HUMAN SERVICES COMMITTEE MINUTES WEDNESDAY, MARCH 20, 2013 3:30 P.M. PRESENT: ALSO PRESENT: Katie Bonelli, Chairwoman Mike Anagnostakis, Patrick J. Berardinelli, Sr., Roxanne Donnery, Myrna K. Kemnitz, Roseanne Sullivan, Matthew A. Turnbull Michael R. Pillmeier, Chairman Michael Amo, Independence Party Leader Antoinette Reed, Legislative Counsel David Jolly, Commissioner of Social Services Anthony Zippo, Director, Veterans’ Service Agency Colleen Grogan, Budget Analyst Ms. Bonelli opened the committee meeting at 3:34 p.m. and asked everyone to stand for the Pledge of Allegiance. All committee members were present. Mr. Berardinelli moved to create a new Part-time Courier, Grade 5 position for the Orange County Veterans' Service Agency, seconded by Ms. Donnery. Mr. Zippo addressed the committee stating the new part-time courier position was due to higher volume in van services to local hospitals and deliveries for the food pantry and while drivers are only supposed to work 980 hours, they have been working closer to 1100 hours to get the work done. Mr. Turnbull thanked Mr. Zippo for being there for their veterans and this was the least they could do to assist them. Mr. Berardinelli asked if all drivers were equipped to drive both the vans and bus. Mr. Zippo replied that they are. Ms. Kemnitz asked if Mr. Zippo would be looking in the civil service pool or if it would be a veteran. Mr. Zippo replied that it was not a civil service position and he would more than likely hire a veteran for the position. Motion carried. All in favor. Mr. Berardinelli moved to request appropriation from contingency of county taxation for entry level 19-hour per week Courier, $12,810.00, seconded by Ms. Donnery. HUMAN SERVICES COMMITTEE, WEDNESDAY, MARCH 20, 2013 2 Motion carried. All in favor. Ms. Bonelli addressed the committee and explained that Ms. Maglione, Director for Office for the Aging would be unable to attend the meeting due to a sudden death in her family. The next item on the agenda was the monthly report from the Department of Social Services. Ms. Bonelli asked if anyone had any questions as they had already received a copy of the report. Mr. Turnbull commented that the trend continues to go downward. Mr. Jolly explained that the trend in medicaid has stayed the same, but they are anticipating that temporary assistance will drop. Mr. Turnbull commented that based on the report, can they assume there was very little attempt to defraud the system. Mr. Jolly replied that fraud would be handled by what they call FED (front end detection) and anyone who completes an application for a benefit has a FED done on them because they do try to catch fraud before it occurs and entails having an investigator go out to make sure the person actually exists and living at the address they listed. He added that they conduct between 40 and 60 FED’s per month with the majority of their fraud cases being in welfare assistance relating to cash assistance and not generally a food stamp or medicaid benefit. Ms. Kemnitz asked if the numbers in child support had gone down because people were out of work. Mr. Jolly replied that there are several factors that affect child support, one being the number of weeks and paychecks issued in the month with another being that twice a year they do tax intercepts with March or April and September being higher months as they are intercepting tax refunds and for this particular month child support was not in fact down but because there were less payroll reporting periods it showed a drop in child support. He added that they are doing a very good job in regard to child support which was due primarily to the UTX system which tracks a social security number and the minute it has any income attached to it, they attach a child support order to it. The Department of Social Services and the Sheriff’s Department are working on what they call “The Deadbeat Dad Project” which looks into serving warrants on those individuals that live out of state, but the jurisdiction in every state is different with some states being more lenient than others. There are roughly 33,000 cases and while 98% of people pay their child support it’s the other 2% they spend their time trying to collect from. Mr. Berardinelli asked if there are any stipulations for those individuals that become ill or hospitalized while paying child support. Mr. Jolly replied, yes, they can do a modification order with a magistrate but it must be done in a timely manner because if they do not their arrears would continue to grow. HUMAN SERVICES COMMITTEE, WEDNESDAY, MARCH 20, 2013 3 Mr. Amo asked Mr. Jolly to explain “spousal refusal.” Mr. Jolly explained that “spousal refusal” allows a married couple with one person entering a skilled nursing facility or getting long term care to refuse financial assistance to that person therefore, exempting their income from the spouse still in the community. Every year in the New York State budget there’s been the provision to remove “spousal refusal” from the medicaid rolls eliminating the spouse’s ability to refuse but every year the Assembly pulls it out. However, this year was different because CMS the federal agency that oversees medicaid has asked New York State “who has given you the authority to do this, when no other state does” and because of this the New York State Department of Health has told the Legislature that they do not think they have the authority in state or federal regulations to allow the spouse to refuse. Therefore, in the New York State budget this year was the elimination of “spousal refusal” which amounts to approximately $38 million. Mr. Amo asked what Orange County’s percentage was toward medicaid payments. Mr. Jolly replied that it was approximately 16.1%. Ms. Sullivan asked how they handle the scheduling of staff during HEAP. Mr. Jolly replied that they still have the same number of HEAP staff, although they did add four temps this year. Ms. Sullivan asked if individuals were getting their services before they’re cut off. Mr. Jolly responded that they have done better in past years, primarily because the HEAP benefit was much stronger than it is now. Ms. Donnery asked Mr. Jolly if New York has been compared to other states in regard to medicaid. Mr. Jolly replied that no other state compares to the New York State medicaid program and if they were to look at the average cost per user they would see that New York is triple what other states are in total dollars spent per recipient. He added that two years ago the federal government looked at the spending in OPWDD and in the federal report it states that here in New York State they attach medicaid revenue to every service possible and are spending more per recipient for a developmental disability than any other state. The federal government this year disallowed roughly $1 billion in medicaid revenue resulting in New York State having to cut $500 million from the medicaid program. Mr. Jolly stated that he would email the Federal Report to all committee members. The last item on the agenda was a discussion on the Affordable Care Act. Mr. Jolly explained that within the ACA the major provision was that everyone would be required to have health insurance on January 1, 2014 with a walkup period between 2014 and 2018. The Supreme Court decision stated that individuals are not mandated to have health insurance but if they don’t they would be required to pay a larger income tax. There’s also a great deal of money tied into provisions with federal funds being invested in preventive measures. He added that ACO’s HUMAN SERVICES COMMITTEE, WEDNESDAY, MARCH 20, 2013 4 such as Crystal Run Health Care are designed to have multiple providers join together to ensure that the health care needs of individuals are coordinated because currently if someone were to have something done with a doctor at one office and something done with a doctor at another office neither doctor knows what has been done but with the ACO they pull that care under one roof. In addition, beginning next year the penalties per individual without health insurance would be $685.00 this means that when they do their taxes at the end of 2014 their taxes will have gone up by $685.00 unless they qualify for an exemption. Individual exemptions cannot be larger than 2.5% of their gross income or falls between $9350.00 and $18,700.00 but would scale up every year going forward. Mr. Jolly went on to explain the employer requirements for health insurance with 98% of employers having more than 100 employees generally providing health insurance, while 90% with 50 to 100 employees and those with less than 50 employees would have the ability to buy health insurance from New York State. Businesses with 51 or more full-time employees would be fined $2,000.00 per employee excluding the first 30 employees if they do not offer insurance with the fines continuing to go up every year. While small businesses with fewer than 25 employees would be eligible for a tax credit if they have to purchase health insurance. Mr. Amo asked about provider impact. Mr. Jolly replied that some specialty doctors have exempted themselves from taking insurance so they can only charge patients that can afford it. Mr. Anagnostakis commented that eventually they would be paying the tax on both their gross income and their health insurance. 4:35 p.m. On motion of Ms. Kemnitz, seconded by Mr. Berardinelli, the meeting adjourned at