1. Ulster C.A.R.E.S. Community Access Through Restructuring of Essential Services Ulster County Executive Mike Hein May 23, 2013

2. -2- Ulster C.A.R.E.S. Current Service Model is Not Sustainable There has been a 50% decline in Federal and State aid for mental health clinic services in Ulster County

3. -3- Ulster C.A.R.E.S. What Happens if We do Nothing?  Choice 1: Reduce access by only serving Medicaid eligible clients, leaving hundreds of residents without needed mental health treatment;  Choice 2: Dramatically raise property taxes; and  Choice 3: Eliminate other essential but non- mandated services.

4. -4- Ulster C.A.R.E.S. Ulster C.A.R.E.S “It is not about a bigger government or a smaller government…but a better government.”

5. Ulster C.A.R.E.S. Community Access Through Restructuring of Essential Services Ulster County Executive Mike Hein May 23, 2013

6. -6- Ulster C.A.R.E.S. Ulster C.A.R.E.S = Better Government  Ensures the ongoing provision of quality adult mental health services to Ulster County residents by a highly respected mental health care agency;  Preserves and enhances the services of the Department of Mental Health Local Government Unit in accordance with State law;  Ensures that Ulster County receives the maximum available Federal and State aid to reduce local costs;  Protects taxpayers by ensuring that comprehensive mental health clinical and support services are available without an increase in taxes; and  Brings stability and maximizes the efficiency of the Ulster County workforce.

7. -7- Ulster C.A.R.E.S. How the Ulster C.A.R.E.S Project works Forms an innovative public/private partnership with Hudson Valley Mental Health to operate Adult Mental Health Clinics in Ulster County  Hudson Valley Mental Health (HVMH) is a local not for profit with a long standing track record of accessible, affordable, and culturally competent services. Creates a seamless transition to ensure continuity of care  Professional staff from the Ulster County Department of Mental Health will continue to provide direct care to Ulster County residents with no change in employment status; and  HVMH will lease existing clinical space and equipment at current clinic sites in Kingston, Ellenville and New Paltz.

8. -8- Ulster C.A.R.E.S. How the Ulster C.A.R.E.S Project works Preserves and enhances the services provided by the Ulster County Department of Mental Health Local Government Unit  Addresses new State mandates related to the New York Secure Ammunition and Firearms Enforcement (SAFE) Act;  Improves coordination of inmates who are released from the Ulster County Jail;  Collaborates with Law Enforcement including ongoing dialogue and training for police to assist the management of emotionally disturbed individuals;

9. -9- Ulster C.A.R.E.S. How the Ulster C.A.R.E.S Project works  Increases school-based mental health services;  Enhances performance monitoring of community partners to optimize resource allocation;  Procures funding for hospital diversion and crisis services; and  Implements enhanced community-wide training on suicide and violence prevention and intervention.

10. -10- Ulster C.A.R.E.S. Ulster C.A.R.E.S Staffing Plan  18 employees will staff the Department of Mental Health’s Local Government Unit;  17 employees will provide direct services to clients of clinics operated by Hudson Valley Mental Health;  13 employees will join the staff of the Department of Social Services;  County employees impacted by this plan will retain their employment status, wages and benefits under the collective bargaining agreement.

11. -11- Ulster C.A.R.E.S. How the Ulster C.A.R.E.S Project works This staff reassignment to the Ulster County Department of Social Services will help address service needs and maximize Federal and State reimbursement.  Creates a dedicated Energy Assistance Unit within the Ulster County Department of Social Services to increase efficiency and support HEAP and other economic assistance programs;  Provides enhanced service to seniors by assigning staff to the Office for the Aging to coordinate HEAP applications; and  Enhances the Coordinated Children’s Services Division to further meet the needs of Children and Families.

12. -12- Ulster C.A.R.E.S. Financial benefits of Ulster C.A.R.E.S.  Saves approximately $120,000 the first year through reduction of expenses and leveraging of available State and Federal aid; and  Results in additional anticipated savings over the term of the service agreement.

13. -13- Ulster C.A.R.E.S. Proposed Timeline  Legislative Action – 6/18/13  Clinic Transition – 7/1/13 to 12/31/13  Staff Orientation and Training – 9/1/13 – 12/31/13  Transfer Clinic Operations – 1/1/14  Transfer Staff to DSS – 1/1/14

14. -14- Ulster C.A.R.E.S. Community Access Through Restructuring of Essential Services For more information visit the county website at www.co.ulster.ny.us or contact the Office of the County Executive at (845) 340-3800