HomeMy WebLinkAbout2013-2014 Plan - Block Grant
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Franklin County Human Services Plan
Fiscal Year 2013/2014
Submitted: June 14, 2013
PUBLIC HEARING NOTICE
The Board of Commissioners approved the County’s Human Services Plan, as illustrated by their signatures
found in Appendix A – Assurance of Compliance.
Pursuant to the Sunshine Act, 65 Pa.C.S. 701-716, the County Commissioners conducted two public hearings to
receive input on the Human Services Plan detailed in this document. Public meetings were held at 1:00 PM on
May 22, 2013 and 9:30 AM on June 11, 2013. Appendix B contains the proof of publication and summaries of
the public meetings.
WAIVER
The County is not requesting a waiver at this time.
COUNTY PLANNING TEAM
Planning team members include human services providers and stakeholders as well as consumers and advocate
family members. In addition, the team includes staff support from each of the departments included in the block
grant. Appendix D includes a comprehensive list of the members of the planning team and their affiliations.
The leadership team is comprised of key fiscal and human service administration staff and includes the: Human
Services Administrator, Fiscal Specialist, Human Services Fiscal Director, Grants Associate, and the Assistant
County Administrator. The team connected with direct MH/ID staff who reached out to engage individuals and
family advocates. Their efforts resulted in a planning team that now benefits from the expertise and input of
individuals receiving services and their family member advocates. The leadership team considers this a
significant change from the team composition last year.
The County Planning Team members once again used an iterative planning process that began with a
department-by-department review of current services and budgets. The County Planning Team then reviewed
proposals for funding from projected funds available through the block grant. Staff then provided suggestions
on best ways to utilize the flexible funds, with a focus on cross-systems initiatives. Staff also provided
information regarding local needs and services, as well as process and outcomes data as available.
After staff reviews and clarifications, County Planning Team members offered suggestions and comments and
made decisions that fall into one of two categories. First, the County Planning Team identified enhancements to
current activities and initiatives; this document details those decisions. The County Planning Team also
identified service enhancements that, due to complexity and/or timing, will be considered in future plans. From
a planning perspective, this second ‘future’ category is heartening because it suggests that County Planning
Team members value the planning process and wish to continue the idea moving forward.
One of the suggestions for future plans included an assessment initiative aimed at enhancing data available
regarding local needs, services delivery, and consumer outcomes. During this process, County Planning Team
members acknowledged that the existing data lacks the breadth and depth to make critical decisions regarding
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comprehensive human services initiatives that are responsive to local needs and the current service delivery
environment. The data available this year is slightly improved compared to what was available last year. Staff
was able to provide process data, or outputs, this year. While the county also required outcomes for the 12/13
fiscal year, the block grant planning actually preceded the outcomes. In other words, the outcomes data was not
available – in many cases the programs were still underway – when the County Planning Team had to decide on
the plan for the 13/14 fiscal year. The County Planning Team still desires to establish an objective decision-
making framework that incorporates needs, outcomes and values when developing future human services plans.
The collaborative nature of the Block Grant Plan process remains extremely beneficial to the county, especially
this year when we were able to include more consumer and family perspectives. The team was better able to
take a holistic approach because they better understood each department’s mission and services. The process
also yielded more empathy among planners. When the time came for the County Planning Team to deny
requests, or deny fully funding requests, departments on their own suggested cuts to their own proposals in
order for other departments to receive adequate funding. At the end of the first planning meeting one team
member commented, “Well, this is the first time I’ve ever seen collaboration at this level.” Planners were
actually reducing their share in order for others to have more: a heartwarming experience.
The County Planning Team still considered the weighty question of, “How can we be expected to pick certain
human services over others when there is such great need throughout all of the programs?” But, with the
collaborative nature of Franklin County stakeholders, and the forward movement of integrating objective data
into the decision-making process, this task is not nearly as daunting as County Planning Team members
perceived last year.
NEEDS ASSESSMENT
Utilization rates, and associated funding, were the main data points analyzed to develop the plan proposed
herein. Each affected Block Grant Department provided projected end-of-year spending levels for the County
Planning Team to review. As mentioned earlier, outcomes data was not available in time for SFY 2013-14
Block Grant Plan drafting.
In addition to utilization and spending rates, department staff indicated to the County Planning Team the areas
of greatest need that surfaced during the 2012-13 state fiscal year. For example, during the year the
Homelessness Assistance Program (HAP) ran out of money. The contracted HAP provider is a County
Planning Team member; she acknowledged that referrals and applications are still on the rise, indicating that the
increased need will remain in the next state fiscal year.
Summit Health, our local healthcare and hospital provider, recently conducted a needs assessment that includes
data related to the mental health of Franklin County residents. Mental Health was one of the top four priority
needs identified as a result of this assessment. We will utilize the findings from the Community Needs
Assessment to monitor need.
We will also utilize the PA Youth Survey (PAYS) to assess needs. In addition, we will track the degree to
which the youth-focused programs are changing knowledge, attitudes and behaviors toward substance use and
abuse.
One important point to note is the limitation to utilizing secondary data like the Summit Health Needs
Assessment and the PAYS. The PAYS is administered every two years. The Health Needs Assessment is
conducted every three years. These longer data collection intervals mean that the data will not be as sensitive to
program impact as primary data collection efforts. To address this challenge, we initiated an Outcomes and
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Evaluation Committee that will focus on system-wide outcomes planning to measure the success of human
services initiatives throughout the county. This committee will help inform and evaluate the outcomes criteria
proposed in subsequent Human Services Block Grant Plans. For FY 2013-14, the County Planning Team as a
whole has thoughtfully considered the county-level measures discussed below.
The County level measures that will be monitored by the County Planning Team are presented below in the
order they are addressed in the narrative. These measures include:
Mental Health –
1. Crisis Intervention Team (CIT): We will track the number of personnel trained and the number of
CIT-related calls that these personnel responded to. We plan to also document the final disposition
of these calls (hospital, arrest, etc.).
2. Mental Health First Aid: We will track the number of people trained.
3. Supportive Employment: We will track the number of employers engaged in Supportive
Employment and present the percent change compared to last year.
4. Readmission: We will track the annual readmission rates and present the percent chance compared
to last year.
5. Medication Co-Pay: We will measure the degree to which the program is designed and implemented
6. Older Adults: We will track the number of Mental Health presentations conducted at Senior
Centers. We will also collect the number of referrals to the psychiatric nurse and the number and
types of community services requests.
7. Transition-Age Youth: We will track the number of apartments available as well as if there is a
waiting list and, if so, how many are on it.
8. Children (under 18): We will track the number of youth attending Kick-off events by location
9. Student Assistance Program (SAP): We will track the number of Girls Circle/Boys Council
programs and the number of youth who attended each.
10. Respite: We will track the number of requests for emergency and hourly respite and compare the
figure to last year.
11. CASSP: We will track the number of families and schools accessing service and supports.
12. Grandparents as Caregivers: We will track the number of children placed with Grandparents due to
parents’ MH or C&Y involvement. We will also track the number of programs available to assist
them.
13. Forensic Housing: We will track the number of former inmates in county-funding housing as well as
the number of inmates in Jail lacking an approved home plan who have an SMI.
14. Community awareness: We will track the number of outreach materials produced and distributed
and the location and number of community events attended.
15. Comprehensive Continuous Integrated Systems of Care Model (CCISC): We will track whether or
not the Action Plan and the Change Agent Committee were created and whether or not the Co-
Occurring Competency Certification Program was implemented.
16. Aging Integration: We will track the progress of the decision regarding implementation of cross-
systems mobile team.
17. WRAP®: We will track the number of staff trained and the number of WRAP® plans developed.
Intellectual Disability –
The following goals and desired outcomes are detailed in the Quality Management plan for
Franklin/Fulton MH-ID Developmental Disabilities Program as required by the Administrative Entity.
1. To meet the goal of security and safety in home and community for participants, we will monitor the
number of restraint incidents quarterly through analysis of the HCSIS Incident Data.
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2. To maintain coverage for the Base Funded Supports Coordination for those who have had MA
denial, we will track the number of MA denials and referrals to supports coordination.
3. To maintain the number of people in the lifesharing program, the MH-ID program will offer
lifesharing as the first option for housing, and the number of individuals in the lifesharing program
and their progress in the program will be tracked quarterly by the Quality Management Program
Specialist.
4. To measure the goal of participants in MH-ID who want to vote acquiring the proper identification
cards to vote, ISPs will be cross-referenced with the registered voter list, and registered voters will
be given voter identification information.
5. To measure the goal of reducing the number of 1-2-1 abuse incidents by 10%, the number of
incidents of 1-2-1 abuse will be measured through quarterly analysis of the HCSIS Incident Data, the
target trends to prevent future incidents will be analyzed by the Risk Management Team, and
quarterly reports will be provided by the Quality Management Council.
6. To measure the goal of increasing the number of individuals in community employment by 10% by
7/31/15, data on the number of individuals who want to work and their desired work situations will
be collected by the Transition/Employment Council on an ongoing basis. Providers will meet with
employers to collect data on the available jobs within the community. Quarterly data collection from
providers and the MH-ID Employment Point Person will be used to track the number of individuals
employed in the community.
7. To measure the goal of increasing the number of non-verbally communicative individuals who have
an effective means of communicating their needs and choices by nine people by June 30, 2015, data
will be gathered on nine individuals selected for an assessment and staff training program. The
number of these nine individuals who have an effective means of communication by the end of the
objective period will be measured.
Drug and Alcohol Services –
1. For each treatment type and age-range, we will track the total number of people served as well as the
unduplicated count of residents served in the year.
2. We plan to also track program data on the number of people who have requested assistance more
than once in a 24 month period (the treatment type, time since last service, etc.
3. Comprehensive Continuous Integrated Systems of Care Model (CCISC): We will track the number
of in-county facilities that offer specialized treatment programming for individuals with co-occurring
conditions.
Homeless Assistance –
1. We will use the Point-In-Time (PIT) counts, and compare them to previous years, to measure
homelessness in our county.
2. We will track the numbers served and the waiting lists for local housing providers.
3. We will track the number of providers attending the county’s Local Housing Options Team and will
document identified needs and potential solutions for individuals and families experiencing a
housing crisis.
Children and Youth –
1. Family Group Decision Making: For families with the goal of reunification, we will track the
number of months children are in placement prior to reunification. For families with the goal of
placement prevention, we will track the percent of children who were not placed in a residential
setting.
2. Family Development Credentialing: We will track the number of staff and providers who enrolled
and completed the course.
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Human Services and Supports –
1. Adult and Aging Services: We will track the degree to which adult protective services are available
by measure the number of consumers served.
2. Generic Services: We will measure the number of referrals process through our Information and
Referral program. In addition, we will also track the degree to which residents are accessing the
Link program. Regarding the new transportation initiative, we will track both the number served
and the number of requests that were not able to be served (if applicable).
3. Specialized Services: Teen Intervene will be measured using the fidelity tools included with the
evidence-based curriculum, including whether or not drug and alcohol use decreased among
participants. We will track the number of Girls Circle/Boys Council programs and the number of
youth who attended each. The elementary interventions will be measured by tracking the number of
participants who enrolled, as well as completed, the various curricula. The Intellectual Disabilities
Housing Program will measure the apartment program by monitoring the number of enrollees in the
rental program, which services the individuals are utilizing, and if there are any individuals who
would qualify for the program, but do not currently have an apartment available. Lifesharing
program utilization by the individual who is funded out of the HSDF portion of the block grant will
be measured by quarterly report and progress tracking by the Quality Management Program
Specialist.
4. Interagency Coordination: We will track the number of people who attend the Human Services
professional two-day training. We will also track the number of staff who attend the Introduction to
Human Services workshop.
HUMAN SERVICES NARRATIVE
Created through a collaborative process utilizing local needs data and involving a cross-section of community
stakeholders, the goal of this plan is to provide a comprehensive continuum of human services for residents in
the least restrictive setting appropriate to their needs. Franklin County collaborates as a joinder with Fulton
County in four of the seven funds included in the Block Grant. Both counties have longstanding Human
Services Administrative models.
Mental Health Services
The Franklin/Fulton County Mental Health Program provides services to Franklin/Fulton County adults with
severe and persistent mental illness and children who have a mental health diagnosis or who are at risk of
developing a mental illness.
Through contracted case management, our agency provides intake, assessment, and coordination of the
following services: outpatient psychotherapy, psychiatric and psychological evaluation, medication monitoring,
residential programs, vocational and social rehabilitation, short-term inpatient, partial hospitalization and 24-
hour emergency services.
New programs this year include the Crisis Intervention Team, and Wellness Recovery Action Plan training.
Based on spending of the Human Services Block Grant funds allocated to Mental Health for FY 2012-13, we
are projecting to redistribute $57,224 from the Mental Health budget for FY 2013-14.
The following list describes program improvements:
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Crisis Intervention Team – (CIT) These programs are local initiatives aimed at improving the
community and law enforcement response to individuals experiencing mental health crisis situations.
They rely upon extensive collaborations between first responders, law enforcement, mental health
provider agencies, and individuals and families affected by mental illness.
o Franklin County Police Chiefs and Mental Health committed to a partnership by sending a team
of seven to become trainers for the Memphis Model of CIT. The team representing our county
includes: three law enforcement officers, one dispatcher, one advocate, one crisis worker, and
one mental health professional. We are creating a roll out plan in our community. The goal is to
offer the first 40 hour course in February 2014. Our target audience includes police officers,
emergency responders, probation officers, jail staff, crisis staff, and sheriff deputies.
Mental Health First Aid – Mental Health First Aid is an interactive 12 hour public education program
that enables individuals to identify, understand, and respond to signs of mental illnesses and substance
use disorders. The course provides an overview of mental illness and substance use disorders in the U.S.
and introduces participants to risk factors and warning signs of mental health crises. Participants learn a
5-step action plan to respond and connect individuals with appropriate resources.
o Mental Health sponsored four sessions this past year in both Franklin and Fulton County.
o We trained over 30 people and plan to continue offering this training program in the future as
well. The target audience will be staff working with our older adults, first responders, office staff
responsible for welcoming individuals into service, and the primary care staff.
Employment
o Attended Senator Alloway’s job fair to continue educating our community employers on
employees’ mental health needs and stress management for their employees. We also offered
education regarding the evidence based supported employment philosophy.
o Continued working with our supported employment providers on the evidence based philosophy
and increased business interest in hiring individuals with a mental illness.
In a review of system service needs, MH/ID recognized that historically, our system has required improvements
in data collection related to quality of care. In response, MH/ID partnered with other entities in our community
to identify what areas should be analyzed for our system. We have created workgroups and assigned them to
priority areas for system indicators analysis.
Readmission rates
o We have a high readmission rate for individuals experiencing a serious mental illness. In
response, we organized a workgroup comprised of outpatient providers, behavioral health unit,
advocates, crisis, case management, healthchoices, managed care, and the county. The group is
focused on identifying any commonalities and discrepancies in our services compared to
neighboring communities. The information will be combined with results of a survey from
individuals that have experienced multiple admissions with the goal of creating an action plan.
Medication co-pays
o Co-pays for mental health medication may be a barrier for some individuals. We are examining
solutions to address this need and identify funding.
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In the July 2013 CCISC implementation meeting, Outpatient providers representing our
area will be surveyed to determine the level of need.
We will also survey our Mental Health Association, Crisis, and our Certified Peer
Supports to gather information.
During September and October 2013, programs and funding options will be explored.
By January 2014 a medication co-pay assistance program structure will be developed.
Older Adults (ages 60 and above)
Mental Health presentations for the senior centers are underway. The target audience is older adults,
family, and staff. The goal is to provide education and community resources for advanced directives,
grief and loss, depression, medication and welcoming individuals into service.
A community psychiatric nurse provides educational programs to the senior center members. She is also
available to answer questions and refer individuals to community services as needed.
Transition-Age Youth (ages 18 through 26)
Franklin County MH addresses Transition-Age Youth through a housing program geared toward meeting
the needs of this age demographic. At the end of the 2010-2011 fiscal year, MH/ID developed a transitional
housing program focusing on the needs of transition age (18-26) and the forensic population. The committee
agreed to start with one apartment to ensure the treatment team composition and supports are established.
The purpose of the program is to provide a transition to independent living to young adults and individuals
re-entering the community after incarceration. The goal is to provide three apartments by the year 2014.
Children (under 18)
The Community Coalition’s goal is to bring together area leaders, residents, agencies/organizations and
professionals to support youth in making drug-free choices. Last year’s Kick Off Your Drug-Free
Summer brought in close to 400 area youth and adults. We are hoping to see at least 500 area youth this
year. This event will be open to any area resident who wishes to join and provides the public with a fun,
free opportunity to interact with members of the community. This event helps to showcase local
activities for youth and promote healthy decision-making. We have expanded this event to include
Fulton County and Waynesboro this year and hope to add more locations in the future.
Our Student Assistance Program has implemented Girls Circle (an OJJDP Promising Practice) and Boys
Council this school year as a group available to our youth during school hours.
Respite is available on both an hourly and an emergency overnight basis. In 2012, there was an increase
in respite use by new families. We have seen a decrease in the emergency respite needed now that the
hourly respite is available and families can schedule this service.
The CASSP Coordinator has increased the communication between the schools and the families.
Families and schools have become aware of additional supports and services available in the local
communities and have accessed them.
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Our area has seen an increase in grandparents and great grandparents responsible for parenting young
children. Due to age requirements, these grandparents do not always qualify for support from the Area
Agency on Aging.
Special/Underserved Populations
Franklin County Mental Health/Intellectual Disability serves individuals with co-occurring diagnoses through a
collaborative housing program.
Another underserved population that receives MH/ID program focus is the group of Justice-involved
individuals. Franklin County serves these individuals through implementation of the CIT program, which
emphasizes effective communication techniques for first responders and law enforcement in order to deescalate
crisis situations. The goals of CIT are to reduce the number of emergency responses resulting in arrests and to
increase the safety of those in crisis as well as officers. Additionally, the Forensic Housing program addresses
the needs of those individuals returning to the community after incarceration, many of whom receive MH
services.
Other programs for special/underserved populations are described in greater detail under the Recovery-Oriented
Systems Transformation section that follows.
Recovery-Oriented Systems Transformation
Results of family and individual satisfaction surveys indicate a lack of knowledge and understanding of the
roles and responsibilities of the County MH/ID office. As a result, the discussion of systems transformation
priorities fostered the creation of a campaign of awareness and community outreach.
It is anticipated that by increasing the presence and understanding of MH/ID in the community, the utilization
of services will improve. At the same time, we will have a greater opportunity to improve the co-occurring
competency of our service system. Creating a system that responds to the complex issues of individuals with
improved coordination between programs will allow greater access to services for children, transition age
individuals, adults, and older adults.
Mental Health awareness campaign –
o Gather educational materials on mental illness for distribution throughout the community.
o Target the community through health fairs, job fairs and other community events.
CCISC Implementation –
o Analyze COMPASS-EXEC and create an action plan that includes any themes that may emerge
from the analysis by July 2013.
o Creating a Change Agent committee that will be responsible for educating their peers in direct
care about complex issues.
o Team has identified a need for a certification program for providers in our community committed
to be co-occurring competent.
o Continued educational program this past year with motivational interviewing. The coming year
will focus on children/adolescents with complex issues.
Transition age and Forensic Housing availability –
o With the close of the 2010-2011 fiscal year, MH/ID was able to develop a transitional housing
program focusing on the needs of transition age (18-26) and the forensic population. The
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committee agreed to start with one apartment to ensure the treatment team composition and
supports are established. The purpose of the program is to provide a transition to independent
living to young adults and individuals re-entering the community from incarceration. The goal is
to reach three apartments by the year 2014.
Aging integration –
o In 2013, a workgroup will be assembled to research the ability to create an integrated mobile
team that represents aging, MH/ID, and healthcare profession. The team will expect referrals
from law enforcement, crisis, MH/ID, and aging at a minimum.
Pilot for the WRAP® for Everyday lives
o “WRAP® stands for Wellness Recovery Action Plan™. WRAP® is a self-management and
recovery system developed by a group of people who had mental health difficulties and who
were struggling to incorporate wellness tools and strategies into their lives. WRAP is designed
to:
Decrease and prevent intrusive or troubling feelings and behaviors
Increase personal empowerment
Improve quality of life
Assist people in achieving their own life goals and dreams
WRAP is a structured system to monitor uncomfortable and distressing feelings and behaviors
and, through planned responses, reducing, modifying, or eliminating them. It also includes plans
for responses from others when you cannot make decisions, take care of yourself, or keep
yourself safe.”
Mental Health and Intellectual Disabilities will be hosting a facilitator training series in July and
September 2013 to encourage providers to have staff trained and be able to offer WRAP® plans as part
of treatment.
Intellectual Disability Services
It is the mission of Franklin/Fulton Mental Health/Intellectual Disabilities/Early Intervention to partner with the
community to develop and arrange for the availability of quality services and supports for individuals and
families. Through the use of a person-centered planning approach and the utilization of Prioritization of
Urgency of Need for Services (PUNS), the ID program assists individuals in accessing services and supports
within their community regardless of the funding stream. The PUNS gathers information from the person-
centered planning approach to identify current and anticipated needs. This information allows Franklin/Fulton
Mental Health/Intellectual Disabilities/Early Intervention to budget and plan for the continuum of services and
to develop programs to meet the needs of the community. Programs support client engagement and provide
access to services for employment, training, housing and family support as appropriate. As of May 1, 2013,
there were 475 people registered in the Intellectual Disabilities program in Franklin County, of which 30 were
participants in the Lifesharing program.
New programs this year include the ID apartment program, and the Wellness Recovery Action Plan training.
Based on spending of the Human Services Block Grant funds allocated to Intellectual Disabilities for FY 2012-
13, we are projecting to redistribute $50,000 from the Intellectual Disabilities budget for FY 2013-14.
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Estimated / Actual Individuals
served in FY 12-13
Projected Individuals to be
served in FY 13-14
Supported Employment 25 25
Sheltered Workshop 7 7
Adult Training Facility 5 5
Base Funded Supports
Coordination
55 55
Residential (6400) 2 2
Lifesharing (6500) 0 0
PDS/AWC 24 29
PDS/VF 0 0
Family Driven Family Support
Services
0 0
Supported Employment
The "Transition to Adult Life Success" program engages young adults with disabilities in discussions and
activities pertaining to areas of self-determination and career exploration. The "Transition to Adult Life
Success" program activities include presentations on employability, community resources, and post-secondary
opportunities. One-to-one services include connecting with employers, job shadowing, community based work
assessments, and work incentive counseling.
Supported Employment: Supported Employment Services include direct and indirect services provided in a
variety of community employment work sites with co-workers who do not have disabilities. Supported
Employment Services provide work opportunities and support individuals in competitive jobs of their choice.
Supported Employment Services enable individuals to receive paid employment at minimum wage or higher
from their employer.
Transitional Work: Transitional Work Services support individuals transitioning to integrated, competitive
employment through work that occurs at a location other than a facility subject to 55 Pa. Code Chapter 2380 or
Chapter 2390 regulations. Transitional work service options include mobile work force, work station in
industry, affirmative industry, and enclave.
Pre-vocational: This service is assists individuals in developing skills necessary for placement into competitive
employment. Prevocational Services focus on the development of competitive worker traits, using work as the
primary training method.
The ID department is concentrating on Community Employment for the Quality Management Goal. As of May
1, 2013, there were 60 Franklin County residents receiving Community Employment services. Franklin
County’s goal is to increase by ten percent the number of people receiving Intellectual Disability services who
are competitively employed in the community. Franklin County expects to participate in the state initiative to
double the number of individuals with intellectual disabilities that are employed over the next five years.
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Base Funded Supports Coordination
Base Funded Supports Coordination includes home and community based case management for clients in
nursing facilities and in community residential settings. These services are only paid for clients who have had a
denial of Medical Assistance Coverage. Currently no one is leaving the State Hospital system from Franklin or
Fulton Counties, so transition services are not needed at this time.
Lifesharing Options
According to 55 Pa. Code Chapter 6500: “Family Living Homes are somewhat different than other licensed
homes as these settings provide for life sharing arrangements. Individuals live in a host life sharing home and
are encouraged to become contributing members of the host life sharing unit. The host life sharing arrangement
is chosen by the individual, his or her family and team and with the life sharing host and Family Living
Provider Agency in accordance with the individual’s needs. Licensed Family Living Homes are limited to
homes in which one or two individuals with an intellectual disability who are not family members or relatives of
the life sharing host reside.”
Lifesharing is the first residential option offered to any person who needs a residential placement. This is
documented in the Individual Support Plan. Currently, there are 30 people living in Lifesharing Homes in
Franklin County. All 30 people have waiver funding to support the services they need in the lifesharing home.
Almost one-third (31%) of people who are living in a residential placement have chosen lifesharing. The
Intellectual Disability Program’s Quality Management Goal is to maintain the number of people in Lifesharing.
Franklin County is funding one additional participant in its Lifesharing program through the Human Services
Development Fund. Please refer to this section for the description of this portion of the program.
Cross Systems Communications and Training
ID collaborated with the Copeland Center for Wellness and Recovery and Mental Health to pilot WRAP® for
Self-Determined Life. WRAP® is a recovery oriented evidence-based model that is accepted internationally.
Franklin/ Fulton County and Philadelphia are the pilot areas. Training for this pilot program will be sponsored
with ID Waiver Admin monies.
Emergency Supports
If waiver capacity is unavailable, individuals will be supported out of funds in the block grant. Base money will
be provided to graduates for day programs and transportation to maintain their residence at home, and so their
parents can maintain their employment status. Additionally, the new apartment program, which is described in
greater detail in the Human Services Development Fund section of this narrative, will allow those with the skills
to live independently with some supports. The Franklin County ID department will increase the availability for
combinations of Companion, Home and Community Habilitation, Transportation, and Respite so that
individuals can continue to live at home instead of residential programs which are more costly.
Per the ODP, waiver slots will be given to new graduates (14 in 2013-2014) and aging caregivers again in the
2013-14 fiscal year.
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Administrative Funding
The administrative funding supports three program specialist positions. Two Program Specialists support all
base contract functions. The third position collects and analyzes data for the Intellectual Disabilities portion of
the Block Grant and monitors base providers. For FY 13-14, the program specialists will also use base admin
monies to implement and maintain the new apartment program.
Waiver Admin monies primarily support the three program specialist positions. Each program specialist
has specific duties in the AE Operating Agreement for which they are responsible. Program Specialist #1 is
primarily responsible for waiver capacity. This program specialist makes sure all clients served have the correct
waiver to meet their needs. She is also responsible for Waiver Capacity Commitment, Residential Vacancy
Management, Unanticipated Emergencies, Waiver Enrollment and Pre-surveys for IM4Q which are all in the
AE Operating Agreement. IM4Q data is analyzed and used to measure objectives in the Quality Management
Plan (Appendix E, Attached).
Program Specialist #2 is primarily responsible for Incident Management/ Risk Management. She is responsible
for making sure incidents are entered, investigated and finalized in a timely manner. She also approves all
incident reports at the county level. She is responsible for assuring for the safety and well-being of all
individuals involved in an incident. She reviews all incidents within 24 hours of occurrence. She also takes all
incident data and other associated data to facilitate the Risk Management Committee. She is responsible for the
delegated functions in the AE operating agreement. She is also responsible for the level of care determinations
and re-determinations. These duties are also part of the AE Operating Agreement. Two goals in the QM plan
that are part of incident management are Restraint Reduction and Individual to Individual Abuse reduction.
Program Specialist #1 and #2 also are responsible for Intakes for eligibility, offering free choice of willing and
qualified providers, approval and authorization of Individual Support Plans, Provider Recruitment and notice of
Fair Hearing and Appeals. These duties are included in the AE Operating Agreement.
Program Specialist #3 is primarily responsible for Quality Management. She is to make sure the PUNS are
done and completed in a timely manner. She also assures Provider Qualifications, Provider Monitoring, the AE
Oversight Monitoring and any Corrective Actions Plans from the monitoring is completed in a timely manner.
She is also responsible for the writing, implementation, data collection and analysis of the data for the Quality
Management Plan. She is the facilitator of the Quality Improvement Council. She is also the Closing the Loop
Point Person for IM4Q. These duties are indicated in the AE Operating Agreement. She also acts as the
community liaison for the ID program at community events.
Homeless Assistance
Homeless and near homeless assistance is provided through the County’s Information and Referral Coordinator,
PATH, ESG and HAP. There are two main shelters within the County, the Franklin County Shelter and the
Waynesboro New Hope Shelter. South Central Community Action Program (SCCAP) runs the Franklin County
Shelter for the Homeless and is contracted to administer the County’s HAP funds. Because of the flexibility of
the block grant, we were able to provide additional support for HAP and the Franklin County Shelter for the
Homeless for FY 2012-2013.SCCAP has received ESG funding in the past and will apply for funding in future
years. New Hope Shelter in Waynesboro is receiving ESG funds to assist with rapid rehousing and shelter
operations. In 2012, Franklin County contracted with Waynesboro New Hope Shelter to provide forensic
housing to former inmates of the Jail. Franklin County also provides transitional housing and offers an
independent living program through the Mental Health funding.
13
Estimated / Actual Individuals
served in FY 12-13
Projected Individuals to be
served in FY 13-14
Bridge Housing 0 0
Case Management 322 280
Rental Assistance 314 275
Emergency Shelter 121 43
Other Housing Supports 12 12
Bridge Housing
Due to the limited funds available Franklin County has not expanded into bridge housing support.
Case Management
Case Management services activities offered by SCCAP, as defined by the HAP Guidelines, may include but
are not limited to the following:
Intake and assessments (service plans) for individuals who are in need of supportive services and who
need assistance in accessing the service system.
Assessing service needs and eligibility as well as discussion with the client of available and acceptable
service options.
Referring clients to appropriate agencies for needed services.
Providing referrals to direct services such as budgeting, life skill training, job preparation, etc.
Providing advocacy, when needed, to ensure the satisfactory delivery of request services.
Protecting the client’s confidentiality.
Follow-up to assure compliance with the continuity, appropriateness, and effectiveness of service.
Case Management services are contracted out to South Central Community Action Program (SCCAP). Every
rental assistance applicant will be part of HAP case management. Specifically, case management provides
referrals with regard to budgeting, parenting, hygiene, sanitary housekeeping, accessing resources, life skills,
and becoming more self-sufficient. A service plan is established and signed by each applicant that includes
referrals to address factors that led to the housing crisis in addition to other factors that may have contributed to
the problem.
The SCCAP HAP Program Coordinator is responsible for completing all intakes and assessments for Franklin
County Homeless Assistance Program. This process includes assessment of other needs, especially those
contributing to the housing crisis.
Rental Assistance
HAP’s Rental Assistance Program provides funding for rent and security deposits for eligible low-income
applicants who are homeless or near homeless as defined below:
Individuals or families are homeless if they:
14
Are residing in a group shelter; domestic violence shelter; hotel or motel paid for with public or
charitable funds; a mental health; drug, or alcohol facility; jail; or hospital with no place to reside; or
living in a home, but due to domestic violence; needs a safe place to reside;
Have received verification that they are facing foster care placement of their children solely because of
lack of adequate housing, or need housing to allow reunification with children who are in foster care
placement;
Are living in a “doubled-up” arrangement for six months or less on a temporary basis;
Are living in a condemned building;
Are living in housing in which the physical plant presents life and/or health threatening conditions; e.g.
having dangerous structural defects or lacking plumbing, heat, or utilities; or
Are living on the streets, in cars, doorways, etc.
Individuals and families are near homeless if they;
Are facing eviction (having received either written or verbal notification from the landlord that they will
lose their housing unless some type of payment is received. Verbal notification must be followed up
with written documentation).
Individuals served by the HAP program must have been a resident of Franklin County for six (6) months prior
to applying for assistance.
Priority for Rental Assistance will be given to Franklin County applicants who can demonstrate that they will be
able to become self-sufficient within three (3) months with regard to housing. Applicants are required to
cooperate with case management services and clients will be required to sign a service plan showing areas of
responsibility between the case manager and the client.
Clients served by the HAP Rental Assistance Program will fall into one or more of the following categories:
Franklin County families with children who are homeless or near homeless.
Persons fleeing domestic violence.
Individuals who have fallen on hard times who need temporary assistance to get back on their feet.
Homeless families with children who are candidates for Transitional Housing.
To receive financial assistance, the individual or family much be at or below 150% poverty. As appropriate,
those who do not meet the income guidelines will be referred to other agencies that may be able to provide
needed services. Income requirements will be waived for persons fleeing domestic violence and for those who
are experiencing a housing crisis due to a disaster such as fire or flood (upon State approval by the State HAP
Manager as stated in the guidelines).
15
The amount of Rental Assistance allocated will be determined by the facts of the case. A service plan is created
for each household. The plan addresses the conditions precipitating the housing crisis. It also addresses the
acquisition of permanent housing, including the schedule for disbursement of rental assistance funds.
The Block Grant Planning Committee proposes redirecting FY 2013/14 funds to the HAP Rental Assistance
Program in order to address the severe local need: the needs of our citizens outnumbered the funding for the
2012-13 fiscal year.
Emergency Shelter
The Franklin County Shelter for the Homeless is located centrally at 223 South Main Street in Chambersburg,
PA. The Shelter provides 10 bedrooms, two of which are family rooms, with the capacity to house up to 24
individuals at one time. The Franklin County Shelter for the Homeless is the last safety net for the residents
who may find themselves without a place to live. One of its major goals is to move homeless residents back
into permanent housing and toward self-sufficiency. In order to accomplish this, the Shelter staff provides case
management activities, setting goals with the residents to be accomplished during and after their stay, and
cooperates with other agencies within the County to direct residents to the available resources that will help
them achieve their established goals. Clients are also required to participate in a basic life skills program.
In order to become a client at the Franklin County Shelter for the Homeless, an individual/family must be
legally homeless. If legally homeless, the potential client completes a Common Application for Assistance and
Assessment package, which includes a self-declaration of homelessness. A potential client will only be
considered a client once he/she has completed the intake forms. Upon completion of the form, the client/family
works with the staff to identify his/her/their particular causes for homelessness. Once the causes have been
identified, the client/family, in coordination with the staff, develops a plan of action including specific goals to
be achieved during their stay at the Shelter. Long term goals that lead to the attainment of stable housing are
also set. The caseworker assesses the client’s work history, medical history, and educational background. This
information becomes a permanent part of the client’s file. The staff identifies the client’s family needs such as
nutritional education, parenting classes, and drug/alcohol treatment services. Using this information, staff,
under the supervision from the Program Coordinator, acquires the necessary information or services to address
that particular client/family’s needs.
In 2012, the Shelter provided temporary shelter to 121 homeless individuals representing a total of 4,196 nights
of shelter. From January through March 30, 2013, the shelter has served a total of 38 individuals representing a
total of 1,025 nights of shelter.
Homeless Assistance Program funds are needed to support the daily operational costs of the Franklin County
Shelter for the Homeless as it tries to adapt to the steady increase in homeless needs and extensive supportive
services. The shelter staff is finding that an increasing number of homeless individuals need more than 30 days
of emergency shelter due to the lack of employment opportunities.
Other Housing Supports
Franklin County has not used HAP funding for other housing support services. Transitional housing,
independent living and forensic apartments are available through other funding sources.
Franklin County has actively participated in HMIS for approximately three years, entering data from existing
programs, including Shelter Plus Care and Supportive Housing grants through HUD as well as the ARRA-
16
funded Homelessness Prevention and Rapid Rehousing Program (HPRP) grant. Our PATH Coordinator will be
attending a two-day training regarding the data entry into HMIS. Beginning July 1, 2013 all PATH services will
be entered into HMIS.
Children and Youth
The Franklin County Children and Youth Service (FCCYS) is the local public child welfare agency responsible
for ensuring that the children of Franklin County are safe and receiving the essentials of life. The agency
provides services to any child from birth to 18 years of age who has been abused, neglected, exploited, is
incorrigible and/or truant and their families. Additionally, youth who were determined to be ‘dependent’ prior
to the eighteenth (18th) birthday and request to re-enter care are also provided child welfare services.
Services are provided to families who request and voluntarily accept services or who have been ordered to
participate in services by the Franklin County Courts. Services are designed to promote the safety, permanency,
and well-being of children and their families. These are specialized services dealing with the problems of
children whose families need help in caring for them. Reports involving abused, neglected, exploited or
truant/incorrigible children are investigated and in-home services and/or placement services are provided to
families who meet Children & Youth legal criteria. Children and Youth can help intervene in family disputes
and crises; however, Children and Youth does not have the authority to determine, mediate or change Court-
ordered custody or visitation agreements. Government intervention is justified when the family cannot, or will
not, provide for the child’s safety and/or basic needs. Placement of a child by Children and Youth can only
occur if ordered by the Juvenile Court. FCCYS provides an array of services (either in-house or through private
contracted providers) to accomplish the goals set forth above.
Based on spending of the Human Services Block Grant funds allocated to Children and Youth Services for FY
2012-13, we are projecting to redistribute $4,410 from the Family Development Credentialing line to the
Family Group Decision Making line of the Children and Youth budget for FY 2013-14.
Promising Practice
The FCCYS does not provide any ‘Promising Practice’ programs.
Housing
FCCYS does not have any formalized housing programs. (Other than limited emergency placement in a hotel
for homeless families referred to FCCYS.)
Alternatives to Truancy
FCCYS provides significant services to truant and/or incorrigible youth; however, none of these services are
funded by any Special Grant. The agency has a Truancy Prevention Unit comprised of four caseworkers and a
supervisor to work with truants referred to C&Y. A series of truancy elimination classes are provided to youth
and in 2013, the agency developed a two-hour class for the parents of truant youth. Referrals to this class come
from the schools, CYS, and Magisterial District Judges. All of our truancy services are funded through the
Needs-based Budget.
Evidence Based Programs
The Pennsylvania Department of Public Welfare’s Office of Children, Youth, and Families lists Family Group
Decision Making (FGDM) and Family Development Credentialing (FDC) as Evidence Based Programs.
17
Franklin County Children and Youth Service is a Phase II participant in the Administrative Office of PA
Courts’ Office of Children and Families in the Courts’ Permanency Practice Initiative (PPI). A requirement of
the PPI is the implementation of FGDM and FDC.
Family Group Decision Making (FGDM) is a process in which family members, community members and
others collaborate with the child welfare agency to create a plan for a child or youth. The family members
define who comprises their family group. In FGDM, a trained coordinator, who is independent of the case,
brings together the family group and agency personnel to create and carry out a plan to safeguard children and
other family members. FGDM processes position the family group to lead decision making, and the statutory
authorities agree to support family group plans that adequately address agency concerns. The statutory
authorities also organize service providers from governmental and non-governmental agencies to access
resources for implementing the plans.
The key to successful FGDM practice is engaging the family group — those people with kinship and other
connections to children, youth and their parents. This includes those who may not be currently connected to
children and youth — for example, paternal relatives who are often excluded or marginalized.
FGDM affirms the culture of the family group, recognizes a family’s spirituality, fully acknowledges the rights
and abilities of the family group to make sound decisions for and with its young relatives and actively engages
the community as a vital support for families. FGDM has the potential to energize hope, guide change and
foster healing. Through FGDM, a broad support network is developed and strengthened, significantly benefiting
children and their family groups. Government, local and tribal programs also benefit, learning from and relying
on the family group and community as resources that strengthen and support families in ensuring that their
children have a clear sense of identity, lasting relationships, healthy supports and limits, and opportunities for
learning and contributing.
Family Development Credentialing (FDC) is a professional development course and credentialing program
for frontline human service workers to learn and practice skills of strength-based family support with families.
Created in 1996 in New York State (Cornell University), 19 states besides Pennsylvania have implemented the
program. The Community Action Association of Pennsylvania (CAAP) serves as the coordinating body for the
Program in the State and is affiliated with Temple University who provides national coordination for the FDC
program. FDC is a unique worker development program that uses training and supported practice of skills to
transform how agencies provide services to individuals and families, from deficits-based to strengths-based,
empowerment-oriented models of practice.
FDC courses are offered to frontline family workers from a wide range of government, private and not-for-
profit agencies as well as businesses, faith organizations and large corporations. Family development trainees
work with families across the lifespan including families with young children, teen parents, retired people,
people with disabilities, and many other groups.
To earn the credential, a worker must: complete 80 hours of interactive classroom instruction based on the
Empowerment Skills for Family Workers curriculum; participate in approximately 10 hours of portfolio
advisement with a trained portfolio advisor; prepare a Skills Portfolio with support of the portfolio advisor; and
pass a state Credentialing Exam.
Franklin County began offering the FDC training in January 2010, with 23 participants. There have been three
additional ‘cohorts’ graduated/credentialed since that time (a total of four since of 2010). However, there has
been a noticeable decline in the number of participants interested in becoming credentialed, despite the actions
18
of the FDC Implementation Team working diligently to get the word out regarding the FDC Credentialing
Program.
Franklin County anticipated starting another class in January 2013, but was not able to generate enough interest.
Only eight people registered for the course. Instructors prefer a minimum enrollment of 15 students due to the
many activities that involve interaction among the students. The FDC Implementation Team decided to hold
the class in fall of 2013 with the hope that more human service workers will be interested. Newsletters, flyers
and promoting the training at the Franklin County Human Service Training Days will be utilized to promote the
training.
Fiscal Year 2012/2013 C&Y ‘Special Grants’
Special
Grant
Certified
Amount FY
12/13
Share FCCYS Cost
per Unit
No. of Units to
be
provided/actual
Projected
Expenditures
FGDM $47,469.00 State:
$45,095
$2,995.00 per
conference
16/17
Successful
conferences
$53,795.00
Local: $2,374
FDC $11,970.00 State:
$11,372
$1,200 per
participant
10 participants
(or 1
class/NONE)
-0-
Local: $598
Fiscal Year 2013/2014 C&Y ‘Special Grants’
Special
Grant
Tentative Amt.
FY 13/14
Share FCCYS Cost
per Unit
No. of Units to
be
provided/actual
Tentative
Expenditures
FGDM $47,469.00 State:
$45,095
$2,995.00 per
conference
21 referrals $47,469.00
Local: $2,274
FDC $7,560.00 State: $7,182 $1,200 per
participant
10 participants
(or 1 class)
$7,560.00
Local: $378
Drug and Alcohol Services
The Franklin/Fulton Drug and Alcohol Program (FFDA) provides funding for all levels of care for substance
abuse treatment. These levels include inpatient detoxification, rehabilitation, halfway house, partial
hospitalization, intensive outpatient, outpatient, and early intervention outpatient services for Franklin and
Fulton county residents. FFDA also provides case management services and oversight of medication assisted
treatment. In order to provide funding for all levels of care, there are contracts established with facilities across
the Commonwealth. Currently, there are four outpatient treatment providers and one inpatient drug and alcohol
treatment facility located in Franklin County. Within Fulton County, there is one outpatient treatment provider.
All treatment services are provided to any eligible resident despite age, gender, race, and ethnicity. However,
we serve individuals by our priority populations. These priority populations are identified in the following
order: Pregnant Injection Drug Users, Pregnant Substance Users, Injection Drug Users, and all others.
Currently, there is one local outpatient provider who has the ability to provide treatment services for the Spanish
speaking population.
19
An estimated 560 Franklin County residents will be funded for treatment through the drug and alcohol program
in fiscal year 2012-2013. FFDA projects that 348 individuals will receive level of care assessments. Level of
care assessments are completed by contracted outpatient providers or Case Management staff.
Research has shown that a decrease in funding for treatment means an increase in cost for other systems (i.e.
jails, prisons, hospitals, crisis centers). Our population served continues to increase as our funding constantly
reduces each year. Therefore, Franklin/Fulton Drug and Alcohol Program takes the initiative to research and
identify new potential funding sources for services.
FFDA works closely with Adult Probation, Children & Youth, and Juvenile Probation to coordinate drug and
alcohol services for individuals involved in the criminal justice system. Since 2010, D&A partners with
Franklin County Adult Probation to provide a designated Case Manager who works with level three and four
offenders with addictions issues who are sentenced to restrictive intermediate punishment. Funding for this
program is provided through a grant from the Pennsylvania Commission on Crime and Delinquency. In 2013/
2014, the grant will total $236,562.
Through this Block Grant, we plan to allocate additional funding for drug and alcohol treatment services, as
identified in Appendix C.
Older Adults (ages 60 and above)
If indicated, older adults are eligible for all levels of care for substance abuse treatment. These levels include
inpatient detoxification, rehabilitation, halfway house, partial hospitalization, intensive outpatient, outpatient,
and early intervention outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment.
Adults (ages 18 to 55)
If indicated, adults ages 18 to 55 are eligible for all levels of care for substance abuse treatment. These levels
include inpatient detoxification, rehabilitation, halfway house, partial hospitalization, intensive outpatient,
outpatient, and early intervention outpatient services for Franklin and Fulton county residents. FFDA also
provides case management services and oversight of medication assisted treatment. It is anticipated that many
of our priority populations, including Pregnant Injection Drug Users and Pregnant Substance Users will fall into
this age demographic.
Transition-Age Youth (ages 18 through 26)
If indicated, transition-age youth are eligible for all levels of care for substance abuse treatment. These levels
include inpatient detoxification, rehabilitation, halfway house, partial hospitalization, intensive outpatient,
outpatient, and early intervention outpatient services for Franklin and Fulton county residents. FFDA also
provides case management services and oversight of medication assisted treatment. It is anticipated that some
of our priority populations, including Pregnant Injection Drug Users and Pregnant Substance Users will fall into
this age demographic.
Adolescents (under 18)
20
If indicated, adolescents are eligible for all levels of care for substance abuse treatment. These levels include
inpatient detoxification, rehabilitation, halfway house, partial hospitalization, intensive outpatient, outpatient,
and early intervention outpatient services for Franklin and Fulton county residents. FFDA also provides case
management services and oversight of medication assisted treatment. Additionally, FFDA also contracts with
providers of prevention and intervention programs focusing on the adolescent population. These programs are
funded through the HSDF and are discussed in detail in the HSDF section of the Block Grant Narrative.
Individuals with Co-occurring psychiatric and substance use disorders
In conjunction with Franklin/Fulton Mental Health and Tuscarora Managed Care Alliance, the Franklin/Fulton
Drug and Alcohol Program has implemented a Co-occurring initiative in both counties. This initiative uses the
Comprehensive Continuous Integrated Systems of Care Model. All local providers participate in this initiative
for co-occurring competency. There are facilities that offer specialized treatment programming for individuals
with co-occurring conditions for providers outside of the two counties.
Recovery-Oriented Services
In conjunction with Franklin/Fulton Mental Health and Tuscarora Managed Care Alliance, the Franklin/Fulton
Drug and Alcohol Program has implemented a Co-occurring initiative in both counties. This initiative uses the
Comprehensive Continuous Integrated Systems of Care Model. All local providers participate in this initiative
for co-occurring competency. There are facilities that offer specialized treatment programming for individuals
with co-occurring conditions for providers outside of the two counties.
HUMAN SERVICES DEVELOPMENT FUND (HSDF)/HUMAN SERVICES AND SUPPORTS:
The Human Services Development Fund will continue to be essential part of the block grant that allows
Franklin County the flexibility to provide for specialized services throughout the fiscal year.
Estimated / Actual Individuals
served in FY 12-13
Projected Individuals to be
served in FY 13-14
Adult Services 0 0
Aging Services 0 0
Generic Services 3157 3517
Specialized Services 832 221
Adult and Aging Services:
Franklin County is looking at the possibility of starting adult protective services in the upcoming fiscal year.
The program will provide disabled consumers ages 19-59 access to protective services. HSDF will supplement
the costs if the temporary funding mechanism through the State Department of Aging is insufficient to cover the
costs.
Generic Services:
For FY 13/14, Franklin County will continue the Information and Referral program (I&R) under HSDF. I&R
provides information and referrals to individuals and the community through a variety of communication
channels, including in-person presentations, to local agencies to help educate the community of the various
21
services throughout the County. The I&R department is also the contact point for PA 211 coordination. Data
from our I&R resources database is shared with the capital region during quarterly coordination meetings. In
FY 12/13 Franklin County received 1,836 contacts through our office and 1,387 through our contracted after-
hours provider.
The I&R Coordinator assists people who are in crisis, and/or experiencing emergency situations. She also
advocates on behalf of those individuals who are in need of additional support. The I&R Coordinator is certified
by the Alliance for information and Referral Systems (AIRS). By way of a national exam, the Coordinator is
recertified every two years.
Franklin County implemented the PA Link to Aging and Disability Resources (LINK) in February 2011.
Designed to streamline access to long term supports and services, the initiative is part of the nationwide effort to
re-structure services and supports for older adults, persons with disabilities, family members and care providers.
The objective is to provide a “one stop shop” approach for residents in need. The LINK Coordinator refers the
consumer to the agency or agencies that best fits their particular needs.
The block grant committee approved funds into HSDF for transportation services. The funding will provide
transportation to/from non-medical human service appointments or treatment services for approximately 25
clients under the age of 60 who are ineligible for Medicaid and unable to pay for transportation on their own.
Specialized Services:
For FY 12/13 Franklin County implemented the Teen Intervene program and will continue to fund this program
in the upcoming fiscal year. Teen Intervene is an evidence-based program that is listed on the Substance Abuse
and Mental Health Services Administration (SAMHSA), National Registry of Evidence-based Programs and
Practices. It is designed to work with the court system, juvenile probation and schools to provide an
intervention for youth ages 12-19 that have minor to moderate drug and or alcohol use. Students who are caught
possessing substances or who demonstrate evidence of use are the target population for this program. Teen
Intervene is administered individually to youth by a professional in two 1 hour sessions approximately 7-10
days apart. An optional third session for parents is available to address the need for the parent to demonstrate
healthy attitudes and behaviors related to substance use and to monitor the adolescent. The program integrates
stages of change theory and motivational enhancement to help teens reduce and ultimately eliminate their drug
or alcohol use.
Elementary intervention groups are another essential program that will be enhanced for FY 13/14. This service
is being offered to schools in Franklin County that acknowledge having students who might be struggling in
school or at home with issues such as bullying, aggression, low grades, etc. Students are identified and referred
to the groups by teachers, staff or faculty. Groups are held in each school during a time and day designated by
the school. The facilitators use various curriculum including (but not limited to) Too Good for Violence, Girls
Circle and Boys Council. The additional funding will allow the elementary intervention groups to be expanded
throughout the school year and offered to all the elementary schools in Franklin County. The schools will also
be offered multiple groups through the year based on need and referrals.
The Block Grant Committee proposed funding, through the HSDF, a Lifesharing option for one individual
under the Intellectual Disabilities program. This individual was unable to be included in the Lifesharing
program with waiver funding based on his age, and the fact that his caregivers did not qualify for aging
caregiver funding based on their ages. The client and caregivers currently do not meet the criteria for waiver
funding, but it is possible that waiver funding will be utilized for sustained funding of Lifesharing for this
individual.
22
Another program which has been initiated to respond to the residential needs of clients with Intellectual
Disabilities is the housing program. This program represents collaboration between ID and MH Housing to
develop an apartment program for people with intellectual disabilities. This program will allow people who do
not need 24 hour supervision to have their own apartments (HSDF funding for security deposits and rent
subsidies) and the necessary supports to provide for their health and safety are provided by waiver funding. The
Mental Health Housing Program Specialist will manage the rental agreements and the Intellectual Disabilities
Program will provide the funding, monitoring and access to services and support. This pilot program will be
funded by HSDF in the first year, to provide an apartment for one individual in FY 2013/14.
The above programs tie into several categorical programs but best fit into the Human Services Development
Fund due to flexibility and affordability.
Interagency Coordination:
The Information and Referral Coordinator organizes a two-day training event that is available for Human
Services professionals. She also organizes the Introduction to Human Services training that is available two
times a year to new employees within the County government as well as agencies in the community.
23
24
Appendix B – Meeting Minutes and Proof of Publication
Franklin County Block Grant Committee Meeting March 1st, 2013
Franklin County Human Services Building 1:00 PM
Committee Members: Jennifer Johnson, Amanda Black, Traci Kline, Kim Wertz, Anne Larew, Manny
Diaz, Karen Johnston, Cassandra Rahauser, Jean Snyder, Ann Spotswood
Staff: Rick Wynn, Carrie Gray, Stacy Rowe, Christy Russell, Jennifer Lipko, Claire Hornberger, Cori
Seilhamer, Lori Young
I. Welcome and Introductions
a. Rick introduced our new committee members, Kim Wertz- CSP, Anne Larew-Stakeholder, and Jeff
Hoose- Housing Advocate. Jeff unfortunately could not make our meeting. Rick also informed everyone
and welcomed Jim Hook of the Chambersburg Public Opinion.
b. Jean and Rick do double duty for joinder for Franklin and Fulton County. They attend block grant
meetings for each county.
II. Overview of the results from the first distribution
a. We did get contracts sent out for Healthy Communities Partnership and Pyramid Healthcare for
prevention program and activities. These monies came from ACT 152 and the rest of the money was
given to Homeless Assistance to provide services in Franklin County. We are seeing a surplus of calls for
assistance.
III. Explanation of Year to date expenses (through 12/31/2012) and Funds available for redistribution
a. Projected amounts were based on spending and what each program had projected.
b. Discussion about retaining about 1% retained is $9,170 of the total allocation in the event that we would
have some cost overrun. So with 1% beginning as retained, that leaves $77,593 to be redistributed. The
1% is Rick’s recommendation as a safety net for these programs. The committee will be considering at
this meeting Rick’s recommendation for the 1% for overruns and program request for additional
funding.
IV. Program Requests
a. As well as opening it up to the community for requests, Homeless Assistance needs $6,185. There
projections were for the end of the fiscal year. There are large amounts of calls coming into Information
and Referral specifically for shut downs of utilities, housing such as rent, etc. Jean Snyder stated that
Fulton County could spend double the amount that they get for HAP because of the high price of fuel oil
to heat homes.
b. D&A (BHSI) is asking for additional funds of $56,400, as of projections that staff have predicted how
services will flow until the end of the fiscal year. The staff does a good job of maneuvering the money
around to suit services for individuals and their needs. When Expedited Plus Plus didn’t work the way
that they thought, it had a lot to do with how the local county board of assistances categorizes people
and they are getting pressure from the state to categorize them a certain way, that either makes them
ineligible or eligible but does not allow to quickly do Expedited Plus Plus which would get them quicker
into eligibility to Medicaid. The referral volume from forensics and even Fulton County referrals are way
up for services. If no money is given to D&A from the block grant; the Drug and Alcohol program will
continue to run the way they have been with the money and people will not get longer stays and
manage the best for each individual. The increase of referrals is also because SAP is using D&A program
25
Appendix B – Meeting Minutes and Proof of Publication
Franklin County Block Grant Committee Meeting March 1st, 2013
Franklin County Human Services Building 1:00 PM
as a resource for adolescents that are in need of services.
V. For consideration
a. The intent of the committee is to make recommendations to staff to implement what we think is your
wish. We need to be effective and show the state that we can manage our money. We are doing these
plans based on what the state wants and recommends in the time line they have given us. With that
being said, the state would like to have 2013-2014 draft plan to them by May 1st. Even if both programs
got the money that is requested there would be about $14k left for other things/services. Even if all
requests were met there would still be money remaining for other requests. But with the fiscal year
winding down, it is hard to get programs off the ground before the end of the fiscal year. Another
reminder is that even if committee agrees on it and the board of commissioners signs off on the request
that doesn’t mean it will be approved by the state and/or in a timely manner in order to implement
before the end of the fiscal year if we move more than 20%. We will evaluate where each of the seven
funds stand towards the end of the year. Karen Johnston wanted to speak as a service provider, that it is
extremely hard to get programs up and running and completed by end of the fiscal year as part of this
block grant. There could be a lot of work involved once you start adding on layers of systems you want
to effect.
b. Committee members agreed on to keep 1% for overruns. Claire is giving money back from Intellectual
Disabilities (waiver admin dollars, not service dollars) but that is because there are federal rules and the
program cannot spend it because of the rules. A waiver may have to be granted to make this if it
exceeds 20%.
c. Program requests for additional funding, roughly $14k left. If we bump up additional money for D&A
and HAP or we do not spend the extra money it must go back to the state.
d. Ann suggested creative prevention aligned for next strategic plan so that we know where we are going
for Prevention to meet immediate needs. Karen Johnston agreed.
e. Other ideas for using the extra $14-15k. Claire mentioned a program having an ID housing program
similar to the one that is already done for MH through Jennifer Johnson. If there was an option the
money would be converted to HSDF fund and use to serve people with Intellectual disabilities within the
housing realm. This would be a program and a good way to use this money effectively and have this
program up and running in a timely manner.
f. The committee members agreed to give amount to D&A and HAP, as well as have staff seek out other
ideas/requests to use the $14-15k. The requests will then be brought to the table for the committee to
agreed and accompanied by outcome data. Carrie mentioned HUD housing that has been around for the
last 5-8 years.
VI. Information needed for committee members
a. Any methods that staffs have to get information out to community members and programs.
26
Appendix B – Meeting Minutes and Proof of Publication
Franklin County Block Grant Committee Meeting March 1st, 2013
Franklin County Human Services Building 1:00 PM
b. Anne Larew brought up any funding for Transportation. Transportation may be funded through HSDF,
but this would be a need that we could never meet. Christy brought up that a lot of people don’t use
Transportation because of the shared rider program because other people don’t like the inconvenient of
transporting and dropping off other people. We are the largest county without public transportation.
Rick will bring up in the HS Managers’ meeting for staff to do some research on it.
c. We will not know anything about the 3% that we can roll over until October when the final fiscal reports
have been completed. They will approve the 3% but we will not know what that amount is until
October.
27
Appendix B – Meeting Minutes and Proof of Publication
Franklin County Block Grant Committee Meeting May 22nd, 2013
Franklin County Human Services Building 1:00 PM
1. Welcome and Introductions
2. Feedback on projects approved for 2012/2013
a. Review of D&A 12/13, 13/14, HAP 12/13, 13/14 and Prevention activities part of HSDF. In 12/13 ACT
152 was shifted out. HAP was out of money as of April 2013. HCP will be billed out and another prevention activity
will not quite use all their money. Pyramid’s prevention program was slow to start up and is asking for additional
money for another program. Karen gave updates on activities, Teen Intervene and Alcohol True Stories had a slow
start; HCP is trying to get to all agencies for referrals. 10 groups, with 100 some audience. One ID client for
independent living apartment.
3. Review of human services fiscal year 2012-2013 funding summary. We had a total budget of approximately six
million dollars for 12/13; we will be starting with same amount in fiscal year 13/14. Break out of what was spent for
each program, projected with allocation was shared. Unused federal dollars of ID ($64,338) must be sent back to the
state. HAP requested $32k, but to run the shelter program it costs $230k. $26k for shelter, $6k for rental assistance
was recommended to further their shelter. HAP has to use federal funds that Community Actions get and if they use
for shelter they cannot use it for other programs, they also received federal costs. If we give them additional
money, this allows them to do other services and let money free for shelter. Are the commissioners looking at this
and willing to allow this to happen for HAP. Yes. Commissioners are supportive of SCCAP and leadership and the
services they provide in the community. This money to SCCAP is fully Franklin County. SCCAP is in a unique place
they tried to apply for emergency shelter grant but there were changes, they are not asking for increase for next
year. Jennifer Johnson added that there is an increase in the number of homeless individuals. Jeff Hoose has been a
great help sharing the homeless lifestyle. If the committee decides they want to approve an “up to” amount of an
additional $5,000 for the remaining part of fiscal year 2012-2013. A contract amount can be set for the rest of the
fiscal year for the contract, but an option for amending this contract for additional money until the end of the fiscal
year. A motion to approve $32k and “up to” additional amount of $5,000 if needed per an amendment to the
contract. Karen suggested an additional $5k, and then up to $37k for the contract.
a. Total for 13/14 is $5,983,719, balance projected of $67,280 some programs projected over and others
projected under that is the difference between $67,280 and $111,634 on the chart.
b. Summary of requests for funding for 13/14:
i. D&A program is requesting $55,852 for outpatient and inpatient services but mainly for
outpatient.
ii. CYS will be moving Family Development Credentialing into Family Group Decision Making of
$4,410. The judges have requested this training to be held.
iii. Homeless Assistance Program- rental assistance is $23,000 for fiscal year 2013-2014.
iv. Under HSDF:
1. Teen Intervene Program, Elementary Intervention groups, Pyramid prevention program
through HCP. Elementary Intervention groups have been in 15 of 19 schools, average #
of kids per each group is 8. Once a week, 8-10 times for each group. Adding data from
28
Appendix B – Meeting Minutes and Proof of Publication
Franklin County Block Grant Committee Meeting May 22nd, 2013
Franklin County Human Services Building 1:00 PM
these evidenced based programs. Outcomes data cannot be given because the
programs just started and they are in the community.
2. Pyramid Healthcare is asking to use the money they did not spend and roll over into
next year for a new program. Carrie and Doug stated they checked and they found out
that they did not speak to any judges about this program. We reviewed the proposal
that Pyramid Healthcare gave. Get more clarification on the Pyramid proposal
3. Transportation to human services programming with some limitations on this service.
Funding under HSDF that do not qualify under any other program funds for the county
and they need a source of transportation for running on county hours within Franklin
County. MATP Penn Dot requires they must be an adult or accompanied by an adult.
ID is asking for request for ID clients that work in the evening, night shifts, etc. so that
they can go to work. **This is not included in $10k but this is another idea/request. **
Guidelines for Transportation will be drawn up and sent to committee members to
approval.
4. ID apartment and Life Sharing program, one slot from last year, 16yr old receiving
managed care and have reached their benefit per managed care, and still need living
supports because he would not do well when he was around females, high functioning
ID consumer. We move this money into HSDF and can be used for this individual. This
would continue yearly, this is simply a shift of money from ID into HSDF so that the
money can be more flexible to use for this individual to live. ID apt and life sharing
program will be seen by ID program specialist.
a. Note is any other requests need additional money through the year we as a
committee can re look at these and we could give additional money.
b. Staff will get information to Carrie for the BG plan by May 30th.
c. Feedback from the committee members for ideas of the outcomes versus
outputs.
29
Appendix B – Meeting Minutes and Proof of Publication
DRAFT
Franklin County Block Grant Committee Meeting June 11, 2013
Franklin County Human Services Building 10:00 AM
The Board held a Public Hearing on the Human Services Block Grant for Franklin County Plan and
Process for 2013/2014. Richard Wynn, Human Services Administrator provided a presentation and gave the
Board an update on the block grant process for the past year. He said the final allocation will occur in October
but it all depends on the final State budget. Due to the Block Grant process the County avoided cutting
programs. For the 2012/2013 budget the Committee provided extra funding to homeless services which
helped keep a few homeless shelters open. For the 2013/2014 Mr. Wynn asked staff what would it cost to
maintain services in the new year and requests for additional funding came in at $170,112. The Committee
then reviewed all requests and recommended funding $152,000. The following programs and funding were
recommended: Drug and Alcohol – BHSI for $52,733; Children & Youth – Family Group Decision Making for
$4,410; Homeless Assistance Program – Rental Assistance for $23,000; HSDF – Teen Intervene Program for
$8,000; HSDF – Elementary Intervention Groups for $12,000; HSDF – Transportation Services for $10,000;
HSDF – Intellectual Disabilities Apartment Program for $5,000; and HSDF – Intellectual Disabilities Life
Sharing Program for $37,500. The Committee will next be working on having a subcommittee to work on
outputs and outcomes and what the actual effects of the programs will be. There are committee members that
have experience in this. Commissioner Thomas wanted to mention that the $152,000 that recommended be
shifted is a small percentage of overall budget and that the vast majority of the dollars are staying in the
categories where they started. The Block Grant is letting counties put consumers ahead of the rules which is
the goal of the program. Mr. Wynn mentioned that the deadline is June 15th and the Board needs to approve
the recommended adjustments. Chairman Keller opened the floor for public comments.
Cody Reed asked what is line staff? Mr. Wynn responded line staff are people doing the work directly
with consumers face to face. Mr. Reed said the Mental Health part of Block Grant is nothing added and
nothing subtracted. Mr. Wynn responded that Mental Health projected $57,000 was available and not
projected to spend.
Sheri Morgan, Greencastle said although no reductions in Mental Health there was $57,000 not spent
and was reallocated to someplace else and no reduction in services but no increases in services related to
savings. Mr. Wynn responded that was correct. She said there was a list of committee members but there
were no citizens listed as committee members, were these people forgotten on the slide. There was only one
citizen on the committee, so they need more citizens. She thinks they have an attitude problem that do not
value people. Mr. Wynn responded there were a lot more members not listed on the slide and provided the
following consumer committee members missing: Jeff Hoose, Homeless Advocate; Kim Wertz – Mental Health
Consumer; and Anne Larue – Advocate of Intellectual Disabilities
Kim Wertz responded that she’s not worried about not being on list she is more worried about having
her input recognized. She is fine with recommendations being made. She wanted to make sure programs are
funded at minimum operating standard and not losing staff.
Megan Shreve, from SCCAP spoke about when first realized she was on committee she wasn’t excited
and thought it would be a very stressful process. This group is very amendable and they put all options and
every service provider on table, it was an amazing process and they did amazing work. She said people left
better friends then when started. Commissioner Ziobrowski asked if there was any empathy towards
consumers and Ms. Shreve responded there was a lot of empathy for them and they looked at best interest of
people they serve.
30
Appendix B – Meeting Minutes and Proof of Publication
DRAFT
Franklin County Block Grant Committee Meeting June 11, 2013
Franklin County Human Services Building 10:00 AM
Sheri Morgan said still need more consumers on this committee. Have known people that have stories
of the life sharing program from State and did well with them. If have more consumers on Committee may
hear more about the life sharing program.
Commissioner Thomas asked when it was decided to give $32,000 to the homeless program did it go
through the committee. Mr. Wynn responded yes. Commissioner Thomas said it sounds like process is
working.
Kim Wertz said the reason why they moved money was because shelters were about to close and need
to keep them open so don’t have people using the shelter out on the street.
Cody Reed asked who do consumers talk to about requesting services and how do we get word to the
Board? Mr. Wynn responded about the Act of 66 which created the MH/ID Advisory Board. They are
independent and willing to hear about any request. New clients have to go through the intake case
management system. Mr. Reed can go to any Human Services staff if he has an idea.
Chairman Keller asked the Board if they were ready to move forward. The Board agreed to approve
the recommendations as presented. On a motion by Robert G. Ziobrowski; seconded by Robert L. Thomas;
unanimously approved the recommendation of Human Services Block Grant Planning Committee.
Chairman Keller said based on prior discussions by the Board of Commissioners in executive sessions,
the Board is prepared to consider authorizing a Request For Proposal process for the purpose of identifying
prospective buyers for Franklin County’s Nursing Home. In short, the Board has determined that it is not
necessary for the County to own and operate a skilled nursing facility. If a buyer can be found that shares the
County’s philosophy in terms of quality of care, commitment to Medicaid eligible residents, and commitment to
our employees, then the Board would consider a possible sale of the nursing home. Chairman Keller
introduced Jay Wenger of Susquehanna Group Advisors, Inc., Harrisburg who is here today to present the
information that has led the Board to decide to formally consider moving forward with an RFP to sell the
nursing home. Mr. Wenger recently assisted Adams County in the sale of their nursing home in 2010.
The presentation is the same information that was presented to the Board in executive session. The
information reflects input from the Board about the RFP process and the essential goals that would need to be
achieved before a sale of the nursing home would be authorized.
Mr. Wenger summarized the reasons why it is no longer necessary for the County to own and operate a
skilled nursing facility. In particular, counties are not obligated to operate a skilled nursing facility, the County
does not compete with the private sector in any other business or service, it is likely that a private owner can
be found that will provide the same or better quality of care in conjunction with existing staff at the nursing
home, and the county’s residents are well served by numerous privately owned facilities. Mr. Wenger also
noted that the nursing home is a financial liability to the County, and that selling the home would limit taxpayer
obligation and eliminate healthcare industry related liabilities.
Mr. Wenger also noted that 31 Pennsylvania counties do not own and operate a skilled nursing facility.
In recent years, Adams, Cambria, Carbon, Dauphin, Lancaster, Mercer, and Northumberland Counties have
sold their skilled nursing facilities. Several other counties are evaluating the merits of selling in this market of
higher prices for skilled nursing facilities and difficult cash flow. Mr. Wenger stressed that the buyer will not
dump the residents and there will be great opportunities for advancement of employees. The buyer will not get
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Appendix B – Meeting Minutes and Proof of Publication
DRAFT
Franklin County Block Grant Committee Meeting June 11, 2013
Franklin County Human Services Building 10:00 AM
rid of employees and he expects little turnover but some employees may choose to move on. Mr. Wenger said
there is an active market to acquire nursing centers. He has a list of quality buyers that have already
expressed interest, these include profit and nonprofit entities. The County is not obligated to sell to the highest
bidder, the Board will also consider reputation, quality of care and price when making a decision. Chairman
Keller asked Mr. Wenger about the timeline of the RFP process and Mr. Wenger responded that will take five
to six months from start to finish.
Chairman Keller read the following statement: “At the outset, I think it’s important to say that the
county’s employees have done an admirable job of running the nursing home. They have distinguished
themselves – particularly in recent years – by providing a high level of care, and that level of care has been
shown in surveys by the Dept. of Health and in direct feedback from county residents. Having said that, I
agree with the reasons that have been covered by Mr. Wenger as to why it is no longer necessary for the
county to own and operate a skilled nursing facility. In particular, counties are not obligated to operate a skilled
nursing facility, the county does not compete with the private sector in any other business or service, it is likely
that a private owner can be found that will provide the same or better quality of care in conjunction with existing
staff at the nursing home, and the county’s residents are well served by numerous privately owned facilities.
In this context, given that the nursing home is a financial liability, and carries with it other liabilities
unique to the healthcare industry, we would be remiss if we did not consider the option of selling. But, I want to
make it clear that I would only support a decision to sell as the result of an open and transparent process that
ensures that the new owner has a proven track record of sharing Franklin County’s philosophy in terms of our
commitment to the quality of care for our residents, our commitment to Medicaid eligible residents in particular,
and our commitment to our employees. “
Commissioner Ziobrowski read the following statement: “My first reaction to the idea of selling the
nursing home was negative. I have strong feelings about the nursing home - it was my paternal grandparents
last home 40 years ago. And historically, care of the indigent has been a county responsibility. However, as a
commissioner I must put aside my personal feelings and consider how the nursing home fits into the core
functions of county government. What I have seen so far is that there is reason to believe that whether the
county owns the nursing home or not, the facility will continue to operate, the residents will have good care,
and the employees an opportunity to continue their noble vocation. If so, the decision to retain the nursing
home becomes a business decision, and whether it is the role of government to compete with the private
sector.
Thirty years ago the county had less than 400 employees. Now it has over 900. We've grown partly because of
population growth, but mostly because of new responsibilities, many of which were mandated. For example, in
1989 the 911 system was added – we now have roughly 40 people in that department alone.
Since my grandparents were in the nursing home we've added drug and alcohol, children and youth services,
aging services. We organized into departments: information services, human resources, fiscal, risk
management, purchasing.
Government is the only option for many functions, and we do a darn good job. The courts, the jail, 911,
elections - we wouldn't think of privatizing these duties. But government can't continue to grow as duties are
added. Government must be dynamic, and the changes have to include discontinuing functions that are not the
core responsibility of the county.
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Appendix B – Meeting Minutes and Proof of Publication
DRAFT
Franklin County Block Grant Committee Meeting June 11, 2013
Franklin County Human Services Building 10:00 AM
So I welcome this discussion. The way I look at it, the question is not whether Franklin County should sell the
nursing home. What I'll be trying to ascertain is whether nursing homes are part of the core functions of county
government, and if not, whether it makes sense for the county to be in the nursing home business. To
summarize: 1: government is dynamic, constantly changing. And those changes can't involve only taking on
new responsibilities- it is our job as commissioners is to right size government to fulfill our core responsibilities;
2: Nursing homes are highly regulated, and care is almost exclusively paid for by the federal and state
government. Whether the county should be in the nursing home business is a question we need answer; 3:
(And this trumps all others) Before I will consider supporting the sale of the nursing home, I need to be
convinced that the residents will be well cared for and the employees treated fairly.”
Commissioner Thomas read the following statement: “Counties have been given the sole responsibility
of providing certain core services and infrastructure. The only 911 center, the only Judicial Center, official
keeper of land and marriage records, the only Jail, inspection and maintenance of bridges, the list is long.
Nursing Homes, providing care for the indigent and elderly, was once a core function and duty of County
government. At one time, the county was a sole provider. However, changes in the federal payment system
has caused the county to become not just a provider, but also a competitor.
That said, I believe it is our responsibility to look close at a potential sale. But I would not nor will I
agree to a potential buyer that does not concur with our present policies and responsibilities for Medical
Assistance support and endurance of quality care for the residents and commitment to employees.”
Chairman Keller said he is very much in favor of proceeding with the RFP process, given the nature of
a decision to do so, he thinks it would be prudent for the Board to defer a final decision until such time as the
public has had an opportunity to comment on the proposed course of action. He recommends that the Board
invite the public to comment here today following any further comments by the Board. In addition, the public
would be invited to comment at regularly scheduled meetings on Thursday, June 13, Tuesday, June 18 in the
evening, and Thursday, June 20. Based on that proposed schedule for public comment, Chairman Keller
would be comfortable scheduling a final decision on Thursday, June 20, at the Board’s regularly scheduled
meeting, as to whether to proceed with the RFP process.
Commissioner Ziobrowski said if at any point in the game that he doesn’t feel comfortable even after
receiving proposals then no final decision will be made. He said maybe the public will tell the Board some
thing’s that they haven’t thought about. Commissioner Thomas said he will have some conflicts with the
schedule but will follow the process along closely. Chairman Keller opened the floor for comments.
Ken Jones said he agrees that governments shouldn’t be providing these services but his mother spent
last 6 years of her life in a nursing facility. He noticed in private facilities staffing is normally 50-60%. With
county facilities staffing is probably better than that. He sees this as the only drawback versus a private facility
and county facility.
Sheri Morgan said she is versed in Affordable Care Act and it is biased in nursing home care. The
private entities would not purchase nursing homes if not profitable. She agrees that need to have conversation
if this is a core function of the county. The disability community is up in arms because ACA has cut a lot of
programs. Would be great to have this conversation but need to keep in mind, there is a reason they have
potential buyers lined up and it’s not because it’s a money loser.
33
Appendix B – Meeting Minutes and Proof of Publication
DRAFT
Franklin County Block Grant Committee Meeting June 11, 2013
Franklin County Human Services Building 10:00 AM
The meeting was adjourned at 11:38 a.m. with a motion by Robert G. Ziobrowski; seconded by Robert L.
Thomas.
John A. Hart
Chief Clerk/County Administrator
FRANKLIN COUNTY COMMISSIONERS
____________________________________
David S. Keller, Chairman
_____________________________________
Robert L. Thomas
_____________________________________
Robert G. Ziobrowski
34
Appendix B – Meeting Minutes and Proof of Publication
35
Appendix B – Meeting Minutes and Proof of Publication
36
APPENDIX C: HUMAN SERVICES BLOCK GRANT PROPOSED BUDGET AND SERVICE RECIPIENTS
County:
HSBG HSBG PLANNED NON-BLOCK OTHER
ESTIMATED ALLOCATION EXPENDITURES GRANT COUNTY PLANNED
CLIENTS
(STATE AND
FEDERAL)
(STATE AND
FEDERAL) EXPENDITURES MATCH EXPENDITURES
MENTAL HEALTH SERVICES
ACT and CTT
Administrator's Office 757,451 20,201
Administrative Management 597 481,617 13,117
Adult Developmental Training
Children's Evidence Based Practices
Children's Psychosocial Rehab
Community Employment 45 243,774 6,774
Community Residential Services 25 804,221 21,721
Community Services 286 319,801 8,801
Consumer Driven Services
Crisis Intervention 1,500 255,075 7,075
Emergency Services 275 46,233 1,233
Facility Based Vocational Rehab 25 38,528 1,028
Family Based Services 5 25,171 671
Family Support Services 7 10,788 288
Housing Support 39 159,247 4,247
Other
Outpatient 75 311,816 8,316
Partial Hospitalization
Peer Support 35 51,370 1,370
Psychiatric Inpatient Hospitalization 4 66,781 1,781
Psychiatric Rehabilitation 25 93,493 2,493
Social Rehab Services 200 270,206 7,206
Targeted Case Management 225 434,338 11,583
Transitional and Community
Integration 100 87,329 2,329
TOTAL MH SERVICES 3,468 4,448,942 4,457,239 0 120,234 0
37
APPENDIX C: HUMAN SERVICES BLOCK GRANT PROPOSED BUDGET AND SERVICE RECIPIENTS
County:
HSBG HSBG PLANNED NON-BLOCK OTHER
ESTIMATED ALLOCATION EXPENDITURES GRANT COUNTY PLANNED
CLIENTS
(STATE AND
FEDERAL)
(STATE AND
FEDERAL) EXPENDITURES MATCH EXPENDITURES
INTELLECTUAL DISABILITIES
SERVICES
Admin Office 468,425 12,493
Case Management 55 32,032 854
Community Residential Services 6 122,309 3,262
Community Based Services 73 267,566 7,136
Other 171 60,205 1,606
TOTAL ID SERVICES 305 975,186 950,537 0 25,351 0
HOMELESS ASSISTANCE
SERVICES
Bridge Housing
Case Management 280 45,876 1,223
Rental Assistance 275 75,358 2,010
Emergency Shelter 43 15,411 411
Other Housing Supports
TOTAL HAP SERVICES 598 113,658 136,645 0 3,644 0
CHILDREN & YOUTH SERVICES
Evidence Based Services 35 61,068 1,629
Promising Practice
Alternatives to Truancy
Housing
TOTAL C & Y SERVICES 35 59,439 61,068 0 1,629 0
38
APPENDIX C: HUMAN SERVICES BLOCK GRANT PROPOSED BUDGET AND SERVICE RECIPIENTS
County:
HSBG HSBG PLANNED NON-BLOCK OTHER
ESTIMATED ALLOCATION EXPENDITURES GRANT COUNTY PLANNED
CLIENTS
(STATE AND
FEDERAL)
(STATE AND
FEDERAL) EXPENDITURES MATCH EXPENDITURES
DRUG AND ALCOHOL SERVICES
Inpatient non hospital 52 165,750 4,420
Inpatient Hospital
Partial Hospitalization
Outpatient/IOP 373 155,493 4,147
Medication Assisted Therapy
Recovery Support Services
Prevention
TOTAL DRUG AND ALCOHOL
SERVICES 425 290,526 321,243 0 8,567 0
HUMAN SERVICES AND SUPPORTS
Adult Services
Aging Services
Generic Services 3,517 89,830 2,396
Specialized Services 221 64,213 1,713
Interagency Coordination 394 15,761 420
TOTAL HUMAN SERVICES AND
SUPPORTS 4,132 95,968 169,804 0 4,529 0
COUNTY BLOCK GRANT
ADMINISTRATION 0
51,137 0
GRAND TOTAL 8,963 5,983,719 6,147,673 0 163,954 0
39
Appendix D
Block Grant Planning Committee
Jennifer Johnson (Mental Health Housing Specialist)
Megan Shreve (South Central Community Action Programs)
Jeff Hoose (Advocate)
Amanda Black (LINK)
Traci Kline (Aging)
Sheldon Schwartz (Mental Health/Intellectual Disabilities)
Kim Wertz (Advocate)
Anne Lerew (Advocate)
Manny Diaz (Drug and Alcohol)
Karen Johnston (Prevention Provider)
Doug Amsley (Children and Youth Services)
Jean Snyder (Fulton County)
Amy Hicks (United Way)
Ann Spottswood (Summit Health)
Staff Members
Carrie Gray* (Assistant County Administrator)
Rick Wynn* (Human Services Administrator, Drug and Alcohol Director, Mental Health/Intellectual
Disabilities/Early Intervention Director)
Stacy Rowe* (Fiscal)
Christy Briggs* (Fiscal)
Jennifer Lipko* (Human Services)
Cori Seilhamer (Mental Health)
Lori Young (Intellectual Disabilities)
Elizabeth Grant* (Grants)
*denotes Leadership Team Members
40
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Safeguards /Restraint Reduction
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
Participants are
safe and secure
in their homes
and
communities.
People are safe and
restraint free.
Due to the low number of
restraints, Franklin/ Fulton
County Risk Management Team
monitor the number of restraint
incidents and take action
immediately as warranted.
Baseline: Calendar Year 2012-
13
Restraint Incidents = 1
# of individuals = 1
(9 months of data)
Performance Measure:
# of Restraint Incidents
Data Sources:
HCSIS Incident Data
Frequency:
Quarterly
Responsible Party:
F/F Incident Manager
F/F Risk Management Team
F/F ID QI Council
F/F MH-ID
41
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-2015
Focus Area: Provider Capacity and Capabilities/Lifesharing
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
Sufficient HCBS
providers options
are available in
which individuals
live and share
life experiences
with supportive
persons who
form a caring
household.
People live where
they choose.
Maintain 12-31-2011 baseline
level number (n = 32) of people
residing in Life Sharing.
Baseline: 32 people in
Lifesharing in year 2012-13 (9
months of data).
Performance Measure:
# of individuals enrolled in Lifesharing
settings
Data Sources:
Franklin/Fulton ID Lifesharing Tracking Form
Frequency:
Quarterly
Responsible Party:
SC Organization.
F/F MH-ID
42
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Provider Capacity and Capabilities/Lifesharing
Desired Outcome: People live where they choose.
Target Objective: Maintain 7-31-2013 baseline level number (n = 32) of people residing in Life Sharing.
Performance Measure(s): # of new individuals enrolled in Lifesharing settings
Data Source(s): Franklin/Fulton ID Lifesharing Tracking Form
Responsible Person: SC Organization. and F/F MH-ID
Action Item Responsible
Person
Target
Date Status Completion
Date
1. Identify people that have the potential or interest
in residing in Lifesharing. SC Organization. ongoing
2.
Participate in the Central Region Steering
Committee on Lifesharing and actively participate
in the Strategic Planning.
County Lifesharing
Point Person 7/31/2015
3.
Community Awareness and Education to attract
potential Lifesharing homes and individuals
interested in lifesharing.
Providers and F/F
MH-ID 7/31/2015
4. Quarterly data collection to track # of individuals
participating in Lifesharing options
County Lifesharing
Point Person Quarterly/ongoing
5. Quarterly report and tracking of progress Quality Management
Program Specialist Quarterly/ongoing
43
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-2015
Focus Area: Participant Access /Employment
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
Individuals work
in the
community.
People who choose
to work are
employed in the
community.
Increase the # of individuals in
employment by 10% (n = 67) by
7/31/2015.
Baseline: 61 individuals
employed in 2013 (9 months of
data).
Performance Measure:
# of individuals who are employed
Data Sources:
Franklin/Fulton ID and Provider Employment
Tracking Form, ISPs, Employment
Tool
from ODP
Frequency:
Quarterly
Responsible Party:
SC Organization.
F/F MH-ID
Transition Employment Council
ID Providers
44
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Access/Employment
Desired Outcome: People who choose to work are employed in the community.
Target Objective: Increase the # of individuals in employment by 10% (n = 67) by 7/31/2015.
Performance Measure(s): # of individuals who are employed
Data Source(s): Franklin/Fulton ID and Provider Employment Tracking Form, ISPs, Employment Tool from ODP
Responsible Person: SC Organization., F/F MH-ID, Transition Employment Council, ID Provider
Action Item Responsible
Person
Target
Date Status Completion
Date
1.
Provide funding to Transition to Adult Life
Success Program for people ages 14- 21. The
goal of this program is to prepare students for
adult life, encourage, and seek competitive
employment.
F/F MH/ ID
ID Employment Point
Person, Providers
07/01/2013 and
07/01/2014
2.
SCs complete the employment tool to identify
who wants to work and what they would like to
do. Providers meet with employers to determine
jobs that are available in the community.
Transition/Employment
Council, F/F MH-ID,
& SC Organization.
ongoing
3. Coordinate annual Transition/Employment Expo-
for students transitioning from school
Transition/
Employment
Council, F/F MH-ID
07/31/2012
4. Quarterly data collection to track # of individuals
employed in the community.
Providers and F/F MH-
ID Employment Point
Person
Quarterly/ongoing
5. Quarterly report and tracking of progress Quality Management
Program Specialist Quarterly/ongoing
45
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: System Performance/PUNS
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
Franklin/Fulton
MH-ID
performance is
continuously
measured,
evaluated, and
improved.
Franklin/Fulton MH-
ID consistently and
appropriately utilizes
the PUNS to identify
services and
supports needed.
Increase the # of PUNS reviewed
within the expected timeframe of
365 days to 100% by
07/31/2015.
Baseline: % of individuals with
Puns updated in 365 days =
98.5% (9 months of data)
Performance Measure:
Total # of PUNS completed within the
expected timeframe of 365 days
Denominator: Total # of active PUNS
Data Sources:
HCSIS, DocuShare
Frequency:
Quarterly
Responsible Party:
SC Organization.
F/F MH-ID
Quarterly Administrative Entity Oversight
Monitoring Point person
46
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity
Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: System Performance/PUNS
Desired Outcome: Franklin/Fulton MH-ID consistently and appropriately utilizes the PUNS to identify services and
supports needed.
Target Objective: Increase the # of PUNS reviewed within the expected timeframe of 365 days to 100% by the
end of the calendar year.
Performance
Measure(s):
Total # of PUNS completed within the expected timeframe of 365 days, Numerator:
Denominator: Total # of active PUNS
Data Source(s): HCSIS, AE Oversight Monitoring Data, DocuShare
Responsible Person: SC Organization., F/F MH-ID, Quarterly Administrative Entity Oversight Monitoring Point person
Action Item Responsible
Person
Target
Date Status Completion
Date
1. Utilize the PUNS review process established by
the AE. AEOM Point Person Ongoing
2. SC Supervisors will review PUNS completion
during the annual ISP review. SC Organization Ongoing
3. Review of the ODP monthly PUNS report/ Sent
to SC Organization by QM Program Specialist
AEOM Point Person
&
SC Organization
Monthly/ongoing
4. Review and completion of Active PUNS list
report
QM Program
Specialist Quarterly/ongoing
5. Quarterly report and tracking of progress
AEQM Point Person
&
Quality Management
Council
Quarterly/ongoing
47
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant-Centered Service Planning and Delivery/Communication
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
Services and
supports are
planned and
effectively
implemented in
accordance with
each
participant’s
unique needs,
expressed
preferences and
decisions
concerning
his/her life in the
community.
People are
supported to
communicate.
Increase the number of people
who do not communicate through
speech to have an effective
means of communicating their
needs, choices, wishes, etc by 9
people by June 30, 2015.
Baseline: It is an increase of 9
people in 2 years time period;
therefore no baseline is needed.
Performance Measure:
9 people will be chosen by July 1, 2013
and then number of people of these 9 who
have an effective means of communication
on July 31, 2015 will be the performance
measure.
Data Sources:
F/F MH-ID ISPs, assessments, IM4Q
surveys
Frequency:
Quarterly
Responsible Party:
Supports Coordination Organization
F/F MH-ID
IM4Q Coordinator
48
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity
Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant-Centered Service Planning and Delivery /Communication
Desired Outcome: People are supported to communicate.
Target Objective: Increase the number of people who do not communicate through speech to have an effective
means of communicating their needs, choices, wishes, etc by 9 people by June 30, 2015.
Performance
Measure(s):
9 people will be chosen by July 1, 2013 and then number of people of these 9 who have an
effective means of communication on July 31, 2015 will be the performance measure.
Data Source(s): F/F MH-ID ISPs, assessments, IM4Q surveys
Responsible Person: Supports Coordination Organization, F/F MH-ID, IM4Q Coordinator
Action Item Responsible
Person
Target
Date Status Completion
Date
1. Each SC will choose one person who does not
use words to communicate and report to the AE.
SC Organization,
Individual, and ISP
team
July 1, 2013
2.
SC will consult ISP team to develop a
communication goal to develop an effective
means of communication.
SC Organization,
Individual, and ISP
team
December 31,
2013
3.
The AE will approve and authorize ISPs that
require speech and language assessments be
done.
F/F MH- ID Ongoing
4.
In formation on training opportunities will be
provided by the AE to SCO , Providers,
Individuals, and families.
F/F MH-ID July 31, 2015
5. The AE will train SCs on the definition of
“effective means of communication”. F/F MH-ID September 30,
2013
6. Quarterly report and tracking of progress F/F MH-ID & Quality
Management Council Quarterly/ongoing
49
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Rights and Responsibilities/Individual to Individual Abuse(I-2-I)
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
People are safe
in their homes
and their
community.
People are abuse
free.
Reduce the # of I-2-I abuse
incidents by 10% by June 30,
2015 (n= 29).
Baseline: Fiscal Year 2012-2013
I-2-I abuse = 32 (9 months of
data)
Performance Measure:
# of incidents of I-2-I abuse
Data Sources:
HCSIS Incident Data
Frequency:
Quarterly
Responsible Party:
F/F Incident Manager
F/F Risk management Team
F/F MH-ID
ID Providers
50
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity
Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Rights and Responsibilities/I-2-I Abuse
Desired Outcome: People are abuse free.
Target Objective: Reduce the # of I-2-I abuse incidents by 10% by June 30, 2015 (n= 29).
Performance
Measure(s): # of incidents of I-2-I abuse
Data Source(s): HCSIS Incident Data
Responsible Person: F/F Incident Manager, F/F Risk Management Team, SCO, F/F MH-ID, & ID Providers
Action Item Responsible
Person
Target
Date Status Completion
Date
1. Identification of individuals identified as the
target in I-2-Iabuse incidents. Incident Manager Quarterly
2. Look at target trends that may prevent future
occurrences at a broad and/or individual level.
Risk Management
Team Quarterly/ongoing
3.
Offer providers tools to track Individual to
Individual Abuse Trends such as the OPTIMA
form
F/F MH- ID As available/
Ongoing
4.
AE review of incidents to ensure roommate
matches are suitable and offer optional living
arrangements as they become available
F/F MH-ID As
needed/ongoing
5. Quarterly data collection to track # of I-2-I abuse
incidents. Incident Manager Quarterly/ongoing
6. Quarterly report and tracking of progress Quality Management
Council Quarterly/ongoing
51
Appendix E ID Quality Management Action Plan
Administrative Entity Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Rights and Responsibilities/Voting
Goal Outcome Target Objective Performance Measures/Data Source(s)/
Frequency/Responsible Person
People exercise
their rights.
People who want to
vote are supported to
vote.
100% of people registered to
vote have the proper
Identification Card to vote.
Baseline: There are 134 people
registered vote. Eleven people
need an ID card to vote. Forty
people have an ID card but it is
not known whether it is valid for
voting. The remaining 83 people
have a state issued photo ID that
will enable them to vote. (9
months of data)
Performance Measure:
Numerator: Number of Voters with ID
Denominator: Total number of people
registered to vote.
Data Sources:
F/F MH-ID voter declination forms, ISPs
Frequency:
Quarterly
Responsible Party:
F/F MH-ID
SC Organization
52
Appendix E ID Quality Management Action Plan
Action Plan
Administrative Entity
Name: Franklin/Fulton MH-ID Developmental Disabilities Program Year: 2013-
2015
Focus Area: Participant Rights and Responsibilities/Voting
Desired Outcome: People who want to vote are supported to vote.
Target Objective: 100% of people registered to vote have the proper Identification Card to vote.
Performance
Measure(s):
Numerator: Number of Voters with ID
Denominator: Total number of people registered to vote.
Data Source(s): F/F MH-ID voter declination forms, ISPs
Responsible Person: F/F MH-ID, SC Organization
Action Item Responsible
Person
Target
Date Status Completion
Date
1. Determine baseline data of those already
registered to vote.
QM Program
Specialist
06/320/2013
2. SC Organization will offer the voter registration
declination form at every ISP annually. SC Organization Ongoing
3. Identification card information will be included in
the ISP. SC Organization As needed/
Ongoing
4. QM Program Specialist will cross reference the
registered voter list with the ISP.
QM Program
Specialist
Ongoing
5.
QM Program Specialist will send free voter
Identification information to each person without
an ID.
QM Program
Specialist Ongoing