Common use of Non-Medi Clause in Contracts

Non-Medi. Cal and Medi-Cal recipients shall be screened financially in accordance with the DMH Uniform Method of Determining Ability to Pay (UMDAP). The recipient’s annual liability shall be calculated in accordance with UMDAP effective 10/1/1989. While a Medi-Cal recipient cannot be charged any fees for specific services, the UMDAP establishes their liability should they have to pay and must be maintained as part of the clinical record. Medi-Cal reimbursement rate shall be accepted as payment in full for appropriate Medi-Cal beneficiaries. This is a fee for services contract. CONTRACTOR will be paid for services at the rates set forth below. All rates are per session unless otherwise noted. This payment provision is subject to modification with approval of the County Contract Administrator and the Revenue and Budget Manager, not to exceed the total payment indicated in Section 3 of the main agreement, and limited to moving identified funding amounts between lines and rate changes within 10% of rate listed in this agreement. Detailed Budgets are on file and managed by the Contract Administrator, by type of service. • Treatment services (Mode 15) shall be billed at the rate of $2.80 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Specialty mental health treatment services shall be billed at the rate of $2.80 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Couples Counseling services shall be billed at the rate of $138 per couple per 60-minute session. CONTRACTOR shall submit a manual invoice to COUNTY on a monthly basis for these services. Support services (Mode 60) shall be billed at actual cost, as included in the following line item budget. CONTRACTOR shall submit a manual invoice to COUNTY at a minimum of monthly for these expenses. • Crisis Services: varies $ 27087 $ 1,466 $ 61,001 13% $ 7,930 12% $ 7,320 $ 76,252 $ 2,600 $ 400 $ 500 $ 3,500 $ 79,752 14% $ 11,962.73 $ 91,714 On site Crisis Specialists Crisis Specialists Program Administrator Total Salaries Benefits as % of Salaries Payroll Taxes as % of Salaries

Non-Medi. Cal and Medi-Cal recipients shall be screened financially in accordance with the DMH Uniform Method of Determining Ability to Pay (UMDAP). The recipient’s annual liability shall be calculated in accordance with UMDAP effective 10/1/1989. While a Medi-Cal recipient cannot be charged any fees for specific services, the UMDAP establishes their liability should they have to pay and must be maintained as part of the clinical record. Medi-Cal reimbursement rate shall be accepted as payment in full for appropriate Medi-Cal beneficiaries. This is a fee for services contract. CONTRACTOR will be paid for services at the rates set forth below. All rates are per session unless otherwise noted. This payment provision is subject to modification with approval of the County Contract Administrator and the Revenue and Budget Manager, not to exceed the total payment indicated in Section 3 of the main agreement, and limited to moving identified funding amounts between lines and rate changes within 10% of rate listed in this agreement. Detailed Budgets are on file and managed by the Contract Administrator, by type of service. • Treatment services (Mode 15) shall be billed at the rate of $2.80 2.75 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Specialty mental health treatment services shall be billed at the rate of $2.80 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Couples Counseling services shall be billed at the rate of $138 per couple per 60-minute session. CONTRACTOR shall submit a manual invoice to COUNTY on a monthly basis for these services. Support services (Mode 60) shall be billed at actual cost, as included in the following line item budget. CONTRACTOR shall submit a manual invoice to COUNTY at a minimum of monthly for these expenses. • Crisis Services: Crisis Manager $ 37.50 40% $ 31,200 Crisis Specialists varies $ 27087 26,045 Program Administrator $ 1,466 1,410 Benefits as % of Salaries $ 61,001 137,625 Payroll Taxes as % $ 7,930 of Salaries 12% $ 7,320 7,039 TOTAL PERSONNEL EXPENSES $ 76,252 73,319 Clinical Supervision (1 hrs/week * $50/hr) $ 2,600 Staff Development (2 per year/$200 each) $ 400 Job Postings/Recruitment $ 500 TOTAL OPERATING EXPENSES $ 3,500 ADMINISTRATIVE OVERHEAD $ 79,752 1410,754.63 Notes: - 3% increase $ 11,962.73 33.66 1.00 $ 91,714 On site 70,014 Crisis Specialists Manager Crisis Specialists Specialists/Placement Coordinator Program Administrator Total Salaries Program Administrative Support Benefits as % of Salaries Payroll Taxes as % of Salaries

Non-Medi. Cal and Medi-Cal recipients shall be screened financially in accordance with the DMH Uniform Method of Determining Ability to Pay (UMDAP). The recipient’s annual liability shall be calculated in accordance with UMDAP effective 10/1/1989. While a Medi-Cal recipient cannot be charged any fees for specific services, the UMDAP establishes their liability should they have to pay and must be maintained as part of the clinical record. Medi-Cal reimbursement rate shall be accepted as payment in full for appropriate Medi-Cal beneficiaries. This is a fee for services contract. CONTRACTOR will be paid for services at the rates set forth below. All rates are per session unless otherwise noted. This payment provision is subject to modification with approval of the County Contract Administrator and the Revenue and Budget Manager, not to exceed the total payment indicated in Section 3 of the main agreement, and limited to moving identified funding amounts between lines and rate changes within 10% of rate listed in this agreement. Detailed Budgets are on file and managed by the Contract Administrator, by type of service. • Treatment services (Mode 15) shall be billed at the rate of $2.80 2.75 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Specialty mental health treatment services shall be billed at the rate of $2.80 2.75 per minute. Psychiatrist/medication management shall be billed at the rate of $6.33 per minute. CONTRACTOR shall input treatment and billing data into COUNTY’S Avatar software system. • Couples Counseling services shall be billed at the rate of $138 per couple per 60-minute session. CONTRACTOR shall submit a manual invoice to COUNTY on a monthly basis for these services. Support services (Mode 60) shall be billed at actual cost, as included in the following line item budget. CONTRACTOR shall submit a manual invoice to COUNTY at a minimum of monthly for these expenses. • Crisis Services: Crisis Manager $ 33.66 0.10 $ 7,001 Crisis Specialists varies $ 27087 36,412 Program Administrator $ 1,466 $ 61,001 1,410 Benefits as % of Salaries 13% $ 7,930 5,827 Payroll Taxes as % of Salaries 12% $ 7,320 5,379 TOTAL PERSONNEL EXPENSES $ 76,252 56,029 Clinical Supervision (1 hrs/week * $50/hr) $ 2,600 Staff Development (2 per year/$200 each) $ 400 Job Postings/Recruitment $ 500 TOTAL OPERATING EXPENSES $ 3,500 SUBTOTAL Program $ 79,752 59,529 ADMINISTRATIVE OVERHEAD 14% $ 11,962.73 8,334.02 TOTAL EXPENSES $ 91,714 On site 67,863 Notes: - 3% increase $ 33.66 0.90 $ 63,012 Crisis Specialists Manager Crisis Specialists Specialists/Placement Coordinator Program Administrator Total Salaries Program Administrative Support Benefits as % of Salaries Payroll Taxes as % of Salaries