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HomeMy WebLinkAboutAgreement A-14-704-1 with Central Star Behavioral Health Inc..pdf Agreement No. 14-704-1 1 AMENDMENT I TO AGREEMENT 2 THIS AMENDMENT, hereinafter referred to as"Amendment I", is made and entered into 3 this 24th day of May , 2016,by and between the COUNTY OF FRESNO, a Political 4 Subdivision of the State of California, hereinafter referred to as "COUNTY", and CENTRAL STAR 5 BEHAVIORAL HEALTH, INC., a for-profit organization, whose address is 1501 Hughes Way, 6 Suite 150, Long Beach, California 90810, hereinafter referred to as "CONTRACTOR" (collectively 7 as the "parties). 8 WHEREAS the parties entered into that certain Agreement, identified as COUNTY Agreement 9 No. 14-704, effective January 1, 2015, whereby CONTRACTOR agreed to operate a sixteen(16)bed 10 acute inpatient psychiatric health facility(PHF)to provide inpatient psychiatric services to youth, 11 twelve(12)years of age to eighteen(18)years of age, who may be admitted on a voluntary or 12 involuntary basis and may include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal 13 beneficiaries, indigentluninsured consumers, and juvenile inmates who are referred by COUNTY's 14 Department of Behavioral Health(DBH), a contract provider with DBH, or hospital emergency room, 15 other County departments and other agencies; and 16 WHEREAS the parties desire to amend COUNTY Agreement No. 14-704, regarding changes as 17 stated below and restate the Agreement in its entirety. 18 NOW, THEREFORE, for good and valuable consideration,the receipt and adequacy of which 19 is hereby acknowledged,the parties agree to amend the Agreement as follows: 20 1. That the following text of Agreement No. 14-704, Page Six (6), beginning with 21 Paragraph One (1), Line Two (2), with the word "The" and ending on Page Six (6), Line Seven(7), 22 with the word"rate"be deleted and the following inserted in its place: 23 "The maximum contract amount for the second period of automatic renewal (July 1, 24 2016 through June 30, 2017) shall not exceed Four Million, One Hundred Sixty-One Thousand, Eight 25 Hundred Eighteen and No/100 Dollars ($4,161,818.00). COUNTY shall pay CONTRACTOR Eight 26 Hundred, Forty-Four and No/100 Dollars($844.00)for a daily bed rate. The COUNTY shall pay the 27 CONTRACTOR for twelve (12)beds per day for FY 2016-17 (July 1, 2016 through June 30, 2017) 28 less any beds purchased and/or utilized and charged to other outside agencies. CONTRACTOR shall 1 - COUNTY OF FRESNO Fresno, CA 1 seek payment, if applicable, for any costs above the maximum amount stated herein for FY 2016-17, 2 from other outside agencies. During the second period of automatic renewal the facility will operate 3 at a sixteen(16)bed capacity." 4 2. That the following text of Agreement No. 14-704, Page Fifteen(15), beginning with 5 Line Ten(10), with the word"MODIFICATION" and ending on Page Fifteen(15), Line Twenty- 6 Three (23), with the word"herein"be deleted and the following inserted in its place: 7 447. MODIFICATION 8 Any matters of this Agreement may be modified from time to time by the written 9 consent of all parties without, in any way, affecting the remainder. 10 Notwithstanding the above, changes to line items in the budget, as set forth in 11 Revised Exhibit B, that do not exceed ten percent (10%) of the maximum compensation payable to the 12 CONTRACTOR, and changes to the daily bed rate, volume of units of services/types of service units 13 to be provided as set forth in Revised Exhibit B, may be made with the written approval of 14 COUNTY's DBH Director, or designee, and CONTRACTOR. Changes to line items in the budget 15 that do exceed 10% of the maximum compensation payable to the CONTRACTOR, may be made 16 with the signed written approval of COUNTY's DBH Director, or designee, and CONTRACTOR 17 through an amendment approved by COUNTY's County Counsel and COUNTY's Auditor- 18 Controller/Treasurer-Tax Collector's Office (Auditor). Said budget line item and daily bed rate, 19 service volume/types of service units changes shall not result in any change to the annual maximum 20 compensation amount payable to CONTRACTOR, as stated herein. 21 In addition, changes to the scope of services and responsibilities of the 22 CONTRACTOR, as needed to accommodate changes in the law relating to mental health treatment, as 23 set forth in Exhibit A, may be made with the signed written approval of COUNTY's DBH Director, or 24 designee, and CONTRACTOR through an amendment approved by County Counsel and Auditor. 25 Said changes shall not result in any change to the maximum compensation amount payable to 26 CONTRACTOR, as stated herein." 27 3. That all references in existing County Agreement No. 14-704 to "Exhibit B" shall be 28 changed to read"Revised Exhibit B,"where appropriate. A copy of Revised Exhibit B is attached - 2 - COUNTY OF FRESNO Fresno, CA 1 hereto and incorporated herein by reference. 2 4. COUNTY and CONTRACTOR agree that this Amendment I is sufficient to amend the 3 Agreement; and that upon execution of this Amendment I, the Agreement and Amendment I together 4 shall be considered the Agreement. 5 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 I shall become effective upon execution by all parties. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 - COUNTY OF FRESNO Fresno, CA 1 IN WITNESS WHEREOF,the parties hereto have executed this Amendment I to Agreement 2 No. 14-704 as of the day and year first hereinabove written. 3 4 CONTRACTOR: COUNTY OF FRESNO 5 CENTRAL STAR BEHAVIORAL HEALTH,INC. 6 7 By By 8 ,�r' Chairman,Board of S ervisors Print Name: 9 Title: Date: 10 Chairman of Board, or 11 President, or any Vice President 12 13 BERNICE E. SEIDEL, Clerk Board of Supervisors 14 13 15 16 Print Name: By —�us, .� 17 Title: JUJU harp c c7 Secretary(of Corporation),or 18 any Assistant Secretary,or 19 Chief Financial Officer,or any Assistant Treasurer 20 21 PLEASE SEE ADDITIONAL 22 SIGNATURE PAGE ATTACHED 23 24 Mailing Address: Central Star Behavioral Health, Inc. 25 1501 Hughes Way, Suite 150 Long Beach,Ca. 90810 26 27 Contact: Kent Dunlap, Senior, Vice President Phone: (310) 221-6336 ext. 125 28 - 4 - COUNTY OF FRESNO Fresno, CA 1 APPROVED AS TO LEGAL FORM: 2 DANIEL C. CEDERBORG, COUNTY COUNSEL 4 By 5 6 APPROVED AS TO ACCOUNTING FORM: VICKI CROW, C.P.A., AUDITOR-CONTROLLER/ 7 TREASURER-TAX COLLECTOR 8 9 By 10 11 REVIEWED AND RECOMMENDED FOR APPROVAL: 12 13 14 By Dawan Utecht, Director 15 Department of Behavioral Health 16 17 Fund/Subclass: 0001/10000 18 Account/Program: 7294/0 19 Organization: 56302112 20 Fiscal Year Daily Bed Rate Program Cost 21 2014-15 $451,189 (Ramp Up January 1, 2015 —March 31, 2015) 22 2014-15 $844.00 $921,648 (Operational Period April 1, 2015—June 30, 2015) 2015-16 $797.55 $3,502,840 23 2016-17 $844.00 $4,161,818 2017-18 $732.96 $4,280,486 24 2018-19 $753.79 $4,402,134 25 2019-20 $775.27 $4,539,981 26 27 28 COUNTY OF FRESNO Fresno, CA Star Behavioral Health REVISED EXHIBIT B Page 1 of 45 Start Up Phase FIXED ASSETS: Furniture&Fixture Assets(Useful lire more than 1 year and valued at more than$5 000) Computer Assets(Useful life more than 1 year and valued at more than$5,000) Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,000) Capital Lease(Transfer of ownership or Bargain Purchase Option or long lease term or Lease payments high) 2000 Furniture&Fixture $ 6,867.85 $ 11,279 $71,140 $ 82,414 reportable to County if items meet all criteria 2001 Access Control System& C $ 4,380.08 $52,561 $ 52,561 reportable to County 20_02 IT Minor Equipment $ 1,304.17 $ 6,250 $ 9,400 $ 15,650 Maybe reportable as sensitive asset forcontractor tracking purposes only FIXED ASSETS TOTAL $150,625 Fiscal Year 15-16 FIXED ASSETS: 2000 Furniture Replacement $ 833.33 $ 10,000 $ 10,000 reportable to County ifitems meet all 4 criteria 2001 IT Minor Equipment $ 250.00 $ 3,000 $ 3,000 May be reportable as sensitive asset for contractor tracking purposes only 2002 $ 2003 cost to replace damaged furniture based on historical costs $ FIXED ASSETS TOTAL $ 13,000 Fiscal Year 16-17 FIXED ASSETS: 2000 Furniture Replacement 833 10.000 $10,000 reportable to County if items meet all 4 criteria 2001 IT Minor Equipment 255 3,060 $3,060 May be reportable as sensitive asset for contractor tracking purposes only 2002 $0 2003 cost to replace damaged furniture based on historical costs $0 FIXED ASSETS TOTAL $13,060 Fiscal Year 17-18 FIXED ASSETS: 2000 Furniture Replacement 833 10,000 $10,000 reportable to County if items meet all 4 criteria 2001 IT Minor Equipment 260 3,121 $3,121 May be reportable as sensitive asset for contractor tracking purposes only 2002 $0 2003 cost to replace damaged furniture based on historical costs $0 FIXED ASSETS TOTAL 13,121 0 $131121 Fiscal Year 18-19 FIXED ASSETS. 2000 Furniture Replacement 833 10,000 $10,000 reportable to County if items meet all criteria 2001 IT Minor Equipment 265 3,183 $3,183 May be reportable as sensitive asset for contractor tracking purposes only 2002 $0 2003 cost to replace damaged furniture based on historical costs $0 FIXED ASSETS TOTAL $13,183 Fiscal Year 19-20 FIXED ASSETS: 2000 Furniture Replacement 854 10,250 $10,250 reportable to County if items meet all 4 criteria 2001 IT Minor Equipment 272 3,262 $3,262 May be reportable as sensitive asset for contractor tracking purposes only 2002 $0 2003 cost to replace damaged furniture based on historical costs $0 FIXED ASSETS TOTAL $13,512 REVISED EXHIBIT B Page 2 of 45 Expected Published Contract Other Cost/yr. 16 Operational Contract capacity Rate Rate/Bed agencies beds Expenditure' Maximum 16 Rork FY 2014-15* 3 months 451,189 451,189 FY 2014-15** 13 months 1 12 $875.001 $844.001 1 1,228,864 921,648 921,648 FY 2015-16***112 months 12 $918.751 $797.551 1 4,657,692 3,502,840 4,657,692 FY 2016-17 1 16 $964.691 $844.001 1 4,161,818 4,161,818 4,161,818 IFY 2017-18 1 1 161 $1,012.921 $732.961 1 4,280,486 1 4,280,486 1 4,280,486 1 FY 2018-19 1 1 16 $1,063.571 $753.791 1 4,402,134 1 4,402,134 1 4,402,134 FY 2019-20 16 $1,116.75 $775.27 4,539,981 4,539,981 4,539,981 Published Rate: estimated published rates listed are cost charged to other agencies. $ 22,260,096.00 23,414,948.00 Objective during initial six months Contractor will secure other agency contracts. Three month Ramp Up Period, January 1, 2015 through March 31, 2015 ** 3 month operational cost April 1, 2015 through June 30, 2015 (91 days). County to pay padded rate. We are allowing Contractor a six month period (ramp/three month) to meet and greet community stakeholders for contracting. Rate built expenses at 16 bed capacity. ***First full year of operations: Contractor is expected to finalize securing other agency contracts. County will facilitate with a 12 month year end cost report within 90 days of June 30, 2016. *** Based on Estimated Revenues County shall pay Contractor for operational cost of 12 Beds for the first 15 months April 1, 2015 through June 30, 2016 REVISED EXHIBIT B Page 3 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc. Start Up Budget- Proposed Start Date through proposed end date(FY 2014-15-Jan-Mar 2015) Budget Categories __-, -__ -._ - Total Proposed Budget - -- - - Line Item Description Must be itemized FTE% Admin. Direct Total PERSONNEL SALARIES: 0001 RN-DON -___- _-___. 1.00 $_ -- 16,640 $ 16,640 0002 _t_R_N - _ - 3.20 $ -_-10,677 $ 10,677 0003- LVN _2.80 $ -- -5,096 $ -- -5,096 0004_ - +Rehab Therapist --_-- --_-- . 1.40 $ _ 2,548 $ 2,548 0005_- ;Rehab Aide 3.00 $__ 3,500 $ 3,500 0006. __Youth Counselor _-_ _ - 16.80 - - $ =20,952 $ - 20,952 0007 Admissions Coordinator i 1.00 $ 2,427 $- 2,427 0008 Family Advocate _ _ 1.00 $ 1,400 $ 1,400 0009 Social Workers 2.80 $ 7,159 $ 7,159 0010 .Program Director 1.00 $ 10,400 $ 10,400 0011 _'FCook- 2.10 $ 2,452 $ 2,452 0012 Administrator 0.75 $ 22,246 $ 22,246 0013 IHR Manager 0.50 $ 7,353 $__ 7,353 0014._- 'QA Medical Records_ _ +_ -0.501 $ _- 1,083 $ _-_ 1,083 L0015 -_ ,Training Coordinator_ -__ 0.50 $ 1,065 $ 1,065 0016 !Billing Clerk_ - 1.00 $ 953 $ 953 0017_ Maintenance Tech- _ - 1.00 $ 1,333 $ 1,333 0018 lHousekeeper 1.50 $ 1,249 $ 1,249 SALARY TOTAL 41.85 $ 35,282 $ 83,249 $ 118,532 PAYROLL TAXES: 00.30 FICAIMEDICARE_--_ -__--- $ 2,699 $ 6,369_ $ 9,068 - - -- - r i I 10031-_ SUI --- - ----- -- - - --- $ - -- 190 i$ __ 449 r$ 640 0032 FLITA $ 332 $ 783 $ 1,114 PAYROLL TAX TOTAL $ 3,221 $ 7,601 $ 10,822 i EMPLOYEE BENEFITS: 0040 - lRe_tirement $ 29 $ $ 29 L0941_ Workers Compensation $ 1,750 $ 4,129 $ 5,879 0042 Health Insurance medical vision,life,dental,401k) $ 1,130 $ 1,130 EMPLOYEE BENEFITS TOTAL $ 2,9091 $ 4,129 $ 7,038 SALARY&BENEFITS GRAND TOTAL $ 136,392 REVISED EXHIBIT B Page 4 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) _ _Central Star Behavioral Health,Inc._ Start Up Budget- Proposed Start Date through proposed end_date(FY 2014-15-Jan-Mar 2015) FACILITIES/EQUIPMENT EXPENSES: I 1010 Offsite Lease-Admin/Business Office $ 1,500 $ 1,500 1011 Leased Equipment $ 1,180 ; $_ 1,180 1012 Telecommunications $ 17,155 $ 17,155 i 1013 Utilities - $ - 6,895 _ i_$ _ _ -6,895 1014 aMaintenance- _ _ -_ - ! $__ 1,943 - $ 1,943 - -- 1015 -- -� - -- - - - - - -- $ - 16 $ 10 $ 1017 _ -- - - - - - - $-- -- 1018 $ - FACILITY/EQUIPMENT TOTAL $ 28,673 OPERATING EXPENSES: - ; - - -- - -- 1,400 1060 Purchased Services _-- 1 �$_ _-__ _ - a - ,4 1061 Office Supplies $ 2,000 �$_ _ 2,000 1062 Housekeeping Supplies $ 0 $ ttt + 80 . 800 --- - - - -- - r - - I - 1063 7Education&Traning_ $ 1,000- __ 1 $ 1,000 - ---- I 1064 Licenses $ - - $ 1065 Recruiting $ 7,200 $ 7,200 1066 Travel $ 1,200 $ 1,200 1067 EMIR Cost $ 20,000 $ 20,000 1068 $ - I ' 1069 - -- ---- - --- - -- - -- 1 - --- - $ - - --- 1070 -- - - - -- r- - - — ---- $- - - -- - ------ 1071 ---i --- - - --- -- -- -� ---- $ - 1072 - 1073 $ 1.074 f $ t - 1075-___ t $ - 1076 .1- - --- -- - - 1077 $ - OPERATING EXPENSES TOTAL $ 33,600 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services j $ 54,872 $ _ 54,872 - -- - 1081 General Insurance $ 1,100 $ 1,100 1082 Centralized fiscal service.05 $ 21,484 1083 $ - FINANCIAL SERVICES TOTAL $ 77,456 REVISED EXHIBIT B Page 5 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc. Start Up Budget- Proposed Start Date through proposed end date(FY 2014-15-Jan-Mar 2015 - SPECIAL EXPENSES(Consultant/Etc.): - I I 1087 i Professional Fees 8 Consultation $ 9,795 { $ 9,795 1088 1 Supplies/House Meds - --_ __ ___875. $ 875 1089= ISupplies Medical -- - + - -- - - - I-$ 541 , $- -541 1090- Suupplies Non-Medical - - - -+ -_ _,- - - j $ -- 4,587- $ 4,587 1091 Medical Records Supplies $ 300 _$ -300 1092 Food $ 615 $ 615 1093 Supplies Non Perishables $ 650 $ 650 i 1094 Laundry&Linen $ 1,000_.$ -_ 1,000 - - - i 1095 ,Centralized Services-Program $ 6,080 $ 6,080 SPECIAL EXPENSES TOTAL $ 24,443 FIXED ASSETS: ; - 2000 Furniture 8 Fixture 7 $ 71,140 $ 82,414 2001 Security-Access Control Syslem& Cameras $ 52,561 i $_ 52,561 2002- Equipment:IT Minor E ui $ 6,250 $ 9,400 $- -_-_- 15,650 9 P -- - Assets(useful life more than 1 year and valued at more-than$5,000; 2003 Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,000 FIXED ASSETS TOTAL $ 150,625 TOTAL PROGRAM EXPENSES $ 451,189 Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. Mental Health Services 3000 (Individual/Family/Group Therapy) $ _ 3100 Case Management $ 3200 Crisis Services $ 3300 Medication Support $ 3400 - :Crisis Stabilization-Urgent Care $ 3500 Psychiatric Health Facility _ $ 3600 _ +other _ $ 3700 _ other $ DIRECT SERVICE REVENUE TOTAL $ is h Medi-cal Revenue ___ $ - - - - Cost Per Unit #DIV/O! FUNDNG STREAMS REIMBURSEMENT 4000 1 Realignment funding $ 451,189 $ 451,189 4100 } Other „$ -_ - - $ - 4300 Other -- - - - OTHER REVENUE TOTAL is 451,189 TOTAL PROGRAM REVENUE $ 451,189 REVISED EXHIBIT B Page 6 of 45 FRESNO PHF Budget Narrative - Start-up - --- ---- - ITEM Budget Narrative I SALARIES I RN-DON The Director of Nursing assumes authority, responsibility, and accountability for the delivery of nursing services in the facility. In collaboration with facility Administration,allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical, mental, and psychosocial well-being. Collaborates with medical professionals,consultants,and organizations, including government agencies and advocacy groups,to develop, support and coordinate patient care, related administrative functions,and to represent the interests of the facility. Half a month salary of$4160 RN Nurses, have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors, and limit-setters to patients. Half a month salary for 3.2 FTE of$10,677. LVN Nurses, have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors, and limit-setters to patients. Half a month salary for 2.8 FTE of$5,096. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups. Half a month salary for 1.4 FTE of$2,548. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks. Half a month salary for 3.0 FTE of$3,500. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: I • coaches(encouraging and motivating patients) • teachers (modeling behaviors, monitoring patients,and providing feedback) • counselors(being a good listener, intervening with problem behaviors) • house-parents (assigning and monitoring chores, always knowing where patients are) • limit-setters(enforcing the rules fairly, using discipline to teach patients) Half a month salary for 16.8 FTE of$20,952 ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans; lead admission and discharges planning process,conduct staff supervision as directed and provide back-up to Clinical Director as needed. Half a month salary of$2,427 FAMILY ADVOCATE Family Advocates provide outreach, advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition,and aftercare. For example, Family Advocates can run support,educational and/or focus groups for family members. Half a month salary of$1,400. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Half a month salary for 2.8 FTE of$7,159 PROGRAM DIRECTOR The Program Director has primary responsibility for supervising, managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties. Half a month salary of $2600. REVISED EXHIBIT B Page 7 of 45 COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and regulations,with our established policies and procedures. Half a month salary for 2.1 FTE of$2,452. ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances);and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$12,133 x4 UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements,management and control of forms,thinning charts,auditing, monitoring,tracking, and securing medical records, maintaining active and closed charts organization, assisting in acquiring necessary documents from charts when authorized,and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal, Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data. Half a month salary of 2,383. HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS, standard reporting of HR information, duplicating, sorting and typing. At the direction of the HR Coordinator, maintains employment processing and tracking of employment documents, processes personnel documents,conducts benefits administration, processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,417 x3. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying, researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions,tracking reports, and filing duties required by the Business Office. Half a month salary of$953 MAINTENANCE TECH This hands-on position supervises, and coordinates the maintenance of all the facility and the housekeeping and laundry activities at Fresno PHF to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor, as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22, OSHA, and Fire Marshall physical plant regulations, making necessary recommendations to the Administrator. Half a month salary for.5 FTE of$666. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Half a month salary for 1.5 FTE of$1,249. We offer a comprehensive benefit package which covers medical,dental,vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all likelihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%,the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead,we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax, 1.45% ER Medicare Tax, State Unemployment Insurance is.54%of salaries, FUTA Taxes is .96%of salaries I PENSION EXPENSE There is no Pension Expense during the ramp up period. Employees become eligible after six months 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. HEALTH INSURANCE Average cost of$430 for Health, Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. (FACILITIES/EQUIPMENT EXPENSE: IOFFSITE LEASE-ADMIN BUSINESS OFFICE Lease offsite space for administrative staff based on current market rate in Fresno. I LEASED EQUIPMENT Base copier charges and usage fees based on historical cost. (TELECOMMUNICATIONS Facility cabling, hardware and monthly service cost for telecommunication. Staff cell phone reimbursement(mainly administrator,clinical director& admission coordinator)based on historical cost and amount provided in the RFP. I UTILITIES Electricity,Water,Gas,Trash based on amount provided in the RFP. REVISED EXHIBIT B Page 8 of 45 MAINTENANCE Building maintenance and repairs based on amount provided in the RFP. OPERATING EXPENSES: PURCHASED SERVICES ADP Payroll Services Shredding,Cable Medical Waste Service Wifi EMR Maintenance Cost Safety Training based on historical cost. OFFICE SUPPLIES Pa er Printer Supplies, Envelopes, Pens Etc based on historical cost. HOUSEKEEPING SUPPLIES Household and cleaninq supplies based on historical cost. EDUCATION&TRAINING On oinq Required Training For Staff based on historical cost. LICENSES Business license,OSHPD fee based on historical cost. RECRUITMENT Advertising/Classified/Background Checks/Physical Exams Etc based on historical cost I TRAVEL Staff mileage&travel reimbursement(mainly administrator, clinical director&admission coordinator)based on historical cost EMIR COST Cost to set up a text file to transmit data to Fresno County's Avatar Svstem. FINANCIAL SERVICES EXPENSE CENTRALIZED SERVICES-ADMIN. This is an allocation from Stars Behavioral Health Group of administration,information technology, human resources,communications,finance, and associated fringe benefits and expenses.Costs can be up to 15%of total cost based on historical cost. CENTRALIZED SERVICES-PROGRAM This is a program allocation from Stars Behavioral Health Group of training,outcome research and program practices,electronics medical records,quality assurance, and associated employee benefits and expenses based on historical cost. GENERAL INSURANCE Property And Professional Liabilitv Insurance based on historical cost. I SPECIAL EXPENSES: PROFESSIONAL FEES Medical Director, Primary Phvsician, Psychiatrists(See salaries section). Good&Fowler audit fees based on historical cost. I MEDICAL/CLINICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team, peer review and interdepartmental consultation. Half a month salary of$7,800 PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate,diagnose,and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. Half a month salary of$10,331 PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. Half a month salary of 3,467 SUPPLIES-HOUSE MEDS (Pharmacy charqes for house medication(Aspirin, Tvlenol) over the counter supplies based on historical cost. I SUPPLIES-MEDICAL (Pharmacy charqes for non-covered medications based on historical cost. SUPPLIES NON-MEDICAL (Supplies for client's qroominq, hygiene and living skills based on historical cost. I MEDICAL RECORD SUPPLIES (Medical Records,Charts, Forms And Copyinq based on historical cost. I FOOD I Groceries to be prepared by Cook for the clients based on historical cost. I SUPPLIES (NON PERISHABLE) IPaoer goods and utensils based on historical cost LAUNDRY&LINEN ]Towels, sheets,blankets, laundry service based on historical cost. I FIXED ASSETS: I FURNITURE&FIXTURE (Furniture and Fixture for the client room and dining area. Tables, desks,chairs,conference room table, lateral files,storage lockers,and couch necessary for the PH Facility and Offsite Facility. SECURITY-ACCESS CONTROL SYSTEM (Expense related to installation of cameras and security system CAMERA IT MINOR EQUIPMENT IMinor equipment with a value less than$5000 each. Includes;computers,hardware and software based on historical cost. CGF FUNDS IStart up Funds needed to prepare the facility and staff. I REVISED EXHIBIT B Page 9 of 45 Child-Adolescent Psychiatric Health Facility(16 bed)operated at 12 bed capacity Central Star Behavioral Health,Inc. Operational Budget-April 1,2015 through June 30,2015 Budget Categories- Total Proposed Bud et Line Item Description(Must be itemized) FTE% Admin. Direct Total PERSONNEL SALARIES: 0001 'RN-DON 1.00 _ -24,960 $ 24,960 0002 'RN 3.20 64,064 $ 64,064 0003- LVN_ _ - 2.80 _ __ 30,576 $ _30,576 -- - - -- - I 0004 --- 'Rehab Therapist 1.40 15,288 $_ 15,288_ 0005 +Rehab Aide 3.00 20,998 $ 20,998 0006 Youth Counselor 16.80 125,711 $ 125,711 0007 ;Admissions Coordinator 1.00 - 14,560 $ 14,560 0008 Family Advocate 1.00 8,398 $ 8,398 0009 Social Workers 2.80 42,952 $ 42,952 0010 j program Director 1.00 15,600 $ 15,600 0011 Cook 2.10 14,709 $_ _ 14,709 0012 Administrator 0.75 22,246 $ 22,246 0013 HR Manager - - - -- - - 0.50 ---7,353 -_ - - $ -- -7,353 0014 CIA Medical Records 0.50 6,500 - _- $ - 6,500 0015 Training Coordinator 0.50 6,391 $ 6,391 0016 Billing Clerk 1.00 5,720 $ 5,720 0017 'Maintenance Tech 1.00 7,998 $ 7,998 0018 i Housekeeper 1.50 7,496 $ 7,496 SALARY TOTAL 41.85 $ 63,703 $ 377,816 $ 441,518 PAYROLL TAXES: I 0030 FICA/MEDICARE $ 4,873 $ _28,903 _$ 33,776 0031 SUI 344 __- 2,040 $ _ 2,384 0032 !FUTA 599 3_,551 $ 4,150 PAYROLL TAX TOTAL $ 5,816 $ 34,494 $ 40,310 EMPLOYEE BENEFITS: 0040 Retirement 2,797 16,586 $ 19,383 0041 `Workers Compensation_ - 3,160 18,740 $ 21,899 0042 Health Insurance(medical vision,life,dental,401k) 7,294 43,260 $ 50,554 EMPLOYEE BENEFITS TOTAL $ 13,250 $ 78,586 $ 91,836 SALARY&BENEFITS GRAND TOTAL $ 573,665 REVISED EXHIBIT B Page 10 of 45 ChiWAdolescent Psychiatric Health Facility(16 bed)operated at'12 bed capacity Central Star Behavioral Health,Inc. Operational Budget-April 1,2015 through June 301 2015 FACILITIES/EQUIPMENT EXPENSES: T__ - - - 1010 Offsite Lease-Admin/Business Office $ 500 $ 1,500 $ 1,500 1011 Leased Equipment $ 590 $ 1,770 $ 1,770 1012 Telecommunications $ 2,750 $ 8,250 $ - 8,250 1013 Utilities $ 5,917 $ 17,750 $ 17,750 r 1014 !Maintenance - __-- -- - _$ 500 r$ _1,500 _ $ -_1,500- 1015 (Security-Access Control System& Cameras $ - $ -- - $-- - I FACILITY/EQUIPMENT TOTAL $ 30,770 OPERATING EXPENSES: ------------ 1060 Purchased Services 19,751 $ 19,751 - ---- - - - ---- -- -- - -- - -- - - -- - 1 - ---- 1 - 1061 i0ffice Supplies_ $ 166.67 $ 500 $ 500 - T $ 1.,561 -- !Housekeeping -- 4 - -- - - 1062 Supplies _- 520.20 _ 1063_ iEducation&Traning __- . $ 520.20 ! $ 1,561 - $ 1,561 i 1064 ;Licenses - $ - $ + - $ 1065 $.Recruiting �; 150.00 ' 450 $ 450. 1066_ jTravel $ 1200.00 $ 3,600 ii $ 3,600_ 1067 $ $ - i 1068 i $ 1069 - t 1070 - IOPERATING EXPENSES TOTAL $ 27,422 FINANCIAL SERVICES EXPENSES: ! 1080 Centralized Services $ 28,745 ` $_ 86_,235 $ ,_ 86,235 - — 1081 General Insurance $ 1,1_02 $ 3,305 $ 3,305_ T - - -- -, - - 1082 Centralized fiscal service .05 $ 43,938 FINANCIAL SERVICES TOTAL $ 133,478 REVISED EXHIBIT B Page 11 of 45 Child-Adolescent Psychiatric Health Facility(16 bed)operated at 12 bed capacity Central Star Behavioral Health,Inc. Operational Budget-April 1,2015 through June 30,2015 SPECIAL EXPENSES(Consultant/Etc.): I Page 3 of 3 i ! 1087 Professional Fees&Consultation $ _-_107,990 $ 107,990 1088 rContract Therapist $ 8,286 I $ 8,286 1089 �SuppliesHouse Meds J $ 2,733 $ - 2,733 1090 j Supplies Medical --__— -_-__ j$_ ___ 1,689_�$ _ __ 1,689 1091 !Supplies Non-Medical $ 1,000_, $ 1,000 1092 i Medical Records Supplies $ 165_i$ 165 -- 1093 Food $ 12,4.21 $ 12,421 1094 ;Supplies Non Perishables $ 438 $ 438_ 1096 Laundry&Linen ;$ 3,571r $_ _3,571_ 1097 Allowance -_ $ 1,873_+$ 1,873_ 1098 �Clothin-g _ -- - -�- -�$ - 5,015 �-$_ _5,015 1099 ;Legal_Fees_ _ _ + $ 1,248 $ 1,248 2000 !Employee Benefits Other 765 $ __-- 765 ,Centralized Services-Program $ 9,120 $ 9,120 SPECIAL EXPENSES TOTAL 1 $ 156,314 $ 156,314 FIXED ASSETS: i 2001 _YFurniture Replacement $ $ -_ ' 01 -- - $- - t - -- 2002 IT Minor EcLuipment_ �$_ . $ i - _ Assets(Useful life more than 1 year and valued at more than S5.000) 2003 Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,000) FIXED ASSETS TOTAL i I $ based 16 beds costs TOTAL PROGRAM EXPENSES $ 921,648 - -- -- - - - --- --- Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. 'Mental Health Services 3000_ _(Individual/Family/Group Therapy) _ _ $ 31 - -.-__i (Case Management 3200 {Crisis Services _ $ _ 3300 Medication Support_ _ - $ _ 3400 Crisis_Stabilization-Urgent Care _ $ - 3800chiatric Health Facility r12 beds 1,092 $ 844.0.0 $ 921,648 3600 !other 3700 oother $ - - DIRECT SERVICE REVENUE TOTAL $ 1,092 $ 921,648 12 Medi-cal Revenue $ 875,566 beds _ CiostPer Unit _ _ $ 844.00 FUNDNG STREAMS REIMBURSEMENT __4000 Private-- - --0-1 27,649 410-0 a 4200 Me_dSCa FFPnce 95%I i ' - 18,433 r - - - - 437T83 4300 2011 Realignment_ 437,783 OTHER REVENUE TOTAL 921,648 TOTAL PROGRAM REVENUE $ 921,648 PEVI BED EXHIBIT B Page 12 of 45 FRESNO PHF Budget Narrative - - FY 14-15 - - -- - ----�- -- - -- � (ITEM Budget Narrative (SALARIES: RN-DON The Director of Nursing assumes authority, responsibility, and accountability for the delivery of nursing services in the facility. In collaboration with facility Administration, allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical, mental, and psychosocial well-being. Collaborates with medical professionals,consultants,and organizations,including government agencies and advocacy groups,to develop, support and coordinate patient care, related administrative functions,and to represent the interests of the facility. Monthly salary of$8,330 x 12. RN Nurses, have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments, dispensing of medication,and monitoring of side effects. Nurses are also coaches, teachers, counselors, and limit-setters to patients. Monthly salary for 3.2 FTE of$21,381 x12. LVN Nurses, have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, I+ including providing nursing assessments, dispensing of medication, and monitoring of side effects. Nurses are also coaches,teachers, counselors, and limit-setters to patients. Monthly salary for 2.8 FTE of$10,204 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups. Monthly salary for 1.4 FTE of$5,102 x12. (REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks, treatment setups and routine patient care tasks. Monthly salary for 3 FTE of$7,008 x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches (encouraging and motivating patients) • teachers(modeling behaviors,monitoring patients, and providing feedback) • counselors(being a good listener, intervening with problem behaviors) • house-parents(assigning and monitoring chores,always knowing where patients are) • limit-setters(enforcing the rules fairly; using discipline to teach patients) Monthly salary for 16.8 FTE of$41,956 x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans, lead admission and discharges planning process; conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$4,859 x12. FAMILY ADVOCATE Family Advocates provide outreach, advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition,and aftercare. For example, Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $2,803 x12. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$14,335 x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising, managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties. Monthly salary of$5,206 x12. REVISED EXHIBIT B Page 13 of 45 COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$4,909 x 12 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances);and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$12,254 x12. UR/QA/ MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements, management and control of forms, thinning charts, auditing, monitoring, tracking, and securing medical records, maintaining active and closed charts organization,assisting in acquiring necessary documents from charts when authorized, and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal, Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data.Monthly salary of$4,779 x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS, standard reporting of HR information, duplicating, sorting and typing. At the direction of the HR Coordinator, maintains employment processing and tracking of employment documents,processes personnel documents,conducts benefits administration, processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,457 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying, researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions,tracking reports, and filing duties required by the Business Office. Monthly salary of$1,909 x12. MAINTENANCE TECH This hands-on position supervises, and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHF to ensure clean, safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor, as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22,OSHA, and Fire Marshall physical plant regulations,making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,335 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents, other staff and the public. Monthly salary for 1.5 FTE of$2,502 x12. We offer a comprehinsive benefit package which covers medical,dental, vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all liklihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%,the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead, we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax, 1.45%ER MediCare Tax,State Unemployment Insurance is.54%of salaries, FUTA Taxes is .96%of salaries PENSION EXPENSE 1.74%of total salaries. Employees become eligible for Pension after six months. 401 K ER CONTRIBUTION RATE 10.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 14.96%of total salaries. HEALTH INSURANCE JAverage cost of$430 for Health, Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. REVISED EXHIBIT B Page 14 of 45 (FACILITIES/EQUIPMENT EXPENSES: I IOFFSITE LEASE-ADMIN/BUSINESS OFFICE Lease offsite space for administrative staff based on current market rate in Fresno. ILEASED EQUIPMENT Base copier charqes and usaqe fees based on historical cost. (TELECOMMUNICATIONS Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. (UTILITIES Electricity,Water. Gas.Trash based on amount provided in RFP IMAINTENANCE Buildinq maintenance and repairs based on amount provided in RFP (OPERATING EXPENSES: I IPURCHASED SERVICES ADP Pavroll Services. Shredding. Cable. Medical Waste Service,Wifi, EMIR Maintenance Cost, Safetv Traininq based on historical cost. I (OFFICE SUPPLIES Paper, Printer Supplies. Envelopes. Pens, Etc based on historical cost. IHOUSEKEEPING SUPPLIES Household and cleaning suDDlies based on historical cost. (EDUCATION&TRAINING Ongoing Required Training For Staff based on historical cost. ILICENSES Business license. OSHPD fee based on historical cost. RECRUITMENT Advertisinq/Classified/Back round Checks/Physical Exams Etc based on historical cost ITRAVEL Staff milege&travel reimbursement(mainly administrator, clinical director&admission coordinator based on historical cost I I FINANCIAL SERVICES EXPENSES: I (CENTRALIZED SERVICES-ADMIN. This is an allocation from Stars Behavioral Health Group of administration, information technology, human resources,communications,finance, and associated fringe benefits and expenses. Costs can be up to 15%of total cost based on historical cost. (CENTRALIZED SERVICES-PROGRAM This is a program allocation from Stars Behavioral Health Group of training, outcome research and program practices,electronics medical I records,quality assurance, and associated employee benefits and expenses based on historical cost. (GENERAL INSURANCE Property And Professional Liabilitv Insurance based on historical cost. ISPECIAL EXPENSES: I PROFESSIONAL FEES Medical Director, Primary Physician, Psvchiatrists(See salaries section). Good& Fowler audit fees based on historical cost. MEDICAL/CLINICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team, peer review and interdepartmental consultation. Monthly salary of$15,600 x 12. PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate,diagnose, and collaborate with other team members to treat our youngsters for different mental health disorders.Since I they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. monthly salary of$20,661 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate, diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$6933 x 12. ICONTRACT THERAPIST 3 Contracted Primary Therapists based on historical cost. ISUPPLIES-HOUSE MEDS Pharmacv charges for house medication (Aspirin,Tylenol)over the counter supplies based on historical cost. (SUPPLIES-MEDICAL Pharmacy charqes for non-covered medications based on historical cost. ISUPPLIES NON-MEDICAL Supplies for client's groominq, hvqiene and livinq skills based on historical cost. I IMEDICAL RECORD SUPPLIES Medical Records,Charts, Forms And Copying based on historical cost. I FOOD Groceries to be prepared by Cook for the clients based on historical cost. (SUPPLIES(NON PERISHABLE) Paper goods and utensils based on historical cost (LAUNDRY&LINEN Towels,sheets, blankets, laundry service based on historical cost. (ALLOWANCE Weekly monev distributed to clients based upon points&level based on historical cost I ICLOTHING Monthly amount disbursed for client's clothing Der contract based on historical cost (LEGAL FEES Attorney Fees based on historical cost. (EMPLOYEE BENEFITS Safety Bingo, Gift Cards, Perfect Attendance, Employee of the Month, Holiday Party, Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. FIXED ASSETS: FURNITURE REPLACEMENT Cost to replace damaqed furnitures based on historical cost. IIT MINOR EQUIPMENT Minor equipment with a value less than$5000 each. Includes;computers, hardware and software based on historical cost. I IREVENUES: REVISED EXHIBIT B Page 15 of 45 IMEDI-CAL REVENUE Daily Rate x 365 x 16 x 90% PRIVATE INSURANCE REVENUE Dail Rate x 365 x 16 x 3% UNINSURED REVENUE Daily Rate x 365 x 16 x 2% REVISED EXHIBIT B Page 16 of 45 Child-Adolescent Psychiatric Health Facility(12 bed) Stars Behavioral Health Group Budget- July 1,2015 through June 30,2016(12 months) Budget Categories- Total Proposed Budget Line Item Description(Must be itemized) FTE% Admin. Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $ 101,464 $ 101,464 0002 RN 3.20 $ 260,425 $ 260,425 0003 LVN 2.80 $ 124,294 $ 124,294 0004 Rehab Therapist 1.40 $ 62,147 $ 62,147 0005 Rehab Aide 1.40 $ 39,833 $ 39,833 0006 Youth Counselor 15.40 $ 468,439 $ 468,439 0008 Family Advocate 1.00 $ 34,138 $ 34,138 0009 Social Workers 2.80 $ 174,603 $ 174,603 0010 Program Director 1.00 $ 63,415 $ 63,415 0011 Cook 2.10 $ 59,794 $ 59,794 0012 Administrator 0.75 $ 111,946 $ 111,946 0013 UR/CA/Medical Records 1.00 $ 58,203 $ 58,203 0014 HR/Training/Admin Asst 1.00 $ 66,470 $ 66,470 0015 Billing Clerk 1.00 $ 23,252 $ 23,252 0016 Maintenance Tech 0.50 $ 16,255 $ 16,255 0017 Housekeeper 1.90 $ 38,597 $ 38,597 SALARY TOTAL 38.25 $ 314,723 $ 1,388,552 $ 1,703,275 PAYROLLTAXES: 0030 FICA/MEDICARE $ 24,076 $ 106,225 $ 130,302 0031 SUI $ 1,699 $ 7,497 $ 9.196 0032 FUTA $ 2,958 $ 13,053 $ 16,012 PAYROLL TAX TOTAL $ 28,734 $ 126,775 $ 155,509 EMPLOYEE BENEFITS: 0040 Retirement $ 11,141 $ 49,156 $ 60,297 0041 Workers Compensation $ 15,610 $ 68,873 $ 84,483 0042 Health Insurance(medical vision, life, dental) $ 36,036 $ 158,989 $ 195,025 EMPLOYEE BENEFITS TOTAL $ 62,787 1 $ 277,018 $ 339,805 SALARY&BENEFITS GRAND TOTAL $ 2,198,590 REVISED EXHIBIT B Page 17 of 45 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease-Admin/Business Office $ 500 $ 6,000 $ 6,000 1011 Leased Equipment $ 1,204 $ 14,443 $ 14,443 1012 Telecommunications $ 3,269 $ 39,229 $ 39,229 1013 Utilities $ 7,032 $ 84,383 $ 84,383 1014 Maintenance $ 1,982 $ 23,782 $ 23,782 1015 $ - $ $ 1016 12 months $ 1017 $ 1018 $ FACILITY/EQUIPMENT TOTAL $ 167,837 OPERATING EXPENSES: Monthly Admin. Direct 1060 Purchased Services $ 3,239.83 $ 38,878 $ 38,878 1061 Office Supplies $ 1,560.75 $ 18,729 $ 18.729 1062 Housekeeping Supplies $ 530.42 $ 6,365 $ 6,365 1063 Education&Traning $ 265.00 $ 3,180 $ 3,180 1064 Licenses $ 234.00 $ 2,808 $ 2,808 1065 Recruiting $ 42.50 $ 510 $ 510 1066 Travel $ 208.08 $ 2.497 $ 2,497 1067 $ 1068 $ 1069 $ 1070 $ 1071 $ 1072 $ - 1073 $ 1074 $ 1075 $ 1076 $ 1077 $ - OPERATING EXPENSES TOTAL $ 72,967 FINANCIAL SERVICES EXPENSES: Monthly Admin. Direct 1080 Centralized Services $ 25,382.92 $ 304,595 $ 304,595 1081 General Insurance $ 1,124.04 13,488 $ 13,488 1082 Centralized fiscal service.05 $ 152,297 1083 $ - FINANCIAL SERVICES TOTAL $ 470,380 REVISED EXHIBIT B Page 18 of 45 SPECIAL EXPENSES Consultant/Etc. : Monthly Admin. Direct 1087 Professional Fees&Consultation $ 36,649.00 $ 439,788 $ 439,788 1088 Contract Therapist $ 2,112.92 $ 25,355 $ 25,355 1089 Supplies/House Meds $ 696.92 $ 8,363 $ 8,363 1090 Supplies Medical $ 430.67 $ 5,168 $ 5,168 1091 Supplies Non-Medical $ 2,513.25 $ 30,159 $ 30,159 1092 Medical Records Supplies $ 56.10 $ 673 $ 673 1093 Food $ 3,167.08 $ 38,005 $ 38,005 1094 Supplies Non Perishables $ 111.67 $ 1,340 $ 1,340 1095 Laundry 8 Linen $ 910.33 $ 10,924 $ 10,924 1096 Allowance $ 477.33 $ 5,728 $ 5,728 1097 Clothing $ 1,279.08 $ 15,349 $ 15,349 1098 Legal Fees $ 424.32 $ 5,092 $ 5,092 1099 Employee Benefits Other $ 260.10 $ 3,121 $ 3,121 SPECIAL EXPENSES TOTAL $ 589,065 FIXED ASSETS: Monthly Admin. Direct 2000 Furniture Replacement $ 208.33 $ 2,500 $ 2,500 2001 IT Minor Equipment $ 125.00 $ 1,500 $ 1,500 Assets(Useful life more than 1 year and valued at more than$5,000) $ - 2002 Intangible Software/License Assets Useful life more than 1 year and valued at more than$100,000 $ FIXED ASSETS TOTAL $ 4,000 16 bed TOTAL PROGRAM EXPENSES 1 $ 3,502,840 $ 797.55 100% $ 797.55 Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. Mental Health Services 3000 (Individual/Family/Group Therapy) $ 3100 Case Management $ 3200 Crisis Services $ 3300 Medication Support $ 3400 Crisis Stabilization-Urgent Care $ - 3500 Psychiatric Health Facility 12 bed 4,392 $ 797.55 $ 3,502,840 3600 other $ - 3700 other $ DIRECT SERVICE REVENUE TOTAL 1 $ 4,3921 1 $ 3,5027840 Realignment Medi-cal Revenue 3,152,556 12.03287671 Cost Per Unit $ 797.55 FUNDNG STREAMS REIMBURSEMENT 4000 Private Insurance 8% $ 280,227 4100 Uninsured 2% $ 70,057 4200 Medi-Cal FFP 90% $ 1,576,278 4300 2011 Realignment 90% $ 1,576,278 OTHER REVENUE TOTAL $ 3,502,840 TOTAL PROGRAM REVENUE 1 $ 3,502,840 REVISED EXHIBIT B FRESNO PHF Budget Narrative Page 19 of 45 FY 15-16 ITEM Budget Narrative SALARIES: RN-DON The Director of Nursing assumes authority, responsibility, and accountability for the delivery of nursing services in the facility. In collaboration with facility Administration, allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical, mental, and psychosocial well-being.Collaborates with medical professionals,consultants,and organizations, including government agencies and advocacy groups,to develop, support and coordinate patient care, related administrative functions,and to represent the interests of the facility. Monthly salary of$8,445 x 12. RN Nurses,have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments, dispensing of medication, and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 3.2 FTE of$21,675x12. LVN Nurses,have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication, and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 2.8 FTE of$10,345 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups. Monthly salary for 1.4 FTE of$5,172 x12. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks.Monthly salary for 3 FTE of$7,104x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches(encouraging and motivating patients) • teachers(modeling behaviors, monitoring patients,and providing feedback) • counselors(being a good listener, intervening with problem behaviors) • house-parents(assigning and monitoring chores, always knowing where patients are) • limit-setters(enforcing the rules fairly; using discipline to teach patients) Monthly salary for 16.8 FTE of$42,532x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans; lead admission and discharges planning process;conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$4,926x12. FAMILY ADVOCATE Family Advocates provide outreach,advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition, and aftercare. For example, Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $2,841 x12. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$14,532x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising,managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties.Monthly salary of$5,278 x12. REVISED EXHIBIT B Page 20 of 45 COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$4,977 x 12 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs. The Administrator supervises the functions including:Training and Quality Assurance and Community Relations (including client and family grievances); and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$12,315 x12. UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements, management and control of forms, thinning charts, auditing, monitoring,tracking, and securing medical records, maintaining active and closed charts organization, assisting in acquiring necessary documents from charts when authorized, and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal, Fresno County, other outside agencies, and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data. Monthly salary of$4,838 x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS, standard reporting of HR information, duplicating,sorting and typing. At the direction of the HR Coordinator, maintains employment processing and tracking of employment documents,processes personnel documents, conducts benefits administration, processes documentation for worker compensation,first aid, and other injury claims. Sorts, dates, and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,498 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying, researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions, tracking reports, and filing duties required by the Business Office. Monthly salary of$1,935 x12. MAINTENANCE TECH This hands-on position supervises, and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHFJ to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor, as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22, OSHA, and Fire Marshall physical plant regulations,making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,353 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Monthly salary for 1.5 FTE of$2,536 x12. We offer a comprehinsive benefit package which covers medical,dental,vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all liklihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%, the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead,we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax, 1.45% ER MediCare Tax, State Unemplovment Insurance is.54%of salaries, FUTA Taxes is .96%of salaries PENSION EXPENSE 3.25%of total salaries. 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. HEALTH INSURANCE Average cost of$430 for Health, Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. FACILITIES/EQUIPMENT EXPENSES: OFFSITE LEASE-ADMIN/BUSINESS OFFICE Lease offsite space for administrative staff based on current market rate in Fresno. LEASED EQUIPMENT Base copier charges and usage fees based on historical cost. TELECOMMUNICATIONS Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. REVISED EXHIBIT B Page 21 of 45 UTILITIES Electricity,Water,Gas,Trash based on amount provided in RFP MAINTENANCE Building maintenance and repairs based on amount provided in RFP OPERATING EXPENSES: PURCHASED SERVICES ADP Payroll Services,Shredding Cable,Medical Waste Service,Wifi EMR Maintenance Cost,Safety Training_based on historical cost. OFFICE SUPPLIES Paper, Printer Supplies, Envelopes, Pens, Etc based on historical cost. HOUSEKEEPING SUPPLIES Household and cleaning supplies based on historical cost. EDUCATION&TRAINING Ongoing Required Traininq For Staff based on historical cost. LICENSES Business license,OSHPD fee based on historical cost. RECRUITMENT Advertising/Classified/Background Checks/Physical Exams Etc based on historical cost TRAVEL Staff milege&travel reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost FINANCIAL SERVICES EXPENSES: This is an allocation from Stars Behavioral Health Group of administration,management services,financial services and office support. 10%of CENTRALIZED SERVICES total program cost based on historical cost. GENERAL INSURANCE Property And Professional Liability Insurance based on historical cost. SPECIAL EXPENSES: PROFESSIONAL FEES Medical Director, Primary Physician, Psychiatrists(See salaries section). Good& Fowler audit fees based on historical cost. MEDICAL/CLINICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team, peer review and interdepartmental consultation. Monthly salary of$11,700 x 12. PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate, diagnose, and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. Monthly salary of$16,987 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$6,192 x 12. CONTRACT THERAPIST 3 Contracted Primary Therapists based on historical cost. SUPPLIES-HOUSE MEDS Pharmacy charges for house medication(Aspirin,Tylenol)over the counter supplies based on historical cost. SUPPLIES-MEDICAL Pharmacy char es for non-covered medications based on historical cost. SUPPLIES NON-MEDICAL Supplies for client's grooming, hygiene and livinq skills based on historical cost. MEDICAL RECORD SUPPLIES Medical Records,Charts, Forms And Copying based on historical cost. FOOD Groceries to be prepared by Cook for the clients based on historical cost. SUPPLIES(NON PERISHABLE) Paper goods and utensils based on historical cost LAUNDRY&LINEN Towels sheets blankets, laundry service based on historical cost. ALLOWANCE Weekly money distributed to clients based upon points&level based on historical cost CLOTHING Monthly amount disbursed for client's clothing per contract based on historical cost LEGAL FEES Attorney Fees based on historical cost. EMPLOYEE BENEFITS Safety Bingo, Gift Cards, Perfect Attendance, Employee of the Month, Holiday Party, Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. FIXED ASSETS: FURNITURE REPLACEMENT Cost to replace damaged furnitures based on historical cost. IT MINOR EQUIPMENT Minor equipment with a value less than$5000 each. Includes, computers, hardware and software based on historical cost. REVENUES: MEDI-CAL REVENUE Daily Rate x 366 x 12 x 90% PRIVATE INSURANCE REVENUE Daily Rate x 366 x 12 x 8% UNINSURED REVENUE Daily Rate x 366 x 12 x 2% REVISED EXHIBIT B Page 22 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc Budget- July 1,2016 throu h June 30,2017(12 months) Bud et Categories _-_ --___ _ Total_Pr_o0osed Budget - Line Item Description Must be itemized FTE% Admin. l Direct Total EL SALARIES: PERSONNEL 0001 - RN-DON 1.00 $106,053 $106,053 0002 RN 3.20 $272,202 $272,202 0003 ;LVN 2.80 $129,915 $129,915 0004 _Rehab Therapist 1.40 $64,957 $64,957 0005- -._ Rehab Aide - _- ___ -- 3.00 $89,217 $89,217 0006 Youth Counselor 16.80 $534,134 $534.134 0007 Admissions Coordinator 1.00 $612864 $61,864 0008_ !Family-Advocate _ __-- 1.00 $35,682 $35,682 0009_ Social Workers 2.80 $182,499 $182,499 0011.0 Program Director 1,00 - $66,283 $66,283 0011 _ Cook 2.10 $62,498 $62,498 0012 Administrator 1.00 $156,012 $156,012 0013 UR/QA/-Medical Records 1,00 $60,835 _ $60,835 0014 HR/TraininglAdminAsst 1.00 $69,476 $69,476 0015-_+Billing_C-I_erk --___ - _ 1.00 $24,304 $24,304 10016_ _ yMaintenance Tech_ _ 0.50 $16,991 $16,991 0017 Housekee er 1.50 $31,849 $31,849 SALARY TOTAL 40.10 $359,466 $1,605,304 $1,964,769 PAYROLL TAXES: 0030 FICA/MEDICARE $27,499 $122,806 $150,305 0031 SUI- $1,941 $8,667 $10,608 0032 FUTA $3,379 $15,090 $18,46 PAYROLL TAX TOTAL $32,819 $146,563 $179,381 }EMPLOYEE BENE-FITS:- - _____- 0040_., _ Retirement $12,725 $56,828, $69,55 - - -- 0041_-- 1 Workers Compensation- -- - _ _$17,830 $79,623 $97,45 0042 Health Insurance(medical vision,life, dental) $41,15 $183,807 $224,96 !EMPLOYEE BENEFITS TOTAL $71,71 $320,25 $391,97' 'SALARY&BENEFITS GRAND TOTAL $2,536,12 REVISED EXHIBIT B Page 23 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc Budget- July 1,2016 throuah June 30,2017(12 months) FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease-Admin/Business Office 1,561 18,727 $18,72 1011- . _ Leased Equipment 1,228 I 14,737 $14,737 1012_ Telecommu nications _ _—3,334 t--_ 40,013 $40,013 1013 Utilities _ - 1, __ 7,173 _-_ 86,072 $86,072 1014 Maintenance 2022, 24,260 I - 1015 ;Security-Access Control System& Cameras - $0 1016 $0 1017 $0 1018 $0 FACILITY/EQUIPMENT TOTAL $183,808 OPERATING EXPENSES: 1060 Purchased Services_ 3,362 40,340 1 r --$40,340 1061 Office Supplies _._ _._...__1,816 21,793 _ $2.1,793 1062 Housekeeping Supplies 541 6,487 $6,487 1063_- Education&Traning 541 $6,487 - -- 6,487 1064_ iLicenses _- 477_ 51728 _$5,728 i -I 1065 Recruiting 43 _ $520 520 , i 1066 Travel 212 2,546 $2,546 1067 w $0 1068- -__ $'0 1069- �-- - - - -- - - - -- --- -- - --- I - --- $0 1070 -_ 1071 $0 1072 $0 1073 - $0 1074 $0 1075 $0 1076- --- - -- -$0 1077 $0 OPERATING EXPENSES TOTAL $83,902 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services-- 29,266 351192 _____1 , $351,192 II 1081 iGeneralInsi-urance 1_146 - _13,758_ $13,758 1082 (Centralized fiscal service.05 $198,174 r fi 1083 $0 !FINANCIAL SERVICES TOTAL $563,124 REVISED EXHIBIT B Page 24 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc Budget_- July 1,2016 through June 30,2017(12 months) SPECIAL EXPENSES Consultant/Etc. : 1087 ;Professional Fees_&-Consultation 46,938 ! 563,257 ! $563,257 1088 _ Contract Therapist _-__ 2,873_ 34,480 r $34,480 i --- - 1089 S�lzplies/House-Meds 948 I 11,371 ! $11,371 1090 Supplies Medical 585 7,026 $7,026 1091 ;Supplies Non-Medical 4,965 59,584; $59,584 1092 Medical Records Supplies 57_ _ f 85 $685 1093 Food 1- _- 4,307 51,690 $51,690 1094 rSupplies Non Perishables _ 152 } 1,824, $1,824 --- -- 1095 Laundry8 Linen _ _ _ 1,238 14,859 i __$14,859 1096 Allowance 649 7,785_I $7,785 1097 Clothing 1339 1 _- ____ -- �___-- 20,869 $20,869 1098_ _1LegalFees_ _ 432 '_ 5,190 $5,190 1099 Employee Benefits Other 265 3,182 $3,182 SPECIAL EXPENSES TOTAL $781,802 FIXED ASSETS: 2000-__ Furniture Replacement _ _ 833 10,000 --__ $10,000 - - } -- - + 'Furniture 2001 IT Minor Equipment _255_L _ - 3,060 ___ __ i_ -____ $3,060 Assets(Useful life more than t year and valued at more than$5.000)_ - 1 $0 I 2002 Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,00C! $0 FIXED ASSETS TOTAL $13,060 TOTAL PROGRAM EXPENSES $4,161,818 i - - Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. IMental Health Services 3000 _41ndividual/Family/Group_Therapy) $0 3100 [Case Management $0 3200 Crisis Services $0 3300 -_� Moriiratinn Sirnnnrt $0 3400 _ ' 'Crisis Stabilization-Urgent Care_ $0 3500 Psychiatric Health Facility 4,931 $844,00 $4,161,818 3600 other $0 3700 other $0 DIRECT SERVICE REVENUE TOTAL 4,931 $4,161,818 Medi-cal Revenue $3,745,636 Cost Per Unit i $_844,_0.0 FUNDNG STREAMS REIMBURSEMENT 4000 Private Insurance 8%L +_ _____ 332,945_ - - -- - 4100 Uninsured 2%_ _ _ _ 83,237 M al FFP 9 4200 , edi-00/o 818 r -- - i 1,872, 4300 12011 Realignment 90% 1,872,818 OTHER REVENUE TOTAL $4,161,818 TOTAL PROGRAM REVENUEJ $4,161,818 REVISED EXHIBIT B Page 25 of 45 FRESNO PHF Budget Narrative FY 15-16 ITEM Budget Narrative SALARIES: RN-DON The Director of Nursing assumes authority,responsibility,and accountability for the delivery of nursing services in the facility.In collaboration with facility Administration,allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical, mental, and psychosocial well-being.Collaborates with medical professionals,consultants,and organizations, including government agencies and advocacy groups,to develop,support and coordinate patient care,related administrative functions,and to represent the interests of the facility. Monthly salary of$8,838 x 12. RN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication, and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 3.2 FTE of$22,683 x12. LVN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 2.8 FTE of$10,826 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups. Monthly salary for 1.4 FTE of$5,413 x12. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks.Monthly salary for 3 FTE of$7,435x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches(encouraging and motivating patients) • teachers(modeling behaviors,monitoring patients,and providing feedback) • counselors(being a good listener,intervening with problem behaviors) • house-parents(assigning and monitoring chores,always knowing where patients are) • limit-setters(enforcing the rules fairly;using discipline to teach patients) Monthly salary for 16.8 FTE of$44,511 x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans, lead admission and discharges planning process; conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$5,155 x12. FAMILY ADVOCATE Family Advocates provide outreach, advocacy, training and support for patients'family members throughout all stages of the patient's treatment, transition,and aftercare.For example, Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $2,974 x12. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$15,208 x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising,managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties.Monthly salary of$5,524 x12. COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$5,208 x 12 REVISED EXHIBIT B Page 26 of 45 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances);and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$13,001 x12. UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements,management and control of forms,thinning charts, auditing, monitoring,tracking,and securing medical records, maintaining active and closed charts organization,assisting in acquiring necessary documents from charts when authorized,and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal,Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data.Monthly salary of$5,070x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS,standard reporting of HR information,duplicating,sorting and typing. At the direction of the HR Coordinator,maintains employment processing and tracking of employment documents,processes personnel documents,conducts benefits administration,processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,790 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying,researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions,tracking reports,and filing duties required by the Business Office. Monthly salary of$2,025 x12. MAINTENANCE TECH This hands-on position supervises,and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHF to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor,as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22,OSHA,and Fire Marshall physical plant regulations, making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,416 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Monthly salary for 1.5 FTE of$2,654 x12. We offer a comprehinsive benefit package which covers medical,dental,vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all liklihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%,the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead,we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax, 1.45%ER MediCare Tax,State Unemployment Insurance is.54%of salaries,FUTA Taxes is .96%of salaries PENSION EXPENSE 3.25%of total salaries. Employees become eligible after six months 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. HEALTH INSURANCE Average cost of$430 for Health,Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. REVISED EXHIBIT B Page 27 of 45 FACILITIES/EQUIPMENT EXPENSES: OFFSITE LEASE-ADMI N/BUSI NESS OFFICE (Lease offsite space for administrative staff based on current market rate in Fresno. LEASED EQUIPMENT (Base copier charqes and usaqe fees based on historical cost. TELECOMMUNICATIONS I Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. UTILITIES (Electricity,Water,Gas,Trash based on amount provided in RFP MAINTENANCE IBuilding maintenance and repairs based on amount provided in RFP OPERATING EXPENSES: I PURCHASED SERVICES _ (ADP Payroll Services, Shredding,Cable,Medical Waste Service,Wifi,EM_ R Maintenance Cost,Safety Training based on historical cost. OFFICE SUPPLIES Paper,Printer Supplies,Envelopes,Pens,Etc based on historical cost. HOUSEKEEPING SUPPLIES I Household and cleaning supplies based on historical cost. EDUCATION&TRAINING lOngoing Required Training For Staff based on historical cost. LICENSES I Business license,OSHPD fee based on historical cost. RECRUITMENT (Advertising/Classified/Background Checks/Physical Exams Etc based on historical cost TRAVEL I Staff milege&travel reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost FINANCIAL SERVICES EXPENSES: CENTRALIZED SERVICES This is an allocation from Stars Behavioral Health Group of administration,management services,financial services and office support.9%of total cost based on historical cost. GENERAL INSURANCE Property And Professional Liability Insurance based on historical cost. SPECIAL EXPENSES: PROFESSIONAL FEES Medical Director Primary Phvsician Psychiatrists See salaries section). Good&Fowler audit fees based on historical cost. I MEDICAL/CLINICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team,peer review and interdepartmental consultation. Monthly salary of$16,550 x 12. PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate,diagnose,and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. monthly salary of$21,920 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$7,356 x 12. CONTRACT THERAPIST 3 Contracted Primary Therapists based on historical cost. I SUPPLIES-HOUSE MEDS Pharmacy charges for house medication(Aspirin,Tylenol)over the counter supplies based on historical cost. SUPPLIES-MEDICAL Pharmacy charges for non-covered medications based on historical cost. I SUPPLIES NON-MEDICAL Supplies for client's grooming hvgiene and livinq skills based on historical cost. I MEDICAL RECORD SUPPLIES Medical Records,Charts,Forms And Copyinq based on historical cost. FOOD Groceries to be prepared by Cook for the clients based on historical cost. SUPPLIES NON PERISHABLE Pa er oods and utensils based on historical cost I LAUNDRY&LINEN Towels,sheets,blankets,laundry service based on historical cost. I ALLOWANCE Weekly money distributed to clients based upon points&level based on historical cost CLOTHING Monthly amount disbursed for client's clothing per contract based on historical cost LEGAL FEES Attornev Fees based on historical cost. I EMPLOYEE BENEFITS Safety Bingo,Gift Cards,Perfect Attendance,Employee of the Month,Holiday Party,Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. FIXED ASSETS: I FURNITURE REPLACEMENT Cost to replace damaged furnitures based on historical cost. I IT MINOR EQUIPMENT Minor equipment with a value less than$5000 each.Includes;computers,hardware and software based on historical cost. I REVENUES: I MEDI-CAL REVENUE Daily Rate x 365 x 13.5 x 90% I PRIVATE INSURANCE REVENUE Daily Rate x 365 x 13.5 x 8% I UNINSURED REVENUE Daily Rate x 365 x 13.5 x 2% I REVISED EXHIBIT B Page 28 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) - Central Star Behavioral Health,Inc. Budget-Jul 1,2017t-_g y - hrough June 30,2018 r - 'Page 1 of 3 Budget Categories - _� Total Proposed Budget Line Item Description(Must be itemized) FTE% Admin. Direct Total PERSONNEL SALARIES: r 0001 'RN-DON 1.00 $109,227 $109,227 0002 RN 3.20 $280,336 $280,336 0003 LVN 2.80 $133,819 $133,819 0004 Rehab Therapist 1.40 $66,909 $66,909 0005 Rehab Aide 3._0.0 _ __-_ _$91,895 _ $91.895 0006 - Youth Counselor _ 1 16.80 - $550,290 $550,290 I 0007 IAdmissions Coordinator 1.00 $63,709 $63,709 0008 Family Advocate 1.00 _-__-$36,745 _- ..$36,745 0009 Social Workers 2.80 $187,995 $187,99 0010 -'Program Director 1.00 $68,278 $68,278 0011 -_Kook 2.1 C $64,372 $64,372 0012 (Administrator 1.00 $160,686 $160,686 0013_ - - ItUR/QA/Medical Records _ 1.00 - -_--$62,650 $62,650 0014 HR/Training/Admin Asst i 1 00 $71,553 _$71,553 0015 Billing Clerk 1,00 $25,033 $25,033 0016 Maintenance Tech 0.50 $17,504 $17,504 0017 iHousekeeper 1.50 $32,820 $32,820 SALARY TOTAL 42.10 $370,245 $1,653,574 $2,023,820 PAYROLL TAXES: 0030 FICA/MEDICARE $28,324 $126,498 $154,822 0031_ ,SUI $1,999 $8,928 -_- $10,927 0032 1FUTA $3,480 $15,544 $19,024 PAYROLL TAX TOTAL $33,803 $150,970 $184,773 EMPLOYEE BENEFITS: 0040 Retirement $13,107 $58,537 $71,643 0041 (Workers Compensation $18,364 $82,017 $100,381 0042 Health Insurance(medical vision,life,dental) $42,393 $189,334 $231,727 EMPLOYEE BENEFITS TOTAL $73,864 $329,888 $403,752 SALARY&BENEFITS GRAND TOTAL 1 $2,612,344 REVISED EXHIBIT B Page 29 of 45 -Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc. Budget-July 1,2017 through June 30,2018 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease-Admin/Business Office 1,592 19,107 $19,107 1011 Leased Equipment 1,253 15,032 i $15,032 - - 1012 (Telecommunications 3,401 1 __ 40,808 _ _ $40,808 1013 Utilities __ _ _- - 7,316 ____ 87,798 $87,798 --i --} - - 1014 Maintenance 2,062 24,749 $24,749 1015 Security-Access Control System& Cameras $0 1016 $0 1017 $0 1018 $0 FACILITY/EQUIPMENT TOTAL 187,493 $187,493 OPERATING EXPENSES: 1060 +Purchased Services 3,426 41,111 $4.12111 1061 Office Supplies -_ __- -, 11852_ - -- 22,228 $22,228 1062 !Housekeeping Supplies_ 552 i 6,622 $6,622 1063 jEducation 8_Traning_ _ 552 6,622 _$6622 1064 Licenses 487 5,838 $5,838 1065 Recruiting 44 } 530 $530 1066_ ,Travel 216 -- i-- -- -- I --- - _ � ', 2,595.i--- -$2,595 1. 1067 $0 ;OPERATING EXPENSES TOTAL 85,546 0 $85,546 FINANCIAL SERVICES EXPENSES: ---- - 1080 Centralized Services 30,100 -- - - $361,200 361,200 i 1081 iGeneral Insurance 1,169 14,027 $14,027 1082 Centralized fiscal service.05 $203,844 1083 SO FINANCIAL SERVICES TOTAL 375,227 r $579,071 REVISED EXHIBIT B Page 30 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Central Star Behavioral Health,Inc. Budget_-July 1,2017 through June 30,2018 SPECIAL EXPENSES(Consultant/Etc.): Page 3 of 3 1087 Professional_Fees-&Consultation 48,_335_ 1 -- 580,019 $580,019 1088 Contract Therapist 2,930 35,166 $35,166 r- - - - - -- -- - - - - - i ---- --- - -- 1089 Supplies/House Meds 967 11,604 -$11,604 1090 'Supplies Medical_ 597 ! _- _7,160 $7,160 1091 Supplies Non-Medical I 5,064 � l 60,772_` $60,772 1092 Medical Records Supplies _ 58 698 $698 PP - 1093 !Food 4,393+ - _ --_-52,718 $52,718 --PP -- -- - - - - --f - - $1,860 1094 Su lies Non Perishables 155 1,860 i - - - -1095 Laundry&Linen 1--il ,263-I 15,1.53 1-- -' _ + _ $15,153 1096 Allowance 662I 7,944 ---- - $7,944 --- - - - - -- -'-- --, -- t 1097 Clothing _ 1,774 21285 _ $21,285 I 1098 Legal Fees _ 441_r_ - ___ 5,288 }- $5,288 1099 Employee Benefits Other 270 3,244 $3,244 SPECIAL EXPENSES TOTAL 0 $802,9091 $802,909 FIXED ASSETS: 2-0 0-0 jFurniture Replacement 33 10,0- 00 _ _ $10,000 l 2001 IT Minor Equipment- _- -_ _ _260 i 3,121_ __- ; - _ _ $3,121 ,Assets(Useful life more than 1 year and valued at more than$5,000) $0 2002 iIntangible Software/License Assets(Useful life more than 1 year and valued at more than$100,C $0 FIXED ASSETS TOTAL 13,121 0 $13,121 TOTAL PROGRAM EXPENSES $4,280,486 Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. Mental Health Services 3000 (Individual/Family/Group Therapy) $0 3100 Case-Management $0 3200 _ Crisis Services $0 3300 Medication Support $0 -- - - - 3400- Crisis Stabilization-Urgent Care $0 3500__--_ Psychiatric Health Facility 5,840_ $732.96_ $4,280,486 36II0 -- jother $0 3700 other $0 DIRECT SERVICE REVENUE TOTAL 5,840 $4,280,486 ;Medi-cal Revenue $3,852,438 16'Cost Per Unit 7.3.2_.96 FUNDNG STREAMS REIMBURSEMENT _ 8% ---_;_ _ 342,439 4200 Uninsured _ }_ ° I 85,609 Private Insurance 4100 ---- - 2/o+ Medi-Cal FFP_- - -_ _ 90°%% _- -_ _ 1,926,219 4300 2011 Reali nment 90%, 1,926,219 OTHER REVENUE TOTAL $4,280,486 TO TAL PROGRAM REVENUE $4,280,486 REVISED EXHIBIT B Page 31 of 45 FRESNO PHF Budget Narrative FY 17-18 ITEM Budget Narrative SALARIES: RN-DON The Director of Nursing assumes authority,responsibility,and accountability for the delivery of nursing services in the facility. In collaboration with facility Administration,allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical,mental,and psychosocial well-being.Collaborates with medical professionals,consultants,and organizations,including government agencies and advocacy groups,to develop,support and coordinate patient care, related administrative functions,and to represent the interests of the facility. Monthly salary of$9,102 x 12, RN Nurses,have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments, dispensing of medication, and monitoring of side effects.Nurses are also coaches, teachers, counselors,and limit-setters to patients. Monthly salary for 3.2 FTE of$23,361 x12. LVN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments, dispensing of medication, and monitoring of side effects.Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 2.8 FTE of$11,152 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups. Monthly salary for 1.4 FTE of$5,576 x12. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks.Monthly salary for 3 FTE of$7,658 x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches(encouraging and motivating patients) • teachers(modeling behaviors,monitoring patients,and providing feedback) • counselors(being a good listener,intervening with problem behaviors) • house-parents(assigning and monitoring chores,always knowing where patients are) • limit-setters(enforcing the rules fairly;using discipline to teach patients) Monthly salary for 16.8 FTE of$45,857 x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans; lead admission and discharges planning process;conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$5,309 x12. FAMILY ADVOCATE Family Advocates provide outreach,advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition,and aftercare.For example, Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $3,062 x12. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$15,666 x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising, managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff.Functions as a key management team member in all administrative and program duties.Monthly salary of$5,690 x12. COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards, guidelines and regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$5,364 x 12 REVISED EXHIBIT B Page 32 of 45 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances);and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$13,390 x12. UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements, management and control of forms,thinning charts,auditing, monitoring,tracking,and securing medical records,maintaining active and closed charts organization,assisting in acquiring necessary documents from charts when authorized,and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal,Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data.Monthly salary of$5,221x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS,standard reporting of HR information,duplicating,sorting and typing. At the direction of the HR Coordinator,maintains employment processing and tracking of employment documents,processes personnel documents,conducts benefits administration,processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,963 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying,researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions,tracking reports,and filing duties required by the Business Office. Monthly salary of$2,086 x12. MAINTENANCE TECH This hands-on position supervises,and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHF to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor,as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22,OSHA,and Fire Marshall physical plant regulations,making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,459 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Monthly salary for 1.5 FTE of$2,735 x12. We offer a comprehinsive benefit package which covers medical,dental,vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all liklihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%,the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead,we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax,1.45%ER MediCare Tax,State Unemployment Insurance is.54%of salaries,FUTA Taxes is .96%of salaries PENSION EXPENSE 3.25%of total salaries. Employees become eligible after six months 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. HEALTH INSURANCE Average cost of$430 for Health,Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. REVISED EXHIBIT B Page 33 of 45 FACILITIES/EQUIPMENT EXPENSES: OFFSITE LEASE-ADMIN/BUSINESS OFFICE (Lease offsite space for administrative staff based on current market rate in Fresno. LEASED EQUIPMENT (Base copier charges and usage fees based on historical cost. TELECOMMUNICATIONS (Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. UTILITIES IElectricity,Water Gas,Trash based on amount provided in RFP MAINTENANCE IBuildinq maintenance and repairs based on amount provided in RFP OPERATING EXPENSES: I PURCHASED SERVICES (ADP Payroll Services,Shredding,Cable,Medical Waste Service,Wifi,EMIR Maintenance Cost,Safety Traininq based on historical cost. OFFICE SUPPLIES I Paper,Printer Supplies, Envelopes,Pens,Etc based on historical cost. HOUSEKEEPING SUPPLIES (Household and cleaninq supplies based on historical cost. EDUCATION&TRAINING IOngoinq Required Traininq For Staff based on historical cost. LICENSES IBusiness license,OSHPD fee based on historical cost. RECRUITMENT IAdvertisinq/Classified/Background Checks/Physical Exams Etc based on historical cost TRAVEL Staff mile e&travel reimbursement(mainly administrator,clinical director&admission coordinator based on historical cost FINANCIAL SERVICES EXPENSES: CENTRALIZED SERVICES This is an allocation from Stars Behavioral Health Group of administration,management services,financial services and office support.9%of total cost based on historical cost. GENERAL INSURANCE IPropertyAnd Professional Liability Insurance based on historical cost. SPECIAL EXPENSES: I PROFESSIONAL FEES (Medical Director, Primary Physician,Psychiatrists(See salaries section). Good&Fowler audit fees based on historical cost. MEDICAUCLINICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team,peer review and interdepartmental consultation. Monthly salary of$17,047 x 12. PSYCHIATRIST-CONTRACTOR (Psychiatrists evaluate,diagnose,and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. monthly salary of$22,577 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$7,576 x 12. CONTRACT THERAPIST 13 Contracted Primary Therapists based on historical cost. SUPPLIES-HOUSE MEDS I Pharmacv charges for house medication(Aspirin,Tylenol)over the counter supplies based on historical cost. SUPPLIES-MEDICAL I Pharmacy charges for non-covered medications based on historical cost. SUPPLIES NON-MEDICAL I Supplies for client's qroominq,hvgiene and living skills based on historical cost. MEDICAL RECORD SUPPLIES I Medical Records,Charts, Forms And Cop inq based on historical cost. FOOD (Groceries to be prepared by Cook for the clients based on historical cost. SUPPLIES(NON PERISHABLE) IPaper goods and utensils based on historical cost LAUNDRY&LINEN (Towels,sheets,blankets, laundry service based on historical cost. ALLOWANCE I Weekly money distributed to clients based upon points&level based on historical cost CLOTHING IMonthly amount disbursed for client's clothing per contract based on historical cost LEGAL FEES (Attorney Fees based on historical cost. EMPLOYEE BENEFITS Safety Bingo, Gift Cards, Perfect Attendance,Employee of the Month,Holiday Party,Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. FIXED ASSETS: I I FURNITURE REPLACEMENT ICost to replace damaqed fumitures based on historical cost. IT MINOR EQUIPMENT I Minor equipment with a value less than$5000 each.Includes;computers,hardware and software based on historical cost. REVENUES: MEDI-CAL REVENUE Daily Rate x 365 x 16 x 90% PRIVATE INSURANCE REVENUE Daily Rate x 365 x 16 x 8% UNINSURED REVENUE Daily Rate x 365 x 16 x 2% REVISED EXHIBIT B Page 34 of 45 Child-Adolescent Psychiatric Health Facility(16 bed)_ Central Star Behavioral Health,Inc. Budget-July 1,2018 through June 30,2019 Bud et Categories-_ _ Total Proposed Budget - - - - -- -- - - - o Line Item Description Must be itemized FTE /o Admin. Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $112,509 $1.12,509 0002 RN - 3.20 _- -$288,779 $288,779 0003 'LVN L 2.80 $137,663 $137,663 0004 Rehab Therapist 1.40 -_ _ $68,921 $68,921 0005 - _j Rehab Aide 3.00 $94,662 $94,662 0006 Youth Counselor _i 16.80 $566,867 $566,867 0007 Admissions Coordinator 1.00 $65,618 $65,618 0008 -- Family Advocate 1.00 $37,839 $37,839 0009-- Social Workers 2.80 $193,640 $193,640 0010 Program Director 1.00 $70,316 $70,316 0011 Cook 2.10 $66,309 $66,309 0012- Administrator 1.00 $165,359 $165,359 0013 _BUR/QA/Medical Records 1.00 $64,540 $64,540 0014 'HR/Training/Admin Asst 1.00 $73,690 $73,690 0015- fBilling Clerk 1.00 $25,784 $25,784 0016 Maintenance Tech 0.50 $18,029 $18.029 0017 i Housekeeper 1.50 $33,817 $33.817 SALARY TOTAL 37.10 $381,220 $1,703,123 $2,084,343 PAYROLL TAXES: - - -- - 0030 FICA/MEDICARE_ - $29,163 $130,289 $159,452 - -- 0031 _--tSUI -- - - -- - -- -- - $2,058 - $9,195 $11,253 0032 IFUTA $3,583 $16,009 $19,593 PAYROLL TAX TOTAL $34,805 $155,493 $190,298 E MPLOYEE BENEFITS: 0040 - Retirement $13,495 $60,291 $73,786 0041 Workers Compensation $18,909 $84,475 $103,383 0042 Health Insurance(medical vision,life,dental) $43,650 $195,008 $238,657 EMPLOYEE BENEFITS TOTAL $76,053 $339,773 $415,826 SALARY&BENEFITS GRAND TOTAL $2,690,468 REVISED EXHIBIT B Page 35 of 45 _ Child-Adolescent Psychiatric Health Facility(16 bed)_ Central Star Behavioral Health,Inc. Budget-July 1,2018 through June 30,2019 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease-Adman/Business Office 1,624 $19,486 ' 19,486 1011 Leased Equipment 1,278 15,332 $15,332 1.012- Telecommunications 3,468 41,616 $41,616 1013_ 'Utilities -_I _ 7,462 89,548_ $89,548 --- ,Maintenance 2,104 25,251 $25,251 - - - - - 1015 -- -+ - - -- f- - $0 1016 - - $0 1017 $0 1018 $0 FACILITY/EQUIPMENT TOTAL $191,233 OPERATING EXPENSES: 1060 Purchased Services - _3,490__ -4 1684 $41,884 1061 _(Office Supplies - _ _--_- _ 1189+_____ 22,668 $22,668 1062_ 1Housekeeping Supplies i 563 6,756 $6,756 1063 Education&Training 563 I 6,756 $6,756 1064 Licenses 497 5,961 $5,961 1065 Recruiting 45 541 $541 1066 -_ Travel 220_r 2,644 t $2,644 1067 $0 1068_ $0 1069 � �- -- -- t 1070_---; -- --I - } $0 1071 - a - $0 1072 l --$0 t 1073 - $0 1074 $0 --T --- - - - --- ---- - -- $0 1075 � 1076 -- - - - - _ - - - - - - _$0 1077 $0 OPERATING EXPENSES TOTAL $87,211 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services 30,955 371,460 $371,460 1081 General Insurance 1,192 14,309 $14,309 1082 Centralized fiscal service.05 $209,63 1083 $0 FINANCIAL SERVICES TOTAL $595,401 REVISED EXHIBIT B Page 36 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) _ Central Star Behavioral Health,Inc. Budget-July 1,2018 through June 30,2019 _ SPECIAL EXPENSES(ConsultanVEtc.): 1087 Professional Fees 8 Consultation 49,774 i 597,292 $597,292 1088 Contract Therapist 2,989 35,863 I $35,863 1089 Supplies/House Meds 986 11,836- $11,836 1090 Supplies Medical 609 -- 7,307 $7,307 1091 Supplies Non-Medical 5,165 ! 61,983 $61,983 1 - - 1092 'Medical Records Supplies 59 i + 710 $710 1093 Food 4,481 53,770 1 -_ $53,770 - - -- - - - - ---- + 1094 ^- Supplies Non Perishables158 1,897 '� $1,,897 1095 Laundry Linen 1,288 15,459.1 $15,459 1096 Allowance 675 $8,103 _ 8,10.3 1097 ;Clothing 1,809 1 + _ -21,714 j $21,714 1098 Legal Fees 450 5,398 $5,398 1099 'Employee Benefits Other 275 3,305 $3,305 SPECIAL EXPENSES TOTAL i $824,638 FIXED ASSETS: - 2000 Furniture Replacement 833 10,000 $10,000 2001 IT Minor Equipment _ _ 265 _3,183t_ ---_-_ $3,183 Assets(Useful life more than 1 year and valued at more than$5,000) $0 2002 Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,C $0 FIXED ASSETS TOTAL 1 $13,183 TOTAL PROGRAM EXPENSES $4,402,134 Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. Mental Health Services 3000 - (Individual/Family/Group Therapy) __ $0 3100 Case Management _ $0 3200 Crisis Services $0 3300 ;Medication Support__ 3400 I +Crisis Stabilization-Urgent Care $0 3500 ;Psychiatric Health Facility 5,84.0 _ __$753.79 $4,402,134 - - 3600 other $0 - - - -- 3700 other - - $6 DIRECT SERVICE REVENUE TOTAL 5,8401 1 $4,402,134 Medi-cal Revenue _ i $3,961,920 161Cost Per Unit 7 753.79 FUNDNG STREAMS REIMBURSEMENT 4000 Private In seance 8% $352,171 - 4100 Uninsured 2%1 $88;043 --- - 4200 ;Medi-Cal FFP 90% j $1,980,960 - - . - -- 4300 j2011 Realignment 90%, $1,980,960 OTHER REVENUE TOTAL $4,402,134 TOTAL PROGRAM REVENUEJ $4,402,134 REVISED EXHIBIT B Page 37 of 45 FRESNO PHF Budget Narrative FY 15-19 ITEM Budget Narrative SALARIES: RN-DON The Director of Nursing assumes authority,responsibility,and accountability for the delivery of nursing services in the facility.In collaboration with facility Administration, allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical, mental,and psychosocial well-being.Collaborates with medical professionals,consultants,and organizations,including government agencies and advocacy groups,to develop, support and coordinate patient care, related administrative functions, and to represent the interests of the facility. Monthly salary of$9,376x 12. RN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments, dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 3.2 FTE of$24,065 x12. LVN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects.Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 2.8 FTE of$11,472 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups.Monthly salary for 1.4 FTE of$5,743 x12. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks.Monthly salary for 3 FTE of$7,889 x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches(encouraging and motivating patients) • teachers(modeling behaviors,monitoring patients, and providing feedback) • counselors(being a good listener, intervening with problem behaviors) • house-parents(assigning and monitoring chores,always knowing where patients are) • limit-setters(enforcing the rules fairly;using discipline to teach patients) Monthly salary for 16.8 FTE of$47,239 x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans; lead admission and discharges planning process;conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$5,468 x12. FAMILY ADVOCATE Family Advocates provide outreach,advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition, and aftercare. For example, Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $3,153 x12. SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$16,137 x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising,managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical &support staff. Functions as a key management team member in all administrative and program duties. Monthly salary of$5,860 x12. COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and I regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$5,526 x 12 REVISED EXHIBIT B Page 38 of 45 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances);and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$13,780 x12. UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements, management and control of forms,thinning charts,auditing, monitoring,tracking,and securing medical records,maintaining active and closed charts organization,assisting in acquiring necessary documents from charts when authorized,and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal,Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data.Monthly salary of$5,378x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS, standard reporting of HR information,duplicating,sorting and typing. At the direction of the HR Coordinator,maintains employment processing and tracking of employment documents,processes personnel documents,conducts benefits administration,processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $6,141 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying,researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions, tracking reports,and filing duties required by the Business Office. Monthly salary of$2,149 x12. MAINTENANCE TECH This hands-on position supervises,and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHF to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor,as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22,OSHA,and Fire Marshall physical plant regulations, making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,502 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean, orderly, sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Monthly salary for 1.5 FTE of$2,818 x12. We offer a comprehinsive benefit package which covers medical,dental,vision and pension in addition to the required payroll taxes and workers comp insurance. The total cost of all of these components is equal to 29.9%of wages which is over the 20%county limit but it was not made clear what was included in the county limit. In all liklihood,workers comp was not included by the county. Without the workers comp our benefits %is 24.9%. In order to reach 20%,the only realistic option for us would be to eliminate our pension benefit which is an important part of our EMPLOYEE BENEFITS ESOP culture. Instead,we ask the county for a waiver on this point. PAYROLL TAX 6.2% ER Social Security Tax, 1.45%ER MediCare Tax,State Unemployment Insurance is.54%of salaries,FUTA Taxes is .96%of salaries PENSION EXPENSE 3.25%of total salaries. Employees become eligible after six months 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. HEALTH INSURANCE Average cost of$430 for Health,Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. REVISED EXHIBIT B Page 39 of 45 FACILITIES/EQUIPMENT EXPENSES: OFFSITE LEASE-ADMI N/BUSI NESS OFFICE Lease offsite space for administrative staff based on current market rate in Fresno. LEASED EQUIPMENT Base copier charges and usage fees based on historical cost. TELECOMMUNICATIONS Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. UTILITIES Electricity,Water,Gas,Trash based on amount provided in RFP MAINTENANCE Building maintenance and repairs based on amount provided in RFP OPERATING EXPENSES: PURCHASED SERVICES ADP Payroll Services,Shredding,Cable,Medical Waste Service,Wifi, EMIR Maintenance Cost,Safety Training based on historical cost. OFFICE SUPPLIES Paper,Printer Supplies,Envelopes,Pens,Etc based on historical cost. HOUSEKEEPING SUPPLIES Household and cleaning supplies based on historical cost. EDUCATION&TRAINING Ongoing Required Training For Staff based on historical cost. LICENSES Business license,OSHPD fee based on historical cost. RECRUITMENT Advertising/Classified/Background Checks/Physical Exams Etc based on historical cost TRAVEL Staff milege&travel reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost FINANCIAL SERVICES EXPENSES: CENTRALIZED SERVICES This is an allocation from Stars Behavioral Health Group of administration,management services,financial services and office support.9%of total cost based on historical cost. GENERAL INSURANCE Property And Professional Liability Insurance based on historical cost. SPECIAL EXPENSES: PROFESSIONAL FEES Medical Director,Primary Physician,Psychiatrists(See salaries section). Good&Fowler audit fees based on historical cost. MEDICAUCL/NICAL DIRECTOR-CONTRACTOR The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team,peer review and interdepartmental consultation. Monthly salary of$17,558 x 12. PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate,diagnose,and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. Monthly salary of$23,254 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$7,804 x 12. CONTRACT THERAPIST 3 Contracted Primary Therapists based on historical cost. SUPPLIES-HOUSE MEDS Pharmacy charges for house medication (Aspirin, Tylenol) over the counter supplies based on historical cost. SUPPLIES-MEDICAL Pharmacy charges for non-covered medications based on historical cost. SUPPLIES NON-MEDICAL Supplies for client's grooming,hygiene and living skills based on historical cost. MEDICAL RECORD SUPPLIES Medical Records,Charts,Forms And Copying based on historical cost. FOOD Groceries to be prepared by Cook for the clients based on historical cost. SUPPLIES(NON PERISHABLE) Paper goods and utensils based on historical cost LAUNDRY&LINEN Towels sheets,blankets laundry service based on historical cost. ALLOWANCE Weekly money distributed to clients based upon points&level based on historical cost CLOTHING Monthlv amount disbursed for client's clothing per contract based on historical cost LEGAL FEES Attornev Fees based on historical cost. EMPLOYEE BENEFITS Safety Bingo,Gift Cards,Perfect Attendance,Employee of the Month,Holiday Party,Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. FIXED ASSETS: FURNITURE REPLACEMENT Cost to replace damaged fumitures based on historical cost. IT MINOR EQUIPMENT Minor equipment with a value less than$5000 each.Includes;computers,hardware and software based on historical cost. REVENUES: MEDI-CAL REVENUE Daily Rate x 365 x 16 x 90% PRIVATE INSURANCE REVENUE I Daily Rate x 365 x 16 x 8% UNINSURED REVENUE I Daily Rate x 365 x 16 x 2% REVISED EXHIBIT B Page 40 of 45 Child-Adolescent-Psychiatric Health Facility(16 bed) -- Stars Behavioral Health Group Budget-July 1,2019 through June 30,2020 B Total Proposed Budget Budget Categories- --- _� Line Item Description(Must be itemized) FTE% Admin. Direct Total -PERSONNEL-- -SALARIES: - - 0001- _ _+RN-DON -I__- 1._00 $115,884 - $115,884 0002 _�RN- - _- -- - -__-_ 3.20 - $297,442 $297,442 0003 LVN- _ 2.80 $141,792 $141,792 0004 Rehab Therapist 1.40 $70,989 $70,989 0005 Rehab Aide 3.00 $97,502 $97,502 0006 Youth Counselor 16.80 $583,873 $583,873 0007 Admissions Coordinator - - 1.00 $67,587 $67,587 0008 Family_Advocate - 1.00 $38,974 $38,974 0009 Social Workers 2.80 $199,4 in $199,450 0010 - Pro ram irecto --__-_ 1.00 $72,425 $72,425 0011 ,Cook _- 2.10 $68,298 - $68,298 001_2 Administrator _ too $170,320- $1,70,320 0013 UR/QA/Medical Records 1 - _1.00 - $66,476 0014 HR/fraining/Admin Asst _ 1.00 $75,901 $75,901 0015 Billing Clerk _ 1.00 $26,557 $26,557 001.6_ 'Maintenance Tech 0.50 ._ $18,570 - - -$18,570 0017 1Housekee er 1.50 $34,832 $34,832 SALARY TOTAL 37.10 $392,656 $1,754,216 $2,146,872 PAYROLL TAXES: 0030.- - 'FICA/MEDICARE $30,038 $134,198 $164,236 0031 SUI $2,120 $9,471 $11,591 0032 FUTA $3,691 $16,4901 $20,181 11 PAYROLL TAX TOTAL $35,849 $160,158 $196,007 EMPLOYEE BENEFITS: 0040 -.Retirement $13,900_ $62,099 $75,999 00041 Workers Compensation $19,476 $87,009 $106,485 0042 (Health Insurance medical vision,life,dental $44,959 $200,858 $245,817 'EMPLOYEE BENEFITS TOTAL $78,335 $349,966 $428,301 SALARY&BENEFITS GRAND TOTAL $2,771,180 REVISED EXHIBIT B Page 41 of 45 - Child-Adolescent Psychiatric Health Facility(16 bed) Stars Behavioral Health Group Bud aet-Jul v 1,2019 through June 30,2020 FACILITIES/EQUIPMENT EXPENSES: 1010. __Offsite Lease-Admin/Business Office 19,973 $19,973 1011 'Leased Equipment_ 15,715 $15,715 - r - 1012 Telecommunications 42,656 $42,656 1013 Utilities 91,787 $91,787 10141 __Maintenance 25,882 $25,882 1015 -- i -- -- - - - - ---- -..- $0 110116L - -1 I 1017 4 - f $0 1018 $0 FACILITY/EQUIPMENT TOTAL $196.013 OPERATING EXPENSES: 1060 Purchased Services 3,578 42,931 $42,931 1061 Office Supplies 1,936 23,235 $23,235 1.062 t p _ pp 1 6,925 Housekee in S_u lies- _ 577 $6,925 100.3 --i- --. - - -- -- 1- - - - -1 - Education 8 Tranin9 _ - -_ 577 '' 6, $6,925925 - __ 1064 _ - Licenses -_ --_ ___--_ 509 6,110 + - $6,110 - - _-- -- 1065 Recruitingt555 $555—_ 46I 1066 Travel_ 226 2,710 $2,710 1067- - -- - - - $0 1066 --� - $0 1069 ! -- +-- - $0 - - 1070 - 1 - Ir $0 -- -- -- - 1071 $0 1-072 $0 1073 - - - - _ $0 1074 $0 i 1075 $0 1076 $ 1077 $0 OPERATING EXPENSES TOTAL $89,391 FINANCIAL SERVICES EXPENSES: 1.080 Centralized_Services_ 32,898 394,781 $394,781 - - 1081- - !General Insurance 1,222: 14,667 $14,667 i 1082- Centralized fiscal service.05 $197,39 _7 1083 $ FINANCIAL SERVICES TOTAL $606,83 REVISED EXHIBIT B Page 42 of 45 Child-Adolescent Psychiatric Health Facility(16 bed) Stars Behavioral Health Group Budget-July 1,2019 through June 30,2020 SPECIAL EXPENSES(Consultant/Etc.): 1087 Professional Fees&Consultation 52,502 630,018 ; $630,018 p r $36,760 1088 Contract Thera ist 3,063 36,760_ 1089 1Supplies/House Meds 1,011 12,132 $12,132 1090 Splies Medical + 46 -- _ ___.$ 89 1091 +Supplies Non-Medical 5,294 _ 63 5,33 $63,533 -+- - 1092 Medical Records Supplies----,---- 61 726_ $728 1093 Food 4,593 55,114 $55_,114 - - + I -- - - $1-,94'_ 1094 Supplies Non Perishables 162 1,944 - I I 1095 'Laundry&Linen 1,320 _ - 15,845 {-_ _ $15,845 - t 1096 Allowance- - -- - -- - 6 92� - _8,306 $8 306 - - - - 257 - 1097 -__ 1,855 22 Clothln� I _ - $22,257 1098 Le al Fees 461 5,533 1 $5,533 1099 Employee Benefits Other 282 3,388 $3,388 'SPECIAL EXPENSES TOTAL $863 047 FIXED ASSETS: 2000 Furniture Replacement 854 { 10,250 $1.0_,250 2001 IT Minor Equipment 272 ! 3,262 , $3,262- Assets(Useful life more than 1 year and valued at more than$5,000) 2002 Intangible Software/License Assets(Useful life more than 1 year and valued at more than$100,C $0 FIXED ASSETS TOTAL $13,512 TOTAL PROGRAM EXPENSES $4,539,981 - - - Vol/Units of DIRECT SERVICE REVENUE AT CAPACITY: Svc Rate $Amt. Mental Health Services 3000 (Individual/Family/Group Therapy) $0 3100 Case Management $0 3200 - Crisis Services y_ - _ _ - ___ $0, 300 Medication Support $0 400 Crisis Stabilization-U%ent Care_ _ i _$0 3500 Ps chiatric Health Facility 5,856 $775.27 _ $4,539,981 3600 other -- - - - -_$0 3700 other $0 DIRECT SERVICE REVENUE TOTAL 5,856 $4 539 981 Medi-cal Revenue $4,085,983 16.04384 Cost Per Unit 775.27 FUNDNG STREAMS REIMBURSEMENT 4000 Private Insurance 8% $363,197 4100 Uninsured 2%; $90,800 4200 Medi-Cal FFP 90% $2,042,992 300 2011 Realignment $2,042,992 OTHER REVENUE TOTAL I $4,539,981 - TOTAL PROGRAM REVENUE $4,539,981 i 1 REVISED EXHIBIT B Page 43 of 45 FRESNO PHF Budget Narrative FY 19-20 ITEM Budget Narrative MEDI-CAL REVENUE Daily Rate x 366 x 16 x 90% PRIVATE INSURANCE REVENUE Daily Rate x 366 x 16 x 5% UNINSURED REVENUE Daily Rate x 366 x 16 x 5% MEDICAL/CLINICAL DIRECTOR-CONTRACT The contracted Medical Director is responsible for the overall coordination of medical and psychiatric care to ensure the adequacy and appropriateness as well as plan for the improvement of medical care at the facility. Provides written evaluations for treatment and legal purposes. Other activities include treatment team,peer review and interdepartmental consultation. Monthly salary of$15,600 x 12. PSYCHIATRIST-CONTRACTOR Psychiatrists evaluate,diagnose,and collaborate with other team members to treat our youngsters for different mental health disorders.Since they are physicians they have the ability to prescribe medication and are responsible for medication management and consultation when a patient needs a medical or neurological evaluation. monthly salary of$20,661 x 12. PRIMARY CARE PHYSICIAN-CONTRACTOR Primary Care Physicians evaluate,diagnose and provide treatment as needed for medical conditions. They prescribe medications as needed and make referrals to other health care professionals. monthly salary of$6933 x 12. RN-DON The Director of Nursing assumes authority,responsibility,and accountability for the delivery of nursing services in the facility.In collaboration with facility Administration,allocates department resources in an efficient and economic manner to enable each patient to attain or maintain the highest practical physical,mental,and psychosocial well-being. Collaborates with medical professionals, consultants, and organizations, including government agencies and advocacy groups,to develop,support and coordinate patient care,related administrative functions, and to represent the interests of the facility.Monthly salary of$8,330 x 12. RN Nurses,have the most direct relationships with patients.Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 3.2 FTE of$21,381 x12. LVN Nurses,have the most direct relationships with patients. Nurses are responsible for maintaining professional standards for medical management, including providing nursing assessments,dispensing of medication,and monitoring of side effects. Nurses are also coaches,teachers, counselors,and limit-setters to patients. Monthly salary for 2.8 FTE of$10,204 x12. REHAB THERAPIST The Rehab Therapist is responsible for planning and directing individual and group behavioral interventions. Rehab Therapists and Aides work with other team members to help the patient master problem behaviors.They are responsible for documenting patient behaviors in different situations. They are also responsible for establishing schedules and contents for groups and activities,for ensuring that the groups happen as scheduled, and for running treatment groups.Monthly salary for 1.4 FTE of$5,102 x12. REHAB AIDE Assists the Rehabilitation Therapist with clerical tasks,treatment setups and routine patient care tasks.Monthly salary for 3 FTE of$7,008 x12. YOUTH COUNSELOR Youth Counselors have direct relationships with patients. are: • coaches(encouraging and motivating patients) • teachers(modeling behaviors,monitoring patients,and providing feedback) • counselors(being a good listener,intervening with problem behaviors) • house-parents(assigning and monitoring chores,always knowing where patients are) • limit-setters(enforcing the rules fairly;using discipline to teach patients) Monthly salary for 16.8 FTE of$41,956 x12. ADMISSIONS COORDINATOR The Admission Coordinator is responsible for conducting initial assessment and collecting all documentation needed to develop treatment plans; lead admission and discharges planning process;conduct staff supervision as directed and provide back-up to Clinical Director as needed. Monthly salary of$4,859 x12. FAMILY ADVOCATE Family Advocates provide outreach,advocacy,training and support for patients'family members throughout all stages of the patient's treatment, transition,and aftercare.For example,Family Advocates can run support,educational and/or focus groups for family members. Monthly salary of $2,803 x12. REVISED EXHIBIT B Page 44 of 45 SOCIAL WORKERS The Social Worker provides casework services and psychotherapy to assigned patients and their families. Social Workers have the primary responsibility for treatment and discharge planning,and they must maintain a professional relationship with all referral sources. Social Workers also coordinate treatment services with other departments and outside agencies. Monthly salary for 2.8 FTE of$14,335 x12. PROGRAM DIRECTOR The Program Director has primary responsibility for supervising,managing and coordinating the oversight of programs.The Director has oversight responsibility for the Rehabilitation Specialist and Social Workers. He/she acts as liaison with external agencies and functions on teams with other clinical&support staff.Functions as a key management team member in all administrative and program duties.Monthly salary of$5,206 x12. DIET-COOK The Cook has primary responsibility for preparing food in accordance with current applicable federal,state,and local standards,guidelines and regulations,with our established policies and procedures. Monthly salary for 2.1 FTE of$4,909 x 12 ADMINISTRATOR The Administrator has primary responsibility for oversight of staffing and programs.The Administrator supervises the functions including:Training and Quality Assurance and Community Relations(including client and family grievances),and Admission/Discharge Activities. He/she acts as liaison with external agencies and functions on teams with other clinical and support staff. Monthly salary of$12,254 x12. UR/QA/MEDICAL RECORDS The Medical Records Clerk is responsible for all aspects of medical record management. This person will create charts,assure that all aspects of the record are in keeping with agency policy and Fresno County requirements, management and control of forms,thinning charts, auditing, monitoring,tracking,and securing medical records,maintaining active and closed charts organization,assisting in acquiring necessary documents from charts when authorized,and assists in preparing discharge packets.As a Quality Assurance coordinator,this person is responsible for coordinating auditing of documentation to reconcile with billing and oversees documentation of services by Community Services staff to assure conformity with MediCal, Fresno County,other outside agencies,and internal standards and policies. Position oversees the Continuous Quality Assurance program and records all CQI data.Monthly salary of$4,779 x 12 HR/TRAINING/ADMIN ASST The HR/Training Assistant performs a wide variety of Human Resources clerical and administrative tasks including personnel file maintenance, updating and maintenance of the HRIS,standard reporting of HR information,duplicating,sorting and typing. At the direction of the HR Coordinator, maintains employment processing and tracking of employment documents, processes personnel documents,conducts benefits administration,processes documentation for worker compensation,first aid,and other injury claims. Sorts,dates,and logs mail,and fill in as receptionist for the facility. Handling extensive personal and confidential information is an essential job function of this position. Monthly salary of $5,457 x12. BILLING CLERK The Billing Clerk assures accuracy of Mental Health Billings for all programs through reconciliation of billing summaries and excel reports versus county CDs and printouts. Assists in identifying,researching,and resubmitting denied claims. Provides review of Starbase reports for accuracy and interacts with IT to identify user and system errors.Assists in accounting functions, tracking reports,and filing duties required by the Business Office. Monthly salary of$1,909 x12. MAINTENANCE TECH This hands-on position supervises,and coordinates the maintenance of all the facilitiy and the housekeeping and laundry activities at Fresno PHF to ensure clean,safe and attractive facilities. This person coordinates remodeling and construction projects and obtains and supervises service contractor,as needed. This person accompanies the administrator on regular rounds of facilities and takes corrective action as needed and observes Title 22,OSHA,and Fire Marshall physical plant regulations,making necessary recommendations to the Administrator. Monthly salary for 0.5 FTE of$1,335 x12. HOUSEKEEPER The Housekeeper performs a variety of tasks to ensure that the facility is in a clean,orderly,sanitary and attractive condition.This person has the ability to interact and communicate both verbally and in writing with seriously emotionally disturbed adolescents,other staff and the public. Monthly salary for 1.5 FTE of$2,502 x12. REVISED EXHIBIT B Page 45 of 45 PAYROLL TAX 6.2% ER Social Security Tax, 1.45%ER MediCare Tax, State Unemployment Insurance 3.4%for first$7,000 HEALTH INSURANCE Average cost of$430 for Health,Dental and Vision Insurance based on historical cost. Employees become eligible after 90 days. WORKERS COMP 4.96%of total salaries. PENSION EXPENSE 4.10%of total salaries. Employees become eligible after six months 401 K ER CONTRIBUTION RATE 0.29%of total salaries. Employees become eligible after 90 days. PROFESSIONAL FEES Medical Director, Primary Physician,Psychiatrists See salaries section). Good&Fowler audit fees based on historical cost. PURCHASED SERVICES ADP Payroll Services Shredding Cable Medical Waste Service Wifi EMIR Maintenance Cost Safety Traininq based on historical cost. CONTRACT THERAPIST 3 Contracted Primary Therapists based on historical cost. SUPPLIES-HOUSE MEDS Pharmacy charqes for house medication(Aspirin,Tylenol)over the countersupplies based on historical cost. SUPPLIES-MEDICAL Pharmacy charges for non-covered medications based on historical cost. SUPPLIES NON-MEDICAL Supplies for client's grooming,hygiene and living skills based on historical cost. MEDICAL RECORD SUPPLIES Medical Records,Charts,Forms And Copying based on historical cost. OFFICE SUPPLIES Paper,Printer Supplies,Envelopes,Pens,Etc based on historical cost. HOUSEKEEPING SUPPLIES Household and cleaning supplies based on historical cost. FOOD Groceries to be prepared by Cook for the clients based on historical cost. SUPPLIES(NON PERISHABLE) Paper goods and utensils based on historical cost OFFSITE LEASE-ADM I N/BUSI NESS OFFICE Lease offsite space for administrative staff based on current market rate in Fresno. LAUNDRY&LINEN Towels,sheets,blankets,laundry service based on historical cost. LEASED EQUIPMENT Base copier charges and usage fees based on historical cost. IT MINOR EQUIPMENT Minor equipment with a value less than$5000 each.Includes;computers,hardware and software based on historical cost. ALLOWANCE Weekly money distributed to clients based upon points&level based on historical cost CLOTHING Monthly amount disbursed for client's clothing per contract based on historical cost CENTRALIZED SERVICES This is an allocation from Stars Behavioral Health Group of administration,management services,financial services and office support.9%of total cost based on historical cost. LEGAL FEES Attorney Fees based on historical cost. EDUCATION&TRAINING Ongoing Required Training For Staff based on historical cost. EMPLOYEE BENEFITS Safety Bingo,Gift Cards,Perfect Attendance,Employee of the Month,Holiday Party, Uniforms,Other(Starbucks Winner/Audit Reward)based on historical cost. LICENSES Business license,OSHPD fee based on historical cost. RECRUITMENT Advertising/Classified/Background Checks/Physical Exams Etc based on historical cost TELECOMMUNICATIONS Facility telephone expense and staff cell phone reimbursement(mainly administrator,clinical director&admission coordinator)based on historical cost and amount provided in the RFP. TRAVEL Staff mile e&travel reimbursement(mainly administrator,clinical director&admission coordinator based on historical cost GENERAL INSURANCE Property And Professional Liability Insurance based on historical cost. UTILITIES Electricity,Water,Gas,Trash based on amount provided in RFP MAINTENANCE IBuildinq maintenance and repairs based on amount provided in RFP FURNITURE REPLACEMENT lCost to replace damaged furnitures based on historical cost. SECURITY-ACCESS CONTROL SYSTEM Depreciation expense related to installed security features in the building based on($52,560/60mos x 12mos) CAMERA