HEALTH, EDUCATION & AGRICULTURE COMMITTEE PURITZ-HAYES, HENDERSON, TRIPP, LAGUNA August 15, 2005 Representative Laguna moved for an executive session to discuss a personnel matter. Seconded, Tripp. Total: 4; Ayes: 4. Motion carried. The committee reconvened. DEPARTMENT OF HEALTH – DIANE CUSWORTH, JIM TALLMAN Jim Tallman requested approval to purchase a CAD Router for the 911 system at a cost of $11,000. The funds are in the DOH budget. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Diane Cusworth requested approval to contract with the state for the Bio-Terrorism grant in the amount of $85,000 for the period September 1, 2005 through August 31, 2006. Representative Laguna moved for approval. Seconded, Tripp. Total: 4; Ayes: 4. Motion carried. Mrs. Cusworth requested approval to purchase an audio visual cart with 100% Bioterrorism grant funds from Hummel’s at a cost of $442. Representative Henderson moved for approval. Seconded, Tripp. Total: 4; Ayes: 4. Motion carried. Mrs. Cusworth requested approval for one person to attend a Childhood Lead Poisoning Prevention Conference at SUNY Purchase on October 7, 2005. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Mrs. Cusworth requested approval for the following transfers: Transfer $325 from Lead M&S to Lead Lodging and transfer $1,000 from HHA Mileage to DOH Postage. Representative Laguna moved for approval. Seconded, Tripp. Total: 4; Ayes: 4. Motion carried. The monthly budget reports were reviewed. Mrs. Cusworth said that she contacted Oneida County about its new drug prescription program, which was implemented on July 1, 2005. Out of a county population of 233,000, approximately 700 people have signed up for the program. This program is overseen by the Office for the Aging. There is no cost to the county or residents. The committee asked Mrs. Cusworth to ask a representative of Med Impact, the company that operates the program, to make a presentation at October’s committee meeting. Mrs. Cusworth reported that the agency is doing a lot more rabies testing of animals and post exposure treatments this year. The county is responsible for the cost of the treatments, if the person does not have insurance. The cost is about $3,000, and there have been several cases of uninsured people needing treatment. She said that the state only reimburses a set annual amount for the program. Any costs over that amount are the county’s responsibility. Mrs. Cusworth said that her 2006 budget request will include a county cost to cover higher operating costs and an increase for reimbursements to the veterinarians for handling the animals. DIVISION OF CHILDREN WITH SPECIAL NEEDS – DIANE CUSWORTH Mrs. Cusworth requested approval to contract with the state for the Children with Special Health Care Needs grant ($18,700) and the Early Intervention Administration grant ($40,835) for the period October 1, 2005 through September 30, 2006. Representative Henderson moved for approval. Seconded, Tripp. Total: 4; Ayes: 4. Motion carried. PUBLIC HEALTH NURSING – DIANE CUSWORTH Diane Cusworth requested approval to fill a vacant, funded part-time PHN position and a full-time RN position. Representative Laguna moved for approval. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. Mrs. Cusworth requested approval of updates for the following policies: Bad Debt Health, Education & Agriculture Committee August 15, 2005 Page 2 Policy, Billing Policy, Complete Medical Record Policy, Confidentiality of Individually Identifiable Health Information Policy, Credit/Refund Policy, New Referral Intake Policy, Policy/Procedure Development and Approval Policy, Reporting of OASIS Information and Comprehensive Assessment of Patient Policy, and Revenue Receipts Policy. Representative Laguna moved for approval. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. Mrs. Cusworth said that the patient census is 14 in the Long Term Home Health Care Program, 9 in the CHHA and 6 babies. The referrals for the maternal child health care program are increasing. She said that she has had several meetings with At Home Care about setting up a partnership for wellness programs and that the timeline for moving the Long Term Home Health Care Program over to Otsego Manor is mid-November. Tom Dennison will be at the September 7, 2005 County Board meeting to make a presentation on the restructuring plan. Representative Laguna moved to prepare a resolution to decertify the CHHA and to transfer the Long Term Home Health Care Program to Otsego Manor. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. MENTAL HEALTH – PATRICK DONAHUE The units of service and revenues were reviewed. Patrick Donahue said that these numbers come straight off of the computer. A unit of service is a face to face visit with a client that generates a bill. It can be clinic visits, medical visits, group visits and intakes. The revenues vary from month to month, depending on when checks are received. The average reimbursement rate for a visit to the Mental Health Clinic is $67. Mr. Donahue said that the number of units is up because there are a lot of people in the community that need mental health services. He believes that this demand will continue to grow. In 2003, clinical staff provided 16 units of service per week. Presently, clinical staff is expected to provide 22 units of service, which is comparable to other providers in the area and clinics in surrounding counties. If the clinicians decrease their units of service, a waiting list would again have to be implemented, and there would be a delay in providing much needed service. Mr. Donahue requested approval to transfer $1,426 from Other to Heat & Lights for the final bill at The Commons. Representative Laguna moved for approval. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. Mr. Donahue said that there is new PINS funding ($81,000) to replace TANF funding. The funds will be used for DSS to contract with the clinic for 1.5 Social Worker positions. He requested approval to create a part-time Social Worker position for the remainder of 2005. His 2006 budget request will ask to change this position to full-time for 2006. Representative Laguna moved for approval. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. Mr. Donahue reported that Dr. Janice Stalter is a part-time Physician for both the Mental Health and Chemical Dependencies Clinics. Her salary has not kept pace with the contracted physicians in the clinics. Because of this, she is requesting to convert from county employee status to contract status in 2006. This will be included in next year’s budget request. The committee and Mr. Donahue discussed concerns the committee had with the operation of the Mental Health Clinics. They involved the absence of an administrative person on site during clinic hours and the lack of a receptionist in the waiting room. Mr. Donahue said that he and his administrative staff will rework their schedules so that someone is always available during clinic hours. However, this could mean that certain meetings will not be attended. Mr. Donahue also said that the receptionist was moved at her request for safety and HIPAA reasons. There have not been any problems between the clients. Children and adults are kept in separate waiting rooms. CHEMICAL DEPENDENCIES CLINIC – PATRICK DONAHUE The units of service and revenues were reviewed. Patrick Donahue said that the Health, Education & Agriculture Committee August 15, 2005 Page 3 average reimbursement rate for a visit to the Chemical Dependencies Clinic is $29. He is concerned that the courts are referring an increasing number of people to the clinic that are unable to pay for the service. Mr. Donahue reported that the latest OASES visit showed that the clinic was in full compliance with regulations and charting. OFFICE OF EMPOLYMENT & TRAINING – PENNY SEEGER The monthly participant numbers were reviewed. Penny Seeger reported that Richard Decker, Chairman of the Chenango County Board of Supervisors, has issued a waiver that allows Otsego County to provide services to out-of-school youth. She requested approval for a resolution authorizing the Carl Higgins to sign the contract for $44,800. Representative Laguna moved to approve, contingent upon the County Attorney’s approval of the contract wording. Seconded, Henderson. Total: 4; Ayes: 4. Motion carried. Ms. Seeger said that the CDO WIB will be receiving incentive funds for exemplary performance over the past four years. It could be a significant amount. The award is due to the maintenance and improvement of enrollment levels with fewer staff. STATE LEGISLATION – JAMES POWERS Representative James Powers requested approval for a resolution asking the state to keep the existing Otsego County shotgun territory as is and not change it to rifle territory for deer hunting as proposed. Presently, the land south of the D&H Railroad tracks is the only area in the county that allows rifle hunting. Many local residents and hunters are opposed to the change. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. OFFICE FOR THE AGING – FRANCES WRIGHT The monthly budget report was reviewed. Frances Wright requested approval to create a Coordinator of Services for the Aging position to implement the Long Term Care Insurance Education and Outreach Program, assist with EISEP and supervise the case managers. The position would be 100% state funded through March 31, 2006 and then 87.5% state funded starting April 1, 2006. Representative Puritz-Hayes moved for approval. Since there was no second, the motion failed. Mrs. Wright requested approval to purchase a portable sound system and two open storage units for paper items with grant funds. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Mrs. Wright requested approval to purchase promotional items and refreshments for the Medicare Drug Program activities at a cost not to exceed $5,000. These purchases are 100% reimbursable. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Mrs. Wright requested approval for budget amendments to increase the revenues and appropriations for additional state and federal funding. Representative Henderson moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Mrs. Wright requested approval for three persons to attend the Adult Abuse Conference in Saratoga Springs on October 6 – 7, 2005 and for one person to attend the Enhancing Life Long Health and Fitness Conference in Albany on September 22 – 24, 2005. Representative Tripp moved for approval. Seconded, Laguna. Total: 4; Ayes: 4. Motion carried. Mrs. Wright reported that that the NYSDOH and NYSOFA are trying to establish a plan for a statewide Point of Entry system. The State Office for the Aging will be the lead agency. The local Office for the Aging offices will have the option of establishing a local system, which will be a part of the statewide system. Mrs. Wright would like to see Otsego Health, Education & Agriculture Committee August 15, 2005 Page 4 County establish a local system through the Placement Coordinator’s Office and the Office for the Aging since some of the pieces are already in place. There may be some state funding available for operating a local system. Mrs. Wright gave an update of the EISEP, Homemaker, Caregiver and HEAP programs. Mrs. Wright said that the date for the annual public hearing has been changed to October 21, 2005. COOPERATIVE EXTENSION – JAN COHEN Jan Cohen handed out Cooperative Extension’s 2004 Annual Report and a brochure on their community education programs. She said that they are busy all over the county and are looking at joining other counties in a regional grant to provide financial education programs. Mrs. Cohen stated that some of their grants are ending, and there will be a reduction in some state aid next year. She thanked the committee for its past financial support and said that the 2006 budget request for operating funds will not have an increase. However, there are significant building issues that need to be addressed, such as replacement of a 50 year old furnace, the need for insulation, siding and a handicapped ramp and drainage issues. Cooperative Extension will be applying to the Clark Foundation for financial assistance, but will also be asking the county for separate funding for capital projects. There being no further business to discuss, the committee adjourned until Thursday, September 22, 2005 at 10:00 am.