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FY 2007 Budget
Budget
Development Principles
August 2006
The following represent the principles upon which the CMH budget is developed. These principles will be applied by all of the parties involved in the budget development process.
1. Pace of process balances competing demands: The pace of the budget development process reflects the need to balance two competing values:
A. The need to obtain the most accurate estimates of revenue and expenditure data for the coming year (which calls for a process to begin as late as possible)
and
B. The need to ensure that sufficient time is available to:
< actively solicit and analyze budget balancing proposals
< ensure that all parties have sufficient time to plan for and carry out the budget balancing proposals
< provide adequate notice to consumers and all other stakeholders
(Which call for a process to begin as early as possible)
2. Roles of key parties: Budget balancing proposals will be developed by management, reviewed by senior and middle management, with the input of staff and other stakeholders, with the advice of labor, and recommended to the Board of Directors.
Labor=s role in the process will be to ensure early identification of the impacts of the proposed budget changes and communicate information to staff.
The authority to make final budget decisions resides with the Board of Directors.
Programs and departments are responsible
for successfully implementing proposals and bringing about the budget changes.
3. Transparent inclusive process: The budget development process will use methods that ensure, to the greatest extent possible, an inclusive consensus-based process, involving a range of stakeholders. The type of involvement is limited, however, by the caveat that staff should not take part in decisions to eliminate or reduce their own positions, unless individual staff volunteer to eliminate or reduce their positions.
4. Fiscal stability: To restore or maintain, over several years, an amount sufficient to cover the estimated liability in accordance with the contract between CMH and the MDCH, CMH will continue to maintain a sound Unrestricted Fund Balance and Risk Reserve/Internal Service Fund. To that end, contributions to these funds may be a part of the organization=s Steady State Budget.
5. Consideration of a range of factors: As potential budget balancing proposals are considered, each will be assessed in light of its impact on:
A. Consumers
The impact on the quality of life, health, and safety of consumers, their families, and the community.
Each proposal must ensure that the proposal calls for no less than basic protections, basic standards of care and basic clinical and administrative practices
B. Staff
The impact on staff, including workloads, layoffs, changes to compensation
C. Provider role
The impact on CMH=s ability to maintain and strengthen its role as the direct provider of publicly and privately funded mental health services which are:
< central to managing the service delivery system, as a whole, as well as those which are
< central to managing the service and supports packages that are provided to individual consumers
D. MCO role
The impact on CMH=s ability to maintain and strengthen its role as the direct provider of managed care organization (MCO) functions, for publicly funded mental health services, which are:
< central to managing the service delivery system, as a whole, as well as those which are
< central to managing the service and supports packages that are provided to individual consumers
E. Partners
The
impact on CMH=s development and strengthening of
partnerships designed to address the mental health needs of the community and
to carry out a range of initiatives including advocacy and the acquisition of
expertise and other resources.
F. Alternative resources
The availability of other community resources to close the gap that results from the proposal
G. Compliance with statute, regulations, contractual obligations
Compliance with the Michigan Mental Health Code, the Michigan Public Health Code, MDCH Administrative Rules, other federal and state statutes, local ordinances, Medicaid rules and regulations, and contractual obligations
H. Aggregate net costs
The net impact on costs per person served and total CMH costs must be reduced through the proposal
I. Funding source
The funding source will be tied to each proposal. Because the components of CMH=s operations vary relative to the funding source that supports them, differences in the level of cut(increase) needed or allowed will be dictated by the availability of funds from the respective funding source.
J. Community=s view
The consideration of the public=s potential view of proposal and CMH=s ability to describe the proposal to a lay audience
6. Shared impact: The process will use a modified Ashared impact@ model across programs and administrative departments. This means that each program and administration receives budget balancing targets of equal proportion (if a program=s budget is 15% of CMH=s non-grant budget, then the program=s budget balancing target is 15% of CMH=s total target). This does not mean that all units, within each program or administration, must have a proportionate target.
7. Aggressive fund development: Staff will aggressively seek categorical funding from all public and private sources to close the service gaps created by past and current budget changes, with special attention to prevention and early intervention services.
8. On-going identification of efficiencies: Focus on the identification and implementation of efficiencies and cost effective innovations during the budget development process and on an on-going basis.
9. Investment approach: Employ an investment approach to some expenditures: identifying areas for capital or other one-time investments that will lead to reduced net costs in future years.
10. Budget balancing not to substitute for supervision: Lay offs, to achieve budget reduction goals, should not be used as a method to move staff, with performance and/or disciplinary issues, to other units via the transfer in lieu of lay off process. Performance and disciplinary issues need to be addressed via supervision and through established procedures.
The
Community Mental Health Authority of Clinton, Eaton, and Ingham Counties (CMH)
is a public entity created and empowered under the Michigan Mental Health Code and
an agreement between Clinton, Eaton, and Ingham Counties to plan, design, fund,
provide, manage, and evaluate an array of services to meet the mental health
needs of persons and their families who live in Clinton, Eaton, and Ingham
Counties.
Although CMH will serve others with mental health and substance abuse
needs, the organization has a primary commitment to persons with serious and
persistent mental illness or an impairing personal life crisis; children who
are seriously emotionally disturbed; persons with developmental disabilities;
individuals who are dually impaired with a substance abuse problem and any of
the above conditions.
CMH is committed to ensuring the provision of quality
services to consumers and to achieving the best possible outcomes for
individuals, families, and the community.
Core Values
CMH's
philosophy and guiding principles for service delivery include:
C Developing
a system in the three-county area that ensures timely access to a network of
community services and support, regardless of a person's ability to pay.
C Resources
available shall be used to bring about measurable person-centered outcomes as
well as program and organizational outcomes.
C Service
design and delivery will be based on a thorough, ongoing community needs
assessment for the three county area which must include consistent public
participation.
C All
services, either directly provided or contracted out, will be evaluated against
clear consumer driven criteria including consumer satisfaction, clinical
effectiveness, increased independence, solutions focused on quality of life
issues, and the effective use of resources.
C Developing community
strength by initiating and participating in functional partnerships with other
public and private community service providers to plan, to collaborate, to
share and to increase available community resources.
C All services
or operations managed by CMH, or in cooperation with other service providers,
will honor confidentiality and will be culturally sensitive,
non-discriminatory, least restrictive, consumer focused, and delivered with
dignity and respect.
C Operations
must be publicly accountable to consumers, the community, taxpayers, and
funding sources, with respect to quality and finance.
C The
acknowledgement that a well trained, competent, and caring staff is an
essential component of quality services.
C Service is
enhanced by an individual's participation as a partner in his or her service
design and delivery and that participation of family members and others is
encouraged.
C Evolving and
changing individual and community needs will be reflected in changing policies
and programs.
C Efforts
should empower individuals to participate in the potential opportunities and
responsibilities of community living.
Clinical Philosophy
The services and supports provided by CMH will:
1.
Seek to improve the functioning of consumers and
their quality of life, including (as appropriate to the condition of the consumer)
improvements in a number of life domains as well as symptom relief and
management.
2. Be person-centered (and family-centered in work with adolescents and children and, in work with adults, whenever possible) in their planning and provision, promoting consumer dignity, empowerment, and choice.
3. Acknowledge the importance of consumers and families fully participating in treatment and supports.
4. Acknowledge the importance of consumers and families having knowledge and understanding of the illness/disability, treatment and supports modalities, and the treatment/supports system.
5. Reflect a strength-based approach.
6. Reflect a recovery model in the provision of services and supports to persons with mental illness and substance abuse disorders.
7. Reflect a community inclusion model in the provision of services and supports.
8. Serve to strengthen and supplement but not replace the natural supports of consumers (for example: the consumer, family, friends, employers, teachers, and other community organizations).
9. Promote consumer choice and autonomy in the context of health and safety. When consumer choice and autonomy are in direct and irreconcilable conflict with significant health and safety concerns, health and safety concerns will prevail.
10. serve to ensure access to CMH services and supports to all in the tri-county community in need of these services.
11. Employ least restrictive methods and take place in the least restrictive settings.
12. Be community-based, meaning that they are offered in CMH facilities, throughout the community, and in the places where consumers live, work, volunteer, recreate (play), and socialize.
13. Respect the range of cultures, traditions, and values of consumers.
14. Be provided via a collaborative, inclusive approach that draws upon the involvement and expertise of a range of disciplines, functions, and organizations.
15. Apply research-based and professionally accepted standards and levels of care, clinical pathways and protocols.
16. Be provided within a framework of professional ethics. Staff with clinical differences of opinion regarding treatment should consult with their supervisor, and obtain approval of the Program and Clinical Services Committee before acting contrary to the plan of service.
17. Be designed and provided with the aims of optimizing the related goals of consumer and community well-being, clinical effectiveness, risk management, and cost control.
18. Be directed to fulfill secondary and tertiary prevention needs of consumers.
fy 2006 budget development principles.wpd