<p>St. Lawrence County Services Committee Board of Legislators Monday, April 23, 2012 Board Room 5:30 p.m.</p><p>Members Attending: Mr. Bunstone, Mr. Acres, Mr. Akins, Mr. Arquiett, Ms. Brothers, Mr. Burns, Mr. Lightfoot, Mr. MacKinnon, Mr. Morrill, Mr. Paquin, Mr. Parker, Mr. Peck, Mr. Putman, Mr. Putney, and Mr. Sutherland</p><p>Others Attending: Karen St. Hilaire, Ruth Doyle, Kelly Pearson, Laurie Demers, Mike Crowe, Kevin Felt, Chris Boulio, Keith Zimmerman, Angela Doe, Sue Hathaway, Nancy Robert, Chris Rediehs, Ben Todd, and Laurie Maki</p><p>1. CALL TO ORDER AND APPROVAL OF AGENDA – Chair Bunstone called the meeting to order at 5:30 p.m. Ms. Brothers moved to approve the agenda, seconded by Mr. Putney, and carried.</p><p>2. APPROVAL OF MINUTES –Mr. Peck moved to approve the minutes of October 17, November 21, and December 12, seconded by Ms. Brothers. Mr. Morrill said he has an issue with the timing of minutes as no minutes have been posted to website for 2012. He said the minutes should be posted in a timelier manner. Ms. Brothers said she agrees, but said we removed a position from the Board Office and for this reason, the minutes will be slower. As we are cutting position in departments, we must understand that things may not happen as quickly as before. Motion carried. </p><p>3. PRESENTATION ON TOBACCO USE – BEN GRUDA - Ms. Hathaway introduced Ben Todd and Laurie Maki, members of the tobacco program. She said Mr. Todd will be making the presentation, as Ben Gruda was not able to attend tonight. </p><p>Ms. Hathaway introduced Dr. Tramontano of the Board of Health. </p><p>Mr. MacKinnon said smoking is not allowed in the County buildings, but asked if employees are able to smoke when they want to. Mr. Boulio said most departments have designated times and places that people are able to take a smoke break. </p><p>4. PUBLIC HEALTH – SUE HATHAWAY</p><p>A. St. Lawrence County Board of Legislators Supports the Adoption of a Local Law Written by the Board of Health Prohibiting Tobacco Use on County Property (Info) (Res) - Mr. Morrill moved, seconded by Mr. Parker. Ms. Hathaway said there is a high rate of smoking, and a high cancer death rate in St. Lawrence County. She said we want to have healthier employees, and to educate people on tobacco products. She said it is not only smoking, but also chewing tobacco. We are looking to the Board of Health to do studies on this, and to come up with the final policy. Therefore, we are asking for support of a local law that the Board of Health would draft. Mr. Morrill asked if County property includes vehicles. Ms. Hathaway said yes, it includes all vehicles, County and private. Mr. Morrill asks if it includes people that are here to do County business. Ms. Hathaway said yes. Mr. Morrill asks if it includes the County Forest, and said we may need to watch our wording. Mr. Morrill said he will support this resolution. </p><p>Mr. Peck said his major issue is telling people they cannot smoke in their personal vehicles. He 1 thinks they should be able to smoke in their own vehicles. Mr. Tramontano said allowing people to smoke in the parking lot would cause problems. </p><p>Mr. Putman said he will support this resolution. Smoking is not allowed at other places of business in St. Lawrence County. </p><p>Ms. Brothers thanks Mr. Todd for all the information, and said it can be defined so as not to include private vehicles. She said she has strong feelings about individual rights and personal property. She said despite what Dr. Tramontano said, she sees a car as personal property. She said she will support this if the private, individual vehicles are included. </p><p>Mr. MacKinnon asked Mr. Rediehs how long people are allowed to smoke on their breaks. Mr. Rediehs said there are two 15 minutes breaks. Mr. MacKinnon said he feels that a car is personal property, and he wonders how much right Government has to tell people what to do. He asked if people would have enough time to leave the property and drive off County property to smoke. Mr. Rediehs said yes, they could do that, but it would be difficult. </p><p>Mr. Parker said he supports this resolution in concept. He asks how this will be enforced. Ms. Maki said there are a variety of ways to enforce this. It may come from the Board of Health. There is a phase-in period, and there may be a few problems here and there, but now it is a social norm. A lot of it can be done through education. There should be some sort of enforcement, but it needs to be well thought out and the Board of Health would decide. She said allowing people to smoke in their cars would be undercutting the policy that we are making. She said she is looking at it from the health side of it, and education is the key. Mr. Parker said we have our work cut out for us, but he said he continues to support this. Mr. Parker asked Mr. Crowe if an employee is on break and got into their vehicle and drove off County property, would the County still liable. Mr. Crowe said he did not think the County would be responsible. Mr. Parker said we should think about this, and the risk of liability. Mr. Crowe said he thinks if they are on their own time and choose to leave the County would not be liable. </p><p>Mr. Sutherland asked if there is a plan in place to help the employees quit. Ms. Hathaway said yes, and that is why it would be a long process. Tobacco is an addiction, and there are a number of ways we would be able to help people. A big part of implementing a change like this is to help employees with their addiction. Mr. Sutherland asked what kind of penalties are going to be used on employees and the public. Ms. Hathaway said they are not looking at penalties. Initially it would be by letting them know, counseling and offering assistance. With repeat disregard, it would then probably go to a supervisor. With the public it would just be through peer pressure. We are not looking to do this harshly. Ms. Maki said other Counties have their EAP counseling. With the public, it may go to the Board of Health in which there could be a hearing, but she has never heard of that happening. </p><p>Mr. Putney said it sounds like the plan has been thought out to make it successful. He said others have adopted the tobacco free program. Ten years ago these policies were not enforced, and you had to walk through a cloud of smoke to get into the buildings. He asks how long it would take for the Board of Health to look at the issue and come back for a discussion. Ms. Hathaway said we could present again at the May meeting. She said she thinks it is important enough to not rush it, and wants it to be done correctly. She said we could probably have something this summer. Dr. Tramontano said tobacco usage has gone down 90% with fewer </p><p>2 places allowing people to smoke; which makes it more difficult to smoke. </p><p>Mr. Morrill said he is interested in the logic of someone’s car being their property. He said you can take this logic to the extreme. You own the vehicle, but do not own the property it is sitting on. </p><p>Mr. MacKinnon said you can smoke if you leave County property. He said he is trying to think of ways of not getting into a contract issue. </p><p>Mr. Acres asked how long the program has been in place at the hospitals. Dr. Tramontano said it varies and some people still smoke, but they go onto the sidewalks off hospital property to smoke. He said the culture up here is different, and there is a social taboo about smoking for health reasons. Mr. Acres said this would mean people would give up their right to smoke when they drove onto County property. He said you have the right to smoke, but you do not have the right to have tax payers funding Medicaid and health care issues. If it would lower our cost of these, he said he would approve this resolution. </p><p>Ms. Brothers said said she cannot accept it unless it says people are able to smoke in their private vehicles. Ms. Maki said you would be surprised with the number of employees who are smoking. The lower income, lower educated is a target and this may be another thing that can help them with quitting. Ms. Brothers asked if there was a cessation program. Mr. Boulio said he did not think there was a program, but there is assistance with that. Ms. Maki said Medicaid has better programs and cessation programs than we do for our County employees. She said this is another step, and we have to make a culture change. Ms. Brothers said she would like to hear if it is yes or no on smoking in the vehicles. Ms. Maki said she thinks that would undermine the tobacco free County policy if it were allowed in vehicles. </p><p>Mr. Paquin said he thinks we are debating something that is hypothetical and calls the question, seconded by Mr. Morrill, and carried.</p><p>Motion carried by a roll call vote of eleven (11) yes votes, three (3) no votes (Brothers, Burns, and Peck), and one (1) absent (Arquiett).</p><p>B. Approval of Rates for Related Services for the Pre-School Special Education Program (Res) – Mr. Parker moved to forward this resolution to full Board, seconded by Mr. Putney and Ms. Brother. Mr. MacKinnon asked where the money comes from. Ms. Hathaway said we pay the bills, and then ask New York State for reimbursement. He asked if it was a County cost and if we could cut the rates down; do we have control over these rates. Ms. Hathaway said we do have control over them, but we need to pay the going rate. Mr. MacKinnon asked what parent training was. Laura Duval said it is teaching parents to follow through with things, and to help parents learn to focus on the child. Mr. MacKinnon asked if the prices could be lowered. Ms. Hathaway said these rates have been the same for a number of years, and we have not increased them. They tend to be the same across the State. Mr. MacKinnon said he is not going to vote for this because he does not think the rates have to be that high, except maybe the specialties items. Ms. Hathaway said many of these people have master degrees, and are self- employed. There are guidelines for reimbursements. Mr. MacKinnon said we will be looking at layoffs, and we need to talk about these things. He asked when the last time these rates were raised. Ms. Hathaway said approximately four years ago. </p><p>3 Mr. Burns asked if these rates are based on historical data. Ms. Duvall said they are based on other Counties’ rates and our rates compare. Some may be metropolitan and some may be rural. Mr. Burns asked if our rates are par with other rural areas in the State. Ms. Duvall said she would look at that and let him know. Ms. Hathaway said she would do a comparison and email it to him. </p><p>Mr. Peck said the rates look a bit high, but asked if there are providers for these services. Hathaway said she believes there are and these are mandated. </p><p>Mr. Akins said Mr. Mackinnon brought up a good point, and his figures show the cost would be approximately $81 per hour for this service. </p><p>Mr. Putman said most of these services are provided in the home so there is mileage to consider and time between appointments that are not billable. BOCES is getting out of this business because they have lost money on it. We are better off to take these rates as they are. There are other things to consider such as the time between appointment and driving their vehicles; there is a lot of travel time. </p><p>Mr. Morrill asked what the total cost was of providing these services. Ms. Hathaway said she would look this up and let them know. He wonders how this compared to transportation. </p><p>Mr. Acres moved that we tabled the resolution until we have the answers we need, seconded by Mr. MacKinnon, and failed. </p><p>Mr. Lightfoot said do we have numbers. Ms. Hathaway said we generally have 50 students in the preschool. Mr. Lightfoot asked if these are the rates provided to these 50 students. Ms. Hathaway said yes. Mr. Lightfoot asked if the budget line went up because of the cost of these services. In two years we went from $841,000 to $1.2 Million. The student numbers have not increased and the numbers have not increased. Ms. Hathaway said we have not raised the rates, but there may be more services being provided. Ms. Hathaway said it is part of the factor and how often the service is being provided; these are the parts we do not control. </p><p>Ms. Brothers said she thinks Mr. Akins made an interesting point about the hourly cost. She said it is incredible what the costs of outside consultants are. They are people who run businesses and offer their services based on their expertise and knowledge. She said she does not have a problem with the rates. She said we need to look at how many services and what the scope would be on an average over a span of time. She said she will support this. Motion carried with two (2) no votes (MacKinnon and Lightfoot), and one (1) absent (Arquiett).</p><p>C. Authorizing the Chair to Sign Contracts for Services for the Early Intervention Program in the Public Health Department (Res) – Mr. Peck moved to forward this resolution to full Board, seconded by Mr. Morrill, Mr. Parker, and Ms. Brothers. Mr. Lightfoot said the amounts in this item have gone down a couple of thousand dollars. He asks how many of these overlap one another, and he asked if they can be incorporated into one thing. He said he is amazed at the number of things someone has come up with; not to say we need to reduce care, but he asks if we can combine these. Ms. Hathaway said unfortunately we cannot because each one is different, providers have to be approved by New York State Department of Health and </p><p>4 there is no way to combine them. Mr. Lightfoot asked why there is a decrease. Ms. Hathaway said the amounts are dependent on the number of children. Ms. Hathaway said we have lost staff, and have fewer numbers of nurses. Motion carried.</p><p>D. Authorizing the Chair to Sign Contracts for Services for the Pre-K Special Education Program in the Public Health Department (Res) – Ms. Brothers moved to forward this resolution to full Board, seconded by Mr. Parker. Ms. Hathaway said this resolution is asking for approval to sign contracts for various contracts. Mr. MacKinnon asked if there is a list of people who provide these services, and said he would like a list of the people and payments. Ms. Hathaway said she could provide the list of providers, but she did not know if she could get the payment amounts. Ms. MacKinnon asked if it was individuals or companies. He said he wanted the total payment of what we have paid, and total amounts on each of the accounts. </p><p>Mr. Peck said most have stayed the same in the budget, except the first one. Ms. Hathaway said that is the center base program which is one of the ones with back bills from BOCES. Ms. Hathaway said we had $2 million more in bills last year that we were not expecting. </p><p>Mr. Burns asked if the providers are located in St. Lawrence County. Ms. Hathaway said not all are, but we do try to use people from St. Lawrence County, if we are able. About eighty percent (80%) are from St. Lawrence County. Mr. Burns said it is nice to hear that most come from the County. </p><p>Mr. Putman said he will abstain from this as his school district is one of the providers. </p><p>Mr. Lightfoot said in 2010 Pre-K Special Education cost the County $608,000; this year we budgeted $1,532,000 for that same item. We need to do a better job at looking for ideas on how to reduce this. There needs to be a better way to do things; these are the types of programs that are going to kill us down the road. It is outrageous to see programs more than double in a two year period. During this budget process we need to be proactive in looking at ways to alleviate some of these things that we do not have control over. Motion carried with one (1) abstention (Putman), and one (1) absent (Arquiett).</p><p>5. COMMUNITY SERVICES – ANGELA DOE</p><p>A. Proclaiming May as Global Youth Traffic Safety Month and Supporting the Statewide Campaign Entitled Speak Early Speak Often about Teen Driving Safety (Res) – Mr. Morrill moved to forward this resolution to full Board, seconded by Mr. Parker, and carried.</p><p>B. Community Services Employee Assistance Program (EAP) Contract Renewal (Res) – Mr. Burns moved to forward this resolution to full Board, seconded by Mr. Peck and Ms. Brothers. Ms. Doe said we are seeking to renew our contract for EAP services with the St. Lawrence Seaway Development Corporation. Mr. Parker asked if this is the second year, and if we could get feedback on how well they are performing. Ms. Doe said yes, there is feedback and it seems to be positive. </p><p>Mr. MacKinnon asked the value of the contract. Ms. Doe said it generates $200 - $400 of revenue per year. </p><p>5 Mr. Morrill said we are paying consulting services at a high rate, and asked why we would provide a service that inexpensively. Ms. Doe said we are utilizing our own staff, and this program does not cost us that much money. Mr. Morrill asked why we get paid so little for providing consultation. Ms. Doe said these are not consultation services, but are indeed clinical issues in nature. This is really a courtesy contract. We offer service to be helpful to their employees, and when individuals need services, we sometime service from our own clinic. </p><p>Mr. Burns asked if the EAP Coordinator refers them to an outside agency. Ms. Doe said yes. Motion carried.</p><p>6. SOCIAL SERVICES – CHRIS REDIEHS</p><p>A. Authorizing the Chair to Sign a Memorandum of Agreement with Western New York Independent Living, Inc. for Consumer Directed Personal Assistance Program (Res) – Mr. Peck moved to forward this resolution to full Board, seconded by Ms. Brothers. Mr. Parker asked if Western New York Independent Living Center was going to contract with Massena Independent Living Center why we do not just contract with them. Mr. Rediehs said we aspire to do that at some point, but this is an intermediary step, and as a way of making sure the expertise is there. As some point that may be possible, and they would like to get to a place where that is possible. This seems like a reasonable way to do it to begin with. Mr. Parker said if there is someone in the middles he would assume that they are getting paid. He asked how soon we would make the change. Mr. Rediehs said it should be possible in the coming years, but said he is hesitant to predict a time frame. The rates should be the same as they are set and approved by New York State. This is a Medicaid Program with rates set at a $15 to $16 range.</p><p>Mr. MacKinnon asked what the cost was last year. Mr. Rediehs said it comes without a County cost; these are rates that the State has. Most of Medicaid payments are not coming through the County budget. Mr. MacKinnon asked what kinds of services are provided. Mr. Rediehs said it is a wonderful program that serves chronically ill and physically disabled individuals by allowing them to function as their own employers so they can pick their care providers and they are able to continue to stay in their own homes and to have a say in who is taking care of them. </p><p>Mr. Akins asked if this is temporary as the dates run for 1 ½ years. Mr. Rediehs said it would take longer than six months for them to be on board. It will not happen within the next 1 ½ years. Mr. Akins asked what the holdup would be. Mr. Rediehs said because of the complexity of it, they have large aspirations and great competent, but limited ability to take care of the bookwork that is required with this. They feel incapable of handling what is necessary. Mr. Akins asked if there was not competence in Massena Independence Living Center to do a good job. Mr. Rediehs said he thinks they are competent, yet it would be risky and we need to have everything done the way it needs to be done to make it successful. Motion carried with two (2) no votes (Akins, Parker), and one (1) absent (Arquiett).</p><p>7. OFFICE FOR THE AGING – NANCY ROBERT</p><p>A. Proclaiming May as Older Americans Month and the 2012 Theme of “Never Too Old To Play” (Res) – Ms. Brothers moved to forward this resolution to full Board, seconded by Mr. Putney, Mr. MacKinnon and Mr. Morrill. Ms. Robert said that the month of May is dedicated to recognizing older adults in our communities. Motion carried.</p><p>6 B. Update on use of Cook Product and Cost Review (Info) – Ms. Robert said we came to the Board regarding cook chill food product and we are reporting on that. She introduced Linda Buchanan, Registered Dietician and Dianna McCormick, Nutrition Program Manager. This is a report of twenty products we tested over a nine month period. We found they are not as favorable as first anticipated and there are some disadvantages that were encountered. Certain products are okay to use, such as juices and pie filings. Annual cost savings are 1% of the total food costs, which is less than $4,000. Ordering frequency is difficult, choices are limited, and cost savings are not a noticeable degree. Our recommendation is to continue to use the standard products we list here, continue to use our current vendors, and continue to look at this. </p><p>Mr. MacKinnon said he taste tested the cook chill food, and did not think it was good. He concurs with what was said because he did not think it met the standard of flavor; it was very bland. </p><p>Mr. Burns said he agrees with Mr. MacKinnon’s assessment. He said we have at least saved something and we should continue; whatever we can save is a good thing. We need to change the name as we are now DOCCS. He asked why the number of meals was down. There are no waiting lists for our home delivered meals. Ms. Robert said because of various factors, people are on and off at various times of the year, it is the nature of the service. Ms. McCormick said it is hard to determine why and we cannot find a trend. A lot of our older seniors have passed on, and the younger ones have not gotten to the point of needing home delivered meals. Mr. Burns said our total numbers of meals have gone down, but our unit price has gone up. Ms. Roberts said the number of meals are down about six percent (6%), but realize that food costs are up as well as transportation costs. Ms. Buchanan said she did a calculation on the food costs and we did a per meal costs, we were 1.9% up and we were significantly lower than the consumer price index for inflation for food. Mr. Burns said you are doing a good job. </p><p>Mr. Parker asked if there was a survey of why folks have dropped off. Ms. McCormick said she does call them, but they do not always get an accurate answer as they are too polite to say they do not like the food. Ms. Robert said some may only need it for a short time such as just coming home from the hospital. It is a cycle. Mr. Parker asked if that is one of the factors in the lower numbers. Ms. Roberts said that may be one factor but there are other factors. Mr. Parker asked if there are people who need these meals, but do not like the meals. We need assure these people are getting the nutrition they need. </p><p>Mr. Burns asked about transportation. Ms. Roberts said contracts have been signed, and the next steps are to get the buses to NYSARC. Mr. Burns asked if the routes will start in May and Robert said yes, sometime in May. The buses are at the Highway Department, and they need to be insured by NYSARC to begin the process. </p><p>8. COUNTY ADMINISTRATOR’S REPORT – KAREN ST. HILAIRE</p><p>A. Updating Records Access Officers in Section Two of the Public Access to Records of St. Lawrence County (Res) – Mr. Peck moved to forward this resolution to full Board, seconded by Ms. Brothers and Mr. Lightfoot. Ms. Doyle said we are just updating this record as five individuals have changed. Ms. Brothers said there needs to a correction made as Amy Dona is now the Conflict Defender, not acting Conflict Defender. Motion carried. </p><p>7 The weekly CHHA report was put in each Legislator’s mailboxes.</p><p>Mr. Morrill asked about the progress of the installation of the new system. Ms Doyle said we are working on the Chart of Account. Mr. Felt said we had the kick-off meeting a month ago, and are working on mapping everything to make sure things are correct. Mr. Zimmerman said they are here today working on the Chart of Accounts and the system supports. Next week there will be training to talk about the interface and dashboard. They are very organized and we are pleased with the process. </p><p>Mr. Burns asked if the books would be closed next Monday. Mr. Felt said the books are closed. Mr. Burns asked if we could get the 2011 actual budget in the form of an email. Mr. Felt said it was too large to send in an email. Mr. Putman asked if instead of line by line, if it could be categorized. Mr. Felt said there are a few different reports that could be generated and he will see if it can be condensed. </p><p>Mr. Peck asked if it would be possible to print off one budget book to keep here that could be looked at and compared. Mr. Felt said he would try to condense it as much a possible. </p><p>9. OLD/NEW BUSINESS</p><p>Mr. Putman moved to go into Executive Session at 7:31 p.m. to discuss Personnel, Appointments, and Contracts, seconded by Mr. Morrill, and carried.</p><p>Chair Bunstone called for a two minute break and Executive Session began at 7:33 p.m.</p><p>Mr. Morrill moved to go to Open Session at 8:24 p.m., seconded by Mr. Burns and Ms. Brothers, and carried.</p><p>ADJOURNMENT – Chair Bunstone adjourned the meeting at 8:24 p.m. as there was no further business. </p><p>8</p>