HomeMy WebLinkAboutAgreement No. A-16-362-1 with DHCS.pdfState of California -Health and Human Serv1 ces Agency
PATH ALLOCATION WORKSHEET
STATE FISCAL YEAR: 2016 -2017 FEDERAL CATALOG NO . 93 .150
COUNTY: FRESNO REV ISION NO : 1
The State Department of Health Care Services (DHCS ) provides the Federal Projects
For Assistance in Transition From Homelessness (PATH) Formula Gran t funds to
counties for State Fiscal Yea r (S FY) 2016-2017 . Your Allocation is identified below.
PATH Funding Base: $316 ,524
Total PATH Expenditure: $316 ,524
PURPOSE : INITIAL ALLOCATION March 28 , 2017
Agreement No. 16-362-1
Department o f Hea lth Care Services
Enclosure 1
I , the und ersigned Director, have accepted the Federal PATH funds for the county under the
speci fic conditions included in the ass urances as part of the Co unty Application Package (CAP)
as well as those conditions established by other governi ng federal and state laws , poli cies
regulations , and guidelines. The CAP , as approved by DHCS , will be fo llowed in expending
these funds .
Chairman , Cou nty of Fresno , Board of Supervisors
Brian Pacheco , Chairman , Board of Supervisors
Printed Name
A TTEST:
BERNICE E . S EI D EL, Clerk
B oard of Supervisors
By ~~~~~
De uty
OHCS 1772 P (4 /13)
March 28, 20 17
Date
State of Ca lifornia -Hea lth and Human S ervices Agency
FEDERAL BUDGET SUMMARY
TYPE OF GRANT: PATH STATE FISCAL YEAR: ---=2-=-0..:....:16::._-...:...;17'----
COUNTY : ~F~re=s~n=o __________________ _
FISCAL CONTACT: Harlan Laurenti us Theng TELEPHONE NUMBER: (559) 600-4619
E-MAIL ADDRESS : lharlantheng@co.fresno .ca .us
Object Class Cate go ries
a. Personnel
b . Fringe Be nefits
c. Travel
d. Equ ipment
e . Suppl ies
f . Contra ctual
g . Construction
h . Other
i . Total Direct Charges (s um o f a -h)
j . Indirect Charges
k. TOTALS (sum of i a nd j )
PATH 2016-17 Request for Application
DH CS 1757 (4 /13)
BUDGET CATEGORIES
GRANT PROGRAM, FUNCTION OR ACTIVITY
(1 ) Federal (2) Non-Federa l
$ 199,708 $
$ 36 ,745 $
$ 15 ,580 $
$ $ 5 ,600
$ 7 ,300 $ 10,952
$ 1,500 $ 13,030
$ $
$ 24,950 $ 64 ,590
$ 288,783 $ 94,172
$ 30,741 $ 1 1 ,336
$ 316,524 $ 105,508
DHCS APPROVAL BY :
TELEPHONE :
DATE :
Departm ent of Health Care Services
Enclosu re 7
1
2
8
1
1
2
3
5
State of California -Health and Human SeNices Agency
FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPEOFGRANT: ----~P~A~T~H ________ _
COUNTY: LF~re~s~n~o __________________ __
FISCAL CONT ACT: Laurentius Harlan Theng
TELEPHONE NUMBER: (559) 600-4619
EMAIL ADDRESS : lharlantheng@co.fresno.ca.us
PROGRAM NAME: !...P~A~T!..!H...!.P...!.ro~g:e.r.2eam~---------
STAFFING
TITLE OF POSITION
[TOTAL ST AFF t:XI"'t::N::iES (sum lines 1 thru 11 $
Consultant Costs (Itemize):
Equipment (Where feasible lease or rent) (Itemize):
Supplies (Itemize):
Travel -Per diem, Mileage, & Vehicle Rental/Lease
Other Expenses(ltemize):
ANNUAL
SALARY
-
GRANT
FTE
0.00
9
10
11
12
13
14
15
16
17
18
19
20
2
22
23
24
25
26
27
28
29
30
3
3
3
34
3
36
3 7 COUNTY AUMINI~ I KA II VI: L;U::; I::; (2.9% FED PATH , 2.7% TOTAL PATH )
3
3
4
4
4
8 NET PROGRAM EXPENSES (sum l ines 12 thru 37)
9 OTHER FUNDING SOURCES : Federal Funds
0 Non-Federal F unds
1 TOTAL OTHER FUNDING SOURCES (sum lines 39 & 40)
2 GROSS COST OF PROGRAM {sum lines 38 and 41)
DHCS 1779 P (4 /13)
Department of Health Ca re SeNices
Enclosure SA
STATE FISCAL YEAR 2016-1 7 _.;...._;;__;_ ____ _
SUBMISSION DATE: March 28 2017
PROGRAM CONTACT: .=.E""ar""lia,_,n""'a'-'V"-'a'-'-n..,.g ________ _
TELEPHONE NUMBER: (559) 600-6835
E-MAIL ADD RESS: evang@co.fresno.ca.us
1 2 I 3
FEDERAL PATH NONFEDERAL MATCH
AMOUNT AMOUNT TOTAL
$ -
$ -
$ -
$ -
$ -
$ -
$ -$ -$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ -
$ 9 ,121 $ 2 ,134 $ 11 ,255
$ 9 ,121 $ 2 ,1 34 $ 11 ,255
$ -$ -$ -
$ 9 ,121 $ 2 ,134 $ 11 ,255
DHCS APPROVAL BY:
TELEPHONE:
DATE:
State of California -Health and Human Services Agency
FEDERAL GRANT DETAILED PROGRAM BUDGET
TYPEOFGRANT: ----~P~A~T~H ________ _
COUNTY: ~F~re~s~no~----------
FISCAL CONTACT: Laurentius Harlan Theng
TELEPHONE NUMBER: (559) 600-4619
EMAIL ADDRESS : lh arlantheng@co.fresno.ca .us
PROGRAM NAME: PATH Program
STAFFING
TITLE OF POSITION
ANNUAL
SALARY
1 Pro gram Director $ 96,300.00
2 Clinical Supervisor $ 90,525.00
3 Case Managers $ 4 3,218.00
4
5
6
7
8
9
1
OEL Coordinators $ 32,240.00
Admin istrative S pecialist $ 37 ,730.00
Benefits & Ta xes
I TOTAL STAFF t:J'.t-'t:N~t:~ (sum lines 1 thru 11 $ 300 ,013
Consultant Costs (Itemize ):
Consultant Costs (n etwork & data management)
Consultant Costs (HMIS tra ining, user licenses. & mainte nancej
Eg_u ipment {Where feasible lease or rent) (Itemize):
Equ ipmentRenULease
Computers & Software
Su ppli es (Itemize):
Office Supplies & Equipment & Postag_e
Telephone
Prog ram Supplies (T herap eutic)
Prog ram Su pplies (Outreach)
Medication -Clients
Travel -Per diem, Mil eage , & Vehicle Renta l/Lease
Other Expenses (Itemize ):
Utlities
Client Housing Support & One T ime Emergency Housing
Client C lothing , Food & Hygiene
Client Transportation, Education & Employment
Bu ilding RenULease & Ma intenance
Profess ional Liability Insurance/Staff Ba ckground Checks
GRANT
FTE
0.05
0.64
1.45
2
0 .26
4 .40
10
1
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37 t-'KUVIUt:K AUMINI::> I KA I lVI: LU::> I::> (6 .8% F ED PATH; 7 3% TOTAL PATH)
38
39
40
41
42
NET PROGRAM EXPENSES (sum lines 12 thru 37)
OTHER FUNDING SOURCES: Federal Funds
Non-Federal Fu nds
TOTAL OTHER FUNDING SOURCES (sum lines 39 & 4 0)
GROSS COST OF PROGRAM (sum l ines 38 and 41)
DHCS 1779 P (4/13)
Department of Health Care Services
Enclosure SA
S TATE FISCAL Y EAR--=.20::...1:...:6~·1:....:7 ____ _
S UBMISS ION DATE: March 28, 2017
PROGRAM CONTACT: .:E~a~rl i~a~na~V~an~g~---
TELEPHONE NUMBER : (559) 600-6835
E-MAIL ADDRESS : evang@co.fresno.ca .us
1 2
FEDERAL PATH NONFEDERAL MATCH
AMOUNT AMOUNT
$ 4 ,815 $
$ 57,936 $
$ 62 ,667 $
$ 64,480 $
$ 9,810 $
$ 36,745 $
$
$
$
$
$
$ 236,453 $ -$
$ 13,030 $
$ 1,500 $
$
$
$ 3,100 $
$ 2,500 $
$
$
$ 5,852 $
$ 5,100 $
$ 1,300 $
$ 5,500 $
$ 500 $
$ 15,580 $
$ 5,800 $
$ 6 ,560 $ 29,990 $
$ 2,500 $
$ 11 ,000 $
$ 25,300 $
$ 7,390 $ 1 ,000 $
$ 2 1,620 $ 9 ,202 $
$ 307,403 $ 103,374 $
$ -$ -$
$ 307,403 $ 103,374 $
DHCS APPROVAL BY:
TE LEPHONE :
DATE :
3
TOTAL
4 ,815.00
57 ,936.00
62,667.00
64,480.00
9,810.00
36 ,745.00
-
-
-
-
-
236,453
13,030
1,500
-
-
3,100
2,500
-
-
5,852
5,100
1,300
5,500
500
15,580
5,800
36 ,550
2,500
11 ,000
25 ,300
8,390
30,822
410,777
-
410,777
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2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
AM EN DME NT TO PROJEC TS FOR ASS IST ANCE IN TRANSI T ION FROM HOM ELESS NE SS
(PA TH) G RA NT APPLI CAT ION FY 2016 -17
ATTEST:
COUN TY OF FRESN O
{L~j_
By __ ~~~~-------------
Cha irm a n, Boa rd of S upe rviso rs
Date: 3 -~-\)
BE RN IC E E. SE IDEL, C le rk
Board ofS upe rvi sors
Date : --=3~--=-~-=~--_1 ....:....) __
PLEASE SEE ADDITIONA L
S IGNAT UR E PAGE AT TACH ED
-1 -COUNTY OF FRESNO
Fresno, CA
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APPROV ED AS TO LEGAL FORM:
DA N IEL C. CE DERBORG , CO UNT Y CO UNSE L
\.. -t LS<f-j
By ----'a:b£----!.~-o~/ ___ _
6 AP PR OV ED AS TO ACCO UNT ING FORM:
OSCA R J . GARC IA , C.P.A., AU D ITOR-CONTROLL ER/
7 T REAS U RER-TAX COLL ECTO R
8
9 By (}t?., l ' ~
10
11 REV TEWED AN D RE COMMEN DED FOR
APPROVA L:
Date: ----'~"""'-=-...__/.;;__~_(_t(__,___
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1 4 By ~~ Date ()2-22-0 oaw1U1Ut~~
15 Direc to r, Department of Be hav iora l Hea lth
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Fund /Sub c lass: 000 Ill 0000
Organ izati o n: 5630249 3 ($422 ,032 )
Acc o un t/Program : 4375 /0
-2 -COU NTY OF FRESNO
Fresno , CA