Woodlands Behavioral
Healthcare Network

CEO Updates:  07/20 - 08/12/2010

 To:                   Woodlands Board of Directors

From:               Kathy Boes

Date:               08-12-2010

Subject:         CEO Report

________________________________________________________________

 Legislative/Budget Updates:

It has been a very busy month with budget and legislative advocacy.  Several staff members and I have had the opportunity to meet with our legislators regarding the state budget.  The good news is that the FMAP (Federal Medicaid Assistance Percentage) funding was extended for six months.  Michigan is slated to get $380 million.   However, this is less than the amount previously anticipated and used in the budget drafts by both the House and Senate.   According to Senator Jelinek, the senate budget version is now $250 million short; the House budget has a far greater deficit.   Representative Lori shared with me that the state may have to pass a continuation budget and we have already received notice of continuation funding for our DCH General Fund contract going into FY 10/11.

There has also been activity regarding the amount of Medicaid dollars coming into our PIHP.  The most recent actuarial studies have reflected unanticipated enrollment changes, including those attributed to the implementation of the Bridges eligibility processing system. The new eligibility processing system at DHS, Bridges, re-classified a small percentage of enrollees into different populations (TANF vs. DAB).  There was also an increase in the number of spend-down individuals becoming fully Medicaid eligible. In addition, there was a significant and unanticipated increase in the number of individuals in program Q coverage for 18-25 year olds.  Overall impact of these changes is a reduced payment rate to our PIHP for August and September of this fiscal year. We will continue to closely monitor the Medicaid rates as the vast majority of our services are funded through Medicaid dollars.

The management and executive teams have begun dialogue on program and service planning, given proposed budgetary reductions in FY 10/11 and FY11/12..  I have been meeting with supervisory staff on an individual basis to elicit feedback on cost reduction.  Staff has provided me with some very creative and insightful suggestions.  As mentioned last month, we will continue to develop a budget for FY 10/11 which addresses an anticipated GF reduction of $166, 000.   There are programming changes which will be made in order to shift some clinical operations to higher Medicaid groups, including the expansion of children's service.  More detail on these changes will be discussed during the board meeting.

PIHP Consultation Updates

Two months ago, Jeff Patton (KCMHSAS) provided the board with some updates regarding the role and process of the PIHP consultant.  We will be reviewing this project in detail at the board meeting and will need to identify representatives from the board to participate in this affiliation project. 

In an effort to further enhance the relationship between the PIHP and affiliate boards, the CEOs have proposed a Regional Board Meeting for September 10^th from 8:30am- 1pm at KVCC, M-Tec Building.   We would like to extend an invitation to all board members and executive staff from each CMH.  Please consider attending this event.   (Invitations will be distributed at Board meeting).    

Strategic Planning Date

Please check your calendars for a date in October.  Representatives from management staff, board and consumer advisory board will attend.   Please let May or I know if you would be interesting in participating in this event.

September Board Meeting Date

There is CMH Directors Meeting in Lansing on September 21^st, which is also our board date.  I would like to attend that Directors meeting, given budget and year end challenges.  The September board date would also need to include our budget hearing, which takes place prior to the regularly scheduled meeting.   Please check your calendars for alternate dates and times.

Year End Issues

Despite the funding reductions this past year, WBHN is in a positive position regarding Medicaid and General Fund.  A large portion of GF savings are attributed to low census at Kalamazoo Psychiatric Hospital.  Unfortunately, we are only allowed to carry forward $92,000.  Any savings in GF over that amount must be returned to the state.  We do NOT want to send a message to DCH that we are over funded in General Fund.   To that extent, I will be asking that the board consider approving a Cost of Living Increase (single payment versus pay scale adjustment) up to 2% and a Longevity Increase of up to 2%.  These payments will not be made until September, so payment rate could vary, depending upon an increase in state hospital utilization or other expenses.

Memorandum                         

To:                   Woodlands Board of Directors

From:               Kathy Boes

Date:               07-20-2010

Subject:         CEO Report

________________________________________________________________ 

Legislative/Budget Updates:

There has been little activity with the budget over the past few weeks.  The Legislative sessions will resume tomorrow.  Of primary importance is the possible loss of the FMAP (Federal Medicaid Assistance Percentage) funds, which offset the expense of Medicaid.  Without this source of federal dollars, the general fund deficit will significantly increase.

Senate Bill 421- advocacy is needed regarding the proposals to force consolidation or mergers of CMHSP.  Please see me if you would like a copy of the original or revised language of this bill.  Woodlands is NOT in support of this legislation.

The budget planning process has begun for fiscal year 2010/11.  Our public meeting was held last Monday, the 12^th, with little attendance.  The management and executive teams have begun dialogue on program and service planning, given proposed budgetary reductions.  At this time, we will be planning for a reduction of $166, 000 (senate version) in General Fund.   Ideas/suggestions from the board are welcomed.  I will keep you informed of funding issues as they arise.

The Woodlands Mental Health Foundation Board met last month to review funding requests nd will be awarding WBHN monies to support our Substance Abuse services. Thank you to the Foundation for their continued financial support to the agency.

Board Member Updates

The County Commission has appointed a new board member for Woodlands.  Tara Hicks will be joining us in July.  Please welcome Tara to the board.

PIHP Consultation Updates

Two months ago, Jeff Patton (KCMHSAS) provided the board with some updates regarding the role and process of the PIHP consultant.  The initial phase of this project is nearly complete. CEOs have been meeting monthly to review and discuss the role and structure of the PIHP and have made some recommendations regarding responsibilities of the PIHP versus KCMHSAS. Next month, we will spend some time reviewing the revised Affiliation Advisory and Leadership committee formats and elect representatives to these meetings.