Health and Human Services Committee

Regular Meeting Notes – Draft 1-4-18

Monday, December 18, 2017 4:30 PM

Legislature Chambers

 

Attendance

Attendee Name

Title

Status

Arrived

Anna Kelles

Chair

Present

 

Leslyn McBean-Clairborne

Vice Chair

Late

4:38 AM

Will Burbank

Member

Present

 

Carol Chock

Member

Present

 

Shawna Black

Member

Present

 

Katrina McCloy

Deputy Clerk, Legislature

Present

 

Greg Potter

Director of ITS

Present

 

Frank Kruppa

Public Health Director

Present

 

Lisa Holmes

Director, Office for the Aging

Present

 

Paula Younger

Interim County Administrator

Present

 

Amie Hendrix

Director of Youth Services

Present

 

Kit Kephart

Commissioner, Social Services

Present

 

Marcia Lynch

Public Info. Officer, County Administration

Present

 

Matthew Van Houten

District Attorney

Present

 

 

Guest(s):  Henry Granison, Town of Ithaca resident and Legislator-Elect; Kathy Schlather, Human               Services Coalition; Dr. William Klepeck, Medical Director, Tompkins County Health               Department;  Dr. John Barry, Executive Director, and Michelle McElroy, Deputy Executive               Director, Southern Tier AIDS Program; Dr. Justine Waldman, MD, Emergency Physician;               Nicole Pagano, PharmD, Green Street Pharmacy; and Katharine Celentano, Policy               Coordinator, Ithaca Drug Policy Alliance 

Call to Order

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

Changes to Agenda

              Ms. Kelles requested to make the following changes to the agenda:

·              Add two advisory board applications for consideration and withdraw one application being considered for the Office for the Aging Advisory Committee;

·              Add the revised resolution entitled Resolution to Urge a Repeal of Portions of 16-ADM-11 that Requires Shelter Payments from Individuals with Modest Earned and Unearned Income;

·              Add the resolution entitled Budget Adjustment for Park Grant Continuation in 2018 - Youth Services; and

·              Move the resolutions being considered from the Health Department to be considered prior to the presentation. 

 

Committee member had no objection to these changes. 

Health Department

Resolution No. - Budget Transfer Across Budgeting Units Medical Examiner (4014) and Planning and Coordination, Children With Special Care Needs (4047) – Health Department (ID #7500)

              Mr. Kruppa explained the resolution would allow for funds to be moved to cover the totality of the contract. 

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Carol Chock, Member

SECONDER:              Will Burbank, Member

AYES:              Kelles, Burbank, Chock, Black

ABSENT:              McBean-Clairborne

              WHEREAS, pursuant to Administrative Manual Policy 05-02, Section 4.01, Item B, Transfers Between Budgeting Units or Programs, require program committee and Legislative approval, and

 

WHEREAS, resignations of the Deputy Medical Examiners allowed the department to contract for Deputy Medical Examiner services, and

 

WHEREAS, funds are available in Planning and Coordination of Children With Special Care Needs budgeting unit due to vacancies earlier in the year, now therefore be it

 

              RESOLVED, on recommendation of the Health and Human Services Committee, That the Director of Finance be and hereby is directed to make the following budget transfer on his books:

 

Health Department

FROM              Title                 Amt              TO              Title(s)                                         

4047.51000580              Comm. Hlth. Nurse                            $1,570              4014.54442              Professional Svc. Fees

4047.58800              Fringe                                          $   681              4014.54442              Professional Svc. Fees

* * * * * * * * *

 

Resolution No. - Award of Contract - Purchase and Implementation of an Electronic Case Management Software System for the Early Intervention Program - Health Department (ID #7501)

              Mr. Kruppa explained that the resolution allowed for the selection of a vendor following the request for proposal process for this project.  The approved vendor has done other projects within the State and is familiar with regulations involved.    

 

              Mrs. McBean-Clairborne arrived at this time.

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Will Burbank, Member

SECONDER:              Carol Chock, Member

AYES:              Kelles, Burbank, Chock, Black

ABSENT:              McBean-Clairborne

WHEREAS, the Public Health Department’s Children with Special Care Needs Division completed a thorough review of records and processes related to the Early Intervention Program, and determined that the manual, paper-based system is not capable of meeting current and future public health service needs, and

 

WHEREAS, the Children with Special Care Needs Division, in coordination with Tompkins County Information Technology Services (ITS), issued a Request for Proposals (RFP) for an electronic-case management software system, and

 

WHEREAS, the project team interviewed and heard presentations from various vendors, and

 

WHEREAS, based on the RFP and interview process results, and the additional review of requirements by ITS, the department has selected iCentral located in Garden City, New York, that meets the program documentation needs, now therefore be it

 

RESOLVED, on recommendation of the Health and Human Services Committee, That the Department is granted authority to enter into all contract(s) resulting from this RFP process, other County ongoing professional support contracts, and utilization of the New York State Office of General Service background contract,

 

RESOLVED, further, That the Tompkins County Public Health Department is authorized to expend funds defined in this resolution for professional services, software licensing and maintenance, hardware procurement, and additional County salary and fringes associated with this project implementation,

 

RESOLVED further, That the project be paid for by using funds from account HM Fund - Health Fund HM4006.59239.40.06 (Capital Account - Public Health),

 

RESOLVED, further, That the 2019 Tompkins County Public Health Department fiscal target be increased by $18,800 to cover ongoing licensing fees.

SEQR ACTION: TYPE II-20

* * * * * * * * *

Public Comment

              There were no members of the public present who wished to speak.

Presentation(s)

Video

              Ms. Kelles provided a YouTube video entitled The Caring Community: Ithaca and the Movement for Supervised Injection Facilities for viewing and said it can be found at the following link: 

<https://www.youtube.com/watch?v=0XFDil_7918> .

 

The Rationale for Supervised Injection Facilities (SIFs) John Barry, LMSW, Executive Director, Southern Tier AIDS Program (ID #7507)

Dr. John Barry, Southern Tier AIDS Program, provided a PowerPoint presentation entitled The Rationale for Supervised Injection Facilities (SIFs): A Time to Save Some Lives.             

RESULT:              COMPLETED

* * * * * * * * *

 

Supervised Injection Sites Continued Discussion (ID #7386)

              Ms. Kelles stated the discussion is intended to be educational and to ask the necessary questions of others in attendance.  She stated a Supervised Injection Facility (SIF) is only one of twenty-five recommendations included in the Ithaca Plan. 

 

              Dr. Klepack stated there have been discussions regarding this topic by the Community Mental Health Services Board and the Board of Health that have included honest expressions of concern.  The discussions have shown a need for continued community conversations.  He spoke of the need for additional information and statistics regarding SIFs and the opioid epidemic in Tompkins County.  He further explained that there are limited resources in gaining this information and there is a need to respect those gathering the information. 

 

              Mr. Kruppa reported the Community Mental Health Services Board met earlier in the month and said they are not ready to take a position on this.  They are still gathering information and have requested additional information before making any decisions.  He explained the Board of Health is in a similar position.  The Community Mental Health Services Board asked Mr. Kruppa to relay a message to the Committee that they want to play a role in understanding this issue and provide information and feedback to the Legislature.

 

              Mrs. McBean-Clairborne stressed the importance of receiving input from the advisory committees as this progresses forward.  Ms. Kelles stated she was in agreement and asked Mr. Kruppa to extend an invitation to the members of the Community Mental Health Service Board and the Board of Health to the January 2018 Health and Human Services Committee meeting to join in the discussions. 

 

              Dr. Waldman suggested gaining input and information from Doctors, Nurse Practitioners, and Nurses who work at the hospital and witness the large amount of care and utilization of resources that is expended for substance abuse cases.  She explained that the care provided is not preventative care but rather care that is provided after something has gone wrong and could be more useful in other areas. 

 

              Dr. Waldman spoke of her experience volunteering at the needle exchange program.  She stated 99% of the population she has worked with have higher Adverse Childhood Experiences (ACE) Scores and are extremely vulnerable.  

 

              Ms. Pagano explained how it is bothersome to her to see people being treated the way addicts are treated and views SIFs as community-friendly to assist in providing the connection for the clients with people who will care and help guide them into better decision-making and wellness. 

 

              Ms. Chock agrees this is a public health problem and should be treated as such.  She further believes the pharmaceutical companies that have helped escalate this problem should be held responsible.  Ms. Chock stated County Staff needs to be on board prior to proceeding and using taxpayer funds to move forward with SIFs. 

 

              Ms. Chock inquired about the $6.5 million budget Dr. Barry mentioned in his presentation.  Specifically, she asked how much would be used for the needle exchange program and what types of potential would there be for State and Federal funding.  Dr. Barry spoke of his experiences in dealing with New York State Department of Health (NYS DOH) and said if the funding for a particular program being requested is of interest to the NYS DOH then they usually work to find funding and the NYS DOH is interested in SIFs.  He stated the budget for the needle exchange program is between $600,000 and $700,000 and the funding is provided through the NYS DOH, Office of Drug User Health.  He stated he has found a significant amount of funding for the drug user health programs and he is aware that foundation funding is not sustainable long term. 

 

              Mr. Burbank spoke of the large number of needles not properly disposed of in various places throughout the community.  Dr. Barry stated the needle exchange program collects about 85% of the needles provided and explained that a benefit of the SIF is that people who use at a SIF would use their equipment on sight and dispose of it on sight.

 

              Ms. Black spoke of the video and how it is a constant reminder of a need for assistance in our community.  She said the Legislature is looking at all options in addition to SIFs including treatment options, increase in the number of beds available for treatment, and the LEAD program.  She stated the conversations are taking place and they need to continue.

 

              Ms. Black asked Dr. Waldman how many people she sees in the Emergency Room on an average shift who are there for substance abuse related injuries or illness.  Dr. Waldman stated it varies but on average about ten percent of the patients she sees per shift are there for substance abuse related treatment. 

 

              In response to an inquiry by Ms. Black, Ms. McElroy explained that the number of people seen daily at a needle exchange site varies substantially but on average between twenty and fifty people are seen daily at the Ithaca site and annually over 500 people are seen through the needle exchange site.

 

              Mrs. McBean-Clairborne spoke of moving forward with the Ithaca Plan and how this needs to be done carefully and ensure that there are additional items being addressed.  She said the entire Legislature is not there yet as a body and there is a need for additional conversations so the fears people have can be alleviated and that proper information is disseminated. 

 

              Mrs. McBean-Clairborne in relation to the topic being discussed stated people who are looking for Drug and Alcohol Counselors have found there are very few, if any counselors of color in Tompkins County.  She explained that scholarship opportunities for people of color have been created for those who are interested in entering the field of drug and alcohol counseling.  The Park Foundation in coordination with Tompkins Cortland Community College (TC3) have worked together for the first round of these scholarships and are accepting applications for the next round that are due December 22, 2017.  The requirements include course work to be completed towards a position in drug and alcohol counseling and following completion of the course work the individual would return to Tompkins County for employment.  The program includes tuition to TC3 and they will work to remove any and all barriers to completion of their course. 

 

              Following an inquiry made by Ms. Kelles, Ms. Celentano stated the concepts can be difficult for people to understand but once they are provided the proper data and statistics they realize the positive approach this type of program can have.

 

              In closing, Ms. Kelles stated the County is currently facing a housing crisis, facing a need to identify mechanisms to assist community members who are at risk of incarceration, reduction to recidivism, lack of childcare crisis, large divergence from wealthy to poor, and many other issues.  The County is looking at various programs to address these issues, simultaneously, in addition to discussions regarding SIFs and the importance of continued discussions. 

RESULT:              COMPLETED

* * * * * * * * *

Chair's Report

              Ms. Kelles had no further report.

Comments from Committee Members

              Mr. Burbank stated the Community Mental Health Services Board is in the process of drafting a letter that addresses their concerns regarding SIFs.  Ms. Kelles believes it is important to gain information and address the concerns from the community and the various advisory boards.

 

              Ms. Chock recommended Legislators volunteer to sit on the Greater Ithaca Activities Center (GIAC) Board as she found the work she was involved with on that Board very rewarding. 

 

              Ms. Chock thanked Ms. Kelles for bringing tough items to the Committee for consideration.  She suggested a systematic review of the programs provided by each Department be continued.  She would like the Legislature to think about the current balance being spent for human needs and the physical infrastructure. 

 

              Mrs. McBean-Clairborne re-emphasized the need for advisory committee input regarding issues such as this.

Interim County Administrator's Report

              Ms. Younger had no report

Office of Human Rights

OHR December Report (ID #7505)

RESULT:              DEFERRED              Next: 1/22/2018 4:30 PM

* * * * * * * * *

 

Department of Social Services

Resolution No. - Resolution to Urge a Repeal of Portions of 16-ADM- 11 that Requires Shelter Payments from Individuals with Modest Earned and Unearned Income (ID #7514)

              Ms. Kelles stated a similar version of this resolution will be voted on by New York State Association of Counties (NYSAC) at their next meeting in January 2018. 

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Leslyn McBean-Clairborne, Vice Chair

SECONDER:              Will Burbank, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock, Black

              WHEREAS, Tompkins County stands firmly committed to inclusive access to safe housing for all Tompkins County residents, and

 

              WHEREAS, Tompkins County has a significant shortage of housing and the market rate of housing has risen significantly in recent years, and

 

              WHEREAS, the resulting housing deficiency and rising cost of housing in Tompkins County has resulted in steadily rising numbers of working families that are unable to find, and/or afford housing, and

 

              WHEREAS, Temporary Housing Assistance is administered at the direction of the Office of Temporary and Disability Assistance (OTDA) through the Tompkins County Department of Social Services with the intent of preventing homelessness and providing assistance to homeless persons in Tompkins County, and

 

              WHEREAS, 16-ADM- 11 (Administrative Directive) provides Social Services districts with regulations that the Tompkins County Department of Social Services of Tompkins County is required to abide by, and

 

              WHEREAS, these regulations require that when a person has available income, either earned or unearned, Tompkins County Department of Social Services must incorporate this income into a standard Temporary Housing Assistance budgeting formula in accordance with a previous directive (05 ADM-3) to adjust and effectively reduce the allowable Temporary Housing Assistance for that individual, and

 

              WHEREAS, in Tompkins County this can mean that a homeless person with earned or unearned income who seeks support for Temporary Housing Assistance may have to contribute up to $70.54 per night for sheltering costs (note that these costs do not apply if the temperature is 32 degrees or below with wind chill), and

 

              WHEREAS, if a person was asked to pay the maximum sheltering contribution, it would be the equivalent cost of renting an apartment for approximately $2,100.00 per month including utilities, and

 

              WHEREAS, if a person who is homeless and seeks help through the Tompkins County Department of Social Services, and has earned or unearned income, does not make these payments the person can be asked to leave the shelter, and

 

              WHEREAS, repeal of this requirement would allow homeless Tompkins County residents to accumulate sufficient income to better prepare for obtaining and maintaining more permanent housing, now therefore be it

 

              RESOLVED, on recommendation of the Health and Human Services Committee, That the Tompkins County Legislature calls on its representatives New York State Assemblywoman Lifton, New York State Senators O’Mara, Seward, and Helming, New York State Assembly Speaker Heastie, New York State Assembly Minority Leader Kolb, New York State Senate Majority Leader Flanagan, New York State Senate Democratic Conference Leader Stewart-Cousins, and New York State Senate Independent Democratic Conference Leader Klein, to vote to repeal the required shelter payments as stated in OTDA 16-ADM- 11,

 

              RESOLVED, further, That copies of this resolution be sent to New York State Assemblywoman Lifton, New York State Senators O’Mara, Seward, and Helming, Governor Cuomo, New York State Assembly Speaker Heastie, New York State Assembly Minority Leader Kolb, New York State Senate Majority Leader Flanagan, New York State Senate Democratic Conference Leader Stewart-Cousins, and New York State Senate Independent Democratic Conference Leader Klein.

SEQR ACTION:  TYPE II-20

* * * * * * * * *

 

Youth Services

Resolution No. - Approval of Inter-Municipal Recreation Partnership Agreement (ID #7483)

              Ms. Hendrix explained this resolution will approve the Inter-municipal Recreation Partnership Agreement with the same five year sequence and the change made to the agreement will match what is done with the Recreation Partnership.  She said all municipalities have already adopted the agreement. 

 

              Ms. Chock inquired if there were any municipalities that do not participate in this inter-municipal agreement.  Ms. Hendrix stated Lansing does not participate but instead invests in their own programs.  She said Lansing residents can participate in the programs provided through the agreement for an additional fee. 

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Leslyn McBean-Clairborne, Vice Chair

SECONDER:              Shawna Black, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock, Black

WHEREAS, the County of Tompkins is currently a member of the Inter-municipal Recreation Partnership by agreement dated May 15, 2012, with an original five-year term expiring December 31, 2017, and

 

WHEREAS, the Recreation Partnership has been an excellent and cost-efficient model of inter-municipal collaboration and shared services that enables municipalities to jointly plan, finance, and share a diverse set of high-quality recreation programs, and

 

WHEREAS, the Inter-municipal Recreation Partnership agreement by its own terms may be renewed for an additional five years by appropriate resolutions by each of the municipal partners on or before December 31, 2022, and

 

WHEREAS, any municipality may withdraw from the Inter-municipal Recreation Partnership agreement upon a full calendar year’s notice, now therefore be it

 

RESOLVED, on recommendation of the Health and Human Services Committee, That the County of Tompkins agrees to extend the Inter-municipal Recreation Partnership Agreement for an additional five years, expiring December 31, 2022,

 

RESOLVED, further, That a copy of this resolution be sent to the Recreation Partnership Board care of Tompkins County Youth Services Department at 320 W. State/MLK Jr., Street, Ithaca, NY 14850.

SEQR ACTION:  TYPE II-20

* * * * * * * * *

 

Resolution No. - Budget Adjustment for Park Grant Continuation in 2018 - Youth Services (ID #7521)

              Ms. Hendrix stated this resolution was to move funds that were received from the Park Foundation for a research study regarding youth employment.  The individual conducting this study left County employment mid-year and this resolution will move those funds to 2018 to use to complete the study.  She said the Park Foundation is supportive of this change. 

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Will Burbank, Member

SECONDER:              Shawna Black, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock, Black

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

 

WHEREAS, the Tompkins County Youth Services Department received a Park Foundation Grant in the amount of $10,000, and

 

WHEREAS, the Department received the full revenue amount of $10,000 in its 2017 budget, and

 

WHEREAS, the Grant is to support the Youth Employment Research Project to look deeper into the ways youth are provided youth employment services within Tompkins County, and

 

WHEREAS, due to a position vacancy and the gap in filling said position, the Department was not able to expend the full amount of funds, and

 

WHEREAS, the Park Foundation has granted the Department permission to complete the project in early 2018, and

 

WHEREAS, the Department requests its expenditures be increased by these amounts in its 2018 budget, now therefore be it

 

RESOLVED, on recommendation of the Health and Human Service Committee, That the Director of Finance be and hereby is directed to make the following 2018 budget adjustment as follows:

 

T.C. Youth Services Department

 

Appropriation Acct Title                                                                       Amount

7020.51000049                            Project Assistant                                          $3,461                           

7020.58800                            Fringes                                                                       $1,504

7020.54442                            Prof Services Fees                                          $  430

TOTAL                                                                                                  $5,395

 

SEQR ACTION: TYPE II-20

* * * * * * * * *

 

Minutes Approval

November 20, 2017

RESULT:              ACCEPTED [UNANIMOUS]

MOVER:              Leslyn McBean-Clairborne, Vice Chair

SECONDER:              Will Burbank, Member

AYES:              Kelles, McBean-Clairborne, Burbank, Chock, Black

Appointments

Advisory Board Appointment (ID #7436 and #7509)

Office for the Aging Advisory Committee

Rebecca Sherwood - term expires December 31, 2018

Regina Gold - term expires December 31, 2020

Satomi Z. Hill - term expires December 31, 2020

                                                                                               

Personal Emergency Response Service Advisory Board - terms expire December 31, 2019

Nancy McKeon - Agency representing Disabled or Elderly representative

Beth Harrington - Agency representing Disabled or Elderly representative

 

Community Mental Health Services Board  - terms expire December 31, 2021

Khaki Wunderlich

Mary Hutchens

Kevin McKenna

Stu Bergman

Auguste Duplan

Maria Morog (term expires December 31, 2019)

 

Mental Health Subcommittee - terms expire December 31, 2021

Jean Poland - Consumer representative

Mary Hutchens - Community Mental Health Services Board representative

Tracy Decker - Community Member representative

 

Substance Abuse Subcommittee - term expires December 31, 2021

Thomas Lipa - Community Member representative

Stu Bergman - Community Mental Health Services Board Member representative

 

Development Disabilities Subcommittee - term expires December 31, 2021

Shiela McEnery - Community Mental Health Services Board representative

 

Board of Health

Christina Moylan - At-large representative; term expires December 31, 2022

 

Youth Services Board

Bernice Yarosh - At-large representative; term expires December 31, 2020

RESULT:              RECOMMENDED [UNANIMOUS]

MOVER:              Will Burbank, Member

SECONDER:              Leslyn McBean-Clairborne, Vice Chair

AYES:              Kelles, McBean-Clairborne, Burbank, Chock, Black

* * * * * * * * *

Adjournment

              Ms. Kelles thanked Ms. Chock and Mr. Burbank for the wisdom they brought to the Committee and all the work they have done on the Committee.  She wished them well in their retirement. 

 

              The meeting adjourned 6:29 p.m.

Bdgt Adj. & Transfers (Info. Only)

Information Item - Security Fobs for Mental Health (ID #7477)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - MH Budget Transfer Admin 4310 (ID #7492)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - MH Budget Adjustment PROS 4312 (ID #7494)

RESULT:              COMPLETED

* * * * * * * * *

 

 

 

 

 

Information Item - MH Budget Transfer Clinic 4311 (ID #7493)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - MH Budget Adjustment Health Homes 4330 (ID #7495)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - Tablets for MH Jail Staff (ID #7503)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - Budget Transfer 4090 Environmental Health (ID #7502)

RESULT:              COMPLETED

* * * * * * * * *

 

Information Item - OHR Budget Adjustment and Transfers (ID #7499)

RESULT:              COMPLETED

* * * * * * * * *