Mental Health Board

708 GENEVA COMMUNITY MENTAL HEALTH BOARD January 8, 2013 The Geneva Community Mental Health Board met at 7:00 p.m. on Tuesday, January 8, 2013, in the Geneva City Hall Chambers, 109 James Street, Geneva, Illinois 60134. Present: Chairman John Ford; Members Davidson-Bell, Goldstein, Schoedel. Absent: Member Dantino. Also present: Exec. Dir. Lynn O’Shea with AID; Mayor Kevin Burns; City Admin. Mary McKittrick; and Recording Secretary Celeste Weilandt. 1. CALL TO ORDER/ROLL CALL Chairman Ford called the Mental Health Board meeting to order at 7:00 p.m. and noted whom was present. A quorum was present with four (4) voting members. 2. AMENDMENTS TO THE AGENDA Ms. Goldstein asked to add to the agenda the email she received from the Association of Community Mental Health Authorities of Illinois. Goldstein made a motion to approve the agenda amendment, seconded by Davidson-Bell. Motion carried by voice vote of 4-0. 3. OMNIBUS AGENDA ( OMNIBUS VOTE ) All items listed with an asterisk ( * ) are considered to be routine by the Mental Health Board and will be enacted by one motion. There will be no separate discussion on these items unless a board member or citizen so requests, in which event the item will be removed from the Omnibus (Consent) Agenda and considered in its normal sequence on the Regular Agenda. Schoedel moved to approve the Omnibus Agenda, seconded by Davidson- Bell. Motion carried by voice vote of 4-0. 4. APPROVAL OF MINUTES *A. Regular Meeting Minutes of November 13, 2012 - Approved by Omnibus Agenda. 5. OLD BUSINESS - None 6. NEW BUSINESS [Ms. O'Shea was allowed to edit this material for clarification purposes. No material changes were made with these two exceptions: in the first paragraph, sixth sentence, and again in the eighth paragraph, third sentence, has been corrected from the original "... Affordable Care Act ..." to now read "... State Medicaid Managed Care (Innovations) program ...".] A. Lynn O’Shea regarding Campaign for a Kane 377 Board - Exec. Director Lynn O'Shea provided an update on the developmentally disabilities movement to place a referendum before voters occurring at the county level. Distributing her handouts, she explained that the web site www.ShowYouCareKane.com keeps the public apprised of the latest news developments regarding the developmentally disabled (“DD”) population and explains the difference between the DD population and the mentally ill. Currently she said 10,000 DD Kane County individuals are either in school systems or are at home with parents that need 24-hour care. Ms. O’Shea shared the challenges of parents of taking care of DD family members at home, the state’s inability to keep pace with new individuals coming onto the State’s waiting list, and the ever-decreasing state funds for the DD population. Payments from the State of Illinois were delayed as much as five months and once the new State Medicaid Managed Care (Innovations) program targeting Seniors and Persons with Disabilities is fully operational starts, Ms. O’Shea said it would result in turning over services for DD individuals to the insurance companies and awarding them 2% less than what is currently spent and allowing them to spend up to 13% on overhead, resulting in reducing resources statewide by 15%. Per the chairman’s question, the DD individual would be enrolled in an HMO managed care system as part of the State Medicaid Managed Care (Innovations) program targeting Seniors and Persons with Disabilities. Additionally, the State of Illinois has requested a changed in federal Medicare policies, which would force dually-eligible persons under Medicare and Medicaid into HMO/managed care programs. In order to address the shortfall of money for DD services, a petition drive was undertaken to place the question of a DD Service Board on the April 9 ballot. Ms. O’Shea presented 12,000 copies of the 18,000 petitions needed for the referendum. Because the petition requirement was not met, Ms. O’Shea also explained that the Kane County Board could vote to have the funding increase placed on a referendum ballot. However, she cautioned that if the referendum did not pass, more DD individuals would be placed on the state’s waiting list which would result in seeing more individuals at homeless shelters or mental health institutions, resulting in additional costs -- $160,000 per year for a person at a state run facility versus $50,000 per year for community care. 708 Geneva Community Mental Health Board - 2- January 8, 2013 Ms. O’Shea stated the presentation on the referendum was made to the county’s new Public Health committee last week. Discussed was how the tax increase would affect various taxpayers at different levels, depending on the township and the assessed value of an owner’s home. Asked if the levy amount was the maximum or whether another number could be allowed, Ms. O’Shea stated the stated levy amount was the maximum the legislation allowed but there were efforts being made to lower that number -- anywhere from 50% to $1.00 and that the county board would determine the levy. Wherein, Chairman Ford reminded her that this board, in the past, discussed what levy amount was allowed by legislation, what the board voted for, and what was actually being collected. O’Shea shared that PTELL will limit any increases year to year, i.e., 5% or the cost of living, whichever is lower. She estimated there would be a 1 to 2 percent increase annually but if the levy was set too low, she envisioned the DD services advocates would be back asking for another referendum. Continuing, Ms. O’Shea referenced the actual resolution and invited this board to attend the county’s Executive Committee meeting on Thursday, January 10, 2013, 9:00 AM in the County Board Room, Building A, as well as the full County Board meeting next Tuesday, January 15, 2013. A group of four individuals who will be speaking on behalf of the DD referendum include Messrs. Pat Flaherty, Chuck Miles, Fred Norris, and Walt Dwyer and they will be asking the county board to let the voters decide whether the referendum should be on the April 9th ballot. Ms. O’Shea shared that it has been difficult for county board members to agree to let the voters decide the matter, since it appears that a vote to move it forward is being interpreted as a vote in favor of a tax increase. She shared some of the questions that were raised at the public health meeting, concluding with the statement that the DD levy will be “totally separate” from the county’s levy and it will not affect its tax cap. Addressing the topic of how a new 377 Developmental Disabilities board would affect the responsibilities of a current 708 mental health board, Ms. O’Shea explained that it was a confusing topic. Public Health committee members, and some county board members misunderstood the recently enacted legislation establishing Mental Health Advisory Committees as a mandate and that the county was going to be required to implement new Mental Health services and provide the funding. However, O’Shea said the Mental Health Advisory Committee legislation states that the county shall appoint an advisory committee to study and report mental health service needs; it was not binding and it did not require the county to create or fund a mental health board. However, a county-established advisory committee could make a recommendation to the county board to expand mental health services. Current legislation permits in three ways: 1) each municipality and/or township without an existing mental health board could place a referendum question before their electorate to approve a mental health levy, which would be individually decided upon; 2) the County Board could place a referendum question on the ballot asking their electorate to pass a county-wide 708 board referendum but interaction with the existing seven township and two municipal 708 boards would have to be considered; and 3) the county board could consider asking their electorate to pass a county-wide referendum to enact an increase in the county’s public health levy specifically to provide mental health services. Currently, the county public health statute permits levying up to .15% of assessed valuation specifically for mental health services but not for DD services, which was O’Shea’s concern; she reported that many counties currently had the third option in place. Asked if not being under the home rule statute allowed Geneva’s Mental Health board to determine what guidelines it wanted to follow, Ms. O’Shea explained that her agency’s attorney provided a written opinion that 708 legislation is permissive and it does not mandate what populations or services must be funded. The board could determine what mental health, substance abuse or developmental disabilities services it wanted to fund. However, creating an individual 708 charter, O’Shea explained, was another way to specify what services would or would not be provided by each mental health board. Continuing, Ms. O’Shea discussed the shortfall in funding for the DD population versus the mentally ill population and shared the fact that legislation enacted by the General Assembly allowed for two separate levies: one for mental health and one for DD, which was what her group was asking the county board to allow the voters to decide. Ms. O’Shea commented on the potential impact the levy would have on the County’s budget -- reviewing the 2011 amended budget at $242,290,618 and noting the 2012 adopted budget was reduced to $231,529,259 for a net change of -$10,761,360.00, which amount, if just returned to its original amount, would almost be the full amount of the levy. Lastly, O’Shea pointed out that there were no DD levies enacted in any of the Chicago metro counties except for McHenry County, which was going to be on their upcoming ballot. Some of the southern counties, however, did have DD boards. Should nothing change at the county level or at the 708 level, Ms. O’Shea explained that the long-term impact would be that the state would be turning the services over to the insurance companies and exchanges through the State Medicaid Managed Care (Innovations) program targeting Seniors and Persons with Disabilities. A similar Medicaid managed care mandate was already being seen in Wisconsin -- persons were being sent home; group homes have closed or doubled in size, and public service costs rose. O’Shea reminded the board that the State Medicaid Managed Care (Innovations) program will determine a person’s access to services and it will affect the elderly and the disabled population. Asked how the services under the State Medicaid 708 Geneva Community Mental Health Board - 3- January 8, 2013 Managed Care (Innovations) program are not duplicative of a county-wide DD levy, O’Shea explained that if an HMO will not fund a service, but the local DD board will, it becomes a safety net for those who will not have funding under Medicare or Medicaid. O’Shea stated she does not see how the State will save money by closing state institutions when there are 24,000 on the state’s waiting list who need funding for services already. She added that many states already have their own county-based systems and do not expect the State to run their mental health and DD services. She believes having a county 708 board would be “fairer” from the stand point that the amount levied for services would be the same county-wide, and all county residents would have access to services, which is not the case now.. Ms. O’Shea closed by asking this board to support the need for a DD levy. Mayor Burns asked if the legislation allowed for the county to administer an administration fee for the monies collected and distribute the funds to the mental health board to which Ms. O’Shea said it did. City Admin. McKittrick understood if the referendum were to pass and the county were to levy, Geneva citizens would be paying two levies -- the city’s 708 levy and then the county’s levy. Chairman Ford then understood that the on-going responsibilities of this board, should there be a county-wide levy for DD services, would be to make a decision as to whether or not monies could go to substance abuse and mental illness or reduce the levy (or keep it the same) and then the board create a charter describing where the board’s responsibilities lay. Ms. O’Shea concurred and shared some of the experiences she has seen with other counties, stating some counties have both mental health boards and separate DD boards. Mayor Burn then confirmed that if the ballot passes, the county board still has the authority to regulate the level of the levy. Asked about the Kane County Board chairman’s comments on this referendum, and seeing that the proposed levy would be on a person’s property tax bill, O’Shea explained that the county board chairman told the voters he would not raise taxes and he would, instead, lower other levies. She believed the voters needed to be educated. Lastly, O’Shea commented on the positive model used by the State of Arizona. B. Consider an On-line PDF Funding Application - Schoedel suggested placing the board’s funding application and summary forms, via PDF, online for consistency and transparency purposes. Members seemed supportive of the idea, but the chairman shared his concern that the forms could be difficult to find on the City’s web site. Schoedel offered to draft the fillable forms. City Admin. McKittrick interjected and said that this year’s project was to update the City’s web site. 1. Email from ACMHAI: Goldstein distributed copies of an email and attached memo she received from Ms. Phyllis Russell, Executive Director for ACMHAI, explaining the definition of mental health. Goldstein stated that Ms. Russell would be interested in attending one of this board’s regular meetings. Schoedel reminded Chairman Ford, too, that he wanted the definition of “mental health” be placed in the funding application form. Chairman Ford suggested inviting Ms. Russell to this board’s meeting in the next few month and that members create a list of items they would like her to address. Topics raised included: addressing separate funding for capital budgets; partnering with other funding sources, such as community chests or a foundation or a corporate entity for a capital project; holding fundraisers; whether other 708 boards have done granting writing; connecting one of our funding agencies with an existing civic organization who may like to adopt them; or advocating one of the few high school programs, which currently receives funding from this board, as being more appropriate to this board’s mission than others. Goldstein offered to provide at the next board meeting a suggested list of topics for Ms. Russell to address and Goldstein would find out when Ms. Russell could speak to this board. C. Areas of Interest Reports - None reported. 7. OTHER BUSINESS *A. Approve Payment to Recording Secretary for Services - Approved by Omnibus Agenda. 8. PUBLIC COMMENTS A. Introduction of Guests - Chairman Ford welcomed and thanked Mayor Burns and Mary McKittrick for attending the meeting. B. Written Correspondence - None 9. ADJOURNMENT The board adjourned at 8:20 p.m. on motion by Ms. Davidson-Bell, seconded by Ms. Goldstein. Motion carried unanimously. Recording Secretary, Celeste K. Weilandt