With costs up and state funding remaining flat for the past 18 years, Lebanon County’s Mental Health, Intellectual Disability and Early Intervention program is facing a deficit of over $377,000 for fiscal year 2024-25.
MH/ID/EI administrator Holly Leahy warned County Commissioners while presenting the agency’s new budget that services will not be added unless there is additional state funding in its 2024-25 budget beyond the $20 million legislators approved last year.
The state’s budget deadline is June 30.
For the coming fiscal year, MH/ID/EI is facing a deficit as expenses have increased over revenue received.
“Our expenses increased by $234,704, or 2.75 percent, and are now at $8.780,951,” said Leahy. “We are still using utilization factors to reduce certain budgeted provider contracts, continuing to recognize the need to contract for services that may not be used but must still be available for client choice. While provider contracts have increased, we were able to reduce other line items to keep the total increase to expenses at a minimum.”
Leahy highlighted project revenue of $8.38 million, an increase of $720,188, or 9.4 percent, from the previous year. However, $574,614 of the increase is from mental health reinvestment funding from the HealthChoices system – which is not predictable revenue.
“I really must emphasize that these funds are not permanent, they’re not long-term and this short-term, time-limited funding is a tremendous help to our budget but does not address the ongoing need for permanent sustainable mental health-based funding,” she added.
Leahy said the state last year approved $20 million for statewide mental health funding, but Lebanon County’s share was only $187,000.
“The history of that is back in 2006 was the last time we received an increase in our mental-health based funding and in 2012 we received a 10-percent cut, so while we recognize we did get an increase, $187,000 does not truly fund what is happening here,” said Leahy. “Again, $574,614 in short-term HealthChoices funding and without additional state funding it will be extremely difficult to balance the budget moving forward.”
While grateful for the HealthChoices financial support, Leahy emphasized that leaders must address additional state funding for mental health-based programs. She noted that the MH and ID programs will bear the projected departmental deficit of $377,364.
“Even if legislators approve another $20 million statewide here in fiscal year 2024-25 with our share, again, being $187,000, it really will not put a dent into our deficit, giving us no ability to expand services or initiate any new innovative services,” she cautioned.
Leahy noted the budget includes $600,000 in county funds to meet the required county match and the deficit to the mental health and intellectual development programs.
“What doesn’t need to be said, but I’ll say it anyway, when presenting the numbers and the impact on the ability to provide care, when you talk to anybody in the human services field, whether it be schools, nursing homes, the prison or anywhere, the need continues to rise,” Commissioner Mike Kuhn said after seconding a motion to approve the budget. “This is a drop in the bucket, but what it really means is that we’re really going to continue to have challenges in providing the care that is needed.”
Commission chairman Bob Phillips noted that it was announced that 69 percent of inmates at the Lebanon County Correctional Facility have mental health needs, up by 9 percent over what was reported last year by prison warden Tina Litz.
“It’s quite sad when you look at 2006 and the neglect in light of the reality,” said Phillips.
The $187,000 the county receives pales in comparison to nearly two decades of flat funding, according to Leahy.
“The $187,000 in 2023-2024 doesn’t even remotely account for all of the years of the lack of additional funding,” she said. “All of our providers (are) struggling to just maintain the current line of services and supports in our county. Without additional funding, again, to address all of the needs in the community, we can not expand or initiate any new services without additional state funding. We’ve stretched our funding to the utmost and we can not stretch it any further for anything more.”
Sue Douglas, the county’s fiscal operations officer, said the rates that the state sets for intellectual disabilities are mandated, but there are discussions in Harrisburg to increase the ID eligibility rates.
“To the point that I wasn’t sure whether I should budget for it or not,” she said. “They’re talking about it, but at this point I don’t think they are ready yet. I think that could potentially impact the budget as we go forward if they actually approve these new rates.”
Douglas also noted that mandates exist for Early Intervention eligibility rates, but the state has allowed counties in the past to do “rebudgets” to cover administrative and additional costs incurred during those fiscal years.
County administrator Jamie Wolgemuth said mental health needs puts a strain on numerous county agencies, including Children and Youth Services and the county prison. He said this conversation is one he feels he has every year during budget season.
“It pervades throughout so many of our departments, and not just this one even though it’s the largest,” said Wolgemuth. “It goes on and on and it is just a common thread through so many programs. The less it’s addressed, the bigger the problem gets. Last year, you know, the state threw a nickel at it.”
Commissioners unanimously agreed to pass the agency’s 2024-25 budget.
In addition to seeking approval of the budget, Leahy also presented provider contracts for the coming fiscal year and provider contract amendments for fiscal year 2023-24.
Commissioners unanimously approved 94 agency provider contracts for fiscal year 2024-25 for the three services that agency provides its clients in the amount of $5.82 million. That figure is up from the previous fiscal year by $465,121, according to Leahy.
This agency’s fiscal year, along with the county’s Commission on Drug and Alcohol Abuse and Area Agency on Aging, runs concurrently with state government beginning July 1 annually. Those other two agencies also presented their 2024-25 fiscal year budgets for approval by commissioners.
“If we break that down to the three programs, overall, our mental health contracts total $3,115,216, increased by $262,043, or 9.2 percent over fiscal year 2023-24,” said Leahy.
Intellectual Disability program contracts for the new fiscal year are just over $1 million, a decrease of $42,594, or 3.8 percent, and Early Intervention contracts are $1.53 million, an increase of $226,666, or 17.3 percent more than the previous fiscal year.
“The main service to increase is special instruction, which is almost always county-based funded as MA, or medical assistance, does not pay for this service,” said Leahy. “We also have a new contract this fiscal year for an Early Intervention administrative position at $78,781.”
Leahy told commissioners that Support Services contracts are $82,667, an increase by $17,445 or 26.75 percent, this year. “This is due to our ever-increasing costs for services,” she added.
Leahy also asked for approval for 17 contract amendments for fiscal year 2023-24, totaling $204,921. Those invoices will be covered through the current budget and allocation, meaning the additional bills will be paid without using additional taxpayer dollars.
James Donmoyer, executive director of the County Commission on Drug and Alcohol Abuse, presented his department’s 2024-25 fiscal budget of $2.55 million, which is $84,169 higher than last year for an increase of 3.4 percent.
After highlighting various cost changes, Donmoyer noted that his department is not requesting any support from the county’s general fund. Revenue is provided through the Department of Drug and Alcohol Programs, federal grant funds, the Department of Public Welfare, and a host of other public funding sources.
“There are other ways to fund our office and we get the funding to do that – which is a nice thing,” he added.
Donmoyer also presented 41 provider contracts at 63 different facilities across Pennsylvania for approval with the 2024-25 fiscal year budget.
Those contractors provide drug and alcohol treatment services, intensive outpatient services, medically assisted treatment, detox, in-patient care, and recovery and halfway house living facilities for county residents. There was not a financial figure for these providers since rates vary along with the services that are provided to county residents at those facilities.
Commissioners also recognized employee Terri Rudy with a proclamation for nearly 46 years of service to the county. The entirety of her career was spent in that department, starting as a part-time clerk on July 17, 1978, then going full-time in December of that year. She is retiring on June 29 as the department’s fiscal assistant, a position she’s held since Jan. 1, 1993, and as the second-longest tenured employee in the county’s history.
“She’s been a loyal, dependable county employee,” said Donmoyer. “She’s there every day, gets what she needs to get done, is a team player, I can’t say enough good things about her.”
Adrian Layser, administrator of the county Area Agency on Aging (AAA), also presented her department’s new budget, upcoming provider contracts and contract amendments.
AAA’s budget is $4.52 million, an increase of $345,000 over last year, said Layser. Personnel costs will increase by $469,000 due to union contract increases in August 2023 and via a projected 4-percent increase for two new positions.
Layser noted that the authorized provider rate by the state is up 4.5 percent, which is paid through the Aging Block Grant Program Directive, and there are 34 contracts that were approved for services valued at $973,000. It was noted that personal care contracts with the county’s six providers were updated and will be valid from July 1 through June 30, 2025.
The agency also made numerous changes to its advisory board at its May meeting.
Two board members, Tim George, Caring Hospice, and Carol Levengood, retired-consumer and PA Medi counselor, are ineligible for reappointment since they served their two-year terms, and another board member, Brenda Snyder (retired-consumer), is unable to serve another three-year term.
Members reappointed to another three-year term include Mary Sample, retired-consumer; Bryan Smith, Lebanon County Christian Ministries; and Linda Weindel, G&L Trophies-consumer. New advisory board appointees are Lori Brandt, vice president of the Lebanon Valley Chamber of Commerce; Kathy Hetrick, retired-consumer/advocate for Advanced Career Planning Coalition; and Deborah Spencer, retired-consumer/volunteer.
Both sets of three-year terms run through June 30, 2027.
Wolgemuth said “retired-consumer” is a board representative designation for individuals who are eligible to receive aging agency services.
The advisory board replacement from Lebanon Transit is Betsy Steinberger, who will serve out the remainder of John Callaway’s three-year term, beginning July 1 through June 30, 2025.
The meeting began on a light note with a four-minute performance by 10 members of the St. James Players of “Whatever You Want to Be” from the musical “Peter Pan.” A cast of 27 players will perform the musical beginning Aug. 2 at the Community Theatre at Lebanon Valley Mall.
The youths came to thank commissioners for providing a hotel tax grant to the organization for their Fairy Festival held earlier this year.
Following their performance, Faith Bucks, who chairs the South Londonderry Township Board of Supervisors, told one of the parents that every meeting should begin that way. The rousing performance received enthusiastic applause from those in attendance.
In other business, commissioners voted to:
- Approve an Intermediate Unit 13 contract for an adult education instructor in the amount of $33,016 for classroom instruction and the administration of HiSet testing.
- Set costs for three potential bridge construction projects, which is necessary to obtain funding from the state Department of Transportation. The resolutions for the projects were for $5.61 million for Yordys Road Bridge in North Annville Township, $4.8 million for Golf Road Bridge in Bethel Township, and $3 million for Levans Bridge in Jonestown. It was noted the project price tags, which total $13.4 million, may change if the bridges, which are currently closed, are approved for repair.
- Amend a resolution naming Josie Ames as chairperson to America250PA for Lebanon County to include Jen Kuzo, president of Visit Lebanon Valley; Tom Newmaster of FORCE; and Jan Morrissey of the Lebanon County Historical Society and Historic Preservation Trust of Lebanon County.
- Accept the treasurer’s report, the minutes of their June 6 meeting and June 5 and 12 workshops, and various personnel transactions.
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