HomeMy WebLinkAboutAgreement A-22-023 with CCFMG Amendment I.pdf- 1 -
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AMENDMENT I TO AGREEMENT
THIS AMENDMENT I TO AGREEMENT 18-234 (hereinafter “Amendment”) is made and
entered into this ____ day of _____________, 2022, by and between COUNTY OF FRESNO, a
Political Subdivision of the State of California, Fresno, California (hereinafter “COUNTY”), and Central
California Faculty Medical Group, Inc. (CCFMG), a California professional corporation, whose
address is 2625 East Divisadero Street, California, 93721 (hereinafter “CONTRACTOR”).
WITNESSETH:
WHEREAS, COUNTY and CONTRACTOR entered into Agreement number 18-234, dated the
1st of May, 2018 (hereinafter “Agreement”), pursuant to which CONTRACTOR agreed to provide
licensed psychiatrists to the COUNTY’s Department of Behavioral Health (DBH) for the provision of
psychiatric services to individuals, as well as additional services required by COUNTY; and
WHEREAS, the parties desire to amend the Agreement to include CONTRACTOR’s provision
of psychiatric services to individuals, as well as additional services required by COUNTY, through the
use of nurse practitioners, in addition to licensed psychiatrists; and
WHEREAS, the parties desire to amend the Agreement to revise the compensation incentive
plan terms; and
WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement regarding
changes as stated below and restate the Agreement in its entirety.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
1.That all references in Agreement No. 18-234 to “Exhibit A”, shall be changed to read
“Revised Exhibit A”. Revised Exhibit A is attached hereto and incorporated herein by this reference.
2.That all references in Agreement No. 18-234 to “Exhibit B”, shall be changed to read
“Revised Exhibit B”. Revised Exhibit B is attached hereto and incorporated herein by this reference.
3. That Paragraph Four (4) – Compensation – Section A – of the Agreement, on Page
Three (3), beginning on Line Seventeen (17) with the word “The”, and ending on Page Four (4), Line
Ten (10) with the word “Agreement” shall be deleted in its entirety and replaced with the following:
“The maximum amount payable to CONTRACTOR for the ramp up period (May 1, 2018
18th January
Agreement No. 22-023
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through June 30, 2018) shall not exceed Three Hundred Thirty-Six Thousand Two Hundred
Fifty-Three and No/100 Dollars ($336,253.00).
The maximum amount payable to CONTRACTOR for the initial operational period (July
1, 2018 through June 30, 2019) shall not exceed Three Million Eight Hundred Eighty-One
Thousand Two Hundred Sixty and No/100 Dollars ($3,881,260.00).
The maximum amount payable to CONTRACTOR for the period of July 1, 2019 through
June 30, 2020 shall not exceed Six Million Four Hundred Ninety-Seven Thousand Two
Hundred Eighty-Eight and No/100 Dollars ($6,497,288.00).
The maximum amount payable to CONTRACTOR for the period of July 1, 2020 through
June 30, 2021 shall not exceed Nine Million Four Hundred Eighty-Five Thousand Seven
Hundred Sixty-Three and No/100 Dollars ($9,485,763.00).
The maximum amount payable to CONTRACTOR for the period of July 1, 2021 through
June 30, 2022 shall not exceed Ten Million Five Hundred Eighty-Seven Thousand Five
Hundred Thirty-Four and No/100 Dollars ($10,587,534.00).
The maximum amount payable to CONTRACTOR for the period of July 1, 2022 through
June 30, 2023 shall not exceed Twelve Million One Hundred Fifty-One Thousand One Hundred
Forty-Two and No/100 Dollars ($12,151,142.00).
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
Forty-Two Million Nine Hundred Thirty-Nine Thousand Two Hundred Forty and No/100 Dollars
($42,939,240.00) during the total term of this Agreement.”
4. That Paragraph Four (4) – Compensation – Section H – of the Agreement, on Page Six
(6), beginning on Line Five (5) with the word “COUNTY”, and ending on Page Seven (7), Line Four (4)
with the word “Agreement” shall be deleted in its entirety and replaced with the following:
"H. COUNTY and CONTRACTOR recognize the importance of attracting and
retaining licensed psychiatrists to render services under this Agreement. Therefore,
CONTRACTOR will initiate a compensation incentive plan for CONTRACTOR’s licensed
psychiatrist employees providing direct client care under this Agreement, who have unpaid
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government or commercial loans for school tuition and educational costs (educational loan
repayment) with the goal of improving recruitment and retention of licensed psychiatrists.
COUNTY shall provide CONTRACTOR one lump-sum payment of no more than Fifty
Thousand and No/100 Dollars ($50,000.00) for each eligible licensed psychiatrist each twelve
(12) month period of this Agreement after CONTRACTOR provides written documentation to
COUNTY that: (1) the licensed psychiatrist has applied with at least three (3) eligible Federal,
State, or private educational loan repayment programs mutually agreed upon by
CONTRACTOR and COUNTY’s DBH Director, or designee, during the twelve (12) month
period; (2) the licensed psychiatrist has received less than $50,000 of funding from the eligible
Federal, State or private educational loan repayment programs during the twelve (12) month
period; and (3) the licensed psychiatrist delivered direct client care within COUNTY DBH
medical clinics for a period of twelve (12) consecutive months during the twelve (12) month
period in compliance with performance metrics to be determined mutually by CONTRACTOR
and COUNTY’s DBH Director, or designee. CONTRACTOR must provide written
documentation to COUNTY identifying the total amount of educational loan repayment funds
that have been awarded to the licensed psychiatrist by eligible Federal, State, or private
educational loan repayment programs, if any, during the twelve (12) month period. If a
licensed psychiatrist is awarded a cumulative amount less than $50,000 from one, or more,
eligible Federal, State, or private educational loan repayment programs during the twelve (12)
month period, the COUNTY shall pay CONTRACTOR the difference between $50,000 and the
total cumulative funding amount awarded by the eligible Federal, State, or private educational
loan repayment programs during the corresponding (12) month period.
“Direct client care” is defined as the time CONTRACTOR’s licensed psychiatrists
spend seeing individuals plus the time said licensed psychiatrists spend documenting the
individual visits in a manner ensuring completeness and compliance with all regulations
required for the COUNTY to submit claims to State DHCS for Federal and State
reimbursement for direct care delivered by CONTRACTOR’s licensed psychiatrists to Medi-Cal
eligible individuals.
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Said payment to CONTRACTOR from COUNTY shall survive the term of this
Agreement to ensure licensed psychiatrists that meet the requirements outlined above can
receive the educational loan repayment funds in accordance with the terms and conditions of
this Agreement.”
5. That Paragraph Seven (7) – Modification – of the Agreement, on Page Ten (10),
beginning on Line Sixteen (16) with the word “Notwithstanding”, and ending on Page Ten (10), Line
Twenty (20) with the word “Office.” shall be deleted in its entirety and replaced with the following:
“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 Revised Exhibit A, may be made with the signed written approval of
COUNTY’s DBH Director or designee and CONTRACTOR.”
COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend the
Agreement and, that upon execution of this Amendment, the Agreement and this Amendment together
shall be considered the Agreement.
The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
covenants, conditions and promises contained in the Agreement and not amended herein shall remain
in full force and effect. This Amendment I shall be effective upon execution by all parties.
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1 11 IN WITNESS WHEREOF, the parties hereto have executed this Amendment I as of the day and 2 11 year first hereinabove written. 3 4 11 CENTRAL CALIFORNIA FA CUL TY MEDICAL GROUP, INC. (CCFMG) 5 6;;~~ 7 II (Auth< 8 9 10 11 12 >rized Signature) Joyce Fields-Keene, MPA, CMPE Chief Executive Officer Print Name & Title 12/29/2021 Date Mailing Address: 13 11 2625 East Divisadero Street Fresno, CA 93721 14 11 Phone No. (559) 453-5200 15 16 17 18 19 20 21 22 23 24 25 26 27 28 FOR ACCOUNTING USE ONLY: Fund/Subclass: 0001/10000 Organization: 56302920 56302246 Account/Program: 7295/0 COUNTY OF FRESNO {LAf_ Brian Pacheco, Chairman of the Board of Supervisors of the County of Fresno ATTEST: Bernice E. Seidel Clerk of the Board of Supervisors County of Fresno, State of California ,//. ~ ... ~=------By: -~ Deputy -5 -
Revised Exhibit A
Page 1 of 11
GENERAL PROVISIONS
The General Provisions listed below will apply to all services to be delivered by
CONTRACTOR under this Agreement.
I.SERVICE STANDARDS:
A.The following provisions set forth in this exhibit shall constitute a part of the
Agreement between the COUNTY and CONTRACTOR, for providing psychiatric
services to COUNTY's Department of Behavioral Health (DBH), Adult Services
Programs, and Children's Services Program, and other programs as approved by
COUNTY’s DBH Director, or designee.
II.SERVICE PERFORMANCE MONITOR:
Organization: Fresno County Department of Behavioral Health
Street Address: 1925 E. Dakota Avenue
City and Zip Code: Fresno, CA 93726
III.PROGRAM AND SERVICE REOUIREMENTS:
A.CONTRACTOR shall provide the following throughout the term of this
Agreement:
1.CONTRACTOR shall assign physicians, and nurse practitioners, who are
qualified and licensed pursuant to the laws of the State of California, to COUNTY
in accordance to Section 1 of this Exhibit A of this Agreement.
2.In accordance with Division 5 Part 1 Chapter 4 Section 5405 of the Welfare and
Institutions Code, CONTRACTOR shall submit to criminal history reference
checks, including but not limited to, "Live Scan". CONTRACTOR is solely
responsible for ensuring the completion of this process, including all associated
costs. COUNTY will require additional credentialing by COUNTY for all
CONTRACTOR’s staff. No direct client contact by CONTRACTOR shall occur
prior to written clearance from COUNTY has been given.
3.In the event that recruitment of physicians, and nurse practitioners, is delayed,
COUNTY agrees to maintain utilization of telemedicine services until maximum
recruitment is achieved. Status of recruitment will be reviewed with COUNTY
DBH Director, or designee, quarterly.
B.Director of DBH or designee, and Medical Director shall meet quarterly to discuss
operational and contractual progress. Meetings will cover topics such as, but not
limited to;
1.Recruitment efforts
2.Clinical operations and multi-disciplinary collaboration and integration
3.Physical plant, security services, technology (EHR, computers, VPN, etc.)
4.Providing and maintaining adequate support for the providers including a
Revised Exhibit A
Page 2 of 11
Nurse Manager, OAs, social workers, nurses and therapists, and translation
services as needed.
C. CONTRACTOR’s employees will work within COUNTY facilities subject to the
Facility Use Agreement executed by the Parties in conjunction with this
Agreement. COUNTY will provide office space, computers, office equipment, basic
office supplies, and office furniture necessary to deliver services under this
Agreement. CONTRACTOR will schedule CONTRACTOR’s employees’ work
hours. COUNTY support staff will schedule clients in collaboration with
CONTRACTOR’s medical staff.
D.CONTRACTOR hereby certifies that any staff so assigned to provide services
pursuant to this Agreement shall:
1.Be Post Graduate Year 111 - V (PGY) in the event said staff is a physician.
2.Have and maintain their license in good standing.
3.Perform professional duties to the best of his or her ability, in accordance
with the highest scientific, professional and ethical standards of the
profession, and in accordance with currently approved methods and
practices in the field of psychiatry.
4.Comply with all applicable Federal State, COUNTY or other governmental
agency laws, ordinances, rules and regulations including CONTRACTOR
policy.
5.Comply with the requirements of all appropriate accrediting bodies, including
COUNTY current and future credentialing and/or accreditation requirements, and
any other State-related requirements.
6.Perform psychiatric related services subject to such assignments and work hours
to be arranged in writing to the mutual satisfaction of COUNTY and
CONTRACTOR. It is understood that COUNTY's contract monitoring shall not
include control or direction regarding diagnosis and prescription of psychiatric
treatment assuming that such diagnosis and treatment are in accordance with
MHP standards and all other requirements pursuant to this Agreement.
E.Administrative Requirements
1.CONTRACTOR shall provide a Medical Director that shall oversee all aspects of
psychiatric services under this Agreement.
2.Medical Director shall work collaboratively with other DBH leaders in clinical
and administrative operations.
3.Medical Director shall attend, and actively participate in, specifically identified
COUNTY DBH meetings, including but not limited to
i.Leadership Team Meetings
ii.Clinical Operations Meetings
iii.Compliance Committee
Revised Exhibit A
Page 3 of 11
iv.Quality Improvement Committee
v.Intensive Analysis Committee
Additional meetings will be identified during the duration of this
Agreement. Medical Director shall attend not less than 50% of all
requested meetings.
4.Medical Director shall provide consultation services to the DBH Director, DBH
Leadership Team Members, and other designees, as requested by COUNTY.
5.CONTRACTOR’s Medical Director shall participate in the development of policy
and procedures for services pertaining to this Agreement.
6.The Medical Director shall recruit, hire and retain qualified psychiatrists, and
nurse practitioners, for COUNTY.
7.Should CONTRACTOR determine that the support of an Administrative
Assistant is required for the Medical Director, CONTRACTOR shall
employee the Administrative Assistant.
F.Staffing
1.COUNTY and CONTRACTOR shall mutually agree on psychiatric services
staffing needs. CONTRACTOR shall have final say on staff placement.
2.CONTRACTOR shall be responsible for scheduled work hours of
CONTRACTOR’s employees to meet the mutually agreed upon volume
of services needed under this Agreement.
3.In the event a designated staff member does not perform services as required
by this Agreement because of prolonged absence or resignation, or failure to
meet performance standards, CONTRACTOR will provide a replacement.
If CONTRACTOR is unable to provide a replacement within 30 days, COUNTY
may proceed to use other internal or contracted resources. By mutual
agreement of CONTRACTOR and COUNTY, use of COUNTY internal or
contracted resources shall be utilized prior to 30 days if critical client care needs
are identified.
G.COUNTY and CONTRACTOR will have collaborative clinical oversite of all vendors
providing psychiatric services and staffing, such as; Psychiatrists and/or Nurse
Practitioners. COUNTY retains full authority on all contractual matters of all COUNTY
vendors.
H. CONTRACTOR shall participate in tracking and monitoring of outcome measures,
metrics, and goals on an annual basis with COUNTY.
Such metrics will include, but not be limited to:
1.Timely access to client care.
2.Timely follow-up to crisis.
3. Monitoring appropriateness of polypharmacy.
Revised Exhibit A
Page 4 of 11
4. Client satisfaction.
5.Provider satisfaction.
6.No-show rate.
7.Peer review, including adherence to standards of care.
I.CONTRACTOR’s psychiatry staff shall maintain a minimum standard of 32
weekly clinical hours of productivity (per Full Time Equivalent). At least 75% of
productive time shall be direct client care. Overall, productive time will include:
1.Direct client care.
2.Multidisciplinary clinical collaboration (team meetings, individual case
consultation, etc.).
3.Case review.
4.Providing training for COUNTY’s staff, and network of contracted providers, as
requested by COUNTY DBH
5.Administrative activities (e.g. quality assurance, peer review, pharmacy and
therapeutics committee).
J.Psychiatry staff who are full-time (40 hrs per week) with academic responsibilities
through CONTRACTOR’s affiliation with a medical education program (e.g. UCSF
Fresno) shall be allowed 8 hours of academic time, per week, per FTE. Staff who
are not full-time shall have academic time prorated based on their FTE. Psychiatry
staff without academic responsibilities shall not receive academic time.
Note: FTE represents 32 clinical hours and 8 academic time hours per week.
IV.CONFIDENTIALITY OF INFORMATION:
A.With respect to any information that would identify individual patients receiving
psychiatric services pursuant to this Agreement that is obtained by CONTRACTOR,
CONTRACTOR shall not use any such information for any purpose other than
carrying out the express terms of this Agreement, provided, however, that nothing
herein shall be constituted to prevent CONTRACTOR from using the information in
publication of research where such publication does not violate patient
confidentiality.
1.CONTRACTOR shall obtain written consent from COUNTY prior to
conducting any research.
2.CONTRACTOR shall at all times be in compliance with COUNTY’s policies
related to research including Institutional Review Board process.
B.Neither party shall release any confidential patient records except as required or
authorized by law or regulation. Each party shall respond to all requests for patient
records in accord with federal and state laws.
V.COUNTY SUPPORT FOR DESIGNATED CONTRACTOR STAFF:
A.COUNTY will provide, dependent on program configuration, the following for
CONTRACTOR staff performing services under this Agreement at COUNTY
facilities:
Revised Exhibit A
Page 5 of 11
1. Offices for professional use in connection to staff' assignment to perform at
the County facility.
2. Support services appropriate for the COUNTY’s operation of the clinic, which
shall include scheduling of client appointments, reception services, and support
for written correspondence regarding client care.
3. Such nursing and technical personnel, supplies, services and equipment
necessary for the provision of professional psychiatric services.
B. COUNTY shall also:
1. Reserve the right to require typed reports as necessary depending on the data
system used to maintain client activity records.
2. Reserve the right to change, add or delete the meeting obligations of
CONTRACTOR's staff assuming appropriate negotiation with COUNTY’s DBH
Director, or designee.
3. Notify the CONTRACTOR in writing 30 days prior to changing the Service
Performance Monitor.
4. Meet with CONTRACTOR to discuss any changes in proposed service revision.
5. Complete the Reauthorization process for each client annually to provide
updates regarding the client functioning and service plans/goals and continued
authorization for services.
Revised Exhibit A
Page 6 of 11
ADULT MENTAL HEALTH PSYCHIATRIC SERVICES
(County-Operated Clinics)
I. SERVICE LOCATIONS:
Facility Name: Metro Outpatient Clinic Facility Name: Health & Wellness Bldg
Street Address: 4441 E. Kings Canyon Rd Street Address: 1925 E. Dakota Ave
City and Zip code: Fresno, CA 93702 City and Zip code: Fresno, CA 93726
Facility Name: West Fresno Regional Center
Street Address: 188 E. California Ave
City and Zip code: Fresno, CA 93706
The above service locations are COUNTY’s current service locations, and the COUNTY, over the
duration of this Agreement, may add or change service locations.
II. SERVICE REOUIREMENTS:
A. CONTRACTOR shall provide integrated medication support services of co-
occurring mental health and substance use disorders in accordance with MHP
specialty mental health services requirements and documentation standards.
B. COUNTY will provide appropriate billing and documentation training.
C. CONTACTOR shall provide medication support services and support in
accordance with COUNTY policies, and include the following treatment strategies:
1. Medication Evaluation and Monitoring: CONTRACTOR shall offer medication
evaluation and monitoring to each client when clinically indicated. Medication
services will be provided individually or in a group setting. CONTRACTOR shall
provide not less than fifteen minutes of medication services for all clients within
the clinically appropriate timeframe, but not less than three times per year if
stable. Clients who are stable and maintain higher level of recovery shall be
transitioned when appropriate to outside providers.
2. Psychiatrists, nurse practitioners, and/or other members of the medical team will
complete the Initial Psychiatric Assessment at the start of psychiatric service,
and the Medication Service Plan (Avatar CWS) at the start of service, and
annually thereafter. All signature/co-signature requirements must be completed
in accordance with COUNTY DBH policy.
INITIAL PSYCHIATRY BUNDLE
• Initial Psychiatric Assessment
• Psychiatric MSE
• AIMS
• Diagnosis
• Order Connect
Revised Exhibit A
Page 7 of 11
•Medication Service Plan
•If applicable any new psychiatric tools
ANNUAL PSYCHIATRY BUNDLE
•Psychiatric MSE
•AIMS
•Diagnosis
•Order Connect
•Medication Service Plan
•If applicable any new psychiatric tools
3.The frequency and duration of medication management services will be
based on the client's current needs according to MHP guidelines, including medical
necessity requirements and client goals in accordance with his/her Medication
Service Plan and client choice.
D.CONTRACTOR shall ensure continuity in medication support services until client is
linked with an appropriate service.
E.CONTRACTOR shall ensure that all appointments for medication support services
are adequately covered with utilization of the following resources if for any reason
the psychiatrist, or nurse practitioner, of record becomes unavailable.
F.CONTRACTOR will ensure clients with urgent medication needs can be seen
timely, including the availability for walk-in, and/or crisis service as clinically
appropriate.
G.CONTRACTOR shall conduct psychiatric assessments, perform mental status
examinations and formulate diagnoses of clients being treated at the adult mental
health locations.
H.CONTRACTOR shall provide psychiatric testimony in Court when and where
necessary, with the exception of LPS Conservatorship and Forensic or Incarcerated
cases.
I.CONTRACTOR shall complete medical record documentation as required by
COUNTY’s DBH Policy and Procedures.
J.CONTRACTOR shall provide supervision to Psychiatry Residents assigned to the
COUNTY’s locations.
K.CONTRACTOR shall ensure adequate supervision of mid-level practitioners,
such as nurse practitioners.
L.CONTRACTOR shall perform administrative functions requiring psychiatry
staff and/or MD licensure, including but not limited to, review of inpatient
denials, participation in COUNTY DBH Credentialing Committee, review of
data and reports related to prescribing practices, quality assurance practices
Revised Exhibit A
Page 8 of 11
for medical team, and other functions as mutually agreed by COUNTY and
CONTRACTOR.
M. CONTRACTOR shall provide an onsite Medical Director to provide onsite
supervision (clinical and administrative) to all of CONTRACTOR’s staff.
Medical Director shall:
1. Provide clinical and administrative supervision.
2. Ensure all CONTRACTOR’s staff follow applicable policy and procedures as
required by COUNTY’s DBH.
3. Provide regular coordination with the Chief of the Department of Psychiatry
regarding staffing, periodic training, updating health requirements (as
mandated by an affiliated medical education program and County DBH),
performance and disciplinary issues related to physicians for the intent of
providing consistent quality of clinical care and training to meet the standards
set forth by affiliated medical education program (e.g., UCSF Fresno).
4. Coordinate with an affiliated medical education program (e.g., UCSF
Fresno) on the training of Psychiatry Residents.
5. Collaborate with COUNTY DBH’s Leadership Team in all matters of clinical
operations.
III. ADDITIONAL PROVISIONS:
A. CONTRACTOR shall:
1. Notify the COUNTY in writing or email 30 days prior to making any staffing
modifications to the staff assignments designated for each program/site
location listed in Section I above.
2. Receive written approval from the COUNTY prior to making any changes to
staffing and/or services rendered.
3. Ensure that all adult psychiatry staff remain in good standing with American
Board of Psychiatry and Neurology.
4. Ensure that adult psychiatry staff shall adhere to the rules and regulations as
well as bylaws that govern COUNTY staff.
Revised Exhibit A
Page 9 of 11
CHILD AND ADOLESCENT PSYCHIATRIC SERVICES
(County-Operated Clinic)
I.SERVICE LOCATION(S):
Facility Name: Heritage Center
Street Address: 3133 N. Millbrook Ave
City and Zip Code: Fresno, CA 93703
The above service location is COUNTY’s current service location, and the COUNTY, over the
duration of this Agreement, may add or change service locations.
II.SERVICE REOUIREMENTS:
A.CONTRACTOR shall provide integrated medication support services of co-
occurring mental health and substance use disorder services, in accordance
with MHP specialty mental health services requirements and documentation
standards.
B.COUNTY will provide appropriate billing and documentation training.
C.CONTRACTOR shall assess and provide outpatient psychiatric treatment for
children and adolescents who have been referred to COUNTY DBH.
D.CONTRACTOR shall provide medication support services and in accordance
with COUNTY policies, and include the following treatment strategies:
1.Medication Evaluation and Monitoring: CONTRACTOR shall offer medication
evaluation and monitoring to each client when clinically indicated. Medication
services will be provided individually. CONTRACTOR shall provide not less
than fifteen minutes of medication services for all clients within the clinically
appropriate timeframe, but not less than three times per year if stable. Clients
who are stable and maintain higher level of recovery shall be transitioned when
appropriate to outside providers.
2.Psychiatrists, nurse practitioners, and/or other members of the medical team
will complete the Initial Psychiatric Assessment at the start of psychiatric
service, and the Medication Service Plan (Avatar CWS) at the start of service,
and annually thereafter. All signature/co-signature requirements must be
completed in accordance with COUNTY DBH policy.
INITIAL PSYCHIATRY BUNDLE
•Initial Psychiatric Assessment
•Psychiatric MSE
•AIMS
•Diagnosis
•Order Connect
•Medication Service Plan
Revised Exhibit A
Page 10 of 11
• If applicable any new psychiatric tools
ANNUAL PSYCHIATRY BUNDLE
• Psychiatric MSE
• AIMS
• Diagnosis
• Order Connect
• Medication Service Plan
• If applicable any new psychiatric tools
3. The frequency and duration of medication management services will be
based on the client's current needs and goals in accordance with his/her plan
and client choice.
E. CONTRACTOR shall ensure continuity in medication support services until client is
linked with an appropriate service.
F. CONTRACTOR shall ensure that all appointments for medication support services
are adequately covered if for any reason the psychiatrist, or nurse practitioner, of
record becomes unavailable.
G. CONTRACTOR will ensure clients with urgent medication needs can be seen
timely, including the availability for walk-in, and/or crisis service as clinically
appropriate.
H. CONTRACTOR shall complete medical record documentation as required by
COUNTY’s DBH Policy and Procedures.
I. CONTRACTOR shall provide supervision to Psychiatry Residents assigned to the
COUNTY’s locations.
J. CONTRACTOR shall ensure adequate supervision of mid-level practitioners, such
as nurse practitioners.
K. CONTRACTOR shall perform administrative functions requiring psychiatry staff
and/or MD licensure, including but not limited to, review of inpatient denials,
participation in COUNTY DBH Credentialing Committee, review of data and
reports related to the prescribing practices, quality assurance practices for
medical team, and other functions as mutually agreed by COUNTY and
CONTRACTOR.
L. CONTRACTOR shall dutifully assess and provide treatment to clients being
served as deemed medically necessary.
M. CONTRACTOR shall provide appropriate documentation meeting utilization review
requirements approved by COUNTY. For child psychiatry staff, this will include
meeting guidelines for documentation of vital statistics, laboratory work, medication
service plans, medication consents and other appropriate documentation as
determined by COUNTY.
Revised Exhibit A
Page 11 of 11
N. CONTRACTOR shall coordinate with the Fresno County DBH Medical Director
with regards to medical and psychiatric issues related to the care and treatment
of clients at the Children’s Mental Health location.
III. ADDITIONAL PROVISIONS:
A. CONTRACTOR shall:
1. Notify the COUNTY in writing or email 30 days prior to making any staffing
modifications to the staff assignments designated for each program/site
location listed in Section I above.
2. Receive written approval from the COUNTY prior to making any changes to
staffing and/or services rendered.
3. Ensure that all child psychiatry staff remain in good standing with American
Board of Psychiatry and Neurology.
4. Ensure that child psychiatry staff shall adhere to the rules and regulations as
well as bylaws that govern COUNTY staff.
Revised Exhibit B
Page 1 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director 1.00 $80,625 $0 $80,625
0002 Assistant to Medical Director 1.00 $10,000 $0 $10,000
SALARY TOTAL 2.00 $90,625 $0 $90,625
PAYROLL TAXES:
0030 OASDI $562 $0 $562
0031 FICA/MEDICARE $1,314 $0 $1,314
0032 SUI $574 $0 $574
PAYROLL TAX TOTAL $2,450 $0 $2,450
EMPLOYEE BENEFITS:
0040 Malpractice $896 $0 $896
0041 Retirement $3,119 $0 $3,119
0042 Workers Compensation $743 $0 $743
0043 Health Insurance (medical, vision, life, dental, disabil.)$2,951 $0 $2,951
EMPLOYEE BENEFITS TOTAL $7,709 $0 $7,709
SALARY & BENEFITS GRAND TOTAL $100,784
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $0
1011 Rent/Lease Equipment $0
1012 Utilities $0
1013 Building Maintenance $0
1014 Equipment purchase $0
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone/Paging $210
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
1068 Food $0
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $3,100
1076 Recruiting $184,200
1077 Other - Airfare $1,300
Line Item Description (Must be itemized)
CCFMG
Ramp-Up (May 1, 2018 - June 30, 2018)
Budget Categories -Total Proposed Budget
Revised Exhibit B
Page 2 of 12
CCFMG
Ramp-Up (May 1, 2018 - June 30, 2018)
1078 Other - Rental Car $800
OPERATING EXPENSES TOTAL $189,610
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $43,859
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $43,859
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$0
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $0
FIXED ASSETS:
1190 Computers & Software $2,000
1191 Furniture & Fixtures $0
1192 Other - (Identify)$0
1193 Other - (Identify)$0
FIXED ASSETS TOTAL $2,000
TOTAL PROGRAM EXPENSES $336,253
Revised Exhibit B
Page 3 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director 1.00 $387,000 $43,000 $430,000
0002 Assistant to Medical Director 1.00 $60,000 $0 $60,000
0003 Chief Child Psychiatrist 0.50 $85,000 $85,000 $170,000
0004 Adult/Child Psychiatrist 1.00 $0 $320,000 $320,000
0005 Adult/Child Psychiatrist 1.00 $0 $320,000 $320,000
0006 Adult/Child Psychiatrist 1.00 $0 $320,000 $320,000
0007 Adult/Child Psychiatrist 1.00 $0 $320,000 $320,000
0008 Adult/Child Psychiatrist 1.00 $0 $320,000 $320,000
0009 Compensation Incentive (productivity & quality)$0 $320,000 $320,000
0010 Retention Bonus $0 $50,000 $50,000
SALARY TOTAL 7.50 $532,000 $2,098,000 $2,630,000
PAYROLL TAXES:
0030 OASDI $15,661 $43,784 $59,446
0031 FICA/MEDICARE $7,714.00 $30,421.00 $38,135
0032 SUI $718 $1,579 $2,296
PAYROLL TAX TOTAL $24,093 $75,784 $99,877
EMPLOYEE BENEFITS:
0040 Malpractice $7,167 $26,279 $33,446
0041 Retirement $18,360 $62,940 $81,300
0042 Workers Compensation $4,362 $17,204 $21,566
0043 Health Insurance (medical, vision, life, dental, disabil.)$20,955 $47,685 $68,640
EMPLOYEE BENEFITS TOTAL $50,844 $154,108 $204,952
SALARY & BENEFITS GRAND TOTAL $2,934,829
FACILITIES/EQUIPMENT EXPENSES:
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone $10,080
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
1068 Food $0
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $6,000
1076 Recruiting $419,300
1077 Other - Airfare $3,200
Line Item Description (Must be itemized)
CCFMG
Operational (July 1, 2018 - June 30, 2019)
Budget Categories - Total Proposed Budget
Revised Exhibit B
Page 4 of 12
CCFMG
Operational (July 1, 2018 - June 30, 2019)
1078 Other - Rental Car $1,600
OPERATING EXPENSES TOTAL $440,180
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $506,251
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $506,251
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$0
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $0
FIXED ASSETS:
1190 Computers & Software $0
1191 Furniture & Fixtures $0
1192 Other - (Identify)$0
1193 Other - (Identify)$0
FIXED ASSETS TOTAL $0
TOTAL PROGRAM EXPENSES $3,881,260
Revised Exhibit B
Page 5 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director 1.00 $395,398 $43,933 $439,331
0002 Assistant to Medical Director 1.00 $61,302 $0 $61,302
0003 Chief Child Psychiatrist 0.50 $86,845 $86,844 $173,689
0004 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0005 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0006 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0007 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0008 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0009 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0010 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0011 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0012 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0013 Adult/Child Psychiatrist 1.00 $0 $326,944 $326,944
0014 Compensation Incentive (productivity & quality)$0 $640,000 $640,000
0015 Retention Bonus $0 $100,000 $100,000
SALARY TOTAL 12.50 $543,545 $4,140,217 $4,683,762
PAYROLL TAXES:
0030 OASDI $15,742 $83,588 $99,330
0031 FICA/MEDICARE $7,881 $60,033 $67,915
0032 SUI $718 $3,014 $3,731
PAYROLL TAX TOTAL $24,341 $146,635 $170,976
EMPLOYEE BENEFITS:
0040 Malpractice $7,167 $50,169 $57,336
0041 Retirement $18,758 $124,207 $142,965
0042 Workers Compensation $4,457 $33,950 $38,407
0043 Health Insurance (medical, vision, life, dental, disabil.)$20,955 $91,035 $111,990
EMPLOYEE BENEFITS TOTAL $51,338 $299,360 $350,698
SALARY & BENEFITS GRAND TOTAL $5,205,436
FACILITIES/EQUIPMENT EXPENSES:
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone $14,280
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
1068 Food $0
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
Line Item Description (Must be itemized)
CCFMG
Operational (July 1, 2019 - June 30, 2020)
Budget Categories - Total Proposed Budget
Revised Exhibit B
Page 6 of 12
CCFMG
Operational (July 1, 2019 - June 30, 2020)
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $6,000
1076 Recruiting $419,300
1077 Other - Airfare $3,200
1078 Other - Rental Car $1,600
OPERATING EXPENSES TOTAL $444,380
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $847,472
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $847,472
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$0
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $0
FIXED ASSETS:
1190 Computers & Software $0
1191 Furniture & Fixtures $0
1192 Other - (Identify)$0
1193 Other - (Identify)$0
FIXED ASSETS TOTAL $0
TOTAL PROGRAM EXPENSES $6,497,288
Revised Exhibit B
Page 7 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director 1.00 $403,978 $44,886 $448,864
0002 Assistant to Medical Director 1.00 $62,632 $0 $62,632
0003 Chief Child Psychiatrist 0.50 $88,729 $88,729 $177,458
0004 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0005 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0006 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0007 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0008 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0009 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0010 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0011 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0012 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0013 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0014 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0015 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0016 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0017 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0018 Adult/Child Psychiatrist 1.00 $0 $334,039 $334,039
0019 Compensation Incentive (productivity & quality)$0 $1,088,000 $1,088,000
0020 Retention Bonus $0 $170,000 $170,000
SALARY TOTAL 17.50 $555,339 $6,402,200 $6,957,539
PAYROLL TAXES:
0030 OASDI $15,824 $123,392 $139,217
0031 FICA/MEDICARE $8,052 $92,832 $100,884
0032 SUI $718 $5,023 $5,740
PAYROLL TAX TOTAL $24,594 $221,247 $245,841
EMPLOYEE BENEFITS:
0040 Malpractice $7,167 $74,059 $81,226
0041 Retirement $19,165 $192,066 $211,231
0042 Workers Compensation $4,554 $52,498 $57,052
0043 Health Insurance (medical, vision, life, dental, disabil.)$20,955 $134,385 $155,340
EMPLOYEE BENEFITS TOTAL $51,841 $453,008 $504,849
SALARY & BENEFITS GRAND TOTAL $7,708,229
FACILITIES/EQUIPMENT EXPENSES:
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone $20,160
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
Line Item Description (Must be itemized)
CCFMG
Operational (July 1, 2020 - June 30, 2021)
Budget Categories - Total Proposed Budget
Revised Exhibit B
Page 8 of 12
CCFMG
Operational (July 1, 2020 - June 30, 2021)
1068 Food $0
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $6,000
1076 Recruiting $509,300
1077 Other - Airfare $3,200
1078 Other - Rental Car $1,600
OPERATING EXPENSES TOTAL $540,260
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $1,237,273
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $1,237,273
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$0
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $0
FIXED ASSETS:
1190 Computers & Software $0
1191 Furniture & Fixtures $0
1192 Other - (Identify)$0
1193 Other - (Identify)$0
FIXED ASSETS TOTAL $0
TOTAL PROGRAM EXPENSES $9,485,763
Exhibit B
Page 9 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director - (Dr. Tran)1.00 $412,744 $45,860 $458,604
0002 Executive Assistant - (Shelley McNiff)1.00 $61,465 $0 $61,465
0003 Interim Ass't Chief Peds - (Dr. Cheema)1.00 $360,000 $360,000
0004 Psychiatrist - (Dr. Benavidez)1.00 $350,000 $350,000
0005 Psychiatrist - (Dr. Domanska)1.00 $350,000 $350,000
0006 Psychiatrist - (Dr. Jawad)1.00 $350,000 $350,000
0007 PharmacistD - (Yuchen Wang)1.00 $145,203 $145,203
0008 Psychiatrist 1.00 $350,000 $350,000
0009 Psychiatrist 1.00 $350,000 $350,000
0010 Psychiatrist 1.00 $350,000 $350,000
0011 Psychiatrist 1.00 $350,000 $350,000
0012 Psychiatrist 1.00 $350,000 $350,000
0013 Psychiatrist 1.00 $350,000 $350,000
0014 Psychiatrist 1.00 $350,000 $350,000
0015 Psychiatrist 1.00 $350,000 $350,000
0016 Nurse Practitioner 1.00 $160,000 $160,000
0017 Nurse Practitioner 1.00 $160,000 $160,000
0018 Nurse Practitioner 1.00 $160,000 $160,000
0019 Nurse Practitioner 1.00 $160,000 $160,000
0020 Nurse Practitioner 1.00 $160,000 $160,000
0021 Nurse Practitioner 1.00 $160,000 $160,000
0022 Nurse Practitioner 1.00 $160,000 $160,000
0023 Nurse Practitioner 1.00 $160,000 $160,000
0024 Nurse Practitioner 1.00 $160,000 $160,000
0025 Nurse Practitioner 1.00 $160,000 $160,000
0026 Retention Bonus $270,000 $270,000
0027 Relocation Cost $200,000 $200,000
0028 Compensation Incentive (productivity & quality)$832,000 $832,000
SALARY TOTAL 25.00 $1,776,209 $6,001,063 $7,777,272
PAYROLL TAXES:
0030 OASDI $4,696 $211,601 $216,297
0031 FICA/MEDICARE $1,556 $92,335 $93,891
0032 SUI $262 $5,688 $5,950
PAYROLL TAX TOTAL $6,514 $309,624 $316,139
EMPLOYEE BENEFITS:
0040 Malpractice $478 $79,830 $80,308
0041 Retirement $878 $169,856 $170,734
0042 Workers Compensation $698 $41,392 $42,089
0043 Health Insurance and other benefits $11,743 $350,387 $362,130
EMPLOYEE BENEFITS TOTAL $13,796 $641,465 $655,261
SALARY & BENEFITS GRAND TOTAL $8,748,672
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $0
Line Item Description (Must be itemized)
CCFMG
Operational (July 1, 2021 - June 30, 2022)
Budget Categories - Total Proposed Budget
Exhibit B
Page 10 of 12
1011 Rent/Lease Equipment $0
1012 Utilities $0
1013 Building Maintenance $0
1014 Equipment purchase $0
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone $30,000
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
1068 Food $17,480
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $31,600
1076 Recruiting $352,000
1077 Other - Airfare $18,000
1078 Other - Rental Car $7,000
OPERATING EXPENSES TOTAL $456,080
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $1,380,983
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $1,380,983
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$1,800
1091 Translation Services $0
1092 Medication Supports $0
1093 Other - (Identify)$0
SPECIAL EXPENSES TOTAL $1,800
FIXED ASSETS:
1190 Computers & Software $0
1191 Furniture & Fixtures $0
1192 Other - (Identify)$0
1193 Other - (Identify)$0
FIXED ASSETS TOTAL $0
TOTAL PROGRAM EXPENSES $10,587,534
Exhibit B
Page 11 of 12
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Medical Director - (Dr. Tran)1.00 $420,998 $46,778 $467,776
0002 Executive Assistant - (Shelley McNiff)1.00 $62,695 $0 $62,695
0003 Interim Ass't Chief Peds - (Dr. Cheema)1.00 $367,000 $367,000
0004 Psychiatrist - (Dr. Benavidez)1.00 $357,000 $357,000
0005 Psychiatrist - (Dr. Domanska)1.00 $357,000 $357,000
0006 Psychiatrist - (Dr. Jawad)1.00 $357,000 $357,000
0007 PharmacistD - (Yuchen Wang)1.00 $148,817 $148,817
0008 Psychiatrist 1.00 $357,000 $357,000
0009 Psychiatrist 1.00 $357,000 $357,000
0010 Psychiatrist 1.00 $357,000 $357,000
0011 Psychiatrist 1.00 $357,000 $357,000
0012 Psychiatrist 1.00 $357,000 $357,000
0013 Psychiatrist 1.00 $357,000 $357,000
0014 Psychiatrist 1.00 $357,000 $357,000
0015 Psychiatrist 1.00 $357,000 $357,000
0016 Psychiatrist 1.00 $357,000 $357,000
0026 Psychiatrist 1.00 $357,000 $357,000
0027 Nurse Practitioner 1.00 $163,200 $163,200
0028 Nurse Practitioner 1.00 $163,200 $163,200
0029 Nurse Practitioner 1.00 $163,200 $163,200
0030 Nurse Practitioner 1.00 $163,200 $163,200
0031 Nurse Practitioner 1.00 $163,200 $163,200
0032 Nurse Practitioner 1.00 $163,200 $163,200
0033 Nurse Practitioner 1.00 $163,200 $163,200
0034 Nurse Practitioner 1.00 $163,200 $163,200
0035 Nurse Practitioner 1.00 $163,200 $163,200
0036 Nurse Practitioner 1.00 $163,200 $163,200
0037 Nurse Practitioner 1.00 $163,200 $163,200
0038 Retention Bonus $420,000 $420,000
0039 Relocation Cost $360,000 $360,000
0040 Loan Repayment Cost $500,000 $500,000
SALARY TOTAL 28.00 $1,763,693 $6,998,794 $8,762,488
PAYROLL TAXES:
0030 OASDI $4,772 $238,162 $242,934
0031 FICA/MEDICARE $1,587 $106,909 $108,496
0032 SUI $262 $6,402 $6,664
PAYROLL TAX TOTAL $6,622 $351,473 $358,094
EMPLOYEE BENEFITS:
0040 Malpractice $478 $91,040 $91,518
0041 Retirement $5,266 $189,068 $194,334
0042 Workers Compensation $712 $47,925 $48,636
0043 Health Insurance and other benefits $11,753 $397,507 $409,260
Line Item Description (Must be itemized)
CCFMG
Operational (July 1, 2022 - June 30, 2023)
Budget Categories - Total Proposed Budget
Exhibit B
Page 12 of 12
EMPLOYEE BENEFITS TOTAL $18,208 $725,540 $743,748
SALARY & BENEFITS GRAND TOTAL $9,864,330
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $0
1011 Rent/Lease Equipment $0
1012 Utilities $0
1013 Building Maintenance $0
1014 Equipment purchase $0
FACILITY/EQUIPMENT TOTAL $0
OPERATING EXPENSES:
1060 Telephone $33,600
1061 Answering Service $0
1062 Postage $0
1063 Printing/Reproduction $0
1064 Publications $0
1065 Legal Notices/Advertising $0
1066 Office Supplies & Equipment $0
1067 Household Supplies $0
1068 Food $21,480
1069 Program Supplies - Therapeutic $0
1070 Program Supplies - Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel (Out of County)$0
1074 Staff Training/Registration $0
1075 Lodging $36,400
1076 Recruiting $574,000
1077 Other - Airfare $24,400
1078 Other - Rental Car $10,200
OPERATING EXPENSES TOTAL $700,080
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $0
1083 Administrative Overhead $1,584,932
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $1,584,932
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant (network & data management)$1,800
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $1,800
FIXED ASSETS:
1190 Computers & Software $0
1191 Furniture & Fixtures $0
FIXED ASSETS TOTAL $0
TOTAL PROGRAM EXPENSES $12,151,142