Executive Committee Agenda Tuesday, Aprilll, 2017 3:00 PM- 5:00 PM Central Florida Cares Health System, Inc. Board Room

I. Welcome/Introductions

II. Approve Minutes

• March 14, 2017

III. Financial Report

• Financial Report

• FivePoints

IV. Organization Updates

• STEPS

• CFCHS BOD 6-Year Term Limits

• SOAR Specialist - Motion for CFCHS FTE' s

• GBHI

• Aspire - Anonymous Complaint Letter

v. Annual Provider Contract Amendments/Recommendation

VI. COU Audit

VII. Complaint Investigation Update

VIII. Other/Public Input

IX. Adjourn- Next Executive Committee Meeting

• Tuesday, May 9, 2017, 3:00 pm to 5:00pm

Central Florida Cares

Ian Golden 5 minutes

Ian Golden 2 minutes Group

Charles Rogers 15 minutes Claudia Mason Claudia Mason

Maria Bledsoe 10 minutes

Maria Bledsoe 5 minutes

Anna Lowe 10 minutes

Ian Golden 10 minutes

Group 3 minutes/person

Group 5 minutes

Executive Committee Meeting Minutes Tuesday, March 14, 2017 Central Florida Cares Central Florida Cares Health System, Inc. Board Room

ATTENDANCE

Board o(Directors Present: Ian Golden, President, Brevard County Housing & Human Services Kristen Hughes, Past President, Lassiter-Ware Insurance Debbie Owens, Vice President, Seminole Prevention Coalition

Health System

R. Wayne Holmes, Secretary, Retired Asst. State' s Attorney/Community Advocate Charles Rogers, Treasurer/Community Advocate

Central Florida Cares Health System, Inc. Staff Maria Bledsoe, Chief Executive Officer Claudia Mason, Chief Financial Officer Michael Lupton, Chief Information Officer Karla Pease, Executive Assistant

Guests Mary Christie, DCF Steve Dalsemer, STEPS Elaine K vitek, Orlando Health

Meeting Called to Order The Central Florida Cares Health System, Inc. (CFCHS) Executive Committee meeting was held on Tuesday, March 14, 2017 at 3:00p.m. at Central Florida Cares Health System, Inc., 707 Mendham Blvd., Suite #201, Orlando, FL. Ian Golden called the meeting to order at 3:01p.m.

A motion to approve the February 16, 2017 Executive Committee meeting minutes was made by Debbie Owens, seconded by Wayne Holmes, motion passed.

Financial Report CFO stated the first page is showing CFCHS actuals to the prorated budget where the providers are behind $2M. Page 2 shows spending by provider where 96% of the funds were spent. Page 3 is the SOF where yellow highlight shows underspending. Page 4 is the underspending by provider. Page 5 is all contracts and underspending for each provider and comments. The bottom of the page shows all T ANF providers and the only provider that is ahead is Community Counseling Center, everyone else is behind. Page 6 is the comparison between how CFCHS did from the previous year. It is good CFCHS is spending more money than the previous year due to receiving more money this year. The bottom right chart shows provider invoices needing to come in at $6.IM to spend out the contracted funds, and in January invoices came in at $5.4M. Pages 7-11 is an overview ofhow the spending is by program. 82% ofthe dollars is going to adult services.

There was discussion among members regarding Revenue Maximization and matched dollars. Page 12 is theMEs expenses. CFCHS has 20 employees. Page 13 shows the interest in the bank; $884K spent on FivePoints development. Page 14 shows $1.9M in the bank in January. DCF owed CFCHS for 2 months, CFCHS owed the providers for January and they have since been paid. Page 15 is the statement of cash flows. The statement of revenues and expenditures was next.

Charles Rogers, Treasurer, made a motion to approve the financial statements as presented, Kristen Hughes seconded, motion passed.

FivePoints The CFO spoke about the MOU being reviewed internally. The CEO indicated the attorney will be looking at the MOU next. When CFCHS hears back, it will go to the other MEs for their rev1ew.

The CFO said CFCHS met with FivePoints to map out the next year's direction. The F ASAMS system was discussed at that meeting. The CFO said the state put out the RFP for it. The CFO said CFCHS should go forward with the development of the system in case the Rev Max rolls out, CFCHS will be in a good position. At this meeting with FivePoints in Jacksonville last week, the set up for Rev Max was discussed and what it would take in ensuring CFCHS does not impose a lot more on the providers than necessary. FivePoints has experience with Medicaid.

CFCHS is waiting for the intellectual property attorney to review all the materials and get back with us with their recommendations, according to the CEO.

The CEO shared that CFCHS met with Don Sparks last week to determine what is needed, what is next, a plan was determined with moving forward so he can be prepared to present at the next Board meeting.

The CIO gave an overview of the FivePoints System Enhancements (see handout). He discussed how CFCHS will benefit with flexibility from the enhancements.

Charles Rogers asked about the cost. The CFO answered $129K.

Charles Rogers, Treasurer, made a motion that the Executive Committee approve the expenditure of up to $13 OK .for the enhancements to the FivePoints system to be ratified by the Board of Directors Meeting that meets April20, 2017, since there are invoices already due and we have exceeded the $1 OOK limit, Debbie Owens seconded, motion passed.

It was discussed by members to have the CFO and CIO at the next Board meeting to give an approximation of expenses on system enhancements in this next fiscal year so the Board can approve up to X amount suggested by the CFO and CIO. The CFO will note on the FivePoints chart to show what has been spent on enhancements, the acute care system, derivatives, and what projections are to be spent.

2

Organizational Updates STEPS - No update from the Inspector General's office. Steve Dalsemer, from STEPS, spoke and said they have received confirmation from the IG's office that there will not be any follow­up action. Mary Christie, DCF, said the last she heard is that the IG is waiting for information. Steve said he would forward any emails STEPS has received to CFCHS.

CFCHS Board ofDirector 6-year Term Limits - The handout from the Board of Directors' Composition and from the By-laws speaks about Board of Directors' term limits and was discussed. An Ad-Hoc Committee will be fanned to review the Board By-Laws and Policies to clarify language around terms. CFCHS will research Roberts' Rule of Order and legislative language to ensure the By-Laws and Policies are in compliance.

SOAR Specialist - This position is budgeted and has to stay with the ME. This position will work with the providers and help to complete the applications which takes about 40 hours a week. The providers have indicated this position would be beneficial to them.

The Chair then spoke about a SAMHSA grant in Brevard for SAIMH services for the chronically homeless population which is what SOAR is focusing on. Last week a notice that funding was received. The application is due April 25th. It was determined at the meeting they held March 13th that it fits more underneath CFCHS as the lead agency. Aspire is looking at applying for the grant. The CEO is to reach out to Aspire to discuss collaboration. The Chair stated this is $400K a year for 5 years. If the SOAR position sits under CFCHS, they would coordinate SSI, SSD, HIV, TANF dollars, and tie into housing. This is time sensitive.

Debbie Owens made the motion to allow CFCHS to follow through with the grant process and talk with Aspire to develop a collaborative process. Wayne Holmes seconded, motion passed.

Community Collections Solutions - MH ITN that came out of DOC. They started to have negotiation discussions. When we have additional information, the CEO will bring to the Board's attention.

Gateway Foundation Inc. is applying for the SA ITN that came out of DOC. They reached out to us, wanting a working agreement where CFCHS starts the services inside the corrections facility then follows the clients out in the community. There are preliminary discussions right now, but is time sensitive.

Charles Rogers authorized the Executive Director on behalf of CFCHS to continue discussions with Gateway Foundations Inc., Kristen Hughes seconded, motion passed.

Succession Plan was emailed out to Executive Committee for review and discussion. There was no input or feedback based on the plan from members.

Charles made a motion that the Executive Committee recommends to the Board of Directors approval of the leadership development and emergency succession plan, Wayne Holmes seconded, motion passed.

3

Internal Investigations Policy - The Chair of the Compliance/QI Committee spoke about the Board Policy "Internal Investigations" handout. This policy was reviewed by the Compliance/QI Committee and was proposed when the Compliance hot line was implemented. It was suggested by members to change language when the Board President is implicated to "Board President or designee by the Board."

Debbie made a recommendation to the Board of Directors to accept the Internal Investigations Policy with the amended change, Kristen Hughes seconded, motion passed.

The CEO spoke about the Articles of Incorporation for FAME and their 501 ( c )3 and at the last Board meeting, there was never a motion to allow CFCHS to sign the Articles of Incorporation when needed.

Charles Rogers authorized the Executive Director on behalf of CFCHS to sign off on FAME 50I(c)3, Wayne Holmes seconded, motion passed.

Complaint Investigation Update The Chair stated there is no update. The IG's office is waiting on additional information.

Other/Public Input - None

Next Executive Committee Meeting Aprilll , 2017 at 3:00pm

A motion to adjourn was made by Debbie Owens, seconded by Kristen Hughes, motion passed.

The meeting adjourned at 4:58pm.

Ian Golden President

Karla K. Pease Recording Secretary

4

Board of Directors' Agenda Thursday, April20, 2017 3:00 PM- 5:00 PM

Central Florida Cares Central Florida Cares Health System, Inc. Board Room

I. Welcome/Introductions

II. Financial Report • Financial Report • FivePoints Contract • Architectural Redesign/Enhancement

III. Consultant Update on FivePoints

IV. Recommendations • FivePoints

o Recommendation on systems enhancement • Succession Plan • SOAR Specialist - CFCHS FTE's • GBHI

Ian Golden Group

Charles Rogers Claudia Mason Claudia Mason Mike Lupton

Don Sparks

Mike Lupton/Claudia Mason

Ian Golden

v. Consent Agenda Board • Approve February 16, 2017 Minutes • Finance Committee Minutes Draft • Special Compliance/Quality Improv. Comm. Minutes Draft • Board Member Renewals

(Kristen Hughes, David Solomon, Richard Barlow, and Ken Peach until July 20 18)

(Mark Broms and Daniel Munoz until April2019)

VI. Organizational Updates • STEPS • Update on Gateway Foundation • Update on CCS • Aspire - Anonymous Complaint Letter

VII. Annual Provider Contract Amendments/Recommendation

Vlll. COU Audit

IX. Ad-Hoc Nominating Committee Bill Vintroux, Circles of Care Carl Metzger, UCF Police Dept.

X. Compliance/Quality Committee • lntemal Investigation Board Policy

XI. Ad-Hoc Policy Committee

XII. CFCHS BOD 6-Year Term Limits

XIII. Complaint Investigation Update

XIV. Other/Public Input

XV. Adjourn- Next Board of Director's Meeting • Thursday, June 15, 2017, 3:00-5:00 pm

Maria Bledsoe

Maria Bledsoe

Anna Lowe

Joe Mendoza

Elaine K vitek

Dick Jacobs

Ian Golden

Ian Golden

Group

Group

3 minutes

30 minutes

15 minutes

10 minutes

5 minutes

15 minutes

5 minutes

10 minutes

5 minutes

5 minutes

5 minutes

5 minutes

5 minutes

3 minutes/person

2 minutes

CFCHS Finance Report February 2017 -Budget Vs Actual

Feb2016 Over

Central Florida Cares Health System-Financial Highlights ($000).feb 2017 Burn Rates Diff (Under)

Programs Service Admin Total YTDBud** YTDUnspent Actual% Prorated% Var% Budget

Mental Health (MH):

AdultMH 20,725 1,722 22.447 23,447 (1,000) 63.8% 66.7% 2.8% (172)

ChildMH 3,294 352 3,646 4,044 (398) 60.1% 66.7% 6.6% (390)

Total MH $ 24,019 $ 2,074 $ 26,093 $ 27,492 $ !1,398) 63.3% 66.7% 3.4"/c (562)

Substance Abuse (SA):

Adult SA 11 ,844 1,050 12,894 13,510 (616) 63.6% 66.7% 3.0% (581)

Child SA 4,830 441 5,271 4,653 618 75.5% 66.7% -8.9% (518)

Total SA $ 16,673 $ 1,491 $ 18,165 $ 18,163 $ 2 66.7% 66.7% 0.0°/c (1 ,099)

Total Providers $ 40,692 $ 3,565 $ 44,258 $ 45,654 $ !1,396) 64.6% 66.7% 2.0"/c (1 ,662

Uncontracted Funds $ 114 (114) (362)1 "

Undocumented - 12 12 23 (11)

" PULSE Services 33 4 37 67 (30)

-·-- -

Managing Entity 1,550 1,550 1,559 -

(9) 66.3% 66.7% 0.4"/c (94)

-

Total Network $ 40,726 $ 5,131 $ 45,857 $ ~7,417 $ {1 ,560) 64.5% 66.7% 2.2"/c $ {2,117) ~-

**Based on 08/08/16 SOF $70,990,170 Amendment 22 incorporated in GHME1

1

CFCHS Finance Report February 2017-Spending By Provider

YTD February 2017-Provider Spending ($000) $50,000 120.0%

$45,000 100.0% ....... $44,258

100.0% $40,000

$35,000 80.0%

$30,000 51.7%

$25,000 $22,864 60.0%

~ $20,000

40.0% $15,000

$10,000

$5,000

$-

$1,841 $1,427 $539

20.0%

0.0%

$1,602 $609 $329

$306 $238 0.7% 0.5%

Aspire Circles ParkPl CHS MHRC Eckerd STEPS DVXFBNET Grove lifeStream CTC UBC AIIOther YTD Feb17

2

CFCHS Finance Report February 2017 -SOF Overview

OCF ME Schedule of ~unds (SO~) a Centr., tr1orld• C•r•s H••lth System • Contractlll: OHME1 YTD Below FY 2016·17 u .. o .. lan•tlon · As of 08108/2016 YTD P'ebru•ry 2017 YTD Febru•ry 2017 Other Cost Accumulators Title OCA Feder•f State Tot.l Fed-% Mlu .. Adult l Aotu .. C:hlld l Total (Uns pent) I Burn lbte Target lltequlred

Burn l't•t• -nthly Unspent Spend 100%

Bl't•tYE Admlnlstratlve Costs 153 785 2184 656 2 336 441 7% $1 u. 682 Manaoina Entftv AdmlniSirative CoSio MHSOO 153 785 2.14 1.528 2 295 311 7".4 1.506,4 52 788,859 U .&•t. 197,215 ME Crisis Stabillz.atlon Services MHOCS . 43, 130 43130 0".4 43.130 . 100.0".4 . ME Mental Health System of Care MHOSK . . 0".4 . ME Houslno Coordinet lon MHSHG . . . o•.4 . . . ME C81'o Coord ination MHSCD . . o•.4 . . . -HNIIth -""'" 11ll,781 Z,184 ... U8441 7".4 788 851 66.3% 1B7 211 ME Mental Health Services & SuoPOrt MHOOO 2,522.476 2 3 805.359 26 327,835 10".4 14.767.155 2.846,247 17.613.403 8,714.4 32 ••• , • .4 2,178,608 81>0Ciallzod Troetment Education & Prev MH0 50 . 300 000 300 000 0".4 4 1.208 . 41 ,208 256,792 13.7% $ 156,792 64,698 Purehaae Resident lei Treatment Services MH071 . 390,183 390,163 o•.4 . 191,000 191.000 199.183 .... 0"4 s 69.122 49,796

Community Forensk: Beds MH072 . 524 .4 74 524 ,474 0% 4 90.982 . 490,982 33.4 92 53.6% 8 .373 Florida Assertive CommiSlity Treatment MH073 1 ,199,757 2,356,334 3,556.091 3.(•,4 2 ,405,052 . 2 ,405,052 1, 153.039 57.&•.4 $ . 288,280 FACT)

lndlaent Povehiatrle Modle-'lon Prooram MH076 . 69,078 69,078 o•t. 36,991 . 36,991 32.087 63.6% $ 9.061 8 ,022 Orlando Emergency MHOER . . . 0% . . . . ME-Transltton V ouchers Mental Heeft:h MHTRV . 189,009 189,009 0".4 6,848 . 6 .848 182,161 3.1% s 119.156 45,540 ME C - allzl'd Receiving FaciiHJea MHSC R . 4 ,676,398 4.676.398 0".4 2 , 171,187 . 2 , 171 ,187 2 ,505.211 .... 4% $ 946,412 626,303

Circles ot Care - Cedar Village MHS51 . 485,000 485.000 0".4 320,595 . 320,595 164,405 51.1°.4 41 , 10 1 Circles of Care -Crisis Stabilization MHS52 . 970.000 970.000 0".4 703,080 . 703,060 266.920 72.6°4 66,730 C lreles ot Care • Geropsyehialnc Care MHS55 . 890,000 890.000 0% 553.420 . 553,420 336,580 1 2.2% $ 39,913 84,145 -Grants PATH MHOPG 576.167 576,167 100".4 506.231 . 506,231 69.936 87., % 17,484 Temporary Assist IInCe for Needy F.,illea MHOTB 661 ,245 661,245 100% 266,310 . 266.310 394,9 35 40.3% $ 174.520 98.734 TANF}

Title XXI ChUdren's Health Insurance MHOBN 842.875 125. 133 968.008 87% . 609,000 609,000 359.008 &2 ••• .4 89.752 Proaram Beh•vkw'el HeaHh Net"NNrk

118.525 1 Community Forensic Multidiscic>llnary MHOFH . 652.000 652,000 0 % 177.900 . 177,900 474 ,100 27. 3% $ 2 56.767 Teem s fo< HoscH., O!wniOn ... --He- - 1102,120 H,C:W,MB 41 237 4118 14% 22441MO , .... 248 21053208 16144 280 13., • .4 '78& 070 Sub..-.eeAbuM 0"4

1,747.705 ! ME Substance Abuse Servleos and Suoport MSOOO 10,175.4 98 9.668.511 19 ,844,009 61•,4 9,850.214 3,002,976 12,853,190 6 ,990,8 19 14.8% $ 376. 14 9

HIVServicea MS023 734 085 734.085 100% 351 .788 19,298 371 ,067 363.018 10.1% $ 118,323 90,755 ' Preventlon Services MS025 2 936.339 . 2 936 339 100% 175.49 7 1 ,812,273 1 ,987,771 948,568 67.7% 237.142 PPW SA Services Women & Their Families MS081 . 1,883,426 1 883 4 28 o•.4 1,536,291 . 1,536,291 345,135 81.7% 66,284 Family Intensive Treatment Fl MS091 . 662 ,183 662.183 0".4 4 57,746 . 457,746 204,437 cs.1•.4 51.109 : Temporary Assistance for Needy Famltles MSOTB 860,359 . 860,359 100% 520.178 . 520.178 140.181 78.8% 35,045

ICTANF) Prevention Partnership G.- PPG MSOPP 571106 . 571. 106 100% . 4 36,425 4 38,425 134,681 76.4·.4 33,670 M E-Trwlattlon Vouci'Mtrs Substance Abuae MSTRV . 122734 122734 0".4 . . . 122.734 0.0"4 $ 8 1 .823 30,684

... - llubs-eAbu- 11 0~ 387 1Z,S38 814 27414:141 n •t. 12,8UU6 • 270 W73 18114H8 , 24t 173 ••• 3% 2 312.'" Tot•l Servloea..Provlder Network 20 871107 47 771 122 1811172t 31340161 a e11 221 44 267 871 24 U3 813 SOI84U Tot•l8•rvloes & ME Admin - 21 033112 41,,6& 478 70110170 30".4 31340111 e e17 221 41807418 21 182 7 12 1-4.1% • 2,1178

28.13•,4 70.37"/.

-TANF-AMH Actual Budget B-Rate (Und)Over Aspire 34,537 13% 58,667 39.2% (24,130) Circles 10,770 4% 33,333 21.5% (22,563)

MSOOO Sub Abuse ASA CSA TotaiMSOOO aJdgtt ~· {lltd)Over

STEPS 503,636 503,636 686,324 48.9% (182.688) tdlerd 555,9« 555,9« 681,189 54.4% (1 25,245) Aspi'e 6,101,323 2,425,813 8,527,137 8,589,954 66.2% (62.817)

Life Stream 20,001 8% 26,667 50.0% (6,666) Ct-cles 1,575,910 128,251 1,704,161 1.753.462 64.8% (49,301)

Corrmmity Counseling C 187,611 70% 145,140 86.2% 42,471 Park Place 5,084 2% 23,333 14.5% (18,250)

ttxlse of Fleedom 66,670 66,670 66,667 66.7% 3

lle Stream 131,003 131,003 130,996 66.7% 7 Cotmu11y Treatrrent C 224,700 . 224.700 224,689 66.7% 11

United Way 7,799 3% 40,000 13.0% (32,201) Grove Covnsmg 27,03-1 4-48,380 475,414 473,3-16 67.0% 2,068

lllllOwer 510 0% 113,690 0.3% (113,180' Total TANF AMH $ 266,310 100% $ 440,830 , 40.3% $ (174,520 Under)Over Budget Is (174,520)1

Par1cAace 663,995 532 664,527 622,713 71.1% 41,814 ()her . . TotaiASA $ 1,150,214 $ 3,002,971 $ 12,153,190 $ 13,229,339 • IU~ $ {371,149) 3

CFCHS Finance Report February 2017-UnderSpending By Provider

Network Underspent $By Providers ($000) Feb2017

$1,400 /

$1,200 /

$1,000 /$928

$800 /

$600 /

$400

$200

$-

$(200)

$(400)

Provider

..... ..... ..,.. --"'""u' <i'~OI '1 $65

I $36 $34

I , ,. J $32 ___, , $32

-- --- ---r--- ~--~ ~ ~ ~ 3 0 c c 0 ~ ~ ~ 0 ~ ~ i ~

/:::;' fl) ~ < 0 , I ~ ~ ~ fl) ~ I ~ ~ ~ ; z ~ z ~ < c

~ - - ~

$1,396/

"i1 !!!.

4

CFCHS Finance Report February 2017-Aspire's Spending Aspire Health Partners-Spending By Program

Mental Health Program Adult Mental Health Children's Mental Health Total Mental Health OCA Description Actual YTDBud Unspent Actual YTDBud Unspent Actual YTDBud Unspent MHA01 24Hr Residential 838,619 776,095 62,524 - - - 838,619 776,095 62,524 MHA09 Non-Residential 2,218,123 2,076,447 141 ,676 79,405 67,455 11,950 2,297,529 2,143,902 153,627 MHA18 Crisis & Emer lnpat SRT 5,410,688 5,584,707 (174,019) 490,603 688,374 (197,771) 5,901,291 6,273,081 (371 ,789) MHATB TANF 34,537 58,667 (24,130) 34,537 58,667 (24,130) MHAPG PATH Grant 391 ,800 282,185 109,615 391 ,800 282,185 109,615 MHA72 Forensics 312,479 208,319 104,160 312,479 208,319 104,160 MHA73 FACT Team 802,597 790,883 11 '713 802,597 790,883 11 ,713 MHA76 Indigent Psyc Med 20,921 30,392 (9,471) 20,921 30,392 (9,471) MHTRV Transition Voucher-MH - 75,603 (75,603) - 75,603 (75,603) MHSCR CRC System 864,909 1,800,000 (935,091) 864,909 1,800,000 (935,091) FEMA FEMA 2,745 3,660 (915' 2,745 3,660 (915)

Total $10,897,418 $11,686,958 $(789,540) $ 570,008 $ 755,829 $(185,821) $11,467,426 $12,442,787 $(975,360)

Substance Abuse Program Adult Substance Abuse Children's Substance Abuse Total Substance Abuse OCA Description Actual YTDBud Unspent Actual YTDBud Unspent Actual YTDBud Unspent MSA03 24Hr Residential 3,140,442 3,206,246 (65,803) 859,052 1,091,686 (232,633) 3,999,495 4,297,931 (298,437) MSA11 Non-Residential Alcohol 1,051 ,809 1,074,641 (22,832) 1,050,094 831 ,506 218,589 2,101 ,904 1 ,906,147 195,757 MSA21 Detox 1,909,072 1,911 ,608 (2,536) 516,667 474,268 42,398 2,425,738 2,385,876 39,862 MSA23 HIV 351 ,768 300,593 51 ,175 19,298 60,271 (40,972) 371,067 360,864 10,203 MSA25 Prevention 41 ,898 114,667 (72,768) 806,159 781,229 24,929 848,057 895,896 (47,839) MSCPP PPG Grants - - - 189,910 180,737 9,173 189,910 180,737 9,173 MSA81 Pregnant Women 978,771 815,263 163,508 - 978,771 815,263 163,508 MSATB TANF 23,548 15,699 7,849 - 23,548 15,699 7,849 MSA91 FIT 457,746 441,455 16,291 - 457,746 441,455 16,291 MSTRV Transition Voucher-SA - 49,093 (49,093' - - 49,093 (49,093) Total $ 7,955,055 $ 7,929,265 $ 25,790 $3,441,181 $3,419,697 $ 21,484 $11 ,396,236 $11 ,348,962 $ 47,27 4

!

Aspire YTD $18,852,473 $19,616,223 ${763,750) $4,011,189 $4,175,525 $(164,336) $22,863,662 $23,791,748 $(928,086)j

5

CFCHS Finance Report January 2017 -Prior Year Comparison

Expenditures CY vs PY By Program ($000) February 2017 ¥:"

YTD Februa!l: 2017 $50,000

Pr rams Actual Actual

Mental Health (MH): PY1516 CY1617 Diff. $45,000

AdultMH 18,717,688 22,446,960 3,729,272 $40,000

Child MH 4,050,747 3,646,248 (404,500) $35,000

$30,000

TotaiMH 22,768,435 26,093,208 3,324,773 $25,000 ... 0

Substance Abuse (SA): I I szo,ooo 1{1 li

I ~ 0 ....

2,658,31911 $1S,ooo I 1: ~ t Adult SA 10,235,376 12,893,695 ~A

loU

1: VI

$10,000 I ·. J ~

b i: Child SA 4,596,112 5,270,973 674,861 I • ...

$5,000

Total SA 14,831,488 18,164,668 3,333,180 $· ...... ~ _:_ ' ~ ~ ... ~ __:____=--= ' ----

AMH CMH ASA CSA ME Total

PY·$ CY·$

Total Providers s 37,599,923 s 44,257,876 s 6,657,9531 Req'd Burn Per

Burn Rate Outlook Unse!nt Mo Total Budset

Managing Entity 1,450,563 1,54~582 $ -

99,0191

!Contracted 24,223,430 $ 6,055,857 68,481,306

Uncontracted 170,421 $ 42,605 170,421 I I ,.

Total Network $ 39,050,486 s 45,807,458 s 6,756,972 I I ME 788,859 $ 197,215 2,338,441

Total 25,182,710 6,295,678 70,990,168

Current Mo. Provider Invoices $ 6,310,724

6

CFCHS Finance Report February 2017-Program Service Overview YTD Feb2017 Total By Program $44.2M

8%

• CSA_$5,271

• ASA_$12,894

1 AMH_$22,459 51%

$ 3,646 Distinct # Served

Proaram I Clients I AMH 14,868

AMASA 1,258 YTD Feb. 2017 Summarv of Services AMH CMH 7 I

Program Descr~tion Actual-$ .% Peoole %/Person Est. Charitv Charitv% AMH CMHCSA 3 .

Adult Mental Health 22,446,960 51% 23,580 56% 1,625,605 520fc ASA 6,076

Children's Mental Health 3,646,248 8% 3,403 8% 126,813 40fc 11\SA CMH 1

Adult Substance Abuse 12,893,694 29% 11,060 26% 830,494 26% 11\SA CSA 1 CMH 2,037

Children's Substance 5 270 973 12% 4 217 10% 557 489 18°/c MHCSA 218 Total YTD Jan. 2017 $ 44 257 874 100% 42 260 100%$ 3140 401 100% CSA 3,088

Total 27 557

Provider Est. Charitv-S % I AMH CMH ASA CSA Total

~spire 1,148,997 37% 362,627 408 228,877 557,085 1,148,997

Park Place 780,736 25% 575,701 - 204,631 404 780,736

~ircles of Care 671,834 21% 671 ,834 - 0 - 671,834 ~ommunity Treatment

~ 202,760 6% 0 - 202,760 - 202,760 ~hildren's Home ~ociety 115,755 4% (0) 115,755 - - 115,755

Mouse of Freedom 44,541 1% - - 44,541 - 44,541

Orlando Health 20,044 1% 9,661 10,383 - - 20,044

ifestream Behavioral 144,826 5% 1,849 - 142,977 - 144,826

STEPS 6,708 0% - - 6,708 - 6,708

Wayne Densch 3,933 0% 3,933 - - - 3,933

Devereux (0) 0% - (0) - - (0' YTD Feb2017 $ $

1

Charity$ 3140 401 100%1 625 605 s 126 812 s 830 494 s 557 489 s 3140 401 7

CFCHS Finance Report February 2017-Program Service Overview

YTD Feb 2017 Adult Mental Health-$22.4M or 51%

10% 1

17%

11%

38%

Adult MH YTD Feb. 2017 OCA Service Descri tion Actual Actl 0/o MHA01 24Hr Residential 2,337,858 10°/o MHA09 N on-Resident ial 3,759,619 17o/o MHA18 Crisis & Emer In pat SRT 8,500,618 38°/o MHA25 Prevention 169,061 1 O..fo

MHATB TANF 266,310 1 o/o MHAPG PATH Grant 506,231 2°/o MHA72 Forensics 490,982 2o/o MHA73 FACT Team 2,405,052 11 o/o MHA76 Indigent Psyc Med 36,991 Oo/o MHS5 1 Circles CedarVillage 320,595 1°/o MHS52 Circles Special CSU 703,080 3°/o MHS55 Circles Geropsychiatric 553,420 2°/o MH0 50 STEPS 41,208 0°/o MHTRV Transition Voucher-MH 6,848 Oo/o MHSCR CRC System 2,171 ,187 10o/o

MHOFH Forensic Teams 177,900 1°/o Total Adult Mental Health $ 22,446,960 51%

True Cost $ 24,072,565 93%

• Resid_$2,338

• Outp_$3,760

Crisis_$8,501

Prev_$169

• TANF_$266

• PATH_$506

Foren_$491

FACT _$2,405

IDP_$37

Cedarv _$321

• CirCSU_$703

CirGeroP _$553

STEPS_$41

VouchMH_$7

CRC_$2,171

Forensic Teams_$178

/Person $ 9,661 $ 345 $ 1,036

- $ -477 $ 558 379 $ 1 ,336 595 $ 825

- $ -906 $ 41

17 $ 18,859 423 $ 1,662

66 $ 8,385 132 $ 312 - $ -

1,258 $ 1,726

1 $ 177,900 23,580 $ 952

Est. Chari 499,001 730,511 112,091

-1,879

(0) 198,026

-84,097

---

0 -

0

-$ 1,625,605

$ 1,021 $ 68.94 8

CFCHS Finance Report February 2017-Program Service Overview

42%

35%

Children's MH YTD Feb. 2017 OCA Service Descri tion Actual MHC01 24Hr Residential** 9,900 0% MHC09 Outpatient 1,530,186 42% MHC18 Crisis & Emerg 1,260,681 35% MHC25 Prevention 45,480 1% MHC71 PRTS++ 191,000 5% MHCBN BNET Title XXI 609,000 17%

Total Children's Mental Health 3,646,248 ,. 8% True Cost $ 3,n3,061 96.6%

Total Mental Health Program $ 26,093,208 59%

Resl_$10

Outp_$1,530

Acute_$1,261

Prev_$45

• PRTS_$191

• BNET_$609

1,680 1,108

-5

609 -

3,403 $ $

26,983 ~ $

Person Est Chari 9,900 17,355

911 126,545 1,138 -

- -38,200 (17,087)

1,000 -- -

1,071 126,813 1,109 $ 37.27

967 $ 1,752,418

9

CFCHS Finance Report February 2017 -Program Service Overview

YTD Feb2017 Adult Substance Abuse-$12.8M 29%

Adult SA YTD Feb. 2017 OCA Service Descri tion Actual Peo le MSA03 24Hr Residential Alcohol 4,787,528 37% 860 MSA11 Outpatient 1,980,650 15% 4,043 MSA21 Detox Alcohol 3,082,036 24% 2,027 MSA23 HIV 351 ,768 3% 3,196 MSA25 Prevention 175,497 1% -MSA81 Pregnant Women 1,538,290 12% 758 MSATB TANF 520,178 4% 176 MSA91 FIT 457,746 4% -Uncontracted -Total Adult Substance Abuse $ 12,893,694 ~ 29% 11,060

True Cost $ 13,724,187 93.9%

• Resl_$4, 788

• Outp_$1,983

Detox_$3,434

• Prev_$175

• PPW_$1,538

TANF_$520

FIT_$458

VouchSA_$0

/Person Est Chari $ 5,567 705,531 $ 490 58,478 $ 1,520 -$ 110 0 $ - -$ 2,029 2 $ 2,956 66,483 $ - -$ - -$ 1,166 $ 830,494 $ 1,241 $ 75.091

10

CFCHS Finance Report February 2017-Program Service Overview

Resi_$1,244

Outp_$1,115

34% Detox_$664

21% Prev_$1,812

13% • PPG_$436

Children's SA YTD Feb. 2017 OCA Service Description Actual People Sf Person Est Charity MSC03 24Hr Residential Alcohol 1,243,507 24% 155 $ 8,023 444,740 MSC11 Outpatient 1,114,552 21% 3,664 $ 304 112,749 MSC21 Detox Alcohol 644,918 12% 74 $ 8,715 -

(O) j MSC23 HIV 19,298 0% 324 $ 60 MSC25 Prevention 1,812,273 34% - $ - -MSCPP PPG Grants 436,425 8% - $ - -Total Children's Substance 5,270,973 " 12% 4,217 "$ 1,250 557,489

True Cost $ 5,828,462 90.4% $ 1,382 $ 132.20

Total Substance Abuse Program $ 18,164,666 " 41% 15,277 "$ 1,189 $ 1,387,983

Total Mental Health & Substance 1 $ 44,257,874 " 100% 42,260 "$ 1,047 $ 3,140,401

11

CFCHS Finance Report February 2017-ME Expenditures ME Operating Expenditures YTD Feb. 2017

$906 $18,103

$11,384

$6,099 _$8,717

$34,894

• Personnel Expenses

• Professional Fees

• Supplies

• Office Equipment

• Telephone

Occupancy

• Maintenance & Repairs

• Conferences & Trainings

• Equipment Rental

• Travel Expenses

• 40(8) Expenses

• Printing & Publications

• Dues & Subscript ions

• Miscellaneous

Insurance

Central Florida Cares Helath System-Agency Staffing February 2017 Fiscal Year Admin soc Operations IT/Data RUQ Fin & HR Total

2017 2 6 3 2 3 4 2016 2 5 l 1--~ 4

20 18

Operat ing Expenses YTD February 2017

Personnel Expenses 1,116,722 67%

Professional Fees 273,296 17%

Supplies 3,553 0%

Office Equipment 19,253 1%

Telephone 18,760 1%

Occupancy 124,661 8%

Maintenance & Repairs 405 0%

Conferences & Trainings 14,832 1%

Equipment Rental 6,099 0%

Travel Expenses 11 ,384 1%

40(8) Expenses 906 0%

Printing & Publications 18,103 1%

Dues & Subscriptions 4,154 0%

Miscellaneous 8,717 1%

Insurance 34,894 2%

Total ME $ 1 ,655, 739 100%

Professional Services YTD February 2017 Moore Stephen Lovelace 11,573

Finance/Acctg Software 7,955 Attorney-Friedman & Friedman 6,729 Attorney Grey Robinson 6,740

Fivepoints-Sys tern Development 120,784

Fivepoints-Maint & Support 72,000

Bayshore & lntermedia 18,012

FAME Membership 26,000 Navex VllhistleBiower Line -Don Sparks 2,288 Health Council Needs Assmnt 1,215

Grand Total $ 273,295

12

I

CFCHS Finance Report February 2017-lnterest & Data System

Interest Earned

Fiscal Year July 2015 to June 2016 $ 26,822

July 2016 to February 2017 Net of Fees $ 22,477

CFCHS-Data System Development Cost

Data System Actual Fl-.ePoints $ 781,128 Total Spent Prior Years

FlwPolnts 3,468 4538 Coding & Testing Bed Amend 13b Count-Oper Beds Change

FlwPolnts 1,734 4538-Bed Count Operational Bee Amend 13c, 16c FiwPolnts 43,067 4813-Re-architecture Amend 15 item a FiwPoints 8,455 4843-Requlrements & Design, Amend 15 item d

Billing Resubmit pre\Aously denied sen.lces for processing

Fl-.ePoints 4 ,972 4844-Requlrements & Design Amend 15 Item f Conngurable Billing Run Date

FlwPoints 1,568 5159-De-.elopment testing & Amend 15 Items n deployment to production Bed Count Screen A'IA!ilabllity

FiwPolnts 5 ,225 5159-De-.elopment testing & Amend 15 Items J deployment to production Bed Count Submission

FlwPolnts 1,876 5160-BC Compliance Reports Amend 15 Item k Pre\Aous and Multi-Day wrsion

FiwPoints 1 ,876 5160-BC Compliance Reports Amend 15 item I Pre\Aous and Multi-Day wrslon

FlwPolnts 1,710 5167-Waitlist Compliance Repor1Amend 15 Item 0 Fi-.ePolnts 2 , 185 5191-Dewlopment Testing & Amend 15 Items q

deployment to production Financials add YTD units and payment into

Fl-.ePoints 1 ,520 5192-Dewlopment Testing & Amend 15 Items r deployment to production Flnancials Link to OCA Accrual screen parameters to the ln....oice screen

FlwPoints 14, 377 5277-A016 c CSU Amend 16 Item a FlwPoints 14,377 5277-A016 c CSU Amend 16b FI\.8Polnts 14,377 5277-A016 c csu Amend 16c

$ 120,786 YTD February 2017

$ 901,913 Orand Total I 13

CFCHS Finance Report February 2017- Data System Future Development

FY1617 approved payments and obligation balance AS OF 3/21/17 Amend- Obligation

Ticket# Cost to CFC ment# Paid balance

Architectural redesign of the f ile upload and data management process per Strategy

4813/4850 $ 129,200 15 $ 43,067 $ 86,133 Session ME resubmit previously denied services

4843 $ 16,910 15 $ 8,455 $ 8,455 per Strategy Session Configurable Billing run date as per

4844 $ 9,943 15 $ 4,972 $ 4,971 Strategy Session

5118 $ 14,060 15 $ $ 14,060 CFC manage site IDs t hemselves

Contract dashboard default to most current

5121 $ 1,401 $ 1,401 contract rev is ion Bed Count- Compliance Report changes

5164 $ 6,460 15 $ $ 6,460 due to revisions

5167 $ 3,420 15 $ 1,710 $ 1,710 Wait List- Report changes due to revisions 5190 $ 5,320 17 $ 1,773 $ 3,547 Doc Mgt- Track who's approval is pending

5519 $ 2,470 .

17 $ 823 $ 1,647 Doc Manager- periodicity of weekly

SUBTOTAL $ 189,184 $ 60,800 $ 128,384

FY1617 ~stimates in progress as of 3/21/17 CM Module - Warning Pop Up when a

revisions will impact another area of the 5163 $ 15,000 $ 15,000 system

Add columns to SOC Provider Distribut ion

5178 $ 1,900 $ 1,900 Report

5665 $ 27,000 $ 27,000 Burn rate sheet Ul and export functionality.

5810 $ 1,900 $ 1,900 Remove YTD data from July invoice only Allow partia l payments of services to equal

5834 $ 6,935 $ 6,935 max prorata when applicable

TBD $ 40,000 $ 40,000 <-- Pending FASAMS procurement by DCF.

SUBTOTAL $ 92,73S $ $ 92,735

GRAND TOTAL $ 281,919 $ 60,800 $ 221,119

14

CFCHS Finance Report February 2017-Balance Sheet

Centra l Aorlda cares Hea lth Syste "'- Inc S t a tement o f Rnanclal Position

Balance Sheet

A sset s CUrre nt Assets

T D Bank-Checking T D Bank-Money Market

A s o f 2/28/2017 (tkoa udite d)

Total cas h & cash Equivalents

Program Service AR Due From DCF Due from Other Funders Other Receiva bles-Advance Due From Providers Prepaid Property D&O & other Insurance Prepaid Expenses Deposits

Tota l CUrre nt A s s e t s Long-term Assets

Furniture & Fixtures Computer Eq uipment Software A ccum. Depr eciation - Software

Total Long-term A ssets

Total Asset s

Liab ilities Short-term Ua bilities

Accounts Payable & Accrued Expenses Wages Payable Federal Payroll Taxes Payable SI.JrA Payable Deductions Payable Retirement Pla n Payable Interest & other Payable t o DCF Advance Payable to DCF Carry Forward Deferred Revenue CPA Fee

Total Short-t e rm Uabilities

Total Uabilities

Net Asset s Unrestricted Net Assets

Prior Year Excess Revenues (Expenses) Current Year Excess Revenues (Expenses)

Total Unrestricted Net Assets

Total Net Assets

Total of Net Asset s a nd Uab ilities

$

$

$

Feb-2017 Jun- 2016

2 10 , 362 $ (0) 1,309,003 4 , 105,791

1 , 519,365 4,105,791

12,072,818 5,428,525 - 10,573

24 7,050 34,418

15,000 33,940 26,375 26 375

13,880,608 9 , 639,622

-849,569 849, 569

p88,6832 p88,6832 460,886 460,886

1 4,3 4 1,494 $ 10,100,509

6,247,227 6,529,238 112,364 71,125

8,596 5,441

982 1,308 6,334 5,147 4 ,665 5,923

5,348,976 786,124 2,046,715 2,095,850

11496 13, 775,859 9 , 511,652

13,775,859 9 ,511,652

588,857 544,083 ( 23,2222 44 774 565, 635 588,857

565, 635 588,85 7

14,341,494 $ 10, 100, 509

15

CFCHS Finance Report February 2017-Revenues & Expenses

Central Florid a C ar es Health System, Inc YTO Feb 2017 YTO B udget BudVar

Revenues & Expenditure s

O p e rat ing Reven ue OCF SAMH P roviders

Adult Mental Health 22,446,960 23,447,363 1,000,403 C hildren's Menta l H ealth 3.646,248 4 ,044 .295 398,047 Adult Substance Abuse 12 .893,695 13,623,305 729,6 10 Children's Substance Abuse 5 ,270,973 4,652,855 (618,11 8)

Provider Network 44,267,876 46,767,819 1,609,943

Mgm nt Entity R evenue 1,549,582 1,558,961 9 ,379 ME D eferred Revenues Rec og'd 60,545 303,898 243,353 FL LINC FCCM 42,293 4 1,334 (959) Orange County CRC 33,396 (33,396)

M anaging Entity 1,686,816 1,904,192 218,377

T otal Program Revenue 46,943,692 4 7,672,011 1,728,319

Contributions 2,000 (2,000)

Tot a l R e venues $ 46,946,692 $ 47,672,011 $ 1,726,319

Expenditures Personnel Expenses 1' 116,722 1,192,182 75,460 Professional Fees 272.081 217,555 (54,526) Occupancy 124,661 124.077 (584) Insurance & Mscellaneous 44,826 32,910 (11,916) Office Equipment 19,253 16,330 (2,922) Printing & Publications 18, 103 8 ,560 (9,543) Telephone 18,760 22,827 4,067 Conferences & Trainings 14 ,832 34,018 19,186 Travel Expenses 11,384 13,510 2,126 Equipment R ental 6.099 5,334 (764) Dues & Subscriptions 4,154 1,690 (2,464) Supplies 3 ,553 5 ,804 2,251 403(B) Fees & Expenses 906 1,000 94 Wlaintenance & R epairs 405 667 262

1,666,739 1,676,464 20,726 P rovide r N etwork E xpenses

Adult Mental Health 22,502,259 23,461,192 9 58,933 Children's Mental Health 3,646,248 4,044 ,295 398,047 Adult Substance Abuse 12,893,695 13,837,204 943,509 Children's Substance Abuse 5,270,973 4 ,652.855 (6 18,118)

Provider Networ k E xpe nses 44,313,176 46,996,647 1,682,372

Total Expenditure s 46,968,914 47,672,012 1,703,098

T otal R evenu es over Expenditu res $ (23,222) $ (0 ) $ 23 ,221

16

CFCHS Finance Report February 2017-Amendment 24 SOF

C•ntral Flori do earn Hulth Syam. Contract# GHME1 Amend2A FY 2016-17 U• O.llignation ·As of 08/08/2016 As of 0%/21117 Other Colt Accumulators Title I OCA Federal ISIIIte ITollll Total Change Commenta Admlnl*-1" Colts 153,785 2,184,656 2,338,441 Managing Entity Administratiw Costs MHSOO 153,785 2,1 41.526 2,295,311 2,316,134 20,823 TANF ASO h.nction ME Crisis Stabilization Ser.ices MHOCS . 43,130 43,130 43.130 . ME Mental Health System of Care MHOSK . . . ME Housll'lQ Coordination MHSHG . . . 130,945 130,945 FlXlding Housing Stall ME Care Coordination MHSCD - - - 147,757 147,757 FlXlding CareCoordinator Stall Mental Health Managing Entity Total 1&3,716 2,184,SM 2,331,441 2,137MI 2ttW ME Mental Health Ser.ices & SuPPOrt MHOOO 2,522.476 23,805,359 26,327,835 26,095,183 (232,652) Shift to MHSFP Specialized Treatment, Education & Prev. MHOSO - 300,000 300,00C 300,000 . Po.rchase Residential Treatment Ser.1ces MH071 . 390,183 390,183 390,183 . Cornmoony Forensic Beds MH072 - 524,474 524,474 524,474 -Florida Assertiw Cornmooity Treatment (FACl) MH073 1,199,757 2.358.334 3,558.091 3,558,091 -Indigent Psychiatric Medication Program MH076 - 69,078 69,07e 69,078 -O~Mdo Emergency MHOER - - 180,000 180.000 SERG Grant 1 year $500,000 ME-Pr<Mder Hl.rricane Matthew Crisis Cooosei MHHMP 200 200 Hurricane Matthew aftennath ME-Trmsnion Vouchers Mental Health MHTRV - 189,009 189,009 189,009 -ME Centralized Recei\lng Facilities MHSCR - 4,676,398 4,676,398 4.676,398 . ME MH State Fooded For Profit Sub-receipients MHSFP 232,652 232,652 Shift from MHOOO Circles of Care -Cedar Village MHS51 - 485,000 485,000 485,000 -Circles of Care -Crisis Stabilization MHS52 . 970,000 970,000 970,000 -Circles of Care • Geropsychiatric Care Ser.ices MHS55 - 890.000 890,000 890,000 -Grants PA'TH MHOPG 576,167 - 576,167 576,167 -Temporary Assistance for Needy FamiHes {TANF) MHOTB 661,245 - 661,245 661,245 -Tille XXI Chil<i'en's Heanh Insurance Program (BehaiAoral Health MHOBN 842,875 125,133 968,008 Networ1<) 866,401 (101,607) Reducing BNET Cornmoolly Forensic Multidisciplinary Teams for Hospital MHOFH - 652,000 652,000 Oivelsion 652,000 -SubiDtal lllntal Health 5,102,120 31,4S4,MI 41237488 41 318,081 7861S Substance~

ME Sl.bstance Abuse Ser\Aces 8r1d SuPPOrt MSOOO 10.175.498 9.668.51 1 19.844,009 19,844,009 -HIV Ser.ices MS023 734,085 - 734,085 734,085 -Prewntion Ser.ices MS025 2,936,339 - 2,936,339 2,936,339 -PPW SA Ser.1ces Women & Their Families MS081 - 1,883,426 1,883,426 1,883,426 -Family lntensiw Treatment (Fil) MS091 - 662,183 662.183 662,183 -Temporary Assistance for Needy Families CTANFl MSOTB 660,359 - 660,359 660,359 -Preo.ention Partnership Grant (PPG) MSOPP 571,106 - 571,106 571,106 -ME-Trmsnion Vouchers Sl.bstance Abuse MSTRV - 122.734 122,734 122,734 -Sul*al Subtlllna. Abu• 16 077 387 12,331864 '0414.241 '0414.241 . I Total Servlce,..Provider Network 120,879,907 47 771 822 68661729 68 730 322 I 78593 I Tollll Services & ME Admin 21,033,692 49,966,478 70,990,170 71368 288 I 378 118 I ......... -- .. -·

17

( .

I'

To:

Florida Department of Children and Families BY:, ...................... .

Attention: Consumer Complaint Dept.

400 West Robinson Street, Suite 1129

Orlando, Fl. 32801

Agency for Healthcare Administration

Attention : Consumer Complaint Dept.

2727 Mahan Drive

Tallahassee, FL 32308

Central Florida Cares Health System

Attention: Consumer Complaint Dept.

707 Mendham Blvd. Ste. 201

Orlando, FL 32825

The Honorable Mayor of Orange County, Teresa Jacobs

Attention: Consumer Complaint Dept.

201 South Rosalind Ave.

51h Floor

Orlando, FL 32801

Orlando Sentinel

Attention: Editor

633 North Orange Ave.

Orlando, FL 32801

March 31st, 2017

To whom it may concern,

I am a psychiatrist practicing in the central Florida area for 25 years. I care deeply for the

patients who have entrusted themselves to my care and the dedicated healthcare teams I work with

every day.

I am writing as a concerned physician regarding one the hospitals I have privileges with, Aspire

Health Partners. Aspire is the new name for what was three organizations; Center for Drug Free Living,

Lakeside Behavioral Healthcare and Seminole Behavioral Health. This group merged 3-4 years ago. The

merger was unique and a novel idea to combine community resources.

When Aspire was created it merged with the CEO from each organization. The three were to

insure the mergers success. The CEO of Aspire has been since its inception Dick Jacobs the former CEO

of Center for Drug Free Living. The remaining former CEO's have retired. In addition, many-very

competent staff have also left who served as upper management. Prior to their exit, they each spoke

with me and shared their concern with the direction Mr. Jacobs was taking the company. The fear was

they would see the collapse of all the hard work each company had brought to the merger only to fail.

I have attended Aspire meetings and noted that Mr. Jacobs manages the company with an

abrupt autocratic style. He does not encourage input from the medical staff or his leadership team. I

have not seen a consensus with fina l decisions. He is best described as a delegative leader that assign's

projects to his very large management team but does not consider their recommendations.

I currently serve as Medical Director in multiple organizations where my job is to hear the needs

of the medical and clinical staff and act as a conduit to and from the CEO to provide the best care but

remain fiscally responsible. This model also provides transparency and consensus with decisions made.

Aspire has three Medical Directors which is a model like no other I have ever encountered. The three

physicians are fulltime staff that sit in multiple meetings daily instead of seeing patients. This is when

the country is experiencing a severe shortage of physicians and especially psychiatrists. This model is

very expensive. My experience as a Medical Director is maybe a two-hour period from my monthly

schedule. I also have admitting privileges with the area hospitals and have never seen this model of

excess.

Many of the Aspire meetings I have attended have been lavish when the company is a not-for­

profit. I am introduced to many of the management team I never see in the patient care settings. Aspire

has many Vice Presidents and Senior Vice Presidents in addition to the direct managers and executive

staff. The question t hat is asked by many is, how much of a healthcare dollar is mandated or allowed for

administration? This is a community mental health agency, not a large medical hospital conglomerate.

This model of excess is my concern in combination of the management style. Aspire is in a fiscal

crisis which has been discussed for more than six months. My concern continues and is heightened due

to the multiple leaders that have been hired with the crisis deepening. Announcements of promotions in

the corporate office are frequent when many of the staff have not received a pay raise nor has the

promoted position announced been posted internally for others to apply. Many of the direct care staff

fall into the poverty income levels and receive public assistance. I feel so bad for these people. I had

hoped things would get better, but they have not.

The staff that provide care directly to the patients have supported the merger, company fund

raising events, the administration, the excesses in the management structure and are now being told

they are likely to be terminated soon. The first layoffs were two men that mowed the grass. This was

Aspires first choice in slowing the fiscal crisis? Staff are not vocal with concerns due to fear of retaliation

from management and being targeted for termination.

I am emphasizing my concerns and asking for your intervention to avert a larger crisis. Aspire is

for the patients of this community. The staff that care for the patients made Aspire. The funds that

support Aspire are local, state and federal dollars. Where has the money gone? As a tax payer and a

member of the medical staff I am alarmed. My responsibilities are to treat the patients with behavioral

health and substance abuse disorders. I am now adding to my day hearing from many of the patient care

staff voicing their concerns. One of the most competent nurses I have ever worked with stands before

me and cries from fear of losing her job. A job where she has been hurt from patient violence, staffing

shortages and lack of therapeutic resources. Yet she still comes to work due to her dedication. She

explained that massive layoffs will be coming. She is worried as an older nurse she will be the first to go.

This is not acceptable. I am enraged that this travesty is occurring, prompting me to write this letter.

There is no doubt that Aspire is in a fiscal mess. How it became this dyer is inexcusable. I see the

CEO, Chief of Operations, Chief Financial Officer and the Board of Directors have abandoned their

fiduciary responsibility to the patients and community to which they were entrusted to manage the

company's funding. Where is the accountability? How is this allowed to be the norm? Aspire services

will be cut or diminished, caring and talented caregivers will be summarily dismissed which directly limits the services to the patients and population of Central Florida.

The blatant cronyism and enabling behavior from the Board of Directors and the CEO's

management group of Aspire is inexcusable. How excessive spending could occur and not be checked at

the onset is nothing short of incompetence to a Ieveii believe is criminal. Where is the money going?

I have asked that question and am ignored. The company is accountable to the public, to the state and

federal regulatory agencies. This merger is greater than three years under the direction of the same CEO. Aspire should not be in this avoidable predicament.

At a recent retirement celebration Dick Jacobs has acknowledged he too will be retiring in 18

months or less. I believe he already has. He has been absent to avoid the crisis that Aspire has entered. I

believe he has been allowed an excess of trust by the Board of Directors who frankly have no idea either of what to do nor have held him accountable. How could the Board of Directors let this happen?

Aspire needs immediate intervention with an impartial person or governing group to reorganize,

restructure and implement a recovery plan. Too much is at stake. I implore you to investigate how this organization could get to this state, represent the consumers of Aspire services and retain the group of

talented caregivers that are the true heroes of healthcare today, not a corporate yes person.

I can recite many examples of dedication and care Aspire staff provides. It is Aspire staff that

make the patient treatment outcome successful, it was Aspire staff that were one of the many groups

there in the early morning for the victims and families of the Pulse night club massacre. Now, please be there for Aspire, the patients served and the staff that make a difference in their lives every day.

Central Florida Cares Health System, Inc. 2016-17 Executive Committee Meeting April I 1 , 20 I 7

Chair

Consumer Advocate

Lassiter-Ware Insurance Brevard County Housing & Human Services Seminole Prevention Coalition

Consumer Advocate