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MHSC SCAN August 1996

Annette Mizelle, Tony Celebrezze Join MHSC Board

Annette Mizelle and Anthony Celebrezze, Jr. have joined the MHSC Board for three-year terms. Ms. Mizelle, who was designated for election by the County Commissioners, brings a career worth of experiences in human services with her to the Board. She recently retired from the Franklin County Department of Human Services after thirty-four years of employment. For the past fourteen years she served as the Deputy Director of Income Maintenance and was responsible for administering public assistance programs to area residents. Ms. Mizelle is an active community volunteer with various organizations, including the Child Development Corporation Head Start Program, United Way and the Franklin County Welfare Reform Task Force.

Mr. Celebrezze, who joins the Board after serving on its Standing Committee for Levy-Funded Human Services, is a City of Columbus designee. As vice-chair of the Committee for the last year, he assisted in the review of both the ADAMH and FCCS 1996 levy requests. The Standing Committee is just one of his many community volunteer efforts, as he serves on numerous legal and community boards. Celebrezze is a former State Senator, Secretary of State and Attorney General and is currently in private practice at Dinsmore & Shohl.

tear-off card

Do you have a pressing question about outcomes? If so, jot down your question and return this card to us. We’ll use the questions we receive as we plan an upcoming symposium on outcomes.

My question on outcomes is:

_____________________________________________________________________________

______________________________________________________________________________

I am: (check one)

____ a human services funder

____ a human services provider

____ a community volunteer

____ a business person

____ other ___________________________

Thanks!

MHSC ANNOUNCES SYMPOSIUM ON OUTCOMES

“How do I know my programs are helping people in the community?”

“How do I know my funding dollars are achieving some good?”

MHSC, along with United Way, The Columbus Foundation and the OSU School of Social Work, will present a symposium on outcomes for people working in human services. Participants at the day-long event will explore how the community can better measure the progress made toward improving the condition of area residents. As a first step, the conference will bring together the various elements of the human services community - funders, providers, planners - to discuss how each talks about outcomes and to build a common understanding of what outcomes are and how they can best be used.

A conference on outcomes is needed, MHSC believes, because of a number of observations we have made about the community. First, people in human services use the term “outcomes” in a variety of different ways, referring to objectives, their results and process measurements all as “outcomes.” They also use terms such as goals, visions, objectives and measures almost interchangeably. And, people frequently develop outcome measures first, without doing preliminary work such as establishing goals and objectives that are linked to an organization’s mission. Just as often, people believe outcome evaluation is the end result of the planning process, rather than one part of work to improve people’s quality of life.

MHSC believes that the successful tracking of progress made toward improving people’s condition depends on a common understanding and use of the terms related to outcomes and their context in a good planning process. Accordingly, MHSC and its co-sponsors present the symposium as a beginning of a community-wide effort to work on how we understand and use outcome measures. Elsewhere in this newsletter is a mail-in card asking for your input on the symposium. Registration materials will be mailed in the fall.

The Standing Committee for Levy-Funded Human Services

Jim Bowman, Chair

NatCity Investments

Charles Adams

Public Policy and Management Office, OSU

Marty Anderson

Sowald, Sowald and Clouse

*William Brown, Jr.

Grant Medical Center

*E. William Butler

The Police and Firemen’s Disability and Pension Fund

*Anthony Celebrezze, Jr.

Dinsmore and Shohl

Virginia Colson

Community Volunteer

*Dean Conley

Public Issues Management, Inc.

Jerry Friedman

OSU Medical Center

Robin Johnson

Constantine Group

*Kevin Osterkamp

Roetzel & Andress

*Ronald Sams

Children’s Academy

Claire Sawaya

Project Control Systems

*Charleta Tavares

Ohio House of Representatives

The following individuals joined the Committee for its levy review this year:

Barbara McAdam Muller

Columbus League of Women Voters

Linda Siefkas

Greater Columbus Chamber of Commerce

*William Rittenhouse

Columbus/Franklin County AFL-CIO

Note: * denotes MHSC Board membership

MHSC Board Finds ADAMH, FCCS Levies “reasonable and necessary”

The MHSC Board of Trustees voted in August to accept the reports of its Standing Committee for Levy-Funded Human Services on the ADAMH and FCCS levy requests for the November ballot. The Committee, as part of its ongoing monitoring of levy-funded systems for the Franklin County Board of Commissioners, performed extensive reviews of both agencies’ requests. During the reviews, John Saros of FCCS and Dr. Phillip Cass from ADAMH both made presentations and provided information materials to the Committee. The Committee also solicited community input through surveys and interviews during the review process.

MHSC Board Chair Barbara Jennings forwarded the reports to the Franklin County Board of Commissioners for use in formulating their decision to put the levies on the ballot. On August 13, the Franklin County Board of Commissioners voted unanimously to place both levies on the November ballot.

Copies of both reports are available by calling MHSC. Excerpts from the Executive Summaries of both reports appear below.

Franklin County Board of Alcohol, Drug Addiction and Mental Health Services levy request:

2.2 mill, 10 years

1995 revenues: $79,620,621

local levy: $32,800,755

The Committee concluded that the ADAMH levy request is reasonable and necessary, given its analysis and understanding of the materials provided. This conclusion is based on the Committee's findings and recommendations, which are listed below. Each is discussed in greater detail in the full report.

Findings Regarding Implementation of Managed Care

o ADAMH is committed to the implementation of managed care practices to maintain current levels of service and limit annual expenditure growth to 3.75%.

o Managed care poses a potential risk to the quality of care as a result of its attempt to balance cost containment with access to and quality of services.

o Establishing and tracking baseline data is essential to monitoring the quality of client services in order to measure the improvement in people’s condition over time.

o ADAMH has not yet developed client baseline data for client outcomes, cost or utilization.

The Committee recommends that:

ADAMH, as part of its strategic plan and implementation of managed care, develop baseline data and mechanisms to identify and track utilization and cost data and provide monitoring reports on the achievement of outcomes, for both individuals and in the aggregate;

ADAMH investigate and adopt, to the extent possible, best practice methodologies to assure cost-effective quality of care.

Findings Regarding Administrative Costs

o ADAMH’s administrative costs are not unreasonable, given the current fee-for-service environment.

o The implementation of managed care may present the opportunity to reduce administrative costs.

The Committee recommends that:

ADAMH continue to maintain total system administrative costs below 20%;

ADAMH explore opportunities that managed care may present to reduce administrative costs.

Finding Regarding Fund Balance

o There may be opportunities for ADAMH to reduce its restricted fund balance.

The Committee recommends that:

ADAMH explore strategies to reduce its restricted fund balance;

ADAMH report to the Committee in one year on its findings, any steps taken and savings realized as a result of its exploration.

Finding Regarding Communications

o The public does not clearly identify ADAMH as being responsible for funding the contract agencies that provide alcohol, drug and mental health services.

The Committee recommends that:

ADAMH build community awareness of its role and relationship with contract agencies which provide vital ADAMH services to some of the community’s most vulnerable children, youth and adults.

FCCS Levy Request

1.1 mill, 8 years

1995 revenues: $73,270,346

local levy: 3.15 mill (expires 1999) $41,650,825

.8 mill (expires 1996) $11,523,599

The Committee concluded that the FCCS levy request is reasonable and necessary, given its analysis and understanding of the materials provided. This conclusion is based on the Committee's findings and recommendations which are listed below. Each is discussed in greater detail in the full report.

Findings Regarding Community and Agency Planning for Children

o FCCS performed a pivotal role in initiating community-wide planning for children by convening and leading the Child and Family Serving Network planning process.

o FCCS developed an agency-level Strategic Plan.

o The goals and objectives in the Strategic Plan addressed organizational and tactical issues rather than strategic issues.

o The Strategic Plan does not adequately address child- and family-centered outcomes.

The Committee recommends that:

FCCS provide the Committee, child-serving agencies and advocates with regular, periodic updates on the status of implementation of the Strategic Plan;

FCCS provide the Committee with revised outcomes that are clearly child- and family-focused by June 1997;

FCCS act as a catalyst in the Children’s Cabinet, sharing its expertise on the needs of children and demonstrating the benefits of cooperation and collaboration.

Findings Regarding Interagency Collaboration

o FCCS has demonstrated an active commitment to interagency collaboration through a variety of collaborative efforts.

o FCCS shares with all schools in Franklin County the responsibility for cooperation and collaboration to address all the needs of children.

The Committee recommends that:

FCCS give high priority to strengthening and expanding collaborative efforts with the schools, with particular attention to prevention and early intervention strategies.

Finding Regarding Relationships with Contractors

o FCCS has improved relationships with its contract agencies.

The Committee recommends that:

FCCS continue to work at further improving its relationships with contract agencies in order to improve the quality and cost effectiveness of services to children and families in Franklin County.

Findings Regarding Prevention

o Prevention programming is a valuable and necessary strategy for the community.

o FCCS continues to fund prevention activities on a limited basis.

o There is an absence of clear and substantial commitment to prevention, including shared definitions, by various community entities thereby increasing long-term problems and costs.

The Committee recommends that:

FCCS make specific commitments to assist and provide guidance to the community in the development of prevention services which are based on common definitions and shared, identified responsibilities;

FCCS, wherever possible, commit to specific increases in budget expenditures for prevention programming.

Findings Regarding Placement Costs

o FCCS successfully reached agreement with the Franklin County Commissioners and the Juvenile Court to accept “mutual and shared responsibility” for limiting placement costs to an annual growth rate of 8.5%.

o Significant reduction in the rate of growth in placement costs is a very difficult challenge.

o The agreement (FCCS, County Commissioners, Juvenile Court) does not clearly describe how the parties will deal with placement costs if they exceed the 8.5% growth per year specified.

o Great care must be exercised by FCCS and the Juvenile Court to insure that the desire to limit the growth of placement costs does not lead to an inappropriate reluctance to move children into placement, when appropriate.

o FCCS did not demonstrate that the costs it incurs for placement are comparable to similar child welfare agencies.

The Committee recommends that:

FCCS identify ways in which it can demonstrate that its placement costs are comparable to similarly situated child welfare agencies.

Findings Regarding Administrative Costs

o FCCS’ total administrative costs are not unreasonable.

The Committee recommends that:

FCCS continue to seek additional opportunities through best practices to reduce administrative costs.

MHSC Board of Trustees

Barbara Jennings, Chair

Ohio Tuition Trust Authority

Dean Conley, Vice Chair

Public Issues Management, Inc.

Mark Bainbridge, Treasurer

Ernst & Young

Penelope Bach, Secretary

Huntington Banks

Lou Briggs

Community Volunteer

E. William Butler

Police and Fireman’s Disability and Pension Fund

Anthony Celebrezze, Jr.

Dinsmore & Shohl

Luke Feck

American Electric Power

Nana Jones

Columbia Gas

Annette Mizelle

Community Volunteer

Kevin Osterkamp

Roetzel & Andres

Frederick Rice

Attorney

William Rittenhouse

Columbus/Franklin County AFL-CIO

T. Ronald Sams

Children’s Academy

Charleta Tavares

Ohio House of Representatives

Grayce Williams

Community Volunteer

For further information about MHSC, contact Claudia Herrold at the Metropolitan Human Services Commission, 360 South Third Street, Columbus, OH (614) 224-1336 or by email at claudia@pie.mhsc.org.