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HomeMy WebLinkAbout1986-01-24-HSC-rpt.pdf 7 January 24, 1986 Tau, of is&, HUMAN SERVICES COMMITTEE FISCAL YEAR 1987 BUDGET RECOMMENDATIONS TO THE BOARD OF SELECTMEN The Human Services Committee is pleased to present the attached report to the Board of Selectmen. This report contains the FY 1987 human services budget recommendations followed by a detailed discussion of each agency request It is organized as follows I Summary of Budget Recommendations II Discussion of Agency Funding Requests III Budget Review Criteria IV Human Services Committee Statement of Goals Each year, in an effort to expand its understanding of the human services needs in the community, the Committee invites funding proposals from non-profit provider agencies serving Lexington residents The requests for proposals made to the Committee in the fall of 1985 for FY 1987 funding led to eight responses including renewal requests from six agencies as well as two applicants for first-time funding. Members of the Committee have visited the sites of each agency requesting funding A high premium has been placed on program accountability and fiscal integrity as well as the ability to participate cooperatively in a provider system. In each case, the agency was examined in relation to human service agency review criteria in use since 1981 Cognizant of fiscal constraints facing the Town, the Committee adopted a two-part strategy First, members encouraged agency representatives to limit requests for town funding to their highest priorities Subsequent negotiations resulted in only modest increases in requests from agencies seeking renewal funding. Then, in their own reviews, Committee members endorsed only those proposals which met its criteria as having the greatest need for town funds Were funds unconstrained, the Committee would have recommended nearly $20,000 additional to support worthy agency programs 0,000.s1M0 • 4i 1,1 w •A 1625 MASBACHUOETTS AVENUE • LEXINGTON. MABBAOHUSETTS O21TM • TELEPHONE (617) 662-0500 "^"T -2- Consequently, the Human Service Committee's budget recommendations reflect a modest increase for fiscal year 1987 Lexington is fortunate to be served by a variety of agencies providing a spectrum of programs for our more vulnerable citizens The budget we recommend reflects this diversity and is all the more valuable in a time of financial constraints Respectfully submitted, HUMAN SERVICES COMMITTEE Stan Finkelstein, Co-Chair Judith Zabin, Co-Chair Janet Eustis Leonora Feeney Harvey Lowell Sheila Martin Sylvia Perlman Marion Shepp -3- I Summary of Budget Recommendations Town Agency Council on Aging In making an expanded commitment to senior citizens, the town must expect program growth to lead to increased expenses Either the town must be prepared to assume a growing share, or there needs to be a coordinated effort made to attract outside funds In endorsing the FY 1987 budget request, the Human Services Committee wants all concerned to be aware of this situation. Requested $51,500 Recommended 51,500 Other Human Services Agencies Central Middlesex Association for Retarded Citizens CMARC is a non-profit agency located in Woburn which provides pre-vocational and vocational services to mentally retarded adults Currently CMARC serves 116 clients in a variety of program options including Diagnostic Vocational Evaluation, Personal Adjustment Training, Extended Employment, On-Site Training, and Day Activity Services Eight Lexington clients are currently served at CMARC Requested $7,500 Recommended 7,500 Cooperative Elder Services, Inc CESI operates an adult day health program for frail elderly This program is seeking level funding from the Town of Lexington to provide a sliding scale scholarship payment for Lexington residents who are not covered by insurance or public funds Currently 18 Lexington residents use the program, and six have been assisted with partial scholarships Requested $3,000 Recommended 3,000 Everyone's Youth Group Everyone's Youth Group has as its primary objective the establishment of a setting where adolescents could find guidance in dealing with adolescent issues In 1984, the group of 31 teens, a majority from Lexington, produced a series of eight well-received 25-minute video programs on subjects such as teen suicide, sexuality and drugs Currently requested funds from the Town of Lexington would be used to produce four additional programs to be aired in 1987 Requested $2,000 Recommended 675 -4- ( Lexington Playcare Lexington Playcare is a day care center serving Lexington residents Their request for town support for a lecture series is not recommended at this time as the Human Services Commiteee believes that appropriate alternative sources of funding might be identified Requested $2,000 Recommended none Mystic Valley Mental Health Center Mystic Valley is a community mental health center providing comprehensive services for the whole continuum of mental health and mental retardation disorders Last year 371 Lexington residents and workers were served in a wide variety of programs on a sliding fee basis for with no insurance coverage This year's proposal is to offset reductions in staff by funding fee-for- service clinicians to provide out-patient services to the Lexington population who have the lowest priority for service as determined by D.M.H. guidelines and who cannot affort to pay private fees for treatment Requested $35,000 Recommended 21,000 RePlace, Inc Replace has continued over the last 15 years to meet the needs of adolescents and their families They have provided services to the community through individual and family counseling; a drop-in center; outreach through the schools, the courts and on the street; in-town emergency shelter; crisis intervention; and an information and referral service. The Human Services Commitee recommends the full amount of this year's request to bring Replace's salary structure closer to parity with other human services providers Requested $59,904 Recommended 59,904 Visiting Nurses and Community Health Last year, Lexington's Trustees of Public Trusts approved a request from the Visiting Nurses and Community Health (VNCH) for partial support of its Senior Health Monitor Program which serves more than 20 frail elderly in Lexington who are at risk for nursing home placement VNCH believes it will receive funding from the Department of Elder Affairs to continue this program and is asking the town for contingency funding during a transition or for a sensitive phase-down of the project should it not be funded by the state (The present funding request is also being submitted to the Trustees of Public Trusts ) Requested $3,750 Recommended 3,750 -5 I � 1 Budget H S Comm. Actual Actual Budget Request Recommends Agency FY 1984 FY 1985 FY 1986 FY 1987 FY 1987 Council on Aging 7360 Expenses 29,045 34,900 37,450 51,500 51,500 Other Human Services 7410 Mystic Valley 1,000 15,000 15,000 35,000 21,000 7430 Community Services Replace 44,316 52,064 54,864 59,904 59,904 CMARC 5,000 5,000 5,500 7,500 7,500 Cooperative Elder Services * * 3,000 3,000 3,000 Hospice Care, Inc - - 4,800 0 0 Everyone's Youth Group - - - 2,000 675 Lexington Play Care - - - 2,000 0 Visiting Nurses and Community Health - - * 3,750 3,750 * Funds were received from Lexington's Trustees of Public Trusts -6- LII Discussion of Agency Funding Requests Council on Aging Program Description Each year, the Human Services Committee reviews the activities and proposed budget of the Council on Aging (CoA) , a town agency whose citizen board members are appointed by the Town Manager The CoA is the cornerstone of at least eight agencies in the network of local and state agencies that serve Lexington's elderly Through its continued coordination with these agencies, the Council has been able to enhance and augment a wide range of elderly services Recent Developments The new Senior Center in the redeveloped Muzzey School opened in late 1985 A full-time elderly services coordinator has been hired by the Town Manager and is now responsible for managing the center and its programs These developments represent part of the town's commitment to enhanced services for the elderly, reflecting population projections of a greater proportion of Lexingtonians in the elderly age groups Proposed FY 1987 Budget ( The Council on Aging's proposed FY 1987 overall budget represents only a slight increase over FY 1986 However, due to anticipated losses of earlier grant support, the town is being asked to take on a larger share of the agency's expenses In particular, the CoA request for town funding is up nearly 38% over last year's town contribution Discussion and Recommendation In making an expanded commitment to the needs of senior citizens, the town must expect program growth to lead to increased expenses Further, the town must be prepared to assume a growing share of these costs, or there needs to be a coordinated effort made to attract funds from federal, state or philanthropic sources In endorsing the FY 1987 budget request by the Council on Aging, the Human Services Committee wants to ensure that all parties involved in the management of elderly services be aware of this situation L -7- K- Central Middlesex Association for Retarded Citizens, Inc Program Description The major program goal of the CMARC sheltered workshop is to assist handicapped adults to develop independent vocational skills with the eventual goal of competitve employment Each client is assisted through a system of positive reinforcements and a supportive environment to reach his or her highest level of vocational potential The program makes it possible for clients to work at the CMARC facility in Woburn on subcontracts from businesses in the area In addition, during the past year, CMARC has established on-site work situations located in ten separate companies for 20% of its clients Clients are paid according to prevailing wage standards and can move closer to financial independence through work CMARC offers a variety of challenging, interesting, and well-paying jobs for handicapped adults Program Specific (Internal) In 1985, CMARC had 116 clients The number of Lexington clients has increased from seven to eight this year Since the on-site job program began one year ago, four of these Lexington clients have had the opportunity to participate Currently, the Placement Specialist (supported by the Town of Lexington) is working to develop additional on-site work locations in Lexington and the surrounding area. The program model is a continuation of the Lexington LABS program type, and offers a smooth transition from school to work Goals for 1985 have included providing various levels of on-site employment from fully supervised to supervision once or twice per week On-site locations are more normalized, less restrictive, and provide better industrial opportunities for both the handicapped person and the industrial employees This program type is more expensive because staff to client ratios must be significantly higher (one staff member to six clients as opposed to one staff to 12-15 clients in the Workshop) Fundraising events to raise $9,000 have been held They are halfway to that goal with two major fundraising events yet to take place System Related (External) The sheltered workshop has been extremely successful in establishing on-site work placements for its clients Its goal is to develop on-site situations for every handicapped person who can function in that setting The agency hopes to establish long-term on-sites for those clients who will not be ready to work unsupervised in the near future The contract procurement position, originally funded by the Town of Lexingon, is now full-time Realities of service delivery are less positive There is one rehabil- itation counselor for 116 clients The agency was unable to fill the vocational evaluator's position for six months due to lack of funding Staff members with bachelor's degrees have 12 to 15 clients and make $13,000 per year There is no maintenance staff with 14,000 square feet of space There is one secretary for 21 staff and 116 clients -8- Budget Specific The CMARC budget is $612,000 The primary sources of funding are the Department of Mental Health and the Massachusetts Rehabilitation Commission Industrial revenue is approximately 25% of the budget THe Town of Lexington funding is targeted toward meeting the higher cost of on-site placements for Lexington citizens, extending the contract procurement staff, and providing for the increase in the number of Lexington clients served by CMARC Citizen Involvement The ten member Board of Directors represents citizens from the six towns that are served by CMARC The immediate past president is a Lexington resident Recommendation The Human Services Committee recommends the appropriation of $7,500 for FY 1987 as requested L -9- Cooperative Elder Services, Inc Program Description Coperative Elder Services, Inc (CESI) is a private non-profit organization which currently operates a variety of Adult Day programs in Acton, Concord and Arlington. The program, which originated in Lexington, has been temporarily renting space at St Camilla's Church in Arlington and is about to move to a larger, permanent site in Arlington Lexington residents have been served by CESI since 1979 Conceived as an alternative to institutionalization for frail elders, Adult Day Health Care provides a daytime environment in which the health care, nutritional, psycho-social, emotional and restorative needs of its clients are met Program Specific Presently CESI serves approximately 140 clients; 60% of whom attend the Arlington programs Eighteen of those are Lexington residents who attend the center from two to five days per week The number of Lexington residents has doubled since last year During FY 1987, CESI projects an increase in the number of elders needing their services The new location will accomodate more clients and is equipped to provide more comprehensive services System Related CESI is a part of the network of elderly servies The program maintains ongoing communication with the homecare agencies and Councils on Aging throughout the area Budget Specific The per diem rate is $26 Approximately a third of the Lexington clients are Medicaid-eligible and their Adult Day Health services are Medicaid- reimbursable The others must pay privately Approximately six non-Medicaid- eligible, low-income Lexington clients use the scholarship funds provided by the Town of Lexington These funds have enabled them to attend the center more regularly, receive more comprehensive services and more fully participate in CESI The Director states that several of these clients might have had to be institutionalized or placed in nursing homes were they not so served Recommendation CESI has requested $3,000 level funding from the Town of Lexington to be used for scholarship aid to its needy Lexington clients The Human Services Committee recommends this appropriation. 10-C -10- (- Everyone's Youth Group Program Description In 1980 three adults from the Lexington community formed Everyone's Youth Group It is housed in the Church of Our Redeemer, Lexington The majority of the 31 teens served reside in Lexington. The primary objective was to establish a setting where adolescents could find guidance and support in dealing with adolescent issues The leaders initiated and led parent/teen discussions on adolescent sexuality, drugs and suicide Program Specific In the fall of 1984, a series of eight 25-minute video programs called "Telling It Like It Is" was produced These programs focused on pressure, communication, suicide, sexuality and drugs Their emphasis was on the younger teen and his/her parents and used both skits and discussions The assumption was that a program of this sort would be a catalyst, leading to in-depth communications between parent and child The skills of the adolescents themselves were utilized The young people acted, developed the theme song, designed the credits and participated as crew members By June 1985 the group had grown from 15 to more than 50 teens System-Related The programs were viewed by mental health professionals, teachers, parents and adolescents The American Association of Suicidology presented one of the films at its annual conference A minister in Canton, Massachusetts; the State P T.A. ; Mystic Valley Mental Health Center; and Diamond Junior High School have all expressed interest in using the materials Budget Request In April 1985 the Church Home Society granted $2,000 to assist the group in producing four more programs The money was used to compensate both the actors and the crew members The pilot series was assessed in detail and the sequel retained the original format with some exceptions Several distributors have expressed interest in disseminating it Other non-profit organizations have requested the producer to present one or two programs A grant from the Town of Lexington would be used to produce another four programs which would be aired in the spring of 1987 and would aid in determining whether the program can become financially viable Everyone's Youth Group is requesting money for payment of personnel as well as money to be used for direct costs The latter include purchase of blank video tapes, telephone, postage, music for the tapes and miscellaneous expenses The Human Services Committee recommends the appropriation of $675 for FY 1987 This will cover the direct costs of producing four shows These films will be made available to Lexington town agencies and groups L -11- Lexington Playcare Center Program Description Lexington Playcare Center is a comprehensive day care center which rents space in the Church of Our Redeemer Program Specific Lexington Playcare Center requests $2,000 to sponsor a lecture series for Lexington area parents of small children. The series will provide expert advice and information on issues of child safety and development The Director cited an identified need for such a program. Budget Specific Honoraria for speakers and room rental account for most of the $2,000 budget System Related The Center has informal linkages with the other day care centers in Lexington A member of the Human Services Committee has discussed with the Director the possibility of collaborating with other groups (Pre-School PTA) in providing similar lectures or of applying for a grant available from the Mass / Department of Education Recommendation The Human Services Committee is not recommending this request at the present time We think that Lexington Playcare is knowedgeable about the need for such a series and would be an appropriate sponsor However, we question whether the budget might not be revised to reflect a fee charged to subscribers and/or volunteer speakers Also, we would like Lexington Playcare to explore the possibilities of collaboration with other Lexington groups to fund this project The Director of Lexington Playcare was most receptive to these suggestions -12- Mystic Valley Mental Health Center Association, Inc Program Description Mystic Valley is a non-profit community mental health center organized to provide mental health and mental retardation services to residents of the Town of Lexington and five other area communities Ambulatory, out-patient mental health services are provided at three locations, including one in Lexington for those who work or live in Lexington and Burlington While the center provides advocacy and consulting services, and temporary and long-term residentail as well as day programs for many categories of clients in need, this year's proposal concerns funding specifically for the out-patient clinic Program Specific (Internal) In 1985, 338 Lexington residents or workers were served by Mystic Valley out-patient program, and 33 others in day or residential programs Out-patient Counselling and Therapy - 338 children 44 adults 174 mentally retarded and developmentally dis- abled 6 aftercare (post-hospital) 60 elderly 54 Three priority levels of out-patient clients were developed by the Department of Mental Health to guide the agency in determining service Priority One - the chronically mentally disturbed and mentally retarded, and the Court; Priority Two - children and elderly with histories of hospitalization for severe mental illness; Priority Three - the general population The Center's by-laws and charter mandate that services be available to clients at an affordable cost Consequently, a resident who does not have, or has exhausted, private incurance or public reimbursement would be charged on the basis of ability to pay The Center has established a sliding fee scale of $2 00-$60 00, depending on the nature of the out-patient service required and the financial status of the client System Related (External) The Center is an integral part of the information and referral network of mental health services in Lexington In addition, it has formal contracts for service and/or consultation with the Lexington schools, Minuteman Home Care Corportation, the Visiting Nurse association serving Lexington, and the Lexington Council on Aging MVMHC is a licensed, certified, and regulated provider of mental health and mental retardation services The Departments of Mental Health, Public Health and Social Services, as well as Office for Children, the Executive -13- (- Office for Human Services, Rate Setting Commission, State Auditor, Medicaid Bureau and Massachusetts Blue Cross/Blue Shield evaluate MVMHC regularly to determine compliance with standards of professional credentials, clinical services, costs for services, and life/safety conditions Budget Specific For the Lexington out-patient clinic, the budget for FY 1986 anticipates expenses of $431,696 with revenues of $396,080 from state salary grants, third party insurance and client fees, plus the allocation of $15,000 from Lexington; the Center expects a $20,616 deficit In the past two years the state has withdrawn 20 clinical positions from Mystic Valley and the Lexington clinic is slated for an additional 1 5 FTE reduction for the coming year SOme of the lost positions have, in the past, been supported by the local Mental Health Association out of funds received from fees and from town support The present proposal is to fund fee-for-service clinicians to provide out-patient treatment to the general population, to offset the services of the 1 5 lost clinicians Recommendations Mystic Valley continues to meet the review criteria established by the Human Services Committee and is deserving of the Town's financial support This Committee has preferred, int he recent past, to provide general support to the Center to enable the Committee to evaluate and monitor the impact of all of Mystic Valley's services to the Town However, this year MVMHC is making a specific request, targetted to services to the general population, which might otherwise not be available, and which is aimed at providing basic, general out-patient mental health services to residents and workers in Lexington who cannot afford private treatment, and who might not be served by the Center due to staff shortages The Center's financial reporting for FY 1985 indicates that the out-patient program's services to Lexington residents had a deficit of over $16,000 due to clients' inability to pay and insurance adjustments We are recommending financial support of fee-for-service clinicians to offset the treatment hours lost by staff reduction at the Lexington clinic SInce 40% of the Center's services ar provided to Burlington residents, we propose to fund 60% of this program at a cost of $21,000, which will provide up to 16 visits per person for approximately 66 Lexington residents or workers This represents about 30% of Lexington residents receiving general psychiatric services by the out-patient clinic this year -14- CRePlace, Inc Program Description RePlace is a Lexington-based youth counseling program. It is located at 1912 Massachusetts Avenue in space provided by the Hancock Church The general goals of RePlace are to improve and promote the social and emotional health of Lexington adolescents and their families RePlace provides crisis intervention services; a Drop-In Center; an outreach component; information, referral and community education programs; and counseling and psychotherapy RePlace attempts to become involved as early as possible, employ minimal intervention, and support the strengths and functioning of individuals and their family systems Program Specific (Internal) RePlace attempts to meet the needs of Lexington adolsecents and families through ther services it provides The program is able to evaluate its services through requests and feedback from the adolescents and families who use the service, through periodic evaluation by its Board of Directors, and through feedback from referral souces The program meets all licensing and regulatory requirements established by its Massachusetts Division of Drug Rehabilitation License (which was issued in 1977) and its contracts with the Lexington School Department and the Lexington Board of Health In FY 1985 the staffing situation at RePlace was stabilized The agency continues to employ two full-time workers, the Director and the Outreach Worker, and four half-time staff members, the courselor, intake counselor, administrative assistant and prevention counselor System Related (External) RePlace sees itself as a part of a system of services established by both formal and informal linkages Formal linkages with the Town include the Human Service Committee, the Board of Health and the Lexington school system In addition, formal linkages continue to be maintained with the Concord Court Probation Department and Family Assessment Board, Mystic Valley Interagency Assessment Team, Human Services Providers Council, Neighbor Network and the Mssachusetts Council of Human Services Providers Some examples of informal linkages include Mystic Valley Mental Health Center, Lexington Youth Commission, Mystic Valley area crisis team, Department of Social Services, Department of Mental Health, Office for Children, Emerson Hospital and Middlesex Family Associates Budget Specific The agency's budget for FY 1986 is $110,266 The major funding sources for RePlace are the Town of Lexington, which is providing $54,864 for the current year, and the Department of Public Health, which provides $23,899 Additional funding comes from three other sources 1) cash contributions from private sources ($14,000) ; 2) reimbursement for services provided to Lexington Public Schools ($2,000) ; and 3) client fees for counseling services, charged on a sliding scale basis ($1,000) RePlace would like to apply to the Department -15- of Public Health for $7,000 in funding for a half-time position to oversee a volunteer program, but an impeding reorganization at the Department makes the success of such a proposal uncertain From the Town, RePlace is requesting an increase of $5,040 to provide a 7% increase in staff salaries (This represents a 9% increase in the Town's contribution to RePlace ) Citizen Involvement RePlace offers as evidence of consumer satisfaction unsolicited letters and statements from satisfied clients and teachers, donations from the private sector, offers to assist the program from volunteers, and a demand for counseling and outreach services The Board of Directors has 20 members and meets on a monthly basis The diversified membership is the result of a deliberate attempt to include clients, former clients, parents and individuals with skills valuable to the program. Members of the Board of Directors serve on various committees, such as fundraising, public relations and program evaluations Prevention As previously mentioned, RePlace has as its general and specific goals to provide prevention services to Lexington adolescents and their families The Drop-In Center and outreach program were designed primarily as prevention programs and continue with a strong emphasis on early prevention, information, referral and education Recommendation The Human Services Committee supports granting $59,904, a 9% increase in funding This will allow a 7% increase in salaries This recommendation is justified by the fact that the RePlace staff is not only stable at this point, but is of high quality We believe efforts should be made to retain the current staff at the agency, and that appropriate salary increases will help accomplish that end The Committee also believes that with the reorganization of drug and alcohol services at the Department of Public Health, which reduces the likelihood of RePlace's ability to significantly increase its funding from that source, the agency needs to make careful plans for its financial future RePlace has met our review criteria and provides data quarterly to validate compliance This agency provides detailed information and statistics regarding services L -16- Visiting Nurse and Community Health, Inc Program Description VNCH is a non-profit health care agency delivering health related services to individuals in their own homes The agency primarily serves Winchester, Lexington and Arlington The 116 staff provide nursing, nutrition, rehabilitative and social servies, as well as speech, occupational and physical therapy In addition, the staff consists of home health aides, homemakers and health assistants With new hospital cost containment policies and decreased Medicaid services, VNCH sees the need for its community-based services increasing Program Specific VNCH is requesting $3,750 in support of the Senior Health Monitor Program. THe program was initated at the request of the Executive Director of the Lexington Housing Authority (LHA) in May 1984 She was concerned about the deteriorating health condition and diminishing coping ability of the frail elderly in the Lexington Elderly Housing Two health-oriented staff now monitor the daily health and personal needs of 23 Lexington patients over the age of 80 A comprehensive assessment of patient needs is completed, a visitation schedule is established, and other services are coordinated if appropriate The goal is to maintain the patient in the community for as long as possible, and to help the patient determine when nursing home care is necessary The program is currently being expanded to include 20-30 Arlington residents The program is being evaluated through a grant from the Department of Elder Affairs (DEA) The results of this evaluation will be available in May 1986 Consistent with program goals, the job of Senior Health Monitor requires a licensed practical nurse with home care experience, or a Home Health Aide, both with training in geronotology System Related The VNCH is part of a continuity of care system in the community It works with local hospitals, health care providers and nursing homes as well as Hospice, Inc Cases increased from 1984 (1,614) to 1985 (1,928) by over 300 VNCH trains student interns from greater Boston schools, provides public seminars and has developed a program for cable television, "Healthguard " The Senior Health Monitor Program was developed at the request of the LHA and the Board of Health, with the support of the Executive Office of Communities and Development (EOCD) and DEA Both the LHA and Council on Aging spoke of the high quality of service delivered to clients through this service -17- Budget Specific VNCH appears to financially stable; its income of $1,842,995 consists of revenue from third party reimbursements (Medicaid, Medicare, insurance) , fees for services, contributions and interest on endowments Operating expenses are $1,720,042, or essentially "break even " The Senior Health Monitor Program is budgeted at $33,388 for FY 1986 Funds supporting the program are from DEA, EOCD, Minuteman Home Care Corporation, the Rotary Club and Telephone Pioneers VNCH is requesting $3,750 to fund the program from July 1, 1986 to Octobe 1, 1986 This is the period when DEA funding for FY 1986 has terminated, and VNCH is awaiting approval for DEA funding in FY 1987 If DEA funds the program in FY 1987, VNCH expects that it will be approved for a full year of funding, and Town of Lexington funds will probably not be necessary If, however, VNCH is informed that their DEA contract will not be renewed, this three-month period will be necessary to transition patients to other services and to "wind down" the program. The only other concern is the high indirect cost (25%) of the program budget According to the Executive Director, the program is absorbing some of the overhead of other Medicaid programs In additon, there is a research component The current request of $3,750 appears to reflect only a 15% indirect cost; consistent with rate-setting standards If the program is funded in FY 1987 by DEA, this will be coninuous full year funding VNCH will establish a Medicaid rate and a fee for service Citizen Involvement VNCH has a 15-member Board of Directors, four of whom are Lexington residents There is also a 12-member Professional Advisory Board The target population of the program is the difficult-to-reach elderly population Yet patient satisfaction appears to be high Indicators are 1) low patient turnover In the past year only two patients have left the program; one to enter a nursing home, the second is in full-time adult day care; 2) patient health seems to have stabilized No patients have died The evaluations currently under way will look at client evaluation of the service, other services accessed and health care indicators Recommendation We recommend funding $3,750 for service to 20-25 frail elderly clients for July-September 1986 by VNCH This will be a one-time only commitment The funding will be necessary only if DEA funding is not available This request has also been submitted to the Trustees of Public Trusts - T8- III Human Services Agency Budget Review Criteria 1 Program Specific (Internal) a Program meets an identified need (This need may be identified by the Town, the Human Services Commitee or the program itself ) b The program has a clear statement of goals and objectives c The program can define what specific measures are used to evaluate services in meeting specific objectives d Salaries should be in line with salaries offered similar providers in similar agencies Job descriptions should be available demonstrating that there is a "fit" between the job position and the type of services and outcomes which the service provider is expected to furnish e The program meets all licensing and regulatory requirements as established by state and federal agencies 2 System Related (External) a The program has both formal and informal linkages established with other agencies, so that it sees itself as part of a system of services b The program works to ensure the provision of comprehensive care for all individuals served 3 Budget Specific a The program is financially viable b The program has made an effort to secure funding from other sources 4 Citizen Involvement a Consumers are satisfied with the services provided, and there is a method to determine consumer satisfaction. b The Board of Directors is representative of the community at large and is involved iwth the agency's activities 5 Prevention a The program conforms to the Lexington Human Services Policy prevention. -19- ( IV Human Services Committee Statement of Goals The Lexington Human Services Commitee has as its primary purpose giving advice to the Board of Selectmen on human service policies and their implementation. In the coming year it will continue to carry out its charge as follows Planning Seek connections with Town physical and economic planning agencies and private and government funded human service providers Support the Human Services Coordinator in conducting needs assessments in relation to such groups as the mentally retarded, frail elderly, chronically mentally ill, and adolescents Use all possible means of sensitizing the community about need Support the Enablement Committee on issues of the physically disabled Use the media, especially Cable TV and newspapers, to highlight need and approaches to family problem solving Coordination ( Recommend allocation of Town resources keeping in mind the policy emphasizing prevention Coordinate with Town boards and committees such as the Lexington Housing Authority, Recreation Committee, School Committee and Appropriation Committee Continue regular meetings of local human service providers Coordinate efforts with State agencies, legislators and other towns Evaluation Analyze critically the funding requests presented to the Selectmen and the Town Meeting according to established criteria Review agency budgets