HomeMy WebLinkAboutAgreement A-14-437-1 with Central Star.pdf1
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Agreement No. 14-437-1
AMENDMENT I TO AGREEMENT
THIS AMENDMENT, hereinafter referred to as "Amendment 1", is made and entered into
this 16th day of __ ...!,!M~a'L.y ___ , 2017 , by and between the COUNTY OF FRESNO, a Political
Subdivision ofthe State of California, hereinafter referred to as "COUNTY", and CENTRAL STAR
BEHAVIORAL HEALTH INC., a California Corporation, whose address is 1501 Hughes Way,
Suite 150, Long Beach, CA 90810, hereinafter referred to as "CONTRACTOR" (collectively as the
"parties").
WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
No. 14-437, effective July 29 ,2014, whereby CONTRACTOR agreed to provide outpatient specialty
mental health, court-specific, and community support services for chi ldren and youths involved in the
Child Welfare Services (CWS) system; and
WHEREAS, the parties desire to amend COUNTY Agreement No . 14-437, regarding changes
as stated below and restate the Agreement in its entirety.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
is hereby acknowledged, the parties agree to amend the Agreement as follows:
I. That the existing COUNTY Agreement No. 14-437, Page Three (3), beginning with
17 Line Twenty-Two (22), with the word "COUNTY" and ending on Page Four (4), Line Ten (10) with
1 8 the word "CONTRACTOR" be deleted and the following inserted in its place:
19 "COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
2 0 compensation based on rates per service modality in accordance with the budget set forth in Revised
21 Exhibit B, attached hereto and by this reference incorporated herein and made part of this Agreement.
2 2 COUNTY agrees to reimburse CONTRACTOR on a monthly basis, based on units per service.
2 3 Payment shall be made upon certification or other proof satisfactory to COUNTY that services have
2 4 actually been performed by CONTRACTOR as specified in this Agreement.
25 The maximum contract amount for the period of July 29,2014 through June 30,2015
2 6 shall not exceed One Million Five Hundred Thousand and Noll 00 Dollars ($1 ,500,000.00), as
27 identified in Revised Exhibit B .
28 For the period of July 29, 2014 through June 30,2015, it is understood by
-1 -CO UNTY OF FRESN O
Fresno , CA
COUNTY OF FRESNO
Fresno, CA
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CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million Five
Hundred Thousand and No/100 Dollars ($1,500,000.00) in revenue, including One Million Four
Hundred Thirty-One Thousand Six Hundred Thirty-Three and No/100 Dollars ($1,431,633.00) in
Medi-Cal revenue and Sixty-Eight Thousand Three Hundred Sixty-Seven and No/100 Dollars
($68,367.00) in Social Services revenue to offset CONTRACTOR’S program costs, as set forth in
Revised Exhibit B.
The maximum contract amount for the period of July 1, 2015 through June 30, 2016
shall not exceed Three Million and No/100 Dollars ($3,000,000.00), as identified in Revised Exhibit
B.
For the period of July 1, 2015 through June 30, 2016, it is understood by
CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Three Million and No/100
Dollars ($3,000,000.00) in revenue, including Two Million Seven Hundred Twenty-Six Thousand
Five Hundred Thirty-Two and No/100 Dollars ($2,726,532.00) in Medi-Cal revenue and Two
Hundred Seventy-Three Thousand Four Hundred Sixty-Eight and No/100 Dollars ($273,468.00) in
Social Services revenue to offset CONTRACTOR’S program costs, as set forth in Revised Exhibit B.
The maximum contract amount for the period of July 1, 2016 through June 30, 2017
shall not exceed Three Million Six Hundred Thousand and No/100 Dollars ($3,600,000.00), as
identified in Revised Exhibit B.
For the period of July 1, 2016 through June 30, 2017, it is understood by
CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Three Million Six
Hundred Thousand and No/100 Dollars ($3,600,000.00) in revenue, including Three Million Four
Hundred Thirty-Five Thousand Nine Hundred Nineteen and No/100 Dollars ($3,435,919.00) in Medi-
Cal revenue and One Hundred Sixty-Four Thousand Eighty-One and No/100 Dollars ($164,081.00) in
Social Services revenue to offset CONTRACTOR’S program costs, as set forth in Revised Exhibit B.
The maximum contract amount for the period of July 1, 2017 through June 30, 2018
shall not exceed Four Million and No/100 Dollars ($4,000,000.00), as identified in Revised Exhibit B.
For the period of July 1, 2017 through June 30, 2018, it is understood by
CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Million and No/100
COUNTY OF FRESNO
Fresno, CA
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Dollars ($4,000,000.00) in revenue, including Three Million Eight Hundred Seventeen Thousand Six
Hundred Eighty-Eight and No/100 Dollars ($3,817,688.00) in Medi-Cal revenue and One Hundred
Eighty-Two Thousand Three Hundred Twelve and No/100 Dollars ($182,312.00) in Social Services
revenue to offset CONTRACTOR’S program costs, as set forth in Revised Exhibit B.
The maximum contract amount for the period of July 1, 2018 through June 30, 2019
shall not exceed Four Million and No/100 Dollars ($4,000,000.00), as identified in Revised Exhibit B.
For the period of July 1, 2018 through June 30, 2019, it is understood by
CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Million and No/100
Dollars ($4,000,000.00) in revenue, including Three Million Eight Hundred Seventeen Thousand Six
Hundred Eighty-Eight and No/100 Dollars ($3,817,688.00) in Medi-Cal revenue and One Hundred
Eighty-Two Thousand Three Hundred Twelve and No/100 Dollars ($182,312.00) Social Services
revenue to offset CONTRACTOR’S program costs, as set forth in Revised Exhibit B.
In no event shall the total maximum compensation for actual services performed under
this Agreement be in excess of Sixteen Million One Hundred Thousand and No/100 Dollars
($16,100,000.00). It is understood that all expenses incidental to CONTRACTOR’s performance of
services under this Agreement shall be borne by CONTRACTOR.”
2. That all references in existing COUNTY Agreement No. 14-437 to Exhibit B shall be
changed to read “Revised Exhibit B”, attached hereto and incorporated herein by reference.
COUNTY and CONTRACTOR agree that this Amendment I is sufficient to amend the
Agreement; and that upon execution of this Amendment I, the Agreement and Amendment I together
shall be considered the Agreement.
The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants,
conditions and promises contained in the Agreement, and not amended herein, shall remain in full
force and effect. This Amendment I shall become effective retroactive to April 1, 2017.
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IN WITNESS WHEREOF, the parties hereto have executed this Amendment I to COUNTY
Agreement No. 14-437 as of the day and year first hereinabove written.
CONTRACTOR:
CENTRAL STAR BEHAVIORAL
HEALTH INC.
ByOl>L
Print Name : 0 I j \/lA, Ate.AIVd "-"
Title: Vf ~ (!_ r 0
Chairman ofBoard, or
President, or any Vice President
Print Name: 0/J ~~~ A~~J:J~
Title : Vfc~-C,FO
Secretary (of Corporation), or
any Assistant Secretary, or
ChiefFinanclal Officer, or
any Assistant Treasurer
Mailing Address:
lSOl Hughes Way, Suite ISO
Long Beach. CA 90810
Phone: (310) 221-6336 ext 12S
Contact: Senior Vice President
COUNTY OF FRESNO
By {L ~l._
Chairman, Board of Supervisors
Date : 5 -\ lo ~ \ )
BERNICE E. SEIDEL, Clerk
Board of Supervisors
PLEASE SEE ADDmONAL
SIGNATURE PAGE A1TACBED
-. -COON'rY or nzsNO
rresno, CA
Revised Exhibit B
Page:1 of 10
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Administrator 0.25 $36,764 $0 $36,764
0002 Center Director 1.00 $0 $80,018 $80,018
0003 Psychologist 0.50 $0 $62,504 $62,504
0004 Mental Health Specialist II 7.80 $0 $398,951 $398,951
0005 Psychiatrist 0.23 $0 $80,023 $80,023
0006 Parent Partner 1.00 $0 $22,963 $22,963
0007 HR/Training Coordinator 1.00 $58,822 $0 $58,822
0008 Business Office Coordinator 0.50 $32,500 $0 $32,500
0009 Quality Assurance/Billing Coordinator 1.00 $51,126 $0 $51,126
SALARY TOTAL 13.28 $179,212 $644,459 $823,671
PAYROLL TAXES:
0030 FICA/MEDICARE $13,710 $38,398 $52,108
0031 SUI $968 $2,710 $3,678
0032 FUTA $1,685 $4,718 $6,403
PAYROLL TAX TOTAL $16,363 $45,826 $62,189
EMPLOYEE BENEFITS:
0040 Retirement $7,527 $21,081 $28,608
0041 Workers Compensation $8,889 $24,895 $33,784
0042 $20,520 $57,471 $77,991
EMPLOYEE BENEFITS TOTAL $36,936 $103,447 $140,383
SALARY & BENEFITS GRAND TOTAL $1,026,243
FACILITIES/EQUIPMENT EXPENSES:
1010 Facility Rent $43,266
1011 Leased Equipment $12,156
1012 Utilities $8,221
1013 Maintenance (facility)$7,355
FACILITY/EQUIPMENT TOTAL $70,998
OPERATING EXPENSES:
1060 $22,200
1061 $25,000
1062 $1,000
1063 $7,915
1064 $20,217
1065 $2,400
OPERATING EXPENSES TOTAL $78,732
FINANCIAL SERVICES EXPENSES:
1080 Centralized Services $169,114
1081 Insurance $4,716
FINANCIAL SERVICES TOTAL $173,830
SPECIAL EXPENSES (Consultant/Etc.):
Staff Mileage
Food Snacks
Health Insurance (medical, vision, life, dental)
Telephone
Education and Training
Licenses
Office Supplies
Line Item Description (Must be itemized)
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2014 to June 30, 2015
Budget Categories - Total Proposed Budget
Revised Exhibit B
Page:2 of 10
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2014 to June 30, 2015
Budget Categories - Total Proposed Budget1087Professional Fees $2,161
1088 Purchased Services $21,743
1089 Denied Claims $75,000
1090 Recruitment $2,100
SPECIAL EXPENSES TOTAL $101,004
FIXED ASSETS:
2000 IT Minor Equipment $17,086
2001 Furniture $32,107
FIXED ASSETS TOTAL $49,193
TOTAL PROGRAM EXPENSES $1,500,000
DIRECT SERVICE REVENUE:
Vol/Units of
Svc Rate $ Amt.
3000 Mental Health Services 311,418 $2.81 $875,084.58
(Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab)
3100 Case Management, Linkage/Brokerage 77,126 $2.17 $167,363
3200 Crisis Intervention 0 $4.17 $0
3300 Medication Support 14,904 $5.18 $77,203
3400 Collateral 111,026 $2.81 $311,983
DIRECT SERVICE REVENUE TOTAL 514,474 $1,431,633
$715,816
$572,653
$143,163
$1,431,633
Cost Per Unit $2.78
Social Services Revenue $68,367
OTHER REVENUE:
3500 Psychological Evaluations 4,650 $2.81 $13,067
3600 Bonding Studies 2,400 $2.81 $6,744
3700 Court Documentation, Reports 8,640 $2.81 $24,278
3800 Court Appearance 8,640 $2.81 $24,278
OTHER REVENUE/SOCIAL SERVICES TOTAL $68,367
TOTAL PROGRAM REVENUE $1,500,000
Medi-cal Revenue
Medi-cal Revenue - 50% FFP
Medi-cal Revenue - 40% EPSDT
Medi-cal Revenue - 10% CGF
Revised Exhibit B
Page:3 of 10
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Administrator 0.25 $37,499 $0 $37,499
0002 Center Director 1.00 $0 $81,619 $81,619
0003 Supervisor 2.00 $0 $122,803 $122,803
0004 Psychologist 1.00 $0 $127,508 $127,508
0005 Mental Health Specialist II 16.10 $0 $855,803 $855,803
0006 Psychiatrist 0.47 $0 $163,246 $163,246
0007 Parent Partner 4.30 $0 $100,717 $100,717
0008 HR/Training Coordinator 1.00 $58,822 $0 $58,822
0009 Business Office Coordinator 0.50 $32,500 $0 $32,500
0010 Quality Assurance/Billing Coordinator 1.00 $51,126 $0 $51,126
SALARY TOTAL 27.62 $179,947 $1,451,696 $1,631,644
PAYROLL TAXES:
0030 FICA/MEDICARE $13,766 $98,566 $112,332
0031 SUI $972 $6,956 $7,928
0032 FUTA $1,692 $12,111 $13,803
PAYROLL TAX TOTAL $16,430 $117,633 $134,063
EMPLOYEE BENEFITS:
0040 Retirement $7,558 $54,115 $61,673
0041 Workers Compensation $8,925 $63,907 $72,832
0042 $20,604 $147,527 $168,131
EMPLOYEE BENEFITS TOTAL $37,087 $265,549 $302,638
SALARY & BENEFITS GRAND TOTAL $2,068,345
FACILITIES/EQUIPMENT EXPENSES:
1010 Facility Rent $102,419
1011 Leased Equipment $12,399
1012 Utilities $19,271
1013 Maintenance (facility)$17,242
FACILITY/EQUIPMENT TOTAL $151,331
OPERATING EXPENSES:
1060 $35,773
1061 $4,803
1062 $4,000
1063 $16,324
1064 $42,336
1065 $4,800
OPERATING EXPENSES TOTAL $108,036
FINANCIAL SERVICES EXPENSES:
1080 Centralized Services $388,360
1081 Insurance $13,008
FINANCIAL SERVICES TOTAL $401,368
Staff Mileage
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2015 to June 30, 2016
Budget Categories - Total Proposed Budget
Line Item Description (Must be itemized)
Health Insurance (medical, vision, life, dental)
Telephone
Education and Training
Licenses
Office Supplies
Food Snacks
Revised Exhibit B
Page:4 of 10
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2015 to June 30, 2016
Budget Categories - Total Proposed BudgetSPECIAL EXPENSES (Consultant/Etc.):
1087 Professional Fees $13,850
1088 Purchased Services $58,977
1089 Denied Claims $150,000
1090 Recruitment $3,070
SPECIAL EXPENSES TOTAL $225,897
FIXED ASSETS:
2000 IT Minor Equipment $17,086
2001 Furniture $27,937
FIXED ASSETS TOTAL $45,023
TOTAL PROGRAM EXPENSES $3,000,000
DIRECT SERVICE REVENUE:
Vol/Units of
Svc Rate $ Amt.
3000 Mental Health Services 622,836 $2.81 $1,750,171
(Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab)
3100 Case Management, Linkage/Brokerage 154,251 $2.17 $334,725
3200 Crisis Intervention 0 $4.17 $0
3300 Medication Support 29,808 $5.18 $154,405
3400 Collateral 222,052 $2.81 $623,966
3500 Psychological Evaluations 9,300 $2.81 $26,134
3600 Bonding Studies 4,800 $2.81 $13,488
3700 Court Documentation, Reports 17,280 $2.81 $48,556
3800 Court Appearance 17,280 $2.81 $48,556
DIRECT SERVICE REVENUE TOTAL 1,077,607 $3,000,000
$1,363,266
$1,090,613
$272,653
$2,726,532
Cost Per Unit $2.78
Social Services Revenue $273,468
OTHER REVENUE:
OTHER REVENUE/SOCIAL SERVICES TOTAL $0
TOTAL PROGRAM REVENUE $3,000,000
Medi-cal Revenue - 50% FFP
Medi-cal Revenue - 40% EPSDT
Medi-cal Revenue - 10% CGF
Medi-cal Revenue
Revised Exhibit B
Page:5 of 10
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Administrator 0.25 $37,499 $0 $37,499
0002 Assistant Administrator 1.00 $0 $81,619 $81,619
0003 Supervisor 2.30 $0 $147,139 $147,139
0004 Psychologist 1.00 $0 $102,007 $102,007
0005 Mental Health Specialist II 17.80 $0 $951,524 $951,524
0006 Psychiatrist 0.47 $0 $152,227 $152,227
0007 HR Coordinator 0.50 $29,411 $0 $29,411
0008 Training Coordinator 0.50 $29,411 $0 $29,411
0009 Training Assistant 0.30 $12,480 $0 $12,480
0010 Business Office Coordinator 0.50 $32,500 $0 $32,500
0011 Quality Assurance Coordinator 1.15 $60,798 $0 $60,798
0012 Case Manager 0.90 $0 $33,696 $33,696
0013 Community Services Clerk 0.75 $24,960 $0 $24,960
0014 Starlight Allocated Wages (benefits below)0.30 $27,337 $0 $27,337
0015 Parent Partner 3.94 $0 $92,324 $92,324
SALARY TOTAL 31.66 $254,396 $1,560,536 $1,814,932
PAYROLL TAXES:
0030 FICA/MEDICARE $18,888 $106,055 $124,943
0031 SUI $1,336 $7,490 $8,826
0032 FUTA $2,324 $13,037 $15,361
PAYROLL TAX TOTAL $22,548 $126,582 $149,130
EMPLOYEE BENEFITS:
0040 Retirement $10,388 $58,251 $68,639
0041 Workers Compensation $12,246 $68,761 $81,007
0042 $28,273 $158,739 $187,012
EMPLOYEE BENEFITS TOTAL $50,907 $285,751 $336,658
SALARY & BENEFITS GRAND TOTAL $2,300,720
FACILITIES/EQUIPMENT EXPENSES:
1010 Facility Rent $102,419
1011 Leased Equipment $16,839
1012 Utilities $20,531
1013 Maintenance (facility)$43,862
FACILITY/EQUIPMENT TOTAL $183,651
OPERATING EXPENSES:
1060 $51,261
1061 $37,106
1062 $5,330
1063 $31,404
1064 $52,725
1065 $26,160
OPERATING EXPENSES TOTAL $203,986
Staff Mileage
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2016 to June 30, 2017
Budget Categories - Total Proposed Budget
Line Item Description (Must be itemized)
Health Insurance (medical, vision, life, dental)
Telephone
Education and Training
Licenses
Office Supplies
Food Snacks - Client and Clinical Supplies
Revised Exhibit B
Page:6 of 10
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2016 to June 30, 2017
Budget Categories - Total Proposed Budget
FINANCIAL SERVICES EXPENSES:
1080 Centralized Services $484,360
1081 Insurance $19,048
FINANCIAL SERVICES TOTAL $503,408
SPECIAL EXPENSES (Consultant/Etc.):
1087 Professional Fees $24,889
1088 Purchased Services $73,400
1089 Denied Claims $180,000
1090 Recruitment $7,770
SPECIAL EXPENSES TOTAL $286,059
FIXED ASSETS:
2000 IT Minor Equipment $66,240
2001 Furniture $55,936
FIXED ASSETS TOTAL $122,176
TOTAL PROGRAM EXPENSES $3,600,000
DIRECT SERVICE REVENUE:
Vol/Units of
Svc Rate $ Amt.
3000 Mental Health Services 671,670 $2.81 $1,887,392
(Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab)
3100 Case Management, Linkage/Brokerage 102,124 $2.17 $221,609
3200 Crisis Intervention 0 $4.17 $0
3300 Medication Support 35,769 $5.18 $185,286
3400 Collateral 266,462 $2.81 $748,757
3500 ICC 82,976 $2.17 $180,059
3600 IHBS 75,735 $2.81 $212,816
DIRECT SERVICE REVENUE TOTAL 1,234,737 $3,435,919
$1,717,960
$1,374,368
$343,592
$3,435,919
Cost Per Unit $2.78
Social Services Revenue $164,081
OTHER REVENUE:
3700 Psychological Evaluations 11,160 $2.81 $31,359
3800 Bonding Studies 5,760 $2.81 $16,186
3900 Court Documentation, Reports 20,736 $2.81 $58,268
4000 Court Appearance 20,736 $2.81 $58,268
OTHER REVENUE/SOCIAL SERVICES TOTAL $164,081
TOTAL PROGRAM REVENUE $3,600,000
Medi-cal Revenue - 50% FFP
Medi-cal Revenue - 40% EPSDT
Medi-cal Revenue - 10% CGF
Medi-cal Revenue
Revised Exhibit B
Page:7 of 10
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Administrator 0.25 $37,499 $0 $37,499
0002 Assistant Administrator 0.60 $0 $48,972 $48,972
0003 Supervisor 3.00 $0 $206,003 $206,003
0004 Psychologist 0.20 $0 $25,502 $25,502
0005 Mental Health Specialist II 23.00 $0 $1,239,719 $1,239,719
0006 Psychiatrist 0.20 $0 $119,170 $119,170
0007 HR Coordinator 0.50 $29,411 $0 $29,411
0008 Training Coordinator 0.50 $29,411 $0 $29,411
0009 Training Assistant 1.00 $43,160 $0 $43,160
0010 Business Office Coordinator 0.50 $32,500 $0 $32,500
0011 Quality Assurance Coordinator 1.50 $84,146 $0 $84,146
0012 Case Manager 3.00 $0 $117,000 $117,000
0013 Community Services Clerk 2.50 $87,100 $0 $87,100
0014 Starlight Allocated Wages (benefits below)1.00 $82,840 $0 $82,840
SALARY TOTAL 37.75 $426,067 $1,756,366 $2,182,434
PAYROLL TAXES:
0030 FICA/MEDICARE $21,164 $129,063 $150,227
0031 SUI $1,498 $9,128 $10,626
0032 FUTA $2,606 $15,879 $18,485
PAYROLL TAX TOTAL $25,268 $154,070 $179,338
EMPLOYEE BENEFITS:
0040 Retirement $11,644 $70,959 $82,603
0041 Workers Compensation $13,721 $83,677 $97,398
0042 $31,679 $193,183 $224,862
EMPLOYEE BENEFITS TOTAL $57,044 $347,819 $404,865
SALARY & BENEFITS GRAND TOTAL $2,766,637
FACILITIES/EQUIPMENT EXPENSES:
1010 Facility Rent $102,419
1011 Leased Equipment $17,199
1012 Utilities $23,471
1013 Maintenance (facility)$22,642
FACILITY/EQUIPMENT TOTAL $165,731
OPERATING EXPENSES:
1060 $61,333
1061 $7,205
1062 $5,500
1063 $20,824
1064 $51,966
1065 $7,800
OPERATING EXPENSES TOTAL $154,628
Staff Mileage
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2017 to June 30, 2018
Budget Categories - Total Proposed Budget
Line Item Description (Must be itemized)
Health Insurance (medical, vision, life, dental)
Telephone
Education and Training
Licenses
Office Supplies
Food Snacks
Revised Exhibit B
Page:8 of 10
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2017 to June 30, 2018
Budget Categories - Total Proposed BudgetFINANCIAL SERVICES EXPENSES:
1080 Centralized Services $538,360
1081 Insurance $16,508
FINANCIAL SERVICES TOTAL $554,868
SPECIAL EXPENSES (Consultant/Etc.):
1087 Professional Fees $17,313
1088 Purchased Services $73,721
1089 Denied Claims $200,000
1090 Recruitment $4,470
SPECIAL EXPENSES TOTAL $295,504
FIXED ASSETS:
2000 IT Minor Equipment $28,198
2001 Furniture $34,437
FIXED ASSETS TOTAL $62,635
TOTAL PROGRAM EXPENSES $4,000,000
DIRECT SERVICE REVENUE:
Vol/Units of
Svc Rate $ Amt.
3000 Mental Health Services 746,297 $2.81 $2,097,097
(Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab)
3100 Case Management, Linkage/Brokerage 113,472 $2.17 $246,234
3200 Crisis Intervention 0 $4.17 $0
3300 Medication Support 39,744 $5.18 $205,874
3400 Collateral 296,069 $2.81 $831,955
3500 ICC 92,196 $2.17 $200,065
3600 IHBS 84,151 $2.81 $236,464
DIRECT SERVICE REVENUE TOTAL 1,371,929 $3,817,688
$1,908,844
$1,527,075
$381,769
$3,817,688
Cost Per Unit $2.78
Social Services Revenue $182,312
OTHER REVENUE:
3700 Psychological Evaluations 12,400 $2.81 $34,844
3800 Bonding Studies 6,400 $2.81 $17,984
3900 Court Documentation, Reports 23,040 $2.81 $64,742
4000 Court Appearance 23,040 $2.81 $64,742
OTHER REVENUE/SOCIAL SERVICES TOTAL $182,312
TOTAL PROGRAM REVENUE $4,000,000
Medi-cal Revenue
Medi-cal Revenue - 50% FFP
Medi-cal Revenue - 10% CGF
Medi-cal Revenue - 40% EPSDT
Revised Exhibit B
Page:9 of 10
FTE %Admin.Direct Total
PERSONNEL SALARIES:
0001 Administrator 0.25 $37,499 $0 $37,499
0002 Assistant Administrator 0.60 $0 $48,972 $48,972
0003 Supervisor 3.00 $0 $207,563 $207,563
0004 Psychologist 0.20 $0 $25,502 $25,502
0005 Mental Health Specialist II 23.00 $0 $1,246,895 $1,246,895
0006 Psychiatrist 0.20 $0 $119,170 $119,170
0007 HR Coordinator 0.50 $29,411 $0 $29,411
0008 Training Coordinator 0.50 $29,411 $0 $29,411
0009 Training Assistant 1.00 $43,680 $0 $43,680
0010 Business Office Coordinator 0.50 $32,500 $0 $32,500
0011 Quality Assurance Coordinator 1.50 $84,926 $0 $84,926
0012 Case Manager 3.00 $0 $118,560 $118,560
0013 Community Services Clerk 2.50 $88,400 $0 $88,400
0014 Starlight Allocated Wages (benefits below)1.00 $82,840 $0 $82,840
SALARY TOTAL 37.75 $428,667 $1,766,662 $2,195,330
PAYROLL TAXES:
0030 FICA/MEDICARE $21,339 $129,774 $151,113
0031 SUI $1,511 $9,179 $10,690
0032 FUTA $2,627 $15,967 $18,594
PAYROLL TAX TOTAL $25,477 $154,920 $180,397
EMPLOYEE BENEFITS:
0040 Retirement $11,740 $71,352 $83,092
0041 Workers Compensation $13,834 $84,138 $97,972
0042 $31,941 $194,250 $226,191
EMPLOYEE BENEFITS TOTAL $57,515 $349,740 $407,257
SALARY & BENEFITS GRAND TOTAL $2,782,984
FACILITIES/EQUIPMENT EXPENSES:
1010 Facility Rent $102,419
1011 Leased Equipment $17,199
1012 Utilities $23,471
1013 Maintenance (facility)$22,642
FACILITY/EQUIPMENT TOTAL $165,731
OPERATING EXPENSES:
1060 $61,333
1061 $6,004
1062 $4,750
1063 $20,824
1064 $51,966
1065 $7,800
OPERATING EXPENSES TOTAL $152,677
Staff Mileage
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2018 to June 30, 2019
Budget Categories - Total Proposed Budget
Line Item Description (Must be itemized)
Health Insurance (medical, vision, life, dental)
Telephone
Education and Training
Licenses
Office Supplies
Food Snacks
Revised Exhibit B
Page:10 of 10
Child Welfare Mental Health Services
Central Star Behavioral Health
July 1, 2018 to June 30, 2019
Budget Categories - Total Proposed BudgetFINANCIAL SERVICES EXPENSES:
1080 Centralized Services $538,360
1081 Insurance $16,508
FINANCIAL SERVICES TOTAL $554,868
SPECIAL EXPENSES (Consultant/Etc.):
1087 Professional Fees $17,313
1088 Purchased Services $73,721
1089 Denied Claims $200,000
1090 Recruitment $4,470
SPECIAL EXPENSES TOTAL $295,504
FIXED ASSETS:
2000 IT Minor Equipment $18,800
2001 Furniture $29,437
FIXED ASSETS TOTAL $48,237
TOTAL PROGRAM EXPENSES $4,000,000
DIRECT SERVICE REVENUE:
Vol/Units of
Svc Rate $ Amt.
3000 Mental Health Services 746,297 $2.81 $2,097,097
(Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab)
3100 Case Management, Linkage/Brokerage 113,472 $2.17 $246,234
3200 Crisis Intervention 0 $4.17 $0
3300 Medication Support 39,744 $5.18 $205,874
3400 Collateral 296,069 $2.81 $831,955
3500 ICC 92,196 $2.17 $200,065
3600 IHBS 84,151 $2.81 $236,464
DIRECT SERVICE REVENUE TOTAL 1,371,929 $3,817,688
$1,908,844
$1,527,075
$381,769
$3,817,688
Cost Per Unit $2.78
Social Services Revenue $182,312
OTHER REVENUE:
3700 Psychological Evaluations 12,400 $2.81 $34,844
3800 Bonding Studies 6,400 $2.81 $17,984
3900 Court Documentation, Reports 23,040 $2.81 $64,742
4000 Court Appearance 23,040 $2.81 $64,742
OTHER REVENUE/SOCIAL SERVICES TOTAL $182,312
TOTAL PROGRAM REVENUE $4,000,000
Medi-cal Revenue
Medi-cal Revenue - 50% FFP
Medi-cal Revenue - 10% CGF
Medi-cal Revenue - 40% EPSDT