HEALTH AND HUMAN SERVICES COMMITTEE APRIL 2, 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: K. Schlather, Social Services Department;
S. Whicher, County Administrator; B. Hawley, Senior Citizens Council; A.
Fitzpatrick, Personnel Commissioner; M. Dill, Human Services Coalition; I.
Stein, Office for the Aging Director; B. DeLuca, Mental Health Commissioner;
A. Cole, Public Health Director; S. Connors, Public Health Department; N.
Zahler, Youth Services Director; G. Smith, Youth Services Board Chair
Guests: B. Blanchard, County Legislator
Called to Order
The meeting was called to order at 11:36 a.m.
Chair's Report
Ms. Robertson referred to a Foodnet Report she received
and stated Steve Griffin of Foodnet said the reports were designed and printed
by the Communications Department at CBORD as a donation to Foodnet.
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 20th meeting as revised.
Mr. Whicher reported that he has requested Department
Heads to distribute material for committee review prior to the meeting and
preferably with the agenda. Department Heads were told that if information
is handed out at meetings to expect the item to be postponed until the next
meeting unless permission is granted by the committee chair.
Social Services Department
Search - Social Services Commissioner
Mr. Whicher distributed copies of a memorandum outlining
the proposed search team and time line as well as Article 12 Department of
Social Services of the County Charter. The proposed team being recommended
is as follows:
Seven Members:
County Legislators (2)
DSS Management (1)
CSEA White Collar (1)
Agency/Community (2)
County Administrator (1)
Two Advisory Members:
Commissioner of Personnel
Current DSS Commissioner
Mr. Whicher said this format and configuration are similar
to the outline used for the Commissioner of Planning's position.
Discussion followed and Mr. Koplinka-Loehr suggested changing
the membership to one agency/community member and add one department head
as a member.
Mr. Proto arrived at this time.
Mr. Penniman asked why a member of the CSEA White Collar
was recommended. Mr. Whicher said he wants to involve staff and get
a sense of what the Department's needs and issues are. He said the
search team is used to develop a consensus and feels that since this Department
employs several hundred employees, it makes sense to include employee participation.
Mr. Koplinka-Loehr spoke of his support and feels having an employee involved
is very critical. The Committee was reminded that the County Administrator
makes the appointment with the Board's confirmation. Mrs. Schuler suggested
the CSEA White Collar member could have an advisory role.
Ms. Robertson supports having a Department Head serve as a member, but feels
there should be two agency/community members. Ms. Dill spoke in support
of having a community member represented on the team as well as an agency
head. There are a number of very knowledgeable members of the community
that would provide valuable input, for example, someone from the DSS Advisory
Board. Mr. Koplinka-Loehr said he would support having one agency head
and one community member, as well as one Department Head. Discussion
followed and the Committee agreed with Mr. Koplinka-Loehr's suggestion.
Mr. Proto spoke about the CSEA White Collar member and
thought it would be appropriate to make that seat an advisory role and add
a second DSS Management seat as a member. He also asked what the process
was going to be for other Board members if interested to participate or have
input.
Mr. Proto stated his concern during the budget season
with the uncooperative nature with several of the proposals made with regard
to the union. He does not feel their input should be sought or the
impression that they are being given a silent vote in the process.
Mr. Whicher clarified that he will be making the decision for appointment
and recommending to the full Board and that what he is proposing is a consensus
process.
Ms. Robertson clarified that the Committee is recommending
the following membership for the search team:
Members
Board Members (2)
DSS Management (1)
CSEA White Collar (1)
Agency ( 1)
Community ( 1)
County Administrator (1)
Department Head (1)
Advisory Members
Commissioner of Personnel
Current DSS Commissioner
Mr. Whicher said he will keep the Committee informed of
the process.
Alternatives to Incarceration (ATI) Programs
Ms. Schlather reviewed an outline distributed to Committee
members of the information that will be collected by the ATI programs (Family
Treatment Court, Felony Drug Court, and Day Reporting) and the outcomes that
have been identified to track their success. The data will allow for
program improvement to assure that the resources expended provide the most
effective combination of services and support for the target population.
Ms. Schlather met with all three program directors to discuss the information
to be collected. Both short-term and long-term outcomes are being reviewed.
Short-term outcomes will look at personal success and long-term outcomes
will look at cost effectiveness.
Ms. Robertson asked if it was possible to get data on
our population prior to these programs being called ATI to have a "before
picture" to compare to an "after picture". She would like to see a
profile of the individuals previous to the funding of the ATI programs, e.g.,
with respect to recidivism. Ms. Schlather said you could do a general
look but it would not be an absolute comparison. She will ask what
information is available.
Mr. Proto said having numbers and not just dollar amounts
would be helpful in the evaluation. He would also like to know how
many clients there are and when is success determined. He also asked
if there is way to identify other programs in the County an individual is
accessing and whether they have been successful. Ms.
Schlather said she could inquire about other support services provided but
feels it would be difficult to identify. She does not believe those
questions have been asked but could be in the future.
Ms. Blanchard, Chair of the Public Safety Committee, reported
on meetings she has had with Ms. Schlather and the Social Services Commissioner.
On the Day Reporting program, she and Pat Bueschel, Director, have been meeting
with judges in various municipalities and have asked for feedback on the
program. It is hoped to learn what is happening when individuals return
to court after being sent to Day Reporting. Ms. Blanchard said she
has also been discussing with Ms. Bueschel the idea of having exit interviews
upon graduation from the program to hear about their experience. Ms.
Schlather mentioned that she is also considering running some focus group
sessions with clients and graduates.
Ms. Blanchard also commented that she does not feel the
Family Treatment program should be considered an ATI program as it is a family
unification, preventive foster care program.
Ms. Blanchard also stated that the judges were asked to
indicate on the forms where an individual would have been sent if not to
Day Reporting. Committee members agreed this is needed.
Ms. Blanchard said she would like to see the comparison
of the cost for an individual in an ATI program compared to jail time the
person would have served. Ms. Schlather stated she would try, but that
it would be very difficult to provide appropriate information as many of
these programs are actually aimed at what is going to happen with these individuals
farther in the future.
Human Services Coalition
Ms. Dill gave an overview of the Coalition's 2003 work
plan and commented on the Compass II study that is a community needs assessment.
She also shared posters that advertise a new website www.volunteertompkins.org.
She said the site provides information about volunteer organizations and
the opportunities available. Mrs. Schuler suggested Ms. Skinner, Public
Information Officer, prepare an article concerning this item. At this
time, Ms. Dill explained the Information and Referral Service's 2-1-1 project.
She said it is a national project but only a few states are involved so far.
It is a centralized number to call for information or help and then the call
is directed to the appropriate locality. Currently, there is no money
available for the project, but she hopes Ed Swayze, our I&R Director,
could be the local representative in the Finger Lakes Region if money becomes
available.
Senior Citizens Council
Mr. Hawley introduced himself and said he began as executive
Director January 2, 2003. He noted that within the last two years the
full staff has turned over. He distributed a brochure describing what
the Senior Citizens Council is about.
In the fall, there were a number of focus groups that
looked at several different issues. One item that came up was the entry
age for the Council’s services and it was the consensus to change it from
55 to 50. In 2000, the baby boomers began to turn 50 at a rate of 10,000
per day. In some cases, the Council may serve three generations (child,
parent, and grandparent). He reported on the National Council on Aging
conference he attended in March and said that there was much discussion and
agreement that senior programs are going to be changing drastically in the
future. The challenges he feels he will face include: (1) how will
programming continue for seniors currently being served; and (2) how will
programs serve new seniors in meeting their needs. He said the Council
is a collaboration of private funding, community funding, and public funding.
Many Senior Citizens Councils across the nation are funded by their county
or city.
Mr. Hawley presented a brochure from RSVP (Retired Senior
Volunteer Program) and explained that program. The volunteers are very
busy with tax counseling. Last year, over 1,100 tax returns were done
for seniors and low-income persons.
He invited Committee members to visit the Council on April
29th at 8:30 a.m., as part of site visits organized by the Human Services
Coalition.
Mr. Whicher cautioned Mr. Hawley about expanding programs
(reducing the age to 50) during these challenging budget times. Ms.
Robertson asked about Board turnover; Mr. Hawley feels the Board has been
very stable.
Public Health Department
Resolution
It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler,
to submit the following resolution to the full Board for approval.
Ms. Cole commented that the increase in hours is paid for by the bioterrorism
grant. She also said that she heard the grant has been renewed but
that has not been confirmed. The increased hours will continue if the
renewal grant is received to go past August 31. Ms. Connors reported
the smallpox program is temporarily on hold due to three deaths recently
with cardiac complications. The screening guidelines are being revised
which will likely result in a reduction in the number of staff being vaccinated
at the hospital and Health Department.
A voice vote resulted as follows: Ayes - 5; Noes
- 0. RESOLUTION CARRIED.
RESOLUTION NO. AUTHORIZATION TO INCREASE HOURS – DIRECTOR OF PATIENT
SERVICES – HEALTH DEPARTMENT
WHEREAS, the Public Health Preparedness/Response for Bioterrorism
Grant continues to require increased staff time, and
WHEREAS, the Director of Patient Services is needed to
work an additional five hours per week to complete deliverables as required
by the grant and to manage the smallpox vaccination program, now therefore
be it
RESOLVED, on recommendation of the Health and Human Services
Committee, That the position of Director of Patient Services (89/0230), labor
grade R, competitive class, be increased from 35 hours per week to 40 hours
per week for the period of April 16, 2003, through August 31, 2003.
RESOLVED, further, That no additional funds are required
to accommodate this change, as funds have come from the Bioterrorism Grant.
SEQR ACTION: TYPE II - 20
* * * * * * * * * *
Explanation: The Director of Patient Services is working additional
hours to address ongoing Bioterrorism related work, such as Smallpox policies,
pre and post-event clinic planning, meetings, drills and trainings.
SARS update
Ms. Cole said there have been no reported SARS cases in
Tompkins County, however in some surrounding counties there are suspected
cases. Cornell University and Ithaca College have been very proactive
from the beginning. The Health Department actively sends information
and updates to all physicians and EMTs and remains in high alert mode.
Mr. Whicher commented on the presentation given at the
Department Head meeting by Lee Shurtleff, Peter Meskill, Alice Cole, and
Anita Fitzpatrick concerning emergency preparedness. He complimented
staff and how hard they work and what a great job they do.
Mental Health Department
Mr. DeLuca explained the resolution and Budget Position
Memorandum adopted by the Mental Health Services Board concerning the support
of Mental Health Services funding positions. The resolution and memorandum
advise the Board of Representatives and outline the areas of concern with
services and funding changes in the proposed 2003/2004 New York State Budget.
Impacts could come as early as July this year and the fear is that it will
not show up in the line item budget, but in shortages at the end of the year.
In many cases the impact will be shifted from the Mental Health Department
to Social Services Medicaid-supported programs.
At this time, Mr. DeLuca reviewed the following list of
items referenced in the Budget Position Memorandum:
Mental Health
Reauthorize Community Mental Health Reinvestment Funding : Although
the Governor’s budget proposes to reinstate some form of reinvestment in
next year’s budget, we support the reauthorization of community reinvestment
in the 2003-2004 budget. Closures are proposed for this year which will impact
local services. Savings realized this year should be reinvested in communities
which will provide services to patients relocated to those communities. Since
their care was a state responsibility, funding for local services should
not be borne by property tax.
Assure proposed Medicaid Initiatives hold counties harmless from increases
in County Medicaid Costs: Current funding change proposals will transfer
funding from 100% state funded reinvestment dollars to Medicaid. The proposals
state that the funding will be 50% federal and 50% state but since New York
is a state wherein counties share Medicaid costs, specific mechanisms to
assure that counties are not charged for such Medicaid expenditures should
be defined before support is given to this proposal.
Enact A.4085/S.1152 to limit the cost of court ordered chargebacks
to 30 days : Individuals found incompetent to stand trial following a CPL
§730 examination and individuals hospitalized from county jails are
hospitalized in state facilities. Half the cost of these hospitalizations
are a charge to the county. It is our position that the New York taxpayer
has already paid for the services of state facilities and is charged again
for the same service through property tax. While elimination of this charge
is not now being considered, we SUPPORT the limitation of this charge to
30 days of hospitalization.
Assure adequate Children’s Services : If the proposed closing of Elmira
Psychiatric Center relocates the nearest children’s state beds to Rochester,
local services should be enhanced so as to minimize the problems which will
result from the distance involved.
MR/DD
Continue support of Medicaid Overburden Funding. Eliminate cap on overburden
as proposed : We OPPOSE the capping of overburden to counties. Overburden
is the mechanism with which the state assures that funding that is a 100%
state responsibility does not incur a local cost when Federal participation
is added through Medicaid. Since many programs are now being considered for
such a funding shift, it is essential that this mechanism keep pace with
increasing use of such a funding strategy. The alternative could be local
decisions that the 25% local cost would make the service unaffordable.
Support year #5 of NYS CARES to provide services to persons with mental
retardation and developmental disabilities : Local services to the developmentally
disabled have proven to be a successful and cost effective approach to providing
the required care as New York shifts it’s approach to community based services.
Substance Abuse
Restore $9 million in local assistance for prevention and treatment
programs : We OPPOSE cuts in local assistance deficit financing until such
time as new rate structures prove to support the operation of local treatment
and prevention programs.
Support efforts to assist with appropriate treatment of persons with
dual diagnosis: While the state acknowledges the seriousness and high prevalence
of co-occurring disorders, current funding and program regulations act to
prohibit effective treatment of such disorders. Regulatory and funding reform
is essential if we are to be successful in developing treatment and preventative
programs that can deal with this phenomenon.
It was MOVED by Mr. Koplinka-Loehr, seconded by Mrs. Schuler,
and unanimously adopted by voice vote, to authorize the preparation of a
resolution to be submitted to the full Board at their next meeting that supports
the actions of the Mental Health Services Board funding positions as outlined
above.
Mr. DeLuca restated the funding change causing the greatest concern
in the Governor's budget relates to Medicaid overburden funding, and said
the County opposes the reduction of State responsibility from 100 percent
to 25 percent. Mr. Whicher said considering this shift, the budget
impact is closer to $1,000,000 than the $110,000 cited in the M. H. Services
Board’s resolution. Ms. Robertson said she would draft the resolution for
the Legislature’s consideration, and it would reflect Mr. Whicher’s point.
Youth Bureau
Three-Year Plan
Ms. Zahler explained the Youth Services Board's approach
to resource allocation for 2004. She also distributed copies of the
Resource Allocation Policy and Guidelines for 2004-2006. The direction
she provided the Youth Services Board was to estimate a $250,000 budget cut
to maintain current services. She said the $250,000 is based on three
items: (1) ten percent reduction in youth services in the proposed
Governor's budget which is equivalent to $29,000 less in State Aid; (2) projection
of a 15 percent reduction in the Department's Fiscal Target; and (3) $73,000
in rollover being used this year that will not be available next year.
Changes in the process were highlighted at this time.
The Youth Services Board will ask agencies to focus on one broad goal:
All children will have opportunities to develop and apply their physical,
personal, intellectual, vocational, and social skills in safe, nurturing
settings that complement the efforts of families and schools. The agencies
should also focus on target populations about whom they are concerned.
The other change is the Youth Services Board is supporting the Municipal
Youth Service System to address several goals locally.
The Youth Board will be looking at the funding available
to the Department and the percentage that will be available to contract with
agencies, municipalities, and planning and coordination services provided
by staff.
The Committee accepted the guidelines as presented with
the understanding that there will be proposals submitted exceeding the targeted
amount.
Ms. Zahler informed the Committee that she will submitting
a proclamation at the next Board meeting asking the Chair of the Board to
proclaim Youth Services Week.
Guest Editorial Assignments
Ms. Robertson said she began working on her introductory
piece for the newspaper. She suggested that Mr. Proto contact the Health
Department to possibly write a piece on the Home Health Care program.
A summary was provided at the last Committee meeting and Ms. Robertson agreed
to provide Mr. Proto with the information. Mr. Proto also said he wanted
to write about the impact on the health care workers and cutbacks in nursing
homes.
Mr. Koplinka-Loehr said he has been in contact with Ms.
Dill about Compass II. He hopes to have a draft piece by June 1.
Mr. Koplinka-Loehr was excused at 1:30 p.m.
Mr. Penniman suggested a timeline be established and said
he would like to have something prepared in May.
Mrs. Schuler said she is working with Mr. DeLuca on mental
health services.