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HomeMy WebLinkAboutCOM 0150.045 1998-2000 4~YtY Of M,f~Y,, J. CURTIS TYLER, III i ~,t,,,; Tel: (808) 961-8273 Councifinember yy]] Fax: (808) 969-3291 ~'S • of x~ COUNTY COUNCIL County of Hawaii Hawaii County BuitAing 25 Aupuni Street April 27, 1999 Hila, Hatuaii 96720 MEMORANDUM TO: James Y. Ar aki, Cha ncilmembers FROM: J. Curtis Tyler hai Human Serv es Fjco "t~i Committee SUBJECT: Transmittal of A/Sexual Assault Su rt Senices Sitc Review Re rts For your information, I am forwarding copies of two reports compiled by [hc Sex Abuse Treatment Center (SATC) of Kapiolani Medical Center for Women and Children (KMCWC). Both reports were transmitted to the Hawaii County Council's Committee on Human Services and Economic Development a[ my request. - The first report, a written summation of the YWCA Hawaii Island Sexual Assault Support Service (SASS) program was prepared by Gerald A Correa, M.D., a psychiatrist and clinical consultant to Kapiolani SATC. It was submitted to the Department of Health, State of Hawaii on April 14, 1999. The second report was prepared by Adriana Ramclli, M.S.W., Dircclor oC the Sex Abuse Treatment Center, and Allison Lopes, Direcor of Gmnts and Contmas for Kapiolani Medical Center Their findings were compiled after several sift monitoring visits to the SASS program and includes clinigl monitoring pcr(ormcd by Dr. Correa. Since July 1, 1997, the state department of health has contracted KMCWC to provide statewide sexual assault trqunent and community education services. KMCWC has subcontracted the YWCA of Hawaii Island to provide these services since July I, 1997. That subcontract will expire June 30, 1999. KMC WC has decided to issue a Request for Proposal (RFP) seeking qualif ed providers to furnish these services for the upcoming biennium period beginning July 1, 1999. Accordingly, there is a possibility that an agency other than the YWCA will be subcontracted to provide sexual assault support services on the Big Island in the very near future. In light of the programrnatic and clinical deficiencies noted in the attached reports, coupled with the issuance of a RFP seeking qualified prodders, I propose that the Council retain its present Cunding recommendation of SSQo00 for FY1999- 2000, with the provision that, upon submittal and review of an application for funds not to escced S50,1)D0, the Council may re-appropriate funds to the provider selected by the state contractor, KMCWC, effective July I, 1999. In that way, the Council can uphold its historical commitment to services for sexual assault victims and sustain effective liaison between the provider and our police, prosecutor, nurse examiners, and children's advocacy centers in Hilo and Kona. 1 have submitted a bill to amend Chapter 2, Article 25, Hawaii County Code, to provide clear authority for such intentional re-appropriation of funds. It is scheduled for first reading in the Finance Committee mceting on May 26. 1 hope this information is helpful. 1 am grateful for your thoughtful attention to these materials. 'y Attachments Comm. No. O' ~~5 cc: Legislative Auditor File No. u Finance Director P ~u NQ ~L Ref. Eo: Ref. Date NAY 0 5 1999 77-6399 Nalani St., Suite 1-A Kailua-Kona, Hawaii 96740 Kona Telephone: (808) 326-5684 Fax: (808) 326-5697 April 12, 1999 KAPI`OLANI MEDICAL CENTER z Connie Kiriu (or Women ~ Children Legislative Auditor County of Hawaii 25 Aupuni Street Hilo, HI 96720 Re: Statewide Sexual Assault Treatment and Community Health Promotion Services Dear Ms. Kiriu: The Sex Abuse Treatment Center (SATC) of the Kapi'olani Medical Center for Women and Children (KMCWC) has served the community for the past twenty two years and has received DOH funding since its inception in 1976. SATC is a provider of a comprehensive range of crisis intervention, treatment and prevention education services for sexual assault victims, their families, and the general public. Effective July 1, 1997 the State of Hawaii, Department of Health entered into a contract with KMCWC to provide statewide sexual assault treatment and community health promotion services. This current contract pot only requires the statewide provision of treatment and education services but also establishes the onset of the following statewide developmental and implementation components: • Sexual assault treatment and education needs assessment • Standards of care and practice for sexual assault treatment services, and • Standardized system of measuring the effectiveness of sexual assault treatment and education services KMCWC has subcontracted the YWCA of Hawaii Island to provide sexual assault treatment and education services for the island of Hawaii since July 1, 1997. The current contract is due to end Jure 30,1999. DOH has informed KMCWC that we have been selected as the sole source provider of statewide sexual assault services for the next biennium period beginning July 1, 1999. In turn, KMCWC has decided to issue a Request for Proposal (RFP) publication for the island of Hawaii, seeking qualified providers. Therefore, it has not been determined if the current contract with the YWCA Hawaii Island and KMCWC will continue or be terminated. It is our intent to publish the RFP in the last week of April 1999. We appreciate the opportunity to provide this information. Should you have any questions please do not hesitate to contact me at (808) 535-7507. Sincerely, Allison Lopes Director, Grants and Contracts 1319 Punahou Sveet Honolulu, Hawaii 96826 Telephone (BOB) 983-6000 KAPI'aLANI MEDICAL SPECIALISTS SATC Site Review Big Island YWCA SASS Program 1'r and 2"d Quarter 1999 , I. Review of Program Oaerations: The Sex As:~ault Support Service (SASS) of the Big Island YWCA is contracted by the Kapi'olani Medical Center for Women and Children (KMCWC) in July, 1996 to provider sexual assault services for the island of Hawaii. The range of services is to include sexual assault treatment and community health promotion services to women, children, and men throughout the island. Funding is through a contract with the State of Hawaii, Department ~f Health with the master contractor being KMCWC and managed through the KMCWC s Sex Abuse Treatment Center (SATC). The scope o'` services within this contract include Crisis intervention services 24 hours a day/ 7 days a week, 24 hours a day Crisis Phone Intakes and Hotline service, Crisis Stabilization and Crisis Counseling and Legal Advocacy Services. Following an investigational site visit by Kapi'olani's Director of Grants and Contracts and Kapi'olEni's Director of the Sex Abuse and Treatment Center, it was determined that there we re a number of serious contract non-compliance and program deficiencies. Four of the major deficiencies, identified have requiring monitoring and on-going consultation by this writer. They included 1) lack of any clinical supervision of SASS program per:~onnel and activities, 2) continued use of Bachelor's level SASS personnel to provide cl~unseling services, 3) reported service hours unsupported by the SASS client tracking system documentation and 4) insufficient crisis intervention services and clinical legal advocacy services hours to meet contracted scope of service. A case by c(~se review of the YWCA SASS Clinical Program commenced on January 14, 1999 anti Is ongoing on a weekly basis. In addition to the review of clinical services and clinical operations, on-going consultation and clinical supervision has been provided to file entire staff of the YWCA SASS since the start of the review process. General Cornments: 1. Since the departure of the Clinical/Program director in September 1996, there has been no direct clinical or programmatic supervision of the staff. However, after intervfew:~ with the current staff and reviews of the Ginical records, it appears that there have been deficiencies in the areas of clinical and program supervision prior to the past c'~irector's termination. 1319 Punahou Slraol. Gnz 5107 Honolulu, Hawall A(',g2(', YWCA SA8s Program Review Telcphono (000) 5??-0178 Apri114,1999 rnx teas) 977-3080 1 2. For exariple, there is no documentation of regularly scheduled supervision of the therapy :staff or crisis SASS on-call staff. Likewise, there is no documentation of clinical o~ program oversight that should have determined that clinical assessments, standardized rules of documentation (progress notes, encounter forms, etc.}, consistent chartlrecord keeping were grossly deficient. 3. The hiring of a new Program Director in January1999 has been fortunate. However, this Program Director has been hampered by a lack of a comprehensive understanding of the clinlcal and administrative obligations of the SA7C contract. This has bean measurably improved over recent weeks. A. The hiring of an under-qualified therapist for the Kona office, with acknowledgement of the S4SS staff that this was known has hampered the success of the SASS program and has significantly diminished SASS's ability to be an effective member of the pr~vlder community in the area of sexual assault treatment. Because of the departunj of the previous clinlcal/Program director, this therapist was not supervis~:d, given adequate orientation and training that is required for that position. The therapist has been terminated as of March 12, 1999 which again leaves West Hawaii without a clinical therapist end decreases the number of SASS crisis workers available for on-call responsibilities. 5. These dfrflclencies have impacted both the name and reputation of the YWCA in the area of :.ex Assault services to the degree that referral agencies (such as the Kona police of9cers, Child Advocacy Center and Child Protective Services have directed their referrals to other agencies. 6. The SA: S staff has been eager to accept direction, structure and supervision and have made gains in regponding to the consultations and directions given them by SA7C personnel. II. Review of clinlcal Records: Charge slip: for the 1`r Quarter, 1999 were tallied, as the agency's spreadsheets are lost. The Y\VCA figures reported for the 1`r Quarter 1999 reflect services provided paid for by Kapi'ulani SATC funds only. For the 2"tl Quarter, 1999, a total of 39 charts were reviewed from both the Hilo and Kona offices (33 from Hilo and 6 from Kona) which were all the charts available to me for this audit. This total number of cases consisted of all clients seen between July1, 1998 and December 31, 1998. General Comments: The overall ~:ondition of the clinical records were alarmingly deficient in all areas: 1. There was no consistent manner of documenting who was the identified client. For example, one chart could contain 1,2 or more names of family m ambers, often with different lest names. 2. Idantificatlon numbers were inconsistently assigned, as multiple family m ambers had the same ID numbers, only with an alpha letter inconsistently aclded on. YWCA SASS Program Ravlew April 14,1999 2 3. Thus, Consents for Treatment ar~d Rights and Responsibilities were in~:onsistently completed as it w•as unclear how many clients were being seen per clinical record. 4. Buth client and therapist often signed consents for "Authorization for Release of Information", but these forms were incomplete, s.g., no designation of who wFis tc be the receiving party. 5. A cumber of charts were incompletely assembled, although the cases were ongoing. ' 6. Charts were not consistently stored in a single, secured file cabinet. Some charts where kept by the therapist in her office, and some charts were taken ofl'the premises to be worked on at therapist's home. Clinical notes were kept on therapist's home computer and therefore not filed in the client's charts in a timely manner. 7. Closed charts were filed NOT by client name, but by initial date of service. This made the ability to locate a particular client's chart problematic et best. 8. Tt a vast majority of clinical records lacked adequate identification of the client or each page of the clinical record. 9. Fr3quently, personal /biographical data were lacking. 10. Some entries were not completely dated (i.e., no year was given on an entire pn~gress note sheet.) 11. A ~'ew of the provider signatures were difficult to decipher. , 12. Pragress notes by the cunent therapists were done by hand on paper, then transferred to a word processing document and printed sequentially on the same sheets of paper, giving the impression that notes were written in conglomerate, not after each session. This could have serious implications if re.:ords were to be subpoenaed by the courts. In addition, due to a therapist's home computer going 'down', there are a number of clinical charts wi•:hout any progress notes or treatment plans. Clinical review: 1. The vast majority of all charts had NO initial assessment, but for a one paragraph description of a client's history. 2. If ~r psychological assessment form was included in the chart (which was rare), there was no assessment that was completed with a signature and date. 3. Nu formal 5 Axis DSM-IV diagnosis was ever present in any of the clinical re~:ords 4. Although stipulated in the RFP, there was no evidence of GAF scores done on any client; the use of the MPSS for adults and CRI for clients 7-17years oici were rarely done or completed and none were scored with some StEilement about relevance of the scores obtained. 5. There was only ONE completed treatment plan in any of the charts reviewed. 6. This one treatment plan was signed only by the therapist of record without clinical oversight by a licensed social worker, clinical psychologist or psychiatrist in evidence. YWCA SA88 Proprsm R~vi~w April 74,1999 3 1 7. 6~3cause of the total lack of a multidisciplinary treatment plan (initial or review), there were a total lack of documentation of treatment goals related to a DSM-IV diagnosis. 8. Likewise, there was neither documentation of a problem list, time frames for goals to be achieved nor problems to be resolved nor documentation of any ccrosideration of termination of treatment. 9. Progress notes frequently described in adequate detail the current history of the client. However, there was a noticeable lack of documentation of the therapist's assessment of the current condition of neither the client nor any concrete plans for the client or tt~e therapist for the next session. 10.A review of the few termination summaries revealed a significant lack of d}agnosis; progress of stated gaats, condition of the client on discharge nor recommendations and disposition. Billing Documentation: 1. B~nsed on the YWCA SASS database, the following findings were noted: A. There Is a major discrepancy between whet is documented and what is reported AND what is expected (based on 2 therapists at 0.75 FTE; expected clinical hours = 18 hours/week face-to-face time.) B. There was a consistent error of charging case management" for time spent writing progress notes. C. The data base was difficult to interpret due to a poor database structure (e.g., using first name and last name of client in one cell, making it difficult to tally by client) 2. Charge slips are consistently turned in past the 48-hour deadline; they were often incomplete and often difficult to match client with service provided. In addition, a number of charge slips were often 'adjusted' by a therapist after bating turned into the office for tallying, resulting in confusion as to what cr urges were or were not entered. Items not met as part of the RPP Stipulations: 1. NO Clinical Initial Intake documenting past Mental Health and/or Substance Abuse history, Psychosocial functioning, current use of community resources. (page 26) 2. Outcome and Performance Measures: A. Global Assessment of Functioning (GAF) scores and measure of Improvement or change B. Modified PTSD Symptom Scale (MPSS) scores and measure of Improvement or change C. Ch(Id Recovery Index {CRI) scores and measure of improvement or change D. Accurate tallies of clients' health insurance information 3. Utilization of the submitted YWCA SASS Quality Assurance Plan (QAP) Forms YWCA 8A83 Program Review Apr11 14,1999 4 A. Listed forms that are claimed to be utilized are nowhere in evidence nor is there evidence that the QAP is even followed: 1) SASS Al -Frequency, Duration and Regularity of Support Specialist Supervision 2) SASS A2 -Frequency, Duration and Regularity of SART Member Supervision 3) SASS B1 -Content of Support Specialist Supervision 4) SASS B7 -Content of SART Member Supervision ' 5) SASS C1 -Observation of SART Hospital Attendance 6) SASS D1 -SASS Chart Review 7) SASS E1 -Intake and Assessment Chart Review 8) SASS F1 -Clinical Supervision Form Conclusion:: and Recommendations: There is Seri pus concern for the viability of the YWCA SASS program on the island of Hewali. The deficiencies noted above are severe, and their severity was only magnified by the previc us clinical/program director's departure in September 1998. The marked deficiency in the expected amount of crisis counseling services and legal advocacy se vices by the therapist(s), coupled with the very poor documentation, lack of clinical asse:rsments, case formulation and treatment planning suggests that the SASS program as I': currently exists is not equipped to provide basic mental health counseling services on fm on-going basis. The SASS crisis team, that provides 24-hour call crisis intervention services (telephone) and Forensic examination support, appears to be doing a good job. Documentation was again in~:onsistent and unstructured, but that has Improved w/ clinical supervision and training in the appropriate manner in which to document the team members' activities. Therefore, the following recommendations take into account the SATC contract's end date of 6/30/!9: 1. Rework filing system, client identification system to ensure discreet ident~cation numberrs, discreet client files for both clinical and legal confidentiality reasons 2. Implernent previous recommendations made to Program Manager regarding: a. FAX confidentiality both Kona and Hilo offices. Both fax machines are shared by other programs (one with a Teen Court office in Kona) and are NOT confidential. (Done 4/98) b. ID Name tags for all personnel having contact with public c. Us~3 of single scheduling book to document appointments and no-shows d. Us~~ of single scheduling book to reconcile charge slips e. Enforce mandatory attendance at monthly team meetings for SASS crisis workers and have sign-in sheets to document compliance YWCA BASS Program Raviaw April 14,1999 5 1 f. implement office accountability for ensuring timely response to messages g. Enforce standards of practice regarding progress note documentation (including evaluations, indlvldual progress notes), billlnra ttmeframes h. Enforce timely completion of psychological assessments, treatment planning dccumentation and discharge s4mmary documentation 3. Redu;e total therapist FTt3 time to 0.5FTE to address the actual amount of cilnicrd raervicea aulually dnllvered 4. Stron sly consider alliance with an island-wide clinical therapy group to handle all crisis psychotherapy and consolidate efforts to provide 24-hour crisis calls and forernac examination support anti ler~al advncacy services 5. Implement "OFFICE PROCEDURES". See Appendix "C". Respectfully submitted, ~ ~'r-vi.u.-, C3erald A. Correa, M.17. Child, Adolescent and Adult Psychiatrist Medical Dirsctor, Kapl'olani Behavioral tioallh Care Plans Clinical Con>ultant, Kapl'olanl SAYC and Cr'C YWCA SASS Program RevlNv April 1q,1009 8 w. ~ 'p d L y cp ~Q Ct ~ VC'1 v •~.U:o v ~ c~ V~p comp v,Oc ~+~u E~~u ~ to ? ~ F°- n°°. r ui vi ~ N ~ r N rr V ~ ~ ~ ~ ~ ~ in w Q d ~ ~D O~ tD d Q IJJ ~V J~ N z m ~ a Z la ~ C a` ' ti W lC r,+ H •c a i] Div y aci ~ ~ Q ~~cm wm ~ ~ cNa v ttt ~ tT h ~ M M r ~ y C_ ~ ~ N C N ~ ~ G ~ ~ ~ r U ~ ~ ~ ` ~ d d d ~ ~m c~a-~+~~a~iar-'e da C7~C7~dcC~~aY ~-a,,...~' N~NQc d N ~ d tri ~ ~ w t~~ C . . O H ~ E ~ s dew ~ ~ m ~ n a C N N Of ~ 07 C ~N d~vaNh N (O O ~ ~ d ~ n~ ~ o 0 0~ r; M ~ ~ Q~ ~ O to v~ m V ~ e{ ~ d' 00 N N t~7 (R ~ h NM VAN ~.-~~N Q r N N OI 16 ~ rn ~ ~ o o N w yy r 41 JQ Oiost~ oorti N OD (O e~ ~ m iY ~ K ~J ~ Z ~ ~ a~~ w "5 `o v, •'c a ` m N f- ~ Q Fa ~ c~~n g~o~o O( tD ' N Q d Mf t7 U ~ ao o~ (~J ni r~ ~ ~C M c9 ~ ~T Q ~ ~ o a e~i, y~ ~j ttpp- YY V7 N 00 O r V Q~t~l Ne'f O~1 N~f0 ~b9 a^ r t- } C m ~ E C ~c ~ c W Q ~ ~ d paNZW ~ f. ~ ~ ~ ~ ~wQxQ bxw pc°c~'~~~~a ~ h X ~W (D ~X ~ W ~ ~LL~~(( ' 0.'fF-uotiGW 4 C0 V a W u. C7 x. X J ~ Z O G. _ APPENDIX C BIG ISLAND YWCA -SASS Office procedures: Client contacts and documentation 1. All cl ants are required to have individual charts with appropriate consents and • authorizations signed and in each chart. 2. ALL DOCUMENTS (progress notes, phone reports, crisis stabilization reports, etc) acre to be completely signed and dated by the caregiver. Any subsequent conts~cts and/or activities are to be documented on a progress note. 3. ALL DOCUMENTS are to have the client's full name and ID number on each page (and each side if form is 2-sided). Q. It is E:VERYONE's responsibilities to ensure that each client record is complete and up to date. ' a. All entries are fo be dated end signed each time a contact or activity is performed. b. All appointments are to be recorded in the SASS APPOINTMENT BOOK and will be the official document for which all activities and billings will be reconciled. c. Each staffs (therapist or crisis intervention worker) schedule of available appointment hours are to be rnarked in the SASS APPOINTMENT BOOK in order for the clerical staff to be able to schedule appointments. d. All meetings, off-site appointments etc. are to be documented in the SASS APPOINTMENT BOOK to avoid errors in scheduling of clients. e. These schedules are to be kept up to date and should reflect at least 2-3 weeks in advance. f. At the end of each dav, tho SASS worker is to reconcile the day's appointments and record on the SASS APPOINTMENT BOOK what actually occurred: 1) Each client listed on the SASS APPOINTMENT BOOK for that day should be 'checked off' by the clerk when the client arrives fora scheduled appointment. 2) The therapist or crises worker puts by each client's name what actually occurred: The convention will be "1"for full session," 1/2" for half-session, "NS° for no show, "RS" for rescheduled, "NC° for no charge. g. A progress note for each contact will reflect the above designations where appropriate. For example, if the client is a "NO SHOW ,that occurrence should be documented in the progress notes. h. A completed charge slip is to be turned in to clerk within 48 hours of ' completed appointment. There are NO EXCEPTIONS. YWCA SASS Program Revlsw April 14,1999 8 APPENDIX C BIG ISLAND YWCA -SASS (continued) i. The charge slip will be reconciled with the SASS APPOINTMENT BOOK by the clerk. Any discrepancies will be returned for immediate correction(s). 5. ALL D9ESSAGES (SASS office andlor answering service) are to be recorded on ' the SASS MESSAGE LOG (automatic carbon) with complete names, time and date of call and message. 6. ALL f;ECORDS are to be stored in the file cabinets at all times. No charts are to be taken outside the facility. ' 7. All phone reports or crisis stabllizatian cases that require follow-up contacts and/or initial appointment(s) are to be logged in with time and date given to therapist for scheduling. Follow-up with therapist by clerk will be within 24 hours there~~fter, t i YWCA SASS Program Ravlew April 14,1999 10 YWCA Sexual Assault Support Service-Hawaii 4/6199 Analysis of fiscal year 1999 quarter 1 and quarter 2 (Q1 & Q2) expenditure and program reports for the general funds contract. Note: The unit cost indicated for the quarterly tables are calculated by dividing the , agency's fi>cal expenditure by units confirmed by master contractor (MC). I. Cr s I rtervention Services Target for r]1 and Q2: • 50% of annual service units (890): 445 50% of annual expenditure ($67,717): $33,858.50 • Unit co ~t as calculated for fiscal year: $76.09 gUARTER 1;-Report of expenditures (personnel cost-salaries,& wages) ' . as ¢ubmitted by agency and projected targets as calculated by master , contractor. Staff FTE % time Total Hours Target Billable charged to (24 hr. service) {60% direct service) contrast Gibson .10 NA Rusnak .OB NA O'Brien .11 NA Enri ues .OS NA SART On• .33 NA call NA TOTAL .86 NA Q1 TOTALS Units Reported Units Confirmed Agency Fiscal Unit Cost B A enc b MC Ex enditure for Service 140.07 Not able to $12,082 $86.26 confirm' - 'YWCA HI no! able fo provide KMCWC w(th documentation to confirm. 1 QUARTER t -Report of expenditures (personnel cost-salaries & wages) as submittr:d by agency and projected targets as calculated by master contractor ' Staff FTE % time Total Hours Target Billable charged to (24 hr. service) (BO% direct service) contract Gibson .10 NA Rusnak .O6 NA O'Brien .11 NA Enrl ues .05 NA SART On- .33 NA Cell TOTAL .65 ~ NA Q2 TOTALS , Units Repcrted Units Confirmed Agency Fiscal Unit Cost B A enc b MC Ex enditure for Service 84.79 48.27 $12,082 $250.30 Q1 8 Q2 SUMMARY -Crisis Intervention Services ~ Target Units Units Variance Agency Fiscal Unit Cost Units Reported By Confirmed Expenditure for A enc b MC Service 445 224.86 188.34' -256,66 $24,164 $128.30 (at 42% of (71% budget) tar et bud et "YWCA HI not a6/e to provide KMCWC with documentation to confirm Q7, ref/acted z t reported amount. Total units provided 188.34 Lb program's unit cost of $76.09=$14,330.79 2 ID >t):=~~-°,>`-.'S.i. HFr lt. ~ 1. i~,~~ ~ II. Clinicallletlal advocacy aervlces Targets for 01 & 02: • 50% ar Heal service units (863):431.50 • 50 % a lnual fiscal expenditure ($82,G76): $41,338 • Unit co:~t as calculated for fiscal year: 595.80 p (p ties & wages) , QUARTER'I -,Report of ex enditures ersunnel cost-sala es submittt~d b a enc 'arid pro acted tar ets as calculated b master contractor Stall FTE % tlme Total Hours Target Blliabla 90% AtlJusted charged to (5281hrs) (60% direct Holidayl contract servlce Vacation Enriques .11 58.08 34.85 31.36 Gibson 14 73.92 44.35 39.92 Rusnak .05 26.40 15.84 14.26 TOTAL .30 158.40 95.04 85.54 01"TOTALS Units Repcrted Units Confirmed Agency Fiscal Unit Cost B A enc b MC Expenditure for Service 78.99 161.97" $13,929 $176.34 `KMCWC ivas told by YWCA H/ that only 78.99 clinical hours were funded by KMCWC contract, and that the balance was funded by YWCA VOCA contract. QUARTER a - Reporl Ot expenditures (personnel cost-salaries & Wages), as submitted b ages and pro'ected to ets as calculated b master contractor 9taH FTE % tlme Total Hours Target Blilable 90% AdJusted charged to (5281hrs) (80% direct Holidayl contract servlce Vacation Enri ues .11 58.08 34.85 31.36 Gibson .14 73.92 44.35 39.92 Rusnak .05 26.4D 15.84 14.26 TOTAL .30 158.40 95.04 85.54 Q2 TOTALS,, , Units Reported Units Confirmed Agency Fiscal Unit Cost B A enc b MC Expenditure for Service 242.OC 131.09 $13,930 $106.26 3 Q1 8 Q2 SUMMARY - CllnicaULega1 Adv:,cacy Services Target Unlta Units Variance Agency Fiscal Unit Coat Units Rzported isy Confirmed Expenditure A enc b MC for Service 431.50 320.99 210.08" -221.42 $27,859 $132.61 (at 49% of (97% budget) tar et bud et) 'KMCWC was told by YWCA HI that only 78.99 clinical hours were funded by KMCWC contract, and that the balance was funded by YWCA VOCA contracf. Total units vrovided 210.08 @ programs unit cost o($95.80=$20,125.66 III. Comm unity Health Promotion Services Targets fo r q1 8 D2: 50% of annual service units (166) 83.00 0 50% of annual fiscal expenditure ($10,572): $5,286 ° Unit co'>t calculated for fiscal year: $63.69 QUARTER%I,• Repoli of ezpenilitures (personnel Cost-salaries & wages): as submitted b aenc -and ro acted tar ets as calculatetl b master contractor; Staff FTE % time Total Hours Target Billable 90% Adjusted charged to (5281hrs) (80% direct Holiday! contract service Vacation Gibson .01 5.28 3.17 2.85 Eceves 05 26.40 15.84 14.26 Enri ues .07 36.96 22.18 19.96 TOTAL .13 88.84 41.19 37.07 q1 TOTAL8 , Units Repcrted Units Confirmed Agency Fiscal Unit Cost t3 A enc b MC Ex enditure for Service 28.25 Not able to $2,053 $78,21 confirm' `YWCA Hl not a61e to provide KMCWC with documentation to confirm. gUARTER .t -Report of expenditures (personnel cost-salaries & wages) as submitted b a -enc and ro acted tar ets as calculated 6master contraotor~ Stall FTE °!o time Total Hours Target Billable 90% Adjusted charged to (5281hrs) (60% direct Holiday! contract service Vacation Gibson .01 5.28 3.17 2.85 Eceves .05 26.40 18.84 14.26 Enri ues .07 36.96 22.16 19.98 TOTAL .13 88.84 41.19 37.07 4 1 L V _ _ _ _ _ _ n _ _ , - - - - - Q2 TOTALS Units Repoted Units Confirmed Agency Fiscal Unit Cost B A enc b MC Expenditure for Service 70.50 70.50 $2,053 $29.12 t17 & Q2 3 UMMARY - Communit Health Promotlon'Servlces Target Units Units Variance Agency Flacal Unit Cost Units Reported By Confirmed by Expenditure for A enc MC Service 83 98.75 96.75' +13.75 $4,106 $42.44 (at 117% of (77% budget) ter et bud et) "YWCA HI not able to provide KMCWC with documentation to confirm Q1, reflected at reported amount. Total units provided 96.75@ program's unit cost of $63.69=$6,162.01 S