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HomeMy WebLinkAboutResolutions - 1993.05.27 - 23258MISCELLANEOUS RESOLUTION I/93092 May 27, 1993 BY: GENERAL GOVERNMENT COMMITTEE - DONALD W. JENSEN, CHAIRPERSON IN RE: DEPARTMENT OF INSTITUTIONAL AND HUMAN SERVICES - COMMUNITY MENTAL HEALTH "FULL MANAGEMENT" CONTRACT TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: WHEREAS the Investigating Team created pursuant to Miscellaneous Resolution #92064, has explored the potential advantages and disadvantages of a "Full Management" contract between the Oakland County Community Mental Health Services Board and the Michigan Department of Mental Health, and has recommended a contract that maximizes the advantages to the County inherent in the State's model, while minimizing or eliminating many of the disadvantages; and WHEREAS the Community Mental Health Services Board has recommended that it enter into the Full Management contract developed by the Investigating Team, whereby the Community Mental Health Services Board would assume responsibility for funding and oversight of all public mental health services to Oakland County citizens, whether rendered by the State, the County or other contractual providers; and WHEREAS the Oakland County Executive supports the proposed Full Management contract at total State funding level of $82,492,131, which improves the County's position in per-capita State mental health funding in comparison with other counties; and WHEREAS the Oakland County Board of Commissioners is supportive of its Community Mental Health Services Board assuming Full Management authority, and recognizes that the contract as presented would be financially and programmatically beneficial to the County's Community Mental Health program and the citizens it serves. NOW THEREFORE BE IT RESOLVED that the Oakland County Community Mental Health Services Board is authorized to execute the Full Management contract as developed and recommended by the Investigating Team. BE IT FURTHER RESOLVED that termination of the Full Management contract (except as provided in Part I (A) (8) of the contract), or amendment of the contract, shall require the prior and express approval of the Oakland County Board of Commissioners. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. GENERAL GOVERNMENT COMMITTEE [1.2*.1.1.1n10 W-- L. BROOKS PATTERSON OAKLAND COUNTY EXECUTIVE MICHIGAN COUNTY 2 3 Ic ve40=t Jars K.'HaVeman, Di May 24, 1993 MEMORANDUM OF UNDERSTANDING BETWEEN OAKLAND COUNTY AND THE MICHIGAN DEPARTMENT OF MENTAL HEALTH 1) Oakland County agrees to enter into a full management contract with the Michigan Department of Mental Health as quickly as possible so that full management is achieved by July 1, 1993. The approval date of the contract shall be June 1, 1993 or before and will cover the period October 1, 1992 through September 30, 1993. The Michigan Department of Mental Health has obligated $82,492,131 in State funds in support of formula funding. Included within the $82,492,131 is $50,000 for one-half of the cost of a facilitator mutually selected by the Department of Mental Health and Oakland's Office of the County Executive. 4) The Department of Mental Health imposed a 2.1 percent funding reduction applied to other Community Mental Health Boards in fiscal year 1991-92. Had the County not accepted full management for the 1992-93 fiscal year, the funding reduction would have been required of the County. As a condition of Oakland County's adoption of full management, the Department of Mental Health shall permanently forgive this funding reduction. 1,14/94nigan Department of Mental Health ef V ci (0:5 • Date Nat Pernick, M.D., Vice-Chairman Oakland County CMH Services Board Date L. Brooks PaVterson /Date Oakland County Executive Larry Crake, Chairman Oakland County Board of Commissioners Date EXECUTIVE OFFICE BUILDING e 1200 N TELEGRAPH RD DEPT 409 * PONTIAC MI 48341-0409 e (313; 25E-0/184 * FAX (313) 452-9215 MICHIGAN DEPARTMENT OF MENTAL HEALTH/ OAKLAND COUNTY COMMUNITY MENTAL HEALTH SERVICES BOARD CONTRACT FOR FULL MANAGEMENT PART I A. General Provisions The Michigan Department of Mental Health (hereinafter "Department") and the Oakland County Community Mental Health Services Board (hereinafter "Board"), agree to the provisions of this Contract for the purpose of ensuring the provision of services to identified populations according to standards and policies as specified in this Contract. Notwithstanding any provisions in this Contract, the Department shall retain its constitutional and statutory responsibility for providing Mental Health services for county residents with the Board acting under contract with the State. Nothing in this Contract shall require the County of Oakland or its Board to commit funds in excess of the local match requirements established in the Michigan Mental Health Code. 2. This Contract is entered into under the authority granted by Sections 116(e)(ii) and 6) and Sections 226(g) and 228 of Act 258 of the Public Acts of 1974, as amended. Provisions of that Act, all rules promulgated and adopted under that Act and applicable state and federal laws shall govern the expenditure of funds and provision of services. The Community Mental Health Board enters into this Contract under the authority granted in Section 226(g) and 228 of Act 258 of Public Acts of 1974 and by Oakland County Board of Commissioners Miscellaneous Resolution 93 , or pertinent subsequent resolutions authorizing full management status. 3. This Contract shall not be construed to establish any employer-employee or principal- agency relationship between employees of the Board and the Department, nor between any of the Board's subcontractors or subcontractor's employees and the Department. 4. The Board shall have the freedom to arrange for the provision of Mental Health services as it deems necessary and appropriate, in accordance with Oakland County Board of Commissioners procedures. The Board may subcontract for the provision of any of the services specified in this Contract. The terms and conditions of its contracts shall be within the exclusive discretion of the Board and not subject to the review of the Department. The Board shall ensure that all subcontracts are conSistent with the provisions of this Master Contract and the affirmative action requirements as set forth in paragraphs I, B. 5 and 6. In the event a subcontract is determined to be inconsistent with this Master Contract, the provisions of the Master Contract shall prevail. .1/ r 5. This Contract shall commence on October 1, 1992 and shall constitute a continuing contractual arrangement unless amended or terminated according to the provisions for amendment or termination. The budget and fiscal provisions of this Contract shall be adjusted as funding authorizations issued by the Department change. An initial adjustment shall be made to reflect the DMH authorizations issued at the beginning of each fiscal year. The Department shall respond in writing to the submission of said adjustments covering a new fiscal year within thirty (30) days of submission of the document, signed by the Board, to the Department's Area Manager. The response shall either approve the adjustments or identify specific reasons for failure to approve. Failure to respond within thirty (30) days shall constitute approval of the adjustments. 6. With exception of those amendments described in Part I, C, 3, below, amendments may be made only by written agreement of the Department and the Board acting under the authority,of Oakland County Board of Commissioners Resolution. A request for such amendment must be received no later than forty-five (45) days following the end of the state fiscal year. Failure by any party to approve or deny in writing a request for amendment within thirty (30) days of receipt of such request shall constitute approval of the amendment. 7. A written request for a compliance review of provisions of this Contract may be initiated by either party to the Contract. Such a request shall include a statement of specific areas of alleged non-compliance. A written response to such a request shall be provided by certified mail within thirty (30) calendar days of receipt of the request. The response shall either (a) present facts which refute the allegation of non-compliance, or (b) present a proposal for remediation which may include amendment to the Contract. Failure to respond in writing within thirty (30) days shall be deemed as verification and acceptance of the allegation. Should the response be unsatisfactory, a request for a hearing involving the Department Director, the Board Director and other parties as may be designated by either will be held. Such hearing shall be scheduled within thirty (30) days of receipt of the request. The results of this hearing shall be provided in writing to both parties within fifteen (15) days of the hearing. 8. This Contract may be terminated at any time by either party by giving one hundred twenty (120) days notice in writing to the other party by certified mail or within a time frame mutually agreed upon. Such termination shall not relieve either party of any obligations incurred prior to the effective date of such termination. It is mutually agreed that if total Slate funding for all programs and populations for Oakland County drops below either (a) 95% of the previous year's full year cost funding, or (b) the sum of $72,598,700 as adjusted for inflation, whichever is greater, then this shall cause the Contract to cease within 120 days or a time mutually agreed upon, unless contraindicated by the Oakland County Board of Commissioners. 9. All liability, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities to be carried out pursuant to the obligation of the County of Oakland or the Board under this Contract shall be the responsibility of the County and the Board, and not the responsibility of the Department, if the liability, loss, or damage is caused by, or arises out of, the actions or failure to act on the part of any County or Board member, employee, or agent, provided that nothing herein shall be construed as a waiver of any governmental immunity the County, the Board, their agencies or employees has, as provided by statute or modified by court decisions. 2 10. All liability, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities to be carried out pursuant to the obligations of the Department under this Contract shall be the responsibility of the Department and not the responsibility of the County or the Board if the liability, loss, or damage is caused by ; or arises out of, the action or failure to act on the part of any Department employee or agent, provided that nothing herein shall be construed as a waiver of any Governmental immunity the State, its agencies or employees has, as provided by statute or modified by court decisions. 11. All costs, including reasonable attorney fees which the County and/or the Board may incur in the event that the courts of this state hold that a co-employer status exists with reference to persons employed in non-inpatient residential facilities under contract with the Board, shall be the responsibility of the Department and not the responsibility of the County or the Board, provided, that said costs are anributable solely to that period of time prior to the transfer of contracts for such residential facilities from the State of Michigan to the County and the Board. 12. Both parties recognize that the Department will abide by and enforce the operating procedures contained in the State Facility/Board Agreement(s), and the said Agreement(s), when agreed upon by the Department, State Facilities/Centers, and the Board, will be appended to this Master Contract between the Department and the Board. The operating procedures contained in these agreements shall establish the Board as the single point of entry to and exit from State facilities/centers and shall include provisions for all of the following: a. Evaluating the appropriateness of an individual for admission and preparation of an alternative treatment report. b. Serving as the single point of entry to a state facility/center. c. Participation by the Board in providing treatment. d. Discharge of residents at the time and in the manner determined by the Board. e. State facility or center/Board agreements shall provide a procedure for Board review of recipient rights formal complaints filed by or on behalf of Oakland County patients in the facility/center or its contracted services. f. All physicians employed by or under contract to the Board shall have the right to be accorded admitting, treatment and discharge privileges at State manacled facilities/centers in accordance with medical staff by-laws. 13. In the event that circumstances occur that are not reasonably foreseeable, or are beyond the Board's or Department's control, which substantially reduce or otherwise interfere with the Board's or Department's ability to provide or maintain specified services or operational procedures for its County, the parties to the Contract shall immediately notify the other party and shall negotiate a revision of the Service Summary and Spending Plan reflective of the reduction which shall become an amendment to this contract, Examples of such occurrences include, but are not limited to, default of subcontracts, acts of God, damage to facilities, employee strikes, and ruling(s), order(s) and/or opinion(s) of a State or Federal Court. 3 14. Department policies to be implemented by the Board during the life of the Contract shall be limited to applicable Federal and State statutes and local ordinances and policies enumerated in this Contract, including its attachments and in the CMFI/State inpatient facility/center contracts. 15. In the event that a new Fiscal Addendum to this Contract is not signed by the end of the State fiscal year of the current Addendum, the terms, conditions and funding levels contained in the current Fiscal Addendum attached to this Contract shall remain in effect, subject to legislative appropriation, and for ninety (90) days following issuance of the Board's base continuation allocation and appropriated economic increases applicable to the new fiscal year. By mutual written consent, this Fiscal Addendum, in whole or in part, may be extended further. The conditions in the contract governing fiscal year closing and cost settlement shall pertain if the Contract is continued. 16. Inquiries and requests concerning the terms and conditions of this Contract, including requests for amendment, should be directed by the Board to the attention of the Department's Area Manager serving the Board's area, Performance and expenditure reports should be submitted to the Department of Mental Health, Finance Division, with a copy to the Area Manager, and a copy to the Department's Bureau of Community Mental Health Services in Lansing. 17. Notwithstanding any provision of this agreement to the contrary, this Contract shall not be construed or interpreted to permit a violation of the Consent Judgment of July 29, 1991, entered in the matter of Oakland County v State of Michigan Department of Mental Health ; et. _al., nor shall it constitute a waiver of the provisions of said judgment by Oakland County. Further, it shall not be construed to allow a violation of Const. 1963, art. 9, 5 29. B. Board Assurances The Board agrees: 1. To ensure the provision of services to populations designated in Part II of this Contract. The populations to be served shall include: a. Individuals located in the service area of the Board who are not residents of Department state inpatient facilities/centers or Department contracted residential settings; and b. Individuals located in Department state inpatient facilities/centers or Department contract residential settings for whom the Board (County) is financially liable for the cost of care under P.A. 258 of 1974, Sec. 306. 2. To comply with the operational procedures specified in Part Ill of this Contract. 3. To immediately notify the Department of modifications in provision of services and compliance with operational procedures under the following conditions: a. Action by the Oakland County Board of Commissioners which removes the Board's funding for or authority to provide specified services. 4 b. Action by the Oakland County Board of Commissioners which reduces the Board's funding level below that required to maintain specified services in the Board's service area. c. Action by Federal or local funding sources which removes funding or reduces the Board's funding levels below that required to maintain specified services in the Board's serve area. In the event of any or all of the conditions specified in "a" through "c" occurring, the Board shall submit a revision of the Service Summary and Spending Plan reflective of the reduction, which shall become an amendment to this Contract. Such amendments shall be received by the Department no later than forty-five (45) days following the end of the contract period. Failure by the Department to approve or deny the request within thirty (30) days shall constitute approval. 4. To permit authorized representatives of the Department or a properly identified representative of a DSS Medicaid Review Office, to make such review of the records of the Board as may be deemed necessary to satisfy audit purposes. That no otherwise qualified person shall be excluded from participation in, be denied the benefits of, or be subject to discrimination in any programs or activities solely on the basis of race, color, national origin, religion, age, sex, marital status, physical or mental handicap, or ability or inability to pay therefor. The Board agrees to analyze service delivery by age, race, sex and physical handicap, to identify barriers to service delivery for those groups found to be under-served, and to prepare a plan for removing such barriers. 6. That no employee or applicant for employment shall be subjected to discrimination with respect to hiring, recruitment, advancement or discharge or in the terms, conditions or privileges of employment, or a matter directly or indirectly related to employment solely because of religion, race, color, national origin, age, sex, height, weight, marital status, record or arrest without conviction, or physical or mental handicap, and that affirmative action will be taken to assure equal employment opportunity for Blacks, Hispanics, American Indians, Asians, women and handicappers where they are under-utilized, by making all good-faith efforts to comply with the goals contained in Oakland County's approved Affirmative Action Plan. 7. To comply with program and fiscal standards identified in Attachments A and B, which are attached to and made a part of this Contract. 8. To furnish to the Department statistical and other management information as designated in Parts ll and Ill of this Contract. Information concerning services provided and expenditures shall be submitted no later than thirty (30) days following the end of each reporting period. A preliminary written estimate of anticipated accounts payable to the Department or accounts receivable from the Department shall be submitted within sixty (60) days following the end of the contract year. The final year-end report shall be submitted within ninety (90) days following the end of the State's fiscal year. The reporting requirements for grant projects shall be specified in the agreement governing the grant, which shall be appended to and become part of this Contract. 5 9. To ensure the collection of information required by the CMH Face Sheets (DMH-1810 & DMH-1830), Staff Activity Form (DMH-1709) and Client Attendance Form (DMH-1710). The Board agrees to submit information generated from these data when specifically requested with at least thirty (30) days notice from the Department. 10. To submit a written report to the Department explaining deviations from the Contract with regard to services provided or expenditures by non-Department agencies within sixty (60) days of the end of each reporting period. This report must present a proposal to bring performance and/or expenditures into conformance with the total contractual commitment or request a revision to the Contract, if: a. The deviation is projected to result in a deviation in excess of ten percent (10%) from the total projected end of year expenditures. • - b. The deviation is projected to result in a deviation in excess of five percent (5%) from projected end of year expenditures for Board Administration. The Department shall approve or disapprove the Board proposal for remediation in writing within thirty (30) days of receipt of the Board's report. If approval or disapproval is not received within thirty (30) days, the proposal shall be deemed approved. A report of deviation shall not be construed as a determination of compliance or non- compliance with this Contract. C. Department Assurances The Department agrees: 1. To provide funds to the Board, subject to legislative appropriation and availability of funds, as stipulated in the Fiscal Addendum to this Contract for assuring that services designated in Part II and the Fiscal Addendum of this Contract are provided. 2. To ensure funding stability, subject to the availability of legislatively appropriated and allocated funds, to the Board during the life of the Contract. The Department shall immediately notify the Board of modifications in funding commitments in the Contract under the following conditions: a. Action by the State legislature which removes the Department's funding for, or authority to provide for, specified services. b. Action by the State legislature which reduces the Department's funding level below that required to maintain services on a Statewide basis. c. Action by the Governor pursuant to Const. 1963, art. 5, 5320 which removes the Department's funding for specified services, or which reduces the Department's funding level below that required to maintain services on a Statewide basis. d. A formal directive by the Governor, or Department of Management and Budget on behalf of the Governor, requiring a reduction in expenditures below that incorporated in contracts. 6 In the event of any of the conditions specified in "a" through "d" occurring, the Board shall submit a revision of its Service Summary and Spending Plan reflective of the funding reduction, which shall become an amendment to this Contract. In the event of a reduction of funding to the Board, the Board shall, subject to the provisions of Part I , Section A, paragraph 8, decide how the reduction is to be implemented within its programs, within policy established in the P.A. 258 of 1974 and its Rules, except that: Reduction of services underwritten by funds allocated by the State legislature for demonstration and prevention grants shall be negotiated with the Department. Funding in the base for continuation of demonstration projects shall be governed • by Department Guideline 1V-H-007-0001. 3. To permit the Board to redirect funds within target populations (M1-A, MI-C, DD, Other) among program elements as clients move to more appropriate treatment settings, with the exceptions noted in the Fiscal Addendum, Section 2 (A). The Board may redirect Department funds, with the exception of those funds identified in the Fiscal Addendum, Section 2(A), among target populations (MI-A, MI-C, DD, Board Administration and Other Populations) as changing needs of the Board's residents require response from the Board, so long as the amount of Department funding transferred into or out of each population group and Board Administration, in any given State fiscal year, does not exceed five percent (5%) of the amount allocated to each population and Board Administration in the original Contract. If movement of clients and the funds associated with their care results in cost savings, the Board may utilize funds saved for the purpose of expanding or improving the Board's program, as contained in this Contract, during the life of this Contract. Redirected funds and cost savings realized as a result of movement of clients to more appropriate treatment settings shall be included in the Board's base program for the purpose of planning for the following fiscal year. Additional funds awarded to the Board beyond the base funding of this Contract as indicated in the Fiscal Addendum shall not be restricted for special categorical programs by the Department, unless so mandated by the State legislature or accepted by the Board for a specific program or population. Funds authorized to the Board by the Department for those purposes specified in the Fiscal Addendum, Section 2 of this Contract shall not be redirected without prior approval of the Department. 4. To provide ongoing assistance to the Board in the implementation of this Contract. 5. That it will not establish any direct funding to an agency or individual, absent legislative mandate, to serve Oakland County residents, nor with any Oakland County family, circumventing the Board. The Department certifies that all such contracts which it held prior to the inception of this Contract have, as of that date or a mutually agreed upon date, been terminated or transferred to the Board. This provision does not apply to contracts held by facilities/centers of the Department, for purchase of services consistent with the statutory function of said facilities/centers. 6. That it agrees to cooperate and assist in the Board's effort to pursue and collect funds from third-parties, whenever possible. 7 7. That it shall be financially responsible for all audit exceptions pertaining to State provided services which occurred prior to the date of this contract. 8. Nothing in this Contract shall negate the State of Michigan's ultimate constitutional responsibility to provide appropriate treatment for those persons adjudged to be a threat to themselves or others, in accordance with the provisions of P.A. 258 of 1974. PART 11 SPECIFICATION OF SERVICES. FUNDING LEVELS AND RELATED REPORTING REQUIREMENTS Section 1. Service Plan_ Service Plan funding levels are as set forth in the Fiscal Addendum attached to this Contract. Section 2. Funding Levels and Reporting Requirements A. Total Obligations Total funding obligations are set forth in the Fiscal Addendum attached to this Contract. B. Cash Advances Including Medicaid Advances Cash advances and Medicaid advances shall be made as set forth in the Fiscal Addendum attached to this Contract. The Medicaid advance amount will be adjusted at least annually and/or upon approval of a spending plan amendment which reflects a change in total Title XIX revenues of at least $300,000. Any decrease to this advance will be deducted from the regular monthly cash advances to the Board and the Department will notify the Board to adjust its Medicaid cash advance liability. Any increase to the Medicaid advance will be paid to the Board, and the Department will advise the Board to increase its Medicaid cash advance liability. The Department will also provide advances monthly, subject to availability of funds or conditions identified in Part I. The amount of each advance will be determined in accordance with the Board's Service Summary and5 ending Plan. This amount will consist of 1/12 of Federal Medicaid as reflected in the \ A -2-- Contract plusr1/2 f the Contract obligation which includes the State share of Medicaid. These cash advances will e reduced by the amount of gross Medicaid/Personal Care payments received since the previous Department advance of funds. This advance will not be affected by the fiscal year change. The Board's October advances will, therefore, be reduced by actual Medicaid payments processed by DSS/DMH during the month of August and so on. Advances are conditional upon receipt, within thirty (30) days of the end of each reporting period during the life of the Contract, of the following required reports completed in accordance with Department instructions: 1. A semi—annual report of services provided during the first two quarters of the State fiscal year which indicates number of clients served and units of services, by population and program element, completed according to instructions issued by the Department. 8 // 2. A bi-monthly expenditure report, completed according to instructions issued by the Department. Section 3 - Funding Obligations for State-Operated Services A. Funding obligations shall be as set forth in the Fiscal Addendum attached to this Contract. The Board may withhold payment for days of care provided to specified individuals when such care is delivered in a fashion which is contrary to the provisions stated in either the Master Full Management Contract or the facility/center subcontracts. Payments shall not be withheld until the Board has notified the facility/center director of specific areas, related to a specified client, in which the subcontract has been violated. A copy of this notification shall be forwarded by the Board to the Department's Area Manager within five (5) days of the point of non payment. B. The Department commits itself to a good-faith effort to achieve equitable funding for Oakland County in comparison with other counties, based on consideration of per-capita funding and other relevant factors. C. This Contract shall be reopened and the funding base revised in the event that the Board and/or the Department discovers data which supports such a revision. D. The Department agrees that when State-managed services are transferred to the Board, the State shall transfer dollars representing the negotiated amount that reflects the costs necessary to operate the program, including but not limited to, administrative and support costs, day programming, transportation, recipient rights protection, public relations costs, on to one staffing, power and other utility costs, exception payments, and day program funding for residential clients. Any and all programs and services currently under development by the Department for Oakland County residents shall be transferred to the Board with full funding folded into the base of this Contract. Any and all cost increases, either economic or salary, made to State-managed services or employees shall also be made available to the Board if funding is appropriated. E. Changes in State-operated facilities/centers' per diem rates will be accompanied by a corresponding change in State allocation to the Board's Contract base. F. The Department agrees to fund costs of serving "out-of-county' residents of residential facilities situated in Oakland County until such time as legislation is passed which addresses the transfer of financial responsibility for this population. G. All public mental health funds designated for direct or indirect treatment, administration, public relations, recipient rights or other support activities for Oakland County residents shall be provided by the Department to a single source, the Board. 9 3 H. The Department will arrange for the Board to receive notice from the Center for Forensic Psychiatry as soon as possible when the status of a forensic client may change to a probated order. It is the Department's intent that at least thirty (30) days prior notice shall be given. The Board is liable for the State share of inpatient costs under the probated order when the client is receiving service from a hospital under contract to the Board, except that such liability shall be waived for up to thirty (30) days from the date of receipt by the Board of the notice described in the preceding sentence. If this waiver is to be activated by the Board, it will provide appropriate documentation to its Area Manager demonstrating less than thirty (30) days notification. The Board agrees to initiate an effort with the probate courts and prosecutors in its catchment area within ninety (90) days after signing the Contract to develop agreements providing that those agencies notify and involve the Board in arranging services for persons being considered for a probated order, as well as persons in need of aftercare services. The Board shall have the right to admit its clients to State facilitiesicenters outside of its usual catchment areas for persons requiring specialized services not available at Clinton Valley Center or Fairlawn Center, with authorization from the Department. J. Full management bills for services provided by the Department will not be payable by the Board until thirty (30) days after the end of the month in which services were rendered. Payment for State-operated services shall be made at the full management billing rate in effect on October 1, 1992 based upon a bill which identifies the individuals served and days of care provided at a fixed net State cost per day. The Board shall authorize payment of undisputed bills within thirty (30) days of receipt of the bill, or thirty (30) days following receipt of the advance, whichever is later. Failure to authorize payment of undisputed billings when due will result in delayed advances. K. The Board agrees to authorize payment of the county match portion of the net cost of services provided to persons who are its residents as defined by Section 306 of P.A. 258 of 1974. Authorization of undisputed bills or undisputed portions of bills will be made within thirty (30) days of receipt of the billing. The Board agrees to identify to the Department disputes concerning bills on a case-by-case basis within thirty (30) days of the bill and to work with the Department in • resolving these disputes on a timely basis. The Department may refer to the Department of Treasury for collection of all bills which are both undisputed and overdue. Section 4. Cost Settlement With regard to funds expended for provision of services covered by the Board's Service Summary and Spending Plan, the Department will cost settle with the Board subject to contract liMitations based upon the Board's reported actual net matchable costs by target population, identified in accordance with general accounting principles and in accordance with the Community Mental Health Financing Guidelines published by the Department pursuant to Administrative Rules R.2038 and R.2044 (IV-F-001-0001, 1117/85), as revised, contained in the addendum to Attachment C of this Contract. Matchable expenses are subject to audit by the Department or by the Auditor General. End-of-the-year cost settlements shall be considered final and not reopened for negotiation in subsequent fiscal years as it regards the State share of cost of services, except where audit finds the basis for cost settlement to be inaccurate or out of compliance with Department guidelines. 10 < PART III !OPERATING PROCEDURES A. Financial Management Procedures. 1. Payable for Medicaid Fund Advance. The Medicaid advance is provided as additional cash to meet current obligations pending receipt of reimbursement for Title XIX billings. This advance amount does not increase the Department's commitment or establish any additional spending authority in excess of Department matchable costs as obligated in the approved spending plan. It is agreed that the Medicaid advance represents an on going liability due to the state. In the event that the Contract is amended, terminated, or the Legislature requires the return of this advance to the State, the Board will refund the permanent advance in full within thirty (30) days. If the Board is unable to return the full amount of the advance, it is acireed that the Department will collect the outstanding advance from future cash advances to the Board, Medicaid or personal care payments and/or from the County's revenue sharing payments through the Department of Treasury. At the end of each fiscal year, the Board must cert4 in writing to the Department with submission of the final expenditure report or earlier with the new year Contract Fiscal Addendum submission that the permanent advance has been maintained and a liability totaling $ 1,145,832 is recognized as being due to the State of Michigan. It should be further indicated that this advance has not been committed or obligated for expansion of Board operations beyond the amounts authorized in the approved spending plan. Upon receipt of this certification and approval of a Board Spending Plan for the new fiscal year, any decrease indicated to the Medicaid advance will be deducted from the regular monthly cash advances to the Board, and the Department will advise the Board to adjust its Medicaid cash advance liability accordingly. Any increase to the Medicaid advance will be processed as an additional payment to the Board with a letter advising the Board to increase its Medicaid cash advance liability. 2. Accounting and Auditina Standards, Principles and Procedures: Expenditure reports are to reflect the accrual of client-based revenues. The following documents should guide Board accounting procedures: • a. National Council of Governmental Accounting (MGA) - Statement Nos. 1 and 2 (March 1979), No. 3 (December 1981) and No. 4 (August 1982). b. Michigan Governmental Accounting and Auditing Guide, issued by the Department of Treasury, State of Michigan (April 1982). c. Uniform Reporting Format for Financial Statements for Counties and Local Units of Government in Michigan, issued by the Department of Treasury, State of Michigan (April 1982). d. Audits of State and Local Governmental Units, issued by the American Institute 11 • / of Certified Public Accountants in 1978, 3. Fiscal Auditing The Board will ensure that a fiscal audit of each of its service agencies identified by the Board and the Department is performed in conformance with the Departments CMH Financing Guidelines, and the results submitted to the Department, if requested. b. The Board agrees to permit the Department to conduct an annual financial audit of the Board's fiscal records and/or submit an independent audit for this contract period. 4. County Appropriation Process The appropriation by the County Board of Commissioners and the appropriation process, as it relates to the responsibility of the County Executive and the Board of Commissioners, shall be in accordance with Public Act 2 of the Public Acts of 1968, as amended, known as the "Uniform Budgeting and Accounting Act," and the General Appropriations Act Resolution adopted by the Oakland County Board of Commissioners. (Signatures): Chairperson, Oakland County Board of Commissioners Date County Executive, Oakland County Date Chairperson, Oakland County Community Mental Health Dale Services Board Director, Oakland County Community Mental Health Date Services Board Director, Michigan Department of Mental Health Date 12 a. Please note that figures will change Fiscal Addendum Michigan Department of Mental Health/ Oakland County Community Mental Health Services Board CONTRACT FOR FULL MANAGEMENT It is agreed among the parties, the Michigan Department of Mental Health ("Department") and the Oakland County Community Mental Health Services Board ("Board") that the followina constitutes the fiscal provisions for State fiscal year 1992-93 related to the CONTRACT FOR FULL MANAGEMENT. Section 1. Service Plan The parties agree that the population will be served in accordance with the Service Summary and Spending Plan of the Board with funding from all sources of $ 85.439,733 (Grand Total for Service Summary and Spending Plan). Portions of this service plan are supported by cateaorical and other funding sources (substance abuse, Federal sources, other State departments, local non-match, Department grants, and earned revenue) in the amount of $ 707 ,595 (Lines A through F). The remaining portions of this service plan are supported by formula funding (the maximum match totals) in the amount of $ -84,732,138 (Line G). Section 2. Funding Levels and Reporting Requirements A. Total Obligations The parties agree that decisions and actions outside of the terms of the Contract may influence the level of categorical and other funding sources, and therefore service performance. Changes in categorical and other funding sources which occur during the fiscal year will be reported to the Department in the form of Contract amendments. The parties agree to obligate their respective share of formula funds in accordance with the Service Summary and Spending Plan. The Department has obligated $ 72,519,860 in State funds in support of formula funding. This obligation includes State funds as identified below which may be used only for the specified purpose: 1. Funds allocated in FY 90 for development or expansion of the following programs: a. Services to Seriously and Persistently Mentally Ill Adults b. Services to Persons with DD Residing in the Community c. Services to Children $ - 0 - d. Services to Fulfill the Requirements of OBRA with Regard to Nursing Homes $ - 0 - e. Residential and Support Service Programs $ - _ $ - $ -0- 13 $ 0- $ -0 - $ ° $ 476,867 $ - - $ 39,958 $ 0 - $ 17,707 $ 0 - $ 197,363 2. Funds allocated in FY 91 for development or expansion of the following programs: a. Services to Seriously and Persistently Mentally III Adults b. Services to Persons with DD Residing in the Community c. Services to Children d. Services to Fulfill the Requirements of OBRA with Regard to Nursing Homes e. Residential and Support Serviced Programs 3. Funds allocated in FY 92 for development or expansion of the following programs: a. Services to Fulfill the Requirements of 0E3RA with Regard to Nursing Homes b. Residential and Support Service Programs 4. Funds to support transportation to sheltered workshops. 5. Funds to support the cost of drugs formerly provided by state facilities. 6. Funds to support services to children under Dtv1H Model Waiver II. Such categorical funds shall be automatically rolled over into the Board's base funding unless contraindicated by legislative appropriations or conditions of original funding. Specifically, the Department agrees to pay the Board, on a net matchable basis, the state share of non- reimbursed expenditures not to exceed the State ceiling established in this Contract, unless amended, for formula funding for each service element within the various population croups and for Board Administration. The Board has obligated $7 .693,630in local funds in support of formula funding. The Board agrees to pay its share of non-reimbursed expenditures or the balance of formula fund expenditures, whichever is higher. B. Medicaid Advances The Department agrees to provide the Board with an advance equal to 116th of the total Title XIX revenues (Federal and State share) as reflected in the attached approved spending plan. Based upon total expected Title XIX revenues of $ 6,874,993 (total of items G 1 a(1) plus G 1 b(1) plus G 2 a(1) plus G 2 b (2)(a) of Service Summary and Spending Plan). The Board acknowledges that upon receipt of this advance, a liability due to DMH for $ 1,145,832 (1/6 of above) will be established separately. 14 Section 3 - Funding Obligations for State-Operated Services The parties agree that the Board shall authorize payment for the actual number of days of care provided to its residents in State inpatient and residential facilities/centers, up to the maximum funding obligation aggregated by population, as follows: Contract Base Vulnerability Maximum Funding Factor Oblioation MI ADULTS: Inpatient 112,054 Days/$19,653,011 Residential 80,300 Days/$ 5,058,900 $24,711,911 x 1.05 = $25,947,506 MI CHILDREN: Inpatient 22,307 Days/$ 5,145,593 Residential 25,185 Days/$ 2,956,865 $ 8,102,458 x 1.05 = $ 8,507,581 DEVELOPMENTALLY DISABLED: Inpatient 19,741 Days/$ 1,999,603 Residential 243,331 Days/$19,186,499 $21,186,102 Signatures: x 1.04 = $22,033,546 Chairperson, Oakland County Community Mental Health Date Services Board Director, Michigan Department of Mental Health Date Concurrance: Chairperson, Oakland County Board of Commissioners Date County Executive, Oakland County Date Director, Oakland County Community Mental Health Date Services Board 15 ./1 FISCAL NOTE BY: FINANCE COMMITTEE, JOHN P. McCULLOCH, CHAIRPERSON IN RE: DEPARTMENT OF INSTITUTIONAL AND HUMAN SERVICES - COMMUNITY MENTAL HEALTH "FULL MANAGEMENT" CONTRACT - MISCELLANEOUS RESOLUTION #93XXX TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XI-G of this Board, the Finance Committee has reviewed Miscellaneous Resolution #93xxx and finds: 1. The Oakland County Community Mental Health Services Board (CMH) and the Oakland County Board of Commissioner's General Government Committee recommends the full Board authorize CMH to enter into a full management contract with the Michigan Department of Mental Health (DMH). 2. Total annual authorization for this contract equals $96,345,472, with DMH providing $82,492,131, other revenue sources (medicaid, etc.) generating $4,806,565 and County match equalling $9,046,776 as detailed on the attached Schedule A. 3. The DMH allocation of $82,492,131 represents a per capita expenditure of $76.13 and becomes the base allocation for the Fiscal Year 1994 allocation. 4. Due to the fact that only four (4) months remain in the 1992/1993 fiscal year, projected spending for the contract period equals $93,895,855, with DMH providing $80,758,522, other revenue sources generating $4,806,565 and County match equalling $8,330,768, also detailed on the attached Schedule A. 5. The 1993 County budget anticipated a County match of $8,330,768, there is no anticipated increase in the required County match above that budgeted amount. 6. The 1993 County budget be amended, as reflected in attached Schedule B, to reflect the anticipated contract expenditure. Further amendments may be presented in the fourth quarter of 1993 as the state legislature formalizes the Fiscal Year 1994 appropriations for DMH. FINANCE COMMITTEE Prepared by: Budget.Division/TS 26-May-93 Schedule A Oakland County Community Mental Health Service Board Full Management Contract State Other County ' Total ANNUAL AUTHORIZATION Supported Revenue Match Program In-Patient/Residential Programs $63,493,439 $0 $6,983,756 $70,477,195 Community Based Programs 18,998,692 4,806,565 1,785,925 25,591,.182 County Support. Respite/Jail Svs. 0 0 277,095 277,095 Total Annual Authorization $82,492,131 $4,806,565 $9,046,776 $96,345,472 ANTICIPATED EXPENDITURES In-Patient/Residential Programs $62,56.9,830 Community Based Programs .18,188,692 County Support. Respite/jail Svs. 0 $0 $6,343,936 $68,913,766 4,806,565 1,709,737 24,704,994 0 277,095 277,095 Total Anticipated Expenditures $80,758,522 $4,806,565 $8,330,768 $93,895,855 Schedule B Oakland County Community. Mental Health 1993 Budget Amendment Current Amended Budget Budget EXPENDITURES Amendment In-Patient/Residential Community Based County Supported Total Expenditures REVENUES State Other Sources Total Revenues COUNTY MATCH $6,126,136 $68,913,766 26,817,680 24,704,994 277,095 277,095 • $33,220,911 $93,895,835 $62,787,630 (2,112,686) 0 ----------- $60,674,944 $20,685,400 $80,758,522 $60,073,122 4,204,743 4,806,565 601,822 $24,890,143 $85,565,087 $60,674,944 $8,330,768 $8,330,768 $0 Prepared by: Budget Division/TS 26-May-93 Resolution # 93092 May 27, 1993 Moved by Jensen supported by Pernick the resolution be adopted. AYES: Crake, Dingeldey, Douglas, Garfield, Gosling, Huntoon, Jensen, Kingzett, Law, McCulloch, Miltner, Moffitt, Oaks, Obrecht, Palmer, Pernick, Powers, Price, Schmid, Taub, Aaron. (21) NAYS: Johnson, Kaczmar, Wolf. (3) A sufficient majority having voted therefor, the resolution was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on May 27, 1993 with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this 27th day cj May 1993. Lynn D. Allen, County Clerk