FY 2015 and FY 2016 Community Services Performance...

Henrico Area Department of Mental Health and Developmental Disabilities

HENRICO AREA

MENTAL HEALTH & DEVELOPMENTAL

SERVICES Serving the Counties of

Henrico, Charles City, and New Kent

FY 2015 and FY 2016 Community Services

Performance Contract

Henrico Area Mental Health &

Developmental Services 10299 Woodman Road Richmond, VA 23060

804.727.8500

Henrico Area Mental Health & Developmental Services

CQuarter

Mental HealthServices

Consolidated Budget (Pages AF-3 through AF-8)

Developmental Services

Substance Abuse

Services

TOTALFunding Sources

FY 2015 And FY 2016 Community Services Performance Contract

FY 2015 Exhibit A: Resources and Services

State Funds 5,311,840

Local Matching Funds 6,771,508

Total Fees 4,365,087

TOTAL ALL FUNDS 16,961,979

51,182

6,912,297

5,009,920

12,317,799

1,096,457

301,256

190,302

2,542,502

6,459,479

13,985,061

9,565,309

31,822,280

Federal Funds 507,294 0 954,487 1,461,781

Other Funds 6,250 344,400 0 350,650

State Retained Earnings 0 0 0 0

2,343,511

Local Match Computation

Federal Retained Earnings 0 0 0

Cost for MH/DV/SA Services 13,358,750 12,175,478 2,585,832 28,120,060

7.26%

Other Retained Earnings 0 0 0 0

CSB Administrative Expenses

Total Admin. Expenses

32,281,876Total Expenses

Administrative Percent

State Funds One-Time 0 0 0 0

Federal Funds One-Time 0 0 0 0

Subtotal Ongoing Funds 16,961,979 12,317,799 2,542,502 31,822,280

Subtotal One -Time Funds 0 0 0 0

Total Local Matching Funds 13,985,061

Total State Funds 6,459,479

Total Local Match %(Local/Total State + Local)

68.40%

Total State and Local Funds 20,444,540

Total Cost 32,281,876

Transfer Fees In/(Out) 0 0 0 0

Cost for Ancillary Services (AP-4) 1,694,908

Cost for Emergency Services (AP-4) 2,466,908

7/14/2014Report Date AF-1

Financial Comments

Exhibit A: Resources and Services

FY2015 Community Services Performance Contract


Comment1 MH Other Funds $ 6250 is Lakeside Center Snack Bar revenue

Comment2 Regional funds transfer in contains:

Comment3 Acute Care $ 499,220; Regional DAP $ 165,937

Comment4 MH Other Regional $ 178,814; Crisis Stabilization $ 143,422

Comment5 MH Recovery $ 217,107

Comment6 Expenses included on services pages for regional programs paid by RBHA:

Comment7 $ 8,237 Regional DAP in MH320

Comment8 $ 92,273 MH Other Regional for Utilization Management in MH320

Comment9 $ 4,340 MH Other Regional for Rubicon HOPE in SA521 co-occuring diagnosis

Comment10 $ 179,242 Childrens Ambulatory in MH420

Comment11 $ 136,514 Childrens Crisis Stabilization Unit in MH510

Comment12 $ 38,990 SA Federal Block Grant Rubicon HOPE in SA521

Comment13 Total $ 459,596

Comment14

Comment15

Comment16

Comment17

Comment18

Comment19

Comment20

Comment21

Comment22

Comment23

Comment24

Comment25

Report Date 7/14/2014 AF-2


Developmental Services (DV)

Funds

Exhibit A: Resources and ServicesFY 2015 Community Services Performance Contract Financial Summary

Funding Sources


DV Other Medicaid Fees 4,668,816

DV Medicaid ICF/ID Fees

Total DV Fees 5,009,920

FEDERAL FUNDS

DV Other Federal ‐ DBHDS 0

DV Other Federal ‐ CSB 0

TOTAL DV FEDERAL FUNDS 0

STATE FUNDS

0

DV Workshop Sales

TOTAL DV OTHER FUNDS 344,400

DV Fees: Other 341,104

DV Other Funds

344,400

OTHER FUNDS

DV State Funds 32,572

DV OBRA 18,610

Total DV Unrestricted State Funds 51,182

TOTAL DV LOCAL MATCHING FUNDS 6,913,340

DV Local Interest Revenue 0

DV Local Government Appropriations 6,913,340

LOCAL MATCHING FUNDS

FEES

DV State Retained Earnings

0

0

DV In‐Kind Contributions 0

DV Philanthropic Cash Contributions 0

DV Transfer Fees In/(Out) 0

DV NET FEES 5,009,920

DV Other Retained Earnings 0

Total DV All Funds 12,318,842

TOTAL DV STATE FUNDS 51,182

DV Crisis Stabilization (Fiscal Agent) 0

DV State Retained Earnings‐Regional Prog 0

DV Rental Subsidies 0

DV Crisis Stabilization – Children 0

TOTAL DV Restricted State Funds 0

Report Date 7/11/2014 AF‐6


Substance Abuse (SA) Services

Funds


Funding Sources


SA Medicaid Fees 8,700

SA Fees: Other 181,602

Total SA Fees 190,302

FEDERAL FUNDS

FEES

SA Transfer Fees In/(Out) 0

SA NET FEES 190,302

SA FBG Alcohol/Drug Trmt (93.959) 675,510

SA FBG Women (includes LINK at 6 CSBs) (93.959) 38,294

SA FBG Prevention‐Women (LINK) (93.959) 0

SA FBG SARPOS (93.959) 56,948

SA FBG Recovery (93.959) 0

SA FBG Prevention (93.959)

0

SA Other Federal ‐ DBHDS 0

SA Other Federal ‐ CSB 0

TOTAL SA FEDERAL FUNDS 954,487

SA FBG Jail Services (93.959) 0

STATE FUNDS

SA Facility Reinvestment (Fiscal Agent) 0

SA Facility Reinvestment Transfer In/(Out) 0

SA Net Facility Reinvestment 0

732,458

SA FBG Co‐Occurring (93.959)

183,735

SA FBG New Directions (93.959) 0

SA FBG Prev‐Family Wellness (93.959) 0

Total SA FBG A/D Trmt Funds

38,294Total SA FBG Women Funds

183,735Total SA FBG Prevention Funds

Regional Funds



Substance Abuse (SA) Services

Funds


Funding Sources


OTHER FUNDS

SA State Retained Earnings 0

TOTAL SA OTHER FUNDS 0

Total SA Unrestricted Other State Funds 1,095,057

SA Other Funds 0

SA Federal Retained Earnings 0

SA State Funds 938,691

SA Region V Residential 0

TOTAL SA STATE FUNDS 1,096,457

SA Jail Services/Juv Detention 69,059

SA Local Interest Revenue 0

LOCAL MATCHING FUNDS

TOTAL SA LOCAL MATCHING FUNDS 300,802

SA Local Government Appropriations 300,802

TOTAL ALL SA Funds 2,542,048

SA In‐Kind Contributions 0

SA Philanthropic Cash Contributions 0

SA FBG Alcohol/Drug Trmt (93.959) 0

TOTAL SA ONE‐TIME FUNDS 0

ONE‐TIME FUNDS

SA Other Retained Earnings 0

TOTAL SA Funds 2,542,048

SA State Retained Earnings‐Regional Prog 0

SA FBG Prevention (93.959) 0

SA FBG Women (includes LINK‐6 CSBs) (93.959) 0

SA MAT ‐ Medically Assisted Treatment 0

SA SARPOS 56,578

SA Recovery 0SA HIV/AIDS 30,729

Other State Funds

SA Women (includes LINK at 4 CSBs) (Restricted) 1,400

SA State Funds 0

Total SA Other State Funds 1,096,457

Unrestricted Other State Funds



City/County Tax Appropriation

FY 2015 Community Services Performance Contract

Local Government Tax Appropriations

New Kent County 100,574

Henrico County 13,770,507

Charles City County 113,980

Total Local Government Tax Funds: 13,985,061

7/11/2014Report Date AF‐9

Supplemental Information


Reconciliation of Projected Revenues and Utilization Data Core Services Costs by Program Area

DVServices

SAServices

Emergency Services Total

MHServices


Ancillary Services


12,175,478

2,542,502

2,585,832

0

1,694,908

142,321 -43,330 -1,694,908

Other: 459,596

Difference results from

Explanation of Other in Table Above:

Regional programs paid for by RBHA on behalf of Henrico Area- $8237 DAP; $ 315,756 MH Crisis Response & Child Psychiatry; $ 96613 MH Reinvestment (Other); $ 38990 SA FBG Rubicon HOPE

31,822,280

32,281,876

-459,596

12,317,799Total All Funds (Page AF-1)

Cost for MH, DV, SA, Emergency, and Ancillary Services (Page AF-1)

Difference

13,358,750

3,603,229

16,961,979

2,466,908

-2,466,908

7/14/2014Report Date AF-10

CSB 100 Mental Health Services


Report for Form 11

Costs

Core Services Code


Service Capacity


Projected Projected

250 Mental Health Acute Psychiatric Inpatient Services $542,4991.4 Beds

310 Outpatient Services $3,866,70720.75 FTEs

350 Assertive Community Treatment $2,537,85216 FTEs

320 Case Management Services $3,230,86521.25 FTEs

420 Ambulatory Crisis Stabilization Services $179,2420.9641 Slots

425 Mental Health Rehabilitation $1,094,31255 Slots

460 Individual Supported Employment $273,5782.5 FTEs

510 Residential Crisis Stabilization Services $136,5142.2 Beds

551 Supervised Residential Services $249,0476 Beds

581 Supportive Residential Services $1,248,1348.5 FTEs

Total Costs $13,358,750

Report Date 7/14/2014 AP-1

CSB 200 Developmental Services


Report for Form 21

Costs

Core Services Code


Service Capacity


Projected Projected

310 Outpatient Services $399,4682.8 FTEs

320 Case Management Services $4,114,49726.5 FTEs

425 Developmental Habilitation $3,523,136133 Slots

430 Sheltered Employment $974,92650 Slots

465 Group Supported Employment $780,00330 Slots

460 Individual Supported Employment $460,6515.5 FTEs

521 Intensive Residential Services $1,922,79720 Beds



CSB 300 Substance Abuse Services


Report for Form 31

Costs

Core Services Code


Service Capacity


Projected Projected

260 Community-Based SA Medical Detoxification Inpatient (Hospital) Services $28,2530.4 Beds

310 Outpatient Services $1,489,28315.25 FTEs

335 Medication Assisted Treatment Services $61,3760 FTEs

521 Intensive Residential Services $150,2662.6 Beds

610 Prevention Services $856,65411 FTEs



CSB 400 Emergency and Ancillary Services


Report for Form 01

Costs

Core Services Code


Service Capacity


Projected Projected

100 Emergency Services $2,466,90815.5 FTEs

318 Motivational Treatment Services $187,6701.5 FTEs

390 Consumer Monitoring Services $142,3211 FTEs

720 Assessment and Evaluation Services $1,364,9175 FTEs



FY 2015 and FY 2016 Community Services Performance Contract

05-09-2014 55.

FY 2015 Exhibit F: Federal Compliances Certification Regarding Salary: Federal Mental Health and Substance Abuse Prevention and Treatment Block Grants Check One 1. The CSB has no employees being paid totally with Federal Mental Health Block Grant funds or Federal Substance Abuse Prevention and Treatment (SAPT) Block Grant funds at a direct annual salary (not including fringe benefits and operating costs) in excess of Level 1 of the federal Executive Schedule. 2. The following employees are being paid totally with Federal Mental Health or SAPT Block Grant funds at a direct annual salary (not including fringe benefits and operating costs) in excess of Level 1 of the federal Executive Schedule. Name Title 1. _________________________________ __________________________________ 2. _________________________________ ___________________________________ 3. _________________________________ ___________________________________ 4. _________________________________ ____________________________________ 5. _________________________________ ____________________________________ 6. _________________________________ ____________________________________ Assurances Regarding Equal Treatment for Faith-Based Organizations The CSB assures that it is and will continue to be in full compliance with the applicable provisions of 45 CFR Part 54, Charitable Choice Regulations, and 45 CFR Part 87, Equal Treatment for Faith-Based Organizations Regulations, in its receipt and use of federal Mental Health Services and Substance Abuse Prevention and Treatment Block Grants and federal funds for Projects for Assistance in Transitions from Homelessness programs. Both sets of regulations prohibit discrimination against religious organizations, provide for the ability of religious organizations to maintain their religious character, and prohibit religious organizations from using federal funds to finance inherently religious activities.

FY 2015 and FY 2016 Community Services Performance Contract

05-09-2014 57.

FY 2015 Exhibit G: Local Contact for Disbursement of Funds 1. Name of the CSB: Henrico Area Mental Health & Developmental Services Board 2. City or County designated

as the CSB's Fiscal Agent: County of Henrico If the CSB is an operating CSB and has been authorized by the governing body of each city or county that established it to receive state and federal funds directly from the Department and act as its own fiscal agent pursuant to Subsection A.18 of § 37.2-504 of the Code of Virginia, do not complete items 3 and 4 below. 3. Name of the Fiscal Agent's City Manager or County Administrator or Executive: Name: John A. Vithoulkas Title: County Manager 4. Name of the Fiscal Agent's County or City Treasurer or Director of Finance: Name: Eugene H. Walter Title: Director of Finance 5. Name, title, and address of the Fiscal Agent official or the name and address of the CSB if it acts

as its own fiscal agent to whom checks should be electronically transmitted: Name: Eugene H. Walter Title: Director of Finance Address: Government Center Parham and Hungary Springs Road P. O. Box 90775 Henrico, VA 23273-0775

This information should agree with information at the top of the payment document e-mailed to the CSB, for example: Mr. Joe Doe, Treasurer, P.O. Box 200, Winchester, VA 22501.


Total Appointments: 12 Vacancies: 1 Filled Appointments: 11

Number of Individuals Who Previously Receives Services: 0

Number of Family Members: 3

Table 1: Board of Directors Membership Characteristics

Henrico Area Mental Health & Developmental ServiName of CSB:

Number of Individuals Currently Receiving Services: 2

7/11/2014Report Date AP-5


113.20

17.20

116.55

7.75

25.50

3.95 36.00

2. 3. 4. 6. 7.

Peer Counselors are hourly staff who work between 30 and 40 hours in a payperiod. The number listed for Peer Staff Service FTE equals the number of peer counselors within the agency.

Explanations for Table 2a

1.

Support Staff FTEs

TOTAL FTE CSB Employees

Consumer Service FTEs

Table 2b: Community Service Board Employees

Table 2: Board Management Salary Costs

277.95

64.90

352.85140.40 124.30 29.45 36.00

MH DEV SA ADMIN TOTALNo. of FTE CSB Employees

10.00 0.00 0.00Peer Staff Service FTEs 10.00

22.70

0.00

5.

22.70

SAOPA

0.00



Henrico Area Mental Health & Developmental SeName of CSB:

Management Position Title Beginning Ending

Salary RangeFY 2015

FY 2015

Budgeted Tot.

Salary Cost

Tenure

(yrs)

Table 2: Board Management Salary Costs

Table 2a:


Executive Director $115,186.00 $206,981.00 $167,610.00 10.00

Table 2: Integrated Behavioral and Primary Health Care Questions

a federally qualified health center

Name: Daily Planet

a free clinic

Name:

a local health department, or

Name:

another organization

Name:

on‐site in a CSB program,

on‐site at the primary health care provider, or

another site ‐‐specify:

on‐site in a CSB program,

on‐site at the primary health care provider, or

another site ‐‐specify:

2. If yes, who is the partner?

3. Where is primary health (medical) care provided?

4. Where is behavioral health care provided?

Yes

1. Is the CSB participating in a partnership with a federally qualified health center, free clinic, or local health department to integrate the provision of behavioral health and primary health care?


Exhibit D: CSB Board of Directors Membership List


Name Address Phone Number Start Date End Date Term No.


(804) 329-8756 3/12/2013 12/31/2015 1Brenda Brown 3121 River Bluffs Court Henrico,VA 23223

(804) 647-1071 1/14/2014 12/31/2016 1Jessica Brown, Ph.D 1256 N. James Estates Drive Henrico,VA 23231

(804) 747-1025 1/18/2013 12/31/2015 1Surya Dhakar, DDS 11616 Old Covington Way Glen Allen,VA 230595698

(804) 740-8550 1/11/2011 12/31/2016 2Nita Grignol 1710 Windingridge Drive Henrico,VA 23238

(804) 515-7962 9/9/2008 12/31/2015 2Joyce Hann 11423 Long Meadow Drive Glen Allen,VA 23059

(804) 432-6553 4/27/2012 4/30/2015 1Lindsey Johnson 4715 Cool Hill Road Providence Forge,VA 23140

(804) 672-2775 1/13/2009 12/31/2014 2Mark Johnson 8008 Grassmount Ct Henrico,VA 23228

(804) 264-2409 5/8/2012 12/31/2015 1Judith Layne 2102 Spider Drive Henrico,VA 23228

(804) 852-1836 1/14/2014 12/31/2016 1Kathryn Merritt 5604 Tumbleweed Circle Henrico,VA 23228

(804) 360-7216 1/31/2004 12/31/2014 3Gregory Morrison 10812 Dominion Fairways Drive Glen Allen,VA 23059

(412) 720-2986 1/14/2013 12/31/2014 1Lynne Szewczyk 11540 Royal Lane Providence Forge,VA 23140


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