Present: N. Schuler, T. Todd, C. Evans, S. Davis (arrived at 9:07 a.m.), S. Stein, (arrived at 9:12 a.m.)
Staff: A. Cole, Public Health Director; B. Grinnell-Crosby, Public Health Administrator; S. Kerr, Public Health; I. Stein, Office for the Aging Director; M. Dolan, Social Services Commissioner; N. Burston, Human Services Coalition; Foodnet Representatives: Steve Griffen, Kate Friedlander, and Gertrude Brewster
Called to Order
The meeting was called to order at 9:06 a.m.
Ms. Davis arrived at this time.
Changes to Agenda
The following item was added to the agenda:
It was MOVED by Mr. Todd, seconded by Mr. Evans, and unanimously adopted by voice vote by members present, to approve the minutes of the September 14th meeting as submitted.
Chair's Report
Mrs. Schuler made the following announcements:
October 17th - hearing on Flouride
October 23rd - public hearing for Office for the Aging to comment
on annual plan and discussion of proposed prescription plan
Mrs. Schuler also reported that the Director of Aidswork was not aware that a budget over-target request of $10,000 was submitted. This will be brought to the attention of the next Expanded Budget and Fiscal Policy Committee meeting.
Mr. Stein arrived at this time.
Public Health
Resolutions
It was MOVED by Ms. Davis, seconded by Mr. Evans, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval:
RESOLUTION NO. – AUTHORIZATION FOR MEMBERSHIP – BEACON INSTITUTE – HEALTH DEPARTMENT
WHEREAS, the
Tompkins County Home Health Care program is seeking membership in the Beacon
Institute at a cost of $395 per year, and
WHEREAS, the
membership in the Beacon Institute would serve as a valuable resource for
the Home Health Care Program at a time of rapid government Medicare changes,
and
WHEREAS, membership
provides a twice monthly Homecare Question and Answer newsletter; weekly
email alerts of home care news and analysis; expert home care advice via
fax; discounts on catalog resources, and
WHEREAS, membership
provides a free loan library of over thirty quality educational training
videos and lesson plans for staff, now therefore be it
RESOLVED,
on recommendation of the Health and Human Services Committee, That Tompkins
County Home Health Care is authorized to join Beacon Institute,
RESOLVED,
further, That no additional funding is required.
SEQR ACTION: TYPE II-20
Explanation: Each year our Home Health Care program has dealt with rapid regulatory Medicare and Medicaid changes in billing and clinical care expectation for our clients. Membership in Beacon Institute would offer our management and nursing staff a resource that not only provides general information but individualized responses specific to our agency needs.
It was MOVED by Ms. Davis, seconded by Mr. Evans, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval. Ms. Grinnell-Crosby stated the Department had been contracting with Jack Venesky, but due to changes in the company, the Health Department renegotiated the contract.
RESOLUTION NO. – AUTHORIZATION TO EXECUTE AUTOMATIC RENEWING AND MULTI-YEAR CONTRACTS– HEALTH DEPARTMENT
WHEREAS, the
Tompkins County Health Department has contracts for PCAP (Prenatal Care
Assistance Program) physician services, contracts with numerous insurance
companies to establish a preferred provider relationship, and a contract
with Delta Health Systems for maintenance of our previously purchased software,
and
WHEREAS, the
PCAP physician contract outlines the services to be provided by both parties
only, the department no longer handles the billing component for the physicians,
and no money is exchanged, and
WHEREAS, the
contracts with insurance companies are difficult to negotiate and generally
require an automatic renewal clause that they are not willing to remove,
and
WHEREAS, all
insurance companies have been willing to negotiate rates on an annual basis
and the department would propose processing an addendum to accommodate
the rate changes, and
WHEREAS, the
Delta contract covers maintenance of the billing and statistical software
we purchased from them, and rates are set every July and are generally
non-negotiable, now therefore be it
RESOLVED,
on recommendation of the Health and Human Services Committee, That the
Health Department is authorized to execute multi-year and automatic renewal
contracts as necessary for PCAP, insurance companies and Delta Health Systems.
SEQR ACTION: TYPE II-20
Explanation: Signatures for multi-year and/or automatic renewals on the contracts listed will reduce paperwork and personnel time reviewing and processing each year. In addition the department will be better able to enter into insurance markets seeking our services.
It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval. Ms. Kerr commented that there are on average 2-3 active Tuberculosis cases a year.
RESOLUTION NO. – AUTHORIZATION TO ACCEPT FUNDS, BUDGET ADJUSTMENT –TUBERCULOSIS FUNDS – HEALTH DEPARTMENT
WHEREAS, the
Maternal Child Unit of the Tompkins County Health Department is in receipt
of one-time funding of $25,000 to enhance the County Tuberculosis Control
Program activities, and
WHEREAS, the
New York State Department of Health has encouraged counties with low-prevalence
Tuberculosis to apply these funds for one-time, non-recurring costs, and
WHEREAS, funds
would be used to purchase office furniture, equipment and supplies; computer
software and hardware; medical equipment and supplies, program outreach
incentives; and educational programs and resources for staff and clients,
and
WHEREAS, funds
would be expended between October 1, 2000 and January 31, 2001 for Tuberculosis
Control Program activities, now therefore be it
RESOLVED,
on recommendation of the Health and Human Services Committee, That the
Health Department is authorized to accept said funds,
RESOLVED,
further, That the Director of Finance is authorized to make the following
budget adjustment on his books:
REVENUE
A4016.44959 Federal Grant
$ 19,940
APPROPRIATION A4016.52206
Computer Hardware
$ 4,500
.52214 Office Furnishings
6,875
.52220 Departmental Equipment
1,515
.52222 Communication Equipment
280
.52230 Software
510
.54303 Office Supplies
750
.54319 Program Supplies
3,375
.54332 Books/Publications
1,135
.54354 Medical Supplies
750
.54412 Travel & Training
250
SEQR ACTION: TYPE II-20
Explanation: The New York State Department of Health has received federal funds to support Tuberculosis program activities in low Tuberculosis counties. We were encouraged to purchase off and medical equipment and supplies, acquire educational materials and to upgrade our clinical equipment. In addition, per state recommendations we will purchase grocery, phone and transportation incentives to encourage clients to adhere to the strict Tuberculosis medication schedule. Funds cannot be used to pay for personnel, medications or to replace any state or local monies already allocated for the TB program. FYI: In 1999 the Maternal Child Unit nursing staff of the Health Department assisted with four active TB cases, screened 31 individual case contacts and case managed ~20 individuals on preventive TB treatment.
It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval:
RESOLUTION NO. – RECOMMENDATION ON PHYSICAL ACTIVITY
– HEALTH DEPARTMENT
WHEREAS, physical
activity is an important modifiable risk factor for many diseases such
as cardiovascular disease, diabetes, and osteoporosis, and
WHEREAS, the
1996 Surgeon General’s Report recommended that persons of all ages obtain
"a minimum of 30 minutes of physical activity of moderate intensity, for
example brisk walking on most, if not all, days of the week," and
WHEREAS, walking
is one of the most accessible ways to be physically active, and
WHEREAS, having
walkways accessible to persons, places of residence and business with interconnecting
walkways linking home, business, and shopping is a necessary condition
to encourage walking, now therefore be it
RESOLVED,
on recommendation of the Tompkins County Board of Health and the Health
and Human Services Committee, That communities in Tompkins County seek
to create safe and suitable walkways for promoting physical activity of
our population in an effort to lower the prevalence of diseases of the
heart and lungs, diabetes, and osteoporosis,
RESOLVED,
further, That this resolution be communicated to both the governing bodies
and the planning boards for all communities residing within Tompkins County,
including, but not limited to, villages and towns.
SEQR ACTION: TYPE II-20
Justification: From Morbidity Mortality Reports, Volume 49, #25, Page 560, a review of physical activity recommendations is conducted. In general, physical inactivity is an important modifiable risk factor for many diseases, most notably cardiovascular, osteoporosis, and diabetes. In 1996, the Surgeon General’s report recommended that persons of all ages obtain a minimum of 30 minutes of physical activity of moderate intensity, i.e., brisk walking, on most, of not all, days of the week. Walking is encouraged. It is one of the most accessible ways to be physically active. The findings of studies, i.e., the Michigan Study Report, in this publication indicate that walking is the most common form of leisure time physical activity and that most only walkers were walking for at least 30 minutes at a time. However, many only walkers did not walk frequently enough or fast enough to comply with recommendations. Recommendations are that walking at approximately 3.5 miles per hour be a goal that needs to be modified based on other circumstances, such as being unconditioned, elderly, overweight, or having another disabling condition. In such cases, exercise needs to be started with a short duration of moderate intensity activity, gradually increasing duration and/or intensity. Walking at lower intensity such as 2.0 – 2.9 miles per hour can be an initial goal, however, a further goal should be to increase intensity and speed as the body adapts.
Early Retirement Proposal
The Health Department's proposal is for Donna Evershed, Dental Hygienist, to take early retirement in 2000. The proposal being recommended and accepted by the County Administrator is to use the half-time scenario. The total cost to keep a dental hygienist half time would be $19,517. Funds available for allocation total $17,722. The additional $1,795 will be funded through the CHS (4016) budget. The Department has applied for a grant to hire 1 1/2 positions for this. Ms. Cole stated the Ithaca City School District has cut this item in their budget therefore the need is only a half-time staff.
It was MOVED by Ms. Davis, seconded by Mr. Stein, to approve the above early retirement proposal as submitted. A voice vote resulted as follows: Ayes - 3 (Evans, Stein, and Todd); Noes - 2 (Davis and Schuler). MOTION CARRIED. Mrs. Schuler stated it is her opinion that the schools should be supporting this item and that is why she voted against the proposal.
Office for the Aging
Program Updates (Millennium implementation)
Ms. Stein said one recommendation from the Millennium report addressed a concern that low-income people were not aware of the help available. An informational piece of contacts was put together and distributed at the Social Security office and through the human resource departments of Tompkins County's larger employers. She said this has been well received and numerous other requests have been made for this brochure.
Another outcome from the report was a needs assessment for a medical adult daycare program that is covered by Medicaid. The Health Planning Council's Long-Term Care Committee conducted the assessment by doing a survey of providers which resulted in a very strong response. The next step is to discuss how to proceed.
Ms. Stein also reported that due to some changes in the Department, there was some money leftover that allowed the Department to enter into an agreement with Greater Ithaca Activities Center for their senior trip that will enable people from Senior Homes to go on this trip. Also, some of the leftover funds has allowed the Department to extend its Food Shopping Contract with Southside to include all City residents. She said there had been a decline in the program due to the changes in bus schedules.
Foodnet Update
Ms. Stein introduced representatives from Foodnet: Steve Griffen, Kate Friedlander, and Gertrude Brewster. Ms. Stein reported that Foodnet now owes the County $27,000 and soon hopes to reduce that to $18,000.
Ms. Brewster began by stating there have been a number of changes in the composition of the Board. It is a diverse group of members with special talents. She provided an update on the fundraising efforts and said there were a number of people in the community that did not know what Foodnet was until the campaign kicked off. Mr. Griffen followed up with stating that one of the contributors and Rotary Club pushed Foodnet over the $400,000 mark. He said it has helped stabilize the foundation and allowed them to purchase equipment, etc. Ms. Davis asked if information about the success of Foodnet's fundraising campaign could be compiled and shared with other organizations or agencies.
Mr. Griffen reviewed some of the programs offered through Foodnet. Recently it began offering the option of a sandwich meal to all Home Delivered Meal clients as a supplement to the hot lunch delivery. There are approximately 110 clients taking advantage of the additional sandwich meal which will total 8,000 additional meals provided to Tompkins Seniors by the end of 2000.
Mr. Griffen announced a cooperative effort with Cayuga Medical Center for Foodnet to take over the Meals on Wheels Program. It will include the preparation and delivery of daily meals with the assistance of the network of volunteer drivers from the Meals on Wheels Program.
Ms. Friedlander spoke about the Long-Term Care Database. This will allow Foodnet to be linked with Office for the Aging and the Department of Social Services Long Term Care Services and streamline the assessment process for clients who receive multiple services. She also reported that next year a part-time social worker will be hired to assist with completing comprehensive client assessments.
Department of Social Services
July and August 2000 Reports
The Committee reviewed and discussed the monthly reports from Ms. Dolan. Mr. Stein said when he attended the New York State Association of Counties conference, he heard concerns from other counties about the increase in costs of Medicaid. He noticed it appears the activity in Medicaid is going up and asked if Tompkins County may be experiencing some of the same problems as other counties. Ms. Dolan said she has assessed the County's numbers in comparison with other counties and feels one of the differences is the proposal called "Intergovernmental Transfer" which affects any county that operates a skilled nursing facility. It is a mechanism to draw down additional federal reimbursement on nursing home expenses. The counties that operate nursing homes have two problems: (1) labor costs are extraordinarily higher than the private profit and non-for-profit market; and (2) reimbursement rates are fixed. She said other counties are also budgeting more for the additional cost that will be incurred for families that will sign up for individual and family health plus. The number she budgeted was based on the caseload that was provided by the Health Department.
Mr. Stein commented on the Department's budget requests for 2001. He noted that there has been a decrease in county funds over the last few years by a significant amount. He said he is still hearing comments about the Department's budget and how much it is costing for welfare and why the amounts continue to increase. Ms. Dolan said she would put together an article to explain and share it with the media and Board members. Ms. Dolan agreed to share this information at the next Board meeting. Mr. Stein feels it is important to show how the County's contribution has gone down.
Mr. Todd said he is concerned with the increase in staff. Ms. Dolan explained the request for the additional staff and the importance for the expansion of hours. She said the increase in hours is her number one priority. She feels that private as well as public agencies need to come into the 21st Century with a clientele that is primarily working and that there needs to be a movement for non-traditional hours. The need for additional hours was identified through a customer survey.
Ms. Dolan reported that her Department has been working with the Workforce Development to start the informant program for non-custodial parents which began Monday.
Ms. Dolan provided the Committee with information on grant applications that have been submitted by the Department or through the Department for potential funding. The Committee agreed to discuss this at the next meeting.
Mrs. Schuler asked for clarification on the funding requests for Catholic Charities. Ms. Dolan said the funding request in the Social Services budget supports the administration of programs and the funding in the Coalition's budget is for the voucher system (emergency funds).
Next Meeting
The Committee agreed to change the next meeting to November 8th at 3:30 or 4:00 p.m.
Mental Health
Budget Adjustment
It was MOVED by Mr. Evans, seconded by Mr. Todd, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:
Revenue:
4313.42665
$450
Appropriation: 4313.54421
Vehicle Maintenance
$450
Explanation: Amount received from auction of old auto to be used to pay for vehicle maintenance.
It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:
Revenue:
4323.42797 Other Government Revenue
$54,508
Appropriation: 4323.54400
Program Expense
$54,508
Revenue:
4322.42770 Miscellaneous Revenue
$54,508
Appropriation: 4322.54442
Professional Service Fees
$54,508
Explanation: New budget item: TST BOCES monies sent to Tompkins County Finance to pay for Franziska Racker Centers professional services rendered to TST BOCES. Vouchered through Tompkins County Mental Health.
Office for the Aging
Budget Adjustment
It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:
Revenue: 6793.44772
Federal Revenue
$1,270
Appropriation: 6793.54491
Subcontracts
$1,270
Explanation: Revenue increase permits increase in subcontract.
Liaison Reports
Mental Health
Services Board
Mr. Evans
reported there was a new Director at Alpha House.
Personal
Emergency Response System
Mrs. Schuler
reported the committee has not met. It is looking at the scale of eligibility.
Tompkins
Community Action
Mrs. Schuler
reminded committee members of the ribbon cutting ceremony at 10:00 a.m.
on Saturday, October 14th. There is an attempt to try to break
the Guinness Book of World Records.
New Business
Mr. Stein said that he would like to discuss and consider a process that would allow the County to loan money to non-profit organizations. He said the County can borrow using a lower interest rate which would also be helpful to the County in the long run. Discussion followed and the following motion was made:
It was MOVED by Mr. Stein, seconded by Mr. Evans, and unanimously adopted by voice vote, to forward this request to the County Administrator for action:
"Begin developing a process to explore the issues and bring back to the appropriate Board Committee a policy on how we use County's credit to assist various non-profit organizations or contract agencies with giving special and early attention to Tompkins Community Action."
Adjournment
The meeting adjourned at 10:58 a.m.
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