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HomeMy WebLinkAboutAgreement A-22-041 w FCSS Resiliency Ctr. of Fresno.pdf- 1 -COUNTY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AMENDMENT I TO AGREEMENT NO. 21-377 THIS AMENDMENT, hereinafter referred to as “Amendment I”, is made and entered into this ____ day of _______, 2022, by and between the COUNTY OF FRESNO, a political subdivision of the State of California, hereinafter referred to as “COUNTY”, and each provider listed in Revised Exhibit A “Provider List”, attached hereto and by this reference incorporated herein and made part of this Agreement, and collectively referred to hereinafter as, “CONTRACTORS”. Reference in this Agreement to “Party” or “Parties” shall be understood to refer to COUNTY and each individual CONTRACTOR, unless otherwise specified. WITNESSETH WHEREAS, the Parties entered into that certain Agreement, identified as COUNTY Agreement No. 21-377, effective September 21, 2021, hereinafter referred to as “Agreement”, wherein CONTRACTORS agreed to operate a Mental Health Services Act (MHSA) Innovation-funded school- based trauma response program, which will respond to children and families immediately after a traumatic or stressful life event to provide early support, including, but not limited to, screening and assessing children for early indicators of mental health symptoms, empowerment of families with the tools they need to cope and recover, and connect children and families to any additional necessary resources, while reducing stigma and discrimination against mental illness; and WHEREAS, COUNTY, through the Department of Behavioral Health (DBH), and the CONTRACTORS are willing to correct the name of the CONTRACTOR Resiliency Center of Fresno from “The Fresno Police Chaplaincy Resiliency Center” to “Resiliency Center of Fresno”; and WHEREAS, the Parties desire to amend Agreement as stated below and restate the Agreement in its entirety. NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the Parties agree to amend the Agreement as follows: 1. All references in the existing Agreement to “Exhibit A” shall be changed to read “Revised Exhibit A,” attached hereto and incorporated herein by this reference. 2. All references in the existing Agreement to “Exhibit B” shall be changed to read “Revised Exhibit B,” attached hereto and incorporated herein by this reference. 1st February Agreement No. 22-041 - 2 -COUNTY OF FRESNO Fresno, CA 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 3.All references in the existing Agreement to “Exhibit C-1” shall be changed to read “Revised Exhibit C-1,” attached hereto and incorporated herein by this reference. 4.Agreement Section Twenty (20) “FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT,” on Page Twenty-Two (22), Line Twenty-Two (22) through Page Twenty-Three (23), Line Five (5), starting with the word “The” and ending with the word “Agreement” is deleted in its entirety and replaced with the following: “The Parties agree that, pursuant to Title 34 of the Code of Federal Regulations section 99.31(a)(1)(i)(B) and California Education Code section 49076(a)(2)(G), COUNTY and RESILIENCY CENTER OF FRESNO are contractors and consultants within the meaning of FERPA to whom FCSS has outsourced institutional services or functions that provide a legitimate educational interest for sharing personally identifiable information (“PII”) from pupil records in order to accomplish the functions, activities, or services provided for in this Agreement. The uses and disclosures of PII may not be more expansive than those afforded to FCSS employees. COUNTY and RESILIENCY CENTER OF FRESNO shall comply with all rules and laws related to contractors and consultants under FERPA. This provision allows FCSS to share information and records regarding those served under this Agreement with COUNTY and RESILIENCY CENTER OF FRESNO. Moreover, FCSS can share information under both FERPA and related California law due to the emergency nature of the services provided pursuant to this Agreement.” 5.COUNTY and CONTRACTORS agree that this Amendment I is sufficient to amend the Agreement and that upon execution of this Amendment I, the Agreement and Amendment I together shall be considered the Agreement. The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants, conditions, and promises contained in the Agreement that are not amended herein, shall remain unchanged and in full force and effect. This Amendment I shall be effective retroactive to September 21, 2021. /// /// /// 1 IN WITNESS WHEREOF , the Parties hereto have executed this Amendment I as of the day and 2 year first hereinabove written . 3 CONTRACTOR(S): 4 Please see attached signatures 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Fund/Subclass: 0001/10000 Account/Program : 7295/0 COUNTY OF FRESNO By :_IL_· ~_J_ __ Brian Pacheco , Chairman of the Board of Supervisors of the County of Fresno Date : ;i. --I -2 o 2. "J.... ATTEST: Bernice E. Se idel , Clerk to the Board of Supervisors County of Fresno , State of California By : ___ '1/-zt..:LL.~~E::....'-iiE!c::£:.l:~=~==--- Deputy Date : __ _;ol~--'J_--~2.-"-o-~_?..... ___ _ 27 Organization/Cost Centers: 56304794 ($1 ,061,460) 28 FY 2021 -22 $34 1,539 , FY 2022-23 $357 ,289 , FY 2023-24 $362,632 -3 -COUN TY OF FRESNO Fresno , CA Revised Exhibit A Page 1 of 1 Mental Health Services Act – Innovations Project Handle with Care Plus Schools and Community Innovation Services to Children/Youth (Ages 4-11 Years) and Family Provider List __________________________________________________________________________________ Fresno County Superintendent of Schools (FCSS) 1111 Van Ness Ave. Fresno, CA 93721 Phone: (559) 265-3010 Contact: Jim Yovino, Fresno County Superintendent of Schools Resiliency Center of Fresno (Resiliency Center) 3845 N. Clark ST Suite 201 Fresno, CA 93726 Phone: (559) 621-2121 Contact: Rodney Lowery, Executive Director __________________________________________________________________________________ Revised Exhibit B Page 1 of 14 Mental Health Services Act – Innovations Project SCOPE OF WORK PROGRAM NAME: Handle with Care Plus CONTRACTOR(S): Fresno County Superintendent of Schools (FCSS) 1111 Van Ness Ave. Fresno CA 93721 (559)265 – 3010 Jim Yovino, Fresno County Superintendent of Schools Resiliency Center of Fresno (Resiliency Center) 3845 N Clark ST. Suite 201. Fresno CA 93726 (559)621 – 2121 Rodney Lowery, Executive Director SERVICES: Schools and Community Innovation Services to Children/Youth –Ages 4-11 Years and Family SERVICE SITES: See Section V CONTRACT TERM: Three Year MHSA – Innovation Project Upon Contract Execution – June 30, 2024 CONTRACT AMOUNT: Fiscal Year Total Contract 2021 – 2022 $ 341,539.00 2022 – 2023 $ 357,289.00 2023 – 2024 $ 362,632.00 Maximum Compensation All Three (3) Years: $1,061,460.00 I.SCHEDULE OF SERVICES The standard hours of operations for this project will generally be Monday through Friday from 8:00 AM to 5:00 PM. FCSS will provide services throughout the school year and abide by their 8-hour employee workday and 12-month employee work calendar. The Resiliency Center will operate the Parent Cafés and host pre-scheduled or by appointment only non-traditional hours of operations to meet the needs of families. In general, operational hours of each component will be flexible to meet the needs of youths and families who are unavailable for services during standard business hours, including scheduled appointments on Saturdays and Sunday as needed. The hours of operations for this innovation project may be modified, with written approval from all Parties involved, based on the need to be effective and efficient. Hours of operation will be reviewed and discussed for appropriate changes. II.TARGET POPULATION The target population for this innovation project are children, ages 4-11 years of age and families who have experienced a life impacting event or trauma who attends one of the four Revised Exhibit B Page 2 of 14 identified schools (in Section V). These students and families will vary in age, gender, ethnicity, and lower socio-economic backgrounds and from neighborhoods surrounding identified schools. Although the target population for this project will revolve around the individuals of the four targeted schools, all youths identified will be referred and/or linked to appropriate community resources. III. PROJECT DESCRIPTION AND CONTRACTOR(S) RESPONSIBLITIES In Fresno County, many children, teens, and communities have been exposed to some sort of trauma and significant stressful life event(s). These traumatic events can include but are not limited to; violence in the home or community; loss of loved ones through divorce, death, incarceration, and other separations; and any major life changes from natural disasters, accidents, and other life altering incidents. If traumatic events are not addressed, it can have many effects on a person’s behavior, body, emotions, and way of thinking. If these children do not develop resilience post-trauma, they may experience health problems, including serious mental health illness and mental health crises. In accordance with the Innovation Plan approved on July 7, 2020 by the Fresno County Board of Supervisors, the proposed innovations program, Handle with Care Plus, is intended to measure the outcomes of a trauma response team and determine if a psychoeducational parent café component can assist in reducing effects of trauma. If this project is successful, it will provide a viable and replicable model to be applied to other parts of the county and the state for proactive response to mental health rather than reacting with more costly intervention in the future. This project is a collaboration with Fresno County’s Department of Behavioral Health’s (DBH) community partners, Fresno County Superintendent of Schools (FCSS) and the Resiliency Center of Fresno (Resiliency Center), that will respond to children and families immediately after a trauma or a stressful life event(s). The focus is to provide early support, screening, and assessment of children for early indicators of mental health symptoms, empower the family with the tools they need to cope and recover, and connect children and families to any additional necessary resources. This focus on parent education and empowerment distinguishes this innovation program from similar Handle with Care programs provided in California. When the Fresno Police Department responds to calls, they enter call data into a secure smart application developed and operated by the Fresno Police Chaplaincy. The app allows real-time, accessible data that allow for timely response and notification of traumatic events. The Resiliency Center will access and review this data to screen for all calls to consist of a traumatic or life impacting event in which children were involved and quickly notify FCSS of the event. FCSS will notify the child’s school via the Handle with Care notice, that the student has experienced a potentially traumatic event and may experience difficulties performing their daily activities (without violating any Family Educational Rights and Privacy Act (FERPA), related California Education Code sections and/or other applicable state or privacy laws) so that the school can notify relevant staff – such as school administration, teachers, counselors, and other appropriate service providers. FCSS will screen and assess the child and connect the family to support—such as the Parent Cafés to help the child and family in their recovery from the life- Revised Exhibit B Page 3 of 14 impacting or traumatic event. If the child is in one of the four targeted schools (in Section V), the Triage Team will screen the child to identify the potential need for additional individual support and family supports including resources offered by the Resiliency Center’s Parent Café. If the child is not in one of the targeted schools, FCSS will have already sent the Handle with Care notice to the child’s school and refer to the Resiliency Center or All 4 Youth program, which will respond with their available resources. During the screening process, the Triage Team will determine if the student has existing supports through a community provider. If they do, the student will be connected to those providers for follow-up services. Families will be provided with information on the Parent Café program to access education and supports that increase resilience following exposure to a traumatic life event. If the individual has no existing community support, they will be linked to the appropriate resources in the community and families will be referred to the Resiliency Center’s Parent Café program and any other appropriate educational opportunities. All processes and referrals will abide by confidentiality and privacy laws applicable to the agency. FCSS staff will also notify other schools (not targeted in this innovations project) to connect any siblings or other household members who reside with the involved student but attend a different school. This step is intended to bring awareness to school staff (not at the targeted schools) that there is a Handle with Care situation and the potential that siblings and other relatives who may need supports from school-based services. Handle with Care Process: When the Triage Team receives notification from the Resiliency Center of a student is involved in a traumatic event, FCSS will identify the school that the child attends and immediately send the school a Handle with Care notice. This notice has no confidential or clinical information, only the child’s name and grade (the Handle with Care notice form will be developed by the Parties involved and will maintain the confidentiality of the child as required by applicable laws). Step 1: Upon FCSS sending Handle with Care notice to the targeted school, the student and their family will be assigned to the Triage Team consisting of the FCSS Clinician and Resiliency Center Family Partner. Step 2: The responding team will search DBH’s electronic health record system (currently Avatar) to determine whether the student has a history in the behavioral health system (if they are currently receiving services so to avoid any duplication), etc. If the student has an open record in Avatar, FCSS will reach out to the parent/guardian to request approval to inform their child’s provider in the community of the life impacting or traumatic event. The student’s family will be provided with information on the Resiliency Center’s Parent Café program that could support and educate family on being resilient after being exposed to trauma. Revised Exhibit B Page 4 of 14 If the family declines authorization for notification of existing provider and/or the Parent Café program, the referral will then be closed by FCSS, and referred to the Resiliency Center for resources. If the student has no history in Avatar or does not have an active case, the Triage Team will: Step 1: Contact the family to offer support services. If the parent/guardian declines services, FCSS will ask if they can mail the family information on services, the Parent Café program, and other educational opportunities in case the family would like to access information later. FCSS will inform the Resiliency Center that the family declines services, FCSS will then close out the referral and families will be referred to the Fresno Police Chaplaincy for resources. Step 2: If the parent/guardian accepts the services for their child, Triage Team clinician will screen for the impact of trauma on the child and provide mental health services or resources based on the results. If at that time the child does not show any symptoms the parents will still be provided with Parent Café information. The school will be notified of the results of the screening and ask to re-refer the child if symptoms manifest in the future. Although the Triage Team will have the child as their primary focus, this program can assist parents with access and linkage for them or other family members as well. Step 3: If, based on the screening, the child may need additional services or treatment, the FCSS Triage Team Clinician will conduct a clinical assessment to determine the need. If the intervention will take beyond six sessions, a warm handoff will be provided to link them into the services they are needing (either school-based or with another provider). If the symptoms can be addressed in short intervention, then the Triage Team will provide up to six session. This is to ensure the child is not without services while awaiting to access clinical services. FCSS will also notify other schools not targeted in this project, for any siblings or other household members who reside with the student but attend a different school (i.e. a sibling or cousin who is in junior high or high school), to ensure that the school is aware of the handling with care situation, and they can refer those students, not in the four participating elementary schools to the school based services available there or other community resources for screening and/or assessment. Screening tools considered are; Pediatric ACES and Related Life-event Screener (PEARLS), the Pediatric Symptom Checklist (PSC-35), along with other screeners in The National Child Traumatic Stress Network database. However, utilization will be determined based on its compatibility with the target population and setting, and responsiveness. A convening of all Parties will decide upon the appropriate screening tool for this project. The Handle with Care Plus Flowchart, attached hereto and referenced herein as Exhibit B-3, provides a general outline for FCSS and the Resiliency Center to follow through with care coordination for the individuals identified and may be modified and/or amended to meet the needs of the clients and/or as agreed upon by all Parties: DBH Director or designee, FCSS, and The Resiliency Center. Revised Exhibit B Page 5 of 14 Parent Café: The Parent Café component will assist in the development of the parent or caregiver’s understanding of the trauma or life impacting event that affected them and their child, increase their understanding about the protective factors of their family and build a sense of community within the Parent Café where mental health stigma can be discussed, addressed, and reduced. Parent Cafés have various curriculum designs. Based on the Innovation Project proposal, we are implementing a curriculum similar to the Strengthening Families curriculum. This curriculum was designed as a resource for those training or conducting professional development with child welfare workers but has since been adapted by many other programs to create content that is relevant for their target audience. This researched-informed approach was designed to increase family strengths, enhance child development, and reduce the likelihood of child abuse and neglect. It is based on engaging families, programs, and communities in building five (5) key Protective Factors: parental resilience, social resilience, knowledge of parenting and child development, concreate support in times of need, and social and emotional competence of children. DBH has partnered with Brain Wise Solutions Group, INC via a separate agreement to develop the Parent Café curriculum. Brain Wise will incorporate the five protective factors and modify the curriculum appropriately for our communities’ children and families exposed to trauma. The Resiliency Center will implement the developed Parent Café curriculum and seek to create a coffee house environment to welcome gatherings of parents who are identified as potentially benefiting from group learning and sharing. The Resiliency Center will offer psychoeducation to parents centered on trauma informed skills and the impact of ACES on children. The Parent Café curriculum will be an eight-week course covering social determinants to health, peer roles and empowerment, and whole family resilience. When the Resiliency Center receives the referral from FCSS, they will contact the student and family members and schedule them for an initial Parent Café meeting. Voluntary participation will also be reviewed for appropriateness. The Parent Café will be staffed by a Clinician and a Parent Partner. The Parent Partner will create meaningful relationships and engaging conversation while demonstrating respect, trustworthiness, empathy, and collaboration with the families. The Parent Partner will support the Parent Cafes’ strength-based framework that emphasizes physical, psychological, and emotional safety and help support resiliency in the community. The Parent Partner will facilitate the workshops in the Parent Café and will be accompanied by a clinician to ensure fidelity and provide any answers to clinical inquires. The Parent Partner will work to coordinate and provide warm hand-offs to parents seeking other services, both at the Resiliency Center as well as in the community. The Resiliency Center will provide monthly trainings to staff, staying up to date on current methodologies for trauma informed interventions and tools, by a mental health clinician who is onsite that has received Trauma-Informed training from the Community Resilience Initiative. The clinician provides on-going training to the Resiliency Center staff and clinicians with a research-based approach to responding to trauma. The Resiliency Center will also leverage ongoing resources at the center to complement services to the Parent Café participants. Currently, ongoing services at the center are Revised Exhibit B Page 6 of 14 educational mentorship programs, counseling and linkage services. Parent Café participants will earn incentives and prizes to encourage ongoing engagement. At the conclusion of the trauma-informed training for parents at the Parent Café, an evaluation will be completed by each participant to determine the effectiveness and impact of the instruction. Utilizing its current MOU with Fresno Unified School District (FUSD), the Resiliency Center will receive quarterly data on attendance, grades, and behavior for each child in their school who is receiving services from the Resiliency Center. This information will be helpful in assessing the child’s current state as well as informing the Resiliency Center on its impact on the child in their educational environment. IV. STAFFING The Resiliency Center will staff the Parent Cafés: .80 FTE - Associate Marriage and Family Therapist Bilingual mental health clinician who will provide the didactical presentations to the parents as well as any support for the participants, to ensure accurate information is presented, and to be able to properly interview and mitigate any possible crisis. .80 FTE - Triage Liaison/Case Manager This will be a position that will support the Resiliency Center and the Fresno Police Chaplaincy in their overall efforts to screen and process calls for both this program and for overall efforts for family engagement. The focus for this position will be to prioritize efforts to screen all calls and to identify calls which meet the project criteria and narrow them to the four participating schools and neighborhoods. This position will then share the relevant calls with the trauma response school team. This position ensures the project has dedicated staff to assist with screenings and ensure the real-time/timely acquisition of data to generate referrals and response. When not reviewing data and call information for the project, the Triage Liaison will screen other calls to support the outreach of the Resiliency Center. For cases where families decline services from the trauma response team, those cases will be submitted to the Triage Liaison, who will then forward those cases on to the Resiliency Center. .68 FTE - Parent Peer/Liaison A Parent Peer/Liaison, who will possess lived experience involving behavioral health (these individuals have experience living with mental health illness and/or supports someone living with mental illness) will create meaningful relationships and engaging conversation while demonstrating respect, trustworthiness, empathy and collaboration with the families. The Parent Partner will support the Parent Cafes’ strength-based framework that emphasizes physical, psychological, and emotional safety and help support resiliency in the community. The Parent Partner will facilitate most of the workshops in the Parent Café. The Parent Partner will work to coordinate and provide warm hand-offs to parents seeking other services, both at the center as well as in the community. 1 FTE - Family Partner/Peer Professional A Family Partner/Peer Professional, who will possess lived experience involving Revised Exhibit B Page 7 of 14 behavioral health (these individuals have experience living with mental health illness and/or supports someone living with mental illness) under general supervision, will engage children and their families as part of the Triage Team with the FCSS Clinician as a tandem or individually to; deliver peer to peer support services to behavioral health clients and their family members/caregivers; provide peer-to-peer support services including: monitoring, informing, supporting, assisting and empowering clients and their family members/caregivers who directly or indirectly receive behavioral health services; develop and coordinate activities, programs and resources which directly support clients and family members/caregivers in achieving wellness and recovery oriented goals; facilitate peer-to-peer assistance as a part of a team setting; conduct outreach to clients, family members/caregivers and the community; and, acting in a liaison role between clients, family members/caregivers, and community service providers. Collaboration between both the Resiliency Center and FCSS will be essential in the overall effectiveness of this position because this individual will be part of the Triage Team with FCSS’s Clinician. The Resiliency Center will oversee and supervise this individual. FCSS will work in collaboration and coordination with the Resiliency Center to create and support the Triage Team. This position’s responsibilities may be modified as the project develops and as agreed upon by the Parties and DBH Director, or designee. The Fresno County Superintendent of Schools (FCSS) will staff: 1 FTE - Bilingual Behavioral Health Clinician (BHC II) A licensed Bilingual Behavioral Health clinician position, under the direction of the assigned supervisor, will coordinate and provide behavioral health services to students and families within Fresno County; provide assessment and assistance with the goal of facilitating and promoting appropriate behavioral health and personal growth; provide clinical supervision of assigned interns/associates and student interns/trainees to ensure the delivery of a clinically sound comprehensive program; identify the behavioral health needs of students and develop therapy goals and objectives for implementation through an individual therapy plan; provide supervision, consultation, and technical assistance to pre-licensed Behavioral Health Counselors. This position can provide both direct services and lead the project. The clinician will be able to leverage from FCSS existing All 4 Youth school-based clinicians at these school sites for any additional clinical support (assessment, evaluation) and/or treatment. V. SERVICE LOCATIONS While services will mainly be relegated to the service locations identified below, services can be arranged by CONTRACTOR(S) and families to be receive in the home, school, or other community space as agree upon by all Parties. Any referrals where the children are not linked to these piloted schools will be referred/linked to resources in the community for behavioral health services. Targeted Schools and service locations: 1. Del Mar Elementary – 4122 N. Del Mar AVE. Fresno, CA 93704 Revised Exhibit B Page 8 of 14 2. Lowell Elementary – 171 N. Poplar AVE. Fresno, CA 93701 3. Pyle Elementary – 4140 Augusta ST. Fresno, CA. 93726 4. Heaton Elementary – 1533 N. San Pablo AVE. Fresno, CA. 93728 Parent Café service locations: 1. Resiliency Center – 3845 N. Clark ST. Suite 201. Fresno CA. 93726 2. Resiliency Center – 905 N. Fulton ST. Fresno, CA. 93728 VI. SERVICE START DATE Ramp-Up Period – Up to 30 days upon contract execution date • CONTRACTOR(S) to secure and/or develop space and recruit and hire staff (including orientation, training, and any necessary onboarding protocols). Phase 1 – Upon contract execution date to June 30, 2022 • CONTRACTOR(S) to begin direct services, including, but not limited to; screening calls, making referrals, notification of schools, screening of students, parent engagement, and facilitation of the Parent Café. • Lowell Elementary and Heaton Elementary to begin participation. • CONTRACTOR(S) to assist evaluators with the evaluation process, including participation in meetings, services and data collection, and evaluation coordination. Phase 2 – July 1, 2022 to June 30, 2024 (2 Fiscal Years) • Program direct services and project evaluation supports to continue. • Del Mar Elementary and Pyle Elementary to begin participation. • Resiliency Center will develop a second Parent Café site in the community around the two new schools to increase accessibility of support services. Transition Plan Phase – April 1, 2024 to June 30, 2024 • DBH, FCSS, and Resiliency Center will collaborate to develop a transition plan for the project, as well as working with evaluators in developing a final report. VII. CULTURAL COMPETENCY A. CONTRACTOR(S) shall provide the following as it relates to cultural competency services: 1. CONTRACTOR(S) shall recruit and hire staff that have demonstrated experience working with Fresno’s diverse communities and to reflect the population of the projects targeted schools and other underserved and inappropriately served populations and have knowledge about the culture of these targeted groups as well as other diverse communities. Revised Exhibit B Page 9 of 14 2. CONTRACTOR(S)’s staff shall attend annual trainings on cultural competency, awareness, and diversity as provided by CONTRACTOR(S). CONTRACTOR(S)’s staff shall be appropriately trained in providing services in a culturally responsive or appropriate manner. 3. CONTRACTOR(S)’s staff shall attend civil rights training as provided by CONTRACTOR(S). 4. CONTRACTOR(S) are recommended to hire bilingual staff, whom are at a minimum, competent in Spanish and Hmong as these are the identified threshold languages in Fresno County. 5. CONTRACTOR(S) shall secure the services of trained translators/interpreters as may be necessary. Translators/interpreters may prove invaluable for languages such as Cambodian, Russian, Arabic, Armenian, Punjabi, and others. Translators/interpreters shall be appropriately trained in providing services in a culturally sensitive manner. 6. CONTRACTOR(S) shall train staff on best practice for utilizing interpreters to ensure effective communication with monolingual consumers and families to assist in the delivery of culturally/linguistically appropriate services. 7. CONTRACTOR(S) shall provide services by placing importance on traditional values, beliefs, and family histories. Cultural values and traditions offer special strengths in treating clients and this should help guide health care messages and wellness and recovery plans. 8. CONTRACTOR(S) shall provide services within the most relevant and meaningful cultural, gender-sensitive, and age-appropriate context for the target population. 9. CONTRACTOR(S) shall develop plans to continually engage targeted populations. 10. CONTRACTOR(S) shall distribute literature/informational brochures in the County’s current threshold languages and request feedback as to how access to care could be improved for these culturally diverse communities. 11. CONTRACTOR(S) shall conduct an annual cultural competency self-assessment and provide the results of said self-assessment to the COUNTY. The annual cultural competency self-assessment instruments shall be reviewed by the COUNTY and revised as necessary to meet the approval of the COUNTY. The CONTRACTOR(S) can create their own cultural competency self-assessment tools or utilize instruments to be provided by COUNTY. 12. CONTRACTOR(S) shall provide services for the project’s pilot areas, the community and home as needed, to increase the frequency of clients obtaining needed services as some children/families are reluctant to seek services at school sites. 13. CONTRACTOR(S) shall promote system of care accountability for performance outcomes which enable children and their families to live independently, work, maintain community supports, stay in good health, and avoid substance abuse and incarceration. Revised Exhibit B Page 10 of 14 14. CONTRACTOR(S) shall provide family support and the creation of family partnerships utilizing peer support for families and parenting support. 15. CONTRACTOR(S) shall use culturally specific multidisciplinary treatment teams responsible for assuring and providing needed services. 16. CONTRACTOR(S) shall provide Parent Café in the preferred language of the participant client/families using interpreters if needed. 17. CONTRACTOR(S)’s staff will be trained to keep an open mind and maintain non- judgmental interaction with clients/families. 18. CONTRACTOR(S)’s hiring and contracting practices shall be based on local data and reflect the needs of the population to be served. 19. CONTRACTOR(S) shall attend the COUNTY’s Cultural Humility Committee monthly meetings, maintain its own cultural competence oversight committee, and develop a cultural competency plan to address and evaluate cultural competency issues. 20. COUNTY shall provide technical assistance and demographic data to CONTRACTOR(S) in relation to cultural competency planning. VIII. COUNTY RESPONSBILITIES A. COUNTY shall: 1. Provide oversight, through its DBH Director, or designee, and collaborate with CONTACTOR(S) and other COUNTY Departments and community agencies to help achieve State program goals and outcomes. In addition to contract monitoring of program(s), oversight includes, but not limited to, coordination with the State Department of Health Care Services in regard to program administration and outcomes. 2. Assist the CONTRACTOR(S) 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 CONTRACTOR(S)’s staff and will be available to the CONTRACTOR(S) for ongoing consultation. 4. Gather outcome information from CONTRACTOR(S) throughout each term of this Agreement. COUNTY DBH staff shall notify the CONTRACTOR(S) when its 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. Assist the CONTRACTOR(S)’s efforts towards cultural and linguistic competency by providing the following to CONTRACTOR(S): a. Technical assistance and training regarding cultural competency requirements. Revised Exhibit B Page 11 of 14 b. Mandatory cultural competency training for CONTRACTOR(S) personnel, at minimum once per year. c. Technical assistance for translating information into COUNTY’s threshold languages (Spanish and Hmong). Translation services and costs associated will be the responsibility of the CONTRACTOR(S). IX. REPORTING REQUIREMENTS AND PERFORMANCE OUTCOMES MONITORING This collaboration is a Mental Health Services Act (MHSA) Innovations funded project and throughout the process of services, CONTRACTOR(S) will provide regular updates to DBH summarizing how the goals and objectives are being met through the provision of services. During the term of this Agreement, additional data collection opportunities may be identified and implemented to support the MHSA Innovation research aspects of the Handle with Care Plus program. DBH and CONTRACTOR(S) will review additional outcomes, MHSA INN requirements and CARF standards to establish and further agreed upon outcomes to be tracked. CONTRACTOR(S) will actively collaborate with DBH and a third-party consultant to develop and refine data collection and reporting processes to ensure compliance with MHSA Innovation Plan requirements. CONTRACTOR(S) shall submit measurable outcomes on an annual basis, as identified in the Departments Policy and Procedure Guide (PPG) 1.2.7 Performance Outcomes Measures, attached hereto, and referenced herein as Exhibit B-1. Performance outcomes measures must be approved by the Department and satisfy all State and local mandates. The Department will provide technical assistance and support in defining measurable outcomes. All performance indicators will reflect the four domains identified by the Commission Accreditation of Rehabilitation Facilities (CARF). The domains are Effectiveness, Efficiency, Access, and Satisfaction. These are defined and listed below. The Fresno County Department of Behavioral Health collects data about the characteristics of the persons served and measures service delivery performance indicators in each of the following CARF Domains: At minimum, one performance indicator will be identified for each of the four CARF domains listed below. 1. Effectiveness: A performance dimension that assesses the degree to which an intervention or services have achieved the desired outcome/result/quality of care through measuring change over time. The results achieved and outcomes observed are for persons served. Examples of indicators include: Persons get a job with benefits, or receive supports needed to live in the community, increased function, activities, or participation, and improvement of health, employment/earnings, or plan of care goal attainment. 2. Efficiency: Relationship between results and resources used, such as time, money, and staff. The demonstration of the relationship between results and the resources used to Revised Exhibit B Page 12 of 14 achieve them. A performance dimension addressing the relationship between the outputs/results and the resources used to deliver the service. Examples of indicators include: Direct staff cost per person served, amount of time it takes to achieve an outcome, gain in scores per days of service, service hours per person achieving some positive outcome, total budget (actual cost) per person served, length of stay and direct service hours of clinical and medical staff. 3. Access: Organizations’ capacity to provide services of those who desire or need services. Barriers or lack thereof for persons obtaining services. The ability of clients to receive the right service at the right time. A performance dimension addressing the degree to which a person needing services is able to access those services. Examples of indicators include: Timeliness of program entry (From 1st request for service to 1st service), ongoing wait times/wait lists, minimizing barriers to getting services, and no-show/cancellation rates. 4. Satisfaction: Satisfaction Measures are usually orientated towards consumers, family, staff, and stakeholders. The degree to which clients, the County and other stakeholders are satisfied with services. A performance dimension that describes reports or ratings from persons served about services received from an organization. Examples of indicators include: opinion of persons served or other key stakeholders in regard to access, process, or outcome of services received, Consumer and/or Treatment Perception Survey. Providers can develop their respective satisfaction survey for distribution which will require County approval. A. Data Collection 1. Data collection and evaluation methods may include, but are not limited to, staff, participant, and family interviews; and case file reviews. 2. CONTRACTOR(S) shall also conduct consumer satisfaction surveys to see if there is a strong correlation of the efficacy of the evidence-based program with specific ethnicities and languages as well as to identify gaps in meeting cultural needs of clients/families, if any. 3. CONTRACTOR(S) shall ensure all program clients/families participate in the semi- annual State Consumer Perception Survey (CPS). CPS surveys will be distributed to all clients/families to fill out and return to CONTRACTOR(S). 4. CONTRACTOR(S) shall collect data regarding the ethnicity and language of each client/family receiving services as well as directing staff to follow-up with the culturally diverse clients/families for suggestions on how to improve the programs and also how to help make the programs more culturally relevant according to MHSA INN regulations. Revised Exhibit B Page 13 of 14 5. CONTRACTOR(S) shall maintain all client data in permanent electronic case records. CONTRACTOR(S) shall have established policies and procedures for data collection and client confidentiality. B. Performance Goals CONTRACTOR(S)’s performance shall also be evaluated according to its scope of work goals and effectiveness indicators listed below and any further agreed upon outcomes to be tracked and reported throughout this Innovation project. CONTRACTOR(S) shall be evaluated on by COUNTY DBH utilizing the following performance outcomes: Effectiveness: Goal/Objective: Children and families will have their needs identified and linked to appropriate services. Outcome: Children and families will be screened to identify needs. Measure: Screening tool (For example: ACE’s, PSC-35, ASQ-3, and PEARLS). Efficiency: Goal/Objective: When the Triage Team receives the notification from the Resiliency Center, they will identify the school that the child attends and immediately send the school a Handle with Care notice. Outcome: Schools will receive a Handle with Care notice from FCSS for identified youth/family. Measure: The number of Handle with Care notices given to the identified two schools in year one of the innovation project. The number of Handle with Care notices given to the identified four schools in subsequent years of the innovation project. Access: Goal/Objective: Engage children and/or families into clinical services or link to care after receiving education from the Handle with Care staff member. Outcome: Engage children and/or families into clinical services or link to care after receiving education from the Handle with Care staff Revised Exhibit B Page 14 of 14 member. Measure: Engage children and/or families into clinical services or link to care after receiving education from the Handle with Care staff member. Satisfaction: Objective: School and family will be satisfied with Handle with Care staff engagement. Outcome: School and families will report satisfaction with engagement, linkage, resources, and clinical care. Measure: Handle with Care Satisfaction Surveys. C. Reports 1. CONTRACTOR(S) shall prepare an evaluation report annually and submit to the COUNTY’s DBH and make said reports available to partnering and interested local agencies and organizations such as the project collaborators, other community agencies and mental health treatment providers. Each annual evaluation report will comply with all State regulations regarding State Performance Outcomes measurement requirements, including MHSA Innovations regulations, and participate in the outcomes measurement process as required by DBH. General performance outcomes reporting contains the following information: demographics of the target population served, services provided to each participant, number of hospitalization, enrollment in school, results of data analysis compared to planned process, output and outcome measures, barriers to program implementation and measures taken to overcome those barriers, accomplishments of program participants, lessons learned, and the final result of any and all satisfactory survey(s). 2. CONTRACTOR(S) shall be expected to comply with all contract monitoring and compliance protocols, procedures, data collection methods, and reporting requirements conducted by the COUNTY. 3. Additional reports/outcomes may also be requested by the COUNTY’s Department of Behavioral Health, based on among other things, identification of client/family specific needs as well as State required reports/outcomes as needed. Employee Salaries Acct #Position FTE Admin Direct Total 1101 Associate Marriage & Family Therapist 0.80 -$ 41,600$ 41,600$ 1102 Triage Liaison / Case Manager 0.80 - 36,608 36,608 1103 Parent Peer / Liaison 0.68 - 30,888 30,888 1104 Peer Support Specialist II 1.00 4,992 33,280 38,272 1105 - - - 1106 - - - 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 3.28 4,992$ 142,376$ 147,368$ Employee Benefits Acct #Admin Direct Total 1101 -$ -$ -$ 1102 - - - 1103 - - - 1104 - - - 1105 - - - 1106 - - - -$ -$ -$ -$ Payroll Taxes & Expenses: Acct #Admin Direct Total 1201 -$ -$ -$ 1202 - 10,892 10,892 1203 - 3,702 3,702 1204 - - - 1205 - - - 1206 - - - -$ 14,594$ 14,594$ 4,992$ 156,970$ 161,962$ Other (specify) Employee Benefits Subtotal: Employee Benefits %: Description 1000: SALARIES & BENEFITS Retirement Worker's Compensation Health Insurance Other (specify) Other (specify) OASDI FICA/MEDICARE SUI Other (specify) PROGRAM EXPENSES Handle with Care Plus Resiliency Center of Fresno Fiscal Year 2021-22 Description Payroll Taxes & Expenses Subtotal: Other (specify) Other (specify) EMPLOYEE SALARIES & BENEFITS TOTAL: Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 1 of 18 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 -$ 3002 - 3003 - 3004 - 3005 - 3006 - 3007 - 3008 - 3009 - 3010 - 3011 - 3012 - -$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 -$ 4002 5,403 4003 1,267 4004 - 4005 - 4006 325 4007 Other (specify) 4008 Other (specify) 4009 Other (specify) 4010 Other (specify) 6,995$ 5000: SPECIAL EXPENSES Other (specify) Other (specify) Clothing, Food, & Hygiene Tables and Chairs Industrial Coffee Grinders Signage and Menu Board Supplies, Glassware, Register Other (specify) Other (specify) Office, Household & Program Supplies Utility Vouchers Program Supplies - Medical Medication Supports Household Items for Clients Employment Support Staff Mileage Subscriptions & Memberships Other (specify) Other (specify) Other (specify) Telecommunications Printing/Postage Client Transportation & Support Client Housing Support Child Care Other (specify) Rent/Lease Vehicles Security Utilities Rent/Lease Equipment FACILITIES/EQUIPMENT TOTAL: OPERATING EXPENSES TOTAL: Staff Development & Training Vehicle Maintenance Line Item Description Line Item Description Line Item Description DIRECT CLIENT CARE TOTAL Other (specify) Other (specify) Advertising Rent/Lease Building Building Maintenance Education Support Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 2 of 18 Acct #Amount 5001 -$ 5002 1,344 5003 - 5004 - 5005 Parent Café 11,500 5006 Other (specify)- 5007 Other (specify)- 5008 Other (specify)- 12,844$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 -$ 6002 - 6003 - 6004 - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 - 6008 Other (specify)- 6009 Other (specify)- 6010 Other (specify)- 6011 Other (specify)- 6012 Other (specify)- -$ 7000: FIXED ASSETS Acct #Amount 7001 7002 - 7003 7004 - 7005 7006 Assets over $5,000/unit (Specify)- 7007 Other (specify)- 7008 Other (specify)- -$ Contractual/Consulting Services (Specify) Translation Services Consultant (Network & Data Management) Furniture & Fixtures Line Item Description Administrative Overhead Depreciation (Provider-Owned Equipment to be Used for Program Purposes) HMIS (Health Management Information System) External Audit Line Item Description Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Other Assets over $500 with Lifespan of 2 Years + 181,801$ TOTAL PROGRAM EXPENSES FIXED ASSETS EXPENSES TOTAL ADMINISTRATIVE EXPENSES TOTAL SPECIAL EXPENSES TOTAL: Line Item Description Professional Liability Insurance Accounting/Bookkeeping Leasehold/Tenant/Building Improvements Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 3 of 18 Acct #Service Units Rate Amount 8001 Mental Health Services 0 - -$ 8002 Case Management 0 - - 8003 Crisis Services 0 - - 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations 181,801 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 181,801$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 Grants (Specify)- 8404 Other Revenue 1 - 8405 Other Revenue 2 - -$ 8200 - REALIGNMENT Estimated Specialty Mental Health Services Billing Totals: Estimated % of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation (FFP) % MHSA Program Name 8300 - MENTAL HEALTH SERVICE ACT (MHSA) Line Item Description REALIGNMENT TOTAL NET PROGRAM COST: PROGRAM FUNDING SOURCES TOTAL PROGRAM FUNDING SOURCES:181,801$ -$ SUBSTANCE USE DISORDER FUNDS TOTAL MEDI-CAL FFP TOTAL MHSA TOTAL Line Item Description Line Item Description 8100 - SUBSTANCE USE DISORDER FUNDS OTHER REVENUE TOTAL Line Item Description 8400 - OTHER REVENUE 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 4 of 18 Budget Narrative ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 161,962 Employee Salaries 147,368 1101 Associate Marriage & Family Therapist 41,600 Provide counseling & associated documentation in a 32 hr work week 1102 Triage Liaison / Case Manager 36,608 Assist children and families exposed to trauma 1103 Parent Peer / Liaison 30,888 Provide parent training on associated trauma topics 1104 Peer Support Specialist II 38,272 Working with FCSS Clinician 1105 0 - 1106 0 - 1107 0 - 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - Employee Benefits - 1101 Retirement - 1102 Worker's Compensation - 1103 Health Insurance - 1104 Other (specify)- 1105 Other (specify)- 1106 Other (specify)- Payroll Taxes & Expenses:14,594 1201 OASDI - 1202 FICA/MEDICARE 10,892 1203 SUI 3,702 1204 Other (specify)- 1205 Other (specify)- 1206 Other (specify)- 2000: CLIENT SUPPORT - 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support - 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (specify)- 2012 Other (specify)- 2013 Other (specify)- 2014 Other (specify)- 2015 Other (specify)- 2016 Other (specify)- 3000: OPERATING EXPENSES - 3001 Telecommunications - 3002 Printing/Postage - 3003 Office, Household & Program Supplies - Resiliency Center of Fresno Handle with Care Plus Fiscal Year 2021-22 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 5 of 18 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage - 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (specify)- 3010 Other (specify)- 3011 Other (specify)- 3012 Other (specify)- 4000: FACILITIES & EQUIPMENT 6,995 4001 Building Maintenance - 4002 Rent/Lease Building 5,403 25% of rent for location in Tower district 4003 Rent/Lease Equipment 1,267 Leasing 2 computers tied to Police Department data 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities 325 less than 8% of utilities expense for location in Tower district 4007 Other (specify)- 4008 Other (specify)- 4009 Other (specify)- 4010 Other (specify)- 5000: SPECIAL EXPENSES 12,844 5001 Consultant (Network & Data Management)- 5002 HMIS (Health Management Information System) 1,344 Avatar expense for two Case Managers/Clinicians 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services - 5005 Parent Café 11,500 8.5 % of rent/utilities, etc. at Clark St. location, materials, printing, guest speakers, childcare, food, incentives, supplies, training 5006 Other (specify)- 5007 Other (specify)- 5008 Other (specify)- 6000: ADMINISTRATIVE EXPENSES - 6001 Administrative Overhead - 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 External Audit - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 Depreciation (Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other (specify)- 6009 Other (specify)- 6010 Other (specify)- 6011 Other (specify)- 6012 Other (specify)- 7000: FIXED ASSETS - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (specify)- 7008 Other (specify)- TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:181,801 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:181,801 - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 6 of 18 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Associate Marriage & Family Therapist 0.80 -$ 41,600$ 41,600$ 1102 Triage Liaison / Case Manager 0.80 - 36,608 36,608 1103 Parent Peer / Liaison 0.68 - 30,888 30,888 1104 Peer Support Specialist II 1.00 4,992 33,280 38,272 1105 - - - 1106 - - - 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotal 3.28 4,992$ 142,376$ 147,368$ Employee Benefits Acct #Admin Direct Total 1101 -$ -$ -$ 1102 - - - 1103 - - - 1104 - - - 1105 - - - 1106 - - - -$ -$ -$ 0 Payroll Taxes & Expenses: Acct #Admin Direct Total 1201 -$ -$ -$ 1202 - 10,892 10,892 1203 - 3,702 3,702 1204 - - - 1205 - - 1206 - - -$ 14,594$ 14,594$ 4,992$ 156,970$ 161,962$ Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Employee Benefits Subtotal: Employee Benefits %: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Handle with Care Plus Resiliency Center of Fresno Fiscal Year 2022-23 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 7 of 18 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 -$ 3002 - 3003 - 3004 - 3005 - 3006 - 3007 - 3008 - 3009 - 3010 - 3011 - 3012 - -$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 -$ 4002 5,403 4003 1,267 4004 - 4005 - 4006 325 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 6,995$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Security Utilities OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Subscriptions & Memberships Vehicle Maintenance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage Other (Specify) Other (Specify) Other (Specify) Other (Specify) DIRECT CLIENT CARE TOTAL Line Item Description Household Items for Clients Medication Supports Program Supplies - Medical Utility Vouchers Other (Specify) Other (Specify) Child Care Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 8 of 18 Acct #Amount 5001 -$ 5002 1,344 5003 - 5004 - 5005 Parent Café 16,891 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 18,235$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 -$ 6002 - 6003 - 6004 - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- -$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- -$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 187,192$ Line Item Description Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Furniture & Fixtures Leasehold/Tenant/Building Improvements Other Assets over $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) SPECIAL EXPENSES TOTAL: Line Item Description Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) Translation Services Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 9 of 18 Acct #Service Units Rate Amount 8001 Mental Health Services 0 - -$ 8002 Case Management 0 - - 8003 Crisis Services 0 - - 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations 187,192 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 187,192$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 Grants (Specify) 8404 Other (Specify) 8405 Other (Specify) - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:187,192$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Line Item Description REALIGNMENT TOTAL 8300 - MENTAL HEALTH SERVICE ACT (MHSA) MHSA Program Name Federal Financial Participation (FFP) % MEDI-CAL FFP TOTAL 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL 8200 - REALIGNMENT PROGRAM FUNDING SOURCES 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Line Item Description Estimated Specialty Mental Health Services Billing Totals: Estimated % of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 10 of 18 Budget Narrative ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 161,962 Employee Salaries 147,368 1101 Associate Marriage & Family Therapist 41,600 Provide counseling & associted documentation in a 32 hr work week 1102 Triage Liaison / Case Manager 36,608 Assist children and families exposed to trauma 1103 Parent Peer / Liaison 30,888 Provide parent training on associated trauma topics 1104 Peer Support Specialist II 38,272 Working with FCSS Clinician 1105 0 - 1106 0 - 1107 0 - 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - Employee Benefits - 1101 Retirement - 1102 Worker's Compensation - 1103 Health Insurance - 1104 Other (Specify)- 1105 Other (Specify)- 1106 Other (Specify)- Payroll Taxes & Expenses:14,594 1201 OASDI - 1202 FICA/MEDICARE 10,892 1203 SUI 3,702 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- 2000: CLIENT SUPPORT - 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support - 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES - 3001 Telecommunications - 3002 Printing/Postage - 3003 Office, Household & Program Supplies - Handle with Care Plus Resiliency Center of Fresno Fiscal Year 2022-23 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 11 of 18 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage - 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (Specify)- 3010 Other (Specify)- 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 6,995 4001 Building Maintenance - 4002 Rent/Lease Building 5,403 25% of rent for location in Tower district 4003 Rent/Lease Equipment 1,267 Leasing 2 computers tied to Police Department data 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities 325 less than 8% of utilities expense for location in Tower district 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES 18,235 5001 Consultant (Network & Data Management)- 5002 HMIS (Health Management Information System) 1,344 Avatar expense for two Case Managers/Clinicians 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services - 5005 Parent Café 16,891 8.5% of rent/utilities etc. at Clark St. location, materials, printing, guest speakers, childcare, food, incentives, supplies, training 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES - 6001 Administrative Overhead - 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 External Audit - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 Depreciation (Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- 7000: FIXED ASSETS - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:187,192 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:187,192 - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 12 of 18 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Associate Marriage & Family Therapist 0.80 -$ 41,600$ 41,600$ 1102 Triage Liaison / Case Manager 0.80 - 36,608 36,608 1103 Parent Peer / Liaison 0.68 - 30,888 30,888 1104 Peer Support Specialist II 1.00 4,992 33,280 38,272 1105 - - - 1106 - - - 1107 - - - 1108 - - - 1109 - - - 1110 - - - 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - Personnel Salaries Subtotal 3.28 4,992$ 142,376$ 147,368$ Employee Benefits Acct #Admin Direct Total 1101 -$ -$ -$ 1102 - - - 1103 - - - 1104 - - - 1105 - - - 1106 - - - -$ -$ -$ 0 Payroll Taxes & Expenses: Acct #Admin Direct Total 1201 -$ -$ -$ 1202 - 10,892 10,892 1203 - 3,702 3,702 1204 - - - 1205 - - 1206 - - -$ 14,594$ 14,594$ 4,992$ 156,970$ 161,962$ Other (Specify) Other (Specify) Other (Specify) Payroll Taxes & Expenses Subtotal: EMPLOYEE SALARIES & BENEFITS TOTAL: Employee Benefits Subtotal: Employee Benefits %: Description OASDI FICA/MEDICARE SUI Retirement Worker's Compensation Health Insurance Other (Specify) Other (Specify) Other (Specify) Handle with Care Plus Resiliency Center of Fresno Fiscal Year 2023-24 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Description Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 13 of 18 2000: CLIENT SUPPORT Acct #Amount 2001 -$ 2002 - 2003 - 2004 - 2005 - 2006 - 2007 - 2008 - 2009 - 2010 - 2011 - 2012 - 2013 - 2014 - 2015 - 2016 - -$ 3000: OPERATING EXPENSES Acct #Amount 3001 -$ 3002 - 3003 - 3004 - 3005 - 3006 - 3007 - 3008 - 3009 - 3010 - 3011 - 3012 - -$ 4000: FACILITIES & EQUIPMENT Acct #Amount 4001 -$ 4002 5,403 4003 1,266 4004 - 4005 - 4006 325 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 6,994$ 5000: SPECIAL EXPENSES FACILITIES/EQUIPMENT TOTAL: Security Utilities OPERATING EXPENSES TOTAL: Line Item Description Building Maintenance Rent/Lease Building Rent/Lease Equipment Rent/Lease Vehicles Subscriptions & Memberships Vehicle Maintenance Other (Specify) Other (Specify) Other (Specify) Other (Specify) Telecommunications Printing/Postage Office, Household & Program Supplies Advertising Staff Development & Training Staff Mileage Other (Specify) Other (Specify) Other (Specify) Other (Specify) DIRECT CLIENT CARE TOTAL Line Item Description Household Items for Clients Medication Supports Program Supplies - Medical Utility Vouchers Other (Specify) Other (Specify) Child Care Client Housing Support Client Transportation & Support Clothing, Food, & Hygiene Education Support Employment Support Line Item Description Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 14 of 18 Acct #Amount 5001 -$ 5002 1,344 5003 - 5004 - 5005 Parent Café 16,891 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 18,235$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 -$ 6002 - 6003 - 6004 - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- -$ 7000: FIXED ASSETS Acct #Amount 7001 -$ 7002 - 7003 - 7004 - 7005 - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- -$ FIXED ASSETS EXPENSES TOTAL TOTAL PROGRAM EXPENSES 187,191$ Line Item Description Computer Equipment & Software Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data Furniture & Fixtures Leasehold/Tenant/Building Improvements Other Assets over $500 with Lifespan of 2 Years + ADMINISTRATIVE EXPENSES TOTAL Administrative Overhead Professional Liability Insurance Accounting/Bookkeeping External Audit Depreciation (Provider-Owned Equipment to be Used for Program Purposes) SPECIAL EXPENSES TOTAL: Line Item Description Line Item Description Consultant (Network & Data Management) HMIS (Health Management Information System) Contractual/Consulting Services (Specify) Translation Services Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 15 of 18 Acct #Service Units Rate Amount 8001 Mental Health Services 0 - -$ 8002 Case Management 0 - - 8003 Crisis Services 0 - - 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 0 -$ 0% - 0%- -$ Acct #Amount 8101 Drug Medi-Cal -$ 8102 SABG -$ -$ Acct #Amount 8201 Realignment -$ -$ Acct #MHSA Component Amount 8301 CSS - Community Services & Supports -$ 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations 187,191 8304 WET - Workforce Education & Training - 8305 CFTN - Capital Facilities & Technology - 187,191$ Acct #Amount 8401 Client Fees -$ 8402 Client Insurance - 8403 Grants (Specify)- 8404 Other (Specify) - 8405 Other (Specify) - -$ OTHER REVENUE TOTAL TOTAL PROGRAM FUNDING SOURCES:187,191$ NET PROGRAM COST: -$ MHSA TOTAL 8400 - OTHER REVENUE Line Item Description Line Item Description REALIGNMENT TOTAL 8300 - MENTAL HEALTH SERVICE ACT (MHSA) MHSA Program Name Federal Financial Participation (FFP) % MEDI-CAL FFP TOTAL 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL 8200 - REALIGNMENT PROGRAM FUNDING SOURCES 8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION) Line Item Description Estimated Specialty Mental Health Services Billing Totals: Estimated % of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Fresno County Department of Behavioral Health Contract Budget Template Revised 9/12/2019 Revised Exhibit C-1 Page 16 of 18 Budget Narrative ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 161,962 Employee Salaries 147,368 1101 Associate Marriage & Family Therapist 41,600 Provide counseling & associated documentation in a 32 hr work week 1102 Triage Liaison / Case Manager 36,608 Assist children and families exposed to trauma 1103 Parent Peer / Liaison 30,888 Provide parent training on associated trauma topics 1104 Peer Support Specialist II 38,272 Work with FCSS Clinician 1105 0 - 1106 0 - 1107 0 - 1108 0 - 1109 0 - 1110 0 - 1111 0 - 1112 0 - 1113 0 - 1114 0 - 1115 0 - 1116 0 - 1117 0 - 1118 0 - 1119 0 - 1120 0 - Employee Benefits - 1101 Retirement - 1102 Worker's Compensation - 1103 Health Insurance - 1104 Other (Specify)- 1105 Other (Specify)- 1106 Other (Specify)- Payroll Taxes & Expenses:14,594 1201 OASDI - 1202 FICA/MEDICARE 10,892 1203 SUI 3,702 1204 Other (Specify)- 1205 Other (Specify)- 1206 Other (Specify)- 2000: CLIENT SUPPORT - 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation & Support - 2004 Clothing, Food, & Hygiene - 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients - 2008 Medication Supports - 2009 Program Supplies - Medical - 2010 Utility Vouchers - 2011 Other (Specify)- 2012 Other (Specify)- 2013 Other (Specify)- 2014 Other (Specify)- 2015 Other (Specify)- 2016 Other (Specify)- 3000: OPERATING EXPENSES - 3001 Telecommunications - 3002 Printing/Postage - 3003 Office, Household & Program Supplies - Handle with Care Plus Resiliency Center of Fresno Fiscal Year 2023-24 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 17 of 18 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3004 Advertising - 3005 Staff Development & Training - 3006 Staff Mileage - 3007 Subscriptions & Memberships - 3008 Vehicle Maintenance - 3009 Other (Specify)- 3010 Other (Specify)- 3011 Other (Specify)- 3012 Other (Specify)- 4000: FACILITIES & EQUIPMENT 6,994 4001 Building Maintenance - 4002 Rent/Lease Building 5,403 25% of rent for location in Tower district 4003 Rent/Lease Equipment 1,266 Leasing 2 computers tied to Police Department data 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities 325 less than 8% of utilities expense for location in Tower district 4007 Other (Specify)- 4008 Other (Specify)- 4009 Other (Specify)- 4010 Other (Specify)- 5000: SPECIAL EXPENSES 18,235 5001 Consultant (Network & Data Management)- 5002 HMIS (Health Management Information System) 1,344 Avatar expense for two Case Managers/Clinicians 5003 Contractual/Consulting Services (Specify)- 5004 Translation Services - 5005 Parent Café 16,891 8.5% of rent/utilities, etc. for Clark St. location, materials, printing, guest speakers, childcare, food, incentives, supplies, training 5006 Other (Specify)- 5007 Other (Specify)- 5008 Other (Specify)- 6000: ADMINISTRATIVE EXPENSES - 6001 Administrative Overhead - 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 External Audit - 6005 Insurance (Specify):- 6006 Payroll Services - 6007 Depreciation (Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other (Specify)- 6009 Other (Specify)- 6010 Other (Specify)- 6011 Other (Specify)- 6012 Other (Specify)- 7000: FIXED ASSETS - 7001 Computer Equipment & Software - 7002 Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures - 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over $500 with Lifespan of 2 Years + - 7006 Assets over $5,000/unit (Specify)- 7007 Other (Specify)- 7008 Other (Specify)- TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:187,191 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:187,191 - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 9/12/2019 Revised Exhibit C-1 Page 18 of 18