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HomeMy WebLinkAboutP-25-525 Procurement Agreement.pdf CO,U County of Fresno GENERAL SERVICES DEPARTMENT Facilities• Fleet• Purchasing• Security O� 185 IO FRVn PROCUREMENT AGREEMENT Agreement Number P-25-525 October 21, 2025 Fresno Interdenominational Refugee Ministries (FIRM) 1940 N Fresno St. Fresno, CA 93703 The County of Fresno (County) hereby contracts with Fresno Interdenominational Refugee Ministries (FIRM) to expand the doula workforce in Fresno County through a Doula Workforce Expansion Program in accordance with the text of this agreement, Attachment"A-C" by this reference made a part hereof. TERM: This Agreement shall become effective November 1, 2025 and shall remain in effect through November 30, 2026. EXTENSION: This Agreement may be extended for two (2)additional one (1)year periods by the mutual written consent of all parties. MINIMUM ORDERS: Unless stated otherwise there shall be no minimum order quantity. The County reserves the right to increase or decrease orders or quantities. CONTRACTOR'S SERVICES: Contractor shall perform the services as described in Attachment"A", Attachment"B", and Attachment"C" attached, at the rates set forth in Attachment"A". ORDERS: Orders will be placed on an as-needed basis by the Department of Public Health under this contract. PRICES: Prices shall be firm for the contract period. MAXIMUM: In no event shall services performed and/or fees paid under this Agreement be in excess of one-hundred thirty-one thousand, three-hundred twenty-six and seventy-six cents ($131,326.76). ADDITIONAL ITEMS: The County reserves the right to negotiate additional items to this Agreement as deemed necessary. Such additions shall be made in writing and signed by both parties. DELIVERY: The F.O.B. Point shall be the destination within the County of Fresno. All orders shall be delivered complete as specified. All orders placed before Agreement expiration shall be honored under the terms and conditions of this Agreement. DEFAULT: In case of default by Contractor, the County may procure the articles/services from another source and may recover the loss occasioned thereby from any unpaid balance due the Contractor or by any other legal means available to the County. The prices paid by County shall be considered the prevailing market price at the time such purchase is made. Inspection of deliveries or offers for delivery, which do not meet specifications, will be at the expense of Contractor. Purchasing Services/333 W Pontiac Way/Clovis, California 93612/(559) 600-7110 *The County of Fresno is an Equal Employment Opportunity Employer* PROCUREMENT AGREEMENT NUMBER: P-25-525 Page 2 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 INVOICING: An itemized invoice shall be sent to requesting County department in accordance with invoicing instructions included in each order referencing this Agreement. The Agreement number must appear on all shipping documents and invoices. Invoice terms shall be Net 45 Days. INVOICE TERMS: Net forty-five (45) days from the receipt of invoice. TERMINATION: The County reserves the right to terminate this Agreement upon thirty (30) days written notice to the Contractor. In the event of such termination, the Contractor shall be paid for satisfactory services or supplies provided to the date of termination. LAWS AND REGULATIONS: The Contractor shall comply with all laws, rules and regulations whether they be Federal, State or municipal, which may be applicable to Contractor's business, equipment and personnel engaged in service covered by this Agreement. AUDITS AND RETENTION: Terms and conditions set forth in the agreement associated with the purchased goods are incorporated herein by reference. In addition, the Contractor shall maintain in good and legible condition all books, documents, papers, data files and other records related to its performance under this contract. Such records shall be complete and available to Fresno County, the State of California, the federal government or their duly authorized representatives for the purpose of audit, examination, or copying during the term of the contract and for a period of at least three years following the County's final payment under the contract or until conclusion of any pending matter(e.g., litigation or audit), whichever is later. Such records must be retained in the manner described above until all pending matters are closed. LIABILITY: The Contractor agrees to: Pay all claims for damage to property in any manner arising from Contractor's operations under this Agreement. Indemnify, save and hold harmless, and at County's request defend the County, its officers, agents and employees from any and all claims for damage or other liability, including costs, expenses (including attorney's fees and costs), causes of action, claims or judgments resulting out of or in any way connected with Contractor's performance or failure to perform by Contractor, its agents, officers or employees under this Agreement, and from any and all costs and expenses (including attorney's fees and costs), damages, liabilities, claims, and losses occurring or resulting to any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of Contractor, its officers, agents, or employees under this Agreement. INSURANCE: Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the following insurance policies or a program of self-insurance, including but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA)throughout the term of the Agreement: A. Commercial General Liability: Commercial general liability insurance with limits of not less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000). This policy must be issued on a per occurrence basis. Coverage must include products, completed operations, property damage, bodily injury, personal injury, and advertising injury. The Contractor shall obtain an endorsement to this policy naming the County of Fresno, its officers, agents, employees, and volunteers, individually and collectively, as additional insureds, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insureds will apply as primary insurance and any other insurance, or self-insurance, maintained by the County is excess only and not contributing with insurance provided under the Contractor's policy. B. Automobile Liability: Automobile liability insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence for bodily injury and for property damages. Coverage must include any auto used in connection with this Agreement. C. Professional Liability: Professional liability insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence and an annual aggregate of Three Million Dollars ($3,000,000). If this is a claims-made policy, then (1)the retroactive date must be prior to the date on which services began P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Page 3 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 under this Agreement; (2)the Contractor shall maintain the policy and provide to the County annual evidence of insurance for not less than five years after completion of services under this Agreement; and (3) if the policy is canceled or not renewed, and not replaced with another claims-made policy with a retroactive date prior to the date on which services begin under this Agreement, then the Contractor shall purchase extended reporting coverage on its claims-made policy for a minimum of five years after completion of services under this Agreement. D. Worker's Compensation: Workers compensation insurance as required by the laws of the State of California with statutory limits. Additional Requirements Relating to Insurance: Contractor shall obtain endorsements to the Commercial General Liability insurance naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned. Such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by County, its officers, agents and employees shall be excess only and not contributing with insurance provided under Contractor's policies herein. This insurance shall not be cancelled or changed without a minimum of thirty (30)days advance written notice given to County. Contractor hereby waives its right to recover from County, its officers, agents, and employees any amounts paid by the policy of worker's compensation insurance required by this Agreement. Contractor is solely responsible to obtain any endorsement to such policy that may be necessary to accomplish such waiver of subrogation, but Contractor's waiver of subrogation under this paragraph is effective whether or not Contractor obtains such an endorsement. Within Thirty (30) days from the date Contractor signs and executes this Agreement, Contractor shall provide certificates of insurance and endorsement as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Department of Public Health, ATTN: Contracts Section-6`floor PO Box 11867, Fresno, CA 93775 or DPHContracts@fresnocountyca.gov, stating that such insurance coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and employees will not be responsible for any premiums on the policies; that such Commercial General Liability insurance names the County of Fresno, its officers, agents and employees, individually and collectively, as additional insured, but only insofar as the operations under this Agreement are concerned; that such coverage for additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by County, its officers, agents and employees, shall be excess only and not contributing with insurance provided under Contractor's policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written notice given to County. Certificates of Insurance are to include the contract number at the top of the first page. In the event Contractor fails to keep in effect at all times insurance coverage as herein provided, the County may, in addition to other remedies it may have, suspend or terminate this Agreement upon the occurrence of such event. All policies shall be with admitted insurers licensed to do business in the State of California. Insurance purchased shall be purchased from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. COMING ON COUNTY PROPERTY TO DO WORK: Contractor agrees to provide maintain and furnish proof of Comprehensive General Liability Insurance with limits of not less than $500,000 per occurrence. INDEPENDENT CONTRACTOR: In performance of the work, duties and obligations assumed by Contractor under this Agreement, it is mutually understood and agreed that Contractor, including any and all of Contractor's officers, agents, and employees will at all times be acting and performing as an independent contractor, and shall act in an independent capacity and not as an officer, agent, servant, employee,joint venturer, partner, or associate of the County. Furthermore, County shall have no right to control or supervise or direct the manner or method by which Contractor shall perform its work and function. However, County shall retain the right to administer this Agreement so as to verify that Contractor is performing its obligations P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Page 4 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 in accordance with the terms and conditions thereof. Contractor and County shall comply with all applicable provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof. Because of its status as an independent contractor, Contractor shall have absolutely no right to employment rights and benefits available to County employees. Contractor shall be solely liable and responsible for providing to, or on behalf of, its employees all legally-required employee benefits. In addition, Contractor shall be solely responsible and save County harmless from all matters relating to payment of Contractor's employees, including compliance with Social Security, withholding, and all other regulations governing such matters. It is acknowledged that during the term of this Agreement, Contractor may be providing services to others unrelated to the County or to this Agreement. NON-ASSIGNMENT: Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties under this Agreement without the written consent of the other party. AMENDMENTS: This Agreement constitutes the entire Agreement between the Contractor and the County with respect to the subject matter hereof and supersedes all previous negotiations, proposals, commitments, writings, advertisements, publications, Request for Proposals, Bids and understandings of any nature whatsoever unless expressly included in this Agreement. This Agreement supersedes any and all terms set forth in Contractor's invoice. This Agreement may be amended only by written addendum signed by both parties. INCONSISTENCIES: In the event of any inconsistency in interpreting the documents which constitute this Agreement, the inconsistency shall be resolved by giving precedence in the following order of priority: (1)the text of this Agreement (excluding Attachment"A-C"); (2)Attachment"A-C". GOVERNING LAWS: This Agreement shall be construed, interpreted and enforced under the laws of the State of California. Venue for any action shall only be in County of Fresno. ELECTRONIC SIGNATURES: The parties agree that this Agreement may be executed by electronic signature as provided in this section. A. An "electronic signature" means any symbol or process intended by an individual signing this Agreement to represent their signature, including but not limited to (1) a digital signature; (2) a faxed version of an original handwritten signature; or(3) an electronically scanned and transmitted (for example by PDF document) of a handwritten signature. B. Each electronic signature affixed or attached to this Agreement (1) is deemed equivalent to a valid original handwritten signature of the person signing this Agreement for all purposes, including but not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. C. The provisions of this section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). D. Each party using a digital signature represents that it has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a), paragraphs (1)through (5), and agrees that each other party may rely upon that representation. This Agreement is not conditioned upon the parties conducting the transactions under it by electronic means and either party may sign this Agreement with an original handwritten signature. Please acknowledge your acceptance by returning all pages of this Agreement to my office via email or USPS. Please refer any inquiries in this matter to Amber Siner, Purchasing Analyst at 559-600-7117 or asiner@fresnocountyca.gov. P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Page 5 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 FOR THE COUNTY OF FRESNO Digitally signed Rleyckburn Riley Blackburn Date:2025.11.14y11:16:3B3a08'00' Riley Blackburn Purchasing Manager 333 W. Pontiac Way Clovis, CA 93612 P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Page 6 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 CONTRACTOR TO COMPLETE: Company: Fresno Interdenominational Refugee Ministries (dba FIRM) Type of Entity: ❑ Individual ❑ Limited Liability Company ❑ Sole Proprietorship ❑ Limited Liability Partnership Corporation ❑ General Partnership 1940 N. Fresno Fresno CA 93703 Address City State Zip 559.487.1500 559.487.1550 yaomee@firminc.org TELEPHONE NUMBER FAX NUMBER E-MAIL ADDRESS Print Name & Matias Bernal, Board Treasurer Title: Print Name &'Jils" Signature: Tho-Lee(Nov iz,zozsis:nz:z9PST) Signature: ACCOUNTING USE ONLY ORG No.: 56201715 Account No.: 7295 Requisition No.: 5622600249 (7/2024) P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 1 of 3 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 ATTACHMENT'A" Budget-Contract Term:November 1,2025-November 30,2026 Vendor Name:Fresno Interdenominational Refugee Ministries BUDGET SUMMARY BUDGET CATEGORIES Total Cost PERSONNEL EXPENSES Salaries $16,129.86 Payroll Taxes $1,209.74 Benefits $1,693.64 Subtotal Personnel $19,033.23 SERVICES&SUPPLIES EXPENSES Doula Training Program Facilitators $38,016.00 Doula Mentors $12,000.00 Doula Training Guest Speakers $4,000.00 Doula Trainee Stipends $20,000.00 Doula Graduation Ceremony $9,794.00 Professional Certification Payments $8,000.00 Professional Liability Coverage for $7,000.00 Doulas Rent $2,850.00 Office supplies $1,800.00 utilites $6,000.00 printing $253.52 nonpersonnel liability insurance $2,580.00 Subtotal Services&Supplies $112,293.52 Indirect Expenses $0.00 TOTAL EXPENSES $131,326.76 P-25-525 Procurement Agreement PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 2 of 3 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 PERSONNEL DETAIL Position %FTE on Salary or Total Cost Description/Justification Project Hourly Wage Expense is to cover Finance Director's time to oversee Finance&Operations Director 5% $88,000.00 $4,230.77 financial records and reconciliations of expenses relating to program.$88,000*0.05 FTE=$4,230.77 for 12 months Expense is to cover Bookkeeper's time in processing Bookkeeper 6% $24.50 $2,940.00 payroll,check requests,and financial record keeping relating to program.$24.50*120 hrs=$2,940. Expense is to cover ED's time overseeing project and Executive Director 7% $95,000.00 $6,909.09 ensuring deliverables are met.$95,000*0.07 FTE_ $6,909.09 for 12 months Expense is to cover Office Manager's time in assisting Office Manager 5% with printing and prepping for monthly activities relating to g $20.50 $2,050.00 project.$20.50*100 hrs during a 12 month period= $2,050 Total Salaries $16,129.86 Payroll Taxes $1,209.74 Tax calculation at 7.5% Benefit Item Total Cost Description/Justification Health Benefits $887.14 Health benefit calculation at 5.5% Retirement Plan $483.90 Retirement benefit calculation at 3% Work Comp $322.60 Work Comp calculation at 2% $0.00 Total Benefits $1,693.64 July 2025 2 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 3 of 3 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 SERVICES&SUPPLIES DETAIL BUDGET CATEGORIES Subtotal Total Cost Description/Justification/Calculations Trained Facilitators responsible for coordinating and implementing the HCO Doula Training Program Facilitators $38,016.00 curriculum Experienced Doula providing one-on-one mentorship and real world training Doula Mentors $12,000.00 guidance.Monthly gift card compensation to ensure retention of quality mentors and acknowledge their significant time commitment in supporting doula trainee development. Specialized experts providing focused training on critical topics.$100 Doula Training Guest Speakers $4,000.00 honorarium per session ensures access to qualified professionals who bring valuable expertise and real-world perspective to enhance the training curriculum Doula Trainee Stipends $209000.00 Stipend payments incentivize program completion while reducing financial barriers to participation. Doula Graduation Ceremony $9,794.00 Celebrates participant achievement and professional development Professional Certification Payments $8,000.00 doula practice including HIPAA certification,CPR certification,and back d c rounhecks Professional Liability Coverage for our ina a in l ua coverage protessional nonmedical is i i y for doulas Doulas $7,000.00 in order to participate in training,observations and build their capacity for first year of their services Rent $2,850.00 Monthly rent=$2,375*10%allocated to cover space usage for staff on the project=$237.50*12 months=$2,850. Office supplies $13800.00 Supplies purchase will include admin shared office supplies such as printing papers,file folders,pens,and sticky notes Monthly shared utility cost for project at 10%of FIRM's overall monthly utilites $6,000.00 utility expense estimation of$5,000 per month printing $253.52 Shared cost of monthly printing expense. Organizational liability insurance $2,580.00 employees for non-medical professional services x 12 months=$1,800 Total Services&Supplies $112,293.52 July 2025 3 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 1 of 4 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Attachment "B" Scope of Work Fresno Interdenominational Refugee Ministries (FIRM) Fresno County Doula Workforce Expansion Program Service Specific Activities Deliverables Outcomes Area/Core Function Doula Training • Support implementation of • Curriculum implementation • Maintain 80%participant Curriculum Health Connect One(HCO) plan attendance rate for training Implementation doula training curriculum, • Training schedule with sessions consisting of 20 interactive dates,times,and locations • Complete 100% of sess 1 Ons •Attendance logs for all 20 scheduled training modules •Utilize staff who are sessions on time certified HCO facilitators to •Participant progress tracking • Achieve 90%participant assist with: system retention rate throughout •Pre/post training the program • Planning and assessments •Document 100% of facilitating • Training materials(digital participant progress and curriculum sessions and print) completion status • Coordinating training •Monthly training progress • Increase in participant logistics including reports knowledge and skills as venue setup, measured by pre/post scheduling, and assessments technology needs • Preparing training materials for all participants • Adapting curriculum content to reflect cultural needs of Fresno County's diverse communities while maintaining fidelity to core components • Conducting pre and post assessments of participant knowledge and skills PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 2 of 4 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Financial Process and distribute all • Monthly payment • Process 100% of Management and program payments according processing logs payments within 30 days of Fund Distribution to FCDPH PEI established • Recipient payment authorization schedules: documentation with • Maintain 100%accuracy signatures in payment distributions • Program facilitators: • Gift card distribution • Ensure all program Monthly payments at records participants receive $22/hour(maximum •Budget tracking spreadsheet payments according to 12 hours per week for • Financial reconciliation schedule each facilitator) reports PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 3 of 4 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Doula Mentors: • Fund distribution schedule • Document 100% of Distribute$100 Visa • Payment method financial transactions with gift cards monthly to documentation required supporting each mentor • Monthly financial reports to materials • Doula Trainee PEI Coordinator • Support program stipends:Three-part retention through timely payments of$500 per financial incentives participant: Initial payment($167), Mid-Program payment($167), Final payment$ 166 • Guest Speakers: $100 Visa gift card per session • Professional Certifications: Process payments for HIPAA, CPR, and Background checks • Doula Graduation Ceremony:Process all expense payments as directed by FCDPHPEI Maintain fiscal oversight and accountability: • Track all expenditures against the approved budget • Maintain detailed financial records and payment documentation • Reconcile all financial transactions monthly • Implement financial controls to ensure accuracy and prevent fraud • Provide regular financial status updates to FCDPH PROCUREMENT AGREEMENT NUMBER: P-25-525 Attachment Page 4 of 4 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Administrative • Prepare and maintain • Tax documentation files • Submit 100%of monthly and Fiscal accurate tax documentation • Monthly invoices with invoices by the 15th of Compliance (W-9, 1099 forms) for all supporting documentation each month payments processed • Secure filing system • Complete 100% of • Submit detailed monthly required tax documentation invoices to FCDPH by the on time 15th of each month • Pass any financial audits • Establish and maintain with minimal findings organized filing system for •Maintain compliance with all financial documents all county and state fiscal • Secure and protect requirements confidential financial and •Respond to financial personal information information requests within • Respond to audit requests 2 business days and information needs Program • Participate in biweekly • Meeting attendance logs • Maintain 95%attendance Coordination and meetings with FCDPH PEI • Communication logs rate at required FCDPH Communication staff • Payment schedule meetings • Serve as fiscal liaison coordination documentation •Ensure clear between program • Issue resolution communication regarding participants and FCDPH documentation all financial matters • Coordinate payment •Resolve payment issues schedules with program within 3 business days implementation timeline •Maintain positive • Communicate payment relationships with all status and updates to FCDPH program stakeholders PEI staff • Support program success • Collaborate with FCDPH through effective fiscal PEI staff to resolve payment coordination issues • Minimize payment delays • Document decisions and disruptions regarding fund disbursement • Maintain regular communication with all payment recipients Financial • Design and implement • Comprehensive financial • Provide 100%accurate Tracking and comprehensive financial tracking system financial data for program Reporting tracking systems • Monthly financial status management • Generate monthly financial reports • Support program reports detailing all • End of Fiscal Year financial evaluation through transactions summary report comprehensive financial • Maintain electronic data database of all financial • Identify and address transactions budget concerns •Prepare final program proactively financial summary report •Ensure transparent financial management Attachment "C" �CDPH California Ue1h.11—t of Public Health Maternal, Child and Adolescent Health Division Fiscal Administration Policy & Procedure Manual oil I , %= to This manual applies to Local Health Jurisdictions (LHJs) and Community Based Organizations (CBOs) operating the: • Maternal, Child and Adolescent Health (MCAH) Program • Black Infant Health (BIH) Program • Adolescent Family Life Program (AFLP) • California Home Visiting Program (CHVP) • Perinatal Equity Initiative (PEI) PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 TABLE OF CONTENTS AdministrativeFunding ............................................................................................. 7 Overview ......................................................................................................................... 7 HRSA Grants — Title V Block Grant and MIECHV............................................................ 7 StateGeneral Funds ....................................................................................................... 8 AgencyFunds ................................................................................................................. 8 CertifiedPublic Funds...................................................................................................... 9 Title XIX Medi-Cal Funds ................................................................................................. 9 Community Based Organizations (CBOs)................................................................... 9 GrantRequirements ...................................................................................................... 10 UEI and SAM.GOV Registration Requirements........................................................ 10 AgencyResponsibilities............................................................................................ 10 Noncompliance Consequences ................................................................................ 10 Federal Financial Participation............................................................................... 11 Overview..........................................................................................................................11 Documentation for FFP Claiming................................................................................... 11 Policy.......................................................................................................................... 11 Documentation ......................................................................................................... 12 FFP Ineligible Activities............................................................................................. 12 ClaimingFFP Funds................................................................................................. 13 FFPTime Studies.......................................................................................................... 13 Requirements ........................................................................................................... 13 Time Study Data Summary Report Format............................................................... 14 FFP Time Studies & Function Codes........................................................................ 16 Reimbursement Rates & Function Codes................................................................. 18 Additional Time Worked............................................................................................ 20 July 2025 3 . California Department of kI Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 FFPFunction Codes................................................................................................. 20 FFP (Title XIX) Decision Tree ....................................................................................21 SPMP Requirements: Professional Classification .......................................................... 22 Policy........................................................................................................................ 22 SPMP Requirements Professional Education and Training ........................................... 23 Policy........................................................................................................................ 23 Procedure................................................................................................................. 23 Example of SPMP Questionnaire.............................................................................. 24 SPMP Requirements: Activity........................................................................................ 25 Policy........................................................................................................................ 25 Title XIX Claiming Cover Letter................................................................................. 25 AttestationForm ....................................................................................................... 30 Medi-Cal Percentage (MCP).................................................................................... 31 Policy............................................................................................................................. 31 Base Medi-Cal Percentage............................................................................................ 31 AFLP Base Medi-Cal Percentage ............................................................................. 31 BIH Program Base Medi-Cal Percentage.................................................................. 31 MCAH Program Base Medi-Cal Percentage............................................................. 31 Local Medi-Cal Percentage MCP................................................................................... 32 Multiple Medi-Cal Percentage MCP For Single Staff...................................................... 32 Weighted Medi-Cal Percentage..................................................................................... 33 Variable Medi-Cal Percentage....................................................................................... 34 MCAH Director- Medi-Cal Percentage (MCP)............................................................... 35 Policy........................................................................................................................ 35 Procedure................................................................................................................. 35 Requirements ........................................................................................................... 36 July 2025 4 . California Department of kI Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 MCP Annual AFA Justification letter.............................................................................. 37 Policy........................................................................................................................ 37 Title V 30/30 Earmarking.......................................................................................... 38 Overview ....................................................................................................................... 38 Requirements ........................................................................................................... 38 TitleV Time Studies ...................................................................................................... 38 BudgetsDocuments................................................................................................. 39 Overview ....................................................................................................................... 39 Budget/Invoice Template............................................................................................... 39 BudgetSummary........................................................................................................... 40 Procedure................................................................................................................. 40 (1) Personnel............................................................................................................. 41 (II) Operating Expenses............................................................................................ 43 (III) Capital Expenditures .......................................................................................... 47 (IV) Other Costs........................................................................................................ 47 (V) Indirect Cost........................................................................................................ 48 BudgetRevisions ..................................................................................................... 50 Overview ....................................................................................................................... 50 Requirementsfor BR's................................................................................................... 50 Invoices and Payments ............................................................................................ 51 Invoices ......................................................................................................................... 51 Invoice Submission (How to Submit Your Invoice).................................................... 51 Special Considerations............................................................................................. 53 Supplemental Invoices.............................................................................................. 54 Invoice Detail Worksheet.......................................................................................... 54 InvoiceDeadlines ..................................................................................................... 55 July 2025 5 . California Department of kI Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Payments ...................................................................................................................... 55 MaximumAmounts Payable ..................................................................................... 55 Reimbursement Limitations ...................................................................................... 55 Recovery of Overpayments ...................................................................................... 56 Procedures ............................................................................................................... 56 PaymentWithholds................................................................................................... 57 Audits ........................................................................................................................... 58 Overview ....................................................................................................................... 58 On-Site Technical Assistance Reviews.......................................................................... 58 CorrectiveAction Plan ................................................................................................... 58 AuditRequirements....................................................................................................... 59 Remedies for Audit Noncompliance............................................................................... 59 Terms and Conditions ............................................................................................. 60 General Terms and Conditions...................................................................................... 60 Special Terms and Conditions....................................................................................... 60 Additional MCAH Provisions .......................................................................................... 60 Subcontract Requirements ....................................................................................... 60 Audit and Record Retention...................................................................................... 61 Capital Expenditures and Inventory Controlled Items................................................ 62 EquipmentDisposition.............................................................................................. 62 Glossary of Terms and Acronyms ........................................................................ 63 July 2025 6 k. California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Administrative Funding Overview Under the California Department of Public Health (CDPH), the State Maternal, Child and Adolescent Health (MCAH) administers federal and state funds to local partners to promote the health of women of reproductive age, pregnant women, mothers, infants, children, and adolescents in California. State MCAH will administer funds to Local Health Jurisdictions (LHJs) and Community Based Organizations (CBOs) annually through contracts and/or allocation agreements. All contracts and allocation agreements are subject to federal and state funding appropriations. Funding sources that support MCAH activities include the Title V Block Grant, the Maternal, Infant and Early Childhood Home Visiting Grant (MIECHV), State General Funds (SGF), and Title XIX (Medicaid) Funds. HRSA Grants - Title V Block Grant and MIECHV The Title V Block Grant is federally administered by the Health Resources and Services Administration (HRSA). Title V Block Grant funds are used to reimburse MCAH, Black Infant Health (BIH), and Adolescent Family Life Program (AFLP) program expenses incurred for activities consistent with the goals and purposes of the grant. The Title V Block Grant is authorized under the Social Security Act of 1935. CDPH/MCAH applies annually for Title V funds to maintain Title V programs. CDPH/MCAH may use Title V Block Grant funds for the provision of health services and related activities (including planning, administration, education, and evaluation) in accordance with the CDPH/MCAH application. The Title V Block Grant funds may not be used for cash payments to intended recipients of health services or for purchase of land, buildings, or major medical equipment. Title V funds help each state to: • Assure access to quality maternal and child health care services for mothers and children, especially for those with low-incomes or limited availability of care. • Reduce infant mortality. • Provide access to prenatal, delivery, and postnatal care, especially for pregnant women who are low-income. • Increase regular screenings and follow-up diagnostic and treatment services for children who are low-income. • Provide access to preventive and primary care services for children who are low-income and rehabilitative services for children with special health needs. • Implement family-centered, community-based, systems of coordinated July 2025 7 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 care for children with special health care needs. • Set up toll-free hotlines and assistance with applying for services to pregnant women with infants and children eligible for Medicaid. Pursuant to the Federal Social Security Act (42 U.S.C., Section 704), the Agency cannot use Title V or MIECHV funds to: • Provide inpatient services. • Make cash payments to intended recipients of health services. • The purchase or improvement of land; construction; or permanent improvement (other minor remodel) of any building or facility, or the purchase of major medical equipment. • Satisfy any requirement for the expenditure of non-federal funds as a condition for the receipt of federal funds. • Provide funds to any entity other than a public or non-profit private entity for research or training services. • Payment for any item or service (other than an emergency item or service) furnished by: • An individual or entity during the period such individual or entity is excluded from participation in any other federally funded program, and/or • At the medical direction or on the prescription of a physician during the period when the physician is excluded from participation in any other federally funded program. State General Funds State General Funds (SGFs) are used to enhance and promote MCAH programs. Pursuant to Section 123255 of the California Health and Safety Code, SGFs are used to maximize the reimbursement of available federal funds claimable under Title XIX of the Federal Social Security Act (42 U.S.C., Sec. 1396 et seq.). Agency Funds Agencies contribute funds toward the total cost of operating and promoting MCAH programs. Pursuant to Section 123255 of the California Health and Safety Code, non- federal agency funds can maximize the use of available matching federal funds claimable under Title XIX of the Federal Social Security Act (42 U.S.C., Sec. 1396 et seq.). Agencies that receive Title V Block Grant funding and contribute Agency funds must report the Agency funds in the proposed program budget and the monthly/quarterly invoices. July 2025 g California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Certified Public Funds Title 42 of the Code of Federal Regulations (42 CFR), Section 433.51, which is based on the authority of Section 1903(a) of the Social Security Act, provides: (a) Public funds may be considered as the State's share in claiming Federal Financial Participation (FFP) if they meet the conditions specified in paragraphs (b) and (c) of this section. (b) The public funds are appropriated directly to the State or local Medicaid agency or transferred from other public agencies (including Indian tribes) to the State or local agency and under its administrative control or certified by the contributing public agency as representing expenditures eligible for FFP under this section. (c) The public funds are not federal funds, or are federal funds authorized by federal law to be used to match other federal funds. CBOs contracting with the CDPH/MCAH or subcontracting with an LHJ under MCAH Programs may utilize public funds that must be certified by a public agency as funds eligible for the drawdown of Federal Financial Participation. Questions regarding use of funds not identified should be directed to your assigned Contract Liaison. Title XIX Medi-Cal Funds Federal Title XIX Medi-Cal (Medicaid) funds may be used to reimburse a percentage of expenses incurred for personnel and associated operating costs for matchable activities. Title XIX matching funds are applicable only to programs that serve Medi-Cal members. The budget may include Title XIX federal funds matched at either an Enhanced rate (75% federal funds and with 25% agency general funds/SGF) or Non-Enhanced rate (50% federal funds and with 50% agency general funds/SGF). Agencies claiming Title XIX funding must conform to requirements contained in the FFP section of this Policy and Procedure Manual. Community Based Organizations (CBOs) CBOs receiving MCH Block Grant funds to provide AFLP services are eligible for FFP. The Non-Enhanced rate (50/50) can be claimed for any of the agency's staff involved in activities that are necessary for proper and efficient Medi-Cal administration. As non- government agencies, CBOs are prohibited by Federal regulations from claiming and receiving the Enhanced rate matching of 75/25. July 2025 9 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Grant Requirements UEI and SAM.GOV Registration Requirements All agencies receiving federal funds through the CDPH/MCAH must be registered with the federal System for Award Management (SAM.gov) and possess an active Unique Entity Identifier (UEI). This requirement applies to both direct recipients and subrecipients of federal funds. The UEI has replaced the legacy DUNS number and serves as the official identifier for federal awards. Agencies are required to comply with federal regulations: • 2 CFR Part 25 — Universal Identifier and System for Award Management • 2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards These requirements promote transparency, accountability, and regulatory compliance in the use of federal funds. Agency Responsibilities Agencies receiving federal funding must: 1. Obtain a UEI through SAM.gov prior to applying for or receiving federal funding (prior to initial Agreement Funding Application (AFA) process). 2. Maintain an active SAM.gov registration for the entire duration of the agreement. 3. Ensure that all subrecipients and subcontractors receiving federal funds are also registered in SAM.gov and fully compliant. 4. Provide verification of UEI and active SAM.gov registration upon request or as part of the award documentation. Noncompliance Consequences Failure to comply with UEI and SAM.gov registration requirements may result in: • Delays in contract execution • Suspension or withholding of federal funds • Disallowance of associated costs • Termination of the funding agreement • CDPH/MCAH reserves the right to purse corrective actions or enforcement measures in accordance with 2 CFR 200.339 in cases of noncompliance by a subrecipient. July 2025 10 ��� California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Federal Financial Participation Overview Fiscal support for programs is available from federal Medicaid Title XIX funds. This fiscal support is called Federal Financial Participation (FFP). The LHJs, i.e., city or county health departments, and CBOs responsible for the public health needs in the designated geographic area can claim partial reimbursement through FFP Title XIX funds. Programs can claim FFP funds when activities meet at least one (1) of the two (2) FFP objectives: 1 . Assisting individuals eligible for Medi-Cal to enroll in the Medi-Cal program. 2. Assisting members on Medi-Cal to access Medi-Cal services. The Centers for Medicare and Medicaid Services (CMS) regulations allow matching for administrative activities that are reimbursable at a Non-Enhanced rate (50/50) for the majority of expenses necessary for the proper and efficient administration of the Medi-Cal program. CMS also allows reimbursement at an Enhanced rate (75/25) for certain activities performed by Skilled Professional Medical Personnel (SPMP) that require specified education and/or training, as well as their direct clerical support that require specified education and/or training, as well as their direct clerical support. This reimbursement: 1. is provided through matching Medi-Cal Title XIX funds with local agency general funds and/or State MCAH allocated SGF to maximize funding for the Program. 2. applies to personnel employed directly by an FFP participating agency or subcontracted agency. Documentation for FFP Claiming Policy The following types of documentation must be part of the agency's time study/FFP audit file: • Organization chart(s) • Job specification for each SPMP position • Position duty statement for each employee • Training log, agenda/brochure of training, and registration receipt • Correspondence related to CDPH/MCAH FFP policies • Supporting documentation • Working papers used to calculate/develop invoices • SPMP questionnaire for claiming status • Signed time studies July 2025 11 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 3ocumentation Supporting documentation to verify and substantiate appropriate Title XIX claiming and percentages of FFP matching must be maintained at all times and, when applicable, provided during on-site audits and/or by written request by CDPH/MCAH. Examples of supporting documentation include daily logs, appointment books, event flyers, meeting agendas with minutes, calendars, journals, and day planners. This documentation must identify the following: • Staff name(s), Position(s), and applicable Title XIX matchable program(s) • Date of each activity or activities • Amount of time spent on each activity or activities • Narrative description of activities conducted and how they support the applicable • Number of clients seen or contacted (target audience), which should be broken out by Medi- Cal eligible clients versus non-Medi-Cal eligible clients whenever possible. Documentation submitted to CDPH can be deidentified and aggregated for reporting purposes, but original records should be maintained in the case of an audit by CDPH or State control agency. • When using a variable Medi-Cal Percentage (MCP), verification and documentation of Medi-Cal enrollment is required (see the Medi-Cal Percentage section of this manual for more information). Time study documents, including supporting documentation, must be kept for a minimum of seven years from the date of the last payment for the fiscal year, and must be presented to MCAH upon request at any time. FFP Ineligible Activities* The following list summarizes the Medi-Cal activities and/or services that are not eligible for federal reimbursement: • Other Programs/Activities • Direct Patient Care • Outreach to Non Medi-Cal Programs • Referral, Coordination, and Monitoring of Non Medi-Cal Services • Facilitating Non Medi-Cal Application • Arranging and/or Providing Non-Emergency, Non-Medical Transportation to a Non Medi-Cal covered Service • Contract Administration for Non Medi-Cal Services • Program Planning and Policy Development for Non Medi-Cal Services • Non-Targeted Case Management *See full list in the DHCS County-Based Medi-Cal Administrative Activities (CMAA) Operational Plan. Additional examples of unallowable FFP expenses include but are not limited to: • Malpractice insurance • Equipment used for providing medical treatment July 2025 12 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Medical Supplies • Drugs and Medications • Payments made to resolve audits • Costs of elected officials and their related costs • Costs for lobbying activities • Fund Raising Note: If you have questions regarding allowable activities, please consult your Program Consultant. Claiming FFP Funds There are two factors that determine the amount of FFP funds an agency can claim: 1. Title XIX time studied activities 2. Agency's Medi-Cal Percentage (MCP) FFP Time Studies To claim Medi-Cal Title XIX funds, agency budgeted staff must document, through time studies, actual staff time worked in all programs during the time study period. Time studies are the primary documentation source of FFP and used to determine the percent of personnel time that is matchable and non-matchable. The time claimed to receive FFP match must be spent performing Medi-Cal administrative activities that meet at least one of the two FFP objectives. Requirements Each person listed on a program budget claiming Title XIX activities (full-time, part- time, or temporary staff) must complete weekly time studies that document 100% of their paid work time for a minimum of one full month each quarter and submit a state MCAH time study data summary form or alternate approved format. Note: At times of a state of emergency, such as the COVID-19 pandemic, staff may be required to time study everyday as a perpetual time study until CDPH/MCAH provides guidance that the requirement is no longer necessary. July 2025 13 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 ime-Study Uato Report for Summary of FFP (Q.1) AGENCY- TIME STUDY PERIOD: LAST NAME: TIME 5TUDY MONTH: FIRST NAME- JOB TITLE- SPMP= TIME BASE: The percentages below are based on the program activities performed by this staff member and can only be used to invoice for the Fiscal Year and Time Study Period entered above, Directions-Please enter the budget line number,program name;and Medi-Cal Factor(MCFI%far each program the staff vrcrks in. For subprograms or MCAH,BIH,ARLP,enter them after the main program name e_g_,KWM-SIDS Percentage Distribution of Staff Time by Program Program % of Referen Budget Not Non- time in Medr-Cal ce Line# Program Matchable Enhanced Enhanced Pro ram' Factor'1. A --- ------------ -- -------------- ---- --------------------- -- ---------------- ---------------- .--------- ---- --------- _--- --------------. B C D E IF G -.... ...... ........... .... .............................................. ................... ............--------.................... .......--........I- I ................ Staff FFP Report MCAH Dlr Note: Prior approval of an alternate time study format or data collection system must be approved by MCAH prior to implementation. Agencies must retain MCAH written approval for audit and administrative purposes while receiving MCAH Funding and provide such information to MCAH upon request. Annually during the AFA process, all MCAH agencies must designate in writing their time study month as (1 st, 2nd, or 3rd month) and must remain constant with the time study period throughout the fiscal year. Any deviation from the approved period must be pre-approved by the MCAH Program Consultant and Contract Liaison via formal written approval. Time Study Data Summary Report Format All MCAH funded agencies must use the MCAH developed time study template unless they have received formal written approval to use an alternate template. If an alternate time study data summary report format is approved, it must be consistent with the MCAH Time Study Data Summary Report components identified below: • Agency name • Time study period • Time study month • First and last name of employee • Employee classification or title July 2025 14 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Time base (e.g., full-time or part-time) • Employee eligible for SPMP (e.g., "yes" or"no") • Budget line number • Percent of time studied to each program listed • Percentage of time by activity classification o Enhanced (75/25) o Non-Enhanced (50/50) o Unmatched - Not eligible for any Title XIX matching funds • If applicable, MCP for each program and/or employee listed The signed invoice package submission certifies and verifies all documents including the time studies. If staff does not conduct a time study within the required time study period, FFP is not claimable, and your invoice will be rejected. Please consult your Contract Liaison and Program Consultant with any time study questions. July 2025 15 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 FFP Time Studies & Function Codes: The time study report is the mechanism used to document reimbursable activities performed by staff. There are 12 total function codes used to identify these unique set of activities, including paid time-off. When completing the time study, enter a time to the appropriate function code (1-12) and a program code (A-L) into each weekly slot. Time worked in programs other than MCAH programs must be coded to Other Programs. See example below: FFP Monthly Time Study Calculation Allocated Functions Manual Entry of Funedon Code Week1 Week2 Weekl Weak1 Weeks Totals Toml 10 12 3 00 7.00 3.00 3.00 Program A: MCAH Manual Entry of Function Code Weak Weak Week Weak Week5 Totals Total Al 3.00 3.00 A2 6.00 8.00 A3 3.00 3.00 A4 1-00 6 00 7.00 A5 A6 700 7.00 Al 0.50 2.00 2.50 AB A91 2.00 1 1 1 1 11.00 A11111 0.50 1 8.00 1 3.00 1 111.50 22.00 14.00 8.00 44.00 Program B: MCAH-SIDS Manual Entry of Function Code WeekI Weak Weak Weak4 Met,5 Totals Total Bl B2 B3 114 135 B6 B7 BB 09 B11 1 00 3 00 6.00 1000 1.00 3.00 6.00 f0.00 Program C: BIH Manual Entry of .Function Code Week 1114e1t2 R11111111111 Week3 111feak4 MM1ek5 Totals Total cl C2 C3 4.00 4.00 C4 C5 C6 5.00 5.00 C7 CB C9 C 19 40.00 2000. 10.00 70.00 4.00 40.00 20.00 15.00 79.00 Program D: Other Programs Manual Entry of Function Code Week 1 Week 2 Week 3 Week Week 5 Totals Total D7 D2 5.00 5.0D D3 3.00 3.00 D4 8 00 3.00 11.00 D5 D6 D7 DB 8.00 8.00 D9 D11 16.00 11.00 17.00 Note: Time spent doing the following administrative activities associated with a function code is to be considered as time spent doing the function. • The performance of necessary paperwork, travel, and supervision including the supervision of the SPMP staff by a SPMP supervisor. • Employee break time is coded to the activity the employee is engaged in immediately before or July 2025 16 California Department of kk Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • after the break period. Lunchtime is NOT coded because it is unpaid time. Once the data entry portion of the Title XIX time study is filled out, the information rolls onto the Title XIX summary page. Time-Study Data Report for Summary of FFP(v3.1) AGENCY; Bean Ccanty TIME STUDY PERIOD:July-September(01) LAST NAME: Smith TIME STUDY MONTH:August FIRST NAME; I.tary JOB TITLE: PHPI SPMP: Yes TIME BASE: Full-Time The percentages below are based on the program activities performed by this staff member and can only be used to invoice for the Fiscal Year and Time Study Period entered above. Directin—Please em•erthe budget line number,program name,and Medi-Gat Factor(MCF)%for each program the staff umrks in. For subprograms of MCAH,BIN,AFLP,enter them after the main program name e.g.,MCAH-SIDS Percentage Distribution of StaffTime by Program %of Program Budget time in Medi-Cal Reference Line t Program Not Matchable Non-Enhanced i Enhanced Program" Factor% A 1 MCAH 54.20% 17.61% 28.18% 28.03% 62.0% - - - - ............................................... . . . . . . . ---------------------------------- - - ------------------ ----------------------- B 2 MCAH SIDS 100.011% 6.37% 62.0% -------- ----- ------------=--------- --- ------------------ --------------------- C b BIH 90.32% 9.68% 50.32% 85.0% -- -- - D Dther programs 100.00% 1s.29'6 '-'--'-'----......-'------"...........•............... .... .............................................. E ............'-"---"-'---"-----".................................. .............................................. F G ...................................................... ......-".................................... ..................." H K L Total 100,00 4 This information is to be used by agencies to determine the percentage of staff salap that is billable to MCAH Programs.It can be used by agencies that do not maintain a daily record of program time. Once the function codes and program codes are entered for each week, the time study report calculates the percent of time, by program, that staff is allowed to claim within four rates of reimbursement. The rates are: • Enhanced (75/25)— Reimbursement for Medi-Cal administrative activities performed by a Skilled Professional Medical Personnel (SPMP) and/or clerical support staff directly supervised by a SPMP that are directly necessary for the completion of the professional medical responsibilities and functions of the SPMP. In addition to the qualification of the SPMP personnel, the activity must require the use of their professional medical knowledge, training, and/or expertise. The rate of reimbursement is $0.75 for every dollar expended for activities that meet one of the two FFP objectives. • Non-Enhanced (50/50) — Reimbursement for Medi-Cal administrative activities performed by any of the agency's staff. The rate of reimbursement is $0.50 for every dollar expended for activities July 2025 17 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 that meet one of the two FFP objectives. • Not eligible for Title XIX (Unmatched) — Reimbursement for activities performed by agency staff that meet the requirements of the Scope of Work but do not meet one of the two FFP objectives. This may be claimed under Title V, State General Funds or Agency funds. • Allocated — Reimbursement for costs, which are prorated according to the ratio of time recorded under the above rates. Reimbursement Rates & Function Codes Each rate of reimbursement is unique in its reimbursement formula. Within the four rates, there are a total of 12 function codes. Each function code has a definable and unique set of activities that are performed by staff. Consequently, all activities and paid time-off are identified under the function codes in the appropriate reimbursement class. Enhanced Rate Enhanced rate function codes are reimbursed at the rate of 75/25 and may be used for salary, benefits, travel costs, training, and possibly subcontract costs. Subcontractor costs can be enhanced if the subcontractor is a governmental agency contracted by a governmental agency that time study (Refer to the Budget Documentation Section, for detailed information). The Enhanced rate covers activities performed by a SPMP and/or clerical support staff when directly supervised by a SPMP that are directly necessary for the completion of the professional medical responsibilities and functions of the SPMP under the following function codes: Title/DescriptionFunction Code 2 SPMP Administrative Medical Case Management 3 SPMP Intra/Interagency Coordination, Collaboration & Administration 6 SPMP Training 8 SPMP Program Planning & Policy Development 9 Quality Management by SPMP Non-Enhanced Rate Non-Enhanced rate function codes are reimbursed at the rate of 50/50 for salary, benefits, training, travel costs, and associated operating expenses. Subcontractor costs may be reimbursed at a Non- Enhanced rate if Title XIX requirements are met. July 2025 18 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 The Non-Enhanced rate covers activities under the following function codes: FunctionD- • • Code 1 Outreach 4 Non-SPMP Intra/Interagency Collaboration & Coordination 5 Program Specific Administration 7 Non-SPMP Training Not eligible for Title XIX (Unmatched Rate) The unmatched rate function code is for activities included in the Scope of Work (SOW) that may or may not meet one of the two FFP objectives. Title/DescriptionFunction Code 11 Other Scope of Work Activities Allocated Rate Allocated rate function codes are to be used by all staff to record usage of any paid leave other than Compensatory Time Off (CTO), including holiday, vacation, and sick leave. The allocated activities are covered by the following function codes: Title/DescriptionFunction Code 10 Non-Program Specific General Administration: Non-program specific general administration is prorated between programs and matchable and unmatchable function codes. The portion allocated as matchable may only be matched at the Non- Enhanced rate (50/50). 12 Paid Time Off: Paid Time Off is prorated between programs and matchable and unmatchable function codes. CMS permits the matchable amount to be proportionately distributed between the Enhanced (75/25) rate and the Non- Enhanced (50/50) rate. July 2025 19 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Additional Time Worked Overtime and/or CTO earned must be recorded to the function code appropriate for the activities performed. CTO time is recorded when earned, and NOT to be recorded when used. .-FP Function Codes Please note the function codes table has moved to MCAH Administrative Funding and Fiscal Documents page under Title XIX Function Codes. The Department of Health Care Services Title XIX Claiming Toolkit is also available to provide additional guidance and clarification to assist with appropriately documenting and seeking reimbursement for Title XIX matching funds through interagency agreements (IAs) maintained between DHCS and the California Department of Public Health (CDPH), California Department of Social Services (CDSS), and other state departments. July 2025 20 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 FFP (Title XIX) Decision Tree Title XIX Decision Tree Is this activity in the MCAH,CHVP, BIH. PEI or AFLP Scope of Work? YES NO Code to: "Other Programs" Does this activity meet Objective#1 or#2 of the FFP Guidelines? Objective#1 -Assisting individuals eligible for Medi-Cal to enroll in the PAedi-Cal program' Objective #2—Assisting members on IvIedi-Cal to access Medi-Cal covered benefits and services* YES NO Code to code 11 'Other Activities" 3. Does this activity require the skill, knowledge, and expertise of an SPMP? YES NO i i SPMPs only All staff includinq SPMPs Code to one of the Code to one of the following codes: following codes: 2. 3. 6. 8_ or 9 1. 4. 5. or 7 Code 10 Non-Program specific general administration: This code is to be used by staff when attending an Agency required meeting, training, staff development. etc. (Examples: Sexual Harassment training, Workplace Violence, IT Security. Any training or meeting that is mandatory for your employment). Code 12 Paid time off Sick Leave, Vacation, and Paid Holidays. "Includes MCAH program activities that support the proper and efficient administration of the Medi-Cal Program. Jul 2025 21 ,� California Department of Y *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 SPMP Requirements: Professional Classification Policy The Agency has the responsibility to substantiate claiming based on SPMP status. The Agency's job class specification must stipulate that the incumbent be from one of the following classifications and the Program duty statement must reflect enhanced and non- enhanced activities. Pursuant to Title 42, Code of Federal Regulations (CFR), Sections 432.2 and associated State policy, SPMP classifications include the following: • Physician • Registered Nurse • Physician Assistant • Dentist • Dental Hygienist • Registered Dental Assistant • Nutritionist—with a Bachelor of Science (BS)degree in Nutrition or Dietetics and registered with the Commission of Dietetic Registration (RD) • Licensed Clinical Social Worker with medical specialization or master's degree in social work • Licensed Vocational Nurse • Licensed Clinical Psychologist—with a PhD in psychology • Licensed Audiologist—certified by the American Speech and Hearing Association • Licensed Physical Therapist • Licensed Occupational Therapist— registered by the National Registry of American Occupational Therapy Association • Licensed Speech Pathologist • Licensed Marriage and Family, Therapist) SPMP includes only professionals in the field of medical care. SPMP does not include non- medical health professionals, such as public administrators, medical budget directors, analysts or senior managers of public assistance or Medicaid programs. Experience in the administration, direction or implementation of the Medicaid program is not considered the equivalent of professional training in a field of medical care. The following are not considered to be SPMP classifications consistent with federal guidance and state policy: • Master of Social Work without a Licensed Clinical Social Worker (LCSW) license • Master of Public Health (MPH) • Health Education Consultant (HEC) • Community Health Worker (CHW) July 2025 22 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 SPMP Requirements Professional Education and Training Policy Per 42 CFR, Chapter IV Subchapter C 432.50, for the enhanced FFP rate of 75 percent to be available for expenditures for salary or other compensation, fringe benefits, travel, per diem, and training for SPMPs, or staff directly supporting such personnel, the following requirements must be met: • The activities performed by the SPMP, or staff directly supporting such personnel, must be necessary for the proper and efficient administration of the Medicaid State Plan and must not include expenditures for medical assistance. • The staff designated as SPMP must have professional education and training in the field of medical care or appropriate medical practice. • "Professional education and training" means the completion of a 2-year or longer program leading to an academic degree or certificate in a medically related profession (42 CFR 432.2.(d) o This is demonstrated by possession of a medical license, certificate, or other document issued by a recognized National or State medical Iicensure or certifying organization; or o A degree in a medical field issued by a college or university certified by a professional medical organization. The activities performed by the SPMP must require the use of their professional medical knowledge, training, and/or expertise. • The staff supporting SPMPs are secretarial, stenographic, and copying personnel and file and records clerks who provide clerical services that are directly necessary for the completion of the professional medical responsibilities and functions of the SPMP. • The SPMP staff must directly supervise the supporting staff and the performance of the supporting staff's work. • The SPMP, and staff directly supporting such personnel, must have a documented employer- employee relationship. • The Agency must have a written agreement with the State to verify that the requirements listed above are met. Procedure Review the optional SPMP questionnaire that follows. If you find it would be a helpful resource, reach out to your Contract Liaison for the most recent version. Complete the optional SPMP questionnaire to determine the SPMP/non-SPMP status of an employee. The questionnaire needs to be administered only once, although periodic repetition may help the Agency to identify changes in staff education and composition. Retain any completed SPMP questionnaires as part of July 2025 23 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 the Agency's audit files while SPMP staff are employed with the Agency and through the documentation retention period. Example of SPMP Questionnaire i+.aNn Ca•k•MCV• Skilled Professional Medical Personnel S Directly Supporting Staff Questionnairf, PART I: INSTRUCTIONS Tnis Skilled Professional Medical Personnel (SPNIP) and Directly Supporting Staff(DSS I questionnaire is intended to be a helpful tool for our state and county partners to utilize in making determinations as to whether a specific position or classification performing certain activities qualifies for enhanced SPMP/DSS Title XIX claiming.' We encourage state and county partners to complete this SPMP/DSS questionnaire and maintain it as part of the supporting documentation for any enhanced SPMP/DSS Title XIX claiming. For additional guidance regarding enhanced Title XIX claiming, please note the following • This SPMP/DSS questionnaire is not intended to be a replacement for applicable federal statutes, regulations. or audits that outline requirements for SPMP/DSS claiming but instead is adjunctive to those resources. Please review the applicable federal law (Social Security Act 1903(2XA)) and regulations (Title 42 Code of Federal Regulations (CFR) Section 431. 1 —432 55), excerpted in relevant part below For the full text, please visit one of the following links o SSA Section 1903(2)LA), available at: https-/twwwssa.gov/OP Home/ssact/btIe19/1903 htm. 0 42 CFR Sections 432.1 -432.55, available at: https://www qpo govlfdsyslpkg/CFR-19%-title42-vol3/pdflCFR-IQQ- itie42- vol3-part432.pdf. • Each state and county partner claiming enhanced SPMP/DSS Title XIX expenditures must maintain supporting documentation evidencing compliance with applicable federal statutes, regulations and audits • For more information about enhanced SPMP/DSS Title XIX claiming, please refer to the Department of Health Care Services (DHCS)document titled "Title XIX Claiming, Expenditures and Invoicing Frequently Asked Questions.' which was provided to state partners separately DHCS will also post this document on the DHCS website PART II: SPMP CLASSIFICATIONS Please use the following questions to help determine if you an employer or supervisor filling the form out on behalf requirements for enhanced Title XIX funding for SP inforrhatcr•contained in this document Mona advice In addition Jul 2025 24 � California Department of y *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 SPMP Requirements: Activity Policy In addition to the qualifications of the provider meeting SPMP criteria, the activities performed by the SPMP must require the use of their professional medical knowledge, training, and/or expertise in order to qualify for enhanced matching funds. Work by directly supporting staff is also eligible for enhanced funding when secretarial, stenographic, and copying personnel and file and records clerks who provide clerical services that are directly necessary for the completion of the professional medical responsibilities and functions of the SPMP. The SPMP staff must directly supervise the supporting staff and the performance of the supporting staff's work. The SPMP and staff directly supporting such personnel must have a documented employer-employee relationship. The local or county partner must have a written agreement with the State to verify that the requirements listed above are met. Title XIX Claiming Cover Letter For invoices claiming enhanced SPMP Title XIX expenditures (including allocated rates for paid time off), LHJs must submit their invoices using a standardized detailed description letter and accompanying documentation to substantiate expenditures billed under the applicable inter-agency agreement. Each state department or LHJ claiming expenditures under an inter-agency agreement must submit a Title XIX Claiming Cover Letter (as shown below) which includes the following information: July 2025 25 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 ODepartment/County:Bean County Program Name: Maternal,Child and Adolescent Health(MCAH) Invoice Number(s):2022XX MCAH Ql ITotal amount of requested Yrtle XIX funding: $ 57,937.17 OFY and Quarter:FY 2022-232022.01 MCAH Ql Period(s)of Service: July-September 2 Direct Services(Types of services provided and to what population;include information about procedural safeguards to assure expenditures billed are only for Medi-Cal services.): Provided screening and case management services to Medi-Cal eligible children under 6 years of age residing in Bean County.Functions at the county level are used to indicate Medical eligibility; expenses billed under non-Medi-Cal eligible function codes are not included in this invoice. 4 Other Funds Hours:IN Hours:Enhanced Hours:Allocated (non-claimable) 50/50 (75/25 (50/50:75/25 Ratio) Quarter PCA Code(s): PCA Code(s): PCA Code(s): Paid Time Off Salary 53107&53112 53118 53117 SPMP with Function Code(s: Function Code(s): Function Code(s): Function Code(s): Eligible Fringe 10 11 1 4 5 7 2.3.6 8 9 12 `3 Name Classification (Y/N) Benefits Time Cost Time% Cost Time% Cost Time% Cost 1 May Trin MCAH Director N $37,736.87 83.2% $31,397.08 16.8% $6,339.79 0.0% $0.00 2 Michael Trinidad MCAH Coordinator Y $52,782.02 51.1-A $26,950.50 44.696 $23,540.78 4.3% $2,290.74 3 Ma Smith Public Health Nurse/SIDS Coordinator Y $27,217.13 61.8% $16,825.63 31.7% $8,627.83 65% $1,763.67 4 Adrianna Lopez Public Health Nurse Y $39,935.18 29.3% $11,697.01 19.7% $7,871.22 51.0% $20,366.94 5 Joanne Park Community Health Worker N $45,260.45 86.0% $38,923.99 14.0% $6,336.46 0.0% $0.00 6 Luke Whitewall Epidemiologist N $34,169A9 83.1% $28,377.76 17.0% $5,791.73 0.0% $0.00 7 8 9 10 Direct Service Expenses $0.00 300.0% $0.00 0.0% $0.00 0.0% $0.00 Indirect Costr $59,275.2 665.0% $3,,540.79 35.0% $20,734.49 Non-Reimbursable Amount $ $0.00 $0.00 $0.00 Total Expenditures 5 $192,712.76 $79,242.31 $24,421.35 $0.00 Title XIX federal funding: $39,621.16 $18,316.01 $0.00 G Summaryof otherfundin sources used for the Title XIX match,includingsource(e..,County Rea ent Funds,taxes,etc)totaling: $238,439.25 $10,000.00 expended from Bean County 2022 Realignment Fun t$10,225.08 expended from Blue County general fund(including property tax revenue). I certify underpenalty of perjury that the information provided on this document is true and correct to the best of my knowledge,based on actual expenditures incuaed for the period claim and that O in funds provided are in accordance with 42 CFR 433.51. Approved by: Title: Phone: Email:7 vgn ondprint name Health and Safety Code Sections 124060(322.2),124060(322.5),124070(323),124075(322.2)are the payment authority. p Attachment Invoice 8 Page 1 of 1 Instructions for Filling Out the Title XIX Claiming Cover Letter by Section 1. Header - Enter names of state department or county/LHJ and program (e.g., Maternal, Child, and Adolescent Health), invoice number(s), state fiscal year and quarter, and period(s) of service covered by the invoice. 2. Direct Services - (Yellow cell in the template) If the invoice includes direct services, provide information on the types of services provided and to what Medi-Cal population(s). Include information about procedural safeguards as to how the claiming state department or LHJ assures that the expenditures billed are for Medi-Cal members or services only. For example, some July 2025 26 * California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 programs use a dedicated billing code at the county level to designate Medi-Cal eligibility of a service recipient. Please ensure this is completed. 3. Staff Details — For staff providing direct services or support, provide the following: a) Names of individual staff persons (no initials, full name is required). Please ensure you are listing the full names under the personnel cells. First and Last names should be visible and not truncated. Extending the cell may be required. b) Use official state/LHJ classifications and titles (no acronyms for classifications or titles; Must match duty statements and organizational charts provided). For SPMP staff with a Director/Coordinator/Supervisory classification, please add Public Health Nurse, Registered Nurse, etc. c) Names and classifications— Please ensure all name and classification columns are wide enough to accommodate all the words. You may extend the cell/s if necessary. d) SPMP eligibility status, to be consistent with the Code of Federal Regulations (CFR), Title 42, https://www.ecfr..qov/current/title- 42/chapter-IV/subchapter- C/part-432 State Personnel Administration: i. "Skilled professional medical personnel means physicians, dentists, nurses, and other specialized personnel who have professional education and training in the field of medical care or appropriate medical practice and who are in an employer- employee relationship with the Medicaid agency. It does not include other nonmedical health professionals such as public administrators, medical analysts, lobbyists, senior managers or administrators of public assistance programs or the Medicaid program." (Excerpted from 42 CFR Section 432.2, emphasis added.) Note: Consistent with federal guidance, DHCS interprets medical care and practice strictly in accordance with 42 CFR Section 432.50, Subsection (d). ii. "Directly supporting staff means secretarial, stenographic, and copying personnel and file and records clerks who provide clerical services that directly support the responsibilities of [SPMP], who are directly supervised by the [SPMP], and who are in an employer-employee relationship with the Medicaid agency." (Excerpted from 42 CFR Section 432.2.) e) Monthly salary, with fringe benefits. 4. Hours — Non-Claimable, Non-Enhanced, Enhanced, and Allocated Paid July 2025 27 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Time Off (PTO) a. PCA and function codes should be those assigned to the services for each column. Note: Please attach forDHCS'records standard detailed descriptions of the reimbursable activities that fall under each PCA/function code claimed as an expenditure. A brief list of function names is not sufficient. b. Percentage of time worked per category of non-claimable or claimable function, from the period(s) of service for the invoice(s) summarized. Note: The calculation for Paid Time Off (PTO) is a weighted average that automatically calculates based upon the percentages of time the employee worked on Non- Claimable, Non-Enhanced, and Enhanced activities. For example, if an employee spent all of their work time performing Non-Enhanced activities, their paid time off will also be at the Non- Enhanced rate. However, if the employee spent only one-half of their time in the office at the Non-Enhanced rate, only one-half of the paid time off will be reimbursed at the Non- Enhanced rate. Please also note that the allocated cost of each employee's PTO is immediately visible at only its reimbursable portion, whereas the cost columns for Non- Enhanced and Enhanced activities show the total labor cost in each row and prorate to the reimbursable portion at the bottom, next to "Title XIX federal funding." Accordingly, the costs within each row may not add up to 100 percent of that employee's salary if any percent of their time is being reimbursed at the allocated rate for PTO. This does not indicate an error. The percentage of time worked for each row must include at least one number above zero in order for the automatic calculations to be correct. The default is to have 100 percent in the Hours: Non- Claimable column. Any TXIX cover sheet that includes excel value errors (#VALUE!) must be corrected by removing the zero under the "Total Wages" and/or "Actual Benefits" on the quarterly invoice tab. c. Direct service expenses. d. Indirect/ operating expenses (if allowed under the appropriate inter- agency agreement) are ineligible for enhanced or allocated rates. 5. Total amount of Title XIX federal funding being requested — These cells will automatically calculate subtotals for enhanced, non-enhanced, and allocated rates. The overall total federal funding requested appears at the top right of the cover letter 6. Summary of non-federal expenditures (Yellow cell) used for matching the Title XIX reimbursement. Please describe the qualifying expenditures, July 2025 28 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 including source (e.g., County Realignment Funds, taxes, etc.), in the box provided. 7. Approval —Sign and print name on printed copy. Please include official classification title (no acronyms), phone number, and email address. 8. Page numbers — Please add the current and total page numbers for the invoice submittal package. If the number of the employees for the invoice(s) summarized exceed the space on a single cover letter, include subsequent pages. Additional guidance on Title XIX funding for your reference: • CMS State Operations Manual available at cros.gov. • Medicaid Administrative Claiming available at medicaid.gov. • CMS Regulations & Guidance available at cros.gov. July 2025 29 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Attestation Form This form certifies that SPMP criteria for all enhanced classifications have been met. In addition, the form must be dated, completed in its entirety, and signed by authorized staff who have signing authority. Signing authority is defined as the person listed on your Agency Information Form (AIF) which was submitted with your AFA package, dated, boxes checked, and returned MCAHFinAct(a_)_cdph.ca.gov with a Cc to your Contract Liaison. This form only needs to be submitted at the beginning of the fiscal year with your AFA package, however, if there are changes within SPMP staffing, a new form must be submitted to your Contract Liaison. C D P H Health and Human Services Agency California Department of Public Health QO Erica Pan,MD, MPH Gavin Newsom Director and State Public Health Officer Governor Attestation of Compliance with the Requirements for Enhanced Title XIX Federal Financial Participation (FFP) Rate Reimbursement for Skilled Professional Medical Personnel (SPMP) and their Direct Clerical Support Staff In compliance with the Social Security Act(SSA) section 1903(a)(2), Title 42 Code of Federal Regulations(CFR)part 432.2 and 432.50, and the Federal and State guidelines provided.. has determined that the list of individuals in the attached Exhibit A are eligible for the enhanced SPMP reimbursement rate, for the State Fiscal Year based on our review of all the criteria below: V Professional Education and Training ❑ Job Classification ❑ Job Duties/Duty Statement ❑ Specific Tasks (if only a portion will be claimed as SPMP enhanced functions) ❑ Organizational Chart ❑ Accurate, complete, and signed SPMP Questionnaire ❑ Active California License/Certification ❑ The undersigned hereby attests that he/she: • Has personally reviewed the criteria above and its supporting documentation and determined that the individuals meet the federal requirements for the enhanced SPMP reimbursement rate. • Will maintain all the aforementioned records and supporting documentation for audit purposes for a minimum of 3 years. • Certifies that SPMP expenditures are from eligible non-federal sources and are in accordance with 42 CFR Section 433.51 • Understands that if SPMP requirements are not met, the agency will be financially responsible for repaying the costs to the California Department of Public Health (CDPH) • Understands that CDPH may request additional information to substantiate the SPMP claims, and such information must be provided in a timely manner. Agency Name/Local Health Jurisdiction Name and Title Signature Date Jul 2025 30 � California Department of y Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Medi-Cal Percentage (MCP) Policy Title XIX FFP funds are intended to reimburse agency costs for time spent doing certain administrative activities that benefit Medi-Cal members exclusively. However, Program activities are generally performed for both Medi-Cal members and the general population. Therefore, it is necessary to use a base MCP to identify what portion of the general population receiving services are Medi-Cal members. A program's MCP is the percent of the primary target population served by the program that are current Medi-Cal beneficiaries. The purpose of this section is to clarify policy and requirements regarding calculation, documentation, approval, and use of a base MCP for the BIH, AFLP, CHVP, PEI and MCAH Program. Base Medi-Cal Percentage The Base MCP is the number of Medi-Cal births divided by the total number of live births for a region. It is re-calculated when new birth data is available. AFLP Base Medi-Cal Percentage AFLP's base Medi-Cal Percentage MCP is calculated by CDPH/MCAH for each AFLP agency using their client data entered in the software information system provided by the Program Consultant. BIH Program Base Medi-Cal Percentage The BIH Base Medi-Cal Percentage MCP is calculated by CDPH/MCAH for each BIH Agency using data from the BIH MIS Current Pregnancy Report (statewide aggregate data) and the BIH pregnant individuals from the prior calendar year. Each BIH Agency must use the MCP posted on the BIH Base MCP table. MCAH Program Base Medi-Cal Percentage The MCAH Base MCP is calculated by CDPH/MCAH for each MCAH Agency using data compiled from the Birth Statistical Master File to derive the percent of Medi-Cal paid births to total County live births. Each MCAH Agency can use the MCP posted on the MCAH Base MCP table. Besides using the MCAH Base MCP posted by CDPH/MCAH, the MCAH Medi-Cal Percentage can also be any of the following: 1. A Local MCP determined by the Agency, approved by CDPH/MCAH, and used for some or all staff. July 2025 31 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 2. Factoring two or more Medi-Cal Percentages MCP for one staff (multiple or weighted MCP). 3. Variable Medi-Cal Percentages MCP for staff dependent on their actual client contacts. Note: When performing client counts for any of the above alternate methods, Medi-Cal members with a Share of Cost (SOC) can be included in the Medi-Cal enrolled client counts. When a MCAH Agency uses an MCP other than the MCAH Base MCP, supporting documentation is required to substantiate the invoiced MCP. If an audit reveals that the documentation does not support the invoiced MCP, the Agency will be responsible for repayment of the difference between the invoiced amounts and the amounts the documentation supports. If there is no supporting documentation, the repayment amount will be calculated based on the MCAH Base MCP. Local Medi-Cal Percentage MCF An Agency may have access to more current or region-specific final birth data and can use an alternate Local MCP for some or all of their staff. Local MCPs must be reviewed and approved by CDPH/MCAH each fiscal year they are used. To use a Local MCP an Agency must: 1. Submit with the Agreement Funding Application (AFA), via the Budget Template (I) Justification worksheet, the data source(s) and methodology used for the calculation(s). 2. Calculations need to be based on population-wide, publicly available (posted on the city or county website) and statistically valid data. 3. Maintain the data sources, methodology, CDPH/MCAH approval, client counts and any other supporting documentation for audit purposes. When proposing a Local MCP, the data source(s) and methodology must be submitted to CDPH/MCAH for approval each fiscal year. Multiple Medi-Cal Percentage MCP For Single Staff In some instances, Agency staff duties can be divided into two or more specific areas of responsibility. Each area is based on a different function, activity, or client contact, and stated on two or more budget and invoice lines. For example, a MCAH Director performs 60% general administrative MCAH Director duties and 40% Perinatal Services Coordinator (PSC) duties. The Director could be listed on two budget and invoice lines with one line stating 60% FTE as the MCAH Director performing administrative functions using the CDPH Base or Local MCP; and on the second line 40% FTE performing PSC duties claiming up to 95% MCP. The Comprehensive Perinatal Services Program (CPSP) is a Medi-Cal program; therefore a Medi-Cal Percentage MCP of up to 95% may be claimed for a PSC. Specific activities of the PSC will determine the percent of FFP match with each time July 2025 32 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 study period. The duty statement of the PSC must describe the activities assigned to that position including activities that qualify for FFP. To use Multiple Medi-Cal Percentage MCP for the same staff an Agency must: 1. Submit with the AFA, via the Budget Template (1) Justification worksheet, the data source(s) and methodology used for the calculation(s). 2. Verify each fiscal year that there were no data changes or shifts in workload. If there are changes, an updated methodology needs to be submitted for CDPH/MCAH review and approval each fiscal year. 3. Maintain the methodology, CDPH/MCAH approval, client counts, supporting documentation, and any other substantiating documentation for audit purposes. Weighted Medi-Cal Percentage Only MCAH Directors and Coordinators can use a "Weighted" MCP. A Weighted MCP must be approved by CDPH/MCAH. The weighted MCP is a projection factoring the expected FTEs and MCPs. You will invoice using the actual FTE based on the time studies and MCPs based on actual client counts for that quarter. The Weighted MCP is based on time (% FTE) spent in managing varying programs or entities that have a higher MCP than the MCAH Base or Local Medi-Cal Percentage. The Weighted MCP is calculated by adding the sums of the MCP multiplied by the percentage of time performing activities in a program. For example: Activity/Program • • - • MCP CPSP .1 FTE x 95% 9.5% High Risk Visiting Program .2 FTE x 80% 16.0% General MCAH Work .7 FTE x 52% (Base MCP) 36.4% (MCP on Budget) 1.0 FTE �61.9% To use a Weighted MCP an Agency must: 1. Complete the Weighted MCP table located at the bottom of the (1) Justification worksheet within the MCAH Budget Template. 2. Submit with the AFA via the MCAH Budget Template (1) Justification worksheet, the data source(s) and methodology used for the calculation(s). 3. Verify each year that there were no data changes or shifts in workload. If there are changes an updated methodology needs to be submitted for CDPH/MCAH review and approval each fiscal year. July 2025 33 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 4. Maintain the data sources, methodology, CDPH/MCAH approval, client counts, and any other supporting documentation for audit purposes. Variable Medi-Cal Percentage MCAH Agency staff whose job duties and duty statement specify that they work with a unique population are permitted to use Variable MCPs. A Variable MCP is one that varies each quarter and is based on 100% client counts during the time study month for that quarter. The Variable MCP is determined each quarter using one of the following methods: 1. The total number of clients seen with documented Medi-Cal member identification numbers, divided by the total number of clients served by a specific staff member. 2. An Agency with a specialized program may determine a Variable MCP based on data for the entire program. If CDPH/MCAH approved, all staff working in that program can use the same Variable MCP. During an Agency's time study month each staff claiming a Variable MCP must document 100% of their client contact as either "non Medi-Cal" or "Medi-Cal" in their supporting documentation. "Medi- Cal" does not mean assumed eligibility. A client must be a current Medi-Cal beneficiary. Supporting documentation must be able to substantiate a client's Medi-Cal enrollment status in the event of an audit. When budgeting Variable Medi-Cal Percentage for individual staff an Agency is proiectinq what the FYs ratio of Medi-Cal enrolled to total client contact will be for that specific staff. Budget projections should be based on prior year actual client counts and staff duty statements. Invoicing with Variable Medi-Cal Percentage must reflect actual client counts for that claiming period and client count documentation must be maintained for a minimum of seven years for audit purposes. This documentation will be reviewed during an on-site audit, and copies can be requested at any time by CDPH/MCAH staff to substantiate an Agency's Variable MCP. If a client's Medi-Cal enrollment cannot be verified, they cannot be counted as Medi-Cal enrolled. Documentation of client counts to support Variable MCP must identify the following: 1. Staff name and position/title 2. Date and time span of activity 3. Activity and nature/intent of activity (e.g., outreach at health fair) 4. Total number of"clients" seen or contacted 5. Documented Medi-Cal verifications (e.g., member's Medi- Cal identification numbers) To use a Variable MCP for one or more staff an Agency must: 1. Submit with the AFA via the MCAH Budget Template (I) Justification worksheet the data source(s) and methodology used for the calculation(s). July 2025 34 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 2. Staff or Program need to document 100% of their client contact as either Medi-Cal enrolled or not in their supporting documentation during the time study month. Verification of client enrollment status needs to be maintained for audit purposes. 3. Calculate MCP as a percent using the number of Medi-Cal enrolled clients to the total clients seen by a staff member for the quarter being invoiced. Use that MCP for the corresponding quarterly invoice for that staff member. 4. The actual client counts must be re-calculated each quarter for each quarterly invoice. 5. Maintain the data sources, methodology, quarterly calculation summaries, client counts, CDPH/MCAH approval, and any other supporting documentation for audit purposes. MCAH Director - Medi-Cal Percentage (MCP) Policy The Division's intent is to assure that all pregnant women and their children can obtain quality maternal and child health services in the State of California. The MCAH Director is responsible for overseeing local MCAH staff and activities that carry out this mission. It is important that the MCAH Director's MCP be representative of the target population being served. LHJs can augment their Programs' funds using FFP, which provides federal funding (Title XIX) for certain activities that: • Assist individuals eligible for Medi-Cal to enroll in the Medi-Cal program • Assist members on Medi-Cal to access Medi-Cal services Reimbursement of costs for matchable activities and related expenses is based on time spent by qualified staff performing matchable activities on behalf of Title XIX, Medi-Cal beneficiaries only. A Program's MCP is the percent of the primary target population served by the program that are current Medi-Cal beneficiaries. I)rocedure The local jurisdiction's MCAH Director Medi-Cal percentage, the MCP may be determined by one of three different methods: • Using the CDPH/MCAH Base MCP Table — CDPH/MCAH calculates the percent of Medi-Cal beneficiaries in the population of each local health jurisdiction based on the Medi-Cal paid delivery and birth data from the previous calendar year. The MCAH Director is allowed to time study all activities performed in the MCAH program time using the CDPH/MCAH's Base MCP for reimbursement. • Using a locally determined MCP — This is a locally determined MCP based upon population wide, publicly available or documented data (Local Base MCP), or direct documentation of Medi-Cal July 2025 35 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 beneficiary's identification numbers (Variable MCP). • Using more than one MCP — The MCAH Director may be responsible for overseeing local MCAH staff and activities in more than one MCAH program. The MCAH Director is allowed to time study to each specific MCAH program (such as MCAH, CPSP, FIMR, Education/Outreach and Dental) and use the MCP for each of these programs for claiming purposes. Each program can be budgeted and invoiced on separate lines in the MCAH Budget and Invoice template. Requirements Prior written approvals from the MCAH Program Consultant and Contract Liaison are required to claim an MCP different from the one listed in the CDPH/MCAH's Base MCP Table. Role and responsibilities for participation or oversight of local jurisdiction MCAH or MCAH-related programs must be addressed in the MCAH Director's duty statement. Local jurisdictions must determine the percent of time spent per program based on actual time documented for activities/programs on the CDPH/MCAH approved Time Study. The MCAH Director must include 100% of their work time on the time study including time worked outside of MCAH related programs. All data sources and methodology used to determine the MCAH Director MCP must be maintained for seven years for audit purposes. The audit file must be maintained until the records retention schedule for the same audit period expires. Note: If a State or Federal audit is performed in which there are findings resulting from the data or methodology used to determine the MCAH Director's MCP, the local jurisdiction is solely liable for any financial recovery and/or penalties as a consequence of the findings. July 2025 36 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 MCP Annual AFA Justification letter Policy Agencies must submit a signed justification letter, which provides the rationale for your intended MCP percentages if utilizing a MCP other than base. This letter must be on county letterhead and include your justification in claiming each of the various MCPs that are being requested on your budget. The letter will not replace the MCP justification area for personnel on the budget template. We have provided an example letter for your reference titled "Bean County" letter. Bean County Maternal, Child and Adolescent Health May 21, 2021 Angelica Jimenez-Bean PO Box 000 MS-0000 City of Beans; CA 900000-000 To CDPHIMCAH, Bean county is using the following Medi-Cal Factors(MCF}for this Fiscal Year(FY) 21122, which includes the justifications- MCF%J us tificab on VCF Type Maximum characters=1024 Variable Direct documenta'ion&number anc parcen'o'%ledi-Cal eligible served on file Local Actual percentage of Medi-Cal clients participating in program dung 2018-2019_ Weighted Oversees pragrarrms targeting MediCal eligible women of childbeanng age and high nsk infanWchiidren needing MediCal services. MuWple Oral Health Care Coordination will be serving the Medical population in access and ensuring Denti-Cal clients are seeking Preventative and restorative dental care Base NIA Sincerely, Angelica Jimenez-Bean Bean County MCAH Director July 2025 37 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Title V 30/30 Earmarking Overview Pursuant to Title V of the Social Security Act, Section 505, CDPH is mandated to provide oversight in the expenditure of Federal MCH Title V Block Grant funding. Federal MCH Title V Block Grant funding is the key source of support for promoting and improving the health of all mothers and children, including children with special health care needs. Requirements As required by Federal regulation, CDPH is required to track and utilize all Federal MCH Title V Block Grant funding as follows: • At least 30% of Federal MCH Title V Block Grant funds received are to be expended for Preventive and Primary Care Services for Children (PPCSC) • At least 30% of Federal MCH Title V Block Grant funds received are to be expended for Children & Youth with Special Health Care Needs (CYSHCN) to provide and promote family-centered, community- based, coordinated care and to facilitate the development of community-based systems of services for such children and their families • 30% (Other) MCAH activities • 10% Administrative costs Title V Time Studies Currently, only the MCAH Program is required to report Title V expenditures to be in compliance with Federal regulations. SIDS activities can be coded to Category I and FIMR should be coded to Category III. Note: This time study is required and separate from the Title XIX time study. Title XIX time study must be submitted with the quarterly invoice and Title V time studies must be submitted no later than the month following invoice submittal. Time Studies must be performed for one full month during each of the fiscal quarters listed below. • July — September • October— December • January— March • April — June Each agency will designate in their AFA the month in each quarter that Title V 30/30 Earmarking Time Studies are to be completed. Agencies must communicate their selected month to the MCAH Program upon receipt of the first quarter time study. July 2025 38 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Budget Documents Overview Budget documents form the basis for Agency payments and fiscal accountability for audit compliance. All expenses shown on the budget documents must directly relate to the accomplishment of the goals, objectives, activities, timelines and outcomes identified under the Program(s) Scope of Work (SOW). The Program Budget/Invoice template contains all the necessary documents for submitting a proposed budget. GUIDE ORIGINAL = m Justification (II-V)Justifications m Q1 TXDC m Q2 TXX • Justification worksheets are incorporated in the Budget/Invoice template file to allow agencies to document explanations of each expense listed under Personnel, Operating Expenses, Capital Expenditures and Other Costs. Justifications must include all particulars as specified by CDPH/MCAH for evaluating the necessity or desirability of each expenditure. This portion of the Program Budget Document is used for monitoring and auditing purposes. The budget and corresponding justification worksheets are a required component of the final approved AFA. .budget/Invoice Template BUDG&TSUMMAFtY FGGLY6IR YYGIQ�T BUGC6TSTATYi I auxeT 70t9.10 IORiOiNAL ACTIVE a e �-w-- Fmmal.cNrrteae ram. ix M[MN IN'Y1.1R5 [=iGNrtf03 ' A a a M! fR ml �fA IN m fm�r.c.,� N..rtwlw X muv % top % aR % ,xx. e % Al1IpCAROx1!] nm f.ao om III f4kSONNI p am ♦w Pn OP[-.-r11P[xws a0a pap ]pp 0!0 1101 CAPFtft EMPE""RES om am om ow ox o.m ptry orxtx lnss am pm (IJ IN61RFri—T% pap pW BUDGET TOTALS' a.N 4m QN oN 0.N Rm ►-N n.N Alufegq 000 ON 0.00 TOTAL TITLE oN TOTAL SIDS ON OM TOTAL TITLE XDt TOTAL AGENCY FUNDS _per,p ON $ - MaXIMUM Amount Payable from Slat fI NA9NFN IYNl9lfFlf Itll f11YNT1 LWR 1M1lN Al l x!'AH 11f1vM91MIM AYp1'IYl'YM11 Note: Contact your Contract Liaison if you are having any difficulty accessing the Budget/Invoice template. Within the Budget/Invoice template are cells shaded in yellow. These cells will accept data entry. July 2025 39 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Note: Some of the yellow shaded cells within the Federal/Agency Non-Enhanced column under the Operating Expenses and Other Charges line items contain automatic calculations that may be overridden to reduce percentages if necessary. All other cells are locked, and password protected to prevent accidental entries. Any unauthorized changes made to the original format will require a resubmission by the Agency. Agencies must ensure that the most current approved version of the Program Budget/Invoice template file is used at all times. The template version is located at the top of the Budget Worksheet in the cell above the Program name. esan5. UOa uA loqfam: Maternal,Child and Adoiescent Health(MCAH) yrool: Selec4.................. SUM • All other data (non-shaded cells) are calculated by formulas embedded in the worksheet cells. • The allocation amount(s), the Indirect Cost Rate (ICR) percentage and application and the Base MCP will automatically populate when the agency name is selected on the Budget Summary Page. • Funding totals are automatically calculated and forwarded from each of the detail sections (Personnel, Operating Expenses, Capital Expenditures, Other Costs, Indirect Costs, and Operating Expenses) to the Budget Summary Page. • Negative balances (or red), with the exception of agency funds, are not allowed on any budget or invoice summary page. • The total balance shown on the Budget Summary Page cannot reflect a negative balance. Budget Summary The Budget Summary Page contains the following expense categories: I. Personnel EXPENSE CATEGORY II. Operating Expenses (1) PERSONNEL (II) OPERATING EXPENSES III. Capital Expenditures (Major Equipment) (m) CAPITAL EXPENDITURES IV. Other Costs (ft') OTHER COSTS V. Indirect Costs I%') INDIRECT COSTS r rocedure The following provides information on formatting, inputting & submission procedures: • The California Fetal Infant Mortality Review Plus (CA FIMR+) and Sudden Infant Death Syndrome (SIDS) programs are funded by Title V and cannot be reimbursed with Title XIX funds. July 2025 40 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Agencies cannot use federal funds derived from any other entity for the purpose of Title XIX reimbursement. • The print command will automatically generate the Budget Summary Page and budget detail pages; however, you must select each justification worksheet individually to print. • Each Program Budget/Invoice template file is used for both budgeting and invoicing purposes. Submit budget documents via email for each MCAH funded Program. • Once the budget documents are approved by CDPH/MCAH, the budget must be signed by the Agency's Program Director and Fiscal Agent (Not applicable to clarify CBOs or CHVP). • The Excel version of the Budget/Invoice template file must be sent via email to the Contract Liaison. • Submit a scanned signed copy of the budget via email to your Contract Liaison. Electronic signatures are acceptable. (1) Personnel Personnel Costs are listed as the first line item on the Budget and Invoice (1) PERSONNEL DETAIL Summary Page. The Personnel Detail TOTAL PERSONNEL COSTS 0.00 FRINGE BENEFIT RATE 1 0.00 Section is titled 'T" and is located after TOTAL VAGES 000 FULLANNUAL the W. Indirect Costs Detail Section." (Firs[Nme^Last Name) TITLE`N Aeron'ms)SSIFICATION XFTE SALARY TOTAL VAGES The Personnel Detail Section needs to be completed prior to all other 11 000 sections within the budget worksheet 5 0.00 in order for the template to auto calculate for matching purposes. Staff name, job title or classification, FTE, the average fringe benefit rate and annual salary entered in the Personnel Detail Section of the budget will populate the (1) Justification worksheet. Agencies may not go over the salary cap limitation imposed by the Health Resources & Services Administration. Total costs from the Personnel Detail Section will populate the Personnel line item on the Budget Summary Page. Requirements The requirements of the Personnel Detail Section are: • All Program staff, regardless of time worked in the program, or funding source (unless included in indirect expense line items), must be included in the Personnel Detail Section. • Personnel listed in the Personnel Detail Section must meet all applicable program policies and requirements as detailed in the Program Policy and Procedure Manual. You must also ensure that you insert full names, no abbreviations, and that cells are not truncated. • Anticipated salary increases must be included in the initial preparation July 2025 41 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 of the Personnel Detail Section. • Vacancies must be budgeted at middle salary range. • CDPH/MCAH allows reimbursement for fringe benefits that meet each of the following criteria: o Necessary and reasonable for the performance of the Program Agreement and budget o Determined in accordance with Generally Accepted Accounting Principles o Consistent with policies that apply uniformly to all activities of the Agency • Fringe benefits may include, but are not limited to: o Health plans (i.e., health, dental and vision) o Unemployment insurance o Worker's compensation insurance • Fringe benefits do not include: o Compensation for personnel services paid currently or accrued by the Agency for services of employees rendered during the term of this agreement which is identified as regular or normal salaries and wages, vacation, sick leave, holidays, jury duty and/or military leave o Incentive or bonus pay o Relocation allowances o Hardship pay o Cost-of-living differentials • Travel o Travel column has been added to the Personnel Detail section in the budget template. For budgeting purposes, the staff members who will be traveling will have to select the "X" from the drop down. This will also help average the Match % allowed in the Operating Expenses section for Travel. Procedure List each staff's first and last name and their job title or classification in the appropriate column. Note: Job titles and classifications should be consistent with all duty statements and organization charts. Enter"VACANT" in the name column if the position is vacant. • Enter percent of Full Time Equivalent (FTE) for each employee. • Enter the total annual salary for employees as if they were employed full time. • Once the FTE and annual salary are entered for an employee, the total wages will populate. • Insert an average fringe benefit rate that will be applied to the total wages listed in each column. A fringe benefit rate is the cost of an July 2025 42 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 employee's benefits divided by their total wages. • Enter the non-enhanced and enhanced percentages based on historical time study data. The combined total of non-enhanced and enhanced percentages should not exceed the allowable MCP for each staff person. If the percentages do exceed the MCP, the cell containing the MCP will turn red. Adjustments to the non-enhanced and enhanced percentages will need to be made until they are at or below the MCP. • Travel costs are automatically matched at the Non-Enhanced rate, based on the "Percent of Personnel Matched". Agencies electing to enhance travel costs must determine the allowable percentage or amount in accordance with FFP requirements. (1) Personnel Justification Worksheet • Choose Program name from the dropdown selection in column "I." (e.g., MCAH, FIMR, SIDS, AFLP, BIH). • The Base MCP percentage will auto populate under the MCP% column for all staff. If the MCP type is variable, weighted, multiple, or local, enter the appropriate MCP percentage and select the corresponding MCP type from the dropdown menu. • For the current Fiscal Year MCP rates please refer to the Agreement Funding Application instructions. Note: When selecting a Multiple MCP type (two or more lines for one staff), you must complete the "MCP % Justification" column. • When selecting a Weighted MCP you must complete the Weighted MCP Calculation Table (located below the MCP Requirements on the (I) Justification Worksheet), in addition to providing written justification in the "MCP % Justification" column. • Enter the MCP justification for each staff when using (or projecting for Variable MCPs) an MCP higher than the base. Include source data if applicable, i.e. Penelope software for AFLP. Justification cannot exceed 1024 characters. • The MCP percentage entered under the justification worksheet will populate in column 16 of the Personnel Detail Section. Operating Expenses The Operating Expenses Detail Section is comprised of three expense areas listed under the main expense category: • Travel • Training • Operating Expenses (Other than Travel and Training, lines 1-15) The total dollar amounts from the Operating Expenses Detail Section will populate the Budget Summary Page. Operating expenses (other than travel and training) are automatically distributed July 2025 43 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 to the Title V and Non-Enhanced Combined Federal/Agency columns according to how personnel costs are distributed (Percent of Personnel Matched). Lines 1 through 15 of the Operating Expense Detail Section cannot exceed the Percent of Personnel Matched. Some travel and training costs may be manually distributed to the Enhanced combined Federal/Agency columns if it is in accordance with FFP requirements. The distribution of these costs can be changed as needed by manually entering new percentages into the percent columns. The allowable Percent of Personnel Matched for operating costs that are Title XIX reimbursable can be found in the Percent of Personnel Matched box located in column 16. Travel Travel costs are listed on the budget for all staff who travel to conduct Program business and to attend conferences and training that is directly related to the objectives described in the SOW. The cost of travel cannot exceed the established State rates noted in the State Travel Reimbursement Information on the CalHR website. For County/Local Health Jurisdictions Only: Mileage: Local health jurisdictions may use their county/agency mileage rate as long as they can provide documentation to substantiate the rate. If the county/agency does not have a county/agency mileage rate, then they must provide documentation to show how the rate included in their allocation agreement was derived. This rate will then be dependent on State approval and will require support documentation when invoices are submitted. Lodging: If lodging cost exceed the posted amount in the State Travel Reimbursement Information section, then the traveler must request and submit an Excess Lodging Rate Request form to the state. This request must be submitted two weeks prior to the start of travel and approved by the State. The State may not be able to honor requests submitted after the start of travel. Out-of-State travel is allowed for agency leadership to travel to the following national conferences, including but not limited to: • Annual meetings of the Association of Maternal and Child Health Programs (AMCHP) • Center for Disease Control and Prevention's MCAH Epidemiology Conference • Annual CityMatCH Conference Travel to other national conferences may be approved on a case-by-case basis and requires prior written MCAH approval. All requests must be submitted in writing via email to your Contract Liaison and Program Consultant with a brief description that July 2025 44 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 includes the items listed below: • Name and date(s) of the conference, training, meeting, etc. • Name and title of the individual(s) traveling • Necessity of the trip, how it relates to the goals and objectives of the SOW and how it improves the skills of the attendee • Travel location and dates • Breakdown of the proposed costs of the trip Out-of-State travel must be identified in the training area of the (ll-V) Justifications worksheet of the budget and under the appropriate goal and objective in the SOW. Travel costs are automatically matched at the Non-Enhanced rate, based on the Percent of Personnel Matched. Travel can be reimbursed at an Enhanced rate if it is in accordance with FFP requirements. Travel cannot be matched at a higher percent than the percentage listed on the Personnel Detail Section for those staff traveling. There is a Travel column on the Personnel Detail section in the budget template. To accurately calculate the average Match %, an "X" must be selected from the drop down for each staff member who will be traveling. Requirements Prior MCAH written approval is required for travel and training costs for staff not listed on the Program Budget, but who contribute a portion of their time to the MCAH program. Any written approval from CDPH/MCAH as well as any receipts or information required for Travel Reimbursement must be retained by the Agency for audit purposes. Training Training costs are listed on the budget for staff who conduct or attend conferences and training that are directly related to the objectives described in the SOW. • Agencies may host or sponsor Program-related trainings, seminars, workshops, or conferences. • Training cannot be matched at a higher percentage than what is listed on the Personnel Detail Page for those staff for whom training is being budgeted. Training can be reimbursed at an Enhanced rate if a SPMP is providing training to another SPMP and it meets one of the FFP objectives. Requirements Prior written MCAH approval is required for the following: • Training and associated travel and per diem costs for staff not listed on the budget, but who contribute a portion of their time to the Program. • To host trainings, seminars, workshops, or conferences. July 2025 45 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Procedure Agencies requesting approval to host trainings or seminars must submit the following items: • A description of the proposed training or seminar in the Program Budget Justification Narrative • A written request at least 60 days prior to the proposed training or seminar date(s) to the Contract Liaison and Program Consultant which includes: o The date and location of proposed training or seminar o Subject matter of the training or seminar o Draft of agenda and list of instructors o Draft of instructional/educational materials o Targeted audience and projected number of attendees o Draft of publicity materials o Total cost Note: Federal regulations disallow the use of any federal funds for advocacy at the local, state, or federal level. Therefore, the $1,100 allocated for the semi- annual MCAH Action training conference may only be used for training and travel related expenses to assist in meeting the educational needs of the MCAH Director. This should be shown in your budget under the travel and/or training line items, as appropriate. Any expenses related in any way to advocacy must be paid from local agency funds and are not eligible for Title XIX matching funds. Operating Expenses Other Than Travel and Training Operating expenses other than travel and training include, but are not limited to, items or costs used to support staff such as: • Rent (methodology required: FTEs x 200 sq. ft. x up to $3 per square foot x 12) • Office Supplies • Communications • Duplication • Utilities • Postage • Minor Equipment-Audio/Visual equipment or Telecommunication items (including phone systems, teleconferencing equipment computers, printers, and furniture) having a base unit cost of less than $10,000. For lines 1 through 15, enter in each operating expense type and the corresponding dollar amount. A justification for each expense must be entered on the (II-V) Justifications Worksheet. The justification must be detailed enough to substantiate the costs. Operating Expenses, other than travel and training, can only be reimbursed at the Non-Enhanced rate. The total percentage of the Non-Enhanced Combined Federal/State and Combined Federal/Agency columns in each line item cannot exceed the Percent of Personnel Match as indicated on the right side of column 15 July 2025 46 1 California Department of kk Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 in the Operating Expenses Detail. Operating Expenses that do not meet the FFP requirements must be claimed as unmatched (see page 9). The formula in the cell under the non-enhanced column will have to be deleted in order to claim the expense as unmatched. (III) Capital Expenditures These expenditures are defined as major equipment items with a base cost of $10,000 or more and useful life expectancy of one or more years. MCAH must approve all capital expenditures in writing prior to purchase. Capital Expenditure items purchased using any amount of CDPH/MCAH funds become the property of the State of California. Expenses entered will automatically be spread based on the Percent of Personnel Matched but may be adjusted as necessary by shifting costs between funding sources. On the (II—V) Justifications Worksheet, briefly describe the necessity and cost for each expenditure. (IV) Other Costs The Other Costs Detail Section is comprised of two expense areas as listed under the main expense category below: • Subcontracts • Other Charges (i.e., Client Support Materials, Educational materials, etc.) The total dollar amounts entered in the Other Costs Detail Section will populate the Budget Summary Page. Subcontracts A subcontract is a written agreement between the Agency and a subcontractor. Subcontracts or consultant services can be used only for activities directly related to meeting the goals and objectives of the primary SOW. Subcontractors of LHJs may match at the Enhanced rate only if the subcontractor is performing Enhanced activities and is a governmental agency. If a subcontractor is matching at either the Enhanced or Non- Enhanced rate, they are subject to all guidelines as stated in the FFP Section of this Policy and Procedure Manual. The use of a subcontractor or consultant must be explained and justified on the (II- V) Justifications Worksheet. Line-item titles and amounts entered in the Other Costs Detail section will populate in the (II-V) Justification Worksheet. Briefly describe the necessity, types of services and cost for each subcontract. Note: For any subcontract $5,000 or more, the agency must provide a subcontract package for review and approval as described in the Subcontractor Agreement Transmittal form. Subcontract Requirements are included in the Terms and Conditions section of this manual. July 2025 47 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Other Charges Other Charges include, but are not limited to, costs to support the program such as: • Client support materials items used in support of desired behaviors/goals or items that have been determined as necessary for risk reduction after an assessment has been completed. Items such as cabinet locks, plug covers, pack `n plays, cribs, car seats, breast pumps, diapers, baby clothes, school readiness materials (e.g., picture books, manipulative toys), bus passes or other transportation tokens and flash drives can be included in the invoiced amount. • Educational Materials • Outreach Materials • Services such as development costs of media campaign advertising Line-item titles and amounts entered in the Other Costs Detail Section will populate in the (II-V) Justification Worksheet. On the worksheet, provide a brief explanation of the necessity and cost of each expenditure. Indirect Cost CDPH requires each Local Health Department (LHJ) to submit their proposed Indirect Cost Rate (ICR) and identify the method used to apply it - either: • Total personnel costs (wages + fringe benefits), or • Total allowable direct costs (includes personnel, fringe, operating, capital expenditures, and *other costs). * When using the direct cost method, overhead may only claim overhead charges on the first $50,000 of each subcontract. Agencies must use the ICR percentage and method approved by CDPH, as published at the start of each program's annual AFA announcement letter. If an agency chooses to apply a lower rate than the approved ICR, they must complete the MCAH ICR Certification Form, available on the current Fiscal Year AFA website. Note: CDPH MCAH may also require agencies to complete the ICR Certification Form even when using the approved rate. This form helps substantiate the rate being applied by confirming the agency's methodology for calculating indirect costs and ensures consistent documentation for audit and compliance purposes. • Indirect Cost Limits: o Up to 25% of total personnel costs, or o Up to 15% of total allowable direct costs (as defined above). • AFLP CBO's grant agreements are limited to claiming up to 15 percent of personnel costs (wages and fringe benefits). Unless an alternate Federal approved ICR has been submitted to MCAH and approved for use. July 2025 48 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Total Indirect Costs are distributed among the Agency's Unmatched and Non- Enhanced budget columns based upon the Percent of Personnel Matched. • Total Indirect Costs are not matched at an Enhanced rate. July 2025 49 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Budget Revisions Overview CDPH/MCAH allows changes to previously approved Program Budget Documents to update and accurately reflect program need once per fiscal year. Budget revision (BR) proposals will be accepted for consideration only if the following criteria have been met: • Your request must be submitted during the third quarter period, January- March, of the current fiscal year. • Your 2nd quarter invoice has been submitted and approved, and your BR must be submitted no later than March 31 st. • Agencies must first contact their assigned Contract Liaison of the intention to do BR. Once CL approves the BR request, the agency can complete the BR tab on the budget template and submit for review and approval. MCAH Contract Liaisons and program consultants will review the request and if the revision is approved, the Contract Liaison will inform the agency of approval. All budget revisions will require CDPH/MCAH written approval prior to implementation. Requirements for BR's Upon approval, agencies allowed to proceed with a budget revision must submit their proposed revision as follows: • Submit the proposed budget revision via email to your Contract Liaison. • Obtain formal written approval from CDPH/MCAH to proceed with signed BR. • Sign approved budget template and submit to your CDPH/MCAH Contract Liaison. • Any invoice affected by the pending budget revision cannot be submitted to CDPH/MCAH until the revised budget is approved. The following documents are required for submission via email: • Cover Letter stating reason the budget revision is necessary and where changes are requested • Revised Budget Template (including completed Justification tabs) • Revised or additional duty statements, if applicable • Revised organization charts, if applicable • Any other documents/forms that are applicable, for example, updated FFP/TXIX attestation form if new SPMP personnel are added to the budget. Once the revised budget documents are approved by CDPH/MCAH, the agency will submit a signed copy of the budget documents to their MCAH Contract Liaison. July 2025 50 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Invoices and Payments Invoices CDPH/MCAH reimburses agencies for actual costs incurred in meeting the objectives as specified in the SOW, not to exceed the approved program budget. Quarterly and monthly invoices are due to CDPH 45 days after the end of the invoiced period and 45 days after for final invoices. A preliminary review is not required but can be helpful in identifying potential errors. Prior to submitting a formal invoice, agencies may submit their invoice package directly to their Contract Liaison for preliminary review. A preliminary review must be submitted no less than two (2) weeks prior to the invoice deadline. Contact your Contract Liaison to arrange the review. Agencies ready to submit their invoices must utilize their approved and State MCAH certified budget and invoice workbook. Each signed invoice and its supporting documentation must be submitted in a separate email (one invoice per email) in PDF and excel format to the dedicated MCAH invoice inbox: MCAHlnvoices(a)_cdph.ca.gov. Invoice Submission (How to Submit Your Invoice) Your Contract Liaison and Program Consultant will review the invoice for correct format, accuracy and availability of funds. Failure to use the appropriate naming convention can result in delays in reimbursement. To ensure appropriate processing, please use the following invoice naming protocol and in the subject line of the email: Agreement Number, Agency Name, Fiscal Year and Invoice Month and Number (starting with Month 1 or Quarter 1 as applicable) CBO Example: AGREEMENT#20-10004, SAN DIEGO COUNTY, FY2020-21, MONTHLY/QUARTERLY, INVOICE LHJ Example: AGREEMENT#201801, SACRAMENTO COUNTY, FY 2020-21, Q1 INVOICE Invoice package includes the following: • Signed Cover letter on official agency letterhead (PDF) — the date the cover letter was prepared, program being invoiced, inclusive dates for invoicing period, agreement number, invoice number, total amount of the invoice, contact name, contact number, original signature, agency remittance July 2025 51 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 address and an explanation on the cover letter regarding any variance from the approved budget such as: o Personnel changes or vacancies o Substitutions of items budgeted under Other Costs o Adjustments or corrections from a prior quarter • Signed Invoice (PDF)— signed and dated by the agency's fiscal agent and Program Director • Excel Version of the invoice (invoicing of the approved CDPH/MCAH invoice excel workbook) • Signed & completed TXIX Cover Sheet (if applicable) • Signed and checked Attestation form (only applicable if there are new staffing) • Title V and/or Title XIX Time Studies (if applicable)- Time Study Data Report for Summary of FFP (for all staff invoicing Title XIX Funds) and/or Title V Time Study Report for the time study month of the invoice period (for all staff in the MCAH budget invoicing Title V Funds) For updated invoicing process, including a list of invoice deadlines please visit the CDPH/MCAH website. Your Contract Liaison and Program Consultant will review the invoice package for the correct format, accuracy, and available funds. It may be returned due to incompleteness or other discrepancies that cannot be processed by program staff. FFP Requirements Invoicing requirements for FFP are as follows: 1. Expenses requiring prior written approval will be reimbursed only if approval has been granted. 2. Personnel costs invoiced must be based on either a time card or a time study (for all personnel claiming FFP), rather than approved budget documents. Budget documents are only an estimate of expenditures and invoices are based on actual costs. 3. Invoices claiming FFP must be accompanied by an approved time study report for each person claiming FFP. The time study report must reflect 100% of employee's paid work time for a minimum of one full month per quarter, and at a minimum contain the following information: • Agency name • Time study period • Time study month • First and last name of employee • Employee classification or title • SPMP — yes or no • Time base —full time/part time • Budget line number • Percent of time studied to each program listed • Percentage of time by activity classification July 2025 52 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Enhanced — (75/25) • Non-Enhanced — (50/50) • Unmatched • MCP for each program and/or staff listed 4. The time study summary report is contained in the CDPH/MCAH FFP Calculation File which is available in the Forms Section of the AFA page on the CDPH/MCAH website. Agencies must use the most current version of the FFP Calculation File or a CDPH/MCAH approved alternate. 5. Negative balances (red) are not allowed on any funded total line. 6. When the budget is overspent in one column and underspent in another, agencies have the option to move expenses from an Enhanced rate to a Non-Enhanced rate (from 75/25 to 50/50), or from matched funds (Title XIX) to unmatched funds (Title V, SGF, agency funds). 7. Information entered on the invoice will automatically update the Fund Reconciliation Worksheet. This worksheet is used to monitor remaining fund balances and should be reviewed before submitting invoices to avoid payment reductions due to insufficient funds. Special Considerations MCAH provides two methods to recoup costs from previous quarters or months when the fiscal year has not been closed. 1. Recoup on subsequent invoices for the same fiscal year when the year is not closed out. Agencies should contact their MCAH CM for assistance with this option. 2. The Supplemental Invoice. Costs entered as changes or adjustments from a previous quarter must be listed and described on a separate line item in the appropriate expense category. Please describe the following: • The type of cost or line item. • Invoice period in which the cost was incurred. • Percentages used to distribute the costs should be the same as those used on the invoice originally submitted for the period in which the expenditures occurred. Any changes or adjustments must be explained on the invoice cover letter. CBOs that submit monthly invoices have the choice to invoice using the most current information data system downloaded MCP for each month, or to use the same MCP for all three months of the quarter. At the beginning of each fiscal year CBO's that invoice monthly must decide which method to use. Note: Federal regulations disallow the use of any federal funds for advocacy at the local, state, or federal level. Therefore, the $1,100 allocated for the semi- annual MCAH Action training conference may only be used for training and travel related expenses to assist in meeting the educational needs of the MCAH July 2025 53 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Director. This should be shown in your budget under the travel and/or training line items, as appropriate. Any expenses related in any way to advocacy must be paid from local agency funds and are not eligible for Title XIX matching funds. Agencies are responsible for federal audit exceptions and must indemnify the State in the event any exceptions are found, such as services that were: • Invoiced for FFP but were not eligible for FFP • Invoiced for FFP but for which there was no proper FFP match • Invoiced for FFP but for which agency dollars were not expended, as invoiced, when claiming FFP • Invoiced for FFP but were not adequately documented MCAH approval and payment of invoices is not evidence of allowable costs. Allowable costs are determined by means of a State and/or Federal fiscal and program audit. Supplemental Invoices A Supplemental Invoice is to be used only when the agency determines additional charges are necessary after all invoices have been submitted and processed by CDPH/MCAH. Supplemental invoices must be pre-approved by the Contract Liaison prior to submission, approved Supplemental Invoices are due September 30th If a Supplemental Invoice is being submitted, it must meet all the requirements for a standard invoice as noted above and must additionally: • Be titled "Supplemental Invoice" • Reflect only the amount of the supplemental billing • Reflect the same percentage distribution as the invoice period in which the actual cost was incurred Invoice Detail Worksheet Invoice Detail Worksheets are nearly identical to the Budget Worksheet in format and operation and share many of the same policies and requirements. Therefore, this Section will only note the unique differences of the Invoice Worksheets. Please refer to the Budget Documents Section for more information regarding Budget/Invoice policies, requirements and procedures. Personnel Detail Section: • For each staff member enter the actual fringe benefit amount for the month or quarter in which you are invoicing. • For each staff member enter the total wages for the time period being claimed • If matching, enter the non-enhanced and enhanced percentages. • Enter the percent time in program for each staff member that is claiming FFP. This percentage can be found on the Time Study Data Report for Summary of FFP. July 2025 54 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 invoice DeadlineE Invoice Deadlines for the following programs: MCAH, AFLP, BIH, All CHVP, and PEI. Quarter Inclusive Dates Date Due to MCAH Quarter 1 July-September November 15th Quarter 2 October-December February 15th Quarter 3 January-March May 15th Quarter 4 April-June August 15th *Approved Supplemental Invoices are due September 30tn Payments CDPH/MCAH is liable only for actual costs expended against the approved program budget and SOW. Maximum Amounts Payable The maximum amount payable for any fiscal year cannot exceed the CDPH/MCAH approved Agreement and Budget amounts for that fiscal year. The agency must meet all the objectives as specified in the SOW and have incurred the actual costs to receive the maximum amount payable under an approved Agreement and Budget. Agencies are responsible for ensuring that all costs included in this proposal are allowable in accordance with the requirements of Federal award(s) to which they apply, including 45 CFR Part 75, Uniform Administrative Requirements, Cost Principles and Audit Requirements for Health and Human Services Awards. Reimbursement Limitations CDPH/MCAH will not reimburse the agency for: • Overtime at a rate greater than the employee's regular hourly salary • Earned CTO • Any services that the agency may claim for reimbursement under any other State, Federal, agency, or other governmental entity contract or grant, any private contract or agreement, or from the Medi-Cal program • Any services provided under this Agreement and Budget, which are otherwise reimbursable by any third-party payer(s). The agency must fully exhaust its ability to receive third-party reimbursement • Any subcontract funds expended prior to CDPH/MCAH approval may not be reimbursable in the event CDPH/MCAH should subsequently disapprove the proposed subcontract July 2025 55 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 If the agency receives any third-party reimbursement for services already reimbursed by CDPH/MCAH, the agency must immediately remit that amount to CDPH/MCAH or offset the amount against future invoices. Recovery of Overpayments CDPH/MCAH will recover overpayments to the agency including, but not limited to, payments determined to be: • In excess of allowable costs • In excess of expenditures that can be supported by required time study documentation (i.e., required FFP, Title XIX matching) • In excess of the amounts usually charged by the agency or any of its subcontractors • For services not documented in records of the agency or any of its subcontractors • For any services where the documentation of the agency or any of its subcontractors only justifies a lower level of payment; • Based upon false or incorrect invoices • For services deemed to have been excessive, medically unnecessary or inappropriate • For services arranged for or rendered by persons who did not meet the standards for participation in the program at the time the services were arranged for or provided • For services not covered in the program SOW • For services that should have been billed to other programs, the Medi- Cal program or any other entitlement program for which the client was eligible to receive payment for such services Procedures CDPH/MCAH has three options available for the recovery of overpayments: 1. Agency may pay the full amount in one payment 2. Agency may arrange with CDPH Accounting Section to make payments (12 months maximum) 3. Agency may request that CDPH/MCAH deduct the amount of over payment from a subsequent invoice(s). Repayment is to be made as soon as possible but final payment shall not exceed 12 months from the date of the discovery Upon receipt of an audit `Action Notice,' CDPH Accounting will send an invoice to the agency, establish accounts receivables, and work with the agency in determining a recovery method. All recovery activities are coordinated directly through CDPH Accounting. July 2025 56 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Payment Withholds CDPH/MCAH, at its discretion, may withhold up to 100% of any amount billed for services until the agency complies with the provisions of the Agreement. CDPH/MCAH will notify the agency in writing regarding non-compliance determinations. This notification includes: • The reason for each payment withhold determination • The percentage withheld (if applicable), or the intent to withhold • The effective date, conditions, and duration of the withhold The agency will be afforded a reasonable opportunity to discuss with CDPH/MCAH and respond to the notification. Upon agency compliance, CDPH/MCAH will release the amount withheld for payment to the agency. July 2025 57 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Audits Overview All agencies receiving funding from CDPH/MCAH must comply with applicable federal and state audit and reporting requirements. These include, but are not limited to: • 2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards • Generally Accepted Government Auditing Standards (GAGAS, also known as the Yellow Book) • Reporting and Audit Requirements per Exhibit F — Federal Terms and Conditions for Allocations and Cooperative Agreement (version October 2014) Federal and state officials may conduct audits, monitoring or on-site reviews of agencies and their subcontractors during standard business hours. These reviews are intended to assess compliance with program agreements. CDPH/MCAH may also conduct technical assistance site visits. On-Site Technical Assistance Reviews CDPH/MCAH may initiate an on-site technical assistance review, either at its discretion or at the agency's request. These informal assessments help identify potential compliance issues and ensure alignment with program expectations ahead of formal audits. Review process: • Entrance Meeting - Review scope, required documents, and workspace needs. • On-Site Review - Examine administrative, programmatic, and fiscal practices. • Exit Meeting - Share preliminary findings and allow time to respond. • Agency Response Window— 2-4 weeks to submit supporting documentation. • Summary Report - Document findings and recommendations. • Corrective Action Plan (CAP) - Required if deficiencies are identified. • CAP Monitoring - Follow-up on implementation of corrections. • Fiscal Recovery Plan - Required for recovery of unallowable costs, if needed. Corrective Action Plan (CAP) If any review or audit identifies areas of noncompliance, the agency must submit a CAP that: • Address each finding July 2025 58 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Describes corrective actions and responsible personnel • Include timelines for completion Failure to submit or follow the CAP may result in sanctions, such as funding reductions, cost disallowance, or termination of the agreement. Audit Requirements Agencies that expend $1,000,000 or more during the agency's fiscal year in Federal awards must undergo a Single Audit or Program Specific Audit in accordance with 2 CFR 200.501 . Audit reports must be submitted to the Federal Audit Clearinghouse (FAC): • within 30 calendar days after the agency receives the auditor's report, or • within 9 months after the end of the audit period (whichever comes first). Remedies for audit noncompliance In cases of continued inability or unwillingness to have an audit conducted in accordance with this part, the following actions may be taken under 20 0.339: a) Temporarily withhold payments until the recipient or subrecipient takes corrective action. b) Disallow costs for all or part of the activity associated with the noncompliance of the recipient or subrecipient. c) Suspend or terminate the Federal award in part or in its entirety. d) Initiate suspension or debarment proceedings as authorized in 2 CFR part 180 and the Federal agency's regulations, or for pass-through entities, recommend suspension or debarment proceedings be initiated by the Federal agency. e) Withhold further Federal funds (new awards or continuation funding) for the project or program. f) Pursue other legally available remedies. July 2025 59 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Terms and Conditions General Terms and Conditions All MCAH program agreements and budgets are subject to limitations set by federal or state law, legislature or court decisions. These agreements must comply with: • 2 CFR Part 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards • State Contracting Manual • General Terms and Conditions for non-IT services contracts except for Interagency Agreements (Effective 4/4/2017) CDPH/MCAH may revise or void agreements and budget within 30 days' written notice in the event of funding reductions or legal changes. If an agreement is rendered invalid, CDPH/MCAH will have no financial or contractual obligations, and the agency will be released from its obligations as well. Agencies receive funding from CDPH/MCAH, as the pass-through entity, to provide MCAH-related services must deliver the full scope of services described in the Scope of Work (SOW), regardless of the proportion of funding provided by CDPH/MCAH. Special Terms and Conditions All MCAH agreements must also comply with: • Exhibit D — CDPH Special Terms and Conditions for Cooperative Agreement in accordance to HSC 38070 (August 2022). • Exhibit F — Federal Terms and Conditions for Allocations and Cooperative Agreement (October 2014). • Information Privacy and Security Requirements— IPSR Exhibit used for all agreements (September 2022). Additional MCAH Provisions Subcontract Requirements (Applicable when subcontractors or consultants are engaged) a. Prior Authorization: Required for any subcontract $5,000 and over. b. Competitive Bidding: Minimum three bids or documented justification. c. CDPH/MCAH Approval: CDPH reserves the right to approve or reject the subcontractors. (1) Costs incurred before approval may not be reimbursed. (2) Subcontract replacement must be completed within 30 days if required. d. Documentation: Maintain agreements and procurement records for CDPH/MCAH. July 2025 60 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 e. Payment and Oversight: Prime agencies are responsible for payment and performance. f. Compliance Pass-through: The subcontract agreement must include a clause: "(Subcontractor Name) agrees to maintain and preserve all records related to this agreement for seven (7) years following the termination of(Agreement Number) and final payment from CDPH to the contractor. During this period, (Subcontractor Name) shall grant CDPH or any authorized representative, access to review, audit, or examine any pertinent books, documents, papers and records. (Subcontractor Name) also agrees to make relevant personnel available for interviews regarding such records upon request." Audit and Record Retention Under 2 CFR 200.337, federal and state officials must be granted access to any records relevant to the award. Per the State Contracting Manual, Section 7.50, subsection B — Records Keeping and Retention, agencies and/or subcontractors must retain and provide the following documentation for seven (7) years upon request: 1. Policy and Procedures, including updates 2. Notices of Intent to Award 3. Approved Agreement Funding Application 4. Initial fiscal year budget and all subsequent revisions 5. SOW, duty statements, organization charts, position classifications. 6. Copies of all changes that occur to any of the documents above during the year, including CDPH/MCAH approvals of those changes. 7. Employee timesheets/timecards 8. FFP time studies documentation 9. Indirect Cost documentation 10.Invoices and expense supporting documentation 11.Cost allocation files 12.Supplemental invoice (if applicable). Filing Format: Audit files can be kept in electronic or paper format. Further audit requirements are detailed in Exhibit F. Capital Expenditures and Inventory Controlled Items In accordance with 2 CFR 200.1 Capital Expenditures means expenditures to acquire capital assets or expenditures to make additions, improvements, modifications, replacements, rearrangements, reinstallations, renovations, or alterations to capital assets that materially increase their value or useful life. Agencies must obtain prior written approval before purchasing capital assets and inventory-controlled items. Requirements include: • Demonstrated program necessity July 2025 61 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 • Maintenance of inventory records (CDPH 1204) • Submission of vendor receipts upon request • Allowance for audit and verification Failure to obtain prior approval may result in cost disallowance. Equipment and other capital expenditures are unallowable as indirect costs (See more rules of allowability with 2 CFR 200.439). Equipment Disposition In line with 2 CFR 200.313 (e) Equipment Disposition — When equipment acquired under a Federal award is no longer needed for the original project, program, or for other activities currently or previously supported by a Federal agency, the recipient or subrecipient must request disposition instructions from the Federal agency or pass- through entity if required by the terms and conditions of the Federal award. Agencies shall follow CDPH/MCAH's disposition instructions as follows: 1. Notify the Contract Liaison (CL) of disposal intentions. 2. The CL will obtain the approval from the Program Support Division (PSD) Asset Manager. 3. Follow specific procedures depending on item value and sensitivity. * Use forms CDPH 1204, STD 152, and CDPH 9051 (for data-wiping sensitive IT) July 2025 62 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Glossary of Terms and Acronyms Term Definition Actual Cost The actual price paid for real bona fide purchase costs of goods and services pursuant to the conduct of the MCAH Agreement and Budget. AFA Agreement Funding Application (AFA). The agreement between CDPH/MCAH and the Agencies to administer the MCAH programs. This includes, but is not limited to, the SOWs, Budget Documents, and Policies and Procedures. AFLP Adolescent Family Life Program (AFLP). Agency A Local Health Jurisdiction (LHJ); i.e., city or county health department or Community Based Organization, responsible for the public health needs in that designated geographic area. In California there are 61 Local Health Jurisdictions, 58 county public health departments and 3 city public health departments (Berkeley, Long Beach & Pasadena). Agency Funds Agency contributions towards the budget to help fund the activities needed to fulfill the program SOW. Allowable Cost Costs incurred which are necessary to meet the provisions of the SOW and are approved in the MCAH Agreement and Budget. Base Cost Per Unit The purchase price of an item, excluding tax, delivery, installation charged, etc. Budget Revision A revision in the previously approved budget to change line items and/or amounts. Capital Expenditures Major Equipment with a base cost per unit of$10,000 or more and a useful life expectancy of one or more years, including Telecommunications, and Electronic Data Processing/ Automated Data Processing software CBO A Community Based Organization (CBO), a non-profit organization which works to serve the disadvantaged in the community in which it is located. July 2025 63 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Term Definition CDPH California Department of Public Health (CDPH) works to protect the public's health and shape positive outcomes for individuals, families, and communities. CDPH 1203 Contractor's Equipment Purchased with CDPH Funds is a form to track Contractor equipment and miscellaneous property which is purchased with CDPH funds and is used to conduct state business under the contract. CDPH 1204 Inventory/Disposition of CDPH Funded Equipment form for inventory and disposition of equipment purchased with CDPH funds. CMS Centers for Medicaid and Medicare Services (CMS). Confidential Any information containing patient identifier, including but not limited to: Information Names Address Telephone number Social Security number Medical identification number Driver license number Contract Liaison A CDPH/MCAH staff assigned to an agency, who provides consultation (CL) concerning fiscal direction and issues such as Budget development and Invoicing. Corrective Action If an audit reveals that an Agency is not following required procedures or Plan (CAP) maintenance of documents, CDPH/MCAH will instruct the Agency to develop a Corrective Action Plan (CAP). The CAP will define the corrective actions the Agency must implement to become compliant. The CAP must be reviewed and approved by CDPH/MCAH staff. CPSP Comprehensive Perinatal Services Program (CPSP) is an obstetrical, psychosocial, nutritional, and health education services and related case coordination provided by or under the personal supervision of an approved CPSP provider during pregnancy and 60 calendar days following delivery. CTO Compensatory Time Off (CTO), time off in lieu of overtime pay. July 2025 64 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Term Definition DHCS Department of Health Care Services (DHCS) is the state agency responsible for managing and administering California's Medicaid program, known as Medi-Cal. Duty Statement Defined activities specific to program and position requirements and are considered legal and contractual obligations which can be audited. Enhanced Rate Federal Title XIX reimbursement of eligible approved costs at the ratio of 75% federal dollars to 25% State or Agency general fund dollars. FFP Federal Financial Participation (FFP) program is a funding mechanism used to generate additional revenue by reimbursing Agency or State funds with Title XIX dollars at an Enhanced and/or Non-enhanced rate for the proper and efficient administration of the Medi-Cal program's two objectives. Fringe Benefits Employer contributions for employer portion of payroll taxes (i.e., FICA, SUI, SDI, Training), Employee health plans (i.e., health, dental, and vision), Unemployment Insurance, Workers Compensation Insurance, and Employer's portion of pension. Retirement plans are included, provided they are granted in accordance with established written organization policies and meet all legal and Internal Revenue Service requirements. FTE Full-Time-Equivalent (FTE) means a standard eight-hour workday; 40 hours per week; or 2,080 hours per year. Goals Goals are overall statements of the mission and purpose of the program or an individual program component. July 2025 65 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Term Definition Good Cause Circumstances which are beyond the control of the agency and includes, but is not limited to: Damage to or destruction of the Agency's business office and/or records by a natural disaster, including fire, flood, or earthquake or when circumstances involving such disaster have substantially delayed Agency's operations. Theft, sabotage, or other deliberate, willful acts by an employee that have been reported to the appropriate law enforcement or fire agency when applicable. Other circumstances that are clearly beyond the control of the Agency that have been reported to the appropriate law enforcement or fire agency when applicable. Failure by CDPH/MCAH to fully execute the MCAH Agreement and Budget later than six months after the MCAH Agreement and Budget start date. Untimely illness or absence of any employee trained to prepare invoices, reports, or Budget Revisions. This does not include an Agency vacancy. All circumstances will be reviewed and approved/disapproved on a case-by-case basis by CDPH/MCAH management. Failure by CDPH/MCAH to fully execute revisions before the MCAH Agreement and Budget's termination, expiration date, or fiscal year end. Indirect Costs Those costs which are within the Agency and cannot be clearly identified as expenses to direct program costs. The calculation is based on Total Wages (excluding benefits) from the Personnel Detail Worksheet. Job Specification County civil service classification describing standard educational and experience requirements for appointment to specific positions. Job Specification can be referred to as a classification specification LHJ A Local Health Jurisdiction (LHJ), i.e., city or county health department, responsible for the public health needs in that designated geographic area MAA Medi-Cal Administrative Activities (MAA). July 2025 66 * California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Term Definition Major Equipment A tangible or intangible item having a base unit cost of$10,000 or more with a life expectancy of one (1) year or more and is either furnished by CDPH or the cost is reimbursed through this Agreement. Software and videos are examples of intangible items that meet this definition. MCAH Maternal, Child and Adolescent Health (MCAH). MCAH Director The Maternal, Child and Adolescent Health (MCAH) Director is an individual appointed by the Agency who is responsible for carrying out the terms and conditions of the MCAH program Agreement and Budget. MCAH-Related Programs operated under CDPH/MCAH and accountable to follow the Programs policies set forth in this manual; MCAH, AFLP, FIMR, SIDS, BIH and CHVP. MCP The Medi-Cal Percentage (MCP) is a percentage that identifies the portion of the region's general population receiving MCAH-related services that are Medi- Cal beneficiaries. The MCP is one of two components that determine Title XIX claiming amounts. Medi-Cal California's Medicaid program that provides healthcare and service to those who meet Medi-Cal eligibility requirements. Medi-Cal Eligible Individuals who have applied for and been granted Medi-Cal benefits, as well as the Medi-Cal potential eligible population (i.e., the population at the poverty rate qualified to receive Medi-Cal benefits). Minor Equipment A tangible item having a base unit cost of less than $10,000 with a life expectancy of one (1) year or more and is either furnished by CDPH or the cost is reimbursed through this Agreement. Non-Enhanced Federal Title XIX reimbursement of eligible approved costs at the ratio of Funding 50% federal dollars to 50% State or Agency general fund dollars. Organization Chart A diagram illustrating the interrelationship of the local health jurisdiction staff associated with all MCAH-funded programs. July 2025 67 California Department of *Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Outreach Activities to inform and/or connect persons to available services or care. Term Definition Program Consultant A CDPH/MCAH staff person, assigned to an agency or program, that (PC) provides skilled expertise in the areas of program standards, SOW, personnel, program policy development, and quality improvement. PSC Perinatal Services Coordinator (PSC) is the person, in collaboration with the MCAH Director, responsible for the implementation of the CPSP in the LHJ. QA Quality Assurance (QA). A program for the systematic monitoring, evaluation, and improvement of the various aspects of a program, entity or group. Salary Savings Salary savings are a result of unfilled positions and reduced FTEs and are not allowable in AFLP without Contract Liaison Approval. The criteria is that services provided should not be diminished to cover operational expenses. Please consult the MCAH Program Consultant or Contract Liaison. Supporting Supporting documentation gives support to the claiming of matchable FFP Documentation funding, can be requested by CDPH/MCAH to verify high percentages of FFP matching, and is reviewed during on-site audits to verify the percentage of FFP matching. SGF State General Fund (SGF). SIDS Sudden Infant Death Syndrome (SIDS). SOW A Scope of Work (SOW) is a component in the MCAH Agreement and Budget which contains the goals, objectives and methods of evaluation to be met under the terms and conditions of this MCAH Agreement and Budget. SPMP Skilled Professional Medical Personnel (SPMP) have the education and training at a professional level in the field of medical care or of an appropriate medical practice. July 2025 68 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Subcontract A written agreement between the Agency and a subcontractor specifically related to securing or fulfilling the Agency's obligation to CDPH/MCAH under the terms of the MCAH Agreement and Budget. TCM Targeted Case Management (TCM), a Medicaid program. Time Study A method to record time spent on all activities for those staff claiming FFP. July 2025 69 California Department of Public Health PROCUREMENT AGREEMENT NUMBER: P-25-525 Fresno Interdenominational Refugee Ministries (FIRM) October 21, 2025 Term Definition Title V Funds Unmatchable federal MCAH Block Grant funds authorized under Title V of the federal Social Security Act. Title XIX Funds Federal Medicaid money obtained under Title XIX of the federal code by means of State and/or local revenue match for costs of activities related to eligible and potentially eligible Medi-Cal women and children. July 2025 69 California Department of Public Health P-25-525 Agreement PDF Final Audit Report 2025-11-12 Created: 2025-11-04 By: Christine Barker(christine@firminc.org) Status: Signed Transaction ID: CBJCHBCAABAAVdWaktlNv5-haD84ajni54jA_bswvC2j "P-25-525 Agreement PDF" History Document created by Christine Barker(christine@firminc.org) 2025-11-04-9:56:18 PM GMT Document emailed to Thoua Lee (thoua.lee1979@gmail.com)for signature 2025-11-04-10:02:21 PM GMT Christine Barker(christine@firminc.org) replaced signer Thoua Lee (thoua.lee1979@gmail.com) with Thoua Lee (thoualee@hmongtvnetwork.com) 2025-11-12-4:32:28 PM GMT Document emailed to Thoua Lee (thoualee@hmongtvnetwork.com)for signature 2025-11-12-4:32:28 PM GMT Email viewed by Thoua Lee (thoualee@hmongtvnetwork.com) 2025-11-12-7:27:10 PM GMT Document e-signed by Thoua Lee (thoualee@hmongtvnetwork.com) Signature Date:2025-11-12-9:42:30 PM GMT-Time Source:server Document emailed to Matias Bernal, PhD (mattdromundo@gmail.com) for signature 2025-11-12-9:42:32 PM GMT Email viewed by Matias Bernal, PhD (mattdromundo@gmail.com) 2025-11-12-9:43:53 PM GMT Document e-signed by Matias Bernal, PhD (mattdromundo@gmail.com) Signature Date:2025-11-12-9:45:47 PM GMT-Time Source:server Agreement completed. 2025-11-12-9:45:47 PM GMT 0 Adobe Acrobat Sign