addendum packet · city and borough of juneau assembly finance committee meeting wednesday, april...

City and Borough of Juneau Assembly Finance Committee Meeting Wednesday, April 29, 2015, 4:30 p.m.

Assembly Chambers

Addendum Packet

JEDC.org 612 West Willoughby Ave. Suite A

Juneau, AK 99801 Phone 907‐523‐2300

Fax 907‐463‐3929

Mayor Merrill Stanford Office of the Mayor City and Borough of Juneau

April 14, 2015

Dear Mayor Stanford,

The Juneau Economic Development Council looks forward to undertaking our assigned actions alongside our community partners to accomplish identified goals and objectives in the Juneau Economic Plan. The enthusiasm and momentum that has been generated in the community during the development of the plan must now be harnessed to make the transition from planning to implementation quickly and smoothly. JEDC would like to offer to the CBJ our hands‐on experience with implementing, promoting and supporting pragmatic consensus‐based economic development initiatives within Juneau and the region. JEDC feels that the overall impact on our economy will be greater if actions of the plan are coordinated and, to the degree possible, integrated with other community actions and initiatives.

With CBJ funding, JEDC can serve in a coordinating capacity to support overall implementation of the Juneau Economic Plan. Funding would be used to accomplish the following tasks:

Overall Plan Support and Coordination: JEDC would first convene an AdvisoryStakeholder Group consisting of the CBJ City Manager (or designated representative/s),some members of the CBJ Assembly, and 8‐10 other civic and business leaders withspecial insight into economic issues in our community. This group will initially be taskedwith establishing key metrics that can be tracked to indicate overall progress oninitiatives. We anticipate this group will then continue to meet on a quarterly basis tomonitor and ensure that overall plan progress is made. This group will be tasked withthe responsibility to report out to the Assembly and the public with an update onimplementation and economic impact. JEDC will provide quarterly meeting facilitationand administrative support (agenda preparation, convocation, meeting summaries,follow‐up actions) to this group.

Implementation of Eight Initiatives: JEDC proposes that progress on each specific actionthat supports the eight initiatives identified in the plan can best be achieved if regularmeetings are convened of key initiative stakeholders to oversee and support progress.

2

JEDC will convene an implementation team for each of the eight initiatives, consisting of a representative of each of the community groups, organizations or agencies assigned to accomplish the actions within that initiative. These eight Implementation teams will each meet monthly to track and report out on tasks accomplished, to coordinate their activities, and to trouble shoot any obstacles to proposed actions. JEDC will provide facilitation and administrative support (agenda preparation, convocation, meeting summaries, follow‐up actions) to each Implementation Team.

Communications: To keep the public informed as progress toward goals areaccomplished, JEDC will maintain and update a web presence dedicated to the Planimplementation.

Annual Report on Progress and Annual Update to Plan: On an annual basis, JEDC willprepare a summary review of all activities and achievements for the year on behalf ofthe Advisory Stakeholder Group to present to the CBJ Assembly. In addition, the JuneauEconomic Plan, created under the economic scenario of 2014, should be a livingdocument, not a static plan rigidly frozen at that date. JEDC will facilitate an annualplanning session to review and update the Plan, and re‐prioritize actions and activitiesbased on changes in the local, national and world economy.

Discretionary and Incidental Funds: It is anticipated that implementation teams mayhave a need for discretionary funds to cover incidental expenses. Therefore, funding isrequested to create a small discretionary funding pool. JEDC will manage requests fordisbursements from this fund.

This funding request is for a total of $99,600, annually, distributed as follows:

Task Level of Effort Funds Requested

Overall Plan Support and Coordination

One week per quarter (160 hours) $10,400

Implementation of Eight Initiatives

One day per initiative per month (768 hours)

$49,240

Communications Two days per month (192 hours) $12,480

Annual Report on Progress and Annual Update to Plan

Two weeks per year (80 hours) $5,200

Discretionary and Incidental Funds

$6,000 $6,000

Overhead 20% (Rent, Accounting, Phones) 15,600

Total Request per year $99,600

3

JEDC will be happy to provide more detail about this coordinating role proposed to provide plan implementation oversight and the additional resources which would be required to be most effective. We look forward to working closely with the CBJ to realize the potential of Juneau’s Economic Plan.

Sincerely,

Brian Holst

4

CBJ AFC MeetingApril 29, 2015

CBJ Funding for Education

CAP Funding Funding

Outside of Cap Total

School District Request on 3/31/2015 24,982,600$ 770,000$ 25,752,600$

Assembly Initial Commitment as of 4/22/2015 24,526,900 - 24,526,900

Difference 455,700$ 770,000$ 1,225,700$

Information as of April 28, 2015State Funding Scenario 24,926,000$ 770,000$ 25,696,000$ Legislature's Adopted Budget -- Reduced foundation, No state grants

Difference 399,100$ 770,000$ 1,169,100$

Funding Request Outside of CapStudent Activities 565,000$ Pupil Transportation Middle & Elementary School Activities 35,000 Homeless Students 35,000 Subtotal 70,000 Community Schools 135,000 Total 770,000$

5

Juneau School DistrictRevised Operating Fund Budget Scenarios

FY 2016

For releaseApril 28, 2015

Scenario 1

DistrictApproved

Budget

Governor's Requested

Budget 2 3

Legislature Adopted Budget

Revenue Increases (Decreases)CBJ Funding -56,600 -56,600State Foundation (Net of enrollment adjustment) 175,048 -398,613State Grants -559,555 -559,555Fund Balance Estimate 0Revenue Increases (Decreases) -441,107 -1,014,768

Expenditure ReductionsTighten teacher discretionary budget 20,000 20,000 20,000 20,000 20,000 20,000Reduce 4 instructional coaches 410,424 410,424 410,424 410,424 410,424 410,424Move MAPS to grant funding 56,278 56,278 56,278 56,278 56,278 56,278Revise assumptions for negotiations 249,750 249,750 249,750 249,750 249,750 249,750Revise heating oil per gallon price 111,000 111,000 111,000 111,000 211,000 191,424Reduce supplies, materials & media 120,000 120,000 120,000 120,000 120,000 120,000Cut district-wide budget 100,000 100,000 100,000 100,000 100,000 100,000Postpone social studies curriculum 240,000 240,000 240,000 240,000 240,000 240,000Reduce (Increase) JCCS allocation -11,284 3,691 17,965 17,965 17,965 17,976Reduce financial support for high school activities 293,500 293,500 293,500 293,500 293,500Cut district level budget, second time 125,025 125,025 125,025 125,025 125,025Change teacher allocation in Gr 3 - 5 by 1.00 0 153,906 153,906 153,906Change teacher allocation in Gr 6 - 8 by 1.00 256,512 256,512 256,512 256,512Change teacher allocation in Gr 9 - 12 by 1.00 266,776 266,776 266,776 266,776Reduce school budgets by 10% 64,216 64,216 64,216 64,216 64,216Reduce support staff (1.00 FTE) 66,209 66,209 66,209 66,209 66,209Eliminate high school intramurals 29,699 29,699 29,699 29,699 29,699Eliminate drug testing 0 0 21,375 21,375 0Adjust for revised enrollment projection -105,070 -105,070Adjust for grant funding changes -24,629 -24,629Keep principal FTE at current levels 64,746Eliminate financial support for elem student activities 30,000 0Eliminate middle school activity financial support 15,000 0Eliminate middle school activity stipends for coaches 33,501 0Change teacher allocation in Gr K - 2 by 1.00 307,818Expenditure Reductions 1,296,168 1,889,792 2,297,655 2,602,635 2,781,136 2,904,560

6

Ordinance April 28, 20152015-21 JSD Request Difference

State law required minimum local contribution 13,094,500$ 13,027,948$ (66,552)

Additional CBJ funding per the State Foundation Funding Formula 11,888,100 11,898,052 9,952

Subtotals * 24,982,600 24,926,000 (56,600)

CBJ Funding outside the CAP 770,000 770,000 -

Totals 25,752,600$ 25,696,000$ (56,600)

CBJ AFC MeetingApril 29, 2015

CBJ Funding for Education

7

BARTLETT REGIONAL HOSPITAL

COMPARATIVES

FY14 Amended Projected Approved RevisedActuals Budget Actuals Budget Budget

EXPENSES:Personnel Services 49,706,000$ 51,718,400 58,947,300 52,752,800 55,522,000 Commodities and Services 24,962,500 25,534,400 20,063,300 26,047,700 25,326,400 Capital Outlay 1,738,200 7,207,500 5,400,000 7,212,800 7,212,800 Debt Service 1,680,000 1,656,700 1,656,700 1,652,100 1,656,700 Support to General Fund 100,000 130,000 240,000 130,000 340,000 Total Expenses 78,186,700 86,247,000 86,307,300 87,795,400 90,057,900

FUNDING SOURCES:Charges for Services 80,198,700 86,591,500 86,074,200 82,891,500 87,954,800 State Grants 717,700 - 613,500 - 685,000 Interest Income 621,200 73,500 180,300 128,400 180,300 Support from:Liquor Tax 987,000 945,000 945,000 945,000 945,000 Tobacco Excise Tax 136,000 178,000 178,000 178,000 518,000 Marine Passenger Fee 54,500 61,500 61,500 61,500 90,000

Equity From (To) Fund Balance (4,528,400) (1,602,500) (1,745,200) 3,591,000 (315,200) Total Funding Sources 78,186,700$ 86,247,000 86,307,300 87,795,400 90,057,900

STAFFING 420.18 434.65 434.65 434.65 434.65

FUND BALANCE 49,050,600$ 50,653,100 50,795,800 47,204,800 51,111,000

FY15 FY16

as of 4/28/2015

8

BARTLETT REGIONAL HOSPITAL RESPONSES TO QUESTIONS FROM ASSEMBLY MEMBERS OF THE

CITY AND BOROUGH OF JUNEAU April 15, 2015

Thank you for a good discussion during our budget presentation and for opportunities to answer the questions that were asked. Question from Ms. Crane: Should the standard for days cash on hand be the same for Bartlett, with CBJ’s treasury backing, as for other hospitals? Bartlett Response: Benchmarks for hospitals affiliated with municipalities are not readily available. Bartlett compares its cash balances with industry benchmarks. We are seeking out bond industry experts to answer this question. Bartlett’s leaders will meet with CBJ Finance and Treasury to discuss Bartlett’s cash on hand and its requirements. Question from Mr. Kiehl: Mr. Kiehl requested examples of Bartlett’s strategic fee increases. Bartlett Response: Attached are examples from the past couple of years of Bartlett’s strategic pricing implementation. SEE EXHIBIT A. Bartlett’s Senior Leaders are working with managers of the clinical departments to review costs and the hospital’s fees. Bartlett’s Finance Committee will review pricing changes at its May 21, 2015 meeting. Bartlett will provide specific examples for 2016 to the CBJ Assembly following the May Finance Committee meeting. Question from Mr. Jones: How can we predict higher Emergency Department volumes given Medicaid expansion and Housing First? Bartlett Response: Fiscal 2015 will be close to 15,000 visits. When projecting Fiscal 2016, Bartlett used volumes from February 2014 through January 2015. We do not expect either the Housing First Project or Medicaid Expansion to happen this fiscal year. Interestingly, the experience of other states that have implemented Medicaid Expansion is that Emergency Department use actually rose the first couple of years due to pent up demand and difficulty getting in to a primary care provider.

9



EMERGENCY DEPT. VISITS

YEAR TOTAL

FY 2011 Actual 14,636

FY 2012 Actual 14,416

FY 2013 Actual 14,565

FY 2014 Actual 14,384

FY 2015 Budget 14,131

FY 2015 Projected 15,121 Question from Mr. Jones: Will Juneau Emergency Medical Associates “JEMA” doing their own billing result in lower staffing needs for Bartlett. Bartlett Response: Bartlett will not reduce its coding expenses as its certified coders must review all Emergency Department medical records to determine the hospital’s level of service and will be reassigned to handle hospitalist billing. Bartlett has reduced one full time equivalent (one person) from its personnel budget because the hospital will no longer be submitting claims for JEMA. Question from Mr. Jones: Will Bartlett have a lower risk with compliance issues because JEMA is billing for its own services? Bartlett Response: The hospital’s focus on compliance will not change with JEMA’s decision to bill for its services, as the hospital bills for its facility services; however, it will remove that highly visible area from under Bartlett’s umbrella. Question from Mr. Jones: Will CBJ Law review the contracts with JEMA? Bartlett Response: Yes. CBJ Law will review all contractual changes and documents.

10



Question from the Assembly: Provide a detailed income statement for Rainforest Recovery Center. SEE EXHIBIT B. Bartlett Response: The following income statement summarizes direct and indirect costs related to the Rainforest Recovery Center for the fiscal year ending June 30, 2014: While the Medicare Cost Report characterizes the expenses shown as indirect, in actuality, those other than Administrative and general are true costs of the program.

11



EXHIBIT A

Date of Fee Change Room Charge - MedSurg

% Change from Prior Year

7/1/2011 $1,813.00 4/1/2012 $2,035.00 12.2%

7/1/2013 $2,137.00 5.0% 7/1/2014 $2,244.00 5.0%

Operating Room - First Hour

7/1/2011 $1,491.24 7/1/2014 $1,566.00 5.0%

Note: No fee change from 2011 to 2014

Emergency Room - Level 4

7/1/2011 $502.75 7/1/2012 $539.24 7.3%

7/1/2013 $798.00 48.0% (adjustment to

market) 7/1/2014 $838.00 5.0%

CT Head without Contrast

7/1/2010 $1,789.75 7/1/2011 $1,639.75 -8.4%

11/1/2014 $1,721.75 5.0% Note: Fee decreased from 2010 to 2011

MRI Brain with/without Contrast

7/1/2010 $3,489.50 7/1/2011 $3,569.00 2.3%

7/1/2012 $3,569.00 0.0% 7/1/2014 $3,390.75 -5.0%

12



BARTLETT REGIONAL HOSPITAL RAINFOREST RECOVERY CENTER

INCOME STATEMENT FISCAL YEAR 2014

EXHIBIT B

1 REVENUE FISCAL 2014 Bartlett Comments

2 INPATIENT $3,663,517 3 OUTPATIENT $554,896 4 OTHER $611,721

6 TOTAL REVENUE $4,830,134

8 REVENUE DEDUCTIONS 9 CONTRACTUALS $3,090,733 Contractual allowances computed by financial group

10 COMMUNITY FUNDED CARE 11 POLICY/OTHER $145,362 12 TOTAL $3,236,096

14 NET REVENUE $1,594,038

16 BRH DIRECT EXPENSES 17 SALARIES AND WAGES $1,770,106 18 SUPP,UTIL,REPAIRS,RENT $72,768 19 FEES,INS,OTHER $48,165

MCR Cost Report reclass -$144,804 20 INTEREST EXPENSE 21 BAD DEBT $887,142 22 DEPREC & AMORT $83,798 Depreciation directly attributable to RRC

MCR Cost Report reclass -$83,798

24 TOTAL OPERATING EXP $2,633,377

26 NON-OPERATING REVENUES $1,123,018 Grant revenues from CBJ

28 MARGIN -$144,923

INDIRECT COSTS PER MEDICARE COST REPORT CAPITAL RELATED COSTS $86,823 Depreciation for common areas allocated to RRC ADMINISTRATIVE & GENERAL $602,645 Costs for administrative accounts EMPLOYEE BENEFITS $786,550 Benefit costs associated with RRC staffing PLANT OPERATIONS $711,824 Allocated costs of utilities and maintenance based on square footage LAUNDRY & LINEN $39,149 Allocated costs for laundry and linen based on patient days HOUSEKEEPING $171,158 Allocated costs for housekeeping based on square footage DIETARY $591,175 Allocated costs for meals based on patient days CAFETERIA $126,426 Allocated costs for meals based on employee SOCIAL SERVICES $61,815 Allocated costs based on patient days

SUB-TOTAL - ALLOCATED EXPENSES $3,090,742

NET CHANGE IN NET ASSETS -$3,235,665

13

DescriptionGeneral

Government Other CommentsExpenditures

a Additional School Funding $ 500,000 $ -

Pending further understanding of the JSD funding needs and final decisions regarding school funding by the State of Alaska.

b Law Department 14,600 - Prisoner Care expensec Parks & Rec 37,000 - Electric Doors in Stairwells of DTC. Total cost $60k.

d Eaglecrest - 50,000 Cover FY15 Operating expenses due to low snow year, funded from Eaglecrest fund balance.

e Airport - 104,800 Funded by Airport Revenuesf Airport - 40,000 Wood Chipper - Funded by Equip Replacementg Equipment Replacement Fund - 11,000 General Equip Replacement overageh

Revenues1 Secure Rural Schools - Title III $ - $ 45,000 Additional revenue in FY15 - restricted as to use2 Secure Rural Schools - Title I 592,000 - Additional revenue in FY153

Net revenue (cost) 40,400$ (160,800)$

CBJ FY15 Supplemental Itemsas of April 29, 2015

FY15 Projected Budget - Supplemental Items

14

addendum packet · city and borough of juneau assembly finance committee meeting wednesday, april...

Documents