COMMUNITY MENTAL HEALTH SERVICES OF ST. JOSEPH COUNTY

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

EXECUTIVE DIGEST #3949699
COMMUNITY MENTAL HEALTH SERVICES OF ST. JOSEPH COUNTY

INTRODUCTION
This report, issued in February 2000, contains the results of our performance audit of Community Mental Health Services of St. Joseph County (CMHSSJC), 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
CMHSSJC was established in 1967 and operates under the provisions of the Mental Health Code, being Sections 330.1001 - 330.2106 of the Michigan Compiled Laws.

CMHSSJC's mission is to ensure that a comprehensive range of mental health services is available to enhance the self-sufficiency of its consumers and its organization.

CMHSSJC operates and/or contracts for mental health services, including inpatient, outpatient, day program, residential, case management, respite, crisis, and prevention services for mentally ill (MI) and developmentally disabled (DD) individuals.

The CMHSSJC Access Unit serves as the single entry point for St. Joseph County residents seeking mental health services.

CMHSSJC operations generally are funded by State, federal, and local funds. Total expenditures for the fiscal year ended September 30, 1998 were approximately $8 million. As of September 30, 1998, CMHSSJC had 50 full-time equated employees and was serving 1,933 consumers.

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

Conclusion: CMHSSJC was generally effective and efficient related to the delivery of services. We noted reportable conditions related to CMHSSJC's continuous quality improvement (CQI) process, day activities case records, proper documentation, and person-centered planning (Findings 1 through 4).

Noteworthy Accomplishments: CMHSSJC has maintained its accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) without interruption since June 1996. Also, in 1996, CMHSSJC streamlined its access to community mental health services and reduced the length of time from service request to scheduled intake appointment, which reduced wait time for clinical services.

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

Conclusion: CMHSSJC's management system for processing Medicaid reimbursements and capitated payments was generally effective.

AUDIT SCOPE AND METHODOLOGY
Our audit scope was to examine the program and other records of Community Mental Health Services of St. Joseph County. Our audit was conducted in accordance with Government 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 CMHSSJC records and activities for the period October 1, 1996 through August 30, 1999. We interviewed CMHSSJC and contractual staff; reviewed applicable statutes, rules, policies, and procedures; assessed the effectiveness of applicable internal controls; and analyzed applicable program, financial, and clinical records. Also, we surveyed consumers and referral sources (survey summaries are presented as supplemental information). In addition, we analyzed contracts with mental health service providers and tested compliance with the contracts. Further, we conducted site visits of contract providers.

AGENCY RESPONSES
Our audit report includes 4 findings and 4 corresponding recommendations. CMHSSJC preliminary response indicated that it agreed with our recommendations and has taken steps to implement them.

Full Audit Report - #3949699 - COMMUNITY MENTAL HEALTH SERVICES OF ST. JOSEPH COUNTY

Documents prefaced by require the Adobe Acrobat Reader®, a free application available on the Adobe homepage.

This page was created on February 17, 2000.


INTRODUCTION This report, issued in February 2000, contains the results of our performance audit of Community Mental Health Services of St. Joseph County (CMHSSJC), 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 CMHSSJC was established in 1967 and operates under the provisions of the Mental Health Code, being Sections 330.1001 - 330.2106 of the Michigan Compiled Laws. CMHSSJC's mission is to ensure that a comprehensive range of mental health services is available to enhance the self-sufficiency of its consumers and its organization. CMHSSJC operates and/or contracts for mental health services, including inpatient, outpatient, day program, residential, case management, respite, crisis, and prevention services for mentally ill (MI) and developmentally disabled (DD) individuals. The CMHSSJC Access Unit serves as the single entry point for St. Joseph County residents seeking mental health services. CMHSSJC operations generally are funded by State, federal, and local funds. Total expenditures for the fiscal year ended September 30, 1998 were approximately $8 million. As of September 30, 1998, CMHSSJC had 50 full-time equated employees and was serving 1,933 consumers.

AUDIT OBJECTIVES, CONCLUSIONS, AND NOTEWORTHY ACCOMPLISHMENTS Audit Objective: To assess CMHSSJC's effectiveness and efficiency related to the delivery of services. Conclusion: CMHSSJC was generally effective and efficient related to the delivery of services. We noted reportable conditions related to CMHSSJC's continuous quality improvement (CQI) process, day activities case records, proper documentation, and person-centered planning (Findings 1 through 4). Noteworthy Accomplishments: CMHSSJC has maintained its accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) without interruption since June 1996. Also, in 1996, CMHSSJC streamlined its access to community mental health services and reduced the length of time from service request to scheduled intake appointment, which reduced wait time for clinical services. Audit Objective: To assess the effectiveness of CMHSSJC's management system for processing Medicaid reimbursements and capitated payments. Conclusion: CMHSSJC's management system for processing Medicaid reimbursements and capitated payments was generally effective.

AUDIT SCOPE AND METHODOLOGY Our audit scope was to examine the program and other records of Community Mental Health Services of St. Joseph County. Our audit was conducted in accordance with Government 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 CMHSSJC records and activities for the period October 1, 1996 through August 30, 1999. We interviewed CMHSSJC and contractual staff; reviewed applicable statutes, rules, policies, and procedures; assessed the effectiveness of applicable internal controls; and analyzed applicable program, financial, and clinical records. Also, we surveyed consumers and referral sources (survey summaries are presented as supplemental information). In addition, we analyzed contracts with mental health service providers and tested compliance with the contracts. Further, we conducted site visits of contract providers.

AGENCY RESPONSES Our audit report includes 4 findings and 4 corresponding recommendations. CMHSSJC preliminary response indicated that it agreed with our recommendations and has taken steps to implement them.