HEALTH AND HUMAN SERVICES COMMITTEE
MARCH 20, 2003     9:00 A.M.
SCOTT HEYMAN CONFERENCE ROOM


Present:  M. Robertson, Chair; M. Koplinka-Loehr; P. Penniman; N. Schuler (arrived at 9:03 a.m.)

Excused: F. Proto

Staff:      S. Whicher, County Administrator; B.  Crosby, Health Department; A. Cole, Public Health Director; W. Skinner, Public Information; N. Winograd, SPCA; S. Connors, Health Department; N. Zahler, Youth Bureau Director; A. Balander, Health Department; M. Gatch, Health Department; M. Dolan, Social Services Commissioner

Guests:    D. Higgins, Ithaca Journal Reporter


Called to Order

    The meeting was called to order at 9:00 a.m.

Changes to Agenda

    There were no changes to the agenda.

Approval of Minutes

    It was MOVED by Mr. Koplinka-Loehr, seconded by Mr. Penniman, and unanimously adopted by voice vote by members present, to approve the minutes of the March 5th meeting as submitted.

    Mrs. Schuler arrived at this time.

2003 Goals and Calendar

    Ms. Robertson briefly reviewed the 2003 goals and calendar and asked Mr. Penniman if the first sentence reflected his comments from the last meeting.  Mr. Penniman asked and the Committee concurred to add to the sentence the words "all of" our residents, so that the opening sentence of the 2003 Goals statement reads: “Support the Legislature’s vision of a county where all of our residents’ social and economic well-being flourishes in an environment that is physically safe and supportive.”

    It was the consensus of the Committee to accept the goals as amended.

Health Department

    Resolution - SPCA Agreement
    It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler, to submit the following resolution to the full Board for approval. Mr. Winograd addressed some of the concerns and issues raised recently and spoke specifically about the number of cats and dogs the SPCA handles and the procedures followed.  Every year approximately 2,000 cats and 1,000 dogs are brought in.  Of the 2,000 cats, 100 are usually classified as feral or wild.  He stated that the remaining cats, which are tame and therefore considered “stray,” are considered adoptable. For the most part they are held until they’re adopted, and are never neutered and then released to the community. He feels this is where some of the confusion has been.  Mr. Winograd said he would make the SPCA's Annual Report available to Committee members upon request.  He also spoke specifically about the County's relationship and contract agreement.   At this time, Ms. Balander briefly reviewed feral cat information she obtained from the New York State Bureau of Communicable Disease Control.  Ms. Robertson noted that there are enough stray cats, and enough cases of human exposure to rabies-suspect cats, to justify the need for the cat shelter.

    Mr. Penniman understands the SPCA's mission is slightly different from the County's mission, however, he feels this is the most cost-effective approach for this service.  Mr. Winograd commented that the SPCA works with the Sheriff's Department with a reported 150-200 animal cruelty cases per year with the costs being absorbed by the SPCA.  He said monthly reports for dog control are provided for each municipality and commented that he could prepare reports for the County as well.  Ms. Cole said this is a contractual issue and would like to negotiate this item and determine the information needed for the report. 

    A voice vote resulted as follows on the resolution:  Ayes - 4, Noes - 0, Excused - 1 (Proto).  RESOLUTION CARRIED.

RESOLUTION NO.               - APPROPRIATION FROM CONTINGENT FUND AND AUTHORIZATION TO AMEND GRANT FUNDING AGREEMENT WITH THE SPCA –HEALTH DEPARTMENT

WHEREAS, funding in the 2003 Tompkins County budget for the SPCA is dramatically less than in previous years, and
WHEREAS, the SPCA has demonstrated that it cannot continue to provide services at the same level as in prior years with a sixty percent decrease in funding, and
RESOLVED, on recommendation of the Health and Human Services and Budget and Capital Committees, That the Board of Representatives authorizes entering into a three year agreement with the SPCA,
RESOLVED, further, That the Animal Control Contract for 2003 be increased by $10,264,
RESOLVED, further, That the Public Health Budget appropriations be increased by $5,582,
RESOLVED, further, That the total paid by Tompkins County including payments made by the Public Health Department be $36,000 for 2003 which is a decrease of $11,240 from 2002,
RESOLVED, further, That the total paid by Tompkins County including payments made by the Public Health Department be $36,720 (representing a two percent increase) for 2004,
RESOLVED, further, That the total paid by Tompkins County including payments made by the Public Health Department be $37,454 (representing a two percent increase) for 2005,
RESOLVED, further, That the fiscal target for the Public Health Department for 2004 be increased by $71 and the fiscal target for Animal Control be increased by $527,
RESOLVED, further, That the fiscal target for the Public Health Department for 2005 be increased by $73 and the fiscal target for Animal Control be increased by $537,
RESOLVED, further, That the Director of Finance be authorized and directed to make the following budget appropriations and adjustment:
FROM:            A1990.54400 Contingent Fund                                                             $13,836
TO:                  A3520.54400 Animal Control Program Expense                                 $10,264
                         A4090.54400 Environmental Health Program Expense                     $  3,572   

APPROPRIATION:     A4090.54400 Environmental Health Program Expense       $  2,010
REVENUE:                    A4095.43401 Public Health State Aid                                   $  2,010
SEQR ACTION: TYPE II-20
* * * * * * * * * *

Explanation: 
Current funding in the 2003 Adopted Budget for the SPCA is $16,066
Current funding in the 2003 Health Department Budget is $4,088
Total funding in the 2003 Budget is $20,154.
The Health and Human Services Committee and the SPCA have agreed to funding of $36,000 for 2003 with an increase in 2004 and 2005 equal to the CPI.  Since the CPI is not a figure that is readily available the author of this resolution in consultation with the Health Department has specified a 2% increase in 2004 and 2005.

This resolution appropriates $13,836 from the Contingent Fund and makes $2,010 of SPCA funding offset by State Aid.

Funding Summary:
2003 Adopted                                                                      $20,154
Contingent Fund Appropriation                                       $13,836
Funds made available through State Aid increase        $  2,010
Total Appropriation for SPCA in 2003                             $36,000

    Home Health Care Services
    Ms. Connors introduced Melissa Gatch who has been working with the Home Health Care program for 16 years.  Ms. Gatch reviewed the program information she distributed.  The mission is to promote high quality health care in the home to all members of the Tompkins County community by providing health education, supportive care, and professional services regardless of ability to pay.  Home Health Care Services include skilled professional registered nurses, physical therapy, occupational therapy, speech language pathology, and home health aides through five community licensed agencies.  The average age of clients served in 2002 was 75 and 83 percent of all clients live in their own home.  The goal of the program is to keep people home.  There were 460 clients served in 2002 through 13,721 visits. 

    At this time, Ms. Connors reviewed the program’s accomplishments and changes over the years. 

    State Budget Impacts
    Ms. Cole reviewed the proposed program cuts in the Governor's budget that are slated to be effective January 1, 2003 and total $317,121.  Combined with a possible 0.6% assessment on our Home Health revenues, the total impact would be $325,178.  This represents approximately 12% of the Health Department local share.  Below is a list of potential cuts:

1. Reimbursement rate for core services drops from 36 percent to 30 percent; loss of $53,734.

2. Reimbursement rate for “optional” services drops from 30 percent to 0 percent; loss of $263,387 for such “optional” services as:
         Home Health Services - $97,850
         Laboratory Services - $7,980
         Early Intervention Service Coordination/3-5 Program Administration - $97,963
         Employee Health & Safety - $17,798
         Various Environmental Services - $488
         Emergency Medical Services – $40,673
         Health Admin. on Medical Examiner/Physically Handicapped Children’s Prog./EI - $635

In addition the Governor has proposed requiring low-income families to contribute up to 20 percent toward the cost of their children’s Early Intervention services. Ms. Robertson noted that some of the “optional” services listed above are the administrative costs incurred to provide state-mandated services, such as Early Intervention.

Mrs. Schuler asked if the department would be looking at fee structures such as in environmental health.  Ms. Cole said that this issue would be discussed this year.

Ms. Crosby spoke about another concern with the State budget.  She said the current proposal is to cap the amount of State Aid available.  The State will roll claims from 2002 into 2003 which will decrease the amount available for 2003; the rough estimate is a 53 percent reduction in Public Health funding statewide.  It is unknown how this will effect health programs statewide.

    Ms. Cole said she would keep the Committee informed and will continue the lobbying efforts to try to  have all programs considered “core” services and eliminate the "optional" category. 

Social Services Department

    February 2003 Reports
    Ms. Dolan briefly reviewed the February reports and said the first two months are average with the exception of the family assistance program, in which the caseloads have increased by 80 cases.  She learned last week that the County should not expect advances or settlements until at least April which means the cash position will not be known until after that time; the cash flow from the State is slowing down.  Mr. Whicher said the Budget and Capital Committee will continue its discussions on these budget issues.  He said the capping proposal will not have an impact this year, but it will impact Social Services, Public Health, and Mental Health in future years.  Mr. Penniman commented that this is the same concern with Tompkins Cortland Community College as payments are being delayed.

    2002/2003 Goals

    Ms. Dolan distributed and highlighted the Department's 2002 goals.  She explained the two goals that were not met:  (1) provide improved customer service through expanded hours one evening per week; and (2) complete phone access improvement project. 

    At this time, Ms. Dolan briefly reviewed the accomplishments for each of the divisions/units:  eligibility, children's services, administrative services, and child support unit.  In addition, she reviewed the 2003 goals for adult protective and long term care services and the 2002 staff development goals and planning unit goals. 

    Ms. Dolan reported Kathy Schlather is preparing an update on the alternatives to incarceration programs.

    Ms. Dolan also reported that it appears the Department expects that there will be a shelter increase in the cash assistance program beginning in September 2003.  A point-in-time look at the cases has been conducted, with gross costs estimated to rise approximately $4,000 per month in the family assistance program.  This static look does not provide the full picture since rents will rise if the shelter rates are increased. 

Ms. Dolan also noted that it is increasingly difficult to reconcile what the State is doing in the Medicaid program to the fiscal reality faced by local districts.  In the Medicaid program and what is happening at the State level and the Department level are difficult to bring together.  There is a change in the Medicaid rules that states individuals are no longer required to have a face-to-face interview to re-certify for Medicaid, which will result in more mail-in applications.  If an individual fails to reapply in the public assistance area, the case is transferred and remains open for one year.  This is a change from past practice and will result in additional cases remaining open for Medicaid for a full year.

    Ms. Dolan reported that the family planning program continues to grow.  Forty applications have been processed and 80 are pending. 

    Mr. Whicher requested the Committee discuss filling the Social Services Commissioner's position in April.

Youth Bureau


    Budget Adjustment
    It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler, and unanimously adopted by voice vote by members present, to submit the following budget adjustment to the full Board for approval:

Revenue Acct              Title                             Amt        Approp Acct    Title(s)   
7020  43820      Programs for Youth            - $12,000    7020  51000634 Youth Bureau Planner
7020  42770     Other Misc. Revenue            $12,000    7020  51000634 Youth Bureau Planner
7020  42770     Other Misc. Revenue            $     600    7020  54303       Supplies
7020  42770     Other Misc. Revenue            $  1,000    7020  54330       Printing
7020  42770     Other Misc. Revenue            $  1,900    7020  54412       Travel/Training
7020  42770     Other Misc. Revenue            $     610    7020  54452       Postage
7020  42770     Other Misc. Revenue            $  3,000    7020  54442       Professional Service Fees
7020  42770     Other Misc. Revenue            $  3,000    7020  52230       Computer Software
7020  42770     Other Misc. Revenue            $  1,500    7020  52206       Computer Equipment

Explanation:  Notified that anticipated NYS Integrated County Planning funds will not be available for 2003.  To replace the salary decreased due to not receiving in the ICP funding.  Funds to cover increased usage of paper, toner, cartridges, etc. due to services we'll be providing the Community Drug Task Force.  Funds to cover increased printing and copying needs of reports and materials for grant.  Funds to cover a mandatory conference in Washington, DC and several meetings/trainings to be held in Albany.  Funds due to increased mailings necessary.  Funds to design and update the OJ Book and to offer Youth Worker trainings in Fall 2003.  Funds to upgrade computer software to be able to receive and send materials electronically as required by the Community Drug Task Force grant.  Funds to purchase a scanner and replace a non-safe 19" monitor.

    Program Report on Youth Served
    Ms. Zahler reviewed the information distributed concerning the number of youth served by the Youth Bureau.  Below is an outline of the three ways youth are served.

    1.  Contracted agencies
         2,053 youth were served in 14 programs operated by agencies, including the Ithaca Youth Bureau 
    2.  Municipal Youth Service System
         3,527 youth were served in programs that were offered locally by municipalities under the oversight of youth commissions or community councils
         289 of the 3,527 youth earned wages or stipends through local programs
    3.  Recreation Partnership
         4004 different youth participated in Recreation Partnership Programs which had over 7,787 registrations in 2002

In response to a question, Ms. Zahler briefly updated the Committee on the Outings Program.  In 2002/2003, a ten percent cut was made resulting in fewer kids being served.  The core service of the program continues on a smaller scale.  Independent contracts with municipalities such as the Town of Lansing are being established and/or negotiated.  The goals and indicators achieved in 2002 were briefly reviewed as well. 

    Recreation Partnership Update
Ms. Robertson reported on a meeting held concerning the City’s request for support of its recreational facilities and said the five Board members in attendance (Booth, Schuler, Penniman, Winch and Robertson) did not feel there could be a new commitment from the Board for facilities.  County Funds could possibly be shifted from the Recreation Partnership to facilities.  The Health and Human Services Committee will discuss this further at a future meeting.

Mental Health Department

    Resolution - Terminal Pay
    It was MOVED by Mrs. Schuler, seconded by Mr. Penniman, and unanimously adopted by voice vote by members present, to submit the following resolution to the Budget and Capital Committee for approval:

RESOLUTION NO.      - APPROPRIATION FROM CONTINGENT FUND FOR TERMINAL PAY - MENTAL HEALTH DEPARTMENT

    WHEREAS, during 2002, the following employees terminated their employment with Tompkins County:
    Esther Sullivan, 4313, Caseworker (October 4, 2002)
    Clare Nicholetti, 4311, Psychiatric Social Worker (October 25, 2002)
    Linda Slade, 4313, Case Aide (August 29, 2002)
    Taylor Peck, 4311, Forensic Counselor (March 1, 2002)
and,
    WHEREAS, the Fiscal Policy of Tompkins County allows for reimbursement of terminal pay through the 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:        A1990.5440        Contingent Fund                                     $8,049
TO:              A4313.51000562    Salary - Caseworker                            $   720
                     A3131.58800        Fringe - Caseworker                             $   253
                     A4311.51000599    Salary - Psychiatric Social Worker  $4,341
                     A4311.58800        Fringe - Psychiatric Social Worker    $1,525
                     A4313.51000511    Salary - Case Aide                              $   216
                     A4313.58800        Fringe - Case Aide                                $     76
                     A4311.51000712    Salary - Forensic Counselor              $   679
                     A4311.58800        Fringe - Forensic Counselor                $   239
SEQR ACTION:  TYPE II-20
* * * * * * * * * *

Guest Editorial Assignments

    Ms. Robertson asked Committee members to draft an outline and contact appropriate staff in preparation of their guest editorials.  She reported that she’s been meeting with a group from the Human Services Coalition working on messages to the public through the media, on the theme “Tompkins County; Home for a Lifetime.”

Adjournment

    The meeting adjourned at 11:11 a.m.


Go to Tompkins County Homepage.

Questions or Comments