Attachment F_Mobile Crisis Costing Model_OMH.CCSI_04.2025.xlsx

XLSX spreadsheet 87 KB Posted Aug 13, 2025

Attached to: Mobile Crisis Services State and local contract opportunity
Solicitation number: 2025-052
Issued by: Broome County, New York

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Written by GovTribe AI · Aug 13, 2025

The document is a comprehensive Mobile Crisis Services costing model spreadsheet prepared by the New York State Office of Mental Health (OMH) for Comprehensive Community Support Initiative (CCSI) Mobile Crisis Response services. The file details staffing models, service configurations, and financial projections for three distinct geographical models: Upstate Rural, Downstate Urban, and Upstate Urban, each with different staffing ratios, service hours, and operational parameters. The models outline mobile crisis response scenarios including telephonic crisis triage, mobile crisis responses, and follow-up services, with estimated contact volumes ranging from 890-1035 total crisis interactions per model.

The financial analysis demonstrates detailed cost structures, including staff salaries, fringe benefits, and operational expenses, with total costs ranging from $429,076 (Rural) to $777,354 (Downstate Urban). Each model projects different Medicaid participation rates (70-75%), billable percentages (35-60%), and capacity utilization, with staffing costs comprising the majority of expenses. The models calculate revenue potential, showing significant operational deficits across all scenarios, with the Upstate Rural model experiencing a $335,067 deficit and the Downstate Urban model showing a $178,171 deficit. Staffing models include combinations of licensed professionals, peers, coordinators, and on-call personnel, with service hours typically spanning 8:00 AM to 1:00 AM across different geographic regions.

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Other files for this state and local contract opportunity

Other files attached to Mobile Crisis Services, newest first.
File	Type	Posted
Attachment A_NYS Crisis Intervention Benefit_02.2025.pdf	PDF	Aug 13, 2025
Attachment B_SPA Updates to Mobile Crisis Services_02.01.2024.pdf	PDF	Aug 13, 2025
Attachment H_Attestations A-B-C-D_07.2025.pdf	PDF	Aug 13, 2025
RFP-2025-052 - Mobile Crisis Services.pdf	PDF	Aug 13, 2025
Attachment C_NYS OMH Mobile Crisis Program Guidance_09.20.2019.pdf	PDF	Aug 13, 2025
Attachment D_Mobile Crisis Guidelines for BC_07.2025.pdf	PDF	Aug 13, 2025
Attachment E_Mobile Crisis Budget Template_07.2025.xlsx	XLSX spreadsheet	Aug 13, 2025
Attachment I_NYS OMH Telehealth Guidance_04.2023.pdf	PDF	Aug 13, 2025
Attachment J_RFP Evaluation Rubric_07.2025.pdf	PDF	Aug 13, 2025
Attachment G_Mobile Crisis Medicaid Reimbursement Rates_06.30.2025.xlsx	XLSX spreadsheet	Aug 13, 2025

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Sample A-Staff Plan Assumptions

CCSI Mobile Crisis Response - Costing Model
Sample A - Staff Plan Assumptions
			40	hrs	PTO Factor	0.15
	2024
Row Labels	Count of Date	Example Staffing Model
Friday	52	Staffing Plan					Staff Equivalent

FTE

Monday	53	Week Days Hrs	FT	Per deim	Days	Hours	PTO	% Activated	Activation Hrs	On call	3
Saturday	52	8-4	1	0	262	2,096	314				1
Sunday	52	3-11	1	0	262	2,096	314	0%	0	0
Thursday	52	11-8	0	1	262	0	0	15%	0	2,096
Tuesday	53
Wednesday	52	Weekends
Grand Total	366	8-4	1	0	104	832	125
		3-11	1	0	104	832	125	0%	0	0
		11-8	0	1	104	0	0	15%	0	832

Per Deim		Total Paid Hours	6,734
Per hour to be on call	20	Total On Call Hours	2,928

Sample B-Costing Model

CCSI Mobile Crisis Response - Costing Model
Sample B - Costing Model - Upstate Rural
			Key:	Input	Calculated	Downstate:	N
								Work week in Hours		40
Medicaid Participation		75%	Billable %:	38%								Rural Mobile Crisis Model - 1 MHP, 1 Peer full time 8:00AM-11:00PM. 1 On-Call Peer 11:00 PM - 8:00 AM
Medicaid Billable		50%			Billable to Paid Hrs.:		35%
Rate Code	Procedure Code	Modifier	Revenue Calculator	Estimated Number of Contacts	Estimated Number of Billable Contacts	Unit measure	Duration	% by Type	Average Length Min	Estimated Revenue	Estimated Staff Hours	Expense Calculator	Paid Hrs	FTE	Avg Salary	Fringe %	Total Staff Costs
			Number of Telephonic Crisis Triage and Response	1850	694							Licensed professional	3,367	1.62	65,000	26%	132,576
4609	H2011	GT	Licensed professional			15 minute	Up to 90 min	78%	15	30,790	361	Unlicensed/Certified peer	3,367	1.62	41,600	26%	84,848
4610	H2011	GT, HO	Unlicensed/Certified peer			15 minute	Up to 90 min	22%	15	5,212	102	On-call Expense	2,928	1.41	41,600	26%	73,786
4611	S9485	GT	Licensed professional			Per Diem	90 min - 3 hrs	0%	120	0	0	Coordinator - Supervisor	2,080	1.00	65,000	26%	81,900
4612	S9485	HO	Unlicensed/Certified peer			Per Diem	90 min - 3 hrs	0%	120	0	0
								100%		36,002	463	Total FTE staffing:		5.65		Staffing Costs:	373,110
												Direct Care FTE:		4.65
			Number of Mobile Crisis Responses	1315	493							Direct Care Capacity Utilization:		35%
4615	H2011	HE	1 person Licensed			15 minute	Up to 90 min	0%	15	0	0	Service Hours:		2,356
4616	H2011	HK	2 person licensed and unlicensed/certified peer			15 minute	Up to 90 min	86%	15	52,374	1,696
4617	H2011	HE, HK	2 person both licensed			15 minute	Up to 90 min	0%	15	0	0	Other than Personal Services					0
4618	S9485	HE, U5	2 person licensed and unlicensed/certified peer			Per Diem	90 min - 3 hrs	0%	120	0	0	Operating Expense:					373,110
4619	S9485	HE,HK,U5	2 person both licensed			Per Diem	90 min - 3 hrs	0%	120	0	0
4620	S9485	HE	2 person licensed and unlicensed/certified peer			Per Diem	> 3 hrs	0%	240	0	0	Overhead %	15%				55,966
4621	S9485	HE, HK	2 person both licensed			Per Diem	> 3 hrs	0%	240	0	0	incl. rent, insurance, vehicle, etc.
NA	NA	NA	Peer Only			Not billable		14%
								100%		52,374	1,696	Total Cost:					$ 429,076
				45%	% of mobile crisis reponses agreeing to telephonic follow-up
			Number of Telephonic Follow-up Services	591.75	222							Estimated Billed Revenue:					94,009
4613	H2011	TS, GT	Licensed professional			15 minute	up to 60 min	5%	15	561	7	Other Revenue:					0	$ 44.36
4614	H2011	TS, HM	Unlicensed/Certified Peer			15 minute	up to 60 min	95%	15	4,361	141	Total Revenue:					$ 94,009
								100%		4,922	148
				5%	% of mobile crisis reponses agreeing to in-person follow-up							Surplus/(Deficit)					$ (335,067)
			Number of Mobile Crisis Follow-up Services	65.75	25
4622	H2011	TS	1 person face to face licensed			15 minute	90 min	0%	15	0	0	Cost per hour of service					$ 182.14
4623	H2011	TS, HE	1 person face to face unlicensed			15 minute	90 min	100%	15	711	49	Revenue per hour of service					$ 39.91
4624	H2011	TS, SC	2 person face to face licensed and non licensed			15 minute	90 min	0%	15	0	0
								100%		711	49
			Estimate of % of Contacts billable:	38%
								Total Revenue:		$ 94,009
								Total Hours:			2,356
			Average Travel time for Mobile response or follow-up (in minutes):			30
35%								Rev per service Hr		$ 39.91

Total	Average Medicaid		Estimated # of Telephonic Crisis Triage			Downstate	Upstate
0	95	4609	Licensed professional	15 minute	90 min	63.92	56.88
	81	4610	Unlicensed/Certified peer	15 minute	90 min	38.36	34.14
	1	4611	Licensed professional	Per Diem	90 min - 3 hrs	575.23	511.99
	1	4612	Unlicensed/Certified peer	Per Diem	90 min - 3 hrs	345.15	307.19

			Estimated # of Mobile Crisis Responses
0	51	4615	1 person Licensed	15 minute	90 min	102.27	91.02
	96	4616	2 person licensed and unlicensed	15 minute	90 min	138.79	123.53
	45	4617	2 person both licensed	15 minute	90 min	204.54	182.04
	11	4618	2 person licensed and unlicensed	Per Diem	90 min - 3 hrs	1249.13	1111.72
	3	4619	2 person both licensed	Per Diem	90 min - 3 hrs	1840.82	1638.32
	1	4620	2 person licensed and unlicensed	Per Diem	> 3 hrs	1665.5	1482.3
	0	4621	2 person both licensed	Per Diem	> 3 hrs	2454.42	2184.44

			Estimated # of Telephonic Follow-up Services
0	66	4613	Licensed professional	15 minute	60 min	56.81	50.57
	88	4614	Unlicensed/Certified	15 minute	60 min	23.24	20.68

			Estimated # of Mobile Follow-up Services
0	14	4622	1 person face to face licensed	15 minute	90 min	85.22	75.84
	24	4623	1 person face to face unlicensed	15 minute	90 min	31.96	28.44
	23	4624	2 person face to face licensed and non licensed	15 minute	90 min	117.18	104.3

0 600

Downstate Urban

			Key:	Input	Calculated	Downstate:	y
								Work week in Hours		40
Medicaid Participation		70%	Billable %:	60%								Downstate Urban Mobile Crisis Model - 3 full time staff 9:00 AM - 5:00 PM - 3 full time staff 5:00 PM - 1:00 AM - 2 full time staff 1:00 AM - 9:00 AM
Medicaid Billable		85%	Capacity Factor:	5	Billable to Paid Hrs.:		80%
Rate Code	Procedure Code	Modifier	Revenue Calculator	Estimated Number of Contacts	Estimated Number of Billable Contacts	Unit measure	Duration	% by Type	Average Length Min	Estimated Revenue	Estimated Staff Hours	Expense Calculator	Paid Hrs	FTE	Avg Salary	Fringe %	Total Staff Costs
			Number of Telephonic Crisis Triage and Response	890	530							Licensed professional	3,367	1.62	90,000	34%	195,221
4609	H2011	GT	Licensed professional			15 minute	Up to 90 min	53%	60	71,821	472	Unlicensed/Certified peer	3,367	1.62	48,000	34%	104,118
4610	H2011	GT, HO	Unlicensed/Certified peer			15 minute	Up to 90 min	47%	60	38,222	418	On-call Expense	2,928	1.41	41,600	34%	78,470
4611	S9485	GT	Licensed professional			Per Diem	90 min - 3 hrs	0%	120	0	0	Support Staff	2,080	1.00	48,000	34%	64,320
4612	S9485	HO	Unlicensed/Certified peer			Per Diem	90 min - 3 hrs	0%	120	0	0	Coordinator - Supervisor	2,080	1.00	125,000	34%	167,500
								100%		110,043	890
												Total FTE staffing:		6.65		Staffing Costs:	609,630
			Number of Mobile Crisis Responses	1035	616							Direct Care FTE:		4.65
4615	H2011	HE	1 person Licensed			15 minute	Up to 90 min	25%	60	62,998	453	Direct Care Capacity Utilization:		80%
4616	H2011	HK	2 person licensed and unlicensed/certified peer			15 minute	Up to 90 min	45%	60	153,890	1,631	Service Hours:		5,389
4617	H2011	HE, HK	2 person both licensed			15 minute	Up to 90 min	22%	60	110,877	797
4618	S9485	HE, U5	2 person licensed and unlicensed/certified peer			Per Diem	90 min - 3 hrs	5%	120	38,473	285	Other than Personal Services					37,200
4619	S9485	HE,HK,U5	2 person both licensed			Per Diem	90 min - 3 hrs	2%	120	22,679	114	Equipment					3,500
4620	S9485	HE	2 person licensed and unlicensed/certified peer			Per Diem	> 3 hrs	1%	240	10,259	99	Rent					30,000
4621	S9485	HE, HK	2 person both licensed			Per Diem	> 3 hrs	0%	240	0	0	Operating Expense:					680,330
								100%		399,176	3,377
												Overhead %	15%				97,024
			Number of Telephonic Follow-up Services	770	458
4613	H2011	TS, GT	Licensed professional			15 minute	up to 60 min	43%	30	22,376	166	Total Cost:					$ 777,354	$ 80.37
4614	H2011	TS, HM	Unlicensed/Certified Peer			15 minute	up to 60 min	57%	30	12,134	219
								100%		34,510	385	Estimated Billed Revenue:					599,183
												Other Revenue:					0
			Number of Mobile Crisis Follow-up Services	305	181							Total Revenue:					$ 599,183
4622	H2011	TS	1 person face to face licensed			15 minute	90 min	23%	60	14,191	123
4623	H2011	TS, HE	1 person face to face unlicensed			15 minute	90 min	39%	60	9,024	208	Surplus/(Deficit)					$ (178,171)
4624	H2011	TS, SC	2 person face to face licensed and non licensed			15 minute	90 min	38%	60	32,239	406
								100%		55,454	737	Cost per hour of service					$ 144.25
			Estimate of % of Contacts billable:	60%								Revenue per hour of service					$ 111.18
								Total Revenue:		$ 599,183
								Total Hours:			5,389
			Average Travel time for Mobile response or follow-up (in minutes):			45
80%								Rev per service Hr		$ 111.18

Total	Average Medicaid		Estimated # of Telephonic Crisis Triage			Downstate	Upstate
890	95	4609	Licensed professional	15 minute	90 min	63.92	56.88
	81	4610	Unlicensed/Certified peer	15 minute	90 min	38.36	34.14
	1	4611	Licensed professional	Per Diem	90 min - 3 hrs	575.23	511.99
	1	4612	Unlicensed/Certified peer	Per Diem	90 min - 3 hrs	345.15	307.19

			Estimated # of Mobile Crisis Responses
1035	51	4615	1 person Licensed	15 minute	90 min	102.27	91.02
	96	4616	2 person licensed and unlicensed	15 minute	90 min	138.79	123.53
	45	4617	2 person both licensed	15 minute	90 min	204.54	182.04
	11	4618	2 person licensed and unlicensed	Per Diem	90 min - 3 hrs	1249.13	1111.72
	3	4619	2 person both licensed	Per Diem	90 min - 3 hrs	1840.82	1638.32
	1	4620	2 person licensed and unlicensed	Per Diem	> 3 hrs	1665.5	1482.3
	0	4621	2 person both licensed	Per Diem	> 3 hrs	2454.42	2184.44

			Estimated # of Telephonic Follow-up Services
770	66	4613	Licensed professional	15 minute	60 min	56.81	50.57
	88	4614	Unlicensed/Certified	15 minute	60 min	23.24	20.68

			Estimated # of Mobile Follow-up Services
305	14	4622	1 person face to face licensed	15 minute	90 min	85.22	75.84
	24	4623	1 person face to face unlicensed	15 minute	90 min	31.96	28.44
	23	4624	2 person face to face licensed and non licensed	15 minute	90 min	117.18	104.3
3000	600

Upstate Urban

			Key:	Input	Calculated	Downstate:	N
								Work week in Hours		40
Medicaid Participation		70%	Billable %:	60%								Upstate Urban Mobile Crisis Model - 3 full time staff 9:00 AM - 5:00 PM - 3 full time staff 5:00 PM - 1:00 AM - 2 full time staff 1:00 AM - 9:00 AM
Medicaid Billable		85%	Capacity Factor:	5	Billable to Paid Hrs.:		80%
Rate Code	Procedure Code	Modifier	Revenue Calculator	Estimated Number of Contacts	Estimated Number of Billable Contacts	Unit measure	Duration	% by Type	Average Length Min	Estimated Revenue	Estimated Staff Hours	Expense Calculator	Paid Hrs	FTE	Avg Salary	Fringe %	Total Staff Costs
			Number of Telephonic Crisis Triage and Response	890	530							Licensed professional	3,367	1.62	62,000	28%	128,464
4609	H2011	GT	Licensed professional			15 minute	Up to 90 min	53%	60	63,910	472	Unlicensed/Certified peer	3,367	1.62	41,000	28%	84,952
4610	H2011	GT, HO	Unlicensed/Certified peer			15 minute	Up to 90 min	47%	60	34,017	418	On-call Expense	2,928	1.41	41,600	28%	74,957
4611	S9485	GT	Licensed professional			Per Diem	90 min - 3 hrs	0%	120	0	0	Support Staff	2,080	1.00	50,000	28%	64,000
4612	S9485	HO	Unlicensed/Certified peer			Per Diem	90 min - 3 hrs	0%	120	0	0	Coordinator - Supervisor	2,080	1.00	75,000	28%	96,000
								100%		97,927	890
												Total FTE staffing:		6.65		Staffing Costs:	448,373
			Number of Mobile Crisis Responses	1035	616							Direct Care FTE:		4.65
4615	H2011	HE	1 person Licensed			15 minute	Up to 90 min	25%	60	56,068	453	Direct Care Capacity Utilization:		80%
4616	H2011	HK	2 person licensed and unlicensed/certified peer			15 minute	Up to 90 min	45%	60	136,970	1,631	Service Hours:		5,389
4617	H2011	HE, HK	2 person both licensed			15 minute	Up to 90 min	22%	60	98,680	797
4618	S9485	HE, U5	2 person licensed and unlicensed/certified peer			Per Diem	90 min - 3 hrs	5%	120	34,241	285	Other than Personal Services					37,200
4619	S9485	HE,HK,U5	2 person both licensed			Per Diem	90 min - 3 hrs	2%	120	20,184	114	Equipment					3,500
4620	S9485	HE	2 person licensed and unlicensed/certified peer			Per Diem	> 3 hrs	1%	240	9,131	99	Rent					20,000
4621	S9485	HE, HK	2 person both licensed			Per Diem	> 3 hrs	0%	240	0	0	Operating Expense:					509,073
								100%		355,274	3,377
												Overhead %	15%				72,836
			Number of Telephonic Follow-up Services	770	458
4613	H2011	TS, GT	Licensed professional			15 minute	up to 60 min	43%	30	19,919	166	Total Cost:					$ 581,909	$ 60.16
4614	H2011	TS, HM	Unlicensed/Certified Peer			15 minute	up to 60 min	57%	30	10,797	219
								100%		30,716	385	Estimated Billed Revenue:					533,271
												Other Revenue:					0
			Number of Mobile Crisis Follow-up Services	305	181							Total Revenue:					$ 533,271
4622	H2011	TS	1 person face to face licensed			15 minute	90 min	23%	60	12,629	123
4623	H2011	TS, HE	1 person face to face unlicensed			15 minute	90 min	39%	60	8,030	208	Surplus/(Deficit)					$ (48,638)
4624	H2011	TS, SC	2 person face to face licensed and non licensed			15 minute	90 min	38%	60	28,695	406
								100%		49,354	737	Cost per hour of service					$ 107.98
			Estimate of % of Contacts billable:	60%								Revenue per hour of service					$ 98.95
								Total Revenue:		$ 533,271
								Total Hours:			5,389
			Average Travel time for Mobile response or follow-up (in minutes):			45
80%								Rev per service Hr		$ 98.95

Total	Average Medicaid		Estimated # of Telephonic Crisis Triage			Downstate	Upstate
890	95	4609	Licensed professional	15 minute	90 min	63.92	56.88
	81	4610	Unlicensed/Certified peer	15 minute	90 min	38.36	34.14
	1	4611	Licensed professional	Per Diem	90 min - 3 hrs	575.23	511.99
	1	4612	Unlicensed/Certified peer	Per Diem	90 min - 3 hrs	345.15	307.19

			Estimated # of Mobile Crisis Responses
1035	51	4615	1 person Licensed	15 minute	90 min	102.27	91.02
	96	4616	2 person licensed and unlicensed	15 minute	90 min	138.79	123.53
	45	4617	2 person both licensed	15 minute	90 min	204.54	182.04
	11	4618	2 person licensed and unlicensed	Per Diem	90 min - 3 hrs	1249.13	1111.72
	3	4619	2 person both licensed	Per Diem	90 min - 3 hrs	1840.82	1638.32
	1	4620	2 person licensed and unlicensed	Per Diem	> 3 hrs	1665.5	1482.3
	0	4621	2 person both licensed	Per Diem	> 3 hrs	2454.42	2184.44

			Estimated # of Telephonic Follow-up Services
770	66	4613	Licensed professional	15 minute	60 min	56.81	50.57
	88	4614	Unlicensed/Certified	15 minute	60 min	23.24	20.68

			Estimated # of Mobile Follow-up Services
305	14	4622	1 person face to face licensed	15 minute	90 min	85.22	75.84
	24	4623	1 person face to face unlicensed	15 minute	90 min	31.96	28.44
	23	4624	2 person face to face licensed and non licensed	15 minute	90 min	117.18	104.3
3000	600

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File details come from the government source that posted it. Updated Aug 13, 2025.