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HomeMy WebLinkAboutMinutes 1987EVANSTON MENTAL HEALTH BOARD Meeting Minutes January 8, 1987 (Minutes Approved) Members Present: Hones (Chairperson), Buren, Remo, Nelson, Graff, Leggett* Members Absent: Lynch, Jones Staffs Fox, Savor, Carpenter. Lim, Pappas, Zimorman Comm u n I ty Representatives: Chris Pasinski, Sherman Brown (ACORN); Nancy Smiegorskl (Association House); Jean Mltheli, Jeanne Hanford (Alliance for the Mentally 111); Heien Lome (First St") Georgette LePage (Evanston Hospital/Dept. of Psychiatry) i . I ntrnduct l ms/Comments Carol Hones, Chairperson, called the meeting to order at 7135 p.m.. and asked members of the audience to introduce themselves. Ms. Hones gave acknowledgement to Gone Weiss, and read his letter of resignation that was sent to Mayor Barr. She read a resolution and a placque honoring his participation as a number of the Mental Health Board. II. Minutes ot_Cctnber 30 and Nnvmeher 13, 1986 &0±1= Ms. Graff moved to accept the minutes of October 30, 1986. Mr. Ream seconded the motion. Motion passed 6 yes, 0 no. Ms. Herres requested a reorganization of information relating to the Mental Health Board appeal process in the November 13, 1986, minutes. Ms. Nelson moved to accept the minutes as corrected. Mr. Leggett* seconded the motion. Motion passed 6 yes - 0 no. Ill. EvaluatlQn of Funding Guidelines, Allocation Process and Agoeal Process A. Funding Guldelines. Ms. Nelson indicated that the Committee was pleased with the Mental Health Board's positive responses to the survey about the funding guidelines and the allocations process. There was consensus about the use of the guidelines and criteria for next year's allocation process, The Board requested that Commmlttee pursue the develop- ment of Its recommendations about changes and modifications in the guidelines. These will be brought back to the Board for approval. B. Appeal Process. Ms. Fax reported that Human Services Committee was requesting recommendations about the appeal process which Is utilized by the Mental Health Board for Its funding allocations/decisions. Discussion Included the following: An appeal should focus upon an agency's concerns and new Information not available at time of hearing, or that it was dealt with unfairly, and not Just that it needed more money; it Is unfair for 3 agencies heard only by the Mental Health Board to have to appeal to the Board; the tight time constraints of the Human Services'Committee's -2- timetable for their budget recommendations make appeals difficult to City Council. Any appeal might change the Mental Health Board budget which had already been submitted; any docission to change an agency's funding could result In another agency being cut, and then they have the right to appeal. Because Human Services Committee Is the final authority, an appeal to the Mental Health Board Is not necessary. Ms. Nelson moved that a recommendation be made to the Human Services Committee that the appeal process for funding allocation decisions for the Mental Health Board be conducted only through City Council. Ms. Graff seconded. The motion passed i yes - 2 no. Ms. Hones requested that any Board members who had not already sent in their evaluations of UBP to do so at once. IV. Mal Health Board Management Information System (MIS) Mr. Saver Introduced Marllyn Zimmerman, a student who is working on her Master in Business from Roosevelt University. She Is acting as a consultant on the development of MIS for the Mental Health Board. She indicated that they had been locking at the current information system to analyze the Information needs, and who uses what information, in order to begin to design a program to be Implemented on the computer. Mr. Saver said that the Introduction of an MIS for the Board was a developmental process, and would mix reflect the Information which was being collected from agencies. In response to questions, Ms. Fox Indicated that the development of an MIS was a M B objective for 1987-88, and was being Implemented to provide consistency, reliability and validity of the data which is being collected quarterly. As the system develops, it will be able to provide a better picture of the utlllztlon of, and needs for, services In the community. Mr. Saver indicated that staff time would be saved, in the future, in reporting on agency information for budget allocation purposes. He will provide updates about the development of the system as there is progress to report. V. Rghert Mood Johnson Foundation Proposal for Mental Health Services Development Program Ms. Fox presented background on the need for a unified system of care for the chronically mentally ill (CHI) in Evanston. In addition, community agencies have Identified unmet needs for the population: continuous case management, housing, workshop and Job activities, social activities. She has been working with a group of agencies to develop a grant proposal to the Robert wood Johnson Foundation in order to design a system for complete care with additional services. Ms. Fox indicated that the Board's endorsement was needed for her to continue the grant development process, and to plan on using the Mental Health Board as a conduit for the funds. The grant would be used to develop the system; additional funding sources would be soliclted for services. The foundation has not ruled out any possible use of the funds. In addition, Department of Mental Health has expressed Interest In working with Evanston to have local control over some hospital beds for Evanston residents. No details for the grant were available due to the newness of the process. -3- Ms. Hones Invited cos■ients from community members about the concept of the granti Shermar Brown (ACORN Participant). Need additional financial supports; more transitional housing to help people move to a more stable living arrangement. More structured activity for times when there are no workshops or training scheduled - those are very critical times. Goorgette LePage (Service provider perspective). Individuals with rental health problem In the community get squeezed - as they get better, there are fewer funds available to them to sustain themselves In the cowwunity. Critical need for sources for In- dependent living, vocational training and placement and additional support systto ensure that the person does not slip back and have to return to the hospital. Ms. Fox clarified that if the Mental Health Board endorsed the pursuing of the proposal they could be responsible and acccvuntah!4 for the grant programs and funds If received. A similar project design had previously been agreed to by City Council and by the City for the ESgln grant. Ms. Hones pointed out that the project gave Mental Health Board the opportunity to further coordinate the network for CMI. Graft and Nelson expressed concern about.the ability of the Mental Health Board agencies to provide a 1/3 match of funds which would be needed for the grant, and also how the community could guarantee that, after the grant expired, It mould be responsible for the expanded services. Graff and Hones asked for clarification from staff of the section on use of grant funds: "grant funds may wt be used to pay for patients care or renovation of facilities..." Graff further requested from staff a method of monitoring the population to be discharged Into community during the project, so that discharges from the hospital did not increase with successful treatment in facilities in the community. Mr. Buren moved that the Mental Health Board approve, at this time, to be the conduit of funds for the proposed grant to the Robert Mood Johnson Foundation, and to allocate staff time up to 16 hours a week to facilitate the development of the project ant the gran tproposal. Mr. Leggette seconded. Motion failed 3 yes - 3 no. Ms. Hones moved that the Mental Health Board agreed to the concept of being the conduit of funds for the grant proposal to the Robert Wood Johnson Foundation, and to request staff to begin to draft a proposal and present at the February meeting a description of the proposed project and how the funds would be used, Mr. Buren seconded. Motion passed 6 yes - 0 no. > Youth Services. The Human Services Committee Is continuing its consideration of a coordinated approach to services for youth. The com,Ittee convened by Helen McCarthy has been meeting to identify the issues to be dealth with, and Is In process of de- veloping recommendations. Ms. Foam attends these meetings and works on issues as needed. -<- > Forensic Issues. Ns. Nelson indicated that the verbal agreement with long term care facilities continued to be acceptable, at this time. The committee will continue to research the ways In which other commiunitles are handling the issue. > Substance Abuse. Mr. Leggett* reported that the Evanston Substance Abuse Prevention Council has been working with an organizational consultant to reorganize Its activities, and to get more involvement from community agencies. The group wlII be planning a spring event. > State Proposed Long Term Care Standards for mental health facilities: Specific screening criteria will not be included. These proposed standards are a replica of our focal standards but different staffing patterns. Ms. Foxc ropoorted that Ms. Graff and Ms. Nelson are reviewing and evaluating the standards being proposed. > Monthly Staff Reports. The Board requested that future staff activity reports provide information only for the most important staff activities for the month, and be organized by goals for the Mental Health Board. > Personal Issues. Ms. Hones appointed a Personnel/Evaluation Commm l "oe of the following: Lee Loggette, Ann Graff, Carol Hones. Meeting adjourned at 10:05 p.m. Respectfully submitted, 4J!an neFoxutive Director EVANSTON MENTAL HEALTH BOARD MINUTES February 12, 1987 (Minutes approved) Presents Carol Hones (Chairperson), Janice Jones, Ann Graft, Alderman Davidson Ream, Marcia Nelson, Lee Legg9tte, Jack Lynch Absenti Michael Buren Staffs Jeanne foot, Harvey Saver, Melissa Pappas, Carolyn Lim CowunIty Ann Eskra (League of Women Voters), Sue Ebersold (ACORN), Represontatives: Marge Sondler (Mental Health Association) i. I[Ilroductlons Carol Hones, Chairperson, called the meeting to order at 7:45 p.m. and asked members of the audience to Introduce themselves, Ms. Hones reviewed the agenda and added consideration of additional monies for Human Services, and Long Term Care Issues. Ms. Graff made some changes in Section V of the January 8th minutes regarding the Robert Wood Johnson Foundation proposal. Mr. Ream moved to accept the minutes of January 8th, 1987 as amended. Ms. Nelson seconded. Motion passed unanimously. Harvey Saver gave an overview of the contracts and the collection of data from agencies via accountab111ty forms. The contract format Is standardized for all the agencies, although the content Information may differ. An emphasis Is given to the financial Information and program information for monitoring purposes. Consistency Is important for both the City and the Mental Health Board. The Mental Health Board staff monitors all contracts. Section J of the contract becomes a base for the accountability forms. The Management Information System (MiS) will provide both the financial Information and program Information by giving feedback to the Board about the volume of services. Mr. Leggette asked If MIS will provide a historical file. Mr. Saver stated that the MIS will have the capacity to pull the information together on a year to year basis for com- parison purposes. Melissa Pappas explained some possibilities In creating and using new report forms with the Management Information System. Four forms were distributed and discussed. She stated the major advantage of using the MiS is that we can look at the historical file, trends of activities, and classification differences across agencies. • • . -2- IV. Performance Contract Prnlect Mr. Leggette stated that Ms. Jones and he reviewed the performance contract pilot project and concluded that performance contracts are not workable for the Board. The reasons not to develop performance contracts ares 1. Mental Health Board budget Is very limited. Using performance contracts would mean limiting the number of agencies that we can fund. 2. Performance contracts require an enormous amount of staff time to monitor. At this time It Is not feasible. We already have one element of performance contracts through the developamt of performance objectives. Accountability for public funds Is our goal and each year we are taking steps toward obtaining more reliable data from our agencies. V. Palley Guidelines The Board reviewed the Policy Guidelines for contracts which were significantly revised last year. Ms. Hones asked about how Mental Health Board monitors current client record keeping. Ms. Four responded that the Mental Health board staff currently has no system to monitor client record keeping within agencies. Alderman Ream moved that the Policy Guidelines as edited be approved. Ms. Jones seconded the motion. The motion passed 7-0. VI. Additlenal S15.750 fgC Human SeCvlces Prnjar= All existing agencies will be able to apply for these additional funds requested by the Human Services Committee from City Council. Ms. Graff moved to allocate $10,000 to Family Counseling for child abuse. Ms. Jones seconded. The Board discussed how it could participate In the decision making process for allocation of these monies. In discussing the motion, Mr. Leggette commented that Mental Health Board needs to be consistent regarding funding recommendations. The Mental Health Board needs to look at all those agencies we have cut and to explore changes In other agencies. Hs. Jones recommended that we look at the agencies that appealed. Ms. Graff commented that Family Counseling has been cut by OCFS and that the SI6,750 Is a different pot of money. The vote on the motion was: 2 yes, 4 no and I abstain. Mr. Lynch recommended two considerations for making recommendations for the allocation process: 1. Consider those agencies who received cuts. 2. Consider those agencies that did not get what they asked for. Human Services Committee has asked Helen McCarthy to send letters to the agencies requesting their current financial status. The Board recommendations need to be made after receiving the agencies' requests. -3- The Board requested staff to have a list of agencies that have received cuts and agencies that did not get what they asked for for the next Board meeting. Staff was directed to communicate to the City's Unified Budgeting representatives and the Human Services Committee their process and timetable for making recommendations. VII. Bylaws RsXlslon The Board reviewed the draft bylaws line by line and made revisions with a request for clarification of Section 3 and 6. A revised draft will be ready at the March Board meeting. Vlll. Long Tjrm Care Issues The Forensic/long Term Care Committee recommended that the committee be disbanded, and that the entire Board be Involved in the review of long term care Issues, due to the importance and complexity of the subject. Ms. Hones recommended that an In-service training on long term care be provided at the next meeting to understand and to explore the Issues of long term care as they affect our target population and what they mean to the Mental Health Board. IX. Robert KQW Johngon Foundation Praoosal (NJF) The Board revived a progress report prepared by Ms. Fox. She has been meeting with the executive directors of agencies/programs working with individuals who hey,, a mental illness in the community. All participants have agreed that the process has been very effective In opening up communication and clarlfying the issues which need to be resolved. The Board requested a monthly progress report from his. Fox. X. Informational Items Ms. Graff moved to approve the proposal fc- !"antal Health Board staff to provide leadership for a public hearing rn developmentally disabled Issues and possible legislation. Mr. Ream: seconded. The motion passed unanimously. Ms. Jones moved to adjourn the meeting. Ms. Nelson seconded. Meeting adjourned at 10:23 p.m. Into an executive session regarding a personnel utter. Respectfully submitted, i . s ox tive Directo r MENTAL HEALTH BOARD MEETING f1INUTES iARCH 1 1 , 1987 (Minutes Approvod) Present: Carol Hones, Janice Jones, Ann Graff, Aid. Davidson Ream, Marcia Nelson, Lee Leggette, i11chael Buren Absent: Jack Lynch Staff: Jeanne Fox, Harvey Saver, Melissa Pappas and Carolyn Lim Community Representatives: Sue Ebersold (ACORN), Margo Sondler Mental Health Association), Helene Lome (Ist Step), Shirley Dare U CORN), John Buckley (Family Counseling). Carol Hones, Chairperson, called the meeting to order at 7:45 p.m. i.linutes were approved with corrections. I -lotion passed unanimously. Ms. Fox presented an overview of the tlontal Health roard's role In long term care Issues In the Evanston community. The role of the Mental Health Board as stated in the Evanston Long Term Care Ordinance are twofold: 1) to determine if a social work applicant meets the guidelines for a Master Degree waiver, Z) to monitor and sign off on skill development training for specific staff groups In facilities serving our target populations. In addition the Pealth Department utilizes the Mental Health Board Staff as consultants regarding mental health issues In long term card facilities. She then explained how long term care was regulated and funded. Sharon Harris, Director of Community Health Promotion for the Evanston Health Department joined the Mental HealTh Board to explain the City's Long Term Care Ordinance and the role of the Health Department in monitoring long term care facilities. The State Long Term Care Ordinance, which Is monitored by the Illinois Department of Public Health, sets minimum standards for long term care facilities. The Evanston Long Term Care Ordinance incorporates the State Ordinance and adds additional standards which must be met by facilities. The State Department of Public Health has delegated the State Licensing Authority to the Evanston Health Department. The long term care facilities cannot receive a State license unless they have received an Evanston license. Based on its licensing and Investigatory powers, the Evanston Health Department can assess fines for violations. The State may also Investigate a violation and assess a fine. She explained how the Health Department assessed violations, determined penalties and Implemented the process for correcting violations. She ex- plained how the City's Health Department inspected, Ilcensed and monitored -2- facilities for the State Department of Public Health. The role of the Mental Health Board under the ordinance was explained. !ds. Henes thanked ids. Harris for Joining the Board for this discussion and stated that this was one of two meetings when the Board will be focusing on long term care issues. At the April meeting, Rldgevlew owners and staff will Join the Board to talk about their facilities and how residents' needs are planned for and met within the facilities. Sillz� ■ W i•. . L •.n.nM@F .j . ■ 0-T : •ua 16FILTEW- OT .,. 111111 .� ■ n-0 The Funding Guidelines Committee of the Board presented Its recom- mendatlons for allocations as follows: Family Counseling Service /Child Abuse 55,000 ACORN - Drop -in Center 54,950 Evanston Comprehensive Drug Treatment Program $2,300 'dental Health Association 52,000 North Shore Association for the Retarded 52,500 The Committee stated that these recommendations were based on changes In service or funding that have occurred since allocations In November. Each agency submitted a proposal to the Departmont of Health and Human Services outlining significant changes affecting the agency. The allocation process Involves sending the Mental Health Poard recommendations on to the City's Unified Budgeting representatives, which will then submit recommendations to the Human Services Committee. Ms. Nelson moved to forward recommendations as presented. She also moved that the recommendations state the Mental Health Board priority ranking. Motion passed unanimously. The meeting of the Funding Guidelines Committee was changed from March 30 to March 31 at 7:30 p.m. A draft of funding guldlelnos will be presented at the April "ental Health Board meeting, and will go to agencies for review In May. • •r. . i.I a F.T11;-.• The purpose of this group was to got surrounding communities to work together to create a regional housing committee to address housing needs of special populations in the Northern suburbs. The Committee didn't accomplish Its desired goals. The Committee agreed they need more grass -roots support, and Input from elected officials In other communities to accomplish Its purpose. Ms. Henes asked the Board to review recom- mendations of the Committee. -3- 1•Is. Nelson moved that the Manta I lira I tth Board thank all those persons who worked together to focus on this Issue, particularly Marge Viold and her Committee, and pledged to assist in any fray possible the activities toward the goal of regional planning for housing for persons with sp*clal needs. Motion passed unanimously. Vl. Unified BUdoetln0 Evaluatlgn and Report Ms. Henes asked for an additional Mental Health Hoard representative to attend the Unified Oudgeting Process evaluation meeting with her on March 19, 1987. Lis. Belson agreed to attend. The issues to be addressed at the March 19 meeting Include: the purpose and effectiveness of UBP; current appeal process; process issues such as agency presentations before UBP, representation of Mental Health Board on U6P (regular/consistent reps or rotating). t1s. Hones stated that the Issue of rotating or consistent representa- tion at UBP meetings needed to be discussed. There have been UBP members who feel that rotating Mental Health Board representatives hinders group process. The 3oard discussed their representation on UBP Panol and agreed that the current system seems to be working well for them as this Is their only budget process. VII. Bylaws All Board members were pleased with the result and thanked those who contributed to the effort. Some minor technical changes were approved. The amended Bylaws will be presented at the next meeting. Motion to accept the Bylaws as emended was passed unanimously. 11r. Buren will review current (dental Health Board policies and make recommendation at the April meeting. Ms. Graff will review and edit Mental Health Board Ordinance and will present recommendations at the April meeting. VIIl. Informatigpgi Items A. Illinois Qgoar_tment of Mental Health and Developmental Disabilities. 1 Di•1HDD ) Ms. Fox told the Board about the proposal to change acute hospitali- zation for Evanston residents from Elgin Hospital to Read Zone Center. She stated that there are many issues yet to be negotiated. The State sees this as a positive change, but ?Is. Fox expressed concern over benefits for the community. She will present more information at the April meeting. B. Substance Abuse Conference 1r. Saver briefed the Board on the proposal for logislsative forum to be held on i,lay 1, at the Civic Center in regards to substance abuse. Repre- sentatives from advocacy groups will also be there to presnet group's perspective. 9 -4- C. Developmentally Disablad (DD) Hearing Mr. Savor informed the Board about a forum to deal with Issues of OD which will be held April 15 at 7:00 p.m. In Palatine. The forum is co- sponsored with Parents Association of Handicapped Citizens. Lee l.eggette agreed to represent the Mental Health Board and participate In the hearings. Fleeting adjourned at 9:55 p.m. Respectfully submitted, Q� J no M. rox kf . Ww—wIV TAL. HEALTH BOAFZr3 MEETIM MIM[1TBS PAMUL S. 1967 (Mnwtes approved) PRESENTS Carol Hones. Ann Graff, Jack Lynch, Marcia Nelson Michael Buren. Lee Leggette, Bonn Greenspan (not yet confiread) ABSENT: Ald. Davidson Roam. Janice Jones STAFF: Jeanne Fox. Harvey Saver. Melissa Pappas, Carolyn Lin COMMUNITY REPRESENTA- TIVES: Marge Sondler (Mental Health Association of Evanston); Sue Ebersold. Patrick Cunningham. (ACORN); Darlene Wheat (SHORE); Helen Loss (First Step); Ken Mocko (DMHDD); Harriette Cross, Carl& Esser (Northwestern University students); Mary Aran Conte, Bonnie Broeseit. Clauden K.ircheclager (Evanston Ridgeview); Sidney Weinschneider, Abe Sova. Jay Sova. Trudy Gast. (Dunhill and Spencer, Ltd.) I . �rtt rodiact i otr Carol Honer, Chairperson, called the meeting to order at 7:35 P.M. She introduced Bonn Greenspan, who was recently appointed to the Mental Health Board (confirmation pending). Me. Graff moved that the minutes be approved as corrected. Ms. Nelson seconded. Motion passed unanimously. 2.Is (a) Ridgeview Long Term :.are Facility No. Fox Save a summary of recent changes in the programming and community relations at the Ridseview. She introduced the now facility owners, from Dunhill and Bradstreet, Ltd. They introduced the Evanston Ridgeview administrative staff who were present. They provided an overview of their experiences Ora in providing health cars. Ions term care, and programming for Individuals with mental illness and developmental disabilities. They also summarized their initial impressions of the Ridssviev. A Question and Answer session with the Board followed. Qs What maJor problems have they discovered in this Initial period? As (1) Lack of programming. with residents having too much idle time; (2) The physical plant is shabby and needs refurbishingi They have already made a "goodwill" capital Investment of $100 , 000 ; (3) The facility has had poor public relations and interaction with the community. They are holding com- munity meetings, doing outreach to invite people in. and beginning to work with community; (4) There is an inordinate amount of employee turnover. Inservice training and employes programme are beginning to be provided; (5) Their reimbursement and staffing is based upon a geriatric model. They are beginning to move toward a psychosocial model. Q: What now programming have they been providing? A: Nov psychosocial and community reintegration programs. Small, structured groups to provide remotivation In activity of daily living skills, socialization. com- munication skills. personal care and grooming. Q: Will the Ridgwview provide enough activities to talcs the strain off the community? As The residents at the Ridseview will always need to make use of community resources and activities. These re- sources are appropriate and requisite in order to effect community reintegration. Currently 73 out of 425 at the Ridseview are going in to the community for services; more outside services and transportation are needed. In some cases, people in the Ridseview are scared to go in to the community for services. Q: What plans or chanson are planned for the Ridseviev Pavilion? -3- A: Initially, they are focusing upon improving the quality of life for all their clients. They do not yet know how they will begin to address problems for individuals with developmental disabilities. In the next month, they hope to have a better idea of the future of their programs for developmental disabilities. They have already started programs In occupational therapy. physical therapy and daily living skill training. (b) Illinois Department of Public Health Proposed Nov Level of Care for Intermediate Care Facilities for the Mentally 111. Me. Fox presented a comparison of what the new standards would require in comparison to Ridgeview's present staffing configuration. Ms. Fox also indicated that she is assisting the Ridseview with development of a grant to provide a special unit to deal with crisis intervention, for the comimunity and for the Ridgeview. The unit will offer structure and control for Individuals who are de-compensatins. not taking their medications, and/or their be-havior is beginning to escalate. The obJective is to reduce inappropriate utilization of beds at Elgin and private hospitals. If individuals require hospitalization, they will not be able to stay at the Ridanview. Iv. Fundy_ guidmllmes Jack Lynch Gave an overview of the Funding Guidelines Committoe process and recommmndations with rationale for each change. He then led the group through each recommended change. After a brief discussion of the difference between weighting the Service Area/Mandated Population Score 50% or 80%. Jack Lynch recommended that the Service Area/Mandated Population criterion be weighted 80%. This would provide more discrete differences between programs. Michael Buren moved with a second by Marcia Nelson that the Service Area/Mandated Population Score be weighted 80%. The notion passed unanimously (6-0). The Mental Health Board then considered how volunteer services or community education would be handled in the Service Area/Mandated Population scale. After a brief discussion it was determined that the Board needed to focus on its new definition of Counseling and High Risk before determining -4- how to handle volunteers and community education. Ann Graff moved with a second by .Tack Lynch to accept the Funding Guidelines recommended definition for Counseling and High Risk which are: > Counseling (Service Area) The.provision of corrective, therapeutic services to individuals In the community, through trained. paid/non-paid staff, In order to intervene in. and alleviate, conditions that contribute to individual and/or family stress or individual dysfunctioning. Program Components: 1. Services to provide Intake, evaluation, diagnosis. and development of treatment plan; 2. Capacity to respond to crisis and to provide emergency response to explosive situations; 3. Capacity to provide response to marital conflict, parent -child relationship problems, impaired social functioning, emotional problems and life --stress situations; 4. Availability of other supportive services. directly or through referral. > High Risk (Population) Individuals or families who have recived no formal mental health diagnosis. and for whoa a lack of services may lead to deterioration oP emotional. physical or psychological well-being, or threaten one's ability to be independently sustained in the community. Situations may include problems in parent - child and/or family relationships. impaired social functioning. emotional problems. Lee Lessette stated he wanted to caution the Board that we have the responsibility of serving all our target populations and that these numbers should be utilized as a tool to help us make decisions. Ms. Graff stated that these funding guidelines would be utilized only as a tool to help make decisions. never to dictate the decision. Mr. Lynch stated the Funding Guideline Committee agreed and is recommending that these guidelines be used the same as last year. -b- The Board then returned to its discussion of determining Program categorise for Mental Health Association of Evanston (NUE) Volunteer Program, MHAE's Community Companion Program and ACORN's Volunteer Program. Jack Lynch moved with a second by Lee Leggette that MHAE's CommRunity Companion Program be Counseling MI - the same as last year. The motion railed. (2 yes. 3 no. 1 abstain). Jack Lynch moved with a second by Lee Leggette that ACORN's Volunteer Program remain Day Treatment/MI. The notion failed (2 yes, 3 no. 1 abstain). Marcia Nelson moved with a second by Ann Graff that ACORN's Volunteer Service be Support Service. The motion passed ( 3 yee, 2 no. 1 abetai n) . Marcia Nelson moved with a second by Ann Graff that MHAE'e Volunteer Program be a Support Service. The motion passed (3 yes. 2 no. 1 abstain) . Marcia Nelson moved with a second by Ann Graff that MHAE's Community Companion Program be categorized as Support Service. The motion passed ( 3 yes. 2 no. 1 abstain). Mr. Lynch stated that he hoped ACORN and MHAE would help the Mental Health Board to reconsider these decisions by providing more information and that all agencies should feel free to appeal their categories. Jack Lynch moved with a second by Marcia Nelson. that the Funding Guidelines be accepted as amended. The motion passed unanimously (6-0). Mr. Lynch then suggested that when the amended guidelinws go out to agencies for review and comment. that a sample computation of the score of each agency program be made based on last year's data to assist agencies in knowing how changes will effect their score. After a lengthy discussion the Board decision was to only send the Funding Guidelines as amended to the agencies. Me. Graff commended the Funding Guidelines Committee and staff for its excellent work. ...a_ T ♦ 1 Ms. Hones presented issues and recommendations from the UBP Comwitteo for a more effective budgeting process. 1. The Board agreed with recommendations about meetings to do community planning and develop collective priorities for negotiations between funding sources. 2. The Board agreed to attempt to have consistent re- presentation at UBP hearings but thinks that it is important that the entire Mental Health Board be in- volved in UBP. 3. The Board indicated that it has already developed a list of priorities for the purposes of funding. These will be used in working with the other funders on community priorities. Ms. Fox indicated that there has been no change in the situation she described in her meno. She will be working with providers in the community to respond to DMHDD's plans. and to recommend. from the community's perspective. the best way for plans to develop. V311. ! I of al iiea� t h Board E nedi i Ms. Graff moved that no changes be recommended in the Ordinance. at this time. Mr. Lynch seconded. Motion passed unaninousl y. Iarormetional: Michael Buren indicated that due to his increase need to travel for his work, he was planning to resign from the Mental Health Board. He expressed his regrets and wished the Board wall in all its endeavors. Meeting adjourned at 10.15 p. no. Respectfully submitted, 0jigm-0 b I �?� tAnno M. Fox MENTAL HEALTH E30ARCJ MEET I N G M I N IJTEs MAY 14, 1981 ( Ili nuten Approved) Present: Carol Henes, Ann Graff. Jack Lynch, Marcie Nelson, Alderman Gene Feldman. Janice Jones Absent: Benn Greenspan, Lea Leggette Staff: Jeanne Fox, Melissa Pappas, Eric Carpenter, Carolyn Lim, Mariorie McDonald Special Guests: Arthur Diers. potential Mental Health Board member and Patricia Barger, Ph.D.. Illinois Department of Mental Health and Developmental Disabilitien Community Representatives: Jim Kaufman, Mental Health Association of Evanston: Sue Ebermold. ACORN; Laura Guilfoyle, Alliance for the Mentally 111; Helene Lome, First Step; Gerry Gulley, Shore: Community Services for Retarded Citizens. Carol Hones. Chairperson, called the moetina to order at 7:40 p.m. She introduced Art Diers, potential new Mental Health Board member. She asked him to share information about himself with the board. She than welcomed Gone Feldman as tho newly appointed Aldorma n to the Board. She introduces Marzio McDonald, a now Woters Degree intern from Roonovelt University School of Public CIdminiatration. She then stated that Benn Greenspan is not able to attend the meeting because ha wale out of town. Lao Loamette had a prior work commitment. Illinois Department of Mental Hpulth and DevolgpDa tal_ Disabilit,iea (DMHQQp Its. Hones then asked Dr_ Patrician b argur and Jim Kaufman to .loin the Mental Health board at the table. Dr. Barger had requested the opportunity to diacunm with the Mental Health Board the potential change of Evanoton'd acute state hospital from Elgin Mental Health Center (EMHC) to Read Zone Center. Since the Mental Health Aosociation of Evanoton had exchanged letters regarding this issue with Ann Kiley, Director, DMADD, Jim Kaufman was naked to ,loin the diocuopion. Dr. Barger stated that the EMHC is over crowded and is not accredited. Due to a recent Justice Department decision, the EMHC must reduce utilization. Evanston is the closest community to another State facility,(which is currently served by Elgin Mental Health Center.) She also stated DMHDD is looking to the Evanston 708 Board. as a local authority, to provide a coordinated service system for chronically mentally ill. She stated it is planned that Read Zone Center would designate a unit for Evanston's acute patients). It would be a dedicated unit fir Evanston residents,. The unit would be "K'' unit. The K unit would serve Z4 porssons and would be run by State employees. However, Evanston could have clinical oversight responsibilities. with particular responsibilities for intake and dis;charue. The unit would also have to take some percentage of undomiciled individuals. These persons are equally distributed among all Read Zone units. The State believers that it is more cost effective for the Evanston community in terms of transportation cost for the patients. and the community staff, as cell as being easier for fnmiliou of the patients. She then shared how state facilities are orannizud and special services were provided within the State system. Dr. Barger stated that the Evanston community had 205 admissions at Elgin rcntal Health Center last year. 89 of thono admissoion8 were from long; term care facilities. Tho community hasp an average of 17 admissions a month. (hie. Fox statod the community statistics show IOS admissions from long term care facilities). July 1, 1937 is the planned target date_ However, it would be a phased in procossn_ No. Nelson asked what will happen to those Evanston patients who need long term hospitalization - longer than six months. Dr. bnrussr responded that they will be trannforred to Elgin. The Read unit is for acute/crisis stabilization. Na. Nelson Asked what will happen if Evanston needs more than 24 beds? Dr. Barger stated that other units within Read would bo used if needed. All units take rotation of undomiciled persons as needed. The hospital has a no decline option. Mr. Kaufman asked if the additional admissions to Read would then make Read over crowded. Dr. Baraor responded that Read has empty beds usually. The month of March was an unusual month for all facilities with a hiahor admission rate than any other time in several years. Although over crowding can occur. , it is not forseen. Mr_ Di©rs asked if Dr. Barger could give a high or low number of Evanston admissions. Dr. Barger said no. Howssver Me. Fox said from community information the range was 1S - 20 admissions a month. Mr. Diersz asked what is the definition of acute in term of lonxth of stay in the hospital? Dr. Barger responded that acute is 30-90 days. 90 days - 1 year is intermediate and 1 year or more is extended care. Ms. Graff nuked how admission is determined for each unit. Dr. Barger stated that it is based on an individual care plan. All admissions go into an acute unit first. Medication, stabilization, type of care required, and other alternatives are considered. -3- A person going to a long term care facility and needing to be readmitted, even within days, must first be admitted to an acute unit. There all psychiatric and physical work up must be completed, except For some x-rays, ©von if patient had been gone for only a few days. Mr. Diers asked what are the consequences of a high recidivism rate, particularly among long term care facilities residents? Dr. Barger stated that all communities are asked to utilize DMHDD monies (grants In aid) to reduce utilization of hospital days. This utilization rate is considered ea a factor in the grant award procoua. Although Evanston receives a higher per capita amount of DMIDD monies in comparison with other communities. many factors need to be taken into consideration such as the number of seriously mantally ill parsons communities have to deal with. She explained the Northwestern Montal Health Center model and catchmwint area. Ms. Heenan anked whether there was a difference in the Quality of care between Road and Elgin. Dr. bargor responded that Read is an accredited hospital which is not understaffed. EMHC is not accredited, is over crowded and understaffed. Mr. Lynch asked what are the disadvantagon to the move to Road. Dr. Barger responded that she saw none except concern by staff of losing poaitive relationships developed over a period of years. Ms. Hone.:, asked Dr. Larger to define what she meant by looking to the Evanston 708 board as a local authority to devviop a model of coordinated care for the chroncially mentally ill (CMI). Dr. Barger said that she is looking for a continuous system of care for CMI with few barriers between staff or institutions which will improve the Quality of life for the CMI regardless of where they live. Specifically, she stated that 708 leadership should be geared toward allocation of resources, according to priorities, to insure no duplication of service, with appropriate division of labor and resources for specific target population needs. Ms. Graff stated that she thought we already ware doing this, particularly under the Elgin grant. Other Board members agreed. Dr. Barger stated more could be done. No. Graff asked what will happen if all bode are filled; will a person be discharged when a new person needs a bed? Dr. Barger said all persons who need hospitalization Rot admitted. In the real world, people get discharged at times before they are ready. Ms. Nelson asked about additional resources for the community. Dr. Barger replied that the General Assembly has reduced the DMHDD budget to the 1987 level. The Director, Ann Kiley, has stated that if nothing changes the 1987 grants -4- in aid would have to be reduced 2% from the '87 level. Ms. Hones thanked Dr. Baruor and Mr. Kaufman for joining the Board for this discussion. Jack Lynch moved with ra second by Gone Foldman to convey to DMHDD that the Mental Health Board was very interested in the proposal of the move of Evanston acute beds from Elgin Mental Health Center to Road Zone Cantor, with the following statement: The Board wants quality care for its reoidents and that although Read Zone Center is accredited. not overcrowded. or understaffed. unlike Elgin, the Board had several concorno which It would like answers to in writing before it Rave approval. 1. Assurance that all Evanston residents in need of hospitalization will have access to care (hospi- talization) regardless of length of stay or type of care needed if the Evanston 24 boda oro full. 2. Since Read Zone Center is closer to Evanston, and through use of public transportation, patients can easily return to the community. what nafesuards does the hoeital employ to guard against patients returning to the community against medical advice? 3. Since the Evanston community does not have crisis beds or transitional housing available. the com- munity needs assurance that Evanston residento will not be discharged without housing to live in the community. The Board voted 5-0 (1 abstain) to direct staff to Communicate the above motion to DMHDD throush Dr. Pat Barger. M. Fox stated that we, as many other communities. have reduced unnecessary state hospital admissions, shortened hospital stays and established lees restrictive treatment settings. However, the state has not transferred the cost savings to the community programs. but has transferred the responsibility of the patients to the community. Younger and sicker persons are expected to live in the community with minimum support services. Without adequate support services the patient suffers regardless of whore they live. Since June, 1982. due to the Elgin %rant and continued emphasis by the Illinois Department of Mental Health and Developmental Disabilities (DMHDD) the following asenciesfprograms have been working, together to develop and -J- enhance services to the chronically mentally ill (CMI ) of Evanston: ACORN. Miles Township Sheltered Workahop. St. Francis Hospital Adult and Child Guidance Center, ►alliance for the Mentally I11. Mental Health Association of Evanston, Evanston Hospital Dopnrtment of Psychiatry, Ridgeview and American Plaza. We have a history of working together and resolvA ng problems regarding the CMI. In addition, the Evanston providers and No. Fox have boon meeting to discuss how this possible system might work assuming a move from Elgin to Read. The providers have made the assumption that the state will move Evanston Acute State Hospital from Elgin to Read. A proposal has boon developed by the providers for expanded community services to meet this new responsibility. The draft proposal to DM1iDD by the providers was then discussed by the Board. Mr. Feldman stated that all the programs presented had merit, but how much can we do for people. At the same time, uo do not want to cut People off from our beat efforto. Mts. Graff stated all CMIs, roaardlesa of whore they live, deserve the best care we can give them, but we do not want to crest© a level of service in the community that we can not sustain. Mr_ Lynch stated that the Homeless is a good example of is problem that wan forced on Evanston. Ms. Graff stated that although she supported the development of more services, she was concerned that those additional services would mean an increase in number of people with special needs for which the community is reoponsible. Mr. Feldman agreed that thin is a concern, however we also want to &azure that services needed are available. Mr. Lynch asked whether these services would still be needed if the Evanston community services were not moving to Read. Mo. For, anowered yeas. Tho only thin$ that would not be In place, if the community acute beds stay at Elgin, is the psychiatric coverage of a special unit and the additional amount T of after care staff time at the state facilities. Mr. Diers stated he was pleased with the proposed range and coordination of services. It was very creative. Mr. Lynch stated that even though on paper it would save DMHDD monies it was obvious that DMHDD +jould just put it back into the State system. not the community system. Mr_ Lynch moved with a second by Janice Jones to support the proposal to DMHDD by the providers for the expansion of community services to provide for increased continuity of care, and to enhance quality of life for the chronically mentally ill. The vote passed unanimously 6-0. Lest islatiga- Gerry Gulley, Melissa Pappas and Laura Guilfoyie Joined the Board to discuss proposed legislation affecting the developmentally disabled and mentally ill. Mo. Pappas nave an overview of the variety of legislative bills and their status. Gerry Gulley spoke about the significant bills affecting the developmentally disabled (DD) and their progress through the House and Senate. Legislation is designed to help the aging out population and the deinstitutionallzed, who were put into Inappropriate nursins homes and need community oervicao. Monies need to follow the DD population into the community. Mr. Gulley stated the DD priorities from his Poropective are: 1. To maintain existing services. 2. Home and day training service expann i on. 3. Housing - appropriate to meet the need. Laura Guilfoyle stated that the needs of the mentally ill are also urgent. DD community services far exceed services for mentally Ill. She otated we all need to make sure DMHDD's budget is not alashad, and that existing services are maintained. In addition, in cooperation with other groups like 708 Associations. Illinois Association of Community Mental Health Agencies. Mental Health Asnociation of Evanston and Manic Depressive Association, the Alliance for the Mentally Ill (AMI) has been working to pans logioletion that would require mandated community services for the mentally ill. The group agreed on the Following priority needs: array of services to meet the variety of needs. case c.3ordination and housing. 1. Maintain and/or increase DMHDD's budget. 2. Support addition of definition of mental illness to Mental Health Code. (Bowman) 3. Support Community Mandated Servicou Bill 1210. 4. Support expansion of community services for DD and MI. R Qognitlon of Student Interns Me. Hones stated that thin to the last Mental Health Board meeting for Eric, one of our student interne from Roosevelt University. Eric Carpenter in completing his undergraduate work in public administration at Roosevelt University. He has just won the distinguished undergraduate award in public administration given by the Public Administration Alumni Network. Eric has been with teh Board since September, 1986. He helped the staff to get through the Unified Budgeting Process. -7- 01 gathered information. analyzed data. organized materiasl and took minutes. In addition, he tracked several significant City Issues thorush different committees and monitored agency data. Eric always wanted to know what is the most cost affective way to provide a service and if this money is really going to make a difference in someone's life? Eric wants to go into Criminal Justice Administration. Eric was presented a plant as a token of our appreciation. Eric Carpenter thanked the Board for the opportunity for his growth and wished the board well. After reviewing several informational items,. the meeting adjourned at 10: 25 p.m. Respectfully submitted. r J nI 1 [. Fox EVANSTON MENTAL HEALTH BOARD Meeting Minutes June 11. 1987 (Approved Minutes) Members Present: Carol Hones (Chairperson). Ann GrafP, Art Diere, Janice Jones. Jack Lynch. Marcia Nelson. Lee Leggette, Gene Feldman. Benin Greenspan Staff: Jeanne Fox. Harvey Saver. Carolyn Lim Community Representatives: Natocy Smissowski. Chris Pasinski (ACORN); Ron Rozensky, Lynn Barnett. Mary McMahon. Georgette LePage (Evanston Hospital); Marge Sandler (Mental Health Association of Evanston); Joe Anne Sullivan. (Evanston Drug Treatment); Penny Jarchow (OATES) . The meeting was called to order at 7:35 p.m. I. Introduction& and Con- nity Comments Me. Henes announced that Jack Lynch had been reappointed to a four (4) year term on the Board. On July 14, there will be a City -sponsored volunteer recognition night at the Lagoon, with a concert and food. Mental Health Hoard members will be invited. Me. Hones paid special recognition to Davidson Ream and Michael Buren, recently retired members of the Mental Health Board. Certificates and paperweishto were presented to each as tokens of appreciation_ The following remarks were entered into the record: "Davidson Ream served an the aldermanic representative to Mental Health Board from June. 1983 - May, 1937. As a Mental Health Board member he was the agency liaison for Family Focus and Family Counseling Service. David could always be counted on to do his home work and to be knowledgeable of the issues. David consistently advocated for quality human services and the Mental Health Board benefited by his advocacy efforts. David, on behalf of the Mental Health Board and the Evanston community, please accept this paper weight as a token of our appreciation for your 4 years of time and energy addressing the mental -2- health needs of the Evanston community." " "Michael was a Mental health Board member from September, 1979 to April. 1987. As a Mental Health Board member, he served as vice president for the year. 1986. During his tenure as a Board member he provided leadership in the areas of long term cure.and personnel evaluation. He initiated the process for the development of a Mental Health Board manual. Michael always wanted to be sure. before 10:00 D. m.. that we know why we did what we did. and made sure all opinions were heard before a decision or vote wee taken. Michael was consistently concerned that the Mental Health Board's public monies be used to serve Evanston residents who could not pay for services and for equity in distribution of these hinds. Michael, on behalf of the Evanston comity and the Mental Health Board, are thank you for your 8 ]mars of dedication, commitment and caring for the mental health needs of the Evanston commitnity. Please accept this paper weight as a reminder of our thanks." Me. Henee also thanked the students who had done internships with the Mental Health Board over the previous your. Melissa Pappas and Carolyn Lim- In addition, she also recognized Marilyn Zimmerman, who volunteered as a consultant in the development of a management information system. The Following cos nts were made: "Melissa Pappas. a graduate social work intern from, the University of Chicago, came to the Mental Health Board with a variety of experience with not -for -profit agencies and was therefore able to work with Harvey and Marilyn Zimmmermnn to develop our computerized manamemant infor- mation system. She has also monitored legislation that could affect our tarset populations." "Carolyn Lis is also a first year graduate student intern from the University of Chicago School of Social Work. Carolyn has focused on evaluating the Unified Budgeting Proceen and its issues. She ham analyzed data. and is completing research on host to deal with substance abusers who are not amenable to treatment." "Marilyn Zimmoerman. A Graduate student in Roosevelt University School of Busyness, specializing in manage- ment information systems, in not able to be with us -3- tonight. It was her expertise and time which Rave us the computer program for our management information SY*tiL All students helped to analyze budgets. prepare contracts and to analyze agency data. Now eyes looking at the same information have Riven us now ideas to improve our system_ Marilyn, Melissa and Carolyn -- please accept these tokens as a rememberance of your time with us and our thanks." Mr. Feldman thanked staff for the organization and layout of the Board packet. II. Minutes of May 14. IS87 After discussion, Ms. Graff moved that the minutes of the May meting be approved as amended. Ms. Nelson seconded the notion. Passed 8 aye - O no. III. Report of the Nominating Committee Me_ Jones and Mr. Lynch presented the slate of officers suggested by the Noninatins Committee. They are: Chairperson - Carol Hansa Vice -Chairperson - Lee Lessette Ms. Nelson moved to elect the slate for a one year terl. Mr. Feldman seconded the motion which passed unanimously (9 aye - O no). IV. Funding Guidelines Committee Report Ms. Nelson discussed the feedback provided by Mental Health Board -funded agencies to the Committee about the Funding Guidelines- She then reviewed the Committea's process and final rec omme ndat i o nz . Mr. Lynch moved to accept the Committee's recommendation to accept the appeal of the Mental Health Association to reclassify the Service Area/Mandated Population of Community Companions, and that the program be designated as Counseling/MI. Ms. Jones seconded the notion. (Mr. Greenspan joined the Board). After discussion, the motion passed 6 aye - 2 no -- 1 abstain. Ms. Graff moved to adopt the Funding Guidelines, as amended for the 1387 funding allocation process. Mr. Lynch seconded the motion which passed unanimously (9 aye - O no). Mr. Lynch will prement information about the guidelines to Humen Services Committee when a time can be scheduled, hopefully in August. -4- V. Move of Evanston Acute Beds to Read Zone Center Dr. Pat Barger's response to the Board's questions was reviewed. Mr. Feldman raised concern about response to the issue regarding unauthorized absence of recipients, and indicated that he was not any more comfortable with the response then he was before. Me. Fox emphasized that we would have to continue to monitor the ongoing impact of the move upon the community. Mr. Greenspan questioned why we were being asked to support the move, and what real function would it play. Ms. Fox sold that. as the local mental health authority. DMH wanted our stamp of approval. However. locally the providers believe that the move is already a fait d'accompli. Mr. Feldman indicated that he thought that the Board should not give carte blanch to DMH. Ms. Graff moved that the Mental Health Board indicate that It would cooperate with the DMHDD proposal to move Evenston's acute beds. with the understanding that it still had concerto, would wonitor and amsess the ongoing impact. and would evaluate the effect upon the comity within a year. Mr. Lynch seconded the motion. Passed 8 aye - l no. Ms. Hones requested that staff communicato the Board's intent to DMHDD. VI_ Dialogue with Evanston Hospital Department of Psychiatry Ron Rozsnsky. Associate Chairman of Evanston Hospital's Department of Psychiatry. .joined the Board to discuss their Position that there is a need for ongoing financial support of their programs from the Board. This was prompted, in part. by discussion at UBP the previous year. While they do receive DMHDD funds, the Board In the only source of local public funding. The Department of Psychiatry has 83 employees, 36 in programs supported by the *107,000 Mental Health Board provides. This is soon as both financial support. as wall as recognition that Department of Psychiatry provides a wide range of services to the community. The Mental Health Board funds support 1466 unduplicated Evanston individuals, and provide 25.000 service units for the Evanston community, in the Outpatient Psychiatry Department. Of the Evanston residents receiving support, 96% in Extended Care/ACCESS. 94% in Refocus and 67% in Crisis Intervention) are considered indigent. Of all Outpatient Psychiatric Department's Evanston clients. 46% are low income. Mr. Rozensky discussed the hospital administration's outlook on Outpatient Psychiatry's financial profile. While the hospital is relatively wealthy, Outpatient Psychiatry in "poor" and unable to cover all of their costs. Their clinics have increased services by 68% over the last 2 1/2 year&. and re- duced their losses. However, the hospital administration is continually putting pressure on all departments to most their expenses. Any loss of funds from any funding source would decrease Outpatient Psychiatry's ability to serve. Dr. Rozensky believes that a reduction in support from the community would result in reduced support from the hospital, and less willingness to accept a deficit budget. Evanston is the only will discount their foes. by the Mental Health Board MM community for which Evanston Hospital This discount is supported, in part, funds. Outpatient Psychiatry has a strong commitment to the Evanston community and commuunity services. Crisis Intervention is available 24 hours a day. 366 days a year. This program is the Mental Health Board's highest priority concern. It provides continuous backup for 28 other agencies in off hours and emergencies - 18 of these are Evanston agencies. It costs $35.000 .just to have someone available for those contingencies. This year. they have already done 81 cossrunity workshops and traininas - 75% have been for the Evanston community about mental health issues. The Department of Psychiatry has the ability to be a full -service community mental health agency. They offer a continuity of care, and are cost-effective, because they are able to provide all of their services through one system_ Mir. Rozensky invited questions from the Board. Mr. Graff: Is Outpatient Psychiatry being pressured to increase their number of clients? A: The pressure in to increase the number of patients who can pay the Pull Pee. They already have an extensive caseload. and have developed a waiting list. Ms. Graff: How would you describe the clients and where they are from. in programs the Mental Health Board supports? A: Extended Care has 330 CHI, 68 who are from long term care Pacilitles. There are 539 people in Outpatient Psychiatric programs, 67% who are CKI. but few who are from long term care. Crisis Intervention serves a larser number from long term care. Mr. Diers: I have some concerns about Evanston Hospital Making a lot of money from the community. Shouldn't we discuss with the hospital administration the responsibility of the hospital to the community? Mr. Greenspan: In 1986. of Evanston residents requiring hospitalization. 2l3 go to Evanston Hospital. The hospital has done a good .lob of health care. The Mental Health Board dollars effectively serve as leverage in keeping the administration's attention on outpatient psychiatric services. Mr. Feldman: Who is your competition for paying clients? Where else mould they go? Q� A. In the Evanston community. largely private practitioners. They charge higher rates then we do. Rather than go ofter private patients. the hospital administration would nook to balance the budget through staff cuts. Me. Hone&: Isn't it unfair to have such great inequities in amounts of local funding received by agencies with such large differences in mounts of funds supporting their operations, e.g., Evanston Comprehensive Drug Treatment Program with little capital behind them, verous Outpatient Psychiatry with the hospital's total resources behind their programs. A: As I indicated. each hospital department is being node to stand on its own_ Ws don't really have a wealthy institution entirely behind us. (["Lary McMahon. Director of Crisis Services. discussed extensive backup services provided by the hospital to support work that Crisis does. The cost of these services is not reflected in the budget for Crisis Intervention. Mr. Feldman: Is there real substance to warnings groat this hospital? Are imminent cuts a realistic consideration? A: I believe these are realistic protections from tur boss. There is no pressure, at this point. for our programm to cut their deficit. However, Mantel Health Board cuts in Novesbmr could easily result in hospital cuts for Outpatient Psychiatry. VI I. Substance Abuse Issues and Legislation Current Issues -- Joe Anna Sullivan and Penny Jarchow .coined Mr. Saver in presenting information about current legislative and budget initiatives. and program changes. in the substance abuse arena. Mr. Saver reviewed the current atatus of legislation In Springfield. Very fey bills had been introduced relating to prevention or service expansion, while a large number focused on punitive. criminal and sentencing measures_ Unlike mentai health leg.ialation being monitored. there were few bills otill undor coniiiduration which would have a progressive Impact upon the services system. r1r. Saver reported the protected lose of 10-15X of community treatment slots if there were no new funds allocated to DASA_ !"lea. Sullivan announced that her agency was formally changing its name to PEER Services (Prevention, Education. Evaluation and Recovery). This will better .•eflect the expansion of their services to the community and to potential clients. In the past, they had only offered adult methadone treatment. They will now emphasize drug free treatment for adults. and prevention and early intervention services for youth. Ms. Sullivan also discussed the potential Impact upon community services with proposed licensure changes. and if there are any - 7- cuts in the DASA budget. One important bill In Son. Kustra's proposed tax on the manufacture and distribution of alcoholic beverages. Revenue would support expanded treatment and prevention services. The bill is dead in this session. It will be reintroduced. and would be a valuablo initiative for the Mental Health Board to consider supporting- Mo. Jarchow provided an update on the O. A.T. E.S. programs. They have been providing more community service and outreach. through which community members are identifying themselves as having a substance abuse problem. While they are not licensed for DUI programs, they are seeing many more individuals in this category who end up going in to a recovery program. They have also been soeinst an increase in adult children from addicted families, and an increase in seniors who are having problems with substance abuse. Me_ Graff moved that the Mental Health Board communicate to local legislators the need to endorse a strong budget for DASA which provides at least maintenance for treatment services. Mr. Legstette seconded the motion_ Panned unanimously 8 eye - O no. Mr. Diers moved that the Mental Health Board communicate to City Council about the need to advocate for strong budgets for DMiDD and DASA. No- Nelson seconded. Passed unanimously 8 aye - O no. Carolyn Lin Joined the Board to discuss her work for the Board on the reference from City Council. to develop and implement a process to determine how bent to treat within the community chronic substance abusers who are not amenable to outpatient services. From her discussions with community service providora, it appoare that this is a perceived problem_ After discussion. Cos. Graff moved that the flontal Health Board send Ms. Liar's report to the Human Services Committee. The cover letter accompanying the report should recommend that in light of the chronic shortage of human services resources, additional funding not be allocated for people who routinely refuse help. Mr. Greenspan seconded. Pasoed 7 aye - 1 no. Staff was asked to draft a memo before the July Board meeting that outlines more concretely the resources required to address the problem_ 7 VIII. Mental Health Board Policies The Board agreed to have a subco■m►ittee review the policies. Ms. Jones and Mr. Greenspan volunteered to serve on the committee. IX. UBP Schedule Ms. Fox reviewed the UBP schedule and proposed changes in the process. Board members will soon be polled to develop schedules for UBP hearings. X. Inrormationai Items - Me. Fox discussed letters or support ror agency budgets, and the Mental Health Board role in re- viewing and commenting on their requests. -- Mr. Feldman requested Board comments about youth advocacy program proposals. -- The August mmet i ng will be discussed at the July Board meeting. Meeting adjourned at 10:30 P.m_ Respectfully submitted. EVANSTON MENTAL HEALTH BOARD MEETING MINUTES JULY S. 1987 (Approved Minutes) Members Present: Carol Hones. Chairperson; Bonn Greenspan, Art Diers, Gene Feldman. Lea Leggette. Marcia Nelson, Jack Lynch. Janice Jones. Ann Graff Staff: Jeanne Fox. Harvey Sever Community Representatives: Sue Ebersold (ACORN); Georgette LePage. Mary 11--hahon (Evanston Hospital) ; Alberta Porges, Margo Gordon. Maureen Thomure (Community Coordinated Child Care); Diane Goodson. Bob Wolf (Early Childhood Develop- ment Center) Me. Hones called the meeting to order at 7:35 p.m. I. Minutes of June 11, 1987 After discussion. Mr. Lynch moved that the minutes of the June meeting be approved as ascended. Mr. Leggette seconded the motion. Passed 9 aye - O no. by the Mental H%:kjth Board CgMMunity Coordina&ed Child Carg, Alborta Porges, Executive Director of 4 C's, introduced Margo Gordon, President of the 4 C'ss Pplicy Board. and Maureen Thomure, Social Worker. r1s. Pore$ briefly recounted the history of 4C's. When the 708 Board was established in Evanston in 1968 a key element promised to the community was pro --school services. Initially. the Board had a full-time staff person who collected data, did enrollment of children and identified child care resources. In 1973, these functions devolved from the Board to 4C's. The Board provided funding which was applied toward the Title XX match. Today, 4C's has four full-time employees. Of the individuals being supported through Title XX Funds. SON are from single parent families -- in many the mother has never been married. A number of these children are "at risk" of future problems if there are no supports provided at this stage of their development. 4C's attempts to ensure that the mothers and children have access to, and successfully Set through, the day care experience. -2- The Mental Health Bopard funding supports 4C's social worker, and provides supplemental day care for special education and special needs children. The Board's funds provide about 10% of the latter budget. and provides match for social services. Me. Thomure reviewed several case studies of individuals receiving specialized help and individual care plane. She described special day care arrangements which enable these kids with specialized needs to stay in day cars. Their services are particularly important in keeping mothers who are iwthout family networks or other supports which might otherwise provide for day care needs. Ms. Porses discussed the threat of a potential decrease in the State's Donated Funds Initiative. Subsidized care is provided for 320 of the 670 kids in day care in Evanston. There are 460 - SW kids on a waitint list. Included in this are those high-school ass mothers who are planning on returning to ETHS in the Fall. after having been on leave for the birth of their child. Ms. Porses expressed concern that cutbacks at the State level would effect the availability of supported day care and might result in some working mothers having to so on welfare. At this point. if them is an identified problem with the child or Family, this is treated as a priority. and they are not placed on the waiting list. In the Baby Toddler Program. 1/3 of the 75 children are "at risk"; these children have a special care plan which is developed for them. In the m, 9 0-3. infants and toddlers homes, special needs children who are identified by the school district are abosrbed. Me. Thosure indicated that, in these cases. a good home provider would not necessarily have specialized training. but would be selected because of a perceived patience and desire to work with kids with special needs_ However, monthly inservice training is offered to these providers. Ms. Porses read the following to the Board. "Foundations should abandon the tired rofrain about providing seed money for innovative projects. First, not every protect should be Innovative. Nothing is wrong with a tried and tested program that efficiently accomplishes wheat it sets out to do. Most organizations that are doing a good .lob today don't need 'seed money': they need long term support." (The Non -Profit Times. June, 1987) She concluded by emphasizing that she thought that 4C's was a basic program which would still need to be funded, as a foundation for the service netowrk, even after any new program were funded. -3- Dr. Diane Goodson. Executive Director of ECDC/CHASI, introduced Bob Wolf. Vice -President. of CHASI. Dr. Goodson briefly reviewed ECDC's history. In 1968, the Mental Health Board had identified early intervention for children as a critically -needed service area. The Board had requested CHASI to start ECDC in Evanston, and to provide early Intervention services for the commiunity. ECDC provides this service for children who are 8 and under, and their families. The Evanston service network has designated ECDC as the local agency in serving this network. ECDC works to prevent out -of -hoes placeaaent, to intervene early with identified probelss (assessed by ECDC or other comity agencies), and to prevent anti -social behavior in later life. They wrjrk with kids, assess and treat adults, and work within the systems and networks of the community. Dr. Goodson reviewed 1 case study from the child's perspective to exemplify the work. that ECDC does. Mr. Wolf said that CHASI has been very pleased with its ongoing relationship with the Mental Health Board and with the Evanston com Anity. They have experienced it as an effective partnership. In its very beginning in 1970, the Mental Health Board provided 50% of ECDC's budget and CHALI funded WS. He passed out charts providing detail on income by source for FY '81 and FY '87 for ECDC. He highlighted the drop in the category fees for services. There has been ea dramatic shift in 6 years in ECDC clients not being able to afford any fees for services; 74% of their clients meet Title XX guidelines for logs income. Mr. Wolf emphasized that there are remaining to sppek out for the needs of day care slots around the State. They have to sot rid of 50% of these beCOLMe support them. They are counting on the advocates, and asked the Board to take problem that no one is speaking up for. III. Mental Health Board Policies very few advocates children. CHASI has 400 have been told they will there is no monoy to Mental Health Board as very variously the or concerned about kids. Me. .Tones and Mr. Greenspan presented recommendations about policy for the Mental Health Board, from the Board's subcommittee. Recommendation *1. Me. Graff moved to eliminate the policy on primary prevention, because prevention has been added as a Mental Health Board goal. Ms. Nelson seconded. Motion passed 8 aye - 0 no. -4- Recommendation 02. Ms. Graff moved to eliminate the policy letter of agreement with the Suburban Cook County/DuPase County Health System Agency, because health system agencies no longer exist. Ms. Nelson seconded. Motion passed 9 aye - O no. Blcommendsd 43, Mr. Greenspan explained that there was a need for guidelines about administrative decisions needing to be wade. between meetings, related to funding issues, e.g.. administrative support for agencies, letters of endorsement for proposals. approval for proposals to Deparmtent of Mental Health. Me. Jones expressed concern about hour much staff time might be spent assisting asenciss which the Board does not fund in looking for funds. Mo. Graff stated that these concerns were not policies, but should be included as administrative guidelines. Ms. Graff mo%md to drop the policy regarding a process for requesting Mental Health Board action on funding requests outside of the regular funding cycle, and to retain the process as an administrative suideline. Me. Nelson seconded. However. after further discussion the motion was withdrawn. Mr. Greenspan moved that a category of administrative guidelines be developed by the Hxmcutive Director for approval of the Mental Health Board, and thereafter reviewed yearly by the Mental Health Board. Ms. Graff seconded. Motion passed 9 aye - O no. Ms. Graff moved to eliminate as a policy the processes for requesting Mental Health Board action on funding requests outside of the regular funding cycle, and to develop these as administrative guidelines. Mr. Cassette seconded. Motion passed 9 aye - O no. Discussion ensued regarding the need for certain Mental Health Board policinn uhen Montnl 11on1th Hoard gcaln and mission were clearly stated in the Bylaws. Mr. Greenspan clarified that policies are vehicles For communicatins to the public in a concise way the Mental Health Board goals and objectives. Me. Fox clarified that policy statements of the Board are, by ordinance, required to be sent forward throush Human Services Committee to the City Council. EWcommendation 04. Mr. Lynch moved to eliminate as a policy the guidelines for applicants requesting community mental health funds. and to develop these as a part of a procedure in the administrative guidelines. Me. Graff seconded. Motion passed 9 aye - O no. Mr. Lynch moved that the Board adopt as policy that any agency asking for funding from the Mental Health Board must give -5- priority to Evanston residents. Mr. Feldman seconded. (lotion passed 6 aye - 2 no - 1 abstal n. Mr. Lynch moved to amend the previous notion to read that those program services which are funded by the Mental Health Board shall give priority to Evanston residents. Mr. Feldman seconded. Motion passed 8 aye - 1 no. R, _QjWWndatiop W!5, Mr. Lynch moved that a policy on specialized housing needs be developed by staff for the Board's consideration. Mr. Greenspan seconded. Motion passed 9 aye - O no. Rscomsiend"Lon 06_ Mr. Greenspan moved to eliminate the policy regarding Evanston residency as a requirement for residential program participation. (The procsss for giving priority to Evanston residents and documenting need has already been formalized in the Group and Residential Care Ordinance). Ms. Nelson seconded. Motion passed 9 eye - 0 no. Rocamnsndntion 07_ Mr. Lynch moved to eliminate the current policy stating that the Mental Health Board funds services and programs, rather than grants to individuals. Staff is requested to update the policy for the Board's consideration. Mr. Greenspan seconded. Motion passed 9 aye - O no- tion. N8, Me. Graff moved to eliminate the current policy regarding the development of a full continuum of services for Evanston residents, including non- prof sesi onal mental health services. Staff is requested to update the policy for the Board's consideration. Ms_ Nelson seconded_ notion passed 9 aye - O no. Recommendation 03, Me. Graff moved to postpone consideration of the Mental Health Board levey for a future agenda. Mr_ Lynch seconded_ Motion passed 9 aye - a no. Recommeandation !IQ,._ Mr_ Lunch moved to postpone consideration of the policy on the Mental Health Center budget for a Future agenda. Me_ Graff seconded_ Motion passed 9 aye - 0 no. Recommendation *,11- Mr_ Lynch moved that administrative guidelines be developed for the annual review and affirmation of contract policy guidelines. Mr. Greenspan seconded. Motion passed 7 aye - 0 no - 2 abstain. Recommendation e12 Mr. Lynch moved that the Mental Health Board adopt the policy of reviewing and adopting funding guidelines annually. Mr. Greenspan seconded_ Motion passed 4 aye - 2 no - 3 abstain_ -6- Recommsndatign 013. Mr. Lynch moved to have the Mental Health Board develop a procedure for recording policies and actions taken by the Mental Health Board at meetings. Me. Jones seconded. Motion passed 9 aye - O no. Ms. Hones requested that the Policy Subcommittee continue to Function and to review the development of adwinistrative guidelines with staff_ IV. Specialized Substance Abuse Intervention Program Ms. Hones reviewed earlier discussion about development of a process to determine how best to treat in the community individuals who are substance abusers and who are not amenable to treatment. Ms. Fox presented additional Information that staff had developed in researching the issue further and explained the staff recommendation. Ms. Nelson raised the concern that, with dollars limited. resources should be focused upon persons who were amenable to being helped. Mr. Feldman raised the concern that there were other areas of higher priority which should be the target for additional resources. Ms. Graff said that staff efforts should be addressing areas of higher priority. Mr. Lynch said that the staff recommendation did not discuss spending any funds on programs, but su"eated a process for determining the facts and assessing the real costs of a proposed program. Mr. Feldman said that. based upon the referral from City Council, it would better serve the purposes of the Human Services Committee if more information and a better understanding of the problem could be provided_ Mr. Greenspan moved to reconsider the action taken in the June meeting, and to have the Board president draft a memo to Human Services Committee combining the Information in the staff report with Board's concerns that the problem was not a high priority. and should not divert the current. limited resources. Ms. Graff seconded. Motion passed 9 aye - O no. V. Legislative Issues and Budgets of Department of Mental Health and Developmental Disabilities (DMHDD) and Department of Alcohol and Substance Abuse (DASH). Due to the lateness of the hour, staff stated they would distribute a revised report by mail. VI. Group and Residential Care Licensing Process - Mental Health Board Role. Mo. Fox reported that there was no additional information to provide in this area except that which was provided in her memo. - 7- VII. Unified Budgeting Process Ms. Fox distributed and reviewed the summary of changes in the 87 UBP process. Board members were asked to submit their schedule of availability for Mental Health Board and Unified Budgeting Process meetings in the fall, and the list of agencies they would like to visit. V111. Informational Items - The Regionalized Housing Committee Report has been adopted by City Council. The plans for the imple- mentation of the report are being developed. - The Mental Health Board In on the agenda for Hunan Services Committee on August 10. to discuss several items. Mr. Lynch will present the revised Mental Health Board Funding Guidelines. -- The Mental Health board's August meeting will be on August 13 at 7:0Q - 9;OQ. The agenda will consist of the Mental Health levy. Mental Health Board policies. and administrative guidelines. After the meeting members will adJourn to a nearby restaurant. - The Mental Health Board reviewed the exchange of letters between Ray Ganey and Jeanne Fox regarding the one-time grant by DMHDD of S29.900 to Evanston Hospital. Department of Psychiatry, for expansion of services to the chronically mentally ill. Mr. Diers asked Whether the ironies could have been divided between all the agencies. No. Fox said no. not by DMHDD auidelinea. Ms. Graff suggested that the Board chairperson be apprised of this type of request in the future. Mo. Fox stated the recom- mendation waB breed on the Evanston network plan for unified system of card for chronically mentally ill. approved by the Mental Health Board and submitted to the Illinois Department of Mental Health and Developmental Disabilities. Mr. Lynch suggested that members of the Evanston network also be apprised before any allocations are made. Fleeting adiourned at 10.45 p.m. Respectfully submitted, Jeanne M. � Fox, EVANSTON MENTAL "EAL'TH BOARD MEETING MINUTES nUGUST 13. 1387 (Nd nut"aa rapprov0d ) Members Present: Carol Honva (Chai rporson), benn Greenspan. Art Uiero. Gone Feldman, Le" Lt gaottu. Marcia Nelson, Jack Lynch. Janice Juneo, Ann Graff Stuff: Jennno Fox, Harvoy Savor Community Representatives: Carla Siegel (Madill School of Journalism) Ms. He-ine s c<al lod thd: m.it.jt. i nL4 to or-d4-r at. l: r.1O p.m. f'__J+J. -A_ i 1�i7 Mn. Jonon moved to approve We mi nutun of the July we[etina an eorrrartod. rlrs. Noloon socontitad then motion. l'utsnod: ! teyo O no_ II. Mer�r�l__klc� rit,t� 13nrfr�l 1'nl 0__<ndi Admi,niokra 41Y" _f'r_yne unvu Ms. H nee vL ated that tKo board would tar, c:unaidloring :sach policy and procedure uporwLol y. (Mr. Gree3n pen joined the mooting). > Statement of Mission and Goals. Ms. Graff moved to adopt the statement of Mission and Goals as Policy 8-11T-1. Ma. Nelson seconded tho motion. After brief discussion, the motion was withdrawn. Mrs. Graff monad Lht► SLatemont of Misaion and Goeain Lie trannmittod to the Human Servicon Committee an an introduction to the Hoard'a Pol icion and Provedurot;t_ Mr. Lynch nc:condod thhe motion. Panned: fl aye - 0 no. >Priori ty to Evanston Resident,- rls- Groff mov"d to adopt this subject as Policy 5 -8: - 1 , with the language pr-n—nt "d in Option V on r"go 3 of this August d, 15BA PK•mo accumponyinK tht, Commi tt"e3 's rucommondldati ona. Mr. Lynch :se:c orAnd tho motion. Commeanta were made that thin would re+quiro that the contract policy guidelines for FY 88-89 be c:hcanzed, and. that this would be to retreat from tho Beard's previous position that Evanston dollars should provide services for Evanston residents. Motion- failed 1 aye - 7 No. Mr. lynch moved to adopt Pol icy tt t3,'-1 a:i Iirvat-tntod. Mr. Legyie+ttc, seconded t.h:3 motion. Notion f:tiloJ. :3 eiyci - !, no. Mr. Great3nnpan move-d to adopt Policy ti t3l-l. unbending "give Priority" in UA-,, 3rd paragraph to "givers proferonco" . Mrs. donee noconde d this motion. Pa:soed: 6 ayv -- 2 no. > Method of F'undi ng. Gv.iFf' muwod to adopt Policy N -li l- Z. Mr. �.ync the m -o , Lori. Corrlrrwinto i ncl udod t.hr)t funding only not —tor —profit or-xansz.rition�. W4-)clld tie thkv Boar--i'o hands, i f .i t,# t.t.or• service wni:% of *E)r—J; that being u not -for -prof i t. orwanization .7:s:_> airs;Ady .s 011P glii(IoI , no; and that th#:j Boat-d _should rvt nk.i.0 a pr+l; c:y ,thokit. an :suu unto sc it had tu. No t i uri 4 ayc 1 no. Mrs- Nelson asr)N:d to adopt the poi iev with tlst) removal of "I I 1 inois Nlot- For- 11rof i t" i n tho 3rd j.rsrngresph. Mr. lynch socundoad the) runt i on. lliv%sc>d : 5 t2yo - 3 no. kl1r. Fe•1dmats joined t.'sc) mc-+_ting). > 1'rtinot t a-)r) of N 0FI-- 1 n-t i tut i.1Isu i i"3rca. Mo. Jones moved to adotst th io item an Policy 8 ti l- 3- t-r.;. Graff cencondod the abut i on. 1'ts.st;crd : y ay s - 0 orb. > ct.=,ri-inx Rtziot,S os t.►st• ti�„rd (Pr•ocedkiro tl). M-.. Graff Lac,P%md to amnnrl tilt, f i rrat p► %resgvaph Co 1 i owi rkq csoct i ran I on p4mau 2. of thcs earuf of the Iivit i;unLonco, to i nC:lude) ".. ..sod rshal 1 enter is I int. of tho•_.o vot i nx on ooc h :;kits. " Mr. Fuldnan fsex:orxlt-d tho motion. Fancied: 9 ayu - U nu. Ms. Jonen mo%md to amend thr) E'i r_zt ue)ntonco in St)ction I on page 2 to i tic l ude ". . . , a<iasi itirstrat i ve prcx;udurrt_ .. Mr. Lynch noconded tt.o motion- Piusvod: © ayu 1 no. ?In. }Ionia nwavFad to it)c,)PAO on vaxe J under fldroiniotrativo Issues tho i"ol i owi na; "E- Stuff nhal l prori-aro a wri tton montlil y rePort. " Mrs_ Jones ssoeondtxi Lho motion. Patsfs". !j rsye -- O no. Mo. Urnff muvod to luansnel the languaRts in Section 1'. under nylas,rca on Piwa 2 to read the csame on Articla VIII (jr) 11ylawu Amondmont.r. in tt>o Board'-- Bylaws. M. NIOID011 csr)c"ntted tho mot i o n _ PiFua s;,r"I : _i ay" - U n o . Mr. lynch moved to adopt Proceduro IS--67-n an ankiti Lod. Mrs. N016on t;cconded tho motion. Parustsd: 9 ayo - U no. > Allocation Procenn of Merotj[jl I oalth Board Fun(i ; tProcedure B). Ms. Nealson moved to adopt Procedures U-11? 13. an corrocted_ Mo. Greiff necondod. the motion. Pasn"d: 3 nye - U no. -3-- .> Guidelines for Applicants (Procedure C). MR. Jones moved to change item 4 on page i to read "...to give preference...", instead of "... to give priority... " Mr. Lynch necondod the notion. Paused: 9 aye - O no_ Ms_ Gruff moved to change item 5A on pixgo 1 to read "Applicant must be ootablitshod no a corporation. " Ms. Nelson seconded the motion. Pawned: 9 ayes - O no. ME. Graff moved to include all of item 3 as the socond paragraph of item 2, and to include the second and third paragraphs of item Z an item 3. tie. Jones seconded the motion. !lotion Panned: 9 aye - O no_ Mr. Lynch moved to adopt Procedure 8-8l-C as amtsrulixi. no - Graff noc:ondud the mul.ion. Panned: 9 ayu - U no. ill. Mental Health Board Levy Ma. Fox roviowod the history of the Mental Health Hoard levy. Stw indicated that the . 1 mil rate has been used as an upper limit for establishing the hoard lovy (budget), and that the Board has Mover reached that limit- AFter the City consolidated the Board ' €► budget within tho Ci ty's operational budget from general rovenuen, the Board has utilized the budget guidelinea from they City Manager. Board members' commonts included: Mental Health Board's budget has been accepted by Council bocauno it acted within reasonable parametora; Mental Health Board should have its own internal budget guidelines for offective intornal diocipline; the general policy should by the City Manager's budget policy directions; to always follow the City's guidul inen m"y abdicate responsibility as advocates for mental health needs~ of board's target populations; without a Board policy. almost looking to the City for guideliaens; need to have options available in order to respond to spocial needn and situations; there in already a guidelines based upon practice. evon if it is not on paper; the City'o budget prccoor is best served by strong, independent boarder willing to sect community priorities. and to make: a strong case for the budget necessary to meet the needs. MO. Graff moved to retain the current policy that the Mental health Hoard budget. if were computed as a levy, nhal l not exceed I%- Mcs_ Jones neconded the motion. Pacssseed: l aye (Hones, Graff, Nelson. Greenspan. Feldman. Loygetto. Jones) 1 no (Diers) - 1 abstain (Lynch). Mo. Nelson moved that the proviouss motion be adopted ass Policy B-87-4 for the Mental Health Board. Mr. Greenspan -4 - secondod the motion. Passed: 8 aye -- 1 abota i n (Lynch) . Me. Jonas moved to maintain the guideline of no were then 251 of tho total Mental Walth Board budsot be allocated for Mental tkialth Center Operations. Mo. Graff noconded the motion. Panned: 8 aye - 1 no (Loggotto) . Mr. Lynch moved to have one policy which Would include the langucjg" from both budget iisBuov. Ma. Nelson vecondod the motion. Motion failed: 3 aye (Lynch, Graff, Nelson) -- 6 no (Grttionspan. Hones, Laggotto. Jonas, Foldman, Diers). IV. Informational I teMZ3 - The Monta l Health Center budget will be d incuassed at the September moot i na. -- Ms. Hones reviewed thu Board'" d i s.;cus ui can With Human Servicoo Conmri ttev. Thoy ar o considering how thoy might use tt,e Mental Health board rundi ng Guidol inns for thoi r own process, and they accepted the Mental Health Board recommendation about spvcLalizod subntance abuse services. -- The Mental Health Hoard Funding Committee will meet on Friday, October 30. at A30 a. m. to develop initial allocation recommendations. - The Mental flea! th Board schedule for UBP repreaenta- tives was reviewed with no changes. - Ms. Hanes received comments on the draft of her correspondence rasapond i ng to issues raised by Ivan Lippitz, and suggested that the Mental Health Board addrous some of the issues at a future meetinx. Meeting ad.lourned 9:20 p.m. Respectfully submitted, JW nne M_ Fax Note: The M1ental Health Board Policies will be sent out with the minutes from the September meeting. EVANSTON MENTAL_ HEALTH BOARD MEET I RIG M I NLJ-hI,�.S September 10, 1387 (Minutes approved) Members Present: Carol Henos. Chairw--irraon, Hnruia Nelson, Lee Loaaet.te, Jack Lynch, Art. Dxars Staff: Jeanne Fox. Hnrvey Snver Community Representatives: Helene Lome (F•'irot. Stop); Tom Goblolski ([`Mental Health Chair of Wiliard School PTA) Me. Henos r_allod the mooting to order at 1:40 P.M. 1. Minutes of Augunt. 13, 108 .1 Mr. Lynch moved to npprovo the minutes of the AuSust 13 meating. Me. Nelson secundod. Paannd: 5 Elyse - O No. Mr. Savor indicated that Alh"rtn Porxos. Director of 4 C's had provided clarification on several points she fad made its her presentation at tho July 9 Board mvet i ny. (The fol 1 owe ny changer are made in Section II , 4 C:'s presentation) Page 1. par. 1 - ". ..Today, 4 (. n has QQv"D f'ul l--t irlO VmQl_gye o2sgnd a arit. rr�ct : rvi��_pruv d©�- ,.__� �_MentyL Powe 2, peer. 1 - "... The Board' a funds Gov jqd about 10% of tho latter budget in EX ti and �rn4Qn ly provide _thy match for social services.'' II. Final Approvnl of Policy Guidolinos: The Board reconsidered Policy 8-87--4, Mental Health Hoard Budget Policy. and discussed the need for the separate policy for the Mental Health Board levy and a separate procedure for the Mental Health Center budget. After discussion. Mr. leggetto moved to reaffirm Policy 8-87--4, an correcLad. Mr. Lynch seconded. Panned: 5 aye - 0 no. III. Mantal health Boaro Budget Process Mrs. Fox provided tho Board with an orientation to the annual devel opmont of the Mental Health Board budgot. City Council created ea budget policy for the City and oath year budget guidelines are developed. The City Manager these gives budget directives to staff. In the case of the Mental Health Hoard, staff use these directives to prepare the budget for -2- the Board's review and approval. This budget is then sent to Human Services Committee, which makes recommendations to City Council for final budget approval. (This year, the Mental Health Board will present its budget to Human Services Committee on Monday, November 16) . In 1982, the City went to a program budgeting model. The Mental Health Board budget was broken up into Purchased Services and Mental Health Systeme3 Monitoring (Advocacy and Evaluation). All of thecae program areas have specific program goals and objectives- Mo. Fox then reviewed the funding cycle and the Unified Budgetinsz Process. She then provided an overview of the highlights of the Mental Health Board. and of the mental health service network in town. IV. Mental Health Board Budget Ms. Fox discussed the proposed Mental Health Board objectives for FY 88-89. She emphasized that in order to accomplish the objectives, it assumed that there would be 5 full time equilavent (FTE) availcsble (4 FTE program; 1 FTE clerical/secretarial), which includes time from students and Work Opportunity Progra+n. Mr. Diore expressed concern about the absence of any planning items or iaBues related to children. He said that the Mantt%l Health ©oard should begin thinking about an objective for the future rfilated to children's irs3uea. i.e.. dealing with the basics which enable children to function effectively. He suggested the.t tho Mental Health Board consider a planning objective to asscoort the mental health needs of children under the age of 12. Mo. Nelson suggested this objectives could be included in the noods assesament model. The MonLal Health Board stave tentative appro%ml to the revised proposed objnctivau_ The Fined ob.ioctiven wit be considered at tho November meeting, durinst the approval of the FY '88-89 Mental Health Board budget. Staff was requested to develop a proposed FY 88-89 objective. for consideration of the Board, to plan and imple- ment a needs assessment. Staff was asked to deturmine tho cost. amount of staff time required. and specific focuEs, and other Board objoctivos. which would be sacrificed if a needs assessment were to be implemented. The Mental Health Board will consider this objective and the staff recommendation. at the November meeting. Ms. Hones led the discussion about the Mental lioalth Hoard budget. The information provided by staff indicated that 93.7% of the Mental Health Center budget of S105.340 was fixrmd by the budget office. After a discussion, the Board requested that an -3- inquiry be sent to the City Manager about getting additional funds in the Mental Health Center budget to cover the cost of staff time spent on the development and monitoring of City contracts. Baced upon his resporme. the Executve Committee is empowered to follow up and take action with the City Manager. Current City Budget policy allows budgets to increase by 1. 6% in FY 98-89. There wee a consensus decision that the Increase nhould be split. proportionately. between Purchaamod Services and the Mental health Center. After discussion. the proposed FY 88-89 Mental Health Board budget was given tentative approval in a consensus decision. The Board discussed the human services needs ourveay which is being prepared for the Human Services Committee. Me. Nelson suggested staff consider utilizing and building on the Human Service Committee Needo Survey for the Mental Health Board Needs Assessment. In a consansun descision. the Mental Health Board decided to encournse3 Humian Services to request that additional City funds bo allocated For human services. if the needs survey and UBP proposal indicate that gores Funds are merited. V. Unified Budgeting Schedule Me. Nelson presented the report from the Funding Guidelines Committees. She recommended that panelinto fill out their Board Program Asesossment (BPA) forms, when they arts present at a hearing, and Leave them with staff, in ordor to speed the proceso along. She emph.xaized that the calondar that staff. developed for returning proposals must be followed. Individuals who will bo out of town at then end of Lhe schedul4e should turn their BPA rating forms in beforchnnd. In a concensusa decision. tho report and recoa nkdationu of the Funding Guidelines CosmLittoe3 were accepted. VI. Informational Items - Ms. Fox reported that Human Services Committee its planning to utilize the model developed for the Mental Health Board funding guidelines. With revisions specific to City fundins priorities. - The Human Services Needs Ac000nment Report is completed and will b© sent to the Mental Health Board_ Meeting adJ our ned at 9 : 50 p.m. Respectfully submitted. .lea ,M. Fos , Evanston Mental Health Board Sua ry of Decisions Meatine of September 10, 1987 1. Policy 8-87-4 (Mental Health Board Budget Policy) was reaffirmed, with corrections. (They will be sent on to Human Services Committee/City Council). 2. Tentative approval was given to FY 88-89 Mental Health Board Objectives. for further development. A specific objective regarding a needs assessment process with resources needed is to be developed by staff for consi- deration of Board at the November meeting. 3. The 1.5% increase in the Mental Health Budget For FY 88-89. per City Budget Policy, was proportionately split between Purchased Services and the Mental Health Center budget. 4. The proposed FY 88-83 Mental Health Board Center Budget was given tentative approval. (Final reviow and approval will take place at November meeting). 6. If merited by funding requeate and needs. the Mental Health Board agreed to encourage Human Services Committee to break City Budget Policy and allocate additional funds for human servicen. B. The Funding Guidelines Committee report about use of Board Program Assessment, (BPA) rating forms was accepted. 4 n r EVIAN TON 1$NTAL HEALTH BOARD METIM13 lT MME S OCTODER 13. 1997 (M nutos approved) Members Present: Jack Lynch. Lee Leggette. Carol Hanes, Marcia Nelson, Ann Graff, Art Diers. Gene Feldman Staff: Jeanne Fox, Harvey Sager Com uni t y Representatives: Marge Sondler. George Cyrus, Rosalie Greenberger, Mental Health Association; Dr. Diane Goodson, Bob Wolf. Early Childhood Development Center; Laura Guilfoyie, Joan Rosner. Alliance for the Mentally Ill Ms. Hones (Chairperson) called the meeting to order at 7:35 P. m. 111r. LAmMett• shoved to approve the minutes of September 10 MOstina as written. Ks_ Nelson seconded_ Passed: 7 aye -- O no. The Mental Health Board heard the following requests for funding: Mental Health Association of Evanston. Early Childhood Development Conter, Alliance for the Mentally III of Greater Chicago. (Working notes are available upon request). ( Janice .Tones joined the Board at 8: 3Q p. m. ) III, Long Term Caresues Ms. Hones indicated that several events had recently occurred which raised questions about the Quality and appropriateness of care and supervision in specific long term care facilities. In consultation with its members, she requested Mental Health Hoard's Long Term Care Committee to reconvene to develop a plan for Mental Health Board's Involvement on those issues with Evanston's long term care facilities. They have already met once with Ms. Fox to be updated on recent events, and to begin to develop a strategy. -z- Ms. Graff said that the Committee discussed a recent incident Involving the death of a resident of the Ridgeview, outoide of the facility. This raised questions about the level of care and supervision at the facility. They also discussed licensing and certification issues which are being raised with the Rideeview Pavilion and Golf Mill Plaza. both owned by the owners of the Ridgeview. She expressed the concern that. while the Mental Health Board does not have authority over long terra care facility programming, the Mental Health Board needo to determine what it can do to leverage better care for ita mandated populations in these facilities. Me. Fox reported that the Health Department has notified the Ridgoview Pavilion that they are out of compliance with the local Long Term Core Ordinance. The Health Department will Initiate licoruse revocation by notifying the Pavilion that, if they are not in compliance by a certain date, their license will be revoked. The lose of the local licenses will © i mul taneousl y result in the lose of the State license. In a consensus decision, the Board directed the Long Torte Cure Committee to recoiBnd revisions of the Long Tern Care Ordinance in order to improve the quality of care and super- vision of long torn care residonta_ The Committee will cooperate with other co■amity aroups in this effort_ I V. I nforsaat t onal Items » The Evanston - Elgin/Road Network has been monitoring the use of -icute beds at Read Zone Center. So far, 7 acute cases have been admitted to Road at the beginning of October. A member from the network has been at Road every day since then transition began. The institution staff have been very co- operative. » Me. Fox disc:usood the recommendation from Human Services Committee to increase funding. this year. to City and Mental Health Board contract agencies by $70,000. This money will be earmarked for job -related programs and will free up additional funds for other contract agencies_ City Council will discuss the recommendation on October 26. Mr. Feldman indicated that Human Services Committee would rely upon UBP to determine which agencies would receive these funds. These added funds for human services would increase the Rending base for agencies in the future. G -3- >> Mr. Lynch discussed the process the UBP panel will utilize at the final Thursday hoaring. to make initial community funding recommendations. and to estimate the agencies' needs for community funding. >> The Mental Health Board discussed the October 31 Evanston Community Forum. There was a request that, If Ms. Hens was to speak for the the Mental Health Board at the Forum, her remarks should be circulated beforehand. >> Mr. Saver reminded Board members that they needed to be prompt In returning the program rating forms in order to insure being able to have the information for the funding guidelines prepared on time for their consideration. All members graciously agreed to comply. Meeting adJ ourned at 10 : 15 p.m. Respectfully submitted. J nne M. Fox EVANSTON MENTAL HEALTH BOARD MEETING MINUTES NOVEMBER 2, 1367 7: 30 P.M. (Minutes approved 1-14-88) Members Present: Carol Hanes, Lee Leggette, Marcia Nelson. Ann Graff, Art Diers. Gene Feldman. Bonn Greenspan, Janice Jones Staff: Jeanne Fox. Harvey Savor Community Reps: Marge Sondler, Evanston Mental Health Association; Dr. Diane Goodson. Early Childhood Development Center; John Buckley, Family Counseling Service of Evanston and Skokie Valley; Ray Ganey. St. Francis Hospital Adult and Child Guidance Center; Helene Lome. First Step. Nilea Township Sheltered Workshop; Gerald Gulley. SHORE; Chris Pasinraki, Vaugnn Gordy. Nancy Smiegowski, ACORN; Kate Mahoney, PEER Services; Bob Roy, Community Defender; Delores Holmes. Family Focus. Carol Hones. Chairperson. called the meeting to order at 6: 40 p.m. Ms. Graff moved that the minutes of October 13, 1987 be approved as written. Mr. Greenspan seconded the motion. Motion passed: 8 aye, 0 no. Mental Health Board Coeatiittee Reports: Neade eggegp nt Me. Nelson stated that the Sub -committee had decided that they will deal with the needs assessment issue after the Unifiod Budgeting process was completed. A report will be ready for the Mental Health Boisrd in December. Lonst Term Care (LTC) Committee Ms. graef reported that the LTC Committee continues to meet. No action is needed by the Board of this time. Ms. Fox otated that the Ridgeview Pavilion has requested a hearing, so the legal process stops until that administrative hearing takes place. Also, the Commission On Aging and the Mental Health Board staff are developing a plan. if needed, for moving the current vulnerable populations living in the Pavilion to alternative residential placements. -z- :n response to a question from Alderman Feldman. Me. Fox explained the role of the Mental Health Board under the Evanston Long Terse Care Ordinance for monitoring the training of LTC staff rosardins needs of mentally ill and developrnentdlly disabled and social work requirements. Mr. Greenspan expressed the desire of the Mental Health Board Long Tern Car* Committee to develop quality standards for long term care facilities so that staff can help clients to develop and grow as well as provide a safe environment. Ms. Nelson stated that the Funding Guidelines Coswittee had art on October 30 and had reviewed the final *cores of each agency. The Cosrittee's funding recoaa4endations were th*,Y presented to the Board. She thanked the Board members for their input over these past aronths and corAbanded staff eor their excellent aupport. She stated that she thought that it was very useful that most of the Mental Health Board were able to attend the October 23 meeting of Unified Budgeting when all agency allocations were discussed from a community perspective. Ms. Hones stated that all tho Board =*sober* had read all the proposals. visited agencies. been to Unified Budgeting hearings, participated in Mental Health Board hearing:. analysed information prepared by staff and had evaluated the agencies based on their Board Program Aersenament Forms. Each agency will be reviewed in alphabotic:al order. utilyzing the Funding Guidelines Committee's recoemwndeation as a starting point. These recomu ndations will be examined individually by program and by agency. The first vote will be a preliminary vote. The Funding Guidelines Coaunittee assumed that monies would be available from the City because of Real Estate Transfer Tax funds earmarked For job related progrnms. Earn and Learn and ACORN proarmmo would be eligible. In response to a Question by Mr. Leggett*. Ms. Fox stated that it is hoped that the Tax Transfer monies will be available to support the Earn and Learn social work component and the ACORN job support position. Mr. Leazette then stated that in pact U niPied Budgeting hearings the Mental Health Board has taXo n a lot of Neat for having a fixed position in regard to its allocations. He asked whether the Board should consider setting aside a pool of money by which to negotiate or move around in the Unified Budgeting discussion on Saturday. Alderman Feldman stated that he felt that the recom- -3- mendations of the entire Board were vary important and that these recommendations could be supported. The agencies were then discussed in alphabetical order: (A detailed report of the discussion resardins each prcmras is available upon request). Janice Jones moved with a second by Alderman Feldman that ACORN would receive a total of 314.609 With 37.603 for the Drop -In Center: 92,000 for the Rasidential Services: and S5.000, a reduction of *2.000 from current fundins for the case menasoment services. Approved: 8-0 . Me. Nelson moved with a second by kid. Feldman that Atli be allocated i1.000. which maintains current funding. Approved: 8 - 0. Comfun i t y Coordinated_ ChiL,Srr s (s C' s) Ms. Nelsen moved with second by Mo. Graff that 4C's be allocated S21.561. which maintains current Fundins. Approved 8-0_ Cook County Legal Assistance Egundation Me. Nelson moved with second by M. Graff that no allocation be made to Cook County Losal Assistance Foundation. Approved: 8-0. Communir,X Defander Me. Graff moved with a second by Arid. Feldman that the Community Defender social work program be allocated 22.200. an increase of 870.00. Approved. 8-0. RaC1` Childhood 2eve12PM2nt Canter (ECDC) Bean Greenspan moved with a second by Ald. Feldman that ECDC be allocated $45.000. an Sa.000 increase over last year. Tim. Graff stated that ECDC serves a critical. vulnerable population oP youngsters, many of whom have been abused and are in need of support services. Approved: 7-1 (Lessette) Ms. Nelson moved with a second by nr. Or nsvan that -4- a $107,000 allocation be given to Evanston Hosvital, Department of Psychiatry, with sa.000 to ACCESS, a decrease of 31,000; 552,000 to Crisis Intervention, 947,000 to Department of Psychiatry Outpatient, 83,500 to Refocus program, a decrease of 31.000. The total allocation is the same as last, year. Approved: a-0. Me. Graff moved with a second by Me. Nelson that Family CoUneel l ne Service be allocated a total of 35A,802 with 227.047 for Child Abuse Services, an increase of 32 , SM i 812,325 for Individual and Family Counselins. the same as Loot year, and maintain 015.230 for the Senior Counseling Program. Me. Graff stated that the Mentai Health board is recosmending the increase to Child Abuse is *47.00 nor* than was requested. This 247.00 is merely a me►thematical adjustmsnt. Approved. 7-0. (Fe l dmnen absent) . Me. Nelson moved with a second by Bonn Greenspan that 817.900 be allocated to Family Focus for its social worker position, which is maintained at current funding. Approved: 7-0 . ra. .cones moved with a second by rA. Nelson that 511, SOO be allocated to the riental Healtn Association. This is a reduction of S2. COO f rcem current f undi rut. Approved: 6-1 (LAMSette ) Niles ToWMhsn Shsl sr2d +ierkshoo Mb. Graff vovad wth a second by rig. Nelson to allocate 84,000 to the Niles Townsnip Sheltered Workshop/First Step Program. a reduction of ii.000. Approved: 7-0. MD. Nelson moved with a second by fir. Locaette that a total of S33.767 be allocated to PEER Services with 330.165 to Druz Counselirm a $2.000 reduction. and 23.602 to PEER Youth Services - a $4.000 increase - a net increase to the agency of $2.000. Approved: 7-0 . -5- Ms. Nelson moved with a second by Les Leasette that Project Earn and Learn not be funded by the Mental Health Board for next fiscal Year because the board expects/hopes the City`s Tax Transrer monies will fund the social worker. Approved: 7-0. Ms. Graff moved with a second by Ms. Jones that 933,140 be allocated to SHORE community services with $15,140 to the Day Treatment Program, an Increase of 51.380 and 418,000 to the Residential Services Progress, an increase of 91.250. Approved: 7-O. Mr. Greenspan moved with a second by Mr. Diers that a total of $72,000 be allocated to the St. Francis Adult and Child Adolescent programs; 322.000 for Outpatient; 91.600 for DD Counseling; 35.600 for the Elgin Project Case Manager; 921.000 for Individual and Family; Counseling. $3.300 for OATES. a reduction of $700; and 812,500 to St. Francis Hospital Police Outreach. an increase of N700. The total allocation is the same as last year. Approved: 7-0. Having completed a preliminary vote on funding for each Program, Me- Nelson mo%mod that the Fi mdlnu Committee mendations for 0110catioin be accepted as voted.. Ms. 6~:F seconded the motiom- Mr. LQggette stated that he had no Quarrel with how the decisions wars made but with some of the allocations. He was concerned with the philosophy of granting such a high increase to one program at the coat to other programs. He stated that ACORN. Earn and Learn, Mental Health Association, and Pules Township Sheltered Workshop agencies were all reduced In'order to provide mayor funding to one agency (ECDC). Ms. Hones started that $5.000 from chronically mentally ill program of ACCESS; 91.000; Community Companion: 32.000; Refocus: 51.000; and First Step: $1.000 were reallocated to high risk youth programs. Mr. Lezzatte stated that he believes that ECDC deserves a substantial increase but that increase may not be able to be supported through the years, and could be a problem next year. Mr. Diers stated that he appreciated the shift of funding for the populations at risk and the increase to ECDC. Mr. Diers asked whether the Board did not have a responsibility to advocate with appropriate fenders to increase funds to pro- grams that we are reducing. Thera was consonswe by the riental Health Board members that advocacy for fu—ia for those programs should be emphaiei.zed_ Mr. Leggett* stated that he thought that vs should select cos agency a year and help then develop fumdino from othar ■ouress, , in order to =et the. out ar the circle of Isptal Hsaith Board support and Mow them tosasrd being self sustaining_ There was consensus, that this times a good ides amd should be p4nrsuod. Ms. Hanes stated that she would like to have all the agencies move to developine outcome measures. and to give moms information regarding impact of programs. Mr. Diers stated that information recoived from agencies regarding how agencies work to develop staef and how they support their staff is inadequate. 21r. Grseumm m cailed for the vote on the quo %ion on whoWier to accept the recomminedimcAomm on prmmmontad_ The more was 8 m�m - 1 any. tl.s�szte 3 . Ms. Hanes then stated that the Board needed to consider directions to give to the Mental Health Board Unified Budgeting representatives for the negotiation process for Saturday, November 8. She stated that we have made the asstmption that there is 34,828 from Earn and Learn and 32.000 from ACORN available to reallocate. Therefore, we need to consider what we should do if these monies are not supported by City Real Estate Tax Transfer monies. Ms. Graff moved that no alternati%m to funding rocoa ndations to made. Ms. Nelson seconded. After discussion. Me. Jones mado a substitute motion to present only the fund..Ing recommendations as voted on by the Mental Health Board. This substitute motion was accepted by Pis. Graff and Pas. Nelson. Mr. Lagzstts asked whether we would not fund Earn and Learn under any circumstances? rs. Jones stated that we have faith that the City will Provide sore Funds for this- astency. Mr. Lazzette stated that he is concerned that UBP will not fund Earn and Learn at all. We have consistently zivren them the message that we want to reduce our funding to this agency because it is clearly a school program and he would support this decioion. Mr. Greenspan stated that S4,6Z8 is only 1.4% of total program revenues. ra. Nelson stated that YOU does a similar program with the school and is not funded by Mental Health Board. r%. Graff stated that the program has a stronger connection to the school and although it is an e--mellent program. It needs the school's support. Cs. Fox stated that funds could also be requested from District 4202. Mr. Diers stated that the reduction to ACORN of S2.000 concerned hies. This is a very vulnerable agency and is not like Earn and Learn. which has a fundints relationship with the school districts. !"s. Nelson stated that ACORN's score vas not very high. Both prouramm rated a 6.7. Mr. Lezzette stated that he had trouble voting on this action - lumping two agencies together. Ps. Graff therefore zeds the substitute motion, that the Unified Budgeting represantatives be directed to =n]M no cha>Ses in t: s allocation to Earn and teem.. rft. Nelson aeconded the Motion. -"7'- The ■ntioo passed 7--0. lir- Greenspan mtywed the% FA=M's allocation be mmtoimsd as earlier voted vpom6. HW- Mslsoa secot+- I I the motion. Mr. Diers felt uncomfortable with the Board's recommendation for this agency. Ms. Graf stated that there are other staff available within the agency to provide the volunteer supervision. The Mental Health Board is not saying that the program is not important. It is only saying that it is hoped that the City will provide manias from its Real Estate Taut Transfer monies for this program which will amen an increase ror the asency, and that this reimbursement should be sufficient to help the agency provide its services. The motion passed 6--1 (Dierm). Mo. Hens asked if other funders want to change our allocations, how do we respond? Me. Graff stated that she believes that we do not change our allocations. Mr. Lessetto stated that he thousht that we could change dollars within agencies. Mr. Diers stated that it was difficult for the Board assobers to direct Unified Budgeting representatives completely. He stated that he felt that the Mental Health Board Unified Budgeting representatives had a sense of direction and priorities of the Mental Health Board, and that they would negotiate in good faith_ Mr. Greenspan stated that the rental Health Board Unified Budgeting represontati%me would maintain the philosophical intent of the funding decisions roads tonight. Ms. Jones stated that it was important to note that the four agencies to which we are the only (under are a part of our decisions. Ms. Jones also stated that it is important to state that the reduction to agencies for service for the chronically mentally ill and the shift of those funds to other programs reflect the r%ntal Y.aalth Board'$ shift in priorities. r2r. ie tt a stated that he wand lilacs to have a throe yam r historical picture of fuzd1 ng to all agemy programs. Ms. Fox stated that she will provide this in the packet for Unified Budgeting representatives for Saturday. Ms. Nelson thanked the Board members and staff on behalf of the Funding Guidelines Comsaittee for their time and input into this funding process this year. She Felt that it was a vast improvement over previous yearsai and had been very beneficial to all. The board adJourned at Sz 45 p.n. spactfu�lly submitted n H: SUNWAY OF DECISIONS M!A!. HEALTH BOARD MEETING NOVEMER 2. 1987 1. The recommended funding allocations of the Funding Guide,. - lines. Committee for FY 88-83 were accepted as presented, for recowmendation to the Unified Budgeting Panel. 2. In a consensus decision. the Mental Health Board recomr- mended that advocacy for funds for programs which re- ceived Dental Health Board funding cuts for FY 88-89 should be emphasized. 3. Staff was requested to provide a three-year history of Montel Health Board funding for agency programo, for consideration at the UBP final Saturday decision -making meeting. •. In a consensus decision. the Mental Health Board recom- mended for consideration the development of a strategy to provide assistance to one agency a year in order to help them develop funding from other sources. which would take the place of Mental Health Board funds. S. The Mental Health Board Budgeting representatives were directed to make no changes in the recommended allocation to Earn and Learn at the UBP final Saturday meeting. S. The Funding Guidelines Committee allocation recommendations for ACORN'S progrw= were sustained. ADDENDUn ?'l11UM HEALTH BOARD MMU TES NOVEMEEL 2. t987 The Mental Health Board, utilizing the Unified Budgeting agency recommendation to maintain this agency, hopes that the City will fund, through the Real Estate Tax Transfer funds, some part of the program, particularly the .fob support position. The 42.000 reduction For the Volunteer Case Management Services should not be viewed as a lacy of confidence in the agency, but that the Mental Health Board has lighted resources and several other priorities. It is hoped that the supervision of volunteers can be performed by other staff positions in ACORri. Mr. Legzette questioned if this vote is really a vote for a decrease for the agency or really a hope that the agency Will be eligible for Real Estate Tax Transfer monies. The Coam.ittee members assured Mr. Lassatte that the intent of the reduction was in response to th expectation that monies from the City's Taut Transfer would be available to this agency and that the total allocation to the agency would be an increase. The Committee recommendations are based on the small number of Evanston residents served by thin program. The Mental Health Board greatly appreciates the advocacy work of the Alliance for the Mentally Ill of Chicago and grants to keep a relationship with this agency. It is important to the Evanston community that the Alliance for the Mentally Ill is providing such a significant service of residential programs as well as self-help groups. Ms. Nelson noted that the Unified Budgeting agency recommendation was to increase funding to this agency. It was noted that the $21,561 would be the Mental Health Board's part of the maintenance of the community match for State funds. Me. Nelson stated that It is necessary that 4C's maintain accessibility and availability of day care services for children with special needs. Mr. Diem expressed his concern that there be adequate money to maintain community day care mote. Ms. Nelson noted that the Unified Budgeting recommendation Was to maintain funding. However. the Mental Health Board Funding Guidelines Committee decided, as the Mental Health Board, d.id last year. not to fund this agency. It is not primarily a mental health service and it is hoped that other funding will be available to continue to provide these legal services to low Income residents, especially of long term car* faci Lities. Ms. Hones stated that the request from the Community Defonder program is for expansion of the social work position from 2/3 to full time. Mr. Greenspan stated that the rental Health Board wants to communicate that it is an excellent program and a unique service. Howe%mr. we do have limited funds and wanted to maintain them at current amount. The S 70. OCR extra Is really a mathematical increase after all other decisions were made. This recommendation is In line with Unified Budgeting recommendation to maintain funding to this agency at current level. Ald. Feldman stated that this decision is a clear message of the values of this Board. rA. Hanes stated that it is our understanding that this agency's clientele are not usually covered by insurance. Ms. Graff stated that State funds have boon declining. Mr. L.aggetto stated that this agency provides a very valuable service, but cautioned members that we are recoamrendins a significant Increase and that next year. we will have to continue to fund at this level as we are the only fonder cf this program. The final score is quite hizh. but are we sure we want to commit this significant increase? Mrs. Graff statod that if 6m are able to address problems early wr would not have a need for as many adolescent outpatient services. If it seems that the funding: to ECDC is disproportionate to other funding allocations. it is because the Mental Health Board is the only funder of this agency. Mr. L.ogsetLe stated treat when we are looking at th,ca amount of money. we mast realize that we cannot go backwards, because a reduction to this agency would be significant. This Is not a one year decision. Ms. Graff states that this investment In the future is a desire of the Mental Health Board to emphasize prevention and intervention service Por high risk persons in the community. Ald. Feldman stated that we must recognize that there is a disastrous increase in the number of children they have to work with, and the Mental Health Board is Just recognizing the need. Mr. Lazzetto stated that we must reall=e that next year we also have a commitment to fund at this greatly increased 'Level. Other agencies. like the hospitals, have the ability to shift funds within an agency, but this program does not. Ms. Nelson stated that this decision regarding this agency reflects the moor shift of the Mental Health Board funding towards high risk Youth. The pie is getting smaller and the decisions are getting more difficult. This decision reflects our priorities. Mir. Greenspan stated that our Board assessment &core is that this agency has one of the highest scores. It also reflects a priority that we have that other funders do not necessarily share. The Unified Budgeting reco=andation was to maintain funding for Evanston Hospital at current level. The Evanston Mental Health Board is the only (under of Evanston Hospital. The allocations reflect the shift of some monies from programs serving chronically mentally ill residents of long term care facilities to services for high risk youth. Mr. Greenspan stated that it also reflects the priority of services to residents of the coo=unity at large and the desire of the Board to support the Suicide Prevention positin in the Outpatient Psychiatry Department. It should be noted that funding for the ACCESS and Refocus programs ranks lower. It is hoped that it could be supported by funding from other sources. Ms. Graff stated that it is hoped that the State would reward local agencies for decreasing bad day utilizations at State hospitals and that these two programs would benefit. Ald. Feldman asked to speak to the Board as he was leaving for another meeting. He stated that he was pleased to be part of the Friday worning Funding Guidelines Committee meeting, and he stated that the decisions were the result of an intense discussion and thorough knowledge on the part of the Board. He agreed with all the recommendations as presented. Mir. Leggette stated that two years ago, the Mental Health Board had reduced significantly Family Counseling Service, and asked whether there vas any discussion or attempt to restore the monies reduced. Ms. Nelson stated that the increase given was for a specific program and was not an attempt to restore agonies reduced. Mr. Greenspan stated that there was a strong vote of the Unified Budgeting Panel to increase funding of this agency and it is hoped that it will be reflected in the Unified Budgeting allocation process on Saturday. Ms. Hones stated that the request for increase was for additional monies for the social work component. Mir. Greenspan stated that Unified Budgeting Panel recommendation was to increase this support for this agency. He stated that he thought that other funding is available for this programL The Mental Health Board wants to support this service. r&. Hanes noted that the recommendation was to eliminate funding S2.QG0 for the Community Companion Program. It is hoped that the Volunteer Training component of the Mental health Association will be involved in this service. Again. this is a reflection of the Mental Health Board's concern that the program serves long term care facility residents and the long term care facilities should contribute. Mr. I atto stated that the Community Companion prozram had a high score. Also, why did the !'dental Health Board fund the program last year. if they weren't going to continue funding then alter the first year? Hs. Henae stated that this indeed was an innovative program last year and the Board wanted to show support for it. Cie. Graff stated that this program only involves a small number of people and there are ways to provide service through the Volunteer program. The Mental Health Board has recouni=ed that the Mental Health Association has not been as dependent on our dollars and there- fore no cuts were made. Mr. L.azzotte asked if this was going to harm the program seriously. Ma. Nelson stated that if the Ions term care facilities find this program beneficial. they will support the program. Mr. L ozzotte asked if this was fair to the program. Ms. Nelson stated that our decrease does not mean that the program is not a meaningful program. In fact. they have done a particularly good Sob. However, it is the feeling that between the long term care facilities and the Volunteer Training component. this specific program could be maintained without the 92.000. The First Step program was recommended for a $1.000 decrease using the same rationale as for the decrease in the ACCF..S"S program and the Community Co:ipanlon program. This program serves chronically mentally III long term cars residents. This program has been very successful in saving bed days. Therefore, it is hoped that the State and/or the long terns care facilities can pick up part of this cost. It is a successful program and had a high score. Again, this decision reflects a shift in priorities of Funding for the Mental Health Board. Mr. Leggette stated that last year we allocated 35,000 because it was an outstanding program; are we withdrawing support from this program? Me. Graff stated that this reduction is not enough to undermine the program. There are other funds available to :his program and 51.000 represents a small percentage of the total. Me. Nelson stated that the Board recommended decreasing $2,000 from the Drug Counseling Program and adding the $2.000 to PEER Youth Services. Ms. Hones stated that intervention Programs are becoming important to us. She stated that it is important to note that the Board is concerned about the outcome indicators for the PEER Youth Intervention Service and asked that these indicators become more reliable in the future. Me. Nelson asked whether or not the Mental Health Board tracks monies for services through the agencies or does the agency utilize the monies within the agency as long as they provide the service? Me. Fox responded that the Mental Health Board does not track money through the agency as the Department of Mental Health does. for the services provided. The Board requires accountability for services purchased. Project Earn and L&arn _ Qincussi on: This recowmsndation should not be considered by the agency as a lack of support for their program. Mr. Greenspan stated that this program is excellent. It is believed that the Mental Health Board reduction will be replaced with City eunds. rs. Jones asked if we are giving a doable message to the agency. Do we have a rationale for an alternative decision if the City monies are not able to support this program? Me. Fox stated that the Unified Budgeting representatives of the City are meeting November 3 to make their decisions. We will possibly know before November 8 what their recommendations are. Ms. Graff stated that in the past two years, the Executive Director of the program has stated that if we did not fund the agency District 065 would not fund the social worker. However this has not happened. She stated that she believed that District 065 should fund this position. Mr. Diers stated that this is such a good program, the rental Health Board should support or advocate for the support of the social work position. SHORE Discuaaion: Mr. Greenspan stated that this agency provides a unique service to one of our mandated populations in Evanston, and the fixed cost for day treatment programs continue to rise without increase in State rates. Mr. Greenspan stated that the Committee reviewed this agency and its programs and found it to be outstanding in every way. It has the highest ranking of any agency and the quality of service is exemplary. This agency should be emulated by other programs who serve the same population. This allocation is the beat we can give. Ms. Hones stated that we have given an increase to this agency every year because of its high ratings. Also, the Mental Health Board, in reviewing its allocations for target populations. noted that developmentally disabled are not receiving[ proportionately, the amount of money de the chronically mentally Ill. Ms. .cones stated that the agency is already doins fund raisins for the ' canine year and has had a significant increase in fund raising activities resulting in increased revenues during the past year. -not Folk r , 11 11r. Greenspan stetted that St. Francis provides a range of Programs to the community within an unusual spread of programs that results in a synergy in the community as a result of its work. !'Such of their work is aimed at services for high risk faai.liao and the young, particularly the Poiics Outreach program. We would sive more of our money to this proarm. but this is the best we can do. It prevents lone rang• problems. No other sources fund the Police Outreach program from Uni.'isd dudsetins. r1r. Las;sette stated that there was no increase in thy► Elgin Case Manswoment Program, yet they haw a high scars. Me. Hones reapo ndsd that the requested increase in for the coo* manager position to be expanded to full time from half time. This is another indication or the rental Health Board support for community residents and AAsInerablo young populations. we are again. maintainlns the total allocation to tho agency as Unified Budgeting has requested, but eh.iftins $700 from tno OATEa program to the Police Outreach Program. Mr. Greenspan stated that we are maintaining the DO counseling program et its current level, bocatmse it supports an indizenous group of community residents. Ms. Graff stated that it is hoped that the Department of dental Health will fund the other programs at a higher level. However. the rental Health 9oard monies must provide services to high risk community persons. gVVVmTON INWAL HBALTH BOARD NMTIMB MIMUTBS �IOVBl�Eik 10, 1867 (M nutes approved 1-14-68 ) Members Present: Art Dior*. Aid. Gene Feldman. Ann Graff. Bonn Greenspan. Carol Hones, Leo L.ogaette. Jack Lynch, Marcia Nelson Staff: Joanne Fox. Harvey Saver Commiuni t y Representatives: Shirley Dare (ACORN), Marge Sandler (Mantai Health Association of Evanston), Jim Stavish (Niles Township Sheltered Workshop), Holene Loess (First Step). M. Berger. P. Arist. Jean Mitchell. Joanne Hafrend, Dorothy Berg, Jars Dora, Mary Rose Coburn. (Alliance for the Mentally Ili of Chicago). Me. Hones, Chairperson, called the meeting to order at 7:40 p.m. The minutes of the November 2 Board mooting are being p repaered . I. Introdu9tion and CQmmxinitx Comment$ Ms. Hones asked the community members to introduce themselves. She then recognized those individuals who had come to address the Mental Health Board. Maras Sandler, Mental Health Association of Evanston (on behalf of Mental Health Association of Evanston. Alliance for the Mentally Ill. ACORN. First Stop. St. Francis Adult and Child Guidance Center, Evanston Hospital Sustaining Care). Written statement attached. Jim Stavish, NTSW✓First Step. (Letter had previously boon sent to the Board). When working with the chronically mentally ill. it is important to consider reduction of recidivism. While this is an objective criteria, it means that individuals are functioning better and not disrupting the comm unity. If funding In decreased for the chronically mentally ill, the problem won't so away. nor will the people - the programs will. He suggested that a meeting be convened by the Mental Health Board with local providers and Illinois Department of Mental Health officials to discuss community issues related to the chronically mentally ill. Me. Hones thanked individuals for their comments. She indicated that the Mental Health Board would consider the remarks during consideration of the Mental Health Board FY 88-88 objectives and budget. _2- �. 1 r• We I . Me. Graff roved to adopt the proposed amended Mental Health board ObJectives, with additions, For FY 88-83. Mr. Diers seconded the motion. Ms. Graff said that the obJectives reflect the Mental Health Board's charge to address the entire community. Mr. Lynch asked if. based Won the information provided. there was sufficient available staff' time to accomplish the obJesctives. Me. Fox indicated that there was a possibility of obtaining students for the second somsster. Me. Hennes said that priorities mmy need to be established based capon available staff tins. The original motion was withdrawn In order to consider changes In now obJectives. no. Qraff moved to channe the 2nd Objeeativa undor additioaml obJecoiver to read: By Jawm ry I. ISM. to haws Improved the qu.lity and loyal of servi.cea for residle"A of loos term care facilities oervi me the arewtal 1 y ill and drWal opmanta►i l y eiisabied bred oa recomma datiossa of the Lone Term Care Committee. Mr. Diers seconded the matinee,. Mtior porssd a aye - O no. Mr. Lynch asked that the Mental Health board establish peramsrters and priorities for the expectations of staff time. The staff" were requested to provide sours direction for priorities on Mental Health Board objectives and a status report on the current Mental Health Board obJ*ctive for the January meeting. Ald. Feldman aao%ead to adopt the FY a&-a9 Mental Health Board ObJectiveers as arnded. no. Graff seconded the motion. Motion passed a eve - O no. (A►lailable upon r.rgtwwt). MENTAL. HEALTH CENTER W)GET . 11r. Lynch moved to adopt the p . 1 nostal Henal'th Center budget for FY 88-88 of i112.3aO. nr. Fold■as oncoodsd the notion. Paamsed 8 aye - O no. (Total Budget available upon request). PURCHASE SERVICES BUDGET. Me. Hones asked if the Mental Health Hoard wanted to reconsider its allocations based upon the communications which were received. The Pollowins coaments were made: The Mental Health Board's aaission is both for those with problems and those at risk of having problems. The FY 88-83 Mental Health Board obJectivas should basin to address the problems of the chronically mentally ill; the funding decisions were not an abandonment of the population. -3- There was an attempt to minimize all funding cuts. The Mental Health Board is now a long term Punder, but there in a need to address hoer such can be set aside for start-up funding and innovative programs. The Mental Health Board utilized UBP funders' recommendations throughout. Funding Is only one part of what the Mental Health Board does. The amount of staff time spent in dealing with the chronically mentally ill is great compared with other target populations and reflects the Mental Health Board's commitment. Mr. Greenspan moved to adopt the pr.,. L Purchase Service Allocations for FY 56-88 of 0424.277. Ald. Feldman seconded the motion. Pawned 6 ave, - O no. Ile- Nelson pr . , , i that a matins be convened by the Tlsntal Health board to discuss community issues related to the chronically mentally ill with local providers and the Illinois Depart see nt of He ntal H m&L t h_ The board concurred. IV. Information ,jteMs > The Ridgeview Pavilion has now staff who have conducted assessments and has a new social worker. The facility has asked for a hearing on the revo- cation of its license. so the legal action is on hold. > Me. Fox asked the Mental Health Board to consider having sons future Mental Health Board msetinss at the location of Mental Health Board funded providers. in conJunction with their respective boards of directors. > Ms. Graff reported that the Long Term Care Committee has not met recently because of other responsibilities of the Committee members. > The Funding Guidelines Committee will meet In January to evaluate the funding guidelines and the funding process. The meeting was adi our ned at 9 : D6 p.m. S erely. J anne M. Fox 6V M I GN nENI AL. NNUMTH BOARD SU ARY of DeMSIONS rMWnm a OF NaVBl M 10, 1867 1. ObJ ctive 2 of the FY 88-89 Mental Health Board Objectives was amended to reed: by January 1. IWO, to have improved the quality and level of services for residents of ions term care facilities serving the mentally ill and developmentally disabled based an recomm ondations of the Long Term Care Committee. 2. The FY 5O-58 Mental Health board objectives were adopted. 3. The FY 88-89 Mental Health Center Budget was adopted_ t. The FY 88-89 Purchase Service Allocations were adopted. 5_ A mooting should be convened by the Mental health Board to discuss community issues related to the chronically mentally ill with local providers and the Illinois Department of Mental Health. Statm■nt to Mental Health Hoard by Marge Sondler,MW NOV. 10, 1987 I an speaking on behalf of the HiAE, the Alliance for the Mentally I11, ACORN, First Step, St. Frarris Adult and Child Guidance Center, and Evanston Hospital's Sustaining Care Progr:ans. We are all advocates for the people in this r^mmmtty who have a serious aratal illness and as such, we strongly protest the Mental Health Board's chtaga in priorities, and the funding reductions of progrthat serve the chraaically mentally ill. we the need for program for children and agree that they c= pra�ta emotionally healthy a&Its. They cm=t, however, prevent serious mental 413saessas. We umt to pout out that for the vast majority of people with schizophrenia and amok deprc3siaa, the illness first becomes apparent in laze adolescence or early adulttwod. These people have normal childhoods in loving faea_Lies, to the same degree as t.?ose who do not become mentally ill. Thera is much research that indicates a straug likelihood that serious mental illnesses have bihmzal causes. The point is that we do not yet know how to prevent sariaus m intal illnss, nur can we predict who will have it. All we can do is try to treat it once it occurs. You have reduced bxd=g to this population in preference for irncrasad Bing for other populations. Yet the chronically mentally ill are surely one of ymw =ndated service populations, one that all too often is shortchanged when it cones to services, housing, research, jobs, and funding, due to the stigma attached to mental illness. Since the Mental Health Board is, or should be, an advocate for the seriously mentally ill, you send a strange and unfortunate message to the public -- that those with a chronic mental illness are somehow less deserving of our concern. Moan of the 'seriomsly am =Uy ill am Live in the ca munity and their need for bospito I L"zilm cm be ��e with .r:..r.:it! Support and t37atwnL_ Assisting them to do that shmild be a major priariry of this board. we tha there are i needs for fia:ding. Obviously, we believe tbut frrdfor the serimsly ventaLly ill should have been im=Vued. idaht moo, Mental SmIldL 3oeQ* fmdinz ed fJc2t"y for services to the seria I r AMZLUY LU aftMtn Mly 9 k of Years total PZChaem of sasVicr &rds. Yaw ire arras yw ropment a: LIM decrease in fimdAm rise this PwAlaxim. At the vex ► Ism, the Mental Health mold milt hrm used- the Aftk1= ••m W it bas this yum to lkmd ire psmfsrrwithart diMiag into the I istited fix ds allotted to the chs -1 dcally = urtaily ill . We see this as pelt of a �.tx'bfnc: ts+sod is the Boasd tb • fgWm ter meads of the It mr=LUY ill based as the uctLm tha S� _tb at d =Tiici _iU proviAs. at is wt TU? i5ti-C. Mm i fstt vM be, instead, a 1 ex�+�g Of service, a Canaaeitsat tmcreasm in hcspri and i..4,.t....r. iota discliarge, m sad hwden am the c mmmit7, and am and L in the lives of the nmtally M. . we Strway mW Yaw priorities mad Itiam We also ash that the limtoa mmul Health Neum rh, which includes . all the groups I mod, be given the �.Vv v...asitp to sit dam and t &U with the Mortal, Hestlth Bog d about the Chronically mentally ill in this ec=Laity end -how best to met their ameds. 'flank yvu.