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HomeMy WebLinkAboutAgreement A-25-277 Amendment No. 2 to Agreement No. 24-618 with Central Star.pdf Agreement No. 25-277 1 AMENDMENT NO. 2 TO SERVICE AGREEMENT 2 This Amendment No. 2 to Service Agreement ("Amendment No. 2") is dated 3 June 24, 2025 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 service Agreement No. 8 20-238 ("Agreement"), as amended by County Agreement No. 24-618 (Amendment No. 1) 9 effective December 3, 2024, for a 16-bed acute inpatient psychiatric health facility (PHF) to 10 provide inpatient psychiatric services to adolescent youth, twelve (12) years up to eighteen (18) 11 years of age. 12 B. The County and the Contractor now desire to amend the Agreement to extend the term 13 for an additional six (6) month base and optional six (6) month renewal term and increasing the 14 maximum compensation by Seven Million, Two Hundred Ninety-Two Thousand, One Hundred 15 Ninety-Five and No/100 Dollars ($7,292,195.00). 16 The parties therefore agree as follows: 17 1. Term. This Amendment extends the term of the Agreement through December 31, 2025. 18 The term of this Agreement may be extended for no more than one six-month period only upon 19 written approval of both parties at least thirty (30) days before the first day of the six-month 20 extension period. The County's DBH Director, or designee, is authorized to sign the written 21 approval on behalf of the County base on the Contractor's satisfactory performance. The 22 extension of this Agreement by the County is not a waiver or compromise of any default or 23 breach of this Agreement by the Contractor existing at the time of the extension whether or not 24 known to the County. 25 2. All references to Revised Exhibit C shall be deemed references to "Revised Exhibit C-1." 26 Revised Exhibit C-1 is attached and incorporated by this reference. 27 3. Section 5 of Amendment No. 1 (Agreement No. 24-618) beginning on Page 2, Line 23 is 28 amended to add the following: 1 "The maximum compensation payable to the contractor under this Agreement for 2 the period of July 1, 2025, through December 31, 2025, for Specialty Mental 3 Health Services shall not exceed Three Million, Five Hundred Forty-Nine 4 Thousand, Three Hundred Forty-One and No/100 Dollars ($3,549,341.00). The 5 maximum compensation payable to the contractor under this Agreement for the 6 period January 1, 2026, through June 30, 2026, for Specialty Mental Health 7 Services shall not exceed Three Million, Seven Hundred Forty-Two Thousand, 8 Eight Hundred Fifty-Four and No/100 Dollars ($3,742,854.00)." 9 4. A portion of Section 5 of Amendment No. 1 (Agreement No. 24-618) located at Page 3, 10 Lines 1 through 4 is deleted and replaced with the following: 11 "In no event shall the total maximum compensation amount under this 12 Agreement beginning July 1, 2020, through June 30, 2026, exceed Thirty-Six 13 Million, Two Hundred Twenty-Four Thousand, Four Hundred Seven and No/100 14 Dollars ($36,224,407.00)." 15 5. When both parties have signed this Amendment No. 2, the Agreement, Amendment 1, 16 and this Amendment No. 2 together constitute the Agreement. 17 6. The Contractor represents and warrants to the County that: 18 a. The Contractor is duly authorized and empowered to sign and perform its obligations 19 under this Amendment. 20 b. The individual signing this Amendment on behalf of the Contractor is duly authorized 21 to do so and his or her signature on this Amendment legally binds the Contractor to 22 the terms of this Amendment. 23 7. The parties agree that this Amendment may be executed by electronic signature as 24 provided in this section. 25 a. An "electronic signature" means any symbol or process intended by an individual 26 signing this Amendment to represent their signature, including but not limited to (1) a 27 digital signature; (2) a faxed version of an original handwritten signature; or (3) an 28 1 electronically scanned and transmitted (for example by PDF document) version of an 2 original handwritten signature. 3 b. Each electronic signature affixed or attached to this Amendment (1) is deemed 4 equivalent to a valid original handwritten signature of the person signing this 5 Amendment for all purposes, including but not limited to evidentiary proof in any 6 administrative or judicial proceeding, and (2) has the same force and effect as the 7 valid original handwritten signature of that person. 8 c. The provisions of this section satisfy the requirements of Civil Code section 1633.5, 9 subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 10 2, Title 2.5, beginning with section 1633.1). 11 d. Each party using a digital signature represents that it has undertaken and satisfied 12 the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) 13 through (5), and agrees that each other party may rely upon that representation. 14 e. This Amendment is not conditioned upon the parties conducting the transactions 15 under it by electronic means and either party may sign this Amendment with an 16 original handwritten signature. 17 8. This Amendment may be signed in counterparts, each of which is an original, and all of 18 which together constitute this Amendment. 19 9. The Agreement, as previously amended and as amended by this Amendment No. 2 is 20 ratified and continued. All provisions of the Agreement as previously amended and not 21 amended by this Amendment No. 2 remain in full force and effect. 22 [SIGNATURE PAGE FOLLOWS] 23 24 25 26 27 28 3 1 The parties are signing this Amendment No. 2 on the date stated in the introductory 2 clause. 3 CENTRAL STAR BEHAVIORAL HEALTH, COUNTY OF FRESNO 4 INC. 5 6 Kent Dunlap, President and CEO Ernest Buddy Mendes,'Chairman of the 7 1501 Hughes Way, Suite 150 Board of Supervisors of the County of Fresno Long Beach, CA 90810 Attest: 8 Bernice E. Seidel Clerk of the Board of Supervisors 9 County of Fresno, State of California 10 By: _ 11 Deputy 12 For accounting use only: 13 Org No.: 56302112 Account No.: 7295 14 Fund No.: 0001 Subclass No.: 10000 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4 Revised Exhibit C-1 Page 1 of 32 Psychiatric Health Facility Services Central Star Behavioral Health, Inc Fiscal Year(FY)2025-26-JUL-DEC'25 PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FTE Admin Program Total 1101 Admistrator 0.67 $ 53,249 $ 53,249 1102 HR 0.86 30,123 30,123 1103 QA 1.07 44,867 44,867 1104 Training 0.52 19,126 19,126 1105 - 1106 - 1107 1108 1109 1110 1111 1112 1113 1114 1115 - Direct Personnel Admin Salaries Subtotal 3.12 $ 147,365 $ 147,365 Acct# Program Position FTE Admin Program Total 1116 Director of Nursing(DON) 1.00 $ 70,304 $ 70,304 1117 Clinical Director 1.00 57,200 57,200 1118 Program Coordinator 1.00 45,001 45,001 1119 Social Worker 4.00 173,056 173,056 1120 Peer Support 2.00 47,840 47,840 1121 Recreation Therapist 1.00 37,440 37,440 1122 Rehabilitation Aid 3.00 72,883 72,883 1123 RN/NC 1.40 74,999 74,999 1124 YC/Safety Specialist 17.80 438,734 438,734 1125 LVN/LPT 9.00 345,758 345,758 1126 Admissions Coordinator 1.40 54,048 54,048 1127 Clerk/Discharge Coordinator 3.00 69,764 69,764 1128 Housekeeper 1.50 34,070 34,070 1129 - 1130 - 1131 - 1132 - 1133 - 1134 - - Direct Personnel Program Salaries Subtotal 47.10 $ 1,521,096 $ 1,521,096 Admin Program Total Direct Personnel Salaries Subtotal 50.22 $ 147,365 $ 1,521,096 $ 1,668,461 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 2 of 32 Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement $ 6,632 $ 68,450 $ 75,082 1202 Worker's Compensation 2,947 30,422 33,369 1203 Health Insurance 16,211 167,321 183,532 1204 Other(specify) - - - 1205 Other(specify) - - 1206 Other(specify) - - - Direct Employee Benefits Subtotal: $ 25,790 $ 266,193 $ 291,983 Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ 9,137 $ 94,308 $ 103,445 1302 FICA/MEDICARE/FUTA 2,312 24,694 27,006 1303 SUI 851 12,859 13,710 1304 Other(specify) - - - 1305 Other(specify) - - 1306 Other(specify) - - - Direct Payroll Taxes&Expenses Subtotal: $ 12,300 $ 131,861 $ 144,161 DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total $ 185,455 $ 1,919,150 $ 2,104,606 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 Clothing, Food,&Hygiene 218,164 2005 Education Support 2006 Employment Support 2007 Household Items for Clients 3,219 2008 Medication Supports 455,700 2009 Program Supplies-Medical 35,491 2010 Utility Vouchers 2011 Translation Services 2,771 2012 Laudry Services 10,101 2013 Client Needs - 2014 Other(specify) 2015 Other(specify) - 2016 Other(specify) - DIRECT CLIENT CARE TOTAL $ 725,446 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 3 of 32 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 23,747 3002 Printing/Postage 3003 Office, Household&Program Supplies 18,007 3004 Advertising 3005 Staff Development&Training 7,085 3006 Staff Mileage 1,000 3007 Subscriptions&Memberships 3008 Vehicle Maintenance 3009 Recruitment 1,597 3010 Other(specify) - 3011 Other(specify) 3012 Other(specify) DIRECT OPERATING EXPENSES TOTAL: $ 51,436 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ 5,182 4002 Rent/Lease Building 2,115 4003 Rent/Lease Equipment 6,196 4004 Rent/Lease Vehicles 4005 Security 989 4006 Utilities 300 4007 Other(specify) - 4008 Other(specify) 4009 Other(specify) - 4010 Other(specify) - DIRECT FACILITIES/EQUIPMENT TOTAL: $ 14,782 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(specify) - 5006 Other(specify) - 5007 Other(specify) - 5008 Other(specify) DIRECT SPECIAL EXPENSES TOTAL: $ - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 4 of 32 6000:INDIRECT EXPENSES Acct# Line Item Description Amount 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 3,424 6005 Insurance(Specify): 24,732 6006 Payroll Services 296 6007 Depreciation(Provider-Owned Equipment to be Usedfor Program Purposes) 6008 Personnel(Indirect Salaries&Benefits) 6009 Centralized Services Private/Other County 110,214 6010 Centralized Services Fiscal-Fresno 117,841 6011 Centralized Services Administration 273,980 6012 lCentralized Services Program 100,165 6013 1 Other(specify) - INDIRECT EXPENSES TOTAL $ 630,652 INDIRECT COST RATE 21.61% 7000:DIRECT FIXED ASSETS Acct# Line Item Description Amount 7001 Computer Equipment&Software $ 21,863 7002 Copiers,Cell Phones,Tablets, Devices to Contain HIPAA Data 7003 Furniture&Fixtures 556 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 $ 22,419 TOTAL PROGRAM EXPENSES $ 3,549,341 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Page 5 of 32 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Estimated Specialty Mental Health Services Billing Totals: $ 2,223,770 Estimated%of Clients who are Medi-Cal Beneficiaries 61% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 1,356,500 Federal Financial Participation (FFP)% 1 50% 678,250 8001 Medi-Cal Specialty Mental Health Services MEDI-CAL FFP TOTAL $ 678,250 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 $ 1,768,955 REALIGNMENT TOTAL $ 1,768,955 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 MHSA TOTAL $ 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ 8402 Client Insurance 8403 Grants(Specify) - 8404 Other(Private Insurance) 712,895 8405 Other(Out of County) 389,241 OTHER REVENUE TOTALI $ 1,102,136 TOTAL PROGRAM FUNDING SOURCES: $ 3,549,341 NET PROGRAM COST: $ (0) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Psychiatric Health Facility Services Central Star Behavioral Health, Inc Fiscal Year (FY) 2025-26 JUL-DEC'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 PHF/BHS/Fresno 0.67 Administrator CRT/BHS/Fresno 0.33 Total 1.00 Position Contract#/Name/Department/County FTE QA PHF Bakersfield 0.41 QA PHF/BHS/Fresno 0.40 QA CRT/BHS/Fresno 0.19 QA QA PHF/BHS/Fresno 0.67 QA CRT/BHS/Fresno 0.33 Total 2.00 Position Contract#/Name/Department/County FTE HR PHF Bakersfield 0.88 HR PHF/BHS/Fresno 0.86 HR CRT/BHS/Fresno 0.48 HR TAY/BHS/Fresno 0.58 HR All-Star/BHS/Fresno 0.78 HR WRAP/BHS/Fresno 0.49 HR CRU/BHS/Merced 0.51 HR CBHST/BHS/Stanislaus 0.42 Total 5.00 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Position Contract#/Name/Department/County FTE Training PHF Bakersfield 0.53 Training PHF/BHS/Fresno 0.52 Training CRT/BHS/Fresno 0.29 Training TAY/BHS/Fresno 0.35 Training All-Star/BHS/Fresno 0.47 Training WRAP/BHS/Fresno 0.29 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 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 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 Revised Exhibit C-1 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 Revised Exhibit C-1 Psychiatric Health Facility Services Central Star Behavioral Health,Inc Fiscal Year(FY)2025-26-JUL-DEC'25 Budget Narrative PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS 2,104,606 Administrative Positions 147,365 1101 Admistrator 53,249 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.The Administrator represents the CSBH agency and its programs to governmental agencies and the community. (Remainder of FTE is for overseeing the CRT). PHF Fresno®7%11176.42 x 1040 x.67=$53,249 CRT Fresno®3%$76.42 x 1040 x.33=$26,227 1102 HR 30,123 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. PHF Kern $33.68 x 1040 hrs.x 17.6%x 5 FTE=$30,8240 PHF Fresno $33.68 x 1040 hrs.x 17.2%x 5 FTE=$30,123M CRT Fresno $33.68 x 1040 hrs.x 9.6%x 5 FTE=$16,8130 TAY Fresno $33.68 x 1040 hrs.x 11.6%x 5 FTE=$20,316M All-Star Fresno $33.68 x 1040 hrs.x 15.6%x 5 FTE=$27,3210 WRAP Fresno $33.68 x 1040 hrs.x 9.8%x 5 FTE=$17,16311 CRU Merced $33.68 x 1040 hrs.x 10.2%x 5 FTE=$17,8640 CBHST Stanislaus$33.68 x 1040 hrs.x 8.4%x 5 FTE=$14,711 1103 QA 44,867 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. QA Director PHF Kern $44.42 x 1040 hrs.x 41%x 1 FTE=$18,9410 PHF Fresno $44.42 1040 hrs.x 40%x 1 FTE=$18,479M CRT Fresno $44.42 x 1040 hrs.x 16%1 FTE=$8,7777 QA Manager PHF Fresno $37.87 x 1040 hrs.x 67%x 1 FTE =$26,388 CRT Fresno $37.87 x 1040 hrs.x 33%x 1 FTE=$12,9970 TOTAL=$44,867 FOR QA FOR FRESNO PHF 1104 Training 19,126 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. PHF Kern $35.64 x 1040 hrs.x 17.6%x 3 FTE=$19,57119 PHF Fresno $35.64 x 1040 hrs.x 17.2%x 3 FTE=$19,1260 CRT Fresno $35.64 x 1040 hrs.x 9.6%x 3 FTE=$10,6750 TAY Fresno $35.64 x 1040 hrs.x 11.6%x 3 FTE=$12,8990 All-Star Fresno $35.64 x 1040 hrs.x 15.6%x 3 FTE=$17,34719 WRAP Fresno $35.64 x 1040 hrs.x 9.8%x 3 FTE=$10,8970 CRU Merced $35.64 x 1040 hrs.x 10.2%x 3 FTE=$11,3420 CBHST Stanislaus$35.64 x 1040 hrs.x 8.4%x 3 FTE_$9,341 1105 0 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 0 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE Program Positions 1,521,096 1116 Director of Nursing(DON) 70,304 Director of Nursing: Pay rate is$67.60per hour x 1040 hours for Jul'25-Dec'25=$70,304 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 57,200 Clinical Director: Pay rate is$55 per hour x 1040 hours for Jul'25-Dec'25=$57,200 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.He/she acts as liaison with external agencies and internal teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties. 1118 Program Coordinator 45,001 Program Coordinator: Pay rate is$43.27 x 1040 hours for Jul'25-Dec'25=$45,001 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 24/7 basis. 1119 Social Worker 173,056 Social Worker: Pay rate is$41.60 per hour x 4 FTE x 1040 hours for Jul'25-Dec'25=$173,056 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. 1120 Peer Support 47,840 Peer Support Specialist/Counselor: Pay rate is$23 per hour x 2 FTE x 1040 hours for Jul'25-Dec'25=$47,840 This team of 2,provides outreach,advocacy,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. 1121 Recreation Therapist 37,440 Recreation therapist: Pay rate is$36 per hour x 1040 hours for Jul'25-Dec'25=$37,440 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. 1122 Rehabilitation Aid 72,883 Rehabilitation Aide: Pay rate is$22.90 per hour x 2%OT=$23.36 per hour x 3 FTE x 1040 hours for Jul'25- Dec'25=$72,883 The Rehabilitating Aide provides direct and indirect rehabilitation services to adolescent clients through individualized and/or group activities. Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1123 RN/NC 74,999 Charge&Registered Nurse: Pay rate is$51.51 per hour x 1.40 FTE x 1040 hours for Jul'25-Dec'25=$74,999 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. 1124 YC/Safety Specialist 438,734 Youth Counselor/Safety Specialist: Pay rate is$22.36 per hour x 6%OT=$23.70 per hour x 17.80 FTE x 1040 hours for Jul'25-Dec'25=$438,734 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. Youth high acuity and Conservatorship requires Physician ordered interventions such as 1:1 supervision,line of sight supervision,which requires additional Youth Counselors. Conservatorship 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. 1125 LVN/LPT 345,758 LVN/LPT: Pay rate is$36.00 per hour x 2.6%OT=$36.94 per hour x 9 FTE x 1040 hours for Jul'25- Dec'25=$345,758 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. Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE 11 ACCT# LINE ITEM A DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1126 Admissions Coordinator 54,048 Admissions Coordinator: Pay rate is$35.56 per hour x 4.3%OT=$37.12 per hour x 1.40 FTE x 1040 hours for Jul'25-Dec'25=$54,048 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. 1127 Clerk/Discharge Coordinator 69,764 Clerk/Receptionist/Discharge Coordinator: Pay rate is$22.36 x 3 FTE x 1040 hours for Jul'25-Dec'25=$69,764 This position 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. 1128 Housekeeper 34,070 Housekeeper: Pay rate is$21.84 x 1.50 FTE x 1040 hours for Jul'25-Dec'25=$34,070 This position performs a variety of tasks to ensure that the facility is in a clean,orderly, sanitary,and attractive condition. 1129 0 1130 0 1131 0 1132 0 1133 0 1134 10 1 - Direct Employee Benefits 1201 Retirement 75,082 Retirement:based on 4.5%of salary expense.This includes ESOP,401k employer match, and Life Insurance/AD&D.The total benefits and especially the retirement benefit has been underfunded in the PHF contract. This adjusts the total benefits to be 26%of wages which is on par with our other County contracts. 1202 Worker's Compensation 33,369 Worker Compensation:based on 2%of salary expense 1203 Health Insurance 183,532 Health insurance:based on 11%of salary expense 1204 Other(specify) - 1205 Other(specify) 1206 1 Other(specify) Direct Payroll Taxes&Expenses: 144,161 1301 OASDI 103,445 OASDI Payroll Taxes:based on 2024 rates at 6.2%. 1302 FICA/MEDICARE/FUTA 27,006 FICA Payroll Taxes:based on 2024 rates 1.45%plus FUTA at.8%per the first$7,000 of each employee wages. 1303 SUI 13,710 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#of FTE x 3.9%) 1304 Other(specify) - 1305 Other(specify) 1306 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2000:DIRECT CLIENT SUPPORT 725,446 2001 Child Care - 2002 Client Housing Support 2003 Client Transportation&Support - 2004 Clothing,Food,&Hygiene 218,164 This item includes the cost of meals and food for clients.Morrison Supplier cost per year is estimated at$428,952 per Contract,at$214,476 for six months.Plus$3,688 for snacks not covered by Supplier.Total Cost for six months is$218,164. 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 3,219 Clothes and hygiene items for six months$3,219 for clothes and items needed for personal hygiene. 2008 Medication Supports 455,700 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, $110K Dr.Grossman yearly($86.4K annual+$23,6K for follow up appointments). Nutritionist is$3,400 yearly.Total per year is$911,400,for six months is$455,700. 2009 Program Supplies-Medical 35,491 Program Supplies Medical-Contracted with Omnicare Pharmacy,Medline Industries, Lab Diagnostics,X-rays,and other suppliers.This cost is based on current trend.This cost varies based on census and needed services per client and program supplies.This budget is based on trend Jul'24-Jan'25+3%COLA. 2010 Utility Vouchers - 2011 Translation Services 2,771 Translation Services:This cost is based on current trend.It varies based on the need and lengths of stay of some clients needing this service.This budget is based on trend Jul'24- Jan'25+3%COLA. 2012 Laudry Services 10,101 Laundry&Linen:The supply,cleaning,and management of linens.This includes cleaning and replacement of bed and bath linen.This budget is based on trend Jul'24- Jan'25+3%COLA. 2013 Client Needs - 2014 Other(specify) 2015 Other(specify) 2016 1 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACcr#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 3000:DIRECT OPERATING EXPENSES 51,436 3001 Telecommunications 23,747 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.The cost of TPX Phone internet$28,994,Comcast$2,840,Verizon$960, Comcast Fiber$7,812, Arista Cloud,and$450+TMobile$336=$41,392+$6,101 in Employee Phone/internet reimbursement$6,101(includes($1536=for 8 staff from HR/QA/Training at 20%allocation at$80 per month)+$965 =(for Administrator at $120 per month at 67%for PHF)+3600=for the Coordinator,DON,and Director at $100 per month)for full year.Total full year is$47,493,23,747 for six months.We are also waiting on the release of new rates happening annually.We would like to have $2,041 buffer for new rates in case of inflation. 3002 Printing/Postage - 3003 Office,Household&Program Supplies 18,007 This line item includes various program services such as confidential material shredding service,water dispenser fee,postage,carrier,and license fees.This includes city license, Join Commission,Fire department inspection.This cost also includes various household items such as cleaning supplies,and food disposable supplies such as cups and paper plates used mostly by clients.The yearly cost is FedEx,First Choice,Office Depot,Pacific Shredding,Subscriptions,and Licenses.This budget is for 6 months+3%COLA. 3004 Advertising - 3005 Staff Development&Training 7,085 Staff Training/Registration:This cost includes on-going program required education, Education training,Staff Certifications,and training materials for staff.This cost is based on current trend+3%COLA. 3006 Staff Mileage 1,000 Staff Mileage/Vehicle maintenance:Estimated staff travel reimbursement for supplies shopping,training,and meetings for 6 months at current trend of$971 per six months+ $29, 3%COLA. 3007 Subscriptions&Memberships - 3008 Vehicle Maintenance 3009 Recruitment 1,597 Recruitment: Fees for background check and random drug testing.This cost is based on current trend. 3010 Other(specify) - 3011 Other(specify) 3012 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACcr#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 4000:DIRECT FACILITIES&EQUIPMENT 14,782 4001 Building Maintenance 5,182 Building Maintenance:This cost includes six months of repairs and maintenance for PHF facility,Fresno County invoices for 6 months were$4,834.We are adding$348 for six months($58 monthly)for shared allocation cost at 3433 W Shaw for Central Star Admin. PHF Kernl1117.6%1112,0263357 PHF Fresno[07.2%S2,026[$348 CRT Fresno®.6%1112,0263194 TAY Fresnol11.6%S2,026[]$235 All-Star Fresno®5.6%t$2,026G$316 WRAP Fresno®.8%$2,026[S199 CRU Merced®0.2%$2,0263207 CBHST Stanislaus8.4%$2,026r$107 4002 Rent/Lease Building 2,115 Rent/Lease Building:Administration area at 3433 W Shaw a shared cost of Central Star Administration staff.Allocation as follows: Jul-Dec'2026 rent for 15%of space for Admin Central is$12,296 for six months. PHF Kernl17.6%11I355.2[]$2,164 PHF Fresno®7.2%S347.11]$2,115 CRT Fresno9.6%%93.8[]$1,180 TAY Fresnol11.6%S234.1[]$1,426 All-Star Fresno®5.6%t$314.8G$1,918 WRAP Fresno®.8%$197.8C$1,205 CRU Mercedl10.2%$205.9C$1,254 CBHST Stanislaus8.4%$169.51$1,033 4003 Rent/Lease Equipment 6,196 Rent/Lease Equipment:Copier lease,toner,and equipment maintenance.This is based on Central IT department trend.We have two copiers that cost average$373 per item per month=2 x$373 x 6=$4,476-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.This is based on 6 months trend at$1720.Total amount for PHF Fresno is$6196 for six months. 4004 Rent/Lease Vehicles - 4005 Security 989 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 based on current trend+3%COLA. 4006 Utilities 300 Utilities:Cost of utilities for the Central Administration shared location at 3433 W Shaw. The cost is allocated among Central programs,trend for PHF is$305 for six months. This cost doesn't include PHF location. PHF Kern $1771 x 17.6% =$312 PHF Fresno $1771 x 17.2% =$3050 CRT Fresno $1771 x 9.6%=$1700 TAY Fresno $1771 x 11.6% _$205M All-Star Fresno $1771 x 15.6% =$276M WRAP Fresno $1771 x 9.8% _$1741] CRU Merced $1771 x 10.2% =$181M CBHST Stanislaus $1771 x 8.4% _$149 4007 Other(specify) 4008 Other(specify) 4009 Other(specify) 4010 1 Other(specify) 5000:DIRECT SPECIAL EXPENSES 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 1 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 6000:INDIRECT EXPENSES 630,652 6001 Administrative Overhead 6002 Professional Liability Insurance - 6003 Accounting/Bookkeeping - 6004 External Audit 3,424 External Audit:This is for external annual audits fees as per county agreement.Annual cost for PHF Fresno from Supplier is approximately$6,847 per year,$3,424 for six months. The allocation is based on revenue projection as follows: PHF Fresno 23%, $6,847 All-Star Fresno 11%,$3,275 TAY Fresno 10%,$2,977 WRAP Fresno 13%,$3,870 CRT Fresno 9%,$2,679 CRU Merced 11%,$3,275 CBHST 6%,$1,786 PHF Kern 17%,$5,061 6005 Insurance(Specify): 24,732 Liability Insurance:General liability,property,and professional liability.The cost for PHF Fresno is at$4,122 per month.Insurance cost report file will be provided along with this budget.The cost of insurance is based on multiple factors that are calculated in an extensive worknbook with multiple worksheets.Will be provided as requested. 6006 Payroll Services 296 Payroll services:ADP supplier fee for printed and electronic payroll check stubs.Fresno PHF receives approximately 65 paycheck processes per pay period x 26 pay periods per year x$.35 cents per payment process=$.35 x 65 x 26=$592/2(six month term)_ $296 for six months. 6007 Depreciation(Provider-Owned Equipment to be Used 6008 Personnel(Indirect Salaries&Benefits) - 6009 Centralized Services Private/Other County 110,214 This item includes centralized fiscal service allowed profit from private insurance and other counties.Calculated at 10%of the total other revenue.Calculates as yearly Other Revenue Private$1,425,790+Other Revenue Out of County$778,482=$2,204,272 x .10=$220,427/2=$110,214 for six months. 6010 Centralized Services Fiscal-Fresno 117,841 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.Calculation is $2,970,363*.04=$118,815 6011 Centralized Services Administration 273,980 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%.Calculation is$2,970,363 .093=$276,244 6012 Centralized Services Program 100,165 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.Calculated as$2,970,363*.034=$100,992. 6013 Other s ecif Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 7000:DIRECT FIXED ASSETS 22,419 7001 Computer Equipment&Software 21,863 The annual services are for Microsoft Office,$21,090,Azure Microsoft Cloud data center,$10,000,Microsoft web online app,$3,060,Microsoft CoPilot,$1,566,Microsoft email protection,$1,914,PDF Pro$1,150,Security awareness$1,131,Misc software badge maker app,PDF writer app,Dragon naturally speaking software,$3,815.The total is$43,726 annually, $21,863 for six months. 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA - 7003 Furniture&Fixtures 556 For furniture replacement and repair. 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: 3,549,341 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 3,549,341 BUDGET CHECK: - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Psychiatric Health Facility Services Central Star Behavioral Health, Inc Fiscal Year(FY)2025-26-JAN-JUN'26 PROGRAM EXPENSES 1000:DIRECT SALARIES&BENEFITS Direct Employee Salaries Acct# Administrative Position FTE Admin Program Total 1101 Admistrator 0.67 $ 57,509 $ 57,509 1102 HR 0.86 32,533 32,533 1103 QA 1.07 47,361 47,361 1104 Training 0.52 20,656 20,656 1105 - 1106 - 1107 1108 1109 1110 1111 1112 1113 1114 1115 Direct Personnel Admin Salaries Subtotal 3.12 $ 158,060 $ 158,060 Acct# Program Position FTE Admin Program Total 1116 Director of Nursing(DON) 1.00 $ 75,928 $ 75,928 1117 Clinical Director 1.00 61,776 61,776 1118 Program Coordinator 1.00 48,601 48,601 1119 Social Worker 4.00 186,900 186,900 1120 Peer Support 2.00 51,667 51,667 1121 Recreation Therapist 1.00 40,435 40,435 1122 Rehabilitation Aid 3.00 78,707 78,707 1123 RN/NC 1.40 80,998 80,998 1124 YC/Safety Specialist 17.80 473,865 473,865 1125 LVN/LPT 9.00 373,379 373,379 1126 Admissions Coordinator 1.40 58,322 58,322 1127 Clerk/Discharge Coordinator 3.00 75,345 75,345 1128 Housekeeper 1.50 36,796 36,796 1129 - - 1130 - 1131 - 1132 - 1133 - 1134 - Direct Personnel Program Salaries Subtotal 47.10 $ 1,642,719 $ 1,642,719 Admin Program Total Direct Personnel Salaries Subtotal 50.22 $ 158,060 $ 1,642,719 $ 1,800,779 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 Direct Employee Benefits Acct# Description Admin Program Total 1201 Retirement $ 7,113 $ 73,923 $ 81,036 1202 Worker's Compensation 3,161 32,854 36,016 1203 Health Insurance 17,387 180,700 198,087 1204 Other(specify) - - - 1205 Other(specify) - - 1206 Other(specify) - - - Direct Employee Benefits Subtotal: $ 27,661 $ 287,477 $ 315,139 Direct Payroll Taxes&Expenses: Acct# Description Admin Program Total 1301 OASDI $ 9,800 $ 101,849 $ 111,649 1302 FICA/MEDICARE 2,467 26,458 28,925 1303 SUI 852 12,859 13,711 1304 Other(specify) - - - 1305 Other(specify) - - 1306 Other(specify) - - - Direct Payroll Taxes&Expenses Subtotal: $ 13,119 $ 141,166 $ 154,285 DIRECT EMPLOYEE SALARIES&BENEFITS TOTAL: Admin Program Total $ 198,840 $ 2,071,363 $ 2,270,203 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 Clothing, Food,&Hygiene 218,164 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 3,219 2008 Medication Supports 455,700 2009 Program Supplies-Medical 35,491 2010 Utility Vouchers - 2011 Translation Services 2,771 2012 Laudry Services 10,101 2013 Other(specify) - 2014 Other(specify) 2015 Other(specify) - 2016 Other(specify) - DIRECT CLIENT CARE TOTAL $ 725,446 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 3000:DIRECT OPERATING EXPENSES Acct# Line Item Description Amount 3001 Telecommunications $ 23,747 3002 Printing/Postage - 3003 Office, Household&Program Supplies 18,007 3004 Advertising - 3005 Staff Development&Training 7,085 3006 Staff Mileage 1,000 3007 Subscriptions&Memberships - 3008 Vehicle Maintenance - 3009 Recruitment 1,597 3010 Other(specify) - 3011 Other(specify) 3012 Other(specify) DIRECT OPERATING EXPENSES TOTAL: $ 51,436 4000:DIRECT FACILITIES&EQUIPMENT Acct# Line Item Description Amount 4001 Building Maintenance $ 5,182 4002 Rent/Lease Building 2,179 4003 Rent/Lease Equipment 6,196 4004 Rent/Lease Vehicles - 4005 Security 989 4006 Utilities 300 4007 Other(specify) - 4008 Other(specify) 4009 Other(specify) 4010 Other(specify) DIRECT FACILITIES/EQUIPMENT TOTAL:j $ 14,846 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(specify) - 5006 Other(specify) - 5007 Other(specify) - 5008 Other(specify) DIRECT SPECIAL EXPENSES TOTAL: $ - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 6000:INDIRECT EXPENSES Acct# Line Item Description Amount 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 3,424 6005 Insurance(Specify): 24,732 6006 Payroll Services 296 6007 Depreciation(Provider-Owned Equipment to be Usedfor Program Purposes) - 6008 Personnel(Indirect Salaries&Benefits) - 6009 Centralized Services Private/Other County 110,214 6010 Centralized Services Fiscal-Fresno 124,512 6011 Centralized Services Administration 289,491 6012 lCentralized Services Program 105,835 6013 1 Other(specify) - INDIRECT EXPENSES TOTAL $ 658,504 INDIRECT COST RATE 21.35% 7000:DIRECT FIXED ASSETS Acct# Line Item Description Amount 7001 Computer Equipment&Software $ 21,863 7002 Copiers,Cell Phones,Tablets, Devices to Contain HIPAA Data - 7003 Furniture&Fixtures 556 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 $ 22,419 TOTAL PROGRAM EXPENSES $ 3,742,854 PROGRAM FUNDING SOURCES 8000-SHORT/DOYLE MEDI-CAL(FEDERAL FINANCIAL PARTICIPATION) Acct# Estimated Specialty Mental Health Services Billing Totals: $ 2,223,770 Estimated%of Clients who are Medi-Cal Beneficiaries 61% Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries 1,356,500 Federal Financial Participation (FFP)% 50% 678,250 8001 Medi Cal Specialty Mental Health Services MEDI-CAL FFP TOTAL $ 678,250 8100-SUBSTANCE USE DISORDER FUNDS Acct# Line Item Description Amount 8101 Drug Medi-Cal $ - 8102 SABG $ - SUBSTANCE USE DISORDER FUNDS TOTAL $ - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 8200-REALIGNMENT Acct# Line Item Description Amount 8201 lRealignment 1 $ 2,640,718 REALIGNMENT TOTAL $ 2,640,718 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 MHSA TOTAL $ 8400-OTHER REVENUE Acct# Line Item Description Amount 8401 Client Fees $ 8402 Client Insurance 8403 Grants(Specify) - 8404 Other(Private Insurance) 712,895 8405 1 Other(Out of County) 389,241 OTHER REVENUE TOTALI $ 1,102,136 TOTAL PROGRAM FUNDING SOURCES: $ 3,742,854 NET PROGRAM COST: $ (0) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Psychiatric Health Facility Services Central Star Behavioral Health, Inc Fiscal Year (FY) 2025-26 JAN-JUN'26 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 PHF/BHS/Fresno 0.67 Administrator CRT/BHS/Fresno 0.33 Total 1.00 Position Contract#/Name/Department/County FTE QA PHF Bakersfield 0.41 QA PHF/BHS/Fresno 0.40 QA CRT/BHS/Fresno 0.19 QA QA PHF/BHS/Fresno 0.67 QA CRT/BHS/Fresno 0.33 Total 2.00 Position Contract#/Name/Department/County FTE HR PHF Bakersfield 0.88 HR PHF/BHS/Fresno 0.86 HR CRT/BHS/Fresno 0.48 HR TAY/BHS/Fresno 0.58 HR All-Star/BHS/Fresno 0.78 HR W RAP/BHS/Fresno 0.49 HR CRU/BHS/Merced 0.51 HR CBHST/BHS/Stanislaus 0.42 Total 5.00 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Position Contract#/Name/Department/County FTE Training PHF Bakersfield 0.53 Training PHF/BHS/Fresno 0.52 Training CRT/BHS/Fresno 0.29 Training TAY/BHS/Fresno 0.35 Training All-Star/BHS/Fresno 0.47 Training WRAP/BHS/Fresno 0.29 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 Contract#/Name/Department/County FTE Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 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 Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 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 Revised Exhibit C-1 Psychiatric Health Facility Services Central Star Behavioral Health,Inc Fiscal Year(FY)2025-26-JAN-JUN'26 Budget Narrative PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000:DIRECT SALARIES&BENEFITS 2,270,203 Administrative Positions 158,060 1101 Admistrator 57,509 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.The Administrator represents the CSBH agency and its programs to governmental agencies and the community. (Remainder of FTE is for overseeing the CRT). PHF Fresno G$79.48 x 1040 x 67%=$57,509 CRT Fresno $79.48 x 1040 x 33%=$28,326 1102 HR 32,533 Human Resources:This team manages all human resource clerical and administrative 1103 QA 47,361 QA:This team is responsible for utilization review and assisting in medical record 1104 Training 20,656 Training:This team has primary responsibility for development,coordination,and 1105 0 - 1106 0 1107 0 1108 0 1109 0 1110 0 1111 0 1112 0 1113 0 1114 0 1115 10 Program Positions 1,642,719 0 1116 Director of Nursing(DON) 75,928 Director of Nursing: Pay rate is$70.30per hour x 1080 hours for Jan-Jun'26=$75,928 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 61,776 Clinical Director: Pay rate is$57.20 per hour x 1080 hours for Jan-Jun'26=$61,776 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.He/she acts as liaison with external agencies and internal teams with other clinical&support staff. Functions as a key management team member in all administrative and program duties. 1118 Program Coordinator 48,601 Program Coordinator: Pay rate is$45.00 x 1080 hours for Jan-Jun'26=$48,601 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 24/7 basis. 1119 Social Worker 186,900 Social Worker: Pay rate is$43.26 per hour x 4 FTE x 1080 hours for Jan-Jun'26=$186,900 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. 1120 Peer Support 51,667 Peer Support Specialist/Counselor: Pay rate is$23.92 per hour x 2 FTE x 1080 hours for Jan-Jun'26=$51,667 This team of 2,provides outreach,advocacy,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. Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT# LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1121 Recreation Therapist 40,435 Recreation therapist: Pay rate is$37.44 per hour x 1080 hours for Jan-Jun'26=$40,435 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. 1122 Rehabilitation Aid 78,707 Rehabilitation Aide: Pay rate is$23.82 per hour x 2%OT=$24.292 per hour x 3 FTE x 1080 hours for Jan-Jun'26= $78,707 The Rehabilitating Aide provides direct and indirect rehabilitation services to adolescent clients through individualized and/or group activities. 1123 RN/NC 80,998 Charge&Registered Nurse: Pay rate is $51.51 per hour x 1.40 FTE x 1040 hours for Jul'25-Dec'25=$74,999 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. 1124 YC/Safety Specialist 473,865 Youth Counselor/Safety Specialist: Pay rate is$23.25 per hour x 6%OT=$24.649 per hour x 17.80 FTE x 1080 hours for Jan- Jun'26=$473,865 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. Youth high acuity and Conservatorship requires Physician ordered interventions such as 1:1 supervision,line of sight supervision,which requires additional Youth Counselors. Conservatorship 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. 1125 LVN/LPT 373,379 LVN/LPT: Pay rate is$37.44 per hour x 2.6%OT=$38.413 per hour x 9 FTE x 1080 hours for Jan- Jun'26=$373,379 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. Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#J LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1126 Admissions Coordinator 58,322 Admissions Coordinator: Pay rate is$36.98 per hour x 4.3%OT=$38.573 per hour x 1.40 FTE x 1080 hours for Jan- Jun'26=$58,322 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. 1127 Clerk/Discharge Coordinator 75,345 Clerk/Receptionist/Discharge Coordinator: Pay rate is$23.25 x 3 FTE x 1080 hours for Jan-Jun'26=$75,345 This position 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. 1128 Housekeeper 36,796 Housekeeper: Pay rate is$22.71 x 1.50 FTE x 1080 hours for Jan-Jun'26=$36,796 This position performs a variety of tasks to ensure that the facility is in a clean,orderly, sanitary,and attractive condition. 1129 0 1130 0 1131 0 1132 0 1133 0 0 1134 10 1 - 0 0 Direct Employee Benefits 0 1201 Retirement 81,036 Retirement:based on 4.5%of salary expense.This includes ESOP,401k employer match, and Life Insurance/AD&D.The total benefits and especially the retirement benefit has been underfunded in the PHF contract. This adjusts the total benefits to be 26%of wages which is on par with our other County contracts. 1202 Worker's Compensation 36,016 Worker Compensation:based on 2%of salary expense 1203 Health Insurance 198,087 Health insurance:based on 11%of salary expense 1204 Other(specify) - 1205 Other(specify) 1206 1 Other(specify) 0 Direct Payroll Taxes&Expenses: 154,285 0 1301 OASDI 111,649 OASDI Payroll Taxes:based on 2024 rates at 6.2%. 1302 FICA/MEDICARE 28,925 FICA Payroll Taxes:based on 2024 rates 1.45%plus FUTA at.8%per the first$7,000 of each employee wages. 1303 SUI 13,711 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#of FTE x 3.9%) 1304 Other(specify) - 1305 Other(specify) 1306 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACCT#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 2000:DIRECT CLIENT SUPPORT 725,446 2001 Child Care - 2002 Client Housing Support 2003 Client Transportation&Support - 2004 Clothing,Food,&Hygiene 218,164 This item includes the cost of meals and food for clients.Morrison Supplier cost per year 2005 Education Support - 2006 Employment Support - 2007 Household Items for Clients 3,219 Clothes and hygiene items for six months$3,219 for clothes and items needed for 2008 Medication Supports 455,700 Medication Supports-Psychiatrists,Nurse Practitioner,and MD services.Psychiatrists 2009 Program Supplies-Medical 35,491 Program Supplies Medical-Contracted with Omnicare Pharmacy,Medline Industries, 2010 Utility Vouchers - 2011 Translation Services 2,771 Translation Services:This cost is based on current trend.It varies based on the need and 2012 Laudry Services 10,101 Laundry&Linen:The supply,cleaning,and management of linens.This includes 2013 Other(specify) - 2014 Other(specify) 2015 Other(specify) 2016 1 Other(specify) 3000:DIRECT OPERATING EXPENSES 51,436 3001 Telecommunications 23,747 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.The cost of TPX Phone internet$28,994,Comcast$2,840,Verizon$960, Comcast Fiber$7,812, Arista Cloud,and$450+TMobile$336=$41,392+$6,101 in Employee Phone/internet reimbursement$6,101(includes($1536=for 8 staff from HR/CW/Training at 20%allocation at$80 per month)+$965 =(for Administrator at $120 per month at 67%for PHF)+3600=for the Coordinator,DON,and Director at $100 per month)for full year.Total full year is$47,493,23,747 for six months.We are also waiting on the release of new rates happening annually.We would like to have $2,041 buffer for new rates in case of inflation. 3002 Printing/Postage - 3003 Office,Household&Program Supplies 18,007 This line item includes various program services such as confidential material shredding 3004 Advertising - 3005 Staff Development&Training 7,085 Staff Training/Registration:This cost includes on-going program required education, 3006 Staff Mileage 1,000 Staff Mileage/Vehicle maintenance:Estimated staff travel reimbursement for supplies 3007 Subscriptions&Memberships - 3008 Vehicle Maintenance - 3009 Recruitment 1,597 Recruitment: Fees for background check and random drug testing.This cost is based on 3010 Other(specify) - 3011 Other(specify) 3012 Other(specify) Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020 Revised Exhibit C-1 PROGRAM EXPENSE ACcr#I LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 4000:DIRECT FACILITIES&EQUIPMENT 14,846 4001 Building Maintenance 5,182 Building Maintenance:This cost includes six months of repairs and maintenance for PHF facility,Fresno County invoices for 6 months were$4,834.We are adding$58 monthly for shared allocation cost at 3433 W Shaw for Central Star Admin. 4002 Rent/Lease Building 2,179 Rent/Lease Building:Administration area at 3433 W Shaw a shared cost of Central Star Administration staff.Allocation as follows: Jul-Dec'2026 rent for 15%of space for Admin Central is$12,668 for six months, additional$373 for rent increase from Term 1. PHF KernO 17.6%$355.21$2,230 PHF Fresnol17.2%$347.1[$2,179 CRT Fresno®.6%$193.80$1,216 TAY Fresnol11.6%I$234.1[$1,470 All-Star Fresno®5.6%$314.81$1,976 WRAP Fresno9.8%I$197.81$1,242 CRU Merced®0.2%I$205.9[$1,292 CBHST Stanislaus8.4%t$169.51$1,064 4003 Rent/Lease Equipment 6,196 Rent/Lease Equipment:Copier lease,toner,and equipment maintenance.This is based 4004 Rent/Lease Vehicles - 4005 Security 989 Security:Camaras and Security services cost.Security is for the cost of service and the 4006 Utilities 300 Utilities:Cost of utilities for the Central Administration shared location at 3433 W Shaw. 4007 Other(specify) - 4008 Other(specify) 4009 Other(specify) 4010 Other(specify) 5000:DIRECT SPECIAL EXPENSES 5001 Consultant(Network&Data Management) 5002 HMIS(Health Management Information System) 5003 Contractual/Consulting Services (Specify) 5004 Translation Services 5005 Other(specify) 5006 Other(specify) 5007 Other(specify) 5008 Other(specify) 6000:INDIRECT EXPENSES 658,504 6001 Administrative Overhead - 6002 Professional Liability Insurance 6003 Accounting/Bookkeeping - 6004 External Audit 3,424 External Audit:This is for external annual audits fees as per county agreement.Annual 6005 Insurance(Specify): 24,732 Liability Insurance:General liability,property,and professional liability.The cost for PHF 6006 Payroll Services 296 Payroll services:ADP supplier fee for printed and electronic payroll check stubs.Fresno 6007 Depreciation(Provider-Owned Equipment to be Used - 6008 Personnel(Indirect Salaries&Benefits) - 6009 Centralized Services Private/Other County 110,214 This item includes centralized fiscal service allowed profit from private insurance and 6010 Centralized Services Fiscal-Fresno 124,512 This item includes centralized fiscal allowed profit from Fresno County.Calculated at 4% 6011 Centralized Services Administration 289,491 Centralized services-Administrative Overhead-This is an allocation from Stars 6012 Centralized Services Program 105,835 Centralized Program Services:Is comprised of the SBHG corporate and regional support 6013 1 Other(specify) 7000:DIRECT FIXED ASSETS 22,419 7001 Computer Equipment&Software 21,863 The annual services are for Microsoft Office,$21,090,Azure Microsoft Cloud data center,$10,000,Microsoft web onl app,$3,060,Microsoft Copilot,$1,566,Microsoft email protection,$1,914,PDF Pro$1,150,Security awareness$1,131,Misc software badge maker app,PDF writer app,Dragon naturally speaking software,$3,815.The total is$43,726 annually, $21,863 for six months. 7002 Copiers,Cell Phones,Tablets,Devices to Contain HIPAA - 7003 Furniture&Fixtures 556 For furniture replacement and repair. 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) TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE: 3,742,854 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE: 3,742,854 BUDGET CHECK: - Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020