WAYS & MEANS COMMITTEE 2014 BUDGET REVIEW OF

HEALTH COMMITTEE DEPARTMENTS

SEPTEMBER 16, 2013

DAVID KNAPP, CHAIRMAN

MEMBERS PRESENT:  Mr. Jordan, Mr. May, Mr. Kilmartin, Mr. Holmquist, Mrs. Ervin, Ms. Williams

ALSO PRESENT:  Chairman McMahon, Mr. Dudzinski, Mr. Liedka, Mr. Plochocki, see also attached list

Chairman Knapp called the meeting to order at 9:20 a.m.

HUMAN SERVICES REORGANIZATION:

Ann Rooney, Deputy County Executive:

• These are wholesale changes, but changes that will be better for the community, clientele, and staff – to make the ease of how they do business better, more effective - coordination will be much better
• Local Law is on desks to be considered at the October session prior to the budget vote
• Have been looked at Human Services structure for a year – in terms of responsiveness to clientele or for those that go out and visit families because of calls received about potential child abuse, youth arrested, mental health issues, etc.
• It became apparent that the coordination of services can be done better
• It is not because of a crisis; it is because we can do better as a government in serving citizens and preventing them down the road from having ongoing, long-term connection to our system, which becomes very costly
• proposing to abolish certain county departments and create new ones

Proposal:

Abolish Department of Mental Health

Abolish Department of Aging & Youth

Abolish Veterans Services – into Dept. of Long Term Care Svcs.

        Creating 3 new departments: 

1.     Department of Children & Family Services – child protective, Children’s Mental Health, Youth component of Aging & Youth; Juvenile Justice-Hillbrook, OnCare (federal mental health grant)

        2.     Department of Long Term Care Services  - adult protective from DSS; adult side of Mental Health, Aging component of Aging & Youth; Veterans Services Agency, Long Term Care Service coordination

With Van Duyn being transferred Dec. 1st, there will still be a component of long-term care services where the county assists families with navigating residential/nursing home systems for the aging population.

        3.     Department of Social Services – Economic Security – trimmed down DSS – currently over 700 employees; ranges from adult protective, child protective and all public benefits.  They are really different lines of work and asking one commissioner to supervise all of it.  The proposal:  have service departments on children’s side and on adult side and all public benefits will be in the DSS Economic Security (Medicaid, HEAP, Food Stamps (SNAP), Day Care, Fraud unit, Child Support)

• will create better service delivery; allow better evaluation of how we are doing, how we are allocating better resources
• potential significant savings down the road – as services are coordinated, should become more efficient and better at the operation

Ms. Rooney said that each department currently has accounting, personnel staff, and DSS has attorneys.  The reorganization extracts the infrastructure pieces out of operating departments.  The reorganization on the Human Services side is the first step in that direction.  It is fully anticipated with next year’s budget, seeing further extraction of the infrastructure pieces out of the physical services and administrative sides of government.

Create a Division of Financial Operations in the Department of Finance – will be the administrative arm that will service all departments in a more coordinated fashion.

• Goal is to better assist families, children, and adults to be successful in school, home and community.  The coordination of services will go a long way towards that goal

Steve Morgan, CFO:

Mr. Morgan distributed an information packet entitled Onondaga County Human Services Reorganization 2014 (copy on file with Clerk) and provided the following Power Point Presentation:

• High level view of restructuring
• At this point Health Department is not involved with the restructuring.

• Losing 4 positions:  1 program position; 3 finance positions.  Probation will stay pretty much the same with the exception of the coordination of the juvenile justice piece

• Right column shows positions transferred into this division

• Four positions transferred in from Social Services – 3 assistant Welfare attorneys, 1 Welfare attorney

• Move management of employee benefits to Personnel from Finance; personnel and payroll functions within the restructured departments are being transferred to Personnel Dept.

• Mental Health – 55 current; 0 proposed – dept. will be abolished
• Aging & Youth – 17 current; 0 proposed
• Probation – 87 current; 83 proposed
• DSS – 703 current; 725 proposed
• Hillbrook – 21 current; 0 proposed
• Veterans – 4 current; 0 proposed
• Personnel – 41 current; 51 proposed
• Law – 46 current; 51 proposed
• Finance – 42 current; 72 proposed

• Detail of fiscal crosswalk was provided to legislature (on file with Clerk)
• Div. of Management budget – decrease – employee benefits staff transferred to Personnel Dept.
• Div. of Fiscal Operations – new division – all fiscal staff from restructured departments
• County Attorney – increase – 4 positions transferring in from DSS
• Mental Health – abolished - $0
• Aging and Youth –abolished - $0
• Personnel Dept. – increased – employee benefits staff transferred from Finance, personnel & payroll staff transferred in from restructured departments
• Probation Dept. – decrease – losing l position in Juvenile Justice, and 3 fiscal positions will be transferred into the Div. of Fiscal Operations
• Hillbrook – transfer into Dept. of Children & Family Svcs, zeroed out
• DSS – Economic Security – rolled up program costs and purchase of services costs – not only administration
• Purchase of Services and Program – zeroed out
• Dept of Long Term Care – new department
• Dept. of Children & Family Services – new department
• Veterans Service Agency – eliminated; rolled into Dept. of Adult and Long Term Care Svcs.

• Revenue moves as well

• Local Dollars – decreasing by nearly $6 million vast amount due to decrease in Medicaid, Affordable Care Act – Federal will cover 75% in New York and ramping up to 95% will be covered.  Counties are being cautioned by NYSAC about the approach in budgeting – there is some uncertainty to the implementation to the Affordable Care Act – any number of things could jeopardize the savings factored into the budget
• Temporary Assistance – decrease – seeing caseload level off - $1 million local savings
• State Training School – out of home placements for troubled youth – $1 million decrease related to, hopefully, the elimination of retroactive rate adjustments
• The Reorganization is not reducing local dollars, but the hope is that in the future that is the goal

Mr. Morgan continued:

Finance – consolidation made sense – not a new idea--in most major companies the infrastructure is not attached to the product line; it is a combined consolidated infrastructure that supports that whole entity.  That is the goal here.  It made sense when it was concluded that the programmatic restructuring made sense.  The fiscal piece had to change by the mere fact that the departments were being restructured.  On the fiscal side, we do not need a fiscal attached to each of the departments.  There are specialties and nuances unique to these departments.  There are some really good fiscal folks that exist in these departments – pulling them together will allow crossing training and leverage the value of the fiscal staff.  The hope is that long term they can level some economies and get more efficient.  It really creates another service department and has to operate at a high level.  The restructured departments need support; there has to be coordination/collaboration or it won’t work.  They will be able to look at the funding streams and hopefully maximize reimbursement, invest those resources to the best extent possible.  The real work is what lies ahead— looking at the services we provide, what they cost, what outcomes are achieved or not achieved.

Mr. May asked, aside from increases in state aid this is in large part budget neutral.  Mr. Morgan agreed.  Mr. May asked if from a headcount standpoint are we person for person.  Ms. Rooney said that it is pretty much neutral.  Mr. May asked beyond contractual increases, are there any positions that will require increases or upgrades to properly align people in the new departments.  Ms. Rooney said “no”, there are no raises.  Everything is lateral.  Mr. Morgan said that there may be a promotion into a new position; there is no existing position that will get any type of grade increase.  There is a position that will be vacated by the current Commissioner of DSS; the proposal is for the current Commissioner of DSS to run the Department of Children and Family Services.  The proposal is to fill that vacancy with an existing employee.  In that case, there is going to be a raise; it is a promotion.  The commissioner and deputy commissioners will be in new titles, but are keeping the same grades.  Mr. Holmquist asked if there is a list of those employees that are getting promotions.  Mr. Morgan said that it is just one person. 

Mr. Holmquist said that presumably this has been worked on for some time, and the leadership was involved in the process.  He asked if the Comptroller’s office was involved and to what role.  Mr. Morgan said that it was limited.  The Comptroller’s office was consulted when it came time to look at the potential changes that need to be made to PeopleSoft in terms of this; what would it mean in terms of modifying our financial system to account for this.  Mr. Holmquist said that this is a lot to digest; it sounds great; would love to trust but verify – hard to ask questions when we don’t know, and it is jammed into the budget.  He was hoping that at some point the Comptroller’s Department could chime in on some of the high points.  Mr. Morgan said that in working with the legislative staff; this is transparent.  He is trying to provide answers to any questions that the legislators or legislature’s staff have so legislators can make an informed decision.  Ms. Rooney said that they welcome the Comptroller’s input; they have been invaluable with the process of transferring Van Duyn.  Their help with coordinating PeopleSoft with this has been great.

Mr. Holmquist said that he is concerned about any areas where the responsibility of the legislature is being shifted towards the executive in this whole reorganization, which he had discussed in committee.  The answer was that there was none – no responsibilities or duties from the legislature would be shifted.  Ms. Rooney said that the Law Dept. is very careful when it comes to that and have guided them step by step to make sure none of that was compromised.

Mr. Holmquist said that up until now there have been line-by-line discussions during the budget process with department heads.  Once the budget is passed, that money is the maximum that can be spent.  If a transfer is needed within a department over $7,500, it has to come to the legislature.  He asked, how it changes with this reorganization, with a mega pot of money for a huge bureau of half the county.  Mr. Morgan said that it doesn’t.  Some departments are being abolished, and some new ones are being created, but with that department, the same rules apply.  They are actually taking the biggest department and making it smaller.  The resources are allocated appropriately, but within those budgets, they are separate stand-alone budgets and the requirement still applies.  With the way the departments are restructured, you will actually have smaller departments.

Ms. Rooney added that at Hillbrook there is an additional revenue of almost $750,000 budgeted.  Monroe County has approached us, as their detention facility sat on private land that the owner of the land has sold to Costco.  Their detention facility will be demolished.  They have approached Onondaga County about housing their juveniles prior to adjudication.  Hillbrook's budget last year was based on an 11 average daily population; next year Hillbrook is budgeted for an average daily population of 20 – it includes 11 out of county, 9 in county kids; $750,000 additional revenue anticipated.  This is an opportunity as there is a 32-bed facility there; typically there is around 10 – 15; this will allow us to accommodate another county and enjoy the benefit of that additional revenue.  The arrangement will start in October of November.

Mr. Holmquist asked where the savings are coming from with the reorganization.  Mr. Morgan said they are programmatic savings, actual benefits to clients.  The hope is that in years to come there are savings on the administrative side as they become more efficient and effective. 

Mr. Holmquist asked going forward, if Ms. Rooney and Mr. Morgan will present the budget for all of this every year.  Ms. Rooney said “no” it will be a one-time deal; next year the commissioners will present .

Mr. Holmquist said that he would like to hear the Comptroller’s opinions on the reorganization.

Mrs. Ervin reiterated that no one will be losing any jobs during the reorganization, Ms. Rooney & Mr. Morgan agreed.  Those moving to new positions will be compensated the same way, but taking on more responsibility; how will that affect things going forward.  Ms. Rooney said she thinks all of the commissioner and deputy commissioners are excited about the professional opportunity of having these services coordinated.  Rather than being responsible for a little piece of the pie where they lacked the ability to formally coordinate, this gives them the opportunity to pull services together in a structural way.  The division of work will be such that they will move as a team.  She is not going to say that there is more responsibility; i.e. Ms. Alford will have a lot more support around her than as she did in just running a tiny department.  Mrs. Ervin referred to long term and question if next year there will be requests for increases because these folks are having different responsibilities.  Ms. Rooney said that historically this county executive has not brought over raises for department heads and deputies, and she doesn’t think that will be the plan going forward.  It is where we are and it is consistent across the county for size of departments and grade level of each of the deputy commissioners.  Mrs. Ervin said that this is new, and questioned if these people will be having a lot more work.  Ms. Rooney and Mrs. Morgan said “different work”.  Mr. Morgan said that he doesn’t know that it’s more work; it is different – their responsibility is going to change.  In working with the Personnel Dept., it didn’t change to the level of needing to look at re-grading positions.  Mrs. Ervin asked if they are all happy with this reorganization.  Ms. Rooney said they have all been involved in the planning of it.  If there were issues, there has been plenty of opportunity for it to have been discussed.

Mr. Jordan referred to financial assistance – Safety Net and asked if these are people that don’t meet the financial eligibility requirements.  Mr. Morgan said that in Temporary Assistance there are two accounts – Family Assistance and Safety Net.  Family Assistance is for families; Safety Net is a general assistance program that the State created – not all states have it.  Safety Net is for singles and childless couples.  There is a 5 year limit on Federal Assistance under TANF, so there are also families that move over to Safety Net if they are not able to transition off before the 5 year period.  There are very little federal dollars for the program.

In answer to Mr. Jordan regarding SNAP, Mr. Morgan said that they don’t budget for the food stamp program; just the administration of it.  It is a direct pay by the State; food stamp benefits do not flow through the budget.

Mr. Jordan asked what fulfills someone’s obligations/duties under the JobsPlus program.  Mr. Morgan explained that when someone comes in looking for assistance from the county, an immediate goal is to determine their employability.  There are potential barriers to employment – physical issues, mental issues, substance abuse, and domestic violence.  They are assessed and a determination is made if there are barriers present and if a person is able to work.  Once made, they are required to participate in work activities – looking for work with an ultimate goal of obtaining work.

Mr. Sutkowy said that once someone applies for assistance, they start engaging them in employment activities right away.  JobsPlus staff actually works in the Civic Center hand in glove with the eligibility unit on the 2nd floor.  They try to begin having the person look for work.  If they can’t find work immediately, they are placed into work activities.  Work experience, practical, on-the-job training, is the core of the program.  Mr. Morgan said that many individuals are used in the County; many in Facilities Management and in light clerical duties.  Mr. Jordan said that he has heard that the “work activity” includes taking members to the grocery store, and cleaning a family member’s home.  Mr. Sutkowy said that all of the work sites are with not-for-profit organizations; they are mostly clerical, janitorial, office work in nature. He does not know of any service that organizes activities like that.  JobsPlus is helping about 200 people get jobs and have their welfare cases close each month.  A lot of the jobs are minimum wage or a little above.  People are getting jobs, the cash assistance case is closing, but the family isn’t earning enough to really get out of poverty.  They are relying on supplemental benefits like food stamps, Medicaid and childcare in order to stay employed in the work force.

Regarding SNAP, Mr. Jordan questioned the 5.6% increase in SNAP cases when unemployment classes are going down.  Ms. Rooney said this is the working poor – often eligible for foods stamps and Medicaid benefits.

In answer to Mr. Jordan regarding overtime wages, Mr. Morgan said that with all the restructured departments, the main overtime is the contractual overtime in Social Services for night service.  It is for nights and weekends when there is a call into the Child Protective hotline--they are required to go investigate it.

Mr. Jordan asked for details on the contracted services.  Mr. Morgan said it depends on the department.  In Social Services, JobsPlus is nearly a $10 million contract; there are approximately 20 not-for-profits in the community that help with the child welfare work, i.e. Salvation Army, Catholic Charities.  There are also contracts for shelters with the Rescue Mission, Catholic Charities.  Mental Health Dept. has a host of contracts that help with their mission with adults and children.  There are a lot of contracts.

Mr. Liedka asked if there is a date to actually put the plan in place; are there any potential costs associated with it that may not be expected at this point.  Ms. Rooney said that they have met with Duane Owens, Facilities Management Commissioner about a plan for the employees affected to physically move inside the Civic Center.  With current renovations, there is some swing space available.  They have been able to accommodate everyone who will be affected that they would somehow be attached to their new department. The Department of Children and Family Services will be focused on the 7th & 8th floors.  Adult and Family Services will largely be on the 10th floor; bringing in the Aging component into Mental Health on the 10th floor.  Fiscal Operations will be housed on the 4th floor.  There will be minimal costs because they are just picking up employees and putting them down somewhere else where there already is furniture and computers.  It is on track to occur before January 1st.

Mr. Liedka asked about the Project Director Community Services position request as part of the reorganization for December 2013.  He questioned why it is needed this year.  Mr. Morgan said it is a transfer related to Van Duyn, which is happening in December – it is not a new position.  They are moving people from DSS Community Service to Long Term Care Services. 

Mr. Ryan asked how the restructure helps in moving forward as to what needs to be addressed short and long term.  Ms. Rooney gave an example and said that at the end of the day they would like to see much less involvement formally with the systems.  Right now 75% of the youth that come into Hillbrook in any given year have been involved in the child protective system.  At some point, they were victims in the child protective system and are now accused of being perpetrators in the juvenile justice system.  The coordination is in looking at cases when they come in -- what can they be doing to stay in touch with families as they come in the child protective system; what can be done to stay with them longer – hopefully prevent them from ever getting into that extremely costly part of the system.  At the end of the day, if they are involved deeply in the juvenile justice system the likelihood of them being successful as adults goes down exponentially. 

Mr. Ryan referred to Hillbrook and bringing in kids from Monroe County; he asked if any jobs would be added at Hillbrook.  Ms. Rooney said “no”, but food cost will go up a little, and some other costs will go up, but it will be 100% reimbursable.  Chairman Knapp asked if the empty wing at Hillbrook will be opened back up because of the arrangement with Monroe County.  Ms. Rooney said that it will be.  Chairman Knapp reiterated that there won’t be any additional staff; Ms. Rooney agreed.

Mr. Holmquist referred to the resolution providing for the personnel changes and noted that 4th paragraph down reads…. RESOLVED, that given the size and complexity of this transfer resolution, the Commissioner of Personnel is hereby authorized to make any administrative corrections as may be reasonably needed to affect the intent of this resolution and the positions authorized within the 2014 county budget.  He would like language added in there about some mechanism to report to the legislature or advise the legislature.  Also, the 5th paragraph refers to the employees described in attachment A, which he does not have.  Mr. Morgan said that it should be sent over today.  They were working on it over the weekend. 

Mr. Liedka asked if there is money in the budget for the Veterans Outreach Center.  Ms. Rooney said it was in the 2013 budget; are working with Clear Path and putting it all together; it is on track and being built as we speak.  Mr. Liedka asked about any additional money for 2014.  Ms. Rooney said that the county money was used for the building of it; they have not come back for another request.  Ms. Dennis said that they received a grant for $185,000 and won’t be asking for any additional money.

Chairman Knapp asked about the County Office Building and asked if the long-term goal is to fill it.  Ms. Rooney said that in October or November the Probation reporting, which occurs 4 days per week, will be relocated to the 1st floor of the COB.  About 35 elevator trips per week in the Civic Center will be eliminated.  It alleviates a lot of traffic and concerns that they have heard about the elevators.  There are plans for every inch of the COB.  A lot involves bringing in county staff, which are in leased spaces currently, back into the footprint of our complex. 

Mr. Kilmartin asked if there is a rough draft concept plan for the COB and Civic Center, as well as timelines for those transitions.  Ms. Rooney said that she will relay the request to Mr. Millea and Mr. Owens, and have it available for the Facilities Management budget presentation.  Mr. Kilmartin asked for any detail on how it would impact expenses on the outside from savings generated by bringing people back in house.

Mr. May referred to Van Duyn, and asked where the Medicaid insurance and/or private revenues are recognized in the Van Duyn budget.  Mr. Morgan said that the majority of the revenue that comes in is from Medicaid and Medicare, it is located on pg. 4-135 Services, Other Government-Health.  Mr. May said it goes to $0 at the end of this year.  There is a pretty dramatic lag between our billings and getting paid, and asked how the revenue will be recognized going forward.  Mr. Rooney said that one of the components of the transaction was that the buyer receives all of the accounts receivable with a drop-dead date of November 30th.  Anything that comes in after that date is a benefit to the buyer.  Chairman Knapp asked about if the County hadn’t billed for something yet.  Ms. Rooney said it was very black and white; it is a straight drop-dead date.  Chairman Knapp said that if our processing folks didn’t get to something, then the Upstate folks can do it themselves.  Mr. Rooney agreed, but added that with the 2013 budget, the legislature approved the enhancement of the financial office staff so Van Duyn could get up to date, and they currently are.

Mr. Jordan referred to institutional costs after the transfer of Van Duyn and asked how long they will continue.  Mr. Morgan said that pension costs are not an issues; the pension bill is based on salaries of the county.  When the county drops those employees, the salaries come out of the base to calculate our pension costs.  There will be retiree health costs for years to come and debt costs have to run out.  In the 2014 budget there is just under $6 million.  Regarding retirement, the timing is such that the estimate that they are going to use for our pension bill has Van Duyn salaries still in it.  We will receive credit when they true that up and receive actual salaries.  There is retirement cost in 2014; after that it will just be retiree health and any debt costs that remain.  Mr. Jordan asked about a projection of the costs over the years.  Mr. Morgan said that the number will decrease quite a bit going into 2014.  There is some fund balance there, and there may still be availability to pull IGT funds down.  Mr. Morgan will provide the numbers for the debt going forward.

Chairman Knapp asked about IGT eligibility and the anticipation of receiving it.  Mr. Morgan said that his understanding is that as long as the County owns the facility at the time that they are applying this payment, then the County would be eligible for it.  The last payment at the end of last year was for the 2010/2011 or 2011/12 year—the Feds are behind.  The hope is that they would approve another payments and he would recommend to the legislature to take advantage of it.  He hopes to hear something towards the end of the year. 

Chairman Knapp noted that 9/26 and 9/27 are open, if additional review is needed on the reorganization.

The meeting was adjourned at 10:40 a.m.

Respectfully submitted,

DEBORAH L. MATURO, Clerk

Onondaga County Legislature