Health and Human Services
Regular Meeting
April 18, 2006 3:00 p.m.
Scott Heyman Conference Room

Present:  F. Proto, Chair; N. Shinagawa, Vice Chair (4:27 p.m.); M. Hattery; M. Robertson; G. Stevenson
Staff:   K. Fuller, Deputy Clerk of the Legislature; J. Grogan, Public Information; R. DeLuca, Mental Health

Called to Order

 The meeting was called to order at 4:05 p.m. by Mr. Proto, Chair.

Additions/Changes to the Agenda

Mr. Proto allowed Mr. DeLuca, Mental Health Commissioner to provide a brief report to the Committee (this was done in Executive Session).

Health Department

RESOLUTION NO. – AUTHORIZATION TO INCREASE HOURS AND APPROPRIATION FROM CONTINGENT FUND – HEALTH DEPARTMENT

 It was MOVED by Ms. Robertson, seconded by Mr. Hattery, to recommend approval of the following resolution to the full Legislature.  It was noted this provides for a continuation of work being conducted on an Audit of the WIC program.  Although no definite end date is known, the resolution represents the best estimate made by Ms. Connors of the Health Department.

 A voice vote on the motion resulted as follows:  Ayes – 4; Noes – 0; Temporarily Excused – 1 (Legislator Shinagawa).  RESOLUTION ADOPTED.

 WHEREAS, the WIC Program record review is projected to be completed by May 27, 2006, and
WHEREAS, additional staff hours are required to complete this review, including the Director of Patient Services (5 hours/week), one Community Health Nurse (20 hours/week) and one Health Aide (7 hours/week),
WHEREAS, funds were not budgeted to complete this record review and are requested from the contingent fund, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee and Budget and Capital Committees, That the standard workweek of the Director of Patient Services (88-230), shall be temporarily increased from 35 hours to 40 hours per week, effective April 30, 2006 and
 RESOLVED, further, That the temporary increase in the authorized workweek will sunset on May 27, 2006, and
RESOLVED, further, That the Director of Finance is hereby authorized and directed to make the following budget appropriation:
FROM:  A1990.54440 Contingent Fund $4,684
TO: A4016.51000230 Director of Patient Services 692
 A4016.51000580 Community Health Nurse 2,082
 A4016.51000654 Health Aide 596
 A4016.58800 Fringes 1,314
SEQR ACTION: TYPE II-20

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Explanation:  The salary requested supports the review and correction of over 5,500 WIC participant records in response to a NYS Department of Health audit.  Records date back to 1999 and continue up to 2005.  The Director of Patient Services coordinates the review process and assists in the record review and correction.  The Community Health Nurse reviews and corrects records and the clerical employee pulls and re-files records.  The record search is time consuming due to the need to search through scores of boxed records in the basement and office storage.

 Mr. Proto reported that a former Health Department employee, Joanne Brazo, passed.  He recalled her as a well-thought of individual who worked in the Children’s Special Care Unit.

Mental Health

Executive Session

 It was MOVED by Mr. Hattery, seconded by Mr. Proto, to enter into executive session to discuss a potential contractual matter.  A voice vote on the motion resulted as follows:  Ayes – 3; Noes – 1 (Legislator Robertson); Temporarily Excused – 1 (Legislator Shinagawa).  MOTION CARRIED.

 An executive session was held at 4:08 p.m. and returned to open session at 4:25 p.m.

 Mr. Shinagawa arrived at this time (4:27 p.m.).

RESOLUTION NO.  -  SUPPORTING CHANGES IN MEDICARE PART D

  Mr. Proto stated that the resolution had come before the Committee at the April 5th meeting, at which time it was agreed to approve the resolution with the understanding that amendments would be made and reviewed.  He asked that comments be limited to the amendments.   In addition, he requested that Mr. Hattery’s substitute be brought forward at the Legislature meeting.

 A brief discussion took place, during which Mr. Hattery indicated he had no objection to the additional WHEREAS paragraphs added to the resolution.  He expressed concern about the change of “millions” of dollars savings to “billions”.  Ms. Robertson indicated a review of material had indicated that the savings would be in billions of dollars; Mr. Hattery said he feels that in any circumstances such as the proposed legislation, various analysts could be found to endorse a variety of perspectives.  The Committee reached consensus that the resolution would go forward as initially adopted, including the reference to “millions”, with the addition of language to indicate it is the current bills being supported, as well as the following WHEREAS clauses:

“WHEREAS, the Tompkins County Legislature is concerned about the costs of Medicare Part D being borne by local government, nonprofits, pharmacists, and physicians, specifically extensive staff time required to help clients negotiate the system, and
WHEREAS, Medicaid recipients who are also eligible for Medicare (called “dual-eligibles”), including those who are disabled, now must start paying co-pays out of pocket, requiring our Mental Health Clinic personnel to collect co-pays from some clients and submit for state reimbursement for other clients, and “.

WHEREAS, Medicare Part D has provided many Medicare recipients with necessary medications at a more affordable price than before the program was initiated, and
WHEREAS, certain features of the program, however, have created unnecessary complexity and leave Medicare recipients at risk of signing up for incorrect or inadequate drug coverage, without the option to change plans, for example:
· During the plan year, after Medicare recipients sign up, insurance companies are permitted to increase their copays, change their formularies, and drop previously covered medications;
· After May 15, 2006, Medicare recipients can only change drug plans once a year (during the six-week open enrollment periods) even if the drugs they need are dropped from the plan, their medication needs change to a drug that is not on their plan, or the copays go up, and
 WHEREAS, because Medicare Part D is provided by private insurance companies rather than as an add-on to basic Medicare, the decisions Medicare recipients must make are overwhelming and confusing, and represent a barrier to many people rather than a benefit. For example, recipients in New York State must choose from among 47 different plans offered by 21 different companies, and
WHEREAS, the resulting confusion about Medicare Part D, as reported in the media and by local people, makes it hard for many people to meet the May 15, 2006, enrollment deadline, putting them at risk of paying late enrollment penalties, as follows:
· After May 15, 2006, there is a late enrollment penalty. If a person does not sign up by May 15, they must wait until the next enrollment period, which is November 15 through December 31, 2006. People who enroll then will be charged a 7% penalty*.
· Those who enroll in 2007 (November 15 - December 31) will have to pay a 19% late penalty.
· The penalty continues to increase each year thereafter by 12%.
WHEREAS, basic Medicare has much lower administrative overhead (2-3%) than private insurance companies (15-25%), and Medicare Part D as written includes governmental subsidies to private insurance companies, and
WHEREAS, the Federal government is prohibited from negotiating on behalf of Medicare beneficiaries for lower drug prices, and
WHEREAS, the Tompkins County Legislature is concerned about the costs of Medicare Part D being borne by local government, nonprofits, pharmacists, and physicians, specifically extensive staff time required to help clients negotiate the system, and
WHEREAS, Medicaid recipients who are also eligible for Medicare (called “dual-eligibles”), including those who are disabled, now must start paying co-pays out of pocket, requiring our Mental Health Clinic personnel to collect co-pays from some clients and submit for state reimbursement for other clients, and
WHEREAS, the Tompkins County Legislature wants Medicare recipients to have prescription drug coverage that is as comprehensive, user friendly, and cost effective as possible, now therefore be it
RESOLVED, on recommendation of the Health and Human Services Committee, That the Tompkins County Legislature supports Federal legislation to fix the major problems with Medicare Part D in the short term, and correct the program’s structural problems in the long term,
RESOLVED, further, That the Legislature urges passage of the Medicare Prescription Drug Savings and Choice Act of 2005 (H.R.752 and S.345), which would establish a standard drug-coverage plan administered by Medicare, mandate price negotiation for prescription drugs, and save taxpayers an estimated millions of dollars,
RESOLVED, further, That the Legislature supports other legislation that would extend
the initial open enrollment period beyond May 15, 2006, waive the late enrollment penalty, and permit beneficiaries to change plans if their prescription needs change, or their provider changes the formulary or significantly raises prices during the benefit year,
RESOLVED, further, That copies of this resolution be forwarded to President George W. Bush, Senators Charles Schumer, Hillary Clinton, Michael Enzi, Edward Kennedy, Senate Majority Leader William Frist and Senate Minority Leader Harry Reid, and Representatives Maurice Hinchey, Sherwood Boehlert, Joseph Barton, John Dingell, and Speaker Dennis Hastert.
SEQR ACTION:   TYPE II-20

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* The late enrollment fee is a percentage of the average monthly cost of all plans nationally. The average cost is currently $35.00.

Homeless and Housing Taskforce Liaison Position

 Mr. Shinagawa said that he had agreed to act as liaison to the Homeless and Housing Taskforce; however, the actual meeting time had changed to 9:30 a.m. – 11:30 a.m. making it impossible for him to do so.  It was decided that Ms. Robertson will take the liaison position with Mr. Shinagawa as an alternate.

Southern Cayuga Lake Intermunicipal Water Commission (Bolton Point)

 Mr. Proto reported that as a result of the pending litigation brought forth by the members of the Southern Cayuga Lake Intermunicipal Water Commission (Bolton Point), and towns associated with them, on advice of the County Attorney and County Administrator, discussions regarding the topic are suspended, as well as a request for the Health Department to put on hold the information that had been requested by the Committee.

Committee Work Plan

 The Committee discussed the 2006 Committee Work Plan, particularly areas such as the nursing shortage.  Mr. Proto has communicated with Maurice Hinchey’s office to see if the program to assist in funding individuals desiring certification in the field is still operational.  Members of the Committee will speak to Tompkins Cortland Community College to determine the status of their program.  The Committee also spoke of the need to determine how to include Human Services within the County’s Comprehensive Plan which is not presently covered.  Mr. Proto said he believes it is a role for the Committee; Mr. Hattery felt it is important to include individuals dealing with the Human Services field on a daily basis.  Ms. Robertson suggested Mr. Marx be approached to provide his perception of how this issue would fit into the Comprehensive Plan.  A clean copy of the Committee Work Plan will be provided to members.  Mr. Hattery suggested that prioritization be completed to determine what can be done by the Committee this year.  Mr. Proto also suggested members review the material relating to Home Health Aide salaries for consideration at a future meeting.

Additional Meetings

 Mr. Proto reminded individuals to provide times they would be available during May to meet and discuss Medicaid and agency reviews.

Adjournment:  On motion, the Committee adjourned at 4:59 p.m.
 

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