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Geauga County Mental Health and Recovery Services Board (GC-MHRS) - May 17, 2023

Meeting Details: Regular monthly meeting, May 17 at 6:00 pm at the Board offices located at 13244 Ravenna Rd., Chardon, OH 44024. In person only.  No recording. No agenda available in advance on the website or social media.

Public Comment Policy: No formal policy but in practice, public comment is permitted at the end of the meeting.

All Board members attended: Chair, Steve Oluic; Vice Chair, Linda Miller; Secretary, Alberta Chokshi; Treasurer, Michael Petruziello, and board members Ann Bagley, Walter Claypool, Reba Dykes, Marty Fay, Jimmy Lee Holden, Kathy Johnson, Carolee Lesyk, Ryan Mekota, Greg O’Brien, and Mary Ruth Shumway.    

Staff members attending: Executive Director Christine Lakomiak, Secretary/Receptionist Teresa Slater, and Finance Director Jim Mausser.  

Service Providers: Representatives from service providers including Ravenwood Health, Lake-Geauga Recovery Center, NAMI Geauga, Signature Health, Catholic Charities, and Torchlight VMA.

Guests: Two members of the general public and Kathy Franz, LWVG Observer

Call to Order, Roll Call, and Pledge of Allegiance occurred as listed on the agenda.

Minutes from the April 19, 2023 meeting were approved.

Chairman’s Report: 

Board Chair Oluic welcomed participants. Noting the full agenda, he moved on to the Executive Director’s report. 

Executive Director’s Report: Ms. Lakomiak reported on these items:

America Rescue Plan Grant for Step-down Housing (See vote in Action Items)

Ms. Lakomiak discussed the America Rescue Plan grant opportunity.  This funding is  for Residential Treatment Type 1 housing/programming. Geauga County Board of Developmental Disabilities has 4 homes and has offered 2 as possible housing for transitioning mental health clients as they stabilize and rejoin the community following inpatient treatment.  The homes are and would continue to be owned by the Commissioners (the county).  The application to pursue this funding needs approval of the commissioners.  It was due last week, but not formally due until this Friday. 

GC-MHRS  has worked with staff at Geauga County Developmental Disabilities to come up with a budget of  $1.13 million for renovations to make these 2 houses suitable for at least 16 clients. Match is $126,000.  This will provide further rehabilitation for people being discharged from in-patient mental health treatment who are transitioning from residential settings  to home.  While residing in these in county homes, they will receive services to aid in the transition. This is one- time funding available for renovation.  Part of the application required putting out a request for intention to bid making sure that if the facilities are renovated, at least one provider will be willing to bid on running the program.  Ravenwood is willing.  Other providers can be solicited as the process goes on. 

Discussion followed with many board members participating. Points raised included 

that housing has long been identified as a need for serving Geauga County mental health clients as many are now living out-of-county because there is a lack of in-county options. The discussion also touched on how program services would be funded. Possible sources mentioned included fees for service, insurance, and Medicaid.

• Mr. Claypool remarked that  “...these dollars are “credit card” dollars” (referring to the American Rescue Plan)and he feels they are contributing  to the demise of our country.

• Ms. Bagley asked if anyone had seen the buildings? It was stated that the buildings had been seen.  There are currently 8 bedrooms per building with the potential to add more with the walk-out basement. It was stated that these two homes are designed for this type of use with staff rooms, a medical area, medicine management area, and a big basement. There are 4 identical homes: 2 for MR DD and 2 for MH clients. 

• Ms. Chonski asked if there were options for funding after this one-time grant is gone? It was stated that Insurance and mental health dollars would be used to supplement as GC-MHRS does now for this population. It was stated that the buildings  would remain county property and that the commissioners would own the property.  They would allow GC-MHRS to use it for 10 years.  

• Mr. O’Brien stated that these two homes are almost turnkey as they were designed for supervised group living and that they fit our needs. 

The budget for the houses includes two new roofs, painting, furnaces, kitchen equipment, medical equipment, and $600,000 for first-year operating funds to get started. 

It is asked how many Geauga County residents are currently in out-of-county placements but staff said it can be difficult to track this number. If Medicaid is paying, the GC-MHRSB might not know. It was added that having in-county housing options is an important part of Stepping Up, a program to help jail inmates with mental illness.

Staff was asked how confident they are that we could fill these rooms?  The GC-MHRSB  knows of 7 county individuals who are in the state hospital.  These facilities would be an important part of transitioning those individuals back into the community. 

• Mr. Claypool asked if mixing these populations might be dangerous?  Ms. Shumway noted that not everyone in jail belongs in jail and that some individuals are there because there is no other housing option in-county and that that’s part of what the Stepping Up program seeks to remedy. 

• Mr. O’Brien stated that the GC-MHRS still has some time to research further while this decision is being made and that it will be at least three months before the grant decision is made. 

• Board Chair Oluic reaffirmed for the GC-MHRS that the board has consistently identified housing as the single greatest need in Geauga County

• Mr. Claypool noted that the county commissioners would be letting GC-MHRS use the two houses and that if the board finds out the need is not great, they could probably give the houses back to the commissioners. 

• Mr. Petruziello noted a concern about keeping staff, an issue that has been a problem for Ravenwood.  

Ms. Lakomiak clarified that there is a definition of Type 1 residential housing in the ORC. She summarized that this type of housing emphasizes avoiding hospitalization and providing stability, learning skills, transportation, and job skills, etc. 

A motion to apply for the funds was discussed but a vote was not taken at this point. 

Stepping Up

Stepping Up is having a ZOOM meeting on May 25. All Board members and many community stakeholders should have received an invitation via e-mail.  Check your spam folder if you did not get the invitation.  It should be very informative. 

Other

Ms. Lakomiak is going to Bainbridge Fire tomorrow.  She feels it would be beneficial to recruit some first responders on the MH board.

Committee Reports

Agency Relations Committee:  Ms. Johnson reported meetings with agency directors are complete and that they were positive. She noted that there is a spirit of cooperation in Geauga County and that they hope to hold these meetings quarterly throughout the year. 

Finance Committee: Mr. Petruziello reported that they will be submitting the initial budget for 2024 and System of care for 2024. Ms. Clark (Ravenwood Health) explained the Crisis Stabilization Program which involves keeping kids in the home which creates significant cost savings. Mr. Petruziello asked what would happen if funding went away and it was noted that Medicaid billing would continue. However, those not on Medicaid wouldn’t get the service.  Other resolutions later in the agenda were also listed; including the Levy and EMDR training. 

Planning and Policies Committee:  

• Ms. Lakomiak drafted a Health Officers Policy which was reviewed by the Planning and Policies Committee last night.  The committee discussed creating health officers who can facilitate hospitalizations. There are specific persons who can commit individuals, who are at risk of harm to themselves and others, such as police, medical doctors, etc.  Per the ORC, MH boards can appoint additional people to act as health officers.  It was stated that 90% of boards do appoint health officers to compensate in counties that do not have enough staff within the given definitions to assist when this need arises. It was noted that Ms.Lakomiak is qualified to train these potential additional Health Officers should the GC-MHRS Board decide to add Health Officers. 

Mr. Claypool raised a concern about “taking people’s liberty away from them.” 

• Mr. Claypool requested a written summary of what was learned from all the Agency Relations meetings.  Ms. Johnson responded that these were relationship building meetings and that they asked providers to identify gaps in services. Providers reported that they don’t see major gaps in service. 

• Mr. Claypool discussed going through the whole policy and procedures manual.  He stated that a definition of housing is needed, adding that it might be a priority or something to focus on.  

• The Organizational Chart proposed in the Board packet was discussed. It was noted that there is a new position of Clinical and Compliance Manager who is tasked with improving outcomes and services. The chart also includes modifying the Secretary position to more of an office manager.  

Capital Planning: Ms. Shumway stated meeting dates are June 21, Aug 16, and Nov 15.  4:30-5:30. These are board meeting dates. Anyone is welcome to attend. 

Opiate HUB Committee:  Ms. Miller is working on First Responders recognition in this area.

Board Review and Action Items: 

• Resolution 23-05-1  Behavioral Healthcare Levy: The Geauga County Board of Mental Health and Recovery Services shall seek a renewal of the current countywide 5 year, 7/10ths of one mill mental health services levy on the November 2023 ballot. APPROVED by unanimous vote.

• Resolution 23-05-2  System of Care Funding Allocation for SFY 2024. Funding for Family First Council, Crisis and Hospital Inpatient, Residential Services, Special Projects Fund, Medication Subsidy, Community Education/Prevention, Trauma Informed Care Development and Response, Risk Pool. Total Funds $530,000.00. APPROVED by unanimous vote.

• Resolution 23-05-3 Board Operational and Community Education Budget for SFY2024.  Total Funds $571,725. APPROVED by unanimous vote.

• Resolution 23-05-4 Agency Funding Request for Eye Movement Desensitization and Reprocessing Training (EMDR) for 16 therapists from Lake-Geauga Recovery Centers, WomenSafe, Family Pride, Catholic Charities and Ravenwood Health. Total Funds $22,400.00. Following discussion, APPROVED 11-3 with Mr. Claypool, Mr. Holden and Mr. Petruziello opposing.

• Resolution 23-05-5 Mobile Response Stabilization Service (MRSS) Funding Allocation. Total Funds $199,753.97. Following discussion, APPROVED 11-3 with Mr. Claypool, Mr. Holden and Mr. Petruziello opposing.

• Motion to Apply for American Rescue Plan funding for Residential Type 1 housing funding.  APPROVED 12-2 with Mr. Claypool and Mr. Petruziello opposed. Observer note: There was a caveat added that in the next few months, a budget for  the first few years be developed to assure the programming can be funded.

• Financial Reports - Mr. Mausser 

Color coded financial reports which are in the Board packet were reviewed.  All looks fine. Collections are at almost 100% collected and reports were well received and showed funds at the appropriate place for this time in the budgetary cycle, which ends on 6/30/23.

Discussion Items

• Nominating Committee.   Mr. Oluic stated that he had asked Ms. Johnson to be the chair of the nominating committee and she agreed.

• Agency Unit Rate Adjustment.  This was suggested as a way to help agencies and would be a retroactive increase in unit billing rate. For next year, a Medicaid rate increase is in the works from the state which will be discussed at the next meeting.  Ms. Clark says the State recently  gave a 10% retroactive rate adjustment. 

• Cell Phone/Laptop for Executive Director. Mr. Mausser suggested this does not need Board action. There are funds that could be used for this.

• Agency Fundraisers.  Mr. Petruziello questioned if there should be  a line item for fundraisers.   Mausser is comfortable with using funds in community education to support fundraisers for provider agencies as there is already $25,000 there to be used at the Director’s discretion.  Ask agencies what their needs might be. 

Old Business 

None

New Business 

Changes to organization chart: APPROVED by unanimous vote.

New job description for Clinical and Compliance Manager:  APPROVED by unanimous vote.

Health Officer Policy: noted that a few amendments were made by the Prosecutor.  Motion to approve as amended by prosecutor. APPROVED by unanimous vote.

• Ms. Johnson noted that the ORC allows this and that having Health Officers present when possible adds a level of kindness and compassion. 

• Mr. Holden said he has pink-slipped lots of people in his role as a police officer (pink slips are used to order an emergency hospitalization for mental health reasons) and that police officers often don’t have time to wait for clinicians. 

• Ms. Shumway noted that the point is to make sure clinicians who do go along are certified. 

Public Comment:

There is an urgent Advocacy Alert regarding the Ohio Senate Committee.  Go to namigeauga.org. 

Mr. Oluic noted that there is so much going on and that as a Board, we need  to keep moving forward. 

Adjournment - at about 8:00 pm. 

Board Minutes: https://www.geauga.org/board-minutes/

Next meeting: The next Board meeting was not announced but it should be on June 21 , 2023  (third Wednesday) at 6:00 pm with no virtual option. 

More Information: https://www.geauga.org/

Observer: Kathy Franz

Editor: Anne Ondrey

Reviewer: Shelly Lewis

The League of Women Voters of Geauga is a 501(c)(3) nonpartisan political organization that encourages informed and active participation in government, works to increase understanding of major public policy issues, and influences public policy through education and advocacy. They do not support or oppose individual candidates or parties. Learn more 00. about the LWVG at www.lwvgeauga.org.