APPROVED MINUTES
HEALTH AND HUMAN SERVICES COMMITTEE
SPECIAL MEETING
AUGUST 13, 2002       1:00 P.M.
SCOTT HEYMAN CONFERENCE ROOM


Present:    D. Winch, Chair;  D. Booth, M. Robertson, F. Proto

Excused:  N. Schuler

Staff:   Irene Stein, Office for the Aging; M. Dolan, Department of Social Services; A. Cole, and
E. Brazauskas  Health Department; N. Zook, and Kris Bennett, Youth Bureau; S.
Whicher, Administration; N. Burston, M. Fisher, and J. Hart, Human Services Coalition;
B. DeLuca, Mental Health; K. Fuller, Recorder

Call to Order

    Chair Winch called the meeting to order at 9:00 a.m.

Discussion of Budget Review Meetings

     Chair Winch and the Committee members discussed when to hold the September program committee budget review meetings.  Consensus was reached on the following dates:

September 9, 2002 – 7:00 p.m. – 9:00 p.m. – Budget Review
September 10, 2002 – 8:00 a.m. – 11:00 a.m. – Regular Meeting - Action Only Items followed by Budget
    Reviews
September 18, 2002 – 1:00 p.m. – 3:00 p.m. – Budget Review
September 19, 2002 – 7:00 p.m. – 9:00 p.m. – Budget Review

Approval of Minutes of July 9, July 15, and July 18, 2002

     It was MOVED by Mr. Booth, seconded by Ms. Robertson and unanimously approved by members present to accept the minutes of July 9, 2002 as amended, and July 15 and July 18, 2002 as submitted.

Department of Social Services

     Ms. Dolan expanded upon information received in Mr. Herden’s monthly report relevant to an apparent increase in costs for services associated with the Franziska Racker Center.  She indicated that the  increased costs are due in part to a State Health Department approved rate increases for services that include a 3 percent cost of living increase, 3.5 percent trends increase and approximately 3.25 percent retroactive rate increase. She noted that an individual client may reside in a location that is fully funded, yet still carrying local share expenses for a different service they are receiving.  The process of determining exact cost to the County to project subsequent budget year expenses is therefore difficult.  Ms. Dolan said the number of individuals served in a community based waiver sites is finite; however there is a shift of where the funding comes from.  She noted that funds previously from the State budget and now are from Federal dollars and the manner in which payments are made varies.  Ms. Dolan said she is working with the County Administrator and Mental Health Director to determine the extent of overburden and when to anticipate reimbursement of funds.

     Mr. Proto inquired about unfilled positions within the Department of Social Services.  He requested a summary that would provide the number of unfilled positions and whether a request to fill them had been made to the Fiscal Management Committee.  Ms. Dolan said she was asked to provide the number of positions coming forward to the 2003 budget process, what is the turn-over in the department, and she is adding what the impact of employee absence due to disability is.  Mr. Winch asked that a summary be provided to all Board Members.

RESOLUTION NO. APPROVAL OF THE DEPARTMENT OF SOCIAL SERVICES THREE-YEAR CONSOLIDATED CHILDREN’S SERVICES PLAN – ANNUAL UPDATE

     MOVED by Ms. Robertson, seconded by Mr. Proto.  Ms. Dolan explained the report and the manner in which it was developed to Committee members.  Mr. Proto inquired whether the PINS information is incorporated within this report.  Ms. Dolan said that it was a separate plan that was the result of the changes in the law. Ms. Robertson said she appreciated the work that went into this report.  A voice vote was taken by all members present and it was unanimously approved as amended.  MOTION CARRIED.

     WHEREAS, the New York State Office of Children and Family Services (OCFS) has required the Department of Social Services to develop and submit an Annual Update to the Consolidated Children’s Services’ Three-Year Plan which covers children’s services for the period of January 1, 2002 to December 31, 2003, and
     WHEREAS, County Administrative Policy 01-35 states that “plans whose public participation requirements mandate advertising in newspapers of general circulation must be approved by the Board of Representatives upon review by the County Administrator and the appropriate program committee,” and
     WHEREAS, such advertising was required with regard to the Plan’s development, and
     WHEREAS, the County Administrator and the Health and Human Services Committee have reviewed the Department’s Plan, now therefore be it
     RESOLVED, on recommendation of the Health and Human Services Committee, That the Annual Update to the Department of Social Services Three-Year Consolidated Plan for Children’s Services is approved.
SEQR ACTION:  TYPE II-20

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Charter Review

     Moved by Mr. Booth, seconded by Mr. Porto.  Mr. Winch inquired whether Ms. Dolan was present at the Charter Review meeting and concurred with the suggested changes to the Charter.  Ms. Dolan said she was present and did concur.  Mr. Booth inquired whether Mr. Wood, County Attorney, was in agreement with the language involving attorneys.  Ms. Dolan said she believed Mr. Wood was in agreement.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

Creation Of A Dental Case Manager (Senior Social Welfare Examiner)
 
     Members of the Committee discussed the position that is to be proposed for consideration in the future.  Questions regarding funding for the position were responded to by Ms. Dolan.  She explained that rollover funding would be available for a portion of this position from 2000 and that this position should be adequately covered in the proposed 2003 budget, however, there would be Medicaid expenses incurred for the Medicaid recipients for services rendered over and above the cost for the position.  She said that the cost of this position for the sixteen month period is estimated to be $94,000 with revenue $47,400.  Rollover from 2000 budget will cover the local share cost of $47,000.  She said that there would be an additional local share cost associated with the position under the “A” mandate spending that is not subject to target.  Ms. Dolan said that actual total cost of moving forward for a sixteen-month period would be approximately $74,000.  Suggestions were made that the resolution required for this pilot program to move forward include language that indicates it to be a sixteen month program with a total cost of $75,131.  Also that it include the information that the rollover funding has been approved for this project and that those funds would cover a portion of the sixteen-month pilot program up to $26,613. Members of the Committee decided to request this discussion continue at Committee budgetary meeting in order to enable all Committee members to participate in this discussion as well as allowing Ms. Dolan the opportunity to fully indicate how funding for the program would be set within the 2003 budget.

Health Department

RESOLUTION NO.     - ESTABLISHMENT OF MEDICAID DENTAL CLINIC RATE – HEALTH DEPARTMENT

     MOVED by Mr. Booth, seconded by Ms. Robertson.  Ms. Cole explained that the purpose of the resolution was to enable the Health Department to set a dental clinic rate as allowed by their operating certificate.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

     WHEREAS, the Tompkins County Dental Services Advisory Committee has been charged with the responsibility to find and implement a sustainable solution to meet the needs of Medicaid and certain other low-income individuals for dental care at the most reasonable cost and by the most reasonable target date, and
     WHEREAS, the Tompkins County Dental Services Advisory Committee’s research indicates that the development of a clinic rate to reimburse for dental services is the next step and necessary component to finding a solution and meeting the needs of the Medicaid and low-income eligible, and
     WHEREAS, the County is currently a licensed Article 28 clinic operator, with dental services recognized as an authorized service on the operating certificate issued by the New York State Department of Health, and
     WHEREAS, since the County is already licensed to provide dental services, a Medicaid rate could be established by filing a Medicaid cost report with the New York State Department of Health and an operating budget for the Dental Clinic, and
     WHEREAS, the Tompkins County Dental Services Advisory Committee has recommended that it is advantageous to have a clinic rate established in the event a mobile or free-standing clinic is needed, and
     WHEREAS, the Health Department has an approved contract with Urbach, Kahn and Werlin, Inc., an accounting firm with the expertise to complete the cost report necessary to establish this rate with New York State Department of Health, and
     WHEREAS, local funds in the form of 2000 Rollover have already been approved for this project, now therefore be it
     RESOLVED, on recommendation of the Health and Human Services Committee, That approval is given to the Health Department to request that this cost report be completed by Urbach, Kahn and Werlin, Inc.,
     RESOLVED, further, That the Department of Social Services will pay for these services at a cost not to exceed $10,000 ($2,805 local cost) from the remainder of Department of Social Services’ original $95,000 appropriation.
SEQR ACTION:  TYPE II-20

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Charter Review

    MOVED by Mr. Proto, seconded by Ms. Robertson.  Mr. Winch inquired whether Ms. Cole was present at the Charter Review meeting and concurred with the suggested changes to the Charter.  Ms. Cole said she was present and did concur.  Mr. Booth inquired whether the change from water systems to supplies would provide enough authority to deal with that particular area of environmental health.  Ms. Cole said that she felt it was appropriate. A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

Bernie Bus Services, Inc.

     Moved by Mr. Proto, seconded by Ms. Robertson.  A discussion took place regarding the requested rate increase for Bernie Bus Services, Inc.  This increase is part of the renewal option for the services.  Birnie Bus Services, Inc. by their agreement would have had an option to request a higher amount, however, taking into account the difficult budget year is asking for 1.7%, which is the year-to-date Consumer Price Index increase for New York.  Committee members inquired whether the firm is meeting the expectations of the Health Department.  Ms. Cole indicated they were.  Questions regarding annual costs, ways to save money, and the purpose of the different rates involved were asked and responded to.  A voice vote was taken by all members present to approve the increase and it was unanimously approved.  MOTION CARRIED.

     Ms. Robertson said she had received numerous letters from parents requesting that budget cuts not be made in areas that are presently serving their children.  She inquired whether the services described are mandated, and therefore, not subject to cuts.  Ms. Cole said that while many parts of these programs are mandated, some areas that do not immediately effect the program may be subject to cuts.

Office for the Aging

Charter Review

    MOVED by Ms. Robertson, seconded by Mr. Booth.  Mr. Winch inquired whether Ms. Stein was present at the Charter Review meeting and concurred with the suggested changes to the Charter.  Ms. Stein said she was present and did concur.  Mr. Proto asked if there was any changes to the Office for the Aging Advisory Board that might require a change in the Charter.  Ms. Stein indicated she was not aware of any.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

RESOLUTION NO.      - AUTHORIZATION TO EXECUTE A CONTRACT WITH  CORNELL UNIVERSITY TO DEVELOP A COMMUNITY CONVERSATION ON CAREGIVING AND AN ASSOCIATED CURRICULUM FOR THE PERIOD OF AUGUST 1, 2002 THROUGH JULY 31, 2003 - OFFICE FOR THE AGING

     MOVED by Mr. Proto, seconded by Mr. Booth.  Ms. Stein informed the Committee that this resolution is to provide training of individuals to increase public awareness of the importance of elderly care.  She said that the program is a joint effort with Cornell University Gerontology Research Institute, Division of Human Development, and that they will be providing funding for this project.  Once completed, this curriculum will be presented at two other sites.  Ms. Stein felt this was an excellent opportunity to receive some funding for a program that the Office for the Aging would like to develop to raise community awareness.  Suggestions were made by Mr. Booth to amend the wording of the resolution.  Mr. Proto inquired about Ithaca College’s involvement in this project.  Ms. Stein replied that they are involved as a member of the coalition.  A voice vote was taken by all members present and it was unanimously approved as amended.  MOTION CARRIED.

    WHEREAS, caregiving of elders is becoming more common as the number of elderly increases, and
    WHEREAS, the Office for the Aging has identified a need for a community conversation on caregiving, and
    WHEREAS, Cornell University Gerontology Research Institute, Department of Human Development, wishes to enter into a contract with Tompkins County that enables the Office for the Aging to present and in-service training to educators and representatives from agencies in other counties on how to develop such a community conversation, now therefore be it
    RESOLVED, on recommendation of the Health and Human Services Committee, That the contract with Cornell University in the amount of $10,500 to develop a community conversation on caregiving and an associated curriculum, and to organize and conduct in-service training in two sites on how to develop a community conversation on caregiving be approved for the period August 1, 2002 through July 31, 2003,
     RESOLVED, further, That the Finance Director is hereby authorized to make the necessary budget adjustment as follows:

 REVENUE:               6773.42797      Cornell University Caregiver Training   $10,500
 
 APPROPRIATION:  6773.51000215                            Salary                     $  7,692
                                   6773.58800                                  Fringe                         2,045
                                   6773.54414                                  Local Mileage                113
                                   6773.54330                                  Printing/Copying             300
                                   6773.54472                                  Telephone                      150
                                   6773.54452                                  Postage                          200
                                             TOTAL                                                             $10,500
SEQR ACTION:  TYPE II-20

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Budget Adjustments

     MOVED by Mr. Booth, seconded by Ms. Robertson and unanimously approved by voice vote of all members present to approve the following budget adjustments.  MOTION CARRIED.

Office for the Aging (#49)
Revenue Acct  Title   Amt      Approp Acct      Title(s) ______
6777  43803       State Revenue         $3,518     6777  54491      Subcontract
Explanation:  Increase in State revenue permits increase in subcontracts for CSE program.

Office for the Aging (#50)
Revenue Acct  Title   Amt      Approp Acct      Title(s) _____
6774  43803        State Revenue         $    23         6774  54491      Subcontract
Explanation:  Increase in State revenue permits increase in Foodnet subcontract for SNAP program.

Office for the Aging (#51)
Revenue Acct      Title                           Amt           Approp Acct      Title(s) _____
6781  44772       Federal Revenue        $2,459.42  6781  54400      Program Expense
Explanation:  Revenue Increase permits additional respite hours for Title III-E (Project Care)

Office for the Aging (#52)
Revenue Acct      Title                           Amt           Approp Acct      Title(s) _____
6772  44772       Federal Revenue        $1,794       6772  51000559    Salary
6772  44772       Federal Revenue        $   466       6772  58800     Fringes
6772  44772       Federal Revenue        $1,000       6772  54491          Subcontract
Explanation:  Increase in Federal Revenue permits coverage of Aging Services Specialists salary and fringes in Title III-B.  Increase in Federal Revenue permits increase in subcontract for publishing one more issue of the “Senior Circle.”

Office for the Aging (#53)
Revenue Acct      Title                           Amt           Approp Acct      Title(s) _____
6780  43803       State Revenue       ($4,115)          6780  54991      Subcontract
Explanation:  Error in calculations of reappropriated State monies requires reduction in home care contracts.

Office for the Aging (#54)
Revenue Acct      Title                           Amt           Approp Acct      Title(s) _____
6795  44772       Federal Revenue        ($603.57)  6775  51000559  Salary
6795  44772       Federal Revenue        ($156.93)  6775  58800        Fringes
Explanation:  Decrease in Federal Revenue makes it necessary to decrease the Aging Services Specialist salary and fringes in Title III-D (Medication Management).

Office for the Aging (#55)
Revenue Acct      Title                      Amt           Approp Acct      Title(s) _____
6771  43803       State Revenue       $200        6771   54414      Local Mileage
Explanation:  Revenue increase permits increase in much needed local mileage for State Ombudsman program.
SEQR ACTION:  TYPE II-20

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Youth Board

Updates

     The Committee reviewed a written report received from Ms. Zahler.  Ms. Robertson inquired how much staff time was expended obtaining funds from the State and other sources.  Ms. Bennett indicated that the goal is to spend the least amount of time possible and that the hope is to provide coordinated services for all municipalities for the funds received.  Mr. Proto inquired whether the grant of $100,000 capital funds would, if successful, make a tacit commitment to anything else.  Ms. Zook said that this was funding obtained through Assemblyman Luster’s office.  She said that they are determining the best way to utilize these funds in an appropriate manner.  These funds are a result of Mr. Luster’s staff seeking funding for respite services.

RESOLUTION NO.  -  APPROVAL OF 2001-2003 COMPREHENSIVE YOUTH SERVICES PLAN UPDATE

     MOVED by Ms. Robertson, seconded by Mr. Booth.

    WHEREAS, Tompkins County is required to develop a County Comprehensive Youth Services Plan to qualify for $397,867 in State Aid from New York State, and
    WHEREAS, the New York State Office of Children and Family Services requires that the Strategic Component of the County Comprehensive Interim Plan submitted for 2001-2003 be updated by July 2002, and
    WHEREAS, the update has been prepared by the Tompkins County Youth Bureau and approved by the Youth Board as required, and
    WHEREAS, the New York State Office of Children and Family Services requires that the Strategic Component of the Interim Annual Plan Update be signed by the Chief Elected Official, now therefore be it
    RESOLVED, on recommendation of Health and Human Services Committee, That the Tompkins County Board of Representatives approves the Tompkins County Youth Bureau’s 2002 Update to the 2001-2003 County Comprehensive Youth Services Plan,
    RESOLVED, further, That the Chairman of the Board of Representatives be and hereby is authorized to sign the Interim Annual Plan Update - Strategic Component for 2002- 2003 as required by New York State.
SEQR ACTION:  TYPE II-20

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Charter Review

    MOVED by Mr. Booth, seconded by Ms. Robertson.  Mr. Winch inquired whether Youth Board staff was present at the Charter Review meeting and concurred with the suggested changes to the Charter.  Ms. Zook said the Youth Board did concur.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

Youth Board Appointments

     It was MOVED by Mr. Booth, seconded by Ms. Robertson, and unanimously adopted, to submit the following appointments to the full Board for approval:
Joel Lewenstein – Youth Representative – term to expire August 31, 2003
Sloan Sheridan-Thomas – Village of Freeville Representative – term to expire December 31, 2002

Request for Information

    County Administrator, Steve Whicher, requested a flow chart be provided that would indicate the interaction of the various agencies involved with the Youth Bureau and how the youth are served.  He felt that it would be useful to follow funding of the various programs.  Mr. Whicher said that he is achieving a greater understanding of the complexity of the Youth Bureau and its relationship with other agencies.

Review Cost Effectiveness Indicators

     Ms. Bennet and Ms. Zook provided the Committee with written information regarding cost effectiveness indicators for a variety of programs.  This report shows the effectiveness of spending dollars on programs that will assist in the future need of more costly expenses associated with youth.  Questions were asked about parental involvement in programs designed to assist the entire family’s needs.  Ms. Zook said that every effort is made to involve parents to the extent possible and to maintain a level of involvement to assist the youth without becoming a surrogate parent.

Mental Health Department

Charter Review

    MOVED by Mr. Booth, seconded by Mr. Proto.  Mr. Winch inquired whether Mr. DeLuca was present at the Charter Review meeting and concurred with the suggested changes to the Charter.  Mr. Deluca said that he did see an item to change – Section 13.01 – Duties of the Commissioner should read “Government Unit and Community Mental Health Center.”    Mr. Proto said that he felt that a modification should take place under Section 13.02, Section (e).  He felt that the language stating “from time to time” was not clear enough.  Following discussion, consensus of the Committee was that the suggested statement “Such plans shall be reviewed from time to time” to “or as required by the New York State Department of Mental Hygiene regulations.”  The last change suggested was that Section 13.00 be amended to indicate that it is the “State Commissioners of Mental Health, Mental Retardation, and Substance Abuse” who appoint the Commissioner.  A voice vote was taken by all members present and it was unanimously approved as amended.  MOTION CARRIED.

Advisory Board Review

     Members of the Committee held a discussion regarding the current advisory boards.  It was decided that the County Attorney or Government Operations Committee be asked to provide members with a list of what advisory boards are required by law so that a better determination of effectiveness and necessity of advisory boards be made.  The other issue discussed to be passed on to the Government Operations Committee,  was the need to develop a system for attendance accountability at advisory board meetings.  The Committee felt that absences quite often created a situation that would not allow advisory boards to conduct their official business in an appropriate fashion.  Members felt that it was important that individuals appointed maintain an adequate attendance rate and that in addition to a record of attendance it is necessary to develop a means to notify individuals of removal from advisory boards in the event their attendance requirements are not met, and recommend rules for this procedure.  Mr. Proto felt that it would be appropriate for the advisory board staff take the first step in notifying members of the possibility of removal from the board due to absence.  Mr. Winch felt that copies of attendance sheets should be submitted to the Board office prior to the reappointment of individuals for advisory boards.

Adjournment

     The meeting adjourned at 11:11 a.m.

Respectfully submitted, Karen Fuller, Deputy Clerk

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