HomeMy WebLinkAboutRes2016-054Sponsored by: Hunt
CITY OF SEWARD, ALASKA
RESOLUTION 2016-054
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD,
ALASKA, APPROVING THE 2017 GRANT YEAR BUDGET FOR THE
SEWARD COMMUNITY HEALTH CENTER AS REQUIRED BY THE CO -
APPLICANT AGREEMENT'BETWEEN THE CITY OF SEWARD AND THE
SEWARD COMMUNITY HEALTH CENTER
WHEREAS, the Seward City Council enacted Ordinance 2010-008 on December 13, 2010,
establishing the powers and duties of the Governing Board of Directors ("Governing Board")
charged with oversight of the Seward Community Health Center, as amended by Ordinance 2013-
013 on December 16, 2013; and
WHEREAS, the City of Seward ("City") and the Seward Community Health Center
("CHC") are co -applicants as a federally qualified health center in accordance with Section 330 of
the Public Health Service Act (42 U.S.C. §254b); and
WHEREAS, the City and the CHC entered into a Co -Applicant Agreement dated February
20, 2014, wherein the parties agreed that the CHC budget would be submitted to the City Council
after approval by the Governing Board and providing that "the City Council may not unilaterally
revise a budget approved by the Governing Board or approve an alternate budget for the Health
Center without review and final approval by the Governing Board, with subsequent follow-up by the
City Council"; and
WHEREAS, the Governing Board of the CHC approved the 2015 Seward Community
Health Center Section 330 (Year 3) grant budget at a board meeting held on August 27, 2015, and
the Coordinating Committee ("Committee") of the CHC met to review the grant budget, and both the
Governing Board and the Committee recommend approval by the Seward City Council.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF SEWARD, ALASKA that:
Section 1. The Seward City Council hereby approves the 2017 budget of the Seward
Community Health Center ("CHC"), representing the Year 3 grant budget for Section 330 funding
through the Health Resources and Services Administration.
Section 2. The CHC is requesting a financial contribution from the City of Seward in the
amount of $400,000 for the 2017 grant year which will be subject to approval by the Seward City
Council during its upcoming budget deliberations.
Section 3. This resolution shall take effect immediately upon its adoption.
CITY OF SEWARD, ALASKA
RESOLUTION 2016-054
PASSED AND APPROVED by the City Council of the City of Seward, Alaska, this 6h day
of September, 2016.
THE CITY OF SEWARD, ALASKA
can Bardarson, Mayor
AYES:
Casagranda, Keil, Squires, McClure, Altermatt, Bardarson
NOES:
None
ABSENT:
Butts
ABSTAIN:
None
ATTEST:
Brenda J. B ou, CMC
Acting Cito�,db
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Meeting Date: September 6, 2016
'To: City Council
Through: Jim I-Iunt, City Manager
From: Kristin Erchinger, Finance Director
Agenda Item: City Council Co -Applicant Approval of Section 330 Seward Community
Health Center 2017 Budget
BACKGROUND & JUSTIFICATION:
The Seward City Council authorized the creation of the Seward Community 1--lealth Center (SCHC)
and governing Board when it enacted Ordinance 2010-008 in December 2010, subsequently
amended by Ordinance 201.3-013 on December 16, 2013.
The City of Seward and SCHC are co -applicants for Section 330 federal funding to operate a
federally qualified health center in Seward; together, the entities comprise the Health Center. The
parties entered into a Co -Applicant Agreement (Agreement) on February 20, 2014 approved by City
Council Resolution 2014-018. This Agreement requires that the SCHC budget be approved first by
the governing Board and then by the City Council, and includes the following language:
§ 3.2.4 "The Governing Board shall approve the annual operating and capital budget in accordance
with Section 330 requirements and City policies, The overall plan and budget shall be prepared
under the Governing Board's direction by the Health Center's management team and the
Finance Committee (rfthe Governing Board "
§ 3.2 5 "The Governing Board shall submit an annual budgetfi)r the health center to the City Council
for approval, as a co -applicant requirement of Section 330. The Board shall submit the budget
no later than October I (?f each yearjbr, the, following year. if the Board unreasonably fails to
approve an annual budget, the City may still submit the annual funding request tinder Section
330 of the Federal Public Health Service Act. No budget shall become e ctivcr without City
Council approval.
§ 4.2.4 "The City Council shall be responsible for adopting the Health Centers, annual operating and
capital budgets as finally approved by the Governing Board; the City Council may not
unilaterally revise a budget approved b)� the Governing Board or approve an alternate budget
for the, Health Center without review and final approval by the Governing Board with
subsequent.161low-up by the Council in accordance with Seward City Code 2.40.030(a).
In accordance with Section 5 of the Agreement, the parties also agree to participate in a Coordinating
Committee comprised of one member each of the Governing Board, the City Council, the Health
Center executive director, and the City Manager or his designee. This group met to review the
proposed 2016 Seward Community Health Center budget and has recommended its approval. The
budget must be submitted to MRSA no later than September 19, 2016.
Further, Health Resources and Services Administration (HRSA) issued Policy Information Notice
2013-01 on March 18, 2014, requiring that health centers prepare and submit grant applications that
contain a total budget for the health center scope of services for 12 months, and the budget must
include a separate budget breakdown for the Section 330 funding proposed for the application
period, showing costs supported by the grant and costs supported by other sources of non-I-IRSA
funding (i.e. patient revenue, City grant funding, other funding).
INTENT:
Fulfill the City's obligation as co -applicant Section 330 grantee, to approve the 2016 Seward
Community Health Center grant budget.
CONSISTENCY CHECKLIST:
Yes
No
N/A
1.
Comprehensive Plan (document source here): "L.ffivive,
.4�ctive, accessible,
�f
X
16rdable healthcare ", p. 12.
af
Strategic Plan (document source here): "Maintain and enhance medical
2.
services",,
X
3.
Other (list): Co -Applicant Agreement dated 2120114; MRSAMRSAPIN 2013-
X
01, p_5 -ti.
FISCAL NOTE:
The SCHC anticipates HRSA federal funding for the period 2/l/16-1/31/17 totaling $1,204,453
including a base allocation of approximately $709,681 and expanded services allocation of $341,462.
These amounts are subject to change by IIRSA, depending on patient visits. The SCFIC requests
$500,000 from the City to support its 2016 operations during its first year operating with a full staff
of three full-time providers. As the clinic achieves its goal of increasing patient visits, it is expected
that patient revenues will comprise a larger portion of clinic funding, necessitating less operating
subsidy From the City. The clinic is estimating patient revenues of $1,217,805 in 2016.
Approved by Finance Department:
4 � ", < —
ATTORNEY REVIEW: Yes — No—X
RECOMMENDATION:
Resolution 2015 - 054 City Council approve the Section 330 Co -Applicant Seward Community
Health Center 2016 Budget.
SEWARD COMMUNITY HEALTH CENTER
City of Seward City Council
August 26, 2016
Action Item
Topic: Seward Community Health Center 2017 330 Grant Budget
Recommended By: SCHC Board of Directors
Action Requested:
The Board of Directors is recommending that the Seward City
Council approve the 330 Grant Budget for grant year 2017 for
submission to HRSA
Discussion:
Every three years 330 grantees are required to submit a rigorous set of application
materials through a funding announcement called a Service Area Competition (SAC).
and three of this three-year
project period cycle, we are required to submit an annual Budget Period Progress Report
or BPR. One major part of this multi-part BPR is our proposed 330 grant budget for the
th
upcoming budget period. Our BPR is due to be submitted no later than September 19.
Our Co-Applicant Agreement requires that the City Council approve the annual federal
grant budget after it has been approved and recommended by the SCHC Board of
Directors. The Board unanimously approved the grant budget at its regular monthly
meeting held on Thursday Augusts 25, 2016, and is, therefore, recommending approval
of the grant budget by the City Council.
Please remember that there are some unique requirements for submitting federal 330
grant budgets that make them different than how we do our annual fiscal year budgets
(which come through the Board process in November and December of each year). 330
grant budgets must achieve a $0 bottom line. And we have to budget our federal dollars
to a very specific number contained in one of the boxes on our most recent Notice of
Grant Award (NGA). But even with these budget requirements, we do our best to make
the budget calculations and estimates as realistic and relevant as possible so that much of
what we prepare can also be used when preparing the fiscal year budget in a few months.
\[2017 GRANT BUDGET HIGHLIGHTS AND ASSUMPTIONS FOLLOW\]
Page 1 of 3
2017 330 Grant Budget Highlights and Key Assumptions
SUMMARY:
Following the required federal grant budget format, there are two sections/columns to the grant
budget which when combined make up the total budget:
HRSA (Federal) 330 grant revenue $1,147,754, and
Other (Non-Federal) revenue of $1,921,174
The budget includes a breakdown of sources for Revenues & Expenses.
Revenues \[$3,068,928\]
o HRSA 330 Budget $1,147,754
1
o City of Seward contribution $400,000
o Patient Revenue $1,361,174
o Other/In-kind revenue $160,000 ($100k for 340B and $60,000 in-kind rent)
Expenses \[$3,068,928\] Note: HRSA grant budgets require that expenses equal revenues
o HRSA 330 funds used entirely for salaries and wages $1,147,754
o Non-Federal Expenses (includes some salaries/benefits & other operating costs)
$1,921,174
Salary & Benefits $1,329,485
Other Operating Costs $591,689
KEY ASSUMPTIONS:
Patient volume totals 6,679 billable provider encounters. This begins with our targeted
projection of unduplicated patients for 2017 which is the same as that which is contained in our
SAC application or 3,036 patients. The number of patients assumption is then multiplied byan
average of 2.2 encounters per patient per year for a total of 6,679 encounters.
Patient revenue/payer mix is based on estimated billable encounters per payor from our actual
billing history and net income (gross charges less discounts and allowances) per visit as follows:
60% of encounters are Private Insurance @ $204.82 per encounter (up from 52%)
14% are Medicaid @ $289.74 per encounter (up from 11%)
18% are Medicare @ $194.52 per encounter (down from 20%)
8% are Self-pay @ $44.15 per encounter (down from 17%)
The Staffing Profile includes 2 physicians and 2
s are being increased from current level and include:
o 3.75 providers (2 physicians & 2 physician assistants)
o 6.50 clinical support staff (RN, medical and nursing assistants)
o 1.0 RN quality manager (new)
o 3.0 front desk staff (registration & medical records)
o 1.0 RN health educator/case manager
o 2.0 outreach & enrollment (1 social worker/1 coordinator)
o 1.0 billing specialist
1
SCHC requested and received $500,000 from the City for 2016 and a $400,000/$100,000 two-tier allocation in
2017
Page 2 of 3
o 3.15 admin staff (Executive Director, Finance Director, Executive Asst., Medical
Director)
Usual and customary non-personnel expenses include:
o Billing/RCM services ($72,142 or 6% of net patient revenue)
o Electronic Health Records System and IT Support fees ($29,900)
o CHC CFO/fiscal management oversight services ($18,000 Providence Seward)
o Independent Auditor ($15,000)
o Legal Services ($3,000)
o CHC technical consultation ($38,000 Suzanne, 340B, APCA, others)
o Utilities & Services from Providence ($90,982)
o Liability insurance packages ($20,257)
o Medical, pharmaceutical and office supplies ($100,358 detailed analysis of recent
history done for this budget)
o Community Outreach and Enrollment ($8.800)
o Minor equipment ($29,449 this is where we adjusted expenses to get bottom line to
zero)
o Board travel and education ($14,000 4 director trips @ $3,500/trip)
o Provider and staff travel and training ($35,000)
Page 3 of 3
Seward Community Health Center, Inc.Year 1
2017 Budget DraftHRSAOtherTOTAL
WORKING BUDGET - NOT FOR SUBMISSIONFederalNon-Federal
Volume:
# of Patients 3,036
Patient Encounters6,679
Revenue:
Federal BPHC 330 Grant1,147,754 1,147,754
Applicant -
State / Local- 400,000 400,000
Other Federal Funding-
Other- 160,000 160,000
Program Income (Patient Revenue)- 1,361,174 1,361,174
TOTAL REVENUE1,147,754 1,921,174 3,068,928
Expense:
Personnel - Refer to Form 2 Staffing Profile
Administration / Management211,735 128,824 340,559
Facility and Non-Clinical Support Staff152,264 - 152,264
Physicians - 420,000 420,000
NP, PA, and CNMs240,000 - 240,000
Medical378,968 - 378,968
Dental- - -
Enabling Services164,787 - 164,787
Other Programs and Services- - -
Total Salary Expense1,147,754 548,824 1,696,578
Fringe Benefits:
Health Insurance 32.84% 557,174- 557,174
1.06% 18,00018,000
Housing Allowance
Medicare/SS 6.71% 113,766113,766
0.97% 16,39716,397
AK SUI
Retirement 3.00% 50,897- 50,897
1.44% 24,427- 24,427
Workers' Compensation
Total Fringe Benefits 46.01% 780,661- 780,661
Subtotal Personnel and Fringe1,147,754 1,329,485 2,477,239
Travel:
Providers and Staff- 24,500 24,500
Board- 14,000 14,000
Other- -
Subtotal Travel- 38,500 38,500
Supplies:
Pharmacy / Medications$ 6.56 43,805- 43,805
$ 6.70 44,74544,745
Medical Supplies
Office- 11,808 11,808
Minor Equipment (<$5,000)- 29,449 29,449
Subtotal supplies- 129,807 129,807
Seward Community Health Center, Inc.Year 1
2017 Budget DraftHRSAOtherTOTAL
WORKING BUDGET - NOT FOR SUBMISSIONFederalNon-Federal
Contractual:
Patient Care:
Patient Related/Contractual- 4,740 4,740
Non-Patient Care:
Accounting- 18,000 18,000
Audit 15,00015,000
Billing & Coding72,142 72,142
Legal- 3,000 3,000
Services - Electronic (HIT)29,900 29,900
Technical Assistance / Consulting- 38,000 38,000
Subtotal Contractual- 180,782 180,782
Other:
Bank Fees- 6,000 6,000
Communications- 27,960 27,960
Dues & Subscriptions- 10,000 10,000
Equipment Maintenance- 3,000 3,000
Facility Janitorial Contract/PSMC10,560 10,560
Insurance - Malpractice Gap Coverage- 15,664 15,664
Insurance - Property1,018 1,018
Insurance - D&O3,575 3,575
Outreach & Enrollment8,800 8,800
O&E Supplies1,800 1,800
O&E Advertising/Promotion5,000 5,000
O&E Postage2,000 2,000
Patient Transportation1,200 1,200
Postage / Freight- 1,500 1,500
Rent: Clinic - 60,000 60,000
Repairs & Maintenance- 40,616 40,616
Training- 10,500 10,500
Utilities- 39,806 39,806
Community Health Education- 2,400 2,400
Subtotal Other- 242,599 242,599
3,068,928
TOTAL EXPENSE1,147,754 1,921,174
Must = 0 for balanced budget 0- 0