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2010-160-Minutes for Meeting March 03,2010 Recorded 3/23/2010DESCHUTES COUNTY OFFICIAL RECORDS CJ 1410'!60 NANCY BLANKENSHIP, COUNTY CLERK COMMISSIONERV JOURNAL 03/23/2010 03:32:12 PM 111111111111111111111111111 Do not remove this page from original document. Deschutes County Clerk Certificate Page If this instrument is being re-recorded, please complete the following statement, in accordance with ORS 205.244: Re-recorded at the request of [give reason] previously recorded in Book _ or as Fee Number to correct and Page Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org MINUTES OF WORK SESSION DESCHUTES COUNTY BOARD OF COMMISSIONERS WEDNESDAY, MARCH 39 2010 Present were Commissioners Dennis R Luke, Alan Unger and Tammy Baney; Dave Kanner, County Administrator; Erik Kropp, Deputy County Administrator; and, for a portion of the meeting, Ronda Connor, Personnel; Laurie Craghead, Scott Johnson, Health and Human Services; Jay Henry, CEO of St. Charles Medical Center, Bend; and, by conference call, Mark Nelson and Erica Hagedorn of the Public Affairs Counsel. No representatives of the media or other citizens were present. Chair Luke opened the meeting at 1: 30 p.m. Conference Call with Public Affairs Counsel regarding February Session Wrap-up. Erica Hagedorn said that the major pieces of legislation dealt with greenhouse gas emission goals. HB 3604 and SB 1050, which dealt with public contracting requirements - "buy USA" - did not pass. SB 1031 regarding Destination Resorts passed. SB 1039 regarding nonprofit clubs' liquor licensing died. Mark Nelson stated that the question of having annual sessions is going to the ballot in November. He suspects there will be dollars raised to support it. He does not know whom, if anyone, will oppose it at this time. Commissioner Luke said in regard to 2011, he would like to see an interim work group address events proposed for EFU ground. He thinks that AOC may help staff the study group to look into this issue. Mr. Nelson asked how Deschutes County will develop its 2011 legislative agenda. Dave Kanner replied that the summer prior to the session they will solicit input from department heads and bring PAC into the discussion in late August or early September. Minutes of Board of Commissioners' Work Session Wednesday, March 3, 2010 Page 1 of 6 Pages Commissioner Unger added that they need to look at working with partners to see what they need. He would also like to build stronger relationships with local representative offices. Commissioner Baney expressed interest in farmers' markets types of events and licensing. Scott Johnson said he would like to see public safety more in balance with the needs of communities. 2. Discussion of Health Care Service Delivery in Central Oregon. Jay Henry, CEO of St. Charles Medical Center, Bend, gave a little information about his background. He then talked about collaboration that reduces the overall cost of medical care for everyone. Discussion occurred about how bringing in an extra hospital requires a lot more equipment, staffing and trailing. Collaborating reduces the overall costs, and requires a smaller number of protocols that allow for world-class care. He explained that getting physicians on board is a major challenge. Services have become segmented and there is much more dependence on physician assistants and nurses. There are not enough doctors. A health care delivery system that uses all aspects and talent is needed. Commissioner Baney observed that there is a big difference between health care and medical care. Mr. Henry said that it will take hospitals working with each other and other entities taking a community approach to be successful. Physicians need to be aligned and health models examined. Central Oregon is in a unique situation due to the isolation from the mountains and desert, making it a bit easier to analyze and find ways to collaborate. He feels that the County and hospital are good partners and wants to keep the dialogue going. Ronda Connor said that the physician/hospital alignment has been discussed, but what is missing is the payor, who needs to be involved as much as possible, instead of forcing change. Mr. Henry noted that there is a similar issue with insurance companies. Most are open to working on the issues together. Minutes of Board of Commissioners' Work Session Wednesday, March 3, 2010 Page 2 of 6 Pages Ms. Connor stated that there are surgery centers in town, but Medicaid patients seem to be going to the hospital. Mr. Henry said that OR's have not been run as effectively as they could be. The centers were formed to be profitable but also because hospitals were not run as efficiently as they should be. He wants to be able to bring back the surgeons. Commissioner Luke pointed out that the County is self-insured, and St. Charles receives a lot of payments made. Discounts are made to larger carriers, and this results in local groups like Deschutes County having to subsidize. He asked if there are discounts in place for the County. Mr. Henry replied that he is not sure and is not familiar with the historical aspects. They try to keep things relatively parallel. He is open to talking further about changes in the benefit plan. They are working on health reform in general, and hope to lower the cost of access to doctors. Commissioner Luke said that the County is looking at forming an employee clinic. He asked if Mr. Henry is familiar with those. Mr. Henry said that he has not seen any since the late 1980's, and those were mostly within huge corporations. They can make a big difference and are not necessarily competition to the hospitals, but might be to family practitioners or immediate care clinics. The size of the population makes a difference. Commissioner Luke pointed out that some people go to the emergency room for minor things because they don't have a regular physician. Mr. Henry stated that starting on April 1, they will have an immediate care clinic. It will be cheaper than the emergency room, but won't be open 24 hours a day. It will be located on the hospital campus. Commissioner Unger explained that the Commission on Children & Families has a list of assets of what is needed to be productive in life. This includes what is needed for children so they form well. He thought that perhaps some kind of partnership between the CCF and the hospital could help with this. Mr. Henry noted that there are lots of opportunities to start children off right. They can make gains in people over age 20, but biggest impact is in those who are younger. When asked what his employees pay for health coverage, he replied that it is tiered by family status, but is free to the employee. Ms. Connor said that all County employees pay, as their program is not tiered. Mr. Henry and Ms. Connor left at this time. Minutes of Board of Commissioners' Work Session Wednesday, March 3, 2010 Page 3 of 6 Pages 3. Other Items. The minutes of the department head meeting were removed from the consent agenda earlier in the day, as they have not yet been reviewed. BANEY: Move approval of the minutes from the morning business meeting agenda, with the except of the department heads meeting. UNGER: Second. VOTE: BANEY: Yes. UNGER: Yes. LUKE: Chair votes yes. Discussion occurred about an e-mail that is circulating regarding a wellness program that costs $35 per month. Mr. Kanner said another way to spin this is to go up to $65, or increase it to $60, encourage a wellness program and then drop it back down again. It would reduce costs tremendously. He said that he explained to the Bulletin e-board that the co-pay could be used as an incentive to enter a wellness program. This taxes behavior you want to discourage. Commissioner Baney said that discussion has occurred regarding adding health benefits costs to the departments as indirects. Mr. Kanner stated that this was discussed at a January budget meeting. The general fund revenue forecast is not yet available, and it needs to be balanced against budget requests. They are still using a zero increase in health insurance and PERS charges. This will cost about $2 million next year, but they are drawing down from the health benefits trust fund. The health clinic may help reduce this number. Next year will not be that bad even if there are no wage concessions. The growth in property tax revenue will be zero or maybe negative. They need to determine how large to make the general fund contingency, and how to pay for one-time expenditures. They can lower PERS expenses if needed. They are still in relatively good shape. Management and supervisory employees are not going to get the whole increase. Going forward, after next fiscal year, a way has to be found on how to make that up to them in a way that does not impact payroll. There are ways to do this. Minutes of Board of Commissioners' Work Session Wednesday, March 3, 2010 Page 4 of 6 Pages At this time, discussion occurred regarding debt service on the various buildings and how to fund these expenses. Commissioner Luke asked about the Deschutes Recovery Center and how long-term repairs would be handled. He asked about the 91 I/OSP building as well. The Fair/Expo facility was set up for its own repairs and maintenance. Commissioner Baney said they have asked for general funds in the past, however. Commissioner Unger stated that groups need help getting up to speed on how to handle the RFP process and the history behind the idea. The RPF process should be addressed in a public venue. If you are adding a benefit to the health plan, you ask EBAC to make recommendation. If the Board bypasses the process, EBAC will feel they are not needed. It was determined that a meeting should take place to see what the Commissioners want in the RFP process, and then see what EBAC comes up with. Mr. Kanner said that he would like to see an RFP out in June. Commissioner Baney stated that it may help to have an outside group look at it. Commissioner Luke said that adding bariatric surgery is small compared with opening a County clinic. It may work, but he has a problem with the process. It is a major change and a huge investment. Mr. Kanner noted that it went to EBAC and then to a subcommittee. Commissioner Baney feels it is on track, but to keep the Board in the loop. Commissioner Luke stated that he is not happy with process. It would be good to bring in someone who does this kind of thing all the time. No one on staff has ever built one of these. Mr. Kanner noted that Ms. Connor has put one together. Commissioner Luke would like a field trip to visit some, along with additional research. Mr. Kanner said he would arrange for site visits. Commissioner Unger noted that every site is different. Commissioner Unger said he met with representatives of the Bureau of Reclamation. They are learning about activities in this area; he told them about the Deschutes Water Alliance model. Minutes of Board of Commissioners' Work Session Wednesday, March 3, 2010 Page 5 of 6 Pages Regarding the State of the County meeting, it was determined that Sheriff Blanton would go first; then Commissioners Unger, Baney and Luke. Commissioner Baney said that the Chamber wanted to find out more about shared services last year. There was additional discussion regarding business development funds and an incentive fund; attracting new businesses and retaining current ones; and ways to help local businesses expand and be successful. Commissioner Baney stated that EDCO was clear that there are no funds available for businesses that cannot get private or business funding. Commissioner Unger expressed concern about using public money for this purpose, but he would be okay with helping infrastructure efforts. The Board then went into executive session under ORS 192.660(2)(h), litigation, after which no action was taken. Being no further items addressed, the meeting adjourned at 3:30 p.m. DATED this 3rd Day of March 2010 for the Deschutes County Board of Commissioners. Denniiss`R. Luke, Chair Alan Unger, Vice Chair ATTEST: / Recording Secretary Tammy Baney, Commisoner Minutes of Board of Commissioners' Work Session Page 6 of 6 Pages Wednesday, March 3, 2010 Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org WORK SESSION AGENDA DESCHUTES COUNTY BOARD OF COMMISSIONERS 1:30 P.M., WEDNESDAY, MARCH 3, 2010 1. Conference Call with Public Affairs Counsel regarding February Session Wrap-up 2. Discussion of Health Care Service Delivery in Central Oregon - Jay Henry, CEO, Cascade Healthcare Community 3. Other Items PLEASE NOTE: At any time during this meeting, an executive session could be called to address issues relating to ORS 192.660(2) (e), real property negotiations; ORS 192.660(2) (h), pending or threatened litigation; or ORS 192.660(2) (b), personnel issues Meeting dates, times and discussion items are subject to change. All meetings are conducted in the Board of Commissioners' meeting rooms at 1300 NW Wall St., Bend, unless otherwise indicated. If you have questions regarding a meeting, please call 388-6572. Deschutes County meeting locations are wheelchair accessible. Deschutes County provides reasonable accommodations for persons with disabilities. For deaf, hearing impaired or speech disabled, dial 7-1-1 to access the state transfer relay service for TTY. Please call (541) 388-6571 regarding alternative formats or for further information. vii ~C AFFAIRS ~:s~L. Deschutes County Agenda Wednesday, March 3, 2010 1:30 p.m. 1-866-279-1568 *8678842* 1. INTRODUCTIONS II. FEBRUARY SESSION OVERVIEW a. Overall Session Overview b. Budget Overview c. Policy Bills i. Priority 1 1. HB 3604: Local Preferences for Meeting Greenhouse Gas Emissions Goals a. DEAD ii. Priority 2 1. HB 3612: Annual Property Tax Repayments for Error a. PASSED 2. HB 1024: Highway Access Standards a. PASSED 3. SB 1031: Destination Resorts a. PASSED 4. SB 1039: Non Profit Clubs Liquor Licenses (Sen. Telfer) a. PASSED 5. SB 1050: "Buy America" Contracting Requirements a. DEAD 6. SB 1059: MPO Greenhouse Gas Reduction Planning a. PASSED iii. Priority 3 1. HB 3630: Authorizes Local Forced Release Plans 1'(BOX 12947, SALEM, OR 97309 $67 111BURIN STRi.i . C l\ I, P1,-J 503.363.7084 • FA 503. 7124 71 r 11.110.: pncounsel(a, kulxom a. DEAD 2. HB 3673: Recreation Landowner Liability a. PASSED 3. HB 3600: Permission for County Fees for Premium Permit Processing a. DEAD 4. HB 3601: DUI Hearings (Rep. Stiegler) a. PASSED 5. HB 3609: Enterprise Zone Flexibility a. PASSED 6. SB 1036: Guest Ranches in Eastern Oregon in EFU Zones a. PASSED 7. SJR 46: Constitutional Amendment Referral to Limit Non- Economic Damages to $1 Million for Public Bodies, Non- Profits and Health Care Providers a. DEAD III. 2011 SESSION AGENDA SETTING a. Proactive b. Reactive c. Interim Work Groups i. Public Contracting Mandates 1. Buy American/Greenhouse Gases ii. Destination Resort Restrictions iii. MPO Greenhouse Gas Reduction Planning IV. OTHER BUSINESS a. Schedule Next Meeting W) 13(_).X' 12945, SA.LFAl, OR 977309 , 86-17 1..113}"?R' YS'1"RT l .TXl' PH 503.363.7084 1.1Y 5{)3.371.24-71 ENAIL: i r I 1)11bIL~'C: FFAIRS C Q U; N` E L March 2, 2010 To: Deschutes County Commissioners From: Mark Nelson and Erica Hagedorn RE: Oregon 2010 Special Legislative Session Overview Commissioners Baney, Luke and Unger, Below please find our February 2010 Special Session overview. Let us know if you have any questions. 2010 Legislative Session Overview For the second time in four years, Oregon lawmakers called themselves into a "supplemental" emergency session this February in an attempt to test annual legislative sessions. Because Oregon is one of a handful of states without constitutionally mandated annual meetings, legislators have tried to demonstrate in the last few years that annual sessions will serve to improve the management of state government. The noisy prelude to this February session was a debate over two tax increase measures the legislature approved last year. On January 26, just days before the session, voters approved Measures 66 and 67. These permanent personal and corporate income tax increases were heavily supported by public employee unions and opposed by the business community. The campaign was a bitter precursor to the February session, which the press reported was colored by a rash of retribution bills aimed at certain business groups that opposed the tax increases. In past special sessions, leadership kept their promise to kill controversial bills and stick to the task of balancing the budget and going home. This time, however, legislators were allowed to introduce all kinds of legislation, from the most bland (economic gardening) to the most controversial (public use of private waterways, chemical restrictions and bank regulation). No policy holds were barred during a month that was PO BOX 12945, SALENI, OR 97309 • 867 LIBERTY STREET NE • PH 503.363.7084 • FAX 503.371.2471 ENTAIL: pacounsel@aol.com 1 heralded as a time to prop up Oregon's ailing economy and improve the state's 11 percent unemployment rate. Many capitol veterans complained that the session felt like May of a regular session- an intense, smash mouth session full of surprises at every turn. The budget-writing Ways and Means Committee proved the quietest place in the building in February after voters approved the tax increases on which the original budget was based. The Ways and Means Co-Chairs quickly patched a $100 million budget hole by "sweeping" dollars from state agency reserves, dipping into state reserve funds and raiding the state's tax amnesty account. Even as economists predicted slow tax revenue collections in 2010, the February budget reconciliation included new expenditures. These same economists also warned that the real budgeting horror would occur in the 2011 Session. A year from now, Salem will be forced to grapple with a $3 billion+ budget hole. In the end, it was the annual session proposal to voters in the November Election that delayed adjournment for an extra day. House and Senate leaders haggled over the number of days they would propose to meet each year. The final deal for voters to consider proposes 160 days during the even-numbered years and. 35 days during the odd-numbered years. Both chambers rejected proposals to limit the scope of bills introduced in even-numbered years to reduce the mischief during short sessions. Voters will have the final say over whether to authorize annual sessions in November For Deschutes County, the session yielded generally positive results. After the Oregon Office of Economic Analysis reported that budget writers would only need to plug a $100 million budget hole in order to adjourn the abbreviated session, the House Revenue Committee revealed the framework for garnering $50 million in savings from a haircut to the to the Business Energy Tax Credit (BETC) program. LFO staff needed to identify another $50 million in budget cuts and savings in order to balance the budget and ended up sweeping funds from several agencies and reserve funds, but did not raid county revenue sharing as in previous sessions. HB 5101 did, however, reduce the video lottery distributions to counties by $3.2 million based on the revenue forecast. PAC engaged in the discussions surrounding SB 1050, which would have mandated "Buy American" materials requirements for public construction contracts. The bill, which was supported by trade unions, but opposed by local governments and contractors, was too complicated for the short session and Sen. Joanne Verger, D-Coos Bay, asked that the conversation about the concept continue into the interim. PO BOX 12945, SALEM, OR 97309 - 867 LIBERTY STREET NE • PH 503.363.7084 - FAX 503.371.2471 EMAIL: pacounsel@aol.com 2 HB 3604, which began as a bill to create public contracting preferences for contractors who can demonstrate a low carbon footprint, died in Ways and Means because this issue will be a part of the larger public contracting discussion surrounding SB 1050. Few big environmental proposals were floated this session, but SB 1059 served as the hallmark greenhouse gas emission reduction bill in February. Originally, the bill would have handed a wide swath of greenhouse gas reduction planning responsibilities to local governments. Local government associations agreed to amendments that mainly direct ODOT and LCDC to create a "tool kit" for local governments in Metropolitan Planning Organizations (MPOs) to reduce greenhouse gas emissions by using new transportation and land use planning methods. Although the bill appeared stalled in Ways and Means due to a $2 million fiscal, ODOT and LCDC rearranged other projects to finance their new responsibilities under SIB 1059 and the bill passed. SB 1031 passed easily, which was the work product of an interim work group after the last-minute demise of HB 2227, the sweeping destination resort restriction proposal of 2009. The bill creates some sideboards for destination resort development mainly based on existing Deschutes County standards. PAC will work with Deschutes County in the interim to develop an agenda for the 2011 session, which is likely to be totally driven by the looming budget "crater." 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