BCCS Director Bill Morrison in April was extremely worried the heroin epidemic was going to force them to ask voters for additional funds when they pose their levy question next November. The number of children in the agency’s custody shot up to 420 then, but was down to 389 in mid-October. The average for 2015 was 424 kids in custody.
County Administrator Charlie Young said everyone at the agency is focused on finding strategies for keeping families intact rather than just removing the kids to foster care.
He said everyone from the front line workers to management are looking for ways to give families the tools and support to succeed with their children safely at home. Another key Young said is being willing to make changes when you notice something isn’t working and expand the strategies that are succeeding.
“It is possible to combat the ravages of this opiate epidemic,” he said. “It’s not easy but it’s possible and to do so in a fiscally responsible manner… It’s possible to do it with existing resources and just utilizing them differently. It’s not always just a matter of money or additional people.”
Morrison said when they re-instituted the family preservation program — there used to be an in-house unit but budgetary constraints put it on hiatus several years ago — using provider Pressley Ridge it was the best decision they could have made. He said they are still having to remove kids from their opiate addicted parents in many cases but the intense supervision of the family preservation program is showing great success elsewhere.
“Because Presley Ridge has a deep history of providing those services in other jurisdictions, they were able to hit the ground running much quicker than any other new program I’ve ever started,” Morrison said. “It immediately started affecting our practice.”
Morrison and Young both said it is too soon to tell whether BCCS will be requesting a levy renewal or if they’ll need to ask for more money from taxpayers.
The Board of Developmental Disabilities and the Butler County Care Facility — among other agencies reliant on Medicaid dollars — have been at the mercy of ever-changing funding streams. The DD board was staring down a $3.6 million deficit at the beginning of the year, however Business Services Director Hailey Quinn told the Journal-News a state cost reimbursement has cut that amount to $2 million.
The largest contributor to the organization’s budget shortfall has been an increase in local waiver matching funds for Medicaid to keep people with disabilities integrated in the community.
This year the local match is $12 million and BCBDD served 3,350 clients last year. The agency had 2,716 clients in 2011 and the Medicaid match was $7.6 million.
The agency submitted a $29.1 million budget for next year which represents a three percent reduction from this year’s budget and contains a $3.8 million deficit but also $28.7 million in reserves.
The county's nursing home has had to borrow $1.1 million from the commissioners since 2013 to fill gaps in the budget, largely because of shifting rules and funding levels of Medicaid reimbursement. There is $500,000 outstanding on the tab with the commissioners.
The commissioners hired business consulting firm Plante Moran earlier this year to make recommendations that would keep the facility afloat. Chris Joos, a partner at the consulting firm, gave the county three "scenarios" that included the "do nothing" option.
He said the county could raise taxes, outsource billing and accounting functions — some of that is being done — and downsize to 99 beds and spend $500,000 fixing up the place. Under this plan “the BCCF would be able to reach a healthy cash balance of $1 million by 2019,” Joos wrote.
The commissioners have said that a tax levy is out of the question.
“We’re not putting a levy on, that’s not going to happen,” commissioner Don Dixon said. “We’ll find a way to make it work.”
The commissioners haven’t made any decisions yet on what to do, but they have already determined they must keep operating the home. BCCF Director Chuck Demidovich penciled in $6.6 million for next year, which is a $371,603 reduction.
“It’s due to the change in Medicaid rate, it went from $187 to $172 in July,” he said. “It doesn’t lok good but it’s reality.”
Demidovich said he expects they will be discussing the study and the various options during his hearing.
The commissioners will hear from eight office holders and department heads as they wrap up budget hearing month.
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