Genesee County Human Services Committee

Fiscal year 2023 was one of “rebuilding” due to the loss of helicopters and the tragic death of a pilot in April 2022. However, the number of ground ambulance calls hit a high, Mercy Flight Executive Vice President Scott Wooton says.

“We actually spent most of the year that fiscal year with only two helicopters as opposed to four, which we're now back up to. But it wasn't until June of 2023 that we took delivery of a third. And then in August, when we got our fourth. So certainly from the flight standpoint of things, it was a very low, very kind of down year for us in terms of being able to respond to the demand for services,” Wooton said during his annual report to county legislators this week. “Ground ambulance activity, as opposed to air ambulance, was the highest year we've had on record. And we've continued to see that's been a trend since 2009.”

A year-to-year comparison would show that air response was down, he said, and out of the 187 requests for air ambulance service, Mercy Flight completed 65 helicopter transports, and another nine were ground transports, he said. Another 78 of those 187 requests were canceled by the caller as not needed, “which is, generally a good thing,” he said, “and then 34 were canceled due to inclement weather conditions that prevented us from being able to fly.”

The nonprofit had to deal with a major financial and emotional blow when pilot James Sauer and a flight instructor died in a crash while aboard a Mercy Flight helicopter on April 26, 2022, in Elba. The company and staff have gradually recovered and built the fleet back up while not only maintaining but growing ground ambulance services, which Wooton opted to include in his report.

“In the past, we've always sort of reported on air ambulance activity in this meeting, but I did add in ground ambulance activity as well. Obviously, the grant that we request is really intended to support the air ambulance service; we have a separate contract with the county related to our ground ambulance service. But again, I figured we'll report on that as well,” Wooton said. “When we came to Genesee County and started performing ground ambulance service, we've just seen a continual sort of organic growth in requests and in transports for ground ambulance services. Certainly, we're receiving very generous support from Genesee County to ensure adequate staffing and stability in our staffing for our ground ambulance service. And that has been very much appreciated. 

“I want to make sure that's made very clear, that's been an enormous benefit for us and our employees. What we've committed to do and what we're doing is taking that support from the county and passing it right on to our providers in the form of pay increases,” he said. “And obviously, what that's done for us is helped to stabilize the staffing so that we're meeting the minimum requirements set by our contract.”

He said that Genesee County’s commitment to Mercy Flight EMS “is really a win-win” for everyone. It means having the infrastructure and systems already in place for that ground ambulance response. The county and nonprofit struck a deal that runs from Jan. 1, 2024, to Dec. 31, 2026, for $452,460 per year. 

“So just some more information on ground ambulance, we received over 10,000, almost 11,000 requests for service that resulted in about 8,300 instances of patient contact, most of those being transports to a facility, but that could be things like lift assists or a treatment release,” he said. “Again, these represent all-time highs for our system here in Genesee County. In November 2022, Mercy Flight EMS absorbed the New York State Department of Health certificate of need that had previously belonged to COVA in Orleans County. We made our best effort to continue to serve Orleans County with the 35 employees that we hired from COVA, and we continued to do that … until April 2023 when Monroe Ambulance obtained the contract for the six or seven towns in Central and Eastern Orleans.”

Mercy Flight EMS has taken those 35 employees and folded them into its Genesee and Niagara County operations, he said, which has helped stabilize staffing.

In looking ahead, Wooton said the nonprofit has hired several pilots, flight medics and flight nurses to replace some staffing lost through attrition over the past two years.

 “So I think, as of probably about a month or so from now, we're going to have a full complement of flight paramedics, flight nurses that are out of orientation, and many of them coming from other services where they have plenty of helicopter EMS experience or are very longtime ground ambulance paramedics that are looking to get their wings if you will,” he said. “So all signs are really pointing to Mercy Flight being back on firm footing and being ready to respond and help the residents and many visitors of Genesee County.”

Legislators who are part of the Human Services Committee tentatively approved Mercy Flight’s request for $12,825 in funding. The request will go to the full Legislature for a vote next Wednesday.

Genesee County Social Services Commissioner Carla Mindler hopes someone can fill a newly proposed hybrid job—pending county Legislature approval—that would combine youth bureau and child welfare in a merged position she feels would best meet her department's needs.

Due to employee resignations from two part-time Youth Bureau positions, a reassessment showed that one full-time youth program assistant/child care worker sufficiently works in lieu of those part-time jobs, Mindler said during this week’s Human Services meeting.

“So at the Youth Bureau, currently we have two full-time and two part-time positions, and in sort of working with the Youth Bureau and doing some restructuring, learning about the Youth Bureau and kind of seeing how things flow throughout the year, it's become pretty evident that really what would most benefit that area of DSS would be the two full-time positions (one each, a youth program assistant and youth program coordinator),” she said. “But then, I'm not sure we really need two part-time positions; however, I could definitely use one. So, what I would like to do is eliminate the two part-time positions in the Youth Bureau and create a full-time position that is half Youth Bureau and half child welfare work.

“So we will sort of divvy up the job duties dependent on what the need is really, if the Youth Bureau is very busy, which it does kind of ebb and flow, then they would be used heavily over there. And then they could help out in the cluster care unit,” she said. “So the childcare worker position already exists in DSS. It's the youth workers that work in our cluster homes, which are where, like some of the older kids, are placed that were maybe removed because of behavioral issues they are having, rather than there were allegations against the parents. So the childcare workers work with these children and with the families. So they would be splitting their time between those duties.” 

This type of collaboration will be the trend moving forward, she said, as the Youth Bureau is going to be a division of DSS. 

“So it's just like how I have different units right now. Right now, someone works in child welfare, but we also have adult services. So there'll be child welfare and the Youth Bureau, just two units of DSS essentially splitting their time,” she said.

She was asked about the seemingly incongruent job responsibilities and whether it was feasible to get good job candidates for this new hybrid position. Mindler didn’t seem concerned. She recently received communications from people new to the area seeking job opportunities in a youth bureau-type setting and has let them know there may be an opening in the near future.

As far as the experience required for this new full-time role, Mindler said she was careful about drafting the description. 

“The part-time person is often because it's an assistant position. They help out with the events and activities. And they will actually if they have kids that they're working with from the cluster homes, those kids could actually help out as well because it is more like assistant-type work. So that will be potentially some crossover that they'll be able to pull the kids in to have some time to help with the events. And then they won't be working with the kids on any sort of case management level such that they would need experience or training in child welfare,” she said. “That's why we were very careful. (HR Director) Anita and I worked on the job duties. I kept all of the youth program assistants, but I only pulled in the childcare worker duties that seemed appropriate for someone without having the training and experience in child welfare.”

The job would be established once the Legislature votes to adopt a resolution on March 13. It states that the full-time Youth Program Assistant/Child Care Worker position, CSEA Grade 9, is to be effective immediately upon legislative approval with a starting pay rate of $20.11/hour. 

The total cost of the newly created position will be $73,567.78 for calendar year 2024. State and Federal reimbursement ranges between 62% and 100%, as determined by case-specific eligibility.

Public Health Director Paul Pettit took a deep breath before launching into his annual report for Human Services Committee members Monday, covering everything from lead and radon poisoning to drug and virus wastewater analysis, skyrocketing preschool transportation costs, and some good news for Genesee and Orleans counties’ accreditation progress.

The  GLOW-based health department will be working from a $1.3 million grant for the next five years to detect homes with radon, mold and lead and remediate them for safer, healthier places for families — children in particular — to live. 

That program adds to a heavy advertising initiative to educate folks about the potential presence and dangers of lead in older homes. The department uses technology that can evaluate paint layer by layer — even six and seven layers deep — to sense if there is lead present, Pettit said. 

“Do you get a lot of calls to do this?” Legislator John Deleo said.

“We do,” Pettit said, underscoring that by telling the group there were 31 cases of children this past year with elevated blood levels of lead. 

The warning level has been a five, which the Centers for Disease Control just lowered to 3.5, he said. New York State has yet to catch up with that rating.

“New York State has not adopted that yet. But that is under discussion and consideration. If it does, that will increase the potential action in need, you know, for kiddos that may be poisoned, and we’ll need to go in and do more work within the homes,” he said. “So basically, if it's above five, we provide education information, but we don't really get involved from the action level on the environmental, the home side.”

Other funding measures have included a $10,000 grant for radon education, homeowners were reimbursed $145,857 through 2023 for a septic repair program, and a $250,000 grant will go toward a GLOW region interactive healthy neighborhoods program that runs through 2028.

The department also received a federal HUD lead educational and remediation grant of $2,455,000 to be used through 2028, and $248,266 from the Centers for Disease Control for lead education and assistance to homeowners, to be used through 2026; a $95,514 annual Healthy Neighborhoods grant for the city and town of Batavia through 2027; and $131,738 from the CDC for infrastructure, namely for staff retention and development. 

The department has been collecting data from wastewater for analysis about the types and amounts of opioids and various drugs used here and has been doing the same for viruses of COVID, flu, and RSV. The public can actually go online to the health department’s website and see the results of the virus collection to see a resident county's current status. 

When it comes to finances for the department, preschool transportation is taking much of the heat. The bill was $862,000 to bus those kids this past year, and “we will probably be pushing $1 million for busing preschool” this year, he said. Costs for transportation and center programs have been on the rise as an "underfunded mandate," he said.

“One of the drivers that’s really expensive is that more kids get referred.  You probably saw on the governor's proposal, she's proposing a 5 percent rate increase across the board. And then there's a 4 percent rider for rural counties, which we would fall under that bucket. So that'd be a 9 percent rate increase for early intervention,” he said. “And this is one of those programs that, again, we don't have a lot of control over the services that are provided … we do sit at those meetings, we send someone to all the meetings to have a voice, but ultimately it's a full committee decision on what services are provided, and then we are the payer. That's the way the system is set up in New York. You don't get full decision, but we pay the bill locally.” 

He shared enthusiasm for this year’s push to get the department nationally accredited with the Public Health Accreditation Board. (See also GO Health pursues national accreditation.) 

“So it's national standards. We haven't been accredited. We have not. We had about 93 percent of all of our measures fully and partially met in the initial push last fall. So they just want a little bit more,” he said. “We're close. Staff, I think, wants to get there. I want to get there. It's been a long ride. COVID slowed us down. And we're close, I think we'll get there pretty soon.” 

Genesee Orleans Health Department has until November to get all of its ducks in a row — an updated strategic plan and quality improvement projects added to some 90 percent of already completed requirements — to obtain state accreditation, Public Health Director Paul Pettit says.

Unlike other states, New York does not require its health departments to be accredited; however, Pettit and his staff have been steadily working toward that end goal as a form of best practices for the field, he said.

“It’s an optional accreditation at the moment, there has been discussion, and there are actually some states in the country that do require it. So Ohio requires all of their local health departments to be accredited. New York has looked at it, they have not made that a requirement yet, so currently, it is still optional,” Pettit said after delivering a similar message during the county’s Human Services meeting. “But we looked at this many years ago, and had discussions with the Board of Health and determined that this was a worthwhile endeavor, that, again, by gaining efficiencies and meeting certain metrics and standards, similar, like a health system or other type of agencies, it shows that you're using the public resources and dollars and making sure you're using them the best you can to deliver public health services.”

The department met around 90 to 93 percent of the requirements last year, and were told they needed just "a little bit more," Pettit said. So staff is back at it, with intentions to come back armed with more documentation and projects to resubmit for a hopeful approval in 2024.

And will this increase your opportunities for funding?
“Well, it does. I mean, so one of the things that we've really been, you know, pushing, is that, when you are accredited and you have that recognition, obviously, funders want to know, do you have systems in place? Do you have those partnerships? Are you using those resources appropriately, so when you're accredited, it basically shows that you are and that you've proven that you are, so it is something that you're starting to see more of, some grants,” he said. “Even putting that in there, are you an accredited health department, those type of things in New York State, one of the incentives, or the performance incentive funds this year, if you're accredited or working on accreditation, you're getting a little extra money, those type of things. So there are ways they're trying to encourage and or reward that process.”

There are 17 accredited health departments in New York, with the closest one being in Livingston County. 

The Public Health Accreditation Board oversees the accreditation process. There are 10 essential public health services, according to the organization’s materials:

• Build and maintain a strong organizational infrastructure for public health;
• Assess and monitor population health;
• Investigate, diagnose and address health hazards and root causes;
• Communicate effectively to inform and educate;
• Strengthen, support and mobilize communities and partnerships;
• Create, champion, and implement policies, plans and laws;
• Utilize legal and regulatory actions; 
• Enable equitable access;
• Build a diverse and skills workforce; and
• Improve and innovate through evaluation, research and quality improvements. 

Pettit’s department plans to work on remaining projects that will be put together with an application and submitted later this year, he said, as “about 90 to 93% of all of our measures are fully or partially met, which is what you need to be able to be accredited.”

“We're resubmitting some of the documents and updating ones, and we're working on that over the next six months, and then we'll go back in for the final decision,” he said. “We have ’til November to get it all in because it gives you a year to be able to put those documents together and put it in, but we expect to have them all uploaded prior to that. So we're looking forward to hopefully a good decision probably in early fall.”

In October 2022, Social Services Commissioner Carla Mindler was figuring out how to fill a gap when the STAR program ended, and the Student Transformation and Empowerment Program (STEP) was put in its place and operated at Robert Morris in Batavia. 

This year, Mindler had to find new space for STEP when she learned that Robert Morris would no longer be able to house the program and its middle and high school student participants after the end of this school year, she said. 

As it happens, she knew a guy who knew a guy — Ryan Macdonald of City Church — who offered to rent out a portion of St. Anthony’s for the county-run program. 

“So I'm looking to enter into a lease agreement with City Church, which is doing the business of St. Anthony's Church, to move the STEP program. We were notified by Batavia City School District that Robert Morris would not be available after the school year, so we've been looking for a site. We did find this location, it absolutely meets all of our needs,” Mindler said during Monday’s Human Services meeting. “We have access to all of the rooms, we have a gym, we have classrooms, we have an office. I had to go to the school district and ask that they terminate our lease early because it went through August, and we wanted to move in sooner just so we didn't lose the spot. And we're also hoping to move between when they're off for Christmas. So we're looking to start this January 1.”

The contract with the school district was $3,000 a month for Robert Morris, and it will be $3,500 a month for St. Anthony’s, she said. 

The program includes academic lessons, physical exercise, and behavioral therapists. It is considered a preventive program for at-risk youth within child welfare and prevention.

STAR had an ongoing contract for these services, and program leaders did not renew the contract last fall, leaving a potential void that Social Services personnel opted to pick up. That included the hiring of full-time adolescent behavioral specialists I and II, and a full-time adolescent behavioral coordinator to work directly with the youth in their homes and schools to mentor, guide and assist them with their required tasks.

There have been about 40 kids in the program, Mindler has previously said. 

“So we need two classrooms because we keep the kids separated by age, so kind of the middle school and high school kids. We have an office for the program coordinator, then we need access to the gym because we like to get them moving, especially in the morning. They do their exercises, calisthenics, and we have them back there in the afternoon,” she said. “We need space for when the therapist comes in and does group meetings with the kids. And so it's all right there kind of on the floor. It really checks all of our boxes. So we don't want to lose the space.”

The committee agreed to pass along the contract to Ways & Means, and then it will go to the full county Legislature for a final vote. 

If approved, the contract would be for $3,500 a month from Jan. 1, 2024, to Dec. 31, 2028, for St. Anthony’s Church at 114 Liberty St., Batavia. The expenses are paid out of funding for Community Optional Preventive Services, which are 36.3 percent local share, or $15,246 per year.