionals, agencies, and systems should strive. Becoming culturally competent is a developmental process and incorporates at all levels the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally-unique needs. Offering those services in a manner that fails to achieve its intended result due to cultural and linguistic barriers is not cost effective. To assist the vendor efforts towards cultural and linguistic competency, DBH shall provide the following at no cost to vendor(s): A. Technical assistance to vendor regarding cultural competency requirements and sexual orientation training. B. Mandatory cultural competency training including sexual orientation and sensitivity training for DBH and vendor personnel, at minimum once per year. County will provide mandatory training regarding the special needs of this diverse population and will be included in the cultural competence training(s). Sexual orientation and sensitivity to gender differences is a basic cultural competence principle and shall be included in the cultural competency training. Literature suggests that the mental health needs of lesbian, gay, bisexual, transgender (LGBT) individuals may be at increased risk for mental disorders and mental health problems due to exposure to societal stressors such as stigmatization, prejudice and anti-gay violence. Social support may be critical for this population. Access to care may be limited due to concerns about providers’ sensitivity to differences in sexual orientation. C. Technical assistance for vendor in translating behavioral health and substance abuse services information into DBH’s threshold languages (Spanish, Laotian, Cambodian and Hmong). Translation services and costs associated will be the responsibility of the vendor. PROGRAM OBJECTIVES AND OUTCOMES CONTRACTOR shall utilize a computerized tracking system with which performance and outcome measures and other relevant client data, such as demographics, will be maintained. The data tracking system may be incorporated into CONTRACTOR’S electronic health records (EHR) system or be a stand-alone database. DBH must be afforded read only access to the data tracking system. The following items listed below represent program goals to be tracked and achieved by the vendor during the contract terms. Exhibit A Page 7 of 8 0302adbh Full Service Partnership 1. Effectiveness a. Psychiatric Hospitalizations – To assess the degree of effectiveness for FSP level services, CONTRACTOR will track decreases in the number of days hospitalized post- enrollment and compare to the total number of days spent in the psychiatric setting 12 months prior to program enrollment. b. Incarcerations – To reduce the total number of days spent confined in a jail or prison setting, CONTRACTOR will track decreases and compare to the total number of days spent incarcerated 12 months prior to program enrollment c. Homelessness – To reduce the total number of days spent homeless, CONTRACTOR will track decreases and compare to the total number of days spent homeless 12 months prior to program enrollment. d. Medical Hospitalizations – To reduce the total number of days spent in a hospital or emergency department setting, CONTRACTOR will track decreases and compare to the total number of days hospitalized 12 months prior to program enrollment. e. Housing – Clients in independent housing will develop a plan for assisting in paying their own housing costs. Clients will assume responsibility for housing costs when deemed ready and appropriate. f. Supplemental Security Income – Within six months of enrollment, ninety-nine percent (99%) of clients without SSI will have made SSI applications. CONTRACTOR shall provide a written report regarding these goals on a semi-annual basis. g. Productivity – Direct service productivity rate shall be a minimum of eighty percent (80%). h. Reaching Recovery – To track the degree of change across multiple domains of wellness, CONTRACTOR will utilize tools designed to measure recovery. 2. Efficiency a. Cost Per Client – CONTRACTOR will efficiently use resources and maintain or minimize costs per client. Costs include all staffing and overhead costs associated with program operations. 3. Access a. Length of Time from Referral to First Contact – CONTRACTOR will provide timely service for clients requesting services. The goal wait time from referral to first contact is within 3 business days. b. Length of Time from Referral to First Intake/Assessment Appointment – The goal wait time from referral to first intake/assessment appointment is within 10 business days. c. Length of Time from Referral to First Psychiatry Appointment – The goal wait time from referral to first psychiatry appointment is within 15 business days. 4. Satisfaction a. Consumer Perception Survey – CONTRACTOR will gauge satisfaction of clients and collect data for service planning and quality improvement. The surveys are conducted every six months over a week period. Program beneficiaries are encouraged to Exhibit A Page 8 of 8 0302adbh participate in completing the survey. The goal is for 75% of clients to be satisfied for each domain. Intensive Case Management / Outpatient 1. Effectiveness a. Psychiatric Hospitalization – To prevent hospitalizations and re-admissions for clients, CONTRACTOR will provide effective preventive interventions and provide timely post-hospitalization follow up services. The goal expectancy is for 10% or less of ICM/OP clients served to experience a psychiatric hospitalization. Post- hospitalization follow up services will occur within 10 days or less. b. Inpatient Crisis Stabilization Services – To prevent crisis stabilization services and re-occurrence of crisis stabilization services, CONTRACTOR will provide effective preventative interventions and timely post-crisis stabilization follow up services. The goal is for 10% or less of ICM/OP clients served to experience a crisis stabilization service. c. Compliance – CONTRACTOR will comply with all requirements of the Department of Behavioral Health Managed Care Organizational Provider Manual. d. Supplemental Security Income – Within six months of enrollment, ninety-nine percent (99%) of clients without SSI will have made SSI applications. CONTRACTOR shall provide a written report regarding these goals on a semi-annual basis. e. Productivity – Direct service productivity rate shall be a minimum of eighty percent (80%). f. Reaching Recovery – CONTRACTOR will track the degree of change across multiple domains of wellness utilizing tools designed to measure recovery. 2. Efficiency a. Cost Per Client – CONTRACTOR will efficiently use resources and maintain or minimize costs per client. 3. Access a. Length of Time from Referral to First Contact – CONTRACTOR will provide timely service for clients requesting services. The goal wait time from referral to first contact is within 3 business days. b. Length of Time from Referral to First Intake/Assessment Appointment – The goal wait time from referral to first intake/assessment appointment is within 10 business days. c. Length of Time from Referral to First Psychiatry Appointment – The goal wait time from referral to first psychiatry appointment is within 15 business days. 4. Satisfaction a. Consumer Perception Survey – CONTRACTOR will gauge satisfaction of clients and collect data for service planning and quality improvement. The surveys are conducted every six months over a week period. Program beneficiaries are encouraged to participate in completing the survey. The goal is for 75% of clients to be satisfied for each domain. FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.16 $16,417 $16,417 0002 ASSISTANT PROGRAM DIRECTOR 0.64 $54,719 $54,719 0003 MHP/TEAM LEAD 4.21 $319,656 $319,656 0004 SUPERVISING PSC 0.48 $25,991 $25,991 0005 CASE MANAGER 3.84 $185,863 $185,863 0006 DRIVER 0.48 $12,568 $12,568 0007 NURSE 1.28 $69,275 $69,275 0008 NURSE SUPERVISOR 0.16 $9,265 $9,265 0009 PEER SUPPORT 0.48 $14,583 $14,583 0010 ADMITTING INTERVIEWER/SECRETARY 2.24 $82,768 $82,768 0011 BILLING CLERK 0.32 $12,914 $12,914 0012 ADMINISTRATIVE ASSISTANT 0.16 $7,669 $7,669 0013 ADMINISTRATIVE SUPERVISOR 0.16 $7,616 $7,616 SALARY TOTAL 14.61 $0 $819,304 $819,304 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $68,492 $68,492 0032 SUI $3,031 $3,031 0033 ACCRUED PAID LEAVE $87,747 $87,747 PAYROLL TAX TOTAL $0 $159,270 $159,270 EMPLOYEE BENEFITS: 0040 Retirement $13,343 $13,343 0041 Workers Compensation $11,664 $11,664 0042 Health Insurance (medical, vision, life, dental)$124,512 $124,512 EMPLOYEE BENEFITS TOTAL $0 $149,519 $149,519 SALARY & BENEFITS GRAND TOTAL $1,128,093 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $54,400 1011 Rent/Lease Equipment $0 1012 Utilities $6,728 1013 Building Maintenance $10,744 1014 Equipment Maintenance $2,920 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $74,792 Line Item Description (Must be itemized) RURAL MENTAL HEALTH FULL SERVICE PARTNERSHIP (FSP) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2018-2019 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION Exhibit B OPERATING EXPENSES: 1060 Telephone $25,840 1061 Answering Service $0 1062 Postage $800 1063 Printing/Reproduction $2,536 1064 Publications $1,520 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $3,840 1067 Household Supplies $3,040 1068 Food $1,976 1069 Program Supplies - Therapeutic $4,640 1070 Program Supplies - Medical $3,760 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $44,136 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $4,000 1075 Lodging $824 1076 Other - (Vehicle Insurance/ Vehicle Lease)$23,904 1077 Other - (Client Activities/Outreach Events)$5,020 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$2,912 1078 Other - (Recruitment)$784 1078 Other - (Employee-Employer Relations)$2,800 1079 Licenses $14,400 OPERATING EXPENSES TOTAL $146,732 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $896 1082 Liability Insurance $4,816 1083 Administrative Overhead $256,918 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $262,630 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$4,160 1091 Translation Services $5,760 1092 Medication Supports $17,800 1093 O/S Labor Clinical - Counselor $5,280 1094 O/S Labor Clinical - Nurse $480 1095 O/S Labor Clinical - Psychiatrist $216,323 SPECIAL EXPENSES TOTAL $249,803 FIXED ASSETS: 1190 Computers & Software $3,420 1191 Furniture & Fixtures $5,400 1192 Other - (Expendable Equipment)$8,004 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $16,824 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$75,905 2001 Client Housing Operating Expenditures (SFC 71)$1,400 2002.1 Clothing, Food & Hygiene (SFC 72)$15,100 2002.2 Client Transportation & Support (SFC 72)$1,216 2002.3 Education Support (SFC 72)$1,090 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $94,711 TOTAL PROGRAM EXPENSES $1,973,585 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)50,373 $2.59 $130,561 3100 Case Management 73,492 $1.22 $89,830 3200 Crisis Services 9,354 $2.35 $21,961 3300 Medication Support 43,878 $4.01 $176,048 3400 Collateral 24,842 $2.59 $64,388 3500 Plan Development 5,596 $2.59 $14,504 3600 Assessment 8,719 $2.59 $22,599 3700 Rehabilitation 144,291 $2.59 $373,987 Estimated Specialty Mental Health Services Billing Totals 360,545 $893,878 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $893,878 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$698,391 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$195,487 MEDI-CAL REVENUE TOTAL $893,878 OTHER REVENUE: 4000 Other - (Client Fees)$1,500 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $1,500 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $1,078,207 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $1,078,207 TOTAL PROGRAM REVENUE $1,973,585 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.16 $16,912 $16,912 0002 ASSISTANT PROGRAM DIRECTOR 0.64 $56,367 $56,367 0003 MHP/TEAM LEAD 4.21 $336,178 $336,178 0004 SUPERVISING PSC 0.48 $27,450 $27,450 0005 CASE MANAGER 3.84 $194,759 $194,759 0006 DRIVER 0.48 $13,285 $13,285 0007 NURSE 1.28 $71,960 $71,960 0008 NURSE SUPERVISOR 0.16 $9,546 $9,546 0009 PEER SUPPORT 0.48 $15,262 $15,262 0010 ADMITTING INTERVIEWER/SECRETARY 2.24 $86,088 $86,088 0011 BILLING CLERK 0.32 $13,306 $13,306 0012 ADMINISTRATIVE ASSISTANT 0.16 $7,902 $7,902 0013 ADMINISTRATIVE SUPERVISOR 0.16 $8,160 $8,160 SALARY TOTAL 14.61 $0 $857,175 $857,175 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $71,656 $71,656 0032 SUI $3,031 $3,031 0033 ACCRUED PAID LEAVE $91,771 $91,771 PAYROLL TAX TOTAL $0 $166,458 $166,458 EMPLOYEE BENEFITS: 0040 Retirement $13,959 $13,959 0041 Workers Compensation $12,203 $12,203 0042 Health Insurance (medical, vision, life, dental)$124,525 $124,525 EMPLOYEE BENEFITS TOTAL $0 $150,687 $150,687 SALARY & BENEFITS GRAND TOTAL $1,174,320 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $57,120 1011 Rent/Lease Equipment $0 1012 Utilities $7,064 1013 Building Maintenance $11,281 1014 Equipment Maintenance $3,066 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $78,531 Line Item Description (Must be itemized) RURAL MENTAL HEALTH FULL SERVICE PARTNERSHIP (FSP) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2019-2020 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $27,132 1061 Answering Service $0 1062 Postage $840 1063 Printing/Reproduction $2,663 1064 Publications $1,596 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $4,032 1067 Household Supplies $3,192 1068 Food $2,075 1069 Program Supplies - Therapeutic $4,872 1070 Program Supplies - Medical $3,948 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $46,343 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $4,200 1075 Lodging $865 1076 Other - (Vehicle Insurance/ Vehicle Lease)$25,099 1077 Other - (Client Activities/Outreach Events)$5,271 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$3,058 1078 Other - (Recruitment)$823 1078 Other - (Employee-Employer Relations)$2,940 1079 Licenses $15,120 OPERATING EXPENSES TOTAL $154,069 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $941 1082 Liability Insurance $5,057 1083 Administrative Overhead $268,236 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $274,234 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$4,368 1091 Translation Services $6,048 1092 Medication Supports $18,690 1093 O/S Labor Clinical - Counselor $5,544 1094 O/S Labor Clinical - Nurse $504 1095 O/S Labor Clinical - Psychiatrist $227,139 SPECIAL EXPENSES TOTAL $262,293 FIXED ASSETS: 1190 Computers & Software $672 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$16,153 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $16,825 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$79,700 2001 Client Housing Operating Expenditures (SFC 71)$1,470 2002.1 Clothing, Food & Hygiene (SFC 72)$15,855 2002.2 Client Transportation & Support (SFC 72)$1,277 2002.3 Education Support (SFC 72)$1,145 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $99,447 TOTAL PROGRAM EXPENSES $2,059,719 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)54,792 $2.59 $142,015 3100 Case Management 84,015 $1.22 $102,693 3200 Crisis Services 9,472 $2.35 $22,238 3300 Medication Support 46,814 $4.01 $187,827 3400 Collateral 26,133 $2.59 $67,734 3500 Plan Development 6,374 $2.59 $16,521 3600 Assessment 11,202 $2.59 $29,034 3700 Rehabilitation 148,945 $2.59 $386,049 Estimated Specialty Mental Health Services Billing Totals 387,747 $954,111 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $954,111 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$745,451 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$208,660 MEDI-CAL REVENUE TOTAL $954,111 OTHER REVENUE: 4000 Other - (Client Fees)$1,500 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $1,500 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $1,104,108 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $1,104,108 TOTAL PROGRAM REVENUE $2,059,719 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.16 $17,422 $17,422 0002 ASSISTANT PROGRAM DIRECTOR 0.64 $58,066 $58,066 0003 MHP/TEAM LEAD 4.21 $350,539 $350,539 0004 SUPERVISING PSC 0.48 $29,003 $29,003 0005 CASE MANAGER 3.84 $203,241 $203,241 0006 DRIVER 0.48 $13,861 $13,861 0007 NURSE 1.28 $74,767 $74,767 0008 NURSE SUPERVISOR 0.16 $9,835 $9,835 0009 PEER SUPPORT 0.48 $15,847 $15,847 0010 ADMITTING INTERVIEWER/SECRETARY 2.24 $89,124 $89,124 0011 BILLING CLERK 0.32 $13,709 $13,709 0012 ADMINISTRATIVE ASSISTANT 0.16 $8,141 $8,141 0013 ADMINISTRATIVE SUPERVISOR 0.16 $8,744 $8,744 SALARY TOTAL 14.61 $0 $892,299 $892,299 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $74,590 $74,590 0032 SUI $3,031 $3,031 0033 ACCRUED PAID LEAVE $95,503 $95,503 PAYROLL TAX TOTAL $0 $173,124 $173,124 EMPLOYEE BENEFITS: 0040 Retirement $14,531 $14,531 0041 Workers Compensation $12,703 $12,703 0042 Health Insurance (medical, vision, life, dental)$124,536 $124,536 EMPLOYEE BENEFITS TOTAL $0 $151,770 $151,770 SALARY & BENEFITS GRAND TOTAL $1,217,193 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $59,976 1011 Rent/Lease Equipment $0 1012 Utilities $7,418 1013 Building Maintenance $11,845 1014 Equipment Maintenance $3,219 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $82,458 Line Item Description (Must be itemized) RURAL MENTAL HEALTH FULL SERVICE PARTNERSHIP (FSP) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2020-2021 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $28,489 1061 Answering Service $0 1062 Postage $882 1063 Printing/Reproduction $2,796 1064 Publications $1,676 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $4,234 1067 Household Supplies $3,352 1068 Food $2,179 1069 Program Supplies - Therapeutic $5,116 1070 Program Supplies - Medical $4,145 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $48,660 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $4,410 1075 Lodging $908 1076 Other - (Vehicle Insurance/ Vehicle Lease)$26,354 1077 Other - (Client Activities/Outreach Events)$5,535 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$3,210 1078 Other - (Recruitment)$864 1078 Other - (Employee-Employer Relations)$3,087 1079 Licenses $15,876 OPERATING EXPENSES TOTAL $161,773 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $988 1082 Liability Insurance $5,310 1083 Administrative Overhead $279,270 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $285,568 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$4,586 1091 Translation Services $6,350 1092 Medication Supports $19,625 1093 O/S Labor Clinical - Counselor $5,821 1094 O/S Labor Clinical - Nurse $529 1095 O/S Labor Clinical - Psychiatrist $238,496 SPECIAL EXPENSES TOTAL $275,407 FIXED ASSETS: 1190 Computers & Software $706 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$16,961 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $17,667 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$83,685 2001 Client Housing Operating Expenditures (SFC 71)$1,544 2002.1 Clothing, Food & Hygiene (SFC 72)$16,648 2002.2 Client Transportation & Support (SFC 72)$1,341 2002.3 Education Support (SFC 72)$1,202 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $104,419 TOTAL PROGRAM EXPENSES $2,144,485 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)54,792 $2.59 $142,015 3100 Case Management 84,016 $1.22 $102,694 3200 Crisis Services 9,473 $2.35 $22,241 3300 Medication Support 46,814 $4.01 $187,827 3400 Collateral 26,133 $2.59 $67,734 3500 Plan Development 6,373 $2.59 $16,518 3600 Assessment 11,202 $2.59 $29,034 3700 Rehabilitation 148,945 $2.59 $386,049 Estimated Specialty Mental Health Services Billing Totals 387,748 $954,112 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $954,112 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$745,452 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$208,660 MEDI-CAL REVENUE TOTAL $954,112 OTHER REVENUE: 4000 Other - (Client Fees)$1,500 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $1,500 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $1,188,873 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $1,188,873 TOTAL PROGRAM REVENUE $2,144,485 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.16 $17,948 $17,948 0002 ASSISTANT PROGRAM DIRECTOR 0.64 $59,815 $59,815 0003 MHP/TEAM LEAD 4.21 $361,818 $361,818 0004 SUPERVISING PSC 0.48 $30,249 $30,249 0005 CASE MANAGER 3.84 $211,220 $211,220 0006 DRIVER 0.48 $14,467 $14,467 0007 NURSE 1.28 $77,356 $77,356 0008 NURSE SUPERVISOR 0.16 $10,133 $10,133 0009 PEER SUPPORT 0.48 $16,458 $16,458 0010 ADMITTING INTERVIEWER/SECRETARY 2.24 $91,824 $91,824 0011 BILLING CLERK 0.32 $14,124 $14,124 0012 ADMINISTRATIVE ASSISTANT 0.16 $8,388 $8,388 0013 ADMINISTRATIVE SUPERVISOR 0.16 $9,369 $9,369 SALARY TOTAL 14.61 $0 $923,169 $923,169 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $77,168 $77,168 0032 SUI $3,031 $3,031 0033 ACCRUED PAID LEAVE $98,768 $98,768 PAYROLL TAX TOTAL $0 $178,967 $178,967 EMPLOYEE BENEFITS: 0040 Retirement $15,033 $15,033 0041 Workers Compensation $13,142 $13,142 0042 Health Insurance (medical, vision, life, dental)$124,546 $124,546 EMPLOYEE BENEFITS TOTAL $0 $152,721 $152,721 SALARY & BENEFITS GRAND TOTAL $1,254,857 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $62,975 1011 Rent/Lease Equipment $0 1012 Utilities $7,789 1013 Building Maintenance $12,438 1014 Equipment Maintenance $3,380 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $86,582 Line Item Description (Must be itemized) RURAL MENTAL HEALTH FULL SERVICE PARTNERSHIP (FSP) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2021-2022 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $29,913 1061 Answering Service $0 1062 Postage $926 1063 Printing/Reproduction $2,936 1064 Publications $1,760 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $4,445 1067 Household Supplies $3,519 1068 Food $2,287 1069 Program Supplies - Therapeutic $5,371 1070 Program Supplies - Medical $4,353 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $51,093 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $4,631 1075 Lodging $954 1076 Other - (Vehicle Insurance/ Vehicle Lease)$27,672 1077 Other - (Client Activities/Outreach Events)$5,811 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$3,371 1078 Other - (Recruitment)$908 1078 Other - (Employee-Employer Relations)$3,241 1079 Licenses $16,670 OPERATING EXPENSES TOTAL $169,861 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $1,037 1082 Liability Insurance $5,575 1083 Administrative Overhead $289,753 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $296,365 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$4,816 1091 Translation Services $6,668 1092 Medication Supports $20,606 1093 O/S Labor Clinical - Counselor $6,112 1094 O/S Labor Clinical - Nurse $556 1095 O/S Labor Clinical - Psychiatrist $250,421 SPECIAL EXPENSES TOTAL $289,179 FIXED ASSETS: 1190 Computers & Software $741 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$17,809 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $18,550 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$87,870 2001 Client Housing Operating Expenditures (SFC 71)$1,621 2002.1 Clothing, Food & Hygiene (SFC 72)$17,480 2002.2 Client Transportation & Support (SFC 72)$1,408 2002.3 Education Support (SFC 72)$1,262 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $109,641 TOTAL PROGRAM EXPENSES $2,225,035 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)54,792 $2.59 $142,015 3100 Case Management 84,016 $1.22 $102,694 3200 Crisis Services 9,472 $2.35 $22,238 3300 Medication Support 46,814 $4.01 $187,827 3400 Collateral 26,133 $2.59 $67,734 3500 Plan Development 6,373 $2.59 $16,518 3600 Assessment 11,203 $2.59 $29,037 3700 Rehabilitation 148,945 $2.59 $386,049 Estimated Specialty Mental Health Services Billing Totals 387,748 $954,112 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $954,112 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$745,452 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$208,660 MEDI-CAL REVENUE TOTAL $954,112 OTHER REVENUE: 4000 Other - (Client Fees)$1,500 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $1,500 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $1,269,423 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $1,269,423 TOTAL PROGRAM REVENUE $2,225,035 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.16 $18,489 $18,489 0002 ASSISTANT PROGRAM DIRECTOR 0.64 $61,618 $61,618 0003 MHP/TEAM LEAD 4.21 $373,030 $373,030 0004 SUPERVISING PSC 0.48 $31,560 $31,560 0005 CASE MANAGER 3.84 $218,218 $218,218 0006 DRIVER 0.48 $14,905 $14,905 0007 NURSE 1.28 $80,045 $80,045 0008 NURSE SUPERVISOR 0.16 $10,441 $10,441 0009 PEER SUPPORT 0.48 $16,957 $16,957 0010 ADMITTING INTERVIEWER/SECRETARY 2.24 $94,607 $94,607 0011 BILLING CLERK 0.32 $14,552 $14,552 0012 ADMINISTRATIVE ASSISTANT 0.16 $8,642 $8,642 0013 ADMINISTRATIVE SUPERVISOR 0.16 $10,039 $10,039 SALARY TOTAL 14.61 $0 $953,103 $953,103 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $79,668 $79,668 0032 SUI $3,031 $3,031 0033 ACCRUED PAID LEAVE $101,940 $101,940 PAYROLL TAX TOTAL $0 $184,639 $184,639 EMPLOYEE BENEFITS: 0040 Retirement $15,520 $15,520 0041 Workers Compensation $13,567 $13,567 0042 Health Insurance (medical, vision, life, dental)$124,556 $124,556 EMPLOYEE BENEFITS TOTAL $0 $153,643 $153,643 SALARY & BENEFITS GRAND TOTAL $1,291,385 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $66,124 1011 Rent/Lease Equipment $0 1012 Utilities $8,178 1013 Building Maintenance $13,059 1014 Equipment Maintenance $3,549 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $90,910 Line Item Description (Must be itemized) RURAL MENTAL HEALTH FULL SERVICE PARTNERSHIP (FSP) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2022-2023 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $31,409 1061 Answering Service $0 1062 Postage $972 1063 Printing/Reproduction $3,083 1064 Publications $1,848 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $4,668 1067 Household Supplies $3,695 1068 Food $2,402 1069 Program Supplies - Therapeutic $5,640 1070 Program Supplies - Medical $4,570 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $53,648 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $4,862 1075 Lodging $1,002 1076 Other - (Vehicle Insurance/ Vehicle Lease)$29,055 1077 Other - (Client Activities/Outreach Events)$6,102 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$3,540 1078 Other - (Recruitment)$953 1078 Other - (Employee-Employer Relations)$3,403 1079 Licenses $17,503 OPERATING EXPENSES TOTAL $178,355 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $1,089 1082 Liability Insurance $5,854 1083 Administrative Overhead $300,312 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $307,255 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$5,057 1091 Translation Services $7,001 1092 Medication Supports $21,636 1093 O/S Labor Clinical - Counselor $6,418 1094 O/S Labor Clinical - Nurse $583 1095 O/S Labor Clinical - Psychiatrist $262,942 SPECIAL EXPENSES TOTAL $303,637 FIXED ASSETS: 1190 Computers & Software $778 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$18,699 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $19,477 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$92,263 2001 Client Housing Operating Expenditures (SFC 71)$1,702 2002.1 Clothing, Food & Hygiene (SFC 72)$18,354 2002.2 Client Transportation & Support (SFC 72)$1,478 2002.3 Education Support (SFC 72)$1,325 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $115,122 TOTAL PROGRAM EXPENSES $2,306,141 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)54,792 $2.59 $142,015 3100 Case Management 84,016 $1.22 $102,694 3200 Crisis Services 9,473 $2.35 $22,241 3300 Medication Support 46,814 $4.01 $187,827 3400 Collateral 26,133 $2.59 $67,734 3500 Plan Development 6,373 $2.59 $16,518 3600 Assessment 11,202 $2.59 $29,034 3700 Rehabilitation 148,945 $2.59 $386,049 Estimated Specialty Mental Health Services Billing Totals 387,748 $954,112 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $954,112 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$745,452 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$208,660 MEDI-CAL REVENUE TOTAL $954,112 OTHER REVENUE: 4000 Other - (Client Fees)$1,500 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $1,500 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $1,350,529 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $1,350,529 TOTAL PROGRAM REVENUE $2,306,141 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.84 $86,189 $86,189 0002 ASSISTANT PROGRAM DIRECTOR 3.36 $287,274 $287,274 0003 MHP/TEAM LEAD 22.09 $1,678,195 $1,678,195 0004 SUPERVISING PSC 2.52 $136,450 $136,450 0005 CASE MANAGER 20.16 $975,778 $975,778 0006 DRIVER 2.52 $65,984 $65,984 0007 NURSE 6.72 $363,696 $363,696 0008 NURSE SUPERVISOR 0.84 $48,644 $48,644 0009 PEER SUPPORT 2.52 $76,561 $76,561 0010 ADMITTING INTERVIEWER/SECRETARY 11.76 $434,533 $434,533 0011 BILLING CLERK 1.68 $67,801 $67,801 0012 ADMINISTRATIVE ASSISTANT 0.84 $40,265 $40,265 0013 ADMINISTRATIVE SUPERVISOR 0.84 $39,981 $39,981 SALARY TOTAL 76.69 $0 $4,301,351 $4,301,351 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $359,581 $359,581 0032 SUI $15,913 $15,913 0033 ACCRUED PAID LEAVE $460,672 $460,672 PAYROLL TAX TOTAL $0 $836,166 $836,166 EMPLOYEE BENEFITS: 0040 Retirement $70,048 $70,048 0041 Workers Compensation $61,236 $61,236 0042 Health Insurance (medical, vision, life, dental)$653,690 $653,690 EMPLOYEE BENEFITS TOTAL $0 $784,974 $784,974 SALARY & BENEFITS GRAND TOTAL $5,922,491 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $285,600 1011 Rent/Lease Equipment $0 1012 Utilities $35,322 1013 Building Maintenance $56,406 1014 Equipment Maintenance $15,330 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $392,658 Line Item Description (Must be itemized) RURAL MENTAL HEALTH OUTPATIENT / INTENSIVE CASE MANAGEMENT (OP/ICM) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2018-2019 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $135,660 1061 Answering Service $0 1062 Postage $4,200 1063 Printing/Reproduction $13,314 1064 Publications $7,980 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $20,160 1067 Household Supplies $15,960 1068 Food $10,374 1069 Program Supplies - Therapeutic $24,360 1070 Program Supplies - Medical $19,740 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $231,714 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $21,000 1075 Lodging $4,326 1076 Other - (Vehicle Insurance/ Vehicle Lease)$125,496 1077 Other - (Client Activities/Outreach Events)$26,355 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$15,288 1078 Other - (Recruitment)$4,116 1078 Other - (Employee-Employer Relations)$14,700 1079 Licenses $75,600 OPERATING EXPENSES TOTAL $770,343 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $4,704 1082 Liability Insurance $25,284 1083 Administrative Overhead $1,268,063 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $1,298,051 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$21,840 1091 Translation Services $30,240 1092 Medication Supports $4,200 1093 O/S Labor Clinical - Counselor $27,720 1094 O/S Labor Clinical - Nurse $2,520 1095 O/S Labor Clinical - Psychiatrist $1,135,697 SPECIAL EXPENSES TOTAL $1,222,217 FIXED ASSETS: 1190 Computers & Software $25,080 1191 Furniture & Fixtures $32,600 1192 Other - (Expendable Equipment)$30,646 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $88,326 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$22,470 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$0 2002.2 Client Transportation & Support (SFC 72)$6,384 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $28,854 TOTAL PROGRAM EXPENSES $9,722,940 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)436,342 $2.59 $1,130,952 3100 Case Management 199,204 $1.22 $243,490 3200 Crisis Services 10,865 $2.35 $25,509 3300 Medication Support 446,312 $4.01 $1,790,695 3400 Collateral 117,293 $2.59 $304,011 3500 Plan Development 80,054 $2.59 $207,491 3600 Assessment 264,925 $2.59 $686,657 3700 Rehabilitation 368,482 $2.59 $955,067 Estimated Specialty Mental Health Services Billing Totals 1,923,477 $5,343,872 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $5,343,872 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$4,175,190 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$1,168,682 MEDI-CAL REVENUE TOTAL $5,343,872 OTHER REVENUE: 4000 Other - (Client Fees)$0 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $4,379,068 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $4,379,068 TOTAL PROGRAM REVENUE $9,722,940 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.84 $88,788 $88,788 0002 ASSISTANT PROGRAM DIRECTOR 3.36 $295,928 $295,928 0003 MHP/TEAM LEAD 22.09 $1,764,935 $1,764,935 0004 SUPERVISING PSC 2.52 $144,114 $144,114 0005 CASE MANAGER 20.16 $1,022,485 $1,022,485 0006 DRIVER 2.52 $69,749 $69,749 0007 NURSE 6.72 $377,788 $377,788 0008 NURSE SUPERVISOR 0.84 $50,118 $50,118 0009 PEER SUPPORT 2.52 $80,128 $80,128 0010 ADMITTING INTERVIEWER/SECRETARY 11.76 $451,965 $451,965 0011 BILLING CLERK 1.68 $69,855 $69,855 0012 ADMINISTRATIVE ASSISTANT 0.84 $41,484 $41,484 0013 ADMINISTRATIVE SUPERVISOR 0.84 $42,841 $42,841 SALARY TOTAL 76.69 $0 $4,500,178 $4,500,178 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $376,192 $376,192 0032 SUI $15,913 $15,913 0033 ACCRUED PAID LEAVE $481,795 $481,795 PAYROLL TAX TOTAL $0 $873,900 $873,900 EMPLOYEE BENEFITS: 0040 Retirement $73,284 $73,284 0041 Workers Compensation $64,065 $64,065 0042 Health Insurance (medical, vision, life, dental)$653,755 $653,755 EMPLOYEE BENEFITS TOTAL $0 $791,104 $791,104 SALARY & BENEFITS GRAND TOTAL $6,165,182 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $299,880 1011 Rent/Lease Equipment $0 1012 Utilities $37,089 1013 Building Maintenance $59,227 1014 Equipment Maintenance $16,097 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $412,293 Line Item Description (Must be itemized) RURAL MENTAL HEALTH OUTPATIENT / INTENSIVE CASE MANAGEMENT (OP/ICM) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2019-2020 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $142,441 1061 Answering Service $0 1062 Postage $4,410 1063 Printing/Reproduction $13,980 1064 Publications $8,379 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $21,168 1067 Household Supplies $16,758 1068 Food $10,893 1069 Program Supplies - Therapeutic $25,578 1070 Program Supplies - Medical $20,727 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $243,300 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $22,050 1075 Lodging $4,543 1076 Other - (Vehicle Insurance/ Vehicle Lease)$131,771 1077 Other - (Client Activities/Outreach Events)$27,673 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$16,052 1078 Other - (Recruitment)$4,322 1078 Other - (Employee-Employer Relations)$15,435 1079 Licenses $79,380 OPERATING EXPENSES TOTAL $808,860 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $4,939 1082 Liability Insurance $26,548 1083 Administrative Overhead $1,323,449 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $1,354,936 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$22,932 1091 Translation Services $31,752 1092 Medication Supports $4,410 1093 O/S Labor Clinical - Counselor $29,106 1094 O/S Labor Clinical - Nurse $2,646 1095 O/S Labor Clinical - Psychiatrist $1,192,482 SPECIAL EXPENSES TOTAL $1,283,328 FIXED ASSETS: 1190 Computers & Software $3,528 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$84,805 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $88,333 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$23,594 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$0 2002.2 Client Transportation & Support (SFC 72)$6,703 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $30,297 TOTAL PROGRAM EXPENSES $10,143,229 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)459,536 $2.59 $1,191,068 3100 Case Management 254,447 $1.22 $311,014 3200 Crisis Services 11,498 $2.35 $26,995 3300 Medication Support 461,729 $4.01 $1,852,551 3400 Collateral 124,066 $2.59 $321,566 3500 Plan Development 84,136 $2.59 $218,071 3600 Assessment 277,965 $2.59 $720,455 3700 Rehabilitation 392,916 $2.59 $1,018,396 Estimated Specialty Mental Health Services Billing Totals 2,066,293 $5,660,116 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $5,660,116 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$4,422,273 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$1,237,843 MEDI-CAL REVENUE TOTAL $5,660,116 OTHER REVENUE: 4000 Other - (Client Fees)$0 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $4,483,113 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $4,483,113 TOTAL PROGRAM REVENUE $10,143,229 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.84 $91,466 $91,466 0002 ASSISTANT PROGRAM DIRECTOR 3.36 $304,844 $304,844 0003 MHP/TEAM LEAD 22.09 $1,840,329 $1,840,329 0004 SUPERVISING PSC 2.52 $152,265 $152,265 0005 CASE MANAGER 20.16 $1,067,016 $1,067,016 0006 DRIVER 2.52 $72,771 $72,771 0007 NURSE 6.72 $392,529 $392,529 0008 NURSE SUPERVISOR 0.84 $51,637 $51,637 0009 PEER SUPPORT 2.52 $83,198 $83,198 0010 ADMITTING INTERVIEWER/SECRETARY 11.76 $467,899 $467,899 0011 BILLING CLERK 1.68 $71,972 $71,972 0012 ADMINISTRATIVE ASSISTANT 0.84 $42,742 $42,742 0013 ADMINISTRATIVE SUPERVISOR 0.84 $45,901 $45,901 SALARY TOTAL 76.69 $0 $4,684,569 $4,684,569 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $391,598 $391,598 0032 SUI $15,913 $15,913 0033 ACCRUED PAID LEAVE $501,392 $501,392 PAYROLL TAX TOTAL $0 $908,903 $908,903 EMPLOYEE BENEFITS: 0040 Retirement $76,285 $76,285 0041 Workers Compensation $66,688 $66,688 0042 Health Insurance (medical, vision, life, dental)$653,815 $653,815 EMPLOYEE BENEFITS TOTAL $0 $796,788 $796,788 SALARY & BENEFITS GRAND TOTAL $6,390,260 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $314,874 1011 Rent/Lease Equipment $0 1012 Utilities $38,942 1013 Building Maintenance $62,188 1014 Equipment Maintenance $16,902 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $432,906 Line Item Description (Must be itemized) RURAL MENTAL HEALTH OUTPATIENT / INTENSIVE CASE MANAGEMENT (OP/ICM) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2020-2021 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $149,563 1061 Answering Service $0 1062 Postage $4,631 1063 Printing/Reproduction $14,679 1064 Publications $8,798 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $22,226 1067 Household Supplies $17,596 1068 Food $11,437 1069 Program Supplies - Therapeutic $26,857 1070 Program Supplies - Medical $21,764 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $255,465 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $23,153 1075 Lodging $4,770 1076 Other - (Vehicle Insurance/ Vehicle Lease)$138,360 1077 Other - (Client Activities/Outreach Events)$29,055 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$16,856 1078 Other - (Recruitment)$4,538 1078 Other - (Employee-Employer Relations)$16,207 1079 Licenses $83,349 OPERATING EXPENSES TOTAL $849,304 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $5,186 1082 Liability Insurance $27,875 1083 Administrative Overhead $1,377,148 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $1,410,209 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$24,079 1091 Translation Services $33,340 1092 Medication Supports $4,630 1093 O/S Labor Clinical - Counselor $30,561 1094 O/S Labor Clinical - Nurse $2,779 1095 O/S Labor Clinical - Psychiatrist $1,252,106 SPECIAL EXPENSES TOTAL $1,347,495 FIXED ASSETS: 1190 Computers & Software $3,704 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$89,044 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $92,748 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$24,773 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$0 2002.2 Client Transportation & Support (SFC 72)$7,038 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $31,811 TOTAL PROGRAM EXPENSES $10,554,733 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)459,536 $2.59 $1,191,067 3100 Case Management 254,448 $1.22 $311,015 3200 Crisis Services 11,498 $2.35 $26,995 3300 Medication Support 461,729 $4.01 $1,852,550 3400 Collateral 124,066 $2.59 $321,565 3500 Plan Development 84,136 $2.59 $218,071 3600 Assessment 277,965 $2.59 $720,455 3700 Rehabilitation 392,917 $2.59 $1,018,397 Estimated Specialty Mental Health Services Billing Totals 2,066,293 $5,660,115 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $5,660,115 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$4,422,272 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$1,237,843 MEDI-CAL REVENUE TOTAL $5,660,115 OTHER REVENUE: 4000 Other - (Client Fees)$0 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $4,894,618 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $4,894,618 TOTAL PROGRAM REVENUE $10,554,733 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.84 $94,224 $94,224 0002 ASSISTANT PROGRAM DIRECTOR 3.36 $314,031 $314,031 0003 MHP/TEAM LEAD 22.09 $1,899,546 $1,899,546 0004 SUPERVISING PSC 2.52 $158,808 $158,808 0005 CASE MANAGER 20.16 $1,108,903 $1,108,903 0006 DRIVER 2.52 $75,949 $75,949 0007 NURSE 6.72 $406,117 $406,117 0008 NURSE SUPERVISOR 0.84 $53,201 $53,201 0009 PEER SUPPORT 2.52 $86,407 $86,407 0010 ADMITTING INTERVIEWER/SECRETARY 11.76 $482,077 $482,077 0011 BILLING CLERK 1.68 $74,153 $74,153 0012 ADMINISTRATIVE ASSISTANT 0.84 $44,036 $44,036 0013 ADMINISTRATIVE SUPERVISOR 0.84 $49,187 $49,187 SALARY TOTAL 76.69 $0 $4,846,639 $4,846,639 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $405,133 $405,133 0032 SUI $15,913 $15,913 0033 ACCRUED PAID LEAVE $518,531 $518,531 PAYROLL TAX TOTAL $0 $939,577 $939,577 EMPLOYEE BENEFITS: 0040 Retirement $78,922 $78,922 0041 Workers Compensation $68,993 $68,993 0042 Health Insurance (medical, vision, life, dental)$653,867 $653,867 EMPLOYEE BENEFITS TOTAL $0 $801,782 $801,782 SALARY & BENEFITS GRAND TOTAL $6,587,998 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $330,618 1011 Rent/Lease Equipment $0 1012 Utilities $40,889 1013 Building Maintenance $65,297 1014 Equipment Maintenance $17,747 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $454,551 Line Item Description (Must be itemized) RURAL MENTAL HEALTH OUTPATIENT / INTENSIVE CASE MANAGEMENT (OP/ICM) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2021-2022 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $157,043 1061 Answering Service $0 1062 Postage $4,862 1063 Printing/Reproduction $15,412 1064 Publications $9,237 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $23,338 1067 Household Supplies $18,476 1068 Food $12,010 1069 Program Supplies - Therapeutic $28,200 1070 Program Supplies - Medical $22,851 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $268,238 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $24,310 1075 Lodging $5,008 1076 Other - (Vehicle Insurance/ Vehicle Lease)$145,277 1077 Other - (Client Activities/Outreach Events)$30,509 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$17,698 1078 Other - (Recruitment)$4,764 1078 Other - (Employee-Employer Relations)$17,017 1079 Licenses $87,516 OPERATING EXPENSES TOTAL $891,766 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $5,446 1082 Liability Insurance $29,270 1083 Administrative Overhead $1,427,744 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $1,462,460 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$25,282 1091 Translation Services $35,007 1092 Medication Supports $4,862 1093 O/S Labor Clinical - Counselor $32,090 1094 O/S Labor Clinical - Nurse $2,917 1095 O/S Labor Clinical - Psychiatrist $1,314,711 SPECIAL EXPENSES TOTAL $1,414,869 FIXED ASSETS: 1190 Computers & Software $3,890 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$93,497 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $97,387 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$26,011 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$0 2002.2 Client Transportation & Support (SFC 72)$7,390 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $33,401 TOTAL PROGRAM EXPENSES $10,942,432 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)459,536 $2.59 $1,191,068 3100 Case Management 254,448 $1.22 $311,016 3200 Crisis Services 11,498 $2.35 $26,995 3300 Medication Support 461,729 $4.01 $1,852,551 3400 Collateral 124,066 $2.59 $321,566 3500 Plan Development 84,136 $2.59 $218,071 3600 Assessment 277,964 $2.59 $720,453 3700 Rehabilitation 392,916 $2.59 $1,018,396 Estimated Specialty Mental Health Services Billing Totals 2,066,293 $5,660,116 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $5,660,116 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$4,422,273 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$1,237,843 MEDI-CAL REVENUE TOTAL $5,660,116 OTHER REVENUE: 4000 Other - (Client Fees)$0 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $5,282,316 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $5,282,316 TOTAL PROGRAM REVENUE $10,942,432 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 PROGRAM DIRECTOR 0.84 $97,067 $97,067 0002 ASSISTANT PROGRAM DIRECTOR 3.36 $323,496 $323,496 0003 MHP/TEAM LEAD 22.09 $1,958,407 $1,958,407 0004 SUPERVISING PSC 2.52 $165,691 $165,691 0005 CASE MANAGER 20.16 $1,145,646 $1,145,646 0006 DRIVER 2.52 $78,251 $78,251 0007 NURSE 6.72 $420,239 $420,239 0008 NURSE SUPERVISOR 0.84 $54,812 $54,812 0009 PEER SUPPORT 2.52 $89,025 $89,025 0010 ADMITTING INTERVIEWER/SECRETARY 11.76 $496,684 $496,684 0011 BILLING CLERK 1.68 $76,400 $76,400 0012 ADMINISTRATIVE ASSISTANT 0.84 $45,371 $45,371 0013 ADMINISTRATIVE SUPERVISOR 0.84 $52,705 $52,705 SALARY TOTAL 76.69 $0 $5,003,794 $5,003,794 PAYROLL TAXES: 0030 OASDI $0 $0 0031 FICA/MEDICARE $418,260 $418,260 0032 SUI $15,913 $15,913 0033 ACCRUED PAID LEAVE $535,185 $535,185 PAYROLL TAX TOTAL $0 $969,358 $969,358 EMPLOYEE BENEFITS: 0040 Retirement $81,479 $81,479 0041 Workers Compensation $71,229 $71,229 0042 Health Insurance (medical, vision, life, dental)$653,918 $653,918 EMPLOYEE BENEFITS TOTAL $0 $806,626 $806,626 SALARY & BENEFITS GRAND TOTAL $6,779,778 FACILITIES/EQUIPMENT EXPENSES: 1010 Rent/Lease Building $347,148 1011 Rent/Lease Equipment $0 1012 Utilities $42,934 1013 Building Maintenance $68,562 1014 Equipment Maintenance $18,634 1015 Equipment Purchase $0 FACILITY/EQUIPMENT TOTAL $477,278 Line Item Description (Must be itemized) RURAL MENTAL HEALTH OUTPATIENT / INTENSIVE CASE MANAGEMENT (OP/ICM) PROGRAM TURNING POINT OF CENTRAL CALIFORNIA FY 2022-2023 Budget Categories - Total Proposed Budget BUDGET - EXPENSES FOR EXISTING SIX CLINICS AND EXPANSION OPERATING EXPENSES: 1060 Telephone $164,895 1061 Answering Service $0 1062 Postage $5,106 1063 Printing/Reproduction $16,183 1064 Publications $9,699 1065 Legal Notices/Advertising/Program Enhancement $0 1066 Office Supplies & Equipment $24,504 1067 Household Supplies $19,400 1068 Food $12,610 1069 Program Supplies - Therapeutic $29,610 1070 Program Supplies - Medical $23,994 1071 Transportation of Clients $0 1072 Staff Mileage/Vehicle Maintenance $281,649 1073 Staff Travel (Out of County)$0 1074 Staff Training/Registration $25,526 1075 Lodging $5,258 1076 Other - (Vehicle Insurance/ Vehicle Lease)$152,542 1077 Other - (Client Activities/Outreach Events)$32,035 1078 Other - (Taxes,Bank Charges,Interest,Depreciation)$18,582 1078 Other - (Recruitment)$5,003 1078 Other - (Employee-Employer Relations)$17,868 1079 Licenses $91,893 OPERATING EXPENSES TOTAL $936,357 FINANCIAL SERVICES EXPENSES: 1080 Accounting/Bookkeeping $0 1081 External Audit $5,718 1082 Liability Insurance $30,733 1083 Administrative Overhead $1,478,483 1084 Payroll Services $0 1085 Professional Liability Insurance $0 FINANCIAL SERVICES TOTAL $1,514,934 SPECIAL EXPENSES (Consultant/Etc.): 1090 Consultant (Network & Data management)$26,546 1091 Translation Services $36,757 1092 Medication Supports $5,105 1093 O/S Labor Clinical - Counselor $33,694 1094 O/S Labor Clinical - Nurse $3,064 1095 O/S Labor Clinical - Psychiatrist $1,380,447 SPECIAL EXPENSES TOTAL $1,485,613 FIXED ASSETS: 1190 Computers & Software $4,084 1191 Furniture & Fixtures $0 1192 Other - (Expendable Equipment)$98,172 1193 Other - (Expendable Furniture)$0 1194 Other - (Identify)$0 FIXED ASSETS TOTAL $102,256 NON MEDI-CAL CLIENT SUPPORT EXPENSES: 2000 Client Housing Support Expenditures (SFC 70)$27,310 2001 Client Housing Operating Expenditures (SFC 71)$0 2002.1 Clothing, Food & Hygiene (SFC 72)$0 2002.2 Client Transportation & Support (SFC 72)$7,760 2002.3 Education Support (SFC 72)$0 2002.4 Employment Support (SFC 72)$0 2002.5 Respite Care (SFC 72)$0 2002.6 Household Items $0 2002.7 Utility Vouchers (SFC 72)$0 2002.8 Child Care (SFC 72)$0 NON MEDI-CAL CLIENT SUPPORT TOTAL $35,070 TOTAL PROGRAM EXPENSES $11,331,286 MEDI-CAL REVENUE:Units of Service Rate $ Amount 3000 Mental Health Services (Individual/Family/Group Therapy)459,536 $2.59 $1,191,068 3100 Case Management 254,449 $1.22 $311,017 3200 Crisis Services 11,497 $2.35 $26,993 3300 Medication Support 461,728 $4.01 $1,852,547 3400 Collateral 124,066 $2.59 $321,566 3500 Plan Development 84,136 $2.59 $218,071 3600 Assessment 277,965 $2.59 $720,455 3700 Rehabilitation 392,917 $2.59 $1,018,399 Estimated Specialty Mental Health Services Billing Totals 2,066,294 $5,660,116 Estimated % of Clients that are Medi-Cal Beneficiaries 100% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries $5,660,116 Federal M/Cal Share of Cost % (Federal Financial Participation-FFP)(Blended ACA,EPSDT,S/D)78.13%$4,422,273 State M/Cal Share of Cost % (BH Realignment/EPSDT) 21.87%$1,237,843 MEDI-CAL REVENUE TOTAL $5,660,116 OTHER REVENUE: 4000 Other - (Client Fees)$0 4100 Other - (Client Insurance)$0 4200 Other - (Identify)$0 OTHER REVENUE TOTAL $0 MENTAL HEALTH SERVICES ACT (MHSA) REVENUE: 5000 Prevention & Early Intervention (PEI) Funds $0 5100 Community Services & Supports (CSS) Funds $5,671,170 5200 Innovation (INN) Funds $0 5300 Workforce Education & Training (WET) Funds $0 MHSA FUNDS TOTAL $5,671,170 TOTAL PROGRAM REVENUE $11,331,286 EXHIBIT C--FSP SERVICE DELIVERY MODEL Page 1 of 4 FULL SERVICE PARTNERSHIP SERVICE DELIVERY MODEL This document outlines requirements for Full Service Partnership collaborations and can be found in its entirety at http://www.dmh.ca.gov/MHSA/docs/CSSfinal 8.1.05.pd f. Full Service Partnerships (FSP) are designed as a partnership between enrollees and the service provider. The FSP service delivery ethic incorporates recovery and cultural competence into the services and supports offered to consumers. In this partnership, the service provider commits to do "whatever it takes" and to "meet the client where they are" in order to assist the enrollee achieve their personal recovery/resiliency and wellness goals. 1.The Target Population is consistent with the population identified in the Fresno County MHSA Community Planning Process The target population must meet requirements for SMI/SED diagnosis; and must address reduction of specific ethnic disparities, as indicated in the MHSA Community Services and Supports proposal on which the RFP is based. The target population will include individuals who are not currently served and meet one or more of the following criteria: •Homeless•At risk of homelessness -such as youth aging out of foster care or•persons coming out of jail•Involved in the criminal justice system (including adults with child•protection issues)•Frequent users of hospital and emergency room services or are so underserved that they are at risk of: •Homelessness -such as persons living in institutions or nursing homes •Criminal justice involvement•Institutionalization Diagnoses that serve as criteria for inclusion in the target population will be based on definitions found in 5600.3 California Welfare and Institutions code defining severe mental disorder. The operational definition of "diagnosis" for programs serving the chronically homeless may also include: co-occurring disorders, personality disorders, general anxiety/mood disorders, and Post Traumatic Stress Disorder). 2.FSP Program Components: All MHSA FSP Programs must include the following in their program descriptions •Providers who are part of the multidisciplinary, community based "treatment" teams serve as an ally to the consumer's recovery process. The partnership allows clients and family members opportunities for informed choice o The team description must demonstrate commitment and capacity to do "whatever it takes" to assist the enrolled member, specifically:•Low staff to client ratio (approximately 1: 12; or the ratio that has been specified in the RF P's statement of work)•24/7 availability of the multidisciplinary team;•Team culture is created where each member of the team knows each client and the clients are familiar with each member of the team. EXIDBTT C--FSP SERVICE DELIVERY MODEL Page 2 of 4 •Members of the team speak the client's language, are familiar with community resources that reflect the healing beliefs of the client's culture, and are positioned to assist the client make meaningful connection with those resources.•Crisis response comes from a person known to the client.•Staff is given the administrative flexibility and flex-funding to connect consumers with non-mental health services and same day needs. Examples include: Housing; Primary Care; Dual Disorder Services, Education Services and Supports; Vocational services and supports; Payee services/benefits advocacy; Community recreational activities (YMCA classes, libraries, movie theaters); Social Services, Food, Transportation, and Clothing.•Availability of Integrated Dual Diagnosis Treatment or other dual recovery intervention that will provide effective treatment for the target population. •Outreach and engagement. The team's outreach and engagement strategy must be voluntary and driven by the values of client culture. This means that consumers will be engaged "where they are" in terms of their community location, their need for clinical and non-clinical services/supports and their phase of recovery. Outreach workers will have culturally competent language skills and will function as an ally to the consumer's decision to receive services. Peer Support will be included in the outreach and engagement of new clients. •Procedures for enrollment and dis-enrollment will be easily understood, clearly communicated and non-coercive. Enrollment is voluntary. A condition of enrollment is that the client indicates that they want services from the assertive-community treatment model team. •Each adult, older adult, and transition age youth enrollee must have a Personal Service Coordinator (PSC). The PSC is an ally to the enrollee and acts as a "single point of responsibility" within the multidisciplinary team for coordinating services and supports. "Personal Service Coordinators (PSCs) for adults -case managers for children and youth -must have a caseload that is low enough so that: (1) their availability to the individual and family is appropriate to their service needs, (2) they are able to provide intensive services and supports when needed, and (3) they can give the individual served and/or family member considerable personal attention ... PSCs/case managers must be culturally competent, and know the community resources of the client's racial ethnic community." (Source: DMH Planning Requirements, Section Ill Identifying Populations for Full Service Partnerships, Aug 2005) •Each enrollee must have an Integrated Services and Supports Plan that is developed with their Personal Services Coordinator. This ISSP is a planning tool that builds on the consumer's strengths. It includes goals and provides a map of the steps that the enrollee identifies as necessary to move along his/her recovery path. "Integrated _Services and Supports Plans must operationalize the five fundamental concepts( identified listed in section three of this Exhibit) and should reflect community collaboration, be culturally competent, be client/family driven with a wellness/recovery/resiliency focus and they must provide an integrated service experience for the client/family. In addition, the ISSP will be person/child-centered, and give individuals and their families' sufficient information to allow them to make informed choices about the services in which they participate. Services should also include linkage to, or provision of, all needed services or benefits as defined by the client and or family in consultation with the PSC!case manager. This includes the capability of increasing or decreasing service intensity as needed ." (Source: DMH Planning Requirements, Section Ill Identifying Populations for Full Service Partnerships, Aug 2005) •Peer support services will be made available to the client. At least two staff (a minimum of 1 FTE) who act in peer support roles will be employed in each MHSA program. o The enrollee is given significant access to peer recovery and self-help services. Tools such as Advanced Directives are made available to adult and older adult clients, and EXHIBIT C--FSP SERVICE DELIVERY MODEL Page 3 of 4 Wellness Recovery Action Plans (WRAP) are made available to adult, transition age youth and older adult clients. o Peer Counselors are included as equal partners in the multidisciplinary team, and play a critical role in developing the recovery culture and client orientation of the team. 3.The Five (5) Core MHSA Concepts are embedded in each program Concept 1: Recovery/resiliency orientation: FSPs will embody the values of recovery and resiliency (i.e., hope, personal responsibility, self­ advocacy, choice, respect) and the program principles of recovery and resiliency, including: •Client-driven goal setting and Individualized Services and Supports Plans •Providers are allies to the client's recovery process. •A harm-reduction approach to substance abuse that encourages recovery and abstinence but does not penalize consumers or withdraw help from them if they are using. •A built in understanding and expectation of setbacks as part of recovery. •Links to a range of services that are part of the consumers "pathway to wellness" (i.e., employment, health care, peer support, housing, medications, food and clothing) FSPs will collaborate with the MHSA Family Education Center which makes support services available to family members and the MHSA Wellness Recovery Resource Hub which makes wellness recovery training and technical assistance available to FSP staff. Concept 2: Cultural Competence Orientation: The program's structure, staffing and service delivery values will reflect the cultural values and orientation of the program's target populations. The FSP program will embody principals of cultural competence including: •Diverse staff, representative of the primary ethnic groups to be reached through the program•Staff trained regarding common access barriers for racial and ethnic groups targeted (including the impact of housing discrimination)•Links to community-based organizations that share the healing beliefs and practices of ethnic communities served by the FSP. The FSP program must also be able to deal with gender and sexual orientation diversity. Training in sensitivity to gender and sexuality issues is a key component for staff on the Team. Concept 3: Community Collaboration: FSP Collaborations ensure that community resources are made available to enrollees. These collaborations include subcontracts between the vendor and other agencies, memoranda of understanding with community non-profits and businesses regarding providing services to clients, and informal relationships built between FSP staff and community stakeholders that result in improved access and decreased discrimination. Concept 4: Client/Family Driven program: In FSPs, the Integrated Services and Supports Plan (ISSP) is used by adult clients and families of children and youth to identify their needs and preferences which lead to the services and supports that will be most effective for them. Providers work in full partnership with clients to develop these ISSPs. Their needs and preferences drive the policy and financing decisions that affect them. Concept 5: Integrated Service Experience: FSP programs were incorporated into the MHSA to ensure that these dollars funded "integrated service experiences." This means that services are "seamless" to clients and that clients do not have to negotiate multiple agencies and funding sources to get critical needs met and to move towards recovery and develop resiliency. Services are delivered, or at a minimum, coordinated through a single agency or a system of care. The EXHIBIT C--FSP SERVICE DELIVERY MODEL Page 4 of 4 integrated service experience centers on the individual/family, uses a strength-based approach, and includes multi-agency programs and joint planning to best address the individual/family's needs using the full range of community-based treatment, case management, and interagency system components required by children/transition age youth/adults/older adults. Exhibit D Page 1 of 1 Electronic Health Record Software Charges CONTRACTOR(S) understand that COUNTY utilizes NetSmart’s Avatar for its Electronic Health Records Management. CONTRACTOR(S) agree to reimburse COUNTY for all user license fees for accessing NetSmart’s Avatar, as set forth below. Description FY 2018-19 FY 2019-20 FY 2020-21 FY 2021-22 FY 2022-23 Fee Per User/License NetSmart Avatar Monthly Hosting Service (per named user per month) $ 37.00 $ 37.00 $ 37.00 $ 37.00 $ 37.00 NetSmart Avatar Annual Maintenance/License* (per named license per year) $ 249.95 $ 249.95 $ 249.95 $ 249.95 $ 249.95 OrderConnect License1 (per named license per year) $ 1,278.00 $ 1,278.00 $ 1,278.00 $ 1,278.00 $ 1,278.00 Reaching Recovery (per named user per year) $ 10.00 $ 10.00 $ 10.00 $ 10.00 $ 10.00 Should CONTRACTOR(S) choose not to utilize NetSmart’s Avatar for its Electronic Health Records management, CONTRACTOR(S) will be responsible for obtaining its own system for Electronic Health Records management. ______________________________________________________________________________________________________________________ *Annual Maintenance increases by 3% each FY on July 1st. 1Includes 100 faxed pages per month. An additional fee of $0.20 per faxed page will apply thereafter. Exhibit E Page 1 of 3 FRESNO COUNTY MENTAL HEALTH COMPLIANCE PROGRAM CONTRACTOR CODE OF CONDUCT AND ETHICS Fresno County is firmly committed to full compliance with all applicable laws, regulations, rules and guidelines that apply to the provision and payment of mental health services. Mental health contractors and the manner in which they conduct themselves are a vital part of this commitment. Fresno County has established this Contractor Code of Conduct and Ethics with which contractor and its employees and subcontractors shall comply. Contractor shall require its employees and subcontractors to attend a compliance training that will be provided by Fresno County. After completion of this training, each contractor, contractor’s employee and subcontractor must sign the Contractor Acknowledgment and Agreement form and return this form to the Compliance officer or designee. Contractor and its employees and subcontractor shall: 1. Comply with all applicable laws, regulations, rules or guidelines when providing and billing for mental health services. 2. Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their professional dealing related to their contract with the County and avoid any conduct that could reasonably be expected to reflect adversely upon the integrity of the County. 3. Treat County employees, consumers, and other mental health contractors fairly and with respect. 4. NOT engage in any activity in violation of the County’s Compliance Program, nor engage in any other conduct which violates any applicable law, regulation, rule or guideline 5. Take precautions to ensure that claims are prepared and submitted accurately, timely and are consistent with all applicable laws, regulations, rules or guidelines. 6. Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement of any kind are submitted. 7. Bill only for eligible services actually rendered and fully documented. Use billing codes that accurately describe the services provided. Exhibit E Page 2 of 3 8. Act promptly to investigate and correct problems if errors in claims or billing are discovered. 9. Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct and Ethics by County employees or other mental health contractors, or report any activity that they believe may violate the standards of the Compliance Program, or any other applicable law, regulation, rule or guideline. Fresno County prohibits retaliation against any person making a report. Any person engaging in any form of retaliation will be subject to disciplinary or other appropriate action by the County. Contractor may report anonymously. 10. Consult with the Compliance Officer if you have any questions or are uncertain of any Compliance Program standard or any other applicable law, regulation, rule or guideline. 11. Immediately notify the Compliance Officer if they become or may become an Ineligible person and therefore excluded from participation in the Federal Health Care Programs. Exhibit E Page 3 of 3 Fresno County Mental Health Compliance Program Contractor Acknowledgment and Agreement I hereby acknowledge that I have received, read and understand the Contractor Code of Conduct and Ethics. I herby acknowledge that I have received training and information on the Fresno County Mental Health Compliance Program and understand the contents thereof. I further agree to abide by the Contractor Code of Conduct and Ethics, and all Compliance Program requirements as they apply to my responsibilities as a mental health contractor for Fresno County. I understand and accept my responsibilities under this Agreement. I further understand that any violation of the Contractor Code of Conduct and Ethics or the Compliance Program is a violation of County policy and may also be a violation of applicable laws, regulations, rules or guidelines. I further understand that violation of the Contractor Code of Conduct and Ethics or the Compliance Program may result in termination of my agreement with Fresno County. I further understand that Fresno County will report me to the appropriate Federal or State agency. For Individual Providers Name (print): _____________________________________ Discipline: Psychiatrist Psychologist LCSW LMFT Signature :________________________________ Date : ___/____/___ For Group or Organizational Providers Group/Org. Name (print): _______________________________________ Employee Name (print): ________________________________________ Discipline: Psychiatrist Psychologist LCSW LMFT Other:___________________________________________ Job Title (if different from Discipline): ___________________________ Signature: _________________________________ Date: ____/___/____ Exhibit F Page 1 of 3 Documentation Standards For Client Records The documentation standards are described below under key topics related to client care. All standards must be addressed in the client record; however, there is no requirement that the record have a specific document or section addressing these topics. All medical records shall be maintained for a minimum of 10 years from the date of the end of the Agreement. A. Assessments 1. The following areas will be included as appropriate as a part of a comprehensive client record. • Relevant physical health conditions reported by the client will be prominently identified and updated as appropriate. • Presenting problems and relevant conditions affecting the client’s physical health and mental health status will be documented, for example: living situation, daily activities, and social support. • Documentation will describe client’s strengths in achieving client plan goals. • Special status situations that present a risk to clients or others will be prominently documented and updated as appropriate. • Documentations will include medications that have been described by mental health plan physicians, dosage of each medication, dates of initial prescriptions and refills, and documentations of informed consent for medications. • Client self report of allergies and adverse reactions to medications, or lack of known allergies/sensitivities will be clearly documented. • A mental health history will be documented, including: previous treatment dates, providers, therapeutic interventions and responses, sources of clinical data, relevant family information and relevant results of relevant lab tests and consultations reports. • For children and adolescents, pre-natal and perinatal events and complete developmental history will be documented. • Documentations will include past and present use of tobacco, alcohol, and caffeine, as well as illicit, prescribed and over-the-counter drugs. • A relevant mental status examination will be documented. • A DSM-5 diagnosis, or a diagnosis from the most current ICD, will be documented, consistent with the presenting problems, history mental status evaluation and/or other assessment data. 2. Timeliness/Frequency Standard for Assessment • An assessment will be completed at intake and updated as needed to document changes in the client’s condition. • Client conditions will be assessed at least annually and, in most cases, at more frequent intervals. B. Client Plans Exhibit F Page 2 of 3 1. Client plans will: • have specific observable and/or specific quantifiable goals • identify the proposed type(s) of intervention • have a proposed duration of intervention(s) • be signed (or electronic equivalent) by:  the person providing the service(s), or  a person representing a team or program providing services, or  a person representing the MHP providing services  when the client plan is used to establish that the services are provided under the direction of an approved category of staff, and if the below staff are not the approved category,  a physician  a licensed/ “waivered” psychologist  a licensed/ “associate” social worker  a licensed/ registered/marriage and family therapist or  a registered nurse • In addition,  client plans will be consistent with the diagnosis, and the focus of intervention will be consistent with the client plan goals, and there will be documentation of the client’s participation in and agreement with the plan. Examples of the documentation include, but are not limited to, reference to the client’s participation and agreement in the body of the plan, client signature on the plan, or a description of the client’s participation and agreement in progress notes.  client signature on the plan will be used as the means by which the CONTRACTOR(S) documents the participation of the client  when the client’s signature is required on the client plan and the client refuses or is unavailable for signature, the client plan will include a written explanation of the refusal or unavailability. • The CONTRACTOR(S) will give a copy of the client plan to the client on request. 2. Timeliness/Frequency of Client Plan: • Will be updated at least annually • The CONTRACTOR(S) will establish standards for timeliness and frequency for the individual elements of the client plan described in item 1. C. Progress Notes 1. Items that must be contained in the client record related to the client’s progress in treatment include: • The client record will provide timely documentation of relevant aspects of client care • Mental health staff/practitioners will use client records to document client encounters, including relevant clinical decisions and interventions Exhibit F Page 3 of 3 • All entries in the client record will include the signature of the person providing the service (or electronic equivalent); the person’s professional degree, licensure or job title; and the relevant identification number, if applicable • All entries will include the date services were provided • The record will be legible • The client record will document follow-up care, or as appropriate, a discharge summary 2. Timeliness/Frequency of Progress Notes: Progress notes shall be documented at the frequency by type of service indicated below: A. Every Service Contact • Mental Health Services • Medication Support Services • Crisis Intervention Exhibit G Page 1 of 6 STATE MENTAL HEALTH REQUIREMENTS 1. CONTROL REQUIREMENTS The COUNTY and its subcontractors shall provide services in accordance with all applicable Federal and State statutes and regulations. 2. PROFESSIONAL LICENSURE All (professional level) persons employed by the COUNTY Mental Health Program (directly or through contract) providing Short-Doyle/Medi-Cal services have met applicable professional licensure requirements pursuant to Business and Professions and Welfare and Institutions Codes. 3. CONFIDENTIALITY CONTRACTOR shall conform to and COUNTY shall monitor compliance with all State of California and Federal statutes and regulations regarding confidentiality, including but not limited to confidentiality of information requirements at 42, Code of Federal Regulations sections 2.1 et seq; California Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code. 4. NON-DISCRIMINATION A. Eligibility for Services CONTRACTOR shall prepare and make available to COUNTY and to the public all eligibility requirements to participate in the program plan set forth in the Agreement. No person shall, because of ethnic group identification, age, gender, color, disability, medical condition, national origin, race, ancestry, marital status, religion, religious creed, political belief or sexual preference be excluded from participation, be denied benefits of, or be subject to discrimination under any program or activity receiving Federal or State of California assistance. B. Employment Opportunity CONTRACTOR shall comply with COUNTY policy, and the Equal Employment Opportunity Commission guidelines, which forbids discrimination against any person on the grounds of race, color, national origin, sex, religion, age, disability status, or sexual preference in employment practices. Such practices include retirement, recruitment advertising, hiring, layoff, termination, upgrading, demotion, transfer, Exhibit G Page 2 of 6 rates of pay or other forms of compensation, use of facilities, and other terms and conditions of employment. C. Suspension of Compensation If an allegation of discrimination occurs, COUNTY may withhold all further funds, until CONTRACTOR can show clear and convincing evidence to the satisfaction of COUNTY that funds provided under this Agreement were not used in connection with the alleged discrimination. D. Nepotism Except by consent of COUNTY’s Department of Behavioral Health Director, or designee, no person shall be employed by CONTRACTOR who is related by blood or marriage to, or who is a member of the Board of Directors or an officer of CONTRACTOR. 5. PATIENTS' RIGHTS CONTRACTOR shall comply with applicable laws and regulations, including but not limited to, laws, regulations, and State policies relating to patients' rights. STATE CONTRACTOR CERTIFICATION CLAUSES 1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the non-discrimination program requirements. (Gov. Code§ 12990 (a-f) and CCR, Title 2, Section 111 02) (Not applicable to public entities.) 2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish a Drug-Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; 2) the person's or organization's policy of maintaining a drug-free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations. c. Every employee who works on the proposed Agreement will: 1) receive a copy of the company's drug-free workplace policy statement; and, Exhibit G Page 3 of 6 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.) 3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.) 4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO REQUIREMENT: Contractor hereby certifies that Contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003. Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State. Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services. 5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California. 6. SWEATFREE CODE OF CONDUCT: a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under Exhibit G Page 4 of 6 penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108. b. The contractor agrees to cooperate fully in providing reasonable access to the contractor’s records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor’s compliance with the requirements under paragraph (a). 7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3. 8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35. DOING BUSINESS WITH THE STATE OF CALIFORNIA The following laws apply to persons or entities doing business with the State of California. 1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification. Current State Employees (Pub. Contract Code §10410): 1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment. 2). No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services. Former State Employees (Pub. Contract Code §10411): 1). For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency. 2). For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was Exhibit G Page 5 of 6 employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service. If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub. Contract Code §10420) Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e)) 2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) 3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.) 4. CONTRACTOR NAME CHANGE: An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment. 5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA: a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax. c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State. 6. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body Exhibit G Page 6 of 6 which by law has authority to enter into an agreement, authorizing execution of the agreement. 7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be: (1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution. 8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. 9. INSPECTION and Audit of Records and access to Facilities. The State, CMS, the Office of the Inspector General, the Comptroller General, and their designees may, at any time, inspect and audit any records or documents of CONTRACTOR or its subcontractors, and may, at any time, inspect the premises, physical facilities, and equipment where Medicaid-related activities or work is conducted. The right to audit under this section exists for 10 years from the final date of the contract period or from the date of completion of any audit, whichever is later. Federal database checks. Consistent with the requirements at § 455.436 of this chapter, the State must confirm the identity and determine the exclusion status of CONTRACTOR, any subcontractor, as well as any person with an ownership or control interest, or who is an agent or managing employee of CONTRACTOR through routine checks of Federal databases. This includes the Social Security Administration's Death Master File, the National Plan and Provider Enumeration System (NPPES), the List of Excluded Individuals/Entities (LEIE), the System for Award Management (SAM), and any other databases as the State or Secretary may prescribe. These databases must be consulted upon contracting and no less frequently than monthly thereafter. If the State finds a party that is excluded, it must promptly notify the CONTRACTOR and take action consistent with § 438.610(c). The State must ensure that CONTRACTOR with which the State contracts under this part is not located outside of the United States and that no claims paid by a CONTRACTOR to a network provider, out-of-network provider, subcontractor or financial institution located outside of the U.S. are considered in the development of actuarially sound capitation rates. Exhibit I Page 1 of 2 FFRREESSNNOO CCOOUUNNTTYY MMEENNTTAALL HHEEAALLTTHH PPLLAANN GGRRIIEEVVAANNCCEESS AANNDD IINNCCIIDDEENNTT RREEPPOORRTTIINNGG PPRROOTTOOCCOOLL FFOORR CCOOMMPPLLEETTIIOONN OOFF IINNCCIIDDEENNTT RREEPPOORRTT • The Incident Report must be completed for all incidents involving clients. The staff person who becomes aware of the incident completes this form, and the supervisor co-signs it. • When more than one client is involved in an incident, a separate form must be completed for each client. Where the forms should be sent - within 24 hours from the time of the incident • Incident Report should be sent to: DBH Program Supervisor Exhibit I Page 2 of 2 INCIDENT REPORT WORKSHEET When did this happen? (date/time) Where did this happen? Name/DMH # 1. Background information of the incident: 2. Method of investigation: (chart review, face-to-face interview, etc.) Who was affected? (If other than consumer) List key people involved. (witnesses, visitors, physicians, employees) 3. Preliminary findings: How did it happen? Sequence of events. Be specific. If attachments are needed write comments on an 8 1/2 sheet of paper and attach to worksheet. Outcome severity: Nonexistent inconsequential consequential death not applicable unknown 4. Response: a) corrective action, b) Plan of Action, c) other Completed by (print name) Completed by (signature) Date completed Reviewed by Supervisor (print name) Supervisor Signature Date Exhibit I Page 1 of 2 Fresno County Mental Health Plan Grievances Fresno County Mental Health Plan (MHP) provides beneficiaries with a grievance and appeal process and an expedited appeal process to resolve grievances and disputes at the earliest and the lowest possible level. Title 9 of the California Code of Regulations requires that the MHP and its fee- for-service providers give verbal and written information to Medi-Cal beneficiaries regarding the following: • How to access specialty mental health services • How to file a grievance about services • How to file for a State Fair Hearing The MHP has developed a Consumer Guide, a beneficiary rights poster, a grievance form, an appeal form, and Request for Change of Provider Form. All of these beneficiary materials must be posted in prominent locations where Medi- Cal beneficiaries receive outpatient specialty mental health services, including the waiting rooms of providers’ offices of service. Please note that all fee-for-service providers and contract agencies are required to give their clients copies of all current beneficiary information annually at the time their treatment plans are updated and at intake. Beneficiaries have the right to use the grievance and/or appeal process without any penalty, change in mental health services, or any form of retaliation. All Medi-Cal beneficiaries can file an appeal or state hearing. Grievances and appeals forms and self addressed envelopes must be available for beneficiaries to pick up at all provider sites without having to make a verbal or written request. Forms can be sent to the following address: Fresno County Mental Health Plan P.O. Box 45003 Fresno, CA 93718-9886 (800) 654-3937 (for more information) (559) 488-3055 (TTY) Provider Problem Resolution and Appeals Process The MHP uses a simple, informal procedure in identifying and resolving provider concerns and problems regarding payment authorization issues, other complaints and concerns. Exhibit I Page 2 of 2 Informal provider problem resolution process – the provider may first speak to a Provider Relations Specialist (PRS) regarding his or her complaint or concern. The PRS will attempt to settle the complaint or concern with the provider. If the attempt is unsuccessful and the provider chooses to forego the informal grievance process, the provider will be advised to file a written complaint to the MHP address (listed above). Formal provider appeal process – the provider has the right to access the provider appeal process at any time before, during, or after the provider problem resolution process has begun, when the complaint concerns a denied or modified request for MHP payment authorization, or the process or payment of a provider’s claim to the MHP. Payment authorization issues – the provider may appeal a denied or modified request for payment authorization or a dispute with the MHP regarding the processing or payment of a provider’s claim to the MHP. The written appeal must be submitted to the MHP within 90 calendar days of the date of the receipt of the non-approval of payment. The MHP shall have 60 calendar days from its receipt of the appeal to inform the provider in writing of the decision, including a statement of the reasons for the decision that addresses each issue raised by the provider, and any action required by the provider to implement the decision. If the appeal concerns a denial or modification of payment authorization request, the MHP utilizes a Managed Care staff who was not involved in the initial denial or modification decision to determine the appeal decision. If the Managed Care staff reverses the appealed decision, the provider will be asked to submit a revised request for payment within 30 calendar days of receipt of the decision Other complaints – if there are other issues or complaints, which are not related to payment authorization issues, providers are encouraged to send a letter of complaint to the MHP. The provider will receive a written response from the MHP within 60 calendar days of receipt of the complaint. The decision rendered buy the MHP is final. Exhibit J Page 1 of 2 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT I. Identifying Information Name of entity D/B/A Address (number, street) City State ZIP code CLIA number Taxpayer ID number (EIN) Telephone number ( ) II. Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued. A. Are there any individuals or organizations having a direct or indirect ownership or control interest of five percent or more in the institution, organizations, or agency that have been convicted of a criminal offense related to the involvement of such persons or organizations in any of the programs established YES NO by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒ B. Are there any directors, officers, agents, or managing employees of the institution, agency, or organization who have ever been convicted of a criminal offense related to their involvement in such programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒ C. Are there any individuals currently employed by the institution, agency, or organization in a managerial, accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒ III. A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are related to each other, this must be reported under “Remarks.” NAME ADDRESS EIN B. Type of entity: ❒ Sole proprietorship ❒ Partnership ❒ Corporation ❒ Unincorporated Associations ❒ Other (specify) C. If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations under “Remarks.” D. Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities? (Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses of individuals, and provider numbers. .......................................................................................................... ❒ ❒ NAME ADDRESS PROVIDER NUMBER Exhibit J Page 2 of 2 YES NO IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒ If yes, give date. B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒ If yes, when? C. Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒ If yes, when? V. Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒ If yes, give date of change in operations. VI. Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒ VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒ (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code B. If the answer to question VII.A. is NO, was the facility ever affiliated with a chain? (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the information requested may result in denial of a request to participate or where the entity already participates, a termination of its agreement or contract with the agency, as appropriate. Name of authorized representative (typed) Title Signature Date Remarks Exhibit K Page 1 of 2 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Exhibit K Page 2 of 2 CERTIFICATION (1) The prospective primary participant certifies to the best of its knowledge and belief, that it, its owners, officers, corporate managers and partners: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: Date: (Printed Name & Title) (Name of Agency or Company) Exhibit L Page 1 of 2 SELF-DEALING TRANSACTION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as “County”), members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the County. A self-dealing transaction is defined below: “A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest” The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1) Enter board member’s name, job title (if applicable), and date this disclosure is being made. (2) Enter the board member’s company/agency name and address. (3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the County. At a minimum, include a description of the following: a. The name of the agency/company with which the corporation has the transaction; and b. The nature of the material financial interest in the Corporation’s transaction that the board member has. (4) Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5) Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). Exhibit L Page 2 of 2 (1) Company Board Member Information: Name: Date: Job Title: (2) Company/Agency Name and Address: (3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to) (4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a) (5) Authorized Signature Signature: Date: