agenda - tuesday, may 21, 2019
TRANSCRIPT
MCHENRY COUNTY MHB FINANCE & AUDIT
AGENDA ● MAY 21, 2019
Public Meeting Mental Health Board - Main Floor Conference Room 5:00 PM 620 Dakota Street, Crystal Lake, IL 60012
McHenry County Page 1 Updated 5/16/2019 3:20 PM
I. CALL TO ORDER Roll Call
II. PUBLIC COMMENT III. APPROVAL OF MINUTES - FOR ACTION
Minutes of the April 16, 2019 Finance and Audit Committee Meeting
IV. TREASURER'S REPORT - FOR DISCUSSION / RECOMMENDATION Treasurer's Report for the Period Ending April 30, 2019
V. OLD BUSINESS - FOR DISCUSSION / RECOMMENDATION / APPROVAL A. FY20 Draft Budget
1. 25Org20 2. 25Goals20 3. 25PerformanceIndicators20 4. 25AlternativeServiceDelivery20 5. 25PotentialBudgetReductions20
B. FY20 Provider Budget Worksheet Template
VI. NEW BUSINESS - FOR DISCUSSION / RECOMMENDATION / APPROVAL VII. PUBLIC COMMENT VIII. ADJOURN
McHenry County Mental Health Board
Finance Committee Meeting
April 16, 2019 ● 5:00 p.m.
Held at: Mental Health Board, 620 Dakota Street, Crystal Lake, IL 60012
MINUTES
Committee Members present: Mike Baber, Rachel Boldman, Tracy Champion, Sam Melei
Committee Members absent: Paula Yensen
Others present: Holly Puchner, Scott Block, Jane Wacker, Terry Braune, Pat Peterson,
I. CALL TO ORDER - Sam Melei called the meeting to order at 5:00 p.m. Roll Call was taken.
II. PUBLIC COMMENT - None.
III. APPROVAL OF MINUTES - FOR ACTION
Mike Baber motioned to approve the Minutes of the February 20, 2019 Finance and Audit Committee Meeting.
Seconded by Rachel Boldman. A VOICE VOTE WAS TAKEN. All in favor. Motion carried.
IV. TREASURER'S REPORT - FOR DISCUSSION / RECOMMENDATION
Jane Wacker provided the treasurers report
Pp. 5 - Balance Sheet cash balance and fund balance are steadily going down as tax dollars are used
Pp. 6 - Salaries Y-T-D is higher due to vacation payout for resigned personnel. Snow removal is at 77%.
Maintenance Agreement is due to Sherman Mechanical contract for HVAC.
Computer Equipment is for 3 projectors for conference rooms.
Pp. 7 - shows a couple of agencies are at low usage for the year due to no receipt of affidavits of their Schedule B’s.
Terry noted that this is a coding issue with changes to coding through State. Large agencies like Rosecrance and
Thresholds have not yet made changes in these areas and so do not yet reflect services using “Medicaid-type” billing
codes. It is more difficult for large agencies to make these changes. They do have 180 days to bill MHB.
Pp. 8 - Clearbrook FFS projects under by large amount having to do with missing affidavits. Once this is caught up this
number will go down.
Pp. 9 - HOS shows under-utilizing for year, but they are ahead of last year’s YTD. Last year’s pattern was similar and
HOS used the full funding. Staff will keep an eye on this issue, as HOS also may work with AID for the provision of
Medicaid certified services by AID onsite at HOS.
Pp. 12 - Turning Point, CVA program is billing considerably under last year’s utilization Y-T-D. Follow up is needed.
PAIP amount awarded was lowered, Turning Point is billing at same level as in the past but this will be capped at the
amount they were awarded.
Pp. 13 – The Psych Loan Reimbursement has been adjusted for the doctor from Mathers Clinic that left. This is why it
appears as under-utilizing for the year. These funds would potentially be available for another psychiatrist seeking
employment in McHenry County. Tracy Champion motioned to recommend approval to move the Treasurer's
Report for the Period Ending March 31, 2019 to the full Board. Seconded by Mike Baber. A ROLL CALL
VOTE WAS TAKEN. Mike Baber – Yes, Rachel Boldman – Yes, Tracy Champion – Yes, Sam Melei – Yes. All
in favor. Motion carried.
V. OLD BUSINESS - FOR DISCUSSION / RECOMMENDATION / APPROVAL – None.
VI. NEW BUSINESS - FOR DISCUSSION / RECOMMENDATION / APPROVAL
A. Vendors/Categories Pre-Approved for Check Release
Jane explained the reasoning for the pre-approved list for check release. She and Scott listed the names and reasons for
use of all those new vendors on the list. Approved ICA contracts are typically for network trainings.
Mike Baber motioned to recommend approval to move the Vendors/Categories Pre-Approved for Check
Release to the full Board. Tracy Champion seconded. A VOICE VOTE WAS TAKEN. All in favor. Motion
carried.
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B. Fiduciary Payments, Monitoring and Auditing – REVISED
Scott reviewed changes made to the policy. The County used to hold checks, MHB would be holding them and needed
to revise the policy based on current practice and changes to D365 processes. This is the proposed policy revision. Jane
noted sections changed and that checks will not be held at the County. The checks will be marked return to department
and the MHB accounting assistant will hold them to ensure that checks go out at the proper time. Rachel Boldman
motioned approval to move the revised Fiduciary Payments, Monitoring and Auditing to the full Board. Mike
Baber seconded. A VOICE VOTE WAS TAKEN. All in favor. Motion carried.
C. 2019 Cost Allocation Plan
Jane explained that this plan is updated each year and noted three small changes to the document. The date was
changed, the word Lease was added in addition to Possession Agreement. This is in relation to building occupants
leasing space in the facility. The final paragraph is updated to include the words Division 2500 since this is new in
D365. Tracy Champion motioned approval to move to the full Board the revised 2019 Cost Allocation Plan.
Mike Baber seconded. A VOICE VOTE WAS TAKEN. All in favor. Motion carried.
D. FY19 – Kaizen Health Budget Adjustment
Pp. 23 - Scott reviewed Kaizen history in response to need to increase transportation. This was in place last year, in
FY17 and in increased budget in FY18 with capped rides based on budget. In FY19, for first quarter, this cap was lifted
to determine need. This action demonstrated need. Because of this Scott is looking to increase this to make a formal
budget adjustment by $20,000. This will move to the full Board with decision memo for formal action. Scott explained
that 11 agencies use this services for about 1000 rides. Additionally, he explained how clients using courts rely on the
Kaizen program. Scott noted that MHB currently has $73,000 unallocated; this action would still leave $53,000 to
support staffing in the homeless shelter and still leave remaining funds. Mike Baber motioned to recommend
approval of the Kaizen Health Budget Adjustment of $20,000 to the full Board. Seconded by Tracy Champion.
A ROLL CALL VOTE WAS TAKEN. Mike Baber – Yes, Rachel Boldman – Yes, Tracy Champion – Yes, Sam
Melei – Yes. All in favor. Motion carried.
E. FY20 – Draft Budget
The FY20 Draft Budget was provided by handout to Committee members. This is an initial working draft document for
the next several months. Scott walked the Committee members through the document pointing out that the MHB’s
overall administrative expenses are reduced to a bit over 11% and there is no longer a building debt.
Scott had a discussion with the County Administrator regarding MHB dollars and an expectation of FY20 abatement.
The County Board would like to build in a standing abatement of 10%. MHB currently has $1.5M in Fund Balance
Reserve and is about to spend $675,000 on a year-round homeless shelter and recovery home.
This budget assumes fund utilization of $500,000. An abatement of $250,000 would mean MHB would not be able to
allocate the $250,000 for funding.
Total client budget is $10.3M less $250,000 abatement, on par with FY19 budget and a bit over FY17 and FY18. MHB
is spending down fund balance. This would leave the MHB with about $400,000 in Fund Balance.
The expectation is that MHB participate in the abatement along with other County departments that are in the position
to cut budget. The County Board is looking to cut the budget 10% overall. Individual departments are not necessarily
expected to cut the full 10%. The County has the authority to appropriate the MHB budget as a whole. The MHB
Board of Directors does the work of allocation.
The last four years MHB has been operating on increased budgets as the result of utilization of fund balance. The levy
is $10.9M, amounts over this cannot be sustained. Our budget should be as close to $10.9M each year. The MHB has
had the luxury of providing special projects in the past years.
Jane noted that with new growth in the County the $10.9M could increase as to what is available.
A Draft Budget spreadsheet was provided as a handout. Scott guided members through the categories:
Personnel - budget is projecting over slightly which includes merit increases and personnel changes
Administration – will be meeting with County IT and facilities maintenance to finalize those items
Transfers Out - covers maintenance agreement, IT support, no longer have a debt payment
Occupancy - defined items related to repair and maintenance issues and building operations and include next
year potential amount
Client Services - this would be area where $250,000 abatement would hit if it is approved
Community Funding (Provider Managed) and Community Funding (MHB Managed) - reviewed
Expenditure Budget Total overall is about $2.1M less than last year
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The Year-Round Homeless Shelter funding and approval process was reviewed and should be approved by County
Board on May 21, 2019.
Each year, staff has made funding allocation recommendations closer to actual spending which is important. Years-end
Reconciliation amounts will always be an unknown which will perpetually create carry over funds and will balance out
over a course of several years. This budget does not take into consideration any new programs to be considered,
including:
Detox or Residential Substance Use Services
Case Management Services at Year-Round Homeless Shelter
Psychiatric Services
Discussion to increase Utilization of Fund Balance to include another $250,000 – $400,000 in available budget dollars
in order for Board to make funding decisions (staffing needs at shelter and recovery home, detox, residential,
transportation, school district partnering) but not allocate all funds right away. Of the projected available Fund
Balance, Sam would be willing to increase the budgeted amount for FY20 utilization.. This would result in a FY20
budget of approximately $12M. This will increase pressure to fill service gaps and needs. Scott would prefer to be the
one actively seeking targeted needs as a Network and will work with providers accordingly.
Direction of the MHB Finance and Audit Committee is to increase the Utilization of Fund Balance as discussed.
Sam asked about changes in Personnel. Scott explained change and noted that this maintains staff at 10.67 FTE.
VII. PUBLIC COMMENT – None.
VIII. ADJOURN - Rachel Boldman motioned to adjourn. Tracy Champion seconded. A VOICE VOTE WAS
TAKEN. All in favor. Motion carried. The meeting adjourned at 6:22 p.m.
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MHB IT Operations
Coordinator (7E)
1.0 FTE
2019-2020 McHenry County Mental Health Board Organizational Chart
Executive Director
1.0 FTE
Fiscal Operations
Manager II (12E)
1.0 FTE Executive Assistant (6N)
1.0 FTE
Contract & Grant
Lifecycle Monitor (5N)
1.0 FTE
Training Coordinator
(4N) 1.0 FTE
Administrative
Specialist II (3N)
1.0 FTE
Accountant II (9E)
1.0 FTE
Accounting
Assistant II (4N)
.67 FTE
Deputy Director (14E)
1.0 FTE
Compliance
Coordinator (6N)
1.0 FTE
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Fiscal Year 2019/2020 Budget
Highlights and Goals
Page 1 of 1
McHenry County Mental Health Board
FY2019 Highlights
McHenry County Mental Health Board (MHB) received the Community Behavioral Health Association's Ellen T. Quinn Memorial Award for Agency
Achievement. The “Award” recognizes novel approaches to the delivery of behavioral health services and efforts toward industry excellence.
MHB collaborated with schools to address the mental health needs of area youth through Youth Mental Health First Aid Training (YMHFA).
YMHFA is designed to teach adults how to help adolescents (age 12-18) experiencing a mental health/addictions challenges.
MHB sponsored a 40-hour Recovery Coach Training workshop training eight attendees to become Illinois Credentialing Board Certified Peer
Recovery Support Specialists to facilitate a strengths-based recovery support approach for people with addictions, or in recovery from alcohol,
other drugs, or mental health concerns.
Satisfied Series 2010-B debt certificates to reduce interest expense and maximize facility use. (County Strategic Initiative: Quality Infrastructure)
In partnership with the County Department of Public Health, United Way and local healthcare agencies, MHB provided leadership in planning,
funding and execution of the 2020 McHenry County Healthy Community Study. (County Strategic Initiative: Leadership & Governance)
MHB used data-driven decisions for allocation of resources resulting in maintenance of a comprehensive network of community services and the
addition of new services. (County Strategic Initiative: Organizational Advancements and Services)
– Established an Applied Behavioral Analysis Therapy Program and Autism Resource Center – Driven by FY19 Autism Services
Needs Assessment – Referenced in MHB 2018-2020 Three Year Plan
– Allocated funds to increase Recovery Residence/Sober-Living beds – Referenced in MHB 2018-2020 Three Year Plan
– Allocated funds for a Year-round Homeless Shelter – Referenced in Continuum of Care to End Homelessness Strategic Plan
FY2020 Goals
Achieve CARF International Behavioral Health Network Re-Accreditation.
Implement a program focusing on frequent users of Crisis/Emergency Services to reduce costly utilization of mainstream systems such as first
responders, emergency rooms, etc.
Implement Substance Use Disorder services to meet gaps in care identified per results of the FY19 McHenry County Substance Use Services
Assessment. (County Strategic Initiative: Organizational Advancements and Services)
Establish Network Core Competency Training to develop essential skills/knowledge related to the delivery of quality behavioral healthcare
services for incoming direct service staff employees of MHB Network Providers. (County Strategic Initiative: Economic & Workforce Development)
Enhance use of Foundant Technologies Grant Management System to improve MHB Network Provider reporting compliance and data
collection/evaluation and work with County Dynamics 365 Core Team to create financial reports that meet County/MHB needs.
Allocate financial and personnel resources to support and explore point-to-point/on-demand transportation options increasing access to behavioral
healthcare services. (County Strategic Initiative: Quality Infrastructure)
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Fiscal Year 2019/2020 Performance Indicators
Department – Mental Health
Primary Performance Indicator: Maintain a comprehensive network of community mental health services using data-driven decisions for allocation of resources. (County Strategic Initiative: Organizational Advancements and Services)
Performance Indicators:
2018 Actual
2019 As of 5/31/18
2020 Projected
Dollars allocated to client/community mental illness, developmental disability, and substance abuse needs
$ $4,052,278 $10,119,241
# of McHenry County work plans supported with local MHB funds
89 74 80
# of MHB work plans receiving Compliance Audits
110 71 100
% measureable outcomes achieved within programs supported with local MHB funds
72% 81% 75%
Consumer satisfaction rate within programs supported with local MHB funds
91% 95% 90%
# of evidence-based practices utilized within programs supported with local MHB funds
32 36 36
# of MHB coordinated, supported, and hosted Trainings offering Continuing Education Credits to local professionals
24 9 24
# of attendees at MHB coordinated, supported, and hosted Trainings offering Continuing Education Credits
1332 405 1250
# of QPR™ Suicide Prevention Trainings
48 14 28
# of attendees at QPR™ Suicide Prevention Trainings
2943 547 1094
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Department:
Fund: 30 OCA: 250005/251009
Service or Program for Review:
Current Service Cost:
Estimated Savings:
Partners:
Description (who, what, where, and how):
$5,000
$30,000
Enterprise Resource Planning
County of McHenry
Fiscal Year 2019-2020 Budget Process
POTENTIAL ALTERNATIVE SERVICE DELIVERY OPTIONS
McHenry County Mental Health
Privatiziation
Managed Competition
Consolidation
Shared Services
Public Private Partnership
County of McHenry
MHB is collaborating with the County on D365 which eliminated MHB's need to purchase a separate accounting software to fulfill MHB's independent accounting needs. Through continuous careful planning and setup of D365, it is the goal of the MHB to fulfil its reporting needs through particpation in the County's development of comprehensive financial reports.
Many forms of government are looking at new methodologies in providing needed services while controlling costs. The County Board supports this new philosophy and is encouraging all Department Heads and Elected Officials to review the cost of service delivery within their departments and to give consideration to other forms of service delivery to achieve potential cost saving for the taxpayers.
Consolidation - Local government operations and services merge together to form a single entity.
Managed Competition - Employees restructure, innovate, and cost compete against contractors to provide the organizational services required.
Privatization - Governmental Unit sells the operation's assets, and eliminates the service responsibility and costs.
Public/Private Partnership - A long-term, strategic contractual agreement between a local government and a private sector entity.
Shared Services - Local governments work collaboratively to deliver services across boundaries.
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DEPARTMENT POTENTIAL BUDGET REDUCTIONS FISCAL YEAR 2019-2020 BUDGET PROCESS
Department # 25 Department Name: McHenry County Mental Health
CODE 1. Program 2. Service 3. Other
Cd
Description
Organizational Impact
The MHB feels that it has developed and adopted a budget that meets the spirit of the County Board Resolution Authorizing the Approval of a Formal Budget Policy for the Fiscal Year 2019-2020 which states a budget shall be developed which “represents an earnest attempt by all departments and this County Board to develop a budget that is drawn with the cognizance of current economic conditions and future economic trends.” Therefore, to maintain and enhance the current network of services available to McHenry County residents, no further reductions are under consideration.
OCA Code: Amount
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Total
Cd
Description
Organizational Impact
OCA Code: Amount
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Total
Cd
Description
Organizational Impact
OCA Code: Amount
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Object Level 3-4:
Total
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