Staff: K. Fuller, Deputy Clerk of the Legislature; A. Cole, B. Crosby, S. Connors, Health Department; S. Whicher, County Administrator; N. Zahler, Youth Services; L. Holmes, Office for the Aging; S. Martel Moore, P. Younger, Deputy County Administrators; R. DeLuca, Mental Health
Guests: J. Morgan, Tompkins Cortland Community College
Called to Order
The meeting was called to order at 3:02 p.m. by Mr. Proto, Chairman.
Additions/Changes to the Agenda
Members of the Committee were proved with a budget transfer for the Office for the Aging.
Approval of Minutes of June 7, 2006
It was MOVED by Mr. Stevenson, seconded by Mr. Shinagawa, and unanimously approved by voice vote of members present, to accept the minutes of June 7, 2006, as submitted. MINUTES APPROVED.
Youth Services
Update on Gang/Violence Activities
Mr. Proto inquired if there was any information available regarding an incident occurring recently involving youth. Ms. Zahler indicated she did not have any information specific to the incident. She reported that earlier in the day a meeting occurred with Mayor Peterson, District Attorney Wilkinson, and other pertinent individuals in order to respond to issues identified at the recent forums as well as to talk about whether there is a more systematic approach with regard to Youth and/or Gang Violence. It was thought that if the nature, scope and prevalence of the violence were reviewed it could assist in determining a comprehensive approach to take. It was noted that it appears the incident was more of an interpersonal disagreement than gang/group violence oriented.
Overview of Tompkins County Youth Services Board’s 2007 Resource
Allocation Recommendations
Ms. Zahler provided written information regarding the Youth Services
budget procedure, and spoke of how the Youth Board reviews and recommends
funding for programs. She explained that eighty percent of the Youth
Service’s budget goes to not-for-profit agencies and municipalities for
their youth programs. The County Youth Board reviews and recommends
what County and/or State funding should go to the various programs.
Each year the progress and performance of programs is reviewed prior to
setting the next year’s budget. Ms. Zahler said the material was
being provided to allow members of the Committee a chance to see what projected
revenues and the requests made by communities and the recommended levels
of funding.
Ms. Zahler indicated her department works on a three-year funding basis in order to provide a clear picture of the effectiveness of programs rather than having changes each year. The 2007 budget is considered a renewal year. She said there are 13 agencies with various program offerings; the Youth Board volunteers determined they are all meeting the criteria required to continue. She indicated the requests were for more than the budget, and there will be a request for a 3.5 percent cost of living increase as well as a target increase to continue at the same level of service. She explained there are no new expenses or different programs being considered.
Ms. Zahler spoke of last year’s over-target requests that were approved; one for an increase in the base salary for Cooperative Extension employees who work in the rural community programs to more appropriately reflect the level of training and responsibilities of the positions. The dollars used were a combination of target funds and some rollover funds. This request will be made again this year and is not an additional amount, but rather to maintain the same level as last year. A second over-target request was for funds to provide the State increase in minimum wage for the summer teen employment. The third over-target request is related to the administrative and coordination of the programs; if the recommended fiscal target option is approved as offered in the Budget and Capital Committee meeting, there will be an $8,000 shortage. The Youth Board recommended asking for the OTR rather than cutting administrative staff time.
Mr. Proto suggested members of the Committee review the information that will be discussed further at the August 2, 2006 meeting.
Ms. Robertson indicated that although there are no new programs offered at this time, many new initiatives have been suggested for future consideration. Mr. Proto requested a summary of the suggestions be provided for the Committee.
Ms. Robertson suggested the possibility of committing funds in an undesignated matter for possible PILOT programs.
Update on Youth Transportation Survey
Ms. Zahler reported that at the conclusion of the Youth Transportation Survey, 969 surveys were completed, representing twenty-five percent of the high school age students. This survey was a joint project between school districts and Youth Services, with different levels of participation. The data provided within the survey will be reviewed at two levels, what was specific to a school district, and what recommendations could be considered on a countywide basis. One practical suggestion was bicycle racks at bus stops. Mr. Proto inquired how the information would be provided to others such as Tompkins Consolidated Area Transit and was informed that it would be through staff reporting; however, Mr. Mengel of TCAT is part of the group overseeing the initiative and may be able to immediately utilize some information he has seen. It was suggested that a presentation be given to the TCAT Operations Committee when information is compiled.
Mental Health
Timothy’s Law Update
Mr. DeLuca, Mental Health Commissioner, reported that after five years of effort, both the Senate and Assembly have passed a version of legislation referred to as “Timothy’s Law”. The legislation requires health insurance policies sold in NYS, not exempt under Federal law, to provide at least 30 inpatient days and 20 outpatient visits for mental health treatment. Perhaps more importantly, co-payments for accessing such services will be equalized with other co-payments for physical health needs included in a policy. Small employers of 50 or fewer employees will be held harmless from any potential premium increases through a reimbursement/credit program offered by the State. People working for large employers will receive unlimited mental health benefits for the treatment of bipolar disorder, major depression, panic disorder, obsessive-compulsive disorder, anorexia, bulimia, schizophrenia/psychotic disorders, attention-deficit/hyperactivity disorders, disruptive behavioral disorders and pervasive developmental disorders. Small employers would have the option to purchase this same coverage. The legislation will now require the Governor’s signature on a Letter of Necessity. Mr. DeLuca said although he believes the Governor may be sympathetic to this problem he did not know what the end result would be. He said many states have passed similar legislation regarding this issue. It appears that if the Order of Necessity is signed the legislation could be in place this fall. Mr. Proto asked if information could be made available to determine what the effect of the Legislation may have for the County and whether it would be good to assist in advocating the matter. Mr. DeLuca said he might be able to get information regarding the potential cost to assist in the matter. He will also provide information regarding the impact on the clinic; individuals who would be affected are those who presently do not have any coverage. Mr. DeLuca said unfortunately, the legislation would not cover substance abuse counseling.
Mr. Proto suggested that Mr. DeLuca work on a resolution of support to be brought forward prior to the anticipated fall date for the Governor’s review.
Unity House Update
Mr. DeLuca reviewed the history to date, noting that at this time Lakeside is applying for the HUD funding to provide eight additional beds for the SRO, rather than the original ten that were applied for by Unity House. It was also noted that the SRO would require City approval. Mr. DeLuca has received verbal assurance that the property on Green Street would not be sold with the funds being distributed outside of the community at other Unity House locations, but may be utilized for programming for the developmentally disabled. Unity House is not accepting any new admissions at the Green Street residence. Mr. DeLuca said at this time there are ten requests through the single point of access, the process for mental health patient housing, which puts individuals on a waiting list. He indicated that Lakeside Nursing Home operators are attempting to create an adult residence facility on one floor of their building. Mr. DeLuca was requested to check with the Finance Director on any matter that speaks to financial matters.
Members of the Committee and staff expressed their disappointment in the manner in which the situation occurred.
Mental Health/Developmental Disability Hearing in Albany
Mr. DeLuca spoke of a situation within the County where a family could not obtain services through the State Developmental Disability or Mental Health offices. He had individuals from these two offices come to the hospital to witness the individual’s needs. Mr. DeLuca said both he and members of the Community Services Board were very upset with the lack of coordination between the agencies and brought the concern to Assemblywoman Lifton’s office. As a result, at the Statewide Hearing for New York State Assembly members, regarding individuals with Mental Health and Developmental Disabilities and the difficulties they face as a result of the dual diagnosis, Mr. DeLuca and others throughout the state, including the individual and their family provided testimony that has led to legislation designed to provide consistent review and reporting regarding coordination of individuals with multiple disabilities.
Mr. DeLuca expressed his admiration for the young man who testified to the State legislators. The Committee expressed a desire to personally hear from him in the future.
Health Department
Building Update
Ms. Cole indicated the only problem presently occurring was a loss of telephone systems when power outages are experienced.
RESOLUTION NO. – APPROPRIATION FROM CONTINGENT FUND – TERMINAL PAY – HEALTH DEPARTMENT
It was MOVED by Ms. Robertson, seconded by Mr. Hattery, and unanimously
approved by voice vote, to recommend approval of the following resolution
to the full Legislature. RESOLUTION APPROVED.
WHEREAS, the Health Department had a Public Health Sanitarian
retire effective May 19, 2006, and
WHEREAS, the Fiscal Policy of Tompkins County allows for terminal
pay from the Contingent Fund, now therefore be it
RESOLVED, on recommendation of the Health and Human Services
and Budget and Capital Committees, That the Director of Finance is hereby
authorized and directed to make the following budget appropriation:
FROM: A1990.54440 Contingent Fund $ 7,905
TO: A4090.51000595 Public Health Sanitarian $ 5,687
A4090.58800 Fringes $ 2,218
SEQR ACTION: TYPE II-20
RESOLUTION NO. – ABOLISHING VARIOUS HEALTH DEPARTMENT POSITIONS
It was MOVED by Ms. Robertson, seconded by Mr. Stevenson, and unanimously approved by voice vote, to recommend approval of the following resolution to the full Legislature. RESOLUTION APPROVED.
WHEREAS, the Tompkins County Health Department has identified several
vacant positions for which there is no longer a need, and
WHEREAS, deletion of these extraneous, positions will make record keeping
easier and more accurate, now therefore be it
RESOLVED, on recommendation of the Health and Human Services
and Budget and Capital Committees, That the following positions in the
Tompkins County Health Department are hereby abolished effective immediately:
Administrative Assistant (12-535) 17.5 hours per week, Position
Identification Number 477, created by Resolution No. 123 of 2002,
Case Manager – PHCP (12-686) 35 hours per week, Position Identification
Number 494, created by Resolution No. 109 of 1991,
Clerk (4-503) 17.5 hours per week, Position Identification Number
529, created by Resolution No. 88 of 2001,
Community Health Nurse (15-580) 35 hours per week, Position Identification
Number 1170, created by Resolution No. 384 of 1988,
Community Health Nurse (15-580) 35 hours per week, Position Identification
Number 1191, created by Resolution No. 39 of 1994,
Community Health Nurse (15-580) 17.5 hours per week, Position
Identification Number 531, created by Resolution No. 247 of 1996,
Community Health Nurse (15-580) 21 hours per week, Position Identification
Number 463, created by Resolution No. 180 of 1986,
County Clinical Nurse Trainee (14-706) 35 hours per week, Position
Identification Number 1171, created by Resolution No. 243 of 1992,
Data Entry Machine Operator (6-509) 35 hours per week, Position
Identification Number 1172, created by Resolution No. 200 of 1987,
Dental Hygienist (13-543) 35 hours per week, Position Identification
Number 438, created by Resolution No. 201 of 1978,
Health Aide (8-654) 11.7 hours per week, Position Identification
Number 1173, created by Resolution No. 406 of 1991,
Keyboard Specialist (5-507) 21 hours per week, Position Identification
Number 1174, created by Resolution No. 201 of 1994,
Marketing/Media Specialist (11-651) 35 hours per week, Position
Identification Number 1175, created by Resolution No. 171 of 1988,
Medical Social Worker (13-628) 17.5 hours per week, Position
Identification Number 1180, created by Resolution No. 290 of 1999,
Nutrition Aide (8-524) 35 hours per week, Position Identification
Number 465, created by Resolution No. 310 of 1994,
Nutrition Aide (8-524) 35 hours per week, Position Identification
Number 508, created by Resolution No. 80 of 1981,
Public Health Technician (11-554) 35 hours per week, Position
Identification Number 534, created by Resolution No. 209 of 1986,
Public Health Technician (11-554) 35 hours per week, Position
Identification Number 512, created by Resolution No. 209 of 1986,
Senior Account Clerk Typist (9-529) 17.5 hours per week, Position
Identification Number 1188, created by Resolution No. 204 of 1993,
Senior Clerk (7-518) 10.2 hours per week, Position Identification
Number 1189, created by Resolution No. 268 of 2000,
Senior Clerk (7-518) 35 hours per week, Position Identification
Number 533, created by Resolution No. 100 of 1980,
Senior Clerk (7-518) 35 hours per week, Position Identification
Number 476, created by Resolution No. 232 of 1990,
Tuberculosis Physician (87-265) 35 hours per week, Position Identification
Number 532, created by Resolution No. 382 of 1988.
SEQR ACTION: TYPE II-20
RESOLUTION – APPROPRIATION FROM CONTINGENT FUND – KEYBOARD SPECIALIST
Ms. Cole requested the resolution be withdrawn at this time. She said it now appears there will be State funding for the position.
Update of WIC Record Audit
Ms. Sigrid Connors provided information regarding last fall’s State-requested audit of the WIC (Women, Infant’s, and Children) program. Initially the request was to audit 1,500 records from the period of 1999 to 2005, but this figure was amended to a total of 5,643 records. She reported the audit has been completed after approximately 370 hours of staff time. Ms. Connors reported a certified health nurse was assigned fifty percent of her time, and support staff was assigned twenty-five percent of their time to assist in completing this task. The overall figures were as follows: of the 5,643 records requested, 5,459 were located. Of the files located, 92 percent had supporting documents; the other 8 percent had items such as missing signatures or due to software program difficulties at the time, a different individual’s electronic filing identification. Ms. Cole said the information has been sent on to the State officials who are pleased with the information; Ms. Connors will meet with WIC representatives next week. In response to a question by Ms. Robertson, Ms. Connors said it is not known what the State may determine following the audit. Ms. Cole expressed her gratitude to Ms. Connors for her effort in completing this audit. Mr. Whicher also expressed gratitude to Ms. Cole for her support during the audit.
Social Services
Mr. Proto noted Ms. Robertson requested a formal discussion of the monthly reports at the next meeting.
Office for the Aging
There were no action items for the Office for the Aging. Ms. Holmes reported that the long-term care Point of Entry designation application has been submitted to the State.
Ms. Robertson requested information regarding revenue figures for the Personal Emergency Response (PERS) Program for 2005. [As part of the Chair’s report, Mr. Proto indicated the revenue is as follows: $46,000 participant fees, $700 contributions, $0 County dollars.]
Chair’s Report
Mr. Proto asked members to review the work plan and provide suggestions and updates to be discussed at the next meeting. He also asked members to provide dates and times they would be available during the next moth so a meeting with human service agencies may take place. Following receipt of required agenda items, an update on the Free Clinic may be added to the August agenda.
Nursing Services Overview
Ms. Morgan, Director of Nursing Services at Tompkins Cortland Community College spoke to the Committee regarding the nursing program and community nursing needs. She indicated that normally there are approximately 125 students in the program with over one-half the coursework specific to the nursing degree. Upon completion of the four semester courses students receive an AAS in nursing, and are eligible to take a certification exam to become a nationally accredited registered nurse. Once passing the certification, nurses are able to work in any territory of the United States. Ms. Morgan indicated this past year 55 students were graduated and placed.
Ms. Morgan spoke of having witnessed cycles in the field. She said there was a drop of students in the 1990’s, with one incoming class had 39 new entrants, and a total of 60 students in the program. She sees an upswing in the cycle and that it appears all have the to be placed, with the ability to relocate and find a position as well. Ms. Morgan noted due to the high interest in this field they are able to choose highly qualified applicants for the program.
Mr. Proto inquired whether she was aware of any new programs for
Licensed Practical Nurses, Home Health Aides and Certified Nursing Assistants.
Ms. Morgan said health care facilities interested in lowering costs are
looking more at Licensed Practical Nurses to fill their needs. She
said the local BOCES used to offer this program, however, the local program
was eliminated and interested students now attend classes in either Syracuse
or Elmira. With regard to nursing assistants, some are certified
nursing assistants who have completed a one-hundred hour training, which
is not offered through the community college; some nursing homes offer
this training. Ms. Morgan spoke of the difficulty working in a nursing
home due to the lifting requirements. She indicated initiatives are
taking place to provide lifting equipment that is safe for the patient
and individual assisting in moving patients. She said the Veteran’s
Administration facilities are not a “lift-free” environment. In addition,
turnover is high due to the hard work, limited benefits, and low salaries.
The Committee discussed the possibility of having a Certified
Nursing Assistant (CNA) program initiative at Tompkins Cortland Community
College. Ms. Morgan indicated that upon completion of the first year
of nursing training individuals could become a CNA. Mr. Proto
asked if an individual did this could they come back to complete nursing
training. Ms. Morgan said it is possible if done within several years.
It was noted that at this time the local BOCES does have a CNA program.
Ms. Morgan indicated if the college decided to have a CNA program it would
be a different age group than BOCES students and might be possible.
In addition it was believed that although individuals could work while
completing training, nursing homes include the course as part of the position.
Ms. Morgan reported the Long Term Care Committee of the Health Planning Council is planning a recognition event for Home Health Aides this fall.
Mr. Proto spoke of a recent article indicating that Senator Schumer is seeking funding for an initiative that would provide a recertification for individuals who were registered nurses but had let the certification expire. It was believed it would be useful in the event of an emergency such as a pandemic.
The Committee briefly spoke of clinical training of nurses within local facilities. Ms. Morgan said the college has included within its master plan renovations that would provide a lab setting for clinical experience including high-tech mannequins. Presently, the college regularly utilizes Cortland Regional Medical Hospital and Cayuga Medical Center, however facilities have cut down on the number of beds, particularly with pediatric wards. Due to the pediatric limitations some students are working in day care facilities and schools. Ms. Morgan said the demand is high for utilizing the local hospitals for in patient hospital study and students from Binghamton University, Mansfield, and Keuka Nursing School request placement in the hospitals. Mr. Proto suggested looking into the Weil Medical Center which was connected with Cornell University.
Ms. Morgan suggested that in order to increase participation in the nursing program is to use different hours; however, this would require additional staffing and could be very expensive with three faculty members supervising twenty students. Mr. Proto asked if personal care aid and home health aid training could be done at the college to assist in meeting the needs of the aging population. Ms. Morgan thought it could be possible but would require discussion prior to initiation due to other areas that are presently training individuals for these professions. It was thought that Betty Falcao of the Health Planning Council and Joan Murphy of Family and Children Services should be included in any discussions. Ms. Morgan noted that five percent of the students are males. In addition, she does not think any courses will be transferred to the downtown Ithaca area.
Adjournment: On motion, the Committee adjourned at 4:55 p.m.
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