2016 DADS and DSHS Report III Training Texas Council of Community Centers CFO/Financial Management Consortium 2016 DADS and DSHS Report III Training

History of Report III Report III provides the primary source of financial data for DSHS and DADS about the services and use of funds by Community Centers The report was a combined summary of expenditures by program from its inception to 2006 In 2005 House Bill 2292 and the 78th Legislature merged 12 HHSC agencies into 5 paving the way for changes in the Report III as TDMHMR divided into DADS and DSHS

History of the Report III Pre – 2006 Combined Actual Revenues by Source of Funds General and Administration MH Adult - Assessment, Service Coordination, ACT, Supported Employment, Supported Housing, Crisis Resolution, New Gen Medications (Meds Only), All Other MH Adult Community Services MH Child - Assessment, Service Coordination, New General Medications, All Other Children’s Community Services MH Community Hospitals IDD - Assessment, Service Coordination, Vocational Training, Supported Employment, Training & Support Services, In Home and Family Supports, Waiver Services, ICF – ID, IDD Comm Residential Services Other Services Non Priority Population TDMHMR

History of Report III Changes from 2006 to 2007 The Revenue by Source of Funds was split into two separate reports, one for DSHS and one for DADS DSHS updated the columns to separate medications costs, track value added services, and identify Medicaid type services. DADS added separate columns for HCS and TxHml to track activity separately.

History of the Report III 2006 Revenues by Source of Funds Mental Health IDD General and Administration MH Adult - New General Medications, Other Medications, Medication Related Services, Flex Funds, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential MH Child –New General Medications, Other Medications, Medication Related Services, Family Support Services, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential Community Hospital IDD - Assessment, Service Coordination, Respite, Vocational Training, Supported Employment, Training & Support Services, In Home and Family Supports, HCS, TxHmL, ICF – ID, IDD Comm Residential Services Other Services Non Priority Population DSHS and DADS

DSHS and DADS began to require the filing of two independent reports History of Report III Changes from 2006 to 2007 DSHS and DADS began to require the filing of two independent reports DSHS report required all elements from 2006 with the addition of two columns in the Other Services sub strategy, one for no admin and one for General and Administrative only DADS moved MH expenditures to the Other Service Column and added a row to record all related revenues

History of the Report III 2007 Mental Health Revenues by Source of Funds General and Administration MH Adult - New General Medications, Other Medications, Medication Related Services, Flex Funds, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential MH Child –New General Medications, Other Medications, Medication Related Services, Family Support Services, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential Community Hospital IDD - Assessment, Service Coordination, Respite, Vocational Training, Supported Employment, Training & Support Services, In Home and Family Supports, HCS, TxHmL, ICF – ID, IDD Comm Residential Services Other Services Non Priority Population – Split, Other Services – Both GA & AA, Other Services – No Admin, Other Services – GA Only Intellectual and Developmental Disabilities – IDD Only Assessment, Service Coordination, Community Support, Respite, Employment Assistance and Supported Employment, Vocational Training, Day Habilitation, Specialized Therapies, In Home and Family Support, HCS, TxHmL, ICF-ID, IDD Residential Services Other Services (MH) – Both GA & AA, Other Services – No Admin, Other Services-GA Only DSHS and DADS Requires Submission of two separate reports

History of Report III Changes from 2007 to 2008 DSHS added three columns to record New Crisis activity received in the legislative session which created MCOT teams and other crisis expansion DSHS moved IDD services to the Other Services Column but still required method of finance be recoded on specific rows at a detailed level for the IDD services No changes for DADS

History of the Report III 2008 Mental Health Revenues by Source of Funds General and Administration MH Adult - New General Medications, Other Medications, Medication Related Services, Flex Funds, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential MH Child –New General Medications, Other Medications, Medication Related Services, Family Support Services, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential New Crisis Services-Crisis Residential, Crisis Outpatient, Crisis Screening & Eligibility, Crisis Other Community Hospital Waiting List Other Services (IDD)– Both GA & AA, Other Services – No Admin, Other Services – GA Only Intellectual and Developmental Disabilities – IDD Only Assessment, Service Coordination, Community Support, Respite, Employment Assistance and Supported Employment, Vocational Training, Day Habilitation, Specialized Therapies, In Home and Family Support, HCS, TxHmL, ICF-ID, IDD Residential Services Other Services (MH) – Both GA & AA, Other Services – No Admin, Other Services-GA Only DSHS and DADS

Move eliminated Waiver Service columns History of Report III Changes from 2008-2013 to 2014 DSHS had no changes DADS eliminated the requirement to submit a DADS CAM and reworked the Report III to categorize the expenses into CAM related sub strategies to be paired with encounter data Move eliminated Waiver Service columns

History of the Report III 2014 Mental Health Revenues by Source of Funds General and Administration MH Adult - New General Medications, Other Medications, Medication Related Services, Flex Funds, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential MH Child –New General Medications, Other Medications, Medication Related Services, Family Support Services, Medicaid Type Services, Value Added Services, Screening & Eligibility, All Other Outpatient Services, Crisis Residential New Crisis Services-Crisis Residential, Crisis Outpatient, Crisis Screening & Eligibility, Crisis Other Community Hospital Waiting List Other Services (IDD)– Both GA & AA, Other Services – No Admin, Other Services – GA Only Intellectual and Developmental Disabilities – IDD Only Assessment, Eligibility Determination, Service Coordination (R017,R019,341,345,355,360), Service Coordination (351), Independent Living Support, Respite – In Home, Respite – Out of Home, Supported Employment, Vocational Training, Day Habilitation, Specialized Therapies – Various Therapies, Spec Therapy – Behavior Supports, Spec Therapy – Nursing, IDD Residential Services, CLOIP Other Services (MH) Both GA & AA, Other Services – No Admin, Other Services – GA Only. DSHS and DADS

2016 Report III House Keeping Items 2016 Report III is Submitted Quarterly DADS - Deadline can be found in Attachment N of the Performance Contract and is emailed to the Center’s Quarterly by DADS staff Title of submission calendar item is either IDD Financial Reporting or Report III (3rd Quarter 2016) Instructions are sent out each quarter by DADS. The due date ranges between the 15th and the 17th of the month following each quarter, with the final year end report due December 30th of the next fiscal year. DADS provides a Report III submission file each Quarter, with very specific naming convention guidelines in the instructions (170 Report III ID Q3) File is uploaded SFTP IP address 168.58.225.183 or website https://sftp.hhs.state.tx.us/ (At PBCC we currently use Filezilla to perform this transmission) If the sftp site is down then submission would be done by email to the Contact Manager for each Center and to performance.contracts@dads.state.tx.us

2016 Report III House Keeping Items 2016 Report III is Submitted Quarterly DSHS - Deadline can be found in Information Item S (Submission Calendar) of the Performance Contract Title of submission is Quarterly CARE Report III & IV. Report IV is the In Kind Match Report included in the Report III files. Ranges between the 15th to the 17th of the month following each quarter with the final year end report due December 30th of the next fiscal year, just like DADS. DSHS provides the Report III instructions annually located in Information Item D of the Performance Contract. The Report III submission file is provided annually to each Center at the time the Budget deadline is established. The naming convention is similar to DADS but not addressed in the instructions. (170 Report III MH Q3) File is uploaded FTP ftp2.mhmr.state.tx.us (At PBCC we currently use Filezilla to perform this transmission) The file should also be submitted by email to the Center’s Contact Manager and to performance.contracts@dshs.state.tx.us

DSHS and DADS Instructions Highlights 2016 Report III DSHS and DADS Instructions Highlights DADS Instruction Highlights – Very specific about electronic submission and the naming convention as previously mentioned III Revenue ID is the name of the Revenues by Source of Funds worksheet in the Report III workbook. This worksheet should Include all funds earned by the Local Authority, including those over and above what is necessary to fund services. III ID is the worksheet for recording expenditures by method of finance. Expenditures can include items unallowable under the Federal Circular that are funded by local funds or other non-state sources. Attachment F of the performance contract provides the service descriptions, CARE reporting codes, and their crosswalk to the III-ID worksheet. Addendum I to the instructions provide the detailed instructions of what should be included in General Administration. Administration expenses are limited to 10%, anything above must be funded by other funds.

DSHS and DADS Instructions Highlights 2016 Report III DSHS and DADS Instructions Highlights DADS Instruction Highlights – Strategy A.4.2 includes column ID Community Residential Services which would be General Revenue funded IDD residential services, Centers must have specific authorization to report expenditures in this column. Other Services I – Both GA and AA will include all MH expenses with the exception of medications. Medications belong in Other Services II - No Admin Other Services III – GA Only will include Substance Abuse, ECI, DARS, HUD, TDCJ, etc. The row for Capital Outlay includes only individual items costing in excess of $5,000, regardless of the Centers local capitalization policy. GR must be used at 100% of what is allocated or returned to DADS HCS funds do not include IDD TCM delivered to HCS consumers and the same goes for any other waiver revenues reported for ICF, TxHml, etc. All funding included in lines 701-708 can be included as match except Workshop or Production Income, including revenues generated through TXDOT contracts.

DSHS and DADS Instructions Highlights 2016 Report III DSHS and DADS Instructions Highlights DSHS Instruction Highlights – Pretty much the same as the IDD instructions with exception of the below Centers should use the DSHS Community Mental Health Service Array to map the Encounter codes to each Report III sub-strategy. This can be found in MBOW. DSHS Contract Attachments and Amendments will also include notes to which rows and sub-strategies the expenditures and revenues should be reported on in Report III Centers should use the definitions for classification of General Administration as provided in Attachment V of the CAM manual. As with DADS, General Revenue funds up to 10% for administration. MH Block Grant funds can use up to 5% for administration Any excess must be funded by other funds Other Services I – Both GA and AA will include all IDD expenses with revenues recorded on specific rows.

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Phase I Extract data from the iServ for Texas Centers clinical system by running reports that detail all staff and client time delivered for the current Report III time period. PBCC utilizes these data sets to create summaries of hours three ways Client Time by Project ID, Staff Type when necessary (Physician, Crisis Worker, Screener, State Hospital Liaison, etc.), and Report III sub strategy Client Time by funding source for the IDD division (Remnant from the 2008 to 2013 reports which required detailed costing of waiver services in separate columns, this is still used to assure as much as possible that no GR is used to support waiver service activities) Staff Time by Project ID and IDD service code for vocational, day habilitation, and SHL/PAS-HAB transportation for IDD workshops

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Client Time by Project ID, Staff Type when necessary (Physician, Crisis Worker, Screener, State Hospital Liaison, etc.), and Report III sub strategy Allows the division of MH clinics with multiple functions by sub strategy based on the services activity codes recorded in the clinical system.

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 2. Client Time by funding source for the IDD division Allows cost to be summarized by funding source for IDD to assure that waiver services are not covered by any GR. Documented in the work papers since the report no longer seperates these funding sources.

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Staff Time by Project ID and IDD service code Allows the breakout of IDD Workshop services by service based on the staff’s time rather than the client’s time to maintain proper staff to client ratios

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Phase II Summarize / Organize the General Ledger for entry into the main work papers PBCC uses an accounting structure made up of 90 revenue accounts and 88 expenses accounts to allow easy categorization into reports Revenue and Expenses are placed into 130 Project IDs to track by grant, division, program, county, and function. PBCC dumps the General Ledger to Excel, ties the revenues and expenses to the income statement taken to the Board of Trustees, then separates each into its own work paper Expenditures Labeled by account to summarize into the Report III expenditure rows using a Excel Pivot Table Items unallowable or funded by local and non-state / federal funds are identified during this step and either moved to Other Services to resolve any confusion on what funding was used or placed in a separate work paper to assure funding appropriately Including but not limited to: Client Wages and Supplies used in IDD workshop production activities Food expenses that are in programs that do not serve food to clients Travel reimbursements in excess of the allowed State and Federal Per Diems Sales Tax, Chamber of Commerce Dues, Texas Council Annual Fees, Employee Relations Costs, Employee Entertainment Costs, Association of Substance Abuse Programs (ASAP) Annual Fees

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Phase II Expenditures Individual Capital Purchases in excess of $5,000 are labeled as Capital Outlay (Center Capitalization threshold is $500) Remaining item in capital accounts are labeled as Non-Capitalized Equipment A detailed report of Wages and Benefits by Staff and Project ID is reviewed as a quality assurance measure to make sure all staff are categorized into the programs as expected Corrections are made by journal entry before proceeding Expenditure work papers are devised to place expenses into sub strategies based on the following mapping created from the instructions

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - MH

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - MH

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - MH

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - MH

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - MH

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - IDD

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures by Sub-Strategy - IDD

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Expenditures Project ID have the following paths to Report III: Project IDs that are clinical/programmatic indirect and thus allocated by the activity presented in the direct service Project IDs that they support Project IDs for workshops that need allocated by both Staff and Client Hours Project IDs that require allocation by Client Hours Project IDs that specifically identify to a sub-strategy in the report

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 1. Programmatic Indirect Expenditures Programmatic Indirect Allocations are allocated using Labor Costs to Project IDs of benefit

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 2. Distributed Project IDs – IDD Workshop Expenditures IDD Workshop Expenses are allocated using first staff time and then client time

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 3. Distributed Project IDs – MH Expenditures MH Expenses are distributed by Project Id to sub strategies using clinical data

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 3. Distributed Project IDs – IDD Expenditures IDD Expenses are distributed by Project Id to sub strategies using clinical data

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process 4. Project IDs Benefitting a specific sub strategy Project IDs that benefit a specific sub strategy are entered directly to the sub strategy

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues Using Project IDs or Cost Centers the revenues are organized into the various Divisions so that a high level method of finance can be prepared that balances the revenues and the expenses Important Items of Emphasis: Identify the in-kind revenues available from facilities, volunteers, PAP, etc. to assure that the preparer is aware of how much cash match much be shown Identify client fees for DADS and DSHS programs, in addition to the amount of interest that is available from prospective DSHS and DADS deposits to show the funds as spent and a cash match source Be sure to show all Performance Contract funds for DADS and DSHS as spent

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues Important Items of Emphasis: Identify all unallowable expenses to assure coverage with non state / federal funding Identify all Client Wages and Production Supplies associated with IDD workshop activities to assure coverage with TXDOT or Production Income funding sources Identify all funding from Managed Care Organizations for placement in line 704 Know what revenue sources are flexible and can be placed in reserve and which sources must be shown as spent Recommendation: Classify revenues by division and report strategy as earned and move as little as possible to bring into balance

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues – Report III Funding Summary

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues – Report III Funding Summary

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues – Report III Funding Summary

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues – Report III Funding Summary

Permian Basin Community Centers Preparation Process 2016 Report III Permian Basin Community Centers Preparation Process Revenues – Report III Funding Summary

2016 Report III - Permian Basin Community Centers Preparation Process Revenues – The Balancing Act – IDD Example Page

2016 Report III - Permian Basin Community Centers Preparation Process Review of the PBCC Actual DADS and DSHS Excel files filed for the 2nd Quarter of 2016

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson) 1) Completion of Legislative Budget Board performance measures, which are reported through the Automated Budget and Evaluation System of Texas (example from prior fiscal year pasted below). These measures are generally due on the 21st-23rd day following the close of each state fiscal quarter. STRATEGY-RELATED MEASURES DEFINITIONS REPORT 83rd Regular Session, Performance Reporting Automated Budget and Evaluation System of Texas (ABEST) Agency Code: 537 Agency: State Heath Services, Department of Goal No.: 2 Community Health Services Objective No.: 2 Provide Behavioral Health Services Strategy No.: 1 Mental Health Services for Adults Measure Type: EF Measure No. 1 Average Monthly Cost Per Audit: Community Mental Health Services

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson) Measure No. 1 - Average Monthly Cost Per Adult: Community Mental Health Services BL 2014 Definition This measure captures information regarding what it costs the state each month, on average, to provide community mental health services to each adult consumer who is assigned to any of the Resiliency & Disease Management service packages (levels of care 1-4). It measures the DSHS appropriation authority cost per consumer per service package as defined by the companion output measure. BL 2014 Data Limitations The accuracy of the department's client database is dependent upon accurate and timely information being entered into the data warehouse by the local mental health authorities. If the local authority does not provide accurate data for the quarter, this measure will not be accurate. (At the end of the fiscal year, community centers report preliminary expenditure information which is used for reporting in ABEST. Final expenditure information may be entered into CARE up to 4 months following the end of the fiscal year. Therefore, end of year values for efficiency will be updated in ABEST when information is available)

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson) Measure No. 1 - Average Monthly Cost Per Adult: Community Mental Health Services BL 2014 Data Source At the end of each quarter, staff of the local authorities input expenditure information into the data warehouse. The local authority indicates the fund sources used to finance the expenditures. The method of finance includes funds that are part of the DSHS appropriation authority as well as other local funds, grant funds, and earned revenues. BL 2014 Methodology DSHS appropriation authority funds include all general revenue and federal funds allocated through the performance contract. Also included are administrative claiming funds that the local authority receives following the submission of quarterly cost reports and Medicaid Service Coordination and Rehabilitation funds that the local authorities receive based on the submission of claims. The number of months in the reporting period are 3 for each quarter and either 3, 6, 9, or 12 for year to date. The numerator is the total DSHS appropriation authority funds utilized to fund adult MH community services as reported in the data warehouse / the number of months in the reporting period. The denominator is the average monthly number of adults receiving mental health community services that are served with DSHS appropriation authority funds. The formula is number / denominator.

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson) Measure No. 1 - Average Monthly Cost Per Adult: Community Mental Health Services BL 2014 Purpose This measure captures DSHS appropriation authority cost per person for adult community mental health services provided through the Resilience & Disease Management service packages levels of care (1-4). .

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson) 2. Development of new, and refinement of existing, Local Mental Health Authority Performance Measures (example: the new service targets deployed with the fiscal year 2016 amendment packet 1 were developed using expenditure data from CARE Report III). 3. DSHS staff regularly use CARE Report III when developing Legislative Appropriation Requests, which may include exceptional items (i.e., requests of new funding to develop or enhance programs), and return on investment analyses. It is also used when analyzing and attempting to understand the full scope of resources and services within Local Mental Health Authority local service areas, and the relationship between expenditures and service delivery. 4. Countless analyses required by agency and enterprise executive staff, or requested by governmental/legislative bodies or the general public.

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson)

DSHS Primary uses for Report III (Special Thanks to Christopher Dickinson)