Sullivan County Democrat
Callicoon, New York
March 1, 2013 Issue
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Legislators wrangle with increasing health costs

By Dan Hust
MONTICELLO — The costs of providing social services in the county, including mandated ones, are getting close looks by legislators.
Social Services panel started
The Health and Family Services Committee agreed 4-1 on Thursday to create a Social Services District Review Panel.
If approved by the full Legislature on September 20, the panel’s five members – yet to be identified – will review the mandates and services associated with Safety Net, Temporary Assistance to Needy Families (TANF), Medicaid, Food Stamps, Home Energy Assistance Program (HEAP) and Adult & Child Protective Services.
Recommendations are due by December 15, with an eye toward cutting costs – even though these programs have state and federal mandates.
Committee Chair Cindy Gieger said a primary goal is “to try to phase out of” the Safety Net program, as “it costs us a tremendous amount of money.”
Still, she acknowledged that the timeframe is exceedingly short for such a study, and fellow legislators Kitty Vetter and Alan Sorensen worried about undertaking a review when now-retired Health and Family Services Commissioner Chris Cunningham’s replacement has yet to be hired.
But extending the timeframe, said Legislator Jonathan Rouis, would push the report past the date legislators need to take action on the 2013 budget.
“I think this group should be in place tomorrow and get moving,” Legislator Kathy LaBuda insisted.
LaBuda, Gieger, Vetter and Cora Edwards voted in favor, with Rouis opposed.
“I don’t disagree with the concept,” Rouis explained. “I just don’t know about the practicality.”
Commish Coming
County Manager David Fanslau told the Democrat that nearly two dozen resumés had been received for the Health and Family Services commissioner post, left vacant by Chris Cunningham’s retirement on August 31.
The county’s Personnel Dept. qualified 10 of those, he added, and he and a group that includes four legislators are interviewing six, with a hiree expected to be named by the end of this month.
Housing for the homeless
Elsewhere during Thursday’s Health Committee meeting, Gieger said the county is once again considering other ways to house the homeless besides local motels and hotels.
“We found out that costs paid to these hotels is higher than if someone came out of the area and stayed in their rooms,” she explained.
The county’s head social welfare examiner, Kevin Bennett, presented research from neighboring counties – but he didn’t necessarily find savings. For example, Orange County pays $850,000 a year to house 14-19 people in Newburgh.
By contrast, Sullivan County, which currently has about 75 homeless people it houses, spent $1.2 million on such costs for all of 2011, utilizing close to a dozen local hotels (of which around eight are “pretty much exclusive” to county use, said Bennett).
Upstate, Bennett found Cayuga County spent about $281 per person per day housing the homeless in two converted residences.
Legislator LaBuda, who sits on the Sullivan County Federation for the Homeless’ board, urged the county to help the Federation in its yearslong quest to land a grant to open up second-floor housing at its Monticello headquarters.
“There’s no way the county can do this without a grant,” acknowledged Legislator Edwards. “That’s a certainty.”
High mileage, no solution?
Also during the Health meeting, Edwards pointed out that the county’s Medicaid transportation rates – set by the state – are near the top statewide.
Community Services Director Joe Todora thought that’s because the county has little public transportation, but Legislator Gieger said her research indicated other counties with little to no public transportation have lower rates.
County Manager David Fanslau agreed, saying Delaware County – also with minimal public transportation – has a rate 50 cents lower per mile.
The county’s recent request to have those rates re-examined and lowered was denied by the NYS Dept. of Health, and Fanslau mused that legislators may have to appeal directly to their Albany representatives to affect what is already a $2.5 million bill in the first half of this year.
But it may not be worth trying – reducing the rates would save the state and federal governments money, but the county would not see any reimbursement or lowering of rates, said officials.
Sullivan County still has to pay around $28 million a year to the state, only part of which is for these transport costs and which is expected to rise in the next few years, pending a possible “cap.”
Health forum coming
In response to a recent report ranking Sullivan County almost at the bottom of several important health issues statewide, the county’s Public Health Nursing Dept. is planning a Community Health Improvement Forum.
Scheduled for Thursday, October 4 from 6-8 p.m. at the Ted Stroebele Recreation Center in Monticello, the free forum will include a report on local health statistics, a five-minute video titled “Is Inequality Making Us Sick?” plus a public discussion on solutions and a recognition of oncologist Dr. Kathryn Siebert.
There will also be door prizes and giveaways.

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