HUMAN SERVICES COMMITTEE

Monday, April 16, 2018 - 9:30 PM

 

 

Charles Harrington, Chairperson

Noel Merrihew, Vice-Chairperson

 

Vice-Chairman Merrihew called this Human Services Meeting to order at 9:30 am with the following Supervisors in attendance: Archie Depo, Shaun Gillilland, Ronald Jackson, Mike Marnell, Stephen McNally, Noel Merrihew, James Monty, Gerald Morrow, Ron Moore, Randy Preston, Tom Scozzafava, Michael Tyler, and Joe Pete Wilson. Robin DeLoria, Joseph Giordano, Dean Montroy and Roby Politi were previously excused. Charles Harrington arrived after the meeting was called to order.

 

Department Heads present: Linda Beers, Judith Garrison, Krissy Leerkes, Michael Mascarenas, Terri Morse and Daniel Palmer.

 

Deputies present:Jim Dougan

 

Also present: Steve Feinbloom, Rose Koop-Angelicola, Angie Allen, Sue Allott, Department of Social Services Family/Children Services employees and Margaret Bartley.

 

News Media present: Keith Lobdell - Sun News.

 

 

MERRIHEW: Good morning everyone.I will in the absence of Mr. Harrington call this Human Services committee to order.Please join me in the pledge of allegiance to the flag.Thank you again.First on the agenda is the Department of Social Services, Mike Mascarenas. Good morning.

 

MASCARENAS:Good morning.Today we have a bunch of folks in the crowd that I asked them to join us in Celebration of Child Abuse Prevention Month.Typically you show up to the county on this day, youíll see a bunch of pinwheels outside and a sign that I put up in the front here but the weather is clearly not allowed us to do that this month.

Child abuse is an act that is intended to harm the emotional or physical development of a child. It also includes the acts of negligence toward the child.It can take place at all levels of our community regardless of culture, religion, ethnicity and income. The abuse is further classified as physical, sexual, emotional and neglect.The harshness of the abuse varies from place to place and can lead sometimes to physical injuries or even death.April in National Child Abuse Prevention Month.A time to remember that we can each play a part in promoting social and emotional well-being with children in our communities.The pin wheels that you typically see represent childhoods and the bright futures all children deserve.The people in the crowd are the folks that face diversity on a daily basis to ensure that children get the best possible opportunity to receive that childhood they so deserve.They are the people that are in the trenches doing the necessary work to provide the best outcome for children and families.Today we celebrate them for their contribution to the communities across Essex County. Today really is about all of you.Iím going to shut up.Iím going to ask that we have Angie Allen, Sue Allott and Terri Morse join me if thatís okay with the Chairman to do a brief presentation.

 

MERRIHEW:Certainly, yes.

 

MORSE:Good morning. At Essex County Mental Health we have an individual who has been working with us for many years.I believe it is 23 years of service yes, 1994 and he is going to be moving on to greener pastures and taking responsibility for his own time so what I mean by that is heís not going to be moving outside of his position at Essex County Mental Health into another role as a mental health provider within another agency heís retiring for the seek of better words.Steve Feinbloom, Steve would you be willing to come up front so as I said Steve, come up here please. Heís been with us since 1994, but heís also been integral in the child servicing system as the childrenís and adult SPOA coordinator so what that means and what that stands for Single Point of Access and so what he does is he coordinates all those children who really need to be part of the bigger system that theyíre not just working with Families First or theyíre not just working with Essex County Mental Health or just DSS theyíre coming into, they have higher needs and are working with a cross section of the child serving system within Essex County. Steve has given his heart, his soul and his energies to providing services to the children of Essex County.Heís going to be greatly missed and we hope that we can fill his void and I really want to say thank you for all the efforts that you put in to helping children in Essex County so please give him a round of applause.

 

FEINBLOOM: Thank you.

 

MORSE:Youíre welcome.Do you want to say anything?You can if you like.

 

FEINBLOOM:Well, thanks.I appreciate it.Thank you Terri. Thank you everybody. Thank you to all the agencies and departments who have worked to develop this child serving system. The system is a group of elements that are working together in such a way that when one changes all may have to change.The ideal that Iíve worked on in this system is that each service belongs to every one of us and that each child and each family is the responsibility of every one of us.Iíve had the pleasure of working on this system and within the system since the year 2000 when the New York Office of Mental Health initiated Single Point of Access.I have enjoyed the opportunity to work with everybody.Iíve got everybody on speed dial and I appreciate the fact that thereís been absolutely buy in from all agencies and departments working on behalf of all the children and families.Thank you.

 

MORSE: Thank you Steve.

 

ALLOTT: Good morning.I wanted to take this opportunity from the Essex County Health Department to recognize Rose Koop-Angelicola during child abuse prevention month for her exemplary dedication for the health and well-being of Essex County children. Rose has worked for the Essex County Health Department for twenty plus years professionally handling referrals and collaborating with community agencies to access the best available resources for our residents. Rose is an integral member of the Birth to Three coalition and Safe Kids Coalition. Sheís dedicated to child safety and is a valued resource for the Essex County Children Services and Legal System.Emily Spring Essex County mother and past family health client states, ďRose Koop-Angelicola has provided services to my daughter over the years.She is compassionate, has a kind and sympathetic nature to her professionalism and all that she does.She is one of a kind and the best MOMS nurse the Essex County Health Department has.ĒCongratulations Rose.

 

KOOP-ANGELICOLA:Just very briefly Iíll say that anybody working with children and family you have to have a team and every department I work with in Essex County whether it be social services, WIC, Early Intervention, Mental Health, ACAP everybody works together to make the life better for children and families so itís all about teamwork.Thank you.

 

MERRIHEW: Thank you very much.

 

ALLEN:Good morning.Iím not a podium person so donít mind me with the microphone.Thatís how it goes with Angie but anyways thank you for this time this morning. Mike asked me to keep it to a five minute speech and Iím one that can talk for hours regarding this topic so if you ever want to hear more just give me a call but this morning I want to do something a little different I want to take on you a journey so each person has a card with a blue ribbon in front of them would you please turn that card over youíll see thereís three numbers okay while you look at your card I want you to visualize a child you may know inside your head maybe itís a granddaughter, a grandson, a niece, nephew, uncle someone being coached on their little league team, maybe itís one of your own children okay, just take a moment and think about that please.What the first number represents is the actual age of a child who we are serving in our foster care system, itís actual a child itís one of our people on our roles and we currently have 35 of them cases with siblings thatís what the first number represents.The second number is an age of a child that we currently have in our CPS investigations.We currently have 109 of those open at this very moment and that age is a number of one of those children. The third number listed is an age of a child, a child on our roles that is being served by our Preventive Unit and we currently have 48 preventive cases open.Now if you actually look at your neighbors the numbers are all different so some of you may have 3, 4 and 5 but if you look at your neighbors they are all different.The youngest is two weeks, the oldest is 17 remember that child in your head my guess right now is you have a little burning in your stomach probably a lump in your throat well, guess what gentlemen that is what my staff the staff that children services feel on a regular and consistent basis. Whatís the next call going to be?Am I going to make a difference?Can I keep this child safe?What do I say to this child as I am pulling them from their parentís arms and putting them in a car headed to a strangerís home in foster care?Every moment of every day, thatís what the children services staff go through 365 days a year, 24-7 CPS operates 24-7.Two oíclock in the morning phone calls for two week old babies.So as you think about that and the child that youíve pointed out in your mind Iíd like you to do me a favor would you please, stand and rise and join me in recognizing and applauding the services of children services. Thank you workers.

 

MASCARENAS:Really the point today was to show that no one agency can do it alone.We could do this for hours as Angie alluded to and this certainly isnít all that deals with preventing child abuse and working with families. We have so many partners throughout the county and if we could be celebrate them all that would be great but time simply doesnít allow us to do that today so please join me one more time applauding everyone in the audience who took time to come today. We really appreciate it.Keep doing what youíre doing.You do make a difference I promise you that.

And I did have my report if anybody wanted to ask any questions on it.I would just point you to the RTE which is responding to emergencies training. Summer is coming we promise at some point. You are going to want to open up your day camps.We did send this out to you and Iíve given it to you in this report that our training is going to be May 16, 17, 21 and 23 for all responding to emergency folks so if you have any questions on that please let me know call myself or Dan Sadowski.

 

MERRIHEW: Thank you Michael.Any questions or comments to Michael while he is here?

 

MONTY:Well Mike thank you for bringing your people in.Itís incredible and heart wrenching.My question goes back to your summer camps is it required that a day camp Director have a four-year degree?

 

MASCARENAS:No sir thatís one of the criteria that would be allowable the other I believe is three yearsí worth of camping experience.I do have the specifications.A few year back in 2010 working with Mr. Palmer we actually made them reflect the Department of Health specifications for a long time the two didnít jive now they do so I can get those to the whole board weíll email them out to you.

 

MONTY: Our youth commission has some different thoughts on it and making it mandatory for a four year degree and I didnít believe that was a requirement for a day camp.

 

MASCARENAS:No itís not. Itís one of those specifications thatís written and or for a degree but I believe itís three years of camping experience, donít quote me on that.

 

MONTY: Thank you.

 

MERRIHEW:Thank you Michael. Further questions for Michael?

 

SCOZZAFAVA: Mike I see in your report, very good report by the way that currently in CPS you have 98 open investigations.How long is the average investigation?I mean before you Ė

 

MASCARENAS: Well it depends really.It depends on the level that the caseworker is looking at when they enter a home.It could be very quick and it could take a very long time depending on the collateral contacts that you have to develop in to prove your case or disapprove any case so you know, minimal caseworker has to be there within 24 hours make that initial investigation.You know courts determine how long weíre in there depending if we do decide to remove a kid so right now youíre seeing 98 open investigations but within that we have 47 children in foster care so all those investigations donít turn into permanent placements or permanent children that weíre in charge of looking after but it varies and the court plays a big part of that.We have some families that we havenít removed yet and the courts have offered that we provide seven daysí worth of services in a week in order to keep that child in a home so it all depends.

 

SCOZZAFAVA: So legally can a caseworker if they go in and they see that thereís an immediate danger to this child can they remove them right there?

 

MASCARENAS:Absolutely if they feel that thereís an immediate risk of that that can happen immediately yes.

 

SCOZZAFAVA: Okay thank you.

 

MERRIHEW:Further questions for our Director?Being none, Michael thank you very much.

 

MASCARENAS:Thank you.

 

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††††††††††† The next item on the agenda was the Mental Health Department with Terri Morse reporting as follows:

 

MERRIHEW: Ms. Terri Morse one more time. Good morning.

 

MORSE:Good morning again.So Iíd like to ask you to skip to the second page of highlights before we go into resolutions and then I have some education to do on an initiative within our county that you should be aware of. So what I want to bring to your attention kind of the new news within our department is that we are making headway on obtaining psychiatry services so we will be adding and I donít have a date yet so please donít put this in the newspaper yet but I do have some headway on doing implementing tele-site with two providers so that would add two days of service provision and also a psychiatric nurse practitioner that wants to provide service in our building one day a week so thatís Iím just doing cartwheels down the hallway about that one.Not literally.

The other thing is I just wanted to acknowledge again the Department of Public Works and the work that they are doing at our agency to renovate our waiting area and one of our offices to just make it more efficient in there theyíve really just done a bang up job and of course a day like today they are probably not going to be in my building but theyíre really doing a great job.

So letís shift to resolutions the first resolution involves the appointment of Karen White as a member of the Essex County Community Services Board for a term of January 1, 2018 to December 31, 2018.

 

RESOLUTION AUTHORIZING THE APPOINTMENT OF KAREN WHITE AS A MEMBER OF THE ESSEX COUNTY COMMUNITY SERVICES BOARD (CSB) FOR A TERM EFFECTIVE JANUARY 1, 2018 TO DECEMBER 31, 2018.

Moved by Mr. Wilson, second by Mr. Harrington.

 

MERRIHEW:Comments, questions on the resolution?Being none, all those in favor, opposed Ė motion carries.

 

MORSE: The next three resolutions number two, three and four we can do as one basically it appoints three positions out of the Adirondack Medical Center to basically sign pick up orders and that is Dr. Mikhail Leykin, Dr. Ammar Kafa and Dr. Oleksadr Seleverstov.

 

MERRIHEW:You did well there.

 

RESOLUTION AUTHORIZING THE APPOINTMENTS OF MIKHAIL LEYKIN, MD, AMMAR KAFA, MD AND OLEKSADR SELEVERSTOV, MD AS DIRECTORS OF COMMUNITY SERVICESí DESIGNEE PHYSICIANS, IN ACCORDANCE WITH NEW YORK STATE MENTAL HYGIENE LAW.

Moved by Mr. Harrington, second by Mr. Monty.

 

MERRIHEW:Comments, questions on the resolution?Being none, all those in favor, opposed Ė motion carries.

 

MORSE:The next resolution is about establishing a petty cash account at Essex County Mental Health to be used as a cash drawer in the amount of $136.02.

 

MERRIHEW: Sounds like a nice round number.

 

RESOLUTION AUTHORIZING A PETTY CASH ACCOUNT IN THE AMOUNT OF $136.02, AT THE ESSEX COUNTY MENTAL HEALTH DEPARTMENT.

Moved by Mr. Wilson, second by Mr. Scozzafava.

 

PALMER: Sounds like what they have in there right now but weíll look at it.

 

MORSE: This is a formality.

 

PALMER: Yeah, before Ways and Means weíll look at it we may establish that set amount at $200.00 or something.

 

MERRIHEW: Thank you very much. Further questions or comments?Being none, all those in favor, opposed Ė motion carries.

 

MORSE:Resolution #6, I need to make an adjustment to the amount I indicated it actually is a total amount of $6,285.00, we obtained funding from DSRIP for funding three clinicians to be trained in an evidenced based treatment to reduce PTSD called EMDR, eye movement desensitization reprocessing and this is my effort to help address the opioid epidemic that we have in Essex County.Itís my belief that a lot of the opioid epidemic is; the foundation of it is in trauma so weíre going to start working very, very diligently at training our clinicians on different tools and modalities that can help this issue.

 

MERRIHEW:Prior to asking for the resolution, are we okay there or should I move an amendment?

 

PALMER: No that amount would change from the $2,985.00 to the $6,285.00.

 

MERRIHEW: With that understanding moved by Mr. Monty, second by Mr. Harrington.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE MENTAL HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $6,285.00, DSRIP FUNDS.

Moved by Mr. Monty, second by Mr. Harrington

 

MERRIHEW:Any comments, questions on the resolution?Being none, all those in favor, opposed Ė motion carries.

 

MORSE:The last resolution is remember that we went through the RFP process of the Community Services Board for substance abuse treatment.We had one responded that was St. Joeís that RFP was beyond what, they exceeded our expectations.Very professional submission so with that said we voted on the Community Services Board to award them the contract so this is now your chance to do the same.

 

RESOLUTION AUTHORIZING THE PURCHASING AGENT TO AWARD RFP TO ST. JOSEPHíS ADDICTION TREAMENT AND RECOVERY CENTERS IN THE AMOUNT OF $265,101.00, FOR SUBSTANCE ABUSE AND ADDICTIONS SERVICES IN ACCORDANCE WITH THE ESSEX COUNTY PROCUREMENT/PURCHASING POLICY.

Moved by Mr. Scozzafava, second by Mr. Harrington

 

MERRIHEW:Any comments, questions on the resolution?

 

MONTY:I just wanted to check, this was in the budget?

 

PALMER:Oh yeah, yes this is part of the budget.

 

MERRIHEW:Congratulations. Thatís a good amount of money.

 

MORSE:Thank you.

 

MERRIHEW:Being none, all those in favor, opposed Ė motion carries.

 

MORSE: Okay so the next thing I need to go over with you and this might take about five minutes is the section of my packet about the North Country Behavioral Health Care Collaborative (NC-BHCC).So before I get into this I want to thank Dan Manning and Dan Palmer because when I was in the position as Director of Mental Health after about three weeks I got thrown this little bit of a curve ball and sat down with them on several occasions and asked for their advice, brought them up to speed about what I knew about it and we worked together to figure out this process which is not done by any means and in some ways this is just the beginning.

So what I want to do is answer for you a few questions because the reason that you need to know this is eventually thereís going to come a time where the Board of Supervisors is going to have to make a decision about contracts with the Behavioral Health Care Collaborative so Iím going to be presenting you some basic information about BHCC today next Human Services committee meeting in May there will be a presentation by representatives of the North Country Behavioral Health Collaborative that will take what I share with you today to another level so Iím kind of doing the basics they will do some more information next meeting.

So what is a Behavioral Health Care Collaborative?First of all the word, behavioral health in this context basically means substance abuse providers and mental health provision so this initiative is put together by the NYS Department of Health, the Office of Mental Health, the Office of Substance Abuse Treatment and the purpose of a BHCC in general and there are 19 of these in New York State is to get us value based payments ready.Iím just curious if any of you know what value based payments is?Have you ever heard the term?Okay, Mr. Monty knows what it is so because I anticipated the fact that you may not know what that is I answered that question as the next one.So what is value based payments?Basically itís restructuring the way that providers are reimbursed. They are moving away from fee for services structure of reimbursement so fee for services is you go to the doctor, they take your blood pressure the facility gets reimbursed for that and every time you do that you get reimbursed for that and if your blood pressure is still high fifteen years from now they still get money every time you walk in and get your blood pressure taken.So what they are trying to do is really revamp the system so that it can be more about quality of services rather than quantity of services.So one of the things about value based payments is that if you ask me how is it measured, my answer to that is I donít know yet. They are still figuring that out and itís very early on in the process, itís early but itís moving fast.So what Medicaid believes is that creating a value based payments form of reimbursement it will improve outcomes and save money.In order to save money itís believed that when providers come together that costs will be lower because inefficiencies will be reduced additionally they believe that outcomes will improve because gaps will be filled so there wonít be two providers doing the same thing.

The example I wanted to share with you about how theyíre kind of looking at revamping the system as there was a provider down in New York City it was actually a hospital and what they noticed is that COPD the symptoms associated with COPD in the summer time were just increasing rapidly people were coming in the ER and they were struggling with their illness so as a creative measure what they did is the hospital actually bought air conditioners and had them installed in the peopleís homes well, a little bit of money spent saved a lot of medical dollars because the people were getting the care.†† Now granted thatís not an example that really applies to northern, you know up here in rural America, rural New York but I thought it was a good example of how the creative solutions to problems are encouraged by Medicaid.So the counties that are involved in the North Country BHCC are Essex, Clinton, Warren Washington, Franklin, St. Lawrence and Hamilton. Three of those counties have county run clinics thatís Clinton, Essex and St. Lawrence within the North Country BHCC there are 15 different providers across all of those counties and in Essex that means Essex County Mental Health, the Mental Health Association in Westport, St. Josephís Addiction Treatment Center, Families First and the Prevention Team so what that will mean well, kind of right now Iím focusing as the Director of Essex County Mental Health is that one of the things weíre focusing on is putting Mental Health treatment in hopefully all the schools in Essex.Weíre also going to be increasing Mental Health services at the Correctional Facility in Lewis and we will also be providing clinical services in a primary care physicians office which we do not do currently also we will be providing more mobile Mental health services across Essex County.

So what do you guys need to know?So itís important that you understand the direction that Medicaid is taking within the behavioral health industry and that sometime in the future as I shared, you will need to make a decision about how Essex County Mental Health in particular enters into contract with the North Country BHCC.If you want to learn more about value based payments you can spend about twenty hours and go to that website because thereís a lot of information about it.The other thing I need to make you aware of is that the North Country BHCC is asking me to sign a confidentiality agreement. Dan Manning has reviewed that confidentiality agreement he has allowed me to sign it up but he wanted me to bring it to your attention that Iím being asked to sign such an agreement and he feels that Iím still allowed to share information with you but thereís just some details that I canít share publically so at times we may have to go to executive session to talk about some of the finer details of this.Thatís it for my education piece.I hope I didnít overwhelm you.Do you have any questions?

 

MERRIHEW: Do we have any questions this morning for Terri?The one I have under reimbursement for the new program, is there an appeals process set into that or do we just take the determination from the Medicare review board and say you know youíre either delivering the value we want or youíre not.In that case do we have another option to say, no, we felt we were efficient in this manner or this manner to appeal that?

 

MORSE: Iím going to answer your question but there is something I didnít tell you about that I should so the point of these seven counties, service providers coming together is at Medicaid has a belief that if youíre big you can secure better reimbursement rates so if anybodyís been paying attention to whatís going on with UVM and the fact that they now UVM is oversees CVPH and Elizabethtown Hospital and Ticonderoga Hospital and various providers so Iím not saying that is exactly whatís going to happen to our behavioral health world but itís a really, really,good example.So the point to answer your question yes, there will be opportunities to have a conversation about that the value of the reimbursement rate but if we donít meet bench marks over time we might have to pay money back yes.

 

MERRIHEW: OKAY, thank you.

 

MONTY:My experience with this was for a big private insured to sign it verses Medicaid now probably seven years ago when New York was looking to sign a contract with new value options with Optimum they looked into the logistics of this and while it sounds all good where it works well in the more Metropolitan areas where there is a lot more providers to choose from but when you get in the rural areas it tends to be a little more difficult.Now I know weíre talking Medicaid vs. private insured.

 

MORSE:Itís all Medicaid.

 

PALMER: Itís all Medicaid.

 

MONTY:Because I would be curious as to how they are going to do it.

 

MORSE:Me too.

 

PALMER:Thereís a lot of complicating factors to it and believe me weíve all kind of you know weíve been around with this both Dan and I and Terri looking at this. There is genuinely some concern as to how we can enter into an agreement which is essentially a non-profit group but ultimately when youíre talking about itís all still Medicaid dollars but itís being leveraged now through the insurance companies and if you are a larger group so to speak you can leverage better rates through the insurance companies because you carry a larger pool so to speak in terms of your overall claims that youíre going to be putting in. So that the intent there is that youíre going to have a better reimbursement rate from the Fidelisís of the world so to speak based upon the value youíre going to have with this group of individuals that have kind of joined together how that ultimately plays out Iím not sure but the bottom line to this is like most things weíre really being asked to do more with less and this is a way to try to be more efficient to do that.I donít know what the alternative is. The problem with this is when weíve had this discussion, is if weíre not part of this group what happens to us as a stand-alone and it gets pretty scary looking at it as a stand-alone so we, I think we have to listen to what they have to say, I think we have to kind of weigh the options that are out there and ultimately we are going to ask you to make a decision based upon our recommendation obviously but I do think it has to be considered simply because standing alone is not a good option.

 

MORSE:Yeah, itís not a viable option.

 

MERRIHEW:Thank you very much Dan on that explanation.Any further questions, comments for Terri?Being none, thank you very much.

 

MORSE:More to come. Thank you.

 

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††††††††††† The next item on the agenda was the Public Health Department with Linda Beers reporting as follows:

 

BEERS:Good morning.I have several resolutions to get through today, several of them are moving money forward and some are accepting grants but I did want to start today by reminding everybody I have lunch and learn. Iíve got a panel of distinguished quests following this committee meeting, not this one but all the committeeís here at the DSS building and weíve got pizza from Ernieís and salad and youíre all invited and we Dr. Celotti coming in today and Bill Larrow from Moriah and lots of fine people that can answer any questions in reference to Tobacco 21.I just wanted to resolve any other future questions. You can ask anything you want. Itís just a learning session so we would love to have you all there.With that also being said the 20th at 1:00 here at the DSS building is the Essex County Heroin and Opioid coalition meeting youíre all welcome to attend as you always have been and weíd love to see you there. We have lots of great initiatives coming up in the future and we always value your support. Also just to piggyback on what Terri was saying Essex County Public Health Certified Home Health Agency is equally involved in value base payment.We have been for quite some time.We started sending bench marks about two years ago so what that means weíve bench marked our qualities our faults and all of those things and thatís our bench mark so as we get better, more proficient weíre showing that we could increase value.Quite honestly weíve done really well at it and when we get which I believe somewhat similar to Terri I believe that lots of people will want to contract with us because we are key to not having seniors readmitted to the hospital we are the reason right, if you can provide home care at home people are much healthier staying home with few services and getting them back on their feet so that equally will be coming and potentially Iíll get with Dan and weíll give an update on value based payment because quite honestly once you know it itís the same for all of our payers.

So that will bring me to my resolutions and the first resolution I have is a grant and I have several grants today and with that I want to just really recognize my staff who keep writing them and seeing if we can get money for this county.They are eager and all of this money has no in-kind so these are things that they are getting. This first one, number one is for the amount of $2,500 and it was from the Adirondack Foundation Acts grant and itís going to support parenting and child development so itís again $2,500, itís going to the Public Health Department to increase opportunities for child youth development.

 

MERRIHEW:Thank you.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $2,500.00, ADIRONDACK FOUNDATION GENEROUS ACTS GRANT.

Moved by Mr. Monty, seconded by Mr. Harrington.

 

MERRIHEW:Questions or discussion on that? Being none, all those in favor, opposed Ė carried.

 

BEERS:These are a little out of order. I apologize.You know that every quarter I have a professional advisory council, thereís two one is for the Public Health side of our house and one is for the Home Health Aid side of our house.The second resolution is to adopt the reviews of the policies and procedures that were done at the Public Health side, prevent side on 3/16 again they were reviewed by our board and signed off by Dr. Celotti.

 

MERRIHEW:Thank you.

 

RESOLUTION ADOPTING AND APPROVING THE QUALITY IMPROVEMENT REVIEWS AND POLICIES AND PROCEDURES FOR THE PREVENTATIVE SERVICES AND APPROVED BY THE PUBLIC HEALTH ADVISORY COUNCIL ON 3/16/18.

Moved by Mr. Harrington, seconded by Mr. Monty.

 

MERRIHEW:Questions or discussion on that?

 

MONTY: On the resolution paperwork it says 3/6 but it should say 3/16?

 

BEERS:Right it depends on when it comes to this board the meeting actually took place already.As of the date Iím never quite sure what dates goes on there if you want the date of todayís meeting on these resolutions or the date I wrote them?I write them the date after you meet here I start writing resolutions but I will write it consistently for the date of the resolution from this day forward.

 

MERRIHEW:Any other questions? Being none, all those in favor, opposed Ė carried.

 

BEERS:The next one is the exact same thing except itís the Home Health Unit; we separated them out for our accreditation.

 

RESOLUTION ADOPTING AND APPROVING THE QUALITY IMPROVEMENT REVIEWS AND POLICIES AND PROCEDURES FOR THE ESSEX COUNTY HOME HEALTH UNIT AND APPROVED BY THE PUBLIC HEALTH ADVISORY COUNCIL ON 3/16/18.

Moved by Mr. Harrington, seconded by Mr. Monty.

 

BEERS:The next one is a grant with CCHL itís Cultural Competency and Health Literacy.We looked at an opportunity to gain money for this totaling up to $5,000 and it was just plain gaging our staff and things they should be doing which looking to be culturally competent and putting health literacy in all of our policies and procedures. We signed up to do that and we do a review of it and for our engagement they have awarded us $1,250.00.

 

MERRIHEW:Congratulations.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $1,250.00, DSRIP-AHI TO INCREASE CULTURAL COMPETENCY AND HEALTH LITERACY (CCHL).

Moved by Mr. Harrington, second by Mr. Wilson.

 

MERRIHEW:Questions or discussion on that? Being none, all those in favor, opposed Ė and that motion carries also.

 

BEERS:Thank you.Number five is hats off to Kristy Berger in the WIC department who equally wrote a grant to the Adirondack Foundation and they were awarded for $2,500.00.If you ever been in our WIC department you will see some old donated and some pretty old toys and things for the children to play on.This money is going to be used to purchase all brand new equipment in the waiting area for the WIC department here at the health department it will be age appropriate and educational in value.

 

MERRIHEW: Good stuff.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $2,500.00, GENEROUS ACTS GRANT TO IMPROVE WIC PLAY, LEARN, FUN AREA.

Moved by Mr. Harrington, seconded by Mr. Wilson.

 

MERRIHEW:Questions or discussion on that?

 

HARRINGTON:I have a question on the toys.How do you keep them sanitary?

 

BEERS:We have a policy. They are to be washed down every night with washcloths and bleach or I should say bleach mixture.Thatís a great question.I appreciate that question.

 

MERRIHEW:All those in favor, opposed Ė resolution carries.

 

BEERS:The next one is to accept the following payment for completing the PPS which is the DSRIP workforce assessment.Again this really goes with the value based payment. Weíve been doing these assessments and more and more of them with DSRIP and PPS to set bench marks for the CHHA the Certified Home Health Agency so when value based payment comes in I think weíre going to be poised to do it.If we werenít in this game a long time ago we would be struggling to catch up now but we really, weíre at the cusp of it and I think weíre well seated to do that because of doing that, theyíve awarded us $2,500 to do an assessment for them that talks about the workforce that we have in Essex County.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $2,500.00, DSRIP-AHI FOR COMPLETING THE PPS WORKFORCE ASSESSMENT.

Moved by Mr. Wilson, seconded by Mr. Harrington.

 

MERRIHEW: Discussion on the resolution? Being none, all those in favor, opposed Ė resolution carries.Congratulations your department has been really busy with brining in those grant funds.

 

BEERS:The rest are moving money forward so tell me I have money to move forward meaning it wasnít spent in 2017, itís moving forward to 2018 and these grants donít follow a calendar year so I have to move it forward this way so Iíll read them one by one the account number is 4189. Iím moving DSRIP funds that weíve totaled up to $111,812.96. Itís resolution number seven and I need to move that money into 2018.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $111,812.96, UNEXPENDED 2017 DSRIP FUNDS.

Moved by Mr. Harrington, seconded by Mr. Scozzafava.

 

MERRIHEW:Questions or comments?

 

MONTY:So thatís what you had is $111,812.96, that youíre moving forward?

 

BEERS:Yes.

 

MONTY:Is there a timeframe Linda that you have to spend the money by?

 

BEERS: 2020.

 

MONTY: Oh, wow thatís good.

 

BEERS: It is and thatís really engagement funds.Itís fabulous.Itís been very valuable for our county.

 

MERRIHEW: Thank you.Further questions, comments?Being none, all those in favor, opposed Ė motion carries.

BEERS:So I referred to the Essex County Heroin and Opioid grant which is also called bridging the gap we had money left in, actually we are moving forward the amount of $15,262.18.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $15,262.18, UNEXPENDED 2017 ESSEX COUNTY HEROIN AND OPIOID GRANT (ECHO).

Moved by Mr. Scozzafava, seconded by Mr. Harrington.

 

MERRIHEW:Questions or comments? Being none, all those in favor, opposed Ė motion carries.

 

BEERS:MRC is the next one which stands for Medical Reserve Corp.We were given money by the State of New York to keep the medical reserve corp. in events of emergency. We had $3,583.99 in í17 we need to move forward into í18.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $3,583.99, UNEXPENDED 2017 MEDICAL RESERVE CORP.

Moved by Mr. McNally, seconded by Mr. Wilson.

 

MERRIHEW:Questions or comments? Being none, all those in favor, opposed Ė motion carries.

 

BEERS:The next one is the nature of request is to move unexpended funds from 2017 budget forward for the Adirondack Rural Health Network grant and is in the amount of $1,104.88.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $1,104.88, UNEXPENDED 2017 ADIRONDACK RURAL HEALTH NETWORK (DPP) GRANT.

Moved by Mr. Scozzafava, seconded by Mr. Monty.

 

MERRIHEW:Questions or comments? Being none, all those in favor, opposed Ė motion carries.

 

BEERS: The next one is Adirondack Rural Health and Chronic Disease grant thatís $1,987.66

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $1,987.66, UNEXPENDED 2017 ADIRONDACK RURAL HEALTH NETWORK CHRONIC DISEASE GRANT.

Moved by Mr. Scozzafava, seconded by Mr. Wilson.

 

MERRIHEW:Questions or comments? Being none, all those in favor, opposed Ė motion carries.

 

BEERS: Thank you.The next one is unexpended funds NACCHO Accreditation grant.We have $716.00 left and weíre moving it forward.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $716.00, UNEXPENDED 2017 NACCHO ACCREDITATION GRANT.

Moved by Mr. Monty, seconded by Mr. Wilson.

 

MERRIHEW:Questions or comments?

 

SCOZZAFAVA:Dan are these reimbursable dollars?In other words, we spend and then we get it? Is that how it works?

 

BEERS: No this money we already have in our coffers.

 

SCOZZAFAVA:This is money already sitting in the accounts?

 

PALMER:It goes into the accounts.These go in ahead.

 

BEERS:Right so honestly this is another testament youíll hear grant, after grant, after grant this is not money that we had gotten from our budgets or our block grant this is money that weíve got Ė

 

SCOZZAFAVA: That weíve received, we just need to spend it down.

 

BEERS:Thatís exactly what it is.

 

PALMER:And because of the different fiscal years you get this roll over.

 

SCOZZAFAVA: Thank you.

 

BEERS: Youíre welcome.

 

MERRIHEW: Further questions? Being none, all those in favor, opposed Ė carries.

 

BEERS:To move unexpended funds from AHI Ė Adirondack Health Institute $14,420.80.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $14,420.80, UNEXPENDED 2017 ADIRONDACK HEALTH INSTITUTE GRANT.

Moved by Mr. Monty, seconded by Mr. Wilson.

 

MERRIHEW:Discussion?Being none, all those in favor, opposed Ė motion carries.

 

BEERS:That brings it to an end our projects for all of these we have new fiscal people down there and weíll probably get it better next year to move that money in a block some but we are, those again are all grants and the money is in our budgets and we had to close out one year to figure out how much exactly we had moving forward so I thank you for your patience.I hope to see you all at lunchtime.

 

MERRIHEW:Further questions, comments for the Director while she is here?Being none, we will see you later this afternoon thank you very much.

 

************************

††††††††††† The next item on the agenda was the Office for the Aging with Krissy Leerkes reporting as follows:

 

LEERKES:Good morning.Everybody does have my report but I did just want to point out that we will be collaborating again with Champlain Valley Senior Community during the month of May.On May 16 weíll hold the third annual senior celebration.Itís really where we gather all of the Human Services agencies to come to one place the older adults and their caregivers can come in, learn more about the services and Champlain Valley Senior Community provides us with lunch and the site for free so that will good. The report gives a lot of information but weíre actually going to move it from 10:00 to 2:00 so everybody will get an invitation so feel free to stop by.

We also, last month we had mentioned that we were going to enter into a contract with Dennin and Dennin out of Lake Placid for our legal services so that contract is actually in the mail to them as we speak so fairly soon we will be able to make those referrals so weíre excited about that.

We just recently completed our transition of our life line provider from a previous provider to a new one due to going out to RFP so that has gone off without a hitch. Weíre now able to actually serve over double the amount of individuals we were able to last year so youíll see in our numbers youíll see an increase of served clients and also in May is Older Americanís Month so youíll see a lot of different events going on next month.Every year the Office for the Aging is able to nominate two volunteers that go above and beyond and youíll see they are State recognized and this year we have nominated Joan Decesare who is from Keene. She is a previous Title 5 worker who aged out of that program and now continues to come to our office and volunteer and do a lot of clerical work for us and then also Steven Thompson out of Ticonderoga who is one of our volunteer drivers who is one the road every day, sometimes Monday through Saturday bringing folks back and forth to dialysis, to appointments who otherwise would not have any transportation so weíll get you more information in regards to those individuals next month.

I do have a couple of budget amendments. The first one is again to accept $2500 from DSRIP funding again this is for the same reason Linda had mentioned. We completed the organizational profile survey for AHI in doing so they provided us with $2500.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $2,500.00, DSRIP-AHI.

Moved by Mr. Monty, seconded by Mr. Wilson.

 

MERRIHEW:Questions or comments on the transfer? Being none, all those in favor, opposed Ė motion carries.

 

LEERKES: And the next one is to accept $10,000.00 from DSRIP funding from AHI and this is pay for performance funds for DSRIP year two.

 

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $10,000.00, DSRIP-AHI.

Moved by Mr. Wilson, seconded by Mr. Monty.

 

MERRIHEW:Discussion?Being none, all those in favor, opposed Ė motion carries.

 

LEERKES:And the last two youíll actually see on your desks.Judy put them on there either Thursday or Friday.We are working with the two managed long term care plans for Essex County Fidelis Care at Home and Nascentia they were formally known as Home Care Options.Under those provider plans we have the insurance coverage home delivered meals is a reimbursable service so we with your permission we would like to enter into an agreement with both Nascentia and Fidelis Care for reimbursement of home delivered meals for individuals that are currently receiving services under those plans that is not going to, basically these individuals we are already serving but going into contract it will allow us to bill these two plans for those meals.

 

MERRIHEW:Great program.

 

RESOLUTION AUTHORIZING A CONTRACT WITH THE OFFICE FOR THE AGING AND NASCENTIA HEALTH FOR THE REIMBURSEMENT OF HOME DELIVERED MEALS.

Moved by Mr. Harrington, seconded by Mr. Scozzafava.

 

MERRIHEW:Comments or questions?Being none, all those in favor, opposed Ė motion carries.

 

RESOLUTION AUTHORIZING A CONTRACT WITH THE OFFICE FOR THE AGING AND FIDELIS CARE AT HOMEFOR THE REIMBURSEMENT OF HOME DELIVERED MEALS.

Moved by Mr. Harrington, seconded by Mr. Scozzafava.

 

MERRIHEW:Comments or questions?Being none, all those in favor, opposed Ė motion carries.Thank you it sounds like a great program right there.

 

LEERKES:It will bring more money into the county.

 

MERRIHEW: Great job.Further questions or comments for the Director while sheís here?Being none, thank you very much.

 

LEEKES:Thank you.

 

MERRIHEW:Further business to come before the Human Services committee?

 

MONTY: I just had a question Dan on the Transportation are we anywhere as far as?

 

PALMER: Jim and I in DPW are working together to put a plan together for the board to consider and hopefully weíll have it by at least by ways and means Iím thinking maybe.Iím not sure about DPW but certainly weíll be ready by ways and means.

 

MONTY:Thank you and the other question is here a year or so ago we were in conversation about the Medicaid taxi stuff that was going on.Where are we with that?

 

PALMER:Well, we have picked up a lot of that Medicaid taxi rides out of the transportation department. We actually purchased one vehicle and we are purchasing a second one so I donít know the exact numbers I think I would have to sit down with Mike and kind of go over what we did but we are increasing ridership based upon that through the transportation department.

 

MONTY:Good. Thank you.

 

MERRIHEW:Thank you. Any further business to come before the committee?Being none, we stand adjourned.

 

††††††††††† As there was no further business to come before this Human Services Committee it was adjourned at 10:25 am.

 

Respectfully submitted,

 

 

 

Judy Garrison, Clerk

Board of Supervisors