The Public Services Committee of the DeKalb County Board met on Monday, April 7, 2003, @ 6:00p.m. in the Administration Building’s Conference Room East.  Chairman Marlene Allen called the meeting to order.  Members present were Pat LaVigne, Steve Faivre, Julia Fullerton, Richard Osborne, Sue Leifheit, Eileen Dubin, Eric Johnson and Robert Rosemier.  Others present were Mary Olson, Karen Grush, Tom Zucker, Ellen Rogers, Dave Ruggles, Patty Stevens, Betsy Steele, Bill Wilkinson, Steve Chermanski, Jeanette Smith, Karen Hagen, Val Hinz, Marshall Hayes.

APPROVAL OF THE MINUTES

Moved by Ms. LaVigne, seconded by Mr. Johnson, and it was carried unanimously to approve the March 2003 minutes.

APPROVAL OF THE AGENDA

Moved by Mr. Faivre, seconded by Ms. Fullerton, and it was carried unanimously to approve the agenda.

Chairman Allen mentioned to the committee that the letters included in the weekly mailing were from the Supervisor of Assessments notifying the committee that there were members that needed to be recommended for reappointment to two of her boards.  Those names will be mentioned at the Executive Committee Meeting tomorrow evening for appointment.

RESOLUTION: GENOA-KINGSTON FIRE PROTECTION DISTRICT FOR 911 DISPATCHING CAPABILITES.

Chairman Allen said that the resolution before the committee this evening is just like the other one that the committee recommended last month from the City of Genoa for 911 Dispatching capabilities. 

Moved by Mr. Johnson, seconded by Mr. Rosemier, and it was carried unanimously to recommend the resolution to the full board for approval.

Before beginning the public hearings, Mr. Rosemier mentioned that he sits on the Elder Care Board and Ms. Fullerton mentioned that she sits on the Health Department’s Board.

SENIOR SERVICES TAX LEVY HEARINGS

Chairman Allen said that there was one thing that she wanted to say. She said that there was no question in her mind that all of these agencies are using all the monies that they receive.  She said to keep in mind that the levy only increased by $10,000.00 because of the assessments. 

Health Department

Ms. Karen Grush, DeKalb County Public Health Director, introduced herself to the committee.  She said that since 1998 she has asked for the same amount of money each year, which is $25,000.00.  The money will be used for the Home Care Program and the Hypertension Screening and Monitoring Program.  She said that the Home Care Program is available to individuals living in DeKalb County.  IN 2002, the Home Care Program served 947 individuals. Of these, 41% were male and 59% were female.  The majority, 98%, is Caucasian with 2% being other races.  Seventy-nine percent (79%) of the individuals served were 55 years of age and older.  This group is where they serve the seniors. 

In 2002, the program provided 17,900 home health visits to 947 individuals.  The costs per visit are estimated at $100 for skilled nursing, physical therapy, occupational therapy and speech therapy, $50 for home health aide, and $150 for medical social services.  Individuals not covered by Medicare are placed on a sliding fee scale based on income.  The Home Care Program is requesting funding to subsidize all or part of the cost of an estimated 400 home visits to 35 medically indigent patients.  The Senior Services Levy would be assessed the difference between the cost of the visit and the amount billed and received from the individual and/or Medicaid.

The Hypertension Screening and Monitoring Program.

According to the National Center for Health Statistics, it is estimated 8,641 DeKalb County individuals have high blood pressure and 6,463 DeKalb County individuals have heart disease.  Both nationally and in DeKalb County, heart disease is the leading cause of death, with strokes being the third leading cause of death.  The Health Department has conducted this program since 1975. 

Funding is being requested to help subsidize the cost of this program.  The program cost is $11,000 annually for staff salaries and miscellaneous supplies.  It is estimated in FY2003 the Health Department will screen 500 individuals by hypertension and monitor blood pressure on 250 diagnosed hypertensives.  In total, it is estimated 1,500 blood pressures will be taken. 

Ms. Grush said that this year that none of the monies awarded to them for this year’s costs were used for the Hypertension Program.  They have no money left. 

Chairman Allen asked Ms. Grush if the smallpox vaccine program that is on hold right and would the health department receive any funding from the government?  Ms. Grush said no, however, if someone comes in they will serve him or her anyway.

Voluntary Action Center – Trans Vac and Meals-On-Wheels

Mr. Tom Zucker, Director of Trans Vac and Ms. Ellen Rogers, Director of Meals-On-Wheels thanked the committee for their support with the levy.  Mr. Zucker said that they were one of the leaders of the campaign that passed the levy several years ago.  What motivated them to do that is the fact of the need of services and the costs of services that they provide were outpacing the grants that were available to them. 

During FY2003, VAC will provide 12,000 meals through the DeKalb County Senior Levy.  Vac proposes 13,500 meals at a rate of $6.00 per meal during FY2004. 

Mr. Zucker said transportation services that are being funded by the levy are being referred to as community transportation.  Community transportation coordinates, public transportation, special needs transportation, and medical need under one roof.  Certainly the services that they are providing under the levy are the special needs.  They target seniors for services under the levy by trying to identify those seniors that are at the greatest risk for premature institutionalization and the greatest need.  The market is growing and changing in demographics.  They have seen that the general public population that they provide service for has more health issues at a younger age and more financial problems.  The Med Vac provides services for out-of-town medical appointments. 

In FY2002, VAC provided 123,681 rides to DeKalb County residents through its transportation programs.  Twenty-seven, one hundred, seventy-one rides (27,171) were provided for senior citizens.  The Senior Levy funded 9,000 rides for 319 individuals. Funding for senior transportation includes an Older American’s Act Title III-B grant which funds 89% of 5,250 rides (requires 11% local match) and a Title XX grant which funds 75% of the cost of 10,188 rides (requires 25% local match).

In FY 2003, the Senior Levy will fund 10,000 rides to medical appointments and for essential shopping.  So far in FY2003, 305 people have received more than 5,000 rides. In FY2004, VAC proposes to provide 10,000 rides to medical appointments and for essential shopping.

They have seen a 50% increase over last year in gas prices and insurance costs have been challenging.  These both are reasons to request the increase in funding.

The funding request for Meals on Wheels of $81,000 will be utilized to provide 13,500 meals. The additional funding will be used to help eliminate the waiting list of people for service.  In addition it will provide for local match in many DeKalb County communities.  Mr. Rogers said that they have a waiting list now for this service.  She believed that there were 23 people on that list currently.

The funding request for VAC of $70,000 is for transportation services.  This request will fund 10,000 rides at a cost of $7.00 per ride.  Costs include the operating and administrative expenses for providing the proposed services.

Mr. Rosemier asked what the cost per meal is - will it remain the same? Ms. Rogers said that they anticipate some increases.  There is a Congregate Program, which is a program that occurs at various sites throughout the county.  Money is going to be taken from the program and transferred into Meals On Wheels.  There will be about a 20% transfer from that program.  It is taking away from one program to give to another and so you still have the same problem. 

Ms. Dubin asked if the MPO would impact their operation?  Mr. Zucker said that the impact of urbanization of a part of the county is primarily going to have any impact on transportation funding.  The grants that for many years, the federal grant that funded transportation throughout the County, would no longer fund transportation in the urban areas (DeKalb, Sycamore and Cortland).  We need to replace that grant.  That will be a loss of about $375,000 for those areas.  There are a couple of ways to replace that and one of them is a state grant known as Downstate Operating and the other is the Urbanized Federal Grant, the  Section 5307 Grant.  We are many months away in setting the federal grant in place.  The State grant may hold some promise.  July 1^st is when the change takes place.  They will have to cut back significantly on services if funding doesn’t come through.

Fox Valley Older Adult Services.

Mr. David Ruggles, Director of Fox Valley Older Adult, said that seniors need growth and they provide those with activities and spiritual growth.  Mr. Ruggles said that they serve 35 clients from DeKalb County throughout the year through their Adult Day Care Program. This program is designed for impaired adults, age 55 and older.  Currently, of the DeKalb County senior residents served, 78% are over the age of 70, 48% are aged 80 or older and 22% of the clients are aged 90 years or older.  They currently provide 7,000 hours a year of service.  Mr. Ruggles said that they are also looking at opening up a new location in the City of DeKalb by September 1^st to serve people up here in the northern part of the County.  They are respectfully requesting $30,000, which is no increase over last year’s request.

Family Services Agency of DeKalb County.

Ms. Betsy Steele and Mr. Bill Wilkinson represented Family Services Agency.  They are requesting $132,000 for their Assisted Living Program.  The Assisted Living Program provides assistance with the tasks of daily living to the elderly and frail-elderly residents of DeKalb County and is requesting funds to support the provision of those services. The County funds permit them to serve the low-income elderly population of DeKalb County. A comparison of service hours from December of 2001 to December of 2002 shows an increase in 2002 of 1,700 additional hours of service provided. 

Ms. Leifheit asked about the projected figures from last year.  It shows that you service 297,000 but actually 250,000 were served for 2002 so she is a little skeptical about the numbers, but doesn’t question the severity.  That gives her cause that the numbers may not go up that much.  Ms. Steele said that she understands but that they draw the projections from the data that they have.  Halfway through the year last year they were anticipating that they were going to serve a lot more people and that it didn’t happen.

Ms. Steele said that the hourly rate is $11.25 so therefore it is 11,733 hours of service.  Ms. Olson said therefore their hourly rate has stayed the same, so they are still maintaining their hourly rate of service and anticipate increasing their number of hours of service.

Opportunity House.

Mr. Stephen Chermansky and Ms. Jeannette Smith represented Opportunity House for the hearings this evening.  Mr. Chermansky said that they have 11 people who are at least 60 years of age.  Six of these people have severe or profound mental retardation. The other 5 people have multiple disabilities.  Some live in-group homes and others live with their families.  They also serve 13 individuals with Down Syndrome, a condition that causes a person to physically age faster than their chronological age.  Thus, their physical functioning declines, associated with the aging process, long before they reach 60 years of age.  Of those 13 people, 5 are age 54-57.  They will keep direct service time records by client, by the hour, for the program services.  We plan to provide 600 hours of direct service staff time during the year to elderly clients, said Mr. Chermansky.

They are requesting $15,500 for this program.  This is an increase over last year’s request due to several factors.  They would like to increase the hours of direct service from 400 to 600 hours for the year.  This increase is because of staff time necessary for personal care with the individuals.  Five of the individuals require total assistance with toileting and make numerous trips to the bathroom throughout the programming day.  Others require varying amounts of personal assistance with toileting.  A lot of staff time is being spent assisting clients in the bathroom and oftentimes, 2 staff at a time are pulled away from direct programming to administer personal care.  This money will pay for their staff hours for up to 11 ½ hours a week.  Currently it is around 6 ½ hours.  They will be losing some money over the next year probably from the State.  They don’t know how much though. 

Hospice.

Ms. Karen Hagen from Hospice introduced herself and briefly explained what Hospice does.  Ms. Hagen said that 3 years ago they applied for Medicaid certification and were approved for it.  Because of this, there are certain rules and regulations that they need to abide by in admitting someone into their program.  In the Transitions program they have to be certified by a physician and have to have been diagnosed with a life limiting illness and prognosis of one year of less, regardless of their treatment.  Sadly, most of their clients are served within a two-week time frame.  Most of the people who try to get their loved ones into the program want their loved ones not to be put in a hospital.  They have 55 direct care volunteers in their program that offer emotional support and care.  All but 2 of the 17 clients admitted into this program to date currently live in their own homes.  All but 2 of these clients have been 60 years old or older.  They are currently servicing clients in DeKalb, Genoa, Hinckley, Lee, Sycamore and Sandwich.

The total funding request for this project is $10,708.00.  This would be used to support an average of 15 senior Transitions clients per month at $51.00 per client per month.  It would also be used to support an average of 2 senior Transition client admissions a month at $34.00 per admission.  Also included in this request is the support of 1 team meeting per month at $17.00 per meeting and 2 chaplain hours per month at $17.00 per hour.  The request also includes $100.00 for the Transitions portion of the Direct Care Volunteer training.

Ms. Leifheit asked Ms. Hagen, since the Transitions program has been running since July 2002, how’s it been funded so far?  Ms. Hagen said that at the very beginning from the DeKalb County Community Foundation to actually be trained in the program and to bring the trainer here, because of Medicare regulations. 

Elder Care Services of DeKalb County, Inc.

Mr. Marshall Hayes, Executive Director, briefly reviewed what his agency does.  He stated that his agency is seeking funding of two programs, Case Management Assistance and Elder Abuse Investigation. They are requesting $20,000 for each program.  The goal of the Case Management Program is to make the aging services system work more effectively for older individuals and to assure that vulnerable older persons receive assistance appropriate to their needs.  The reason that they are requesting $20,000.00 this year is because last year they were awarded with $10,000 and moved through that money in 6 months.  They are also asking $20,000 for their Elder Abuse Program, he said.  In FY2002 they lost a $46,000.00 grant that they were using to help offset their costs of elder abuse investigations.  Because of that loss they were forced to cut back on their staff and on the service hours that they could provide to seniors in DeKalb County. 

The last point that he wanted to make is that he is aware of the other agencies that are requesting funding because he works very closely with a number of them.  For example the Family Service Agency provide in-home care with the tax levy money that they receive.  All of the clients that they serve in this in-home program are referrals from us.  They are actually cases that they have opened also and case coordinated.  Many of the clients that are served by Voluntary Action Center are also clients of his agency. Some of them are referrals from them and some of them come back to his agency.  This also is part of the case management program.  What he is hoping tonight is that “we” could raise our funding rate to be commensurate with these other agencies.

Ms. Leifheit, said, so you are proposing that we lower the amount or percentage of these other agencies funding?  We only have an additional amount of $10,000 to work with this year and you are asking for an additional $30,000.  So we should lower their funding?  Mr. Hayes says that he doesn’t want to put any number on it.  What I am saying, he further stated, is that this constellation of services, and my agency is included in this constellation of services.  We are providing at levels that are close to the other agencies, then we would like to be funded at or near their amounts, Mr. Hayes further stated.  Ms. Leifheit said, then we would have to cut them.   Mr. Hayes said, I understand that.  From my perspective, the tax levy money comes here, it’s not VAC money, it’s not FSA money, it’s tax money that comes in to be used for the purpose of that it was designed for.  That purpose is to keep seniors from being institutionalized.  Where that money goes is based on how valuable those services are to that mission.  So he doesn’t look to take money from anyone, I understand that there are limited funds.

Ms. Leifheit said that she understands that he needs more funding, there is not one agency here that doesn’t.  I find every one of them just as valuable as the other, she continued. 

Every agency had been heard and now the committee began discussion on the allocation of funds.  It was suggested that possibly in the future that the committee should look at other ways of funding the Health Department’s request through the County’s budget process.  The rest of these agencies are not county government offices like the Health Department is.  It was agreed that this subject would be talked about at the budget process.

Moved by Mr. Faivre, seconded by Mr. Osborne, and it was carried unanimously to allocate the funds the following way:  $25,000 to the DeKalb County Health Department; $-0- to Hospice; $12,000 to Elder Care Case Management Program; $7,000 to Elder Abuse Neglect Program; $120,000 to Family Service Agency; $30,000 to Fox Valley Older Adults; $10,000 to Opportunity House; $62,000 to Voluntary Action Center – Transportation; $74,000 to Meals On Wheels.

It was moved by Ms. Fullerton, seconded by Mr. Rosemier to forward this recommendation on to the full board for approval.

ADJOURNMENT

Moved by Ms. Leifheit, seconded by Mr. Johnson, and it was carried unanimously to adjourn the meeting.

                                                          Respectfully submitted,

                                                          __________________________________
                                                          Marlene Allen, Chairman

_____________________________
Mary C. Supple, Secretary