Health and Human Services Committee

Regular Meeting Notes – Draft 8-28-17

Monday, August 21, 2017 4:30 PM

Legislature Chambers



Attendee Name



Anna Kelles



Leslyn McBean-Clairborne

Vice Chair


Will Burbank



Carol Chock



Peter Stein



Katrina McCloy

Deputy Clerk


Amie Hendrix

Director of Youth Services


Lisa Holmes

Director, Office for the Aging


Karen Baer

Director of Human Rights


Kit Kephart

Acting Commissioner, Social Services


Kathleen Schlather

Exec. Director, Human Services Coalition


Frank Kruppa

Public Health Director


Joe Mareane

County Administrator



Guests:               Julianna Garcia and Nick Filippini, Open Doors; Amanda Champion, Town of Ithaca; Shawna               Black, Town of Ithaca; Rob Statham, New York Association of Psychiatric Rehabilitation               Services, Inc., and Media

Call to Order

              Ms. Kelles, Chair, called the meeting to order at 4:35 p.m.

Changes to Agenda

              There were no changes to the agenda.

Youth Services

Housing Runaway and Homeless Youth Services 2017 (ID #7238)

              Ms. Hendrix provided a PowerPoint presentation entitled Tompkins County Youth Services, Overview Of: Runaway and Homeless Youth Services 2017.  She noted the Youth Services Department does not directly work with youth but rather provides services for youth through various programs.


              Ms. Hendrix said discussions have been taking place regarding a Youth Shelter in Tompkins County since currently there is not one and the closest one is in Syracuse.


              Ms. Chock inquired about the total cost of programs and the local share of those costs.  Ms. Hendrix will provide that information to Committee members. 


              Ms. Hendrix introduced Julianna Garcia and Nick Filippini from Open Doors and complimented them on the work they do for youth in that program.  Mr. Burbank asked what can be done to help the program out.  Ms. Garcia stated they are in need of more host homes county-wide and said it is difficult to find host homes due to the huge burden it can place on families.  Ms. Hendrix explained the process that a family would go through to become a host home. 

* * * * * * * * *

Public Comment

              No one from the public wished to comment.

Youth Services - Continued

Resolution No. - Budget Adjustment Related to Acceptance of 2017 New York State Office of Children and Family Services  Funding - Youth Services (ID #7205)


MOVER:              Will Burbank, Member

SECONDER:              Carol Chock, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein

WHEREAS, pursuant to Administrative Manual Policy 05-02, budget adjustments exceeding $5,000 require Legislative approval, and


WHEREAS, the New York State Office of Family and Children Services has notified the County of our final 2017 state-aid figures, and


WHEREAS, the County’s state aid is re-allocated to municipalities, programs, and our department, and


WHEREAS, the department has amended existing contracts and accounts, now therefore be it 


RESOLVED, on recommendation of the Health and Human Service Committee, That the Director of Finance be directed to make the following 2017 budget adjustment as follows:


Revenue Acct                             Title                                                                       Amount

7022.43820                             Programs for Youth, State Aid                             $28,006


Appropriation Acct               Title                                                                       Amount

7026.54400                            Program Expense                                          $28,006



* * * * * * * * *


Department of Social Services

Brief overview of Child Protective Services (ID #7235)

              Ms. Kephart provided a PowerPoint presentation entitled Child Protective Services (CPS) that was a brief overview of the CPS Program in Tompkins County.  She stated the focus of CPS is to protect children from further abuse and neglect and that removing a child from their home is a last resort.  There is a dual track system in Tompkins County; Child Protective Services Investigations (INV) primarily conducts investigations and Family Assessment Response (FAR) is an alternative approach that does not require an investigation.  She distributed a Family Assessment Response (FAR) - Tompkins County flowchart to assist with the understanding of how cases are handled in Tompkins County.        


              Ms. Kelles asked what the number was of children in Foster Care in Tompkins County.  Ms. Kephart did not have the exact figure but will provide it to Committee members.  She stated there are approximately 1,200 reports made annually through the New York State Central Register of Child Abuse and Maltreatment for Tompkins County and they used to be split 70/30; 70% of those reports were referred to FAR and 30% to INV.  She explained that with the increase in opiate use those 1,200 calls are now being split 50/50.


              Ms. Kelles and Mr. Mareane spoke of statements made at Legislature meetings regarding the Department of Social Services being motivated by a financial gain to remove children from their home and put in Foster Care.  Ms. Kephart stated Tompkins County does not receive additional funding for a child being put in Foster Care; there is no financial gain for the County, instead it is very costly to put a child in Foster Care.  She explained the Foster Care family receives a stipend for that child based on the child's needs but is not a large amount and added that with the opiate epidemic there has been a larger number of cases involving children with higher needs.  The Department provides training to the Foster Care parents and those children with more needs are typically placed with a Foster Care parent or family that has had more training and the stipend they receive is higher based on those additional needs.  She stated an assigned Caseworker remains involved with the child while he or she is in Foster Care to ensure their needs are maintained.  In addition, she explained how the increased cost for the County can include access to needed services for the parents.  The Department makes every attempt to ensure the safety of all involved in a case.


              Ms. Chock asked if the poverty level has an impact on cases reported and do lower income families have an increased number of CPS cases.  Ms. Kephart stated traditionally there are an increased number of cases for families who are struggling financially at that level and spoke of programs made available that may assist in those situations; however, the Child Welfare Program is not income restrictive.  Ms. Chock asked if there was a level of income that families needed to achieve that could remove them from these situations.  Ms. Kephart stated there would always be family stress and there are other resources available. 


              Ms. Kephart explained how when the child is put into Foster Care the Department can make the parents pay child support but due to the strain already placed on the parents that option is rarely used by the County as it would be an added stressor.


              Ms. Chock inquired about a comparison of numbers and percentages of CPS cases and how they have changed, if they have, as they relate to the population changes.  Ms. Kephart will provide that information to Committee members. 

* * * * * * * * *

Mental Health

Resolution No. - Authorizing the Continuation of Salary for Position Above the Salary Range - Medical Director, Tompkins County Mental Health (ID #7222)

              Mr. Kruppa explained that the person in the Medical Director position recently resigned and Mr. Kruppa appointed another Psychiatrist to serve as the Medical Director on a temporary basis.  The salaries are “red-lined”, it is above the Civil Service range to accommodate the professional credentialing that is required.  This resolution would allow the salary of the former Medical Director to be moved to the salary of the temporary Medical Director. 


              Mrs. McBean-Clairborne inquired if there was any advertising for this position or was it an internal promotion.  Mr. Kruppa stated he had the authority to make the appointment and did so.  The appointment was made as an interim appointment due to the fact that the Department is evaluating the need for an additional psychiatrist.  Civil Service does not recognize an Interim Medical Director title.  This is a provisional appointment to the Medical Director title and the person in that position is aware of the evaluation being done and is in agreement with that.  Once the long-term decision is made the process would be evaluated and the best course of action would be taken. 


MOVER:              Will Burbank, Member

SECONDER:              Carol Chock, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein

WHEREAS, in 2007 the Legislature determined that the system utilized by Tompkins County to assign salaries to positions based on job description was unable to match the market-rate salary of the specialized professional position of Medical Director of the Mental Health Department, and


              WHEREAS, a salary was, accordingly, set by Resolution No. 38 of 2007, and


              WHEREAS, the Legislature desired to revisit that salary upon a vacancy in the position, and


WHEREAS, circumstances with regard to the assignment of salaries based on the job description have not changed in relationship to market-rate salary for this position, and


              WHEREAS, the Medical Director at the Mental Health Clinic holding the position for the last 20 years resigned as of the 21st of July, 2017, and


WHEREAS, the Mental Health Department has a fully qualified Medical Doctor certified in Psychiatry on staff who is able to take on the duties and responsibilities for Medical Director and has been appointed by the Commissioner of Mental Health, now therefore be it


              RESOLVED, on recommendation of the Health and Human Services and the Budget, Personnel, and Capital Committees, That the salary be approved in the amount of $102.81 per hour ($213,845 annually) for the Medical Director of Tompkins County Mental Health Services, effective immediately.


RESOLVED, further, That no new monies are needed to fund this.


* * * * * * * * *


Mental Health Support Services in the Tompkins County Jail (ID #7246)

              Mr. Kruppa explained how the Mental Health Department had a social worker for approximately seven hours a week at the Tompkins County Jail to provide basic assistance for inmates until March 2017.  Over the last year during the discussions about the Jail, the Mental Health Department was made aware of the need for additional support services at the Jail.  Mr. Kruppa, as an interim change, began to send three social workers, a total of 21 hours weekly, to the Jail to expand the services being provided including inmate screening and deeper evaluations.  This interim situation allowed time for planning and creating a stronger response with a long-term focus.    


              Mr. Kruppa distributed copies of a document entitled NEW Mental Health Department Organization Chart and Tompkins County Jail Mental Health Forensic Services to Committee members that is a proposal and explanation of the vision for the Forensics Mental Health program and is what they are working towards.  He stated the Department is proposing two new positions in the 2018 Budget; a forensics social worker at the Jail and a case worker to work on re-entry services. 


              Mr. Kruppa stated the forensic social worker would be a full-time position stationed at the Jail and would screen every inmate and expand evaluations as a result of those screenings for mental health and substance abuse issues.  They would also be able to coordinate any services that may be needed while incarcerated.  He said this is not a proposal to open a “clinic” at the Jail, but rather have someone available with clinical skills to provide some support services.  Mr. Kruppa stated this would also help coordinate and connect those individuals with services upon their release and due to the limited space at the Jail he will work with any space made available for this position.


              Mr. Kruppa said the duties of the caseworker position would be to assist and coordinate transition from the Jail to connection with community services.  Those services are not limited to mental health and substance abuse but could include the full scope of needs that the individual may have and are similar to the caseworkers in the Home Health programs.  He explained that the idea is that the moment a person enters the jail they would begin discharge planning and work to have them connected with the needed services so they are successful with staying out of jail.  The caseworker would spend a portion of their time at the jail but would not need to be stationed there.       


              Mr. Kruppa stated the positions are not expected to start until January 1st and there is time to work with the necessary community partners for further development of the positions and work out the details. 


              Ms. Kelles and Mr. Mareane explained that the caseworker position could be the coordinator for the Re-Entry program and the two positions will be brought before the Legislature in the form of over-target requests (OTR) during the 2018 budget process.  The proposal will transition from the re-entry approach that has been outsourced the past twelve months through Cornell Cooperative Extension (CCE) and replace it with an in-house re-entry program that has been described with these positions. 


              Mr. Mareane stated the County is a complex organization to navigate and by utilizing someone in-house it will assist in making the necessary connections for the individuals involved.  He said this is a change in the approach to re-entry to it being done in-house and coordinated through Mental Health. 


              Ms. Kelles spoke of the funds set aside for the contracted services with CCE in the amount of $80,000 that can be used to offset the $171,000, the total cost of the two positions, and leave the net new County cost of $91,000.


              Mr. Kruppa explained that this will also assist the Mental Health Department due to the fact that there will be three social workers with a total of 21 hours a week returning to the clinic to continue ongoing treatment and doing other community-based forensics work. 


              Ms. Kelles stated there have been forensic services available at the Jail for a number of years and the Jail Study Assessment found that there was not enough.  Inmates not being assessed early on is part of the problem with them being in jail longer than they should be.  Ms. Kelles spoke of a report from a Kentucky jail that houses 220 inmates and has seven forensic counselors on staff. 


              Mr. Kruppa stated Sharon McDougal, Deputy Commissioner of Mental Health, has toured the Erie County Holding Center and reviewed their innovative programs.  Erie County has been very open and has shared the policies and procedures of their programs. 

* * * * * * * * *

Office for the Aging

Resolution No. - Revenue Adjustment for Balancing Incentives Program New York Connects Expansion and Enhancement and Budget Transfers Necessary to Fund One (1) Full-time Information Aide within Tompkins County Office for the Aging (ID #7217)

              Ms. Holmes explained that all Office for the Aging county offices statewide had funding cuts in the NY Connects program.  She had anticipated there would be cuts made to this program and budgeted very conservatively, but the cuts were more than expected.  The decrease in funding this year and the projected cut for next year has made it necessary to reclass a position from Long Term Care Specialist to Information Aide at a much lower salary.  That has taken place in the past few months. 


MOVER:              Carol Chock, Member

SECONDER:              Leslyn McBean-Clairborne, Vice Chair

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein

WHEREAS, pursuant to Administrative Manual Policy 05-02, SECTION 4.02 B, All adjustments over $5,000 must be reviewed and upon the recommendation of the Director of Finance must be approved by the program committee of the budgeting unit and the Legislature, and


WHEREAS, pursuant to Administrative Manual Policy 05-02, SECTION 4.01 A, Transfers from program accounts to personnel lines may require further explanation and are made at the discretion of the Director of Finance and notification to the County Administrator, as well as optional approval or disapproval by the appropriate program committee, and


WHEREAS, the County Office for the Aging, hereafter known as COFA, has received a 2017 Notification of Grant Awards that results in a $38,574 decrease in funding in the Balancing Incentives Program New York Connects Expansion and Enhancement, and


WHEREAS, COFA has deemed it necessary to cut one position on its staff and to decrease Program Expense funding in order to sustain the decrease, and


WHEREAS, COFA has within its means funding to sustain one full-time Information Aide, now therefore be it


RESOLVED, on recommendation of the Health and Human Services Committee, That the Director of Finance is hereby directed to make the following adjustments:


Office for the Aging Budget Adjustments


Revenue Account              Title              Amt              Approp Acct              Title              Amt


A6797-43803              State Revenue              $-38,574              A6797-51000081              Salary              $-10,099.62

                                          A6797-52230              Comp. Softw.              -353.70

                                          A6797-54400              Prog. Exp.              -24,798.68

                                          A6797-58800              Fringes              -3,322.00


Office for the Aging Budget Transfers


From:  Expenditure Account              Amount              To:  Expenditure Account


A6797-51000081              Salary              $1,901.68              A6797-51000214              Salary              $4,702

A6797-54412              Travel/Training              2,800.32             


A6777-54400              Program Expense              $7,241              A6777-51000214              Salary              $5,049

                                          A6777-58800              Fringes              2,192             



* * * * * * * * *


County Administrator's Report

Resolution No. - Budget Adjustment and Appropriation of Unspent Funds from 2016 and Prior Years to Various Accounts of the Departments that Report to the Health and Human Services Committee (ID #7221)

              Mr. Mareane stated these are rollover funds and the large request is from the Health Department for electronic records in the Early Intervention program.  He explained that the resolution is based on his recommendations.  He did not recommend a request made by the Office of Human Rights to cover the cost of law books to be used for enforcement due to the unknown status of enforcement and the memorandum of understanding (MOU) with New York State.  The remainder of the recommendations are as requested. 


              Mr. Kruppa explained the electronic health records for the Children With Special Care Needs program is one of the last of the paperless initiatives and they are still using pen and paper for their recordkeeping.  He stated this is a very extensive program with many State regulations.  He is developing a request for proposal (RFP) and would like to post it next week if this resolution is approved.  He will come back to the Committee with more specifics in the future. 


MOVER:              Will Burbank, Member

SECONDER:              Leslyn McBean-Clairborne, Vice Chair

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein

WHEREAS, Section 4.06 of Tompkins County Fiscal Policy on “Re-appropriation (Carryover or Rollover)” authorizes County Department Heads to “request re-appropriation of unspent funds from the previous year, provided that they are certified by the Director of Finance to be available and provided that this re-appropriation is authorized by the established appropriation procedures of the Legislature,” and


WHEREAS, various departments have been certified by the Director of Finance to have available unspent appropriations and excess revenues from 2016 totaling $698,168, which, combined with balances from prior years, results in an available rollover balance of $1,135,477 on the County’s books as of December 31, 2016, and


WHEREAS, pursuant to County Fiscal Policy, surplus funds of $159,635 have been requested by departments that report to the Health and Human Services Committee, of which $156,635 have been recommended for use in the current year budget by the County Administrator, now therefore be it


RESOLVED, on recommendation of the Health and Human Services and the Budget, Capital, and Personnel Committees, That the following transactions are approved:





General Fund Balance










Requested  Rollover


Use of Funds


Health Department




Electronic Health Record for Early Intervention







Office of Human Rights




Enforcement Effort: Law Books/Legal Database




Outreach Effort:  Office of Human Rights Tabling Banner




Technology Package:  Desktop upgrades, notebooks (2), & multimedia projector/screen




Equipment:  Office Furniture




Software:  Adobe Acrobat Pro DC




Membership: NYSBA Affiliation








*See County Administrator’s recommendation on attached Office of Human Rights Rollover Request (PDF)








* * * * * * * * *

Chair's Report

              Ms. Kelles had no report.

Comments from Committee Members

              Mrs. McBean-Clairborne requested regular updates be included on the agenda and the Departments keep the Committee informed of any affects the opioid epidemic has had on them.  Ms. Kelles stated the Health Department would be reporting next month on the effects it has had on their Department and their involvement.

Minutes Approval

July 17, 2017


MOVER:              Will Burbank, Member

SECONDER:              Leslyn McBean-Clairborne, Vice Chair

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein


Advisory Board Appointment (ID #7186)

Office for the Aging Advisory Committee

Wilma Lawrence - At-large representative; term expires December 31, 2019


MOVER:              Carol Chock, Member

SECONDER:              Leslyn McBean-Clairborne, Vice Chair

AYES:              Kelles, McBean-Clairborne, Burbank, Chock

EXCUSED:              Stein

* * * * * * * * *


              The meeting adjourned at 6:18 p.m.

Bdgt Adj. & Transfers (Info. Only)

Information Item - Alzheimers Revenue Increase Allocation (ID #7218)

RESULT:              COMPLETED

* * * * * * * * *


Information Item - 6777 Budget Transfer (ID #7213)

RESULT:              COMPLETED

* * * * * * * * *


Information Item - 6777 Rev Increase-Transfer (ID #7212)

RESULT:              COMPLETED

* * * * * * * * *