Staff:  Irene Stein, Office for the Aging; A. Cole, Health Department; N. Zahler, Youth Bureau; S. Whicher, Administration;
         M. Dill, Human Services Coalition Director; G. Potter, Information Technology Services; B. Grinnell-Crosby, Health
         Department; M. Dolan, Social Services Department; T. Herden, Social Services Department; B. DeLuca, Mental
         Health; N. Zook, Youth Bureau; S. Kerr, Health Department; K. Fuller, Recorder

Guests:  Mary Agnew, Stacy Cangelosi, Lynne, Teeter, Arpi Hovaguimian, and Florence Ricciuti,  Alcohol and Drug Council
             of Tompkins County

Called to Order
Chair Winch called the meeting to order at 9:00 a.m.

Additions to the Agenda

 The following items were added to the agenda:

Office for the Aging
1. Budget Transfer
2. Budget Adjustment

Mental Health Department
1. Resolution – Accept $4,800 Grant Subsidizing Mental Health Client Weight Watcher
   Program from Eli Lilly and Company

Approval of Minutes
 It was MOVED by Mrs. Schuler, seconded by Ms. Robertson and unanimously approved to accept the minutes of March 12, 2002 as amended.

Health Department
 
Authorization to send out RFP and award contract Home Health Care Software
     Ms. Cole and Ms. Kerr of the Health Department brought forth the request to resend a Request for Proposals out for bid.  They explained that in February 2001, a Software Search Committee was formed of nursing, support and management staff that work most critically with the Home Health Care computer billing and clinical system.  The committee’s goal is to review, purchase, and install, train and implement a comprehensive billing, report and clinical documentation system as of January 2003.  They have identified ten companies that are most likely to meet the standards.  This new system will allow the County to continue to provide quality home nursing, therapy and aide services to the most senior and vulnerable members of the community.  Ms. Cole said that the request was sent to bid previously, however, the bids were scheduled to be received over the period that 9/11 occurred and some of the bid proposals were lost in the mail at that time.  Due to the nature of the national tragedy, this work was delayed until the present time.  It was also reported by Ms. Crosby that part of this request is a gap study to determine the extent and location of special confidentiality systems within the County during the process of billing and record keeping.

     MOVED by Mrs. Schuler, seconded by Ms. Robertson.

RESOLUTION NO.  - AUTHORIZATION TO SEND OUT SEEK REQUEST FOR PROPOSAL - HOME HEALTH CARE SOFTWARE - HEALTH DEPARTMENT

    WHEREAS, the Tompkins County Health Department operates an Article 36, Certified Home Health Agency and maintains a computer system that accommodates all billing, statistical, and clinical records in accordance with Medicare, Medicaid, Federal and State regulations, and
    WHEREAS, in August of 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA), one intent of which is to enforce electronic security and confidential standards for the transmission of all patient health information no later than April 1, 2003, and
    WHEREAS, since 1996, the Home Health Care program has been using the Siemens Health Systems (formerly known as Delta Health/SMS) computer system which does not meet HIPAA standards, is being phased out and is based on a DOS operating system, and
    WHEREAS, a capital project was approved to upgrade the Home Health Care clinical and billing computer system in the 2001 budget for the amount of $411,065, $200,000 for servers, PC’s and laptops and $211,065 for software, training, and implementation costs, and
    WHEREAS the Request for Proposal was distributed in October, 2001, and not awarded due to minimal response as a result of insufficient length of time to respond and delays in mail delivery to some potential bidders due to the anthrax incidents in postal facilities, now therefore be it
    RESOLVED, on recommendation of the Health and Human Services Committee, That the Health Department, in conjunction with the Purchasing Department, develop a Request for Proposal defining our computer hardware and software billing, statistical, and clinical needs to companies identified by our search committee, and allow the software search committee to determine the specifications and recommend to the Board a vendor to be awarded the contract.
SEQR ACTION:  TYPE II-20

 
      A brief discussion occurred regarding the area of confidentiality and the newly established requirements of the State and possible consequences of not having the system in place by the deadline established.  It was noted that if the system were not in place it could possibly mean fines as well as the possibility of not being able to provide this service.

     Ms. Cole and Ms. Kerr said that the length of time spent in the project has enabled those involved to have a thorough knowledge of the various companies offering this product and their service history,  and they felt confident that an appropriate decision could be made.

    A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED. (Note:  Mr. Squires recommended a revision from the way presented in order to follow procedural guidelines of award of bid and the resolution reflects these changes.)

    Mr. Proto arrived.

RESOLUTION NO.   – AUTHORIZATION TO INCREASE HOURS – ACCOUNT CLERK TYPIST – ENVIRONMENTAL HEALTH – HEALTH DEPARTMENT
 
     MOVED by Ms. Robertson, seconded by Mrs. Schuler.

    A brief discussion occurred and the resolutions was revised as noted below to reflect the fact that  of the eleven hours all but two hours were absorbed within the department by other workers.  Mr. Proto requested that any resolutions that indicate changes in hours provide a summary of the net cost or savings to the County.  Mr. Whicher said that it would be possible to do so.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

     WHEREAS, Environmental Health has an Account Clerk Typist (06/513), labor grade F, competitive class, who has been reduced from 35 hours per week to 24 hours per week on a permanent basis, and
     WHEREAS, the division has reorganized the workload among several employees as much as possible and has an Account Clerk Typist (06/513), labor grade F, competitive class, who is willing to work 37 hours per week to accomplish the balance of the work, eliminating the need to hire additional staff, now therefore be it
     RESOLVED, on recommendation of the Health and Human Services Committee, That the position of Account Clerk Typist (06/513), labor grade F, competitive class, be increased from 35 hours to 37 hours per week, effective immediately,
     RESOLVED, further, That no net additional funds are required to accommodate this change.
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    Hours/
FTE Title   Week  Salary  Fringe  Total
Budgeted:
2.0  Account Clerk Typist  70   49,654  12,910  62,564
Proposal (annualized):
  .69 Account Clerk Typist 24  17,024    4,426  21,450
1.06 Account Clerk Typist 37   26,246    6,824  33,070
1.74 Total Acct. Clk. Typ. 61  43,270  11,250  54,520
Savings:
  .26     9    6,384    1,660    8,044

Budget Adjustments

    It was MOVED by Mr. Proto, seconded by Mrs. Schuler and unanimously approved by members to approve the budget adjustment submitted.

Women, Infants & Child (WIC) (#19)
Revenue Acct  Title   Amt  Approp Acct Title(s) __________
4012  44402  WIC Federal Aid $ 882  4012  54400 Program Expense
Explanation:  Addition by the NYS Department of Health of $882 to the WIC budget specifically to acquire breast pumps and/or collection kits.

Department of Social Services

Budget Adjustment

     It was MOVED by Ms. Robertson, seconded by Mrs. Schuler and unanimously approved by members to approve the budget adjustment submitted.

     Ms. Dolan said these funds are a result of requested increases in the market rate Day Care costs for Tompkins County.  This will not involve any local funds.

Department of Social Services (#21)
Revenue Acct  Title   Amt  Approp Acct Title(s) __________
6055  41855  NYSCCBG  $283,000 6055  54400 Day Care
Explanation:  Higher-than-anticipated Day Care expenditures have necessitated our tapping more of the NYS Child Care Block Grant allocation intended for this purpose.

Monthly Report

     Ms. Dolan spoke to the Committee about the Customer Satisfaction Survey that was recently completed.  Future surveys will have the period between surveys lengthened in an effort to satisfy the clients.  The Department has decided to take comments and post them in a highly visible location in the lobby area as well as printing the complete results in order to clearly show clients that their comments were taken seriously.  It was suggested that a Commissioner’s response to the survey be provided as well.  She said that they are in the planning stage for surveys in the Family and Children’s Service and Child Support area as well.

Review of Projected Medicaid and Other “A” Mandated Spending – 1st Quarter

 Mr. Herden provided a memo to the Committee that outlined the projected increase in local share of the Medicaid and other “A” mandated spending lines.  It was noted that it is anticipated that the local share will increase approximately 19.65 percent for 2002.  A discussion took place regarding the possible causes for this large increase and steps that may be taken to reduce the balance.  It was reported by Mr. Herden and Ms. Dolan that extensive review of material has and will continue to be done in an effort to discover the specific subcategories and/or providers who are most closely associated with the increases.  This review requires obtaining the information from multiple areas and is a lengthy process to conduct, however, it should enable a better evaluation of the situation.

     Mr. Winch congratulated Ms. Dolan and her entire Department on receiving the Ruth Pettingill award from the Human Services Coalition.  He said that it was very honorable that Ms. Dolan would not accept it without having the entire Department acknowledged.

Office for the Aging

Budget Adjustments

     MOVED by Mr. Booth, seconded by Ms. Schuler.  Ms. Stein provided the Committee with information related to these adjustments.  She said that the SNAP Program is State funded and the adjustment is due to a decrease in the State allocation.  She noted that the Federal revenue is an increase.  Following a question from Mr. Booth about how the reduction is calculated, which is from the State accounting departments, a voice vote was taken of members present,  and it was unanimously approved by members to approve the budget adjustment submitted.

Office for the Aging (#23)
Revenue Acct  Title   Amt  Approp Acct Title(s) __________
6776  44772  Federal Revenue $7,008  6776  54491 Subcontract

Explanation:  Revenue Increase in Title III-C for Foodnet.

Office for the Aging (#26)
Revenue Acct  Title   Amt  Approp Acct Title(s) __________
6774  43803  State Revenue  ($ 378)  6774  54491 Subcontract

Explanation:  Revenue Decrease in Supplemental Nutrition Assistance Program (SNAP).

     Ms. Stein informed the Committee that she has fully discussed the current budget situation with her staff, both as a group and individually.  She said that they do understand that at this time it is a tentative scenario being recommended to the Budget Committee and Board Members.

Mental Health Department

     MOVED by Ms. Robertson, seconded by Mr. Proto.  Mr. DeLuca said that this is a grant received by a pharmaceutical firm and will be used to assist clients who may not otherwise be able to afford a weight-loss program.  It was asked if the grant was specific to Weight-Watcher’s only and Mr. DeLuca said that it was.  It is estimated to provide a service for fifty to seventy-five individuals.

RESOLUTION NO.           - ACCEPT $4,800 GRANT SUBSIDIZING MENTAL HEALTH CLIENT
                                               WEIGHT-WATCHER PROGRAM FROM ELI LILLY AND COMPANY
 

    WHEREAS, the Mental Health Clinic has been awarded a $4,800 grant from Eli Lilly and Company to subsidize a client Weight-Watcher program, and
    WHEREAS, a check for the above amount has been received and deposited to the clinic miscellaneous revenue account, now therefore be it
    RESOLVED, on recommendation of the Health and Human Services Committee, That the Director of Finance is hereby authorized and directed to make the following budget appropriation:

FROM:  A4311.42770  Other Misc. Rev. $4,800

TO:  A4311.54400     Program Expense        $4,800

SEQR ACTION: TYPE II-20

     Mr. Proto inquired about the pending resolutions scheduled to go through Government Operations Committee relative to salary increases for positions within the Mental Health Department.  He was not certain if they should, in fact, go through the Health and Human Services Committee.  It was determined that this is a contractual item and that Government Operations Committee is the appropriate committee.

Alcoholism Council Presentation

     Ms. Mary Agnew, Executive Director of the Alcoholism Council, gave a brief presentation about her agency.  The slide presentation included information on the Council’s Purpose Statement, hours of operation, history and services provided to clients.   She gave the committee copies of the full-page articles that appeared in The Ithaca Journal on April 9, 2002, the flyer describing services offered, and pages from their website www.alcoholdrugcouncil.org.  Ms. Agnew told the committee specifics on services offered including an Outpatient Clinic, Education/Prevention related to Peer Education, Drinking Driver, Open Minds, and Syringe Access programs and their work with other community programs such as a smoking cessation group, family support and education group, Drug Free Workplace presentation.  She then spoke to the work done in local schools, public health fairs, and with a variety of drug courts, the Justice Center, as well as evaluation services and staff training.  Ms. Agnew also spoke of the public exposure that the Alcoholism has through a variety of media.  She said that there is a monthly article in the newspaper and that there is a program though the local radio and television stations as well.

     Committee members questioned Ms. Agnew on the subjects of the syringe program that is collecting data to determine the effectiveness of providing syringes in an attempt to reduce HIV/AIDS, and other diseases associated with intravenous drug use, methods of payment for services, extended services when particular programs were completed, etc.  Ms. Agnew said that the program is scheduled to run for three years and that data is collected and compared to the local Health Department records.

     Ms. Agnew was asked how the Alcoholism Council programs differ from others.  She said that in some ways there are similarities; however, other programs offer residential facilities and other needs are met.  One point she felt strongly is that each agency offers something to individuals and all are being utilized, showing the needs.  If a client has a special need it may be met by utilizing more than one agency.

     A concern that was mentioned and addressed was transportation for individuals who have lost driving privileges.  It was suggested to contact Mr. Ghearing at TCAT to discuss this problem.

 Members of the Committee inquired whether Cornell and Ithaca College students utilize the services.   Ms. Agnew said that normally students utilize services that are on campus.

Youth Bureau

     Ms. Zahler distributed copies of reports that provided information regarding the number of youth served in various contracted agencies, demographic location, etc. for the year 2001.  It was noted that although demographics indicate a reduction in the number of youth within the City of Ithaca to approximately fifteen percent, the number of City of Ithaca youths being serviced by agencies continues to be between twenty-five to forty percent.  She said that the figures do not include the four thousand plus youth served by municipal programs.  Mr. Proto suggested that Ms. Zahler contact Mr. Marx, Commissioner of Planning, to perhaps coordinate information for the Vital Communities initiative that is presently underway.

     Next, Ms. Zahler reviewed programs that were cut for the 2002 budget in response to the request to reduce spending for the year.  She reported that although some programs are still operational, the manner in which they are operated is not at the same level as when funded by the Tompkins County Youth Bureau.  The Committee then reviewed data of the age, gender, and ethnicity of the youth served, as well as information on runaway and homeless youth services.  Ms. Johnston and Ms. Zahler spoke about the success of the BRIDGES program and how they have been able to see a reduction of youth requiring foster/juvenile care as a result of the program.

     Mr. Winch inquired whether the Youth Bureau was working in conjunction with the Department of Social Services and Probation to provide parenting skills courses for clients?  Ms. Zahler noted that there had been a joint effort to contract with Cooperative Extension to provide this service; however,  budget cuts are making it difficult to maintain.  One attempt to assist in the ease of providing appropriate training is done by a one-time registration that would allow clients to easily seek out services from all agencies and not have to go through a lengthy process.

     Mr. Booth inquired whether the data provided was required by the State or other agencies for funding.  Ms. Zahler said that it was done in-house in order to obtain information necessary for appropriate program operation.

Proposed Budget Preview Meeting

     Mr. Winch spoke to the Committee regarding a meeting to review the preliminary budget scenarios.  It was determined to have a meeting on May 1, 2002 at 1:00 p.m. [Note:  this meeting was postponed.]

 Adjournment

The meeting adjourned at 11:17 a.m.

Respectfully submitted:  Karen Fuller, Deputy Clerk