Finance Committee Executive Committee February 5, 2018

FY18 Performance - December Cash position up $229k from 11/30 – Cash balance 1/29/18 - $2.7M (includes $0.98M CD’s) New Medicaid/DMH is $1.14M down $38K from last month; A/R - $132K from grant funders (high confidence to collect). Have received to date in Jan for older non-DMH A/R balances - $171K. DMH-Medicaid A/R remaining open from FY17 is $76.8K. $100K investment in Page General Partner – write off debt from Page Project Accred Liabilities – $102K for 3rd payroll in March 2018 Dec revenue represents ramp up to projected run rate

FY18 Performance YTD

Questions Moving Forward FY18 Financial Performance % to Revenue FY18 YTD FY17 YTD 6,858,259.53 5,832,893.22 93% 89% Finance Committee Feb 1 - FY18 Budget Projections Revenue CCBHC Revenue Projections Analysis – Billable Visits T1 Housing – Medicaid Contra added to budget (prior year Deferred Revenue) – through Nov ($209K) A/R is accountable Expenditures Wages, Tax, Benefits - ↑ 12%, (10%) under budget Professional Fees - ↑ 292%, 177% over budget – ($350K) Cash Infrastructure - $0.6 - $0.8K Sept 3 payrolls Sept billable visits Performance Excellence Clinical/Operations and Finance Treatment Plans - Outcomes CCBHC Revenue Projections Analysis # Visits (by different staff, visits to claims into $189) # Health Coaches (clinical staff) – 162 in Oct & Nov # Work Days in Month – 21 or 22 Billable Visits – 1.7/FTE Hired Financial Analyst Forecasting Treatment Plans Impact for Clients’ Health/Life Improvement

Value Stream Mapping, Dashboard Development December 19 & 20 Client Engagement through Cash Collection PfP A3 Objectives linkage through Finance A3 Objectives Drill Down Process Map – Client Engagement through Cash Collection; Effective Visual Communication within PfP Process Improvement – Productivity/Efficiency Gains – Premier Health Organization Revenue Forecast Model Treatment Plan Model FTE Health Coaches Billable Hours ACT Team – Monthly Contacts ~$115/Contact Residential Specialists ~$200/Contact Grant Revenue Work Session Agenda Cash position Current finance packet report Billing & Payment Processes A/R Model – Billing to Receipt, 100% Complete 12 – 6 – 3 Month Rolling Average

Value Stream Mapping, Dashboard Development December 19 & 20 Client Engagement through Cash Collection Hope Journey We arrived at our next steps to build the Revenue Forecast Model Treatment Plan Model –   Laura & I will meet with you for 30 minutes at 3 pm on January 3rd, prior to our Executive Committee Meeting, and walk through our recommendations on how to get this done without disruption to the organization (gathering new data, why are we gathering data, etc.) – included is what people/functions will be involved, estimate of # of man hours, time frame to complete (4-5 weeks?) After our meeting, based on your input, we can present it to the Executive Committee (5 minute discussion) on January 3. After the Executive Committee approval, I believe we should meet with the 3 Clinical Directors & possibly Gary Morse & Jamie Greenfield to get their “buy-in “ to our process; the process focused on our time spent with clients, helping them on their journey – this is not a process designed to find “poor performers”.  We discussed this briefly during our September Finance meeting.  I believe this process assists our Health Coaches provide effective assistance to our clients.  The 3 Clinical Directors & HR should help us craft the message we send the organization (formally or informally) to keep this on a positive, helpful activity. At a mutually agreed upon start date (Feb 1, mid-Feb, March 1) we will begin the development of the Revenue Forecast model Treatment Plan model. We are excited to begin this journey – definitely an important step to becoming a premier health organization.

Health Coaches Develop Customized Journeys for Clients “Provide caring, effective services to help those with the greatest challenges recover from mental illness and associated chronic illnesses.” Through the provision of accessible, efficient, effective and accountable treatment services; individuals and families served will reach their full potential for a purposeful and meaningful life. The Hope Journey Begins - Levels of Care – CPRC, ACT Team, Transition "Illuminating the possibilities" and working collaboratively with those we serve to design a path toward a meaningful life. Housing Employment Therapy Health Coaches Develop Customized Journeys for Clients The Recovery Center Medical Services Path Intake Assessment Outreach “…to have the opportunity to live, work and thrive as an integral part of their community…” Nurturing Children & Youth Treatment Plan Model – Client Impact Moving Forward

Treatment Plan – Client Impact Next Steps Develop historical monthly FTE report by Category; 1/2016 – 3/2017 Health Coaches ~$100/Hour ACT Team – Monthly Contacts ~$115/Contact Residential Specialists ~$200/Contact Dr/RN/Other ~$80/Event Develop special report to collect Billable Hours by FTE Category; 1/2016 – 3/2017 Treatment Plan Analytics – Merge FTE Category with Billable Hours by FTE Category Treatment Plan Client Impact – Baseline Model of Time with Client Insight – Understand New Model of Visits/Contacts Daily with Clients

Health Coaches Develop Customized Journeys for Clients “Provide caring, effective services to help those with the greatest challenges recover from mental illness and associated chronic illnesses.” Through the provision of accessible, efficient, effective and accountable treatment services; individuals and families served will reach their full potential for a purposeful and meaningful life. The Hope Journey Begins - "Illuminating the possibilities" and working collaboratively with those we serve to design a path toward a meaningful life. Levels of Care – CPRC, ACT Team, Transition Health Coaches Develop Customized Journeys for Clients Treatment Plan Housing Employment Treatment Plan Therapy Treatment Plan Billable Hours Client Impact Client Impact Client Impact 25 The Recovery Center Medical Services Path Intake Assessment Outreach “…to have the opportunity to live, work and thrive as an integral part of their community…” Nurturing Children & Youth Treatment Plan Model – Client Impact Moving Forward Enhancements, Effectiveness for Client Impact Share Best Practices amongst Health Coaches Forecasting Treatment Plans Impact for Clients’ Health/Life Improvement Next Steps – Team Session with Clinical Directors, Gary & Jamie

CCBHC Journey Intake to Billable Visits to Payment April 2016 FY18 Budget FY Actuals FY18 Actuals versus Budget PfP developed CCBHC Cost Report $189 per Billable Visit, from $100 per Billable Hour FY18 Actual Costs for Treatment Plan >$189/Visit In FY19, PfP will Re-Base Cost Report to >$200/Visit DMH allows Cost Re-Base sometime 1/2019 → 1/2020? Medicaid Revenue based on Estimated Billable Visits Professional Fees: Program & Service Costs estimated from CCBHC Cost Report CCBHC Requirement Estimated Charity (Non-Medicaid) Revenue (DMH) & Costs Out Patient Program: Estimate Revenue & Costs No Capex Budget Impacts Cash Flow Oct – Dec ↓ 1.7 Billable Visits per FTE/Health Coach July 1 Projected $.34M Budget Surplus ↓ 1.7 Billable Visits, Revenue ($.94M), Professional Fees ($.74M), Charity Projected FY18 Deficit ($1.3M) Run Rate: FY18 ($.94M), Bridges & Peter & Paul Run Rate: FY18 ($.74M) Non-Case Management Psychiatric, Therapy, Substance Abuse, Eating Disorder Capex: $0.21M

PfP Health Coach Playbook Connected CCBHC Journey Processes - Intake to Billable Visits to Payment PfP Health Coach Playbook CCBHC Aggressively Pursue Re-Base FY18 Budget FY19 Budget Process Priority Impact, Execute FY18 Actual Costs for Treatment Plan >$189/Visit In FY19, PfP will Re-Base Cost Report to >$200/Visit DMH allows Cost Re-Base sometime 1/2019 → 1/2020? Regional Allocation from other Providers FY18: $0 - $0.6M DMH allow PfP to Recoup the $/Visit to New Base Cost Medicaid Revenue based on Estimated Billable Visits Professional Fees: Program & Service Costs estimated from CCBHC Cost Report CCBHC Requirement Estimated Charity (Non-Medicaid) Revenue (DMH) & Costs Out Patient Program: Estimate Revenue & Costs No Capex Budget Impacts Cash Flow April - June ↑ 2.7 Billable Visits per FTE/Health Coach Head Count Adds (3 - 4) Clinical + Fuel (Fill up the Tank) Develop, Change CCBHC Processes Fuel – Easy, “Go Do It” behaviors in Playbook Good Practices – Clinical Cross Team Input 30 Days to Implement New Practice in Playbook Productivity, 1.7 to 2.7 to 3.5 Billable Visits per Health Coach Project Professional Fees: FY18 Actuals & Insight Project Charity Costs: FY18 Actuals & Insight Non-Case Management Psychiatric, Therapy, Substance Abuse, Eating Disorder FY19 Capex Budget