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Home My WebLink AboutAgreement A-25-033 Amendment II to Master Agreement No. A-23-285.pdf Agreement No. 25-033 1 AMENDMENT NO. 2 TO SERVICE AGREEMENT 2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated 3 January 28, 2025 and is between Contractor(s) listed in Exhibit A "List of 4 Contractors" ("Contractor(s)"), and the County of Fresno, a political subdivision of the State of 5 California ("County"). 6 Recitals 7 A. County, through its Department of Behavioral Health (DBH), is a Mental Health Plan 8 (MHP) as defined in Title 9 of the California Code of Regulations (C.C.R.), Section 1810.226. 9 B. On June 20, 2023, the County and the Contractor entered into County Agreement No. 10 23-285 ("Agreement"), for qualified agencies to operate Full-Service Partnership (FSP) program 11 sites for culturally competent and linguistically accessible specialty mental health services for 12 target cultural/ethnic/linguistic unserved and/or underserved populations with a serious mental 13 disturbance (SED) and/or serious mental illness (SMI). 14 C. On April 9, 2024, the County and the Contractor entered into Amendment No. 24-151 to 15 the Agreement ("Amendment No. 1"), to increase the specialty mental health services maximum 16 compensation budget amount. 17 D. The County and the Contractor now desire to amend the Agreement to increase the 18 Mental Health Services Act (MHSA) maximum compensation of the Agreement to add housing 19 support funds due to an increase in the number of persons served who lack housing stability 20 and would benefit from housing support services. 21 The parties therefore agree as follows: 22 1. Section 4.3 of the Agreement located on page nine (9), lines three (3) through line seven 23 (7) is deleted in its entirety and replaced with the following: 24 "4.3 Cost Reimbursement Maximum Compensation. The maximum compensation 25 payable to the Contractor(s) under this Agreement for the period of July 1, 2023 through 26 June 30, 2024 is Forty Two Thousand and No/100 Dollars ($42,000.00). The maximum 27 compensation payable to the Contractor(s) under this Agreement for the period of July 1, 28 1 Doc ID: bbbfc6d87b2e39d91e3795e5ee9b e3824a5e2d6 1 2024 through June 30, 2025 is Seventy Two Thousand and No/100 Dollars 2 ($72,000.00)." 3 2. A portion of subsection 4.5 of the Agreement located on page nine (9), lines seventeen 4 (17) through twenty-one (21) is deleted and replaced with the following: 5 "4.5 Total Maximum Compensation. In no event shall the maximum contract amount 6 for all the services provided by the Contractor(s) to County under the terms and 7 conditions of this Agreement be in excess of Seven Million, Three Hundred Sixty-Four 8 Thousand, and No/100 Dollars ($7,364,000.00) during the entire term of this 9 Agreement." 10 3. All references in the Agreement to Exhibit H shall be deemed references to 11 "Revised Exhibit H," which is attached and incorporated by this reference. 12 4. When both parties have signed this Amendment No. 2, the Agreement, Amendment No. 13 1, and this Amendment No. 2 together constitute the Agreement. 14 5. The Contractor represents and warrants to the County that: 15 a. The Contractor is duly authorized and empowered to sign and perform its 16 obligations under this Amendment. 17 b. The individuals signing this Amendment on behalf of the Contractor are duly 18 authorized to do so and his or her signature on this Amendment legally binds the 19 Contractor to the terms of this Amendment. 20 6. The parties agree that this Amendment may be executed by electronic signature as 21 provided in this section. 22 a. An "electronic signature" means any symbol or process intended by an individual 23 signing this Agreement to represent their signature, including but not limited to 24 (1) a digital signature; (2) a faxed version of an original handwritten signature; or 25 (3) an electronically scanned and transmitted (for example by PDF document) 26 version of an original handwritten signature. 27 b. Each electronic signature affixed or attached to this Agreement (1) is deemed 28 equivalent to a valid original handwritten signature of the person signing this 2 Doc ID: bbbfc6d87b2e39d91e3795e5ee9b e3824a5e2d6 1 Agreement for all purposes, including but not limited to evidentiary proof in any 2 administrative or judicial proceeding, and (2) has the same force and effect as 3 the valid original handwritten signature of that person. 4 c. The provisions of this section satisfy the requirements of Civil Code section 5 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, 6 Division 3, Part 2, Title 2.5, beginning with section 1633.1). 7 d. Each party using a digital signature represents that it has undertaken and 8 satisfied the requirements of Government Code section 16.5, subdivision (a), 9 paragraphs (1) through (5), and agrees that each other party may rely upon that 10 representation. 11 e. This Agreement is not conditioned upon the parties conducting the transactions 12 under it by electronic means and either party may sign this Agreement with an 13 original handwritten signature. 14 7. The Agreement as amended by this Amendment No. 2 is ratified and continued. All 15 provisions of the Agreement not amended by this Amendment No. 2 remain in full force and 16 effect. This Amendment No. 2 is effective upon execution. 17 [SIGNATURE PAGE FOLLOWS] 18 19 20 21 22 23 24 25 26 27 28 3 Doc ID: bbbfc6d87b2e39d91e3795e5ee9b e3824a5e2d6 1 The parties are signing this Amendment No. 2 on the date stated in the introductory 2 clause. 3 CONTRACTOR(S) COUNTY OF FRESNO 4 See Exhibit A"List of Contractors" 5 Subsequent signature pages are attached. 6 Ernest Buddy Mende , Chairman of the Board of Supervisors of the County of 7 Fresno 8 Attest: Bernice E. Seidel 9 Clerk of the Board of Supervisors County of Fresno, State of California 10 11 By. Deputy 12 13 For accounting use only: 14 Org No.: 5630 Account No.: 7295 15 Fund No.: 0001 Subclass No.: 10000 16 17 18 19 20 21 22 23 24 25 26 27 28 4 Doc ID: bbbfc6d87b2e39d91e3795e5ee9b e3824a5e2d6 1 The parties are executing this Amendment No. 2 to Agreement No. 23-285 on the date 2 stated in the introductory clause. 3 4 CONTRACTOR: 5 THE FRESNO CENTER 6 7 8 9 Pao Yang, President and CEO 10 11 12 Jensen Vang, Chief Financial Officer 13 14 15 16 The Fresno Center 4879 E. Cesar Chavez Boulevard 17 Fresno, CA 93727 18 19 20 21 22 23 24 25 26 27 28 5 Doc ID: bbbfc6d87b2e39d91e3795e5ee9b e3824a5e2d6 Exhibit A List of Contractors Contractor Exhibit B subpart 1. The Fresno Center Exhibit B-1 Business Type: Private, non-profit, 501 (c)(3) corporation Business Address: 4879 E. Cesar Chavez Blvd Fresno, CA 93727 Contact: Pao Yang, President/CEO Service Address: 4879 E. Cesar Chavez Blvd Fresno, CA 93727 Target Population: Southeast Asian Children/Youth, Adult and Older Adult Level of Care: Outpatient/intensive Case Management and Full Service Partnership A-1 Doc ID:4d60c4b294a1f4c01b16803f8ec6c3d977296b22 FY 2023-24 Revised Exhibit H Specialty Mental Health Outpatient Rates for Contracted Providers Field Based Provider Rate Provider Type Per Hour Psychiatrist/Contracted Psychiatrist $988.85 Physicians Assistant $443.50 Nurse Practitioner $491.73 RN $401.65 Certified Nurse Specialist $491.73 LVN $211.00 Pharmacist $473.34 Licensed Psychiatric Technician $180.89 Psychologist/Pre-licensed Psychologist $397.68 LPHA(MFT LCSW LPCC)/ Intern or Waivered LPHA (MFT LCSW LPCC) $257.35 Occupational Therapist $342.58 Mental Health Rehab Specialist $193.62 Peer Recovery Specialist $203.30 Other Qualified Providers-Other Designated MH staff that bill medical $193.62 FSP AOT TBS Provider Rate Provider Type Per Hour Psychiatrist/Contracted Psychiatrist $1 140.98 Physicians Assistant $511.73 Nurse Practitioner $567.38 RN $463.45 Certified Nurse Specialist $567.38 LVN $243.47 Pharmacist $546.16 Licensed Psychiatric Technician $208.72 Psychologist/Pre-licensed Psychologist $458.87 LPHA(MFT LCSW LPCC)/ Intern or Waivered LPHA (MFT LCSW LPCC) $296.95 Occupational Therapist $395.28 Mental Health Rehab Specialist $223.41 Peer Recovery Specialist $234.58 Other Qualified Providers-Other Designated MH staff that bill medical $223.41 FY 2024-25 Revised Exhibit H Fresno County Department of Behavioral Health Specialty Mental Health Services Outpatient Rates FSP and AOT Provider Rate Per Provider Type Hour Psychiatrist/Contracted Psychiatrist $1,176.12 Physicians Assistant $527.47 Nurse Practitioner $584.86 RN $477.73 Certified Nurse Specialist $584.86 LVN $250.97 Medical Assistant $172.52 Pharmacist $562.98 Licensed Psychiatric Technician $215.15 Psychologist/Pre-licensed Psychologist $473.00 LPHA(MFT LCSW LPCC)/ Intern or Waivered LPHA $306.09 (MFT LCSW LPCC) Occupational Therapist $407.45 Mental Health Rehab Specialist $230.28 Peer Recovery Specialist $241.80 Other Qualified Providers-Other Designated MH staff that bill medical $230.28 Maximum Units That Flat Rate Type Unit Can Be Billed Rate 1 per allowed Interactive Complexity 15 min per unit procedure per $18.32 provider per person Sign Language/Oral Interpretive Services 115 min per unit Ivariable $30.92 Effective 7/1/2024 Exhibit H Revised Exhibit H Living Well Center-FSP-Cultural Specific Services The Fresno Center Fiscal Year(FY)2023-24 PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FTE Admin Program Total 1101 $ $ 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 Direct Personnel Admin Salaries Subtotal 0.00 $ $ Acct# Program Position FTE Admin Program Total 1116 $ 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 Direct Personnel Program Salaries Subtotall 0.00 1 $ $ Admin Program Total Direct Personnel Salaries Subtotal 0.00 $ $ $ Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement $ 1202 Worker's Compensation 1203 Health Insurance 1204 Other(specify) 1205 Other(specify) 1206 Other(specify) Direct Employee Benefits Subtotal: $ $ $ Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ $ $ 1302 FICA/MEDICARE 1303 SUI 1304 Other(specify) 1305 Other(specify) 1306 Other(specify) Direct Payroll Taxes&Expenses Subtotal: $ $ $ DIRECT EMPLOYEE SALAR 0�n*`affAg AT§aTQTAL: Admin Program Total Fresno County Department of Behavioral Health H-2 Revised 2/7/2020 Exhibit H Revised Exhibit H $ $ $ DIRECT EMPLOYEE SALARIES&BENEFITS PERCENTAGE: Admin Program #DIV/01 #DIV/0! 2000:DIRECT CLIENT SUPPORT Acct# Line Item Description Amount 2001 Child Care $ 2002 Client Housing Support 30,000 2003 Client Transportation&Support - 2004 Clothing,Food,&Hygiene 2,500 2005 Education Support - 2006 Employment Support 2007 Household Items for Clients 1,500 2008 Medication Supports - 2009 Program Supplies-Medical 2010 Utility Vouchers - 2011 Other(specify):Client Flexible Support Expenditure Support 4,000 2012 Other(specify) - 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 Other(specify) DIRECT CLIENT CARE TOTAL $ 38,000 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 3002 Printing/Postage 3003 Office,Household&Program Supplies 3004 Advertising 3005 Staff Development&Training 3006 Staff Mileage 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Other(specify) 3010 Other(specify) 3011 Other(specify) 3012 Other(specify) DIRECT OPERATING EXPENSES TOTAL: $ 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities 4007 Other(specify) 4008 Other(specify) 4009 Other(specify) 4010 Other(specify) DIRECT FACILITIES/EQUIPMENTTOTAL: $ 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 - 5005 Other(Student Stipends) 4,000 5006 Other(specify) - 5007 Other(specify) 5008 Other(specify) - DIRECT SPECIAL EXPENSES TOTAL:j$ 4,000 6000:INDIRECT EXPENSES Acct#I Line iR r iv Amount �] Fresno County Department of Behavioral Health H-3 Revised 2/7/2020 Exhibit H Revised Exhibit H Administrative Overhead 6001 Use this line and only this line for approved indirect cost rate $ Administrative Overhead 6002 Professional Liability Insurance 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Usedfor Progrom Purposes) 6008 Personnel(indirect Salaries Benefits) - 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 Other(specify) INDIRECT EXPENSES TOTAL $ INDIRECT COST RATE 0.00% 7000:DIRECT FIXED ASSETS Acct# Line Item Description Amount 7001 s $ 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA Data 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 jAssets over$5,000/unit(Specify) 7007 Other(specify) 7008 Other(specify) FIXED ASSETS EXPENSES TOTAL $ - TOTAL PROGRAM EXPENSES $ 42,000 PROGRAM FUNDING SOURCES 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ 8102 ISABG 1 $ SUBSTANCE USE DISORDER FUNDS TOTAL $ 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $ REALIGNMENT TOTAL $ 8300-MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services&Supports $ 42,000 8302 PEI-Prevention&Early Intervention - 8303 INN-Innovations 8304 WET-Workforce Education&Training 8305 CFTN-Capital Facilities&Technology MHSA TOTAL $ 42,000 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ 8402 Client Insurance 8403 Grants(Specify) 8404 Other(Specify) 8405 Other(Specify) OTHER REVENUE TOTAL $ TOTAL PROGRAM FUNDING SOURCES: $ 42,000 NET PROGRAM COST: $ Contract Budget Narrative Fresno County Department of Behavioral Health H4 Revised 2/7/2020 Exhibit H Revised Exhibit H Living Well Center-FSP-Cultural Specific Services The Fresno Center Fiscal Year(FY)2023-24 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 Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Fresno County Department of Behavioral Health H-5 Revised 2/7/2020 Exhibit H Revised Exhibit H 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#/NaQaet/D�ftadpM6htv%ovnty FTE 76 Fresno County Department of Behavioral Health H-g Revised 2/7/2020 Exhibit H Revised Exhibit H Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Position Contract#/Name/Department/County FTE Tota 1 0.00 Contract Budget Narrative Fresno County Department of Behavioral Health H-7 Revised 2/7/2020 Exhibit H Revised Exhibit H Living Well Center-FSP-Cultural Specific Services The Fresno Center Fiscal Year(FY)2023-24 Budget Narrative PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS Administrative Positions 1101 0 1102 0 1103 0 1104 0 1105 0 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 0 Program Positions 1116 0 1117 0 1118 0 1119 0 1120 0 1121 0 1122 0 1123 0 1124 0 1125 0 1126 0 1127 0 1128 0 1129 0 1130 0 1131 0 1132 0 1133 0 1134 0 Direct Employee Benefits 1201 Retirement 1202 Worker's Compensation 1203 Health Insurance 1204 Other(specify) 1205 Other(specify) 1206 Other(specify) Direct Payroll Taxes&Expenses: 1301 OASDI 1302 FICA/MEDICARE 1303 SUI 1304 Other(specify) 1305 Other(specify) 1306 Other(specify) 2000:DIRECT CLIENT SUPPORT 38,000 2001 Child Care - 2002 Client Housing Support 30,000 Client Housing Support Expenditures(SFC 70) For cost of providing housing supports.including housing subsidies for permanent, transitional and temporary housing:master leases;motel and other housing vouchers and shelters;rental security deposits:first and last month rental payments;and eviction prevention and other fiscal housing supports. Estimated @$30,000 annually. 2003 Client Transportation&Support Contract Budget Narrative Fresno County Department of Behavioral Health H-8 Revised 2/7/2020 Exhibit H Revised Exhibit H PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2004 Clothing,Food,&Hygiene 2,500 Clothing,Food&Hygiene(SFC 72) To provide supports to clients,which may include food vouchers and other items necessary for daily living(such as,clothing,hygiene,etc.).Estimated @$2,500 annually 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 1,500 Household Items(SFC 72) To provide supports for clients with household items need.Estimated at$1,500 2008 Medication Supports - 2009 Program Supplies-Medical 2010 Utility Vouchers - 2011 Other(specify):Client Flexible Support Expenditure 4,000 Client Flexible Support Expenditures Support(SFC 72) Support To provide supports to clients and their caregivers,may include vouchers,goods, services,and other family support services.Also maybe use for personal/community integration to assist clients in achieving their treatment goals and in supporting their integration into the larger community.Items may include,but are not limited to socialization and recreational activities.This funding may also be used for medical, dental and optical care,prescriptions,and laboratory tests when the client does not have insurance to pay for such care.Estimated @$4,000 annually 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 I Others ecif 3000:DIRECT OPERATING EXPENSES 3001 Telecommunications 3002 Printing/Postage 3003 Office,Household&Program Supplies 3004 Advertising 3005 Staff Development&Training 3006 Staff Mileage 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Other(specify) 3010 Other(specify) 3011 Other(specify) 3012 other(specify) 4000:DIRECT FACILITIES&EQUIPMENT 4001 Building Maintenance 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities 4007 Other(specify) 4008 Other(specify) 4009 Other(specify) 4010 1 Other(specify) 5000:DIRECT SPECIAL EXPENSES 4,000 5001 Consultant(Network&Data Management) - 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) - 5004 Translation Services 5005 Other(Student Stipends) 4,000 To train 4 graduate students in mental health work force @ 500 per semester for 2 semesters x 4 students=$4,000 5006 Other(specify) - 5007 Other(specify) 5008 Other(specify) 6000:INDIRECT EXPENSES 6001 Administrative Overhead 6002 Professional Liability Insurance 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): Fresno County Department of Behavioral Health H-9 Revised 2/7/2020 Exhibit H Revised Exhibit H PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used 6008 Personnel(Indirect Salaries&Benefits) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 Other(specify) 6013 1 Other(specify) 7000:DIRECT FIXED ASSETS 7001 Computer Equipment&Software 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(specify) 7008 1 Other(specify) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 42,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 42,000 BUDGET CHECK: - Contract Budget Narrative Fresno County Department of Behavioral Health H-10 Revised 2/7/2020 FY 2024-25 Revised Exhibit H Living Well Center-FSP-Cultural Specific Services The Fresno Center Fiscal Year(FY) 2024-25 PROGRAM EXPENSES 1000:SALARIES&BENEFITS Employee Salaries Acct# Position FTE Admin Direct Total 1101 - 1102 - - - 1103 - - - 1104 - - - 1105 - - - 1106 - - - 1107 - - - 1108 - - 1109 - - 1110 1111 1112 1113 1114 - - 1115 - - - 1116 - - - 1117 - - - 1118 - - - 1119 - - - 1120 - - - 1121 - - - 1122 - - - 1123 - - - 1124 - - - 1125 - - - 1126 - - - 1127 - - - 1128 - - - 1129 - - 1130 - - 1131 - - 1132 - - 1133 - - 1134 1135 - - - Personnel Salaries Subtotal 0.00 $ - $ - $ - Employee Benefits Acct# Description Admin Direct Total 1201 Retirement $ - $ - $ - 1202 Worker's Compensation - - - 1203 Health Insurance - - - 1204 Other(specify) - - - 1205 Other(specify) - - - 1206 Other(specify) - - - Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 FY 2024-25 Revised Exhibit H Employee Benefits Subtotal: $ - $ - $ - Payroll Taxes&Expenses: Acct# Description Admin Direct Total 1301 OASDI $ - $ - $ - 1302 FICA/MEDICARE - - - 1303 SUI - - - 1304 1 Other(specify) - - - 1305 10ther(specify) - - - 1306 1 Other(specify) - - - Payroll Taxes&Expenses Subtotal: $ - $ - $ - EMPLOYEE SALARIES&BENEFITS TOTAL: $ - $ - $ - 2000:CLIENT SUPPORT Acct# Line Item Description Amount 2001 Child Care $ - 2002 Client Housing Support 60,000 2003 Client Transportation &Support - 2004 IClothing, Food,& Hygiene 2,500 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 1,500 2008 Medication Supports - 2009 Program Supplies-Medical - 2010 Utility Vouchers - 2011 Other(specify):Client Flexible Support Expenditure Support 4,000 2012 Other(specify) - 2013 Other(specify) - 2014 Other(specify) - 2015 Other(specify) - 2016 Other(specify) - DIRECT CLIENT CARE TOTAL 1 $ 68,000 3000:OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ - 3002 Printing/Postage - 3003 Office, Household& Program Supplies - 3004 jAdvertising - 3005 Staff Development&Training - 3006 Staff Mileage - 3007 Subscriptions& Memberships - 3008 Vehicle Maintenance - 3009 1 Other(specify) - 3010 Other(specify) - 3011 Other(specify) - 3012 Other(specify) - OPERATING EXPENSES TOTAL: $ - 4000: FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ - 4002 Rent/Lease Building - Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 FY 2024-25 Revised Exhibit H 4003 Rent/Lease Equipment - 4004 Rent/Lease Vehicles - 4005 Security - 4006 Utilities - 4007 1 Other(specify) - 4008 Other(specify) - 4009 Other(specify) - 4010 Other(specify) - FACILITIES/EQUIPMENT TOTAL: $ - 5000:SPECIAL EXPENSES Acct# Line Item Description Amount 5001 Consultant(Network& Data Management) $ - 5002 HMIS(Health Management Information System) - 5003 Contractual/Consulting Services (Specify) - 5004 ITranslation Services - 5005 Other(specify):Student Stipend 4,000 5006 Other(specify) - 5007 Other(specify) - 5008 Other(specify) - SPECIAL EXPENSES TOTAL: $ 4,000 6000:ADMINISTRATIVE EXPENSES Acct# Line Item Description Amount 6001 Administrative Overhead $ - 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 1 External Audit - 6005 Insurance(Specify): - 6006 Payroll Services - 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) - 6008 Other(specify) - 6009 Other(specify) - 6010 Other(specify) - 6011 Other(specify) - 6012 Other(specify) - ADMINISTRATIVE EXPENSES TOTAL $ - 7000: FIXED ASSETS Acct# Line Item Description Amount 7001 Computer Equipment&Software $ - 7002 Copiers,Cell Phones,Tablets, Devices to Contain HIPAA Data - 7003 Furniture& Fixtures - 7004 1 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 $ - TOTAL PROGRAM EXPENSES $ 72,000 Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 FY 2024-25 Revised Exhibit H 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 lCollateral 0 - - 8006 Plan Development 0 - - 8007 Assessment 0 - - 8008 Rehabilitation 0 - - 8009 Other(Specify) 0 - - 8010 Other(Specify) 1 0 - I - Estimated Specialty Mental Health Services Billing Totals: 10 $ - Estimated%of Clients who are Medi-Cal Beneficiaries 0% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries - Federal Financial Participation (FFP)% 1 0% - MEDI-CAL FFP TOTAL $ - 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ - 8102 SABG $ - SUBSTANCE USE DISORDER FUNDS TOTAL $ 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment $REALIGNMENT TOTAL $ 8300-MENTAL HEALTH SERVICE ACT(MHSA) Acct# MHSA Component MHSA Program Name Amount 8301 CSS-Community Services&Supports $ 72,000 8302 PEI -Prevention & Early Intervention - 8303 INN -Innovations - 8304 WET-Workforce Education &Training - 8305 ICFTN -Capital Facilities&Technology I - MHSA TOTAL $ 72,000 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ - 8402 Client Insurance - 8403 Grants(Specify) - 8404 Other(Specify) - 8405 1 Other(Specify) - OTHER REVENUE TOTAL $ - TOTAL PROGRAM FUNDING SOURCES: $ 72,000 NET PROGRAM COST: $ - Fresno County Department of Behavioral Health Contract Budget Template Revised 4/10/2020 FY 2024-25 Revised Exhibit H Living Well Center-FSP-Cultural Specific Services The Fresno Center Fiscal Year(FY)2024-25 Budget Narrative PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:SALARIES&BENEFITS Employee Salaries 1101 0 1102 0 1103 0 1104 0 1105 0 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 0 1116 0 1117 0 1118 0 1119 0 1120 0 1121 0 1122 0 1123 0 1124 0 1125 0 1126 0 1127 0 1128 0 1129 0 1130 0 1131 0 1132 0 1133 0 1134 0 1135 0 Employee Benefits 1201 Retirement 1202 Worker's Compensation 1203 Health Insurance 1204 Other(specify) 1205 Other(specify) 1206 Other(specify) Payroll Taxes&Expenses: 1301 OASDI 1302 FICA/MEDICARE 1303 SUI 1304 Other(specify) 1305 Other(specify) 1306 Other(specify) 2000:CLIENT SUPPORT 68,000 2001 Child Care - 2002 Client Housing Support 60,000 Client Housing Support Expenditures(SFC 70) For cost of providing housing supports.including housing subsidies for permanent, transitional and temporary housing:master leases;motel and other housing vouchers and shelters;rental security deposits:first and last month rental payments;and eviction prevention and other fiscal housing supports. Estimated @$60,000 annually. 2003 Client Transportation&Support Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 FY 2024-25 Revised Exhibit H PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2004 Clothing,Food,&Hygiene 2,500 Clothing,Food&Hygiene(SFC 72) To provide supports to clients,which may include food vouchers and other items necessary for daily living(such as,clothing,hygiene,etc.).Estimated @$2,500 annually 2005 Education Support 2006 Employment Support 2007 Household Items for Clients 1,500 Household Items(SFC 72) To provide supports for clients with household items need.Estimated at$1,500 2008 Medication Supports 2009 Program Supplies-Medical 2010 Utility Vouchers 2011 Other(specify):Client Flexible Support 4,000 Client Flexible Support Expenditures Support(SFC 72) Expenditure Support To provide supports to clients and their caregivers,may include vouchers,goods, services,and other family support services.Also maybe use for personal/community integration to assist clients in achieving their treatment goals and in supporting their integration into the larger community.Items may include,but are not limited to socialization and recreational activities.This funding may also be used for medical, dental and optical care,prescriptions,and laboratory tests when the client does not have insurance to pay for such care.Estimated @$4,000 annually 2012 Other(specify) 2013 Other(specify) 2014 Other(specify) 2015 Other(specify) 2016 1 Other(specify) 3000:OPERATING EXPENSES 3001 Telecommunications 3002 Printing/Postage 3003 Office,Household&Program Supplies 3004 Advertising 3005 Staff Development&Training 3006 Staff Mileage 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Other(specify) 3010 Other(specify) 3011 Other(specify) 3012 1 Other(specify) 4000:FACILITIES&EQUIPMENT 4001 Building Maintenance 4002 Rent/Lease Building 4003 Rent/Lease Equipment 4004 Rent/Lease Vehicles 4005 Security 4006 Utilities 4007 Other(specify) 4008 Other(specify) 4009 Other(specify) 4010 Other(specify) 5000:SPECIAL EXPENSES 4,000 5001 Consultant(Network&Data Management) - 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services - 5005 Other(specify):Student Stipend 4,000 To train 4 graduate students in mental health work force @ 500 per semester for 2 semesters x 4 students=$4,000 5006 Other(specify) 5007 Other(specify) 5008 Other(specify) 6000:ADMINISTRATIVE EXPENSES 6001 Administrative Overhead Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 FY 2024-25 Revised Exhibit H PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6002 Professional Liability Insurance 6003 Accounting/Bookkeeping 6004 External Audit 6005 Insurance(Specify): 6006 Payroll Services 6007 Depreciation(Provider-Owned Equipment to be Used for Program Purposes) 6008 Other(specify) 6009 Other(specify) 6010 Other(specify) 6011 Other(specify) 6012 1 Other(specify) 7000:FIXED ASSETS 7001 Computer Equipment&Software 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA Data 7003 Furniture&Fixtures 7004 Leasehold/Tenant/Building Improvements 7005 Other Assets over$500 with Lifespan of 2 Years+ 7006 Assets over$5,000/unit(Specify) 7007 Other(specify) 7008 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 Mental Health Services 8002 Case Management 8003 Crisis Services 8004 Medication Support 8005 Collateral 8006 Plan Development 8007 Assessment 8008 Rehabilitation 8009 Other(Specify) 8010 Other(Specify) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 72,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 72,000 BUDGET CHECK: - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020