Mental Health Center of Denver (MHCD) is one of seventeen community mental health centers in Colorado, but it stands out as a leader in offering innovative, holistic programs for mental health and overall well-being.
Its Dahlia Campus for Health & Well-Being offers therapy and mental well-being programs, including a four-acre garden and farm space, that’s open to the community. It offers an aquaponics greenhouse and 46,000 square feet of indoor therapeutic, classroom, play, and community gathering spaces. Skyline Academy is a day treatment and education program offered through the organization. In addition to individual and group therapy, Emerson St. for Teens and Young Adults offers free public workshops in creative writing, music, art, yoga, financial literacy, cooking, and computer skills, as well as general education and employment support.
Despite such progressive and groundbreaking approaches to mental health services, MHCD was less adept when it came to understanding its own finances. In fact, when Angela Oakley joined the organization as chief financial officer, she discovered that many leaders in the organization didn’t understand the financials.
“More than one person told me that our financials were a mystery,” Oakley says. “They didn’t have any understanding of what happened to money after they sent it to the office.” Another individual described getting a headache from looking at the highly detailed monthly statements—and Oakley herself was confused by many of the entries, some of which were accounts named for twenty-year-old grants that no one could remember.
“Financial information needs to be clear and understandable so that readers can grasp the details—and their implications—immediately.”
These were important stumbling blocks. MHCD operates on a 2 percent margin and needs to be able to spot financial issues and respond to them quickly, appropriately, and effectively.
To make the numbers more accessible and more meaningful to daily operations, Oakley simplified their presentation to three pages each month—an income statement, a balance sheet, and a rolling forecast through the end of the year. Instead of hundreds of accounts, the each document covers just seven categories each of revenue and expenses.
She also worked with the IT team to create an online Team Profit and Loss tool, where program managers and higher-level leaders can gain controlled access to more detailed statements arranged by service groups.
“Financial information needs to be clear and understandable so that readers can grasp the details—and their implications—immediately,” Oakley says. “Mystery isn’t a good thing when it comes to financials.”
Her simplified reports and efforts at basic financial education produced immediate results. Oakley says that financial discussions are more interactive and productive, and that staff respond with more informed questions. In one instance, it was discovered that a particularly important contract was not paying as much as expected. “I couldn’t believe how creative staff ideas were for addressing the shortfall,” she says. “We ended up identifying great opportunities, renegotiated the contract, and met budget for the year when we’d been on track to miss it by a significant amount.”
One of Oakley’s other priorities is developing alternative funding sources. Currently, 75 percent of MHCD’s revenue relies on state and federal funds, 62 percent of which comes from Medicaid. Funding is further complicated by the fact that MHCD’s innovative programs frequently fall outside the requirements of traditional mental health reimbursement, which is typically bound by a limited number of in-office visits.
Because of the uncertain nature of some of its funding, MHCD nurtures its relationships with various foundations, grants, and relationships that provide alternative sources of revenue. Sanderson Apartments, a permanent supportive sixty-unit tax credit housing project that was built with an equity partner that owns nearly all of the project, is one such partner.
Such progressive approaches often attract other interested parties. A local church contacted MHCD about the possibility of developing Glenarm Commons, another forty-eight unit tax credit project identified in downtown Denver. Based on MHCD’s efforts around faith and spirituality, The Rose Community Foundation also awarded a $30,000 grant to fund work on the Capacity Building to Assist Faith Communities Working with Refugees and Immigrants project.
Working with commercial insurance providers, which currently account for only 3–5 percent of revenue for community mental health organizations, is another funding source with tremendous potential. The challenge is convincing them that long-term programs that utilize intensive, high-level services that extend beyond a limited number of visits for therapy produce positive and cost-effective outcomes.
“On paper we look expensive,” Oakley acknowledges. “But we provide exceptional care that has tremendous value to the community, reduces hospital visits, and lowers insurers’ cost of care over time.”
She leverages MHCD financials to help tell that story to prospective companies in black and red. The numbers help demonstrate how initiatives like the organization’s teen suicide prevention program saves lives and money, even though they don’t meet standard criteria for being billed to Medicaid.
“Commercial insurers are very interested in our approach, but it’s going to require more education efforts on our part to create a new type of contract that’s not based on the traditional rigid parameters for care and treatment,” Oakley says.
These are just some of the challenges she faces on a daily basis. In addition, the state’s Department of Health Care Policy and Financing, which is responsible for administering Colorado’s Medicaid and Child Health Plan Plus programs, has changed to value-based funding, as well as how it calculates payments.
But Oakley remains optimistic. “I’ve worked in finance for more than twenty-five years,” she says. “If we can maintain a clear understanding of the financials, I’m confident they’ll lead us to creative solutions and help us recruit like-minded partners along the way.”
KeyBank’s strong focus on healthcare allows our dedicated teams to provide comprehensive solutions, industry expertise, and unique insight to our clients on the issues and challenges faced by healthcare providers. Melissa Whitmer commends Angela Oakley for her leadership and vision and the difference that she has made in the healthcare community.
Citywide Banks is a Colorado-focused, community bank committed to delivering responsive service, local expertise, and comprehensive financial tools for Colorado businesses, healthcare organizations, and families. Visit www.Citywidebanks.com to learn more. Citywide Banks is a member FDIC and an Equal Housing Lender.