340 Review Stakeholder Workgroup Fifth Meeting August 23, 2022 10 am

340 Review Stakeholder Workgroup Fifth Meeting August 23, 2022 10 am – 2:15 pm Columbus, Ohio

Welcome to the fifth 340 Review Stakehold er Workgrou p Meeting THANK YOU FOR JOINING US. THE MEETING WILL BEGIN SHORTLY. Workgroup MEMBERS who are attending in person, please also join the meeting on Teams. Please mute your laptop speaker and your Teams audio to prevent sound feedback. Please use the microphones in the room—this will ensure we get a good recording since we are in a larger room with a higher ceiling. Workgroup MEMBERS who are attending virtually via Teams, please make sure your computer audio is turned on and use your Teams mute/unmute to participate in the meeting. ALL Workgroup MEMBERS: Please leave your Teams video on as you feel comfortable, but we ask that you turn it on when speaking. When you’d like to speak, please use the “raise hand” function in Teams to alert me. Members of the PUBLIC and MEDIA who are joining virtually via Teams, make sure your audio is turned on to hear the meeting. If you have any difficulty joining virtually, you may also dial in by phone by calling 614.721.2972 and use passcode: 512 966 878#. All public participants will be in listen-only mode. There will be a public comment period following the presentation and member discussion, and all comments and questions can be submitted via the chat function in the Teams meeting or emailed to [email protected]. Closed captioning is available to all Teams participants through the “Turn Live Captions On” function under the ellipses ( ) icon in the top right corner.

Our Agenda Today 1. Welcome and Overview of the Agenda 2. Roundtable Discussion – ADAMHS Board Contracting Authority 3. Lunch Break 4. Roundtable Discussion – Miscellaneous Topics 5. Roundtable Discussion – Landmark Thinking Moving Forward 6. Public Comment Opportunity 7. Upcoming Regional Listening Sessions 8. Adjourn

ADAMHS Board Contracting Authority Roundtable Discussion: R.C. 340.036

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports SUMMARY BY DIVISION Division (A) – REQUIREMENT TO CONTRACT Requires each ADAMHS board, subject to rules adopted by the OhioMHAS Director, to enter into contracts with: (1) Public and private facilities for the operation of facilities; (2) Community addiction services providers for addiction services and recovery supports; and (3) Community mental health services providers for mental health services and recovery supports. Division (B) - PROHIBITIONS Prohibits a board from doing any of the following: (1)Contracting with a residential facility required to be licensed by OhioMHAS unless the facility is so licensed; (2)Contracting with a community behavioral health (BH) services provider for certifiable services and supports unless those services and supports are certified by OhioMHAS; and (3)Contracting with a BH services provider for recovery supports that are required by the OhioMHAS Director to meet quality criteria or core competencies unless the recovery supports meet those criteria and competencies.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports (continued) SUMMARY BY DIVISION Division (C) – CONDITIONS ON CONTRACTING Specifies conditions on an ADAMHS board contracts when it contracts with a community BH services provider: (1)The board must consider both (a) the cost effectiveness and quality of the provider’s services and supports and (b) continuity of care. (2)The board may review cost elements, including salary costs, of the services and supports. (3)The board may establish, in a way that is most effective and efficient in meeting local needs, a utilization review process as part of the contract.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports (continued) SUMMARY BY DIVISION Division (D) - 120 DAY NOTICE REQUIREMENT Specifies that if a board or community BH services provider proposes not to renew a contract or proposes substantial changes in contract terms, the other party must be given written notice at least 120 days before the expiration date of the contract. Requires that during the first 60 days of this 120-day period, both parties must attempt to resolve any dispute through good faith collaboration and negotiation in order to continue to provide services and supports to persons in need. Permits either party, if the dispute is not resolved 60 days before the contract’s expiration, to notify the OhioMHAS Director of the unresolved dispute. The Director may then require both parties to submit the dispute to another entity with the cost shared by the parties. (NOTE: This provision was removed in 2011 through the main budget act for the 129th General Assembly, H.B. 153; but then it was restored the next year in 2012 through the Mid-Biennium Review bill for the 129 th General Assembly, H.B. 487). My understanding from other OhioMHAS staff is that it has not been used.) Requires that, not later than 20 days before the contract’s expiration or a later date to which both parties agree, the other entity to issue to the parties and the Director recommendations on how the dispute may be resolved. The Director must adopt rules establishing procedures of this dispute resolution process. Specifies that competitive bidding requirements (under R.C. 307.86) do not apply to these contracts.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports (continued) SUMMARY BY DIVISION DIVISION (E) – COMPETITIVE BIDDING Specifies that competitive bidding requirements (under R.C. 307.86) do not apply to these contracts.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports DIVISION COMMENT THEMES FROM SURVEY DIVISION (A) – Requirement to contract No specific comments. Requires each ADAMHS board, subject to rules adopted by the OhioMHAS Director, to enter into contracts with all of the following: (1) Public and private facilities for the operation of facilities; (2) Community addiction services providers for addiction services and recovery supports; and (3) Community mental health services providers for mental health services and recovery supports.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports DIVISION DIVISION (B) – Prohibitions Prohibits a board from doing any of the following: (1)Contracting with a residential facility required to be licensed by OhioMHAS unless the facility is so licensed; (2)Contracting with a community behavioral health (BH) services provider for certifiable services and supports unless those services and supports are certified by OhioMHAS; and (3)Contracting with a BH services provider for recovery supports that are required by the OhioMHAS Director to meet quality criteria or core competencies unless the recovery supports meet those criteria and competencies. COMMENT THEMES FROM SURVEY Remove (B)(3), which prohibits a board from contracting with a BH services provider for recovery supports that are required by the OhioMHAS Director to meet quality criteria or core competencies unless the recovery supports meet those criteria and competencies. Clarify (B)(3), so that it does not preclude contracting with recovery housing operators but rather requires those entities to meet the quality criteria for recovery housing.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports DIVISION DIVISION (C) – Conditions on contracting Specifies conditions on an ADAMHS board contracts when it contracts with a community BH services provider: (1)The board must consider both (a) the cost effectiveness and quality of the provider’s services and supports and (b) continuity of care. (2)The board may review cost elements, including salary costs, of the services and supports. (3)The board may establish, in a way that is most effective and efficient in meeting local needs, a utilization review process as part of the contract. COMMENT THEMES FROM SURVEY Clarify (C)(2), which specifies that a board may review cost elements, including salary costs, of the services and supports when contracting with a provider.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports DIVISION DIVISION (D) – 120 day notice requirement Specifies that if a board or community BH services provider proposes not to renew a contract or proposes substantial changes in contract terms, the other party must be given written notice at least 120 days before the expiration date of the contract. Requires that during the first 60 days of this 120-day period, both parties must attempt to resolve any dispute through good faith collaboration and negotiation in order to continue to provide services and supports to persons in need. Permits either party, if the dispute is not resolved 60 days before the contract’s expiration, to notify the OhioMHAS Director of the unresolved dispute. The Director may then require both parties to submit the dispute to another entity with the cost shared by the parties. Requires that, not later than 20 days before the contract’s expiration or a later date to which both parties agree, the other entity to issue to the parties and the Director recommendations on how the dispute may be resolved. The Director must adopt rules establishing procedures of this dispute resolution process. Specifies that competitive bidding requirements (under R.C. 307.86) do not apply to these contracts. COMMENT THEMES FROM SURVEY 120 day notice period needs clarification or revision. It has been widely interpreted, misapplied, and now being litigated by boards and providers. Length of contractual period should be owned by the boards. Provisions should not allow boards to reserve the right to implement changes. Boards lack flexibility to changes services, funding, and provider mix; providers lack flexibility to change program, staff, services, etc.

R.C. 340.036 – Authority of ADAMHS board to contract for services and supports DIVISION DIVISION (E) – Competitive bidding Specifies that competitive bidding requirements (under R.C. 307.86) do not apply to these contracts. COMMENT THEMES FROM SURVEY Add language to explicitly permit boards to use a selection process for services and supports in a board’s continuum of care since this authority continues to be questioned despite court rulings stating boards have that discretion.

Miscellaneous Topics Roundtable Discussion: R.C. 340.13, 340.11, and 340.10

R.C. 340.13 – Setting aside contracts for bidding by minority business enterprises only SUMMARY Requires an ADAMHS board to strive to set aside each fiscal year 15% of the aggregate value of contracts for equipment, materials, supplies, or services (other than 340.036 services) for minority business enterprises (MBEs). In general, an MBE must be owned and controlled by a U.S. citizen who is an Ohio resident and a member of one or more of the following minority groups: Blacks or African Americans, American Indians, Hispanics or Latinos, and Asians. If no bid for such a contract is made, specifies that the contract must be awarded according to normal bidding procedures. Requires, to the extent an ADAMHS board is authorized to enter into construction contracts, the board to strive to set aside each fiscal year 5% of the aggregate value of construction contracts for EDGE business enterprises. EDGE business enterprises are economically and socially disadvantaged business enterprises certified by the Director of Development as participants in the Encouraging Diversity, Growth, and Equity (EDGE) Program. Permits a board unable to comply that goal (after making good faith effort) to apply to the OhioMHAS Director for a waiver or modification of that goal. Requires boards to file yearly reports with OhioMHAS with certain information related to demonstrating compliance with this section.

R.C. 340.13 – Setting aside contracts for bidding by minority business enterprises only COMMENTS FROM SURVEY Modify the definition of MBE to include women, veterans, and individuals with disabilities. In division (C), consider increasing (from 15 to 25%) the set aside for equipment, materials, supplies, and certain services contracts. In division (C), authorize the achievement of the 15% set-aside standard by allowing non-MBE businesses to serve as primary contractors with the obligation to subcontract with MBEs; the intent would be to provide business for MBEs when the MBEs themselves aren’t able to meet the requirements to serve as the primary entity.

R.C. 340.11 – Liability insurance SUMMARY COMMENTS FROM SURVEY Minimal response on this: Authorizes an ADAMHS board to procure an Boards avoid liability insurance insurance policy insuring board members or Policy procurement policies do not match between employees of the board or providers with providers, boards which the board contracts against liability arising from the performance of their official duties. Specifies that if the liability insurance is unavailable or the amount a board has procured or is able to procure is insufficient to cover the amount of a claim, the board may indemnify a board member or employee for certain actions/inactions or against certain expenses.

R.C. 340.10 – County auditor is auditor and fiscal officer of ADAMHS district or joint-county district SUMMARY COMMENTS FROM SURVEY Specifies that the auditor and fiscal officer of a ADAMHS Keep politics out. district is the county auditor. Language on who is the auditor and fiscal officer of a joint-county ADAMHS district is unclear (there may be a mistake in drafting). Specifies that state funds allocated for the support of a service district must be paid to the county treasurer or, in a joint-county ADAMHS district, to the treasurer of the county designated in an agreement as the custodian of the funds. Specifies that the treasurer is authorized to make payments on the order of the county auditor and on recommendation of the ADAMHS board or the board’s executive director when authorized by the board. Requires the auditor to submit to the board a monthly statement of receipts, disbursement, and ending balances for the funds of AS, MHS, and recovery supports.

Landmark Thinking Moving Forward Roundtable Discussion

Common Theme Through All Workgroup Meetings The community-based behavioral health system of care must be (1) personcentered and (2) emphasize not just treatment of mental illness and substance use disorders but also overall health, wellness, and recovery.

(1) Are there imaginative/creative ways of transforming the current behavioral health system of care to make it more personcentered and emphasize overall health, wellness, and recovery? Question s to Consider (2) What would this transformation look like when fully implemented? (3) What role would various players play in this transformation: ADAMHS boards, providers, people with lived experience, family members, OhioMHAS, and others? (4) What are the barriers and challenges to accomplishing this transformation?

Public Comment Opportunity Please submit comments and questions via the Teams chat or via email to [email protected].

Upcoming Regional Listening Sessions DATE Monday, September 19 (2 hours – afternoon) REGIONAL PSCHIATRIC HOSPITAL CATCHMENT AREA(S) Twin Valley Behavioral Healthcare Thursday, October 13 (2 hours – afternoon) Northcoast Behavioral Healthcare & Heartland Behavioral Healthcare Thursday, October 27 (2 hours – afternoon) Appalachian Behavioral Healthcare Monday, November 11 (2 hours – afternoon) Summit Behavioral Healthcare Monday, November 14 (2 hours – afternoon) Northwest Ohio Psychiatric Hospital

Upcomin g Regional Listenin g Sessions Meeting Format Meeting Agenda

THANK YOU Connect with us online at: https://mha.ohio.gov/community-partners/advisor y-groups/340-workgroup or by email at: [email protected]