Central Florida Cares

Transcription

1 Finance Committee Agenda Friday, September 30,2016 1:00PM-2:30PM Central Florida Cares Health System, Inc. Training Room Central Florida Cares I. Welcome/Introductions Charles Rogers II. Treasurer's Report Charles Rogers a. Minutes from July 29, 2016 Finance Committee Meeting III. COSO presentation to new board members Claudia Mason a. New Member Orientation appointment is 9/30/16 at 3:00pm IV. CFO Report Claudia Mason a. Financial Statements-June 2016 Final and August Spending Highlights ii. Balance Sheet 111. Schedule of Funds FY tv. Grove Update 5 minutes 5 minutes 5 minutes 25 minutes V. Old Business a. FivePoints Data System 1. Review ofdetail of Charges Initiative 11. Contract Language 111. Third ME Big Bend-Changes to ownership clause in contract with FivePoints b. Provider Monitoring Update VI. New Business Charles Rogers & Claudia Mason a. Moore Stephens Lovelace-Audit Planning i. On the agenda for October 28, 2016 Finance meeting b. Jennifer Campbell, member no longer employed by CHS 15 minutes 5 minutes VII. Other/Public Input 3 minutes per person VIII. Adjourn- Next Finance Committee Meeting Friday, October 28, :00-2:30 pm

2 Finance Committee Meeting Minutes Friday, July 29, 2016 Central Florida Cares Health System, Inc. Library Room Central Florida Cares ATTENDANCE Central Florida Cares Health System - Finance Committee Members Charles Rogers, Chair Mark Broms, Brevard Homeless Coalition Carla Caponi, Aspire Health Partners Scott Griffiths, Aspire Health Partners Bill Vintroux, Circles of Care Sandra Urban, STEPS, Inc. Daniel Munoz. Michael Moecker & Assoc. (Absent) Central Florida Cares Health Svstem. Inc. Staff Maria Bledsoe, ChiefExecutive Officer Claudia Mason, Chief Financial Officer Agnes Mcintosh, Sr. Financial Analyst Sharon Ramsaran, Sr. Accountant Karla Pease, Executive Assistant Meeting Called to Order The Central Florida~ares Health System, Inc. (CFCHS) Finance Committee Meeting was held on Friday, July 29,2016, at I :00 p.m. at 707 Mendham Blvd., Suite 201, Orlando, FL The meeting was called to order at I :08 p.m. Treasurer's Report A motion to approve the minutes from July 8, 2016 was made by Bill Vintroux, Carla Caponi, seconded, motion passed. COSO Presentation to New Board Members CFO stated she would be getting with new members to discuss a time to present. CFO Report Financial Highlights YTD June 2016 The CFO indicated providers are under by $1.3M, $455K that CFCHS did not contract, $170K was for HIV, Pulse funding spent $262K of$500k, $look should roll forward of the $238K remaining. $1 OOK of MH T ANF dollars was transferred to South Florida Behavioral. Total behind $2.1 M. Page 2 shows spending by provider where Aspire is receiving over 50% of the funds. Page 3 shows a comparison of spending to the previous year and expenditures by program. The adrnin rate has to stay at 15% or less and CFCHS is at 11.40%. The underspending by provider is shown on page 5. Since Aspire has data problem and wasn't able 1

3 to draw down their contract dollars, CFCHS was able to pay all providers 100% of their invoices through May. CFO thanked Aspire for the float on behalf of other Providers in the network. Page 6 shows the bum rate by provider where $290K of adult MH T ANF will be reverted. All adult SA T ANF dollars were spent and then some. All MH dollars should be spent, but CFCHS may have to revert SA dollars. Page 7 shows TANF dollars spent at $704K, which is $218K more than the budget. The schedule of funds as of was adjusted for the Pulse funding. The CFO estimated that some units may be purchased, some dollars will carry forward, and some will revert. This will be finalized after providers submit their final invoices on and the CFO office notifies CFCHS of the carry forward dollars. Page 9 is a detail of where the excess units may be purchased. Pages are services by category. The ME operating expenditures are shown on page 14. The next chart is the new schedule of funds for FY No funds were put in for the Housing Specialists and Care Coordinators but the Dept. is working on it. The next page shows new funding for a transition voucher program to assist clients who are homeless of at risk of being homeless to transition into permanent housing. The balance sheet shows $4M in the bank, DCF owes us for one month, providers will receive about $3.5M; approximately 65% of their June invoices. Cashflows are listed on page 19. Mark Broms commented on looking to collaborate with continuum of care where his agency could function as a referral source. Bill Vintroux stated his organization would be glad to partner with Mark if they have not alreaqy worked with someone at Circles of Care. CFCHS' CEO stated the System of Care staff can present at the Behavior~! Health Provider meeting that is scheduled. The CEO will Diane Kneehouse to be placed on the agenda. Administrative Cost Savings CFO spoke about cost savings from Verizon after switching CFCHS' cell phone plan. Information was sent to the provider network where Aspire, Park Place and Circles of Care benefited from cost reductions of ~pproximately $ ~OK each. Reducing administration costs is a part of our charter. The Sr. Financial Analyst found a GPO through the State of Minnesota where CFCHS received 38% savings on. the purchase of Surfaces. CFCHS will extend this to the providers as well once the state signs off. PULSE Spending and SERG Grant t ' The CEO indicated a conference call on the SERG grant occurs today. The Grove The next meeting has been scheduled relating to the payback. Old Business FivePoints Don Sparks is trying to start determine what CFCHS is paying for in maintenance support. He is looking at software as well. No update received from the DCF yet. CFCHS is requesting clarity and changes in the contract language. CFCHS is asking that Big Bend remove the clause that they own the system. Provider Monitoring Update 2

4 CFO stated monitoring is finished and the plan is to send reports out by 8/31/2016. New Business New check signers CFCHS is adding five Executive Committee members and two local Board members to sign the CFCHS checks that two CFCHS staff members cannot sign. AHCA 1115 Waiver The CFO researched this as a suggestion of Mark Broms. This waiver is still being worked on and the current version only mentions the MMAs. The MEs are only mentioned as a partner in AHCA's PowerPoint presentation. TheMEs may still be involved. Moore Stephens Lovelace Audit Planning- The auditors may be interviewing Finance Committee members at the October 29, 2016 Finance meeting. Other/Public Input - None Next Financial Committee This is scheduled for Friday, August 26, 2016 at 1:00pm. The meeting was adjourned at 1 :58 pm. Charles Rogers Karla K. Pease, Recording Secretary 3

5 CFCHS Finance Report August 2016-Budget Vs Actual Aug2015 Over Central Florida Cares Health System-Financial Highlights ($000)-Aug 2016 Burn Rates Diff (Under) YTD Programs Service Admin Total YTDBud** Unspent Actual% Prorated% Var% Budget Mental Health (MH): Adult MH 4, ,235 5,781 (546) 15.1% 16.7% 1.6% (582] Child MH ,092 (108) 15.0% 16.7% 1.6% (126] Total MH $ 5,711 $ 508 $ 6,219 $ 6,873 $ (654) 15.1% 16.7% 1.6% (708) Substance Abuse (SA): Adult SA 2, ,979 3,271 (291) 15.2% 16.7% 1.5% (781) Child SA 1, ,147 1,298 (151) 14.7% 16.7% 1.9% (317) Total SA $ 3,789 $ 337 $ 4,127 $ 4,569 $ (442) 15.1% 16.7% 1.6% (1,098J Total Providers $ 9,500 $ 845 $ 10,345 $ 11,442 $ ~1,097! 15.1% 16.7% 1.6% 11,806) Uncontracted Funds $ - - PULSE Services T ANF to SFBHN Managing Entity % 16.7% -0.3% (56) Total Network $ 9,500 $ 1,242 $ 10,742 $ 11,832 $ (1,090) 15.1% 16.7% 1.5% $ (1,862) **Based on 08/08/16 SOF $70,990,170 not amended in GHME1 1

6 CFCHS Finance Report August 2016-Spending By Provider YTD August 2016-Provider Spending ($000} $12, % 100.0% $10,000 liii 100.0% - $8, % % $6,000 $5, % I'\ $4,000 I 40.0% $,...,. 7% $2,000 ~% $446 $354 [ $413 $ % - $588 $169 $80 $ % 4.3% 4.0% 3.4% 1.5% $66 1.6% ~72 0.8% o.% 0.6% $326 $- ~ !1 =:as..:::: ~ 0.0% - ~ - - 1a,..._<8-" ~e 'I-.e" ~" ~(.-,:.e ~".;:.+ ~?:> c-<q} ~c.- q} ~., ~(c.,..p~ G~"' ~ (.; ~:~ ~.._o e<.. e 0-:i'..s ~.i'~e ~~ e.::. (c.,f:f ~..s <:),~~ ~0 ~.._o " - 2

7 CFCHS Finance Report August 2016-Prior Year Comparison YTD August 2016 Programs Actual Actual Mental Health (MH): PY1516 CY1617 Diff. Adult MH 4,241,075 5,234, ,763 Child MH 918, ,794 65,785 12,000 Expenditures CY vs PY By Program ($000) August2016 Total MH 5,159,084 6,218,632 1,059,548 Substance Abuse (SA): Adult SA 2,402,146 2,979, ,268 Child SA 976,289 1,147, ,000 10,000 8,000 6,000 Total SA 3,378,434 4,126, ,268 4,000 Total Providers $ 8,537,518 $ 10,345,334 $ 1,807,816 2,000 --::... ~..,...,--:_ AMH CMH ASA CSA ME Total Managing Entity , ,7~ $ - 66,665 :J PY-$ CY-$ Total Network $ 8,867,606 $ 10,742,087 ~ 1,874,481 3

8 CFCHS Finance Report August 2016-Unamended New SOF 8/08/2016 ME Schedule o f F u n d s (SOF) 2 C entral Florida C ares Health S ystem - Con tract# G HME 1 FY Use Oesla natlon- As o f 08/08/2016 YTD Auaust 2016 YTD August 2016 O ther Cost Accumulators T itle OCA Federal State Total Fed-% Actual Adult I Actual Child I Total Unspent I B urn Rate Admin istrative Costa % $ M3naging Entity Administrative Costs MHSOO 153,785 2,141,526 2,295,311 7% 396,753 (1,898,558) 17.3% ME Crisis Stabilization Services MHOCS 43,130 43,130 0% - (43,130) 0.0% ME Mental Health System of Care 1\AHOSK % ME Housing Coordination IIAHSHG 0% - - ME Care Coordination MHSCD % - - Mental Health Manaain % { ) 17.0% ME Mental Health Services & Support MHOOO 2,522,476 23,805, % 3,754, ,797 4,524,746 (21,803,089) 17.2% Specialized Treatment. Education and Prevention MH ,000 0% (300,000) 0.0% Services Purchase of Residential Treatment Services for MH , ,183 0% - 44,997 44,997 (345,186) 11.5% Emotionally Disturbed Children and Youth Community Forensic Beds MH , % 99,051-99,051 (425,423) 18.9% Florida Assertive Community Treatment (FACT) MH073 1,199,757 2,358, ,091 34% 620, ,997 (2,937,094) 17.5% Indigent Psychiatric Medication Program MH076 69, % 7,648 7,648 (61,430) 11.1% Orlando Emergency MHOER % ME-Transition Vouchers Mental Health MHTRV 189, % - - (189,009) 0.0% ME Centralized Receiving Facilities MHSCR 4,676, % 364, ,656 (4,311,742) 7.8% Circles of Care - Cedar Village MHS51 485, ,000 0% 8 1,840 81,840 (403,160) 16.9% Circles of Care- Crisis Stabilization ll.t-!s52-970, % 161, ,667 (808,333) 16.7% Circles of Care - Geropsyc hiatric Care Center MHS55-890, ,000 0% (890,000) 0.0% Services i Grants PATH MHOPG % 101, ,499 (474,668) 17.6% Temporary Assistance for Needy Families (TANF) MHOTB 661, % 42,531-42,531 (618,714) 6.4% Title XXI Children's Health Insuranc e Program MHOBN 842, , ,008 87% - 169, ,000 (799,008) 17.5% Behavioral Health Network) Community Forensic MJitidisciplinary Teams for Hospital Diversion ll.t-!ofh - 652, ,000 0 % (652,000) 0.0% Subtotal Mental Health % ( ) 15.1% Substance Abuse 0% ME Substance Abuse Services and Support MSOOO 10,175,498 9,668, % 2,324, ,083 3,220,984 ( 16,623,025) 16.2% HIV Services MS , , % 91,060 4, ,373 (638,712) 13.0% Prevention Services MS025 2, , % 42, , ,373 (2,724,966) 7.2% PPW SA Services Women & Their Families MS081-1,883,426 1, % 366, ,649 (1,516,777) 19.5% Family Intensive Treatment (FIT) MS , % 73,294-73,294 (588,889) 11.1% Temporary Assistance for Needy Families (TANF) MSOTB 660, % 80,812-80,812 (579,547) 12.2% Prevention Partnership Grant (PPG) MSOPP 571, % - 78,219 78,219 (492,887) 13.7%!ME-Transition Vouchers Substance Abuse MSTRV - 122, ,734 0% ( ) 0.0% I Subtotal Substance Abu se % ( ) 15.1% I T otal Services-Provider Network I I ( )!Total Services & ME Admin , ,956,478 70,990,170 30% ( ) 15.1% 29.63% 70.37%

9 CFCHS Finance Report August 2016-FY SOF r--- P r io r Year I P rior Yr Vs. Ex pl n tlon II No n Annualized Projected SOF Actu a l Vs SOF FY Recurring Pro rate d & FY Projected Funds In New FY2015- SOF FY2016 FY (63,353) ,821, ,809! 2,295, ,701 One Ume (21.429) 43,130 58,333 (58.333) Par11al WIP 116, (175,000) _ (26,721) Partial WIP 124, ,939 (150,939) r ( ) ( ) ,000 New Other , , ,474 3,558,091 3,558, ( ) O ne lime New New CRCs ,676, AnnuaHze 82, , ,000 New (98.732) (98.732) Up $32.9K ,000 New ,848 5,736,640 1,053,987 4,848,052 38,794,913 2,442, , (764,520) 18, {170,421) 541, , ,470 ( ) I , , , New , ,176 (1,744,782} ,114,283 2,299, ,707 $ 6,402,463 $ (2,820, 198) $ 5, $ 66, $ 4.459,724 5

10 CFCHS Finance Report August Final Carry Forward.. Central Florida Cares Health System, Inc Carry Forward Balance-GHME1 June 30, Jun-16 Carry Forward Description FY Managining Entity Admin June 30, ,544 June 30, ,267 Total ME Admin $ 506,811 Services/Network Related June 30, ,286 FIT MSA91 Program 281,591 Total Service Related $ 1, ,420 Admin General 44,055 Housing 7,542 Care Coordination 120,01 7 Total ME Adllin 9,680 PRTS 100,000 MHOER PULSE 216,069 MSOOOGR 325,749 Service Related June 30, 2015 Balance 1,634,687 Correction 50,688 MHOOO Mental Health Over SOF (5, 153} Undocumented Clients (30, 139' June 30, 2016 Balance $ 1,650,083 Designated Spending June 30, 2016 Balance $ 1,650,083 ME Admin-FivePoints & AHCA (506,811) FIT MSA91 Program (281,591) Undoc. Clients-4years (150,000) CareCoord MHSCD Housing MHSHG Housing Specialist-4Years (275,022) Care Coordinator-4Years (280,591' Total Designated (1 494,015) Undesianated 6/~()/~016 $ 156, ,766 $ 2,095,850 (1 00,000) MHOER PULSE (68,420) Add to Designated (100,000) (575,231 ) (281,591 ) (150,000) (7,542) (44,055) 44,055 7,542 (7,542) (44,055) (230,967) (273,049) (1,662,435) $ 225,749 Add to Undesignated $ 433,414 6

11 CFCHS Finance Report August 2016-lnterest Earned Interest Earned ~ Fiscal Year July 2015 to Jun~ 2016 $ 26, July 2~1.6 to August 2016 $ 6,

12 CFCHS Finance Report August 2016-ME Expenses $2,997 ME Operating Expenditures YTD August 2016 $13,100 $2,182 $7,573 $0 $34,661 $4,250 $ $11,182 $2,048 $1,444 Personnel Expenses Professional Fees Occupancy Maintenance & Repairs Insurance Conferences Miscellaneous I Telephone Printing & Publications Travel Expenses Operating Expenses YTD August 2016 Personnel Expenses 283,361 62% Professional Fees 60,594 13% Occupancy 34,661 8% Maintenance & Repairs - 0% Insurance 34,418 8% Conferences 7,573 2% Miscellaneous 2,997 1% Telephone 4,250 1% Printing & Publications 13,100 3% Travel Expenses 2,1 82 0% Office Equipment 11,182 2% Supplies 2,048 0% Equipment Rental 1,444 0% Total $ 457, % Office Equipment Supplies Equipment Rental Central Florida Cares Helath System-Agency Staffing August 2016 Fiscal Year Admin soc Operations IT/Data RUQ Fin & HR Total Professional Services YTD Au ust 2016 Moore Stephen Lovelace 5,000 Finance/Acctg Software 6,032 Attorney-Friedman & Friedman 1,269 Attorney Grey Robinson Fivepoints-System Development - Fivepoints-Maint & Support 18,000 Bayshore-New Help Desk 2,628 FAME Membership 26,000 Navex WhistleBiower Line - Don Sparks 450 Health Council Needs Assmnt 1,215 Grand Total $ 60,594 8

13 CFCHS Finance Report August 2016-Balance Sheet Cent:ral Florida Cares Healt:h Syst:ern, Inc St:at:ernent: or Financial IP'oslt:lon As or 08/31/2016 {Unaudlt:ed) Balance Sheet: Aug un-2016 Asset:s Current: Asset:s TO Bank-Checking TO Bank- Money Market Tot:al Cash&. Cash Equlvalent:s Program Service AR Due From DCF Due from Other Funders Other Receivables-Advance Due From Providers Prepaid Property D&O & Other Ins urance Prepaid Expenses DePOSitS Tot:al Current: Asset:s Long-term Assets Furniture & Fixtures COmputer Equipment Software A ccum. Depreciation- Software Tot:al Long-t:errn Asset:s Tot:al Asset:s Llablllt:les Short:- t:errn Llablllt:les Accounts Payable & Accrued Expenses VVages Payable Federal Payroll Taxes Payabl e SUTA Payable Deductions Payable Retirement Plan Payable Interest & Other Payabl e to DCF Advance Payable to DCF carry Forward Deferred Revenue CPA Fee Tot:al Short:-t:errn Llablllt:les Tot:al Llablllt:les Net: Asset:s Unrestricted N et Assets Prior Year Excess Revenues (Expenses) Current Year Excess Revenues (Expenses) Total Unrestricted Net Assets Total Net Assets Tot:al of' Net: Asset:s and Llablllt:les $ $ $ 404,644 $ 418,988 5,493,790 3,686,803 5,898,434 4,105,791 15,807,679 5, ,573 10, , ,418 15,000 33,940 26,375 26,~7~ c639, , ,569 (148,396} (148,396} 701, ,173 22,788,635 $10,340,795 8,289,844 6,529, ,673 71,125 8,160 5, ,308 6,101 5,147 6,853 5,923 11,484, ,124 2,095,850 2,095, ,009,974 9c511,652 22,009,974 9c511, , ,083 (50, , ,& '7'Bc&&O 829,144 22,788,635 $10,340,795 9

14 CFCHS Finance Report August 2016-Revenues & Expenses Central Florida Cares Health System August 31, 2016 YTD August 31, 2016 Aug0816 SOF- Variance- Aug0816 SOF- Variance- Statement of Revenues & Expenses Actual Unamended Revised Actual Unamended Revised Operating Revenue Program Revenue $ 5,621,494 5,915,848 $ (294,353) $ 10,742,087 11,831,695 $ (1,089,608) FLINC Revenues 5,287 5,287 (O) 10,573 10,574 (1) Deferred Revenues Total Revenue 5,626,781 5,921,135 (294,354) 10,752,660 11,842,269 (1,089,609) Expenditures: Managing Entity Expenses 207, ,870 (12,457) 457, ,740 (68,069) Adult Mental Health 2,791,250 2,890,648 99,398 5,234,838 5,781, ,457 Children's Mental Health 522, ,810 23, ,794 1,091, ,825 Adult Substance Abuse 1,443,386 1,635, ,040 2,979,413 3,270, ,440 Children's Substance Abuse 660, ,094 (11,844) 1,147,289 1,298, ,898 Total Program Services 5,418,254 5,720, ,723 10,345,334 11,441,954 1,096,620 Total Expenditures 5,625,581 5,915, ,266 10,803,143 11,831,695 1,028,551 Net Revenue Over Expenditures $ 1,199 $ 5,287 $ (4,088) $ (50,483) $ 10,575 $ (61,057) 10

15 CFCHS Finance Report August 2016-Statement of Cash Flows Central Florida Cares Health System St:at:ernent: of' Cash Flows YTD 08/31/2016 (Unaudited) Cash f'lows f'rorn Operating Act:ivit:ies: Current Year Excess Revenues (Expenses) YTD August: 2016 ( 50,483) Depreciation Expense (Increase)Decrease Progra m Service Due Fr DCF (Increase)Decrease Due from Other Funders (Increase)Decrease Oth er Receivables (Increase) Decrease Prepaid D&O & Other Insurance (Increase)Decrease Prepaid Expenses (Increase) Decrease Deposits Increase(Decrease) Accounts Payable Increase(Decrease) Wages Payable Increase(Decrease) Payroll Taxes Payable Increase(Decrease) SUTA Increase(Decrease) Deferred Revenues CPA Fee Increase(Decrease) Deductions Payable Increase(Decrease) Retirement P lan Payable Increase(Decrease) Interest Payable to DCF Increase(Decrease) Advance Payable to DCF Increase( D ecrease) Carry Forward Total Cash f'lows f'rorn Operating Act:ivit:ies ( 10,379, 154) (329,400) 34,418 18,940 1,760,605 35,548 2,719 (385) ,697,951 1,792,644 cashf'lows f'rorn Investing Act:lvlt:ies: Purchase of Fixed Assets Tot:al Cash f'lows f'rorn Investing Activities C hange In cash & cas h Equival ent s Beginning Balance cash & Equivale nts Ending Balance Cash & Equivalents 1,792,644 4,105,791 $ 5,898,435 Interest: Paid During Period $ 11

16 CENTRAL FLORIDA CARES HEALTH SYSTEM, INC. COMMUNICATIONS WITH THE FINANCE COMMITTEE AUDIT PLANNING 2016 Year Ended June 30,2016

17 MSL -- MOORE STEPHENS LOVELACE CPAs & ADVISORS September 21, 2016 To the Finance Committee Central Florida Cares Health System, Inc. 707 Mendham Blvd., Suite 104 Orlando, FL Our professional standards require that we inform you of certain matters related to our audit of Central Florida Cares Health System, Inc.'s (the "Organization") financial statements for the fiscal year ending June 30, This report is intended to convey those matters to you. As you are aware, our audit is designed to express an opinion on the basic financial statements of the Organization. As of the date of this letter, we have started the planning and interim testing phases of the audit. This allows us to provide you with our initial assessment of risk areas we consider significant to the risk of material misstatement of the Organization's financial statements. Based on our assessment, we intend to execute our audit plan using procedures to mitigate those risks. While we were not engaged to, and are not performing, an audit of internal control over financial reporting, we will obtain an understanding of the Organization, its environment, and its internal controls sufficient to plan the audit and determine the nature, timing, and extent of our audit procedures. Communication is an essential part of the audit process. After reviewing our plan, if you have any questions, concerns, or would like us to consider other matters, please contact me at the number below. We are dedicated to delivering the quality service you expect and deserve. We appreciate the opportunity to serve the Organization. Should you have any questions, please contact me at (407) Respectfully submitted, ~~ Farlen Halikman, CPA Engagement Shareholder

18 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Preface Government Auditing Standards require that Moore Stephens Lovelace, P.A. ("Auditor"), the Auditor for Central Florida Cares Health System, Inc. ("Organization"), communicate during the planning stage of the Organization's fiscal year ended June 30, 2016 financial statement audit certain information to officials of the Organization, or their designated representatives. We have been directed to communicate this information to the Organization's Finance Committee, as the representative for the Board of the Organization. The information that follows fulfills this requirement. Identification of Financial Statement Elements The Auditor will audit the Organization' s basic financial statements for the year ended June 30, The basic financial statements include:! Financial Statements! Notes to the Financial Statements! Supplemental Information! Major Federal Programs and State Projects Audit Objectives The objective of our audit is 1) the expression of opinions as to whether your basic financial statements are fairly presented, in all material respects, in conformity with U.S. generally accepted accounting principles and 2) to report on the fairness of the additional information referred to above when considered in relation to the basic financial statements taken as a whole. The objective also includes reporting on:! Internal control related to the financial statements and compliance with the provisions of applicable laws, regulations, contracts, agreements, and grants, noncompliance with which could have a material effect on the financial statements in accordance with Government Auditing Standards.! Internal control related to major federal programs and state projects and an opinion (or disclaimer of opinion) on compliance with laws, regulations, and the provisions of contracts or grant agreements that could have a direct and material effect on each major program or state project, in accordance with the audit requirements of Title 2 U.S. Code of Federal Regulations, Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards ("Uniform Guidance"); and requirements described in the Department of Financial Services State Projects Supplement, respectively.! Applicable provisions of Chapter , Rules of the Auditor General, which govern the conduct of nonprofit and for-profit organization audits performed in the state of Florida (if applicable).

19 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Auditor Responsibilities As the Organization's Auditor, we are responsible for:! Expressing opinions as to whether your basic financial statements are fairly presented, in all material respects, in conformity with U.S. generally accepted accounting principles and to report on the fairness of the additional information when considered in relation to the basic financial statements taken as a whole.! Reporting on internal control related to the financial statements and compliance with the provisions of applicable laws, regulations, contracts, agreements, and grants, noncompliance with which could have a material effect on the financial statements in accordance with Government Auditing Standards.! Reporting on internal control related to major federal programs and state projects and an opinion (or disclaimer of opinion) on compliance with laws, regulations, and the provisions of contracts or grant agreements that could have a direct and material effect on each major federal program or state project in accordance with the Uniform Guidance, and requirements described in the Department of Financial Services State Projects Supplement, respectively.! Informing you in our reports on internal control and compliance that the reports are intended for the information and use of the Organization's Board, management, specific legislative or regulatory bodies, federal or state awarding agencies and, if applicable, pass-through entities and are not intended to be, and should not be, used by anyone other than these specified parties.! Informing you in advance of any reasons that would result in us issuing other than unmodified reports on the financial statements or the Single Audit compliance opinions.! Informing you that we may decline to express opinions or to issue a report as a result of this engagement if we are unable to complete the audit or are unable to form, or have not formed, those opinions.! Conducting our audit in accordance with U.S. generally accepted auditing standards; the standards for financial audits contained in Government Auditing Standards issued by the Comptroller General of the United States; the Single Audit Act Amendments of 1996; the provisions of the Uniform Guidance, the Florida Single Audit Act, and the requirements described in the Department of Financial Services State Projects Supplement, and will include tests of accounting records, a determination of major program(s) in accordance with the Uniform Guidance; Chapter , Rules of the Auditor General; and other procedures we consider necessary to enable us to express such opinions and to render the required reports. 2

20 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Auditor Responsibilities (Cont)! Communicating to you the planned audit schedule. Page 8 of this report documents the timetable agreed upon with management for the June 30, 2016 audit.! Communicating audit areas we consider significant to ensure that we plan our audit to properly address the risk of material misstatement to your financial statements. A listing of those areas may be found on page 7 of this report. Please review this list. If you have any questions or believe the list is incomplete, please contact us to ensure we have properly identified all significant risks.! Communicating the concept of materiality. The concept of materiality recognizes that some matters, either individually or in the aggregate, are important for the fair presentation of your basic financial statements in conformity with GAAP, while other matters are not important. In performing the audit, based on our professional judgment, we assess matters that, either individually or in the aggregate, could be material to the financial statements. Our consideration of materiality is based on our professional judgment.! Informing you that at the completion of the audit, we will request certain representations from management.! Informing you regarding some general audit procedures, as well as procedures related to internal controls and compliance. Discussion of those items is on the following page. Those Charged with Governance and Management Responsibilities Those charged with governance and management, except where indicated, are jointly responsible for:! The basic financial statements and all accompanying information, as well as all representations contained therein in conformity with U.S. generally accepted accounting principles.! Making all management decisions and performing all management functions relating to the financial statements and related notes and for accepting full responsibility for such decisions.! Management is responsible to acknowledge in the management representation letter that it has reviewed and approved the financial statements and related notes prior to their issuance and has accepted responsibility for them.! Management has designated Claudia Mason, CFO, as the responsible party for oversight of our audit.! Management is responsible for establishing and maintaining internal controls, including monitoring ongoing activities, the selection and application of accounting principles, and the fair presentation in the basic financial statements in conformity with U.S. generally accepted accounting principles. 3

21 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Those Charged with Governance and Management Responsibilities (Cont.)! Management is responsible for making all financial records and related information available to us and for the accuracy and completeness of that information. Adjusting the financial statements to correct material misstatements and for confirming to us in the representation letter that the effects of any uncorrected misstatements aggregated by us during the current engagement and pertaining to the latest period presented are immaterial, both individually and in the aggregate, to the basic financial statements.! The design and implementation of programs and controls to prevent and detect fraud, and for informing us about all known or suspected fraud affecting the Organization involving (1) management, (2) employees who have significant roles in internal control, and (3) others where the fraud or illegal acts could have a material effect on the financial statements. This responsibility includes informing us of any allegations of fraud or suspected fraud affecting the Organization received in communications from employees, former employees, grantors, regulators, or others.! Identifying and ensuring that the Organization complies with applicable laws, regulations, contracts, agreements, and grants, and for taking timely and appropriate steps to remedy any fraud, illegal acts, violations of contracts or grant agreements, or abuse that we may report.! Establishing and maintaining a process for tracking the status of audit findings and recommendations.! Management is responsible for identifying for us previous audits or other engagements or studies related to the objectives discussed in the Audit Objectives section above. This responsibility includes relaying to us corrective actions taken to address significant findings and recommendations resulting from those audits or other engagements or studies. Management is also responsible for providing its views on our current findings, conclusions, and recommendations, as well as planned corrective actions. 4

22 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Audit Procedures - General An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements; therefore, our audit will involve judgment about the number of transactions to be examined and the areas to be tested. We will plan and perfonn the audit to obtain reasonable, rather than absolute, assurance about whether the financial statements are free of material misstatement, whether from (1) errors, (2) fraudulent financial reporting, (3) misappropriation of assets, or ( 4) violations of laws or governmental regulations that are attributable to the Organization, or to acts by management or employees acting on behalf of the Organization. Because the determination of abuse is subjective, Government Auditing Standards do not expect auditors to provide reasonable assurance of detecting abuse. Because an audit is designed to provide reasonable, but not absolute, assurance and because we will not perform a detailed examination of all transactions, there is a risk that material misstatements or noncompliance may exist and not be detected by us. In addition, an audit is not designed to detect immaterial misstatements or violations of laws or governmental regulations that do not have a direct and material effect on the financial statements or major programs. However, we will inform you of any material errors and any fraudulent financial reporting or misappropriation of assets that come to our attention. We will also infonn you of any violations of laws or governmental regulations that come to our attention, unless clearly inconsequential. We will include such matters in the reports required for a Single Audit. Our responsibility as auditors is limited to the period covered by our audit and does not extend to any later periods for which we are not engaged as auditors. Our procedures will include tests of documentary evidence supporting the transactions recorded in the accounts, and may include tests of the physical existence of inventories and direct confirmation of receivables and certain other assets and liabilities by correspondence with selected individuals, creditors, and financial institutions. We will request written representations from the Organization's attorneys as part of the engagement. At the conclusion of our audit, we will also require certain written representations from management about the financial statements and related matters. 5

23 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Audit Procedures - Internal Control Our audit will include obtaining an understanding of the Organization and its environment, including internal control, sufficient to assess the risk of material misstatement of the financial statements and to design the nature, timing, and extent of further audit procedures. Tests of controls may be performed to test the effectiveness of certain controls that we consider relevant to preventing and detecting errors and fraud that are material to the financial statements and to preventing and detecting misstatements resulting from illegal acts and other noncompliance matters that have a direct and material effect on the financial statements. Our tests, if performed, will be less in scope than would be necessary to render an opinion on internal control and, accordingly, no opinion will be expressed in our report on internal control issued pursuant to Government Auditing Standards. As required by the Uniform Guidance and the Florida Single Audit Act, we will perform tests of controls over compliance to evaluate the effectiveness of the design and operation of controls that we consider relevant to preventing or detecting material noncompliance with compliance requirements applicable to each major federal award program and state project. However, our tests will be less in scope than would be necessary to render an opinion on those controls and, accordingly, no opinion will be expressed in our report on internal control issued pursuant to the Uniform Guidance and the Florida Single Audit Act. An audit is not designed to provide assurance on internal control or to identify significant deficiencies. However, during the audit, we will communicate to management and those charged with governance internal control related matters that are required to be communicated under professional standards, Government Auditing Standards, the Uniform Guidance, and the Florida Single Audit Act. 6

24 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Audit Procedures - Compliance As part of obtaining reasonable assurance about whether the financial statements are free of material misstatement, we will perform tests of the Organization's compliance with applicable laws and regulations and the provisions of contracts and agreements, including grant agreements. However, the objective of those procedures will not be to provide an opinion on overall compliance, and we will not express such an opinion in any of our reports, as described under the Audit Objectives section above. Compliance areas we currently anticipate to be tested include:! Specific requirements of Major Federal Programs and State Projects! General requirements under the Uniform Guidance! General requirements under the Florida Single Audit Act! Florida Statutes! Rules of the Auditor General! Organization Policies and Procedures Our procedures will consist of tests of transactions, review of documents, testing applicable reporting requirements, and other procedures we deem necessary to issue the appropriate reports, as described in the Audit Objectives section above. Recurring Significant Accounting and Reporting Issues! Compliance with contracts, laws, regulations, and grant agreements! Capital assets accounting! Information Technology (IT) Independence Disclosure Moore Stephens Lovelace, P.A. and Moore Stephens Tiller, LLC have been defined as a network within an association under the AJCPA Rules of Professional Conduct. Management has confirmed to us that it is not aware of any prohibited relationship that would impair our independence under the AICPA Rules of Professional Conduct between our Firm and Moore Stephens Tiller, LLC and its employees. We are also not aware of any such relationships. 7

25 Central Florida Cares Health System, Inc. Audit Planning 2016 Required Communications Accounting and Reporting Issues New Auditing Standards Issued We do not expect any new standard to place any additional accounting or reporting burden on the Organization' s management or staff. Additional Audit Issues to be Evaluated for the Current Year! Continued general economic recovery! Budgetary constraints! Sub-recipient Monitoring Audit Schedule The schedule below has been approved by management: Interim fieldwork June 2016 Year-end fieldwork Review offinancial Statements Finance Committee meeting (draft report) Presentation to Board of Organization Audit Progress to Date October 2016 November 2016 December 2016 December 2016! Planning and control testing started during interim fieldwork! Single Audit testing will be performed during year-end fieldwork! IT assessment update is in process 8

26 Program Guidance for Managing Entity Contracts Contract Reference: Authority: Frequency: Due Date: Section C General Appropriations Act Quarterly Report Guidance 29 Transitional Voucher The 18th of the month following the quarter Discussion: The purpose of this document is to provide guidance for the implementation and management of the Transitional Voucher pilot project funded by line XXXX of the FY General Appropriations Act. This project provides care coordination and vouchers to purchase services and supports for adults transitioning from Florida Assertive Community Treatment (FACT) teams, acute crisis services, and institutional settings to independent community living. I. GOALS The Transitional Voucher pilot project is a time-limited, flexible, consumer-directed voucher system designed to bridge the gap for persons with behavioral health disorders as they transition from acute or more restrictive levels of care to lower levels of care. The intent of this project is to enable individuals to live independently in the community and build a support system to sustain their independence, recovery, and overall well-being. The project aims to: Prevent recurrent hospitalization and incarceration; Provide safe, affordable, and permanent housing opportunities; Maximize use of FACT resources and community supports; Increase participant choice and self-determination in their service selection; and Improve community involvement and overall quality of life for program participants. Transitional vouchers provide a participant with a monthly budget to be spent on allowable services pursuant to Rule 65E , F.A.C. This service is intended to support Care Coordination efforts outlined in Guidance 4- Care Coordination. "Voucher" refers to any electronic or paper record documenting a Network Service Provider's agreement to pay a third party for allowable services provided to an eligible program participant. This project offers time-limited financial assistance to support consumer-driven services based on the person's needs assessment and care plan objectives. The use of vouchers requires shared decision making in planning and service determinations, emphasizing selfmanagement. Care coordinators provide options and choices such that the care plan reflects the individual's values and preferences. This pilot project has two funding and implementation components. One component targets FACT participants in select counties; the second targets additional individuals in need of specialized community integration supports. II. FACT TARGETS This component satisfies the terms of a settlement agreement entered into by the Department and Disability Rights Florida targeting circuits 4, 6, and The settlement agreement requires the Department to develop a pilot project designed to more fully utilize existing FACT resources and create additional opportunities for, T.W., P.M. and Disability Rights Florida v. Michael Carroll, Department of Children and Families (Case No. 4:13-CV-457 RFUCAS) Settlement Agreement Effective: October 1, 2016

27 community integration of individuals being discharged from state mental health treatment facilities (SMHTFs). This component is intended to transition approximately 96 FACT participants during FY to less intensive community based services and supports, allowing persons referred from SMHTFs to fill the vacated slots. Annually, each Managing Entity and Network Service Provider specified in Table 1 shall select a minimum of twelve active FACT participants determined to be clinically and functionally ready for lower levels of care ready to transition out of FACT services. Considerations for transition readiness include, at a minimum, the individual's choice, their ability to self-manage, and the availability of a natural support system. During the transition, the Network Service Provider may offer Transitional Voucher project services while an individual is still enrolled in FACT. Each Network Service Provider FACT team shall accept individuals referred for discharge from SMHTFs to replace individuals selected to receive Transitional Voucher services. TABLE 1 Participating Agencies FACT Team Managing Entity Circuit & Counties Served Mental Health Resource Center - North Lutheran Services of Florida Circuit 4 Mental Health Resource Center- South (LSF) Health Systems Duval, Clay and Nassau Counties Boley Centers Central Florida Behavioral Health Circuit 6 Suncoast Center for Community Mental Health Network (CFBHN) Pasco and Pinellas Mental Health Resource Center \ Counties BayCare Health Systems Northside Community Mental Health Mental Health Resource Center... l Central Florida Behavioral Health Circuit 13 Network (CFBHN) Hillsborough County Ill. COMMUNITY INTEGRATION TARGETS Research indicates that a combination of long-term housing, treatment, and recovery support services leads to improved residential stability and reductions in substance use and psychiatric symptoms.2 The Transitional Voucher project is intended to assist eligible individuals obtain and maintain accessible, affordable housing with supportive recovery services. Each Managing Entity shall approve individuals who meet transitional voucher eligibility requirements. Persons eligible for services under this component must be currently receiving Department-funded SAMH services pursuant to chs. 394 and 397, F.S., and must meet one the following alternative characteristics: 1. Experiencing homelessness; meaning an individual who lacks housing, including: a. An individual whose primary overnight residence is temporary accommodation provided by a supervised public or private facility, and b. An individual who resides in transitional housing 2 Substance Abuse and Mental Health Services Administration, Leading Change: A Plan for SAMHSA's Roles and Actions HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration,

28 or 2. Receiving Care Coordination services pursuant to Guidance 4. IV. IMPLEMENTATION OF TRANSITION VOUCHERS A. MANAGING ENTITY RESPONSIBILITIES Managing Entities shall: 1. Determine the eligibility of Network Service Provider's and non-network Service Providers to provide services funded with Transitional Vouchers. Such determination will be based on licensure or certification in good standing, history of licensing or certification complaints, appropriateness of services, staff training and qualifications, evidence of staff and organizational competency, interviews with organization staff, and other knowledge of significance unique to the individual provider. a. Treatment providers must be licensed by the Department, Agency for Health Care Administration (AHCA), or a related professional license. b. Recovery support providers not licensed by the Department or AHCA must provide documentation of compliance with fire and safety codes and applicable professional certifications. 2. Establish a system for referral and approval of individuals to receive Transitional Voucher services. 3. Specify expectations for transition to other fund sources based on factors such as subsequent access to disability benefits, insurance, employment, or housing vouchers; and assist with timely and efficient transitions. 4. Develop a data and communications system to tr~ck and manage;) referrals, transitions, vouchers and outcomes. 5. Develop written agreement~ with community partners (i.e. specialist groups, housing agencies, hospitals and community agencies) that include guidelines and expectations for referral and transition processes. 6. Use a standardized assessment process. 7. Provide quarterly reports documenting Transitional Voucher services for each participating Network Service Provider using Template 17- Transitional Voucher Quarterly Report. B. NETWORK SERVICE PROVIDER RESPONSIBILITIES 1. Provide Care Coordination services to coordinate services with other providers and organizations to ensure the needs of the participant are addressed at any given time; 2. Monitor each participant's progress and work with providers to adjust services or providers as needed. 3. Ensure Transitional Voucher funds are used only for services and supports that cannot be paid for by another funding source; a. Network Service Providers and participants are responsible for locating other payor sources for services or supports prior to using Transitional Voucher funds. b. In collaboration with the participant, Network Service Providers must certify no other payer source is available and due diligence was exercised in searching for alternative funding prior to the use of Transitional Voucher funds. c. Network Service Providers must submit a certification form for each use of Transitional Voucher funds with the monthly invoice. 3

29 4. Establish accurate record keeping that reflects specific services offered to and provided for each participant; 5. Approve Transitional Voucher invoices and expenditures for services provided by non-network Service Providers. C. ALLOWABLE EXPENSES 1. Transitional Voucher services may be authorized only to the extent that they are reasonable, allowable and necessary as determined through the assessment process; are clearly identified in the care plan; and only when no other funds are available to meet the expense. 2. The person served is the primary decision maker as to the services and supports to be purchased and from what vendor those services are procured. 3. Allowable expenses include the following Covered Services as defined by ch. 65E , F.A.C.: a. Aftercare; b. Assessment; c. Case Management; d. Day Care; e. Day Treatment; f. Incidental Expenses; g. In-Home and On-Site; h. Intensive Case Management; i. Intervention; j. Medical Services; k. Medication-Assisted Treatment; I. Outpatient; m. Recovery Support; n. Respite Services; 0. Substance Abuse Outpatient Detoxification; p. Supported Employment; and q. Supportive Housing/Living. 4. Allowable Incidental Expenses include time limited transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals and other incidentals as approved by the Managing Entity in compliance with Rule 65E , F.A.C.. 5. Network Service Providers and non-network Service Providers must adhere to: a. State purchasing guidelines for allowable expenses as promulgated by the Department and the Department of Financial Services b. The requirements of Chapter 65E-14, F.A.C., and c. Managing Entity protocols regarding allowable purchases. D. DATA COLLECTION AND MANAGEMENT 4

30 In addition to service data reported in accordance with DCF Pamphlet 155-2, Network Service Providers must submit the Transitional Voucher Reporting Template with each monthly invoice. The Transitional Voucher Reporting Template shall be completed using the template provided at: (INSERT LINK) Data should be reported for events occurring during the reporting month only, not year to date. 5

31 Transition Voucher Project Report Template Instructions DRAFT (as of ) Reports are due quarterly by the 18th of the month following quarter end. Please forward reports to Data should be reported for events occurring that month, not year to date. Managing Entity Name Point of Contact (Full Name/Phone Number) Circuit Fiscal Year Monthly Enrollment ADMISSION INFORMATION Number of New Individuals Admitted Employment/Education Status at Intake Number of individuals employed Number of individuals in volunteer situations Number of individuals pursuing education Housing Status Immediately Prior to Intake Number of admissions from a state mental health treatment facility Number of admissions from a community acute care setting Number of homeless individuals Number of individuals at risk of homelessness Number of admissions from ALFs Number of admissions from a residential treatment facility Number of individuals living as dependent with family Number of individuals living independently Ju/-16 Aug-16 Sep-16 Number of admissions from other living arrangements Services in Place at Intake Number of individuals receiving FACT services Number of individuals receiving medication management Number of individuals receiving case management services Number of individuals receiving non-clinical recovery services Number of individuals receiving supported employment

32 Number of individuals receiving other services Benefit Status at Intake Number of Individuals receiving disability benefits- SSI or SSDI Individuals receiving insurance, Medicaid and/or Medicare Number of Individuals receiving Food Stamps Number of Individuals receiving veterans benefits Number of Individuals receiving TANF or other financial assistance PROGRESS MEASURES Number of admissions to Baker Act receiving facility (i.e. CSU, SRT, inpatient psychiatric unit) in the 6 months prior to admission Number of admissions to state treatment facilities (civil and forensic) in the 6 months prior to admission Number of incarcerations into jails or prisons in the 6 months prior to admission Number of admissions into inpatient detoxification facilities in the 6 months prior to admission Number of NEW admissions to Baker Act receiving facility (i.e. CSU, SRT, inpatient psychiatric unit) Number of NEW admissions to state treatment facilities (civil and forensic) Number of NEW incarcerations into jails or prisons Number of NEW admissions into inpatient detoxification facilities DISCHARGE INFORMATION -1 Number of New Individuals Discharged Employment/Education Status at Discharge Number of individuals employed Number of individuals in volunteer situations Number of individuals pursuing education Housing Status At Discharge Number of discharges to a state mental health treatment facility Number of discharges to a community acute care setting Number of homeless individuals Number of individuals at risk of homelessness Number of discharges to ALFs Number of discharges to a residential treatment facility Number of individuals living as dependent with family Number of individuals living independently Number of discharges to other living arrangements

33 1- Services in Place at Discharge Number of individuals receiving FACT services Number of individuals receiving medication management Number of individuals receiving case management services Number of individuals receiving non-clinical recovery services Number of individuals receiving supported employment Number of individuals receiving other services Benefit Status at Discharge Number of Individuals receiving disability benefits - SSI or SSDI Number of Individuals receiving insurance, Medicaid and/or Medicare Number of Individuals receiving Food Stamps Number of Individuals receiving veterans benefits Number of Individuals receiving TANF or other financial assistance VOUCHER EXPENDITURES Housing Expenditures Covered Service Expenditures (excluding Incidentals) Other Incidental Expenditures

34 Central Florida Cares Health System, Inc. Finance Committee Meeting September 30, 2016 Barlow Richard Health care Brevard Homeless Coalition Jennifer Health Partners Health Partners Michael Moecker & Assoc. Ro Charles Finance Chair u Sandra Inc. Circles of Care uo