Staff:  E. Brazauskas, A. Cole, Health Department; M. Dolan, Social Services; I. Stein, Office
for the Aging

Call to Order

Chair Winch called the meeting to order at 8:02 a.m.

Approval of Minutes of August 13 and 20, 2002

  It was MOVED by Mr. Booth, seconded by Ms. Robertson and unanimously approved by  members present to accept the minutes of August 13 and 20, 2002 as amended.

Health Department

 MOVED by Ms. Robertson, seconded by Mrs. Schuler.  A discussion of the following resolution occurred during which time Ms. Brazauskas explained was in response to information received concerning proposed changes in the Early Intervention Program reform that would change from a fee schedule to a tuition rate and the impact it would have on the program.  Ms. Brazauskas explained that at the present time service providers compete to provide the best available rate for services rendered.  New York City lobbyists are attempting to put through legislation that would have a flat rate for services.  She said that if it was successful it would be set up in a manner that would not provide accountability for services.  The purpose of the resolution is to maintain the present fee structure and to request that the Governor look at the current rate structure with references to accountability of providers, and making decisions on clinical judgment rather than input from a lobby group.  She said Tompkins County presently has one agency and thirty-five service providers.  The change in the structure could potentially create a problem as the agency would most likely not be able to accommodate all the clients.  Members of the Committee supported the principles outlined by Ms. Brazauskas; however, felt that the resolution itself needed to be rewritten to more clearly explain its purpose.  It was agreed by the Committee that the resolution would be rewritten prior to presentation to the full Board.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.

RESOLUTION NO. - URGING THE COUNTY REFORM AGENDA REGARDING EARLY INTERVENTION RATE RESTRUCTURE – HEALTH DEPARTMENT
 

WHEREAS, in the interests of children, families and taxpayers of Tompkins County, and
 WHEREAS, the Tompkins County Health Department supports the five point recommendations by the New York State Association of Counties regarding the proposed the Early Intervention rate restructure, and
 WHEREAS, the first point is to promote the consultant model of service delivery to meet the family’s outcomes for their child, and the Consultant model should reflect child-specific developmental expectations that address the family’s resources and priorities rather than recommend “any or desired” service, and
WHEREAS, the second point is to revise the current service taxonomy rather than create a new process, and
WHEREAS, the third point recommends continuing using the current rate methodology until a new process has been demonstrated to be successful, and that there be consensus with a new rate methodology among the stakeholders of the Early Intervention Program, and

WHEREAS, we do agree to New York State Department of Health and County monitoring to work towards the goal of increased accountability in the maintenance of independent and agency providers, and
WHEREAS, we believe that every effort must be made to more equitably distribute the financial responsibility of this statewide program, to reduce the current disproportionate burden on local tax dollars, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee, That the Tompkins County Board of Representatives urges Governor Pataki and the New York State Legislature to consider all of the counties, families, private providers and agency providers of the Early Intervention Program regarding the reassessment of the Early Intervention financial structure, and
 RESOLVED, further, That the Board of Representatives shall forward copies of this Resolution to the New York State Association of Counties, Governor George E. Pataki, the New York State Legislature and all others deemed necessary and proper.
SEQR ACTION: TYPE II-20

Department of Social Services

RESOLUTION NO.         – APPROVING AN AGREEMENT WHEREBY THE DEPARTMENT OF SOCIAL SERVICES WILL PAY THE TOMPKINS COUNTY EMPLOYEE CREDIT UNION’S FEES FOR GENERATING MONEY ORDERS FOR CASH-PAYING DEPARTMENT OF SOCIAL SERVICES CLIENTS

 MOVED by Mrs. Schuler, seconded by Ms. Robertson. Ms. Dolan explained that in order to provide a secure method of receiving funds required of clients an agreement was made with the Tompkins County Employee Credit Union and that it would be cost effective.  A voice vote was taken by all members present and it was unanimously approved.  MOTION CARRIED.
 
WHEREAS local social services districts are mandated by New York State to accept cash payments and repayments from certain current and former recipients, and
WHEREAS, both the quantity and the sums involved in these transactions have increased significantly in recent years and are expected to continue increasing, and
WHEREAS, the Tompkins County Department of Social Services (DSS) desires to both simplify its processes for managing these transactions and to decrease its exposure to the risks inherent in handling cash, and
WHEREAS, the Tompkins Employees Federal Credit Union is conveniently co-located in the Human Services Building and is able and willing, so long as their money order origination fee is covered, to accept cash from DSS-referred clients in exchange for money orders of equal value made payable to the Department, and
WHEREAS, the cost of paying those fees will be less expensive to the Department than would other options for meeting the requirements, now therefore be it
RESOLVED, on recommendation of the Health and Human Services Committee, That the Department of Social Services is authorized to enter into an agreement with the Credit Union to implement the relationship described above.
SEQR ACTION: TYPE II-20

Explanation: The Department of Social Services is mandated to accept payments from a variety of former and current recipients.  Some of these transactions are re-payments of benefits previously issued; others are more like deposits which guarantee the payor’s eligibility for Medicaid coverage.  At present some of these payments take the form of checks and money orders, but many are made in the form of currency.

The department’s Receptionists take in cash payments at the Front Desk, an area frequently busy, noisy, and crowded on both sides of the counter.  As the number and value of the cash transactions has grown in recent years, so have the problems associated with managing the cash transactions in this milieu.

The Credit Union is much better suited to handling cash transactions, is ideally located to serve our clients, and has agreed to issue money orders to our payor clients on a trial basis.  At $.50 per money order issued, it is anticipated that the fees paid by the Department to the Credit Union will amount to approximately $750 dollars annually.

Alternatives to the proposal outlined in this resolution were considered and rejected as being ineffective, impractical, and/or too costly.  These included:  bonding reception area staff; restricting the days and times of day during which cash payments will be accepted; designating an alternative, DSS-staffed area for accepting cash payments; and assigning Accounting Unit staff to accept cash payments in the reception area.

Monthly Report

 The Committee briefly discussed various portion of the monthly expenditure reports provided.  Ms. Dolan said that she and Mr. Herden will meet with the Franziska Racker Center in the near future to reconcile accounts so that everyone understands how funds are being spent.  She said she does not anticipate any decline in Medicaid costs.  She also reported that we are presently in the fifth quintile of enrollment within the State for the Family Health Plus and the number of participants in the program increases monthly.

Office for the Aging

 It was MOVED by Mr. Proto, seconded by Ms. Robertson, and unanimously adopted by voice vote of members present, to submit the following budget adjustments to the full Board for approval:

Office for the Aging
Revenue Acct  Title    Amt  Approp Acct Title(s) ______
6871.44772  Federal Revenue  $262  6781.54414 Local Mileage
Explanation:  Revenue increase permits increase in mileage for Aging Services Specialist and Project Assistant for Title III-E (Project Care).

Office for the Aging
Revenue Acct  Title    Amt  Approp Acct Title(s) ______
6778.41972  Charges Program for Aging $446  6778.51000517  Salary
6778.41972  Charges Program for Aging $116  6778.58800      Fringes
6778.41972  Charges Program for Aging $300  6778.54330        Printing
6778.41972  Charges Program for Aging $100  6778.54414       Local Mileage
6778.41972  Charges Program for Aging $351  6778.54452     Postage
6778.41972  Charges Program for Aging $300  6778.54472       Telephone
Explanation:  Additional contract monies in HEAP to cover costs rather than from local dollars.

Office for the Aging
Revenue Acct  Title    Amt  Approp Acct Title(s) ______
6796.42801  Interfund Revenue  $2,897.37 6778.51000517  Salary
Explanation:  To accommodate county accounting

Community Conversation

  Ms. Stein provided the Committee with an update on the program being created to raise awareness of the needs of caregivers.  She noted that the majority of individuals requiring assistance are provided this through family members.  As the numbers of elderly increase, so will the needs of families to understand the needs and seek information, counseling, information on diseases, support groups, etc.  The program currently being developed will provide the opportunity to discuss this ever-growing problem and assist individuals in actively seeking assistance when they are called upon to care for elderly family members as well as seeking volunteers.   The Community Conversation that was approved in a previous resolution is an opportunity to increase public awareness through the use of media in the form of a series of articles within the Ithaca Journal as well as a television broadcast on the subject.  Subsequent to the television broadcast viewers will be interviewed and their responses will appear in the local newspaper.  The program will be formatted into a curriculum and then presented to members of Cooperative Extension at two locations.  Ms. Stein said the development of this project should take approximately a total of nine months and she will continue to provide updates to the Committee.

 Mr. Winch asked if information on individuals who have elderly relatives living in other communities would be addressed.  Ms. Stein said that it will be a topic addressed in the series.  Requests for information on long-distance care giving are numerous.  Mr. Winch shared his experience with the County Office for the Aging and the assistance and encouragement he was given by Mr. Stoyell in the area of long-distance care giving that was invaluable.

Adjournment

 The regular meeting adjourned at 9:00 a.m.

Respectfully submitted – Karen Fuller, Deputy Clerk