BARRY COUNTY COMMUNITY MENTAL HEALTH SERVICES

Michigan Office of the
Auditor General
Thomas H. McTavish, C.P.A.
Auditor General

EXECUTIVE DIGEST #3940899
BARRY COUNTY COMMUNITY MENTAL HEALTH SERVICES

INTRODUCTION
This report, issued in May 2000, contains the results of our performance audit of Barry County Community Mental Health Services (BCCMHS), an agency under contract with the Department of Community Health.

AUDIT PURPOSE
This performance audit was conducted as part of the constitutional responsibility of the Office of the Auditor General. Performance audits are conducted on a priority basis related to the potential for improving effectiveness and efficiency.

BACKGROUND
BCCMHS was established in 1974 and operates under the provisions of the Mental Health Code, being Sections 330.1001 - 330.2106 of the Michigan Compiled Laws.

BCCMHS's mission is to provide accessible and affordable mental health services focused on prevention, treatment, and rehabilitation to county residents who can benefit from its endeavors. Its mission will be supported by efficient and prudent use of its finances and appropriate diversification.

BCCMHS operates and/or contracts for mental health services, including inpatient, outpatient, day program, residential, case management, respite, crisis intervention, and prevention services for mentally ill and developmentally disabled individuals. BCCMHS's consumer intake unit serves as the single entry point for Barry County residents seeking mental health services.

BCCMHS operations are generally funded by State, federal, and local government funds. Reimbursements from individuals and private insurance companies also make up a significant portion of BCCMHS revenues. Total expenditures for the fiscal year ended September 30, 1998 were approximately $3 million. In April 1999, BCCMHS had 33 full-time and 4 part-time employees serving 926 consumers.

AUDIT OBJECTIVES, CONCLUSIONS, AND NOTEWORTHY ACCOMPLISHMENTS
Audit Objective: To assess BCCMHS's effectiveness and efficiency related to the delivery of services.

Conclusion: BCCMHS was generally effective and efficient in the delivery of services. However, we noted reportable conditions related to person-centered planning, quality improvement, preemployment background checks, and the community mental health services board of directors (Findings 1 through 4).

Noteworthy Accomplishments: BCCMHS developed and implemented a training program to cross-train both mental health and substance abuse staff. As a result, BCCMHS staff can coordinate efforts more effectively and better serve consumers who are diagnosed with both mental health and substance abuse needs. Also, in April 1997, BCCMHS received a three-year accreditation from the Rehabilitation Accreditation Commission (CARF).

Audit Objective: To assess the effectiveness of BCCMHS's management system for processing Medicaid reimbursements and capitated payments.

Conclusion: BCCMHS's management system was generally effective in its processing of Medicaid reimbursements and capitated payments.

AUDIT SCOPE AND METHODOLOGY
Our audit scope was to examine the program and other records of Barry County Community Mental Health Services. Our audit was conducted in accordance with Governmental Auditing Standards issued by the Comptroller General of the United States and, accordingly, included such tests of the records and such other auditing procedures as we considered necessary in the circumstances.

To accomplish our objectives, we examined BCCMHS records and activities for the period October 1, 1996 through August 31, 1999. We interviewed BCCMHS staff; reviewed applicable statutes, rules, policies, and procedures; assessed the effectiveness of applicable areas of internal control; and analyzed applicable program, financial, and clinical records. Also, we surveyed consumers and referral sources (survey summaries are presented as supplemental information). We analyzed contracts with mental health service providers and tested contracts for compliance. In addition, we tested for compliance with Department of Community Health financial reporting requirements.

AGENCY RESPONSES
Our audit report contains 4 findings and 4 corresponding recommendations. BCCMHS's preliminary response indicated that it agreed with all 4 findings.

Full Audit Report - #3940899 - BARRY COUNTY COMMUNITY MENTAL HEALTH SERVICES

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This page was created on May 25, 2000.


INTRODUCTION This report, issued in May 2000, contains the results of our performance audit of Barry County Community Mental Health Services (BCCMHS), an agency under contract with the Department of Community Health.

AUDIT PURPOSE This performance audit was conducted as part of the constitutional responsibility of the Office of the Auditor General. Performance audits are conducted on a priority basis related to the potential for improving effectiveness and efficiency.

BACKGROUND BCCMHS was established in 1974 and operates under the provisions of the Mental Health Code, being Sections 330.1001 - 330.2106 of the Michigan Compiled Laws. BCCMHS's mission is to provide accessible and affordable mental health services focused on prevention, treatment, and rehabilitation to county residents who can benefit from its endeavors. Its mission will be supported by efficient and prudent use of its finances and appropriate diversification. BCCMHS operates and/or contracts for mental health services, including inpatient, outpatient, day program, residential, case management, respite, crisis intervention, and prevention services for mentally ill and developmentally disabled individuals. BCCMHS's consumer intake unit serves as the single entry point for Barry County residents seeking mental health services. BCCMHS operations are generally funded by State, federal, and local government funds. Reimbursements from individuals and private insurance companies also make up a significant portion of BCCMHS revenues. Total expenditures for the fiscal year ended September 30, 1998 were approximately $3 million. In April 1999, BCCMHS had 33 full-time and 4 part-time employees serving 926 consumers.

AUDIT OBJECTIVES, CONCLUSIONS, AND NOTEWORTHY ACCOMPLISHMENTS Audit Objective: To assess BCCMHS's effectiveness and efficiency related to the delivery of services. Conclusion: BCCMHS was generally effective and efficient in the delivery of services. However, we noted reportable conditions related to person-centered planning, quality improvement, preemployment background checks, and the community mental health services board of directors (Findings 1 through 4). Noteworthy Accomplishments: BCCMHS developed and implemented a training program to cross-train both mental health and substance abuse staff. As a result, BCCMHS staff can coordinate efforts more effectively and better serve consumers who are diagnosed with both mental health and substance abuse needs. Also, in April 1997, BCCMHS received a three-year accreditation from the Rehabilitation Accreditation Commission (CARF). Audit Objective: To assess the effectiveness of BCCMHS's management system for processing Medicaid reimbursements and capitated payments. Conclusion: BCCMHS's management system was generally effective in its processing of Medicaid reimbursements and capitated payments.

AUDIT SCOPE AND METHODOLOGY Our audit scope was to examine the program and other records of Barry County Community Mental Health Services. Our audit was conducted in accordance with Governmental Auditing Standards issued by the Comptroller General of the United States and, accordingly, included such tests of the records and such other auditing procedures as we considered necessary in the circumstances. To accomplish our objectives, we examined BCCMHS records and activities for the period October 1, 1996 through August 31, 1999. We interviewed BCCMHS staff; reviewed applicable statutes, rules, policies, and procedures; assessed the effectiveness of applicable areas of internal control; and analyzed applicable program, financial, and clinical records. Also, we surveyed consumers and referral sources (survey summaries are presented as supplemental information). We analyzed contracts with mental health service providers and tested contracts for compliance. In addition, we tested for compliance with Department of Community Health financial reporting requirements.

AGENCY RESPONSES Our audit report contains 4 findings and 4 corresponding recommendations. BCCMHS's preliminary response indicated that it agreed with all 4 findings.