1 Strategic Planning Budget Retreat COMTREA Board and
1 Strategic Planning & Budget Retreat COMTREA Board and Leadership Council Thursday, June 13, 2019
AGENDA I. 8: 00 AM Meeting Opens II. Review of Mission Statement & Vision III. Stakeholder Feedback IV. FY 2020 10 BIG ROCKS V. FY 2020 Strategic Plan & 3 Year Plan (2018 -2020) VI. Presentation of the FY 2020 Budget VII. Meeting Closing 2
COMTREA Our Mission To lead in providing quality, comprehensive healthcare that is affordable and accessible, and to support the dedicated professionals who make caring for the individuals we serve their number one priority. Our Vision To be recognized as a leader in comprehensive healthcare, challenging and inspiring individuals, families, and employees to reach their full potential and purpose. Our Values C – COMPASSION AND COMMUNITY CENTERED CARE O – OUTREACH AND OPPORTUNITY M – MEANINFFUL AND MEASURED SERVICES T – TRAUMA INFORMED AND POSITIVITY FOCUSED R – RESPONSIVE, RESPECTFUL AND RESILIENT E – EXCELLENCE AND EVIDENCE BASED SERVICES A – AFFORDABLE AND ACCESSIBLE 3
OUR MISSION STATEMENT Why is it important? TACTICS MISSION VISION • • It determines the company’s direction It focuses the company’s future It provides a template for decision-making It forms the basis for alignment It welcomes helpful change It shapes strategy It facilitates evaluation and improvement 4
AWARENESS OF SERVICES (SLIDE 1) AWARENESS OF SERVICES Primary medical care for children/youth/adults Dental care for children/youth/adults Integrated care delivery for medical, dental and behavioral health. Co-occurring/Integrated Tx service for substance use & a mental health disorder Out-patient counseling Outpatient treatment for alcohol/substance use for children, youth and adult [CSTAR] Psychiatric evaluations and medication management for youth and adult “A Safe Place” shelter for domestic violence Keaton ALF for persons with serious and persistent mental illness Supportive Parents court-ordered program 2019 YES NO 115 91% 115 92% 114 92% 116 95% 117 96% 116 94% 114 93% 80 65% 72 59% 11 9% 10 8% 6 5% 5 4% 7 6% 9 7% 43 35% 50 41% Change % Yes PY 2018 3% -1% 3% 4% 3% 1% 2018 YES NO 79 88% 84 93% 80 89% 82 91% 84 93% 11 12% 6 7% 10 11% 8 9% 6 7% NA 2% 2% -5% Change % Yes PY 2017 14% 22% 5 2017 YES NO 75 74% 73 72% 27 26% 29 28% 89% 15% 4% 7% 8 9% 33 37% 32 36% 5% 4% 0% -4% -14% 2016 YES NO 27 77% 30 86% 8 23% 5 14% 31 89% 34 97% 34 94% 4 11% 1 3% 2 6% 28 78% 9 25% 17 47% 8 22% 27 75% 19 53% 0% 78 76% 91 89% 88 86% 24 24% 11 11% 14 14% NA 82 91% 57 63% 58 64% Change % Yes PY 2016 -12% -8% NA 88 86% 60 59% 65 64% 14 14% 41 41% 36 36% 8% 34% 17%
AWARENESS OF SERVICES (SLIDE 2) AWARENESS OF SERVICES Community Psychiatric Rehabilitation (intensive in home & community based CM) Out-patient, both office and community based, case management Psychosocial Rehabilitation Program (PSR) DWI Court (SROP – serious repeat offender program) Family Drug Court Motivational Probation, formerly known as Juvenile Drug Court Veterans Court Adult Drug Court 2019 YES NO 96 27 78% 22% 111 12 90% 10% 79 44 64% 36% 76 46 62% 38% 95 26 79% 21% 69 53 57% 43% 55 67 45% 55% 89 33 73% 27% Change % Yes PY 2018 2% 0% -7% -3% 6% -5% -3% -4% 2018 YES NO 68 22 76% 24% 81 9 90% 10% 64 26 71% 29% 59 31 66% 34% 65 25 72% 28% 55 35 61% 39% 43 47 48% 52% 69 21 77% 23% Change % Yes PY 2017 -5% 12% 20% -9% -12% -16% -22% 5% 6 2017 YES NO 81 20 80% 20% 79 22 78% 22% 52 49 51% 49% 75 26 74% 26% 85 16 84% 16% 78 23 77% 23% 70 31 69% 31% 71 28 72% 28% Change % Yes PY 2016 -3% -14% 10% 13% -5% -17% 11% -6% 2016 YES NO 30 6 83% 17% 35 3 92% 8% 15 21 42% 58% 22 14 61% 39% 32 4 89% 11% 34 2 94% 6% 21 15 58% 42% 28 8 78% 22%
AWARENESS OF SERVICES (SLIDE 3) 2019 AWARENESS OF SERVICES Children’s Advocacy Center Crime Victim Services: Court and Community Victim Advocacy Hospital and ED intervention/ diversion services Disease Management and Care Coordination supports with community physicians Tails with Tails program/canine program School Liaisons services within all Jefferson County schools. Utilizes social media to get information out to the public? Like COMTREA on Facebook to get the latest updates. . YES NO 107 15 88% 12% 75 46 62% 38% 85 36 70% 30% 77 44 64% 36% 88 33 73% 27% 101 19 84% 16% 82 37 69% 31% Change % Yes PY 2018 7% -10% 6% 4% -16% -5% NA 2018 YES NO 73 17 81% 19% 65 25 72% 28% 58 32 64% 36% 54 36 60% 40% 80 10 89% 11% Change % Yes PY 2017 -1% 13% 21% 27% 7 2017 YES NO 81 18 82% 18% 59 41 59% 41% 43 57 43% 57% 33 67 33% 67% Change % Yes PY 2016 -7% -8% 15% 11% 89% NA NA NA 2016 YES NO 32 4 89% 11% 24 12 67% 33% 10 26 28% 72% 8 28 22% 78%
PERFORMANCE RATING (SLIDE 1) PERFORMANCE MEASURES Scores calculated w/o "NA" TOTAL REPORTING The mission and successes of COMTREA are effectively communicated 8 % Change % Strongly 3 Year in SA/A in Agree or Change 2019 over 2018 over 2017 over Agree PY PY PY 20% 128 83% 5% 90 79% -4% 102 82% 19% 35 63% Satisfied or highly satisfied with being a COMTREA community partner. 23% 88% 7% 80% -2% 83% 18% 65% Education and training of COMTREA services for your organization and/or community 25% 85% 10% 75% 5% 69% 10% 59% Access to services in a timely manner 29% 74% 13% 61% -7% 68% 23% 44% Ensuring that the physical health needs of clients in our care met 4% 93% 12% 81% -3% 84% -5% 89% Ensuring that mental health needs/substance use treatment needs of clients in our care met 15% 80% 11% 69% -8% 77% 13% 65% Ensuring that the oral health needs of clients in our care met -2% 94% 11% 83% -4% 87% -9% 96%
PERFORMANCE RATING (SLIDE 2) PERFORMANCE MEASURES Scores calculated w/o "NA" TOTAL REPORTING Providing a range of support services needed by clients and their families 3 Year Change 9 % % Change % Strongly in SA/A in Strongly Agree or 2019 over Agree or 2018 over Agree or 2017 over Agree or Agree PY Agree 25% 128 95% 9% 90 86% 0% 102 87% 16% 35 71% Responding to you/your organization’s concerns 23% 82% 11% 71% -10% 81% 22% 59% Providing staff who are well-trained and knowledgeable 16% 91% 8% 83% -9% 92% 18% 74% Coordinating services with other agencies or community organizations 19% 91% 11% 80% -6% 86% 15% 71% Clients, family members and/or community partners are treated with respect 7% 96% 6% 90% -2% 92% 3% 89% Access to information on the COMTREA website 9% 97% 12% 85% -6% 91% 3% 88%
PROPERTY OWNED End of FY 2019 10 PROPERTY OWNED – FY 2019 A Safe Place and Garage SQ. FOOTAGE ACRES 6, 810 5 Anderson Building (Arnold) 22, 500 3 O’Brien Building (Festus) 26, 550 “A” Building (CAC – Festus) 5, 600 Total Festus Main Campus 2 --- Keaton Center 7, 800 --- COMTREA Annex 8, 000 1 Northwest Office (Seeley Building) 6, 500 4 Bridle Ridge Acres 8, 646 45
PROPERTY LEASED 11 End of FY 2019 PROPERTY LEASED – FY 2018 Drug Court Office (Hillsboro) Union CAC Office Farmington CAC Office Hickory Plaza Health Center High Ridge Family Medical Center Valley Middle School Fox Service Center 110 South 2 nd Street (Festus Dental) 112 South 2 nd Street (Festus Centralized Intake) 109 Mill Street (Marketing) Truman Boulevard (Welcome Center) Total Square Footage Lease Total (Annually) SQ. FOOTAGE 4, 800 1, 500 1, 800 7, 150 4, 800 4, 500 3, 700 1, 000 2, 400 2, 500 35, 150 $258, 789 Note: In 2018/2019 the Truman Boulevard location was added for the Welcome Center and Marketing relocated to 109 Mill
VEHICLES OWNED 12 End of FY 2019 TYPE # Automobiles 46 Pick-Up Trucks 6 # with snow plows Note: For FY 2020, approximately 12 vehicles need to be replaced we will lease these vehicles through Enterprise Leasing at $412/mth per car. This will be approximately $60, 000. (this is without fuel cost that is in the budget at current trend). 6 Vans / Minivans 15 Mobile Dental Vans* 4 Mini Buses 2 TOTAL 73 *Includes MAP Trailer in count
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA CHNA Top Priorities 13 MHJ COMTREA Strategic Plan Mental Health Needs and Available Resources Substance Use & Opioid Epidemic Insurance Coverage and Cost Access to Care (Availability of Services & Provider Shortage) Housing (Affordability and Availability) Chronic Disease Management/Monitoring Transportation Food Insecurity Homelessness Obesity/Poor Nutrition/Physical Inactivity Violence (Domestic/Child Abuse, Theft & Break-ins) Tobacco Use Dental/Oral Health Limited Knowledge of Resources in the County Accidents/Unintentional Injuries (guns, driving safety/texting)
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA # COMMUNITY NEEDS FEEDBACK STAKEHOLDER SURVEY % 1 Mental Health Needs (Depression, Self. Harm, Suicide) 23% 2 Substance Use (Drugs, Alcohol) 23% COMTREA Resources/Action Steps Strategic Plan # M&C #1 M&C #7 A&S #3 A&S #10 IS #2 3 Transportation 7% 14 Certified Community Behavioral Health Center 13 Psychiatry Providers and total full-time equivalency of 8. 0 Community Support Specialists (CSSs) Welcome Center for Behavioral Health needs triage and access to care Treatment Courts Tails with Tails Canine Therapy Program (in the schools, hospitals, libraries) Medication services for Opiate Use Disorder and Substance Use treatment/counseling services; EPICC (Engaging Patients in Care Coordination); PSR (Psycho-Social Rehab) School liaison program Outreach/Engagement Service Diversion via Emergency Department and Inpatient treatment units-face to face engagement and referral to treatment. School based counseling/therapy services Collaboration with community partners around suicide intervention and prevention RFP process through the Jefferson County Community Mental Health Fund Board (JCCMHFB) with up to $250, 000 distributed annually to agencies that serve individuals with mental illness in Jefferson County. Certified Peer Recovery Specialists for mental health and substance use treatment support and Family Supports. Annual screenings of mental health needs for individuals served in Primary care with access to a Behavioral Health Consultant during visits during the Primary Care Visit. SBIRT (Screening, Brief Intervention, and Referral to Treatment) for Drug and Alcohol use in Primary Care For patients with Medicaid, transportation may be a covered benefit (if requested three to five days prior to apt) Jeff. Co Express OATS Uber For Community Psychiatric Rehabilitation individuals (CSS’s will bring them to services as component of service delivery)
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA 15 # COMMUNITY NEEDS FEEDBACK STAKEHOLDER SURVEY % COMTREA Strategic Plan # COMTREA Resources/Action Steps 4 Access to Care (Insurance Coverage Costs, Medication Costs) 7% A&S #9 IS #4 IS #7 Sliding scale Enrollment Specialist for Insurance 340 B Program and other options for medication funding support (Pro. Care, Needy Meds) 5 Homelessness 5% 6 Housing (Availability, Transitional Housing, Sober Living) 5% M&C #5 COMTREA assists individuals and families impacted by behavioral health and other disorders with obtaining and sustaining stable housing. Services are provided utilizing state and federal resources and include case management, financial assistance for independent and residential care placement costs, and linkage to community housing supports. 7 Access to Care (Provider Shortage, Appointment Availability, Teleheath) 5% E&L #2 IS #1, 5 & 8 COMTREA staff refer individuals and families to the following resources: Homeless Shelters in the STL Region St Patrick’s Center Salvation Army Homeless Connect hotline Good Samaritan Service Center Catholic Charities Housing Resources 11 clinical delivery sites Clinical affiliations with academic sites and physician/dental/psychiatry/nursing programs Expanded use of digital technology Expanded telepsych and teledental services Recruitment Workgroup Centralized Admissions (one call for all new appointment types) Integrated Scheduling (Appointments can be scheduled for any services by Office Management staff at any location) Co-location of primary care with behavioral health services for improved care coordination Same day access/walk in for primary care, behavioral health and oral health
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA # 8 COMMUNITY NEEDS FEEDBACK STAKEHOLDER SURVEY Awareness of COMTREA Services/Resources & Website Functionality % 4% COMTREA Strategic Plan # A&S #1 A&S #6 COMTREA Resources/Action Steps 16 Updated website with robust patient portal capabilities and user friendly navigation Consumer access function for education and training resources Internal Speaker list for community presentations Fundraising and marketing program Expanded social media presence and video productions 9 Funding for Services 4% A&S #1 A&S #2 IS #4 Quarterly advocacy participation a state and Federal level Leadership positions within state associations that influence funding, payment reform and program priorities Active grant review and writing process Fundraisers that contributes $415, 000 annually Designated Administrative Agent in Jefferson County for DMH 330 funding as an FQHC 10 Additional Clinical Need/Services including Hepatitis C, Eating Disorders, Vision Services, Pain Management. 4% M&C #2 MOUs with community partners Hep C: Quest Lab & Dr. Bruce Bacon Eating Disorders: Mc. Callum Place in St. Louis and St. Louis Behavioral Health Medicine Vision: Lens Crafters in South County offers a program called One. Sight Pain Management: Limited known options in Jefferson County 11 Dental (Oral Health) 4% M&C #4 IS #2 & 3 Dental clinics as part of the FQHC 8. 0 full-time dentists Mobile dental program with preschool and school based programs. MAP clinic (55 -foot trailer with 3 operatories) Walk In Emergency Clinic
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA # 12 COMMUNITY NEEDS FEEDBACK STAKEHOLDER SURVEY Clinical/Educational Program Training & Delivery & Disease Management (Parent/Family Training, Vocational Education, Trauma Informed, Law Enforcement) % 3% COMTREA Strategic Plan # M&C #1 M&C #2 M&C #3 A&S #10 IS #3 IS #6 COMTREA Resources/Action Steps 13 Partner Agency Collaboration Opportunities 3% M&C #2 M&C #3 A&S #10 17 Community based services – CSSs and Community Health Workers Behavioral Health Care Home Primary Care Health Home Population Health Management through data analytics, care coordination and resources for chronic disease School-based clinics in three school districts including Northwest, Fox and Dunklin. Family Education classes and CPRT (Child and Parent Relational Therapy) classes beginning. Implementation plan for Vocational Education in FY 2020 OEND (Opioid Education and Naloxone and Narcan Distribution) Training CMHL (Community Mental Health Liaison with law enforcement) Children’s Advocacy Center provides training for the Crisis Intervention Team (CIT) for Jefferson County Law Enforcement MOUs with community partners including three acute hospitals (Mercy South, Mercy Jeff & SSM St. Clare), Health Dept. COMTREA advocated to state, county and local governments to implement or join the St. Louis County Prescription Drug Monitoring Program (PDMP). COMTREA participated in a county-wide mass PDMP registration of providers and delegates in April, 2018. Collaboration within MO Eastern Region in STL with Behavioral Health Network Tails with Tails Canine Therapy Program in the schools, hospitals, residential care facilities, nursing homes, hospice and libraries. Outreach/Engagement Service Diversion via Emergency Department and Inpatient treatment units Coordination with the Health Dept. for mobile dental services in the schools
COMMUNITY HEALTH NEEDS ADDRESSED BY COMTREA 18 # COMMUNITY NEEDS FEEDBACK STAKEHOLDER SURVEY % COMTREA Strategic Plan # COMTREA Resources/Action Steps 14 Social/Family Support Needs (Food access, Child care, Legal Care) 2% M&C #6 IS #7 Referral relationship with the Health Dept. and Mercy Jefferson for dietary and nutrition training 15 Domestic/Child Abuse 1% M&C #5 Child Advocacy Centers – advocacy, assessment and treatment A Safe Place Emergency Shelter for victims of domestic abuse and intimate partner violence (women and children) Year 2 of a Capital Campaign to raise $3. 1 million dollars to build Mary’s House of Hope, which is the transitional housing for individuals transitioning out of the emergency shelter
EVALUATION OF IMPACT § Mental Health and Substance Use COMTREA is a Certified Community Behavioral Health Center (CCBHC) and the Administrative Agent for Jefferson County as designated by Department of Mental Health. There is a complete range of programs available to meet needs include the following: Community Support Specialists; Medication services for Opiate Use Disorder and Substance Use treatment/counseling services; EPICC (Engaging Patients in Care Coordination); Psychosocial Rehabilitation (PSR); Welcome Center for Behavioral Health needs triage and access to care; Certified Peer Recovery Specialists for mental health and substance use treatment support and Family Supports; collaborative partner with Jefferson County Treatment Courts; School liaison program that provides mental health professionals in each school in Jefferson County; Tails with Tails Canine Therapy Program (in the schools, hospitals, libraries); Outreach/Engagement Service Diversion via Emergency Department and Inpatient treatment units-face to face engagement and referral to treatment; and school based counseling/therapy services Additional services include an assisted living facility (Keaton Center) for individuals with persistent and severe mental illness. Through a contractual relationship with the county, the Jefferson County Community Mental Health Fund Board (JCCMHFB) administers an RFP process with up to $250, 000 distributed annually to agencies that serve individuals with mental illness in Jefferson County. 19 § Access to Care (Insurance Coverage) COMTREA Outreach & Enrollment program works to get everyone who qualifies enrolled in Medicaid and health insurance. § Access to Care (Availability of Services) In addition to the 11 clinical sites for scheduled appointments and follow-up, COMTREA provides same day access for behavioral health needs at the Welcome Center located in Festus, same day/emergency oral health needs at Twin Cities Dental in Festus, and same day walk-in for primary care services at both Emerson and Hickory Plaza. § Housing COMTREA assists individuals and families impacted by behavioral health and other disorders with obtaining and sustaining stable housing. Services are provided utilizing state and federal resources and include case management, financial assistance for independent and residential care placement costs, and linkage to community housing supports.
EVALUATION OF IMPACT § Chronic Disease Monitoring/Management COMTREA provides chronic care management for all individuals served with comprehensive care management including care transitions and coordination of home- and community-based services. COMTREA’s Primary Care Health Home (PCHH) and Behavioral Health Care Home (BH HCH) are models for Chronic Disease Management with a team approach consisting of the Nurse Care Manager (RN), Behavioral Health Consultant (LCSW), Patient Care Coordinator and a physician champion. The PCHH is customized to meet the specific needs of low-income patients with chronic medical conditions such as diabetes, cardiovascular disease, obesity, chronic obstructive pulmonary disease, mental health condition, substance use disorder, asthma, and tobacco use. 20 Clients enrolled in BH HCH have at least two chronic disease. The nurse care managers give basic health management information for specific disease processes and ways to improve overall health. We can also help with diabetes management (A 1 c, glucose monitoring and discussing diet changes), if that is something that the client needs help with. The nurse care managers will also give the clients names of possible referral doctors for specialty practices like endocrinologists or cardiologists. They ask that the clients take the names to their PCP for an actual referral since it needs to come from their PCP. Ø The Nurse Care Manger takes a lead role by the promotion of health services including increasing an individual’s health literacy, development of individualize treatment and or selfmanagement plans, assisting with obtaining and adhering to medications and other prescribed treatments. Ø The Patient Care Coordinator assists with the individual’s barriers by finding an appropriate linkage for appointment scheduling, referrals, follow-up monitoring, and communicating with other providers and family members when needed.
EVALUATION OF IMPACT § Obesity/Poor Nutrition/Physical Inactivity The management of obesity is a growing issue within Jefferson County. Food intake, eating disorders, sedentary lifestyle, physiological influences, and or prescription medication are some of the causes that the clinical team assess for reasons of obesity. Health promotions that are always a constant is encouraging exercise or diet alterations. An integrated approach with Primary Care and Behavioral Health is with individualized lifestyle counseling and motivational interviewing to try and achieve healthy changes in behaviors. Social Determinants of Health Screenings are performed to help reduce barriers when it comes to poor nutrition and physical inactivity. COMTREA offers food portioned plates, FIT BITs, Health Cook Books and scales as tools to assist in weight loss. Community based staff (Community Health Workers, Community Support Specialists) work directly with individuals served including shopping for healthy food choices, healthy food preparation and food bank access. Prevention and education is key, so at every visit all individuals starting at the age of 3, who are evident of an above average body mass index, are counseled for nutrition and physical activity at the time of service. We also use many of our community partners from the Jefferson County Health Department’s trained Dieticians, Local Hospitals, and the YMCA, who all offer a reduced cost for services for those individuals who could not otherwise afford services. Promotion of the use of local school gym tracks and parks are shared with individuals. For many who do not have easy access to some of these facilities, education on how to exercise around the home is given. 21 § Violence COMTREA provides crisis intervention, as appropriate, via phone and face to face. Our Crisis Intervention Team provides direct supports, referrals and crisis resolution. Our CMHL (Community Mental Health Liaison) provides support to law enforcement. Clinical staff also work with community partners to provide direct intervention and or referrals related to domestic violence and or intimate partner violence. A Safe Place pamphlets are available in each office, along with other community resources. § Tobacco Use COMTREA has staff trained, both nursing and clinical, in Tobacco Cessation. This is addressed in the full assessment from clinical staff and providers and this service is provided to clients throughout the year, individually and in group settings. Additional resources include use of the MO Quit Line. When individuals served present for oral health services, dentists and dental assistants discuss the importance of smoking cessation and pamphlets are available in each office
EVALUATION OF IMPACT § Dental/Oral Health COMTREA provides comprehensive dental care as part of the FQHC. Additionally, COMTREA provides the following: mobile dental program that serves preschool, school based programs and residential facilities; MAP clinic (55 -foot trailer with 3 operatories) that serves various locations through Jefferson County on a rotating schedule; and a Walk In Clinic for dental emergencies. § Accidents/Unintentional Injuries Unintentional injuries can lead to lost lives, high health costs, and a decreased quality of life, and yet many can be preventable, which is why the entire health team at COMTREA promotes safety tips to individuals served and their family members as part of their everyday care received. Predictable and preventable educational promotions include wearing seat belts, bicycle safety, home fall prevention, swimming safety, gun lock safety, proper medication storage, and wearing sun screen. Outside the clinic, the Community Health Worker and the Community Support Specialist, who visit the individuals in their home environment assesses and address any safety concerns they may observe The Primary Care Physician is usually the first step with x-rays and treatment as indicated. If the injury was severe and needed immediate treatment we would obviously send them to the ER. 22
COMTREA LEADERSHIP 23 Involved at the state level and within the community • BHR Board Chair • Comm. Care Board Secretary • Mo Coalition for Community Beh Health Board • BHN Visioning Workgroup • DDA Board Chair • Mo Coalition for Comm BH • MPCA CMO Meetings • St. Louis Com College Hygiene Advisory Board • MPCA Dental Director Meetings • Greater St. Louis Dental Society Amy Rhodes Margo Pigg Dr. Rohatgi Dr. Garland • Health Services Advisory Committee – Head Start • MOQuin • Health Care Compliance Association • Katie – Natl Human Resource Association (NHRA) • MPCA HR Meetings • JCHN Provider Recruitment • JCGA Board Secretary • Counselor Advisory Group – JRVII • Northwest Chamber Member • Leading Ladies Business Group Jeff County • • • MPCA Executive Board MHP Executive Board Pony Bird Board SSM Advisory Board Enterprise Bank Advisory Board • Kiwanis (Festus) • Jefferson County Park Board • COO Group at state level with MPCA • CFO Group at state level for BH Coalition and MPCA Sue Curfman Lisa Rothweiler • Festus/CC Rotary • Twin City Optimist Club • CAC of E Central MO Advisory Board • A Safe Place Committee • Child Abuse and Neglect Review Board State of MO • Missouri Kids First Directors Committee • CANRB committee cochair Kim Elbl Cindy Vessell Patty Vanek Katy Murray • Donna – Society for Human Resource Management (SHRM) of Greater St. Louis Katie Harman/Donna Harris-Brekel Lisa Wigger
FY 2020 STRATEGIC PLANNING TIMEFRAME 24 Phase 1 Phase 2 Phase 3 Phase 4 Phase 5 July – Dec 2018 • CHNA – Focus Group Sessions throughout the county Jan – Feb 2019 • COMTREA Stakeholder Survey • Employee Engagement Mar – Apr 2019 • Data Aggregate • Review and Prioritization May 2019 • FY 2020 Update • CHNA COMTREA written report June 2019 • Presentation to the Board • Board Approval • FY 2020 Implementation
10 BIG ROCKS & FULL STRATEGIC PLAN The full FY 2020 Strategic Plan, 10 Big Rocks and 3 yr plan are attached to your meeting packet for review. The Board will vote to approve these at the June 17 th, 2019 Annual Meeting. 25
THREE YEAR STRATEGIC PLAN FY 2018 -2020 GOAL / INDICATOR - THREE YEAR STRATEGIC PLAN Mission and Community Collaboration 1 2 3 4 5 6 7 Increased behavioral health services and access, both mental health & substance use, across the age continuum (children, youth and adult) MOUs & Engagement with referral partners, including hospitals, to strengthen/expand the continuum of care for individuals served Integration/Collaboration of community resources Early intervention and outreach to early childhood Emergency shelter and transitional housing Education for individuals served for identified topics of nutrition, parenting, smoking cessation & vocational training Establish a process for funding requests made from agencies that serve individuals with mental illness in Jefferson County. 26 FY 2018 FY 2019 FY 2020 1 1 1 1 Employee Engagement & Leadership Training 1 2 3 4 5 6 7 8 Compensation Package - Salary Scales, Incentive payment methodology & bonuses; Performance appraisal process & merit-based increases; and Company benefits Recruitment of qualified professionals and providers Staff Retention and Leadership Mentoring program Cross training support staff with consistency across departments and programs Organizational mapping/charts with work flows, work load determination & scope Improved Security at all locations. Internal Networking Updated Mission Statement 1 1 1 Note: 3 year update FY 2021 -2023 we anticipate significant changes to parallel the healthcare transformation. The Big Rocks and Priorities will change to value based payment, digital technology (reduction in face to face clinician visits, addressing housing, transportation and food along with the inclusion of social determinants.
THREE YEAR STRATEGIC PLAN FY 2018 -2020 GOAL / INDICATOR - THREE YEAR STRATEGIC PLAN Accountability and Financial Sustainability 1 2 Marketing with specific need to increase community awareness of what COMTREA does Funding for services from Federal and State Agencies and readiness for alternative payment systems including capitation, P 4 P and increased risk sharing. 3 4 5 6 7 8 9 10 11 More innovative, efficient and integrated use of the school liaison program EMR Integration with data accessibility to all staff and user friendly dashboard Financial readiness for new medical center loan External Technology (website, resource friendly) Upkeep of current facilities with new paint, color scheme and flooring Restructure access to invoice payments processing, ordering & payment approval system Sliding scale & all fee schedules Expand strengthen partnership with schools Implement Security Awareness and Training program for electronic information FY 2018 1 27 FY 2019 FY 2020 1 1 Integrated Care Delivery 1 2 3 4 5 Telehealth & teleconsultation Improve & expand core services Integrated delivery of care by site (multidisciplinary teams) and future new build Affordable Health Care & Medication Funding Timely access to obtain a 1 st appointment with a standardized integrated intake & timely follow-up appointments 6 Internal referral process through defined work flows with designated contact points to improve access to care and quality outcomes. 7 8 9 Outreach and Engagement Evening and weekend hours for all services Phone contact and scheduling issues 1 1 1 1
BUDGET FY 2020
BUDGET FY 2020 REVENUES: CLIENT 1, 227, 282. 00 GROUP HEALTH INSURANCE/EAP 1, 803, 630. 00 MC+ 5, 140, 854. 00 DMH/MEDICAID 11, 055, 000. 00 MEDICAID - STRAIGHT 2, 836, 158. 00 MEDICARE 382, 821. 00 COURT 85, 000. 00 GRANTS 3, 071, 000. 00 SALES TAX 2, 800, 000. 00 MIL TAX 2, 900, 000. 00 UNITED WAY 84, 600. 00 FUND RAISING/DONATIONS 258, 000. 00 SCHOOL SERVICES 25, 000. 00 340 B PHARMACY 740, 000. 00 OTHER 277, 500. 00 OPERATING REVENUE $ 32, 686, 845 29
BUDGET FY 2020 – PERSONNEL EXPENSES: SALARIES 19, 055, 620 Staff Count Total 435 ( 403. 34 FTE) 1, 4 PAYROLL TAXES 56, 607 2, 1 Full time – 348 BENEFITS 78, 147 Part time/PRN – 45 (24. 61 FTE) TRAINING & EDUCATION 75, 223 CONTRACTED PSYCHIATRIST 50, 000 Physician Primary Care – 3 (1. 6 FTE) 3 NP – Primary Care – 4 (3. 25 FTE) Psychiatrist – 6 (4. 08 FTE) PERSONNEL EXPENSES 403. 34 FTE Benefits = 19. 47% of salaries $23, 115, 597 Contracted Psychiatrist – 7 (1. 5 FTE) APN – Psychiatry – 4 (3. 5 FTE) 74. 4% OF TOTAL Dentist – 14 (11 FTE) BUDGET Hygienist – 11 (10. 3 FTE) 30
BUDGET FY 2020 – OPERATING EXPENSES 31 4 PROF FEES-CONTRACT 55, 300 MARKETING 00, 845 PROF FEES-OTHER (AUDIT & LEGAL) 45, 000 FUND RAISING 66, 000 TRAVEL MEDICAL-PRESCRIPTIONS/LABS/RADIOLOGY/340 B INVENTORY BUILDING-RENT BUILDNG-UTIL 58, 290 82, 500 58, 789 09, 000 1, 3 FOOD SERVICE 10, 000 2 CONTRACTED SERVICES 24, 707 1 HOUSING EXPENSE 10, 000 DEPRECIATION 3 94, 236 INTEREST-BUILDING 2 46, 800 BAD DEBTS 50, 000 93, 131 COMM-TELEPHONE 59, 101 INSURANCE-PROPERTY/LIABILITY 03, 552 INSURANCE-WORK COMP REP & MAINT 1 18, 000 1 OTHER 91, 090 6 SUPPLIES 50, 730 1 EQUIPMENT 69, 797 VEHICLE EXPENSES 05, 600 RECRUITING 44, 000 OPERATING EXPENSES 2 $ 31, 062, 065
BUDGET FY 2020 OPERATING REVENUE $32, 686, 845 OPERATING EXPENSES $ 31, 062, 065 OPERATING PROFIT/LOSS $ 1, 624, 780 32 4. 97% Revenues § § § All projections reviewed and approved by program directors Revenues are based on expectation of productivity factoring a 30% no show rate Sales Tax / MIL Tax – no increase Total Revenue 6. 4% increase over current year end projections Patient Revenues 9. 3% increase over current year end projections
BUDGET FY 2020 Expenses § 5 New Positions + Current positions = 435 Positions § Salary Adjustments include: Ø 1. 5% COLA Ø 1% Performance increase (distribution to be determined) § Benefits at 10% increase overall § All expenses based on trends, norms and any specific increase due to need. 33 Expenditures - Construction A Safe Place Transitional Housing Maintenance Shed Painting Outside Bldg A & B - Festus Parking Lot - Arnold Parking Lot – High Ridge Budget Impact $1, 200, 000 $50, 000 $45, 000 $9, 000 $35, 000 Expenditures – Equipment/Furniture Replace 12 vehicles through Enterprise Leasing ($4944/car/year) IT System – EMR, software & upgrades Carpet - Arnold Misc. Office equipment/furniture Budget Impact $60, 000 $200, 000 $50, 000 $100, 000 *Equipment purchases will be made as cash flow is maintained and agency operations are stable. Approved purchases are subject to change.
PROJECTED CASH 6/30/2020 Beginning Cash 7/1/2019(est. ) 34 $ 1, 200, 000 Budgeted Change in Net Assets 1, 624, 781 Budgeted Increase of MHOH funds includes $696, 455 restricted for MHOH 773, 766 Add Back in Depr (non cash) 1, 304, 236 Add Back in Bad Debt (non cash) 150, 000 Add Back - Principal Payments from Sunny Hill 87, 064 Cash for Principal Payments (867, 905) includes line of credit Capital Projects: A Safe Place Transitional Housing Maintenance Shed (50, 000) IT Infrastructure (200, 000) Painting - Festus (45, 000) 12 vehicles (Lease) (60, 000) Carpet Arnold (50, 000) Parking Lot - High Ridge & Arnold (44, 000) Misc. Furniture & Equipment Ending Cash Balance 6/30/2020 (1, 200, 000) (100, 000) $ 2, 522, 942 includes approx. $280, 221 for MHOH
MHOH BUDGET FY 2020
MHOH BUDGET FY 2020 COMMUNITY TREATMENT, INC Mary's House of Hope Capital Project FY 2020 BUDGET DRAFT - TO BE APPROVED 6/17/19 REVENUES: 36 PROF FEES-CONTRACT 7, 218 SUPPLIES 1, 000 MARKETING 2, 500 GRANTS 460, 000 FUND RAISING/DONATIONS 366, 000 REP & MAINT OPERATING REVENUE $826, 00 0 CONTRACTED SERVICES DEPRECIATION EXPENSES: SALARIES OTHER 13, 858 PAYROLL TAXES 1, 060 BENEFITS 2, 598 PERSONNEL EXPENSES --. 50 FTE $17, 516 11, 000 500 2, 000 10, 000 500 OPERATING EXPENSES OPER PROFIT/LOSS $773, 766 93. 68% $52, 234
DON’T FORGET! COMTREA BOARD MEETING Monday, June 17 th at 7: 30 am, JCCMHFB Meeting follows immediately
- Slides: 37