Oakland Community Health Network

1. Order of Business

   4:30 pm EDT
   1. Roll Call
   2. Public Comment
   3. Approval of the Agenda
2. Finance Committee - John Young
   1. Financial Review - Anya Eliassen
   2. Budget Amendment #2 - Anya Eliassen
3. Policy Management - Malkia Newman
   1. Corporate Compliance Update - Marquitta Massey & Bernard Hooper
   2. Mental Health Awareness Proclamation - Suzanne Weinert
4. Other Business
   1. Events - Suzanne Weinert
5. Closed Session: Per Public Act 267 of 1976, 15.268(1)(h)
6. Public Comment
7. Board Member Comments
8. Adjournment

Attendance

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Members

Present: Sheila Barrett, John Paul Torres, Bijaya Hans, Adam Fuhrman, Dana Lasenby, Christina Root, Callana Ollie, Dennis Cowan, Bernard Hooper, John Young, Yvette Woodruff, Adam Jenovai

Absent: Malkia Newman, Jonathan Landsman, Sarah May, gilesy@oaklandchn.org

Notes: Sheila Barrett Board Liaison, John Paul Torres Vice Chair, Adam Fuhrman Secretary , Dana Lasenby CEO, Dennis Cowan Treasurer

1. Revenue is expected and staying consistent with what we were seeing last year.  Eligibles is flat and no changes. Will start to see a change with Pubilc Health Emergency ends later this year. 
2. Assets Comparison - Cash and Investments is up, receivable is down, which is typical until accruals are applied. Other assets is roughly flat and capital assets is down slightly. 
3. Liabilities Comparison - Vender payables is down compared to the end of fiscal year, due to state is roughly the same, employee payable is increase due to distribution to PTO accounts. Long term debt continues to go down each month. 
4. Net Position Comparison - total assets and liabilities are down and Net position is increased to around 8 million dollars. 
5. Revenue Comparison - This is comparing to a year ago. Revenue is up around 16 million, noting a large portion is related to CCBHC.  Rates have not changed over  the last two years. County funds is the same. State general fund is down slightly but we are now at our base. All other is increased, related to grant funding.  
6. Expenses Comparison - Administration expenses are up, due to adding positions, and provider network expenses is up, primary due to CCBHC and increases to DCW funding. Grants are up a bit.
7.  Net Income Comparison -Total Revenue is increased about 20,000,000. and Total expenses is increased about 30,000,000.
   

Revenue:  

• Medicaid revenue sources updated to reflect October through February experience annualized for the full fiscal year 
• Other revenue updated to reflect year to date grant adjustments, increase to SUD grants, and block grant funding. 

Expenses: 

• The Administration line increased to account for additional positions approved to meet MDHHS contractual requirements.  
• Core Provider Adult Increases are primarily related to the $16 DCW adjustment for persons served via Self Determination. Additional increases are for TCM utilization at TTI and the $400k for MORC transportation increase request.  
• Crisis service increase is related to an increase in HRA (Hospital rate adjuster) due to higher utilization and the remaining 12 hour funding for the CG Mobile Crisis Team (not included in their budget until staff have been hired). HRA is based on hospital utilization, and this has been increasing over the last few years. HRA is calculated by MDHHS and a pass through from MDHHS to the community hospitals on top of their contracted rates. 
• The reduction in the Core Provider kids category is related to the end of the Oakland Schools contract and the shift of all CCHBC expenses to separate CCBHC line within the budget. 

• Substance Use expense increase related to grants mentioned in revenue and adjustment to Methadone rate increase. 
• The Grant adjustments are equal to revenue as noted above 
• Vocational services increase related to the adjustment to $16 DCW funding amount 
• Residential/CLS services increase is related to adjustment to $16 DCW funded amount and utilization adjustment year to date 
• Behavioral Health Home expense increase related to increased utilization 

• CCBHC expense adjustment from provider lines above and year to date utilization. OCHN uses the PPS-1 days to calculate CCBHC expenses. The PPS-1 days are determined by encounters submitted by the providers. There is also a split between capitation and supplemental.  MDHHS determined splits for the capitation and supplemental portion of funding. 

The change in Net Assests result is ($8,922,508) based on current spending. As noted, there are a couple of adjustments in hospital and residential funding that should help rein in spending. Additionally, we have a rate setting meeting on 4.19.23 to discuss FY23 rates and the end of the PHE. 

OCHN has put it place some cost mitigation strategies to offset the projected overage as outlined below: 

1. The single case agreement authorization and rate negotiation previously sat at the provider level. This function has been brought internally to ensure resources are used as efficiently as possible. This should reduce the volume and cost of single case agreements. 

1. With the onset of the pandemic, all providers were moved to cost reimbursed funding to assure service delivery was not adversely impacted. Over the past year, OCHN has moved networks back to service model funding. As of April 1, 2023 the Specialized Residential and CLS network has been moved back to service model funding. This network represents roughly 1/3 of OCHN’s expenses. With the implementation of the $16 direct care wage adjustment, OCHN expects an impact to reduce turnover and help with staff recruitment. With the move back to standard funding, providers still have the option to request stabilization payments through OCHN.  

Finally, OCHN will be monitoring expenses closely to determine if and/or when additional adjustments need to be made and keep the CEO and the Board informed. 

1. Marquitta presented a summary of compliance issues reported in Quarter 1 FY23. The presentation will also include a discussion on corrective and preventative actions taken in response to the issues reported. 
2. Content will present a summary of compliance issues reported in Quarter 1 – FY 23. The presentation will also include a discussion on corrective and preventative actions taken in response to the issues reported.
3. MDHHS contract requires that PIHPs have a compliance program that oversees program integrity activities of the network. 
4. PIHPs are required to investigate allegations involving fraud, waste or abuse. When an instance reveals suspicion of fraud, the MDHHS OIG (Office of Inspector General) is promptly notified.
5. Reports to the Board are provided quarterly. No previous Board action has been required.
6. An effective compliance program benefits the public/persons served by ensuring that OCHN has processes in place to comply with laws, rules, and regulations. Additionally, the program ensures that there is a healthy path of communication between stakeholders and the compliance program for reporting concerns. 
7. FY22 Reported Issues: 

1. Training – additional coaching and counselling to staff pertaining to the protection of PHI (Security of Protected Health Information)
2. Implementation of additional verification checks of documentation prior to billing
   
3. Increasing Volume of billing verification checks with new vendor
   
4. Continuing mailing of Explanation of Benefit Statements to random sample of persons served quarterly.
   
5. Increased awareness of Hotline
   
6. Provider Education
   
7. Penalties for repeat citations