HUMAN SERVICES COMMITTEE

Monday, March 10, 2025 - 10:30 AM

JoePete Wilson, Chairperson

Charles Harrington, Vice-Chairperson

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

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

WILSON:  Good morning everyone. I will call the Human Services committee to order and first up we’ll get Angie Allen and the Department of Social Services.

ALLEN:  Good morning.  Happy Monday, happy spring. I do have spring fever warning you all right now so if I kind of go on a tangent it’s because of spring.  You have my report.  Any questions? Any thoughts?

WILSON: Well, that’s pretty easy.

ALLEN: That is pretty easy.  So I did figure I would bring something to entertain because Mr. Clark has been asking where my jokes are so frequently.  So this one’s for you.  Why didn’t the hamburger buns ever get along?  They always had a beef between them.  There will be a day that you don’t scratch your head.

WILSON: Thank you.  Alright that was all business.  Next, Mental Health and Terri Morse.

MORSE:  Sorry Angie, you and I are praying against each other because I would love another 16 inch snow storms, I want to go snowmobiling.

You have my report and I just wanted to share with you I thought the positive impact story was something that was, I don’t normally share stories about the law enforcement mental health referral system something we call LEMHRS        but this was a story that was told from one of the outreach persons that worked for the mental health association and just how their intervention was beneficial to getting not only the individual they were outreaching or they got the LEMHRS on but the whole family involved in services so I wanted to just bring that to your attention.

Also, we still do have a waiting list. The number is about 55 unfortunately it is sort of climbing back up again. We do feel like we are serving the individuals that are needing services if somebody demonstrates a high risk, high needs those people always go to the front of the line but I guess I’m just bringing this to your attention that we have basically one FTE worth of people that are on our waiting list most of them are children about 40 of them are children so I just wanted to bring that to your attention. That’s all I have.  No resolutions either.

WILSON:  Any questions?  Well, thank you Terri.  Okay, public health and Linda Beers.

BEERS:  Good morning everybody.  You have my report. I’ve had a lot of time away in the last couple of weeks. I was NYSAC representing and I ran a committee for public health and mental health. I sat on the board of Early Intervention and standing committee and then I moderated a panel there was standing room only, on public health and then I moderated another panel so it was very busy for two days at NYSAC and honestly a little stressful.  Then I went as the President of NYSACHO which is New York State Association of County Health Officials and I did testimony and if you don’t know what that’s like it’s really nerve racking. They make you come in at 8:30 in the morning and I went on at 4:30 at night. I had to sit there and wait and it’s a little different, they pair you with a group of people and I was paired with the head of a FQHC and likes of people who have real big issues verses even public health this year so hopefully I represented well and I think it went really well. They were pleased with what we did and that’s it.

Also, I did a press release on Friday. I did talk to our Chairman of the Board, Shaun Gillilland and Mike Mascarenas and together we drafted a press release on avian influenza H1N1 there’s lots of links in there. I know many of you had questions on that so I do say to you I hope that you consider me a trusted resource if you have any questions. I did have a lot of that information that you were seeking and I’ve been following it obviously very closely because honestly it’s a flu virus that potentially could impact humans so we follow that and of course along with the measles outbreak which is also fun for most right now in the United States of America with two cases in New York City now. 

And I do have resolutions and they are moving money I believe. The first resolution I had my professional advisory meeting, thank you Mr. Doty, Supervisor Doty for being there.  It was well attended and we did our professional advisory council and our public health advisory council and I have a resolution adopting the policies and procedures that were reviewed.

RESOLUTION ADOPTING AND APPROVING POLICIES AND PROCEDURES AND QUARTERLY REPORTS FOR THE HEALTH DEPARTMENT AND  HOME HEALTH SERVICES WHICH WERE  APPROVED BY THE PROFESSIONAL ADVISORY COUNCIL (PAC), PUBLIC HEALTH ADVISORY COMMITTEE (PHAC) AND THE MEDICAL DIRECTOR, ON MARCH 4, 2025.  Wright, Doty

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

BEERS: And the next one is DSRIP funds. This is the 1115 waiver that’s been holding on. We’ve been extremely frugal and really using that money to benefit the sort of home health agency which is the organization that actually brought those funds in.  They were left over in our account so we are moving them forward into 2025 for the amount of $676,515.46.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $676,515.46, CARRY OVER 2025 UNEXPENDED DSRIP FUNDS.  Stanley, Doty

WILSON: Any questions?

GILLILLAND:  Linda, these DSRIP funds, is there a Federal flip in that line of recourse?

BEERS: No we have them they are in the coffers of this county.

GILLILLAND: I know but altogether, that line item it is a Federal vase?

BEERS: 1115 is Medicaid waiver funding.  The new 1115 waiver clearly up for anything think could be yes.

GILLILLAND: I just want to keep the board aware.

MASCARENAS: DSRIP Mr. Gillilland was an old process.

BEERS: All the same waiver they just called it that so 1115 waiver was done every five years across the United States they let every State come up with some way they can save Medicaid dollars. DSRIP’s initiative was to reduce hospital rate admissions our CHHA got really involved and even to this day we still have tele health which has proven to reduce hospital readmissions up to 62% and we’re still putting that in. This money we earned from our hospital readmission rates and gets paid to us, we have that money in the county.  They can’t touch that. The new 1115 waiver is more Mental Health and Terri has been playing with that.  Is that money forever?  Anything is possible.  I don’t know if that money has all been received but yeah, certainly something federal funded and Medicaid slash able as we move into the next world.

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

BEERS: Also, I call your attention to the rabies clinics are out for the year. We had some big showings in Moriah this year. Schroon Lake was a little light we usually have a huge one in Schroon Lake so our numbers were a little down. It is a service. We know how many animals live in Essex County and we didn’t come close.  People do privately don’t get me wrong to get their animals vaccinated but anything you can do to encourage this would be fabulous and that ends my report.

WILSON: Do you have one more resolution? There were three on here.

BEERS: I do, thank you so much.  I have recruitment and retention this is also Medicaid funding. We used to get a lot of this. This is from the CHHA.  Medicaid gives funding for the recruitment and retention based on how much you bill and we have $29,966.25 that money is dwindling to a nothing.  That money is left over and I doubt we’ll see that even going into the next year.

RESOLUTION AUTHORIZING A BUDGET AMENDMENT IN THE PUBLIC HEALTH DEPARTMENT INCREASING REVENUES AND APPROPRIATIONS IN THE AMOUNT OF $29,966.25, CARRY OVER 2025 UNEXPENDED RECRUITMENT AND RETENTION FUNDS.  Wright, Stanley

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

TYLER: I’m not on this committee but I tell you it’s very frustrating in the Town of Westport we had approximately 40 geese that died obviously it’s from the bird flu or whatever you want to call it and I see that the health department is monitoring that. I went to DEC I talked to everybody right up the chain that I could talk to and they blame it on Fish & Wildlife, Fish & Wildlife blames it on Federal so in the meantime these birds are dead out there and the Eagles are sitting there eating them so I’m certain we are going to have a bunch of dead Eagles out there too and that is very concerning to me and what’s really upsetting is nobody wants to do anything about it.

BEERS: Yeah, so there is guidance –

TYLER: They told us if you want to go pick them up and put them in your landfill well, guess what? We don’t have any landfills in the Adirondack Park anymore.

BEERS: That is the direction and homeowners have been calling us that is what we are telling them.   You triple bag them and you put them in your regular garbage and there’s a whole protocol for picking up the animals. This is happening all over the United States it’s not unique to us and the good news is song birds I guess don’t get this virus but raptors and specifically geese are extremely prone to it so I hear what you’re saying.

TYLER: I was just hoping there was something that could be done so somebody can do something. Right now nobody is doing anything.

BEERS:  Correct and I don’t think there’s any plan like rabies in the sense that once we know it’s in an area we stop testing.  They are going to ask that you put it in to make a ding on a map but Essex County is already blue we know that we have avian flu here. As far as the DEC going around and picking up dead birds all over Essex County or all over New York State –

TYLER: Well, I haven’t heard anybody else in Essex County having any problems except one dead eagle out in Willsboro.

BEERS: Right that was in December that was tested and came back positive.

TYLER: The issue is their attitude I talked to the one DEC officer and he said, sure we’ll come down. He called back and said my boss told me not to come down so it starts right at the top, it starts right at Albany and here we go again.

GILLILLAND: I just have a question were those birds out on the ice? The geese?

TYLER: Yes, they were.

GILLILLAND: So you don’t know how long actually they were laying there?

TYLER: Well, what happened was there was a little bit of water next to the marina that was not frozen over and there was hundreds of birds in there and the next thing you know we had approximately 40 of them died and there’s more of them there swimming around in circles I’m sure they are going to die too but the issue for me we spent all this money or somebody did to get the eagles back in the area now they are eating them now they are all going to die too so.

GILLILLAND: I totally understand that. I will just say I was out in Salt Lake as you know, I went out to the Great Salt Lake and they lose birds out on that one by the millions and they send the Boy Scouts out to pick them up anyway, this is going to get a lot worse before it gets better.

BEERS:  Just to be fair too Chairman Gillilland is talking equally some of those birds died from migration causes they are not passing away from avian influenza.

GILLILLAND: No, but the numbers spiked because of avian flu.

BEERS: Absolutely and again we have a real protocols, I don’t the DEC has real protocols of triple bagging them –

TYLER:  Yeah their protocol is don’t do anything.

MONTY: Linda, I know you had some Federal funded programs down there with the cutbacks and what is happening in Washington is that going to affect any of your employees?

BEERS: I gave Mike Mascarenas and Shaun I gave them a report of exactly what funding I believe NYSCHO asked for it across the state from our organization so WIC is completely Federal funded so I call it federal funding.  WIC is one of them, Early Intervention is another one, State grant public health infrastructure grant and there’s another small grant preparedness is another grant. Are they going to affect employees? I have really no idea. I will tell you that it’s federal pass through.

MASCARENAS: So what I can tell you is the answer you heard from Mr. Stanley is still the answer.  I’ve asked all of our department heads to give me a list of their federally funded programs and try to explain the best they can on what’s impacted. So what I’ve been getting is that from departments but with a wait and see because there is no definite answer coming out of Washington. We have saw certain programs get limited.  You and I had a conversation about one locally that was struggling and had to go borrow money and those dollars stopped. We haven’t witnessed that at the county level yet.  Office for the Aging which you will see in just a moment has a laundry list of funds that could be impacted but to date, we have no good answers so until I have something to worry about I’m not going to worry about it.  We’re going to take it a day at a time, a week at a time. We’re going to stay on top of it and as soon as we have something definitive we’ll certainly get that out to the board and let them know.

DOTY:  Linda if my memory serves me from your report last week you actually had a line item of concern total federal concerns which was $533,000?

BEERS: I shared with Mike my professional advisory council, Mike has the exact same document I shared with him first.  So, yes, thank you all of that. I will also say I got an email from Krista Berger today you know how we’ve been doing those food boxes all over, they are going to end.  The funding was cut already, ending 3/27 now.

WILSON: Anything else for Linda?  Thank you very much.  Office for the Aging, Krissy Leerkes.

LEERKES:  Good morning.  Everybody has my report. I do want to draw your attention to the last page.  Last month I had mentioned very briefly that we were looking to be, we were asked to be a pilot county on the MedQR bracelet so we will be getting probably 70-75 of these bracelets. I have a little demo right here if anybody wants to look at them afterwards but it will have our logo here. It’s very comfy to wear and I’m not one to wear anything on my wrists.  It does not bother me but you’ll see on the right side of your paper, when that is scanned and it has a QR code back here that is what actually comes up on the screen and the other really cool thing is when that is scanned an actual notification goes to your two emergency contacts if you assign it so let’s say Mike has his bracelet scanned as soon as that is scanned his emergency contact will be notified. That maybe a family member not within our county, not within our state it could be somebody that they live with but it’s an actual notification to them. Very quick and easy it took me literally probably about 45 seconds to upload all of my information so I will be meeting with OES to discuss it with them, Sheriff Reynolds and then looking if we can partner at first with maybe one or two local rescue squads or emergency departments so that way we have everybody up and trained. We can track it, see if it’s something we can sustain going forward so very cool if anybody wants to see that and like Linda and Mike said he has a copy of our county impact regarding any of the federal funds and any of those matching funds that go along with it or client contributions.

MASCARENAS: Krissy do you mind just for the board’s sake letting them know of the programs that are federal that support the work you do?

LEERKES:  Yes so rough estimate would be about 1.7 million dollars because it does take into account the actual federal funding that we receive any required match as well as the contributions. So those are our Title III’s which includes Title IIIB which a lot of that is our transportation, our mileage reimbursement to our volunteers, it includes our legal services, it includes a significant amount of staff, wage and fringe.  We have Title IIIC2 and Title IIIC1 which is our contract with our nutrition provider so that is probably about 85-90% of our funding for nutrition. We have Title IIID which is our contract Cornell for our health promotion and we have Title IIIE which is our caregiver respite which is basically a lot of contract for respite and staff, wage and fringe. Those are the bigger ones.

MASCARENAS: So Mr. Gillilland eluded to this earlier in the conversation. The key with the federal cuts are mandated vs. non mandated and what are those things we are required to do verses what are the things that we really like to do that provide quality service to our constituency?  So far what you’re hearing is well, those are things we don’t necessarily have to do in terms of a mandate but boy, they are a critical service that nutrition program right?  They matter in rural America not just Essex County so again, we’ll wait and see and we’ll make those difficult decisions when the time comes to make those decisions but just know the mandated verses non mandated are really the key items here because we could lose funding in areas that we have no choice and have to support and sometimes that comes at a cost of doing something you would prefer to do and that’s the difficulty this board could face.

WILSON: Does nutrition include meals on wheels?

LEERKES: It is and I know the $1.7 is a very large number I just want to really reiterate because I don’t want to have like bells and whistles going off that the nutrition program is closing or anything like that.  I would say of that $1.7 million at least probably 80-85% of that is county match so that’s a large number but that is because county funds really support those programs above and beyond what is required so I just want to put that out there.

HUGHES: Mike, I don’t want to make more work for you so please feel free to reject this suggestion.  Is it worthwhile for the Personnel committee next week to put together a summary of the departments and their potential federal connections so that it can make the board on where those potential, possible cuts or reduction of services could take place in the future just to kind of elucidate us?

MASCARENAS:  I can certainly get something out to you guys regarding that.  It will be somewhat incomplete for this reason we have a lot of individuals that do a lot of different work so in Essex County what you’ve probably learned is that people wear many hats so a part of someone’s job might be doing this so there wouldn’t be a definitive answer on would you lose a job because of that or would you lose a service but bridges we get federal funding for bridges annually that would hurt bad but I’m not going to lose jobs over that bridge being cut.  I’m going to do less this year and try to plan for the future so yeah, let me get you something, let me come up with a process.

HUGHES:  Because what Krissy is saying is really important. There’s a lot of important facts and figures and that’s what you live with every day and we hear it once a month as a group and we may have to make some decisions or at least be better educated and I was just wondering that a document like that might help but I don’t want to make it difficult.

MASCARENAS: I have a lot of it now so when I do my budget report for the board before you adopt you’ll see where all of our funding is coming from, how much of it is local, how much of it’s sales tax driven, how much of it’s federal, how much of it’s state so even just looking at some of those totals will be easier for you to make some decisions on and see where that federal money is going some of it is also funneled through the state which is kind of iffy so money that gets pushed from the feds to the state you don’t always know when the state is providing that oversite so that can be a little tricky too.

HUGHES: Understood.

MCNALLY: I think we should offer an open invitation for our Congresswoman to come here and explain to us what we are going to do with the current situation. Does she realize what this is going to do with the people of Essex County if they follow through with all these cuts?  Because I think the people that voted for her should hear how she is going to make things better for us.

STANLEY;  I was also going to throw out there these issues in uncertain times are why it’s important for our municipalities to have a healthy fund balance to weather these storms because we can get a notice today that’s something is ended and maybe rescinded tomorrow.  So I think we all need to definitely make sure we remain calm and work within what we have like Mike, you’ve done a great job with this board over the past few years breaking the tax cap when we need to and making sure we stay solvent in being able to make the decisions we need to make but we don’t need to make them like this minute or tomorrow because we have that ability to keep our programs running and our staff employed and things like that so I definitely want to make sure that we don’t ring alarm bells but make sure we are moving towards the future smartly.

MASCARENAS: Yeah, I appreciate that Mr. Stanley and you bring up a valid point, I feel way better in March about the decision we made in November kind of knowing. What we know is that we are in uncertain times and that the only people we can really rely on are ourselves and we need to be prepared to react in any circumstance whether it be a FEMA event or a loss in programming and we know best what our county lacks and where services need to be delivered and planning for that financially needs to be our goal and continue to be our goal.

THURSTON: I’m not on this committee but I do like what you’re saying there Mike and all this kind of brings to mind that maybe we should maybe have a separate committee to look at different aspects for example, meals on wheels I mean that is something that is absolutely critical but maybe there is a way that we can if, if, I’m just using that as an example so no one get upset but if for example the funding for meals on wheels got cut what could we do as a county and still provide that service, maybe make changes to it, look at these funds very carefully and still be able to provide these services to our constituents at a reduced cost even if it changes the program it still allows for it and I think that it might make sense to move forward with a committee to look at these kinds of issues and be proactive rather than reactive if we lose funding.

WILSON: Anything else?  Krissy did you get to complete your report?

LEERKES: I just had two more things, three things so our Director of the State Office for the Aging prepared this report for us that we just discussed and they also prepared it by congressional district and that has been shared as well.  We are a small piece of the puzzle that maybe effected but I just wanted to share that.

The other thing is in our office we have only one fiscal person and she’s been with the county for a very long time.  She transferred to us back I think 2018 or 2019 from emergency services and she’s actually looking at retiring so we are in the process of hiring and getting a new person in there to have a little overlap with her so as soon as that person comes in I’d like to bring just to the board because that is a one man, one woman show in our fiscal team.

And then last but not least is every March there is a march for meals campaign and I just want to open up if anybody is interested in I know you are familiar with your congregate sites if there is one in your community but if anybody is ever interested in taking a tour of the central kitchen and meeting the nutrition staff if you have not already done so I welcome that and we could do that after ways and means I believe is like the 24^th or something maybe if anybody is interested just please let me know and we can prepare accordingly.

MONTY: That’s a great idea Krissy.

WILSON: Alright thank you very much.  Any members of the committee have anything else?

MONTY:  The animal task force will be meeting at 11:30 in the back room, thank you.

WILSON: Alright then we are adjourned.

            As there was no further discussion to come before this Human Services committee it was adjourned at 11:01 a.m.

Respectfully submitted,

Judith Garrison, Clerk

Board of Supervisors