BOARD OF COUNTY COMMISSIONERS AGENDA ......2016/01/04 · Shawnee County Health Agency 1615 SW 81h Avenue-Topeka, KS 66606-1688 Ph. (785) 251-2000 Fax (785) 251-2098 SCHA CHC BOARD

BOARD OF COUNTY COMMISSIONERS AGENDA MONDAY, JANUARY 4, 2016

COMMISSION CHAMBERS, ROOM B-11 I. PROCLAMATIONS/PRESENTATIONS

II. UNFINISHED BUSINESS

III. CONSENT AGENDA

1. Acknowledge receipt of the January 5th SCHA CHC Board agenda and minutes of the December 151 meeting-Health Agency.

2. Consider approval of request to pay invoices from the Diversion Fund account in a total amount of $597.03-District Attorney.

IV. NEW BUSINESS

A. COUNTY CLERK- Cynthia Beck

1. Consider all voucher payments.

2. Consider correction orders.

B. HEALTH AGENCY-Alice Weingartner/Allison Alejos

1. Consider approval of request to utilize a temporary staffing agency to fill an RN position at a cost of$50.95 per hour from January 4, 2016 to April3, 2016-CHC.

2. Consider approval of Contract C1-2016 with the American Medical Association for the 2016 Data Files End User Internal Use License Agreement for health care billing and coding at a cost of $1,098.50 for the year.

3. Consider approval of Resolution No. 2016-1, rescinding Resolution No 2015-25 to increase the business credit card limit for the Purchasing/Payroll Specialist II, Jayme Byers, to be used for the Shawnee County Health Agency (SCHA) Local Health Department (LHD) and Community Health Center (CHC).

V. ADMINISTRATIVE COMMUNICATIONS

VI. EXECUTIVE SESSIONS

Shawnee County Health Agency 1615 SW 81

h Avenue- Topeka, KS 66606-1688 Ph. (785) 251-2000 Fax (785) 251-2098

www.snco.us/ha

SCHA CHC BOARD AGENDA SCHA Auditorium

Tuesday, January 5, 2016 11 :30-Lunch Available

12:00pm-Meeting

1. Call to Order 2. Approval of December 1,2015, Board Minutes 3. SCHA Board Committees

a. Governance Committee 1. Board Composition and Governance Authority 2. 2016 Slate of Officers

b. QA Committee-December Meeting Cancelled c. Executive Committee

1. Chairman Annual Report d. Finance Committee

4. CHC Executive Director's Report 5. Medical Director's Report 6. Health Access Report- Karla Hedquist 7. New and/or Miscellaneous Business

a. Committee Review b. Board Self Evaluation Results

8. Adjourn

Next SCHA CHC Board Meeting Tuesday, February 2, 2016

SCHA Auditorium 12:00pm

Leading the way to a healthier Shawnee County.

:w=



SCHA CHC BOARD MEETING SCHA Auditorium December 1, 201512:00 PM

www.snco.org

MEMBERS PRESENT: Tanya Tostado, CHC Board Chair, Michelle Sweeney, CHC Board Vice-Chair, Kim Hodgson, CHC Board Secretary, Commissioner Robert Archer, Wanetta Bean, Jim Kinderknecht, Walter Stevenson, Rick Woods, Sherry Obrosky, Dr. VanSickle, Karla Hedquist, and Chris Hartman

MEMBERS ABSENT:

GUESTS: Barbara Lerma, LOWV

STAFF PRESENT: Alice Weingartner, CHC Executive Director, Dianna Yates, Division Manager, Dr. Vogt, Medical Director, Nancy Mitchell, Accountant II, Ashley Siegert, Assistant County Counselor, and Elly Shughart, Office Assistant Ill

CALL TO ORDER Community Health Center (CHC) Board Chair called the meeting to order at 12:12pm. A quorum was present. Due notice had been mailed.

APPROVAL OF MEETING MINUTES The minutes of the November 3, 2015, CHC Board meeting were approved as presented.

QUALITY ASSURANCE (QA) COMMITTEE The committee reviewed the third quarter report card and third quarter incident reports. The Executive Director announced the CHC was deemed for Federal Tort Claims Act (FTCA) coverage and the coverage will begin in January 2016. The QA Committee will not be meeting in December.

EXECUTIVE COMMITTEE The committee reviewed the media release that went out regarding the new timeline for the CHC's transition to GraceMed, Inc. Instead of transitioning as of January 1, 2016, the transition may take place in mid-to-late 2016. The committee also reviewed the newly revised relinquishment letter that was sent to the Health Resources and Services Administration (HRSA) due to the date change for the transition. The Executive Director stressed the importance of the CHC Board staying in place and maintaining function


until the transition occurs. The CHC is still required to meet all of the requirements for being a Federally Qualified Health Center (FQHC).

Michelle Sweeney made a motion that the CHC Board acknowledges and supports the revised relinquishment Jetter that was sent to HRSA. No discussion took place. Motion carried.

FINANCE COMMITTEE The Chair reported in October, total revenue earned year to date (YTD) at $4,658,545. October YTD expenditures are $4,151 ,527 which leaves the YTD net income at $507,018. The average income projected adjustments by yearend are estimated to be $11,254 and it is anticipated the CHC will need $0 of the $320,175 set aside in the initiative funds to cover 2015 expenses. This brings the estimated total yearend income to approximately $449,898. The CHC is under budget by 15.78% and about $817,716 of that is due to staff vacancies. The committee reviewed the proposed 2015 courtesy write offs that total approximately $4,200.

Dr. VanSickle made a motion to approve the proposed 2015 courtesy write offs with leniency on the amount for accounts that may need to be added. No discussion took place. Motion carried.

The committee also reviewed the revised Intrauterine Device (IUD) Cost Sheet. The cost sheet was revised due to a more cost effective change in vendors. There was some confusion as to what Board members were approving in this scenario. The Accountant II advised Board members are approving the charge of the device and not the actual device.

Wanetta Bean made a motion to approve the revised IUD Insertion-RemovalDevice Upfront Cost Cheat Sheet and amend the fee schedule to reflect the changes in cost. No discussion took place. Motion carried.

CHC EXECUTIVE DIRECTOR'S REPORT •!• The move from the VanSickle-Thorn Clinic to the Main Office is scheduled to

take place on December 3rd, 4th, and ih. The Women's Health and Maternal and Infant (M&I) clinics will resume services on Tuesday, December 8, 2015.

•!• The Service Area Competition-Additional Area (SAC-AA) grant application was opened on November 17, 2015. The final deadline for applications to be submitted is February 2, 2016. It is anticipated it will take approximately 30 days for HRSA to announce the awards. Once the grant is awarded, HRSA gives 120 days for the transition to occur so if everything takes place according to the anticipated timeline, the transition may occur on July 1, 2016.

•!• Work continues on identifying positions that are vacant or will be vacant at the end of the year and determining which vacant positions will be taken to the Board of County Commissioners (BCC) for approval to fill. When these positions are

filled they will model GraceMed's current staffing plan to help make the transition go smoothly when it happens.

•!• The Executive Director presented Board members with the Noncompeting Continuation (NCC) Progress Report. Once the grant is awarded, an annual progress report has to be done once a year for three years so that progress can be monitored. An income analysis was done which is what was projected when the grant was first submitted. The report details required, additional, and specialty services provided. The report lists service sites and other activities/locations such as health fairs and activities that do not take place at service sites but are still covered by FTCA. The report details program narrative updates which are environment and organizational capacity, patient capacity and supplemental awards, and clinical/financial performance measures. The annual progress report is due on December 18, 2015. There was discussion regarding the Affordable Care Act (ACA) and the Shawnee County Health Agency's (SCHA's) Outreach and Enrollment program in relation to the annual progress report.

•!• The Executive Director announced the CHC Board members will be electing new officers at the January 2016 meeting. The Governance Committee is meeting to select the slate of officers.

•!• Valeo hired a new Executive Director. He is making rounds and meeting people and may be stopping by a Board meeting in the future to meet members.

MEDICAL DIRECTOR'S REPORT Work continues on the move of the VanSickle-Thorn Clinic to the Main Office. The Medical Director is looking forward to the closer collaboration with staff from that clinic and the move will be great for cross-training the nursing staff.

Karen Edelman, Advanced Practice Registered Nurse (APRN), is retiring December 31, 2015. There will be an in-house retirement celebration on December 16, 2015, over the lunch hour. More information will be sent out regarding this and Board members are encouraged to come.

HEALTHACCESS(HA)REPORT Karla reported the annual HA fund raiser "Music .... Just What the Doctor Ordered" will take place on Sunday, April 3, 2016.

NEW/MISCELLANEOUS BUSINESS No new business.

ADJOURN The meeting was adjourned at 1:11pm.

Minutes taken by Elly Shughart

Reviewed by:

CHC Board Chair

CHC Executive Director



www.snco.us/ha

SCHA CHC GOVERNANCE COMMITTEE MEETING Shawnee County Health Agency Auditorium

December 1, 2015 1:00pm

1. Call to Order 2. Approval of August 11, 2015 Minutes 3. Executive Director's Report 4. New and/or Miscellaneous Business

a. Board Composition & Governance Authority b. Slate of Officers for 2016

5. Adjourn




www.snco.us/ha

SCHA FQHC GOVERNANCE COMMITTEE MEETING SCHA Auditorium December 1, 2015 1:OOpm

MEMBERS PRESENT: Tanya Tostado, Chair, Wanetta Bean, Kim Hodgson, Michelle Sweeney, and Sherry Obrosky

MEMBERS ABSENT:

STAFF PRESENT: Alice Weingartner, CHC Executive Director, Dianna Yates, Division Manager, and Elly Shughart, Office Assistant Ill

CALL TO ORDER The Committee Chair called the meeting to order at 1:18pm. A quorum was present. Due notice had been mailed.

APPROVAL OF MINUTES The minutes of the August 11, 2015 meeting were approved as presented.

EXECUTIVE DIRECTOR'S REPORT No new business.

NEW/ MISCELLANEOUS BUSINESS The nominations for the 2016 slate of officers for the Community Health Center (CHC) Governing Soard are Michelle Sweeney as Chairman, Wanetta Bean as Vice-Chairman, and Sherry Obrosky as Secretary.

Michelle Sweeney made a motion to recommend to the CHC Board that she be elected as Chairman, Wanetta Bean be elected as Vice-Chairman, and Sherry Obrosky be elected as Secretary. Tanya Tostado seconded the motion. Motion carried.

There are five CHC Board members whose terms expire in January 2016. They are Walt Stevenson, Tanya Tostado, Kim Hodgson, Jim Kinderknecht, and Dr. VanSickle. Dr. VanSickle is still deciding whether or not to continue to serve on the CHC Board in 2016 but the rest have shown interest in continuing to serve on the Board. Commissioner Archer's term also expires in January but the commissioners usually rotate Board seats each year.

Michelle Sweeney made a motion to recommend to the CHC Board that Walt Stevenson, Tanya Tostado, Kim Hodgson, Jim Kinderknecht, and Dr. VanSickle continue to serve on the CHC Board. Kim Hodgson seconded the motion. Motion carried.


Kim Hodgson suggested having a Governance Committee meeting in January. The group agreed it was unnecessary because there is nothing on the agenda calendar for the Governance Committee in January.

MEETING ADJOURN The meeting adjourned at 1:34pm.

Recorded by Elly Shughart

Reviewed by:

Chair

Date

TO: FROM: DATE:

RE:

Shawnee County Health Agency 1615 SW 8th Avenue- Topeka, KS 66606-1688

Ph. (785) 368-2000 Fax (785) 368-2098 www.shawneehealth.org

Allison Alejos, Director Local Health Department Alice Weingartner, Director Community Health Center

Community Health Center Governance Committee Alice Weingartner November 17, 2015

Board positions and membership

With the county retaining the operations of the CHC it is necessary to determine who intends to

remain as board members and who will fill the officer positions in 2016. Following the December 1st Board Meeting, the Governance Committee will meet to establish a slate of

officers for 2016 as well as determine the interest of current board members in retaining their

membership on the CHC Board.

The following terms are scheduled to expire January 2016 and noted is the feedback regarding

continued participation.

MEMBER INITIAL CURRENT

NAME TYPE APPOINTMENT

TERM NOTES EXPIRES

Bean, Wanetta Wants to remain a member Consumer Jun-03 Jan-16

Walt Stevenson Wants to remain a member Consumer Feb-14 Jan-16

Tostado, Tanya Consumer Jul-13

Wants to remain a member Chair Jan-16

Hodgson, Kim Consumer Dec-11 Jan-16

Considering remaining as a board member. Secretary

Kinderknecht, Jim Non- Wants to remain a member Consumer Apr-00 Jan-16

Van Sickle, Greggory Non- Appointed Jan-16

Considering remaining as a board member. MD Consumer byBCC

Archer, Robert Non-

County May change with 2016 Commission County Commissioner Appointed Jan-16 committee re-assignments.

Consumer Jan-15

Sweeney, Michelle Consumer Jan-15 Jan-16

Could be rotated to Chair position Vice Chair

Based on the by-laws the board can consist of between 9 to 13 members with 51% of the members being individuals who receive services at the CHC. Current board consists of 7 consumers and 4 non-consumers. I would not recommend increasing the size of the board.

The governance committee will review this information to make recommendation to the full board in January and will include a slate of officers for approval.


Ph. (785) 251-2000 Fax (785) 251-2098 www.snco.us/ha

SCHA CHC EXECUTIVE COMMITTEE MEETING AGENDA Shawnee County Health Agency Library

Tuesday,December15,2015 12:00pm

1.) Call to Order 2.) Approval of November 17, 2015, Minutes 3.) CHC Executive Director's Report 4.) New and/or Miscellaneous Business

a. Chairman Annual Report 5.) Adjourn

Next Executive Committee Meeting January 19, 2016

12:00 - 1 :00 Shawnee County Health Agency Library




www.snco. us/ha

SCHA CHC EXECUTIVE COMMITTEE MEETING Shawnee County Health Agency Library December 15, 201512:00pm

MEMBERS PRESENT: Tanya Tostado, Chair, and Kim Hodgson

MEMBERS ABSENT: Michelle Sweeney and Dr. VanSickle

STAFF PRESENT: Alice Weingartner, CHC Executive Director, Ashley Biegert, Assistant County Counselor, and Elly Shughart, Office Assistant Ill

CALL TO ORDER The Committee Chair called the meeting to order at 12:09pm. Due notice had been mailed. A quorum was not present.

APPROVAL OF MINUTES The November 17, 2015, meeting minutes were not approved as presented.

CHC EXECUTIVE DIRECTOR'S REPORT The Executive Director reported that it is anticipated there will be a cut of $379,000 in primary care funding in state fiscal year 2017. The Community Health Center (CHC) currently receives $175,000 which is used to support behavioral health services and the prescription assistance program. The state primary care association is asking for letters of support from patients and community partners to request that the $379,000 is reinstated in 2017. The Executive Director encouraged committee members to provide letters of support and get them back to her no later than January 5, 2016.

Work continues to fill vacancies for the CHC. It is anticipated a media release will come out in the next few days announcing that Marian Clinic is closing at the end of the year. They have approximately 500 active patients and Marian Clinic is working to identify places those patients can go to get healthcare and some of them will start being seen by providers at the CHC. The Marian Dental Clinic is staying open.

The Committee Chair needs to start working on the annual report for the CHC Governing Board. The Office Assistant Ill will send her an example from a previous year. This is due January 5, 2016.

ADJOURN The committee adjourned at 12:09pm due to lack of quorum.

Minutes recorded by Elly Shughart


Reviewed by:

Chair

Date

Weingartner, Alice

Subject: FW: Action Requested- Letters of Support for 2016 Legislative Session

Subject: Action Requested - Letters of Support for 2016 Legislative Session

Good morning!

As the 2016 Legislative Session QUICKLY approaches (I honestly feel like it just ended), we are in full swing getting ready. As you may remember last session, the Primary Care Clinic budget cut was restored for SFY 2016; however, this session we are still facing a $379,000 cut for SFY 2017. As part of the agreement to restore funds to SFY 2016, the House and Senate Social Services Budget Committees wilt hold informational hearings on safety net clinics during the 2016 session. This hearing will allow us to really showcase safety net clinics and your tremendous value to the healthcare system. We (including some of you) will present on your patient demographics, funding sources, services provided, etc.

In addition to this, KAMU will be gathering testimony from our state partners, associations, and foundations to have them share their support of the safety net clinics. We also feel that it is critical to gather support from your local communities, as well. We would like to request that you each gather AT LEAST Sletters of support or written testimony from your PATIENTS, local hospital(s), outside health providers, mental health centers, businesses, government, school boards, etc. to be presented at our hearing. Feel free to reach out to other partners that I may not have mentioned, too. I'm not sure when our hearing will be scheduled for, but the session starts January 11, 2016. I would ask that you have all of these letters turned into me by that date. The more letters we can provide to these committees, the better our chances of getting funding restored for SFY 2017. You can send them to be by email, fax or snail mail. Once a hearing date has been set, I will let all of you know so that you can attend, maybe it will work out to do on our Advocacy Day on Feb. 2"d!

You are all such wonderful advocates for the safety net and underserved population! I greatly appreciate all of your efforts to gather these letters.

Merry Christmas & Happy New Year! Katrina

1

l ... '

Memorandum

To: CHC Finance Committee

From: Elly Shughart

Date: December 15, 2015

Re: December 21, 2015, Finance Meeting

Please advise, the meeting has been changed from Tuesday, December 22, 2015, to Monday, December 21, 2015 at !2:00pm in the SCHA Library.

If you have any questions or concerns, please call me at 785-251-2091 or email me at [email protected]. Thank you.

p p Promote Protect

p p Prov1de Prevent



www.snco.us/ha

SCHA CHC FINANCE COMMITTEE MEETING AGENDA Shawnee County Health Agency Library

December 21, 2015 12:00pm

1. Call to Order 2. Approval. of November 23, 2015, Minutes 3. CHC Financial Summary for November 4. Revenue and Expenditures Report 5. Grants Report 6. AR Trend Summary 7. Financial Class Summary/Aging by Financial Class 8. New and/or Miscellaneous Business 9. Adjourn

Next SCHA CHC Board Finance Committee Meeting 12:00pm Shawnee County Health Agency Library

January 26, 2016

Leading the way to a healthier Shawnee County. ,"J


Ph. (785) 251-2000 Fax (785) 251-2098

www.shawneehealth.org .

SCHA CHC FINANCE COMMITTEE MEETING SCHA Library December 21, 2015 12:00pm

MEMBERS PRESENT: Chris Hartman, Chair, and Tanya Tostado (via conference call)

MEMBERS ABSENT: Wanetta Bean and Jim Kinderknecht

STAFF PRESENT: Alice Weingartner, CHC Executive Director, Dianna Yates, Division Manager, Nancy Mitchell, Accountant II, and Elly Shughart, Office Assistant Ill

CALL TO ORDER The committee chair called the meeting to order at 12:06pm. Due notice had been mailed. A quorum was not present.

APPROVAL OF MINUTES The November 23, 2015, minutes were not approved as presented.

REVENUE AND EXPENDITURES REPORT The Accountant II presented the finance report, which is included in the meeting packet of information. Key issues included the following:

The total visits for the Community Health Center (CHC) are at about 64% of the visits used to create the 2015 county budget and program revenues generated by those visits are at about 66% of the budgeted amounts. At the end of November, the CHC should be at 92% of the budget. The CHC is behind budget due to lower than budgeted visits.

This leaves total revenue earned year to date (YTD) at $5,091 ,550. November YTD expenditures are $4,526,199. The November YTD net income is $565,350.

The average income projected adjustments by yearend are estimated to be $28,188. Subtracting $71,500 because the payroll expense will be increased and the net income will be reduced by approximately that amount in December due to the four days worked in 2015 but paid in 2016. It is anticipated the CHC will receive $2,049 for the Early Detection Works (EDW) program. It has been estimated that the CHC will need $0 of the $320,175 set aside in the initiative funds to cover 2015 expenses. This brings the estimated total yearend income to approximately $524,087.


EXPENDITURES November YTD expenditures are $4,526,199 which is 73.32% of the budget. The CHC is under budget by 18.35%. The MSA I is under budget by $930,342 due to staff vacancies. The Contractual Services object code 50230 is high this month due to paying for a Registered Nurse (RN) and a Certified Medical Assistant (CMA) through a temporary staffing agency. The Immunizations/Pharmaceuticals object code 50343 is high this month due to paying for a stock of birth control.

GRANT REVENUES In November, drew down $100,201 for the 330 grant which includes the Expanded Services grant and the Quality Improvement (QI) grant. Although the CHC spent $16,484 more than anticipated for the Expanded Services grant YTD, there is still $53,650 to spend on this grant. The CHC spent $26,239 of the $38,552 Ql grant and some blood pressure trees and a blood sugar testing machine have been ordered.

In November, the CHC received $0 for Community Base Primary Care and $0 for the Prescription Drug Assistance grant.

The CHC received $560,352 in tax allocation in October for the months of October, November, and December which brings total county tax allocation for 2015 to $2,241,409.

FINANCIAL NARRATIVE The total cost per patient is at $851.51. The 11 month encounter goal at current staffing levels is 21,403. The YTD actual encounters are at 16,821. The CHC is 4,582 encounters below the goal. The CHC's total patient revenue monthly goal is $133,629. In November, the CHC received $104,212 in patient revenue which is $29,417 below the goal.

ACCOUNTS RECEIVABLE (AR) AND COLLECTIONS REPORT The AR trend summary report reflects an ending AR balance of $310,029 which is a net AR decrease of $50,924.

There are approximately 444 cases in the collections module totaling $56,611. November payments collected from patients were $26,156. This is a decrease in patient payments received and posted compared last month's $31,187. Payments collected represent regular payments, monthly payment plans, and upfront collections. November upfront collections were $20,469 which is a decrease from last month's $26,285.

FINANCIAL CLASS SUMMARY/AGING BY FINANCIAL CLASS The CHC has a total AR over 91 days of 43% or $82,319 compared to last month's 33% or $67,182. The goal is to maintain an average of 20% or less which is approximately $40,000.

Patient pay total AR over 90 days has increased to $74,835 compared to last month's $62,245 and represents 91% of the AR over 90 days. There were 147 guarantor accounts totaling $13,598.75 that were sent to collections on December 10, 2015. This

(\

caused patient pay AR over 90 days decrease to $63,616 as of December 14, 2015. Total AR over 90 days is 27.47% of total AR as of December 14, 2015.

NEW AND/OR MISCELLANEOUS BUSINESS In January, the Finance Committee will review and discuss the proposed 2016 fee schedule.

The Finance Office is working to purchase refrigerators and monitors for vaccines with the new expanded services funding received this year.

MEETING ADJOURNED The meeting was adjourned at 12:06pm due to no quorum.

Recorded by Elly Shughart

Reviewed by:

Chair

Date

CHC FINANCIAL SUMMARY for NOVEMBER 2015

REVENUES

1. Total visits for the CHC are at about 64% of the visits used to create the 2015 County budget and program

revenues generated by those visits are at about 66% of budgeted amounts. At the end of November, we

should be at 92% of our budget. We are behind County revenues budget due to lower than budgeted visits.

2. Line 3- Total Revenue Earned YTD is $5,091,550.

3. Line 4- YTD Expenditures are $(4,526,199}.

4. Line 5- YTD Net Income is $565,350.

5. Line 6- The average projected income by yearend is estimated to be $28,188.

6. Line 7 -We are subtracting $71,500 because we will increase payroll expense and reduce net income by

approximately that amount in December due t o the 4 days worked in 2015 but paid in 2016.

7. Line 8 -We expect t o receive $2,049 for the EDW program.

8. Line 9 -We are currently estimating that we will need $0 of the $320,175 set aside in t he initiative funds to

cover our 2015 expenses.

9. Line 10-This brings our Estimated Total Yearend Income to approximately $524,087.

EXPENDITURES

1. YTD Expenditures are $(4,526,199} which is 73.32% of th e budget. We are under budget by 18.35%. 2. MSA I (YTD Salaries & Benefits Variance) is under budget by $930,342 due to staff vacancies.

3. The Contractual Services object code 50230 is high this month because we are paying for an RN and a CMA

through a temporary staffing agency.

4. The Immunizations/Pharmaceuticals object code 50343 is high this month because we paid for a stock of

birth control.

5. There are no other noteworthy expenditures.

GRANT REVENUES 1. In November, we drew down· $100,201 for the 330 Grant, which includes the Expanded Service and the

Quality Imp rovement grant. a. We have spent $16,484 more than anticipated for the Expanded Services grant YTD. We still have

$53,650 to spend on this grant.

b. We have spent $26,239 ofthe $38,552 Quality Improvement and have ordered some blood pressure

trees and a blood sugar testing machine.

2. In November, we received $0 for the Community Based Primary Care and.$0 for the Prescription Drug

Assistance grant. This is received intermittently.

3. We received $560,352 in tax allocation in Oct ober for the months of October, November and December

which brings the total 2015 County Tax Allocation support to $2,241,409.

FINANCIAL NARRATIVE

1. Total Cost per Patient: The current cost per patient is $851.51. This will gradually go up throughout the year to approximately $900 per patient.

2. Encounters & Productivity: Our 330 grant goal at full staff is 1,988. Based on the monthly goal of2,030, the

11-month encounter goal at current staffing levels are 21,403. The YTD actual encounters are 16,821. This

leaves the clinic 4,582 encounters below the 11-month goal.

3. Net Patient Revenue: CHC Total Patient Revenue Month ly Goal is $133,629. In November, we rece ived

$104,212 which is $29,417 under our goal. ~

CHC BUSINESS OFFICE ACCOUNTS RECEIVABLE AND COLLECTIONS REPORTS

1. The AR Trend Summary Report reflects an ending AR balance of $310,039 which is a NET AR increase of

$50,924. The current ending AR balance is depicted in the first graph.

a. COLLECTIONS: We have 444 cases totaling $56,611 in the AR collections module that are either active

payment plans or the account is ready to be sent to collections once the client receives 3 statements

and 90 days has passed with no payment. This is depicted in the second graph.

b. The third graph reflects total patient payments received of $26,156 which is a decrease compared to

last month's $31,187. This represents all patient payments including upfront collections, regular

payments, and monthly payment plans. November had 4 less working days than October.

" c. The fourth graph trends upfront collections of $20,469 which is a decrease from last month's

$26,285.

2. The Aging by Financial Class Report reflects that we have a total AR over 91 days of 43% or $82,319

compared to last month's 33% or $67,182. Our goal is to maintain an average of 20% or less Total AR over 90

days which is approximately $40,000 (See the first graph).

a. The Patient Pay Total AR over 90 days has increased to $74,835 compared to last month's $62,245

and is 91% of the AR over 90 days.

b. 147 guarantor accounts totaling $13,598.75 were sent to collections on December 10. This made

Patient Pay AR over 90 days decrease to $63,616 as of December 14. Total AR over 90 days is 27.47%

of total AR as of December 14.

OTHER UPDATES

1. In January, we will discuss the proposed fee schedule in this meeting and make a recommendation to the

full Board.

2. We are working on purchasing refrigerators and monitors for vaccines with the new expanded services

funding we received earlier this year.

NOVEMBER 2015 REVENUE 0.92

SHAWNEE COUNTY HEALTH AGENCY BK*(11/12)=BH BH- BI=BJ BK -CHC FY 2015 BUDGET OF REVENUES J CHC YTD

-'-Monthly Revenue November November CHC Total Budget to CHC

Nov 2014 r Nov 20~ Nov 2015 Nov 2015 YTD 2014 YTD 2015 YTD Actual 2015 Revenue OBJECT CHC REV CHC Rev ADMIN Rev REVENUE REV REVENUE Budg~ Variance Budget

41004 Returned Checks 25 - - - 370 122~ 122 -41626 Fees - Patient Pay/Health Access 27,719 28,589 1,297 29,886 334,848 351 ,663 502,212 (150,549) 547,868

41627 Fees - Medicaid (Non-MCO) 333 4 ,21 9 - 4,219 29,434 42,819 - 42,819 -41628 Fees - Medicare (Part A & B) I 8,734 25,424 - ! 25,424 221,213 1 314,143 388,208 (74,065) 423,500

41630 Fees - Insurance Co- BCBS & Others 4,837 13,917 - 13,917 106,536 I 188,105 146,208 41,896 159,500

41 642 Fees- Medicaid MCO's, Cost Report 88,001 61,614 - 61,614 753,734 780,092 1,298,047 (517,955) 1,416,051 Fees - Coventry HMO Cost Report, Medicaid

41643 Wrap, & Health Wave Prog - - - - (1) - - - -41644 Fees- EDW I 2,815 1,446 - 1.446 I 11,541 9,309 5,500 3,809 6,000

41652 Fees- Medicare Incentive-Meaningful Use I 28 - - - 224 696 - 696 -41690 Fees- HA Receivables (Collections) 2,502 2,934 - 2,934 40,955 34,395 50,417 (16,021) 55,000

45701 Reimbursement- Mise I - - - - - - - - -47501 Other Revenue Mise 1,508 6,578 - 6,578 17,594 66,032 67,819 (1,786) 73,984

47502 Other Revenue Fed (330 Grant & O&E) 81,261 100,201 - 100,201 771,250 1,042,776 891,924 150,852 973,008

47503 Other Rev KS (CBPC & CPC Pharm DA) 21,875 - - - 175,000 153,125 165,000 (11,875) 180,000 60006! County lnterfund Transfers (Tax Allocation) - - - - 2,453,536 2,241,409 2,054,625 186,784 2,241,409

SCHA Internal lnterfund Transfers 60009 (Admin Indirect fees received f rom Programs) - - - - 22,527 1 53,647 94,387 (40,740) 102,968 39000 Unreserved Fund (lntiative Fund Transfers) - - - I - - - I 293,494 (293,494) 320,175'

Line 1 T OTAL YTD OPERATING REVENUE 239,638 244,923 1,297 246,220 4,938,760 5,278,334 5,957,841 (679,507) 6,499,463

LESS TAX Allocation Received & Not Yet

I Line 2 Earned - 1 month (December) 204,461 99,206 87,578 186,784 (204,461) (186,784) (186,784)

Line 3 TOTAL REVENUE EARNED YTD 444,100 344,129 88,875 433,004 4,734,299 5,091,550 5,957,841 (866,291)

Line 4 LESS: CHC Total YTD Expenditures (347,868) (296,004) (78,668) (374,673) (4, 149,999) (4,526, 199) 5,957,841 1,431,642 6,499,463

Line 5 2015 YTD Net Income(+) or Loss(-) 96,232 48,125 10,207 58,332 584,300 565,350 ADD: Projected Income (+) or Loss(-) (Bal/11

Line 6 Mo*1 Fut Mo) 28,188

Line 7 LESS: Year End Payroll Adjustment (71,500)

Line 8 ADD: Early Detection Works $'s due 2,049 Line 9 ADD: Initiative Funds to Cover Expense .

Adjusted Projected Total INCOME Line 10 by end of 2015 524,087

-- -- -- -- - · - ------- - --- - - - --

~,....

12/14/2015

1 - -

NOVEMBER 2015 CHC EXPENDITURES A B c B+C=D oc112=e E-D=F cu cu+cv=cv cw+cx=cz oc'(11/12)=DA JoA-CZ=DB J oc

SHAWNEE COU NTY HEALTH AGE NCY I j I_ I I __! I J C HC Monthly Financial Re po rt ..M.2.nthly Expenditures I MONTHLY YTD 2015

CHC TOTAL CHC ADMI N~ CHC TOTAL! Budget to CHC CHC TOTAL CHC TOTAL CHC Total YTD Budget CHC 2015 ~--+----------------------------------4 LINE NOV 2014 Nov 2015 Nov 2015 Nov 2015 Monthly Actual YTD 2014 YTD 2014 YTD 2015 YTD to Actual TOTAL CODE DESCRIPTION EXPEND EXP EN D EXPEND EXPEND Budget Variance EXPEND EXPEND EXPEND Budget Variance BUDGET

50100 UNCLASSIFIED EMPLOYEES 76,352 1 81,266 14,366 . 95,632 j 11 9,094 23,462 599,955 765,967 1 1,119,288 1,31 0,036 190,747 1,429,130 50101 UNION 99,141 72,732 20,415 93,147 140,283 47,136 981,175 1,257,369 1,195,871 1,543,115 347,244 1,683,398 501 03 CLASSIFIED EMPLOYEES 33,465 18,619 11,803 30,422 44,206 13,784 235,738 395,672 I 380,206 486,271 106,064 530,477 50106 INTERMITTEN 2,366 8,780 - 8,780 I 5,215 (3,565) 37,907 37,907 36,125 57,360 21,235 62,574 50116 EMPLOYEE BENEFITS 89,773 64,738 21,939 86,677 ' 118,486 31,809 697,161 977,486 I 1,034,343 1,303,344 269,001 1,421,830

MSA I Tota l 301,097 246,1 35 68,524 314,659 427,284 112,626 2,551 ,937 3,434,401 3,769,783 4,700,125 930,342 5,1 27,409 50200 PROFESSIONALSERVICES 12,453 7,741 - 7,741 12,528 4,787 144,260 147,260 90,231 137,803 47,571 150,330 50210 FEESFORSERVICE 225 - - - 434 434 3,278 3,863 3,235 4,771 1,536 5,205 50220 REPAIRS & SERVICING 27 - - - 329 329 2,681 3,777 3,388 3,621 232 3,950 50221 BUILDING MAINT SERVICES &REPAIRS 1,354 2,396 1,352 3,747 4,958 1,211 25,681 37,750 40,699 54,534 13,836 59,492 50230 CONTRACTUALSERVICES 3,909 11,226 5,221 16,446 8,561 (7,885) 47,799 82,177 162,448 94,174 (68,_274) 102,735 50233 Outside Vehic le Repairs & Servic ing - - - - 146 146 - - 23 1,604 1,582 1,750 i

50240 PRINTING & ADVERTISING (Agency) 66 - 75 75 725 650 24,911 25,223 3,136 7,975 4,839 8,700 50241 ADVERTISING (Agency Posit ions) 192 - - - 358 358 1,654 2,919 883 3,942 3,059 4,300 50251 MILEAGE 291 309 166 475 1 375 (100) 2,980 4,092 1,587 4,125 2,538 4,500 50252 TRAVEUACCOMODATIONS/SUBSISTANCE 2,396 15 13 28 3,372 3,344 8,106 10,817 10,990 37,088 26,098 40,460 50254 PROMOTIONAL SERVICES - - - - 42 42 - - 660 I 458 (201) 500 50260 STAFFTRAINING 1,420 - 604 604 1,396 792 10,421 14,380 27,608 15,352 (12,256) 16,748 50261 MEMBERSHIPS/Subscriptions - - - - 1,016 1,01 6 4,038 4,325 5,309 11,177 5,868 12,193 50270 PROPERTY/LEASE RENTAL - - - - 1,000 1,000 - - - 11,000 11 ,000 12,000 50281 ELECTRICALSERVICE 1,534 1,552 - 1,552 3,858 2,307 16,949 41,769 37,627 42,442 4,815 46,300 50282 WATERSERVICE - 388 38 425 542 117 2,652 4,134 4,917 5,958 1,041 6,500 50283 SEWER/WASTE 342 200 155 355 367 12 2,130 3, 760 3,458 4,033 576 4,400 50284 TELEPHONE/COMPUTER SERVICE (SN COUNTY) 1,140 240 588 828 1,042 214 488 11,013 15,084 11,463 (3,621) 12,505 50285 POSTAGE 100 17 - 17 1 63 45 25 139 425 688 262 750 50286 GAS 137 191 - 191 992 801 3,485 8,926 6,315 10,908 4 ,593 11,900 50290 GENERAL LIABILITY INSURANCE PREMIUMS - - - - 458 458 - 4,676 4,151 5,042 890 5,500 50291 PROFESSIONAL MALPRACTICE INSURANCE PREMIUMS 849 - - - 3,060 3,060 7,302 11,980 34,928 33,663 (1,266) 36,723 50293 MOTOR VEHICLE INSURANCE PREMIUMS - - - - 83 83 - 1,387 971 I 917 (54) 1,000

MSA II Total 26,433 24,273 8,211 32,484 45,703 13,219 308,840 424,367 458,073 502,738 44,664 548,441 50300 CLOTHING (UNIFORMS) 20 - - - 50 50 97 428 158 1 550 392 600 50310 FOOD 190 169 - 169 233 64 1,861 1,901 3,055 2,567 (488) 2,800 50320 BOOKS & REFERENCE MATERIALS I - - - - 146 146 2,127 2,665 3,955 1 1,604 (2,351) 1,750 50330 OFFICESUPPLIES 2,267 840 339 1,179 4,214 3,035 20,291 27,616 25,728 46,356 20,627 50,570 50340 HEALTH EDUCATION PROGRAM SUPPLIES - - - - 54 54 - - I -I 596 596 650 50341 MEDICALSUPPLIES 5,924 3,250 - 3,250 8,082 4,832 34,596 34,779 40,118 88,899 48,781 96,981 50343 IMMUNIZATIONS / PHARMACEUTICALS 6,127 9,779 - 9,779 6,358 (3,420) 71,669 71,669 81,411 69,942 (11,469) 76,300 50345 LABS AND X-RAYS 447 6,361 - 6,361 6, 550 189 60,417 60,417 56,060 72,051 15,991 78,601 50346 PROGRAM SUPPLIES AND MATERIALS - 687 - 687 433 (253) - - 2,721 4,767 2,046 5,200 50350 MAINTENANCESUPPLIES 381 297 890 1,187 1,794 607 5,925 11,422 12,287 1 19,736 7,449 21 ,530 50358 SNOW/ICE REMOVAL - I - - - - - 179 920 - I - - -50360 VEHICLE/EQUIPMENT SUPPLIES - - - - 121 121 - 246 I 596 I 1,329 733 1,450 50362 GASOLINE I 76 - 59 ' 59 1 231 172 - 1,920 1,330 I 2,544 1,213 2,775 50365 LICENSES - - - - 25 25 100 100 I - 275 275 300 50370 MISCELLANEOUS SUPPLIES l - - - - 91 91 - - - 1,004 1,004 1,095 50374 COMPUTERSOFTWARE I 4 ,233 2,007 646 2,652 7,358 4,706 31,978 40,554 44,952 80,942 35,990 88,300 50375 Computer Hardware <1,500 583 - - - 2,323 2,323 20,201 20,744 2,519 25,553 23,034 27,876 50377 Office/Medical EQJINVENTORY <1500 57 - - - 2,319 2,319 2,434 2,434 6,014 25,506 19,492 27,825 50380 LEASE/PURCHASE AGREEMENTS I - - - I - - - - - - - - -

~ 12/14/2015

CHC TOTAL CHC ADMIN CHC TOTAL Bud get to CHC CHC TOTAL CHC TOTAL CHC Total YTD Budget CHC 2015

LINE NOV 2014 I Nov 2015 Nov 2015 1 Nov 2015 I Monthly Actual YTD 2014 YTD 2014 YTD 2015 YTD to Act ual TOTAL

CODE DESCRIPTION EXPEND I EXPEND EXPEND EXPEND Budget Variance EXPEND EXPEND EXPEND Budget Variance BUDGET

50381 PROGRAM EQUIPMENT LEASE/PURCHASE I - - - ~ I - - - - · I - - -50385 Lease/Purchase Interest - - - I - - - - -I - - -

MSA Ill Total 20,304 23,389 1,934 25,323 40,384 15,060 251,875 277,815 280,906 444,21 9 163,314 484,603

50503 CLAIMS - - . I - I - - - I - 190 - (190) -50701 REFUNDS I 35 1 2,207 - I 2,207 1 417 (1,790) 2,922 I 2,922 27,811 4,583 (23,228) 5,000

MSA IV Total 35 2,207 - 2,207 417 (1,790) 2,922 2,922 28,001 4,583 (23,417) 5,000

59200 LAND( CAPITAL OUTLAY) - - - :I 4,55~ - - - - - - -59300 BUILDING IMPROVEMENTS (CAPITAL OUTLAY) - - - - - - I - - - -59400 OFFICE FURNITURE/EQUIPMENT (CAPITAL OUTLAY) - - - 4,558 - - I - 50,135 50,1 35 54,693

59500 MOTOR VEHICLES (CAPITAL OUTLAY) - - - -I 113 11 3 - - - 1,238 1,238 1,350

59600 PROGRAM EQUIPMENT( CAPITAL OUTLAY) - - - - - - - - - - - -59990 EOY Exp . Payroll Payable Adjustment - - - - - - (134,691) (187,032) (239,211) • I 239,211 -

External lnterfund Exchanges

175,00; 1 160,41; -70001 (Fees paid to County Dept) - •=J - - - - - - -

County lntertund Transfers 70007 (Qrtrly County Indirect Fees) - - - - 14,583 14,583 - 175,000 (14,583) 175,000

SCHA Internal lnterfund Transfers (Reimbursements .I 70009 or Admin Indirect fees paid by Programs) - - - 8,581 8,581 22,527 22,527 53,647 94,386 40,739 102,967

MSA V Total - - - - 27,834 27,834 (112,164) 10,495 (10,564) 306,176 31 6,740 334,010

Total Expenditures & Remaining Monthly Budget $'s 347,868 296,004 78,668 374,673 541,622 166,949 3,003,410 4,1 49,999 4, 526,199 5,957,841 1,431,642 6,499,463 TOTAL CHC & ADMIN INDIRECT AS% of BUDGET 4,526,199 73.32% Monthly Budget 541,622

Avg Monthly Budget % 8.33% YTD Budget% 91.67% Under Budget -18.35%

~g Monthly Assessment of Revenues & Expenditures Oj .....

.!l' $1,200,000

....

" ~ ~ (<; <fi ">'

$1,000,000 "' ~ "' .,

I \ i rl $ .... $800,000 r; n.

G/ /}/ V '\. ~ 7 'r\.. .;; ~ /" ~oif!fl / ::?\. !:!

$600,000 'l:)o.~ ~ 4"' -~ ~ ~ "! ~

# / ~' /\ '\. .:: " "''/ '\.. t':l ~· ~-~~if' -~' / "' '\. /:/ ; $400,000

:il ~ /11 "' ill . .::? :i/ II _j V"'~ _:.:4 ~ "l C.' 'C: / b .... -u /}/ ;::: $200,000 :;;; "' "' .X .....

S· ,. .,

"' ._, ~"'' \l.,_s ,.<:'. ,o:- ~~ ~,. ... \v""' \.S." v~'-

._, ~"''

._, <f'~

._<-"-<f' ,.,.._"!: :<>'v ~"' ~'" i'v"' <f'~ o~'-o <f'~ ,._ '<"- ""'"'-"'

,.e "'0 Q \''"'v "'0

-G-o Revenues ~Expenditures

~ 12/14/2015

Expected Received

Expected Received

Expected Received

Expected Received TOTAL

Expected Received

Expected Received

Expected Received

Expected Received

Expected Received

Oct 89,082 89,082

Oct -

-

Oct 11,689 14,570

Oct 3,504

425

Shawnee County Health Agency- Community Health Center 2015 Grant Revenues -Calendar Year

330 Grant Total Budget Total Expected/

(5/1-4/30) Received Grant Remaining Balance Nov Grant Year YTD Grant Year 89,078 1,022,542 488,074 534,468 89,078 1,022,542 577,152 445,390

Outreach & Enrollment Grant Total Budget Total Expected/

(5/1-4/30) Grant Received Grant Remaining Balance Nov Year YTD Grant Year

- 134,634 134,634 -

- 134,634 134,634 -Expanded Medical Services Grant Total Budget Total Expected/

(9/1-8/31) Grant Received Grant Remaining Balance Nov Year YTD Grant Year 11,689 210,408 140,274 70,134 11,123 210,408 156,758 53,650

Quality Improvement Grant Tota l Budget Total Expected/ (10/1-11 /30) Received Grant Remaining Balance

Nov Grant Year YTD Grant Year 3,504 38,552 35,048 3,504

- 38,552 26,239 12,313 104,078 1 100,201 1,406,136 894,783 51 1,353

Community Based Primary Care Grant Total Budget Total Expected/

(7/1-6/30) Grant Received Grant Remaining Balance Oct Nov Year YTD Grant Year 18,750 18,750 150,000 56,250 93,750 18,750 - 150,000 56,250 93,750

Prescription Drug Assistance Grant Tota l Budget Total Expected/

(7/1-6/30) Grant Received Grant Remaining Balance Oct Nov Year YTD Grant Year

3,125 3,125 25,000 9,375 15,625 3,125 - 25,000 9,375 15,625

Total Grants Received Total Expected/

Total Budget Received Grant Remaining Balance Oct Nov Grant Year YTD Grant Year

126,150 126,146 1,581,1 36 863,655 717,481 125,953 100,201 1,581,136 960,408 620,728

County Tax Allocation Tota l Budget Total Expected/ (1/1-12/31) Received Grant Remaining Balance

Oct Nov Grant Year YTD Grant Year 560,352 - 2,241,409 2,241,409 -

560,352 - 2,241,409 2,241,409 -Total Grants & Tax Allocation Received

Total Expected/ Total Budget Received Grant Remaining Balance

Oct Nov Grant Year YTD Grant Year 686,502 126,146 3,822,545 3,105,064 717,481 686,305 100,201 3,822,545 3,201,817 620,728

Total Expected/ Received Calendar

Year 757,782 846,860


Year -

36,266


Year 116,890 133,411


Year 35,048 26,239

1,042,776


Year 131,250 131,250


Year 21,875 21,875


Year 1,062,845 1,195,901


Year 2,241,409 2,241,409


Year 3,304,254 3,437,310

NOVEMBER SUMMARY:

Shawnee County Health Agency Community Health Center Financial Narrative

November 2015

Oct-15 Nov-15 YTD 2015 Goal Oct-14 Nov-14 YTD 2014

Net Patient Revenue 143,666 139,442 1,720,648 147,847 134,966 1,498,628

Tota l Reven ue 462,424 433,004 5,091,549 443,466 444,100 4,734,300 Tot al Expense 427,234 374,673 4,526,200 405,542 348,472 4,150,604

Net Income/ (Net Loss) 35,190 58,332 565,350 37,925 95,628 583,697 Tota l Cost Per Patient 820.59 851.51 851.51 <$800.00 788.09 811.82 874.72 Months in Reserve 3.40 3.52 3.52 >3 MO 4.08 4.35 2.84

Total Cost Per Patient: Total Expense divided by Total Patients seen

National Avg: $762.62 Kansas Avg: $505.24

YTD 2013

2,135,615

5,461,612 4,615,436

846,177

796.10

3.04

Months in Reserve: Is the number of months the Health Center could have no income and stil l have enough funds to meet

al l of its expenditures.

Patient Payor Mix YTD:

Medicare Medicaid

Private Insurance

Se lf Pay/U ninsured

Revenue Payor Mix YTD :

Medicare

M edicaid

Pr ivat e Insurance

Self Pay/Uninsured

Patient, Encounter & Revenue Comparison:

Jan -Oct Jan- Nov

YTD 2015

Payor Mix

12.04%

22.86%

32.82%

32.28%

YTD 2015

Revenue

18.26%

47.83%

10.93%

22.98%

Patients 15 15 YTD 2015 2015 Goal Jan -Oct 14

lunduplicated 5,272 1 5,5241 5,5241 7,0121 5,0401 CHC Unduplicated Patients goal for Project Period Ending 4/30/17 is: 8,595

Encounters Oct-15 Nov-15 YTD 2015 2015 Goal Oct-14 Primary Care/WH/ M&I 1,481 1,298 15,895 23,000 1,522 Behavioral Hea lt h 67 96 926 850 72 Tota l Encounters 1,548 1,394 16,821 23,850 1,594

2015 annual/monthly encounters goa l w1th full staff 1s: 23,850/1,987.5.

2014 2013

12.74% 11.52%

23.76% 25.49%

29.07% 21.91%

34.42% 41.08%

2014 2013

14.66% 13.45%

52.63% 48.27%

7.32% 4.33%

24.70% 34.49%

Jan- Nov

14 2014 2014 Goal

5,5171 6,5891

Nov-14 YTD 2014 2014 Goal

1,200 14,406 20,628

58 799 1,319

1,258 15,205 21,947

Our monthly encounter goal at current staffing is: 2,030. The 11-mont h encounter goal at current staffing levels is 21,403.

Our 330 grant tota l annual/monthly encounter goal for Project Period Ending 4/30/17 is: 24,974/ 2081.

Net Patient Revenue Oct-15 Nov-15 YTD 2015 2015 Goal Oct-14 Nov-14 YTD 2014

Primary Care/WH/M&I 157,455 99,425 1,551,628 1,531,520 128,174 110,223 1,353,558 Behavioral Health 10,613 4,786 92,808 72,032 29,114 8,811 88,186 Tota l Patient Revenue 168,069 104,212 1,644,437 1,603,552 157,288 119,033 1,441,744

Our 330 grant Net Pat ient Revenue Goa l for Project Period Ending4/30/ 17: $1,897,419 Tota l Net Patient Revenue Annual/Month ly Goa l is: $1,603,552/$133,629. Received $104,212: $29,417 under t he goa l.

Productivity per Provider (PC/WH/M&I}

Encounters Encounters per Hour

Productivity per Provider {PC/ WH/ M&I} Oct-15

Encount ers 1,481 Days 201 Encounters per Day 7.36

Nov-15 YTD 2015 2015 Goal Oct-14

1,298 15,895 23,000 1,522 165 2,011 2,246 174

7.88 7.91 10.24 8.73

0:\ !HACommon\ CHC\BOARD\Financial Narrative- Productivity\ 2015\ 2015 Financial Na rra t ive.xlsx

Nov-14 YTD 2014

1,200 14,406

147 1,426

8.16 10.11

2014 Goal

1,482,643

114,196

1,596,839

2014 Goal

20, 628

2.24

2014 Goal

20,628 1,750

11.78

NOVEMBER 2015 AR TREND SUMMARY Collection's Status

Patient and Patient and Dollar Amount

Accounting Insurance Insurance Net AR #of Cases in Associated to

Period Charges (-) Payments(+} Adjustments(+) Change Ending AR Collection Cases

September

October

November

TOTALS

Q) u

$340,000

$320,000

.§ $300,000 ra co 0:: <C tl.O s:::

$280,000

$260,000

$

$

$ $

212,503 $ (143,636) $ (78,253) $

247,764 $ {168,069) $ (85,395) $

215,604 $ (104,212) $ (60,468) $ 2,628,691 $ (1,644,438) $ (935,558) $

1 - AR Trend Summary

:c $240,000 1:

LU

I ~ ~~------------------~~--------------------------------"'' .u,. """' Lf) """

-------------~1----------------------~o~--------------------------------

$220,000

$200,000

$36,000

~~ ~ ~ ~ '\,<::> ,-§. 0' ec.,e "~ "..:::;. - ~,-§.

"' v.1i ~(l5> ~ · '>'?}~

i..~ "?-~ ~'?}~ e.

'>'>~ :::-..~ <} ~ e.' ~

'>.:;). '>~ i? ,__(§> i? ""' .,.,_e. 0(., ~e.

ci~ ~0

3 - Total Patient Payments Received (Upfront Collections, Regular Payments, and Payment Plans)

$34,000 -, x. LS: $32,000 - ~ .,...,. ~- ::L:l:::: ~ $30,000

$28,000

$26,000

$24,000 -

f'YJ' '<:1-' •

11~~ 31 ({]-!:i--,..__ ~ "" "X '$ tt' ~ --~f'YJ (Cj "' C\:) .....,, (() ....., " ":; -~--~--....::_0 __ /fi, ~' $: 3? :; ~r:n_ ....., .

0 0 ry f'YJ Oo' Oo' 0 ~-------,~~----~~-.----.-, ~~0~-.--r--~

~ ~ ~ "~ 0' ~~ -~'?}~ :<::-e. .;y~ '><}- ~ ~ ~ i? i? "'<::> :~.'>'?} - ~r§ "?-'< ~ '>..:::;. '> v.<!O i? ,__CP ~'0 ~ ~ ~ ~ ~· ""' ~ & ~

~0 "'e. v.'b' ~ e.~ ~0 ~ ~

O:Finance Office>My Doc>FO>CHC Monthly Budget Report & HA Common>EHS Reports> Monthly Financia l Report>

(9,386)

(5,699)

50,924

48,695

$60,000

$55,000

$50,000

$45,000

$40,000

$35,000

$30,000

$25,000

$20,000

$ 264,815 489 $

$ 259,115 449 $

$ 310,039 444 $ $ 50,924

Net Change

2- Dollars in Collection Moduie (151+ days- Ready to send to Valentine)

00 I N ~~

N Lrl ...... L{)

rl L{) lJ) o'

I (J) ~ N

57,814

57,938

56,611

rl rl \.D

~ ~/~ ~ ~ ~ # ~ ~ ~ ~ ~ ~ :e::-'> :~,'>'?> ,-§. "?-~ ~ '>.:;). ) v.<IO i? ,__2? i?

c.,e '>'?> (l5> ~ I?' "!<..e. Oc., ~e. ~ ~ # ~

4- Patient Upfront Payments $32,000

$30,000

$28,000

$26,000

$24,000

$22,000 $20,000

$18,000

~~ ~ ~ e.~ i? '\,<::>"y ~~ ~ -~ _,o.s. e.c.,e. "~ ~,.::> - ~,-§. "?-~<.. - ~'?>~ :<::-e. ,- 0 v.1i ~e ~ ~ · '>..:::;.

'>'?}~

:::-..~ <} e.' ~ ~ '>..:::;. v.¢o'> i? ,__(§> i?

I?' .,.,_e. 0 v ~e

se.~ ~o

SHAWNEE COUNTY HEALTH AGENCY Aging by Financial Class

As Of 11/30/ 2015

November October September August July June

Financial Class AR TOTAL

0 - 30 31-60 61- 90 91- 120 121- 150 151+ Total AR over

OfoofAR 91 davs Balance over 91 +

A HEALTH ACCESS $10,620 $6,820 $4,063 -$41 $0 $0 -$222 -$222 0°/o B BLUE CROSS BLUE SHIELD $7,103 $3,979 $2,390 $218 $216 $0 $300 $516 1°/o c, G, I COMMERCIAL, Aetna, & Coventry $4,839 $1,212 $2,644 $542 $202 $0 $239 $441 1°/o D MEDICAID Non-MCO $881 $870 $70 $273 $20 $0 -$352 -$332 0°/o E EARLY DETECTION WORKS $4,098 $748 $973 $1,125 $621 $0 $631 $1,25 2 2°/o H MEDICAID MCO/HMO [UNI/COV] $18,370 $9,418 $4,587 -$72 -$808 -$803 $6,049 $4,437 5% I( KANSAS HEALTH SOLUTIONS $0 $0 $0 $0 $0 $0 $0 $0 0°/o M MEDICARE $12,739 $6,861 $4,366 $120 $234 $0 $1,158 $1,392 2°/o N MEDICARE HMO $1,732 $951 $748 $33 $0 $0 $0 $0 0°/o 0 OTHER- Cenpatico $0 $0 $0 $0 $0 $0 $0 $ 0 0°/o

l -$74,83 5 91% p PATIENT PAY $132,742 $10,117 $25,648 $22,141 $16,576 $17,165 $41,094 -

T TITLE X [COLPOL STATE PROG] $0 $0 $0 $0 $0 $0 $0 $0 0°/o X COLLECTIONS $0 $0 $0 $0 $0 $0 $0 $0 0°/o

Report Grand Total $193,123 $40,976 $45,489 $24,339 $17,061 $16,361 $48,896 $82.319 43°/o

Goal fo r AR 91+ days is 20% or less than $40,000 Goal for Patient Pay AR Balance 91+ days is less than $28,000

%of Tota l AR 91+ days Total Patient Pay AR 91+ days 45%

40%

35%

30%

25%

20%

15% -: ,--, '- '-Q) Q)

..0 ..0

E E Q) Q)

> u 0 Q)

Lf"l c- ..c ·c > Q) > ..... '- '-,...., ~ "' c Vl Q) Q)

0 "' 0.. ~ :::J

:::J :::J ..0 ..Q

"' :::J "' <( ~

-, tlO E 0 '- ~ :::J ..... c- ..Q <( Q) u Q) ..... 0

"' u.. 0.. z 0 :::J Q)

c Vl

"' -,

HaCommon: FO>CHC Monthly Report>EHS Report>Aging x Fin Class also HaCommon:

~:>

'-Q)

..Q

E Q)

> 0 z

85,000 .,------------------- -------

75,000 '"" /\" , {!'" t>-

65,000

55,000 -:-' ----,:,

::::::~ 25,000 -:----,--.----,-,---,--,--.,---.------.---.---,--~-~~

'- '-Q) Q)

..Q ..0 E E Q) Q) > u 0 Q)

z 0

> '-

"' :::J c

"' -,

c-"' 2

..Q Q) u..

..c "§_ > Q) u "' c '- ~ :::J

"' <( -, ~

2:: ..... '- '- '-Vl Q) Q) Q)

:::J :::J ..Q ..0 ..Q -, tlO E 0 E :::J ..... <( Q) u Q)

0. 0 > 0

Q) z Vl

Shawnee County Health Agency CHC Board

Committee Member List 2015

Governance Committee

Tanya Tostado, Committee Chair Wanetta Bean

Michelle Sweeney Kim Hodgson

Sherry Obrosky

Executive Committee

L T~I'!Y~tTostado, CoiT!_mittee ChNair Michelle Sweeney r-------

Dr. VanSickle Kim Hodgson

Quality Assurance Committee

Kim Hodgson, Committee Chair Wanetta Bean

......_ ___ Sherr~ Obrosk Tanya Tostado

Finance Committee

Chris Hartman, Committee Chair Jim Kinderknecht

Wanetta Bean Tanya Tostado

Staff

Alice Weingartner Elly Shughart

Staff

Alice Weingartner Ashley Biegert ------. Elly Shughart

Staff

Alice Weingartner Dianna Yates Ell Shughart ____ _..

Theresa McGannon

Staff

Alice Weingartner Dianna Yates

Nancy Mitchell Elly Shughart

Shawnee County Health Agency

CHC Board PROPOSED Committee Member List

2016

Governance Committee

Michelle Sweeney, Committee Chair Wanetta Bean

Tanya Tostado Kim Hodgson

Sherry Obrosky

Executive Committee

Michelle Sweeney, Committee Chair Wanetta Bean Dr. VanSickle

Sherry Obrosky

Quality Assurance Committee

Kim Hodgson, Committee Chair Wanetta Bean

Michelle Sweeney Sherry Obrosky Tanya Tostado

Finance Committee

Chris Hartman, Committee Chair Jim Kinderknecht

Wanetta Bean Tanya Tostado

Rick Woods

Staff

Alice Weingartner Elly Shughart

Staff

Alice Weingartner Ashley Biegert Elly Shughart

Staff


Elly Shughart Theresa McGannon

Staff


Nancy Mitchell Elly Shughart

2014 SCHA CHC Board Self Evaluation

Please rank to the best of your ability the following statements using the following guidelines: l=Disagree completely 2=Somewhat Disagree 3=Somewhat Agree 4=Agree completely DK=Don't Know

8 surveys turned in/each question has a possible total of 32

-- 1. The Shawnee County Health Agency (SCHA) Community Health Center (CHC) Board holds monthly meetings. [Review Board minutes.] 32/32-100%

2. Minutes are taken at every SCHA CHC Board meeting and are distributed to each CHC Board member for approval. [Review Board minutes.] 32/32-100%

-- 3. The SCHA CHC Board ensures adequate Committee structure (e.g., executive, finance, quality assurance, governance). [Spelled out in Public Health Services Act.] 32/32-100%

4. The SCHA CHC Board holds Committee meetings as appropriate. [Review Executive, Governance, Finance and Quality Assurance Committee minutes.] 32/32-100%

5. The SCHA CHC Board Committees report to the SCHA CHC Board all ratified actions taken by the Committee and, as appropriate, request ratification by the whole Board. [Review all Committee minutes, Board minutes, and Board Motions Log.] 32/32-100%

__ 6. The SCHA CHC Board holds nominations and elections in due course. [Review Board minutes. Spelled out in bylaws.] 32/32-100%

__ 7. The SCHA CHC Board ensures appropriate Board composition (including the number of Board members; the mix of experiences, expertise, skills of members; a majority of Board members who are consumer members that use SCHA as their principle source for CHC services; and who, collectively, represent SCHA's target population in terms of demographic factors, such as race, ethnicity, and gender; requirements for non-user Board members) in accordance with the Bylaws as applicable. [Grant applications.] 31/32-97%

8. Recruits, trains, and orients new SCHA CHC Board members as needed. [Review Governance Committee minutes.] 30/32-94%

__ 9. Directly interacts with the Executive Director and the CHC Division Manager, and oversees implementation, but does not get involved with the day-to-day management of SCHA. [Review Executive Committee minutes.] 30/32-94%

_ _ 10. Regularly evaluates and makes recommendations for improvement, if applicable, for the Executive Director. [Review Executive Committee minutes.] 26/32-81%

1:;0

__ 11. Establishes, approves, and, as necessary, modifies key documents, such as the Mission and Vision statements, Bylaws, and conflict of interest statement. [Review Board minutes. Review Board and Committee calendars.] 31132-97%

-- 12. Ensures that the CHC is operating in accordance with applicable Federal, state, and local laws and regulations, presumably through establishment of compliance program. [Quality Assurance Committee minutes/Corporate Compliance Work plan. Attendance at Retreats.] 32/32-100%

13. Establishes, reviews, and, as necessary, updates the general policies of the CHC (i.e. health care, financial management, quality assurance.) [Quality Management Plan. Board and Committee Calendars. Committee minutes] 32/32-100%

__ 14. Establishes, reviews, and, as necessary, updates the CHC activities related to the provision of services (including service utilization patterns, provider productivity, patient satisfaction, and achievement of project objectives). [Quality Assurance Committee minutes] 31132-97%

15. Selected and approved the services provided by the health center, as well as appropriate site locations and hours of operation, given the demonstrated needs in the community. [Form 5 in Grant Application, Policies on Hours and Signage, Size to Population, Needs Assessment] 28/32-88%

__ 16. Establishes, reviews, and, as necessary, updates procedures to ensure that the CHC maintains a system that assures accountability for center resources, priorities, and long-range financial planning, as well as policies regarding the eligibility for services (including criteria for partial payment schedules). [Board Motions Log, Provider Productivity, Financial Performance Measures, Policies on Cash Control and Collections, Strategic Plan and Healthcare Plan. Motions Log, Board and Committee minutes.] 32/32-100%

-- 17. Engages in the annual strategic and operational planning processes and needs assessment activities. [Attendance at Retreats. Grant Applications] 29/32-91%

__ 18. Evaluates the CHC achievements during the previous year and modified goals, objectives and plans, as necessary. [Report card, Grant Applications, UDS updates] 29/32-91%

19. Approves the annual budget and project plan, as submitted in grant applications, and otherwise ensures the CHC is financially viable in the changing health care marketplace. [Finance Committee minutes.] 31/32-97%

__ 20. Evaluates expenditures and finance reports of the CHC on a monthly basis. [Finance Committee minutes.] 32/32-100%

__ 21. Compares the approved budget with actual expenses and makes mid-course corrections, if necessary. [Finance Committee minutes.] 30/32-94%

Additional comments or ideas for future trainings:

TO:

OFFICE OF THE DISTRICT ATTORNEY THIRD JUDICIAL DISTRICT OF KANSAS

Chadwick J. Taylor, District Attorney

MEMORANDUM

Board of County Commissioners

FROM: Chadwick J. Taylor, District Attorney

DATE: December 30, 2015

RE: Request for Diversion Fund Payments

The District Attorney's Office wishes to pay the following invoices from their Diversion Fund account:

1) Clayton Paper & Distribution, Inc. for copy paper a) Invoice No. 88539 dated December 22,2015 in the amount of$185.40

2) Independent Stationers for office supplies a) Invoice No. 579601 dated December 23, 2015 in the amount of $153.20 b) Invoice No. 579861 dated December 29, 2015 in the amount of $171.81

3) LindySpring Systems for monthly water service a) Invoice No. 996672 dated December 7, 2015 in the amount of$58.00 b) Invoice No. 997870 dated December 20, 2015 in the amount of$2.62 c) Invoice No. 999860 dated December 20,2015 in the amount of$10.00 d) Invoice No. 999861 dated December 20, 2015 in the amount of $10.00

4) Woodward, Tracy for transcript fees a) Invoice No. 122915 dated December 29,2015 in the amount of$6.00

The District Attorney's Office hereby requests placement on the consent agenda for consideration of the above itemized invoices, in the total amount of$597.03, to be paid from the Diversion Fund account.

Shawnee County Courthouse 200 SE 7th Street, Suite 214 • Topeka, Kansas 66603 • (785) 251-4330

Sold To SHA,WNEE COUNTY 200 SE 7TH STREET PURCHASING B-27 TOPEKA KS 66603

customer# Order Date 12/16/2015

·Invoice u · Invoice Date

0~85:,39 12/22/2015

.-.: : .. .-: : :'.

······::'

1 4 4 GP999705

2 2 2 GP999705

fg_n~ture Proof of De 1 i very:

12/21115 10:34

CLAYTON PAPER AND DISTRIBUTION 1302 S. 58th. Street ST.JOSEPH. MO 64507 www.claytonpaper.com

Ship To

INVOICE Phone 8-,6-·364·0220 Fi!X 816,364-0086

(Page. 1/l .]

DISTRICT ATTORNEY'S OFFICE 200 SE 7TH TOPEKA KS 66603

Sales Order # Buyer Customer P/0 # 088539

Ship Date Frerght Terms Job !\lumber

12/21/15 PREPAID

**·*** · Invoice Message 4 CS ADULT OFFICE

*****

: ·2 dS · JV:. OFFICE ··

****************************** ... :

---

_SPECTRUM MULTI-USE COPY PAPER Cs 8; SX11..:20# :92 BRIGI-iT 10/500 . PER CASE SPECTRUM MULTI.-USE COPY PAPER Cs 8.5X11-20# 92 BRIGHT 10/500 PER CASE

UPCOMING CLOSINGS: DECEMBER 25, 2015-CHRISTMAS JAN 1, 2016-NEW YEAR'S DAY

Terms & Conditions All claims must be made within 5 days. Amounts over 60 days past due are subject to 1.5% monthly service charge. If account is placed with collection. buyer is resoonsible.for all fees.

Ship Via Salesman Tr LL/003 60 Terms

...

NET 30 DAYS

30.90 $123 ._60

30.90 $61.80

Merchandise 1$5.40 Freight 0.00 Mise Charges 0.00 Sub Total 185.40 Taxable 0.00 Tax nsE) 0.00 TOTAL $185.40

::!ustomer Copy Pay By 01/21/2016 Writer: AD

1dependent Stationers .0. Box 677426 IALLAS, TX 75267

hone : 877-872-8599

Bill To: Shawnee County 200 SE 7th St TOPEKA, KS 66603

Customer PO #:

Special Instructions: Office will be closed Dec. 24 and 25

Invoice""- IN-000579601 Customer Account ........... : Invoice Date ..................... : 12/23/2015 Sales Order .................... : S0-000583115 Order Date ....................... : 12/23/2015 Payment Terms ............... : Net 30 days Contact Name .................. :-- · Contact Phone ................. : . -v ~v ,-~uvv Page ................................ : 1 of 1 Payment Method .............. : Check

Ship To: District Attorney 200 SE7th Room 214 Topeka, KS 66603

m Number Description UOM .9!Y_ Billing Code Price Extended

:FCM15233 CHAIRMAT,45X53LIP,BVL EA 1. Line comments: Jacqie Spradling's Office

. $153.20 $153.20.

Sub-Total: Freight:

Sales Tax: Total:

Deposit: Amount Due:

$153.20 $0.00 $0.00

$153.20 $0.00

$153.20 -----------------------------ensure proper credit, please attach this portion and return h payment. Be sure customer number is written on check.

·ase remit payment to: lependent Stationers ). Box 677426 .LLAS, TX 75267

Invoice#: IN-000579601 Total Amount Due : $153.20

Customer Name: Shawnee County

Customer Account#: Invoice Due Date : 1/22/2016

Thank you for your Business!

If you are paying by credit card, then no balance is due at this time. Thank you.

(

1dependent Stationers .0. Box 677426 IALLAS, TX 75267

hone : 877-872-8599

Bill To: Shawnee County 200 SE 7th St TOPEKA, KS 66603

Customer PO #:

m Number

~C364A \X190319 IV43624 IV39913 IV83410

Description

TONER,HP LJ 4015,BK HEADSET,HEADPHONE,BK

· BOARD,DRY,ERASE,36X48,WE PEN,GEL,CLR BARL,0.7MM.BE TAPE,.75X1000 6ROL/PK,CR

ensure proper credit, please attach this portion and return h payment. Be sure customer number is written on check.

!ase remit payment to: fependent Stationers J. Box 677426 ILLAS, TX 75267

UOM .9!L_

EA 1 EA 3 EA 1 DZ 3 PK 1

i

lnvoic~ __ IN-uD0579861 Customer Account ........... : Invoice Date ..................... : ·r;,:t;.:l::lt;.:u·ro Sales Order .................... : 50-000583360 Order Date ....................... : 12/29/2015 Payment Terms ............... : Net 30 days Contact Name .................. :'"'-"- .. .., ___ .., Contact Phone ................. : Page ................................ : 1 of 1 Payment Method .............. : Check

Ship To: District Attorney 200 SE 7th Room 214 Topeka, KS 66603

Billing Code Price J Extended

$109.96 $3.72

$30.99 $5.49 $3.23

Sub-Total: Freight:

Sales Tax: Total:

Deposit: Amount Due:

$109.96 $11.16 $30.99 $16.47

$3.23

$171.81 $0.00 $0.00

$171.81 $0.00

$171.81

Invoice#: IN-000579861 Total Amount Due : $171.81

Customer Name: Shawnee County

Customer Account# Invoice Due Date : 1/28/2016

Thank you for your Business!

If you are paying by credit card, then no balance is due at this time. Thank you.

ADDRESS SERVICE REQUESTED

1 AV *A-01-1XG-AM-00600-3

lll 111111h•l1111111ll•l•l•ll•lllllhllll111l11 llll•lllll11lllltl DISTRICT A TINY OFFICE 200 SE 7TH ST STE 214 U TOPEKA KS 66603-3933 ~

MONTHLY STATEMENT If paying by Credit Card, please complete this section

ojwSAj D. CARD NUMBER

SIGNATURE

CARDHOLDER NAME (Please Print)

• . • . . .:. Pl.l?J~l.qTAlTNYQFflGE .. .> . . .. ..

·12{2Qt?Q15· 1 of3 . $ MAKE CHECKS PAYABLE TO:

Amount$ LINOYSPRING BOTTLED WATER ~nclosed TERMS: Pa ment Due U on Recei t y p p

11111••1111111•1111111 l11llllllll•llllllll111l1lllll•llll•ll dIll LINDYSPRING BOTILED WATER 115 NWVAN BUREN ST TOPEKA KS 66603-3315

AMOUNT

EXP.DATE

0

284~6·7

DATE I - INVOICE NO. I - DESCRIP'TIOW ---· QUANTITY' I LINE TOTAL·- I BALANCE

Balance Forward 204.05 12/07/2015 996672 5 Gal Lindyspring (Delv) 10.00 58.00 12/07/2015 996672 INVOICE TOTAL 12/20/2015 997870 Late Fees 12/20/2015 997870 INVOICE TOTAL 12/20/2015 999860 Hot/Cold Rental 12/20/2015 999860 INVOICE TOTAL 12/20/2015 999861 Hot/Cold Rental 12/20/2015 999861 INVOICE TOTAL

LINDYSPRING BOTTLED WATER .i~Dt.iiiu 115 NW VAN BUREN ST

TOPEKA KS 66603-3315

II D SPRINB(785) 234.5551 (785) 234.3478 Fax (866) 234.7659

S Y S T E M S [email protected]

-{·/'I'~ ···.!;. ,

1.00

1.00

1.00

58.00 . 2.62

2.62 10.00

10.00 10.00

10.00

Go paperless! We now offer eStatements and automatic bill pay. Please call the office for more information.

Shawnee County Health Agency Community Health Center

December 30, 2015

TO:

FROM:

Board of Commissioners Shawnee County

Alice Weingartne~ Director - Community Health Center

Leading the Way to a Healthier Shawnee County

RE: Signature on the agreement with Cascade Health Services for extending the use of an RN to fill Registered Nurse (RN) vacancy in Community Health Center

Action Requested: Signature for approval on agreement for continued use of RN to fill a vacancy in Community Health Center (CHC).

On July 13, 2015 the Shawnee County Board of County Commissioners originally approved the filling of a RN vacancy through Cascade Health Services, a temporary staffing agency. The agreement was extended until December 31, 2015. The RN who has been in this position is agreeable to continuing to work for the CHC until April 3, 2016. Based on the time and effort spent in orientation and training this individual it is our preference to continue with this arrangement. During this time we intend to advertise to fill this position with permanent staff based on the clinical staffing model.

It is requested that the commission continue to approve this agreement for the period of January 4, 2016 to April 3, 2016. The rate remains $50.95 per hour.

AW/tnjc Encl.

Cc: Dianna Yates, Community Health Center Division Manager

1615 SW 8th Topeka, KS 66606 1 785.251.2765 www.shawneehealth.org

Individual Service Agreement Guaranteed Hours of TEMP Client Form

This service agreement allows Client to utilize the services of a Temp Cascade Employee on a regular basis, for a set length of time, as outlined below.

1ent an asca e Heat Serv1ces aaree to t e o owma: Start Date: 1/4/16

(Original 7/27/15 to 10/18/15 then 10/19/15 to 12/31/15)

End Date: 4/3/16 Unit: Clinic

#of Weeks: 13 Schedule: Days

# of Hours Guaranteed: (Cascade PPE, MON day to SUN night shift) 30 Client may cancel ONE shift OR part of ONE shift, every 30 days Client may cancel ONE shift every 30 days

during the contract. Defined as: The first time client cancels any shift, they can NOT cancel another shift, for 30 days after each subsequent

Use Cascade PPE of Monday to Sunday cancellation

Hourly Bill Rate: *from ss~ or negotiated $50.95 Hours Over 40: (1.5 of bill rate?) Any hours over 40 are billed at 1.4x

Orientation: Bill Regular Rates Holidays: Billed at 1.4x for Night shift the night before, and day, evening

and night shift the day of: New Year's Day, Easter Sunday, Memorial Day, July 4111, Labor Day, Thanksgiving, Christmas

· Day. Christmas Eve & New Year's Eve= Evening shift ISA prepared by: Maggie

*IF USTED ABOVE, Weekly # of hours agreed upon above are' gUaranteed to Temp while on this agreement. Client will be billed for the # of hours weekly stated above, even if Client' decides to utilize Temp for fewer hours per week than stated. IF Temp must cancel any shifts during this agreement Client will NOT be billed for the guaranteed hours in that particular week.

This agreement is cancelable for poor performance of employee, and that performance must be reported to Cascade and documented in writing by Client and such documentation must be given to Cascade within 48 hours of incident or cancellation of agreement. Upon request, Cascade will make it's best effort to replace Temp.

*If Client/Cascade have a previously agreed upon and signed arrangement, the fees and time frames for buyout/hiring fees may be less than below- RN: $3000, LPN/LPIV: $2000, PT/OT/RT: $8500, CNA: $1500, CMNCMT: $1750, PTA/COTA: $6000, others-contact mgmt. for amounts. *After written notification from Client of intention to buy out Cascade Healthcare Professional, Healthcare Professional may be put on a 520 hour temp to perm contract, with up to a $1500 conversion fee at the end of contract. If Client desires to hire Cascade Healthcare Professional outright without utilizing temp to perm contract, fees will be as listed above. All past invoices must be paid to current for Healthcare Professional to begin employment with Client. Client may not hire Healthcare Professional through ANY entity/sister facility or any related entity without written approval of Cascade or fees will still apply. *Cascade Healthcare Professionals who have worked for Client through Cascade may not be hired for a period of 6 months from last day of work for Client without incurring buyout/recruitment fees. ***Use of our services/personnel binds Client to terms of our rate letter regardless of signature(s.)

CLIENT:

I ~~i~:: I I Signature: I Date:

CASCADE: .. .. .

I ~~i~:: I J Signature: I Date:

HANK YOU for usin CASCADE-Premier Provider of Healthcare Services Since 1988.

Shawnee County Health Agency Community Health Center

December 30, 2015

TO:

FROM:


Al. w. \iO Ice emgartne~"

Director- Community Health Center


RE: American Medical Association 2016 Data Files End User Internal Use License Agreement

Action Requested: Approval of the American Medical Association's license agreement to use revised data files for heath care billing and coding.

The 2016 CPS/HCPS data files are required to bill insurance companies for our services. These files are downloaded from the American Medical Association (AMA) and uploaded to the Electronic Heath System (EHS), our patient management system. This is the third year to purchase these files, however this is the first year AMA has required a user agreement.

Total cost for this download is $1098.50.

AW/tnjc Encl.

Cc: Edith Matthews, Finance Officer Kathy Ortega, Business Office Manager

1615 SW 8th Topeka, KS 66606 1 785.251.2000 www .shawneehealth.org

American Medical Association 2016 Data Files End User Internal Use License Agreement

This Agreement (the "Agreement") is between the American Medical Association, a not-for-profit corporation, located at AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, Illinois 60611-5885, USA (the "AMA"), and Shawnee County Health Agency, with principal offices at 1615 SW 8th Avenue, Topeka, KS 66605 ("you").

The parties agree to the following:

1. License Subject to the terms and conditions of this Agreement, the AMA licenses you to use the data as contained in the electronic data files published by the AMA in the English language as used in the United States (each a "File" and collectively "Files").

International Classification of Diseases, Ninth Revision, Clinical Modification 2016 File available in August, 2015

No. of Users: Royalty Fee: $ ___ (calculated as $400 for the first 25 users plus $17.50 for each additional user)

International Classification of Diseases, 1Oth Revision, Clinical Modification and Procedure Coding System 2016 File available in August, 2015

No. of Users: Royalty Fee: $ ___ (calculated as $400 for the first 25 users plus $20 for each additional user)

Current Procedural Terminology ( CP~ 2016- Standard available in August, 2015

No. of Users: 32 Royalty Fee: $576 (calculated as $80 plus $15.50 for each user)

Current Procedural Terminology (CP~) 2016- Developer's Toolkit available in August, 2015

No. of Users: Royalty Fee: $ ___ (calculated as $12,50.0 plus $15.50 for each user)

Healthcare Common Procedure Coding System, Levell/ 2016 available in December, 2015

No. of Users: 32 Royalty Fee: $522.50 (calculated as $400 for the first 25 users plus $17.50 for each additional user)

Licensed use. The Files may be used in your Electronic Product as described below, only internally, at a single legal entity within your facilities within the United States and its territories, only by you, your employees, or agents, and only by the number of users for which you have paid. Notwithstanding anything herein to the contrary, if you are licensing Current Procedural Terminology (CP~) 2016- Developer's Toolkit, you acknowledge that you have entered into a license with the U.S. National Library of Medicine ("NLM") including Appendix 2 ("Affiliate License") for use of SNOMED C~ and that SNOMED c'f® as contained in the 2015 SNOMED® to CP'f® Map is licensed to you by NLM and not by the AMA. You further agree to comply with the provisions of the Affiliate License including the payment of fees, if any. Upon request, you will provide AMA with documentation that you entered into the Affiliate License. If more users than you have paid for will use any File, then you shall report the increase in writing to the AMA and pay the applicable royalty fee for such additional users within 30 days. You will keep complete and accurate books and records concerning this Agreement for at least three (3) years following the year to which they pertain. The AMA or its representative shall have the right to audit your books and records to insure compliance with this Agreement no more than once per twelve (12) month period. AMA shall provide you with reasonable

notice of such audit and such audits shall not occur on less than fourteen (14) business days' prior written request. The books and records shall be made available to AMA at a single location in the United States, during normal business hours. AMA may employ an independent auditor or AMA may choose to conduct such audit on its own behalf. AMA shall be responsible for paying the auditor's fees unless such audit discloses an aggregate under payment for the audited period in excess of five percent (5%); in which case you will reimburse AMA's reasonable audit expenses excluding travel expenses. You shall immediately pay the AMA any amounts due as a result of an audit. AMA will keep your records confidential. This paragraph shall survive termination of this Agreement for one (1) year.

Name and Description of Electronic Product: Greenway Success

A user of a File is defined as an individual who: (i) accesses, uses, or manipulates the File; or (ii) accesses, uses, or manipulates a program which includes the File to produce or enable an output (data, reports and the like) that could not have been created without the File embedded in the program even though the File may not be visible or directly accessible; or (iii) makes use of an output of a program which includes the File that relies on or could not have been created without the File embedded in the program even though the File may not be visible or directly accessible.

Delivery. The AMA will deliver the Files to you electronically, promptly upon availability of the File provided that payment has been received and this Agreement has been executed.

Copies and modifications. You may copy the Files into any machine readable or printed form for backup in support of your use of the File. You may modify the Files and/or merge them into another program for your own use. Any copy, modification or merged portion or version of the Files will continue to be subject to the terms and conditions of this Agreement. You must reproduce and include the copyright notice as it appears in each File on any copy or portion of the Files merged into another program to give reasonable notice of the AMA's copyright under the copyright laws of the United States and any rules and regulations thereunder.

Prohibitions. You may not use, copy, or modify the Files or any copy, modification or merged portion or version of the Files, in whole or in part, in any other manner except as expressly provided for in this Agreement. You agree that uses not authorized by this Agreement are expressly prohibited. These prohibitions include, without limitation, any use of the Files or any copy, modification or merged portion or version of the Files in any public computer-based information system, including the Internet or World Wide Web, and creating derivative works including translations. You may not sell, sublicense, assign or transfer this Agreement or the Files or any copy, modification or merged portion or version of any Files to any party. Any attempt to sell, sublicense, assign or transfer any of the rights, duties or obligations hereunder is void and shall immediately terminate this Agreement and the license granted under it.

2. WARRANTIES DISCLAIMED a) AMA WARRANTS IT HAS THE AUTHORITY TO GRANT THE RIGHTS HEREIN AND THAT

THE FILES DO NOT VIOLATE THE COPYRIGHT OR TRADEMARK RIGHTS OF ANY THIRD PARTY. EXCEPT FOR THE FOREGOING AND TO THE FULLEST EXTENT PERMITTED BY LAW, YOU EXPRESSLY ACKNOWLEDGE AND AGREE THAT THE USE OF THE FILES IS AT YOUR SOLE RISK, AND THE ENTIRE RISK AS TO SATISFACTORY QUALITY, PERFORMANCE, ACCURACY AND EFFORT IS WITH YOU, AND THE FILES ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANT ABILITY AND FITNESS FOR A PARTICULAR PURPOSE AND WITHOUT ANY REPRESENTATION OR WARRANTY WHATSOEVER INCLUDING THAT THE FILES ARE ACCESSIBLE OR UNINTERRUPTED. TO THE FULLEST EXTENT PERMITTED BY LAW, THE AMA DISCLAIMS RESPONSIBILITY AND ANY LIABILITY FOR (i) ANY ERRORS IN THE FILES AND ANY CONSEQUENCES, DECISIONS, JUDGMENTS OR RESULTS ATTRIBUTABLE TO OR RELATED TO ANY USES, NON-USES OR INTERPRETATIONS OF

2

INFORMATION OR DATA CONTAINED IN OR NOT CONTAINED IN THE FILES; (ii) ANY DAMAGE TO YOUR EQUIPMENT OR ANY OTHER INFORMATION OR FILE OR APPLICATION YOU HAVE; (iii) ANY INTERRUPTION OF ANY SERVICE OR APPLICATION; AND (iv) ANY OTHER DAMAGE NO MATTER THE CAUSE.

THE AMA DOES NOT WARRANT THAT THE DATA CONTAINED IN THE FILES WILL MEET YOUR REQUIREMENTS OR THAT THE OPERATION OF THE FILES WILL BE UNINTERRUPTED OR WITHOUT ERROR. YOU ACKNOWLEDGE THAT THE FILES HAVE NOT BEEN DEVELOPED ACCORDING TO YOUR SPECIFICATIONS AND HAVE NOT OTHERWISE BEEN CUSTOM-MADE.

THE AMA DOES NOT DIRECTLY OR INDIRECTLY PRACTICE MEDICINE OR DISPENSE MEDICAL SERVICES. FEE SCHEDULES, RELATIVE VALUE UNITS, CONVERSION FACTORS AND/OR RELATED COMPONENTS ARE NOT ASSIGNED BY THE AMA, ARE NOT PART OF CPT, AND THE AMA IS NOT RECOMMENDING THEIR USE. THE FILE DOES NOT REPLACE THE AMA'S CURRENT PROCEDURAL TERMINOLOGY BOOK OR OTHER APPROPRIATE CODING AUTHORITY. THE CODING INFORMATION CONTAINED IN THE FILE SHOULD BE USED ONLY AS A GUIDE.

b) LIMITATION OF LIABILITY. THE AMA SHALL NOT BE LIABLE, AND DISCLAIMS ANY LIABILITY, FOR ANY CLAIM, LOSS OR DAMAGE, DIRECT OR INDIRECT, INCLUDING, WITHOUT LIMITATION, COMPENSATORY, CONSEQUENTIAL, INCIDENTAL, INDIRECT, SPECIAL, EXEMPLARY OR PUNITIVE DAMAGES OF ANY KIND WHATSOEVER IN CONNECTION WITH, AS A RESULT OF, OR ARISING: (i) OUT OF THE USE OF OR INABILITY TO USE THE FILES; (ii) FROM ANY INTERRUPTION IN AVAILABILITY; (iii) FROM ANY LOSS OF DATA AND/OR FROM ANY EQUIPMENT FAILURE; (iv) FROM UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR OAT A; (v) OUT OF THE USE OF, REFERENCE TO, OR RELIANCE ON, THE FILES; (vi) OUT OF ANY CONTENT, MATERIALS, ACCURACY OF INFORMATION, AND/OR QUALITY OF THE FILES; OR (vii) OUT OF ANY OTHER MATTER RELATING TO THE FILES.

IN THE EVENT YOU ARE DISSATISFIED WITH, OR DISPUTE, THIS AGREEMENT OR THE FILES, YOUR SOLE RIGHT AND EXCLUSIVE REMEDY IS TO TERMINATE YOUR USE OF THE FILES, EVEN IF THAT RIGHT OR REMEDY IS DEEMED TO FAIL OF ITS ESSENTIAL PURPOSE AND TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, YOUR EXCLUSIVE REMEDY AND ENTIRE LIABILITY FOR ANY CLAIM RELATED TO THE SUBJECT MATTER OF THIS AGREEMENT, WHETHER IN CONTRACT, WARRANTY, TORT, OR ANY OTHER LEGAL THEORY, SHALL BE LIMITED TO THE TOTAL AMOUNT YOU PAID TO USE THE FILES PROVIDED HEREUNDER UPON WHICH THE LIABILITY IS BASED. YOU CONFIRM THE AMA HAS NO OTHER OBLIGATION, LIABILITY OR RESPONSIBILITY TO YOU OR ANY OTHER PARTY.

c) EXCLUSIONS PERMITTED BY LAW. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES OR CONDITIONS OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR LOSS OR DAMAGE CAUSED BY NEGLIGENCE, BREACH OF CONTRACT OR BREACH OF IMPLIED TERMS, OR INCIDENTAL OR CONSEQUENTIAL DAMAGES. ACCORDINGLY, ONLY THE ABOVE LIMITATIONS WHICH ARE LAWFUL IN YOUR JURISDICTION WILL APPLY.

d) INDEMNIFICATION. YOU AND THE AMA (THE "INDEMNIFYING PARTY") WILL EACH INDEMNIFY AND DEFEND THE OTHER (THE "INDEMNIFIED PARTY") FROM ANY CLAIMS, LIABILITIES, PROCEEDINGS, ACTIONS, AND SETTLEMENTS BROUGHT BY THIRD PARTIES, INCLUDING FEES, COSTS, FINES, AND PENAL TIES, INCLUDING REASONABLE ATTORNEY'S FEES, ARISING OUT OF ANY MATERIAL BREACH BY THE INDEMNIFYING PARTY OF ANY WARRANTY OR OTHER PROVISION IN THIS AGREEMENT PROVIDED

3

THAT (A) THE INDEMNIFYING PARTY IS NOTIFIED OF THE ACTION, PROCEEDING, OR CLAIM PROMPTLY AND IN ANY EVENT WITHIN A REASONABLE TIME; (B) THE INDEMNIFYING PARTY HAS SOLE CONTROL OF THE DEFENSE AND SETTLEMENT OF THE ACTION, PROCEEDING, OR CLAIM, PROVIDED THAT THE INDEMNIFYING PARTY MAY NOT SETTLE ANY SUCH CLAIM WITHOUT THE INDEMNIFIED PARTY'S WRITTEN CONSENT, UNLESS SUCH SETTLEMENT (i) INCLUDES A RELEASE OF ALL COVERED CLAIMS PENDING AGAINST THE INDEMNIFIED PARTY; (ii) CONTAINS NO ADMISSION OF LIABILITY OR WRONGDOING BY THE INDEMNIFIED PARTY; (iii) IMPOSES NO OBLIGATIONS UPON THE INDEMNIFIED PARTY; AND (iv) THE SETTLEMENT DOES NOT MATERIALLY REDUCE THE INDEMNIFIED PARTY'S RIGHTS AND BENEFITS UNDER THIS AGREEMENT; AND (C) THE INDEMNIFIED PARTY PROVIDES REASONABLE ASSISTANCE IN CONNECTION WITH THE DEFENSE AND SETTLEMENT OF THE ACTION, PROCEEDING, OR CLAIM. THE INDEMNIFIED PARTY MAY PARTICIPATE IN THE DEFENSE OR PROSECUTION OF ANY CLAIM WITH COUNSEL OF ITS CHOICE AT ITS OWN EXPENSE.

3. Copyright, Trade Secret and Trademark CPT codes, descriptions and other data are copyright 1966, 1970, 1973, 1977, 1981, 1983-2015 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. The CPT File is copyrighted by the American Medical Association 2015. You acknowledge that the AMA retains all right, title, and interest in the Files provided to you. AMA claims no copyright to government data that is in the public domain.

4. U.S. Government Rights CPT is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, Illinois 60611-5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015 (b) (2) (February 2014) and/or subject to the restrictions of DFARS 227.7202-1 (a) (June 1995) and DFARS 227.7202-3 (a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (May 2014) and/or subject to the Limited Rights Notice or the Restricted Rights Notice of FAR 52.227-14 (May 2014) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

5. Term The term of this Agreement begins December 2, 2015 and the license to use the Files as described in this Agreement is effective until terminated. This Agreement and license granted hereunder shall be terminated in whole or with regard to any particular File (a) at the option of the AMA if you fail to fulfill any material obligations (including royalty payments) and continue to do so for 30 days after notice from the AMA or as otherwise expressly provided in this Agreement; (b) at your option at any time by destroying the applicable Files along with any copies, modifications or merged portions or versions in any and all forms; (c) with regard to the CPT File, at the option of the AMA if there is an imposition of a governmental prohibition or restriction rendering it unlawful or jeopardizing the AMA's rights to CPT, including copyright; or (d) at the option of the AMA upon ninety (90) days written notice to you if the AMA no longer produces the File(s). You agree that the AMA will be awarded court costs and reasonable attorney fees if it prevails in any action or proceeding against you due to your breach of this Agreement. You agree upon termination for any reason to destroy the applicable Files together with all copies, modifications and merged portions or versions in any form and you hereby waive any rights to continued use of the Electronic Product containing the File(s). Warranties, indemnification and litigation obligations shall survive termination of this Agreement.

6. General Provisions You shall be responsible for all sales, use, or other taxes, except taxes based on the income of the AMA. This Agreement will be governed by the internal laws of the State of Illinois without regard to

4

choice of law principles. The courts of the State of Illinois and/or the United States District Court. for the Northern District of Illinois shall have exclusive jurisdiction over any action concerning the subject matter of this Agreement, and the parties agree to submit to the jurisdiction of the courts of the State of Illinois and the United States District Court for the Northern District of Illinois. Nothing contained in this Agreement shall be deemed to constitute a joint venture, partnership or agency between parties. You acknowledge that you have read this Agreement, understand it, and agree to be bound by Its terms and conditions. You represent you are a legal entity having authority to enter into this Agreement. You agree that this Agreement is the complete and only agreement between us which supersedes any proposal or prior agreement, oral or written, any other click-wrap or shrink-wrap agreement for internal use of any of the Files, and any other communications between us relating to the subject matter of this Agreement. The delay or failure to assert a right hereunder shall not constitute a waiver of that right or excuse a subsequent failure to perform under this Agreement. You agree to take all steps necessary, by Instruction, agreements or otherwise, to ensure compliance with the terms of this Agreement by your employees and agents. If any provision hereof is held to be unenforceable or contrary to public policy the parties agree that the remaining portions are enforceable. Both parties shall hold the terms of this Agreement confidential. This Agreement only becomes effective upon execution by both parties. Any amendment must be in writing signed by both parties. You may not assign this Agreement or any rights herein without the prior approval of the AMA. Any attempted assignment shall be null and void. Notices and requests for approval shall be sent by overnight delivery service to the addresses set forth above or by email to the AMA care of Vice President, Sales and Marketing ([email protected]), with a copy of the notice to the Office of General Counsel ([email protected]) and to you care of Kathy Ortega (email address [email protected]); or to such other persons, addresses, and numbers as either party may designate.

ACCEPTED AND AGREED:

American Medical Association Shawnee County Health Agency

By: ___________ _ By: ___________ _

Print Name: __________ _ Print Name: ___________ _

Title: ___________ _ Title: ____________ _

Date: ____________ _ Date: _____________ _

Approved as to legal form for the AMA by ___ _ Approved by Office of Finance by ___ _

G:IDMIANDREA'.cPTAOII:fonn AJ!ROI!lents\2016 Porm Agreem<ntsi2016Compooite Dota Fil<s Inttlllol Uso Li<mso Agte<ment PINAL ACF IO·Il·IS.doot

5

~r:!J~~ ASSOCIA>riON ~ ~

December 2, 2015

Kathy Ortega Shawnee County Health Agency 1615 SW 8th Avenue Topeka, KS 66605

Dear Ms. Ortega:

ama-essn.org ~ (312)464·5000

This letter is to confirm the amount due for use of the Standard Current Procedural Terminology 2016 (CPr®) and HCPCS data files.

AMA TAX I.D. # 360727175

Internal Use License of Standard CPT® codes 2016 $80 Entity Fee $80 $15.50 per user 32 users $496

Internal Use License of HCPCS 2016 $400 (includes first 25 users) $17.50 per user after your first 25

32 users $522.50

TOTAL AMOUNT DUE $1098.50

All payments are due in accordance with the Agreement. Please indicate Shawnee County Health Agency (as noted on the Agreement) and specify "CPT Licensing Royalties I Budget Code: AC53-2654" in the memo section of the check.

Please mail payment to my attention at: American Medical Association - CPT Royalty 75 Remittance Drive - Suite #6968 Chicago, IL 60675-6968

Feel free to contact if there are questions or concerns about this letter.

Sincerely,

Cheryl Ashe

AMA PLAZA I 330 N. WABASH AVE. I SUITE 39300 I CHICAGO, IL 60611-5885

Rev. 09/2013 ATTACHMENT To

SHAWNEE COUNTY CONTRACT C. ___ _

CONTRACTUAL PROVISIONS ATTACHMENT The undersigned parties agree that the following provisions are hereby incorporated into the contract to which it is attached and made a part thereof, said contract being dated the ___ day of --------20 __ .

1 . TERMS HEREIN CONTROLLING PROVISIONS. It is expressly agreed that the terms of each and every provision in this attachment shall prevail and control over the terms of any other conflicting provision in any other document relating to and a part of the contract in which this attachment is incorporated.

2. AGREEMENT WITH KANSAS LAW. It is agreed by and between the undersigned that all disputes and matters whatsoever arising under, in connection with or incident to this contract shall be litigated, if at all, in and before a Court located in the State of Kansas, U.S.A., to the exclusion of the Courts of any other states or country. All contractual agreements shall be subject to, governed by, and construed according to the laws of the State of Kansas.

3. TERMINATION DUE TO LACK OF FUNDING APPROPRIATION. Shawnee County is subject to the Kansas Cash Basis Law, K.S.A. 10-1101 et seq. If, in the judgment of the Financial Administrator, Audit-Finance Office, sufficient funds are not appropriated to continue the function performed in this agreement and for the payment of the charges hereunder, County may terminate this agreement at the end of its current fiscal year. County agrees to give written notice of termination to contractor at least thirty (30) days prior to the end of its current fiscal year. In the event this agreement is terminated pursuant to this paragraph, County will pay to the contractor all regular contractual payments incurred through the end of such fiscal year. The termination of the contract pursuant to this paragraph shall not cause any penalty to be charged to the County or the contractor.

4. DISCLAIMER OF LIABILITY. Neither the County of Shawnee nor any department thereof shall hold harmless or indemnifY any contractor for any liability whatsoever.

5. ANTI-DISCRIMINATION CLAUSE. The contractor agrees: (a) to comply with the Kansas Act Against Discrimination (K.S.A. 44-1001 et seq.) and the Kansas Age Discrimination in Employment Act, (K .. S.A. 44-1111 et seq.) and the applicable provisions of the Americans With Disabilities Act (42 U.S.C. 12101 et seq.) [ADA] and to not discriminate against any person because of race, religion, color, sex, disability, national origin or ancestry, or age in the admission of access to or treatment or employment in, its programs or activities; (b) to include in all solicitations or advertisements for employees, the phrase "equal opportunity employer"; (c) to comply with the reporting requirements set out in K.S.A. 44-1031 and K.S.A. 44-1116; (d) to include those provisions in every subcontract or purchase order so that they are binding upon such subcontractor or vendor; {e) that a failure to comply with the reporting requirements of (c) above or if the contractor is found guilty of any violation of such acts by the Kansas Human Rights Commission, such violation shall constitute a breach of contract; (f) if the contracting agency determines that the contractor has violated applicable provisions of ADA, that violation shall constitute a breach of contract; (g) if (e) or (f) occurs, the contract may be cancelled, terminated or suspended in whole or in part by the County. Parties to this contract understand that subsections (b) through (e) of this paragraph number 5 are not applicable to a contractor who employs fewer than four employees or whose contract with the County totals $5,000 or less during this fiscal year.

6. ACCEPTANCE OF CONTRACT. This contract shall not be considered accepted, approved or otherwise effective until the required approvals and certifications have been given and this is signed by the Board of County Commissioners of the County of Shawnee, Kansas.

7. ARBITRATION, DAMAGES, WARRANTIES. Notwithstanding any language to the contrary, no interpretation shall be allowed to find the County has agreed to binding arbitration, or the payment of damages or penalties upon the occurrence of a contingency. Further, the County shall not agree to pay attorney fees and late payment charges; and no provisions will be given effect which attempts to exclude, modifY, disclaim or otherwise attempt to limit implied warranties of merchantability and fitness for a particular purpose.

8. REPRESENTATIVE'S AUTHORITY TO CONTRACT. By signing this document, the representative of the contractor thereby represents that such person is duly authorized by the contractor to execute this document on behalf of the contractor and that the contractor agrees to be bound by the provisions thereof.

9. RESPONSIBILITY FOR TAXES. The County shall not be responsible for, nor indemnifY a contractor for, any federal, state or local taxes which may be imposed or levied upon the subject matter of this contract.

I 0. INSURANCE. The County shall not be required to purchase, any insurance against loss or damage to any personal property to which this contract relates, nor shall this contract require the County to establish a "self-insurance" fund to protect against any such loss or damage. Subject to the provisions of the Kansas Tort Claims Act (K.S.A. 75-6101 et seq.}, the vendor or lessor shall bear the risk of any loss or damage to any personal property to which vendor or lessor holds title.

VENDOR/CONTRACTOR:

By:

Title:

Date:

BOARD OF COUNTY COMMISSIONERS SHAWNEE COUNTY, KANSAS

Kevin J. Cook, Chair

Date:

ATTEST:

Cynthia A. Beck, Shawnee County Clerk

Shawnee County Health Agency

December 16, 2015

TO:

FROM:


Alice Weingartner¥ Director- Community Health Center

Allison Alejos ~~ ~ Director - Local Health Department


RE: CONSENT AGENDA- Rescind and Replace County Resolution No. 2015-25

Action requested: Approval to rescind and replace County Resolution No. 2015-25 to increase the business credit card limit for the Purchasing/Payroll Specialist II, Jayme Byers, to be used for the Shawnee County Health Agency (SCHA) Local Health Department (LHD) and Community Health Center (CHC).

With the recent resignation of the Purchasing/Payroll Specialist I, the SCHA LHD and CHC relinquished a credit card with a $7500 limit. This position supported multiple LHD and CHC divisions, programs, and administration by ordering supplies, making travel arrangements, paying registration fees as well as other program and administration needs. The Purchasing/Payroll Specialist I position will not be refilled and those duties will be assumed by remaining staff.

The Purchasing/Payroll Specialist II currently has a business credit card with a limit of $1,500. SCHA is requesting this credit card limit to be increased to $5,000 for the Purchasing/Payroll Specialist II, Jayme Byers, to fulfill the same expectation of supporting multiple LHD and CHC divisions, programs and administration.

AA/EM/tnjc Encl.

cc: Betty Greiner, Director, Shawnee County Administrative Services Edith Matthews, Finance Officer, Shawnee County Health Agency

1615 SW 8th Topeka, KS 66606 I 785.251.2000 www.shawneehealth.org

RESOLUTION NO. 2016· ...;;;;;.L'----

A RESOLUTION AUTHORIZING AN INCREASED LIMIT ON A SHAWNEE COUNTY CREDIT CARD FOR OFFICAL BUSINESS

WHEREAS, Jayme Byers, an employee of the Shawnee County Health Agency made proper

application for the issuance of a Shawnee County credit card for official business; and

WHEREAS, a Shawnee County credit card was issued to Ms. Byers on March 19, 2015 via

Resolution No. 2015-25; and

WHEREAS, Ms. Byers has made a request for an increased limit on the Shawnee County credit

card issued to her; and

WHEREAS, the Audit Finance Administmtor has determined that Ms. Byers has demonstrated

the need for an increased limit on the Shawnee County credit card; and

WHEREAS, the Audit Finance Administrator recommends approval of Ms. Byers' request of an

increased limit on the Shawnee County credit card;

NOW THEREFORE, the Board of County Commissioners of the County of Shawnee, Kansas,

sitting in regular session on this __ day of _____ , 2015, resolves to authorize Ms. Byers an

increased limit on her issued Shawnee County credit card, subject to the normal purchasing procedures as

set forth in Home Rule Resolution No. HR-2014-1, as amended. This authorization is automatically

withdrawn and revoked upon the cessation of Ms. Byers' employment with the Shawnee County Health

Agency, and upon such occun·ence, she shall immediately retwn any Shawnee County credit care in her

possession to her supervisor OI' the Audit Finance Administrator.

ATTEST:

Cynthia A Beck, Shawnee County Clerk

BOARD OF COUNTY COMMISSIONERS SHAWNEE COUNTY, KANSAS

Kevin J. Cook, Chair

Michele A Buhler, Vice·Chair

Robert E. Archer, Member

TO BE READ AND SIGNED BY RECIPIENT OF SHAWNEE COUNTY CREDIT CARD:

All Shawnee County credit cards shall be used strictly for official business. At no time shall any Shawnee County issued credit card be used to pay for personal expenses incurred by the user. Any charges for person expenses shall be the sole responsibility of the user. In addition, any

. employee who charges or attempts to charge personal expenses to a Shawnee County credit card shall be subject to the disciplinary procedure as established by their appointing authority, the Shawnee County Personnel Rules and Regulations and/or any applicable Union contract.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ THE ABOVE PARAGRAPH, THAT I UNDERSTAND AND AGREE TO THE SAME.

(::JtAI~- (3!-iUk:J---· Jayme Byers Date

Documents

BOARD OF COUNTY COMMISSIONERS AGENDA ......2016/01/04 · Shawnee County Health Agency 1615 SW 81h Avenue-Topeka, KS 66606-1688 Ph. (785) 251-2000 Fax (785) 251-2098 SCHA CHC BOARD