Mental Health Board Minutes on Pioneer Center Problems

These are draft minutes from last Wednesday’s 708 Mental Health Board minutes.

The only reporter in the room was The First Electric Newspaper’s Pete Gonigam. You can find the link to his article in McHenry County Blog’s article entitled, “Pioneer Center in Trouble.”

Pioneer Center Revision

1. 201612-03 FY16 Decision Memo Pioneer Center Funding Allocation Revisions

B. Available Client Services Budget

McHenry County Mental Health Board Building

McHenry County Mental Health Board Building

Connee [Meschini] prefaced the discussion by inviting Pioneer Center representatives to the table and thanking them for their
leadership through a difficult time.

She noted that everyone here, Pioneer Center and MHB, want to do their best to continue to provide quality behavioral health services to the citizens of McHenry County.

Prior to discussion about the larger organizational plan, the first thing that the Board would like to address is the current state of MHB funded Mental Health programs at Pioneer and related client services.

Through communication from the former CEO/President and the prior meeting, held with Pioneer Center officials, the MHB would like to be clear that it has not unilaterally withheld FY16 contracts.

The decision was made in consultation with, and as a result of information shared from Pioneer Center.

After discussion, the decision was made that the MHB and Pioneer together would actively begin seeking providers to continue

  • psychiatric services,
  • certain adult behavioral health services, and
  • TBI Services.

This is the MHB’s and the behavioral health community’s first priority and focus.

(The MHB needs to understand the) overall position of Pioneer Center as the MHB has a fiduciary responsibility to ensure that Pioneer is in a position to deliver services indicated in DD/Homeless Services Contracts (and therefore needs to be certain
of) Pioneer Center’s plans for the continuation of DD/Homeless services under MHB contracts.

Mike Moushey, Board President came to the table.

He announced the appointment of Sam Tenuto as Pioneer Center Interim ED, replacing Jackie Wells. Mike continued providing a history to-date of Pioneer Center.

He noted that his team has been unable to articulate their financial situation and has since brought in an outside consultant to enable Pioneer staff to understand the circumstances.

Mike cited primary fundamental issues with revenue cycle management causing issues with billing and a team that did not adequately understand revenue cycle management or have the ability to articulate the situation in a timely manner.

He continued, noting that there is no clear timing for relief from the state for approximately $3.2M of account receivable.

Further issues involve an IT system not working properly causing about 25% of billing to be rejected.

Mike outlined a 90-Day Action Plan, provided to the MHB executive director at 3:37 p.m. today, that centers around a very aggressive revenue cycle management program with new staff, triage on IT issues to identify system gaps, a plan to strengthen billing tracking (manual or automatic), and assessing programs that may not be a good fit for the organization.

Scott noted that the MHB members and staff had been operating under the opposite premise as of last Friday, and until 3:37 p.m. today when this letter detailing a 90-Day Action Plan arrived via email.

Dave McArdle noted that on Dec. 4, he and Jackie Wells, Mike Moushey, Connee Meschini, and Scott Block met for discussion arriving at a cooperative understanding that the MHB would seek out other providers for the MI programs.

The MHB did that time-intensive work and found other providers. Dave asked Mr. Moushey for clarification that he and Pioneer Center now want the MHB to stop that action, and that Pioneer wants to continue these programs for 90 days to prove that they could successfully maintain the programs.

Bruce Treadway voiced that the MHB has a fiduciary responsibility to the taxpayers of McHenry County.

Strategically, he was concerned with the radical shift of intent over that past weeks and how the direction has changed dramatically from what the MHB Board and staff knew just this morning.

He noted deep concern that the MHB has supplied many staff hours as a resource in attempt to accomplish what Pioneer had originally requested.

Financially he voiced concern over the testing of (the Evolve system begun in August which has now found $1M
misplaced by lack of training) a new system.

Connee added that Dan McCaleb had called her just days ago and asked how soon the Board could take over the Pioneer Center programs. Board members voiced that their confidence level is low.

Mike said that the 90-Day Plan is a final plan as a bridge to seek best service to clients in the future from an efficiency, cost and client service perspective.

Dave McArdle clarified that the funding contract already approved and provided to Pioneer as their original request was at one level and since then Pioneer Center has determined that this was not enough funding; the bridge funding being asked for according to Mr. Moushey is somewhere near an additional $100,000 per month.

Scott noted the importance of continuity of services on behalf of the clients. The MHB and Pioneer Center still have $1.2M in DD contracts in place, the Board is now struggling with which agency is best able to supply the services ongoing and is not in an informed position this evening to make a decision regarding bridge contracts and the
justification of $100,000 in additional funding as requested.

Work has already begun with Aunt Martha’s, Epilepsy Foundation and Thresholds and the Board would have to do their fiduciary responsibility to ensure prudent funding decisions be made.

He noted that MHB funds account for only 15% of the Pioneer budget.

It may be possible to come up with a short-term contract until other agencies are ready to move.

The Board has found at least four other providers willing to step in to provide the Pioneer services and needs to handle this in a fiscally responsible manner.

The Board needs time to review the information and the financials submitted this evening.

Given the late notice of this 90-day plan, and after much discussion, the Board voiced lack of confidence in Pioneer Center.

Concern was noted over the amount of MHB staff resources, already overburdened, attempting to fix service issues based on request of Pioneer Center.

Further concern was mentioned regarding the four agencies who have struggled to ramp up services in order to meet demands voiced by Pioneer Center.

Most importantly, concern was voiced for the clients receiving services who would likely experience interruption in care.

The Board determined it was best to make no decision at this time, rather to study the information just provided and present this for discussion at the December 22 regular meeting.

The MHB requested the following of Pioneer Center:

  • A revised budget accounting for the $100k shortfall with justifications,
  • numbers as a stand-alone DD agency in the event that the Board would grant bridge funding,
  • a well-articulated plan, clear strategic direction ensuring that both internal staff and external stakeholders understand the situation,
  • financial controls,
  • a contingency plan for divesting Pioneer Center of MI, and
  • financials through October by Friday in order for inclusion into the Board member packet information.

Mike asked that Scott formulate a request to ensure contents.

= = = = =
5 PM on Tuesday night another meeting of the 708 Board will be held on Pioneer Center at 620 Dakota Street, Crystal Lake.

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