• Veterans Affairs (50)
• Planning and Zoning Department (19)
• Budget: Department of Human Services (45)
• Budget: Mental Health/Developmental Disabilities Services (46)

Board of Supervisors members present in the Johnson County Administration Building at 9:00 a.m. were: Jonathan Jordahl and Sally Stutsman; absent: Joseph Bolkcom, Charles Duffy, and Stephen Lacina.

Supervisors Stutsman and Jordahl noted the absence of Lacina, Duffy, and Bolkcom and apologized for the lack of a quorum. Veterans Affairs Commission Chairperson Marie Weldon began with a request for a $1,000 decrease for food. She noted continued increases in requests for rent coupled with fewer food requests. She added that Veterans Affairs has never had a problem finding money in the food line item to meet requests. Secondly, Weldon and Veterans Affairs Director Leo Baier noted Baier's proposed attendance of the National Association of County Veteran Service Officers Training Conference, emphasizing the importance of him attending the conference, which will be held in Des Moines, Iowa, thus decreasing travel costs for attendance of the conference. Weldon then moved to line item 3 and its attendant supporting information attached to the handout Veteran Affair's passed to the Board of Supervisors. Weldon explained the method for choosing comparison counties: Some counties were chosen because of geographical proximity, thus similar rent guidelines; some counties were chosen for comparable veteran population; some counties were chosen based on disparity in population size relative to Johnson County. Marie Weldon then moved to line item 3, a proposal to update Veteran Affairs Guidelines which establish eligibility for Veterans/Families of Wartime, Honorably Discharged Johnson County residents. The last up-date was in 1995. Veterans with incomes just above the old Guidelines were noted as examples of people having trouble keeping up with the increase in rent in Johnson County, noted as the state of Iowa's highest cost of living County. Stutsman asked how many veterans would be eligible under the new Guidelines. Weldon responded by noting figures for rent vouchers for different amounts for FY 1998; just under $20,000 for rent. 7 for $350, one for $336, one for $300, 28 for $250, and 50 for just under $250, all individual rent assistance. Jordahl asked for clarification of how voucher money for rent is dispersed. Baier explained the process, which rarely meets each request for full rent amount. Marie Weldon noted that 78% of Veteran Affairs total budget is spent on rent. She then responded to Stutsman's query about the policy of assist limits, saying assists are limited to 4 per year per person, regardless if the request is for rent, food or utilities; 4 total per year. Marie Weldon reiterated that rent requests far out-pace requests for other types of assistance. Stutsman asked how an increase in the Guidelines will reflect on the budget. Baier believed 5% would cover the increase, but 4% is fine as well. Baier said that right now in their current budget they are under but that can change from month to month.

Jordahl noted that the proposal for the July 1999 conference Baier will attend will consume 80% of the $1,000 saved on food for FY 2000. Jordahl expressed concern over appropriating money from the food line to rent for FY 2000. Weldon offered an increase in last year's conference budget and transfer of that money to rent as a way to allay this concern. All agreed the prevailing issue is one of semantics. Jordahl asked why the rate of rent assistance is nearly double its prior rate. Weldon explained the nature of savvy assistance program users, those "hard-core" users that negotiate the program well and that population of veterans, generally single and unmarried in the late 40 to early 60 age range, seems to be increasing. Married veterans with families are infrequent requesters, by contrast. Stutsman asked what the options may be. It was agreed that many of these "hard-core" users suffer from mental disorders and are virtually unemployable. Measures are taken to seek employment for those deemed competent to work after an interview has been conducted. Weldon stated the Commission's efforts toward equity among approvals of requests. Weldon and Baier explained that they also work with other Veteran's facilities around the state to provide care to Johnson County veterans. Jordahl introduced Baier to Supervisor-Elect Mike Lehman.

Planning and Zoning Administrator Rick Dvorak began by noting that proposed expenditures other than salaries have been kept within $10 of last year and the previous year's budget. He reminded the Board of Supervisors of his request last year for $5,000 to be set aside to add to the $10,000 set aside the year before for the replacement of his office's 1988 Dodge truck, which was denied. He requested $10,000 for this year for the new vehicle. The request is noted on the capital expenditures worksheet. The $14,500 requested in capital expenditures includes money for a new copy machine; the money for the copy machine would be broken down into $4,500 each of the next 2 fiscal years. Dvorak emphasized the burden and repair costs of his office's current copy machine. He noted they put copies of documents on the Internet for people to access, but there are still large numbers of copies requested. Assistant Planning and Zoning Administrator R.J. Moore added the environmental savings of using a duplex copier capable of producing 2 sided copies. Dvorak proceeded to discuss the computer budget. He wondered what the procedure will be for hardware and software purchases. Stutsman explained that large technology purchases would be included in the large budget and Information Services would work with departments to keep track of individual department requests.

Dvorak then proposed a final item of increase: 2 position proposals, beginning with an upgrade of the current secretarial position from part-time to full-time. He explained their job for part-time people is terrible. Without acceptable applicants for this position, he explained that individuals in his office and other offices are having to work nights and weekends to do the work of that position. Stutsman asked if they have the work for a full-time position and whether another office could share the additional hours. Dvorak noted discussion that the Board might be looking for a part-time person. He said a shared agrement might work for a period of time, but he indicated the full-time position is needed in his office because of the night meetings.

Dvorak said the minute-taking is very, very time consuming. Moore explained that having the other secretarial person in the office work extra hours to get work of the part-time position done, and taking comp time to be used later on, doubles the problem when she is gone. Dvorak requested having an assistant planner in his office. He reminded the Board of Supervisors of the approaching projects that will demand more time from his office, including implementing the Land Use Plan, representing the County for the Census of 2000, and working with the E-911 system. He said the intent is to keep the work within the office, rather than hiring consulting work. Stutsman inquired as to the duties of the proposed assistant planner. Moore explained that in order to free up Dvorak for more administrative functions, the assistant planner would assume some of his own responsibilities, while he would assume some of Dvorak's responsibilities.

Moore also invoked the implementation schedule of the new Land Use Plan as evidence of looming weighty time demands on the Planning and Zoning Office if it is adopted by the Board of Supervisors. Stutsman noted the proliferation in department demands for more personnel. She expressed her feeling that departments need to be working "smarter, not harder", to explore all options before adding staff. She requested more documentation of labor division in the office. Dvorak emphasized the increased demand on his office's time the Land Use Plan will have and speculated on contracting some of the future work out to consulting firms, something he hasn't been totally satisfied with in the past. Jordahl agreed with Stutsman on the need to delineate the work responsibilities of each member of the Planning and Zoning Office.

Jordahl credited the department for utilizing University of Iowa's student interns as a way of decreasing County costs. Stutsman supported the plan for Dvorak to be given time to focus on administrative duties as opposed to extraneous field duties. Dvorak noted Linn County has an individual dealing only with enforcement. Moore indicated Iowa City has approximately 9 or 10 planners on staff. Moore pointed out that a necessary project for the next few years is to recodify the County Zoning Ordinance, which he deemed as outdated and unintelligible. Stutsman responded by noting that the legislature will be discussing issues that may impact local land use decisions.

Jordahl commended the department for its effort to make available all of its documents to the public on the Internet. Jordahl wondered what bearing a new professional position would have on the GIS needs. Dvorak informed the Board of the new requirements in the graduate program, classes in ARC/INFO, ArcView, and Intergraph. Jordahl requested some estimation of what an independent GIS Coordinator could do for GIS. Dvorak said he would not like the new person devoted to GIS but was just noting the current graduate training requirement. Welsh agreed the department needs more assistance.

General Relief Director Kay Hull began by explaining General Assistance as a County funded program for people who have emergency needs, such as rent, utilities, hospital bills, prescription medications, etc. In conjunction, she noted that said program does not duplicate state and federal programs or the Veteran Affairs program. She noted that the program currently pays $1,000 for funeral services, probably one of the lowest in the state of Iowa. She requested the transfer of $4,000 from the Hospital line item, $3,000 of that to be moved to Burials. She would like to shift the remaining $1,000 to the Nursing Care line item. She noted delays in Title 19 reimbursements kicking in as a contributing factor in increased requests by the public for extra help. Jordahl asked for a pertinent document. Accountant Kathy Lynch replied that should be with the detail documentation submitted.

Stutsman mentioned phone calls she had received from funeral home directors that were positive, but she noted adjustments need to be made. Hull said that she had asked for the past 3 or 4 years for a proposal from funeral directors. It has not been forthcoming, but she noted the funeral directors' willingness to work with people. Jordahl wondered if the Nursing Home question requires more money. Hull said 2 days of payment for Nursing Home is $127. Lynch said Hull is proposing line item shifts, not an increase or decrease. Jordahl said not having an increase was great, that that is the Director's job. Hull pointed out that nursing homes have had very few requests, all coming this year. Hull remarked that the increase in requests for funeral service assistance is a result of an aging population in Johnson County.

Stutsman asked if things such as Rent were OK. Hull responded in the affirmative, even in light of last year's $50 increase in the guideline. She said their clientele are trying to work the part-time temporary no-benefit jobs which put them over the guideline. Jordahl asked if the guidelines were fixed. Lynch replied that the guidelines were set equal to the Family Investment Program, formerly known as the Aid to Dependent Children Program.

Department of Human Services Area Administrator Cheryl Whitney referred to the Iowa Department of Human Services FY '98 Memo given to the Board of Supervisors as an outline of what was being requested in terms of each percentage of increase, giving a picture of the bottom line. She said they have looked for some line item increases in available funds in other line items. Her request under the one percent increase was for an increase to full-time their current half-time Social Worker 2. For the 2 percent budget increase, Whitney identified additional needs. First, increasing the Primary Treatment line item by $3,000 to allow more funding for dental services. She noted her office's ongoing agreement with the Dental College to serve indigent people. She said that service had to be discontinued halfway through the year due to moneys being used up. Hull mentioned that the Dental College is now working with inmates from the jail, thereby adding to the financial demand. She explained that work done for inmates is to relieve pain; routine work is not offered. Stutsman asked if the money for the inmates comes out of the Social Services budget or the Sheriff's budget. Whitney replied that it comes from their office's budget. Jordahl asked if an inmate would receive funding if he or she had independent resources. Whitney said no, that people are screened.

Also under the 2 percent budget increase, Whitney proposed to increase the Volunteer Program by $2,134 to bring the funding level back to $18,000. She explained that it had been reduced because of a prior line item for Rent at United Way. They surveyed all the agencies that are served by that Volunteer Action Center and reported that hiring a replacement for the person who has left is necessary. Stutsman asked if this increase would just be for Rent, not for salary. Whitney replied that there is a separate line item for the United Way Space Rent.

The final item on the 2 percent list that Whitney remarked on was a request for an increase in the Daycare Service line item by $5,579 for the purpose of increasing the availability of neighborhood based home care providers, particularly for infant care, which is the most critical need. She reported that 80 percent of the calls received by 4Cs are requests for infant care. Whitney said there is one slot available for every 6.5 infants; by contrast, for children ages 2-5, there is one slot available for every 2.5 children. Stutsman asked if the money would be used to pay for slots. Whitney replied in the negative. She elaborated by saying it would be used for more start-up costs. She expressed hope that slots could be paid for by state child-care assistance since there isn't state money for start-up costs. Jordahl said he serves with the HACAP Board and noted how that board divided into Head Start versus Housing operations; that he is on the Head Start portion. He said they have had some opportunity to access additional funds for day-care in this area that would be half day slots augmenting availability of child-care in Johnson County; that other resources may be available. He wondered if these avenues of funding had been investigated. Whitney said she had talked with HACAP and other programs about using state child care assistance money. Jordahl proposed the idea that County resources might be used to draw down additional federal resources and wondered if that was a realistic possibility and had that been studied. Whitney replied that they plan to first use state dollars then with their Empowerment application ask for money to provide what they call consistency of care.

Whitney then moved to the 3 percent budget increase. She said the new addition to this proposal is a line item for Foster Care Home Support with funding for $10,712, which will provide resources to enhance recruitment and support for foster family homes. She noted that the proposed 4 and 5 percent budget increases differ only in that the 4 percent request asks for all of the above plus an additional one percent increase to the Foster Care Home Support for a total of $21,424 and the 5 percent increase requires an additional one percent for a total of $32,136. Whitney explained the Foster Care Home Support money as assistance to foster parents who have little money. She said this money could assist that program. She noted that they have a time limited grant called the Foster Care Reunification Grant. She said within it there has been recognition for new types of need. Jordahl asked if a priority scale existed in terms of special needs children. Whitney replied that children in need of safety are the primary concern.

Whitney turned to the second page of the memo, calling it an overview. She then remarked on the graph on page 3 of the memo. She said it is a pictorial representation of the need for an increase in the social worker slot for Foster Home licensing. She interpreted the legend and graph. She said that due to an increase in the number of children in need of foster care, her agency has turned to foster homes in other counties, among other things. Stutsman, Whitney, and Hull discussed the severity of children's home situations today. Jordahl asked if statistics were available on the in-migration effect. Whitney noted the difficulty counting that. She continued with noting an increase in the number of families moving to Johnson County that need assistance and an increase in the number of children per family that need foster care, both of which are increasing the burden of the agency. Jordahl clarified that he is not asking for some way of treating people differently because of their origins, but that he is looking for demographic information that will help to inform the budget process across-the-board.

Whitney then turned to the fourth page of the memo, calling it a narrative that discusses Title IV-E Foster Care and Adoption Assistance and Community-Based Administrative Claiming. She relayed one of the recommendations of the Child Welfare Task Force which was to pursue all sources of federal money for the child welfare system. She stated that they were looking at Title IV-E, with some of the Decat Project funded services, to match with Federal money. She said that in Johnson County they have some things that are funded in County dollars that she felt they would be able to draw in community based IV-E money. She stated that State officials need to do some things in order to get this going. She stated that they wanted to happen with the new quarter beginning January 1, but it was probably not going to happen until March 1st. Whitney stated that her department had not projected any increased revenue in the next year's budget related to this because they did not want to overproject on revenue. She felt that if they could get this off the ground they could bring in some revenue to help offset some of the Johnson County expenditures. She wanted to let them know that Title IV-E is something that would help the communities.

Stutsman asked if Whitney had any ideas about dollar amounts for the revenue. Whitney said she tried to be pretty conservative, her estimate was close to $30,000. She stated this was for certain staffing things out of Fund 45. She stated that was a small part of what they would look at. She as thinking in terms of increasing the social work position, training, and others. She that they just needed to keep after it. Whitney hoped that they would have it in place and be able to get revenue next year, but she did not show it in the revenue projections. She said it would probably not really come in until the year 2000. Kathy Lynch, Accountant for Social Services, stated that they would claim it at the end of June if they began on March 1st of '99 and it would be after the beginning of fiscal year 2000. Stutsman congratulated them on putting the budget together in the manner they wanted it. She stated it was very clear to understand.

Whitney stated that the Medicaid numbers are increasing so she included some graphs and numbers together to show that in the budget proposal. She pointed out that 51% of their business in public assistance is Medicaid funded. Stutsman asked if that was Federal reimbursement. Whitney answered it was for the most part, there was a little County participation in some of the services for disabled person, but for the most part it is State and Federal money. She stated that people in their office determine eligibility for Medicaid. She stated that the eligibility workers are State employees. They are the IM workers on the document under Public Assistance.

Supervisor Elect Mike Lehman stated that the presentation was very informative. He felt that their concerns were the demands of their clientele and the quality of services they are able to pass on. He stated it was very hard for them to budget how many clients they would have. Whitney said that if he had questions he should feel free to call them.

Welsh stated that they needed to look at ways to help the State recognize that the Foster Care Program is a State program and that the funds they provide are not really adequate.

Recessed at 11:11 a.m.; reconvened at 11:23 a.m.

Craig Mosher, Director Mental Health/Developmental Disabilities Services, read from the Mental Health/Developmental Disabilities Services Memo dated November 18, 1998, to the Board of Supervisors regarding the FY 2000 Budget. He explained that the budget is constrained by the cap on county tax and they are experiencing a 7% net increase in new consumers. Mosher cited the move to a managed care approach and the efficiency of management concerning County dollars, moving to a fee-for-service basis in place of giving large block grants, as reasons for the large carryover last year of $734,103. The estimated carryover for the current year is $394,000. Jordahl asked Mosher to explain the difference in dollars between the FY 98 and FY 99 carry-overs. Mosher referred to cuts in this year's budget in State dollars and increases in the budget. He noted there was less spending last year on residential services, the Mental Health Institute, community support services, the Mental Health Center, child day care, and work activity programs. He added that only about $40,000 was spent of the $106,000 allocated for Brain Injury. He said there has been some adjustment for that this year, but there will probably be some carryover. He suggested there could be a rate increase. He said next year they have projected for next year $0 carryover. He said the cuts in State funding and the increases in services and consumers should balance out. He said they will talk to the Planning Council about it. Jordahl said the trends could lead to being short in 2001. Mosher agreed they should project to 2001 and beyond. He said the increase in new consumers has gone from 11% the first year down to 7%. He thought the move from block grants to fee for service added a lot of the people who weren't in the system under block grants. They were added as cases to manage for workers in his offices. He handed out graphs Laurie Smith prepared showing the increase in case loads. He said they are up to 680 cases being managed by case workers in his office. He added there were people receiving services who don't have case workers because they don't have the level of service to require a case worker. Jordahl remarked on the need for real caution about instituting new services. Mosher said they need to identify the amount of the carryover they want to save to cover new consumers. Stutsman expressed her concern about how legislators would look at large carryover balances. Mosher said they provide about 400 of their 680 clients with social work services that are not on Medicaid. The other 280 he said are served with case managers, a service for which they are reimbursed by the Federal government.

Mosher said this is a conservative budget in the sense that he rounds up, which provides a slight cushion. He reviewed the 6 major changes in line items. He noted Mental Health Center Services and Primary Treatment are line items that much goes to the Mental Health Center. He said the outpatient psychiatry and psychotherapy and the clubhouse and counseling are down because collections from other counties have improved. He said this year they have only billed $350 for uncollectible billings. He said the Mental Health Institute is up because there is a client who has been placed on a long-term basis who wasn't there previously. He explained State Hospital Schools expenditures are down as part of the trend of deinstitutionalization. Medication expenses, he explained are up. Mosher explained CSALA and Supported Community Living are services for individuals living in their own apartments to provide counseling in the home to help with daily living skills and it is a cost-effective service in comparison to residential treatment. He said they are seeing some increase in these services. He added that more people similarly prefer supported employment in the community with a job coach rather than in a sheltered workshop and they are seeing some increases there.

Jordahl asked Mosher about line 80 on the budget, noting the FY '99 budget and re-estimated figures were identical, but the FY 2000 budget number was nearly $20,000 more. Mosher responded by noting that the increase was due to the movement of some money from a line formerly known as Services Management; the change is a result of consolidation of line items, not a change in services. Jordahl asked about possible cuts given the carry-over for last year and projected for this year's budget. Mosher cited the increasing number of consumers, attracted by the variety of services available within Johnson County, including the University Hospital and Veterans Hospital, or to attend the University of Iowa, and stay in the county. He calls Johnson County a magnet county. Mosher said there are unmet needs. Jordahl asked why the carryover wasn't spent to meet those needs. Mosher said it needs to be done in a planful way, working with the Planning Council. Stutsman asked if he was talking about future needs. Mosher said he was. He said there is a need for supported housing, for employment services, and adult day programming. Jordahl sought clarification about adult day programming and Mosher said most of the people he is talking about have severe mental retardation.

Mosher said the rate increase for providers follows the purchase of service rates set by the State, but some providers have not had a rate increase for 10 years . He said 3 years ago they had a 4% increase and he would propose in this budget a 5% rate increase. He said this would mainly affect the large agencies in helping them fill positions which they can't pay at a competitive wage. He said Hillcrest is developing a new supported apartment building and they have put $50,000 in to support services. He said Chatham Oaks is developing a supported community living service to have staff go to people's apartments. He was pleased that this would help transition from living at Chatham Oaks full time to living on their own. This funding would be for $30,000 and a contract is being prepared. The Respite Service is for people with mental illness to be able to go into a group home, Hillcrest, on a short-term basis. This funding is for $2,000.

Mosher said there are 2 new positions in the budget, an intake worker and an additional Social Worker/case Manager. He said these would not be funded through new County dollars but by existing budget. He said they do need to be approved as part of the budget. The total salary and benefits for the 2 positions would be about $84,000. He noted he had put in a line item for the 27th pay period, which can't be supplemented by the County budget.

Stutsman asked Mosher about the whether the intake worker, a worker that deal with eligibility and legal settlement, would be needed if the Legislature changes legal settlement. Mosher said the intake worker should be budgeted because the Legislature's decision isn't yet known and that even if it decided on some sort of change in legal settlement, at least a partial need might still exist. An audience member asked Mosher to explain legal settlement. He said it is a means to ensure a county doesn't pay for other counties' residents and outlined the process. Stutsman noted in most states the state pays, not the counties.

Jordahl said looking at the numbers the cost per person for services has gone up and asked whether it should be cheaper if services are provided more efficiently. Mosher said services such as supported employment are expensive but provide a better service. Stutsman said the carryover amount hasn't been spent on services. Jordahl asked why they taxed for it. Stutsman said the question is what are they going to do with the carryover. She was concerned about whether they cut back and cut the levy if there will be increased demands. Jordahl asked about the Service Priorities List. Mosher noted it ranks the services from most critical to least critical in order to determine where to cut if needed. Jordahl said there needs to be discussion of where new services fit on the list. Mosher said residential services are high on the list because if a person is homeless and needs a place to live, that's a high priority.

Stutsman asked if in looking at an adult day program he had been talking to Pathways. Mosher said they haven't gotten to that point because this was one of the lowest priority needs. Mosher said the intake workers position besides determining legal settlement also determines eligibility for services. The work load has increased with an increasing number of consumers. Mosher said they are just adding a social worker position that they had talked about in the past. He also said the case management cases are up and he might be back before the end of the year with a budget amendment. Jordahl discussed the possibilities of office space at different locations. Lehman discussed Mosher's budget presentation. Jordahl had questions on legal settlement. Mosher thanked them for taking time with his presentation.

Adjourned at 12:15 p.m.