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HomeMy WebLinkAboutCentral Star PHF Agt 14-704-2.pdfCOUNTY OF FRESNO Fresno, CA -1 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AMENDMENT II TO AGREEMENT THIS AMENDMENT, hereinafter referred to as “Amendment II”, is made and entered into this ____ day of _______________, 2017, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as “COUNTY”, and CENTRAL STAR BEHAVIORAL HEALTH, INC., a for-profit organization , whose address is 1501 Hughes Way, Suite 150, Long Beach, CA 90810, hereinafter referred to as “CONTRACTOR” (collectively as the “parties”). WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement No. 14-704, effective January 1, 2015, and COUNTY Amendment No. 14-704-1, effective May 24, 2016, (collectively referred to herein as “Agreement No. 14-704”) whereby CONTRACTOR agreed to provide inpatient psychiatric services to youth, twelve (12) years of age to eighteen (18) years of age, who may be admitted on a voluntary or involuntary basis and may include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal beneficiaries, indigent/uninsured consumers, and juvenile inmates who are referred by COUNTY’S Department of Behavioral Health (DBH), a contract provider with DBH, hospital emergency room, or other County departments and agencies; and WHEREAS, the parties desire to amend COUNTY Agreement No. 14-704 and No. 14-704-1, regarding changes as stated below and restate the Agreement in its entirety. NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the parties agree to amend the Agreement as follows: 1.That the text of Agreement No. 14-704 at Page Four (4), beginning with Line Fourteen (14), with the number “4.” and ending on Page Ten (10), Line Twelve (12) with the word “(SED)” be deleted and the following inserted in its place: “4. COMPENSATION COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation in accordance with the budget set forth in Revised Exhibit B-1, attached hereto and by this reference incorporated herein and made part of this Agreement. For the period of April 1, 2015 through June 30, 2016, the COUNTY shall pay CONTRACTOR for operational costs for up to twelve (12) beds per day to assist in the program development/capacity of the PHF. The COUNTY and COUNTY OF FRESNO Fresno, CA - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTRACTOR agree that the CONTRACTOR will actively solicit and contract with other entities/agencies for bed placement at the PHF at no cost to the COUNTY. CONTRACTOR will provide the COUNTY, in writing, a list of secured contracts with hospitals, other agencies, and counties utilizing the PHF. The COUNTY shall pay the CONTRACTOR for up to twelve (12) beds per day for FY 2014-15 (April 1, 2015 through June 30, 2015) and FY 2015-16 (July 1, 2015 through June 30, 2016), less any beds purchased and/or utilized and charged to other outside agencies. A. Maximum Contract Amount The maximum amount under this Agreement for the Ramp Up period (January 1, 2015 through March 31, 2015) shall not exceed Four Hundred Fifty-One Thousand, One Hundred Eighty-Nine and No/100 Dollars ($451,189.00) as identified in Revised Exhibit B-1. 1. The maximum amount for the initial operational term (April 1, 2015 through June 30, 2015) shall not exceed Nine Hundred Twenty-One Thousand, Six Hundred Forty- Eight and No/100 Dollars ($921,648.00). During the initial operating term, the facility will operate at a twelve (12) bed capacity. COUNTY shall pay CONTRACTOR for operational costs for up to twelve (12) beds per day, less any beds purchased and/or utilized and charged to other outside agencies. The COUNTY shall pay CONTRACTOR Eight Hundred Forty-Four and No/100 Dollars ($844.00) for a daily bed rate. For the initial operational term (April 1, 2015 through June 30, 2015), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate Four Hundred Thirty-Seven Thousand, Seven Hundred Eighty-Three and No/100 Dollars ($437,783.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, Private Insurance, and Uninsured payable under this Agreement shall not exceed Four Hundred Eight-Three Thousand, Eight Hundred Sixty- Five and No/100 Dollars ($483,865.00) as set forth in the budget identified in Revised Exhibit B-1. 2. The maximum amount for the second operational term (July 1, 2015 through June 30, 2016) shall not exceed Three Million, Five Hundred Two Thousand, Eight Hundred Forty and No/100 Dollars ($3,502,840.00). During the second operational term, the facility will operate at a twelve (12) bed capacity. The COUNTY shall pay the CONTRACTOR for twelve beds COUNTY OF FRESNO Fresno, CA - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 per day, less any beds purchased and/or utilized and charged to other outside agencies. COUNTY shall pay CONTRACTOR a daily bed rate of Seven Hundred Ninety-Seven and 55/100 Dollars ($797.55) for Fresno County clients. For the second operational term (July 1, 2015 through June 30, 2016), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million, Five Hundred Seventy-Six Thousand, Two Hundred Seventy-Eight and No/100 Dollars ($1,576,278.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, Private Insurance, and Uninsured payable under this Agreement shall not exceed One Million, Nine Hundred Twenty-Six Thousand, Five Hundred Sixty-Two and No/100 Dollars ($1,926,562.00) as set forth in the budget identified in Revised Exhibit B-1. 3, The maximum amount for the third operational term (July 1, 2016 through June 30, 2017) shall not exceed Four Million, One Hundred Sixty-One Thousand, Eight Hundred Eighteen and No/100 Dollars ($4,161,818.00). During the third operational term, the facility will operate at a sixteen (16) bed capacity. The COUNTY shall pay the CONTRACTOR for twelve (12) beds per day, less any beds purchased and/or utilized and charged to other outside agencies. COUNTY shall pay CONTRACTOR a daily bed rate of Eight Hundred Forty-Four and No/Dollars ($844.00) for Fresno County clients. CONTRACTOR shall seek payment, if applicable, for any costs above the maximum amount stated herein for FY 2016-17, from other outside agencies. For the third operational term (July 1, 2016 through June 30, 2017), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million, Eight Hundred Seventy-Two Thousand, Eight Hundred Eighteen and No/100 Dollars ($1,872,818.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, Private Insurance, and Uninsured payable under this Agreement shall not exceed Two Million, Two Hundred Eighty-Nine Thousand, and No/100 Dollars ($2,289,000.00) as set forth in the budget identified in Revised Exhibit B-1. /// COUNTY OF FRESNO Fresno, CA - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4. The maximum amount for the fourth operational term (July 1, 2017 through June 30, 2018) shall not exceed Four Million, Two Hundred Eighty Thousand, Four Hundred Eighty-Six and No/100 Dollars ($4,280,486.00). During the fourth operational term, the facility will operate at a sixteen (16) bed capacity. COUNTY shall pay CONTRACTOR for operational costs for up to sixteen (16) beds per day, less any beds purchased and/or utilized and charged to other outside agencies. The daily bed rate for Fresno County clients shall be Seven Hundred Thirty-Two and 96/100 Dollars ($732.96), during this term. For the fourth operational term (July 1, 2017 through June 30, 2018), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million, Three Hundred Six Thousand, Seven Hundred Thirty-Five and No/100 Dollars ($1,306,735.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, private insurance, uninsured, and other revenue payable under this Agreement shall not exceed Two Million, Nine Hundred Seventy-Three Thousand, Seven Hundred Fifty-One and No/100 Dollars ($2,973,751.00) as set forth in the budget identified in Revised Exhibit B-1. 5. The maximum amount for the fifth operational term (July 1, 2018 through June 30, 2019) shall not exceed Four Million, Four Hundred Two Thousand, One Hundred Thirty-Four and No/100 Dollars ($4,402,134.00). During the fifth operational term, the facility will operate at a sixteen (16) bed capacity. COUNTY shall pay CONTRACTOR for operational costs for up to sixteen (16) beds per day, less any beds purchased and/or utilized and charged to other outside agencies. The daily bed rate for Fresno County clients shall be Seven Hundred Fifty-Three and 79/100 Dollars ($753.79), during this term. For the fifth operational term (July 1, 2018 through June 30, 2019), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million, Three Hundred Forty-Two Thousand, Six Hundred Fifty and No/100 Dollars ($1,342,650.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, private insurance, uninsured, and other revenue payable under this Agreement shall not exceed Three Million, Fifty-Nine Thousand, Four COUNTY OF FRESNO Fresno, CA - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Hundred Eighty-Four and No/100 Dollars ($3,059,484.00) as set forth in the budget identified in Revised Exhibit B-1. 6. The maximum contract amount for the sixth operational term (July 1, 2019 through June 30, 2020) shall not exceed Four Million, Five Hundred Thirty-Nine Thousand, Nine Hundred Eighty-One and No/100 Dollars ($4,539,981.00). During the sixth operational term, the facility will operate at a sixteen (16) bed capacity. COUNTY shall pay CONTRACTOR for operational costs for up to sixteen (16) beds per day, less any beds purchased and/or utilized and charged to other outside agencies. The daily bed rate for Fresno County clients shall be Seven Hundred Seventy-Five and 27/100 Dollars ($775.27), during this term. For the sixth operational term (July 1, 2019 through June 30, 2020), it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to generate One Million, Three Hundred Eighty-Four Thousand, Six Hundred Ninety-Four and No/100 Dollars ($1,384,694.00) in Medi-Cal Federal Financial Participation to offset CONTRACTOR’s program costs. It is further understood that the amount of Mental Health Realignment, private insurance, uninsured, and other revenue payable under this Agreement shall not exceed Three Million, One Hundred Fifty-Five Thousand, Two Hundred Eighty-Seven and No/100 Dollars ($3,155,287.00) as set forth in the budget identified in Revised Exhibit B-1. 7. In no event shall the total maximum compensation for actual services performed under this Agreement be in excess of Twenty-Two Million, Two Hundred Sixty Thousand, Ninety-Six and No/100 Dollars ($22,260,096.00). It is understood that all expenses incidental to CONTRACTOR’s performance of services under this Agreement shall be borne by CONTRACTOR. B. If CONTRACTOR fails to generate the Medi-Cal revenue amounts set forth in Revised Exhibit B-1, the COUNTY shall not be obligated to pay the difference between the estimated revenue and the actual revenue generated. It is further understood by COUNTY and CONTRACTOR that any Medi-Cal revenue and other reimbursement above the amounts stated herein will be used to directly offset the COUNTY’s contribution of funds identified in Revised Exhibit B-1. The offset of funds will also be clearly identified in monthly invoices received from CONTRACTOR as further described in Section COUNTY OF FRESNO Fresno, CA - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Five (5) of this Agreement. Travel shall be reimbursed based on actual expenditures and mileage reimbursement shall be at CONTRACTOR’s adopted rate per mile, not to exceed the Internal Revenue Service published rate. Payment shall be made upon certification or other proof satisfactory to COUNTY’s DBH that services have actually been performed by CONTRACTOR as specified in this Agreement. C. It is understood that all expenses incidental to CONTRACTOR’s performance of services under this Agreement shall be borne by CONTRACTOR. If CONTRACTOR fails to comply with any provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation. D. Payment shall be made by COUNTY to CONTRACTOR in arrears, for services provided during the preceding month, within forty-five (45) days after the date of receipt and approval by COUNTY of the monthly invoicing as described in Section Five (5) herein. Payment shall be made after receipt and verification of actual expenditures incurred by CONTRACTOR in performance of this Agreement and shall be documented to COUNTY on a monthly basis by the tenth (10th) of the month following the month of said expenditures. The parties acknowledge that the CONTRACTOR will be developing the PHF during the time period beginning at the execution of this Agreement through March 31, 2015 and will be performing hiring, training, and credentialing of staff, configuring the facility and office space, obtaining site certification from the County Mental Health Plan (Mental Health Plan), and other administrative tasks associated with launching the PHF. CONTRACTOR shall submit to the COUNTY by the tenth (10th) of each month a detailed general ledger (GL) itemizing costs incurred in the previous month. Failure to submit GL reports and supporting documentation shall be deemed sufficient cause for COUNTY to withhold payments until there is compliance, as further described in Section Five (5) herein. E. For the Ramp Up period (January 1, 2015 through March 31, 2015), payments shall be made by COUNTY to CONTRACTOR in equal installments. COUNTY will pay to CONTRACTOR on the twentieth (20th) of each month for the services to be provided the following COUNTY OF FRESNO Fresno, CA - 7 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 month in the arrears. CONTRACTOR shall submit to COUNTY by the tenth (10th) of the each month a detailed general ledger (GL) itemizing cost incurred in the previous month. Each payment will be reconciled to CONTRACTOR’s GL, and any amounts identified as owed to COUNTY will be reduced from COUNTY’s next payment to CONTRACTOR. The first reconciliation shall be performed after the third month of the facility’s operation with subsequent reconciliation performed every month thereafter. The parties agree that the CONTRACTOR shall have the PHF facility operational commencing April 1, 2015. Failure to submit GL reports and supporting documentation shall be deemed sufficient cause for COUNTY to withhold payments until there is compliance, as further described in Section Five (5) herein. F. For the operational period (April 1, 2015 through June 30, 2015), COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation based upon actual expenditures incurred by CONTRACTOR for monthly program costs, in accordance with the budget identified in Revised Exhibit B-1. For the operational period (July 1, 2017 through June 30, 2018) and every twelve (12) month operational period following, COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation based upon actual expenditures incurred by CONTRACTOR for monthly program costs, in accordance with the budget identified in Revised Exhibit B-1. G. Except as provided below regarding State payment delays, payments by COUNTY shall be in arrears, for services provided during the preceding month, within forty-five (45) days after receipt, verification, and approval of CONTRACTOR’s invoices by COUNTY’s DBH. If CONTRACTOR should fail to comply with any provisions of this Agreement, COUNTY shall be relieved of its obligation for further compensation. All final claims and/or any final budget modification request shall be submitted by CONTRACTOR within sixty (60) days following the final month of service for which payment is claimed. No action shall be taken by COUNTY on claims submitted beyond the sixty (60) day closeout period. Any compensation which is not expended by CONTRACTOR pursuant to the terms and conditions of this Agreement shall automatically revert to COUNTY. COUNTY OF FRESNO Fresno, CA - 8 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 The services provided by CONTRACTOR under Agreement are funded in whole or in part by the State of California. In the even that funding for these services is delayed by the State Controller, COUNTY may defer payment to CONTRACTOR. The amount of the deferred payment shall not exceed the amount of funding delayed by the State Controller to COUNTY. The period of time of the deferral by COUNTY shall not exceed the period of time of the State Controller’s delay of payment to COUNTY plus forty-five (45) days. CONTRACTOR shall be held financially liable for any and all future disallowances/audit exceptions due to CONTRACTOR’s deficiency discovered through the State audit process and COUNTY utilization review during the course of the agreement. At COUNTY’s election, the disallowed amount will be remitted within forty-five (45) days to COUNTY upon notification or shall be withheld from subsequent payments to CONTRACTOR. CONTRACTOR shall not reiceve reimbursement for any units of services rendered that are disallowed or denied by the COUNTY Quality Improvement Committee utilization review process or through State Department of Health Care Services (DHCS) cost report audit settlement process for Medi-Cal eligible clients. H. It is understood by CONTRACTOR and COUNTY that this Agreement is funded with mental health funds to service individuals with serious emotional disturbances (SED).” 2. That the text of Agreement No. 14-704 at Page Ten (10), beginning with Line Thirteen (13), with the word number “5.” and ending on Page Fourteen (14), Line Seventeen (17) with the word “requirements” be deleted and the following inserted in its place: “5. INVOICING A. COUNTY’s DBH shall invoice CONTRACTOR by the fifth (5th) day of each month for the prior month’s expenditures for security, janitorial, landscaping, building maintenance and utilities for the PHF. CONTRACTOR shall provide payment for these expenditures to County of Fresno, Department of Behavioral Health, Accounts Receivable, P.O. Box 712, Fresno, CA 93717-0712, Attention: Business Office, within forty-five (45) days after the date of receipt by CONTRACTOR of the monthly invoicing provided by COUNTY. B. CONTRACTOR shall invoice COUNTY in arrears by the tenth (10th) day of each month for the prior month’s services rendered to DBHInvoices@co.fresno.ca.us. After COUNTY OF FRESNO Fresno, CA - 9 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CONTRACTOR renders service to referred clients, CONTRACTOR will invoice COUNTY for payment, certify the expenditure, and submit electronic claiming billing directly into COUNTY’s electronic information system for all clients, including those eligible for Medi-Cal as well as those that are not eligible for Medi-Cal, including contracted cost per unit and actual cost per unit. COUNTY must pay CONTRACTOR before submitting a claim to the State Department of Health Care Services (DHCS) for Federal and State reimbursement for Medi-Cal eligible clients. C. At the discretion of COUNTY’s DBH Director, or designee, if an invoice is incorrect or is otherwise not in proper form or substance, COUNTY’s DBH Director, or designee shall have the right to withhold payment as to only that portion of the invoice that is incorrect or improper after five (5) days prior notice to CONTRACTOR. CONTRACTOR agrees to continue to provide services for a period of ninety (90) days after notification of an incorrect or improper invoice. If after the ninety (90) day period, the invoice(s) is still not corrected to COUNTY’s DBH satisfaction, COUNTY’s DBH Director, or designee, may elect to terminate this Agreement, pursuant to the termination provisions stated in Section Three (3) of this Agreement. In addition, for invoices received ninety (90) days after the expiration of each term of this Agreement or termination of this Agreement, at the discretion of COUNTY’s DBH Director, or designee, COUNTY’s DBH shall have the right to deny payment of any additional invoices received. D. Initial invoice for ramp up period (January 1, 2015 to March 31, 2015) will not contain roster reporting. Monthly invoices during the operational period (after March 31, 2015) shall include a client roster identifying bed utilization unit/bed volume reported by payer group for clients served (including clients from other agencies and third party payer of services) by month and year-to-date. For the initial fifteen months of the operational contract (April 1, 2015 to June 30, 2016) the CONTRACTOR’s client roster reporting will contain the twelve (12) bed funding calculation as stated in Section Four (4) above. E. CONTRACTOR shall submit monthly invoices and general ledgers that itemize the line item charges for monthly program costs (per applicable budget, as identified in Revised Exhibit B-1), including the cost per unit calculation based on clients served within that month, and excluding unallowable costs. Unallowable costs such as lobbying or political donations must be COUNTY OF FRESNO Fresno, CA - 10 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 deducted from the monthly invoice reimbursements. The invoices and general ledgers will serve as tracking tools to determine if CONTRACTOR’s program costs are in accordance with its budgeted cost compared to actual cost per unit, as set forth in Revised Exhibit B-1. The actual cost per unit will be based upon total costs and total units of service. It will also serve for the COUNTY to certify the public funds expended for purposes of claiming federal reimbursement for the cost of Medi-Cal services and activities. CONTRACTOR shall remit to COUNTY on a quarterly basis, a summary report of total operational costs and volume of service units to report the actual costs per unit compared to the negotiated rate, as identified in Revised Exhibit B-1, to report the interim cost per unit. The quarterly reports will be used by COUNTY to ensure compliance with Federal and State reimbursements certified public expenditures. F. CONTRACTOR will remit annually within ninety (90) days from June 30, a schedule to provide the required information on published charges for all authorized services. The published charge listing will serve as a source document to determine the CONTRACTOR’s usual and customary charge prevalent in the public mental health sector that is used to bill the general public, insurers, or other non-Medi-Cal third party payers during the course of business operations. G. CONTRACTOR shall submit monthly staffing report that identify all direct service and support staff, applicable licensure/certification, and full-time hours worked to be used as a tracking tool to determine if CONTRACTOR’s program is staffed according to the services provided under this Agreement. H. CONTRACTOR must maintain such financial records for a period of seven (7) years or until any dispute, audit, or inspection is resolved, whichever is later. CONTRACTOR will be responsible for any disallowances related to inadequate documentation. I. CONTRACTOR is responsible for collection and managing data in a manner to be determined by DHCS and the Mental Health Plan in accordance with applicable rules and regulations. COUNTY electronic information system is a critical source of information for purposes of monitoring service volume and obtaining reimbursement. CONTRACTOR must attend COUNTY DBH’s Business Office training on equipment reporting for assets, intangible and sensitive minor assets, COUNTY’s electronic information system, and related cost reporting. COUNTY OF FRESNO Fresno, CA - 11 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 J. CONTRACTOR shall submit service data into COUNTY’s electronic information system within thirty (30) calendar days from the date services were rendered. Federal and State reimbursement for Medi-Cal specialty mental health services is based on public expenditures certified by the CONTRACTOR. CONTRACTOR must submit a signed certified public expenditure report with each respective monthly invoice. DHCS expects the claim for reimbursement to equal the amount the COUNTY paid the CONTRACTOR for the service rendered less any funding sources not eligible for Federal and State reimbursement. K. CONTRACTOR must provide all necessary data to allow the COUNTY to bill Medi-Cal, and any other third-part source, for services and meet State and Federal reporting requirements. The necessary data can be provided by a variety of means, including but not limited to: 1) direct data entry into COUNTY’s electronic information system; 2) providing an electronic file compatible with COUNTY’s electronic information system; or 3) integration between COUNTY’s electronic information system and CONTRACTOR’s information system(s). L. If a client has other health coverage (OHC) such as private insurance, or Federal Medicare, the CONTRACTOR will be responsible for billing the carrier and obtaining a payment/denial, or have validation of claiming with no response ninety (90) days after the claim was mailed, before the service can be entered into the COUNTY’s electronic information system. A copy of explanation of benefits or CMS 1500 is required as documentation. CONTRACTOR must report all revenue collection from OHC, third party, client-pay, or private-pay in each monthly invoice and in the cost report that is required to be submitted. CONTRACTOR shall submit monthly invoices for reimbursement that equal the amount due CONTRACTOR less any funding sources not eligible for Federal and State reimbursement. CONTRACTOR must comply with all laws and regulations governing the Federal Medicare program, including, but not limited to 1) the requirement of the Medicare Act, 42 U.S.C. section 1395 et seq; and 2) the regulation and rules promulgated by the Centers for Medicare and Medicaid Services as they relate to participation, coverage, and claiming reimbursement. CONTRACTOR will be responsible for compliance as of the effective date of each Federal, State, or local law or regulation specified. /// COUNTY OF FRESNO Fresno, CA - 12 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 M. Data entry shall be the responsibility of the CONTRACTOR. The direct specialty mental health services data must be reconciled by the CONTRACTOR to the monthly invoices submitted for payment. COUNTY shall monitor the number the volume of services and cost of services entered into the COUNTY’s electronic information system. Any and all audit exceptions resulting from the provision and billing of Medi-Cal services by CONTRACTOR shall be the sole responsibility of the CONTRACTOR. CONTRACTOR will comply with all applicable policies, procedures, directives, and guidelines regarding the use of COUNTY’s electronic information system. N. Medi-Cal Certification and Mental Health Plan Compliance CONTRACTOR will establish and maintain Medi-Cal certification or become certified within ninety (90) days of the effective date of this Agreement through COUNTY to provide reimbursable services to Medi-Cal eligible clients. In addition, CONTRACTOR shall work with the COUNTY’s DBH to execute the process if not currently certified by COUNTY for credentialing of staff. During this process, the CONTRACTOR will obtain a legal entity number established by the DHCS, as this is a requirement for maintaining Mental Health Plan organizational provider status throughout the term of this Agreement. CONTRACTOR will be required to become Medi-Cal certified prior to providing services to Medi-Cal eligible clients and seeking reimbursement from the COUNTY. CONTRACTOR will not be reimbursed by COUNTY for any services rendered prior to certification. CONTRACTOR shall provide specialty mental health services in accordance with the COUNTY’s Mental Health Plan. CONTRACTOR must comply with the “Fresno County Mental Health Plan Compliance Program and Code of Conduct” set forth in Exhibit C, attached hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR may provide direct specialty mental health services using unlicensed staff as long as the individual is approved as a provider by the Mental Health Plan, is supervised by licensed staff, works within his/her scope, and only delivers allowable specialty mental health services. It is understood that each claim is subject to audit for compliance with Federal and State regulations, and that COUNTY may be making payments in advance of said review. In the event that a service is disapproved, COUNTY may, at its sole discretion, withhold compensation or set COUNTY OF FRESNO Fresno, CA - 13 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 off from other payments due the amount of said disapproved services. CONTRACTOR shall be responsible for audit exceptions to ineligible dates of services or incorrect application of utilization review requirements.” 3. That all references in Agreement No. 14-704 to “Exhibit A” shall be changed to read “Revised Exhibit A,” attached hereto and incorporated herein by reference. 4. That all references in Agreement No. 14-704 to “Revised Exhibit B” shall be changed to read “Revised Exhibit B-1,” attached hereto and incorporated herein by reference. 5. COUNTY and CONTRACTOR agree that this Amendment II is sufficient to amend the Agreement; and that upon execution of this Amendment II, the Agreement, Amendment I, and Amendment II together shall be considered the Agreement. The Agreement, as hereby amended, is ratified and continued. All provisions, terms, covenants, conditions and promises contained in the Agreement, and not amended herein, shall remain in full force and effect. This Amendment II shall become effective upon execution by all parties. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 1 2 3 4 5 6 7 8 9 10 IN WITNESS WHEREOF the parties hereto have executed this Amendment II to COUNTY Agreement No . 14-704 as of the day and year first hereinabove w ritten. CONTRACTOR: CENTRAL STAR BEHAVIORAL HEALTH INC. By L¥~~ PrintName : ~L~n+ 4?. <r ~ __,-- Title: f'/e'p£t4_/:~ {A_o Chairman of Board , or COUNTY OF FRESNO (lll_ By ________ ~~------------ Chairman, Board of Supervisors Date: Lp -d--0 - \ J 11 President, or any Vice President 1 2 1 3 14 15 16 17 1 8 19 20 21 22 23 24 25 26 27 28 By &~ Print Name: 7 t:lnA-nJoy-gr.n Title: S-c.crz..e P ~ Secretary (of Corp t10n ), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer Mailing Address: Central Star Behavioral Health Inc . 1501 Hughes Way, Suite 150 Long Beach , CA 9081 0 Contact: Senior Vice President Phone: (31 0) 221-6336 ext 125 BERNICE E. SEIDEL, Clerk Board of Supervisors PLEASE SEE ADDITIONAL SIGNATURE PAGE ATTACHED -14 -COUN TY OF FRESNO Fresno, Cl'l Revised Exhibit A Page 1 of 7 YOUTH ACUTE INPATIENT PSYCHIATRIC SERVICES Psychiatric Health Facility (PHF) Scope of Work ORGANIZATION: Central Star Behavioral Health, Inc. ADDRESS: 1501 Hughes Way, Suite 150, Long Beach, CA 90810 SITE ADDRESS: 4411 E. Kings Canyon Road, Fresno, CA, 93702 SERVICES: Psychiatric Health Facility PROJECT DIRECTOR: Kent Dunlap, Senior Vice President Phone Number: (310) 221-6336 ext. 125 CONTRACT PERIOD: January 1, 2015 - March 31, 2015 (ramp up period) April 1, 2015 – June 30, 2015 with an option for five (5) twelve (12) month renewals (operational period) CONTRACT AMOUNT: $ 451,189 1/1/2015 through 3/31/2015 (ramp up period) $ 921,648 4/1/2015 through 6/30/2015 (initial operational period) $3,502,840 FY 2015-16 $4,161,818 FY 2016-17 $4,280,486 FY 2017-18 $4,402,134 FY 2018-19 $4,539,981 FY 2019-20 SCHEDULE OF SERVICES: CONTRACTOR shall operate the youth Psychiatric Health Facility (PHF) 24 hours per day, seven (7) days per week. The PHF shall be located at 4411 E. Kings Canyon Road, Fresno, CA 93702, a COUNTY owned building, pursuant to a separate lease agreement between COUNTY and CONTRACTOR. TARGET POPULATION: The target population will include youth twelve (12) years of age up to 18 years of age, who may be admitted on a voluntary or involuntary basis. These clients will include Medi-Cal beneficiaries, Medicare and Medicare/Medi-Cal beneficiaries, and indigent/uninsured clients who are referred by the Department of Behavioral Health (DBH) and other County Departments, a contract provider with the DBH, a hospital emergency room (aka emergency department), Juvenile Hall, and other agencies. PROJECT DESCRIPTION: CONTRACTOR will implement a youth Psychiatric Health Facility (PHF) to serve 684 (57/month) clients for each 12 month period of this agreement. Services include intensive, acute care, trauma-informed residential treatment to youth twelve (12) years of age up to 18 years of age. CONTRACTOR will provide 12 beds for the initial fifteen (15) months of operation (April 1, 2015 through June 30, 2016). In Fiscal Year 2016-17, and each subsequent year, CONTRACTOR will provide for 16 beds at any given time. Fresno County Department of Behavioral Health will have a designated amount of dedicated beds as stated in Paragraph 4 of the Agreement. Program goal of the PHF is to provide acute psychiatric hospitalization, coordinated discharge planning and effective linkages to post-hospital outpatient mental health treatment programs and other supportive services for youth and their families. Revised Exhibit A Page 2 of 7 CONTRACTOR shall be responsible to comply with the requirements of the Fresno County Mental Health Plan (FCMHP) and must complete and submit supporting documentation for all admissions regardless of payer source to the Fresno County Mental Health Plan (FCMHP). The FCMHP will perform a utilization review of all Medi-Cal beneficiaries to determine that the documentation demonstrates that medical necessity criteria, as defined by the California Department of Health Care Services. The 16 bed facility will be licensed by the State of California, Department of Health Care Services (DHCS), and meet all regulations required for operating a psychiatric health facility W&I Code 4080 Article 3; Health and Safety Code 1250.2 and meet Medi-Cal certification by the County. CONTRACTOR shall be responsible to enter all Client Service Information, admission data and billing information into the County data system (AVATAR) and will be responsible for any and all audit exceptions pertaining to the delivery of services. The CONTRACTOR will also be responsible for the mandated reporting of patient information and admission/discharge data and other required reports to the Office of State Health Planning and Development (OSHPD), the California Department of Health Care Services, and meet the submission deadlines on June 30 and December 31 each calendar year. CONTRACTOR’S RESPONSIBILITIES: A. GOALS: 1. Management and alleviation of client’s acute psychiatric symptoms to prevent clients from requiring inpatient services and use a less restrictive level of care. 2. Clinical program recovery/strength based with appropriate professional staffing on a 24 hour, 7 day a week basis. 3. Safe, secure and structured environment that promotes the clients wellness and recovery, including connections to family and community. 4. Comprehensive multi-disciplinary evaluation and client-centered care plan for each client. 5. Dietary services through the availability of nourishment or snacks in accordance with Title 22, Division 5, Chapter 9, Article 3, Section 77077. A dietician will be utilized for menu planning and assessment for dietary special needs, consistent with Title 22 requirements. 6. Admission procedures will be in place for voluntary and involuntary clients. 7. Treatment Planning – The Psychiatric Health Facility staff will provide the following services captured in written assessment and care plans: a. Mental Status Examination b. Medical Evaluation c. Psycho-Social Assessment d. Nursing Assessment e. Multi-Disciplinary Milieu Treatment Program f. Individualized Focused Treatment Planning g. Aftercare Planning 8. Staffing a. The staffing pattern and all staff working at the PHF shall meet all State licensing and regulatory requirements including medical staff standards, nursing staff standards, social work and rehabilitation staff requirements pursuant to Title 9, Division 1, Chapter 11, Revised Exhibit A Page 3 of 7 Article 3, Section 1840.348 of the California Code of Regulations for Psychiatric Health Facilities All staff, which requires state licensure or certification, will be required to be licensed or certified in the State of California and be in good standing with the state licensing or certification board. b. All facility staff, who provide direct patient care or perform coding/billing functions, must meet the requirements of the FCMHP Compliance Program. This includes the screening for excluded persons and entities by accessing or querying the applicable licensing board(s), the National Practitioner Data Bank (NPDB), Office of Inspector General’s List of Excluded Individuals/Entities (LEIE), Excluded Parties List System (EPLS) and Medi-Cal Suspended and Ineligible List prior to hire and monthly thereafter. In addition, all licensed/registered/waivered staff must complete a FCMHP Provider Application and be credentialed by the FCMHP’s Credentialing Committee. All licensed staff shall have Department of Justice (DOJ), Federal Bureau of Investigation (FBI), and Sheriff fingerprinting (Lives can) executed. c. Peer and/or Family Support staff will help to educate, support and advocate on behalf of children, youth and their families during the hospitalization and will assist with discharge planning and the transition to follow-up care. 9. Medical Records and Mandated Reporting: a. The CONTRACTOR shall be responsible to enter all Client Service Information, admission data and billing information into the County data system (AVATAR) and will be responsible for any and all audit exceptions pertaining to the delivery of services. b. The CONTRACTOR will be responsible for “release of information” requests f or the PHF and shall adhere to applicable federal and state regulations. c. The CONTRACTOR will report information and admission/discharge data to the Office of Statewide Health Planning and Development and meet the submission deadlines of June 30 and December 31 each calendar year. 10. Organized Clinical Staff - clinical staff will be licensed mental health professionals as well as Rehabilitation Therapists with appropriate education, credentialing and experience to reach status as a Qualified Mental Health Professional (QMHP). 11. Pharmaceutical and Medication Services – controls traditional to PHF’s for pharmaceutical and medication services will be reflected. CONTRACTOR will have policies, procedures and physician/nursing protocols in place regarding medication labeling, storage/security, orders, use of med carts, administration, polypharmacy, and monitoring response will observed. 12. Physical Health Care – CONTRACTOR will contract with a primary care physician and a registered dietician. CONTRACTOR will provide a full health history upon admission. CONTRACTOR will have a written agreement with one or more acute care hospitals to provide services for youth requiring additional needed services. 13. Schedule of Active Therapies - CONTRACTOR shall provide a daily schedule of therapeutic activities that will be provided as part of the clinical treatment program. The schedule shall include wellness education with motivational support, psycho-social and life skill building groups on varied topics, family therapy, creative expressive arts, recreational and fitness programs. The treatment team is expected to schedule clients participation activities tailored to each client’s individual needs. There will also be daily meetings among the staff and youth for general education and guidance about unit activities and to collectively address milieu living issues. 14. Utilization Review, Billing and Cost Report: Revised Exhibit A Page 4 of 7 a. CONTRACTOR shall notify the Department of any admission of a County client within 24 hours or the next business day in a manner approved by the County. The notification method shall be mutually acceptable by both County and CONTRACTOR. b. CONTRACTOR shall be responsible to insure that documentation in the client’s medical record meets medical necessity criteria for the hours of service submitted to County for reimbursement by federal intermediaries, third-party payers and other responsible parties. c. CONTRACTOR shall enter all mental health data and billing information into the County data system and will be responsible for any and all audit exceptions pertaining to the delivery of services. For Medi-Cal billing denials by the State, CONTRACTOR will maintain an error rate no greater than five percent (5%). d. CONTRACTOR shall submit a complete and accurate State of California Department of Health Care Services Short (DHCS)/Doyle Medi-Cal Cost Report for each fiscal year ending June 30th affected by the proposed agreement within 90 days following the end of each fiscal year. e. CONTRACTOR shall insure that cost reports are prepared in accordance with general accounting principles and the standards set forth by the DHCS and the County. 15. Patients Rights and Certification Review Hearings a. CONTRACTOR shall adopt and post in a conspicuous place a written policy on patient rights in accordance with section 70707 of Title 22 of the California Code of Regulations and section 5325.1 of the California Welfare and Institutions Code and Title 42 Code of Federal Regulations section 438.100. b. CONTRACTOR shall allow access to County clients by the Patients’ Rights Advocate designated by the County. c. CONTRACTOR shall conduct Mental Health Certification Review Hearings in accordance with regulations in a location within the facility that allows for confidentiality and is compatible with and is least disruptive to the treatment being provided to the County patient. 16. Grievances and Incident Reports - CONTRACTOR shall log all grievances and the disposition of all grievances received from a client or a client’s family in accordance with Fresno County Mental Health Plan policies and procedures as indicated within Exhibit H. CONTRACTOR shall provide a summary of the grievance log entries concerning County-sponsored clients to the Department of Behavioral Health Director or designee at monthly intervals, by the fifteenth (15th) day of the following month, in a format that is mutually agreed upon. CONTRACTOR shall post signs, provided by the County, informing clients of their right to file a grievance and appeal. CONTRACTOR shall notify County of all incidents or unusual occurrences reportable to state licensing bodies that affect County clients within twenty-four (24) hours. The CONTRACTOR shall use the Incident Report form as indicated within Exhibit I for such reporting. Within fifteen (15) days after each grievance or incident affecting County-sponsored clients, CONTRACTOR shall provide County with the complaint and CONTRACTOR’S disposition of, or corrective action taken to resolve the complaint or incident. Within fifteen (15) days after CONTRACTOR submits a corrective action plan to a California State licensing and/or accrediting body concerning any sentinel event, as the term is defined by the licensing or accrediting agency, and within fifteen (15) days after CONTRACTOR receives a corrective action order from a California State licensing and/or accrediting body to address a sentinel event, CONTRACTOR shall provide a summary of such plans and orders to County. Revised Exhibit A Page 5 of 7 B. OBJECTIVES 1. Safe and Secure Environment - to provide for clinical and medical assessment, diagnostic formulation, crisis intervention, medication management and clinical treatment for mental health clients with acute psychiatric disorder. All client care staff will be trained and certified by a nationally recognized assault crisis training that is principally focused on crisis prevention and de-escalation. 2. Provide the appropriate type and level of staffing to provide for a clinical effective program design. 3. Provide an intensive treatment program which has individualized client care plans. 4. Stabilize consumers as soon as possible in order to assist them in their recovery from mental illness. 5. Effectively partner with other programs in the Crisis Intervention Redesign in accepting County consumers for admission for acute inpatient psychiatric services and also to work collaboratively in discharge planning to insure appropriate ongoing outpatient specialty mental health treatment services are provided. 6. Identify County consumers with frequent admissions during the fiscal year and to develop strategies with other County and community agencies to reduce readmissions. 7. Effectively interact with community agencies, other mental health programs and providers, natural support systems and families to assist consumers to be discharged to the more appropriate level of care. 8. Integrate mental health and substance abuse services through comprehensive continuous integrated systems of care for the life span of those served and to work as partners with a shared vision: to create a coordinated and comprehensive system of service delivery. The CONTRACTOR shall perform the following: a. Demonstrate familiarity with the County Comprehensive Continuation Integrated System of Care (CCISC) consensus document and with the process of CCISC implementation, both in terms of county level activities, as well as the continuous quality improvement process that each program organizes in order to make progress toward co-occurring disorder capability. b. Conduct an on going agency self survey using the COMPASSTM (Co-Morbidity Program Audit and Self-Survey for behavioral health services), using the recommended focus group process to engage staff of all levels in the conversation. c. Identify a Change Agent to represent the program, and support that Change Agent to participate actively in the County change agent team. The role of the change agent is to provide training and supervision in accordance with the principles of the Comprehensive Continuous Integrated Systems of Care model in order to establish and enhance dual diagnosis competency in program staff and to provide consultation to facilitate development and implementation of quality improvement action planning to establish and enhance dual diagnosis capability in the program as a whole. d. Develop a formal written Continuous Quality Improvement (CQI) action plan to identify measurable objectives toward the achievement of Co-Occurring Disorders (COD) capability that will be addressed by the program during the contract period. These objectives should be ACHIEVABLE and REALISTIC for the program, based on the self assessment and the program priorities, but need to include attention to making progress on the following issues, at minimum (as outlined in the Charter): Revised Exhibit A Page 6 of 7 1. Welcoming policies, practices, and procedures related to the engagement of individuals with co-occurring issues and disorders; 2. Removal or reduction of access barriers to admission based on co-occurring diagnosis or medication; 3. Improvement in routine integrated screening, and identification in the data system of how many clients served have co-occurring issues; 4. Developing the goal of basic co-occurring competency for all treatment staff, regardless of licensure or certification, and 5. Documentation of coordination of care with collaborative mental health and/or substance abuse providers for each client. C. Regarding cultural and linguistic competence requirements: 1. CONTRACTOR shall provide services as stated in section 29 of the Agreement. D. Regarding direct admissions to the PHF from COUNTY DBH programs or its contracted providers, the CONTRACTOR agrees to the following: 1. To allow direct admits from COUNTY DBH programs or its contracted providers when PHF beds are available. 2. Said direct admits shall not require medical clearance. However, in the event a referred client is known to possess a contagious medical condition, said patient shall be medically cleared by a local hospital prior to admission to the PHF operated by CONTRACTOR. E Regarding the provision of court testimony related to PHF patients, CONTRACTOR agrees to the following: 1. CONTRACTOR’S appropriate staff shall provide court testimony relevant to PHF clients when required. COUNTY RESPONSIBILITIES: COUNTY shall: 1. Perform a utilization review (through its FCMHP) of all Medi-Cal beneficiaries to determine that the documentation demonstrates that medical necessity criteria as defined by the California Department of Health Care Services (DHCS) was met for each period of the admission, except for the episode of discharge. 2. Provide oversight (through the County Department of Behavioral Health (DBH), Children’s Mental Health Division Manager or designee) of the CONTRACTOR’S PHF program. In addition to contract monitoring of program(s), oversight includes, but not limited to, coordination with the State Department of Health Care Services in regard to program administration and outcomes. 3. Assist the CONTRACTOR in making linkages with the total mental health system. This will be accomplished through regularly scheduled meetings as well as formal and informal consultation. 4. Participate in evaluating the progress of the overall program and the efficiency of collaboration with the CONTRACTOR staff and will be available to the contractor for ongoing consultation. 5. Receive and analyze statistical outcome data from CONTRACTOR throughout the term of contract on a monthly basis. DBH will notify the CONTRACTOR when additional participation is required. The Revised Exhibit A Page 7 of 7 performance outcome measurement process will not be limited to survey instruments but will also include, as appropriate, client and staff interviews, chart reviews, and other methods of obtaining required information. 6. Recognize that cultural competence is a goal toward which professionals, agencies, and systems should strive. Becoming culturally competent is a developmental process and incorporates at all levels the importance of culture, the assessment of cross-cultural relations, vigilance towards the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally-unique needs. Offering those services in a manner that fails to achieve its intended result due to cultural and linguistic barriers is not cost effective. To assist the CONTRACTOR’S efforts towards cultural and linguistic competency, DBH shall provide the following at no cost to CONTRACTOR: A. Technical assistance to CONTRACTOR regarding cultural competency requirements and sexual orientation training. B. Mandatory cultural competency training including sexual orientation and sensitivity training for CONTRACTOR personnel, at minimum once per year. County will provide mandatory training regarding the special needs of this diverse population and will be included in the cultural competence training(s). Sexual orientation and sensitivity to gender differences is a basic cultural competence principle and shall be included in the cultural competency training. Literature suggests that the mental health needs of lesbian, gay, bisexual, transgender (LGBT) individuals may be at increased risk for mental disorders and mental health problems due to exposure to societal stressors such as stigmatization, prejudice and anti-gay violence. Social support may be critical for this population. Access to care may be limited due to concerns about providers’ sensitivity to differences in sexual orientation. C. Technical assistance for CONTRACTOR in translating behavioral health and substance abuse services information into DBH’s threshold languages (Spanish, Laotian, Cambodian and Hmong). Translation services and costs associated will be the responsibility of the CONTRACTOR. Revised Exhibit B-1 Page:1 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $0 $16,640 $16,640 0002 RN 3.20 $0 $10,677 $10,677 0003 LVN 2.80 $0 $5,096 $5,096 0004 Rehab Therapist 1.40 $0 $2,548 $2,548 0005 Rehab Aide 3.00 $0 $3,500 $3,500 0006 Youth Counselor 16.80 $0 $20,952 $20,952 0007 Admissions Coordinator 1.00 $0 $2,427 $2,427 0008 Family Advocate 1.00 $0 $1,400 $1,400 0009 Social Workers 2.80 $0 $7,159 $7,159 0010 Program Director 1.00 $0 $10,400 $10,400 0011 Cook 2.10 $0 $2,452 $2,452 0012 Administrator 0.75 $22,246 $0 $22,246 0013 HR Manager 0.50 $7,353 $0 $7,353 0014 QA Medical Records 0.50 $1,083 $0 $1,083 0015 Training Coordinator 0.50 $1,065 $0 $1,065 0016 Billing Clerk 1.00 $953 $0 $953 0017 Maintenance Tech 1.00 $1,333 $0 $1,333 0018 Housekeeper 1.50 $1,249 $0 $1,249 SALARY TOTAL 41.85 $35,282 $83,249 $118,532 PAYROLL TAXES: 0030 FICA/MEDICARE $2,699 $6,369 $9,068 0031 SUI $190 $449 $639 0032 FUTA $332 $783 $1,115 PAYROLL TAX TOTAL $3,221 $7,601 $10,822 EMPLOYEE BENEFITS: 0040 Retirement $29 $0 $29 0041 Workers Compensation $1,750 $4,129 $5,879 0042 $1,130 $0 $1,130 EMPLOYEE BENEFITS TOTAL $2,909 $4,129 $7,038 SALARY & BENEFITS GRAND TOTAL $136,392 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease - Admin/Business Office $1,500 1011 Leased Equipment $1,180 1012 Telecommunications $17,155 1013 Utilities $6,895 1014 Maintenance $1,943 FACILITY/EQUIPMENT TOTAL $28,673 OPERATING EXPENSES: 1060 $1,400 1061 $2,000 1062 $800 Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. Start Up Budget - proposed start date through proposed end date (FY 2014-15 - Jan-Mar 2015) Budget Categories - Total Proposed Budget Revised Exhibit B-1 Page:2 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. Start Up Budget - proposed start date through proposed end date (FY 2014-15 - Jan-Mar 2015) 1063 $1,000 1064 $0 1065 $7,200 1066 $1,200 1067 $20,000 OPERATING EXPENSES TOTAL $33,600 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $54,872 1081 General Insurance $1,100 1082 Centralized fiscal service .05 $21,484 FINANCIAL SERVICES TOTAL $77,456 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $9,795 1088 Supplies - House Meds $875 1089 Supplies - Medical $541 1090 Supplies Non-Medical $4,587 1091 Medical Records Supplies $300 1092 Food $615 1093 Supplies Non-Perishables $650 1094 Laundry & Linen $1,000 1095 Centralized Services - Program $6,080 SPECIAL EXPENSES TOTAL $24,443 FIXED ASSETS: 2000 Furniture & Fixture $82,414 2001 Security-Access Control System & Cameras $52,561 2002 IT Minor Equipment $15,650 Assets (useful life more than 1 year and valued at more than $5,000) 2003 Intangible software/License Assets (useful life more than 1 year and valued at more than $100,000)$0 FIXED ASSETS TOTAL $150,625 TOTAL PROGRAM EXPENSES $451,189 Recruiting EMR Cost Travel Education & Training Licenses Revised Exhibit B-1 Page:3 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. Start Up Budget - proposed start date through proposed end date (FY 2014-15 - Jan-Mar 2015) DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility $0 DIRECT SERVICE REVENUE TOTAL 0 $0 #REF! Cost Per Unit #DIV/0! FUNDING STREAMS REIMBURSEMENT 4000 Realignment Funding $451,189.00 $451,189 4100 Other 4200 Other 4300 Other REVENUE TOTAL $451,189 Medi-cal Revenue Revised Exhibit B-1 Page:4 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $0 $24,960 $24,960 0002 RN 3.20 $0 $64,064 $64,064 0003 LVN 2.80 $0 $30,576 $30,576 0004 Rehab Therapist 1.40 $0 $15,288 $15,288 0005 Rehab Aide 3.00 $0 $20,998 $20,998 0006 Youth Counselor 16.80 $0 $125,711 $125,711 0007 Admissions Coordinator 1.00 $0 $14,560 $14,560 0008 Family Advocate 1.00 $0 $8,398 $8,398 0009 Social Workers 2.80 $0 $42,952 $42,952 0010 Program Director 1.00 $0 $15,600 $15,600 0011 Cook 2.10 $0 $14,709 $14,709 0012 Administrator 0.75 $22,246 $0 $22,246 0013 HR Manager 0.50 $7,353 $0 $7,353 0014 QA Medical Records 0.50 $6,500 $0 $6,500 0015 Training Coordinator 0.50 $6,391 $0 $6,391 0016 Billing Clerk 1.00 $5,720 $0 $5,720 0017 Maintenance Tech 1.00 $7,998 $0 $7,998 0018 Housekeeper 1.50 $7,496 $0 $7,496 SALARY TOTAL 41.85 $63,703 $377,816 $441,518 PAYROLL TAXES: 0030 FICA/MEDICARE $4,873 $28,903 $33,776 0031 SUI $344 $2,040 $2,384 0032 FUTA $599 $3,551 $4,150 PAYROLL TAX TOTAL $5,816 $34,494 $40,310 EMPLOYEE BENEFITS: 0040 Retirement $2,797 $16,586 $19,383 0041 Workers Compensation $3,160 $18,740 $21,900 0042 $7,294 $43,260 $50,554 EMPLOYEE BENEFITS TOTAL $13,250 $78,586 $91,837 SALARY & BENEFITS GRAND TOTAL $573,665 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease - Admin/Business Office $1,500 1011 Leased Equipment $1,770 1012 Telecommunications $8,250 1013 Utilities $17,750 1014 Maintenance $1,500 1015 Security-Access Control System & Cameras $0 FACILITY/EQUIPMENT TOTAL $30,770 OPERATING EXPENSES: 1060 $19,751 1061 $500 Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) operated at a 12 bed capacity Central Star Behavioral Health, Inc. Operational Budget (April 1, 2015 through June 30, 2015) Budget Categories - Total Proposed Budget Revised Exhibit B-1 Page:5 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) operated at a 12 bed capacity Central Star Behavioral Health, Inc. Operational Budget (April 1, 2015 through June 30, 2015) 1062 $1,561 1063 $1,561 1064 $0 1065 $450 1066 $3,600 OPERATING EXPENSES TOTAL $27,422 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $86,235 1081 General Insurance $3,305 1082 Centralized fiscal service .05 $43,938 FINANCIAL SERVICES TOTAL $133,478 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $107,990 1088 Contract Therapist $8,286 1089 Supplies - House Meds $2,733 1090 Supplies - Medical $1,689 1091 Supplies Non-Medical $1,000 1092 Medical Records Supplies $165 1093 Food $12,421 1094 Supplies Non-Perishables $438 1096 Laundry & Linen $3,571 1097 Allowance $1,873 1098 Clothing $5,015 1099 Legal Fees $1,248 2000 Employee Benefits Other $765 Centralized Services - Program $9,120 SPECIAL EXPENSES TOTAL $156,314 FIXED ASSETS: 2000 Furniture & Fixture $0 2002 IT Minor Equipment $0 Assets (useful life more than 1 year and valued at more than $5,000) 2003 Intangible software/License Assets (useful life more than 1 year and valued at more than $100,000)$0 FIXED ASSETS TOTAL $0 TOTAL PROGRAM EXPENSES $921,649 Recruiting Travel Housekeeping Supplies Education & Training Licenses Revised Exhibit B-1 Page:6 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) operated at a 12 bed capacity Central Star Behavioral Health, Inc. Operational Budget (April 1, 2015 through June 30, 2015) DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 12 beds 1,092 $844.00 $921,648 DIRECT SERVICE REVENUE TOTAL 1,092 $921,648 $875,566 Cost Per Unit $844.00 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Private Insurance 3%$27,649 4100 Uninsured 2%$18,433 4200 Medi-Cal FFP 95%$437,783 4300 2011 Realignment $437,783 REVENUE TOTAL $921,648 Medi-cal Revenue Revised Exhibit B-1 Page:7 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $0 $101,464 $101,464 0002 RN 3.20 $0 $260,425 $260,425 0003 LVN 2.80 $0 $124,294 $124,294 0004 Rehab Therapist 1.40 $0 $62,147 $62,147 0005 Rehab Aide 1.40 $0 $39,833 $39,833 0006 Youth Counselor 15.40 $0 $468,439 $468,439 0008 Family Advocate 1.00 $0 $34,138 $34,138 0009 Social Workers 2.80 $0 $174,603 $174,603 0010 Program Director 1.00 $0 $63,415 $63,415 0011 Cook 2.10 $0 $59,794 $59,794 0012 Administrator 0.75 $111,946 $0 $111,946 0013 UR/QA/Medical Records 1.00 $58,203 $0 $58,203 0014 HR/Training/Admin Asst 1.00 $66,470 $0 $66,470 0015 Billing Clerk 1.00 $23,252 $0 $23,252 0016 Maintenance Tech 0.50 $16,255 $0 $16,255 0017 Housekeeper 1.90 $38,597 $0 $38,597 SALARY TOTAL 38.25 $314,723 $1,388,552 $1,703,275 PAYROLL TAXES: 0030 FICA/MEDICARE $24,076 $106,225 $130,301 0031 SUI $1,699 $7,497 $9,196 0032 FUTA $2,958 $13,053 $16,011 PAYROLL TAX TOTAL $28,734 $126,775 $155,509 EMPLOYEE BENEFITS: 0040 Retirement $11,141 $49,156 $60,297 0041 Workers Compensation $15,610 $68,873 $84,483 0042 $36,036 $158,989 $195,025 EMPLOYEE BENEFITS TOTAL $62,787 $277,018 $339,805 SALARY & BENEFITS GRAND TOTAL $2,198,589 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease - Admin/Business Office $6,000 1011 Leased Equipment $14,443 1012 Telecommunications $39,229 1013 Utilities $84,383 1014 Maintenance $23,782 FACILITY/EQUIPMENT TOTAL $167,837 OPERATING EXPENSES: 1060 $38,878 1061 $18,729 1062 $6,365 1063 $3,180 1064 $2,808 Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Education & Training Licenses Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (12 Bed) Central Star Behavioral Health, Inc. July 1, 2015 through June 30, 2016 Budget Categories - Total Proposed Budget Revised Exhibit B-1 Page:8 of 21 Child-Adolescent Psychiatric Health Facility (12 Bed) Central Star Behavioral Health, Inc. July 1, 2015 through June 30, 2016 1065 $510 1066 $2,497 OPERATING EXPENSES TOTAL $72,967 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $304,595 1081 General Insurance $13,488 1082 Centralized fiscal service .05 $152,297 FINANCIAL SERVICES TOTAL $470,380 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $439,788 1088 Contract Therapist $25,355 1089 Supplies - House Meds $8,363 1090 Supplies - Medical $5,168 1091 Supplies Non-Medical $30,159 1092 Medical Records Supplies $673 1093 Food $38,005 1094 Supplies Non-Perishables $1,340 1096 Laundry & Linen $10,924 1097 Allowance $5,728 1098 Clothing $15,349 1099 Legal Fees $5,092 2000 Employee Benefits Other $3,121 SPECIAL EXPENSES TOTAL $589,065 FIXED ASSETS: 2000 Furniture & Fixture $2,500 2002 IT Minor Equipment $1,500 Assets (useful life more than 1 year and valued at more than $5,000) 2003 Intangible software/License Assets (useful life more than 1 year and valued at more than $100,000)$0 FIXED ASSETS TOTAL $4,000 TOTAL PROGRAM EXPENSES $3,502,838 Recruiting Travel Revised Exhibit B-1 Page:9 of 21 Child-Adolescent Psychiatric Health Facility (12 Bed) Central Star Behavioral Health, Inc. July 1, 2015 through June 30, 2016 DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 12 beds 4,392 $797.55 $3,502,840 DIRECT SERVICE REVENUE TOTAL 4,392 $3,502,840 $3,152,556 Cost Per Unit $797.55 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Private Insurance 8%$280,227 4100 Uninsured 2%$70,057 4200 Medi-Cal FFP 90%$1,576,278 4300 2011 Realignment 90.0%$1,576,278 REVENUE TOTAL $3,502,840 Medi-cal Revenue Revised Exhibit B-1 Page:10 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $0 $106,053 $106,053 0002 RN 3.20 $0 $272,202 $272,202 0003 LVN 2.80 $0 $129,915 $129,915 0004 Rehab Therapist 1.40 $0 $64,957 $64,957 0005 Rehab Aide 3.00 $0 $89,217 $89,217 0006 Youth Counselor 16.80 $0 $534,134 $534,134 0007 Admissions Coordinator 1.00 $0 $61,864 $61,864 0008 Family Advocate 1.00 $0 $35,682 $35,682 0009 Social Workers 2.80 $0 $182,499 $182,499 0010 Program Director 1.00 $0 $66,283 $66,283 0011 Cook 2.10 $0 $62,498 $62,498 0012 Administrator 1.00 $156,012 $0 $156,012 0013 UR/QA/Medical Records 1.00 $60,835 $0 $60,835 0014 HR/Training/Admin Asst 1.00 $69,476 $0 $69,476 0015 Billing Clerk 1.00 $24,304 $0 $24,304 0016 Maintenance Tech 0.50 $16,991 $0 $16,991 0017 Housekeeper 1.50 $31,849 $0 $31,849 SALARY TOTAL 42.10 $359,466 $1,605,304 $1,964,769 PAYROLL TAXES: 0030 FICA/MEDICARE $27,499 $122,806 $150,305 0031 SUI $1,941 $8,667 $10,608 0032 FUTA $3,379 $15,090 $18,469 PAYROLL TAX TOTAL $32,819 $146,563 $179,381 EMPLOYEE BENEFITS: 0040 Retirement $12,725 $56,828 $69,553 0041 Workers Compensation $17,830 $79,623 $97,453 0042 $41,159 $183,807 $224,966 EMPLOYEE BENEFITS TOTAL $71,713 $320,258 $391,972 SALARY & BENEFITS GRAND TOTAL $2,536,122 FACILITIES/EQUIPMENT EXPENSES: 1010 Offsite Lease - Admin/Business Office $18,727 1011 Leased Equipment $14,737 1012 Telecommunications $40,013 1013 Utilities $86,072 1014 Maintenance $24,260 1015 Security-Access Control System & Cameras $0 FACILITY/EQUIPMENT TOTAL $183,808 OPERATING EXPENSES: 1060 $40,340 1061 $21,793 1062 $6,487 Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2016 through June 30, 2017 Budget Categories - Total Proposed Budget Revised Exhibit B-1 Page:11 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2016 through June 30, 2017 1063 $6,487 1064 $5,728 1065 $520 1066 $2,546 OPERATING EXPENSES TOTAL $83,902 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $351,192 1081 General Insurance $13,758 1082 Centralized fiscal service .05 $198,174 FINANCIAL SERVICES TOTAL $563,124 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $563,257 1088 Contract Therapist $34,480 1089 Supplies - House Meds $11,371 1090 Supplies - Medical $7,026 1091 Supplies Non-Medical $59,584 1092 Medical Records Supplies $685 1093 Food $51,690 1094 Supplies Non-Perishables $1,824 1095 Laundry & Linen $14,859 1096 Allowance $7,785 1097 Clothing $20,869 1098 Legal Fees $5,190 1099 Employee Benefits Other $3,182 SPECIAL EXPENSES TOTAL $781,802 FIXED ASSETS: 2000 Furniture Replacement $10,000 2002 IT Minor Equipment $3,060 Assets (useful life more than 1 year and valued at more than $5,000) 2003 Intangible software/License Assets (useful life more than 1 year and valued at more than $100,000)$0 FIXED ASSETS TOTAL $13,060 TOTAL PROGRAM EXPENSES $4,161,818 Recruiting Travel Education & Training Licenses Revised Exhibit B-1 Page:12 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2016 through June 30, 2017 DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 16 beds 4,931 $844.00 $4,161,818 DIRECT SERVICE REVENUE TOTAL 4,931 $4,161,818 $3,745,636 Cost Per Unit $844.00 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Private Insurance 8%$332,945 4100 Uninsured 2%$83,237 4200 Medi-Cal FFP 90%$1,872,818 4300 2011 Realignment 90.0%$1,872,818 REVENUE TOTAL $4,161,818 Medi-cal Revenue Revised Exhibit B-1 Page:13 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $49,920 $33,280 $83,200 0002 RN 2.50 $0 $165,867 $165,867 0003 LVN 6.80 $0 $322,065 $322,065 0004 Rehab Therapist 1.00 $0 $52,136 $52,136 0005 Recreation Therapist 0.50 $0 $26,895 $26,895 0006 Rehab Aide 1.60 $0 $54,559 $54,559 0007 Youth Counselor 13.80 $0 $411,963 $411,963 0008 Unit Clerk 1.00 $0 $29,238 $29,238 0009 Family Advocate 1.00 $0 $33,486 $33,486 0010 Social Workers 4.00 $0 $247,927 $247,927 0011 Program Director 1.00 $0 $94,378 $94,378 0012 Cook 2.00 $0 $55,096 $55,096 0013 Administrator 0.60 $74,346 $0 $74,346 0014 UR/QA/Medical Records 0.50 $31,360 $0 $31,360 0015 HR/Training/Admin Asst 0.50 $55,335 $0 $55,335 0017 Housekeeper 1.20 $23,707 $0 $23,707 SALARY TOTAL 39.00 $234,667 $1,526,889 $1,761,557 PAYROLL TAXES: 0030 FICA/MEDICARE $17,952 $116,807 $134,759 0031 SUI $1,078 $13,783 $14,861 0032 FUTA $1,568 $20,048 $21,616 PAYROLL TAX TOTAL $20,598 $150,638 $171,236 EMPLOYEE BENEFITS: 0040 Retirement $5,163 $33,592 $38,754 0041 Workers Compensation $7,040 $45,807 $52,847 0042 $31,680 $206,130 $237,810 EMPLOYEE BENEFITS TOTAL $43,883 $285,528 $329,411 SALARY & BENEFITS GRAND TOTAL $2,262,203 FACILITIES/EQUIPMENT EXPENSES: 1011 Leased Equipment $22,535 1012 Telecommunications $40,469 1013 Utilities $87,798 1014 Maintenance $24,260 1015 $0 FACILITY/EQUIPMENT TOTAL $175,061 OPERATING EXPENSES: 1060 $36,301 1061 $16,200 1062 $6,487 1063 $6,379 1064 $5,838 Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2017 through June 30, 2018 Budget Categories - Total Proposed Budget Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Education & Training Licenses Revised Exhibit B-1 Page:14 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2017 through June 30, 2018 1065 $8,291 1066 $16,185 1067 Personnel Allocation from Starlight $103,424 1068 Centralized Program Services $136,499 1069 General Insurance $19,547 1070 OPERATING EXPENSES TOTAL $355,151 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $259,004 1081 Centralized fiscal service .05 $134,835 1082 Private Insur./Other County - Centralized fiscal service .10 $158,378 FINANCIAL SERVICES TOTAL $552,217 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $795,400 1088 Supplies - House Meds $11,604 1089 Supplies - Medical $35,860 1090 Medical Records Supplies $21,816 1091 Food $26,280 1092 Supplies - non-perishables $7,349 1093 Laundry & Linen $10,607 1094 Allowance $600 1095 Clothing $1,500 1096 Legal Fees $2,000 1097 Employee Benefits - Other $3,717 SPECIAL EXPENSES TOTAL $916,733 FIXED ASSETS: 2000 Furniture & Fixtures $2,500 2002 IT Minor Equipment $1,181 2003 IT Software $10,640 2004 IT Expense/Service $4,800 FIXED ASSETS TOTAL $19,121 TOTAL PROGRAM EXPENSES $4,280,486 Recruiting Travel Revised Exhibit B-1 Page:15 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2017 through June 30, 2018 DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 16 beds 5,840 $732.96 $4,280,486 DIRECT SERVICE REVENUE TOTAL 5,840 $4,280,486 $1,306,735 Cost Per Unit $732.96 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Out-of-County 22%$844.00 $941,707 4100 Private Insurance 15%$929.00 $642,073 4101 Uninsured 2%$83,237 4102 Medi-Cal FFP 30.5%$1,306,735 4103 Realignment 30.5%$1,306,735 REVENUE TOTAL $4,280,486 Medi-cal Revenue Revised Exhibit B-1 Page:16 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $51,418 $34,278 $85,696 0002 RN 2.50 $0 $170,843 $170,843 0003 LVN 6.80 $0 $331,727 $331,727 0004 Rehab Therapist 1.00 $0 $53,700 $53,700 0005 Recreation Therapist 0.50 $0 $27,702 $27,702 0006 Rehab Aide 1.60 $0 $56,196 $56,196 0007 Youth Counselor 13.80 $0 $424,322 $424,322 0008 Unit Clerk 1.00 $0 $30,115 $30,115 0009 Family Advocate 1.00 $0 $34,491 $34,491 0010 Social Workers 4.00 $0 $255,365 $255,365 0011 Program Director 1.00 $0 $97,209 $97,209 0012 Cook 2.00 $0 $56,749 $56,749 0013 Administrator 0.60 $76,576 $0 $76,576 0014 UR/QA/Medical Records 0.50 $32,301 $0 $32,301 0015 HR/Training/Admin Asst 0.50 $56,995 $0 $56,995 0017 Housekeeper 1.20 $24,418 $0 $24,418 SALARY TOTAL 39.00 $241,709 $1,572,697 $1,814,406 PAYROLL TAXES: 0030 FICA/MEDICARE $18,491 $120,311 $138,802 0031 SUI $1,078 $13,783 $14,861 0032 FUTA $1,568 $20,048 $21,616 PAYROLL TAX TOTAL $21,138 $154,142 $175,280 EMPLOYEE BENEFITS: 0040 Retirement $5,318 $34,599 $39,917 0041 Workers Compensation $7,251 $47,181 $54,432 0042 $32,631 $212,314 $244,945 EMPLOYEE BENEFITS TOTAL $45,200 $294,094 $339,294 SALARY & BENEFITS GRAND TOTAL $2,328,979 FACILITIES/EQUIPMENT EXPENSES: 1011 Leased Equipment $22,986 1012 Telecommunications $41,683 1013 Utilities $90,432 1014 Maintenance $24,988 1015 $0 FACILITY/EQUIPMENT TOTAL $180,089 OPERATING EXPENSES: 1060 $37,027 1061 $16,524 1062 $6,617 1063 $6,507 1064 $5,955 Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2018 through June 30, 2019 Budget Categories - Total Proposed Budget Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Education & Training Licenses Revised Exhibit B-1 Page:17 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2018 through June 30, 2019 1065 $8,457 1066 $16,509 1067 Personnel Allocation from Starlight $108,050 1068 Centralized Program Services $139,229 1069 General Insurance $19,938 1070 Private Insur./Other County - Centralized fiscal service .10 OPERATING EXPENSES TOTAL $364,811 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $264,184 1081 Centralized fiscal service .05 $138,667 1082 Private Insur./Other County - Centralized fiscal service .10 $162,879 FINANCIAL SERVICES TOTAL $565,730 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $819,262 1088 Supplies - House Meds $11,836 1089 Supplies - Medical $36,577 1090 Medical Records Supplies $22,252 1091 Food $26,806 1092 Supplies - non-perishables $7,496 1093 Laundry & Linen $10,819 1094 Allowance $612 1095 Clothing $1,530 1096 Legal Fees $2,040 1097 Employee Benefits - Other $3,791 SPECIAL EXPENSES TOTAL $943,023 FIXED ASSETS: 2000 Furniture & Fixtures $2,550 2002 IT Minor Equipment $1,205 2003 IT Software $10,853 2004 IT Expense/Service $4,896 FIXED ASSETS TOTAL $19,503 TOTAL PROGRAM EXPENSES $4,402,134 Recruiting Travel Revised Exhibit B-1 Page:18 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2018 through June 30, 2019 DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 16 beds 5,840 $753.79 $4,402,134 DIRECT SERVICE REVENUE TOTAL 5,840 $4,402,134 $1,342,650 Cost Per Unit $753.79 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Out-of-County 22%$869.32 $968,469 4100 Private Insurance 15%$956.87 $660,321 4101 Uninsured 2%$88,043 4102 Medi-Cal FFP 30.5%$1,342,650 4103 Realignment 30.5%$1,342,650 REVENUE TOTAL $4,402,134 Medi-cal Revenue Revised Exhibit B-1 Page:19 of 21 FTE %Admin.Direct Total PERSONNEL SALARIES: 0001 RN-DON 1.00 $52,960 $35,307 $88,267 0002 RN 2.50 $0 $175,968 $175,968 0003 LVN 6.80 $0 $341,679 $341,679 0004 Rehab Therapist 1.00 $0 $55,311 $55,311 0005 Recreation Therapist 0.50 $0 $28,533 $28,533 0006 Rehab Aide 1.60 $0 $57,882 $57,882 0007 Youth Counselor 13.80 $0 $437,052 $437,052 0008 Unit Clerk 1.00 $0 $31,019 $31,019 0009 Family Advocate 1.00 $0 $35,525 $35,525 0010 Social Workers 4.00 $0 $263,026 $263,026 0011 Program Director 1.00 $0 $100,126 $100,126 0012 Cook 2.00 $0 $58,451 $58,451 0013 Administrator 0.60 $78,874 $0 $78,874 0014 UR/QA/Medical Records 0.50 $33,270 $0 $33,270 0015 HR/Training/Admin Asst 0.50 $58,705 $0 $58,705 0017 Housekeeper 1.20 $25,151 $0 $25,151 SALARY TOTAL 39.00 $248,960 $1,619,878 $1,868,838 PAYROLL TAXES: 0030 FICA/MEDICARE $19,045 $123,921 $142,966 0031 SUI $1,078 $13,783 $14,861 0032 FUTA $1,568 $20,048 $21,616 PAYROLL TAX TOTAL $21,692 $157,752 $179,444 EMPLOYEE BENEFITS: 0040 Retirement $5,477 $35,637 $41,114 0041 Workers Compensation $7,469 $48,596 $56,065 0042 $33,610 $218,683 $252,293 EMPLOYEE BENEFITS TOTAL $46,556 $302,917 $349,473 SALARY & BENEFITS GRAND TOTAL $2,397,754 FACILITIES/EQUIPMENT EXPENSES: 1011 Leased Equipment $23,445 1012 Telecommunications $42,934 1013 Utilities $93,145 1014 Maintenance $25,737 1015 $0 FACILITY/EQUIPMENT TOTAL $185,261 OPERATING EXPENSES: 1060 $37,768 1061 $16,854 1062 $6,749 1063 $6,637 1064 $6,074 Line Item Description (Must be itemized) Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2019 through June 30, 2020 Budget Categories - Total Proposed Budget Health Insurance (medical, vision, life, dental, 401k) Purchased Services Office Supplies Housekeeping Supplies Education & Training Licenses Revised Exhibit B-1 Page:20 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2019 through June 30, 2020 1065 $8,626 1066 $16,839 1067 Personnel Allocation from Starlight $113,353 1068 Centralized Program Services $142,014 1069 General Insurance $20,337 1070 OPERATING EXPENSES TOTAL $375,250 FINANCIAL SERVICES EXPENSES: 1080 Centralized Services $280,759 1081 Centralized fiscal service .05 $143,009 1082 Private Insur./Other County - Centralized fiscal service .10 $167,979 FINANCIAL SERVICES TOTAL $591,747 SPECIAL EXPENSES (Consultant/Etc.): 1087 Professional Fees & Consultation $843,840 1088 Supplies - House Meds $12,073 1089 Supplies - Medical $37,309 1090 Medical Records Supplies $22,697 1091 Food $27,342 1092 Supplies - non-perishables $7,646 1093 Laundry & Linen $11,036 1094 Allowance $624 1095 Clothing $1,561 1096 Legal Fees $2,081 1097 Employee Benefits - Other $3,867 SPECIAL EXPENSES TOTAL $970,076 FIXED ASSETS: 2000 Furniture & Fixtures $2,601 2002 IT Minor Equipment $1,229 2003 IT Software $11,070 2004 IT Expense/Service $4,994 FIXED ASSETS TOTAL $19,893 TOTAL PROGRAM EXPENSES $4,539,981 Recruiting Travel Revised Exhibit B-1 Page:21 of 21 Child-Adolescent Psychiatric Health Facility (16 Bed) Central Star Behavioral Health, Inc. July 1, 2019 through June 30, 2020 DIRECT SERVICE REVENUE: Vol/Units of Svc Rate $ Amt. 3000 Mental Health Services $0.00 (Assessment, Plan of Care, Individual/Family/Group Therapy, Rehab) 3100 Case Management, Linkage/Brokerage $0 3200 Crisis Intervention $0 3300 Medication Support $0 3301 Crisis Stabilization - Urgent Care $0 3302 Psychiatric Health Facility 16 beds 5,856 $775.27 $4,539,981 DIRECT SERVICE REVENUE TOTAL 5,856 $4,539,981 $1,384,694 Cost Per Unit $775.27 FUNDING STREAMS REIMBURSEMENT Population Served Percentage 4000 Out-of-County 22%$895.40 $998,796 4100 Private Insurance 15%$985.58 $680,997 4101 Uninsured 2%$90,800 4102 Medi-Cal FFP 30.5%$1,384,694 4103 Realignment 30.5%$1,384,694 REVENUE TOTAL $4,539,981 Medi-cal Revenue