HEALTH AND HUMAN SERVICES COMMITTEE
AUGUST 26, 2004 11:30 A.M.
SCOTT HEYMAN CONFERENCE ROOM
Present: M. Robertson, Chair; T. Todd; B. Blanchard; M. Koplinka-Loehr; N. Schuler
Staff: B. DeLuca, Interim Mental Health Commissioner;
S. Whicher, County Administrator; N. Zahler, Youth Services Director; W.
Skinner, Public Information; P. Carey, D. Bodnar, K. Hendley, M. Boradynski,
C. Mitchell, C. Manning, Department of Social Services; K. Leinthall, J.
Gorovitz, Probation Department; N. Zook, Youth Services
Guests: S. Hatch, Law Guardian's Office; J. Saul, Community Dispute
Resolution Center; M. Mauboussin, Ithaca City School District, A. Tutino,
Ithaca Journal
Called to Order
The meeting was called to order at 11:30 a.m.
Changes to Agenda
There were no changes to the agenda
Youth and Youth Services in Tompkins County
Ms. Robertson began by asking individuals to introduce
themselves. She thanked everyone for attending the meeting and expressed
appreciation for the chance to look at services being offered in a holistic
manner.
It was noted that there are five areas requiring review
in order to obtain a full viewMs. Zahler suggested five questions to focus
the discussion of needs and services available for youth:
1) Current youth needs;
2) Why focus on certain needs;
3) Emerging and unmet needs;
4) Funding or service trends;
5) What should be preserved?
Ms. Zahler said that at the previous Committee meeting it was determined
that the five areas noted above represent things presently being addressed.
It is hoped that the information that would be provided will assist in understanding
how the present services being provided were determined by the County Departments
as well as the emerging and/or unmet needs that may need to be addressed.
In addition, she spoke of the need to review the trend for funding services,
as it is an extremely important piece to prioritize services. Ms. Zahler
then provided a chart that showed the silo format of needs and services as
it presently exists. She spoke of the difficulties associated with
this type of format that does not easily provide a clear-cut manner in which
to direct parents and educators to the most appropriate service provider
for a particular youth. She pointed out that as a result of collaboration
between among departments Tompkins County has developed a holistic approach
to determine the best course of action and make an appropriate recommendation
within the regulations. Ms. Zahler spoke of how the departments reviewing
situations seek strength-based solutions, making every effort to focus on
positives to work with when youth come into the programs. It was noted
by Ms. Robertson that in other states counties operate the schools, which
provides a direct connection. Ms. Zahler said that with New York State
schools there might be differences between buildings in school districts
and that the connection between the County and school may need to be reviewed
to determine how to better collaborate.
Ms. Blanchard inquired how many youth are served and was informed that of
the approximate 18,000 youth ages 0-20 in the county, including college students,
in the county approximately 10,000 are within the ages of 10 to 19.
Of these 10,000, approximately 25 percent will require services in some manner.
Members were provided with an informational packet the that provided a definition
of Juvenile Delinquent and youth that would come under Persons in Need of
Supervision (PINS). PINS was defined as a minor under the age of 18 "who
is an habitual truant or who is incorrigible, ungovernable or habitually
disobedient and beyond the lawful control of parent or other lawful authority."
Juvenile Delinquent was described as a minor between 7 and 16 years of age
who is charged with an act committed a crime (misdemeanor or felony) that
if they were older thanover 16, the act would be treated as a misdemeanor
or felonyan adult. If an appearance ticket were presented to the minor
by local authorities they would be sent to probation for evaluation and possible
diversion. PINS participants will be evaluated to determine if services
could be offered that would prevent a court appearance. Ms. Gorovitz
spoke of having probation officers assigned to the schools to develop a rapport
with school officials and assist in early intervention with youth.
Every attempt is made to connect the youth with appropriate services and
if warranted, the probation officer works with Department of Social Services
(DSS) if abuse is suspected. Ms. Gorovitz spoke of Probation Department's
desire to engage families in the process and when parent involvement is unsuccessful
preventive services will be brought into the matter. School referrals
are normally a paper referral followed with parental contact to set up a
meeting that will include the child as well.
A brief discussion took place related to the Designated Assessment Services
team (DAS) process that includes Probation, Department of Social Services,
and Mental Health. DAS can be dealt with through either a consult
or by bringing parents in to work with. Ms. Gorovitz noted that it
is the preference to involve the parents but it is sometimes not possible
due to work schedules and other responsibilities. The collaboration
of the multiple agencies has been effective through the review of the entire
situation to determine the best course of action for the family unit.
Ms. Leinthall noted that if the situation bringing the referral were resolved
within fifteen days there would be no DAS meeting. Ms. Gorovitz said
the department doesn’t have the resources to hold DAS meetings every day
as you’d need to, but Probation does work with the family from day one.
Ms. Hatch spoke of the difficulties associated with school referrals; parents
often view it in a negative manner and it is difficult to achieve parental
support.
Ms. Carey, Department of Social Services Commissioner, spoke of progression
of the collaborative effort to provide services. She indicated that
approximately four to five years ago conceptualization began regarding service
procedures as a result of recognizing a disconnect between agencies.
Ms. Carey said that approximately two to two and one-half years ago it was
recognized that there were problems within the system indicating including
that several caseworkers may be working on a single family unitthese cases
were spread out among Child Welfare caseworkers, who also did adult and other
types of cases, often with different perspectives on how to assist families
in periods of conflict. As a result, a joint effort between agencies
has taken place to effectively determine how to best serve clients within
regulations and avoid duplication of efforts and communication gaps.
The following information was provided regarding current procedures:
· Youth and Family Services Unit (DSS) - this was
created to assist in working with PINS and Juvenile Delinquent referrals
· Of every four referrals from Probation, generally
a formal case will be opened in one, and will be assigned to a worker
following assessment
· Departments work as a team to determine the best
course of action to avoid placements outside the home, utilizing the strengths
that exist when making a determination
· Probation Department communications with Department
of Social Services is almost immediate (previously was at least 24 hours
of referral)
· SPOA (Single Point of Access) team reviews each
referral to determine if there is are services that could be offered to prevent
placement
· SPOA must immediately review and approve placement for a youth to be sent to detention
· Although there is a greater need, many services are not readily available for all
· Family and Children Services noted a higher number
of youth have mental health issues and schools speak of more children who
exhibit anxious behaviors
· New concerns - medical and housing needs are not
met, and basic poverty issues are emerging in neglect and PINS petitions.
· During the past year 50 percent of youth in foster care were in the adolescent unit.
· It was noted that the increase was not thought
to be a result of migration from other counties to obtain services but rather
an increase caused by other factors.
Ms. Carey then spoke of the VERA Institute workshops related to better communication
and front-end work. She spoke of having a good dialogue with school representatives
who expressed a desire to have a team of Mental Health, Probation, and Department
of Social Services representatives on-site, styled like the DAS concept.
Ms. Carey said it would be like a PINS preventive service that would assist
in identification of a need and possible services not available to the schools.
Ms. Carey then spoke of a pilot program utilizing two schools presently involved
and interested in modifying services, Newfield and Dewitt. She said
that members of the Newfield School District have been involved with the
present processes and attend meetings with families and students. Dewitt
school representatives were in attendance at the VERA workshops and have
expressed an interest to work with County service providers to provide early
assistance to students and families. It is thought these two schools
could act as models to develop the process of having employees of Probation,
Mental Health and Department of Social Services participate with the schools
one day per a week. They will be available for school staff meeting
and also to meet with families, students and staff to possibly divert the
PINS process.
The Committee then reviewed the PINS intake information noting differences
between elementary and high school intake numbers. It highlighted that
perhaps more middle school intervention is necessary. Mr. DeLuca noted
that different school districts are complex and vary greatly, even within
the district itself. He stated these are the primary community for
youth outside of their home.
Ms. Manning reviewed information relating to the placement process, noting
that the goal is to identify what is required to bring the child back home.
She spoke of attempting to find local solutions in the case of youth placed
in foster care, noting it usually does not require additional services.
However, when the youth is placed in a residential treatment center it is
due more extreme behavioral issues. Upon being sent to a residential
treatment facility a YAP (Youth Advocacy Program) referral is made at six
months for all youth in the residential facility for six months in order
to develop an individual plan for how to return the youth to the community.
She noted it is very strength-based, seeking family and community resources
to connect with to allow independence. She said that often it is asked
that intensive work occur between the youth and family members but it is
often difficult due to the geographical distance between them. In addition,
it was noted that a residential treatment facility provides an a safe but
artificial setting; upon returning to home the youth may be faced with many
of the same problems that previously existed, often causing them to come
back into the system.
Mr. Todd spoke of the importance of employment or learning good work skills.
The Committee and staff discussed this topic and noted that it is recognized
that work is an important piece in redirecting the youth and is an integral
part of the DAS review. It was noted that there are not enough jobs
or work-related programs available to provide each youth with this experience,
particularly if they are the highest-risk youth. Ms. Gorovitz noted
this problem exists for the adult offenders as well, often those who need
this structure the most find it difficult to obtain employment. In
addition, with the increase in age for PINS more youth are requiring meaningful
work. Ms. Leinthall stated the most effective service to date is the
Juvenile Accountability Community Service Program (JACS). The youth
enjoy participation in the program that performs real work and although without
pay, feel good about doing something. Ms. Zahler spoke of the Youth
Services programs that are available, some providing stipends, and that they
often are not available to youth. She spoke of the Learning Web being
a very effective program with a waiting list of 80 youth. It was particularly
the 16 and 17 year old youth requiring intervention would most be interested
in working. For this reason a collaborative effort is being made with
Workforce Development to obtain funding to fill this gap.
The Committee and staff then reviewed additional information related to the
number of PINS referrals who did not continue due to moving out of the area
or school districts; those who were able to resolve the conflict without
having to proceed to the next step of court. The chart indicated that
46 percent of youth who started this process did not continue onend up going
to court.
Mr. DeLuca spoke of the forum completed two years ago that focused
on two needs; a child psychologist and housing needs for the mentally ill.
He indicated these needs are nationwide. At this time Family and Children's
Services are attempting to collaborate with County Mental Health to bring
in a child psychologist to the area. In addition, he said the manner
that the County has developed their SPOA has been unique and positive.
He stated that the ability to look at all the problems associated with the
youth to assist the family, recognizing that the child's community is the
home and school environment is beneficial. Mr. DeLuca spoke of his
meeting with the Deputy New York State Mental Health Commissioner, he was
notified of a fourteen-bed unit in Binghamton and an eight-bed unit in Hutchings,
which will assist in placements of those with mental health needs.
In addition, discussions occurred regarding the silo gaps noted in the meeting
today.
Ms. Robertson thought that perhaps in future meetings information related
to the Cayuga Medical Adolescent Unit and school suspension issues might
be appropriate topics.
Carol Mitchell, of the Life Skills Program, spoke about this program.
She noted that as a result of a 1984 study of the 1980 census, which showed
eighty percent of homeless in New York City had been foster children, the
Chaffee Act, whose latest revision is 1999, came about. This Act provided
legislation to enable any individual who was in foster youth from the ages
of 14 through 21 must have life skills training to enable independent living.
In January 2005, all youth 14 and 21 who have ever been in foster care will
be eligible to maintain participation in this program through age 21.
The program provides courses on job seeking, job maintenance, cooking, and
other skills normally developed in the home atmosphere. In addition
emotional self-care and housekeeping skills are taught in both class settings
and individual. Some of the youth who have participated now have their
own families, yet are able to continue this necessary training. Ms.
Mitchell noted that seven years ago there were 26 individuals eligible and
now there is are 66. One half of these youth are above the age of 17.
Ms. Carey stated that she feels that all children over 16 years of age should
involve life skills training; the Chaffee Act has re-emphasized this.
This service is offered, but not mandatory. At this time there are
44 participants in this program. Ms. Gorovitz spoke of the need to
assist all youth 16 and above coming through the system; many feel they should
live on their own and have no comprehension of how to do this. It was
noted that most of the youth in the Life Skills Program have the unmet need
of housing. In addition, the ability of youth finding jobs has become
more difficult.
Ms. Zahler spoke of the historical background of providing assistance to
youth, stating that often youth were given a special education label in order
to provide services. She said the PINS diversion work has been an attempt
to provide assistance without having to fully go into the system. Ms.
Carey stated that the COPS program allows funding for non-DSS youth to participate
in programs offered to DSS clients.
Ms. Carey said that the next step is to determine how to fund gaps; a worksheet
was provided that identified these. She said that one way is to seek
cross-system funding sources. Ms. Zahler said that the Youth Board
has also identified gaps within their department. Ms. Zook said that
they would like to offer a pilot program to work with staff on anger management
therapy. Ms. Zahler stated programs developed by her department are
more flexible than others and are willing to find a way to redirect services
to those needing it.
Ms. Robertson asked individuals what they feel is working and should be preserved and what are the gaps.
Mr. DeLuca said the primary need is a child psychologist.
He would like to see a school-based mental health system. He said the
step-down is in the works a community-residence for youth leaving Elmira
Psychiatric Center. This will be a ten-county regional unit.
Ms. Zook felt it is a larger question related to the step-down and will require careful thought.
Ms. Hatch said supervised visitation support for families
is an area of a gap. She spoke of attempts to locate funding from private
and other sources without success. She noted this is a critical concern
within the Family Court System as it is felt necessary to alleviate difficulties
with children of parents who are divorcing.
Ms. Zahler stated that it is important to make the distinction
of intensive needs for a small number of people and the needs that affect
many. Transportation is a need affecting thousands of youth; treatment
for sex offenders affects a few youth but is very necessary.
Ms. Manning stated she sees the gaps varied depending
on what is occurring on a daily basis. Overall she sees the need for
things such as longer-term school programming, including in-school programs
for suspended students, noting that putting suspended children put on two-
hour tutoring is inconsistent with the need for supervision.
Ms. Leinthall feels there is a need to continue toincrease
work in schools; for the time being, the pilot program will use with existing
resources. In addition, the Juvenile Intensive Services Person (JISP)
officer is working with three times the number of clients it he should be
have to be effective. She feels more staffing is necessary and that
there is a need to reassess community services. Ms. Leinthall said
that the electronic monitoring system might be a way to assist in monitoring
juveniles; there is a need to assess the cost to determine if this is feasible.
Ms. Gorovitz said youth need accountability immediately.
She said it is not possible to keep the communication going with on overloada
caseload of 55. She feels it is very important to engage families more.
She said the Multi-Systemic Therapy is working with families and helps parents
to get consistency and learn what is needed. It is presently available
to those families whose youth is are at risk for placement and misses a huge
segment, just starting in the PINS process, that could utilize benefit from
it as well. She feels more funding to open MST and family functional
therapy up to others would be available to avoid placements.
Ms. Boratynski said that children are within the school
community the most and that better identification and early intervention
to prevent problems later on would be most effective. She feels that
there needs to be the resources available to do this and that the present
staff is stretched too thin and often aren’t aware of community services
that are available. It is also important that the community services
be supported adequately, so that when Probation or the schools makes a referral,
the services are actually there.
Ms. Hendley feels the biggest gap is within the schools.
In addition she said youth aging out of programs is also a concern.
She would like to see independent living program in the County.
Ms. Bodnar said that she feels it is important to get
the families involved early and provide skills that are supportive of needs.
County Administrator's Report
Mr. Whicher reported that the review of the over-target
requests has been completed and that the vast majority was from Health and
Human Services, from agencies, Tyler the TILOR Amendmentamendment, and State
Aid adjustments. He said the agencies have included salary adjustments,
which were not reflected within requests from County departments. He
said that he has tried to present these as a maintenance effort and that
unless there is a cooperative venture for a new initiative he did not include
themit. Two that were included was the child psychologist and one for
the library for a collaborative effort with Cayuga Medical Center.
Mr. Whicher said that for the vast majority of the 154 over target requests
he did not believe much time would have to be spent reviewing. He did
state there may be some big issues to deal with and that the focus should
be spent there. Mr. Whicher said that the discussions should be taking
place at the expanded budget meeting. Ms. Robertson hoped to have more
information on how this process will take place.
Chair's Report
Ms. Robertson stated she received information regarding
Better Housing for Tompkins County and Ithaca Neighborhood Housing Services;
the Governor has vetoed appropriations for their basic operationscut the
basic funding. It was noted that it was recommended by Bruno to not
do anything until after the elections. In addition, Ms. Robertson reported
on information received from Senator Kuhl's office regarding the SRO funding;
it is believed that funding is in place for the full capital program proposed
in the 2004 budget. Mr. Whicher said in the Governor's vetoes there
are ones relating to mental health capital programs. She then saidMs.
Robertson noted that Ms. Schuler provided copies related to an article on
FDA information on drug purchasing.
Approval of Minutes
It was MOVED by Mr. Koplinka-Loehr, seconded by Ms. Blanchard,
and unanimously adopted by voice vote by members present, to approve the
minutes of the August 11, 2004 meeting as submitted.
Adjournment
The meeting adjourned at 1:30 p.m.
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