COUNTY RATE INFORMATION SYSTEM 2013 TRAINING SEMINAR

1. COUNTY RATE INFORMATION SYSTEM 2013 TRAINING SEMINAR Presenters: Karen Jess Connie Heeren

2. Welcome • CRIS (County Rate Information System) • Began in 2000-2001 • In the process of wrapping up the 12th year! • ISAC provides administrative support • The Electronic Transactions Clearinghouse is the governing body

3. The role of EideBailly • Maintain provider database • Administer & review the cost report • Issue reports • Provide support • Provide training • Solicit input for improving the process

4. Forms • Service Information Form • In Excel format • Looks like an Iowa Basic Skills test form! • Referred to as the SIF • Cost Report • In Excel format • Format is similar to other cost report forms (HCBS, HAB, etc). • Has 24 service columns. More available if necessary.

5. Prepare SIF Negotiate rates Complete cost report Reports issued Eide Bailly reviews & finalizes cost report Process flow…… START HERE

6. What is a Service Information Form? • Converts the service information into a 7-digit code based on 6 unique criteria. • Establishes which services the Provider should be tracking the costs for and reporting on in the coming year. • This form is the FOUNDATION for the process.

7. When to complete the SIF? • Prior to the start of the Provider fiscal year being reported. • The best time to complete the form is when you are negotiating rates. • The SIF should be completed TOGETHER– both the CPC & Provider should have input on services to be reported. • The CPC is responsible for submitting both a signed and an electronic SIF to EideBailly • The initial SIF may need to be updated if services change.

8. Develop a game plan • Is the Provider already completing a CRIS report? • Could you work with other member counties to identify which services the Provider should list? • If several counties are involved, it could become difficult for the provider to organize their information to satisfy everyone.

9. Game plan continued ……………….. • What services are provided? • Who funds these services? • What services should be detailed? • Could services be combined? • Is there subcontract or retail activity? • If so, how should the related revenue be reported?

10. Game plan continued…… • How is the unit defined—hourly, daily, etc.? • Do clinician credentials affect the rate? • What is the staff to client ratio for the service?

11. Completing the SIF (Provider Info) • CRIS ID# - ignore this field • Provider name • Federal ID # • Provider Address • Host County No. (use dropdown list) • Fiscal Year End • Provider Signature • CPC Signature

12. Completing the SIF (Other Information) • County No. – Host County 2-digit number • If more than 1 host county (reporting together), then combine the 2-digit numbers (lowest to highest). • Description Code- Should be “Z” unless specific service type is other, 2 or more of the same 7-digit code, or you need a unique description to appear on reports. • Description of service is informational only, but is highly recommended.

13. Completing the SIF (description code) • If the description code is something other than “Z”, a briefdescription of the service is needed in the table on the second tab of the Excel file. • This description will print on reports (following provider name), to further define the service. • Description codes MUST be consistent from year to year.

14. Service Code Segments • The code is composed of 6 segments • General Service Type • Facility Size • Specific Service Type • Unit of Service • Rate Dependent on Clinician Credentials • Staff to Client Ratio

15. General Service Types • 3 = Support Services • 4 = Treatment Services • 5 = Vocational/Adult Day Care • 6 = Residential

16. Facility Size • 0 = Not a residential service program • 3 = 1-5 beds • 4 = 6-15 beds • 5 = 16-49 beds • 6 = 50+ beds

17. Facility Size • Residential services use codes 3-6, depending on the number of beds available • SCL typically uses code #3 (1-5 bed). SCL in this category would typically be focused on living skills training and not medical treatment support. • All other services will report using zero as the code

18. Support Services • 25 = Respite • XX = Transportation • 99 = Other

19. Treatment Services • 05 = Therapy/Treatment • 09 = Partial Hospitalization • 63 = Adult Day Treatment • 96 = CSP/CSS • 97 = Psychiatric Rehabilitation (ACT) • 98 = Psychiatric Rehabilitation (IPR) • 04 = Consultation/Education • 39 = Activity Services • 99 = Other

20. Vocational/Adult Day Care • 60 = Shelter Workshop • 62 = Work Activity – Pre Voc • 64 = Job Placement • 67 = Adult Day Care – Day Hab • 68 = Supported Employment • 69 = Enclave • 99 = Other

21. Residential • 14 = RCF • 15 = RCFMR • 16 = RCF PMI • 17 = Nursing Facility • 29 = Supported Community Living • 99 = Other

22. Unit of Service • Daily = 1 • Hourly = 2 • Monthly = 3 • ½ Day = 4 • Mile = 5 • Trip = 6

23. Rate Dependent on Clinician’s CredentialsNormally only affects MHC’s • 0 = No distinction • 1 = Psychiatrist • 2 = Psychologist – licensed PHD/Health Care Register • 3 = Master Level Nurse/Social Worker/Psychologist • 4 = Nurse Practitioner

24. Rate Dependent on Clinician’s Credentials Cont. • 5 = Licensed Mental Health Counselor • 6 = Blended rate (one rate is developed for all mental health clinicians excluding psychiatrists.

25. Staff to Client Ratio • 0 = N/A – transportation only • 1 = 1:1 • 2 = 1:2-5 • 3 = 1:6-10 • 4 = 1:11-15 • 5 = 1:16 + (RCF’s – use 3-11 shift)

26. Staffing Target Number • Will help to standardize the calculation of units staffed on the cost report. • Staffing target number – This is the staffing ‘goal’. If the last digit in the code is 2 (1:2-5), then the target should be 2, 3, 4, or 5. This target number is used to compute units staffed for all hourly and daily services (except 24 hour RCF’s). If the target is 2, then the expectation is that for every 2 consumers, there will be 1 direct staff on duty.

27. Subcontract • Expenses associated with production/contract work should NOT be reported with the vocational service. The host county will need to identify production/contract work as a separate service on the SIF(without a 7-digit code). The Provider will then report these costs in a separate column on the cost report (consumer wages, etc).

28. Miscellaneous • PLEASE do not alter the form. It is designed to import into an Access database program • If you need additional columns, complete a 2nd form

29. After the form is complete • Email a completed form to EideBailly for import into their database • Send a signed copy of the form to EideBailly for their files • Keep a copy for your records – both CPC and Provider • Highly recommended that the Provider send a copy to the person preparing the cost report

30. Summary • Develop a game plan • Use the team approach – work together • Simplify when possible • Send copies to EideBailly when completed • Recommended that you send a copy to whomever is preparing the cost report • Update codes as necessary

31. Questions on the SIF??

32. County Rate Information System (CRIS) Cost Report Form

33. Cost Report Components • Certification Page • Units staffed worksheet - complete after Sch E • Schedule A – revenue • Schedule B – staff numbers & wages • Schedule C – expense adjustment • Schedule D – depreciation • Schedule E – expenses • Schedule F – balance sheet • Schedule G – equity reconciliation • Schedule H – allocated costs

34. Suggested Completion Order • Certification Page - leave units staffed blank for now • Schedule A - make sure it ties to the audit - if different, provide reconciliation. May be different due to expenses netted with revenues on audit, etc. • Schedule B - need payroll records showing FTE's etc. This cannot be completed by an outside accounting firm without help from management. • Schedule C • Schedule D

35. Completion Order, cont. • Schedule E • Column 1 - agree to audit, with exceptions similar to #2 above • Column 2 - make sure it agrees to Schedule A • Column 3 - should agree with Schedules C & D • Column 4 is a computed column • Show allocation methods in Column 5 - put some thought into this! • Direct cost section by service • Statistical information table at bottom of page by service • Compute allocation basis values - may want to do this at the bottom of the schedule. • Allocate admin, occupancy support care and other costs based on allocation methods chosen. BE CONSISTENT from year-to-year. • Review the calculated values at the bottom of the schedule - do they make sense?

36. Completion Order, cont. • Units staffed worksheet - complete using the information you reported in the table at the bottom of Schedule E. The calculated value should then be input on the Certification Page in the Statistical section. • Schedule F - information should agree to audited figures. • Schedule G - most of the information is carried from other schedules. If the ending equity does not agree to Schedule F, you must make the adjustment on this schedule and explain it. • Schedule H - check yes or no. If yes, you must show how the parent arrives at the value of the expenses allocated to you.

37. Certification Page • Cost report is due 90 days after your fiscal year end - Provider is responsible for using the correct version of the form. (print preview: revised 5/21/07) • Complete ALL sections • ALL services identified on the Service Information Form (SIF) must be entered in the “Statistical Data for Period of Report” section. (even those without a code)

38. Certification Page – cont. • Required to have a CPA firm perform an audit of your financial statements (the CPC may elect to accept reviewed or compiled statements) • Required to send a copy of your agency’s audit/review/compilation report to EideBaillywithin six months after close of your agency’s fiscal year

39. VERY IMPORTANT TO COMPLETE PROPERLY • Description Code from SIF – alpha-letter assigned to the service code. • Description of service – highly recommended for easier identification on Sch E • Service Code – this must be the same code as assigned on the SIF

40. Certification Page – cont. • Units of Service Staffed: recommended you complete this after completing Schedule E • Units of Service Provided – billable units as defined in instructions • This number is NOT a guesstimate! • Use correct unit type (hour, day, etc.)

41. Schedule A - revenue • Total revenue should agree to your audit report (provide reconciliation if different) • Adjustment Amount - make sure total agrees to Schedule E (column 2) – upper items automatically carry to this column on Sch E, others need to be manually entered on Sch E in the same column.

42. Schedule A – Grants • Grants that enhance services need to be recorded as reimbursement income (and offset against expenses). • Expenses that enhance a service would be expenses that were not necessary to provide the service and only occurred because grant funding was received.

43. Schedule A – Grants • Enhancement grants should be listed in the upper section of Sch A and in column 2 on Sch E as an offset to the related expense, or on one of the “Other:” lines • Include a description • Can also report in a separate column

44. Schedule A - Subcontract & retail • These are listed on the SIF with nocode • Schedule A – 3 ways to report • All revenue offset • No revenue offset • Partial revenue offset This needs to be discussed with CPC prior to completion of the report!

45. Schedule B – job classification • ADMINISTRATOR WAGES. Salary of the agency administrator only • BUSINESS OFFICE/CLERICAL WAGES. Include salaries and wages for other administrative positions such as assistant administrator, CFO, controller, bookkeeper, and clerical support.

46. Schedule B – job classification (cont) • OTHER SUPERVISORY WAGES. Salaries and wages for other supervisory staff not included in business office/clerical. Include supervisors of maintenance staff, direct care staff , and laundry/dietary service staff. • MAINTENANCE WAGES. Include salaries and wages for positions that provide maintenance services or housekeeping services.

47. Schedule B – job classification (cont) • PROFESSIONAL DIRECT STAFF WAGES. Salaries and wages of staff that provide professional services to the consumers and may provide supervision, assistance, and support to direct care staff. These staff must spend at least 50% of their time working directly with MHDD clients. Examples of positions include psychiatrists, psychologists, nurses, social workers, program supervisors, team leaders, and coordinators.

48. Schedule B – job classification (cont) • OTHER DIRECT STAFF WAGES. Employees who are working in a non-supervisory position with consumers. Duties of a direct care staff might include: assisting consumers with daily living skills, personal care needs, employment training or vocational activities, implementing behavior management plans, transporting consumers, and providing individual comprehensive plan training.

49. Schedule B – job classification (cont) • LAUNDRY/DIETARY SERVICE WAGES. Salaries and wages for positions that provide laundry or dietary services such as dietary supervisors, dietary aides, cooks, launderers, and dishwashers. • OTHER SUPPORT STAFF WAGES. Salaries and wages for non-supervisory staff that do not fit into other staff descriptions.

50. Schedule B - wages • Number of Staff • Enter the number of staff working full time or part time for each job title (body count) • FTE’s (full-time equivalents) are based on 2,080 hours. FTE’s are an important analytical tool and need to be reported accurately • An employee can be considered full-time and represent more or less than 1 FTE