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B02292012 New Hanover County Board of Social Services Meeting Minutes Commissioner's Conference Room 601 10:00a.m. — 2:00 p.m. The New Hanover County Board of Social Services met in open session on Wednesday. February 29. 2012 at 10:00 in Conference Room 601 of the New Hanover County Government Center. ATTENDING: John Craig. Chairman: Patrick Riley. Vice Chairman: Evelyn Bryant: Diana Woolley and Jonathan Barfield Jr. ALSO ATTENDING: LaVaughn Nesmith. Secretary to the Board: Stephanie Monteath, Administrative Support Specialist The Chairman called the meeting to order at 10:20 a.m. Mr. Craig asked for a motion to approve the agenda. Mr. Riley moved for approval of the agenda. The motion was passed with a unanimous -aye-. Ms. Bryant led the invocation. Mr. Riley led the Pledge of Allegiance CONSENT AGENDA Mr. Craig asked for a motion to approve the consent agenda. Mr. Riley moved to approve the consent agenda. The motion was seconded by Ms. Woolley and passed unanimously. INFORMATION AGENDA Mr. Craig noted the numbers in Food and Nutrition is up. Ms. Woolley remarked that the protective services numbers are up significantly since the previous year. Ms. Woolley wants to ensure there is enough staff to handle the increase in caseloads. Ms. Woolley also asked that a discussion take place about sufficient staff for Family and ChildrenIs Medicaid and Adult Services. Karen Graham reviewed budget expenditures. Director Nesmith shared that the Department of Social Services is investigating a foster care child fatality that occurred this morning on the way to school. Mr. Craig asked about the letter to the Cape Fear Public Ltility Authority. Director Nesmith and Chris Coudriet clarified that they have not Vet passed a resolution as to how to proceed with information sharing. Mr. Craig asked if DSS has enough people to handle the long list of mandated services DSS must provide. It was agreed to discuss this further during the action agenda. Brian Bocnuk gave detail about the proposed policy on allowing foster children to drive. Basically the proposal gives responsibility to the tester parents — to pros ide insurance. training, access to a Page 2 of 7 car. etc. Mr. Hollandsworth. Senior Attorney. shared the agency plans to review licensure on a case by case basis. The County will run this through their legal department and risk management. • The item was tabled. No action was taken by the Board. The board recessed for a 5 minute break at 10:31 AM. The board reconvened at 10:37 AM. STRATEGIC ACTION AGENDA New Hanover County Department of Social Services Proposed Budget for FY12-13 LaVaughn Nesmith discussed the fiscal state of the agency and reviewed the extraordinary measures the agency has taken to stretch current resources and staff to meet the needs of the community with significant cuts in funding. Bruce Shell. County Manager. commented DSS has had more challenges than any other department with the economy. While the economy is improving. DSS numbers are getting worse due to volume. The Board of Commissioners asked Mr. Shell to put together a 2 year budget. Mr. Shell gave the department credit for thinking outside of the box to meet the needs of the public. Mr. Nesmith noted that while we utilized volunteers really successfully last year. the Federal 0 Government now prohibits the use of volunteers with sensitive information containing social security numbers. Cutting the use of volunteers cost the agency 880.000.00. Patricia Robinson introduced the budget process roadmap with the County. Ms. Robinson explained how Leading By Results works with the budget process. Ms. Graham reviewed the Guiding Principles used to develop the budget. Ms. McNamee discussed Managing for Results. Ms. Marino explained the process has helped the agency measure its successes and has been an excellent management tool. Lora Thackrah reviewed the customer service initiative explaining the agency hopes to unfreeze 3 positions. add an additional 2 full time positions and add additional overtime to provide exceptional service. There are several strategies DSS is employing to meet the growing needs of the community. Ms. McNamee explained that DSS is using new technology and utilizing kiosks. Angelina Bernard explained the benefits of increasing the agency vehicle fleet and how using the rental vehicles are more cost efficient for trips further than 80 miles out of the County. Ms. Marino discussed several strategies Social Work is using to meet demands through the outsourcing of many services including child and family team meetings. out of county visits. family preservation services, clinical assessments and reunification services. CPA services and CAPP's (Child Advocacy and 0 Parenting Place) parenting classes. The proposed new expenditures for the upcoming year are as follows: • reinstate 3 new positions Item 2 Page 2 Page 3 of 7 • increase contracting 0 • upgrade automation and technology • additional 2 direct services staffing positions Mr. Barfield asked for clarification as to where the reinstated positions and 2 new positions would be placed. Ms. Graham answered 1 child protective service/treatment position, 1 adult protective services position and 1 Family and Children's Medicaid position. The 2 additional positions would go to Food and Nutrition Services and Adult Medicaid. All programs adding staff have had caseloads increased by 50-100%. The County share would be 50% of the funding for each position. Ms. Graham reviewed the expenditures pie chart, noting the proposed budget for 2012/2013 is 838.100.087.00, a total combined budget including Federal, State and County funds. Broken down, Federal dollars pay 44.28% of the budget. State dollars pay 14.41% of the budget and the County pays 40.33% of the budget while the last .99% is paid by other resources. Ms. Graham explained that if the County does not meet that match, the Federal and State funds would be pulled and the County would be 100% responsible for funding the agency which would be State run. Beth Schrader further explained the budget break down. Mr. Barfield noted he is trying to understand how to cover all the expenses with no increase in County revenue. The board recessed for a 5 minute break at 11 :24 AM. The hoard reconvened at 11 :29 AM. • Karen Graham reviewed Administrative Support The target for 1 1 '12 is to utilize 100% or greater of all available state and federal dollars for allowable costs. Ms. McNamee discussed measuring wait time. 76% of the clients were seen within 30 minutes of registering. There may be some extra wait time in the upcoming year with the installation of new technology and training to use that. Ms. Woolley suggested the target should be lowered to 70% instead of 80% to not set up staff for failure. Mr. Barfield and Mr. Nesmith felt the bar should not be lowered. Stephanie Monteath reviewed staff turnover noting the number is cumulative and the goal for FY 12/13 is < 10%. Currently. turnover is higher in Economic Services than in Social Work. As of the first 6 months of the fiscal year turnover is at 6%. Ms. McNamee introduced Food and Nutrition Services explaining that due to the economic downturn, citizens that have never used services before are not only eligible. but coming in to the agency for services. Ms. Brantley continued that the agency is serving 91.68% of eligible participants, far exceeding the goal of reaching 62% of the population. Mr. Barfield noted during hurricane Irene. many people came in to ask for emergency food replacement services. Mr. Barfield asked how the agency weeds through the folks coming in for 0 services that did not actually lose food. Ms. McNamee noted there is a fraud unit in place in the agency. Ms. Brantley shared that during the period following Hurricane Irene, many people learned they were eligible for regular monthly assistance with food. but not everyone that applied was given disaster EBT cards. Item 2 Page 3 Page 4of7 • Ms. Brantley shared strategies for efficiency put in place to serve the 100% increase in people applying and receiving Food and Nutrition Services. to include the upcoming Northwoods project and NC Fast. It is important to process all cases timely or the agency will be fined by the State. The proposed budget for Food and Nutrition Services in FY2012/2013 is 52,065.023.00. Ms. Brantley reviewed Child Care Subsidy. The vision is to ensure safe. quality, accessible and affordable child care for children in New Hanover County. supporting the independence of families by enabling responsible adults to secure and maintain employment and meet the basic needs of their children. The Child Care Unit has worked with the Community Child Protection Team to develop a protocol to give Day Care Subsidy to a family that may be able to place a child with other family members in order give that child permanency, as the family may not be able to care for that child without that assistance. Ms. Marino gave examples. Chris Coudriet clarified that if this measure were in place. the cost of foster care may be cut as the child would often be able to stay with family or even at home. The Community Child Protection Team has identified lack of continuing childcare assistance as a gap contributing to recurring maltreatment. An increase in daycare funding will not necessarily decrease foster care numbers but would shorten the amount of time for finding permanency, which ultimately could result in cost savings for the County. The proposed budget for Child Care is 58.691,594.00. 0 Ms. McNamee introduced Medicaid and Health Choice. In FYIO%1 1 95.80% of the eligible population received Medicaid and Health Choice services. Kathi Heslin explained the caseloads in Medicaid continue to grow. Through healthcare reform. the goal is to become just one Medicaid (not Family and Children's Medicaid and Adult Medicaid). The Medicaid unit has worked with II and automated Medicaid packets. saving staff at least 8 hours a month in time. There are two tele- working staff in Medicaid. They handle all mail-in applications over 200 a month. The unit is constantly looking for creative ways to handle the increasing caseloads. All areas of Medicaid are paperless as of the first of the year and expect the Northwoods project to positively impact the unit. Ms. Heslin would like to add 2 positions to Medicaid. The proposed budget for Medicaid/Health Choice is 54.289,695.00. Mr. Barfield reiterated that it will be difficult to ask the County for funds when there is no increase in revenue. Ms. Woolley would like to present a clean chart to the Commissioners explaining how taking money from one place affects another place and a second chart to show what DSS adds to the economy. The Board broke for lunch at 12:15 PM. The meeting reconvened at 12:57 PM. 0 Ms. McNamee introduced Child Support Enforcement which was outsourced by the New Hanover County Commissioners 14 years ago. Alyssa Harrell of Young Williams reviewed Child Support Enforcement goals. In FY 10-1 1 the program collected 101.7% of the support obligated. During Item 2 Page 4 Page 5 of 7 the first 6 months of this fiscal year. collections are at 49?°o. Currently Young Williams •is meeting or exceeding most statewide averages. The proposed budget for Child Support Enforcement is S1.691,987.00. This amount could vary due to incentive money that may be recouped by the State and money that the Federal Government will reimburse the County. Director Nesmith does not expect this to impact the proposed budget. Wanda Marino explained that three years ago when the agency lost 27 staff, the agency lost a lot of tenured social workers. As well, the prevention unit. which was housed within the Work First unit. was dissolved. The prevention unit was really successful in keeping families intact, keeping children out of foster care and prevented recidivism. Prevention however, is not a mandatory service so it was cut. Gwen Stahl explained the goal of the Work First unit is removing barriers that keep families from becoming self sufficient. There are 2 targets for Work First: • Move 50°o of Work First participants to sustained employment • Keep Work First recipients from returning to the Work First program after six months The second target has been achieved by 100°0. The Work First social workers administer Emergency Assistance funds through programs such as Low Income Energy Assistance Program (LIEAP). General Assistance. Good Friends Funds. Faith Community Funds. Crisis Intervention Program (CIP) and Share the Warmth. Mr. Barfield asked about the impact working with Cape Fear Public Utility has had with Emergency Assistance. The CFPU has not yet authorized the release of information. Although Ms. !Marino explained the screening process and criteria for eligibility that could be used to expend CFPU funds. the Cape Fear Area United Way has expended the original funding and could continue to screen for those funds. Mr. Nesmith also noted that people who are fined for tampering with reconnecting their water illegally will not be receiving assistance in paying those fines from DSS. The proposed budget for Work First and Emergency Assistance is S2.557.834.00. In addition to the Emergency Assistance funds. NHCDSS receives private donations through individuals and churches Ms. Marino explained the goal for Nevt Iia10N-er Countv--s aged and disabled adults (age 18 and above) is to live in safe. healthy. stable and most appropriate environments. As New Hanover County attracts a lot of retiring adults and the numbers of adults needing assistance is rising. There are 2 targets for Adult Services: • 000 of aged and disabled adults will be repeat victims of confirmed maltreatment • 00.,0 of aged and disabled adults will be abused. neglected or exploited. Currently 8.33"0 of aged and disabled adults are confirmed repeat victims of maltreatment. Ms. Stahl explained that DSS can not force an adult to utilize DSS services and people often ask DSS to leave. Many people are victims of self neglect. The Adult Services unit is meeting its second target. Page 6of7 Ms. Stahl explained that Adult Protective Service staff is carrying a caseload of 33 cases per social • worker. double of the State recommendation of 15 cases per social worker. All APS workers were reclassified to zone 2 social workers to enable all staff to do investigations. As well. the agency has restructured several times to place additional workers in Adult Services from other areas of social work. Ms. Stahl is asking for an additional staff person to meet State standards. Ms. Woolley noted she will ask if there is sufficient staff for Adult Services every month as not only is the over 60 population growing, but people are living longer than they used to. Ms. Stahl shared that DSS has received 541 protective services reports and investigated 386 reports since December 2011. Dean Hollandsworth shared a story from another county, wherein a Mental Health agency was serving as guardian for adults and did not know 3 of its wards were deceased. Contracting out guardianship/oversight responsibilities is not guaranteed to be as thorough as DSS oversight. The proposed budget for Adult Services is $2,476.313.00. Ms. Sanders explained recidivism in child abuse and neglect and gave examples. The targets for Child Protective Services are: • Repeat maltreatment is less than 7.1% during FY2012/2013 • Less than 20% of children who had a confirmed CPS report will be placed in custody of the department during FY2012/2013 411) The State standard of caseloads for intensive services social workers is 8 to l. Currently social workers are carrying caseloads of 13-15 to 1 which is really challenging as there are multiple visits to families each week. Since July 1, 2011. 104 children have been placed into foster care however 60% of the children involved in confirmed CPS reports have been able to remain in the home due to increasing the number of treatment social workers that work intensively with families to maintain the family. The agency is requesting an additional treatment social worker for the upcoming year. Mr. Bocnuk added that he believes there is a direct correlation to increasing treatment workers with families to the drop in children coming into custody. Mr. Bocnuk talked about foster kids. children who have failed to thrive or have been very severely abused. There are four targets for foster care services. 'Tl r 1 r 1 1 •1 1 ' 1- --- _ --.1---1- --_ _._:1: _.,a..,._ . - L uc 1u>1 jwat 1J w uuu • 11ll1UILII 1JGluIa11ull.y I�iu1111 vIw yLa1, Vl IILLII �1 1l C. 1VUUU1v.auvll vl permanent placement. It has been a challenge for myriad reasons. The second target is to find children eligible for adoption an adoptive home within two years. Often delaying this process are appeals to termination of parental rights as parents may clearly love their children but are unable to safely care for them. 0 The third target is connecting eligible children to LINKS services, helping kids transition from foster care to independent young adults. The agency is meeting this target. The last target is to keep kids ages 16- 18 Years old avoid high risk behavior. Currently 91.89% of kids in that age group have avoided high risk behavior in the first six months of the fiscal year. Item 2 Page 6 Page 7 of 7 • The proposed budget for Children's Services is $12.985.701.00. Karen recapped the entire budget including administrative costs. Mr. Nesmith asked Leslie Chaney to explain the S70,000.00 technology costs for the agency. to include scanners, replacement computers and incoming systems such as NCFAST and Northwoods. Ms. Chancy noted that tele-working has been pioneered by DSS. Director Nesmith gave closing remarks. The Chairman asked for a motion to support the proposed agenda for FY 2012/2013. Ms. Woolley moved to support the budget to include 283 full time employees. The motion was seconded by Mr. Riley and passed unanimously. Next Meeting Objectives Program Integrity Investigations Challenge Program Integrity Recovery Efforts Achievement Additional Items Ms. Woolley asked to be notified when the County Manager accepts the budget. • As there were no further items to discuss as P rovided in G.S. 154A-98 to consider information that is confidential pursuant to G.S. 108A-80 and or G.S. 154A-98, the board by consensus adjourned at 2:49 PM Respectful submitted. LaVaughn Nesmith. Secretary to the Board -vi-t)-e---- E. G-0-`1 .ohn E. Craig, Chairman LN: scm B022912 Item 2 Page 7