HomeMy WebLinkAboutAgreement A-12-184-3 with Turning Point of Central California Inc..pdf Agreement No. 12-184-3
1 AMENDMENT III TO AGREEMENT
2 THIS AMENDMENT, hereinafter referred to as Amendment III, is made and entered into
3 this 16th day of June , 2015,by and between the COUNTY OF FRESNO, a
4 political subdivision of the State of California, hereinafter referred to as "COUNTY", and TURNING
5 POINT OF CENTRAL CALIFORNIA,Inc., a California Non-Profit Corporation, whose remit to
6 address is P. 0. Box 7447,Visalia, CA 93290, and whose service address is FIRST STREET CENTER,
7 3636 N First Street Suites 135 and 154, Fresno, CA 93726, hereinafter referred to as
8 "CONTRACTOR".
9 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
10 No. 12-184, effective April 24, 2012, Amendment I,No. 12-184-1, effective September 11, 2012, and
11 Amendment 11,No. 12-184-2, effective April 22, 2014 (hereinafter referred to as the "Agreement"); and
12 WHEREAS, CONTRACTOR agreed to provide outpatient mental health, outpatient substance
13 use disorder treatment services, and Full-Service Partnership (FSP)treatment services to AB109 Public
14 Safety Realignment and the Post-release Community Supervision Act of 2011; and
15 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below and
16 restate the Agreement in its entirety.
17 NOW,THEREFORE, in consideration of their mutual promises, covenants and conditions,
18 hereinafter set forth,the sufficiency of which is acknowledged, the parties agree as follows:
19 1. That the following text in Agreement#12-184, Page Six (6), beginning with Paragraph
20 Four(4), Section E, Line Seventeen (17)with the line, "For the period July 1, 2015 through June 30,
21 2016"and ending on page Seven (7), Line Four (4)with the word "costs" be deleted and the following
22 inserted in its place:
23 "E. For the period July 1, 2015 through June 30, 2016
24 1) In no event shall the maximum compensation under this Agreement for
25 Substance Use Disorder Services, Outpatient Mental Health Services, and FSP-Services combined
26 exceed Three Million Nine Hundred Ninety-Six Thousand Three Hundred Sixty-Seven and No/l00
27 Dollars ($3,996,367.00).
28 2) Substance Use Disorders and Outpatient Mental Health-The maximum
1 - COUNTY 01:MIESNO
Vre.no,CA
1 compensation under this Agreement for Substance Use Disorder Services and Outpatient Mental Health
2 Services shall not exceed Two Million Four Hundred Forty Thousand Four Hundred Sixty-Four and
3 No/100 Dollars ($2,440,464.00). CONTRACTOR is expected to invoice Medi-Cal for those clients
4 that are eligible, prior to invoicing the COUNTY.
5 3) Full Service Partnership - The maximum compensation under this
6 Agreement for FSP Services shall not exceed One Million Five Hundred Fifty-Five Thousand Nine
7 Hundred Three and No/ 100 Dollars ($1,555,903.00). It is further understood by CONTRACTOR and
8 COUNTY that CONTRACTOR estimates to generate Eight Hundred Fifty Thousand Nine Hundred
9 Three and No/100 Dollars ($850,903.00) in Medi-Cal Federal Financial Participation (FFP) and Five
10 Thousand and No/100 Dollars ($5,000.00) from the collection of consumer rents to offset
11 CONTRACTOR's program costs.
12 2. That the following text in Agreement#12-184, Page Twenty-Six (26), beginning with
13 Paragraph Twenty-Eight (28), Section G, Line Twenty (20) with the line, "A single audit report is not
14 applicable if all of CONTRACTOR's federal contracts do not exceed $500,000" and ending on page
15 Twenty-Six (26), Line Twenty-One (21) with the word "Medi-Cal." be deleted and the following
16 inserted in its place:
17 "A single audit report is not applicable if all of CONTRACTOR's federal contracts do
18 not exceed $750,000 or CONTRACTOR's only funding is through Drug related Medi-Cal."
19 3. That all references in existing COUNTY Agreement No. 12-184 to "Exhibit A" shall be
20 changed to read "Revised Exhibit A—Amendment 11I" where appropriate, attached hereto and
21 incorporated herein by reference.
22 4. That all references in existing COUNTY Agreement No. 12-184 to "Exhibit C" and
23 "Revised Exhibit C" shall be changed to read "Revised Exhibit C— Amendment III" where appropriate,
24 attached hereto and incorporated herein by reference.
25 5. That all references in existing COUNTY Agreement No. 12-184 to "Exhibit I" shall be
26 changed to read "Revised Exhibit I — Single Audit Requirement" where appropriate, attached hereto
27 and incorporated herein by reference.
28
— 2 — COUN Y U1'FR1:SNO
I resnu,CA
1 6. COUNTY and CONTRACTOR agree that this Amendment III is sufficient to amend
2 Agreement No. 12-184, Amendment I No. 12-184-l and Amendment II No. 12-l 84-2 and that upon
3 execution of this Amendment III, the Agreement, Amendment I, Amendment II, and Amendment III
4 together shall be considered the Agreement.
5 7. The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
6 covenants, conditions and promises contained in the Agreement, and not amended herein, shall remain
7 in full force and effect. This Amendment III shall become effective upon execution by all parties.
8
10
12
13 HI
14 ///
15 HI
16
17
18
19
20
21
22
23
24
2 5
26
27
28
3 — COUNTY OF FRkSM)
14cs11o,CA
1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment III to the Agreement 12-
2 184 as of the day and year first hereinabove written.
3
ATTEST:
4
5 CONTRACTOR:
TURNING POINT OF CENTRAL
6 CALIFORNIA, INC.
7
8 By: /
9 Print Name:
10
11 Title: _
Chairman of Board, or President,
12 or any Vice President
13
14
15 By: lc
16 Print Name:
17 Title: 6 D
18 Secretary (of Corporation), or
any Assistant Secretary, or
19 Chief Financial Officer, or
20 any Assistant Treasurer
21
22
Mailing Address:
23 P. O. Box 7447
24 Visalia, CA 93290
Contact: Executive Director
25
26
27 PLEASE SEE ADDITIONAL
SIGNATURE PAGE ATTACHED
28
— 4 — COUNTY 0I FRI!SNO
Fresno,CA
1 APPROVED AS TO ACCOUNTING FORM: COUNTY OF FRESNO
2 VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
3 �
5 By: By.
DEBORAH A. POOCHIGIAN, Clh6kman
6 Board of Supervisors
7
8 APPROVED AS TO LEGAL FORM: BERNICE E. SEIDEL, Clerk
DANIEL C. CEDERBORG, COUNTY COUNSEL Board of Supervisors
9
10
11 By: By: CW
12
13 REVIEWED AND RECOMMENDED FOR
14 APPROVAL:
'15
'16 By'
17 DA AN U ECHT, Dir ctor
Department of Behavioral Health
18
19 The following is for COUNTY's use:
20
Fund/Subclass: 0001/10000
21
22 Organization: 56302070 56304525 Total Contract
23
FY 2011-12 $ 300,000.00 $ 87,500.00 $ 387,500.00
FY 2012-13 $1,988,246.00 $ 460,007.00 $2,448,253.00
24 FY 2013-14 $2,038,246.00 $ 599,262.00 $2,637,508.00
25 FY 2014-15 $2,038,246.00 $ 744,696.00 $2,782,942.00
FY 2015-16 $2,440,464.00 $1,555,903.00 $3,996,367.00
26
Account/Program: 7294/0
27
28 bb
— 5 — COUNTY OF FRESNO
Fresno,CA
REVISED EXHIBIT A AMENDMENT III
Page 1 of 13
AB 109
SCOPE OF WORK
Section 1: Outpatient Mental Health and Substance Use Disorders Services
Section 2: Full Service Partnership Services
ORGANIZATION: Turning Point of Central California
MAILING ADDRESS: P.O. Box 7447, Visalia CA 93290
SERVICE ADDRESS: 3636 N. First Street, Suites 135 and 154, Fresno, CA 93726
SERVICES: Mental health outpatient (OP) services, substance use disorders
(SUD) treatment services, and full service partnership (FSP) services
as required by AB109 Public Safety Realignment and the Post-release
Community Supervision Act of 2011.
SUBSTANCE USE DISORDERS AND OUTPATIENT SERVICES
SU/OP Director: Ryan Banks, (559) 906-8673
Regional Director: Dennis Reid, (559) 269-4087
County Division: Department of Behavioral Health, Contracts Division
County Contact: Baldomero Berber, Staff Analyst, (559) 600-0609
FULL SERVICE PARTERNERSHIP SERVICES
FSP Director: Ryan Banks, (559) 906-8673
Regional Director: Sharon Ross, (559) 226-01678983
County Division: Department of Behavioral Health, Contracts Division
County Contact: Baldomero Berber, Staff Analyst, (559) 600-0609
CONTRACT PERIOD: April 24, 2012 through June 30, 2013, with an option for three (3)
twelve (12) month renewal terms
CONTRACT AMOUNT:
Total Substance Use Full Service
Term Budget and Outpatient Partnership
FY 11-12 $387,500 $300,000 $87,500
FY 12-13 $2,448,253 $1,988,246 $460,007
FY 13-14 $2,637,508 $2,038,246 $599,262
FY 14-15 $2,782,942 $2,038,246 $744,696
FY 15-16 $3,996,367 $2,440,464 $1,555,903
REVISED EXHIBIT A AMENDMENT III
Page 2 of 13
SECTION 1
Outpatient Mental Health and Substance Use Disorders Services
OUTPATIENT SERVICES:
In anticipation of a large percentage of the Fresno County's AB-109 population requiring outpatient
substance use treatment and mental health services, First Street Center (FSC) Outpatient Program
aims to assist. FSC Outpatient Program will provide services that have been personalized to the
client's needs. The First Street Center Outpatient program will emphasize a broad and cohesive
substance abuse and co-occurring treatment approach for all clients with the following essential
components being established:
• The FSC Outpatient Program will be open for morning, early afternoon, late afternoon, and
evening classes for its clients. The FSC Outpatient Program will be available for individual
Substance Use Disorder Counseling sessions and/or Case Management sessions primarily
between the hours of 8am and 5pm, Monday through Friday and at various scheduled times
that have been scheduled by the Case Manager/Substance Use Disorder Counselor and the
client.
• When a client presents to the FSC Outpatient Program with a substance use disorder as well
as a mental health need, each disorder will be considered primary thus allowing the client to
embrace an integrated plan for their individual treatment.
• The FSC Outpatient Program understand the need for psychiatric services with the co-
occurring population thus the FSC Outpatient Program will work on a direct treatment
approach that emphasizes the need of the client while focusing on the integrated care of the
client.
• The FSC will focus on a "treatment on demand" approach that utilizes a "whatever it takes"
component. The FSC Outpatient Program will also focus on cultural/linguistic awareness
while taking on an empathic, non-judgmental, evidenced based, person-centered approach
that is not only built for substance use disorders but one that is also built around the needs of
the co-occurring and mental health client.
• The team at the FSC Outpatient Program will use an approach that focuses on the client's
strengths and current skills with the belief that all clients should participate in their own
treatment plans.
• The FSC Outpatient Program will strive to become Medi-Cal compliant.
Further, the FSC Outpatient Program will provide treatment services to adults aged 18-years old and
up and their families. The FSC Outpatient Program will work under the "treatment on demand"
approach where no client is given priority over the next. The FSC Outpatient Program will work
directly with the AB-109 probationary department for all referrals and complete the screening process
for all clients directly at the A13-109 probationary department.
The FSC Outpatient Program is available from 8am to 5pm regularly with evening classes and Case
Management/Substance Use Disorder Counseling/Mental Health sessions as scheduled. The FSC
Outpatient Program will also have telephone contact with their clients as needed and crisis
management as needed. The following crisis response measures shall also be followed by the staff
at the FSC Outpatient Program:
1. The FSC Outpatient Program will follow the direct lead of the Program Director and/or
Supervisor during the crisis.
REVISED EXHIBIT A AMENDMENT III
Page 3 of 13
2. The FSC Outpatient Program will respond to all crises in a rapid and flexible manner.
3. The FSC Outpatient Program understands that there are several types of crisis situations that
can occur with the clients who are involved in the outpatient program, which may include:
housing crisis, suicidal ideation, homicidal ideation, relapse, decompensation, and others.
4. Due to the FSC Outpatient Program understanding that there will undoubtedly be different
types of crises, the FSC Outpatient Program will be fully aware of all crisis situations that occur
within the Outpatient Program through a staffing that will immediately follow the crisis
situations.
5. When a housing crisis occurs at the FSC Outpatient Program, the Program Director, the FSC
Supervisor, and the FSC Case Manager will be notified immediately of said housing crisis.
a. The FSC Outpatient Program will take every measure to ensure that the FSC clients
have housing, whether in a sober living environment or in inpatient treatment (either
voluntary or involuntary).
b. When such a need for housing has been acknowledged, the FSC Outpatient Program
staff shall collaborate with the treatment staff in such facilities.
6. The FSC Outpatient Program believes that all crisis services shall be monitored to ensure that
all interventions have begun appropriately and that will be commenced with a discharge plan
that will take place in collaboration with staff at the appropriate agency.
All staff at the FSC Outpatient Program will be trained on the housing situations in Fresno County as a
way to assist clients in locating, securing, and inhabiting appropriate housing that has been deemed
appropriate for their exact level of care. Further, the FSC Outpatient Program will provide housing
options to all clients in need as well as maintain clients in independent living by providing needed
services to all clients, accessing appropriate resources for each client, and encouraging all clients to
live responsible and productive lives in an independent setting.
The FSC Outpatient Program will provide a variety of services in the area of psychotropic medication
management, which will include: tele-psychiatry, the prescribing of psychotropic medications, the
administration of psychotropic medications by way of injectable medications, monitoring the client
after they have begun psychotropic medications, and the documentation of all avenues leading to the
course of medication management and further by completing the following:
1. The tele-psychiatrist working with through the FSC Outpatient Program shall assess each
client's mental illness thereby prescribing any appropriate medication that the client is in need
of; regularly review and documents that client's symptoms and response to their mediation;
educate the client on how their medications work; treat and documents any adverse reactions
that come from the client's medication.
2. The FSC Program Nurse shall establish medication policies and procedures which will train
the client in the knowledge of their own medication as well as all staff. The FSC Program
Nurse will provide necessary training to all FSC staff that is required for their overall learning.
3. All FSC staff will document their client's mental illness symptoms and how the client responds
to their medication. All FSC staff will observe the side effects of their client's medication and
discuss any concerns that they have with the Lead Mental Health Clinician as well as the FSC
Program Nurse.
The FSC Outpatient Program will provide substance use disorder treatment that is not only intensive
and comprehensive but also level appropriate for the client. The FSC Outpatient Program will work
under the lens of"treatment on demand" where clients are served according to their need and not
upon the timeline of the treatment program. The FSC Outpatient Program will work under the needs
of the clients whether the client is being seen for their substance use disorder, co-occurring disorder,
or mental health disorder.
REVISED EXHIBIT A AMENDMENT III
Page 4of13
The FSC Outpatient Program team will have access to several resources for their clients, including
the ability to make emergency purchases of food, clothing, prescriptions, and other basic needs for
their clients. The FSC Outpatient Program will have sound practices for tracking these purchases.
The FSC Outpatient Program shall provide training and instruction to support and assist all clients in
learning the skills of personal hygiene, job-readiness skills, resume writing, mock-interview sessions,
"how to dress to impress", provide suits and ties to male clients and dresses to females after courses,
linkage services that apply to general relief, SSI, and others. The FSC Outpatient Case Managers
assist clients with scheduling doctor appointments and the follow-through with appointments as well
as court services. FSC Case Managers also provide linkage services between clients and the FSC
Mental Health team for additional support.
The FSC Outpatient Program shall provide initial support of all clients with scheduling activities that
are built around the client's level of care. FSC Substance Use Disorder Counselors will facilitate
group processes and the educational building in the client through the delivery of all SUD Educational
Classes that are focus-driven and psychoeducational in manner. The FSC Substance Use Disorder
(SUD) Counselors will provide a key focus to all AB-109 clients that aim at the Criminal and Addictive
Thinking process of the client and how to overcome past barriers. The FSC SUD Counselors will
teach socialization skills to clients that are in need, while also focusing on the relapse prevention
model. FSC SUD Counselors will also emphasize the importance of Familial systems in the client's
recovery by assigning the client on a needs basis to family group or familial therapy with a Mental
Health Clinician through First Street Center. FSC SUD Counselors will provide UA testing (both on 5-
panel and 10-panel, as needed) of all clients. The FSC SUD Counselors will test clients at time of
DISCHARGE and during the discharge planning. Referrals will be made to clients in the level of care
3 and 4 to Aftercare treatment. FSC Substance Use Disorder Counselors will be available 24/7 for
crisis management at an on-call basis.
The FSC Outpatient Program will provide an integrated approach for all co-occurring clients. The
FSC Outpatient Program will work with a "treatment on demand" principle that is empathic,
nonjudgmental, unique, and having a positive regard that focuses on the client's individual needs.
The FSC Outpatient Program will work to minimize the client's involvement in the criminal justice
system, whether it is in the Fresno County Jail or elsewhere within the California Department of
Corrections and Rehabilitation by means of classes, groups, or individual sessions between the client
and their assigned SUD Counselor, Case Manager, or Mental Health Clinician.
STAFFING REQUIREMENTS:
One of the most critical features of the FSC Outpatient Program is the team delivery method, which
shall be the unified team approach with the client and their families at its focus. With this client/family
approach, the FSC Outpatient Program will unify their team in an effort to build a unified focus that
strengthens each FSC staff member's diverse skills. Due to the FSC Outpatient Program working
under a "treatment on demand" lens, the FSC Outpatient Program will have no exact staff to client
ratio. Designated staff shall be on-call during the off-hour periods, on a rotating basis in order to
respond to the exact needs of the clients. The AB-109 psychiatrist (or Licensed Psychiatric Nurse
Practitioner) will be available during regular business hours.
GRIEVANCES AND INCIDENT REPORTS:
The FSC Outpatient Program understands that there will be times of grievances and incident reports.
The FSC Outpatient Program will notify Fresno County of all incidents or unusual occurrences
reportable to state licensing bodies that affect Fresno County clients within (24) twenty-four hours of
the incident. The FSC Outpatient Program will within (15) fifteen days after each grievance or incident
REVISED EXHIBIT A AMENDMENT III
Page 5 of 13
affecting the Fresno County sponsored clients inform provide the Fresno County with the corrective
action that will be taken to resolve the complaint or incident.
REPORTING REQUIREMENTS:
The FSC Outpatient Program will maintain an up-to-date caseload record of all clients who are
participants in the FSC Outpatient Program. The FSC Outpatient Program will provide Fresno
County with client, programmatic, and other demographic information upon request.
PROGRAM OUTCOMES
The following items listed below represent program outcomes to be tracked by the vendor during the
term of the contract:
A. Engagement:
1. 95 percent of all referrals will receive intake/assessment within one week of referral.
Average number of days can be calculated with a goal of reducing the average.
2. 25 percent of cases will engage the families of the offender in the offender's treatment.
B. Retention:
1. The number and percentage of offenders who complete each of the five levels of
treatment will be calculated with the following percentage as goals for each level: Level
1 — 70 percent; Level 2 — 65 percent; Level 3 — 60 percent; Level 4 — 55 percent; Level
5 — 65 percent, and voluntary aftercare — 30 percent.
2. The average length of treatment episode for offenders participating per level.
C. Abstinence/Sobriety:
1. A goal of 90 percent of all urine tests for drug alcohol use (random, scheduled and for
cause) will be negative.
2. 70 percent of discharges completing treatment with no alcohol or drug use detected by
urine testing.
3. 95 percent of discharges completing treatment with no alcohol or drug use detected
during the month prior to discharge.
4. 70 percent achieving progress as determined by Addiction Severity Index drug and
alcohol use subscales.
D. Treatment Objectives/Achievements:
1. Number and percentage of offenders achieving 75 percent of their individual treatment
goals.
2. Number and percentage of offenders attaining essential treatment/recovery information
and skills as determined by post-activity written test (goal of 80 percent).
3. 75 percent of all participants will develop ongoing recovery support network of family,
friends, and sobriety communities, or mainstream resources.
REVISED EXHIBIT A AMENDMENT III
Page 6 of 13
E. Mental Health:
1. Number and percentage of mentally ill offenders who substitute illicit drugs with
authorized medications.
2. Number and percentage (goal — 85 percent) of mentally ill or dually diagnosed who
evidence no hospitalization, incarceration, or use of County Crisis services (include
hospital emergency departments) as result of their mental illness during their program
participation.
3. Number and percentage who develop a wellness/recovery plan (goal — 85 percent).
4. Number and percentage of mentally ill participants who have adequate ongoing
housing, income, medication, social supports, mental health treatment services, and
ongoing mainstream resources at the time of program discharge.
5. Percent of participant and families that self-report wellness and recovery at the time of
program discharge.
F. Consumer Satisfaction:
1. Client perception of care is rated as satisfactory or better in pre- and post-discharge
survey (goal of 75 percent).
G. Law-Abiding Lifestyle:
1. Post-discharge recidivism for new crimes, and violation of terms of community
supervision.
REVISED EXHIBIT A AMENDMENT III
Page 7 of 13
SECTION 2
AB109 Full Service Partnership
FULL SERVICE PARTNERSHIP PROGRAM DESCRIPTION
The AB 109 Full Service Partnership (FSP) program shall provide innovative and evidence-based
mental health services specifically tailored to meet the unique needs of the seriously mentally ill (SMI)
population identified among the AB109 post-release adult male and female offenders. This project
shall include the use of innovative approaches resulting in increased access to services for the
underserved criminal justice clients thereby encouraging and assisting this population in transition
towards growth, stability, wellness, and recovery. Services shall be delivered with a focus of"meeting
the clients where they are" utilizing a "whatever it takes" approach. Services shall be culturally and
linguistically competent, values-driven, evidence-based and co-occurring capable. An important
element of this project will be close and constant communication and collaboration between
CONTRACTOR, the criminal justice system, Fresno County Probation Department, and Fresno
County Department of Behavioral Health, Mental Health Services Act.
SCHEDULE OF SERVICES
CONTRACTOR staff shall be available to provide FSP services to a minimum of forty-five (45)
consumers 24 hours per day, 7 days per week including telephone and face-to-face contact as
needed; and spend at least 75% of their time on billable activities on behalf of the consumers.
TARGET POPULATION
The target population is comprised of AB109 post-release adult male and female offenders, age 18
and older and their families, who have a serious mental illness (SMI) such as schizophrenia major
depression with psychotic features or bi-polar disorders. This program will serve a minimum of 45
AB109 transfer consumers referred by the Probation Department at any given point in time.
STAFFING REQUIREMENTS
1. CONTRACTOR shall implement and support the use of a team delivery method, which shall
be the unified team approach with a consumer/family centered focus. With this approach,
the multiple staff members that make up the team shall "unify" their diverse skills in order to
address each consumer's mental health and substance abuse needs. Staffing responses
and program design should show evidence of consumer/family support as provided through
consumer/family specialists
2. The FSP AB 109 Team staff to consumer ratio shall be set at or between 1:10 to 1:15, or
one staff serving no more than ten to fifteen consumers. All treatment staff will be included
in the ratio. The FSP AB 109 Team must meet the ratio requirements.
3. The FSP AB 109 Team shall be available twenty-four (24) hours per day, seven (7) days per
week. The staff shall have hours that allow them to work evenings and weekends. Staff
shall be on-call during off-hour periods, on a rotating basis in order to respond immediately
to consumers by telephone or in person, as dictated by consumer needs. The Psychiatrist,
or Psychiatric Nurse Practitioner, shall be available during normal business hours and on-
call during off-hours periods.
CONTRACTOR'S RESPONSIBILITIES
CONTRACTOR shall ensure that:
REVISED EXHIBIT A AMENDMENT III
Page 8 of 13
1. Staff be available to provide intensive case management and crisis outreach services 24
hours a day, 7 days a week;
2. Staff spend a minimum of 75% of their time on billable activities on behalf of FSP program
consumers;
3. When substance disorder and psychiatric disorder co-exist, each disorder should be
considered primary; an integrated dual treatment approach is recommended, where each
disorder receives appropriately intensive diagnosis-specific treatment;
4. Services are delivered with a focus of"meeting the client where they are" utilizing a
"whatever it takes" approach;
5. Services shall be culturally/linguistically competent, values-driven, evidence-based and co-
occurring capable;
6. A strength-based approach is implemented which will help consumers build on their current
skills and the consumer will actively participate in their individual treatment planning; the
goal being to help the consumer towards growth, stability, wellness, and recovery;
7. Highest priority for FSP services is given to individuals in a complex crisis;
8. FSP services offer an array of integrated mental health and substance abuse services that
are need driven, not appointment driven, and that involve case management and recovery
based peer support as well as community and family support;
9. FSP AB 109 Team and services adhere to the following crisis response measures:
a. Response to crisis shall be rapid and flexible;
b. When crisis housing is necessary for short-term care and inpatient treatment (either
voluntary or involuntary), the staff shall collaborate with the treatment staff in such
facilities. Support shall be provided, including accompanying the consumer to the
facility, remaining with the consumer during assessment, and beginning the process
of planning with the consumer for discharge to the community as soon as possible;
c. Usage of crisis services and hospitalizations shall be monitored to ensure that
interventions were initiated and that discharge planning took place in collaboration
with the admitting facility. Monitoring can include and lead into costs to the service
provider for inpatient days in the event discharge is delayed due to lack of response
or discharge options for enrollees.
10. FSP AB 109 Team make available/coordinate housing services for each consumer as
follows:
a. Training and assistance to consumers in locating, securing and inhabiting housing
which is appropriate to their level of functioning;
b. Providing housing options and maintain clients in independent living by providing
needed services, accessing resources and encouraging consumers to be
independent, productive and responsible;
c. Assisting consumers in securing supported independent and permanent housing as
appropriate for consumers in their community throughout the metropolitan, and rural
(western and eastern areas) of Fresno County where consumers prefer to reside;
REVISED EXHIBIT A AMENDMENT III
Page 9of13
d. Assisting consumers in securing emergency housing voucher.
11. The FSP AB 109 Team provide services in the areas of medication prescription,
administration, monitoring, and documentation as indicated below.
a. The team psychiatrist shall assess each consumer's mental illness and prescribe
appropriate medication, regularly review and document symptoms as well as the
consumer's response to the prescribed medications, educate the consumer and
family members, and monitor, treat and document any medication side effects.
b. The nurse shall establish medication policies and procedures which identify
processes to administer medications, train other team members, and assess
regularly other team members' competency in this area.
c. All team staff shall document consumer's mental illness symptoms and behavior in
response to medication and shall monitor for medication side-effects during the
provision of observed self-administration and during ongoing face-to-face contacts.
d. Medication provision and psychiatric services are the full responsibility of the selected
provider.
12. The FSP AB 109 Team provide whatever direct assistance is necessary and reasonable to
ensure that the consumer obtains the basic necessities of daily life, such as food, housing,
clothing, medical/mental health/substance abuse services, and other financial support.
13. The FSP AB 109 Team provide intensive and comprehensive alcohol, tobacco and drug
abuse treatment services in accordance with harm reduction principles. The provision of
integrated dual recovery substance abuse/mental health services is a key ingredient in the
FSP service delivery model.
14. The FSP AB 109 Team members have access to resources in order to make emergency
purchases of food, shelter, clothing, prescriptions, transportation, or other items for
consumers, as needed. The team shall also have access to larger sums of client assistance
funds for deposits, furniture purchases, and other items. The FSP will utilize sound
accounting practices for recording and monitoring the use of these funds.
15. The FSP AB 109 Team may serve as "representative payee" or work with an organization
which provides such services, for some consumers. The FSP will utilize sound accounting
practices to monitor these situations. The team may utilize client assistance funds to assist
consumers with short-term loans or grants, as necessary. The team shall link consumers to
appropriate social services, provide transportation as necessary, and link the client to
appropriate legal advocacy representation.
16. The FSP AB 109 Team provide training and instruction to support and assist the client in
developing personal skills and assist in the identification of and participation in community
based recreational and social activities.
17. The FSP AB 109 Team provide integrated, co-occurring capable alcohol, tobacco and drug
abuse services as needed, in accordance with harm reduction principles. The provision of
substance abuse/mental health services is a key ingredient in FSP services.
18. The FSP AB 109 Team work to minimize the consumer's involvement in the criminal justice
system and will service as program representative during any contact with local law
enforcement agencies.
REVISED EXHIBIT A AMENDMENT III
Page 10 of 13
19. CONTRACTOR shall develop a satisfaction survey, approved by DBH that complies with the
mandated State performance outcome and quality improvement reports/outcomes. At a
minimum, seventy-five percent (75%) of consumers will report satisfaction with the program
services.
PROGRAM REPORTS AND OUTCOMES
1. FSP Requirements - As required by the Mental Health Services Act, CONTRACTOR shall be
responsible for correctly completing the following Full Service Partnership Forms into the
State web-based database on a monthly basis:
a. Partnership Assessment Forms (PAF) - completed once, when partnership is
established with a client (baseline).
b. Key Event Tracking Form (KET) - completed when change occurs in key areas.
c. Quarterly Assessment Form (3M) - completed every 3 (three) months.
These forms can be viewed at http://www.dmh.ca.gov/POQI, then select "Forms" under the
"MHSA Full Service Partnership Evaluation". CONTRACTOR shall complete all Full Services
Partnership Reporting according to DMH regulations.
2. Grievances
a. CONTRACTOR shall log all grievances and the disposition of all grievances received
from a consumer or a consumer's family in accordance with Fresno County Mental
Health Plan policies and procedures (Exhibit 1).
b. CONTRACTOR shall provide a summary of the grievance log entries concerning
County-sponsored consumers to the Department of Behavioral Health Director or
designee at monthly intervals, by the tenth (20th) day of the following month, in a
County approved format.
c. CONTRACTOR shall post signs, provided by the County, informing consumers of
their right to file a grievance and appeal.
d. Within fifteen (15) days after each grievance or incident affecting County-sponsored
consumers, CONTRACTOR shall provide County with the complaint and
CONTRACTOR's disposition of, or corrective action taken to resolve the complaint or
incident.
e. Within fifteen (15) days after CONTRACTOR submits a corrective action plan to a
California State licensing and/or accrediting body concerning any sentinel event, as
the term is defined by the licensing or accrediting agency, and within fifteen (15) days
after CONTRACTOR receives a corrective action order from a California State
licensing and/or accrediting body to address a sentinel event, CONTRACTOR shall
provide a summary of such plans and orders to County.
3. Incident Reports
a. CONTRACTOR will notify County of all incidents or unusual occurrences reportable
to state licensing bodies that affect County consumers within twenty-four (24) hours.
CONTRACTOR shall use the CONTRACTOR specific form for such reporting.
REVISED EXHIBIT A AMENDMENT III
Page 11 of 13
b. Within fifteen (15) days after each grievance or incident affecting County-sponsored
consumers, CONTRACTOR shall provide County with the complaint and
CONTRACTOR's disposition of, or corrective action taken to resolve the complaint or
incident.
c. Within fifteen (15) days after CONTRACTOR submits a corrective action plan to a
California State licensing and/or accrediting body concerning any sentinel event, as
the term is defined by the licensing or accrediting agency, and within fifteen (15) days
after CONTRACTOR receives a corrective action order from a California State
licensing and/or accrediting body to address a sentinel event, CONTRACTOR shall
provide a summary of such plans and orders to County.
4. Report Delivery and Content Requirements
CONTRACTOR shall deliver all MHSA required reporting in data collection format that
reflects MHSA and Data Infrastructure Grant (DIG) requirements in a timely and accurate
manner. Reporting information should include demographics and attendance, as well as
track unduplicated and duplicated consumer counts as required by DMH reporting
standards.
5. Billable Services
CONTRACTOR shall ensure billable Mental Health Specialty Services meet any/all County,
State, Federal regulations including any utilization review and quality assurance standards,
and provide all pertinent and appropriate information in a timely manner to County to bill
Medi-Cal for services rendered.
6. Utilization of Services
CONTRACTOR may be required to closely monitor and report monthly the utilization of
services by consumers to ensure the dollars available during each term of this Agreement
provide the level of program services as identified this Agreement. CONTRACTOR shall
submit a monthly report to the COUNTY of the units of service provided by service function
code and dollars billed, actual expenses, revenues generated from non Medi-Cal billed
services (such as collecting consumer rents), the number of consumers served and waiting
list for the purpose of contract monitoring within 30 days after the last day of the previous
month. CONTRACTOR may be required to submit Quality Improvement reports within the
timeframe as specified by the Fresno County Mental Health Plan.
7. Short/Doyle Medi-Cal Cost Report
CONTRACTOR shall submit a complete and accurate State of California Department of
Mental Health (DMH) Short/Doyle Medi-Cal Cost Report for each fiscal year ending June
30th affected by this Agreement. The cost report must be submitted to the County's DBH
Business Office within 90 days following the end of each fiscal year. All cost reports must be
prepared in accordance with general accounting principles and the standards set forth by the
DMH and the County.
8. Caseload Records
CONTRACTOR shall maintain an up to date caseload record of all clients receiving services
from the AB 109 FSP program, and provide consumer, programmatic, and other
demographic information to the COUNTY. Reports are to be submitted to the DBH MHSA
REVISED EXHIBIT A AMENDMENT III
Page 12 of 13
Administrative Staff Analyst or the DBH Director or designee by the 20th of each month
unless otherwise directed by DBH Director or designee.
9. Outcome Measurements and Reporting
Outcomes are to be reported annually on the Outcomes Template included in Invoices and
Reports (Exhibit D). Outcomes to be tracked include, but may not be limited to,
increases/decreases in: LOCUS scores, hospitalization/crisis, homelessness, and
incarceration. In addition, consumer progress with education, employment, socialization and
other life skills may be used to determine Program success and effectiveness. Annual
recommendations to the County Board of Supervisors for Agreement renewals will be based
upon CONTRACTOR's successful delivery, maintenance, tracking, and reporting of program
services and outcomes. Outcome reporting will be requested by DBH annually (typically in
January for the previous calendar year).
10. Consumer Satisfaction Survey
Consumer Satisfaction Survey shall be tracked and reported on at a minimum annually and
shall be submitted with Outcome Measures when requested by DBH (typically in January for
previous calendar year). At a minimum, seventy-five percent (75%) of consumers will report
satisfaction with the program services.
COUNTY'S RESPONSIBILITIES
COUNTY shall:
1. Provide oversight (through the County Department of Behavioral Health (DBH), Adult
System of Care, and the Mental Health Services Act, Division Managers or designees) of the
CONTRACTOR's FSP program. In addition to contract monitoring of program, oversight
includes, but not limited to, coordination with the State Department of Mental Health, Mental
Health Services Act in regard to program administration and outcomes.
2. Assist CONTRACTOR in making linkages with the total mental health system. This will be
accomplished through regularly scheduled meetings as well as formal and informal
consultation
3. Participate in evaluating the progress of the overall program and the efficiency of
collaboration with the CONTRACTOR staff and will be available to the CONTRACTOR for
ongoing consultation.
4. Receive and analyze statistical data outcome information from CONTRACTOR throughout
the term of contract on a monthly basis. DBH will notify the CONTRACTOR when additional
participation is required. The performance outcome measurement process will not be limited
to survey instruments but will also include, as appropriate, client and staff interviews, chart
reviews, and other methods of obtaining required information.
5. Recognize that cultural competence is a goal toward which professionals, agencies, and
systems should strive. Becoming culturally competent is a developmental process and
incorporates at all levels the importance of culture, the assessment of cross-cultural
relations, vigilance towards the dynamics that result from cultural differences, the expansion
of cultural knowledge, and the adaptation of services to meet culturally-unique needs.
Offering those services in a manner that fails to achieve its intended result due to cultural
and linguistic barriers is not cost effective. To assist the CONTRACTOR efforts towards
REVISED EXHIBIT A AMENDMENT III
Page 13 of 13
cultural and linguistic competency, DBH shall provide the following at no cost to
CONTRACTOR:
a. Technical assistance to CONTRACTOR regarding cultural competency requirements
and sexual orientation training.
b. Mandatory cultural competency training including sexual orientation and sensitivity
training for DBH and CONTRACTOR or personnel, at minimum once per year.
COUNTY will provide mandatory training regarding the special needs of this diverse
population and will be included in the cultural competence training(s). Sexual
orientation and sensitivity to gender differences is a basic cultural competence
principle and shall be included in the cultural competency training. Literature
suggests that the mental health needs of lesbian, gay, bisexual, transgender,
questioning (LGBTQ) individuals may be at increased risk for mental disorders and
mental health problems due to exposure to societal stressors such as stigmatization,
prejudice and anti-gay violence. Social support may be critical for this population.
Access to care may be limited due to concerns about providers' sensitivity to
differences in sexual orientation.
c. Technical assistance for CONTRACTOR in translating behavioral health and
substance abuse services information into DBH's threshold languages (Spanish,
Laotian, Cambodian, and Hmong). Translation services and costs associated will be
the responsibility of CONTRACTOR.
PROGRAM OBJECTIVES (FSP Program)
The items listed below represent program objectives to be tracked and achieved by CONTRACTOR
during the contract terms.
1. Reduce frequency of hospitalization for each consumer served.
2. Reduce frequency of homelessness for each consumer served.
3. Reduce frequency of access to crisis services provided by the DBH Intensive Services Division.
4. Reduce frequency of incarceration for each consumer served.
5. Improve LOCUS scores for each consumer served;
6. Improve socialization and life skill for each consumer served
7. Direct service productivity rate shall be a minimum of eighty Percent (80%)
8. At a minimum, seventy-five percent (75%) of consumers will report satisfaction with the
program services.
0 o v D
G� D n m c. m a c
cr
a f 'S °i x ,.,. W WT >CLWX CA D *0 ° W3cnc m W T T T T T
3 ;o -cn 3 to n 'n (o m 3 ° cA Dam E « «
7 CIL 3 3 b y ?. A
W x m O) N A W N
� M M 1A M N yi M fA H M M
TI
N
N co O O O O N N -G
N V V -( O O O O
CA (n to N O O O O
V O O cc O O CD
O C. o , O O CD O CD N
M !A 4A M fA 1A to 4A M M D
to df Nf #A cn
N N N N C C
A N T W
p OAi O N co W N O C 0 0 0 0 a (n O
o O W V O DO O O O O O O O O W !7
N O O O O N N O O N tD ,y
w O O 00 A A O O
W V O , V O O O cc
to fA M di 6/fA df &W b1(A M
N N O O O N
01 to -� -+W O (n W N YI O o 0 0 O D
w w W N W w O O -G -0-0-0 -0
V 0 pp O pp O O O o 0 n C.
m N N O V O N N cc W 0 0 0 0 0 (n N
O a) 00 O O A A C.O N
tb N 00 N O o 01 0 0 A C
O
df M M'LA (A 4A 6! !A VI 6f fA v
4A c (D
A !°
N H! fA fA H
04 V N W O w W N T O O O O A (D
O A W j N W W O O 'f j d (D
N A W O O 0D 0o O O y
A N o A o A A o o A n
N m O O 0) 0 O OY 0 0 � fll
N
M M IA EA M !A M fA ;o
tftW N N N N N p �I D
&f 4, w w w W C O W
t00 (n N(n a, (n W O 0
N O O O -G o DD dv Otl C 3
Q) N O A o
m 0 0 0 0 0 � A 0 o fn A A A A
T O) O) O »
-4 w O O W O A C" a0 00
lcn
40 IA 4A 40 N N N 1 EA C 3
A o 0 w , y D X.
A w w Oo 0 f
O OD 00Co -C, rA m 3
m AAA °
A m m m o 3
x
3 cn
v+ fA a fA yt S -D
w w w w
(n (T in N V D N
0000 .
A
O O O O N T
0 0 0 0 0 C
ooOoo :3 ci
W (D
3
m
m d
N Ch W O
O N V D 0
W W V O _
O A Qf o
w T N V T
'11
CD
df to j D
W N _ N D
O O tli 0046
t° W
00
O 0 0 m D
7
n
!A M 41 N1 W
(n w w fA m
0 twit o 0 o A
0 0 0 0
H
(n pVp tD 4 � � y N
(n p t0 O v 2 x
N N O (n Ci d 3
O
° a) N -4 W cn al
(' m
D <
wNNNd+ 3 �m
to -4 (n AA co D x m
m NW( W -4d ° o m
m P 0 (Nn $ d c m m=
-( N CO w 3 Z W
z
n
REVISED EXHIBIT C
AMENDMENT III
Substance Use Disorder Services(AB109)-Outpatient Portion
Turning Point Of Central CA,Inc.
July 2015-June 2016
Budget Categories- Total Proposed Budget
Line Item Description (Must be itemized) FTE% Admin. Direct Total
PERSONNEL SALARIES:
1 Program Director 0.65 $ 42,857 $ 42,857
2 Mental Health Professional/Team Leader 0 $ -
3 Supervising Personal Service Coordinator 1 $ 44,302 $ 44,302
4 Intake Specialist 0.75 $ 31,621 $ 31,621
5 Substance Abuse Counsler 5 $ 193,390 $ 193,390
6 Driver 1 $ 26,369 $ 26,369
7 Nurse 0 $ - $ -
8 Case Manager 1 $ 36,298 $ 36,298
9 Secretary 1 $ 31,907 $ 31,907
10 Billing Clerk 0.5 $ 15,954 $ 15,954
SALARY TOTAL 10.9 $0 $ 422,698 $ 422,698
PAYROLL TAXES:
30 OASDI $0
31 FICA/MEDICARE $ 33,557 $ 33,557
32 SUI $ 9,663 $ 9,663
PAYROLL TAX TOTAL $0 $ 43,220 $ 43,220
EMPLOYEE BENEFITS:
40 Retirement $ 6,652 $ 6,652
41 Workers Compensation $ 4,641 $ 4,641
Health Insurance (medical,vision, life,
42 dental) $ 77,888 $ 77,888
EMPLOYEE BENEFITS TOTAL $0 $ 89,181 $ 89,181
SALARY&BENEFITS GRAND TOTAL $ 555,099
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $35,250
1011 Rent/Lease Equipment $0
1012 Utilities $8,434
1013 Building Maintenance $3,500
1014 Equipment Maintenance $1,510
1015 Equipment Purchase $0
FACILITY/EQUIPMENT TOTAL $48,694
OPERATING EXPENSES:
1060 Telephone $2,575
1061 Answering Service $0
1062 Postage $6
1063 Printing/Reproduction $850
1064 Publications $535
1065 Legal Notices/Advertising $0
1066 Office Supplies&Equipment $5,368
1067 Household Supplies $755
1068 Food $0
1069 Program Supplies-Therapeutic $755
1070 Program Supplies-Medical $0
1071 Transportation of Clients $3,986
1072 Staff Mileage/vehicle maintenance $9,900
1073 Staff Travel(Out of County) $0
1074 Staff Training/Registration $1,006
1075 Lodging $236
1076 Other-(Vehicle Insurance) $2,330
1077 Other-(Client Activities) $1,761
1078 Other-(Depreciation) $0
1079 Other-(Recruitment) $346
1080 ADP Licensing $6,408
1080 O/S Labor Clinical-Psychiatrist $11,592
OPERATING EXPENSES TOTAL $48,409
REVISED EXHIBIT C
AMENDMENT III
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $1,510
1082 Liability Insurance $1,006
1083 Administrative Overhead $106,825
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $109,341
SPECIAL EXPENSES(Consultant/Etc.):
1090 Consultant(network&data management) $0
1091 Translation Services $0
1092 Medication Supports $0
SPECIAL EXPENSES TOTAL $0
FIXED ASSETS:
1190 Computers&Software $0
1191 Furniture&Fixtures $0
1192 Other—(Identify) $0
1193 Other—(Identify) $0
FIXED ASSETS TOTAL $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Intensive Substance Use Disorder Services(SFC 70) $200,000
2001 Residential Services(SFC 71) $848,625
2002.1 Clothing,Food&Hygiene(SFC 72) $1,500
2002.2 Client Transportation&Support(SFC 72) $0
2002.3 Education Support(SFC 72) $0
2002.4 Employment Support(SFC 72) $0
2002.5 Respite Care(SFC 72) $0
2002.6 Household Items $0
2002.7 Utility Vouchers(SFC 72) $0
2002.8 Child Care(SFC 72) $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $1,050,125
TOTAL PROGRAM EXPENSES $1,811,668
MEDI-CAL REVENUE: Units of Service Rate $Amount
3000 Group Contacts 2234 $26.23 $58,598
3100 Individual Contacts 220 $67.38 $14,824
3200 0 $0.00 $0
3300 0 $0.00 $0
3400 0 $0.00 $0
3500 0 $0.00 $0
3600 0 $0.00 $0
3700 0 $0.00 $0
Estimated Medi-Cal Billing Totals 2454 $73,422
Estimated%of Federal Financial Participation Reimbursement 100.00% $73,422
Estimated%of Clients Served that will be Medi-Cal Eligible 0.00%
MEDI-CAL REVENUE TOTAL $73,422
OTHER REVENUE:
4000 Other—(AB 109 Funds) $1,538,246
4100 Other—(SAPT Funds) $200,000
4200 Other—(Identify) $0
4300 Other—(Identify) $0
OTHER REVENUE TOTAL $1,738,246
MHSA FUNDS:
5000 Prevention&Early Intervention Funds $0
5100 Community Services&Supports Funds $0
MHSA FUNDS TOTAL $0
TOTAL PROGRAM REVENUE $1,811,668
REVISED EXHIBIT C
AMENDMENT III
Mental Health Services(AB109)-Outpatient Portion
Turning Point Of Central CA,Inc.
July 2015-June 2016
Budget Categories- Total Proposed Budget
Line Item Description (Must be itemized) FTE % Admin. Direct Total
PERSONNEL SALARIES:
1 Program Director 0.35 $ 23,077 $ 23,077
2 Mental Health Professional/Team Leader 1.00 $ 65,934 $ 65,934
3 Supervising Personal Service Coordinator 0.00 $ - $ -
4 Intake Specialist 0.25 $ 10,540 $ 10,540
5 Eligibility Worker 050 $ 24,660 $ 24,660
6 Substance Abuse Counsler 0.00 $ - $ -
7 Driver 0.00 $ - $ -
8 Nurse 0.50 $ 25,135 $ 25,135
9 Case Manager 2.00 $ 82,425 $ 82,425
10 Secretary 0.00 $ - $ -
11 Billing Clerk 0.50 $ 15,954 $ 15,954
12 Personal Service Coordinator/CM 0.00 $ - $ -
13 Records Technician 0.50 $ 20,421 $ 20,421
SALARY TOTAL 5.6 $0 $ 268,146 $ 268,146
PAYROLL TAXES:
30 OASDI 0 $0
31 FICA/MEDICARE $ 20,513 $ 20,513
32 SUI $ 6,442 $ 6,442
PAYROLL TAX TOTAL $0 $ 26.955 $ 26,955
EMPLOYEE BENEFITS:
40 Retirement $ 3,783 $ 3,783
41 Workers Compensation $ 2,669 $ 2,669
Health Insurance (medical,vision, life,
42 dental) $ 49,846 1 $ 49,846
EMPLOYEE BENEFITS TOTAL $0 I $ 56,298 $ 56,298
SALARY& BENEFITS GRAND TOTAL $ 351,399
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $39,200
1011 Rent/Lease Equipment $0
1012 Utilities $8,220
1013 Building Maintenance $2,700
1014 Equipment Maintenance $890
1015 Equipment Purchase $0
FACILITY/EQUIPMENT TOTAL $51,010
OPERATING EXPENSES:
1060 Telephone $1,818
1061 Answering Service $0
1062 Postage $4
1063 Printing/Reproduction $723
1064 Publications $315
1065 Legal Notices/Advertising $0
1066 Office Supplies&Equipment $3,107
1067 Household Supplies $445
1068 Food $0
1069 Program Supplies-Therapeutic $445
1070 Program Supplies-Medical $0
1071 Transportation of Clients $74
1072 Staff Mileage/vehicle maintenance $0
1073 Staff Travel(Out of County) $0
1074 Staff Training/Registration $594
1075 Lodging $139
REVISED EXHIBIT C
AMENDMENT III
1076 Other—(Vehicle Insurance) $0
1076 Other—(Client Activities) $1,039
1076 Other—(Depreciation) $0
1076 Other—(Recruitment) $202
1077 ADP Licensing $0
1078 EMIR Licensing $6,000
1080 O/S Labor Clinical-Therapast $20,800
1080 O/S Labor Clerical $0
1080 O/S Labor Clinical-Psychiatrist $74,880
OPERATING EXPENSES TOTAL $110,585
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $890
1082 Liability Insurance $594
1083 Administrative Overhead $94,319
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $95,803
SPECIAL EXPENSES(Consultant/Etc):
1090 Consultant(network&data management) $0
1091 Translation Services $0
1092 Medication Supports $20,000
SPECIAL EXPENSES TOTAL $20,000
FIXED ASSETS:
1190 Computers&Software $0
1191 Furniture& Fixtures $0
1192 Other—(Identify) $0
1193 Other—(Identify) $0
FIXED ASSETS TOTAL $0
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Intensive Substance Use Disorder Services(SFC 70) $0
2001 Residential Services(SFC 71) $0
2002.1 Clothing, Food& Hygiene(SFC 72) $0
2002.2 Client Transportation&Support(SFC 72) $0
2002.3 Education Support(SFC 72) $0
2002.4 Employment Support(SFC 72) $0
2002.5 Respite Care(SFC 72) $0
2002.6 Household Items $0
2002.7 Utility Vouchers(SFC 72) $0
2002.8 Child Care(SFC 72) $0
NON MEDI-CAL CLIENT SUPPORT TOTAL $0
TOTAL PROGRAM EXPENSES $628,797
MEDI-CAL REVENUE: Units of Service Rate $Amount
3000 Mental Health Services(Individual/Family/Group 57,330 $2.20 $126,126.0
3100 Case Management 35,000 $1.80 $63,000.0
3200 Crisis Services 19,965 $2.95 $58,896.8
3300 Medication Support 24,976 $3.75 $93,660.0
3400 Collateral 8,100 $2.20 $17,820.0
3500 Plan Development 32,400 $2.20 $71,280.0
3600 Assessment 5,400 $2.20 $11,880.0
3700 Rehabilitation 28,718 $2.20 $63,180.0
Estimated Medi-Cal Billing Totalsi 211,889 $505,843
Estimated%of Federal Financial Participation Reimbursement 50.00% $177,044.00
Estimated%of Clients Served that will be Medi-Cal Eligible-SD 70.00%
Estimated%of MAGI Federal Financial Participation Reimbursement 100.00% $151,752 83
Estimated%of Clients Served that will be Medi-Cal Eligible-ACA 30.00%
MEDI-CAL REVENUE TOTAL $328,796.83
REVISED EXHIBIT C
AMENDMENT III
OTHER REVENUE:
4000 Other—Client Fees $0
4100 Other—Client Insurance $0
4200 Other—(Identify) $0
4300 Other—(Identify) $0
OTHER REVENUE TOTAL $0
MHSA FUNDS:
5000 AB 109 Funds $0
5100 Community Services&Supports Funds $300,000
MHSA FUNDS TOTAL $300,000
TOTAL PROGRAM REVENUE $628,797
REVISED EXHIBIT C
AMENDMENT III
Mental Health &Substance Use Disorder Services (AB109) -FSP Portion
Turning Point Of Central CA, Inc.
July 2015-June 2016
Budget Categories- Total Proposed Budget
Line Item Description
(Must be itemized) FTE % Admin. Direct Total
PERSONNEL SALARIES:
1 PSC B 6 $230,000 $230,000
2 Peer Support-PSC 0.5 $11,926 $11,926
3 MH Professional 1 $66,339 $66,339
4 Program Director 1 $80,979 $80,979
5 Nurse 1 $43,321 $43,321
6 Billing Clerk 0.5 $20,175 $20,175
7 Secretary 1 $30,519 $30,519
8 Psychiatrist 0.4 $144,390 $144,390
9 PSC C 1 $43,321.00 $43,321
10 Substance Abuse 1 $34,473.00 $34,473
11 Title 0 $0
12 Title 0 $0
SALARY TOTAL 13.4 $0 $705,443 $705,443
PAYROLL TAXES:
30 OASDI $4,900 $4,900
31 FICA/MEDICARE $42,000 $42,000
32 SUI $11,275 $11,275
PAYROLL TAX TOTAL $0 $58,175 $58,175
EMPLOYEE BENEFITS:
40 Retirement $14,390 $14,390
41 Workers Compensation $5,300 $5,300
Health Insurance
(medical, vision,
42 life, dental) $126,000 $126,000
EMPLOYEE BENEFITS TOTAL $0 $145,690 $145,690
SALARY& BENEFITS GRAND TOTAL $909,308
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $34,000
1011 Rent/Lease Equipment $1,500
1012 Utilities $8,000
1013 Building Maintenance $5,000
1014 Equipment purchase $0
FACILITY/EQUIPMENT TOTAL $48,500
REVISED EXHIBIT C
AMENDMENT III
OPERATING EXPENSES:
1060 Telephone $7,000
1061 Answering Service $0
1062 Postage $500
1063 Printing/Reproduction $1,000
1064 Publications $250
1065 Legal Notices/Advertising $0
1066 Office Supplies& Equipment $11,500
1067 Household Supplies $1,000
1068 Food $0
1069 Program Supplies-Therapeutic $500
1070 Program Supplies-Medical $0
1071 Transportation of Clients $0
1072 Staff Mileage/Vehicle maintenance $25,500
1073 Staff Travel (Out of County) $0
1074 Staff Training/Registration $1,000
1075 Lodging $1,000
1076 Other-Vehicle Insurance $4,200
1076 Other-Client Activities $4,000
1076 Other-Depreciation $600
1076 Other-Recruitment $580
$0
OPERATING EXPENSES TOTAL $58,630
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $0
1081 External Audit $0
1082 Liability Insurance $1,800
1083 Administrative Overhead $202,214
1084 Payroll Services $0
1085 Professional Liability Insurance $0
FINANCIAL SERVICES TOTAL $204,014
SPECIAL EXPENSES (Consultant/Etc.):
1090 Consultant(network&data management) $0
1091 Translation Services $0
1092 Medication Supports $45,000
SPECIAL EXPENSES TOTAL $45,000
FIXED ASSETS:
1190 Computers&Software $1,000
1191 Furniture& Fixtures $0
1192 Other—(Identify) $0
1193 Other—(Identify) $0
FIXED ASSETS TOTAL $1,000
REVISED EXHIBIT C
AMENDMENT III
NON MEDI-CAL CLIENT SUPPORT EXPENSES:
2000 Client Housing Support Expenses (SFC 70) $270,000
2001 Client Housing Operating Expenses (SFC 71) $3,351
2002.1 Clothing, Food& Hygiene (SFC 72) $10,000
2002.2 Client Transportation& Support(SFC 72) $5,000
2002.3 Education Support(SFC 72) $500
2002.4 Employment Support(SFC 72) $500
2002.5 Respite Care (SFC 72) $0
2002.6 Household Items $0
2002.7 Utility Vouchers (SFC 72) $0
2002.8 Child Care (SFC 72) $100
NON MEDI-CAL CLIENT SUPPORT TOTAL $289,451
TOTAL PROGRAM EXPENSES1 $1,555,903
MEDI-CAL REVENUE: Units of Service Rate $Amount
Mental Health Services
(Individual/Family/Group
3000 Therapy) 61031 $2.61 $159,291
3100 Case Management 100044 $2.02 $202,089
3200 Crisis Services 2741 $3.88 $10,635
3300 Medication Support 11034 $4.82 $53,184
3400 Collateral 1675 $2.61 $4,372
3500 Plan Development 2997 $2.61 $7,822
3600 Assessment 5127 $2.61 $13,381
3700 Rehabilitation 234810 $2.61 $612,854
Estimated Medi-Cal Billing Totalsi 0 $1,063,628
Estimated % of Federal Financial Participation Reimbursement 50.00% $212,726
Estimated % of Clients Served that will be Medi-Cal Eligible-SD 40.00%
Estimated %of Federal Financial Participation Reimbursement 100.00% $638,176.94
Estimated % of Clients Served that will be Medi-Cal Eligible-ACA 60.00%
MEDI-CAL REVENUE TOTAL $850,903
OTHER REVENUE:
4000 Other—(Client Rents) $5,000
4100 Other—(Identify) $0
4200 Other—(Identify) $0
4300 Other—(Identify) $0
OTHER REVENUE TOTAL $5,000
MHSA FUNDS:
5000 Prevention& Early Intervention Funds $0
5100 Mental Health Services Act Innovations Funds $350,000
5100 AB109 Realignment Funds $350,000
MHSA FUNDS TOTAL $700,000
TOTAL PROGRAM REVENUE $1,555,903
REVISED EXHIBIT I—SINGLE AUDIT REQUIREMENT
SINGLE AUDIT REQUIREMENT
A. If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars
($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to
conduct an annual audit in accordance with the requirements of the Single Audit Standards as
set forth in Office of Management and Budget (OMB) Circular A-133. CONTRACTOR shall
submit said audit and management letter to COUNTY. The audit must include a statement of
findings or a statement that there were no findings. If there were negative findings,
CONTRACTOR must include a corrective action plan signed by an authorized
individual. CONTRACTOR agrees to take action to correct any material non-compliance or
weakness found as a result of such audit. Such audit shall be delivered to COUNTY's
Department of Behavioral Health, Business Office for review within nine (9) months of the end
of any fiscal year in which funds were expended and/or received for the program. Failure to
perform the requisite audit functions as required by this Agreement may result in COUNTY
performing the necessary audit tasks, or at COUNTY's option, contracting with a public
accountant to perform said audit, or, may result in the inability of COUNTY to enter into future
agreements with CONTRACTOR. All audit costs related to this Agreement are the sole
responsibility of CONTRACTOR.
B. A single audit report is not applicable if CONTRACTOR's Federal
contracts do not exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement
or CONTRACTOR'S only funding is through Drug related Medi-Cal. If a single audit is not
applicable, a program audit must be performed and a program audit report with management
letter shall be submitted by CONTRACTOR to COUNTY as a minimum requirement to attest
to CONTRACTOR's solvency. Said audit report shall be delivered to COUNTY's Department
of Behavioral Health, Business Office for review, no later than nine (9) months after the close
of the fiscal year in which the funds supplied through this Agreement are expended. Failure to
comply with this Act may result in COUNTY performing the necessary audit tasks or
Page 1 of 2
contracting with a qualified accountant to perform said audit. All audit costs related to this
Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective action
to eliminate any material noncompliance or weakness found as a result of such audit. Audit
work performed by COUNTY under this section shall be billed to the CONTRACTOR at
COUNTY's cost, as determined by COUNTY's Auditor-Controller/Treasurer-Tax Collector.
C. CONTRACTOR shall make available all records and accounts for
inspection by COUNTY, the State of California, if applicable, the Comptroller General of the
United States, the Federal Grantor Agency, or any of their duly authorized representatives, at all
reasonable times for a period of at least three (3) years following final payment under this
Agreement or the closure of all other pending matters, whichever is later.
Page 2 of 2