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HomeMy WebLinkAboutResolutions - 1988.09.22 - 176941-IEEV APPROVE THE FOREGOING RESOLUTION _ 1 A-7 HEALTH & HUMAN SERVICES COMMITTEE Miscellaneous Resolution # 88257 September 22, 1988 BY: HEALTH & HUMAN SERVICES COMMITTEE-Susan G. Kuhn, Chairperson RE: INSTITUTIONAL & HUMAN SERVICES/COMMUNITY MENTAL HEALTH-- WOODLAND HEIGHTS COMMUNITY SUPPORT PROGRAM APPLICATION TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Mr. Chairperson, Ladies and Gentlemen: WHEREAS there is a severe shortage of safe, adequate, supervised housing in the City of Pontiac and throughout Oakland County for chronically mentally Hi citizens, a shortage which results in homelessness for some and a perpetuation of substandard living arrangements for many others; and WHEREAS federally subsidized apartment facilities exist in Pontiac which have vacancies and which are intended for chronically ill adults and other low-income groups; and WHEREAS the City of Pontiac has proposed that the Oakland Community Mental Health Division provide supervision and programming in the 197 -unit Woodland Heights apartment building for its mentally ill residents which would permit accepting additional clients of Community Mental Health who are in need of permanent housing; and WHEREAS a proposal for such on-site supervision and programming has been developed jointly by the City, Community Mental Health, and its Pontiac General Hospital CMH Clinic for submission to the Michigan Department of Mental Health for funding; and WHEREAS this proposal has been strongly endorsed by the Mayor of the City of Pontiac; and WHEREAS the proposal envisions a model housing unit for chronically mentally ill adults offering furnished, federally subsidized single apartments for 80 citizens, client services management and psychiatric supervision, a recreation and activities program for the residents, and both on-site and off-site vocational programming; and WHEREAS some existing funding and staff from the CMH Case Management Unit of the Pontiac General Hospital would be redirected into the new Woodland Heights program, and off-setting Medicaid revenue is also projected. This results in a net new-dollar cost of $208,868 for the program for the balance of the current fiscal year (October-December), requiring County match in the amount of $20,887; and $761,070 on a full-year basis in 1989, requiring County match of $76,107. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves the Woodland Heights Community Support Program application as recommended by the Community Mental Health Services Board. BE IT FURTHER RESOLVED that Community Mental Health provide a full report to the Health & Human Services Committee after one year. Mr. Chairperson, on behalf of the Health & Human Services Committee, I move the adoption of the foregoing resolution. REPORT TO THE HEALTH AND HUMAN SERVICES COMMITTEE BY: FINANCE cogmmEE, DR. G. WILLIAM CADDELL, CHAIRPERSON IN RE: INSTITUTIONAL, AND HUMAN SERVICES/COMMUNITY MENTAL HEALTH - WOODLAND HEIGHTS COMMUNITY SUPPORT PROGRAM APPLICATION In accordance with Miscellaneous Resolution 1186186, Revised Federal and State Grant application and Reimbursement Contract Procedures, the Finance Committee has reviewed the application for the Woodland Heights Community Support Program and finds: 1) This is a proposal to the Michigan Department of Mental Health for supervised apartment housing for chronically mentally ill adults; 2) The proposal has been developed jointly by the City of Pontiac, CommunitTMental Health, and the Pontiac General Hospital CMH Clinic; 3) The program is expected to be approved by the State for the fiscal year beginning October 1, 1988; 4) Full year cost for the program is $969,273 Which would be funded by reappropriation 9f costs associated with the current CMH Case Management Program at Pontiac General Hospital, Medicaid revenue, 90% State match, and 107 County match per the attached schedule; 5) The total program would be contracted with Pontiac General Hospital, therefore, no additional County personnel are required; 6) Application or acceptance of the contract does not obligate the County to any future commitment. Mr. Chairperson, on behalf of the Finance Committee, I move the acceptance of the foregoing report. FINANCE COMMITTEE FINANCIAL ANALYSIS WOODLAND HEIGHTS COMMUNITY SUPPORT PROGRAM APPLICATION PROGRAM COMPONENTS REMAINDER OF FULL YEAR 1988 COST COST (10/1-12/31) (1989) REVENUES NEW REVENUE: STATE - 90% MATCH $17,981 $684,963 COUNTY - 10% MATCH 20,887 76,107 MEDICAID 15,286 61,143 SUBTOTAL 224,154 822,213 REAPPROPRIATION FROM CURRENT PROGRAM 36,765 147,060 TOTAL FUNDING $260,919 $969,273 EXPENDITURES SALARIES AND FRINGES* 109,014 436,055 OFFICE FURNITURE (NONRECURRING COST) 12,000 0 OFFICE EQUIPMENT (NONRECURRING COST) 3,600 0 OFFICE SUPPLIES 600 2,400 TELEPHONE 1,125 4,500 TELEPHONE INSTALLATION (NONRECURRING COST) 1,500 0 MOVING COSTS (NONRECURRING COST) 1,500 0 EQUIPMENT RENTAL AND MAINTENANCE 1,825 7,299 PERSONAL MILEAGE 963 3,850 TRAVEL AND CONFERENCE 600 2,400 CLIENT SERVICES 900 3,600 MEDICATION** 4,000 16,000 PROFESSIONAL SERVICES** 4,250 17,000 CLIENT TRANSPORTATION 250 1,000 RECREATIONAL SUPPLIES 1,756 7,025 EDUCATIONAL SUPPLIES 125 500 EQUIPMENT 345 1,380 PRINTING 125 500 TREATMENT PROGRAMS 77,604 310,414 CLIENT FURNITURE 38,837 155,350 TOTAL EXPENDITURES (CONTRACTUAL SERVICES) $260,919 $969,273 *SALARIES AND FRINGES INCLUDES REAPPROPRIATION FROM CASE MANAGEMENT PROGRAM OF $28,515 FOR PARTIAL YEAR AND $114,060 FOR FULL YEAR. **MEDICATION AND PROFESSIONAL SERVICES ARE TO BE REAPPROPRIATED FROM CASE MANAGEMENT PROGRAM. NOTE: THE CITY OF PONTIAC IS PROVIDING OFFICE SPACE WITHIN THE . HOUSING UNIT AT NO CHARGE TO THE COUNTY. PREPARED BY BUDGET DIVISION 8/24/88 OAKLAND COUNTY COMMUNITY MENTAL HEALTH SERVICES BOARD WOODLAND HEIGHTS COMMUNITY SUPPORT PROGRAM The City of Pontiac through its Housing Authority, currently maintains a low income apartment complex which houses primarily elderly and physically handicapped persons. The facility known as Woodland Heights is located on the City's East side at 120 North Edith. It has a capacity of 197 units, however its current occupancy rate approximates 50%. Twenty-eight (28) of the residents have been identified as recipients of CMH Services at one or more of our programs. The City has suggested that they could and would accommodate an increased capacity of mentally handicapped persons if we could provide 24 hours resident care services with professional back-up to handle emergency situations. It has been proven that specialized residential services can increase the success rate of citizens living independently. Citizens that participate would be given the opportunity to maximize their ability to succeed in a modified supported independence. Our proposal would be to provide though a contract with Pontiac General Hospital, 24-hour on-site para-p-rofessional personnel with a crisis backup team. In addition, professional staff would occupy offices in the facility to provide on-site programming and socialization activities. This program would give the citizens of Oakland County the opportunity to demonstrate their ability to live more independently and maintain a quality of life that has not been available in the past. Representatives of the Michigan Department of Mental Health have visited the facility and have agreed to fund a Program Revision Request for the upcoming fiscal year. PROGRAM REVISION REQUEST WORKSHEET 1. PRR TITLE: WOODLAND HEIGHTS COMMUNITY SUPPORT PROGRAM OF PONTIAC 2. DIVISION: [-IIKT-A I IMI-C I_IDD LIAdmin 1_14A I:IPrevntn LI Other: OFFICE SPACE - Do not mark For FY PRR ID # Priority of Net DMH Funds .$ Date Written or Revised: , by 4. The population to be addressed is ITIMentally Ill Adults l'IMentally Ill Children IIIDevelopmentally Disabled citizens 111Ethnic/Minority citizens 1Chronically Impaired LI Special Needs group LIQuality of Care needs I:10ther (check all that apply) 5. The need/problem area addressed is . It has become more and more difficult for chronically mentally ill citizens to find and keep housing that is affordable, well maintained, safe and located in neighborhoods with accessible, clinical support. When citizens are discharged from Clinton Valley Center, or are ready to move out of a group home or away from their families into an independent setting. There are few housing resources available and what is available, is often substandard or too costly. There is a great need for housing that would enable citizens to move from a dependent setting to an independent setting at an affordable cost and with accessible clinical services. 6. The specific target group to be served is ... I IN/A Citizens with a chronic mental illness who are over the age of 18 and reside in Oakland County and have had one or more hospitalizations at CVC or other institution and have been unable to re-integrate into the community and have an impairment level with a GAS score average of 49.25 and range between 35 - 65 GAS. 7. EXTENT OF NEED AND NATURE OF CURRENT SERVICES: (complete at least one) 200 persons with this need/problem are not currently served by the public mental health system. (= UNSERVED CITIZENS) 50 persons with this need/problem are being served, but not provided the amount or intensity of service they need. (= UNDER- SERVED) 50 persons with this need/problem are being served, but not with the kind of service they need. (- INAPPROPRIATELY SERVED) . SERVICES TO BE PROVIDED: 1 1 N/A 8. (EXTENT OF NEED continued:) N/A It has been reported by Clinton Valley Center that as many as 70 citizens could use a sustaining housing program with intensive support in the community. Local homeless shelters report that as many as 45% of the citizens they serve are mentally ill. Statistical data reveals that 40% of the mentally ill at Central Case Management, live with and are dependent on their families. Less than 20% live in a place of their choice. 9. This proposal would serve Planning Areas 1 2 3 4 5 6 7 8 9 VIThis proposal will serve all of Oakland County. Chronically Mentally Ill Citizens FIThis proposal will serve Living at Woodland Heights (describe area) LO. ALTERNATIVE RESOURCES TO MEET THE NEED: 1 ) N/A There is no program that currently offers the level of independence, support and low cost housing that this proposal would provide. The mission and philosophy of the proposed service will be to . Provide low-income housing, psychiatric services, prevocational habilitation services, 24-hour crisis intervention and recreational services to 80 chronically mentally ill citizens residing in the Woodland Heights Project in order to increase and facilitate their integration in the community, increase independent living skills and reduce recidivsm at CVC. Chronically mentally ill adults given support can successfully be intergrated into the community at large. The philosophy of service is based on the conceptual framework of two levels of integration. The first level of integration is achieved in the housing project itself by combining a maximum of 40% chronically mentally ill along with senior citizens and physically impaired. The second level is achieved in the community at large by linking the residents to other community programs, employment and social functions. In order to provide a continuum of services needed in the rehabilitative process of the chronically mentally ill. A social and recreational program will be offered during the evenings and weekends only to ensure community involvement. 111This Proposal is for expansion of the existing program without any change in its mission or philosophy. 12. Community resources involved in the development and guidance of the program will include ... 1. Redirection of partial Pontiac General Hospital Case Managemehtl" budget to care for 80 citizens 2. The Pontia6:-Housing Commission will provide 80 units to house the. citizens and to provide office space if needed. 3. OLSHA may provide some meals. 4. New monies to provide services as outlined in PRR. S. Senior Companion Program. 6. Residence Council. 7. Day Treatment Team. 8. SOLEC Treatment Team. 9. Sheltered Workshop Team. 10. Supported Employment Team. 11. Volunteer Council. 12. Alliance for the Mentally Ill (AMI). 13. Admission criteria for the program will be ... L_IN/A Must be 18 years old. • Resident of Oakland County. • Have a diagnosis of mental illness. • To be determined appropriate for mental health services. • Be willing to participate in the program. • Have demonstrated a moderate degree of functioning with daily living skills. • Have demonstrated reliability in taking medication without supervision/or willing to work on a plan. . Have sufficient behavioral self-control in order to act appropriately in public settings. • Clinical assessment should not indicate acute suicidal or homicidal potential. • No bizarre or anti-social behavior. - . Be stabilized medically and psychologically with his/her current medication. Not be actively involved with substance abuse in the last year. Additional criteria as required by HUD. This proposal is for expansion of an as noted under item 11 and admission criteria 14. Specific service activities to be provided wi:: _:-.:.-:_7ie (check all that apply) Licse finding j_jiden:ifi:a -_ii7 .:reeni:-.g 1/1assess- ment/diagnosis - lirevention lo _ ,_ 13--(:rls:s e i :X;clnt ser- vice management-CSM Ix clinical therapies s.-7 -ialization 1 -1single• entry single exit _community npatient care Xj•ommuniTy _c on- sultation 1x1skill training rilhealth care ;)( ir.-.home support 'Warn -ily support Ill training: (specify) I '(work activity 1 -jsheltered work _ -- I IsuppOrted em21. ntransitional empl. j -Irespite care: (specify) I 'crisisI Isch -e-duled 1 -1in -home _ 1 lout -of -home _1 igroup _ lijshelter: (specify) klindep. 1 I -.-IP I jAIS 1 -1Gen AFC 1 -1nursing - - _ _ ...... home LjLevel II I 'Level III I 'Level IV Illother: Staff Mileage Travel & Conference Client Assisting Funds Medication Medical, Lab Fee, Dental $ 3,850 2,400 3,600 16,000 (Redirection) 17,000 (Redirection) $42,850 Sub Total - 33,000 Redirection $ 9,850 TOTAL (FOR NON-RESIDENTIAL PROGRAMS) 15. STAFFING NEEDS AND QUALIFICATIONS: Redirection from:PGH Case Management No. of FTE's Discipline I:1 No staff requested Recommended Staff:Citien Ratio 2.0 Case Managers $ 57,181 1.0 Psychiatric Nurse 34,033 , .2 Clinical Support 22,846 New Staff Requested $114,060 Sub-Total (Redirectional) 2.0 Recreational Therapists 56,964 1.0 Coordinator 38,420 .3 Clinical Support 34,354 2.0 Clerical Support 42,420 1.0 Vocational Rehabilitation Specialist 28,000 1.0 Research Coordinator 32,300 3.0 Residential Care Aide (RCA) 78,537 On Call Time 11,000 $321,995 Total 16. SPACE REQUIREMENTS: 171 None Office Space Provided by Pontiac Housing Commission 17. FURNITURE AND EQUIPMENT: 0 None Office Furniture (for 7 new FTE l s) $ 12,000 (non recurring) Office Supplies 2,400 Office Equipment (copier, typewriters) 3,600 (non recurring) Beepers 400 Maintenance contracts for equipment 449 $18,600 non recurring) Phone tie-in 1,500 (nonrecurring) Monthly phone 4,500 , Lease one (1) van 5,100 Upkeep, gas 1,350 Moving costs 1,500 (non recurring) $32,799 TOTAL 18. OPERATING ITEMS 1:1 None PONTIAC GENERAL HOSPITAL COMMUNITY MENTAL HEALTH CENTER (ACTIVITY PROGRAM) Supplies 1. TRANSPORTATION (rental of bus for special events $ 1,000.00 II. SUPPLIES A. Occupational Therapy B. Horticulture (Rental & Supplies) C. Music Therapy (Instruments & Instructional Material) D. Activities of Daily Living (Cooking & Grooming) Ex: cookingl utensils, grooming appliances & equipment III. EQUIPMENT & TOOLS Fitness Equipment Equipment Rental (Cross Country Skis, Ice Skates, Canoes) 1,475.00 2,950.00 600.00 2,000.00 $ 380.00 1,000.00 IV. EDUCATIONAL MATERIAL Training Modules for Coping Skills $ 500.00 V. PRINTING (Newsletter) $ 500.00 $10,405.00 $9,200 per slot per year x 7 = $ 64,400 $293,708 OFF SITE PROGRAM SLOTS 1. Day Treatment--,Eighteen (18) slots Six weeks of stay:430 days x 158.00 per day - $4,740 x 18) = $ 85,320 2. SOLEC - Five (5) slots $6,769 - : per slot per year x 5 . = $ 33,846 3. Sheltered Workshop - Twenty (20) slots $105.50 per week x 52.2 weeks x 20 =$110,142 4. Supported Employment - Seven (7) slots ON SITE PROGRAM WORK PROGRAM 1. In House Volunteer Program - Eight (8) slots Linked to Community Volunteer Program - Eight (8) slots Four hours per week x 52.2 x 8 Slots x $4.00 per hour 2. Gardening Group - six (6) slots Four hours per week x 52.2 x 6 slots x $4.00 = $ 6,682 = $ 5,012 3. Recreational Aide - Four (4) slots Four hours per week x 52.2 x 4 x $4.00 = $ 3,342 4. Housekeeping Aide - Two (2) slots Four hours per week x 52.2 weeks x 2 x $4.00 $ 1,670 $ 16,706 TOTAL $310,414 50 x $350.00 50 x $200.00 50 x $ 75.00 50 x $100.00 50 x $ 50.00 100 x $ 25.00 100 x $ 25.00 50 x $600.00 START-UP CITIZEN FURNITURE 50 x $15.00 50 x $15.00 50 X $25.00 50 X $15.00 50 X $25.00 50 x $50.00 50 x $ 6,00 50 x $35.00 50 x $15.00 50 •X $300.00 50 x $100.00 50 x $300.00 50 x $250.00 50 x $150.00 50 x $ 50.00 50 x $ 30.00 50 x $200.00 KITCHEN Toaster Coffee Pots Set of Dishes Set of Glasses Set of Utensils Pots and Pans Wastebaskets Iron and Ironingboard Clock DINING ROOM Table and four chairs 50 BATH Shower Curtain Towels Toilet Set BEDROOM Mattress, Box Springs and Frame Chest of Drawers Night Stand Chair Lamp Pillows (2), Linens (2). Blankets (2), Mattress Pad (1), Spread (1) LIVING ROOM Sofa Chair End Table Coffee Table Lamps (2) Drapes (2) Pictures (2) Entertainment Center with Equipment ESTIMATED COST $ 750 750 1,250 750 1,250 2,500 300 1,750 750 $10,050 Subtotal $15,000 Subtotal $ 5,000 Subtotal $15,000 12,500 7,500 2,500 1,500 $10,000 $49,000 $17,500 $10,000 $ 3,750 $ 5,000 $ 5,000 $ 2,550 $ 2,500 $30,000 $76,300 Subtotal $3,107 per unit x $50.00 - ($155,350 TOTAL) $ 28,515 60,499 22,150 10,713 77,604 2,601 38,837 $.:260, 919 - 36,765 $ 224, 154 - 128E $208,86-8 GROSS 187,981 DMH 90% $ 114,060 321,995 14,199 42,850 310,414 10,405 155,350 $ 969,273 GROSS -147,060 - 61,143 $ 761,070 GROSS 684,963 DMH 90% TOTAL COST PHASE IN 10/88 - 12/88 Redirection of PGH staff New Staff Furniture & Equipment Operating Items On & Off Site Programming Supplies for On and Off Site Programming Start-up Furniture for Citizens PGH Redirection Projected Third Party Revenue $ 20,887 CMH 10% FULLYEAR COST 01/89 .- 12/89 Redirection of PGH Staff New Staff Furniture & Equipment Operating Items ON & Off Site Programming Supplies for On and Off Site Programming Start-up Furniture for Citizens PGH Redirection Projected Third Party Revenue $ 76,107 CMH 10% (FOR RESIDENTIAL PROGRAMS) 15. This proposal is for. . II -bed Level home(s). Iii —SIP beds. Other: Hud Low Income Apartments (80 beds) 16. SPECIAL F:UIPMENT/ANCILLARY SERVICE, DAY PROGRAM AND TRANSPORTATION NEEDS: See Non Residential Ancillary Services: 1=1 a) Clothing 1:1 b) Medical care 111 c) PT/OT d) Psychiatric services e) Psychological services 1:1 f) Nursing services 1_1 g) Other 17. ADDITIONAL MONITORING STAFF REQUIRED: No. of FTE's Discipline -Reciended Staff:Resident Ratio See Non Residential 18, IMPACT ON PUBLIC INPATIENT FACILITY: prcposal would serve community-based citizens in need of resider.-.1a1 placement. This prci:csal would impact to reduce the census of by 25 beds and 9125 resident-days on a fuIl- year bal-ls_ CVC 19, PLANNED SERVICE REVIEW: Service Review N/A PART II 100 80 cases will be served at any one time (static capacity). cases will be —Served over the fiscal year (dynamic capacitvt. 10,400 units* of dir ect service will be delivered per year, and -4160 units of indirect service. (This equates to 1300 units of direct service per FTE, and 520 units of indirect service.) The average length of stay expected in the program is I - 3 yrs. and the average number of contacts per case is expected to be 130 . The average number of indirect service hours per case is expected to be 52 20. The expected outcomes of the service for citizens are . . 1. To provide low income housing not to exceed 30% of citizens income. 2. Increase level of independent living skills. 3. Maintenance and stabilization of psychiatric symptoms, 4. Reduce recidivism at CVC. 5. Increase integration into the Community. 21. These outco.es be reviewed through - 1. Percent of apartments occupied within the first year. 2. Pre-test, post-test, variance in ADL skills. 3. BPRS, Brief Psychiatric Rating Scale - Decrease. 4. Decrease number of hospitalizations in a year. Decrease number of days hospitalized. 5. Number of contacts with the community at large by the residents, monthly contacts in the community. 22. The progra 7ec:ves will be to achieve . . 1. 100% occupancy within the first year. 2. An increase of 30% in the ADL scale. 3. Maintain or reduce the BPRS Scale. 4. Decrease number of hospializations by 30% and number of days by 30%. 5. To increase contacts in community by 30%. (II. PLANNED SERVICE REVIEW continued) 23. Program performance against these objectives will be measured by ... 1. Data collection gathered from HUD statistics on occupancy. 2. Administer ADL test to all chronically mentally ill residents entering and leaving Woodland Heights Project. 3. Administer the BPRS scale at admission & annually. 4. By comparing number of hospitalizations for 3 years prior to occupancy at Woodland Heights, one year after residency. Days, same. 5. Community participation scale, pre and post test, annually. 24. Key performance indicators for the program will include . ...an acceptable range of static capacity from 60 cases to 80 cases; • an acceptable range of dynamic capacity from 60 cases to 100 cases; ...an acceptable minimum of 7000 for units of direct service de- livered; - • an acceptable case load range per discipline of 1 to 40 for Case Managens 1 to 80 for Nurse I to 40 forRecreational And. to 80 for PsT.71ir. ...an acceptable range of average length of stay (ALOS) from 52 to 156 weeks; an acceptable average number of contacts per case from 52 to 130 • an acceptable average for hours of indirect service per case fror. 1 to 2 Other: 25. Revenue 1. The number_pf citizens eligible for Medicaid is esti- mated at 2. The number of citizens eligible for Medicare is esti- mated at 3. The number of citizens eligible for Blue Cross/Blue Shield Outpatient or Selected Outpatient Psychiatric Programs is estimated at 4. The number of citizens eligible for other outpatient psychiatic insurance programs is estimated at 5. The number of citizens with ability to pay is esti- mated at Projected net revenue from third party and other source funding is estimated at _ 40% 60% 0 0 $ 61,143 26. The cost per slot in the propos,ed service will be $ 10,557 the cost per activity will be $ 58.00 27. IMPLEMENTATION: 12 This proposal will require months for full implementation from the time that CMH has final State and County approval of funding, Resolution #88257 Sep.teMber 22, 1 988 22nd this . day of LAW tember 188 Clerk/Register of De Moved by Susan Kuhn supported by Rowland the resolution (with positive Fiscal Note attached) be adopted. AYES: Caddell, Calandro, Crake, Doyon, Gosling, Hobart, Jensen, R. Kuhn, S. Kuhn, Lanni, Law, Luxon, A. McPherson, R. McPherson, Moffitt, Page, Pernick, Rewold, Rowland, Skarritt, Wilcox, Aaron. (22) NAYS: None. (0) A sufficient majority having voted therefor, the resolution (with positive Fiscal Note attached) was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lynn D. Allen, Clerk of the County of Oakland and having a seal, do hereby certify that I have compared the annexed copy of the attached resolution adopted by the Oakland County Board of Commissioners at their regular meeting held on_ September -22, 1988 with the original record thereof now remaining in my office, and that it is a true and correct transcript therefrom, and of the whole thereof. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County at Pontiac, Michigan