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HomeMy WebLinkAboutMinutes 08-30-2012 APPROVED 10/16/2012 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS WORK SESSION August 30, 2012 7:OOpm The Orange County Board of Commissioners met for a Work Session on Thursday, August 30, 2012 at 7:00 p.m. at the Southern Human Services Center, in Chapel Hill, N.C. COUNTY COMMISSIONERS PRESENT: Chair Bernadette Pelissier and Commissioners Valerie Foushee, Alice M. Gordon, Barry Jacobs, Pam Hemminger, Earl McKee, and Steve Yuhasz COUNTY COMMISSIONERS ABSENT: COUNTY ATTORNEY PRESENT: John Roberts COUNTY STAFF PRESENT: County Manager Frank Clifton, Assistant County Managers Gwen Harvey and Michael Talbert and Clerk to the Board Donna S. Baker (All other staff members will be identified appropriately below) 1. District Court House Tour— Court Proqrams Overview Head District Court Judge Buckner made a PowerPoint presentation. Judge Buckner gave some background information prior to the start of the PowerPoint. He said that there is an 18-20 year history that shows that the rules were often made in Raleigh. Orange County District Court House Tour Court Programs Overview Hillsborough, NC January 23, 2012 Current Jail Situation �:� The Orange County Jail averages around 150-155 inmates per day �:� The jail is filled nearly to capacity �:� By housing and transporting federal inmates, the Sheriff's Department brings revenue in through federal reimbursements �:� Approximate Average Daily cost per inmate - $48.00 �:� Total projected cost for upcoming fiscal year - $3,815,127 Sentencinq Chanqes for Misdemeanants �:� 90 days or less - Placed in jail; no change here. o Funded through local government �:� Between 90 days and 180 days — Law passed in 2011 places these offenders in county jails, reimbursed by the DOC, a local cost. �:� Over 180 days — Placed in Prison o Funded by Dept. of Corrections Pretrial Services �:� Provides the judge with release from jail options for offenders - �:� Supervision for offenders with pending charges �:� Investigates inmates for appropriate recommendation �:� Facilitates placements for problems that manage offender risk factors such as mental health or substance abuse treatment �:� Pro-active on strike order supervision, preventing jail costs on the "front end" as well as avoiding costs after arrest Pretrial Services Creates a Social Safety Net: �:� Calls attention to poor risk factors & revokes non-compliance promptly with re-arrest �:� TREMENDOUS COST SAVINGS: 300 inmates released through pretrial at a savings of$70 per day annually Example: average 12 days saved per defendant X $70/ day (jail costs) X 300 releases = $252,000 saved �:� Cost sharing of overhead ended with state grant 6/30/2011 �:� Admissions for services increased 100% from two years ago $54,000 increase needed to cover program costs over the $70,000 allocation from last year @ 70% cost in 15-B cost sharing of overhead ended with state grant last fiscal year Druq Treatment Court �:� Goal: Rehabilitate drug and alcohol offenders while also saving our justice and judicial system's valuable resources in the long run. �:� Method: Hold chemically dependent offenders accountable by requiring them to meet rigorous court ordered treatment plans for a MINIMUM of 12 months. �:� Results: Over 2/3 remain in treatment for over six months. Overall: Effective in rehabilitating offenders while also saving resources. Problem: Druq Treatment Court's State Fundinq Cut �:� In the state budget, Drug Treatment Courts were eliminated leaving district courts searching for funding from local and other sources. �:� For FY 2011/12 — Orange County Commissioners approved $67,000 to keep the court operational �:� In 2011 DTC served 61 offenders and graduated 13. Currently, we have 38 participants in this court, 3 of which are in long term residential programs. DTC Cost Savings An example of cost savings: From July to September 2011, we had 5 graduates with suspended sentences totaling over 7 years in prison, however, they served a combined 12 days jail while in DTC, totaling $763.80 (12 days jail* 63.65). This county and the state did not have to pay for approximately 2543 days of jail/prison, or approximately $161,862. Community Resource Court �:� Goal of Community Resource Court: Collaboration between mental health and judicial professionals to provide support for offenders suffering from diagnosed mental health conditions. �:� Method: Require these offenders to complete CRC court, as a way to keep them out of trouble, rehabilitate them, provide support, and eventually have their charges dropped. �:� Results : Around 50 participants per year/Orange Co. only— (54 in 2010) Graduation rate has averaged 50% over the last 10 years. Local studies show recidivism is slowed after CRC involvement. What is Community Resource Court? (CRC) CRC was created to address the treatment needs of people with mental health issues who became involved with the criminal courts. �:� Links offenders with services and supports that help them to better manage their mental illness. �:� Also called "Mental Health Court" because it helps people address their mental health needs as well as helping them to be law abiding residents. �:� Funding is $189,000 per year which comes from DHHS and covers the salary and expenses of the program manager and care coordinator-covers both Orange and Chatham Counties �:� Currently there are no funds that cover court administrator, judges, or attorneys time �:� The total number served since 2000 in Orange County: 780 Dispute Settlement Center: �:� The Dispute Settlement Center is the original and model mediation center in NC, founded in 1978 by concerned citizens with support of Orange County Board of County Commissioners. �:� DSC serves 3000 people a year through Mediation, Public Disputes, Training and Youth Programs. District Court Mediation �:� DSC's core program for over 30 years �:� FY 12 state budget eliminated the allocation to DSC for court mediation: $60,227 �:� Mediators worked with an average of 200 cases/year with 85% resolution rate for mediated cases �:� Mediation saves court time and effectively moves cases through the system Commissioner Foushee arrived at 7:13 PM. Commissioner Yuhasz asked about the Mental Health Court and how it is funded. Judge Buckner said that it is funded by the Department of Health and Human Resources. Commissioner Yuhasz asked if this funding was going to be terminated. Judge Buckner said that it is such a small problem that the State has indicated that it will continue to sustain it. Commissioner Hemminger asked Judge Buckner what he was looking for in a new jail. Judge Buckner said that most of the time they are trying to deal with dockets of hundreds of cases, so it is critical to the operation of the court to get people into queue. In the design, there should be the capacity to meet with more people that are incarcerated. Chair Pelissier asked Judge Buckner to comment on the effort of improving the homelessness population. Judge Buckner said that they have been trying to keep up with this population and coordinate services when these individuals are in court. This has been successful. Commissioner Jacobs suggested looking at who the County will be building the prison for and what other resources/programs are there. He asked Judge Buckner what he would like to see the Board of County Commissioners do. Judge Buckner said that the State mandates are on the prison population. He said that it is worth a look. He said that a lot of other people need to weigh in on this conversation. Commissioner Jacobs said that if the County was proactive, this would be a good time to bring together stakeholders to look at other alternatives to decrease the prison population. Chair Pelissier agreed with Commissioner Jacobs. Sheriff Pendergrass said that daily it is an operation of manipulation to keep the numbers between 135-140 people each day. He said that he tries to keep the jail population at a number that is safe to manage. He said that there are over 600 people on probation in Orange County and at any given time, 5-30 will violate probation and come back to jail without notice. Many unpredictable factors in running a jail and they also never know at any given time how many female inmates they will have, which creates a problem too. He said that there has to be a new jail with a capacity of about 250 inmates. The old jail can be used for misdemeanors, etc. He said that there are 30-40 people that are continuously brought into jail off the streets from Chapel Hill and Carrboro, and they are street people. He said that it is like a revolving door, and there need to be other places for these people besides the jail. Commissioner McKee said that in the long run it will be imperative to look at a new facility and he liked the idea of looking at alternative means to treat these homeless people. Frank Clifton said that on September 11 th the Council of State will meet about the County's request for a long-term lease on property for a future jail site. He said that additional jail space is needed for female inmates and alternative programs. Chair Pelissier said that she would hope that the Sheriff and everyone in the criminal justice systems will be involved in the creation of a new jail and the County needs to look at this and alternative programs simultaneously. 2. Draft Comprehensive Assessment of Emerqency Medical Services and 911/ Communications Center Operations Study Michael Talbert said that the County Commissioners will be receiving a final draft Comprehensive Assessment of Emergency Medical Services and 911/ Communications Center Operations Study. The County Commissioners approved this in December of 2011 and it has taken a little over six months to complete. It has been thoroughly vetted through the Emergency Services Work Group. Steve Allan, from Solutions for Government, was present to give an overview of the report. Steve Allan made a PowerPoint presentation. The call volume in 2011 was 10,719, which was an increase from 10,420 in 2010. The primetime of the day for calls is from 9:00 a.m. to 9:00 p.m. He explained the turn-out time and the travel time, which total the response time. Regarding the Emergency vs. Non-Emergency Response Times, he explained that Emergency is a response with lights and sirens and Non-Emergency has no lights or sirens. The Average Event Duration Time is the time it takes for the vehicle to respond to an emergency, transport the patient, and be ready to respond again. The increase in this is a combination of the travel distance and the backup in the emergency vehicles. The issues of concern are: Availability of Ambulances, Response Times, and EMS Facilities. Availability of Ambulances During 2011 ambulances were directed to "MOVE" 2,360 times from their identified staging area or location to another point in the County because: a. The number of ambulances immediately available was down to one (1) and the subject ambulance was directed to move to a location (typically) near the center of the County in anticipation of being able to respond in any direction the call may direct. or b. In tracking the status of multiple ambulances, the Communications Center and/or EMS Supervisor(s) noted significant area gaps in coverage and redirected movement of ambulance(s) accordingly. Steve Allan said that moving ambulances this many times is significant. Response Time "The time from the initial alert or announcement by the Communications Center of the reported emergency, to the time that the service vehicle and appropriate personnel arrive on the scene." The factors that most commonly impact response time include: - The time required to access and engage the vehicle - The speed at which the emergency vehicles is able to travel - The distance that must be covered to the incident dispatched, and - Under what conditions Consequences of increased response times for cardiac arrest/stroke: 0-1 minute; cardiac irritability 0-4 minutes; brain damage not likely 4-6 minutes; brain damage possible 6-10 minutes; brain damage very likely >10 minutes; irreversible brain damage Response Time ".....have recommended that EMS vehicles should respond to deliver BSL (basic life support) skills within 3 to 4 minutes, with ALS (advanced life support) skills available within 6 to 8 minutes. The ALS-within-8-minute concept was developed from research that showed the survival rate of cardiac arrest victims decreases significantly with each passing minute, and that optimal probabilities for survival increase when BLS has been provided within 4 minutes followed by ALS within 8 minutes." American College of Emergency Physicians American Heart Association American Association of Orthopedic Surgeons National Fire Protection Association He said that it is a concern that the average response time in 2011 was 10:47. Response Time OCEMS Agency Standards per System Plan: For Emergency Responses; .....a paramedic on scene within 12 minutes 90% of the time For Non-Emergency Responses; ......a paramedic on scene within 15 minutes 90% of the time Although not acceptable to the referenced standards setting and professional organizations cited, concern can be offset somewhat by effective and timely response from certified BLS responders; i.e. certified Medical Responders (MR) and Basic Level Emergency Medical Technicians (EMT's). In Orange County, these responders-per the OEMS System Plan-are comprised of members of the 12 municipal and community Fire Departments. South Orange Rescue Squad (SORS): - 57 certified EMT's - 36 on OEMS Roster w/NCOEMS - Share duties w/OEMS on Medic 8 - 3-4-3-4-3 alternating schedule - Includes use of SORS' 2-BLS ambulances Average Response Times: All rescue squads: 5:53 Volunteer rescue squads: 7:59 Career rescue squads: 5:02 Response Time Average vs. Fractile Response Time Performance Criteria Given what has been learned about the need for an eight-minute response to maximize survivability from cardiac arrest, an average eight-minute response, by definition, means that one-half, or more, of the service's patients are not reached within that critical time. Many high-performance emergency ambulance services use a different methodology to measure response times to ensure service equality to all patients: fractile distribution; in most instances as suggested by NFPA and others, reported at the 90t"percentile. EMS Base Facilities ....EMS "staging" locations Orange County EMS, like Law Enforcement, is an ongoing and at times almost continuous service that functions 24 hours a day throughout the entire County. Its services are far from occurring on a "periodic" or "sporadic" basis. This concern (facilities) must be addressed as a long-term issue. And, it must dovetail with the Ambulance Availability and Response Time issues previously addressed. Steve Allan said that Orange County does not have any base facilities and the locations lack a lot. EMS Base Facilities An EMS facility must include at least, the following type of spaces: - Indoor, temperature controlled vehicle bays with exhaust ventilation and recharging stations - Secure equipment, materials and medication storage - Special storage for certain narcotics and refrigerated medical supplies - Decontamination showers for personnel - Decontamination/wash areas for equipment - Space for air drying decontaminated equipment after washing - Storage accommodations for contaminated clothing, waste, sharps, etc. - Accommodations for the handling of inedical gases (oxygen) - Laundry facilities - Food preparation and dining space - Common/dayroom space - Multipurpose storage space - Staff restrooms - Technology to permit wireless internet capabilities, phone, radio, and pager communications - Public entrance and space to accommodate meetings with visitors The actual issue of Fire and EMS "sharing" facilities is more complex: - The ultimate purpose (mission) of each is different - Fire Department service areas are specific and limited - EMS service area is the entire County - The schedules of each are different - EMS may run continuously for extended period(s) of time - Fire will more often respond to "periodic" incidents - The work habits of each are different - The facility requirements of each are different - Fire Departments are visible within their respective communities - Existing Fire station locations are not strategically located to adequately address the deployment of EMS vehicles - To push the "sharing" of these facilities would simply continue a practice that has already worn out its welcome EMS Base Facilities 8:00 Minute RT Coverage 19 Stations 204 FTE's VS. 6 Locations 63 FTE's Total Personnel Cost $10,135,975.82 Less Existing Budget Personnel Cost $ (3,703,295.00) Less est. Overtime Savinqs $ (200,000.00) [1/2] Total Net Cost Addt'I Personnel $ 6,232,680.82 12:00 Minute RT Coverage 9 Stations 97 FTE's VS. 6 Locations 63 FTE's Total Personnel Cost $ 4,818,233.16 Less Existing Budget Personnel Cost $ (3,703,295.00) Less est. Overtime Savinqs $ (200,000.00) [1/2] Total Net Cost Addt'I Personnel $ 914,938.16 Issue: Availability of Ambulances R-1. Adjust Medic 5 and Medic 8 Coverage Hours - Move Medic 5 from 6:OOam-6:OOpm to 9:OOam-9:OOpm - Move Medic 8 from 6:OOpm-6:OOam to 12:OOpm-12:OOam R-2. Add ALS Ambulance 9:OOam-9:OOpm @12 hrs/7 days R-3a. Utilize available SORS/BSL ambulance for non-emergency transports; the basis being to free up ALS units to reduce travel time to/from medical facilities and be available sooner to respond to emergency status calls. R-3b. OEMS to staff a BLS ambulance to be available for non-emergency transports; the basis being the same as 3a, however in the event that SORS/BLS ambulance is not available. R-4. Assess Fire Department capabilities necessary to meet MFR Response Time objectives; via independent assessment of call volume, roster, paid vs. volunteer personnel, vehicles, base location(s), past call locations, included map grids, existing funding, and anticipated performance requirements. R-5a. Schedule and implement Fire Department MFR initiative with included performance objectives. R-5b. Staff and equip four (4) EMS/QRV's for assignment 12 hours/7 days; with shift start/end times to be determined by EMS. R-6. Staff and equip six (6) 12 hour/7 day ALS ambulances at appropriate staging/base facility locations proximate to (1) Zones 1 & 2, (2) Zones 7 & 5, and (3) Zones 6 & 8. R-7. Hire Paramedic Level Shift Supervisor @ 24/7. R-8. Prepare a detailed Space Needs Assessment that addresses the essential building and site requirements to accommodate a stand-alone, functional, code compliant EMS base facility that can serve as a prototype for all future facilities. R-9. Identify a minimum of nine (9) strategic locations, preferably no less than one (1) location within each major Zone for the potential location in each of a future EMS base. R-10. County to purchase/obtain identified sites (and/or buildings) for development. R-11. Procure EMS base planning and design services. R-12. Advertise, bid, and commence construction on designated EMS base facilities. Steve Allan said that the growth rate for Orange County is the highest of its neighboring counties. 911/Communications Center Orange County's emergency services network, which includes virtually all of the public safety agencies operating in the County, could not exist; i.e. could not begin to approach the general public's expectations of it, without a sophisticated emergency communications system. Issues of Concern Staffing: During the course of study, the Communications Center: - Total allocation of 30 full-time positions - Plus one (1) Operations Manager; 31 total During that time: - Nine (9) of those positions were either vacant (5) - Or in training (4) and therefore unavailable If you "know": - The number of positions to be filled - The hours/year each needs to be in service - The hours/year a single employee is available You can: - Calculate the Position "Relief Factor" used to - Determine total staff required Position Coverage Annual Hours Hours Available/Yr. Relief Factor Required/Position Per Employee 24 hrs/7 days 8,760 1,718 5.10 12 hrs/7 days 4,380 1,718 2.50 Staffinq If you want to determine the number of post positions to be filled based on workload: The number of positions needed to adequately handle the call volume can be calculated based upon a formula matrix which utilizes: Average call Duration: 102 seconds Peak Call Rate/Hr. 236/hour Staffinq In addition, and currently missing from the Communications Center; i.e. one having this level of Telecommunicator staffing and annual call volume: 1. FT Data System Manager 2. FT Quality Assurance Officer 3. FT Training Officer The need is CRITICAL! Data The communication Center's; i.e. the County's; technical capabilities were not up to speed, nor have they been up to speed in the eyes of the agencies it serves. The information is there! Its accessibility and the format in which it exists has been a problem. It's 20 years old! Issue: Staffinq R13. Hire a full-time dedicated Data System Manager to be located as close as possible, preferably adjacent to the Communications Center, and answerable first to the Communications Center Operations Manager. R14. Hire a full-time, dedicated Training/Quality Assurance Officer to be located as close as possible, preferably adjacent to the Communications Center, and answerable first to the Communications Center Operations Manager. R15. Anticipating increasing responsibilities due to the number of personnel forthcoming, hire an additional fulltime Training/Quality Assurance Officer no later than the end of year 3. R16. Prepare a schedule for the hiring and training of the identified Telecommunicator positions and identify date to begin solicitation of applications. R17. Hire the 17 new, full-time Telecommunicators. Issue: Data R18. Purchase necessary AVL vehicle hardware for each new EMS vehicle purchased to enable compatibility with newly purchased CAD software and existing AVL system hardware. R19. Following the installation of recently purchased Communications Center software and the training of in-house personnel; organize and provide informational meetings to emergency service system users, particularly Fire Departments and Law Enforcement, with regards to the system's capabilities and the information that will be available to them for their use. Commissioner McKee said that this may be a bit overwhelming but it can be implemented over time. He said that this is a needed study and he would like to implement what they can as quickly as possible. He said that it is critical to get feedback from the Board of County Commissioners to the work group and then come back with a final report. Commissioner Hemminger said that she is concerned about some of the facilities and their placement because of lack of cell phone coverage in many areas of the County. She wants to be proactive with this report. Frank Clifton said that the telecommunications analysis is also going on right now, so there is a potential that this analysis will bring forward some cell towers that could be located. Commissioner Jacobs thanked Commissioner McKee and Commissioner Foushee for working on the Emergency Services work group. He made reference to the extra 15 seconds to take information when dispatching calls and he asked if ambulances would be added. He asked staff to come back with an implementation plan with the costs of adding ambulances. Steve Allan said that the key to feedback in those arenas is going to be important as to who you ask and has diverted this Board in the wrong directions for years. He said that the facility he quoted is bare bones. He said that he was impressed with Orange County in that it has asset management and all are involved in the decision making of the purchase of ambulances. He said that he was not prepared or asked to come up with the type of vehicle for Orange County to purchase. Commissioner Jacobs asked if the work group would be recommending the priority of order for these recommendations. Commissioner McKee said that it has not been decided yet, but his idea is to get feedback from Board of County Commissioners and incorporate it into study, and for the work group to come back with a general list of recommendations with what could be implemented the most quickly and with the least cost. Steve Allan said that he is still responsible as the County's consultant to meet with the fire chiefs, etc., and to have a public meeting to provide them with a presentation so the County Commissioners can provide him with suggestions and feedback. Commissioner Foushee said that it seems it would be easier for the work group to make suggestions in depth after hearing these comments and feedback from stakeholders and the public. Commissioner Jacobs said that he would like to see a recommendation from staff or have someone put these recommendations in priority order. Commissioner Gordon made reference to the methodology and said that she wanted to know more about the variability in the response times. She made reference to page 30 at the top and then again on page 112-113 with respect to response times. She asked about the data on the response times from other districts and if it is the fire departments responding, EMS, or both. Steve Allan said that, regarding the fire departments, how fast they respond is dependent upon how far away they are from the emergency. He said that everything in the data is average total response time for just EMS. Commissioner Gordon said that she would like to have one more input session from the Board of County Commissioners before the final report comes back to the Board. Commissioner McKee summarized the process of the Emergency Services work group up to this point. He wants to avoid this becoming a loop of a protracted discussion. He suggested that as the consultant goes forward with other stakeholders that the work group will incorporate feedback into the document and then the work group will review these and come back to the Board of County Commissioners with a consensus of a report of recommendations (generalized). This is a living document. He does not want to put this on a shelf. Commissioner Gordon summarized the process. If the public or County Commissioners have a question, they can go to one of the meetings or email Michael Harvey with questions. When that is wrapped up, it will go to the work group, which will answer the questions and prioritize the recommendations. This will then get folded into the consultant's report. At a later time, it will come to the County Commissioners to approve, and then come through the budget process after that. The Board agreed with the process by consensus. Michael Talbert agreed that this is a living document and will be changed annually. It will be brought forward every year with the CIP. He reminded the Board that improvements have been made in EMS funding every year through additional ambulances, new EMTs, and new telecommunicators. Staff is looking for priorities from the Board as to what would be most important for the County Commissioners to do first. He will take these priorities back to the work group. Commissioner Yuhasz said that the performance of the fire departments as first responders is a necessity. Steve Allan said that the fire department study and the space study are to be quick and he was not charged with analyzing the fire departments. He would like to meet with the fire departments and talk about medical first responding. Commissioner Jacobs said that there is nothing in the report about the Emergency Services work group and Steve Allan said that it will come in the narrative. Commissioner Jacobs said that part of the document should have an email for the public to send comments or questions to. He said that he also appreciates the fractile measures. He said that Orange County does need better resources, but he is appreciative of the Emergency Services staff that does so much with so little. Frank Clifton said that, as they have added staff, some of the significant issues with these workers include the high stress, the high technical training required, and that these workers are in high demand across local government, all of which can contribute to the high rate of turnover in Emergency Services. Orange County will need to be competitive in all areas of the hiring process, especially the pay. Chair Pelissier said that the Board would like the work group to come back with priorities and recommendations at the end of the process. Commissioner McKee said that when comments are received, Michael Talbert should put it into a memo and distribute to the County Commissioners. Frank Clifton suggested videotaping the next presentation by Mr. Allan to the public and placing it on the website. 3. Report on Paperless Aqendas Chief Information Officer Todd Jones said that agendas are now being produced using a paperless process. There is interest in using iPads during the meetings. There are a lot of hardware and software options. There are also small format laptops available as well. He said that he would be happy to train anyone on using various devices for this process. Commissioner Hemminger said that the training was great and helpful. She liked the iPad better and she annotated tonight and it worked well. She said that the maps are much clearer on the iPad. Chair Pelissier said that she did not use paper at all tonight and used the iPad and it worked well. Frank Clifton said that there are some limitations with the iPad because the County uses all Microsoft products. John Roberts said that there are some things that should not be done with internet access at a public meeting. A motion was made by Commissioner Jacobs, seconded by Commissioner McKee to adjourn the meeting at 10:21 PM. VOTE: UNANIMOUS Bernadette Pelissier, Chair Donna S. Baker, CMC