COMMUNITY SERVICES 2014 BUDGET PRESENTATON · Regional Eligibility Trainer … Super Community …...

Inside this issue:

Human Services Value Curve

2

Community Services Strategic Priorities,

3

Manage The Resources 5-7

BDRs 8-18

Promising Practices 18-19

Legislative 4

COMMUNITY SERVICES 2014 BUDGET PRESENTATON

NOVEMBER 21, 2013

Vision Vision

A safe, thriving and inclusive community.

A Different Kind of Future

… Non-traditional Partnerships

… Creative Financing Models –

Investing in Social Outcomes

… Analytics – Unlocking Data That

Matters

… Looking to the Outside

… Integration – Wrapping Around the Whole Person

MissionMission

As part of the community, we strive for the safety, well-being and stability of children, families and adults in Olmsted County

Community Services Department Strategy Map

Prioritize and Sustain Effective Services

Demonstrate Sound Fiscal Management

Pursue Operational Excellence

Recruit a Diverse Workforce

Build the Community

Managethe

Resources

Run the Business

Develop the Employees

“Managing for Results (M4R) – Olmsted County’s Strategic Management System” May 2013

AccountabilityInnovation

IntegrityPartnership

Person-CenteredRespectValues

Vision: “A Safe, Thriving and Inclusive Community”

Engage and Leverage Key Stakeholders

Implement Effective and Innovative Technology

Build a Competent Workforce

Promote Staff Resilience

November 21, 2013 Community Services 2014 Budget l of 19

BUILD THE COMMUNITY

NEW PARTNERSHIPS

… Community Health Integration

… Analytics

… Child Advocacy Center

… Anoka Metro RTC social worker

… Dodge County

… Regional Eligibility Trainer

… Super Community

… Found, Engaged, Connected

Dr. Jerry Mechling, PhD …………….. http://www.innovations.harvard.edu/

Generative Business Model

IntegrativeBusiness Model

CollaborativeBusiness Model

RegulativeBusinessModel

Human Services Value Curve

Efficiency In Achieving Outcomes

FSA2.29

1.60

DFO

Community Services Survey –Program Level

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

CFSAFS

2.46 2.33

REGULATIVE

COLLABORATIVE

INTEGRATIVE

GENERATIVE

CS Strategic Priorities

3. TECHNOLOGY

…

1. H OUS ING

… Youth & Family Homeless Needs

… Housing Summit

… Community Housing Research Study

… Potential Growth Impacts

… Reintegration of offenders/housing

needs

… DMC

… Permanent Supportive Housing

… LEAP … Analytics

… EDMS … Learning Management System

… Northwood's … Dashboards

… HS App … PH Doc

… More online services and apps

2. I NTEGRATION

… Children’s Mental Health & Adolescent Behavioral Health

merged shared intake

… Adult Probation Officer/Social Worker & CMH Social worker

team for Juveniles in DFO with mental health needs

… Regional Anoka Metro Social Worker—Divert Clients

… Dodge County Children’s Services

… Crossover team CFS and Juvenile Probation

… Community Resource Specialist Pilot Project

… Human Services App

… Sexual Assault Interagency Council

… Child Advocacy Center (CFS, DFO/Victim Services, Mayo)

LINKING STRATEGIC PRIORITIES, BALANCED SCORECARDS AND BUDGETS

Senior Management is reviewing

the Community Services strategic

plan and organizational structure.

November 21, 2013 Community Services 2014 Budget l of 19

Threats

… Federal deficits

… Sequestration – reduction in VCA grant

… Cost Shifts

… Potential Food Support Cuts

Successes County advocacy in helping to achieve:

1. Affordable Care Act increased staff funding

2. CRAFT legislation passed

3. CD Pilot legislation passed

4. Northstar

5. Statewide human services outcomes

6. Statewide funding of Parent Support Outreach

Program (PSOP)

November 21, 2013 l Community Services 2014 Budget l of 19

New Mandates/Cost Shifts

… ACA - MnSure

… MnChoices

… Increase in payments for Sex Offenders

… Anoka Metro Regional Treatment Center

… St. Mary’s—Generose

… Minnesota Security Hospital

… Drug testing in public assistance

Potential Future Legislation Positions … Long-term Residential Psychiatric Services

… Reduce shifts

… Increase community resources

… Sex offender funding

…

2003 2013

.0029 .0023

FTE’s PER CAPITA

Challenges MANAGE THE RESOURCES


Salary & benefit increases $ 1,549,000

Adults Targeted Case Management (TCM)

112,000

Sex Offender treatment (4 new individuals)

120,000

Anoka Metro Regional Treatment Center

100,000

St. Mary’s 110,000

MN Security 120,000

Child Welfare TCM 158,000

ITS Intra-County Payments 276,000

TOTAL $ 2,545,000

Social Services Time Study (SSTS)

$ 1,419,000

ACA Impact 425,000

Building Rent 145,000

TOTAL $ 1,989,000

ENVIRONMENTAL FACTORS

… Olmsted County and Community Services (CS)

added to reserves the past 5 years

… CS has a reserve of about 43% of total revenues.

This is within the recommended amount from the

state auditor of 35-50%.

… To cover growth in costs for 2014 we need 3-5%

depending on labor agreements, insurance

increases, and pension payment changes.

… Organization integration and alignment

… LEAP and technology

Human Services FTEs—Reduction

2003 2013

FTE’s 385 * 339

Population 132,013 148,560

* Includes positions added during 2013

Opportunities

Histor ica l Cuts

In the past years we have reduced posi-

tions mainly through attrition, some

layoffs, furloughs, and cutting non-

essential services.

… Associate Director—Youth & Fam-

ily Services

… Adolescent Behavioral Health Ser-

vices

… Many Rivers Treatment

… Many Rivers Detention

… Volunteer Program Privatization

… Incredible Years

… CAP Privatization

… Victim Services

… Developmental disabilities

… PSOP

… Adult Protection

… Finance staff

… Program evaluator

… Case aides

…

Positions — Repeated cuts from the Feds and State for man-

dated services. Continued additions of new un-

funded mandates:

… $3.1 million State cuts 2003. $50 million

state-wide cut in the Children & Community

Service Act (CCSA) funding with promise to

fund in the future.

… 2005 made $50 million CCSA cut permanent.

… 2006 $2.8 million federal cuts from DEFRA

and rule changes.

… 2008 & 2009—reality of Federal cuts. State

economic issues—more cuts.

— Decreases

— in Child welfare funding over $1.3 million

— Early intervention $700,000 for our community

— $200,000 in child support funding. Increases

every year until 2010

— Sex offender hold costs passed on to counties a

state cost shift of $400,000


Rank

Summary By Funding Source

Additional Levy New Positions No levy

requested

Reserves

General Fund 801 Dept: 0171 Unit: 1931

1 .60 FTE Veterans Service Officer Regulative 55,478

General Fund 801

1 1.0 FTE Probation Officer Regulative 78,816

Human Services Fund 805

1 1.0 FTE Adult Behavioral Health Case Manager

Regulative

$-5,186 9,000

2 1.0 FTE Social Worker CMH Case Manager targeted to serve children in CFS & DFO who are at imminent risk or are currently in group/residential care (one-time costs covered by reserves).— Integrative

0 8,600

3 1.0 FTE Support Services staff (one-time costs

covered by reserves) — Regulative

$65,645 $2,750

4 1.0 FTE Parent Support & Outreach Program

(PSOP)(one-time costs covered by reserves)

— Integrative

$51,317 $8,600

5 Integration of Child & Family Services and

Juvenile Probation clinical team in the 2118

building — Integrative

$60,000

6 Increase funding for respite services for adult

family foster care— Collaborative

$10,000

7 Add two vehicles to the Motor Pool which will be

dedicated to Social Services — Regulative

$46,000

8 H) Equipment replacement as needed —

Regulative

$60,000

Totals $ 321,256 $ -5,186 $ 134,950


Expense Revenue Levy FTE

$55,478 $0 $55,478 0.60

$55,478 $0 $55,478 0.60

Service Level Changes for 2014Departmental Requests

Rank Strategic Priority with Community/County Impact

1 M4R: - BUILD THE COMMUNITY

0.6 FTE Veterans Service Officer

We request to increase our current 0.4 FTE Veterans Service Officer position to full time. By doing so, we will be able to do a better job at ensuring veteran, dependent, and survivor economic stability, enhance productivity by serving more clients, and maximize state and federal VA funds flowing into Olmsted County.

Our current 0.4 FTE is fully covered by the mileage do-nation program, not levy. [Regulative]

Veteran's Fund: 0801 Dept: 0171 Unit: 1931


Olmsted County Veteran Services Client Visits (Office & Outreach) January 2004 through October 2013

Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total 2004 12 11 7 3 4 12 3 4 6 13 4 2 81 2005 7 9 11 3 8 4 29 87 85 98 83 99 523 2006 101 111 97 102 115 87 82 124 85 119 64 88 1175 2007 95 109 129 91 95 76 98 97 85 119 84 84 1162 2008 132 120 117 167 151 145 150 150 189 198 129 146 1794 2009 186 157 205 196 138 166 170 206 207 180 183 155 2149 2010 172 165 197 160 191 189 181 154 118 250 174 125 2076 2011 156 143 169 146 158 134 113 175 188 298 226 184 2090 2012 213 217 260 206 225 226 243 274 204 271 204 161 2704 2013 244 189 234 229 176 210 203 208 202 171 2066

Total: 15820


… Community safety services/responses

… Rising client risk/needs

… Domestic violence response/supervision/services

… Evidence Based Practice implementation

… Quality Assurance

… Integration of DFO

… Rural services

… Affordable and available client housing

… Sexual offender population/transition services/housing

… Criminal Justice Coordination Council

Corrections

Core Services … Court Ordered Investigation/Reports

… Juvenile Detention

… Juvenile Diversion

… Juvenile Probation Supervision

… Sexual Assault Crisis Intervention/Response

… Sexual Assault Prevention Programming

… Supervised Release: Adult Prison Transition

… Crime Victim Services

Strategic Priorities

… Reintegration of offenders/housing needs

… Crossover team CFS and Juvenile Proba-tion

… Sexual Assault Interagency Council

… Adult Probation Officer/Social Worker & CMH Social worker team for Juveniles in DFO with mental health needs

Priorities and Challenges̶

… Youth and adult mental health services

… Continuum of community based services for

clients

… Youth psychiatric services

… Family coaching services

… Youth and family needs assessments

… Seamless services to all crime victims (Parallel

Justice)

… Leadership development

… Staff support around secondary stress and

trauma

Service Level Changes for 2014 - Departmental Requests

Expense

Revenue

Levy

FTE $78,816 $0 $78,816 0.00

$78,816 $0 $78,816 0.00



1 M4R: - ENHANCE COMMUNITY SAFETY

1.0 FTE Probation Officer

Caseload sizes in DFO are at their maximum level of ef-fectiveness. To keep caseloads at an acceptable level,:

… we are forced to reduce some mid-level risk needs offenders to lower levels of supervision.

… Caseloads of adult domestic violence clients are be-yond their level of effectiveness.

… Domestic violence clients, unless they are low risk, should not be reduced to a low level of supervision.

Incoming high-risk clients are outpacing low/medium risk clients. Absent an intentional response to rising high risk cases, clients' and victims' needs will go unmet.

Currently, there are more than 140 domestic violence clients on low level supervision to keep actively super-vised caseloads at acceptable, but not optimal, levels. We enhance community safety by:

… working with our clients to promote short term and long term safety.

… striving to avert harm through primary prevention, early intervention and community education efforts, and

… reducing the risk of further harm through community supervision and programming that holds clients accountable and promotes rehabili-tation.

This BDR represents only Olmsted's portion of the new FTE. Dodge's share is $8,341 and Fillmore's is $7,543.

[Regulative]

OFFENDERS WITH DOMESTIC VIOLENCE CASES

DV workload is very high; caseload sizes in DFO are beyond their maximum level of effectiveness.

Workload pressures have compromised our abilities to adequately supervise medium risk needs clients to a supervision level below their needs.

Absent an intentional response to rising high risk cases, client and victim needs will go unmet.

An additional FTE would allow us to provide a higher level of supervision to more domestic violence clients.

November 21 , 2013 l Community Services 2014 Budget l of 19

Child & Family Services … Protect children from maltreatment

… Protect women and children in domestic violence

… Early intervention services

… Adequate transportation resources to support self-sufficiency.

… Adequate child care resources that is timely, safe and affordable.

… Provide quality, accessible, affordable housing

… Crossover youth and families with Juvenile Probation

… Trauma-Informed Child Welfare System

… Integrated youth behavioral health services

… Child mental health services

… Increase access to child & adolescent psychiatry

… Crisis Services

… Support youth in extended foster care

Priorities and Challenges̶

… Adult Protective Services

… Psychiatric services access

… Crisis Services

… MA Expansion impact … Housing services funding

… Maintaining Homeless services

… Quality, accessible, affordable housing

… High intensity services

… Integrating social services and health care

Adult & Family Services

Core Service

s Family Support & Assistance

… Child Support Services

… Food and Cash Assistance

… Health Care

… Public Assistance Eligibility

Adult & Family Services

… Adult Protection

… Behavioral Health Services

… Case Management

… Developmental Disabilities Services

… Elderly and Disabled Services

… Housing

… Psychiatric Services

… Waiver Case Management

… EDMS Installation

… MNsure Implementation

… Drug testing

Family Support & Assistance

Child & Family Services

… Adolescent Behavioral Health

… Adoption

… Child Care

… Childcare Licensing

… Child Protection

… Foster Care

… Teen Parent Program –

Bright Futures


1.0 FTE Social Worker

Increasing Adult Behavioral Health Case Management (CM) caseloads are higher than recommended

… Caseloads at 30+ per Social Worker have stressed the current staffing levels.

CM is a mandated service that helps individuals with Serious Mental Illness access needed services and housing.

Research indicates that CM helps:

… reduce the need to higher cost services by supporting individuals in community based services.

Higher caseloads typically result in lower rates for CM services;

… we estimate a $122,000 decrease to this 2014 revenue due to a decrease in our 2013-14 rate.

Each CM generates more than $89,000 per year, not including a potentially higher rate in the future due to a lower caseload for all workers.

This BDR includes a request for $9,000 for one-time expense for furniture, equipment and ITS charges to be covered by the use of Human Services Fund Reserves.

[Regulative]


Expense

Revenue

Levy $92,915 $98,101 -$5,186

$92,915 $98,101 -$5,186

FTE

1.00

1.00


Human Services Fund Fund: 0805

…

November 21, 2013 l Community Services 2014 Budget of 19

MENTAL HEALTH AND THE ADULT DETENTION CENTER

… In 2012, nearly 4000 people were released

from the ADC

… 25% have mental health issues, 90% have

substance abuse/dependency issues

… Case managers can provide on going

engagement and rapport building strategies,

assessment, goal planning and support

coupled with skill building, problem solving and

the ongoing practice of pro-social behavior in a

community setting



… Increasing caseload size has created challenges in meeting the high level of needs of children and families entering the Children's Mental Health Case Management.

… These children are at high risk of out-of-home placement es-pecially group/residential care.

… The addition of a Children's Mental Health Case Manager al-lows caseloads to be reduced to ensure intensive community-based services for children and the ability to maximize third party revenue due to high Targeted Case Management (TCM) rates for Children's Mental Health case management.

… This position would be a component of the integrated CFS/JPO strategic plan.

… This position is fully funded by TCM earnings, SSIS reimburse-ment, plus a reallocation of $15,463 from a POS expense line for psychiatry services. We have been unable to purchase these services from a POS vendor, so this additional position enables us to shift qualified staff into therapy-related work to help fulfill this need.

Rank Strategic Priority with Community/County Impact Human Services Fund Fund: 0805


Expense

Revenue

Levy $77,743 $77,743 -$0

$77,743 $77,743 -$0

FTE

1.00

1.00


This BDR includes a request for $8,600 for one-time ex-pense for furniture, equipment and ITS charges to be covered by the use of Human Services Fund Reserves.

[Integrative]



The Parent Support Outreach Program (PSOP) provides a child

welfare response offering family support services to at-risk families.

PSOP outcomes reflect:

… 87% of high risk families served have no new maltreatment

determination at one year post service.

… promotes family preservation in which 99% of children served in

PSOP have no new out of home placement episode at one year post

service.

… Funding would provide the ability to expand an effective early intervention

model to families with older children including a focus on families and

youth experiencing homelessness.

Each CM generates an estimated $29,343 per year, resulting in additional

levy request of $51,317 after $3,255 in SSIS reimbursement and $8,600 for

one-time expense for furniture, equipment and ITS charges to be covered by

the use of Human Services Fund Reserves.

[Integrative]


Expense

Revenue

Levy $92,515 $41,198 $51,317

$92,515 $41,198 $51,317

FTE

1.00

1.00


3 M4R: - RUN THE BUSINESS

1.0 FTE Clerk Specialist 2

Increasing workload, especially in the number of phone calls, along with additional responsibilities related to advances in technology, has created increased difficulty in the Support Unit's ability to cover/provide back-up for reception duties. Adding one additional FTE will provide for better customer services.

This BDR includes a request for $2,750 for one-time expense for equipment and ITS charges to be covered by the use of Human Services Fund Reserves.

[Regulative]


Expense

Revenue

Levy $68,395 $2,750 $65,645

$68,395 $2,750 $65,645

FTE

1.00

1.00





PSOP provides early intervention services to at-risk fami-

lies who might not traditionally receive services.

The aim is to connect families with enduring community supports that promote safety, permanency and child/family well-being.

In 2012 Child and Family Services Intake received 1,632 reports regarding child safety or well-being. Of these 488 reports received a child protection assessment or investigation. Another 488 reports were referred to PSOP where 253 families accepted and received voluntary services. Referrals often come from screened out reports of child maltreatment, although families as well as other community partners make referrals to the program.

While many counties contract out for PSOP services, Olmsted runs an internal program strongly embedded within the “front lines” of Child Protection Services.

This allows Olmsted to provide families at-risk with the support they need to keep children safe and to prevent further escalation and referrals into high-end, higher cost programming.

Unduplicated family

members served

during year

Number of FT

PSOP staff

2007 1,190 3

2008 1,342 4

2009 1,647 4

2010 1,528 3

2011 1,513 3

2012 1,614 3

Child Placement (Cases Closed 2011, n=204)

99.5% of PSOP case management cases with no placement dur-ing case management services.

92% of PSOP case management cases with no child placement one year follow up from discharge.

16 cases (13 PSOP and 3 AOD) with 27 children placed during one year following discharge.


Children with mental health concerns are found in multiple units throughout social services but one unit, Juvenile Corrections, is faced with unique challenges.

… Children with unaddressed mental health needs often en-ter a juvenile justice system that is ill-equipped to assist them,

… a partnership between Olmsted County Juvenile Probation and Child Family Services is working to change that.

$50,000 of funding would support enhancing existing clinical infra-structure to provide community-based/evidenced-based intensive case management services for high risk youth.

$60,000 of this request asks for funding to use currently unused space in the 2118 building; payment will be made to the Building Fund.

We anticipate that this new expense will be offset in part by reduced out of home placement costs, estimated at $50,000. [Integrative]


Expense

Revenue

Levy $110,000 - $50,000

$0 $60,000

$60,000 $0 $60,000

FTE

0.00

0.00


Youth in the most restrictive placements result in the highest cost:

∗ Residential Treatment

∗ Department of Corrections

∗ Group Home

Integration of Olmsted County Child Family Services and Juvenile Probation clinicians is needed to provide chemical, mental health and family systems assessment and treatment in-cluding individual, group and family therapy. A co-located site adjacent to the JDC and Youth Night Campus offers the clinical space needed for an integrated clinical team as well as links to youth served in JDC.



7 M4R: - OPERATIONAL EXCELLENCE

We request approval to add two vehicles to the Motor Pool which will be dedicated to Social Services.

The ACT team currently has a leased vehicle that it uses daily. Since it is more economical to own a vehicle than it is to lease one, we request purchasing a vehicle when the lease expires next spring. The second new vehicle is needed to relieve the current pressure that Social Services staff are putting on the Public Works non-dedicated Motor Pool vehicles. Our staff use one of those vehicles an average of 17 times a month.

Social Services staff put more than 156,000 miles on Motor Pool vehicles in 2012. USE OF HUMAN SERVICES FUND RESERVES [Regulative]


Expense

Revenue

Levy

$10,000 $0 $10,000

$10,000 $0 $10,000

FTE

0.00

0.00



Expense

Revenue

Levy $46,000 $46,000 $0

$46,000 $46,000 $0

FTE

0.00

0.00

6 M4R: - MANAGE THE RESOURCES AND BUILD

THE COMMUNITY

With the growing reliance on Adult Family Foster Care as

the best alternative to provide housing stability and services

for some individuals, the need to provide respite opportuni-

ties for the families doing this work becomes very important.

By adding this resource to the existing funding for respite, it

allows for up to 10 additional opportunities for respite and

helps with provider retention and ultimately client satisfaction

with services.

[Collaborative]

Rank Strategic Priority with Community/County Impact Human Services Fund Fund: 0805

*2013 current through three quarters


In 2013 Olmsted County added a Liaison Social Worker to manage human and fiscal costs of patients at

the Anoka Metro Regional Treatment Center.

… Patients that Do Not Meet Medical Criteria (DNMC) cost the County additional funds, nearly 60% more than the initial

rate.

… To compare costs across 2011, 2012 and 2013, all DNMC patient days are billed at the average 2013 DNMC rate of

$510 a day.

… To date (10-18-2013) five patients have used 137 DNMC days for an average of 28 days each. Those 137 days cost $69,870, or, $13,974 each patient. All five of those patients were discharged in this period.

$41,820$59,160

$14,280

82

116

28

0

20

40

60

80

100

120

140

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

2011 2012 2013*

Average Anoka Days & Costs by Patient Not Meeting Medical Criteria

Average Expense Average Days

*To date (October 18,2013)


Expense

Revenue

Levy

FTE

$60,000 $60,000 $0 0.00

8 M4R: - OPERATIONAL EXCELLENCE

Replace worn or broken equipment as the need arises, to provide staff with equipment that works.

… Family Support: $15,000

… Child and Family: $15,000

… Adult and Family: $15,000

… Administration: $10,000

… Finance: $5,000

USE OF HUMAN SERVICES FUND RESERVES

[Regulative]

November 21, 2013 l Community Services 2014

Promising Practices


$507,568 $325,792 $181,776 4.00

AP Financial Exploitation Investigator: Detective Dave Rikhus

New Position Beginning March 2013 for 14 hrs/week

Outcomes:

… $1,200 case submitted to County Attorney (CA) and charged out.

… Approx $450,000 submitted to CA expected to be charged out at the end of the month. This case 3500 pages of financial information/evidence.

… Approx $100,000 case being finalized now to be submitted to the CA yet this year.

… Foster Care provider accused of exploiting one of her clients. Investigation partially completed.

… Two cases pending.

November 21, 2013 Community Services 2014 Budget l of19

COMMUNITY SERVICES 2014 BUDGET PRESENTATON · Regional Eligibility Trainer … Super Community …...

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Transcript of COMMUNITY SERVICES 2014 BUDGET PRESENTATON · Regional Eligibility Trainer … Super Community …...