HomeMy WebLinkAboutAgreement A-14-275-1 with MHPRAP.pdf1
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Agreement No. 14-275-1
AMENDMENT I TO AGREEMENT
THIS AMENDMENT, hereinafter referred to as Amendment I, is made and entered into this
_ _,._,18....,th'-'---__ day of June , 2019 , by and between the COUNTY OF FRESNO , a Political
4 Subdivision of the State of California, hereinafter referred to as "COUNTY", and Mental Health
5 Patient's Rights Advocate Program, a Sole Proprietorship, whose address is 1357 W Shaw A ve Suite
6 #101 , Fresno , CA 93711 , hereinafter referred to as "CONTRACTOR".
7 W I T N E S S E T H:
8 WHEREAS , the parties entered into that certain Agreement, identified as COUNTY Agreement
9 No. 14-275 , effective Jul y 1, 2014 , whereby CONTRACTOR agreed to provide Mental Health
10 Patient 's Rights Advocacy Program services, and
11 WHEREAS , COUNTY, through its Department of Behavioral Health (DBH), is in need of a
12 qualified agency to operate mental health patient 's rights advocacy services in accordance with Welfare
13 and Institutions Code Division 5 , Part 1, Chapter 6.2 ; Article 3 , sections 5520 through 5523 of the
14 Lanterman-Petris-Short Act; and
15 WHEREAS , COUNTY , through its Managed Care program, is a Mental Health Plan (MHP) as
16 defined in Title 9 of the California Code of Regulations (C.C.R. ), section 1810.226 ; and
1 7 WHEREAS , CONTRACTOR is qualified to operate a patient's rights advocacy program , and
18 has the facility , equipment and personnel skilled in the provision of such services pursuant to the terms
1 9 and conditions of Agreement No. 14-275 , and
2 0 WHEREAS , the parties desire to amend the Agreement regarding changes as stated below and
2 1 restate the Agreement in its entirety.
22 NOW, THEREFORE, for good and valuable consideration , the receipt and adequacy of which is
2 3 hereby acknowledged , COUNTY and CONTRACTOR agree as follows :
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I. That the existing COUNTY Agreement No. 14-275, Section two (2) "TERM", shall be
revised by adding the following at Page Four (4), Line Three (3), after the word "term."
"This Agreement shall be extended for an additional six (6) month period beginning July
I , 2019 through December 31 , 2019."
2. That the existing COUNTY Agreement No. 14-275, Section Four (4) "Compensation",
-1 -COUNTY OF FRESNO
Fresn o , CA
COUNTY OF FRESNO
Fresno, CA
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beginning on Page Four (4), Line (27), with the word “Contingent” and ending on Page Five (5), Line
Nineteen (19) with the word “herein” be deleted and the following inserted in its place:
“Contingent upon confirmation of funding by the California Department of Health Care
Services and annual outcomes satisfaction performance, total maximum amount of said contract is One
Million Two Hundred Fifty-Eight Thousand Seven Hundred Thirteen and No/100 Dollars
($1,258,713.00) upon execution of this Agreement through December 31, 2019.
County agrees to pay CONTRACTOR and CONTRACTOR agrees to receive, monthly,
one twelfth (1/12) payment of each yearly contract term’s maximum compensation identified in
Revised Exhibit B-1, attached hereto and incorporated herein by reference.
In no event shall services performed under this Agreement by in excess of Two Hundred
Twenty-Two Thousand Seven Hundred Fifty-Six and No/100 Dollars ($222,756.00) for the period of
July 1, 2014 through June 30, 2015.
In no event shall services performed under this Agreement by in excess of Two Hundred
Twenty-Six Thousand Eight Hundred Ninety-Seven and No/100 Dollars ($226,897.00) for the period
of July 1, 2015 through June 30, 2016.
In no event shall services performed under this Agreement by in excess of Two Hundred
Thirty-One Thousand One Hundred Sixty and No/100 Dollars ($231,160.00) for the period of July 1,
2016 through June 30, 2017.
In no event shall services performed under this Agreement by in excess of Two Hundred
Thirty-One Thousand One Hundred Sixty and No/100 Dollars ($231,160.00) for the period of July 1,
2017 through June 30, 2018.
In no event shall services performed under this Agreement by in excess of Two Hundred
Thirty-One Thousand One Hundred Sixty and No/100 Dollars ($231,160.00) for the period of July 1,
2018 through June 30, 2019.
In no event shall services performed under this Agreement by in excess of One Hundred
Fifteen Thousand Five Hundred Eighty and No/100 Dollars ($115,580.00) for the period of July 1,
2019 through December 31, 2019.”
3. That effective July 1, 2019, all references in existing COUNTY Agreement No. 14-275 to
COUNTY OF FRESNO
Fresno, CA
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“Exhibit A,” shall be changed to read “Revised Exhibit A-1,” attached hereto and incorporated herein
by reference
4. That effective July 1, 2019, all references in existing COUNTY Agreement No. 14-275 to
“Exhibit B,” shall be changed to read “Revised Exhibit B-1,” 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 this Amendment
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.
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1 IN WITNESS WHERE10f, the parties hereto have executed this Amendment to Agreement as
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2 of the day and year first hereirhapove written .
3 ATTEST:
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CONTRACTOR: !
Mental Health Patient's Rir' ~ts
Advocate Program i
: : I .
~---I '~ =:-:--,..., ..-1 ____ _
(Authorized Signature) .... I
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Print Name & Title
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Mailing Address
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FOR ACCOUNTING usE o'.NlY : I .
ORG No .: 5630471 0; 563020'0t 56302230
Account No .: 7295/0 :
Fund/Subclass: 0001/10000
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Mailing Address: / ·'
Mental Health Patient's Rights :Advocate Program
1357 West Shaw Avenue j !
Fresno, CA 93711 , :
Phone: (559) 492-1652 J :
Contact: Stan Lum, Sole Prot r~etor
I • I ,
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I
COUNTY OF FRESNO
Nathan Magsig,
Chairman of the Board of Sw
County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervi ors
County of Fresno, State of Ca ifomia
Deputy
-4 -COUNTY OF FRESNO
Fresno , CA
Revised Exhibit A-1
Page 1 of 9
MENTAL HEALTH PATIENT’S RIGHTS ADVOCACY PROGRAM
SCOPE OF WORK
ORGANIZATION: Mental Health Patient’s Rights Advocate Program
SITE ADDRESS: 1357 W. Shaw Ave, Fresno CA 93711
SERVICES: Mental Health Advocacy Services
PROJECT DIRECTOR: Stan Lum, Sole Proprietor
Phone Number: (559) 492-1652
CONTRACT PERIOD: July 1, 2014 – December 31, 2019
CONTRACT AMOUNT: FY 2014-15 $222,756
FY 2015-16 $226,897
FY 2016-17 $231,160
FY 2017-18 $231,160
FY 2018-19 $231,160
Term 7/1/2019 - 12/31/2019 $115,580
The Local Mental Health Director is responsible for the provision of Patients’ Rights Advocate
(PRA) services in Fresno County, as indicated in the Welfare and Institutions (W&I) Code
Division 5, Part 1, Chapter 6.2, Article 3, § 5000 et seq.
The County’s goals and objectives for the patients’ rights advocacy program include:
A. Develop/maintain a comprehensive, high quality Patients’ Rights Advocacy
program which assures the rights and dignity of mental health clients.
B. Provide sound policy consultation to the Department of Behavioral Health
administration.
C. Report to and work with the Director of the Department of Behavioral Health or
designee to ensure local compliance with state law regarding rights of clients of
psychiatric services (monthly or as requested).
I. GENERAL REQUIREMENTS
A. Patients’ Rights Advocacy program will encompass two components; receiving and
investigating grievances and function as the client’s representative in all AB 3454
certification review hearings. The PRA shall provide notification of rights to the
individual and shall represent the individual at the certification review hearings.
B. The vendor shall provide relief/backup coverage for advocate staff in the event of
illness and vacation. All potential advocate staff identified by position and/or name
must be stated in the proposal response or the bid may be rejected.
C. Provide training and education about mental health law and patients’ rights to mental
health providers. Contractor will provide mental health Patient’s Rights trainings, to
Revised Exhibit A-1
Page 2 of 9
licensed health and community care facilities staff, at minimum 13 per year, or
requested by County. Trainings will be conducted at health and community care
facilities.
D. Ensure that recipients of mental health services in all licensed health and community
care facilities are notified of their rights.
E. Exchange information and cooperate with the State Patients’ Rights Office.
F. Provide monthly and quarterly reports detailing accomplished work, or as requested,
written documentation of activities in all the above areas, and prepare such written
reports relating to the responsibilities and activities of the Patients’ Rights Advocate as
may be necessary or required by the County Plan, the Department of Behavioral
Health, the Mental Health Board, the State Patients’ Rights Office, or State directive or
mandate.
G. Flexible or adjustable hours of operation to meet accessibility needs of clients and/or
family members.
H. Have a working knowledge of the Lanterman Petris Short (LPS) Act. In addition,
Contractor shall strictly adhere with all applicable Federal (including HIPAA laws),
State of California and/or local laws and regulations relating to client confidentiality and
protected health information.
I. Submit monthly invoices to include the time period services were provided and the
programs, departments/agencies and exact facilities services were provided. Invoice
must also be accompanied by all required reports requested by the Local Mental
Health Director, or designee.
J. Report to and work with the Director of the Department of Behavioral Health or their
designee to ensure local compliance with state law regarding rights of clients of
psychiatric services, including but not limited to services outlined in this Scope of
Work.
K. Contractor shall be in full compliance with Title VI of the Civil Rights Act of 1964.
Contractor must guarantee that services provided will be performed in compliance with
all applicable State and Federal laws and regulations pertinent to this Agreement and
shall execute the agreement in full compliance with Title VI of the Civil Rights Act of
1964.
L. Contractor shall provide/demonstrate ability access competent and appropriate
linguistic services in the identified client’s language of choice and have a working
knowledge of accessing and utilizing qualified staff /third-party interpreters or language
lines during advisement and hearing certification processes, complaints/grievances
and investigations or other related services. Interpretation services will be at the cost
of the selected contract provider.
M. Assist with the review and revision of policies and procedures which are critical
components of an effective advocacy program. These policies will be established to
enhance/improve facility advocacy component.
N. Contractor to provide advocates who are aware of the cultural differences in the
Revised Exhibit A-1
Page 3 of 9
treatment of mental health clients. It is essential that the advocate, in doing his/her
job, is aware of the dynamic that culture plays in competent service representation. In
representing and promoting the rights and interest of a client, the advocate must be
aware that it is the client’s voice that is being heard and represented and that
sensitivity to the cultural context of the client is recognized. This will require an ongoing
commitment by patients’ right advocates being knowledgeable of and promoting
cultural understanding and self-awareness. Agencies contracted with the County of
Fresno, Department of Behavioral Health are required to adhere to the Departments
Cultural Competency requirement.
Contractor shall do the following to ensure services are delivered in a culturally
competent manner and meet the needs of culturally and linguistically diverse
communities:
• Staff shall be recruited and hired that have demonstrated experience working with the
Latino, African American, Southeast Asian, Native American, and other minority
populations and have knowledge about the culture of these targeted groups as well
as other diverse communities.
• Staff shall attend annual trainings on cultural competency, awareness, and diversity
as provided by Contractor, or online via the County’s eLearning system. Staff shall
be appropriately trained in providing services in a culturally sensitive manner.
• Staff shall attend civil rights training as provided by Contractor, or online via the
County’s eLearning system.
• Contractor shall hire bilingual staff. At a minimum, MHPRAP shall hire staff
competent in Spanish and Hmong as these are the identified threshold languages in
Fresno County.
• Contractor shall secure the services of trained translators/interpreters as may be
necessary. Translators/interpreters may prove invaluable for languages such as
Cambodian, Russian, Arabic, Armenian, Punjabi, and others. Interpreters/translators
shall be appropriately trained in providing services in a culturally sensitive manner.
• Contractor shall provide services by placing importance on traditional values, beliefs
and family histories. Cultural values and traditions offer special strengths in treating
clients and this should help guide health care messages and wellness and recovery
plans.
• Contractor shall provide services within the most relevant and meaningful cultural,
gender-sensitive, and age-appropriate context for the target population.
• Contractor shall develop plans to continually engage targeted populations.
• Contractor shall recruit and hire client/family members as a significant portion of their
staffing.
Revised Exhibit A-1
Page 4 of 9
• Contractor shall have demonstrated knowledge and experience in working with
Latino, Southeast Asian, African American, and Native American communities, as
well as other diverse communities.
• Contractor shall ensure a streamlined approach to accessing appropriate services
which are available at times convenient for the targeted populations.
• Contractor shall distribute literature/informational brochures in appropriate languages
and request feedback as to how access to care could be improved for these culturally
diverse communities.
• Contractor shall conduct an annual cultural competency self-assessment and provide
the results of said self-assessment to the County. The annual cultural competency
self-assessment instruments shall be reviewed by the County and revised as
necessary to meet the approval of the County.
• Contractor shall provide services throughout Fresno County in the community as
opposed to services being performed at traditional mental health department offices
to increase the frequency of clients obtaining needed services as some
children/families are reluctant to seek services from traditional mental health settings.
• Contractor shall collaborate with agencies that are recognized and accepted by the
targeted populations.
• Contractor shall give consideration to gender sensitivity and the differing
psychologies and needs of boys and girls when providing services. Items such as
who are the primary care giver, domestic violence, and women’s health issues shall
also be considered in the provision of services.
• Contractor’ staff will be trained to keep an open mind and refrain from making
inappropriate judgments on clients/families.
• Contractor’ hiring and contracting practices shall be based on local data and reflect
the needs of the population to be served.
• Contractor shall maintain a cultural competence oversight and cultural competency
plan to address and evaluate cultural competency issues within its respective
organization.
O. Collaborate with County Mental Health Services Act (MHSA) program providers
promoting and educating awareness of the PRA and available services.
P. It is important that vendor advocates (community/faith based organizations staff)
recognize that the rights and desires of the client are being represented and not
organizational staff advocates).
Revised Exhibit A-1
Page 5 of 9
II. SPECIFIC REQUIREMENTS
The County delineates the two components of the Patients’ Rights Advocate program as
follows:
1. Advisements and Hearings
2. Receive/Investigate Grievances and Coordinate County-approved Advocacy
Activities
A. COMPONENT 1: ADVISEMENTS AND HEARINGS
The duties of the contracted Patients’ Rights Advocate shall include, but not be limited
to the following:
1. The Patients’ Rights Advocate (PRA) shall function as the patient’s
representative in all AB 3454 certification review hearings. The PRA shall
provide the notification and advisement of rights to those individuals admitted to
County-operated and County-contracted acute inpatient psychiatric facilities, as
required by Welfare and Institutions Code Sections 5250, 5260 and 5270, prior to
the certification review hearing. The contracted PRA may be directed by the
Local Mental Health Director to provide similar services at other mental health
facilities in the County of Fresno based on requirements of the W&I Code.
2. Function as the patient’s representative in all certification review hearings held in
Fresno County. Hearing activity and outcome shall be logged and provided in a
secure electronic format to the respective Department Director and/or designee
on a monthly basis by the 10th of each month. Report of notification and hearing
activity must include, but not be limited to:
a) Documentation of notification of rights for each client.
b) Date, start/end time of hearing, location, outcome of hearing for each
client.
c) Identification of family/support system present at hearing.
d) Identify 5250, 5260, and 5270 certification clients for tracking recidivism
3. Contractor advocate(s) must be knowledgeable of the LPS Act. The LPS Act, in
shifting the emphasis of mental health treatment away from involuntary treatment
to a commitment to community-based voluntary treatment narrowed the criteria
under which a person can be detained involuntarily. The only three reasons a
person can be detained are: 1) if they are gravely disabled; 2) a danger to
themselves; or, 3) a danger to others. These definitions are not open for
interpretation.
Revised Exhibit A-1
Page 6 of 9
B. COMPONENT 2: RECEIVE/ INVESTIGATE GRIEVANCES/COMPLAINTS
AND COORDINATE COUNTY-APPROVED ADVOCACY ACTIVITIES
The duties of the contracted Patients’ Rights Advocate shall include, but not be limited
to the following:
1. Under contract supervision, plans, directs, and coordinates advocacy services on
behalf of mental health clients and their families and performs related tasks as
required that will promote and support the transformative components of Mental Health
Services Act (Vision and Values).
2. Advocate services to provide both information, referral and grievance resolution
services to clients and family members. Information and referral may involve a
brief explanation of legal rights and available services. Grievance resolution
activities are the services provided when a client or family member alleges a
violation of her/his rights. Grievance resolution can range from a simple phone
call to a provider to multiple interviews, record reviews and written
correspondence. Every effort should be made to resolve complaints at the lowest
level.
Receive and investigate complaints from or concerning recipients of mental
health services residing in licensed health or community care facilities regarding
abuse, unreasonable denial, or punitive withholding of rights guaranteed under
the provisions of Division 5 (commencing with Section 5000) of the Welfare and
Institutions Code. Contractor shall respond to each grievance within forty-eight
(48) hours.
Under the provision of the Mental Health Services Act (MHSA), also known as
Proposition 63, the provision of these client advocacy services will assist in
transforming the mental health system to ensure that services are client focused
and family centered and that it addresses the issue of underutilization and under
representation on the part of populations of cultural/ethnic decent.
3. To receive and investigate grievances from or concerning recipients of mental health
services residing in licensed health or community care facilities regarding abuse,
unreasonable denials or punitive withholding of rights guaranteed under the provisions
of the Welfare and Institutions Code:
A. Develop and implement a format for the recording of patients’ rights
grievances and the disposition of each grievance. Such a format shall
indicate both the level of care provided to the individual, conservatorship
status, voluntary or involuntary treatment status, facility, nature of the
grievance, validity of the grievance, disposition of the grievance, and any
other information deemed necessary by the Local Mental Health Director.
Written documentation of the investigation of each grievance, including the
disposition of each grievance, shall be prepared and forwarded to Local
Mental Health Director at the office of the Director of Behavioral Health.
B. Report significant patients’ rights grievances to the Local Mental Health
Director, or designee, as soon as possible, verbally and in writing no later
than five (5) days after receipt of grievance in the event of facility violation,
Revised Exhibit A-1
Page 7 of 9
harm/death to client or other significant event requiring immediate notification
and action. Monthly reports of patients’ rights complaints shall be prepared
for the Director or designee, including verbal and written response when
required. Monthly and quarterly reports detailing the work accomplished
during the reporting period and problems, existing or anticipated, shall be
brought to the attention of respective Director of the Department of
Behavioral Health or designee.
C. Avail the files maintained by the Patients’ Rights Advocate to authorized
representative from the Department of Behavioral Health (DBH) upon
request. Contractor shall meet with DBH officials to determine authorized
representative.
D. All reports related to complaints and investigations should be sent to the
Local Mental Health Director/designee. .
4. To monitor mental health facilities, services and programs for compliance with
statutory and regulatory patient’s rights provisions.
Monitor mental health facilities services and programs for compliance with
statutory and regulatory patients’ rights provisions. Each mental health facility
shall be visited at least once every three (3) months.
Monitoring is the systemic observation of a mental health facility, its staff, its clients
and/or its records. Monitoring is important because it provides information about the
ways an institution functions, and why. An Advocate identifies institutional policies and
practices, reviews how they affect clients, and identifies if goals toward wellness and
recovery, client-focused, and culturally/linguistically accessible services are being
provided. Monitoring usually focuses on finding patterns as opposed to one-time
occurrence, looking at patients' problems in the aggregate rather than individually.
Although the process may be initiated by an individual grievance or informal
observation, monitoring focuses on the institution and institutional change. Monitoring
should have a high degree of organization, formality and objectivity in the investigation,
documentation and use of information and specifically gauge policy and practice to the
Mental Health Services Act guiding principles.
5. To provide training, education, and promote mental health and patients’ rights
regulations to community mental health providers as requested and scheduled through
County designee. Trainings are to be arranged/take place at least quarterly.
6. To ensure that recipients of mental health services in all licensed health and
community care facilities are notified of their rights.
7. To act as a liaison, to exchange information and cooperate with the State Department
of Health Care Services Mental Health Patients’ Rights Office.
8. Ensure that patients’ rights are posted in all facilities where posting is required
pursuant to Section 860 the Title 9 of the California Code of Regulations.
9. To act as advocate on behalf of clients who are unable to register a grievance
because of the mental or physical condition.
Revised Exhibit A-1
Page 8 of 9
10. To act as the local consultant in the area of clients’ rights.
11. To confer and meet with DBH administration regarding programs, policies, procedures,
and operational issues regarding the client advocacy program.
12. Act as a liaison between the DBH and client or family members, the community, county
and state agencies and the Mental Health Advisory Board.
13. Act as the Departmental liaison in providing leadership, technical assistance and
program guidance on client and family driven services.
14. Participate in the orientation activities for new DBH staff to ensure they have a client
perspective in the delivery of services.
15. Assist in developing, monitoring and evaluating client mental health projects and
programs.
16. Develop various techniques and tools to systematically analyze and report on specific
client focused performance outcome measures.
17. Assist in the oversight of culturally efficient, co-occurring capable services to ethnically
diverse mental health clients.
18. Develop means of direct communication with clients such as the development of a
newsletter, client specific focus groups, and the administration of client satisfaction
survey.
19. Develop an open line of communication for client’s and their families/support system
such as a 1-800 phone line or utilization of an exchange service for after hours or
when direct lines are unavailable.
20. Visit County-designated facilities which include, but are not limited to: Community
Behavioral Health Center (CBHC), Fresno County Psychiatric Health Facility (PHF),
Veterans Affairs Central California Health Care Systems, Exodus Recovery Fresno
Crisis Stabilization Center, and Community Regional Medical Center (CRMC); these
designations are subject to change and will be communicated to selected vendor for
service provision.
In addition to facilities mentioned above, the Department is planning to add an
adolescent psychiatric health (PHF) facility and an adolescent crisis stabilization unit
(CSU). Contractor shall provide all services as stated in this Agreement to the
proposed Adolescent/Children’s PHF and CSU. Details will be communicated to the
Contractor as they become available. Contractor’s budget includes cost for increase in
volume of anticipated children’s programs accordingly.
III. ESTIMATE OF SERVICES EXPECTED TO BE PROVIDED:
A. The following is an estimate of the volume of the various activities the Advocate will be
involved as defined in Component 1:
• 14-day Certification: average 80 per quarter
• Advisement to Clients average 80 per quarter
Revised Exhibit A-1
Page 9 of 9
• Hearings Attendance: average 80 per quarter
• 14-Day Post Certification (5260); average 1 per quarter
• 30-Day Post Certification (5270): average 16 per quarter
B. The following is an estimate of the volume of the various activities the Advocate will be
involved as defined in Component 2:
• Telephone Contacts: average 315 per quarter
• Number of Complaints/Grievances average 49 per quarter
• Number of Visits to County–designated facilities: average 52 per quarter
• Participation on committees: average 6 meetings per quarter
• Monitoring of Records: average 270 records per quarter
IV. REPORTS
A strong evaluation component will be built into the contract for services under this
Agreement. Attachment One (1) of this Exhibit A, identifies measureable outcomes,
hearings and advisements required documentation, and monthly complaints & grievance
reports template (see Attachment I). Contractor will also provide additional reports as
requested by the Department of Behavioral Health.
Revised EXHIBIT B-1
Page 1 of 8
MENTAL HEALTH PATIENT’S RIGHTS ADVOCACY PROGRAM BUDGET
FY 2014-15
Budgets inclusive of both components 1 & 2; Hearings & Receive/Investigate Grievances
Budget Categories BUDGET Line Item Description
Administrative Direct Total
PERSONNEL WAGES:
Supervisor Patient’s Rights Advocate 1 FTE 53,598 $53,598
Senior Patient’s Rights Advocate 1 FTE 44,285 $44,285
Patient’s Rights Advocate 1 FTE 40,125 $40,125
Salary Total $138,008
PAYROLL TAX & BENEFITS:
F.I.C.A./O.A.S.D.I. 10,558 $10,558
S.U.I. 690 $690
F.U.T.A. 828 $828
Workers Comp. Insurance 13,289 $13,289
Retirement
Health & Dental Insurance 13,318 $13,318
Life Insurance
Payroll Tax & Benefit Total $38,683
Total Salary, Payroll Tax & Employee Benefits $176,691
OPERATIONAL EXPENSE:
Employee Travel & Per Diem 9,090 $9,090
Office Rent 13,200 $13,200
Office Maintenance
Utilities
Insurance
Furniture & Equipment Maintenance
Postage 250 $250
Photocopy/Printing 225 $225
Communications 4,800 $4,800
Advertising/Public Outreach 1,000 $1,000
Vehicle Maintenance/Gas
Computers/IT 3,000 $3,000
Operational Expense Total $31,565
Revised EXHIBIT B-1
Page 2 of 8
FINANCIAL SERVICE EXPENSES:
Accounting/Bookkeeping 12,000 $12,000
External Audit
Worker's Compensation Insurance
Liability Insurance 2,500 $2,500
Insurance – Other
Financial Service Expense Total $14,500
TOTAL ANNUAL BUDGET $222,756
Revised EXHIBIT B-1
Page 3 of 8
MENTAL HEALTH PATIENT’S RIGHTS ADVOCACY PROGRAM BUDGET
FY 2015-16
Budgets inclusive of both components 1 & 2; Hearings & Receive/Investigate Grievances
Budget Categories BUDGET Line Item Description
Administrative Direct Total
PERSONNEL WAGES:
Supervisor Patient’s Rights Advocate 1 FTE 55,206 $55,206
Senior Patient’s Rights Advocate 1 FTE 45,615 $45,615
Patient’s Rights Advocate 1 FTE 41,328 $41,328
Salary Total $142,149
PAYROLL TAX & BENEFITS:
F.I.C.A./O.A.S.D.I. 10,558 $10,558
S.U.I. 690 $690
F.U.T.A. 828 $828
Workers Comp. Insurance 13,289 $13,289
Retirement
Health & Dental Insurance 13,318 $13,318
Life Insurance
Payroll Tax & Benefit Total $38,683
Total Salary, Payroll Tax & Employee Benefits $180,832
OPERATIONAL EXPENSE:
Employee Travel & Per Diem 9,090 $9,090
Office Rent 13,200 $13,200
Office Maintenance
Utilities
Insurance
Furniture & Equipment Maintenance
Postage 250 $250
Photocopy/Printing 225 $225
Communications 4,800 $4,800
Advertising/Public Outreach 1,000 $1,000
Vehicle Maintenance/Gas
Computers/IT 3,000 $3,000
Operational Expense Total $31,565
Revised EXHIBIT B-1
Page 4 of 8
FINANCIAL SERVICE EXPENSES:
Accounting/Bookkeeping 12,000 $12,000
External Audit
Worker's Compensation Insurance
Liability Insurance 2,500 $2,500
Insurance – Other
Financial Service Expense Total $14,500
TOTAL ANNUAL BUDGET $226,897
Revised EXHIBIT B-1
Page 5 of 8
MENTAL HEALTH PATIENT’S RIGHTS ADVOCACY PROGRAM BUDGET
FY 2016-17; FY 2017-18; and FY 2018-19
Budgets inclusive of both components 1 & 2; Hearings & Receive/Investigate Grievances
Budget Categories BUDGET Line Item Description
Administrative Direct Total
PERSONNEL WAGES:
Supervisor Patient’s Rights Advocate 1 FTE 56,862 $56,862
Senior Patient’s Rights Advocate 1 FTE 46,982 $46,982
Patient’s Rights Advocate 1 FTE 42,568 $42,568
Salary Total $146,412
PAYROLL TAX & BENEFITS:
F.I.C.A./O.A.S.D.I. 10,558 $10,558
S.U.I. 690 $690
F.U.T.A. 828 $828
Workers Comp. Insurance 13,289 $13,289
Retirement
Health & Dental Insurance 13,318 $13,318
Life Insurance
Payroll Tax & Benefit Total $38,683
Total Salary, Payroll Tax & Employee Benefits $185,095
OPERATIONAL EXPENSE:
Employee Travel & Per Diem 9,090 $9,090
Office Rent 13,200 $13,200
Office Maintenance
Utilities
Insurance
Furniture & Equipment Maintenance
Postage 250 $250
Photocopy/Printing 225 $225
Communications 4,800 $4,800
Advertising/Public Outreach 1,000 $1,000
Vehicle Maintenance/Gas
Computers/IT 3,000 $3,000
Operational Expense Total $31,565
Revised EXHIBIT B-1
Page 6 of 8
FINANCIAL SERVICE EXPENSES:
Accounting/Bookkeeping 12,000 $12,000
External Audit
Worker's Compensation Insurance
Liability Insurance 2,500 $2,500
Insurance – Other
Financial Service Expense Total $14,500
TOTAL ANNUAL BUDGET $231,160
Revised EXHIBIT B-1
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MENTAL HEALTH PATIENT’S RIGHTS ADVOCACY PROGRAM BUDGET
Term 7/1/2019 – 12/31/2019
Budgets inclusive of both components 1 & 2; Hearings & Receive/Investigate Grievances
Budget Categories BUDGET Line Item Description
Administrative Direct Total
PERSONNEL WAGES:
Supervisor Patient’s Rights Advocate 1 FTE $32,600 $32,600
Senior Patient’s Rights Advocate 1 FTE $24,612 $24,612
Patient’s Rights Advocate 1 FTE $20,800 $20,800
Salary Total $78,012 $78,012
PAYROLL TAX & BENEFITS:
F.I.C.A./O.A.S.D.I. $5,968 $5,968
S.U.I. $210 $210
F.U.T.A. $42 $42
Workers Comp. Insurance $858 $858
Retirement
Health & Dental Insurance $9,390 $9,390
Life Insurance
Payroll Tax & Benefit Total $16,468 $16,468
Total Salary, Payroll Tax & Employee Benefits $94,480 $94,480
OPERATIONAL EXPENSE:
Employee Travel & Per Diem $1,800 $1,800
Office Rent $9,150 $9,150
Office Maintenance
Utilities
Insurance
Furniture & Equipment Maintenance
Postage $0 $0
Photocopy/Printing $0 $0
Communications $2,300 $2,300
Supplies/Advertising/Outreach $550 $550
Vehicle Maintenance/Gas
Computers/IT $1,100 $1,100
Operational Expense Total $14,900 $14,900
Revised EXHIBIT B-1
Page 8 of 8
FINANCIAL SERVICE EXPENSES:
Accounting/Bookkeeping 5,250 $5,250
External Audit
Worker's Compensation Insurance
Liability Insurance 350 $350
Insurance – Other
Payroll Processing 600 $600
Financial Service Expense Total $6,200 $6,200
TOTAL ANNUAL BUDGET $115,580 $115,580