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HomeMy WebLinkAboutMinutes-05-18-2023-Budget Work Session 1 APPROVED 9/5/23 MINUTES ORANGE COUNTY BOARD OF COMMISSIONERS BUDGET WORK SESSION May 18, 2023 7:00 p.m. The Orange County Board of Commissioners met for a Budget Work Session on Thursday, May 18, 2023, at 7:00 p.m. at the Whitted Human Services Center in Hillsborough, NC. COUNTY COMMISSIONERS PRESENT: Chair Jamezetta Bedford and Commissioners Amy Fowler, Sally Greene, Jean Hamilton, Phyllis Portie-Ascott, and Anna Richards COUNTY COMMISSIONERS ABSENT: Commissioner Earl McKee 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 Bedford called the meeting to order at 7:00 p.m. All commissioners were present except Commissioner McKee. 1. Discussion of Durham Technical Community College, Pgs. 134-137 of the Operating Budget and Pg. 144 of the Capital Investment Plan The Board reviewed and discussed the Durham Tech Community College FY 2023-24 Operating and Capital Investment Plan Budgets. BACKGROUND: The County Manager presented the FY 2023-24 Recommended Budget on May 2, 2023. Since that time, the Board has conducted one public hearing to receive residents' comments regarding the proposed funding plan. This discussion is the first opportunity the Board has had to discuss next year's recommended funding plan related to Durham Tech Community College (DTCC) Operating and Capital Funding: Current Expense for Durham Tech Community College is recommended to increase by 10% or $80,941. In addition, Durham Tech is recommended to be funded $390,000 from Article 46 sales tax proceeds. The total funding for Durham Tech Community College is $1,544,379 from all sources, including debt service payments. The funding for DTCC is discussed on pages 134 and 137 of the FY 2023-24 Recommended Operating Budget. In the Capital Investment Plan, Durham Tech has $10,500,000 in year one funding to expand its Orange County Campus. The project is found on page 144 of the Recommended Capital Investment Plan and has $500,000 of available planning funds authorized by the Board in FY 2022-23. JB Buxton, Durham Technical Community College President, made the following presentation: 2 Slide#1 DURHAM TECH BudgetOrange County -. President Buxton introduced Andrew Kleitsch, Chief Financial Officer, Jacklyn Krohn, Executive Director of Orange County Operations of Durham Tech, and Dr. Kara Battle, Chief Academic Officer. He said he will go over items included in the Manager's Recommended Budget and will also discuss items that are included in the Durham County Manager's Recommended Budget that are intended to be joint funding opportunities. He said he is excited about the continued expansion of the Orange County Campus and will keep the Board apprised of the developments. Slide #2 INCLUDED IN THE MANAGER'S RECOMMENDATIONS 1. IJurham Tech Promise; $200,000 Continued funding of$200.000for Durham Tech Promise scholarships for public high school s g raduates Z Back to Work scholarships:$100,000 Back to Work scholarships for 6-8 week courses that offer preparation for in-demand, entry-level jobs in areas like biotech, health care, construction,and IT,The scholarships cover the cost of tuition (average$250)and$250 to defray the expense of books,supplies, and technology 3, Carolina Innovation Flub rent:$20.000 Requestfor rentfor new spacein the Innovation Hub in partnership with UNC-Chapel Hill for workforce training,small business pounseling,and other programming_In future years,the renIwill increase to$100.000 to support dedicated space in this new facility, 4. Small Business Center(SB ) Coordinator: $70,000 Request for continued funding of the position. chift"Och#;AJ President Buxton thanked Bonnie Hammersley for the support of these items and their inclusion in the Manager's recommended budget. He said the Durham Tech Promise provides up to $500 per semester for up to four semesters for graduates of Orange County High Schools. He 3 said this is an important opportunity for individuals in the county to continue to have access to Durham Tech. He said it is a first dollar scholarship and people know this resource is available to them. President Buxton said the Manager is recommending a $50,000 increase for the Back to Work Scholarships. He said this scholarship is available for short-term workforce credentials critical for people shifting their position in the workforce. He said this is financial aid that is not available any other way, as Pell grants and other similar aid are not typically available for continuing education or short-term courses. He said this scholarship fund is typically depleted quickly, so he appreciates the extra recommended contribution. President Buxton said the Carolina Innovation Hub is a new item in conjunction with UNC- Chapel Hill. He thanked the University, the Town of Chapel Hill, and the Chamber for a Greater Chapel Hill-Carrboro for their letters of support for this so that some programming can be brought to downtown Chapel Hill. He said he recalls there was a recommendation from the Board when the second building at the Orange County Durham Tech Campus was being discussed to ensure there are locations throughout the county, and this is an effort to lean into that. President Buxton said Small Business Center Coordinator will continue to specifically focus on the work being done in Orange County. Slide #3 MATCH FOR DURHAMYS CONTRIBUTION 1. Apprenticeship Coordinator:$8,249 The College has supported an Apprenticeship Coordinator from the federal Higher Education Emergency Relief Funding The Durham County Managerhas included a 90% share( 69.500)in her recommended budget. 2. Facilities Technician and Plumber:$45,408 The College requests 20%of both a Facilities Tech position to reduce our technician per square foot ratio from 100,000 sf to 50,000 sf(industry standard)and a new plumber position to address a major service need. These positions will reduce contracted services needs.The Durham County Manager has included an 80% share($140,715)in her recommended budget. 3. Recruitment and Retention Fund.-$10,000 This i5 a fund to boost the College's capacity to recruit and retain faculty in a highly competitive labor market,The Durham County Manager has i ncludW a 90% sha re( 90,000)in her recommended budget PAR 0LAtrr4 n#du President Buxton said the items on this slide are not included in the Manager's Recommended budget but are important for economic development and facilities maintenance. He said he is asking the Board to take a minority share of the cost for these items and the Durham County portion is included in the Durham County Manager's Recommended Budget. President Buxton said the Apprenticeship Coordinator position was created to help create and connect students with apprenticeships. He said the federal money that was used initially to fund this position has run out, and he would like Orange and Durham Counties to provide the funding as an economic development investment. President Buxton said it is becoming more and more of a challenge to not only keep up with the physical growth of buildings, but also maintain the aging buildings on campus. He said 4 currently some facility needs and all plumbing needs are fulfilled through contracted services, which is more expensive. President Buxton said Durham Tech would like to put together a Recruitment and Retention Fund to be competitive with area universities and industry. Slide #4 SALARIES AND CRITICAL POSITIONS ■ Durham 7eeh Salaries ■ Average S�-month faculty salary $60,005 ■ 8-month faculty salaries range from S45,44 74.8V ■ Faculty salaries are based on educational attainment and work experlence_ ■ Average staff salary S! 3,515 • Critical disciplines and positions ■ Neafth&Wetfness,Ltfe Sciences faculty Comppetltlon with the Duke and LINC health systems,local colleges,and universities for nursing Instructors. Sig ning bonuses are ashighas 320,000. ■ .AdvancedManufactaring facufty.Director's position has been vacant for over year in this highly competitive market ■ lT Facutty and Staff r0169.Competlng with Intlustry-level salarles ror both raculty and stafrposltlons_ ■ Campus Force These are high-turnover positiorm. Durham PD is Currently offering$14,0Whiring incentive ar}d a$3.WOrelaoatiorito rKruittop talent, ■ NVAC Vectrtelan staff roles.These high demand positions are competltive as the plpellne for these professionals Is low as man y are reti ring_ 44 r dLj#Mn *rn*4j President Buxton said there has been some investment at the state-level for salaries, but the reality is that the average 9-month faculty salary is $50,000. He said this is a tough salary to deal with when competing with industry. He said a fund of$100,000 is not enough but would help put the salaries in the ballpark. President Buxton said the last item he wants to mention is a request for a sworn officer for the Orange County Durham Tech Campus. He said security at all college campuses is vital, and there are a lot of vacancies for campus police. He said there have been a few incidents at the Orange County Durham Tech Campus that have thankfully not escalated but have demonstrated the need for a sworn officer. Commissioner Fowler asked if the law enforcement officer is included in one of the amounts listed. President Buxton said it is not included on the slides but is part of the request. Andrew Kleitsch said the cost is $78,200 with salary and benefits. Commissioner Fowler asked if the state provides any money for campus police. Andrew Kleitsch said no, all funding comes from local sources for campus police. Commissioner Greene asked what the total amount of Durham Tech's request is outside of the Manager's recommended budget. President Buxton said they are requesting $65,000 to match the Durham County Manager's recommended funding, and $78,200 for the sworn officer position. Commissioner Greene asked what the slide above indicates in reference to those amounts. President Buxton said this slide is for context for the Recruitment and Retention fund. 5 Chair Bedford said enrollment numbers went down during the pandemic, and asked how the numbers now compare to before COVID. President Buxton said enrollment numbers are still down from before COVID. He added that registration for this coming fall is up 20% from last year at the same time, so the numbers are returning. Chair Bedford asked if the Innovation Hub is the same thing as Launch. Travis Myren said the Innovation Hub will be in the same space as Launch. Chair Bedford said the Board has already designated $70,000 for Launch. She said she supports the recommended $20,000 for funding now, but it concerns her that the rent will grow to $100,000. She asked how this will be different than the work skills program that will be at the new 203 Project in Carrboro. President Buxton said the Nurse Aide program, ESL programming and some GED programming will switch over from the Europa Center to the 203 Project. He said the challenge is finding other spaces for small business center counseling for customized training and curriculum programs. He said the$20,000 is to give access to the facility, $100,000 is a projection that would give Durham Tech dedicated space. Chair Bedford asked if the Board is committed to $100,000 if$20,000 is approved. President Buxton said no. He said Durham Tech would likely come back with the request based on the usage they would like to have there. He said programs like clinical trials and data analytics have them looking at a pathway from Durham Tech to UNC for some classroom work. Chair Bedford said it sounds like people are taking the 6-8-week certificate programs, so the additional $50,000 will be spent. Andrew Kleitsch said funds ran out this school year in December, and he anticipates the need will continue. He said community colleges are shifting to short term classes, so this funding is important. Commissioner Hamilton asked what the enrollment is at the Orange County campus. Jacklyn Krohn said 1,400 took at least one class at Orange County Campus this year, not including summer terms. Commissioner Hamilton asked if the number is unduplicated. President Buxton said yes. He added that there are about 15,000 students enrolled at Durham Tech in total. Commissioner Hamilton asked how many instructors are working at Orange County Campus. President Buxton said the instructors work across campuses. Jacklyn Krohn said around 35 instructors teach at the Orange County Campus. Commissioner Hamilton said the challenge for her as a commissioner is balancing needs across the county. She said the Board would do everything if they could but have to make choices. She said she looks closely at duplication of services. She said the Back-to-Work scholarships sound wonderful and looking at the industries, people will be paid well. She said she does not think the county can afford to be subsidizing something where people could afford to pay the tuition themselves. She asked for information on who receives these scholarships. President Buxton said he will send that information. He said the scholarships are awarded at a balanced level across ages, racial and ethnic background, and a number of different industries. Commissioner Hamilton said she was glad to hear that it is balanced at the current funding level but wondered if an increase would make it unbalanced. Commissioner Portie-Ascott asked if the 1,400 students at the Orange County Campus includes the people accessing the Small Business Center or if there is a different number. If not, she asked for that number and if there is a charge to these folks. President Buxton said it is free. 6 Jacklyn Krohn said she does not have the numbers for the Small Business Center, but they would not be included in the number of students. President Buxton said they will follow up with some data on this. He said this is done in both Durham and Orange in partnership with the Small Business and Technology Development Center (SBTDC). Commissioner Richards thanked President Buxton for his presentation. She asked if safety is provided by the county. President Buxton said it is provided through the overall budget. Commissioner Richards asked if the current police officers are paid for by the county. Andrew Kleitsch said because safety officers are rotating between Durham and Orange counties, Orange County provides 15% of the salaries for those rotating officers. He said they are looking for a dedicated officer for the Orange County Campus. Commissioner Richards asked where that is reflected in the budget. Andrew Kleitsch said it is listed under Service Maintenance and Skilled Employees in their budget request. Commissioner Richards asked if the increase would occur in that category if funding was provided for the sworn officer. Andrew Kleitsch said it was included in a separate line item in the budget request in order to stand out, but that it is the same category. Commissioner Richards said she is curious about the Sheriff's Office's role in K-12 education and the difference in the treatment with community colleges. Bonnie Hammersley said the county has a contract with the school districts for one nurse at every school in Orange County, and SROs to every elementary, middle, and high school in Orange County Schools, and every middle and high school in Chapel Hill-Carrboro City Schools. Commissioner Richards asked if that was a practice or a law. Bonnie Hammersley said it is practice and can be changed. Commissioner Richards said money has been dedicated to the 203 Project around workforce and small business. She said she would appreciate learning about the synergy that is anticipated between the 203 Project and the Innovation Hub. She asked what kind of outcome and payback the Board can expect with this additional investment. President Buxton said until a year ago there was no dedicated coverage at the Small Business Center and the numbers reflected it. He said there was very little activity from the college to support individuals, who often reach out for assistance in the early ideation stages of their business. He said there is no cost for services through this process and people are often connected with additional resources. He said the Hillsborough campus is a good location, but other locations are needed for walk-in and meeting services. He said the Innovation Hub would provide space for small business counseling in Downtown Chapel Hill, space for customized training as more businesses locate there, as well as space for continuing education and curriculum-based classes. He said the college will have to pay rent somewhere and this seems like a good place for the county to invest in. He said they also like the partnership and synergy with UNC Chapel Hill in some areas that are pathways for students for jobs in the university or for programming for high school students. Commissioner Richards asked if the SBTDC from UNC will be at the Innovation Hub. President Buxton said he is not sure about that. Commissioner Richards said offering classes here makes sense, but not the small business support. She said she thinks the county's Economic Development department is proposing a small business support as well. Travis Myren said that is just for software. He said the Economic Development department does not do any training. He said the county relies on Durham Tech and SBTDC for that as well as other organizations. President Buxton said rather than asking for dedicated space upfront, the agreement with UNC Chapel Hill is to see how that program goes and if it works, pursue dedicated space. Commissioner Hamilton said the 203 Project will have a Skills Center, and asked if there is space there for Durham Tech programming. Travis Myren said the Nursing Tech Program, GED Program, and ESL will move from the Europa Center to the 203 Project. Commissioner Hamilton said the 203 Project is geographically close to UNC, and asked if space could be made there rather than paying more at a different location. Travis Myren said it was not originally programmed for it, but staff can look. Commissioner Fowler asked if there was room to rearrange current staffing for a permanent officer on the Orange County Campus. Andrew Kleitsch said current the force is currently understaffed for the facilities that are covered. He said in order to better serve the Orange County Campus they really need officers for two shifts, and the first shift officer would provide some consistency in security for students. Chair Bedford said the Innovation Hub and the $50,000 increase in Back to Work Scholarships are covered by Article 46. She said the County Manager is recommending a 10% increase to current expenses, and that could absorb the apprenticeship coordinator and recruitment and retention. She said she feels they could get some more mileage from the County Manager's Recommendation. President Buxton said the Durham Tech Promise is a reimbursement in Orange County, so they do not have that money to put toward other expenses. Chair Bedford said she understands that, but there is a recommended 10% increase in current expense that is higher than inflation, and some of the additional items can be covered. She asked how many serious security incidents there have been. President Buxton said he does not have that number right now but there have been some significant issues that have shown a sworn officer is important. He said some incidents have been difficult ones and security personnel are not as well trained as a sworn officer. He said this request puts the campus in the best position to protect and serve. He said as far as the other requests go, he focused on areas where Durham is picking up 80-90% of the cost and would like Orange County to consider the 10-20% in partnership. He said the 10% increase in current expenses is certainly generous and the college will do what it can with that funding. Commissioner Portie-Ascott asked if there is also an officer at the Innovation Hub. President Buxton said Durham Tech will be a tenant there and not responsible for security. 2. FY 2023-24 Fire Districts' Tax Rates, Pgs. 151-155 The Board reviewed and discussed the FY 2023-24 fire districts' tax rates, including tax rate increases recommended for nine (9)fire districts. BACKGROUND: Nine (9) fire districts have requested tax rate increases for FY 2023-24. As in the past, fire districts requesting tax rate increases present their needs for a tax increase to the Board during a budget work session. Staff have invited representatives from these districts to the work session to answer any questions and/or provide additional information to the Board regarding the proposed increases. Attachment A provides information regarding tax rate requests from all twelve (12) fire districts and/or fire service districts in Orange County for FY 2023-24, and the amount of funds one cent on the tax rate generates. Information regarding all fire districts is located in the Fire District section of the FY 2023-24 Manager Recommended Budget beginning on page 151. 8 The Fire Chiefs/department representatives introduced themselves. The following were present: Chief Jeff Cabe of Orange Rural Fire Department, Chief John Stroud of North Chatham Fire Department, Chief Jeff Borland of Cedar Grove Fire Department, Chief Charles Bowden of New Hope Fire Department, Chief Ricky Baker of Orange Grove Fire Department, Chief Kevin Brooks of Efland Fire Department, Assistant Chief Joe Bumgarner of Caldwell Fire Department. Travis Myren, Deputy County Manager, began the following presentation: Slide #1 County Fire Tax District C E Map L RIY 12 Fire Tax Districts r*%Ja]D#irlctareq"sWylax rate ocreaees -0 R L Total FY2029-24 Rercammerlldad Flrs Dairlct Expet4bwes M e 1sB,E44,339 • inoresseaf$U9,2Wover It N FY211)22-29 + AM I AN O O ! R U I �1 C HILL J 3011 11 - - { 6RA✓stlgNXPrL MILL ORANGE COUNTY 8 7kJA U� rl 15 kM1k TR 013LE 11r ORTlL CA R0I-1 NA I Slide#2 Fire District Recommendations F Dlifference Cents 24 Tax RAte in cents cetierGrove 7A3 9.00 1.37 Chapel Fir 13,97 1187 a.aa Dam&scuS 11.80 12.80 1,00 Lila n d GIB 10.2E 2.00 ENO 1196 $,$$ 0.00 Little River 6.3D 7,39 I.% NOW Hope 11.56 12.57 1.01 GrangeGrove 7.27 8,27 1.00 OrangeRural 4AD 10A0 1,00 Sout^G'a-ge 9.09 9.09 4.a0 Sou#hem Triangle 11AD 12.90 1.4� Wh Ite Cross 12.34 1 LU 1.50 ORANGE COUNTY 9 NORTL L CAROLINA 9 Slide #3 Fire District Recommendations Recommended Fire District Tax Rain FY2023-2d 16 12 8 12.67 �2 6 12 loll 10 9 — a rr e e 2 0 Cedar Orwo Chapol HI C7� r Eflmd Eno Litlk Rvar Na Hape Ormge Grme OrmgoAura1%Lrh Orange %uliam M he Croar Trkrgla ��.. GRANGE COUNTY M DRT1[CARC}L]NA Travis Myren said the line across the middle shows the total average tax rate which is 10.87 cents. Slide #4 Fire District Recommendations Recommended Fire District Tax Ratea and Revenue SSAOD OOp iE ii aOp OOp 789 12.6T 12.0 i-0 ii fOp OOp 12 11ACIDA00 9.B8 31.240300 i0 sx 11A00300 B 349000 6 %Op Opp i !•i90p Opp — —_ . lull, Cedar Crwb rhapd HI Da"us MUM Eno Lnk F.Qf NQw Hapb Oranga orange RwW South Bouliam Atiba Uxa Gfwa Dranga Trkrgla 4 1 M�NG c OUNPJDLIATY Travis Myren said one of the reasons the rates are different between districts is because all the tax bases are different. He said the value of the tax base in each district determines how much each penny will raise in tax revenue. 10 Slide #5 Fire District Recommendations • District F equests page 151-155 • Cedar Grove Fire District • Etland Fire District - 1.37 cent lax rate increase - 2.00 cent lax rate Increase - Increasl ng cost of personnel, fuel,fire - Debt service payment on Fire Statlon 01 equipment renovatlon - Replace 36 yearotd brush truck - Replace support vehicle - Upgrade fire suppression equipment • DamascuwSouthern Triangle Fire District • Little River Fire District - 1.00 cent lax rate increase - 1.00 cent lax rate increase - SeMce pmNlded to bath dlstrlcts by North - Sulld reserve to replace fire engi no Chalham Fire Deparlment - Addlllonal part lime staff ORANGE COUNTY 17 r4C>RT1 P CAROL1NA Travis Myren said the themes across increases are inflation for equipment and the need for position recruitment. Slide #6 Fire District Recommendations • District Requests — page 151-155 • New Hope Fire District Orange Rural Fire District - 1.01 cenl tax Pale increase - 1.00 cent lax rate Increase - Additional part tlme staff - Increase salary and benellts to retain employees - Inc reusing cost of and equipment - Increasing cWoffuel and equipment * Orange Grove Fire District . White Cross Fire District - 1.00 cent increase compared to FY 2021-22 Rate _ 1.00 cent increase compared to FY 2021-22 Rate - Increase salary and benefils to retain employees - Replace costs of Sett Cornained Breathing raws (SCSA) - Add full time firefighter to increase daytime service levels ORANGE COUNTY 13 MORTtt CARQLINA Chair Bedford asked what it means when it says "the Town of Carrboro will continue to provide fire protection for the fire insurance district through a contract with Orange County" under South Orange Fire Service District in the budget document. 11 Kirby Saunders, Emergency Services Director, said the county contracts with each of the districts to provide services. He said in that particular district, the Carrboro Municipal Department provides coverage in the Carrboro Extraterritorial Jurisdiction. Commissioner Richards asked about the increase for the Efland Fire District. She asked what the impact of the increase will be for people who live in Efland. Chief Brooks said the 2-cent increase will generate $98,000. He said they hope to refurbish Station 1 with sleeping quarters for future paid staff. He said it seems like a lot, but they have not increased over the years, and they signed a contract to add onto the station, which will cost $2.3 million. He said the Efland Fire District does not see any revenue from all of the new warehouses in Efland because since Mebane provides the infrastructure, they annex it. Commissioner Richards said she has heard feedback from Efland residents who do not understand why there can be a big fire station there but no recreation, etc. She said that is where her question came from, and thinks the county needs to do a betterjob communicating the benefit to the people who live there because there is an issue of perception around where the county resources are going. Chief Brooks said the department has an open house every year where they show their plans for the future. He said volunteerism is not what it used to be, and they still have to find a way to fill the gaps in order to continue service to the community. Commissioner Richards said she believes that and is just sharing feedback. Travis Myren said an EMS station and a Medical Examiner's Office are also being built in Efland. 3. Discussion of County Departments' FY 2023-24 Recommended Budgets within the Public Safety and Human Services Functional Leadership Teams (including Operations, Capital, and Fee Schedule Changes) The Board reviewed and discussed FY 2023-24 recommended departmental budgets within the Public Safety and Human Services Functional Leadership Teams. BACKGROUND: The County Manager presented the FY 2023-24 Recommended Operating Budget on May 2, 2023. Since then, the Board has conducted one public hearing to receive residents' comments regarding the proposed funding plan. On May 11, 2023, the Board discussed recommended FY 2023-24 budgets for Chapel Hill-Carrboro City Schools Board of Education and Orange County Schools Board of Education. This budget work session offers the Board an opportunity to review and discuss the recommended budgets directly with County departments within the structure of Functional Leadership Teams, including operations, capital, and department fee schedule change recommendations. Functional Leadership Teams: The following Functional Leadership Teams are scheduled to attend the budget work session: Public Safety • Courts, Pg. 113 • Emergency Services, Pgs. 138-145 • Sheriff, Pgs. 208-211 • Non-Departmental, Pgs. 193-194 (Note: Due to a scheduling issue, the Criminal Justice Resources Department will be discussed at the May 23, 2023 Budget Work Session.) 12 Human Services • Aging, Pgs. 51-57 • Alliance Health, Pg. 58 • Child Support Services, Pgs. 93-95 • Equity and Inclusion, Pgs. 146-148 • Health Department, Pgs. 158-164 • Housing Department, Pgs. 165-171 • Library Services, Pgs. 179-182 • Social Services, Pgs. 212-217 • Non-Departmental, Pgs. 189-192 Travis Myren continued the presentation: Slide #7 Public Safety • Courts — page 11 - Operating Costs and Recurring Capital#or Security($44,256) Align budgeled expendEtures to acluals • Badge readers Cameras • Intruder alarms - Security Analysis/ ulnerabilityAssessrnent($75,806) Corksuiting services to review security systems and prolocals at the Justice Center • Funded using County Capllal Reserve Fund ORANGE COUNTY 14 NORTH CA6tOLINA Chair Bedford said the Public Defender's Office was not included and asked if the county provides space for them. Travis Myren said yes, they have space on King St. in Hillsborough. 13 Slide #8 Public Safety • Emergency Services — page 18 • Total expenditure budget- $15,647,795 — Total Cciunty costs decreeeedbyW95WframBaeeBuiget • Recommended Budget Changes — Behavioral Health MoblleClisis Pilot-$97,404sa month cast » Part nershipwith Town of Chapel Hill » Fourperaonrespolfaeteam • County fwWs 911 C4nwrCllnlclan and Community Paramt4c • Tmm funds Clinical S inisIWarMrand Peer Support Specialist w Teem ie unarmed,nict under drection of law enforcement,responeedeterniiredhy defined probxols a Program evaluation through SCIG Criminal Justice Ilrnovalion Lab GRANGE COUNTY N Evaluation to inform potential expansion in FY2025-26 MORTf f CAROL]NA Kirby Saunders said Elizabeth Farnan, Fire Marshall, was not able to attend tonight. Travis Myren said $97,404 is the six-month cost and they expect that to double if they move forward. He said that this is a non-law enforcement involved response and would include a 911 Center Clinician, a Community Support Paramedic, a social worker, and a peer support specialist. Slide #9 ff Durham's HEART Program Public Safety C-unkyRnpensi c6 aColl 014ir71a+ Date Range TtaimI€RT] (oc61 Emergency Services — page 138 6�2zVzaz o sf � 1992 13 S4 CRT €Co 11414paiisac Creating a Crisis Contlnuum of Care + 3 V ChI T})rc bV CA TrP>i Mwro4 VwM }}' fir.+�•4r T6 Share of encounters whasa HEART respnndors nuparlyd "4 Mnulrs 6u Saerrc Ary Mnutes io famra foaling safes '. 93 x gm6jlr}o.kene Arg Call % 41.9 9.4 tB "T"MnuFes Aq k[al Minutes 14 Commissioner Fowler asked how 988 works in conjunction with this. Kirby Saunders said 988 currently transfers to 911 Center and they will investigate how to refer callers that meet the criteria to 988. Commissioner Greene asked if the 6 months is at the beginning or end of the fiscal year. Travis Myren said it will be at the end of the next fiscal year. Commissioner Greene said it could seamlessly tie in. Travis Myren said yes. Chair Bedford asked how this ties in with the grants for a social worker in the police departments. Kirby Saunders said the HEART program has a co-response model and the grant will broaden that. He said that this is a request for the four-person team when law enforcement may not be needed. He said that it provides a better service and reserves responders for when they are really needed. Travis Myren said the goal is to create a crisis Continuum of Care. Slide #10 Public Safety dP Emergency Services — page 138 F Recommended Budget Changes — Lo-�l*bcaT�chnlclan-�6+0,568 » Reepande(DEMSdemand w Restoclamodlcar*upplIes Fwe Mam^N Educamn anoTralning Suppll►a-$U.l 9 » Lamm freex&kguieheftmining w Smc &c%tecWrdl*bnbuWn — Otherahangee » Fl�ducllanlnmcrgu�caelrackdu�loEi]and5ub*Wnlcn+M�dcarExaminarpfhc�(316,�40J » Reductieninane-timeeaneuldgee�vicea($44,354] w lwftloeme+ weeaso*foe wvformsando"raMht$3d,566 4 ORANGE COUNTY 17 NORT[[C, PJDL1 NA Commissioner Portie-Ascott asked about the hours for the 4-person response team. She said they will not be working 24 hours a day and asked who would take the calls when they are not working. Kirby Saunders said the clinician and the mobile crisis team would be scheduled during the peak times of 9:00 am-6:00 pm. He said they would revert to the normal response when they are not working during pilot project—either co-response or traditional response. 15 Slide #11 Public Safety • 911 Calls Call Taking Efficiency Calls Processed 9501 Cob ii7}0 8acoi7daw 1156 0l C4 ua 20 8v€onc4 •5„c�a a...x ao-.r Caps MAW 9r00% — --- 299a9u �r 05 00% 15P 9G7 B9 GU 1KP00% 11CaFiF 11A14I 1112d8 11f,T# B190% 10pOM B9 00% HAD B7 00% BSQ% FM73-19 FM73-ZU Fr902D41 FMM-M Fr2M-M FTMV�24 FV271B.lB FY201MO FY2020-21 FIM21-22 FIM22-23 FY2023-24 PY9f BAIL F#al EMBat ORANGE COUNTY 1B N€>RT[[CAROLINA Slide #12 Public Safety • 911 Calls by Service Type 2020.2021 2021-2022 2022-Present ■FYre ■EM3 ■LE ■UnclasslMed ORANGE COUNTY 19 NORT[.[CAROL-NA 16 Slide #13 Public Safety • 911 Call Volume EMS An n ual Call Volume 0 Deman0 �troa 2€.ASn 25 R,P 9% aABa 2aom ,9378 ie% {B3a 14An2 45.52B MAN ,S Uri 13.7R ,5897 ,+,,i0 79 i% 7Z9Ji ,now 22s Bran MDU RMU MOTE ROM re2017 FY20,B MM FY202n R2021 re2m FY20M Pic, re204 BuoQc[ ORANGE COUNTY 20 WORT[[CAROLINA Travis Myren said often more than one unit is dispatched to a call. Commissioner Greene asked if there is a relationship between the calls and COVID. Kim Woodward said this surge is nationwide and they are trying to figure this out. She said that the vast increases are in the lower acuity calls, but they are analyzing and trying to see what the drivers of the impacts were. Commissioner Greene asked about the impacts for drug overdose. Kirby Saunders said it has gone up 29% since last year. Slide #14 Public, Safety a 2022 Response by Emergency Medical Dispatch Complaint Percent of C.I I Typt, Vowvoe Y4Y p4rc rit Grwmh Sick Nuon ION Ak 1076 FeLle 12% A 1% 7rafflcAccldent 110h A 11% TrensferIFaterkeFiltyfParlletM&Cere S% A nx 9reathingpMblem 7% T 4.5% tkK9mdi;us/Hlntln¢ �,% A a% Uk"PaM(N0tk-TriKaM tkl 695 A 13% Ca,wurslonsJSslamm MA Rmarrhate/Lmerabm 1% la% Strokoj"A t% ■3% Owerdoee�POBonrn€/Fa ibn 1% A 29% _ ORANGE COUNTY 21 Iti ORT[L CA RC}I3 NA 17 Slide #15 Public Safety • EMS Responses by Location � • 3-year Heat Map of F-N-I s � Calla r * Consistentgrowth in population centers • Emerging growth in Efland community r ` J-.-I ORANGE COUNTY Slide #16 Public Safety • EMS Response by Time of Darr Peak['emend Feria Ifil Yt POL r ALS Ambularct: .I+12 heur.LLI arbLL—n,& I1 I 1 r44 i 24$imblilbr." 3 DOD !I%SORS BL9 11154z5 BLS _'500 am 15CO 566 23 ■BLS Clete—.wts MALS L>s*ern+inenSs 18 Slide #17 Public Safety EMS Response Time Average Response Tirm 1 t37 11:p4 1 tQ2 iG:12 iR09 9 qp 943 999 9+e B iJ 9AF HAM 9np 7AD 7:12 rVM4-15 ryms-lc nanaiT FIMT-4e .y rang-m rtia�3i FVMI-= r+=.Zsaq rram'a 5"W ORANGE COUNTY 24 MORT[[CAPJDL]NA Travis Myren said that because of the high call volume, the calls come out while they are still on the road and the unit is immediately dispatched to another call before ever returning to station. He said that they should see the impact of unit added last year in next year's data. Kirby Saunders said they should have two additional life support vehicles to show in the data next year. Slide #18 Public Safety • ERAS Revenue-Collected by Tax Administration Emergency Medical Services Charges f6.WUAGU — U.MDPOp LS.{a7.N1 #8.24k IT9 4k4�.!}Q #A121AOp a�� S3.U]OA00 i2,MGAOp i1,MGAOp �¢ I Fr 2flil6 FryplSif Fr 2fl�l7 Fr 2t17-19 FYeM41} Fr801!•21 F'rRtb.Y41 FYe0M-27 F7e]Cts}PuA F1ie]Q7-2VBMW ORANGE COUNTY 25 MORT[[CAROL]NA 19 Slide #19 Public Safety • EMS Revenue Collection Rates and Payer Mix Collection Ratm FY23 Payer M ix (as of 12J31122) �GUY 68 GUY 59 ai% eGGUY Auto Insurance 0-38% as GOY Contract 11-26a a�ooY wao9s EM% Medicaid 13.271r(o BG GUY M0D); $xzE% Medicare 22,861r6 M0D); Madtcare HMO 3.551/0 Fa GUY Patent e�GpY 19,141/o FYMI-IF F5M1,'F FY."" FWM42 F'RlMFly Rail-2 SNW Private Irrsumnce 29-44% 4 GRANGE COUNTY 26 MORT1 I CAPJDLI NA Travis Myren said the higher rates in FY 21-22 could be attributed to stimulus payments and that more people were receiving Medicaid during the public health emergency. Slide #20 Public Safety . Sheriffs Office — page 208 • Total expendlture budget- $1B,301,548 - No increase in net Coaert r costa • Recommended Budget Chan gas - Increaeebtdgetedrevenue6os6gn with aotualcallectum Report reproduckri-11 W.000� OCR ScNccl R�sourc�CNk�n{E62,Dt 4} - Aadfouq4.D}FTE D►1&mIon-0Mctrs » GnatieatFeetwhh revenue racogrruan-$$232,914 - Sheriffs Office target(cc De!1eMDn Center etafrig-31 FTEbssedonhtaeerayAFctm�BctStudy w Ab:1"IS In FY2D22-23 w Rscommrrded4.0 FTE In FY2D23-24 w Staff neededto achieve 8hariff stxget-12 ORANGE COUNTY 27 tiORTI I CAROL]NA Sheriff Blackwood said they have hired 9 and he has interviews this week with the other 8. He said that leaves him at a net minus 2. He said that he had reduced his request from 15 to 9 and that he is very appreciative of the 4 that they have. He said they have accepted that more 20 people are not coming to help and they have to do what is needed with the staffing they have. He said the idea of doing more within the detention center as far as the programs discussed with CJRD will require more staff. Commissioner Richards asked the capacity. Travis Myren said 144 beds. Commissioner Richards said the average has been below that and asked if the staffing is not adjusted based on population. Travis Myren said that the Sheriff would explain staffing Slide #21 Public Safety IF Detention Center Population Detention Center Populatlon Pei ntin Time by Month 144 13B 120 ifl9 161 11U [q 7�7 100 1aa 91 B1 B1 yp 91 es N EM 7e JVJ 77 79 7B rg 67 dB 50 13 p •gale Servng E03 •Fbtl7ral ■Ntlid 4G 2G U I p �Lp V-' j "0, Sheriff Blackwood said that the staffing is based on workstations within the detention center and not based upon number of inmates. He said that additional staffing becomes critical when discussing moving inmates between areas of the center. He said he has had to bring deputies off the road to work in the detention center. He said they have been able to maintain their salaries and retain great employees and that has gotten them through the storm. Commissioner Richards said the detention center was designed with a certain number of staff, population, and programs. She said that they haven't implemented all the programs so she is trying to understand the need for staff since all programs have not been implemented. Sheriff Blackwood said that the staffing study has nothing to do with the programs they have talked about. He said the staffing study looks at workstations and fulltime employees that need to be there for the shifts that they have. He said that it does not consider the additional programs they have discussed such as the GED or Lantern programs. He said it considers booking, magistrates, movement of inmates from place to place, control room, and kitchen. He said you have to run a whole jail and you can't just run half of it. Commissioner Richards said that she has toured and read a lot and the new detention was supposed to be different than the old one. She said if they have designed a center that will need the same level of staffing regardless of inmate population, they still have not implemented programs, like the in-person visitation. Sheriff Blackwood said in person visitation is available, but no one chooses to use it. 21 Commissioner Richards asked if it is video or actual in-person visits. Sheriff Blackwood said that it is in-person, and the attorneys are using it now. He said that in-person visits are starting back this month. He said that he understands the confusion because it is not a simple operation. He said that if there are 100 people in the jail and 50 leave, that does not mean that deputies can simply be sent home. He said they have to stay at the workstations. Commissioner Portie-Ascott asked if any of the 9 would be used to cover tower shifts. Sheriff Blackwood said the goal is to have 4 in the tower. He said sometimes there is only 1 in the tower. Commissioner Portie-Ascott said when she toured, she saw how difficult it was for one person to work in the tower and really see what is happening in the units. She said that she is happy to see that the staff will be used in the tower. Sheriff Blackwood said that is one of their biggest concerns. He said that when a deputy is running screens, they also open and close every door in the building. He said while they are doing that, they do not have the time to look out the window. Travis Myren clarified that the tower is central control. Commissioner Hamilton asked about rightsizing. Kirk Vaughn said they reviewed the trend of actuals in the accounts and the budget increased to match the actuals being received. Commissioner Hamilton asked if it was not reflected before. Kirk Vaughn said they were not. Commissioner Fowler asked if the 31 is an addition. Sheriff Blackwood said of the 31, 15 were awarded to the office and of the 15, 9 have been hired and 8 will be hired within the week. He said that of the 4 that is being given now, 2 are factored into the 8 and 2 more will be added. He said that leaves a balance of 10-12. Commissioner Fowler asked how many staff are in the detention center. Sheriff Blackwood said around 38. Commissioner Richards asked if all internet issues are resolved to enable telehealth and other visitation services. Sheriff Blackwood said Froi Romero in IT was able to identify every call came through the system in the jail, and once he flipped the switch, it took the load off of them and the other systems worked more robustly. He said the telehealth camera was purchased and is close to being implemented. Commissioner Richards asked when that ability can be expected. Sheriff Blackwood said the system is very sensitive and gives the doctor the ability to look at facial movements and body movements. He said that it should be up and running very soon. Chair Bedford said she was with him when the Attorney General was at the meeting, and he is on the state committee for recruiting and retaining. She said he mentioned some strategies like part time officers. She asked if that has happened. Sheriff Blackwood said that has not happened yet. He said there were 31 identified and of the 31 initiatives, there were 5 identified as low hanging fruit. He said he has a meeting with the director of Crime Control and Public Safety, and they will meet with others to discuss hiring and retention. He said there are a lot of ideas out there, some may require legislative changes, but there is a lot of low-hanging fruit. Chair Bedford asked how many non-detention officer vacancies there are. Sheriff Blackwood said that on patrol there are 5 vacancies. He said that in regard to personnel, 30 years ago there was a program implemented by the federal government that hired 100,000 cops through grants. He said those numbers are now retirement age. He said that he will have at least 6 retiring from natural attrition. He said that while there are many reasons that people leave the industry, he said they are not losing people at the rapid rates of surrounding agencies. He said that a big part of that is the support from the Board. 22 Slide #22 Human Services • Aging — page 51 • Total Expenditure Budget-$2,666,854 - Net Courdy caetsincnaase by 379,530i cmEk3se Budget • Recommended Budget Changes - b31,7WIncr►armintomporaryalamng foe Ih&S4nlorC4nwr►aerryhowa, - $20,129gwemwmasaPo+Moblllt Wnapmw-Grant - T315,B10 increase in livilg wage forhamehealth sid'ee - T33,474 increase in porting end operating€bets. ORANGE COUNTY MORT[[CARC}L]NA Slide #23 Human Services IF Senior Lunch Meals Served Senior Lunch ProVam Meals Served 5q� 40LMd +ate +ate 3' NAZO rMN 2RM 2ROD kE,on KM rrav rt�o-x7 rrrr.v rro-v rtm.xa rrav rrt�.x3 'rxxas� rexsai dd�.e ORANGE COUNTY 30 MORTr r C#AFL]NA 23 Slide#24 Human Services • Senior Center Attenda nce Senior Center Attendance 29g0W z!aa3a Y21&96 ;!MSIR WIDLG N�4Y2i 19&155 gym° Lem L9g0W iLA68Y unwo WPM R'i3Li Nid L5 r'YLS-id r'YLr17 RVAD RiDA9 FVS-M FwaYL Fd2h-12 riO-M FM-Yd ORANGE COUNTY 31 MORT[[CARC}L]NA Travis Myren said there are also virtual services that may be impacting attendance. Slide#25 Human Services • Unduplicated Participants at Senior Centers Undupkated Nrticipants-at the Senior Centers Learn Dim iQam 9.Li9 �aoa ivx �Pm Ri6Y7 RIMS RiB-L9 Fti O-IG 2: F+'2L•Y2 RU-3?IP31 P'�3i blot ORANGE COUNTY 32 M4011T[[CAMOLYNA Janice Tyler thanked the Board for their support. She said they do project more attendance. She said they have checked into the numbers and there was a problem with tracking in some of the activities and also had problems with the Rectrac system. She said they are trying to put better practices in place to get people to scan in so they can track usage. She said that 24 some folks have come in for one program and just get counted once. She said that folks are hesitant to come back in, they lost some folks, older adults stayed at home for a couple of years and became more frail, so they are working hard to get everyone back. Slide #26 Human Services • Alliance Health — page 58 BudgetRecommended Managed byAlllance Health MCO $897,850 Funding to County Departments` $458.124 Total Maintenance of Effort $1,866,974 `Detailed next Aide ORANGE COUNTY 33 NORT1l CArtOLINA Travis Myren said the three biggest contracts are Freedom Housing, Club Nova, and UNC Psychiatry. He said that the reason those funds are provided help defray the cost of providing service to the uninsured. He said that hopefully the uninsured will decrease with the expansion of Medicaid. He said that there may be a shift of some of these costs to the Crisis Diversion Center. Slide #27 Human Services • Alliance Health — page 58 Fundingto Cowity Deparoymm DeWW _ Oepartrnenl Servlae D"Nwan M`ank Cnminel Juglce Resource Once Case Assemnwi Spedalst S B2,43B Cnminal Jrshoe Resource Om[e WnI&I Fleahh Llarson Ty Ya dh S 79XI5 M Mh Department Clydeal Soda]Worker-Ilrha9ratad 190w9aral HeaM S 11M1 Halralop and Cm"!:i DmbWTwt Rapid RehoiwA S 72,b79. 54clalisemca3 Trawo F&IBMTrieraplFa $ 5D,ap3. Sa[lel SeMces Counseling Ter Farrilles In PrctectMe Senicee 8 22,aD3 �4o[lal SeMces SeM[es Tor ReM&bal Chlltlren In Fader Care S SSOG7 TOTAL _ S ME6124 ORANGE COUNTY 34 MC>R-Fl l CAROLINA 25 Commissioner Hamilton said when thinking about changing funding she will want to see who they are funding and how many people they are serving. She said funds taken from this may still be needed. Travis Myren said that should be available from Alliance. Commissioner Hamilton said she will be needing to see all of the county services so she can share that with the Alliance Board and compare it with what other counties are receiving. Slide #28 Human Services • Child Support Services — page 93 • Total Expenditure Budget-$1,186,08.8 - Totalrevenue af($1,49U,756) - N�1 Gral Fund canlrlbtirlor-f33p4,$6.6} • Recommended Budget Changes — Ti 1,644 expendrtum increase based an increase in taut filings end poky changes in the filing fees charged to orange County — Ti16,274decreaeeinrevenuebasedonStweestimamwhichisbasedmspendigintheprimyear. 4 ORANGE COUNTY 35 NORT[[CAROL]NA Slide #29 Human Services • SMART Goal, Establish child support orders for 85_03%of the total caseload in FY2022-23_This target increases to 85-2%of the total caseload in F 2023-24. -QFd;rGgSL2MIshW 7grBpt �aat `0 8� 0 3� sex s 79% 0 lax 4 ORANGE COUNTY 36 NORT[[CAROL7 NA 26 Slide #30 Human Services • SMART Goal;Collect at least 69%of all current support owed monthly in FY2022-23 and FY2623- 24 r —Child suppul eella"ed —Tuger fw+Pre Kud 7N6 73% n 717d c 70% 6,d% --------------------------w---w—f—w--f—w--------- &W G776 v w ��' � 10 alp', 41 + `'od a ' ' � ' .� � 470, 100, ORANGE COUNTY 37 NORTI I C0.ROLINA Commissioner Richards asked if the paternity establishment outcomes are 100%. Erica Bryant said it is typically over 100% because they use numbers from two fiscal years. She said they look at the number of children born out of wedlock and then the number of paternity matches and that exceeds 100% this year. Chair Bedford asked if COVID caused a backlog for collections. Erica Bryant said they were fortunate to not have a backlog because of a partnership with Register of Deeds for birth certificates. Commissioner Fowler asked where the revenue comes from. Erica Bryant said they receive 67% federal reimbursement and federal incentive funds for performance. She said it is not part of the money collected but it is based on performance. Bonnie Hammersley praised Erica Bryant's leadership of Child Support. Slide #31 Human Services • Office of Equity & Inclusion— page 146 • Total Expenditure Budget-$604,982 — $5,54t7increesen net County coetsrompenedtot33seBudget Number of Fair Housing Inquiries Fair Phasing Cases Initiated d6 a a m LF Be sa ss in s 6 6 FrffnMg P205-A F52 WI FUM-22 FURZ-23 MU23-U MM11,13 F ZD19-29 F ZHO-21 FUM-72 R=-M F=23-M Wq SLOpt hq eLdpt ORANGE COUNTY 38 NORTI I CAMOLINA 27 Travis Myren said this will topic come back on 5/23. Slide #32 Human Services • Office of Equity & Inclusion Number of Limited English Proficiency outreach Activities YZ ea Lz YU v Y6 O F.'MAS Ff2K!3-b} PYr D-M FYW2i-2t FYMZt20" FY2920-2+9u�tlt ORANGE COUNTY ?9 N012T[[CP4ROLINA Slide #33 Human Services • Health Department — page 158 • Total Expendlit.ure Budget-$12r547,M - $152,084 decrease in net County costa campmed to base Budget • Recommended Budget Changes - S$2,141nelcowysaw.kgsiromexpanslonofRylonoPiwonban Support T"m grant from NCDHHS - $Bl,768netcouvtysaaigefiamexpensionafPsndemkRe€overyPragram - T316,464in cream inCommurityHeelth Servioesforetaffuaiurg need's - $10,500inc ream farTrenepartationSerAcestoremaoathishm&rtocsre - No*Accoun"T-schnlclan and BIIIIngTechnlclan pos@ans f$12D.257)offw by wreasod Modcald reimbursement revenue - T359,489decreaseto county oastinaentalHealthServioesfromoperational swings and ircresee+d utilization ofMedicaid Maximtzabon funds ORANGE COUNTY aD IIADRT[[CAROL]NA 28 Slide#34 Human Services • Health Department • Medicaid Transformation's Impact on Billing — Statewide analysts Indlealas claims processing requl res, on average,an additional 84 hours per week to *uecessfully process 80-99b of claims. Prior to Transformalion. arrwsl all claims were paid on a timely basis. — An analysis by NC Asumlatlon of Local Health DI rectors fauna that Personal Hleafth provlidam are Iming approximately $10 mllllon annually because of Issues felated to Medlcatrl Transformallon- — Denied claims must be evaluated,corrected and re%0inilled in order to be reimbursed, typicak within 60-90 days OC Health Departnlenl denied claims emlmaled at approxdmately $20,OM per month or$240,444 per year In FY23 ORANGE COUNTY =1 MORT1 r CARDL]NA Slide #35 Human Services • Health Department - Dental Health Services Division Dental Care Patient Visits fi,99p 59b1 fi 992 .T�1' 6131 6BOB §.6oB 5a0p d.B9B 6Ap9 apOU 3'940 200 199p 0 PY2914-1F Ff2B19-19 PY291B-17 FY2917-1B FM19-19 PY291B-20 FY2029-21 FY2921-22 FM22-21P1vi PYND-24 9kdgm ORANGE COUNTY t MORTr r C#ADL]NA Travis Myren said decreases can be attributed to decreased staffing. 29 Slide #36 Human Services • Health Department - Dental Health Services Division €]entaI Revenue by 56uroe ORA�NCE COUNTY 13 Iti[RI-I I CAROLINA Slide #37 Human Services • Health Department - Environmental Health Division 2020-21 428 2021-22 4a3 2022-23 Propmon 420 23,24 BWV 394 ORANGE COUNTY 44 NDRTE-[CAROL]NA 30 Slide #38 Human Services • Health Department - Environmental Health Division New Food Establishment Permits Issued a¢ � rn eo ,¢ 46 a¢ 38 ]U 21) 1¢ FY2018-19 FY2019-20 FY2029-21 FY2021-22 FY2022-23 N F427 23-24 9udpet 4 ORANGE COUNTY M DRT[[CARC}L]NA Slide #39 Human Services • Health Department - Personal Health Services Division Personal Health Cost Recovery FY2020-21 41.8% FY2021-22 35.2% FY2022-23 Projection 26 7% FY2023-24 Bud el 27.3"go- ORANGE COUNTY 46 MOIlT[.[CAPJDL]NA 31 Slide #40 Human Services • Health Department • Postna#al Care - S of hcA"wads made WAhln two-four weeks of d*+very v 100Koflwomevieks were wMGkkFV2021-22 » X%pmJaclWorFY2022,23 ii 90%budgetedforFY2023,2+4 • Medical Services for Uninsured,Underinsured,and Medicaid Eligible Clients - *LftorofchlldEuelpwvlslkx ii 1015 n FY2021,22 n 1224 pr4ecWc1in FY2022.23 n 1500eudq*1*dIn FY2023. ORANGE COUNTY NO RI-1 Slide #41 Human Services • Health Department - Transportation Assistance Program � r Unduplicated patient Count 17 16 25 25 Taal Rides 55 70 204 2r30 Total Distance W9 miles 403 miles 954 miles 1760 miles Total Cost 07 $734 $3,209 $4,278 Average Distance per trip 7 miles 8 miles 7 miles 10 miles • Pilot started in October 2019 with grant funding • In FY23-24 the program is recommended to be funded by the General Fund ORANGE COUNTY F NORTE-E CAPJDUNA Commissioner Richards asked why postnatal care is projected to go down. Quintana Stewart said some of that is because they took on clients from Chatham County but that decreased because they will likely not all return to Orange County for care and it is also hard to keep up with the patients outside of the county. Travis Myren said that the state pays Orange County for the out-of-county patients. 32 Commissioner Richards asked if Orange County has access to their birth certificates. Quintana Stewart said it is more challenging. Commissioner Richards said those visits are a step into other services such as early childcare and that it is helpful if they can start the conversation early on. Slide #42 Human Services • Housing Department — page 165 - Total expenditure budget- $10,624,110 - Nei County east Increase of$628,650 • Recommended Budget Chia nges - No*Grant Caardlnator and Comww Ay Do"lopment$9"a el posAlaa of}a 1:t y aiwamnal savoss » Phasing out$60,000TfiangleJ cantractimCammunity DevelopmemspeciAstscope ofwcd - TronslMn Housmg Hwpllno to Gonors Furod-$229,664 - TronsforCammunity Homo Trum and to -Faolh Caunoll vwlwrfromwi*Ideargfncy fundog W d000MY"nt-$546,E41 - Stafkbe costs fcecWweamorawlwr-$14,4U - In mstIn local tehalWaMn and tepw pmg nto m of somana.$42,4U - County sham ciffrndingfor Rapid Rehausing and 5treetOutreschpreviouslycmwadbyARRA io Ica lo Gaewrol Fund-521,26$ ORANGE COUNT =9 NC>RTt r CA R-OL1NA Travis Myren said a lot of the net county increase is due to transferring services from ARPA to the General Fund. Slide #43 Human Services Housing Helpline Program Coordinated Fiscal Year *Cllients t,Cal Is 4 Ernails 0 Walk-ins Entries 2020-21 6,654 17,658 14,889 0 258 2021-22 6.881 19.204 10,692 541 312 2022.23 Prot 8,371 16,171 11,054 3,750 554 2023-24 S. o 16,200 11,000 3,750 600 Budget ORANGE COUNIFFY 50 MORTr r CAROLINA 33 Travis Myren said the number of clients is increasing over time. Slide #44 Human Services • Cold Weather Shelter - Operated 9 nights between February 3 and March 20, 2023 - Served 80 guests at Operation Ooldw4aOor shNl•rop4nwd*hen nlg o*m"rahwesW4 fore€astto tie below 32 degreea Fob$ 9 Operated at uouthem Human Ser kea Feb 4 S Swff4d 4 tgmporary porso-41 Feb 17 iAerch 1 FY2023-24BudgetrecommendscuMnuingthepragramala scat of�14.468 March 14 11 March 14 March 48 y March 19 March ZD C. ORANGE COUNTY 04U-11.L CA R.DLI N A Chair Bedford asked if a space should be available at the 203 project for the cold weather shelter. Travis Myren said staff can look into that. Commissioner Richards said there was a department request for staffing at SHSC and asked why that was not included. Corey Root said there is currently a part-time employee at SHSC that acts as the first point of contact, but the request was to make this a full-time person because of the increase in the number of clients. Commissioner Richards asked year to date, what are the actuals on the number of clients and calls, etc. and what projections are close to actuals. Kelly Guadalupe said YTD, there are 7,325 clients. She said that there have been 14,150 calls, 9,672 emails,1,254 walk-ins, and 508 coordinated entries and those are combined between SHSC and Whitted. Commissioner Richards said it would be helpful to have it by location. Corey Root said it is double the number of coordinated entries from a couple of years ago. She said this means they are currently experiencing homelessness or housing in jeopardy within 2 weeks. She said that a vast majority are not at risk by the federal definition of homelessness. 34 Slide#45 Human Services American Rescue Plan Act Expenditures • Total ARPA fundsto support housing needs-$13.5 million — 47° of the County's total ARPA Award • Total recommended for r-Y2023-24 - $2,3S8,849 mergency Housing Asslstance $10,823,581 $2.148. $12.972.41 or"g Tme Homeowner Assistance Program $266, $254, $516.364 Total $11.0w.921 $2.398.80 $13.488.77 ORANGE COUNTY 52 M DRT[[CARC}L]h]A Slide #46 Human Services • Emergency Housing Assistance Program Design Changes with FY2023- 4 funding level 52.05 mielon for direct assWarrce — 3100,0W For temporary slaF4ng Homeowner Mortgage Assistance Yes-Wh*n not available via NCHFA No—avallal~te vla MCHFA program grogram Only If necessary to prevent evlatlon Fee arrears a55i5lan-�e Yes or Nxnele5une54 Serves 30%AMI and below Yts Only for people in eviatlon proceedings or imitin 174meIessr s Award am4unl cap $6,044 annUaDy 551ow annv411y ORANGE COUNTY 53 MOIlT[-[CAPJDL]NA Travis Myren said that the primary change will be that they are serving only those in eviction proceedings or exiting homelessness. He said that a correction on the slide is that the award amount cap should actually reflect that there is no need to change the award amount cap after all. 35 Commissioner Fowler asked if the funds for the $250,000 long-term housing assistance program have been exhausted. Kirk Vaughn said those funds are exhausted now. Commissioner Greene said the reduction to $2 million is not a surprise, but it is very sad. She said she does not know what can be done, if anything, but wants to make sure that community partners know about this. She said that it is unfortunate that they are at this point. Corey Root said there is a robust communications plan and sessions are planned with service providers and clients. Commissioner Richards asked the number before COVID. Corey Root said there were four different programs and that now all four jurisdictions have a joint program. She said that it was far less than $1 million. Commissioner Richards said it would be good to have that perspective since that they are trying to meet an ongoing need. Commissioner Greene said she thinks the need is greater and COVID exposed it. Commissioner Portie-Ascott asked if they are only providing assistance to folks who are already getting housing assistance. Travis Myren said no, and they would have to be actively being evicted or exiting homelessness for them to receive rental assistance. Commissioner Portie-Ascott asked if they already have a housing choice voucher. Corey Root said there may be a few with vouchers served by EHA, but not likely going forward. Commissioner Portie-Ascott asked if those receiving help are already receiving some other form of service. Corey Root said this would largely benefit people with low service needs. She said it is security deposit or first month's rent. She said those with higher service needs require case management and other services. She said that because there are a finite number of resources, they want to provide enough money to assist the client, but they can't afford to spend more than just enough. Commissioner Hamilton said part of the difficulty with housing issues is that so many people can be affected in different ways. She said that the COVID shock to the economy, people could not go to work, and they hope they will be able to go back to work. She said then there are more individual issues that may cause homelessness. She said in this community, it is more structural with rising housing costs and increased demand to the community from outside Orange County. She said this is a lot harder to deal with because it is a change that the county does not have the resources to fix, and it is ongoing. She said that she wants more information on what factors are causing people to reach out for services. Corey Root said the structural piece is hard to overestimate. She said people are buying properties and turning them into luxury units. She said that data shows that every 6 seconds a new household moves to the Triangle from a much higher housing cost market. She said that the structural piece is intense. 36 Slide #47 Human Services • Emergency Housing Assistanoe — 3017 households served since 2020 — $17.2 millianawarded since 2020 from EHA and HOPE 1.0 programs. Emergency Housing Assistance by Household Location Winmr,�d arargaL4A25 amity .696 Filimwoigh.S1.3SJ,9$ OR rr�N f ca.COUNTY LI NA Slide #48 Human Services Emergency Housing Assistance EHA by Intome L-avel EHA by RactOrtthnicay eo�;,rti ilr,igae f}ouseho+cls Awn.1 SKr Yh,umem MtlAa Eaelrm. ass - ORANGE COUNTY 55 NOIlT[.[CAROL]NA 37 Slide #49 Human Services Emergency HousingAssis#ance EHA by Purpose 54wR k pash w.aHas AMcMi3.Fee 199ti Obi H�4 Du" G% atel Smy G% MVP 3 ORA{NNE COUNTY 56 h;[RI1LCAROLINA Slide #50 Human Services • Street Outreach,Harm Reduction and Deflection(SOHRAD) Prnram Performance October 2020 to present Individuals Served Over 314 Ind IvIduals secured permanentnousing 113 (48wlth HCV) Individuals entered transitional housing 78 Individuals entered other temporary destinations(family,friends,motel,etc,) 38 Individuals provided supplies,food.trensportatlon supports Over 275 Individuals recelv4m COVID vaccine 40 Individuals provided clinical support Over 120 Individuals deflected from law enforcement involvement Over 162 ORANGE COUNTY 57 N DRT[[CAROL]NA 38 Slide #51 Human Services • Housing Choice Vou her Program (H IV) Housing Choice Vouchers Under Lease >W 610 65 Sad Sfifi ,i33 499 4W 489 Sod Lad 3Ud M im U MD17-10 MULWO MAM-ID MU G-21 MMI-21 TM=-I3Ra rIM23-3AeWA1 80 voucher holders are currently conducting housing search ORANGE COUNTY 5B M DRT[[CARC}L]NA Slide #52 Heiman Services Housing Department — Page 16 Urgent Repair Units AEpoirs is hwbh.1%.7d*j.ammribrbig-kD%AMI ue h+ hd d 6 + t U MMm Lx FfmLYAN MIMM-13 f Z19.1C MDUNIL r-M L•32 MAM-13P-j fr=.1Aeud Ak SirNOe Family HOusing Rehabilitation Units a ConpraM1lrek4 RaWbIlHOun tar LDw and K%3WrWm Mama FarNLa7 M%AN a 7 a a a 2 L 6 R'RSAY ar2dLM- F2M-i.9 FlWo W RHOD-31 RML-32 FVKQL-25hal rIM-NOWItt Chair Bedford said one issue with the Partnership to End Homelessness is that people have not been added to the list for permanent supported housing. She said that IFC has only been funded for two social workers at this point. She said there was a timing issue, and the Partnership did not ask for any expansion dollars because the towns are not sure if they will even 39 fund the continuation budgets. She asked if the county were to fund another social worker, would IFC be able to manage that. Corey Root said current social workers at the IFC are amazing. She said that the way to fill the gap is $200,000 in local money and this would allow the IFC to have a match and double the size of their program by hiring two additional staff. She said there is a high acuity for permanent supportive housing for folks experiencing chronic homelessness. Chair Bedford said she asked, via email, if the COVID funding that is being cutback from $6 million, is it still necessary to have as many of the housing helpline folks. She said that the answer is that the calls are continuing to increase. Commissioner Portie-Ascott asked how the number of people searching for housing with vouchers has changed. Corey Root said it has not changed since the pandemic. She said that despite throwing a lot of interventions and ideas at the issue, a lot has not changed. She said that it is taking folks an average of 90 days to find a unit to accept the voucher. Slide #53 Human Services • Library Services - page 17 Total expenditure budget- $2,636.623 — Net County costs inc reaseby$5.275€ompa:edlo Base BLdget Recommended Budget Changes — y5,464 ax*ease in iempadaq staff?a•i-,audy race increase — �215 increase for mileage natBixreaee ORANGE COUNTY 96 Iti ORTL L CA RC3I.INA 40 Slide #54 Human Services • Library Services Main Library Circulation Physical and Digital Cal lertions iKox 414ma ap00pG 3MQ03C �03C 254OWN — ■PhpWbl ■p�ta 2�m0 — MOW — 56.U00 F+21X?-A n2m-is FrMOV-20 FffflMYt Ff=Y-32 RIM-29wmj FUM-bi BWlei ORANGE COUNTY 91 MORT[[CARC}L]NA Slide #55 Human Services • Library Services Visits to Main Library 15p Op0 WS SO 3pp OG7 iB9y41 N.WB 15p Op0 110 pop ipp OD3 B5.090 92000 E6.791 HAD UA39 PF2019-17 FY2917-1B FY291B-9 FYM-29 FY2029-21 FY2921-22 FY2922-23Pm1 FY2ON-2aDjog{I GRANGE COUNTY MORT[[C#ADL]NA Erin Sapienza said there is not a solid explanation for the lack of return users, but they have seen more intentional visits to the library. She said there are fewer repeat visits but there is more borrowing per visit. She said they are doing more outreach and they are hoping to beef up the publicity and welcome people back. She said access is an issue for everyone and they are working to meet people where they are and reduce the barriers to access. 41 Commissioner Greene said during COVID people figured out they could access things digitally and that number has stayed up. Commissioner Richards asked what the projections are for the Southern Branch Library. Travis Myren said that a way to estimate usage is to look at the number of cardholders from Carrboro that are using the Chapel Hill library. Slide #56 Human Services • LibraryServioes Visits to Carrboro Library Resources 49Aao 4D 492 4oAau MOO 2BbU720.623 29Aap ■C1ara7 20A01) rM[.oayglb 15Aap 1oAaa 6AUU I ',Lq FY3716.17 F421)17-19 FY2779.19 F42D19-2a FUM-21 F42DZM2 FY2722.33 FUC123-249ulpt ORANGE COUNTY 93 IYORT[I CAROLINA Slide #57 Human Services • Library Task Force Recommendation oc s5 Ibr oc Libraries 2,326,615 2,77U.132 1,1W.135 3,224,644 1,320.761 3.429,3B4 3,522,995 3.6M585 r I of 0c RgSlelan[c in Town 41_55 41_51 41.a AIA4 41.40 4137 4133 41.34 OC$$to CHOL with Phosed APPf"Ch M-1,1" 137A97 9NJ355 1.075.213 1.245.571 1.4L4.933 iAs& A9 mq&r5ok • Access Model—Number of Chapel Hill residents who live in Chapel Hill and have access to Library Services via Town of Chapel HilI F FkYe year phase-in using projected rY2027-28 as f u n d Ing ta r-get($1,4UX3) ORfN E 84 Increase (5846,794) spread over five years at$169.359 annually 1 C�oUNAT 42 Slide #58 HUC-1'1n Services * Library Card Holders by Jurisdiction- Usage Model Number of Nrcu agied Nsrr eefor pmentap*of Cardhead*rs Total Carsrwlaers Total arrboro 10,314 22.5 bola 5.765 12. borough 6" '1,4 Hillsborough 6,642 14,4 ft4(or.) 94 0.2 sbsn*(GC) 1,366 3. JniwarpcirffbecICMra%eCaurTl:y 5.773 12.6 Unlncorporalsd Orange Courly 10.-Z4 M hapel Flip 26,0643 66.9% owel♦•IIII MA7 21. of 4917 6.4 UMr $,469 12.1 Id i OF ANGE COUNT 6,; lti[IZI-I I CA ROLI NA Travis Myren said many cardholders likely have cards in both library systems, but they cannot get additional information about those numbers. Slide #59 Human Services * Library Card Holders by Jurisdiction Chapel Hill Llbrarycardholders DrengeCaulrty Llb(aryCardBoldrrs v Hlmhanxgh Ne4ar ICC' Nelms QOC) ORANGE COUNTY 66 M012TI I CAROL]NA 43 Slide #60 Human Services • Funding Policy Cansiderations — Out of Jurisdictlon Fee(565 per year)currently waged for all Orange County residents using Chapel Hill Library — plumber of Cardholders does not represent other uses such as programming — Access model as proposed may dampen County spending on Library Services For every additional dollar spent, the conlribulion to Chapel Hill increases by$0.40 — Carrboro Branch scheduled to open rall2024 Cardmro Cardh*lers mpm5senl 22.5%of Chapel Hill Library Cardholders — Chapel Hill residents also use Orange County Main Library %W or 21.5%QF tQtal Ora nQe Counly Mai n Library Ca rdhdders are Chapel Hill msiderns ORANGE COUNTY 07 NORTr I CA ROOT NA Chair Bedford directed the Board to look at the sheet at their seats. She said that the purpose was to look at the 9.7% increase, and that the proposed budget has an increase of 6.33%. She said that the formula ties Orange County's hands too much. She said there are higher priorities, like EMS, homelessness, feeding people, but she thinks it is important to keep up with inflation for the library. She said that it cannot be done by square footage. She said that library services are not mandated by counties, whatsoever. She said that permanent supportive housing is more important than this, but yet she thinks the Chapel Hill library should be supported more. Commissioner Greene said she thinks these are reasonable proposals. She said she could support the bottom option with 3%. Chair Bedford said there is no MOU this year because it has been so dramatically different the last five years and they need discretion. She said that she does not support an MOU in the future either. Commissioner Richards said the con is from a planning standpoint it is nice to know but we do not need to be locked in. Commissioner Greene said there are so many variables. Commissioner Richards said she understands why they want an MOU, but things change so much from year to year, and they need the ability to move funds as needed. Commissioner Fowler said she agrees with not locking it in but, in thinking of it for the county's own planning, there might be a way to work it in. Commissioner Greene said it is a good faith expectation. Commissioner Portie-Ascott said she agrees. Commissioner Hamilton said she does not think the Board should be locked in either. She said there are lots of needs and a need to balance them. She said if they charge $65 to cardholders, maybe that could be implemented. Commissioner Greene said she has been reviewing the minutes from the Chapel Hill Town Council meetings and she was on that board previously. She said that she had forgotten how close the Town Council was to charging for the cards. She said that there is a state law that says you cannot charge a partial fee so it would be all or nothing. She said that the fee should really be around $100, but no one would want to pay that. 44 Chair Bedford said the report showed that interoperability, as much as the board wanted it, is not cost effective. She thanked the library staff for their work. Erin Sapienza introduced Nitya Fiorentino, the Library Services business officer, and said that she participated in the task force and has a lot of information if the Board needs it. She said that they have good rapport with Chapel Hill, and they are attempting to continue low-level interoperability while making sure not to duplicate services. She said all locations are doing unique things, so the residents have an opportunity to experience those things. Slide #61 Human Services • Social Services —page 212 Total expenditure budget-S24,444,855 - Toter+aRCo4.4y�o*Rlnar4as4afy961,E21aomppr4�1o9aa4Bu0g41 Reccmmended Budget Changes - $643,W Inanas4fornln•(9)full•um4 p4r*ombel for M4dKW Exp*ns an ofhmbyadcmlo"Slow temu4 - 565,64EInanaa4 for two(2)pa04m4 p+r*a+.n4110 a**I*Rln*uperva.yal*IRs eR Famlly Tkm Hau*• - �22R3,9151narw*4tormaa*otnan•�4pa+lmfnlaldad*partm4nkarap4ra11aarbudg4R — 5713,450 increase forcoMnue6on in progreme previously funded with ARPAhmde x PereMFeasbFGhlldcare >< CaunRywtid4 Foal�irlbtlllan and Staray4 x Stabil"on PrcgramfarFomnerFaEterYauih w Suppo+l for Law Imorno Fomllles » Youth Enhancement Fund ORANGE COUNTY 55 NCSRT[[CAROLINA Travis Myren said after expansion they anticipate about 6,000 new Medicaid recipients. Slide #62 Human Services • Food and Nutrition Services Households Reteivl ng rood&N utrltlon Servloes Monthly Average noon 9nw .am 7AM 5.7m 5.B79 COW Si4 5RT4 4ars �P_ �P_ O.Ow ]11m IJIm I'Y]IIIh15 I•/]IIIS1. !I'�L41.9 TL1418 I"I]11161F I•/]IIIF-It IID1419 !I'a]9111 IY]G]6]1 I'Y]ml-]k Td2i?!R4 TaR3b1 11d,* ORANGE COUNTY 94 NORT[[CAROL]NA 45 Travis Myren said that as the public health emergency ends, the numbers receiving food and nutrition services will drop and that this is expected. Slide #63 Human Services * Food and Nutrition Services Month5-when 95%of FN5 Exped ited Cases are Prooessod within 4 Calendar Days U 10 B 6 i N NILP.2L1 MOZO-21 TD¢L•32 rF=.27 PrgU IY1Q2S2+EudpL ORANGE COUNTY NORTI I CAROLINA Slide #64 Human Services * (Medicaid Recipients Medicaid Reciplents Monthly Average maw NA90 MAW 2 676 L P,_1 2Upm :sxe MAP MAP L6.5L6 iSAW L" ]rpm Fr2K3-i4 R']PL�B RIDLE L6 Ff2Kf i? RIDLT-LB R'EDLM9 FOR940 RXLN>-21 Mffli-22 Ff7P2Z-DPM1 Fw26Y-Nkld RL 4 ORANGE COUNTY 71 NC>RT[I CARQLINA 46 Travis Myren said there has been a gradual increase since FY 19-20. He said these numbers include the anticipated addition of 6,000 and the number of those that will not receive services any longer. Slide #65 Human Services 4 Medicaid Time Standards Medicaid AppllcailarrsProcessed With In Tlme Standards ,A%State Goa I L IM „ Jam; 3� > 90K 61Yi �Shd RRu�nnl �{1u7iY F�T[+r o-+tt T9% eca Ica ffD113-17 rf3D17.11 IY3d1LFL9 MOL0.2o rfm1D2L rf301L•23 rnm@ zsp.H rfmu-m eudpd ORANGE COUNTY NiDRT[[CAROL]NA Slide #66 Human Services • Children and Family Services HauseholdsA* +forAbuseand Neglect L,ND L.2D0 L XW 579 up en S5p %D ao-r 4W HO F72D LB-L9 R DL9-ID FUMM FfMk-Z2 W2 -za h1i FTZM-bi Bu1FL ORANGE COUNTY 73 'KO-RTSf c7ARC3T.1NA Travis Myren said this number increased during the pandemic and has remained steady. 47 Slide #67 Human Services * Children and Family Services Children,in M Legal Custody wa - a E* d m MOLFLP MOLP,30 Mm43-31 ra3031-32 MM 3m 35PM rrmn.neLdm1 MeedingmDwtkmto establish permsne�_= - FY 20.21 Efdyles 37.E;ht�4i 4 ,� - FY 21-22 Erfias m�4.Eu�12 � - FY2 -23F-rtrles 25.E I ORANGE COUNTY 1 MO12T[[CARC}L]NA Travis Myren said that the number of children in custody is increasing because it is taking longer to achieve permanence in placement. Slide #68 Human Services Economic Services Work Partldpants Gairad Employmmyt LED — LbkF LAG LM ..a se S: uo LID E* ao- �a m POGUIL7 Rla" prim" rffflLY. rfbL Frb'MM FeM" R7 I rfM2-n PPQ R77tl,AI1 Wl ORANGE COUNTY 75 M012T[[CAROL]NA Travis Myren said they are expecting these numbers to increase dramatically with the labor market needs. 48 Slide #69 Human Services • Childcare Subsidy Average Number of Children Served per Month by Child Care Subsidy sro 8l•} 765 FOP 7;-0 �3G TOd GG} 50} 4M aw L� F7IPLFL7 IYmLF-LI MM-19 MULP-M rr=WRIL MMIL-12 rrA=.33Prgl n=M-NIELtlW ��.. ORANGE COUNTY MORT[[CARC}L]NA Slide #70 Human Services • Childcare SubsidyTime Standards %of Subsidy Applications Processed in 30 Calendar Days 95 State Goa I LP9Lo- VA L L[ DX 99i !Wk 99b 95% 99�4 9111 +xr.Rnpk—rt ■sx �[o-,MPo+a�rverx IZ% 75 7P4 RZX741 RaRM9 Maig-b} MWY34L FwML-t2Wq gymn:-n9ud0� GRANGE COUNTY FT MORT[[C#AFL]NA Nancy Coston said numbers are starting to look like pre-pandemic. Commissioner Richards asked if the adolescent parenting program participants are teen parents. Nancy Colston said it is for teen parents and the goals are finishing high school or GED and delaying a second pregnancy. 49 Commissioner Richards asked about the number of participants. Nancy Colston said she does not have the exact number, but it is lower than it has been in years. Commissioner Richards asked if there is a program for kids aging out of foster care. Nancy Colston said youth that are 18-21 can stay with a foster parent or they could receive funds for a rental. She said that there are usually 7-8 at a time and others that have stopped receiving payments but have kept in touch with a social worker. She said that up until age 21 they can stay in touch, and up until 25, they can stay on Medicaid. She said there are also college tuition benefits beginning at age 18. She said it is based on the child's interest. Commissioner Hamilton asked what is driving increase in Medicaid. Nancy Colston said it was the way North Carolina handled Medicaid, but the real increases were children living up to 200% in poverty until age 18. She said with the public health emergency, they have not been terminating people from benefits. She said it meant if a parent's income increased, the child could still remain on Medicaid. She said they are now losing some because parents' incomes have increased. Commissioner Hamilton said she hears a lot of uncertainty. She is left wondering about the mix of recipients. Nancy Colston said it will be a lot of working parents, others from 18-64 who have come to them with medical situations and unable to get insurance. She said that many put off medical care until 65 but they already had serious chronic conditions that they had not received services for. She said there will be a lot of activity in the first few years. She said there will also be parents that are signing up quickly. She said there may also be increases with those that do not request the benefit until they see the need. Slide #71 Human Services Community Centers - page 189 Ten percent(10%) Increasefrom FY2022-23 — Rogers Road CornwrAy Cenber Toial $100.131 — #oa+Grov*Cammuniky��if*Taka� �103,459 — 9fland0h*NcsCommunikyC4nterTcW $101.235 RANGE (ZOUNTY 7B N OTU-1 I CA ROLI NA 50 Slide #72 Human Services • Questions ORANGE COUNTY ?9 NORTE E CAROL-INA Adjournment A motion was made by Commissioner Fowler, seconded by Commissioner Hamilton, to adjourn the meeting at 10:16 p.m. VOTE: UNANIMOUS Jamezetta Bedford, Chair Recorded by Tara May, Deputy Clerk to the Board Submitted for approval by Laura Jensen, Clerk to the Board.