Agenda. December 21, :00 AM Mental Health Center, Board Room B. 9) Adjournment Action. Main Office

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1 Agenda TO: FROM: SUBJECT: HealthWest Board Members Janet Thomas, Chair, via Julia Rupp, Executive Director Full Board Meeting December 21, :00 AM Mental Health Center, Board Room B 1) Call to Order 2) Approval of Minutes of November 30, 2018 (Previously Forwarded) Action 3) Committee Reports A) B) C) Program/Personnel Committee (Attachment #1) Rights Advisory Committee (Attachment #2) Finance Committee (Attachment #3) Action Action Action 4) Items for Consideration 5) Old Business 6) New Business 7) Communication A) Director s Report (To be distributed) Information 8) Audience Participation 9) Adjournment Action /ab c: County Administration Main Office 376 E. Apple Ave. Muskegon, MI P (231) F (231) HealthWest.net

2 HEALTHWEST FULL BOARD MEETING MINUTES December 21, a.m. Mental Health Center CALL TO ORDER The regular meeting of the Full Board was called to order by Chair Thomas at 8:00 a.m. ROLL CALL Members Present: Members Excused: Others Present: Guests: Marvin Engle, Jason Coleman, Jeff Fortenbacher, John Snider, II, Cheryl Natte, Stephanie Umlor, Charles Nash, Thomas Hardy, Janine Norwood, Janet Thomas, Dr. Remington Sprague John Schrier Brandy Carlson, Amber Berndt, Judy Cohen, Margaret Tietze, Marcia VandenBerg, Dave McElfish, Adam Burger None MINUTES HWB It was moved by Commissioner Engle, seconded by Mr. Snider, to approve the minutes of the November 30, 2018, meeting as written. COMMITTEE REPORTS Program/Personnel Committee via Cheryl Natte HWB It was moved by Ms. Natte, seconded by Commissioner Engle, to approve the minutes of the October 12, 2018 meeting as written. HWB It was moved by Ms. Natte, seconded by Commissioner Engle, to authorize the reclassification of the Supports Coordinator position (X85223/Wage Grade HX-00160) to a Case Manager position (Wage Grade HX-00160), effective December 21, HWB It was moved by Ms. Natte, seconded by Commissioner Engle, to authorize the addition of an Administrative Assistant position (Wage Grade HO-00210) effective December 21, HWB It was moved by Ms. Natte, seconded by Commissioner Engle, to authorize the reclassification of the full-time Behavioral Analysis Technician (N11704/7319, Wage Grade HO ) to a full-time Registered Behavior Technician (RBT) (Wage Grade HO-00170), effective December 21, 2018.

3 December 21, 2018 Page 2 of 4 Recipient Rights Advisory Committee via Janet Thomas HWB-030 It was moved by Ms. Thomas, seconded by Dr. Sprague, to approve the minutes of the October 12, 2018 meeting as written. HWB-031 It was moved by Ms. Thomas, seconded by Dr. Sprague, to approve the Recipient Rights Report for October/November HWB-032 It was moved by Ms. Thomas, seconded by Dr. Sprague, to approve the Recipient Rights Annual Report for the period of October 1, 2017, through September 30, Finance Committee via Commissioner Snider HWB 037 It was moved by Commissioner Snider, seconded by Commissioner Engle, to approve the minutes of the November 16, 2018, meeting as written. HWB-038 It was moved by Commissioner Snider, seconded by Commissioner Engle, to approve expenditures for the month ending November 30, 2018, in the total amount of $5,726, HWB-039 It was moved by Commissioner Snider, seconded by Commissioner Engle, to sign Amendment No.1 to the FY18 contract between the Lakeshore Regional Entity (PIHP) and HealthWest for the Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Programs, the Healthy Michigan Program, and Substance Use Disorder Community Grant Programs, beginning October 1, 2017 through September 30, HWB-040 It was moved by Commissioner Snider, seconded by Commissioner Engle, to authorize the HealthWest Director to sign a contract with Rehmann Robson for professional consultation services, effective December 1, 2018 through September 30, 2019, renewable annually, with an expected cost of $19, per year plus agreed upon out of pocket expenses. ITEMS FOR CONSIDERATION There were no items for consideration. OLD BUSINESS There was no old business. NEW BUSINESS New Board members Thomas Cowboy Hardy and Janine Norwood introduced themselves to the Board members and HealthWest staff.

4 December 21, 2018 Page 3 of 4 COMMUNICATION There was no communication this month. AUDIENCE PARTICIPATION There was no audience participation. ADJOURNMENT There being no further business to come before the board, the meeting adjourned at 8:06 a.m. Respectfully, Jeff Fortenbacher Board Secretary /ab PRELIMINARY MINUTES To be approved at the Full Board Meeting of January 25, 2019

5 HEALTHWEST PROGRAM/PERSONNEL COMMITTEE REPORT TO THE BOARD Via Cheryl Natte, Committee Chair 1. The Program/Personnel Committee met on Friday, December 14, * 2. It was recommended, and I move to approve the minutes of the October 12, 2018 meeting as written. * 3. It was recommended, and I move, to authorize the reclassification of the Supports Coordinator position (X85223/Wage Grade HX-00160) to a Case Manager position (Wage Grade HX-00160), effective December 21, * 4. It was recommended, and I move, to authorize the addition of an Administrative Assistant position (Wage Grade HO-00210) effective December 21, * 5. It was recommended, and I move, to authorize the reclassification of the full-time Behavioral Analysis Technician (N11704/7319, Wage Grade HO-00160) to a full-time Registered Behavior Technician (RBT) (Wage Grade HO-00170), effective December 21, /ab

6 HEALTHWEST PROGRAM/PERSONNEL MEETING MINUTES December 14, :00 a.m. Mental Health Center CALL TO ORDER The regular meeting of the Program/Personnel Committee was called to order by Chair Natte at 8:03 a.m. ROLL CALL Members Present: Members Excused: Others Present: Guests: John Schrier, Jason Coleman, Janet Thomas, Cheryl Natte Stephanie Umlor Amber Berndt, Margaret Tietze, Larry Spataro, Susan Plotts, Gina Schaner, Dave McElfish, Julia Rupp, Brandy Carlson, Marcia Vandenberg None MINUTES It was moved by Mr. Schrier, seconded by Ms. Thomas, to approve the minutes of the October 12, 2018 meeting as written. ITEMS FOR CONSIDERATION Authorization to reclassify a Supports Coordinator position to a Case Manager position It was moved by Ms. Thomas, seconded by Mr. Schrier, to authorize the reclassification of the Supports Coordinator position (X85223/Wage Grade HX-00160) to a Case Manager position (Wage Grade HX-00160), effective December 21, Authorization to add an Administrative Assistant position It was moved by Mr. Schrier, seconded by Mr. Coleman, to authorize the addition of an Administrative Assistant position (Wage Grade HO-00210) effective December 21, Authorization to reclassify a full-time BAT to a full-time RBT It was moved by Mr. Coleman, seconded by Mr. Schrier, to authorize the reclassification of the full-time Behavioral Analysis Technician (N11704/7319, Wage Grade HO-00160) to a full-time Registered Behavior Technician (RBT) (Wage Grade HO-00170), effective December 21, 2018.

7 Program/Personnel minutes, December 14, 2018 Page 2 of 2 OLD BUSINESS There was no old business. NEW BUSINESS There was no new business. COMMUNICATION There was no communication. DIRECTOR S COMMENTS Ms. Rupp updated the Board on the LRE Board meeting yesterday. She stated that Mr. Snider represented us well in letting LRE leadership know that we will align with the rest of the CMHs and PIHPs in that we will attempt to do whatever it takes to find and obtain increased revenue. We will continue to take the stance that we believe Medicaid is an entitlement and that the State is responsible for making up the deficit. The State had collected data to potentially adjust the rates and, despite the region wide deficits, they decided to keep the rates for this year the same as last year. AUDIENCE PARTICIPATION There was no audience participation. ADJOURNMENT There being no further business to come before the board, the meeting adjourned at 8:15 a.m. CN/ab PRELIMINARY MINUTES To be approved at the Program Meeting of February 9, 2019

8 HEALTHWEST RECIPIENT RIGHTS ADVISORY COMMITTEE REPORT TO THE BOARD via John Schrier, Committee Chairperson 1. The Recipient Rights Advisory Committee met on December 14, * 2. It was recommended, and I move to accept the minutes of the October 12, 2018 meeting as written. * 3. It was recommended, and I move, to accept the Recipient Rights bi-monthly report for October/November * 4. It was recommended, and I move, to accept the Recipient Rights Annual Report for the Period of 10/01/17 through 09/30/18. /gs

9 CALL TO ORDER HEALTHWEST RECIPIENT RIGHTS ADVISORY COMMITTEE MEETING MINUTES Friday, December 14, a.m. Mental Health Center Board Room B The regular meeting of the Recipient Rights Advisory Committee was called to order by Mr. Schrier, Committee Chair, at 8:15 a.m. ROLL CALL Members Present: Members Excused: Others Present: Guests: John Schrier, Jason Coleman, Janet Thomas, Cheryl Natte Stephanie Umlor Amber Berndt, Margaret Tietze, Larry Spataro, Susan Plotts, Gina Schaner, Dave McElfish, Julia Rupp, Brandy Carlson, Marcia Vandenberg None APPROVAL OF MINUTES It was moved by Ms. Natte, seconded by Ms. Thomas, to approve the minutes of the October 12, 2018 meeting as written. ITEMS FOR CONSIDERATION Motion to Accept Recipient Rights Report for October/November 2018 It was moved by Ms. Natte, seconded by Mr. Coleman, to approve the Recipient Rights Report for October/November For the months of October/November 2018 there were 47 HealthWest and 119 provider employees trained: Rights Updates HealthWest 34 Rights Updates Provider 60 New Employee Training HealthWest/Contracted 13 New Employee Training Provider 58 SUD Recipient Rights Orientation HealthWest SUD Recipient Rights Orientation Provider 1 For the months of October/November 2018 there were 516 incident reports and 43 rights allegations.

10 Recipient Rights Advisory Committee Meeting Minutes December 14, 2018 Page 2 of 2 Statistical data showing type and code was provided for review. Discussion was held regarding this month s incident reports. There were a total of three deaths reported in October/November Motion to Accept the Recipient Rights Annual Report for 10/01/17 through 09/30/18 It was moved by Ms. Natte, seconded by Mr. Coleman, to approve the Recipient Rights Annual Report for 10/1/2017 through 09/30/2018. OLD BUSINESS There was no old business. NEW BUSINESS Appeals Training Information Held: January 8, :00 am 3:00 p.m. Newaygo County CMH 1049 Newell, White Cloud, MI Contact Stefanie Heath COMMUNICATIONS The FY18 ORR Semi-Annual Report Statistical Analysis of CMHSP and LPH Data was reviewed. The MDHHS Behavioral Health and Developmental Disabilities Administration Standards for Behavior Treatment Plan Review Committees document was reviewed. DIRECTOR S COMMENTS There were no Director s comments. AUDIENCE PARTICIPATION There was no audience participation. ADJOURNMENT There being no further business to come before the committee, the meeting adjourned at 8:37 a.m. Respectfully, Mr. John Schrier HealthWest Rights Advisory Committee Chair /ab

11 HEALTHWEST FINANCE COMMITTEE REPORT TO THE BOARD via John Snider, Committee Chair 1. The Finance Committee met on December 19, * 2. It was recommended, and I move, to approve the minutes of the November 16, 2018, meeting as written. * 3. It was recommended, and I move, to approve the preliminary expenditures for the month ending November 30, 2018, in the total amount of $5,726, * 4. It was recommended, and I move, to sign Amendment No.1 to the FY18 contract between the Lakeshore Regional Entity (PIHP) and HealthWest for the Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Programs, the Healthy Michigan Program, and Substance Use Disorder Community Grant Programs, beginning October 1, 2017 through September 30, * 5. It was recommended, and I move, to authorize the HealthWest Director to sign a contract with Rehmann Robson for professional consultation services, effective December 1, 2018 through September 30, 2019, renewable annually, with an expected cost of $19, per year plus agreed upon out of pocket expenses. /ab

12 HEALTHWEST FINANCE COMMITTEE MEETING MINUTES Friday, December 19, :00 a.m. Mental Health Center Board Room CALL TO ORDER The regular meeting of the Finance Committee was called to order by Chair Snider at 8:01 a.m. ROLL CALL Committee Members Present: Committee Members Excused: Add l Board Members Present: Marvin Engle, Charles Nash, John Snider, Janet Thomas, Dr. Remington Sprague, Jeff Fortenbacher None None Also Present: Brandy Carlson, Amber Berndt, Sam Wolff, Judy Cohen, Marcia Vandenberg, Julia Rupp Guests: None MINUTES It was moved by Commissioner Engle, seconded by Dr. Sprague, to approve the minutes of the November 16, 2018, meeting as written. ITEMS FOR CONSIDERATION A. Approval of Expenditures for November 2018 It was moved by Commissioner Engle, seconded by Mr. Fortenbacher, to approve the expenditures for the month ending November 30, 2018 in the total amount of $5,726, B. Interim Analysis of Expenditures Ms. Carlson presented the draft expenditures for the month of November 2018 noting that HealthWest is 5.5% under budget. C. Interim Analysis of Revenues Ms. Carlson presented the Interim Analysis of Revenues through November 30, Juvenile Justice Team funding is now billing for services provided and are we no longer being paid a flat rate. We will continue to monitor the effects of the billing change as time progresses. D. Interim Balance Sheets of November 2018 Ms. Carlson presented the Interim Balance Sheets of November 2018, noting that there was a negative cash balance of ($4,053,178.64) for Fund Fund 7930 has a positive cash balance of $507,

13 December 19, 2018 Page 2 of 3 E. HealthWest Expenditures Financial Statement Ms. Carlson presented the HealthWest Expenditure report for November 2018 which shows the estimated true variance to date of ($168,934). Expenditures are over budget to date. F. Finance Update Fees and Inpatient Summary The Substance Abuse Fee Report has negative variance of $23,190 through the month of November It should be noted that this variance report is based on the budget approved by the HealthWest Board during the month of May The Other Fees Report has a negative total variance of $646,208 through the month of November The variance report is based on the budget approved by the HealthWest Board during the month of May The Inpatient Summary Report indicates a positive variance to date of $31,310 for Community Inpatient, which is based on the budget approved by the HealthWest Board during the month of May G. Budget Variance Analysis Report Our projected budget variance, based on the budget approved by the HealthWest Board during the month of May 2018 is ($168,934). There are no contingencies at this time. That would leave us with a net variance of approximately ($168,934) after the first two months of the fiscal year. Due to the different periods of the budget year that these variances are calculated over, this would prorate out to a negative variance of approximately ($1,018,057) for the whole fiscal year. However, this figure does not really give us a true picture of where we stand as we are not able to use the different funding sources (i.e., State GF and Medicaid, etc.) to offset each other s shortfalls. Therefore, a truer picture would be as follows: Medicaid (Traditional) $49,817 Medicaid (Healthy Michigan) $(495,604) Medicaid (Autism) $9,293 State General Fund $(581,563) H. Month End Projection Trends Ms. Carlson presented the month-end projection trends for board member review. I. Medicaid Eligibles by Program Ms. Carlson presented the Medicaid Eligibles trends for HM, DAB, and TANF for board member review. J. Authorization to Sign Amendment #1 for the Contract between the LRE and HealthWest It was moved by Commissioner Engle, seconded by Ms. Thomas, to sign Amendment No.1 to the FY18 contract between the Lakeshore Regional Entity (PIHP) and HealthWest for the Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Programs, the Healthy Michigan Program, and Substance Use Disorder Community Grant Programs, beginning October 1, 2017 through September 30, 2018.

14 December 19, 2018 Page 3 of 3 K. Authorization to Sign Contract with Rehmann Robson for Consultation Services It was moved by Dr. Sprague, seconded by Commissioner Engle, to authorize the HealthWest Director to sign a contract with Rehmann Robson for professional consultation services, effective December 1, 2018 through September 30, 2019, renewable annually, with an expected cost of $19, per year plus agreed upon out of pocket expenses. OLD BUSINESS Julia discussed Mr. Snider s participation at a past LRE meeting and how thankful she was for him speaking up despite his suggestions not being incorporated into the language of the letter that Mr. Stek sent out. NEW BUSINESS There was no new business. COMMUNICATIONS There was no communication. DIRECTOR S COMMENTS Julia informed the Board that she will not be present at Friday s meeting and also let the Board know that we have two new Board members who should be joining us Friday. Julia updated the Board on the rate setting done by the State, as well as the potential changes that may occur in February based on the actuary s suggestions. Last week Milliman gave the 298 Director s mock rates of what the 298 numbers might look like. They ve been asked to work with the CFOs to figure out if those rates will work. AUDIENCE PARTICIPATION There was no audience participation. ADJOURNMENT There being no further business to come before the committee, the meeting adjourned at 8:32 a.m. Respectfully, John Snider Committee Vice-Chair JS/ab PRELIMINARY MINUTES To be approved at the Finance Meeting of January 18, 2019