Staff:      A. Cole, Public Health Director; J. Kippola, Administration; B. Falcao, Health Planning
Council; P. Carey, Social Services Commissioner; B. Chin, Health Planning Council; Aliza, Intern, Health Planning Council; B. DeLuca, Interim Mental Health Commissioner; M. Dill, Human Services Coalition; S. Whicher, County Administrator; N. Zook, Youth Services; N. Zahler, Youth Services Director; S. Allinger, Health Department; J. Andersson, Health Department; S. Connors, Health Department; B. Crosby, Health Department

Called to Order

 The meeting was called to order at 11:30 a.m.

Changes to Agenda

 There were no changes to agenda.

Report on Rx Request for Proposals

 Ms. Kippola said she reviewed the Request for Proposals (RFP) from Nassau County and provided the Committee with highlights of the program.  The RFP was for a Pharmacy Benefits Manager at no cost to the County or its residents.  The card was issued to all County residents and does not include the names of the individuals on the cards.  One requirement of the RFP was at least 70 percent of the local pharmacies already had to be participating with that company responding to the bid.  With a much smaller population than Nassau, Tompkins County may need to construct their RFP in another way, such as the vendor must have a participating pharmacy being within five miles of each town and village for the convenience of the residents.  Nassau County had an evaluation team of five people and used a point system.  Ms. Kippola highly recommended using this approach as well and suggested experts from the Human Services Coalition be involved as well as a member of the Legislature.  Representatives from Nassau County have agreed to a conference call with the Committee at the July 28th meeting.  She also recommended a list of qualifications of how each company would be looked at similar to Nassau County's evaluation form.  There are many questions that should be addressed and it was recommended that a list of questions be developed and sent to the appropriate representatives to answer prior to the conference call.

 Ms. Blanchard recommended contacting Tioga County as they just issued an RFP for their discount card; they only received one response.  Ms. Robertson also recommended contacting Ulster County as they sent out an RFP as well.

 Ms. Blanchard suggested, and the Committee agreed, to have appropriate staff and representatives familiar with this subject participate in the conference call rather than the Committee. She feels the right questions would be asked and there would be a better understanding of the answers.  Following a brief discussion, Jackie Kippola, Betty Falcao, and Beverly Chin agreed to participate in the conference call and report back to the Committee.

 Ms. Chin briefly reported on Rx Outreach and said most pharmaceutical companies have a patient assistance program for households falling below 150-250 percent poverty level.  The Health Planning Council helps people apply for this program which only offers brand name medications.  However, there is a movement to have generic drugs available through another company that currently offers a similar program; however, the poverty level is not as low.  At this time, flyers about these programs were distributed to the Committee and members were encouraged to direct any questions to the Health Planning Council for more information.
Mental Health Department

 Budget Report
 Mr. DeLuca said there is one policy question the County is being confronted with now and in the future:  "How we are going to keep good and affordable access to mental health care in Tompkins County".  The County clinic maintains approximately 21 new intakes per week and there is no waiting list.  In other counties around the region that is not the case.  The Department runs three programs and funds 13 different agencies in disability areas:  mental health, developmentally disabilities, and substance abuse.  Mr. DeLuca said he felt this year the Human Services Cabinet has had several good discussions of budget issues.

At this time he highlighted the proposed budget he will be submitting for 2005.  He anticipates a reduction of state aid in the amount of $188,096, which will be a recurring cut in future years, and reviewed the four over target requests that will be submitted to offset that amount.  He reminded the Committee that the Mental Health Board has not reviewed his proposals yet.  He also explained two other over target requests he is proposing.  One is the long-time goal of recruiting  a Child Psychiatrist for one day a week.  He feels this would be very helpful in the Department and could generate more revenue.  The second is a one-time request for computer hardware and software to continue moving toward electronic records, billing, new programs, and HIPPA compliance.  The total amount in OTRs is $244,496.  There was considerable discussion of the shifts the State is making in how it funds mental health services, from Reinvestment funds to Medicaid.  Under Medicaid there are more restrictions on how the money can be used.  Ms. Carey agreed and noted that this could have consequences for the Starlight Club.

Mr. Whicher asked Mr. DeLuca if his Department was technically a Federally certified agency receiving Federal funds, which would make us eligible for a new program that could save us money on jail medical.  Mr. DeLuca said he would have to look into it and discuss it further with Mr. Whicher.

The Mental Health Services Board will review the proposed budget at their July 26th meeting.  Mr. DeLuca said he will continue to look at programs internally and try to find ways to generate more revenue.

SRO Update
Mr. DeLuca said there was nothing new to report.  The Office of Mental Health began a feasibility study and appraisal of the proposed site; however no purchase offer or RFP has been sent out.

In response to the question concerning the contact with the appropriate Legislator representing the district where said site is located, Mr. DeLuca said he will make that contact in order to begin addressing some of the community issues.  Ms. Robertson asked if Jerry Scott of OMH could attend the next Committee meeting and Mr. DeLuca said he will make the invitation; Mr. Scott has previously offered to come to speak with the committee.

Youth Services

 Announcements
 Ms. Zahler reminded the Committee that this Thursday and Friday, the Departments of Youth Services, Social Services, Mental Health and Probation will jointly host a planning session with key County providers and school officials from many districts involved with the juvenile justice system.  The goal is to look at the increase in PINS rates and to consider alternatives to detention, and to learn from the national best practice experts and the Vera Institute.  We will be looking at services, procedures, referrals and how to make them work better for families, schools, etc.  She hopes to have a report to present to the Committee in late August.  Maryanne Banks of DSS was instrumental in getting the state funding which paid all costs for the retreat.

 Ms. Zahler also announced the Workforce Development Board receives Federal funding and allocates it to the community. The allocation for youth services has increased dramatically this year over previous years, to $310,000; it is not expected to be continued after one-two years. At a meeting of various providers, it was decided that a single collaborative proposal would be developed and the Youth Services Department was asked to take the lead. The program will provide direct services to young people who are low income and meet the eligibility requirements. They will be screened and assessed for a learning plan based on what type of job skills or career interest they have.  Some may go to the Learning Web or other agencies, get a paid work experience, job coaching, etc.  The role of Youth Services staff will maintain records, perform assessments and do testing, etc.

 In response to Ms. Zahler’s question of what level of involvement the Committee would like to have in this, Mr. Koplinka-Loehr said he would like to have a one-page summary and the Committee agreed.

 Budget Report
 Ms. Zahler distributed a "snap shot" of the proposed budget requests and the impact if not funded.  She anticipates a total of $79,675 in maintenance of effort requests being made with the one large policy question to address: the County's continued participation in the Recreation Partnership.  Ms. Robertson reported the Recreation Partnership Budget Committee passed a budget last evening including the potential loss of $38,100 from the County to the Recreation Partnership that will result in the loss of 7 programs serving 1,531 youth.   However, there is a possibility that municipalities may consider a budget that would replace half of the County's funding.

Health Department

 Transportation Bid
 It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Blanchard, to approve and submit the following resolution to the full Legislature for approval.  Ms. Allinger distributed copies of a cost comparison chart for the companies that responded to the Transportation Request for Proposals (RFPs).  Two bidders responded:  Donson Transportation Services, Inc. and Birnie Bus Service, Inc.  She spoke about the one addition to the RFP that asks for the annual cost of transportation with and without an aide.  The current year contract is approximately $248,378.87 local share.  Discussion followed concerning the bidders and Ms. Allinger's strong opinion that having an aide will reduce the liability issue.  She contacted other counties and the trend is that as new contracts are being renewed aides are being placed on the buses.  The State Health Department reimburses the county only $2.50 per child per day of transportation.

 Following further discussion, Ms. Schuler MOVED to amend the resolution and award the contract to Donson Transportation, Inc.  MOTION FAILED FOR LACK OF A SECOND.  Questions were raised as whether an escape clause existed in the contract and it was felt there was, but staff agreed to follow up and let the Committee know if an escape clause was not included.

 A voice vote resulted as follows on the resolution as follows:  Ayes - 4 (Robertson, Koplinka-Loehr, Blanchard, and Todd); Noes - 1 (Schuler).  RESOLUTION ADOPTED.

RESOLUTION NO.   - AUTHORIZATION TO EXECUTE A THREE YEAR CONTRACT -  ADMINISTRATION AND PROVISION OF TRANSPORTATION
FOR EARLY INTERVENTION AND PRESCHOOL SPECIAL EDUCATION CHILDREN RESIDING IN TOMPKINS COUNTY -  HEALTH DEPARTMENT
 

 WHEREAS, the Tompkins County Finance Department, in cooperation with the Tompkins County Health Department, has duly advertised for proposals for administration and provision of transportation services to children ages 0-5 who are enrolled in programs PL-9457 (as authorized by Tompkins County to attend educational/rehabilitation programs) who reside in Tompkins County, and
 WHEREAS, two proposals were received by the July 7, 2004, deadline, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee, That the contract be awarded to Birnie Bus Service, Inc., of Syracuse, New York,
 RESOLVED, further, That the contract be awarded for a period of three (3) years commencing September 1, 2004, and terminating August 31, 2007, with the option to renew for an additional two year period,
 RESOLVED, further, That the Health Department is authorized to implement this proposal on behalf of the County, funds are provided for in Account A2960.54400 and A4054.54400.
SEQR ACTION:  TYPE II-20

 Budget Report
 Ms. Cole provided an overview of the maintenance of effort requests she will be proposing for 2005.  The over target requests total $128,903 and include six separate OTRs as listed below in priority order:
          County Cost
 1. Account Clerk Typist (1 FTE) - Community Health Services Division     $10,707
 2.  Senior Typist (.50 FTE) - Children with Special Care Needs Division       16,359
 3.  Community Health Nurse - Children with Special Care Needs Division     49,050
 4.  Laptop Computer - Children with Special Care Needs Division                    1,400
 5. Vehicles (3) - Environmental Health Division          30,432
 6. Vehicles (2) - Community Health Services Division         20,605

 At this time, the Division Heads explained the justification and need for each of the over target requests listed above.

 Update on 2003 Shortfall
 Ms. Crosby said a comment made by an accountant was that 2003 was not a typical year for the Department.  She said monthly graphs are provided for the Board of Health and she can make them available to the Committee if requested.  The graphs are showing dramatic increases in caseloads beginning in December 2003, which continued through June.  The revenue is up and at the end of June the Department was almost exactly on target.

 Mr. Whicher said the Committee will need to discuss this issue at the next meeting and make a decision on how the Department should handle the shortfall.  The recommendation from Administration is to consider waiving the deficit; Ms. Cole was directed to prepare a resolution for the next meeting.

Resolution - Unity House

 It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Blanchard, to approve and submit the following resolution to the full Legislature for approval.  Mr. Whicher briefly explained the resolution and said Unity House would like to double their size of capacity on Green Street.  There is a potential of receiving a matching grant from HUD up to $200,000; total project cost is $400,000.  The County was approached to see if it could provide up to $200,000 for the matching grant.  Following discussions, it was felt that it would be in the County's best interest to support the mortgage as it would likely save the County money in the future.  Ms. Carey updated the Committee on the discussions she has had and it is now anticipated the County's share will be $165,000 as a result of cost adjustments with the architect.

 Following a brief discussion, a voice vote resulted as follows:  Ayes - 5, Noes - 0.  RESOLUTION ADOPTED.

RESOLUTION NO.   - SUPPORTING HUD APPLICATION FOR EXPANSION OF GREEN STREET CONGREGATE CARE LEVEL II RESIDENCE

 WHEREAS, several human services agencies and County departments are presently collaborating on a HUD "Continuum of Care" grant application to address housing issues in our community, and
 WHEREAS, one component of the application involves an expansion of Unity House's Green Street Congregate Care II residence by ten (10) beds, and
 WHEREAS, the availability of these new beds could decrease the County's expenditures through the Department of Social Services for emergency shelter, and
 WHEREAS, this expansion, if approved, will entitle the partners to additional Federal funds to support other of the grant's component programs, now therefore be it
 RESOLVED, on recommendation of the Health and Human Services Committee, That the Department of Social Services is hereby authorized to sign a letter of intent to provide fiscal support for the Green Street expansion, assuming that the grant is approved.
SEQR ACTION:  TYPE II-20

Unity House hopes that Social Services will share in the local cost portion of the expansion project.  The Department's provisional analyses of the proposal (see attached) suggest that the net fiscal impact will range from an additional $15,415 to a reduction of $48,200 annually.

Approval of Minutes

 It was MOVED by Ms. Blanchard, seconded by Mr. Koplinka-Loehr, and unanimously adopted by voice vote, to approve the minutes of June 23, 2004 as amended.

Chair's Report

 Ms. Robertson distributed a graph illustrating average home prices from the late 1980’s through June 2004 and bednights through May 2004.  She said this will be part of the package she is working on, that collects those sections of the minutes from the 2003 HHS Committee on the subject of homelessness and housing.

Adjournment
 
The meeting adjourned at 1:36 p.m.