Excused: N. Schuler, F. Proto

Staff:   B. Wright, J. Andersson, B. Grinnel-Crosby, A. Cole, S. Kerr, E. Miller, Health Department; S. Whicher, Administration; G. Newlin, M. P. Dolan, R. Bush, R. Steve, M. Banks, Department of Social Services

Call to Order

Chair Winch called the meeting to order at 1:00 p.m.  He noted that today’s meeting will be a review of the Health Department and Department of Social Services and include the over target requests that the departments are planning.

Health Department

Ms. Cole provided Committee members with information relevant to reduction impacts for her department and their priority in the over target request area.  She noted that she is suggesting the reduction of her hours from thirty-five hours to thirty hours as well as other possible reductions within the department in order to meet the requested reduction.  Another over target request that was discussed was a new server for the department.  Questions about the funding for the server were answered by indicating that the funds were available from rollover funding and would be a one-time expense.  Members of the Committee inquired whether a reduction of hours by Ms. Cole would enable her to complete required duties.  Ms. Cole indicated that she felt if there was the possibility of other positions being effected by the reduction she needed to let her employees know that she too was willing to accept a reduction.  She reviewed the other proposed cuts and over target requests, noting the potential impact of each if the over target request was not granted.

Next, Ms. Kerr reviewed community health service programs under her direction and indicated that she also is proposing a reduction of time for herself to 35 from 40.  She noted that previously it was at 40 to assist in the round-the-clock coverage that her position encounters.  She also said that they have held several nursing positions open in an effort to reduce the budget, and they are not included in the over target request.  She also noted that a position for a medical social worker, approved previously, had received authorization from the State but has not been filled to keep the budget down.  At this time, the State has noted the deficiency and request an explanation.  Ms. Kerr explained that the medical social worker position is part of the municipal health service plan approved by the Board and State and is to assist maternal child and health care clients.  She then reviewed the other over target requests and explained what the program components were.  Committee members asked if the AidsWork program would be reduced and revised in some manner regardless of the current budget scenario.  It was noted that there would be a change in the funding of this program as it has merged with Southern Tier Agency Program.  Mr. Whicher inquired how many employees worked in the community health services area.  Ms. Kerr said that at the present time 54 of the 90 employees in the Health Department worked in this division.  Questions regarding previous reductions were asked of Ms. Kerr.  She informed the Committee that a shift in childhood immunizations back to physicians provided a reduction of the number of immunizations given by the department and at that time, the reductions were not as significant as they could be through a reduction at present.  Further information was provided that services previously offered to parents of all newborns such as information on the services provided by the Health Department are no longer done.  Ms. Kerr said that the targeted families for medium to high risk are now contacted to inform parents of services available and assess the needs of a family.  She said that quite often, the nursing staff is the intermediary step prior to child protective services having to take possible action.  Ms. Robertson thought it would be useful to see a flowchart of services.  Mr. Winch said that it would be useful to have the listing of the history of staffing over the past several years, noting increases and decreases and the reasons for them.

Ms. Kerr said that her biggest concern is the shift from preventive medicine such as inoculations to training and education for communicable diseases and those diseases potentially arising from bioterrorism.  Questions were asked regarding procedure in the event of an unknown disease, or potentially hazardous one.  It was explained that normally the first step when someone is ill is to go to one’s own physician and that the physician is required to contact the Health Department as are laboratories.  Tompkins County does have an infectious disease specialist if needed.  If someone was to have a disease that would cause concern they normally would be transported to a larger facility outside of Tompkins County.

Mr. Andersson spoke about the three areas within the Environmental Health section that he is  requesting consideration for an over target request.  He discussed each area and the impact if the request was not completed.  It spoke about the need to reduce certain services if the over target requests were not made.  Members of the Committee inquired whether the State would take over some of the services in the event there was not funding at the County level.  Ms. Cole indicated that Tompkins County is a full-service Health Department and that if we did not offer the services the State would step in.  When asked how long the County has provided these services Mr. Anderson indicated that the history of the Environmental Health Department goes back to approximately 1963 or 1964.  Mr. Winch reminded Committee members of a joint meeting between Planning and Health and Human Services Committee members regarding Pesticide Notification taking place on Thursday, July 18 at 1:30 p.m.  When asked how work for this would be completed if passed by the Board, Ms. Cole said that in order to complete this task another would have to be reduced and/or eliminated.

Ms. Cole then reviewed the information for Children with Special Care Needs division.  She noted the possible reductions outlined in the reduced budget scenario.  Ms. Cole said nursing staff in this program are required to undertake extensive training.

Mr. Winch reminded individuals that all items being discussed are at this point only scenarios and do not necessarily represent the final outcome.  Ms. Robertson and Mr. Booth asked for written information regarding scenarios with present and proposed employee numbers, services, and funding for each.

Mr. Whicher inquired of costs within the current budget, citing information received today.  Ms. Cole said her costs have been fairly stable and it was noted that increases are more than likely due to Department of Social Services increases.

Department of Social Services

 Ms. Newlin spoke about the Family Preservation Program.  This program has seven workers and is designed to assist in the prevention of out-of-home placement.  The Family Preservation Program is an intensive, short-term program where the caseworker is actively involved within the family unit, working with all parties in an attempt to resolve the differences/problems and enable the family unit to remain intact.  These workers are available twenty-four hours a day, seven days a week and have proven themselves to be eighty percent effective in resolving the issues and maintaining the family.  She then explained some experiences she had within the program and the positive reaction of both the adult and youth members of the family.  Questions from the Committee noted that there is no income eligibility for this service and it is available to all members of the community.

Next, Ms. Newlin spoke about the Foster Care Treatment program and explained it assists in preventing a higher level of care and trauma of multiple moves.  She said that the children in this program have behavioral problems or other difficulties that have led to the placement situation. This program assists the children and the foster families toward the goal of returning to their homes, or becoming productive members of the community.  Ms. Newlin said many of the foster parents are very dedicated and assist youth who might otherwise be placed in a group home situation.  The program also allows temporary respite for the foster parents when necessary. Youth within these foster homes have succeeded in obtaining employment positions for the summer, have successfully completed their grade levels in school.  She said that the most important aspect of the program is that the majority of these youth are able to successfully transition back to their residences, or if that option is not chosen, to be successful in an independent living situation.  Questions were asked regarding whether funding was the same regardless of income.  It was explained by Ms. Dolan that the request for services if through Child Protective Services is mandated and therefore at no cost, or if through the PINS system it is normally part of a court mandate and not chargeable.  If it was not one of these situations, she felt that it would be possible to charge a fee for services.

Ms. Steve spoke to the Committee regarding the Child Assistance Program (CAP) and its services.  She said that the program is designed to use a combination of wages and child support to assist parents in becoming independent and self sufficient by the use of intensive case management, job development and child support services in a non-traditional atmosphere that promotes respect, dignity, and support.  Ms. Steve explained how the CAP staff work together as a team to develop short-term and long-term goals, obtain appropriate child support, assisting clients to have appropriate transportation to and from work through other programs such as Wheels to Work, and grants, and assisting in completing forms for various housing programs.  Statistical information was given as well as examples of cases that have been dealt by with the unit.  Ms. Steve also provided information on services available upon closure of the case.  She indicated that at times small-scale assistance is given in an effort to maintain the success and eliminate the need to return to the social services assistance programs.

Ms. Dolan then spoke to the Committee on a variety of topics, indicating that she would like assistance on whether future educational sessions would be helpful to the members.  She then reviewed the over target requests submitted to administration and explained any gaps in service were they not approved.  Ms. Robertson inquired whether there were cuts in the base budget that were not included in the over target request.  Ms. Dolan informed her that there were cuts that are not included in the over target request and briefly reviewed this information and said that she would provide information regarding the size of her department over the past years and reimbursement information.  Committee members inquired about turnover of employees within the Department and Ms. Dolan informed them that studies have been done and she will obtain the figure.  She also noted that one study showed that employees out on disability or utilizing sick time averaged ten per day.  Ms. Dolan said she would be happy to have individuals speak to the Committee as desired.

Mr. Whicher inquired about the change in costs for mandates from the State.  Ms. Dolan said it was due to the escalation of high-cost programs but felt that if able to maintain the preventive programs it would assist in keeping the overall cost down in the future.

Adjournment

The meeting adjourned at 2:40 p.m.

Respectfully submitted:  Karen Fuller, Deputy Clerk