MAY 27, 2004

ATTENDANCE: Jeannette Olmstead-Sawyer, Chair; Doug Sutton, Common
Council/Committee Member (7:40 p.m); Leona Williams, Common Council/Committee Member (7:40 p.m.)

STAFF: Tim Callahan, Director of Health; Linda Wilock, Director
of Youth Services

CALL TO ORDER

The Chair called the meeting to order at 7:40 p.m.

APPROVAL OF MINUTES OF APRIL 22, 2004

** CHAIRMAN OLMSTEAD-SAWYER MADE A MOTION TO TABLE THE MINUTES OF APRIL 22, 2004 UNTIL THE NEXT MEETING.
** MOTION PASSED UNANIMOUSLY.

HEALTH DEPARTMENT UPDATE

Mr. Callahan noted that a local pediatrician, Dr. Shah had recently run into a problem with the Medicaid Program, Vaccine for Children Program and the IRS. Mr. Callahan said that Dr. Shah pleaded guilty to the charges and that this has had an effect on her practice. He said that Dr. Shah was suspended from the Medicaid Program, her privileges at Norwalk Hospital were suspended and she is going to be sentenced to jail time in August. Mr. Callahan said that Dr. Shah has two part-time pediatricians working in her office. He said that neither one of them are credentialed at Norwalk Hospital and therefore cannot admit patients there, nor are they enrolled in any of the health plans. Mr. Callahan said that this poses somewhat of a challenge for the Health Department and the City because of the roughly 4,500 eligible HUSKY children who live in Norwalk, Dr. Shah’s practice accounted for about 1,500 patients.

Mr. Callahan said that he met with Dr. Mitchell Kresh, Chairman of Pediatrics at Norwalk Hospital and the Medical Director and Executive Director of the Community Health Center to try to come up with a plan. Mr. Callahan said that the Community Health Center is a federally qualified health center and is reimbursed at a much higher rate than a physician in private practice receives for the same Medicaid visit. They get their costs back, which is in excess of $100 per visit versus a doctor in private practice probably getting about $40 per visit. Mr. Callahan said there is a great opportunity for the Health Center to quickly develop a pediatric practice. He said hopefully the Health Department would make some progress in getting them ready to do this in the very near future. Mr. Callahan said that he would keep the Committee posted on developments.

Mr. Callahan said that it is unfortunate that this happened but at the same time, the Community Health Center was built to serve the people in our community and is constructed in a way to give them the financial wherewithal to deal with the Medicaid programs that are historically poor payers and to get this enhanced rate. Mr. Callahan said that his concern is that just before school opens there are a lot of children who need physicals and all of the pediatricians in town are booked. He said with one doctor who is a main provider out of commission this could cause a real problem. He said the Health Department is preparing to add some extra sessions. Last year pre-school physicals were provided in late August and early September. He said that this would depend largely on the availability of pediatricians.

Chair Olmstead-Sawyer asked about the process for hiring the doctors and nurses employed by the Community Health Center. Mr. Callahan said that there are actually two employers there. He said the Community Health Center employs support personnel, i.e., nurses, clerical staff, billing staff, Executive Director, Finance Director and Medical Director. The providers, such as the physician who work in Pediatrics and OB/GYN, the Midwives in OB, a Physician’s Assistant and a Nurse Practitioner in Pediatrics are employed by Norwalk Hospital. Mr. Callahan said that the Community Health Center has a contract with Norwalk Hospital where they buy the time for those physicians from the Hospital. The Hospital pays them and then bills the Health Center for that cost. He said that relationship is presently being reviewed. Mr. Callahan said that doctors are more apt to work in a hospital like Community Health Center because they make more money. He said they have a broad scope of experience because they do spend some time in the hospital.

Ms. Williams said that the only issue she has with the Health Center is that there is a gap in service as it relates to follow-up testing. She said that she hopes this will be looked at. Ms. Williams said she feels that the clinic is very accommodating and flexible with various schedules and gives more expedient service than private practice doctors.

Mr. Callahan said the Health Center will be adding more providers and will look at extended hours. Mr. Sutton asked if the idea is to pattern the Health Center after the doctor’s office. Mr. Callahan said yes. He said the idea was to have 3 distinct practices under one roof. Mr. Callahan said there are several areas in need of improvement. He said the Health Center does not have a team concept unlike the Health Department and this does not lend itself to a really great environment to work in. He said that hopefully in the next few months this would change. Mr. Callahan said that he would keep the Committee updated.

Mr. Callahan said that the Health Department has been approached by the Town of New Canaan and that the demand for environmental health services exceeds the capacity of the inspectors. He said that First Selectwoman, Judy Neville and David Reed, part-time Health Director contacted him and they are interested in purchasing environmental services from the Norwalk Health Department. Mr. Callahan said that in the spirit of cooperation and mutual aid it would be an interesting opportunity for the City of Norwalk to pursue. He said the inspections would be for various environmental matters such as food establishments, public pools, beauty salons, barbershops, wells and septic systems. Mr. Callahan said that the Town of New Canaan would compensate the City of Norwalk at a rate of $60 per hour. He said that is the rate that the City of Norwalk uses to determine the fees that they are going to charge for their services. He said this rate includes wages, benefits, travel and overhead such as supervision. He said the Health Department would like to pursue this opportunity. He said that this would benefit both the City of Norwalk and the Town of New Canaan. Mr. Callahan said that he is about to lose funding for a grant funded positions and the revenue generated through this initiative would go a long way towards covering those funds. Mr. Callahan said that due to increased construction in New Canaan and almost the entire Town in on septic system. He said that this would be helping them out while generating revenues for the City of Norwalk. Mr. Callahan said this is a pilot and that he would like to see how it goes for the next 6 months.

Chair Olmstead-Sawyer said that the Committee would vote on Items a and b together.

** MR. SUTTON MADE A MOTION THAT THE PUBLIC HEALTH & WELFARE
COMMITTEE a) AUTHORIZE THE MAYOR, ALEX A. KNOPP, TO EXECUTE
ANY AND ALL DOCUMENTS NECESSARY FOR THE PROVISION OF
PUBLIC HEALTH SERVICES TO THE TOWN OF NEW CANAAN FOR THE
PERIOD JUNE 15, 2004 THROUGH DECEMBER 31, 2004 AND b) TO
AUTHORIZE THE MAYOR, ALEX A. KNOPP, TO EXECUTE ANY AND
ALL AGREEMENTS AND INSTRUMENTS NECESSARY TO PROVIDE
PUBLIC HEALTH SERVICES TO THE TOWN OF NEW CANAAN AND ANY
AMENDMENTS THERETO.
** MS. WILLIAMS SECONDED THE MOTION.
** MOTION PASSED UNANIMOUSLY.

Mr. Callahan referred the Committee to a newspaper article with regard to the Allergy Bill. He said that Representative Bob Duff of Norwalk was instrumental in drafting legislation that is similar to the Good Samaritan law where someone administers emergency medical services in an after school program, they are covered by the Good Samaritan law so that they would not be liable if they acted in good faith.

YOUTH SERVICES DEPARTMENT UPDATE

Ms. Wilock distributed a chart outlining the services of the Youth Services Department, which includes Prevention Programs, Peer Outreach Group, which teaches skill building and decision-making and School Readiness Program. Ms. Wilock said that there are programs that Youth Services subcontract to Norwalk Economic Opportunity Now (NEON) for staff at Roodner Court. She said that the Counseling Programs serve middle and high school students 11 to 18 years old. She said that when fully staffed there is a Marriage and Family Therapist and two part-time people. Both part-time staff persons are Licensed Marriage and Family Therapists. Ms. Wilock said that there is a vacancy now that Youth Services has not been allowed to fill. She said that the Mayor intends on eliminating the counseling component of the Department. Ms. Wilock said that the Mayor has said that as of the end of the calendar year the remaining people will be no longer with Youth Services. Chair Olmstead-Sawyer noted a petition that she received with regard to this. Ms. Wilock said that the full-time counselor was responsible for the petition. She said that a lot of people have been calling the office because the program is very much needed. She said that Youth Services is serving primarily people who do not have the financial resources to go elsewhere. She said that until the vacancy came about they were able to serve people without a waiting list. Ms. Wilock said that Youth Services is trying to provide early intervention for youth. She said that these are not kids with serious psychiatric problems. She said that one of the Mayor’s concerns was that Youth Services does not have the same services as Mid-Fairfield Child Guidance does. She said they are not seeing the same range of cases and if they see a child with serious mental health issues Youth Services would make a referral to someone who could provide those services. She said that the Department of Youth Services sees children who might be under performing, been suspended for fighting, children’s who parents might have trouble controlling them, etc. She said that that this is really where prevention slides into early intervention.

Chair Olmstead-Sawyer asked what the rationale on the part of the Mayor as to why he would cut this particular area. Ms. Wilock said that the Mayor talked about having liability concerns, yet the Department of Youth Services has never been sued or threatened with a suit. Chair Olmstead-Sawyer asked if all the people who work for the Department Youth Services are qualified. Ms. Wilock said absolutely, they are all licensed. Chair Olmstead-Sawyer asked how Youth Services got clients. Ms. Wilock said referrals mainly come from the school system and also from Tony Daddona who does Administrative Hearings and Bruce Morris who is responsible for Sexual Harassment and discrimination cases. There are also referrals from other agencies and the Police Department. Ms. Wilock confirmed that the Department of Youth Services handle cases beyond regular school counseling.

Ms. Williams asked how many cases Youth Services handles per year. Ms. Wilock said that for eleven months thus far they have served 96 and 12 are on a waiting list. Ms. Wilock said that the Mayor made some reference that the cases presently handled by the Department Youth Services going to Mid-Fairfield Child Guidance but there is nothing firm in the works that she is aware of. She said this is a real concern. There was discussion with regard to a hand out regarding the Mayor’s position. Ms. Wilock said that the program has been instituted since 1978. Chair Olmstead-Sawyer asked Ms. Wilock if a written report as to the progress of various individuals who are part of the program is generally given because she is trying to figure out why a program that has been going since 1978, suddenly there is concern about being sued when they have not been sued in all those years. Ms. Wilock said that a report is generally given and she has never heard of any complaint. Ms. Wilock said that there is no conflict with Mid-Fairfield Child Guidance and that the two agencies work together. Ms. Wilock said that under the Mayor’s plan, 3 positions would be eliminated. Ms. Williams suggested having a Public Hearing on this issue. Chair Olmstead-Sawyer recommended scheduling a Public Hearing on this item before the next Common Council meeting.

OTHER BUSINESS

Chair Olmstead-Sawyer asked Mr. Callahan what was going on with regard to Aids in Norwalk, especially among the minorities. Mr. Callahan said there would be a series of health fairs in the City. A week of health fairs is scheduled for late June. He said the Senior Center will host one and there will be discussion with regard to people being tested.
Chair Olmstead-Sawyer said that Mr. Callahan reported that there is no increase in the City yet on the national level there is an increase. Mr. Callahan said that he could give the numbers that he has collected and he does not know if there are people who are not being tested so that the Health Department has no knowledge of it. He said that he would do some research and report back to the Committee.

Chair Olmstead-Sawyer said that, with regard to playgrounds around town, there is a lot of standing water in the different complexes and kids are playing it. She said that this is a health concern. She said that Washington Village is one complex in particular. Mr. Callahan said that this is probably due to a lack of maintenance. He said that he would ask someone from the Health Department to go to Washington Village and take a look. Mr. Callahan said that the action that the Health Department can take is the Larvicide Program. He said it is a non-toxic organic material that works on mosquitoes. The material is put in catch basins and applied to swampy type areas and lasts 30 to 60 days. He said the program would begin in mid-June and would be applied again in July.

ADJOURNMENT

** MR. SUTTON MADE A MOTION TO ADJOURN THE MEETING.
** MS. WILLIAMS SECONDED THE MOTION.
** MOTION PASSED UNANIMOUSLY.

The meeting was adjourned at 8:49 p.m.

Respectfully submitted,
Linda L. Custis
Telesco Secretarial Services

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