MENTAL HEALTH/DEVELOPMENTAL DISABILITIES DIRECTOR ELAINE SWEET: MENTAL HEALTH/DEVELOPMENTAL DISABILITIES SERVICES REORGANIZATION; and APPOINTMENT OF PAT HARTIN TO THE MENTAL HEALTH/DEVELOPMENTAL DISABILITIES PLANNING COUNCIL
Stutsman: Item 6 has been taken off the agenda, so we will move on to Item 7. This is from Elaine Sweet, Director of Mental Health Developmental Disabilities Service. Subsection A concerns the reorganization of that department. Good morning, Elaine.
MH/DD Director Elaine Sweet: Good morning.
Stutsman: We also have Lora Shramek, Human Resources Director, with us too. Whenever you’re ready, Elaine, if you want to go ahead and explain to the Board what your Reorganization Plan is about.
Sweet: Over the last couple of months I’ve visited briefly with you on a number of occasions about the potential of reorganizing the management structure of the MH/DD Services Department. Today I bring you 3 proposed job descriptions in draft form, as to what that new management structure might look like. The job descriptions I’d like to discuss this morning are first, a Clinical Supervisor position, which would blend the 2 current management positions, the Social Worker III positions, a Case Management Supervisor and Social Work Supervisor. It would blend that clinical supervision into one position. The 2nd is a new position, which is a Financial and Statistical Supervisor. That position would be responsible for the budgeting, financial and statistical quality assurance, financial reporting, those kinds of things. In the past, there was a position that’s been open for about a year which was called the Management Analyst position. I would propose not filling that position, but instead going for the Financial and Statistical Supervisor, which is the new job description I bring you this morning. The last job description, again, is a new position, and that would be the Administrative Assistant position. This is a confidential position. It would act as an Administrative Assistant and Confidential Secretary, assuming responsibility for staffing, Planning Council, and the 5 Planning Council committees, and also responsibility for personnel administration, payroll, time and attendance systems, those kinds of things. Would you like to take a few minutes to read through, skim through the job descriptions as they’re proposed?
Stutsman: Does the Board want to take the time to do that?
Jordahl: Perhaps you could kind of skim for us.
Sweet: Sure. Starting with the Clinical Supervisor, this position would coordinate all aspects of the Case Management Program and the Social Work Services. It would oversee the Title 19 Targeted Case Management Program, insuring compliance with Federal and State guidelines, and would be responsible for hiring, training and supervising staff, quality assurance, and for consumer and systems advocacy. The standards, the minimum education, training, and experience are the minimum that are required by the State Accrediting Agencies for the Title 19 Case Management Program. The specific duties would be to plan and implement the goals of the targeted Case Management Program in Johnson County, to assist in planning, implementing, and measuring progress to departmental and system goals and objectives. Policy and procedure administration, making recommendations for Case Management and social work standards and practices for operating policies. Managing the Clinical Continuous Quality Improvement Program. Here I am distinguishing between the Clinical Quality Improvement and the Financial and Statistical Quality Improvement. The Financial and Statistical would be the responsibility of that supervisor. Working with the MH/DD services budget as it relates to services and the casework, assisting case workers and the clinical portion of their job. Actually providing backup coverage in the absence of a case worker. Serving as a resource and a consultant in the clinical areas, and maintaining a Clinical Records Management Program. Also preparing reports and maintaining a database for the clinical portion of the MH/DD Services. Participating in committees as requested, and also participating in professional development opportunities and maintaining professional affiliations.
Stutsman: Does the Board have any questions about this job description? You talk about case workers and not social workers.
Sweet: Case managers and social workers. I’m combining each of the terms, case workers, for the purpose of this rather than distinguishing the 2. They both do case work.
Stutsman: All right. This would be both units then, case managers and social workers.
Duffy: Maybe I missed this, but dollar wise, what are we thinking?
Sweet: This would combine 2 clinical managers into one position, and in lieu of the other clinical management position, I’m proposing the Administrative Assistant to do a lot of the clerical function and personnel administration. The net impact on MH/DD Services annual budget would approximately $10,000 less annually with this structure.
Duffy: Great.
Jordahl: You’ve got Charlie’s attention.
Duffy: I kind of thought that’s the way it was when you said you’d combine the 2.
Stutsman: What pay range would these different ones be?
Sweet: These are all exempt positions, the 2 being management and supervisory positions, and the one being a confidential position. The Clinical Supervisor and the Financial and Statistical Supervisor would be in range 20, and the Administrative Assistant would be range 17.
Stutsman: Elaine, can you talk a little bit about why you feel this type of reorganization will work for this department. I’m thinking especially with the Clinical Supervisor. It seems like that’s one person to supervise a lot of individuals
Sweet: That person will have a full plate. That’s for sure. In the past, the supervisors have done a lot of the clerical work themselves. They’ve done a lot their own word processing, they’ve maintained a lot of their own filing, they processed their own personnel and payroll records. With some of the change that’s occurring in the department, I think it’s prudent at this point in time to go with the one supervisor. One of the reasons being that I feel it’s very important for all of the case workers to report to one individual, and for there to be consistency in the administration and the communication of personnel policy. When there are 2 clinical supervisors, basically for the same class, the same kind of work, both the personnel policies and procedures. But actually the service provision, the interpretation of policies and procedures as they relate to clients’ eligibility to the services that are provided, the service settings are judgmental in many ways. I feel it’s very important for the case workers to have one person as a resource for that and consistency in the way those policies and procedures for both service provision eligibility and personnel administration are consistently interpreted and administered.
Jordahl: Will there be a sort of a change in the character of that administration. As we discussed file review at the last Planning Council meeting, where the financial person, what’s the title again…?
Sweet: Financial and Statistical Supervisor.
Jordahl: Financial and Statistical Supervisor would have some sort of records keeping? We were talking recently, I think you were here, about the Decategorization, how they have performance measures and, I wonder what all that’s called. Would there be a way in which this Financial Supervisor is supervising people concerns their reporting and records keeping?
Sweet: The proposal, the Financial and Statistical Supervisor would be responsible for and supervise the support the support staff. The Clinical Supervisor would supervise all of the case workers. If you look at the specific duties, though, for both of those job descriptions, for the Clinical Supervisor, one of the specific duties is to manage the Clinical Continuous Quality Improvement Program. One of the specific duties of the Financial and Statistical Supervisor is to manage the Administrative Continuous Quality Improvement Program. The Clinical Supervisor, one of the specific duties is to maintain an effective Clinical Records Management Program to insure compliance with regulatory requirements and departmental policy and to facilitate timely retrieval of data. For the Financial and Statistical Supervisor, the specific duty is to maintain an effective Records Retention Program to insure compliance with regulatory requirements and to facilitate timely retrieval of records, reports and files. They would both be responsible for that Records Management Program. For the Clinical Supervisor, it would be related to the clinical portion, for the Financial and Statistical, it would be related more to the State’s requirements, or our database, the Financial Eligibility Criteria, and those kinds of things. We’re actually splitting the clinical part versus the financial, administrative, statistical part.
Jordahl: But as you go to develop clinical eligibility criteria, there’s an obvious overlap between the 2. I’m wondering how that will be coordinated.
Sweet: When it comes to developing clinical eligibility criteria, that will be done in committees, Planning Council, and incorporated into our managed care plan, which will be Board approval, not developed within the departments. That way they’ll be in from workers in the department. That’s more of an administrative system function than a departmental function.
Stutsman: Are there any more questions about the Clinical Supervisor job description? Any other things that need to be clarified?
Jordahl: I think it’s a good thing that you’re doing. I think the idea of the consistency in administration oversight and the development of financial reporting that will allow us to do some prediction of where we’re going to be at is very, very important in a frozen budget.
Sweet: That is specific in the Financial and Statistical Supervisors position. We talk about a Fiscal Encumbrance Program to accurately project annual expenditures and cash flow requirements, and also fund balance projections, both short and long term.
Thompson: In the minimum education, you mention a license to practice as a registered nurse. What about the social worker license that they have now?
Stutsman: Carol, which one are you…oh, OK. You’re doing the Clinical Supervisor one. All right.
Sweet: That’s verbatim from Chapter 24, rules and regulations for our Case Management Supervisor.
Stutsman: Are we ready to move on and talk about the Financial and Statistical Supervisor?
Sweet: The Financial and Statistical Supervisor concentrates on the business portion of what we do as MH/DD Services. As I mentioned earlier, it is a supervisory position, and the support staff would be reporting to this individual. The specific duties include managing the routine accounting and statistic information processing and reporting, assisting in planning, implementing, and measuring progress toward departmental and system goals and objectives, communicating and implementing policies and procures relative to financial and statistical reporting. Again, managing the administered of the Continuous Quality Improvement Program. Assisting and developing the Managed Care Plan for MH/DD Services. Assigning general ledger account numbers and grouping accounts within supporting journals for financial reporting, and also being sure that supporting documentation is accurate and complete. Also, organizing and managing the COMA’s generated reports that are required by the State. It talks about insuring timely and accurate interim financial statements for Finance Committee and Planning Council. Reconciling account balances with the Auditor’s Office. Determining consistency of reporting and identifying any variances from the norm. Keeping abreast of new and existing legislation to insure that the financial and statistical statements meet federal and state mandates. Maintaining the Fiscal Encumbrance Program to project annual expenditures, and also the fund balance projections. Supervising the preparation of year-end audit worksheets and audit reports and coordinating those with the Johnson County Auditor’s Office. Establishing financial and accounting guidelines. Collaborating with the preparation analysis and presentation of financial reports to those appropriate audiences. Again, acting as a resource and consultant for issues related to the areas of responsibility, just as a Clinical Supervisor does for the clinical part, this person would for the Financial and Statistical. Also assisting in preparing the budget and reviewing the budget on a monthly basis for significant variances. Again, serving on committees and agencies and participating in professional development.
Jordahl: Sounds great.
Stutsman: Yes. Any other questions, comments?
Jordahl: Can we have one of these in every department?
Stutsman: Yes, no kidding. Let’s move on to the Administrative Assistant then.
Sweet: The Administrative Assistant then will provide the staff support for the 2 supervisors (inaudible) so we can do all these things. Under general supervision then, the Administrative Assistant would provide secretarial support, maintaining confidential materials related to MH/DD Services, assisting in administering personnel policies and procedures, and also the time and attendance and payroll system. The specific job duties are to provide staff support for the Planning Council and 5 committees, maintain the membership lists, the attendance records, preparing agendas, mailings, the supporting records, drafting minutes for committee approval, transcribing the minutes from tape recordings, establishing and maintaining filing systems, and providing organization for the office, maintaining the calendar of committee, department and director activities, reserving and preparing meeting rooms, participating in preparing the Managed Care Plan, the MH/DD Service budget and the annual report, handling correspondence for the supervisors and myself, performing general clerical duties, photocopying, completing internal forms, receiving mail, preparing and delivering the outgoing mail, answering the telephone, taking messages, referring questions appropriately, assisting with the time and attendance policy, running reports from the time clock, producing the biweekly time sheets, the weekly sign-outs sheets and reconciling leave slips in all of those documents. Entering the data and payroll information into spreadsheets and generating reports for Administrative Analysis, maintaining personnel files, assisting in preparing performance evaluations and disciplinary actions. Participating in the MH/DD Services, Agency Provider and Statewide Committee meetings and recording the minutes as necessary. Ordering and maintaining the inventory of office supplies, and again, participating in professional development as appropriate.
Stutsman: That answers the telephone, take messages, how does that fit with the receptionist at DHS?
Sweet: The receptionist at DHS screens the calls, and anything for our unit passes them on, generally. The temporary that’s been in this position takes a lot of telephone calls from staff calling into report that their staffing are taking longer when they call in ill or call requesting vacations and those kinds of things, all those calls have been going to the Administrative Assistant.
Stutsman: I just wanted to make sure that this wasn’t going to end up to be a receptionist job at the front desk.
Sweet: There’s a lot of telephone responsibility, too, associated with the committees, that people are going to be absent from committee meetings and Planning Council. Most of those calls go to this individual as well, and just general questions as to when is the committee meeting, or can you put something on the agenda, those kinds of things.
Jordahl: Is this addressing also the current records keeping concerns? It says maintains databases and files, or is this files within the central office only?
Sweet: This would be more related to personnel files and administrative files than to actual consumer files. The case files themselves would be the primary responsibility of the Clinical Supervisor, particularly when it comes to the things related to clinical practice. The Financial and Statistical Supervisor would have a part of that for things like financial eligibility criteria, the more business related and statistical part of that, but for the most part, the case file itself would be the responsibility of the Clinical Supervisor
Jordahl: As I understand, the reason this is an exempt position is the word confidential in the first paragraph.
Sweet: That’s correct. This would be a confidential position.
Human Resources Administrator Lora Shramek: You need to do a little more analysis of the specific duties. It’s kind of on one of these borderline positions, see what percentage of the duties would relate strictly to the administrative, with the policies, and (inaudible). That may change before the final draft.
Stutsman: What may change? Whether this is an exempt…
Shramek: An exempt status.
Jordahl: As I look at the duties, you know, that were described here, I don’t see a great deal of… It’s just maintained personnel files. This (inaudible) performance evaluation and disciplinary actions is the one that seems to require the confidentiality.
Shramek: With the Fair Labor Standards, a category of the Administrative, we have to analyze the job description because it is a new position, relative to those standards, and make a final determination.
Jordahl: What are we being asked to do?
Stutsman: Nothing. Lora’s doing it, right? To address what you were saying, Jonathan, we heard some concerns that there’s nobody to help the staff with failing and maintaining records. Would this administrative be available to do that? OK.
Sweet: No, that’s not my intent. There are some options there.
Stutsman: What are those?
Sweet: We currently have 2 persons in clerical positions within the department, and we’re currently looking at their job descriptions, their responsibilities, and we may be coming back, visiting with you about some specific proposals in that area. In the past, the department had used the services of a temporary file clerk through a temporary agency. The reason that we discontinued that was that the request of staff. I think staff’s having some second thoughts now, and we can revisit that. I visited with Cheryl last week at the possibly of bringing that temporary clerical person back in on a very part time basis to assist with filing. That is another option that we can be considering. It is not my intent for this Administrative Assistant to provide staff support for the workers. I think the 2 clerical people that we have in the department are there for that purpose and can continue the staff’s needs. It would be my intent for this Administrative Assistant to be providing staff support for the Clinical Supervisor, the Financial and Statistical Supervisor, and myself.
Shramek: The temporary position Elaine’s speaking of, I believe was 2 hours a week.
Sweet: It was very minimal.
Stutsman: Just to do filing, that’s all they did, was filing.
Duffy: How many hours a week?
Sweet: 2.
Duffy: Just 2.
Stutsman: On these job descriptions, it seems like the standard line always was and perform any other duties as assigned. How come that’s not included?
Shramek: That’s included in the specific duties. It’s bolded. The following duties are (inaudible) of this position and aren’t to be construed as exclusive or uninclusive. Other duties may be required (inaudible).
Stutsman: OK. Just a little different format, then. Any other questions? You say that this would be $10,000 additional?
Jordahl: Less.
Stutsman: Less. $10,000 less. OK.
Jordahl: The number of positions is one less, or the same?
Sweet: The number would be the same.
Jordahl: Have you had any talks with the union about this… There’s a reduction in one union position, is that correct?
Sweet: We’re just not going to be using that position any longer. That was the Management Analyst position, and it was not a supervisory position. It was more of a clerical.
Jordahl: But that would, I mean, in terms of the number of people who are members of the union in this unit, that would be one fewer if you don’t fill that position. Would that position continue to exist, then?
Shramek: Yes. I mean, it would go unfilled.
Jordahl: Do we expect at some point to wish to fill that position?
Sweet: That would not be my intent.
Jordahl: Why don’t we just clean up the books and get rid of it then?
Shramek: At the appropriate time that could be discussed.
Lehman: Procedure you have to follow to basically reduce the time period?
Stutsman: OK, so where do we go from here. We have to formally approve these job descriptions, right? If the Board’s comfortable, we can put that on for Thursday, unless the Board wanted some other time to think about this. Once those are approved, then you can get in the process of advertising and filling positions. The person who is currently a supervisor there, then, would be free to apply for the job?
Sweet: For the Clinical Supervisor position, she certainly would be. I had a brief conversation with her, and I don’t believe that she will. I don’t believe that she’s interested in the position, but she certainly is free to apply for it.
Stutsman: It’s a big job. A lot of responsibilities. OK. Does the Board want to put this on for Thursday for approval? Do you need some more time to think about it, any other questions?
Jordahl: There was some indication that Lora was working on something?
Shramek: We’ll have final drafts. We’ll just have a few refining things to do. (Inaudible) double check the status of the Administrative Assistant and a few other changes.
Stutsman: What do you mean status?
Jordahl: Exempt or not.
Stutsman: Well, maybe we’re not ready to put it on for Thursday. Maybe a week from Thursday?
Shramek: I think we’d be ready for Thursday. I think we can finish up our changes today.
Jordahl: I’m OK with having it on if you’ll be ready.
Stutsman: Is the rest of the Board OK?
Thompson: How many case workers are there?
Sweet: I have 9 case managers, 2 of those are part time, and 7 social workers. There’s a total of 6 people, but 15 full time equivalents.
Thompson: You’re table of organization will show that you supervise the 2 supervisors, one of the supervisors supervises the 2 clerical and the Administrative Assistant, and the other supervisor has 15 and a half professional staff.
Sweet: 15.
Stutsman: Full time equivalent.
Thompson: OK.
Stutsman: I’m wondering how this one person can supervise 15 people. I don’t know the structure over there. If there’s a lot of supervisory time. I know they’re good staff, they’re competent staff, and I don’t know what’s required as far as day-to-day supervision and things. But you feel confident that this one person can do that 15?
Sweet: I do.
Stutsman: OK.
Shramek: Since August, I’ve been doing my position, the work that typically the Management Analyst had done in the past, and I’ve been short one of those clinical supervisory positions almost that entire time in addition to having a couple major projects occurring at the same time, and I’ve been able to manage. I wouldn’t expect anyone to be working the hours that I have been during that time, but I think the balance here is appropriate for the moment. I think we need to keep in mind, too, that as a result of the file review, there may be some changes coming in the department as to how we do business and how many positions we need. One of the things that we’ve identified is the number of cases that appear to be able to be closed, and in consideration of that, I’m not real eager to be adding positions. I need to fill positions in the right places to be able to continue the work and do it in a quality manner. But I would rather err on the side of not stepping adequately than to overstep at this point in time until we bring resolution to some of the other things that are occurring.
Thompson: If it looks, after the person is hired, if it seems unmanageable, you’ll make a decision then, about…
Sweet: I’ll be back.
Shramek: There’s also the addition of the Administrative Assistant to assist the Clinical Supervisor and personnel and payroll.
Jordahl: It seems reasonable to, again, with a frozen budget, to try and not topload the thing with administration and see what really is necessary as things shake up. We don’t have good statistics on the service need or how it is assessed yet.
Stutsman: Just when we were talking here, I think we need to move ahead on this, because as you just pointed out, Elaine, you’ve been doing a lot of work over there with positions that haven't been filled and people on maternity leave and things. I guess I would say, we need to move ahead with this and get these approved so you can start hiring people to replace people or get this in place.
Sweet: I’ll assume responsibility for these not being done because I early on identified the probability that there might be a better way of doing business. I’ve asked not to fill those positions until I’ve had time to study it carefully and research it and feel comfortable with my proposal. I’m at that point. I feel comfortable with this proposal.
Stutsman: Any other discussion?
Shramek:: I just want to say I hope that you (inaudible) particularly when (inaudible) 7,000 on the clinical supervision consistency. I think that, as Mike knows, one of the things that the Finance Committee looked at was whether or not all things have been consistent, and I think having a central person there will sure help with that.
Stutsman: Good point. OK. Let’s move on to Item B. Appointment of Pat Hartin to the Mental Health Developmental Disabilities Planning Council. Thanks, Lora, for your work on those job descriptions and things.
Sweet: The Planning Council, last week, voted to recommend for Planning Council membership, Pat Hartin as a provider/representative. Pat is associated with Chatham Oaks and has been very active in the MH/DD Services System through the years. I bring that recommendation to you today.
Stutsman: Are we comfortable in putting that on for approval on Thursday? I think Pat will be a good addition to the Planning Council. It’s good to have somebody with connections to Chatham Oaks on that Board.
Sweet: She’s been very active in all of the committees on the Planning Council. She has a lot to contribute.
Stutsman: Great. We’ll put that on then for Thursday.
Sweet: Thank you.
Stutsman: I’m just thinking. Is it necessary for Elaine to come back on Thursday for either of these items?
Duffy: No, it doesn’t look like it to me.
Sweet: OK. You don’t need to come back to the Board meeting on Thursday to approve these things.
Sweet: I appreciate the time.
Stutsman: That’s what I thought. You’ve got plenty of other things to do.
Sweet: Thank you.
Stutsman: Thanks, Elaine.