WELCOME! PLANNING COUNCIL MEETING April 12, 2018

Transcription

1 WELCOME! 1 PLANNING COUNCIL MEETING April 12, 2018

2 INTRODUCTIONS 2 Please state your name for the record. Please note: You do NOT have to disclose your status during the introduction if you do not want to. *Moment of Silence*

3 3 APPROVE MEETING MINUTES (H-1) March 8, 2018 Steps in approving minutes: 1. Review minutes 2. Make a first and second motion to approve minutes 3. Vote All in Favor: Yes, approve minutes Opposed: No, do not approve minutes Abstention: Absent from previous meeting/ Decline to vote

4 GROUND RULES 4 Be on time Silence cell phones Participate Be respectful Agree to disagree Ask questions Speak up so everyone can hear you No Side Conversations Presenters represent agencies- no personal attacks Don't ask questions that accuse or assume where someone is coming from. Stick to asking questions regarding information. Respect the option for presenters to come back with additional information or answers. Send questions with more detailed explanations to the Executive Committee or PCS Whenever possible, enjoy yourself Don t assume everything is public knowledge Raise your hand and wait to be acknowledged by the Chair Step up, step back Don't interrupt

5 COMMITTEE REPORTS (H-2) 5 Each month, the Committee Chairs will provide a summary of their committee's activities. You can also refer to a handout in your packet for written updates.

6 6 Priority Setting Exercise (H-3 & H-4) Dan Drolet & Idayat O. Salami, SPEC

7 Priority Setting Exercise Instructions 1. Use the optional worksheet to help you practice the Priority- Setting Exercise. 2. Rank ALL the service categories 1 = most important 17 = least important 3. Copy the results onto the Priority-Setting BALLOT 4. Return the ballot to the Planning Council Support. Please do not turn in the worksheet

8 8 Sweeps Presentation & VOTE Adelina Alves & Jazzz Bennet, NRAC

9 FY18 UNDER-EXPENDED SWEEPS PRESENTATION Adelina Alves & Jazzz Bennett Needs, Resources and Allocations Committee (NRAC) April 12, 2018

10 Funding Process Review HRSA awards $$ to the Boston EMA to spend during the FY Boston EMA Planning Council directs BPHC to allocate award to specific service categories. BPHC awards $$ to providers according to Council directives.

11 Background Terms Used Un-expended Money: Money left over from the grant at the end of the year Under-expended Funds: Money from agencies spending at a rate less than they are supposed to

12 Types of Funds for Annual Allocation Unexpended Under-Expended Funding Scenarios FY 2017 (3/1/2017-2/28/2018) BPHC closes the books Any $$ leftover is returned to HRSA Unexpended Money FY2018 (3/1/2018 2/28/2019) Money not spent during the current grant year Enable BPHC to use an administrative process we call Sweeps. FY2019 (3/1/2019 2/28/2020) NRAC committee constructs a plan for next year s grant (Funding Scenarios) BPHC administers $$ Sweeps

13 The Sweeps Timeline Contracts are issued at beginning of Fiscal Year BPHC conducts review of spending at end of 1 st Quarter (May) and sends warning letters for programs that have spent less than 25% of funding After 6 months into fiscal year, BPHC reviews which agencies still are behind in spending (under-expended funds) BPHC meets afterwards to conduct a sweeps meeting to reallocate dollars that agencies have indicated that they would not be able to spend before the end of this year If necessary, this process can be repeated by the end of the 3 rd Quarter (November) with another sweep conducted to reallocate dollars

14 Some Causes of Under-spending Start-up delays in new programing Staffing vacancies Changes in the funding environment Utilization of other sources of funding

15 Consequences of Un-expended Money Reduction in future awards if greater than 5% Less flexibility to reallocate dollars Requires a request to HRSA to get the money back Reduces time to spend money if request is granted Reduces services in the Boston EMA

16 Benefits of Sweeps Process Maximizes services in the Boston EMA Maintains local control and flexibility of dollars Responds to changes in the EMA Respects the work of the previous Council by following funding priority Rapidly re-allocates money

17 Sweeps Process for FY18 BPHC monitors the provider contracts and sweeps up $$ from providers if they are not spending on schedule. FY 2018 Sweeps $$ BPHC allocates the sweeps $$ - first within the category from which they came, if another provider in that category can absorb them. Based on need within and among categories, feed the dollars through the remaining categories in accordance with the priorities established for FY2018 by last year s Planning Council. Service Category A Service Category B Service Category C

18 QUESTIONS?

19 Motion to Approve Reallocating FY18 Under-Expended Dollars Vote to accept the Needs, Resources & Allocations Committee (NRAC) recommendation for FY18 Under-Expended dollars, as presented: Expend the sweeps dollars first within the category from which they came, if the category can absorb them. Based upon need within and among categories, feed the remaining dollars in categories in accordance with the priorities established by the Planning Council for the current year, FY 2018.

20 20 Assessment of Administrative Mechanism (AAM) Presentation, Recommendations, and small group discussion Richard Swanson & Stephen Corbett, SPEC (H-5)

21 ASSESSMENT OF ADMINISTRATIVE MECHANISM By: Services, Priorities, and Evaluation Committee April 12, 2018

22 Provide summary of the Assessment of Administrative Mechanism (AAM) survey results Presentation Goals Learn about and discuss SPEC s recommendations for the Boston Public Health Commission (BPHC) 22

23 What is the Assessment of Administrative Mechanism (AAM)? A federally mandated assessment of how efficiently and rapidly the grantee (BPHC) allocates funds to the areas of greatest need within the Boston Eligible Metropolitan Area (EMA). 23

24 Timeline Oct Nov SPEC reviewed and updated survey tool December 2017 Distributed survey to all Boston EMA Part A agencies (32) Jan Feb Reviewed results from 32 Part A agencies April 2018 Presenting results to YOU! Feb.-March Draft and present recommendations in SPEC 24

25 Summary of Findings 94% of agencies responded to the survey This percentage reflects surveys received from 32 agencies Total number of responses: 42 25

26 1. Procurement 2. Disbursement of Funds 3. Contract Monitoring Process 4. Additional Questions The four survey sections: 26

27 Introductory questions (Q.1-3) Q-1: Agency Name (32) 27

28 TOP THREE SERVICE CATEGORIES THAT RESPONDENTS REPRESENT Question 2 Which Boston EMA Part A service categories were you funded for in FY 2017? 28

29 Question 3 Did you respond to the AAM survey in the past two years? 29

30 Procurement Description: A process in which Part A dollars are awarded to agencies to offer a particular service for PLWH. Process: 1. BPHC releases a Request For Proposal (RFP) 2. Interested agencies apply for funding 3. External (community participants) and Internal (BPHC staff) committees conduct reviews 4. Selected agencies are awarded Part A dollars for the following Fiscal Year 30

31 Procurement (Q. 4-6) 31

32 Procurement (Q. 7-8) 32

33 Procurement (Q. 9) Was sufficient time allotted to the RFP process? If not, please explain. 100% (22 out of 42 responses) said yes. Although we could always use more time, I believe sufficient time was allocated. The time was enough but more time could be given since we all have competing priorities. 33

34 Procurement (Q.10) What three suggestions would you offer to improve the RFP document and process? Give more time. Have more conference calls and Q&A before the process. Explain why some services are not funded. When calling with questions, quicker responses would be appreciated. 34

35 Disbursement of Funds Description: A process in which providers are reimbursed monthly for the services they provide to PLWH. Process: 1. At beginning of fiscal year, a contract is signed by agency and BPHC 2. A Purchasing Order (PO) number is created 3. Agency submits invoices each month 4. BPHC reimburses agency after processing invoice 35

36 Disbursement of Funds (Q ) Question Number Multiple Choice Results (39 responses) 11 86% reported that BPHC provides a clear scope of service for each contract % reported it takes BPHC between 7-15 days, 61% reported it takes BPHC between days and 26% reported it takes BPHC over 30 days to reimburse their agency for services, once a complete invoice is submitted. 36

37 Disbursement of Funds (Q. 13) What three suggestions would you offer to improve the disbursement process? Clarity and consistency. Expedite contract executing process, simplify budget revision process. Keeping agencies informed as to the status of the disbursement. 37

38 Contract Monitoring Process Description: A process in which BPHC communicates with Part A service providers to address challenges, offer technical assistance, and ensure adequate services are being provided for PLWH. Process: 1. Annual site visit 2. Quarterly reporting 3. Monthly calls 4. Data evaluation in E2Boston 38

39 Contract Monitoring Process (Q ) Question Number Multiple Choice Results (40 responses) 14 93% reported BPHC provided written instructions on what documentation would need to be available during the site visit % reported BPHC s feedback was helpful at or following the site visit % reported BPHC s ability to provide timely technical assistance was between average to excellent % reported BPHC s ability to provide complete technical assistance was between average to excellent. 39

40 Contract Monitoring Process (Q. 18) What three suggestions would you offer to improve the monitoring process? I believe we could use more advance notice when scheduling the site visit. BPHC are very good in communication regarding the monitoring process. Improved communication between contract staff and monitoring staff so all are on the same page and consistent messages to grantees so we are clear with expectation of the work. 40

41 Additional Questions (Q.19) Question Number Multiple Choice Results (N= 40) 19 68% were between very satisfied and completely satisfied with BPHC s administration of Ryan White Part A funds. 20% were satisfied with BPHC s administration of Ryan White Part A funds. 10% were slightly satisfied with BPHC s administration of Ryan White Part A funds. 2% were not at all satisfied with BPHC s administration of Ryan white Part A funds. 41

42 Is there anything else that may be helpful in assessing the administrative mechanism in place for the Boston EMA? Additional Questions (Q.20) BPHC does a great job administering the funding and helping my agency meet the requirements in the most efficient manner. Quicker turnaround and clearer guidelines around line item amendments. This process constantly changes depending on who reviews it. 42

43 Recommendations FY19 Categories: 1. Procurement 2. Disbursement of Funds 3. Contract Monitoring Process 4. Additional Recommendations for BPHC 43

44 SPEC Recommendations FY19 Procurement: 1. BPHC should create a system in order to submit RFP's via the web. 44

45 Disbursement of Funds: SPEC Recommendations (Cont d) 1. Standardize no more than 30 days to respond, complete, and execute a budget revision. 2. Send scope of services no more than 30 days from the start of a contract. 3. Reimburse for a portion of invoices that are correct and resubmit for incorrect in order to expedite payment. 45

46 Contract Monitoring Process: SPEC Recommendations (Cont d) 1. During the agency monitoring site visit, maintain the highest level of transparency possible, allow agencies to be a collaborative part of the process, and communicate preliminary results by the end of the site visit with the goal of no surprise citations. 2. Fiscal and agency monitoring team conduct site visits together. 46

47 Contract Monitoring Process: SPEC Recommendations (Cont d) 3. Have regular communication with agencies regarding expectations of agency and site visit agenda items prior to the site visit. Make it a discussion agenda item on monthly calls. 4. New contracts or newly contracted agencies should receive a site visit at the beginning of the FY (beginning of implementation). 47

48 Additional recommendations for BPHC 1. Recommend that BPHC reconcile discrepancies, if any, that exist between the monitoring team and the program coordinator who actually knows the agency. 48

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50 What surprised you about the results? Small Group Discussion Questions What were BPHC s strengths? What are the main areas that BPHC could improve? Are there additional points you want to make that would help improve BPHC s administrative process? 50

51 Vote on recommendations during the May 10 th Planning Council Meeting. Give BPHC an opportunity to respond in writing to recommendations. Next Steps BPHC will respond to recommendations during a presentation in June. 51

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53 AGENCY REPRESENTATIVE REPORTS (H-6) 53 Each month, each representative will offer policy, legislative, and programmatic updates from their government agency. The agency reps are: MA Office of Medicaid Alison Kirchgasser NH Department of Health and Human Services, NH Care Program Sarah McPhee MA Department of Public Health, Office of HIV/AIDS - Barry Callis Mayor's Office of Health and Human Services - André Lima Boston Public Health Commission Dennis Brophy

54 OTHER ANNOUNCEMENTS 54 This is your chance to spread the word about community events, research studies, or other resources that are related to the Planning Council's work.

55 EVALUATION AND ADJOURN (H-7) 55 Please fill out your evaluation forms! Don t forget to clean up & recycle!