Monday, May 13, 2024 - 10:30 AM


JoePete Wilson, Chairperson

Charles Harrington, Vice-Chairperson


Vice-Chairman Harrington called this Human Services Committee to order at 10:30 am with the following Supervisors in attendance: Clayton Barber, Matthew Brassard, Chris Clark, Robin DeLoria, Derek Doty, Shaun Gillilland, Charlie Harrington, Kenneth Hughes, Steve McNally, Jim Monty, Cathleen Reusser, Favor Smith, Matthew Stanley, Michael Tyler, Davina Thurston, Meg Wood and Mark Wright.Joe Pete Wilson was excused.


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


Also Present: Jessica Darney-Buehler.


News Media present: None.


HARRINGTON:I will call the Human Services committee to order and weíll begin with mental health.


MORSE:Good morning.For the motherís in here, Happy Motherís day.My report is pretty self-explanatory what I wanted to share with you today though is that I probably spend way too much time trying to figure out how we are in a situation in the year 2024, where our mental health waiting list is just exploded.What is going on?What is contributing to this? I donít get it.And so I constantly search for answers and landed on an author of a book called the anxious generation and I bought a lot of copies of it through BRIEF and Iím going to be giving it to the schools but I brought some for anybody here that wants a copy of it but basically Jonathan Haidt is saying that we can look at smart phones as a contributor to, smart phones and social media as major contributors to how we got to this place.Now he doesnít really talk a whole lot about the opioid epidemic and how there are children that are growing up with parents who have higher levels of addictions than we are used to or some other factors but I thought his message was something that was important for us to pay attention to and that might have some answers and he actually doesnít just talk about the problem he talks about things that we can do as a society to help go around a curb and make things better because I truly donít understand why we are in this situation that weíre in and why there are so many schools that are saying that the children are struggling and suffering so thatís been helpful to me and weíre going to be supporting the schools if they want to put some forms of a band on cell phones in the schools because I know Iíve spoken to a lot of the school staff, their leaders and they are as frustrated with the situation as what this author is saying so I did bring some copies. I will leave a stack down there and you are welcome to partake in that.

So Iím going to jump to the resolutions and any questions about what I just said?So Iím going to jump to resolutions.I am so sorry.I was going to do a presentation today on our resolution about the credible minds and I neglected to bring my computer so thank you Judy for setting it all up but I forgot to bring my computer. So one of the resolutions that we have is that Essex County Mental Health received funding from the Office of Mental Health in the amount of $49,500.00, and this grant funding is to support a collaboration between Mountain Lake Services and our office we have a handful of kids in our community are what they are called dual diagnosed which means they have OBWD diagnosis and a mental health diagnosis and very often those kids get stuck between the, itís your kid, no, itís your kid and so we want to do more collaboration on that and Mountain Lake Services does not get a lot of funding for respite services so some of this money will be used to contract with them so they can provide an increased level of support to the family for kids that are really kind of chewing up a lot of the resources in Essex County. This will help DSS. This will help those kids that are just really struggling. Itís really for families that are struggling with these kids so looking to gain acceptance to accept those funds.




HARRINGTON:All those in favor, opposed Ė carried.


MASCARENAS: Just for clarity Judy, this should also be in a form of a budget amendment because unless Iím wrong it looks like you already got the funds?


MORSE: We did.


MASCARENAS: So increasing revenue and appropriations by $49,500.


MORSE: Thank you.


GARRISON: Thank you.


MORSE: Our next resolution is to put out an RFP for a position. This is a follow up to the community conversations we did last month and this individual will be coordinating with all those people that filled out a form and said Iíd like to be part of what community conversations is trying to do and what community conversations is trying to do is to build more resilient communities, get the community members part of the team approach to schools and the provider system and letís all work together at helping improve the well-being of community members so weíre looking to put an RFP out to get somebody to help us with that.




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


MORSE: Iím going to skip the next resolution and Iím going to come back to it Mike, because Mike has some things he wants to add about that.So the next resolution is about to contract with an organization Credible Mind. Credible Mind is a web based platform that provides evidenced based information and also some assessments so that individuals could maybe gain more independents when it comes to their questions about their own mental well-being. So for example, one of the assessments is am I depressed or am I just blue?And based on the outcome of that assessment they can gain some tools and technics through the recommendations, evidence based technics that are appropriate for somebody to be a little more self-directed in their own mental health needs. This is an effort to try to address our waiting list. We want to be able to give individuals something to grab onto while they are waiting for services rather than I wonít say nothing but letís give them more tools and this is a collaboration between the public health department and mental health and the amount is $1,000 to set it up and then $6700 a year to keep it going.Right now I have money through the BRIEF coalition to support this and there is supposed to be opioid settlement funding on an ongoing basis Iíve heard for 16 years that will be coming to the community services board. Thatís money separate to what is coming directly to the county that we can use to help continue this on.


DOTY:Terri, the licensing fee is like three quarters of the cost of that program.Where does that money go?


MORSE: The licensing fee?


DOTY: Yes, the set up and $6,210 for the annual licensing fee.


HUGHES: It goes to the company for the service they provide.


DOTY:For a program, yearly?


MORSE:So the amount of work that organization, so itís based on population that amount is so this is something that all 38,500 residents in Essex County will have access to.


DOTY: And who refers a patient or a client to this digital program?


MORSE: Thank you, good question. We will be putting together a marketing program to get this word out.My staff will be, you know people call and say whether they are in crisis or referring themselves we will give them the please use website, you know, Essex County Credible


DOTY: So itís a form of telemedicine?


MORSE: No, itís more about resources.Thereís no therapist on the website.Itís tools and information so that people, if somebody thought well, Iím depressed so rather than go to YouTube and listen to videos that may not be so evidenced based this is a platform that they can get good information on to help them try and figure that out.


DOTY: Iím having a hard time visualizing it.


MASCARENAS: Yeah, I think itís more like a survey for people to self-evaluate on kind of whatís going on with them at any given time and present recommendations right, for evidence based process that they can get through while they maybe awaiting services.Iím guessing thereís times where youíll probably get a red alert card on somebody that may come through that thinking you may need to get them in immediately but some people probably may be able to just with a little pointing in the right direction can handle their own circumstance for a lower cost and present more availability with the service we are providing here locally.


MORSE:So weíll definitely be able to include information thatís relevant to Essex County on the resources page of that website.Thereís also data on the back end that we will have access to for how many people are accessing this assessment on Ė so thatís a little bit of what that licensing fee is going to so there will be data that will be available to us and then yes, I know Livingston County built in a like, I need help and this is emergent and then they would be hooked to our Essex County Mental Health crisis line 988, MHAís hope line.


DOTY:Thank you.


MORSE:Youíre welcome.




HARRINGTON:Is there any further questions or concerns?


HUGHES: Terri, you said $6700 for the annual licensing fee but it is $6210 in this resolution which is it?


MORSE: It is $6210 plus the $1000 for the initial set up.


HUGHES: Thank you.


HARRINGTON: Other questions?


HUGHES: Have you used this?


MORSE: I went to Livingston Countyís, so this initiative was brought forth to the New York State Public Health Directors maybe about six months ago and the Public Health Directors were encouraged to collaborate with the Mental Health Directors Community Services Board Directors so Livingston County I know has this up and running and I understand thereís about four other counties that are putting this together.


REUSSER: What is stopping Essex County from instituting our own program Credible Mind?


MORSE: It would be extraordinarily expense for us to do it by ourselves.Probably $25,000 would cost us and then you would have to have staff to manage it yeah, the cost would be extraordinarily high.


HARRINGTON: Other concerns?All those in favor signify by saying aye, opposed Ė carried.


MORSE: Thank you. So the last item, going back up to number three is Iím asking for allowance to put through an RFP for a Registered Nurse up to 20 hours a week and this is for per diem work and that the budget item would be, itís already budgeted itís already in our budget. Weíre having a lot of difficulty gaining applicants for our part time registered nurse position weíve had it out there for probably a year and what we are being informed is part of the issue is that the salary on an hourly basis is difficult to compete against with the nurses at hospitals and other kinds of medical settings and so we would like permission to put through an RFP for a part time registered nurse.




HARRINGTON: Questions or concerns in regards to that?


GILLILLAND: Is there special requirements for this RN?Is it a psychiatric RN?


MORSE: You mean as opposed to an RN that is working in a hospital setting?


GILLILLAND: I was just wondering is it a specialized RN?


MORSE:So I would say that yes, an RN that is working in our office needs to understand psychiatric medications, needs to understand indicated medications with other medical issues a lot of RNís donít have that specialty information and knowledge about psychiatric concerns.


GILLILLAND:So there is additional certification other than just an RN?


MORSE: There is not.


GILLILLAND: There is not?


MORSE: Correct.


MASCARENAS:So, what weíll do Mr. Gillilland and this is becoming increasingly complicated throughout the county.Public Health Department struggles with a similar problem in recruiting RNís especially on a part time basis. We have a couple of things we have to really look at. I think Iíve been working with Mr. Hughes, Chairman of the Personnel committee weíve started those discussions on how to best tackle this problem. One is through RFP.RFP does allow you to define specifically what youíre looking for and scoring it in a manner that gives people points for some of those qualifications you are speaking to so Terri will work with Linda Wolf on directly developing specifications for that and Iím assuming that those things that you need there will have specific point totals to that.Now, am I confident that weíre going to get responds?No, Iím not.I know that weíve done RFP in the past for different types of nursing services and we have not. Another thing we need to really look at are per diem rates. When we used to have Horace Nye Nursing Home we used to have per diem rates for nurses. We currently do not so Mr. Hughes and I are going to work on recommendations to make to this board on per diem rates for nurses.The other thing that is difficult with nurses is yes many of them do compare salaries to that in hospitals but it is also hard to compare apples to apples with nurses in particular just because of the different levels of specializations and work shifts and holidays and vacations and retirements and all those things are very different in a hospital setting than there are here.So whenever you have that private public type comparison itís very hard to make that comparison in terms of apples to apples but we do have some ideas. We also have the IRS issue thatís very large here when youíre looking at contractorsí verses employees and what those individuals are.So contractors are contractors. Contractors do not have office space in your building.Contractors do not drive your cars.Contractors arenít told when to work by you those are employees and if youíre not following those rules youíre not in compliant with the IRS either so this here will make sure we are doing our due diligence whether it be per diem, whether it be an RFP process or full time and in the end if none of those things work, we also need to be compliant with regulatory agencies who require us to provide a service and how do we get that done?Right?So thereís people pulling at us in both directions in terms of compliance issues and we just need to do our due diligence to make sure weíre leaving no rock unturned when trying to find these individuals to provide these services.


HARRINGTON: Other questions regarding this? There being none, all those in favor signify by saying aye, opposed Ė carried.


MORSE: Thatís it for my report.


HARRINGTON: Thank you.Next up is Linda Beers.


DARNEY-BUEHLER:You have me today.Good morning.I did submit a report that you have in your packet today and I just wanted to draw your attention to a few things. So during the warmer months we will doing car seat tech Tuesdays and that provides an opportunity with anybody that has a car seat to have their seat assessed with our technicians to make sure they are installed correctly.Essex County does have quite a high rate of boat accidents and we want to ensure that our littles are all safely secured in their car seat so this is a way that we can do that.If somebody needs assistance with the purchase of a car seat we can also distribute car seats to those that are eligible.

Last week I had the opportunity to meet with a state level group of folks representing Birth to three, Birth to five and looking at universal home visiting programs so as some of you might remember last year in August we did a launch on the front lawn here launching our universal home visiting program for newborns called, Baby Steps to Bright Futures and so what I did with that opportunity last week was to talk with those representatives about what our program is, what evidence based programs and services we have looked at to model our program after and how we want to make it work here in Essex County. Some of the key things that we had as important as we were just discussing our nursing shortage issue was making this a social model rather than a clinical or nursing model and weíve really successfully done that. Some of that does include mental health screenings and itís really focusing on how we can connect our people to existing programs and services. For example, we have that Healthy Families New York program in Essex County before our program they had about 12 slots that they could accept families with and they didnít have any of those slots filled they were having trouble getting those refilled and once we started our Baby Steps program they now have all of those slots filled and they have a waiting list and so weíre working with Healthy Families through Early Head Start, Head Start again to wrap our families in that additional care that they need to have the best outcomes possible for their families and their youngsters.

With our lead program we are trying to work more closely in collaboration with PRIDE and Adirondack Roots to fulfill some of those applications for people that do need home renovations done.The applications for people in the community I think feel very intimidating and what we can provide for them is that level of assistance to make sure they get their applications in and that they are eligible and they are accessing those funds.

We have been out and about in our schools doing sexual and reproductive health education.A lot of our schools take us up on that especially in the spring and that has been really well received Cassidy Christian does that for our department and itís going so well.

We have over the course of the year instituted a once a month check in with our school nurses called the Stetho-Scoop.Our nurses provide an opportunity to connect with the school nurses and one of the things that weíve learned about those positions in the community previously is that the nurses in schools feel really isolated, they are sort of that one person within that facility doing that one thing and they wanted a better opportunity to collaborate with each other to learn from each other to express concerns, get ideas, share programs and so forth so weíve successfully done that.In that regard, we have had two contracted nurses that we have been working with in our Public Health unit and both of those have resigned.They will be terminating their contracts with us here in May and we are working on reposting our positions.If we fail to get an applicants for those then we would also seek like Terri is seeking to go back and find another solution to how we can meet the requirements that we have as a local health department of New York State.I certainly am tapping into all the people I know to see if they would be interested in what we have and I also ask everybody here to do the same if they would please. Iím a great point of contact if they want to learn about what it is that they would be doing for our department. Iím happy to talk to anybody about that and I know as an example we had somebody who made contact with somebody else over the weekend to try and recruit and they said I really canít make a change itís about a $15 an hour pay difference from what I am earning right now in the private sector so we understand that thatís kind of the terms and conditions that we are working with competitively out there as Mike was describing the differences between public and private/

I know that our home care services also has a number of nursing positions open but I did want to bring your attention to our Director of Patient Services, Jennifer Newberry and she was recommended and received the NYS Trail Blazer Award from the Association of Home Care Agencies in New York State so thereís a little clip on that and I can send that video clip out to everybody after the meeting so you can take a look at that and the kind words that were offered to Jennifer from Linda Beers and some others and like in our department.

The only other thing I wanted to bring up was just regarding rabies. We did put a press release out last week I think it was and to date this season we have four known cases in rabies in Essex County 2 skunks in Westport, we had the woodchuck in the Village of Port Henry and then we had a raccoon in the hamlet of New Russia (Elizabethtown) and so weíre keeping an eye on that.Another thing that we have going on regarding rabies is that on June 7 we will be up at the Public Safety Building with NYS Ag and Markets to do a training for the Dog Control Officers and Animal Control Officers so that will include representation from NYS Ag and Markets and our office ready to talk about how those positions interact and how we work collaboratively on the terms and conditions of dog confinements, quarantine, etc. so if you would tap your dog and animal control officers on the shoulder make sure that they know of that date and please ask them to join us.And I can accept any questions. I do not have any resolutions to put forth.


HARRINGTON: Any questions?


MONTY:Just so you are aware Jess that there are two other groups that offer assistance besides Adirondack Roots, PRIDE of Ti does the same exact thing as well as United Way.




MONTY: So add them to your list.


DARNEY-BUEHLER: Yeah, thanks very much Jim and the other thing I was thinking about too is if your town or community has additional funds or ways that we can work with homeowners to work on lead abatement or restoration issues within their homes we want to keep people in their homes, we want to keep our families together whenever possible definitely let me know about those so that we can redirect our families to those services.


MONTY:So you have money? Because itís not cheap.


DARNEY-BUEHLER:No, I know, I know. I think basically what we would look at are what are the cheapest ways to get the job done that would meet the assessment. The lead abatement at home works a little bit differently but what we try to do is we have somebody from the Saranac Lake District Office go in with one of our staff. We work with the family on things like nutrition and how they can mediate any kind of lead poisoning and then the environmental gives people an assessment of what they found in the home.Itís been our experience that that assessment is incredibly intimidating to people.Itís a lot of legal terminology.It terrifies them and so then instead of trying to do something to fix the best that they are able their own circumstance they just stop picking up the phone altogether so what we want to do is keep that relationship going, figure out how we can cover up any of the lead or take out any of the lead as appropriate for each unique situation.


MONTY: I understand completely the biggest thing that weíve found is the cost.The cost especially dealing with the clientele you are talking about thatís going to be another driving force that is going to scare them.


DARNEY-BUEHLER: Absolutely. So weíll add the United Way to our list and we have the PRIDE of Ticonderoga and Adirondack Roots.


REUSSER: I just had a statement when weíre talking to nursing personnel from other areas yes, they may make more money per hour.When you look at Essex County Government and what you have and health care costs, retirement so you may not have that money immediately but in the lifetime of your career you come away with a lot more so I think you really need to help people focus in on not just the per hour but the value of a career.


DARNEY-BUEHLER:Absolutely I agree Cathy. I couldnít agree more. We definitely do that when we are talking to people. The last time that we did our request for applications and that structure we put it out through Indeed and we had over 20 people submit applications and then I started with phone interviews to talk about the position. I think one of the biggest areas is interest in the type of work that we have to do, beyond the money I think itís incredibly important that we have people that are invested in the work and want to do that type of work whether itís home care or working with us in the public health areas of family, health, immunizations and things like that they have to be interested in that work or they just wonít stay.We definitely share staff across the departments. I know that weíve had some conversations about that before too and if we get anybody in we would be happy to do that.


MASCARENAS: We are looking at a lot of different ways.You hit the nail on the head and that becomes the stumbling block. We have to take a short break. We have another meeting that is supposed to start at 11:00 and then weíll get back into Human Services so I donít know if Charlie wants to adjourn quickly?


HARRINGTON:We will adjourn this and continue after the Special Board.




HARRINGTON:We will return to the Human Services committee and begin with Department of Social Services, Angie Allen. Angie, Iím sorry we skipped you but we will leave the next to the last for best.


ALLEN:Good morning.Iíd like to start off with a resolution and Shaun as you can see I brought my own glasses today.Itís a resolution authorizing the Department of Social Services to spend $5,890.09, to complete an NVR upgrade project for the DSS security camera system from Alltech Integrations. Basically our program is old and we want to go to a web base program. We do have security cameras towards like a 360 I believe view? Mike is that what we are looking for?


MASCARENAS: Yeah, we are looking for a 360 view.Itís a network video recorder. It gives you the ability to store so much space when we have something that happens before it resets. I think ours is about fourteen or fifteen years old.Itís not going to be supportive any longer.It was there prior to me in DSS, prior to Angie in DSS so weíre looking to do that we have been utilizing that quite often. Itís our eyes and ears for whatís happening around our building when nobody else is here to watch.They have the budgeted we donít need extra money it just is higher than my threshold of approval. I can only approve up to $5,000, so we need to bring it to board.




HARRINGTON:Further questions or concerns in regards to this resolution?There being none, all those in favor, opposed Ė carried.


ALLEN:Thank you. Iíd like to start off with some happy news because if you guys take a look at the report you will probably get into some negative questions. We did have one more adoption this past week which is wonderful.This was a little guy that has been with the family for about four years. I was part of the original removal so it was kind of wonderful to see the little guy with his family and with the celebration of the community.They actually had neighbors and friends and everyone come to the courthouse so it was a really kind moment that Iíd like to share with you guys.

In terms of my report are there any specific questions?Iím sure that Hey, sad but true fact was kind of little mind blowing, a little sad so unfortunately I bring the taste of reality to this room a lot and I like the fun facts and the hey, did you knows but I think that to keep the pulse on whatís happening in the community is also very important.You know, itís amazing what the belly of the beast shows to each of you in your towns. Davina and I are working on something right now and itís something that is a first time for me so itís a very interesting world out there so I do have the breakdown if you guys would ever like in terms of CPS reports, allegations by mandated report and by towns.Mike and I have discussed over the years that I donít list out the towns specifically because you know fingers could be pointed right? And when we take a look at tourism we donít want to deter that either but if any of you would like that data I do have it available.Any other questions.Thank you.


HARRINGTON: Next up Krissy Leerkes, Office for the Aging.


LEERKES:Good morning everybody. So everybody has my report. I just have a few things to touch base on so for those that have been around you probably know May is Older Americans Month so I just want to thank first Mr. Hughes and the Town of Essex.They proclaimed May 12 as Older Americans Day in the Town of Essex so thatís really great that one of the towns did that and Mr. Hughes that was something that came from 1984?


HUGHES: 1986 my Deputy Town Clerk found the resolution by Supervisor Wally Hill at that time so I think it was just worthwhile to redo it in 2024.


LEERKES:Well, thank you.So each May New York State has an older New Yorkers Day celebration so this is a time where every county is able to recognize the volunteers that we have as a whole but we are able to nominate too. We actually go down, we go down to the egg tomorrow for a nice celebration for all the counties and all of our honorees.They will have a nice time with our NYS Office for the Aging Director and other individuals so I just wanted to call our attention to those two individuals that will be recognized tomorrow and both are from the Town of Moriah. The first is Roy Bristol.He is one of our six medical transportation volunteers and Roy has really stepped up the last couple of months we have him on the road many days of the week so we are very, very proud of Roy and then also Melinda Morin.She has been instrumental in the Town of Moriah food pantry.Has I believed volunteered there since 2013 and thatís a very busy food pantry and those volunteers do an amazing job down there.Like I said those two individuals will come actually Melinda is not going to be attending tomorrow but Roy and his wife will be going down with us tomorrow.Just in talking about volunteerism in Essex County so our office relies very heavily on the volunteers through AmeriCorps. Seniors they are also based out of the Town of Moriah but they cover the whole entire county with volunteers from those that are working at the food pantry, our exercise class instructors, many of them are working at some of the congregate sites so on and so forth so I just wanted to give you a little bit of data. AmeriCorps Seniors actually celebrated their 50th anniversary here in Essex County this year so they will be doing a nice little celebration in the summer so you will expect to receive an invite for that so just some examples so for the last year April 1, 2023 to March 31 they had 111 volunteers across the county that served 8400 hours and what we do know about the volunteers is that 8400 hours probably is doubled, volunteers are very humble and they donít always put their information out there a lot of times it just goes unreported.In the Town of Schroon lake they have a lot of volunteers that are at the Senior Center and at the congregate site and they deliver meals each day so thatís something we are proud of and in Willsboro there are six volunteers that are trained for bone builders program so this is training that they went through, were never paid for but they do this for individuals throughout their communities and they have 42 participants in those two programs and then again throughout the county we have volunteers that do friendly calls, home visits, friendly visiting and again, it just goes to show the volunteers in our county I cannot do the day to day work without their support and Iím just really proud of them.

So I have two resolutions the first is going to be a budget amendment and this to accept $2500, from the Adirondack Foundation from the Generous Acts grant for healthy and active aging. These funds will be used to really put a lot of emphasis and education to older adults in regards to scams that are targeting older adults as well as financial exploitation we are seeing more and more of the grandparent scam, we are seeing unfortunately the romance scams so we just want to get more information out and do some training opportunities.




HARRINGTON:Questions or concerns regarding this resolution?There being none all those in favor signify by saying aye, opposed Ė carried.


LEERKES:And the last resolution is just proclaiming May 2024 as Older Americans Month in Essex County. There is an attached proclamation that in interest of time I wonít read it.




HARRINGTON:All those in favor signify by saying aye, opposed Ė carried.Are there any concerns regarding Office for the Aging?


HUGHES: Krissy do you feel it is worthwhile for the supervisors to offer a resolution of appreciation for Mr. Bristol and Ms. Morin this morning?


LEERKES: That would be absolutely amazing if Mr. Brassard if heís on our committee could do that?


BRASSARD: Yes. I would make a resolution appreciation to Roy and Melinda for the work they do.




HARRINGTON: Anything else?Thank you.Any other concerns to come before the Human Services Committee?There being none we are adjourned.


††††††††††† As there was no further discussion to come before this Human Service committee it was adjourned at 11:28 a.m.


Respectfully submitted,




Judith Garrison, Clerk

Board of Supervisors