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2014-508-Minutes for Meeting October 06,2014 Recorded 10/27/2014 NANCYUBLANKECOUNTY OFFICIAL NSHIP, COUNTY CLERKDS 4J Oiring COMMISSIONERS' JOURNAL 1�/1'� 0i4 08:33:15 AM 1111111111111111111111 2034- 8 AIN ;R .< n Deschutes County Board of Commissioners 1300 NW Wall St., Bend, OR 97701-1960 �' , (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org MINUTES OF WORK SESSION DESCHUTES COUNTY BOARD OF COMMISSIONERS MONDAY, OCTOBER 6, 2014 Present were Commissioners Tammy Baney, Anthony DeBone and Alan Unger. Also present were Tom Anderson, County Administrator; Erik Kropp, Deputy County Administrator; David Doyle, County Counsel; and,for a portion of the meeting, Susan Ross and James Lewis, Property & Facilities; Wayne Lowry, Finance; Jane Smilie, Health Services; Dan Despotopulos and Butch Graham, Fair & Expo; David Givans, Internal Auditor; Judith Ure, Administration; and one other citizen. Chair Baney opened the meeting at 1:35 p.m. 1. Update on Food/Beverage Program. Mr. Graham gave an overview of his background in the food and hospitality industry, which covers decades in restaurants, lounges, hotels and a football stadium. He worked for the Fair & Expo in Lane County, followed by managing over twenty accounts throughout the west. Dan Despotopulos said they started the new program in September, which is one of the slower months. He provided an overview (a copy of which is attached). They are developing menus, and will allow outside vendors. There will be contracts with outside caterers and concessionaires, and event organizers can choose which one they want. There are no other facilities of significant size that allow outside caterers. This may increase use of the buildings by those groups that have wanted to utilize their own caterer. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 1 of 7 Pages Room tax funds are now being received for marketing purposes, and they are updating their website to include menus and the prices provided by the vendors. They will still be doing all of the alcohol service in-house, and have the appropriate liquor license through the OLCC and the Redmond Police Department. Mr. Despotopulos stated that alcohol is handled in-house, mostly for security reasons to make sure everything is done per OLCC regulations. Also, there is often more money generated through alcohol than through food. Commissioner DeBone asked if the Fair & Expo could be the caterer. Mr. Despotopulos said that they have the ability for an in-house caterer. There are lists of prep people, servers, bartenders and others who are hired through a specific temporary agency. People cannot provide their own food through a potluck or buying a bunch of pizzas. It has to be done with the Health Department inspector in mind. There are 28 points of service. Vendors have to sign a contract and have appropriate insurance coverage. Those who provide food are monitored and rated. They always do a good job of monitoring the vendors, in particular at the Annual Fair, but now it will be covered more thoroughly all year. Mr. Graham will oversee this part of the program. Chair Baney asked for feedback from the Commissioners. Commissioner DeBone said that a few smaller vendors in the community that want to be involved find it difficult to compete. Mr. Despotopulos stated that they need to be able to keep up with things, and certain hours are required. They try to work with local clubs and organizations, as long as they can pay the percentage required and can perform. They have tried to accommodate some smaller vendors in certain venues to give them a chance. Commissioner Unger said that perhaps the winter months might be the best time for vendors to try this. Mr. Despotopulos stated that some events just do not make a lot of money, but they have to keep in mind that there are expenses no matter what, and cannot cut the percentage they require. Chair Baney asked when the Board could expect updates. Mr. Despotopulos said they could come out to visit, or set certain dates for a review. They now have a beginning inventory established so it will be easier to show in the future. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 2 of 7 Pages He said the monthly Finance report would have a line item for the food and beverage program, so they can see how it is doing financially. Wayne Lowry emphasized that this is a seasonal business, and feels that a longer period of time is appropriate to understand how it is working. It should be at least six months from now, but a year might be better. Mr. Anderson stated that they will have to make decisions for the next budget, and that preparation will start as early as February. He and Mr. Despotopulos also meet on a monthly basis. Mr. Despotopulos said he was in Corvallis recently and went to the annual 4-H/ Extension dinner, and Deschutes County received an award for being an outstanding supporter of 4-H. They have built a big greenhouse at the Fairgrounds, and he said it would be great if they could include these greenhouse vegetables as appropriate in the meals that are served. They have spent some funds on marketing the RV area, and are tracking this. They are already looking at revenues at or above what was budgeted. Food and. beverage will be a big part of this. He said that Tate & Tate Catering is signing a contract as well, after clarifying who will provide the dishes and flatware. 2. Discretionary Grant Review. Judith Ure went over the status of grant funds in each category. The Commissioners have about $4,000 per quarter each for discretionary grants. • Bear Creek Elementary School — PA System - $1,500. Commissioner Unger said there are many schools here, and is concerned about doing this for one. Chair Baney stated she normally declines school requests since they have other funding sources. Commissioner DeBone agreed. Commissioner Unger stated that in terms of policy, this is not the path the County should take. The request was declined. • Family Kitchen — Meals for the Needy - $2,000. There is an increase need for meals, and the price of food has gone up. Chair Baney stated they are overwhelmed by the need. It is not a solution but anything will help. Commissioner Unger would like to help them find ways to generate more money through fundraising efforts. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 3 of 7 Pages Chair Baney said they could consider this a challenge grant. They are serving as well as writing grants, so are very limited on what they can do. Commissioner DeBone asked if the organization is doing okay, or if it is in transition. This is the right time of year to help with this kind of effort. Commissioner Unger supports the need today, but wants to hear from them as to how the County can help them strengthen their marketing efforts. $2,000 split three ways. • Family Access Network— Fundraiser Luncheon for Children - $2,500. This is a fundraiser. The Board decided that $2,500 is appropriate. • Hospice of Redmond — Festival of Trees - $3,000. This is a fundraiser. Last year, they received $3,000. Chair Baney said the grant should cover the Fairgrounds costs of$2,100. Commissioner Unger feels that they should get $2,500. The Board agreed. • Sisters Area Chamber of Commerce —Technology Upgrades — $3,240.94. Chair Baney stated that this should be in the Chamber's budget. Commissioner Unger added that the County supports the Chambers already. He felt $1,500 is appropriate since that is what the others get, if the Sisters Chamber wishes to use that funding for this purpose. Chair Baney said that they say this will help with economic development, but she does not see how purchasing chairs and other equipment fit into this. The Commissioners granted $500 each. Judith Ure stated that there would be probably two requests for a forgivable business loan presented later this month. If both are awarded, the Board will need to decide whether to recapitalize the fund from general fund this fiscal year. Commissioner DeBone favors doing so because they have seen good results from the previous loans. However, it was not meant to be a forever program. The Commissioners would like Mr. Anderson to come back with some ideas on how they could proceed. Ms. Ure said there seems to be a lot of interest in this program, per EDCO. Regarding a grant regarding the Sage Grouse issue, Ms. Ure said the application was presented, and Peter Gutowsky of Community Development is overseeing this effort. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 4 of 7 Pages 3. Other Items. Jane Smilie presented a Central Oregon Health. Council proposal. This is meant to help the system function better. Next year there will be around $7.3 million available in this area. The proposal involves addressing substance abuse, and reproductive health issues. It was submitted last week at the deadline, with no time to present it to the Board. The request is for $102,000 to use for the reproductive health clinic, and to assess any barriers since this usage could be better. They will also address the availability of services for substance abuse clients. No additional staff will be required. Tom Anderson said Ms. Smilie had talked with him and he advised them to proceed prior to the deadline. Commissioner Unger stated that it is straightforward and he wants to see the County on a path to get involved with this funding source. Chair Baney said that she wants to get to the needs of the individuals. She is tenuous on public health telling private providers how to do their work. The County should be in a leadership role and not regulatory. Ms. Smilie indicated they would not be regulatory and want to work in partnership. She has heard some providers say that a preliminary assessment has to come through the County, which is not the case. They hope to gather information and work towards the system being better. There is also a perception that there is not enough help for substance abuse services, but studies show that these services might be underutilized. DEBONE: Move approval of the application, nunc pro tunc. UNGER: Second. VOTE: DEBONE: Yes. UNGER: Yes. BANEY: Chair votes yes. James Lewis updated the Board on the County-owned property in eastside Redmond. There have been incidents at the sports complex there. There was some shooting and damage. The Redmond Park & Rec District asked if the County would consider a "no shooting" zone there. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 5 of 7 Pages He said they could not just post it as "no shooting". There has to be findings to support it. It requires a text amendment through an Ordinance. A petition has to be signed by participating property owners, but there are just four owners, the City, Park & Rec, BLM and the County. BLM already has their land designated as "no shooting". Most of the incidents are related to the sports center, but they had three public meetings this year to address the trail system, and comments were made regarding shooting issues. Hiking, cycling and equestrian trails are not compatible with shooting. Chair Baney asked what the right thing to do is. A sports complex and bullets are not compatible. It is so close to the City that at some point they will have to address this. Commissioner Unger feels that the use is changing and these uses do not blend well. Education on this issue is key. He would like to start the process. Commissioner DeBone asked how BLM has it designated "no shooting" already. Susan Ross stated this is in the BLM plan, and can be enforced by the Sheriff if it is formalized. Tom Anderson said this type of thing has been done along the Deschutes River on Forest Service lands, and is enforced by the Sheriff by contract. Mr. Lewis said they could post the notices at the trails and along the canal, and. over time people will stop shooting there. There is plenty of land in other areas of the BLM for shooting. The Redmond Police Chief has also asked for this to be addressed. The property owners of adjacent properties can ask to be included in the "no shooting" district if they so desire. The Board feels this should be investigated further and a plan developed to obtain feedback before moving forward. Supreme Court will do oral argument in two cases at Bend High School on Wednesday morning. Commissioners Baney and Unger will be present, so might be a few minutes late to the Board business meeting. The Board went over the candidate ballots for the Bend Chamber of Commerce and made a few selections. Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 6 of 7 Pages Being no further items discussed, the meeting adjourned at 3:10 p.m. DATED this (9-6 ■ Day of �-- 2014 for the Deschutes County Board of Commissioners. T) Tammy :aney, C la' d7//4*&____ Anthony DeBone, Vice Chair ATTEST: �" "'' aktp- Alan Unger, Commissioner (6-M44AL Recording Secretary Minutes of Board of Commissioners' Work Session Monday, October 6, 2014 Page 7 of 7 Pages U L eli'fk141:k 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., MONDAY, OCTOBER 6, 2014 1. Update on Food/Beverage Program — Dan Despotopulos 2. Discretionary Grant Review —Judith Ure • Bear Creek Elementary School — PA System - $1,500 • Family Kitchen — Meals for the Needy - $2,000 • Family Access Network—Fundraiser Luncheon for Children - $2,500 • Hospice of Redmond— Festival of Trees - $3,000 • Sisters Area Chamber of Commerce — Technology Upgrades — $3,240.94 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)(c),real property negotiations;ORS 192.660(2)(h),litigation;ORS 192.660(2)(d),labor negotiations;or ORS 192.660(2)(b),personnel issues;or other issues under ORS 192.660(2),executive session. Meeting dates,times and discussion items are subject to change. All meetings are conducted in the Board ofC'ommissioners'meeting rooms at 1300 NW Wall St.,Bend,unless otherwise indicated. If you have questions regarding a meeting,please call 388-6572. Deschutes County encourages persons with disabilities to participate in all programs and activities. This event/location is accessible to people with disabilities. If you need accommodations to make participation possible,please call(541)388-6571,or send an e-mail to bonnie.baker(d;deschutes.org. FOOD & BEVERAGE Introduction of Butch Graham—Food/Beverage Manager Overview of Food/Beverage Plan(attached) Results of September Food/Beverage(attached) Discussion items: Utilize 4H/Extension—Farm to Market Program Festival of Trees Event—Tate&Tate Marketing Food/Beverage program DESCHUTES COUNTY FAIR & EXPO CENTER FOOD & BEVERAGE PLAN On September 1, 2014 the Deschutes County Fair& Expo Center took control of all food & beverage at the facility. We have hired Butch Graham as our food/beverage manager who has over 30 years experience in the industry, which covers catering, concessions and alcohol management. CATERING We will develop our own menus and strategies for our own catering functions,while allowing outside catering companies to provide service as well. All outside caterers will come from a preferred list(pre-qualified), which the event may choose from. If an outside catering company is chosen and does not require use of our kitchen there will be a 10— 15%charged based on gross sales.The volume of business the outside caterer does with us will determine the 10—15%. If they chose to utilize our kitchen facilities and flatware there will be an additional charge (see attached sheet). This will be overseen by the Food/Beverage manager. CONCESSIONS We will provide concessions for all events,which will be managed by our F/B manager. We will allow outside concessionaires for some events as needed.They will come from a preferred list(pre-qualified) and be required to pay 25%of gross sales. ALCOHOL All alcohol service will be managed by the F/B manager, no outside alcohol service will be allowed. ADDITION INFORMATION As we develop our new website we will begin to promote/advertise our menus along with other catering companies that satisfy our requirements. Deschutes County Food and Beverage at the Fair and Expo Center September 2014 Revenues $17,350.34 Cost of Goods Sold Beginning Food&Beverage Inventory Note 1 - Purchases Food&Beverage 1,047.65 Ending Food&Beverage Inventory - Cost of Food&Beverage 1,047.55 Labor 2,334.40 Cost of Goods Sold 3,381.95 Gross Profit 13,988.39 Expenses/Expenditures Personnel 8,519.85 Building&Grounds R&M 295.00 Fees&Permits 805.20 Minor Equipment 795.00 Total Expenses/Expenditures 10,414.85 Income-Food&Beverages Activities $ 3,553.64 Note 1: Cost of beginning and ending inventory of Food&Beverages not yet available pruntnlla C 1Nt1 l'.ulr(iR Nios ElaR On Site Concessions at Catering Please Rate Excellent Very Good Good Fair Poor Comments Quality of Food ✓ Customer Service ✓ Timeliness V T Food Presentation Rental Facility/Operations Please Rate Excellent Very Good Good Fair Poor Comments Cleanliness ✓ Room Set-up ✓ Responsiveness of Staff Staff Appearance ✓ Attention to detail Sales Manager Please Rate _Excellent Very Good Good _ Fair Poor Comments Responsiveness Communication ,Follow-up Number t of Attendants? / %of Out-of-Town? 5 t_a Who a did yu y? earn Fpier t... �... /4,2 fdr hca air s Restaurants visited? 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C 0 lV G •U U 00 c• C d 0 C 0 u, ,c - cc E m rn g m 2 O N 8 E E d c E _O cam) CI E 0. c v m 0L) - ° > `"di ! w m tu c b fi ; o •0 p ° co ° a co.. ,= 7 N N C -0 0 03-0 m o Z 7 LL � c c = (0—E > E a E m co } `°_ m Z v ro 9) 7 0- E _ aaL1- � - `° L awls N E T 2 .T. m N f_7 e E a lftl V Q1 E wO aLL m cOOCCLL FYI IQl, ° vcm0. › ,00_ 5..cc °, mN = Ea� ` wEI m m ONJOZJ8OONJQ U- V) OI IU- H i r SBIRT QIM Proposal: Central Oregon Substance Abuse Intervention 1. Provide contact information for the person or organization submitting the proposal, including a working e-mail address and phone number. Tom Kuhn Community Health Manager Deschutes County Health Services Thomas.kuhn@deschutes.org (541) 322-7410 2. Summarize the funding request.Be sure to include information about the proposed funding recipients.Attach documentation to demonstrate that each proposed funding recipient has reviewed this proposal and supports the proposal. The Central Oregon Substance Abuse Intervention is designed to improve the number of screenings and referrals specific to alcohol and other drug use from medical providers to substance abuse treatment providers. Deschutes County Health Services (DCHS)proposes to: 1. Immediately implement the SBIRT tool (after staff training)within the Reproductive Health Services Clinic to achieve 200 screenings amongst OHP clients by December 31, 2014. 2. Coordinate regional support for integrating SBIRT into primary care settings through assessment and capacity building among the top Medicaid Member clinics within Crook, Deschutes and Jefferson Counties, by December 2015. 3. Secure tools,resources and a community endorsed guideline for referring patients to Medicaid serving treatment facilities within Crook;Deschutes and Jefferson Counties,by December 2015. DCHS requests $102,000 to accomplish these outcomes. 3. Explain how this proposal is designed to impact the QIMs or other issues identified by the Finance Committee in its Request for Targeted Quality Proposals: SBIRT,ADIID, developmental screens, adolescent well care visits, and access. Quantify how the proposal,if funded,will impact the QIMs or access issues. This proposal is based on the premise that SBIRT screenings and referrals are currently underutilized in Central Oregon primary care settings and that without completely understanding what current practices are and what barriers exist,this metric will be not be met. It is also understood that within Deschutes County (the other counties were not assessed) adults 18-25 years of age consistently underutilize treatment services compared to the State for similar time frames, despite having dependence rates similar to the State. This is coupled with knowing that treatment facilities have the capacity to serve (based on provider focus group feedback) additional clients. Thus,this plan seeks to understand and improve not only screening and identification of alcohol and other drug use but to ultimately increase patient outcomes with through improved referral to treatment methods. DCHS will not only implement SBIRT within the Reproductive Health Services Clinic but will also coordinate an assessment and community engagement process to improve SBIRT implementation throughout all Medicaid Serving clinics and treatment facilities within Central Oregon. To conduct implementation within the DCHS Reproductive Health Clinic,DCHS will hire a qualified SBIRT trainer to train staff and to address workflow issues. The training will occur as soon as possible after grant award to allow for as many SBIRT screenings as possible prior to the end of 2014. It is estimated that 100 OI IP clients will be screened per month based on current clientele. A budget of$2,000 is projected to hire a SBIRT trainer to train and provide consultation for work flow issues. To coordinate regional support for integrating SBIRT in the primary care setting and appropriate support resources for improving referrals to treatment, DCHS will conduct an assessment of primary care and substance abuse providers as the first step in the system-wide roll out. The assessment will examine existing: Screening tools being used *Referral systems from primary care to substance abuse treatment *Follow-up and feedback from substance abuse providers to the referring medical provider to close the loop ar ' Pnhance and continuum of care •Comfort ley piuiiary care providers in discussing and communicating substance abuse issues with clients *Implementation readiness *Knowledge of referral services and existing resources The assessment will include an appropriate combination of key informant interviews and survey data collection. The assessment results will be analyzed and presented to key stakeholders (as described in#4). Together the group will identify key steps and resources to successfully implement SBIRT in the region. With these key steps and resources identified,primary care providers will be trained on the screening tools, improving the metric and patient outcomes. A budget of$1 00,000 is projected to accomplish this task. The funding will be used to hire a contractor to coordinate activities, travel as necessary throughout the region, conduct trainings and to develop/secure resources as defined by the key stakeholder group over the course of 12 months. 4. Explain how these funds will be targeted to the Medicaid population. These funds must be used in order to maximize the benefit to the Medicaid population. The Medicaid population will be addressed by targeting the clinics serving the largest number of Medicaid providers in Central Oregon. Medicaid substance abuse treatment providers,where referrals will be made, include BestCare,New Priorities, Pfeifer and Associates, Rimrock Trails, Serenity Lane, and all Community Mental Health Programs. 5.Explain whether and how these funds may impact workflows, patient care,or provider processes within single or multiple organizations. By assessing the current capacity and barriers to implementation and working with a community driven process,this proposal seeks to directly improve the work flows,patient care, and provider processes for system-wide screening and referral of substance abuse. 6.Explain how each proposed funding recipient intends to track any quality-pool QIM dollars disbursed to the recipients to be sure the funds are used for the purpose intended. Provide a plan to explain how this will be analyzed and tracked. Health Services will monitor budget and spending. In addition, quarterly reports will monitor activities and the number of people involved according to the timeline below: • Quarter 1 (October—December 2014)—Train Reproductive Health staff, implement SBIRT in-house, identify and hire contractor. • Quarter 2 (January—March 2015)—Conduct key informant interviews, implement survey, analyze survey and compile data. • Quarter 3 (April—June 2015)---Stakeholder presentation, define tools and resources to support SBIRT, conduct SBIRT training and provide resources for providers, increase provider capacity to implement SBIRT. • Quarter 4 (July---September 2015)--Conduct SBIRT training and provide resources for providers, increase provider capacity to implement SBIRT. • Quarter 5 (October—December 2015) - Conduct SBIRT training and provide resources for providers, increase provider capacity to implement SBIRT, create fmal report of project accomplishments. 7. Distributions of quality-pool QIM dollars should be viewed as one-time or limited-time distributions. Sustainability is a significant goal.Explain how funding this proposal means that additional funds will not be required in the future to impact the same quality metric or quality issue. As stated previously,the Finance Committee is less interested in funding FTEs versus other types of more sustainable investments. Detail a sustainability plan in the proposal. The intent of this proposal is to implement SBIRT in a manner that assesses the current system's readiness and builds upon it to ensure sustainability following completion of the program. We will do this through a community engagement process that seeks to understand what currently exists and collaboratively determining how the screening and referral methods can be incorporated, fostering a sustainable culture. We intend to identify barriers to implementation, address them through a community decision making process and to sponsor training of trainers to sustain implementation. Training is the key sustainability feature of this proposal. Using a train-the-trainer model, Medicaid providers will have their own in-house staff that has the knowledge of the screening and referral process. This will aid in addressing turn-over of clinicians and empower entities to own their process. Ultimately,this proposal will improve the healthcare system's foundation and processes to implement screening and referral. 8. Discuss whether the organization submitting this proposal (or any proposed funding recipients set forth in Section I, above) is a party to any contract with PacificSource, including any contract for commercial insurance or Medicare Advantage. If the organization is a party to any contract with PacificSource, explain whether the organization is incentivized to impact any of the quality metrics or quality issues set forth in the Request for Targeted Quality Proposals. DCHS holds two contracts with WEBCO for which the funds are from PacificSource. These are for community mental health services and a small maternal child health initiative. DCHS is not - .. incentivized to impact any of the quality metrics or issues set forth in the Request for Targeted Quality Proposals.