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Minutes Not Final Until Approved By LGAC

Local Government Advisory Committee
Minutes-July 12, 2002

Room 473, Human Services Building, Salem

Contents:

Attending

Cindy Becker, DHS — Chief Administrative Office, Administrative Services

Lennie Bjornsen, DHS — Assistant Director, Continuous System Improvement

Larry Cole, League of Oregon Cities

Susan Columbus, DHS — Administrative Services

Joe Corsiglia, Columbia County Board of Commissioners

Vic Falgout, Douglas County Juvenile Department

Irene Fischer-Davidson, Clackamas County Human Services

Ramona Foley, DHS — Assistant Director, Children, Adults and Families

David Foster , Oregon Housing and Community Services

Robert Furlow, Douglas County Health and Human Services

Sharon Guidera, Association of Mental Health Program Directors

John Hartner, Oregon Association of Community Corrections

Cathy Iles, DHS — Continuous System Improvement

Chris Johnson, Yamhill County Health and Human Services

Margy Johnson, DHS — Deputy Assistant Director, Health Services

Lisa Joyce, DHS — Legislative and Intergovernmental Relations Manager, Director’s Office

Sue Kupillas, Jackson County Board of Commissioners

Michael Lamon, DHS — Contracts and Procurement, Administrative Services

Lydia Lissman DHS — Assistant Director, Seniors and People with Disabilities

Bobby Mink, DHS — Director

Linda Modrell, Benton County Board of Commissioners

Gillian Nicolaides, Douglas County Commission on Children and Families

Ann Peltier, Conference of Local Health Officials

Doug Wilson, DHS — Assistant Director, Finance and Policy Analysis

Minutes: Dena Comer, DHS–Director’s Office Administration and Staff to LGAC

Introductions/Approval of Minutes

Meeting called to order by Sue Kupillas, and roundtable introductions were made. Minutes of the June 14 meeting were approved, with a minor change to the wording on page three, paragraph eight.



Elections/Membership

Handout #1: LGAC Membership Representation

Lisa Joyce clarified the LGAC Bylaws pertaining to office term lengths, and suggested that the Member Representation document (handout #1) be reviewed and ratified by the group. Additionally, Joyce explained that while the terms of office are for a period of two years, members are not obligated to serve this length of time.

Kupillas added that county commissioners met and agreed that she and Jean Cowan would remain as co-chairs, yet the remaining members should endorse this decision, as others may wish to run for the office. If elected, Kupillas and Cowan have committed to serving through December of 2003.

  • Moved, seconded, passed: A motion to continue with Kupillas and Cowan as co-chairs.
Budget Update

Handout #2: Comparison of Special Session 3 Selective Program Reductions

Handout #3: DHS All Clusters

  • Special Session
Doug Wilson distributed the first of his budget documents, (handout #2), and reviewed each of the reduction items. He explained the unspecified cuts, equal to approximately $6.3 million for DHS, resulting from the Legislature’s decision to not fund more than 75 percent of state employee salary increases. DHS will have to pay for those increases, and the Department of Administrative Services (DAS) has not yet identified the resulting reductions.

Bobby Mink added that a budget note directed the unspecified reductions to be made, but not disproportionately. The note also directs DHS to not provide management with a yearly salary increase. Whether or not the Governor decides to follow this budget note remains to be seen.

Wilson continued his review by explaining that, of the approximate 200 positions the Department has been given, designations include food stamp and health plan eligibility, Temporary Assistance to Needy Families (TANF) program management, and

Bio-terrorism response positions. Clarification on which of these positions DHS will be allowed to hire should be available within the next two weeks.

Wilson reported that the Governor said this week that he isn’t satisfied with what the Legislature has done. The Governor also discussed four potential vetoes, which would create a large hole (approximately $400 million) in the legislatively adopted plan. The Legislature can override the vetoes, however.

  • Policy Packages
Mink suggested that, as discussion continues surrounding DHS budget packages, the group remember that the Legislature for 2003-05 is facing at least a $1.4 billion hole. In addition to preparing its budget packages, DHS must also complete its reduction options, which by law must be 10 percent. While not yet confirmed, DAS may ask the Department to meet 30 percent, which equates to approximately $1.5 billion.

Mink explained that the DHS budget packages (handout #3) have satisfied state and federal mandates, and addressed the back-fills of reductions needing to be restored. The packages then reflect those addressed by local partners, as discussed in previous meetings. Mink added that his most important goal is to lay the groundwork of need, and to spread the message that LGAC and DHS are supporting each other, and working together.

Group discussion included local flexibility surrounding funding streams, and concern for how the Legislature will deal with the $1.4 billion hole. Kupillas commented that it is the responsibility of local government to examine the reductions being made, and their affect on local communities, and to ensure public understanding that the Legislature has made the decisions, not the local government.

Further discussion included the challenges of managing by reductions, with clarification from Mink and Wilson surrounding the budget process. DHS’ current service level will be approximately $2 billion in the next legislative session, with 30 percent reductions equaling approximately $950 million. Mink commented that conversation is needed, however difficult, surrounding priorities of programs.

Wilson explained that the DHS package document (handout #3) is a work in progress, and subject to change. It sets the stage, in the event of a tax increase or other circumstance, for establishing the funding needs of the Department. As DHS continues to work with DAS, some reprioritization may occur.

Sharon Guidera inquired about when planning funds will be released, and Wilson replied that he would contact DAS for an answer.

A brief question-and answer session between the group and Wilson included concerns about the result of the reductions on protective services as a whole. Robert Furlow requested that DHS investigate funding for these services with a global perspective. He asked that the Department remember the impact on local governments when it addresses packages to satisfy state and federal mandates. Of additional concern to Furlow is the effort DHS has put into strengthening its computer and accountability infrastructure, including performance measures, while the services being tracked may be reduced. Kupillas commented that these partnership issues are ongoing as the reorganization continues and the budget issues are approached.

Mink explained that the budget package document will be sent to DAS in the next week for a preliminary review. He added that the budget notes provide an indication of the Legislature’s scrutiny surrounding filling positions, or anything they determine will involve discretionary funding. He asked the group to maintain a heightened awareness of the accountability that DHS will have, and the impacts it will have on its local partners. Mink will be visiting each of the Department’s Service Delivery Areas (SDAs) and their advisory committees, to collect feedback on the reorganization and the 2003-05 budget development process. If there are any opportunities to speak to advocacy groups throughout the SDAs, please let Bobby know so they can be scheduled into the visit plan.



In wrapping up this discussion, Kupillas suggested that the group speak to the gubernatorial candidates about their budget concerns.

  • Action: Following the meeting, Wilson will contact DAS and inquire as to when planning funds will be released, and provide their answer to Guidera.
Managing in this budget climate

Mink referred to the recent special session, and commented that reductions could have been much worse for the human services continuum. He explained that DHS is not alone in taking reductions, and asked the group to consider the greater whole of state agencies and the impact on their budgets.

With respect to the state’s hiring freeze, Mink explained that his recommendation to the Governor is to make it rolling, rather than long-term, to avoid appearing as though we don’t need the staff. Additionally, Mink reported that the Public Retirement System (PERS) would be modifying mortality rates to reflect today’s increased lifespan as compared to the 1970’s, when tables were last updated. How these rate adjustments will affect those staff eligible for retirement is yet to be seen, as some may choose to retire before rate changes go into effect.

Kupillas reported that Ben Boswell would be following up with DAS regarding their commitment to work with local governments as the budget packages are developed.

Linda Modrell suggested that a clear graphic document would be helpful to illustrate the impact on local governments, particularly when addressing advocacy groups. Joyce replied that while DHS does not have a document specific to this, DHS would provide what it has. Additionally, there are available resources such as the Social Support Investment Work Group (SSWiG) pie chart, which might be utilized.

  • Action: Joyce will provide the group with the fall JLCIMT dates when they become available.
  • Action: Modrell agreed to work with Joyce to develop a graphic document, which illustrates the impact of the reductions on local communities.


HIPAA and the DHS 2100

Handout #4:HIPAA Meeting Information 2002: Oregon DHS Presentations

Handout #5:DHS Confidentiality and the Authorization for Release of Information

Handout #6:Draft — DHS Confidentiality Policy

Handout #7:Authorization to Release Medical Information

Handout #8:Authorization for Release of Non-Medical Information

Cindy Becker reported on her meeting with Community Mental Health Directors in June, where they suggested accompanying DHS to the September Emergency Board

(E-Board). DHS invites this participation, and will be going to the Joint Legislative Committee on Information Management Technology (JLCIMT) in the fall. Joyce agreed to provide the dates when they are available.

Guidera suggested that, along with presenting other impacts to the JLCIMT, it would be helpful to present the Health Insurance Portability and Accountability Act (HIPAA) costs as both state and local. Becker responded that these costs are federally mandated.

Discussion ensued surrounding the HIPAA costs, and included comments that they are the cost of doing business with DHS, regardless of the federal mandates. Concerns were expressed regarding local governments needing assistance to implement HIPAA requirements, particularly if DHS will be monitoring their compliance.

Becker explained that DHS is not setting the mandates, and that local governments may define their own responses. DHS is attempting to share the information it has, without directly telling local governments what to do. These are unfunded mandates facing everyone, and DHS will give the local governments anything it develops, including forms and training. Becker reminded the group that the training would be geared to DHS’ implementation requirements, not to local government, and to keep this in mind when participating.

Becker continued with the explanation that DHS will not be monitoring local government compliance, but rather the federal government will do this. DHS is concerned about the liability it has in working with contractors and other entities that are not complying with HIPAA.

Other concerns included how DHS will be setting up its data systems to implement HIPAA, and how local governments will then be effected, and that local partners are government entities who are doing work for DHS. Additionally, Becker was asked whether or not DHS has determined its minimum requirements, or a model, for compliance. Becker responded that DHS is struggling with this, along with everyone else.

Becker distributed a DHS HIPAA meeting information document (handout #4), and reported that over the past few months the Department has been traveling throughout the state, and collecting feedback on the privacy (2100) form. DHS’ goal has been to not have a 2100 process and a HIPAA privacy process, but rather to merge them together, addressing the entire issue of confidentiality and privacy. Becker further explained that there isn’t going to be a statewide privacy policy; each agency will act on their own. A draft DHS Confidentiality and the Authorization for Release form (handout #5) was distributed.

Discussion continued with concerns over the lack of a privacy policy for local governments, and the liabilities involved. Kupillas suggested that this issue be discussed at a later date.

Susan Columbus distributed three additional documents (handouts #6, #7, & #8), and provided a brief overview of each. She explained that these are all draft documents, and advised the group that if others want to use the forms, legal counsel should review them.

Kupillas advised the group that, if they have comments or questions, please contact either Becker or Columbus.

Performance Measures

Handout #9:DHS Vision, Mission, and Goals

Handout #10:DHS Quarterly Results, May 15, 2002

  • Tying measures to budgets and contracting
Lennie Bjornsen and Cathy Iles provided a brief update on the Department’s progress on performance measures, reminded the group of DHS’ Vision and Goals (handout #9) and distributed the latest DHS Quarterly Report (Handout #10).

There was concern that, as local government tracks its own data, it uses the same benchmark and database for determining the issues. Iles responded that DHS is working toward coordinating this, including more analysis in each report. Bjornsen and Iles offered to provide a complete framework of the performance measurements, including a key for each letter used in handout #9. The framework would also include what key measures DHS is proposing to DAS through its budget document. Iles is the lead person for the Quarterly Reports, and can be contacted if there are any questions.

Bjornsen reported that he is also working with SDA managers to understand management information data points, which could be generated electronically and on a monthly basis.

County Contracts

  • Performance-Based Contracts
    Michael Lamon explained that both the County Contracts Task Force and the Performance-Based Contracts Committee are beginning to create tangible results. The last meeting of the Task Force took place on June 14, where a draft standard county contracts/intergovernmental agreement was distributed by the Department of Justice’s (DOJ) Business Transaction group. Lamon added that a county concern at the meeting surrounded an indemnity clause, which addresses DHS’ ability to recover what a funding source would consider as inappropriate use. Lamon will collect comments on an appropriate remedy to this, as well as comments on the draft agreement, by July 15. The next Task Force meeting will be on July 30.

    Lamon continued by explaining that the Performance-Based Contracts Committee is actually a subgroup of the Task Force, and last met on June 11. At the meeting the group decided to use a "logic model" to assist in identifying performance measures and separating output from outcomes.

    Group concerns included the Staley settlement requirements and accommodations for what the counties are required to do, the contracts for which seem prescriptive and not outcome-focused, and a request that DHS intervene. Additionally, there is a time issue, considering that the service was approved by the Legislature in June, 2001, and is actually arriving in July of 2002.

    Becker concurred with the validity of the question surrounding the time issue, and explained the use of a contract as a more expeditious method than the amendment and exemption process with DOJ. Joyce agreed to find out why the contract was developed on a fast track.

    Furlow commented on the need for language in the contracts, which speaks to the lack of funding for the outcomes. Kupillas concurred, and suggested that this discussion be continued later.

    • Action: Joyce agreed to find out why the contract was developed on a fast track.
    Other Items

    Handout #11:April - June Newspaper Clippings, of Interest to LGAC

    No discussion of these handouts occurred. Copies of these documents were distributed to group members as informational only.

    Future Agenda Items

    Actual agenda is dependent upon a LGAC Executive Committee meeting.

    Next Meeting

    Date: August 9, 2002

    Time: 9:00AM - Noon

    Location: HSB 473



    If you would like copies of the handouts, contact:

    Dena Comer
    DHS Director’s Office, 4th Floor
    500 Summer Street NE, E-15
    Salem, OR 97301-1097
    Telephone: (503) 945-6843
    e-mail: dena.comer@state.or.us Americans with Disabilities Act Notice: Do you have a physical or mental impairment that makes it hard for you to communicate? If so, you can get this document in Braille, computer disk, large print or oral presentation by contacting Jessica Ferge, Department of Human Services, Director’s Office, (503) 945-6609, TTY (503) 947-5330.