The plan to 1 December

1. The decision this plan exists to reach

This plan exists to arrive at 1 December 2026 with all four options still open. Cost reduction is the method, not the purpose.

The board then decides what Arukah becomes: merge, wind down, close, or continue. Doing nothing removes three of them. The reductions are sized to stabilise within 60 days, showing the 90-day position with 30 days left to change course.

2. Where the organisation stands

3. Cash: the payroll calendar

Arukah runs out at a payroll, not on a date. Every pay period to 30 November, with the projected balance going into each.

The two paths

The lender is unidentified. Interest of about $94,800 a year implies $1.0 to $1.3 million of debt, and no lender is named in any document we hold. Section 12.

4. What changes on 2 September

Three changes, same day. Staggering them means staff spend three weeks waiting for the next one, which costs more than the changes save.

How it is communicated

The detail is built 31 August and 1 September. The shape is fixed now:

1. The ten hear it first, individually, in person. Not in a group, not by email.
2. Remaining staff, together, the same morning. The gap between the two is measured in hours.
3. Partners and referrers, on a short notice saying services continue and naming who to contact.

Three chief executives in twelve months, and staff who watched a hospital in the same town close with no notice. Anything they hear from a neighbour first costs more than the reductions save.

Client continuity

Every departing clinician's caseload needs a named receiving clinician before 2 September, and every affected client needs to hear it from a person.

5. What it saves

The leadership team took the preliminary list and produced a revised one. Ten positions, not nine, and $78,794 more than the preliminary figure. They cut deeper than they were asked to.

🔴 Three of the ten are conditional, and the list says so itself

What the revised list corrected, unprompted. It removes the highest-billing therapist in Arukah's own revenue model, and it removes a post that was entirely grant funded and would have saved nothing. Both were on the preliminary list. The leadership team fixed the two worst items without being asked to.

6. What it costs to do

7. Revenue: the half that is not cuts

A board reading only a cut list concludes management has no plan beyond shrinking, and would be right to. Several of these are larger than the reductions.

Six items nobody has worked

• Credentialing gaps. An uncredentialed clinician is unbillable, so every hour is a pure loss.
• A no-show policy with teeth. A third of psychiatry appointments do not happen.
• Group versus individual therapy mix. Different reimbursement, different clinician hours.
• Copays at time of service. Collected at the desk, or chased for months.
• Prior authorisation tracking. Work delivered without an authorisation is delivered free.
• Sliding scale discipline. Applied without documentation, it is a discount with no policy behind it.

Rental income of $81,984 sits in the budget, under-collected.

8. Expenses: money that costs nobody a job

Twenty-four items against real FY26 budget lines, in three tiers. $1,223,960 identified, $933,500 of it Arukah's own money.

Three controls that are missing rather than expensive

• Credit and fuel cards. Spending lands inside other budget lines, so nobody can say what is on them.
• Purchase approval threshold. Reported internally as broken. Until it works, every other control leaks.
• The indirect rate. Recovering 9.7 percent. A real rate on future grants is worth more than most items above.

9. Service integration, including psychiatry

Written by the leadership team, answering one question: what does integration between clinical services and psychiatry mean in practice.

What it asks for

• Every psychiatry client has a named clinical contact other than the psychiatrist, who tracks attendance, adherence and risk between medication appointments, holds the treatment plan, and completes a formal reassessment at least every 180 days.
• Most psychiatry clients are also in one other service where it is clinically warranted. It does not have to be therapy: case management and community support qualify and are preferred where therapy is not indicated. Nobody is placed in weekly therapy to satisfy a rule.
• Responsibility splits explicitly. Psychiatry keeps diagnosis, medication management, medication response and psychiatric recommendations. The clinical contact takes daily functioning, psychosocial needs, treatment goals, behavioural work, risk monitoring and coordination. Today all of it lands in a medication appointment.
• The expectation is set with the client before they reach psychiatry, so the psychiatrist is not explaining or enforcing the organisation's model during a medication visit.

What it deliberately does not do

• Nobody is discharged for missing therapy. Non-engagement triggers a look at the barrier and an attempt to re-engage, not a discharge.
• Clients with an established outside therapist keep them. Arukah obtains releases and coordinates rather than forcing anyone to drop a working relationship.
• Stable medication-only clients are reviewed individually, never discontinued abruptly, and never left without a route to their medication.
• A written exceptions process covering developmental, cognitive or communication limitations, treatment happening elsewhere, and cases where a second service is not clinically indicated. Documented once and reviewed, rather than argued client by client.

One hard rule. School-based psychiatry requires the student to be actively in therapy, so the therapist, family, school and psychiatrist are coordinated rather than running a standalone medication service.

Three things the model does not answer

1. The reimbursement basis. On a single rate per client per period, a second service adds cost and no revenue. Paid per service, it adds real revenue. Arukah's model uses hourly fee-for-service rates with a 30 percent write-off, which is not how a prospective-payment clinic models. This decides whether the model earns or costs.
2. Caseload capacity. Every client needs a named contact and a reassessment every 180 days. ✅ The revised staffing list contains no therapist, no case manager and no community support worker, so every front-line role the model depends on is retained; what goes is a supervisory layer above case management. That removes the obvious objection. It does not prove the remaining hours are sufficient, which is a question for the clinical director.
3. The transition destination. Stable medication-only clients route back to a primary care physician or another prescriber, and across five rural counties that may not exist. The one element capable of harming a client. Not policy until the receiving providers are named.

10. Time off: the only item requiring a vote

for board approval, sought before 2 September Leave is frontloaded, granted at hire rather than accrued. The proposal merges vacation and personal into one accrued bank with service bands and a cap.

Sick leave unchanged at 10 days. Every full-time employee loses at least a week. Years four and five lose two. Say that to the board, because staff will.

11. Risks this plan carries

12. What is asked of the board

reported Staffing reductions, service consolidation and expense actions. Management decisions under the interim chief executive, reported for oversight.

for approval, by Friday if possible The paid time off policy. Matt is asking the board to approve it before 2 September so it lands with the rest of the plan rather than trailing it. Whether that is possible depends on what the bylaws allow between meetings, which is being checked. If it is not, the announcement says the change is coming and takes effect on approval.

feedback by Monday 31 August, morning Anything received by then is answered directly and, where accepted, built into the rollout.

Three things only the board can help with

1. The lender. Identify who sits behind about $94,800 of annual interest, and open that conversation before a covenant problem.
2. Nine leased vehicles stranded when their grant ended. This wants a director who negotiates commercially.
3. ⚖️ Employment counsel, and this is now urgent. One scoped call: terminating an employee who is on FMLA leave, whether a state rule requires the Pathways CCSO supervisor post to be filled, the separations generally, the leave policy, the retirement plan question, and the notification statute.

13. Assumptions register

Every number here that is not yet real, who owns it, and what changes if it lands differently. If a figure looks wrong to you, this is the section for it.