HomeMy WebLinkAboutRes2021-092
City Council Agenda Statement
Meeting Date: August 23, 2021
To: City Council
From: Janette Bower, City Manager
Agenda Item: Resolution 2021-092: Approving the 2021 Grant Year Budget for the Seward
Community Health Center (SCHC) as Required by the Co-Applicant
Agreement Between the City of Seward and SCHC
Background and justification:
Ordinance 2010-008 authorized creation of the Seward Community Health Center (SCHC) and
governing Board.
The City of Seward and SCHC are co-applicants for Section 330 federal funding to operate a
federally qualified health center in Seward. The parties entered into a Co-Applicant Agreement
February 20, 2014 approved by City Council Resolution 2014-018, and subsequently amended it in
Resolution 2018-067, approved on August 13, 2018.
The co-applicant agreement requires City Council approval of the annual federal grant budget after it
has been approved and recommended by the SCHC Board. The SCHC Board approved the 2022
budget on August 9, 2021. The SCHC Administration and Board recommend City Council approval
of the budget.
SCHC Budget 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 $1,468,419 and
Other (Federal & Non-Federal) revenue of $2,603,526
The budget includes a breakdown of source for Revenue & Expenses.
Revenues \[$4,071,945\] o HRSA 330 Budget $1,468,419
o Other Federal Awards $444,625
o Patient Revenue $1,989,581
o Other/In-kind revenue $169,320 ($75k for 340B; $60,000 in-kind rent; $19,400 USAC
Program; $14,920 Misc Fee Agent, Interest, Etc)
Expenses \[$4,071,945\] - Note: HRSA grant budgets require that expenses equal revenues
o HRSA 330 used predominantly for salaries $1,312,809 vs $155,611 Operating Costs
o Non-Federal Expenses (includes some salaries/benefits & operating) $2,603,526
Salary & Benefits $1,744,512
Operating Costs $859,014
Consistency checklist:
Comprehensive Plan:Effective, accessible, affordable healthcare
Strategic Plan: Maintain and enhance medical services
Other: Co-applicant agreement dated 2-20-14
Fiscal note:
There is not a fiscal impact to the City and does require any type of funding.
Finance Department approval:
Attorney Review:
Yes No Not applicable
Recommendation
City Council approve Resolution 2021-092.
SEWARD COMMUNITYHEALTH CENTER
Board of Directors
August9, 2021
Action Item
Topic:2022Federal 330 Grant BudgetApproval
Recommended By:Finance Committee and Executive Director
Action Requested:The Board of Directors is requested to approve the 330 Grant
Budget for grant year 2022and recommend approval to Seward
City Council.
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).
Our last SAC was submitted and approved in 2018for the three year “Project Period” of
February 1, 2019,through January 31, 2022. Each of these three grant years is called a
“Budget Period.”Due to COVID, HRSA has extended our grant period by one year to
February 1, 2023.One major part of this multi-part renewalis our proposed 330 grant
budget for the upcoming budget period.Our report is due to be submitted no later than
September10, 2021.
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. The
th
Finance Committee has reviewed,and our board approved the 2022 budget on August 9,
2021.The SCHC Administration andthe Board is recommending approval to theCity
Council.
There are some unique requirements for submitting federal 330 grant budgets. The330
grant budgets mustachieve a $0 bottom line
\[2022GRANT BUDGET HIGHLIGHTS AND ASSUMPTIONS FOLLOW\]
2022330 Grant Budget Highlights and Key Assumptions
SUMMARY:
Following the required federal grant budget format, thereare two sections/columns to the grant
budget which when combined make up the total budget:
HRSA (Federal) 330 grant revenue $1,468,419and
Other (Federal & Non-Federal) revenue of $2,603,526
The budget includes a breakdown of source for Revenue & Expenses.
Revenues \[$4,071,945\]
o HRSA 330 Budget $1,468,419
o Other Federal Awards $444,625
o Patient Revenue $1,989,581
o Other/In-kind revenue $169,320 ($75kfor 340B;$60,000 in-kind rent; $19,400
USAC Program; $14,920 Misc Fee Agent, Interest, Etc)
Expenses \[$4,071,945\]-Note: HRSA grant budgets require that expenses equal revenues
o HRSA 330 usedpredominantlyfor salaries $1,312,809 vs $155,611 Operating Costs
o Non-Federal Expenses (includes some salaries/benefits & operating) $2,603,526
Salary & Benefits $1,744,512
Operating Costs $859,014
KEY ASSUMPTIONS:
Patient volume totals 6,510 billable encounters. This begins with our targeted projection of
unduplicated patients for 2022 which is 2,367. Through June of 2021 we are averaging 9.0
patients per provider day worked. Our 2022 projection will increase this metric by 11% to 10.0
patients per provider day worked.
Patient revenue/payer mix is based on estimated billable encounters per payor from our actual
billing history and net income through June of 2021 (gross charges less discounts and
allowances) per visit as follows:
54% of encounters are Private Insurance
23% are Medicaid
18% are Medicare
5% are Self-pay
COVID-19 Supplemental awards account for $414,625 in other federal funding.
The Staffing Profile, which includes 1.08physicians,2.20mid-level (PA, NP), and 1.17FTE for
Behavioral Health provider brings our FTE’s. to (22.56) projected for 2022.This is consistent
with 2021 budget FTE’s (22.56). Increases in wages are offset with decreases in benefit premium
contributions for a net of (17,511) from 2021 Budget. FTE’s include:
o 4.44providers (1.08physicians,2.20mid-level and 1.17BHclinician.
o 7.28clinical support staff (RN’s, medical and nursing assistants)
o 5.49front desk staff (registration, billing & medical records)
o 1.0 health educator/case manager/ clinic nurse
o 1.0outreach & enrollment (coordinator)
o 3.35 admin staff (Executive Director, Finance Director, Revenue Manager,
Administrative Services Manager)
Usual and customary non-personnel expenses include:
o Contractual expenses (418,170) decreased by 14.3% over 2021 Budget and include
ElectronicHealth Records System and IT Supportfees ($68,550)
Independent Audit ($33,000)based on 2021annual audit expenses
Behavioral Health prevention and screening services provided under contract
($145,000)
COVID-19 related contract project management services (57,000)
o Travel for staff and board(27,608) for 4 provider, 6staff and 4 board trainings and
conferences(approx. $2,000/trip).$5k increase over 2021 budget.
o Utilities & Facility Services ($96,950) 8% inc over 2020
o Liability insurance packages (24k) 15% increaseover 2020
o Medical,pharmaceutical and office supplies ($66,408) 11% decreaseover 2020
o Community Outreach and Enrollment ($10,450)
o Minor equipment ($89,650) –$85k allocated for COVID-19 related special projects
o Training and education ($12,350) –(4 providers, organizationaltraining resources)
Seward Community Health Center, Inc.GY 2022
2022 Budget Period Progress ReportHRSAOtherTOTAL
Budget Narrative - H80CS26600330 Federal
Volume:
# of Patients2,367
Patient Encounters6,510
Per Form 3, line 6
Revenue:
Federal BPHC 330 Grant1,468,419-1,468,419
Anticipated grant amount based on historical
awards (Includes IBHS Rollover Award $145k)
State / Local---
Other Federal Funding-444,625444,625
COVID-19 H8F Award = $414,625 + Anticipated
Quality Award = $30k
-
Other-169,320169,320
In-kind revenue from City of Seward for rental value
of clinic space = $60k and USAC Program $19,400;
340B Program Revenue $75k; Misc Income (Fee
Agent, Interest, Donations, etc) = $14,920
Program Income (Net Patient Revenue)1,989,5811,989,581
Per Form 3, based on historical reimbursement
information
TOTAL REVENUE1,468,4192,603,5264,071,945
Expense:
Personnel:
Administration/Management249,219250,571499,790
Facility & Non-Clinical Support Staff172,912125,659298,571
Physician174,107142,087316,194
NP, PA, and CNMs184,727160,627345,354
Medical353,398270,340623,738
General Practitioners / Supervising Physicians4,8482,9527,800
Behavioral Health (Mental Health & Substance Abuse)40,209109,485149,694
Enabling Services30,54323,76854,311
---
Total Salary Expense (Includes PTO Expense)1,209,9621,085,4892,295,451
Fringe Benefits:
Health Insurance (Includes Med/Den/Vis/LTD/STD/Life)-508,049508,049
Cell / Housing / Travel Allowance-1,5001,500
Medicare/SS90,74763,494154,241
AK SUI12,1008,46620,566
Retirement-60,99460,994
Workers' Compensation-16,51916,519
Benefits calculated as a % of salary expense
based on actual costs except housing allowance,
work comp and health insurance
Total Fringe Benefits102,847659,023761,870
-
Budget Justification
Page 1 of 4
Seward Community Health Center, Inc.GY 2022
2022 Budget Period Progress ReportHRSAOtherTOTAL
Budget Narrative - H80CS26600330 Federal
Subtotal Personnel and Fringe1,312,8091,744,5123,057,320
-
Travel:-
Providers and Staff-21,49721,497
2 staff @ $2,000 to lower 48 + 4 staff @ $2,500 to
lower 48 + 4 staff @ $1,500 for CME Travel + 4
staff @ $375 ea.for Anchorage trainings
Board-5,5005,500
2 Board @ $2,000/trip to lower 48; 4 Board @ $375
ea. for Anchorage trainings
Other - Local area Mileage611-611
Staff reimbursement for local travel @ $.55/mile
Subtotal Travel61126,99727,608
Supplies:
Medical Supplies/ Medications-69,85069,850
Medications at $3.69/encounter + medical suplies
at $6.97/encounter from 2022 budget + vaccines @
$500
Office Supplies5,00016,05921,059
~$4k per quarter estimated for 2021 projection +
$5k allowance for program specific supplies
Subtotal supplies5,00085,90990,909
-
Contractual:-
Patient Care:-
Patient-related/Contractual145,00032,320177,320
Contracts for after hours nurse call/triage and
follow-up / reminder services @ 125/month + client
transportation services @ $135/month + PRN
Translation services @ $600 + $145k/yr behavioral
health service contract + $28,600/yr 340B program
initiatives
-
Non-Patient Care:-
Accounting, Auditing, and Billing Services-101,850101,850
Includes $33k for annual audits; $850/mo contract
for statement & collection services; $2,575/mo
contracted payroll & benefit administration services;
$2,500 Medicare Cost Reporting Consulting;
$1,200/mo 340B administration services; $7,500
Software conversion support; $3,350 Other reviews
(401k, charge master, etc)
Legal-2,5002,500
10 hours @ $250/hour above current pro bono
contribution
-
Information Technology-68,55068,550
Budget Justification
Page 2 of 4
Seward Community Health Center, Inc.GY 2022
2022 Budget Period Progress ReportHRSAOtherTOTAL
Budget Narrative - H80CS26600330 Federal
Community Connect/EPIC annual support fees for
E.H.R. $6,240/Qtr; ConstantlyOn IT Services
contract $2,730k/mo; Contracted IT support for
COVID-19 related special projects $10,830
-
Contracted Facility Services-10,95010,950
Janitorial provided by PSMC; $912.50/mnth
Other-57,00057,000
COVID-19 related contracted project management
support services
Subtotal Contractual145,000273,170418,170
-
-
-
Other:-
Training-12,35012,350
Professional Membership Renewals $4,350/yr;
Foraker Trainings $2k/yr; 4 @ $1,500 CME
Educational Allowance
-
In-Kind Facility Expenses: Rent + USAC Telecom-79,40079,400
In-kind expense for value of donated rental of clinic
space $5k/mo; USAC Telecom Contribution
$4,850/qtr
-
Utilities-39,00039,000
Utility cost-sharing arrangement with PSMC based
on sq. ft. @ (+/-) $3k/mo.; $250/month for utilities
for administrative modular building.
-
Minor Equipment / Furniture-89,65089,650
IT Equipment Replacements $4,800 (laptops,
Ipads, etc); $84,850 COVID-19 related Telemed &
IT System update projects
-
Repairs & Maintenance-47,00047,000
Facility repair, maintenance, snow removal, and
groundskeeping costs paid to PSMC per cost-
sharing agreement @ (+/-) $3,500/mo; $5,000
Mobile Clinic project maintenance items
-
Tele-Communications-36,30036,300
Includes phone @ $1,775/mo; Internet @
$1,250/mo
-
Dues & Subscriptions-89,87389,873
Technical subscriptions / software licenses / web
hosting / etc @ $44,523k/yr; Software fees related
to COVID-19 telehealth projects $25,260; employee-
related memberships and license renewals @
$4,820/yr; General business / Chamber of
Commerce / Newspaper / etc @ $13,270/yr;
Vaccine Assessment @ $2k/yr.
-
Postage / Freight-2,6502,650
Shipping and miscellaneous postage costs @
$2,650/year based on 2021 projection
-
Budget Justification
Page 3 of 4
Seward Community Health Center, Inc.GY 2022
2022 Budget Period Progress ReportHRSAOtherTOTAL
Budget Narrative - H80CS26600330 Federal
Bank Fees-8,0958,095
Credit card processing fees @ $460/month
estimated based on current charges; Bank Fees @
$2,575/yr
-
Equipment Maintenance / Lease-3,8713,871
Equipment lease for postage machines @
$1670/yr; Repair and maintenance of copiers, fax
machines, laptops and medical equipment
estimated @ $550/qtr.
-
Recruiting & Retention5,00029,70034,700
Recruiting ads @ $750/qtr; License/Credential
renewals, salary scales, certifications $7,775/yr;
New hire testing, background check, setup
@$1,925/yr; $5,500/qtr SHARP for providers;
-
Insurance - Malpractice Gap Coverage/Property/D&O-24,00024,000
Premiums estimate based on 2021 contract
-
Outreach and Enrollment10,45010,450
Outreach supplies average $1,125 per quarter;
media communications for outreach and enrollment
program @ $1,250; outreach postage costs are
$500; $4,200 general advertisements
-
Subtotal Other5,000472,938477,938
-
TOTAL DIRECT COSTS1,468,4192,603,5264,071,946
-
Retained Earnings---
-
TOTAL EXPENSE1,468,4192,603,5264,071,945
Budget Justification
Page 4 of 4