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2018-308-Minutes for Meeting May 31,2018 Recorded 7/24/2018BOARD OF COMMISSIONERS 1300 NW Wall Street, Bend, Oregon (541) 388-6570 8:15 AM Recorded in Deschutes County CJ2018-308 Nancy Blankenship, County Clerk Commissioners' Journal 07/24/2018 7:20:16 AM FOR RECORDING STAMP ONLY BUDGET HEARING MINUTES THURS SAY, May 31, 2018 ALLEN CONFERENCE ROOM Present were Budget Committee Members Bruce Barrett, Mike Maier, and Bill Anderson, Commissioners Tammy Baney and Anthony DeBone. Commissioner Henderson was present at 8:24 a.m. Also present were Tom Anderson, County Administrator; Erik Kropp, Deputy County Administrator; Wayne Lovvry, Finance Director and Loni Burk, Budget Analyst; and Sharon Keith, Board Executive Assistant. Several citizens and no representatives of the media were in attendance. RECONVENE: Chair Barrett reconvened the budget hearing at 8:16 a.m. SUPPORT SE VICES: FACiUT MS: Facilities Department Staff Lee Randall and Jessica Campbell presented the proposed budget. Mr. Randall reported on projects including improvements to the Clerk's lobby, roof and flooring replacements. There were 950 work orders in total for 2017. The Deschutes County campus properties have doubled in square footage since 2004. Highlights for this year are to improve flexibility and responding to growth with a shift of focus of work performance and capacity to manage work which may need to additional FTE. Custodial FTE have been reduced from 11 to 9 and are currently contracting out for custodial services. The department requests a few vehicles including one custodial van. 70% of the department's workers compensation claims have been due to loading and unloading equipment which leads to the request of the custodial van. BUDGET HEARING MAY 31, 2018 PAGE 1 OF 8 Mr, Randall explained there has been a minimal increase to internal service fund charges. Mr. Maier congratulated Mr. Randall for the beautiful work on the campus grounds. Mr. Randall reported over the past few years the trees have been thinned on the campus park. The park is checked daily and they work with James Lewis, Property Management and the Sheriff's Office to respond to any issues with campers. Discussion held on the possibility of using summer internships and Mr. Randall would be interested in that concept especially for seasonal landscaping. Mr, Randall reviewed the internal fund charges for services to the County departments, NFOR ATI N TECHNOLOGY: Kevin Furlong, IT Operations Manager presented the proposed Information Technology budget. Challenges coming forward for the department is a new phone system as well as adoption of new processes and cyber security. Mr, Furlong explained the process of emails traveling through the County and the server and firewall system. The department is due for a third party security assessment, The various systems within the County and privacy policy. LEGAL: David Doyle, Legal Counsel presented the proposed budget for the Legal Department, Staffing levels have remained the same for 13 or 14 years and the volume of vvork has grown 5% each year. Next year Mr. Doyle expects he will need to request another attorney. Mr. Doyle has a full case load and the assistant attorneys are involved in a lot of triage cases. In addition to the County departments, legal services are provided to the service districts as well, Legal fees charged to departments are on a percentage basis, Commissioner DeBone inquired on the case management software. Mr. Doyle noted all of the files are now in the electronic case management files which has proved very efficient to the department. Commissioner DeBone inquired on public records log. The public records log was created by the Legal department and is accessible on the County's website and the departments send in statistics annually. The department is working on plans to remodel to ensure confidentiality, RECESS: At the time of 9:20 a.m., a short recess was taken and was reconvened at 9:27 a.m. BUDGET HEARING MAY 31, 2018 PAGE 2 OF 8 DESCHUTES CIUNTY 9-1-1 SERVICE DISTRICT: 9-1-1 Operations staff present were Interim Director Sara Crosswhite, Training Manager Megan Craig, Operations Manager Chris Perry, Administrative Supervisor Kim Morse and Technical Systems Manager Rick Silbaugh. Ms. Crosswhite reviewed the strategic plan. Ms. Crosswhite explained the model call receiving order, The department only has two vacancies now and the hiring process was changed to bring in a better culture to improve staff morale and bring in the right people for the positions. Three additional call -taking consoles were added. Commissioner DeBone wants the user group to know vve advocate a high service level. Ms. Crosswhite provided history and status of the radio project. Commissioner Henderson stated in November 2016 it was decided to not go forward with the tower at jackpine and wondered how that decision was made, Mr. Maier asked why we would be concerned so much with what happened in the past and stop dwelling on that and wants us to go forward. Mr. Barrett noted the importance of clarity for the public, Commissioner DeBone inquired on the Overturf temporary site. Ms. Crosswhite noted a review of the site vvill be done for 30 days and if it is working well it will be transferred to a permanent site, The capital projects include the radio system, a new CAD system, and a staff vehicle replacement. Commissioner Baney made motion to approve the Deschutes County 9-1-1Service District operating budget of $16,198,013 and set tax rate at $.3618 per $1,000 of assessed valuation. Motion was supported by Mike Maier, Motion Carried unanimously. Commissioner Baney made motion to approve Deschutes County 9-1-1 Service District Equipment Reserve budget of $2,687,000. Motion was supported by Bill Anderson, Motion Carried unanimously. Chair Barrett closed this portion of the budget hearing. JUSTICE COU T: Present from Justice Court was judge Chuck Fadely and Jodi Stacey. A summary of business and revenue trends was reviewed byjudge Fadely, The new offices are located in the Redmond City Hall. Citations provide a good revenue source. Commissioner Baney inquired if there are enough staff. Ms. Stacey noted the level of projects in the department and the work load is at capacity. There is a pro -tern that assists with the case load once per month. Judge Fadely feels staffing help is needed and would be a future request. Commissioners Baney and DeBone asked to not hold off with the request even if it is mid -year. The challenges with case files is due to a lack of storage. All archive files are in the process of being converted into electronic files. The budget includes BUDGET HEARING MAY 31, 2018 PAGE 3 OF 8 a request for extra help for that project. Commissioner DeBone advocates for asking for resources and complete the project. RECESS: At the time of 10:29 a.m., a recess was taken and was reconvened at 10:45 a,m. Note: One member of the media was present during this discussion, SHERIFF'S OFFICE: Sheriff Shane Nelson and Sheriff's Office staff presented the proposed budget for the Sheriffs Office, The proposed budget presented a 4.7% increase over last year. Total staff in the department is at 232,51 FTE. Personnel requests will include one deputy sheriff for marijuana enforcement and one field law enforcement technician. Sheriff Nelson spoke on public safety for the community and the assurance of livability. Sheriff Nelson noted the great partnership with Wayne Lowry on preparing the budget. The proposed property tax rate is shows a request for an $ ,08 increase for Countywide Law Enforcement District 1 and a $ ,06 reduction for Rural Law Enforcement District 2. Staffing of the department was reviewed including the growth and concerns to be addressed in Deschutes County. The accomplishments over the past year include installation of ten HVAC units, collaborations for the solar eclipse event, replacement of sally port doors outside of jail booking, and the exterior painting of the Sheriff's Office and jail, Sheriff Nelson noted the challenges for fiscal 2019 include the reduction in state funding, the increase in the tax rate for district 1, marijuana enforcement, staffing, and the request of $25,000 for suicide prevention hotline. The position to cover marijuana enforcement will be funded through the marijuana taxes. The department has hired a new full time lawyer and is keeping the previous lawyer (that retired) on staff due to the heavy amounts of issues. Staff training has been increased. The Sheriff is requesting to consider the addition of $25,000 in the budget for a teen suicide prevention hotline. Additional funding has also been secured from a high intensity drug trafficking board and the City of Bend, County Administrator Anderson noted currently there is a suicide hotline as a part of the Health Services Crisis Team. Commissioner Baney noted this new hotline is a peer to peer hotline having teens on the calls. Outreach will be done with the schools. Commissioner Baney noted this engages youth to be aware in their own population. Mr. Lowry reviewed the operating budget of the Sheriff's Office comparing fiscal year 2018 to 2019. Sheriff Nelson reported on major issues ahead include legislation, technology and BUDGET HEARING MAY 31, 2018 PAGE 4 OF 8 storage of data, and recruitment. Correction Services challenges ahead will be for staffing, inmate vulnerability, medical and mental health. Discussion held on the jail if there is a need for expansion. Commissioner Henderson inquired on the Stepping -Up Initiative and the Sheriff's Office has been doing that vvork for years. Mr. Maier requests a commitment to look to the future and start saving money in case there is a need for a jail expansion. In the Detectives Division, the challenges will be the availability of lab resources, the need for a new detective for marijuana enforcement, and increasing population and visitors. The activity seen by Search and Rescue Operations proves Deschutes County has the second highest level of requested response in the state, In the Patrol and Training Division, the challenges will continue to be technology, training, and staffing levels. To cover staffing shortages and in patrol there are currently eight contingent job offers. Chair Barrett noted the Countywide Law Enforcement District and the Rural Law Enforcement District presentation will continue at 2:00 p,m, on Friday, June 1, RECESS: At the time of 12:20 pm., a short recess was taken and reconvened at 12:37 p,m, CAPTAL MP VEMENT PROGRAM: F C1LMES: Deputy County Administrator Erik Kropp and Lee Randall presented the General Capital Reserve Fund, This fund is used to accumulate County resources for capital investments related to the Board of County Commissioner goals and objectives and the General County Projects Fund which provides resources for higher -cost facilities maintenance items and for improving and remodeling County buildings. Mr. Kropp spoke on the Public Safety Campus plans and the Courthouse expansion. The courthouse expansion includes growth for a new judge. Commissioner Baney noted the state court administrator is aware of the challenges in Deschutes County. Mike Maier presented the concept of moving the judges to another building as an option if it is too expensive to expand. Mr. Kropp reported on an option being considered the the Deschutes Services Building parking lots including removing rocks at the dedicated campus park to expand the parking lot. Commissioner Baney noted it is important to respect the fact that Worrell Wayside Park was dedicated to a certain individual. Commissioner Henderson suggested looking into the expansion of parking to the locked vehicle lot as an option. Mr. Randall noted issues with camping in the park and trying to make it more user friendly for visitors too. Commissioner Henderson noted moving the rocks from the park area would be expensive. Mr. Maier like the idea with getting a remote parking lot and provide shuttle service for BUDGET HEARING MAY 31, 2018 PAGE 5 OF 8 employees. Mr. Maier inquired how many non -county employees park on the Wall Street lot and inquired if we are subsidizing parking spaces for other businesses, Mr, Randall commented on parking permits. Mr, Randall reviewed projects completed and carried over. The roof replacements for Adult Parole and Probation, Annex downtown clinic and Community Development Department were completed. Exterior paint on the Deschutes Services Building is a priority for this year. Projecting out HVAC and roof replacement needs. ROAD: Road Director Chris Doty, County Engineer Cody Smith, and Fleet 8, Equipment Manager Randy McCulley presented the Capital Improvement Plan for the Road Department. Mr, Smith reported safety audits and traffic investigations are done to identify needed projects. The four primary programs are transportation, pavement preservation, traffic safety, and bridge constructions. Mr. Smith reviewed the fiscal year 20'19 projects including intersection improvements. The pavement preservation, traffic safety, bridge construction, and transportation system projects were reviewed. Mr. McCulley reviewed the requested replacement equipment for fiscal year 2019, COMM MTV DEVELOPMENT DEPARTMENT: Community Development Department staf Nick Lelack, Director and Sherri Pinner Management Analyst presented the proposed budget. Mr, Lelack gave an overview of the department's structure, The staff provide services in four locations: Bend, Redmond, La Pine and Sisters, A lobby remodel will begin within the next few weeks. I -pads are located at each of the counters for customers to rate service, Challenges include the goal to maintain high customer service with appropriate staffing levels and increased levels of workloads. There has been a steady growth in applications processed since the year 2010. Mr, Maier inquired on services and revenues that had been received when the Environmental Health department was under Community Development and commented possibly that division should be placed back under the Community Development Department rather than Health Services. Statistics of building activities were reviewed, Seven staff were added in fiscal year 2018. This year they are requesting three more staff. The proposed budget shows anticipated permit volume increase of 8% across all divisions. Proposed fee increases span from 2% to 9%. Long Range Planning request is $141,078 through a general fund request. Right now, the department has 6 or 7 months in reserve BUDGET HEARING MAY 31, 2018 PAGE 6 OF 8 and the target is to have 12 months. The Board wants to look at fees more in depth prior to approving an increase. There is support for the general fund request for the long-range planning. Fee increases requested include 2% for building safety, 4,5% for environmental soils, .21 to .23% of building valuation for code enforcement, and 9% fee increase for planning. Chair Barrett commented on the volume over the past years but the fees haven't been increased at the same time and notes the importance of matching fees with actual cost. One public comment from audience member Stan Terrell was received regarding the question of need for increased staffing when the same level of permits are being processed. Mr. Lelack and Ms, Pinner noted there is an 8% increase in volume and there is anticipation of growth. RECESS: At the time of 2:50 p.m., a recess was taken and reconvened at 3:01 p.m. HEALTH SERVWES: Business Manager James Wood revievved a listing of Health Services by county in Oregon. Deputy Director Hilary Saraceno reviewed the services that are unique to Deschutes County Public Health Services, By merging programs and staff there was a loss of 1.7 FTE in Communicable Disease staffing and the department requests those positions with the proposed budget. Tvvo new grants have been awarded to address concerns this program serves, The budget submitted didn't reflect the 2 FTEs requested for the Reproductive Health Clinic. Ms. Saraceno reported the Public Health reserves have been exhausted. For the Public Health proposed budget, they request 1.10 FTE, Reproductive Health 2.0 FTE, Emergency response a one-time ask of $288,000, and VVIC 1.0 FTE. Deputy Director DeAnn Carr reviewed the services that are provided by Behavioral Health. Ms. Carr spoke of plans the County Stabilization Center with the proposed budget covering services for nine hours per day and 5 days per week, County Administrator Anderson noted the decision on the location of the crisis/stabilization center still needs to be determined. The community partner piece with confirmed commitments needs to be final before presenting a 24-hour 7 day per week center, The proposed budget for Behavioral Health include a 1.0 FTE peer support specialist, case manager .5 FTE, occupational therapist .5 FTE, and administrative support technician .5 FTE. Deputy Director Dave Inbody spoke on the facility square footage of Health Services as it has changed since the year 2011. The department currently has 335 employees. Mr, BUDGET HEARING MAY 31, 2018 PAGE -7 OF 8 lnbody reviewed the department's vacancies. The projection for vacancies in this year's budget is 2% in Public Health and 6% in Behavioral Health. Mr. Maier spoke on the suicide hotline concept in the Sheriff's Office. If the stabilization center would happen that service would go there but at this time the service proposed through the Sheriff's Office and Health are separate. Behavioral Health has been working with the Sheriffs Office for that service. Commissioner Henderson commented the proposed budget is a 26% increase. Ms, Saraceno noted the biggest expense is personnel. Discussion held on the proposed request for $400,000 for the reserve fund. Options were to be provided to Wayne Lowry on the Health Services asks for the budget. Dr, Conway noted one of the highest priorities for the department are the stabilization center and reinstating the reproductive health and communicable disease programs. ECESS: At the time of 5:30 p.m. Chair Barrett called a recess and the Budget Hearings will reconvene at 9:00 a.m. on Friday, June 1. DATED this it Day of 2W 8 for the Deschutes County Board of Commissioners. 4,4 ECORDING SECRETARY BUDGET HEARING ANTHO Y DE*ONE, CH q"\N NDERSON, VCE CHAIR TAMMY BANEY. PMMSS NER MAY 31, 2018 PAGE 8 OF 8 BUDGET COMMITTEE AGENDA Thursday, May 31st, 2018 Program Budget Tab/Page 8:15 AM • Reconvene the Deschutes County budget meeting Support Services • Introductions • Budget Discussion 8:15 - 8:30 AM • Facilities (Fund 620) 6 / 192 8:30 - 8:45 AM • Information Technology (Fund 660) 6 / 209 8:45 - 9:00 AM • Legal (Fund 640) 6 / 213 9:00 - 10:00 AM 10:00 - 10:30 AM Public Safety Deschutes County 9-1-1 Service District (Funds 705-7101 • Open public meeting and introductions • Budget discussion • Public comment • Motions to: • 1) Approve Deschutes County 9-1-1 Service District operating budget of $16,198,013 and set tax rate at $.3618 per $1,000 of assessed valuation (Fund 705-707) • 2) Approve Deschutes County 9-1-1 Service District Eauipment Reserve budget of $2,687,000 (Fund 710) • Motions to be seconded • Budget Committee votes • Close budget meeting Iustice Court (Fund 220) • Introductions • Budget Discussion 10:30 - 10:45 AM Break Page 1 7/218 3/101 10:45 - 12:15 PM BUDGET COMMITTEE AGENDA Thursday, May 31st, 2018 Sheriff's Office (Three Districts) (1) Sheriff's Office (Funds 240-256) (2) Countywide Law Enforcement District (District 1) (Fund 701), and (3) Rural Law Enforcement District (District 2) (Fund 702) • Open public meeting for Countywide Law Enforcement District (District 1) • Open public meeting for Rural Law Enforcement District (District 2) • Introductions • • Budget discussion; • Public comment At conclusion of presentation, continue Countywide Law Enforcement District meeting to Friday, June 1st, at 2:00 p.m. • At conclusion of presentation, continue Rural Law Enforcement District meeting to Friday, June 1st, at 10 2:00 p.m. 12:15 - 1:15 PM Capital Improvement Program (Lunch Discussion) 1:15 - 2:15 PM Direct Services Community Development (Funds 290-303) • Introductions • Budget Discussion; Special Requests 14 / 359-362 2:15 - 2:30 PM Break 2:30 - 5:30 PM Health Services (2nd of 2 sessions) Continue the Deschutes County budget meeting to Friday, June 1st at 9:00 am Program Budget Tab/Page 3/104 4/131 Page 2 2018 Budget Hearing Sign -in Sheet Thursday, May 31, 2018 Name Department '7-ephri LC) Vr ,e IA ri,06eA C rve; Gi ‘A -et (/*.41 rk Pi- CO- (4:1;) PI ( 2/frtif odv;i0i 04,6§,/ C-CiTh ci(2) Dc,,Sr) Qcs--0 Dc sc) pc mAL-7k )\)(-5- Ve. --</644-ede (304-2.4,4 CIL 5 6 k--/- 2018 Budget Hearing Sign -in Sheet Thursday, May 31, 2018 Name Department 4 \lame. ra COUNTY COUNSEL Budget Presentation May 31, 2018 1. Staffing & Workload - since prior to 2005, office staffing has consisted of 4 attorneys and 2 support staff - overall workload volume increases of at least 5% per year for each of the past 4 years - increased workload being managed by (a) Doyle handling full caseload PLUS; and (b) all attorneys providing more and more triage -level services - approaching a point where even Doyle (the King of Triage) is becoming uncomfortable with shallow dives into what are becoming more and more complex matters - anticipate that next year at this time 1 will be requesting budget authority to hire another attorney 2. Scope of Services - full service legal advice and representation to all county departments (excepting bond work due to ORS requirements, and workers compensation) - provide General Counsel to DC 911, SRSD, and BBR PD 3. Budget Numbers - budget increases attributable to impacts from class comp study and continuing adjustments necessitated by successive inflated ending fund balances generated by not filling an open attorney position for 18 months LL/ —k Deschutes County 9-1-1 1 Primary Goals Strategic Plan for 2018 — 2021 1.1 Improve the capability and reliability of the emergency back-up facility. (S&"pternb&r-2020)20217 2022) • Explore partnering with regional public -safety agencies in the development of a regional training center in the Redmond area. 1.2 Remain open to consolidation opportunities with other Public Safety Answering Points. (Ongoing) 2 Objectives — Line Operations 2.1 Staff a law enforcement data channel 12 hours per day. "(April 2018) (July 2019) • Hire, train and deploy Telecommunicators for operational time periods when radio data requests are forecast to be highest. 2.2 Improve the retention rate for new line employees. (Ongoing) • Continually evaluate and improve the entire entry level hiring and training process. 3 Objectives—Technical Division 3.1 Raise the level of the division's engineering expertise and/or support. (Underway now.) 3.2 Add three consoles to the dispatch floor to improve the District's call taking capacity. (July 2019) (May 2018) 3.3 Continue to develop radio system partnerships with other public agencies (Ongoing) • Continue to use the Public Safety Radio Team and customer agency operational committees to engage with the system's user agencies. (Ongoing) • Obtain available grant :funding including supporting partner agency grant applications. (Ongoing) 3.4 Complete the,CAD/RMS integration project. (October 2018) Completed • • Refine the existing RMS agreement to verify funding allocations; required data entry standards; user responsibilities; and system administration and security requirements. 3.5 Completion of Harris Radio Projectwith increased annual preventative maintenance (July 2018) • Resviye Audio Leveling -(June 2018) • Resolve Roaming Issues (August 2018) • Review'and>.design permanent radio site for coverage on Bend's West side (October 2019) 3.6 Radio System Deployrrent'for Fire (Fall 2018) 3.7 Explore inclusion of other entities on the radio system (In Progress) 4 Objectives — Administrative Services 4.1 Develop a policy for capital and operational reserves. (March 2018) (Jan 2019) 4.2 Continually evaluate personnel to back-up existing roles and for succession planning. 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VJ1 rn 0 c Sheriff's Office Budget Committee Meeting May 31, 2018 FY 2019 Proposed Budget Highlights Operating Budget Total Operating Budget FY 2019 Total Operating Budget FY 2018 1 42,964,921 4.7% Increase 41,027,669 Projected District Reserves at 6/30/19 13,154,860 (will be larger per April 30, 2018 Projection) Total Staff FTE 232.51 Personnel changes from prior year budget + 1 Deputy Sheriff— Marijuana Enforcement— Funded by Marijuana Taxes + 1 Field Law Enforcement Technician — Rickard Ranch Proposed Property Tax Rates per $1,000 AV Tax District 1 (Max Rate $1.25) Tax District 2 (Max Rate $1.55) $1.10 (.08 increase) $1.34 (.06 reduction) Sheriff Nelson 2 Total FTE's Actual from FY 2012 to FY 2018, Projected through FY 2023 240.5 205 .. aa.+ .. FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 2 New Positions FY 2019 — Deputy Sheriff / Drug Enforcement & FLET 2 New Positions per Year FY 2020 through FY 2023 FY 2018 Major Accomplishments Sheriff Nelson 3 • Installed 10 HVAC units (3rd year of 5 year plan) • Successful collaborative efforts with public safety partners for Solar Eclipse • Replacement of sally port doors outside of Jail Booking • Painted exterior of Sheriff's Office and Jail Sheriff Nelson 4 FY 2019 Challenges • Reduction in State Funding, SB -1145 • Increase Tax Rate, District 1 • Marijuana • Staffing • Request $25,000 for Suicide Prevention Hotline Sheriff Nelson 5 Tax District Allocation by Division/Unit Tax District 1— Countywide (Fund 701) 2050 — Civil 3750 — Adult Jail 3850 — Court Security 3950 — Emergency Services 4050 — Special Services 4450 — Other Law Enforcement Tax District 2 — Rural (Fund 702) 3350 — Detectives 3450 — Patrol 3550 — Records Split Between Districts 0150 — Sheriff's Services 2950 — Automotive/Communications 4350—Training 4550 — Crisis Center Sobering Station 9950 — Non -Departmental Sheriff Nelson 6 Tax District Allocation by Division/Unit 0150 2050 2950 3350 3450 3550 3750 3850 3950 4050 4350 4450 4550 9950 Revenue Countywide Rural Fund 255 (Other) Total Revenue Department Sheriff's Services Civil Automotive Detective Patrol Records Jail Court Security Emergency Services Special Services Training Other Crisis/Sober Center Non -Departmental TD#1/TD#2 95%/5% 100%/0% 49%/51% 0%/100% 0%/100% 0%/100% 100%/0% 100%/0% 100%/0% 100%/0% 66%/34% 100%/0% 75%/25% 50%/50% Total Tax District # 1 Countywide 2,831,887 1,181,696 1,307,016 0 0 0 18,630,763 551,494 328,580 1,520,623 438,696 1,017,266 419,481 4,165 $28,231,667 Tax District # 2 Rural 162,031 0 1,337,770 1,975,378 10,003,952 881,182 0 0 0 0 228,950 0 139,827 4,164 $14,733,254 TOTAL FY 19 Budget 2,993,918 1,181,696 2,644,786 1,975,378 10,003,952 881,182 18,630,763 551,494 328,580 1,520,623 667,646 1,017,266 559,308 8,329 $42,964,921 Sheriff Nelson 7 Sheriff's Office Operating Budget Year to Year Summary Comparison FY 2018 Revised Budget $22,525,228 $ 10,162,942 $ 7,328,585 $40,016,755 FY 2019 Proposed Budget Dollar Change $25,696,138 $10,313,598 $ 6,872,246 $42,881,982 $2,865,227 Percent Change 7.16% Expenses (Budget) $41,027,669 $42,964,921 $1,937,252 4.7% Wayne Lowry 8 Ending Fund Balance Comparison: Sheriff Recommended vs No Changes (dollars in millions) FY2019 Proposed FY2020 Preliminary FY2021 Preliminary FY2022 Preliminary FY2023 Preliminary Budget Estimate Estimate Estimate Estimate Tax District Tax District Tax District Tax District Tax District Total #1 #2 Total #1 #2 Total #1 #2 Total #1 #2 Total #1 #2 Total Resources (excluding Reserves) 42.7 27.9 14.8 44.7 29.2 15.5 46.5 30.5 16.0 50.3 33.7 16.6 51.9 34.8 17.1 Total Expenses 42.4 27.9 14.5 44.8 29.5 15.2 46.8 30.8 16.0 50.0 33.0 17.0 52.6 34.7 17.9 Net Change in EFB $ .3 0 .3 -.1 -.3 .2 -,2 -.3 .1 .2 .7 -.5 -.6 .2 -.8 Total Months EFB Sheriff Recommended 5.1 3.7 8.7 4.9 3.4 8.5 4.6 3.1 8.3 4.3 3.0 7.5 3.9 3.0 6.4 Net Change in EFB $ with no tax rate changes -1.0 -1.7 .7 -1.6 -2.3 .7 -1.8 -2.4 .6 -3.4 -3.5 .1 '-4.4 -4.1 -3.3 Total Months No Tax Rate Changes 4.9 3.1 8.9 4.1 1.8 9.2 3.4 .7 9.4 2.2 -.9 9.1 .8 -2.6 8.5 Sheriff's Office Major Issues in the Years Ahead • Legislation • Technology - Storage of Data • Recruitment Wayne Lowry 9 Sheriff Nelson 10 Corrections Captain Michael Shults Major Issues in the Years Ahead • Staffing • Inmate Vulnerability • Medical/Mental Health Detective Captain Deron McMaster Major Issues in the Years Ahead • Availability of Lab Resources • New Detective for Marijuana • Increasing Population / Visitors Captain Shults 11 Captain McMaster 12 Patrol Captain Paul Garrison Major Issues in the Years Ahead • Technology • Training • Staffing Levels Questions/Comments Captain Garrison 13 14 Date: May 18, 2018 To: Deschutes County Budget Committee From: Erik Kropp, Deputy County Administrator c4 Re: Capital Funds — Fund 070 (formerly Fund 142) and Fund 060 (formerly Fund 143) Enclosed are updated reports for the following two capital funds: General County Projects (Fund 070) — This fund provides resources for higher -cost facilities maintenance items and for improving and remodeling County buildings. Revenue comes from an approximately 3 -cent portion of the County's property tax levy and occasional General Fund contributions. General Capital Reserve (Fund 060) — This fund is used to accumulate County resources for capital investments related to Board of county Commissioner goals and objectives. Most resources are provided by the General Fund in those years when the General Fund's revenues exceed the General Fund's expenditures (one-time resources). Such accumulation of resources could be used to fully or partially fund future projects according to BOCC priorities. 300 N\/\I Wa.: Sr ee-i Bend. Cmcgor, 97703 .'°‘ (541) 388-6584 (4) eiik k-oop@descnutes .erg 610 vv\Ap,N.dscl utes.org FY 2019 General Capital Reserve - Fund 060 (Formerly 143) Purpose of the fund: This fund is used to accumulate County resources for capital investments related to Board of County Commissioner goals and objectives. Most resources would be provided by the General Fund in those years when the General Fund's revenues exceed the General Fund's expenditures (one-time resources). Such accumulation of resources could be used to fully or partially fund future projects according to BOCC priorities. Resources BNWC Interest Interfund Transfers Total FY 2017 Actual 3,724,157 64,258 7,288,728 FY 2018 Budget 7,280,000 109,200 3,136,663 FY 2019 Proposed 10,533,391 200,000 3,158,024 10,525,863 13,891,415 List of Potential/Identified Projects - these projects have not yet received final approval Fund 060 Potential Projects Estimate for Budgeting Purposes Public Safety Campus projects Courthouse Expansion Relocation of AJ Tucker Building Courtroom remodels (4) Underground Injection Control (UIC) Deschutes Services Building Parking Lot Deschutes Services Building Parking Garage North County Campus Future Jail Expansion Total TBD $19,000,000 $400,000 $1,000,000 $2,100,000 $1,500,000 TBD $6,000,000 TBD $30,000,000 Note: the budget estimates above are very preliminary project estimated costs and based on May 2017 construction costs. Project costs will be refined once a project is approved. Also, project costs will need to be adjusted based on construction cost inflation. FY 2019 General County Projects - Fund 070 (Formerly Fund 142) Purpose of the fund: To provide resources for higher -cost facilities maintenance items and for improving and remodeling County buildings. Revenue comes from an approximately 3 -cent portion of the County's property tax levy and occasional General Fund contributions. As Phase I, BLRB Architects completed a long-term building maintenance needs assessment for the following buildings (enclosed): 1. Adult P&P 2. Annex (DCDC: Deschutes County Downtown Clinic) - Health Services 3. Community Development 4. Courthouse (Gray) 5. Courthouse (Red) 6. Deschutes Services Building 7. Health Services 8. Historical Museum 9. Juvenile 10. Mike Maier Services Building 1 1. Warehouse - Facilities/IT Phase II of the assessments includes the following facilities: 1. Antler Building - Redmond, Health Services 2. Becky Johnson Center (Redmond) 3. Breitenbush House - Health Service 4. OSP/9-1-1 5. OSU/Extension 4-H 6. Programs Building - Adult P&P 7. Recovery Center 8. Road Department 9. South County Services Building 10. Solid Waste - Administrative Building 11. Unger Building - Community Justice 12. Wall Street Services Building - Health Services, DOC, DOC Pharmacy Note: the Phase II list above includes some facilities that are funded by a department fund (such as the Sheriff's Office, Solid Waste, etc.) instead of Fund 142. FY 2019 Fund 070 General County Projects (formerly Fund 142) Capital Maintenance and Remodels Antler Exterior paint $ 25,000.00 Gutters/fascia repair $ 10,000.00 Roof replacement $ 60,000.00 Annex (DCDC) (Roof replacement $ 145,000.00 Siding $ 40,000.00 Deschutes Service Building Paint exterior steel $ 30,000.00 Paint/seal exterior walls $ 75,000.00 Sidewalk improvements (pedestrian safety) $ 50,000.00 HVAC Antler $ 10,000.00 Control upgrades $ 75,000.00 Road air handler $ 75,000.00 Adult P &P roof top units $ 40,000.00 Mike Maier Services Building duct work $ 25,000.00 Mike Maier Services Building roof top units 1$ 30,000.00 Misc. $ 10,000.00 Various Buildings Access control $ 90,000.00 ADA improvements $ 30,000.00 Building envelope maintenance (caulking, gutters, heat tape) $ 232,832.00 Elevator upgrades $ 70,000.00 Energy Trust of Oregon/Strategic Energy Management projects $ 45,000.00 Fire alarm/fire sprinkler major maintenance $ 20,000.00 Flooring $ 100,000.00 Minor remodels $ 30,000.00 Safety improvements $ 60,000.00 Seismic upgrades $ 10,000.00 Sidewalk maintenance/replacement $ 36,500.00 UIC Improvements 1Sediment traps, oil/water separators, drill hole decommissioning $ 50,000.00 Capital Maintenance Subtotal I $ 1,474,332.00 Remodels CDD Lobby 1 $ 30,000.00 Courtroom Remodel and ADA Compliance $ 250,000.00 Mike Maier Services Building 1st Floor 1 $ 15,000.00 Warehouse $ 50,000.00 Remodel Subtotal I $ 345,000.00 Fund 070 Total $ 1,819,332.00 0 U How do we se a.. 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ER Eft ER Eft Eft ER ER ER KNOTT RD: SE 15TH ST TO RICKARD RD KNOTT RD: US 97 TO CHINA HAT RD WARD RD US 20 TO STEVENS RD FRYREAR RD: US 20 TO OR 126 ALFALFA MKT RD: POWELL BUTTE HWY TO MP 4 POWELL BUTTE HWY: COUNTY LINE TO MCGRATH RD YEOMAN RD: OLD DESCHUTES RD TO DESCHUTES MKT RD DESCHUTES MKT RD: HAMEHOOK RD TO YEOMAN RD ALFALFA MKT RD: MP 4 TO DODDS RD ARTERIAL/COLLECTOR ROADS (FY2023 - FY 2028) BEND DISTRICT LOCAL ROADS LA PINE DISTRICT LOCAL ROADS CITY OF LA PINE LOCAL ROADS REDMOND DISTRICT LOCAL ROADS SISTERS DISTRICT LOCAL ROADS 176ZE# 390I88 Oa S31f1H3S30 0l0 170-TLTZ# 3901aa 3AV XOOIIM EO-TLTZ# 3901x8 3M XOOIIM SPRING RIVER RD BRIDGE #17923 REHABILITATION (ODOT LBP/SFLP) (dl3S/dal 1000) 0£OLT# 300188 as 9NI188189 EA EA EA EA EA 0) O O O O b O EA EA EA EA O O O O C O Et EA EA EA p b O O o b p O O b O O $ 00'000`ZTZ $ 00'000`Z6T $ 00'000`0017 SISEMORE BRIDGE #17CO2 REHABILITATION (ODOT LBP/SFLP) $ 00'000`OZZ $ 00'6LZ`9TZ`T HIVd38 NOl1V0Nl03 01753LT# 390Ia8 a0 HV1OS $ 00'000`09T Efl EA EA EA EA O m O 0 N O N 1-1 N O N N O W SIDEWALK RAMP IMPROVEMENTS -CO EA $ 00'000`09T EA S1N31N3AOad W I I IVHGHVf19 $ 00'000`OOT $ 00'000`OOT $ 00'000`00T $ 00'000`00T S1N3W3AOadWI 39VNOIS $ 00'000`00T $ 00'000'OOT O O O O O C O S1N31A13AO8dW1 (Slab) A133VS NOI1V180dSNV81 savoy 11V $ 00'917L`08T EA -o 2 N O N O 0 O 001 N O 0 0 0 W O 0 0 dig IV3A-9 10 -YEAR CIP FY 2019 - 2028 CIP PROPOSAL $61,838,910 $105,492,498 10 -YEAR CIP TOTAL - 9 sc u 6G c16 6HI uU6 8 88 88888 8 88888 atiU4 L:-66 888 88 k898888 : 8888 88882 8888886 8 88888 7„,. -7 --vim--,- — 77.777=--7-777- AAMAAaa e 88888888' 3 Fief §fie 4 UNJj§apeiOM N 88,88..,,8...,,..888 88888888888 .. 88 8688888 8888888888 8E 88 99 88898 '3 86fi8984 88..88...88 8888 8 8888888... 88 88 88 88888 8 8888888 u 88 usr88$8 8 88 8 --A.11 r six liwtO 'Adg a8 ya8u hg8.;81 88� 8888 88'8 aid 8989498 s Aii 888 8888888'8'888'. m 888 8 888889 S 8 98888_8 h§8 n• 41 ?i 8888 888 88 An 48 's” 8 �r8 YJ861 8 8888$ 888 88 881: 88"8888 uigh MOM'8 8949 §8 88 AAA 4;100, `98888 8984 A MAO' 8888....,88, 888 ,.8§ 8 8 848 8888888 8 8 888 8888 88 88'8 8 8888 888 888 8 88888 88 88 8 8 88 v ((� 2 R G b i�L`%gr Y' 9 $y ap § A§§A2AU � � 89 98� § 88994 AA.g..,.8 AAAAAA 8_888 1888888 8 888888 88'8 8 8888888 1:k888 15.88$8,88 8 '8$88 AA 88 88 88888'8 A„ ai sc88888 A V8y8 g8 88 8 lata i 48 8� X88 884 8 98 88 ,.,88.8 8888.8 G At g ..9 88 1:88898 $ '8888 88 888 8888 8 r: 5 8 88 88pp88888. 8§Vi88 88_8888888_888888 rr,,�8:�+b8S 8l$8�ii���1s85IgsgI;;5ytl pg8a"§ §r�r�. 1888898881888888888888888888818888889$88_ dig IV3A-OT 1uJII*Ii :7�»dN�191�►11 0) Z m m A c m z Proposed Budget FY 2011 9 BUDGET COMMITTEE I MAY 31, 2018 C.x`, E S c0 Q CDD v rview udget Themes Accor plishrnents, Challenges & Emerging Business & Financial Trends Budget Highlights Perf.rmance Measures Summary Qu stions ssues CDD Overview 13011-PING:SO trf DIVISION : - Commercial/Residential Plan Review and Inspections ' 91VOicit4 Current Planning Long Range Planning Information Services ENI/IliciN11ilifITAL SOILS' thvIsoN Onsite Program 00/1SfOfiT Permit Technicians Code Enforcement CDD Mission Statement Our m ssion is to facilitate orderly growth and development in the Deschutes County community through coordinated programs of Land Use Planning, Environmental Soils, Building Safety, Code Enforcement, Education and Service to the public. Main Office 117 NW Lafayette Ave. Bend 1 Mon., Tues., Thurs., Fri, 8:00-5:00 1:1 Wed. 9:00-5:00 Redmond City Hall 437 SW 9th St., Suite 202 Tuesday 8:00-4:30 La Pine City Hall 16345 Sixth Street Monday & Thursday 9:00-4:00 Sisters City Hall 520 East Cascade Ave Tuesday & Friday 9:00-4:00 Budget Themes 2013-14 Beginning the Recovery 2014-15 Sustaining the Recovery 2015-16 A New Normal? 2016-17 A New Era financial stability, heightened complexity, strengthened partnerships 2017-18 Efficiency & Sustainability 2018-19 Modest Growth, Complexity & Controversy Accomplishments Snapshot • Improved department operations through: Technology: New accounting, human resources & timekeeping software; increased use of online permitting services; enhanced parcel research capabilities. CDD Lobby Remodel: Improve safety, customer service & efficiency. Hours of operation in Sisters & La Pin.e: Doubled. • 738 iPad Surveys Achieved overall average of 2.92 on scale of 1-3 (1=Poor, 2=Good, 3=Great) • Code Enforcement: Coordinated with the inmate work crew to resolve solid waste cases, created new anonymous marijuana complaint process. • Building Safety: Continued cross training all staff to perform all 4 residential inspections. • Environmental Soils: Coordinated with DEQ to determine South County protective on-site septic systems & Bend to asses sites eligible for onsite wastewater treatment. co� • Planning: Completed marijuana evaluation; processed text amendments - Lot of a' Record, Flood Plain Combining Zone, Wildlife Area Combining Zone Challen es • Maintaining high customer service levels with appropriate staffing levels. Always operating at the margin with staffing resources. Maximum efficiencies, no additional capacity. • Processing complex, controversial, and matters of first impression land use applications and appeals, all with record levels of public involvement. • Processing record levels of code enforcement cases, including increasing levels of frustration from parties on all sides. Lack of a verifiable violation. • Preparing for workforce turnover (Building Safety & Coordinated Services) through succession planning to ensure a continued and consistent level of high quality services. ® Continuously training new staff - requires dedicated "trainers" & 6-18 months for new staff to learn regulatory complexities, and operate independently & efficiently • Addressing community issues within state law = marijuana regulations, affordable housing, �, rsco non resource lands ��? G2 Emerging Issues • Significantly increased empermitting & online services: • Processing e -permits, email inquiries, update website, project updates, customizing software, modernizing hardware & peripherals, improving processes and operations • Dedicating staff resources for digital services = increased efficiencies • Retaining, haring, training qualified staff to meet business demands • Increased walk-in customers in La Pine, steady in Sisters, declining (very few) in Red r and • Maintaining and enhancing a high quality of life with rapid growth, new types of development and industries, and various perspectives on the future of the County • Addressing a growing need for affordable housing • Implementing State Legislative changes (i.e., rural ADUs?) • Coordinating with the Road Dept., ODOT, and cities to improve transp*r>4.atien systems • Reducing natural hazard risks, preparing for disaster resilience \„..,31-s Co Applications Processed Snapshot 1200 1000 800 600 400 200 - 0 1 2010 2011 2012 2013 2014 2015 2016 2017 New Houses by Month 2 05-2018 140 120 100 80 60 40 20 0 (_ 1111,11 1111,111 II 1,111 111.1111 July- May 2018 L 00 W ' � Total Single Family Home Permits 1,200 1,000 800 600 400 200 0 593 717 875 957 663 320 1 166 102 100 127 218 July - May 2018 393 438 308 II 576 516 o'? o0') 000 \ ow 0°)NC) NN �� N'')) \� N<9 \o �� ` cb ,10 o do ,10 o ,10 io o o do do o o o o o oo1 o0)2 oo� o0' o0° ooh o0'6 o0°) o``o o`er o` d`� N< o` ' d`o o`\ ti ti ti ti ti ti ti ti ti ti ti ti ti ti ti ti 2,500 2,000 1,500 Total Building Permits Cb ti July -May 2018 QOM 0, yeti ti 1 ti� 11 10 9 8 7 6 5 4 Revenue in lions) /0.66 FY 1 1 FY 12 FY 11 - 17 Actual FY 13 FY 14 FY 15 FY 16 FY 17 FY 18 FY 18 - Year End Projection FY 19 FY 19 - Proposed Budget 60 55 50 45 40 35 30 25 20 Staffing Levels FY 11 FY12 FY13 FY14 FY15 FY 16 FY17 FY18 FY19 Full Time Equivalents FY 14 FY 15 FY 16 FY 17 FY 18 FY 19 Administration & Coordinated Services 12.00 12.40 12.10 14.85 17.00 18.00 Building Safety Division 9.20 10.25 11.05 13.05 15.00 17.00 Planning Division 7.75 9.25 10.55 13.55 16.00 16.00 Environmental Soils Division 1.05 2.10 2.30 3.55 4.00 5.00 Total Community Development FTE 30.00 34.00 36.00, 45.00 52.00 56.00 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 0 General Fund Supp $1,344,985 5960”48/ 5166,770 $141,078* ,,.....p9,03,,t), -,------.', FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 * Long Range Planning c \ S coo < 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 Reserve Funds $5,661,Zbb $® SO SO 0 4 FY 12 FY 13 FY 14 FY 15 FY 16 FY 17 FY 18 FY 19 Resources • FY 19 Proposed Budget = $10,657,000 (18% increase) • Anticipated permit volume increase -- 8% across all divisions • Proposed Fee Increases - 2% to 9% • General Fund Request - $141,078 for Long Range Planning • CLG Historical Grant $12,500 (continuation from FY 18) Historical site inventory - Sisters Propose Fee increases - Averages Buildine Safety Division: 2.0% (Building Electrical) - Est. $80,736 Environmental Soils Division: 4.5% - Est. $33,714 Code Enforcement: Administrative Fee: 0.221% to 0.23% of building valuation - Est. $51,074 Planning: 9.0% - $99,574 o Advanced planning & free public information fee 0.25% to 0.28% of building valuation - Est, Current Planning $73,872; Long Range: $64,800 New / modified fees: System Development Charge Payment Plan - Admin Fee: $300 Hearings Officer Administrative Fee: $500 Non -Conforming Use Verification: $1,648 Non -Conforming Use Alteration (with prior verification): $1,648 Non -Conforming Use Verification (River/Wetland/Flood Plain): $3,050 Requirements Increases in staffing & associated costs (i,e., equipment, training, in -directs) • Hired 7 new staff in FY 17-18 (4 funded for partial year), fully funded in FY 18-19 • Proposed 4.0 new staff for FY 18-19 to meet business needs ® 1.0 Environmental Health Specialist II • 1.0 Administrative Assistant • 2.0 Building Safety Inspectors III ® Proposed 4 new vehicles • 21 current vehicles fully utilized for Building, ES, CE; 2 vehicles for Planning; 1 Admin/CS o 1 Admin/CS (satellite offices), 1 Environmental Soils (new staff), & 2 for Building (new staff) • Reserve Fund increase $1,380,029 Fund 296 Groundwater Partnership • Estimated Fund Balance - $76,312 • Transfer in From Fund 297 - Newberry Neighborhood $37,500 • Proposed expenditures: • Septic system upgrade rebates: $76,312 • Rebate = $3,750; budgeted an estimated 20 rebates • FY 18 transaction update: • Funded 2 rebate requests - April & May 2018 • Neighborlmpact - Non -Conforming Loan Program • Available: $89,163 - 10 loans outstanding; 3 loans repaid Fund 297 Newberry Neighborhood • Estimated Fund Balance - $102,034 • 4 undeveloped lots remain in Crescent Creek; Pahlisch planning for next phase(s) • Proposed expenditures: • Debt service on La Pine Sewer Bond: $54,937 (balance is $835K) • Transfer to Fund 296 - Groundwater Partnership $37,500 • FY 18 transaction update: • Received $95,052 in April 2018- SDC for Housing Works Apartment Complex Safe Communities • Achieve 85% voluntary compliance in Code Enforcement cases Achieved 5 out of 10 months • Resolve 75% of Code Enforcement cases within 12 months. Achieved 9 out of 10 months Healthy People • Achieve compliance with the ATT operation and maintenance reporting requirements of 95% Achieved • Coordinate with cities regarding growth management. Achieved & ngoing Economic Vitality • Coordinate with the City of Bend to implement the Bend Airport Master Plan. ngoing. • Coordinate with the City of Redmond to entitle a large lot industrial site. Ongoing, Service Delivery • Achieve an average of 6 - 10 inspection stops per inspector, per day. Achieved 6 out of 10 months. • Achieve an average turnaround time on building plan reviews of 8 - 10 days. Not Achieved • Issue new onsite septic system permits within 15 days of receiving completed application. Achieved 9 out of 10 months. • Issue all planning administrative decisions requiring prior notice within 45 days. Achieved 7 out of 10 months, • Issue all planning administrative decisions that do not require notice within 21 days. Achieved 2 out of 10 months `x01[S coG Revenue: Summary FY 19 Proposed 4 udget m $10,6570000 (18% increase) Volume - All Divisions - 8% - est. $508,000 Fees - 2.0% - 9.0% - est, $404,000 General Fund Request - Long Range Planning - $141,078 Expenditure: Requested 4.0 FTE: 1,0 Environmental Health Specialist 11 1.0 Administrative Assistant 2.0 Building Safety Specialist 111 4 vehicles -Administration, Environmental Soils and Building Safety (2) Reserve Fund -increase $1,380,029, total $5,331,210 Thank you `\V E S co G `'. n Health Services County Comparison for Budget Cycle 2019 C >- as kon uro CIS 0 $f - / FIA al \ % \ §§ } } - o \ -§ _ 2 0 ] 0 ) k E \ \ To" \ 7r _ 110 ) -e 2 .0 0:1_ _ _ 0 g LS 0.0 \ \ [ • 76 \\ u° 0 2 »I /\ - 0 § ; @ ( 3 & - 5 z k 3 3< < ) 0 m Q■ ,1 0 0 $ 0 as § \ § ' / § m 4 Ci £ a _ _n _n_ « _n n -1 1 1 1 1 7 Ln . � \ § ]-_VS_n_ n _n n ‘-1 k \](i,2 \ § 2§#$N- 00 \ k\ a a 04 • 01 « _ � 0 7 / 1.6 c6 ¥ & _n_m_ e _m n - 119,159,070 $ ° § § 0 § t § / § / . 04 2//4\03 0 /\ $ E Ln "Cr - 00 m m 04 o o ® c k}� = U c U 0 k ]) 3 ¥ 2 \} Multnomah = E E - i f 03k ■ CC_ m__ 00 m S g e q 3 Q § _ Average (of counties shown) County Health Rankings 2018 2018 County Health Rankings for the 36 Ranked Counties in Oregon 0y 2y / 4t)ci O F4*w` 6- w7. v I 4l w' w5'' 6? OJ atm O� k� OJ <tIt OJ kit a a �m fe County sza 1 County sq' .2°1 County a County ` s Baker 21 22 Douglas 32 26 Lake 29 28 Sherman 16 20 Benton 2 1 Gilliam 26 7 Lane 12 12 Tillamook 18 8 Clackamas 3 3 Grant 6 23 Lincoln 34 29 Umatilla 15 32 Clatsop 23 11 Harney 28 18 Linn 20 19 Union 24 15 Columbia 10 16 Hood River 4 5 Malheur 27 35 Wallowa 17 13 Coos 30 34 Jackson 14 27 Marion 11 17 Wasco 13 14 Crook 25 30 Jefferson 36 36 Morrow 19 21 Washington 1 2 Curry 31 24 Josephine 33 31 Multnomah 8 6 Wheeler 22 25 Deschutes 5 4 Klamath 35 33 Polk 7 9 Yamhill 9 10 ttl Healt! Ra £l ins Road For the latest updates on our Rankings, community support, RWJF Culture of Health Prize communities, and more visit countyhealthrankings.org/news. You can see what we're featuring on our webinar series, what communities are doing to improve health, and how you can get involved! Page 121 countyhealthrankings.org Rank 19-27 Rank 10-18 ,-4 http://www.countyhealthrankings.org/sites/default/files/state/downloads/2018%20Health%20Outcomes%20-%20Oregon.png Population Estimates for Oregon and Counties Certified Certified Population Population Population Percent Estimate July Estimate Change Change 1, 2017 July 1, 2016 2016-17 2016-17 Oregon 4,141,100 4,076,350 64,750 1.6% BAKER 16,750 16,510 240 1.5% BENTON 92,575 91,320 1,255 1.4% CLACKAMAS 413,000 404,980 8,020 2.0% CLATSOP 38,820 38,225 595 1.6% COLUMBIA 51,345 50,795 550 1.1% COOS 63,310 63,190 120 0.2% CROOK 22,105 21,580 525 2.4% CURRY 22,805 22,600 205 0.9% DESCHUTES 182,930 176,635 6,295 3.6% DOUGLAS 111,180 110,395 785 0.7% GILLIAM 1,995 1,980 15 0.8% GRANT 7,415 7,410 5 0.1% HARNEY 7,360 7,320 40 0.5% HOOD RIVER 25,145 24,735 410 1.7% JACKSON 216,900 213,765 3,135 1.5% JEFFERSON 23,190 22,790 400 1.8% JOSEPHINE 85,650 84,675 975 1.2% KLAMATH 67,690 67,410 280 0.4% LAKE 8,120 8,015 105 1.3% LANE 370,600 365,940 4,660 1.3% LINCOLN 47,960 47,735 225 0.5% LINN 124,010 122,315 1,695 1.4% MALHEUR 31,845 31,705 140 0.4% MARION 339,200 333,950 5,250 1.6% MORROW 11,890 11,745 145 1.2% MULTNOMAH 803,000 790,670 12,330 1.6% POLK 81,000 79,730 1,270 1.6% SHERMAN 1,800 1,795 5 0.3% TILLAMOOK 26,175 25,920 255 1.0% UMATILLA 80,500 79,880 620 0.8% UNION 26,900 26,745 155 0.6% WALLOWA 7,195 7,140 55 0.8% WASCO 27,100 26,700 400 1.5% WASHINGTON 595,860 583,595 12,265 2.1% WHEELER 1,480 1,465 15 1.0% YAM H I LL 106,300 104,990 1,310 1.2% Prepared by Charles Rynerson, Population Research Center College of Urban and Public Affairs, Portland State University December 15, 2017 www.pdx.edu/prc Health Department: FY 2019 Proposed Budget FY 2019 Proposed Budget ($M) Other Funds General Funds1 2019 Proposed Budget by Division ($M) Clinical Services Mental Health & Addictions Health Officer & Public Health Business & Director's Office Corrections Health Labels reflect Coun General Fund amounts Service and Operational Trends Corrections Health Costs Cost ($M) $16.0 ail Beds 1,310 Primary Care and Dental Clients (Cal. Yr) $19.6 67,267 1,192 FY 15 FY 16 FY 17 FY 18 FY 19 Mental Health Medicaid Enrollment 131,000 170,000 113,000 FY15 FY16 FY17 FY18 FY19 Department Activities County clinics as primary care provider for 52,315 clients Served 6,129 children with mental health needs Over 10,000 mental health assessments in corrections health Ace, Responded to 5,560 communicable disease reports 7,991 receiving addictions prevention or treatment services 66,327 13 14 15 16 17 Health Inspections2 16,408 12,155 FY 15 FY 16 FY 17 FY 18 FY 19 FY 2019 Reductions or Reallocations • County General Fund reallocated from other divisions to cover increasing Corrections Health costs • Providing OTO General Fund to help transition: • 2 Student Health Centers • Immunization services (increasing Medicaid reimbursements) • Accepting more Multnomah Mental Health Medicaid clients, increasing Behavioral Health Care fund by $13 million Clinic Insurance Rates (% Insured) Dental Clinics Primary Care Clinics 83.8% 82.8% FY 15 FY 16 FY 17 FY 18 FY 19 Department FTE FY 15 FY 16 FY 17 FY 18 FY 19 FY 2019 New OTO o Ongoing Funding • Added one position in Medical Examiner's office • $750,000 OTO General Fund for LEAD jail diversion program • $144,000 OTO General Fund to add 5 needle collection boxes • $175,000 OTO General Fund for Pacific Islander Community Equity Study 1 Clinic Revenues are included in Other Funds. 2 Inspections include facilities such as restaurants, mobile restaurants, hotels/motels, RV parks, camps, pools, water systems, and jails. 3 Icons made by Freepik from www.flaticon.com. Health Department • fy2019 proposed budget Diversity and Equity Budget by Division n • Equity and inclusion is a core part of the Health Department's mission. Our goal is to hire, retain and promote a diverse and talented workforce so that we can better serve diverse communities impacted by health disparities. • This year the department prioritized equity by hiring an Equity and Inclusion Manager. The position will help align equity efforts and create a unified vision. The Equity and Inclusion Manager will implement the equity goals articulated in our 2017-19 Strategic Framework, and leading the effort to implement a departmental Workforce Equity Plan. • Beyond implementing strategic goals, the Equity and Inclusion Manager will also help foster a culture of safety, trust, and belonging. This will be accomplished by creating opportunities for leadership and staff to engage meaningfully. • As our community becomes more diverse we are prioritizing services that are culturally responsive. Numerous projects, grants, and programs across the organization provide culturally specific, community -led services and interventions. Division ame Director's Office Health Officer Public Health Integrated Clinical Services Business Operations & Human Resources Corrections Health Mental Health and Addiction Services Total: Health Department FY 2019 General ether Funds Fund To !Division Total FTE Cost $1,356,306 6,102,983 29,392,325 55,983,069 19, 226,174 19,590,664 20.207.555 $0 $1,356,306 5.00 2,316,986 8,419,969 37.50 29,891,417 59,283,742 300.43 60,041,310 116,024,379 608.98 0 19,226,174 0 19,590,664 89.482.854 109.690.409 101.85 108.75 263.59 151,859,076 $181,732,567 $333,591,643 1,426.10 1 www.muitco.us/budget • Health Department 4 OAR 333-014-0560 Describes the activities that Oregon law specifically requires a LPHA to perform: 1. Accepting reports of communicable diseases, outbreaks or epidemics and investigating communicable disease, outbreaks, or epidemics 2. Issuing or petitioning for isolation and quarantine orders 3. Review of immunization records and issuing exclusion orders 4. Making immunizations available 5. Ensuring access to family planning and birth control services 6. Duties and activities related to enforcing the Indoor Clean Air Act, if delegated 7. Licensure of tourist accommodations, including hostels, picnic parks, recreation parks and organizational camps, if delegated 8. Licensure of pools and spas, if delegated 9. Restaurant licensure, including commissaries, mobile units, vending machines and bed and breakfasts, if delegated 10. Regulation of public water systems, if delegated 11. Enforcement of public health laws under ORS 431.150 12. The duties specified in ORS 431.413 (PH Modernization foundational programs and capabilities) Monitor Sexually Transmitted Diseases Deschutes County Sexually Transmitted Diseases (STD) are increasing in Deschutes County. » In 2017, 751 STD cases (people who test positive for chlamydia, gonorrhea, or syphilis) were reported to us compared to 546 cases in 2013, which is a 37.5% increase in five years. Adolescents and young adults (15-24 year-olds) have the highest infection rates of STDs. Each STD case requires extensive case investigation and partner notification and treatment. Deschutes County chlamydia case counts, ORPHEUS, 2013-2017. Chlamydia cases peaked in 2017 with 675 cases. Deschutes County gonorrhea case counts, ORPHEUS, 2013-2017. Gonorrhea cases peaked in 2016 and 2017 with 65 cases. Deschutes County syphilis case counts, ORPHEUS, 2013-2017. Syphilis cases peaked in 2017 with 11 cases. Why are STDs increasing in Deschutes County? » » » 800 700 600 530 15 500 ° 400 E300 200 100 0 Number of Cases 70 60 50 40 30 20 10 Number of cases 0 12 10 8 6 4 2 0 554 496 538 675 2013 2014 2015 2016 2017 12 2013 50 29 65 65 2014 2015 2016 2017 11 10 2013 2014 2015 2016 2017 Decreased condom use for a variety of reasons. Dating apps. Sex is more readily available and more anonymous. This has made the local public health job of partner notification and treatment more difficult. Improved case detection through increased testing by health care providers. Decreased funding and resources for STD services. Last year, the State STD program transitioned disease investigations for syphilis and complicated gonorrhea cases to local health departments without any additional funding or staffing. How has this increase in STDs affected our capacity to respond As STD cases increase, our ability to complete an investigation within seven days (OHA standard) has decreased. Staffing levels have remained stagnant for many years as cases have continued to increase. Cases and partner notification have become more complex over time. Longer investigations increase the potential for further disease spread and outbreaks as well as possible complications from disease (e.g., intertitity, congenital syphilis). Our local health care providers rely on public health to conduct partner notification and ensure partners are being tested and treated. Deschutes County chlamydia case completion time, ORPHEUS, 2012-2017. In 2017, 48% of chlamydia cases were complete within 7 days. 6% of chlamydia cases took >31 days to complete. Deschutes County gonorrhea case completion time, ORPHEUS, 2012-2017. In 2017, 31% of gonorrhea cases were complete within 7 days. 30% of gonorrhea cases took >31 days to complete. Deschutes County syphilis case completion time, ORPHEUS, 2012-2017. In 2017, only 18% of syphilis cases were complete within 7 days. 45% of syphilis cases took >31 days to complete. 100 CO • 80 r 60 E40 20 c 450 • 0 621 80.6 554 76.2 2012 2013 2014 2015 2016 2017 700 600 S 500 0 400 m 300 :.8 200 100 _E v 0 —*—Percent of reports complete within 7 days Number of cases 80 a 60 CU u 40 Q 8 20 2 0 a) v 71.4 66.7 80 65 65 2012 2013 2014 2015 2016 2017 0 —*—Percent of reports complete within 7 days Number of cases > 60 50 50 43 50 II • 40 a 33 30 28.6 d 30 E 20 18.2 0O 10 2 4 6 10 5 11 tiju 0 n_ 2012 2013 2014 2015 2016 2017 80 60 40 20 0 —.—Percent of reports complete within 7 days Number of cases 0 4 4 fil m 0 a CO Iu E 1.1 0 0 0 .0 03 03 fo cm 14 47. 03 C/3 CD N •® Q • 2 norC Ta V! u • NM tlIII= 64.11 014) INJ 173 414= Sou W r73 4.0 W U Schedule: 2 Days/week in Redmond only Schedule: 4 Days/week in both Redmond and Bend Staffing: 3.0 FTE Staffing: 8.0 FTE Client Visits: -600 client encounters (projected) Client Visits: 3,964 client encounters Cost: $417K # of Clients: 2,190 (unduplicated) c v m -0 rcsc c 0 0 ce 0 0 c cu CU w M 0 m � w - tO c .c ea Vf VV) Cost: $1.47M N 0) 0 R3 N cia 4-P E 0 co •.r? •L'a "f • ri E •- i i E 0 4a)cc. c CI • •c vv) 0 • ° f c En a sa C v7 , .a a Services: Well Women, Family Planning, STD testing & treatment, Colposcopy Client Visits: -3,000 client encounters (projected) Cost: $717Kwith an est. additional $300K in revenue Ask: Reinstate 2.0 FTE of the staff cut from Clinic V) V) V .0 V c N E CU oE ao c bA 0 • eL 0 U • 0 -a v V • E N in O N .j O N N U N 0 0 N cc c z Cal p. E 0_ k o DCHS Prevention Program The major causes of illness and death in the United States have shifted dramatically to chronic disease. Chronic diseases account for 75% of US health care spending, or $1.5 trillion annually.' For every $1 invested in Prevention Programming, there is a return of $5.60 in health care savings." Population - based prevention has a large role in improving the public's health and well-being. Prevention saves money. Prevention ensures effective solutions. Prevention leverages community resources. Prevention creates sustainable solutions. Prevention engages kids in the work. F "Deschutes County Prevention makes good things happen. They are a trusted partner and supporter of community outreach, training and program development." "Prevention has given my organization access to community experts and guidance on best practice for suicide response and prevention." "Prevention has been key in coordinating area groups to reduce teen tobacco use." "I oversee many programs at the district. I have to say that all of the supports that we have received from the prevention team are value added to all programming in the school district." "As one who lives with chronic health conditions, I have learned simple ways to make changes in my life. I have found the tools I learned in the workshop have helped me remain active and avoid pain medications. I am able to fully participate in activities with my family, friends and my community." Wu S, Green A. Projection of Chronic Illness Prevalence and Cost Inflation. RAND Corporation, October 2000. Also, Centers for Disease Control and Prevention. Chronic Disease Overview page. Available at: http://www.cdc.gov/nccdphp/overview.htm. Also, Centers for Medicare and Medicaid services. Historical Overview of National Health Expenditures. "Prevention for a Healthier America—Investments in Disease Prevention Report Fiscal Year 2019 Promoting & Protecting the Health ,c,� of Deschutes County Budget Committee Presentation May 31, 2018 Day 2', LPHA Statutory Requirements OAR 333-014.0550 1) Communicable Disease (CD): Reportable diseases, outbreaks or epidemics 2) Isolation and quarantine orders 3) Review immunization records and issuing exclusion orders 4) Ensure access to immunizations 5) Ensure access to family planning (reproductive health=RH) and birth control service! 6) Enforce Indoor Clean Air Act (OHA delegation) 7-9) Environmental Health: Licensure & Inspections 7) Tourist accommodations, parks, hostels, camps 8) Pools and Spas 9) Restaurants, mobile food units, vending machines, 8&8 10) Regulation of public water systems, if delegated 11) Enforcement of public health laws 12) Duties specified in ORS 431.413 (Public Health Modernization) What is "LPHA"? i (Designated) Local Public Health Authority (LPHA) Countygovernment - OAR333-014-0530 2) Local Public Health Agency (LPHA) , Deschutes County Health Services -- Public Health Division .7Local Public Health Administrator (LPHA) Dr. George Conway- OAR333-014-0530 5/31/2018 Day 2: Public Health Focus Topics Programs being reduced and/or impacted by budget decisions: Communicable Disease and STDs Clinical Services - Reproductive Health (-4.7 FTE) Good news, ask isn't$ PH Reserves ($288K) WIC (1.0 FIE) Nurse Family Support Services - No change Prevention - Grant funded programs Environmental Health - Why not self-sustaining All in 30 minutes Public Health Role & State Mandates #1 & #2 = LPHAs have statutory responsibility to receive, respond to & investigate reportable diseases, disease outbreaks, or epidemics (OAR 333-014-0550) All Oregon health care providers and laboratories are required by law to report certain diseases and conditions to local health departments (OAR 333-18-0000) What are the Reportable Diseases? "Exhibit B" Must report w/in 1 day or immediately (24/7 CD on-call) 1 Public Health's Unique Role in Health Care UXiMiii444VM CD -Epi Health Care Program Provider a:2111 1/-1 STDs on Rise in Deschutes County (#1) 37.5% increase in STD cases in the past five years 30% of Chlamydia and Gonorrhea cases were teens (2017) 82% were 29 years or younger (2017) Each STD case requires extensive case investigation, partner notification, testing and treatment ....pictures worth a thousand words SYPHILIS 0.2..ese.c.11,5,01413case,...00416.1.32008...3017 5/31/2018 Gonorrhea Geoperhinscala....01041.115.0.2C47. Chlamydia (HaltrUg 5.0,01.F131.4.17. 2 Chlamydia Incidence rate per 100,000 population by age group, OPHAT, 2011-2015 Why the Increase in STDs? Dating apps - sex is more anonymous. Harder to do partner notification and treatment in order to stop the spread of disease • Increase in unprotected sex - false sense of security Increase in population = increased need but no new funds 5/31/2018 STDs: Long Term Concerns Drug resistance to the one remaining recommended gonorrhea treatment option An increase in syphilis has resulted in an increase in congenital syphilis nationally and in Oregon Serious health consequences include infertility, ectopic pregnancy, mother to child transmission, stillbirth, and increased risk for HIV Can't keep up (H.O.) - increase in numbers of STDs outpacing growth in staffing (.50 FTE, no increase in >10 years) 3:�'-���-`xn'w�1i•.�:`.38'�.,.,5<,»r!.,.,.�:�..:.�;�;':(:^,.t�. v':�'i`iiih;.v��°' "z.���:,.:�'="��s,4;��s.". ,`�'.R'�.`.".J-,:..,..,...�., Local Health Response What PH is doing to address this PH crisis? New Structure (implemented March 2018) Centralized "like programs" and able to cross -train staff Shifted FTE & resources for more capacity to do STD investigations, partner follow-up, testing and treatment Increased STD staff time from .50 FTE to 1.0 FTE - no new FTE Not enough...have done what we can with what we have ivn Cwtlior Lai f(;,, p1000111 ri. u l l i .arid, ,i li,r<I1 for C U/ ti l IJ Invc::n;;au ;m i prior!tvatwn of '.1^: (loin Uunral 0,•101(10 Rn Cu 3, S?) Wol 0, RioPrctuni of 01.1'1 Il our -u r �� ,. r nr'Ir•��•rlur':rni a' 60 "r iljli �,�n:r,�wm,�nlr 3 Communicable Disease Changes Current Structure (FY18) - $1.3M 8.0 FTE , 8 Programs for all of County and some are for region (CD, STD/HIV, IMM, TB, RW, NEX, EP, HIO, EPI) Red = regional program As proposed and submitted (FY19)- $1.7M 9.15 FTE is not "new" FTE 1.14 FTE from Clinical Services Merged programs and staff - staff came with existing responsibilities Did increase FTE for STD Investigations - helps Misleading because merging of programs hides loss of 1.7 FTE in CD Increasing CD Resources While new grants help address an emerging PH need, limited: Regional grants with limitations on how funding is used Funding not just for for Deschutes County Limited target population (but still addresses a need) Funds are for prevention & El, not investigation Limited duration, "soft -fund" grants Why does investment in STD investigation matter? What does it take to do a disease/STD investigation? It depends ":«wFb>::+'.a'.i044Ir7e'o:Co,:.".+i:�"ro...,..i,,,r.' s;"ri'a7<_?aa aa7sS:,Y, ..:., How much time does it take... ...to do STD Investigations? It depends In 2017, based on # of cases, est. average of 3,638 hours for all STD investigations or - 69 hours/week Need -1.6 FTE With new structure, now have 1.0 FTE for STD investigation =.60 FTE short 5/31/2018 Increasing CD Resources Awarded two new grants to address: $500K Grant: To address disease outbreaks in long term care facilities & child care centers with vulnerable populations $330K Grant: Prevention & early intervention for individuals at high-risk of HIV and STD CD & STD investigation Road Map SIO Imeatgsbon process: Chlamy8n. Ga., rhea Syph.5 .Iev Capacity Realities • Inadequate FTE for STD investigations • FY 2019 = 1.70 FTE cut from CD • Can't bill for STD or CD investigations - #1 Increase in CDs & STDs = Increased staff time needed • Increasing rate of STDs outpacing amount receive from state y Currently covers .50 FTE (20 hours/week) for STD Investigation 4 5/31/2018 Option B: CD = Public Safety Issue Option : Benefit to community Need in both CD & STD: .60 FTE for STD Investigation .1.10FTE inCD Policy Option B Request "ask" — not all, but retain some: CGF to support for STD & to reduce cuts to CD (not expand) First time in > 10 years Soecifically: 1.10 FTE Cost ($131.300) .60 FTE PH Nurse ($95,550) .50 FTE Bilingual Tech ($35,750) Improved PH safety through: More effective & timely response to STDs Prevention of further spread and outbreaks Better customer service to our clients nate, �1II' r- 1. 3UU Iw (SL ts+ continue 3cnd-a3c � ,.,r+;�n" (ni``:'+ l4:il� i!;rre4COfi )III iY S) Oux.,31 a:mnties d: unify R>dmnnd foil days/hueek, Ly;ncn uaaiwn of lel 21+ to Commune U+, a,e. ailed Reproductive Health Clinical Services Reproductive Health Clinic Changes Statutory Requirements #5 & #12 Well Women check-ups and exams Family Planning and birth control - STD testing and treatment Special procedures (i.e. Colposcopy) New State level RH Program Structure as of 1 April 2018 - HB 3391: RH Equity Act -"No wrong door" New funding and billing structure for the provision of RH clinical services Medical Services Agreements (contracts) administered by OHA now available to other providers 5 DCHS Reproductive Health Clinical Services Current and Future Clinic Scenarios (Updated 5-24.18) hedule aoay..e.+m ba,hae•Inaandand Pend scaenoa: 4ofit ro tot na .mdnenc.:z wCost sched,I.:x 1layneek a.dmopd any s<amna= 10 rre NtedWeal8aw %earmena hrmreamuown,�yvl,n a om g Cast .1a ule.3 Drzt.xk Ino ->,n Pedmond aid Pend Staffing:sone Services W Iwomen.ramNPlan SSiOwnng° rea,menr, p, py M P.511,e,n., azoeraolme>,axr„r >o nn,n,c Option B - Benefit to the Community w�..,,.,e.r.a.,o,.,.�:-...v._�.>..�.y.,,>.::a<..s..e.�.,..�..,n-�,..:x...��.�„�:a�..�.•a1�.,. �,.,.ur., Assures equitable access to preventive services for most vulnerable citizens (40,#12) Access to services in both Redmond & Bend Co -located with other services Promotes and protects the health of our citizens Saves tax payers money by preventing more costly health care when disease is not detected and progresses we pay now or we pay more later cs,>.a+.e•;...>e),,c�.;N,.s2.;'ii,,x"ettEr,,,YL'sr';aiArAZ'«rd.xx, °.. Public Health "Emergency” Reserves Option C - As submitted - Cut all PH Reserves ($288K) Have been spending down over past ten years, in FY2019 it is completely wiped out - see "Exhibit A' PH reserves intended Or PH. emergency er,potentigi catastrophic. event (disease outbreak, fire, Cascadia, emerging health threat) No reserve funds for "surge capacity" in an emergency Recent examples There are no traditional reserve funds for other unforeseen PH nee 5/31/2018 "Option B" - Reproductive Health Clinic Current Model (FY18) -• $1.47M - 4 days/week in both Bend & Redmond 8.0 FTE (2100 unduplicated clients served, 3,964 client encounters) Budget as Submitted (Option C) - S4171(- Additional Layoffs (2.0 FTE) 2 days/week in Redmond only 3.0 FTE (-600 client encounters & includes "Navigator" position) "Option B" Recommended Model - $717K w/est. $3001( additional revenue: 3 days/ week in both Bend & Redmond • 5.0 FTE (-3,000 client encounters) • Requires Adding back 2.0 FTE for RH clinic (no increase to funds) 4sA)4n*.n.>:::., 4,,:..4,4VignM4a.:;tdV-.,dara.»a"s-: Public Health Reserves Option 8 - Restore PH Reserves ($288K) Benefits • Will have resources needed to be able to respond more quickly and effectively to public health emergencies • To better align with financial best practices, need to have some reserves for other unforeseen expenses 6 WIC Program Option C - Cut 1.0 FTE (RD & Admin. Tech.) - Layoff impact on the Community - barriers to accessing services • Dietitians see some lower risk clients when serving high risk • Families with multiple family members may have multiple appointments in a month (transportation, absenteeism at work, etc.) Option B - Cost to add back • New information: $23,983 increase in FY18 WIC state grant • Need $88,000 to keep position ($88K - $23,983 = $64,017 actual need) c ,nlci!uonal ci ian ;e pr;�.eliv�cl ,idcltuun.t; No .tciciu¢n i,+l c_i salt 5/31/2018 N ct U01-1,11 rit,t tt,,: I)I:•;et,ted Add Lack 1.01 IG In pro yt at Hina Ur stat( Int_Iwles tetnoval of !.0 i1 -!n In ogtanvnant ti47fa (currently i!Iled) fuultet reduruon 0) progranunaiic staff of 05(1 FTI. Nurse Family Support Services Distinct Clients & Visits by Month 7 Environmental Health Why not self-sustaining? Not everything we do is paid for... • What we respond to without direct funding: • Lead, mold, blue green algae, animal bites foodborne and waterborne outbreaks (i.e., E. coli, swimmers' itch, norovirus) • Air quality - Summer of 2017 fires a- Solar Eclipse - Summer of 2017 FDA Voluntary National Retail Food Regulatory Program Standard: "a staffing level of one FTE devoted to every 280-320 inspections" Health Services staff currently perform 583 inspections per FTE 5/31/2018 Add hack 1.3 11111-. School 13,1sed 11343 Center 1,13 c1,13v...• p,000r03,1 Inc -ludo; roinovol of 1.0 EH in School flx,c.ci I loalLh Centel s 111i01,c, reduc.uon 01 1.0 11 f[1. iii Prevonl.lon :.,,,,,,Lvvx:v..mkoptwo(eaSa..a.t.AWAee,LIMVAWPWAS. GonotAl 3ind Stthsidy co 0,AA mcoor,e,1 tIV3s=11,101a0,41,-0,141,..1415.1'&4V11k4141.11,11a1M11,141M1*;11,a-V1X011.1A.11q1:liVX,101.441,ne,,,„.,..,A.An:P. Policy Questions 1) What level of service should EH provide and/or what is county willing to support? 2) What level of CGF support should be provided for Deschutes County Environmental Health Services? 3) Collecting data on fees for BoCC to compare our rates with other OR counties and to provide recommendations for fee structure. Is this something Budget Committee wants to discuss today or bring to BoC work sessiorir• 8 Environmental Health Licenses Total Licensed Facilities by Year 2013 2014 3015 2016 2012 2018 0636pool/ 1054 1092 1138 1166 1192 1242 lorigrns Temporary 431 035 .6 001 405 400 restaurants Childcare s4 63 66 73 e1 75 factlares PurrkW.. 33 34 29 33 33 33 Systems total 1632 168] 1739 1133 I]]] 1810 Food/Pool/Lodging Licenses by Year Year 4610,0,es Change by Year 2013 1054 ----- 2014 1092 +3.6% 2015 1138 +4.294 2016 1166 +2.5% 2017 1197 +2391 2018 1242 +3.896 pnnecte4 Total Increase. 11.8% 5/31/2018 What isn't in FY2019 PH Budget • CD Nurse & FTE bi-lingual Tech = 1.10 FTE ($131,300) Reproductive Health Clinic = 2.0 FTE (off set by new revenue) Emergency Response Reserves = $288,000 (one time ask) • WIC Clinic= 1.0 FTE ($64,017 - partial off set by new revenue) Total Ask Option 8= 483,317 (doesn't cover all of what was lost) Environmental Health Fees • Proposing variable fee increases based on comparisons of small, medium and large county rates for the following: Full Service Restaurants . Mobile Units Traveler's accommodations Recreational Parks (RV) Pools • All other Environmental Health Fees, 3% • This will generate $58K in additional revenue to help sustain Environmental Health staffing and education 9 Food Service Licenses Add{tlonal Revenue: 418,161 County 015 see. (0%) 16-502.1ts (394) 511501.0.15%) 151 and over (6%) Benton. 702 800 89/ 1092 Curry 750 850 950 950+6.15/seat - -- - 924 .-. 964 880 815 827 797 598 09ich)0 o(P1009 6d) Com• Deschutes lances.) Multnomah* Jackson Washington' Marion' /6¢ 675 826 684 742 615 730 645 738 671 732 464 524 •Will be raising fees in FY 2019, data In table,0 current FY 20181¢8. Traveler's Accommodations Licenses 840RInnel Revenue: $11,713 1-25 units 2650units County (3%1 (30%) Curry 419.496 586 Marion' 230-250 314 Multnomah. 330 335 Descfi iests/n00.3.1 Jackson 227 25f1 Washington' 211 211 Coos• 173-294 339 Benton. 371-390 449 Deschutes(curtent) 212 212 `Will he raising/nes in Fy 2019, date in table is current FY 2018 fee. 1035 986 975 935 916 664 5170 amts 76-100 umts (70%) 9100%) 101+ units 664 836 836+7.15/unit 453 527 696 405 430 450+1/unit 3611 .424 ,t.',124'..:3/40h 273 296 320+1,80/amt 279 357 035+21amt 394 438 438+1.25/unit 507 546 546+4/unit 212 212 212 Pool Licenses Addl6onai Revenue: $8,082 County 1st ono)15%1 Multnomah• 740 Cutty 683 Benton' 683 O0*3/01es4PtgJM0 Washington• Deschutes (61/11801) Cnnf• Mason Marlon. 393 250 'Wdi be raislagf0+. in FY2019, data in table iscwrent FY 2018 tee. 469 599 481 461 2nd pool (8%1 add l swots (12%) 740 260 426 519 373 360 281 373 426 519 373 247 281 373 250 Mobile Unit Licenses Addltlonek Revenue:$ 12,054 County Multnomah' 480 480 480 480 W10073490+' 544 544 599 656 Jackson 406 406 049 049 Curr1 378 378 378 peaiD01er,I0/0700449 Benton+ 293 293 Coos' 250 254 Deschutes (current) 228 254 318 Marron. 219 219 219 'Will he raising lees in 90 2019, data in table is current FY 2018 fee. 5/31/2018 Commissary Warehouse Ctass1(1396) Class/1(15V Class III (15%) Class1Y920%) (6%1 (69:) 372 406 366 219 455 589 344 400 399 473 293 129 212 148 Recreational Park (RV) Licenses 6200,0ai Revenue: 93,412 1-25 units 26-50 units 5175 units 76-100amts COuaty {5%) (15%) (20%) (30%) 108+amts Multnomah. 650 665 675 690 700.1/umt 97a3,00• 230,250 314 453 627 696 Curry 419496 586 664 036 836+ 7.15/unit Wasbmgton• 418 539 696 -- --- - 04sthut4s(p71(i5F4d)j -:.,. - ; 01. al( 494 Semon. 371.390 449 507 Coos• 324,348 989 431 Jackson 550 551 504 De:mutls(curren) 287 382 412 ^Wdl be rmsingfees m FY 2019, data in table iscutreot two,/ 2018fee. 546 467 587 462 546+5/unit 509+ 1 35/unit 616+1.80/unit 462+1/004 ;. .<,2 W:,.. , aya. ...... 94•' - 6^ ,6fe.16.ilus . f,•-;62.6s,,1:M682_.."`.`-<.:n"6.+f,_\ 10 PUBLIC HEALTH Positions Filled Open otions Prevention Ps Filled Open Environmental Health Positions Filled Open Clinical Services & Youth Sexual Health Positions Filled Open Communicable Disease (& HIV) Positions Filled Open Women, Infants & Children (WIC) Positions Filled Open Nurse Support Services (& PCC) Positions Filled Open Public Health Administration Positions (& Vital Records) Filled Open BEHAVIORAL HEALTH Positions Filled Open Intensive Adult Services Positions Filled Open Crisis Services Positions Filled Open Outpatient Services (& Hubs) Positions Filled Open Intensive Youth Services Positions Filled Open Intellectual & Developmental Disabilities Positions Filled Open Behavioral Health Administration Positions Filled Open Medical Services Positions Filled Open ADMINISTRATIVE SERVICES -Positions Riled Open Administration Positions Filled Open System Performance Positions Filled Open Operations Positions Filled Open Fiscal Services Positions Jul -17 Aug -17 Sep -17 Oct -17 Nov -17 63.30. = 63.30 59.60 59.60. 3.70 =. 3.70 11.00 11.00 11.00 10.00 0.00 1.00 9.00 9.00 8.00 9.00 1.00 0.00 10.60 10.60 10.00 10.00 0.60 0.60 4.65 4.65 4.65 4.65 0.00 0.00 10.30 10.30 10.30 10.30 0.00 0.00 10.75 10.75 10.65 10.65 0.10 0.10 7.00 7.00 5.00 5.00 2.00 2.00 189.05 189.05 155.95 161.45 32.10 26.60 35.70 35.70 31.60 31.60 4.10 4.10 16.00 16.00 9.00 10.00 6.00 5.00 67.50 67.50 56.00 59.00 11.50 8.50 19.50 19.50 18.50 18.00 1.00 1.50 25.35 25.35 23.35 24.35 2.00 1.00 8.00 8.00 8.00 8.00 0.00 0.00 17.00 17.00 9.50 10.50 7.50 6.50 50.70 50.70 34.001 36.00 3.70 1.70 3.00 3.00 2.00 3.00 1.00 0.00 13.00 13.00 0.00 0.00 0.00 0.00 24.70 24.70 23.00 1 23.00 1.70 1.70 5.00 1 5.00 63.30 1 63.30 J 63.30 61.60 62.20 62.20 1.70 1.10 1.10 11.00 11.00 10.00 10.00 1.00 1.00 9.00 9.00 9.00 9.00 0.00 0.00 10.60 10.60 10.60 10.60 0.00 0.00 4.65 4.65 4.65 4.65 0.00 0.00 10.30 10.30 9.70 10.30 0.60 0.00 10.75 1 10.75 10.65 1 10.65 0.10 1 0.10 7.00 1 7.00 7.00 7.00 0.00 0.00 191.05 1191.05 163.35 172.35 26.70 17.70 35.70 35.70 32.70 3.00 16.00 10.00 5.00 67.50 59.00 8.50 19.50 18.00 1.50 27.35 24.35 3.00 8.00 8.00 0.00 17.00 11.30 5.70 50.70 36.00 1.70 3.00 3.00 0.00 13.00 0.00 0.00 24.70 23.00 1.70 5.00 35.70 0.00 16.00 11.00 4.00 67.50 62.00 5.50 19.50 18.00 1.50 27.35 25.35 2.00 8.00 8.00 0.00 17.00 12.30 4.70 50.70 34.50 3.20 3.00 3.00 0.00 13.00 0.00 0.00 24.70 21.50 3.20 5.00 11.00 10.00 1.00 9.00 9.00 0.00 10.60 10.60 0.00 4.65 4.65 0.00 10.30 10.30 0.00 10.75 10.65 0.10 7.00 7.00 0.00 191.05 171.85 18.20 35.70 35.70 0.00 16.00 11.00 4.00 67.50 63.00 4.50 19.50 16.00 3.50 27.35 25.85 1.50 8.00 8.00 0.00 17.00 12.30 4.70 50.70 37.50 0.20 3.00 3.00 0.00 13.00 0.00 0.00 24.70 24.50 0.20 5.00 Dec -17 Jan -18 Feb -18 Mar -18 Apr -18 63.30 66.70 66.70 69.70 69.70 61.20 61.10 61.10 64.00 63.60 2.10 I 5.60 5.60 5.70 6.10 11.00 11.00 11.00 11.00 11.00 9.00 1 9.00 9.00 8.00 8.00 2.00 2.00 2.00 3.00 3.00 9.00 9.00 9.00 9.00 9.00 9.00 9.00 9.00 9.00 9.00 0.00 0.00 0.00 0.00 0.00 10.60 10.40 10.40 6.80 7.20 10.60 10.40 10.40 6.20 6.20 0.00 0.00 0.00 0.60 1.00 4.65 8.25 8.25 11.85 11.45 4.65 4.65 4.65 9.75 9.35 0.00 3.60 3.60 2.10 2.10 10.30 10.30 10.30 10.30 10.30 10.30 10.30 10.30 10.30 10.30 0.00 0.00 0.00 0.00 0.00 10.75 10.75 10.75 10.75 10.75 10.65 10.75 10.75 10.75 10.75 0.10 0.00 0.00 0.00 0.00 7.00 7.00 7.00 10.00 10.00 7.00 7.00 7.00 10.00 10.00 0.00 0.00 0.00 0.00 0.00 191.05 191.05 191.05 191.05 191.05 173.85 170.35 169.85 169.85 169.85 16.20 20.70 21.20 21.20 21.20 35.70 35.70 35.70 35.70 35.70 35.70 33.70 32.70 32.70 31.70 0.00 2.00 3.00 3.00 4.00 16.00 16.00 16.00 16.00 16.00 11.00 10.00 10.00 10.00 12.00 4.00 6.00 1 6.00 6.00 4.00 67.50 67.50 1 67.50 67.50 67.50 65.00 64.50 1 65.00 64.00 65.00 2.50 3.00 1 2.50 3.50 2.50 19.50 19.50 1 19.50 19.50 19.50 16.00 17.00 17.00 18.00 18.00 3.50 2.50 2.50 1.50 1.50 27.35 27.35 27.35 27.35 1 27.35 25.85 24.85 24.85 24.85 23.85 1.50 2.50 2.50 2.50 3.50 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 0.00 0.00 0.00 0.00 0.00 17.00 17.00 17.00 17.00 17.00 12.30 12.30 12.30 12.30 11.30 4.70 4.70 4.70 4.70 5.70 50.70 s 51.70 51.70 48.70 48.70 36.50 35.50 35.50 32.50 32.50 1.20 3.20 3.20 3.20 3.20 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 0.00 0.00 0.00 0.00 0.00 13.00 13.00 13.00 13.00 13.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 24.70 24.70 24.70 24.70 24.70 23.50 22.50 22.50 1 22.50 22.50 1.20 2.20 2.20 1 2.20 2.20 5.00 5.00 5.00 1 5.00 5.00 Director's Office Filled 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 Open 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Positions 5.00 5.00 5.00 5.00 5.00 5.00 6.00 6.00 3.00 3.00 Filled 4.00 5.00 5,00 5.00 5.00 5.00 5.00 5.00 2.00 2.00 Open 1.00 0.00 0.00 0.00 0.00 0.00 1.00 1,00 1.00 . 1.00 Positions 303.05 303.05 305.05 305.05 305.05 305.05 309.45 309.45 309.45 309.45 Filled 249.55 257.05 260.95 269.05 271.55 271.55 266.95 266.45 266.35 265.95 Open 39.50 32.00 30.10 22.00 19.50 19.50 29.50 30.00 30.10 30.50 Public Health Nurse II Behavioral Health Specialist II Behavioral Health Specialist! Psychiatrist Nurse Practitioner Patient Account Specialist 11 (CCBHC) Behavioral Health Specialist II 107 Behavioral Health Specialist 11 108 Peer Support Specialist (CCBHC) 15 Psychiatrist (CCBHC) 4 Psychiatrist (CCBHC) 5 Psychiatrist (CCBHC) 6 Public Health Nurse II (CCBHC) 10 -BI- Peer Support Specialist (CCBHC) 13 Administrative Support Technician (CCB 17 Peer Support Specialist 6 Management Analyst 'Behavioral Health Specialist II 17 Behavioral Health Specialist II 45 Developmental Disabilities Specialist 1 15 Peer Support Specialist 2 -BH Peer Support Specialist (CCBHC) 14 Public Health Nurse II (CCBHC) 9 -BH Division 7 -PH Public Health 16 Behavioral Health 5 Behavioral Health 3 Behavioral Health 2 -PH Public Health Program iealthy People & Familie Crisis Outpatient Medical Team iealthy People & Familie 3 administrative Service Operations Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Public Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Behavioral Health Administrative Support Technician 18 -PI Public Health Administrative Supervisor 4 -PH Public Health Behavioral Health Program Manager 6 Behavioral Health Behavioral Health Program Manager 7 Behavioral Health Behavioral Health Specialist! (CCBHC) 43 Behavioral Health Behavioral Health Specialist II 32 Behavioral Health Behavioral Health Specialist II 3 -BH Behavioral Health Behavioral Health Specialist II (CCBHC) 106 Behavioral Health Peer Support Specialist (CCBHC) 12 Behavioral Health Psychiatrist I 1 Behavioral Health Administrative Support Technician (CCB 9 Peer Support Specialist Behavioral Health Specialist 1 (CCBHC) Behavioral Health Specialist II Behavioral Health Specialist II Behavioral Health Specialist 111 Environmental Health Specialist II Community Health Specialist II Community Health Specialist II Human Resources Analyst Public Health Nurse I 1 Secretary Behavioral Health Specialist II Community Health Specialist II Administrative Support Technician 8 Behavioral Health Specialist II Psychiatrist 2 1 Behavioral Health WIC Certifier 2 Public Health Administrative Support Technician Behavioral Health Behavioral Health Specialist II 99 Supervisor, Behavioral Health 2 Behavioral Health Specialist II 9 Supervisor, Behavioral Health 4 Supervisor, Behavioral Health Supervisor, Behavioral Health Developmental Disabilities Specialist II Administrative Support Technician Behavioral Health Program Supervisor Behavioral Health Program Supervisor Behavioral Health Specialist 11 Administrative Support Technician Developmental Disabilities Specialist! Administrative Support Technician Behavioral Health Specialist II 102 Behavioral Health Crisis 'Developmental Disabilities Specialist! I 8 Behavioral Health evelopmental Disabilitie 'Behavioral Health Specialist I 2 Behavioral Health I Intensive Youth Services 1 Program Development Specialist 1 Behavioral Health 1lntensive Youth Services Behavioral Health Specialist 111 1 9 Behavioral Health !Intensive Youth Services Behavioral Health Specialist II 1 8 -BH Behavioral Health I Intensive Youth Services Community Health Specialist!! I 8 Public Health Community Health Administrative Support Specialist 4 -BH administrative Service Operations Administrative Support Technician 11 Behavioral Health Developmental Disabilitie Behavioral Health Specialist 1 Outpatient Crisis Crisis Hubs Medical Team Medical Team Medical Team Medical Team Outpatient Crisis Adult Intensive Services Administration I Outpatient Crisis Team Nurse Home Visiting Crisis Child & Family Outpatient Medical Team Clinical Services Billing Crisis Crisis South County Medical Team Medical Team Medical Team Medical Team Child & Family Outpatient Crisis COAST 1.00 Administration 1,001 Adult Outpatient 1.00 Crisis 1.00 Jul -17 17 -Aug 17 -Sep 0.10 1 0.10 ( 0.10 0.10 0.10 0.50 0.50 1 0. 0.50 0.50 ) 0.50 0.60 0,60 0.70 0.70 0.70 1.00 1.00 1.00 1.00 1 1.00 1.00 1.00 1.00 1,00 1.00 1.00 1.00 1.00 1.00 1.00 1,00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 _ 1.00 1 1.00 1,00 1.00 1.00 j 1.00 1.00 1 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 17 -Oct 0.1.0 17 -Nov 17 -Dec 0.10 1 0.10 Jan -18 Feb -18 Mar -18 Apr -18 j)evelopmental Disabilitie Developmental Disabilities 1.00 Adult Intensive Services .ssertive Community Treatmeil 1.00 Hubs Medical Team Operations Administration Administration Administration Outpatient Outpatient North County Medical Team Front Office 1.00 Vital Records 1.00 Administration 1.00 Administration 1.00 Child & Family Outpatient 1.00 Child & Family Outpatient 1,00 Outpatient Access 1.00 Adult Intensive Services Community Support Services 1.00 Outpatient Adult Outpatient 1.00 Medical Team I Medical Team 1.00 -BH administrative Service Operations Front Office 1.00 10 Behavioral Health Crisis I Forensic Diversion 1.00 42 Behavioral Health Outpatient Adult Outpatient 1.00 27 Behavioral Health Hubs I North County 1.00 100 Behavioral HealthHubs I North County 1.00 13 Behavioral Health Adult Intensive Services lssertive Community Treatme 1.00 2 Public Health Community Health I Environmental Health 1.00 5 Director's Office Director's Office I Health Information 1.00 21 Public Health 1 1.00 1 bdministrative Service Administration I Administration 1.00 -BH I Behavioral Health I Medical Team I Medical Team 1.00 2 Behavioral Health Developmental Disabilitie) Support Services EASA 1.00 50 Behavioral Health Intensive Youth Services 7 P Public Health Community Health I Prevention 1 -BH dministrative Service Operations 1 Front Office 1 36 I Behavioral Health Adult Intensive Services lssertive Community Treatment Medical Team 1 -lealthy People & Familiel )evelopmental Disabilitiel Outpatient I Hubs 1 Outpatient 1 Intensive Youth Services) 5 Behavioral Health Hubs 1 8 Behavioral Health Crisis 1 3 Behavioral Health )evelopmental Disabilitie) 17-B141dministrative Service Operations 1 1 Behavioral Health Crisis 1 2 Behavioral Health Intensive Youth Services) 63 Behavioral Health Hubs 1 5 -BH administrative Service Operations 12 Behavioral Health )evelopmental Disabilitie Behavioral Health bevelopmental Disabilitie Behavioral Health Behavioral Health Behavioral Health Behavioral Health Occupational Therapist Public Health Nurse II (EIO) Administrative Support Technician (CCB Administrative Support Specialist Behavioral Health Specialist II Behavioral Health Specialist II -Licensed 5 Behavioral Health Specialist II -Licensed 12 Intellectual & Developmental Disabilitie 11 Epidemiologist (PHM) 2 Community Health Specialist II (EIO) 22 Community Health Specialist II (PHM) 24 Community Health Specialist II (PHM) 23 Peer Support Specialist 4 Supervisor, Administrative 23 Behavioral Health 2 Behavioral Health 32 -PH Public Health 18 -B1 -I; Behavioral Health 7 Administrative Service 109 Behavioral Health Behavioral Health Behavioral Health Behavioral Health Director's Office Public Health Public Health Public Health Behavioral Health 2 Administrative Service Intensive Youth Services Community Health Crisis Operations Crisis Outpatient Adult Intensive Services evelopmental Disabilitie Director's Office Community Health Community Health Community Health Intensive Youth Services Operations Medical Team WIC Support Services Adult Outpatient North County Child & Family Outpatient Wrap Around South County Crisis Developmental Disabilities Front Office Crisis Wrap Around South County Front Office Developmental Disabilities Support Services Forensic Diversion Developmental Disabilities EASA Administration ASA/Young Adults in Transition Wrap Around Prevention Front Office Support Services Adult Outpatient EASA Communicable Disease Crisis Front Office Forensic Diversion School Based Health Centers) ssertive Community Treatment Developmental Disabilities Health Information Communicable Disease Communicable Disease Communicable Disease Young Adults In Transition Front Office 0.50 1.00 1.00 1.00 0.50 1.00 1.00 1.00 0.20 0.60 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0. 0.50 0.70 1.00 1.00 1.00 1.00 1,00 1.00 1.00 1.00 1.00 1.00 0.50 1.00 0.20 1.00 1.00 1.00 0.50 1,00 1.00 1.00 1.00 .00 0.50 I 0.50 0.50 0.50 I 0.50 0.20 II 0.20 1.00 1.00 1.00 j 1.00 j 1.00 1 1.00 1 1,00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 030 0,50 1.00 1.00 0.20 0.20 0.50 0.50 1.00 1.00 1.00 1.00 1.00 1.00 0,50 0.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 i 1.00 1,00 1.00 1.00 1.00 0.50 0.50 0.20 1.00 1.00 1.00 1.00 1.00 1.00 1,00 0.20 1.00 1.00 1.00 1.00 1.00 1.00 0.50 0.50 1 0.20 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.20 0.20 1.00 1.00 1.00 1.00 1.00 1.00 1.00 100 1.00 1.00 1.00 1.00 0.20 1.00 1.00 0.20 1.00 1.00 0.20 1.00 1.00 1.00 1.00 1.00 1.00 1,00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.50 0.50 0.50 0.50 0.50 0.50 0.50 0.50 0.50 1 0.50 0.50 0.50 0.60 1 0.60 0.60 0.60 1.00 1 1.00 1.00 1.0D 1.00 1 1.00 i 1.00 1.00 1.00 ( 1.00 1.00 1.00 1 1.00 1.00 1 1.00 1.00 1 1.00 1.00 1.00 1 1.00 1.00 1 1.00 1 1.00 11.00 1.00 1.00 1 1.00 1.00 1 1.00 1 1.00 1.00 1.00 1 1 Administrative Support Technician (CCB 10 -BH Behavioral Health Specialist II -Licensed 46 Public Health Nurse II (PHM) 33 -PI - Public Health Nurse II 19 -PH Nurse Practitioner 1 Behavioral Health Specialist II -Licensed 62 Community Health Specialist II 13 Peer Support Specialist 7 Community Health Specialist II 25 Administrative Support Technician (CCBI 17 Behavioral Health Specialist I 1 38 Occupational Therapist 3 Behavioral Health Specialist II (CCBHC) 104 Behavioral Health Specialist II -Licensed 101 Community Health Specialist I Supervisor, Health Services Manager, Public Health Program Program Development Specialist Public Health Nurse II 1 5 -PH 4 4 8-8H dministrative Service Operations Behavioral Health Adult Intensive Services Public Health Community Health Public Health iealthy People & Familie Public Health lealthy People & Familie Behavioral Health Outpatient Public Health Community Health Behavioral Health Adult Intensive Services Public Health administrative Service Behavioral Health Behavioral Health Behavioral Health Behavioral Health Public Health Director's Office Public Health Public Health Behavioral Health Community Health Operations Adult Intensive Services Intensive Youth Services Outpatient Outpatient lealthy People & Familie Director's Office .dvancement & Protectio Early Learning Medical Team 1 Front Office Community Support Services Communicable Disease Communicable Disease Clinical Services Access Prevention COAST Communicable Disease Front Office Community Support Services Wrap Around Adult Outpatient Access Clinical Services Health Information Administration Early Learning Medical Team 1.00 1.00 1,00 1 1.00 1.00 j 1.00 0.50 I 0.50 0.60 I 0.60 1,00 .1 1.00 1.00 1.00 1.00 1.00 Total FTE Jul -17 17 -Aug Accounting Technician 2.00 Accounting Technician, Senior 2.00 Administrative Assistant 2.00 Administrative Support Specialist 13.00 Administrative Support Technician 16.15 1.00 Administrative Support Technician (CCBHC) 9.00 2.00 Behavioral Health Specialist 1 20.00 0.50 Behavioral Health Specialist I (CCBHC) 1 2.00 1 2.00 Behavioral Health Specialist!! 31.50 8.10 Behavioral Health Specialist II (CCBHC) 3.00 1.00 Behavioral Health Specialist II -Licensed 44.70 Behavioral Health Technician 1.00 Clinical Information Systems Administator 4.00 Coding & Data Analyst 1.00 Community Health Specialist! 8.20 Community Health Specialist!! 12.65 2.00 Community Health Specialist II (EIO) 1.00 Community Health Specialist 11 (PHM) 1.00 Contracting Specialist 1.00 Credentialing Specialist 1.00 Deputy Director 3.00 1 Director 1.00 Environmental Health Specialist 11 4.00 1.00 Environmental Health Specialist 111 2.00 1 Epidemiologist 1.00 1 Epidemiologist (PHM) 1 1.00 1 Executive Assistant 1 1.00 1 Human Resources Analyst 1.00 1 1.00 Intellectual & Developmental Disabilities Special 15.00 j 1.00 Intellectual & Developmental Disabilities Special 3.00 1 Management Analyst ( 4.00 1 Management Analyst, Senior 1 1.00 Manager, Behavioral Health 1 6.00 2.00 Manager, Business 1.00 Manager, Operations 1.00 Manager, Public Health ( 3.00 Manager, Quality & Performance 1 1.00 Medical Assistant 1.00 Medical Director 1 1.00 Medical Records Technician 1 2.00 Nurse Practitioner 1 1.80 0.60 Nurse Practitioner, Psychiatric 1 2.00 Occupational Therapist I 2.50 Patient Account Specialist 1 2.50 Patient Account Specialist II 1 1.00 Patient Account Specialist II (CCBHC) 1.20 0.70 Peer Support Specialist 10.00 3.00 Peer Support Specialist (CCBHC) 4.00 4.00 Program Development Specialist 0.00 Prevention Coordinator 1 1.00 Psychiatrist 1 1.50 Psychiatrist (CCBHC) 3.00 Public Health Nurse 1 (CCBHC) 1.00 Public Health Nurse 11 13.35 Public Health Nurse II (CCBHC) 2.00 Public Health Nurse 11 (EIO) 0.60 Public Health Nurse II (PHM) 1.00 Public Health Nurse 111 1.50 Quality Improvement Analyst 3.00 Registered Dietician 1.30 Registered Health Information technician 1.00 Supervisor, Administrative 3.00 Supervisor, Behavioral Health 10.00 Supervisor, Health Services 10.00 Supervisor, Intellectual & Developmental Disabi 2.00 309.45 1.50 1 3.00 1.00 0.10 2.00 2.00 1.00 0.50 m 7.60 1.00 1.00 1.00 2.00 0.60 0.70 2.00 4.00 1.50 3.00 0.10 2.00 1.00 .1 1.00 1.00 39.50 31.00 17 -Sep 17 -Oct 17 -Nov 17 -Dec Jan -18 Feb -18 Mar -18 Apr -18 2.00 2.50 0.50 1.00 2.00 1.00 8.00 5.00 7.00 0.00 0.00 0.00 1.00 1.00 1.00 0.60 1.00 1.00 1.00 1.00 1.00 0.70 2.00 3.00 0.70 3.00 0.10 2.00 4.00 31.10 0.70 2.00 1.00 1.00 1.00 1.00 0.50 0.50 0.50 0.50 1 0.50 1.00 1.00 2.00 2.00 1 3.00 6.00 6.00 5.50 5.50 4.50 0.00 0.00 0.00 0.00 0.00 1.00 1.00 1.00 1.00 1.00 2.00 1.00 2.00 3.00 3.00 3.00 2.00 1.00 2.00 1.00 2.00 2.00 1.00 1.00 1.00 2.00 3.00 1.00 3.40 1.00 1.00 1.00 1.00 2.00 1.00 1.00 0.60 0.60 0.50 0.50 0.50 1.50 0.20 0.20 0.20 1 0.20 0.20 0.20 3.00 3.00 3.00 1.00 2.00 2.00 1.00 1.00 1.00 1.00 1.00 1.00 0.70 1 0.70 3.00 3.00 0.10 1.00 0.70 0.70 0.70 0.70 3.00 3.00 3.00 3.00 0.10 0.10 0.50 1.00 1.00 1.00 1.00 1.00 0.60 0.60 0.60 1.00 3.00 ] 3.00 2.00 23.00 1.00 1.00 1.00 0.70 3.00 1 1.00 1 0.50 1 1.00 1 0.60 22.50 22.50 30.50 31.00 31.10 31.50