Health and Human Services
Special Meeting
December 20, 2005 10:30 a.m.
Courthouse Conference Room

Present:  M. Robertson, Chair; G. Stevenson; D. Kiefer; B. Blanchard; F. Proto (arrived at 4:12 p.m.)

Staff:      S. Whicher, County Administrator; B. Crosby, Public Health Administrator

Called to Order

 The meeting was called to order at 4:10 p.m.

Resolutions

 It was MOVED by Ms. Blanchard, seconded by Ms. Kiefer, and unanimously adopted by voice vote by members present, to approve and submit the following resolution to the full Legislature for approval:

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

 WHEREAS, Tompkins County’s accounting consultant, John Kropski, CPA, of Freed Maxick & Battaglia, PC, 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 2006 rates in December 2005, and
 WHEREAS, all changes proposed were made to align charges with actual costs per unit of service as determined during Mr. Kropski’s most recent review of our financial and statistical data, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services and the Budget and Capital Committee, That the Tompkins County Health Department implements the charge structure below, as recommended by John Kropski, CPA, in order to maximize Medicaid, Medicare and other third party revenues:
2006 Tompkins County Home Health Care Fee Schedule

                                         2003              2004/2005         2006
Skilled Nursing                  $126.00          $140.00          $150.00
High Tech Nursing             $135.00          $165.00          $185.00
Physical Therapy               $105.00          $105.00          $110.00
Speech Therapy                $105.00          $105.00          $105.00
Occupational Therapy        $105.00          $105.00          $105.00
Medical Social Work         $105.00          $105.00          $105.00
Home Health Aide             $  41.00/hour   $  45.00/hour  $  45.00
                                         $  75.00/visit    $  90.00/visit   $  90.00

 RESOLVED, further, That the Department sets the per hour Nursing Administrative Charge at sixty-two dollars ($62.00) per hour, for services as appropriate (i.e. rabies post exposure, hypertension screening clinics, etc).
SEQR ACTION: TYPE II - 20

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Note:  The fees are established to maximize dollars from Medicaid, Medicare and other third party payers. The department maintains the use of a sliding fee scale for those patients paying for services out of pocket.  In addition we have negotiated agreements with a number of insurance providers and accept payment in full from them.  The department continues to maintain the ability to waive a fee in special circumstances.

The following are allowable costs used to determine our average cost per visit:
Administration Costs: Salary and Fringe Benefits for administrators, directors, supervisors and others, Contractual services including Care at Home, Software Support/Maintenance, Cost Reporting Services, etc.), Supplies, telephone, etc., Depreciation, POM, Transportation.

Direct Services Costs: Salary and Fringe Benefits, Contractual Arrangements, Drugs, Depreciation, POM and Transportation.

 It was MOVED by Ms. Kiefer, seconded by Ms. Blanchard, and unanimously adopted by voice vote by members present, to approve and submit the following resolution to the full Legislature for approval:

RESOLUTION NO.     -  TEMPORARY INCREASE IN HOURS - PUBLIC HEALTH DIRECTOR AND DIRECTOR OF PATIENT SERVICES

WHEREAS, a staffing shortage has created a temporary need to increase the hours of the Public Health Director and the Director of Patient Services, and
WHEREAS, it is anticipated that this increase in hours would not be required beyond March of 2006, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services and the Budget and Capital Committees, That the standard workweek for the position of Public Health Director (90-250) shall be temporarily increased from 35 hours per week to 37.5 hours per week effective December 4, 2005,
RESOLVED, further, That the standard workweek for the position of Director of Patient Services (88-230) shall be temporarily increased from 35 to 40 hours per week effective December 4, 2005,
RESOLVED, further, That the temporary increase in the authorized workweek for these two positions will sunset on March 25, 2006,
RESOLVED, further, That on March 26, 2006, the positions will revert to a standard workweek of 35 hours per week.
SEQR ACTION: TYPE II-20

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 Mr. Proto arrived at this time.

 It was MOVED by Ms. Kiefer, seconded by Mr. Stevenson, to approve and submit the following resolution to the full Legislature for approval.  Mr. Proto MOVED to delete the following language from the last Whereas: …"free from the influences of tobacco industry marketing and from addiction to tobacco,".  MOTION FAILED DUE TO LACK OF A SECOND.

 Following a brief discussion, a voice vote resulted as follows:  Ayes - 5; Noes - 0.  RESOLUTION CARRIED.

RESOLUTION NO.   - URGING BAN ON SALE AND MARKETING OF FLAVORED CIGARETTES IN NEW YORK STATE

  WHEREAS, tobacco use is the number one cause of preventable death in the United States, and 90 percent of adult smokers started smoking before they were 18 years old, and
WHEREAS, nationally each day, more than 4,000 young people try smoking for the first time, and another 2,000 youth become regular daily smokers, and
WHEREAS, the Surgeon General has concluded that tobacco advertising greatly contributes to youth smoking rates, and
WHEREAS, an estimated one third of adolescent experimentation with smoking can be directly attributed to tobacco advertising and promotional activities (SOURCE:  Pierce, John P., et. al. "Tobacco industry promotion of cigarettes and adolescent smoking." JAMA. February 1998; 279(7):511-515.), and
WHEREAS, the Master Settlement Agreement (MSA) reached in 1998 between state Attorneys General and major tobacco companies forbids cigarette manufacturers from directly or indirectly targeting youth in advertising, marketing and promotion of tobacco products aimed at initiating, maintaining or increasing youth smoking, and
WHEREAS, internal tobacco industry documents strongly suggest that manufacturers intentionally targeted youth through use of candy-like flavors in cigarettes, and
WHEREAS, research from the Harvard School of Public Health (published November 2005) found that cigarette makers are targeting young smokers with new candy- and liqueur-flavored brands that mask the harsh and toxic properties found in tobacco smoke. Tobacco companies use youth-oriented colorful and stylish packaging, and exploit adolescents’ attraction to candy flavors with names such as “Mandarin Mint”, “Winter Warm Toffee” and “Twista Chill”, and
WHEREAS, Tompkins County supports a safe environment in which our youth can grow and prosper, free from the influences of illegal tobacco industry marketing and from addiction to tobacco, now therefore be it
RESOLVED, on recommendation of the Health and Human Services Committee, That the Tompkins County Legislature urges re-introduction and passage of proposed bills in the New York State Legislature (A.03983 and S.01952) prohibiting the sale and marketing of flavored cigarettes,
RESOLVED, further, That copies of this resolution be sent to Governor George Pataki, Senators Seward, Nozzolio and Winner, and Assemblyperson Lifton, and Health Committee Chairs Senator Kemp Hannon and Assemblyman Richard Gottfried.
SEQR ACTION:  TYPE II-20

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Other Business

 Mr. Proto asked to receive salary information on home health aide workers.  Ms. Crosby said the rates in 2006 range from $16.25-$26.04 which is the amount the Department pays to the licensed agency.  The total cost the Department pays for home health aide is approximately $316,000.  Ms. Crosby said she will provide a summary of this information, but commented that in the past this information has been made available and is considered propriety data and not to be released.

Adjournment

 The meeting adjourned at 4:20 p.m.
 


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