HomeMy WebLinkAboutAgenda - 06-07-1993 - VII-D 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No. V JI-)
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 7, 1993
SUBJECT: Orange-Person-Chatham Mental Health Services
Space Needs In Southern Orange
DEPARTMENT: County Manager PUBLIC HEARING YES: NO: X
ATTACHMENT(S) : INFORMATION CONTACT: Albert Kittrell
Ext. 2300
TELEPHONE NUMBER-
Hillsborough -732-8181
Chapel Hill -968-4501
Mebane -227-2031
Durham -688-7331
PURPOSE: To receive. a report regarding Orange-Person-Chatham Mental
Health Services space needs.
BACKGROUND: Tom Maynard, Area Director, OPC Mental Health
Services will present a slide show outlining OPC' s need
for additional space in Southern Orange County. The
presentation will review facts related to the growth of
the mental health service system due to deinstitutional-
ization, and the resulting space crisis. Handouts
including supporting materials will be available at the
meeting.
RECOMMENDATION(S) : Manager recommends the Board receive the report
as information.
OPC - MHC
Southern Orange County
Space Needs
Developed for Presentation to
the Orange County Commissioners
June 1993
Slide 1
Northside Community Mental Health Center SPACE NEEDS
Slide 2
OPC Facts
'Established in 1968 by Federal Grant
•OPC's mission is to serve individuals who are seriously
ill , close to home.
•OPC's service to the indigent population is growing:
35% indigent in 1990
55% indigent in 1991
69% indigent in 1992 (See attachment A)
•Deinstitutionalization continues
Slide 3
Who are we serving? Then. . . . Now
Slide 4
THEN 1970 to mid-1980 's
•CLIENT POPULATION
'Smaller caseloads
'Fewer indigents
•More "worried well"
•SERVICE MODEL
*Outpatient oriented
'More clients served in institutions
•Create and fill programs
'Many seriously ill inappropriately served
Slide 5
NOW mid 1980 's to Now
•CLIENT POPULATION
•More long term, seriously ill
*More dual diagnosis
'More violent children
'More chronic substance abusers
•SERVICE MODEL
*More individually oriented
*More rehabilitation oriented
'More intensive services per client
Slide 6
What do our clients need now?
*Community Forums confirm that clients need more of the
following services :
*specialized housing
*rehabilitation services
*vocational services
*life skills training
*outreach support and crisis management
•access to allied services
Slide 7
We Grow Whether or not we want to
Slide 8
WHY?
• Inadequate services have resulted in lawsuits and mandated
services .
*Needs are intense - many still underserved
•Deinstitutionalization has continued
*Pressure from advocates to develop appropriate service system
Slide 9
OPC Growth OPC' s caseload has doubled in the past 12
years.
Slide 10
(Graphic) In 1979 the OPC caseload was 1285 . In 1991 the OPC
caseload was 2578 . (See attachments B and C)
Slide 11
Workforce Growth. The OPC workforce has doubled in eight
years .
Slide 12
(Graphic) In 1985 , the OPC workforce totaled 135 . In 1993 ,
the OPC workforce totals 270 . (See attachments D, E and F)
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Slide 13
NORTHSIDE GROWTH
•In 1978 , 35 staff moved into :
'54 offices
•6 group rooms
•2 common areas
•In 1993 , the same space is used by:
•71 staff and students , 3 days a week
.82 staff and students , 2 days a week
By the end of this year, 12 staff will need offices in Chapel
Hill . Southern Orange workforce growth rate is 4 . 6 staff per year .
(Please note that the overall OPC workforce growth rate has vastly
accelerated in the past 4 years . )
Slide 14
How do we put 71 (and sometimes 82) people in 54 offices?
Slides 15 through 44
We share, we are out of closet space, common areas are
gone. . . partitioned, we have very sophisticated juggling of office
space and we rent space in Chapel Hill . Estes Drive - 22 staff and
Lincoln Center - .2 staff .
Slide 45
Space - Southern Orange. Problems , Solutions and Long Term
Issues.
Slide 46
ASSUMPTIONS
'Mental Health will remain on Northside Campus .
'Orange County will provide space for services .
'The Orange County CIP plan allows for OPC expansion into the
Multipurpose Center.
"North Carolina will continue to view space as a local
responsibility.
3
Slide 47
1993 : IMMEDIATE SOLUTION
to current overcrowding at Northside
"PURCHASE MODULAR BUILDING •
'12 New Offices
'Cost : $55 , 000
'RENOVATE LOWER FLOOR NORTHSIDE #2
'10 New Offices
'Cost : $100 , 000
Slide 48
OUTCOME
•POSITIVE
"Can be implemented fast
'Board approved
"Renovation improves Northside #2
•NEGATIVE
• Inadequate solution
"Uses $155 ,000 of OPC Fund Balance
Leaves inadequate reserve (See attachment G)
"Modular is only a short term solution
Slide 49
1996 : ORANGE COUNTY CIP
PLAN : OPC will expand into the Northside Multipurpose Center
upon completion of the new Southern Orange Human Services Complex.
Slide 50
1996 : OUTCOME
•POSITIVE
'Gain 21 Offices Total : 97
'Clinics stay in Northside Complex
•NEGATIVE
'Does not meet space needs at current rate of growth -
97 offices , 98 staff (based on conservative estimates)
"Will still rent space for 24 staff
'No money in CIP to cover Multipurpose Center renovations
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Slide 51
LONG TERM SPACE ISSUES
*All current plans fall short of need
• In 10 years , 151 staff will need offices in Southern Orange
County
*We will then be 32 offices short
•10 years of rent = $270 , 232
*Modular will be 10 years old
Slide 52
SUMMARY
*Space in Southern Orange is in crisis stage
*Future growth is inevitable - services still are inadequate
*OPC is spending the last of its available resources on a
temporary fix
*The current CIP, which provides OPC with Building #1 , is
already an obsolete plan
*We need help now in providing for our needs tomorrow
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Attachment A
Payment Percentages for
Active Clients
May 1993
Percent of all
Payment 'Rate % Number of Clients clients
Without medicaid
0% 275 9. 2%
1-10% (Min chg. ) 1061 35 . 3%
11-20% 133 4 . 4%
21-30% 82 2 . 7%
31-40% 79 2 . 6%
41-50% 65 2 . 2%
51-60% 45 1. 5%
61-70% 32 1 . 1%
71-80% 25 0 . 8%
81-90% 19 0 . 6%
91-100% 452 15 .0%
With medicaid
0% 737 24 . 5%
TOTAL 3005 100 .0%
•
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Attachment B
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Attachment C
OPC Caseload Summary
1979-1992
These figures represent clients who have open charts at OPC. They
do not show intensity of service such as the number of different
services they receive at OPC nor does it show how many hours of
service they receive in a year.
FISCAL YEAR
1979 1285
1980 1288
1981 1374
1982 1458
1983 Information not readily available.
1984 2023*
1985 1804
1986 1879
1987 2061
1988 2154
1989 2496*
1990 2212
1991 2578
Current active caseload is 2800 to 3005 . Approximately 200 cases
need to be cleaned up for our current computer conversion.
*Each of these spikes occur the year directly prior to OPC' s two
computer conversions . They are statistical anomalies and reflect
a situation where the client terminates with OPC but the state
office (where this data is compiled) is not notified. This
information is transmitted by computer disc and there is a
reporting hiatus during the conversion process . This causes the
OPC caseload to artificially inflate and stay inflated until staff
clean up the data.
Figures taken from the Annual Report , Client Information Branch,
Division of Mental Health, Developmental Disabilities and Substance
Abuse Services , Raleigh, N.C.
8
-229
153 155 159 A
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Attachment E
OPC Workforce Growth
The overall rate of growth over the past 9 years averages 4 . 5
people per year.
The rate of growth over the immediate past 4 years averages
25 people per year.
Since 1989, OPC has created (but not necessarily filled) 239
positions area wide . Eighty one (81) of those positions were
created in Southern Orange County. (34%)
•
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\ . .
. . . . Growth
1979 1993
/\ 14,000,000 .
FY 1979 $2,453,922.
. 12,0 00,0 0O FY 1993 $13,131,71. }
.
10,000,000
.
8,000,000 - . \
§,000,000
\\ 4,000,000
. ) /
< . \ 7
2,000,000
.
#
\ \� O
// . >
1979 1980 1981 1982 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 \ -
Attachmnt G
OPC-MHC Fund Balance
How the purchase of the modular building for the Northside campus
and the completion of the renovation of the downstairs of Northside.
building depletes OPC Fund Balance as of May 1993:
Current Fund Balance $1 ,118 ,000 .
Reserved by State Statute 450 ,000 .
Reserved for Willie M program 150 ,000 .
Total NOT AVAILABLE 600 ,000 .
Balance 518 ,000 .
Board Adopted Policy requires
5% of OPC Budget be maintained
in reserve and NOT appropriated.
Current budget is $13 ,000 ,000 .
5% of 13 million is $650 ,000 .
$518,000 . of 13 million is 4%.
Modular Building Purchase 55,000 .
Renovation of Northside downstairs 100 ,000 .
New fund balance after above
expenses (3% of budget) $363,000 .
•
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