PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. Contractor shall comply with all relevant rules, regulations, statutes, and County policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. Contractor shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude Contractor’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. This provision of this Agreement shall not be construed to replace or conflict with the duties of County’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code.

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. County shall comply with all relevant rules, regulations, statutes, and County policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. County shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary problem resolution process. This does not preclude County’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of County’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code.

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. CONTRACTOR shall comply with all relevant rules, regulations, statutes, and COUNTY policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. CONTRACTOR shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude CONTRACTOR’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of COUNTY’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code. Name of Agency: Xxxxxx Xxx Family Community, Inc. Date: March 10, 2017 Salaries and Wages $63,453.00 $63,453.00 Fringe Benefits $13,325.00 $13,325.00 TOTAL PERSONNEL $76,778.00 $76,778.00 Office Supplies $1,020.00 $1,020.00 Office Equipemnt $200.00 $200.00 Printing/Duplicating $420.00 $420.00 Space/Rent $3,180.00 $3,180.00 Utilities $900.00 $900.00 Communication $780.00 $780.00 Mailing and Stamps $240.00 $240.00 Equipment $180.00 $180.00 Trainer/Handout materials/training fees $1,200.00 $1,200.00 Insurance $2,700.00 $2,700.00 Financial Audit $2,100.00 $2,100.00 Subcontract $27,000.00 $27,000.00 Travel/Perdiem $613.00 $613.00 Subtotal Operational Costs $40,533.00 $40,533.00 Indirect Costs (8% of Personnel) $6,142.00 $6,142.00 Total Expenditures: $123,453.00 $123,453.00 NAME OF AGENCY: Xxxxxx Xxx Family Community, Inc. DATE: March 10, 2017 Work. Comp. - 2% $1,269.06 Other (Health, etc.) - 2.8% $1,776.68 Life/Pension Plan - 3% $1,903.58 Total Benefits - 21% $13,325.08 Executive Director $84,262.00 1 12 12.5 $10,532.75 Behavioral Heath Clinician $52,920.00 1 12 100 $52,920.00 Benefits Details Total Salaries $63,452.75 FICA - 6.2% $3,934.07 Total Benefits $13,325.08 SUI & SDI- 7.0% $4,441.69 Grand Total $76,777.83 SERVICE COMPONENT: Integrated Primary Care and Mental Health DATE: March 10, 2017 Desktop supplies, i.e. paper, pens, toner, stapler, etc. $85/mo. X 12 mos. Office Equipment i.e. printer/copier $ 1,020 $ 200 $ 1,220 Outreach Education Materials Brochures, flyers, and resource and translation materials $35/mo. X 12 mos. = $ 420 Other Expenses Rent/Office space $265 per month X 12 months = $ 3,180 Utilit...

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. Xxxxxxxxxx shall comply with all relevant rules, regulations, statutes, and Merced policies and procedures related to individuals’ rights to a complaint process and timely complaint resolution. Xxxxxxxxxx shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude Xxxxxxxxxx’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this MOU shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this MOU shall not be construed to replace or conflict with the duties of Merced’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code. 1. Xxxxxxxxxx shall be responsible for investigating complaints and providing the results of all investigations to DHCS by secure, encrypted e-mail to XXXXxxxxxXxxxxxx@xxxx.xx.xxx within two business days of completion.

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. CONTRACTOR shall comply with all relevant rules, regulations, statutes, and COUNTY policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. CONTRACTOR shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude CONTRACTOR’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of COUNTY’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code. FY 2017/2018 FY 2018/2019 FY 2019/2020 CONTRACTOR shall provide IHBS which, per definition, are intensive, individualized, and strength-based, needs-driven intervention activities that support the engagement and participation of the child/youth and his/her significant support persons, and to help the child/youth develop skills and achieve the goals and objectives of the plan. CONTRACTOR shall provide IHBS to youth who have returned or are returning home from out-of-home care and require community based services, or are at imminent risk of placement due to mental health issues, emotional disturbance, or substance abuse. The intent of this service is to provide the clinical intervention and support necessary to successfully maintain each child in his or her home or community. The goal is to provide a degree of clinical care and supervision in the home and community setting that is appropriate to children discharged from a more restrictive setting (e.g., residential, psychiatric hospitalization), or as an alternative to a more restrictive setting. All treatment, care and support services must be provided in a context that is child centered, family-focused, strength based, culturally competent and responsive to each child’s psychosocial, developmental, and treatment care needs. CONTRACTOR shall provide IHBS in any setting in which the child/youth is naturally located, including the home (biological, xxxxxx, or adoptive), schools, recreational settings, childcare centers, and other community settings. CONTRACTOR shall ensure availability of IHBS wherever and whenever needed, including evenings, weekends and holi...

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. HSA/AAA shall comply with all relevant rules, regulations, statutes, and BHRS policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. HSA/AAA shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude HSA/AAA’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of BHRS’ Patients’ Rights Advocate as described in Section 5520 of the W & I Code. MHSA Program Name: PEARLS Contract No.: 2009267 Fiscal Year: July 1, 2017 - June 30, 2018 Personnel Extra Help Salaries 39,208.00 Extra Help Payroll Taxes 4,233.00 Administrative Services 34,145.00 Operating Communications - Internal Services 1,100.00 Household Expense 3,100.00 General Liability 283.00 Maintenance - Equipment 400.00 Maintenance - Structure 1,600.00 Office Expense - General 1,131.00 Spec. Dept Exp 1,500.00 Special Dept Exp - Software 3,150.00 County Vehicle 3,950.00 Transportation & Travel-In State Overnight 500.00 Utilities 4,700.00 Indirect Expense 11,000.00 I. HSA/AAA shall provide implementation of the MHSA-PEI Integrated Primary Care and Mental Health Program to Encourage Active, Rewarding Lives for Seniors (PEARLS), age 60 and over, in accordance with the following goals: A. Provide services that are: 1. In the home or located in places where people already go; 2. Culturally and linguistically appropriate; 3. Leveraging existing community assets and knowledge; and 4. Comprehensive and family based. B. PEARLS objectives are to: 1. Identify older adults, age 60 and over, at risk of depression. 2. To ensure fidelity of the program, CONTRACTOR shall staff at least two (2) trained home visiting care managers to work with older adults. 3. Conduct an assessment on participant's nutrition and food security needs and make referrals as necessary to food pantry and senior meals program. 4. Provide enrichment opportunities for older adults to reduce isolation, socialize with others, and make new connections. 5. Coordinate with other older adult serving organizations to ensure that there are opportunities for no...

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. HSA/AAA shall comply with all relevant rules, regulations, statutes, and COUNTY policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. HSA/AAA shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and/or Mental Health Services Act problem resolution process. This does not preclude HSA/AAA’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of COUNTY’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code.

PATIENT RIGHTS AND PROBLEM RESOLUTION PROCESS. CONTRACTOR shall comply with all relevant rules, regulations, statutes, and COUNTY policies and procedures related to individuals’ rights to a complaint process and timely compliant resolution. CONTRACTOR shall comply with the Mental Health Plans (MHPs) Medi-Cal beneficiary and MHSA problem resolution process. This does not preclude CONTRACTOR’s commitment to resolve problems or complaints by Medi-Cal beneficiaries at the informal level as simply and quickly as possible. Nothing in this Agreement shall prevent Medi-Cal beneficiaries’ from utilizing the MHPs and other rights and processes regarding complaints and grievances, which are guaranteed by statute. Provision of this Agreement shall not be construed to replace or conflict with the duties of COUNTY’s Patients’ Rights Advocate as described in Section 5520 of the W & I Code. Contractor Name: Remittance Address: City/State/Zip: Contractor Phone No.: Contact Name and Email: MHSA Program Name: Contract No.: Fiscal Year: EXPENSE DESCRIPTION ANNUAL PROGRAM BUDGET Licensed Clinical Social Worker (100%) 78,000 Patient Services Coordinator 0 Director of Behavioral Health (20%) 18,630 Benefits (25.5%) 24,641 Office Supplies/Equipment 830 Outreach Education Materials 1,500 Contractual: Staff Training 1,400 Travel & Per Diem Expenses 1,100 Contractor Name: Remittance Address: City/State/Zip: Contractor Phone No.: Contact Name and Email: MHSA Program Name: Contract No.: Fiscal Year: EXPENSE DESCRIPTION ANNUAL PROGRAM BUDGET Cultural Broker (100%) 54,000 Director of Behavioral Health Services (4%) 3,654 Benefits (25.5%) 14,702 Office Supplies/Equipment 500 Outreach Materials 943 Contractual: Staff Training 943 Food 500 Travel & Per Diem Expenses 1,400 I. CONTRACTOR shall provide implementation of the MHSA-PEI Integrated Mental Health in Primary Care Settings in accordance with the following goals: A. Reduce disparities in access to mental health care and provide short term mental health services to address the psycho-social impact of trauma. B. Address depression and suicide prevention in all patients. C. Augment the services available at existing primary care centers to help ensure that they are more able to provide early intervention for mental health issues such as depression, anxiety, and suicide ideation for all patients. D. Provide services that are: 1. Located in places where people already go. 2. Culturally and linguistically appropriate. 3. Leveraging existing community assets and knowledge. 4. Comprehensi...

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