HomeMy WebLinkAboutAgreement A-22-207 with DHCS.pdf• Agreement No. 22-207
State of California-Health and Human Services Agency Department of Health Care Services
Enclosure 1
Projects for Assistance in Transition from Homelessness (PATH)
State Fiscal Year (SFY) 2022-23 Funding Allocation
FRESNO 03/21/2022
County Name Date
RUJLP1 K3WWK9
X Entity Data Detail.pdf is included
SAM Unique Entity Identifier"
** See guidance on mandatory transition from DUNS to SAM number for Federal Grants
on Enclosure 9 Checklist
Total Allocation S 317,162
The County requests the continuation of the PATH grant. These funds will be expended
in accordance with all applicable federal and state requirements, and will be used as
stated in the enclosed PATH Funding Agreements with Federal Requirements on Use of
Allotments, Certification Statements and Compliance Assurances.
This estimate is the proposed total expenditure level for State Fiscal Year (SFY) 2022-23
and is subject to change based on the level of appropriation approved in the State Budget
Act of 2022. In addition, this amount is subject to adjustments only for a net reimbursable
amount to the county. The adjustments include, but are not limited to, Gramm-Rudmann-
Hollings (Federal Deficit Reduction Act) reductions, prior year audit recoveries, federal
legislative mandates applicable to categorical funding, augmentations, etc. The net
amount reimbursable will be reflected in reimbursable payments as the specific dollar
amounts of adjustments become known for each county.
The County will use this funding allocation worksheet to build the County's SFY 2022-23
budget for the provision of services to reduce or eliminate homelessness for individuals
with serious mental illnesses (SMI), co-occurring substance use disorders, and who are
experiencing homelessness or are at imminent risk of becoming homeless.
-76'77—
County Mental Health Director Signature Date
Susan Holt
Print Name
Rev. 03/22
Enclosure 2
Certifications
1.Certification Regarding Debarment and Suspension
The undersigned(authorized official signing for the applicant organization)certifies to the best of his or her knowledge and belief,that the applicant,
defined as the primary participant in accordance with 2 CFR part 180,and its principals:
a. Agrees to comply with 2 CFR Part 180,Subpart C by administering each lower tier subaward or contract that exceeds$25,000 as a"covered
transaction"and verify each lower tier participant of a"covered transaction"under the award is not presently debarred or otherwise disqualified
from participation in this federally assisted project by:
a. Checking the Exclusion Extract located on the System for Award Management(SAM)at http://sam.gov
b. Collecting a certification statement similar to paragraph(a)
c. Inserting a clause or condition in the covered transaction with the lower tier contract
2.Certification Regarding Drug-Free Workplace Requirements
The undersigned(authorized official signing for the applicant organization)certifies that the applicant will,or will continue to,provide a drug-free work-
place in accordance with 2 CFR Part 182by:
a. Publishing a statement notifying employees that the unlawful manufacture,distribution,dispensing,possession or use of a controlled substance
is prohibited in the grantee's work-place and specifying the actions that will be taken against employees for violation of such prohibition;
b. Establishing an ongoing drug-free awareness program to inform employees about--
1. The dangers of drug abuse in the workplace;
2. The grantee's policy of maintaining a drug-free workplace;
3. Any available drug counseling,rehabilitation,and employee assistance programs;and
4. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
c. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by
paragraph(a)above;
d. Notifying the employee in the statement required by paragraph(a),above,that,as a condition of employment under the grant,the employee will-
1. Abide by the terms of the statement;and
2. Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than
five calendar days after such conviction;
e. Notifying the agency in writing within ten calendar days after receiving notice under paragraph(d)(2)from an employee or otherwise receiving
actual notice of such conviction.Employers of convicted employees must provide notice,including position title,to every grant officer or other
designee on whose grant activity the convicted employee was working,unless the Federal agency has designated a central point for the receipt
of such notices.Notice shall include the identification number(s)of each affected grant;
f. Taking one of the following actions,within 30 calendar days of receiving notice under paragraph(d)(2),with respect to any employee who is so
convicted?
1. Taking appropriate personnel action against such an employee,up to and including termination,consistent with the requirements of the
Rehabilitation Act of 1973,as amended;or
2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by
a Federal,State,or local health,law enforcement,or other appropriate agency;
g. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(a),(b),(c),(d),(e),and(f).
3.Certifications Regarding Lobbying
Per 45 CFR?75.215, Recipients are subject to the restrictions on lobbying as set forth in 45 CFR part 93.Title 31,United States Code,Section 1352,entitled
"Limitation on use of appropriated funds to influence certain Federal contracting and financial transactions,"generally prohibits recipients of Federal
grants and cooperative agreements from using Federal(appropriated)funds for lobbying the Executive or Legislative Branches of the Federal Government
in connection with a SPECIFIC grant or cooperative agreement.Section 1352 also requires that each person who requests or receives a Federal grant or
cooperative agreement must disclose lobbying undertaken with non-Federal(non-appropriated)funds.These requirements apply to grants and
cooperative agreements EXCEEDING$100,000 in total costs.The undersigned(authorized official signing for the applicant organization)certifies,to the
best of his or her knowledge and belief,that
1. No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned to any person for influencing or attempting to
influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering
Page 1 of 2
into of any cooperative agreement,and the extension,continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or
cooperative agreement.
2. If any funds other than Federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an
officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in
connection with this Federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,
"Disclosure of Lobbying Activities,"in accordance with its instructions.(If needed,Standard Form-LLL,"Disclosure of Lobbying Activities,"its
instructions,and continuation sheet are included at the end of this application form.)
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers(including
subcontracts,subgrants,and contracts under grants,loans and cooperative agreements)and that all subrecipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this
certification is a prerequisite for making or entering into this transaction imposed by Section 1352,U.S.Code.Any person who fails to file the required
certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure.
4.Certification Regarding Program Fraud Civil Remedies Act(PFCRA)(31 U.S.0?3801-3812)
The undersigned(authorized official signing for the applicant organization)certifies that the statements herein are true,complete,and accurate to the
best of his or her knowledge,and that he or she is aware that any false,fictitious,or fraudulent statements or claims may subject him or her to criminal,
civil,or administrative penalties.The undersigned agrees that the applicant organization will comply with the Public Health Service terms and conditions
of award if a grant is awarded as a result of this application.
S.Certification Regarding Environmental Tobacco Smoke
Public Law 103-227,also known as the Pro-Children Act of 1994(Act),requires that smoking not be permitted in any portion of any indoor facility owned
or leased or contracted for by an entity and used routinely or regularly for the provision of health,daycare,early childhood development services,
education or library services to children under the age of 18,if the services are funded by Federal programs either directly or through State or local
governments,by Federal grant,contract,loan,or loan guarantee.The law also applies to children's services that are provided in indoor facilities that are
constructed,operated,or maintained with such Federal funds.The law does not apply to children's services provided in private residence,portions of
facilities used for inpatient drug or alcohol treatment,service providers whose sole source of applicable Federal funds is Medicare or Medicaid,or
facilities where WIC coupons are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to$1,000 for each violation and/or the
imposition of an administrative compliance order on the responsible entity.
By signing the certification,the undersigned certifies that the applicant organization will comply with the requirements of the Act and will not allow
smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act.
The applicant organization agrees that it will require that the language of this certification be included in any subawards which contain provisions for
children's services and that all subrecipients shall certify accordingly.
The Public Health Services strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of tobacco products.This
is consistent with the PHS mission to protect and advance the physical and mental health of the American people.
Name
Brian Pacheco
Title
Chairman, Board of Supervisors
Organization
County of Fresno
Signature: OA_ Date: 6
Footnotes:
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
BY Deputy
Page 2 of 2
Enclosure 3
COMPLIANCE ASSURANCES
The County, as a subrecipient of PATH grant funds, acknowledges and
agrees that the County and its subcontractors shall provide services in
accordance with all applicable Federal and State statutes and regulations.
I hereby certify that the County of Fresno agrees to the following:
A. Amounts received under the PATH Formula Grant will be used solely to
provide services to persons who have a serious mental illness, or have a
co-occurring serious mental illness (SMI) and substance abuse disorder
(SUD), and who are homeless or at imminent risk of becoming homeless.
B. PATH funds must be used to supplement, not supplant, existing services
to individuals who have SMI, or who have co-occurring SMI and SUD, and
who are homeless or at imminent risk of becoming homeless.
C. At a minimum, providers must provide both Outreach and Case
Management. Additional grant funds shall be expended only for the
following services:
1. Screening and diagnostic treatment services;
2. Habilitation and rehabilitation services (relating to training and
education to improve the individual's functioning in the community);
3. Community mental health services;
4. Alcohol and/or drug treatment services;
5. Staff training (for individuals who work in shelters, mental health
clinics, substance abuse programs, and other sites where individuals
require homeless services);
6. Supportive and supervisory services in residential settings;
7. Referrals for primary health services, job training, educational
services, and relevant housing services; and
8. Housing services including minor renovation, expansion, and repair
of housing; planning of housing, technical assistance in applying for
housing; improving the coordination of housing services; security
deposits; the costs associated with matching eligible homeless
individuals with appropriate housing situations; and one-time rental
payment to prevent eviction.
D. Grants will be made pursuant to Section 522(a) of the Public Health
Service Act only to entities that have the capacity to provide, directly or
through arrangements, the specified service(s) including coordinating the
provision of service(s) in order to meet the needs of eligible homeless
individuals who are both mentally ill and suffering from substance abuse.
PATH 2O22-23
Request for Application Page 1 of 3
Enclosure 3
E. Special consideration will be given to funding entities with a demonstrated
effectiveness in serving veterans who are homeless.
F. Grant funds will not be given to any entity that has a policy of excluding
individuals from mental health services due to the existence or suspicion
of substance abuse or which excludes individuals from substance abuse
services due to the existence or suspicion of mental illness.
G. No more than ten percent of Federal PATH funds received shall be
expended for administrative expenses. The 10 percent administrative
expense cap includes both the county's and the subcontractor's
administrative costs in aggregate.
H. None of the funds in this grant shall be used to pay the salary of an
individual through a grant or other extramural mechanism at a rate in
excess of Executive Level II of the Federal Executive Pay Scale. Effective
January 2, 2022, the amount is $203,700.
I. Not more than 20 percent of the payments will be expended for allowable
housing services. The payments will not be expended to support
emergency shelters or construction of housing facilities for inpatient
psychiatric or inpatient substance abuse treatment costs or to make cash
payments to intended recipients of mental health or substance abuse
services.
J. The county will make available, directly or through donations from public
or private entities, non-federal contributions toward such costs in an
amount that is not less than one dollar ($1) for each three dollars ($3) of
federal funds provided in such payments. The amount of the county
match is $105,721.
K. The description of intended use will be revised throughout the year to
reflect substantial changes in the programs and activities funded through
the PATH grant. Changes in services will not be provided until the
appropriate approval has been received.
L. The county agrees to provide all reports required by the State Department
of Health Care Services (DHCS).
M. The county will comply, as applicable, with the Substance Abuse and
Mental Health Services Administration's (SAMHSA) Charitable Choice
statutes codified at sections 581-584 and 1955 of the Public Health
Service Act (42 USC 290k, et seq., and 42 USC 300x-65 et seq.) and their
governing regulations at 42 C.F.R. part 54 and 54a respectively.
PATH 2O22-23
Request for Application Page 2 of 3
Enclosure 3
N. The county has budgeted SFY 2022-23 non-PATH funds for services to
individuals who are homeless and mentally disabled as follows:
$ 0 Federal (non-PATH)
$ 0 Other
L —0'2
Signature of Chairman, Board of Supervisors Date
Brian Pacheco
Print Name
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By. Deputy
PATH 2O22-23
Request for Application Page 3 of 3
Enclosure 4
Assurances - Non-Construction Programs
Note:Certain assurances may not be applicable to your project or program.If you have questions,please contact the awarding agency.Further,certain Federal
awarding agencies may require applicants to certify to additional assurances.If such is the case,you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,and the institutional,managerial and financial capability(including funds sufficient to pay the
non-Federal share of project costs)to ensure proper planning, management and completion of the project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States,and if appropriate,the State,through any authorized
representative,access to and the right to examine all records,books,papers,or documents related to the award;and will establish a proper
accounting system in accordance with generally accepted accounting standard or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or
organizational conflict of interest,or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970(42 U.S.C.§§4728-4763)relating to prescribed standards for merit systems for
programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standard for a Merit System of Personnel
Administration(5 C.F.R.900,Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination.These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964(P.L.
88-352)which prohibits discrimination on the basis of race,color or national origin;(b)Title IX of the Education Amendments of 1972,as amended(20
U.S.C.§§1681-1683,and 1685-1686),which prohibits discrimination on the basis of sex,(c) Section 504 of the Rehabilitation Act of 1973,as amended
(29 U.S.C.§§794),which prohibits discrimination on the basis of handicaps;(d) the Age Discrimination Act of 1975,as amended(42 U.S.C.§§6101-
6107),which prohibits discrimination on the basis of age;(e)the Drug Abuse Office and Treatment Act of 1972(P.L.92-255),as amended,relating to
nondiscrimination on the basis of drug abuse;(f)the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970(P.L.91-616),as amended,relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g) §§523 and 527 of the Public Health
Service Act of 1912(42 U.S.C.§§290 dd-3 and 290 ee-3),as amended,relating to confidentiality of alcohol and drug abuse patient records;(h)Title VIII of
the Civil Rights Act of 1968(42 U.S.C.§§3601 et seq.),as amended,relating to non-discrimination in the sale,rental or financing of housing;(i)any
other nondiscrimination provisions in the specific statute(s)under which application for Federal assistance is being made;and 0)the requirements
of any other nondiscrimination statute(s)which may apply to the application.
7. Will comply,or has already complied,with the requirements of Title 11 and III of the Uniform Relocation Assistance and Real Property Acquisition Policies
Act of 1970(P.L.91-646)which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or
federally assisted programs.These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation
in purchases.
8. Will comply with the provisions of the Hatch Act(5 U.S.C.§§1501-1508 and 7324-7328)which limit the political activities of employees whose
principal employment activities are funded in whole or in part with Federal funds.
9. Will comply,as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C. §§276a to 276a-7),the Copeland Act(40 U.S.C. §276c and 18 U.S.C.
§874),and the Contract Work Hours and Safety Standards Act(40 U.S.C.§§327-333),regarding labor standards for federally assisted construction sub-
agreements.
10. Will comply,if applicable,with flood insurance purchase requirements of Section 102(a)of the Flood Disaster Protection Act of 1973(P.L.93-234)which
requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable
construction and acquisition is$10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following:(a)institution of environmental quality control measures
under the National Environmental Policy Act of 1969(P.L.91-190) and Executive Order(EO)11514; (b)notification of violating facilities pursuant to EO
11738;(c)protection of wetland pursuant to EO 11990;(d)evaluation of flood hazards in floodplains in accordance with EO 11988;(e)assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972(16 U.S.C.§§1451 et
seq.);(f)conformity of Federal actions to State(Clear Air)Implementation Plans under Section 176(c)of the Clear Air Act of 1955,as amended(42 U.S.C.
§§7401 et seq.);(g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L.93-523);and
(h) protection of endangered species under the Endangered Species Act of 1973,as amended, (P.L.93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968(16 U.S.C.§§1271 et seq.)related to protecting components or potential components of the
national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966,as amended (16 U.S.C.
§470),EO 11593(identification and protection of historic properties),and the Archaeological and Historic Preservation Act of 1974(16 U.S.C.
§§469a-1 et seq.).
14. Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related activities supported by this
award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966(P.L.89-544,as amended,7 U.S.C.§§2131 et seq.)pertaining to the care,handling,and
treatment of warm blooded animals held for research,teaching,or other activities supported by this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C.§§4801 et seq.)which prohibits the use of lead based paint in
construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984.
Page 1 of 2
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program.
19. Will comply with the requirements of Section 106(g)of the Trafficking Victims Protection Act(TVPA)of 2000,as amended(22 U.S.C.7104)which prohibits
grant award recipients or a sub-recipient from(1)Engaging in severe forms of trafficking in persons during the period of time that the award is in
effect(2)Procuring a commercial sex act during the period of time that the award is in effect or(3)Using forced labor in the performance of the award
or subawards under the award.
HHS Assurances of Compliance(HHS 690)
ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964,SECTION 504 OF THE REHABILITATION ACT OF 1973,TITLE IX OF THE
EDUCATION AMENDMENTS OF 1972,THE AGE DISCRIMINATION ACT OF 1975,AND SECTION 1557 OF THE AFFORDABLE CARE ACT
The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants,loans,contracts,property,discounts or other Federal
financial assistance from the U.S.Department of Health and Human Services.
THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH:
1. Title VI of the Civil Rights Act of 1964(Pub.L 88-352),as amended,and all requirements imposed by or pursuant to the Regulation of the Department
of Health and Human Services(45 C.F.R.Part 80),to the end that,in accordance with Title VI of that Act and the Regulation,no person in the United
States shall,on the ground of race,color,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected
to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department
2, Section 504 of the Rehabilitation Act of 1973(Pub.L.93-112),as amended,and all requirements imposed by or pursuant to the Regulation of the
Department of Health and Human Services(45 C.F.R.Part 84),to the end that in accordance with Section 504 of that Act and the Regulation,no
otherwise qualified individual with a disability in the United States shall,solely by reason of her or his disability,be excluded from participation in,
be denied the benefits of,or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance
from the Department
3. Title IX of the Education Amendments of 1972(Pub.L.92-318),as amended,and all requirements imposed by or pursuant to the Regulation of the
Department of Health and Human Services(45 C.F.R.Part 86),to the end that,in accordance with Title IX and the Regulation,no person in the United
States shall,on the basis of sex,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under any
education program or activity for which the Applicant receives Federal financial assistance from the Department.
4. The Age Discrimination Act of 1975(Pub.L.94-135),as amended,and all requirements imposed by or pursuant to the Regulation of the Department
of Health and Human Services(45 C.F.R.Part 91),to the end that,in accordance with the Act and the Regulation,no person in the United States shall,
on the basis of age,be denied the benefits of,be excluded from participation in,or be subjected to discrimination under any program or activity for
which the Applicant receives Federal financial assistance from the Department.
5, Section 1557 of the Affordable Care Act(Pub.L 111-148),as amended,and all requirements imposed by or pursuant to the Regulation of the Department
of Health and Human Services(45 CFR Part 92),to the end that,in accordance with Section 1557 and the Regulation,no person in the United States shall,
on the ground of race,color,national origin,sex,age,or disability be excluded from participation in,be denied the benefits of,or be subjected to
discrimination under any health program or activity for which the Applicant receives Federal financial assistance from the Department
The Applicant agrees that compliance with this assurance constitutes a condition of continued receipt of Federal financial assistance,and that it is binding
upon the Applicant,its successors,transferees and assignees for the period during which such assistance is provided.If any real property or structure
thereon is provided or improved with the aid of Federal financial assistance extended to the Applicant by the Department,this assurance shall obligate the
Applicant,or in the case of any transfer of such property,any transferee,for the period during which the real property or structure is used for a purpose for
which the Federal financial assistance is extended or for another purpose involving the provision of similar services or benefits.If any personal property is
so provided,this assurance shall obligate the Applicant for the period during which it retains ownership or possession of the property.The Applicant
further recognizes and agrees that the United States shall have the right to seek judicial enforcement of this assurance.
The grantee,as the awardee organization,is legally and financially responsible for all aspects of this award including funds provided to sub-recipients in
accordance with 45 CFR Part 75.351-75.352,Subrecipient monitoring and management
Name
Brian Pacheco
............
Title ATTEST:
Chairman,Board of Supervisors BERNICE E.SEIDEL
--- - — ------ Clerk of the Board of Supervisors
Organization County of Fresno,State of California
County of Fresno By_ `t L LGZ Deputy
Signature: Date:
Footnotes:
—. Page 2 of 2
State of California—Health and Human Services Agency Department of Health Care Services
Enclosure 5
PATH SFY 2022-23
COUNTY INTENDED USE PLAN
County: Fresno
Address: 1925 E Dakota Ave City, Zip Code: Fresno, CA 93726
County Program Contact: Gavin Harrison, Staff Analyst
Telephone: 559-600-7664
Fax: N/A
Email: garrison@fresnocountyca.gov
County Fiscal Contact: Harlan Theng
Telephone: 559-600-4619
Fax: N/A
Email: ltheng@fresnocountyca.gov
Indicate which of the following essential services will be provided by this provider with PATH funding:
®Outreach
®Case Management
®Community Mental Health Services
®Habilitation & Rehabilitation Services (relating to training and education to improve the individual's
functioning in the community)
®Staff Training
®Screening and Diagnostic Services
❑Alcohol or Drug Treatment
❑Supportive and Supervisory Services in Residential Settings
®Referrals for Primary Health Services, Job Training, Education Services and Relevant
Housing Services:
❑Minor Renovation, Expansion, and Repair of Housing
❑Planning of Housing
®Technical Assistance in Applying for Housing Services
®Improving the Coordination of Housing Services
®Security Deposits
®Cost Associated with Matching Eligible Homeless Individuals with Appropriate Housing Situations
®One-Time Rental Payments to Prevent Eviction
Indicate which budget categories are funded with PATH funds: Click on Check Box:
®Personnel ®Equipment ®Travel
®Consultants ®Supplies ®Other
Description of the flow of federal PATH funds in California: PATH funding in California is allocated to the
counties from the California State Department of Health Care Services. Each county has a Mental Health
Program that provides services to the public in California; the PATH funds are distributed at the county level to
either county or contracted providers.
PATH County Intended Use Plan—SFY 2022-23 Page 1 of 5
Rev. 03/22
State of California—Health and Human Services Agency Department of Health Care Services
Enclosure 5
PATH SFY 2022-23
COUNTY INTENDED USE PLAN
Directions — County Intended Use Plan —
The County Intended Used Plan should provide a summary of information from providers, as well as County
specific information, and should be answered at the county level.
1. Total Federal PATH dollars allocated from County: $317,162
2. Total match dollars in budget: $105,721
3. Who provides the match? Fresno County
4. What funding source is used for match? Mental Health Services Act (MHSA)
5. Please provide the names of each organization you will contract with in SFY 2022-23 to provide PATH
eligible services in your county, and the amount of Federal PATH funds they will receive. Please also
include the county administration costs as a provider.
Expected Provider's name as listed on the Provider Intended Use Plan
Contract
Amount
$308,000 Kings View
$9,162 County Administration
$317,162 Total
6. The purpose of this section is to provide a description of your county plan to provide coordinated and
comprehensive services to eligible PATH clients. Please provide the following information as it relates
to activities for SFY 2022-23.
a. The projected number of adult clients to be contacted county-wide using PATH 350
funds.
b. The projected number of adult clients to be enrolled county-wide using PATH 200
funds.
c. The projected percentage of adult clients county-wide served with PATH funds to 75%
be "literally" homeless (i.e., living outdoors or in an emergency shelter rather than
at imminent risk of homelessness).
PATH County Intended Use Plan—SFY 2022-23 Page 2 of 5
Rev. 03/22
State of California—Health and Human Services Agency Department of Health Care Services
Enclosure 5
PATH SFY 2022-23
COUNTY INTENDED USE PLAN
d. Identify activities that will occur in the county to maximize the use of PATH funds to serve adults
who are literally homeless as a priority population
Fresno County Department of Behavioral Health(DBH) oversees the PATH funding and contract,
currently with Kings View, to operate the PATH Program to offer outreach, engagement, linkages, and
specialty mental health services to the target population. Meetings between both parties occur on a
monthly/quarterly basis to review data, outcomes, and expenditures in order to ensure the program is on track
to spend down funds in an appropriate and effective manner.
The County, through various departments (such as the County Administrative Office and Sheriffs
Department), also provide the PATH Program with referrals to adults who are literally homeless, including
those at encampment sites.
e. Identify strategies the county has planned to ensure PATH dollars are funding programs who provide
the minimum services of street outreach and case management as priority services. In addition,
describe services and community supports to be provided to assure long-term housing for veterans
with serious mental illness that are experiencing homelessness.
The County undergoes a Request for Proposal (RFP)process in which bidders are required to explain how their
organizations will meet the service requirements of the PATH funding source, including street outreach and
case management. Once awarded, the bidder enters into an agreement with the County to oversee the PATH
Program with two primary components: Outreach, Engagement and Linkage (OEL) and Specialty Mental
Health Services (SMHS). The PATH-funded OEL component will focus on outreach and case management
services. Through outreach efforts in the streets, shelters, and other non-traditional settings as well as referrals
from the County's Adult System of Care, PATH is expected to provide outreach services to a minimum of 350
clients during FY 2022-23 (July 1, 2022 through June 30, 2023), with a minimum of 200 engaged/enrolled in
services, referrals, and linkages. Those engaged/enrolled will coordinate with the outreach/case management
team to evaluate their needs and are offered specialty mental health services. All are linked to an Access Site for
housing navigation services. For those interested in mental health services, a licensed clinician will conduct a
biopsychosocial assessment and plan of care to enroll clients in PATH-SMHS. For those enrolled in PATH-
SMHS, services include, but not limited to: assessments; case management; mental health and/or co-occurring
services; linkage to County programs and other community service providers; ongoing consultation; peer
support services; assistance in applying for General Relief and SSI/SSD benefits; transportation; provision of
basic necessities of daily life; and supportive interim or bridge housing services. Case management services will
be provided to all clients through an assigned case manager within 24 hours of enrollment in the program along
with the development of a client-centered plan of care to meet the client's needs. Program staff have the
flexibility to increase service intensity to a client in response to the client's presented needs. They have the
capacity to provide frequent contacts with clients where they live or are most comfortable, in order to assist
them in accessing behavioral and physical health care, financial, educational, vocational, rehabilitative, or other
needed community services, especially as these services relate to meeting the client's mental health and housing
needs.
Additionally, veterans are eligible to all PATH program services, including mental health, substance use, and
housing services. The PATH Program provides transportation to veterans' services. Persons served are also
referred to programs available through the Veterans Administration(VA) and San Joaquin Valley Veterans
(SJVV).
f. Please summarize a list of the evidence-based practices currently used in the county for the target
population.
DBH utilizes and encourages Kings View's PATH Program to utilize Wellness Recovery Action Plan
(WRAP), Cognitive Behavioral Therapy, and Motivational Interviewing. The program model is
designed to empower clients, improve quality of life, and allow staff to assist clients in attaining their
personal goals. Team members collaborate on assessments, treatment plants, and day-to-date
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interventions. DBH also incorporates the Recovery 360 model into all County mental health program
services, in order to build and measure wellness, recovery, and resiliency supports within a team
approach. DBH encourages Kings View PATH team members to participate and receive training on
an ongoing basis to ensure clients receive services that support this wellness and recovery model.
7. Describe your organization's participation in the US Department of Housing and Urban Development
Continuum of Care (CoC) program and any other local planning, coordinating or assessment activities.
If you are not currently working with the CoC, briefly explain the approaches to be taken by your agency
to collaborate with the local CoC.
The Fresno/Madera Continuum of Care (FMCoC) develops local strategies to build housing and service
capacity to end homelessness. DBH and the Fresno County Department of Social Services (DSS) are active
participants and voting members of the FMCoC, which is comprised of volunteers from over 21 government
agencies, non-profits and individuals dedicated to serve homeless youth, adults, and families in Fresno and
Madera Counties. DBH contributes to the community planning by advocating for the homeless mentally ill and
encourages all appropriate County contracted providers serving the homeless and at risk of homelessness
population who have SMI and/or a co-occurring disorder to also participate and provide feedback.
DBH is part of the leadership team along with the FMCoC in the national 25 Cities Initiative to end veteran and
chronic homelessness for the Fresno community by identifying, assessing and matching housing for the
veterans and the chronically homeless. A weekly meeting is held to clarify key processes and services,
determine existing housing capacities, and follow-up with specific and high priority cases if needed. Kings
View PATH assists in outreach efforts, service provision and data collection. In addition, DBH actively
participates in the CoCs annual Point-In-Time (PIT) Count of homeless in Fresno County.
DBH also provides mental health clinicians and community mental health specialists at the Multi-
Agency Access Program Point at Poverello House (MAP Point at Pov). MAP is the coordinated service entry
effort created by the FMCoC and the Hospital Council's Community Conversations in Mental Health to
establish and formalize a collaborative intake process across all service providers for individuals facing
housing/homelessness, mental illness, substance use disorder, physical health, social service and/or vocational
needs. The intake process consists of a standardized screening for life-domain needs and assessment with the
Vulnerability Index Service Prioritization Decision Assistance Tool (VI-SPDAT) to customize service
eligibility and access to housing matches. As part of the DBH's work plan for Integrated Behavioral Health
Access, operation of additional MAP Points were contracted out in January 2017 to target strategic, geographic
locations with underserved and unserved populations. Kings View PATH staff may participate in MAP Point
activities to assist in intake and serve as a service provider for the homeless with SMI and/or co-occurring
disorder
8. Describe the county's participating in the Homeless Management Information System (HMIS) and
describe plans for continued training and how the county will support new staff. For any county not fully
participating in HMIS, describe plans to complete HMIS implementation.
DBH is fully participating in HMIS to ensure accurate data collection, analysis and reporting, and will
continue to actively participate as necessary to improve data collection and use. New staff shall be
trained in HMIS, as well as refresher training as available/needed for existing staff.
9. Provide a detailed budget narrative that provides specifics and calculations used for PATH
Administration funds. The narrative should describe the attached Federal Grant Detailed Program
Budget.
Enclosure 8 Program 1 - Provider Budget and Enclosure 8 Program 2 - County Budget provides the
breakdown of PATH program costs. PATH Allocation ($317,162) and County Match ($105,721) in the
amount of$422,883 will be used to fund contracted services and administrative cost for the County and
contracted service provider, while providing outreach, case management, housing, mental health and/or
co-occurring services and linkage to homeless adults with SMI and/or co-occurring disorder. Staffing
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costs of$258,664 will fund 3.81 FTE positions comprised of 0.07 FTE Staff Analyst, 0.01 FTE Senior
Staff Analyst, 0.01 FTE Executive Director, 0.01 FTE Regional Director, 0.60 FTE Program Manager,
0.94 FTE Case Managers, 2.00 FTE OEL Outreach Workers (also may meet classifications as personal
service coordinators/peer support specialists), 0.07 FTE Accountant, 0.05 FTE QI Data Analyst and 0.05
FTE Administrative Specialist, inclusive of personnel taxes and benefits. Consultant costs include
$11,686 for network and data management information services and $200 for translation services.
Equipment costs include $1,710 for a copier lease and $2,900 for computer equipment and software
expenses. Supplies include office supplies and equipment costs of$4,065, $800 for printing and postage,
$5,600 for program supplies (such as soap, shampoo, and towels), telecommunication costs (data
connectivity, landline and cell phone service) of$4,625, and $100 toward furniture and fixtures. Travel
expenses include staff mileage of$300, vehicle lease costs of$13,312 for two vehicles, and $17,750
toward vehicle maintenance. Other expenses include direct client expenses toward clothing, food,
hygiene, transportation(e.g. bus passes, assistance), and housing support (one time emergency funds,
security deposits, household supplies) totaling $17,703 and education and employment support totaling
$460. Staff development, recruitment, and HMIS implementation(user licenses, training) costs total
$2,895. Building lease, maintenance, and utility costs total $24,032. Insurance costs for liability
insurances total $13,693. Lastly, other expenses include subscription&memberships to assist in the
provision of services equaling $100. In addition, funding will provide for administrative costs for the
County and Kings View as the contracted provider in the amount of$42,288 ($4,945 for County admin
overhead costs and$37,343 for Kings View admin overhead costs -no greater than 10% of PATH
funding).
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County: Fresno
Legal Name of Business: Kings View
Program Name: PATH Program
Address: 4910 E. Ashlan Ave. Ste 118
City, Zip Code: Fresno, 93726
Service Area (City and Zip Codes):
Fresno: 93650, 93701, 93702, 93703, 93704, 93705, 93706, 93707, 93708, 93709, 93710, 93711,
93712, 93714, 93715, 93716, 93717, 93718, 93720, 93721, 93722, 93723, 93724, 93725, 93726,
93727, 93728, 93729, 93730, 93737, 93740, 93741, 93744, 93747, 93750, 93755, 93760, 93761,
93764, 93765, 93771, 93772, 93773, 93774, 93775, 93776, 93777, 93778 93779, 93786, 93790, 93791,
93792, 93793, 93794, 93844, 93888
Clovis: 93611, 93612, 93613, 93619
Provider Contact: Jennifer Bolen
Telephone: (559) 256-4474
Fax: (559) 348-9345
Email:jbolen@kingsview.org
Indicate which of the following essential services will be provided by this provider with PATH
funding:
®Outreach
®Case Management
®Community Mental Health Services
❑Habilitation & Rehabilitation Services (relating to training and education to improve the individual's
functioning in the community)
®Staff Training
®Screening and Diagnostic Services
❑Alcohol or Drug Treatment
❑Supportive and Supervisory Services in Residential Settings
®Referrals for Primary Health Services, Job Training, Education Services and Relevant
Housing Services:
❑Minor Renovation, Expansion, and Repair of Housing
❑Planning of Housing
®Technical Assistance in Applying for Housing Services
®Improving the Coordination of Housing Services
❑Security Deposits
®Cost Associated with Matching Eligible Homeless Individuals with Appropriate Housing
Situations
®One-Time Rental Payments to Prevent Eviction
Indicate which budget categories are funded with PATH funds: Click on Check Box:
❑Personnel ®Equipment ®Travel
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®Consultants ®Supplies ®Other
Description of the flow of federal PATH funds in California: PATH funding in California is allocated
to the counties from the California State Department of Health Care Services. Each county has a
Mental Health Program that provides services to the public in California; the PATH funds are
distributed at the county level to either county or contracted providers.
Directions — Provider Intended Use Plan —
The Provider Intended Use Plan will provide specific information on each organization and
program funded with PATH Federal and Match funds, and should be answered at the provider's
level.
1. Provider Name (if different from the Legal Name):
2. Total Federal PATH dollars allocated from counties: $317,162
3. Total match dollars in budget: $105,721
4. Who provides the match? Fresno County
5. What funding source is used for match? Mental Health Service Act
6. Please provide a brief overview of your organization's history, current existing programs, region
served, and services provided.
Kings View has been providing mental health services in Central and Northern California for 68 years.
Kings View started with the opening of a mental health hospital in Reedley and then expanded its scope
of services to underserved and unserved populations through community programs including drug and
alcohol treatment, crisis intervention treatment, specialty mental health services, wellness centers and
telepsychiatry to Fresno Metropolitan and rural areas. Kings View has been responsive to mental health
community services, needs by serving the mentally ill homeless population in 14 local and regional
California counties.
In Fresno County, Kings View is contracted to operate several MHSA programs; one of which is the
existing PATH program,providing an array of outreach, case management, and mental health services
to the homeless with serious mental illness (SMI). Kings View also operates the Blue Sky Wellness
Center for mentally ill clients, and their families throughout Fresno County and rural areas. Kings View
operates the Rural Crisis Intervention Team (CIT) Program and the Metro Crisis Intervention Team
(CIT) Program to provide crisis mental health services by co-locating and co-responding with law
enforcement and emergency service personnel (first responders). Kings View also operates the Central
Valley Suicide Prevention Hotline which is a 24/7, 365 days per year service for children and adults
through the main number of the National Suicide Prevention Hotline. Kings View has a collaborative
partnership with two other community agencies to provide nine Multi-Agency Access Program (MAP)
Points, where Navigators provide an integrated screening process to link individuals and families facing
behavioral, social, housing, employment, health and other related challenges to supportive services.
7. The purpose of this section is to provide a description of your organization's plan to provide
coordinated and comprehensive services to eligible PATH Clients. Please provide the following
information as it relates to activities for SFY 2022-23.
a. The projected number of adult clients to be contacted using PATH funds. 350
b. The projected number of adult clients to be enrolled using PATH funds. 200
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c. The projected percentage of adult clients contacted using PATH funds to be 75%
"literally" homeless (i.e., living outdoors or in an emergency shelter rather than at
imminent risk of homelessness.)
d. Describe how the services to be provided using PATH funds will align with PATH goals to
target outreach and case management as priority services, and maximize serving the most
vulnerable adults who are literally and chronically homeless. In addition, describe services and
community supports to be provided to assure long-term housing for veterans with serious
mental illness that are experiencing homelessness.
Kings View's PATH-funded program will prioritize serving adults who are literally
homeless or at risk of homelessness by focusing outreach efforts in places not meant for
human habitation. Seventy-five percent of clients served are projected to be literally
homeless. By having evidence based practice (EBP) trained and recovery experienced
staff, clients are more likely to be engaged and reveal PATH eligibility in order to start
program services. Services include assistance to housing services, providing food,
clothes, transportation and linkage to housing programs, County Mental Health, social
service programs and community-based organizations as needed. Additional services
include on-site safety planning, assessments, case management, individual and group
support groups, mental health rehabilitation, Telepsychiatry, medication monitoring and
supportive and stable housing services.
e. List the evidence-based practices currently used.
In outreach and engagement efforts, the Kings View PATH team utilizes ASIST
(Applied Suicide Intervention Skills Training)to use a suicide intervention model to
identify individuals with thoughts of suicide, develop a safeplan based upon a review of
risk and follow-up when servicing individuals. Outreach staff and Case Managers are
also trained and aware of trauma informed and gender specific care, and cultural
competency needs of clients. Kings View PATH program utilizes the Wellness
Recovery Action Plan(WRAP) model along with Cognitive Behavioral (CBT) and
Motivational Interviewing (MI)models designed to engage individuals with serious
mental health challenges, whose needs have not been met through the traditional service
delivery model. Team members collaborate on assessments,plan of care and day to day
interventions in order to better monitor and assist individuals to self-sustained recovery.
f. Provide a brief description of partnerships and activities with local community organizations
that provide key services (e.g. outreach teams, primary health, mental health, substance use
disorder, housing, employment) to PATH-eligible clients, and describe the coordination of
activities and policies with those organizations. Provide specific information about how
coordination with other outreach teams will be achieved.
Kings View PATH collaborates with various community organizations to provide key
services to homeless adults who are mentally ill. Initial contact and stabilization of
PATH grant eligible clients will be done through clinical assessment by a licensed
therapist at the PATH program. Homeless mentally ill clients with a substance abuse
disorder who receive case management services and require additional support will be
referred to the Fresno County Department of Behavioral Health and its other contracted
providers specializing in treatment services for co-occurring disorders such as
WestCare. For primary health care, linkage will be made to Federally Qualified Health
Care clinics, other health care facilities such as the Fresno Community Hospitals,
Clinica Sierra Vista and local private doctors. PATH encourages and assists clients to
register through the Affordable Health Care Act Programs within California. Social
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services and employment service linkages will be made to the Fresno County
Department of Social Services, Social Securtiy Administration, California DMV, and
West Fresno Family Resource Center. Additional organizations that may provide
services or resources include Fresno County Superior Court, Poverello House, Fresno
Rescue Mission, Centro La Familia, Marjaree Mason Center, Veteran's Administration,
Kings View Behavioral Health Services, MAP, WestCare, SOS,NAMI, Fresno County
Housing Authority, Turning Point Triage Shelters and faith based organizations.
g. Explain the gaps in current service systems that pertain to your PATH client population.
Emergency Shelter and Permanent Supportive Housing is still scarce for the homeless
population in Fresno County. Permanent supportive housing through the Coordinated
Entry System (CES) is even more limited and has strict guidelines which homeless
individuals with mental illness and or co-occurring disorder may not qualify. Kings
View PATH works with a large population of clients with substance use disorders and
the lack of available residential treatment facilities such as room and boards and
transitional housing. There continues to be a high volume of homeless that live in the
rural communities who lack the ability to access basic services for housing,
transportation, emergency shelter and mental health due to limited availability and
transportation barriers.
h. Provide a description of the current services available to clients who have both a serious
mental illness and substance use disorder.
Kings View PATH program provides co-occurring rehabilitation and support services
embedded in a variety of behavioral health services including assistance into permanent
housing, targeted case management, psychiatric services, referrals to other program
services and providing transportation for such services. Groups with rehablitation
interventions are provided to support decompensation/relapse, stabilization and
maintenance. Co-occurring clients also receive substance use disorder psycho-education
and counseling. Appropriate referrals are made to substance use disorder treatment
providers when a higher level of care is needed and the clients sees a need for more
support.
i. Indicate the strategies that will be used for making suitable housing available for PATH clients
(e.g. indicate the type of housing provided and the name of the agency).
Kings View continuously supports the development of housing works with community
organizations such as the Fresno Housing Authority and the County by participating in
weekly outreach committees and collaboratives. Fresno County provides housing
opportunities through MHSA Housing programs and Housing Authorities. Fresno
County also currently provides supported independent living through several housing
projects including Shelter Plus Care, Renaissance sites (Alta Monte, Trinity, and Santa
Clara), and No Place Like Home sites (currently Villages at Paragon and Villages at
Broadway) that are dedicated to the mentally ill and homeless. These project exist
through the Memorandum of Understanding between Fresno County and Fresno
Housing Authority. In addition to the various placement facilities available within the
County, Kings View PATH program will provide ongoing supported housing services to
assist clients to attain and maintain housing. The PATH program will utilize less than
20% of the available PATH program funding to support assisted housing, security
deposits, and one-time payments to prevent eviction. PATH staff also work with
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different room and board providers (Clovis Christian Sober Living, Quality Homes Inc.,
BK House of Hope and Jeremiah's Home) in order to assist clients in getting off the
streets as soon as possible while still waiting for permanent housing. PATH provides
technical assistance to individuals navigating and advocating for them with programs
like Shelter Plus Care, STASIS, Fresno County DBH Permanent Supportive Housing,
Fresno Housing Authority, low income housing apartments through the county. The
PATH Program also links clients to the emergency triage shelters that are managed by
Turning Point, Fresno City and the Fresno Housing Authority as a temporary placement
until obtaining permanent housing. Additionally, staff are committed to assist and
support clients in staying connected to their local natural supports who may also be able
to provide them with housing (e.g. family members, friends, church members, churches
and other organizations).
j. Describe how PATH eligibility is determined, when enrollment occurs, and how eligibility is
documented for PATH-enrolled clients.
Kings View's PATH-funded program will prioritize serving adults who are literally
homeless that have a severe mental illness (SMI) by focusing street outreach efforts in
places such as homeless encampments and places not meant for human habitation.
Eligiblity is determined by a standard clinical assessment conducted by a licensed
professional to determine if a client meets eligiblity for a(SMI) diagnosis and minimum
HUD criteria for homelessness. Enrollment on the same day occurs by entering the
client in AVATAR and HMIS. In addition, intake documentation forms approved by
Fresno County are also reviewed and filled out with the client during the assessment
session as part of the enrollment process.
8. Describe your organization's participation with local Housing and Urban Development Continuum
of Care (CoC) recipient(s) and other local planning activities and program coordination initiatives,
such as coordinated entry activities. If the organization is not currently working with the
Continuum(s) of Care, briefly explain the approaches to be taken by the organization to collaborate
with the CoC(s) in the areas where PATH operates.
Kings View PATH is an associate member of the Fresno Madera Continuum of Care (FMCoC).
The PATH program does not receive any HUD funds and so FMCoC full membership is not required.
The County is a voting member. Kings View participates in weekly FMCoC collaborative meetings and
activities to better serve the homeless youth, adults and families in the Fresno area including the Point
in Time (PIT)homeless count and outreach efforts in the 25 Cities Initiative. Kings View also attends
Coordinated Entry System(CES) Meetings and planning sessions.
9. Describe your Coordinated Entry/Assessment Program and roles of key partners.
The FMCoC has a CES, which Kings View PATH has been participating in since the planning
stage. The system includes the use of an initial screening to determine the client needs, the use of a
shared database, weekly shifts at MAP, outreach referrals taken regularly for new coordinated entry
clients and navigation through the housing referral process. Close collaboration is necessary with
the MAP Community Coordinator, RH Community Builders, Turning Point, Clinica Sierra Vista,
San Joaquin Veterans, WINGS Advocacy Fresno, Poverello House, DBH, WestCare, Marjoree
Mason Center and the Department of Social Services, who all participate in the FMCoC and may
provide the needed services or resources identified upon completion of the initial screening.
10. Describe the organization's participation in the Homeless Management Information System (HMIS)
and describe plans for continued training and how providers will support new staff. For any
providers not fully participating in HMIS, please describe plans to complete HMIS implementation.
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Since FY 2016-2017, Kings View PATH has been fully implementing HMIS for PATH
services. All program staff(Outreach Workers, Case Managers and Program Manager)have been
trained in HMIS data collection and entry. Staff currently input and maintain universal data
elements and PATH project specific data elements in HMIS for all clients. Kings View has
established a relationship with the Fresno Housing Authority, designated by the FMCoC as the
HMIS Lead Administrator to resolve data collection and entry issues, specifically the setup of
appropriate PATH data element fields and to ensure data quality through the creation of specialized
monthly and annual reports. The PATH project setup in HMIS will continue to be maintained in
order to meet all PATH Annual Reporting guidelines. HMIS training and data systems maintenance
will be financed through PATH and County MHSA funds. The PATH program will continue to
support all HMIS trainings and system use licenses for staff involved in outreach and case
management services in order to maintain data accuracy for clients served in the Continuum of
Care.
11. Describe the organization's plan to ensure that PATH staff have completed the SOAR Online
Course and which staff plan to assist consumers with SSI/SSDI applications using the SOAR
model and tracking the outcomes of those application in the SOAR Online Application Tracking
(OAT) system.
If the organization does not use SOAR, describe the system used to improve the accurate and
timely completion of mainstream benefit applications (e.g. SSI/SSDI). Describe the efforts used to
train staff on this alternative system and what technical assistance or support they receive to
ensure quality applications if they do not use the SAMHSA SOAR TA Center.
Kings View PATH will assist clients in obtaining any and all benefits by applying for Social
Security Income/Social Security Disability Income (SSUSSDI) and Affordable Health Care Act(ACA).
We have two new Case Managers within the PATH Program that are certified in SOAR training. Any
new staff hires within the PATH program are expected to complete the SOAR training within the first
couple of months and any existing staff will participate in any refresher course. PATH staff have
assisted clients to obtain proper documentation and support to follow up with their attorney's
recommendations on the application process and to ensure their client's make it to their attorney
appointments and hearings.
12. Describe how staff providing services to the PATH population will be sensitive to age, gender,
disability, LGBT, and racial/ethnic differences of clients. Describe the extent to which staff will
receive periodic training in cultural competence and health disparities.
Currently, the PATH program have staff that range in ages from 22-50 years old,bilingual
English/Spanish speaking, and among diverse backgrounds and exposures allow staff to identify,
understand and respect the variety of cultural, social and religious values of the client population.
Services are culturally sensitive to client needs based on age, gender, sexual orientation, race and
ethnicity. The County encourages and mandates all contractors to provide services in a culturally
sensitive and competent manner. Kings View staff participate in Cultural Competency trainings
quarterly and additional workshops provided by Fresno County.
13. Describe the demographics of the client population.
76%White or Caucasian
18%African American
3%American Indian
1%Asian
2% Native Hawaiian or Other
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Age Group Breakdown:
18-23: 1%
24-30: 1%
31-40: 29%
41-50: 37%
51-61: 31%
62 and older: 1%
Gender:
56%Males
42%Females
2% Transgender
Veteran Status:
1%Veteran
99%Non-Veteran
Staff Composition
25%White or Caucasian
75%Hispanic
30%Male
70%Female
14. Describe how individuals who experience homelessness and have serious mental illness, and their
family members, will be meaningfully involved at the organization level in the planning,
implementation, and evaluation of PATH-funded services. For example, indicate whether
individuals who are PATH-eligible are employed as staff or volunteers or serve on governing or
formal advisory boards (see Enclosure "Guidelines for Consumer and Family Participation").
Clients and their families are encouraged to participate at the organizational level in the
planning, implementation, and evaluation of PATH-funded services through the Fresno County
Behavioral Health Board (BHB). The BHB is a public advisory board on adult, children, and
justice system mental health and substance use disorder issues. Although at least 50% of the
members of the Behavioral Health Board are mental health clients and or family members, none
of the PATH-eligible clients have chosen to participate. Additionally, Fresno County DBH
conducts a Community Planning Process to collect stakeholder input for the County's MHSA
Three-Year Plan and Annual Updates, which report on the status of current and future planned
MHSA-funded programs. Kings View PATH encourages clients to attend Behavioral Health
Board and Community Planning Process meetings to provide input and feedback. In the past,
Kings View has hired homeless, mentally ill clients, and peer supports at various levels of the
organization.
15. Describe veteran-specific services your organization will provide. Identify community organizations
that provide veteran-specific services with which the PATH program collaborates.
Kings View PATH is proactive in encouraging veterans to seek services. Clients who self-
identify as a veteran are eligible to all PATH program services in regards to mental health,
substance use and housing services. In addition, veterans are referred to programs available
through the Veterans Administration (VA) and San Joaquin Valley Veterans (SJVV).Veterans
who have been Other than Honorable (OTH) discharged or do not qualify for VA services are
linked to other County Programs or community agencies. Kings View has partnered with
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different agencies to identify and link veterans to appropriate services. Specific services also
include transportation to veteran's services. The PATH program works closely with agencies
that work with veterans especially those that are members of the FMCoC in order to help
promote successful assistance, referral and linkage for continuity of care.
16. Provide a detailed budget narrative that provides specifics and calculations used for PATH funds.
The narrative should describe the attached Federal Grant Detailed Program Budget.
Enclosure 8 Program 1 - Provider Budget and Enclosure 8 Program 2 - County Budget provides
the breakdown of PATH program costs. PATH Allocation($317,162) and County Match
($105,721) in the amount of$422,883 will be used to fund contracted services and
administrative cost for the County and contracted service provider, while providing outreach,
case management, housing, mental health and/or co-occurring services and linkage to homeless
adults with SMI and/or co-occurring disorder. Staffing costs of$258,664 will fund 3.81 FTE
positions comprised of 0.07 FTE Staff Analyst, 0.01 FTE Senior Staff Analyst, 0.01 FTE
Executive Director, 0.01 FTE Regional Director, 0.60 FTE Program Manager, 0.94 FTE Case
Managers, 2.00 FTE OEL Outreach Workers (also may meet classifications as personal service
coordinators/peer support specialists), 0.07 FTE Accountant, 0.05 FTE QI Data Analyst and
0.05 FTE Administrative Specialist, inclusive of personnel taxes and benefits. Consultant costs
include $11,686 for network and data management information services and$200 for
translation services. Equipment costs include $1,710 for a copier lease and $2,900 for computer
equipment and software expenses. Supplies include office supplies and equipment costs of
$4,065, $800 for printing and postage, $5,600 for program supplies (such as soap, shampoo, and
towels), telecommunication costs (data connectivity, landline and cell phone service) of$4,625,
and$100 toward furniture and fixtures. Travel expenses include staff mileage of$300, vehicle
lease costs of$13,312 for two vehicles, and$17,750 toward vehicle maintenance. Other
expenses include direct client expenses toward clothing, food, hygiene, transportation(e.g. bus
passes, assistance), and housing support (one time emergency funds, security deposits,
household supplies) totaling $17,703 and education and employment support totaling $460.
Staff development, recruitment, and HMIS implementation(user licenses, training) costs total
$2,895. Building lease, maintenance, and utility costs total $24,032. Insurance costs for liability
insurances total $13,693. Lastly, other expenses include subscription& memberships to assist in
the provision of services equaling $100. In addition, funding will provide for administrative
costs for the County and Kings View as the contracted provider in the amount of$42,288
($4,945 for County admin overhead costs and $37,343 for Kings View admin overhead costs -
no greater than 10% of PATH funding).
PATH Provider Intended Use Plan —SFY 2022-23 Page 8 of 8
Rev. 03/22
I!I_SAWGov°
FRESNO, COUNTY OF
ALERT! This entity is only available FOR OFFICIAL USE ONLY.
DUNS Unique Entity ID SAM Unique Entity ID CAGE/NCAGE
080055902 RUJLP1 K3WWK9 7JJ15
Purpose of Registration Registration Status Expiration Date
All Awards Active Mar 28,2023
Physical Address Mailing Address
4417 E Inyo AVE Bldg 333 1925 E Dakota AVE
Fresno,California 93702-2977 Fresno,California 93726-4821
United States United States
Doing Business as Division Name Division Number
Department of Behavioral Health Behavioral Health (blank)
Congressional District State/Country of Incorporation URL
California 16 (blank)/(blank) https://www.co.fresno.ca.us/departments/behavior
al-health
MPIN
*****no10
Registration Dates
Activation Date Submission Date Initial Registration Date
Mar 30,2022 Mar 28,2022 Jan 13,2016
Entity Dates
Entity Start Date Fiscal Year End Close Date
Apr 19,1856 Jun 30
Immediate Owner
CAGE Legal Business Name
(blank) (blank)
Highest Level Owner
CAGE Legal Business Name
(blank) (blank)
Executive Compensation
In your business or organization's preceding completed fiscal year,did your business or organization(the legal entity to which this specific SAM record,
represented by a DUNS number,belongs)receive both of the following: 1.80 percent or more of your annual gross revenues in U.S.federal contracts,
subcontracts,loans,grants,subgrants,and/or cooperative agreements and 2.$25,000,000 or more in annual gross revenues from U.S.federal contracts,
subcontracts,loans,grants,subgrants,and/or cooperative agreements?
No
Does the public have access to information about the compensation of the senior executives in your business or organization(the legal entity to which this
specific SAM record,represented by a DUNS number,belongs)through periodic reports filed under section 13(a)or 15(d)of the Securities Exchange Act of
1934(15 U.S.C.78m(a),78o(d))or section 6104 of the Internal Revenue Code of 1986?
Not Selected
Proceedings Questions
Is your business or organization,as represented by the DUNS Number on this entity registration,responding to a Federal procurement opportunity that
contains the provision at FAR 52.209-7,subject to the clause in FAR 52.209-9 in a current Federal contract,or applying for a Federal grant opportunity
which contains the award term and condition described in 2 C.F.R.200 Appendix XII?
No
Does your business or organization,as represented by the DUNS number on this specific SAM record,have current active Federal contracts and/or grants
with total value(including any exercised/unexercised options)greater than$10,000,000?
Not Selected
Within the last five years,had the business or organization(represented by the DUNS number on this specific SAM record)and/or any of its principals,in
connection with the award to or performance by the business or organization of a Federal contract or grant,been the subject of a Federal or State(1)
criminal proceeding resulting in a conviction or other acknowledgment of fault;(2)civil proceeding resulting in a finding of fault with a monetary fine,penalty,
Last updated by Sean Patterson on Mar 28,2022 at 12.-16 PM FRESNO,COUNTY OF
reimbursement,restitution,and/or damages greater than$5,000,or other acknowledgment of fault;and/or(3)administrative proceeding resulting in a
finding of fault with either a monetary fine or penalty greater than$5,000 or reimbursement, restitution,or damages greater than$100,000,or other
acknowledgment of fault?
Not Selected
Exclusion Summary
Active Exclusions Records?
No
I authorize my entity's non-sensitive information to be displayed in SAM public search results:
Yes
Business Types
Entity Structure Entity Type Organization Factors
U.S.Government Entity US Local Government (blank)
Profit Structure
(blank)
Socio-Economic Types
Check the registrant's Reps&Certs, if present,under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small
business concern.Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the
SBA supplemental pages during registration.
Government Types
U.S.Local Government
County
Financial Information
Accepts Credit Card Payments Debt Subject To Offset
Yes No
EFT Indicator CAGE Code
0000 7JJ15
Electronic Funds Transfer
Account Type Routing Number Lock Box Number
Financial Institution Account Number
Automated Clearing House
Phone(U.S.) Email Phone(non-U.S.)
Fax
Remittance Address
EIN Type of Tax Taxpayer Name
*****0512 Applicable Federal Tax COUNTY OF FRESNO
Tax Year(Most Recent Tax Year) Name/Title of Individual Executing Consent TIN Consent Date
2020 Behavioral Health Business Manager Mar 28,2022
Address
P.O.Box 1247
Fresno,California 93715
Accounts Receivable POC
0
1.
Sean Patterson
spatterson@fresnocountyca.gov
https:ll,sam.govlentityIO800559021coreData?status—Active Page 2 of 3
Last updated by Sean Patterson on Mar 28,2022 at 12.-16 PM FRESNO,COUNTY OF
5596004601
Electronic Business
1. 1925 E Dakota AVE
Sean Patterson Fresno,California 93726
spatterson@fresnocountyca.gov United States
5596004601
Government Business
1925 E Dakota AVE
Sean Patterson Fresno,California 93726
spatterson@fresnocountyca.gov United States
5596004601
Company Security Level Highest Level Employee Security Level
(blank) (blank)
NAICS Codes
Primary NAICS Codes NAICS Title
Yes 621420 Outpatient Mental Health And Substance Abuse Centers
621330 Offices Of Mental Health Practitioners(Except Physicians)
623220 Residential Mental Health And Substance Abuse Facilities
624190 Other Individual And Family Services
921190 Other General Government Support
IGT Size Metrics
Annual Revenue(from all IGTs)
(blank)
Worldwide
Annual Receipts(in accordance with 13 CFR Number of Employees(in accordance with 13 CFR
121) 121)
$290,189,923.00 745
Location
Annual Receipts(in accordance with 13 CFR Number of Employees(in accordance with 13 CFR
121) 121)
(blank) (blank)
Industry-Specific
Barrels Capacity Megawatt Hours Total Assets
(blank) (blank) (blank)
This entity did not enter the EDI information
This entity does not appear in the disaster response registry.
https://sam.govlentityIO800559021coreData?status—Active Page 3 of 3
State of California-Health and Human Services Agency Department of Health Care Services
SFY 2022-23 v1.3 Enclosure 8
Current ICR 0.00%
I FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPE OF GRANT Projects for Assistance in Transition from Homelessness (PATH)
PROGRAM NAME PATH (Provider)
bUbMibblUN
COUNTY Fresno DATE 4/6/2022
Fiscal Contact Harlan Theng I Phone 559-600-4619
Email Address Itheng@fresnocountyca.gov
Program Contact Gavin Harrison Phone 559-600-7664
Email Address gharrison@fresnocountyca.gov
STAFFING 1 2 3
ANNUAL RANT FEDERAL NOW
TITLE OF POSITION SALARY FTE PATH FEDERAL TOTAL
1 Executive Director $ 135,100 0.01 $ 1,351 $ 451 $ 1,802
2 Regional Director $ 90,500 0.01 $ 905 $ 302 $ 1,207
3 Program Manager $ 89,507 0.60 $ 53,704 $ 17,921 $ 71,625
4 Admin Specialist $ 38,620 0.05 $ 1,931 $ 645 $ 2,576
5 Outreach Worker $ 28,514 2.00 $ 57,027 $ 19,029 $ 76,056
6 Case Manager $ 32,488 0.94 $ 30,539 $ 10,191 $ 40,730
7 Accountant $ 41,143 0.07 $ 2,880 $ 961 $ 3,841
8 Quality Improvement Data Analyst $ 50,480 0.051 $ 2,524 $ 842 $ 3,366
9 $ - 0.00 $ - $ - $ -
10 $ - 0.00 $ - $ - $ -
11 $ - 0.00 $ - $ - $ -
12 $ - 0.00 $ - $ - $ -
13 $ - 0.00 $ - $ - $ -
14 Fringe Benefits $ - 0.00 $ 37,715 $ 12,585 $ 50,300
15 TOTAL STAFF EXPENSES sum lines 1 thru 14 $ 188,576 $ 62,927 $ 251,503
Consultant Costs (Itemize):
16 Network and Data Management Consultant $ 8,762 $ 2,924 $ 11,686
17 Translation Services $ 150 $ 50 $ 200
18 $ - $ - $ -
Equipment (Where feasible lease or rent) (Itemize):
19 Rent/Lease Equipment Copier $ 1,282 $ 428 $ 1,710
20 Computer Equipment and Software $ 2,174 $ 726 $ 2,900
21 $ - $ - $ -
22 $ - $ - $ -
Supplies (Itemize):
23 Office Supplies & Equipment $ 3,048 $ 1,017 $ 4,065
24 Printing/Postage $ 600 $ 200 $ 800
25 Program Supplies $ 4,199 $ 1,401 $ 5,600
26 Telecommunications $ 3,468 $ 1,157 $ 4,625
27 Furniture & Fixtures $ 75 $ 25 $ 100
Travel -Per diem, Mileage, &Vehicle Rental/Lease
28 Staff Mileage $ 225 $ 75 $ 300
29 Rent/Lease Vehicle $ 9,981 $ 3,331 $ 13,312
30 Vehicle Maintenance $ 13,309 $ 4,441 $ 17,750
31 $ - $ - $ -
Other Expenses (Itemize):
32 Client Food, Clothing, Hygiene, Transportation & Housing Suppo $ 13,274 $ 4,429 $ 17,703
33 Staff Development, Recruitment, and HMIS Implementation $ 2,171 $ 724 $ 2,895
34 Building Lease, Maintenance, and Utilities $ 18,019 $ 6,013 $ 24,032
35 Insurance Costs (Professional, Liability) $ 10,267 $ 3,426 $ 13,693
36 Client Education and Employment Support $ 345 $ 115 $ 460
37 Subscriptions & Memberships $ 75 $ 25 $ 100
38 COUNTY DIRECT ADMINISTRATIVE COSTS (10% PATH) $ 28,000 $ 9,343 $ 37,343
39 INDIRECT ADMINSTRATIVE COSTS (Per County ICR %) $ - $ - $ -
41 NET PROGRAM EXPENSES (sum lines 15 thru 39) $ 308,000 $ 102,777 $ 410,777
OTHER FUNDING SOURCES
41 Federal Funds $ - $ - $ -
42 Non-Federal Funds $ - $ - $ -
43 TOTAL OTHER FUNDING SOURCES (sum lines 41 and 42) $ - $ - $ -
44 GROSS COST OF PROGRAM (sum lines 41 and 43) $ 308,000 $ 102,777 $ 410,777
Rev. 03/22 DHCS APPROVAL BY: Seongsook Duncan
DATE: 4/14/2022
State of California-Health and Human Services Agency Department of Health Care Services
SFY 2022-23 v1.3 Enclosure 8
Current ICR 0.00%
I FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPE OF GRANT Projects for Assistance in Transition from Homelessness (PATH)
PROGRAM NAME PATH (County)
COUNTY Fresno DATE 4/6/2022
Fiscal Contact Harlan Theng I Phone 559-600-4619
Email Address Itheng@fresnocountyca.gov
Program Contact Gavin Harrison Phone 559-600-7664
Email Address gharrison@fresnocountyca.gov
STAFFING I 1 1 2 3
ANNUAL �GRANT� FEDERAL NOW
TITLE OF POSITION SALARY FTE PATH FEDERAL TOTAL
1 Staff Analyst $ 64,350 0.07 $ 4,704 $ 1,457 $ 6,161
2 Senior Staff Analyst $ 83,590 0.01 $ 750 $ 250 $ 1,000
3 $ - 0.00 $ - $ - $ -
4 $ - 0.00 $ - $ - $ -
5 $ - 0.00 $ - $ - $ -
6 $ - 0.00 $ - $ - $ -
7 $ - 0.00 $ - $ - $ -
8 $ - 0.00 $ - $ - $ -
9 $ - 0.00 $ - $ - $ -
10 $ - 0.00 $ - $ - $ -
11 $ - 0.00 $ - $ - $ -
12 $ - 0.00 $ - $ - $ -
13 $ - 0.00 $ - $ - $ -
14 Fringe Benefits $ - 0.00 $ - $ - $ -
15 TOTAL STAFF EXPENSES sum lines 1 thru 14 $ 5,454 $ 1,707 $ 7,161
Consultant Costs (Itemize):
16 $ - $ - $ -
17 $ - $ - $ -
18 $ - $ - $ -
Equipment (Where feasible lease or rent) (Itemize):
19 $ - $ - $ -
20 $ - $ - $ -
21 $ - $ - $ -
22 $ - $ - $ -
Supplies (Itemize):
23 $ - $ - $ -
24 $ - $ - $ -
25 $ - $ - $ -
26 $ - $ - $ -
27 $ - $ - $ -
Travel -Per diem, Mileage, &Vehicle Rental/Lease
28 $ - $ - $ -
29 $ - $ - $ -
30 $ - $ - $ -
31 $ - $ - $ -
Other Expenses (Itemize):
32 $ - $ - $ -
33 $ - $ - $ -
34 $ - $ - $ -
35 $ - $ - $ -
36 $ - $ - $ -
37 $ - $ - $ -
38 COUNTY DIRECT ADMINISTRATIVE COSTS (10% PATH) $ 3,708 $ 1,237 $ 4,945
39 INDIRECT ADMINSTRATIVE COSTS (Per County ICR %) $ - $ - $ -
41 NET PROGRAM EXPENSES (sum lines 15 thru 39) $ 9,162 $ 2,944 $ 12,106
OTHER FUNDING SOURCES
41 Federal Funds $ - $ - $ -
42 Non-Federal Funds $ - $ - $ -
43 TOTAL OTHER FUNDING SOURCES (sum lines 41 and 42) $ - $ - $ -
44 GROSS COST OF PROGRAM (sum lines 41 and 43) $ 9,162 $ 2,944 $ 12,106
Rev. 03/22 DHCS APPROVAL BY:
DATE:
State of California-Health and Human Services Agency Department of Health Care Services
SFY 2022-23 v1.3 Enclosure 7
Current ICRI 0.00%
FEDERAL GRANT BUDGET SUMMARY
TYPE OF GRANT I Projects for Assistance in Transition from Homelessness(PATH)
Fiscal Contact Harlan Theng JPhone 559-600-4619
Email Address Itheng@fresnocountyca.gov
BUDGET CATEGORIES
GRANT PROGRAM, FUNCTION OR ACTIVITY
Object Class Categories (1) Federal (2) Non-Federal
a. Personnel $ 156,315 $ 52,049
b. Fringe Benefits $ 37,715 $ 12,585
c. Consultant $ 8,912 $ 2,974
d. Equipment $ 3,456 $ 1,154
e. Supplies $ 11,390 $ 3,800
f. Travel $ 23,515 $ 7,847
q. Other $ 44,151 $ 14,732
h. Total Net Costs sum of a - $ 285,454 $ 95,141
i. Direct Administrative Costs $ 31,708 $ 10,580
Indirect Costs $ - $ -
k. TOTALS sum of h thru ) $ 317,162 $ 1055721
Enclosure 9
Checklist for PATH Application SFY 2022-23
All application documents may be submitted electronically. Before submitting the
application electronically, please use this checklist to ensure your application includes all
the following components:
® Enclosure 1 - PATH Funding Allocation worksheet - to be signed by the County Mental
Health Director. This document must be scanned and submitted electronically.
® Enclosure 2 - Federal Assurances - to be signed by the County Mental Health
Director. This document must be scanned and submitted electronically.
® Enclosure 3 - Compliance Assurances - to be signed by the County Mental Health
Director. This document must be scanned and submitted electronically.
® Enclosure 4 - Federal Assurances - Non-Construction - to be signed by the County
Mental Health Director. This document must be scanned and submitted electronically.
® Enclosure 5 - County Intended Use Plan — required only if the county is
subcontracting with another organization or operating two or more PATH programs.
® Program contact information - information for a contact within the County who is
responsible for the program functions of PATH.
X Fiscal contact information - information for a contact within the County who is
responsible for the fiscal functions of PATH.
® Please indicate all essential services and budget categories that pertain to the
County and providers which are funded by PATH FEDERAL and MATCH funds only.
M Intended Use Plan for the County - The Intended Use Plan for the County is to
provide a summary of information from providers; however, questions are county-
specific and should be answered from the county level.
® Enclosure 6 - Provider Intended Use Plan — one per distinct PATH program.
Organization Information - Please provide all requested information.
® Service Area - Please provide information on the city and zip codes where the
specific organization provides PATH eligible services.
® Provider Contact - Please provide a contact for the organization, such as the
head outreach worker, counselor, or case manager.
® Please indicate all essential services and budget categories that pertain to the
provider, which are funded by PATH FEDERAL and MATCH funds only.
PATH SFY 2022-23 Request for Application Page 1 of 3
Enclosure 9
® Intended Use Plan for the provider - The Intended Use Plan for the provider is to
provide specific information on each organization and program funded with PATH
Federal and MATCH funds, and should be answered from a provider's level.
® Enclosure 7 & 8 Detailed Budget Workbook - Effective SFY 2022-23, Enclosures 7 & 8
will be combined into a single workbook. Please note, Enclosure 7 will auto populate so no
action is needed.
® Enclosure 7 — Federal Budget Summary —This tab is formula driven and will
automatically calculate the total cost of the County's PATH Program.
® Enclosure 8 — PATH Federal Grant Detailed Program Budget - This required
budget template is to be submitted for each program funded with PATH funds.
The budget line items must contain a specific level of detail and must correlate with
its program description.
® ** Entity Data Detail.pdf document
System for Award Management (SAM) Unique Entity Identifier (UEI)
Unique Entity Identifier (UEI) Update *
The System for Award Management (SAM) website (SAM.gov) generated UEI will become
the new official identifier in April 2022. Government transition from DUNS Number to the
new UEI will occur on April 4, 2022. At this time, the federal government will stop using the
DUNS number to uniquely identify entities. Entities doing business with the federal
government will use a SAM UEI created in the (SAM.gov) website. Entities will no longer
have to go to a third-party website to obtain their identifier (DUNS). This transition allows
the government to streamline the entity identification and validation process, making it
easier and less burdensome for entities to do business with the federal government.
More information regarding this transition can be found online at:
https://sam.gov/content/duns-uei
SAM Unique Entity Identifier Number
Please note that counties applying for PATH funding are required to provide their SAM
UEI, created on SAM.gov, to DHCS. Guidance can be found online at:
https://sam.gov/content/duns-uei
Your County's SAM UEI number must also be registered and active in the SAM.gov
website, and updated annually. Guidance can be found online at:
https://sam.gov/content/duns-uei
The county must ensure the downloadable "Entity Data Detail.pdf" form obtained from
the SAM.gov website is included with all other required application documents.
Applications will not be reviewed until a valid and current "Entity Data Detail.pdf' has
PATH SFY 2022-23 Request for Application Page 2 of 3
Enclosure 9
been received from the county. Please check the box on page one to verify "Entity
Data Detail.pdf" is included with required application documents.
Please reach out to our team via email at PATH ,dhcs.ca.gov if your county requires
additional assistance in downloading the "Entity Information.pdf."
PATH SFY 2022-23 Request for Application Page 3 of 3