Proposed 2018 budget for Human Services Human Services Director Jodi Wentland Hennepin County Health and Human Services

Health & Human Services strategic planning Transform how we deliver services Create a vibrant organizational culture Improve outcomes for our residents by changing the experience Hennepin County Health and Human Services

Health & Human Services Public Health Medical Examiner’s Office NorthPoint Health & Wellness Hennepin Health Human Services Eligibility and Work Services Child Support Children and Family Services Access and Case Management Hennepin County Health and Human Services

Human Services looks ahead to 2019 Strategies Utilization of personal services Increase revenue efforts Expense reduction efforts Multi-pronged behavioral health efforts Contract management efforts Environmental factors Federal deficits, potential Medicaid changes, cost shifts & other federal actions Over-reliance on deep-end services & bottlenecked behavioral health system Systems modernization Growth in personal-services costs Fund-balance utilization Hennepin County Health and Human Services

Contracts and ratings Mandated or core services Complementary services Community resources Further review needed Hennepin County Health and Human Services

Staffing Pain points Challenges How we’re creating efficiencies and maximizing staffing capacity Hennepin County Health and Human Services

Non-mandated programs and services Hennepin Providers Schools What programs are achieving outcomes? Are other providers doing the same work? What is the effort and impact of Hennepin conducting this work? What can be eliminated? State Hennepin County Health and Human Services

Who is presenting today? Area Director Janine Moore, Children and Family Services Area Director Deborah Huskins, Eligibility and Child Support Chief Financial Officer Gary Harmon Area Director Mike Herzing, Access and Case Management Officer Neil Doyle, Veterans’ Service Hennepin County Health and Human Services

Financial Analysis and Accounting Chief Financial Officer Gary Harmon Hennepin County Health and Human Services

Operating budget 2017 adjusted 2018 proposed Percent change Access and Case Management $177,658,678 $171,387,968 (3.53%) Eligibility and Child Support 151,330,998 148,344,004 (1.97%) Children and Family Services 126,476,529 136,763,643 8.13% Public Health 61,663,858 62,333,124 1.09% Internal Services 44,152,851 52,796,299 19.58% Admin & Community-Based Services 9,738,965 19,259,438 97.76% Veterans’ Service 1,280,047 1,277,304 (0.21%) Total 572,301,926 592,161,780 3.47% Hennepin County Health and Human Services

Property tax 2017 adjusted 2018 proposed Percent change Access and Case Management 80,998,467 66,463,863 (17.94%) Eligibility and Child Support 44,059,881 37,516,714 (14.85%) Children and Family Services 67,589,499 76,957,945 13.86% Public Health 23,485,508 23,954,827 2.00% Internal Services 29,927,211 39,263,030 31.20% Admin & Community-Based Services 8,857,965 18,587,871 109.84% Veterans’ Service 1,253,047 1,250,304 (0.22%) Total 256,171,578 263,994,554 3.05% Hennepin County Health and Human Services

Full-time equivalents (FTEs) 2017 adjusted 2018 proposed Percent change Access and Case Management 735.6 732.1 (0.48%) Eligibility and Child Support 1,053.9 1,052.9 (0.09%) Children and Family Services 628.6 615.6 (2.11%) Public Health 416.9 425.6 2.04% Internal Services 369.2 368.5 (0.19%) Admin & Community-Based Services 198.3 200.5 1.10% Veterans’ Service 14.0 13.0 (7.69%) Total 3,416.5 3,408.2 (0.24%) Hennepin County Health and Human Services

Access and Case Management Area Director Mike Herzing Connects residents to services Assesses and provides case management for people living with disabilities and for seniors Provides adult protection Hennepin County Health and Human Services

Budget driver: MnCHOICES State-imposed cost shift: $4.5 - 5 million Staffing levels = inadequate to meet state requirements Demand for long-term services is growing Total assessments completed per year with predictions for 2016-2020 Hennepin County Health and Human Services

Budget driver: Mental illness & community options Efforts to increase community options for people living with mental Illness are offset by cost shifts and cost increases at state regional treatment centers Despite systemic challenges, we have continued to work to move patients out of unnecessary care. Hennepin County Health and Human Services

Children and Family Services Area Director Janine Moore Hennepin’s child welfare agency Responds to concerns about child safety Works with families to develop child well-being and family stability Hennepin County Health and Human Services

Budget driver: More reports Hennepin County Health and Human Services

Budget drivers: Placements, rides and care Out-of-home placements Transportation Child care Year Cost 2015 $33.5M 2016 $39.7M 2017 $42.8M* Year Cost 2015 $776,369 2016 $2.1M 2017 $2.2M* Year Cost 2015 $3.7M 2016 $4.4M 2017 $4.2M* * Projected Children in out-of-home placement 2015: 1,311, 2016: 1,629 and 2017: 2,089 Hennepin County Health and Human Services

Child well-being: Getting upstream Parent Support Outreach Services Chronic neglect services addressing the “root cause” Disparity reduction efforts Increased partnership with community providers Hennepin County Health and Human Services

Steps we’re taking now for child well-being Increasing the amount of time spent with families in investigations Partnering with Brooklyn Park and Minneapolis police departments to divert children Reducing the length of time to permanency – collaborative effort with courts, County Attorney’s Office, and police departments Partnering with Minneapolis Public Schools for pilot for prevention More planning for in-home safety Hennepin County Health and Human Services

Veterans’ Service Veterans’ Service Officer Neil Doyle To enhance the veteran’s quality of life through counseling, claims assistance, education, advocacy and special projects Hennepin County Health and Human Services

Customer Service Data Hennepin County Health and Human Services

Veterans Court initiatives Maintain an active presence Participate in staffing and steering committee meetings Support court veterans needing to file claims Lead the court mentoring program Assist in the orientation brief for new court candidates Hennepin County Health and Human Services

Our work contributes $151,583.79 for Hennepin County veterans, spouses and dependents Hennepin County Health and Human Services

Budget driver: Veterans housing Data from the Minnesota Homeless Veteran Registry Hennepin County Health and Human Services

Using state grants to enhance internal operations Workflow efficiencies Increased internal and external marketing To provide better tools for staff to successfully complete their mission Hennepin County Health and Human Services

Eligibility and Work Services & Child Support Area Director Deborah Huskins Eligibility is often first encounter with majority of clients Child Support is a key anti-poverty service Hennepin County Health and Human Services

Eligibility and Work Services Child Support 198,000 134,434 Cases People served Hennepin County Health and Human Services

Poverty Low-wage jobs Lack of education Unemployment Hennepin County Health and Human Services

Child Support: Key anti-poverty service Mission: Both parents support their children About 1/3rd of cases – no involvement in assistance programs Another 56% were on assistance, but thanks to Child Support have higher incomes Hennepin County Health and Human Services

Budget drivers Assuring every child has legally recognized parents Establishing reasonable orders for support Enforcing with compassion Welcoming new staff and gathering wisdom as staff retire Hennepin County Health and Human Services

Child Support services Federal Performance FFY 2017 Paternity 99.59% Establishment 83.66% Collections 71.58% Arrears 69.81% Hennepin County Health and Human Services

Budget driver: Increasing Eligibility & Work Services’ caseload Hennepin County Health and Human Services

Eligibility & Work Services: Reduce disparities Food Cash Health care coverage Child care assistance Emergency financial assistance Emergency shelter Connection to employment and training Hennepin County Health and Human Services

Budget drivers: Workaround Higher staffing levels due to state system complexities, manual workarounds Taking a more holistic approach, investing upstream Continued transformation of service delivery Workaround Hennepin County Health and Human Services

By focusing on disparities in education, employment and income, we help people move to improved stability and self-sufficiency transportation employment housing income health education justice Hennepin County Health and Human Services

Strategic efforts for 2018 System of care Housing alignment work Employment Child well-being transformation Hennepin County Health and Human Services

Jennifer DeCubellis, deputy county administrator Jennifer.DeCubellis@Hennepin.us, 612-596-9416 Jodi Wentland, director Jodi.Wendland@hennepin.us, 612-543-4344 Hennepin County Health and Human Services