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HomeMy WebLinkAboutMinutes - 04-16-2001APPROVED 11!712001 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS ORANGE COUNTY BOARD OF HEALTH WORK SESSION APRIL 16, 2001 The Orange County Board of Commissioners met with the Orange County Board of Health on Monday, April 16, 2001 at 5:30 p.m. in the Government Services Center in Hillsborough, North Carolina. COUNTY COMMISSIONERS PRESENT: Chair Stephen H. Halkiotis and Commissioners Margaret W. Brown (arrived at 6:30), Moses Carey, Jr., and Barry Jacobs BOARD OF HEALTH MEMBERS PRESENT: Chair Jonathan Klein and members Barry Lynn Adler, Melvin Hurston, Alan E. Rimer, Martha Jane Stucker, Janet H. Southerland, Sharon E. Van Horn, Lee D. Werley III and Alice White COUNTY ATTORNEY PRESENT: Geoffrey Gledhill COUNTY STAFF PRESENT: County Manager John M. Link, Jr., and Clerk to the Board Beverly A. Blythe (All other staff members will be identified appropriately below} NOTE: ALL DOCUMENTS REFERRED TO IN THESE MINUTES ARE IN THE PERMANENT AGENDA FILE IN THE CLERK'S OFFICE. 1. WELCOME AND INTRODUCTIONS Chair Halkiotis welcomed everyone to the meeting and everyone was introduced. 2. ITEMS FOR DISCU551ON a. Strategic Plan for Orange County Health Department Dr. Klein thanked the County Commissioners for taking time from their busy schedules to hear their presentation. He said that this process took approximately two years. The focus of the plan is on strengthening mandated services because these services are critical to protecting the overall health of the public. He made a presentation. In summary Dr. Klein focused his presentation on high priority areas far the next year of the multiyear plan. This plan identifies gaps and weaknesses in services which is the basis the Board of Health will use for justifying additional programming needs. Alan Rimer said that the plan includes a report on wells and on-site wastewater treatment, food, lodging and institutional inspections and WTMP expansion. He emphasized that in 1999 a study was done at UNC which reported that the County is only providing 1/3 of the essential functions which are necessary for our citizens. The plan is recommending one additional staff person which will reduce the waiting time for permits to 1-2 weeks, work to identify failing systems and repair strategies and prevent waterborne disease outbreaks. The plan also includes one additional environmental health specialist for the food and lodging program and one environmental health educator for awareness and education effort. The Board of Health recommends one new person. Lee W rley III did the presentation starting with communicable diseases. The average cost of caring for a patient with TB is $20,000 per year. Six months of screening and preventive therapy costs $7,112 per case. He said that there is a 350% increase in communicable diseases. There is a need to increase outreach, education and surveillance. Regarding sexually transmitted infections, they need to integrate clinical functions at bath sites to optimize service delivery. One thing that would help in this effort would be to have computers, modems and software. Melvin Hurston talked about nutrition therapy and clinical health education services. He emphasized that the Health Department is not in compliance with maintenance of health education & nutrition protocols. Childhood obesity rates are high and adolescent eating disorders are rising. They need to review, revise and update protocols. The plan proposes a registered dietician with health education skills. He summarized the outcomes as listed in the report. He noted that changes need to be made in how the County bills Medicaid far services because Medicaid denials account far about $20,000 lost income each year. The plan calls for an additional billing support staff for both clinical sites. Sharon E. Van Horn summarized the childhood immunization-tracking portion of the presentation. She said that the County is not even close to meeting state standards fora "clean" database. The County does not know what the County's immunization status is far children under the age of 5. The report recommends an increase in the number of months from 10-12 for a public health nurse 1 position. She talked about services to limited English proficient residents and how the Health Department is handling the Asians and Hispanic/Latinos population. They are asking for afull-time medical interpreter. Dr. Jonathan Klein said that the total direct medical care cost of coronary heart disease in 1997 was estimate at $47.5 billion in the US and including lost productivity, the cost rises to $90.0 billion. He outlined why heart disease is the leading cause of death. The three primary preventable conditions are nutrition, fitness and tobacco use. The need as outlined in the report is to shift from screening to education. They want to change the environment to one which supports healthy lifestyles. He outlined the outcomes from a change in lifestyle. Dr. Janet Southerland talked about Dental Clinical Services for adults and children. The reasons for providing this mandated service is that many private dentists will not accept Medicaid, adult populations are even more severely limited than children. Also, a growing need among senior populations as identified by the Master Aging Plan and an unmet need among Medicaid children of up to 40% is not being met. The report proposes that positions be converted from time-limited to permanent and that the positions be transferred off of grant funding. Alice White talked about sheltering animals. She noted that the lease on the Orange County Animal Shelter will expire in 2006. There is a need to study and plan for a new shelter site and design. Commissioner Jacobs asked about the APS involvement with building a new shelter and Health Director Rosemary Summers said that the APS would be involved. However, who would run the shelter would need to be decided. The consultant would do a facility study and not an operational study. They have talked with the APS about the facility but not about funding a new shelter. Chair Halkiotis noted that there are a lot of groups in Orange County interested in animals and with developing an animal shelter. listed below: Rosemary Summers summed up the presentation by listing the long-range priorities which are • Improving Air Quality • Community Education for Animal Care • Media & Marketing program • Injury prevention program Expansion • Family Care Management Services • Provision of Clinical Primary Care Services • School-based health Centers • Jail Health • Increased Surveillance Mechanisms • Disaster Management for Animals Commissioner Carey made reference to emergency services preparation for catastrophes and how that may relate to the Health Department. Rosemary Summers said that one of the things they will be doing with EMS with a grant EMS received, is some tabletop exercises. They are in the process of planning far public health emergencies. b. Appointment Terms for Board of Health Members Dr. Klein made reference to his letter and his reasons for wanting to extend the terms of the members on the Board of Health whose terms expire at the end of June, 2001. It was decided that the County Commissioners would discuss this issue at an upcoming County Commissioners meeting. c. Other Items NONE 3. ADJOURNMENT With no further items for the County Commissioners to consider, a motion was made by Barry Jacobs, seconded by Commissioner Carey to adjourn the 5:30 portion of the April 16, 2001 meeting. The adjournment time was 7:20 p.m. VOTE: UNANIMOUS The next regular meeting is scheduled at 7:30 p.m. on this same evening at the Government Services Center in Hillsborough, North Carolina. Stephen H. Halkiotis, Chair Beverly A. Blythe, CMC APPROVED 11!712001 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS BUDGET WORK SESSION APRIL 16, 2001 The Orange County Board of Commissioners met for a Budget Work Session on April 16, 2001 at 7:30 p.m. in the meeting room of the Government Services Center in Hillsborough, North Carolina. COUNTY COMMISSIONERS PRESENT: Chair Stephen H. Halkiatis and Commissioners Margaret W. Brown, Moses Carey, Jr., Alice M. Gordon and Barry Jacobs COUNTY STAFF PRESENT: County Manager John M. Link, Jr., Assistant County Manager Rod Visser and Clerk to the Board Beverly A. Blythe (All other staff members will be identified appropriately below} NOTE: ALL DOCUMENTS REFERRED TO IN THESE MINUTES ARE IN THE PERMANENT AGENDA FILE IN THE CLERK'S OFFICE. 1. PAY AND BENEFITS PLAN FOR FY 2001-02 Elaine Holmes summarized the discussion from the County Commissioners' November work session on employee pay and benefits plan. She noted that the County Commissioners indicated they were pleased with the employee pay and benefits plan that had been in place the last two years. The County Commissioners asked that the County staff seek to improve the consistency in granting meritorious awards from department to department and asked her to bring back options far improvement of the County's 401 K plan contribution. The decisions far 2001-2002 are listed below: • Amount of COLA Increase • Amount of In-range Progression • Amount of the 401 K Contribution • Classification and Pay Study • Benefits far Domestic Partners The Manager presented two options for the cost of living increase. Option A would give County employees a 2.5°~ COLA/increase with the 401 {k) contribution increased to $20.00 per pay. Option B would give County employees a 2.75% COLA/increase with the 401 (k) remaining the same. He noted that the cost of living as measured by consumer price index increased 3.4°~ in year 2000. The Manager recommends that the in -range progression remain the same at 2.5°~. In terms of meritorious service awards, he reviewed with department heads the Board concerns about consistency. Also, he initiated additional training sessions. Based on July-March, overall consistency has improved both as to department participation and participation of employees at the lower salary grades. With reference to the 401 (k},the County contributes $15.00 per pay for each employee who participates. There are several options listed in the notebook. In terms of the classification and pay study, the County Commissioners supported moving ahead with the study. The study would cover all 725 employees and would include a market salary survey. A consultant would do the study and would recommend a salary implementation plan. Elaine Holmes asked that she be authorized to move ahead with an RFP for a consultant so she could return in June with a recommendation. The schedule would have a recommendation come back to the County Commissioners in the spring of 2002 sa that the implementation can be taken into consideration for that budget cycle. Benefits for domestic partners is in the packet. In answer to a question from Chair Halkiotis about the estimated cost for a consultant, Elaine Holmes said that this cost is based on the cost of other studies done in our area. The nine counties we would use for comparison are those counties that are facing a tight labor market the same as Orange County. Commissioner Gordon said that she would like to recommend adding Alamance, Person and Chatham Counties to the list. Commissioner Jacobs asked how the classification and pay study would take into consideration the organizational assessment that will be done at the same time. Elaine Holmes said that the study will take some time and she believes that they can include the positions, which would be affected by the organizational assessment. Commissioner Jacobs asked what one-cent on the tax rate will generate and Budget Director Donna Dean said 840,000 to 850,000 compared to $715,000 last year. Commissioner Carey made reference to page 10 and asked about the 401 K plan and if the $76,000 is the total cost of the $15.00 to $20.00. Elaine Holmes explained that the $76,000 is the cast of going from $15.00 to $20.00 per pay period. Commissioner Jacobs asked if the idea of not doing a percentage would have a greater impact on the lower paid employees and Elaine said that the flat amount plus a percentage would help with recruitment and also address the lower paid employees. Commissioner Gordon said that she thought a comparable worth study was going to be done. Elaine Holmes explained that a comparable worth study is very complex and it would be extended beyond this study. As part of this study, each job will be reviewed systematically and the study will cover pay equity. Commissioner Carey remembers Commissioner Gordon raising the question about comparable worth and said that he knows that the study would be complex but that the comparable worth part could be an add on to the RFP. Elaine Holmes agreed to add this as part of the request for proposal. Commissioner Jacobs made reference to the information in the agenda on recruitment of Hispanic/Latino employees and said that he would like to see the County have a plan far aggressively recruiting Hispanics and people with disabilities. He wants to knave what percentage we are interviewing, how many are offered positions, etc. Elaine Holmes said that that kind of information will be included in the next Affirmative Action Plan. She will use the census information and determine what kind of goals need to be set. Commissioner Jacobs made reference to meritorious service awards and asked if department heads were still included and Elaine Holmes said yes. He asked if everybody an the board feels that should be the case. Commissioner Jacobs asked why department heads would not be addressed through salary instead of meritorious service. Commissioner Jacobs said that he would like to reward department heads another way. Chair Halkiotis said that he still does not feel that department heads should be considered for meritorious awards Commissioner Carey feels we should look at all options available because department heads should have an incentive for doing their best. He would be interested in looking at options. Commissioner Jacobs said that first he feels we should pay people a competitive wage but that meritorious awards should not be paid to department heads. He feels that a department heads should have satisfaction in doing a good job. Chair Halkiotis asked if there is any movement toward rewarding county employees for presenting cast-saving ideas. Elaine Holmes said that she is not sure if the Innovation and Efficiency Committee will address this issue or not. Commissioner Jacobs made reference to domestic partners and asked if County employees were surveyed to see if anyone is interested. He suggested that if someone is interested, it may be cheaper to just buy that individual an insurance policy. He feels it is something the County should do but the upfront cost is a $25,000 surcharge and that is too much. He would like to see if it is an issue with County staff before adding domestic partner coverage. Elaine Holmes explained that they estimate 1 % or 7 employees may take this insurance. It will cost the County 1 % for all employees as a condition of participation. A motion was made by Commissioner Carey, seconded by Commissioner Gordan to authorize staff to begin the process for a Request for Proposal for the countywide classification and pay study. VOTE: UNANIMOUS 2. ORGANIZATIONAL ASSESSMENT -PLAN AND APPROACH John Link said that during the November pay and benefits work session, the Board of Commissioners expressed an interest in an organizational assessment and briefly discussed several possible areas for review. He is recommending that the Board consider the fallowing five areas which have been impacted by changes occurring in recent years: ^ Parks, open space and conservation ^ Solid waste ^ Services to the Elderly ^ Transportation ^ Public Information, communications and e-government John Link said that this assessment would involve using internal staff and outside consulting support which may not be the same far all areas but consultants who have expertise in specific areas. The time and scope would be similar to that used far the Y2K study. Elaine Holmes made reference to page three of the Orange handout, which listed the focus areas as listed above and said that staff is looking for guidance from the County Commissioners on the next steps. If the County Commissioners confirm that these are the specific areas and right approach, County staff will move ahead with a plan of work. If the County Commissioners da not agree with these specific areas or approach, County staff would welcome any further direction from them before continuing. Chair Halkiotis made reference to the list of possible focus areas. He made reference to the report heard earlier this evening from the Board of Health and noted that one of the long-term goals far the Board of Health was to improve air quality. He had asked Health Director Rosemary Summers if they work with the County's Department of Environment and Resource Conservation or the Commission for the Environment and she indicated that they da review the agenda but that the Board of Health does not really work with that particular department or commission on the issue of air quality. Elaine Holmes said that there will need to be a strong staff component to this study. It will be necessary to talk with the department heads to gather information. Commissioner Brown feels that there needs to be collaboration between the County's Animal Control division and the APS and wonders if this study could address that sort of organizational need. She wonders if this study would show where coordination and issues should come together. John Link said yes as it relates to specific issues as identified by the County Commissioners. He suggested that staff identify five ar six issues this year and indicate how they integrate with County government. Commissioner Brown asked if having a suggestion box would be appropriate or if these are the kind of Issues that this study would address. Commissioner Jacobs said that as the County Commissioners respond to these five focus areas that they will hear issues that ga beyond the study and can, at that time, take that information back to the County Manager. Commissioner Jacobs feels it would be good to let employees have input into this study. Commissioner Gordon said that she is shocked at the cost of this study and does not support spending $130,000 for a study. She feels internal staff could do some of this work. She said that not all of these issues are substantive issues for which money should be spent. She believes much of it could be done easily inhouse. She feels the County Commissioners should ask staff to do one or two areas and then report back to the Board. She does not feel that it will be the consultant's job to look at the interaction of all the departments and analyze the functions of all these departments. Commissioner Carey said that there are a variety of opinions of what should be studied and if a consultant should be used. He feels that it revolves on the credibility of the report. Part of the reason for doing any type of study like this is to get a fresh clear independent study so that the product will not be viewed as protecting one's turf from being scrutinized. We need to decide those areas for which we need to get a consultant. He has no interest in doing an inhouse study. The purpose is to add credibility that goes beyond our perception so that we can have this information. We need to decide what set of functions on which to focus. Chair Halkiotis said that it would be helpful if Elaine Holmes could find another County, which has done this sort of study and find out the pros and cans of doing such a study. Communications would be a good place to begin because all the departments communicating with each other would be a piece of this study. He also feels we should look at services to the elderly. Solid waste is being driven by outside forces and we need to be careful and get this under control. While Solid waste is important, he would start with Communications and move forward from there. Commissioner Jacobs agreed with Commissioner Carey. The NCACC recently did an organizational assessment and so did OWASA and TJCOG -three examples. He agrees with beginning with these five issues. Maybe communications should include Information Technology (IT} and coordinating the different areas. These areas need a new perspective and we would hope that we would get from this report alternative ways of doing things. He would add for solid waste that it is in transition from a landfill driven enterprise to a solid waste enterprise. He does not feel that we have the expertise internally to look at how to approach things differently. Also it would give our staff an incentive to look at different ways of doing things. He feels it will be good for the consultant to hear what the County Commissioners have to say about these issues. He supports this proposal. Commissioner Brown agreed with Commissioner Carey. She asked specific questions about what it would cover and what it would not cover. She asked about DSS and Health and Elaine Holmes said that it would not go into thane departments except as they serve the senior population. Commissioner Brown said that she would like to see one of these studies. John Link said that we can get copies of reports from other entities. When we talk about consultants, it may be that we have some resources at the University who may want to be involved in this study. Commissioner Brown asked if this would have levels of feedback from employees and John Link said that a consultant could do surveys that would get this information. Jahn Link said that he has no hesitancy at examining what we do. He feels that this organization works as hard as any organization he knows. The question is are we putting resources in the best location. Commissioner Brown feels that the Strategic Information Technology (I T) plan is crucial and should be included in the study. John Link will come back with examples and some potential resources that may be available from the University. Commissioner Gordon suggested using two different types of consultants -one for organizational structure and one for expertise in specific content areas. For the study on solid waste, she would like to see public works included. Chair Halkiotis made reference to IT and said that IT has to be looked at and suggested putting IT in the middle to indicate its importance as it reaches out to all of County government. He would like to know if there is adequate sharing of software. The GIS investment was money well spent. John Link reiterated that he will report back on studies done for other government entities, start examining what folks can do, internally and externally and add the concept of IT and the IT plan. He will report back on wham they can get to do the study. He will work with Commissioner Gordan and Commissioner Jacobs and the consultant an Transportation issues. 3. INTERIM CAPITAL INVESTMENT PLAN PROPOSAL Jahn Link asked that Donna Dean came forward to present the interim CIP proposal. He said that this does not have an impact on what we are now funding. He said that it is likely that all priority capital needs far County and School projects can be addressed solely through the November 2001 bond referendum. Also the amount of the pay-as-you-go funds in future years is limited. He outlined the interim proposal and listed the pay-as-you-go projects that will begin July 1, 2001. Commissioner Gordon asked if the 10-year plan would be changed. Budget Director Donna Dean said that one thing that changes from year to year is the amount of sales tax the County receives. Those projections have been revised downward for the next 10-years. Commissioner Gordon feels that it is really important to look at the needs for the next ten years and the money that it will take to fund the needs. It would be much better to work back and determine what needs to be funded by the bond. John Link said that he is suggesting that the CIP not be adopted at the time the budget ordinance is adopted but that adoption be postponed until it is decided what will be an the November bond referendum. Commissioner Carey feels that the projects will not change over the next ten years, but how they are funded may change. He sees no reason to do the CIP until it is determined what the band will include. Commissioner Jacobs asked how the County has handled bond years before and John Link said that this particular bond year presents a lot more opportunities and challenges. The County needs include Justice facilities, community college and other County space issues. The number of major projects have never been as numerous. There is going to be less money coming into the County and also some constraints. Commissioner Brown asked if it is better to postpone spending money as long as you can an a project. John Link said that it depends on the project. Factors that are positive for postponing would depend on the urgency of the project. Commissioner Brown said that we have a high school, middle school and an elementary school coming on line. She asked if a bond issue would be necessary if there was only one school district. John Link said that the needs are based on the dialogue that the County Commissioners have had with the two school boards. If the data indicates that this school or that school needs to be built by a certain time, the Board's policy is driving the County Commissioners forward to build the schools in time. Chair Halkiotis said that in two years if the Chapel Hill-Carrboro City Schools need another high school and Orange County's new high school only has 300 ar 400 students, would it Hat seem more feasible to have one system. lines. Rod Visser said that a dialogue needs to take place about sharing facilities across school boundary Commissioner Jacobs said that when the County Commissioners met with the two school boards, they indicated they would be looking at collaboration in specific areas so he feels they will pursue that direction. Commissioner Gordon asked if the bond committee has the information about the capacity and membership of each school. She requested this information which she indicated should be fonrarded to the Capital Needs Task Force. 4. OPEN SPACE TASK FORCE REPORT Environment and Resource Conservation Director David Stancil said that the Commissioner's task force has been meeting for the past few months. They have been working to try to integrate everything that has been done with open space over the past few years. He said that what has been prepared is very similar to the Lands Legacy document. Section B an the second page of the Executive Summary list the goals for parks, open space and resource lands. They are listed below: / Work toward completion of projects in the 1988 County Master Recreation and Parks Plan / Work toward completion of projects {acquisition and facilities) suggested in the 1999 Joint Master Recreation and Parks Wark Group report / Promote appropriate joint parks and open space projects between Town and County, consistent with adopted criteria / Acquire top Priority identified Natural Areas and Wildlife Habitat and Prime Forests / Acquire conservation easements on top priority Prime and Threatened Farmland in Water Supply Watersheds / Aggressively pursue grants and partnerships with other local governments and associations David Stancil continued saying that pages 4 and 5 lists the short-term priorities {2-5 years) for land acquisitions for parks, open space and resource conservation and park and open space facility development. He said that the Task Force would like for the County Commissioners to approve the Executive Summary and the two tables on pages 4 and 5 so that the report can be forwarded to the Capital Needs Task Force next week. In answer to a question from Commissioner Carey about soccer fields, David Stancil said that they have been integrated into both tables. Also, some soccer fields would be included in some of the facilities listed on page 2 of the report. Several questions were asked by the County Commissioners and were answered satisfactory by David Stancil. Commissioner Jacobs said that he would still like to see the County Commissioners make a statement about having abalance -north and south - in spending priorities. There is nothing in Efland or Fairview Park, and the vast majority of the spending is in the southern part of the County. He would like to see some sort of language to indicate that over the years, achieving a balance would be priority. David Stancil said that he needs to know from the County Commissioners what to share with the Capital Needs task force on April 25tH Commissioner Jacobs said that table I on page 4 seems fairly balanced but 3/4 of the money is going to one township. He feels it might be goad to have some undesignated money. Also, a master plan needs to be done for Fairview Park. Commissioner Gordon noted that table II is not finished. The Task Force used the information that was available at the time this document was written. John Link said that table I is consistent with the Lands Legacy Program and table II appears to be major recreational facilities as identified by the Towns of Chapel Hill and Carrboro. Also, the Recreation and Parks Advisory Committee still has their recommendation to come forward. David Stancil said that he will take all the comments made above and incorporate these into this document and have it ready for the County Commissioners to consider at tomorrow nights meeting. 5. ADJOURNMENT With no further items for the County Commissioners to consider, a motion was made by Commissioner Brown, seconded by Commissioner Carey to adjourn this meeting at 10:12 p.m. VOTE: UNANIMOUS The next meeting is scheduled for April 17, 2001 at 5:30 p.m. at the Southern Human Services Center in Chapel Hill, North Carolina. Stephen H. Halkiatis, Chair Beverly A. Blythe, CMC