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Agreement No . 14-276-2
AMENDMENT JI It AGREEMENT
THIS AMENDMENT, hereinafter referred to as Amendment II, is made and entered into
t his 18th day of ___ J-u ...... ne"------' 201,, by and between the COUNTY OF FRESNO, a
Political Subdivision of the State of California, hereinafter referred to as "COUNTY", and
MENTAL HEALTH SYSTEMS, INC., a private Non-profit, 501 (c) (3), Corporation , whose
address is 9465 Farnham Stre et, San Diego, California 92123, hereinafter refe1red toas
"CONTRACTOR" (collectively the "parties").
WHEREAS, the parties entered into that certain Agreement, identified as COUNTY
Agreement No. 14-276, effective June 1. 2014, and COUNTY Amendment No .14-276-1,
effective June 1, 2014, hereinafter collectively refe1Ted to as COUNTY Agreement No. 14-
276, whereby, CONTRACTOR agreed to operate Mental Health Services Act (MHSA) Co-
Occurring Disorders Program (CDP) for adults and older adul ts with active co-occurring
disorders and symptems who have failed out of other drug w:eatment programs, including
methadone and residential treatment; and
WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), is a Mental
Health Plan (MHP) as defined in Title 9 of the California Code of Regulations (C.C.R .),
section 1810 .226; and
WHEREAS, CONTRACTOlt is qualified and willing to operate sait CDP pursuant to
the tenns and conditions of this Agreement.
WHEREAS, the parties desire to amend COUNTY Agreement No. 14 ~276 , regarding
changes as stated below and restate the Agreement in its entirety.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of
which is hereby acknowledged, COUNTY and CONTRACTOR agree as follows :
1. That the existing COUNTY Agreement No . 14-276, Section Two (2)"TERM",
shaJl be revised by adding the following at Page Three (3), Line Two (2) after the word "term ":
"This Agreement shall be extended for an addition a l six (6) month period
beginning July l , 2019 through December 31 , 2f19 ."
2. That all references in existing CeUNTY Agreement No . 14-276 to "Exhibit A ,"
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COUSTY Of FRESN O
E"resno , CA
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shall be changed to read "Revised Exhibit A," where appropriate, attached hereto and
incorporated herein by reference.
3.That all references in existing COUNTY Agreement No. 14-276 to "Revised
Exhibit B," shall be changed to read "Revised Exhibit B-1," where appropriate, attached hereto
and incorporated herein by reference.
4.That the Agreement, Section Four ( 4) "COMPENSATION", at Page Three (3),
beginning with Line Twenty-Six (26) with the word "The" and ending on Page Four (4), Line
Eighteen ( 18) with the word "Agreement", be deleted in its entirety and replaced with the
following:
"The maximum amount to be paid to CONTRACTOR by COUNTY under this
Agreement for each of the following twelve (12) month periods, (June 1, 2014 through June 30,
2015; July l, 2015 through June 30, 2016; July 1, 2016 through June 30, 2017; July 12017
through June 30, 2018; and July 1, 2018 through June 30, 2019) shall not exceed Two Million
One Hundred Fifty-Nine Thousand Nine Hundred Sixty-Five and No/100 Dollars
($2,159,965.00). For each twelve (12) month period, (June 1, 2014 through June 30, 2015; July
1, 2015. through June 30, 2016; July 1, 2016 through June 30, 2017; July 1 2017 through June 30,
2018; and July I, 2018 through June 30, 2019), the maximum amount ofMHSA funding under
this Agreement, shall not exceed One Million One Hundred Ninety-Seven Thousand Six
Hundred Sixty-Eight and No/100 Dollars ($1,197,668.00). In addition, it is understood by
CONTRACTOR and COUNTY that for each twelve (12) month period, (June 1, 2014through
June 30, 2015; July l, 2015 through June 30, 2016; July 1, 2016 through June 30, 2017; July 1
2017 through June 30, 2018; and July I, 2018 through June 30, 2019), CONTRACTOR
estimates to generate Nine Hundred Thirty-Seven Thousand Two Hundred Ninety-Seven and
No/100 Dollars ($937,297.00) in Medi-Cal Federal Financial Participation (FFP), Seventeen
Thousand and No/100 Dollars ($17,000) in client rents and Eight Thousand and No/100 Dollars
($8,000) in client insurance to offset CONTRACTOR's program costs as set forth in the budget,
attached hereto as Revised Exhibit B-1 and incorporated herein by reference.
The maximum amount to be paid to CONTRACTOR by COUNTY under this
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COONTY OF FRESNO Fresno, CA
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Agreement for the period of July, 2019 through December 31, 2019 shall not exceed One Million
Seventy Nine Thousand Nine Hundred Eighty Two and No/I 00 Dollars ($1,079,982.00). For the
period of July I, 2019 through December 31, 2019 the maximum amount ofMHSA funding
under this Agreement, shall not exceed Five Hundred Ninety-Eight Thousand Eight Hundred
Thirty-Three and Noll 00 Dollars ($598,833.00).
In addition, it is understood by CONTRACTOR and COUNTY that
CONTRACTOR estimates to generate Four Hundred Sixty-Eight Thousand Six
HundredFortyNine and No/100 Dollars ($468,649.00) in Medi-Cal Federal Financial
Participation (FFP),Eight Thousand Five Hundred and No/I 00 Dollars ($8,500.00) in client
rents and Four Thousand and Noll 00 Dollars ($4,000.00) in client insurance to offset
CONTRACTOR's program costs as set forth in the budget, attached hereto as Revised Exhibit
B-1 and incorporated herein by reference.
To assist CONTRACTOR with sta1t-up costs, the maximum amount of sta1tup
funds available to CONTRACTOR under this Agreement is Two Hundred Fifteen Thousand
Nine Hundred Ninety-Seven and No/100 Dollars ($215,997.00). COUNTY agrees to pay
CONTRACTOR and CONTRACTOR agrees to receive a one time advance payment ofTwo
Hundred Fifteen Thousand Nine Hundred Ninety-Seven and No/100 Dollars ($215,997.00) upon
execution of this Agreement. Said advanced payment shall be prorated over the twelve
(12)month period beginning July 1 , 2014 through June 30, 2015, at the rate of Seventeen
Thousand Nine Hundred Ninety-Nine and 75/100 Dollars ($17,999.75) per month, and said
monthly amount shall be deducted from monthly invoicing received from CONTRACTOR
during the twelve (12)-month period beginning July I, 2014 through June 30, 2015.
The total maximum compensation to be paid by COUNTY to CONTRACTOR for
the entire term shall not exceed Twelve Million Ninety Five Thousand Eight Hundred Four and
No/100 Dollars ($12,095,804.00)."
5.That the Agreement, Section Seven (7) "MODIFICATION'', at Page Nine (9),
beginning with Line Nine (9) with the word "Notwithstanding" and ending on Page Nine (9),
Line Fifteen (15) with the word "herein", be deleted in its entirety and replaced with the
following:
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COUNTY OF FRESNO Fresno, CA
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"Notwithstanding the above, changes to services, staffing, and responsibilities of
CONTRACTOR, as needed, to accommodate changes in the laws relating to mental health
treatment, as set f01th in Revised Exhibit A, may be made with the signed written approval of
COUNTY's DBH Director or desi gnee and CONTRACTOR through an amendment approved by
COUNTY's County Counsel and the COUNTY's Auditor-Controller's Office.
In addition, changes to expense category (i.e., Salary & Benefits,
Facilities/Equipment, Operating, Financial Services, Special Expenses, Fixed Assets, etc.)
subtotals in the budgets, as set forth in Revised Exhibit B-1, that do not exceed I 0% of the
maximum compensation payable to CONTRACTOR may be made with the WTitten approval of
COUNTY's DBH Director or designee. Changes to the expense categories in the budget that
exceed ten percent (10%) of the maximum compensation payable to CONTRACTOR, maybe
made with the signed written approval of COUNTY's DBH Director or designee through an
amendment approved by COUNTY's Counsel and COUNTY's Auditor-Controller's Office.
Modifications shall not result in any change to the annual maximum compensation
amount payable to CONTRACTOR, as stated in this Agreement."
6.COUNTY and CONTRACTOR agree that this Amendment II is sufficient to
amend the Agreement; and that upon execution of this Amendment II, the Agreement,
Amendment I and Amendment II together shall be considered the Agreement.
The Agreement, as hereby am ended, is ratified and continued. All provisions,
terms, covenants, conditions and promises contained in the Agreement, and not amended herein,
shall remain in full force and effect. This Amendment II shall become effective upon execution
by all parties.
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COUNTY OF FRESNO
Fresno, CA
1 EXECUTED AND EFFECTIVE as of the date first above set forth .
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Print Name:
James C. Callaghan, Jr .
8 Title :
President & CEO
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By:
Chairman of the Board, or President, or
any Vice President
Print Name:
Title:
Secretary (of Corporation), or any
Assistant Secretary, or Chief Financial
Officer, or any Assistant Treasurer
Date: __ __,_l.D..__-. ..L\£->~-__,\,_C\~----
Mailing Address :
Phone No.:
Contact :
FOR ACCOUNTING USE
ONLY: ORG No .: 0001 /10000
Account No.: 56304763
Requisition No .: 7295/0
COUNTY OF FRESNO
By: -~~~s:~~_____j~-__,,~::::::::_-
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Nathan Magsig,
Chairman of the Board of Supervisors
of the County of Fresno
ATTEST:
Bernice E . Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
COUNTY OF FRESNO
Fresno, CA
ORGANIZATION:
ADDRESS:
SERVICE ADDRESS:
SERVICES:
Department of Behavioral Health
Co-Occurring Disorders Program (CDP)
Full Service Partnership (FSP)
Scope of Work
Mental Health Systems, Inc.
9465 Farnham Street, San Diego, CA 92123
REVISED Exhibit A
Page 1 of 17
2550 West Clinton Avenue, Building A, Suite B, Fresno, CA 93705
Co-Occurring capable integrated, comprehensive, consumer-centered mental
health services
PROGRAM DIRECTOR: Kathryn Wilbur, LCSW, Vice President, Central Valley Region
(559)264-7521; kwilbur@mhsinc.org
SCHEDULE OF SERVICES:
Mental Health Systems (CONTRACTOR) staff shall be available to provide services to clients 24
hours per day, seven (7) days per week, and at least 35% of their time shall be spent on billable
activities on behalf of the client. (NOTE: Billable time/percentage will be re-evaluated periodically
and may be adjusted to reflect implementation of the Affordable Care Act (ACA) as its impact is
realized.) Target enrollment level for this program is a minimum of 140 unique clients served at any
given time, plus 3 (three) residential treatment beds. The Program shall reach and continue to
maintain full capacity the remainder of the contract term.
TARGET POPULATION:
Participation for CONTRACTOR's Mental Health Services Act {MHSA) Co-Occurring Disorders Full
Service Partnership (FSP) program is on a consumer voluntary basis. The target population to be
served under this Agreement will be adult and older adult clients with co-occurring DSM V-TR Axis I
mental health and substance abuse disorders who are frequent users of crisis services, emergency
rooms, detoxification services, jails, or hospitals. These clients will be enrolled after they have utilized
crisis services and will have already been referred to outpatient substance abuse services; these
clients may not have completed the waiting period or may have "failed out" of substance abuse
treatment in the past.
PROJECT DESCRIPTION:
The Department of Behavioral Health (COUNTY) MHSA Co-Occurring FSP is a "whatever-it-takes"
program to work toward providing a welcoming, recovery oriented, integrated, co-occurring disorder
capable service delivery to adults and older adults with serious mental illness and substance abuse
disorders. CONTRACTOR staff will provide innovative interventions, comprehensive services,
integrated behavioral health and substance abuse treatment services, and housing services to
support the consumer in recovery and self-sufficiency. In addition, residential treatment beds are
provided for a minimum of three (3) clients at any given time. Services shall be consumer-directed
and employ psychosocial rehabilitation and recovery principles. Further, it is understood that
individuals served will have medical conditions, cognitive and learning difficulties, and that these
individuals with complex needs will be welcomed into service and engagem ent in empathetic,
REVISED Exhibit A
Page 2 of 17
hopeful, integrated, recovery oriented partnerships to address each and every one of their issue s
over time in order to achieve a happy, meaningful life.
The MHSA Co-Occurring FSP program shall be a partnership between Mental Health Systems
(CONTRACTOR) and the Department of Behavioral Health (DBH). CONTRACTOR shall provide
multi-level services directed to individual needs of the enrollees. Services will include, but are not
limited to: personal services coordination, food, clothing, housing, daily living skills, mental and
physical health treatment, co-occurring capable integrated substance abuse services (as well as
having capacity for referral to specialized substance abuse treatment, when indicated, through a
subcontract), supported education and employment, vocational skills assessment and development,
transportation, advocacy and peer support. When possible, COUNTY staff shall provide vocational
services and supported educational services. COUNTY will oversee program outcomes, reporting,
and contract monitoring.
Co-Occurring Disorders Full-Service Partnership services will provide a staff to client ratio which
shall not exceed 1 :15 for those requiring 24/7 'wrap style' services. CONTRACTOR shall provide a
minimum of 14.22 Full Time Equivalent (FTE) staff, as identified in the Agreement program budget
-Exhibit B. CONTRACTOR shall also provide for an on-call Psychiatrist for initial and ongoing
consumer services as needed.
CONTRACTOR'S RESPONSIBIUTIES:
CONTRACTOR shall:
1.Maintain facilities and equipment, and operate continuously with the number and
classification of staff required described under this Agreement and in Exhibit B. If
CONTRACTOR does not have the positions filled for these services as described in
Exhibit B, CONTRACTOR shall notify COUNTY in writing within fifteen (15) days of the
vacancy and shall include a plan of action which explains how the CONTRACTOR will
continue with the contracted level of services. In addition, CONTRACTOR shall provide
a monthly personnel report to DBH by the 1 oth of each month.
2.Be required to comply with any requirements of COUNTY's Mental Health Managed Care
program as related to performance outcomes, quality of life and/or customer satisfaction
as a Medi-Cal Organizational Provider, as described in Exhibit F.
3.Maintain its approved service location which is to be accessible by public transportation.
4.Be required to comply with all State regulations regarding State Performance Outcomes
measurement requirements and part icipate in the outcomes measurement process as
required by the COUNTY.
5.Shall participate in performance outcomes throughout each term of this Agreement.
COUNTY MHSA staff will notify the CONTRACTOR when its participation is required.
The performance outcome measurement process will not be limited to sur vey
instruments but will also include, as appropriate, client and staff interviews, chart
reviews, and other methods of obtaining needed information.
6.Collaborate with other community agencies for the provision of non-direct mental health
services (Public Guardian, Social Services, physical health, etc.). These services are
particularly needed to reach people with co-occurring chronic or medical conditions.
Client's Program Service Plans must include needed mental health services and
REVISED Exhibit A
Page 3 of 17
integ rated co-occurring substance abuse services that are recovery oriented.
CONTRACTOR shall help link clients to any community services that will provide the
most potential benefit for each individual consumer.
7.Develop Provider Progra m Service Plans that include all safety, emergency and crisis
procedures in the field and in the organization's offices.
8.Provide a Program Service Plan that shall contain an outline that will list and describe
each multidisciplinary, multicultural and services provided by staff.
The client component of the Program Service Plan will describe the Personal Service
Plan. In addition, a treatment chart which meets Medi-Cal and Medicare requirements
will be maintained for each client.
9.Develop strategies which include the following components:
A.Client self-directed care plans (e.g., Wellness Recovery Action Plans or other similar
models);
B.Welcoming individuals with co-occurring substance use disorders into care, identifying
their needs, and providing appropriately matched integrated services for both mental
health and substance issues within a recovery framework;
C.Integrated physical and mental health services in collaboration with primary care
physicians;
D.Integrated services with law enforcement, probation and courts;
E.Education for clients and family or other caregivers as appropriate to maximize
individual choice about the nature of medications, the expected benefits and the
potential side effects as well as alternatives to medications; and
F.Values-driven, cultura lly competent, evidence-based or promising clinical services
that are integrated with overall service planning and support housing, employment,
and/or education goals.
10.Provide the following services to increase cultural competency:
A.Be required to assess and document the demographic make-up and population
trends of its service area to identify the cultural and linguistic needs of the eligible
beneficiary population. Such studies are critical to designing and planning for
providing appropriate and effective behavioral health and substance abuse services.
B.Provide and/or coordinate necessary behavioral health and substance abuse services
in a culturally competent manner.
C.Whenever possible will hire racially and ethnically diverse community members and
client/family members to provide or assist with culturally competent, client and family
driven mental health supportive services. CONTRACTOR will collaborate with
members of the various ethnic communities to gain cultural perspective. Each ethnic
community's perspective on mental illness, co-occurring disorders, and wellness and
recovery may include different concepts and practices. By working together to
REVISED Exhibit A
Page 4 of 17
explore these concepts, appropriate approaches can be dl3veloped for each ethnic
group.
D.Make sure that an assessment of a client's sexual orientation is included in the bio
psychosocial intake process. CONTRACTOR staff will assume that the population
served may not be in heterosexual relationships. Gender sensitivity and sexual
orientation must be covered during annual training.
E.Utilize existing community supports, referrals to transgender support groups, etc.,
when appropriate.
F.Required to annually attend the Cultural Competence, Compliance, Billing and
Documentation training.
G.Gender appropriate services will be emphasized when working with this population.
11.Maintain compliance with all MHSA reporting as required by the State and County.
12.Participate in a Quality Improvement Plan. The vendor is required to have an organized
quality improvement process and plan to continually impr ove care in order to better serve
clients. Quality improvement activities should be aligned with the County vision of
services, including making progress toward recovery orientation, cultural competency,
and co-occurring disorder capability.
I.CONTRACTOR will provide the following staffing components:
A.Staff work schedules shall be responsive to client needs. Staff shall be available
Monday through Friday from 7:00 a.m. to 7:00 p.m. and on Saturdays and Sundays
and from 8:30 a.m. to 6:00 p.m. During off-hours periods, staff shall maintain on-call
coverage on a rotating basis and shall be available to respond immediately to clients
by telephone or in person, as dictated by client needs.
B.CONTRACTOR Personal Services Coordinator's (PSC) staff shall be available to
provide crisis assessment and intervention twenty-four hours per day, seven days per
week throughout the year, including telephone and face-to-face contact as needed.
There shall be no barrier to access crisis services based solely on active substance
use. Response to crisis shall be rapid and flexible. The vendor shall collaborate with
facilities and designated COUNTY staff to provide emergency placement should crisis
housing, short-term care and inpatient treatment (voluntary or involuntary) be needed.
CONTRACTOR's staff shall provide support to the maximum extent possible,
including accompanying the client to the facility, per forming a face to face visit if
admitted to crisis facility and remaining with the client during the assessment. As
soon as possible CONTRACTOR staff shall begin the process of planning for
discharge and return to the community.
C.The CONTRACTOR shall provide services in the areas of medication prescription,
management, administration, monitoring and documentation. The CONTRACTOR's
psychiatrist(s) shall:
•Assess each client's mental illness and substance use disorder symptoms and
prescribe appropriate medication as necessary. Medication for clients who do not
have a third-party payor will be provided medication by the CONTRACTOR.
REVISED Exhibit A
Page 5 of 17
•Regularly review and document the client's mental illness and substance use
disorder symptoms as well as his/her response to the prescribed medications;
•Educate the client and client support system on the purpose of medication and any
side effects; and
•Monitor, treat and document any medication side effects.
D.The ratio of staff to clients will be no less than 1: 12 (1 clinical staff member to 12
clients) and no more than 1: 15 (1 clinical staff member to 15 clients). A primary goal
will be to keep clients in a stable living environment while reducing interactions with the
criminal justice system and reducing inpatient mental health hospitalizations.
E.The CONTRACTOR shall evaluate the staffs competency for performance purposes
and establish medication policies and procedures which identify processes to
administer medications to clients and train other staff and family members regarding
medication education, medication delivery, medication side effects, observation of self
administration of medication and medic ation monitoring. Policies and procedures must
indicate how individuals with co-occurring su bstance use disorders will be engaged
and maintained on necessary medications, even when they might still be using
substances.
F.Staff shall assess and document the client's mental health symptoms in response to
medication and monitor for medication side-effects during the provision of observed
self-administration and during ongoing face-to-face contacts.
G.CONTRACTOR shall incorporate client-directed, psych osocial rehabilitation and
recovery principles. CONTRACTOR shall utilize a peer-to-peer support network that
includes hiring recovering clients/family members. Staff shall employ harm reduction in
philosophy and motivational interviewing techniques and principles.
H.CONTRACTOR shall have at least one mental health specialists, e.g. "Mental Health
Advocate", "Peer Advocate," "Family Advocate." Vendor(s) may determine the exact job
titles for these specialists. The mental health specialists shall be a current client
receiving COUNTY or COUNTY contracted services and/or family member of a current
consumer. All peer specialists will be expected to have competency working with clients
with co-occurring substance use issues.
A client and/or family member will have demonstrated one year of volunteer or paid
experience working with individuals with serious and persistent mental illness to meet
the requirements of a mental health specialist. A mental health specialist shall be
regarded as a full, professional member of the clinical team, function under the same
job description as other mental health specialists and receive salary parity.
The mental health specialists shall not provide services to their respective family
members nor serve on a team which provides services to a family member/significant
other. Decisions regarding disclosure to clients, their families and significant others, that
a staff person is himself/herself a client or a family member, shall respect the individual
preference of that staff person and be made in consultation with the team director.
REVISED Exhibit A
Page 6 of 17
2.CONTRACTOR will provide specific services as it relates to mental health and co
occurring substance use disorders:
A.CONTRACTOR will reach minimum capacity enrollment of 140 clients. CONTRACTOR
shall maintain enrollment capacity at a minimum of 140 clients at any given time.
Service capacity will be met by serving clients in metropolitan and rural Fresno County
who present serious and persistent mentally illness residents with a co-occurring
disorder and who have frequently accessed crisis, detox services and/or have required
law enforcement intervention related to their substance abuse. FSP services are
voluntary.
B.CONTRACTOR will provide for three (3) residential treatment beds at any given time.
The goal shall be to utilize these three (3) residential treatment beds at capacity at any
given time.
C.CONTRACTOR will utilize the Recovery Model to provide co-occurring capable services
to all enrolled clients, twenty-four hours a day, seven days a week, during weekend
hours, and on call. Wrap-around services will be provided.
D.CONTRACTOR will have the flexibility to increase service intensity to clients in
response to client need. A critical feature of the service delivery shall be the unified
team approach, in which multiple staff members with a diversity of skills address each
client's mental health, substance abuse and community life support needs in a
comprehensive manner. Staff shall have the capacity to provide as many contacts as
needed to clients experiencing significant problems in daily living.
E.CONTRACTOR will operate a multidisciplinary treatment team including
licensed/unlicensed mental health professionals, nursing and psychiatric staff, and
mental health specialists, peer/family specialists who will assist clients in developing
their Personal Services Plan. The CONTRACTOR is encouraged to hire individuals with
specific experience in working with co-occurring substance use disorders, but
nonetheless, all staff will be required to work on developing co-occurring disorder
competency over time.
F.CONTRACTOR will be available to provide symptom assessment, personal service
coordination and supportive counseling to assist clients to cope with and gain mastery
of symptoms and disabilities due to mental illness and/or substance abuse. These
services shall include, but not be limited to, the following:
•Ongoing assessment of the client's mental illness and substance abuse symptoms
and response to treatment;
•Education of the client regarding his/her mental illness, substance use, and the
effects (including side effects) of prescribed medications;
Symptom management efforts directed to help the client identify the symptoms and
their occurrence patterns and development of methods (internal, behavioral,
adaptive) to lessen their effects; and
•Pr ovision, both on a planned and on an "as needed" basis, of such psychological
REVISED Exhibit A
Page 7 of 17
support as is necessary to help clients accomplish their personal goals and to cope
with the stresses of day-today living.
•Developing recognition of the concept of stages of change for each type of problem
and working on providing stage matched interventions and outcomes as indicated.
G.CONTRACTOR will provide training and instruction, including individual support,
problem solving, skill development, modeling and supervision, in home and community
settings, to teach the client to:
Carry out personal hygiene tasks;
Perform household chores, including housekeeping, cooking, laundry and shopping;
•Develop or improve money management skills;
•Use community transportation;
•Providing training and assistance to clients in locating, securing, maintaining and
financing safe, clean and affordable housing which is appropriate to their levels of
functioning; and
•Providing training and instruction, including individual support, problem solving, skill
development, modeling and supervision, in home and community settings, including
choices, decisions, and skills regarding substance use.
H.Ensure staff provides appropriate age, culture, gender and language services and
accommodations for physical disability (ies) to clients.
I.Assign a staff within 24 hours of receiving referral and the development of a tentative
client centered Personal Services Plan to meet the client's identified needs.
J.Ensure that the team members are able to have on hand, in their possession, during
regular working hours (and when appropriate during on-call hours) an adequate amount
of petty cash with which to make emergency purchases offood, shelter, clothing,
prescriptions, transportation, or other items and services as needed for clients. This
may include security deposits, rent subsidy, and other items needed by clients
(CONTRACTOR is to provide policies and procedures to MHSA Coordinator or
designee as to the handling of petty cash).
K.Ensure and monitor that staff provide frequent contacts, at least three times per week,
with clients where they live or are most comfortable, in order to assist them in accessing
behavioral and physical health care, financial, education, vocational, rehabilitative, or
other needed community services, especially as these services relate to meeting the
client's mental health and housing needs. At minimum, at least one contact per week
will be face-to-face.
L.Link clients to appropriate social services, legal advocacy and other representation,
provide transportation as necessary and serve as a "representative payee" or refer
client to other payee services for client's SSI/SSD benefits.
REVISED Exhibit A
Page 8 of 17
M.Develop and support the client's participation in recreational and social activities and
positive social relationships and activities in a community setting. Staff shall provide
support and help individual clients to establish positive social relationships and activities
in community settings. Such services shall include, but not to be limited to, assisting
clients in:
De veloping social skills in order to produce meaningful personal relationships;
•Planning appropriate and productive use of leisure time including familiarizing clients
with available social and recreational opportunities and increasing their use of these
activities;
•Interacting with landlords, neighbors and others effectively and appropriately;
•Developing assertiveness and self-esteem; and
•Using existing self-help centers, self-help groups and other social, church and
recreational groups to combat isolation and withdrawal.
N.Provide alcohol, tobacco and drug abuse services as needed, in accordance with harm
reduction principles. This will include, but is not limited to, individual and group
interventions to assist clients in:
•Identifying alcohol, tobacco and drug abuse effects and patterns;
Recognizing the interactive effects of alcohol, tobacco and drug use, psychiatric
sy mptoms, and psychotropic medications;
•Developing motivation for decreasing alcohol, tobacco and drug use;
Developing coping skills and alternatives to minimize alcohol, tobacco and drug use;
•Achieving and rewarding periods of improvement and/or periods of abstinence and
stability;
•Attending appropriate recovery or self-help meetings; and
•Achieving an alcohol, tobacco, and drug free lifestyle, if consistent with the
individual's recovery goal.
0.Provide information, in an educational format, on the use of alcohol, tobacco,
prescribed medications, and other drugs of abuse and the impact that chemicals have
on the ability to function in major life areas. Information shall also include eating
disorders, gambling, overspending, sexual and other addictions, as appropriate.
P.Make appropriate referrals and linkages to addiction services that are beyond ACT
wrap-around type services to individuals with coexisting alcohol, tobacco and drug
abuse and other addictive symptoms that are more severe than what the Co-occurring
FSP can be reasonably expected to provide.
Q.Minimize client involvement with the criminal justice system, with services to include,
but not be limited to:
REVISED Exhibit A
Page 9 of 17
Helping the client identify precipitants to the client's criminal involvement;
•Providing necessary treatment, support and education to help eliminate any unlawful
activities or criminal involvement that may be a consequence of the client's mental
illness;
Collaborating with police, court personnel and jail/prison officials and psychiatric staff
to ensure appropriate use of legal and mental health services; and
Working with COUNTY jail psychiatric mental health staff in planning for their release
from custody and transition back into the community (staff will pass Sheriffs
Department security screening in order to obtain passes to provide outreach linkage
and assessment services at the jail).
•Working with the Behavioral Health Court.
R.Provide support to the client's social network to help them manage the co-occurring
mental health and substance use symptoms and illness of the client and reduce the
level of social stress associated with the illness.
S.Assist client, family and other members of the client's social network to relate in a
positive and supportive manner through such means as:
•Education about the client's illness and the support person's role in the therapeutic
process;
Supportive counseling;
•Intervention to resolve conflict;
•Referral, as appropriate, to family therapy, self-help and other family support
services; and
Provision to the client's other support systems with education and information about
serious mental illnesses and treatment services and supports.
T.Coordinate services with other community mental health and non-mental health
providers, as well as other medical professionals. Methods for service coordination and
communication between CONTRACTOR and other service providers serving the same
clients shall be developed and implemented consistent with Fresno County
confidentiality rules and will include the following:
•Formal and informal affiliations with appropriate mental health, social services, health
care, substance abuse, and other human service providers, and inpatient units;
•Involvement of other pertinent agencies, the client's family, and members of the
client's social network in the coordination of the assessment, and in the
development, implementation and revision of service plans;
REVISED Exhibit A
Page 10 of 17
•Advocacy for and assistance to clients to obtain needed benefits and services such
as Supplemental Security Income (SSI), housing subsidies, food stamps, medical
assistanca, and lagal s.arvice.s .. The FSP unde.rstands that SSI can be a tremendous
long-term benefit to the client and will give this resource appropriate attention;
•Coordination of meetings of the client's service providers in the community;
•Maintenance of ongoing communication with all other agencies serving the client
including hospitals, rehabilitation services and housing providers, as needed;
•Maintenance of working relationships with other community services, such as
education, law enforcement and social services;
•Coordination with existing community agencies to develop needed community
support resources including housing, employment options and income assistance;
and
•Maintenance of an empathic, hopeful, integrated clinical treatment relationship with
the client on a continuing basis whether the client is in the hospital, community,
involved with other agencies or in the criminal justice system.
U.Network with peer support services and appropriate services offered through the Mental
Health Services Act (MHSA), as implemented.
V.Provide wrap-around services. Services will be intensive treatment and rehabilitation
case management services to promote adaptive functioning in the community and
prevent unnecessary admissions to psychiatric hospitals.
Wrap-around services shall include:
The development of a client-centered personal service/care plan reflective of
behavioral health assessments (including risk assessments);
The development, location, coordination, and maintenance of independent or other
appropriate housing for all clients within the community;
•The development, maintenance and involvement of all clients in lower levels of care
in a peer-to-peer support network and social engagement activities;
•The development and maintenance of a 24/7 crisis inte rvention service;
•The 24/7 crisis intervention phone number will be given to all enrolled clients, the
number will be printed on all CONTRACTOR business cards, and CONTRACTOR
will regularly remind clients that 24/7 crisis intervention services are available.
•The development and maintenance of integrated mental health and substance abuse
treatment services for all individuals with co-occurring disorders;
•The development and maintenance of supported employment and/or supported
education with involvement of all clients who can benefit from these services;
REVISED Exhibit A
Page 11 of 17
The development and maintenance of "wrap around" fund to provide for the client's
immediate basic needs or to purchase specialized services that are required to
reduce the client's. risk factors whe.n no othe.r funding s.ource is available;
The development and provision of family involvement/support services to all
interested families;
•The development and provision of Personal Service Coordinator services that will
access all entitlements or make referral to any support services for which a client is
eligible;
•The development and provision of transportation and other support services clients
may need to access heath care, mental health services, education, employment,
rehabilitation, peer support, recreational or other services within the community;
•The development and maintenance of a "representative payee" service for all clients
who would benefit from this service. CONTRACTOR may help clients link to
established payee services in the community;
The provision of integrated medical support services including psychiatric
assessments, psychopharmacological treatment, and medication education and
monitoring for all clients;
•The provision of all other mental health services that may be needed or required by
clients;
The integration of mental health and substance use disorder recovery principles and
practices promoting employment; and
The facilitation of a client-centered approach in all treatment services.
W.Initiate voluntary commitment should there be a need after every reasonable
intervention has been attempted; CONTRACTOR's staff shall work with COUNTY staff
within the Intensive Services Division. COUNTY staff will sign the involuntary
commitment papers. CONTRACTOR will clearly document and chart all interventions
attempted with consumer in every potential crisis situation.
X.CONTRACTOR will identify and document diversity of said population, along with
housing status, identifying gender, ethnicity, date of birth and/or age and other
demographics as requested by COUNTY and maintain a database of targeted
population. CONTRACTOR will provide this information to COUNTY as re quested.
Y.Individualized services may include drug testing on a random basis, as appropriate, as
an integral part of the Personal Services Plan. Services will also include linking client to
appropriate substance abuse treatment services.
Z.Ensure staff participate in education and training activities provided by the COUNTY,
State of California, and/or organizations to strive for the best practices model.
AA. Provide assistance and advocacy in obtaining any available public benefits and
REVISED Exhibit A
Page 12 of 17
accessing needed behavioral health and physical health care for clients.
BB. Provide whatever direct assistance is reasonable and necessary to ensure that the
client obtains the basic necessities of daily life. CONTRACTOR shall have vehicle(s)
available to staff to transport clients to appointments and social group activities. Bus
tokens and/or passes will be made available by the CONTRACTOR to encourage and
empower client to utilize public transportation to their scheduled appointments.
CC.Enter Information Technology Web Services (ITWS) data via the web-based data
collection operated by the State DMH (CONTRACTOR are to receive approval from the
State prior to entering data). CONTRACTOR will complete ITWS data entry in a timely
fashion.
DD.Deliver all MHSA required reporting in data collection format that reflects MHSA and
data Infrastructure Grant (DIG) requirements in a timely and accurate manner. DMH
has identified domains on which data must be captured by FSP's. CONTRACTOR will
be required to assign staff to data entry and input; contact the Performance Outcomes
and Quality Improvement Division of the California state Department of Mental Health
to schedule trainings; and establish procedures to complete the MHSA Full-Service
Partnership Outcomes Assessment (FSP) forms. These forms can be accessed at:
http://www.dmh.ca.gov/POQI/Full Service.asp.
Reports are to include: Changes to Client and Services Information (CS!) system
reporting, outcome assessments for Full-Service Partnership (FSP) clients and
notification of cost report changes, annual updates and progress reports as outlined in
Department Of Mental Health Information Notice 06-02 dated April 18, 2006. COUNTY
shall provide a timeline on when each report is due to the COUNTY. COUNTY at its
sole discretion may withhold future amounts payable to CONTRACTOR, until such time
that all reports are satisfactorily received by the COUNTY.
CONTRACTOR shall maintain an up to date caseload record of all clients enrolled in
services, and provide consumer, programmatic, and other demographic information to
the COUNTY. Reports are to be submitted to the DBH MHSA Staff Analyst, DBH
Director, or designee on a monthly basis.
CONTRACTOR will work in partnership with DBH in a quality improvement process on
improving recognition of the numbers of individuals who have co-occurring substance
use issues and disorders and reporting that information routinely and reliably into the
county data system.
CONTRACTOR will compile quarterly reports indicating the total number of clients
served in a particular Fiscal Year, along with each quarter's target count versus the
actual count.
EE. Ensure billable Mental Health Specialty Services meet any/all COUNTY, State, Federal
regulations including any utilization review and quality assurance standards. Provide all
pertinent and appropriate information in a timely manner to COUNTY to bill Medi-Cal for
services rendered.
FF. Ensure that the COUNTY's Department of Social Services (DSS) are informed of all
new and current clients who qualify for General Relief.
REVISED Exhibit A
Page 13 of 17
GG.lnform COUNTY's DSS of clients enrolled through contact with the vendor staff
assigned to the client and a monthly report provided to MHSA Administration and DSS
by CONTRACTOR.
HH. Ensure clients who qualify for General Relief sign the General Relief Cash Aid client
form.
11.Refer clients who meet the criteria and are eligible for entitlement programs for
benefits/services. All clients cur ren tly in the program and any new clients to be enrolled
will go through DSS to qualify for financial resources.
JJ. Ensure that all clients without financial resources apply for Medi-Ca\ and complete SSI
applications, establish benefits or have developed an alternative plan for eventually
assuming their own housing costs.
3.CONTRACTOR will provide specific services as it relates to housing:
Success in the community is critically enhanced by obtaining and retaining appropriate
housing. MHSA programs are structured to provide housing opportunities and supports for
enrollees.
The CONTRACTOR will empower clients to take an active role in the recovery process.
The CONTRACTOR will provide housing options and maintain clients in independent living
by providing needed services, accessing resources and encouraging clients to be
independent, productive and responsible. The CONTRACTOR will be responsible to
negotiate and establish relationships with apartment owners/landlords and provide housing
to clients.
Clients will be assisted to choose the type of housing that they want and will receive
assistance to be successful in that housing. As part of this, clients will be assisted to make
choices regarding substance use in their housing, and to develop the skills and supports
needed to be successful in deciding what the right amount of substance use for them will
be appropriate to maintain the housing of their choice, or in deciding whether they would
be more successful making different choices to be in a different type of housing.
Individuals will not be excluded from housing solely because of continuing substance use.
A.CONTRACTOR's housing staff shall provide whatever direct assistance is reasonable
and necessary to ensure that the client obtains the necessities of daily life, including but
not limited to:
•Safe, clean, affordable housing;
•Food and clothing;•Appropriate financial support, which may include housing deposits, Supplemental
Security Income, Social Security Disability Insurance, General Relief, and money
management services.
B.The CONTRACTOR shall have rapid access to client assistance funds for purchase of
furniture, and other items needed by clients.
C.CONTRACTOR will ensure clients maintain their respective housing and utilize
supportive housing resources by:
REVISED Exhibit A
Page 14 of 17
•Providing supportive and independent housing as appropriate for the client. The goal
is to have every client in supported independent and independent housing, as
appropriate, with proper supports, as soon as possible;
D.Provide appropriate number of staff members that will service the maximum capacity of
140 clients at any time. CONTRACTOR shall provide a methodology on the number of
Housing Monitors to be assigned for both clustered and scattered site housing.
E.Meet regularly with MHSA staff to discuss and resolve any issues and/or any client
status changes. Status changes include but are not limited to hospitalization,
incarceration, crisis calls, housing etc.
F.Staff shall send written notice to landlords of housing facilities that explains the financial
responsibility of CONTRACTOR and the client (tenant) for payment of rent and utilities
within three business days.
G.A completed client rental agreement shall document the amount of rent and the
minimum utility expense that a client is required to pay. Housing Coordinator shall also
provide a monthly receipt to client and staff of the payment received. CONTRACTOR
will establish and follow clear Policies and Procedures regarding financial issues related
to housing.
COUNTY RESPONSIBILITIES:
COUNTY shall:
1.Provide oversight, through its MHSA Coordinator or designee, of the Housing and
Recovery Expansion services as restored and expanded through MHSA funding and
collaborate with CONTRACTOR and other COUNTY Departments and community
ag encies to help achieve State program goals and outcomes. In addition to contract
monitoring of program(s), oversight includes, but not limited to, coordination with the State
Department of Mental Health in regard to program administration and outcomes.
2.COUNTY DBH shall assist CONTRACTOR in making linkages with the total mental health
and substance abuse system. This will be accomplished through regularly scheduled
meetings as well as formal and informal consultation.
3.Participate in evaluating the progress of the overall program and the efficiency of
collaboration with the CONTRACTOR staff and will be available to CONTRACTOR for
ongoing consultation.
4.Gather outcome information from target client groups and CONTRACTOR throughout each
term of contract. MHSA staff will notify CONTRACTOR wh en its participation is required.
The performance outcome measurement process will not be limited to survey instruments
but will also include, as appropriate, client and staff interviews, chart reviews, and other
methods of obtaining required information.
5.Assist the consumer to determine food stamp eligibility. Upon determination of food stamp
REVISED Exhibit A
Page 15 of 17
eligibility, enrollees shall receive food stamps when they reside in housing that does not
include meals.
6.MHSA Administration and DBH recognize that co-occurring capability is a goal for all
programs, and will provide continuing training, consultation, and technical assistance for all
programs in order to help them make progress in that goal, as part of their own quality
improvement plan. DBH is also supporting the development of a change agent tea m in the
county to support this process and encourages each program to have active representation
on this team.
7.MHSA Administration recognizes that cultural competence is a goal toward which
professionals, agencies, and systems should strive. Becoming culturally competent is a
developmental process and incorporates at all levels the importance of culture, the
assessment of cross-cultural relations, vigilance towards the dynamics that result from
cultural differences, the expansion of cultural knowledge, and the adaptation of ser vices to
meet culturally-unique needs. Offering those services in a manner that fails to achieve its
intended result due to cultural and linguistic barriers is not cost effective. To assist the
CONTRACTOR's efforts towards cultural and linguistic competency, the DBH shall provide
the following at no cost to CONTRACTOR:
A.Technical assistance regarding cultural competency requirements and sexual
orientation training.
B.Mandatory cultural competency training including sexual orientation and sensitivity
training for DBH and contactor personnel, at minimum once per year. County will
provide mandatory training regarding the special needs of this diverse population and
will be included in the cultural competence training(s). Sexual orientation and sensitivity
to gender differences is a basic cultural competence principle and shall be included in
the cultural competency training. Literature suggests that the mental health needs of
lesbian, gay, bisexual, transgender (LGBT) individuals may be at increased risk for
mental disorders and mental health problems due to exposure to societal stressors
such as stigma tization, prejudice and anti-gay violence. Social support may be critical
for this population. Access to care may be limited due to concerns about providers'
sensitivity to differences in sexual orientation.
C.Technical assistance for translating behavioral health and substance abuse services
information into DBH's threshold languages (Spanish, Laotian, Cambodian and
Hmong). Translation services and costs associated will be the responsibility of the
CONTRACTOR.
PR OJECTED OUTCOM ES:
The following items listed below represent program goals to be achieved by CONTRACTOR.
The program's success will be based on the number of goals it can achieve, resulting from
performance outcomes. CONTRACTOR will utilize a computerized tracking system with which
outcome measures and other relevant client data, such as demographics, will be maintained.
1)Each enrollee will have no more than six (6) recidivism events (specifically
incarceration, homelessness, crisis or inpatient hospitalization admission) during the
first six months in the program. There will be a reduction of key events for enrollees
tracked as:
REVISED Exhibit A
Page 16 of 17
a)No more than 3 key recidivism (incarceration, homelessness, and crisis or inpatient
hospitalization admission) during months 6-12 of enrollment in program.
b)No more than 1 key recidivism (incarceration, homelessness, and crisis or inpatient
hospitalization admission) during months 13-18 of enrollment in program.
2)FSP will show zero (0) days of homelessness after being enrolled in the program,
unless consumer declin ed housing assistance. CONTRACTOR will notify MHSA
Manager or designee of con sumer's decline and document accordingly. The provider
must have clear documentation of efforts to house clients in appropriate setting.
3)FSP will show a 90% reduction in Consumer's days in in-patient psychiatric
hospitalizations after being enrolled in FSP compared to the year before being enrolled
in the FSP.
4)FSP will show a 90% reduction in Consumer's days incarcerated after being enrolled in
FSP compared to the year before being enrolled in the FSP.
Regarding Linkages and Referrals:
1)Within 90 days of being enrolled in the FSP, 100% of clients who did not have SSI will
have completed applications to request SSI. FSP will provide this data to MHSA on a
monthly basis by the 10th of each month regarding SSI status.
2)Within six months of being enrolled in the FSP, 100% of clients will have linkages to
and documentation of a Primary Care Physician.
3)No clients that are enrolled in the FSP will be referred to or placed on conseNatorship
while enrolled in the FSP.
4)Within 30 days of enrollment, 100% of clients will have participated in forming their
individualized seNice plan.
5)Within 120 days of enrollment, at least100% of clients will be provided/linked to job
coaching activities.
6)CONTRACTOR will make an objective assessment of each client's ability to function
and move to independent housing in the community and report results in written form
as requested to MHSA Coordinator or designated staff.
7)CONTRACTOR will develop a satisfaction suNey that is approved by the MHSA
Coordinator and will comply with mandated State performance outcomes and quality
improvement reports/outcomes (www.dmh.ca.gov/POQl/l. At a minimum, 75% percent
of clients will report their satisfaction with program seNices through MHSIP Client
Oriented Report Card overall score. This Report Card will be completed every six
months.
8)Direct services productivity rate is expected to be at a minimum of eighty percent (80%)
REVISED Exhibit A
Page 17 of17
and reported in writing at regularly scheduled meetings with the Department.
Productivity to be reviewed monthly to address projected revenues and outreach
activities related to target population requiring benefits assistance.
9)Clients in independent supportive housing and lower levels of care will develop a plan
to provide for their own housing costs. Clients will assume responsibility for housing
cost, when ready and as appropriate. CONTRACTOR will work with clients on payment
issues. Within six months of enrollment, all clients without SSI will have made SSI
applications, establish benefits or have developed an alternative plan for eventually
assuming their own housing costs. A report regarding consumer plans for housing costs
will be submitted to COUNTY on a semi-annual basis.
Revised Exhibit B-1,
Page 1 of3
Fresno IMPACT I Co-Occuring Disorder Mental Health Services I Contract No. 14-276·1
Mental Health Systems, Inc.
FY 2019-2020
Budget Categories Total Proposed Budget
Line Item Descrintion (Must be itemized) FTE% Admin. Direct Total
PERSONNEL SALARIES:
Program Manager 1.00 $41,600 $0 $41,600
Administrative Assistant 1.00 $19,760 $0 $19,760
Clinical Supervisor 1.00 $27,300 $11,700 $39,000
RN 1.00 $0 $37,440 $37,440
LVN 1.00 $0 $26,000 $26,000
Program Supervisor 1.00 $22,880 $5,720 $28,600
Dual Recovery Specialist 1.00 $0 $24,960 $24,960
Dual Recovery Specialist 1.00 $0 $24,960 $24,960
Dual Recovery Specialist 1.00 $0 $24,960 $24,960
Peer Support Specialist 1.00 $0 $16,640 $16,640
Peer Support Specialist 1.00 $0 $19,240 $19,240
Housing Specialist 1.00 $12,480 $8,320 $20,800
Employment Specialist 1.00 $0 $18,720 $18,720
24/7 on-call capacity 0.01 $0 $364 $364
Vice President of Clinical Services 0.20 $2,080 $8,320 $10,400
Program Financial Analyst 0.07 $159 $2,116 $2,275
SALARY TOT AL 13.28 $126,259 $229,460 $355,719
PAYROLL TAXES: Rates: 67% 33%
OASDI $130 $64 $194
FICA/MEDICARE $18,232 $8,981 $27,213
SUI $1,907 $939 $2,846
PAYROLL TAX TOTAL $20,269 $9,984 $30,253
EMPLOYEE BENEFITS:
Retirement $19,067 $9,391 $28,458
Workers Compensation $2,383 $1,174 $3,557
Health Insurance (medical, vision, life, dental) $15,134 $7,453 $22,587
EMPLOYEE BENEFITS TOTAL $36,584 $18,018 $54,602
SALARY & BENEFITS GRAND TOTAL $440,574
If I
. . ,., .,J Equipment repair/maintenance
FACILITY/EQUIPMENT TOTAL
OPERATING EXPENSES·
Telephone
Answering Service
Postage
Printing/Reproduction
Publications
Legal Notices/Advertising
Office Supplies & Equipment
Household Supplies
Food
Program Supplies -Therapeutic
Program Supplies -Medical
Transportation of Clients
Staff Mileage/vehicle maintenance
Staff Travel (Out of County)
Staff Training/Registration
Lodging
Other -Licenses/Taxes
Other-Other Business
Other-Depreciation
Other-Interest
Outside Labor-Registered Nurse
OPERATING EXPENSES TOTAL
FINANCIAL SERVICES EXPENSES·
Accounting/Bookkeeping
External Audit
Liability Insurance
Administrative Overhead
Payroll Services
Professional Liability Insurance
FINANCIAL SERVICES TOTAL
SPECIAL EXPENSES (Consultant/Etc)· ..
Consultant-The Hacienda
Translation Services
Medication Supports
SPECIAL EXPENSES TOTAL
FIXED ASSETS:
Computers & Software
Furniture & Fixtures
Revised Exhibit B·l
Page 2of3
$10,728
$88,669
$11,700
$0
$240
$462
$0
$0
$5,400
$120
$0
$150
$3,400
$0
$3,045
$5,488
$2,758
$0
$1,015
$3,804
$0
$0
$0
$37,582
$200
$0
$1,188
$136,766
$0
$4,320
$142,474
$13,440
$500
$97,456
$111,396
$2,000
$1,150
Other -(Identify)
FIXED ASSETS TOTAL
NON MEDI-CAL CLIENT surrORT EXPENSES·
Client Housing Support Expenditures (SFC 70)
Client Housing Operating Expenditures (SFC 71)
2002.1 Clothing, Food & Hygiene (SFC 72)
2002.2 Client Transportation & Support (SFC 72)
2002.3 Education Support (SFC 72)
2002.4 Employment Support (SFC 72)
2002.5 Respite Care (SFC 72)
2002.6 Household Items
2002. 7 Utility Vouchers (SFC 72)
2002.8 Child Care (SFC 72)
NON MEDI-CAL CLIENT SUPPORT TOTAL
Revised Exhibit B�l
Page 3 of 3
$0
$3,150
$226,997
$0
$10,600
$11,640
$500
$1,850
$0
$4,000
$50
$500
$256,137
TOTAL PROGRAM EXPENSES $1,079,982
MEDI-CAL REVENUE: Service Rate $ Amount
Mental Health Services (Therapy, Collateral, PD, Rehab, etc.) 66,727 $2.73 $182,166
Case Management 47,044 $2.11 $99,262
Crisis Services 1,205 $4.06 $4,891
Medication Support 36,177 $5.04 $182,330
Non-Billable 18,351 $0.00 $0
Estimated Medi-Cal Billing Totals 169,503 $468,649
Estimated % of Federal Financial Participation Reimbursement 100.00% $468,649
Estimated % of Early and Periodic Screening, Diagnostic, and Treatment Reimbursement 0.00% $0
MEDI-CAL REVENUE TOTAL $468,649
OTHER REVENUE·
other-Rent $8,500
other -Other Health Coverage $4,000
Other • (Identify) $0
Other -(Identify) $0
OTHER REVENUE TOTAL $12,500
MHSA FUNDS·
Prevention & Early Intervention Funds $0
Community Services & Supports Funds $598,833
Innovation Funds $0
Workforce Education & Training Funds $0
MHSA FUNDS TOTAL $598,833
TOTAL PROGRAM REVENUE $1,079,982