HomeMy WebLinkAboutAgreement A-13-311-2 with Comprehensive Youth Services of Fresno Inc..pdf Agreement No. 13-311-2
1 AMENDMENT II TO AGREEMENT
2 THIS AMENDMENT, hereinafter referred to as Amendment Il, is made and entered into this
3 12th day of June , 2018, by and between COUNTY OF FRESNO, a Political Subdivision of
4 the State of California, hereinafter referred to as "COUNTY", and COMPREHENSIVE YOUTH
5 SERVICES OF FRESNO, INC., a California non-profit Corporation, whose business address is 4545 N.
6 West Avenue, Fresno, CA 93705, hereinafter referred to as "CONTRACTOR" (collectively the
7 "parties").
8 WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
9 No. 13-311, effective June 4, 2013, and COUNTY Amendment No. 13-311-1, effective July 11, 2017,
10 herein collectively referred to as COUNTY Agreement 13-311, whereby, CONTRACTOR agreed to
11 provide a Mental Health Services Act (MHSA) funded Functional Family Therapy (FFT) Program to
12 deliver Prevention and Early Intervention (PEI) mental health and community services to underserved
13 or unserved high risk youth ages primarily 11-18 with Serious Emotional Disturbance (SED), who
14 although not incarcerated, are involved with the juvenile justice system; and
15 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below and
16 restate the Agreement in its entirety.
17 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is
18 hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
19 1. That the existing COUNTY Agreement No. 13-311, Section Two (2) "TERM", shall be
20 revised by adding the following at Page Two (2), Line Twenty-Seven (27) after the word "2018":
21 "This Agreement shall be extended for an additional six (6) month period beginning July
22 1, 2018 through December 31, 2018."
23 2. That the existing COUNTY Agreement No. 13-311, beginning on Page Three (3), Line
24 Twenty-Three (23) with the word "The" and ending on Page Three (3), Line Twenty-Six (26) with the
25 word "Term" be deleted and the following inserted in its place:
26 "The maximum amounts to be paid to CONTRACTOR identified in this Agreement are
27 stated in Revised Exhibit A-1, attached hereto and incorporated herein to this Agreement. For the
28 period July 1, 2013 through June 30, 2014, the maximum amount of compensation for services
1
1 rendered under this Agreement shall not exceed One Million, Five Hundred Seventy-One Thousand,
2 Three Hundred Fifty-Three and No/100 Dollars ($1,571,353.00).
3 The maximum compensation under this Agreement for the period of July 1, 2014
4 through June 30, 2015, shall not exceed One Million, Five Hundred Seventy-One Thousand, Three
5 Hundred Fifty-Three and No/100 Dollars ($1,571,353.00).
6 The maximum compensation under this Agreement for the period of July 1, 2015
7 through June 30, 2016 shall not exceed One Million, Five Hundred Seventy-One Thousand, Three
8 Hundred Fifty-Three and No/100 Dollars ($1,571,353.00).
9 The maximum compensation under this Agreement for the period of July 1,
10 2016 through June 30, 2017 shall not exceed One Million, Five Hundred Seventy-One Thousand,
11 Three Hundred Fifty-Three and No/100 Dollars ($1,571,353.00).
12 The maximum compensation under this Agreement for the period of July 1,
13 2017 through June 30, 2018 shall not exceed One Million, Nine Hundred Seventy-Four Thousand, Nine
14 Hundred Seventeen and No/100 Dollars ($1,974,917.00).
15 The maximum compensation under this Agreement for the period of July 1,
16 2018 through December 31, 2018 shall not exceed Nine Hundred, Eighty-Seven Thousand, Four
17 Hundred Fifty-Eight and No/100 Dollars ($987,458.00).
18 The total maximum compensation to be paid by COUNTY to CONTRACTOR upon
19 execution through December 31, 2018 should not exceed Nine Million, Two Hundred Forty-Seven
20 Thousand, Seven Hundred Eighty-Seven and No/100 Dollars ($9,247,787.00)."
21 3. That, effective July 1, 2018, all references in existing COUNTY Agreement No. 13-311
22 to "Exhibit A," shall be changed to read "Revised Exhibit A-1," attached hereto and incorporated herein
23 by reference.
24 4. That, effective July 1, 2018, all references in existing COUNTY Agreement No. 13-311 to
25 "Exhibit B," shall be changed to read "Revised Exhibit B-1," attached hereto and incorporated herein by
26 reference.
27 5. COUNTY and CONTRACTOR agree that this Amendment II is sufficient
28 to amend the Agreement; and that upon execution of this Amendment 11, the Agreement, Amendment 1
2
1 and Amendment II together shall be considered the Agreement.
2 The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
3 covenants, conditions and promises contained in the Agreement and not amended herein shall remain in
4 full force and effect. This Amendment 11 shall become effective upon execution by all parties.
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1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment II to Agreement
2 No. 13-311 as of the day and year first hereinabove written.
3
4 CONTRACTOR: COUNTY OF FRESNO
5 COMPREH t4SIVE YOUTH SERVICES OF
FRESN -IDfC.
6
7 (A,ut rize Signature) Sal Quint o, 4airperson of the Board of
8 {— -- Supervisor he County of Fresno
laftRv�
9 Print Name
10 Title (Chairman of 8oard, or President, or ATTEST:
11 CEO) Bernice E. Seidel
Clerk of the Board of Supervisors
12 j County of Fresno, State of California
,On � I I
13 (Authorized Si natu ie)
By: r� bn
14 I��' _ ---- Deputy
Print Name
15 �tU
16 Title (Secret dry of Corporation, or Chief
17 Financial Officer/Treasurer, or any
Assistant Secretary or Treasurer)
18
19 i
MAILING ADDRESS:
20 4545 N. West Avenue
21 Fresno, CA 93705
(559) 229-3561
22 Becky Kramer, Executive Director
I
23
24 FOR ACCOUNTING USE ONLY:
25 Organization: 56304321
26 Fund/Subclass: 0001/10000
Account/Program: 7295/0
27
28
4
Revised Exhibit A-1
Page 1 of 7
MHSA Functional Family Therapy Services to Children/Youth
Scope of Work
ORGANIZATION: Comprehensive Youth Services of Fresno, Inc.
4545 N. West Ave.
Fresno, CA 93705
SERVICES: Functional Family Therapy (FFT) Services to Children & Families
CONTRACT PERIOD: July 1, 2013 — December 31, 2018
CONTRACT AMOUNT: July 1, 2013 —June 30, 2014 ($1,571,353)
July 1, 2014—June 30, 2015 ($1,571,353)
July 1, 2015 —June 30, 2016 ($1,571,353)
July 1, 2016 —June 30, 2017 ($1,571,353)
July 1, 2017 —June 30, 2018 ($1,974,917)
July 1, 2018 — December 31, 2018 ($987,458)
Maximum Compensation: $9,247,787
I. SCHEDULE OF SERVICES:
CONTRACTOR's staff shall be available to provide services to consumers 12 hours per day(8:00 am
to 8:00 pm), five (5) days per week (Monday— Friday).
II. TARGET POPULATION:
CONTRACTOR shall provide Mental Health Services Act (MHSA), Prevention and Early Intervention
(PEI), services (mental health and client support services) to youth, ages 11 — 18, with serious
emotional disturbance (SED) and their families as stated in COUNTY's RFP#952-5105 and
CONTRACTOR's response to RFP #952-5105. The target population shall include youth who are at-
risk of involvement, or are currently involved in the juvenile justice system, and have significant family
conflict. Additionally, services shall be provided to clients/families in rural/metro areas;
clients/families that have no or limited means of payment for services; clients/families who have
traditionally been reluctant to seek services from traditional mental health settings; and
clients/families who are in danger of homelessness, hospitalizations, out of home placements,
emergency room visits.
A minimum caseload consisting of 350 consumers shall be enrolled in this program throughout each
twelve (12) month period of this Agreement.
III. PROJECT DESCRIPTION:
FFT is a short-term, high quality intervention program with an average of 15 sessions, once a week
for 15 weeks, employing three phases of intervention: 1) engagement and motivation; 2) behavior
change; and 3) generalizations. Services are conducted in both clinic and home settings, and can
also be provided in a variety of settings including schools, child welfare facilities, probation and
parole offices/aftercare systems, and mental health facilities.
FFT is a strength-based evidence-based mental health PEI model. At its core is a focus and
assessment of those risk and protective factors that impact the adolescent and his or her
environment, with specific attention paid both intrafamilial and extrafamilial factors, and how they
present within and influence the therapeutic process.
Revised Exhibit A-1
Page 2 of 7
The determination of which services and supports are to be provided to each client/family shall be
made on the basis of the individual services and supports plan, or plan of care, which is created by
the client/family and the Community Mental Health Specialists (CMHS).
An individual services and supports plan is a plan developed with the CMHS, to identify the client's
goals and describe the array of services and supports necessary to advance these goals based on
the client's needs and preferences and, when appropriate, the needs and preferences of the client's
family.
The concepts of wellness and recovery shall be embedded in this program through all interventions
that will focus on the strengths of the family and work toward the goal of enhancing those strengths
and self-sufficiency.
CONTRACTOR shall provide services that will encourage clients and families to achieve wellness
and recovery. As clients and families advance in the program they will be able to reach a level of
wellness and recovery that should allow them to successfully discharge from the program or move to
a lower level of service. CONTRACTOR shall make appropriate decisions that allow it to efficiently
serve enrolled clients and families and those that are on a waiting list for services.
IV. CONTRACTOR RESPONSIBILITIES:
A. CONTRACTOR shall provide the following staffing components:
1. CONTRACTOR shall employ one Clinical Director to provide overall responsibility for the
FFT program.
2. CONTRACTORS shall employ ten (14) full time equivalent (FTE) CMHS who possess a
Master's degree.
3. CONTRACTORS shall employ three (4) FTE Parent Partners/Care Managers who
possess a Bachelor's degree (preferably in psychology, counseling, etc). Care Managers
shall assist in service coordination and ensuring that families receive peer support,
education, and advocacy services as needed. Parent Partners shall work with staff and
families to assist in the planning and provision of treatment to youth and families.
B. Provide the following specific services as it relates to the FFT evidence-based PEI model:
1. CONTRACTOR shall carefully adhere to the principles of FFT evidence-based practice
model and procedures, as well as the competent delivery of the model.
2. CONTRACTOR shall participate in continuing training and technical assistance with a
certified agency that can provide clinical oversight of the delivery of the FFT model.
C. Provide the following as it relates to cultural competence:
1. CONTRACTOR shall recruit and hire staff that have demonstrated experience working
with the Latino, African American, Southeast Asian, Native American, and other minority
populations and have knowledge about the culture of these targeted groups as well as
other diverse communities.
2. CONTRACTOR's staff shall attend annual trainings on cultural competency, awareness,
and diversity as provided by selected bidder(s), or online via the COUNTY's eLearning
Revised Exhibit A-1
Page 3 of 7
system. CONTRACTOR's staff shall be appropriately trained in providing services in a
culturally sensitive manner.
3. CONTRACTOR's staff shall attend civil rights training as provided by CONTRACTOR, or
online via the COUNTY's eLearning system.
4. CONTRACTOR shall hire bilingual staff. At a minimum, CONTRACTOR shall hire staff
competent in Spanish and Hmong as these are the identified threshold languages in
Fresno County.
5. CONTRACTOR shall secure the services of trained trans I atorsh nterpreters as may be
necessary. Translators/interpreters may prove invaluable for languages such as
Cambodian, Russian, Arabic, Armenian, Punjabi, and others. Translators/interpreters
shall be appropriately trained in providing services in a culturally sensitive manner.
6. CONTRACTOR shall provide services by placing importance on traditional values, beliefs
and family histories. Cultural values and traditions offer special strengths in treating
clients and this should help guide health care messages and wellness and recovery plans.
7. CONTRACTOR shall provide services within the most relevant and meaningful cultural,
gender-sensitive, and age-appropriate context for the target population.
8. CONTRACTOR shall develop plans to continually engage targeted populations.
9. CONTRACTOR shall recruit and hire client/family members as a significant portion of their
staffing. Regarding the recruitment of client/family members, the CONTRACTOR will be
able to consult with the COUNTY DBH.
10. CONTRACTOR shall have demonstrated knowledge and experience in working with
Latino, Southeast Asian, African American, and Native American communities, as well as
other diverse communities.
11. CONTRACTOR shall develop and expand partnerships with the following unserved and
underserved populations by engaging leaders and community members: Latino (migrant
workers, immigrants, etc), African-American (specific targeted zip codes), South East
Asian (refugees, etc.), Native American (specific targeted tribes) to identify and document
their specific needs. Engagement to include visiting rancheros, reservations, and other
targeted population areas.
12. CONTRACTOR shall ensure a streamlined approach to accessing appropriate services
which are available at times convenient for the targeted populations.
13. CONTRACTOR shall distribute literature/informational brochures in appropriate languages
and request feedback as to how access to care could be improved for these culturally
diverse communities.
14. CONTRACTOR shall conduct an annual cultural competency self-assessment and provide
the results of said self-assessment to the COUNTY. The annual cultural competency self-
assessment instruments shall be reviewed by the COUNTY and revised as necessary to
meet the approval of the COUNTY. The CONTRACTOR can create their own cultural
competency self-assessment tools or utilize instruments to be provided by COUNTY.
15. CONTRACTOR shall provide services throughout Fresno County in the community as
opposed to services being performed at traditional mental health department offices to
Revised Exhibit A-1
Page 4 of 7
increase the frequency of clients obtaining needed services as some children/families are
reluctant to seek services from traditional mental health settings.
16. CONTRACTOR shall promote system of care accountability for performance outcomes
which enable children and their families to live independently, work, maintain community
supports, stay in good health, and avoid substance abuse and incarceration.
17. CONTRACTOR shall develop individual services and supports plans which are flexible
and open to meet the unique needs of the targeted populations.
18. CONTRACTOR shall collaborate with agencies that are recognized and accepted by the
targeted populations.
19. CONTRACTOR shall provide family support and the creation of family partnerships
utilizing peer support for families and parenting support.
20. CONTRACTOR shall establish culturally specific multidisciplinary treatment teams
responsible for assuring and providing needed services.
21. CONTRACTOR shall provide supportive housing vouchers and referrals for safe,
adequate, and affordable housing.
22. CONTRACTOR shall provide parenting groups that are conducted in the preferred
language of the participant client/families.
23. CONTRACTOR shall give consideration to gender sensitivity and the differing
psychologies and needs of boys and girls when providing services. Items such as who is
the primary care giver, domestic violence, and women's health issues shall also be
considered in the provision of services.
24. CONTRACTOR's staff will be trained to keep an open mind and maintain non-judgmental
interaction with clients/families.
25. CONTRACTOR, when developing program services and service delivery approaches,
shall seek to hire and train staff and community stakeholders (i.e., consumers, family
members, etc.) that are providing services to consumers and families on appropriate
methods and approaches to delivering gender and age specific services.
26. CONTRACTOR's hiring and contracting practices shall be based on local data and reflect
the needs of the population to be served.
27. CONTRACTOR shall attend the COUNTY's Cultural Diversity Committee monthly
meetings, maintain its own cultural competence oversight committee, and develop a
cultural competency plan to address and evaluate cultural competency issues.
28. COUNTY shall provide technical assistance and demographic data to CONTRACTOR in
relation to cultural competency planning.
29. CONTRACTOR shall train staff on best practice for utilizing interpreters to ensure effective
communication with monolingual consumers and families to assist in the delivery of
culturally/linguistically appropriate services.
V. COUNTY RESPONSIBILITIES:
Revised Exhibit A-1
Page 5 of 7
A. COUNTY shall:
1. Provide oversight, through its MHSA Coordinator, or designee, and collaborate with
CONTACTOR and other COUNTY Departments and community agencies to help achieve
State program goals and outcomes. In addition to contract monitoring of program(s),
oversight includes, but not limited to, coordination with the State Department of Health
Care Services in regard to program administration and outcomes.
2. Assist the CONTRACTOR in making linkages with the total mental health system. This
will be accomplished through regularly scheduled meetings as well as formal and informal
consultation.
3. Participate in evaluating the progress of the overall program and the efficiency of
collaboration with CONTRACTOR's staff and will be available to the CONTRACTOR for
ongoing consultation.
4. Gather outcome information from target client groups and CONTRACTOR throughout
each term of this Agreement. COUNTY MHSA staff shall notify the CONTRACTOR when
its participation is required. The performance outcome measurement process will not be
limited to survey instruments but will also include, as appropriate, client and staff
interviews, chart reviews, and other methods of obtaining required information.
5. Assist the CONTRACTOR's efforts towards cultural and linguistic competency by
providing the following to CONTRACTOR:
a. Technical assistance and training regarding cultural competency requirements at no
cost to CONTRACTOR.
b. Mandatory cultural competency training for CONTRACTOR personnel, at minimum
once per year.
c. Technical assistance for translating information into COUNTY's threshold languages
(Spanish and Hmong). Translation services and costs associated will be the
responsibility of the CONTRACTOR.
VI. PERFORMANCE MEASUREMENT:
A. Data Collection
1. Data collection and evaluation methods may include, but are not limited to, staff,
participant, and family interviews; and case file reviews.
2. CONTRACTOR shall also conduct consumer satisfaction surveys to see if there is a
strong correlation of the efficacy of the evidence-based program with specific ethnicities
and languages as well as to identify gaps in meeting cultural needs of clients/families, if
any.
3. CONTRACTOR shall ensure all program clients/families participate in the semi-annual State
Performance Outcomes Quality Improvement (POQI) survey. POQI surveys will be
distributed to all active clients/families to fill out and return to CONTRACTOR.
4. CONTRACTOR shall collect data regarding the ethnicity and language of each
client/family receiving services as well as directing staff to follow-up with the culturally
diverse clients/families for suggestions on how to improve the programs and also how to
help make the programs more culturally relevant.
Revised Exhibit A-1
Page 6 of 7
5. CONTRACTOR shall maintain all client data in permanent electronic case records.
CONTRACTOR shall have established policies and procedures for data collection and
client confidentiality.
B. Performance Outcomes
CONTRACTOR's performance will also be evaluated by COUNTY DBH utilizing the following
performance outcomes:
Goal/Objective 1: Increase the delivery of mental health treatment services to
unserved and underserved clients and families with limited or
no means of payment.
Outcome 1A: FFT PEI program services shall be provided to clients and
families with limited or no means of payment.
Outcome Indicator More than 50% of clients/families receiving FFT PEI program
1A: services shall have limited or no means of payment for mental
health services as indicated by the payer sources identified for
the clients on monthly client rosters and program reports.
Outcome 1 B: FFT PEI program services shall be provided to clients/families
in rural Fresno County areas.
Outcome Indicator More than 50% of the clients/families receiving FFT PEI
1 B: program services shall reside in rural Fresno County areas as
indicated by the zip codes identified for clients on monthly
client rosters and program reports (client rosters should include
client demographic data, e.g., age, gender, residence, etc.;
and client utilization data, e.g., quantity/quality of services
delivered).
Goal/Obiective 2: Identify and build upon individual and family strengths and
assets to help parents and children develop new skills to
enhance family cohesion.
Outcome 2: Clients will gain skills to reduce family conflict and the ability to
identify familial strengths. .
Outcome Indicator 2: 75% of clients/families completing the FFT program will report
an increase in family cohesion as measured by Client Outcome
Measurement tools and Outcome Questionnaires.
Goal/Objective 3: Improve functioning of clients completing the FFT PEI
program.
Outcome 3: Clients will gain self confidence, increased ability to handle
anger and manage difficult situations, and experience
improved individual functioning.
Outcome Indicator 85% of the clients that participate in the FFT PEI program will
3A. report functional improvement measured by CANS
(Child/Adolescent Needs and Strengths) scores.
Revised Exhibit A-I
Page 7 of 7
Outcome Indicator 50% of the clients that complete the FFT PEI program will
38. report a decrease in school problems between start of program
and end of program.
Outcome Indicator 50% of the clients that complete the FFT PEI program will
3C- report a decrease in inpatient mental health crisis visits
between start of program and end of program.
Outcome Indicator 50% of the clients that complete the FFT PEI program will
3D, report a decrease in recidivism into the Juvenile Justice
System between start of program and end of program.
Outcome Indicator 85% of the clients participating in the FFT PEI program that are
3E. diagnosed with mental health disorders, e.g., conduct disorder,
oppositional defiant disorder, disruptive behavior disorder, etc.,
when they begin the FFT PEI program will report improvement
after successfully completing the program.
Goal/Objective 4: Ensure clients/families are actively engaged in the FFT PEI
program.
Outcome 4: Clients/families will indicate satisfaction with FFT PEI program
services they receive.
Outcome Indicator 4: At a minimum, 80% percent of clients/families will report their
satisfaction with program services on the CONTRACTOR's
consumer satisfaction surveys, and the semi-annual State POQI
survey.
C. Reports
1. CONTRACTOR shall prepare an evaluation report annually and submit to the COUNTY's
DBH, and make said reports available to partnering and interested local agencies and
organizations such as the project collaborators, other community agencies and mental heath
treatment providers. Each annual evaluation report will include the following information:
demographics of the target population served, services provided to each participant, number
of hospitalization, enrollment in school, results of data analysis compared to planned
process, output and outcome measures, barriers to program implementation and measures
taken to overcome those barriers, accomplishments of program participants, lessons
learned, and the final result of any and all satisfactory survey(s).
2. CONTRACTOR shall be expected to comply with all contract monitoring and compliance
protocols, procedures, data collection methods, and reporting requirements conducted by
the COUNTY.
3. Additional repo rts/outcomes may also be requested by the COUNTY, based on among other
things, identification of client/family specific needs as well as State required
reports/outcomes as needed.
Revised Exhibit B-1
MHSA CHILDREN FUNCTIONAL FAMILY THERAPY Page 1 of 3
COMPREHENSIVE YOUTH SERVICES
Six Month Extension Budget:July 2018-December 2018
Budget Categories- Total Proposed Budget
Line Item Description (Must be itemized) FTE% Admin. Direct Total
PERSONNEL SALARIES:
0001 Program Manager 1.65 $ 69,020.00 $ 69,020.00
0002 Clinical Director 0.25 $ 17,569.00 $ 17,569.00
0003 Peer Review/Lead Therapist/Clinical Supervisor 1.12 $ 47,453.00 $ 47,453.00
0004 Community Mental Health Specialists 14.00 $ 324,389.00 $ 324,389.00
0005 Care Managers/Parent Partner 4.00 $ 76,262.00 $ 76,262.00
0006 Executive Dir/Finance Director/Accounting/Clerical Varies $ 28,361.50 $ 28,361.50 $ 56,723.00
SALARY TOTAL 21.02 $ 28,361.50 $ 563,054.50 $ 591,416.00
PAYROLL TAXES:
0030 OASDI $ -
0031 FICA/MEDICARE $ 4,339.00 $ 40,903.00 $ 45,242.00
0032 SUI $ 252.00 $ 2,943.00 $ 3,195.00
PAYROLL TAX TOTAL $ 4,591.00 $ 43,846.00 $ 48,437.00
EMPLOYEE BENEFITS:
0040 Retirement $ 2,272.00 $ 21,397.00 $ 23,669.00
0041 Workers Compensation $ 575.00 $ 6,636.00 $ 7,211.00
0042 Health Insurance(medical,vision, life,dental) $ 6,403.00 $ 80,694.00 $ 87,097.00
EMPLOYEE BENEFITS TOTAL $ 9,250.00 $ 108,727.00 $ 117,977.00
SALARY& BENEFITS GRAND TOTAL $ 757,830.00
FACILITIES/EQUIPMENT EXPENSES:
1010 Rent/Lease Building $ 61,264.00
1011 Rent/Lease Equipment $ 13,209.00
1012 Utilities $ 15,449.00
1013 Building Maintenance $ 7,967.00
1014 Equipment purchase $ -
FACILITY/EQUIPMENT TOTAL $ 97,889,00
OPERATING EXPENSES: Page 2 of 3
1060 Telephone $ 18,361.00
1061 Answering Service $ -
1062 Postage $ -
1063 Printing/Reproduction $ -
1064 Publications $ -
1065 Informational Publications $ 400.00
1066 Office Supplies&Equipment $ 8,954.00
1067 Household Supplies $ -
1068 Food $ 700.00
1069 Program Supplies-Therapeutic $ 3,100.00
1070 Program Supplies-Medical $ -
1071 Transportation of Clients $ -
1072 Staff Mileage/vehicle maintenance $ 18,993.00
1073 Staff Travel (Out of County) $ 8,850.00
1074 Staff Training/Registration $ 14,208.00
1075 Lodging $ 13,500.00
1076 Other-(Identify) $ -
1077 Other-(Identify) $ -
OPERATING EXPENSES TOTAL $ 87,066.00
FINANCIAL SERVICES EXPENSES:
1080 Accounting/Bookkeeping $ -
1081 External Audit $ 6,265.00
1082 Liability Insurance $ -
1083 Administrative Overhead $ 3,252.00
1084 Payroll Services $ 2,151.00
1085 Professional Liability Insurance $ 9,072.00
FINANCIAL SERVICES TOTAL 1 $ 20,740.00
SPECIAL EXPENSES(Consultant/Etc.):
1090 Consultant(network&data management) $ 9,833.00
1091 Translation Services $ 500.00
1092 Medication Supports $ 300.00
SPECIAL EXPENSES TOTAL $ 10,633.00
FIXED ASSETS:
1190 Computers&Software $ -
1191 Furniture&Fixtures $ -
1192 Other-Leased Automobile $ 3,300.00
1193 Other-(Identify) $ -
FIXED ASSETS TOTAL $ 3,300. 00
NON MEDI-CAL CLIENT SUPPORT EXPENSES: Page 3 of 3
2000 Client Housing Support Expenditures(SFC 70) $ -
2001 Client Housing Operating Expenditures(SFC 71) $ -
2002.1 Clothing, Food & Hygiene(SFC 72) $ 7,000.00
2002.2 Client Transportation &Support(SFC 72) $ 2,000.00
2002.3 Education Support(SFC 72) $ 625.00
2002.4 Employment Support(SFC 72) $ 375.00
2002.5 Respite Care(SFC 72) $ -
2002.6 Household Items $ -
2002.7 Utility Vouchers(SFC 72) $ -
2002.8 Child Care(SFC 72) $ -
NON MEDI-CAL CLIENT SUPPORT TOTAL $ 10,000.00
TOTAL PROGRAM EXPENSES $ 987,458.00
MEDI-CAL REVENUE: Units of Service Rate $Amount
3000 Mental Health Services(Individual/Family/Group Therapy) 164,513.00 $ 2.61 $ 429,379.00
3100 Case Management 34,104.00 $ 2.02 $ 68,890.00
3200 Crisis Services 580.00 $ 3.88 $ 2,250.00
3300 Medication Support - $ 4.82 $ -
3400 Collateral 6,886.00 $ 2.61 $ 17,972.00
3500 Plan Development 2,116.00 $ 2.61 $ 5,523.00
3600 Assessment 45,586.00 $ 2.61 $ 118,979.00
3700 Rehabilitation 3,051.00 $ 2.61 $ 7,963.00
Estimated Medi-Cal Billing Totals 256,836.00 $ 650,956.00
Estimated%of Federal Financial Participation Reimbursement $ 0.50
Estimated%of State EPSDT Reimbursement $ 0.50
MEDI-CAL REVENUE TOTAL $ 650,956.00
OTHER REVENUE:
4000 Other-(Identify) $
4100 Other-(Identify) $
4200 Other-(Identify) $
4300 Other-(Identify) $
OTHER REVENUE TOTAL $
MHSA FUNDS:
5000 Prevention &Early Intervention Funds $ 336,502.00
5100 Community Services&Supports Funds $ -
5200 Innovation Funds $ -
5300 Workforce Education &Training Funds $ -
MHSA FUNDS TOTAL $ 336,502.00
TOTAL PROGRAM REVENUE $ 987,458.00