Dane County Human Service Budget Briefing

This is from last Wednesday, a week ago, but the information is important. The County gave back $6,243,062 in budgeted funds for Human Services to the General Fund . . . just think what that could have funded. $6.2 MILLION DOLLARS! And yet we scrap and fight every year over $10,000 or $20,000 or even $80,000 for small programs. $90,000 would have kept TRC funded to serve people outside the City of Madison. Public hearings on the 15th.

Note: Read the Q&A and the supplemental (lack of) information. If the public feels left in the dark most of the time, its no wonder, county board supervisors can’t even get information about what’s going on with shelters and the day center.

TRADITIONAL UPDATES/BUDGET SUMMARY
i.e. the propaganda piece . . . from Lynn Green

DANE COUNTY DEPARTMENT OF HUMAN SERVICES 2017 REQUESTED BUDGET SUMMARY

The 2017 budget request totals $289,273,253. This request is an increase of $3,767,778 over the Department’s 2016 adopted budget. The 2017 budget request increases county taxes/General Purpose Revenue (GPR) by only $927,913 to $73,515,123 while increasing outside revenue by $2,839,865 to $215,758,130. This revenue increase is due mainly to the expansion of Comprehensive Community Services (CCS) revenue in our budget but is also in part due to staff and provider’s continued aggressive pursuit of other outside revenue. This budget proposal complies with the Department of Administration’s 2017 budget guidelines. In the 2017 budget formulation the Department did not increase GPR beyond the base budget and some cost to continue allowances provided to us.

The Department developed this proposal with the following goals:
– To preserve our core and mandated and non-mandated services at a level that ensures protection and high quality of life for our community’s most vulnerable and needy populations
– To continue to meet the needs of current Department consumers while adding new consumers or new services where feasible
– To maximize outside revenue to the greatest extent possible
– To accurately reflect 2017 revenues, expenses, and utilization based on current and past experience and adjust budget lines accordingly
– To identify areas where the 2016 budget reflects a projected deficit and adequately fund those
– To continue to analyze the sources of past Department surpluses and maximize the use of those revenues in the operating budget
– To re-align funding based on priority needs
– To promote efficiencies, partnerships, and service system changes as alternatives to budget reductions in both the Department and provider community
– To preserve the continuum of services from prevention to intervention to the greatest extent possible
– To be responsive to input from providers, consumers, and policy makers regarding priorities and cost control measures
– To provide safe working conditions for Department staff
– To align the Department for the transition to Family Care with the accompanying loss of revenues, local contribution, and staff

Despite the zero GPR reduction target this year, the Department did face some fiscal challenges in preparing this proposal. While the need for local human services continues to increase among Dane County residents, financial resources to support those services continues to decrease or remain flat in some areas at the State and Federal levels. This budget proposal reflects a loss of revenue and grants that either needed to be covered with other funding or resulted in service reductions or eliminations. Among these losses are Youth Aids funds ($79,964) and a variety of grant drop-offs or reductions such as the PATHS Pilot ($224,246), Independent Living ($108,432), Dementia Care ($5,705), and Safe Haven ($46,197). Fortunately, Dane County maintains its incredible local contribution to human services in this proposal.

This budget proposal maintains Dane County’s extraordinary investment of local resources in non-mandated services. Funding of $779,276 in non-mandated senior case management through the focal point system, over $1.5 million for Joining Forces for Families, over $2.2 million for homeless/housing/shelter services, and $148,084 for Youth Resource Centers are all fully preserved or in some cases increased. In fact, funding for almost all contracted services is proposed to continue at least at 2016 levels. Results of the annual RFP process are reflected in this proposal which does result in a change of providers for some services.

Recent initiatives such as the Community Restorative Court and school based mental health are sustained. There are new positions proposed in the Children, Youth & Families Division to address the increase in child abuse and neglect reporting, increased staffing to support the Comprehensive Community Services initiative, and an AmeriCorps Coordinator. An expansion of supervised visitation and mobile crisis are funded. More funding for senior nutrition site management, RSVP driver services, and the caregiver support program were included in the AAA budget. A major expansion of mental health and AODA services is funded with Comprehensive Community Services (CCS) revenue.

Given the recommendation of the Living Wage Review Council that “budget increases to meet the living wage requirement be funded from resources outside the Human Services Department base budget”, this proposal does not fund the Living Wage. Doing so would have cost the Department $34,480 in GPR and resulted in cuts and eliminations of critical services. However, the proposal does continue our practice of funding new high school graduates in the developmental disabilities system. This proposal contains $331,920 in GPR to serve 59 new consumers who will graduate from high school in 2017 and $361,502 in GPR to annualize the cost of serving 60 graduates from 2016 and caseload increases.

In the developmental disabilities (DD) system, $4.01 million in additional expenditures are added to the Adult DD system for an increase of 4.8%. There is no cut to the providers or SDS grants.

Badger Prairie Health Care Center moved into a new, state-of-the-art facility on February 23, 2011. Due to the functionality of the new facility along with incredible work on the part of the staff, Badger Prairie continues to be able to maintain a high census and care for medically and behaviorally complex residents. Some of these residents are diverted or discharged from psychiatric hospitalization settings; this both saves money for the County and also provides a higher quality of life for these individuals. This budget proposal maintains the staffing and full support for this incredible skilled nursing facility.

Our Economic Assistance and Work Services Division continues to experience high caseloads and unprecedented major program changes. In 2012 staff successfully led the formation of the Capital IM Consortium and absorbed thousands of new cases. In 2016 Sheboygan County was added to the Consortium. Staff continue to address the workload issues associated with the Patient Protection and Affordable Care Act (PPACA) and the elimination of the BadgerCare Plus waiting list for single adults at or below 100% of the Federal Poverty Level. This proposal reflects the conversion from project to permanent status of one Economic Support Supervisor and six Economic Support Specialists previously funded by PPACA revenue and now supported by core IM funding.

Funding for critical but non-mandated homeless/housing services is sustained. This proposal reflects the opening of the Day Resource Center in 2017, funds gap services until that opening, continues the single point of entry for this system, and reflects the new focus of the Salvation Army sheltering services from overnight emergency shelter to rapid re-housing.

In summary, this budget proposal fully preserves vital public safety services such as child protection, delinquency, and elder abuse services. In addition, it continues funding for a number of services that no other county provides such as Joining Forces for Families, the Early Childhood Initiative, and senior case management at the focal points. Given the very challenging fiscal environment in which Human Services continues to operate and at a time of truly unprecedented increase in the amount and severity of need, this 2017 Department budget proposal maintains a high quality human services system that Dane County can be proud of. Below are a few Division specific changes between the adopted 2016 budget and this 2017 budget proposal. The complete proposal is posted on the Department’s website at http://www.danecountyhumanservices.org/.

Administration

The Department’s proposed general Administration budget for 2017 is $5,176,887 ($1,017,671 GPR & $4.2 million outside revenue). This maintains the Department’s tradition of an extremely low administrative overhead and prioritization of the funding of services to consumers. Funding to maintain support for the Commission on Sensitive Crimes is maintained at the 2016 level. A Program Analyst position in the Planning & Evaluation Unit is proposed to oversee the planning and quality assurance requirements of the rapidly expanding CCS initiative. Progress is made in aligning revenues that support Administration given the transition to Family Care in 2018.

Children, Youth & Families

The Department’s proposed expenditures for 2017 for the Children, Youth & Families (CYF) Division are $57.9 million ($28.7 million GPR & $29.2 million outside revenue). This is an increase of .6% over the CYF Division’s 2016 adopted budget.

Once again, this proposal reflects a decrease in GPR in the alternate care budget based on decreased costs and utilization. The prevention/early intervention continuum is maintained, and almost all funding for provider agencies is at the 2016 level except where earmarked revenues/grants decreased. The popular Joining Forces for Families program is fully continued as is the Early Childhood Initiative, the Early Childhood Zones, and school based mental health. Enhanced supervised visitation is funded. Increased staffing to address the growing number of child abuse and neglect reports is proposed as is the creation of an AmeriCorps Coordinator so that the Prevention Services Manager can return to her work in that area full-time.

The loss of several grants such as the PATHS Pilot ($224,246), Independent Living ($108,432), and Safe Haven ($46,197) causes some reduced services as does the loss of Youth Aids revenue ($79,964). In addition, the loss of 2016 one time only funding will lower the capacity of the Juvenile restorative justice effort.

Adult Community Services

Proposed 2017 expenditures for the Adult Community Services (ACS) Division are $179.7 million ($25.6 million GPR & $154.1 million outside revenue). This is an increase of 3% over the ACS Division’s 2016 adopted budget.

This proposal funds the services in the Area Agency on Aging (AAA) at $4.9 for a 3.4% increase over 2016. This includes maintaining our unique focal point case management system that is non-mandated and increasing funding for senior nutrition site management, RSVP driver services, and the caregivers support program, all priorities of the AAA Board. One time only special projects at the focal points, case management, and funding for the cultural diversity program are maintained. The ADRC, which has been extremely beneficial for consumers, continues and is fully funded by outside revenue.

The adult developmental disabilities (DD) system’s 2017 proposed budget increases $4.01 million. Core services for consumers in the adult Self Directed Services (SDS) program are maintained with no cut to help accommodate caseload expansion and annualize the cost of the new consumers from 2016. This budget fully funds services for 59 new high school graduates with developmental disabilities, provides full year services for the 60 high school graduates added in 2016, and annualizes the cost of new consumers and rate increases in 2016. This proposal continues the long-standing practice in Dane County of funding high school graduates, a commitment that no other county makes.

The adult mental health budget increases $2.03 million or 7.4% mainly as a result of new revenue from the Comprehensive Community Services (CCS) benefit that will allow for the funding of mental health and AODA services to hundreds of consumers. An effort is made in this proposal to stabilize the revenue projections and funding to critical services. The psychiatric hospital line shows a net increase based on increased utilization. Mobile crisis and CSP services are enhanced.

Badger Prairie Health Care Center

Badger Prairie Health Care Center’s (BPHCC) budget is proposed to increase only $3,054 and essentially remain at $21.6 million ($12.2 million GPR & $9.4 million outside revenue).

This budget proposal reflects a lowering of dependency on contracted nursing services, increased Art and Music Therapy support, and funds for the potential ongoing support of scheduling software.

Economic Assistance and Work Services

The Economic Assistance and Work Services (EAWS) Division budget decreases by $2.3 million to $24.8 million ($5.4 million GPR & $19.4 million outside revenue). This is an 8.4% decrease in expenditures in this Division entirely due to the loss of outside FSET and PPACA revenue.

Dane County continues to provide eligibility determination and case management services for W-2 recipients under a contract with Forward Service Corporation. The county operation of Income Maintenance services continues with Dane County being the lead for the IM Capital Consortium which includes seven (7) other counties. The county also oversees Regional FSET operations. The homeless/housing budget is increased slightly. All shelter, housing case management, information and referral, and food pantry and clothing distribution services are maintained at their 2016 budgeted levels. This proposal reflects the annual Day Resource Center budget, funds the single point of entry for this system, budgets Hospitality House to remain open until the Day Resource Center opens, continues the Porchlight van services, and reflects the new focus of the Salvation Army sheltering services from overnight emergency shelter to rapid re-housing.

I want to extend my sincere thanks to everyone whose thoughtful input and hard work made the creation of this budget proposal possible. My special appreciation goes to my fiscal and management staff for their time and dedication and to all the providers, consortiums, and entities that offered ideas for changes, efficiencies, and partnerships. I sincerely believe that this proposal is a reflection of all those efforts and the continued commitment of Dane County to provide quality human services to its residents. I look forward to working with everyone throughout the upcoming 2017 budget deliberations.

VERBAL UPDATES AT THE MEETING
She didn’t do a powerpoint, she is IT challenged, there are handouts.

Other things she added, in specifics, are as follows (as best I can, its hard to understand some time):
– Total = $289.3 Million, a $4 Million increase over 2016
– Most is outside revenue, only $73 Million is GPR or tax dollars raised in Dane County
– They did a zero GPR with only increases in their base budget
– 1.3% increase in revenue
– The living wage is not funded as is traditional. It only went up 3 cents per hour. $64,600 is what it will cost.
– Does not eliminate and positions that will create layoffs.
– Laundry worker position and social worker position cut.
– 4.375 new positions – 2.5 access social workers (abuse and neglect – sounds like they added 1.0 for total 2.5), Americorp coordinator back in the budget, adding CCS program analyst and intake worker and adding a kinship care social worker goes to full time.
– Nothing in here for Famiily Care but they have a placeholder and they are hoping someone adds some money.
– Capital budget request for replacement items
– They are trying to get waiver money out of admin. (? Not sure I know what that means)
– They are hoping to start doing POS audits again (i.e. checking to see if non-profits are doing what they say they are doing with their money and doing it well)
– She says the suicide prevention money is in there, the program is no longer in place, it will go to RFP, in the absence of a suicide prevention service Safe Communities used that money.
– There were several RFPs this year, there are competitive grants out there for some programs in alternative sanctions.
– One drug court service was reduced.
– They put money in for OWI and drug court.
– The re-entry position of Jerome Dillard is in the budget but vacant.
– Journey Mental Health, CTA community CSP program added two positions. (for the jail)
– There are adjustments in Case Managment, there is an increase in nuitrition site and senior AODA.
– Decreased mental health services due to use.
– Catering for senior meals increased when it went to RFP
– They did some increases with an extra $100,000 they had.
– They met the goals of the senior advocacy groups through the AAA board.
– DD adult budget increases by $4M due to revenue increases, no changes in children.
– Changes in Mental Health in 2016 are continued in 2017.
– Mobile crisis got $100,000 more to ride along with police, its very popular and successful.
– They are trying to control psychiatric hospitalization costs this year.
– There are some changes between Tellurian and Journey Mental Health beds.
– CCS increase of $2M and some adjustments in POS agencies where CCS has money to fund it.
– One decrease of $1M in CLA personal care which is mutual, there is no loss of services
– Badger Prairie is the same, trying to increase core staff and less LTEs
– Children Youth and Families – largest changes here, but in alternate care they can control the lines and they removed $294,000 and put them into other needs. Transportation line had to be increased.
– Protective Childcare line increased.
– Youth aids decreased and it was replaced with GPR
– Grant losses for Safe Haven (DAIS supervised visits), Independent Living Grant (loss of Mary Beth Wilks position, she transferred, state privatized that), grant to get kids into housing was lost as well.
– Canopy reduced $30,000 due to lack of use of services
– Briarpatch not earning MA case management we budgeted, they reduced that.
– Nehemiah is getting youth enrichment funds, Boys and Girls club no longer funded for that.
– They are spending $12,000 with the city, county and united way to backfill money Oscar Mayer used to fund.
– They got $150,000 in additional grants for something as well – sorry she talks in code words I don’t understand.
– Then they lost two more grants – one for municipal tickets and the other I didn’t understand.
– $2M lost in FSET because of lack of utilization. So no impact.
– Working with Forward Services on W-2, they kept it flat, they are expecting a $4M drop, W-2 participants have been cut in half. They are hoping to help workers find a place to land.
– They are shifting positions due to Packer(?) reductions
– Library will be leaving and they will be able to put their staff back in the building. They won’t renew the lease across the parking lot.
– Homeless services $330,000 for the day resource center.
– Briarpatch has a gap but will not ask for it to be filled, their ADP is at 1.1 and is looking to make reductions in their budget.
– $80,560 funds are redirected to Hospitality House to keep it open til the day resource center opens. There is enough money if not extra.
– Restructure of Salvation Army from shelter to rapid rehousing, there will be less motel money.
– She is proud of her budget.

Q & A
– Jeremy asks about beds at detox (?)/ mental health? – Tellurian is doing all the beds. 15 beds. They had $600,000 left in that line and will work with Journey Mental (they are talking very softly and I can’t hear)
– They are talking about how great Badger Prairie is doing
– More clarifications – some one time revenues not backfilled for restorative justice programs
– more very quiet talking . . . Family Service and Healthy Minds are not getting as many referrals as they thought they would and they reduced staff.
– Drug court worker called and said they didn’t need all the money, so they shifted it. Oasis model hasn’t been updated in a while. They switched to weekend supervised visitations.
– They talk about best practices in Drug Court and they need more discussion and they will have to figure out how to do the evaluations with the money they have.
– Americorp position remains, funded by Americorp.
– Wegleitner talks about the Ombudsman program that was eliminated last year, and clarifies the mental health worker remains.
– Wegleitner asks about the budget surplus. Green doesn’t know. Sounds like she says around $3M, but her update says $6M
– She clarifies about CCS, they have 300 people on the program now, they are adding money ($2.1M) which is 15 new adults per month through the end of 2017, so 180 new adults and 75 through the end of this year, they think it is conservative numbers, assuming the state continues funding it. They are nervous about that.
– More clarifications on specialized transportation formula and state funding and funding decreased $30,000 for aging and disability transportation – 3% reduction in $900,000. Concerns about what happens under family care and the biggest concerns is the millions Metro gets for paratransit. It’s more than $3M per year.
– They talk about the volunteers that transport kids with issues, parents can’t ride in the cars and social workers try to adjust when MA payments don’t meet the needs of the family, that is the increased funding discussed above. There are some concerns about people who are doing the transit. Workers are not using it when they could.
– CPS access why 2.5 instead of 1. Heavy call volume in the middle of the day. They are hiring 5 workers and they are overlapping in the afternoons.
– Wegleitner asks when they will get details on the Salvation Army changes. Green says she will send it.
– Wegleitner asks why no COLA (cost of living increase). Green says it will cost $2.5 (?) million. (too quiet)
– Where is the library moving? (Couldn’t hear) Will they have enough space to bring their staff back? Yes they will.
– Forward Services is losing $200,000 a month on the W-2 program and we are the only ones that get certain services. She says FSET services are also contracted to them. Their FSET workers are connected to sites throughout the county. The $2M cut can be absorbed by reductions, no loss in services there is less need in the community.
– very quiet talking again . . . IMDs, beds, difficult clients, GPR, not getting much out of this, but they are talking about hard to serve people who can’t stay at Mendota and are to agressive to place elsewhere. $200,000 per person per year, they have 4 beds, they like it when there are 0 or 1 or 2. Or maybe its $135,000 per person after looking at the math.

SUPPLEMENTARY UPDATES
From Lynn Green after the meeting:

Health & Human Needs, Human Services Board, & Long Term Support Committee members –

In addition to sending the attached electronic versions of the documents I distributed at the meeting last night, here is the information on the other items that I was asked to address:

Salvation Army Program Change:

Salvation Army is transforming their emergency sheltering program for families at both their facility and through motel vouchers into Rapid Re-housing. Rapid Re-Housing means that the household is assisted to obtain permanent housing as quickly as possible. There is no universal deadline or time limit that defines “rapid.” It may take days or weeks to find a vacancy in housing an individual or family can afford, with a landlord who will accept their rental history. The important point is that permanent housing is the immediate goal. Households are not required to wait in temporary housing while they attend classes, acquire skills or otherwise demonstrate a given level of “housing readiness.” They move directly into permanent housing. If there are skills and information they must learn to sustain their housing, those things are learned in their own housing.

The Salvation Army’s goal is to place families into apartments rather than emergency shelters and support them financially and with services until they can be self sufficient in that apartment. The Salvation Army is working with landlords who are willing to make apartments available for these families for this purpose.

Dane County has agreed to support this effort by redirecting the money previously contracted to them for hotel vouchers and some of their 90 day programs funding into rent support for DAWNS, their new Rapid Re-housing program.

As a result, the Department’s 2017 budget proposal reflects the following change:
– Rapid Rehousing for Families – EASHLSAV EMSHAA – $206,300
– Emergency Overnight Shelter for Women and Families – EASHLSAV EMOFAA – $733,031

Below are more details about the budget proposal:

Rapid re-housing background:
The Salvation Army is requesting that the amount of money previously used for hotel vouchers, and some funding from their 90 day program, be re-directed to rent support for DAWNS, their new Rapid Re-housing program.

Assuming a fair market rent of $900 for a 2 bedroom apartment, with an average of six months of rental support ($5,400), the county’s funds could help safely and permanently house 38 families in 2017.

The figure above is a general estimate from the Salvation Army based on the national average of how long people in Rapid Re-housing require assistance. Some families may be able to use their own income for rent, and some families may need more than 6 months of assistance to become ready to take over a lease.

Comparatively, using funds for hotel vouchers provided only temporary shelter for fewer families at a higher cost. Smaller families could stay in a hotel for $5,850 for 90 days (the program limit). Larger families required two adjoining hotel rooms at a cost of $11,700 for 90 days. Often, vouchers were used for larger families due to capacity at the Salvation Army’s Warming House.

Overnight Shelter Background:
The Salvation Army is converting their 90 day family shelter program to a drop- in shelter program. This change will give them more flexible space at their East Washington facility to accommodate the great need for emergency shelter. Currently, even with the overflow program at First United Methodist Church, the Salvation Army is still denying some families due to capacity.

The Salvation Army will not have a shelter stay limit for their drop-in program, allowing families in need to more consistently access shelter if they need to.

The drop-in program for single women will continue, serves 45 women, and has a 90 day shelter stay limit.

Cost of a POS COLA:
The cost of a 1% COLA for the Department’s purchased services is approximately $1,500,000 ($420,000 Revenue and $1,080,000 GPR).

Day Resource Center Operator RFP Results:
Casey has asked Dane County Purchasing to share with you whatever information they can regarding the recent Day Resource Center Operator RFP and selection process. The Purchasing Agent overseeing this process has indicated that Purchasing cannot release any documents submitted for this RFP by vendors or any documents that are a part of the evaluation and negotiation process until a contract has been fully executed. Therefore, the only information available right now is who submitted proposals for this RFP which is indicated on the RFP Summary online.

Hopefully this covers all the follow-up requests from last night’s meeting. Let me know if you have any further questions or concerns. See you at the Public Hearing on the Department’s 2017 Budget Proposal on Thursday, September 15th, at 6:00 pm at the Alliant Energy Center.

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