AGENDA. Committee Members: Present Excused Absent Present Excused Absent Others Present: BABH: Marci Rozek, Chris Pinter, and Sara Brandt

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1 AGENDA BAY ARENAC BEHAVIORAL HEALTH BOARD OF DIRECTORS FINANCE COMMITTEE MEETING Wednesday, August 8, 2018 at 5:00 pm Behavioral Health Center, Room 225, 201 Mulholland, Bay City, MI Committee Members: Present Excused Absent Present Excused Absent Others Present: Richard Gromaski, Ch Patrick McFarland BABH: Marci Rozek, Chris Pinter, and Thomas Ryder, V Ch Robert Pawlak, Ex Off Sara Brandt John Andrus James Anderson, Ex Off Ernie Krygier Richard Byrne, Ex Off Legend: M-Motion; S-Support; MA- Robert Luce Motion Adopted; AB-Abstained Agenda Item Discussion Motion/Action 1. Call To Order & Roll Call 2. Public Input (Maximum of 3 Minutes) Investment Earning Reports for August of 2018 Contracts 4.1) Finance August 2018 Contract List Unfinished Business 5.1) None 3.1) M - S - MA Refer to full Board for information 4.1) M - S - MA Refer to full Board for approval of the Finance August 2018 contract list

2 AGENDA BAY ARENAC BEHAVIORAL HEALTH BOARD OF DIRECTORS FINANCE COMMITTEE MEETING Wednesday, August 8, 2018 at 5:00 pm Behavioral Health Center, Room 225, 201 Mulholland, Bay City, MI Page 2 of 2 6. New Business 6.1) 2018 Equipment/Capital Purchases 6.2) Fiscal Year 2018 Rate Adjustment for Internal Community Living Support Staff 6.3) Amendment 1 To The Annual Operating Budget For Fiscal Year Ending September 30, ) Bay Metro-Arenac Opportunities, Inc./Transportation Relationship 6.5) 2016 Compliance Audit Results 6.1) M - S - MA Receive the report 6.2) M - S - MA Refer or receive 6.3) M - S - MA Refer to full Board for approval 6.4) M - S - MA Receive the report 6.5) M - S - MA Receive the report 7. Adjournment M - S - pm MA

3 Bay-Arenac Behavioral Health Authority Estimated Cash and Investment Balances July 31, 2018 Balance July 1, ,778,390 Balance July 31, ,328,097 Average Daily Balance 4,448,249 Estimated Actual/Accrued Interest July ,257 Effective Rate of Interest Earning July % Estimated Actual/Accrued Interest Fiscal Year to Date 36,853 Effective Rate of Interest Earning Fiscal Year to Date 0.90% Note: The Cash and Investment Balances exlcude Payroll and AP related Cash Accounts. Page 3 of 16

4 Cash Available - Operating Fund Rate Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Beg. Balance Operating Funds - Cash, Cash equivalents, Investments 4,079,660 4,077,324 3,666,000 3,395,374 3,618,076 4,590,868 5,280,042 3,186,356 5,983,324 6,383,453 5,466,960 5,069,055 Cash in 4,037,847 4,091,706 3,867,588 3,832,582 5,466,367 4,379,801 2,036,794 6,606,924 4,436,219 5,545,752 5,254,240 7,594,141 Cash out (4,040,182) (4,503,031) (4,138,213) (3,609,881) (4,493,575) (3,690,628) (4,130,480) (3,809,956) (4,036,090) (6,462,245) (5,652,145) (7,044,865) Ending Balance Operating Fund 4,077,324 3,666,000 3,395,374 3,618,076 4,590,868 5,280,042 3,186,356 5,983,324 6,383,453 5,466,960 5,069,055 5,618,332 Investments Money Markets 4,077,324 3,666,000 3,395,374 3,618,076 4,590,868 5,280,042 3,186,356 5,983,324 6,383,453 5,466,960 5,069,055 5,618,332 Total Operating Cash, Cash equivalents, Invested 4,077,324 3,666,000 3,395,374 3,618,076 4,590,868 5,280,042 3,186,356 5,983,324 6,383,453 5,466,960 5,069,055 5,618,332 Average Rate of Return General Funds 0.42% 0.43% 0.72% 0.75% 0.75% 0.75% 0.75% 0.75% 0.75% 0.79% 0.80% 0.81% 0.90% 4,859,184 Cash Available - Other Restricted Funds Rate Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Beg. Balance-Other Restricted Funds - Cash, Cash equivalents, Investments 1,204,896 1,205,612 1,205,827 1,206, , , , , , , , ,335 Cash in 301, , , , Cash out (300,793) 0 0 (803,075) 0 0 (302,125) (303,003) Ending Balance Other Restricted Funds 1,205,612 1,205,827 1,206, , , , , , , , , ,765 Investments Money Market 402, , , , , , , , , , , , % % 301, , , % 302, , , % 303, , , % , , , % 501, , , % Total Other Restricted Funds 1,205,612 1,205,827 1,206, , , , , , , , , ,765 Average Rate of Return Other Restricted Funds 0.53% 0.56% 0.85% 0.86% 0.86% 0.86% 0.88% 0.89% 0.90% 0.91% 0.91% 0.99% 1.70% 757,254 Total - Bal excludes payroll related cash accounts 5,282,936 4,871,827 4,601,424 4,323,390 5,296,405 5,985,801 3,893,280 6,690,591 7,091,053 6,175,937 5,778,390 6,328,097 Total Average Rate of Return 0.45% 0.47% 0.77% 0.79% 0.79% 0.79% 0.78% 0.78% 0.79% 0.83% 0.86% 0.90% Page 4 of 16

5 Page 1 of 1 Bay-Arenac Behavioral Health Finance Committee Summary of Proposed Contracts August 2018 Old Rate New Rate Term Out Clause? Performance Issues? (Y/N) Risk Assessment Rating (Low/Mod/High) SECTION I. SERVICES PROVIDED BY OUTSIDE AGENCIES Clinical Services 1 R Residential and CLS providers 2-month CLS rate enhancements 8/1/18-9/30/18 Y N 2 N Braintrust Behavioral Health LLC ABA services: Initial assessment (approx 4 hours, 2x year) Functional Behavioral Analysis (FBA) - first 30m FBA - addtl 30m Adaptive Behavior Treatment (ABT) - first 30m ABT = addtl 30m Group ABT - first 30m Group ABT - addtl 30m ABT w protocol mods, clinical observ & direction by ML/BL - first 30m ABT w protocol mods, clinical observ & direction by ML/BL - addtl 30m Family behavior treatment guidance (60-75m) Multiple family behavior treatment guidance (90-105m) Adaptive behavior treatment social skills group (90-105m) Exposure ABT w protocol mods requiring 2+ techs - first 60m Exposure ABT w protocol mods requiring 2+ techs - addtl 30m (FY17 State rates) $480 ML, $340 BL $60 ML, $42.50 BL $60 ML, $42.50 BL $30 ML+BL, $25.00 AL $30 ML+BL, $25.00 AL $8.57 ML+BL, $7.86 AL $8.57 ML+BL, $7.86 AL $60 ML, $42.50 BL $60 ML, $42.50 BL $120 ML, $85 BL $72 ML, $51 BL $51.43 ML, $36.43 BL $100 ML+BL, $90 AL $50 ML+BL, $45 AL 9/1/18-9/30/19 Y New provider 3 R Forest View Hospital ML = Masters level BL = Bachelors level AL = Aide level Inpatient services: Increase to rates for FY19 $900/day - Days 1-7 $855/day - Days 8-15 $832/day - Days 16+ (all inclusive) $927/day - Days 1-7 $881/day - Days 8-15 $857/day - Days 16+ (all inclusive) 10/1/18-9/30/19 Y N 4 R Hope Network BHS: Harbor Point Intensive Spec Residential rate increases effective 10/1/18: Harbor Point East/West/North (1 placement) $344.77/day $361.02/day 10/1/18-9/30/19 Y N 5 M Sterling Area Health Center Interagency Collaboration/Referral Agreement Non-monetary Effective upon signature Y N Admin/Other Services 6 T Netsource One, Inc. Termination of Opt-E-Man circuits at: Mulholland Madison Wirt North Bay Termination of ASE 20 Mbps (megabits per second) circuit Arenac Center $1,120/month $1,120/month $1,120/month $1,350/month $1,475/month 0 Effective 8/31/18 Y N 7 N Netsource One, Inc. AT&T Advanced Services Ethernet 50 Mbps connections: Mulholland Madison Wirt North Bay Arenac Center Hub to connect all $748/month $748/month $748/month $748/month $748/month $1,250/month 9/1/18-8/31/21 Y N 8 S Verizon Wireless Renew wireless service $132,000 max Same 8/30/18-8/29/19 N N R = Renewal with rate increase since previous contract D = Renewal with rate decrease since previous contract S = Renewal with same rate as previous contract ES = Extension Page 5 of 16 M = Modification N = New Contract/Provider NC = New Consumer T = Termination

6 2018 Investments/Capital Purchases 1. Vehicle/Fleet Replacements (2) regular vehicle replacements at BABH service locations 2. Technology/Computer Replacements Replace several older monitors throughout BABH office locations Additional Network Switch and device replacements Replacement of aged devices in Cloud Backup system Secure disposal of aged data drives 3. Recommendations from Annual Security Assessment Install shatter proof reception windows in the Arenac Center, Madison Children s and Mulholland 3 rd Floor waiting areas Install key pad and intercom system on all North Bay entrances/service doors Additional security measures at Mulholland 2 nd floor under consideration 4. Medical/Public Safety Recommendations Defibrillators at care sites (referred to medical staff for consideration) Bed-bug remediation kits at each office site Additional supply of Narcan kits for distribution in both counties 5. Mulholland 3 rd Floor Remodel 335 with new drywall and paint to create separate storage area/corridor for improved area functionality Replacement 335 conference room chairs Remodel 342 to remove existing cabinetry with new drywall and paint for improved functionality Replacement 342 conference chairs Install 2 nd door in first contact room on West side hallway Replace several aged desks and office chairs 6. Arenac Center Replace older desks and office chairs Replace several guest/waiting room chairs 7. Madison Clinic Repaint and new artwork for Children s waiting room Page 6 of 16

7 8. North Bay Replace older desks and office chairs Replacement shower chair Install high profile toilet in existing restroom for improved safety 9. Wirt Office Replace several office and conference room chairs Replace conference room table 10. Horizon Home Repair and repaint entire interior of facility Page 7 of 16

8 Compensation Scale for Direct Care Staff Step 0 Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 *Horizon Home Compensation Scale At 12/31/ ,400 21,100 21,750 22,430 23,120 23,800 24,500 Currently 24,960 25,917 26,874 27,830 28,787 29,744 30,680 % Change 22.4% 22.8% 23.6% 24.1% 24.5% 25.0% 25.2% **North Bay Compensation Scale At 12/31/ ,528 23,150 24,856 27,186 28,080 29,765 Currently 22,568 24,190 25,896 28,226 29,120 30,805 % Change 4.8% 4.5% 4.2% 3.8% 3.7% 3.5% *Compensation Scale permanently adjusted twice since 12/31/15 -Adjusted 1/1/16 and 2/1/18 -Lump Sum payments at 9/30/16 of 3% & 9/30/17 of 5% **Compensation Scale permanently adjusted once since 12/31/15 -Adjusted 2/1/18 -Lump Sum payments at 9/30/16 of 3% & 9/30/17 of 5% Full year affect of contractual rate adjustments -Residential & CLS per diems adjusted on an average of 6% -CLS 15 minute services adjusted 10% Page 8 of 16

9 Bay-Arenac Behavioral Health Authority Report to Board Meeting August 16, 2018 Amended Budget #1 - Fiscal Year 2017/18 FY 17/18 Revenue Original Budget $ 49,332,246 FY 17/18 Expense Original Budget $ 48,730,994 Adjusted Medicaid Subcontract Revenue 1,453,300 Net Increase in Salaries and Fringe Benefits Expense 234,196 Salary Schedule adjustment effective February 1, 2018, Adjustment to Health Insurance Adjusted Autism Subcontract Revenue 409,500 Increase in Contract Physician Costs 32,000 Additional Child Psychiatry Time Adjusted State General Fund Revenue 8,999 Increase in Facility Expense 70,643 End of year Facility Maintenance Adjusted Healthy Michigan Revenue (320,100) Increase in Communications 70,678 Budget Adjustment Increase in Grant Revenue 169,134 Increase in Office Supplies 47,140 Upgrade Office Furniture Increase in Partnership Revenue - COFR $31,056 Increase in Minor Equipment 71,854 Budget adjustment, including end of year equipment purchases Net Increase in Local Revenue - Performance Bonus Incentive Payment 250,000 Increase in Community Inpatient, Residential, Community Living Support and Vocational Services 1,544,404 Contractual Rate Adjustments & State Mandated Direct Care Worker rate increase Increase in Interest Income 29,000 Increase in Local Portion of State Facility 55,900 Decrease SED (Serious Emotional Disturbance) Waiver Revenue - no new enrollments Decrease in Children's Waiver Revenue - Lower than anticipated enrollment (35,700) Net Decrease Miscellaneous Revenue (8,453) (16,906) Decrease in Miscellaneous Expense (24,455) FY 17/18 Revenue Amended Budget #1 $ 51,302,077 FY 17/18 Expense Amended Budget #1 $ 50,833,354 Page 9 of 16

10 BAY-ARENAC BEHAVIORAL HEALTH AUTHORITY Fiscal Year Operating Budget Amended Budget #1 FY Percent FY ACCOUNT DESCRIPTION Amended Budget #1 of Total Original Budget OBRA 200, % 111, MI Child - 0.0% General Fund.. 1,411, % 1,402, P.A. 423/Client Fees , % 226, SSI 62, % 53, Medicaid - PIHP... 46,335, % 44,792, Medicaid - Children's Waiver , % 183, Medicaid - SED Waiver... 1, % 18, Grants , % 375, County of Arenac - General , % 104, County of Bay - General , % 682, Interest 49, % 20, Miscellaneous Revenue , % 89, Miscellaneous Revenue From Partnership 1,302, % 1,271,603 TOTAL REVENUE 51,302, % $49,332,245 Page 10 of 16

11 BAY-ARENAC BEHAVIORAL HEALTH AUTHORITY Fiscal Year Operating Budget Amended Budget #1 FY Percent FY ACCOUNT DESCRIPTION Amended Budget #1 of Total Original Budget Salary (Direct & Indirect).. 11,246, % 10,879, Fringe Benefits. 4,604, % 4,744, Salary (direct & Indirect) + Fringe Benefits 15,851, % 15,624, Board Per Diem.. 38, % 38, Board conference and travel 18, % 11,100 TOTAL PERSONNEL SERVICES $15,908, % $15,674, Consumer food, clothing, etc.. 1, % 1, Consumer activities... 18, % 18, Public Transportation 75, % 75, Contract physician costs , % 532, Staff travel, service related. 102, % 102, Transportation 76, % 70, Grant specific cost. 31, % 31, Nongrant expense. 1, % 1, Professional Services - Other 686, % 683, Rental Space.. 215, % 215, Rental Equipment 10, % 7, R & M Supplies 127, % 83, Janitorial services 86, % 83, Public Utilities 106, % 89, Communications 157, % 86, Prior Fiscal Year Expense 27, % 8, Consumer compensation 3, % 3, Consumer conference and travel 1, % 1, Temporary staffing cost (0) 0.0% 10, Staff conference and travel 100, % 100, Staff development and training 32, % 32, Staff recruitment expenses 24, % 24, Employee health services 7, % 7, Operating Supplies.. 63, % 59, Mobile communications 72, % 72, Office Supplies. 174, % 127, Postage 15, % 15, Computer/Communication Related Exp % Community Education 2, % 2, Consumer info and printing 3, % 3, Public relations and advert 9, % 9, Legal and consulting 40, % 90, Accounting and audit 21, % 21, Purchased services 31, % 28, Software license maintenance 586, % 582, Subscriptions and publications 2, % 2, Memberships and Dues 21, % 21, Licensing and accreditation 6, % 6, General & Professional liab insurance 101, % 96, Local Funds Paid to State.. 545, % 545, Interest Expense. 31, % 30, Gain/Sale on Capital Asset % 0 BABH Contractual Healthcare Costs 30,433, % 28,833,620 SUBTOTAL EXPENDITURES $34,622, % $32,821, DEPRECIATION EQUIPMENT. 178, % 183, MINOR EQUIPMENT 123, % 52,131 TOTAL EXPENDITURES $50,833, % $48,730,994 Page 11 of 16

12 BAY-ARENAC BEHAVIORAL HEALTH AUTHORITY Fiscal Year Operating Budget Amended Budget #1 FY SETTLEMENT ACTIVITY Amended Budget #1 NET SURPLUS BEFORE SETTLEMENT $ 468,723 Current Year Savings Medicaid - Healthy Michigan Autism - General Fund (66,797) TOTAL FUND BALANCE INCREASE/(DECREASE) $ 401,926 Restricted Unrestricted 401,926 TOTAL FUND BALANCE INCREASE/(DECREASE) $ 401,926 UNRESTRICTED FUND BALANCE 10/1/17 $ 712,499 Budgeted Increase to Unrestricted Fund Balance 401,926 Requested Usage of Funds Restricted for Capital Purposes TOTAL UNRESTRICTED FUND BALANCE 9/30/18 $ 1,114,425 Page 12 of 16

13 BAY-ARENAC BEHAVIORAL HEALTH AUTHORITY Fiscal Year Operating Budget Capital Expenditures Amended Budget #1 Location Description Cost North Bay 2018 Chevrolet Impala 25,000 ACT 2018 Chevrolet Impala 25,000 Total Capital Expenditures $ 50,000 Page 13 of 16

BAY ARENAC BEHAVIORAL HEALTH AUTHORITY BOARD OF DIRECTORS Resolution #18-08-00X AMENDMENT 1 TO THE ANNUAL OPERATION BUDGET FOR FISCAL YEAR ENDING SEPTEMBER 30, 2018 WHEREAS, WHEREAS, WHEREAS,

14 BAY ARENAC BEHAVIORAL HEALTH AUTHORITY BOARD OF DIRECTORS Resolution # X AMENDMENT 1 TO THE ANNUAL OPERATION BUDGET FOR FISCAL YEAR ENDING SEPTEMBER 30, 2018 WHEREAS, WHEREAS, WHEREAS, WHEREAS, WHERE AS, The annual operating budget for fiscal year ending September 30, 2018 was adopted at a meeting of the Bay Arenac Behavioral Health Authority Board of Directors held on September 27, 2017 by Resolution # , and; Additional revenue sources and expense trends currently warrant a budget amendment incorporating new contractual agreements for community living supports, vocational services, and Healthy Michigan and autism services, and; Bay Arenac Behavioral Health continues to focus on community demand and support needs while providing quality care to individuals receiving specialty behavioral health services, and; The Chief Executive Officer has submitted to the Bay Arenac Behavioral Health Authority Board of Directors an amendment, which increases the overall annual operating budget for fiscal year ending September 30, 2018, and; It is the opinion of the Bay Arenac Behavioral Health Authority Board of Directors that the amended operating budget as adopted complies with the Uniform Budget and Accounting Act, Public Act 621 of 1978; THEREFORE, BE IT RESOLVED THAT: The Bay Arenac Behavioral Health Authority Board of Directors adopts the following schedule of operating revenues, transfers, and expenditures: General Operating Budget Beginning Unrestricted Fund Balance: $ 712,499 Projected Revenues and Transfers-In: $ 51,302,077 Projected Expenses and Transfers-Out: $ (50,900,151) Projected Ending Unrestricted Fund Balance: $ 1,114,425 This resolution was adopted at a regular meeting of the Bay Arenac Behavioral Health Authority Board of Directors held on August 16, 2018 pursuant to the Open Meetings Act, Public Act 267 of 1976, on a motion by and supported by with the following votes: Yeas: Nays: Absent: Richard Byrne, Board Chair Colleen Maillette, Board Secretary Page 14 of 16 Behavioral Health Center, 201 Mulholland, Bay City, MI 48708

15 July 31, 2018 Mr. Christopher Pinter, Chief Executive Officer Bay-Arenac Behavioral Health 201 Mulholland Bay City, MI Re: FY 2016 Compliance Management Decision Dear Mr. Pinter: The Michigan Department of Health and Human Services (MDHHS) has completed its review of the Bay-Arenac Behavioral Health Compliance Examination Report for the fiscal year ended September 30, The corrective action plan for this finding has also been reviewed. The following paragraphs detail our understanding of the finding, the corrective action plan adequacy and status, and our conclusion regarding whether the corrective action plan corrects the finding. Finding on Federal Procedures disclosed that Bay-Arenac did not have written federal procedures over grant compliance. Lack of written federal procedures could cause errors in grant reporting and management. We have determined this is a valid finding because under the contract the CMHSP is required to have written procedures on Uniform Grant Guidance covering cash management, conflict of interest, payroll and federal timekeeping, financial management systems, payments, allowable costs, period of performance, matching or cost sharing, program income, procurement, equipment and real property, supplies, copyrights, subawards to debarred and suspended parties, monitoring and reporting program performance, financial reporting, retention and access requirements for records. Bay-Arenac concurs with this finding and the corrective action plan is as follows: Bay-Arenac has updated their current policies and procedures to meet the federal procedures requirement. All modifications and additions to the current policies and procedures that are developed will be presented to the Board of Directors for approval. The corrective action plan was implemented in fiscal year 2017 and is ongoing. Finding on Ability to Pay disclosed that Bay-Arenac sub-contracted service providers during testing showed that ability to pay was not determined for the period the consumer was serviced. The sampling did not identify any cases in which the forms were missing or incomplete when the determination was the Authority s responsibility. We have determined this is a valid finding because under the contract the CMHSP and its service providers are required to determine responsible parties insurance coverage and ability to pay before, or as soon as practical after, the start of services as required by MCL Page 15 of 16

16 Page 16 of 16

BOARD OF DIRECTORS SPECIAL MEETING

BOARD OF DIRECTORS SPECIAL MEETING Tuesday, September 25, 2018 at 5:00 pm Behavioral Health Center, Room 225, 201 Mulholland Bay City, MI 48708 AGENDA Page 1. CALL TO ORDER & ROLL CALL 2. PUBLIC INPUT