Staff:      P. Carey, Social Services Commissioner; S. Whicher, County Administrator; S. Allinger, Health
Department; M. Dill, Human Services Coalition; R. DeLuca, Mental Health; A. Cole, Public Health Director; N. Zahler, Youth Services Director; J. Johnson, Youth Services; B. Falcao, Health Planning Council

Guests:   J. Owens, Food Distribution Network; C. Pothier, Loaves and Fishes;

Called to Order

 The meeting was called to order at 11:33 p.m.

Changes to Agenda

 The minutes from the May 26th meeting were withdrawn from the agenda.  Copies of the revised calendar was distributed for information and review by Committee members and staff.

Department of Social Services

 Staffing Transition
 Ms. Carey announced Becky Bush, Director of Eligibility, is retiring in August after 25+ years of service with the County.  This will be a tremendous loss to the Department and the community.  Some of her responsibilities include:  public assistance, Medicaid, special services, services for the homeless, and daycare, etc.  Ms. Carey meets regularly with Ms. Bush reviewing the job duties and delegating to appropriate staff.  Many relationships have been developed with outside agencies and a number of reports from the State are handled by Ms. Bush.  Ms. Carey is working on developing contacts for these areas as well.  Ms Bush will take off the month of July as a “test” of the arrangements being made to fulfill her job responsibilities, and will return to work for the month of August.  A final plan has not been established yet to replace Ms. Bush; however, options are currently being considered.

 Ms. Blanchard raised a concern with the transportation area services and said Ms. Bush was very active in developing transportation programs.  She asked to be kept informed of any concerns in this area as Mr. Ghearing, General Manager of Tompkins Consolidated Area Transit, is also leaving.

 New York State Legislation Update
 Ms. Carey said there is no update on the New York State budget; however, there may be some employment-related programs funded through TANF programs that will be unfundedmay see their funding end at the end of this month that arebecause no state budget is in place. employment related programs through Taniff funding.  A request has been made for emergency short-term funds to fund maintain the programs until the Sstate Budget budget is adopted, but she has not heard if that will happen.  The local agencies that are affected have been contacted and made aware the programs will end at the end of June if short-term funding legislation is not passed. to continue the short-term funding.

 She Ms. Carey reported on two proposed legislative bills being considered:  One bill allows a parent to voluntarily place their child in under the control of Social Services without the Department having legal custody of the child.  It currently has the support of the Senate and Assembly.  ; however, tThe Department is concerned as because under the bill will not allow those placements will not be elgibible for Federal reimbursement for those placements if the child is not in the Department does not have's custody. Therefore such placements and will become a local cost.  The Department opposes the legislation due to this financial issue, but not on philosophical grounds.

 Mr. Koplinka-Loehr arrived at this time.

 The other legislation, which the Department does support, will radically modify family court action to facilitate more frequent court appearances quickerreview and to haveing more judges involved in cases sooner.   There are two very similar bills very similar relating to this subject, --one is in the Assembly and the other is in the Senate.  The difference between the two bills are one is for court appearances to happen in three months and the other is six months.

 Monthly Reports
 There was no discussion concerning the monthly reports; however, Mr. Whicher commented on the increase in Medicaid cases and said he would like more background on what is driving the numbers.  Ms. Carey said most of the increases are a result of new programs such as Child Health Plus and Managed Care.  Ms. Robertson suggested that the rise in caseloads should be a topic for a future meeting of the committee.

Human Services Coalition

 Ms. Dill distributed copies of the 2003 Salary and Benefits Survey and said that 50 nonprofit agencies responded to the survey, which there was an 83 percent response to the surveyrate.  Ms. Dill summarized the results, saying that most positions saw a modest increase in salaries since the last survey was done (1999-2000), but the costs of benefits are being shifted to workers.  In answer to a question she said that TC3 was not included in the survey.  Ms. Robertson asked that further discussion on the report be held at a future meeting to allow Committee members time to review it.

 Food Distribution Network
 Ms. Owens updated the Committee on the Tompkins County Food Distribution Network.  Last year it wasShe noted that Second Harvest Foods are was on the decline last year and Ms. Owensshe feels that trend will continue.  Second Harvest Foods is a national organization where foods are rescued and diverted into the food pantry system.  She shared the distribution of food and funds from 2002 to 2003 among the Food Bank of Southern Tier.  Because of the cost of food, and the fact that the commercial distribution system has become more efficient, the same amount of funding is buying less food for the pantries. The Network’s resources increased from $150,529 in 2002 to $176,602 in 2003, but the distribution of food actually decreased from 948,526 pounds in 2002 to 899,156 pounds in 2003.  She shared the distribution of food and funds from 2002 to 2003 among the Food Bank of Southern Tier.  They are trying to keep up with the need by doing more private fundraising. The distribution of food decreased from 948,526 pounds in 2002 to 899,156 pounds in 2003.  However, the funding increased from $150,529 in 2002 to $176,602 in 2003.

 Ms. Owens spoke about the $40,000 received from the County.  She said the money is given to the Food Bank of Southern Tier and is distributed as a line of credit for all of the fourteen food pantries in the network.  The Food Bank of Southern Tier monitors the food banks and assures compliance.  Each pantry receives $1,000 and the remainder is distributed based on the number of clients served by each program.  She Ms. Owens also noted there are approximately 500 volunteers throughout the Network.

 Loaves and Fishes
 Ms. Pothier provided the Committee with an overview of the Loaves and Fishes program and highlighted some of their activities.  It is a member of the Food Bank of Southern Tier and provides free meals.  The average number of guests attending meals is 125 each weekday.

Mental Health Department

 Resolution - Terminal Pay
 It was MOVED by Ms. Schuler, seconded by Mr. Koplinka-Loehr, and unanimously adopted by voice vote, to approve and submit the following resolution to the full Legislature for approval:

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

WHEREAS, during 2003, several employees terminated their employment with Tompkins County, 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 Government Operations 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 $ 23,297.00
TO:        A4311.51000599  Salary - Psychiatric Social Worker $ 12,946.50
               A4311.51000511  Salary - Case Aide             656.39
               A4311.58800       Fringe                                       5,031.21
             A4312.51000255 Salary - Program Director            3,403.90
               A4312.58800       Fringe              1,258.00
SEQR ACTION: TYPE II-20

 Position Request
 It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Schuler, and unanimously adopted by voice vote, to approve the request to fill the Fiscal Coordinator's position as presented.

 Resolution - Increase in Hours - Fiscal Coordinator

  It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Blanchard, and unanimously adopted by voice vote, to approve and submit the following resolution to the full Legislature for approval:

RESOLUTION NO.     - INCREASE IN HOURS - FISCAL COORDINATOR - MENTAL HEALTH

 WHEREAS, the Mental Health Department's Fiscal Coordinator is required to administer and coordinate all aspects of the funding streams for the Mental Health Department, and
 WHEREAS, the duties and responsibilities of this Fiscal Coordinator position are such that they can only be efficiently accomplished in a forty-hour work week, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee, That one position of Fiscal Coordinator - Mental Health (782/14) competitive class be hereby increased from 35.0 hours to 40.0 hours per week effective immediately,
 RESOLVED, further, That no additional County funding is necessary at this time.
SEQR ACTION:  TYPE II-20

 Update on Single Room Occupancy (SRO) Project
 Mr. DeLuca reported that he has been in discussions with the State Office of Mental Health and they are trying to get 25 new SRO beds for the Tompkins County SRO.  He said that OMH staff have offered to come to Tompkins County to meet with us about the project.

Public Health Department

 Children with Special Care Needs Program
 Ms. Allinger provided an overview of the Children with Special Care Needs Program and said it is made up of four different programs:  Early Intervention Program (children ages 0-3), Preschool Special Education Program (children ages 3-5), Children with Special Health Care Needs Program (ages 0-21), and Physically Handicapped Children's Program (ages 0-21). The Early Intervention Program began in New York State in 1993 and is a mandated program and highly regulated by the State.  At this time, Ms. Allinger explained the procedures for the Early Intervention Program.  In 2003, there were 183 new referrals to the Program which totaled 327 cases.  Since 1998, the number of cases has almost doubled.  Out of 327 cases, 26 of them had their delay resolvedhave progressed out of the program.  Each Service Coordinator handled approximately 48 cases in 2003.  This year, the caseload per staff is 52.5.  Since 1999, the staff level of four community health nurses has decreased by a halftime position.

 Ms. Allinger also reviewed the billings and reimbursements for the program in 2001.  Almost $1 million was billed for services that year, of which Tompkins County paid 27.5% ($269,817) after all reimbursements were received. In 2003, about $1 million was billed again. Of that total, $549,580 was billed to private insurance (This is the protocol when a child has private insurance coverage.), but only $84,430 has been received for services rendered.  Ms. Allinger said that there is a major lobbying effort statewide to require insurance to cover these services.

 Ms. Allinger also described difficulties receiving appropriate reimbursements from the Medicaid and Child Health Plus programs.  In 2003 our department billed Child Health Plus $63,109 for services and to date has only received $3,525 (5.6%) for these services.

 Transportation Bid
 Ms. Allinger reported that one bid was received for the Transportation Request for Proposals.  The proposal received will would double the current cost to approximately $750,000 to $800,000 per year.  Following review of options, the Department is requesting to revise the Request for Proposals as follows and re-bid this item:
· Revise the contract period - three year contract with an option for a two year renewal
· Revise performance bond to amount of $200,000
· Use of Department of Transportation approved Yellow School Buses or Vans
· Present detailed information pertaining to all of the routes
· General area of child's bus "pick-up"
· Drop-off point/destination
· Time and days of the week attending program

She Ms. Allinger is also asking for Committee approval and reconsideration to change the automobile liability insurance from $5 million to $2.5 million.  Smaller companies are unable to afford this insurance and therefore the County is not attracting other bidders.

 Mr. Koplinka-Loehr was excused at 12:53 p.m.

 Mr. Whicher encouraged the Committee to re-bid and said he will look into the question about the liability insurance.  The Committee agreed with Mr. Whicher's recommendation.

Presentation - SUNRx

 Ms. Serenelli provided background information about SUNRx and why it began.  SUNRx provides a prescription benefit program for groups such as unions, employers, etc. nationwide.  Prescriptions must be provided through an FDA- approved plant or manufacturer and be an FDA- approved drug.  Of the 92,000 different drugs on the market, about 4,600 drugs have been approved by the FDA and can be imported under the SUNRx program.  Ms. Serenelli described the example of a factory in Ireland that the FDA has approved for Lipitor.  Two lines of the drug are produced, one with English only on the label, which goes to the U.S., and the other line with English and French labels for sale in Canada.  Ms. Serenelli said that the Canadian government sets the prices that can be charged, in contrast to the American system.  As a  result, generics in Canada are not significantly cheaper than brand name drugs, while here our generics are cheaper.

There are approximately 7,500 people currently enrolled in this program.  The enrollment fee is $64.99 for the first year including a $15 application fee; however, the application fee would be waived for Tompkins County. Ms. Serenelli explained how the prescription plan works and spoke about some of the groups that participate, including the employees of Chautauqua County.  Chautauqua has already saved $150,000 in costs for their employees, after joining in 2003.  Tompkins County employees may participate and/or Tompkins County may sponsor a program for its residents.  She reviewed and outlined the procedures for the two programs offered:  American Only/Mail Order Program and International Program.  The programs are guaranteed for one year.

 Ms. Serenelli said the average savings are 30%, and depending on the drugs used the savings can be up to 80%.  Ms. Robertson asked for a list of the most common prescriptions used by SUNRx customers and the discounts; Ms. Serenelli agreed to provide this information.

 Below is a list ofof the following are the local pharmacies that participate in the prescription benefit program: Eckerd, Target, Tops, Wegmans and Kmart.
 Eckerd
  Target
 Tops
  Wegmans
 Kmart

Betty Falcao of the Health Planning Council distributed a chart listing nine local pharmacies and the discounts they offer to customers, as of June 7, 2004.  None offered any discount to individuals without insurance; five of the nine offered a 10% discount to seniors.  The only other discount was with Eckerd, which had a plan that offered 5%-30% discount for a family paying $6.50 per month.

Youth Services Department

 Recreation Partnership - County's Role
 Ms. Zahler distributed copies of a report outlining the planning support currently provided by the Youth Services Department to the Recreation Partnership Board.  Ms. Robertson said town officials have been discussing the issue of the County possibly pulling out of the Recreation Partnership and what that would involve financially and administratively.

 Ms. Zahler reminded the Committee that a decision was made last year during the budget process on the financial support for the programs offered through the Recreation Partnership; however, there was no discussion decision made concerning the County's role in providing the staff support and coordination. and whether that would continue or not.

 Ms. Johnson reported that this morning she met with the recreation staff from the towns (Ithaca, Dryden, Groton, Newfield and Lansing) to discuss the issue of sharing staff support for the Partnership Board.  Ms. Zahler suggested that the municipalities who asked the County to provide the current role review the information distributed and provide feedback and recommendations to the Partnership Board on how to proceed.

 Ms. Robertson reported that the Towns of Ithaca and Ulysses have passed resolutions asking the County to continue its involvement.

 Following a brief discussion, the Committee agreed to proceed as suggested by Ms. Zahler above.

Adjournment

 The meeting adjourned at 1:34 p.m.