Prepared for Matt George · 2026-08-19 · Internal
Every figure in the source documents checked against the board-approved payroll. Nothing here is decided. Twelve questions at the end need answers before Friday.
Six things worth knowing before reading the detail.
How to read the markers
A green chip like 01 links to the source document and shows the exact figure on hover. An amber confirm chip means the statement rests on the Aug 19 recording or on general knowledge rather than a document, and Matt should verify it. Figures on a soft grey background show their arithmetic on hover.
Every live date in one place. Red is a grant ending, amber is a decision point, green is an action already scheduled.
The collision worth resolving first
Case management is being consolidated under Clinical in the same week it is scheduled to absorb the transitioning NAS clients, on Aug 28, and three days before the people who hold those clients are notified. Whoever is running case management on Sept 1 needs to know that before Aug 28, not after.
Four grants expire between April and September. Three of those expirations were scheduled and written into the budget the board approved in March.
FY26 grant portfolio, by grant
Red bars end within the next six weeks or have already ended. Green bars continue.
| Grant | Amount | Ends | Status in the workbook |
|---|---|---|---|
| HFS Pathways | 271,041 | April 30 | Already expired. Marked non-renewable. |
| Neonatal HRSA 49884 | 329,163 | Aug 31 | 12 days away. Marked "expires Aug 26." |
| SAMHSA CCBHC 86905 | 678,000 | Sept 30 | 6 weeks. Whiteboard says "End Sept 29." Replacement applied for Aug 17. |
| Crisis DHS 590 | 577,496 | Stripped | Budget increased this line by $113,481 over FY25. |
| Total ending | 1,855,700 | 65% of the portfolio |
Source: Grant Projection tab. 01 Renewal dates and the Aug 17 application are on the whiteboard. 10
One grant status is unconfirmed
Living Rooms 55068, $300,000. The Grant Projection tab says it renews July 31 and continues, and this page counts it as continuing. The whiteboard reads as an end date of 7/31/26. $300,000 of revenue and $216,622 of refillable salary capacity turn on which is right, so it is worth one email.
Say this differently on Friday
The Stabilization Plan tells the board "The Crisis Grant is gone. We expect to lose approximately $2.0 million." 03 The total is close to right. The cause is not. Crisis DHS 590 is $577,496 in the board-approved workbook.
A version that survives scrutiny: four grants worth $1.86 million expire between April and September, three of them were always going to, and the grant portfolio drops 65%.
Grants at Arukah are pass-through. Losing grant revenue costs little on its own. What costs money is keeping the staff the grant used to pay for.
The assumption everything else rests on
The FY26 budget assumed clinical income would grow 77%, from $1,925,537 in FY25 to $3,404,224. Every gap figure on this page uses that budget number as the revenue side.
At 90% of budget the monthly gap moves from $158,000 to $186,000. At 80% it is $215,000. That one assumption swings the problem more than every cut on this page combined, which is why it is the first slider on the Friday deck.
Every category on the grant income side matches its expense counterpart to the penny. One line has no expense counterpart: 4512 Indirect, $278,809.79, which is 9.7% of grant revenue. So each grant dollar lost costs about ten cents of overhead recovery, as long as the attached cost leaves too. 02
The approved budget does not let the cost leave. It moves those salaries to Overhead, which has no revenue attached.
Who pays each salary dollar, across FY26
Total salary is $4,146,727 in all four periods. Only the split changes as grants expire.
Overhead salary triples, from $626,897 to $2,118,547. That is $1,491,650 of annual salary moving from "a grant pays for this" to "nobody pays for this." The Clinical line never moves. It stays at $924,635 in all four periods.
The clearest case is SAMHSA, which was paying 75% of most therapists' salaries. In the October to December columns, Taelor Alexander, Alivia Blair, Kristina Menzel, Seth Miskowiec, Lara Petersen and Heather Kidd all read Clinical 25% and Overhead 75%. Only Stephen Christopherson is budgeted at Clinical 100%. 01
What this means for Friday
The work is to turn grant-funded clinical hours into billed clinical hours. That is worth about $1.5 million. The layoffs are worth about $769,000 and are necessary, but they are not the lever that closes the gap. Both need to happen, and Matt already said that on Wednesday: if the reorg happens without the service integration, the savings never appear.
Separate item, costs nobody a job
Indirect recovery is 9.7%, at or below the federal de minimis rate. A behavioral health organization's true indirect cost is normally well above that, so Arukah has been absorbing part of its own grant overhead for years. Ruth should confirm the current de minimis rate under 2 CFR 200.414 and whether Arukah has ever negotiated its own rate. A few points on this portfolio is worth six figures a year with no service change.
What the consolidation actually changes. This is the centerpiece of the plan and the part that is easiest to explain.
Eleven separate departments in the workbook, each budgeted and reported on its own.
Care-facing services consolidated under Clinical. Everything else stands alone.
Clinical
Matt named four of these directly on Wednesday: Psychiatry, Case Management, Crisis and the Living Room move under Clinical. He named Pathways separately, saying it is a clinical program and should never have been reported on its own. Therapy and Intake are already clinical, so they sit there naturally.
Why this is the right answer independent of the money
The Stabilization Plan identified the separation as a structural fault before anyone counted heads. Its words: Psychiatry, Case Management and Clinical run as three separate buckets, they should not, and that separation is part of why psychiatry patients are not consistently connected to therapy and why case management sits underused. Fixing the structure because care is disconnected is a much better answer to "why now" than the deficit is. 03
Not yet decided
Who runs the consolidated Clinical function. On paper it is Ariel Swanson, Director of Clinical Services, and the change puts four more service lines and roughly forty people under her while nine people leave, with no additional resource named. Separately, Yoga sits outside every stated grouping, and Matt questioned on Wednesday why the organization has a yoga room at all. Neither point is on the elimination list.
Roughly $800,000 of budget relief and cost reduction sits outside the elimination list. Worth settling before the painful decisions, and worth leading with on Friday.
| Item | Amount | What it is |
|---|---|---|
| Positions never filled | 779,710 | Twelve roles carried in the Payroll tab as "to be hired", including a permanent CEO at 180,250, an accountant at 77,250 and an HR manager at 82,400. About 489,250 of it is Arukah's own money rather than grant-funded. Not hiring is budget relief, not cash. |
| Outsourced billing | 160,250 | Paid to an outside firm while Erin says she spends only about 20% of her time on revenue cycle confirm because Credible administration takes the rest. |
| Outsourced accounting | 150,000 | Paid out while the budgeted in-house accountant seat at 77,250 sits empty. Matt is already planning a fractional arrangement. |
| Misc consulting | 54,000 | Separate from Andrew and Sara. |
| Recruitment | 56,000 | Budgeted spend on hiring, in the same year as a reduction in force. |
| Advertising services | 24,000 | Separate from Cory Scott's salary, so the true marketing spend is over $97,000. |
| Total | 1,223,960 | Roughly $933,500 is Arukah's own money. Note that $489,250 of that is unfilled posts, which relieves the budget rather than producing cash, so the amount that actually reaches the bank is closer to $444,000. |
All six figures from the FY26 budget summary. 02 Unfilled positions from the Payroll tab. 01
Three things inside this that are worth more than the money
The billing and accounting spend is the same problem as the billing capture gap. $310,250 goes out the door annually for two functions that are both visibly underperforming, and the budget already contains the in-house roles to replace them.
Ottawa is underutilized and there is already a plan for it. Pat Schou's June memo proposed hiring an APRN with psychiatric certification for Ottawa, to cut no-shows from that area, supervise the service and build a MAT program. 24 Dr. Shepherd asked for the same thing in July, wanting one or two nurse practitioners. That single hire addresses the sole-prescriber risk, the Ottawa utilization problem and the MAT opportunity at once. It is the only proposal in the whole document set that solves three problems with one decision.
Interest expense of $94,800 implies roughly $1.0M to $1.3M of debt. That means a lender is a party to any merger conversation and has a view on a missed payroll. No document in the set mentions the lender.
Two capacity facts that affect who can absorb work
Grace Eager moved into compliance two weeks ago and is going on maternity leave, with Jen covering. She had offered in writing to take on sustainability analysis, chart reviews, policy drafting and job descriptions specifically to reduce reliance on outside consultants. 29 That offer is real but her availability is not, so she should not be counted on in the coverage plan.
Pathways carries two management layers over two producers. The workbook's own Pathways tab shows Hannah Chapman and Morgan Kremer at zero clients and zero revenue, against Heather Halterman at 16 clients and Sheila McCusker at 10. 01 Matt's decision to move Pathways under Clinical addresses the reporting line. It does not by itself address the staffing shape, and Hannah Chapman is in Friday's session.
Twenty-four items against the actual FY26 budget lines, ordered by how fast they release money. Several are already in motion. Nothing here needs board approval; it is management doing its job.
| Item | Budget line | Amount | Note |
|---|---|---|---|
| Credit cards | Not visible as a line | unknown | Pull the list of holders, limits and last 90 days of spend. Card spend lands inside other lines, so it is invisible here. Suspend or cap anything non-essential. |
| Fuel cards and vehicle use | 5506 Auto repairs | 12,000 | Who holds fuel cards, what mileage is being claimed. Matt has already seen three vehicles that have not moved. |
| The nine leased vehicles | 5112 Auto insurance | 30,000 | Leased against the dead Crisis grant. Matt is taking Tom to negotiate. Insurance falls with them. |
| Purchase approval | Process, not a line | n/a | Ethan describes the path from conceived to approved to received as broken. A dollar threshold requiring the CEO signature costs nothing and stops leakage immediately. |
| Recruitment | 5109 | 56,000 | Budgeted hiring spend in the same year as a reduction in force. Stop it. |
| Promotion, appreciation, meals | 5103, 5118, 5603 | 22,500 | Pause. Small individually, visible symbolically, and it is the kind of spend staff notice continuing during layoffs. |
| Travel | 5601 | 25,000 | Pause anything a grant does not require. |
| Color Run | 7003 and 4402 | 10,000 cost | Budgeted to raise 30,000 against 10,000 of cost. Confirm it still nets and that the volunteer time is worth it this year. |
| Item | Budget line | Amount | Note |
|---|---|---|---|
| Retirement match pause | Inside 5202 fringe | 436,913 total | Confirmed Aug 20: the 941 payroll tax returns and the 403(b) remittances are current, which closes the personal-liability exposure that otherwise sits with whoever signs. Pausing the employer match for 90 days then reassessing. This is not purely a management decision: it usually needs a plan amendment and advance notice to participants, and if the plan is safe-harbor the rules are stricter. Ask the plan administrator and counsel before announcing a date. |
| Billing vendor | 5407 | 160,250 | Move to a percentage of collections or terminate. Erin says she spends about 20% of her time on revenue cycle because Credible administration takes the rest. |
| Accounting | 5401 | 150,000 | Fractional arrangement already in progress. The budget also carries an unfilled in-house accountant at 77,250. |
| Misc consulting | 5408 | 54,000 | List every engagement and what it produced this year. Separate from Andrew and Sara. |
| Dues and subscriptions | 5104 | 54,000 | Seat-by-seat audit. In an organization this size, unused licences are usually 20 to 40% of the line. |
| Computer tech and hardware | 5105 | 54,000 | Defer everything not required to keep clinical systems running. |
| Internet and telephone | 5106 | 27,000 | Cell phone audit, already on Matt's whiteboard. Check for lines belonging to people who have left. |
| Insurance, all four policies | 5111 to 5114 | 179,215 | Re-bid as a package. Building insurance alone is 106,017 and the vehicle decision changes the auto line. |
| Janitorial | 5504 | 65,000 | Re-bid or reduce frequency, particularly at the underutilized site. |
| Audit fee | 5402 | 45,633 | Confirm the scope actually required. A single-audit threshold question is worth asking given the grant changes. |
| Item | Budget line | Amount | Note |
|---|---|---|---|
| Space consolidation | 5503, 5502 | 120,000 | Utilities 70,000 plus building repairs 50,000. Ottawa is described as significantly underutilized. This is the largest facilities lever and the slowest. |
| Talk to the lender | 5116 interest | 94,800 | Implies roughly $1.0M to $1.3M of debt. Go to them before a missed covenant makes them come to you. A lender who hears the plan early behaves very differently from one who hears about it after. No document in the set names them. |
| Rental income | 4600 | 81,984 | Arukah is a landlord to someone. Confirm who, whether it is at market, and whether it can rise. |
| Negotiate a real indirect rate | 4512 | 278,810 | Recovery is running at 9.7%, at or below the federal default. A negotiated rate is worth six figures a year with no service change and no new grant. |
| Capital project scope | Outside operating | n/a | Bids came in at roughly double budget. Matt has already raised the video production room and the yoga room as scope worth questioning. |
| Grant closeout discipline | Grant fund | n/a | Four grants terminating means four closeouts. Unspent or unallowable costs become clawbacks, which is a cash claim against an organization that has none. |
What is missing from the expense conversation entirely
Six revenue-side items that behave like cost reductions because they raise income per existing hour, and none appear in any document in the set.
1. Credentialing. Is every clinician credentialed with every payer Arukah accepts? An uncredentialed clinician is an unbillable clinician, and this is one of the most common quiet revenue leaks in behavioral health. Erin can check.
2. A no-show policy with teeth. 34% of psychiatry appointments do not happen. Reminder cadence, a waitlist to backfill same-day cancellations, and a stated policy are cheaper than any cut on this page.
3. Group work. Group therapy earns more per clinician hour than individual. The consultant document lists group rates and nobody has modelled the mix.
4. Time-of-service collection. Copays and self-pay balances collected at the desk rather than billed later. The front desk is already named as the key artery.
5. Prior authorization tracking. Services delivered without authorization are written off entirely.
6. Sliding scale discipline. Confirm the scale is applied consistently and documented, rather than becoming an informal discount.
Any one of these is worth more than several lines in the tables above, and none require a board decision or cost a job.
There are three versions. They are the same plan at three dates, not three different plans.
Positions for Elimination 1 and 2 are earlier drafts, not wrong ones. Six of doc 1's seven roles carry forward to Matt's current list. The one that dropped off is the crisis position, which is what you would expect once the decision to keep Crisis was made. Matt's list then adds Taelor Alexander, Kevin Scruggs, Max Brandenburg, and the two consultants. Doc 2's three roles are all inside doc 1 already. Doc 2's value is not its cut list, it is the revenue model, which is still the only sizing anyone has done for crisis growth.
| Matt's note | Payroll record | Listed | Payroll | Grant paid | Arukah-paid |
|---|---|---|---|---|---|
| Alex Taelor | Taelor Alexander, Behavioral Healthcare Therapist | 69,500 | 69,903 | 0% | 69,903 |
| Kevin Scruggs | Kevin Scruggs, WORTH Youth Prevention Educator | 73,000 | 72,728 | 100% | refill |
| Cory S | Cory Scott, Branding and Graphic Design | 75,000 | 73,713 | 10% | 66,342 |
| Brook S | Brook Schafer, Procurement Specialist | 57,000 | 56,602 | 0% | 56,602 |
| Dustin C | Dustin Coss, System Analyst | 90,000 | 88,438 | 5% | 84,016 |
| Max B | Max Brandenburg, Facilities and Safety Officer | 70,000 | 85,696 | 0% | 85,696 |
| Beth Townsend | Elizabeth Townsend, NAS Recovery Support Specialist | 53,435 | 53,431 | 0% | 53,431 |
| Brittany Vedder | Brittany Vedder, MHP and Case Management Supervisor | 63,361 | 63,098 | 80% | refill |
| Tara Stueve | Tara Stueve, NAS Recovery Support Specialist | 49,275 | 40,384 | 0% | 40,384 |
| Andrew and Sara | Two consultants at $13,000 per month each. Andrew ended in July, Sara ends Aug 21, so both are leaving regardless of the reorganization. | 300,000 | 312,000 | n/a | 300,000 |
| Total | 11 items | 900,971 | 915,994 | 768,994 |
Grant share and Arukah-paid cost use the Payroll tab's October to December allocation. "Refill" means the post is grant-funded, so the saving comes from moving an Overhead-funded person into that slot rather than from the leaver's salary. 01 20 Two small arithmetic notes: Matt's nine listed salaries sum to $600,571 against a written subtotal of $600,971, a $400 difference; and $13,000 per month for two people is $312,000 a year rather than the $300,000 written down.
Stated savings against savings that reach the bottom line
$300,000 of consultants was already leaving regardless of the reorganization. The grant-funded slots are not lost savings, they are savings that land on a different person once someone from Overhead is moved in.
Corrected: a grant-funded post is a slot, not a sunk cost
An earlier version of this page said cutting a grant-funded position saves Arukah nothing, because the grant was paying the salary. That was wrong, and Matt caught it.
Grant funding attaches to the work, not the person. Cut a grant-funded post and move someone who is currently sitting on Overhead into that slot, and the grant now pays for them instead. Arukah's own cost falls by whatever that person was costing it. The saving is real. It just shows up on a different name.
That matters more here than anywhere else, because the budget has $2,118,547 parked on Overhead by the fourth quarter with no revenue behind it, and $606,384 of continuing grant salary capacity across WORTH, Living Rooms and BCBS. Every dollar moved from the first column to the second is a dollar Arukah stops paying.
Three limits, so nobody over-promises it in the room: the backfilled person has to do work that genuinely qualifies under that grant, the grant's approved personnel line caps how much can be charged without a budget modification, and time-and-effort has to be documented for whoever is charged. Within those limits it is one of the cleanest levers available.
Five of the nine people have direct client contact. Four do not. That distinction should drive the notification order and the coverage plan.
| Person | Role | Client contact | Who picks it up |
|---|---|---|---|
| Taelor Alexander | Behavioral Healthcare Therapist | Active therapy caseload, 1,104 budgeted billable hours | Not decided |
| Brittany Vedder | MHP, Case Management Supervisor | Case management plus Living Room, 70% Living Rooms grant | Reports to Amanda Picatto under the change already approved |
| Elizabeth Townsend | NAS Recovery Support Specialist | NAS caseload moving to case management | Case managers assigned Aug 28 per Vedder's plan |
| Tara Stueve | NAS Recovery Support Specialist | NAS caseload moving to case management | Case managers assigned Aug 28 per Vedder's plan |
| Kevin Scruggs | WORTH Youth Prevention Educator | Youth prevention delivery in schools | Not decided |
| Dustin Coss | System Analyst | None, but owns the psychiatry compliance dashboard and the billing dashboard Erin needs | Not decided |
| Cory Scott | Branding and Graphic Design | None | Absorb or drop |
| Brook Schafer | Procurement Specialist | None | Absorb or drop |
| Max Brandenburg | Facilities and Safety Officer | None | Matt says already off the books confirm |
The gap
No document in the set records how many clients any of these people carry. The workbook budgets hours and revenue, not caseloads. So the coverage plan the leadership team asked for on Wednesday cannot actually be built until someone pulls caseload counts from Credible for the five people with client contact.
That is a one-query job for Erin as the Credible administrator, and it should happen before Friday, because the answer determines whether the remaining therapists can absorb the work or whether the billing plan and the coverage plan are in direct conflict.
Three things that follow from it
Continuity of care is a licensing matter, not just a courtesy. Clinical staff leaving with active caseloads triggers transfer and client notification obligations. Worth putting to counsel in the same call as the WARN question.
Taelor Alexander is the sharpest case. She is the highest-billing therapist in the workbook's own model and the only therapist on the list, so her caseload both matters most clinically and is the hardest to absorb while the plan is also asking the remaining therapists to bill more.
Dustin Coss has no clients but two dependencies. He is building the psychiatry compliance dashboard in the Psych Plan and the billing dashboard Erin asked for on Wednesday. Both stop unless someone picks them up.
The third thing Matt wants to announce on the same day as the reorganization. It carries a cash consequence for the layoff that is not named anywhere, and two questions that are probably legal rather than discretionary.
| Leave type | Today | Proposed |
|---|---|---|
| Sick | 10 days (80 hrs) frontloaded at hire, resets at the anniversary. Unused time rolls over to a 4-week cap, treated as the equivalent of short-term disability. Full-time only. | Unchanged for full-time. Open question whether to start offering it to part-time staff. |
| Personal | Full-time: 5 days (40 hrs) frontloaded at hire, resets at the anniversary. Part-time: accrued at 1 hour per 40 worked, resets Jan 1 because the payroll system cannot reset on anniversaries. | Combined into a single PTO bank, accrued each pay period rather than frontloaded. 0 to 2 years: 10 days, 3.08 hrs per period. 3 to 5 years: 15 days, 4.62 hrs. 6+ years: 20 days, 6.154 hrs. Plus a balance cap, above which accrual pauses. Two options are given for unused time: "use it or lose it", forfeited at the anniversary, or up to 3 days (24 hrs) rolled over automatically. The author recommends starting with use-it-or-lose-it and adding rollover once the finances are healthier, explicitly caveated "unless applicable laws dictates otherwise". |
| Vacation | 10 days (80 hrs) frontloaded after 90 days. Rises to 15 days at the 2nd anniversary and 20 days at the 3rd. Up to 5 days may roll over with CEO approval. |
Source: PTO Program document. 30
The connection to the layoff that nobody has made
Vacation and personal leave are frontloaded, not accrued. An employee receives the whole year's bank at their anniversary rather than earning it gradually. So someone terminated part-way through their anniversary year can be holding a full, unused, already-granted bank.
For nine people that is a real cash number, payable in the same weeks the organization is running on very little cash. It is exactly the cost-to-terminate figure Ruth asked for on Wednesday, and switching to accrual does not reduce it, because the people leaving are still on the current frontloaded terms. Compute it from the current policy, not the proposed one.
Two questions that are probably not discretionary confirm
"Use it or lose it" is the recommendation most likely to be a problem, and the document already says so. The author caveats it with "unless applicable laws dictates otherwise" and lists the question first under Need to Know, so this confirms their instinct rather than contradicting it. Illinois has historically treated earned vacation as wages that cannot simply be forfeited, and generally requires unused earned vacation to be paid out at separation. A cap on further accrual is a different thing and is usually acceptable, so the cap may be fine while the forfeiture may not.
"We do not currently offer sick time for part-time employees. Should we start?" may not be a choice. Illinois introduced a statewide paid leave requirement covering most employees including part-time staff. Whether the current part-time personal leave accrual already satisfies it is a question for counsel rather than an internal preference.
Correction: the change is bigger than an earlier draft of this page said
An earlier version counted only the vacation milestone. It missed that merging vacation and personal removes the 5 personal days from everyone. The full picture, sick leave unchanged at 10 days:
| Service year | Today | Proposed | Change |
|---|---|---|---|
| Years 1 to 2 | 10 vacation + 5 personal = 15 days | 10 days | -5 days |
| Year 3 | 15 vacation + 5 personal = 20 days | 15 days | -5 days |
| Years 4 to 5 | 20 vacation + 5 personal = 25 days | 15 days | -10 days |
| Year 6 and over | 20 vacation + 5 personal = 25 days | 20 days | -5 days |
Every full-time employee loses at least a week. Years four and five lose two. That is a real change to terms of employment for all fifty full-time staff, landing the same hour nine colleagues lose their jobs. It is defensible, but it should be a deliberate decision and it needs to be explained as one.
What the change is actually worth, and what it is not
Three separate effects, and they are commonly confused with each other. Figures use the workbook's own numbers: 50 full-time staff, average salary $66,484, so $31.96 an hour and $256 a day.
| Effect | If everyone loses 5 days | If years 4 to 5 are a third of staff | What kind of money |
|---|---|---|---|
| Lower accrued leave liability, and lower payout on any separation | 63,927 | 85,236 | Balance sheet and cash at separation. Real, but it only becomes cash when someone leaves. |
| Recovered billable capacity, 22 clinicians | 68,297 | ~91,000 | Probably not real. The Stabilization Plan states that several clinicians do not already have enough clients on their schedules. If demand is the constraint rather than clinician days, freeing days produces nothing. Treat this line as zero until schedule fill is measured. |
| Reduction in payroll expense | 0 | 0 | Salaried staff are paid the same whether or not they take the day. There is no payroll saving here. |
Capacity is valued at the workbook's own model rate of $199 an hour less its own 30% write-off and 5% fee, so $129.35 net, and at the budgeted 24 billable hours per clinician week.
On the liability effect alone the change is worth roughly $64,000 to $85,000 a year, and none of it is a payroll saving. The capacity half only materialises if clinician schedules are actually full, and our own document says they are not. That matters, because presenting a leave reduction as a cost cut invites the obvious question of why payroll did not fall, and there is no good answer to it.
The number that would make this exact confirm
The workbook carries no hire dates and no years of service, so the bands above are a range rather than a calculation. One column from the payroll system, years of service for the 50 full-time staff, turns this into an exact figure in about ten minutes. It also tells Matt precisely how many people are in the years four and five band who lose two weeks rather than one, which is the group most likely to react.
This one needs the board. The rest does not.
The PTO change alters terms of employment for every member of staff and it lives in the handbook, so it goes to the board for approval. The handbook is already scheduled to reach them for the September meeting, so the natural route is to take the PTO change as part of that package rather than as a separate item.
Everything else in this plan is management doing its job and is reported to the board rather than approved by it: the reorganization, the eliminations, the expense sweep, the service consolidation. Keeping that line clear protects Matt. It means the board is not asked to bless operational decisions that are his to make, and it means the one thing that genuinely needs their authority actually gets it. Sequencing consequence: if board approval lands at the September meeting, the PTO change cannot take effect on Aug 31 with the rest. It follows, and the announcement should say so plainly rather than leave staff to work it out.
Matt has decided to keep Crisis and two advisors recommended cutting it. That decision is not revisited here. What follows is what the numbers say and the options for closing the gap.
Nine people are charged to the Crisis grant in payroll: the seven Crisis department positions plus Amanda Picatto and Melissa Knoth. That matches the nine in doc 2.
Crisis cost against Crisis revenue
Loaded cost uses the payroll fringe rate of 18.8%. Revenue figures are from doc 2.
The program tab separately shows Crisis expense of $639,854 against Crisis grant revenue of $577,496, so the program was losing money while fully funded. 01
Decision 1
Option A
Grow volume and cross-sell
Matt's plan as drawn: Living Room from four days to six, late and weekend hours, groups, front desk hour changes, and routing crisis contacts into substance use, community support, case management and Living Room services.
Own model: $572,456 revenue at $400,000 cost at higher volume
Option B
Charge for crisis capacity
Take a priced offer for guaranteed crisis coverage to the five county 708 boards, which levy dedicated property taxes, plus regional hospitals carrying emergency department boarding cost, Medicaid managed care plans, and the 988 and CESSA structures.
Slower. County budgets run on annual levy calendars.
Option C Suggested
Both, starting now
Run A immediately because it needs nobody's permission. Start B in parallel because it is the only thing that fixes the structural gap. Use the $144,000 wind-down grant as the bridge.
$77,000 of the wind-down comes up front, per Matt confirm
Why C. Option A alone does not close a $272,869 gap, and it asks the crisis team to work more hours during a restructure. Option B fixes the structure but no money arrives before November. Running both uses the wind-down grant for exactly what it is for. Argument for A alone: it needs no outside party and no negotiation, which matters if the timeline is short. Argument for B alone: if referral capacity is already full, growth is not available and effort on A is wasted.
One note on the workbook
The Open Items tab reads "Crisis: need to understand volume from North Central." That asks a potential buyer a question that could instead be answered with a price. Whether to price Crisis to more than one party depends on where the board conversation stands, which this document cannot judge.
Four decisions with options, a suggestion, and the argument for the alternatives. Each depends partly on information Matt has and this document does not.
Decision 2
On Aug 5 Brittany Vedder sent Matt and Grace a NAS Grant Transition Plan arguing that the grant ending frees Beth Townsend and Tara Stueve, because NAS eligibility restrictions disappear and they can take broader referrals and bill more. All three are on the elimination list. 22
Option A
Proceed as planned
Eliminate all three. Simplest, and consistent with the message that unfunded work goes.
Saves about $106,435
Option B Suggested
Test it for 30 days
Hold the two NAS staff against a written billable target through September. Decide on Brittany separately on her own merits. The transition steps are already scheduled for Aug 28 and Sept 4.
Defers about $93,815
Option C
Retain one, release one
Halves the risk in both directions and still produces a test.
Saves about $46,900
Why B. The plan depends on turning grant-funded time into billable time. These two people are the clearest test of whether that works, the argument came from the manager closest to the work, and nobody has tested it. Argument for A: Brittany has an interest in the answer, a 30-day hold weakens a clean break, and Matt has performance information this document does not. Argument for C: preserves the test at half the cost, though one case is weaker evidence. Note that Brittany is 80% grant-paid and now reports to Amanda under the change already approved, so her economics differ from the other two.
Decision 3
Option A
Proceed
Eliminate. Reduces headcount and signals that grant-funded work is not protected.
Saves $0 while the grant runs
Option B Suggested
Confirm the end date first
If WORTH runs to 2027, hold the position and let it end with the funding. If it truly ends this year, it belongs on the list.
Turns entirely on question 06
Option C
Cut and reduce the draw
Eliminate the role and reduce the matching grant draw, if the award allows it.
Neutral to cash, cleaner structurally
Resolved 2026-08-20. WORTH runs to about July 2027, and the answer is to eliminate the position and contract the video work. WORTH is a video-based prevention programme, so the grant does require video to be produced, but Arukah employed a full-time videographer to deliver what a contractor could. Eliminating the role and buying the video for the grant deliverable keeps the obligation met at lower cost and leaves no stranded post when WORTH ends. The same logic settles marketing: no marketing or social output in the past month, a well-paid role, and work that contracts easily. The principle for Friday is buy the service rather than employ it, which is far easier to explain than cutting a programme.
Decision 4
He was not at Wednesday's meeting, and his signature line on the Aug 5 leadership charter is the only one left blank. 11 He also wrote the most useful document in the folder, a detailed reply to Matt's five questions naming same-day cancellations as his biggest daily problem and asking for MAT expansion and nurse practitioner support. 25
Option A Suggested
Brief him privately, first
Lay the plan out with specifics and numbers attached, ask him to own the psychiatry half, then bring him into the group discussion.
What Grace, Ethan and Erin each advised separately confirm
Option B
Include him Friday
Treat him as a peer from the start with no separate track.
Risk: the no-show figure is still unreconciled
Option C
Finish the plan, then tell him
Complete the plan Friday and present it to him early the following week.
Matt's stated leaning on Wednesday
Why A. Three people who know him well said the same thing independently: he wants it laid out, he is uncomfortable with open-ended leadership asks, and he should hear it before everyone else. Ethan added the reason that matters most, which is his history with St. Margaret's and how badly that closure was handled. This got easier on Aug 20: the number is now settled at 14% no-shows plus 20% cancellations, 34% combined. Matt can go to him with the correct figure rather than the 60% in the board document, which removes the one thing most likely to lose him in the first ten minutes. The Stabilization Plan still needs correcting before the board sees it. Argument for C: a half-finished plan is harder to buy into than a finished one. Argument for B: a separate conversation can look like managing him rather than including him.
Decision 5
Option A Suggested
All three on one day
Reorg, service integration, and PTO plus expenses announced together on Aug 31, with a clean break Sept 1. Matt's plan as stated.
Stops the "what else is coming" cycle
Option B
Cheapest money first
Announce vacancies, vendors and consultants now, people later. Opens with roughly $800,000 that costs nobody a job.
12 unfilled roles are budgeted at $779,710
Why A. Matt's own reasoning is the strongest argument available: if the reorg happens without the integration, the savings never appear and ten people were released for nothing. Staff already sense something is coming, and staging extends that. Argument for B: it earns credibility before the painful part, and it is honest to say that eliminating vacancies relieves the budget rather than producing cash. A middle path keeps the single announcement day and simply leads that day with the reductions that do not cost anyone a job. One constraint on the PTO leg: the proposed "use it or lose it" rule may not be lawful in Illinois, and the milestone change cuts leave from 20 days to 15 for anyone in their fourth or fifth year. If counsel cannot clear both before Aug 31, the PTO change moves to its own date. See section 10.
Matt asked for the plan to be made readable and said he would spend 48 hours on the package. This is a suggested shape.
Shape A Suggested
Agree the numbers, then the plan
Twenty minutes settling the conflicting figures so everyone works from the same set. Then the plan. Then build the four artifacts.
Stops the numbers being challenged mid-discussion
Shape B
Plan first, questions after
Present the whole plan in fifteen minutes, then open it up. Matt's instinct on Wednesday.
Faster to the substance
Four things were asked for on Wednesday. They are the test of whether Friday worked:
An opening that holds up
Four grants worth $1.86 million expire between April and September. Three of them always were going to. The approved budget handled that by moving $1.49 million of salary into Overhead, where nothing pays for it. The job is to make that work billable or let it go.
That framing also explains why the consolidation is right on its own terms. Running Psychiatry, Case Management, Crisis and the Living Room as separate units is what the Stabilization Plan itself named as a structural fault, before anyone counted heads. Matt made the same call about Pathways on Wednesday. Fixing the structure because care is not connected is a better answer to "why now" than the deficit is.
Ten things still to settle, each with an owner. Everything Matt answered on 2026-08-20 has been written into the sections above rather than left here, because those are facts now, not questions. What changed as a result is summarised below.
Answered on Aug 20, and where each one now lives
Seven questions closed. Each changed something in the page rather than just being ticked off.
The two that changed the plan most are the savings restatement and the no-show correction, because both are numbers Matt would otherwise have said out loud.
Other figures that disagree, lower priority
Cash is $4,200 per Matt on Aug 19 and $36,000 in the July documents. Psychiatry loses $250,000 per the Stabilization Plan and $194,052 per Grace Eager's model. The FY2026 "forecast" of $195,175 in the Stabilization Plan is identical to the March board budget, which contains no grant loss at all. The crisis wind-down grant is $150,000 on the whiteboard and $144,000 per Matt. Doc 1's own table adds to $472,000 while its total line says $467,000 and its prose says $457,000. The program expense tab returns #REF! for four grants, so the per-service profit and loss the Stabilization Plan promises the board does not currently calculate.
Everything behind this page. Shared with Matt as viewer. No public link.
Two sources are not in the folder. The Illinois HFS list of provisionally certified CCBHC locations is public at hfs.illinois.gov. The Aug 19 leadership meeting recording sits in the Glassroot OS transcript store. Statements attributed to Wednesday come from that recording. Speaker labels in the automatic transcript are unreliable, so attributions were made from content rather than speaker number and should be read as close paraphrase, not exact quotation.