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HomeMy WebLinkAboutMINUTES - 05042004 - C61 FHS #t3 .o a Contra TO: BOARD OF SUPERVISORS , Costa FROM: FAMILY AND HUMAN S'ERVI'CES COMMITTEE DATE: MAY 4, 2004 Countyj"�`�� SUBJECT: ANNUAL REPORT FROM JSPAC SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION Recommendation: ACCEPT reports from the Revenue, Juvenile Sex Offender and Transition Work Groups established by the Family and Human Services Committee to review suggested cost savings measures proposed by the Juvenile Systems Planning Advisory Committee, as recommended by the Family and Human Services Committee. Fiscal Impact. None Backaround: The Juvenile Systems Planning Advisory Committee (JSPAC) responded to the County Administrator's request for cost cutting strategies, which was referred to the Family and Human Services Committee in June 2403. The Committee recommended the establishment of three working groups to study specific issues surrounding juvenile sex offenders, transitional housing, and revenue enhancement. On June 24, the Board of Supervisors directed formation of these workgroups. These groups were formed with members from Employment and Human Services Department, Homeless Division, Mental Health Division, Probation Department, the Office of Education, the County Administrator's Office and JSPAC. Topics of discussion were the current system in place, systems in place in other jurisdictions, where service delivery gaps existed, current cost, potential increased costs, and potential savings. A variety of ideas were investigated. The recommendations in the attached reports have been developed and agreed to by the entire membership of each group. CONTINUED ON ATTACHMENT: YES SIGN TUBE: -RECOMMENDATION OF COUNTY ADMINISTRATOR /RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER t a ; t • SIGNATURE(S): + _ MARk beSAUL R J [OIA ACTION OF BOARD ON Ma4--, 2004 APPROVE AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE R UNANIMOUS (ABSENT Nori' ) AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED MaY 4 , 2004 JOHN SWEETEN,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person: Dorothy Sansoe(5-1009) CC: CAO HSD EHSD JSPAC Probation Office of Education ( ff BY: � �������'�X�-�' DEPUTY County of Centra Casty OFFICE OF THE COUNTY ADMINISTRATOR MEMORANDUM DATE: March 22, 2004 TO: Family and Human Services Committee FROM: Dorothy Sansoe, Staff SUBJECT: Referral #3 --Oversight of the Work of the Juvenile Systems Planning Advisory Committee—Report on the Work of the Revenue;JSO and Transition Work Croups RECOMMENDATION ACCEPT the three attached reports from the Revenue, JSO and Transition Work Groups. ACKNOWLEDGE that the County is currently in the midst of an unprecedented fiscal crisis that will take a minimum of several years from which to recover, and which may degrade the current level of services. CONSIDER, once the budget crisis is over and additional funding becomes available, pursuing the recommendations in each of the reports. BACKGROUND On March 4, 2003, the County Administration requested that local stakeholders and interested groups recommend cost cutting or other strategies to help balance the County budget for the 2003-04 fiscal year. The Juvenile Systems Planning Advisory Committee (JSPAC)was one of the committees that responded to this request. On June 2, 2003 the Family and Human Services Committee met and discussed the work being performed by the Juvenile Systems Planning Advisory Committee(JSPAC). At this meeting, Florence McAuley, the Chairman of JSPAC, requested and the Committee approved,the establishment of three working groups to study specific issues surrounding juvenile sex offenders, transitional housing, and revenue enhancement. On June 24, the Board of Supervisor directed that these workgroups be formed. Staff from Employment and Human Services, Mental Health, Homeless,Probation, County Administrator, Office of Education, and JSPAC were invited to participate in the work groups. Over a six-month period.,the three individual groups met at least four times each. These groups discussed the current system in place, systems in place in other jurisdictions,where service delivery gaps existed,current cost,potential increased costs, and potential savings. A variety of ideas were investigated. The recommendations in the attached reports have been developed and agreed to by the entire membership of each group. Sandy Marsh, from the Health Services Department,Mental Health Division, agreed to facilitate all three work groups. I would like to formally thank Sandy for the effort she has put in over the past six months. In addition to coordinating all three groups, she also provided status reports to JSP'AC. Her assistance has been greatly appreciated. Fiscal Workgroup Report To Family and Human Services Committee RECOMMENDATIONS: ACCEPT the report of the Fiscal workgroup. ACKNOWLEDGE that the County is currently in the midst of an unprecedented fiscal crisis that will take a minimum of several years from which to recover. REQUEST the Departments to continue to work together as an ongoing fiscal committee made up of the same member Departments to continue to look at changes in regulations related to funding opportunities, to cooperate whenever feasible to alleviate the fiscal burden of any partner(i.e., allowing a pass through in order to draw down`a match, etc.), and to report to the County Administrators Office for leadership and direction. BACKGROUND: There are multiple revenue sources used by different Departments as part of either their mandates or discretionary allocations(i.e., grants, etc.). Because of the current fiscal reality, it is imperative for County departments to investigate these various revenue sources to see if they are being under utilized or are leveraging other funds whenever possible. This workgroup looked at various funding source regulations to determine if they could be used to replace County General Funds or claimed in such a way as to pull down matching funds. This work group looked at the following funding sources: EPSDT*, STOP*,IDEA*, SB163*, VOC*, Title IV-E(NB)*, Title XIX*, COPS*, MAA*, SB90*,TANF*, and JJCPA*. Generally,CCC utilizes all of the allocations that are available to their maximum limit. There are some funds that are not limited and could be expanded to enhance programs, services or positions. However,many of these funds require a County match that would also need a funding source. There are, as well, other groups working on utilizing specific funding sources. [Note: the Sustainability workgroup made up of participants from EHSD,Probation,Mental Health, and Public Health have been working on plans to sustain the Mental Health Federal Grant. They have analyzed SB163 which is a funding option to reduce group home placements by providing Wraparound services. They are moving forward with a plan that needs State Department of Social Services approval for implementation.] During this process each department was asked if there were positions that might qualify under another funding stream. We did find some instances when a position could be paid for by a particular funding stream that was currently paid for by County general funds (CCF). In those cases,we inquired with the specific departments responsible for those funds to make the appropriate adjustments that would allow CGF savings. 1 FINDINGS: 1 Centra Costa County generally utilizes all of the current Funding available at its capped amount(when appropriate) and has considered the alternatives(i.e., using Title IV-E instead of MAA billing For a particular Probation position because the draw down is higher). 2 Many funding resources have criteria that are complicated and lock out other combinations or blending options. 3 The state and County are currently in a severe fiscal crisis. There may be whale programs eliminated or drastic reductions of some of the funding opportunities making it difficult to predict or plan a utilization strategy(i.e.,EPDT may well have an SMA* decrease,increased County match and may be capped) 4 Some revenue resources are"promising„ future payment,can't be counted on currently and are risky payment reimbursements(i.e.,VOC and SB94) 5 Because of the decreasing funding resources and complicated"strings" attached to funds, it is not appropriate to pool the available department resources. 6 There has been and continues to be a great Ileal of collaboration between the Departments creating an atmosphere of respect and cooperation. CCC has dedicated a great deal of time and energy into the collaborative process and values ongoing interagency coordination. 7 Some departments have grants that require ongoing fiscal collaborative oversight. *See attached Glossary 2 FISCAL WORKGROUP GLOSSARY EPSDT-Early and Periodic Screening,Diagnosis and Treatment- is a category of federal Medicaid that provides comprehensive health care for individuals under age 21 who are eligible for the full-scope of MediCal benefits that are medically necessary to correct or ameliorate a defect,physical and mental illness or condition. EPSDT is funded at 50% State and 50°la Federal reimbursement. (Note: since fiscal year 02/03 the County has a 5%match to State funding for all EPSDT"growth") STOP- Supportive and Therapeutic Options Program-provides treatment, supports and aftercare services to families with at-risk children and youth that cannot access needed services through current funding mechanisms(i.e., youth who do not qualify for MediCal or Health Families). STOP funding is shared at 70%State General Funds and 30% matching County Funds. Funds are allocated at 50% for EHSD, 25%for Probation and 25% for Health Services for a maximum 02/03 allowance of$215,307. IDEA- Individual with Disabilities Education Act- funds services for children of all income groups who meet special education's disability criteria. S11163-Senate Bill 163-allows counties the flexible use of State foster care dollars to provide youth"in or at-risk"of Level 10-14 placement with family based'Wraparound services. The sharing ratio is 0/40/60(fed/state/county)of placement dollars per youngster enrolled. The funds are flexible and can be accumulated. VOC- Victims of Crime Program- (Victim/Witness, Victim Compensation Program)- provides funding to reimburse expenses that are necessary as a direct result of a crime. TITLE IV-E-Foster Care and Adoptions Assistance funding program supporting foster care, administration and training child welfare functions. TITLE IV-B- are federal funds for prevention of out-of-home placement by promoting safe and stable families. TITLE XIX-federal funding for health related services for foster youth. The reimbursement is 50%for social work staff and 75%for licensed staff. COPS-Citizen Options for Public Safety- are State funds for County Probation and Police to address safety issues. CCC Probation has created several programs and services through the Juvenile Justice Crime Prevention Act(JJCPA under COPS). MAA-MediCal Administrative Activities—is funding related to outreach activities including program planning and development, contract monitoring and MediCal eligibility. SB90-Senate Bill 90-is legislation that allows for the State to reimburse counties each year for the cost of state mandated services for special education youngsters. 1 TAN'F-Temporary Assistance to Needy Families- is capped block grant funds with no state match to provides services for needy families with children. SMA- Standard Maximum Allowable- is the Medical maximum reimbursement rates for various services. 2 Transition Workgroup Report To Family and Human Services Committee RECOMMENDATIONS: ACCEPT the findings of the Transition Workgroup. ACKNOWLEDGE that the County is currently in the midst of an unprecedented fiscal crisis which will take a minimum of several years from which to recover. REQUEST that EHSD,Health Services(MH,AOD,Homeless Program, PH),Probation, and COE participate in an informal, ongoing Transitioning Youth Committee with the charge to explore housing possibilities, collaborative funding opportunities,model programs, etc.,to coordinate with other collaboratives working on these issues as part of a continuum of care, and to report to the Board of Supervisors at such time when funding is identified and available. BACKGROUND: A Committee composed of representatives from the County Administrator's Office, Health Services,Employment and Human Services,Probation, Education,and JSPAC convened to explore the feasibility of developing an in-county Transitional Housing program for youth.. Because the term"transition youth"is used to reflect various situations, the group mapped out existing resources and services gaps. The target population was narrowed to include 16 to 19 year old Contra Costa residents who may need stabilization(i.e.,bouncing from one higher level group home to another), independent living skills,mental health treatment, and/or school counseling. The youngsters might be runaways or homeless. The group added new partners(Contra Costa Homeless Program.)who have resources and knowledge about this population. The group investigated)how other Counties are handling this issue(i.e., Fred)Finch operates4 Transitional Youth programs in Alameda County). FINDINGS • There is a serious housing need for transitioning youth in Contra Costa County. + There is a significant gap in the service continuum for this population. • There may be county owned buildings that could be used to house these youngsters or other facilities that may become available(i.e.,Drake House). + There are fundis which may be available from HUD, SHIA EPSDT, ILS, Capital Development Loans, and other grants to assist in funding these needs. + There are currently outer collaboratives working on similar issues(i.e., Care Collaborative, etc.). • There are successful programs in other counties as models for development. 1 +� There is interest between departments to continue collaborating on these issues including exploring cooperative funding opportunities, service gaps, assessments and referrals, etc. 2 Juvenile Sex Offender Workgroup Report To Family and.Human Services Committee RECOMMENDATIONS: ACCEPT the findings of the JSO workgroup. ACKNOWLEDGE that the County is currently in the midst of an unprecedented fiscal crisis, from which it will take a minimum of several year to recover, and which may degrade the current level of services. CONSIDER,once funding becomes available,pursuing the renovation of the Lions Cate facility [where the Juvenile Court is currently located pending remodel of their space in the old Juvenile Hall] or another facility available to the County, as a possible co- location for a JSO program with the Summit Center for Boys. BACKGROUND: Juvenile Sex.Offending is a serious and expensive problem in Contra Costa County (CCC). It tears apart families and impacts our Communities. Offenders often come from abusive backgrounds themselves and the problem may continue for generations. Because many juvenile sex offenses are incestuous in nature, it has become a multi-agency issue. Usually the offender is removed from the home, and sometimes the victim is also taken out of the home,multiplying both the emotional and financial costs to the families, as well as, the burden on the CCC taxpayer. In the current economy, as the County budget is affected by the State's financial crisis, it makes sense to analyze the potential cost differences between the existing system and any other means of addressing the problem of treating and monitoring juvenile sex offenders in Contra Costa County. The Probation Department has 25 to 30 adjudicated youngsters placed in out-of-county sex offender facilities at any given time. This has been a fairly stable statistic in CCC for a number of years. Most of the offenders are boys who,ultimately, are placed in age- and offense-appropriate treatment programs for an eighteen-month to three year period. All of those programs are located outside CCC. The average County cost per year per boy is $36,500 for a total annual cost of over one million dollars. The JSO workgroup was asked to look at the feasibility of having an in-county residential sex offender program including costs, obstacles,issues, and other pros and cons. Based upon work done by a previous workgroup,the current array of services available in Contra Costa County were mapped to include: individual therapy, two adolescent groups, one non-offender parent group, one offender parent group, and psychological evaluations to determine community safety issues. Two Community Based Organizations(CBOs), Crossroads and A Step Forward,perform most of the direct offender treatment, educational, and relapse prevention services for young offenders. Community Violence Solutions and many other programs provide services for victims of sexual offenses. 1 Issues examined by this workgroup include: 1. Community Concern& Safety--NIMBY, facility security 2. Client/Offender Safety-security of the boys placed at the facility 3. Service Gaps-the transition/step-down services offered 4. Costs-county operated vs. CBO operated 5. Offender only vs.mixed treatment facility Research(Borduin et al, 1990,Multisystemic treatment of adolescent sexual offender, International Journal of Offender Therapy and Comparative Criminology, 34, 105-114) (Rasmussen, 1999)suggests that family involvement in treatment decreases recidivism and allows for a more successful transition back into the Community. This would positively impact the cost of placement. As well, Edward Latessa,Ph.D., Dean of Criminal Justice,University of Cincinnati, Ohio in What Works in Correctional Intervention, reports that it is not helpful to keep youngsters in residential treatment beyond one year. Children and families lose hope and the maximum benefit has already been achieved. Looking at the above issues,the group analyzed the cost of a county operated program (i.e., Summit Center,an in-county CBO operated facility)and the current out-of-county CBO contractor run facilities. The discussion also included possible problems with an in- county CBO contractor operated facility(i.e., safety, security,control and collaboration). We looked into the possibility,both pragmatically and financially,of expanding the Summit Center to include a Sex Offender Unit. FINDINGS: • There is a continuing need to address the treatment and placement of juvenile sex offenders • Characteristics of sex offenders(poor peer&family relationships, lack of empathy, educational difficulties,thinking errors,poor anger management and impulse control, etc.) are the same as other juvenile offenders and those issues, as well as,the offense itself, need to be addressed. (Johnson, S., 1994. Character Styles, NY: W.W.Norton&Co.)(Miner'and Crimmins, 1995)(Spaccarelli et al., 1997) • The effectiveness of segregating juveniles who have committed sex offenses has not been proven and some studies suggest otherwise (Juveniles who have sexually offended, OJJDP report March 2001). (Nate: Family Life Center is a residential treatment facility in Petaluma, CA,utilized by Contra Costa County Probation who co-locate/integrate juvenile offenders) • It is fiscally beneficial to operate an in-county JSO facility. The amount saved will depend on which plan and how implemented. The tables below are rough estimates of two plans based upon Probation County Dollars. 2 The following table compares the"program per child costs " (that is,the costs for a child to complete a program)for our County Operated Program (Summit)and an out-of-county CBO operated program. Because the Summit Program is an in-county program and able to work intensely with the families as best practice dictates, the length of stay is shorter than for the out-of—county programs. This allows for a cost savings per child, as well as, allowing more youngsters access to treatment. If Summit were expanded more savings per child would be generated. The County operated facility vs. Out-of County CRO facility: ,Facility #enrolled Probation Average Total d$$ $$per year Length of Stay $$for 1 saved per child in program child to complete program Summit 20 $50,000 1 year $50,0003 $4,750 CBO 20 $36,500 1 12 years $54,750 Per child conservative) If Summit were a 30 bed facility(based upon an increase in Probation staff and services)the costs/savings would be: Summit 30 $45,500 1 year $45,5003 $9,250 CBO 30 $36,500 1 'la years $54,750! per child The table below compares the"program per child costs"of an in-county and an out-of-county CBO operated program. This comparison concludes that while the annual cost per child would be the same, a savings would be realized with a shortened length of stay. In County CBO facility vs. Out of County CBO facility-If CCC could control the length of stay Facility #enrolled Probation Average Total$$for d,$$$ $$per Length of 1 child to saved year per Stay complete' child program In- 20 $36,500 1 year $36,500 County $18,250 CBO per Out-of 20 $36,500 1!2 years $54,750 child County conservatively CBO 3 • It is a better practice for families to be involved in treatment(Ivlorenz& Becker,1995, from Juveniles Who Have Sexually Offended, OJJDP, 3/01) and more practical With an in-county facility. • Family involvement allows for a shorter length of stay for youngsters in residential treatment which is key to reducing residential treatment costs. • There may be opportunities to collaborate with neighboring counties concerning these youngsters. • if the County would develop an in-county JSO residential facility(based upon the scarcity of community services for juvenile sex offenders)there would be a need to improve transition and step-down services including community supervision and ongoing treatment. • There is a need to either move Summit Center or secure it as a free- standing residential facility after the closure of the old Juvenile Hall. This Will require some County funding. [Note: When the new Juvenile Hall is completed,the old Juvenile Hall(to which Summit Center is physically attached and dependent on for utilities)will shut down.] • Expanding Summit Center to include a JSO program would result in savings in placement costs to Probation. (see above table). • The County's current fiscal and legal priorities may prohibit any immediate change in the status quo. 4