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HomeMy WebLinkAboutMinutes 04-04-2019 Work Session 1 APPROVED 5/2/2019 MINUTES BOARD OF COMMISSIONERS WORK SESSION April 4, 2019 7:00 p.m. The Orange County Board of Commissioners met in regular session on Tuesday, April 4, 2019 at 7:00 p.m. at the Southern Human Services Center in Chapel Hill, N.C. COUNTY COMMISSIONERS PRESENT: Chair Penny Rich and Commissioners Jamezetta Bedford, Mark Dorosin, Sally Greene, Earl McKee, Mark Marcoplos and Renee Price COUNTY COMMISSIONERS ABSENT: None COUNTY ATTORNEYS PRESENT: John Roberts COUNTY STAFF PRESENT: County Manager Bonnie Hammersley, Deputy County Manager Travis Myren, and Clerk to the Board Donna Baker (All other staff members will be identified appropriately below) Chair Rich called the meeting to order at 7:04 p.m. Chair Rich asked that item #3 be moved before Item #2, and the Board agreed by consensus. Chair Rich asked Deputy Jones to come forward, and she recognized him for an award he received this weekend: Excellence in Evidence Collection and Storage from the NC Sheriffs' Police Alliance. She said the State had many untested sexual assaults kits, and Deputy Jones spent about 120 hours working on 87 sexual assault evidence kits, and identified 12 kits to be of higher priority for testing Deputy Jones said they had to do a lot of research and the oldest kit was from 1986. He said none were computerized, and involved reading paper copies and putting their hands on these kits. He said there were 12 kits that needed to be prioritized and tested. He said the State had these rape cases tested, and three came back with DNA hits, which gave the victims some closure. Chair Rich said this was an old fashioned process. Deputy Jones said most of the reports were hand-written in cursive. Chair Rich said the funeral service for Fred Battle will be Monday, April 8tn and the Board of County Commissioners' (BOCC) proclamation will not be ready yet, but will be completed and sent to his wife. 1. County Commissioners: Boards and Commissions —Annual Work Plans/Reports The Board provided feedback and/or direction on the second group of boards and commissions' annual work plans/reports with their Chairs (or representatives) in attendance. (A first group of boards and commissions' annual work plans/reports was discussed at the Board's March 12, 2019 work session.) • Animal Services Advisory Board Maureane Hoffman, Chair and Bob Marotto Maureane Hoffman said their board serves as a sounding board for policy issues raised by residents or identified by the BOCC. She said residents are referred to the ASAB as a critical step in any consideration of stakeholder concerns, before bringing an item to the Board of County Commissioners. She said integral to this general responsibility is a concern with ensuring that the practices and outcomes of Orange County Animal Services meet or exceed prevailing professional standards. 2 Commissioner Dorosin arrived at 7:10 p.m. Maureane Hoffman reviewed some of the ASAB's accomplishments in 2018: • The ASAB continued to work with staff and stakeholders managing pet overpopulation in Orange County. Free-roaming cats have been of great significance to recent efforts in this area, and among other things, the ASAB and staff together have sought to establish strong working relations with community partners Including the Agricultural Preservation Board. • Central to this effort has been the creation of a "working barn cat" program. Within the last year more than 150 working barn cats have been sterilized, vaccinated, microchipped and vaccinated through this program. This innovative and important program has received very positive coverage in the media including a feature article in the Herald Sun and News and Observer. • Also, the board worked closely with Animal Services staff and one of the County's staff attorneys to develop some needed amendments for the Unified Animal Ordinance. These were developed on the basis of the County's experience with the Unified Animal Ordinance since its adoption early in 2016. The BOCC adopted these amendments in November of 2018. • In a related vein, the ASAB has collaborated with staff to develop several recommendations for the County's legislative agenda. As can be seen from Attachment B, these include a number of recommended changes to the State's dangerous dog law. Specifically, they would allow for the review of potentially dangerous dog declarations; for dogs declared potentially dangerous to interact with a certified trainer in a secure area without being muzzled; and for there to be an evaluation of dogs seized in dog fighting cases in order to make a final determination as to whether they are dangerous. • One deliverable was that staff developed a more satisfactory procedural approach to animals suffering from neglect that are surrendered to Animal Services. Another was a coordinated effort between Animal Services and the County's Homelessness Coordinator to identify community resources that can be tapped to help care for pets belonging to the homeless as they undergo different transitions. Maureane Hoffman reviewed some of the on-going concerns for the ASAB going into 2019: • Managing Pet Overpopulation: The board will continue to work with staff to implement a plan for managing free roaming cats. In particular, the board will work with staff to coordinate with the Agricultural Preservation Board and other entities to advance the "working farm cat" program. The board will also continue to work with staff to develop and sustain community partnerships and resources for addressing the challenges presented by free roaming cats. • Easement Area Dog Walking Trails: The ASAB is continuing to support staff in ensuring that dog walking trails are recreated in the area of the new OWASA and Duke Energy easements. The board also plans to continue to support Animal Services working with other County staff to ensure that the entrance and presentation of the Animal Services Center is not compromised by these easements. Doing so is critical to the intent of making the Animal Service Center an attractive and welcoming facility, an actual destination for the community. 3 • Unified Animal Ordinance and Legislation: The ASAB will continue to coordinate with staff to identify and address "issues" in the administration of the ordinance in areas that may be subject to administrative appeal. As in the past, it is expected that this may bring forth recommendations for ordinance amendments based upon the experience of the Animal Services Hearing Panel Pool with the appeal process. The ASAB will also continue to work with staff to identify legal changes that may be addressed by the BOCC through the County's legislative agenda. Commissioner Price referred to dog walking trails/easements, and asked if there are issues with this. Maureane Hoffman said no, and the issue is that these easements were not initially well communicated to Animal Services staff and the advisory board. She said this communication failure has been addressed. Bob Marotto said they are working now with Duke and OWASA's easements, as well as Solid Waste. He said they are working with the Town of Chapel Hill regarding a brook that runs through the area near the landfill. Commissioner Bedford asked if any lessons were learned during the hurricanes. Bob Marotto said the department has been at the edge of a newer approach of housing animals in the context of emergencies, and this year's hurricanes prompted a need to co-locate pets in the same building as their owners. He said a lesson learned was the importance of recruiting more volunteers to help with the co-location. Maureane Hoffman said it also showed the commitment of the Animal Services staff to working both the shelters and the facility. Chair Rich asked if there is an update on the number of free roaming cats. Bob Marotto said this remains a real challenge, but up to 200 cats have been sterilized through the working barn cat program. He said this will be a long term effort to make any significant impact. Commissioner McKee arrived at 7:18 p.m. Maureane Hoffman said it is hard to get hard data on the free roaming cats, and this problem is best addressed intensively, one area at a time. • Arts Commission Tim Hoke, Chair Tim Hoke reviewed some of the Arts Commission's accomplishments: • Hosted annual Arts Grants Program. Thirty-eight, or 57%, of the 67 applications were funded. Of the funded applications, 32% were first-time applicants. Requested funding totaled$163,859, with $61,394 available for disbursement. • Served as ambassadors and panelists for the Emerging Artist Program, the Annual Piedmont Laureate Program, and the 4th US Congressional District High School Art Competition. • Served as county lead for Arts Day 2018, gathering local arts supporters to advocate for public arts support through Arts North Carolina. • In partnership with the Hillsborough Arts Council, hosted 2nd Annual Paint it Orange: Plein Air Paint-out & Wet Paint Sale, as a fundraiser for OCAC and HAC, drawing artists from four states. • Coordinated "Arts Moments" to kick off each Board of County Commissioners meeting in 2018 featuring local writers. 4 • In partnership with The ArtsCenter, hosted a three-day Racial Equity and the Arts workshop for leaders within the arts community. • In partnership with the Chapel Hill Public Library and the Chapel Hill/Carrboro NAACP, hosted the Frederick Douglass Bicentennial Celebration by funding a free interpretive titled "The Frederick Douglass Speaking Tour" at The ArtsCenter. • Served as part of leadership team in the coordination of the inaugural Orange County LocalFest. Coordinated volunteers and assisted in general logistics. Solicited and juried arts vendors. • In partnership with Hillsborough Arts Council and Town of Hillsborough, partnered on Calvin St. Tree project, which will provide public art in River Park slated for Spring 2020. Some highlights: Economic Development through the arts. • The OCAC has presented the findings of Americans for the Arts, Arts & Economic Prosperity Study 5, to local boards and commissions, informing community leaders that the arts are a $130.3M industry for Orange County, employing 5,001 full-time equivalent jobs (4th largest industry employer), and generating $5.3M for local government. Presentations were made to Orange County Economic Development Board, Town of Chapel Hill Town Council, Orange County Board of County Commissioners, Hillsborough Chamber of Commerce Board of Directors, Orange County Artists Guild, Carrboro Board of Aldermen, Chapel Hill-Carrboro Chamber of Commerce Board of Directors, Chapel Hill/Orange County Visitors Bureau Board of Directors, Orange County Economic Development Summit 2019, Orange County Employee Advocacy Roundtable, and Chapel Hill Rotary. • In partnership with the Hillsborough Arts Council, hosted 2nd Annual Paint it Orange: Plein Air Paint-out & Wet Paint Sale, as a fundraiser for OCAC and HAC, drawing artists from four states. Diversity • The OCAC Arts Grants review process includes prioritizing of applications that hire artists of color. Thirty-two percent of 2018-19 grants funds were allocated towards projects that fulfilled this goal. • In an effort to have a broader range of voices as part of our leadership, the OCAC has Latino origin as well as one African-American. Commissioner Marcoplos asked if the legislature came through with funding. Katie Murray said in the past several years, the State legislature has given more increases toward the arts than when it has been under democratic control. • Board of Health (BOH) Tim Smith, Chair Quintana Stewart reviewed of the highlights: • Identified priority areas from the 2015-19 Community Health Assessment: Social Determinants of Health, Physical Activity & Nutrition, and Mental Health & Substance Abuse. • Racial and health equity training. • "Resilience" Documentary shown to all staff last summer, along with discussion afterward. Seeking to be a trauma informed care center. Working with ACES. 5 • Board Of Health awarded Orange County Schools with funding to purchase the CATCH Curriculum (Coordinate Approach to Child Health) for elementary and middle school students. Each year they put out a grant opportunity for their two school systems and they have three applicants this year, and they will be awarding more grants this year. • They are up for their community health assessment, racial equity, drinking water/fluoridation. Tim Smith said the BOH and staff is working collaboratively with other departments. Quintana Stewart recognized their newest board member: Commissioner McKee Commissioner Dorosin asked if the Health Department has a top priority for the upcoming year. Quintana Stewart said the Community Health Assessment and racial equity work. Commissioner Dorosin asked if the Health Department works with other health departments around the state, because he heard Person County has the highest infant mortality and asked if assistance is offered to their colleagues. Quintana Stewart said they try to connect monthly with their regional partners, of which Person County is one. She said Person County reached out asking for assistance with nursing staff training, and Orange County hosted them for training. Quintana Stewart said right now everyone is working on Medicaid transformation. • Board of Social Services Tamara Dempsey-Tanner, Chair Tamara Dempsey Tanner reviewed the following: The Orange County Department of Social Services (DSS) Board members would like to publicly recognize the staff's ability to model resiliency and fortitude, not just in their daily practices; but also in the face of unexpected and disastrous situations that impact our county residents already at risk for health and economic inequity. Specifically, the government shut-down and its impact on federally supported programs, along with assisting clients and the DSS staff affected by Hurricanes Florence and Michael by providing inland shelter support and processing affected county residents' applications for emergency aid. In going forward into FY 19-20, DSS continues to be a key pilot site for NCFAST (North Carolina Families Accessing Services through Technology data platform), providing feedback on user testing improvements to provide a more efficient and effective statewide system. Our child welfare program staff work tirelessly to ensure that children are in healthy, safe and nurturing households, managing caseloads of 11-12 clients/families at any given time or addressing the now 114 children in Orange County DSS foster care. While it is important to have realistic, programmatic performance measures for quality assurance and improvement purposes, next fiscal year will begin the State's review and subsequent action related to program non- compliance related to these new State Child Welfare performance measures. To date, there are 746 children receiving childcare subsidies, of which 55 are on a wait list now, mandated as the State is reviewing statewide subsidy expenditures and allocations formulas. In the interim, we are fortunate to still have access to local funds to support crisis situations requiring childcare placement via subsidies. Our employment fairs continue to be a crucial resource for county residents to collective meet with potential area employers. On average, 81 employers attend the bi-annual employments fairs with an average of 232 participating job seekers. Finally, the State's Medicaid Managed care plan will begin this summer. On July 1, two regions will begin the initial enrollment process, which includes Orange County. This managed care 6 plan and all of its enrollment elements will be a significant transition to navigate for our monthly clients which average 16,436. We anticipate that families will call with questions beginning in June as the enrollment information is distributed; therefore, more staff time will be needed in this capacity, along with verifying current addresses for enrolled participants. As we go forward into this next fiscal year, the DSS Board members appreciate the ongoing support from the county commissioners and county manager in our staff's work and services to our Orange County citizens. Going forward, the DSS Board appreciates the support of the Board of County Commissioners Commissioner Price asked if there could be clarification about the 55 on the wait list. Nancy Coston, DSS Director, said the State had everyone go to a childcare wait list while it determined if there were any available funds to reallocate. She said DSS is looking into how much County funds are available to serve children without getting over extended. She said some funds may be moved around to serve more children, and this waiting list has a tendency to grow rapidly. Commissioner Price asked if this was the same list to which the Board directed additional funding last year, or the year before. Nancy Coston said yes, it was three years ago when the State made large cuts. She said there were a few years thereafter when the money was not needed, but it is needed again. Commissioner Marcoplos asked if the federal shutdown had an impact. Nancy Coston said there was some bad information that went out about the food program, and her food and nutrition staff was very stressed; but the State managed to space out the next distributions so the families did not get into a crisis, and any gaps were filled with extra funds, food bank, donations, etc. Commissioner Dorosin referred to the subsidies, and asked if there is an issue in capacity of service providers, or if it is just an issue of funding. Nancy Coston said at this point, it is just an issue of funding. • Agricultural Preservation Board (APB) Cecilia Redding, Vice Chair Cecelia Redding said she is a farmer in Orange County, and reviewed the following APB's accomplishments: • In 2018, reviewed and recommended approval for 16 additional farms as Voluntary Agricultural District and Enhanced Voluntary Agricultural District farms, adding 1,748 acres to these programs. This increased the total enrollment in both programs to 14,303 acres on 109 farms throughout the County, and increased acreage in all of the seven Agricultural Districts. • Hosted the third annual breakfast program/informational workshop for existing and prospective VAD/EVAD farm owners to encourage new participants and answer questions; nearly 100 attended at the Schley Grange Hall. • Starting in 2018, the APB fills a dedicated seat on the board of the Orange County Food Council, in recognition of the close ties between the two programs. • Promoted participation in the Century Farm Program by assisting farm owners with the enrollment process. • Continued installing new road signs to identify farms enrolled in the Voluntary Agricultural District programs, as well as to recognize participating farmers and increase program visibility 7 • Promoted the creation of an "Agriculture Investment Grant" program as one of the projects to be funded by revenue generated by the new one quarter ('/4) cent "Article 46" sales tax enacted in 2012 (5% of the annual revenue, or approximately $60,000) Pete Sandbeck highlighted activities that the APB expects to carry out in 2019: • Continue to promote and recommend Voluntary Agricultural Districts and Enhanced Voluntary Agricultural Districts • Support continuation of the successful Farm-to-Table Event for 4th-grade students held annually at Blackwood Farm Park. • Educate/inform new, established and prospective farmers about the recent elimination of the present-use tax value requirement for VAD/EVAD participation. • Purchase and install additional road signs to better identify farms in the Voluntary Agricultural District Program (existing and new farms) • Enroll additional farm owners in the Century Farm Program • Continue the Orange County Agricultural Heritage Project to document and make a record of the County's farms, farmers and farm life, including oral histories and video/photo documentation Peter Sandbeck reviewed some of the APB's concerns going forward: • Dairy farms, which have been an important part of Orange County's agricultural heritage, are in crisis. The number of dairies in Orange County has dwindled to 3. Commodity milk prices can no longer support our local dairies. One way forward is to work to help create a local market for our Orange County dairy products, as a way to encourage more dairy farms and keep the ones still active. Dairy farming once represented a significant percentage of the County's farmland. Action is needed to retain enough infrastructure to support the existing dairy farms now. • The average age of our farmers continues to increase, causing concerns about retirement and farm succession planning. This is an ongoing issue despite the rising numbers of young people farmers control and farm a large percentage of the County's prime open farmland, thus creating the potential for a significant decline in active farm acreage over the next decade. • The majority of the new farm operations now being started in Orange County are small market crop farms, where crops are grown intensively on smaller parcels, to be sold locally at markets. • The APB supports the concept of creating a "Present Use Value Trust Fund" to support a grant program to promote local agricultural activities and increase local markets for food produced in the County. This is proposed to be funded by deferred property tax revenue collected by the County when farmland ceases to be used for agricultural purposes. When land is taken out of the three years of deferred property taxes back to the County. Cabarrus County established a very successful program on this model. • Explore ways to educate farmers and prospective farmers about the many new agritourism opportunities that could be used to enhance and diversify farm income and bring visitors to farms. • The newly formed Food Council offers ways for the APB to become more involved in a range of initiatives to enhance local markets for farm products. Commissioner Price asked if the number of century farms is known. Peter Sandbeck said there are 28 or 29 in the Century Farm program. Peter Sandbeck said they are trying to enroll more African American farmers, and during the depression farmers had to turn to neighbors for help. He said one had to sell an adjoining 8 white farmer with the understanding that it would be sold back. He said this resulted in the African American farmers going in and out of farm ownership. He said the Century Farm program stipulates that the farm has to have been with the same farmer the whole time. He said staff is working on this issue, as it is inherently unfair. Commissioner Price asked if the present use value trust fund is already up and running. Peter Sandbeck said no, not yet, and this was part of their annual work plan. He said the Food Council asked for APB support for creating a future trust fund to help fund agricultural preservation and farming. He said this will be presented to the BOCC at a future meeting. He said the idea is to use lapsed tax revenue from a farm that has gone out of present use value to put towards preservation. Commissioner Price asked if there is a program to link older farmers with newer farmers. Peter Sandbeck said Mike Ortosky oversees this program, but there have not been that many takers yet. Commissioner Greene thanked him for the collaboration with the Food Council, which did approve the trust fund at its last meeting. She said the proposal would take this "old" money and set it aside, with half going to lands legacy for easements, and the other half to the small farmers grant program. She said she hoped the APB and the Food Council can continue to collaborate at every level Commissioner Marcoplos said meat is a recurring issue in discussions, and cows that are eating grain create methane while grass fed cows to do not. He asked if the APB could do a survey of who is raising grass fed beef, and what food sources are selling this local meat. Commissioner Dorosin referred to "continuing the Orange County agricultural heritage project" and asked if this has started yet. He said having some kind of video of the VAD Program etc., would be helpful to have on the website. He said this would actually be helpful for all advisory boards to do, as it would raise the profile of all of this good work. Peter Sandbeck said some oral histories and videos are sitting around, and the documentation part is important, but he also agrees the informational/educational aspect is equally important. Commissioner Dorosin said he would love to see 90-second videos created that could provide information to the public. Commissioner Greene said as these videos are distributed in the county, it may be a way to recruit new or younger farmers. Commissioner Price said the Community Farm Stewardship Association used to link younger and older farmers, and asked if this still occurring. Peter Sandbeck said he assumes so, as this is an active group. • Commission for the Environment Bradley Saul, Chair Bradley Saul said the past year they spent much of their time on their upcoming State of the Environment report, which is due out in October 2019. He said there will hopefully be a community event in conjunction with that report. He said they have been in touch with Todd McGee, Community Relations Director, for some weekly eco-tips. He said the Department of Environment, Agriculture, Parks and Recreation (DEAPR) has a forest tree policy management program, and a former commissioner has suggested that this should be implemented countywide. He said other local governments are considering similar things, and all will be meeting to discuss further to create unity. He said the greenhouse gas emissions inventory is still in progress. Commissioner Marcoplos said he appreciated their work on the value of trees, and noted that he, Commissioner Greene and Commissioner Jacobs were part of the 30th celebration of the rural buffer. 9 Commissioner Marcoplos said the rural buffer is designed to provide density in the urban areas, and he said trees may be cut down in Chapel Hill, but overall more trees are being saved because sprawl is not occurring, due to the rural buffer. He said it would be helpful to promote this information. Commissioner Marcoplos said it is important to quantify what these trees are doing for the community. Bradley Saul said the Commission is gathering data on one area in 2008 and 2018, and said there is little change in the rural buffer, but bigger changes countywide. Commissioner Greene referred to his notes, and the desire to "develop a plan for researching potential environmental impacts on the rural buffer," and asked if there if anything other than the size of the tree canopy will be measured. Bradley Saul said the plan is to reach out to the Planning Department and UNC and develop a larger set of research questions around the rural buffer. He said carrying out the research is the bigger challenge. Commissioner Greene said she recently attended the Climate Reality Conference, where trees were heavily emphasized. David Stancil, DEAPR Director, said staff has learned that there is an amazing amount of activity, regionally, looking into tree protection. Chair Rich asked if the Commission feels it representing the entire County on its membership Bradley Saul said that is an area of weakness, and there are only 1-2 members that live north of 70. Chair Rich said it would be nice to recruit more from the northern and western portions of the County. Commissioner Price asked if the Commission is looking at reforestation. Bradley Saul said the Commission has considered creating a net-gain policy, but this has yet to be worked out in detail. Commissioner Price said she would like to pursue such a policy. Bradley Saul said the Commission is looking at this in a general manner. Commissioner Price asked if the Commission was working with the Planning Board. Dave Stancil said to his knowledge, no, and he said the focus has been on protecting the forest canopy. Commissioner Price said one idea is having trees in parking lots, as opposed to only asphalt. Dave Stancil that conversation was consumed by a larger, bigger picture conversation. Commissioner Price said these types of details would require partnership with the Planning Board. • Historic Preservation Commission (HPC) Art Menius, Vice Chair Art Menius reviews some of the HPC's accomplishments from 2018: • Historic Resources Publication Project: The HPC is nearing completion of its major project to publish a book documenting the historic resources of Orange County and Hillsborough, in partnership with the Alliance for Historic Hillsborough/Town of Hillsborough. The author is now under contract and is preparing a manuscript for this long-awaited book, to be printed in 2020. Obtained a grant of$25,000 from the Alliance, to match County funds made available in FY 2018-19 budget. (ongoing) • Schley Grange National Register Nomination: Initiated a project to have the historically significant Schley Grange Hall nominated to the National Register of Historic Places. Contracted with a historic preservation consultant to prepare the nomination report, to be approved by the State Historic Preservation Office in 2019. Project funded jointly by the 10 Grange and County through Lands Legacy program. (2018-19) • Cedar Grove Community Center National Register Designation: Consultant completed draft National Register Nomination for the historic Cedar Grove Negro School and submitted to State Historic Preservation Office for final review. Property should be listed on National Register in 2019. A plaque will be installed. (2018-19) • Piper-Cox House at Eno River State Park: The HPC assembled a team of members and historic restoration experts to assist the State Park in assessing damage caused when a large tree fell on the roof of this important historic house. HPC prepared report outlining recommendations and submitted to park; HPC chair made personal contacts with local legislator to get the State to take action to make repairs to prevent damage. (2018) • Annual "Farm to Table" Demonstration for Historic Preservation Month: HPC members once again presented hands-on programs on historic woodworking, historic hand tools and traditional farm life skills for over 300 fourth graders at Blackwood Farm Park, as part of the annual "Farm to Table" event sponsored by DEAPR. (2018) • Efland Home National Register Nomination: Completed a project to prepare a National Register Nomination for the historic Efland Home (NC Industrial Home for Colored Girls) with funding provided through the County's Lands Legacy Program. (2017). • Historic Courthouse Archaeology and Preservation Project: Contracted with professional archaeologists to carry out archaeological survey of the Old Courthouse Square, using ground penetrating radar (GPR). Contracted with an architectural historian to carry out research about Old Courthouse and Square as part of upcoming CIP project to preserve the historic Old County Courthouse and the Courthouse Square. (2017-19) • Historic Resources Inventory: Completed a two-year project to update the County's historic resources inventory. The HPC obtained federal grants totaling $20,000 for this effort from the State Historic Preservation Office, through the Certified Local Government (CLG) program.(2016) • New Historic Landmarks: Designated four additional properties as Orange County Local Historic Landmarks since 2013: the Dr. Arch Jordan House in Caldwell (2017); the White Cross School in White Cross (2015); the Nicholas Corbett Hester House in Cedar Grove (2015); and, the Captain John S. Pope Farm in Cedar Grove (2013). This brings the total to ten landmarks. • Blackwood Farm Park: Provided assistance with the restoration work at Blackwood Farm Park, including development of interpretive signage for the Strayhorn slave cemetery (2015). • Regional History Symposium: Held a successful piedmont regional history symposium in partnership with Preservation Chapel Hill and the Alliance for Historic Hillsborough (2014) He reviewed some of their activities they propose to carry out in 2019: • Historic resources book, in preparation for publication in 2020. Author is now under contract and writing is well underway. (Fiscal impact: the FY 2018-19 budget included $25,000 in County funds, allowing the project to secure $25,000 in matching funds from the Alliance. HPC staff will provide project support. • Historic Piper-Cox House at Eno River State Park: Continue a partnership with the Eno River State Park to promote the appropriate restoration of this historic site, to repair roof damage caused by a falling tree in 2018. The HPC will help the Park develop creative new uses for the house to ensure that it remains a viable attraction for park visitors. • County Historic Marker Program: Develop guidelines and procedures for a proposed County Marker Program, modeled on other successful marker and map-driven programs. The goal is to provide historical content in an accessible/interactive format 11 about important historic resources, places and people, for the educational benefit of the public. The project would be linked to a web site to provide access to more in-depth information. This program can be linked to other efforts to promote heritage tourism in rural parts of the county. (Fiscal impact: 2018-19: none; the HPC staff will provide support) • Designating Landmarks in Town ETJ's: Continue working with the various municipalities to develop an interlocal agreement to govern the designation of historic landmarks within the various town's ETJ's. (No fiscal impact) • Promote Landmark and National Register Programs: Increase efforts to promote the Local Historic Landmark and National Register programs, with special focus on African American sites and other important but overlooked or threatened historic resources. Goal is to generate at least two new landmark and/or National Register applications per year (No fiscal impact—already budgeted in the Lands Legacy program funding) Commissioner Marcoplos referred to Old Greensboro Highway, where there are two old markers, and asked if the significance of these is known. Art Menius said he has seen them, but did not know what they were for. Peter Sandbeck said they may be mile markers, but would check on them. Commissioner Greene asked if the HPC has ever thought of having an historic site tour. Art Menius said there was such a tour in the 1980s, but not since. Commissioner Price said in early 2000s they started to set up a tour of local landmarks, but many were privately owned and it did not go much further. Commissioner Greene said permission would be needed, but in Chapel Hill the Historic Society has done tours of the historic homes at Christmas time. Art Menius said they have looked at many models for this type of program from all over the world, many of which had digital assets to avoid going into the actual home. • Parks and Recreation Council (PRC) Haywood Rhodes, Chair Haywood Rhodes said part of what the PRC does is advise the BOCC on issues regarding parks and recreation activities. He reviewed the following highlights for the upcoming year(s): • Biennial meetings with sister boards • Mountains to Sea Trail (MST) • Revising plans for the River Park improvements • Blackwood Farm Park- phase two design process now, and next is the building of a permanent parking lot; design and development of a disc park; and nature center • County acquired additional land next to soccer.com and they are looking at planning/designing the additional facilities out there. There is a lack of facilities for this ever growing sport. • Overall lack of facilities...sign up for County programming filled up in record time. Lack of gymnasium space, in particular. • Potential development of an inclusive playground; pollinator gardens • There is need for greater racial and gender diversity on the PRC; there is excellent geographic diversity. Commissioner Dorosin asked if the Board of County Commissioners wanted to build an inclusive playground, where would it go. 12 Dave Stancil said possibly Fairview Park or Efland Cheeks Community Center, due to public transportation access. Chair Rich asked if a senior's playground has ever been discussed. Dave Stancil said one of the trends taking off is having full comprehensive age treatment for play apparatus. He said the master plan for Twin Creeks includes a play facility that is designed to accommodate activities that interest those of all ages (e.g. spray ground to bocce ball). He said nature play is increasing in popularity. Chair Rich said she has watched seniors in front of the senior center, who are all seeking active movement. Dave Stancil said intergenerational interaction is beneficial to everyone. • Chapel Hill/Orange County Visitor's Bureau Anthony Carey, Chair Anthony Carey thanked the Board for letting him serve on this board, and thanked Chair Rich for being the BOCC representative from the Board of County Commissioners. He said Laurie Paolicelli, Visitor's Bureau Director, does a great job of gathering and assimilating data. He said he is a hotelier, and is concerned by the massive influx of AirBnBs. He said the VB has discussed this greatly, and feels some regulations may be necessary. He said the number of there were 132,663 AirBnB listings in Orange County in 2018, with 109,836 being for the entire home. He said this averages 301 whole homes for rent for the year, which is like 3 hotel rooms per night. He said they do not have a grasp on this information when they are putting business plans together, as AirBnBs are not part of the data. He said these travelers fly under the radar, but should be paying occupancy tax. He said the VB subscribes to a report called Air DNA, which shows a lot more usage than AirBnB shows. Anthony Carey said as an Orange County resident, he is very concerned about health and safety issues with the AirBnBs. He said since AirBnB is a booking site, it is not held responsible for poor behavior or inappropriate use of the land. He said with not having businesses regulated, there are side deals going on to bypass AirBnB. He said Laurie Paolicelli as a County employee cannot join the Hoteliers in this battle, but she recommended that the group approach the Chamber of Commerce, which several groups have done. Anthony Carey said, in a few weeks, the impact of tourism on the County will be issued, and is expected to be $200 million. He said foot traffic is down within the VB, and while the presence on Franklin Street still seems necessary, but a new space is being pursued. He said the new Wegman's store may be an option. Commissioner Marcoplos said the AirBnB issue a thorny one, but it does have some benefits: having an option for lower income travelers; allowing seniors to remain in their homes as they rent out a portion; etc. He said he hopes there is a good solution. Anthony Carey said he thinks so, and he loves the idea of host homes. He said the group is not opposed to owner occupied, single room use, but rather a whole home being vacant to make revenue without any safety issues taken into account. Chair Rich said people staying in AirBnBs are still spending money in the County, which is a revenue stream, but the records of tax dollars does not match the data coming in regarding activity. Commissioner Dorosin asked if, in 2020, it still make sense to have a physical VB presence versus online, and having hard copies of things in places like hotels, etc. Chair Rich said this is discussed at every VB meeting, and that recommendation is always being discussed. Anthony Carey said the education and purpose of a visitor's center would serve well to the residents of Orange County. He said setting up a pop up tent in a high traffic area would be 13 a highly effective way to disseminate information, and the VB should be more creative in connecting with residents about all that Orange County has to offer. Chair Rich said the VB still needs office space, but not necessarily a building. Commissioner Greene said she has a different perspective, and despite being high tech, she and her family still frequent visitor centers all over the country simply for the "human touch" aspect. She said there is still some talk about turning the old Town Hall into a museum and co- locating the visitor's center there, and wondered if this idea is still on the table. She said visitors love stories and personal recommendations. Commissioner Price said she also likes to frequent visitor's centers around the country, and finds the human presence to be important. • Economic Development Advisory Board Jim Kitchen, Chair& Steve Brantley Jim Kitchen said he wanted to remind the Board about the Point of the Economic Development (ED) SWOT analysis that the Economic Development Advisory Board (EDAB) initiated in 2018. He said the purpose was to: 1. Determine the number of viable sites in the Economic Development Districts (EDDs) 2. Determine what to do next with what to do next in order to be more competitive with the surrounding counties 3. Develop a plan for more shovel ready sites, and move the needle significantly for creating more opportunities to diversify Orange County's tax base, while funding education, delivery of services, etc. 4. Promote social justice by bringing in high quality, high paying jobs to those who need them. Jim Kitchen said the BOCC has spirited ED discussions in the fall, including the pre- zoning and optioning of land within the EDDs; the type of industries Orange County wishes to attract; commissioning a GIS study; ED in Cedar Grove, etc. He said Orange County lacks a clear and defined ED strategy, and he thinks this strategy should come from the Board of County Commissioners. He said the ED office can do it, but the BOCC should take charge as the CEO's of the County. He said he did not run any of his remarks past Steve Brantley, but plans to proceed with them anyway. He said the ED plan should do the following: • Determine why ED is vital to Orange County, first deciding, "is it?" or"isn't it?" • Determine where ED currently stands and where does the Board want it to go. • Determine where ED will be physically located in the rural parts of the County, what locations make the most sense, and align rules, regulations, and zoning with these goals. • Develop quantifiable, measurable goals ED to get there. • Determine the potential impact on the County's budget: how much funding, if any, should be allocated to ED. Jim Kitchen said all of the above can only be achieved via a comprehensive strategic plan around ED. He said this plan is vital due to the following: • Potential GIS sites cannot be identified, if one does not know what one is looking for • One cannot know if the land across West Ten Road makes sense without a needs assessment • How to know which land to option • How to know which companies to attract • How are we positioned relative to competitors 14 • How to know on what to spend Article 46 funding Jim Kitchen said the Timmons report included 5 viable Morinaga sites within the current EDDs, and if that is the case, why are Article 46 monies being used to fund water and sewer in some of these EDDs. He said the EDAB feels a comprehensive ED strategic plan is vital, with 5, 10 and 20-year tangible, identifiable, and measurable goals, and would like to see the BOCC have a serious, day long, facilitated work session with the ED staff and dedicate effort to this need. Commissioner Dorosin said he thought the plan was to designate the EDDs, put infrastructure into them, and then work to recruit businesses to locate in the EDDs; however, he would agree that this is not a plan that has worked other than Morinaga. He said one consideration is to ask if the Board should start from scratch, or build onto the base of the EDDs. He said at the last Board retreat, a closer look at the Eno EDD showed that it may not as viable as once thought, and perhaps resources should no longer be invested into it without further investigation. He said he is in favor of Jim Kitchen's suggestions, but wants to evaluate how wedded to, or constrained by, the BOCC is to that which has already been done. Jim Kitchen said some great pieces of the puzzle already exist: highly competent staff, some fairly decent land, etc. He said the BOCC is not starting from scratch, but some basic questions need to be asked: what, where, why, when, and how. He said this is not a 5-year process, but rather great progress can be made by starting with "do we want this and why" and allow the discussion to flow with a moderator keeping everyone on track. Commissioner Marcoplos said he appreciated him prodding the Board on this, and a lot of these questions have been answered in discussions, but documentation is lacking. He said pre-zoning is an example, and is underway to some extent. He said the Board has also discussed the EDD, and he can predict where this discussion would go if it were to continue. He said he is full support of having an intense work session to hammer these details out, and feels the finish line is not far away. Jim Kitchen said Morinaga was a win about four years ago, but he wants to know how the County will pay for new schools in the next 10 years. He said the tax bills of Orange County residents need to be reduced. He said he wished that Steve Brantley's office had more of a mandate to know exactly what it could and should do, if it had more to sell. He said Orange County has so much to offer, but so few sites to sell. He said if Morinaga and the EDDs are taken out of the equation, almost everyone would struggle to come up with any type of ED strategy that exists in Orange County. Commissioner McKee said he agreed with Jim Kitchen, and various discussions have occurred, but nothing has been finalized. He said there are many options to pursue, but details need to be determined. He said if the County moves forward, it needs to do so hard and fast; and if it is not going to move forward, this also needs to be communicated. Jim Kitchen said it would very helpful for the Board and ED to meet and determine a list of objectives for that day's meeting, with follow up down the road. Commissioner McKee said the policy issues should be addressed first, so that those policies can then be used to address specific issues of one area versus another, etc. Commissioner Greene said she supports the direction of this conversation, but also wants to be sure to include the local food economy, and not just large industry. Chair Rich said all need to be willing to coordinate with the Board's other municipal partners, taking note that all ED in Orange County affects Orange County. Commissioner Dorosin said if there is a work session on this topic, there needs to be some parameters, clear goals and which policies the Board wants to come out of the session with. He said Orange County has seven CEOs in the form of the BOCC, and clear goals and direction will be vital, as these conversations have been had before. 15 Commissioner Price said a more concrete strategic plan is needed, but is not sure if another work session will be beneficial. She said the BOCC does set policy, but maybe the EDAB could come back to the BOCC with a plan. She said everyone needs to get more pragmatic about ED, as opposed to discussing wants, and the lack of money. Commissioner Marcoplos said if the BOCC had an agenda at a work session that dealt with some of these issues that reoccur in and out of meetings that pertain to the whole EDD idea, and resolve the Eno EDD, the pre-zoning, the West Ten issue and discuss the issue that there is very valuable land available but is not in any of the EDDs. Chair Rich said this seems like an oversimplification, and not all Commissioners would agree. Jim Kitchen said Steve Brantley's office could build the framework and come to the Board of County Commissioners with the basics, and answer some key questions. Steve Brantley said he hopes to have some closed sessions with the Board soon, and ED is making some headway with a couple of projects. He said the Manager's office, the Planning Department, and ED have been working together to analyze the existing inventory of sites, as well as other locations. He said many areas of ED are very successful (small businesses, incubator, the arts, etc.), and the only area that is really at issue here is industrial recruiting. 2. Health and Human Service Initiatives and County Impacts The Board received an update on various state initiatives impacting Social Services and other human service departments, including Social Services Reform, Child Welfare Reform, Medicaid Transformation, and the Memorandum of Understanding (MOU) between Orange County and the North Carolina Department of Health and Human Services regarding performance expectations. In addition, Social Services will provide information on current workload and discuss impacts of these changes on future workload. The Health Director and the Child Support Director will discuss the impacts of Medicaid Transformation and the MOU on their departments. BACKGROUND: In 2017, the North Carolina General Assembly approved Social Services Reform legislation (House Bill 630). This legislation contains many components including: hiring of a consulting firm to develop plans for reform; establishing a workgroup to develop recommendations on creation of state regional offices; developing a plan for regionalization of local offices; and implementing performance agreements between local social service agencies and the state Department of Health and Human Services (DHHS). The outside consulting firm, the Center for the Support of Families, is conducting research in North Carolina, has completed Phase I of the work and has published its first recommendations for Social Service Reform and for Child Welfare Reform. The Social Services Work Group, facilitated by the UNC School of Government, has issued its first report on establishing state regional offices and is now working on local agency regionalization plans. Performance Agreements On June 29, 2018, the Board of Commissioners approved the first performance agreement (Memorandum of Understanding) with DHHS. The performance agreement section of the law was effective July 1, 2018, but the actual tracking of the performance measures by DHHS began in January 2019 with progressive corrective actions effective July 2019. A revised MOU (attached) has now been executed and reflects recent negotiations to change how some of the measures will be calculated. If counties have continued failures in performance after corrective action, the Secretary of DHHS may assume control of service delivery. These agreements apply 16 to child welfare programs, adult protective services, adult guardianship services, child support and all public assistance programs except Medicaid. Although Medicaid is not included in the agreements, there is separate legislation with additional sanctions for any performance issues with Medicaid eligibility. Orange County Department of Social Services (DSS) has integrated Medicaid with other public assistance programs during the intake process so performance among these programs is interrelated. Social Services Reform The Phase I report from the consulting firm has been published. Much of the report focuses on the plan to provide support and supervision for counties through seven state regional offices. Organization of county or regional offices will be addressed in Phase II. Child Welfare Reform The Phase I report from the consulting firm has been published. This report contains a long list of recommendations including implementing a practice model that emphasizes trauma informed, evidence based practice by social workers and strong state supervision. Medicaid Transformation North Carolina recently received approval for its waiver to move forward with integrated, managed care for Medicaid participants. Although Social Services will continue to establish eligibility, participants will also need to be informed about selecting a medical home. Other impacts of managed care will be realized by all Medicaid providers, including county agencies such as health and transportation. Orange County is in one of first regions scheduled to implement managed care with some of the Medicaid clients. During the work session, Social Services will provide additional information about each of these critical changes as well as anticipated impacts from these changes. Nancy Coston acknowledged some DSS board members in the audience. She said there are a lot of things going on in the DSS world, and tonight's presentation will not go into great detail, and there may need to do some follow up at a later date. Nancy Coston introduced Crystal Mitchell, Child Welfare Manager, who began the following PowerPoint presentation: Health and Human Services Initiatives and County Impacts April 4, 2019 BOCC Regular Work Session Agenda • Child Welfare Reform o Child Welfare Overview o Policy Changes and Requirements o Performance Measures o Plan and Recommendations • Social Services Reform o Overview and Update on Reform Plan o Performance Measures o Plan and Recommendations • Other DSS Services, Programs, and Activities • Medicaid Transformation Child Welfare Overview Intake -- Assessment-- In-home services -- Permanency Planning (Foster Care) -- Adoptions and Licensing — LINKS 17 Court Timelines • Child Planning Conference—within seven days • Adjudication Hearing —within 60 days of filing of the petition • Disposition Hearing —within 30 days of the adjudication hearing • Review Hearing — at least every six months; typically held every 3 months in Orange County • Permanency Planning Hearing —within 12 months of child entering custody; subsequent hearings at least every six months Policy Changes and Requirements: Assessments • All children must be interviewed separately from their parents at each contact and a home visit should occur the same day as initiation • Social Worker should tour the home and premises where the child sleeps, eats, and plays • Must see all children and parent/caretaker at a minimum of twice/monthly • Must conduct a home visit with the non-resident parent before the child visits if the non- resident parent is an alleged perpetrator of abuse/neglect Policy Changes and Requirements: In Home Services • Frequency of Contact o Moderate: must have face-to-face contact with all children and the parent/caretaker twice per month. One of the contacts must occur in the home. o High: must have face-to-face contact with all children and the parent/caretaker weekly. Two of the contacts each month must occur in the home. • Children must be interviewed separately from their parent/caretaker at each face to face visit • Social worker must tour the home once a month to observe where child sleeps, eats, and plays • Monthly contact with non-resident parent • Two collateral contacts per month Policy Changes and Requirements: Permanency Planning • Face to Face Contacts o Child: within 7 days of entering custody; monthly thereafter in placement o Parent: once monthly when primary plan is reunification; 3 out of 6 of the contacts should occur where the parent is residing o Placement Provider: within 7 days of child's placement; monthly thereafter. All caretakers in the home at least quarterly Policy Changes and Requirements Within 7 Days of Entering Custody • Non-secure custody hearing (Child Planning Conference) • Initial medical exam for the child • First visit with parents • Best Interest Determination meeting within 5 school days • Completion of Child Education Status component 18 Policy Changes and Requirements: Within 30 Day of Entering Custody • Shared Parenting Meeting within 14 days • Family Time Plan creation within 14 days • Relative notification letters mailed • Comprehensive Medical exam • Family Services Agreement development Policy Changes and Requirements: Permanency Planning Reviews • Timeframes for reviews o Within 60 days of child entering custody o Every 90 days thereafter throughout the life of the case; and o When there is a change in the plan or family circumstance • Family Service Agreements are reviewed and updated at each review Performance Measures (graph) • Total of 6 performance measures but only three are shown tonight • Impacting factors: o Data validation o Unable to locate families o Households with multiple children Commissioner Dorosin said these challenges are not unique to Orange County. Crystal Mitchell said that is correct. She resumed the PowerPoint presentation: Performance Measures (graph) • Impacting factors: o Data validation o Therapeutic placements o Placement characteristics Performance Measures (graph) • Impacting factors: o Removal factors o Treatment engagement o Treatment access and models Nancy Coston resumed the presentation: Plan and Recommendations: • Reduce caseloads of child protective services social workers allowing more time for additional requirements (positions are reflected in budget proposal) • Provide timely mental health intervention by using mental health maintenance of effort (MOE)funds to contract for onsite therapist • Conduct planning sessions with staff, partners, and community to gather feedback and develop strategies for improving child and family outcomes • Seek grants or other opportunities to develop more prevention initiatives Chair Rich asked if the number of children in foster care is known. Crystal Mitchell said it is currently 107 children. 19 Nancy Coston said this number fluctuates, and about 75% of cases involve severe mental health or substance abuse issues on the part of the parents. Overview and Update on Reform Plan • North Carolina Department of Health and Human Services has published 14 recommendations based on the reform work completed thus far • Highlights include: o DHHS to create 7 regions, phasing in by first establishing virtual regions and using existing community space by March 2020 o Modify language of NC REACH legislation to include youth who exit foster care to a permanent home through Guardianship Assistance Program o Modify legislative language to include provision for training Social Services Boards no less than 2 times annually o DHHS to conduct a feasibility and cost study for transferring adult guardianship cases from the Department to the counties o DHHS, in collaboration with key stakeholder groups, study and recommend a workforce development model for key positions in county DSS, regional offices and central offices • House Bill 291 authorizes the continuation of the Social Services Working Group • Directs the group to provide more detailed recommendations in certain areas • Continues work toward exploring mandatory regionalization of social services departments Commissioner Marcoplos asked if there was a particular impetus to do these measures. Nancy Coston said a few things, but it mostly came out of the federal government citing North Carolina as failing the Child and Family Review. She said every state failed, and the federal measures are almost impossible to meet. She said there was also a desire to review how child fatalities that were active child welfare cases, were reviewed. Erica Bryant, Child Support Director, resumed the PowerPoint presentation: Performance Measures: Child Support • All state performance measures for Child Support are set at a threshold of 80% • County goals may be set higher or lower by the state • Orange County met all county goals in SFY18 Erica Bryant said the County goal is based on federal incentive goals, which turns into revenue for the County. She said 80% was picked as the goal for the performance measures for House Bill 630, because that is where the incentive benefits are maximized. Commissioner Greene said she does not understand how 108% of paternities can be established. Erica Bryant said looks at the number of children born out of wedlock the previous year, and it is calculated by the number of paternities that are established this year. She said the birth rate is declining, so the figure will continue to be above 100%. Commissioner Greene asked if this is because some are being counted from last year. Erica Bryant said the base figure is always the number of children born out of wedlock the previous year, which is the federal calculation. Commissioner Dorosin clarified that the only item on which the County is behind its goal, is the percent of orders established. Erica Bryant said yes, and last year DSS met all of the incentive categories, being 1 of only 3 counties in the state to do so. 20 Commissioner Dorosin asked if the amount of funding that comes back as a result could be identified. Erica Bryant said $70,000 in incentive funds. Lindsey Shewmaker, Economic Services Manager, resumed the PowerPoint presentation: Performance Measures: Social Services (graph) • Many measures in economic services are in policy • Some measures have very low case counts • Data is still not available and/or has not been validated for many measures Commissioner Dorosin clarified that the reason DSS does not have data is because it is relying on the state to provide the data. Lindsey Shewmaker said that is correct. Commissioner Dorosin asked if DSS can collect its own data. Lindsey Shewmaker said yes, DSS could hand count some of the data, which it will do at some point. She said, ultimately, the goal is to rely on that data which the state provides, because it is that to which DSS will be held accountable. She said the data collection can be difficult. Commissioner Dorosin asked if the state's data is based on data it receives from Orange County. Lindsey Shewmaker said yes, data that DSS puts into systems. Commissioner Dorosin clarified that DSS can correct state data if it is inaccurate. Lindsey Shewmaker said yes, and DSS is having a data validation meeting with the Division of Aging and Adult Services later this month, but the state is still working on data that DSS cannot validate because it does not yet have it. She resumed the PowerPoint presentation: Performance Measures: • New MOU will come before the end of the year and may contain additional data elements if validated by then • Failure to achieve performance benchmarks will initiate a correction action plan between the county and the state • Continued failure to meet the terms of the corrective action plan will enact the takeover clause in legislation • Medicaid performance is included in separate legislation o Includes standards for application timeliness and accuracy o Errors in eligibility determination will result in county payback of state and federal funds o Temporary assumption of Medicaid program administration is included in § 108A- 70.42 Chair Rich asked if the number of staff working just on Medicaid could be identified. Lindsey Shewmaker said: Adult Medicaid: 10 staff Family and Children: 10 staff Intake interviews: — 20 staff Commissioner Dorosin asked if the state is doing constant reviews of files, or is there an annualized review in Medicaid. 21 Lindsey Shewmaker said Medicaid is a different animal. She said there are single county audits (some cases pulled every year); there are also a large federal review, where a percentage of state cases are pulled; and a new piece that requires the state to have a QC plan, which went into effect in January, and the state is pulling a certain number of applications, and a certain number of reviews (from the review counties) each month. She said last process was calculated based on a risk ratio, and Orange County is in year 3 of this process. Nancy Coston said it feels like reviews are constantly taking place. Lindsey Shewmaker resumed the presentation: Plan and Recommendations: • Moving DSS data collection methods and measures to correspond with the state's proposed areas of emphasis • Utilize state and internal data to inform program improvement • Participate in planning sessions with the State representatives to identify needed state support and to influence the role of regional offices Other DSS Services, Programs, and Activities- hand out • Food and nutrition services • Work First • Energy Assistance • Emergency Assistance • Disaster response and sheltering • Adult services • Child care subsidy • Medicaid • Health choice • Veterans' services • Adolescent parenting • Adult and youth employment services • Prevention social work services • Fishing licenses • Voter registration • Youth enhancement fund Chair Rich said asked if there is any way to talk with clients about the census. Nancy Coston said staff can do some of that, and they can have pop up census intakes at DSS facilities as well. Medicaid Transformation: • Medicaid will be changing from a primarily fee-for-service to managed care starting this year • Orange County will be in the first phase to roll out • DHHS has selected the 4 statewide Prepaid Health Plans and an enrollment broker • Medicaid clients will begin selecting a PHP in July of this year • Staffing at DSS will be impacted • Other impacts will be felt by Health, OPT, and Emergency Services on the provider-side Quintana Stewart said the Health Department will be seeing this coming their way in November, and is currently working on contracts with the four awarded PHPs across the state. 22 Nancy Coston said all of them are in the information-gathering mode as far as the provider community, and what that will look like. Commissioner Bedford asked if there will be any standardizations with the PHPs forms. Quintana Stewart said there is no standardization as of now, but the Health Directors Association is considering hiring an attorney to do some negotiation on behalf of the Health Departments to gain some consistency. Nancy Coston said contracts with all four PHPs will be necessary, and there will be lots of confusion. Commissioner Marcoplos said it seems that there may be issues all across the state, and asked if the odds are in favor of the plan surviving in the future. Nancy Coston said the odds are probably around 50%, and it started with those that wanted to control Medicaid. She said it expanded to include people who wanted to Medicaid to pay for things that it traditionally had not. She said the first group going in will be children, and there may be problems down the line if that does not go well. Commissioner Dorosin asked Nancy Coston if she can clarify how this will impact staff. Nancy Coston said when clients receive packets in the mail, many will call with questions, and that will impact the regular workload. She said DSS cannot tell families with whom to enroll, and must simply help families understand the process. She said some additional temporary staff may need to be hired. Commissioner Dorosin asked if there will be other impacts like negotiating these new contracts. Quintana Stewart said yes and how they will now be paid; and the same thing with OPT and Emergency Services. Nancy Coston said for several years it is going to be fee-for-service and capitated, because not everyone is going in. She said this is confusing when determining revenue sources. Commissioner Bedford referred to the "removal reason for children currently in care," and asked if"inadequate housing" could be clarified. Crystal Mitchell said that is not an issue of homelessness, but rather inadequate housing may be some safety issues in the home, like drugs, etc. Commissioner Dorosin said the hour is late, and the next item may take some time. He thanked DSS for the very comprehensive presentation. He said there is much to think about, and how the BOCC can be most supportive. Commissioner Dorosin asked if item 3 could be delayed. Commissioner Greene agreed. Commissioner Dorosin suggested moving the item to the April 9th work session, and Commissioner Greene seconded that suggestion. The Board agreed to defer Item 3 until the April 91h work session and make this item 1 on that agenda. 3. Discussion on a Potential Framework for Intergovernmental Collaboration with Municipal Partners The Board will consider discussing a potential framework for intergovernmental collaboration with the County's municipal partners. DEFERRED A motion was made by Commissioner Bedford, seconded by Commissioner Dorosin to adjourn the meeting at 10:12 p.m. 23 VOTE: UNANIMOUS Penny Rich, Chair Donna Baker Clerk to the Board