Staff:   I. Stein, Office for the Aging; M. Dolan, Department of Social Services; A. Cole, A.
Balander, C. Chase, and R. Ewald, Health Department; S. Whicher, Administration; M.
Dill, Human Services Coalition; B. DeLuca, Mental Health; N. Zahler, Youth Bureau; K.
Fuller, Recorder

Call to Order

Chair Winch called the meeting to order at 9:02 a.m.

Approval of Minutes of August 19, 2002 and September 10, 2002

It was MOVED by Ms. Robertson, seconded by Mr. Booth and unanimously approved by members present to accept the minutes of August 19, 2002, and September 10, 2002 as submitted.

Mental Health Department

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.

Mental Health (#62)
Revenue Acct  Title   Amt  Approp Acct Title(s) ____
4310.43485  OMH Comm Riv* $40,907  4335.43485 OMH Comm Riv
4310.54400  Program Expense $40,907  4335.54400 Program Expense
4310.43485  OMH Comm Riv $12,180  4318.43485 OMH Comm Riv
4310.54400  Program Expense $12,180  4318.54400 Program Expense
4310.43485  OMH Comm Riv $12,180  4319.42485 OMH Comm Riv
4310.51000  Regular Pay  $12,180  4319.54400 Program Expense
Explanation:  OMH *Reinvestment grant moving to Supportive Case Management (SCM), Intensive Case Management (ICM) Children’s Account, and ICM Adult Account; OMH Reinvestment expenses in SCM, ICM Children’s Account, and ICM Adult Account.

**********
Appointment

MOVED by Mr. Booth, seconded by Ms. Robertson, and unanimously adopted by voice vote by members present to submit the following appointment for full Board approval:

Mental Health Board

Laura L. Chacona - Public/Consumer Seat - term to expire December 31,2002.

Department of Health

Presentation by Environmental Health

Carol Chase, Environmental Health Food Division, provided an oral report to the Committee that outlined the scope of work performed by the employees of the division. When a complaint is received regarding an individual becoming ill after eating in an establishment the worker must act quickly and obtain as much information as possible related to the incident, obtain food samplings, inspect the facility and perform subsequent follow-up and analysis of all the information. She cited one recent case that involved forty individuals becoming ill after ingesting food at an establishment. It required 2.5 full-time staff two weeks to complete all the necessary preliminary information with regard to the case and two more weeks subsequent to complete the necessary paperwork and filing of the information. Also involved during investigative periods is the necessity to quash rumors that may be associated with investigations and numerous calls are received to the office during this process.

At the present time there are 1.5 FTE's in the division and they are required to borrow staff from other divisions in the event of 1arge-scale investigations. She noted that investigations are the priority and that other work, including answering telephone calls, is set aside during this process. She expressed concern that the 1.5 FTE ' s have a difficult time completing all required tasks. The division is responsible for over four hundred facilities and that the lack of manpower will significantly reduce its effectiveness. The requirement of food establishment inspections is having to be reduced from two inspections per year to one, and in high-risk facilities that handle food through many temperature stages, increasing the risk factors. In the past, the division has made every attempt to repeatedly visit these establishments to ensure proper education of workers as well as determine that they are in code compliance. Mr. Ewald said a very large part of the program has been the educational aspect of proper food handling. It was felt that without proper levels of staffing this portion will be less effective and consequently the probability of an increase in calls related to possible food contamination.

A brief period of questions followed during which Ms. Chase was asked if the over target request was to maintain or add staff. It was noted that it was to add. Mr. Booth requested a list of the Department of Health's sanitarians and their assignments.

Next, Ms. Balander, senior sanitarian, spoke of her job duties that included checking of day camps, motels, beaches and pool areas, and handling calls connected to potential rabid animal contact. She shared with the Committee an experience occurring during the summer that involved extensive investigation during evening and weekend hours when a potentially rabid animal attacked an individual at a campsite. The number of people involved from the department was extensive and required expedient handling as some individuals involved were from out of state, as well as the potential for those exposed coming into contact with others during the Grassroots Festival. Numerous investigative work was done, individuals became available to enable pathology of the animal, and it was proven to be rabid and required individuals to undergo the series of rabies shots. She noted that many of the sanitarians are required to be available during non-standard work hours and that dependent upon the nature of the assignments there can be a great deal of stress.

Mr. Proto inquired what would the result of the loss of staff be and was informed that the educational aspect would suffer as the enforcement was mandated. Mr. Winch inquired what would the impact of Pesticide Notification policy be upon the department. Ms. Cole indicated it would require reviewing the assignments and create additional work load on the present employees.

Mr. Booth asked what the cost of the rabies series is. He was informed that it is approximately $3,000 per individual and that any amount not covered by private insurance is paid for by the County.

Next, members of the committee inquired what fees are being charged for special event permits. It was felt that this charge could be increased as a means to support the department.

Youth Bureau

Appointment

MOVED by Mr. Booth, seconded by Ms. Robertson and unanimously approved by members present to submit the appointment of Laura Cooper as a Youth Representative to the Tompkins County Youth Board for a term to expire August 31, 2003 to the full Board for approval. MOTION APPROVED.

Review Status of Recreational Facilities Planning

Ms. Zahler provided a brief update of the Recreational Facilities Planning, noting that the final report from ERA consultants was done. She looked to the Committee for guidance on the Board's position. Members of the committee agreed that inasmuch as there was significant usage and interest by the City Youth Bureau for facilities that they should develop a proposal to be reviewed by the County. Ms. Zahler will hold a brief meeting on October 10, 2002 for interested County parties to assist in determining the next course of action to be taken. Mr. Winch noted that while information from the consultant was not what was hoped for they have earned their contracted amount. He feels that it was a difficult task as the requests of the Recreational Facilities Planning Committee modified the scope of work significantly from its initial task. Mr. Booth noted that he had heard there is possibly a line item related to the facilities within the proposed City budget that reflects a dollar amount received from the City .He was concerned as we presently have not provided a dollar amount for financial commitment in the 2003 budget for this. Mr. Proto questioned whether the end result was a request from the City for the County to take over the facilities. Ms. Zahler did not feel that was the case at this time.

First and Second Quarter Program Statistics From Agencies

Ms. Zahler distributed statistical information of participation of youth in programs offered. She noted that at the half-way point all of the programs are either at the level, or exceeding the level, of participation anticipated. Programs exceeding the anticipated level are: Red Cross Case Management, Day Care Council Teen Pregnancy and Parenting Program, Learning Web Volunteer Program, and the TCA: Primary School Family Support Program. She noted that the Primary School Family Support Program was one item requested in the over-target requests, followed by the Outings Program and the Red Cross Program. She noted that the figures do not include the youth served independently by the Recreation Partnership. Committee members inquired if there is any form of duplication within the figures, i.e., can one child be calculated in more than one program? Ms. Zahler said that due to the nature of the type of programs offered she does not think it likely, however, there may be instances this occurs.

A brief discussion took place regarding the 1 to 1 program and its funding. Ms. Zahler said that the Youth Bureau presently pays for funding to serve 120 County youth. At the present time there are 81 County being served. She explained that the program indicates more participation than the contracted 120 children; however, the 89 additional youth being served are funded by the City of Ithaca Youth Program. Ms. Zahler explained that the process is that the City provides the figures of the cost for serving 120 youth, the estimated number for this year; if we exceed that number we do not pay more, and conversely, if we have a nominal number under the contracted amount we do not reclaim the funds.

Update on Healthy Youth, Vital Communities Planning for 2004-2006

Ms. Zahler informed the Committee that the State requires them to complete a three-year plan and are presently in the middle of compiling this. At this time it is ready to be brought forth to the public for input and review. She indicated that the scope of State requirements is that the plan include all youth up to the age of twenty-one. At the present time they have gathered information to provide historical needs and participation in a variety of programs and are in the process of comparison with other communities in the State. This information will provide a benchmark of where the County lies in the effectiveness of services. She said they are also in the process of compiling a list of youth clubs that exist in the County in order to refer individuals and offer support to the clubs who serve them. The Youth Bureau is working in cooperation with Department of Social Services, Mental Health Department, COMPASS, Health Department, and Day Care Council.

At this time the information obtained will be discussed as it related to this plan during the Youth Leadership gathering in two weeks. The Youth Bureau will also be contacting youth who do not currently participate in activities to seek their input. There will be a Community Forums in the month of November by municipalities to discuss what services are needed for youth and whether it needs to be addressed by the County Youth Bureau.

Mr. Proto inquired whether there will be a comparison provided of the new plan and how it relates to the previous ones. Ms. Zahler said that it could be made available.

Update on Recent Grant Submissions

Ms. Zahler said that the Youth Bureau is submitting a variety of grants. They have applied for a New York State planning grant in the amount of $12,000. She said that if it is not awarded to the Youth Bureau they would possibly have to reduce staff. She then reviewed the variety of grants that they have recently submitted. Ms. Robertson inquired whether the Outings Program is actively seeking grant funding. Ms. Zahler said that the Youth Bureau has provided an informational package that outlines some options available for alternative funding. She said that the Youth Bureau has offered to work with them in an effort to seek funding.

At the present time there is the possibility of contracting with the City of Ithaca to coordinate a Federal grant they had received. The Youth Bureau, for the finds allotted for the coordination and administration of the grant, could effectively provide this service for the City who is not property trained or staffed to do so.

Department of Social Services

RESOLUTION NO.  -AUTHORIZATION FOR EARLY RETIREMENT - DEPARTMENT OF SOCIAL SERVICES

MOVED by Mr. Booth, seconded by Ms. Robertson. Mr. Winch inquired how the vacancies noted; within the resolution would effect the Department. Ms. Dolan said that she has spoken to staff about the vacancies and that a reorganization would be required to in order to effectively complete necessary tasks. Mr. Winch asked how many full time equivalents have been eliminated over the past several years. Ms. Dolan said that seventeen positions equaling 14.5 full time equivalents since April 200 I. Mrs. Schuler asked how the caseloads of the retiring individuals will be distributed. Ms. Dolan said that the cases will be reviewed and distributed during the reorganization, noting that child protective services cases are the priority.  Ms. Robertson inquired on the number of child protective cases served and how they compare to previous years. Ms. Dolan said that the numbers are increasing over time. A voice vote on the resolution resulted as follows: Ayes - 5, Noes - 0, MOTION PASSED.

WHEREAS, the Tompkins County Board of Representatives authorized participation in the 2002 Early Retirement Incentive Program, and
WHEREAS, the following Department of Social Services employees are eligible and have voluntarily chosen to retire during the open period:
Ann Rider, Senior Caseworker
Joan Brock, Senior Account Clerk Typist
Michel Kelly, Case Supervisor
Bill Chapp, Senior Welfare Examiner
and
WHEREAS, this incentive may be used on behalf of any eligible employee who so chooses, provided there is a plan in place that results in a financial savings equal to fifty percent of the base salary of the retiring employee over a two-year period following the retirement, and
WHEREAS, the Department of Social Services has submitted a savings plan as required by the New York State Retirement System, and
WHEREAS, this plan will leave vacant one full-time caseworker, one full-time keyboard specialist, one half-time staff development specialist, and one half-time social welfare examiner thereby realizing the required savings in one year, and
WHEREAS, such plan has been reviewed and recommended by the County Administrator, now therefore be it
RESOLVED, on recommendation of the Health and Human Service Committee, That Ann Rider, Joan Brock, Michel Kelly, and Bill Chapp be authorized to retire under the terms of the 2002 Early Retirement Incentive Program,
RESOLVED, further, That the fiscal target adjustment will be made in one blanket resolution later this year for all those approved for the Early Retirement option.
SEQR ACTION: TYPE II-20

RESOLUTION NO.    -CREATION OF A DENTAL CASE MANAGER (SENIOR SOCIAL WELFARE EXAMINER) -DEPARTMENT OF SOCIAL SERVICES

MOVED by Mrs. Schuler, seconded by Ms. Robertson. A brief discussion followed, during which Mr. Proto inquired if the grant applied for by the Health Department was the funding for the program. Ms. Dolan said that the grant, if received, is additional funding, not reflected in the resolution, for this pilot program. The resolution allows funding through April 2003 from 2000 rollover funds; following this, certification of additional year's rollover would fund it for the continuation. Ms. Robertson inquired what would happen if future funding was not available for the pilot program. Ms. Dolan felt that proceeding with the pilot would provide information and data to determine if this is a viable way to deliver dental services to Medicaid and low-income families. Mrs. Schuler said that having been involved with the committee determining a way to address the problem of dental services for these individuals the pilot would resolve some issues that presently exist. Mr. Proto inquired whether the program could be introduced at another time as not all dentists are willing to work with the program. Ms. Dolan said that she feels there are enough willing to work with the program to make it successful at the present time. A voice vote on the resolution resulted as follows: Ayes - 3 (Schuler, Robertson, Booth), Noes - 2 (Winch, Proto), MOTION PASSED.

WHEREAS, the Tompkins County Dental Services Advisory Committee was charged with choosing a sustainable solution for meeting the dental care needs of Medicaid and certain other low- income individuals at the most reasonable cost and by the earliest reasonable target date, and
WHEREAS, that body's research indicates that the creation of a Case Management Program has the best potential for increasing the services provided to these under-served county residents, and
WHEREAS, as Surgeon General David Satcher describes in the preface to Oral Health in America: A Report of the Surgeon General, "...it is abundantly clear that there are profound and consequential disparities in the oral health of our citizens. Indeed, what amounts to a 'silent epidemic' of dental and oral diseases is affecting some population groups. This burden of disease restricts activities in school, work, and home and often significantly diminishes the quality of life. Those who suffer the worse oral health are found among the poor of all ages, with poor children and poor older Americans particularly vulnerable. Members of racial and ethnic minority groups also experience a disproportionate share of oral health problems.", and
WHEREAS, a case management staff person will be required to assist and support dental office sites, educate and counsel clients, provide feedback mechanisms and coordinate all other aspects of the program, and
WHEREAS, a 15-month pilot program would allow sufficient time for the program to develop and for its effectiveness to be evaluated, 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 the County create a Senior Social Welfare Examiner position within the Department of Social Services to perform dental case management from October 1,2002 through December 31,2003,
RESOLVED, further, That the Director of Finance be directed to execute a transfer of $8,755 from 6010.54442 [Professional Services] to 6010.51000558 [Senior Social Welfare Examiner salary] and also $2,276 from 6010.54442 [Professional Services] to 6010.58800 [Fringes].
SEQR ACTION: TYPE II-20

RESOLUTION NO. -AUTHORIZATION FOR EARLY RETIREMENT- SOCIAL SERVICES COMMISSIONER

MOVED by Mr. Booth, seconded by Ms. Robertson. Mr. Winch said that he wishes Ms. Dolan well in retirement and that she has made his time on the Board very enjoyable. He said he likes individuals who are frank and to the point, and she was such. Ms. Dolan said that she is happy to work next year to assist with the transition that will occur. Ms. Robertson spoke of Ms. Dolan' s history of not accepting an award by herself, but including her entire department and how it shows how much she has cared for those she works for and with. She said the County is indebted to Ms. Dolan for the service she has provided. Mr. Proto spoke of the challenges they have met together. Ms. Dolan said that in her letter to her staff she noted that every day working for the County has been a privilege. A voice vote on the resolution resulted as follows: Ayes- 5, Noes -0, MOTION PASSED.

WHEREAS, the Tompkins County Board of Representatives authorized participation in the 2002
Early Retirement Incentive Program, and
WHEREAS, the Commissioner of Social Services, Mary Pat Dolan, is eligible and has
voluntarily chosen to retire during the open period, and
WHEREAS, this incentive may be used on behalf of any eligible employee who so chooses, provided there is a plan in place that results in a financial savings equal to fifty percent of the base salary of the retiring employee over a two-year period following the retirement, and
WHEREAS, the Department of Social Services has submitted a savings plan as required by the New York State Retirement System, and
WHEREAS, this plan involves the current incumbent committing to part-time, salaried work scheduled through 2003 in order to facilitate a smooth transition during a search for a new commissioner, and
WHEREAS, the required savings will be recouped in one year by leaving certain positions vacant or filled on a part-time basis, and
WHEREAS, such plan has been reviewed and recommended by the County Administrator, now therefore be it
RESOLVED, on recommendation of the Health and Human Service Committee, That Mary Pat Dolan be authorized to retire under the terms of the 2002 Early Retirement Incentive Program,
RESOLVED, further, That the fiscal target adjustment will be made in one blanket resolution later this year for all those approved for the Early Retirement option.
SEQR ACTION: TYPE II-20

Monthly Report
Ms. Dolan said that the HEAP Program is underway and desired to thank Linda Eva and her staff for their work with the summer HEAP Program. Tompkins County was one of the first to take advantage of this program and received over nine hundred applications for this program. Although it was only a fifty dollar award, it assisted many. In the foster care area, there is presently an increase to nineteen. She said that the cost of these placements is between $130,000 to $180,000 per year. She said that some are special education placement and that the child care budget line is an area of concern. Family Health Plus presently has three hundred nineteen participants and the figures will be reflected in a charge for premiums through Medicaid costs. At the present time it is unknown what this figure will be until sometime in 2004. At the present time there are discussions with a potential vendor of Family Health Plus in our area. Mr. Winch asked if HEAP funding might be increased due to the higher costs. Ms. Dolan said she has not yet had any confirmation but feels it might have a small increase. Ms. Dolan said that her staff is looking into areas to assist in heating costs and do so in a manner not to jeopardize other benefits they may be entitled to. Ms. Schuler inquired whether the children in an institutional setting has been through other programs first. Ms. Dolan said that sometimes they are unknown to her department when coming from a Committee on Special Education and that the determination is not made by her department. She works with the local Board of Cooperative Educational Services to review and determine if there is any other possible placement.

Mr. Proto inquired whether the proposed reduction of the Tompkins Consolidated Area Transit budget that assists transportation of clients by $15,000 would it effect the Federal or State portion of TANF funds for this use. Ms. Dolan wi1l1ook into this and provide an answer to Mr. Proto.

Office for the Aging

Budget Adjustments

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

Office for the Aging (#64)
Revenue Acct  Title   Amt  Approp Acct Title(s) ___________
6795.44772  Federal Revenue $      38  6795.54330 Printing
Explanation:  Revenue Increase permits increase in printing for brochures in Title III-D Program (Medication Management).

Office for the Aging (#65)
Revenue Acct  Title   Amt  Approp Acct Title(s) ___________
6776.44772  Federal Revenue $    459  6776.54491 Subcontract
Explanation:  Revenue increase permits increase in Foodnet contract in Title III-C (Home-delivered meals).

Appointments

 MOVED by Mrs. Schuler, seconded by Ms. Robertson and unanimously approved by members present to submit the following appointments to the Office for the Aging Advisory Board to the full Board for approval:

 Mary Elizabeth Ostrom - term to expire December 31, 2003
 Marie W. Layer - term to expire December 31, 2005

WRAP Program

 Ms. Stein said they have completed an evaluation of this program that is funded by Federal funds, local funding, and New York State Electric and Gas Power Partners program.  This program provides packages that will assist in health and safety minor repairs for low-income individuals as well as provide referrals to Tompkins Community Action for weatherization services.  She said this is a consistently used program.  She said thirty-eight individuals surveyed noted satisfaction for the quality of work, all were satisfied with the courtesy and treatment by the Office for Aging, three noted they were not satisfied with their repairs, and three clients who had several repairs said and were not satisfied with one portion.  Ms. Stein said repairs are referred to Better Housing for the work and when needed pay private contractors and providers.  If dissatisfaction is noted in the work completed the purveyor is not used in the future.  Identified problems were some clients not meeting the criteria and this has been corrected.  The survey showed no clients in the Enfield or Danby areas, which seemed unusual.  A comparison was done with Better Housing and it was indicated they have served those areas.  In order to assure seniors in those two areas are aware of the programs available, the outreach worker will speak to the senior groups in these areas.  She said that many individuals feel the program's assistance gave them the ability to remain in their homes.  Areas that indicated a need to be improved have been modified to do so.

 Mr. Booth inquired what the process of awarding work is and how they are able to do so without a bid.  Ms. Stein said that the amount of the contract award is less than the amount required to go to bid.  Mr. Winch asked who determines the scope of work.  Ms. Stein indicated that their employee partners with those who will be doing the work as well as the client to determine what is to be completed.  Mr. Winch said he recognizes that this program is one that ultimately saves funding by allowing clients to remain independent.

Community Conversation

 Ms. Stein provided a review of this project that will provide information on caregiving for the elderly.  Members of various agencies and individuals are preparing information to be presented that will best provide the information and resources available to caregivers of the elderly.  Ms. Stein said most caregivers are family members and that there will be more need for caregiving and less individuals able to do so.  Articles will be in the newspaper providing information and there is a PBS program being shown as well as radio broadcasts.

Human Services Coalition

 Ms. Dill announced that the Health Planning Council received an award of $10,000 from the Holland Foundation, located in Broome County.  These funds will be utilized for work on the Inlet Trail towards accessibility for the disabled.

Youth Bureau Handout

Ms. Zahler provided material to be distributed to the full board relating to the 2003 budget.

Adjournment

On motion the meeting adjourned at 11:12 a.m.

Respectfully submitted, Karen Fuller, Deputy Clerk