Numbers dwindle rapidly at Butler County’s adult day care facility

Credit: DaytonDailyNews

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The Butler County Board of developmental disabilities closes adult day care before mandated timeline.

Credit: DaytonDailyNews

County leaders and clients of the Butler County Board of Developmental Disabilities say they have complete faith in the organization despite it facing a $2 million deficit and rapidly declining numbers of employees and clients at a soon-to-be shuttered adult day care facility.

Boards of developmental disabilities can no longer provide direct services, according to new federal and state mandates. Despite a deadline to get out of the adult daycare business by 2024, the Butler County board announced its intention to close its Liberty Adult Center by March 2017, according to documents obtained by the Journal-News.

Since the end of March, the number of clients enrolled at Liberty Adult Center has dropped dramatically — from 125 to 10, according to Lisa Guliano, superintendent of the Butler County Board of Developmental Disabilities. Staffing has also dropped quickly as employees sought new jobs, going from 40 to seven by the end of this month, she said.

Guliano estimates the board could save $1.4 million a year with the closure of Liberty Adult Center, but said the mass exodus of employees, and then clients, could force its closure sooner than 2017.

The board will be addressing the dwindling numbers at Liberty Adult Center during its meeting today, she said.

“It’s a little like we can pull this band aid off really slowly and painfully with uncertainty, or we can just do it and say now let’s move forward and let the healing, whatever needs to happen, begin,” DD Board President Kathy McMahon-Klosterman said about the early closure. “With a number of the families the parents and siblings are older and wouldn’t it be in their best interest to know where their family is going to be, rather than wonder for five or six years where they might wind up.”

The board was also staring down a $3.6 million deficit at the beginning of the year, however Business Services Director Hailey Quinn said a state cost reimbursement has cut that amount to $2 million.

McMahon-Klosterman said deficit or no, they needed to make a pay adjustments for the county organization that employs about 160 people.

“We took the commissioners quite seriously for a good number of years and have been fiscally conservative I think as a board,” she said. “But at some point people have to pay their own bills too… We had to make some adjustments it seemed, really, to keep staff and to be fair and just with the workers.”

In 2010 and 2011 none of the employees received raises, according to documents reviewed by the Journal-News. From 2012 through 2014, up to two percent was available for raises. For the next two years $550 lump sum bonus were approved for raises, but last month the board approved a two percent raise for all employees which will be given out based on performance.

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 phase out of personal property tax was also a big hit, going from almost $2 million in 2005 to $1,352 this year.

The DD Board passed a $19 million general fund budget this year and $18 million is planned for 2017. The total budget, including state and federal funds is $29 million this year and $28.4 million for next year with an expected $3.4 million deficit. However, the board is expected to have a cash balance of $28.6 million this year, reserves they have had to dip into because of ever changing levels of state and federal funding.

Guliano said they have been off the ballot for a levy for a dozen years and that, and a board mandate for at least a six month reserve, is why the reserve is so robust.

“It’s not so much about collections it’s about savings and staying off the ballot,” she said. “We have a history of business decisions we’ve made over the last 10 years that have enabled us to stay off the ballot. We were last on in 2004, we said we would stay off for five years and we’ve been off 12.”

The county commissioners have asked all the social service agencies not to have levies on at the same time. The DD Board is now slated to go back on in 2018. The board has two levies and combined are expected to bring in $20.2 million this year.

Oversight of finances

It is Probate Judge Randy Rogers’ responsibility to appoint two of the seven DD Board members; county commissioners appoint the rest. Each member serves a four-year term.

The board meets once a month and the members also serve on a number of committees. Tony Yocco, vice president of the board and head of the finance committee, said the finance committee meets every month and is very hands-on.

“We go over (finances) line-item-by-line-item,” Yocco said. “Every expenditure, every contract is reviewed prior to being discussed and voted upon by the board. There is a detailed level of oversight for the finances. Not only do we recognize that we have to provide the best possible care for the individuals we serve but we also understand we are stewards of money entrusted to us by the taxpayers.”

Even though the DD Board is funded by taxpayers and has an annual budget hearing like other county departments, commissioners cannot dictate how it spends money, according to Commissioner Don Dixon.

The commissioner said he is satisfied the board is handling things the right way.

“I’m comfortable with what they’re doing and the how the budgets are running,” he said. “They are under the same kind of budget constraints we are and everybody else is. We’ve been holding the line and trying to get everything fiscally back on a good solid foundation and I think that’s probably what they are doing now.”

Finding new care for clients

Guliano said it was nice to have a “little bit of a luxury” last month when numbers at Liberty Adult Center were 12 staff to 15 clients, because it allowed them to work more closely with each individual to help them find a new center — there are 35 to 40 providers in the county. Only the most challenged clients are left at the center on Liberty Fairfield Road, she said.

Now, Guliano said the extra staff are also working on closing the facility’s “massive” building, including moving supplies and equipment that were once used to care for 125 people.

“The individuals we have left, many of them are getting some direct support from our staff, our staff is taking them to their new provider, helping with the transition, working with the new provider,” she said. “Any employees that are not assigned to individuals on any given day we’ve started the process of breaking down the building.”

Elizabeth Maynard’s son Ben recently moved to The Charleston Club, a day service program in West Chester Twp. She describes her son, who was born almost 24 years ago on Christmas Day in Anchorage, Alaska, as a “little character” who is developmentally delayed, with complex health issues due to a very rare chromosomal condition.

She said staffers at the DD board were very supportive in the family’s search for new care.

“Liberty Center, and the team at Butler County, they had no choice, and they have been so supportive in terms of trying to find the right fit for Ben,” she said.

Dave Parris’ daughter Ashley transitioned from the center to Easter Seals earlier this summer and recently started a job as a stocker at Walgreens. She has Dandy Walker Syndrome which for a while caused the 25-year-old to have anger issues before they found medicine that works to keep that under control.

Parris said for most of the time she was under the county’s care, staff had to have eyes on her all the times because she would cause trouble.

He said he suspects the DD board needs to maintain the staffing levels because the clients who are left have the most needs.

“My gut tells me that everybody that’s on Ashley’s level has moved on already,” he said. “And the people that are left there are the hardest to place.”

Yocco, vice president of the board and head of the finance committee, defended keeping the staff-to-client ratio.

“First and foremost is the safety of individuals we serve there at the center,” he said. “Regardless if it’s ten, 100 or even one, they still deserve to be provided proper supervision and care. The leadership that’s overseeing that, I trust their judgment because that is our mission.”

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