Excused: L. McBean

Staff:  M. Dolan, DSS; A. Cole, Health Department; E. Brazauskas, Health
 Department; B. DeLuca, Mental Health; S. Whicher, Administration; K.
Fuller, Recorder

Call to Order

 Chair Schuler called the meeting to order at 10:00 a.m.

Changes to Agenda

The following information was provided to Committee Members:

· Written material for the Mental Health Report on Statistics and Cost of Assisted Outpatien Mandate and Mental Health Board and Subcommittees Vacancies

· Budget Transfer – Office of the Aging

Approval of Minutes of October 17, 2001

 It was MOVED by Mr. Proto, seconded by Mr. Stein, and unanimously approved by members present to accept the minutes of October 17, 2001 as amended.

Chair’s Report

 Mrs. Schuler shared information with the Committee that a new booklet entitled Serving Up Safe Food has been prepared and is now available to the public.  This booklet was published by the Health Department and will assist in providing information to a variety of individual vendors and community organizations when serving food to the public.  This booklet is available through the Environmental Health Division and will be distributed with Food Service Permits and will be mailed to community churches and clubs as well.

 Mrs. Schuler also noted that New York State Family and Children’s Services are inquiring about four specific questions relative to meeting the needs of the PINS cuts throughout the State.  Ms. Dolan noted that information on record over the past several years should be adequate to provide the State with the requested information.

Office for the Aging

 Budget transfers made by the Office for the Aging were reviewed by Committee members.  Mr. Proto requested information regarding the over-estimated contract in the amount of $2,991.  The Committee also requested to be provided a report of the PERS units currently owned and distributed by the County.

Health Department

Resolutions:

Resoluton - Appropriation from Contingent Fund for Replacement Pay and Terminal Pay

 It was MOVED by Mr. Proto, seconded by Mr. Winch.

 A discussion was held with regard to the placement of employee names within the body of the resolution.  The Committee members expressed their preference to not have this information included and asked that a memorandum be distributed to departments to indicate this preference.

 Following discussion it was unanimously passed by all members present to approve the resolution as amended.  RESOLUTION APPROVED.

WHEREAS, during 2001, the following employees terminated their employment with Tompkins County resulting in terminal pay of $7,234, plus fringes ($1,809):

 Christina Morse, Community Health Nurse (3/30/01)
 Kathleen Reichel, Community Health Nurse (3/19/01)
 Anne Timmerman, Community Health Nurse (5/23/01)
and

 WHERAS, an Account Clerk Typist in the Community Health Services Division has been absent from work for longer than two months, and
 WHEREAS, the cost of unbudgeted replacement pay in the amount of $13,956 plus fringes ($3,489) for the period of January 1, 2001 through September 15, 2001 has been incurred by the Department, and
 WHEREAS, the Fiscal Policy or Tompkins County allows for reimbursement of terminal pay and replacement pay through the Contingent Fund, and
WHEREAS, the department operated with a deficit in 2000 in the amount of $6,015, and submitted a plan to repay this deficit by reducing the amount eligible from contingent fund, now therefore be it
  RESOLVED, on recommendation of the Health and Human Services and Budget and Capital Committees, That the Director of Finance is hereby authorized and directed to make the following budget appropriation:

 FROM:  A1990.54440  Contingent Fund  $21,103
 TO:  A4016.51000513 Salary – Account Clerk Typist $  7,941
   A4016.51000580 Salary – Comm. Hlth. Nurse $  7,234
  A4016.58800  Fringes    $  5,298
SEQR ACTION:  TYPE II-20

Resolution: Appropriation from Contingent Fund – Medical Examiner

 It was MOVED by Mr. Proto, seconded by Mr. Stein.

 A discussion followed during which information regarding the requested funding.  Mrs. Cole noted that the request is to enable payment to various vendors for services completed.

 Following discussion it was unanimously passed by all members present to approve the resolution as amended.  MOTION CARRIED.
 WHERAS, under Public Health Law, Tompkins County must certify unattended and suspicious deaths through a Medical Examiner system, and
 WHEREAS, the number of deaths and the resulting autopsies, removals and forensic laboratories have exceeded budget allocations, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services and Budget and Capital Committees, That the Director of Finance is hereby authorized and directed to make the following budget appropriation:
 FROM:  A1990.54440  Contingent Fund  $21,820
 TO:  A4014.54442  Professional Service Fees $21,820
SEQR ACTION: TYPE II-20

It was MOVED by Mr. Proto, seconded by Mr. Stein.

 Mr. Proto inquired as to why the changes are being requested.  Ms. Cole explained that since there is no control over the situation and that it is solely driven by the required laws, it would be beneficial to include some areas within the specified mandate area.  Ms. Crosby-Grinnel noted that the areas to be included would be the removal, the autopsy and related forensic services costs.  It was requested that the specified areas be included within the text of the resolution.  Mr. Stein noted that it appeared that information was inadvertently omitted from one of the paragraphs.  Ms. Crosby-Grinnel said she would provide this when she amends the resolution as requested.  Mr. Winch asked what happens to unexpended funds within the budget year and it was noted that they would return to the general fund.

 Following discussion it was unanimously passed by all members present to approve the resolution as amended.  MOTION CARRIED.

 WHERAS, Tompkins County is mandated by County Law, Article 8, Chapter 11 Section 400, and
 WHEREAS, the County is mandated under County Law, Article 17-A  to investigate and certify unattended and suspicious deaths, and
WHEREAS, the Department has very little control over the manner in which the service is provided, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services and Budget and Capital Committees, That a budgeting unit called Medical Examiner Services be created and classified as an ‘A’ mandate.
SEQR ACTION:  TYPE II-20

Resolution – Authorizing Changes in Charge Structure – Tompkins County Home Health Care

 It was moved by Mr. Winch, seconded by Mr. Stein.

 A discussion was held regarding the fee structures and how they were determined.  Mr. Winch asked what the average visit for an aide is.  Ms. Cole said a standard visit is 1.5 hours.  Mr. Proto also inquired if it would be possible to obtain a survey of businesses utilized by the County to determine what their actual charges are, what the base pay for their Home Health Aides are, and an explanation of which businesses provide with regard to insurance coverage for employees.  Ms. Cole will compile this information and provide it to the Board.

 Following discussion it was unanimously passed by all members present to approve the resolution as amended.  MOTION CARRIED.

 WHEREAS, Tompkins County’s accounting consultant, Michael McCarthy, CPA, has recommended changes in the Certified Home Health Agency fee structure to maximize Medicaid and Medicare revenues, and
 WHEREAS, New York State currently promulgates rates on the day the County legislature approves them and it is therefore, desirable for Tompkins County to adopt the 2002 rates in December 2001, and
 WHEREAS, all changes proposed were made to align charges with actual costs per unit of service as determined during Mr. McCarthy’s most recent financial and statistical analysis, now therefore be it

 RESOLVED, on recommendation of the Health, Human Services and Education and Budget and Personnel Committee, That the Tompkins County Health Department implements the charge structure below, as recommended by Michael McCarthy, CPA, in order to maximize Medicaid and Medicare revenues.

2002 Tompkins County Home Health Care Fee Schedule

                                                          2001   2002
Skilled Nursing                                $102.00  $110.00
High Tech Nursing                           $110.00  $115.00
Physical Therapy                             $  92.00  $105.00
Speech Therapy                              $  95.00  $105.00
Occupational Therapy                     $  92.00  $105.00
Medical Social Work                      $  90.00  $105.00
Home Health Aide                          $  34.00/hour $  36.00/hour
                                                      $  65.00/visit $  70.00/visit
SEQR ACTION: TYPE II - 20

Team Leader Vacancy

 It was MOVED by Mr. Winch, seconded by Mr. Stein.

 Ms. Cole requested that the Committee approve a position within her department which comes under the new Soft-Freeze on Hiring Policy.  A resignation from the individual currently in this position and requested that it be continued.  She noted that this position is a critical position within the department and it would be a benefit to continue it.  The County Commissioner of Personnel and County Administrator have both reviewed this request and are in support the request.  It was noted that this position was budgeted for 2002.

 Following discussion it was unanimously passed by all members present to approve the request to fill the position.  MOTION CARRIED.

Liaison Assignment

 Mr. Winch, the current liaison for the Children Special Care Needs Committee, noted that due to personal obligations he is unable to continue this position.  The next meeting of this committee will be January 10, 2002 from noon to 2:00 p.m.  Mr. Winch was thanked for the time he has given to the Committee.

Appointments

 It was MOVED by Mr. Proto, seconded by Mr. Winch and unanimously approved by voice vote of members present to appoint the following:

Tompkins County Board of Health

Dr. James McMillen
Dr. Sullivan

 Mr. Winch requested that Ms. Cole provide information related to the Shelter Valley Water system.  Mrs. Schuler noted that the County Attorney’s office would be contacted regarding this request and it will be a topic of discussion at the next meeting.

Mental Health Department

 Chair Schuler expressed appreciation for individuals involved with obtaining and placing a bench outside of the Mental Health Building.  She noted that it is always in use when she goes by the building.

 Mr. Deluca, the Mental Health Commissioner, reviewed the material provided to the Committee relative to the Report on Statistics and Cost of Assisted Outpatient Mandates.  He discussed the background of the two programs covered under Kendra’s law.  The programs are designed to allow the Mental Health Department to study individual’s behavior when having received a request to do so.  He explained how the screening is done and the levels of service offered as a result of the study.

 Mr. DeLuca noted that statistically, he felt that the Department was right on target with his initial estimate of the number of cases.  He noted that although this was the case this year, costs could be higher as a result of lack of Medicaid eligibility, number of cases, etc.

 The Committee reviewed the information and inquired of the step-by-step process of determining the requirements and services provided as a result.  Mr. Winch asked Mr. DeLuca if he felt that Kendra’s law has been an effective tool for the County.  Mr. DeLuca noted that he felt the outpatient area provided by the law does not provide any more authority to provide service to a potential client but rather, puts a mandate as well as a liability exposure on the County that did not exist before.  Ms. Dolan said that she feels it gives individuals an alternative to make a referral for mental health and engage an expert.

Mental Health Board and Subcommittee Vacancies

 Mr. DeLuca provided the Committee with a spreadsheet indicating the various seats and expiration dates for the Mental Health Board and its subcommittees.  Also provided to the Committee were a variety of resume applications received by members of the community desiring to participate on them.  Following a brief discussion of length of terms served, number of terms served, and the need to be provided with attendance figures for those wishing reappointment; it was decided to postpone any action until the December meeting.

 Mrs. Schuler noted that she was pleased to see the halfway house mentioned in the Substance Abuse Subcommittee and that Mr. Robert DeLuca was involved with this subcommittee.

Department of Social Services

 Mr. Whicher, County Administrator, notified the Committee that his office would like to recognize an individual who is employed by the Department of Social Services for going above-and-beyond their normal duties.  He read a report that noted that Mr. Holleran, a security guard, recently assisted in life-saving measures of a client who was having an asthma attack.  Upon arrival of the medical personnel, Mr. Holleran proceeded to secure the clients belongings, including their pet, and kept in touch with the client, informing her of this situation, to alleviate concern.

 Mr. Whicher indicated that administration is preparing a resolution and inquired whether the Health and Human Services Committee would sponsor it.  A voice vote of all members present unanimously approved the resolution.

 A brief discussion was held regarding various methods of recognition within the Department of Social Services, other departments, and suggested positive and negative aspects of these programs.

It was MOVED by Mr. Stein, Seconded by Mr. Winch.

  Ms. Dolan came to the Committee with a request to fill seven positions within her Department.  The positions requested came under the new policy for filling positions vacant by resignation or termination.  Ms. Dolan noted that her department currently has 23 vacancies at the present time and that she has discussed these vacancies with the Commissioner of Personnel and County Administrator.  Following these discussions, it was determined that out of the 23 vacancies that seven positions were felt by Ms. Dolan to be critical to the day-to-day operations of the Department of Social Services.  The Commissioner of Personnel and County Administrator have had the opportunity to review five of the seven noted by Ms. Dolan.  Mr. Whicher stated that he approves the five reviewed and would not oppose the remaining two if the Committee chose to approve them.

 It was MOVED by Mr. Proto to postpone a decision until a determination has been made with regard to all seven requests.  No second was made, MOTION FAILED.

It was MOVED by Mr. Stein, seconded by Mr. Winch to approve filling all seven positions, contingent upon receiving a positive recommendation from the County Administrator on the remaining two positions.  A voice vote of the motion resulted in the following:  Ayes – 3 (Schuler, Stein, Winch); Noes – 1 (Proto).  MOTION CARRIED.

Adjournment

 The meeting adjourned at 11:40 a.m.

Note: A joint meeting between Health and Human Services Committee and the Planning Committee followed to discuss the subject of Pesticide Neighbor Notification Laws.