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HomeMy WebLinkAbout1980-03-25-HSC-min.pdf HUMAN SERVICES COMMITTEE 3-25-80 Present Carol Perez, Ruth Nablo, Barry Marshall, Ruth Butler, Stephen Baran, Nicky Osborne, Howard Levingston Also Elizabeth Pressman The meeting was called to order at 7 30 P M by Carol Perez Mr Roy Hebert of the CMARC board asked to read a letter from the board's vice-president, Irwin Alterson Due to a conflict with another meeting Mr. Alterson could not be present in person In his letter Mr Alterson thanked the committee for its support He also asked to meet with the committee at a future date to clarify the position of a salaried person for contract procurement The letter indicated that the new executive director of CMARC will be in place on April 1, 1980 Members of thi H S committee were invited to the CMARC board meeting on April 10, 1980 at the workshop, 2 Sixth Road, Woburn, at 7 30 P.M Mrs Nablo asked for a copy of the latest audit report Mr Hebert gave her a copy The minutes of March 18, 1980 were accepted as written The committee discussed their role in pursuing answers from Mystic Valley vis a vis escrow funds Will the Selectmen or the committee do this? At this evening meeting the committee should let Mystic Valley know that they will be hearing further about the requested responses Nicky suggested that Dr Carbonneau talk about where the center has been and where they are going He also should discuss the impact of $30, 000 on the center and its services Some of the respon.ees to the committee' s previous questions for Mystic Valley such as how the agency counts the number of counseling hours and what percent or number of clients go to centers not in their own town Nicky Osborne felt that it would be difficult to ask quantitative questions at the meeting, though the Mystic Valley people should have the answers Mrs Perez thanked Ruth Nablo for representing the committee at the High School mock Town Meeting The committee then turned to a discussion of agency evaluation criteria Steve Baran asked whether, at some point, the committee wished to make a preventive model part of the criteria? DL-eussion followed Ruth Butler felt there is a lack of support for prevention from a promotional, educational point of view on an individualized basis Steve Baran wants programs to clearly explicate the model that they have What would their ideal program be? What are the discrepancies be- tween what they are doing and the ideal? How will they work toward the ideal? There should be a distinction between short, one year goals and long range goals, stated Nicky Osborne Dr Baran added that programs often lack goals and objectives for individual clients Discussion of whether or not "maintenance" could be a goad followed Howard Levingston suggested that REPLACE needs more direction, more focus on planning rather than just "putting out fires " Other committee members concurred Nicky Osborne asked Mr Levingston just how he will help REPLACE He replied that he will only advise them if they want him to do so It wil] be done in his role as a member, of the H S committee not as an individual He also stated that he would 2 3-25-80 want another committee member knowledgeable in the human service/mental health field to go with him In that way hi. area of expertise on the management side would be complemented and data could oe analyzed The workshop approach to providing advice to agencies was discussed Mrs Perez questioned the time and effort needed to run a workshop She asked whether the same results could be obtained by requiring specific things be done by an agency in order for them to be funded? Mrs Perez commented that she does not see the criteria as hard and fast for every agency, but rather as guidelines for agency review The criteria could also be seen as helping the agencies in a growth process i e not all criteria will be met the first year but should be looked at as ultimately being fulfilled A short discussion of what tne "legacy" of this committee should be followed Carol Perez stated that she would .like to see a paid staff human ser- vices coord ,nator At 8 30 members of the Mystic Valley staff and board joined the meeting; These included the executive director, Dr Richard Carbonneau; the director of Consultation and Education, Nancy Langman Dorwart, the new chief accountant, Thomas Coyne, the director of the Lexington branch, Mary San Martino; and three board members, Dr Gerald Harris, Mrs Althea Korte and Katherine B Macintosh Dr. Carbonneau presented some written materials to the committee In- cluded was a summary of a client satisfaction survey done in March and an account- ing of the number of Lexington residents in various programs of the center The director told the committee that the center is in the process of building up a complete cost findings system They are going from a cash to an accrual method of accounting and to a computerized process By July 1, 1980 they should have a complete breakdown of revenues He said that MVMHC would be willing to earmark the Lexington appropriation for a particular position if the committee wishes, or to use the funds on design of an accounting system Nicky Osborne asked Dr Carbonneau what the overall philosophy of Mystic Valley is, what are its goals and objectives and where he sees the center as having been and going? He answered that the center had evolved from a small child and family service organization fifteen years ago to its present role as a comprehensive community mental health center It enjoys a high reputation for services it provides, he added There are presently 1400 clients and client families being served, 400 of whom would otherwise be hospitalized at a far greater cost The center attempts to provide the fullest range of services as provided by law 9463, Ambulatory out- patient services are the largest part of services provided The staff is multi- disciplined Of the total budget $] lO 000 is asked for from the towns served Since inflationary costs were met by the center's federal grant the towns were not asked to raise their contributions this year Ruth Butler asked what a model program is like at the present time? How is it different from what it was and/or will be? Branch director Mary San Martino related some anecdotes of recent situations handled by the center She said that I I - 3 - 3-25-80 the center is currently reorganizing its administration in order to put more emphasis on children's services, particularly children under stress Children of deinstitutionalized parents have particular need for help Marital counseling often leads to helping children of these couples This is an apportunity to do some preventive work with children Ms San Martino indicated the need to communi- cate planning appropriately to the community The director of consultation and education stated that there are a variety of mental retardation programs There are two goals of these programs, first, to serve the primary prevention population, and second, to serve deinstitu- tionalized patients and the families and communities that have to deal with them Dr Gerald Harris, president of the Board of Directors, explained some of the changes that have taken place with the Board The center has become a private organization, giving the Board more responsibilities and more authority to oversee the management of the center They have asked for development of a management system and of a better accounting system There have been many problems with both the state and federal governments A series of philosophic and guidance questions have been asked of the administration by the Board Ruth Butler asked how a unit of service is defined by the center Dr Carbonneau said it basically is 50 minutes for a counselling session This may vary, depending on the modality If a parent and child are seen simultaneously they are counted as one (1) unit A group or family session is also counted as one (1) group hour Tom Coyne the new chief accountant was introduced There are seven people involved in the financial aspects of the program This is insufficient Mr Levingston asked whether Mr Coyne had brought any financial data to the meeting Dr Carbonneau replied in the negative He stated that the center' s finance committee would be meeting the next evening, March 26, and committee members would be welcome He added that at this point Mystic Valley cannot yet respond to financial data question to the extent that they would like He explained the pro- blems the center has had with the computer they purchased fifteen months ago Mr Levingston asked when the fiscal year is for the center The director answered that their fiscal year ends on June 30, though federal grants expire on April 30 'The federal grant which they currently have runs through 1983 Tom Coyne then described the current and past accounting systems of the center Howard Levingston asked whether there is a financial plan for the year? Tom Coyne said yes In reply to a second question by Mr Levingston about the cost to run the center for a month, the chief accountant said he did not know He will have the figures through February at the finance committee meeting The center is now running at a slight deficit Barry Marshall, referring to an earlier letter from Mr Coyne, asked about the surplus money that would appear when the center changes from the cash to the accrual method of accounting Mr Coyne said that there is no way that the agency will have any kind of surplus He said that the money had been earmarked for specific purposes 4 - 3-25-80 Steve Baran asked whether any services were especially designed for the population of 400 that would otherwise be hospitalized. Dr Carbonneau referred to the crisis intervention team and emergency services Funding comes through the federal government It is not yet known whether the state will provide its share of funds The director of Consultation and Education added that Mystic Valley serves 46 deinstitutionalized patients in nursing homes Currently the center is doing an assessment of patients at Met State They are determining what the needs of the area patients will be when and if they come out Howard Levingston asked whether Mystic Valley does anything with REPLACE Mary San Martino told the committee that until 1-1/2 years ago they had had a consultation arrangement The director of Consultation and Education addded that some services which they previously could provide free of charge must now be paid for Mystic Valley ;ould not sunply REPLACE with the specific services which they requested Mr Levingston suggested that there is a sense in the Town that some of the Town appropriation could be used to help cooperation between agencies The director of C and E said that her agency is still open to negotiation with REPLACE She added that the Town money helps to pay for Lexington residents who can't pay Some free services will still be given to the School Department The Town could look at this as use of its funds Dr Carbonneau said that there is a cross service arrangement with the schools Schools do pay for, special contract programs Ms San Martino said that she frequently consults with school groups without charge Dr Newman and Dr Wolf also provide free consultation services Mr Levingston asked whether Lexington bears the brunt of activity The director replied that Arlington_did Is there a lot of client cross over between towns, Mr Leving .ton asked? Yes was the response from Dr Carbonneau. Mary San Martino stated that Lexington is getting more than its share Ruth Nablo asked whether every town is assessed at 95C/capita? Aren't other services in each town looked at? Dr Carbonneau stated that the answer to the first question was yes, and the second, no He added that there is a correlation between total population and demand for services from Mystic Valley Ruth Butler suggested that the agency could help educate community groups, such as the Human Services committee about the difficulties in the state structure Programs can be crippled by some of the structure She went on to say that the community is looking for parameters in which to measure outcome What benefits are received by children and by families? An agency such as Mystic Valley is looked to by the community for enlightenment on such issues Dr Carbonneau mentioned that the area has seen a great drop in hospitalized residents since the center was established Ms Butler asked whether this was not due to medication? Dr Carbonneau felt the decline was not entirely related to greater use of drugs Mrs Perez thanked Dr. Carbonneau and the others for coming to the meeting 1 5 3-25-80 Mrs Korte of the Mystic Valley board asked that the committee further delineate the first point of the recommendations to the Selectmen about Mystic Valley The committee agreed to do so After the representatives from the agency had left, Ruth Butler said that she felt that they are well intended but lack structure The committee discussed ways in which to communicate their concerns to the agency Mrs Nablo suggested a contacting Winchester about their experience of paying Mystic Valley on a fee for .� service basis Mrs Pressman will do so The meeting was adjourned at 10 10 P.M Respectfully submitted/ , J Elizabeth H Pressman it 7