HUMAN SERVICE COMMITTEE

Monday, March 13, 2023 - 10:30 AM

JoePete Wilson, Chairperson

Charles Harrington, Vice-Chairperson

Chairman Wilson called this Human Service Meeting to order at 10:30 am with the following Supervisors in attendance: Clayton Barber, Robin DeLoria, Stephanie DeZalia, Derek Doty, Charlie Harrington, Kenneth Hughes, Steve McNally, Noel Merrihew, Tom Scozzafava, Matt Stanley, Joe Pete Wilson, Davina Winemiller, Margaret Wood and Mark Wright. Shaun Gillilland, Roy Holzer, Jim Monty and Ike Tyler were excused.

Department Heads present: Angie Allen, James Dougan, Judy Garrison, Krissy Leerkes, Michael Mascarenas and Terri Morse.

Deputies present: Jessica Darney-Buehler, Nick Sitts and Michael LaVallie

News media: Alana Penny – Sun News

WILSON: I will call the Human Services meeting to order please. We’re going to have a little change in the agenda, Terri Morse is going to go first from Mental Health so that she can get back to her previously scheduled engagement.

MORSE: Good morning. So I included in my report a Did you Know, about how Governor Hochul’s state of the state address and some of her initiatives are going to effect the mental health and behavioral health care in our region. At least these are the proposals so you certainly expanding the ability for insurance companies to cover both mental health and physical health which is supposed to have been going on all along but it seems like some insurance companies haven’t gotten there yet.

I’m excited about the third bullet down, increasing the capacity for inpatient psychiatric treatment in New York State by 1,000. I can tell you that I think Sheriff Dave Reynolds would agree with this that there is an increase in individuals with significant mental health issue that are crossing our worlds right now and my example is one of the things as the Director of Human Services I am responsible for is capacity evaluations so if somebody goes to court and a local magistrate or the court system feels that the individual is not competent to stand trial or participate in their own defense they refer them to me, I have to hire two psychologists or psychiatrists to do that evaluation. In my tenure as the Director of Community Services since 2017, the most I have ever had to do in one year, is nine of those already this year, I have nine. So, just so you know when somebody is deemed not capable of participating they are sent to a facility to gain competency at $1100 a day to tax payers so it is our goal to increase our mental health services in Essex County so that we can avoid those kinds of situations. That wasn’t good news. I’m so sorry. So we’re looking forward to the initiatives that she is proposing and hoping that they go through. I stay on top of these things with the conference of Local Mental Hygiene Directors and I’m very involved in that organization.

I have some good news about staffing. We have really only one outstanding position, sorry, two outstanding positions right now one is a receptionist and then, as a peer specialist so that’s good news.

There’s lots of BRIEF updates which I invite you to look at. One last thing, assuming that the weather does not interfere with this opportunity but this afternoon at 6 o’clock and tomorrow morning at 8:30, the Commissioner of Mental Health will be up in Plattsburgh at a community engagement feedback session so if any of you want to provide feedback to the Commissioner about what you experienced in our region it is supposed to be in person but last I heard was that she may be giving a presentation virtually. I am going to be up there tomorrow morning if they don’t cancel it so you’re all invited to that.

I’m going to move to resolutions. So there are two, one of them is to increase an already existing contract we had with a company called Psychiatric Faculty Prescribers out of SUNY upstate in Syracuse and right now we received four hours per week from them but we’re going to be increasing, I’d like to increase their number of hours to eight because right now we’re getting consultative services from SUNY Upstate for our psychiatric program but we’re noticing that by not having a psychiatrist doing some prescribing in our organization that just relying on psychiatric nurse practitioners which are Master Degree people, we have as I just said, we have more individuals in our community that have significant mental health issues and we need more help. So, I’d like to increase that contract to eight hours a week and that’s at $225.00 an hour. It is currently in our budget. We do have already budgeted for it but I need to increase the contract amount.

RESOLUTION AUTHORIZING THE COUNTY CHAIRMAN OR COUNTY MANAGER TO EXECUTE A CONTRACT AMENDMENT WITH PSYCHIATRIC FACULITY PRESCRIBERS INCREASING FROM FOUR (4) TO EIGHT (8) HOURS A WEEK AT $225.00 PER HOUR WITH FUNDS TO COME FROM BUDGETED FUNDS. Scozzafava, Stanley

WILSON: Any questions?

DOTY: Terri, I don’t understand the difference between this extended contract and needing more services at the facility for these folks that are incapable of representing themselves. So, are they services like the Colby unit in Saranac Lake or CVPH and so, what is the relationship between this contract and those nine plus?

MORSE: Yup, the 730’s. There really isn’t any. Those two things are distinct. My linking them together was just saying that what I’m noticing is more individuals in our community with significant mental health issues very complex cases and the complexity of the cases cannot always be facilitated by somebody with a Master’s Degree as a nurse practitioner it requires a higher level of experience and expertise in the form of a psychiatrist so what I am looking to do is increase our psychiatrist services so that we can help some of the complex cases that we have currently enrolled in Essex County Mental Health.

DOTY: Thank you.

MORSE: You’re welcome. Good question.

STANLEY: And there is a need for these extra four hours, correct?

MORSE: Oh, yes.

STANLEY: It looks like we actually make more revenue to cover that cost per hour?

MORSE: Yes. There are no shows but if everything goes well it is definitely –

STANLEY: We are not losing money by adding more hours?

MORSE: Correct.

SCOZZAFAVA: So Terri, they will be on site, correct? I mean, they come to Elizabethtown?

MORSE: I’m very sorry to say that would not be the case. They will be remote workers.

SCOZZAFAVA: Explain that.

MORSE: Remote would mean they are providing services through video.

SCOZZAFAVA: Do we have any that come on site currently?

MORSE: No.

BARBER: That don’t do the first four hours by video?

MORSE: No.

BARBER: But they want this addition by video for the same amount of money?

MORSE: Correct. I would like to think that it is no surprise to you that recruiting psychiatric services to Essex County is not an easy thing to do. There are less providers and they are getting, you know like in New York City a private practitioner, psychiatrist can make $450.00 an hour so recruiting them to Essex County at the hourly rate that we would be able to offer is very difficult so really the only way that we can obtain services of psychiatric nature is by virtual services.

SCOZZAFAVA: How successful is that? Virtual services verses actually sitting down with the psychiatrist?

MORSE: Absolutely in person services is by far the gold standard. I think when Covid was around we had to do virtual services exclusively and so we learned that it is adequate services but yeah, in person services for mental health counseling or psychiatric services are definitely the gold standard.

SCOZZAFAVA: So from the video conferencing sessions that they have right, does it ever come to a point where they say, well, we need to really sit down with this individual one on one, does that happen?

MORSE: So in that case what we do is we bring the individual to our clinic if they are not already at our clinic, sitting in our building working with the individual remotely because that way we can lay eyes on them.

SCOZZAFAVA: You just answered the question. So, they actually are at your building doing this remotely?

MORSE: No, they are sitting in Syracuse. The provider is not in Elizabethtown.

SCOZZAFAVA: No, no the client is in Elizabethtown?

MORSE: Yes if there is a need to do that. If it’s demonstrated yes.

SCOZZAFAVA: Okay thank you.

WILSON: Any other questions? All in favor aye, any opposed – carried. Thank you.

MORSE: These are all good questions you’re asking me. Thank you so much.

The last resolution I have is a resolution honoring an individual that has been at our agency for 38 ½ years. His name is Bob McGoldrick some of you may have known him or worked with him and he is retiring on April 4 and we would like to honor him. I’ve invited him today but he declined that opportunity so we still want to honor him.

RESOLUTION OF APPRECIATION TO ROBERT “BOB” McGOLDRICK FOR HIS YEARS OF SERVICE WITH ESSEX COUNTY MENTAL HEALTH DEPARTMENT. Scozzafava, unanimous

WILSON: Thank you and thank him.

MORSE: I appreciate it. Thank you and that’s it for my report.

WILSON: And now back to our regular order the Department of Social Services, Angie Allen. Thank you for being flexible this morning.

ALLEN: That’s what human services people do right? They have to be flexible. It’s not a problem at all.

You all have my report. Any questions before I point out some highlights? Wow, nice. Well, I have a celebration. Last week we had two children adopted which is huge. As you can see, I did add to the report some of our legal standings and I did add to the report how many kids are awaiting adoption so it can take quite a long time when a child is freed to actual adoption. So with that being said, when the State gives us a timeline of how long children should be in care sometimes it often is extended because of the Family Court process with adoption so we are meeting our State standards but adoptions take longer. Which is pretty cool but two is awesome and we have four more in the waiting so fingers are crossed.

I did want to, Ken, I was prepared I didn’t put it in the report but you always ask about staffing and so right now in the Department of Social Services we are looking to fill eight positions. We have others that are open that we are putting kind of on the back burner. We are not in need now so why fill them if you don’t need them and let’s take a look at what we can do so four of those positions are caseworker positions and then we have two in social services worker positions. A social services worker either can work in eligibility which means under the HEAP department, Temporary Assistance Department or SNAP, Food Stamps Department and Child Support just so you are aware so the Child Support Collecting Unit so we are looking for two more there. We are looking for a DSS Account clerk in our accounting department and that’s key to all of you because it’s about claiming right and Mike has taught me about claiming over the years so we’ve had a couple of applicants. We are taking a look at, we only had one applicant for that specific position so we dropped it down to the ability to look at a trainee position that may not have the amount of years of experience but therefore can earn the years while with us so we’re trying to be creative in that realm when it comes to hiring.

The two, Hey did you Knows, one is under the Accounting and that’s about how we kind of claim staffing hours for reimbursement and the other one is under the Stop DWI and that is about the Victim Impact Panel. Any other questions?

MERRIHEW: I had a question on the bottom where you have monthly VIP attendance, it seems like a phenomenally high percentage of non-compliant. What happens to them in the next step?

ALLEN: Well, it can be reported back to if they are not fully through the whole court process it can back to the courts, to the DA’s office, to the Judge. I’m not quite sure what the final consequences is for that individual because we don’t have control of that right, so but we do report back.

MERRIHEW: Thank you.

WILSON: Any other questions? Anything else? Alright thank you very much.

ALLEN: Thank you.

WILSON: And Public Health, Jessica Darney-Buehler is here today.

DARNEY-BUEHLER: Good morning. I hope I can go out of order of the agenda a little bit and do resolutions first. So my first is a resolution to approve the quarterly reports of the Public Health Unit as approved by the Public Health Advisory Committee with Dr. Michael Celotti at that the March 7, 2023 Public Health Advisory Committee meeting.

RESOLUTION ADOPTING AND APPROVING THE QUARTERLY REPORTS FOR THE PUBLIC HEALTH UNIT AND APPROVED BY THE PUBLIC HEALTH ADVISORY COMMITTEE (PHAC) ON 3/7/23. Scozzafava, Wood

WILSON: Any questions? All in favor aye, any opposed – motion carries. Thank you.

DARNEY-BUEHLER: Thank you and the second is a resolution adopting and approving the advised policies and procedures and quarterly reports for the Home Health Services as approved by the Professional Advisory Committee and Dr. Michael Celotti at the 3/7/23, Professional Advisory Committee.

RESOLUTION ADOPTING AND APPROVING THE QUARTERLY REPORTS FOR THE HOME HEALTH UNIT AND APPROVED BY THE PROFESSIONAL ADVISORY COMMITTEE (PAC) ON 3/7/23. Hughes, Stanley

WILSON: Any questions? All in favor aye, any opposed – motion carries. Thank you.

DARNEY-BUEHLER: Thank you so much and my third is a resolution supporting the goals and ideals of National Public Health Week. The week of April 3 is National Public Health Week and that is coming up. We wanted to bring that forward today. The theme will be centering and celebrating cultures in health. And if I could just read a couple of excerpts from that resolution I will. Whereas, the goal of National Public Health Week in 2023 is to recognize the contributions of public health – most specifically the Essex County Health Department in approving the health of the people of the United States, including all who live, work, and play in Essex County; and working to achieve health equity across all communities. Now therefore be it resolved, that the Essex County Board of Supervisors supports the goals and ideals of National Public Health week; recognizes the efforts of public health professionals and collaborating partners, communities, and individuals in preventing disease and injury. Recognizes the role of public health in preventing and responding to health challenges, addressing social and other determinants of health, and improving the overall health of individuals and communities in Essex County. Recognizes the investments in the Essex County Health Department are necessarily made to meet mandated services and support the implementation of evidence based practices designed to improve health; and encourages everyone to learn about the role of the public health system in improving health.

RESOLUTION SUPPORTING THE GOALS AND IDEALS OF NATIONAL PUBLIC HEALTH WEEK OF APRIL 3, 2023, IN ESSEX COUNTY. Wood, Wright

WILSON: Any questions? All in favor aye, any opposed – motion carries. Thank you.

DARNEY-BUEHLER: Thank you. I wanted to call your attention to what I think we have in your mailboxes or in your packets, which is our rabies clinics coming up. So, this year we will be doing six rabies clinics throughout Essex County as a reminder, or in case you were unaware our Health Department is required to offer at least one, free rabies clinic every four months throughout the year and we surpassed that by doing six. This year we will be doing one in March as part of a public health emergency preparedness exercise with our partners at the DPW to test our mobile attempt for a mobile drive through clinic that is one of the assets that we purchased as part of our Covid response and we have set that up previously but not operationalized it so we are going to try and do that as a two port with a preparedness exercise and a drive through rabies clinic and all of our rabies clinics will be conducted as drive through. They have been well received by the public and our veterinarians like that. That is our plan this year. That was just a call to attention to the clinic schedule and the final thing that I wanted to address today on the report was in fact was a follow up to our Director, Linda Beers did last month in regards to shelters and if I could, may I invite Nick Sitts and Mike LaVallie to come up and join me.

WILSON: Please, yes.

DARNEY-BUEHLER: So these two gents have been working together with the American Red Cross to further find some of the shelter initiatives and how we can best work with our towns and communities on shelters as we had a number of weather events this year alone that have prompted some of our communities to set up shelters. So what you have I believe received is a packet where it talks about the shelters, what we provided is a list of the shelters were submitted to the American Red Cross and any that were submitted for your community and then what we are inviting you to do and asking you to please do is to consider those locations that you may access a shelter within your community and then we can go through that process with you to further define all of the benefits that shelter could provide for your community members should you need to mobilize that. And the other thing that we really want to emphasize, beyond that you have a plan for a shelter in your community and that would be a home base type of initiative on first go, is that you always try to communicate that opening of a shelter up to our Office of Emergency Services and that way they can collaborate with you on making sure if you’re requesting assets or if they know of a shelter that is opening very close by that we can make the best use of all the resources best for our community. I hope all that makes sense. And I think that was really the points that we wanted to emphasize here but I would ask either Nick or Mike to chime in if they have anything in addition.

SITTS: So, yes, hi my name is Nick I am the new Emergency Services Coordinator with the Public Health Department. I started back in December. So, yes, I did create those packets for you. We ask that you at least look through it what the current shelters are and if you want to keep those shelters you can write keep next to them, if you want to delete them, you can delete them. I also did include in the very back of the packet, a blank survey of what the Red Cross looks for when they go out to survey shelters so just for your reference, the Red Cross will go out and eventually survey the buildings when they have a completed list of what they want for shelters in the county so just for your reference but as far as the process for opening shelters and what you would need to do to activate a shelter I’ll let Mike speak about that with Emergency Services.

LAVALLIE: So normally in the past I believe the supervisors reached out to either Mr. Jacques or Mr. Watts directly basically saying, in my community the power is out, we’ve checked with NYSEG or National Grid, it’s going to be an extended period say, six or seven hours, it’s 30 below out, what is going to be our plan here? We’re going to open up a warming shelter or a place that somebody can come that needs to warm up because it is 30 or 40 below out? All we ask is that you coordinate with us and just let us know. I’ll use this example, Supervisor Scozzafava says I’m going to open up a the Port Henry Fire House or the Moriah Fire House as a warming place because the power is out for the residents of Moriah, he would coordinate with us, just let us know. We would supply an assets that he would need as far as that’s concerned. The big difference and I want to emphasize, I’m sure Nick will emphasize and the Red Cross has emphasized these are temporary usually okay? There’s a difference between a permanent shelters where we are going to food, shower, sleeping quarters stuff like that compared to a warming shelter okay? There’s a big difference there. If this is going to be an extended period where say, some major infrastructure is gone down then we are going to be in an extended shelter where there are going to need to be restrooms and sleeping quarters and shower quarters and food provisions to be able to feed the people that are coming. So I just want to emphasize that. I’m sure Nick and the Department of Health has with your packets there but again, I just want to put that out there a warming shelter compared to a shelter that we’re going to have for days. There are certain criteria involved differently with that. Thank you.

DARNEY-BUEHLER: One additional point on the shelters is to always consider the Health Department a collaborator and I know Krissy with the Office for the Aging equally, we work really hard when towns do decide to open up shelters to communicate that out to the people. I know you have your own channels with your own departments but we also have significant following and ways to reach out to our constituents and we would always offer that opportunity of collaboration.

WILSON: Any questions?

DARNEY-BUEHLER: Thank you.

WILSON: Anything else?

DARNEY-BUEHLER: That concludes my report.

WILSON: Alright, thank you. Thank you all. Office for the Aging – Krissy Leerkes.

LEERKES: Good morning everybody. So, you have my report and before I go into my resolutions I just wanted to touch base about a new initiative that we are exploring at the Office for the Aging. So New York State Office for the Aging and the Association on Aging is partnering with a company called blooming health and it is an online platform basically that will allow us to send out mass, to do mass outreach. So, currently right now eight Offices for the Aging’s across the state are participating in it. We will have a dedicated phone number for us so what will happen is we’ll have a dashboard that myself and my receptionist will have access to. We’ll be able to upload client lists from our current data base upload into the system and we can define what type of message that individual would be able to receive. So we could say, Mr. McNally is going to get a phone call, Mr. Doty is going to get a text, Mr. Hughes is going to get a text and an email and he wants the phone call as well and then we can develop the message and send it out to that client list that we defined. Really cool, like I said, it’s a dedicated phone number so it’s not going to be a this number, this type and the next time we send out a message it’s going to be a different number so we can actually just give t hose individuals that are going to be getting a text or a phone call that dedicated number instead of them thinking it’s a spam call. We again, another cool thing with the phone with getting a telephone call it can actually be our voice that they are going to receive. It’s not going to be like an automated, like a robot talking. It will be Hi, this is Krissy from Office for the Aging or what have you.

So a couple of things that we are looking at doing this for is obviously increasing program delivery so if we have a say, an exercise class that we are offering down in Minerva and our participation is not the greatest we can do an outreach and say, hey, did you know that this is happening and so on and so forth. We can do it for emergency weather alerts again, Jess just mentioned about the closures. I know you guys all have social media followings, some of your towns have kind of like a system like this set up where we can be an added resource to that. So, currently through the end of the year this will be covered in full through New York State Office for the Aging and the Association. We’ll kind of take a look at it within a couple of months to see really is there participation, what the actual outcomes are and then we’ll explore if we would look into contracting with this service next year. If it is well received across the State NYSOFA may put it in their budget, they’ve done that the last couple of years so I just want to play it out. They asked us to be a PILOT county so why not do it for free. So, that’s just an update there.

I do have a couple of resolutions and it’s really carrying over funds from 2022 to 2023. So the first one is to carry over unexpended gifts and donations funds from ’22 to ’23 in the amount of $13,860.06.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $13,860.06, UNEXPENDED 2022 GIFTS & DONATIONS FUNDS. Hughes, Wright

WILSON: Any questions? All in favor aye, opposed – motion carries. Thank you.

LEERKES: Next, same concept. This is to carry over unexpended FFCR stimulus Covid 19 funding in the amount of $183,104.66.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF$183,104.66, UNEXPENDED FFCRA STIMULUS COVID 19 FUNDING. Hughes, Wright

WILSON: Any questions? All in favor aye, opposed – motion carries. Thank you.

LEERKES: And the last resolution is to carryover unexpended DSRIP funding from ’22 to ’23 in the amount of $168,991.70.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $168,991.70, UNEXPENDED 2022 DSRIP FUNDS. Hughes, Stanley

WILSON: Any questions? All in favor aye, opposed – motion carries. Thank you.

LEERKES: And I actually have one more, I thought I had three sorry. Is to carryover the unmet need funds, we talked about that last year, we talked about it last month we are using a lot of those funds to we are in the process of purchasing a glass chiller for our central kitchen, we are using a lot of the funds to get more Home health aides in the home, keep individuals out of the hospital, out of the nursing home so we just want to carry that money over in the amount of $80,109.80. I do anticipate having a conversation with Mr. Mascarenas by the end of the month and possibly bringing an additional resolution. We will have some of those funds that have not been spent and of course we don’t want to lose them so we would look at decreasing the county portion of the Nutrition contract and using these Unmet needs funds to pick that cost up. The contract would not change, the money would still be the same just where the money comes from would be a little bit different but we have to kind of pinpoint down to a dollar figure on that.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE OFFICE FOR THE AGING DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $80,109.80, UNEXPENDED 2022 UNMET NEEDS FUNDS. Wright, Scozzafava

WILSON: Any questions? All in favor aye, opposed – motion carries. Thank you. Anything else for Krissy? Alright, do you have anything else?

LEERKES: I’m good. Thank you.

WILSON: Any members of the board have anything else for Human Services committee? We are adjourned.

As there was no further discussion to come before this Human Services committee it was adjourned at 11:15 a.m.

Respectfully submitted,

Judith Garrison, Clerk

Board of Supervisors