HomeMy WebLinkAboutAgreement A-20-284 with Reading and Beyond Inc Approved 8.4.2020.pdfAgreement No . 20-284
AGREEMENT 1
2 THIS AGREEMENT is made and entered into this _...1!h_ day of _ ..... A.....,u.._.g""'"us ..... t __ , 2020, by and
3 between the COUNTY OF FRESNO , a Political Subdivision of the State of California , hereinafter
4 referred to as "COUNTY", and READING AND BEYOND, INC., a non-profit organization, whose
5 address is 4670 E. Butler Avenue Fresno, CA 93702, hereinafter referred to as "CONTRACTOR"
6 (collectively as the "parties").
7 WITNESS ETH:
8 WHEREAS , COUNTY, through its Department of Behavioral Health (DBH), Mental Health
9 Services Act (MHSA), Community Services and Supports (CSS) component , and through input from
10 the MHSA community stakeholder process , is in need of a qualified provider of Family Advocacy
11 Services for the provision of advocacy, support , and other services to family members and support
12 systems of individuals currently receiving , or in need of, COUNTY mental health services; and to act as
13 a liaison between family members , and other support systems and COUNTY professional staff and
14 other groups or organizations in the community ; and
15 WHEREAS , CONTRACTOR is qualified and willing to provide said services pursuant to the
16 terms and conditions of this Agreement.
17 NOW, THEREFORE , in consideration of their mutual covenants and conditions , the parties
18 hereto agree as follows :
19
20
1. COVERED SERVICES
A. CONTRACTOR shall perform all duties , including but not limited to oversight and
21 coordination of family advocacy services and activities , as identified and set forth in Exhibit A , "Scope of
22 Work", attached hereto and by this reference incorporated herein and made part of this Agreement.
23 B . CONTRACTOR shall also perform all services and fulfill all responsibilities as
24 specified in COUNTY's Request for Proposal (RFP) No. 20-023 dated October 24 , 2019 and
25 Addendum No. One (1) dated November 7 , 2019 , hereinafter collectively referred to as COUNTY's
26 Revised RFP No. 20-023 , all incorporated herein by reference and made part of this Agreement. In the
27 event of any inconsistency among these documents, the inconsistency shall be resolved by giving
28 precedence in the following order of priority: (1) to this Agreement, including all Exhibits ; (2) to
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COUNTY’s Revised RFP No. 20-023; and (3) to CONTRACTOR’s Response to COUNTY’s Revised
RFP No. 20-023. A copy of the COUNTY’s Revised RFP No. 20-023 and CONTRACTOR’s Response
to COUNTY’s Revised RFP No. 20-023 shall be retained and made available during the term of this
Agreement by COUNTY’s Internal Services Department – Purchasing Division.
C. CONTRACTOR shall align programs, services, and practices with the vision,
mission, and guiding principles of the DBH, as further described in Exhibit B, “Fresno County
Department of Behavioral Health Guiding Principles of Care Delivery”, attached hereto and by this
reference incorporated herein and made part of this Agreement.
D. CONTRACTOR shall send to County’s DBH upon execution of this Agreement, a
detailed plan ensuring appropriate leadership and supervision of their program. Recruitment and
retaining leadership with the competencies to oversee services based on the level of care and program
design presented herein shall be included in this plan. A description and monitoring of this plan shall
be provided.
E. It is acknowledged that upon execution of this Agreement, CONTRACTOR’s
service site for the delivery of Family Advocacy Services program will be located as stated in Exhibit A.
F. CONTRACTOR agrees that prior to providing services under the terms and
conditions of this Agreement beginning on July 1, 2020, it shall have appropriate staff hired and in place
for program services and operations, or COUNTY may, in addition to other remedies it may have may
terminate this Agreement, in accordance with Paragraph Three (3) of this Agreement.
G. CONTRACTOR shall participate in periodic workgroup meetings consisting of
staff from COUNTY’s DBH. The meetings shall be held monthly, or as needed, to discuss
requirements, data reporting, training, policies and procedures, overall program operations and any
problems or foreseeable problems that may arise.
H. CONTRACTOR shall attend bimonthly DBH meetings for all contracted mental
health providers in the DBH system of care, as required by the COUNTY. Schedule for these meetings
may change based on the needs of the COUNTY.
I. It is acknowledged by all parties hereto that COUNTY’s DBH Contracts Division
shall monitor said Family Advocacy Services activities in accordance with Paragraph Fourteen (14) of
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this Agreement.
J. It is acknowledged by all parties hereto that the ramp-up period shall commence
on March 24, 2020 and services are estimated to begin no later than August 1, 2020. The dates of the
ramp-up period and initial operational period identified within the COMPENSATION herein may be
adjusted due to changes and delays caused by the COVID-19 pandemic. These adjustments may be
made with the written approval of the COUNTY DBH Director, or designee.
2. TERM
The term of this Agreement shall become effective retroactive to March 24, 2020 through
and including June 30, 2023.
This Agreement, subject to State of California funding each year, may be extended for
two (2) additional consecutive (12) month periods upon written approval of both parties no later than
thirty (30) days prior to the first day of the next twelve (12) month extension. The COUNTY’s DBH
Director, or designee, is authorized to execute such written approval on behalf of COUNTY based on
the CONTRACTOR’s satisfactory performance.
3. TERMINATION
A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving the CONTRACTOR sixty (60) days advance written notice.
B. Breach of Contract - COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of the COUNTY there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to the COUNTY; and
4) Improperly performed service.
In no event shall any payment by COUNTY constitute a waiver by COUNTY of
any breach of this Agreement or any default which may then exist on the part of the CONTRACTOR.
Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the
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breach or default. The COUNTY shall have the right to demand of the CONTRACTOR the repayment
to the COUNTY of any funds disbursed to CONTRACTOR under this Agreement, which in the
judgment of COUNTY were not expended in accordance with the terms of this Agreement. The
CONTRACTOR shall promptly refund any funds upon demand or, at COUNTY’s option, such
repayment shall be deducted from future payments owing to CONTRACTOR under this Agreement.
C. Without Cause - Under circumstances other than those set forth above, this
Agreement may be terminated by COUNTY or COUNTY’s DBH Director, or designee, or
CONTRACTOR upon the giving of thirty (30) days advance written notice of an intention to terminate.
4. COMPENSATION
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agree to receive
compensation for actual expenditures incurred in accordance with the CONTRACTOR’s budget
documents, attached hereto as Exhibit C and incorporated herein by this reference.
A. Ramp-Up Compensation Amount
Effective upon execution through the end of the ramp-up period, in no event shall
the maximum compensation amount under this Agreement exceed Forty-Four Thousand, Six Hundred
Ninety-Four and No/100 Dollars ($44,694.00).
B. Annual Compensation Amounts
For the initial operational period, estimated to begin August 1, 2020 through June
30, 2021, in no event shall the maximum compensation amount under this Agreement exceed Two
Hundred Fifty Thousand and No/100 Dollars ($250,000.00).
For July 1, 2021 through June 30, 2022, in no event shall the maximum
compensation amount under this Agreement exceed Two Hundred Fifty Thousand and No/100 Dollars
($250,000.00).
For July 1, 2022 through June 30, 2023, in no event shall the maximum
compensation amount under this Agreement exceed Two Hundred Fifty Thousand and No/100 Dollars
($250,000.00).
If performance standards are met and this Agreement is extended for additional
twelve (12) month renewal periods pursuant to Paragraph Two (2), TERM, herein, then in no event
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shall the maximum compensation amount under this Agreement for each subsequent twelve (12)
month period exceed Two Hundred Fifty Thousand and No/100 Dollars ($250,000.00).
C. Total Maximum Compensation Amount
In no event shall the total maximum compensation amount under this Agreement
effective upon execution through and including June 30, 2023 exceed Seven Hundred Ninety-Four
Thousand, Six Hundred Ninety-Four and No/100 Dollars ($794,694.00).
If performance standards are met and this Agreement is extended for an
additional twelve (12) month term, July 1, 2023 to June 30, 2024, pursuant to Paragraph Two (2)
herein, then in no event shall the total maximum compensation amount under this Agreement exceed
One Million, Forty-Four Thousand, Six Hundred Ninety-Four and No/100 Dollars ($1,044,694.00).
If performance standards are met and this Agreement is extended for an
additional twelve (12) month term, July 1, 2024 to June 30, 2025, pursuant to Paragraph Two (2)
herein, then in no event shall the total maximum compensation amount under this Agreement exceed
One Million, Two Hundred Ninety-Four Thousand, Six Hundred Ninety-Four and No/100 Dollars
($1,294,694.00).
D. Travel shall be reimbursed based on actual expenditures and mileage
reimbursement shall be at CONTRACTOR’s adopted rate per mile, not to exceed the Federal Internal
Revenue Services (IRS) current published rate.
E. 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. It is understood that COUNTY shall not be obligated to compensate CONTRACTOR for
any work, services, or functions performed by CONTRACTOR: (1) in seeking to obtain COUNTY’s
business or negotiating with the COUNTY to enter into this Agreement, or, (2) in providing COUNTY
with documentation, explanations, or justifications concerning the adequacy or accuracy of invoices for
the performance of services under this Agreement and resolving same to the reasonable satisfaction of
COUNTY.
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F. Payments 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 Paragraph Five (5) herein. Payments shall be
made after receipt and verification of services provided in the performance of this Agreement, in
accordance with Exhibit C, and shall be documented to COUNTY on a monthly basis by the tenth
(10th) of the month following the month of said service provision.
G. COUNTY shall not be obligated to make any payments under this Agreement if
the request for payment is received by COUNTY more than sixty (60) days after this Agreement has
terminated or expired.
H. All final invoices and/or any final budget modification requests 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 invoices 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.
I. The services provided by CONTRACTOR under this Agreement are funded in
whole or in part by the State of California. In the event that funding for these services is delayed by the
State Controller, COUNTY may defer payments to CONTRACTOR. The amount of the deferred
payment shall not exceed the amount of funding delayed by the State Controller to the 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.
5. INVOICING
A. CONTRACTOR shall invoice COUNTY in arrears by the tenth (10th) of each
month for actual services provided during the prior month to DBHInvoices@fresnocountyca.gov and
DBHInvoiceReview@fresnocountyca.gov, as well as a carbon copy to the assigned DBH Mental Health
Contracts Staff Analyst.
B. CONTRACTOR agrees to submit detailed invoices and general ledgers that
itemize the line item charges for monthly program costs, with the following information included: date of
service; number of hours or fraction thereof of service provided; and name or case or issue for which
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services were provided.
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 is still not corrected to COUNTY DBH’s satisfaction, COUNTY’s DBH
Director, or designee, may elect to terminate this Agreement, pursuant to the termination provisions
stated in Paragraph 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 his or her designee, COUNTY’s DBH shall have the right to deny payment
of any additional invoices received.
D. CONTRACTOR shall submit monthly staffing reports that identify all staff,
applicable licensure/certifications, 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.
E. CONTRACTOR must maintain such financial records for a period of seven (7)
years, or if there a dispute, audit or inspection, until it is resolved, whichever is later. CONTRACTOR
will be responsible for any disallowances related to inadequate documentation.
6. 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
independent contractors, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venture, partner, or associate of COUNTY. Furthermore, COUNTY shall have no right
to control or supervise or direct the manner or method by which each CONTRACTOR shall perform its
work and function. However, COUNTY shall retain the right to administer this Agreement so as to
verify that each CONTRACTOR is performing their obligations in accordance with the terms and
conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable provisions of law and
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the rules and regulations, if any, of governmental authorities having jurisdiction over matters which are
directly or indirectly the subject of this Agreement.
Because of its status as an independent contractor, CONTRACTOR shall have
absolutely no right to employment rights and benefits available to COUNTY employees. Each
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’ 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 COUNTY or to this Agreement.
7. MODIFICATION
Any matters of this Agreement may be modified from time to time by the written consent
of all the parties without, in any way, affecting the remainder.
Notwithstanding the above, changes to services, staffing, and responsibilities of the
CONTRACTOR, as set forth in Exhibit A, as needed to accommodate changes in the law relating to
mental health, may be made with the signed written approval of COUNTY’s DBH Director, or designee,
and CONTRACTOR through an amendment approved by COUNTY’s Counsel and the COUNTY’s
Auditor-Controller/Treasurer-Tax Collector’s Office.
Changes to expense category (i.e., Personnel Expenses, Operating Expenses, Financial
Services Expenses, etc.) subtotals in the budget set forth in Exhibit C that do not exceed ten percent
(10%) of the maximum compensation payable to CONTRACTOR may be made with the written
approval of COUNTY’s DBH Director, or designee. Changes to the expense category subtotals in the
budget that exceed ten percent (10%) of the maximum compensation payable to CONTRACTOR may
be made with the signed written approval of COUNTY’s DBH Director, or designee, through an
amendment approved by COUNTY’s Counsel and COUNTY’s Auditor-Controller/Treasurer-Tax
Collector’s Office.
Said modifications to scope of services and expense category subtotals shall not result
in any change to the maximum compensation amount payable to CONTRACTOR under this
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Agreement.
8. NON-ASSIGNMENT
COUNTY and CONTRACTOR shall not assign, transfer or subcontract this Agreement
nor their rights or duties under this Agreement without the prior written consent of COUNTY and
CONTRACTOR seeking to make such assignment.
9. HOLD-HARMLESS
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
defend the COUNTY, its officers, agents and employees from any and all costs and expenses,
including attorney fees and CONTRACTOR costs, damages, liabilities, claims and losses occurring or
resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its
officers, agents or employees under this Agreement, and from any and all costs and expenses,
including attorney fees and CONTRACTOR 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.
CONTRACTOR agrees to indemnify COUNTY for Federal, State of California and/or
local audit exceptions resulting from noncompliance herein on the part of CONTRACTOR.
10. INSURANCE
Without limiting COUNTY's right to obtain indemnification from CONTRACTOR or any
third parties, each CONTRACTOR, at its sole expense, shall maintain in full force and effect the
following insurance policies throughout the term of this Agreement:
A. Commercial General Liability
Commercial General Liability Insurance with limits of not less than Two Million
Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million
Dollars ($4,000,000). This policy shall be issued on a per occurrence basis.
COUNTY may require specific coverages including completed operations,
product liability, contractual liability, Explosion-Collapse-Underground, fire legal
liability or any other liability insurance deemed necessary because of the nature
of the Agreement.
B. Automobile Liability
Comprehensive Automobile Liability Insurance with limits no less than One
Million Dollars ($1,000,000) per accident for bodily injury and property damage.
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Coverage should include any automobile used in connection with this
Agreement. If CONTRACTOR’s employees are not covered by
CONTRACTOR’s automobile liability insurance policy, CONTRACTOR shall
ensure that each employee as part of this Agreement procures and maintains
their own private automobile coverage in force during the term of this Agreement,
at the employee’s sole cost and expense.
C. Professional Liability
If CONTRACTOR employs licensed professional staff (e.g. Ph.D., R.N.,
L.C.S.W., L.M.F.T., etc.) in providing services, Professional Liability Insurance
with limits of not less than One Million Dollars ($1,000,000) per occurrence,
Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees
that it shall maintain, at its sole expense, in full force and effect for a period of
five (5) years following the termination of this Agreement, one or more policies of
professional liability insurance with limits of coverage as specified herein.
D. Real and Property Insurance
CONTRACTOR shall maintain a policy of insurance for all risk personal property
coverage which shall be endorsed naming the County of Fresno as an additional
loss payee. The personal property coverage shall be in an amount that will cover
the total of the COUNTY purchased and owned property, at a minimum, as
discussed in Paragraph Twenty-One (21) of this Agreement.
All Risk Property Insurance
As applicable, CONTRACTOR will provide property coverage for the full
replacement value of the COUNTY’s personal property in possession of
CONTRACTOR and/or used in the execution of this Agreement. COUNTY will
be identified on an appropriate certificate of insurance as the certificate holder
and will be named as an Additional Loss Payee on the Property Insurance Policy.
E. Worker's Compensation
A policy of Worker's Compensation Insurance as may be required by the
California Labor Code.
F. Child Abuse/Molestation and Social Services Coverage
CONTRACTOR shall have either separate policies or an umbrella policy with
endorsements covering Child Abuse/Molestation and Social Services Liability
coverage or have a specific endorsement on their General Commercial liability
policy covering Child Abuse/Molestation and Social Services Liability. The policy
limits for these policies shall be One Million Dollars ($1,000,000) per occurrence
with a Two Million Dollars ($2,000,000) annual aggregate. The policies are to be
on a per occurrence basis. ///
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G. Cyber Liability
Cyber Liability Insurance, with limits not less than Two Million Dollars
($2,000,000) per occurrence or claim, Two Million Dollars ($2,000,000)
aggregate. Coverage shall be sufficiently broad to respond to the duties and
obligations as is undertaken by CONTRACTOR in this Agreement and shall
include, but not be limited to, claims involving infringement of intellectual
property, including but not limited to infringement of copyright, trademark, trade
dress, invasion of privacy violations, information theft, damage to or destruction
of electronic information, release of private information, alteration of electronic
information, extortion and network security. The policy shall provide coverage for
breach response costs as well as regulatory fines and penalties as well as credit
monitoring expenses with limits sufficient to respond to these obligations.
H. Waiver of Subrogation
CONTRACTOR hereby grants to COUNTY a waiver of any right to subrogation
which any insurer of said CONTRACTOR may acquire against the COUNTY by
virtue of the payment of any loss under such insurance. CONTRACTOR agrees
to obtain any endorsement that may be necessary to affect this waiver of
subrogation, but this provision applies regardless of whether or not the COUNTY
has received a waiver of subrogation endorsement from the insurer.
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.
Within thirty (30) days from the date each CONTRACTOR signs this Agreement, said
CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health,
Contract Services Division, 3133 N. Millbrook Ave, Fresno, California, 93703, Attention: Mental Health
Contract Staff Analyst, stating that such insurance coverages 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
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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.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, 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 from companies possessing a current A.M. Best, Inc. rating of
A FSC VII or better.
12. LICENSES/CERTIFICATES
Throughout the term of this Agreement, CONTRACTOR and CONTRACTOR staff shall
maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions, if necessary
for the provision of the services hereunder, and required by the laws and regulations of the United
States of America, State of California, the County of Fresno, and any other applicable governmental
agencies. CONTRACTOR shall notify COUNTY immediately in writing of its inability to obtain or
maintain such licenses, permits, approvals, certificates, waivers and exemptions irrespective of the
pendency of any appeal related thereto. Additionally, CONTRACTOR and CONTRACTOR’s staff shall
comply with all applicable laws, rules or regulations, as may now exist or be hereafter changed.
13. REPORTS
A. Outcome Reports
CONTRACTOR shall submit to COUNTY’s DBH service outcome reports, as
requested by COUNTY’s DBH. Outcome reports and outcome requirements are subject to change at
COUNTY’s DBH discretion.
B. Additional Reports
CONTRACTOR shall submit to COUNTY’s DBH by the tenth (10th) of each
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month all monthly activity and budget reports for the preceding month. CONTRACTOR shall also
furnish to COUNTY such statements, records, reports, data, and other information as COUNTY may
request pertaining to matters covered by this Agreement. In the event that CONTRACTOR fails to
provide such reports or other information required hereunder, it shall be deemed sufficient cause for
COUNTY to withhold monthly payments until there is compliance. In addition, CONTRACTOR shall
provide written notification and explanation to COUNTY within five (5) days of any funds received from
another source to conduct the same services covered by this Agreement.
14. MONITORING
CONTRACTOR agrees to extend to COUNTY’s staff, COUNTY’s DBH Director, or
designee, and State Department of Health Care Services (DHCS), or their designees, the right to
review and monitor records, program or procedures, at any time, as well as the overall operation of
CONTRACTOR’s program, in order to ensure compliance with the terms and conditions of this
Agreement.
15. REFERENCES TO LAWS AND RULES
In the event any law, regulation, or policy referred to in this Agreement is amended
during the term thereof, the parties hereto agree to comply with the amended provision as of the
effective date of such amendment.
16. COMPLIANCE WITH STATE REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its mental health programs under an
agreement with DHCS, and that under said agreement the State imposes certain requirements on
COUNTY and its subcontractors. CONTRACTOR shall adhere to all State Requirements, including
those identified in Exhibit D, “State Mental Health Requirements”, attached hereto and by this reference
incorporated herein and made part of this Agreement.
17. CONFIDENTIALITY
All services performed by CONTRACTOR under this Agreement shall be in strict
conformance with all applicable Federal, State of California and/or local laws and regulations relating to
confidentiality.
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18. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
A. The parties to this Agreement shall be in strict conformance with all applicable
Federal and State of California laws and regulations, including but not limited to Sections 5328, 10850, and
14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. of Title 42, Code of
Federal Regulations (CFR), Section 56 et seq. of the California Civil Code and the Health Insurance
Portability and Accountability Act (HIPAA), including but not limited to Section 1320 D et seq. of Title 42,
United States Code (USC) and its implementing regulations, including, but not limited to Title 45, CFR,
Sections 142, 160, 162, and 164, The Health Information Technology for Economic and Clinical
Health Act (HITECH) regarding the confidentiality and security of patient information, and the Genetic
Information Nondiscrimination Act (GINA) of 2008 regarding the confidentiality of genetic information.
Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform functions,
activities or services for or on behalf of COUNTY, as specified in this Agreement, provided that such use or
disclosure shall not violate the Health Insurance Portability and Accountability Act (HIPAA), USC 1320d et
seq. The uses and disclosures of PHI may not be more expansive than those applicable to COUNTY, as
the “Covered Entity” under the HIPAA Privacy Rule (45 CFR 164.500 et seq.), except as authorized for
management, administrative or legal responsibilities of the Business Associate.
B. CONTRACTOR, including its subcontractors and employees, shall protect, from
unauthorized access, use, or disclosure of names and other identifying information, including genetic
information, concerning persons receiving services pursuant to this Agreement, except where permitted in
order to carry out data aggregation purposes for health care operations [45 CFR Sections 164.504
(e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)] This pertains to any and all persons receiving services
pursuant to a COUNTY funded program. This requirement applies to electronic PHI. CONTRACTOR
shall not use such identifying information or genetic information for any purpose other than carrying out
CONTRACTOR’s obligations under this Agreement.
C. CONTRACTOR, including its subcontractors and employees, shall not disclose any
such identifying information or genetic information to any person or entity, except as otherwise specifically
permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or other law, required by the
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Secretary, or authorized by the client/patient in writing. In using or disclosing PHI that is permitted by this
Agreement or authorized by law, CONTRACTOR shall make reasonable efforts to limit PHI to the
minimum necessary to accomplish intended purpose of use, disclosure or request.
D. For purposes of the above sections, identifying information shall include, but not be
limited to name, identifying number, symbol, or other identifying particular assigned to the individual, such
as finger or voice print, or photograph.
E. For purposes of the above sections, genetic information shall include genetic tests
of family members of an individual or individual, manifestation of disease or disorder of family members of
an individual, or any request for or receipt of, genetic services by individual or family members. Family
member means a dependent or any person who is first, second, third, or fourth degree relative.
F. CONTRACTOR shall provide access, at the request of COUNTY, and in the time
and manner designated by COUNTY, to PHI in a designated record set (as defined in 45 CFR Section
164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR Section 164.524
regarding access by individuals to their PHI. With respect to individual requests, access shall be provided
within thirty (30) days from request. Access may be extended if CONTRACTOR cannot provide access
and provides individual with the reasons for the delay and the date when access may be granted. PHI
shall be provided in the form and format requested by the individual or COUNTY.
CONTRACTOR shall make any amendment(s) to PHI in a designated record set
at the request of COUNTY or individual, and in the time and manner designated by COUNTY in
accordance with 45 CFR Section 164.526.
CONTRACTOR shall provide to COUNTY or to an individual, in a time and
manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528, to
permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI in
accordance with 45 CFR Section 164.528.
G. CONTRACTOR shall report to COUNTY, in writing, any knowledge or reasonable
belief that there has been unauthorized access, viewing, use, disclosure, security incident, or breach of
unsecured PHI not permitted by this Agreement of which it becomes aware, immediately and without
reasonable delay and in no case later than two (2) business days of discovery. Immediate notification
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shall be made to COUNTY’s Information Security Officer and Privacy Officer and COUNTY’s DPH HIPAA
Representative, within two (2) business days of discovery. The notification shall include, to the extent
possible, the identification of each individual whose unsecured PHI has been, or is reasonably believed to
have been, accessed, acquired, used, disclosed, or breached. CONTRACTOR shall take prompt
corrective action to cure any deficiencies and any action pertaining to such unauthorized disclosure
required by applicable Federal and State Laws and regulations. CONTRACTOR shall investigate such
breach and is responsible for all notifications required by law and regulation or deemed necessary by
COUNTY and shall provide a written report of the investigation and reporting required to COUNTY’s
Information Security Officer and Privacy Officer and COUNTY’s DPH HIPAA Representative. This written
investigation and description of any reporting necessary shall be postmarked within the thirty (30) working
days of the discovery of the breach to the addresses below:
County of Fresno County of Fresno County of Fresno
Dept. of Behavioral Health Dept. of Public Health Information Technology Services
HIPAA Representative Privacy Officer Information Security Officer
(559) 600-6798 (559) 600-6405 (559) 600-5800
3147 N. Millbrook Ave P.O. Box 11867 2048 N. Fine Street
Fresno, CA 93703 Fresno, CA 93775 Fresno, CA 93727
H. CONTRACTOR shall make its internal practices, books, and records relating to the
use and disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR on
behalf of COUNTY, in compliance with HIPAA’s Privacy Rule, including, but not limited to the requirements
set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR shall make its internal practices, books,
and records relating to the use and disclosure of PHI received from COUNTY, or created or received by
the CONTRACTOR on behalf of COUNTY, available to the United States Department of Health and
Human Services (Secretary) upon demand.
CONTRACTOR shall cooperate with the compliance and investigation reviews
conducted by the Secretary. PHI access to the Secretary must be provided during the CONTRACTOR’s
normal business hours, however, upon exigent circumstances access at any time must be granted. Upon
the Secretary’s compliance or investigation review, if PHI is unavailable to CONTRACTOR and in
possession of a Subcontractor, it must certify efforts to obtain the information to the Secretary.
///
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I. Safeguards
CONTRACTOR shall implement administrative, physical, and technical safeguards
as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably and appropriately
protect the confidentiality, integrity, and availability of PHI, including electronic PHI, that it creates, receives,
maintains or transmits on behalf of COUNTY and to prevent unauthorized access, viewing, use,
disclosure, or breach of PHI other than as provided for by this Agreement. CONTRACTOR shall conduct
an accurate and thorough assessment of the potential risks and vulnerabilities to the confidential, integrity
and availability of electronic PHI. CONTRACTOR shall develop and maintain a written information privacy
and security program that includes administrative, technical and physical safeguards appropriate to the
size and complexity of CONTRACTOR’s operations and the nature and scope of its activities. Upon
COUNTY’s request, CONTRACTOR shall provide COUNTY with information concerning such safeguards.
CONTRACTOR shall implement strong access controls and other security
safeguards and precautions in order to restrict logical and physical access to confidential, personal (e.g.,
PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include the
following administrative and technical password controls for all systems used to process or store
confidential, personal, or sensitive data:
1. Passwords must not be:
a. Shared or written down where they are accessible or recognizable
by anyone else; such as taped to computer screens, stored under keyboards, or visible in a work area;
b. A dictionary word; or
c. Stored in clear text
2. Passwords must be:
a. Eight (8) characters or more in length;
b. Changed every ninety (90) days;
c. Changed immediately if revealed or compromised; and
d. Composed of characters from at least three (3) of the following
four (4) groups from the standard keyboard:
///
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1) Upper case letters (A-Z);
2) Lowercase letters (a-z);
3) Arabic numerals (0 through 9); and
4) Non-alphanumeric characters (punctuation symbols).
CONTRACTOR shall implement the following security controls on each
workstation or portable computing device (e.g., laptop computer) containing confidential,
personal, or sensitive data:
1. Network-based firewall and/or personal firewall;
2. Continuously updated anti-virus software; and
3. Patch management process including installation of all operating
system/software vendor security patches.
CONTRACTOR shall utilize a commercial encryption solution that has received
FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
electronic media (including, but not limited to, compact disks and thumb drives) and on portable
computing devices (including, but not limited to, laptop and notebook computers).
CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-
mail or other internet transport protocol unless the data is encrypted by a solution that has been
validated by the National Institute of Standards and Technology (NIST) as conforming to the Advanced
Encryption Standard (AES) Algorithm. CONTRACTOR must apply appropriate sanctions against its
employees who fail to comply with these safeguards. CONTRACTOR must adopt procedures for
terminating access to PHI when employment of employee ends.
J. Mitigation of Harmful Effects
CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that is
suspected or known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or breach
of PHI by CONTRACTOR or its subcontractors in violation of the requirements of these provisions.
CONTRACTOR must document suspected or known harmful effects and the outcome.
K. CONTRACTOR’s Subcontractors
CONTRACTOR shall ensure that any of its contractors, including subcontractors,
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if applicable, to whom CONTRACTOR provides PHI received from or created or received by
CONTRACTOR on behalf of COUNTY, agree to the same restrictions, safeguards, and conditions that
apply to CONTRACTOR with respect to such PHI and to incorporate, when applicable, the relevant
provisions of these provisions into each subcontract or sub-award to such agents or subcontractors.
L. Employee Training and Discipline
CONTRACTOR shall train and use reasonable measures to ensure compliance
with the requirements of these provisions by employees who assist in the performance of functions or
activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
employees who intentionally violate any provisions of these provisions, including termination of
employment.
M. Termination for Cause
Upon COUNTY’s knowledge of a material breach of these provisions by
CONTRACTOR, COUNTY shall either:
1. Provide an opportunity for CONTRACTOR to cure the breach or end the
violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the violation
within the time specified by COUNTY; or
2. Immediately terminate this Agreement if CONTRACTOR has breached a
material term of these provisions and cure is not possible.
3. If neither cure nor termination is feasible, the COUNTY’s Privacy Officer
shall report the violation to the Secretary of the U.S. Department of Health and Human Services.
N. Judicial or Administrative Proceedings
COUNTY may terminate this Agreement in accordance with the terms and
conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a criminal
proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or (2) a finding or
stipulation that the CONTRACTOR has violated a privacy or security standard or requirement of the
HITECH Act, HIPAA or other security or privacy laws in an administrative or civil proceeding in which
the CONTRACTOR is a party.
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O. Effect of Termination
Upon termination or expiration of this Agreement for any reason, CONTRACTOR
shall return or destroy all PHI received from COUNTY (or created or received by CONTRACTOR on
behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall retain no copies of such
PHI. If return or destruction of PHI is not feasible, it shall continue to extend the protections of these
provisions to such information, and limit further use of such PHI to those purposes that make the return
or destruction of such PHI infeasible. This provision shall apply to PHI that is in the possession of
subcontractors or agents, if applicable, of CONTRACTOR. If CONTRACTOR destroys the PHI data, a
certification of date and time of destruction shall be provided to the COUNTY by CONTRACTOR.
P. Disclaimer
COUNTY makes no warranty or representation that compliance by
CONTRACTOR with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be
adequate or satisfactory for CONTRACTOR’s own purposes or that any information in
CONTRACTOR’s possession or control, or transmitted or received by CONTRACTOR, is or will be
secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely
responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI.
Q. Amendment
The parties acknowledge that Federal and State laws relating to electronic data
security and privacy are rapidly evolving and that amendment of these provisions may be required to
provide for procedures to ensure compliance with such developments. The parties specifically agree to
take such action as is necessary to amend this agreement in order to implement the standards and
requirements of HIPAA, the HIPAA regulations, the HITECH Act and other applicable laws relating to
the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days written
notice in the event that CONTRACTOR does not enter into an amendment providing assurances
regarding the safeguarding of PHI that COUNTY in its sole discretion deems sufficient to satisfy the
standards and requirements of HIPAA, the HIPAA regulations and the HITECH Act.
R. No Third-Party Beneficiaries
Nothing express or implied in the terms and conditions of these provisions is
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intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
CONTRACTOR and their respective successors or assignees, any rights, remedies, obligations or
liabilities whatsoever.
S. Interpretation
The terms and conditions in these provisions shall be interpreted as broadly as
necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State laws. The
parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved in
favor of a meaning that complies and is consistent with HlPAA and the HIPAA regulations.
T. Regulatory References
A reference in the terms and conditions of these provisions to a section in the
HIPAA regulations means the section as in effect or as amended.
U. Survival
The respective rights and obligations of CONTRACTOR as stated in this
Paragraph shall survive the termination or expiration of this Agreement.
V. No Waiver of Obligations
No change, waiver or discharge of any liability or obligation hereunder on any
one or more occasions shall be deemed a waiver of performance of any continuing or other obligation,
or shall prohibit enforcement of any obligation on any other occasion.
19. DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent access,
viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of
COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter
into a contractual relationship with the COUNTY for the purpose of providing services under this
Agreement must employ adequate data security measures to protect the confidential information
provided to CONTRACTOR by the COUNTY, including but not limited to the following:
A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices
CONTRACTOR may not connect to COUNTY networks via personally owned
mobile, wireless or handheld devices, unless the following conditions are met:
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1. CONTRACTOR has received authorization by COUNTY for
telecommuting purposes;
2. Current virus protection software is in place;
3. Mobile device has the remote wipe feature enabled; and
4. A secure connection is used.
B. CONTRACTOR-Owned Computers or Computer Peripherals
CONTRACTOR may not bring CONTRACTOR-owned computers or computer
peripherals into the COUNTY for use without prior authorization from the COUNTY’s Chief Information
Officer, and/or his or her designee(s), including but not limited to mobile storage devices. If data is
approved to be transferred, data must be stored on a secure server approved by the COUNTY and
transferred by means of a Virtual Private Network (VPN) connection, or another type of secure
connection. Said data must be encrypted.
C. COUNTY-Owned Computer Equipment
CONTRACTOR may not use COUNTY computers or computer peripherals on
non-COUNTY premises without prior authorization from the COUNTY’s Chief Information Officer,
and/or his or her designee(s).
D. CONTRACTOR may not store COUNTY’s private, confidential or sensitive data
on any hard-disk drive, portable storage device, or remote storage installation unless encrypted.
E. CONTRACTOR shall be responsible to employ strict controls to ensure the
integrity and security of COUNTY’s confidential information and to prevent unauthorized access,
viewing, use or disclosure of data maintained in computer files, program documentation, data
processing systems, data files and data processing equipment which stores or processes COUNTY
data internally and externally.
F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128
BIT or higher. Additionally, a password or pass phrase must be utilized.
G. CONTRACTOR is responsible to immediately notify COUNTY of any violations,
breaches or potential breaches of security related to COUNTY’s confidential information, data
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maintained in computer files, program documentation, data processing systems, data files and data
processing equipment which stores or processes COUNTY data internally or externally.
H. COUNTY shall provide oversight to CONTRACTOR’s response to all incidents
arising from a possible breach of security related to COUNTY’s confidential client information provided
to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected individuals
as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be
responsible for all costs incurred as a result of providing the required notification.
20. PROPERTY OF COUNTY
A. COUNTY and CONTRACTOR recognizes that fixed assets are tangible and
intangible property obtained or controlled under COUNTY’s DBH for use in operational capacity and will
benefit COUNTY for a period more than one (1) year. Depreciation of the qualified items will be on a
straight-line basis.
For COUNTY purposes, fixed assets must fulfill three (3) qualifications:
1. Asset must have life span of over one (1) year.
2. The asset is not a repair part.
3. The asset must be valued at or greater than the capitalization thresholds
for the asset type.
Asset type Threshold
• land $0
• buildings and improvements $100,000
• infrastructure $100,000
• tangible $5,000
o equipment
o vehicles
• intangible asset $100,000
o internally generated software
o purchased software
o easements
o patents
• and capital lease $5,000
Qualified fixed asset equipment is to be reported and approved by COUNTY. If it
is approved and identified as an asset, it will be tagged with a COUNTY program number. A “Fixed
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Asset Log”, attached hereto as Exhibit E and by this reference incorporated herein and made part of
this Agreement, will be maintained by COUNTY’s Asset Management System and annually inventoried
until the asset is fully depreciated. During the terms of this Agreement, CONTRACTOR’s fixed assets
may be inventoried in comparison to COUNTY’s DBH Asset Inventory System.
B. Certain purchases less than Five Thousand and No/100 Dollars ($5,000.00) but
more than One Thousand and No/100 Dollars ($1,000.00), with over one (1) year life span, and/or are
mobile and high risk of theft or loss are sensitive assets. Such sensitive items are not limited to
computers, copiers, televisions, cameras and other sensitive items as determined by COUNTY’s DBH
Director, or his or her designee. CONTRACTOR maintains a tracking system on the items and are not
required to be capitalize or depreciated. The items are subject to annual inventory for compliance.
C. Assets shall be retained by COUNTY, as COUNTY property, in the event this
Agreement is terminated or upon expiration of this Agreement. CONTRACTOR agrees to participate in
an annual inventory of all COUNTY fixed and inventoried assets. Upon termination or expiration of this
Agreement, CONTRACTOR shall be physically present when fixed and inventoried assets are returned
to COUNTY possession. CONTRACTOR is responsible for returning to COUNTY all COUNTY owned
undepreciated fixed and inventoried assets, or the monetary value of said assets if unable to produce
the assets at the expiration or termination of this Agreement.
CONTRACTOR further agrees to the following:
1. To maintain all items of equipment in good working order and condition,
normal wear and tear is expected;
2. To label all items of equipment with COUNTY assigned program number,
to perform periodic inventories as required by COUNTY and to maintain an inventory list showing
where and how the equipment is being used, in accordance with procedures developed by COUNTY.
All such lists shall be submitted to COUNTY within ten (10) days of any request therefore; and
3. To report in writing to COUNTY immediately after discovery, the loss or
theft of any items of equipment. For stolen items, the local law enforcement agency must be contacted
and a copy of the police report submitted to COUNTY.
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D. The purchase of any equipment by CONTRACTOR with funds provided
hereunder shall require the prior written approval of COUNTY’s DBH, shall fulfill the provisions of this
Agreement as appropriate, and must be directly related to CONTRACTOR’s services or activity under
the terms of this Agreement. COUNTY’s DBH may refuse reimbursement for any costs resulting from
equipment purchased, which are incurred by CONTRACTOR, if prior written approval has not been
obtained from COUNTY.
E. CONTRACTOR must obtain prior written approval from COUNTY’s DBH
whenever there is any modification or change in the use of any property acquired or improved, in whole
or in part, using funds under this Agreement. If any real or personal property acquired or improved with
said funds identified herein is sold and/or is utilized by CONTRACTOR for a use which does not qualify
under this Agreement, CONTRACTOR shall reimburse COUNTY in an amount equal to the current fair
market value of the property, less any portion thereof attributable to expenditures of funds not provided
under this Agreement. These requirements shall continue in effect for the life of the property. In the
event this Agreement expires, or terminates, the requirements for this Paragraph shall remain in effect
for activities or property funded with said funds, unless action is taken by the State government to
relieve COUNTY of these obligations.
21. NON-DISCRIMINATION
During the performance of this Agreement, CONTRACTOR and its subcontractors shall
not deny the contract’s benefits to any person on the basis of race, religious creed, color, national
origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital
status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran
status, nor shall they discriminate unlawfully against any employee or applicant for employment
because of race, religious creed, color, national origin, ancestry, physical disability, mental disability,
medical condition, genetic information, marital status, sex, gender, gender identity, gender expression,
age, sexual orientation, or military or veteran status. CONTRACTOR shall insure that the evaluation
and treatment of employees and applicants for employment are free of such discrimination.
CONTRACTOR and subcontractors shall comply with the provisions of the Fair
Employment and Housing Act (Gov. Code §12800 et seq.), the regulations promulgated thereunder
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(Cal. Code Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title
2 of the Government Code (Gov. Code §11135-11139.5), and the regulations or standards adopted by
the awarding state agency to implement such article. CONTRACTOR shall permit access by
representatives of the Department of Fair Employment and Housing and the awarding state agency
upon reasonable notice at any time during the normal business hours, but in no case less than twenty-
four (24) hours’ notice, to such of its books, records, accounts, and all other sources of information and
its facilities as said Department or Agency shall require to ascertain compliance with this clause.
CONTRACTOR and its subcontractors shall give written notice of their obligations under this clause to
labor organizations with which they have a collective bargaining or other agreement (See Cal. Code
Regs., tit. 2, §11105). CONTRACTOR shall include the Non-Discrimination and compliance provisions
of this clause in all subcontracts to perform work under this Agreement.
22. CULTURAL COMPETENCY
As related to Cultural and Linguistic Competence, CONTRACTOR shall comply with:
A. Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Paragraph 2000d, and 45 C.F.R
Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance
from discriminating against persons based on race, color, national origin, sex, disability or religion.
This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access
and participation in federally funded programs through the provision of comprehensive and quality
bilingual services.
B. Policies and procedures for ensuring access and appropriate use of trained
interpreters and material translation services for all LEP individuals, including, but not limited to,
assessing the cultural and linguistic needs of said individuals, training of staff on the policies and
procedures, and monitoring its language assistance program. The CONTRACTOR’s procedures must
include ensuring compliance of any subcontracted providers with these requirements.
C. CONTRACTOR shall not use minors as interpreters.
D. CONTRACTOR shall provide and pay for interpreting and translation services to
persons participating in CONTRACTOR’s services who have limited or no English language
proficiency, including services to persons who are deaf or blind. Interpreter and translation services
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shall be provided as necessary to allow such participants meaningful access to the programs, services
and benefits provided by CONTRACTOR. Interpreter and translation services, including translation of
CONTRACTOR’s “vital documents” (those documents that contain information that is critical for
accessing CONTRACTOR’s services or are required by law) shall be provided to participants at no
cost to the participant. CONTRACTOR shall ensure that any employees, agents, subcontractors, or
partners who interpret or translate for a program participant, or who directly communicate with a
program participant in a language other than English, demonstrate proficiency in the participant’s
language and can effectively communicate any specialized terms and concepts peculiar to
CONTRACTOR’s services.
E. In compliance with the State mandated Culturally and Linguistically Appropriate
Services standards as published by the Office of Minority Health, CONTRACTOR must submit to
COUNTY for approval, within sixty (60) days from date of contract execution, CONTRACTOR’s plan to
address all fifteen (15) national cultural competency standards as set forth in Exhibit F-1 “National
Standards on Culturally and Linguistically Appropriate Services (CLAS)”
(http://minorityhealth.hhs.gov/assets/pdf/checked/finalreport/pdf) and Exhibit F-2, “Cultural Competence
Form”, attached hereto and by this reference incorporated herein and made a part of this Agreement.
COUNTY’s annual on-site review of CONTRACTOR shall include collection of documentation to ensure
all national standards are implemented. As the national competency standards are updated,
CONTRACTOR’s plan must be updated accordingly.
F. CONTRACTOR shall be responsible for conducting an annual cultural
competency self-assessment and provide the results of said self-assessment to the COUNTY’s DBH.
The annual cultural competency self-assessment instruments shall be reviewed by the COUNTY and
revised as necessary to meet the approval of the COUNTY.
G. Cultural competency training for CONTRACTOR staff should be substantively
integrated into health professions education and training at all levels, both academic and
functional, including core curriculum, professional licensure, and continuing professional development
programs. On an annual basis, CONTRACTOR’s direct service providers shall complete eight (8)
hours of cultural competency training. CONTRACTOR on a monthly basis shall provide COUNTY’s
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DBH a monthly monitoring tool/report that shows cultural competency trainings completed.
H. CONTRACTOR shall attend the COUNTY’s Cultural Competency Committee
monthly meetings, maintain its own cultural competence oversight committee, and develop a cultural
competency plan to address and evaluate cultural competency issues.
23. AMERICANS WITH DISABILITIES ACT
CONTRACTOR agrees to ensure that deliverables developed and produced, pursuant to
this Agreement shall comply with the accessibility requirements of Paragraph 508 of the Rehabilitation
Act and the Americans with Disabilities Act of 1973 as amended (29 U.S.C. §794 (d)), and regulations
implementing that Act as set forth in Part 1194 of Title 36 of the Code of Federal Regulations. In 1998,
Congress amended the Rehabilitation Act of 1973 to require Federal agencies to make their electronic
and information technology (EIT) accessible to people with disabilities. California Government Code
Paragraph 11135 codifies Paragraph 508 of the Act requiring accessibility of electronic and information
technology.
24. CONFLICT OF INTEREST
No officer, agent, or employee of COUNTY who exercises any function or responsibility
for planning and carrying out the services provided under this Agreement shall have any direct or
indirect personal financial interest in this Agreement. In addition, no employee of COUNTY shall be
employed by CONTRACTOR to fulfill any contractual obligations with COUNTY.
CONTRACTOR shall also comply with all Federal, State of California, and local conflict
of interest laws, statutes, and regulations, which shall be applicable to all parties and beneficiaries
under this Agreement and any officer, agent, or employee of COUNTY.
25. TAX EQUITY AND FISCAL RESPONSIBILITY ACT
To the extent necessary to prevent disallowance of reimbursement under Paragraph
1861(v) (1) (I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four
(4) years after the furnishing of services under this Agreement, CONTRACTOR shall make available,
upon written request to the Secretary of the United States Department of Health and Human Services,
or upon request to the Comptroller General of the United States General Accounting Office, or any of
their duly authorized representatives, a copy of this Agreement and such books, documents, and
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records as are necessary to certify the nature and extent of the costs of these services provided by
CONTRACTOR under this Agreement. CONTRACTOR further agrees that in the event
CONTRACTOR carries out any of its duties under this Agreement through a subcontract, with a value
or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12) month period,
with a related organization, such Agreement shall contain a clause to the effect that until the expiration
of four (4) years after the furnishing of such services pursuant to such subcontract, the related
organizations shall make available, upon written request to the Secretary of the United States
Department of Health and Human Services, or upon request to the Comptroller General of the United
States General Accounting Office, or any of their duly authorized representatives, a copy of such
subcontract and such books, documents, and records of such organization as are necessary to verify
the nature and extent of such costs.
26. SINGLE AUDIT CLAUSE
A. If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars and No/100
Dollars ($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to
conduct an annual audit in accordance with the requirements of the Single Audit Standards as set forth
in Office of Management and Budget (OMB) 2 CFR 200. CONTRACTOR shall submit said audit and
management letter to COUNTY. The audit must include a statement of findings or a statement that
there were no findings. If there were negative findings, CONTRACTOR must include a corrective
action plan signed by an authorized individual. CONTRACTOR agrees to take action to correct any
material non-compliance or weakness found as a result of such audit. Such audit shall be delivered to
COUNTY’s DBH Business Office for review within nine (9) months of the end of any fiscal year in which
funds were expended and/or received for the program. Failure to perform the requisite audit functions
as required by this Agreement may result in COUNTY performing the necessary audit tasks, or at
COUNTY’s option, contracting with a public accountant to perform said audit, or, may result in the
inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this
Agreement are the sole responsibility of CONTRACTOR.
B. A single audit report is not applicable if CONTRACTOR’s Federal contracts do
not exceed the Seven Hundred Fifty Thousand and No/100 Dollars ($750,000.00) requirement or
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CONTRACTOR’s only funding is through Drug-related Medi-Cal. If a single audit is not applicable, a
program audit must be performed and a program audit report with management letter shall be
submitted by CONTRACTOR to COUNTY as a minimum requirement to attest to CONTRACTOR’s
solvency. Said audit report shall be delivered to COUNTY’s DBH Business Office for review, no later
than nine (9) months after the close of the fiscal year in which the funds supplied through this
Agreement are expended. Failure to comply with this Act may result in COUNTY performing the
necessary audit tasks or contracting with a qualified accountant to perform said audit. All audit costs
related to this Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective
action to eliminate any material noncompliance or weakness found as a result of such audit. Audit work
performed by COUNTY under this Paragraph shall be billed to the CONTRACTOR at COUNTY’s cost,
as determined by COUNTY’s Auditor-Controller/Treasurer-Tax Collector.
C. CONTRACTOR shall make available all records and accounts for inspection by
COUNTY, the State of California, if applicable, the Comptroller General of the United States, the
Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a
period of at least three (3) years following final payment under this Agreement or the closure of all other
pending matters, whichever is later.
27. COMPLIANCE
CONTRACTOR agrees to comply with the COUNTY’s “Contractor Code of Conduct and
Ethics” and the COUNTY’s Compliance Program in accordance with Exhibit G, attached hereto and by
this reference incorporated herein and made a part of this Agreement. Within thirty (30) days of
entering into this Agreement with the COUNTY, CONTRACTOR shall have all of CONTRACTOR’s
employees, agents and subcontractors providing services under this Agreement certify in writing, that
he or she has received, read, understood, and shall abide by the Contractor Code of Conduct and
Ethics. CONTRACTOR shall ensure that within thirty (30) days of hire, all new employees, agents and
subcontractors providing services under this Agreement shall certify in writing that he or she has
received, read, understood, and shall abide by the Contractor Code of Conduct and Ethics.
CONTRACTOR understands that the promotion of and adherence to the Code of Conduct is an
element in evaluating the performance of CONTRACTOR and its employees, agents and
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subcontractors.
Within thirty (30) days of entering into this Agreement, and annually thereafter, all
employees, agents and subcontractors providing services under this Agreement shall complete general
compliance training, and appropriate employees, agents and subcontractors shall complete
documentation and billing or billing/reimbursement training. All new employees, agents and
subcontractors shall attend the appropriate training within thirty (30) days of hire. Each individual who
is required to attend training shall certify in writing that he or she has received the required training.
The certification shall specify the type of training received and the date received. The certification shall
be provided to the COUNTY’s Compliance Officer at 1925 E. Dakota Ave, Fresno, California 93726.
CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon
COUNTY by the Federal Government as a result of CONTRACTOR’s violation of the terms of this
Agreement.
28. ASSURANCES
In entering into this Agreement, CONTRACTOR certifies that it is not currently excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs: that it
has not been convicted of a criminal offense related to the provision of health care items or services;
nor has it been reinstated to participation in the Federal Health Care Programs after a period of
exclusion, suspension, debarment, or ineligibility. If COUNTY learns, subsequent to entering into a
contract, that CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTOR
from responsibility for, or involvement with, COUNTY’s business operations related to the Federal
Health Care Programs and shall remove such CONTRACTOR from any position in which
CONTRACTOR’s compensation, or the items or services rendered, ordered or prescribed by
CONTRACTOR may be paid in whole or part, directly or indirectly, by Federal Health Care Programs or
otherwise with Federal Funds at least until such time as CONTRACTOR is reinstated into participation
in the Federal Health Care Programs.
A. If COUNTY has notice that CONTRACTOR has been charged with a criminal
offense related to any Federal Health Care Program, or is proposed for exclusion during the term of any
contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy of any
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claims submitted to any Federal Health Care Program. At its discretion given such circumstances,
COUNTY may request that CONTRACTOR cease providing services until resolution of the charges or
the proposed exclusion.
B. CONTRACTOR agrees that all potential new employees of CONTRACTOR or
subcontractors of CONTRACTOR who, in each case, are expected to perform professional services
under this Agreement, will be queried as to whether: (1) they are now or ever have been excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2)
they have been convicted of a criminal offense related to the provision of health care items or services;
and or (3) they have been reinstated to participation in the Federal Health Care Programs after a period
of exclusion, suspension, debarment, or ineligibility.
1) In the event the potential employee or subcontractor informs
CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been
convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR
hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said
employee or subcontractor does no work, either directly or indirectly relating to services provided to
COUNTY.
2) Notwithstanding the above, COUNTY at its discretion may terminate this
Agreement in accordance with Paragraph Two (2) of this Agreement, or require adequate assurance
(as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or
subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services
provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be
determined by COUNTY to protect the interests of COUNTY consumers.
C. CONTRACTOR shall verify (by asking the applicable employees and
subcontractors) that all current employees and existing subcontractors who, in each case, are expected
to perform professional services under this Agreement (1) are not currently excluded, suspended,
debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been
convicted of a criminal offense related to the provision of health care items or services; and (3) have not
been reinstated to participation in the Federal Health Care Program after a period of exclusion,
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suspension, debarment, or ineligibility. In the event any existing employee or subcontractor informs
CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to participate in
the Federal Health Care Programs, or has been convicted of a criminal offense relating to the provision
of health care services, CONTRACTOR will ensure that said employee or subcontractor does no work,
either direct or indirect, relating to services provided to COUNTY.
1) CONTRACTOR agrees to notify COUNTY immediately during the term of
this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case,
is providing professional services under this Agreement is excluded, suspended, debarred or otherwise
ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense
relating to the provision of health care services.
2) Notwithstanding the above, COUNTY at its discretion may terminate this
Agreement in accordance with Paragraph Three (3) of this Agreement, or require adequate assurance
(as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or
subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services
provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be
determined by COUNTY to protect the interests of COUNTY clients.
D. CONTRACTOR agrees to cooperate fully with any reasonable requests for
information from COUNTY, which may be necessary to complete any internal or external audits relating
to CONTRACTOR’s compliance with the provisions of this Paragraph.
E. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty
imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of
CONTRACTOR’ obligations as described in this Paragraph.
29. PUBLICITY PROHIBITION
None of the funds, materials, property or services provided directly or indirectly under
this Agreement shall be used for CONTRACTOR’s advertising, fundraising, or publicity (i.e., purchasing
of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. Notwithstanding the
above, publicity of the services described in Paragraph One (1) of this Agreement shall be allowed as
necessary to raise public awareness about the availability of such specific services when approved in
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advance by COUNTY’s DBH Director, or his or her designee, and at a cost to be provided in Exhibit C
for such items as written/printed materials, the use of media (i.e., radio, television, newspapers) and
any other related expense(s).
30. CHILD ABUSE REPORTING ACT
CONTRACTOR shall establish a procedure acceptable to the COUNTY’s DBH Director,
or designee, to ensure that all of the CONTRACTOR’s employees, consultants, subcontractors or
agents described in the Child Abuse Reporting Act, Paragraph 1116 et seq. of the Penal Code, and
performing services under this Agreement shall report all known or suspected child abuse or neglect to
a child protective agency as defined in Penal Code Paragraph 11165.9. This procedure shall include:
A. A requirement that all CONTRACTOR’s employees, consultants, subcontractors
or agents performing services shall sign a statement that he or she knows of and will comply with the
reporting requirements as defined in Penal Code Paragraph 11166(a).
B. Establishing procedures to ensure reporting even when employees, consultants,
subcontractors, or agents who are not required to report child abuse under Penal Code Paragraph
11166(a), gain knowledge of or reasonably suspect that a child has been a victim of abuse or neglect.
31. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST INFORMATION
This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or
managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104,
and 455.106(a)(1), (2).
In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),
(2), the following information must be disclosed by CONTRACTOR by completing Exhibit H, “Disclosure
of Ownership and Control Interest Statement”, attached hereto and by this reference incorporated
herein and made part of this Agreement. CONTRACTOR shall submit this form to COUNTY’s DBH
within thirty (30) days of the effective date of this Agreement. Additionally, CONTRACTOR shall report
any changes to this information within thirty-five (35) days of occurrence by completing Exhibit H.
CONTRACTOR is required to submit a set of fingerprints for any person with a five (5) percent or
greater direct or indirect ownership interest in CONTRACTOR. COUNTY may terminate this
Agreement where any person with a five (5) percent or greater direct or indirect ownership interest in
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the CONTRACTOR did not submit timely and accurate information and cooperate with any screening
method required in CFR, Title 42, Paragraph 455.416. Submissions shall be scanned portable
document format (pdf) copies and are to be sent via email to
DBHContractedServicesDivision@fresnocountyca.gov, Attention: Mental Health Contracts Division.
COUNTY may deny enrollment or terminate this Agreement where any person with a five (5) percent or
greater direct or indirect ownership interest in CONTRACTOR has been convicted of a criminal offense
related to that person’s involvement with the Medicare, Medicaid, or Title XXI program in the last ten
(10) years.
32. DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS
CONTRACTOR is required to disclose if any of the following conditions apply to them,
their owners, officers, corporate managers and partners (hereinafter collectively referred to as
“CONTRACTOR”):
A. Within the three (3) year period preceding the Agreement award, they have been
convicted of, or had a civil judgment rendered against them for:
1) Fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction;
2) Violation of a federal or state antitrust statute;
3) Embezzlement, theft, forgery, bribery, falsification, or destruction of
records; or
4) False statements or receipt of stolen property.
B. Within a three (3) year period preceding their Agreement award, they have had
a public transaction (federal, state, or local) terminated for cause or default.
Disclosure of the above information will not automatically eliminate CONTRACTOR
from further business consideration. The information will be considered as part of the determination
of whether to continue and/or renew the Agreement and any additional information or explanation
that a CONTRACTOR elects to submit with the disclosed information will be considered. If it is later
determined that the CONTRACTOR failed to disclose required information, any contract awarded to
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such CONTRACTOR may be immediately voided and terminated for material failure to comply with
the terms and conditions of the award.
CONTRACTOR must sign a “Certification Regarding Debarment, Suspension, and Other
Responsibility Matters- Primary Covered Transactions” in the form set forth in Exhibit I, attached hereto
and by this reference incorporated herein and made part of this Agreement. Additionally,
CONTRACTOR must immediately advise the COUNTY in writing if, during the term of this Agreement:
(1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for participation in federal or
state funded programs or from receiving Federal funds as listed in the excluded parties’ list system
(http://www.epls.gov); or (2) any of the above listed conditions become applicable to CONTRACTOR.
CONTRACTOR shall indemnify, defend and hold the COUNTY harmless for any loss or damage
resulting from a conviction, debarment, exclusion, ineligibility or other matter listed in the signed
Certification Regarding Debarment, Suspension, and Other Responsibility Matters.
33. DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the CONTRACTOR is operating as a corporation (a
for-profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR changes
its status to operate as a corporation.
Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing
transactions that they are a party to while CONTRACTOR is providing goods or performing services
under this Agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR
is a party and in which one or more of its directors has a material financial interest. Members of the
Board of Directors shall disclose any self-dealing transactions that they are a party to by completing
and signing a “Self-Dealing Transaction Disclosure Form”, attached hereto as Exhibit J and
incorporated herein by reference and made part of this Agreement, and submitting it to the COUNTY
prior to commencing with the self-dealing transaction or immediately thereafter.
34. AUDITS AND INSPECTIONS
CONTRACTOR shall at any time during business hours, and as often as the COUNTY
may deem necessary, make available to the COUNTY for examination all of its records and data with
respect to the matters covered by this Agreement. CONTRACTOR shall, upon request by the
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COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to ensure
CONTRACTOR’ compliance with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
CONTRACTOR shall be subject to the examination and audit of the State Auditor General for a period
of three (3) years after final payment under contract (California Government Code Paragraph 8546.7).
35. NOTICES
The persons having authority to give and receive notices under this Agreement and their
addresses include the following:
COUNTY CONTRACTOR
Director, Executive Director,
Fresno County Department Reading and Beyond, Inc.
of Behavioral Health 4670 E. Butler Avenue
1925 E. Dakota Ave. Fresno, CA 93702
Fresno, CA 93726
All notices between the COUNTY and CONTRACTOR provided for or permitted under
this Agreement must be in writing and delivered either by personal service, by first-class United States
mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice
delivered by personal service is effective upon service to the recipient. A notice delivered by first-class
United States mail is effective three (3) COUNTY business days after deposit in the United States mail,
postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier
service is effective one (1) COUNTY business day after deposit with the overnight commercial courier
service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the
recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is
completed (but, if such transmission is completed outside of COUNTY business hours, then such
delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided
that the sender maintains a machine record of the completed transmission. For all claims arising out of
or related to this Agreement, nothing in this Paragraph establishes, waives, or modifies any claims
presentation requirements or procedures provided by law, including but not limited to the Government
Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with Section 810).
///
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36. SUPERSEDE
This Agreement shall supersede in its entirety and render null and void the Agreement
between the parties, identified as COUNTY Agreement No. 20-119, effective March 24, 2020.
37. SEVERABILITY
If any non-material term, provision, covenant, or condition of this Agreement is held by a
court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions shall
remain in full force and effect, and shall in no way be affected, impaired or invalidated.
38. GOVERNING LAW
The parties agree that for the purpose of venue, performance under this Agreement is in
Fresno County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
39. ENTIRE AGREEMENT
This Agreement, including all Exhibits (listed herein), COUNTY’s Revised RFP No. 20-
023, and CONTRACTOR’s Response to COUNTY’s Revised RFP No. 20-023 constitutes the entire
agreement between CONTRACTOR and COUNTY with respect to the subject matter hereof and
supersedes all previous agreement negotiat ions, proposals, commitments, writings, advertisements,
publications, and understandings of any nature whatsoever unless expressly included in this
Agreement.
Exhibit A Scope of Work
Exhibit B Fresno County Department of Behavioral Health Guiding
Principles of Care Delivery
Exhibit C Budget
Exhibit D State Mental Health Requirements
Exhibit E Fixed Asset Log
Exhibit F-1 CLAS Standards
Exhibit F-2 Cultural Competence Form
Exhibit G Contractor Code of Conduct and Ethics
Exhibit H Disclosure of Ownership and Control Interest Statement
Exhibit I Certification Regarding Debarment, Suspension, and Other
Responsibility Matters- Primary Covered Transactions
Exhibit J Self-Dealing Transaction Disclosure Form
Exhibit K Guide (PPG) 1.2.7 Performance Outcomes Measures
1 IN WITNESS WHEREOF , the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
3
4 CONTRACTOR
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Luis Santana
Print Name
Ex.ECUTIVE DIRECTOR
Title (Chairman of Board, or President,
Executive Director, or CEO)
15 Print Name
Controller
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Title (Secretary of Corporation, or Chief
Financial Officer/Treasurer, or any
Assistant Secretary or Treasurer
MAlLING ADDRESS:
Reading and Beyond
4670 E. Butler Ave.
Fresno, CA 93702
Contact Luis Santana, Executive Director
Phone No.: 559-342-8625
FOR ACCOUNTING USE ONLY:
Fund/Subclass: 0001/10000
Org No.: 56304710
Account No.: 7295
COUNTY OF FRESNO
E.. £Ad ~ h=-1 rd L.._
Ernest Buddy Mendes! ~an of the Board
of Supervisors of the County of Fresno
ATTEST:
Bernice E. Seidel
Clerk of the Board of Supervisors
County of Fresno, State of California
By:
-39-COUNTY OF FRESNO
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Exhibit A
1
SCOPE OF WORK
I. BACKGROUND
The Mental Health Services Act (MHSA), formerly known as Proposition 63, represents a
comprehensive approach to the development of community-based mental health services and
supports for the residents of California. It addresses a broad continuum of prevention and
early intervention, community service and support needs, and the necessary infrastructure,
technology and training elements that will effectively support the local mental health system
within Fresno County. The Community Services & Support (CSS) component of MHSA is
focused on mental health treatment services, community collaboration, cultural competence,
and client and family driven services and systems for unserved and underserved populations.
It also includes a wellness focus with concepts of recovery and resilience, and integrated
service experiences for clients and their families. The Family Advocacy Services will be MHSA
– CSS funded.
II. TARGET POPULATION
Family Advocacy Services shall be provided to family members and support systems of
children, adolescents, transition-age youth, adults and older adults that are in need of or
become engaged with behavioral health care services. CONTRACTOR providing Family
Advocacy Services shall be familiar with the services provided within the DBH system of care
for all age ranges and cultural/ethnic/linguistic populations in Fresno County.
Families and support systems may be self-referrals (walk-in/self-initiated service) or referred
via behavioral health programs. Family Advocacy Services will also work closely with County-
operated and contracted programs and their staff as navigators and liasions between the
behavioral health system and family members/support system.
III. LOCATION OF SERVICES
Family Advocacy Services staff will be provided furnished office space suitable for 2 FTE, one
office space at Metro (Kings Canyon Campus) and one office space at Heritage (at Shields and
Millbrook), but are expected to also workout in the field as appropriate. Included with the office
spaces are: desktop computers, printer and copy machine access, desktop telephones linked
to the COUNTY Family Advocate phone number, COUNTY email addresses, basic office
supplies, and access to COUNTY-contracted translator services. Family Advocacy Services
staff are expected to become fully integrated within the DBH system of care.
IV. DESCRIPTION OF SERVICES
The primary function of Family Advocacy Services is to assist family members/support systems
in coping with the signs and symptoms of mental illness of their loved one (adult or child)
through the provision of culturally sensitive information, education, support, navigation of DBH
services and referral to community resources. Additionally, Family Advocacy Services provides
navigation assistance to family members/support systems through interactions with service
providers to facilitate working relationships between families and providers and the behavioral
health system in general.
Exhibit A
2
Responsibilities
This following list of responsibilities under Family Advocacy Services is neither inclusive nor
exclusive, but indicative of several types of duties to be performed:
1. Develop orientation packets, educational materials and information about community
resources, public assistance programs and support groups that are available to
families/support systems.
2. Interview family members/support systems of mental health clients to obtain information
needed in order to determine personalized needs and to assist in the navigation of the
behavioral health system.
3. Orient the family member/support system to the behavioral health system, including
mental health and substance use disorder services.
4. Advise family members/support systems of available community resources and public
assistance programs. Inform family members/support systems about the limits of
family/caregiver involvement in mental health services. Identify safety concerns posed
by belonging to a family affected by mental illness and refer to appropriate support
groups and organizations.
5. Help empower family members/support systems to better understand and cope with the
problems and realities of severe and persistent mental illness. Assist family
members/support systems in accessing appropriate services for themselves as
caregivers/support persons.
6. Offer confidential assistance and support while at all times maintaining confidentiality,
dignity, and respect for the family member/caregiver.
7. Advocate for families/support systems as a group and facilitate improved communication
with service providers.
8. Act as a liaison between community resources, public assistance programs, support
groups and various organizations and the family/support system. The individuals
providing Family Advocacy Services shall participate in community committees and
stakeholder meetings.
9. Provide administrative duties, and work with DBH’s administrative team in family
advocacy planning and policy development. Family Advocates shall attend, and actively
participate in, specifically identified meetings, including but not limited to: DBH Quality
Improvement Committee, DBH Cultural Diversity Committee, Mental Health Contracted
Providers Meeting, and other meetings as requested by DBH. Participation in client case
management/staffing with DBH Clinical Teams and Contracted Provider treatment teams
may occur upon family request and client authorization.
Exhibit A
3
10. Provide presentations and advocacy services to various boards such as the Behavioral
Health Board, Board of Supervisors, etc.
11. Maintain an activity log and/or database, as determined by the CONTRACTOR, of
interaction with families/support systems. The Family Advocate/Navigators shall record
and maintain accurate and detailed records. Access to the documentation system,
including progress notes as applicable, will be provided to DBH upon request.
Navigators shall be asked to participate in review of DBH tracking processes, client
information, and other forms as determined and directed by the Department. Navigators
shall record referrals into CONTRACTOR’s data system and follow up with the
families/support systems to ensure that the resources provided were available and the
community member’s barrier was addressed.
12. Receive and resolve family members/support systems’ complaints regarding mental
health services in Fresno County and keep an accurate and up-to-date complaint log
with descriptions and disposition of issue.
13. Family Advocates cannot provide therapy services, divulge confidential information
without written consent for release of such information, or make decisions for the family.
14. Family Advocates are expected to ensure high responsiveness to community members
(family members/support systems and concerned stakeholders) by providing response
to phone calls received during hours of operation within 24 hours and in-person
response to support families/support systems through situations. CONTRACTOR shall
describe the average family/support system engagement period in annual program
outcomes reporting.
15. CONTRACTOR must have knowledge and understanding of AB 1424.
16. CONTRACTOR shall develop a staff handbook, training aids, and quick reference cards
to enable the staff to perform their day-to-day responsibilities.
17. Assign senior management to supervise the quality assurance and continuous
improvement plan for the program that will address any concerns or complaints while
ensuring efficiency, effectiveness, access, and maximizing satisfaction for the families
served.
Cultural Competency
In alignment with the County’s DBH Mental Health Services Act Three-Year Plan, Mental Health
Plan, and the Cultural Competency Plan, CONTRACTOR shall provide culturally competent and
culturally responsive services. CONTRACTOR's responsibilities shall include:
1. Mental Health & Substance Use Disorder direct service providers must complete eight
(8) hours of annual cultural competency training. Training hours may include completing
culturally competent courses through DBH Learning Management System or attending
Exhibit A
4
cultural awareness events. DBH will provide opportunities and track completion of
training hours through its Learning Management System.
2. When providing interpretation services for DBH clients, CONTRACTOR must utilize
interpreters who have received annual training and have been monitored for language
competence. By July 1st of each year, CONTRACTOR shall provide DBH with its
current list of interpreters, which includes training dates and monitoring results.
CONTRACTOR shall not utilize any interpreter who has not received annual training
and/or has not demonstrated language competence. CONTRACTOR shall have access
to DBH approved translators via DBH’s established protocol.
3. In order for DBH to ensure cultural, racial/ethnic and linguistic group of direct service
providers in comparison to the population needing services and being served,
CONTRACTOR shall complete and email Monthly Staffing Report, which includes
gender and ethnicity by the 10th of every month.
4. Provide plan to address cultural competency standards as set forth in Exhibit F-1,
“National Standards on Culturally and Linguistically Appropriate Services (CLAS)”.
5. Provide services by placing importance on traditional values, beliefs and family
histories. Cultural values and traditions offer special strengths in health care settings.
6. Provide services within the most relevant and meaningful cultural, gender-sensitive,
and age-appropriate context for the target population.
7. Distribute literature/informational brochures in appropriate languages and request
feedback as to how to access to care could be improved for these culturally diverse
communities. Distributed information will be approved by DBH designee and translated
as needed via DBH protocols.
Additional Required Service Approaches
The resulting program, services, and practices must align with DBH’s vision, mission, and
Guiding Principles of Care Delivery, attached as Exhibit B. DBH’s principles of care delivery
define and guide a system that strives for excellence in the provision of behavioral health
services where the values of wellness, resiliency, and recovery are central to the development
of programs, services, and workforce. The principles provide the clinical framework that
influences decision-making on all aspects of care delivery including program design and
implementation, service delivery, training of the workforce, allocation of resources, and
measurement of outcomes
The CONTRACTOR must be thoroughly familiar with MHSA provisions, including but not
limited to State MHSA regulations, policy interpretations, and definitions. CONTRACTOR will
use MHSA CSS funds to reach family members/support system of clients who receive
services through Fresno County DBH and other contracted services.
Exhibit A
5
V. STAFFING
At a minimum, two full time equivalent (2 FTE) advocates must be provided during normal
business hours.
The Family Advocacy Services staff will be expected to work closely with DBH Administration
and provide high level participation at community forums and meetings on behalf of DBH as
requested.
COUNTY will entertain potential program expansion during the anticipated 5-year contract
term with demonstration of need.
CONTRACTOR shall hire/employ three (3) full-time equivalent (FTE) staff members: two (2)
Family Advocates and one (1) Program Manager, all who will serve as “Family Navigators,” to
provide Family Advocacy Services. CONTRACTOR shall also assign a partial allocation of 0.1
FTE for a Senior Reading and Beyond Manager, for additional oversight and continuous
program improvement, and a partial allocation of 0.2 FTE for a Data and Continuous
Improvement Analyst, who will develop data tracking and reporting tools used to ensure
accurate, efficient, and timely reporting og program deliverables to the COUNTY.
The “Navigators” are responsible for building relationships with government agencies,
community-based organizations, and other supportive service providers to enure that they
understand the capacity and requirements of these organizations in order to ensure that
resources will be available to the community members served.
CONTRACTOR will seek to develop and train Family Advocate staff in the following areas:
trauma-informed care, motivationally enhanced interviewing, strength-based practices, and
two-generational case management.
Distinguishing Characteristics
Family Advocacy Services staff must possess the following: strong organizational, problem-
solving and interpersonal skills; the ability to identify and be responsive to the needs of family
members/support systems of mental health clients and relate well with them; ability to
demonstrate sensitivity to and establish a rapport with the culturally diverse population as well
as special service populations including disabled, children, older adults, diverse cultural groups,
LGBTQ, etc. Family Advocates must be able to exhibit stability under conditions of high stress,
limited supervision and often rapidly changing situations and circumstances. Family Advocates
should be able to effectively interview family members to accurately obtain and record factual
information, communicate effectively orally and in writing, and offer confidential assistance and
support with dignity and respect shown to family members at all times. Family Advocates must
be proficient in diagnosing barriers, creating short and long-term individalized plans to
address barriers, and developing community members’ self-reliance and capacity for self-
advocacy.
Family Advocates should have knowledge of the limits of family involvement in behavioral health
services and be able to communicate effectively an understanding of the mental health and
judicial systems and services that are available. Familiarity with AB 1424 and its intent,
“Persons with mental illness are best served in a system of care that supports and
acknowledges the role of the family, including parents, children, spouses, significant others, and
Exhibit A
6
client-identified natural resource system”, is essential. Family Advocates will provide a full range
of information, support, encouragement, advocacy, and referral to appropriate community
resources and related services in order to assist the family/caregiver in coping effectively with
an immediate crisis or long-term situation.
Minimum Qualifications for Family Advocacy Services staff
I. Education: Bachelor’s degree from an accredited college or university which is
acceptable within the United States’ accredited college or university system, which
includes fifteen (15) semester units from one or more of the following disciplines:
psychology, sociology, social welfare, criminology or a closely related field.
OR
Experience: Full-time paid work experience in behavioral health or mental health
services/settings including but not limited to behavioral health or mental health
advocacy, peer or family counseling or other services, which is comparable to the
description of Family Advocate may be substituted for the above course work on a
year-for-year basis.
II. License: Valid Class C California Driver’s License is required.
III. Other: Family Advocates must complete HIPAA training within the first 10 (ten) days
of the contract period and Mental Health First Aid Training within the first 30 (thirty)
days of the contract period. COUNTY will be able to provide HIPAA training and
Mental Health First Aid Training.
IV. Familiarity with Fresno County Department of Behavioral Health and community
resources is highly desirable.
V. Direct/personal experience as a family member or caregiver of a behavioral health
client is also highly desirable.
VI. Awareness of cultural competency and the diverse community of Fresno County is
essential to success as a Family Advocate.
VI. HOURS OF OPERATION
The Family Advocacy Services program is expected to operate during and outside of standard
business hours in order to provide reasonable and accessible service to client’s family
members/support systems.
The staffing plan will allow for the program to have personnel available at the county offices
during normal business hours as well as available by phone after business hours on the
weekdays as well as over the weekend and holidays. In the event of sudden illness or leave, the
program manager will be able to provide coverage and adjust staff schedules as required.
The COUNTY Family Advocate phone line is expected to be forwarded to the Navigator's cell
phone when out of the office during hours of operation. The Program Manager shall continually
Exhibit A
7
review demand and usage levels, and may adjust staff levels and hours of operatoin as
appropriate for coverage and community need.
VII. PROGRAM OUTCOMES/PERFORMANCE OUTCOMES MEASURES
CONTRACTOR shall submit measurable outcomes on an annual basis, as identified in the
DBH’s Policy and Procedure Guide (PPG) 1.2.7 Performance Outcomes Measures, attached as
Exhibit K. Performance outcome measures must be approved by DBH and satisfy all State and
local mandates. DBH will provide technical assistance and support in defining measurable
outcomes. All performance indicators will reflect the four (4) domains identified by the
Commission Accreditation of Rehabilitation Facilities (CARF). The domains are Effectiveness,
Efficiency, Access, and Satisfaction. These are defined and listed below.
DBH collects data about the characteristics of the persons served and measures service
delivery performance indicators in each of the following CARF DOMAINS. At minimum, one
performance indicator will be identified for each of the four (4) CARF domains listed below.
1. Effectiveness: A performance dimension that assesses the degree to which an
intervention or services have achieved the desired outcome/result/quality of care through
measuring change over time. The results achieved and outcomes observed are for
persons served.
Examples of indicators include: Persons get a job with benefits, or receive supports
needed to live in the community, increased function, activities, or participation, and
improvement of health, employment/earnings, or plan of care goal attainment.
2. Efficiency: Relationship between results and resources used, such as time, money, and
staff. The demonstration of the relationship between results and the resources used to
achieve them. A performance dimension addressing the relationship between the
outputs/results and the resources used to deliver the service.
Examples of indicators include: Direct staff cost per person served, amount of time it
takes to achieve an outcome, gain in scores per days of service, service hours per
person achieving some positive outcome, total budget (actual cost) per person served,
length of stay and direct service hours of clinical and medical staff.
3. Access: Organizations’ capacity to provide services of those who desire or need
services. Barriers or lack thereof for persons obtaining services. The ability of clients to
receive the right service at the right time. A performance dimension addressing the
degree to which a person needing services is able to access those services.
Examples of indicators include: Timeliness of program entry (From 1st request for service
to 1st service), ongoing wait times/wait lists, minimizing barriers to getting services, and
no-show/cancellation rates.
4. Satisfaction: Satisfaction Measures are usually orientated towards consumers, family,
staff, and stakeholders. The degree to which clients, the County and other stakeholders
are satisfied with services. A performance dimension that describes reports or ratings
Exhibit A
8
from persons served about services received from an organization.
Examples of indicators include: opinion of persons served or other key stakeholders in
regard to access, process, or outcome of services received, Consumer and/or Treatment
Perception Survey.
CONTRACTOR must address each of the categories referenced above and may additionally
propose other performance and outcome measures that are deemed best to evaluate the
services provided to families/support systems of clients and/or to evaluate overall program
performance. DBH may adjust the performance and outcome measures periodically
throughout the duration of this Agreement, as needed, to best measure the program as
determined by COUNTY. CONTRACTOR will be required to utilize and integrate data tracking
and other tools as directed by DBH.
Additional Reporting Requirements
CONTRACTOR will be responsible for meeting with DBH on a monthly basis, or more often as
agreed upon between DBH and CONTRACTOR, for contract and performance monitoring.
CONTRACTOR will be required to submit a monthly report to COUNTY that will include, but
not be limited to: actual expenses; the number of families/support systems served/anticipated
to be served; utilization of services by families/support systems; and staff composition. This
report will be due within thirty (30) days after the last day of the previous month or payments
may be delayed.
Exhibit B
Fresno County Department of Behavioral Health
Guiding Principles of Care Delivery
1
rev 01‐02‐2020
DBH VISION:
Health and well‐being for our community.
DBH MISSION:
DBH, in partnership with our diverse community, is dedicated to providing quality, culturally
responsive, behavioral health services to promote wellness, recovery, and resiliency for
individuals and families in our community.
DBH GOALS:
Quadruple Aim
Deliver quality care
Maximize resources while focusing on efficiency
Provide an excellent care experience
Promote workforce well‐being
GUIDING PRINCIPLES OF CARE DELIVERY:
The DBH 11 principles of care delivery define and guide a system that strives for excellence in the
provision of behavioral health services where the values of wellness, resiliency, and recovery are
central to the development of programs, services, and workforce. The principles provide the
clinical framework that influences decision‐making on all aspects of care delivery including
program design and implementation, service delivery, training of the workforce, allocation of
resources, and measurement of outcomes.
1. Principle One ‐ Timely Access & Integrated Services
o Individuals and families are connected with services in a manner that is streamlined,
effective, and seamless
o Collaborative care coordination occurs across agencies, plans for care are integrated,
and whole person care considers all life domains such as health, education,
employment, housing, and spirituality
o Barriers to access and treatment are identified and addressed
o Excellent customer service ensures individuals and families are transitioned from one
point of care to another without disruption of care
Exhibit B
Fresno County Department of Behavioral Health
Guiding Principles of Care Delivery
2
rev 01‐02‐2020
2. Principle Two ‐ Strengths‐based
o Positive change occurs within the context of genuine trusting relationships
o Individuals, families, and communities are resourceful and resilient in the way they
solve problems
o Hope and optimism is created through identification of, and focus on, the unique
abilities of individuals and families
3. Principle Three ‐ Person‐driven and Family‐driven
o Self‐determination and self‐direction are the foundations for recovery
o Individuals and families optimize their autonomy and independence by leading the
process, including the identification of strengths, needs, and preferences
o Providers contribute clinical expertise, provide options, and support individuals and
families in informed decision making, developing goals and objectives, and identifying
pathways to recovery
o Individuals and families partner with their provider in determining the services and
supports that would be most effective and helpful and they exercise choice in the
services and supports they receive
4. Principle Four ‐ Inclusive of Natural Supports
o The person served identifies and defines family and other natural supports to be
included in care
o Individuals and families speak for themselves
o Natural support systems are vital to successful recovery and the maintaining of
ongoing wellness; these supports include personal associations and relationships
typically developed in the community that enhance a person’s quality of life
o Providers assist individuals and families in developing and utilizing natural supports.
5. Principle Five ‐ Clinical Significance and Evidence Based Practices (EBP)
o Services are effective, resulting in a noticeable change in daily life that is measurable.
o Clinical practice is informed by best available research evidence, best clinical
expertise, and values and preferences of those we serve
o Other clinically significant interventions such as innovative, promising, and emerging
practices are embraced
Exhibit B
Fresno County Department of Behavioral Health
Guiding Principles of Care Delivery
3
rev 01‐02‐2020
6. Principle Six ‐ Culturally Responsive
o Values, traditions, and beliefs specific to an individual’s or family’s culture(s) are
valued and referenced in the path of wellness, resilience, and recovery
o Services are culturally grounded, congruent, and personalized to reflect the unique
cultural experience of each individual and family
o Providers exhibit the highest level of cultural humility and sensitivity to the self‐
identified culture(s) of the person or family served in striving to achieve the greatest
competency in care delivery
7. Principle Seven ‐ Trauma‐informed and Trauma‐responsive
o The widespread impacts of all types of trauma are recognized and the various
potential paths for recovery from trauma are understood
o Signs and symptoms of trauma in individuals, families, staff, and others are recognized
and persons receive trauma‐informed responses
o Physical, psychological and emotional safety for individuals, families, and providers is
emphasized
8. Principle Eight ‐ Co‐occurring Capable
o Services are reflective of whole‐person care; providers understand the influence of
bio‐psycho‐social factors and the interactions between physical health, mental health,
and substance use disorders
o Treatment of substance use disorders and mental health disorders are integrated; a
provider or team may deliver treatment for mental health and substance use
disorders at the same time
9. Principle Nine ‐ Stages of Change, Motivation, and Harm Reduction
o Interventions are motivation‐based and adapted to the person’s stage of change
o Progression though stages of change are supported through positive working
relationships and alliances that are motivating
o Providers support individuals and families to develop strategies aimed at reducing
negative outcomes of substance misuse though a harm reduction approach
Exhibit B
Fresno County Department of Behavioral Health
Guiding Principles of Care Delivery
4
rev 01‐02‐2020
o Each individual defines their own recovery and recovers at their own pace when
provided with sufficient time and support
10. Principle Ten ‐ Continuous Quality Improvement and Outcomes‐Driven
o Individual and program outcomes are collected and evaluated for quality and efficacy
o Strategies are implemented to achieve a system of continuous quality improvement
and improved performance outcomes
o Providers participate in ongoing professional development activities needed for
proficiency in practice and implementation of treatment models
11. Principle Eleven ‐ Health and Wellness Promotion, Illness and Harm Prevention, and Stigma
Reduction
o The rights of all people are respected
o Behavioral health is recognized as integral to individual and community well‐being
o Promotion of health and wellness is interwoven throughout all aspects of DBH services
o Specific strategies to prevent illness and harm are implemented at the individual,
family, program, and community levels
o Stigma is actively reduced by promoting awareness, accountability, and positive
change in attitudes, beliefs, practices, and policies within all systems
o The vision of health and well‐being for our community is continually addressed
through collaborations between providers, individuals, families, and community
members
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.10 2,300$ 2,300$
1102 Data Analyst 0.20 2,243 2,243
1103 Program Manager 1.00 10,409 10,409
1104 Family Navigator 1.00 6,154 6,154
1105 Family Navigator 1.00 6,154 6,154
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.30 4,543$ 22,717$ 27,260$
Employee Benefits
Acct #Admin Direct Total
1201 182$ 908$ 1,090$
1202 37 184 221
1203 727 3,633 4,360
1204 19 95 114
1205 - - -
1206 - - -
965$ 4,820$ 5,785$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 282$ 1,408$ 1,690$
1302 66 329 395
1303 91 1,092 1,183
1304 - - -
1305 - - -
1306 - - -
439$ 2,829$ 3,268$
5,947$ 30,365$ 36,313$
2000: CLIENT SUPPORT
Acct #Amount
Employee Benefits Subtotal:
Description
1000: SALARIES & BENEFITS
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
OASDI
FICA/MEDICARE
SUI
PROGRAM EXPENSES
Accrued Paid Leave
Other (Specify)
EMPLOYEE SALARIES & BENEFITS TOTAL:
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2019-2020)
Description
Payroll Taxes & Expenses Subtotal:
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 1 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 245$
3002 15
3003 21
3004 -
3005 1,725
3006 466
3007 -
3008 -
3009 354
3010 -
3011 -
3012 -
2,825$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 20$
4002 -
4003 -
4004 -
4005 -
4006 27
4007 -
4008 -
4009 -
4010 -
47$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
Staff Mileage
Subscriptions & Memberships
Clothing, Food, & Hygiene
Other (Specify)
Other (Specify)
Office, Household & Program Supplies
Utility Vouchers
Program Supplies - Medical
Medication Supports
Household Items for Clients
Employment Support
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Consultant (Network & Data Management)
FACILITIES/EQUIPMENT TOTAL:
OPERATING EXPENSES TOTAL:
Other (Specify)
Advertising
Rent/Lease Building
Building Maintenance
Education Support
Other: Livescan, TB Test, Background Check
Staff Development & Training
Child Care
Rent/Lease Vehicles
Client Transportation & Support
Client Housing Support
Other (Specify)
Other (Specify)
Contractual/Consulting Services (Specify)
Security
Utilities
Rent/Lease Equipment
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Vehicle Maintenance
HMIS (Health Management Information System)
Line Item Description
Line Item Description
Line Item Description
DIRECT CLIENT CARE TOTAL
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 2 of 46
5004 -
5005 332
5006 -
5007 -
5008 -
332$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 4,052$
6002 -
6003 -
6004 -
6005 125
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
4,177$
7000: FIXED ASSETS
Acct #Amount
7001 1,000$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
1,000$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Payroll Services
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Insurance (Specify): General, Auto, Cyber
Other (Specify)
Other Assets over $500 with Lifespan of 2 Years +
PROGRAM FUNDING SOURCES
44,694$ TOTAL PROGRAM EXPENSES
FIXED ASSETS EXPENSES TOTAL
ADMINISTRATIVE EXPENSES TOTAL
MEDI-CAL FFP TOTAL
SPECIAL EXPENSES TOTAL:
Line Item Description
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
External Audit
Professional Liability Insurance
Accounting/Bookkeeping
Line Item Description
Translation Services
Administrative Overhead
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Federal Financial Participation (FFP) %
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 3 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment -$
-$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 44,694$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
44,694$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
8200 - REALIGNMENT
NET PROGRAM COST:
TOTAL PROGRAM FUNDING SOURCES:44,694$
0$
SUBSTANCE USE DISORDER FUNDS TOTAL
MHSA TOTAL
Line Item Description
8100 - SUBSTANCE USE DISORDER FUNDS
OTHER REVENUE TOTAL
Line Item Description
8400 - OTHER REVENUE
Grants (Specify)
Other (Specify)
Other (Specify)
MHSA Program Name
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
Line Item Description
REALIGNMENT TOTAL
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 4 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 36,313
Employee Salaries 27,260
1101 Senior RAB Manager 2,300 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation is higher than
in subsequent years
1102 Data Analyst 2,243 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
The rate of FTE allocation is higher with the ramp-up period than subsequent CFYs
in order to develop case management systems and reports.
1103 Program Manager 10,409 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 6,154 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 6,154 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 5,785
1201 Retirement 1,090 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 221 Worker's Compensation Insurance
1203 Health Insurance 4,360 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 114 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:3,268
1301 OASDI 1,690 OASDI cost is estimated at 6.2% x total salary
1302 FICA/MEDICARE 395 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
Reading and Beyond
Family Advocate Services
Fiscal Year (FY 2019-2020)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 5 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 2,825
3001 Telecommunications 245 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 15 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 21 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training 1,725 Staff Training: RAB has developed a curriculum of training programs for the staff
and manager providing direct services to participants. These programs include 5
two-hour modules online from the Evidence Based Portal (EBPHUB.com) including:
Evidence-based Case Management, Motivational Interviewing, Trauma Informed
Care, and Introduction to Cognitive Behavioral Skills. Each training costs $125.00
per employee per session. RAB will also seek out NAMI Mental Health First Aid
classes for program staff, which are sometimes offered free of charge but may also
cost $75.00 per participant. RAB staff will also participate in department training in
order to build rapport with DBH colleagues and better understand DBH's
organizational philosophy. These training sessions will include but cultural
competency and HIPAA. Training will occur on a regular basis for all staff. RAB will
review training on a yearly basis to ensure the most effective opportunities are
made available to program staff.
3006 Staff Mileage 466 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other: Livescan, TB Test, Background Check 354 Other - (Livescan, TB Test. Background check): RAB conducts several checks and
tests for all newly hired employees. These include fingerprinting / Livescan, a test
for TB, and a background check to confirm employment history and education.
3010 Other (Specify)-
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 47
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 6 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
4001 Building Maintenance 20 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 27 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)- The program will fund one laptop (primarily for the program manager) for
afterhours case management / data entry.
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 332
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 332 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 4,177
6001 Administrative Overhead 4,052 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 125 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS 1,000
7001 Computer Equipment & Software 1,000 The program will fund one laptop (primarily for the program manager) for
afterhours case management / data entry.
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:44,694
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:44,694
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 7 of 46
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.07 9,222$ 9,222$
1102 Data Analyst 0.20 13,493 13,493
1103 Program Manager 1.00 62,459 62,459
1104 Family Navigator 1.00 41,032 41,032
1105 Family Navigator 1.00 41,032 41,032
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.27 22,715$ 144,522$ 167,237$
Employee Benefits
Acct #Admin Direct Total
1201 909$ 5,778$ 6,687$
1202 184 1,170 1,354
1203 3,634 23,111 26,745
1204 568 3,611 4,179
1205 - - -
1206 - - -
5,295$ 33,670$ 38,965$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 1,408$ 8,955$ 10,363$
1302 329 2,094 2,423
1303 91 1,092 1,183
1304 - - -
1305 - - -
1306 - - -
1,828$ 12,141$ 13,969$
29,838$ 190,333$ 220,171$
2000: CLIENT SUPPORT
Acct #Amount
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
Line Item Description
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Accrued Paid Leave
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2020-2021)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 8 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 1,411$
3002 110
3003 82
3004 -
3005 -
3006 2,480
3007 -
3008 -
3009 -
3010 -
3011 -
3012 -
4,083$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 123$
4002 -
4003 -
4004 -
4005 -
4006 159
4007 -
4008 -
4009 -
4010 -
282$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services (Specify)
Security
Utilities
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Office, Household & Program Supplies
Advertising
Staff Development & Training
Staff Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Other (Specify)
Other (Specify)
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 9 of 46
5004 -
5005 2,053
5006 -
5007 -
5008 -
2,053$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 22,659$
6002 -
6003 -
6004 -
6005 752
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
23,411$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 250,000$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify): General, Auto, Cyber
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 10 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 0$
0$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 250,000$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
250,000$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:250,000$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Other (Specify)
Other (Specify)
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 11 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 220,171
Employee Salaries 167,237
1101 Senior RAB Manager 9,222 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation of this staff
member's salary is higher during the initial fiscal years of the program and declines
as oversight / senior management involvement in the program is expected to
decline due to increased staff and program manager capacity.
1102 Data Analyst 13,493 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
Allocation of this staff member's salary is higher during the initial fiscal years of the
program and declines as analyst involvement in the program is expected to decline
due to increased staff and program manager capacity.
1103 Program Manager 62,459 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 41,032 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 41,032 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 38,965
1201 Retirement 6,687 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 1,354 Worker's Compensation Insurance
1203 Health Insurance 26,745 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 4,179 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:13,969
1301 OASDI 10,363 OASDI cost is estimated at 6.2% x total salary
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2020-2021)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 12 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1302 FICA/MEDICARE 2,423 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 4,083
3001 Telecommunications 1,411 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 110 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 82 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training -
3006 Staff Mileage 2,480 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other (Specify)-
3010 Other (Specify)-
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 282
4001 Building Maintenance 123 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 159 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 13 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
5000: SPECIAL EXPENSES 2,053
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 2,053 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 23,411
6001 Administrative Overhead 22,659 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 752 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS -
7001 Computer Equipment & Software -
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:250,000
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:250,000
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 14 of 46
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.05 7,107$ 7,107$
1102 Data Analyst 0.18 12,175 12,175
1103 Program Manager 1.00 62,459 62,459
1104 Family Navigator 1.00 42,000 42,000
1105 Family Navigator 1.00 42,000 42,000
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.23 19,282$ 146,458$ 165,739$
Employee Benefits
Acct #Admin Direct Total
1201 771$ 5,855$ 6,626$
1202 156 1,186 1,342
1203 3,085 23,420 26,505
1204 482 3,659 4,141
1205 - - -
1206 - - -
4,494$ 34,120$ 38,614$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 1,195$ 9,075$ 10,270$
1302 280 2,122 2,402
1303 91 1,092 1,183
1304 - - -
1305 - - -
1306 - - -
1,566$ 12,289.00$ 13,855.00$
25,342$ 192,867$ 218,208$
2000: CLIENT SUPPORT
Acct #Amount
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
Line Item Description
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Accrued Paid Leave
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2021-2022)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 15 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 1,349$
3002 95
3003 71
3004 -
3005 1,725
3006 2,452
3007 -
3008 -
3009 354
3010 -
3011 -
3012 -
6,046$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 123$
4002 -
4003 -
4004 -
4005 -
4006 159
4007 -
4008 -
4009 -
4010 -
282$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services (Specify)
Security
Utilities
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Other: Livescan, TB Test, Background Check
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Office, Household & Program Supplies
Advertising
Staff Development & Training
Staff Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Other (Specify)
Other (Specify)
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 16 of 46
5004 -
5005 2,053
5006 -
5007 -
5008 -
2,053$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 22,659$
6002 -
6003 -
6004 -
6005 752
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
23,411$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 250,000$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify): General, Auto, Cyber
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 17 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 0$
0$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 250,000$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
250,000$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:250,000$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Other (Specify)
Other (Specify)
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 18 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 218,208
Employee Salaries 165,739
1101 Senior RAB Manager 7,107 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation of this staff
member's salary is higher during the initial fiscal years of the program and declines
as oversight / senior management involvement in the program is expected to
decline due to increased staff and program manager capacity.
1102 Data Analyst 12,175 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
Allocation of this staff member's salary is higher during the initial fiscal years of the
program and declines as analyst involvement in the program is expected to decline
due to increased staff and program manager capacity.
1103 Program Manager 62,459 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 42,000 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 42,000 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 38,614
1201 Retirement 6,626 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 1,342 Worker's Compensation Insurance
1203 Health Insurance 26,505 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 4,141 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:13,855
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2021-2022)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 19 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1301 OASDI 10,270 OASDI cost is estimated at 6.2% x total salary
1302 FICA/MEDICARE 2,402 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 6,046
3001 Telecommunications 1,349 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 95 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 71 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training 1,725 Staff Training: RAB has developed a curriculum of training programs for the staff
and manager providing direct services to participants. These programs include 5
two-hour modules online from the Evidence Based Portal (EBPHUB.com) including:
Evidence-based Case Management, Motivational Interviewing, Trauma Informed
Care, and Introduction to Cognitive Behavioral Skills. Each training costs $125.00
per employee per session. RAB will also seek out NAMI Mental Health First Aid
classes for program staff, which are sometimes offered free of charge but may also
cost $75.00 per participant. RAB staff will also participate in department training in
order to build rapport with DBH colleagues and better understand DBH's
organizational philosophy. These training sessions will include but cultural
competency and HIPAA. Training will occur on a regular basis for all staff. RAB will
review training on a yearly basis to ensure the most effective opportunities are
made available to program staff.
3006 Staff Mileage 2,452 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other: Livescan, TB Test, Background Check 354 Other - (Livescan, TB Test. Background check): RAB conducts several checks and
tests for all newly hired employees. These include fingerprinting / Livescan, a test
for TB, and a background check to confirm employment history and education.
3010 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 20 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 282
4001 Building Maintenance 123 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 159 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 2,053
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 2,053 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 23,411
6001 Administrative Overhead 22,659 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 752 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS -
7001 Computer Equipment & Software -
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:250,000
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 21 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:250,000
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 22 of 46
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.05 7,107$ 7,107$
1102 Data Analyst 0.16 10,473 10,473
1103 Program Manager 1.00 62,459 62,459
1104 Family Navigator 1.00 42,879 42,879
1105 Family Navigator 1.00 42,879 42,879
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.21 17,580$ 148,218$ 165,798$
Employee Benefits
Acct #Admin Direct Total
1201 703$ 5,926$ 6,629$
1202 142 1,200 1,342
1203 2,813 23,702 26,515
1204 439 3,703 4,142
1205 - - -
1206 - - -
4,097$ 34,531$ 38,628$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 1,090$ 9,185$ 10,275$
1302 255 2,148 2,403
1303 91 1,092 1,183
1304 - - -
1305 - -
1306 - -
1,436$ 12,425$ 13,861$
23,113$ 195,174$ 218,287$
2000: CLIENT SUPPORT
Acct #Amount
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
Line Item Description
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Accrued Paid Leave
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2022-2023)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 23 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 1,308$
3002 85
3003 63
3004 -
3005 1,725
3006 2,432
3007 -
3008 -
3009 354
3010 -
3011 -
3012 -
5,967$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 123$
4002 -
4003 -
4004 -
4005 -
4006 159
4007 -
4008 -
4009 -
4010 -
282$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services (Specify)
Security
Utilities
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Other: Livescan, TB Test, Background Check
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Office, Household & Program Supplies
Advertising
Staff Development & Training
Staff Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Other (Specify)
Other (Specify)
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 24 of 46
5004 -
5005 2,053
5006 -
5007 -
5008 -
2,053$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 22,659$
6002 -
6003 -
6004 -
6005 752
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
23,411$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 250,000$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify): General, Auto, Cyber
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 25 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment (0)$
(0)$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 250,000$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
250,000$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:250,000$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Other (Specify)
Other (Specify)
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 26 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 218,287
Employee Salaries 165,798
1101 Senior RAB Manager 7,107 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation of this staff
member's salary is higher during the initial fiscal years of the program and declines
as oversight / senior management involvement in the program is expected to
decline due to increased staff and program manager capacity.
1102 Data Analyst 10,473 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
Allocation of this staff member's salary is higher during the initial fiscal years of the
program and declines as analyst involvement in the program is expected to decline
due to increased staff and program manager capacity.
1103 Program Manager 62,459 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 42,879 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 42,879 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 38,628
1201 Retirement 6,629 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 1,342 Worker's Compensation Insurance
1203 Health Insurance 26,515 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 4,142 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:13,861
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2022-2023)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 27 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1301 OASDI 10,275 OASDI cost is estimated at 6.2% x total salary
1302 FICA/MEDICARE 2,403 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 5,967
3001 Telecommunications 1,308 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 85 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 63 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training 1,725 Staff Training: RAB has developed a curriculum of training programs for the staff
and manager providing direct services to participants. These programs include 5
two-hour modules online from the Evidence Based Portal (EBPHUB.com) including:
Evidence-based Case Management, Motivational Interviewing, Trauma Informed
Care, and Introduction to Cognitive Behavioral Skills. Each training costs $125.00
per employee per session. RAB will also seek out NAMI Mental Health First Aid
classes for program staff, which are sometimes offered free of charge but may also
cost $75.00 per participant. RAB staff will also participate in department training in
order to build rapport with DBH colleagues and better understand DBH's
organizational philosophy. These training sessions will include but cultural
competency and HIPAA. Training will occur on a regular basis for all staff. RAB will
review training on a yearly basis to ensure the most effective opportunities are
made available to program staff.
3006 Staff Mileage 2,432 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other: Livescan, TB Test, Background Check 354 Other - (Livescan, TB Test. Background check): RAB conducts several checks and
tests for all newly hired employees. These include fingerprinting / Livescan, a test
for TB, and a background check to confirm employment history and education.
3010 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 28 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 282
4001 Building Maintenance 123 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 159 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 2,053
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 2,053 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 23,411
6001 Administrative Overhead 22,659 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 752 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS -
7001 Computer Equipment & Software -
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:250,000
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 29 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:250,000
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 30 of 46
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.05 7,107$ 7,107$
1102 Data Analyst 0.13 8,771 8,771
1103 Program Manager 1.00 62,459 62,459
1104 Family Navigator 1.00 43,760 43,760
1105 Family Navigator 1.00 43,760 43,760
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.18 15,878$ 149,979$ 165,857$
Employee Benefits
Acct #Admin Direct Total
1201 635$ 5,996$ 6,631$
1202 129 1,214 1,343
1203 2,541 23,984 26,525
1204 397 3,747 4,144
1205 - - -
1206 - - -
3,702$ 34,941$ 38,643$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 985$ 9,294$ 10,279$
1302 230 2,174 2,404
1303 91 1,092 1,183
1304 - - -
1305 - - -
1306 - - -
1,306$ 12,560$ 13,866$
20,886$ 197,480$ 218,366$
2000: CLIENT SUPPORT
Acct #Amount
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
Line Item Description
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Accrued Paid Leave
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2023-2024)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 31 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 1,265$
3002 74
3003 56
3004 -
3005 1,725
3006 2,414
3007 -
3008 -
3009 354
3010 -
3011 -
3012 -
5,888$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 123$
4002 -
4003 -
4004 -
4005 -
4006 159
4007 -
4008 -
4009 -
4010 -
282$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services (Specify)
Security
Utilities
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Other: Livescan, TB Test, Background Check
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Office, Household & Program Supplies
Advertising
Staff Development & Training
Staff Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Other (Specify)
Other (Specify)
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 32 of 46
5004 -
5005 2,053
5006 -
5007 -
5008 -
2,053$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 22,659$
6002 -
6003 -
6004 -
6005 752
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
23,411$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 250,000$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify): General, Auto, Cyber
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 33 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 0$
0$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 250,000$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
250,000$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:250,000$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Other (Specify)
Other (Specify)
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 34 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 218,366
Employee Salaries 165,857
1101 Senior RAB Manager 7,107 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation of this staff
member's salary is higher during the initial fiscal years of the program and declines
as oversight / senior management involvement in the program is expected to
decline due to increased staff and program manager capacity.
1102 Data Analyst 8,771 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
Allocation of this staff member's salary is higher during the initial fiscal years of the
program and declines as analyst involvement in the program is expected to decline
due to increased staff and program manager capacity.
1103 Program Manager 62,459 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 43,760 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 43,760 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 38,643
1201 Retirement 6,631 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 1,343 Worker's Compensation Insurance
1203 Health Insurance 26,525 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 4,144 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:13,866
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2023-2024)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 35 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1301 OASDI 10,279 OASDI cost is estimated at 6.2% x total salary
1302 FICA/MEDICARE 2,404 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 5,888
3001 Telecommunications 1,265 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 74 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 56 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training 1,725 Staff Training: RAB has developed a curriculum of training programs for the staff
and manager providing direct services to participants. These programs include 5
two-hour modules online from the Evidence Based Portal (EBPHUB.com) including:
Evidence-based Case Management, Motivational Interviewing, Trauma Informed
Care, and Introduction to Cognitive Behavioral Skills. Each training costs $125.00
per employee per session. RAB will also seek out NAMI Mental Health First Aid
classes for program staff, which are sometimes offered free of charge but may also
cost $75.00 per participant. RAB staff will also participate in department training in
order to build rapport with DBH colleagues and better understand DBH's
organizational philosophy. These training sessions will include but cultural
competency and HIPAA. Training will occur on a regular basis for all staff. RAB will
review training on a yearly basis to ensure the most effective opportunities are
made available to program staff.
3006 Staff Mileage 2,414 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other: Livescan, TB Test, Background Check 354 Other - (Livescan, TB Test. Background check): RAB conducts several checks and
tests for all newly hired employees. These include fingerprinting / Livescan, a test
for TB, and a background check to confirm employment history and education.
3010 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 36 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 282
4001 Building Maintenance 123 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 159 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 2,053
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 2,053 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 23,411
6001 Administrative Overhead 22,659 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 752 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS -
7001 Computer Equipment & Software -
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:250,000
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 37 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:250,000
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 38 of 46
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Senior RAB Manager 0.05 7,107$ 7,107$
1102 Data Analyst 0.11 7,413 7,413
1103 Program Manager 1.00 62,459 62,459
1104 Family Navigator 1.00 44,465 44,465
1105 Family Navigator 1.00 44,465 44,465
1106 - - -
1107 - - -
1108 - - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 3.16 14,520$ 151,388$ 165,908$
Employee Benefits
Acct #Admin Direct Total
1201 581$ 6,052$ 6,633$
1202 118 1,226 1,344
1203 2,323 24,209 26,532
1204 363 3,783 4,146
1205 - - -
1206 - - -
3,385$ 35,270$ 38,655$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 900$ 9,381$ 10,281$
1302 211 2,194 2,405
1303 91 1,092 1,183
1304 - - -
1305 - - -
1306 - - -
1,202$ 12,667$ 13,869$
19,107$ 199,325$ 218,432$
2000: CLIENT SUPPORT
Acct #Amount
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Taxes & Expenses Subtotal:
EMPLOYEE SALARIES & BENEFITS TOTAL:
Line Item Description
FICA/MEDICARE
SUI
Retirement
Worker's Compensation
Health Insurance
Accrued Paid Leave
Other (Specify)
Other (Specify)
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2024-2025)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Description
Employee Benefits Subtotal:
Description
OASDI
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 39 of 46
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 1,230$
3002 66
3003 49
3004 -
3005 1,725
3006 2,398
3007 -
3008 -
3009 354
3010 -
3011 -
3012 -
5,822$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 123$
4002 -
4003 -
4004 -
4005 -
4006 159
4007 -
4008 -
4009 -
4010 -
282$
5000: SPECIAL EXPENSES
Acct #Amount
5001 -$
5002 -
5003 -
FACILITIES/EQUIPMENT TOTAL:
Line Item Description
Consultant (Network & Data Management)
HMIS (Health Management Information System)
Contractual/Consulting Services (Specify)
Security
Utilities
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
OPERATING EXPENSES TOTAL:
Line Item Description
Building Maintenance
Rent/Lease Building
Rent/Lease Equipment
Rent/Lease Vehicles
Subscriptions & Memberships
Vehicle Maintenance
Other: Livescan, TB Test, Background Check
Other (Specify)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Office, Household & Program Supplies
Advertising
Staff Development & Training
Staff Mileage
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
DIRECT CLIENT CARE TOTAL
Line Item Description
Household Items for Clients
Medication Supports
Program Supplies - Medical
Utility Vouchers
Other (Specify)
Other (Specify)
Client Housing Support
Client Transportation & Support
Clothing, Food, & Hygiene
Education Support
Employment Support
Child Care
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 40 of 46
5004 -
5005 2,053
5006 -
5007 -
5008 -
2,053$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 22,659$
6002
6003 -
6004 -
6005 752
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
23,411$
7000: FIXED ASSETS
Acct #Amount
7001 -$
7002 -
7003 -
7004 -
7005 -
7006 -
7007 -
7008 -
-$
Acct #Service Units Rate Amount
8001 Mental Health Services 0 - -$
8002 Case Management 0 - -
8003 Crisis Services 0 - -
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
0 -$
0%
-
0%-
-$
Federal Financial Participation (FFP) %
MEDI-CAL FFP TOTAL
PROGRAM FUNDING SOURCES
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Line Item Description
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
FIXED ASSETS EXPENSES TOTAL
TOTAL PROGRAM EXPENSES 250,000$
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Administrative Overhead
Professional Liability Insurance
Accounting/Bookkeeping
External Audit
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
SPECIAL EXPENSES TOTAL:
Line Item Description
Line Item Description
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Other Assets over $500 with Lifespan of 2 Years +
ADMINISTRATIVE EXPENSES TOTAL
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Payroll Services
Other: Case Management Online Platform
Other (Specify)
Other (Specify)
Other (Specify)
Insurance (Specify): General, Auto, Cyber
Translation Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 41 of 46
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment 0$
0$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports 250,000$
8302 PEI - Prevention & Early Intervention -
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
250,000$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
OTHER REVENUE TOTAL
TOTAL PROGRAM FUNDING SOURCES:250,000$
NET PROGRAM COST: -$
MHSA TOTAL
8400 - OTHER REVENUE
Line Item Description
Other (Specify)
Other (Specify)
REALIGNMENT TOTAL
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
MHSA Program Name
8100 - SUBSTANCE USE DISORDER FUNDS
Line Item Description
SUBSTANCE USE DISORDER FUNDS TOTAL
8200 - REALIGNMENT
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Exhibit C
Page 42 of 46
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 218,432
Employee Salaries 165,908
1101 Senior RAB Manager 7,107 Senior RAB Manager: A member of RAB's senior management team will be assigned
to monitor the program manager's performance, the overall activities of the
program, and ensure compliance with the requirements of the County Department
of Behavioral Health and all applicable laws and regulations. This senior manager
will also coordinate with other RAB management teams including finance,
information/technology, human resources, etc. The senior manager will not be
responsible for directly assisting any program participants. Allocation of this staff
member's salary is higher during the initial fiscal years of the program and declines
as oversight / senior management involvement in the program is expected to
decline due to increased staff and program manager capacity.
1102 Data Analyst 7,413 Data Analyst: RAB will assign a partial allocation of the data analyst's time to this
project in order to assist the Family Advocate program manager with monitoring of
program performance and determining the needs of the community. The data
analyst has experience assisting other programs that must comply with HIPAA. The
data analyst will not be responsible for directly assisting any program participants.
Allocation of this staff member's salary is higher during the initial fiscal years of the
program and declines as analyst involvement in the program is expected to decline
due to increased staff and program manager capacity.
1103 Program Manager 62,459 Program Manager: This proposal includes a full time allocation of a program
manager who will be responsible for overseeing the program's family advocates.
The program manager will also be the primary person assigned to answer the
Family Advocate phone line or respond to voicemails outside of normal business
hours. The program manager will also attend events in the community and
management meetings at the Department of Behavioral Health.
1104 Family Navigator 44,465 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1105 Family Navigator 44,465 Family Navigator: The Family Navigators will be the primary staff members assisting
program participants. FNs will be hired later than PM in this rampu up period.
1106 0 -
1107 0 -
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 38,655
1201 Retirement 6,633 Reading and Beyond provides a 4% match to employee 401k contributions as part
of the organization's compensation/benefit and retention strategies
1202 Worker's Compensation 1,344 Worker's Compensation Insurance
1203 Health Insurance 26,532 An estimate of health insurance coverage for the staff assigned to the grant.
1204 Accrued Paid Leave 4,146 Reading and Beyond estimates that staff allocated to this program will earn PTO
valued at this rate.
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:13,869
Family Advocate Services
Reading and Beyond
Fiscal Year (FY 2024-2025)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 43 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1301 OASDI 10,281 OASDI cost is estimated at 6.2% x total salary
1302 FICA/MEDICARE 2,405 FICA/Medicare cost is estimated at 1.45% x total salary
1303 SUI 1,183 SUI cost is estimated at 1st $7,000 x 6.8%
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 5,822
3001 Telecommunications 1,230 Telephone/Internet: The allocation in this category reflects the usage of
information/technology services for the data analyst and senior manager as well as
a dedicated cell phone for program services outside of normal business hours.
3002 Printing/Postage 66 Printing/Reproduction: The allocation in this category reflects the usage of the RAB
headquarter office printer/scanner/copier for the data analyst and senior manager.
3003 Office, Household & Program Supplies 49 Office Supplies & Equipment: The allocation in this category reflects the usage of
the RAB headquarter office supplies for the data analyst and senior manager.
3004 Advertising -
3005 Staff Development & Training 1,725 Staff Training: RAB has developed a curriculum of training programs for the staff
and manager providing direct services to participants. These programs include 5
two-hour modules online from the Evidence Based Portal (EBPHUB.com) including:
Evidence-based Case Management, Motivational Interviewing, Trauma Informed
Care, and Introduction to Cognitive Behavioral Skills. Each training costs $125.00
per employee per session. RAB will also seek out NAMI Mental Health First Aid
classes for program staff, which are sometimes offered free of charge but may also
cost $75.00 per participant. RAB staff will also participate in department training in
order to build rapport with DBH colleagues and better understand DBH's
organizational philosophy. These training sessions will include but cultural
competency and HIPAA. Training will occur on a regular basis for all staff. RAB will
review training on a yearly basis to ensure the most effective opportunities are
made available to program staff.
3006 Staff Mileage 2,398 Staff Mileage/Vehicle Maintenance: The allocation represents occasional travel by
the data analyst and senior manager in support of the program. Examples of this
type of travel include periodic visits to the staff at their offices, attending meetings
with department analysts and managers, and attending community events for the
benefit of the program. The allocation for this category also represents staff travel
to offices in order to ensure coverage, the program manager traveling to
department offices and RAB's headquarters in order to oversee the program, as
well as travel to meetings and events related to the program.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance -
3009 Other: Livescan, TB Test, Background Check 354 Other - (Livescan, TB Test. Background check): RAB conducts several checks and
tests for all newly hired employees. These include fingerprinting / Livescan, a test
for TB, and a background check to confirm employment history and education.
3010 Other (Specify)-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 44 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 282
4001 Building Maintenance 123 Allocation of RAB's maintenance / custodial costs based on the administrative
staffing of this program.
4002 Rent/Lease Building -
4003 Rent/Lease Equipment -
4004 Rent/Lease Vehicles -
4005 Security -
4006 Utilities 159 Allocation of RAB's utilities costs based on the administrative staffing of this
program.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 2,053
5001 Consultant (Network & Data Management)-
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services -
5005 Other: Case Management Online Platform 2,053 Other - (Case Management Online Platform): RAB subscribes to the Apricot case
management web based platform, a product of Social Solutions. This site allows for
customized case management profiles, forms, and fields and also for the creation of
customized and updateable reports using this data.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 23,411
6001 Administrative Overhead 22,659 Administrative Overhead (Indirect): RAB's 10% indirect rate provides for the salaries
of administrative staff in the following departments: Finance,
Information/Technology, and Human Resources. These staff are responsible for
processing payroll, invoicing for contracts and grants, providing and maintaining the
equipment used for this program, and the hiring and management oversight of
employees.
6002 Professional Liability Insurance -
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Specify): General, Auto, Cyber 752 Allocation of RAB's organizational insurance costs based on the staffing of this
program.
6006 Payroll Services -
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS -
7001 Computer Equipment & Software -
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
-
7003 Furniture & Fixtures -
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:250,000
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 45 of 46
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:250,000
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Exhibit C
Page 46 of 46
Exhibit D
Page 1 of 6
STATE MENTAL HEALTH REQUIREMENTS
1. CONTROL REQUIREMENTS
The COUNTY and its subcontractors shall provide services in accordance with all
applicable Federal and State statutes and regulations.
2. PROFESSIONAL LICENSURE
All (professional level) persons employed by the COUNTY Mental Health
Program (directly or through contract) providing Short-Doyle/Medi-Cal services
have met applicable professional licensure requirements pursuant to Business
and Professions and Welfare and Institutions Codes.
3. CONFIDENTIALITY
CONTRACTOR and its subcontractors (hereinafter “CONTRACTOR”) shall
conform to and COUNTY shall monitor compliance with all State of California and
Federal statutes and regulations regarding confidentiality, including but not
limited to confidentiality of information requirements at 42, Code of Federal
Regulations sections 2.1 et seq; California Welfare and Institutions Code,
sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the California
Health and Safety Code; Title 22, California Code of Regulations, section 51009;
and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code.
4. NON-DISCRIMINATION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY and to the
public all eligibility requirements to participate in the program plan set
forth in the Agreement. No person shall, because of ethnic group
identification, age, gender, color, disability, medical condition, national
origin, race, ancestry, marital status, religion, religious creed, political
belief or sexual preference be excluded from participation, be denied
benefits of, or be subject to discrimination under any program or activity
receiving Federal or State of California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the Equal
Employment Opportunity Commission guidelines, which forbids
discrimination against any person on the grounds of race, color, national
origin, sex, religion, age, disability status, or sexual preference in
employment practices. Such practices include retirement, recruitment
advertising, hiring, layoff, termination, upgrading, demotion, transfer, rates
of pay or other forms of compensation, use of facilities, and other terms
and conditions of employment.
Exhibit D
Page 2 of 6
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold all further
funds, until CONTRACTOR can show clear and convincing evidence to
the satisfaction of COUNTY that funds provided under this Agreement
were not used in connection with the alleged discrimination.
D. Nepotism
Except by consent of COUNTY’s Department of Behavioral Health
Director, or designee, no person shall be employed by CONTRACTOR
who is related by blood or marriage to, or who is a member of the Board
of Directors or an officer of CONTRACTOR.
5. PATIENTS' RIGHTS
CONTRACTOR shall comply with applicable laws and regulations, including but
not limited to, laws, regulations, and State policies relating to patients' rights.
STATE CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: CONTRACTOR has, unless exempted,
complied with the non-discrimination program requirements. (Gov. Code§ 12990
(a-f) and CCR, Title 2, Section 111 02) (Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: CONTRACTOR will comply
with the requirements of the Drug-Free Workplace Act of 1990 and will provide a
drug-free workplace by taking the following actions:
A. Publish a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled substance is
prohibited and specifying actions to be taken against employees for
violations.
B. Establish a Drug-Free Awareness Program to inform employees about:
1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free
workplace;
3) any available counseling, rehabilitation and employee assistance
programs; and,
4) penalties that may be imposed upon employees for drug abuse
violations.
C. Every employee who works on this Agreement will:
1) receive a copy of the company's drug-free workplace policy
statement; and,
2) agree to abide by the terms of the company's statement as a
condition of employment on this Agreement.
Exhibit D
Page 3 of 6
Failure to comply with these requirements may result in suspension of payments
under this Agreement or termination of this Agreement or both and
CONTRACTOR may be ineligible for award of any future State agreements if the
department determines that any of the following has occurred: the
CONTRACTOR has made false certification, or violated the certification by failing
to carry out the requirements as noted above. (Gov. Code §8350 et seq.)
3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: CONTRACTOR
certifies that no more than one (1) final unappealable finding of contempt of
CONTRACTOR by a Federal CONTRACTOR has been issued against
CONTRACTOR within the immediately preceding two (2) year period because of
CONTRACTOR’s failure to comply with an order of a Federal CONTRACTOR,
which orders CONTRACTOR to comply with an order of the National Labor
Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.)
4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE - PRO BONO
REQUIREMENT: CONTRACTOR hereby certifies that CONTRACTOR will
comply with the requirements of Section 6072 of the Business and Professions
Code, effective January 1, 2003.
CONTRACTOR agrees to make a good faith effort to provide a minimum number
of hours of pro bono legal services during each year of the contract equal to the
lessor of thirty (30) multiplied by the number of full time attorneys in the firm’s
offices in the State, with the number of hours prorated on an actual day basis for
any contract period of less than a full year or ten percent (10%) of its contract
with the State.
Failure to make a good faith effort may be cause for non-renewal of a state
contract for legal services, and may be taken into account when determining the
award of future contracts with the State for legal services.
5. EXPATRIATE CORPORATIONS: CONTRACTOR hereby declares that it is not
an expatriate corporation or subsidiary of an expatriate corporation within the
meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to
contract with the State of California.
6. SWEATFREE CODE OF CONDUCT:
A. All CONTRACTOR subcontractors contracting for the procurement or
laundering of apparel, garments or corresponding accessories, or the
procurement of equipment, materials, or supplies, other than procurement
related to a public works contract, declare under penalty of perjury that no
apparel, garments or corresponding accessories, equipment, materials, or
supplies furnished to the state pursuant to the contract have been
laundered or produced in whole or in part by sweatshop labor, forced
labor, convict labor, indentured labor under penal sanction, abusive forms
of child labor or exploitation of children in sweatshop labor, or with the
benefit of sweatshop labor, forced labor, convict labor, indentured labor
under penal sanction, abusive forms of child labor or exploitation of
children in sweatshop labor. CONTRACTOR further declare under
penalty of perjury that they adhere to the Sweatfree Code of Conduct as
Exhibit D
Page 4 of 6
set forth on the California Department of Industrial Relations website
located at www.dir.ca.gov, and Public Contract Code Section 6108.
B.CONTRACTOR agrees to cooperate fully in providing reasonable access
to the CONTRACTOR’s records, documents, agents or employees, or
premises if reasonably required by authorized officials of the contracting
agency, the Department of Industrial Relations, or the Department of
Justice to determine the contractor’s compliance with the requirements
under paragraph (a).
7.DOMESTIC PARTNERS: For contracts of $100,000 or more, CONTRACTOR
certifies that CONTRACTOR is in compliance with Public Contract Code Section
10295.3.
8.GENDER IDENTITY: For contracts of $100,000 or more, CONTRACTOR
certifies that CONTRACTOR is in compliance with Public Contract Code Section
10295.35.
DOING BUSINESS WITH THE STATE OF CALIFORNIA
The following laws apply to persons or entities doing business with the State of
California.
1.CONFLICT OF INTEREST: CONTRACTOR needs to be aware of the following
provisions regarding current or former state employees. If CONTRACTOR has
any questions on the status of any person rendering services or involved with this
Agreement, the awarding agency must be contacted immediately for clarification.
Current State Employees (Pub. Contract Code §10410):
a). No officer or employee shall engage in any employment, activity or
enterprise from which the officer or employee receives compensation or has a
financial interest and which is sponsored or funded by any state agency, unless
the employment, activity or enterprise is required as a condition of regular state
employment.
b). No officer or employee shall contract on his or her own behalf as an
independent contractor with any state agency to provide goods or services.
Former State Employees (Pub. Contract Code §10411):
a). For the two (2) year period from the date he or she left state employment,
no former state officer or employee may enter into a contract in which he or she
engaged in any of the negotiations, transactions, planning, arrangements or any
part of the decision-making process relevant to the contract while employed in
any capacity by any state agency.
b). For the twelve (12) month period from the date he or she left state
employment, no former state officer or employee may enter into a contract with
any state agency if he or she was employed by that state agency in a policy-
Exhibit D
Page 5 of 6
making position in the same general subject area as the proposed contract within
the twelve (12) month period prior to his or her leaving state service.
If CONTRACTOR violates any provisions of above paragraphs, such action by
CONTRACTOR shall render this Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they do not
receive payment other than payment of each meeting of the board or
commission, payment for preparatory time and payment for per diem. (Pub.
Contract Code §10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: CONTRACTOR needs to be
aware of the provisions which require every employer to be insured against
liability for Worker's Compensation or to undertake self-insurance in accordance
with the provisions, and CONTRACTOR affirms to comply with such provisions
before commencing the performance of the work of this Agreement. (Labor Code
Section 3700)
3. AMERICANS WITH DISABILITIES ACT: CONTRACTOR assures the State that
it complies with the Americans with Disabilities Act (ADA) of 1990, which
prohibits discrimination on the basis of disability, as well as all applicable
regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)
4. SUBCONTRACTOR NAME CHANGE: An amendment is required to change a
subcontractor’s name as listed on the agreement with CONTRACTOR. Upon
receipt of legal documentation of the name change the State will process the
amendment. Payment of invoices presented with a new name cannot be paid
prior to approval of said amendment.
5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:
A. When agreements are to be performed in the state by corporations, the
contracting agencies will be verifying that the subcontractor(s) is currently
qualified to do business in California in order to ensure that all obligations
due to the state are fulfilled.
B. "Doing business" is defined in R&TC Section 23101 as actively engaging
in any transaction for the purpose of financial or pecuniary gain or profit.
Although there are some statutory exceptions to taxation, rarely will a
corporate contractor performing within the state not be subject to the
franchise tax.
C. Both domestic and foreign corporations (those incorporated outside of
California) must be in good standing in order to be qualified to do
business in California. Agencies will determine whether a corporation is
in good standing by calling the Office of the Secretary of State.
6. RESOLUTION: A county, city, district, or other local public body must provide
the State with a copy of a resolution, order, motion, or ordinance of the local
governing body, which by law has authority to enter into an agreement,
authorizing execution of the agreement.
Exhibit D
Page 6 of 6
7.AIR OR WATER POLLUTION VIOLATION: Under the State laws, the
CONTRACTOR shall not be: (1) in violation of any order or resolution not
subject to review promulgated by the State Air Resources Board or an air
pollution control district; (2) subject to cease and desist order not subject to
review issued pursuant to Section 13301 of the Water Code for violation of waste
discharge requirements or discharge prohibitions; or (3) finally determined to be
in violation of provisions of federal law relating to air or water pollution.
8.PAYEE DATA RECORD FORM STD. 204: This form must be completed by all
contractors that are not another state agency or other governmental entity.
9.INSPECTION and Audit of Records and access to Facilities.
The State, CMS, the Office of the Inspector General, the Comptroller General,
and their designees may, at any time, inspect and audit any records or
documents of CONTRACTOR or its subcontractors, and may, at any time,
inspect the premises, physical facilities, and equipment where Medicaid-related
activities or work is conducted. The right to audit under this section exists for ten
(10) years from the final date of the contract period or from the date of
completion of any audit, whichever is later.
Federal database checks.
Consistent with the requirements at § 455.436 of this chapter, the State must
confirm the identity and determine the exclusion status of CONTRACTOR, any
subcontractor, as well as any person with an ownership or control interest, or
who is an agent or managing employee of CONTRACTOR through routine
checks of Federal databases. This includes the Social Security Administration's
Death Master File, the National Plan and Provider Enumeration System
(NPPES), the List of Excluded Individuals/Entities (LEIE), the System for Award
Management (SAM), and any other databases as the State or Secretary may
prescribe. These databases must be consulted upon contracting and no less
frequently than monthly thereafter. If the State finds a party that is excluded, it
must promptly notify the CONTRACTOR and take action consistent with §
438.610(c).
The State must ensure that CONTRACTOR with which the State contracts under
this part is not located outside of the United States and that no claims paid by a
CONTRACTOR to a network provider, out-of-network provider, subcontractor or
financial institution located outside of the U.S. are considered in the development
of actuarially sound capitation rates.
Exhibit E
Page 1 of 2
Vendor:Contract#Contact Person Contact#
Item Make/Brand Model Serial #Fixed AssetSensitive ItemDate
Requested
(If Fixed
Asset)
Date
Approved (
If Fixed
Assset)
Purchase
Date Location Condition
Fresno
County
Inventory
Number
Cost
ExampleCopier Canon 27CRT 9YHJY65R x 3/27/2008 4/1/2008 4/10/2008 Heritage New $6,500.00
ExampleDVD Player Sony DV2230 PXC4356A x n/a n/a 4/1/2008 Heritage New $450.00
Date Prepared:
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
Date Received:
Fixed Asset and Sensitive Item Tracking
EXHIBIT - E
Page 2 of 2
Fi el d Number
Fi el d
Descri pt i on
I nst ruct i on or Comment s
Requi r ed or
Condi t i onal
Header Vendor
I ndi cat e t he l egal name of t he agency cont r act ed t o
pr ovi de ser vi ces.
Requi r ed
Header Pr ogr am
I ndi cat e t he t i t l e of t he pr oj ect as descr i bed i n t he
cont r act wi t h t he Count y.
Requi r ed
Header Cont r act #
I ndi cat e t he assi gned Count y cont r act number . I f not
known, Count y st af f can pr ovi de.
Requi r ed
Header Cont act Per son
I ndi cat e t he f i r st and l ast name of t he pr i mar y agency
cont act f or t he cont r act .
Requi r ed
Header Cont act #
I ndi cat e t he most appr opr i at e t el ephone number of t he
pr i mar y agency cont act f or t he cont r act .
Requi r ed
Header Dat e Pr epar ed
I ndi cat e t he most cur r ent dat e t hat t he t r acki ng f or m
was compl et ed by t he vendor .
Requi r ed
a Item
I dent i f y t he i t em by pr ovi di ng a commonl y r ecogni zed
descr i pt i on of t he i t em.
Requi r ed
b Make/ Br and I dent i f y t he company t hat manuf act ur ed t he i t em.Requi r ed
c Model I dent i f y t he model number f or t he i t em, i f appl i cabl e. Condi t i onal
d Ser i al # I dent i f y t he ser i al number f or t he i t em, i f appl i cabl e. Condi t i onal
e Fi xed Asset
Mar k t he box wi t h an " X" i f t he cost of t he i t em i s
$5, 000 or mor e t o i ndi cat e t hat t he i t em i s a f i xed
asset .
Condi t i onal
f Sensi t i ve I t em
Mar k t he box wi t h an " X" i f t he i t em meet s t he cr i t er i a
of a sensi t i ve i t em as def i ned by t he Count y.
Condi t i onal
g Dat e Request ed
I ndi cat e t he dat e t hat t he agency submi t t ed a r equest
t o t he Count y t o pur chase t he i t em.
Requi r ed
h Dat e Appr oved
I ndi cat e t he dat e t hat t he Count y appr oved t he r equest
t o pur chase t he i t em.
Requi r ed
i Pur chase Dat e I ndi cat e t he dat e t he agency pur chased t he i t em.Requi r ed
j Locat i on I ndi cat e t he physi cal l ocat i on of t he i t em Requi r ed
k Condi t i on
I ndi cat e t he gener al condi t i on of t he i t em ( New, Good,
Wor n, Bad) .
Requi r ed
l
Fr esno Count y
I nvent or y
Number
I ndi cat e t he FR # pr ovi ded by t he Count y f or t he i t em. Condi t i onal
mCostI ndi cat e t he t ot al pur chase pr i ce of t he i t em i ncl udi ng
sal es t ax and ot her cost s, such as shi ppi ng.
Requi r ed
FI XED ASSET AND SENSI TI VE I TEM TRACKI NG
National Standards for Culturally and Linguistically
Appropriate Services (CLAS) in Health and Health Care
The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care
disparities by establishing a blueprint for health and health care organizations to:
Principal Standard:
1.Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse
cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
Governance, Leadership, and Workforce:
2.Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy,
practices, and allocated resources.
3.Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are
responsive to the population in the service area.
4.Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and
practices on an ongoing basis.
Communication and Language Assistance:
5.Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at
no cost to them, to facilitate timely access to all health care and services.
6.Inform all individuals of the availability of language assistance services clearly and in their preferred language,
verbally and in writing.
7.Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals
and/or minors as interpreters should be avoided.
8.Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the
populations in the service area.
Engagement, Continuous Improvement, and Accountability:
9.Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them
throughout the organization’s planning and operations.
10.Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into
measurement and continuous quality improvement activities.
11.Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health
equity and outcomes and to inform service delivery.
12.Conduct regular assessments of community health assets and needs and use the results to plan and implement
services that respond to the cultural and linguistic diversity of populations in the service area.
13.Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural
and linguistic appropriateness.
14.Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent,
and resolve conflicts or complaints.
15.Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and
the general public.
EXHIBIT F-1
page 1 of 2
The Case for the Enhanced National CLAS Standards
Of all the forms of inequality, injustice in health care is the most shocking and inhumane.
— Dr. Martin Luther King, Jr.
Health equity is the attainment of the highest level of health for all people (U.S. Department of Health and Human
Services [HHS] Office of Minority Health, 2011). Currently, individuals across the United States from various cultural
backgrounds are unable to attain their highest level of health for several reasons, including the social determinants of
health, or those conditions in which individuals are born, grow, live, work, and age (World Health Organization, 2012),
such as socioeconomic status, education level, and the availability of health services (HHS Office of Disease Prevention
and Health Promotion, 2010). Though health inequities are directly related to the existence of historical and current
discrimination and social injustice, one of the most modifiable factors is the lack of culturally and linguistically appropriate
services, broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of
all individuals.
Health inequities result in disparities that directly affect the quality of life for all individuals. Health disparities adversely
affect neighborhoods, communities, and the broader society, thus making the issue not only an individual concern but
also a public health concern. In the United States, it has been estimated that the combined cost of health disparities and
subsequent deaths due to inadequate and/or inequitable care is $1.24 trillion (LaVeist, Gaskin, & Richard, 2009).
Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care
and services (Beach et al., 2004; Goode, Dunne, & Bronheim, 2006). By providing a structure to implement culturally and
linguistically appropriate services, the enhanced National CLAS Standards will improve an organization’s ability to address
health care disparities.
The enhanced National CLAS Standards align with the HHS Action Plan to Reduce Racial and Ethnic Health Disparities
(HHS, 2011) and the National Stakeholder Strategy for Achieving Health Equity (HHS National Partnership for Action to
End Health Disparities, 2011), which aim to promote health equity through providing clear plans and strategies to guide
collaborative efforts that address racial and ethnic health disparities across the country. Similar to these initiatives, the
enhanced National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care
disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and
linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the
United States.
Bibliography:
Beach, M. C., Cooper, L. A., Robinson, K. A., Price, E. G., Gary, T. L., Jenckes, M. W., Powe, N.R. (2004). Strategies for improving minority healthcare quality. (AHRQ
Publication No. 04-E008-02). Retrieved from the Agency of Healthcare Research and Quality website:
http://www.ahrq.gov/downloads/pub/evidence/pdf/minqual/minqual.pdf
Goode, T. D., Dunne, M. C., & Bronheim, S. M. (2006). The evidence base for cultural and linguistic competency in health care. (Commonwealth Fund Publication No. 962).
Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf
LaVeist, T. A., Gaskin, D. J., & Richard, P. (2009). The economic burden of health inequalities in the United States. Retrieved from the Joint Center for Political and Economic
Studies website: http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%2
0Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf
National Partnership for Action to End Health Disparities. (2011). National stakeholder strategy for achieving health equity. Retrieved from U.S. Department of Health and
Human Services, Office of Minority Health website: http://www.minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286
U.S. Department of Health and Human Services. (2011). HHS action plan to reduce racial and ethnic health disparities: A nation free of disparities in health and health care.
Retrieved from http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy people 2020: Social determinants of health. Retrieved
from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39
U.S. Department of Health and Human Services, Office of Minority Health (2011). National Partnership for Action to End Health Disparities. Retrieved from
http://minorityhealth.hhs.gov/npa
World Health Organization. (2012). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/
EXHIBIT F-1
page 2 of 2
Page 1 of 1
Exhibit F-2
CULTURAL COMPETENCE FORM
Agency Name:
Program Category:
Identify the Agency’s ability to apply language, gender, and culturally specific competencies to the RFP services provided by
checking all that apply and/or provide the name of Agency that you have an arrangement with to respond to these referrals.
A B C
Language, Gender, and/or Cultural
Competence
Have staff
1 2
Name of Agency that you have an
arrangement with to respond to these
referrals Included in
staffing work
plan
Not included in
staffing work
plan. Explain
below
Spanish (Language)
Vietnamese (Language)
Other Language:
LGBT Staff
African American Staff
Latino Staff
Native American Staff
Asian American Staff
Pacific Islander Staff
Others:
Exhibit G
Page 1 of 3
FRESNO COUNTY MENTAL HEALTH COMPLIANCE PROGRAM
CONTRACTOR CODE OF CONDUCT AND ETHICS
Fresno County is firmly committed to full compliance with all applicable laws,
regulations, rules and guidelines that apply to the provision and payment of mental health services.
Mental health contractors and the manner in which they conduct themselves are a vital part of this
commitment.
Fresno County has established this Contractor Code of Conduct and Ethics with which
contractor and its employees and subcontractors shall comply. Contractor shall require its employees
and subcontractors to attend a compliance training that will be provided by Fresno County. After
completion of this training, each contractor, contractor’s employee and subcontractor must sign the
Contractor Acknowledgment and Agreement form and return this form to the Compliance officer or
designee.
Contractor and its employees and subcontractor shall:
1.Comply with all applicable laws, regulations, rules or guidelines when providing and billing
for mental health services.
2.Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their
professional dealing related to their contract with the County and avoid any conduct that could
reasonably be expected to reflect adversely upon the integrity of the County.
3.Treat County employees, consumers, and other mental health contractors fairly and with
respect.
4.NOT engage in any activity in violation of the County’s Compliance Program, nor engage in
any other conduct which violates any applicable law, regulation, rule or guideline
5.Take precautions to ensure that claims are prepared and submitted accurately, timely and are
consistent with all applicable laws, regulations, rules or guidelines.
6.Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement
of any kind are submitted.
7.Bill only for eligible services actually rendered and fully documented. Use billing codes that
accurately describe the services provided.
Exhibit G
Page 2 of 3
8.Act promptly to investigate and correct problems if errors in claims or billing are discovered.
9.Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct
and Ethics by County employees or other mental health contractors, or report any activity that
they believe may violate the standards of the Compliance Program, or any other applicable
law, regulation, rule or guideline. Fresno County prohibits retaliation against any person
making a report. Any person engaging in any form of retaliation will be subject to disciplinary
or other appropriate action by the County. Contractor may report anonymously.
10.Consult with the Compliance Officer if you have any questions or are uncertain of any
Compliance Program standard or any other applicable law, regulation, rule or guideline.
11.Immediately notify the Compliance Officer if they become or may become an Ineligible person
and therefore excluded from participation in the Federal Health Care Programs.
Exhibit G
Page 3 of 3
Fresno County Mental Health Compliance Program
Contractor Acknowledgment and Agreement
I hereby acknowledge that I have received, read and understand the Contractor Code of Conduct and
Ethics. I herby acknowledge that I have received training and information on the Fresno County Mental
Health Compliance Program and understand the contents thereof. I further agree to abide by the
Contractor Code of Conduct and Ethics, and all Compliance Program requirements as they apply to my
responsibilities as a mental health contractor for Fresno County.
I understand and accept my responsibilities under this Agreement. I further understand that any
violation of the Contractor Code of Conduct and Ethics or the Compliance Program is a violation of
County policy and may also be a violation of applicable laws, regulations, rules or guidelines. I further
understand that violation of the Contractor Code of Conduct and Ethics or the Compliance Program
may result in termination of my agreement with Fresno County. I further understand that Fresno
County will report me to the appropriate Federal or State agency.
For Individual Providers
Name (print): _____________________________________
Discipline: Psychiatrist Psychologist LCSW LMFT
Signature :________________________________ Date : ___/____/___
For Group or Organizational Providers
Group/Org. Name (print): _______________________________________
Employee Name (print): ________________________________________
Discipline: Psychiatrist Psychologist LCSW LMFT
Other:___________________________________________
Job Title (if different from Discipline): ___________________________
Signature: _________________________________ Date: ____/___/____
Exhibit H
Page 1 of 3
DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT
I.Identifying Information
Name of entity D/B/A
Address (number, street) City State ZIP code
CLIA number Taxpayer ID number (EIN) Telephone number
( )
II.Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and
addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued.
A. Are there any individuals or organizations having a direct or indirect ownership or control interest
of five percent or more in the institution, organizations, or agency that have been convicted of a criminal
offense related to the involvement of such persons or organizations in any of the programs established
YES NO
by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒
B. Are there any directors, officers, agents, or managing employees of the institution, agency, or
organization who have ever been convicted of a criminal offense related to their involvement in such
programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒
C.Are there any individuals currently employed by the institution, agency, or organization in a managerial,
accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or
agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒
III. A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling
interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names
and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are
related to each other, this must be reported under “Remarks.”
NAME ADDRESS EIN
B.Type of entity: ❒ Sole proprietorship ❒Partnership ❒Corporation
❒Unincorporated Associations ❒Other (specify)
C.If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations
under “Remarks.”
D. Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities?
(Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses
of individuals, and provider numbers. .......................................................................................................... ❒ ❒
NAME ADDRESS PROVIDER NUMBER
Exhibit H
Page 2 of 3
Exhibit H
Page 3 of 3
YES NO
IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒
If yes, give date.
B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒
If yes, when?
C.Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒
If yes, when?
V. Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒
If yes, give date of change in operations.
VI. Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒
VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
B.If the answer to question VII.A. is NO, was the facility ever affiliated with a chain?
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be
prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the
information requested may result in denial of a request to participate or where the entity already participates, a termination of
its agreement or contract with the agency, as appropriate.
Name of authorized representative (typed) Title
Signature Date
Remarks
Exhibit I
1 of 2
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is
providing the certification set out below.
2. The inability of a person to provide the certification required below will not
necessarily result in denial of participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the certification set out
below. The certification or explanation will be considered in connection with the
department or agency's determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a certification or an explanation
shall disqualify such person from participation in this transaction.
3.The certification in this clause is a material representation of fact upon which
reliance was placed when the department or agency determined to enter into this
transaction. If it is later determined that the prospective primary participant knowingly
rendered an erroneous certification, in addition to other remedies available to the
Federal Government, the department or agency may terminate this transaction for
cause or default.
4. The prospective primary participant shall provide immediate written notice to
the department or agency to which this proposal is submitted if at any time the
prospective primary participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, participant,
person, primary covered transaction, principal, proposal, and voluntarily excluded, as
used in this clause, have the meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549. You may contact the
department or agency to which this proposal is being submitted for assistance in
obtaining a copy of those regulations.
6. Nothing contained in the foregoing shall be construed to require establishment
of a system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
Exhibit I
2 of 2
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS
CERTIFICATION
(1)The prospective primary participant certifies to the best of its knowledge and belief,
that it, its owners, officers, corporate managers and partners:
(a) Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency;
(b)Have not within a three-year period preceding this proposal been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal
offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State or local) transaction or contract under a public transaction; violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or receiving
stolen property;
(c)(d) Have not within a three-year period preceding this application/proposal
had one or more public transactions (Federal, State or local) terminated for cause or
default.
(2)Where the prospective primary participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an explanation
to this proposal.
Signature: Date:
(Printed Name & Title) (Name of Agency or
Company)
Exhibit J
Page 1 of 2
SELF‐DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must
disclose any self‐dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self‐dealing transaction is defined below:
“A self‐dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1)Enter board member’s name, job title (if applicable), and date this disclosure is being made.
(2)Enter the board member’s company/agency name and address.
(3)Describe in detail the nature of the self‐dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a.The name of the agency/company with which the corporation has the transaction; and
b.The nature of the material financial interest in the Corporation’s transaction that the
board member has.
(4)Describe in detail why the self‐dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5)Form must be signed by the board member that is involved in the self‐dealing transaction
described in Sections (3) and (4).
Exhibit J
Page 2 of 2
(1) Company Board Member Information:
Name: Date:
Job Title:
(2) Company/Agency Name and Address:
(3) Disclosure (Please describe the nature of the self‐dealing transaction you are a party to)
(4) Explain why this self‐dealing transaction is consistent with the requirements of Corporations Code 5233 (a)
(5) Authorized Signature
Signature: Date:
Section: Mental Health
Effective Date: 05/30/2017 Revised Date: 05/30/2017
Policy Title: Performance Outcome Measures
Approved by: Dawan Utecht (Director of Behavioral Health), Francisco Escobedo (Sr. Staff Analyst - QA), Kannika
Toonnachat (Division Manager - Technology and Quality Management)
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MISSION STATEMENT
The Department of Behavioral Health is dedicated to supporting the wellness of individuals, families and communities in Fresno County who are affected by, or are at risk
of, mental illness and/or substance use disorders through cultivation of strengths toward promoting recovery in the least restrictive environment.
Template Review Date 3/28/16
Department of Behavioral Health
Policy and Procedure Guide
PPG 1.2.7
POLICY:It is the policy of Fresno County Department of Behavioral Health and the
Fresno County Mental Health Plan (FCMHP) to ensure procedures for
developing performance measures which accurately reflect vital areas of
performance and provide for systematic, ongoing collection and analysis
of valid and reliable data. Data collection is not intended to be an
additional task for FCMHP programs/providers but rather embedded within
the various non-treatment, treatment and clinical documentation.
PURPOSE:To determine the effectiveness and efficiency of services provided by
measuring performance outcomes/results achieved by the persons served
during service delivery or following service completion, delivery of service,
and of the individuals’ satisfaction. This is a vital management tool used to
clarify goals, document the efforts toward achieving those goals, and thus
measure the benefit the service delivery to the persons served.
Performance measurement selection is part of the planning and
developing process design of the program. Performance measurement is
the ongoing monitoring and reporting of progress towards pre-established
objectives/goals.
REFERENCE:California Code of Regulations, Title 9, Chapter 11, Section
1810.380(a)(1): State Oversight
DHCS Service, Administrative and Operational Requirements
Mental Health Services Act (MHSA), California Code of Regulations, Title
9, Section 3320, 3200.050, and 3200.120
Commission on Accreditation of Rehabilitation Facilities (CARF)
DEFINITIONS:
1.Indicator: Qualitative or quantitative measure(s) that tell if the outcomes have been
accomplished. Indicators evaluate key performance in relation to objectives. It indicates
what the program is accomplishing and if the anticipated results are being achieved.
EXHIBIT K
Page 1 of 6
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Department of Behavioral Health
Policy and Procedure Guide
PPG 1.2.7
Policy Title: Performance Outcome Measures
Section: Mental Health Effective Date: 05/30/2017
2.Intervention: A systematic plan of action consciously adapted in an attempt to address
and reduce the causes of failure or need to improve upon system.
3.Fresno County Mental Health Plan (FCMHP): Fresno County’s contract with the State
Department of Health and Human Services that allows for the provision of specialty
mental health services. Services may be delivered by county-operated programs,
contracted organizational, or group providers.
4.Objective (Goal): Intended results or the impact of learning, programs, or activities.
5.Outcomes: Specific results or changes achieved as a consequence of the program or
intervention. Outcomes are connected to the objectives/goals identified by the program
or intervention.
PROCEDURE:
I. Each FCMHP program/provider shall engage in measurement of outcomes in order
to generate reliable and valid data on the effectiveness and efficiency of programs or
interventions. Programs/providers will establish/select objectives (goals), decide on
a methodology and timeline for the collection of data, and use an appropriate data
collection tool. This occurs during the program planning and development process.
Outcomes should be in alignment with the program/provider goals.
II.Outcomes should be measureable, obtainable, clear, accurately reflect the expected
result, and include specific time frames. Once the measures have been selected, it
is necessary to design a way to gather the information. For each service delivery
performance indicator, FCMHP program/provider shall determine: to whom the
indicator will be applied; who is responsible for collecting the data; the tool from
which data will be collected; and a performance target based on an industry
benchmark, or a benchmark set by the program/provider.
III. Performance measures are subject to review and approval by FCMHP
Administration.
IV. Performance measurement is the ongoing monitoring and reporting of progress
towards pre-established objectives/goals. Annually, each FCMHP program/provider
must measure service delivery performance in each of the areas/domains listed
below. Dependent on the program/provider service deliverables, exceptions must be
approved by the FCMHP Administration.
EXHIBIT K
Page 2 of 6
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Department of Behavioral Health
Policy and Procedure Guide
PPG 1.2.7
Policy Title: Performance Outcome Measures
Section: Mental Health Effective Date: 05/30/2017
a. Effectiveness of services – How well programs performed and the results
achieved. Effectiveness measures address the quality of care through
measuring change over time. Examples include but are not limited to: reduction
of hospitalization, reduction of symptoms, employment and housing status, and
reduction of recidivism rate and incidence of relapse.
b. Efficiency of services – The relationship between the outcomes and the
resources used. Examples include but are not limited to: service delivery cost per
service unit, length of stay, and direct service hours of clinical and medical staff.
c. Services access – Changes or improvements in the program/provider’s capacity
and timeliness to provide services to those who request them. Examples include
but are not limited to: wait/length of time from first request/referral to first service
or subsequent appointment, convenience of service hours and locations, number
of clients served by program capacity, and no-show and cancellation rates.
d. Satisfaction and feedback from persons served and stakeholders– Changes or
increased positive/negative feedback regarding the experiences of the persons
served and others (families, referral sources, payors/guarantors, etc.).
Satisfaction measures are usually oriented toward clients, family members,
personnel, the community, and funding sources. Examples include but are not
limited to: did the organization/program focus on the recovery of the person
served, were grievances or concerns addressed, overall feelings of satisfaction,
and satisfaction with physical facilities, fees, access, service effectiveness, and
efficiency.
V. Each FCMHP program/provider shall use the following templates to document the
defined goals, intervention(s), specific indicators, and outcomes.
1. FCMHP Outcome Report template (see Attachment A)
2. FCMHP Outcome Analysis template (see Attachment C)
EXHIBIT K
Page 3 of 6
FRESNO COUNTY MENTAL HEALTH PLAN OUTCOMES REPORT- Attachment A
Revised March 2017
PROGRAM INFORMATION:
Program Title: Provider:
Program Description: MHP Work Plan:
Age Group Served 1: Dates Of Operation:
Age Group Served 2: Reporting Period:
Funding Source 1: Funding Source 3:
Funding Source 2: Other Funding:
FISCAL INFORMATION:
Program Budget Amount: Program Actual Amount: 0
Number of Unique Clients Served During Time Period: 0
Number of Services Rendered During Time Period: Click here to enter text.
Actual Cost Per Client: 0
CONTRACT INFORMATION:
Program Type: Type of Program:
Contract Term: For Other:
Renewal Date:
Level of Care Information Age 18 & Over:
Level of Care Information Age 0- 17:
TARGET POPULATION INFORMATION:
Target Population:
CORE CONCEPTS:
•Community collaboration: individuals, families, agencies, and businesses work together to accomplish a shared vision.
•Cultural competence: adopting behaviors, attitudes and policies that enable providers to work effectively in cross-cultural situations.
EXHIBIT K
Page 4 of 6
FRESNO COUNTY MENTAL HEALTH PLAN OUTCOMES REPORT- Attachment A
Revised March 2017
•Individual/Family-Driven, Wellness/Recovery/Resiliency-Focused Services: adult clients and families of children and youth identify needs and preferences that result in
the most effective services and supports.
•Access to underserved communities: Historically unserved and underserved communities are those groups that either have documented low levels of access and/or use of
mental health services, face barriers to participation in the policy making process in public mental health, have low rates of insurance coverage for mental health care, and/or
have been identified as priorities for mental health services.
•Integrated service experiences: services for clients and families are seamless. Clients and families do not have to negotiate with multiple agencies and funding sources to
meet their needs.
Please select core concepts embedded in services/ program:
(May select more than one) Please describe how the selected concept (s) embedded :
PROGRAM OUTCOME & GOALS
-Must include each of these areas/domains: (1) Effectiveness, (2) Efficiency, (3) Access, (4) Satisfaction & Feedback Of Persons Served & Stakeholder
-Include the following components for documenting each goal: (1) Indicator, (2) Who Applied, (3) Time of Measure, (4) Data Source, (5) Target Goal Expectancy
DEPARTMENT RECOMMENDATION(S):
EXHIBIT K
Page 5 of 6
FRESNO COUNTY MENTAL HEALTH PLAN
Outcomes Analysis Attachment C
Name of Program: Click here to enter text.
What is the Program/Contract Goals? Click here to enter text.
Program Type: ____________ Type of Program: Other, please specify below
Other: Click here to enter text.
CLINICAL INFORMATION:
Does the Program Utilize Any of the Following? (May select more than one)
Evidence Informed Practice Best Practice Evidence Based Practice
Other: Click here to enter text.
Please Describe: Click here to enter text.
OUTCOMES
What Outcome Measures Are Being Used? Click here to enter text.
What Outcome Measures/Functional Variables Could Be Added to Better Explain the Program’s
Effectiveness? Click here to enter text.
Describe the Program’s analysis (i.e. have the program/contract goals been met? Number served,
waiting list, wait times, budget to volume, etc.): Click here to enter text.
What Barriers Prevent the Program from Achieving Better Outcomes? Click here to enter text.
What Changes to the Program Would You Recommend to Improve the outcomes ? Click here to
enter text.
For Committee Use Only:
Recommendations: do include a conclusion and a to-do list with action items
Click here to enter text.
EXHIBIT K
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