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Home My WebLink AboutAgreement A-23-653 Amendment IV to Agreement with MHS.pdf Agreement No. 23-653 1 AMENDMENT IV TO AGREEMENT 2 THIS AMENDMENT(hereinafter"Amendment IV") is made and entered into this 12th day of 3 December , 2023, by and between COUNTY OF FRESNO, a Political Subdivision of the State of 4 California, Fresno, California (hereinafter"COUNTY"), and MENTAL HEALTH SYSTEMS, INC., a 5 California non-profit corporation, whose address is 9465 Farnham Street, San Diego, California, 6 92123, (hereinafter"CONTRACTOR"). 7 WITNESSETH: 8 WHEREAS, COUNTY and CONTRACTOR, entered into Agreement No. A-18-622, effective 9 November 1, 2018, as amended by Amendment No. 18-622-1, effective January 1, 2019, as amended 10 by Amendment No. 18-622-2, effective July 1, 2022, and as amended by Amendment No. 23-314, 11 effective July 1, 2023, hereinafter collectively referred to as "Agreement", pursuant to which 12 CONTRACTOR agreed to provide mental health and substance use disorder(SUD) treatment 13 services to youths incarcerated at the Fresno County Juvenile Justice Campus (JJC), and SUD 14 treatment services for youths and their families referred by Fresno County Juvenile Drug Court, and 15 SUD treatment services for youths released from the JJC; and 16 WHEREAS, Senate Bill (SB) 823 formalized juvenile justice realignment at the state level by 17 transferring responsibility of care, custody and supervision of youths whose case originated in juvenile 18 court to county juvenile facilities until they turn twenty-five (25) years of age; and 19 WHEREAS, CONTRACTOR is qualified and able to provide said services to all youth 20 incarcerated at JJC, and is willing to coordinate with COUNTY's Probation Department and its other 21 juvenile justice realignment providers for group interventions and related case management services; 22 and 23 WHEREAS, the parties wish to extend the agreement six (6) months, and increase the 24 maximum compensation for the agreement to compensate the CONTRACTOR for the extended term; 25 and 26 WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement regarding the 27 changes as stated below and restate the Agreement in its entirety. 28 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which - 1 - I is hereby acknowledged, the COUNTY and CONTRACTOR agree as follows: 2 1. Term. The term of this Agreement shall be extended for an additional six(6) month 3 period beginning January 1, 2024 and shall terminate June 30, 2024.. 4 2. JJC SAU. For claims submitted for SLID and Mental Health Services rendered to 5 incarcerated youth at the JJC SAU under this Agreement, the maximum compensation for period 6 January 1, 2024 to June 30, 2024 is not to exceed Three Hundred Thousand and No/100 Dollars 7 ($300,000.00), as set forth in the budgets attached and incorporated as Exhibit F-8 and Exhibit F-9 to 8 this Agreement. 9 3. New Horizons Program. For claims submitted for intensive SUD and Mental Health 10 Services rendered to incarcerated youth at the JJC New Horizons Program under this Agreement, the 11 maximum compensation for period January 1, 2024 to June 30, 2024 is not to exceed One Hundred 12 Fifty Thousand and No/100 Dollars ($150,000.00), as set forth in the budgets attached and 13 incorporated as Exhibit F-10 to this Agreement. 14 4. Maximum Compensation. In no event shall the total compensation for actual services 15 performed under this Agreement be in excess of Four Hundred Fifty Thousand and No/100 Dollars 16 ($450,000.00) for the period between January 1, 2024 and June 30, 2024. 17 5. When both parties have signed this Amendment IV, the Agreement, Amendment I, 18 Amendment II, Amendment III, and this Amendment IV together constitute the Agreement. 19 6. The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 20 covenants, conditions, and promises contained in the Agreement and not amended herein shall 21 remain in full force and effect. This Amendment IV shall become effective January 1, 2024. 22 23 24 25 26 27 !// 28 /!/ - 2- 1 EXECUTED AND EFFECTIVE as of the date first above set forth. 2 3 CONTRACTOR: COUNTY OF FRESNO 4 MENTAL HEALTH SYSTEMS, INC. 5 �7&Lr C Callaghan,7Y James C C.O.ghnn Jr fNov 20,2M 1611 PST 6 (Authorized Signature) Sal ui o, C airman of the Board of 7 James C Callaghan Jr CEO/President Sup - o e County of Fresno Print Name & Title 8 ATTEST: Bernice E. Seidel 9 Clerk of the Board of Supervisors 10 County of Fresno, State of California 11 By 12 Deputy 13 14 15 16 17 OR ACCOUNTING USE ONLY: 18 Fund/Subclass: 0001/10000 Organization: 56302081 (SUD); 56302235 (MH) 19 Account: 7295 20 21 22 23 24 25 26 27 28 -3- Exhibit F-8 Floyd Farrow Behavioral Health Unit Mental Health Systems,Inc. Fiscal Year(FY)2023-2024(January-June 2024) PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FTE Admin Program Total 1101 Program Manager 0.27 $ 12,636 $ 12,636 1102 Administrative Assistant 0.10 2,600 2,600 1103 Vice President 0.10 6,448 6,448 1104 Program Analyst 0.07 2,625 2,625 1105 - 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 Direct Personnel Admin Salaries Subtotal 0.54 $ 24,309 $ 24,309 Acct# Program Position FTE Admin Program Total 1116 Clinical Supervisor 0.30 $ 14,180 $ 14,180 1117 Mental Health Clinician 1.00 33,280 33,280 1118 1119 1120 Intern 0.40 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 Direct Personnel Program Salaries Subtotall 1.70 $ 47,460 $ 47,460 Admin Program Total Direct Personnel Salaries Subtota17 2.24 $ 24,309 $ 47,460 $ 71,770 Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement 972 1898 $ 2,871 1202 Worker's Compensation 145 284 429 1203 Health Insurance 3488 6811 10,299 1 Exhibit F-8 1204 1205 Life Insurance 11 22 33 1206 Other(specify) 0 0 Direct Employee Benefits Subtotal: $ 4,617 $ 9,014 $ 13,632 Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ - $ - $ - 1302 FICA/MEDICARE 1,860 3,631 5,490 1303 SUI 365 712 1,077 1304 Other(specify) 1305 Other(specify) 1306 Other(specify) Direct Payroll Taxes&Expenses Subtotal: $ 2,224 $ 4,343 $ 6,567 DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total $ 31,151 $ 60,818 $ 91,969 DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program 19% 19% 2000:DIRECT CLIENT SUPPORT Acct# Line Item Description Amount 2001 Child Care 2002 Client Housing Support 2003 Client Transportation&Support - 2004 Clothing,Food,&Hygiene 4,000 2005 jEclucation Support 8,079 2006 Employment Support 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 10ther(specify) 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) DIRECT CLIENT CARE TOTAL $ 12,079 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 803 3002 Printing/Postage 43 3003 Office,Household&Program Supplies 5,500 3004 Advertising 3005 Staff Development&Training 580 3006 Staff Mileage 1,150 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Staff Travel-Out of County 2,025 3010 Licenses/Software 1,315 3011 1 Other Business Services 11,085 2 Exhibit F-8 3012 Other(specify) DIRECT OPERATING EXPENSES TOTAL:1 $ 22,501 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ - 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 ISecurity 4006 Utilities 4007 Minor equipment purchases and equipment repair/maintenance 3,100 4008 Vehicle Insurance 4009 Other(specify) 4010 Other(specify) DIRECT FACILITIES/EQUIPMENT TOTAL:j $ 3,100 5000:DIRECT SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services 900 5005 1 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 Other(specify) DIRECT SPECIAL EXPENSES TOTAL: $ 900 6000:INDIRECT EXPENSES Acct# Line Item Description Amount Administrative Overhead 6001 Use this line and only this line for approved indirect cost rate 19,452 Administrative Overhead 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping 6004 lExternal Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) INDIRECT EXPENSES TOTAL $ 19,452 INDIRECT COST RATE 14.90% 7000:DIRECT FIXED ASSETS Acct# I Line Item Description Amount 7001 lComputer Equipment&Software 3 Exhibit F-8 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA Data 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 10ther(specify) 7008 10ther(specify) FIXED ASSETS EXPENSES TOTAL 1 $ TOTAL PROGRAM EXPENSES $ 150,000 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Line Item Description Service Units Rate Amount 8001 Mental Health Services $ 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation 8009 Non-Billable 8010 Other(Specify) Estimated Specialty Mental Health Services Billing Totals: 0 $ Estimated%of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation(FFP)% I - MEDI-CAL FFP TOTAL $ 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ 8102 SABG $ SUBSTANCE USE DISORDER FUNDS TOTAL $ 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ 150,000 REALIGNMENT TOTAL $ 150,000 8300-MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services&Supports 8302 PEI-Prevention&Early Intervention 8303 INN-Innovations 8304 WET-Workforce Education&Training 8305 JCFTN-Capital Facilities&Technology MHSATOTAL $ 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 IClient Fees 4 Exhibit F-8 8402 Client Insurance 8403 American Rescue Plan Act(ARPA)Grant 8404 Other Revenue 8405 Client Rent Income OTHER REVENUE TOTAL $ TOTAL PROGRAM FUNDING SOURCES: $ 150,000 NET PROGRAM COST: 1 $ (0) 5 Exhibit F-8 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) PARTIAL FTE DETAIL For all positions with FTE's split among multiple programs/contracts the below must be filled out Position Family Support Partner Family Support Partner 18-622-1/New Horizons/DBH/Fresno County 0.50 FamllySUpport Partner 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.50 Total 1.00 Position Contract#/Name/Department/County FTE% Clinical Supervisor Clinical Supervisor 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.30 Clinical Supervisor 18-622-1/New Horizons/DBH/Fresno County 0.32 Clinical Supervisor 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.01 Clinical Supervisor A-16-360/FAA/DBH/Fresno County 0.10 Clinical Supervisor 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.05 Clinical Supervisor 762-2019/Kern ACTION/Kern 0.22 Tota 1 1.00 Position Contract#/Name/Department/County FTE% Program Manager Program Manager 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.27 Program Manager 18-622-1/New Horizons/DBH/Fresno County 0.15 Program Manager 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.05 Program Manager A-16-360/FAA/DBH/Fresno County 0.25 Program Manager 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.25 Program Manager Recovery Residence(Fresno) 0.03 Total 1.00 Position Contract#/Name/Department/County FTE% Administrative Assistant Administrative Assistant 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Administrative Assistant 18-622-1/New Horizons/DBH/Fresno County 0.07 Administrative Assistant 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.25 Administrative Assistant A-16-360/FAA/DBH/Fresno County 0.20 Administrative Assistant 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.20 Administrative Assistant KIND Center(Kings) 0.18 Total 1.00 Position Contract#/Name/Department/County FTE% Program Analyst Program Analyst 18-622-1/1JC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.07 6 Exhibit F-8 Program Analyst 18-622-1/New Horizons/DBH/Fresno County 0.07 Program Analyst 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.07 Program Analyst 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.07 Program Analyst A-16-360/FAA/DBH/Fresno County 0.07 Program Analyst KIND Center(Kings) 0.07 Program Analyst Kings County Act(Kings) 0.07 Program Analyst 762-2019/Kern ACTION/Kern 0.07 Program Analyst 20-014/I1VIPACT MH/DBH/Fresno 0.07 Program Analyst 20-014/I1VIPACT SUD/DBH/Fresno 0.07 Program Analyst Eden House(County of Tulare) 0.09 Program Analyst 20-216/DART West/DBH/Fresno 0.07 Program Analyst FRC(San Diego) 0.07 Program Analyst 565056 TRC North Central(San Diego) 0.07 Total 1.00 Position Contract#/Name/Department/County FTE% Vice President Vice President 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Vice President 18-622-1/New Horizons/DBH/Fresno County 0.07 Vice President 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.07 Vice President 20-014/I1VIPACT MH/DBH/Fresno 0.09 Vice President 20-014/IMPACT SUD/DBH/Fresno 0.01 Vice President Casa Aurora/CDCR 0.27 Vice President 20-216/DART West/DBH/Fresno 0.35 Vice President 762-2019/Kern ACTION/Kern 0.04 Total 1.00 Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Tota I - Position Contract#/Name/Department/County FTE% 7 Exhibit F-8 Total - Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Tota I Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Total Position Contract#/Name/Department/County FTE% 8 Exhibit F-8 Total Position Contract#/Name/Department/County FTE% Total 9 Exhibit F-8 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) Budget Narrative PROGRAM EXPENSE ACCT#1 LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS 92,969 dministrative Positions 24,309 1101 Program Manager 12,636 The Program Manager is responsible for the overall operation of the program. 1102 Administrative Assistant 2,600 This position provides clerical support for the program.The position consists of typical administrative support duties and responsibilities such as typing,filing,answering phones,preparing reports,and sorting mail. 1103 Vice President 6,448 The Vice President is responsible for the oversight and management responsibility of all assigned programs operated by MHS in a designated region including contract compliance,performance outcomes,administrative and clinical supervision,budgetary compliance,financial performance,and community outreach.This position shares allocations across several programs. 1104 Program Analyst 21625 This position is responsible for analyzing contract cost and production data, communicating irregularities,ensuring fiscal contract compliance,preparing and submitting monthly contract billings,responding to audit requests,and other program/contract related ad hoc reporting.Other duties include budget development, budget analysis and review,preparing and reviewing contract billings,and contract compliance for assigned contracts/programs. 1105 0 The Compliance Specialist develops and maintains systems to ensure appropriate documentation is completed within the program.The specialist also performs other duties,as assigned by the Program Manager to ensure overall program compliance and quality assurance within the program.The range of authority and decision making for this position is limited to and consistent with MHS policy for administrative line staff. 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 0 Program Positions 47,460 1116 Clinical Supervisor 14,180 The Clinical Supervisor is responsible for all program clinical supervision,clinical assessment guidelines,clinical assessment guideline review,in-service training and clinical consultation with staff.The range of authority and decision making for this position is limited to and consistent with MHS Policy for Clinical Supervisor staff. 1117 Mental Health Clinician 33,280 The Clinician performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties as needed.in addition,the Clinician ensures clients receive the full spectrum of services in a seamless manner and that they receive the optimal level of care needed to maximize functioning and minimize the need for higher levels of care. 1118 0 - The Clinician performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties as needed.In addition,the Clinician ensures clients receive the full spectrum of services in a seamless manner and that they receive the optimal level of care needed to maximize functioning and minimize the need for higher levels of care. 1119 0 1120 Intern The Intern performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties for clients under the supervision of staff. 1121 1122 1123 1124 1125 10 Exhibit F-8 1126 1127 1128 1129 _ 1130 1131 1132 1133 1134 0 Direct Employee Benefits 13,632 1201 Retirement 2,871 Calculated at 4%of direct salaries 1202 Worker's Compensation 429 Calculated at 0.60%of direct salaries based on the W/C Insurance Factors received for FY 21/22 1203 Health Insurance 10,299 Currently budgeting 16.04%of Direct Salaries-this can be higher or lower depending on individual employee actual elections on coverage.The budgeted percentage is based on historiai average trend. 1204 1205 Ufe Insurance 33 Budgeting at$0.61/pay period per FTE 1206 1 Other(specify) Direct Payroll Taxes&Expenses: 6,567 1301 OASDI - Included with#1302 1302 FICA/MEDICARE 5,490 Social Security+Medicare Tax=7.65%of Direct Salaries 1303 SUI 1,077 Calculated at 1.5%of Direct Salaries based on historical average and updated factor projections from insurance 1304 Other(specify) 1305 Other(specify) 1306 Other(s ecify) 2000;DIRECT CLIENT SUPPORT 12,079 2001 Child Care - 2002 Client Housing Support 2003 Client Transportation&Support 2004 Clothing,Food,&Hygiene _ 4,000 Cost of providing clothing,food,hygiene,and similar support to clients. 2005 Education Support 8,079 cost of providing wrap around service care related to client educational goals and _ needs 2006 Employment Support 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify) 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2 015 Other(specify) 2016 Other(specify) 3000:DIRECT OPERATING EXPENSES 22,501 3001 Telecommunications 803 Recurring costs of phone services,cell phones,laptop data/internet device,and internet services.Also covers the monthly user fees for the MS Teams 3002 Printing/Postage 43 Covers the cost of brochures,business cards,employment announcements,other program printing needs,postage and freight expenses. 3003 Office,Household&Program Supplies 5,500 Office supplies utilized for program operation,including paper,pens,pencils,folders, staples,paper clips,printer cartridges,binders,folder tabs,client chart supplies. Housekeeping supplies such as cleaning products,bathroom products,non stationary paper goods,cleaning,and trash supplies.Recreational/occupational therapy supplies used by clients for their treatment plan. 3004 Advertising 3005 Staff Development&Training 580 Staff development/training costs include CPR and First Aid trainings for staff,MHS course requirements(via Relias platform),and registrations for staff development and trainings held in collaboration with the program's mission(Forensic Mental Health, Evidence-based Trainings,etc.). 3006 Staff Mileage 1,150 In-County mileage reimbursements of staff(without clients)traveling to and from events,meetings and trainings in conjunction with program operations and responsibilities. 3007 Subscriptions&Memberships 3008 Vehicle Maintenance - 3009 Staff Travel-Out of County 2,025 Out of county travel related to PM/VP traveling to San Diego for required training and events 11 Exhibit F-8 3010 Licenses/Software 1,315 Fresno County EHR system:Avatar expenses per user based on published County rates. Welligent Licenses for 3rd party billing and outcomes tracking,Department Of Motor Vehicles registration renewals. IT related user(FTE)license and software expenses like Microsoft license,Cloud Services,ITThreat Protection Services and other IT user licenses necessary for program operations.Software expenses included here are for access to software platforms,not for the acquistion or build out of software assets(RE:#7001). 3011 Other Business Services 11,085 Associated costs for hiring of new employees such as TB screenings,assessments,drug screenings,background checks,and fingerprinting.When TB tests and drug tests are required for current employess,those expenses would be included here.Also includes the cost of movers,HIPPA shredding costs&client file storage retrieval costs,Monthly user fees for Common Ground Software(for client support and treatment),payee services,and other necessary and allowable costs for program operations that do not fit clearly in other budgeted line items. 3012 Other(s eci ) 000:DIRECT FACILITIES&EQUIPMENT 3,100 4001 Building Maintenance 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities - 4007 Minor equipment purchases and equipment 3,100 Equipment repairs/maintenance that encompass the cost of a maintenance contract repair/maintenance for the copier,monitoring of internet firewall,and the repair of other equipment not covered by maintenance agreements such as computers,printers,and telephones. Also covers the cost of maintenance and repair on the leased vehicles,not covered by the lease agreement. Minor equipment replacement of existing equipment that in the normal course of use is worn out and either cannot be repaired or is not practical to have repaired and the purchase of minor equipment necessary to program operations. 4008 IVehicle Insurance 4009 10ther(specify) 4010 10ther(specify) 5000:DIRECT SPECIAL EXPENSES 900 5001 lConsultant(Network&Data Management) - 5002 1 HMIS(Health Management Information System) 5003 Contractual/Consulting Services(Specify) 5004 Translation Services 900 Estimated cost of providing interpreters when there isn't a bilingual staff available. Actual costs might come in higher depending on clients and their needs. 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 Other(speci ) 6000:INDIRECT EXPENSES 19,452 6001 Administrative Overhead 19,452 Indirect/administrative expense per Federally approved Indirect Rate of 14.9%. 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) 7000:DIRECT FIXED ASSETS 7001 Computer Equipment&Software - 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) �7 Exhibit F-8 7007 Other(specify) 7008 Other(s eci PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) PROVIDE DETAILS OF METHODOLOGY(IES)USED IN DETERMINING MEDI-CAL ACCT# LINE ITEM SERVICE RATES AND/OR SERVICE UNITS,IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 Mental Health Services 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation $009 Other(Specify) 8010 Other(5 ecify) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 150,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 150,000 BUDGETCHECK: TRUE 14 Exhibit F-9 JJC SLID(FF-SAU) Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FT Admin Program Total 1101 Program Manager 0.05 $ 2,340 $ 2,340 1102 Administrative Assistant 0.25 6,500 6,500 1103 Vice President 0.07 4,514 4,514 1104 Program Analyst 0.07 2,625 2,625 1105 1106 - 1107 1108 1109 1110 1111 1112 1113 1114 1115 Direct Personnel Admin Salaries Subtotal 0.44 $ 15,979 $ 15,979 Acct# Program Position FIFE Admin Program Total 1116 Clinical Supervisor 0.01 $ 473 $ 473 1117 Supervising Counselor 1.00 31,200 31,200 1118 SUD Counselor 1.00 27,040 27,040 1119 Family Support Partner 0.50 13,000 13,000 1120 - 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 Direct Personnel Program Salaries Subtotall 2.51 $ 71,713 $ 71,713 Admin Program Total Direct Personnel Salaries Subtotal 2.95 $ 15,979 $ 71,713 $ 87,691 Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement 639 2869 3508 1202 Worker's Compensation 96 429 525 1203 Health Insurance 2958 13275 16233 1 Exhibit F-9 1204 1205 Life Insurance 8 35 43 1206 Other(specify) 0 0 Direct Employee Benefits Subtotal: $ 3,700 $ 16,608 $ 20,308 Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ - $ - $ - 1302 FICA/MEDICARE 1,222 5,486 6,708 1303 SUI 240 1,075 1,315 1304 Other(specify) - - - 1305 10ther(specify) 1306 10ther(specify) Direct Payroll Taxes&Expenses Subtotal: $ 1,462 $ 6,561 $ 8,023 DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total $ 21,141 $ 94,882 $ 116,023 DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program 23% 23% 2000;DIRECT CLIENT SUPPORT Acct# Line Item Description Amount 2001 Child Care 2002 Client Housing Support 2003 Client Transportation&Support - 2004 Clothing,Food,&Hygiene 250 2005 Education Support 2,075 2006 Employment Support 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify) 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) - DIRECT CLIENT CARE TOTAL $ 2,325 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 665 3002 Printing/Postage 200 3003 Office,Household&Program Supplies 2,250 3004 Advertising 3005 Staff Development&Training 184 3006 Staff Mileage 575 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Staff Travel-Out of County 1,575 3010 Licenses/Software 2,306 3011 Other Business Services 3,332 2 Exhibit F-9 3012 Other(specify) DIRECT OPERATING EXPENSES TOTAL: $ 11,087 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ - 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities 4007 Minor equipment purchases and equipment repair/maintenance 1,000 4008 lVehicle Insurance 4009 10ther(specify) 4010 10ther(specify) DIRECT FACILITIES/EQUIPMENT TOTAL:j $ 1,000 5000:DIRECT SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services 113 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 10ther(specify) DIRECT SPECIAL EXPENSES TOTAL: $ 113 6000:INDIRECT EXPENSES Acct# Line Item Description Amount Administrative Overhead 6001 Use this line and only this line for approved indirect cost rate 19,452 Administrative Overhead 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) INDIRECT EXPENSES TOTAL $ 19,452 INDIRECT COST RATE 14.90% 7000:DIRECT FIXED ASSETS Acct# I Line Item Description Amount 7001 lComputer Equipment&Software 3 Exhibit F-9 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA Data 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(specify) 7008 10ther(specify) FIXED ASSETS EXPENSES TOTAL $ TOTAL PROGRAM EXPENSES $ 150,000 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Line Item Description Service Units Rate Amount 8001 Mental Health Services $ 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation 8009 Non-Billable 8010 Other(Specify) Estimated Specialty Mental Health Services Billing Totals: 0 $ Estimated%of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation(FFP)% I - MEDI-CAL FFP TOTAL $ 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ 8102 SABG $ SUBSTANCE USE DISORDER FUNDS TOTAL $ 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ 150,000 REALIGNMENT TOTAL $ 150,000 8300-MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services&Supports 8302 PEI-Prevention&Early Intervention 8303 INN-Innovations 8304 WET-Workforce Education&Training 8305 JCFTN-Capital Facilities&Technology MHSA TOTAL $ 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 IClient Fees 4 Exhibit F-9 8402 Client Insurance 8403 American Rescue Plan Act(ARPA)Grant 8404 Other Revenue 8405 Client Rent Income OTHER REVENUE TOTAL $ TOTAL PROGRAM FUNDING SOURCES: 1 $ 150,000 NET PROGRAM COST: 1 $ (0) 5 Exhibit F-9 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) PARTIAL FTE DETAIL For all positions with FTE's split among multiple programs/contracts the below must be tilled out Position Family Support Partner Family Support Partner 18-622-1/New Horizons/DBH/Fresno County 0.50 Family Support Partner, 18 622 1/11C-SUD(FF-SAU)/DBH/Fresno County 0.50 Total 1.00 Position Contract#/Name/Department/County FTE% Clinical Supervisor Clinical Supervisor 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.30 Clinical Supervisor 18-622-1/New Horizons/DBH/Fresno County 0.32 Clinical Supervisor 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.01 Clinical Supervisor A-16-360/FAA/DBH/Fresno County 0.10 Clinical Supervisor 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.05 Clinical Supervisor 762-2019/Kern ACTION/Kern 0.22 Total 1.00 Position Contract#/Name/Department/County FTE% Program Manager Program Manager 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.27 Program Manager 18-622-1/New Horizons/DBH/Fresno County 0.15 Program Manager 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.05 Program Manager A-16-360/FAA/DBH/Fresno County 0.25 Program Manager 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.25 Program Manager Recovery Residence(Fresno) 0.03 Program Manager Tota 1 1.00 Position Contract#/Name/Department/County FTE% Administrative Assistant Administrative Assistant 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Administrative Assistant 18-622-1/New Horizons/DBH/Fresno County 0.07 Administrative Assistant 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.25 Administrative Assistant A-16-360/FAA/DBH/Fresno County 0.20 Administrative Assistant 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.20 Administrative Assistant KIND Center(Kings) 0.18 Total 1.00 Position Contract#/Name/Department/County FTE% Program Analyst Program Analyst 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.07 6 Exhibit F-9 Program Analyst 18-622-1/New Horizons/DBH/Fresno County 0.07 Program Analyst 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.07 Program Analyst 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.07 Program Analyst A-16-360/FAA/DBH/Fresno County 0.07 Program Analyst KIND Center(Kings) 0.07 Program Analyst Kings County Act(Kings) 0.07 Program Analyst 762-2019/Kern ACTION/Kern 0.07 Program Analyst 20-014/IMPACT MH/DBH/Fresno 0.07 Program Analyst 20-014/IMPACT SUD/DBH/Fresno 0.07 Program Analyst Eden House(County of Tulare) 0.09 Program Analyst 20-216/DART West/DBH/Fresno 0.07 Program Analyst FRC(San Diego) 0.07 Program Analyst 565056 TRC North Central(San Diego) 0.07 Total 1.00 Position Contract#/Name/Department/County FTE% Vice President Vice President 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Vice President 18-622-1/New Horizons/DBH/Fresno County 0.07 Vice President 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.07 Vice President 20-014/IMPACT MH/DBH/Fresno 0.09 Vice President 20-014/IMPACT SUD/DBH/Fresno 0.01 Vice President Casa Aurora/CDCR 0.27 Vice President 20-216/DART West/DBH/Fresno 0.35 Vice President 762-2019/Kern ACTION/Kern 0.04 Total 1.00 Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% 7 Exhibit F-9 Tota I - Position Contract#/Name/Department/County FTE% Tota I - Position Contract#/Name/Department/County FTE% Total Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Total Position Contract#/Name/Department/County FTE% 8 Exhibit F-9 Total Position Contract#/Name/Department/County FTE% Tota I - 9 Exhibit F-9 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-2024(January-June 2024) Budget Narrative PROGRAM EXPENSE ACCT#1 LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS 116,023 Administrative Positions 15,979 1101 Program Manager 2,340 The Program Manager is responsible for the overall operation of the program. 1102 Administrative Assistant 6,500 This position provides clerical support for the program.The position consists of typical administrative support duties and responsibilities such as typing,filing,answering phones,preparing reports,and sorting mail. 1103 Vice President 4,514 The Vice President is responsible for the oversight and management responsibility of all assigned programs operated by MHS in a designated region including contract compliance,performance outcomes,administrative and clinical supervision,budgetary compliance,financial performance,and community outreach.This position shares allocations across several programs. 1104 Program Analyst 2,625 This position is responsible for analyzing contract cost and production data, communicating irregularities,ensuring fiscal contract compliance,preparing and submitting monthly contract billings,responding to audit requests,and other program/contract related ad hoc reporting.Other duties include budget development, budget analysis and review,preparing and reviewing contract billings,and contract compliance for assigned contracts/programs. 1105 0 The Compliance Specialist develops and maintains systems to ensure appropriate documentation is completed within the program.The specialist also performs other duties,as assigned by the Program Manager to ensure overall program compliance and quality assurance within the program.The range of authority and decision making for this position is limited to and consistent with MHS policy for administrative line staff. 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 - 1115 10 Program Positions 71,713 1116 Clinical Supervisor 473 The Clinical Supervisor is responsible for all program clinical supervision,clinical assessment guidelines,clinical assessment guideline review,in-service training and clinical consultation with staff.The range of authority and decision making for this position is limited to and consistent with MHS Policy for Clinical Supervisor staff. 1117 Supervising Counselor 31,200 Acts as a supervising Substance Abuse Counselors interact with residents on a day-to- day basis providing individual and group counseling.The Substance Abuse Counselors provide residents with orientation,training,substance abuse recovery skills and information,and leadership necessary to provide them with the ability to recover from substance abuse addiction. 1118 SUD Counselor 27,040 The Substance Abuse Counselors interact with residents on a day-to-day basis providing individual and group counseling.The Substance Abuse Counselors provide residents with orientation,training,substance abuse recovery skills and information, and leadership necessary to provide them with the ability to recover from substance abuse addiction. 1119 Family Support Partner 13,000 The Family Support Specialist serves as a member of a multidisciplinary team and shares practical and personal experience,knowledge and insight related to illness management,life skills,and the lifelong process of recovery.The Family Support Specialist actively promotes greater understanding of clients'points of view and preferences.He or she maximizes client choice while also advocating on behalf of clients when appropriate.The Family Support Specialist also fulfills duties related to supportive counseling,rehabilitation,and collateral interactions with natural supports. 1120 0 _ 1121 1122 1123 1124 10 Exhibit F-9 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 0 Direct Employee Benefits 20,308 1201 Retirement 3,508 Calculated at 4%of direct salaries 1202 Worker's Compensation 525 Calculated at 0.60%of direct salaries based on the W/C Insurance Factors received for FY 21/22 1203 Health Insurance 16,233 Currently budgeting 16.04%of Direct Salaries-this can be higher or lower depending on individual employee actual elections on coverage.The budgeted percentage is based on historial average trend. 1204 - 1205 Life Insurance 43 Budgeting at$0.61/pay period per FTE 1206 Other (specify) Direct Payroll Taxes&Expenses: 8,023 1301 OASDI - Included with#1302 1302 FICA/MEDICARE 6,708 Social Security+Medicare Tax=7,65%of Direct Salaries 1303 SUI 1,315 Calculated at 1.5%of Direct Salaries based on historical average and updated factor projections from insurance 1304 Other(specify) - 1305 Other(specify) 1306 Other(specify) 2000:DIRECT CLIENT SUPPORT 2,325 2001 Child Care - 2002 Client Housing Support 2003 Client Transportation&Support 2004 Clothing,Food,&Hygiene 250 Cost of providing clothing,food,hygiene,and similar support to clients. 2005 Education Support 2,075 cost of providing wraparound service care related to client educational goals and needs 2006 Employment Support 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify) 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) 30DO:DIRECT OPERATING EXPENSES 11,087 3001 Telecommunications 665 Recurring costs of phone services,cell phones,laptop data/internet device,and internet services.Also covers the monthly user fees for the MS Teams 3002 Printing/Postage 200 Covers the cost of brochures,business cards,employment announcements,other program printing needs,postage and freight expenses. 3003 Office,Household&Program Supplies 2,250 Office supplies utilized for program operation,including paper,pens,pencils,folders, staples,paper clips,printer cartridges,binders,folder tabs,client chart supplies. Housekeeping supplies such as cleaning products,bathroom products,non stationary paper goods,cleaning,and trash supplies.Recreational/occupational therapy supplies used by clients for their treatment plan. 3004 Advertising - 3005 Staff Development&Training 184 Staff development/training costs include CPR and First Aid trainings for staff,MHS course requirements(via Relias platform),and registrations for staff development and trainings held in collaboration with the program's mission(Forensic Mental Health, Evidence-based Trainings,etc.). 3006 Staff Mileage 575 In-County mileage reimbursements of staff(without clients)traveling to and from events,meetings and trainings in conjunction with program operations and responsibilities. 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3D09 Staff Travel-Out of County 1,575 Out of county travel related to PM/VP traveling to San Diego for required training and events 11 Exhibit F-9 3010 Licenses/Software 2,306 Fresno County EHR system:Avatar expenses per user based on published County rates. Welligent Licenses for 3rd party billing and outcomes tracking,Department Of Motor Vehicles registration renewals. IT related user(FTE)license and software expenses like Microsoft license,Cloud Services,IT Threat Protection Services and other IT user licenses necessary for program operations.Software expenses included here are for access to software platforms,not for the acquistion or build out of software assets(RE:#7001). 3011 Other Business Services 3,332 Associated costs for hiring of new employees such as TB screenings,assessments,drug screenings,background checks,and fingerprinting.When TB tests and drug tests are required for current employess,those expenses would be included here.Also includes the cost of movers,HIPPA shredding costs&client file storage retrieval costs,Monthly user fees for Common Ground Software(for client support and treatment),payee services,and other necessary and allowable costs for program operations that do not fit clearly in other budgeted line items. 3012 Other(specify) 4000:DIRECT FACILITIES&EQUIPMENT 1,000 4001 Building Maintenance 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities - 4007 Minor equipment purchases and equipment 1,000 Equipment repairs/maintenance that encompass the cost of a maintenance contract repair/maintenance for the copier,monitoring of internet firewall,and the repair of other equipment not covered by maintenance agreements such as computers,printers,and telephones. Also covers the cost of maintenance and repair on the leased vehicles,not covered by the lease agreement. Minor equipment replacement of existing equipment that in the normal course of use is worn out and either cannot be repaired or is not practical to have repaired and the purchase of minor equipment necessary to program operations. 4008 Vehicle Insurance 40D9 Other(specify) 4010 Other(specify) 5000:DIRECT SPECIAL EXPENSES 113 5001 IConsultant(Network&Data Management) - 5002 1 HMIS(Health Management Information System) 5003 Contractual/Consulting Services(Specify) 5004 Translation Services 113 Estimated cost of providing interpreters when there isn't a bilingual staff available. Actual costs might come in higher depending on clients and their needs. 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 116— 5008 Other(specify) 6000:INDIRECT EXPENSES 19,452 6001 Administrative Overhead 19,452 Indirect/administrative expense per Federally approved Indirect Rate of 14.9%. 6002 Professional Liability Insurance - _ 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) 7000:DIRECT FIXED ASSETS 7001 Computer Equipment&Software 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Ufespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 12 Exhibit F-9 7007 Other(specify) 7008 Other(speci ) PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) PROVIDE DETAILS OF METHODOLOGY(IES)USED IN DETERMINING MEDI-CAL ACCT It LINE ITEM SERVICE RATES AND/OR SERVICE UNITS,IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 Mental Health Services 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation 8009 Other(Specify) 8010 Other(Specify) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 150,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 150,000 BUDGET CHECK: TRUE 13 Exhibit F-10 New Horizons Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FTE Admin Program Total 1101 Program Manager 0.15 $ 7,020 $ 7,020 1102 Administrative Assistant 0.07 1,820 1,820 1103 Vice President 0.07 4,514 4,514 1104 Program Analyst 0.07 2,625 2,625 1105 - 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 Direct Personnel Admin Salaries Subtotal 0.36 $ 15,979 $ 15,979 Acct# Program Position FTE Admin Program Total 1116 Licensed Clinical Supervisor 0.32 $ 15,242 $ 15,242 1117 SUD Counselor 1.00 $ 27,040 27,040 1118 Family Support Specialist 0.50 $ 13,000 13,000 1119 1120 - 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 Direct Personnel Program Salaries Subtotal 1.82 $ 55,282 $ 55,282 Admin Program Total Direct Personnel Salaries Subtotal 2.18 $ 15,979 $ 55,282 $ 71,261 Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement 639 2211 $ 2,850 1202 Worker's Compensation 96 330 426 1203 Health Insurance 2945 10188 13,133 1 Exhibit F-10 1204 1205 Life Insurance 7 25 32 1206 Other(specify) 0 0 Direct Employee Benefits Subtotal: $ 3,687 $ 12,755 $ 16,442 Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ - $ - $ - 1302 FICA/MEDICARE 1,222 4,229 5,451 1303 SUI 240 829 1,069 1304 Other(specify) - - - 1305 Other(specify) 1306 Other(specify) Direct Payroll Taxes&Expenses Subtotal: $ 1,462 $ 5,058 $ 6,520 DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total $ 21,128 $ 73,095 $ 94,223 DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program 23% 23% 2000:DIRECT CLIENT SUPPORT Acct# Line Item Description Amount 2001 Child Care 2002 Client Housing Support 2003 Client Transportation&Support 509 2004 Clothing,Food,&Hygiene 4,000 2005 Education Support 6,500 2006 lEmployment Support 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify) 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) - DIRECT CLIENT CARE TOTAL $ 11,009 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 375 3002 Printing/Postage 543 3003 Office,Household&Program Supplies 6,500 3004 Advertising 3005 Staff Development&Training 454 3006 IStaff Mileage 1,150 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Staff Travel-Out of County 2,650 3010 Licenses/Software 3,697 3011 Other Business Services 6,610 2 Exhibit F-10 3012 10ther(specify) DIRECT OPERATING EXPENSES TOTAL: $ 21,979 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ - 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities 4007 Minor equipment purchases and equipment repair/maintenance 2,100 4008 Vehicle Insurance 4009 Other(specify) 4010 Other(specify) DIRECT FACILITIES/EQUIPMENT TOTAL:j 2,100 5000:DIRECT SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services 1,238 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 Other(specify) DIRECT SPECIAL EXPENSES TOTAL: $ 1,238 6000:INDIRECT EXPENSES Acct# Line Item Description Amount Administrative Overhead 6001 Use this line and only this line for approved indirect cost rate 19,452 Administrative Overhead 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) INDIRECT EXPENSES TOTAL $ 19,452 INDIRECT COST RATE r 14.90% 7000:DIRECT FIXED ASSETS Acct# I Line Item Description Amount 7001 lComputer Equipment&Software 3 Exhibit F-10 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA Data 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 10ther(specify) 7008 1 Other(specify) FIXED ASSETS EXPENSES TOTAL $ TOTAL PROGRAM EXPENSES $ 150,000 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Line Item Description Service Units Rate Amount 8001 Mental Health Services $ 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 IPlan Development 8007 Assessment 8008 Rehabilitation 8009 Non-Billable 8010 Other(Specify) Estimated Specialty Mental Health Services Billing Totals: 0 $ Estimated%of Clients who are Medi-Cal Beneficiaries Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries Federal Financial Participation(FFP)% MEDI-CAL FFP TOTAL $ 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ 8102 SABG $ SUBSTANCE USE DISORDER FUNDS TOTAL $ 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ 150,000 REALIGNMENT TOTAL $ 150,000 8300-MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services&Supports 8302 PEI-Prevention&Early Intervention 8303 INN-Innovations 8304 WET-Workforce Education&Training 8305 JCFTN-Capital Facilities&Technology MHSA TOTAL $ 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 jClient Fees 4 Exhibit F-10 8402 Client Insurance 8403 American Rescue Plan Act(ARPA)Grant 8404 Other Revenue 8405 Client Rent Income OTHER REVENUE TOTAL $ TOTAL PROGRAM FUNDING SOURCES: $ 150,000 NET PROGRAM COST: $ (0) 5 Exhibit F-10 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) PARTIAL FTE DETAIL For all positions with FTE's split among multiple programs/contracts the below must be filled out Position Family Support Partner Family Support Partner 18-622-1/New Horizons/DBH/Fresno County 0.50 Family Supp6rt Partner 18-622-1/1JC-SUD(FF-SAU)/DBH/Fresno County 0.50 Tota 1 1.00 Position Contract#/Name/Department/County FTE% Clinical Supervisor Clinical Supervisor 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.30 Clinical Supervisor 18-622-1/New Horizons/DBH/Fresno County 0.32 Clinical Supervisor 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.01 Clinical Supervisor A-16-360/FAA/DBH/Fresno County 0.10 Clinical Supervisor 18-622-1/FYA 1DC PROPS/DBH/Fresno County 122 Clinical Supervisor 762-2019/Kern ACTION/Kern Total Position Contract#/Name/Department/County FTE% Program Manager Program Manager 18-622-1/1JC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.27 Program Manager 18-622-1/New Horizons/DBH/Fresno County 0.15 Program Manager 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.05 Program Manager A-16-360/FAA/DBH/Fresno County 0.25 Program Manager 18-622-1/FYA 1DC PROPS/DBH/Fresno County 0.25 Program Manager Recovery Residence(Fresno) 0.03 Total 1.00 Position Contract#/Name/Department/County FTE% Administrative Assistant Administrative Assistant 18-622-1/1JC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Administrative Assistant 18-622-1/New Horizons/DBH/Fresno County 0.07 Administrative Assistant 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.25 Administrative Assistant A-16-360/FAA/DBH/Fresno County 0.20 Administrative Assistant 18-622-1/FYA 1DC PROPS/DBH/Fresno County 0.20 Administrative Assistant KIND Center(Kings) 0.18 Total 1.00 Position Contract#/Name/Department/County FTE% Program Analyst Program Analyst 18-622-1/JJC-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.07 6 Exhibit F-10 Program Analyst 18-622-1/New Horizons/DBH/Fresno County 0.07 Program Analyst 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.07 Program Analyst 18-622-1/FYA JDC PROPS/DBH/Fresno County 0.07 Program Analyst A-16-360/FAA/DBH/Fresno County 0.07 Program Analyst KIND Center(Kings) 0.07 Program Analyst Kings County Act(Kings) 0.07 Program Analyst 762-2019/Kern ACTION/Kern 0.07 Program Analyst 20-014/IMPACT MH/DBH/Fresno 0.07 Program Analyst 20-014/IMPACT SUD/DBH/Fresno 0.07 Program Analyst Eden House(County of Tulare) 0.09 Program Analyst 20-216/DART West/DBH/Fresno 0.07 Program Analyst FRC(San Diego) 0.07 Program Analyst 565056 TRC North Central(San Diego) 0.07 Total 1.00 Position Contract#/Name/Department/County FTE% Vice President Vice President 18-622-1/11C-MH(FF-SAU)/DBH/Fresno County(DD-SAU) 0.10 Vice President 18-622-1/New Horizons/DBH/Fresno County 0.07 Vice President 18-622-1/JJC-SUD(FF-SAU)/DBH/Fresno County 0.07 Vice President 20-014/IMPACT MH/DBH/Fresno 0.09 Vice President 20-014/IMPACT SUD/DBH/Fresno 0.01 Vice President Casa Aurora/CDCR 0.27 Vice President 20 216/DART West/DBH/Fresno Et5Vice President 762-2019/Kern ACTION/Kern 4Total 0 Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Tota I - Position Contract#/Name/Department/County FTE% 7 Exhibit F-10 Total Position Contract#/Name/Department/County FTE% Tota I Position Contract#/Name/Department/County FTE% Total - Position Contract#/Name/Department/County FTE% Total Position Contract#/Name/Department/County FTE% Tota I Position Contract#/Name/Department/County FTE% 8 Exhibit F-10 Total - Position Contract#/Name/Department/County FTE% Total 9 Exhibit F-10 ASSISTED OUTPATIENT TREATMENT SERVICES Mental Health Systems,Inc. Fiscal Year(FY)2023-24(January-June 2024) Budget Narrative PROGRAM EXPENSE ACCT#j LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS 94,223 Administrative Positions 15,979 1101 Program Manager 7,020 The Program Manager is responsible for the overall operation of the program. 1102 Administrative Assistant 1,820 This position provides clerical support for the program.The position consists of typical administrative support duties and responsibilities such as typing,filing,answering phones,preparing reports,and sorting mail. 1103 Vice President 4,514 The Vice President is responsible for the oversight and management responsibility of all assigned programs operated by MHS in a designated region including contract compliance,performance outcomes,administrative and clinical supervision,budgetary compliance,financial performance,and community outreach.This position shares allocations across several programs. 1104 Program Analyst 2,625 This position is responsible for analyzing contract cost and production data, communicating irregularities,ensuring fiscal contract compliance,preparing and submitting monthly contract billings,responding to audit requests,and other program/contract related ad hoc reporting.Other duties include budget development, budget analysis and review,preparing and reviewing contract billings,and contract compliance for assigned contracts/programs. 1105 0 The Compliance Specialist develops and maintains systems to ensure appropriate documentation is completed within the program.The specialist also performs other duties,as assigned by the Program Manager to ensure overall program compliance and quality assurance within the program.The range of authority and decision making for this position is limited to and consistent with MHS policy for administrative line staff. 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 0 Program Positions 55,282 1116 Licensed Clinical Supervisor 15,242 The Clinical Supervisor is responsible for all program clinical supervision,clinical assessment guidelines,clinical assessment guideline review,in-service training and clinical consultation with staff.The range of authority and decision making for this position is limited to and consistent with MHS Policy for Clinical Supervisor staff. 1117 0 The Clinician performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties as needed.in addition,the Clinician ensures clients receive the full spectrum of services in a seamless manner and that they receive the optimal level of care needed to maximize functioning and minimize the need for higher levels of care. 1118 SLID Counselor 27,040 The Clinician performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties as needed.In addition,the Clinician ensures clients receive the full spectrum of services in a seamless manner and that they receive the optimal level of care needed to maximize functioning and minimize the need for higher levels of care. 10 Exhibit F-10 1119 Family Support Specialist 13,000 The Family Peer Support Specialist utilizes his or her experiences as a recipient of substance abuse and/or mental health services to enhance recovery efforts of clients. He or she serves as a member of a multidisciplinary team and shares practical and personal experience,knowledge and insight related to illness management,life skills, and the lifelong process of recovery.The Family Peer Support Specialist actively promotes greater understanding of clients'points of view and preferences.He or she maximizes client choice while also advocating on behalf of clients when appropriate. The Family Peer Support Specialist also fulfills duties related to supportive counseling, rehabilitation,and collateral interactions with natural supports. 1120 Intern The Intern performs a range of psychotherapeutic and rehabilitative interventions, including psychosocial assessment,individual and group counseling,crisis intervention and limited case management duties for clients under the supervision of staff. 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 NREFI Direct Employee Benefits 16,442 1201 Retirement 2,850 Calculated at 4%of direct salaries 1202 Worker's Compensation 426 Calculated at 0.60%of direct salaries based on the W/C Insurance Factors received for FY 21/22 1203 Health Insurance 13,133 Currently budgeting 16.04%of Direct Salaries-this can be higher or lower depending on individual employee actual elections on coverage.The budgeted percentage is based on historial average trend. 1204 - 1205 Life Insurance 32 Budgeting at$0.61/pay penod per FTE 1206 Other(specify) Direct Payroll Taxes&Expenses: 6,520 1301 OASDI - Included with k1302 1302 FICA/MEDICARE 5,451 Social Security+Medicare Tax=7,65%of Direct Salaries 1303 SUI 1,069 Calculated at 1.5%of Direct Salaries based on historical average and updated factor projections from insurance 1304 Other(specify) - 1305 Other(specify) 1306 Other(specify) 2000:DIRECT CLIENT SUPPORT 11,009 2001 Child Care - 2002 Client Housing Support - 2003 Client Transportation&Support 509 Cost of providing transportation supports to clients when appropriate 2004 Clothing,Food,&Hygiene 4,000 Cost of providing clothing,food,hygiene,and similar support to clients. 2005 Education Support 6,500 cost of providing wraparound service care related to client educational goals and needs 2006 Employment Support - 2007 Household Items for Clients 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify) 2012 Other(specify) 2013 Other(specify) L 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) 3000:DIRECT OPERATING EXPENSES 21,979 3001 Telecommunications 37S Recurring costs of phone services,cell phones,laptop data/internet device,and internet services.Also covers the monthly user fees for the MS Teams 3002 Printing/Postage 543 Covers the cost of brochures,business cards,employment announcements,other program printing needs,postage and freight expenses. 11 Exhibit F-10 3003 Office,Household&Program Supplies 6,500 Office supplies utilized for program operation,including paper,pens,pencils,folders, staples,paper clips,printer cartridges,binders,folder tabs,client chart supplies. Housekeeping supplies such as cleaning products,bathroom products,non stationary paper goods,cleaning,and trash supplies.Recreational/occupational therapy supplies used by clients for their treatment plan. 3004 Advertising - 3005 Staff Development&Training 454 Staff development/training costs include CPR and First Aid trainings for staff,MHS course requirements(via Relias platform),and registrations for staff development and trainings held in collaboration with the program's mission(Forensic Mental Health, Evidence-based Trainings,etc.). 3006 Staff Mileage 1,150 In-County mileage reimbursements of staff(without clients)traveling to and from events,meetings and trainings in conjunction with program operations and responsibilities. 3007 Subscriptions&Memberships - 3008 Vehicle Maintenance - 3009 Staff Travel-Out of County 2,650 Out of county travel related to PM/VP traveling to San Diego for required training and events 3010 Licenses/Software 3,697 Fresno County EHR system:Avatar expenses per user based on published County rates. Welligent Licenses for 3rd party billing and outcomes tracking,Department Of Motor Vehicles registration renewals. IT related user(FTE)license and software expenses like Microsoft license,Cloud Services,IT Threat Protection Services and other IT user licenses necessary for program operations.Software expenses included here are for access to software platforms,not for the acquistion or build out of software assets(RE:#7001). 3011 Other Business Services 6,610 Associated costs for hiring of new employees such as TB screenings,assessments,drug screenings,background checks,and fingerprinting.When TB tests and drug tests are required for current employess,those expenses would be included here.Also includes the cost of movers,HIPPA shredding costs&client file storage retrieval costs,Monthly user fees for Common Ground Software(for client support and treatment),payee services,and other necessary and allowable costs for program operations that do not fit clearly in other budgeted line items. 3012 Other(specify) 000:DIRECT FACILITIES&EQUIPMENT 2,100 4001 Building Maintenance - 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 400S Security 4006 Utilities - 4007 Minor equipment purchases and equipment 2,100 Equipment repairs/maintenance that encompass the cost of a maintenance contract repair/maintenance for the copier,monitoring of internet firewall,and the repair of other equipment not covered by maintenance agreements such as computers,printers,and telephones. Also covers the cost of maintenance and repair on the leased vehicles,not covered by the lease agreement. Minor equipment replacement of existing equipment that in the normal course of use is worn out and either cannot be repaired or is not practical to have repaired and the purchase of minor equipment necessary to program operations. 4008 Vehicle Insurance 4009 Other(specify) 4010 Other(specify) 5000:DIRECT SPECIAL EXPENSES 1,238 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) - S004 Translation Services 11238 Estimated cost of providing interpreters when there isn't a bilingual staff available. Actual costs might come in higher depending on clients and their needs. 5005 Other(specify) - 5006 Other(specify) 5007 Other(specify) 5008 Other(specify) 6000:INDIRECT EXPENSES 19,452 6001 Administrative Overhead 19,452 Indirect/administrative expense per Federally approved Indirect Rate of 14.9%. 6002 Professional Liability Insurance 6003 Accounting/Bookkeeping 6004 External Audit 12 Exhibit F-10 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) 7000:DIRECT FIXED ASSETS 7001 Computer Equipment&Software 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA 7003 Furniture&fixtures 7004 Leasehold/Tenant/Building improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(specify) 7008 Other sped PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) PROVIDE DETAILS OF MEFHODOLOGY(IES)USED IN DETERMINING MEDI-CAL ACCT# LINE ITEM SERVICE RATES AND/OR SERVICE UNITS,IF APPLICABLE AND/OR AS REQUIRED BY THE RFP 8001 Mental Health Services 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation 8009 Other(Specify) 8010 Other(Specify) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 150,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 150,000 BUDGETCHECK: TRUE 13