HEALTH AND HUMAN SERVICES COMMITTEE
MARCH 5, 2003     11:30 A.M.
SCOTT HEYMAN CONFERENCE ROOM


Present:  M. Robertson, Chair; M. Koplinka-Loehr; P. Penniman; N. Schuler; F. Proto (arrived at 11:41 a.m.)

Staff:      S. Whicher, County Administrator; I. Stein, Office for the Aging Director; M. Dill, Human Services Coalition; S. Allinger, Health Department; N. Zahler, Youth Bureau Director; B.  Crosby, Health Department; J. Johnson, Youth Bureau; S. Kern, Health Department

Called to Order

    The meeting was called to order at 11:34 a.m.

Changes to Agenda

    Ms. Robertson requested a discussion and update on the Advocacy Center's proposal be added to the agenda.  Mr. Penniman asked for an update on the Health Department's budget as it relates to the Governor's proposal.  Mr. Whicher spoke about the Department Head meeting held earlier that day and a request made that reports will be provided by Department Heads when there is a clearer direction from the County and State.  Ms. Robertson said the Committee will receive a report on home care services at the next meeting which could include a broader discussion of budget impacts.  

    Mr. Proto arrived at this time.

Approval of Minutes

    It was MOVED by Mr. Koplinka-Loehr, seconded by Mr. Penniman, and unanimously adopted by voice vote, to approve the minutes of the February 20th meeting as corrected.

Office for the Aging

    Ms. Stein provided an overview of her Department and said its mission is to give every senior possible a decent life living in his or her own home where ever that may be, including those living in nursing homes.   The Department is mandated under the Older Americans Act to provide needs assessments, monitoring, and evaluations of programs.  She reviewed the programs and services offered, either directly or through contracts, needed to meet the mission.  A brochure was distributed at this time to provide a quick overview of the programs and services.  An Annual Plan is done and a public hearing held that provides input and is then incorporated into the final Plan. She reviewed the unmet needs and cuts the Department is experiencing in the current year. Although core services remain intact, COFA had to cut some housing assistance and employment aid. Cuts in staff hours have caused slower response time to requests for information and help. Monthly reports are required for each program that include the number of people who are being served and the units of service.  These reports determine which programs will be evaluated.  Quantitative objectives are available for each program.  

    Ms. Stein noted that a presentation on the Weatherization Referral Application Program (WRAP) is scheduled for this committee in June.  Representatives from Tompkins Community Action, WRAP, and Better Housing will be present to explain how the program works. 

    Mr. Whicher briefly reported the bond rating came in today at 1.2 percent for the purchase of the Foodnet building.  At this time, Ms. Stein reviewed the unmet needs identified in the proposed 2003 Plan and the proposed cuts in the Governor's proposal.  She said the Governor's proposed budget shows a $25,000 cut for her Department and noted the Department will be operating with a total cut of $50,000 in 2003.  She commented that although the cuts appear to be small compared to the Department of Social Services,  they are having an enormous impact on the services provided. The local share of COFA funding is $580,335, so a cut of $50,000 is almost 10% of operating money.

    Ms. Stein presented the Committee with the following list of cuts the Department has made or is anticipating:

1.  County Cuts          Fiscal Year 2003                                                                           $51,621  
      Staff cuts resulted in elimination of housing and generic
          Employment programs as well as slower response time
           (In 2002, 333 people were served in housing program; 59 with
            generic employment). There has also been a longer wait for clients
            in general.                                                                                                              $18,722
      Reduction in operating expenses                                                                                7,189
      Substitution of new federal dollars for county dollars                                           25,710

2. Federal Cuts  April 1, 2003- March 31, 2004
    Interstate Funding Formula change to disadvantage of NYS                                  7,024
     Impact to be determined

3. State budget Cuts April 1, 2003-March 31, 2004
In home care (EISEP) and Community Services to the Elderly (CSE) have been combined. The latter serves programs that keep the elderly in independent living.   We have contracts to provide home repairs, long term care assistance, linkage with home care workers (the Registry), outreach and socialization in the minority community and food shopping.            14,448                                    
CSI – congregate health and wellness programs                                                           3,674

We will cut a contract with Senior Citizens Council for CSI services.  We will probably eliminate our contract with the Registry, and are still working on making further cuts. The Registry served 178 seniors in 2002.    

         The required match is increased from 25 to 30%.  Also, a 30% match is added to State Planning and Implementation funds ($20,000).  This does not present an immediate problem.          
    
    Ms. Stein said that if the proposed state and federal cuts stand, COFA would see a net loss of about $50,000, on top of the County’s cuts. There was a discussion of long-term unmet needs. Ms. Stein noted in particular a significant gap in assisted living options for low- and moderate-income seniors and health insurance for uninsured people aged 60-65. She also spoke of the shortage of health care workers in all settings, which will be exacerbated by proposed State cuts to the Health Department.

    Mr. Penniman said he would like to add a statement similar to the Department's mission to the list of Committee goals about serving all elders and would like to have a report on the impact of State cuts on other agencies serving the elderly. 

Youth Bureau

    Resolution - Program Reconfiguration - Recreation Partnership
    It was MOVED by Mr. Koplinka-Loehr, seconded by Mr. Penniman, to submit the following resolution to the Budget and Capital Committee for approval.  Ms. Zahler said there were requests made by the partners to have the funds segregated for better accountability.  This resolution will allow the Recreation Partnership to have its own Fiscal Target that includes only the County's share.  Mr. Koplinka-Loehr asked that a discussion on the Recreation Partnership contribution be discussed at a future meeting of the Committee, and Ms. Robertson noted it is on the schedule for May 22.

    A voice vote resulted as follows on the resolution:  Ayes - 5; Noes - 0.  RESOLUTION ADOPTED.

RESOLUTION NO.     PROGRAM RECONFIGURATION AND TARGET    ADJUSTMENT -  RECREATION PARTNERSHIP - YOUTH BUREAU

WHEREAS, the Inter-municipal Recreation Partnership Board has asked the County to be the fiscal agent to receive municipal contributions and to make payments based on the decisions of the Recreation Partnership Board, on which the County has two voting seats, and
WHEREAS, the approved Recreation Partnership Agreement calls for the funds to be accounted for separately, and
WHEREAS, Program 2401, Recreation Partnership is one program within the Youth Bureau and is included in one Fiscal Target for the entire department, now therefore be it
RESOLVED, on recommendation of the Health and Human Services and Budget & Capital Committees, That the Fiscal Target for Program 2401 Recreation Partnership be made separate for 2004 in the amount of $38,110 which represents the local share of program expenses less local revenues, and
RESOLVED, further, That any residual funds from 2002 and 2003 related to Program 2401, (A7021), exclusive of savings in payroll and fringe, be reported separately, and  
RESOLVED, further, That a copy of the approved resolution be sent to each of the participating municipalities.
SEQR ACTION: TYPE II-20
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    Revised 2003 Goals
    Ms. Zahler explained the goals as sent in the Committee’s packet were revised for clarification as requested at a previous meeting. 

    Drug Task Force Grant
    Ms. Zahler said she will be presenting at the next meeting a resolution for a $23,000 grant acceptance.  She said the grant was for four years and is being extended one more year.  The grant goes to the City of Ithaca to serve the Ithaca City School District.  Copies of the federal goals, evaluation measures, and local components to achieve goals were distributed to Committee members.  A detailed proposal is also available if requested.  Mr. Proto said he would like more detail; Ms. Zahler agreed to provide the additional information.  Ms. Robertson asked if this could be extended to other school districts.  Ms. Zahler said that will happen during the fifth year of the grant. 

    Recreation Facilities Update
    Ms. Zahler distributed copies of a status report of the Recreation Partnership and Recreation Facilities Committee. 

    Ms. Zahler also distributed copies of two other documents:

    - Tompkins County Network of Youth Services and Input for Health Youth/Vital Communities
    - Tompkins County Youth Board's Continuum of Youth Services 2003.

Health Department

    Resolutions
    It was MOVED by Mrs. Schuler, seconded by Mr. Koplinka-Loehr, and unanimously adopted by voice vote, to submit the following resolution to the Budget and Capital Committee Board for approval:

RESOLUTION NO. – APPROPRIATION FROM CONTINGENT FUND – TERMINAL PAY – HEALTH DEPARTMENT
    
    WHEREAS, the Health Department had three employees retire as indicated, Ellen Brazauskas, Community Health Nurse Supervisor (12/02/02), Patricia Stamm, Administrative Assistant (12/30/02) and Sharon Haas, Community Health Nurse (12/19/02), with terminal pay costs totaling $6,014, and
    WHEREAS, the Fiscal Policy of Tompkins County allows for terminal pay from 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:        A1990.54440        Contingent Fund            $6,014
    
TO:        A4010.51000535 Administrative Assistant         $   738
              A4010.58800        Fringes                                        $   192
              A4016.51000580  Community Health Nurse         $1,898
              A4016.58800        Fringes                                        $   493
              A4047.51000601  Community Hlth. Nurse Supv. $2,137
              A4047.58800        Fringes                                         $   556
SEQR ACTION: TYPE II-20
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    It was MOVED by Mr. Koplinka-Loehr, seconded by Mr. Proto, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval:

RESOLUTION NO.   –    AUTHORIZATION TO INCREASE HOURS – ENVIRONMENTAL HEALTH AND WIC PROGRAM – HEALTH DEPARTMENT

    WHEREAS, Environmental Health has 1.0 FTE Public Health Sanitarian position unfilled, funded .50 FTE as one-time funding and .50 FTE in base budget funding, and
    WHEREAS, the division has evaluated the best use of those funds and reorganized the workload among existing employees to accomplish the functions of the department and eliminate the need to hire additional staff, now therefore be it
    RESOLVED, on recommendation of the Health and Human Services Committee, That one position of Senior Public Health Engineer (89/240), labor grade S, competitive class be increased from 35 hours to 37.5 hours per week, effective immediately through 12/31/03, and
    RESOLVED, further, That one position of Public Health Engineer, (15/640), labor grade O, competitive class, be increased from 35 hours to 37.5 hours per week, effective immediately through 12/31/03, and
    RESOLVED, further, That five positions of Public Health Sanitarian, (14/595), labor grade N, competitive class, be increased from 35 hours to 37.5 hours per week effective immediately through 12/31/03, and
    RESOLVED, further, That three positions of Sr. Public Health Sanitarian, (16/607), labor grade P, competitive class, be increased from 35 hours to 37.5 hours per week, effective immediately through 12/31/03, and
    RESOLVED, further, That one position of Public Health Sanitarian is currently filled by an employee working in the WIC Program, and in order for the payroll system to handle the combined hours over 35 hours per week, the WIC Program Nutrition Aide (08/524), labor grade H, competitive class, position must also be increased from 35 hours to 37.5 hours per week effective immediately, and
    RESOLVED, further, That no additional funds are required to accommodate this change.
SEQR ACTION: TYPE II-20
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Explanation:  
At the beginning of 2003, the EH Division has one position of Sanitarian position budgeted but not filled.  Half of this position is funded only for 2003 and we are working to “transition” through the year in anticipation of it not being funded in 2004.  In reviewing the options available it is best felt that as an alternative to hiring an additional staff person (with added advertising costs, interviewing, and training) that staff would try an increase in work hours and potentially hiring up to two people part-time in the summer.  

The WIC position increase is a result of a “glitch” in the payroll system when one employee is hired to work in two separate departments and exceeds the hours approved for the positions.  In this case the employee works a total of 37.5 hours per week, however both positions are approved for 35 hours per week.  This necessitates the increase in hours to 37.5 per week for both positions, even though the full hours will be not be filled.   The WIC Program will not be increasing the time for the Nutrition Aide as a result of this change at this time.

    It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler, to submit the following resolution to the full Board for approval. Ms. Robertson thanked Health Department staff for their flexibility and creativity, as represented by these two resolutions, in dealing with a very difficult budget.

A voice vote resulted as follows on the resolution:  Ayes - 5; Noes - 0.  RESOLUTION ADOPTED.

RESOLUTION NO.   –   AUTHORIZATION TO INCREASE HOURS – SR. ACCOUNT CLERK TYPIST AND COMMUNITY HEALTH NURSE– CHILDREN WITH SPECIAL NEEDS – HEALTH DEPARTMENT

    WHEREAS, the Children With Special Needs Program (CSCN) has reorganized to address the early retirement of the Supervising Community Health Nurse and the workload among several employees, and
    WHEREAS, the Children With Special Needs Program has a .60 FTE Sr. Account Clerk Typist (09/529), labor grade I, competitive class, and a .50 FTE Community Health Nurse (15/580), labor grade O, competitive class, now therefore be it
    RESOLVED, on recommendation of the Health and Human Services Committee, That the position of Sr. Account Clerk Typist (09/529), labor grade I, competitive class, be increased from 21 hours to 35 hours per week, effective immediately, and
    RESOLVED, further, That the .50 FTE Community Health Nurse (15/580), labor grade O, competitive class, be increased from 17.5 hours to 35 hours per week, effective immediately, and    
    RESOLVED, further, That no additional funds are required to accommodate this change.
SEQR ACTION: TYPE II-20
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Explanation:  
A CSCN task force was formed to evaluate the staffing and supervisory needs of the Division.  This task force has determined that the needs of this Division will be best met by increasing these positions at this time.

The Senior Account Clerk Typist’s primary responsibilities are the billing, Medicaid claiming and New York State Department of Education claims for the Committee on Pre-School Special Education Program (CPSE).  With increasing mandates coming from both the State and Federal levels for documentation and justification of the services being delivered, the increase to the details of the workload has doubled.  Currently there are 1.5 FTE’s managing the $2,650,000 in services rendered.

The Community Health Nurse position functions as a Service Coordinator for the Early Intervention Program (EIP).  The EIP population in Tompkins County has increased 118% from 1997 to 2002.  In 2002, the Service Coordinators carried caseloads in the 50s.  The New York State Department of Health recommends caseloads of 35-40.  At the same time, the complexity of these caseloads continues to increase.  The increase in this Community Health Nurse position will offset the reduction in caseload by the Team Leader who is assuming full management responsibility of the Early Intervention Program.  
The Team Leader is assuming full management responsibility of the Early Intervention Program and the Community Health Nurse will pick up some of her cases in this reorganization.

    Update on Governor's Proposal
    Ms. Crosby said that currently the Governor's budget proposes to eliminate State Aid on all optional services which includes the Certified Home Health Agency estimated at $97,000-$98,000.  She said there are a number of other programs that are affected including Children with Special Needs, EMS, health safety, etc.  Ms. Robertson requested a list of optional services and the dollar amounts for the next Committee meeting. 

2003 Committee Goals

    Mr. Penniman spoke about his suggestion earlier in the meeting to add an overall Committee goal about monitoring the delivery of human services in Tompkins County to make sure all citizens have maximum quality of life. 

    Ms. Robertson said she would like each Committee member to choose a department to write an op-ed piece or guest editorial about a program or particular area of interest.   Committee members are encouraged to work with the appropriate staff to draft a statement, and to also enlist Wendy Skinner’s assistance if necessary. Mr. Koplinka-Loehr noted this is one of the Committee’s goals for the year. Ms. Robertson would like members to report back at the next meeting on their progress.  Following is a list of assignments:

    Overall, including purpose of series – Martha Robertson
    Human Services Coalition and Agencies - Mike Koplinka-Loehr
    Mental Health - Nancy Schuler
    Department of Social Services - Peter Penniman
    Health Department - Frank Proto
    Youth Bureau - Martha Robertson
    Office for the Aging - Martha Robertson and Frank Proto

Human Services Coalition

    Advocacy Center
    It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler, and unanimously adopted by voice vote, to hold an executive session to discuss personnel issues.  An executive session was held from 1:10 p.m. and returned to open session at 1:29 p.m.

    Ms. Dill requested and the Committee agreed that she would ask an agency to give a report to the Committee on a monthly basis.

Adjournment

    The meeting adjourned at 1:30 p.m.

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