Excused: F. Proto

Staff:  A. Cole, T. Schiele, J. Andersson, Health Department; N. Zahler, Youth Services; L. Holmes, Office for the Aging; P. Carey, Commissioner of Social Services; K. Fuller, Deputy Clerk

Call to Order

 Chair Shinagawa called the meeting to order at 3:35 p.m.

Health Department

T-19 Discussion

 Ms. Cole, Health Director, stated she was speaking on behalf of her department and not the Board of Health.  She said personally, as a cancer survivor who believes strongly in cancer issues and is the Health Director, she believes it is good to open a dialogue on the subject; however, there is no supporting evidence that increasing the age to 19 to sell tobacco products is successful.  Ms. Cole stated that the Center for Disease Control (CDC) strategies and other sources stress education and enforcement as a means to reduced use of tobacco products among youth.  In addition, Ms. Cole said that increasing the age would result in increased work requirements for the employees of the Health Department.  She expressed a desire to have the Committee discuss the matter and then allow the Board of Health to continue discussions toward possible implementation of an increased age to purchase tobacco products if deemed appropriate.

 Mr. Schiele said he is open to questions and discussions relating to the topic.  He then reiterated Ms. Cole’s statements, sharing information from the New York State Health Department regarding their tobacco programs.  He spoke of the New York State Bureau of Tobacco programs operated by the County for a tobacco prevention/cessation grant received, noting the information does not indicate any evidence-based facts to support the T-19 proposal as an effective strategy.  The County programs are based upon the Guide to Community Preventive Services, a CDC-based program that has three specific areas of identifying results.  The first is recommended, meaning there is sufficient evidence that a program is effective; the second is insufficient evidence, meaning there is not adequate information to indicate whether it is or is not effective; and the third is recommend against, meaning enough evidence exists to indicate the program is ineffective.  He used an example of increasing the excise tax as a method of reducing sales, which has been proven effective.  Other recommended strategies include mass-media education campaigns when combined with other interventions; community mobilization when combined with additional interventions; local laws directed at retailers; active enforcement of retailers; and retailer education with enforcement.  These types of programs are being conducted within Tompkins County and have proven effective, with a reduction in Tobacco Product Use (TPU) to the point of having one of the best ratings in the state.  Although there are some items within the CDC plan indicating raising the age it is not recommended without other interventions.  Mr. Schiele stated that at present the strategies used are effective, with Reality Check obviously having the success of bringing about youth awareness and education, one of the most significant factors.  He believes that continued programs such as Reality Check bringing about awareness would be more effective than implementation of T-19 that could cloud the other programs that are evidence-based.

 Mr. Andersson, Environmental Health Director, spoke of the enforcement portion of the County’s programs dealing with tobacco use and sale.  He reported that at the present time, the State shares fifty percent of signage costs.  He then shared the numerous signage that is required by law to be posted at points of purchase, required reading material providing guidelines to sellers, etc., noting they would all have to be reprinted at the County’s expense in the event the age to purchase tobacco products is increased.  In addition, Mr. Andersson spoke of having to require additional enforcement requirements, which can include checks up to three times per year for those establishments found in violation of the law.  He spoke of the potential increase in health checks at establishments in the near future to include tanning and tattoo businesses, which will increase the workload significantly.  Mr. Andersson said the department does not receive calls reporting sales to minors at this time and does not feel that by passing a law to increase the age would not have any significance in this area.  Additionally, he spoke of the need to train staff on the new rules, as well as vendors, which could be confusing if staff worked in multiple counties.  Mr. Andersson said that overall he believes it would not show substantial enough benefits to warrant a change.

 Ms. Robertson inquired if the State were to enact legislation increasing the age if it would help.  Mr. Shinagawa said at the present there is proposed legislation within the Assembly to do so.  Mr. Schiele spoke of his work with retailers regarding advertising of tobacco products to educate them on various aspects of point of purchase advertising.

 Ms. Zahler reported on the recent meeting of the Community Coalition for Health Youth where the topic was discussed.  She said the members of the Committee expressed a concern that the T-19 would not be an effective strategy as many students in high school are now age 19.  A general thought was that as the Regents requirements increase the high-end age of high school students will also be increasing.  The thought was that if the age to purchase tobacco products were increased to 21, it would be a more effective strategy, particularly since the portion of the brain dealing with judgment does not develop fully until the early twenties.  Ms. Zahler spoke of the group wanting youth to make healthy choices, however, in initial discussions did not culminate in any decision for or against this initiative.  She also said the New York State Department of Health State Reality Check initiative does not endorse T-19 at this time.  The Coalition decided to stay neutral on the proposed initiative and continue to reinforce preventive efforts.

 Following the discussions, it was the sense of the Committee, to refer the matter of T-19 to the Board of Health.

 Ms. Robertson expressed appreciation for staff input and noted if it were widely felt the initiative would be worthwhile she could support it.  She then disclosed the fact that she is a New York Public Interest Research Group (NYPIRG) donor, and commented on the letter that legislators received against T-19.

Mental Health

 It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Robertson, and unanimously approved by voice vote by members present, to recommend approval of the following appointment:

Mental Health Subcommittee
Nancy Rosen – term to expire December 31, 2009

Office for the Aging

Budget Adjustment

 It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Robertson, and unanimously approved by voice vote by members present, to recommend approval of the following budget adjustment:

Office for the Aging
Revenue Acct           Title                       Amt  Approp Acct     Title(s)
6779.43803     State Revenue      $     234 6779.51000215      Salary
6779.43803     State Revenue      $     739 6779.51000517      Salary
6779.43803     State Revenue      $     134 6779.51000529      Salary
6779.43803     State Revenue      $     134 6779.51000637     Salary
6779.43803     State Revenue      $     275 6779.54303           Supplies
6779.43803     State Revenue      $38,000 6779.54400            Program Expense
6779.43803     State Revenue      $     484 6779.58800            Fringes

Explanation:  Reappropriated money to be used in 2007 for Restore Grant.

Update on Lakeside Nursing and Rehabilitation Closure

 Mr. Shinagawa reported that Assemblywoman Barbara Lifton was able to meet with members of Governor Spitzer’s executive staff and recommended Ms. Holmes contact her for information obtained at that meeting.

 Ms. Holmes reported on speaking to Michael Burgess, newly appointed Director of the New York State Office for the Aging, about the pending closure of Lakeside.  Mr. Burgess expressed a willingness to learn more information about Tompkins County and the pending closure.  Following the discussions, Mr. Burgess who initially spoke of the Governor’s support of the Berger Commission recommendations, following the discussion, indicated he would speak to appropriate individuals in Albany.  Additionally, he requested material such as newspaper articles and other documents that would provide him with a sense of the local viewpoint.  Mr. Burgess recommended several individuals to contact and provide the information to as well, one of which was former Office for the Aging Director Irene Stein.  Ms. Holmes has met with Ms. Stein and she will bring the matter up with Michael Schell, Senior Advisor for Intergovernmental Affairs, and will report back to Ms. Holmes.  Ms. Holmes has spoken to Mr. Deptula of Peregrine who is compiling the publicity material associated with the Berger Commission decision.

 Mr. Shinagawa reported he has located a student intern to assist in gathering information on skilled nursing facilities within a fifty-mile radius of the county.  The information will include occupancy and Medicare reimbursement rates.  Ms. Holmes said New York State Department of Health has information available online for within twenty-five miles which would then require the intern to seek the information for the balance of the study area.

 Mr. Shinagawa informed the Committee and Ms. Holmes that Assemblywoman Lifton will be meeting with Mr. Schell in the near future.

Committee Goals

 The Committee held an in-depth discussion regarding Committee goals, including how to define the goals, how they may cross over various departments/committees, and how many goals should be included.  In addition, staff was requested to provide input in the process.  The following items were areas noted:

· The Goals should be very broad.
· Goals should distinguish the work of the Committee versus the work of a department/agency.
· One Goal to be included is the review of the Human Service Coalition role and review process; this should occur earlier in the year to provide input for the budget.
· Goals are a framework for the Committee.
· It could be helpful to know what assistance departments/agencies will need during the year prior to setting all goals.

· Goals should include the strengths and opportunities available in various areas.

Following the discussion it was determined that Mr. Shinagawa will contact Department Heads, enclosing a calendar with meeting dates, requesting they provide information relating to their needs during 2007.  At the next meeting the Committee will review the material received in order to better determine goals.

 Mr. Sigler arrived at this time (4:20 p.m.).

Social Services

 Ms. Carey reported on recently attending a New York Public Welfare Agency (NYPWA) conference where she met many new leaders in Albany.  She was very pleased to see the enthusiasm exhibited by the individuals, who she said started their professions in the entry-level legal field.  Ms. Carey believes they will be a different perspective, will be fiscally responsible, and will make good changes to policy and procedure.

It was reported that Gladys Carrión was appointed to the office of Commissioner of Family and Children Services.  As an individual who has worked up through the ranks she is expected to be an effective Commissioner.  In addition, she has retained most of the existing staff.

The Mental Health Commissioner has not yet been confirmed.

Adjournment

 On motion the meeting adjourned at 4:37 p.m.