HHSA Committee hears medical examination contract and two homeless services contracts

The Cuyahoga County Council Health, Human Services, and Aging committee met on October 6, 2021 to discuss a number of contracts, one for medical screening for children admitted to foster care, another for transitional housing for homeless individuals, and finally a contract for homeless men to receive support for substance use disorders.

MetroHealth contract increased to provide comprehensive medical services for children entering foster care

The first contract was with MetroHealth, as the county exercised its final year of a three contract to provide comprehensive medical services for children who are entering into the foster care system. Paul Porter, Director of Contracts and Administration for the Cuyahoga County Department of Health and Human Services on behalf of the Division of Children and Family Services spoke to the contract. The amendment would extend the contract end date out one year to December 31, 2022, as well as add additional funding totaling $1,551,000 ($443,000 in 2021 and $1,108,000 in 2022). According to Porter, the county has seen an increase in children entering the foster care system this year, thus requiring additional funding. The comprehensive medical services provided to children by MetroHealth, as well as the toxicology testing for caregivers, are available 24 hours a day, 7 days a week. Whenever children are admitted to the county foster care system, they receive an evaluation in less than two hours.

The comprehensive medical services provided to children by MetroHealth, as well as the toxicology testing for caregivers, are available 24 hours a day, 7 days a week.

Medicaid pays for those who are eligible (roughly 55 percent), before county HHS levy dollars are used, according to Porter. However, the county levy dollars are eligible to be reimbursed by the State of Ohio through the State Child Protection Allocation. Porter informed the committee that the county does seek to issue a Request for Proposal (RFP) for a new contract in 2022, which would begin in 2023. HHSA Committee Chairwoman Yvonne Conwell asked if the contract included dental services as well. Porter said that no, dental services are not included.

Karen Stormann, Program Administrator for the Division of Children and Family Services, as well as Latoya Hall, healthcare coordinator at DCFS, spoke next as they explained that for children who are entering into county custody, they receive a medical examination upon arrival as required by the Ohio Revised Code, and they also receive a post placement exam. The children may also receive a referral to other specialized care such as mental health, if required. Of the children who entered the foster care system, 714 children have a primary care physician at Metro even after leaving the foster care system and being reunified with families, according to Hall. The contract was approved by the committee and referred to the full council for second reading.

Four agencies contracted for rapid-rehousing for youth and families in need of emergency shelter

The second contract was a contract extension for four contracts for rapid-rehousing and continuity of care for homeless individuals. The contracts had an end date of May 31, 2021 and would be extended to May 31, 2022, with an additional $992,744 according to Porter. The four agencies are:

Each of the shelters in the contract are unique in the services that they provide to those who find themselves in need of emergency shelter. For example, Family Promise is the only shelter in Cuyahoga County focused on youth parenting homes, for Salvation Army, Zelma George is the largest family shelter in Cuyahoga County, Journey Center operates the only confidential domestic violence shelter in the county. West Side Catholic Center operates one of four family homeless shelters across the county serving both youth and family homeless individuals, according to Porter.

Due to the pandemic the United States Housing Urban Development (HUD) will continue funding for current grantees instead of issuing another RFP.

Due to the pandemic the United States Housing Urban Development (HUD) will continue funding for current grantees instead of issuing another RFP. The dollars for this program are a mix of federal dollars and county HHS levy dollars. It is likely, however, that a new federal Request for Proposals and scoring of local providers will be issued this year.

Chairwoman Yvonne Conwell asked if each of these facilities offered housing services. Porter explained that the purpose of these facilities is to provide temporary shelter for individuals who are in need until more permanent housing can be found. Michelle Sirak, Director of the Cuyahoga County Office of Homeless Services, added that these facilities provide services to families and arrive at the shelters, including mental health treatment, employment, job services, and case management services. In 2020, these providers 984 individuals (341 and 643 children), providing over 76,000 nights of shelter.

Shelter referrals, confidentiality, and capacity challenges

While most homeless shelters providers handle intake through the county Coordinated Entry system, who then makes a referral after assessing the individual or family in need, Journey Center has a confidential intake process of their own to protect those who are seeking safety, according to Sarah Froimson, Senior Director for Crisis Housing and Shelter Services at Journey Center.

During the pandemic, Journey Center had to turn away 320 families.

Froimson went on to add that, prior to the pandemic, the facility had to turn away 150 families due to a lack of capacity. During the pandemic, they have had to turn away 320 families. Unfortunately, there has been an increase in domestic violence during the pandemic.

According to Beau Hill, Executive Director of the Salvation Army Harbor Light Complex, the Salvation Army facility can hold between 100 and 125 people and is full every night. The biggest impact to the length of stay for people is difficulty getting people in housing.

According to John Litten, Executive Director at West Side Catholic Center, the average length of stay is 30-45 days.

This contract was approved under second reading suspension.

New contract with Stella Maris, a shelter for homeless men with substance use disorders

The final contract was a $530,000 two-year contract from July 1, 2021 to June 30, 2023 for Stella Maris, which operates a 46-bed homeless shelter for men with substance use disorders. Porter also presented this contract and explained that this contract is the result of a RFP that was issued earlier this year. The contract is 100 percent funded by county HHS levy dollars. The contract provides basic temporary housing and intensive outpatient treatment for 20 men at a time. Testifying on the details of the contract was Sirak and Jason Daubner, Supportive Housing Manager, Stella Maris. Daubner added that the facility that they operate holds 46 beds total. The other 26 beds are spoken for: 8 for Veterans Administration, the others are for drug courts and for self-pay. Christine Robinson, Clinical Director for Stella Maris, said that they are also a referral destination for the diversion center, but they have received few, if any referrals. Sirak concluded that in 2020, this facility served 144 individuals and 94 percent exited to permanent housing.

The contract was approved under second reading suspension.

The meeting was then adjourned.