HomeMy WebLinkAboutAgreement A-24-618 Amendment No. 1 to Agreement 20-238 with Central Star.pdf Agreement No. 24-618
1 AMENDMENT NO. 1 TO SERVICE AGREEMENT
2 This Amendment No. 1 to Service Agreement No. 20-238 ("Amendment No. 1") is dated
3 December 3, 2024 and is between Central Star Behavioral Health, Inc., a for-profit
4 organization, ("Contractor"), and the County of Fresno, a political subdivision of the State of
5 California ("County").
6 Recitals
7 A. On June 23, 2020, the County and the Contractor entered into County agreement
8 number 20-238 ("Agreement"), for Contractor to operate its sixteen (16) bed acute inpatient
9 psychiatric health facility (PHF) to provide inpatient psychiatric services to adolescent youth,
10 twelve (12) years up to eighteen (18) years of age, who may be admitted on a voluntary or
11 involuntary basis and may include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal
12 beneficiaries, indigent/uninsured consumers, and juvenile inmates who are referred by DBH, a
13 contract provider with DBH, or hospital emergency room, other County departments and other
14 agencies.
15 B. Contractor previously provided services under the Agreement at 4411 E. Kings Canyon
16 Road, Fresno CA 93702, Building 319. County desires to relocate its Adolescent Youth PHF to
17 3115 N. Millbrook Avenue, Fresno, CA 93703 ("Premises").
18 C. County and Contractor now desire to amend the Agreement to reflect services being
19 provided at the new Premises; modify the budget for additional resource availability, Senate Bill
20 525, relocation costs; and revise insurance requirements.
21 D. Contractor may continue to provide services at the current site, 4411 E. Cesar Chavez
22 Blvd, Fresno CA 93702, if there are any delays in relocation including but not limited to
23 construction, licensure, and permits.
24 The parties therefore agree as follows:
25 1. Section 1, subsection G of the Agreement located at Page Two (2), beginning Line
26 Twenty-Two (22) with the word "Contractor" and ending on Page Three (3), Line Five (5) with
27 the word "etc." is deleted in its entirety and replaced with the following:
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1 "Contractor shall execute a mutually agreeable lease agreement with County for
2 the lease of County-Leased property located at 3115 N. Millbrook Avenue,
3 Fresno, CA 93703 ("Premises") as the site for Contractor's provision of
4 Adolescent Youth PHF services under this Agreement. If Contractor or
5 Contractor's affiliate fails to accomplish these tasks prior to providing services
6 under this Agreement, County may, in addition to other remedies it may have,
7 suspend referrals or terminate this Agreement, in accordance with Section Three
8 (3) of this Agreement."
9 2. That all references to the location of"4411 Kings Canyon Road, Fresno, CA 93702" in
10 Agreement shall be deemed references to "3115 N. Millbrook Avenue, Fresno, CA 93703."
11 3. Contractor may continue to provide services at the current site, 4411 E. Cesar Chavez
12 Blvd, Fresno CA 93702 if there are any delays in relocation including but not limited to
13 construction, licensure, and permits. Changes to the date in which relocation funds be spent, as
14 specified in Section 4 of the Agreement, may be made with the written approval of County's
15 DBH Director, or designee for unpreventable delays as determined by the County's DBH
16 Director.
17 4. That all references to "Exhibit C" in the Agreement shall be deemed references to
18 "Revised Exhibit C". Revised Exhibit C is attached and incorporated by this reference.
19 5. A portion of Section 4, subsection A of the Agreement located at page 5 lines 21 through
20 24 is deleted and replaced with the following:
21 "The maximum amount payable to Contractor for the period July 1, 2024, through
22 June 30, 2025 shall not exceed Six Million, Seven Hundred Ninety Nine
23 Thousand, Four Hundred Eighty-One and No/100 Dollars ($6,799,481.00)."
24 6. A portion of Section 4, subsection B located at page 6 lines 6 through 10 is deleted and
25 replaced with the following:
26 "In no event shall compensation paid for relocation costs during the
27 period effective upon execution through March 31, 2025, exceed Thirteen
28 Thousand, Nine Hundred Forty-Eight and No/100 Dollars ($13,948.00).
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1 In no event shall the total maximum compensation amount under this
2 Agreement beginning July 1, 2020, through June 30, 2025, exceed Twenty-
3 Eight Million, Nine Hundred Thirty-Two Thousand, Two Hundred Twelve and
4 No/100 Dollars ($28,932,212.00)."
5 7. Section 10 of the Agreement located at page 15 line 27 through page 18 line 21 is
6 deleted in its entirety and replaced with the following:
7 "The Contractor shall comply with all insurance requirements in Exhibit R
8 "Insurance Requirements" to this Agreement. Exhibit R is attached and
9 incorporated by this reference."
10 8. When both parties have signed this Amendment No. 1, the Agreement, and this
11 Amendment No. 1 together constitute the Agreement.
12 9. The Contractor represents and warrants to the County that:
13 a. The Contractor is duly authorized and empowered to sign and perform its obligations
14 under this Amendment.
15 b. The individual signing this Amendment on behalf of the Contractor is duly authorized
16 to do so and his or her signature on this Amendment legally binds the Contractor to
17 the terms of this Amendment.
18 10. The parties agree that this Amendment may be executed by electronic signature as
19 provided in this section.
20 a. An "electronic signature" means any symbol or process intended by an individual
21 signing this Amendment to represent their signature, including but not limited to (1) a
22 digital signature; (2) a faxed version of an original handwritten signature; or (3) an
23 electronically scanned and transmitted (for example by PDF document) version of an
24 original handwritten signature.
25 b. Each electronic signature affixed or attached to this Amendment (1) is deemed
26 equivalent to a valid original handwritten signature of the person signing this
27 Amendment for all purposes, including but not limited to evidentiary proof in any
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1 administrative or judicial proceeding, and (2) has the same force and effect as the
2 valid original handwritten signature of that person.
3 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5,
4 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part
5 2, Title 2.5, beginning with section 1633.1).
6 d. Each party using a digital signature represents that it has undertaken and satisfied
7 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)
8 through (5), and agrees that each other party may rely upon that representation.
9 e. This Amendment is not conditioned upon the parties conducting the transactions
10 under it by electronic means and either party may sign this Amendment with an
11 original handwritten signature.
12 11. This Amendment may be signed in counterparts, each of which is an original, and all of
13 which together constitute this Amendment.
14 12. The Agreement as amended by this Amendment No. 1 is ratified and continued. All
15 provisions of the Agreement and not amended by this Amendment No. 1 remain in full force and
16 effect. This Amendment No. 1 shall be effective upon execution.
17 [SIGNATURE PAGE FOLLOWS]
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1 The parties are signing this Amendment No. 1 on the date stated in the introductory
2 clause.
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Central Star Behavioral Health, Inc. County of Fresno
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5 011 V(a
<, .
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Olivia Aranda, Vice President and Chief Nathan Magsig, Chairman o the Board of
7 Financial Officer Supervisors of the County of Fresno
8 1501 Hughes Way, Suite 150 Attest:
Long Beach, CA 90810 Bernice E. Seidel
g Clerk of the Board of Supervisors
County of Fresno, State of California
10 11 )f
11 By: V` 'r"-
eputy
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For accounting use only:
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Org No.: 56302112
14 Account No.: 7295
Fund No.: 0001
15 Subclass No.: 10000
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Revised Exhibit C Page 1 of 17
Psychiatric Health Facility Services
Central Star Behavioral Health, Inc
Fiscal Year FY2024-25
PROGRAM EXPENSES
1000:DIRECT SALARIES&BENEFITS
Direct Employee Salaries
Acct# Administrative Position FTE Admin Program Total
1101 Administrator 0.67 $ 118,929 $ 118,929
1102 HR 0.93 62,103 62,103
1103 QA 1.14 83,656 83,656
1104 Training 0.56 36,556 36,556
1105 - -
1106
1107
1108
1109 -
1110 -
1111
1112
1113
1114
1115 - -
Direct Personnel Admin Salaries Subtotal 3.30 $ 301,244 $ 301,244
Acct# Program Position FTE Admin Program Total
1116 Director of Nursing 1.00 $ 137,904 $ 137,904
1117 Clinical Director 1.00 112,200 112,200
1118 Program Coordinator 1.00 88,259 88,259
1119 Case Manager 1.00 49,839 49,839
1120 Social Worker 4.00 339,456 339,456
1121 Peer Support Mentor/Specialist/Counselor 2.00 89,108 89,108
1122 Recreation Therapist 1.00 74,681 74,681
1123 Rehabilitation Aid 3.00 143,208 143,208
1124 RN/CN 1.40 132,396 132,396
1125 YC/Safety Specialist 15.40 838,268 838,268
1126 LVN/LPT 9.00 691,540 691,540
1127 Admissions Coordinator 1.40 106,018 106,018
1128 Clerk/Discharge Coordinator 2.00 91,228 91,228
1129 Housekeeper 1.50 66,831 66,831
1130 Cook 1.20 53,465 53,465
1131 - -
1132
1133
1134
Direct Personnel Program Salaries Subtotal 45.90 $ 3,014,401 $ 3,014,401
Admin Program Total
Direct Personnel Salaries Subtotal 49.20 $ 301,244 $ 3,014,401 $ 3,315,645
Direct Employee Benefits
Acct# Description Admin Program Total
1201 Retirement 6,417.00 64,207.00 $ 70,624
1202 Worker's Compensation 6,024.88 60,288.02 66,313
1203 Health Insurance 28,618.18 286,368.10 314,986
1204 Other(specify) I -
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C Page 2 of 17
1205 Other(specify)
1206 Other(specify)
Direct Employee Benefits Subtotal: $ 41,060 $ 410,863 $ 451,923
Direct Payroll Taxes&Expenses:
Acct# Description Admin Program Total
1301 OASDI $ 18,678 $ 186,893 $ 205,571
1302 FICA/MEDICARE/FUTA $ 4,554 $ 46,345 50,899
1303 SUI/ETT $ 901 $ 12,851 13,752
1304 Other(specify) - - -
1305 Other(specify) -
1306 Other(specify) - - -
Direct Payroll Taxes&Expenses Subtotal: $ 24,133 $ 246,089 $ 270,222
DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total
$ 366,437 $ 3,671,353 $ 4,037,790
DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program
9%1 91%
2000:DIRECT CLIENT SUPPORT
Acct# Line Item Description Amount
2001 Child Care $
2002 Client Housing Support
2003 Client Transportation &Support -
2004 Food and Meal preparation Cost 228,123
2005 Education Support
2006 Employment Support
2007 Household Items for Clients -
2008 Medication Support 947,400
2009 Program Supplies and Services-Medical 64,475
2010 Utility Vouchers -
2011 Clothing/Hygiene 6,250
2012 Other(specify) -
2013 Other(specify)
2014 Other(specify)
2015 Other(specify)
2016 Other(specify) -
DIRECT CLIENT CARE TOTAL $ 1,246,248
3000:DIRECT OPERATING EXPENSES
Acct# Line Item Description Amount
3001 Telecommunications $ 45,528
3002 Printing/Postage -
3003 Office,Household&Program Supplies 51,236
3004 Advertising -
3005 Staff Development&Training 11,539
3006 Staff Mileage 5,500
3007 Subscriptions&Memberships -
3008 Vehicle Maintenance
3009 Recruitment 19,800
3010 Purchase Services -
3011 Other(specify)
3012 Other(specify)
DIRECT OPERATING EXPENSES TOTAL: $ 133,603
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C Page 3 of 17
4000:DIRECT FACILITIES&EQUIPMENT
Acct# Line Item Description Amount
4001 Building Maintenance $ 21,450
4002 Rent/Lease Building 4,491
4003 Rent/Lease Equipment 12,522
4004 1 Rent/Lease Vehicles -
4005 Security 2,069
4006 Utilities 9,499
4007 Other(specify) -
4008 Other(specify)
4009 Other(specify)
4010 10ther(specify)
DIRECT FACILITIES/EQUIPMENT TOTAL:j $ 50,031
5000:DIRECT SPECIAL EXPENSES
Acct# Line Item Description Amount
5001 Consultant(Network&Data Management) $
5002 HMIS(Health Management Information System)
5003 Contractual/Consulting Services (Specify) -
5004 Translation Services 41236
5005 Laundry&Linen 16,299
5006 Other(specify) -
5007 Other(specify)
5008 Other(specify) -
DIRECT SPECIAL EXPENSES TOTAL: $ 20,535
6000:INDIRECT EXPENSES
Acct# Line Item Description Amount
Administrative Overhead
6001
Administrative Overhead
6002 Professional Liability Insurance
6003 Accounting/Bookkeeping -
6004 External Audit 11,000
6005 Insurance-General 63,937
6006 Payroll Services 780
6007 Depreciation(Provider-Owned Equipment to be Used forProgrom Purposes) -
6008 Personnel(Indirect Salaries&Benefits) -
6009 Centralized Services Fiscal-Private/Other County 234,685
6010 Centralized Services Fiscal-Fresno 225,014
6011 Centralized Service Administration 523,159
6012 Centralized Service Program 191,262
6013 Other(specify) j
INDIRECT EXPENSES TOTAL $ 1,249,837
INDIRECT COST RATE 22.52%
7000:DIRECT FIXED ASSETS
Acct# Line Item Description Amount
7001 Computer Equipment&Software $ 60,357
7002 Copiers,Cell Phones,Tablets, Devices to Contain HIPAA Data
7003 Furniture&Fixtures 1,080
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C Page 4 of 17
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over$500 with Lifespan of 2 Years+ -
7006 Assets over$5,000/unit(Specify) -
7007 Other(specify) -
7008 Other(specify) -
FIXED ASSETS EXPENSES TOTAL $ 61,437
TOTAL PROGRAM EXPENSES $ 6,799,481
PROGRAM FUNDING SOURCES
8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION)
Acct# Line Item Description Service Units Rate Amount
8001 Mental Health Services 0 $
8002 Case Management 0
8003 Crisis Services 0
8004 Medication Support 0
8005 Collateral 0
8006 Plan Development 0
8007 Assessment 0
8008 Rehabilitation 0 -
8009 Psychiatric Health Facility Inpatient 1 4,3801 1,015.42 1 4,447,540
8010 10ther(Specify) 1 0 -
Estimated Specialty Mental Health Services Billing Totals: 1 4,3801 $ 4,447,540
Estimated%of Clients who are Medi-Cal Beneficiaries 61%
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 2,712,999
Federal Financial Participation(FFP)% 1 50% 1,356,500
MEDI-CAL FFP TOTAL $ 1,356,500
8100-SUBSTANCE USE DISORDER FUNDS
Acct# Line Item Description Amount
8101 Drug Medi-Cal $
8102 SABG $
SUBSTANCE USE DISORDER FUNDS TOTAL $ -
8200-REALIGNMENT
Acct# Line Item Description Amount
8201 lRealignment $ 3,096,131
REALIGNMENT TOTAL $ 3,096,131
8300-MENTAL HEALTH SERVICE ACT(MHSA)
Acct# MHSA Component MHSA Program Name Amount
8301 CSS-Community Services&Supports $ -
8302 PEI-Prevention&Early Intervention -
8303 INN-Innovations -
8304 WET-Workforce Education&Training -
8305 JCFTN-Capital Facilities&Technology
MHSATOTAL $ -
8400-OTHER REVENUE
Acct# Line Item Description Amount
8401 Client Fees $
8402 Client Insurance -
8403 Out-Of-County 546 1425.79 778,482
8404 Private Insurance 1100 1425.79 1,568,369
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C Page 5 of 17
OTHER REVENUE TOTALI $ 2,346,851
TOTAL PROGRAM FUNDING SOURCES: $ 6,799,481
NET PROGRAM COST: $ -
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C Page 6
of 17
Psychiatric Health Facility Services
Central Star Behavioral Health,Inc
Fiscal YearFY2024-25
PARTIAL FTE DETAIL
For all positions with FTE's split among multiple programs/contracts the below must be filled
out
Position Contract#/Name/Department/County FTE%
Administrator 20-238/PHF/BHS/Fresno 0.67
Administrator 23-275/CRT/BHS/Fresno 0.33
Total 1.00
Position Contract#/Name/Department/County FTE%
CA PHF Bakersfield 0.34
QA 20-238/PHF/BHS/Fresno 0.47
QA 23-275/CRT/BHS/Fresno 0.19
QA
QA 20-238/PHF/BHS/Fresno 0.67
QA 23-275/CRT/BHS/Fresno 0.33
Total 2.00
Position Contract#/Name/Department/County FTE%
FIR PHF Bakersfield 0.81
FIR 20-238/PHF/BHS/Fresno 0.93
HR 23-275/CRT/BHS/Fresno 0.48
HR 23-278/TAY/BHS/Fresno 0.42
HR 23-282/AII-Star/BHS/Fresno 0.78
HR 23-272/WRAP/BHS/Fre5no 0.65
HR CRU/BHS/Merced 0.51
HR CBHST/BHS/Stanislaus 0.42
Total 5.00
Position Contract#/Name/Department/County FTE%
Training PHF Bakersfield 0.49
Training 20-238/PHF/BHS/Fresno 0.56
Training 23-275/CRT/BHS/Fresno 0.29
Training 23-278/TAY/BHS/Fresno 0.25
Training 23-282/AII-Star/BHS/Fresno 0.47
Training 23-272/WRAP/BHS/Fresno 0.38
Training CRU/BHS/Merced 0.31
Training CBHST/BHS/Stanislaus 0.25
Total 3.00
Position Contract#/Name/Department/County FTE%
Total 0.00
Position Contract#/Name/Department/County FTE%
Total 0.00
Position Contract#/Name/Department/County FTE%
Total 0.00
Position IContract#/Name/Department/County FTE%
Fresno County Department of Behavioral Health arrative Revised 2/7/2020
Revised Exhibit C Page 7
of 17
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Position Contract#/Name/Department/County FTE
Total 0.00
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Page 8 our of 17
Psychiatric Health Facility Services
Central Star Behavioral Health,Inc
Fiscal Year FY2024-25 Budget Narrative
PROGRAM EXPENSE
ACCT#1 LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000:DIRECT SALARIES&BENEFITS 4,037,790
Administrative Positions -
1101 Administrator 118,929 Administrator:Manages the overall day-to-day operation of the adolescent Psychiatric
Health Facility(PHF). Assures compliance with Federal,State,County and local laws
and regulations. He/she oversees and assures that there is a comprehensive quality
treatment program and supervision for all PHF patients and reviews and approves all
policies and procedures of the agency. Manages all employee relations. The
Administrator represents the CSBH agency and its programs to governmental agencies
and the community. (Remainder of FTE is for overseeing the CRT.)
1102 HR 62,103 Human Resources:This team manages all human resource clerical and administrative
tasks for the program staff.This position is responsible for supporting the
development of a positive working environment to enhance agency success and
reduce legal risk,as well as management team support and consultation,employee
relations,interpretation and administration of HR policies and procedures,staff
recruitment and selection,compensation,and employee benefits etc.
1103 QA 83,656 QA:This team is responsible for utilization review and assisting in medical record
management by gathering and analyzing agency data and assisting in the agency's
quality control,quality assurance,and quality improvement efforts.
1104 Training 36,556 Training:This team has primary responsibility for development,coordination,and
supervision of training programs for Central Star PHF program.The Training Manager
regularly provides training.The position develops and maintains systems to track in-
service attendance.The position develops opportunities to host training for other
professionals or participate with other organizations in providing such trainings.
1105 0
1106 10
1107 0
1108 0
1109 0
1110 0
1111 0
1112 0
1113 0
Page 9 our of 17
1114 10
1115 10
Program Positions 3,014,401
1116 Director of Nursing 137,904 The Director of Nursing ensures that each PHF client receives the nursing care,
treatment,medications,and diet,which have been ordered by the attending
physician,ensuring the overall quality of licensed nursing care for the PHF Unit. S/he
participates in budget development for the Nursing Department and is responsible for
its implementation and management. S/he selects,hires,and supervises all staff in
the Nursing Department.
1117 Clinical Director 112,200 Clinical Director:This position has primary responsibility for overseeing the provision
of mental health services,case management services and support services to clients
and their families.Has oversight of the Program and provides supervision to clinical
staff. Works in close collaboration with Clinical Director to ensure each client receives
the appropriate care and treatment consistent with the program's requirements.
Responsible for the implementation and management of all regulatory requirements
1118 Program Coordinator 88,259 Program Coordinator:The Coordinator assists the Director of Nursing in directing the
activities of assigned licensed and non-licensed personnel who provide health care
services to clients of the Central Star Youth Psychiatric Health Facility on a 24-hour 7
day a week basis.
1119 Case Manager 49,839 Case Manager:This position has primary responsibility for organizing discharge
information and facilitating the discharge of patients at the Central Star Youth PHF;a
process that begins from initial assessment and unfolds throughout the course of
acute inpatient treatment.The case manager participates in interdisciplinary
meetings,collaboration and communication with outside partners and resources,and
with preparing patients for facility release.
1120 Social Worker 339,456 Social Worker: The leader of each client's treatment team and is responsible for
preparing a comprehensive treatment plan for each client. This position manages the
client's journey from intake,evaluation and assessment,the provision of case
management and other therapeutic services,through discharge planning and final
placement. This position coordinates with other agencies such as Child Protective
Services,Juvenile Probation Department,and County Department of Mental Health.
1121 Peer Support 89,108 Peer Support Specialist/Counselor:This team of 2,provides outreach,advocacy,
Mentor/Specialist/Counselor training,and support for client's family members throughout all stages of the
treatment,transition,and aftercare.They educate,coach,advocate,and act as role
models.They collaborate with other team members and providers to ensure proper,
client-centered services are provided.This position is part of a team that provides
services to youth and their family.Includes$13,904 annualized salary increases as a
result of 56525.Each employee Peer support employee wages per year are$45,360+
includes annual increase+one time 40 hour PTO payout.
1122 Recreation Therapist 74,681 Recreation therapist:The treatment team member who is responsible for providing
recreational services to adolescent clients within the Rehabilitation Program.These
services are provided through individualized and/or group activities to restore,
establish and maintain optimum level of social,vocational,and physical,functioning
which include social activities involving group participation,indoor and outdoor
recreational activities,and exercises.
1123 Rehabilitation Aid 143,208 Rehabilitation Aide:The Rehabilitating Aide provides direct and indirect rehabilitation
services to adolescent clients through individualized and/or group activities.Includes
$5,755 annualized salary increases as a result of SB525.
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1124 RN/CN 132,396 Charge&Registered Nurse:The Nurses are the treatment team members who are
responsible for performing all nursing duties and related nursing activities for clients.
The Charge Nurse is also responsible for the supervision of the Youth Counselor staff
assigned to their respective shift.Nursing staff is impacted by increased acuity due to
the need to provide safe care to persons served throughout the shift and during crisis.
Nurses then provide reports to the next shift to ensure safe continuity of care.This
may lead to overtime as they complete documentation,thoroughly document
incidents/interventions,and required reporting.This is based on actual FTEs from FY
23/24.We determined an increase in Youth Counselors and LVN/LPT would provide a
more cost-effective,though still robust,increase in safety when acuity is higher.
1125 YC/Safety Specialist 838,268 Youth Counselor/Safety Specialist:This position was affected by SB525 requirements.
These positions are responsible for providing direct care to meet the physical and
psychosocial needs of adolescents.This care is provided through direct and indirect
physical and verbal interactions with clients,modeling appropriate behaviors for
clients,and monitoring daily client activities.(1.0 FTE Youth Counselor serves as a
designated Safety Specialist).All direct cares staff are required to have training hours,
48 for full-time and 24 for on-call.Direct care staff are not typically able to provide
care and participate in training at the same time.Some training courses are also in
person,such as yearly ProACT training.To ensure coverage,on-call staff provide
coverage while direct care staff trains.
•There has been an increase in acuity in the youths served.Youth have required
Physician ordered interventions such as 1:1 supervision,line of sight supervision,
which requires additional Youth Counselors.We have also seen an increase in
Conservatorship,which leads to those persons served remaining on the unit long
term,due to lack of placement and programs designed to address aggressive or
destructive behaviors.
•Increased acuity leads to the need for additional staff to maintain the safety of the
clients served which causes the use of staff not previously scheduled to support the
unit.It also causes OT for staff to remain on the unit while waiting for additional staff
to be arranged.Staffing is adjusted to the acuity level of the unit,however,the need
for extra support at night may be unpredictable.Preemptively overstaffing the unit on
a regular basis would lead to increased overspending of the Youth Counselor line item,
therefore an increase in the FTEs of Youth Counselor/Safety Specialists is requested.
This also increases safety without the use of a Security Guard company,which
appears punitive to the person served.The use of increased YCs would allow for
therapeutic interventions during crisis and could focus on the prevention of escalation
to the point of crisis.
•The contract is five years old.Inflation,increase in the minimum wage,and wage
1126 LVN/LPT 691,540 LVN/LPT:This position includes shift differential pay,and increased FTE to cover shifts
for staff absences due to PTO and Training through use of on call staff and overtime.
This position provides direct client care including medications and supervision of
nursing activities performed by professional and para-professional nursing personnel
on the unit.Nursing staff is impacted by increased acuity due to the need to provide
safe care to youths served throughout the shift and during crisis.Staff then provide
reports to the next shift to ensure safe continuity of care.This may lead to overtime as
they complete documentation,thoroughly document incidents/interventions,and
required reporting.All direct care staff are required to have training hours,48 for full-
time and 24 for on-call.Direct care staff are not typically able to provide care and
participate in training at the same time.Some training courses are also in person,such
as yearly ProACT training.To ensure coverage,on-call staff provides coverage while
direct care staff trains.
1127 Admissions Coordinator 106,018 Admissions Coordinator:This Coordinator is responsible for interviewing all
prospective admissions,conducting the initial assessment,and collecting
documentation,ensuring appropriate admission at Central Star Psychiatric Health
Facility. This person maintains liaison with parents and other legal guardians,county
agencies,insurance companies and other payors,hospitals,and health care facilities,
augments existing social services by providing discharge-planning services,provides
direct services to clients,offers consultation and supervision to staff,and acts as
liaison to outside agencies.Increased FTE to cover weekend days where the referral to
intake numbers fall as a result of not having a dedicated person to manage the
process.
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1128 Clerk/Discharge Coordinator 91,228 Clerk/Receptionist/Discharge Coordinator:Provides reception,clerical and
administrative support.They will provide a large variety of data management and
clerical tasks related to admissions and discharges for the Psychiatric Health Facility.
These positions monitor the timeliness of documentation,admission/discharge tasks
and other time-sensitive activities. Includes collaboration with other departments and
outside agencies to process client referrals and assist in completing the admission or
discharge process.Includes$4,311 annualized salary increases because of SB525.
1129 Housekeeper 66,831 Housekeeper:This position performs a variety of tasks to ensure that the facility is in a
clean,orderly,sanitary,and attractive condition.Based salary at$44,554 x 1.50 FTE_
$66,831
1130 Cook 53,465 This cost includes the cost for 2 cooks for meal preparation from Jul'24-Jan'25 at
based salary$44,554
1131 0
1132 0
1133 0
1134 0 -
Direct Employee Benefits 451,923
1201 Retirement 70,624 Retirement:based on 2.13%of salary expense.This includes ESOP,401k employer
match,and Life Insurance/AD&D.
1202 Worker's Compensation 66,313 Worker Compensation:based on 2%of salary expense
1203 Health Insurance 314,986 Health insurance:based on 9.5%of salary expense
1204 Other(specify) -
1205 Other(specify)
1206 Other(specify)
Direct Payroll Taxes&Expenses: 270,222
1301 JOASDI 205,571 OASDI Payroll Taxes:based on 2024 rates at 6.2%.
1302 FICA/MEDICARE/FUTA 50,899 FICA Payroll Taxes:based on 2024 rates 1.45%plus FUTA at.8%per the first$7,000 of
each employee wages.
1303 SUI/ETT 13,752 SUI Payroll Taxes:based on 2024 rates at 3.8%plus ETT at.1% =3.9%,calculated on
the first$7,000 of each employee's wages.($7,000 x 52.68 x 3.9%_$14,381.64,
roundup)
1304 Other(specify) -
1305 Other(specify)
1306 Other(specify)
2000:DIRECT CLIENT SUPPORT 1,246,248
2001 Child Care -
2002 Client Housing Support
2003 Client Transportation&Support -
2004 Food and Meal preparation Cost 228,123 This item includes the cost of meals and food for clients.Includes$31,500 in groceries
for 7 months from July 2024 to January for Meal preparation by Central based on
historical data while relocation takes place in February.Plus,Morrison meal
preparation cost of$196,623 for 5 months from February 2025 to June 2025.The
$196,623 includes,Opening Expenses of$15,805,Annual Management$5,947+
Annual Admin$8,921+Monthly billing$33,190 X 5 Months,$165,950. Grand total
for this line item is$228,123.See Morrisons Contract provided.
2005 Education Support
2006 Employment Support
2007 Household Items for Clients
Page 12 our of 17
2008 Medication Support 947,400 Medication Supports-Psychiatrists,Nurse Practitioner,and MD services.Psychiatrists
evaluate,diagnose,and collaborate with other team members to treat our youngsters
for different mental health disorders.They have the credentials to prescribe
medication and are responsible for medication management and consultation when a
patient needs a medical or neurological evaluation.Included is a Medical Director(Dr.
Brar)who provides services for the PHF program along with supporting management
in the overall coordination and quality control of psychiatrist,primary care physician,
and psychiatric nurse practitioner services,including services provided via
telepsychiatry.Includes contracted medical doctor(Dr.Grossman).This cost is based
on actuals,rates are as follows,$126K for Dr.Saadaabadi,$37K Dr.Bhatia,$62K Dr.
Cheema,$573K Dr.Brar, $86K Dr.Grossman yearly,plus follow up appointments
ranging$2K-$5K monthly.A census increase will increase follow up cost.It also
includes Nutritionist cost of$2,500.Total of FY23-24,plus 3%increase for follow-up
appointments. Dr.Grossman was pulled from professional services to this line
effective FY 23-24 and the Nutritionist costs were under Office,household and
Program supplies.Moving nutritionist to this line.Total YTD costs for FY 23-24
$897,059,add 3%totals 923,971. The remaining difference is the Nutritionist.
2009 Program Supplies and Services- 64,475 Program Supplies Medical-Contracted with Omnicare Pharmacy,Medline Industries,
Medical Lab Diagnostics,X-rays,and other suppliers.This cost is based on FY23-24 actuals and
Census increase expectations 1-2(365-730 yearly)for FY24-25.FY 23-24 YTD expenses
with a 3%COLA totals:$60,274,the difference remaining is the projected average
census is 12
2010 Utility Vouchers -
2011 Clothing/Hygiene 6,250 Incudes$4,250 for undergarment,shirts,pans for clients and$2,000 hygiene items
such as oral hygiene items,deodorant,shampoo,etc.
2012 Other(specify) -
2013 Other(specify)
2014 Other(specify)
2015 Other(specify)
2016 Other(specify)
3000:DIRECT OPERATING EXPENSES 133,603
3001 Telecommunications 45,528 Telephone:This cost includes the cost of landline,internet&phones which includes
Wi-Fi for staff tablets.This is based on actuals,Central IT department forecast,and
size of facility.Fiber line for Millbrook thru ATT•Coax line for Millbrook thru Comcast
Mobile phone service for emergency phone at the PHF•LTE for laptops in case of a
major system outage/disaster at the facility•Managed SDWAN for WAN network
connectivity•Access Point Management(Arista)•Hosted VOIP Phone system for 25
handsets and network switch.Phone reimbursement for Administrator,Director,
DON,Program Coordinator,up to$100 monthly.TPX Phone internet$28,264,
Comcast$2,553,Verizon$960,Comcast Fiber$7,200,Arista Cloud$450,and
Employee Phone reimbursement$6,100.80(includes$1536 for 8 staff from
HR/QA/Training at 20%allocation at$80 per month+$964.80 for Administrator at
$120 per month at 67%for PHF+3600 for the Coordinator,DON,and Director at
$100 per month).
3002 Printing/Postage -
3003 Office,Household&Program Supplies 51,236 This line item includes various program services such as confidential material
shredding service,water dispenser fee,postage,and license fees.This includes city
license,Join Commission,Fire department inspection.This cost also includes various
household items such as cleaning and laundry supplies,and food disposable supplies
such as cups and paper plates used mostly by clients.We are also removing Purchase
services line items for items such shredding,mail carrier,water,cooler,and adding
the costs to this line item.The yearly cost is Fed Ex$300,First Choice$855,Office
Depot,$4,231,Office supplies$785,Shredding$1,930,Subscriptions,Licenses
$18,713.US Foods household items such as,cleaning supplies,garbage bags,toilet
paper,paper plates and cups,$22,800.
3004 Advertising
3005 Staff Development&Training 11,539 Staff Training/Registration:This cost includes on-going program required education,
Education training,Staff Certifications,and training materials for staff.This is based on
current trend,FY23-24 actuals$9,331,added a COLA$9,611,and certification
forecast.Training for peer certification and we increased our Education Assistance
payout amounts due to increased education and training costs and as a retention
effort. Remainder($1,928)is for peer certification.
3006 Staff Mileage 5,500 Staff Mileage/Vehicle maintenance:Estimated staff travel reimbursement for supplies
shopping,training,and meetings.
3007 Subscriptions&Memberships -
3008 Vehicle Maintenance
Page 13 our of 17
3009 Recruitment 19,800 Recruitment: Fees for background check and random drug testing.This is based on
current trend.Based on FY23-24 actuals$18,938,plus 4-5%because of high
employee turnover.
3010 Purchase Services -
3011 Other(specify)
3012 Other(specify) -
4000:DIRECT FACILITIES&EQUIPMENT 50,031
4001 Building Maintenance 21,450 Building Maintenance:This cost includes repairs and maintenance for PHF facility,plus
allocation cost at 3433 W Shaw,which houses administrative staff working only for
Central Star programs and are part of Central Star payroll.The cost of this line item is
mainly for the PHF building,it was based on Fresno County forecast and last two years
of actual cost.Fresno County invoices are approximately 97%of total cost,and 3%for
Shaw Ave facility that houses Administrative Staff.The admin cost allocation is based
on direct program wages projected,CRT 9%,PHF-Fresno 19%,PHF Bakersfield 19%,
CRU 10%,CBHST 8%ALL STAR 15%, TAY 6%,WRAP 14%.Maintenance average cost
for Admin location allocation is$654 yearly,Maintenance from Fresno County
received invoices averages from$10K-S40K. $3442 is total cost for admin show
location.
The total$21,450 represents the last 3 fiscal years average.
4002 Rent/Lease Building 4,491 Rent/Lease Building:Administration area at 3433 W Shaw shared by all programs
allocated using a relative value.This is the shared cost of Administration staff working
only for Central Star programs,Actual cost has decreased because staff recently
moved to a more cost-effective location.Admin cost allocation is based on direct
program wages projected,CRT 9%,PHF-Fresno 19%,PHF Bakersfield 19%,CRU 10%,
CBHST 8%ALL STAR 15%, TAY 6%,WRAP 14%.Rent average cost for Admin location
allocation is$4,360 yearly.$22,947 total admin location allocation(annual amount).
Adding 3%COLA to total$4491.
4003 Rent/Lease Equipment 12,522 Rent/Lease Equipment:Copier lease,toner,and equipment maintenance.This is
based on Central IT department forecast for FY24-25 based on needs.We have two
copiers that cost$373 for the lease•We then pay for usage(printing)for these two
copiers and two printers onsite•We pay.0055 black/.055 color per print and get
toner and support included.•We can predict the annual lease cost,but the usage cost
is based on actuals from the previous fiscal year.
4004 Rent/Lease Vehicles -
4005 Security 2,069 Security:Camaras and Security services cost.Security is for the cost of service and the
monthly fee for shared cost for management location,the methodology is based on
Programs'direct wages percentages.This is for the cost of service and security cost.
Can potentially decrease significantly if Fresno County covers the costs at the new
location.The cost is FY23-24 actual cost+3%cola.
4006 Utilities 9,499 Utilities:This covers the shared cost of utilities for the administrative staff at 3433 W.
Shaw building.The cost is allocated among Central programs.The Administration staff
are responsible for Central Star programs only.This methodology is based on direct
Program wages percentages.Admin cost allocation is based on direct program wages
projected,CRT 9%,PHF-Fresno 19%,PHF Bakersfield 19%,CRU 10%,CBHST 8%ALL
STAR 15%, TAY 6%,WRAP 14%.Utilities average cost for Admin location allocation is
$649 yearly.The$3,416 is total,19%is$649 and 6 months of cost for Utilities based
on the last two quarterly invoices received from Fresno County.Relocation is plan for
December 2024.
4007 Other(specify)
4008 Other(specify)
4009 Other(specify)
4010 Other(specify)
5000:DIRECT SPECIAL EXPENSES 20,535
5001 Consultant(Network&Data -
5002 HMIS(Health Management
5003 Contractual/Consulting Services -
5004 Translation Services 4,236 Translation Services:Annual translation services.This is based on actuals and Census
increase expectations for FY24-25.This cost also varies based on the need and lengths
of stay of some clients needing this service.This cost is based on Jan-6 months
average.
5005 Laundry&Linen 16,299 Laundry&Linen:Comprise of towels,sheets,blankets,laundry service based on
historical cost.
5006 Other(specify)
5007 Other(specify)
5008 1 Other(specify)
Page 14 our of 17
6000:INDIRECT EXPENSES 1,249,837
6001 0
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit 11,000 External Audit:This is for external annual audit fees.Using FY 23-24 YTD expenditures
and adding 3%is$8,034.The remaining covers for the single audit requirement and
alignment with contract max increase.For profit,does not require single audit
however,county agreement states its required.
6005 Insurance-General 63,937 Liability Insurance:General liability,property,and professional liability.Our costs of
insurance has increased significantly on our annual renewal as compared to prior
years,these costs have escalated sharply statewide. Insurance costs have been
increasing tremendously.
6006 Payroll Services 780 Payroll services:This is a fee for printed and electronic payroll check processing.
6007 Depreciation(Provider-Owned -
6008 Personnel(Indirect Salaries& -
6009 Centralized Services Fiscal- 234,685 This item includes centralized fiscal service allowed profit from private insurance and
Private/Other County other counties.Calculated at 10%of the total other revenue.
6010 Centralized Services Fiscal-Fresno 225,014 This item includes centralized fiscal allowed profit from Fresno County.Calculated at
4%of the total expenses minus all Centralized Services line items 6009-6012.
6011 Centralized Service Administration 523,159 Centralized services-Administrative Overhead-This is an allocation from Stars
Behavioral Health Group of operations administration,business development and
contract management with multiple counties,health plans,and insurance companies,
information technology,human resources,communications,finance,and associated
fringe benefits and expenses.The cost is developed from allocating the SBHG costs
among all the programs within all the SBHG companies.This results in significant
savings for all programs. Because rather than staff each program for all necessary
services above,the services are performed by fewer employees and then shared
among all SBHG programs.The SBHG support provides oversight of all programs to
ensure consistency with our standard policies and procedures.Calculated at 9.3%of
the total expenses(Contract budget:less centralized services private/other County,
Fiscal,Program and Administration,line items 6009-6012).Our current actual trend is
9.3%of total expenses less centralized services costs.Total indirect costs without the
added profit from Fresno and private/other county is under 15%.
6012 Centralized Service Program 191,262 Centralized Program Services:Is comprised of the SBHG corporate and regional
support in the numerous areas including support from the Senior Administrator as
well as services provided for Program Development and Evaluation(e.g.,tracking and
reporting outcomes,and implementation of practices),Quality&Compliance(e.g.,
internal chart audits,compliance audits,and TJC-readiness preparation),and Training
(e.g.,TIP and Core Practice trainings provided company-wide).There is a significant
cost advantage to all the SBHG company programs in sharing these costs rather than
building them into each program.SBHG support provides oversight of all programs to
ensure consistency with our standard policies and procedures.Calculated at 3.4%of
the total expenses(Contract budget:less centralized services private/other County,
Fiscal,Program and Administration,line items 6009-6012).Our current actual trend is
3.4%of total expenses less centralized services costs.
6013 Other(specify)
7000:DIRECT FIXED ASSETS 61,437
7001 Computer Equipment&Software 60,357 Planning to buy 4 TVs for the new Millbrook Location; 2 in the mileu space,1
conference room,1 day room•We will replace seven laptops and two desktops;
equipment is more than 5 years old•We plan to add two telehealth stations at the
Millbrook location with a bigger monitor,speakers,and desktop computer•We have
budgeted for one spare device in case we have a device down needing repair.IT
software includes the Microsoft Office Suite and Windows Operating System•The
usage of SharePoint/Email systems•Servers that are in our Microsoft Cloud•Security
Awareness App Knowbe4•Security add ons like Defender for Email•All for roughly 51
staff.This also includes$3000 for walkie talkies for staff for easy communication
through the facility.
7002 Copiers,Cell Phones,Tablets,Devices -
7003 Furniture&Fixtures 1,080 This item includes the cost of potential need for replacement and purchase of
furniture and fixtures.Added funds to help reduce BMRs in the future in case program
incurs this type cost.
7004 Leasehold/Tenant/Building -
7005 Other Assets over$500 with Lifespan
7006 Assets over$5,000/unit(Specify)
Page 15 our of 17
7007 Other(specify)
7008 Other(specify)
PROGRAM FUNDING SOURCES
8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION)
PROVIDE DETAILS OF METHODOLOGY(IES)USED IN DETERMINING MEDI-CAL
ACCT# LINE ITEM SERVICE RATES AND/OR SERVICE UNITS,IF APPLICABLE AND/OR AS REQUIRED
BY THE RFP
8001 1 Mental Health Services
8002 Case Management
8003 Crisis Services
8004 Medication Support
8005 Collateral
8006 Plan Development
8007 Assessment
8008 Rehabilitation
8009 Psychiatric Health Facility Inpatient Units of Service of 12 beds per day is based on FY23-24 historical data and projections
forFY24-25.
8010 1 Other(Specify)
TAIL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 6,799,481
TAIL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 6,799,481 0
BUDGET CHECK: -
Revised Exhibit C Page 16 of 17
Psychiatric Health Facility Services
Central Star Behavioral Health, Inc
Relocation FY2024-25
PROGRAM EXPENSES
1000:DIRECT SALARIES&BENEFITS
Direct Employee Salaries
Direct Personnel Admin Salaries Subtotal 0.00 $ $
Acct# Program Position FTE Admin Program Total
1116 YC/Safety Specialist 5.00 $ 1,418 $ 1,418
Direct Personnel Program Salaries Subtotal 5.00 $ 1,418 $ 1,418
DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total
$ - $ 1,418 $ 1,418
DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program
0%1 100%
2000:DIRECT CLIENT SUPPORT
Acct# Line Item Description Amount
DIRECT CLIENT CARE TOTAL $
3000:DIRECT OPERATING EXPENSES
Acct# Line Item Description Amount
Office Elements $ 500
Purchase Service 3,000
DIRECT OPERATING EXPENSES TOTAL: $ 3,500
4000:DIRECT FACILITIES&EQUIPMENT
Acct# Line Item Description Amount
DIRECT FACILITIES/EQUIPMENT TOTAL: $ -
5000:DIRECT SPECIAL EXPENSES
Acct# Line Item Description Amount
Laundry and Linens $ 1,894
DIRECT SPECIAL EXPENSES TOTAL: $ 1,894
6000:INDIRECT EXPENSES
Acct# Line Item Description Amount
INDIRECT EXPENSES TOTAL $
INDIRECT COST RATE 0.00%
7000:DIRECT FIXED ASSETS
Acct# Line Item Description Amount
Furniture, Fixtures,and Equipment $ 7,136
FIXED ASSETS EXPENSES TOTAL $ 7,136
TOTAL START-UP EXPENSES $ 13,948
NET PROGRAM COST: $ 13,948
Fresno County Department of Behavioral Health Contract Start-Up Budget Revised 7/31/2024
R-i.d E.hibit C Page 17 of
Psychiatric H.——ility Services 17
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Exhibit R
Insurance Requirements
1. Required Policies
Without limiting the County's right to obtain indemnification from the Contractor or any third
parties, Contractor, at its sole expense, shall maintain in full force and effect the following
insurance policies throughout the term of this Agreement.
(A) Commercial General Liability. Commercial general liability insurance with limits of not
less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of
Five Million Dollars ($5,000,000). This policy must be issued on a per occurrence basis.
Coverage must include products, completed operations, property damage, bodily injury,
personal injury, and advertising injury. The Contractor shall obtain an endorsement to
this policy naming the County of Fresno, its officers, agents, employees, and volunteers,
individually and collectively, as additional insureds, but only insofar as the operations
under this Agreement are concerned. Such coverage for additional insureds will apply as
primary insurance and any other insurance, or self-insurance, maintained by the County
is excess only and not contributing with insurance provided under the Contractor's
policy.
(B) Automobile Liability. Automobile liability insurance with limits of not less than One
Million Dollars ($1,000,000) per occurrence for bodily injury and for property damages.
Coverage must include any auto used in connection with this Agreement.
(C)All-Risk Property Insurance. All-Risk Property Insurance with no coinsurance penalty
provision in an amount that will cover the total of County purchased and owned property
in possession of Contractor(s) and/or used in the execution of this Agreement.
Contractor must name the County as an Additional Loss Payee.
(D)Workers Compensation. Workers compensation insurance as required by the laws of
the State of California with statutory limits.
(E) Employer's Liability. Employer's liability insurance with limits of not less than One
Million Dollars ($1,000,000) per occurrence for bodily injury and for disease.
(F) Professional Liability. Professional liability insurance with limits of not less than One
Million Dollars ($1,000,000) per occurrence and an annual aggregate of Three Million
Dollars ($3,000,000). If this is a claims-made policy, then (1)the retroactive date must
be prior to the date on which services began under this Agreement; (2)the Contractor
shall maintain the policy and provide to the County annual evidence of insurance for not
less than five years after completion of services under this Agreement; and (3) if the
policy is canceled or not renewed, and not replaced with another claims-made policy
with a retroactive date prior to the date on which services begin under this Agreement,
then the Contractor shall purchase extended reporting coverage on its claims-made
policy for a minimum of five years after completion of services under this Agreement.
(G)Molestation Liability. Sexual abuse/ molestation liability insurance with limits of not
less than Two Million Dollars ($2,000,000) per occurrence, with an annual aggregate of
Four Million Dollars ($4,000,000). This policy must be issued on a per occurrence basis.
R-1
Exhibit R
(H) Cyber Liability. Cyber liability insurance with limits of not less than Two Million Dollars
($2,000,000) per occurrence. Coverage must include claims involving Cyber Risks. The
cyber liability policy must be endorsed to cover the full replacement value of damage to,
alteration of, loss of, or destruction of intangible property (including but not limited to
information or data) that is in the care, custody, or control of the Contractor.
Definition of Cyber Risks. "Cyber Risks" include but are not limited to (i) Security
Breach, which may include Disclosure of Personal Information to an Unauthorized Third
Party; (ii) data breach; (iii) breach of any of the Contractor's obligations under [identify
the Article, section, or exhibit containing data security obligations] of this Agreement; (iv)
system failure; (v) data recovery; (vi) failure to timely disclose data breach or Security
Breach; (vii) failure to comply with privacy policy; (viii) payment card liabilities and costs;
(ix) infringement of intellectual property, including but not limited to infringement of
copyright, trademark, and trade dress; (x) invasion of privacy, including release of
private information; (xi) information theft; (xii) damage to or destruction or alteration of
electronic information; (xiii) cyber extortion; (xiv) extortion related to the Contractor's
obligations under this Agreement regarding electronic information, including Personal
Information; (xv) fraudulent instruction; (xvi) funds transfer fraud; (xvii) telephone fraud;
(xviii) network security; (xix) data breach response costs, including Security Breach
response costs; (xx) regulatory fines and penalties related to the Contractor's obligations
under this Agreement regarding electronic information, including Personal Information;
and (xxi) credit monitoring expenses.
2. Additional Requirements
(A) Verification of Coverage. Within 30 days after the Contractor signs this Agreement,
and at any time during the term of this Agreement as requested by the County's Risk
Manager or the County Administrative Office, the Contractor shall deliver, or cause its
broker or producer to deliver, to the County Risk Manager, at 2220 Tulare Street, 16th
Floor, Fresno, California 93721, or HRRiskManagement@fresnocountyca.gov, and by
mail or email to the person identified to receive notices under this Agreement,
certificates of insurance and endorsements for all of the coverages required under this
Agreement.
(i) Each insurance certificate must state that: (1) the insurance coverage has been
obtained and is in full force; (2) the County, its officers, agents, employees, and
volunteers are not responsible for any premiums on the policy; and (3) the
Contractor has waived its right to recover from the County, its officers, agents,
employees, and volunteers any amounts paid under any insurance policy
required by this Agreement and that waiver does not invalidate the insurance
policy.
(ii) The commercial general liability insurance certificate must also state, and include
an endorsement, that the County of Fresno, its officers, agents, employees, and
volunteers, individually and collectively, are additional insureds insofar as the
operations under this Agreement are concerned. The commercial general liability
insurance certificate must also state that the coverage shall apply as primary
insurance and any other insurance, or self-insurance, maintained by the County
R-2
Exhibit R
shall be excess only and not contributing with insurance provided under the
Contractor's policy.
(iii) The automobile liability insurance certificate must state that the policy covers any
auto used in connection with this Agreement.
(iv) The professional liability insurance certificate, if it is a claims-made policy, must
also state the retroactive date of the policy, which must be prior to the date on
which services began under this Agreement.
(v) The cyber liability insurance certificate must also state that it is endorsed, and
include an endorsement, to cover the full replacement value of damage to,
alteration of, loss of, or destruction of intangible property (including but not limited
to information or data) that is in the care, custody, or control of the Contractor.
(B) Acceptability of Insurers. All insurance policies required under this Agreement must be
issued by admitted insurers licensed to do business in the State of California and
possessing at all times during the term of this Agreement an A.M. Best, Inc. rating of no
less than A: VI I.
(C) Notice of Cancellation or Change. For each insurance policy required under this
Agreement, the Contractor shall provide to the County, or ensure that the policy requires
the insurer to provide to the County, written notice of any cancellation or change in the
policy as required in this paragraph. For cancellation of the policy for nonpayment of
premium, the Contractor shall, or shall cause the insurer to, provide written notice to the
County not less than 10 days in advance of cancellation. For cancellation of the policy
for any other reason, and for any other change to the policy, the Contractor shall, or shall
cause the insurer to, provide written notice to the County not less than 30 days in
advance of cancellation or change. The County in its sole discretion may determine that
the failure of the Contractor or its insurer to timely provide a written notice required by
this paragraph is a breach of this Agreement.
(D) County's Entitlement to Greater Coverage. If the Contractor has or obtains insurance
with broader coverage, higher limits, or both, than what is required under this
Agreement, then the County requires and is entitled to the broader coverage, higher
limits, or both. To that end, the Contractor shall deliver, or cause its broker or producer
to deliver, to the County's Risk Manager certificates of insurance and endorsements for
all of the coverages that have such broader coverage, higher limits, or both, as required
under this Agreement.
(E) Waiver of Subrogation. The Contractor waives any right to recover from the County, its
officers, agents, employees, and volunteers any amounts paid under the policy of
worker's compensation insurance required by this Agreement. The Contractor is solely
responsible to obtain any policy endorsement that may be necessary to accomplish that
waiver, but the Contractor's waiver of subrogation under this paragraph is effective
whether or not the Contractor obtains such an endorsement.
(F) County's Remedy for Contractor's Failure to Maintain. If the Contractor fails to keep
in effect at all times any insurance coverage required under this Agreement, the County
may, in addition to any other remedies it may have, suspend or terminate this
R-3
Exhibit R
Agreement upon the occurrence of that failure, or purchase such insurance coverage,
and charge the cost of that coverage to the Contractor. The County may offset such
charges against any amounts owed by the County to the Contractor under this
Agreement.
(G)Subcontractors. The Contractor shall require and verify that all subcontractors used by
the Contractor to provide services under this Agreement maintain insurance meeting all
insurance requirements provided in this Agreement. This paragraph does not authorize
the Contractor to provide services under this Agreement using subcontractors.
R-4
On File with the Clerk-Amendment No. 1 to
Agreement 20-238 with Central Star
Final Audit Report 2024-11-05
Created: 2024-11-05
By: Mary Howard(mhoward@starsinc.com)
Status: Signed
Transaction ID: CBJCHBCAABAAS4W700JiXzogzgKdH5TC5dUDmIKP30dx
"On File with the Clerk-Amendment No. 1 to Agreement 20-238
with Central Star" History
Document created by Mary Howard (mhoward@starsinc.com)
2024-11-05-9:53:11 PM GMT-IP address:20.69.78.26
Document emailed to oaranda@starsinc.com for signature
2024-11-05-9:53:53 PM GMT
Email viewed by oaranda@starsinc.com
2024-11-05-9:55:36 PM GMT-IP address:73.252.227.182
Signer oaranda@starsinc.com entered name at signing as Olivia Aranda
2024-11-05-9:56:29 PM GMT-IP address:73.252.227.182
Document e-signed by Olivia Aranda (oaranda@starsinc.com)
Signature Date:2024-11-05-9:56:31 PM GMT-Time Source:server-IP address:73.252.227.182
Agreement completed.
2024-11-05-9:56:31 PM GMT
Q Adobe Acrobat Sign