COUNTY MANAGER’S PROPOSED FY 2020 BUDGET

County Board Work Session

Department of Human Services

February 28, 2019

VisionA community of healthy, safe and

economically secure children, adults and families

MissionStrengthen, protect and empower those in need

Ideal CultureCustomers are our highest priority, receiving quality,

integrated services

Employees are engaged and committed to continuous

improvement

Our organization is built on mutual trust and shared

responsibility

Department of Human Services

Department Initiatives

2

Increasing Demand for Services

• Provides affordable housing and supportive services for people with disabilities to obtain and maintain their housing.

• PSH has grown from 201 clients in FY 2015 to 284 in FY 2020; a 41% increase.

Permanent Supportive

Housing (PSH)

• School Health provides a full range of health services, education and clinic management to school age children and their families.

• SH visits have grown from 17,217 in FY 2015 to 20,400 in FY 2020; an 18% increase.

School Health (SH)

• Youth Mental Health provides outpatient screening, assessment and treatment to Arlington youth.

• YMH has grown from 191 clients in FY 2015 to 250 in FY 2020; a 31% increase.

Youth Mental Health (YMH)

Department Initiatives

3

Increasing Demand for Services

• NCM helps adults aged 60+ maintain their health so they can live independently.

• NCM has grown from 607 clients in FY 2015 to 755 clients in FY 2020; a 24% increase

Nursing Case Management (NCM)

• Opioid use services include assessment, testing, education and treatment.

• Opioid Use Treatment has grown from 35 clients in FY 2013 to 310 in FY 2018; a 786% increase

Opioid Use Treatment

4

Departmental InitiativesChild Care Initiative

Destination 2027

Bridges Out of Poverty – 200 Bridges Pilot

Racial Equity

AC Works!

Summary of Proposed Budget Changes

FY 2019Adopted

FY 2020Proposed Change

%Change

Expenses $138,910,440 $141,586,424 $2,675,984 2%Revenue $41,144,648 $40,538,926 ($605,722) (-1.5%)Staff 694.32FTEs 697.37 FTEs 3.05 FTEs -

5

Significant Budget Changes

6

Medicaid Expansion

• Arlington’s mental health revenue reduced by $2.2 million over two years – 636K in FY 2019 and $1.6 million in FY 2020.

• After DSS personnel reimbursement & insurance billing offsets, the total cost to the county is $1.7 million

• In FY 2020, the $1.7 million cost will be covered by 886K in on-going and 886K in one-time funding.

School Health Staff

• Alice Fleet Elementary and New Middle School will open in the fall of 2019

• To meet the health needs of students, an additional 1.0 Public Health Nurse ($100,113) and 1.55 Clinic Aides ($96,129) are required.

• The total FY 2020 request is $196,242 and 2.55 FTEs.

Housing Grants

• To meet the projected FY 2020 need (1,205 households), an on-going addition of $779,812 will be added to the FY 2019 on-going budget of $8.0 million.

• The maximum allowable rent will increase to address the cost of rising Arlington rents. The cost of the increase is projected to be $548,561.

• The total FY 2020 proposed Housing Grants budget is $9.3 million.

Proposed Reductions

7Department of Human Services

OPTIONAL: An image or graphic can be used to help show, explain or quantify a proposed reduction.

DHS FY 2020 REDUCTION SUMMARY

Personnel Non-Personnel Total Reduction FTE

FY 2020 Reduction $668,393 $124,087 $792,480 5.75 (4 filled; 1.75 vacant)

Detail: Proposed Reductions

8

Reduce Director’s Office Administrative Support Service Impacts Budget Impact

• Reduce the Sequoia Plaza Common Area Maintenance budget by $100,000. The reduction will have no impact due to changes in the landlord’s fee calculation method.

• Reduce the Director’s Office training budget by $50,000. Senior management will have fewer training and professional development opportunities.

• Eliminate a vacant .25 Organizational Development Specialist FTE ($29,478). There is no adverse impact because duties have been reassigned to remaining staff.

FY 2020 Change: -$179,478

Staff Impact

-.25 Organizational Development Specialist (vacant)

Detail: Proposed Reductions

9

Reduce Clarendon House Case Management Support Service Impacts Budget Impact

• Eliminate a vacant .5 Human Service Aide providing case management support to the Clarendon House Program. The elimination will have no adverse impact on service delivery due to the reassignment of duties to remaining nursing and administrative staff.

FY 2020 Change: -$39,387

Staff Impact

-.50 Human Services Aide (vacant)

Detail: Proposed Reductions

10

Reduce Senior Adult Housing FundingService Impacts Budget Impact

• Reduce $30,000 in Birmingham Green Adult Care Home funding for four clients. Due to attrition, there are only three current residents with no other clients eligible for admission. The remaining $117,018 budget is sufficient to house the current residents.

• Reduce $10,000 in local Developmental Disability Services funding. There is no adverse impact on clients or services due to the availability of Medicaid waiver funding.

FY 2020 Change: -$40,000

Staff Impact

None

Detail: Proposed Reductions

11

Downsize the Arlington Employment Center (AEC)Service Impacts Budget Impact

• Eliminate the AEC Intake Unit operated by 2.0 Employment Services Specialists and 1.0 Management Specialist. Intake and assessment duties will be transferred to the Customer Service Center with no disruption in service delivery.

• Eliminate 1.0 Employment Development Specialist responsible for organizing job fairs and connecting clients to employment opportunities. Given decreasing demand, this position can be eliminated with no adverse client impact.

• Eliminate 1.0 AEC Administrator responsible for leadership of the AEC bureau. Due to downsizing the AEC to a program, the remaining staff will report to the Employment Services Supervisor.

• The personnel reduction of $599,528 is offset by a $65,913 increase in funding for training opportunities for difficult to serve populations.

FY 2020 Change: -$533,615

Staff Impact

• 2.0 Employment Services Specialists ($190,167; filled)

• 1.0 Management Specialist ($118,364; filled)

• 1.0 Employment Development Specialist ($94,418; filled)

• 1.0 AEC Administrator ($196,579; vacant)

Non-Profit Requests

12

Doorways for Women & Families

Doorways is requesting a $46,000 ongoing increase to the Domestic &

Sexual Violence Hotline contract.

The $104,000 FY 2019 contract provides a 365 day hotline for people suffering sexual & domestic violence, harassment and human trafficking.

From 2015 – 2018, calls increased by 105% (1,167 to 2,390). Hospital sexual

assault assessments increased by 1,400% (4 to 60.)

Arlington Food Assistance Center

AFAC is requesting a $50,000 ongoing increase.

The $477,925 FY 2019 contract restricts funds for the purchase of

food only.

In FY 2018, AFAC served 5,098 families; a 2.5% (129) decrease over

FY17.

REEP (ESL)

REEP is requesting an increase of $36,000 to conduct a CDA program for

ESL learners.

In FY 2019, REEP’s $817,583 contract was reduced to $645,682; a reduction

of $171,901 (21%).

In FY 2018, REEP filled 3,732 ESL training slots; 347 (9.7%) more than the 3,385 required in the contract.

Proposed Reductions

13

Community Services Board RequestsThe CSB identified increasing service demand for individuals needing substance use, mental health and emergency crisis intervention services. Despite substantial DHS effort to use existing resources, a significant need for therapists remains. The unfunded FY 2020 CSB

request is 2.5 FTEs; $264,144.

Substance & Opioid Use Therapist

An additional 1.0 therapist ($101,972) is required to serve the increasing number of clients with substance use disorders. From FY17 to FY18, substance use clients increased by 89 (19%) from 463 to 552.The Substance & Opioid Use Programs are currently staffed by 9.5 therapist FTEs with an average caseload of 27..In FY 2018, 310 clients with opioid use diagnoses were served. From 2013 to 2018, client demand increased 786% - from 35 in 2013 to 310 in 2018.

Autism Therapist

An additional .5 mental health therapist ($60,200) would be combined with an existing .5 therapist to serve clients on the Autism spectrum who also have a mental health diagnosis.

The additional FTE is required to meet the needs of the 75 current clients with co-occurring diagnoses.

The therapist will develop treatment plans, support family relationships, and provide counseling and case management.

Emergency Services Clinician

An additional 1.0 therapist ($101,972) is needed to meet the increasing need for emergency mental health services for individuals in crisis. From FY17 to FY18, temporary detention orders increased by 140 (29%) from 491 to 613.

In FY 2018, Emergency Services received over 18,000 calls and conducted 2,825 face-to-face assessments for individuals experiencing a mental health emergency.

Proposed Reductions

14

Diversion FirstDiversion First will divert Arlington youth experiencing behavioral health crises from psychiatric hospitalization

through crisis stabilization and care coordination.

Virginia Hospital Center (VHC) is providing a $500,000 five year grant to fund a Diversion First

Mental Health Therapist (estimated cost $122,000 )

The target population is youth up to 22 years of age who present to the VHC emergency department and the DHS Crisis Intervention

Center

The Mental Health Therapist will provide assessment, crisis

stabilization and intensive care coordination with associated case

management supports

Outcome data and reporting will be tracked and reviewed at

quarterly meetings with CSB and VHC staff

VHC will provide $100,000 per year to fund the Diversion First Mental Health Therapist. The

estimated annual County share is $22,000

At the end of the five year grant, DHS will analyze outcomes and may propose a locally-funded

Diversion First program

DHS Housing Programs

Non-Profit Requests

16

FY 2020 projected average cost per household is $650; total projected expenditures are $9.3M. FY 2019 participation dropped 4% due to 59 Housing Grants clients transitioning to the Housing Choice Voucher Program.

Housing Grants

1,302 1,299

1,229 1,230

1,1871,205

1,100

1,150

1,200

1,250

1,300

1,350

FY15(Actuals: $9.1M)

FY16(Actuals: $9.0M)

FY17(Actuals: $8.6M)

FY18(Actuals: $8.8M)

FY19 (proj)(Actuals: $8.7M)

FY20 (proj)(Actuals: $9.3M)

Hou

seho

lds

Housing Grants: Number of Households in Program

Non-Profit Requests

17

Housing Grants – Maximum Allowable Rent IncreaseWe strive for Housing Grants tenants to pay no more than

40% of their income towards rent. The subsidized

rent amount is capped at the current maximum

allowable rent established in 2010 .

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800

$2,000

1 BR 2 BR 3 BR

$1,189$1,344

$1,734

$130

$238

$94

Rent

Am

ount

Apartment Size

Current Housing Grants Maximum Allowable Rent

Current Maximum Allowable Rent Unsubsidized Amt (100% Tenant)

$1,3192018 MAR

$1,5822018 MAR

$1,8282018 MAR

As a result of the high cost of rent and maximum

allowable rents capped at 2010 levels, 40% (506) of

households contribute more than 40% of their income

towards rent.

Non-Profit Requests

18

Housing Grants – MAR versus FMR Comparison

HUD establishes the Fair Market Rent (FMR) for Arlington at the 40th

percentile for gross rents by zip code.

$1,189

$1,344

$1,734

$1,319

$1,582

$1,828$1,913

$2,121

$2,754

$1,000

$1,500

$2,000

$2,500

$3,000

1 BR 2 BR 3 BR

Rent

Am

ount

Unit Size

Maximum Allowable Rent vs. HUD Fair Market Rent Comparison

Current MAR 2018 MAR (60% AMI) 2018 AVG HUD FMR

Utilizing the FMR would significantly increase Housing

Grants expenditures. The program cost is projected to

increase by $4.7 million; $9.3 to $14 million.

Non-Profit Requests

19

The permanent supportive housing waitlist has approximately 60 clients who wait an average of 4-6 months before they can secure housing. Deficits in FY 2019 and FY 2020 will be absorbed by the DHS base budget. Additional funding will be required in FY 2021.

Permanent Supportive HousingFY 2017 FY 2018 FY 2019

(Projected)FY 2020

(Projected)

Available Units (as of 6/30) 236 246 256 265

Occupied Units -(as of 6/30) 190 204 210 216

New UnitsPierce Queen – 8The Springs – 11

Total: 19

Clarendon Court – 10 Total: 10

Columbia Hills - 10Total: 10

Gilliam Place - 9Total: 9

Average Monthly Grant$887 $898 $898 $909

Adopted Budget $2,064,870 $2,064,870 $2,064,870 $2,064,870

Expenditures $2,031,812 $2,104,552 $2,241,408 $2,301,930

(Over)/Under Budget $33,058 ($39,862) ($176,538) ($237,060)