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HomeMy WebLinkAboutAgreement A-22-129 with Exodus.pdf Agreement No. 22-129 1 AMENDMENT III 2 THIS THIRD AMENDMENT TO AGREEMENT (hereinafter "Amendment III") is made and 3 entered into this 5th day of April 2022, by and between COUNTY OF FRESNO, a Political 4 Subdivision of the State of California, Fresno, California (hereinafter "COUNTY"), and EXODUS 5 RECOVERY, INC, a for-profit California corporation, whose address is 9800 Venice Blvd, Suite 700, 6 Culver City, CA 90232 (hereinafter"CONTRACTOR"). 7 WITNESSETH: 8 WHEREAS, COUNTY and CONTRACTOR entered into COUNTY Agreement number 15-594, 9 dated November 17, 2015, as amended by COUNTY Amendment No. 15-594-1, dated June 18, 2019, 10 and COUNTY Amendment NO. 15-594-2, dated June 22, 2021 (hereinafter collectively referred to as 11 "COUNTY Agreement No. A-15-594"), whereby CONTRACTOR agreed to operate an adult sixteen 12 (16) bed acute inpatient psychiatric health facility (PHF) to provide psychiatric services to adult clients 13 (ages eighteen and older) who may be admitted on a voluntary basis or involuntary basis and may 14 include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal beneficiaries, indigent/uninsured 15 clients, and jail inmates (who are referred by the current subcontractor of Behavioral Health services 16 within the Jail), DBH contracted providers, hospital emergency rooms, other COUNTY departments, 17 and other agencies. In addition, conservatees of the COUNTY that are placed in other residential 18 settings and attending court in Fresno County will be temporarily placed at the PHF operated by 19 CONTRACTOR until each such conservatee's court proceeding is completed; and 20 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement, regarding 21 changes as stated below and restate the Agreement in its entirety. 22 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which 23 is hereby acknowledged, COUNTY and CONTRACTOR agree as follows: 24 1. That all references in the COUNTY Agreement No. A-15-594 to "Exhibit A" or"Revised 25 Exhibit A" be changed to read "Revised Exhibit A-1", attached hereto and incorporated herein by this 26 reference. 27 2. That all references in the COUNTY Agreement No. A-15-594 to "Revised Exhibit B" or 28 "Revised Exhibit B-1" be changed to read "Revised Exhibit B-2", attached hereto and incorporated - 1 - 1 herein by this reference. 2 3. That COUNTY Agreement No. 15-594, as set forth in Amendment II (COUNTY 3 Amendment No. 15-594-2), Page Two (2), beginning with Line Nine (9), with the word "The" and 4 ending on Page Two (2) Line Eighteen (18) with the word "Agreement" be deleted and the following 5 inserted in its place: 6 "The maximum amount for the fifth period of renewal (July 1, 2020 through June 30, 7 2021) shall not exceed Five Million, Seventy Thousand, Two Hundred Twenty-Six and No/100 Dollars 8 ($5,070,226.00). 9 The maximum amount for the sixth period of renewal (July 1, 2021 through June 30, 10 2022) shall not exceed Five Million, Six Hundred Seventy-Six Thousand, Two Hundred Eighty-Two 11 and No/100 Dollars ($5,676,282.00). 12 In no event shall the maximum contract amount for the services provided by 13 CONTRACTOR to COUNTY under the terms and conditions of this Agreement be in excess of 14 Twenty-Eight Million, Nine Hundred Ninety-Three Thousand, Six Hundred Seventy-One and No/100 15 Dollars ($28,993,671.00) during the total six (6) year, nine-month (9) term of this Agreement." 16 4. COUNTY and CONTRACTOR agree that this Amendment III is sufficient to amend the 17 Agreement and, that upon execution of this Amendment III, the Agreement, Amendment I, Amendment 18 II and this Amendment III together shall be considered the Agreement. 19 5. The Agreement, as hereby amended, is ratified, and continued. All provisions, terms, 20 covenants, conditions, and promises contained in the Agreement and not amended herein shall 21 remain in full force and effect. This Amendment III shall be effective retroactive to April 1, 2020. 22 23 24 25 26 27 28 - 2 - 1 IN WITNESS WHEREOF,the parties hereto have executed this Amendment III as of the day and year 2 first hereinabove written. 3 CONTRACTOR COUNTY O` FRESNO 4 _ kL uthorized Signatu ) Brian Pacheco, Chairman of the Board of Supervisors of the County of Fresno 6 Luana Murphy, President/CEO 7 Print Name &Title 8 9 10 ATTEST: 11 (Authorized Signature) Bernice E. Seidel Clerk of the Board of Supervisors 12 County of Fresno, State of California LeeAnn Skorohod Cor Secrets /COO 13 Print Name &Title By: 14 Deotty MAILING ADDRESS: 15 Exodus Recovery, Inc. 16 9808 Venice Boulevard, Suite 700 Culver City, CA 90232 17 Contact: Luana Murphy, President/CEO (310)945-3350 18 19 FOR ACCOUNTING USE ONLY: Fund: 0001 20 Subclass: 10000 Org: 56302490 21 Account: 7295 22 Fiscal Year FY 2015-16 $2,048,296 23 FY 2016-17 $3,698,759 FY 2017-18 $3,810,886 24 FY 2018-19 $4,291,345 FY 2019-20 $4,397,877 25 FY 2020-21 $5,070,226 FY 2021-22 $5 676 282 26 Total: $28,993,671 27 28 -3- REVISED EXHIBITA-1 Page 1 of 11 ACUTE INPATIENT PSYCHIATRIC HEALTH FACILITY (PHF) SCOPE OF WORK ORGANIZATION: Exodus Recovery, Inc. ADDRESS: 9808 Venice Blvd Suite 700 Culver City, CA 90232 SITE ADDRESS: 4411 E Kings Canyon Rd Fresno, CA 93702, Bldg 319 SERVICES: Acute Inpatient Psychiatric Services CONTACT: Luana Murphy, President/CEO PHONE NUMBER: (310) 945-3350 CONTRACT PERIOD: October 1, 2015 — June 30, 2016, (start up and implementation period) followed by a three (3) year base contract and an option for two (2) twelve (12) month renewals and an additional one-year renewal CONTRACT AMOUNT: $2,048,296 October 1, 2015 through June 30, 2016 $3,698,759 FY 2016-17 $3,810,886 FY 2017-18 $4,291,345 FY 2018-19 $4,397,877 FY 2019-20 $5,070,226 FY 2020-21 $5,676,282 FY 2021-22 I. SCHEDULE OF SERVICES: CONTRACTOR shall operate the Psychiatric Health Facility (PHF) twenty-four (24) hours per day, seven (7) days per week. II. TARGET POPULATION: The target population will include male and female clients, who are eighteen (18) years and older, who may be admitted on a voluntary or involuntary basis. These clients will include Medi-Cal beneficiaries; Medicare and Medicare/Medi-Cal beneficiaries; indigent/uninsured clients' and jail inmates who are referred by the Department of Behavioral Health (DBH), a contract provider with the DBH, hospital emergency departments, other COUNTY departments and other agencies to the PHF. Jail inmates brought to the PHF will continue to be transported and supervised by the Sheriff's correctional staff. In addition, Conservatees of the COUNTY that are placed in other residential settings and attending court in Fresno County will be temporarily placed at the PHF operated by REVISED EXHIBITA-1 Page 2 of 11 CONTRACTOR until each such Conservatee's court proceeding is completed. CONTRACTOR shall work with the DBH Client Placement Team to execute placement of COUNTY Conservatees that are being discharged from the PHF operated by the CONTRACTOR. Medical clearance in keeping with community standards of care will be required for referred clients where there are indicators of an acute medical condition as determined by a medical screening. However, in the event a referred client is known to possess a contagious medical condition, said client shall be medically cleared by a local hospital prior to admission to the PHF operated by CONTRACTOR. CONTRACTOR shall accept direct admissions to the PHF from COUNTY DBH programs or its contracted providers when PHF beds are available. Said direct admits shall have medical clearance in keeping with community standards. III. CONTRACTOR'S RESPONSIBILITIES: CONTRACTOR shall provide the following: 1. Management of clients' acute psychiatric disorders and prepare clients to successfully use a less restrictive level of care. 2. A clinical program which has appropriate professional staffing on a twenty-four (24) hours/seven (7) days a week (24/7) basis. 3. In general, client admissions are executed any time during operating hours (24/7) when there are PHF beds available. Discharges are generally executed before 9:OOpm each day of the week. 4. Provide a safe, secure environment for clients that encourage wellness and recovery. 5. Provides for a comprehensive multi-disciplinary evaluation and treatment plan. 6. Provides dietary services. 7. Admission procedures for clients, who may be admitted on a voluntary or involuntary basis. Individuals who are on involuntary holds in accordance with Welfare and Institutions Code 5150 may be referred from hospital emergency departments or by local law enforcement agencies or by licensed medical/mental health professionals certified by the County as 5150 Initial Evaluators. REVISED EXHIBIT A-1 Page 3 of 11 8. Treatment Planning - CONTRACTOR shall provide the following services: a. Mental Status Examination b. Medical Evaluation c. Psycho-Social Assessment d. Nursing Assessment e. Multi-Disciplinary Milieu Treatment Program f. Individualized Focused Treatment Planning g. Aftercare planning including care coordination with current and/or identified post discharge providers including sharing of records. h. Appropriate prescriptions to clients at discharge as well as make any other necessary arrangements to ensure the client's well-being. 9. Provide an intensive treatment program which has individualized treatment plans. 10.Stabilize clients as soon as possible in order to assist them in their recovery from mental illness. 11.Effectively partner with other programs in accepting COUNTY clients for admission for acute inpatient psychiatric services and also to work collaboratively in discharge planning to insure appropriate ongoing outpatient specialty mental health treatment services are provided. 12.Identify COUNTY clients with frequent admissions during the fiscal year and develop strategies with other COUNTY and community agencies to reduce readmissions. 13.Effectively interact with community agencies, other mental health programs and providers, natural support systems and families to assist clients to be discharged to the most appropriate level of care. 14.Work effectively with the legal system to provide temporary conservatorship if necessary and appropriate for clients who require additional inpatient care. 15.Ancillary Services — CONTRACTOR shall provide the following: a. Provide services to clients who are designated to be incompetent to stand trial in order to allow clients to stand trial. b. CONTRACTOR's psychiatrist staff shall provide court testimony, written reports, and documentation relevant to the PHF clients when required. REVISED EXHIBIT A-1 Page 4 of 11 16.Comply with the requirements of the Fresno County Mental Health Plan (FCMHP) and must complete and submit a Treatment Authorization Request (TAR) and the supporting documentation for all Medi-Cal, Medi-cal/Medicare, and UMDAP admissions to the FCMHP. The FCMHP will perform a utilization review of all admissions to determine that the documentation demonstrates that medical necessity criteria as defined by the California Department of Health Care Services (DHCS) was met for each day of the hospitalization, except for the day of discharge. 17.Enter all client service information, admission data and billing information into the COUNTY's electronic information system and will be responsible for any and all audit exceptions pertaining to the delivery of services. The CONTRACTOR will also be responsible for the mandated reporting of patient information and admission/discharge data and other required reports to the Office of State Health Planning and Development (OSHPD), DHCS, and meet the submission deadlines each calendar year. 18.Staffing CONTRACTOR shall provide the appropriate type and level of staffing to provide for a clinically effective program design. a. The staffing pattern for the PHF shall meet all State licensing and regulatory requirements including medical staff standards, nursing staff standards, social work and rehabilitation staff requirements pursuant to Title 22, Division 5, Chapter 9, Article 3, Section 77061 of the California Code of Regulations for PHF's. There shall be an appropriate level of supervisory staff as required by regulation or statute. All staff, which requires State licensure or certification, will be required to be licensed or certified in the State of California and be in good standing with the State licensing or certification board. b. All facility staff, who provide direct client care or perform coding/billing functions, must meet the requirements of the FCMHP Compliance Program. This includes the screening for excluded persons and entities by accessing or querying the applicable licensing board(s), the National Practitioner Data Bank (NPDB), Office of Inspector General's List of Excluded Individuals/ Entities (LEIE), Excluded Parties List System (EPLS) and Medi-Cal Suspended and Ineligible List prior to hire and monthly thereafter. In addition, all licensed/registered/waivered staff must complete a FCMHP Provider Application and be credentialed by the FCMHP's Credentialing Committee. All licensed staff shall have Department of Justice (DOJ), Federal Bureau of Investigation (FBI), and Sheriff fingerprinting (Lives can) executed. REVISED EXHIBITA-1 Page 5 of 11 c. Peer and/or family support staff will be utilized on the treatment team to provide Peer/Family specific services to enhance the services provided by professional staff. d. Organized Clinical Staff - The organized clinical staff of CONTRACTOR shall be composed of all licensed mental health professionals as included in Title 22, Division 5, Chapter 9, Article 4, Section 77083 (Organized Clinical Staff) of the California Code of Regulations. e. Organized Medical Staff - CONTRACTOR shall meet the requirement for an organized medical staff pursuant to Title 22, Division 5, Chapter 9, Article 3, Section 77061 (Staffing) of the California Code of Regulations. 19.Medical Records and Mandated Reporting to the Office of State Health Planning and Development a. The CONTRACTOR shall develop and implement a medical record system which meets all State and Federal requirement and clearly documents medical necessity for both treatment and billing services. Medical records shall be kept in such a manner as to comply with the Fresno County Quality Improvement standards and Federal and State quality standards. Fresno County has an electronic medical record system and the expectation is that the CONTRACTOR will participate in this record keeping system. b. CONTRACTOR will be responsible for accommodating appropriate and legal "release of information" requests for the facility and shall adhere to applicable Federal and State regulations in providing protected health information per such requests. c. CONTRACTOR will be required to provide mandated reporting of client information and admission/discharge data to the OSHPD and meet the submission deadlines on June 30 and December 31 each calendar year. 20. Pharmaceutical Services- CONTRACTOR must provide for the level of pharmaceutical services as a PHF pursuant to Title 22, Section 5, Chapter 9, Article 3, 77079.13 of the California Code of Regulations. If CONTRACTOR intends to utilize any type of automated dispensing system, the cost of that system and pharmacy consultants shall be included as part of the CONTRACTOR's budget. 21. Physical Health Care - CONTRACTOR shall provide admission history and physical examination, will order and receive ancillary health exams which are considered community standards of care, provide dietary services and maintain a written agreement for medical services with one or more general acute care hospitals. REVISED EXHIBIT A-1 Page 6 of 11 22.Schedule of Active Therapies - CONTRACTOR shall provide active therapies that will be provided as part of the clinical treatment program. The schedule shall include group therapies, skill development and client education activities, wellness and recovery focused treatment, family therapy, scheduled community meetings, recreational and exercise programs. The treatment team is expected to schedule client's participation activities tailored to each client's individual needs. 23.CONTRACTOR shall provide a safe and secure environment to provide for clinical and medical assessment, diagnostic formulation, crisis intervention, medication management and clinical treatment for mental health clients with an acute psychiatric disorder. CONTRACTOR shall utilize cost containment strategies for the provision of stock and prescription medications to clients (i.e., use of prescription assistance program, contracting with a pharmaceutical benefits management company, etc.). 24.CONTRACTOR shall use the Department's current medication formulary for consistency purposes in the event that clients are discharged from the PHF and potentially linked to other outpatient programs within the Department. In addition, the CONTRACTOR shall execute a contract with a pharmaceutical benefit management (PBM) company or pharmacy. The CONTRACTOR will not use, or be a part of, the Department's current agreement for PBM services. The injectables currently utilized are Haldol and Prolixin. 25.CONTRACTOR shall integrate mental health and substance use disorder services through comprehensive continuous integrated systems of care for the life span of those served and to work as partners with a shared vision: to create a coordinated and comprehensive system of service delivery. CONTRACTOR shall develop a formal written Continuous Quality Improvement (CQI) action plan to identify measurable objectives toward the achievement of Co-Occurring Disorders (COD) capability that will be addressed by the program during the contract period. These objectives should be achievable and realistic for the program, based on the self- assessment and the program priorities, but need to include attention to making progress on the following issues, at minimum: a. Welcoming policies, practices, and procedures related to the engagement of individuals with co-occurring issues and disorders; b. Removal or reduction of access barriers to admission based on co-occurring diagnosis or medication; c. Improvement in routine integrated screening, and identification in the County's electronic information system of how many clients served have co- occurring issues; REVISED EXHIBIT A-1 Page 7 of 11 d. Developing the goal of basic co-occurring competency for all treatment staff, regardless of licensure or certification; and e. Documentation of coordination of care with collaborative mental health and/or substance use disorder providers for each client. IV. CULTURAL AND LINGUISTIC COMPETENCE REQUIREMENTS: CONTRACTOR shall: 1. Ensure compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d, and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which prohibits recipients of Federal financial assistance from discriminating against persons based on race, color, national origin, sex, disability or religion. This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access and participation in federally funded programs through the provision of comprehensive and quality bilingual services. 2. Create and maintain policies and procedures for ensuring access and appropriate use of trained interpreters and material translation services for all LEP consumers, including, but not limited to, assessing the cultural and linguistic needs of its clients, training of staff on the policies and procedures, and monitoring its language assistance program. The CONTRACTOR's procedures must include ensuring compliance of any sub-contracted providers with these requirements. 3. Ensure that minors shall not be used as interpreters. 4. Conduct and submit to COUNTY an annual cultural and linguistic needs assessment to promote the provision and utilization of appropriate services for its diverse client population. The needs assessment report shall include findings and a plan outlining the proposed services to be improved or implemented as a result of the assessment findings, with special attention to addressing cultural and linguistic barriers and reducing racial, ethnic, language, abilities, gender, and age disparities. 5. Develop internal systems to meet the cultural and linguistic needs of the CONTRACTOR's client census including the incorporation of cultural competency in the CONTRACTOR's mission; establishing and maintaining a process to evaluate and determine the need for special - administrative, clinical, welcoming, billing, etc. - initiatives related to cultural competency. 6. Develop recruitment and retention initiatives to establish contracted program staffing that is reflective and responsive to the needs of the program and target population. REVISED EXHIBIT A-1 Page 8 of 11 7. Establish designated staff person to coordinate and facilitate the integration of cultural competency guidelines and attend the COUNTY DBH Cultural Competency Committee monthly meetings. The designated person will provide an array of communication tools to distribute information to staff relating to cultural competency issues. 8. Keep abreast of evidence-based and best practices in cultural competency in mental health care and treatment to ensure that the CONTRACTOR maintains current information and an external perspective in its policies. The CONTRACTOR shall evaluate the effectiveness of strategies and programs in improving the health status of cultural-defined populations. 9. Ensure that an assessment of a client's sexual orientation is included in the bio- psychosocial intake process. CONTRACTOR's staff shall assume that the population served may not be in heterosexual relationships. Gender sensitivity and sexual orientation must be covered in annual training. 10.Utilize existing community supports, referrals to transgender support groups, etc., when appropriate. 11.Report its efforts to evaluate cultural and linguistic activities as part of the CONTRACTOR's ongoing quality improvement efforts in the monthly activities report. Reported information may include clients' complaints and grievances, results from client satisfaction surveys, and utilization and other clinical data that may reveal health disparities as a result of cultural and linguistic barriers. V. TRAINING REQUIREMENTS: CONTRACTOR shall: 1. Attend annual Cultural Competence training. 2. Attend annual Compliance, Billing and Documentation training. 3. Attend County's 5150 certification training. 4. Attend other required trainings provided by the COUNTY. VI. PROGRAM OUTCOMES: The COUNTY DBH is dedicated to supporting the wellness of individuals, families and communities in Fresno County who are affected by, or at risk of, mental illness and/or substance use disorders through cultivation of strengths toward promoting REVISED EXHIBIT A-1 Page 9 of 11 recovery in the least restrictive environment (note - the 1 st five (5) items listed below will be utilized to support this DBH Mission). The following items listed below represent program goals to be achieved by CONTRACTOR in addition to CONTRACTOR- developed outcomes. The program's success will be based on the number of goals it can achieve, resulting from performance outcomes. The CONTRACTOR will utilize computerize tracking system with which outcome measure and other relevant client data, such as demographics, will be maintained. 1. Behavioral Health Integrated Access — The time between client arrival and admission to the PHF, until assessment. 2. Wellness, Recovery and Resiliency Supports — program, services or philosophical approaches which support the concept of wellness, recovery and resiliency in our clients. Client levels of care, peer support, family advocacy, education and employment, housing 3. Cultural/Community Defined Practices — programs, services or philosophical practices which support the unique cultural specific needs of individuals receiving care. Suggested penetration rate for particular groups can possibly be used to measure. 4. Behavioral Health Clinical Care — programs, services where direct therapeutic treatment is provided. Included in the framework of `Levels' of care where a client's needs, as identified through assessment/screening, are matched with a complexity and intensity of services to meet those needs. Recovery 360 — Levels of Care and fidelity of the program are examples. 5. Infrastructure Supports —includes all personnel, equipment, program and facilities which exist to support the delivery of care to the clients we serve. Includes safety, quality and regulatory compliance functions, along with outcome assessments/ program evaluation, training and technology (i.e., cost effectiveness of services, Staff Training and development, Quality Improvement, Program evaluation, regularity compliance efforts, personnel recruitment). 6. Effectiveness of discharge planning as demonstrated by the referral and linkage to the COUNTY DBH programs, community providers and other community resources. 7. Collaborative approach and treatment strategies to reduce readmission of clients with frequent readmissions to the facility. 8. Denial rate for PHF days that do not meet Medi-Cal medical necessity criteria as determined by the utilization review performed by the FCMHP. 9. Initial Screening- Percent of patients discharged that were screened by the third day post admission for all of the following: risk of violence to self, risk of violence to others, substance use, psychological trauma history, and patient strengths. 10.Hours of Physical Restraint Use - Total hours all patients spent in physical restraint as a proportion of total inpatient hours. Restraint is defined as mechanical and manual devises that restrict freedom of movement of the body. REVISED EXHIBITA-1 Page 10 of 11 11. Hours of Seclusion Use - Total hours all patients spent in seclusion as a proportion of total inpatient hours. Seclusion is defined as restricted alone to a room or area where the patient is not allowed to leave without the permission of staff. 12. Discharge on Multiple Antipsychotic Medications - Percent of patients discharged on two or more antipsychotic medications as a proportion of patients discharged on one or more antipsychotic medications. Antipsychotic medications include regularly scheduled oral doses and long-acting injectable forms, regardless of diagnosis. 13. Discharge on Multiple Antipsychotic Medications with Appropriate Justification. Percent of patients discharged on multiple antipsychotic medications with appropriate justification as a proportion of patients discharged on two or more antipsychotic medications. Appropriate justifications are limited to augmentation of clozapine, tapering to monotherapy, and history of at least three failed trials of monotherapy. 14.Continuing Care Plan Created - Percent of patients discharged with a continuing care plan created that includes all of the following: reason for hospitalization, discharge diagnosis, discharge medications, and next level of care recommendations. Minimum information for all discharge medications includes medication name, dose, and indications for use. 15.Continuing Care Plan Transmitted. Percent of patients discharged with a complete continuing care plan (defined in #14) that is transmitted to next level of care provider by the fifth day post discharge. 16.CONTRACTOR shall also propose their own outcomes measures that are deemed to best evaluate the success of the clients and program. 17.COUNTY DBH may adjust the outcome measurements needed under this program periodically, so as to best measure the success of clients and program as determined by COUNTY. VII. COUNTY RESPONSIBILITIES: COUNTY shall: 1. Perform a utilization review (through its FCMHP) of all Medi-Cal, Medi-Cal/Medicare, and UMDAP admissions, to determine that the documentation demonstrates that medical necessity criteria as defined by the DHCS was met for each day of the hospitalization, except for the day of discharge. 2. Provide oversight (through the COUNTY DBH) of the CONTRACTOR'S PHF program. In addition to contract monitoring of program(s), oversight includes, but not limited to, coordination with the DHCS in regard to program administration and outcomes. REVISED EXHIBITA-1 Page 11 of 11 3. Assist the CONTRACTOR in making linkages with the total behavioral health system. This will be accomplished through regularly scheduled meetings as well as formal and informal consultation 4. Participate in evaluating the progress of the overall program and the efficiency of collaboration with the vendor staff and will be available to the contractor for ongoing consultation. 5. Receive and analyze statistical data outcome information from CONTRACTOR throughout the term of contract on a monthly basis. DBH will notify the vendor when additional participation is required. The performance outcome measurement process will not be limited to survey instruments but will also include, as appropriate, client and staff interviews, chart reviews, and other methods of obtaining required information. 6. Recognize that cultural competence is a goal toward which professionals, agencies, and systems should strive. Becoming culturally competent is a developmental process and incorporates at all levels the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally-unique needs. Offering those services in a manner that fails to achieve its intended result due to cultural and linguistic barriers is not cost effective. To assist the CONTRACTOR'S efforts towards cultural and linguistic competency, DBH shall provide the following at no cost to vendor(s): a. Technical assistance to CONTRACTOR regarding cultural competency requirements and sexual orientation training. b. Technical assistance for CONTRACTOR in translating behavioral health and substance use disorder services information into DBH's threshold languages (English, Spanish, and Hmong). Translation services and costs associated will be the responsibility of the CONTRACTOR. Budget FY 20-21 Revised Exhibit B-2 Page 1 of 18 Adult Inpatient Psychiatric Health Facility (PHF) Exodus Recovery, Inc. Fiscal Year (FY 2020-21) PROGRAM EXPENSES 1000: SALARIES& BENEFITS Employee Salaries Acct# Position FTE Admin Direct Total 1101 Program Director/Quality Improvement 1.00 $ 149,893 $ - $ 149,893 1102 Program Support Assistant 1.00 50,318 - 50,318 1103 Program Nurse (LVN, LPT) 9.00 - 523,008 523,008 1104 Program Nurse (RN) 4.05 - 474,473 474,473 1105 LMFT 1.00 - 124,974 124,974 1106 Mental Health Worker 21.55 - 760,500 760,500 1107 Recreational Therapist 1.00 - 72,346 72,346 1108 Senior Data Specialist 0.51 47,305 - 47,305 1109 Social Services Coordinator 1.15 95,356 - 95,356 1110 Administrator 0.10 11,903 - 11,903 1111 - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotall 40.3 I $ 3541775 1 $ 1,955,301 $ 2,310,076 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 20-21 Revised Exhibit B-2 Page 2 of 18 Employee Benefits Acct# Description Admin Direct Total 1201 Retirement $ 105,114 $ - $ 105,114 1202 Worker's Compensation 166,018 - 166,018 1203 Health Insurance 185,886 - 185,886 1204 Other (Specify) - - - 1205 Other (Specify) - - - 1206 Other (Specify) - - - Employee Benefits Subtotal:1 $ 457,018 1 $ - $ 457,018 Payroll Taxes & Expenses: Acct# Description Admin Direct Total 1301 OASDI $ 22,069 $ - $ 22,069 1302 FICA/MEDICARE 158,501 - 158,501 1303 SUI 18,056 - 18,056 1304 Other (Specify) - - - 1305 Other (Specify) - - - 1306 Other (Specify) - - - Payroll Taxes& Expenses Subtotal: $ 198,626 $ - $ 198,626 EMPLOYEE SALARIES& BENEFITS TOTAL: $ 1,010,419 $ 1,955,301 $ 2,965,720 2000: CLIENT SUPPORT Acct# Line Item Description Amount 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 33,853 2009 Program Supplies - Medical 22,263 2010 Utility Vouchers - 2011 Other- Program Supplies -Therapeutic 21,103 2012 Other (Specify) 2013 Other- Food Service 299,384 2014 Other (Specify) - 2015 Other (Specify) - 2016 10ther (Specify) - DIRECT CLIENT CARE TOTAL $ 376,603 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 20-21 Revised Exhibit B-2 Page 3of18 3000: OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 36,363 3002 Printing and Postage 201 3003 Office, Household, and Program Supplies 73,323 3004 Advertising 414 3005 Staff Development and Training 11,597 3006 Staff Mileage/Vehicle Mainteanance 134 3007 Subscriptions & Memberships - 3008 Staff Orientation/Recruitment - 3009 Other-Staff Orientation/Recruitment 683 3010 Other(Specify) - 3011 Other (Specify) - 3012 1 Other (Specify) - OPERATING EXPENSES TOTAL: $ 122,715 4000: FACILITIES& EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ 11,367 4002 Rent/Lease Building - 4003 Rent/Lease Equipment 202 4004 Rent/Lease Vehicles - 4005 Security 150,575 4006 Utilities 74,798 4007 Other-Janitorial 76,561 4008 Other- Business Taxes/License/Permits 133 4009 Other (Specify) - 4010 Other (Specify) - FACILITIES/EQUIPMENT TOTAL: $ 313,636 5000: SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant (Network& Data Management) $ 119,069 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services - Personnel related (Registry, Parking, Relocation, etc.) 468,405 5004 Translation Services 2,260 5005 Other- Laundry Service 35,340 5006 Other - Medical Waste Disposal 11,114 5007 Other-X-Ray and EKG Services 20,343 5008 1 Other(Specify) SPECIAL EXPENSES TOTAL: $ 656,531 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 20-21 Revised Exhibit B-2 Page 4 of 18 6000:ADMINISTRATIVE EXPENSES Acct# Line Item Description Amount 6001 Administrative Overhead $ 617,670 6002 Professional Liability Insurance 9,996 6003 Accounting/Bookkeeping 875 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 10ther (Specify) - ADMINISTRATIVE EXPENSES TOTAL $ 628,541 7000: FIXED ASSETS Acct# Line Item Description Amount 7001 Computer Equipment&Software $ 1,989 7002 Copiers, Cell Phones,Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures 4,491 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 1 Other(Specify) - FIXED ASSETS EXPENSES TOTAL $ 6,480 TOTAL PROGRAM EXPENSES $ 5,070,226 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 20-21 Revised Exhibit B-2 Page 5 of 18 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Line Item Description Service Units Rate Amount 8001 Mental Health Services 0 - $ - 8002 Case Management 0 - - 8003 Crisis Services 0 - - 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 8009 Psychiatric Health Facility Services 6,8671 743.34 1 5,104,516 Estimated Specialty Mental Health Services Billing Totals: 16,8671 $ 5,104,516 Estimated % of Clients who are Medi-Cal Beneficiaries 80% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 4,104,031 Federal Financial Participation (FFP) % 1 50% 2,052,015 MEDI-CAL FFP TOTAL $ 2,052,015 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ - 8102 SABG $ - SUBSTANCE USE DISORDER FUNDS TOTAL $ - Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 20-21 Revised Exhibit B-2 Page 6 of 18 8200- REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ 2,057,231 REALIGNMENT TOTAL $ 2,057,231 8300- MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services &Supports $ - 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 IWET-Workforce Education &Training I - 8305 JCFTN - Capital Facilities &Technology - MHSA TOTAL $ - 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ - 8402 Client Insurance 343,206 8403 Grants (Specify) - 8404 juninsured 1 617,774 8405 1 Other (Specify) I - OTHER REVENUE TOTAL $ 960,980 TOTAL PROGRAM FUNDING SOURCES: $ 5,070,226 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Narrative FY 20-21 Revised Exhibit B-2 Page 7 of 18 Adult Inpatient Psychiatric Health Facility(PHF) Exodus Recovery, Inc. Fiscal Year(FY 2020-21) Budget Narrative ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:SALARIES&BENEFITS 2,965,720 Employee Salaries 2,310,076 1101 Program Director/Quality Improvement 149,893 Program Director 1.00 FTE,Administrative Services 1102 Program Support Assistant 50,318 Program Support Assistant 1.00 FTE,Administrative Services 1103 Program Nurse(LVN,LPT) 523,008 Program Nurse(LVN,LPT)9.00 FTE,Direct Services 1104 Program Nurse(RN) 474,473 Program Nurse(RN)4.05 FTE Direct Services 1105 LMFT 124,974 LMFT 1.00 FTE Direct Services 1106 Mental Health Worker 760,500 Mental Health Worker 21.5 FTE Direct Services 1107 Recreational Therapist 72,346 Recreational Therapist 1.00 FTE Direct Services 1108 Senior Data Specialist 47,305 Senior Data Specialist 0.51 FTE Admin Services 1109 Social Services Coordinator 95,356 Social Services Coordinator 1.15 FTE Admin Services 1110 Administrator 11,903 Administrator 0.10 FTE Admin Services 1111 0 1112 0 1113 0 1114 0 1115 0 1116 0 1117 0 1118 0 1119 0 1120 0 - Employee Benefits 457,018 1201 Retirement 105,114 Employer contributions to a pool of funds set aside for employees future benefit 1202 Worker's Compensation 166,018 Business Insurance that provides beenfits to employees who suffer work-related injuries 1203 Health Insurance 185,886 Employer covered health insurance plan 1204 Other(Specify) - 1205 Other(Specify) 1206 Other(Specify) Payroll Taxes&Expenses: 198,626 1301 OASDI 22,069 Old-Age,Survivors,and Disability Insurance Program 1302 FICA/MEDICARE 158,501 Federal Payroll Tax 1303 SUI 18,056 State Unemploymet Insurance 1304 Other(Specify) - 1305 Other(Specify) 1306 Other(Specify) 2000:CLIENT SUPPORT 376,603 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 33,853 Medication Cost for clients 2009 Program Supplies-Medical 22,263 Medical Supplies for Clients 2010 Utility Vouchers 21,103 2011 Other-Program Supplies-Therapeutic - Therapeutic Supplies for Clients 2012 Other(Specify) #REF! Food services cost for clients 2013 Other-Food Service 299,384 2014 Other(Specify) - 2015 Other(Specify) 2016 Other(Specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Narrative FY 20-21 Revised Exhibit B-2 Page 8 of 18 FF7 LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3000:OPERATING EXPENSES 122,715 3001 Telecommunications 36,363 Phone and Internet usage 3002 Printing and Postage 201 Program related postage and delivery 3003 Office,Household,and Program Supplies 73,323 Office Supplies(pens,paper,binders,staples,paper clips,desk organizers etc.)and Office Equipment 3004 Advertising 414 3005 Staff Development and Training 11,597 On-going staff training 3006 Staff Mileage/Vehicle Mainteanance 134 Mileage,parking,travel expenses etc. 3007 Subscriptions&Memberships - 3008 Staff Orientation/Recruitment - 3009 Other-Staff Orientation/Recruitment 683 On-going staff orientation/recruitment 3010 Other(Specify) - 3011 Other(Specify) 3012 Other(Specify) 4000:FACILITIES&EQUIPMENT 313,636 4001 Building Maintenance 11,367 Maintenance and Repairs 4002 Rent/Lease Building - 4003 Rent/Lease Equipment 202 Leased computers,printers,copiers and faxes 4004 Rent/Lease Vehicles - 4005 Security 150,575 Program Security Personnel 4006 Utilities 74,798 Program Utilities 4007 Other-Janitorial 76,561 Program Cleaning Services 4008 Other-Business Taxes/License/Permits 133 Program business taxes,licenses and permits 4009 Other(Specify) - 4010 Other(Specify) 5000:SPECIAL EXPENSES 656,531 5001 Consultant(Network&Data Management) 119,069 Network&Data management,Cost for consultant ITfirm support,network monitoring and off-site back-up for IT system 5002 HMIS(Health Management Information - System) 5003 Contractual/Consulting Services -Personnel 468,405 Personnel related services including registry as needed,parking,relocation etc. related(Registry,Parking,Relocation,etc.) 5004 Translation Services 2,260 Translation Services for the program 5005 Other-Laundry Service 35,340 Linen service for program 5006 Other -Medical Waste Disposal 11,114 Client medical waste disposal 5007 Other-X-Ray and EKG Services 20,343 X-Ray and EKG serivices 5008 Other(Specify) - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Narrative FY 20-21 Revised Exhibit B-2 Page 9 of 18 ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6000:ADMINISTRATIVE EXPENSES 628,541 6001 Administrative Overhead 617,670 Administrative Overhead fee at 15%of program expenses 6002 Professional Liability Insurance 9,996 Liability,Business and Vehicle Insurance 6003 Accounting/Bookkeeping 875 Cost of financial auditing and monthy financial reviews 6004 External Audit - 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Other(Specify) 6009 Other(Specify) 6010 Other(Specify) 6011 Other(Specify) 6012 Other(Specify) 7000:FIXED ASSETS 6,480 7001 Computer Equipment&Software 1,989 Computers replacementor repair and software for program 7002 Copiers,Cell Phones,Tablets,Devices to - Contain HIPAA Data 7003 Furniture&Fixtures 4,491 Furniture&fixtures replacement or repair 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(Specify) 7008 Other(Specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 10 of 18 Adult Inpatient Psychiatric Health Facility (PHF) Exodus Recovery, Inc. Fiscal Year (FY 2021-22) PROGRAM EXPENSES 1000: SALARIES& BENEFITS Employee Salaries Acct# Position FTE Admin Direct Total 1101 Program Director/Quality Improvement 1.00 $ 149,893 $ - $ 149,893 1102 Program Support Assistant 1.00 52,533 - 52,533 1103 Program Nurse (LVN, LPT) 9.00 - 564,895 564,895 1104 Program Nurse (RN) 4.05 - 538,536 538,536 1105 LMFT 1.00 - 124,974 124,974 1106 Mental Health Worker 21.55 - 961,676 961,676 1107 Recreational Therapist 1.00 - 72,328 72,328 1108 Senior Data Specialist 0.51 20,967 - 20,967 1109 Social Services Coordinator 4.00 149,856 - 149,856 1110 Administrator 0.10 16,515 - 16,515 1111 - - - 1112 - - - 1113 - - - 1114 - - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - Personnel Salaries Subtotall 43.21 I $ 389,764 1 $ 2,262,409 1 $ 2,652,173 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 11 of 18 Employee Benefits Acct# Description Admin Direct Total 1201 Retirement $ 101,752 $ - $ 101,752 1202 Worker's Compensation 145,992 - 145,992 1203 Health Insurance 243,321 - 243,321 1204 Other (Specify) - - - 1205 Other (Specify) - - - 1206 Other (Specify) - - - Employee Benefits Subtotal:1 $ 491,065 1 $ - $ 491,065 Payroll Taxes & Expenses: Acct# Description Admin Direct Total 1301 OASDI $ 17,838 $ - $ 17,838 1302 FICA/MEDICARE 184,327 - 184,327 1303 SUI 17,838 - 17,838 1304 Other (Specify) - - - 1305 Other (Specify) - - - 1306 Other (Specify) - - - Payroll Taxes& Expenses Subtotal: $ 220,003 $ - $ 220,003 EMPLOYEE SALARIES& BENEFITS TOTAL: $ 1,100,832 $ 2,262,409 $ 3,363,241 2000: CLIENT SUPPORT Acct# Line Item Description Amount 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 27,082 2009 Program Supplies - Medical 16,294 2010 Utility Vouchers 2011 Other- Program Supplies -Therapeutic 15,563 2012 Other- Food Service 300,886 2013 Other (Specify) 2014 Other (Specify) - 2015 Other (Specify) - 2016 10ther (Specify) - DIRECT CLIENT CARE TOTAL $ 359,825 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 12 of 18 3000: OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 27,951 3002 Printing and Postage 500 3003 Office, Household, and Program Supplies 44,488 3004 Advertising - 3005 Staff Development and Training 6,743 3006 Staff Mileage/Vehicle Mainteanance 438 3007 Subscriptions & Memberships - 3008 Staff Orientation/Recruitment - 3009 Other-Staff Orientation/Recruitment 3,623 3010 Other(Specify) - 3011 Other(Specify) - 3012 10ther (Specify) - OPERATING EXPENSES TOTAL: $ 83,743 4000: FACILITIES& EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ 12,094 4002 Rent/Lease Building - 4003 Rent/Lease Equipment 647 4004 Rent/Lease Vehicles - 4005 Security 160,129 4006 Utilities 75,650 4007 Other-Janitorial 84,447 4008 Other- Business Taxes/License/Permits 133 4009 Other (Specify) - 4010 Other (Specify) - FACILITIES/EQUIPMENT TOTAL: $ 333,100 5000: SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant (Network& Data Management) $ 89,944 5002 HMIS (Health Management Information System) - 5003 Contractual/Consulting Services - Personnel related (Registry, Parking, Relocation, etc.) 638,000 5004 Translation Services 2,491 5005 Other- Laundry Service 34,323 5006 Other - Medical Waste Disposal 11,624 5007 Other-X-Ray and EKG Services 12,498 5008 10ther (Specify) SPECIAL EXPENSES TOTAL: $ 788,880 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 13 of 18 6000:ADMINISTRATIVE EXPENSES Acct# Line Item Description Amount 6001 Administrative Overhead $ 730,463 6002 Professional Liability Insurance 10,000 6003 Accounting/Bookkeeping 1,030 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 10ther (Specify) - ADMINISTRATIVE EXPENSES TOTAL $ 741,493 7000: FIXED ASSETS Acct# Line Item Description Amount 7001 Computer Equipment&Software $ 3,000 7002 Copiers, Cell Phones,Tablets, Devices to Contain HIPAA Data - 7003 Furniture & Fixtures 3,000 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 1 Other (Specify) - FIXED ASSETS EXPENSES TOTAL $ 6,000 TOTAL PROGRAM EXPENSES $ 5,676,282 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 14 of 18 IPROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Line Item Description Service Units Rate Amount 8001 Mental Health Services 0 - $ - 8002 Case Management 0 - - 8003 Crisis Services 0 - - 8004 Medication Support 0 - - 8005 Collateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 8009 Psychiatric Health Facility Services 1 5,8401 743.34 1 4,341,106 Estimated Specialty Mental Health Services Billing Totals: 1 5,8401 4,341,106 Estimated %of Clients who are Medi-Cal Beneficiaries 80% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 3,490,249 Federal Financial Participation (FFP) % 1 50% 1,745,124 MEDI-CAL FFP TOTAL $ 1,745,124 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ - 8102 SABG $ - SUBSTANCE USE DISORDER FUNDS TOTAL $ - Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Budget FY 21-22 Revised Exhibit B-2 Page 15 of 18 8200- REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ 2,965,834 REALIGNMENT TOTAL $ 2,965,834 8300- MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services &Supports $ - 8302 PEI - Prevention & Early Intervention - 8303 INN - Innovations - 8304 IWET-Workforce Education &Training I - 8305 JCFTN - Capital Facilities &Technology - MHSA TOTAL $ - 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ - 8402 Client Insurance 344,758 8403 Grants (Specify) - 8404 jUninsured 1 620,566 8405 1 Other (Specify) I - OTHER REVENUE TOTAL $ 965,324 TOTAL PROGRAM FUNDING SOURCES: $ 5,676,282 Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020 Narrative FY 21-22 Revised Exhibit B-2 Page 16 of 18 Adult Inpatient Psychiatric Health Facility(PHF) Exodus Recovery, Inc. Fiscal Year(FY 2021-22) Budget Narrative ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:SALARIES&BENEFITS 3,363,241 Employee Salaries 2,652,173 1101 Program Director/Quality Improvement 149,893 Program Director 1.00 FTE,Administrative Services 1102 Program Support Assistant 52,533 Program Support Assistant 1.00 FTE,Administrative Services 1103 Program Nurse(LVN,LPT) 564,895 Program Nurse(LVN,LPT)9.00 FTE,Direct Services 1104 Program Nurse(RN) 538,536 Program Nurse(RN)4.05 FTE Direct Services 1105 LMFT 124,974 LMFT 1.00 FTE Direct Services 1106 Mental Health Worker 961,676 Mental Health Worker 21.5 FTE Direct Services 1107 Recreational Therapist 72,328 Recreational Therapist 1.00 FTE Direct Services 1108 Senior Data Specialist 20,967 Senior Data Specialist 0.51 FTE Admin Services 1109 Social Services Coordinator 149,856 Social Services Coordinator 4.0 FTE Admin Services Required by the State CDL 1110 Administrator 16,515 Administrator 0.10 FTE Admin Services 1111 0 1112 0 1113 0 1114 0 1115 0 1116 0 1117 0 1118 0 1119 0 1120 0 - Employee Benefits 491,065 1201 Retirement 101,752 Employer contributions to a pool of funds set aside for employees future benefit 1202 Worker's Compensation 145,992 Business Insurance that provides beenfits to employees who suffer work-related injuries 1203 Health Insurance 243,321 Employer covered health insurance plan 1204 Other(Specify) - 1205 Other(Specify) 1206 Other(Specify) Payroll Taxes&Expenses: 220,003 1301 OASDI 17,838 Old-Age,Survivors,and Disability Insurance Program 1302 FICA/MEDICARE 184,327 Federal Payroll Tax 1303 SUI 17,838 State Unemploymet Insurance 1304 Other(Specify) - 1305 Other(Specify) 1306 Other(Specify) 2000:CLIENT SUPPORT 359,825 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 27,082 Medication Cost for clients 2009 Program Supplies-Medical 16,294 Medical Supplies for Clients 2010 Utility Vouchers - 2011 Other-Program Supplies-Therapeutic 15,563 Therapeutic Supplies for Clients 2012 Other-Food Service 300,886 Food services cost for clients 2013 Other(Specify) - 2014 Other(Specify) 2015 Other(Specify) 2016 Other(Specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Narrative FY 21-22 Revised Exhibit B-2 Page 17 of 18 ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3000:OPERATING EXPENSES 83,743 3001 Telecommunications 27,951 Phone and Internet usage 3002 Printing and Postage 500 Program related postage and delivery 3003 Office,Household,and Program Supplies 44,488 Office Supplies(pens,paper,binders,staples,paper clips,desk organizers etc.)and Office Equipment 3004 Advertising - 3005 Staff Development and Training 6,743 On-going staff training 3006 Staff Mileage/Vehicle Mainteanance 438 Mileage,parking,travel expenses etc. 3007 Subscriptions&Memberships - 3008 Staff Orientation/Recruitment - 3009 Other-Staff Orientation/Recruitment 3,623 On-going staff orientation/recruitment 3010 Other(Specify) - 3011 Other(Specify) 3012 Other(Specify) 4000:FACILITIES&EQUIPMENT 333,100 4001 Building Maintenance 12,094 Maintenance and Repairs 4002 Rent/Lease Building - 4003 Rent/Lease Equipment 647 Leased computers,printers,copiers and faxes 4004 Rent/Lease Vehicles - 4005 Security 160,129 Program Security Personnel 4006 Utilities 75,650 Program Utilities 4007 Other-Janitorial 84,447 Program Cleaning Services 4008 Other-Business Taxes/License/Permits 133 Program business taxes,licenses and permits 4009 Other(Specify) - 4010 Other(Specify) 5000:SPECIAL EXPENSES 788,880 5001 Consultant(Network&Data Management) 89,944 Network&Data management,Cost for consultant IT firm support,network monitoring and off-site back-up for IT system 5002 HMIS(Health Management Information - System) 5003 Contractual/Consulting Services -Personnel 638,000 Personnel related services including registry as needed,parking,relocation etc. related(Registry,Parking,Relocation,etc.) 5004 Translation Services 2,491 Translation Services for the program 5005 Other-Laundry Service 34,323 Linen service for program 5006 Other -Medical Waste Disposal 11,624 Client medical waste disposal 5007 Other-X-Ray and EKG Services 12,498 X-Ray and EKG serivices 5008 Other(Specify) - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Narrative FY 21-22 Revised Exhibit B-2 Page 18 of 18 ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6000:ADMINISTRATIVE EXPENSES 741,493 6001 Administrative Overhead 730,463 Administrative Overhead fee at 15%of program expenses 6002 Professional Liability Insurance 10,000 Liability,Business and Vehicle Insurance 6003 Accounting/Bookkeeping 1,030 Cost of financial auditing and monthy financial reviews 6004 External Audit - 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Other(Specify) 6009 Other(Specify) 6010 Other(Specify) 6011 Other(Specify) 6012 Other(Specify) 7000:FIXED ASSETS 6,000 7001 Computer Equipment&Software 3,000 Computers replacementor repair and software for program 7002 Copiers,Cell Phones,Tablets,Devices to - Contain HIPAA Data 7003 Furniture&Fixtures 3,000 Furniture&fixtures replacement or repair 7004 Leasehold/Tenant/Building Improvements - 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(Specify) 7008 Other(Specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020