Staff: K. Fuller, Deputy Clerk of the Legislature; K. Kephart, Department of Social Services; A. Cole, B. Grinnell-Crosby, S. Allinger, S. Connors, Health Department; S. Whicher, County Administrator; R. DeLuca, Mental Health Commissioner
Guests: M. Wickham, Lakeview Mental Health; M. Constant, S. Marsland, J. Waldman, Ithaca Free Clinic
Called to Order
The meeting was called to order at 10:35 a.m.
Office for the Aging
The Committee reviewed the budget transfer information; no action was necessary.
Social Services
Request for Positions
It was MOVED by Ms. Blanchard, seconded by Mr. Stevenson,
and unanimously approved by voice vote of members present, to approve the
following positions: Keyboard Specialist, twenty-five percent local
funding, at a salary level of $25,778; and Social Welfare Examiner, fifty
percent local funding, at a salary level of $35,043.
Report on Medicaid Estimates
Mr. Whicher, County Administrator, addressed the initial estimates received from the State for the Medicaid cap for local share, noting it is believed to be a high estimate. Mr. Herden of the Department of Social Services has reviewed the information and disagrees with the initial calculations presented by the State. Mr. Whicher feels when a final figure is provided from the State in June 2006 it will better reflect actual costs, stating Mr. Squires feels comfortable with the County's estimates and budget as well. He said although the figures may come in higher than the 2006 budget he believes there are one-time mechanisms in place that would cover additional expenses.
In response to a question from Ms. Robertson about the initial estimates, Mr. Whicher said it is believed the method of calculation is in error and that the figures projected by the County are more accurate. Mr. Whicher said that although there was the ability to reduce some of the spending on programs it was decided not to cut programs; what has occurred is a limitation of administrative expenses. In addition, physicians were contacted to request reduction of spending where possible; until the final figures are in it is unclear how it will affect the county.
Ms. Kiefer arrived at this time.
Ms. Kephart said she believed notices were mailed to physicians asking for things such as issuing prescriptions in generic form when possible, etc. Mr. Whicher said that due to the cap mechanism no new programs were undertaken that may be beneficial in the future. Mr. Whicher also said the manner in which the State has set up the fiscal year may provide an opportunity for the County to experience additional savings of local dollars in the future.
Monthly Reports
Ms. Robertson noted that programs that are above budget are in the area of youth programs and indicate there is an increase in problems with the youth of the County. Mr. Whicher said there has also been an increase in the number of youth under the age of 19 in the Public Safety building as well.
Ms. Robertson asked for an update on the Heating Energy Assistance Program (HEAP). Ms. Kephart indicated initial applications are low and it is thought people are exhausting all other resources before applying for assistance. Ms. Kephart said outreach (required advertising) has taken place related to the program. The Human Services Coalition and Cornell Cooperative Extension have undertaken work related to energy savings. An upcoming workshop will assist service providers to properly direct individuals to traditional programs as well as how to assist when traditional programs are exhausted.
Ms. Blanchard asked if as a result of the increased energy costs people might conserve with the result a reduction of energy demands. Ms. Kephart said some of the weatherization programs have been assisting in public awareness of ways to reduce energy costs. She recalled a furnace replacement program to replace units that are inefficient or defective. Ms. Kephart believed individuals were being identified through the emergency services division of the department.
Dental Program
Ms. Kephart provided members with a written report from Ms. Stevenson and Ms. Baudner that provided an overview and historical information on the program. The report noted a growth in the program since its inception. Ms. Stevenson has been actively seeking additional providers of services for this program. Some of the providers are out of the area as they specialize in particular services.
Mr. Proto arrived at this time.
It was requested by Mr. Whicher that the net local share information be provided at a future update.
Ms. Robertson noted it is encouraging to see the program's success.
WIC Program
Mr. Whicher said as a follow-up to an executive session, he believes that all issues regarding the WIC program and the State will be resolved, with the final information coming forward through the Health and Human Services Committee. Mr. Proto inquired whether Tompkins Community Action had been approached to possibly administer the program. Mr. Whicher said previously the possibility had been brought up and that perhaps it could be discussed following resolution of the present situation. He indicated it is unclear at this time what the final outcome will be.
Recognition by the Chair
Ms. Robertson presented outgoing Legislator Barbara Blanchard with a thank you gift and expressed her appreciation for all the work she had done on the Committee.
Mental Health - Update on SRO
Mr. DeLuca said that the County has received notice that the State will fund up to thirty beds, which is an increase from the initial thirteen beds funded. He said it had been difficult to find a site and at this time two options are being considered. Property has been located between Third and Fourth Streets that would allow for the construction of the SRO, and the possibility of including SRO housing as part of the Cayuga Green Project has also been discussed.
If the program were housed within the Cayuga Green Project, it would utilize several floors of the building and allow for close proximity to the Mental Health Department. In addition, it may allow for a larger living area for residents. Questions such as Lakeview’s need to own the site may create difficulty in considering inclusion within Cayuga Green, although it is believed this may be resolved through leasing of the site. If the Third/Fourth Street area is chosen it would not affect the tax roll, as the property is presently not on the rolls. In response to Mr. Proto's question, it was noted the present dwellings would require demolition, including asbestos abatement, which would be an expense paid by Lakeview. The demolition expenses would be part of the capital applied for through the low-income housing tax credits with additional funding from the New York State Office of Mental Health. It was noted there would be no difficulty related to parking at this location as zoning requires eleven spaces and the initial plans are for fifteen.
Ms. Robertson asked if there is any neighborhood concern about building the SRO at the Third/Fourth Street location. She was informed that the Neighborhood Association has not had any major opposition to the plan. It appears the concern may be how the building's design would fit into the neighborhood. Mr. DeLuca said the plan presented to the individuals was well received, as it will help beautify the neighborhood compared to the vacant houses presently on site. Mr. DeLuca also noted this area has limited owner-occupied housing.
Ms. Robertson inquired what would be the clients’ preferred site and was informed by Mr. Wickham the Cayuga Green site would be preferred site; a survey of clients indicates individuals would like the proximity to services.
Ms. Kiefer inquired what the timeframe was for this project. Mr. Wickham said a decision would need to be made in the near future. At this time plans are proceeding for the Third/Fourth Street site while determining feasibility for the Cayuga Green collaboration. If Cayuga Green is the chosen option it is believed the plans can be transferred over to accommodate it. Regardless of the site chosen it would be a twelve to sixteen month project with an opening date in 2007.
Mr. Proto asked if there anything in particular that would determine the project would be included with Cayuga Green. Mr. DeLuca said it would require Cayuga Green to indicate they would go ahead without tax abatements or assurance the project would go forward. Mr. Wickham said there are specific requirements for contracts with the New York State Office of Mental Health. It would require a review of draft contracts to determine it is the appropriate price and conditions. If this occurred the State may then allow the contract to proceed.
In response to Ms. Kiefer's question it was noted Lakeview does have an architect for the project; if Cayuga Green were chosen it would be a collaborative effort. Ms. Blanchard inquired if there is staff to assist with negotiations with Cayuga Green and was informed Lakeview has staff but it has not yet progressed to the level where negotiations are required.
Health Department
Building Update
Ms. Cole reported there is a significant odor in one of the offices that has required temporarily moving staff. The shredding of records stored in the basement is complete and the storage trailer has been removed. In addition, the company hired to undergo the roof repair has defaulted on the contract and Mr. LeMaro is taking appropriate measures to resolve the issue. Ms. Cole indicated she is not certain of the exact reason for the contractor's default and that Mr. LeMaro should be able to provide the information.
Position Requests
It was MOVED by Mr. Proto, seconded by Ms. Kiefer, and unanimously approved by voice vote, to approve the following positions that were included in the 2006 budget. Ms. Connors explained the first Team Leader is responsible for assisting with the home care program and acts as a liaison between services and insurance companies. The Community Health Nurse position is critical as there is still a shortage of positions. A brief discussion regarding canvassing for additional nurses occurred. Ms. Cole said many of the staff who leave the county go to work for the hospital due to the benefit package offered.
Team Leader - 2006 Working Rate Salary - $52,256, for 35.0 hours per week at a 50-60% local share;
Community Health Nurse - 2006 Working Rate Salary $47,508, for 35.0 hours per week for less than 50% local share;
Team Leader - 2006 Working Rate Salary - $52,256, for 35.0 hours per week at a 70% local share.
It was MOVED by Ms. Blanchard, seconded by Mr. Proto, and unanimously approved by voice vote to approve the following position:
Keyboard Specialist - 2006 Working Rate Salary - $13,340, for 17.5 hours per week at a 70% local share.
CSCN McGuinness Proposal/Budget Adjustment and Appropriation
It was MOVED by Ms. Blanchard, seconded by Mr. Proto. It was explained this would provide funding for a software program to enable fiscal billing of the department's programs to be forwarded to the State. It is a program highly recommended by Mr. Potter, Director of Information Technology Services, and the financial transactions were recommended by Mr. Squires as the best way to proceed. A voice vote on the motion resulted as follows: Ayes - 5; Noes -0. MOTION APPROVED.
Transfer:
Health Department
Revenue Acct
Title
Amt Approp Acct Title(s) __________________
4095.43401 Public Health Work $23,242 4047.52230
Software
Explanation: Public Health Work State Aid projected
for McGuinness Software purchase.
Appropriation:
Health Department
Revenue Acct
Title
Amt Approp Acct Title(s) __________________
2960.54440 Program Expense $46,758
4047.52230 Software
2960.54440 Program Expense $
7,474 4047.52206 Hardware
Explanation: Purchase of McGuinness Software for
management of Preschool and Early Intervention Programs. Purchase
of server for implementation of McGuinness Software.
Resolution Authorizing Changes in Charge Structure - Tompkins County Home Health Care
The committee will take action on this item prior to the next Legislature meeting, as the figures were not yet received from the State.
Update on Rabies Contract
It was reported that at this time the present contract with the Tompkins County SPCA has been extended for a one-year period, after which a review will occur.
Appointment to Various Advisory Boards
It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, and unanimously approved by voice vote of members, to approve the following appointments:
Community Mental Health Services Board Expiration
Date
Stu Bergman 12/31/2009
Substance Abuse Subcommittee
Thomas Lipa Community Member 12/31/2009
Thomas Schlee Community Member 12/31/2009
Stu Bergman Board Member 12/31/2009
Personal Emergency Response Service Advisory Board
Joan E. Murphy Visiting Nurses Services 12/31/2007
Mental Health Subcommittee
Adrienne Lampert At-Large 12/31/2009
Linda Millaine Pierro Community Member 12/31/2009
Mary Hutchens Board Member 12/31/2009
Youth Services Board
Dr. Jeffry Bishop At-Large 12/31/2008
Office for the Aging Advisory Board
Donna Jean A. Darling 12/31/2008
Robert Spaulding 12/31/2008
Marie Layer 12/31/2008
Youth Services
The Committee spoke of the information related to youth gangs received by Ms. Zahler and discussed in meetings that have been held by various agencies and law enforcement. At one of the meetings an individual employed by the Lansing Girls' School spoke of factors that contribute to a desire to join gangs, such as ineffective school-parental communication, excessive free time, not foreseeing conventional careers available to them, and youth finding specific places to congregate. Ms. Kephart reported that Department of Social Services attended a workshop in Herkimer County that provided information on community models to assist with the problem. The staff was impressed with the information received. Ms. Robertson noted that local discussions have included public safety staff.
Ithaca Free Clinic
Ms. Constant, Clinical Coordinator of the Ithaca Free Clinic, reported on the opening of the clinic in January 2006. She is the only paid staff member. This clinic is one of approximately 1,000 nationwide and has taken eight years of fundraising and nine months of development to open the clinic's doors. The clinic, which has been a project associated with the Ithaca Health Alliance, will be open on Mondays and Thursdays. It is located at the intersection of Route 13 and Fulton Street.
Mr. Marsland and Ms. Waldman, Co-Chairs of the Steering Committee for the clinic, indicated a number of task teams have been formed to assist with various aspects of the clinic. One group works with Assemblywoman Lifton to enact legislation, while others focus on fund raising, credentialing the clinic, and equipment donation. It was reported that at this time approximately $10,000 in equipment has been donated, with a good deal from Northeast Pediatrics. It was noted that there is no affiliation between Cayuga Medical Center and the Ithaca Free Clinic.
The discussion included information relating to uninsured residents of the County. It was noted the Health Planning Council and COMPASS reports indicated there are approximately 10,000 uninsured within the county. In addition, information from the Department of Social Services shows approximately 8,600 individuals on Medicaid.
Ms. Blanchard inquired if the clinic can be sustained by donations. Mr. Marsland informed her that Dennis Whalen, New York State Deputy Commissioner of Health, is interested in the clinic; they are working with a clinic in Albany that received $100,000 in funding as a pilot program each year for the past two years. Mr. Whalen recommended the program be extended to up to ten clinics with funding of $100,000 per year for the next three years. Mr. Marsland said the Ithaca Free Clinic hopes to be included in this funding. The clinic is working to receive an Article 28 status without having all the regulatory pieces in place immediately, and a 501c3 non-profit status as well. Ms. Waldman said there are many ways funding is being sought including local business donations, grants, etc. In addition, Cornell University is considering having Park Fellow students undertake a study to determine how much the clinic may save Cayuga Medical Center in emergency room care, in order to seek support from the hospital. The operating budget of $45,000 is designated to cover the cost of rent, utilities, and the coordinator's part-time salary.
Mr. Marsland said the County support could be in the Total Care area with regard to Medicaid. In addition, it was thought that the County could utilize the clinic in forming alliances with other organizations.
Reality Check
Ms. Thompson provided members of the Committee with written material about State legislation that would ban the sale of flavored cigarettes. In addition, she shared information that showed the marketing strategies of the cigarette manufacturers in movies, designed to make smoking flavored cigarettes more enticing. Mr. Proto strong felt that if any of the actions were in opposition to agreements made within the tobacco settlement action should be taken to prevent this.
Ms. Robertson asked for the sense of the Committee regarding potential resolution(s). It was agreed that a resolution regarding specific state legislation is the most effective thing to do. Ms. Robertson said she would work with Ms. Thompson on a resolution and bring it back to the committee.
Chair's Report
Ms. Robertson reported that the Department of Social Services sent a survey to agencies regarding services provided to senior citizens. The survey results have not yet been compiled, so this topic should be discussed in 2006.
With regard to the 2005 Work Plan, Ms. Robertson indicated there are some items that did not get covered as hoped. She asked members what items they thought should be carried over to 2006. Ms. Kiefer asked about the jail discharge planning. It was noted that it was briefly discussed but should be included next year. Ms. Kiefer questioned whether it should be referred to the Public Safety Committee; Ms. Robertson will note this overlap concern.
Mr. Whicher reported he is working with Department Heads regarding performance measures. He presently is seeking information on how this is done in similar communities.
Approval of Minutes of November 2, 2005
It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, and unanimously approved by voice vote of members to accept the minutes of November 2, 2005, as presented.
Adjournment: On motion, the Committee adjourned at 1:15 p.m.
Respectfully submitted, Karen Fuller, Deputy Clerk.
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