Transcript Slide 1

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To protect and improve the Public’s health
The customer is the public
Create a robust business partnership across the
entire enterprise
Standardize and simply processes wherever and
whenever possible
Consider: Who? What? When? Where? Why? and
How?
Potential benefits: reduce waste, eliminate
duplication, save time, improve performance,
better documentation of success and improved
health outcomes, and an opportunity to celebrate
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Common components of a grants
administration process
Key control points
Examples of incentives
Examples of tactical options
New developments on the horizon
State examples (OH, MI and IA)
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Federal Funding Opportunity Announcement
(FOA)
Federal application process: federal forms, state
clearinghouse forms, assurances, program and
fiscal approvals and signatures, budget and
personnel review and approvals, final sign-off
and submission
Receipt of federal NOA: special conditions,
loading into state systems (budget and acct’g),
federal grant modifications (approvals and
spending plans)
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Subgrantee RFP*: creation of RFP – program and
fiscal elements, subgrantee eligibility
requirements (notice to subgrantees?), final signoffs, release of RFP, standardized elements?
Subgrantee Application*: Receipt of RFP,
preparation of narrative and fiscal elements,
review and sign-off steps, submission of
application, notice of receipt of application
* Can these run concurrently with any prior steps?
Internal grants management process (from receipt
of subgrantee application to approval and NOA):
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review of applications – narrative and budget
special conditions*
non-selected and selected applicant reviews,
approvals, and signoffs
preparation of purchase requisition and cover
letter,
filing of entire package into a project folder
(master file?)
*including any outstanding audit issues?
Purchase order process:
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Purchase order prepared and cross-checked
with approved application
Send NOA and package to subgrantee
Prepare payment transmittal form
Accounting assures cash is available
Disburse initial funds
(how is this done in CO?)
Subgrantee responsibilities:
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Compliance with any special conditions
Implementation of PH program
Submission of required fiscal and program
documentation (procedures? time frames?)
Local oversight and/or fiscal procedures
Annual reconciliation reports
Audits required by law
Federal/state health agency program and fiscal
monitoring responsibilities:
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Implementation of PH program
Site visits and reports
Desk reviews and reports
Failure to comply (consequences)
Budget modification processes* - fiscal limits
and how often in a grant period, “no cost”
extensions, changes in scope or amount of
award, etc.
* a “hidden,” complicating element of a GAP
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Completion of required reports and
closeouts:
Interim FSR
Close-out procedures
Return of unused funds
Final FSR
Failure to comply (consequences)
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Documentation of certifications (SHA to federal
and subgrantee to SHA)
Director’s approvals
Award matches request
Elimination of fiscal exceptions (management
overrides and straight debits for payments to
subgrantees)
Documentation of compliance with deadlines
(applications/NOAs/budget revisions/etc)
Documentation of compliance with special
conditions
Documentation of compliance with final closeout
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One-time submission of certifications
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Standard RFP format
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Standard project reporting elements
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Earned budget flexibility after meeting
defined compliance criteria
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Create flowchart, with documentation, of GAP
Create a GAP policies and procedures manual
for both internal and external audiences
Create a standardized master file for all
subgrant project folders (electronic preferred)
Implement a comprehensive, ongoing internal
and external GAP training program
Establish a minimum dollar threshold for
subgrants
Establish a robust subgrantee audit program
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ASTHO/CDC joint project on improving grant
processes (BSIP)
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ARRA grant requirements
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Fiscal intermediaries
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Health reform funding
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PHAB fiscal standards and measures
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Consistent and more flexible carry-over
policy
Standardize no cost extensions and budget
modifications
Reduce the degree of detail in budget
submission requirements
Standardize data and reporting element
requirements
Eliminate IT “stand alones”
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Standardize, or at least simplify, project
period/budget period start dates
Transparent performance tracking process
Standardize minimum lead time for preparing
applications in response to grant guidance
Specify Business Process Metrics and Key
Sign-offs
Timely issuance of grant/cooperative
agreement guidance including ample time for
application preparation and submission
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Don’t combine (or mask) budget cuts with
integration
Reduce variation and differences in “rule
interpretations” by PGO, programs and states
Create standard applications, invoicing and
reporting
Clarify and standardize maintenance of effort
and match requirements
real-time transparent process for tracking
status of requests
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Confirm agency assurances once annually
Create a means for tracking expenditures –
more refined than timing of state
“drawdowns.”
Track performance on outcomes rather than
on processes
Keep track of categorical funds but allocate to
states in a blended fashion when appropriate
Initiate an appeals process
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Link any expansion of program requirements
(mid grant) with an associated increase in
funding
Conduct proactive needs assessments from state
and local partners
Workloads and expectations should be more
commensurate with funding levels
Explore the possibility of multi-year grants
Simplify the continuation process
Expand the allowable spending period beyond
the prescribed 12 month budget period
Provide Financial Management Systems
Standard A2 B: Establish effective financial
management systems.
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A2.1 B: Comply with requirements for externally
funded programs
◦ Audited financial statements
◦ Program reports
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A2.2 B: Maintain written agreements with entities
providing processes, programs and/or interventions
delegated or purchased by the public health agency
◦ Two examples of current written contracts/MOUs, MOAs for
processes, programs and/or interventions
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A2.3 B: Maintain financial management systems
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Examples of Documentation
◦ Annual agency budget approved by governing entity
◦ Two examples of financial reports (at least quarterly)
◦ Audited financial statements
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Other Examples of Documentation
◦ Documentation that audit has been reviewed by the
governing entity and/or key agency staff
◦ Documentation that financial reports reviewed by the
governing entity and/or key agency staff
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A2.4 B: Seek resources to support agency
infrastructure and processes, programs and
interventions
Examples of documentation
Annual budget submission
Budget revisions
Additional funding requests
Grant applications and fundraising
Newspaper articles/letters to the editor on the need for
improvement in public health (can be issues specific)
◦ Public Health meeting discussing public health funding
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For more information:
http://www.phaboard.org/assets/documents
/PHABStateJuly2009-finaleditforbeta.pdf
Thank you!
[email protected]
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Comprehensive GAP policy and procedures
manual
http://www.odh.ohio.gov/pdf/GAPManual/G
APMANUAL.PDF
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“A-Z” list of recommended changes
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Kaizen Blitz to streamline process
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Department of Community Health (State
Health Agency)
Department of Environmental Health (Water,
Sewage, Campgrounds, and Swimming Pool
Programs)
Department of Agriculture (Food Service
Safety Programs)
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By state statute the State Health Agency is
responsible for the provision of health
services to Michigan Citizens
Statute provides the State Health Agency the
option to grant local health departments
authority to act on its behalf for primary
responsibility and delivery of public health
services to Michigan Citizens
The State Health Agency has exercised this
option
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State Statute requires each county to provide
for a county health department
The legal local governing entity in Michigan is
defined as a county
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45 local health departments serving
Michigan’s 83 counties and the city of
Detroit:
30 are single county departments
14 are multiple county district Health
departments
1 city health department
37 of the 45 local health departments are
classified as rural health departments
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Boards of Health are optional except where
there is a district health department
District boards of health are comprised of two
elected officials (commissioners) from each
county in the district
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CPBC is a contractual agreement between the
State Health Agency and each of the 45 local
health departments
The contract is the administrative and legal
mechanism through which categorical grants
and other funds are disbursed or allocated to
fund required services
The contract contains the majority of State
Health Agency funded programs including
those administered by the Departments of
Environmental Quality and Agriculture
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The 45 CPBC agreements collectively
contained 62 local health service programs
and funding of $101,623.860
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Contains Six Components
1) Boilerplate Parts I
2) Boilerplate Parts II
3) Budget-includes instructions, standard
budget forms, amendment process
4) Output Reporting – H-977-contains
output measures for specific programs as
established by program staff
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5) Special Requirements-includes Minimum
Program Requirements (MPRs), check off list,
special requirements that do not have MPRs
6) Allocation Schedule-contains allocations,
defines programs as staff, fixed unit rate,
performance, and includes performance
measures
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Each program has a budget, performance
indicators, and reporting requirements
Standard forms are used for all programs and
are itemized by program then rolled up to a
combined budget
When possible reporting requirements are
redefined as Minimum Reporting
Requirements (MPRs)
Special reporting requirements are contained
in a Special Reporting Section of the
agreement
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The very extensive reporting requirements
continue to be a barrier to moving from
standardization to true contract consolidation
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February-Previous agreements sent to MDCH
Programs for review by MDCH Grants and
Purchasing Division
March-Revised agreements returned to
Grants and Purchasing Division
April-Final revised agreements returned to
Programs for approval
April-Approved agreements returned to
Grants and Purchasing Division
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May-New agreements for all programs mailed
out to local health department
June-August-Local health department obtains
County or BOH approval
September-Signed agreements returned to
Grants and Contracts Division
October – start new fiscal year
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Local health departments are reimbursed
monthly at 1/12 of planned/approved budget
amount
Local health departments submit quarterly
financial status reports (FSRs) detailing funds
expended
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Local health departments submit an
estimated FSR for the last quarter
(July,Aug,Sept.)
Submit final adjusted actual FSR report by
January 31.
Local health department may request advance
operating funds through a formal process
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All forms (FSR, Budget, Medicaid Cost-based
reimbursement forms in spreadsheet format)
Best practice guidelines
Instructions for completing forms
Instructions for completing local maintenance
of effort reports
Calendar of due dates
Contact directory
* a procedures manual
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Grants and Contracts Division, MDCH-Serves
as a connector between programs and local
health departments, ensure schedules are
kept, performs financial reviews, generates
payments
Office of Local Health Services, MDCH-Serves
as the single point of contact for local health
departments to reach any part of MDCH.
Staffs the annual standards review and
funding formula local/state committees
Program Divisions-Performs program
reviews, approves/doesn’t process payments
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Top Leadership Commitment-Three state
department directors meet quarterly with
local health department leadership to deal
with policy and financial issues
Principles of Collaboration Agreement-signed
by three state department directors and the
leadership of local public health pledging to
work together in a collaborative manner on
all issues relating to the provision of public
health services to Michigan citizens
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Information Technology-Active sharing of
hardware, software, networking, and
technical resources by and between local
health departments, especially important to
smaller local health departments
Local Resource Sharing-Local health
departments not big fans of formal
consolidation of local health departments but
do utilize an associated contractual
arrangement where local health departments
share resources, people, technology.
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The associated contractual relationship allows
resource sharing but each county retains its
own governing entity, budget, and
organization.
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MI state accreditation provides the final piece
of the Standardized contractual relationship
between the state and local health
departments.
MI accreditation uses the same MPRs
Site visits once every 3 years replaces annual
individual program reviews including the WIC
management evaluation
Affords an opportunity for program staff and
local health department staff to interact on a
regular basis in a positive collaborative way.
Thank you!
“Contract Transformers”
November 2-6, 2009
Insert team picture here
Cheryl Christie-DPH, Bruce Brown-DPH, Kathi Nelson Hancock,
John McMullen-DPH,Sherry Frizell-DPH,Sheri Stursma-DPH,Stacey
Hewitt-DPH, Dawn MouwDPH, Mindy Uhle-DPH,Doreen ChristensenCerro Gordo, Mark Vander Linden-DPH, Erin Barkema-DPH, Tim
Wickam-DPH,Diana Von Stein-DPH, Jody Lane-Molnari-DHS, Chris
Everson, MN Marcia Tope-DHS, Mike Rohlf-DM,
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This event will address the service
contracting process from when the Iowa
Department of Public Health program
initiates the writing of the competitive
selection document to the date the fully
executed contract is sent to the contractor.
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5.
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Decrease time from application deadline to contract
signature by 50%
Contract issued to contractor a minimum of 30 days
prior to start date
Reduce steps in the internal review process by 50%
Eliminate duplication of core information from each
provider for different applications by fiscal year 2011
contracts
Meeting established timeline 100%
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6.
7.
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A stream-lined process that improves efficiency and
timeliness
Strengthen relationships with our internal and external
customers
Standardized expectations for the internal and external
customers
Standardized terminology and formats across programs
Improve communication with external and internal
customers regarding process and responsibilities (including
training)
Establish timeline of RFP/contract process from start to
finish
Establish accountability
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Clear objectives
Team process
Tight focus on time
Quick & simple
Necessary resources immediately available
Immediate results (new process designed by end of week)
5S “mindset”--use the steps to support the event activities
 Sort, Set in order, Shine, Standardize, Sustain
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Insert picture of current process here
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Establish accountability
Eliminate Document Review
Define roles and responsibilities
Increase use of technology
Establish clear timelines
Standardization of forms and processes
Training (internal and external)
Improved communication (internal/external)
Insert picture of new process here
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CURRENT
Behavioral Health
HPCDP
ADPER
Total Steps
188
214
194
218
Total Delays
11
14
11
11
Average (BC)
Delay Time –
Days
(WC)
25
40
25
25
262
302
262
262
5
5
5
5
12
16
13
20
3
3
3
3
63
82
86
77
315.5
314
313
307
Value Added
Steps
Decisions
Loop Backs
Total Handoffs
Lead Time Days
58
Tobacco
Current
% Change
Total Steps
814
120
85%
Total Delays
47
8
83%
115
Nm
nm%
1,088
nm
nm%
8
3
63%
Decisions
61
12
80%
Loop Backs
12
1
92%
308
61
80%
526.5
153
71%
Average Delay
Time - Days
Value Added
Steps
Total Handoffs
Lead Time Days
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New
Homework
John
Item Description
Person Responsible
1
Place power point on shared drive
Cheryl
Nov. 9
2
Draft intranet message
Erin
Nov. 9
3
Elimination of Doc. Review
Erin
Nov. 16
4
Communication plan – internal and external
Bruce
Dec. 7
5
Determine what data to collect to measure baseline for
goals for team
Erin
Dec. 7
6
Clarify Roles and Responsibilities
Cheryl
Dec. 7
7
Mandate timelines (internal processes)
Mark
Dec. 7
8
Development of checklist for first meeting
Sheri
Dec. 7
9
5 copies – needed??
Dawn
Dec. 7
Item
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Due Date
Homework
Stacey
Item Description
Person Responsible
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Technology (WIKI, I-3, Share point, Hot Docs. Calendar)
Dawn
Dec. 7
11
Electronic Signature
Dawn
Dec. 7
12
Development of Tracking Spreadsheet
Sheri
Dec. 7
13
Posting of Q&A (process)
Stacey
Dec. 7
14
Resolution of late applications
Tim
Dec. 7
15
Lists serve notification
Dawn
Dec. 7
16
Follow-up survey to contractors (survey monkey)
Erin
Dec. 7
17
Evaluation Team
John
Dec. 7
18
Training plan-All Staff; Peer Training; Cross Training
Stacey/Mindy
Dec. 7
Item
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Due Date
Homework
Stacey
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Item
Item Description
Person Responsible
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Training curriculum
Stacey/Mindy
Jan. 15
20
Master Calendar (public)
Erin
Dec. 14
21
Eliminating Duplication of Core Contractor Info.
Cheryl
Feb. 15
22
Standardization of application forms
Diana
Feb. 1
23
Development of policies and procedures
Cheryl
Feb. 1
Due Date