Oakland Community Health Network

May
09

Committee of the Whole Meeting

5505 Corporate Dr. Troy Mi, 48098

Monday, May 9 2022

4:30pm - 7:30pm EDT

Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 248-462-6341, Phone Conference ID: 363 335 267#

PowerPoint Presentation

Public Comment: 

Oakland Community Health Network is now hosting its public meetings in a hybrid format and will be accessible to members of the public in-person at the address in this notice and online using the link above. Members of the public are provided two separate opportunities to give public comment. Please click the Public Comment Link below to submit your public comment. The meeting facilitator will alert you when it is your turn to speak

Public Comment Link

Agenda

  1. Order of Business
    4:30 pm EDT
    1. Roll Call
    2. Public Comment
  2. Business Operations
    1. Financial Review - Anya Eliassen
    2. Budget Amendment #2
  3. Policy Management
    1. Needs Assessment Outcome Report 2022
    2. Access and Crisis - Kyle Glasgow
  4. Other Business
    1. Events/Outreach - Christine Burk
    2. CMHA Conference - Voting Delegates (5) 
  5. Public Comment
  6. Board Member Comments
  7. Adjournment

Minutes Tab

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Committee of the Whole Meeting

Mon May 9, 2022 8:30 PM - 11:30 PM UTC

Order of Business

Mrs. Newman brought the meeting to order at 4:35 pm 

Roll Call

Roll call attendance was taken as in record. 

Public Comment

Mr. Cummins - Regarding MI legislator threats. 

Business Operations

Financial Review - Anya Eliassen

Revenue trend is up from previous month due to payments being applied. 

Liabilities are down and is expected. Accurals are paid out, due to state is roughly flat.

Net position has gone up 

Eligibles: Continues to be significantly higher and should continue, due to emergency order.

Assets: Cash and investments up, receivable has gone down, other assets slightly down since September, and capital assets continue to decrease over time.

Liabilities: Payables, is down, due to the state being roughly the same, employee payables close to the same and long-term debt keeps going down over time.

Net Position: Total assets: is up, Total Liabilities have gone down, and Net position has gone up due to the reduction in liabilities.

Revenue Comparison: Medicaid is up. The state general fund is down slightly. County funds is the same and all other is close to the same. Noting an HRA payment that needs to be removed from administrative. 

Expenses:  Grants roughly the same as well as all others. Noting an HRA payment that needs to be removed from administrative. 

Net Income is slightly down from prior month. 

Budget Amendment #2

Revenue - decreased $5.6 million overall to a total of $391.7 million

  • COVID Premium Pay increased $6.5 million to $25.8 million
    • Re-allocated $5.3 million from the Medicaid Specialty, Medicaid Waiver and Healthy Michigan lines to Premium Pay to reflect the Premium Pay portion of capitation more accurately
    • $4.2 million increase to reflect the FY2022 Premium Pay increase from $2.00 to $2.35 which was not included in original capitation
    • The increases were offset by a projected $3 million lapse
  • Medicaid Specialty decreased $16.6 million to $275.9 million
    • Approximately $4.7 million was allocated to the Premium Pay line
    • $5.1 million decrease due to slow growth in DAB eligibility, which accounts for the majority of Medicaid funding
    • HSW revenue decreased $5.1 million, having received fewer retro payments than previously projected•
  • Healthy Michigan decreased $1.1 million; eligibility increased at a slower rate than expected
  • CCBHC supplemental revenue and quality incentive withhold increased $2.9 million to $21.5 million based on eligibility and actual revenue

Expenses

  • OCHN staff – revised OCHN staff nurse case manager and diagnostician to appropriate line item on budget.
  • Provider Retention Payment added to BA#2 with approximately $2,266,125 per the provider retention payment surveys. OCHN will be distributing at a rate of $250 and $500
  • EasterSeals – Jail service contract revised to $675,401.90
  • EasterSeals NTE Clubhouse Expense increased from $408,754 to reflect NTE budget per Attachment A dated 11/16/21. A portion of these services are attributable to CCBHC individuals.
  • Vocational Direct Service Providers Expense decreased $2.96 million to an overall total of $16.25 million
    • Individual Supported Employment expense increased $464,738 due to utilization
      • New providers began services this year
      • A few existing providers are already at 75% or more of FY21 utilization, only halfway through the fiscal year
  • Group Skill Building and Supported Employment (fee-for-service) expense decreased $3.17 million due to lower-than-expected utilization
    • Providers cite staffing shortages, primary transportation issues, closures due to winter COVID surges
  • Cost reimbursement expense increased $2.34 million, offsetting the providers’ decrease in service revenue
    • Total cost reimbursement is projected at $4.07 million, still less than FY21’s $5 million total
  • MDHHS Premium Pay expense decreased $2.6 million to a total of $569,369 to reflect actual face-to-face time
    • This is in-line with FY21 expense of $526,000 based on hours reported on FSRs
    • Current projection accounts for group sizes and utilization
  • SUD Prevention If we visit each retailer, that will be $31 x 839 retailers= $26,009. Last year we spent $13,350 in vendor education. The year before we spent $10,650 in vendor education. The difference would be about $12,659 increase from last year.
  • SUD Covid-19 Grant increased by $299 thousand from $1.9 million to $2.2 million for adding ARPA admin, ARPA prevention, and Women Specialty programs to the grant projects
  •  SUD Covid-19 Grant increased by $299 thousand from $1.9 million to $2.2 million for adding ARPA admin, ARPA prevention, and Women Specialty programs to the grant projects

CCBHC Expense increased $5.5M to a total of $24.1 million

  • Projection based on the CCBHC reconciliation payments made to providers
    • Payments are the difference between the CCBHC PPS-1 earned per the payment dashboard and service model pre-payments
    • The total CCBHC expense is $31.3 million YTD and projected at $62.7 million for the year, however, $41.2 million of this is reflected in the service model expenses as part of the 1/12th pre-payments
    • IT is working to add service model benefit plans to the CCBHC dashboards so that we can represent the CCBHC portion of service model expense as line items in the budget

Mr. Young made motion to recommend approval of Budget amendment #2 to the full Board for consideration, supported by Mr. Cowan. Motion carries. 

Anya to provide update on the number of people who requested Oxford co-payment assistance. 

Assigned to: Anya Eliassen, Sheila Barrett, Dana Lasenby

Due: 05/12/2022

Policy Management

Needs Assessment Outcome Report 2022

The presentation conveys the results of the FY23-25 needs assessment survey.

Through OCHN’s Needs Assessment survey, we gathered information from persons served and their families, community stakeholders, providers, and OCHN’s board members to determine the organization’s strategic priorities for the next few years

With the completion of the needs assessment and a review of the results, we will launch the strategic planning process by presenting an outline to the board in May and the plan for approval later this summer.

Board approved FY23-25 Needs Assessment Survey questions in a previous Board meeting. 

The needs assessment survey was distributed to all persons served in the OCHN network, either electronically, through hard copies, or through in-person presentations. Persons served had the opportunity to provide feedback about services and priorities and help set the strategic priorities for OCHN for the next few years

Christine Burk provided outreach information for survey completion. Noting that OCHN had approximately 900 reponses with person served being the highest number of response (42%)

Frances Carly provided detailed response report of survey outcomes. 

How important are the following services to you?

% Identified as Very Important

  1. .Mental Health Treatment – 82.6%
  2. Healthcare Integration – 74.8%
  3. Transportation – 74.8%
  4. Case Management – 74.4%
  5. Recipient Rights and Advocacy – 73.1%
  6. Community Living Supports – 72.3%

Noted Concerns

  • Workforce shortages and salary
  • Transportation
  • Peer supports
  • Legislation to privatize system
  • Lack of crisis services, including residential
  • Responsiveness
  • Stigma for people with mental illness or SUD
  • Coordinated elder care for aging population with I/DD or SMI

Compliments

  • Opportunities to share and voice opinion
  • Long-term assistance over decades
  • Proactive communication
  • Authorizations and documentation for providers
  • Commitment to quality
  • Collaboration
  • Direct workers love their work

Ms. Root made motion to recommend the 2022 Needs assessment to comply with CMHSP contract requirements of Section 330.1226 for full Board approval. supported by Mrs. Woodruff, motion carries.

Add a Board presentation on School Mental health to the Board agenda. 

Assigned to: Christine Burk, Sheila Barrett, Dana Lasenby

Access and Crisis - Kyle Glasgow

Update on Access and Crisis initiatives from Q1 and Q2 FY22, including Access expansion and Children’s Crisis Care Unit (CCSU).

The Access and Crisis Team is working to complete it’s annual departmental goals, in alignment with OCHN’s annual plan.

Provided updated information from the 2 initiatives being covered, included any updated data available at the time of the report.

None, this will be the first quarterly presentation combining Access and Crisis.

The presentation included how each initiative works towards outcomes benefiting individuals receiving services through OCHN and/or the community as a whole.

All costs associated with the initiatives discussed were included in the FY22 budget.

Access

Department Overview: 

Staff:

  • 7 Referral Specialists
  • 10 Eligibility Screeners for both Substance Use Disorders (SUD) and Mental Health (Also Includes Intellectual Developmental Disability (IDD), Applied Behavioral Analysis (ABA) and Infant Mental Health
  • 1 Veteran Navigator and 1 Veteran Peer Support
  • 4 School Mental Health Navigators and 1 School Resource and Referral Specialist
  • 1 SED Waiver Coordinator
  • 1 Administrative and Special Projects-Access
  • Manager, Supervisor and Support staff

Functions as the front door to the public mental health system and verifies service eligibility

Expanding Access

  • New Phone system
  • School Navigators provide support for children and families
  • Hours expanded to Monday through Friday 8 am to 8 pm

Crisis

Department Overview: 

Staff

  • Hospital Liaison
  • Program Evaluator for the Children’s Crisis Care Unit (CCCU)
  • Program Evaluator Assistant for the CCCU

Provides oversight and coordination of acute care and crisis services including screening for higher level of care need including inpatient.

Ms. Root would like OCHN to put more effort into hiring a bilingual staff for access

Assigned to: Sheila Barrett, Edna White, Dana Lasenby, Kimberly Flowers

Other Business

Events/Outreach - Christine Burk

Christine provided May 2022 events and awareness events - full details are located in the Board packet. 

The Board were provided Veterans and Parent Mental Health Community Forum

CMHA Conference - Voting Delegates (5) 

VOTING DELEGATES - Member Assembly Meeting

  • Voting Privileges of CMHSPs/PIHPs: According to Association By-Laws, Article III (D): Voting privileges in the meetings of the Member Assembly shall be composed of three (3) delegates from each member CMHSP: two (2) board members and one (1) CMHSP executive director, OR, three (3) delegates from each member Regional Entity PIHP: two (2) board members and one (1) PIHP executive director, OR five (5) delegates for each member Stand Alone PIHP: four (4) board members and one (1) PIHP executive Director. The executive director vote may NOT be reassigned to any other individual. Voting by proxy is expressly prohibited.
  • Due: May 20, 2022
  • When: MONDAY, JUNE 6, 2022, at 5:40 PM at The Grand Traverse Resort, Traverse City.

Your board’s 3 voting delegates (or 5 for Stand Alone PIHP’s) must sign in at the conference registration to receive their voting card on June 6, 2022. EARLY BIRD REGISTRATION WILL OPEN AT 2:00 PM TO ACCOMMODATE FOR THIS.

Public Comment

Mr. Commins noted focus areas for the Board to consider for legislative

  1. Focus on Fee for Service
  2. Independent advocacy for funding issues
  3. Meaningful recovery for individuals served

Board Member Comments

The board members showed concern regarding needs of more transportation services and accessibility. 

Reminder for Thursday May 12 Special Board meeting. 

Showed appreciation for Board presentations. 

A request from Mr. Cowan for community outreach for indivisuals in group homes and how they are returing back into the community

A request from Mr. Cowan for community outreach for indivisuals in group homes and how they are returing back into the community

Assigned to: Sheila Barrett, Dana Lasenby

Due: 05/16/2022

Adjournment

Mrs. Newman adjourned the meeting at 6:36 PM

Attendance

Members

Name Attendance

Sheila Barrett

Christine Burk

Frances Carley

Dennis Cowan

Anya Eliassen

Kimberly Flowers

Adam Fuhrman

Bijaya Hans

Bernard Hooper

Jonathan Landsman

Dana Lasenby

Victoria Marble

Sarah May

Vasiliki Michalakis

Peter Mouhot

Reena Naami-Dier

Malkia Newman

Callana Ollie

Vasilis Pozios

Christina Root

Steffan Taub

John Paul Torres

Suzanne Weinert

Yvette Woodruff

John Young

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