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1998-99 Ketner Award winners
HUMAN SERVICES Lunch Plus Club-Kannapolis - Cabarrus County The Lunch Plus Club is a Congregate Nutrition Program for the elderly residents of Cabarrus County. The previous Congregate Nutrition Program had undergone a significant decrease in participation in the county, which is also a nation-wide trend. Meanwhile, the overall number of older adults continues to grow at the fastest rate in history. Studies have documented that the need for this nutrition service is greater than ever in order to promote independence and dignity throughout the aging process. The Congregate Nutrition program is a vital component in the service delivery system that helps keep senior citizens out of long-term care facilities and/or institutions. Many seniors do not participate because they think it is a "welfare" or "free lunch" program. Michael Murphy, director of the Cabarrus County Department of Aging, re-designed the program to attract new participants and give more than a nutritious meal for older adults. First of all, he changed the program’s name from "Nutrition Program for the Elderly" to "Lunch Plus Club" to make it sound more positive and to indicate that there is more to the program than just lunch. Secondly, Murphy put together an agreement with the Cannon Memorial YMCA in Kannapolis that gives the Lunch Plus Club seniors free access to the YMCA facility from 9 a.m. to 2 p.m. Monday through Friday. The YMCA provides different levels of fitness classes, water aerobics, weight training, cardiovascular training, indoor and outdoor walking/running tracks, craft classes, art classes, line and square dancing, choir, and a wide variety of leisure activities. Educational classes include various speakers on topics relevant to older adults. Murphy has expanded this collaborative network of service providers to include NorthEast Medical Center, Rowan-Cabarrus Community College, the City of Kannapolis Recreation Commission and Community Development Board, the Rowan County Senior Services Department, the United Way, and the Sisters of Mercy of North Carolina Foundation, Inc. These agencies helped the program to increase the average number of meals served per day over 375 percent. They also provide trained staff to serve as instructors, servers, lifeguards, dishwashers, and custodians. NorthEast Medical Center has provided a part-time nurse to give health screening for participants and educational programs to promote a healthy lifestyle. Since Kannapolis is in both Rowan and Cabarrus Counties, Murphy negotiated with the Rowan County Senior Services Department that allows Rowan County to reimburse Cabarrus County for any meals provided to Rowan residents by this program. The Lunch Plus Club is growing by leaps and bounds. In January, there were a total of 94 enrolled participants; by May, there were 900 at the Cannon Memorial YMCA. The daily attendance currently averages between 225 to 250 people per day, up from 60 people a day. The program has received over $60,000 in grants and contributions. A plan is underway to expand this program throughout Cabarrus County to all of the Lunch Plus sites. Fitness, educational, health, and leisure classes and programs will be spread to four other Lunch Plus sites next year. They will expand the overall format of this program as additional facilities and resources are made available. Program leaders continue to search for additional funding sources and apply for additional grants. Contributions from program participants are averaging almost twice as much per participant as compared with the other Lunch Plus Club locations throughout the County. By developing a network of local service provider agencies/organizations that share the common goal of maximizing services for older adults while minimizing duplication of services, the Lunch Plus Club has achieved a level of success that surpasses the expectations of participating agencies. For more information, contact Michael Murphy at (704) 788-9899. Effectiveness of Liens to Collect Child Support Halifax County Child Support Team The "Effectiveness of Liens to Collect Child Support" project marks the first time that a local North Carolina Child Support program has intercepted proceeds from a class action suit. When the Halifax County Child Support Staff learned that litigants in the J.P. Stevens employment lawsuit should begin receiving settlement checks, they were determined to see those children and families due unpaid child support would also benefit from the lawsuit. The lawsuit began decades ago when J.P. Stevens was accused of discriminating against minority employees. The resulting settlement payments started being paid to employees and to the estates of deceased claimants in 1998. The staff contacted the civil rights trustee attorney to collect a listing of the litigants. Initially, the Child Support staff only hoped to find current addresses of people who were not paying child support. They found 40 non-custodial parents in Halifax County who were delinquent in making child support payments and who owed a minimum of $3,000, thus meeting the criteria for enforcement by lien. With the help of the staff attorney, the team filed thirty-four liens with the Halifax County Clerk of Superior Court. Once they received certified copies of the liens, they served notice on the litigants (by certified mail or personal sheriff service) and forwarded the information to the trustee attorney in Washington, D.C. He handed the Halifax documentation to the federal court for approval. On September 1, 1998, the Child Support staff received a check for $55,776.13 that represented up to 75 percent of each litigant's interest settlement. The Halifax staff will intercept additional monies from the principal payment later. The team credits the Department of Social Services staff attorney, the lawsuit trustee, DSS clients, and the NC Attorney General Office's staff attorney for their success. Of the $55,776.13, seventy-five percent went to Halifax county families. The remainder of the money was used to reimburse the County and State for the public assistance paid to custodial families during the time period where the non-custodial parent did not pay child support. The project benefited the children of Halifax County as well as county taxpayers. In 1998, the Child Support Team briefed the North Carolina IV-D Attorneys' Conference on the procedures they implemented. Also, they won the 1999 Excellence in Service Award from the North Carolina Child Support Conference. For more information, contact Evelyn Dawson or Melody Beaver at (252) 536-6444. PUBLIC SAFETY "Just Us" Program Gudrun Parmer and Jo Iverson The "Just Us" Program targets juveniles 16 to 18 years of age under the supervision of Adult Probation or Juvenile Court Services who do not attend public school. The purpose is to structure the days and provide guidance to young offenders who do not attend school. "Just Us" is administered by the Durham County Criminal Justice Resource Center under Gudrun Parmer, CJRC Director, and Jo Iverson, Deputy Director. The need for this program arose out of the fact that there was no program or agency in Durham County offering specialized services to this particular group of juveniles. In January 1998, 118 offenders under the age of 18 were supervised by Adult Probation in Durham County. Simultaneously, 78 juveniles were supervised the Office of Juvenile Court Services. National and state statistics indicate that one-third of these youth would eventually break the law again. Many of these young offenders on probation in the county had dropped out or were on long-term suspension from school. The local community college admitted youth under 18 on a case-by-case basis. The Durham County Criminal Justice Resource Center had been providing services to adults. The facility was used mostly in the morning and at night. Parmer and Iverson decided to better utilize the staff and facility resources by developing a program specifically designed for 16- to 18-year-olds on probation. The center began the structured day program on July 1, 1998. Participants attend the program Monday through Friday from 9 a.m. to 5 p.m. for six months. Many are placed there as an alternative to training school or being sent to jail. All services are offered on-site and at no cost to the participants or their families. In the morning, Durham Technical Community College teaches GED classes for those who want their high school diploma. Substance abuse therapy is mandatory for drug offenders. Other programs include irrational behavior therapy, drama therapy, substance abuse education, employment services, and life skills, such as nutrition and personal budgeting. Although juvenile and adult programs are held at the same time at the Center, the juveniles are kept away from the adults. In order to fund this program, the Governor’s Crime Commission awarded a $94,199 grant, and Durham County gave the required 25 percent match. No additional administrative costs were incurred because the existing staff provided administrative support. Existing community resources were used for services at no charge or at a reduced fee. Forty-one juveniles were enrolled from July 1, 1998 to March 31, 1999. During this time period, the program’s operation cost averaged $18.15 per juveniles per day compared to $45 a day at the local jail, $67 a day at a youth detention facility, or $82 to $109 a day at a state training school. In its first nine months, "Just Us" saved Durham County and North Carolina taxpayers somewhere between $86,000 to $291,000. For more information, contact Gudrun Parmer or Jo Iverson at (919) 560-0500. S.A.F.E.-Senior Assistance from EMS Ben Reynolds, Debbie Whittaker, Greg Biggs, Bill Andrews, Suzanne LaFollette-Cameron, and Barry Britt S.A.F.E. (Senior Assistance from EMS) is a program provided by the Moore County’s Emergency Services and Department of Aging to ensure the health and safety needs of their at-risk elderly population. EMS paramedics visit the homes of older adults who currently participate in the Department of Aging’s Home Delivered Meals Program and those identified as "at-risk" elderly on an as needed or monthly basis. S.A.F.E. allows paramedics to become personally acquainted with the seniors, discuss their concerns and questions, and encourage these individuals to write down questions to ask their doctors. If there are problems, the paramedics can correct the problem and make referrals to the Department on Aging. Three lives have already been saved. The idea for this program came out of the need to help the large number of elderly in Moore County. Thirty-three percent of the total population is over 55 years of age. Many have relocated to the area and do not have family nearby to aid them. Sometimes these seniors underestimate the seriousness of the physical symptoms they are experiencing and hesitate to call for help. Paramedics are often their first medical contact in a crisis situation. They are inside the homes seeing real-life conditions such as poor hygiene, malnourishment, abuse, and diminishing physical abilities. Many of these seniors live on fixed incomes. They cannot afford to install ramps and grab bars, hire housekeeping/personal hygiene help, or transportation to doctors’ offices. Paramedics come to visit and establish relationships with them and while they are there, they pick up on the senior’s needs. Before EMS workers go out to the house, the senior first fill out a form if they would like a visit. The family is notified that the person is receiving this service. The following are functions preformed by the paramedics:
Currently, there are 40 seniors in the program. The team behind this project- Suzanne LaFollette-Cameron, Aging Director; Barry Britt, Emergency Services Director; Ben Reynolds, Paramedic; Debbie Whittaker, Paramedic; Greg Biggs, Captain; and Bill Andrews, Care Manager- started with one geographical location in the county and have since expanded coverage to two more locations since there are 8,000 potential elder adults who are eligible. The S.A.F.E. program has provided more intensive client services with existing personnel. There are no increases in expenses since on-duty paramedics awaiting emergency calls make visits. To further enhance the quality of service, the Department of Aging provides sensitivity training to the paramedics on elderly needs and concerns and verbal/nonverbal communication with Alzheimer’s clients. Funds from grants have been used to buy carbon monoxide detectors and light-reflecting house numbers for seniors who cannot afford them. Through visitations, three lives have been saved because they were transported to the hospital for treatment. In one case, an 82-year old, partially blind lady had left a stove on and accidentally started a fire. A paramedic scheduled to visit her that day arrived and put out the fire. A spin-off of the S.A.F.E. program, "Honor Thy Neighbor," has evolved to take care of the seniors when the EMS service is no longer needed or if it needs to be supplemented. A volunteer will go out to visit the senior and provide companionship. The Moore County team believes the S.A.F.E program will ultimately decrease the number of emergency and non-emergency calls to 911 and the frequency of hospitalization and doctor visits, thus reducing the cost to taxpayers. For many, EMS is the portal into the health care system. S.A.F.E. helps make this entrance less threatening, and clients recognize these paramedics as friends. The program has also benefited EMS workers by creating relationships that open their eyes to seniors’ needs and friendships that they appreciate. During regular emergency responses and following S.A.F.E. visitations, paramedics are now assessing their findings, and forwarding this information in the form of a referral to the Department of Aging. The Department is now receiving additional requests from individuals beyond the scope of the Home Delivered Meal Program. The success of this community outreach effort has provided the foundation for duplication in other areas of public safety. For more information, contact Suzanne LaFollette-Cameron at (910) 947-2881 or Barry Britt at (910) 947-6317. Fire Inspection Public Awareness Thomas Bender and Carolyn Chandre The purpose of the Ketner Awards Program is to recognize innovative county employees for their successful productivity improvements, but how much more incredible when a program can save a life by preventing a fire! These were the goals of Thomas Bender, Chatham County Fire Marshal, and Carolyn Chandre, Human Resources Manager, in creating the "Fire Prevention Code Enforcement Program" brochure to be mailed to businesses before their fire inspection. Chatham County is experiencing rapid growth in new home and business construction. As a result of this growth, a strain has been put on the Fire Marshal Office’s staff of three with the increase in number of inspections, in addition to fire investigations and educational programs. Furthermore, Chatham County has a high rate of re-inspections. The businesses and residences that require a regularly scheduled fire inspection have only a 50 percent pass rate on the first inspection. Re-inspections are expensive and time-consuming. In order to cover costs and complete the necessary inspections, the Fire Marshal’s Office looked at raising fees or hiring another fire inspector. Unfortunately, the 1999-2000 budget could not provide new personnel and an increase in fees would not guarantee that re-inspection rates would go down. So Bender and Chandre put their heads together to find a pro-active, low-cost solution and developed a flyer and brochure. Implemented in May 1999, the mailing is designed to take the anxiety out of a fire inspection for a business owner, increase the number of businesses that pass inspection the first time, and to inform the public of the helpful functions of the Fire Marshal’s Office. Although the use of a fire safety awareness pamphlet is not new, the way in which Chatham County uses it is different. The mailing includes a flyer called the "Fire Marshal’s Top Ten Checklist" of the most common reasons businesses fail their fire inspection along with a reminder of the date and time of their inspection. The flyer is attached to a pamphlet that outlines the role of the Fire Marshal’s Office and its services, such as volunteer department training, public fire safety education, permits, inspections, and arson investigations. The pamphlet can be easily folded, addressed, and mailed directly to the business. Because appointments are typically made three to four weeks in advance, businesses have time to read the information and correct any problem before their inspection. The Fire Marshal’s Office plans on evaluating the program’s progress every three months. The benefits are numerous. The program increases the Fire Marshal’s Office ability to provide a higher level of service in the inspection process. With lower re-inspection rates, the Fire Marshal will be able to concentrate his energy on arson investigations, training of volunteer units, education campaigns, and other prevention measures to increase the safety of the citizens of Chatham County. Thomas Bender gives all of the credit to being a part of a great county team. "Chatham County is progressive…safety comes first." Also a part of this program is Patrick King, Deputy County Fire Marshal, and Arthur Barber, Fire Inspector. A local Chatham County business, Cabinet Creations, passed their first inspection after receiving the flyer and pamphlet. In the previous year’s inspection, they had to be reinspected. Kathy claimed, "The mailing is a great idea! We just followed the Top Ten list and passed." For more information, contact Thomas Bender or Carolyn Chandre at 919-542-8200. Reducing Inmate Health Care Costs Pat Thompson Pat Thompson has saved Craven County over $70,000 in inmate health care costs by reviewing past practices and making them more efficient. She is an accounting technician with the county’s finance department accounts payable. The Sheriff's Office falls within her responsibility. Counties are responsible for providing health care to inmates prior to the time they are sentenced (the liability shifts after sentencing to the state). These costs include physician charges, dental procedures, hospital emergency room charges, in-patient hospital costs, and prescription drugs. In 1995, Craven County spent $97,000 on inmate health care and by 1998, the cost had skyrocketed to more than $175,000. In an effort to control these costs, Thompson checked records and made phone calls. The following are some of her cost-saving measures: Thompson hand checks that all eligible costs are reimbursed by the State for sentenced prisoners. The jail files a report each month with the state to receive reimbursement for state prisoners' housing costs. She compares the list with medical bills that have been received and paid. When an inmate is matched, the medical bills are filed for reimbursement with the state. Cross-referencing the lists has saved approximately $25,000 for Craven County this past year. Thompson developed a proposal to receive bids for prescription drugs and over-the- counter items. The county has saved around $5,000 a year due to a new provider that offered a lower bid. The county's largest medical cost is clinical and emergency care with the hospital. Thompson provided the data that helped the finance office negotiate an across the board discount from the hospital, saving $6,000 a year. When inmates are sent to Raleigh for safekeeping, the county is billed by the state for the costs of housing and medical care. The county's bill increased each month, prompting Craven County to investigate. They discovered that by law, an inmate had to be not only convicted in Craven County, but that he also must have been a resident of the county prior to his or her arrest. If both these conditions were not met, the state was responsible for the inmate. Thompson researched court records for inmates' last known address and reviewed prior bills. Because of her work, the county received $16,000 in refunds. Thompson saved the county $20,000 by verifying that individual inmates had insurance coverage that would cover their health costs. Instead of assuming that an inmate has no insurance coverage and billing the county, health care providers now file a claim with the company (Medicaid, Medicare, or private insurance) before the county pays the bill. In addition to these changes, she has developed more routine measures. For example, she verifies that a patient was in jail at the time a medical service was provided. Some providers bill the County for costs associated with a person who has been a previous inmate. Thompson confirms with the jail the dates the inmate was incarcerated and pays only for services incurred while the inmate was actually in the jail. Thompson has been a leader in cutting inmate health care costs to the county. She is dedicated to doing the best job possible and is sincerely interested in saving money for Craven County taxpayers. For more information, contact Pat Thompson at (252) 636-6603. Detention Services Sewing Repair Shop Johnny Harrison Officer Johnny Harrison of the Pitt County Detention Center has saved his county $3,700 by implementing a program in which inmates repair the center’s uniforms and sheets. In December of 1998, Harrison, the officer assigned to the laundry, was notified by the contracted sewing company that they were closing their business. Instead of finding another contractor, Harrison saw no reason the service could not be provided in-house. Harrison spent $150 on a sewing machine. He chose one inmate to train on the machine, who in turn trained another inmate. Harrison has four inmates assigned to him in the laundry. Only those who are willing to try and are trustworthy are allowed to use the machine. These "trustee inmates" are usually in the detention center for 30 to 90 days and have been charged with misdemeanor crimes. Prior to the in-house repair project, the Detention Center was paying approximately $3,200 per year for clothing repair and $4,000 per year to replace sheets. This cost-cutting project has resulted in saving Pitt County $2,000 on clothing repairs and $1,700 on sheet replacement, a total of $3,700 for one year with minimal associated costs and no additional personnel. For more information, contact Johnny Harrison at (252) 830-4627. HUMAN SERVICES Recycling Wheelchair Ramps Richard Smith Project CARE (Community Action to Reach the Elderly) is a part of Jackson County’s Department on Aging. The project provides home safety repairs and modifications, which includes building wheelchair ramps for homebound and disabled persons in the county. Project Director Richard Smith has designed ramps that can be taken down and reassembled in like conditions. Previously, when a client no longer needed a wheelchair ramp due to changing residences or death, the ramp was either abandoned or disassembled. With the new design, ramp sections can be easily removed and reassembled at another location. Smith and his assistants build the ramps in their shop in eight-foot sections. At the site, support posts are placed and cross ties are bolted to the posts. Then the sections are laid down and fastened to the post with two screws. Finally, the top and mid rails are installed. The only nails used are to attach the ramp’s treads to the eight-foot sections. When it’s time to take down a ramp, all the volunteers have to do is unfasten the ramp and load it to take to another site. The time-savings is incredible. As a result of this process, 24-foot ramp can be taken apart and loaded in a truck in under an hour. The recycled wheelchair ramps save approximately $4,800 a year for materials alone. Volunteers, such as college students and church groups, provide the labor. At the usual rate for carpenters, these volunteers save $3,500 in labor costs to the county. Smith anticipates recycling 25 wheelchair ramps a year, saving $3,800. Recycling the ramps can save up to eight hours. The time saved allows Project CARE personnel to provide services more quickly to clients on the waiting list. The money saved by recycling wheelchair ramps is used to purchase better tools and equipment. For more information, contact Richard Smith at (828) 586-8562. RITA: Rowan Individual Transportation Assistance Tim Russell, Clyde Fahnestock, Wayne Ashworth, Liz Tennent, Beth Connell Rowan County Manager Tim Russell, Transit System Chairman Clyde Fahnestock, EMS Director Wayne Ashworth, Transit System Manager Liz Tennent, and EMS Manager Beth Connell were faced with a difficult problem. The County’s Emergency Medical Service was experiencing a significant problem with inappropriate requests and frequent misuse of ambulance services. Abuse by the general public and institutional facilities is often unintentional but necessary because in many instances there is no alternative when a person cannot simply walk out of an institution or house and sit in a vehicle. They need a personal attendant to ensure their safety or an accessible vehicle for a wheelchair. Unfortunately, transporting these people is a wasteful use of emergency vehicles and paramedics who are diverted from emergency preparedness. This misuse of resources is also costly to the county when Medicare denies reimbursement and indigent passengers fail to pay the assessed ambulance fees. A solution was created in the Rowan Individual Transportation Assistance (RITA) program. The program was established by the Rowan Transit System (RTS) to provide "assisted" transportation that is practical and useful for residents and institutions who have a mobility need for frail passengers. RTS has dedicated one vehicle for this purpose, along with a driver and a certified nursing assistant (CNA). This system provides a higher level of service and conserves the resources of the emergency vehicles and paramedics. The most significant cost avoidance impact is the lower volume of ambulance calls. There are substantial savings for the passenger as well. A one-way trip on RITA is $30 while an ambulance ride costs $200. The NCDOT Board of Transportation awarded the program a grant to support half of the passenger fee for those who cannot afford it. RITA is available from 7 a.m. to 5 p.m. Monday through Friday. Those who schedule their trips in advance get first priority. EMS referrals receive second priority. Third priority goes to same-day calls for service. The driver and CNA make sure the passenger gets safely and comfortably from their door to the vehicle and back again. People eligible for this service include: general public passengers who need a personal attendant, hospital discharges or transfers, institutional transfers to the hospital, another facility, or the individual’s home, Rowan residents who need transportation to the hospital, their doctor’s office, or a clinic, dialysis patients, people who need a return trip home when an emergency ambulance transport ends at the hospital, and finally those authorized by a physician. For more information, contact Tim Russell at (704) 638-3198 Ext. 225. PUBLIC WORKS Creekside Recreation Park Reuse Irrigation System Roy "Rusty" Hayes The Craven County Water and Sewer Department led by superintendent Roy "Rusty" Hayes has constructed a model disposal project that uses treated water to fertilize a local recreational park saving the county approximately $338,000. The county bought a 180-acre site for wastewater land application to meet the growing need for additional wastewater capacity in Township #7. The county also upgraded their treatment standards. Simultaneously, land was purchased close to the treatment facilities in order to develop a 109-acre recreational park. Creekside Park has four soccer fields, four softball fields, four baseball fields, playgrounds, archery and extensive open space leisure areas. The park gave an opportunity for the water and sewer department and the parks and recreation department to work together to safely dispose additional wastewater while providing needed irrigation for fields. With the addition of the park, the water and sewer department gained 8,000 gallons per day of additional spray capacity and gives the department free disposal. If land had been purchased and infrastructure installed to dispose of this additional capacity, the county would have had to spend $323,000 for a project this size. To provide sufficient irrigation for the park facility, two wells would have been installed at an approximate cost of $15,000. Using the highly treated wastewater from the new system eliminated the need for wells. The wastewater system provides a bountiful nutrient enchanted water supply for the park while eliminating the need for fertilizer at the cost of several thousand dollars per year. This highly treated wastewater is not potable and can be used for lawns, golf courses, parks, and agricultural purposes. Creekside Park receives up to 21 inches a year of the spray. The spraying takes place mostly at night. The Craven County Water and Sewer Department obtained a $200,000 Lower Neuse Basin Association grant to construct the model disposal project. The department considers this project an example to be followed by others in the wastewater field since reuse projects are still relatively new in North Carolina. For more information, contact Rusty Hayes at (252) 636-6600. |