HEALTH AND HUMAN SERVICES COMMITTEE
JUNE 23, 2004 11:30 A.M.
SCOTT HEYMAN CONFERENCE ROOM
Present: M. Robertson, Chair; T. Todd; N. Schuler; M. Koplinka-Loehr; B. Blanchard
Staff: S. Whicher, County Administrator; B.
Chin, Health Planning Council; M. Dill, Human Services Coalition; N. Burston,
Human Services Coalition; N. Zahler, Youth Services; J. Kippola, Administration;
Human Services Coalition Interns (Aliza and Josh)
Called to Order
The meeting was called to order at 11:30 a.m.
Changes to Agenda
There were no changes to the agenda.
Office for the Aging
Long Term Care System
Ms. Stein updated the Committee on the Long Term Care
System. Nursing home care is one end of the continuum of long term
care. Long-term care, which is distinct from acute care, refers to
a wide variety of in-home and community based services as well as institutional
care at various levels, such as adult homes, assisted living, and nursing
homes. Some of the support services that help people remain in their
home and exist in the community for long-term care include PERS (Personal
Emergency Response Systems), home delivered meals, personal care, etc.
Ms. Stein briefly reviewed the chart distributed showing
Tompkins County population projections from 2000 to 2015. An increase
of 26.8 percent is expected from 2000 to 2015 in the number of people 60
and older and an increase of 27.4 percent is expected of people 85 and older.
Ms. Stein explained how the Department handles inquiries
and the steps for evaluating an individual and the family. When a person
comes to COFA, they are evaluated and referred to the Long Term Care Unit
in DSS. There an assessment is made with the client, caregivers, and
family members; a plan is laid out and the case is then managed. One
of the advantages with the system is the Office for the Aging and DSS do
not have a vested interest in promoting particular services, so they can
make unbiased assessments. However, private pay individuals may contact
agencies directly, which may result in consumers not receiving consistent
or unbiased information. Overall, Ms. Stein said the county does not
have the resources to provide the long term care that is needed.
An update on the creation of a single point of entry system
was provided. One of the recommendations of the Medicare Reform Task
Force is to establish a single point of entry system in each county throughout
New York State. This concept is the same as the County's Long Term
Care System. Ms. Stein said she will keep the Committee informed
as this progresses. She said the grant she applied for to develop a
strategic plan to improve the long-term care system in Tompkins County was
denied. However, as part of the planning process for that grant, Ms.
Stein had discussions with Peg Hendricks of the Community Foundation.
As a result a critical issues forum around long-term care is being organized
and Ms. Stein hopes to get some information that can be implemented as part
of the Department's work plan.
In response to a question, Ms. Stein said it’s a concern
for us if private pay clients are “buying more care” than they need, because
that stresses the limited supply of staffing and of nursing home beds.
Also, if private pay clients overspend on care, they can deplete their resources
and end up requiring public subsidies. Mr. Todd mentioned that there
are big differences between the needs of the elderly in rural areas and those
of City and Town of Ithaca residents. Ms. Stein noted that COFA has
just finished a county-wide survey to better quantify our residents’ needs.
Departmental Budget
Ms. Stein gave an overview of the Department's proposed
2005 budget. Assuming no additional cuts:
MOE (Maintenance of Effort) request for EISEP - $37,591
Rollover money to be applied - $30,595
Funding gap for other services - $6,606
Ms. Stein said there continues to be a waiting list for
EISEP of 26 people and if the MOE funding is not approved it would result
in 2,328 hours of personal in-home care not being provided. If the
Department received additional cuts, the home repairs program would likely
be cut first. Ms. Robertson asked about the impact of decreasing funding
for home repairs; Ms. Stein said they could just get through 2005 by using
rollover for home repairs, but EISEP is underfunded. Mr. Whicher agreed
the backlog in EISEP is increasing and that the problem will build; sooner
or later these cases will show up in our Medicaid line.
Human Services Cabinet
Ms. Stein said the Cabinet has not met to consider budget as staff has been on vacation.
Human Services Coalition
Budget Review for Agencies
Ms. Dill reported the review committee for agencies has
just begun to meet to look at requests. She provided an overview of
their present situation but will not be able to provide the review committee's
recommendations until they are complete. The HSC Board will vote on the recommendations
at the end of July. At this time, Ms. Burston explained the process
for reviewing requests submitted by agencies.
Ms. Dill said the HSC reviews programs within the agencies,
but not usually the whole agencies. The programs making requests in
most cases are not receiving funding from local government sources other
than the County. However, the agencies do receive funding from other
sources. Many of the programs have asked for no increase and the maintenance
of effort requests are small amounts.
The only request for new funding came from Mutual Housing,
which the review committee will be looking at this year as housing
is a top need in the community.
One agency, Women's Opportunity Center, due to changes
in the kinds of people they can serve, has requested approximately $20,000.
Ms. Dill reviewed the ways in which programs have already
made cuts as a result of reduced funding, including: no salary increases,
decreased retirement benefits, employees absorbing health insurance increases,
combined jobs, and use of technology (e.g., voice mail) to replace workers.
She commented that it appears there will be some deficits in the agencies
this year. One effect is longer waiting lists. Better Housing
of Tompkins County had a waiting list of six weeks; with the cut in county
funding the wait grew to five months. A legislative member item allowed
them to reduce the wait back to six weeks.
The agencies and programs are encouraged to look for money
elsewhere and are required to report it. This is one of the reasons
the agencies are able to keep up while government funding contracts.
Ms. Dill said among the 16 programs, there were 63 other sources reported
that provided funding to agencies for a total of $1.3 million. United
Way funding has increased a small amount, but federal and state funding has
been flat and extremely hard to predict.
Discussion followed concerning collaboration and connectivity efforts among agencies and programs.
Budget Reviews - Programs
There are three programs under the Human Services Coalition
that have been part of the Coalition for 20 years. Ms. Dill provided
a brief overview of the Information and Referral program and said it continues
to operate with one staff person and a VISTA person. The program needs
more money to increase its marketing. Ms. Dill also briefly reported
on the Human Services Planning program and the Health Planning Council,.
She spoke about the areas that were cut or reduced two years ago in order
to save money and provided an update on the funding streams and increased
expenses of the Coalition.
A brief discussion followed concerning the chart distributed
entitled Number of Families at Specified Income Levels.
Discussion of Rx Plans
Ms. Robertson briefly reviewed the information distributed
from the Health Planning Council showing the comparison between the Arxcel
and SunRx prescription drug discount plans and the chart that lists the ten
most commonly used drugs in upstate New York. She appreciated the two vendor
presentations given and said she has received additional inquiries from other
companies. Ms. Robertson asked Ms. Kippola to attend the meeting to discuss
Mr. Whicher's suggestion to send out a Request for Proposals (RFP).
Ms. Kippola said a consultant would probably be willing to provide the service
needed, to evaluate the responses, at no cost to the County. She commented
that Nassau County has started a similar program and briefly explained their
plan and has requested a copy of their RFP for review. It was noted
that MEGA (the Municipal Electric and Gas Alliance) is a possible model for
how this program could be done across several counties.
Ms. Robertson would like the committee to make recommendations
for what should be included in the RFP. Ms. Kippola agreed to prepare
an outline and make a recommendation for the Committee to discuss and consider.
Report from the Committee Chair
Ms. Robertson updated the Committee on the SRO housing
situation. The State Office of Mental Health (OMH) is looking at adding
additional beds beyond the nine promised earlier. This will be beneficial
as the 16 apartment beds that were going to be converted into SRO beds are
now being used and there is reluctance in giving them up. OMH is hoping
to allocate a total of 25 SRO beds. A site has been identified and
is being evaluated by OMH. As soon as more information is available,
the Committee will receive a report. A representative of OMH working
on this project will have completed a feasibility study by the end of July.
Ms. Robertson said she would like to invite the OMH representative, Jerry
Scott, to come to a Committee meeting and give an update.
Ms. Blanchard asked that the elected representative of
the district be notified where the potential site is being considered.
Ms. Robertson said she will contact Robert DeLuca to make sure that will
happen.
Ms. Robertson also reported that she would like to designate
the August 25th Committee meeting to youth services and ask representatives
from Youth Services, schools, courts, Social Services, etc. to attend and
give presentations.
Report from the County Administrator
Mr. Whicher said he would like to present a proposal at
the next meeting for the Committee to consider. He has been having
discussions concerning the Unity House expansion project (increasing their
capacity by ten beds) on Green Street and feels it would be in the County's
best interest to move forward with this project. The Federal government
will match local funds. As he does not feel it is in the best interest
of the County to appropriate $200,000, Unity House has asked the County to
guarantee payment of their mortgage payment. Unity House will mortgage
their property for $200,000 for 20 years. He will be bringing
forth a resolution at the next meeting for discussion and consideration.
Ms. Schuler was excused at 1:35 p.m.
Approval of Minutes
It was MOVED by Mr. Koplinka-Loehr, seconded by Mr. Todd,
and unanimously adopted by voice vote by members present, to approve the
minutes of May 26 and June 9 as submitted.
Adjournment
The meeting adjourned at 1:37 p.m.
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