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HomeMy WebLinkAboutMinutes 04-22-2021 Virtual Work Session I APPROVED 5/18/2021 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS VIRTUAL WORK SESSION April 22, 2021 7:00 p.m. The Orange County Board of Commissioners met for a Virtual Work Session on Thursday, April 22, 2021 at 7:00 p.m. COUNTY COMMISSIONERS PRESENT: Chair Renee Price, Vice Chair Jamezetta Bedford, and Commissioners Mark Dorosin (arrived at 7:10 p.m.) Amy Fowler, Jean Hamilton, Sally Greene, Earl McKee (arrived at 8:23 p.m.) 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 Laura Jensen. (All other staff members will be identified appropriately below) Chair Price called the Board of County Commissioners meeting to order at 7:00 p.m. Due to current public health concerns, the Board of Commissioners is conducting a Virtual Work Session on April 22, 2021 utilizing Zoom. Members of the Board of Commissioners will be participating in the meeting remotely. As in prior meetings, members of the public will be able to view and listen to the meeting via live streaming video at orangecountync.gov/967/Meeting-Videos and on Orange County Gov-TV on channels 1301 or 97.6 (Spectrum Cable). A roll call of the County Commissioners was called; Commissioners McKee and Dorosin were absent. Laura Jensen introduced Assistant Deputy Clerk to the Board Crystal Long to the Commissioners. 1. Volunteer Advisory Boards and Commissions —Annual Work Plan Summaries The Board provided feedback and/or direction on the second group of boards and commissions' annual work plan summaries with their Chairs (or representatives) in attendance. (The first group of boards and commissions' annual work plan summaries were presented at the Board's March 9, 2021 work session.) BACKGROUND: In the past, as part of the Board of Commissioners' annual planning and goal setting retreats, the Board requested and reviewed/provided feedback on annual plan summaries from the County's internal advisory boards and commissions. This information provided the Board with a yearly overview of the boards and commissions and their projected goals for the upcoming year. This particular process ended in 2007. The Board decided at its April 13, 2010 meeting to reinstate this process independent of the Board's annual retreats. 2 Advisory Boards and Commissions Represented at this meeting: Board Name Representative(s) Presenting Animal Services Advisory Board Ed Tiryakian Adult Care Home Community Advisory Committee Anthony Carey Nursing Home Community Advisory Committee Vibeke Talley Board of Health Quintana Stewart Affordable Housing Advisory Board Erika Brandt Human Relations Commission Annette Moore & Frances Castillo Orange County Parks and Recreation Council Haywood Rhodes Historic Preservation Commission Todd Dickinson & Art Menius Agricultural Preservation Board Cecilia Redding & Portia McKnight Commission for the Environment Kim Piracci Climate Council Brennan Bouma Arts Commission Katie Murray & Fred Joiner Ed Tiryakian presented the Animal Services Advisory Board's (ASAB) work plan. He said the ASAB will establish a relationship with the new Animal Services Director, and work with the County Manager on veterinary services levels. He said the Board of County Commissioners (BOCC) approved a change to the County ordinance for a dog that was declared dangerous that allowed a dog owner to appeal for a waiver of muzzle requirement of a dangerous dog after 18 months. He said State statute does not allow that kind of review, and ASAB planned to make a request of legislature to end that, but missed the filing date. He said in the next short session, it will be possible to file a local bill to have authority for Orange County to serve as a pilot program. He said ASAB thinks this change would be an improvement of the state statute. He said the dangerous dog ordinance can be too severe in some exceptional situations, where a dog is acting out of character. He said ASAB thinks there is reason to take a second look in these types of cases, as is done in Wake County. He said ASAB meets 10 times a year and would like to move out of the Animal Services building and meet in community centers, high schools, etc., 2 to 3 times per year, to show people what Animal Services does and show volunteerism. Commissioner Dorosin joined at the meeting at 7:05 p.m. Commissioner Dorosin said he loved the idea of holding meetings outside of the Animal Services facility and in the community. He asked if the meetings are recorded. Ed Tiryakian said the meetings are recorded, and notice would be provided to the public. Commissioner Dorosin said it is a good board to start something like this with, because people have an interest in animals. Commissioner Dorosin asked if the meetings are video recorded. Ed Tiryakian said he was not sure. Bonnie Hammersley said the meetings are not video recorded. Commissioner Dorosin encouraged the ASAB to get out into the community, and to video record the meetings. Chair Price said she would like to know if the County Attorney thought it was possible. John Roberts said yes with a change to the board's ASAB policy. 3 Vibeke Talley from the Nursing Home CAC (NHCAC) said it was a difficult year for nursing homes, due to coronavirus infections and deaths, as well as isolation from family and friends. She said the NHCAC cannot go into nursing homes at this time, and, as such, she does not have updated information. Commissioner Dorosin left the meeting at 7:13 p.m. Commissioner Hamilton expressed sympathy with the isolation of nursing homes. She asked if anyone is going into facilities. Autumn Cox, Regional Ombudsman, said the Division of Health Service Regulation has been monitoring nursing homes all year, and the Ombudsman program has also had full access since October 2020, and on an as-needed basis prior to that. She said routine visits are still not happening, and there is not a date that volunteers from the CAC can begin visiting again. She said there are 6 new volunteers waiting to be trained, and she is working through that process with them. Commissioner Dorosin rejoined the meeting at 7:14 p.m. Commissioner Bedford said CARES Act funds paid for tablets. She asked if there is anything else the Board can provide to help with the isolation. Autumn Cox said 1 to 2 tablets were purchased for facilities, as well as data service for 1 year. She said after 1 year, the tablet can be used on Wi-Fi, or the facility can purchase a data service. She said CARES Act funds were also used for PPE. She said there is currently not enough PPE for volunteers. Commissioner Bedford encouraged Cox to reach out to the County Manager if anyone needs PPE. Autumn Cox said PPE will likely only be a medical mask. Commissioner Bedford said this situation has highlighted the need in nursing homes, and she hopes things can be better in the future. Chair Price asked if there are enough volunteers for the board. Autumn Cox said she covers a three county area, and volunteers dropped off committees across the state in mid 2020, and it is her goal to keep this board as intact as possible. Commissioner Dorosin left the meeting at 7:20 p.m. Chair Price referred to the tablets, and asked if there was a process to determine which facilities received them. Autumn Cox said it was based on need, and most private pay facilities did not receive any. She said the Medicaid facilities received more. She said those facilities with more than 100 residents could receive two Commissioner Dorosin rejoined the meeting at 7:21 p.m. Chair Price asked if the number of Medicaid facilities in Orange County could be identified. Vibeke Talley said four nursing homes take Medicaid. Chair Price asked the County Manager to consider if the county could help pay for the data service plans in future budgets. 4 Chair Price said some companies are donating PPE, and encouraged Autumn Cox to reach out to the County for PPE if there is a need. Autumn Cox said Shade Little was having trouble accessing the meeting, so she gave a brief overview of the Adult Care Home CAC's work plan and lack of access of adult care homes over the last year. Commissioner Greene noted some of the poor conditions in adult care homes. She referred to #3 on the concerns and emerging issues list, which said, "Local leaders remain apathetic about improving the living conditions for the poor elderly residents in Orange County long term care homes." She asked if there are actions the BOCC could take to intervene to improve the situations, because apathy is not the root of the problem. She asked Autumn Cox if she knew, to what, these comments were referring. Autumn Cox said she did not, as she was given the report, which was approved by the committee. Commissioner Greene said the report asked for incentives to work with adult care providers. She said she was unsure what type of incentives the BOCC could provide, and she would be interested in learning more. Autumn Cox agreed with Commissioner Greene, and said some of the homes are privately owned. She said she would follow-up with the CAC. Commissioner Hamilton also expressed concern about the comments in the report. She said she used to work in adult care homes, and understands that some are in very poor condition. She said she wanted to review the role of the county and the role of volunteers. She said change is needed at all levels, and the Board of County Commissioners should see what it can do. Chair Price agreed. She said she was particularly concerned about no handicap accessible door requirements, and staff ratios. She said the comment about local leadership being apathetic bewildered her. She referred to the comment about incentives for care home providers, and said she would strongly support the Board helping in any way possible. She asked Autumn Cox if she would relay to the CAC that the BOCC would like to work with them remediate these issues. Commissioner Fowler agreed with the previous comments. She asked if inspections are happening, and does the BOCC need to file reports with the State. She referred to the possibility of incentives. She said many staff are underpaid and overworked, and turn over is high. She said the BOCC can continue to focus on raising the minimum wage. Autumn Cox said some of the needs expressed in the report are not required by the state, such as accessible doors and generators. She said assisted living and family care homes are regulated at the state level, while nursing homes regulated at federal level. Commissioner Hamilton said the state Medicaid system is paying adult care homes, and are dependent on what they receive. She said facilities need more compensation to provide better services. Chair Price thanked Autumn Cox for her participation this evening. Quintana Stewart presented on behalf of the Board of Health. She said 3 new board members joined the board in 2020. She said the Community Health Assessment was completed prior to pandemic, which is required every 4 years. She identified 3 new priority areas: access to care, health behaviors, and health equity. She said in the next 4-year cycle, access to health care will be a priority. She said health behaviors will fold in a previous priority of physical activity and nutrition, and will also include substance abuse. She said the goals are broader so as to address as much as possible. She said health equity is also a priority, and the Department will be looking at issues such as poverty, environmental justice, etc. 5 Quintana Stewart said the Health Department obtained a mobile dental van in 2020, and will have a soft launch in August, if COVID-19 restrictions are lifted. She said a tour of the van will be provided to the Board of Health members when they are allowed to meet in person. She said the BOCC would also be invited. Quintana Stewart thanked the community and partners for their response to COVID-19. She said the Health Department and Emergency Services implemented a strike team to visit long-term care facilities in the early days of COVID-19 and helped with testing and PPE. She said the state provided funding for infection prevention teams across the state, and there is one such team here in Orange County that covers 9 counties. She said this team will be highlighted on the weekly NC DHHS call on COVID-19. She said the strike team is also working with vaccination clinics. She said there was a robust group of communicators and the messaging was effective, and the education campaign was really strong. She said everyone worked together, which was so encouraging. She said the county provided its 10,OOO1h first dose vaccination last week. She said this is a great milestone, and there is great relief in the public to receive vaccines. She said the process will transition from a drive through method, to indoor clinics due to increasingly warm and stormy summer weather. She applauded everyone's efforts in fighting COVID. She said Orange County cases are stable, and she wishes the numbers were going down. Commissioner Dorosin left the meeting at 7:42 p.m. Commissioner Dorosin rejoined the meeting at 7:43 p.m. Commissioner Dorosin left the meeting at 7:44 p.m. Quintana Stewart said the community has remained vigilant, and the governor may lift restrictions soon. Chair Price thanked Quintana Stewart for her leadership, and noted her dedication. Commissioner Greene thanked Stewart for her and her staff's work. She highlighted an award that employee Victoria Hudson received for outstanding contributions to the area of environmental health. She said she received this award for working with local organizations and businesses to develop COVID safety plans. Quintana Stewart said the department is very fortunate to have Victoria Hudson as the Environmental Health Director. Commissioner Fowler thanked Quintana Stewart for her leadership. She asked if the Health department is doing targeted vaccinations for the Latinx community. Quintana Stewart said yes, the Health Department has partnered with organizations providing services to the Latinx community. She said the mobile unit ensures access, by going out into the community to reach people more easily. Commissioner Fowler said those who have showed up to clinics say it is because their employers told them to come. Chair Price said the website has translated information. Commissioner Bedford asked about vaccinations for homebound residents. Quintana Stewart said the Health Department will go to the house and give vaccinations in the home. Commissioner Bedford praised the Health department for its efforts over the last year. Chair Price thanked Quintana Stewart. Quintana Stewart introduced her board chairs. 6 Erika Brandt presented for the Affordable Housing Advisory Board (AHAB). She said the AHAB is interested in exploring new housing strategies. She said the AHAB is meeting virtually, only as needed, for high priority items. She said the AHAB reviewed funding applications in August 2020, and met in February of this year to review outside agency applications. Erika Brandt said prior to the pandemic there was a community meeting to learn more about what AHAB does. She said AHAB has a new member from Hillsborough, and bring her own perspective as a resident in affordable housing. She said 3 vacancies that will be filled in the new fiscal year. She said AHAB's goals are to expand outreach; developing a standardized presentation to use at community meetings; attending the NC Affordable Housing conference; and exploring other training opportunities for members. Chair Price thanked Brandt for her work in keeping people in their homes. Frances Castillo presented the work plan for the Human Relations Commission (HRC). She said the 30th annual Pauli Murray Awards were held this past year. She said the HRC conducted two fair housing hearings. She said the HRC is working with Commission for the Environment in order to see things through a social justice lens. She said the HRC expanded its community book read to include author discussions, as well as event with Democracy NC on how to vote safely during the pandemic. She said the HRC reviewed membership of other boards and commissions with an eye for diversity. She said the HRC also participated in the County's listening session about racialized policing, and did a follow up conversation this year on untangling the #defundthepolice debate. Frances Castillo said this year the HRC had a Pauli Murray Award ceremony, which was wonderful. She said this is fair housing month, and the HRC has put together a social media campaign to help people understand their housing rights. She said these materials are being translated to other languages. She said in May, the HRC will have another community conversation about how to build community, and what are people's roles in doing social justice work, as everyone is needed. Frances Castillo said the book read is being planned, and there is a desire to incorporate books families can read with children. She said the selection will be more holistic and multi-lingual, as the HRC wants the entire community to participate. Frances Castillo said there is a future collaboration coming up in September or October, surrounding Pauli Murray and engaging educators. Frances Castillo said the HRC's goals are to engage with community members who are not aware of the HRC's work. She said the HRC is reaching out to other boards, tapping into others' networks, reaching out to faith community, etc. Chair Price thanked Frances Castillo for the work of the HRC, and for bringing people together. Haywood Rhodes presented on behalf of the Orange County Parks and Recreation Council. He said the department pivoted during the pandemic, and provided recreational opportunities online. He said a concern that became apparent was that many residents do not have access to fast Internet. He said the department helped in these situations by sending recordings of the activities. Haywood Rhodes said facilities are of concern, and the parks are getting a lot of use. He said the department would like to find a way to partner with public schools, as they have a lot of capacity. He said the Central Recreation facility in downtown Hillsborough is the only place for basketball currently, and schools could be a great resource. He said there is a local tennis group that is trying to expand tennis offerings in the County. Haywood Rhodes said the second phase of Blackwood Farm construction is coming up. He said the Soccer.com facility master plan is also being reviewed. Commissioner Bedford referred to the lands legacy plan, and asked if clarification could be provided. David Stancil, Department of Environment, Agriculture, Parks and Recreation Director, said lands legacy has a three-year plan which will come to the BOCC in the fall, but advisory boards are providing comments on top priorities. Chair Price thanked the department and council for their work. She said isolation during the pandemic has been difficult. Haywood Rhodes said staff put a lot of effort into virtual resources, and it is hoped that this can continue to allow further reach into the community. Art Menius presented the Historic Preservation Commission's work plan. He said the big project in 2020 was the historic book, for which all 225 entries have been written. Commissioner Dorosin rejoined the meeting at 8:11 p.m. Art Menius said the commission needs to raise $35,000 to print and deliver the book. Art Menius said the commission got two new national Historic Register properties. He said both are important mid century properties, a time period which is now 60-70 years ago. He said the first was Cedar Grove School, which opened in 1951 and was a historically black school. He said the second property was Schley Grange Hall, which won a Sears and Roebuck competition as the best grange in the nation. He said locally Harvey's Chapel AME church's cemetery was added. He said this cemetery is deep in the woods, and was lost for many years, as roads were not maintained for historically black communities in the 1930s. He said the Old Eno Quaker Cemetery was also added, which was started in 1760s. He said the final local property is the David Fawcett house on the Eno River. Art Menius said the commission's main goals for this year are raising funds for the book, as well as a historic marker program, which will help bring in more diversity. He said many properties important to African American heritage no longer extant. He said the marker program will tell the story, even without the property present. He said the commission wants to add more diversity in its historic marker program. Art Menius said the commission will be looking at courthouse square, and the old courthouse in particular. Art Menius said the commission will participate in the 250th anniversary of the Revolutionary War. Commissioner Greene thanked the commission for the historic marker program. She asked if more details could be provided about the old courthouse program. Peter Sandbeck, Cultural Resources Coordinator, said the project was formed in response to county's long range CIP project to do restoration at the old courthouse. He said part of the need is to learn about the physical evolution. He said such a project requires going through minutes, courthouse records, newspapers, etc. He said this led to a larger examination of the history of the county through the courthouse, and an in-depth social history needs to be completed. He said it will be important to secure the ideal research team. Commissioner Greene said the Register of Deeds will be able to help. Chair Price said she is looking forward to the book. She said there are stories in the community about the courthouse. Cecilia Redding introduced the Agricultural Preservation Board's mission and objectives. 8 Peter Sandbeck said the board reviewed 12 farms, and added over 1000 acres. He said 133 farms are now enrolled, totaling 16,500 acres protected from development. He said this maintains the land in farm use, and is a voluntary program. Commissioner McKee joined the meeting at 8:22 p.m. Peter Sandbeck said there has been remarkable growth in 10 years, and he wants to keep the momentum going. He said there has been a lot of administrative work on the transfer of lands, as people can move in and out of the program. Peter Sandbeck said the board is part of the food council project, and has a dedicated seat. He said this has been a very informative partnership. He said the board continues to help farms with the Century Farm program, having added four more farms this year, totaling 32. Peter Sandbeck said grant money has been distributed by economic development to support farming, which has been wonderful. Peter Sandbeck said the board hopes to create an Agricultural Trust Fund, under the auspices of the county, which would promote farm land production to support local food economy. He said this is in the exploratory stage, and would supplement the lands legacy program through a dedicated funding source. Peter Sandbeck said the board wants the county to become a leader in dairy production, which is a large part of the county's history, and looking at ways to achieve this goal. Chair Price thanked farmers for all they do, and looks forward to the board's future plans. Christian Hirni presented for the Commission for the Environment (CfE). He said many CfE members are involved in Earth Day activities, and he is presenting on their behalf. Christian Hirni noted accomplishments for 2020. He said the CfE reviewed the submitted rankings for applicants for the Climate Action Tax Fund Grants; participated in reviewing the lands legacy action plans, and submitting priority recommendations based on environmental concerns. He said the CfE held discussions around Orange County land holdings, and received presentations from the Eno New Hope land conservation group. He said the CfE worked with the Planning Department to review and comment on several county development proposals. Christian Hirni said the CfE would like to draft and submit a proposed tree management plan to manage the tree canopy on Orange County lands. He said the CfE has concerns around food scarcity and availability in the county, and is interested in reviewing opportunities to preserve farmlands. Commissioner Bedford asked if there is a timeline for the next round of proposals for climate tax funds. Brennan Bouma, Sustainability Coordinator, said this process will begin in early May, and be open throughout summer. He said the CfE and the Human Relations Commission will review and score the applications, and come to the BOCC in the early fall. Melissa McCullough presented for the Climate Council, and gave an overview of the council's history. She said this year the council created a database of 200 actions taken by local climate organizations, and brainstormed actions that could be taken by local governments. She said these actions were categorized. She said the council is part of the second round of LEED's beta testing system for cities and communities. She said the Council also held its first annual community update meeting, where actions and goals were presented to 80 local participants 9 Melissa McCullough said goals for this year include a work plan for effective joint actions based on previous evaluations. She said there is not only low hanging fruit, but over ripe fruit that can be accomplished. She said the council will also develop by-laws and member laws for increased collaboration. Commissioner Fowler asked if an example of an over ripe fruit item could be identified. Melissa McCullough said community solar, building codes to promote green building, school curriculum, resilient land use, low carbon, biogas to energy co-digestion, etc. She said the desire is to multiply effects, and there may be some federal money coming to address climate and infrastructure. Melissa McCullough said all the information is available for the BOCC to review. Chair Price asked if that information could please be provided. Commissioner Greene asked if there is a plan in place to coordinate with other local climate plans, in order to avoid duplication and promote synchronization. Melissa McCullough said it is challenging because all entities are in different stages, but the Climate Council is made up of representatives from all of various governments who are all working very closely together. John Roberts said Commissioner McKee asked him two questions prior to the meeting. He said the questions were related to how the Climate Council is a public body. He said the council is a public body under state statutes, and serves the function of policy and providing information. He said the Climate Council cannot fill vacancies or create additional positions, unless the BOCC expressly gives permission to do so. Commissioner McKee said his questions stemmed from the last full paragraph on the first page of the abstract. He said he wanted clarification on the council as an advisory board. Commissioner McKee asked if the number of people originally on the Council could be identified. Brennan Bouma clarified that there were 12 active member organizations on the Climate Council, with a roster of 30 spots. Commissioner McKee asked how many of those positions are filled. Brennan Bouma said he would check. Commissioner McKee asked if staff is working with the Clerk's office to fill the vacancies. Brennan Bouma said yes, staff is working to fill those vacancies. Commissioner McKee asked for clarification on the number of vacancies. Brennan Bouma said that three vacancies were recently filled, and there are still about 7-10 vacancies. He said some positions have never been filled, and the by-laws and membership rosters would help clarify the roles. He said it would be approved by the Board of County Commissioners. Melissa McCullough said the council is also concerned about vacancies. Commissioner McKee said he is concerned about keeping vacancies filled, and sometimes boards and commissions are just too large. Commissioner Bedford said she was glad the council received a grant for membership and training. She said the group has capacity to do a lot of work and collaboration across many areas. She said she was glad the council could provide an update this evening, and their list of things to tackle is very large, and she looks forward to seeing how they proceed. Commissioner Bedford said the new Deputy Clerk to the Board could assist as a liaison. Commissioner Bedford asked if there has been any success in recruiting minority members. Chair Price clarified that there are specific seats for different organizations for the council, and the Deputy Clerk may not have the ability to help. Chair Price said there have been efforts to diversify. 10 Brennan Bouma said the National Association for the Advancement of Colored People (NAACP) is one of the active participants on the Council. He said there is some minority representation, and efforts are getting more serious in this regard. He said it is an active part of the council's discussions. Commissioner Bedford said the by-laws might require legal assistance. She suggested speaking with the managers and mayors to see if things need adjusting, now that some time has passed. She said it is important to consider what is feasible, and to have focused clarity. She said it is important to be confident in the mission. Commissioner McKee said given the high number of members, he would expect to have a more straightforward number of how many members represent diverse groups. Melissa McCullough explained how each organization that makes up the Climate Council is allotted seats on the council. She said each organization makes a recommendation for who represents them. She said the local governments set aside a seat for the NAACP and seats for youth. She said the way it is set up makes it difficult to get proportional representation. She said the council takes this seriously, and is looking for ways to hear other voices, even if they are not on the council. Commissioner McKee said he would like to know the make-up of the council, and wants to know how many members from the Black, Latino, and Asian community are on the council. Chair Price said there is very little diversity on the council. She said staff will have to provide the information. Commissioner McKee asked if there could be clarification about the use of building codes to promote green building. He said he is concerned about regulations. Melissa McCullough said the council would only provide advice to the BOCC. Melissa McCullough said there are groups providing information on green building pertaining to code. She said green building is not just about energy, but also health, mechanisms, mechanical, etc. She said some things are related to codes, some are related to information. She said children learn better in a green building, patients heal faster, people are more productive, etc. She said sometimes those who make code just need to be educated. Fred Joiner presented on behalf of the Arts Commission. He said the commission has tried to be innovative during the COVID-19 pandemic by providing resources to aid the arts industry. He said it has been a busy season, with significant funding being raised to support artists. Fred Joiner said the commission met a need by providing artists' space for 13 artists at the Eno Mill, with net revenue of$16,000. He said the commission is working on phase 2 of this project to provide greater use of the space at the mill. He said there are ongoing conversations with the owner of the mill, including a children's theater, community dark room, ceramics studio, etc. Fred Joiner said annual grants were distributed, and one use of these funds was the "Love Hillsborough" mosaic from Summer 2020. Fred Joiner said there is a plan in the works for Art on the Hill, a partnership with 14 community and governmental organizations. Fred Joiner said a new non-profit is being created to support the work of the Arts Commission. He said the commission participated in the Plein Air project, as it does every year. He said the commission also put out 30 stories of local community members. He said the commission educates the community on the economic impact of the arts, as well as providing high quality arts. He said the commission desires to strengthen the community, provide access to the arts for students and especially artists of color, and showcase the creativity in the community. He said the commission collaborates with over 20 organizations. 11 Fred Joiner said the commission wants to be a clearinghouse for the artistic community, and will continue to provide space and free education opportunities throughout the county for all residents. Fred Joiner said the commission has given thought to economic development, and how best to reopen post pandemic. He said the commission has to plan ahead so that it is ready to be a support to the arts community when it reopens. Fred Joiner said the commission continues to look for artists of color, and arts organizations that practice in racial equity and diversity. He said these efforts are being made across the arts community nationwide. He said he and Katie Murray are looking closely at artist residency programs and aiming to increase diversity therein. He said the commission desires to be a leader in this area. Katie Murray, Arts Commission Director, said there are requests to allocate some of the ARP funding towards Arts Community. She said there will also be a proposal coming to the BOCC on May 4 for Eno Mill. Commissioner Bedford thanked the commission for its efforts in fundraising and continuing to support the arts throughout the pandemic, and thinking about the post-pandemic recovery. She said she would like to speak to the commission at a later time about their efforts to develop a diverse board. She applauded the commission's success in this area. Chair Price said Katie Murray does a great job at personally reaching out to people to serve. Commissioner Greene said the arts can be life changing and life saving for people, and outlets need to be available for everyone to access the arts. Chair Price said the National Association of Counties (NACo) did a resolution for the federal government to put forth funding for arts and mental health partnerships. Chair Price said Fred Joiner is a phenomenal poet. Katie Murray said he is also wonderful board chair. A motion was made by Commissioner Hamilton, seconded by Commissioner Fowler, to recess the meeting. Roll call ensued VOTE: UNANIMOUS RECONVENE THE MEETING Commissioners Dorosin and McKee were not yet present, but due to a quorum of board members being present, Chair Price asked for a motion to reconvene the meeting. A motion was made by Commissioner Fowler, seconded by Commissioner Hamilton, to reconvene at 9:37 p.m. Roll call ensued. VOTE: UNANIMOUS 2. Orange County Crisis/Diversion Facility: Findings and Recommendations by the Orange County Behavioral Health Task Force 12 The Board received information about the findings and recommendations of the Crisis/Diversion Facility Subcommittee of the Orange County Behavioral Health Task Force. In addition, the Behavioral Health Task Force is seeking feedback from the Board and initial support to move forward with detailed design and implementation planning. The first recommended action step is funding for contracting with a project design consultant to conduct detailed planning including design of Facility space, staffing, and licensing. Implementation planning would also include governance, policies and procedures, and cost estimates, budget sources, and funding needs. BACKGROUND: In April 2019, over thirty community stakeholders from the criminal justice system, healthcare, behavioral health system, and housing came together to participate in the Orange County Sequential Intercept Mapping (SIM) Workshop facilitated by the North Carolina Department of Health and Human Services. The SIM process is designed to inform and address community- based responses to the involvement of individuals with behavioral health issues and intercepts with the criminal justice system. An intercept map and Final Report were created (SIM Final Report) and one of the identified community gaps that emerged from this process was the critical need for a Crisis/Diversion facility that would support diverting individuals in behavioral health crisis from the criminal justice system and the Emergency Departments at UNC Hospitals. The Behavioral Health Task Force (BHTF), co-chaired by Barbara-Ann Bybel, Director of Inpatient Psychiatry Services at UNC Hospitals, and Caitlin Fenhagen, CJRD Director, formed in 2019 to address the behavioral health intercept gaps identified in Orange County. The mission of the BHTF is to improve outcomes for individuals with behavioral health disorders through partnerships across justice, law enforcement, mental health, homelessness and substance use service systems. Later in 2019, the Crisis/Diversion Facility Subcommittee was formed and tasked with bringing forth recommendations and a plan for a dedicated Facility. This Facility will offer behavioral health crisis services and allow for law enforcement and hospital ED diversion. The Subcommittee, under Tony Marimpietri's leadership, has met diligently and frequently over the last two years to address this high priority need. This process has included a lengthy literature review of best-practices and elements for a crisis/diversion facility, studying existing state and national crisis/diversion facilities, seeking input from critical local stakeholders, looking at use case scenarios, examining available data and determining the appropriate scope and function for an Orange County Facility. This presentation will share the detailed findings and recommendations of the Subcommittee's work. An overview of these findings and recommendations has previously been shared with the Behavioral Health Task Force, the Justice Advisory Council and Orange County's law enforcement leaders. These presentations have been met with broad support and interest. It is the Behavioral Health Task Force's strong belief that the proposed Facility, and its evidence- based, holistic, trauma-informed policies and practices will lead to necessary enhancements in Orange County crisis system capabilities, will increase diversion and deflection from the criminal justice system and will improve healthy and safe outcomes for residents of Orange County. Caitlin Fenhagen, Criminal Justice Resource Director, introduced the item. Commissioner Dorosin rejoined the meeting at 9:40 p.m. 13 Tony Marimpietri, Orange County Behavioral Health Task Force member, made the following PowerPoint presentation: Slide #1 ORANGE C• CRISISIDIVERSION Recommendations11116� FACILITY Findings and PW "EALYH TASK RUACE Slide #2 EXECUTIVE SUMMARY BHTF ItaparC Thi Npvrt prosw.a Qrangq County Bahavlaral HwM Task FpFnd-ngs and racwnnwndatlonsfor Oranga Covnty w establish a dedicated behatsrarsl health(BH)eHs%•dlrerslon FnmAkr to enhance les erisis respanw sXmm xnd capsb3des. • Currwrt Statu&Orange County dots mat hams a cornpnuhwalva BH crails sysUxn.WQ navy IdwKaAod mny gain mcurNm sarvlcos and IImUd apdons w sutcenhdly entre sat eBdawl in erlse from erdser bmini al.hased emergency deparuxent-(EDy or erintilal pwrice fCj)syuem-Thc nand Is charattarasld In tonins of critical sarvlcw that currwtty aro laclamg and asdmamod swarf for crim care. Rocommondatfum Tim ro nwndatlon prx rtad haroln a for Orange Coveay to enhance m crals system by wtabllshvmg a dtadlcacsd Crals'➢Ivwslon Facility to prondo for BH cram Par++ Arinwml prstice dlvorslon.If anpIvno md."Facky mW�Vad pulldN.prcccdunas. and praedees wi Ind to enhaneemestes in Orange County er&sls system eapabllleles by emhishing services that mrrendy dos ercc or are Ilnatad sm dna or mora Important ways, • Potoretial Borwlits.Tha hono6is of osutlahing tho rvconrmwdod cnsls-dinwrmon Faddy aarm to;ly Ow Individuals erIm.hlslhorfanlly and fnondc2}kww onWa rwntand enwrgoncy nwdlwl profwowak;3)hos tasod ED and In-padernfaday aced staff.and 4)varlous crinseal juuke inkiholden IneludIrkgdeterw6m etwer apem C6 and mff-Through eonwnuni"Ide eollaboradon and nerwerkingwadt am died traatnem and Poral sarvlcas parlrwrP.Qranga County w d mwwwD a continuum of carr thus fadranng affiactive trarippoo from crim card is C0h Wtunl[y areatlasenL Nowt Stops.If tho Board of Covnly Conn wmars acwpts rho BHTF noconemomdhvora,tha noxa phasa wd addma crv.aGon of a doaAod Implementadan plm inr eonser%wfi cpem6on of anOmar CaungCrlse.Dlrerslon Facility_Fundingwi be needed for this detalled pdmnina and additional anlnwnwet work 14 Slide #3 CONTENTS Aeranyme Uted anThls Repan ExhlblkAApr112019 Workshops Intraducdan Se9umesl laroeree�eP4pf.:t�Fmm�venl. M,4..A OrangaCourxy SIM Map Suheonamleee Charge EKlsdrgftnouren Q—54 Exhibit B.Bask PracPss Ind ngs SIMWBrkahep(oppo s�&sN) L&erarureR.I— +M.I S.nleeheltlen(needed senlenJ US.Pragnmsand F-1 Ka • Best PrxKaL—opportunldas far mpmvamaM Exhibit C.Orange Q+w�sf Pace Saurcas and News • fteaaanmendatlen Ndlwtad Fndq • Scope aetd Tunmon • Pocamal BanO. Rtl.d tentiderad— N-5t9ps Slide #4 ACRONYMS USED IN THIS REPORT • lee. Nvw n.d.nal sulddsl rlw k4nvo. • ADATC. Ak hd and DnlgAb—TFwbnam Canter. • 13h. Mhaswnl Hnkh{+ttludes aeRan.—I imsa saM auh—ux diteMenJ. • RHTF. Onnge C.—y Beha—M Hesleh Ts A Form • BQCC. Orange Cawray Boardof'C—q Comnws+orwrs, • CRIPA Ch.,I HIII KA.Dapa—nt • CWN— naonproftcon Tsly c~for Individuals'+145141. • e FIATFL Emergexy RsyehuerieAanunerrt.Tresemene&H An(JnlL • IDD. I 11 unl Deveacjnm wl D9acrder. • I'v'C, I�eaawMaryCemmlm.anc • LEUQ Lav Enforcwna*L-Enhrc inOR— • LMFMCQ LW Manag—EndWManagad Cara Organludan f—ag,Madlcald fwd far rn 0health). • MAT. Medlnden AnlsmdTnei—ne(refento medleadens for Upas®Use Olmrder). • NAMI. Na:5emAA9hn ,Meeua1— • OCSO. Orange C—ty SMrlHOffsa. • SIM Sazluart9aalraarcapt Mapp:r�g: SMI, Serious 11-W Illness. • SIJD. A.Mrnnec the LWerdee. Slide #5 INTRODUCTION:REPORT PREPARATION AND REVIEW • Ttw mporchatbi—prepared"a0ri9sye Counny SHTF Cfeal Olvanlon F3c111cy'.fubBdnllYiC— The napun puq Porth th9 Subcar rr iaic i s mcommandaoon far an Omega County Faclllty and prowldas a summary ofthp msoar-ch and asses lm era worked m retch 1cs retYn—nda J— • These rocormmsirvhtwm have bean pmsencrd to and mvlsrraad by ssnaral advlsary and pubk-PIG max greups opieran>g.n Orargw C—av Including Orange CAuascy EW h-11 Health Task Ferc.4BMTF).January 20,4Ar21. Ora rags,Caumy,ladcaAdalsory C.."$Ac1,Foob rwry 122021, CW*hof flfYee and OmMe Ceunq Sh�rNF.Msrtb 24,202 1. Cwalmants aaW edits proaltlod duringdaasa dacumlons ha+a bwn Incorparatsrd Into that varsson of the®MTP's mponforthao Oran®County Bxird of Ceunq Canmmioners(BOCCI. • FursaaamwgtrMhmaE from the BQCC,tllasa isasls for more 4QoIIg4phomg Including d9slga of FaahY spaces suA6lta.lieealSing Seaarcrnanee•pelleles and pr-sftmLbudgee_and hm frta. s 15 Slide #6 INTRODUCTION:BACKGROUND 2013.CYranrC...y ROCC adopuda Rnoludon suppordmj9L**g4 J,,Mf ..fo Reduce JWe Nuvrk—fhprewhh Merdd IA—Mjaws. 2011,Oranse Caum y Shelia'Chanes Slaekwssad raked rhe Idea of Ineiudlnain the plaeisna far rhe new Orange C—Ay Demenden Center a stpance.urea rhac vraud serve as a drrerslon unit for law eoforcemem_The pianningfor—h a fu3ay wa rot compl—d in dine for cansdaradon by des Oran&.County 90CCAt th.Aria,Jail Pft.ml H.aIdaNbrk Group stA hcld—wumd NC fad, tlwt are prowrd nS se 1—rhacmlbhcbe a model foram Orae Counq faclllry: • 2014.OaAprll2S•25,NCDHHSmdOrmWCouhpheldaserksofwarUhops-SegVenddlfnfwceps MappliuATukMiA:dam JnrChamge fcarte�cesyreJemed m as SFM Wwiuk hep)with 32 local represemtadvra of orpras5oam Involved in crhnaW justice ICJ),UNC Htaldl,oammwlrry 4-Vneno-"amwrXwKxr rnedlwI servi—w address Issues Imvulving BFl orad CJ Thx+wrksfrsp ldwwAwd gaps in wrremtsarvlces and assllped prlorides for amon:a min center was assumed High priority. 2019.In November 2019,mVcmnlhlllq for addre"rhes high piloriq anion In—was.sired m the BHTF Subserprerary,Are CriiW llvenlom Fuiuy Subcommlceewa formedaaduslaed with brim faro.mr—endsaam. 2020.In Deeemher rhe CoverntrItno Frorc for Raadl Fquit y rn CrIminaijusece r"mel in ArAV and reamrnendident.rhrea of im Task Fore's msaomnwndadonsmhu dlrw*v*situadons IrwvIvinglndMduals w0 BH ksuss and crimvW rAdce diversion. Slide #7 INTRODUCTION:SUBCOMMITTEE'S CHARGE Taw AndIRp and reswmnwndadons prwauwd Iwrene ata basad _ on Ase work of a suheomrmitneee rhe Oraa;a Counq Torry M.,Innplerrle ,.. Exhanoril H.1thTadt Furca(SHTF). Chahr NAMI-Orange County M3lsshse Addreashigh pvforlq Item idendr&din SIMVibrkshap. Calclin Fenhagen OC Criminal Justice Resource lack ofa tris.cant., Sponw Depammem(GIRD) Gaols:Formulatt reconsrntmdaoow far4range Caupty erns 8arhara-Ann Byhel, UNC Health Care wrwi—rhacwoLddhoiene dlvenlon of Individuals Sponsor wparlawr1s;5H(MH and VIUD)coals from aK1wr, CFC&pard pf County hospnl-'hmederneraerxy deparamem andlar Ia�ecta Redford CpiYsns13s16nGYs crimsmaspssdca s}staan, Heathror Grlfn•DoWney Freedom How-e Megan Johnson CHPD Crisis On It Angela Strain UNC Health Care PamelaWelden Distrltc Court Judge's Olfloe Kim VYoodv rd orange County EMS Allison Zlrkel Orange County C)RD Slide #8 CURRENT STATUS!SIM WORKSHOP(OVERVIEW) Tho{Tran&.County Crinrau jwdc.f4murea Departmatrc DwrictCourt Judges°4FRce.and mu"cith4rIoW sagsraquestedthe Sequenudllraercept M.*ping and Tdk.tngA.cflen TdrOlwnge wprk0bops held inAprll 2914(SIM Workshop). Ties primary ablecw.s of aha 51WMirksYacpam, - Oexelop a compreherunrc Acture of how people with 51-1 disorders Ibsr thro.Xh Orange Crony crin*W pedce gysrem.Exhibit A describes the SequentulImercept 1 Framr rk and providesderails of dee sequentWirwerceptnappaag fpr Orange Counq. - Idendfy papa.rev,s.rreiamd apperralnldes far saxerxendan and dieheedan at mth Imrenaepr_ - Datarmasw pnaraws to mprow s}stam orad aaMca I.wl reFporasas far rradrnduass In the target populadon, As rvomd In ties rmacrkshopdccurrwnwdan,mprnvingctrOccrncs fcrlustrw-lnwlv.d parscnswlth taaharroral health dlxvrdars raqulrvs pnrtnerahlpsacrpss the lustiee,laxntal heN9klaamekssneds.and tubstaneeuse wrwre.systems. 7be BKFF Is dnrpd+ th Ib"Viii load parmenhlp.ln truss..■nplamna-UVanaf the nedon plan devewped duringth a Ta4ingAtuon Tar Change Mf1L'sb* • Esthi6icA stmmantmasaha programsamd raaouncas alraady.xla In Orar�aCounryThasa rasourcwpro++da a solid iaundadon uponarhsth erila system�hanetmenrs can he nude. 16 Slide #9 CURRENT STATUS:SIM WORKSHOP•(FRAMEWORK) n Inxen..yr0 F Mbraprt =I1W 2 Ma+teprd __T4 �.s 4 ._....IM tipr5 .,. esus .•..� �� (nwapeanwnr 1 c h Yww,., �Cres �. •. aeaa-alaKi.i aWa.�seace _ ,ndl �"•f �.,,a 4" /// ll l l.J . Q 20 i9 Policy R--h Asmci­In The Sequessdsl letercela MappYq Frarrewtark{Ur9fKn-ec al.)a organized as Also-ated.,boyo.SIM Workshop output is orgpnited accard-ang sa dorsa iredarcapts. Orange Caumy Is fertu+ to m have massy exlsx n;Cross-system pregrama.serviees.and ptrtmeftkps t+cax pians mnblI&1*d duringthaWarkshap. • Workshop ldavdfied epporteeides m build on exlsdrq Ordsge[ouncy pxagramsand services widsdK replacing or dupicsdn2 any cxssdng wrs.pas, GriiAn,PJi.Flsilbmn,K•,FlulrgaEP.,0.Hratsv.,lA,d Schubert CeS.(�J•¢AI SI.TheSeo.e.ml I.berce.r M_'-.a.,d Crnsalj.dsnih.mmm�C.mm..ikrRlsereeM'n br IodY Iduak wide 4wloue Mnoral Illnaaa.WawTar6e6�r-0 Ikwvrslq Pears.fs01�10.1 fY13+ar3{c7 dN97A0.144816754:OtrI.00d1 Slide#10 CURRENT STATUS;SIM WORKSHOP(GAP ANALYSIS} Gaps sd.nclf cl by parocnpaasts duringth.51MVV/ kslrop are orgamc.d according to Innercepa as definsd 0 the S.quwwW hstarcem Mappeng frunevrork. Imarcept 0:Community-Balsed Crhls Services,Fxctingcrim WterceptllEjaYsfCmm(5ee Hetej Them is llmiced plio6w wrwcas ha+.Imltad acp.s due to axdueumaryallglblllty telt..... space lnchvP.aentian CasN.r For addi.eawi progranesr .andra Ilmrted ispurs of aperatlon.4alq wal[semes,ti+arts[s vises[ob.ing at ee��nted heus»gfervpenenssvida mores)mess andfer suhsnnce capaclty.and+aro%,Ilrn ddlpdnrgeplanningaodsuppvn. mpolagnpsas TherelspmndalmincrwsenvNa lsandcllnlwl • Istetweepel:Law EnfarcemenvErn.gencylie-lie-There suppere far Otidreathteure and CdMmenee}•9[tlauree[aurexM ambinsted apdont and snpportfor lax enforcemwstcafAcen and thereby allow for.none lndlAduals to..,aces asl=asps. other anergencr sorvica providers for dlnrwq sn&sdrnk frcen CJ OeharCmsWarations:Tha amdtpsaxr mAsJbdhyof ser ties hosy+rat-based EtATIw key Isue at the naaenept is- .art ae Meaditldcn Assssu dTmvrnern(MATj for persans released from Cj s^+hanef awal+.rawnt;esesury a.ress�y:t.ma vndvavcr(vg.BH..gpriuxu • Inbe,,cept ll:lWtW Lustertdanfkskrlal Cuurc))oaring.There fsantlen servletl,eeurn,pefee,uddl aervletl,eenurners,famly .mi-111clent sierra)sertices In dse Oexnden Center m erose mcimb.n.advpcateik.xpand pier ssportmo prurs n—rr. ­axpw#encingamw"bulth tela,xr wngtools not andfaellleare­Idenm appropHateservletl ine.temman ry. Nlll er ulstvntwith best practrws..nd)all svLlT$........bate Notes:IN—Prange Cpwsty Detention Canter du.ac open soon manta)hmkbsynvWw . WE address tweegaps idendliedduragthe4r320lSYJarkshap Slide #11 CURRENT STATUS:LOCAL STAKEHOLDERS(OVERVIEW) Inedd:ezm to theppassenmeneandacsa plan in—idradby rhe 51MY.6r9•sasep,rhe swbeamrnrcuaecxamineEIn decal the needs of wkeholden In Ors-g.Caunq Sobtunraime membershipinelf indwts represmnd+es of key snkeholder groups Involved in Orange Cowry crisis services!emergeney nsedlcal s.rvkes.wasting doicsl sernoes IncludingUMC Idospltale,law enforwmen,cwrts.ant!pM • 'JYerkaq withamk4wider reprticmamxtwe exarnesed,rids deadens dux ante its Orange Cowry and used These m further ldendfy he wrwa.s and fad$•attnll sthac are at.—arid rima If thvr.xiwwd world • Enhance tris..sponseto biro.wares lndlMduals br pruAdingactsky.ne In saw mutt appmpr—svtvrg - Benefit sakehelden wh8 enppge IndlYlduals In trials en s dally bels In Ors+geCeunq bJ fatlllptlng alrerddele rtlpentes Wt nee title sak.holden ami and dollars and mm*m better uutcar—for all e.-sad. The stakena rvyass mddsesdsrmWersrmengof dse gaps thae Im In.ting,vials services deurn.gnrroagthe Snserwoftm SIM worWhops 17 Slide #12 CURRENT STATUS:LOCAL STAKEHOLDER(GAP ANALYSIS) Sever9 bnors Ilmiara elfettNe,eo rchenearcerrtls retpense In Orange Cowry haae beenleentifled by the bed tcallaaberafusrsls EvEdng mr.+maare kmlwd kY ene er meta d eke F�"'rY • Do not pn-Wae a to mMW Intake for law eMoreenem or emergency mrdeet Do not an agave-0 xeda CJ Omenn programs. De net meet dl neeek due ts—n—exelut l,ene— M not pro,%%an appropriate mttingfrar 511 oras cam(not dr least rwcr7tthv ma;Nt • Do not save thecapacitym pro'eda naadlly-a2dabk clinical mrnma For C(procmdingc • Do not tette Incarcerated andPadWN dnaecobilling returodo- • De not akgc pr,,Q,a rtupportor cam mimgamantfvllow up. Do not dvsys prmade aeequate Meharge alanning{21l o lacllltate warm hal Ito eonamun y srcaonent andara—.—p- 0,not it ethe capacity facilitate hollers supporS(racr.+gmaa all demrminants of heakhl. • Do not ever lnmal at—m MAT. 0,dy Freadam Haum aaW dw UNC W At—a—by dw p bk on a 21.744Sbmlcand mr++ms arc ellen at mr aver-p—q, • Slntked rcmuroes W people cabs are in6gent and unlrw Slide #13 BEST PRACTICES:OPPORTUNITIES FOR IMPROVEMENT(LITERATURE) Lieeraeaare Review Etmrmnts aF Curwnt bast PnxNeas Curnndydwry arv-nadonal scandlydsfar ctfsls mraswc Clear Obl-4 . wdaa share exi"for nwdleal serviced(e4.EMS). Embrace that+Wecdva of dnarting lndkiduals morals avmy fran Exl rwraturapoll-m[a an ranar�ngframe-ort for tradoorai Ea and ll deflningcrBis aervlcm. Supporedaa abjaedve wish dednsed fadllden and pregra— Tberaa.anorr tbcdy cfharaturuchat pains to AnyoneAnyt.—A.n}vaf— aeganeafiasadpraetieasthatcan beadoptedincl abrvdw Community-wide Cehborataom. Orange Carxrcy. Calral Erman—en_ • Two rafar;—ary lorryW our-crit aw N"—rk with CwnmumgTr—ami Fravldan. • The Seq—AraJMW,rcpihlad4- HeIll WrapA—A. • MofMiaofGWdeftnes�Ir Crash Carc,A Brat FFarncrTooAtV, Warrn Nandoffs add Cam Man nsPwr c a agwna Spate Suppo Condnuouslne—nwie, a Slide #14 BEST PRACTICES:OPPORTUNITIES FOR IMPROVEMENT(U.S.FACILITIES) • In addldenm the lleeratisre revlCNY,we reuearehed".+aatlng ��r•+a'.w.d ("� �p� programs and faWttas • There areseew f twital pmgatm ane heides terms she Vs. ex sm� w waao : • Sulb—l—menhers ineerviewed repreallta tefa doaan oparaMg and patmad facllldas. Ths twee-Includes raw Initia m N.C.facllld.; • Wakebr-dc . .•euae ^I-Claw Ralalghl• • C33S6[ompmhensgeCart Center(9uncanrbe C—i,q. �w,d,�kyE, �„.q"t'i'•m's AM.Al1e) J ✓� �r W.•a .•a • Flgum-rghsiudu-acl she wide v,Hadon in hcil urcns six dmcaalons • EAlbk R mncalnsmore—rpleoe summnaryof has praasdes 6lasl "`"�'"•`"4P"` R Ifullra� rn< 4 18 Slide #15 RECOMMENDATION:FOCUSING ON THE NEED ham" R� f.w _ kms + Rernp ef[urrem iPoumlm sed Opperfur+tlfes Tw Jmprawanae�if. /! • MvWyaarmrlm MactitwabOralage Cot+Kp from 1915w 1{124. • 57MWorkshcpgap amwsmwKfi—don.cadre[the lnta—roamed BM and Oraaaga County—InaI lundce. SnlxholderAnalyno!focused on Incl seem Idensfled by those engaged in BH adwEal aervim and cHRYllal l aadce In c7r p Counq. • 13uP maes!review of txlsslg U.S and PLC prognms:dad heisec s Slide #16 RECOMMENDATION:ESTABLISHA DEDICATED CRISISIDIVERSION FACILITY LF� � ryr � 5nai r q�•.•i ��' rhdl:amd GINtlFWeraia� Fa_Illy 4Yt monrexnddraeaae Cmurrty eaahasace its crisis ayd[em fay es[aihdhlaM;.:demea[ed CridB101reraionf•uYity[o ddleer B,H c9dh serrlc¢dlcsdminaljus[loe diaessivn. Itee®mrnended Fadirty wd eshLrwe OmMe CMYI[p S trisIN dart and corr@ie ea tObtinmoamof Gare relulunjin bentliea for fatkn[e ellnleaV—Inalluwem nEloaholders.and a amn—Kyat largo. • Faelllq-will provide ellnlnl a WvWnInaIjusbat-resod immie;and will aae[work wlth"IWMpr"namVwrWs Facility will pro-de mrHoes dot currw*do sleet wilat for cllnlwl can:sad%arae as a dekult deadnadon for lam wafurcementand EMS for dh•otrvaq d-W,.k In crlsk. The Furry wtia build on and Inlegran w the mnttapacty and imngths—lt will not dupllcee or mplaot edsdng mrabulpregarm. Slide #17 RECOMMENDATION:SCOPE AND FUNCTION 5—50 scan Vftc rty arebms ai b¢ bmn spetaaed w def the stype aad function of the rawmnwnded Facility Implww-.gthme rceommmda6maawiematash—,Ice,tintdesteteurreiady exeethusenhanelnjcrsals servlee and benci5ng Nl lnvolvedw crit nrc. • In mmmaryncwnrnended faclllq, • 041'ers lmmedfue clinical servlee foraxssnaentseabllladon,and eremmenefar jatierm expereeneingBH cfle(mermii linen and sa.bmarce use dlmrders(In a m—appropnawdeam m0atva sarong(oompared to twspltal-basad ec—s or ptl • Ma4nrcferralsenee--aity treaoneneam aalal serwrcs with warm lnndea'snppermd by use manager ardor peer suppnrespeeafae facllleating traaultion dia6YiMuk f—trials care rn—m-&y4-M Allows access for walkaa patients on a 307365 bass. • Provides 4w enorcemen—A emergency medical me &with a defuh destirtadde and operaees wadtaue rex Mve envy or exelusen c merla(ag.accepts mmkrdw Inflmn-IVC agloted sulcldal). • Prowdeseriminal lumect aealrcAoi&En with clinical asecamene servlee:and a fatality wefer the moss appropriate Bare for lus Invalved xedrnduak In the I—rwMctive acm g poalble. The aexe fear page prmide a detailed ire of greelfin5au for rhe reccomu nded Pxiry In fourraonoHm! • Crtne.Wj,wte • Clinical 5arv1ces • Cnmmunlq Trcaoneneand Seeiul5ervlee NetwoHdM Ptgpal Atsrabuws of dw facility 19 Slide #18 RECOMMENDATION:SCOPE AND FUNCTION(CRIMINAL JUSTICE) • 0-6m,LE perasnnel to—int in F.Aky a—rity. • Ladaad,acurafaclllq Waaa walla4la. • On-vu acurity}wrtantwlto malntalnsaN anvlronnwncafdprovlde raadllyaradable tramporradon far pavenu In cuwwftact as coatarfar IVC and odiaraourt paper•.vartkto and from Facility On•sim preaetxe{or video eaaferenee link}isr rriminal lu,6ce aeakeholders(ems,Magistrau,f3iaufee Atu,rney.R,tic defender•toure,F)udge,, ellnlcal a Ial worker}. On-dre security m wnspcsm*hoard padenu who am in cusrodg(e_tmmfersfr Iall). • FR iFarmally Is rovntWTranaaara)'progra+nkman. Readlly mailable tmmpertauon for IV[{etientt Reesntmens lr Nemadel btsed en astea,ed need of padeneto sttA,de private rar,arnbriuee, or hw enfbrcenaenr- cknical assessment service,for Mall.—R caurr.Processes. • Chn+caa arweat far lndlvlduals wfl zro in castpdy iwmporarytraa Wirsfram date,Fvon faclllry)or awaldng extwrcourt prtaWnvkaring. • No mfusaladnmsian fortaw enfor tneneald emergency medical serviees(24M&S) a indivldualswho are agm%d or under an IVC oedec Commissioner McKee rejoined the meeting at 10:00 p.m. Slide #19 RECOMMENDATION:SCOPE AND FUNCTION (CLINICAL SERVICES) &Hurgent rare t24M. Serve lndlriduali veim tpectal reeds(ea...I0D). Sartia shprc-wm IVC padwru, Faer supportspeoalacs EnmrrwKy 5UD cniatmant sorricw(24R). Muld•dsy temporary boarding peivi"transfermlat Is,britt"crisis Nets-'hosplmlluden deroxlfleadon WViCec managwnom and conmunityuvatmant. Urgent Madlcal Car@Services(to allow rva>�-bfwthreatwwg Otsslte idnrmacy aerNees to allb.padent.be dl,dnraed wish csndldens m be treatedae Faaky) med,c v. On-uta pharm 4grarwcac to cappvrt sia't8aatnan and Initial Thlyd-parcykboratorywlth aralalle.expadlted courier servlce ereatmeneierre paae In Facdlry. Serve pmerrcs in r"xq. point of Cara Testing(qulcktvrnarowd barataryservlcra),Serve Services for adol"cetn padcam(Ii and 17-yarrald), pads In Faelllq. M1W.Servlee,for general puhllc(2447)365} Capa,rty to matragn lndlvlduals wfro ora ag.md.6ut do not Short-term wbulatory traavnv4oe w;(ag ro edas detox) mgudre secured space and restraints. to fadlsate mobilRition Prior m diitlkaPge. Rakrral and cransportato w hoWW and other tmammnt Inldato MAT treatnwnt In anddpWon of iramNrto caannixnary faclraas{after droppog off 6y LEI£M5}. treatmeneprm5der. 20 Slide #20 i REC MMENDA--10N:SCOPEAND FUNCTION(COMMUNITY SERVICES NETWORKING) €m nifty TreamemSerykea Netvmeldrsa • Prvvlda etdormamnahouc all eornmunitytraaemantsarvlem(for all condition;)wham Fadficy is woll Intagratad with eonemunity pra-+kw RANl cc out-paoan0n-pamnc BH ireaunantsarvlcm. Referral to*u.atienWn-padent3UD treamnetn wrKaes(ej-Freedom Har MATADA.TCy • UNC Hospaal rcfarmlllalmo (fackmte tranrfar of patients nwding hlglear level ofc m—0o emmllw nwntof LE or EMS wrteo nmy have brought patwnt to Fac+cr) • Patictttsramakrm erhervmm�ent faellldes("-UNC HwplralgLdemxheifiesk LMEIMCO haisass. • Warmhandoflx;conemunitytraatrnantsarvlcm+naCls rmppartfrwn pwrspawist andlar case naat�gan Soolal Sarvkvs Natrrorldng OC Parenershlpm End Homelessness and Heusi"Aecess(via OC Homing Helplinel- Ldisen for NAM[program. HaaM irrutrame anrommwn llalsun rndvkjlegal mprN%ntatlon. Provide itdernnom aheutand a w•srm handeffm rhe existing nerwnrlt of&seal servlees wAth peer speenrrt suivore Tmnsperezden asalmatte. Slide #21 RECOMMENDATION:SCOPE AND FUNCTION(FACILITY ATTRIBUTES) • Dual enuyt(de3eaamd ency)hsr LE sad EMS C*nlrig arae or living ream ratting, * Roornvbods foragltamd patients. Space for law erdorcemelts and enaerEencp medical personal. Vida.--fore—f.114 to prowada acwrs to ,agatr— • Vidav soedaran eroam for robvstlmk'batwwn Faclllty and MagRtrata.Covrts,015tnct Attorney On-&im erlralihaljuadce space m supperterlretihallustite milrehele tm. St—m beardingspace for padenm await transfer m rhird para oommurairy—i— Dedb tad spaWrtwms for pauanm housed m Fac igr m Ilam of fall. Short—m boardingspace for pabienrs rwa"iVC or other hearvres_ • Addexnt(16•and 17-yearald)rtwnl spree. Ca/cantcrwordmabanedudarg 91 I,EM A&Crim Unitr Hospltals. Span for remmrc lbmry(rdamnoasand Informaden reiaredm treaenaeneserviee.social serriaes stag m Orange Dov"vmldeon). Slide #22 POTENTIAL BENEFITS The remnmeaded Ferny will fudlll the prlmary sou estahlldred by rhe 9HTrn response m dee SIM Workshop and eased an rhe work of she CralcClswrarcne F.*ty 5ubeomt Im.:d-m IndMdualsaxpatwneinga BMmslsfrom"h rlall or EO A—pht ngthmagoais wd rmultln an InlpMtaee m of benekn chat V m accrue m a broad em—don of Orsngc Coumy:Thne bcectm fad Inm fourcatesories tonsunen cad Fancies Law Enferoemerx and EnsergrAy Medical Serwces CrminalJwdca Sysiarn SW hcldan, HaW4J-I-W EDased lnpadwrt Cara 21 Slide #23 POTENTIAL BENEFITS:CONSUMERS AND FAMILIES Damm aaaa swr 4 H sex,e. � urea. [raawxt [�_� rmau Il Eros eo -- 4a .. 6e Capel HIIIF9 a F 5 a 24 G"_mD 3 1 e 3 a HiII,I -ugh Fd 3 1 4 t3CShma a 2 4 6 20 Ar0eangaC..V LE 3 3 DC CI�Drsmwn Cecer 0 0 F4 IC— 11, 116 LNC Hc--A EU 27 1 4 0 27 SMaLCYaa.lhf 114fatlt — bi 7 63. 133 3 _ l. 271 The table ab.—h—s prolecwd lo,-N­rap monthly crlsa eplwdes expecwd w be ser-red by the re.—ended Facility bajada:currcaM Qrarge C—Ey dace(ExhIbk CX Mace 1^Conan rewrmw consmltrngrwAll IVCs aro ncordedunder M,oglsirolclColyd,Opwrcommlcmrncs[eg..•abumr amergwlcX rnedlcaq are recerdedunderehenriold law enforoenstntagencles.Hole 2.Hamekn relaste m 411 callm anoclased vddlladnden.WARvidlab Inrelnng urapass or dlsulbunws anda-record forAROneV Coulry LE.Mow I includes episodes kwobkgjamdceawrdwd 1ndlAdualsor clinical eswarnena fes 1 emlart prneeedlnVL F , Slide #24 POTENTIAL BENEFITS:CONSUMERSAND FAMILIES(CON'T.) Porsans Ser»d There s a de&rite beneBc that acarws to individual m indicawd by tlw proleccad number of crlsb epiod— • The s rnberaf rndrddlrbprojeccedm be served by rhe Crltl^Dherskxa Fuilry b esdrnaced m be epproad irg3M nsea permonch. A wnm#tl yw4yals Indicates dacdes comberof'emkmiluah wrwdoovW rangefrom255m 305permonth.Tlw dmkd break—of the rnitl rn by n"of episodes rhae said beterred by dee recornnsended Furey Is:hewn ea rhe pros apare. • TFw range reflects—lows amunapaaw about the effe ness of diversion ponces.procedum.aaad preavcas In LE EMS.UNC Hospal.jell. and rhe needs of C1 preeeedlrgc • Wsk•Incserrlcea oA Increase die marberod lndlrlduals jarred 24am chose Hexed abaea. Wal kin Servipm FroNdingservlces an a wA4 n 2471365 burls offers help before enols a Aaces to emergancy wr.iws A—ems ria W—diate CYWeal Serrlcea.liadMikkah in BH er'als reeehe Immedate seeess m asaesserm mbmti-mill mamaenes.s— forabroad rangeofMHand SUDosnda . T ralasidons.Faicesug cranaidml cf Individuals frem cri a vara tv conruunlsy.based trcaunen with alequace dbcharge pWrling Including referrals and bridgIngswvlcss pro%%%s dee bast dance of adueNng wawa as wrmsof lung-%r o %;for lndlrlduals an need. • Warm HaMoft lrh adb len"Furey are v ppp*rmd by a warm handah'.suppe r cam manager an&y pair juppertmpedeijc • Holistic Suppe Supp—for the whole parsonfacllkam conn—Nudraduak In vew—thsoclal wn.ws thusncraaaag chanty ofrewwry and nmmlxing ropeat crises. • Il.—eclanand GuHance.hklps—unaers addsosghfag Mabrabciag SH services ohenexperiencedby lndlvldualtfaoesand friends 7yklg to out lwlp. Commissioner McKee left the meeting at 10:05 p.m. Slide #25 POTENTIAL BENEFITS:LAW ENFORCEMENT AND EMERGENCY MEDICAL Reduced Burdenan LEand Emergwacy Medlicaf Servfans.Fadky v d operate—tha no wrangdoor uppresckchat ls.R-A ba a de.1%.. me ref salised t epden for law er cam !_Eam EMStimk oats m wn be able m caftbenu wldh ellniel—m decrees serines wlcheue rsstrlctl envy or exdmlon crItomthem tamldoningusdr tdualsto cries can kskeu of ED orlall.Thie approach aauwersglwsisan of Dhcrlto VA..?. Cost Saxings.EM.S and LE prsunnel respondingm calls sn�a 6H creli,wd spendless dnae m the flad dewrmmmg an appropratte response erre Pen im as e dhe Faaisy{Fen chin I5•nairu—)ramparem d Cc her sloe ED or magiau•ase')all.Such el•unae an app..h will free up pl and equip.—to respond m ot1mr cwnnnureay need, Wpp-a Fu41jc Sitfety Poefamrs,Adan wlch C—.crsTask Forte for Rams Em'pn Crinwaal]usvw(December 3020)by eshbl shinga ditaee ded F.T y dn¢p—ldes a re--fnr Orange Coarscy m jup"rc InVit entadnn cd hey ret —ndadenscf the Tisk Por As sniped aban pra admg a No Wren Door a4sswers the questsm of Dhcrt w Whrm?them supporwsg the fdwrwgTask Force neommeaedaLorn, • Tare Feree Recommirend—Reposgirse pubse safely and relnvettiin emr—unldet. • Saludon+tl-Ragz4ted mora rapriawiyw sswv'ars xmnwrningmersdl�awss,autlsm,mwllaccwal dlsab+oas.suhtanwabeme. Fsanelennest and eeher rwaernergesarp ainadxu. Task Force Rewmnaendadon,Fronvew d[nmlon and whir ilwmadves to arres6 Soludon#16-EsabllA mad expand a a ass no dInrilon program. • Salubmi,#17-Tremaddlietien ase pu6Yeheakdh erlsd,Ineludingiubmaroe umaedrsidhs lhsedbpreperf]—ufffimpaesbimk and brown consmunldes.such as crmdl.cowlne. !s 22 Slide #26 POTENTIAL BENEFITS:CRIMINAL JUSTICE. Drange Cosurety Diventioo toad Harm ReductionPrograms.The mconanrended Facility a a{daed with Oratjeto'E"Con rni nencua dl—loos€irerncrin.rskwdcc aW.Gliilly for Indlvlduals+vh—emote"wrwwatb shy—Inial I­syswm Is due w an undarsymg@H Issue Th. Fairy vd werkwithwidenhaneeseeeral program: • A4ad[Pre-A—kD+earsaan{[1CPAPk • Pratral Ralaasa • DWT eatrrsenta WC---riltyRose ca Courts • Ssreea[Auereaeh•Harm Redaebesa and Delleaeon PYeg•arn(SbHRADk- • betentkan CeneeW0050. Puget with Staawpdng rip Klevoo ws.P—Wescrminal lus—scakahafdars an Juirnad•einr—ung m*a*jA with bhl con—Iran appreprew tevarvg Instead of Rd Aligns wvch Orange Coeany Diicent an Canter SueWng Up nadesusnes byc e."Wbndual eutslde of(all sorting • ProWdett Le=t Rmtrkcdre Setting.Praddesleuc reamecdve modirgforcrisls eareel a a kringenvironreemwith case manaberi and peer sweclallsts drat can safely ianpp thea iniakwlmtrite.Indluldualsm custodyaria not transforrad to other di=nt facilities nor raqulm addldonal=f be brourcao Facility will supplcmwsVcoordlnamOth pibasad rniantal hralits and sub=—use programntng. • Align:cauda Maw Dotendw Cain-Supports n prcgramn1nZm OrangaCounry's naw thhacwsuee CanterAlso pro..diasalterrat+ denlndon far Indlvlduals sn anmdy wdw are ds need of BH:servlee tinea eiminadnghurdenon OG56 av rcnswt ae hasplml. - Caumtafrrmgittrate.—Supporss naenml heddshrmaneox courrs and prevldecrenVnal usdusmkdwldem ready aoxn masennxncsertilce thus awlding iaxtaaW.rag eusEody bacausa nWnWuak stn riaea+a trite an m CrIswCle:iarRan Fauity or erwunant In appropriaw eonanunlry treat—fairy;provides rnmedlam access to trials service for lua5mlnvolved EsdRSdrau who are rot Incarcerated,huc proem to entre with BH crelr aaW prcvadias Maglstraw with reswrws w-plo—pt—fer lndlMduals m a 9H;rise m Ilw of CJ ar fall, tv Slide #27 POTENTIAL BENEFITS:HOSPITAL-BASED CARE Riadtxvs Gsv of NocpktaV Emargaary 5wvdces. • Susdiesauvethowaathat abaem a dnseattd orals fairy,BH patents A tribe arc treated at a hogp eaaeu ED at iii—cer rues tion in conanunitlex wvtlr a diadlcated emelt Fadtq, The ED B recimmd to beard pantie wa gfer z&nleanee to In patent beds or ether mtedendal mrmmLTnia overloads€D and is a poor wtdng for patiw ng for coria.gaarding[mus m EU vary from a few hours so a few dei ss and for soma caws ri—It Wngar. Harem a dedlmted crisis faelllty educe hurdeoon hoaplml.hated ED•whichis frequemly at capacley_Tha abwa ED ee fee u&an patients who requrehe apital.bated payehiavie emergency aerates and to maintain capacity for medic!ernergercy eannoons. • Inwaciwa[Bad UHN:anion, = Nadwick data thetins once a patientis adrnit eeim hespras+bacee ED,stare tt aan m be a hirermese ei inpaaeneheti au aiat as conwariad to h.-%access to a dedxatsd crises facility • A tigaadeant nu IVC padsnet u he eneatee in a aedleatee emit henry imtme of rcgidmrngme of ED.If eve cti erataferm Inpatlw yr rwldwKel care Is r€gwrad,the CT4Iar,1)wrimt Faclllry,will prv,%%quality wry In an wprcpdaw settingat leaver ewcs caste aV/aiM1iffi-fer. Glnli'm Cana Cum Ssnring, SAMMA Z0Y0.dncusses a modW dawlopod by Chis Nowfer conasamon of ckrecal caro cosy In wmnwnn.asss+vataww a corT�riaharalw cHtis sysaem(rKanm an ED and Inpatient beds)va.eon—unielea with a mproheraheenialt system(m Ik."a aedicatM cHse faellley). • The Chis,afowanalysa mdreaws that—assvuEwdOth hospwl-cued—antro mducedon the orderof 50% Slide #28 RELATED CONSIDERATIONS. SomaconWy ntsofaconipmhm"tritesystemerao ide �Ca'r=ITERS 5 aax Cnaflwlltt94Y6 ranalLE sae scope of the subcamrn:tsee•,isvwever they appearirt the hest t'�aI ,�woawaa.rear.ram,wonrv.e area practxas lltaaturia and ata rnandoned iwra bx theyary meta ur.caenaerew+.nan+sw+emxaa .""w.� .• .a+.mem a�„� r°'�"'"r"`tr"'�e •�'w ^w++' n mal co nts of rem am cwrrcnd ay�r�t.a.xenu �tog rnP� s}a y operate m Orange Ranh. Enhaacad CaR C4aa0ar:Coordlnato nal,hot It— " 911f9"a a cehtrafte crul&calls provide for an UOSIS STAOIL17ATlGhESS€1TOL o"m w14--andrasp-se.and gold-mils m GGPAMS PFIMCIPtES SpPACTICES respotueasaes. sn,miearceoa` utxaen' am�wrrexao'• nnewwneuxi Enhwnced Crick Respa—Creartea 24i,785S —' cwnrravmp-mesad n.1bla crisa'rasicwtsa-d Lhak operates Ehmugheu o—ei Cauney and mipond In Ileo There are odwr dements of aerosis system that,deserve casvderaiors of nw enforcemencwhereappmpiiase.In addition,enwre m confuncdon with craaawr of a CrlmRhwrsataia Faclllty(N.SAMH5A kw:rrFarmen'iankbauv tra—d marital haakiv t-ar 2=and CHaa Naw}Suheenvnl_a fdre..1,­two. trials units • While all elemenotofa comprehensiveerlfa syuemare anpartanc action w Inaction w ocher alemwas does nut iwRpw or redueedse need m neeae{erward waiv rexmnxnded Fairy. 23 Slide #29 NEXT STEPS • The®OCC It helnj3&Md w endortethe rreommendsdanprmaivedd in dips report.Tha is an important.but prwhinarystep toward realludon of chip Ideas conalrwd In thq recontmetdaucoAddldonai workei needed to advance dee pnaiea to an opera x1 FaclllW In Qrwr p CounV The belownear stepm aro outlined -Milk MitigMliom Campllea4d* a data and sav Ct atMtporrai etudlec ea r@dooe thetwrr.tartainty In ourNntprciectloneofeh@number and type of pari m who wain he tarred by rhe I'mihry,refne estimates of rmrm and hasefha,md Idaotify44uaeefundingeg5oaes. • Deign.Conduct a prvnlnarydeag+r of Fadllcy spa m prondea properbam for a flnandal am"woM.This ni Induclu dendfrogard an%PT%patw.baa locadone forth@ Fa kf.. Llemsing tired 5eilf Plindrg.IdenSfy lleeaesingeptlens+requiremetan,uscenxd snMphn aaed Farlllg artrihut muraneebillingpelleles and practices,atd+dentlfr+@ aiw.m potnMe#Fashgr oFQrators Gaw�rta>msce,rieeermine arta ste:9 epeerss regrdlnbewnarsl and�evarnanee for the Faeillq- • PoNcyiBrovedurvc.ldemoflcatlon ofnwded poky and pracedamenhancwnents for aP=keholdom to eaesur@county-wld@ca�borat on laadieista msllalnEtha Facility:fro pomawli. FmjeetW Sawinp.D"lopINOme prgecdon of savinge tMt may accrue doe w rcdtewd d Rwai and crine W rAdce hurdeo • Sourcesard Uses of Fund:.PmleucipimVoperatitts6mmeufar FicAty.IdenuylattessfundlnaarratlernelmfarWcfirsefiw years of operationanas�ng local geremmetatmte gevemme LMEsMwranoe,ared pr>>su philamEhmpieoraanluuens. • Ro#d Wfa4,D@wlop in+mplwmemUbt plan or road map fcresabkhing an operating FavbVr Qrar�p County man wtpeditedmamwr: Commissioner McKee rejoined at 10:13 p.m. Commissioner Fowler said the committee outlined the need in a very thorough manner. She said she recognizes there are a large number of moving parts, but there is an extreme need for this. She said it is a reimagining of crisis response, transforming from punishment to rehabilitation and support. She asked if there is a most immediate next step. Tony Marimpietri said consensus, and then some funding, will be needed to take any next steps. He said they need studies for mental health facility design and costs. Commissioner Hamilton said based on her experiences as a mental health professional this type of facility is very needed. She said she also approaches this issue as an economist, and thinks about economies of scale, data on the cost of running facilities, etc. She said she would like to gather data from other existing facilities, and wonders if a more regional approach would be more appropriate. She said this will be an expensive endeavor, as this is essentially a specialized hospital, and the county needs to have as much detail as possible to be realistic, but there is no doubt of the need. Tony Marimpietri said the group needs to tighten its numbers. Barbara-Ann Bybel, Director of Psychiatric Services at the University of North Carolina- Chapel Hill and WakeBrook, discussed funding and said Wake County provides $13 million annually for WakeBrook, which only serves Wake County residents. She said UNC also contributes $5 million per year to WakeBrook, but that commitment ends this year, and discussions are underway about continuing that funding and bringing in other partners. She said behavioral health patients languish in emergency departments, not getting the help they need. She said a facility like this would be ideal, and there is room for County funding, UNC backing, and other partnerships. She said the relationship between Alliance and Wake Brook has been positive. She said this could be a smaller facility than WakeBrook, and a facility like this would give options to law enforcement to take people to an appropriate place. Commissioner Greene said she is supportive of the idea, and appreciates the care and analysis. She said having a facility like this provides indirect savings, and it is important to look at these issues comprehensively. Chair Price thanked the presenters, and said being a role model is important. She said the County will pay for the care either way, and having appropriate care makes more sense. 24 Cait Fenhagen said she appreciates Chair Price's comments. She said this has to be an Orange County facility or it will lose the law enforcement and EMS diversion connection. She said this presentation was also made to law enforcement chiefs, and each one supports the idea, along with the courts and Emergency Management Services (EMS). Commissioner Fowler said it is a shame that there is not an efficiency of scale, but she agrees it needs to be an Orange County facility. She said this will be much better than being taken to an emergency department. Commissioner Bedford said she supports moving forward with next steps, as there is a critical need. She said the schools were involved, as well as other non-profits. She said there was a desire to do more, but the county needs to start smaller and grow from there. She said the goal is to service those most in need, and she hopes to bring in more non-profits to expand with time. Commissioner McKee echoed previous comments, and support moving forward. Commissioner Dorosin agreed. Chair Price said next steps would be working with county staff on data and numbers to bring back to the BOCC for a future presentation. 3. Arts Commission —Appointment Discussion The Board discussed an appointment to the Arts Commission. BACKGROUND: The following appointment information is for Board consideration. NAME SPECIAL TYPE OF EXPIRATION REPRESENTATIVE APPOINTMENT DATE TERM Sarah Shore At-Large First Full Term 03/31/2024 NOTE - If the individuals listed above are appointed, the following vacancies remain: • None Tara May introduced the item. Commissioner Bedford said Sarah Shore was the only applicant for the Historic Preservation Commission (HPC), and she does not want to put a person on more than one board. She said Lamar Richards might be a strong contender for the Arts Commission. Tara May said Lamar Richards is now UNC Student Body President, and is likely very busy, but she can continue to try and reach him. Commissioner Bedford said there are other applicants for the Arts Commission, whereas the Historic Preservation Commission has no other applicants. Commissioner Dorosin said she is the only applicant for the HPC. Chair Price said one can serve on two boards. Commissioner Greene said she would like to honor the Arts Commission's recommendation. She said if Shore's recommendation is not desired by the BOCC, then she asks that the Board defer a decision about the Arts Commission to a later date to give it time to come back with an alternative recommendation. Commissioner Dorosin said he supports putting Sarah Shore on the HPC only, and going back to the Arts Commission for an alternative recommendation. He said while one can serve on two boards, he would like to avoid it, when possible. 25 Commissioners Fowler, McKee and Green agreed with Commissioner Dorosin's comments. Tara May said she would go to the Arts Commission and ask for another recommendation. Commissioner Hamilton expressed concern about the time, and making decisions after lengthy meetings. Chair Price said the board should let staff know if they are not going to approve a recommended applicant. She said she would like the BOCC to be more transparent. Commissioner Dorosin said he thinks the BOCC is being transparent. He said there has never been a guarantee that the BOCC will appoint a recommended applicant. Commissioner Fowler asked if it would be appropriate to ask Sarah Shore what position she would prefer. Commissioner Bedford said she applied for both, and the HPC has been vacant for so long, and she should be appointed there. 4. Board of Health —Appointments Discussion The Board will discuss appointments to the Board of Health. BACKGROUND: The following appointment information is for Board consideration: POSITION NAME SPECIAL TYPE OF EXPIRATION NO. REPRESENTATIVE APPOINTMENT DATE TERM 5 Dr. Bruce At-Large Second Full Term 06/30/2024 Baldwin 6 Dr. Alison At-Large First Full Term 06/30/2024 Stuebe 8 Keith Bagby At-Large Second Full Term 06/30/2024 NOTE - If the individual listed above is appointed, the following vacancies remain: • None Tara May introduced the item. Commissioner Bedford said she the Board should take the recommendations. Commissioner McKee agreed. The Board agreed by Consensus. 5. Chapel Hill Board of Adjustment—Appointment Discussion The Board will discuss an appointment to the Chapel Hill Board of Adjustment. BACKGROUND: The following appointment information is for Board consideration: POSITION NAME SPECIAL TYPE OF EXPIRATION NO. REPRESENTATIVE APPOINTMENT DATE TERM 2 Daniel ETJ or JPA Second Full Term 06/30/2024 Hatley BOCC Appointee (re-appointment) 26 NOTE - If the individuals listed above are appointed, the following vacancies remain: • None Tara May introduced the item. The Board agreed by consensus to appoint Daniel Hatley. 6. Historic Preservation Commission —Appointment Discussion The Board will discuss an appointment to the Historic Preservation Commission. BACKGROUND: The following appointment information is for Board consideration. NAME SPECIAL TYPE OF EXPIRATION REPRESENTATIVE APPOINTMENT DATE TERM Paul Noe At-Large Second Full Term 03/31/2024 Re-Appointment NOTE — If the individuals listed above are appointed, the following vacancies remain: POSITION EXPIRATION VACANCY INFORMATION DESIGNATION DATE At-Large 03/31/2024 Vacant since 01/11/2021 Tara May introduced the item, and said that earlier in the meeting, the Board of County Commissioners expressed interest in appointing Sarah Shore to the vacant At-Large position. Chair Price expressed concern about the lack of diversity on the Historic Preservation Commission. Commissioner Dorosin recommended Paul Noe and Sarah Shore for appointments to the Historic Preservation Commission. Chair Price said she will support Sarah Shore, but she would rather wait to fill the vacancy until the BOCC can get a more diverse applicant pool. Commissioner Fowler asked if the total number of positions on the HPC could be identified. Chair Price said there are 7 positions. Commissioner Fowler asked if the member serve 2 three-year terms. Chair Price said she has no issues with Ms. Shore, and she just wanted to see more diversity. Commissioner Bedford said a few people will rotate off next year. Chair Price said does not accept excuses, and feels strongly there should be diversity. 7. Orange County Parks and Recreation Council —Appointments Discussion The Board will discuss appointments to the Orange County Parks and Recreation Council. 27 BACKGROUND: The following appointment information is for Board consideration: NAME SPECIAL TYPE OF EXPIRATION REPRESENTATIVE APPOINTMENT DATE TERM Christopher Carrboro City Limits First Full Term 03/31/2024 Colvin Robert Little River Township Second Full Term 03/31/2023 Smith (the request is being made to move Mr. Smith from his current At-Large position to the Little River Township position as the resident in Little River Township) NOTE - If the individuals listed above are appointed, the following vacancies remain: POSITION EXPIRATION VACANCY INFORMATION DESIGNATION DATE At-Large 03/31/2024 Vacant since 03/31/2021 Tara May introduced the item. Chair Price asked if there will still be a vacant At-Large position. Tara May said there will be two vacancies. Commissioner Bedford suggested taking the council's recommendation The Board agreed by consensus. Commissioner Bedford reviewed the other applicants for the vacant At-Large positions. Commissioner Dorosin said the BOCC should wait for a more diverse applicant pool. The Board agreed by consensus. 8. Orange Water & Sewer Authority Board of Directors —Appointment Discussion BACKGROUND: The following appointment information is for Board consideration: POSITION NAME SPECIAL TYPE OF EXPIRATION NO. REPRESENTATIVE APPOINTMENT DATE TERM 1 Jo Leslie County BOCC Appointment Second Full Term 06/30/2024 (Jody) Eimers NOTE - If the individuals listed above are appointed, the following vacancies remain: None 28 Tara May introduced the item. Commissioner Dorosin suggested Quinton Harper, instead of Jody Eimers, to increase the diversity on the OWASA board. He said he has served on the OWASA board before, and believes he would be a good candidate. Commissioner Greene asked if there is a reason why he was not approved before. Chair Price the other applicant had more experience. Commissioner Greene said she is torn, and wants to increase diversity, but also feels uneasy about removing someone from a second term without reason. Commissioner Dorosin said there is a reason: there is a better candidate. Commissioner McKee said it all depends on how one defines "better," and he thinks it sets a bad precedent to remove someone who has served well. Commissioner Dorosin said Quentin Harper was a better candidate. Chair Price said she does not follow Commissioner Dorosin's logic, as he just voted to proceed with an appointment to the HPC, when she wanted to wait in order to seek greater diversity. Commissioner Dorosin there was no other candidate, in the case of the HPC. Chair Price said the BOCC could have waited for another applicant for the Historic Preservation Commission. Commissioner Dorosin said the same argument could be made for Harper on the OWASA board. Chair Price said she supported Quentin Harper's appointment last time. Commissioner Hamilton reviewed the other board members and said there are not many women on the board, and reappointing Jody Eimers would keep a woman on the board. Commissioner Hamilton asked about the vacant Chapel Hill Township's seat, and if Quentin could fill it. Commissioner Bedford said Quentin Harper lives in Carrboro. Commissioner Greene asked if the number of County seats on the OWASA board could be identified. Tara May said there are 2 seats. Commissioner Greene asked if the number of Chapel Hill seats could be identified. Commissioner Hamilton said there are 5. Commissioner Greene said when she served on the Chapel Hill Town Council, it took the OWASA seats very seriously. She said appointees on the OWASA board should represent the BOCC's values, and there are policy interests in the people who are appointed. She said diversity is always a goal as well. Chair Price said she and Commissioner Bedford met with the OWASA appointees, who voiced a desire to have people without the expertise and degrees on the board. Commissioner Greene asked if the BOCC wants its OWASA appointees to make policy recommendations that are in line with the BOCC's values. Chair Price said all BOCC members might have different policy goals. She said this has not been required of previous appointments, and rather the BOCC looked at backgrounds and credentials. Commissioner Greene asked if others support her opinion. Commissioner Dorosin said he thought the question should be on a work session agenda. Commissioner McKee said he does not think every appointment should walk in lock step with the BOCC; rather, he wants to appoint people who think and have ability and ethics to vote for best path forward. He said he supports Eimers reappointment, due to her experience on the board, and that she brings gender diversity to the board. 29 Commissioner Bedford said she supports reappointing Eimers to bring gender diversity and technical experience. Commissioner Bedford said Commissioner Greene's concerns could be brought up at meetings with OWASA representatives. Commissioner Bedford agreed that she wants good thinkers, over those who are exactly in lock step with the BOCC. She said the OWASA board listens to all appointees, but ultimately presents the best science and the best facts, rather than thinking about development. She said there will be opportunity for the BOCC to intervene if necessary. Commissioner Fowler said she supports Eimers for the same reasons already outlined. Commissioner Fowler said Quentin Harper has served on the board before, and can cycle back on after a rotation off of the board. Commissioner Dorosin said he served for Carrboro when he was previously appointed. Commissioner Fowler asked how long one must be off of a board, after serving 2 terms, before being able to reapply. Tara May said one year. Commissioner Greene said she would like the BOCC to have a future discussion about this. She said she agreed with Commissioner McKee when considering advisory boards, but the OWASA board is different as three governments control it together. The majority of the board supported Eimers, with the exception of Commissioner Dorosin. A motion was made by Commissioner McKee, seconded by Chair Price, to adjourn the meeting at 11:02 p.m. Roll call ensued VOTE: UNANMIOUS Renee Price, Chair Laura Jensen Clerk to the Board Submitted for approval by Laura Jensen, Clerk to the Board.