The Health & Human Services Committee of the DeKalb County Board met on Monday, April 2, 2006, @ 5:30p.m. in the Administration Building’s Conference Room East.  Chairman Robert Rosemier called the meeting to order.  Members present were Jeff Metzger, Sr., Richard Osborne, Pat LaVigne, Julia Fullerton and Paul Stoddard.  Others present were Marlene Allen, Mary Olson, Sue Plote, Marshall Hayes, Karen Grush, Tom Zucker, Ellen Rogers, Karen Hagen, Charlene Riefler, Bob Shipman, and Ellen Tyne.

APPROVAL OF THE MINUTES

            Moved by Ms. LaVigne, seconded by Ms. Fullerton, and it was carried to approve the minutes from January 2007. Mr. Stoddard abstained. 

Moved by Ms. LaVigne, seconded by Ms. Fullerton, and it was carried unanimously to approve the minutes from February 2007.  Mr. Stoddard abstained.

APPROVAL OF THE AGENDA

            Moved by Mr. Stoddard seconded by Mr. Metzger, Sr., and it was carried unanimously to approve the agenda.

Ms. Olson passed out a summary of what the agencies have reported so far for the 2006 grant monies.  These are unduplicated persons that they are reporting too, said Ms. Olson, as shown in Fox Valley Older Adult Services that shows 76% served.  Ms. Olson also passed out her 3^rd Quarter Report on the Senior Tax Monies for services paid out for the months of February, March and April of 2007.

SENIOR SERVICES TAX LEVY HEARINGS

            Chairman Rosemier reminded the committee members that the agencies were only going to be allowed 15 minutes each for a question and answer period.  After the meeting tonight the committee will then reconvene on Monday, April 9, 2007 at their regular time of 6:30p.m.to discuss the monetary awards to the various agencies chosen. 

Elder Care Services – Case Management and Elder Abuse

Elder Care has three applications this year.  They are regarding Case Management, Elder Abuse and Neglect Program and the newly formed Self-Neglect Intervention Program. 

Request:  Elder Care - Case Management is requesting $30,000 to provide additional case management services in DeKalb County.  Other Sources of income include reimbursement from Illinois Department on Aging.  Their request will be used to support services to 350 clients in FY08.  Elder Care will be providing 5000 units of case management services to these clients. They are requesting support in the amount of $6 per unit of service.

             Elder Care – Elder Abuse is requesting $27,500 to provide additional elder abuse and neglect services in DeKalb County. Other sources of income include contractual reimbursement from the Illinois Department on Aging, requests to DeKalb United Way/Sycamore United Fund and DeKalb Township.  Their request will be used to support services to 92 elder abuse victims in FY08.  The funds will be used to provide 1250 units of service to those clients.  They are requesting support in the amount of $22.00 per unit of service.

            Elder Care Self-Neglect Intervention (ECS) is requesting $50,000 to create and provide a Self-Neglect Intervention Program.  Of the $50,000 requested $35,000 will be used to fund a professional staff position at ECS.  The remaining $15,000 will be available to purchase professional (psychological/medical) services as well as other (home cleaning/home repair, miscellaneous) goods and services. 

            The committee asked, How much do you receive from the State?  They get about $.50 cents on the dollar for Case Management, Elder Abuse is a little bit less and Self-Neglect is much, much less, explained Mr. Hayes.

            Chairman Rosemier said that in the total Elder Care Services budget we see a contribution by DeKalb Township, any other townships contribute any money?  Mr. Hayes said that they receive some money from Malta Township. 

            Ms. Mary Olson said that the total allocations went up about 14% over last year’s, while your increase shows 30% for what you are asking for.  Mr. Hayes said that this is for all three programs.  He continued by stating that they have seen an increase in costs.  They have seen an increase in their insurance, which is five times higher then five years ago.

            Under Self-Neglect Intervention, Chairman Rosemier explained that this is the new program that has come out of the Mental Health Sub-committee recommendation.  The committee agreed that one request, with one agency overseeing the program should apply.  Elder Care will be purchasing services from these providers. 

                Ms. LaVigne asked Mr. Hayes how many employees does he have?  Mr. Hayes said 10 of them.

            Mr. Hayes said that what they are proposing, he feels is cutting-edge on how to help self-neglect cases.  This will be very intensive case management.  They will be spending a lot to address the underlying causes.  Kankakee is doing something like the program and are having great success.  The self-care scale is how they will measure success.  They have set a benchmark at a score of 40 or below. 

Chairman Rosemier said that on page two of Mr. Hayes proposal for the new program, he states that the “strong benefit of their proposal is that the funding that they are requesting allows ECS to tap into additional and State funds that can be used to purchase goods and services.” 

Chairman Rosemier asked, do this exist?

Mr. Hayes stated that he didn’t put that in there because it is sort of a nebulous number, they don’t know what it would be.

Chairman Rosemier asked, but are there funds?

Mr. Hayes replied by stating that once they get them into their designated self-

neglect cases there are pots of money that they could tap into.  They are know as EIS (Emergency Intervention Services Dollars).  They would be able to tap into those dollars prior to, as you saw in the request, $15,000 of the $50,000 is set aside as purchase of service.  Before we even go to those places we would tap into the EIS money that the State allows, which is capped. 

            Ms. Fullerton said that $35,000 is to fund a professional staff person – we do purchase the service instead of funding a staff person, so how does that work?  How do you plan on making up a shortfall to make sure that person has a source of funding for their job? 

            Mr. Hayes said that the State has said that they are hoping to put money in to this, it has not happened currently.  But at some point, the promise that was made, is that we are going to fund this thing.  Eventually they hope to go to National foundations and hopefully they may give them funds, if they have some success, said Mr. Hayes.

Opportunity House

Request:  Opportunity House is requesting $34,000 for their specialized senior program that will help seniors with developmental disabilities to remain in their present living arrangement and prevent or delay referral to a nursing home. The amount that they receive provides for 1100 hours of annual services.  In their program currently they supply 1590 staff hours on an annual basis.

Family Service Agency of DeKalb County

Request:  Family Service Agency is requesting $112,800 to continue homecare service for the low-income elderly residents of DeKalb County.  The other source of income to be used for this portion of the Assisted Living Program is through the Illinois Department of Aging (IDOA).

            IDOA pays for Assisted Living services at a rate of $13.62 per hour.  As they have not been notified that there will be a change in that amount for FY07, they are assuming that that amount will remain.  The cost to Family Service Agency for providing these services is $23.02 per hour.  The difference between these hourly rates is $9.40 per hour - this is the per hour rate that Family Service Agency is requesting from the Senior Tax Levy funds.

            They provided 10,647 hours to IDOA clients in fiscal year 2006.  Based on the service level through January 2008, it is estimated that 12,000 service hours will be provided in FY08, and the $112,800 that they are requesting from the Senior Tax Levy will pay for those service hours at the rate of $9.40 per hour. County funds will enable low-income older adults to receive the care, which they desperately need, and allow Family Service Agency to continually meet emerging needs for assistance with the tasks of daily living. 

            The committee asked Ms. Plote why there were varying amounts found on page 2?  Ms. Plote said that other vendors come into the community and that reduced the numbers referred to Family Service Agency. 

            Chairman Rosemier asked where did they come up with the 12,000 hours? 

            Ms. Plote said that it is based on the number of hours they have done this year and the increase that they are expecting next year.  She also said that they also get other referrals from Elder Care Services.

            Ms. Fullerton asked how did you increase by townships, do you have individuals in mind, let’s say through the “pipeline”?  Ms. Plote said that she went back over the last five years and looked at what they have had.

            Mr. Metzger, Sr., said that he had a question on page 5, regarding the Illinois Dept. on Aging, $13.62 an hour.  Is there a point where you will be notified, as far as what they are going to pay? 

            Ms. Plote said that she has letters for next year that do not include an increase. 

            Mr. Metzger, Sr., then you don’t expect that there would be?

            Ms. Plote said that last year they had  $12.62 because they had not been notified when they were in front of this committee, so it does sometimes come afterwards.

            Chairman Rosemier said that he took the 35 referrals and divided it into 12,000 hours over 52 weeks, and it looks like an average of 8 hours per week, is that right?

            Ms. Plote said that this number sounded right.

            Chairman Rosemier said that you determined your services to equal $23.02 an hour.  He is always concerned about how much actually goes to the care. 

            Ms. Plote said that for the majority of their services - there is not a margin for just about anything.  In the last couple of years they did a really detailed analysis of everything that they do.  It was important for them to know what services they would be able to provide financially and which ones they could not.  That’s where the number came from, there is not margin for anything.

Voluntary Action Center – Transportation and Meals on Wheels

Request:  Voluntary Action Center – Transportation request is for $85,000 for FY07 transportation services (Trans Vac and Med Vac).  This request will fund 7,000 rides at a cost of $12.14 per ride. Costs were calculated by dividing total transportation costs by total number of rides provided.

Voluntary Action Center – Meals On Wheels request is for $90,000 that will be used to provide 12,000 meals, which will purchase 20% of Meals on Wheels services for DeKalb County residents.  Service will include a combination of noon, evening and weekend meals in addition to dietary supplements.

Mr. Tom Zucker, Executive Director of the Voluntary Action Center, and Ms. Ellen Rogers, thanked the committee for continued support of their services and for the Senior Services Tax Levy. 

Hospice

Request:  Hospice is requesting the amount of $3,988 to support an average of nine (9) senior home-based Transitions clients per month.  The average time spent by the Transitions Coordinator on case management and volunteer supervision per client is two hours per month at $18.00 per hour.  The request also includes $100.00 for the Transitions portion of the Direct Care Volunteer training (two trainings/year).

As mentioned before, no Medicare reimbursement money can be used for Transitions.  The Transitions program depends solely on donations, grants and fundraising.  DeKalb County Hospice’s affiliation with Kishwaukee Health System (KHS) has made it possible for DCH to be Medicare certified, as the Medicare reimbursement does not come close to covering the cost of providing hospice care.  This continues to be a nationwide phenomenon.  Since our Medicare certification, KHS has augmented the DCH budget.  It is the goal of KHS and DCH for DeKalb County Hospice to become financially self-sufficient, even with the discrepancy in the reimbursement amount.  Fundraising, grants and donations alone have not made up the Medicare reimbursement discrepancy. The staff of DCH has worked hard to lower costs and increase funding.  They have been successful and are closer to having expenses and revenues being equal.

Prairie State Legal Services

Request:  Prairie State Legal Services is seeking $5000.  These funds will be used as match and supplemental funding for the $4,985 grant from Northwestern Illinois Area Agency on Aging and funding from Legal Services Corporation.  Funds are used for salary, benefits, and pro rata share of telephone, mileage, supplies, insurance, occupancy and related costs. At least 45 DeKalb County senior citizens will apply for legal services and 40 will be found eligible for services after an interview by an attorney.  Legal Advice will be the primary service provided for 30 seniors.  Legal representation or the drafting of legal documents will be provided to at least 10 seniors including seniors at risk of institutionalization.  Prairie State will provide approximately 200 hours of legal services to seniors.  Legal representation will resolve elder abuse issues and decision-making issues in approximately 7 cases.

             Ms. Charlene Riefler, Project Attorney for Prairie State Legal Services, said that the senior service work has increased in DeKalb County regarding elder abuse.

Barb City Manor

Request:  Barb City Manor is requesting $7,956.00 in funds that would assist an average of 3 residents per month for 1 year of service (36 months or units of service) at an average cost of $221.00 per service unit.  Cost of service will vary with financial need of the senior.  Current Section 8 subsidies vary from $27.00 per month to $314.00 per month.  The number of residents assisted and the dollar amount of assistance would not be so great as to exceed the requested amount in the year’s time.  Residents must be able to pay for the majority of their monthly cost of living at Barb city with an average cost of $1,073 per month.  This is done through monthly social security, pensions, interest or savings.  Assistance from Barb City Manor’s Resident Endowment Fund may also be requested.  Barb City’s Endowment Fund is currently $108,556. Residents are receiving $770.00 a month from this fund, which is over the amount the fund is earning in interest.  Residents with very low income or those who have outlived an annuity or other investment sometimes need assistance from more than one source.

Fox Valley Older Adults

Request:  Fox Valley Older Adults Services Agency is requesting $60,000 to provide 21,993 units of service; with 20,241 of that total provided to clients at the DeKalb Day Services unit and 1,752 provided at the Sandwich Day Service.  The facility in DeKalb currently has a client base of 14 residents per week and our facility in Sandwich services 4 DeKalb County residents weekly.  

            Mr. Alan Zaeske, Executive Director of the Fox Valley Older Adults announced that he will be leaving in May and he then introduced the new Director, Ms. Abigale Bruns. 

            Chairman Rosemier asked if they had received funds from other sources that are not reflected in the project budget?

            Mr. Zaeske said that funds identified are going into their General Fund and are not earmarked for any specific purposes.  The reason is that their history has been threatened financially.  Two years ago, he discovered that the IRS was after them for $90,000 for unpaid taxes, that he had $60,000 in bills laying on this desk and he first paycheck bounced and the lines of credit were exhausted.  They are not out of the woods, by any means, but they are now solvent with their net revenues being positive.  They came up with new sources of revenue and cost savings.   The DeKalb facility and the Adult Day Care Center’s number have currently increased by 30. 

            What is the differential between your private and public pay clients?  Ased Ms. LaVigne.    

            Mr. Zaeske said that in Sandwich it is 60% and less than 50% in DeKalb. 

            Chairman Rosemier asked Mr. Zaeske that on his budget he shows $110,000 raised by private pay and he can’t believe that 8 clients…

            Mr. Zaeske commented that some of those clients are 5-days a week, all day.  The rate for private pay is $32.00 for the first 4 hours and then $7.50 an hour additionally, with a maximum per day rate of $62.00 a day.  So, if a person is there 5 days a weeks at 40 hours, that is $300.00 a week for $1200.00 a month for each person that they are getting.   When they have the majority on state contract is when they “bleed”, said Mr. Zaeske.

            You show expenses at $186,000 and revenues @ $185,000?  Asked Chairman Rosemier.

            Mr. Zaeske said that on the revenue side he estimated it at today’s head count and that could go up and down.  Since he estimated that revenue, they lost 4 clients and none came back.  He wanted the committee to see what happens at his agency.

Mr. Zaeske also informed the committee that if they have a 30% increase again this year, that they will be out of space at the DeKalb location.  They will be talking to Kishwaukee Hospital to rent space there in the amount of 1800 square feet.  The problem they could run into is that they rent will be too high, he doesn’t know yet. 

He appreciates whatever amount of money that the committee can give his agency.  Because of the space issue at the DeKalb facility he is asking if the committee could see if they could raise his rate just a little bit this year?  Mr. Zaeske thanked the committee for their consideration.

DeKalb County Health Department

Request:  DeKalb County Health Department is requesting $26,978 to subsidize approximately 287 home care medical visits to 45 medically indigent DeKalb County senior citizens.  Medically indigent individuals are those not covered under Medicare and who are non-insured or under-insured.

Before adjourning Chairman Rosemier reminded the committee that they would be meeting again on Monday, April 9^th to discuss the funds that will be awarded to each agency.  He also reminded them that the fund line item does have funds that have been unspent from the last two years totaling roughly $41,000.00.

ADJOURNMENT

            Moved by Mr. Metzger, Sr., seconded by Mr. Stoddard, and it was carried unanimously to adjourn the meeting.

                                                                Respectfully submitted,

                                                                ______________________________________

                                                                Chairman Robert Rosemier

_________________________________________  

Mary C. Supple, Secretary