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HomeMy WebLinkAboutAgenda - 08-21-2007-4cORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: .August 21, 2007 Action Agenda Item No. ~~ G SUBJECT: Fiscal Year 2007-08 Budget Amendment #1 DEPARTMENT: Budget PUBLIC HEARING: (Y/N) No ATTACHMENT(S): Attachment 1. Budget as Amended Spreadsheet Attachment 2. Year-To-Date Budget Summary Attachment 3. Critical Needs Reserve Status Report Attachment 4. Letters of Support from OPC Mental Health INFORMATION CONTACT: Donna Coffey, (919) 245-2151 PURPOSE: To approve budget ordinance amendments for fiscal year 2007-08. BACKGROUND: Department of Social Services 1. Various agencies and citizens donate monies during the year .to provide funds for the Department of Social Services (DSS) to assist clients with special needs including foster care children. Since July 1, 2007, DSS has received the following donations: • Foster Care Donations -donated funds totaling $20,292 from citizens, through Triangle Community Foundation, to help send foster care children to summer camp. This budget amendment provides for the receipt of these donated funds. • General Assistance Donations -donated funds totaling $102 from citizens to help with special needs of clients. This budget amendment provides for the receipt of these donated funds. This amendment sets these donations aside in the Department's special Adoption Enhancement Fund (outside the General Fund) (see Attachment 1, column #1). Board of Elections 2. The Orange County Board of Elections has received "Help America Vote Act" (HAVA) grant funds totaling $10,125 from the North Carolina State Board of Elections. These funds will be used to purchase Drive-Thru Assist -Alert Systems for all polling places located within Orange County. Alert Systems allow for voters to drive across a hose, located outside of the polling site, and wireless outdoor transmitters send signals to receivers located inside the precincts. A chime will sound inside the polling site thereby alerting precinct workers that a curbside voter has arrived. This budget amendment provides for the receipt of these funds to be used for the above stated purpose. (See Attachment 1, column #2) Health Department 3. The Health Department has received continuation grant funds from the State totaling $88,115 for primary care services at both the Whitted clinic in Hillsborough ($43,346) and the Southern Human Services clinic in Chapel Hill ($44,769). The department plans to use these funds to continue providing primary care services until June 30, 2008. The clinics are staffed with temporary employees In January 2005, Commissioners initially approved funding for the Hillsborough clinic. Currently, the clinic averages 50 clients per month and approximately 40% of those patients are uninsured, self-pay patients. The Board initially approved funding for the Chapel Hill clinic beginning January 2007. Currently the Chapel Hill clinic averages 15 clients. per month and approximately 70% of those patients are uninsured, self-pay patients. During the 2008- 09 budget planning process, as the Board and staff determine the County's core functions and associated programs, continuation of the primary care program beyond June 30, 2008 will be a topic of discussion. This budget amendment provides for the receipt of these funds to continue primary care services at both clinic locations until June 30, 2008. (See Attachment 1, column #3) Gritical Needs Reserve 4. During the 2007-08 budget deliberations, two non-profit agencies, Club Nova and KidsCope, requested additional county funding. With the final approval of the budget, while Commissioners eliminated the recommended appropriation of $125,000 to the County's Critical Needs Reserve, the Board also expressed its intent to carry forward unexpended 2006-07 Critical Needs Reserve appropriations to the new fiscal year. The Board further expressed its desire to award additional funding to Club Nova ($75,000) and KidsCope ($50,000) from the carry forward. Attachment 4 includes correspondence from OPC Area Director, Judy Truitt, expressing organizational support and appreciation for the allocations to Club Nova and CHTOP/KidsCope based upon strengthened commitments to program monitoring and fiscal review. At the end of fiscal year 2006-07 $270,000 remained in the Critical. Needs Reserve. The intent of this budget amendment is to carry forward those available funds and to appropriate $125,000 of the carry forward to Club Nova and KidsCope for fiscal year 2007-08. Following the Club Nova appropriation, $145,000 would remain available in the Critical Needs Reserve for FY 2007-08. (See. Attachment 1, column #4, Attachment 3, Critical Needs Reserve Status Report, and Attachment 4, Letters of Support from OPC Mental Health) Board of County Commissioners 5. This budget amendment transfers funds from the Governing and Management Non- Departmental budget to the Board of County Commissioners' budget to implement the Board's action as to the Clerk to the Board's performance review for 2006-07. The Board completed the Clerk's performance review on June 18, 2007. The Board decided that the Clerk's salary should be adjusted as of July 1, 2007, to $79,416 annually. That adjustment reflects the 3% cost of living increase awarded to all permanent employees as included in the Board's approved budget (an increase in salary from $72,416 to $74,589) and a special salary adjustment related to the Clerk's 2006-07 performance review (an increase in salary from $74,589 to $79,416). This budget amendment enacts the unbudgeted adjustment of $4,827 to the Clerk's salary effective July 1, 2007, and authorizes funding for the cost of the adjustment for fiscal year 2007-08. FINANCIAL IMPACT: Financial impacts are included in the background information above. RECOMMENDATION(S): The Manager recommends that the Board of County Commissioners approve the attached budget ordinance amendments. C d ^0 3 C O O 4.. a~ da ~a ~~ m ~ ~ ~ O ~ .y O U N m m :~ N O ~ a 2 mu'+ .~ j C Ol O v~ 0 rnU c m O ~ ~O C O d ~ O V N N a~ D a N O o N o O O n M N m O ' O O N V O N V N o O m O N Q! 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Truitt ~C: Laura Blackmon Gwen Harvey Date: August 15, 2007 Re: Request to Release One-Time Supplemental Funding to OPC- LME to Support Club Nova Community, Inc. As part of the divestiture efforts mandated by mental health system reform, on April 7, 2005 an RFP was released for Club Nova, a psychosocial rehabilitation program operated by OPC Area Authority. One bid was subsequently received from Club Nova Community, Inc., a private, non-profit that was created by the former advisory board to Club Nova, with the support of Club Nova staff and consumers. In September 2005, a recommendation was made to the OPC Area Board to award the RFP to Club Nova Community, Inc. The program was successfully divested in May 2006. In an effort to assure successful transition of OPC's service programs in Orange County during SFY05-06, the Orange BOCC and OPC Area Board agreed to provide bridge funding for programs equal to one month operating expenses, or $66,663' for Club Nova. In SFY06-07 the Orange County BOCC approved and distributed directly to the program an additional $75,000 of funding. OPC would support Club Nova's request for an additional $75,000 of funding in SFY07-08. As noted in the Chapel Hill Training & Outreach Program (CHTOP) letter of support, the first year following divestiture has been extraordinarily difficult for providers as they build the infrastructure necessary to support their service programs. In addition, psychosocial rehab programs like Club Nova have faced particular challenges related to the mental health reform effort. The new service definitions approved by the Centers for Medicaid and Medicare in March 2006 exclude a consumer from receiving ' OPC Area Board = $25,857 (allocated from county maintenance of effort funding) Orange BOCC = $40,806 (requested & approved July 2005) and .billing for both psychosocial rehab (Club Nova) and Assertive Community Treatment Team services (ACTT). Given that the clubhouse model is based on an assumption that membership is lifelong regardless of payor source, this means that for those consumers who choose to stay with their ACTT team rather than the clubhouse, but continue to attend the clubhouse every day, there will be a loss of revenue. Club Nova believes that this will be approximately $75,000 per year. There is no evidence to suggest that DMH, DMA or CMS is considering changes to this rule, so this will be an on-going funding issue for providers of these two services. It would be OPC's expectation that Club Nova Community, Inc. will continue their efforts to establish a private donor base, maximize funding opportunities for other services provided, and staff according to their resource availability, all of which will stabilize their system in the long term. It is noted that while SFY06-07 was a very difficult year for all providers, OPC staff have been impressed with Club Nova Community's attention to fiscal issues and overall responsible, efficient & effective management of what is essentially a new service program. As always, thank you for your continued support of the public mental health system, and please do not hesitate to call should you need any further information. • Page 2 0 _ , _. To: Orange County Board of County Commissioners Attention: Moses Carey, Chair From: Judy R. Truitt, Area Director CC: Laura Blackmon Gwen Harvey Date: August 16, 2007 Re: Request to Provide Supplemental Emergency Funding in Support of Chapel Hill Training & Outreach Program In October 2005 Chapel Hill Training & Outreach Program accepted operational responsibility for Early Intervention & Family Services of Orange County, as well as KidScope, two service programs formerly operated by OPC Area Authority. To support the successful transition of these programs at the time of divestiture, OPC Area Board and the Orange County Board of Commissioners approved the provision of bridge funding equal to one month operating expenses or $93,882.' Since divestiture of the service programs, Chapel Hill Training & Outreach has provided strong clinical services at both the center-based and the child mental health service programs. However, they have experienced significant challenges establishing an internal, or vendor-purchased, billing and reimbursement system that maximized their ability to draw down Medicaid revenues. Coupled with other systemic issues, this has resulted in a budget shortfall for the 06-07 fiscal year of $200,000. On April 27, 2007 OPC requested that the Division of Mental Health approve an emergency transfer of $100,000 of unexpended child mental health monies for CHTOP. This request was officially approved on May 7, 2007. On May 16, 2007, following review by OPC's Utilization Management Committee, a request was submitted to DMH for an additional $50,000 of unexpended child mental health monies to be transferred to CHTOP. This request was approved on May 25, 2007. ~ OPC Area Board = $36,414 (allocated from county maintenance of effort funding) Orange BOCC = $57,468 !D OPC would support Chapel Hill Training & Outreach Program s request for emergency funding from Orange County to resolve their budget shortfall for the last fiscal year. The problems currently experienced by CHTOP should not be considered significantly different than what is being seen all across the state. The first year following divestiture has been extraordinarily difficult for providers as they build the infrastructure necessary to support their service programs. OPC has been advised that Chapel Hill Training & Outreach has reduced expenses, has reviewed and will adopt new productivity and compensation packages for staff, and will be working closely with other providers in the area to identify .vendors and establish a viable billing and reimbursement system. It is our belief that these changes will enable the agency to move forward into next fiscal year. Thank you for your continued support of the public mental health system and please do not hesitate to call should you need any further information. • Page 2