Geauga County Mental Health and Recovery Services Board (GC-MHRS) - July 19, 2023
Meeting Details: Regular monthly meeting, July 19,2023 at 6:00 pm at the Board offices located at 13244 Ravenna Rd., Chardon, OH 44024. In person only. No recording. No agenda available in advance on the website or social media but agenda is available through a request to Teresa Slater by email at tslater@geauga.org
Public Comment Policy: No formal policy but in practice public comment is permitted at the end of the meeting.
Board members attending: Chair, Steve Oluic; Vice Chair, Alberta Chokshi, Secretary Jimmy Lee Holden, Treasurer, Mike Pertuziello. Board members: Reba Dykes, Marty Fay, Kathy Johnson, Carolee Lesyk, Douglas Lundblad, Greg O’Brien, Patricia Varanese. Absent members: Ann Bagley, Mary Ruth Shumway.
Staff members attending: Executive Director Christine Lakomiak, Secretary/Receptionist Teresa Slater, Finance Director Jim Mausser.
Service Providers: Representatives from service providers including Ravenwood Health, Lake-Geauga Recovery Center, NAMI Geauga, Signature Health, Catholic Charities, and WomenSafe.
Guests: Several members of the general public, including Linda Miller, a previous board member, and Kathy Franz, LWVG Observer.
Call to Order, Roll Call, and Pledge of Allegiance occurred as listed on the agenda.
Minutes from the June 21, 2023 meeting were approved.
Swearing in of New Board Members - Douglas Lundblad and Patricia Varanese were sworn in as new Board members as was Ms. Dykes, who is beginning a new term.
Ms. Varanese and Mr. Lundblad introduced themselves. Ms. Varanese stated she has had a long career in social work with several area non-profit organizations and Mr. Lundblad said he is a veteran who has worked with veterans and is interested in improving coordination between Veterans Affairs and mental health services.
Chairman’s Report:
Board Chair Oluic welcomed participants. He noted he would discuss a number of items later in the agenda.
Executive Director’s Report: Ms. Lakomiak reported on these items:
Michelle Maneage has been hired to fill the Clinical and Compliance Manager position. She starts in August. Ms. Lakomiak shared some of Ms. Maneage’s background, which includes involvement in Doors of Hope Geauga homeless shelter and faith-based activities in Geauga County. Reviewer Comment: Ms. Maneage’s credentials and experience are listed on the Doors of Hope website.
The Director appeared in front of the county commissioners a few times in the past month. A renewal levy will be on the November ballot. It will be 0.07% for five years. Ms. Lakomiak is planning to get meetings going soon to work on strategy.
Ms. Lakomiak stated that In the SFY2024 State Budget, Behavioral Health was well supported. Some line items previously taken out but were put back in thanks to advocacy. At the State level, an increase in Medicaid rate of 10% was approved. It has been the same since the 1980s and other services will get additional increases as well.
At the local level, the Board has been talking about a one time unit increase for SY23 only. This discussion has been on-going since before Ms. Lakomiak’s arrival. The increase of 5, 8 or 10% will be decided at this meeting. See below.
A Request for Proposals for some state funding should be coming out in October. Ms. Lakomiak said she will keep abreast of developments and apply as appropriate.
Geauga now has several Health Officers trained and on board with Health Officer cards and can be used if someone needs to be involuntarily taken to the hospital for an evaluation. Reviewer Comment: For more information view both the New Business and Planning and Policies Committee sections of the May 17, 2023 Observer Report.
There was a brief mention of the Geauga Faith Coalition, which hosted an event in Burton on June 3rd. Reviewer Comment: It was confirmed through an email exchange with Director Lakomiak that the Geauga Faith Coalition has no formal affiliation as a provider with GMHRB but that Board member Kathy Johnson typically attends their events.
Committee Reports
Agency Relations Committee: Ms. Johnson no report. Meeting scheduled in August.
Finance Committee: Mr. Petruziello. New committee members. New dates set for next year.
Planning and Policies Committee - Ms. Chokshi had no report. First meeting is on September 12. They will go back and look at the prior 2 years and minutes in order to to look back before going forward.
Capital Planning/ Housing: Ms. Dykes had no report. These two committees were recently combined. An active schedule of meetings has been set. Ms. Dykes requested clear instructions as to the committee’s purpose.
Opiate HUB Committee: Ms. Miller had no report (Ms. Miller is still the chair even though no longer on the board)..
Board Review and Action Items: All approved unanimously .
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Resolution 23-07-1 Specialized Docket Allocation to Geauga County Court of Common Pleas. Board has received $75,000 for SFY2024 from the Ohio Department of Mental Health and Recovery Services. The Geauga County Mental Health and Recovery Services Board allocates $75,000 to the Geauga County Court of Common Pleas for the purpose of operating the Geauga County Drug Court.
By way of introduction, Mr. Oluic reviewed that the Board has been looking at raising SFY2023 rates retroactively for a long time. The shortfall between reimbursement rates and what it actually costs to deliver services is affecting provider agencies’ ability to retain and hire staff. Covid exacerbated the problem even more but it has existed for some time. The resolution calls for a 5, 8 or 10% rate increase, which is open for discussion,
Discussion followed. Some highlights:
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Questions were asked about funding this for the future. This resolution is one time, retroactive only.
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Questions were asked about why agencies needed money if they are “in the black”? Mr. Mausser explained the spreadsheet doesn’t indicate that agencies are “in the red or black.” It shows encumbered funds the board has budgeted that have not been fully expended or have exceeded the projected encumbrance for last year. Not billing to the amount budgeted does not give the agency more money. If anything, it gives the Board more money. Agencies only get what they bill for.
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Questions were asked about if and how the board monitors that all billing is up to date? Mr. Mausser explained that there is a method to monitor. Quarterly meetings and reviews of billing, to see if finances are varying from the predicted budget. For example, he said, if an agency projects $100,000/year in billing for a specific service, the board staff would expect to see about $10,000/month. Variances are discussed. It is very difficult to predict service usage for a whole year. There has been improvement in the timeliness of billing and it is consistently monitored.
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Several spoke in favor of supporting agencies and encouraging input from staff. Agencies all made presentations about their needs months ago. Ms. Varanese explained that this rate increase can favorably affect staffing as she said staffing is the albatross around every agency’s neck as it’s a competitive environment for hiring staff.
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Mr. Pertruziello asked Mr. Mausser to explain the spreadsheet from the board packet. Mr. Mausser explained the run date was July 10th so it is not yet billing for a full year. Billing is cut off for SFY23 in September. Extra time is allowed because in some cases, insurance must be billed first, so it takes awhile to know the final fee. Mr. Oluic stated, we don’t want to be reactive. Ms. Varanese stated, I am thinking the agencies are thinking we are going to do something. Mr. Oluic stated, we work together to meet the needs of our residents. There is competition to hire and retain staff. Agencies have spoken quite a bit about their needs.
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Mr. O’Brien asked some clarifying questions, which Mr. Mausser answered.
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Ms. Clark, CEO of Ravenwood, was asked what the money would do for them? Ms. Clark replied, the dollars would go to support the dollars already paid to staff. They already have expended over the budgeted amount.. Unit rate they are being paid does not cover their costs of providing each service. This will allow them to make headway trying to cover their rising costs of keeping staff.
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Other providers explained that some unexpended funds are left on the table because they cannot provide the service because they don’t have the capacity/staff. One stated: I need this board to function to do my job. We met 5-6 months ago and it was decided that an across the board rate adjustment was the way to go. Now some are questioning why an across the board rate increase is being proposed.
The question was called. A motion was made to give additional financial support to Catholic Charities, Family Pride, Lake-Geauga Recovery Centers, Ravenwood Health and WomenSafe and allocate to each agency an amount equal to 10% of GOSH claims billed by each agency in SFY2023 through run date 7/10/23.
Roll Call Vote:
Ayes: Oluic, Chokshi, Dykes, Fay, Johnson, Lesyk, Lundblad, O’Brien, and Varanese
No: Holden, Petruziello
Financial Reports
Mr. Mausser reviewed balances and stated all items are in the board packet.
Mr. Fay asked about unspent dollars, asking how does that work? Mr.Mausser explained the terminology encumbered and unencumbered. If at the end of the Fiscal Year (FY), unspent dollars become unencumbered and the money goes into the reserves.
Old Business
None
New Business
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Need for Mental Health Services at the Jail. Mr. Oluic had a conversation about this with the Geauga County Sheriff Hildenbrand.
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There is a meeting this week for providers called by DJFS to discuss the homelessness. Ms. Dykes stated that there are some who could be helped with “ a small lift.” All the county agencies are invited and are asked to address the issue and share resources each might provide. Ms. Dykes and Ms. Lakomiak will both attend.
Public Comment:
This observer asked for an explanation of the Geauga Faith Coalition initiative and its relationship to the GCMHRS Board. See Observer Report for June 21, 2023. Ms. Johnson explained it is not a function of the board, the board is a member, along with community faith leaders and others. It is open to all denominations. It was formed recognizing that people with mental health needs and addiction issues often approach churches first. The group has had some meetings at the Board offices. There is no financial exchange between the Board and the group.
Ms. Gutka, WomenSafe, mentioned that there is a pizza fundraiser going on tonight for WomenSafe in conjunction with a biker's night in Newbury. She thanked the Board for funding EMDR training and relayed that all six of the WomenSafe therapists have completed EMDR training.
A community member thanked the board and providers for work to support veterans.
Several agency directors thanked the board for the passage of the unit rate increase at this meeting.
Mr. Lundblad inquired whether providers ask clients if they are veterans. He went on to talk about a new Veterans Center in Oakwood. Providers responded that they do inquire about veteran status.
Adjournment - at about 730 PM .
Board Minutes: https://www.geauga.org/board-minutes/
Next meeting: There will be no meeting next month. The September Board meeting was not announced but it should be on September 20 , 2023 (third Wednesday) at 6:00 pm with no virtual option.
More Information: https://www.geauga.org/
Observer: Kathy Franz
Editor: Anne Ondrey
Reviewer: Gail Roussey
Date Submitted: June 26, 2023
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