Re:  Report on Recent Site Visits

Mansfield Kaseman Health Program

Mary Lou said that she and Eric Wang did the site visit this summer.  They toured the MobileMed van and interviewed Agnes and Michelle Beadle at Crusader Lutheran, which serves as a waiting room for the van.  She said that no specific program concerns emerged.  She and Eric also talked with two clients; both were very satisfied.  David asked how Mansfield Kaseman keeps its records.  Agnes said that the Primary Care Coalition keeps the records in their main office.  They are moved to the mobile van when they know which patients are scheduled to be seen.

Mary Lou said that the only issue that emerged (which was identified by Eric) concerned an unemployed patient.  MobileMed charges a copay.  On one occasion this patient did not follow through with a visit because he did not have the money for the co pay.  Agnes explained that in these instances MobileMed will see the patient but they don’t waive the fee.  The co pay is $20 to $65, depending on household income.  For many this is a significant amount.

CMR Home Health Care Program

Tim reminded Commission members that they had received a copy of the report in memo form of this site visit.  Mary Lou said that Sarah Duffy, Commission Chair, Lorraine Schack, Senior Social Services Coordinator, and Christine Henry, Recreation and Parks Administrative Services Manager, had all attended the site visit with her.  She pointed out that the report is in draft form so that any concerns Commission members might have could be reflected in the final version. 

Mary Lou explained that Elderly Ministries is the umbrella name and includes the Home Health Care Program, the CDBG-funded Safe and Habitable Home Program, and other smaller programs.  During the FY 07 application process, the recommendation was made to review the program because there were a number of people on the waiting list, demographic trends indicated an increasing need, and the program was asking for increased funding.  The panel considering the grant applications felt it was incumbent for the City to look at the program and decide if any changes should be made.  This memo looks at the program and makes some recommendations.

The first recommendation (at least 85% of the City’s grant funds for this program should be used for contracted home health care while no more than 15% should be spent on administrative costs) does not represent any substantive change.  The second recommendation, namely that all client referrals must be reviewed by the City’s Senior Social Services Program, is similar to the process used for the Rockville Emergency Assistance Program.  Tim asked if staff exists to do this.  Mary Lou said that the expectation is that the program will serve 30 seniors per year, which is not an onerous burden; no additional staff would be required.

The third recommendation relates to the number of hours of home health care clients will receive.  When the program was first presented to the City (1989-1990) it was envisioned that most clients would receive 2-3 hours of care each week.  The recommendation is that if clients need more than 4 hours/week, the Senior Social Services staff will need to review and agree.  This is basically a cost containment measure.  The program was meant to be a bridge program for people waiting to receive County services.  Currently, the County is not accepting new clients unless they need personal care.

Tim asked what Community Ministries of Rockville (CMR) thinks of the recommendations.  Agnes responded that CMR would abide by the recommendations.  She said that the City is pushing for a number, i.e., 30 clients.  When you are providing these services, if none of your program participants die, it is difficult to serve more.  The waiting list for the County is not first come, first served.  It is the same for CMR.  Agnes explained that CMR usually tries to take the client in urgent need first.  She said that CMR has had close communication with the City’s Senior Center for years.  CMR recommends to the City that instead of having a number, there should be a range.  The measurement can’t be just of quantity but must also be of quality of service.  There are many variables.

Shari asked how many people are currently on the waiting list for this program.  Agnes responded one or two.  CMR does not do any outreach so as not to raise expectations.  Mary Lou said that she thinks this is an area that the Commission could weigh in on.  She has been insistent that the program should serve a certain number of clients because they receive one of the largest city grants.  She advised Commission members to look at the issue from the vantage point of Rockville taxpayers who also care about human services.

Tim asked exactly what services are provided through the program; what can be accomplished in two hours per week per client.  Agnes said that chore services including light housekeeping, laundry, personal care, grooming.  They try to avoid using the aide for grocery shopping because Top Banana will deliver.  The aide mainly takes care of the house and the patient.  There is a nurse who makes quarterly visits and takes blood pressure but there is no direct medical care provided.  Most health care agencies won’t provide an aide to go to the home for less than two hours/week.  David commented that family members or neighbors could do many of the duties mentioned.  Mary Lou said that many seniors don’t have family and aides are also trained to assess the client’s mental state.

Shari asked where most of the referrals come from.  Agnes responded that they come from adult apartment communities like Bethany House and from CMR’s member congregations.  She added that with outreach there is a huge potential for the program to grow.

Tim asked Commission members if they had other questions or comments or wanted to take a position on the report.  Shari said that she considers this an important topic and would like to hear from someone on the Senior Commission.  Tim asked Mary Lou if Lorraine Schack could brief the Human Services Advisory Commission on the results of the recent survey of senior residents.  Mary Lou said she would ask Lorraine.  She also agreed to provide statistics of the number of clients served in each of the last five years.  It was decided to revisit the issue at the next meeting.

Re: Suggestions for December 2007 Rockville Reports Insert

Commission members looked at the December Insert to Rockville Reports for 2006.  They suggested that languages could be varied with English on the front and Spanish on the back.  Or, they suggested, just one article could be translated into a different language.  Another recommendation was to translate the description of Korean Community Service Center into Korean and the description of Chinese Culture and Community Service Center into Chinese.  Agnes also suggested putting the Spanish translation in a different color from the English.

Re:  Committee Reports on Proposed Action Plans

Members reported that they had not yet completed their action plans in the areas of Access to Services, Youth Issues and Employment.  Tim suggested that they postpone reporting on action plans until the next meeting.  Joshua Rogers then informed Commission members that he was resigning from the Commission, as he would be starting a new job in a different state.  He had been assigned to the subcommittee on Youth Issues.

Re:  New Business

Rockville Holiday Drive:  Mary Lou said she wanted to ask the advice of Commission members on an issue related to the Holiday Drive.  In past years one part of the Drive has been a toy distribution in December.  This year, Mary Lou said, staff has to rethink this event because of all the toy recalls.  This is a big question because the City relies totally on donations for the items families receive.  Many groups in the city are accustomed to giving toys.  But the multiple recalls are daunting.  Mary Lou said she went to Toys R Us.  Shelves there were full.  There were toy recall sheets posted on the walls.  Mary Lou is skeptical that the general public will pay attention to the recalls; also, she said, not everyone will purchase something new.  Today Chris Henry told her that the store Buy Buy Baby does not pull recalled toys off their shelves.

Tim said he would have a concern about liability.  Mary Lou responded by saying that she had just referred the question to the City attorney.  Chris had also pointed out to her that there is not just a legal question but a moral one.  Shari said she saw this as an opportunity for the City to be a leader; she thought the City should push back with its donors.  David asked if the focus could just be on food.  Mary Lou said that is done in November.  Shari and Agnes suggested asking for donation of educational items, books, games and clothing, but not toys.  Cindy Cotte Griffiths added recreational equipment such as footballs, basketballs, etc.  Tim said he like the idea of book and games; he hasn’t seen any statistics about kids being harmed but he would still worry about liability.

Re:  Adjourn

David moved that the meeting be adjourned to Executive Session pursuant to Section 10-508 (a) (l) (ii) of the State Government Article, Annotated Code of Maryland to discuss a personnel matter that affects one or more individuals..  Josh seconded the motion.  The meeting was adjourned at 9:25 p.m. 

The next meeting of the Human Services Advisory Commission will be held Tuesday, November 13, 2007 at 7:30 p.m. in the Glenview Mansion Dining Room.