WHAT’S NEW FOR

CONTRACTING FY2014–15

July 31, 2014 25 Van Ness Ave, Rm. 610

Overview of Today

CDTA

Grants Administration

BOCC

Cultural Competence

Controller’s Office

Policy Reminders

Budget Office

Welcome 2

Michelle Long

Contract Development & Technical Assistance 3

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CDTA Facts - Did You Know…

DPH Section (FY13-14) New Section Name Con-

tractors

n=129*

Con-

tracts

n=212

Pro-

grams

n=470

Community Behavioral Health Services-Adult and

Older Adult (CBHS - AOA)

Ambulatory Care-Behavioral Health

Services (BHS)-AOA 33% 19% 31%

Community Behavioral Health Services-Children,

Youth, and Families (CBHS - CYF)

Ambulatory Care-Behavioral Health

Services (BHS)-CYF 29% 16% 22%

Community Health Promotion & Prevention (CHPP) Community Health Equity & Promotion

(CHE&P) 3% 2% 2%

Community Oriented Primary Care (COPC) Ambulatory Care-Primary Care (PC) 2% <1% <1%

HIV Health Services (HHS) Ambulatory Care-Primary Care (PC) 29% 23% 15%

HIV Prevention Services (HPS) Community Health Equity & Promotion

(CHE&P) 12% 9% 7%

Housing & Urban Health (HUH) Transitions-Housing Services 22% 14% 9%

Maternal, Child, and Adolescent Health (MCAH) Ambulatory Care-Maternal, Child and

Adolescent Health (MCAH) 2% <1% <1%

Mental Health Services Administration (MHSA) Ambulatory Care-Behavioral Health

Services (BHS)-MHSA 26% 15% 12%

*contractors may have more than one contract across sections; therefore, column exceeds 100%

CDTA NEW WEBSITE!

www.sfdph.org/cdta

Contract Development Documents

Presentation Materials

Procedures and Guidelines

Important Dates

Resources

Staff Directory

Grants Administration Information

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CDTA – Contract Preparation 6

Common things that can slow down the contract

development and certification process

Expired insurance certificates

Use of incorrect document templates

Late documents

Waiting for contract modifications

Speeding up the Certification Process

GOAL: Minimizing the impact of late contract modifications on certification

The Impact of Late Modifications and late documents… The contractor can’t be reimbursed for new program services without a

certified contract.

Late submission of the contract documents limits the amount of time for quality review by DPH staff.

Late submission of contract documents places an undue burden on the Invoice Analysts because they have limited time to prepare invoice templates.

The annual budget process usually starts some time in November. Without a timely certified contract, the Budget Office is unable to reflect an accurate budget baseline by program for the next fiscal year’s budget.

THIS YEAR: 1) Turn in contract documents by the due date; 2) Don’t wait for anticipated modifications - any changes that have not already been included in your Funding Notification will be subject to a later contract modification.

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CDTA Program Managers 8

Francine Austin 255-3933 francine.austin@sfdph.org

Stephen Bañuelos 255-3411 stephen.banuelos@sfdph.org

Joseph Cecere 255-3931 joseph.cecere@sfdph.org

Elizabeth Davis 255-3934 elizabeth.davis@sfdph.org

Erik Dubon 255-3917 erik.dubon@sfdph.org

Mario Hernandez 255-3503 mario.hernandez@sfdph.org

Hilda Jones 255-3924 hilda.jones@sfdph.org

Jim Stroh 255-3445 james.stroh@sfdph.org

Eric Whitney 255-3932 eric.whitney@sfdph.org

Andrew Williams III 255-3928 andrew.williams@sfdph.org

CDTA & Grants Administration Staff 9

Michelle Long, Director 255-3409 michelle.long@sfdph.org

Margaret Elam, Secretary 255-3410 margaret.elam@sfdph.org

Jana Rickerson, Grants Administrator 255-3940 jana.rickerson@sfdph.org

Richelle L. Mojica, Grants Manager 255-3555 richelle-lynn.mojica@sfdph.org

Questions? 10

Jana Rickerson, LCSW

Grants Administration 11

Letter of Support for Your Grants

Thank You!

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Letter of Support for Your Grants

Reminders…

Requests for Letters of Support (LOS) take 2 weeks

The Director of Health needs 2 documents from your agency: Completed LOS form The draft letter you want signed

Once your request completes the DPH process the Assistant to the Director will contact you to arrange receipt of the letter

Sample form in your handout

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Letter of Support for Your Grants 14

Tom Mesa

Business Office of Contract Compliance 15

Review Cycles

Declarations of Compliance Review Cycles July – June

CBHS – Community Behavioral Health Programs

MHSA – Mental Health Services Act Programs

SAPP – Substance Abuse Prevention Programs

ECMH – Early Childhood Mental Health Programs

COPC – Community Oriented Primary Care Programs

HUH – GF (General Fund)

HHS – GF

CHEP – GF

January – December

CHEP – CDC (Centers for Disease Control and Prevention)

March – February

HHS – RW (Ryan White)

HUH - RW

Declarations are electronically sent at the START of review cycles (funding periods.) Program monitoring takes place after the conclusion of the review cycle.

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Performance Objectives

When writing individual program objectives

remember that in order for the performance

objective to be approved by SOC and CDTA, it

must:

Be measureable

Only measure one element per objective

Identify the data source of where the results can be found.

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New Declaration Clarifications

Transgender training and LGBTQ Youth training

Operating hours posted

Completion of ADA (Americans with Disabilities) form

CBHS – CANS (CYF Assessments) – new contact person

CBHS – Release of Information/Billing

CBHS – Medicare ABN (Advance Beneficiary Notice)

Program Profile Updates

Compliance Program – ACA requirement

Updated privacy and data security requirements

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Compliance Program

Affordable Care Act requires that any legal entity

providing healthcare services will have a

Compliance Program approved by their Executive

Director and Board of Directors. DPH requires that

a copy be kept in the Administrative Binder. The

Program will:

Designate a Compliance Officer

Ensure attendance at quarterly Compliance meetings

Be certified by the DPH Compliance Office

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Privacy and Data Security

Each agency must have a privacy official and this

person must be identified in Administrative Binder.

There must be proof that all staff have completed

privacy training upon hire and annually thereafter.

There must be an annually signed data

security/confidentiality form.

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Plans of Action Results

For Fiscal Year 2012/2013:

338 programs reviewed

129 desk audits

209 site visits

93 programs required a Plan of Action (28%)

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BOCC

Our motto:

“People do not do what is expected, people do what is

inspected.”

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Questions? 23

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Cultural Competency Report

Dr. Toni Rucker, Director Office of Health Equity, Cultural Competency, Workforce Development

SFDPH Ambulatory Care Services

July 31, 2014

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The Critical Role for Cultural Competence National & Local Health Care Changes

Affordable Care Act SF Community Health Improvement Plan Integrated, Coordinated Care across SF Health

Network Need for Systemic Planning & Evaluation of CC

standards Consumer, Family, & Community Involvement Reducing African American Health Disparities

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SFDPH Ambulatory Care Services Cultural Competency Report Requirement Annual Cultural Competency Report criteria:

All providers of direct services with contracts in excess of $500,000 (aggregate of all SFDPH Ambulatory Care Services contracts) &

All Ambulatory Care Service Civil Service direct service programs

Reports are due to the Office of Cultural Competence by September 30th annually

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Current CC Report Planning & Implementation

August 2012 – February 2013 (Planning) Cultural and Linguistic Competency Task Force planning &

revising the new standards and structure for CC reporting April 2013 – June 2013 (Trainings)

CLAS Standards & Focus Groups and Community Forums “How to Complete the Cultural Competence Report” &

“Facilitator” CC Reports submitted on September 30th, 2013 Extensions were given to programs services children, youth and

families to November 30th, 2013 Qualitative data analysis completed by students of SFSU and our DPH

external evaluator – April 2014 27

Process Overview: Indicator Development

March 2014 June 2014

SF State

team

preliminary

analysis

Data from the reports

Analysis framework

developed by OCC and

Consultant

Review of

framework Priority

areas generated

Systems-

Level

priority

Selected

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Aggregate Participant Demographics from CC Reports

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A total of 1092 participants across all

agencies*

84% of agencies engaged consumers and/or families members

16% engaged

community constituents

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The Analysis Framework Agencies were asked to explore three

thematic areas in their focus groups: Accessibility Consumer, Family, and Community Engagement Cultural Responsiveness

30 30

The Analysis Framework These three thematic areas were subdivided

into six organizational development categories: Organizational Planning Organizational Hiring Organizational Training Organizational Service Planning Organizational Evaluation Organizational Governance 31 31

Process Overview: Reporting and Implementation

July 2014 September 2014

System-level priority selected

Training sessions for

implementation and reporting

2014 Cultural Competence Reporting

Implementation of systems-level

priority (in 2014)

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What is the systems-level priority to be implemented?

Consumer, Family & Community Engagement Eligible agencies will plan for & implement a

Consumer/Community Advisory Board (CAB) Investigate targeted opportunities for

collaborations that increase clinic or program development & strengthening

For agencies with an existing CAB, the 2014-2015 reporting process will include an assessment and improvement of their existing CAB

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How was the systems-level priority selected?

Based on in-depth qualitative analysis of data gathered through the 2013-2014 CC reporting process

Reflects areas that were mentioned the most & most important to implement in forums and focus groups

Review aligns with ACA, MHSA CHIP, & Organizational Cultural Competence

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Why CABs as a systems-level priority?

With the implementation of the Affordable Care Act, consumer engagement is at the center of quality care

CABs provide an opportunity for meaningful consumer input and feedback on the currently health care delivery models and in quality improvement efforts

Input and data collected through a CAB has the potential to address concerns around quality of care, accessibility, and cultural responsiveness of services as part of agencies’ program Continuous Quality Improvement activities, etc.

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Implementing the systems-level priority

Complete a report outlining development plan for 2014-15 (required for contracts > $500K)

Plan for baseline, standard requirements for CAB development, functioning, and reporting

Document progress towards establishing CABs (and/or improving existing CABs)

Opportunity to learn from DPH clinics or programs with established CABs & receive DPH or State Technical Assistance, as needed

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Next Steps…

CC Report Training Dates

July 22nd

August 27th

September 3rd

Agencies will submit their implementation plan by September 30, 2014

Technical Assistance meetings & trainings

To be determined

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More Questions?

Dr. Toni Rucker (415) 255-3522 Toni.Rucker@sfdph.org Nelson Jim, MFT (415) 255-3422 Nelson.Jim@sfdph.org

S T R E T C H B R E A K 39

Susan Smith

Controller’s Office 40

Nonprofit Monitoring & Capacity Building Program

• What it is/purpose – Joint Citywide fiscal and compliance monitoring (not

an audit) for nonprofit organizations that have multiple City contracts (120+ orgs)

– Saves nonprofits time and City taxpayers resources – Training & TA to nonprofits and City depts. – Corrective Action Policy

• Who is involved: 9 depts. – Department of Public Health, First Five, Department of

Children Youth & Their Families, Department on the Status of Women, Human Services Agency, Mayor’s Office of Housing & Community Development, Office of Economic & Workforce Development, Arts Commission, Sheriff’s Department

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FY 13 Monitoring Findings

• FY 13 Memo – 60 nonprofit contractors (48%) met all standards, no

findings – 66 nonprofit contractors (or 52%) had 1 or more findings – 3 most common findings:

1. Financial Reports (29% of nonprofits), 2. Agency-wide Budget (21% of nonprofits), and 3. Cost Allocation Procedures (18%)

• Appendix A:

– Nonprofit Contractor with Most Findings in FY13 – Nonprofit Contractors with Same Finding Repeated in FY12

and FY13

• How Memo Used

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Support to City-Funded Nonprofits

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• TA – 7 nonprofits referred for TA by departments – Bayview neighborhood-based TA program – Issues focused on budgeting, cost allocation procedures,

fundraising, board development

• Training (Spring 2014) – Surveyed nonprofit contractors on training needs and

changed course offerings (Budgeting, Strategy for Sustainability and Impact; Engaging Board in Governance & Fundraising)

– 81 agencies trained and 34 agencies attended all 3 sessions – Next series: Spring 2015

• Southeast Nonprofit Resource Fair (1st ever, July 16th, 2014)

• Controller’s nonprofit resources website: – http://sfcontroller.org/index.aspx?page=788

Corrective Action Policy

• “Elevated Concern” can occur when a nonprofit has not done any or all of the following by City department deadlines: – Responded to the City’s request for monitoring

documents – Responded to the City’s request for corrective action – Provided a mutually agreed upon corrective action

plan – Implemented corrective action plan

• Red Flag: in rare cases, “red flag” status can occur when a nonprofit is at imminent risk of losing their funding for mismanagement or for being unable to perform services per their agreement

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FY 14-15 Future Directions

• Review policies, procedures and processes

• Create a pre-qualified pool of TA providers

• Increase support/capacity of both City contract monitors and nonprofits

• Ensure consistent accountability & enforcement for nonprofits & City Departments

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Feedback: We Want to Hear from You!

• End of Fiscal Year Survey – early August

• Departmental Monitors & Program Officers

• My contact: Susan.smith@sfgov.org or (415) 554-6126

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Questions? 47

Michelle Ruggels

Policy Reminders 48

Reminders… and Updates… 49

Proposition I Process

Fringe Benefit and Indirect Rate Change

Requests

Focus Groups (system change)

Reminder…Proposition I Requirements

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Agencies with new and existing programs, proposing new locations or site expansion, are required to adhere to the DPH Good Neighbor Policy, which is a departmental adaptation of San Francisco’s “Citizen’s Right-to-Know Act of 1998” (also referred to as Prop. I).

The Prop I legislation dictates mandatory community notification requirements within a specific radius to the proposed new or expanded site, followed by a community meeting(s) and a DPH Health Commission hearing.

The Department has prepared specific documents to assist agencies in understanding and meeting these requirements:

The “Proposition I Policy, Implementation Process and Instructions” contains an overview and includes specific agency implementation instructions; and

The “Request for Program Service Change” is a template that should be completed and submitted to DPH 60 days prior to the implementation of a new program, or a move or expansion of an existing program.

Contact your CDTA Program Manager for these forms.

Reminder…..Fringe Benefit and Indirect

Rate Cap Policies Exist 51

In May, 2012, the DPH Business Office established a formal policy identifying the contractual Fringe Benefit and Indirect Cost rate caps, and identifying the mechanism for making a request to exceed the rate caps. While the caps already existed in practice, the practice was not documented, and there was no formal mechanism for requesting to exceed the caps.

The reason DPH established the policies/rate caps was so that there could be a clear standard to work from across DPH, and a clear mechanism for requesting to exceed the cap. Additionally, by setting a standard, DPH would be part of the conversation should there be a need to increase the rate(s) (i.e. helping to identify how the increase would be funded, assuming no new funding, and thus that the increased rate would impact direct services).

Please contact your CDTA Program Manager for copies of the policies and corresponding forms as needed.

DPH System Planning and Focus Group

Update 52

As you know, the Department has been undergoing a process to determine how the Department will optimize and integrate contracted community based services into the San Francisco Health Network’s integrated delivery system.

We began in April and have completed 12 focus groups on various modalities/services with one more to go.

The notes from the focus groups will be posted, should anyone have more input to share.

The Department is developing a summary report of the findings/themes, etc., which will also be posted for comment, prior to a presentation of the report to the Health Commission.

For services that need to go out for RFP to reflect a proposed new service model, the goal would be for the new service(s) to begin by September, 2015.

Questions? 53

Shirley Giang

Budget Office 54

Cost of Doing Business

In FY14-15, the Department will receive funding to provide an additional 1.5% CODB increase to contractors

CODB award guided by same criteria as last year

General Fund, MHSA, Workorders that are funded by general fund, etc.

Grant funding IS NOT eligible for CODB award

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Newish…Capital Expenditures 56

Capital Expenditures for Cost Reimbursement and Fee-For-Service contract invoices

Proof of purchase is required for all expenses incurred within the Capital Expenditure category. Capital expenditures are items that exceed $5,000 per unit, including units of equipment that exceed $5,000.

DPH requires proof of purchase for capital expenses, (i.e. receipt). This proof of purchase should be submitted with the invoice that includes the expense.

The Contractor is required to submit an inventory list of all capital purchases that were paid by DPH with the final invoice of the Fiscal Year.

Please note:

Capital expenditures are not Medi-Cal reimbursable; therefore, the cost should not be funded by Medi-Cal and its corresponding matching funds, or built into the unit rate that contains Medi-Cal as a funding source. In other words, only non-matched General Fund monies may be used.

Most grants (and often work order) funding do not reimburse capital expenses.

Depreciation Expenses for Cost Reimbursement

and Fee-For-Service contract invoices

Depreciation is an allowable expense that DPH may reimburse. Contractors should

not assume under any circumstance, however, that DPH will provide additional funding, or

approve internal reallocations of existing funding to support this expense without prior

approval.

Contractor who wishes to include depreciation as a funded contract expense will be

required to obtain approval and provide supporting documentation to include an

agency-wide cost allocation plan and a depreciation schedule. This supporting

documentation must be submitted together with the budget justification included in the

Appendix B budget pages for approval.

Charges for depreciation must be supported by adequate property records and physical

inventories must be taken at least once every two years to ensure that assets exist and

are usable and needed.

Depreciation expense is not allowed:

if it is already included in the indirect cost.

if it is already funded though the capital expense category.

if it is used for matching purpose.

*No duplicate billing (i.e., no double dipping)

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Consultant and Subcontractor Expenses

Consultant and Subcontractor for Cost Reimbursement and Fee-For-Service contract Invoices

Contract that contains subcontractor/consultants expenses must submit a copy of all subcontractor contracts to their CDTA Program Manager prior to submission of the first invoice.

Invoice payments will be withheld until a copy of the subcontractor/consultant contract is on file with CDTA Program Manager.

Contractors that are providing reimbursement to subcontractors and/or consultants must attach a copy of the subcontractor/consultant’s invoice each time the contractor’s monthly invoice includes these expenses.

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Quarterly UOS Invoice Review

Fee-For-Service

Invoice

Cost Reimbursement

Invoice 15% below quarterly

benchmark % Invoice payment will be

processed; CDTA and

SOC will be informed for

plan resolution if

required

Invoice payment will be

withheld; CDTA will be informed

to coordinate with SOC for plan

resolution and payment

authorization

15% above quarterly

benchmark % Invoice payment will be

processed; CDTA and

SOC will be informed for

plan resolution if

required

Invoice payment will be

processed; CDTA and SOC will

be informed for plan resolution

if required

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UOS Quarterly Benchmarks

15% below Quarterly Benchmark

Quarterly

Benchmark %

15% below

Benchmark Will Flag Invoice for Follow-up if UOS/Deliverables are:

1st qtr 25% 21% Under 21% of deliverables

2nd qtr 50% 43% Under 43% of deliverables

3rd qtr 75% 64% Under 64% of deliverables

4th qtr 100% 85% Under 85% of deliverables *For Cost Reimbursement invoices, if units of service/deliverables are below 15% of contracted amount, payment authorization is required.

15% over Quarterly Benchmark

Quarterly

Benchmark %

15% over

Benchmark Will Flag Invoice for Follow-up if UOS/Deliverables are:

1st qtr 25% 29% Over 29% of deliverables

2nd qtr 50% 58% Over 58% of deliverables

3rd qtr 75% 86% Over 86% of deliverables

4th qtr 100% 100% Over 100% of deliverables

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Questions? 61

If you remember nothing else… 62

1. Turn in your contract documents on time! Date listed in Funding

Notification.

2. Submit any subcontracts to your CDTA Program Manager

promptly

3. Use the Contract Checklist when preparing your contract

documents – Quality Assurance

4. Use the final version of your FY13-14 contract as the guide

for the development of your FY 14-15 contracts

5. Please sign your finalized contract promptly and return by

messenger or in person to DPH (don’t put it in the U.S. Mail!)