Cuyahoga County HHSA committee approves contracts for foster care and senior services

The Cuyahoga County Health, Human Services and Aging (HHSA) committee met January 22 to discuss two contract-approval requests for the Department of Child and Family Services (DCFS) and one contract-extension request for the Department of Senior and Adult Services (DSAS).

Cuyahoga County is currently dealing with a significant increase in the number of children in county custody.

Christine Alexander, from the Cuyahoga County Department of Health and Human Services, on behalf of the Division of Child and Family Services (DCFS), testified to the committee requesting approval for a contract with the Cuyahoga County Prosecutor’s office. The $4 million contract runs from January 2020 to December 2020. It would allow the prosecutor’s office to add more staff to the Children and Family Services unit. The unit is a collection of specially-trained attorneys who provide legal services and representation to DCFS staff. According to Alexander, the assistant prosecuting attorneys (APAs) in the Family Services unit are present at every child protective service case in all stages of the proceedings. Additionally, the APAs are available for on-call representation 24 hours a day, seven days a week. As Community Solutions has documented in the past, Cuyahoga County is currently dealing with a significant increase in the number of children in county custody. The additional APAs will be added to relieve the high average number of caseloads. One-third of the contract is funded with federal dollars and the remaining two-thirds comes from county health and human services levy dollars. Also appearing with Alexander was Michelle Meyers, supervisor of the prosecutor’s Child Services Unit, and Jim Ginley, the fiscal director of the prosecutor’s office. Councilman Dale Miller inquired about the difference in the 2019 contract versus the 2020 contract, given that the contract in 2019 was for $2.7 million – more than a million less than 2020. Ginley said that the increase was due to the aforementioned increase in staff, but that also the $2.7 million was not enough to cover the budget for the unit. Ginley said that he would get the exact amount spent in 2019 to county council at a later date. The contract was approved under second reading suspension, meaning that it will not have to go through three readings, when it is submitted to county council.

The second contract up for consideration was between DCFS and the Cuyahoga County Board of Developmental Disabilities (DD Board). It is worth $1.4 million and runs from January to December 2020.  Alexander again testified. Appearing with Alexander was Eboni Freeman, from DCFS, as well as John Parkowski from the DD Board.

In this arrangement, 60 percent of the costs for care for these children are paid by Medicaid

This contract agreement covers an arrangement between DCFS and the DD Board to provide services to children in county custody, who may have intellectual, developmental or physical disabilities and/or mental illness, so they can receive support while in foster care. These individuals must be enrolled in the Medicaid Individual Option Waiver and are eligible to receive Medicaid Home and Community Based Services.

In this arrangement, 60 percent of the costs for care for these children are paid by Medicaid. The remaining 40 percent (called the local Medicaid match) is paid by the DD board. DCFS then reimburses the DD board for any cost incurred by the children who use these services while in DCFS custody.

Chairwoman Yvonne Conwell clarified that these children are not at home, but receive care outside of the home. Alexander said that is correct. Councilwoman Shontel Brown also confirmed that federal dollars are involved in the contract. Parkowski added that recipients of these services work with DD case workers to re-enroll in Medicaid, annually.

Parkowski wanted to ensure that councilmembers clearly understood the arrangement. He explained that if these children were in county custody, and this agreement were not in place, DCFS would pay 100 percent of the cost of their care. Through this arrangement with the DD Board, DCFS pays 40 percent of the total cost of care, and the rest is paid for by the federal portion of Medicaid dollars. The DD Board calculates how much local DD board funds are spent on care for children in county custody, and DCFS reimburses them that amount. Miller said that he understood what the contract request was, however, the legislation language did not accurately reflect what was presented. He asked that the legislation summary language be amended to more accurately capture the contract language. The contract was passed under second reading suspension, pending a language amendment to clarify the contract summary wording.

The final contract was an extension worth $3.6 million for the OPTIONS for Independent Living Services program.

The final contract was an extension worth $3.6 million for the OPTIONS for Independent Living Services program. The contract would be extended for an additional year, until December 2020. OPTIONS is a  program that is administered through DSAS. Testifying on behalf of DSAS was Paul Porter, who said the OPTIONS program currently provides county residents with supportive services such as homemaker services, grab-bar installations, home-delivered meals and transportation, through 19 different vendor organizations. These services are meant to allow older adults to stay safely in their preferred residences – their homes – thus reducing the amount of money spent at nursing homes or assisted-living facilities. Testifying alongside Porter was Darlene Wade, Deputy Administrator for DSAS.

Wade explained that the program has increased in popularity due, in large part, to word of mouth. She said the program is not widely marketed due to budget constraints. However, because of a funding increase in the last biennial budget, DSAS is now working on a marketing plan. Conwell later asked exactly how that will be accomplished. Wade shared her department is currently working with the county’s Office on Aging (another division of DSAS) on that plan.

Brown questioned if the 19 vendors were the same as last year and Porter replied that they were. Additionally, Brown asked Wade about the number of clients served in 2019. Wade responded that the number was 1,283.

OPTIONS is available for individuals with incomes below $3,100 per month, who have assets worth less than $35,000 per year, per person, not including one car and one house.

Vice President Pernel Jones concluded the questioning by asking about income eligibility for the OPTIONS program. Wade shared that OPTIONS is available for individuals with incomes below $3,100 per month, who have assets worth less than $35,000 per year, per person, not including one car and one house.

The contract was approved under second reading suspension. The meeting was then adjourned.