Called to Order

 The meeting was called to order at 10:32 a.m.

Changes to Agenda

 The following was added to the agenda:  Resolution - Authorization to Accept Funding for the New York State Long Term Care Insurance Education and Outreach Program (LTCIEOP) - Office for the Aging
 
Office for the Aging

Ms. Stein provided an overview of the Department's proposed 2006 budget and highlighted the following.

· Overall 16.8% more clients are being served than last year.
· PERS Program has seen a 27.7% increase since 2000.
· Home delivered meals have a 22% increase in the last year.
· Long-term care has seen a 20% increase in the last year.
· Last year 5,491 seniors were served; this number does not include the 9,000+ receiving newsletters

Ms. Stein spoke about meeting the balance required in the EISEP program that provides for independent living versus nursing home residence.  The State has provided $36,000 in additional monies to this program, so COFA has eliminated the waiting list for this service at this time.  However, the list is starting to grow again, but the State is expected to again increase the funding in 2006, as they recognize the value of the program.  She will not be asking for an OTR in this area.

Ms. Stein then reported the Federal government has provided a grant in the amount of $50,000 to assist in educating the public about the changes in the Medicare Part "D" Pharmaceutical Program. The Office for the Aging will work with Lifelong to provide the outreach and education necessary.  In addition, the State provided a grant for long term care insurance education and outreach.  This will be another collaboration with Lifelong to develop two centers as well as outreach to various groups, not necessarily seniors, on the benefits gained by purchasing long term care insurance.  She plans to increase hours for the appropriate staff as well as fund another person for 1.5 days per week toward this effort.

 Due to the increases in home delivered meals in the Foodnet program, Ms. Stein will be asking for an OTR of $60,530, with a TILOR of $22,000.  This will provide two new routes for the projected 2006 increase of ten percent.  She believes the request will carry through for all of 2006 and possibly 2007.  Ms. Stein said if this request is not approved a waiting list will have to be made; she anticipates the waiting list could be between 45 to 150 individuals.

 Ms. Stein said the Department has been able to receive revenue to cover their printing and equipment needs and to augment salaries in order to increase hours to complete projects.  She will be attending a White House Conference on Aging later in 2005, and anticipates receiving additional information and providing input on the demographic trends and future needs.

 Ms. Blanchard spoke of how valuable long term care insurance is and the cost benefit when comparing it to a nursing home stay.  She then suggested the feasibility of frozen meals being provided by Foodnet which would possibly reduce the need for additional routes.  Mr. Griffin said Foodnet looked into this option a few years ago, and he will look into the alternative again, as well as a "grocery bag" program. However, a large part of the service is to provide the regular contact with the individuals.  He said while some of the people could possibly do this, not all are able to function well enough to use a microwave or prepare their own meals.  Many would not eat properly if given this option.

RESOLUTION NO.   - AUTHORIZATION TO ACCEPT FUNDING FOR THE NEW YORK STATE LONG TERM CARE INSURANCE EDUCATION AND OUTREACH PROGRAM (LTCIEOP) - OFFICE FOR THE AGING

 It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, to present the following resolution to the full Legislature for consideration.  Mr. Proto asked if this is a one-time funding from the State.  Ms. Stein said this is one-time, however, it is expected to be continued in future budgets.  The work proposed will not require any local share.  COFA and Lifelong will provide outreach at local employer sites as well as service groups such as Rotary.  A voice vote resulted as follows:  Ayes - 4; Noes - 0; Excused - 1 (Legislator Winch).  RESOLUTION APPROVED.

 WHEREAS, the Tompkins County Office for the Aging (COFA) has been awarded a grant through the New York State Office for the Aging (NYSOFA) to inform and educate the public about long term care, including the policies available through the New York State Partnership for Long Term Care and to establish a Long Term Care Resource Center to accomplish these objectives, and
 WHEREAS, informing and educating the public about health insurance options is in accordance with COFA's mission, and
 WHEREAS, the period of funding shall be from April 1, 2005 - March 31, 2006, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee, That of NYSOFA grant in the amount of $50,000 is hereby accepted,
 RESOLVED, further, That the Finance Director is authorized to make the following adjustments to his books:

REVENUE:  A6790-43803  State Revenue  $50,000

APPROPRIATION: A6790-51000559 Salary   $19,412
 A6790-58800  Fringes         7,571
 A6790-52210  Office Equipment        455
 A6790-54303  Supplies         500
 A6790-54330  Printing        1,500
 A6790-54414  Local Mileage          200
 A6790-54412  Travel/Training          500
 A6790-54400  Program Expense         250
 A6790-54491  Subcontract     19,612
SEQR ACTION:  TYPE II-20

Mental Health

Position Request - Secretary

  It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, to approve the position request for Secretary, at a hire rate of $32,641, with no local funding.  Mr. DeLuca stated this position would be filled by the incumbent provisional employee and may provide future staff reduction following an analysis of the new electronic system for client files that is now in progress.  The funding for the position is through reimbursement for other division clinical programs.  This individual is responsible for maintaining client files.  The individual has been in this department twelve years and is at the appropriate level for the civil service listing.  Mr. DeLuca explained that although not mandated, when a Medicaid audit occurs it is the clinical records that are reviewed for verification, therefore this is a necessary position to fill.  At this time there are between 1,100 and 1,300 medical records to be maintained, with 32 clinic staff needing up-to-date access to records.  A voice vote of members present unanimously approved the position.  POSITION APPROVED.

RESOLUTION NO.      - INCREASE IN HOURS – PRINCIPAL ACCOUNT CLERK TYPIST - MENTAL HEALTH

 Mr. DeLuca explained this position is the main connection to insurance company billing for clients.  The addition of hours will provide additional electronic billing submission as well as providing cross-referencing for client records.  It was explained that no funding was requested, as Mr. DeLuca believes he can offset the increase within the present budget due to the vacancy of a lower position.

 It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, and unanimously approved by voice vote of members present, to present the following resolution to the full Legislature for consideration.

WHEREAS, the Principal Account Clerk Typist is required for billing of multiple private insurance companies, assisting in negotiating rates with those companies, accepting client fees and other billing functions for the Mental Health Department, and
               WHEREAS, Private pay insurance payments to the Tompkins County Mental Health Clinic has increased one hundred percent from 1998-2004, and
 WHEREAS, the duties and responsibilities of the Principal Account Clerk Typist position are such that they can only be efficiently accomplished in a forty-hour workweek because of additional duties regarding electronic billing and electronic records that are now necessary, and
 WHEREAS, this increase in hours will enable us to delay hiring or leave vacant a full time position depending upon future needs regarding the transition to electronic records, now therefore be it
 RESOLVED, on the recommendation of the Human Services Committees, That one position of Principal Account Clerk Typist (11-673) competitive class be hereby increased from 35 to 40 hours per week effective immediately,
RESOLVED, further, That no additional County funding is necessary at this time.
SEQR ACTION:  TYPE II-20

Update on 2006 Budget

 Ms. Blanchard, liaison for Mental Health Services Board, expressed her appreciation for the manner in which the Board is reviewing and recommending various budget alternatives.

 Mr. DeLuca said the Board has gone through many scenarios to come to a balanced budget to present to the Legislature.  It involved strategies including new grant sources, and consolidation of administrative staff and case management tasks.  He said the goal was to not have OTR's for operations as well as avoid layoffs.  If a requested grant for the OASIS program is received it will provide $170,000, and existing County funds could then be used for case management.  In addition, it would assist in hiring a Deputy Commissioner and Child Psychologist.  He stated there presently is a waiting list for children’s services, which is relatively unusual and is cause for concern.

Mr. DeLuca explained the two OTR's in the technology and facilities areas.  The first facility request is to upgrade the secure access system for the building as the present system is obsolete.  The second facility request is to provide a canopy or similar structure for the protection of clients standing out of doors.  These requests will cost approximately $24,586.  In the area of technology, there is a request to update the server as well as provide some desktop upgrades.  The present server is out of warranty and the upgrade will allow lower licensing costs, therefore providing greater speed and capability with little or no additional cost.  With regard to the computer hardware request, it will allow the department computers to be compatible with each other as well as upgrade older printers.  This will be very important as the department moves to an all-electronic environment.  Ms. Robertson stated she could not support funding a smoking shelter.  Mr. Whicher said the clientele for Mental Health are often immediately outside the main entrance and the intent is to free the entrance of clients loitering to smoke or otherwise be outdoors.

Mr. DeLuca said he is also concerned about ease of access/egress for handicapped individuals.  He toured with a handicapped individual and witnessed areas in which it was difficult to maneuver.  He is looking at modifications to allow for better maneuverability, and part of the OTR is for automatic door openers.  Ms. Carey noted the Department of Social Services is also investigating the same problems with doors in her building.

Mr. Proto left the meeting at this time (11:15 a.m.).

Approval of Minutes for June 1 and July 6, 2005

 It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, and unanimously approved by voice vote of members present, to approve the minutes of June 1 and July 6, 2005.  MINUTES APPROVED.

Lifelong Update

 Mr. Hawley, Executive Director, said the Human Service Coalition was recommending funding for Lifelong at the same level as last year.  He said he is grateful for County support as other funds received do not assist with the operating expenses and therefore the County funding is critical.  He said outreach is provided to provide health insurance information to Dryden Senior Housing and McGraw House.  Ms. Blanchard asked if there were activities outside of the headquarters and was informed that some occur, however consistent involvement is sometimes difficult which makes outside programming cost prohibitive.

Youth Services

 Ms. Zahler said she presented OTR information in June.  She is requesting to partially restore a planner in order to track youth needs, improve program performance, and assist with grants.  Additionally, OTR's are requested to increase the base salaries of program managers to improve quality and continuity of services, preserve teen jobs at higher minimum wage, place twenty teens in the Learn to Earn program, and restore the County to full partnership status in the intermunicipal Recreation Partnership.  The total if approved for the OTR's is $81,488.  She noted that her department has seen a 19% reduction in funding over the past four years that has affected a variety of factors.  The programs funded have been reduced from 21 to 12, youth served has decreased from 2,500 to 2,000, and although there are 6 FTE positions in the department only 4.5 FTE are funded by the County.  She spoke of the positive impact having a planner makes, particularly with the new mandate to have a single plan that is coordinated with the Department of Social Services.  Ms. Robertson noted that the Department of Social Services’ monthly report indicated that juvenile programs were over budget at this time of the year.  She believes that programs to prevent the need for high-cost services such as foster care are beneficial.

 A brief discussion took place regarding youth requiring placement.  Ms. Zahler said the decrease in programs due to budgetary constraints would have an effect on the outcomes.  Ms. Blanchard expressed dismay that families seem to be denying responsibility to correct children's behaviors.  Ms. Robertson said at the Family Court Advisory Council it has been recognized that suspension of students is not an effective response when difficulties occur in the school.  These children are then very often "out on the street" and unsupervised due to parents' employment.  An attempt is being made to develop an alternative such as an assigned location for students who are suspended from their schools.  Ms. Zahler said the most effective programs recognize parents want to be responsible and are actively engaging the family.

Health Department

 The Committee reviewed written material relating to the proposed 2006 budget.  Ms. Grinnell-Crosby noted that the OTR's include maintenance of effort requests for three positions, a maintenance of effort request for vehicles, and two requests to replace staff previously cut from the department.

Home Care Program

 Ms. Connors spoke of the increases in several of the programs as well as regulatory changes.  She said one significant change is that Medicare will be tying revenue to quality standards.  She explained there are eight scopes of work that will be reviewed under this standard.  Ms. Connors explained the team leader requested is important to this initiative and was cut in prior budget years.  As a result of the lack of a team leader the unit has suffered and the high standards the department held in previous years have dropped without this position.  In addition, the communicable disease program has had outbreaks every year of a variety of diseases that further strains the department.  Mr. Whicher noted the Cornell University tuberculosis screening has helped to contain possible outbreaks.

Early Intervention Program

 Ms. Allinger of the Early Intervention/Children with Special Needs programs spoke of the increase in referrals from 13 in June to 33 so far this month.  The New York State Department of Health continues to update and modify regulatory process resulting in an increased amount of monitoring and tracking required for each client.  The caseloads are still in the 50's rather than the recommended caseload of 30.  She explained the requested keyboard specialist would be responsible for transcription of 90 percent of notes relating to the clients, within a week of receipt.  By providing a transcription method it allows the staff to maintain the higher caseload.  Ms. Allinger spoke of the request to replace the Team Leader in her program that was eliminated previously.  She said it is critical to have it filled to provide the oversight to track and monitor the children at risk.  Ms. Blanchard suggested the possibility of utilizing the voice recognition programs available or a laptop as an alternative to the transcription process.  Ms. Allinger said voice recognition software is currently in the development stage, and would not be able to adequately transcribe the information.  She will continue to review the programs as they become available.  She did note some forms are available to the employees on computers and the division is moving to laptops.

Department of Social Services

 Ms. Robertson called attention to the notation from Mr. Herden that due to earlier accounting decisions, one quarter of the Medicaid overburden reimbursement would not be forthcoming; due to changing mechanics of funding Medicaid, there will be no more overburden aid from the state.

 Mr. Herden reported the 2006 net local budget submitted is $678,000 less than the 2005 amended net budget, including the OTR's, for a net local share of $217,000.  If the OTRs are not approved, the local share cost will decrease from the 2005 budget by $895,000.

 Mr. Herden said the figures submitted are estimates because at this time it is not clear what the exact calculations are; it is based on year to date costs and projections combined with information known regarding the cap.  The State will not provide any figures on the “base year” calculations until November, at which time preliminary figures will be received.  A final figure will not come forward until July 2006.  Although the State Department of Budget and the New York State Association of Counties had promised estimates last month nothing has been received to date.  The figures for the budget may require adjustment, up or down, as the budget process proceeds.

 Mr. Herden then spoke of the uncertainty of the funding under the new Flexible Fund For Family Services block grant program created by New York State that consolidates what was TANF funding.  Due to restructuring the manner in which funds are disbursed by giving the State options versus specific designations, it may necessitate a reduction or elimination of contracts with agencies next year if the anticipated funding is not forthcoming.  He stressed that without knowing what the State allocation for next year will be it is impossible to accurately determine funding.  Mr. Whicher said he would defend the department's fund balance because of the unknown outcomes from the State.

 Mr. Herden spoke of two areas that cause concern:  (1) work participation sanctions that require a certain percentage of those receiving assistance to be employed, as outlined by the Governor, and (2) foster care Federal audits.  He said the Federal guidelines for work participation may be different than the State guidelines and could have the potential of severe sanctions.  Ms. Carey said locally the percentage of those working is 37-38% and within the State's average.  If TANF reauthorization goes through the Federal guideline of approximately 70% would take effect. All counties are concerned about this.  With regard to the foster care program, Federal audits will be taking place in October; we have passed state audits in the past with no errors.  The audit will become a determining factor for funding within the State; if larger communities such as New York City do not pass, the potential funding reduction may be spread out statewide.

Tabled Items

 Due to lack of quorum because Ms. Kiefer had to leave, Ms. Robertson tabled the agenda items for Human Services Coalition, Tompkins Community Action, and Cooperative Extension.

Calling a Meeting

 Due to the lack of quorum, Ms. Robertson, Chair, determined to call a meeting of the Committee for 3:00 p.m., August 16, 2005, in the Scott Heyman Conference Room to complete items from this agenda.

Adjournment

On motion, the Committee adjourned at 12:07 p.m.

Respectfully submitted by Karen Fuller, Deputy Clerk