Health and Human Services
Regular Meeting
June 7, 2006 3:00 p.m.
Scott Heyman Conference Room

Present:  F. Proto, Chair; N. Shinagawa, Vice Chair; M. Hattery; M. Robertson; G. Stevenson
Staff:   K. Fuller, Deputy Clerk of the Legislature; P. Carey, Department of Social Services; L. Holmes, Office for the Aging; A. Cole, B. Grinnell-Crosby, Health Department; P. Younger, Deputy County Administrator; J. Grogan, Public Information; N. Zahler, J. Johnston, Youth Services

Guests: M. Klepack, Ithaca High School; T. Lee, Cornell University; C. Booth, Mental Health Services Board; B. Hawley, Lifelong, K. Schlather, Cooperative Extension; N. Burston, B. Falcao, Human Services Coalition

Called to Order

 The meeting was called to order at 3:02 p.m. by Mr. Proto, Chairman.  Introductions of members and guests occurred.

Additions/Changes to the Agenda

There were no additions or changes to the agenda.

Minutes of March 1, April 5, April 18, and May 3, 2006

 It was MOVED by Mr. Hattery, seconded by Mr. Shinagawa, to approve the minutes of March 1, April 5, April 18, and May 3, 2006.  A brief discussion occurred regarding some suggested amendments.  A voice vote by members to accept the minutes of March 1, April 5, April 18, and May 3, 2006, as amended resulted as follows:  Ayes – 5: Noes – 0.  MINUTES APPROVED.

Youth Services

 Ms. Zahler, Youth Services Director, shared with the Committee an e-mail received that expressed gratitude for the summer camp website, noting it was the best resource for this information ever seen.  Ms. Zahler acknowledged Theresa Albert’s efforts in creating this site.

 Ms. Zahler announced there would be a self-injury workshop taking place on Friday, June 9th.  She then reported today’s discussion would be how her department relates to municipalities, work that is done primarily through Ms. Johnson.

 Ms. Johnson spoke of the Youth Development programs that are designed to meet the need of youth who do not normally join clubs, sports, and things of this nature.  These programs are designed to assist in developing skills, building confidence, etc.  Ms. Johnson explained there these programs are grassroots bottom-up design with three requirements:  (1) a local planning group, (2) a needs assessment to identify needs, and (3) matching funds from the municipalities.

  Ms. Johnson provided an overview of the Youth Development programs that included participation of programs by each municipality as well as pie charts indicating the age of participants and revenue sources.  She explained that each municipality’s Rural Youth Services director is contracted through Cooperative Extension, with County funding paying the salary and Cornell University paying fringes associated with them.  This was done to provide continuity as municipalities found it difficult to train and maintain individuals in these positions.

 Ms. Johnson then spoke of the role of County Youth Services.  She explained they offer technical assistance with regard to needs assessments, training, and future needs.  In addition, they have assisted with projects such as a summer camp for Groton.  This summer camp started as a limited pilot program and after three years has progressed to the point that the camp registration was closed out within three weeks.  The County Youth Services also works closely to help direct municipal youth services to connect with other programs such as Department of Social Services, Foster Care, Probation, etc. when necessary.  Ms. Johnson meets regularly with the Recreation Directors to provide updates in information regarding various program offerings.
 
 A brief discussion occurred regarding funding streams for the programs.  It was noted that State funds are distributed for recreation program and youth development programs; youth development funds can be used for recreation, but recreation funding is solely for recreation.  Funding for the youth services programs can be utilized for the general population.  It was explained that in 1990 there was a thirty percent decrease in funding from the State for youth services, and although there have been modest increases over the years it is somewhat stable.  Each participant in an activity produces $4.44from the State which is shared between local programming and county programming.  Ms. Zahler stated County dollars are much more flexible that those received by municipal programs.

 Mr. Stevenson inquired why the fees in Enfield were higher than others.  He was informed that it results from the various requests for funding from the United Way which has assisted in offering a camp providing before and after camp daycare.  The funds offset the costs to operate the program.

 Mr. Proto asked how decisions are made with regard to programming if funding levels drop.  It was explained each municipality makes a determination whether to fund out of municipal funds, modify, or eliminate programs.  Mr. Proto then asked how funds are determined as there has been large growth areas in the County and many demographics are continually changing.  Ms. Johnson reported the State funds are based upon census information, with approximations for changes.  Youth Services more closely tracks information through the use of school enrollment data.

 Mr. Hattery spoke of the Youth Commission, noting it would be beneficial to have a summary of each municipality’s program offerings.  He feels it is good to have knowledge of joint efforts.

Recreation Partnership

 Mr. Proto spoke of the difficulty in having a quorum at the Recreation Partnership meetings and asked for assistance from Committee members in encouraging representation from their districts.

Health Department

 Mr. Proto reported that July 7th is the anticipated date for the court to hear the Bolton Point lawsuit.  He will have a meeting of parties involved prior to that date and noted it may require a special meeting of the Committee.

Building Issues

 Ms. Cole reported that due to the HVAC unit in the building being inoperable, the resulting heat caused the telephone voice mail to break down.  In addition, the recent heat caused individuals to be uncomfortable at work due to the lack of air conditioning, the rains have caused the odors to return to the building, and a recent completion of roof work has caused odors that are unacceptable to some individuals.  The result of these problems is the need to find alternative work areas for employees.

 Mr. Proto noted the Health Department was a priority within the Capital Plan, with anticipated start dates between 2008 – 2009.  In response to a question on the responsiveness of Facilities Division, Ms. Cole noted that the response is good.

Pandemic Flu Update

 Ms. Cole provided written material developed for the public by the New York State Department of Health as well as an excerpt from the New York State Pandemic Flu Pan.  She noted there are not any significant items to report at this time.

Bio Terrorism Coordinator

 Ms. Cole reported due to a vacancy in the position, Ms. Griep, former Bio Terrorism Coordinator, has assumed the position.

RESOLUTION NO.   – AUTHORIZATION TO REDUCE HOURS – ENVIRONMENTAL HEALTH AND WIC PROGRAM – HEALTH DEPARTMENT

 It was MOVED by Mr. Stevenson, seconded by Mr. Hattery, and unanimously approved by voice vote by members.  RESOLUTION APPROVED.

WHEREAS, Resolution No. 50 of 2003 provided for an increase in hours for both a Public Health Sanitarian and WIC Program Nutrition Aide (since reclassed to Nutrition Educator), now therefore be it
RESOLVED, on recommendation of the Health and Human Services and the Budget and Capital Committees, That the hours of the following positions be changed as follows effective July 2, 2006:
1.0 Public Health Sanitarian (14/595), labor grade N, decrease the position and approved hours from 37.5 to 35.0 per week, and
1.0 Nutrition Educator (8/725), labor grade H, decrease the position and approved hours from 37.5 to 35.0 per week.
SEQR ACTION: TYPE II-20

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Explanation:  Due to reorganization and funding reductions, hours are no longer available at 37.5 hours per week.  By reducing the hours to 35 the employees affected will be more accurately credited with years of service for retirement purposes.

Executive Session

 It was MOVED by Mr. Shinagawa, seconded by Mr. Hattery, and unanimously adopted by voice vote by members present, to enter into executive session at 3:59 p.m. to discuss a personnel matter.  The meeting returned to open session at 4:14 p.m.

Mental Health

Unity House Update

 Ms. Booth, member of the Mental Health Services Board, provided an update on the potential closing of Unity House which houses eighteen individuals who could face homelessness, and/or have mental health issues.  Following a brief history of events leading up to the present, she indicated that the New York State Department of Health, who oversees Unity House, had advised the County obtain Requests for Proposals (RFP) for housing of the individuals who may be effected.  At this time, the New York State Department of Health has not responded to Unity House regarding any closure information (which is necessary to do so).  The RFP had five interested parties, of which Lakeside Nursing Home appears to be the only viable proposal as it is the only one with the New York State Department of Health association.  For those not associated with the New York State Department of Health, the licensing process would be lengthy.  She explained that a concern was expressed about Lakeside’s location not being in the city as well as a concern that if the current house were sold the housing would be lost.  At this time, Ms. Williams of Unity House, has said the house will not be sold, but may be used for mental retardation/developmental disability or low-income individuals.

Ms. Booth reported eight to ten additional beds will be provided for the Lakeview single resident program.

Ms. Younger inquired what wrap-around services are available and was informed that individuals in Unity House have case managers.  Of the eighteen residents, two have indicated the relocation to Lakeside would not present a problem, however, the case managers and other residents have not had the opportunity to fully provide input on the matter.  Ms. Younger then clarified that Mr. Whicher had a concern regarding the potential loss of beds and that it was suggested to have Unity House personnel attend a meeting with members of the Mental Health Board, Legislature, and Administration.

Mr. Proto asked to have the Committee updated as this situation moved forward.

Department of Social Services

 Mr. Proto noted the monthly reports provided was for informational purposes.

Office for the Aging

Personal Emergency Response System (PERS) Evaluation Results

 Ms. Holmes, Interim Office for the Aging Director, provided members with a written survey regarding the Personal Emergency Response System (PERS) that was completed by an intern within her department and noted the last survey was completed in 1999.  She explained the monthly fees for this service are based on a sliding scale based on income and range from no cost to $31.25 maximum cost.  Ms. Holmes said this has proven to be a very successful self-sustaining program that provides seniors and disabled individuals with the ability to feel secure and be independent within their homes.  Ms. Holmes reviewed the information contained within the survey that indicated a high level of satisfaction with the program.  She said one item that became apparent as a result of the survey is that individuals are not testing their equipment often enough.  In the future, each quarterly billing will have a reminder notice to test equipment and batteries.

 Mr. Stevenson left at this time (4:33).

 Ms. Robertson requested a more detailed budget for the program that specifies all revenues and expenses.

Department of Social Services/Office for the Aging Grant Request

 Ms. Holmes and Ms. Carey expressed the intent to apply for a Point of Entry Grant from New York State, due June 23, 2006.  It was explained that this is the grant previously discussed by Ms. Stein, former Director of the Office for the Aging.  The application will name the Office for the Aging and Department of Social Services as co-lead agencies regarding the long-term care programs.  The County has been providing a point of entry service since 1996; this is anticipated to smooth the process further and enhance what is already in place.

Advisory Board Appointments

 It was MOVED by Ms. Robertson, seconded by Mr. Hattery, and unanimously approved by voice vote of members present, to recommend the following appointments to the full Legislature for consideration:

Office for the Aging Advisory Board
Term to expire December 31, 2007
Leroy Wollney – At Large
Ardith Bennett – At Large

Term to expire December 31, 2008
Thomas William Holton – At Large

Budget Adjustments

 It was MOVED by Mr. Shinagawa, seconded by Mr. Hattery, and unanimously approved by voice vote of members present, to recommend the following budget adjustment to the full Legislature for consideration:

Office for the Aging
Revenue Acct           Title                 Amt      Approp Acct  Title                        _________
6788.44772 Federal Revenue  $  7,141    6788.51000559 Salary
6788.44772 Federal Revenue  $ 2,784    6788.58800  Fringes
6788.44772 Federal Revenue $  3,487    6788.52210  Office Equipment
6788.44772 Federal Revenue $  1,000    6788.54414  Local Mileage
6788.44772 Federal Revenue $     298    6788.54303  Supplies
6788.44772 Federal Revenue $     400    6788.52230  Computer Software
6788.44772 Federal Revenue $13,550   6788.54400  Program Expense
6788.44772 Federal Revenue $23,374   6788.54491  Subcontract
Explanation:  Revenue Increase in SPAP Program (Senior Pharmaceutical Assistance Program)

Human Services Coalition

 Ms. Burston reported the Coalition has been able to fund a grants coordinator/technical support specialist position and has filled it with Ms. Lisa Horn.  She provided the new Human Services Directory to Committee members.

Update on TompkinsRx/UrgentRx

 Ms. Falcao provided written reports on the TompkinsRx and UrgentRx programs initiated last year.  She reported they are a continued success and thanked members of the Committee and Legislature for assistance in the startup of the programs.  At this time, eight counties have requested information regarding the programs, having heard of it through Rural Health networks and the New York State Association of Counties.

 Ms. Robertson noted the pharmaceutical mail service number was low.  Ms. Falcao said it is due in part to individuals’ inability to order a three-month supply of prescriptions.  She said there is a GenericRx program that will assist in providing a three-month supply of generic medications for $30.  This information is provided to those having used the UrgentRx program that will cover generic medications following a visit to Cayuga Medical Emergency Room or the Lansing Convenient Care facility.  To date, over 200 individuals have utilized the UrgentRx program.

 Mr. Proto noted the number of users seems to have reached a plateau.  Ms. Falcao said there is a saturation point, although it is unknown what it will be.  Of the 10,000 + who do not have insurance, not all would require medications.  The Committee was informed that continued outreach takes place through the local newspapers, and handouts, but primarily the pharmacies are responsible for continued outreach to their clientele.

 Ms. Falcao noted the UrgentRx has funding to continue for a couple of years; they are working with United Way to find ways to expand the program to include outpatient discharge, assisting the free clinic, etc.

Tracking the Impact of Health Care Reform In Tompkins County – 1997-2005

 Ms. Falcao said the data provided has been accumulated over the last eight years and has not undergone analysis at this time.  She noted there has been an increase in Medicaid over the past several years and information will be provided from Department of Social Services to assist in determining why this increase is occurring.  She also provided information given from Cayuga Medical showing that $3.7 million was provided in service to uninsured patients.  Mr. Proto noted that while a Director at the hospital he learned billings to paying patients included a percentage that would be utilized for non-paying patients.  Ms. Falcao indicated that is due to a State law.  The $3.7 million includes this contribution from paying customers.

 Other discussion occurred regarding various areas of the report.  The following items were noted:

· The report was completed to provide necessary information to complete a Community Needs assessment.
· Medicaid personal services care is not the same level of care as a home health aide would provide.  This is for assistance in bathing, dressing, etc.
· It appears that all costs are increasing approximately ten percent per year.
· It was noted the MOMS program provides for higher income eligibility as a result of recognizing it would cost less in the future.
· Ms. Carey suggested people should apply as the formulas are varied; the listed amounts are guidelines
· It was noted the figures for hospital visits are not unduplicated individuals, and some may be out-of-county residents.

Illegal Dumping Update

 Mr. Proto reported that Ms. Eckstrom will be providing a report in July that will provide statistics on any changes in illegal dumping.

 Ms. Robertson was excused at this time (5:00 p.m.).

LifeLong

 Mr. Hawley, Executive Director, provided an historical overview of Lifelong and the programs it provides.  Highlights of his report are as follows:

· Lifelong is not a congregate meal site
· There are over 35 ongoing programs each week
· The Enhanced Fitness program is the only one in the State; the Center for Disease control certified this program as a means of intervention for arthritis and other illnesses.  Lifelong Enhanced Fitness trainers (2) are certified, one is presently assisting to certify other trainers.  It is hoped to have five more sites throughout the County as a result of Department of Health funding.
· The Lifelong Learning Program is unique as it is not housed at Rochester Institute of Technology as others are.  The program is modeled after the RIT program and uses volunteers from Cornell University and Ithaca College.  This helps reduce the decline of mental capacity.
· Presently Lifelong has four contracts with the County Office for the Aging.
· Assistance is provided to sort out Medicare Part D.
· Flu vaccines are provided at Lifelong.
· Over 400 volunteers in the Retired Seniors Volunteer Program (RSVP) bring in the equivalent of $1.2 million annually to the community.
· The RSVP Tax Counseling Program brought back over $657,475 in Federal refunds into the community through e-filing and assisted one single parent to receive a refund in excess of $15,000.
· The Check It program provides assistance in paying bills and the Plan It program for pre-retirement Planning.  A standard action when using Check It is to see if any unclaimed funds can be found at the State level; one client received $1,000 as a result.

Mr. Hawley stated the funding provided by the County is extremely important to the agency.  He shared information that showed the demographics of seniors utilizing Lifelong’s services indicating a wide-spread clientele.

Mr. Shinagawa spoke of his participation at Lifelong’s Board meetings; he believes them to be a vivacious, energetic, and active Board.

RESOLUTION NO.                – SUPPORT OF NEW YORK STATE ASSEMBLY BILLS A6575, A6576, 10583, AND SENATE BILL S3459 – WHICH ADDRESS THE GROWING HEALTH CARE CRISIS IN NEW YORK STATE

 Mr. Shinagawa briefly discussed the resolution, noting he believes it should go to the full Legislature for consideration.  He is very concerned about all individuals having the ability to have access to health insurance and adequate health care, noting that many low-income workers fall into this category.  He said many times these individuals health care end up being paid through State funding.  The resolution requests that all employers offer health insurance benefits for all workers.

 Mr. Proto asked if an evaluation had been made to determine if the cost of goods sold would be increased by the bill; and if so would individuals now getting health coverage be penalized in a different area.  Mr. Shinagawa said it had not, however he feels that due to the increase in Medicaid costs due to lack of insurance individuals are paying for uninsured through property and income taxes.  He believes that if the other costs increase individuals would have a personal choice of buying the products.

 Following discussion, Mr. Shinagawa noted he will provide additional information for the Legislature and will bring it forward as a member-filed resolution at the June 20th Legislature meeting.

WHEREAS, the rising number of those without access to health insurance and adequate health care continues to be a major crisis afflicting working individuals and families all across New York State, and
WHEREAS, health care costs have steadily increased to dramatic highs over the years, and
WHEREAS, New York State is the 5th wealthiest state, but has the 2nd highest rate of uninsured people, and
WHEREAS, New York State spends $1.2 billion in taxpayer dollars through Medicaid and Family Health Plus to cover the insurance of those who are already employed but do not receive coverage through their employers, and
WHEREAS, many employers, including many small businesses, are responsible and do provide health care to their employees but face unfair, competitive disadvantages against employers that dump the responsibility of rising health care costs onto their employees and taxpayers, and
WHEREAS, despite the growing crisis of health care for individuals and the State, the issue remains unresolved today, at the cost of the health and well-being of 3 million uninsured New York residents, and
WHEREAS, there are three major health-care bills before the New York State Legislature:

A. 6576 (S. 3459) –the New York Health Plan, which would establish a single-payer health-care program in New York State that would cover all residents. This bill first passed the Assembly in 1992, and

A. 6575 (no Senate companion yet) –that would establish a Legislative Commission on health-care reform with two co-chairs, one heading a study of Expanding Traditional Health Care and one studying Publicly Financed Health Care, and

A. 10583 (S. 7090) –Fair-Share Health Care, which would require all employers of more than 100 employees to pay an assessment to New York State (based on number of hours worked annually; initially at $3/hour), with that assessment reduced by what the employer already pays for health coverage for employees and family members—excluding manufacturing and agricultural jobs—and provide necessary benefits for taxpayers and small businesses
, and
WHEREAS, the Tompkins County Legislature believes that both controlling health care costs and ensuring health care for all residents is of paramount importance, and

WHEREAS, this Legislature further believes that the best approach for New York State is to move directly from the current multiple-payer approach, with its high costs of administration and marketing, to a statewide single-payer system, and
WHEREAS, the single-payer approach, such as the New York Health Plan A. 6576, would cover every person in the U.S. for all necessary medical care including prescription drugs; hospital, surgical, outpatient services; primary and preventive care; emergency services; dental and mental health; physical therapy; vision care, and long-term care among others, without deductibles, and
WHEREAS, the next-best approach would be the Study Commission, where the two contrasting approaches would get an up-to-date analysis and be open to easy comparison, and
WHEREAS, the “Fair Share” bill has the potential in New York to: provide 400,000 currently uninsured workers with employer-sponsored health insurance; shift approximately 200,000 workers currently enrolled in Medicaid and Family Health Plus to employer-sponsored health insurance; and, save state and local governments an additional $465 million in reduced spending on uncompensated care for the uninsured, and
WHEREAS, the “Fair Share” bill helps provide New York State with additional revenue to expand health coverage for residents, the bill is presented as a partial, short-term solution to the health care crisis, as a beginning to a better, and still prospective, turn-around to a nationwide, single-payer health care system, now therefore be it
RESOLVED, That the Tompkins County Legislature urges passage of A.6576 and S.3459, New York Health, the approach that ensures health-care coverage for all New Yorkers into the 2006 legislative session,
RESOLVED, further, That the Tompkins County Legislature, in recognition that in any event, the urgency of the current health care situation requires that measures be taken to address the growing crisis also supports the Study Commission and the “Fair Share Health Care” plan.
SEQR ACTION:  TYPE II-20

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Adjournment:  On motion, the Committee adjourned at 5:30 p.m.

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