PART I, LINE 3C:
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IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURED STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
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PART I, LN 7 COL(F):
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DURING 2013, THE CENTER ADOPTED ACCOUNTING STANDARDS UPDATE 2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISION FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS RATHER THAN AS AN OPERATING EXPENSE. THE CENTER'S ADOPTION OF THIS STANDARD HAD NO NET IMPACT ON ITS FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS. THIS STANDARD ALSO REQUIRES HEALTHCARE ENTITIES TO PROVIDE ENHANCED DISCLOSURE ABOUT THEIR POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS, AS WELL AS QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
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PART II, COMMUNITY BUILDING ACTIVITIES:
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THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE REGIONAL TOP HEALTH NEED PRIORITIES TO BE: SUBSTANCE ABUSE NEEDS, MENTAL HEALTH NEEDS, AND ACCESS TO CARE. COMMUNITY MENTAL HEALTH CENTER, INC. (CMHC) IS COMMITTED TO ADDRESS ALL IDENTIFIED NEEDS BY ITSELF AND VIA COMMUNITY COLLABORATIONS AND PARTNERSHIPS.1. SYSTEMS OF CARE AND RECOVERY SERVICES IN DEARBORN COUNTY:THIS INITIATIVE DERIVED FROM THE MAYOR OF LAWRENCEBURG, IN, DEARBORN COUNTY. HE WISHED TO TAKE A PROACTIVE STEP TO ADDRESS THE HEROIN EPIDEMIC IN OUR REGION. THE MAYOR BROUGHT TOGETHER A COALITION COMPRISED OF THE NATIONAL COUNCIL FOR BEHAVIORAL HEALTH ORGANIZATIONS, THE INDIANA DIVISION OF MENTAL HEALTH AND ADDICTION, LOCAL HEALTH CARE PROVIDERS, INCLUDING COMMUNITY MENTAL HEALTH CENTER, INC., AND OTHER SOCIAL SERVICE AGENCIES. THE SYSTEM OF CARE APPROACH IS BEING UTILIZED TO PROVIDE A CONTINUUM OF SERVICES WORKING COLLABORATIVELY VERSUS WORKING IN SILOS TO MEET THE NEEDS OF THOSE INDIVIDUALS AND FAMILIES STRUGGLING WITH SUBSTANCE USE DISORDER (SUD). THE COALITION IS ADDRESSING THE FOLLOWING AREAS: TREATMENT, INFORMATION, HOUSING, TRANSPORTATION, EMPLOYMENT, PREVENTION, AND STIGMA. STAFF FROM CMHC ARE INVOLVED ALL OF THESE AREAS.2. MENTAL HEALTH CAREER DAY:WORKFORCE ISSUES ARE ONE OF OUR INDUSTRY'S BIGGEST CHALLENGES AND PRESENT A BARRIER TO ACCESS TO CARE. WE NEED MORE STAFF IN ORDER TO ADDRESS THE INCREASED NEED FOR CARE PROVISION. OUR ACTIVITIES IN THIS AREA ARE GEARED TOWARD GETTING STUDENTS POTENTIALLY INTERESTED IN A CAREER IN BEHAVIORAL HEALTH WHILE IN HIGH SCHOOL, TO ENGAGE WITH CMHC STAFF TO EXPLORE THIS CAREER FIELD. THE STUDENTS WHO PARTICIPATED IN THE MENTAL HEALTH CAREER DAY STATED THAT IT WAS THE BEST EXPOSURE AND EXPERIENCE THAT THEY HAVE HAD. WE ARE RUNNING A MARATHON AND IT STARTS WITH OUR FIRST STRIDE FORWARD.3. SUICIDE PREVENTION TRAINING TO RIPLEY COUNTY LAW ENFORCEMENT:SUICIDE IS A KEY ISSUE THAT CMHC ADDRESSES WITH INDIVIDUALS, FAMILIES, AND COMMUNITY MEMBERS. SUICIDE RATES HAVE INCREASED OVER THE PAST FEW YEARS IN OUR REGION. CMHC WORKS WITH VARIOUS COMMUNITY STAKEHOLDERS TO AID IN THE PREVENTION OF SUICIDE.4. MEETING WITH SWITZERLAND COUNTY SCHOOLS TO PROCESS THE SUICIDE OF A STUDENT AND CREATE A PREVENTION PLAN FOR THE FUTURE:THIS WAS A SPECIFIC INTERVENTION CONDUCTED BY CMHC STAFF AT THE REQUEST OF THE SWITZERLAND COUNTY SCHOOLS. ONE OF THEIR STUDENTS HAD COMMITTED SUICIDE AND CMHC STAFF PROCESSED THIS INCIDENT WITH STUDENTS AND STAFF AND DEVELOPED A PREVENTION PLAN FOR THE FUTURE. THIS WAS A PREVENTION AND HEALTHY COPING EXERCISE TO HELP DEAL WITH THEIR LOSS.5. DEARBORN CITIZENS AGAINST SUBSTANCE ABUSE:THIS IS A LOCAL COALITION AIMED AT ADDRESSING THE MANY ASPECTS OF SUD. MARTIN JUSTICE IS THE PRESIDENT OF THE COALITION. SEVERAL OTHER CMHC STAFF PERIODICALLY ATTEND THE COALITION'S MEETINGS. THE COALITION HAS MANY INITIATIVES AROUND PREVENTION, TREATMENT, STIGMA RELATED TO SUD.6. CIT PLANNING MEETING:CRITICAL INCIDENT TRAINING (CIT) IS A 40 HOUR TRAINING FOR FIRST RESPONDERS AND LAW ENFORCEMENT PERSONNEL FROM SEVERAL SURROUNDING CITIES IN THREE COUNTIES. THE FOCUS OF THE TRAINING IS TO EDUCATE THESE INDIVIDUALS ABOUT THE DYNAMICS OF MENTAL HEALTH AND ADDICTION DIAGNOSIS, SYMPTOMS, LEGAL ISSUES, TREATMENT, LOCAL RESOURCES, AND INTERVENTIONS. THE GOAL IS TO EQUIP THEM WITH KNOWLEDGE AND SKILLS SO THAT THEY CAN EFFECTIVELY INTERVENE WHEN THEY INTERACT WITH SOMEONE EXHIBITING SYMPTOMS OF MENTAL ILLNESS OR SUD. PLANNING WAS CONDUCTED WITH LOCAL POLICE, EMS, IVY TECH COMMUNITY COLLEGE STAFF, REPRESENTATIVES OF THE LOCAL NAMI GROUP, AND CMHC STAFF. CMHC STAFF ARE CENTRAL TO PRESENTING THE TRAINING MATERIAL.7. ACTUAL CIT TRAINING FOR POLICE AND FIRST RESPONDERS:CRITICAL INCIDENT TRAINING (CIT) WAS A 40 HOUR TRAINING FOR FIRST RESPONDERS AND LAW ENFORCEMENT PERSONNEL FROM SEVERAL SURROUNDING CITIES IN THREE COUNTIES. THE FOCUS OF THE TRAINING WAS TO EDUCATE THESE INDIVIDUALS ABOUT THE DYNAMICS OF MENTAL HEALTH AND ADDICTION DIAGNOSIS, SYMPTOMS, LEGAL ISSUES, TREATMENT, LOCAL RESOURCES, AND INTERVENTIONS. THE GOAL WAS TO EQUIP THEM WITH KNOWLEDGE AND SKILLS SO THAT THEY CAN EFFECTIVELY INTERVENE WHEN THEY INTERACT WITH SOMEONE EXHIBITING SYMPTOMS OF MENTAL ILLNESS OR SUD.8. HEALTH FAIR:THE HEALTH FAIR WAS A LOCAL HEALTH FAIR SPONSORED BY CMHC'S HARMONY HEALTH CLINIC (AN INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH CLINIC). LOCAL NURSING STUDENTS FROM IVY TECH COMMUNITY COLLEGE AND OTHER HEALTH-RELATED PROVIDERS ALSO PARTICIPATED. THE HEALTH FAIR WAS ORIENTED TO AN AUDIENCE OF CMHC PATIENTS AND THEIR FAMILIES, AND LOCAL CITIZENS. THE THEME CENTERED ON CMHC'S MISSION STATEMENT: PARTNERING FOR WELLNESS: HEALTHY MIND. HEALTHY BODY. HEALTHY LIFE. BY FOCUSING ON WELLNESS WE WERE PROMOTING THE HEALTH OF THE COMMUNITY WE SERVE.
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PART III, LINE 2:
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CMHC'S ANALYSIS AND ASSESSMENT OF THE BAD DEBT EXPENSE IS BASED ON THE EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CENTER RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
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PART III, LINE 3:
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ON A MONTHLY BASIS AR CLERK REVIEWS SELF-PAY CLIENTS, WHICH INCLUDE CLIENTS UNDER FAP AS WELL, ACCOUNT ACTIVITY AND BALANCES. ACCOUNTS THAT DO NOT SHOW PAYMENTS ON OUTSTANDING BALANCES OVER 90-DAY PERIOD ARE THEN SENT TO THE LETTER SERVICE.LETTER SERVICE MAKES SIX ATTEMPTS TO CONTACT THE CLIENTS VIA MAIL AND PHONE CALLS ABOUT THEIR OUTSTANDING BALANCE AND PAYMENTS ON THE BALANCE ASKING THEM TO EITHER MAKE PAYMENTS OR CONTACT CMHC TO DISCUSS THE SITUATION, WARNING THAT OTHERWISE THEIR ACCOUNT WILL BE SENT TO COLLECTIONS. THIS PROCESS TAKES UP TO 90 DAYS. IF THERE IS NO PAYMENT OR COMMUNICATION FROM A CLIENT, THEN THEIR ACCOUNT IS SENT TO A COLLECTION AGENCY AND THE AMOUNT IS WRITTEN OFF AS BAD DEBT. THE AMOUNT SHOWING ON PART III, LINE 3 ARE ALL THE PATIENT ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT THROUGHOUT THE YEAR.NONE OF THE BAD DEBT EXPENSE IS INCLUDED IN COMMUNITY BENEFIT.
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PART III, LINE 4:
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THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENT THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS UNDER FOOTNOTE TITLED "ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS"
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PART III, LINE 8:
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THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE ESTIMATED YEAR ENDED JUNE 30, 2018 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST.
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PART III, LINE 9B:
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AN ACTIVE CLIENT FROM WHOM NO PAYMENT HAS BEEN RECEIVED FOR 90 DAYS SHALL BE SENT A LETTER OF NON-PAYMENT, WITH A COPY SENT TO THE CLIENT'S PRIMARY CASE MANAGER. THE PRIMARY CASE MANAGER SHALL ADDRESS THE NON-PAYMENT WITH THE CLIENT TO DETERMINE A COURSE OF ACTION BASED ON THE CLIENT'S CLINICAL AND FINANCIAL CIRCUMSTANCES. A DELINQUENT ACCOUNT WILL BE SENT TO COLLECTION ONLY IN INSTANCES WHEN IT IS CLEAR THAT THE CLIENT HAS THE MEANS TO MAKE PAYMENTS AND REFUSES TO DO SO. REFERRAL TO A COLLECTION AGENCY WOULD ALSO OCCUR ONLY FOLLOWING DISCUSSION WITH THE CLIENT'S PRIMARY CASE MANAGER, THE PROGRAM DIRECTOR/COORDINATOR OR DIVISION DIRECTOR, AND, IF APPROPRIATE, THE CLIENT'S PSYCHIATRIST. IF THE REFUSAL TO PAY IS CLEARLY DUE TO PSYCHIATRIC DECOMPENSATING, THE FOCUS WILL BE ON ALLEVIATING THE SYMPTOMS OF THE CLIENT'S MENTAL ILLNESS FIRST AND SECONDARILY LOOKING AT THE ISSUE OF COLLECTION ON THE DELINQUENT ACCOUNT. THIS PRACTICE APPLIES TO ALL OUTSTANDING PATIENT ACCOUNT BALANCES, NOT ONLY CLIENTS RECEIVING FINANCIAL ASSISTANCE.
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PART VI, LINE 2:
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AS A BEHAVIORAL HEALTH CARE ORGANIZATION, CMHC COLLABORATES WITH MANY OF ITS STAKEHOLDERS TO ASSESS THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY FOR EXAMPLE, WITH CHILDREN, THE ORGANIZATION IS PART OF A SYSTEM OF CARE THAT MEETS REGULARLY WITH CHILD WELFARE, PRIMARY CARE, EDUCATION, PROBATION, EARLY CHILD HOOD PROVIDERS, FAMILIES AND OTHERS TO ASSESS THE GAPS IN SERVICES AND NEEDS OF THE COMMUNITY. CMHC ALSO REGULARLY MEETS WITH DEARBORN COUNTY HOSPITAL, JUDGES, CIVIC LEADERS, LAW ENFORCEMENT, AND PRIMARY CARE PHYSICIANS TO EVALUATE THE NEEDS OF THE COMMUNITY. THE ORGANIZATION IS ALSO AN ACTIVE MEMBER OF THE BOARD OF THE AHEC (AREA HEALTH EDUCATION COALITION). AS AN ORGANIZATION, CMHC REGULARLY SURVEYS PATIENTS AND THEIR FAMILIES TO ASSESS BOTH THEIR SATISFACTION WITH SERVICES AS WELL AS NEEDS. ADDITIONALLY, CMHC HAS AN ADVISORY COMMITTEE MADE UP OF CONSUMERS, STAFF, AND COMMUNITY PARTNERS THAT DISCUSS PROGRAM NEEDS AND SERVICE GAPS. FOR EXAMPLE, AS A RESULT OF FEEDBACK FROM THESE GROUPS AS WELL AS RESEARCH REVIEWS, THE ORGANIZATION HAD IMPLEMENTED AN INTEGRATED PRIMARY HEALTH CARE/BEHAVIORAL HEALTH CARE CLINIC SPECIFICALLY TO MEET PRIMARY HEALTH CARE NEEDS OF ADULTS WITH SERIOUS MENTAL ILLNESS.
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PART VI, LINE 3:
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CMHC UTILIZES CARE MANAGERS TO EDUCATE PERSONS SERVED OF FEDERAL AND STATE ENTITLEMENTS THEY MAY BE ELIGIBLE FOR. IN ADDITION, THE ORGANIZATION IS AN ENROLLMENT CENTER FOR MEDICAID. CARE MANAGERS ASSIST PATIENTS IN APPLYING FOR ASSISTANCE PROGRAMS INCLUDING MEDICAID, MEDICARE, HEALTHY INDIANA PLAN, DRUG ASSISTANCE PROGRAMS, SOCIAL SECURITY BENEFITS AND OTHERS. IF THE PATIENT IS NOT ELIGIBLE FOR ASSISTANCE PROGRAMS, AND HAS NO OTHER INSURANCE, THEN CMHC'S SLIDING FEE SCALE IS EXPLAINED AND PROCESSED.
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PART VI, LINE 4:
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THE ORGANIZATION PRIMARILY SERVES PATIENTS IN FIVE RURAL COUNTIES OF SOUTHEASTERN INDIANA: DEARBORN, RIPLEY OHIO, SWITZERLAND AND FRANKLIN COUNTIES. THERE ARE TWO GENERAL CARE HOSPITALS LOCATED IN RIPLEY COUNTY AND DEARBORN COUNTY FOR THE FIVE COUNTIES. CMHC PRIMARILY PROVIDES OUTPATIENT SERVICES BUT DOES ALSO PROVIDE INPATIENT PSYCHIATRIC ACUTE CARE AND IS THE ONLY PSYCHIATRIC INPATIENT UNIT IN THE FIVE COUNTIES. SWITZERLAND, OHIO AND FRANKLIN COUNTIES ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.
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PART VI, LINE 5:
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AS A COMMUNITY MENTAL HEALTH ORGANIZATION IN INDIANA, CMHC PROVIDES A FULL CONTINUUM OF CARE TO ADULTS, CHILDREN AND FAMILIES IN BEHAVIORAL HEALTHCARE. THIS INCLUDES PREVENTION AND EDUCATION SERVICES, SUPPORT TO SEXUAL ASSAULT SURVIVORS, OUTPATIENT SERVICES INCLUDING INTENSIVE OUTPATIENT AND MANY CARE COORDINATION, CASE MANAGEMENT, REHABILITATION, AND OTHER COMMUNITY BASED SERVICES. THE ORGANIZATION IS ALSO A SUPPORTED EMPLOYMENT PROVIDER AND AN EMPLOYMENT NETWORK PROVIDING EMPLOYMENT SERVICES TO PERSONS WITH DISABILITIES. THE ORGANIZATION PROVIDES EMERGENCY CRISIS SERVICES 24 HOURS A DAY, 7 DAYS A WEEK, AND PROVIDES ACUTE CARE PSYCHIATRIC SERVICES AS WELL AS DETOX SERVICES. CMHC IS PART OF THE INDIANA HOUSING COALITION, AND ALSO PROVIDES A WIDE ARRAY OF HOUSING FOR INDIVIDUALS AND FAMILIES WITH PSYCHIATRIC AND OTHER DISABILITIES. CMHC IS CERTIFIED BY THE DEPARTMENT OF MENTAL HEALTH AND ADDICTIONS IN INDIANA AND IS ACCREDITED BY CARF.
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PART VI, LINE 6:
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NOT APPLICABLE. THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.PART VI, LINE 7: COMMUNITY BENEFIT REPORT FILED IN STATE OF INDIANA.
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