Staff:  A. Cole, B. Crosby-Grinnell, Health Department

Call to Order

 The meeting was called to order at 9:04 a.m.

Approval of Minutes

 MOVED by Mrs. Schuler, seconded by Mr. Booth and unanimously approved by voice vote of those present to accept the minutes of November12, 2002 as amended.

Department of Social Services

 Ms. Dolan reported she has voiced a concern to the County Administrator regarding the significant increase in the number of public assistance, medical, and food stamp cases in the last several months.  She indicated that while some cases will be closing shortly that the numbers are up enough to warrant careful review as the 2003 budget estimates may be low if the trend continues.

 Mrs. Schuler complimented Ms. Dolan and her staff with regard to National Adoption Day and the recent ceremony that took place.   She said that the ceremony was very moving, beautiful, and provided hopeful outcomes to many children.

RESOLUTION NO.          - AUTHORIZING BUDGET ADJUSTMENTS AND USE OF CONTINGENCY FUNDS FOR DEPARTMENT OF SOCIAL SERVICES’ MANDATE PROGRAMS

 MOVED by Mr. Proto, seconded by Mrs. Schuler.  Mr. Winch, Chair, said that this resolution had been passed as a budget adjustment at the last meeting.  However, due to the request for funds from the contingency budget, it needed to be put in resolution format.  Mr. Proto requested that some information contained in it be reviewed with Tompkins Consolidated Area Transit (TCAT) personnel.

 Mr. Proto said he had spoken to Mr. Ghearing of TCAT as well as Ms. Dolan regarding the portion concerning Medicaid transportation expenses.  Ms. Dolan said she has had conversations with Mr. Ghearing and that it is felt that the increases in transportation expenses may be due, in part, to the implementation of a swipe card system for transportation.  This system is operated similarly to debit cards, with the number of rides credited to cards given to clients.  If the card is not fully used or lost it would increase the expense line for transportation.  Mr. Ghearing and Ms. Dolan are in the process of reviewing the information and developing options that would alleviate this situation.  A voice vote was taken on the resolution and it was unanimously approved.  MOTION CARRIED.
 

WHEREAS, expenditures in several Mandate programs in the Department of Social Services are projected to exceed the amounts budgeted for them in 2002, with associated increases in revenues and local cost, and
WHEREAS, there are insufficient local funds in other Social Services Mandate programs to cover the projected shortfalls through budget transfers, and
WHEREAS, utilization of day care subsidy programs has run high in 2002 with non-mandatory daycare subsidies reimbursed at one hundred percent from the Child Care Block Grant, while Mandatory subsidies are reimbursed at seventy-five percent up to the total block grant allocation, and
WHEREAS, medical transportation expenses have been over-budget all year - influenced by the current card-based fare system introduced by Tompkins Consolidated Area Transit late in 2001 with Federal reimbursement at fifty percent and State reimbursement at twenty-five percent, and
WHEREAS, foster care costs have been running over budget all year, driven by court-ordered placements, clients with high-level needs, and increases in the New York State-calculated institutional payment rates, and
WHEREAS, Safety Net costs have also run over budget all year, driven by a sustained jump in emergency shelter costs, and this New York State-mandated program does not qualify for Federal reimbursement and is split fifty/fifty with the State, now therefore be it
RESOLVED, on recommendation of the Health and Human Services and the Budget and Capital Committees, That the Director of Finance be authorized and directed to execute the following budget adjustments and appropriation from the Contingent Fund:

APPROPRIATION:
FROM: A1990.54400 Contingent Fund    $  416,700
TO: A6055.54400 Day Care (Mandated)         23,200
A6101.54400 Medicaid – Non-MMIS           6,000
A6119.54400 Foster Care        240,000
A6140.54400 Safety Net        140,000
A6142.54400 Aid to Dependent Children          7,500

BUDGET ADJUSTMENTS:
REVENUE:  A6055.43655 NYS Child Care Block Grant  $ 197,200
  A6101.44601 Federal Medical Assistance       12,000
 A6119.43619 NYS Foster Care         10,000
 A6119.44619 Federal Foster Care      240,000
 A6140.43640 NYS Safety Net       140,000
 A6142.43642 NYS Aid to Dependent Children         7,500

APPROPRIATION: A6055.54400 Day Care (Optional)        197,200
A6101.54400 Medicaid – Non-MMIS          12,000
A6119.54400 Foster Care         250,000
A6140.54400 Safety Net         140,000
A6142.54400 Aid to Dependent Children           7,500
SEQR ACTION:  TYPE II-20

Tompkins County SPCA

 Mr. Winograd, Director of the Tompkins County Society for Prevention of Cruelty to Animals (SPCA), spoke to the Committee about the services that his non-profit agency will have to eliminate due to budget cuts.  The specific areas to be cut at this time are: stray cat shelter; twenty-four hour emergency service for sick, injured, and vicious cats; rabies abatement; and animal cruelty enforcement.  He explained that the combined loss of funding, $24,000 from the County, and $76,400 from Cornell University, will have a drastic impact on the operation and would require a choice between eliminating of specific services, or implementing a higher fee structure to continue providing contracted services.  Ms. Robertson asked why all the rabies contract would be discontinued or increased as the County had only cut the portion of their contracts related to the feral cat assistance.  The rabies contract had been under Board consideration for funding and she feels that to eliminate the service, or charge an increased fee was not appropriate.

 Mr. Winograd said in the past he has been able to maintain lower fees  by spreading out his funding in the most beneficial manner and that many of the areas crossed over, for example, feral cats coming in were spayed, provided with rabies vaccine, etc.  With the reduction in revenue the expense is not totally borne on one program, therefore requiring an increase in fees.  Mr. Winograd also expressed his disappointment that he had not been reached prior to the additional cut proposed for his agency.  In addition, he also spoke about the comments made implying he could utilize funds from the SPCA endowment proposed capital project to supplement the agency's operations, , indicating that to do so was would be contrary to law.  Mr. Proto addressed the last comment, stating that his comments were limited to the fact that a portion could be utilized, not the entire sum.  Mr. Proto asked Mr. Winograd whether the agency was willing to contract with the County for rabies control and if so what would be the cost involved; if not willing he inquired whether any back-up plan was in place.

 Mr. Winograd said when initially approached by the County to prepare a budget with a twenty percent reduction that he believed it would be difficult but he was determined to find a way to make it work.  Unfortunately, with the additional reduction from the County coupled with the loss of $76,400 from Cornell University it would be impossible to do.  He explained the cost of taking in stray cats is approximately $80,000 annually.  If he were to contract with the County at the initially proposed amount he would be operating under an increasing deficit and did not feel he could justify it.

 When asked about the present contract's expiration dates and what comprises a legal notice of non-renewal, Ms. Cole said she would have to refer the matter to the legal department for a ruling.

 Mr. Winograd addressed the new State regulations regarding rabid animals, indicating that they require animals who are in question be housed in a professional facility for obersvations, at the owner's expense.

 Mr. Proto asked for more details regarding the reduction of revenue from Cornell University, suggesting the Board may be able to assist in that area.

 Next, Mr. Andersson of the Environmental Health Department spoke to the Committee about the long relationship that has existed with the SPCA.  He noted they have been extremely helpful over the years in the area of rabid animals, providing a facility and equipment necessary to perform the required process of head removal and subsequent disposal of the animal body.  He stated that he has attempted to seek a back up facility and/or individual who could assist in the performance of the mandated services.  However, Mr. Andersson has found no individual willing to commit to a contract for these services.  Of those who might provide some assistance they would not be able to accomplish all the requirements of the new mandates, possibly requiring multiple contracts.

 Ms. Robertson asked Mr. Winograd if he would be willing to extend the present services in order to provide an opportunity for all parties to attempt to work out a viable solution to this situation.  Mr. Winograd said he was willing to do so.  Mr. Winch then asked Mr. Winograd, Administration, and the Health Department to collaborate and develop a proposal to bring back to the Committee for review.  Mr. Whicher, County Administrator, inquired if the $24,000 funding were restored what level or services would be provided, and/or how much the estimated annual costs would be to fulfill this mandate.  Mr. Winograd said it would require  reviewing financial data before he could determine a figure.  Mr. Whicher asked Mr. Winograd to please bring forward the bottom-line figures for the County to review.

 Mr. Booth said given the figures provided that indicate today's cost to provide this service it appears that the SPCA has been providing services at a reduced rate in the past and that the County needs to be realistic in their review of costs.

Mr. Proto feels an area that needs to be reviewed when setting costs is the conscious decision of the SPCA to be a "no-kill" facility and that the County should not be required to pay any additional costs associated solely from that policy decision.  Mr. Proto asked that information be provided to indicate the varied costs due to the "no-kill" policy.  He also said that individuals need to be educated on what specifically Cornell University provides to the community and what in addition are they willing to provide.  It was suggested that perhaps they could assist in some way in lieu of taxes.  Mr. Whicher will be meeting with Cornell University representatives in the near future and will speak to this issue.

Health Department

RESOLUTION NO.      - AUTHORIZING CHANGES IN CHARGE STRUCTURE - TOMPKINS COUNTY HOME HEALTH CARE - HEALTH DEPARTMENT

 Moved by Mrs. Schuler, seconded by Mr. Proto.  Ms. Cole said that this is the annual adjustments of rates driven by Medicare and Medicaid.  Members of the Committee inquired how the increase in rates was determined and why there was not an increase in all titles.  Ms. Crosby-Grinnell said the rates were determined by an independent certified public accountant, taking into account all costs associated with the services.  Those areas that did not increase this year had been previously increased.  A brief discussion occurred regarding what a visit comprises and what separate areas such as equipment, supplies, administration, etc. are factored into the fee.  Members of the Committee requested that three years' fee information be included within the resolution as well as information on the components that make up the fee.  A voice vote was taken by all members present and it was unanimously approved.  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 2003 rates in December 2002, 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 and Human Services and Budget and Capital Committees, 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.

2003 Tompkins County Home Health Care Fee Schedule

     2001  2002  2003
Skilled Nursing  $102.00  $110.00  $126.00
High Tech Nursing $110.00  $115.00  $135.00
Physical Therapy $  92.00  $105.00  $105.00
Speech Therapy  $  95.00  $105.00  $105.00
Occupational Therapy $  92.00  $105.00  $105.00
Medical Social Work $  90.00  $105.00  $105.00
Home Health Aide $  34.00/hour $  36.00/hour $  41.00/hour
   $  65.00/visit $  70.00/visit $  75.00/visit
SEQR ACTION: TYPE II - 20

 Mr. Booth spoke to Ms. Cole about his concern for public education on the new nano-technology  building at Cornell University.  He explained that the research taking place in this expanded facility warranted County inquiries regarding potential health hazards.

Human Services Coalition

Compass II

 Ms. Dill, Director, provided the Committee with an update on the Compass II needs assessment survey presently being compiled.   The last survey was done approximately twelve years ago.  The update is approximately fifty percent completed with the expected completion expected within twelve to eighteen months.  The survey will provide information relative to the needs and desires of the community.  She noted that almost eight-five percent of Tompkins County employers hire fewer than nine employees.

Homeless and Housing Task Force

 Ms. Dill reported on upcoming meetings of the Task Force and work undertaken by this group.  She noted that while many organizations have internal organizational difficulties this group has consistently reflected cooperation and coordination of efforts.  Ms. Dill said that members of the Task Force are diverse and represent all facets of housing.  Part of the tasks completed include a monthly update of information relevant to the number of individuals who require housing assistance.  This information assists with grant applications now and in the future.  At the present time a "street count" is being taken, assisted in part with information from the Youth Bureau and Learning Web.  This count is provided to Housing and Urban Development and will assist in providing an overview of specific target group figures and how they compare to other counties.  She said that developing all the information is a lengthy process, but by continually reviewing information and adjusting programs.  They hope to assist in alleviating the difficulties of the homeless  and low income individuals and families.

 Mrs. Schuler agreed with the statements made by Ms. Dill and noted the worthwhile efforts of the Homeless and Housing Task Force.  She also said that figures of those requiring assistance can add up very quickly when it involves families.  Mrs. Schuler spoke of the number of days allowable for shelter assistance and that when families are involved it is sometimes difficult to easily assess all the figures.

 Ms. Robertson inquired whether the number of individuals requiring housing increased in the past several months. She was told that although the numbers have increased that there is no typical pattern relating to the time of year.  Ms. Dill said that although many individuals seeking shelter were not native to our area that there is some connection with this community.  Mr. Proto noted that as a landlord he receives many calls seeking housing for the low income and that often there are no vacancies within most apartment buildings.

Youth Bureau

Recreation Partnership Update

  Ms. Zahler, Director, requested that the Committee provide members of the Recreation Partnership Board clarification regarding the County's intent of the $9,500 over target request, aspproved as a one-time item for 2003.  She said that some municipal members have indicated that they would most likely follow the lead of the County with regard to this particular Board.  Ms. Robertson said she would like to see how much staff time goes into the Recreation Partnership and that she believes that Ms. Johnston's time is equivalent to the twenty percent cut.  She also asked whether the County should be involved in recreation programs.  Mr. Winch said that he does not feel that there is any way to predict what the future intent of the County is with regard to the Partnership.  Mr. Booth suggested that the funding reserve for the Partnership be segregated from the General Fund and recommends that Mr. Squires, Financial Director, or Mr. Whicher, County Administrator be consulted in the matter.  Mrs. Schuler said she feels that the staff support provided by the County should be recognized by the Partnership.  Ms. Robertson feels that a subcommittee should be formed to determine a work plan and participatory level the County should take.

Recreation Facilities Update

 Ms. Zahler said that the City of Ithaca has met and she is now prepared to reconvene the County and Town representatives to discuss the matter as a group.  Mr. Proto inquired whether there is any indication of the Partnership indicating a desire to have the County take over any cost of the facilities.  Ms. Zahler said that although the City does not desire to continue with the full cost of the facilities and has various alternatives under discussion, it has never been indicated that the County pay.

Mr. Winch left at 11:00 a.m. and Vice Chair Schuler took over the meeting.

Healthy Youth/Vital Communities Planning Updates

 Ms. Zahler said that community forums are being held and information is being compiled to assist in directing services to the areas of concern.  Areas of concern include lack of part time employment for youth, family conflict services, and the gap between rich and poor.  Ms. Zahler said that there also appears to be a need to apprise residents of services that are available to them.  This information will be completed in 2003 for consideration in planning 2004 work plans.

Drug Task Force Administrative Contract Update

 Ms. Zahler said that at this time they do not have a contract but all paperwork is in the Federal Government to modify this grant.  The amount of revenue for the Youth Board will be approximately $22,000 during 2003.  She noted that the work being done will provide information to ascertain whether this type of service can be offered to municipalities or agencies.

City-County Committee Update

 The Youth Board is looking at a potential work plan for a joint group at the request of the City.  The City Youth Board of Advisors has decided that this time the matter should be postponed until a permanent director is in place.

Office for the Aging

Foodnet Building Purchase

 Ms. Stein reported that all parties have agreed on the details of a purchase agreement for the real property presently housing Foodnet.  A resolution will be coming forth for this purchase as well as for the occupancy agreement.

 Mr. Whicher said the Committee needs to act upon the resolutions in January 2003.

Change of Hours

 Ms. Stein said that one of her staff will have hours reduced from 35 hours per week to 30.  As the scope of the position varies in its requirements over the year part of the year the employee will work 35 hours for one half year and 25 for the second half.

Budget Adjustment

 It was MOVED by Mr. Booth, seconded by Ms. Robertson and unanimously agreed by members present to approve the following budget adjustment.

Office for the Aging
Revenue Acct           Title  Amt  Approp Acct Title(s) _________
6780  42705           Gifts and Donations   $480   6780  54491 Subcontracts
Explanation:  Contributions greater than expected in the EISEP program.
SEQR ACTION:  TYPE II-20

Appointments

 It was MOVED by Ms. Robertson seconded by Mr. Booth and unanimously agreed to accept the recommendation of the Commissioner of Mental Health to approve the appointments as follows:

Office for the Aging Advisory Committee
Nicholas J. Barra - At-Large - Term to expire December 31, 2005

Personal Emergency Response Service Advisory Board
Phyllis Stout - At-Large - Term to expire December 31, 2004

Mental Health Board
Flora Sagan -  Term to expire December 31, 2006
David Spano -  Term to expire December 31, 2006
A.J. Kircher - Term to expire December 31, 2006
Laura Chacona - Term to expire December 31, 2006
Martin A. Luster - Term to expire December 31, 2006

Mental Health Subcommittee
Flora Sagan - Mental Health Board Representative - Term to expire December 31, 2006

Mental Retardation/Developmental Disabilities Subcommittee
Laura Chacona - Mental Health Board Representative - Term to expire December 31, 2006
John Brooks - Community Member- Term to expire December 31, 2003
Jeffrey Boles - Community Member- Term to expire December 31, 2006
Chris Donovan - Community Member - Term to expire December 31, 2005

Substance Abuse Subcommittee
A.J. Kircher - Mental Health Board Representative - Term to expire December 31, 2006
Tom Schlee - Community Member- Term to expire December 31, 2005
Shane Jaynes - Community Member - Term to expire December 31, 2004
Thomas Lipa - Community Member- Term to expire December 31, 2005
Stu Bergman - Mental Health Board Representative - term to expire December 31, 2005

Adjournment

 Meeting adjourned at 11:17 a. m.
 

Respectfully submitted, Karen Fuller, Deputy Clerk