Cuyahoga County HHSA Committee Features Content-rich October and November Meetings

The Cuyahoga County Health, Human Services and Aging Committee has been very busy the past few weeks, hearing on a variety of issues related to reducing youth homelessness, as well as presentations from the Cuyahoga County Office of Developmental Disabilities and the Cuyahoga County Department of Health.

October 19, 2016

At the October 19, 2016 meeting, Office of Homeless Services (OHS) Administrator Ruth Gillett gave a presentation in which she described a challenge that was issued by an organization called “A Way Home America,” which encouraged cities to collaborate with local organizations on a 100-Day plan to eliminate youth homelessness in their area.  Cleveland/Cuyahoga County was one of three cities chosen in the country (Austin, Texas, and Los Angeles, CA, were the other winners).  The local leadership team resolved that no youth will move from foster care to homelessness in Cuyahoga County. Youth who will be leaving foster care will be linked with permanent housing.  The 100-Day Challenge involves a strategic planning team that will work with the county and community partners to review and improve policies and procedures, however, there are no financial resources associated with the challenge.

Last year, Cuyahoga County and Emerald Development and Economic Network (EDEN) were both recipients of U.S. Department of Housing and Urban Development grants, worth $716,955 and $1,209,434 respectively, which were awarded for the purposes of subsidizing rent for the rapid rehousing of homeless youth. HUD fast-tracked the awarding of that money to Cuyahoga County in order to put the 100-Day Challenge plans into action. The money will be used to subsidize rent costs for each youth, up to four months, to allow the youth to apply for work in hopes that they can then build up their career path on their own. Additionally, the HUD dollars awarded to the county and EDEN includes housing assistance for youth, adults, and families. Ultimately, the county says that the money will be used to house 382 adults, 148 youth, and 50 families. Councilmembers had a variety of questions, including a question from Councilman Dale Miller about the sustainability of dollars from the federal government, as well as how the OHS tracks success. Administrator Gillette replied that the office uses a national data tracking model and she would happy to share with the committee the rate of youth who no longer face homelessness.  The HHSA Committee forwarded the recommendation of passage to the full council for consideration at the November 3, 2016, meeting.

The committee then heard a presentation from Kelly Petty, superintendent of the Cuyahoga County Board of Developmental Disabilities. Ms. Petty described how the Board of Developmental Disabilities was established in 1967, making 2017 their 50th anniversary. Nearly 60 percent of its budget comes from a 3.9 mill continuing levy that was passed in 2005. The levy is a permanent levy. The agency does not receive any funding from the Cuyahoga County Health and Human Services Levy. Last year, the organization decided to leverage $41 million from the county dollars raised from the levy to draw down a 60/40 match in Medicaid dollars from the federal government. The organization is going to be undergoing a drastic change in the coming months due to a rule change from the federal government (Centers for Medicaid and Medicare) that county boards cannot be both an administrator (case management) and a direct service provider, as this is said to be a conflict of interest (this is also known as “conflict-free case management”). Over the next 10 years, county boards across the state will have to decide whether they want to function as a case manager or a direct service provider[1]. Cuyahoga County has decided that they will remain as an administrator and that all direct service providers will be from the private sector. Such a drastic shift to service delivery being provided solely by the private sector has caused concern from citizens that the private sector may not be able to provide the level of service quality, nor meet the demand of individuals with disabilities.  The agency is working hard to scale up the capacity of the private sector and has set a goal of having service delivery completely privatized by 2020. One way that they are doing that is by hosting “provider fairs” to match consumers with service providers.

Councilwoman Yvonne Conwell asked what the agency will be doing in the community as an administrator/case manager. Superintendent Petty said that the department will still be involved with other county agencies to assist them, and will maintain a presence in the schools to support students. Councilwoman Conwell said that she still has questions about the expectations of county residents as they have a familiarity with the county and services provided; she looks forward to updates on the transition.

November 16, 2016

The November 16, 2016, meeting featured testimony from Bob Math, manager for the Cuyahoga County Division of Job and Family Services. In his testimony, he requested authorization for a contract extension with Maximus Health Services. The Work Experience Program contract was first signed in 2015 for one year, with two one-year options. Maximus is a career preparation company that works with clients who have been recommended by JFS. It works with citizens who have a work requirement to retain their Supplemental Nutrition Assistance Program (SNAP) benefit, by providing programming that helps consumers maintain their benefits, by identifying their strengths, career goals, and “soft skills” that will be helpful in finding sustainable employment. The company then identifies organizations that can provide on-site training and development of those skills. Maximus is a for-profit company that specializes in skill and talent development, though county officials are quick to say that they are not a job placement service, which is found elsewhere in county government. The company received 2,500 referrals from JFS in the first 10 months of 2016. Approximately 300 people have already received jobs at their work experience site. Committee Chair Councilman Pernel Jones asked if the agency expected the number to remain similar next year. Mr. Math expects the number of people in the program to increase next year as government officials increasingly begin to attach work requirements to public benefits, including food assistance.

The Cuyahoga County Board of Health (CCBOH) also provided a presentation on efforts to reduce infant mortality. Health Commissioner Terry Allan shared emotional testimony as he described the current disparities that exist in Greater Cleveland. He said that a baby born to an African American mother is three times more likely to pass away than a baby born to White parents. Just as alarming, the rate of 8.0 infant deaths per 1,000 live births is higher than both the state average (6.8) and the national average (5.8). The causes of infant mortality, defined as the death of a live-born baby before his or her first birthday, vary, but most of the causes from 2014 were from issues related to prematurity or sleep-related causes. Angela Newman White briefed committee members on the numerous community-based and institutional efforts to combat the issue, including how the department has now made the issue of infant mortality a top priority. These efforts include increased community engagement for mothers and fathers, increased staff for community education, and continued data compilation and analysis around birth control.

Additionally, the committee heard about legislative efforts at the state level, including a $13 million earmark for the Ohio Department of Medicaid granted to communities across the state.

For more information on statewide efforts to address the issue of infant mortality, please check out the latest report from the Community Solutions.

[1] For more information about the transition, please read materials written by Rose Frech, former research fellow, and Policy Planning Associate Kate Warren at The Center for Community Solutions: