Monday, April 10, 2023 - 10:30 AM




JoePete, Chairman

Charles Harrington, Vice-Chairman


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


Department Heads present:Linda Beers, James Dougan, Judy Garrison and Terri Morse.Krissy Leerkes was excused.


News media:Sun news, Alana Penny.


Also present:Arriana Patraw, North Country Healthy Heart Network



HARRINGTON:I will call this Human Services Committee to order please. First up is Angie Allen from the Department of Social Services.Sheís in the bathroom?Okay, well we will go back to her.Is Terri Morse in the building?Yes, Terri Morse, Mental Health come on down.


MORSE:Good morning. I donít know about you but this morning I heard Megan all referred to the weather but it wasnít, did you all wake up this morning and feel like, spring is here.So beautiful.Okay so I only have one little resolution but Iíd like to give you some updates.I wanted to bring to your attention the law enforcement mental health referral system is really going strong and I want you all to know that this collaboration between law enforcement across all of Essex County so itís New York State Troopers, itís the Sheriffís Deputies, itís Ticonderoga PD, Lake Placid PD and Saranac Lake PD along with Essex County Mental Health, the Mental Health Association in Essex County over in Westport on the flats across the street from the Health Center and also St. Joeís are working together to address those individuals that law enforcement come into contact with that may be showing some sign of a behavioral health issue and behavioral health being substance abuse or mental health and while itís not a crisis response situation weíre doing follow up and we are learning so much about our community. There are unfortunately more people that need services that we were aware of that were accessing services and some individuals with some significant concerns.So, you should know, that this opportunity and this response is in your communities and is helping us get services to those individuals faster and more effectively and we have a really cool story that I shared with you about a situation where we learned of an individual that was probably behaviorally health challenged so mental health and substance use so we did outreach to their home and we had contact with the mother and the father and they both shared with us that they were so pleased to know that somebody in the community cared enough about their family member because we gave the parents Narcan kits which are those reversal opioid overdose reversal kits which they were very pleased about and then we actually did another follow up and we were able to interface with the individual and she relayed to us that like, wow, I really had a tough moment at that time but itís nice to know that I can reach out to you if I need more help.It was the experience for her, the OD was an experience for her that was eye opening but the fact that we did follow up was helpful to her to know. So I wanted to just share with you that story about how the LEMHRS program is how we refer to it has been beneficial to the community, Essex County community and the LEMHRS program is in about five other counties in New York State because of what we started here in Essex county as a collaborative.

I just wanted to share with you that we have a new staff member for counseling services thatís coming on board in May. We do have some adjustments in our psychiatric services going on right now but I wanted to let you know there will be continuity in the services and we will not be missing a step.

And then I have one resolution that is a board member thatís joining our team which is Krissy Leerkes.Itís at the bottom of my report so at the Community Services Board level we have Krissy Leerkes joining the board for a term effective March 8, 2023 to December 31, 2025 and sheís also going to be a member of the Mental Health subcommittee for March 8, 2023 to December 31, 2026.




HARRINGTON:Questions, concerns?There being none, all those in favor, opposed Ė carried.


MORSE: That concludes my report.


HARRINGTON: Thank you.Weíll now return to Angie Allen, Department of Social Services.Good morning Angie.


ALLEN: Good morning you guys are fast this morning.I like it.Spring is in the air.It keeps me on my toes, yes.So good morning just a first a couple things before we take a look at the report I want to say thank you for all that supported the DSS team in regards to the pinwheels that came out.It was lovely seeing everyone there as you saw in the paper the last couple of years it has been just Mr. Mascarenas and I even though invitations were extended to DSS I think it really speaks to the relationships that we are building and the support and moral that we are building with the staff for them to join us.So, I really want to extend an appreciation for that. So, thank you.At that same time itís not just DSS that has to deal with child abuse prevention we have agency partners I would also like to thank such as public health, mental health, probation, ACAP, Families First, you name it, we work with them and so I think that even though DSS was highlighted there wasa lot of agency partners that we couldnít do this without so I just wanted to put that on the record that we need agency partners, we need town supervisors, we need everyone in the community to really take a community look at child abuse prevention and so with that, a huge thank you across Essex County from Essex County DSS.

Number two, we had a long standing, Christy Petro from the Town of Moriah is actually retiring on April 28 with 34 of years in the Child Support Unit right, wow.So just wanted to make sure that is put out there as well.Thirty-four years is a lot of knowledge and commitment. Sheís delightful. Sheís been a great leader and the Child Support Unit will be losing a lot of experience but I have faith in the staff that have undergone training the last couple of years so it should be a smooth transition.

In terms of my report. Any questions?


SCOZZAFAVA:I would move a resolution of appreciation to Christy Petro.




HARRINGTON:Any other questions for social services?


SCOZZAFAVA: I have one.Looking at your report on temporary assistance, 19 people have been referred, 8 clients have been found to be employable and 14 have been referred for substance abuse evaluations what happens after the evaluation?


ALLEN:So there is some qualifications for OTDA which is the Office of Temporary and Disability Assistance right?To where individuals if they are recommended for counseling services for rehabilitative services are recommend to go. Currently the State is actually in kind of a paradigm shift because before individuals would be sanctioned meaning that they wouldnít qualify for services their children would for food stamps and temporary assistance but the adults themselves wouldnít so letís say an adult was homeless and they did not go through the St. Joeís evaluation or St. Joeís recommended services and the adult did not follow through and became homeless there would be a sanction to where we would be forced by hand not to serve them.Again, we can serve children so if there was a family of four DSS would pay for the children but the adults would be expected to pay for themselves but thereís paradigm shift here right?So it is nothing that is concrete at this time but kind of coming down the pike because I think the State is recognizing the need to take another look at alcohol and drug abuse, the physical addiction, the emotional addiction and the impact it has on families so they are relooking at the whole concept of sanctioning because if someone canít meet their bare minimal needs theyíre not going to be able to become sober right? So the State is doing a paradigm shift to really do a look at being more proactive and coming up with more of a carrot verses a consequence because again, without basic needs being met children are not going to be healthy, the parents are not going to be healthy and when they are down in the dumps they are going to use itís just kind of a cycle unfortunately right? And I know that there is others that can speak to that more than I can but from my experience thatís what we see so that is the consequence currently is the sanctioning with 45 days they can reapply but hopefully in the future thereís some different thoughts coming down the pike.


SCOZZAFAVA: Thank you.


HARRINGTON: Any other questions?


HUGHES:Sorry, I should have asked this earlier regarding the TANF, the temporary assistance heating equipment clean and tune it says 13 pending I guess my question is whatís the timeline it takes something from pending to complete?


ALLEN:So that kind of depends right?So thereís actually a timeline in which recipients need to have all their paperwork in right? So once that happens, so that timeline, people usually get about 30 days to get all their paperwork in and then from there there is a review process, so there is that process.Unfortunately what we do see though is traditionally all those letters have been sent out to the home ownerís right and yet, we have a lot of individuals who cannot read.So, where something should take 30 to 60 days it often takes longer and because it is a Governmental program things can stop and you need to reapply so if I donít get my paperwork to you in a certain amount of time then you can pull my application and I need to reapply a week later so the system is broken. What we find in children and adult services is when we know that one of our clients is actually applying we have somebody go to the home and I think Krissy Leerkes does this as well, donít quote me, you can ask her but we recognize that this is all by letter, this is all by mail, snail mail which no one uses anymore. There is the online application and they are pushing for electronic applications but still and we have a population that cannot read so when thereís a deadline and they canít read that there is a deadline they are kind of left in the lurch so we at children services and adult services when we know we facilitate those applications so weíll drop it off, weíll pick them up and drop them back off in the building, weíll have staff there that can read them, read the instructions and read the requirements.If we know that there is a timeline coming up because we donít want foster care we will be calling the home, going to the home and seeing what we can facilitate.


HUGHES:Iím glad to know that the broken system that you just spoke about has opportunities for improvement. Thatís great. Thank you.


ALLEN: Any other questions?


HARRINGTON: With there being none, thank you Angie. Next up, Public Health Linda Beers.


BEERS:Good morning everybody.Iím fighting laryngitis so bear with me.Iím going to go over my resolutions first.The first resolution is to accept funds for NYSACHO.It is a small mini grant we wrote for $3,000 and we were awarded it to include ticks and sunburn kind of initiatives during the summer.So we wrote this mini grant and they funded us and it is a request to accept and apply for the money.




HARRINGTON:Questions or concerns?There being none, all in favor, opposed Ė carried.


BEERS:The next resolution #2, is moving money forward.Itís from the Certified Home Health Agency.Itís recruitment and retention monies that was left in the 2022, budget and we are moving it forward to 2023 in the amount of $25,663.35.




HARRINGTON:Questions or concerns?There being none, all in favor, opposed Ė carried.


BEERS:The next one #3, just to give you an idea, remember DSRIP that was that Medicaid reform we still have $846,168.56 in the 2022 budget, weíre moving it forward to 2023. This is really the result of our certified home health agency and reduction in hospitalizations because they do an amazing job.




HARRINGTON:Questions or concerns?There being none, all in favor, opposed Ė carried.


BEERS:Number four is we applied for the Adirondack Foundation for $5,000.00, to do something called, Kinder Closet because you supported me in the Baby Steps to Brighter Futures this Kinder Closet will be filled with items for baby and moms so when we go out to every new born baby in Essex Countyís home weíll be able to supply them with items that they choose from. Weíll have a wish list and Adirondack Foundation granted us $5,000 for that closet.




HARRINGTON:Questions or concerns?There being none, all in favor, opposed Ė carried.


BEERS:The next resolution Iím really proud to ask you or tell you about and my friend is here today Arriana Patraw. Arriana came here today from North Country Healthy Heart Network to recognize Terri Morse.The Essex County Health Department along with the North Country Healthy Heart Department or Network is here to recognize Terri Morse and Iím just going to read quickly the resolution and also commend Susan Allott on her phenomenal job.

On behalf of the North Country Health Heart Network, the Essex County Health Depart is honored to present this resolution of appreciation;

Working with the North Country Healthy Heart Network since 2014 Essex County Mental Health has been consistently has been committed to decreasing the adult smoking rate in the county;

Terri Morse has ensured outstanding leadership and guidance for promotion of nicotine cessation in the behavioral health setting passing a comprehensive tobacco dependence policy and by appointing Susan Allott as lead tobacco cessation efforts;

Sue Allott has become a trained tobacco treatment specialist;

Sue Allott developed a tobacco cessation quality team that meets quarterly and the tobacco cessation team reviews treatment performance, sets objectives and consistently accomplishes more than they set out to;

Whereas, the North Country Healthy Heart Network recognizes Essex County Mental Health as a model for the North Country region for all health systems to follow;

Therefore, Essex County Health Department commends this accomplishment and appreciates the contributions from Essex County Mental Health so kudos to them.




HARRINGTON: All those in favor, opposed Ė carried.


BEERS: So thank you for coming here today and thank you for recognizing Terri and her team.

You have my report in front of you, Iím not going to read it or go over it very much.I want to talk to you that it is National Public Health Week that was last week. Thereís a banner hanging out there.That was pretty exciting, we have a lot of interesting things on our Facebook site.

Also, we did a joint exercise with rabies clinic and a joint device that we bought a blow up kind of tent and we did a drill with that as well during our recent rabies clinic drive thru clinic and the rest is on there.

I sent out some of this, I sent it to Shaun.Iím not sure you all saw this but I did want to call your attention to in case anybody ever asks you the implication of Canadaís legislation. That little graph with the bars talks about edibles and this is from the Poison Control network thatís excluding New York City but the rest of the state but you can see that the data shows our calls increased six fold from four years ago on children and teens 19 years old and younger who have consumed cannabis containing food products mostly edibles and you can see that they are calling the poison control network because kiddos got in and ate these things unknowingly so weíre really workinghard to change that as we bring on the legalized cannabis stores.

And then probably one of our biggest claims to fame the Essex County Health rankings so kudos to all of you because you make this all a success.Essex County moved from 19th in the state to 15th in the state, people really do look at those metrics when they are moving places and whatnot so in all of New York State Essex County is the 15th highest ranking state for health and a bunch of outcomes that made that all happen so obviously it is a team effort and everybodyís efforts here today really contributed to the success of that so thatís really wonderful.

And then my other thing I just want to really tell you about please go on, Terri did a campaign youíve seen it maybe with lots of famous people in this room right now, Angie Allen doing a public service announcement and why itís great to work and live in Essex County. We use the same firm to talk about vaccinations so I just call your attention, thereís little blips in here and they are amazing they talk about it.So Julianna and Jason are from Lake Placid, Dr. Michael Celotti is from Moriah, The Pulsifers are here in Etown, New York and represent that area of Etown Lewis and Lissa Goldstein is from Keene and Dr. Kristin Mack lives in Ticonderoga and each one of them has a short video about why immunize not just Covid but any immunize so it was really a wonderful campaign and I think Great Range did a wonderful job and then I will call out and continue to call out our services Early Intervention and preschool. We have 13 children in Early Intervention, Iím sorry the graph shows how many children are without services. We have 13 kids waiting in the hopper to be evaluated and preschool those are the number of kids without services no provider and 18 waiting to be evaluated.Lucianna writes this wonderful report and she does tell there is hope.Mountain Lake Services has hired a part time speech pathologist and weíre hoping that will help with the burden.

And I really took a page out of Angie Allenís page, Mike always did, the Did you Know so I encourage you to read them because they are pretty encouraging and then I will tell you about WIC.I will not read it to you but you can see the amazing work that WIC does, March WIC metrics. The targeted case load in the state is 700 we enrolled 652, thatís pretty close. Thatís an amazing accomplishment our WIC does an amazing job.Just to give you an idea thereís 118 women in Essex County that are on WIC, 112 children are infants and 372 children lots a lot of kids we represent in WIC so we really do a great job doing that and Emily French was picked, who works in our WIC department to be on the Association Capitol Hill Advocacy Day and she spoke by zoom to the following representatives and really just advocated for rural WIC dollars to stay here and what we can do about it and then the last page is your Home Care Metrics and I think it trends perfectly.One of the only probably the only thing I would call out to is our case mix which would not ever been seen, I donít think Iíve shown it but this is the diversity, complexity and severity of patient illness. This is how people get paid.You wouldnít know that but when you go to the Doctorís office, if youíre really sick they make more money what we do in home care.The sicker you are the higher the reimbursement rate but I will tell you that nobody also wants an entire caseload of only the sickest people and this is what you can see by the numbers of our Certified Home Health Agency weíve discussed this before and weíre not the only certified home health agency and the other agency is getting the easy folks and weíre getting the toughest ones.So we continue to fight the fight and do a fabulous job and I really believe our numbers show you that in our quality star metrics with the people of Essex County and you guys supporting it.Thatís all I have.

HARRINGTON: Any questions for Linda?


DOTY: Linda, in North Elba in our community development committee has started a data search if you will for determining the demand for child care.Because youíre involved with birth to 3 what entities can we go to for actual census figures?You know not every mom goes to Saranac Lake or they go to Plattsburgh for different reasons maybe even UVM is there a way for the next couple of years to gauge what that birth rate really is?Because birth to three is typically the most expensive part of child care certainly getting school figures for in school population is easy but this birth to three is proving a challenge for us.


BEERS:Well, as you know we are rolling up Baby Steps to Bright Futures and Essex County Public Health Department will be in every home or at least be aware of every single baby born in Essex County.New York State law gives us a tracker by law I know every baby born in Essex County I have always had that but a caveat that it wonít matter to you very much but it will matter to a lot of other people in Ticonderoga and places on the border Moriah, we have a real struggle seeing Vermont data so I will tell you anecdotally babies are born every year in Essex County we know by zip code level data where they are so, and then your next question was what health care facility do they go to or where were they born?


DOTY:Or really just how do I pull in all the information?


BEERS:So our community health assessment has a lot of that in there, I mean, we are happy to help you do that.ACAP also has data on probably the more school age, we would have it all on births.


DOTY:And I have gotten that from ACAP.


BEERS:They can show you the shortages but I have the data about where the kiddos are.Weíre really worked hard to tighten that up and I just to speak on, we just met with Dr. Eppen who is new CEO of UVM he was amazing and he has given us data with Dr. Wouter Rietsema and they are going to, every time a baby is born in New York or Vermont they are going to give us an alert so now in real time we know and can address and meet mom where she is at and follow her home and get into the house early so we are really excited about that. We are also meeting with AMC and weíre also meeting with CVPH and weíre also meeting with Elizabethtown and Ticonderoga. It would be hard to capture the Glens Falls ones so weíre not going to get those folks and Saranac Lake will be covered by AMC.


DOTY: Okay.


BEERS: Folks going really outside that circle we will get them anecdotally it takes about two weeks and then I know any baby born in New York State, Iíll know in two to three weeks.


DOTY: Thanks Linda I will be calling you.


BEERS: I figured you would.


HARRINGTON: Angie Allen has a concern?


ALLEN:Well, actually itís just a statement, also the Day Care subsidy program that we work with ACAP with actually the 100 children that is in our report, we have all the information in terms of how old they are so if you would want a break down regarding child care needs for the children that are through a subsidy we can provide that to you and by zip code.


DOTY: Thanks Angie.


HARRINGTON:Other questions for Linda this morning?


WINEMILLER:Can you please tell me what the income guidelines for WIC is?


BEERS:The income guidelines, you know what they change and they just changed again so Iím happy to send out the link and tell you I donít want to misquote it.Itís a moving dial these days so rather than misspeak Iím happy to send a link out when I get back to the office and it will probably come from Krista Berger telling you the income guidelines because itís not one simply answer but Iíll give you the formulary and you can figure that out.Is that good?


WINEMILLER:Yes, thank you.


HARRINGTON: Anything else to come before Human Services?


MORSE: I just elected to share with you an update about St. Josephís you asked me months ago to provide an update.My update is that I will be providing you with an update next month.They do have a plan in place but they want to get that information out to their staff and community services board before they bring it to this level.So next month I will have something for you.


HARRINGTON:Thank you.Other concerns?Thank you Linda.Office for the Aging, Krissy Leerkes has filed her report and is excused.Anything else to come before Human Services this morning?There being none, it is exactly 11:00 and we are adjourned.


††††††††††† As there was no further discussion to come before this Human Services committee it was adjourned at 11:00 a.m.


Respectfully submitted,




Judith Garrison, Clerk

Board of Supervisors