PRESENT: F. Proto, Chair; D. Kiefer; C. Evans; S. Davis; N. Schuler (excused at 1:15 p.m.)

STAFF: K. West, Deputy County Administrator; I. Stein, Office for the Aging Director; M. Dill, Human Services Coalition; B. Falcao, Health Planning Council; B. Crosby, Public Health Administrator; N. Zahler, Youth Bureau Director; B. DeLuca, Mental Health Director P.Bonaparte-Krogh, Cooperative Extension; John Spence, SPCA

 Called to Order

  The meeting opened at 11:32 a.m.

 Approval of Minutes

  It was MOVED by Ms. Kiefer, seconded by Mrs. Schuler, and unanimously adopted by voice vote, to approve the minutes of the January 20 and 22 meetings as submitted.

 Public Health Department

  Resolution

It was MOVED by Mr. Evans, seconded by Ms. Davis, to submit the following resolution to the Budget and Personnel Committee. Ms. Crosby said since program budgeting began, there have been numerous problems over the years with allocating State aid to various programs and budgeting units. The resolution allows Article 6 State Aid to be put into a separate revenue account. Ms. Kiefer said she would like to receive at budget time a list by program where the money came from including both non-state aid and state aid revenue. Ms. West and Ms. Crosby said the non-state aid revenue will still be attached to the separate programs. The state aid revenue is not related to expenditures on a program-by-program basis. The figure for state aid revenue may be an arbitrary one for each program. Mr. Proto clarified the committee's concern is to be able to track where revenue is coming from.

A voice vote resulted as follows: Ayes - 5, Noes - 0. RESOLUTION CARRIED.

 RESOLUTION NO. - AUTHORIZATION FOR PROGRAM RECONFIGURATION - 1998 - PUBLIC HEALTH

WHEREAS, the Health Department receives Article 6 State Aid (Public Health Work) for public health services that are included and approved in the Municipal Health Services Plan, and

WHEREAS, the current budget structure does not lend itself to allocating Public Health Work in an accurate manner, now therefore be it

RESOLVED, on recommendation of the Health, Human Services, and Education and Budget and Personnel Committees, That Public Health Work (Article 6 State Aid) revenues be reported in their own program entitled "Public Health State Aid" effective January 1, 1998,

RESOLVED, further, That the Director of Finance be and hereby is authorized and directed to make necessary accounting adjustments to reflect this change.

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EXPLANATION: Under State regulation our State Aid is calculated based on the entire department (public health), they do not distinguish between County functional units. For the department to assign State Aid to the functional units we would have to use arbitrary and cumbersome formulas.

Transfers

The transfers presented to committee were accepted as presented.

Mr. Proto asked about the status of the Community Assessment. Ms. Crosby said it was extended through 1998.

Other Business

Resolution

It was MOVED by Mrs. Schuler, seconded by Ms. Davis, to submit to the Budget and Personnel Committee the following resolution. Ms. West explained the reason for the resolution. She said the cost of providing the Human Services Coalition review for human service agencies used to be spread among several departments' budgets. The purpose of the resolution is to centralize the costs.

A voice vote resulted as follows: Ayes - 5, Noes - 0. RESOLUTION CARRIED.

RESOLUTION NO. -TARGET ADJUSTMENT FROM SOCIAL SERVICES TO HUMAN SERVICES COALITION

 WHEREAS, the Department of Social Services has been paying the Human Services Coalition for their share of the cost of providing Coalition review for human service agencies, and

WHEREAS, this procedure generated State Aid on a percentage basis which is no longer occurring, now therefore be it

RESOLVED, on recommendation of the Economic and Workforce Development and Health, Human Services and Education Committee, That the Fiscal Target for Social Services shall be reduced by $14,200 effective January 1, 1999 with a commensurate increase in the Fiscal Target for the Human Services Coalition.

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 Health Planning Council

Ms. Falcao referred to the "Child Health Plus Expansion" handout. She spoke about publicizing it and asked for other suggestions or ideas where it could be advertised. Mr. Proto suggested all the municipal offices and outlying newsletters. Mrs. Schuler also suggested the Little Red Bookshelf. The committee commended Ms. Falcao for the publicity she has done with getting information out to communities.

Ms. Falcao briefly reported on the survey conducted on physician availability in the County. She said the number of primary care physicians has increased from 55 to 68 compared to two years ago. The data are still being analyzed and will be made available when it is complete. She said she would like to discuss this at a future meeting. She reproted Guthrie will be opening space on the Commons in connection with the dental clinic. Mr. Proto noted that Family Medicine Center in Dryden has added a doctor and is now taking new patients.

Office for the Aging

Budget Adjustments

It was MOVED by Mrs. Schuler, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

Office for the Aging (#17)

Explanation: Revenue Increase for Alzheimer’s services permits coverage of unbudgeted salary & fringes.

It was MOVED by Mrs. Schuler, seconded by Mr. Evans, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

Office for the Aging (#18)

Explanation: Revenue Decrease In-Home service requires salary and fringe reduction (to be covered from other sources)

It was MOVED by Mrs. Schuler, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval. Mr. Proto disclosed that he has residents in his apartments that from time-to-time take advantage of the HEAP program. He said he would refrain from voting if the committee wished. The committee permitted Mr. Proto to vote.

Office for the Aging (#24)

Explanation: Increase allocation to Home Energy Assistance Program (HEAP) permits more accurate allocation of salary.

Transfers

The transfers submitted to committee were accepted as presented.

Appointment

It was MOVED by Mrs. Schuler, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following appointments to the full Board for approval:

Personal Emergency Response System

Marilyn Kinner - term expires December 31, 1999

Office for the Aging Advisory Committee

Walter Gutenmann - term expires December 31, 1999

Committee members raised concerns with appointment process and how resume forms are being completed. It was felt the process needs to be reviewed by the appropriate standing committee.

  Resolution

It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following resolution to the full Board for approval. Ms. Stein explained that prior to 1998, physicians who agreed to take Medicare patients took them under the conditions in rules of Medicare and were not allowed to take patients under private contract for services that were covered by Medicare. As of 1998, the rules were changed so physicians could contract for Medicare covered services with individuals privately, but both the physician and individual could not make a claim to Medicare. This resolution is in response to an additional proposed amendment urging the United States Congress not to support the Proposed Kyl/Archer Bill which removes consumer protection clauses and allows physicians to decide who to offer a private contract to and who he wants to offer the Medicare system.

 RESOLUTION NO. - URGING THE UNITED STATES CONGRESS NOT TO SUPPORT THE PROPOSED KYL/ARCHER BILL (S.1194/H.R.2497)

  WHEREAS, the Medicare program has successfully enabled provision of health care to all seniors 65 years of age or older, and

WHEREAS, the Kyl/Archer Bill (S.1194/H.R.2497) allows physicians to contract privately with some patients and under Medicare with others for Medicare covered procedures, and

WHEREAS, the Kyl/Archer Bill will result in a two-tiered system depending on the economic circumstances of the patient, and

WHEREAS, the Kyl/Archer Bill removes consumer protection clauses from the current Balanced Budget Act's Medicare provisions, and

WHEREAS, the Kyl/Archer Bill will require the addition of a massive regulatory system to prevent fraud and abuse, and

WHEREAS, the Kyl/Archer Bill will undermine the current Medicare program, now therefore be it

RESOLVED, on recommendation of the Health, Human Services and Education Committee, That the Tompkins County Board of Representatives urges the United States Congress NOT to support the Kyl/Archer Bill (S.1194/H.R.2497),

RESOLVED, further, That the Clerk of the Board of Representatives send certified copies of this resolution to Hon. Alfonse D'Amato and Hon. Daniel P. Moynihan, United States Senators, and Hon. Maurice Hinchey and Hon. Amory Houghton, House of Representatives.

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  Overview of department

Ms. Stein distributed and reviewed with the committee the direct services the department provides and the 1997 contractual agreements and highlights. In addition, she reviewed the department's plans for 1998 including programs and services, needs assessments and evaluations, targeting, and unmet needs.

  Ms. Stein also distributed copies of a list of acronyms and revenue budget summary.

 Mental Health

  Budget Adjustments

It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval. Mr. DeLuca said $30,000 will be used to furnish a six unit residents place and the balance will fund ten of Alpha House's beds in Trumansburg to bring it to capacity.

Mental Health (#20)

Explanation: Additional state aid allocated for adult respite services.

It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval. Mr. DeLuca said there was a total of $75,000 received that can only be used for a new program or expanding a program. He said the following budget adjustments reflect the $75,000 received and are all program expansions.

Mental Health (#19)

Explanation: Additional state aid allocated for adult respite services.

  It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

 Mental Health (#23)

Explanation: Additional state aid allocated for crisis intervention services.

  It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

 Mental Health (#22)

Explanation: Transferring funds to purchase new tape recorder and microphone.

  It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

 Mental Health (#21)

Explanation: Additional state aid allocated for expansion of program hours and operation of peer support phone line.

  It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval. It was felt that the Public Information Coordinator should be contacted about this.

 Mental Health (#23)

Explanation: Additional state aid allocated for crisis intervention services.

  Appointment

There was discussion that the proposed appointment to the Community Mental Health Services Board - MRDD Subcommittee did not go through the proper review process. The committee agreed to postpone action on the appointment to the next meeting.

Youth Bureau

Comprehensive Planning Update

Ms. Zahler gave a brief update on the comprehensive planning process. She said they are about two-thirds of the way through with creating a new plan for the next three years. At the end of the March, the Youth Board will be adopting priority goals which will be the direction that we set in how resources are used. In April agencies will be asked to submit proposals in response to the priority goals adopted. The review process will take place in July.

Integrated Services Planning Proposal

Ms. Zahler said the Office of Children and Family is interested in having counties figure out ways to integrate services provided across health and human service agencies. She informed the committee that the Health and Human Services department heads and Bill Benjamin, Deputy County Administrator, have been meeting on a regular basis to share with one another what they each do in an effort to try to find opportunities where they might be able to collaborate planning. In the meantime, the State has offered a $75,000 planning grant to help integrate the way planning is done. She distributed copies of an executive summary.

Ms. Schuler was excused at 1:15 p.m.

Budget Adjustment

It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit the following budget adjustment to the full Board for approval:

Youth Bureau (#25)

Explanation: The Youth Bureau has been awarded a State of NY Coordinated Children’s Services Initiative Grant to work towards the reduction of residential placements.

  It was MOVED by Mr. Evans, seconded by Ms. Kiefer, and unanimously adopted by voice vote, to submit the attached budget adjustment to the full Board for approval.

  Appointment

It was MOVED by Mr. Evans, seconded by Ms. Davis, and unanimously adopted by voice vote, to submit to the full Board for approval the appointment of Betty Gloss to the Tompkins County Youth Board as the Department of Social Services representative for a term that expires December 31, 1998.

Cooperative Extension

Mr. Bonaparte-Krogh briefly reviewed staffing changes. In order to balance their budget, $26,000 was cut and two positions were left vacant. Those position were reconfigured and being realigned around Family Well-Being. A position of Extension Educator in Family Well-Being will be created to cover food, nutrition and human development issues. In addition a part-time position of Community Nutritionist will also be hired. He said Cooperative Extension will no longer be doing anything with micro-enterprise and small business, reducing family development and parenting programs dramatically, and the programs for consumer and financial management programming will not increase, the local staff time for agriculture will be reduced, there will also be a reduction in youth and leadership development.

Hospicare

Mr. Proto alerted the committee that at the appropriate time the resolution urging the State to extend Medicaid payment to eligible residents of hospice residences will be brought back for action.

Liaisons Assignments and Reports

Economic Opportunity Corporation

There was a brief discussion about assigning a committee member as the liaison to the Economic Opportunity Corporation. There also continues to be a conflict with their meeting schedule. The committee will postpone this decision until all committee members are present to discuss it.

Reports

Mental Health Services Board

Mr. Evans reported on a concern raised in the drug abuse task force that the use of residential services by women usually means they are at am advanced state and this is their last-ditch attempt. There is concern that all Social Service recipients will be required to be tested for drugs and that this will uncover an unknown number of women using drugs.

Mr. Evans raised a concern of a recipient who received mental health services. A review of those services provided was correct.

Health Planning Council

Ms. Davis reported on the Goals 2000 for the wellness of the community. It is a level the Council would like to attain by the year 2000 and appears to be within the realm of possibility in every area except for smoking parents especially pregnant women. The funding for the smoking cessation program is disappearing. She said they are hoping to assist in the effort so that if the goal is not met it is justified that action was taken. She reported that 95 percent of the people who quit smoking do so on their own.

Drop-In Children's Center

Ms. Davis reported the Center is short about $20,000 to do all the things they said they would do. She told the Director she would bring this to the committee's attention.

Adjournment

The meeting adjourned at 2:01 p.m.

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