2018-320-Minutes for Meeting June 20,2018 Recorded 7/27/2018oi. E S CSG
kti
GJ/..
BOARD OF
COMMISSIONERS
1300 NW Wall Street, Bend, Oregon
(541) 388-6570
3:00 PM
Recorded in Deschutes County CJ2018-320
Nancy Blankenship, County Clerk
Commissioners' Journal 07/27/2018 7:45:34 AM
11111111111111111111111111113u
FOR RECORDING STAMP ONLY
WORK SESSION MINUTES
WEDNESDAY, June 20, 2018 ALLEN CONFERENCE ROOM
Present were Commissioners Tammy Baney, Phil Henderson and Anthony DeBone. Also present were
Tom Anderson, County Administrator; David Doyle, County Counsel; and Sharon Keith, Board Executive
Assistant. No identified representatives of the media were in attendance.
CALL TO ORDER: Chair DeBone called the meeting to order at 3:00 p.m.
OTHER ITEMS:
• Health Services Staff Request: County Administrator Anderson reported
on a staffing request from the Health Services Department. As mentioned at
the Business Meeting on Monday, one of the directives from the budget
committee would be a hiring freeze for Health Services until the fall when the
results of negotiations with PacificSource and the CCBHC expansion grant
process are known. Health Services Department compiled the list of
vacancies and the background and impact of not filling the position.
Commissioner Baney explained there are requirements of the staff and
department to follow with guidelines of grant awards. The Board reviewed
the information provided and spoke on services provided to the community.
The services provided and the staffing levels does tie into the Budget Book
provided by the department. Commissioner Baney trusts both County
BOCC WORK SESSION JUNE 20, 2018 PAGE 1 OF 4
Administrator Anderson and Dr. George Conway to understand the needs to
run the Health Services Department. Commissioner Henderson is not
confident in the recommendations of department and wants to sort through
this information compared to all of the data they have provided.
• 9-1-1 Update: County Administrator Anderson reported on the need to
amend the agreement with Harris Corporation by adding Overturf coverage
maps and design and potential work if Overturf is decided on as a
permanent tower site. County Administrator Anderson asks whether that
should be a change order or a new stand-alone contract. Discussion held on
the differences between change orders and a new contract. Commissioner
Henderson commented the temporary site is near complete and should be
tied into the original contract. Commissioner DeBone noted the engineering
work should have been done regardless to acquire proper communications
for safety. The history of work on the radio system update was reviewed and
Commissioner Henderson would ask for a written history of the work done.
County Administrator Anderson will ask Sara Crosswhite, Interim Director to
request the written history from Harris Corporation. Commissioner DeBone
would lean toward a change order. Joe Blaschka, ADCOMM had reviewed the
statement of work and felt that the work was separate from the initial
contract scope with Harris. The status of the position of Technical Director is
the recruitment has been re -opened. Discussion held on recruitment
options. Discussion held on tower proposals. Commissioner Henderson
feels the contract should include the tower site work. The Board directed
County Counsel Doyle to work with Sara Crosswhite, Interim Director to work
together on this contract. County Administrator Anderson reported on the
audit concept from the users of the radio system with one study to focus on
the external technical work and the response to the issues and with one
study to focus on the internal work that we could have done differently to
minimize the issues. Commissioner DeBone requested a statement on a
public safety technology system in this type of landscaping. County Counsel
Doyle doesn't recall any representative from Harris Corporation speaking
with the User Board about the specifications and outputs of the P25 radio
system. Commissioner Baney requested a statement of the history and what
steps we need to take for the future. The Board agrees with a strong
BOCC WORK SESSION
JUNE 20, 2018 PAGE 2 OF 4
recruitment process for the Technical Director position and the cost that
would be involved.
• Commissioner Baney spoke on the meeting with a citizen about his inquiry to
the Board for his land request donation in order to build his company.
Discussion held on his concerns that he feels there are people living on the
land. County Administrator Anderson, County Counsel Doyle and dames
Lewis will meet for a discussion on the matter.
• Commissioner DeBone reported on a fundraising request from Move Bend
for a donation of $5,000 to the City of Bend. A request for further
information will be extended.
EXECUTIVE SESSION:
At the time of 4:11 the Board went into Executive Session under ORS 192.660 (2) (i)
Employee Evaluations. The Board came out of Executive Session at 5:40 p.m. to
make the following motion:
BANEY: Move to approve contract with favorable review
HENDERSON: Second
VOTE: BANEY: Yes
HENDERSON: Yes
DEBONE: Chair votes yes. Motion Carried
BOCC WORK SESSION
JUNE 20, 2018 PAGE 3 OF 4
ADJOURN
Being no further items to come before the Board, the meeting was adjourned at 5:40 p.m.
DATED this Day of
Commissioners.
ATTEST:
d4f)--
RECOIIWING SECRETARY
BOCC WORK SESSION
2018 for the Deschutes County Board of
ANTH NY DEBONE, CHAIR
'?\\
PHILIP G. ENDE SON, VICE CH IR
TAMMY ANEY, COM
ONE
JUNE 20, 2018 PAGE 4 OF 4
SES
Deschutes County Board of Commissioners
1300 NW Wall St, Bend, OR 97703
(541) 388-6570 - www.deschutes.org
WORK SESSION AGENDA
DESCHUTES COUNTY BOARD OF COMMISSIONERS
3:00 PM, WEDNESDAY, JUNE 20, 2018
Allen Conference Room - Deschutes Services Building, 2ND Floor - 1300 NW Wall Street - Bend
Work Session, which are open to the public, allow the Board to gather information and give direction to staff.
Public comment is not normally accepted. Written minutes are taken for the record
Pursuant to ORS 192.640, this agenda includes a list of the main topics that are anticipated to be considered or
discussed. This notice does not limit the Board's ability to address other topics.
Meetings are subject to cancellation without notice.
CALL TO ORDER
ACTION ITEMS
At any time during the meeting an executive session could be called to address issues relating to ORS
192.5660(2)(e); real property negotiations; ORS 192.660(2)(h) litigation; ORS 192.660(2)(d), labor
negotiations; ORS 192.660(2)(b); personnel issues; or other executive session categories. Executive sessions
are closed to the public; however ,with few exceptions and under specific guidelines, are open to the public.
OTHER ITEMS
EXECUTIVE SESSION
Executive Session under ORS 192.660 (2) (i) Employee Evaluation
These can be any items not included on the agenda that the Commissioners with to discuss as part of the
meeting pursuant to ORS 192.640.
ADJOURN
Board of Commissioners Work Session Agenda
of 2
Wednesday, June 20, 2018 Page 1
Deschutes County encourages persons with disabilities to participate in all programs and
activities. To request this information in an alternate format please call (541) 617-4747.
FUTURE MEETINGS:
Additional meeting dates available at www.deschutes.org/meetingcalendar
Meeting dates and times are subject to change. All meetings take place in the Allen Room at 1300 NW Wall
St. Bend unless otherwise indicated. If you have question, please call (541) 388-6572.
Board of Commissioners Work Session Agenda Wednesday, June 20, 2018 Page
of 2
, HEALTH
SERVICES
Memorandum
Date: June 19, 2018
To: Tom Anderson, County Administrator
From: George A. Conway, MD, MPH
Subject: Request for Permission to Hire
Per this morning's discussion, please find attached (tab: "Critical") a list of five (5) positions
as approved, and eleven (11) positions that we deem critical to fill based on crisis and/or
high-risk populations served, crucial client service, and grant requirements. A narrative
providing the background and necessity of each position is included. Additionally, we have
provided a list of three (3) "on-call" positions.
We are also providing information (tab: "Revenue') on six (6) key positions that provide
important services and can be leveraged to drive additional Health Services revenue (as
illustrated) over and above the cost of the positions.
We believe that filling each of these positions is in the best interest of not only our
organization but also the community we serve. I hope that the County Commissioners will
be supportive of our filling these positions while we all await the results of current contract
negotiations with PacificSource and the CCBHC expansion grant process.
As always, Health Services greatly appreciates your support.
GAC:kh
Attachment
As Approved
Community Health Specialist II
Medical Assistant
Public Health Nurse II
Behavioral Health Specialist II
Behavioral Health Specialist II
Critical Positions
Community Health Specialist II
Community Health Specialist II
Business Manager
Quality & Performance Manager
Quality Improvement Analyst
Behavioral Health Specialist I
Behavioral Health Specialist II
Intellectual & Developmental Disabilities Sp
Status
Not Posted
Not Posted
Not Posted; Increased to 1.00 in
FY 2019
Completing reference checks -
anticipate ready to make offer by
6/20
Completing reference checks -
anticipate ready to make offer by
6/20
Status
Internal Posting Closed 6/7 (2018-
00079) - no applicants
Internal Posting Closed 6/7 (2018-
00080); Can be filled through
reassignment of duties
FTE Division
1.00 PH
1.00 PH
1.00 PH
1.00 BH
1.00 BH
FTE Division
1.00 PH
1.00 PH
AS
Posted 6/4-6/18/18 (2018-00082) 1.00
Not Posted, Recent Resignation 1.00
Not Posted, Recent Resignation 1.00
Interviews in process - Posting 1.00
Closed 5/28/18 (2018-00071 )
Not Posted
Interviews & reference checks
completed - ready to make an
offer - Posting Closed 6/4/18
(2018-00077);
AS
AS
BH
Program
Advancement &
Prevention
Health People &
Families
Advancement &
Prevention
Crisis Services
Crisis Services
Program
Community
Health
Community
Health
Fiscal
System
Performance
Program
System
Performance
Program
Adult Intensive
Services
Team
Comunicable Disease
Clinical Services
(Reproductive Health)
Communicable Disease
MCAT (OPP Grant)
MCAT (OPP Grant)
Team
Prevention (Drug Free
Communities)
Prevention (Substance
Abuse Prevention)
Fiscal
System Performance
Program
Compliance
Residential Services
1.00 BH Crisis Services Crisis Case Management
1.00
BH
Developmental
Disabilities
In -Home Services
Former Employee
Emma Ulrich
NEW
Debbie Amberson
NEW
NEW
Former Employee
Nick Stevenson
Whitney Schumacher
James Wood
Shannon Vandegriff
Lindsay Nokell
Whitney Brenizer
Alison Mostue
Amanda Blatnik
Auth # Background & Impact of Not Filling Position
21
X
19 -PH
X
X
Auth #
14
17
As approved during budget process; Needed to recruit and train youth sexual
health trainings prior to start of school year in September
As approved during budget process; Nurse Practitioner required to set up
and clean rooms in Redmond, poor use of NP and reducing ability to bill
As approved during budget process; Part of PH Modernization Grant.
Immunization coordinator, STD investigations
Hire authorized by BOCC 5/9. Health and safety associated with mobile crisis
services. Failure to meet DOJ/state requirement if not filled by 6/30; Fully
grant funded.
Hire authorized by BOCC 5/9. Health and safety associated with mobile crisis
services. Failure to meet DOJ/state requirement if not filled by 6/30; Fully
grant funded.
Background & Impact of Not Filling Position
This is the only position funded by Drug Free Communities Grant. Risk of not
meeting grant requirements.
This is the only position funded by Substance Abuse Prevention Grant. Risk
of not meeting grant requirements.
This position is responsible for all fiscal operations in the department. Staff in
1 the areas of accounting, data analytics, contracts, grants and project
management will be without a program manager.
Direct compliance oversite and measures key performance. Compliance
investigations, grant reporting and performance metrics will not be
1 completed. Staff in the areas of compliance, privacy, performance
management, quality improvement and policies/procedures will be without a
program manager.
This position is vital to maintaining compliance obligations. This position
represents staff responsible for behavioral health documentation audits and
compliance training. Review of behavioral health clinician documentation
could not be completed leading to potential loss of billing.
Dedicated funding stream pays for this position. Only staff position serving as
the required Extended Network Care Coordinator (ENCC) - is responsible for
3 placement coordination of individuals discharging from the Oregon State
Hospital (OSH) and residential facilities. Helps clients navigate complex
systems.
1
76
Dedicated funding stream pays for this position. Only staff position serving as
the crisis case manager who works with anyone in the hospital or
transitioning out of the hospital -additionally the position is critical for meeting
the 7 day post hospital metric which is part of the CCO contract
Provides service coordination for individuals with I/DD. Position produces bill -
2 able service events which is necessary for meeting match fund goals and
thus producing additional revenue
Critical Positions
Occupational Therapist
Behavioral Health Specialist I
Behavioral Health Specialist II
On - Call Positions
Public Health Nurse II (On -Call)
Public Health Nurse II (On -Call)
Behavioral Health Specialist II (On -Call)
Status
Interviews & reference checks
completed - ready to make an
offer
Not Posted
Posting Closed 5/1/18 (2018-
00058)
FTE Division Program
1.00
1.00
BH
BH
Intensive Youth
Services
Team Former Employee Auth # Background & Impact of Not Filling Position
Wrap Around
Adult Intensive Community Support
Services Services (CSS)
1.00 BH Crisis Services
16.00
Status FTE Division
0.00 BH
Interviewed (2017-00112) 0.00 BH
Interviewed, Offer pending (2017-
00112)
Posted 6/14-6/28/18 (2018-
00089)
0.00 BH
Program
Medical Team
Medical Team
Outpatient
Jail Diversion
Team
Medical Team
Medical Team
Access
Suzanne Garliepp
Tyler Nall
Melissa Thompson
Former Employee
NEW
NEW
Provides treatment services to young people experiencing a first episode of
3 psychosis and other high risk conditions. Position is a fidelity program
requirement.
10
CSS serves high risk SPMI clients that need a significant amount of case
management to keep clients stable and out of the hospital. Both of CSS'
case manager positions are open leaving the CSS team with no case
managers
Dedicated funding stream pays for this position. Grant funded - we will be
102 required to return the associated money if we don't fill the position. Provides
clinical supports and coordination of jail division program
Auth #
X
X
Kiana Kurzynowski 40
Background & Impact of Not Filling Position
Difficult positions to fill, severely understaffed, unable to consistently fill
regular positions
Difficult positions to fill, severely understaffed, unable to consistently fill
regular positions
On-call position fills in when there is inadequate capacity to meet demand for
service and/or required timelines
Revenue Producing
Positions
Behavioral Health Specialist 11,
Licensed
Status
Not Posted
Cost Covered
Commercial &
Former Background & Impact of Not Filling PPS/Month Medicare Total Cost/Month by Dedicated
FTE Division Program Team Auth # Revenue Revenue (Salary & Funding
Employee Position Revenue/Month
Benefits) Stream
1.00 BH Outpatient
Child & Family
Outpatient
Behavioral Health Specialist 1 Posting Closed 6/08/181.00 BH Adult Intensive Supported
(CCBHC Backfill) (2018-00072) Services Employment
Grace Lee 32
Counselor provides treatment to complex need
children and families. Capacity to meet demand for
service has been adversely impacted. This position
produces—$12,180/mo in CCBHC revenue.
$ 12,180.00 $ 907.49 $ 13,087.49 $ 7,859.98
Additional
Revenue
Generated
(Difference between
Cost - Dedicated
Funding and
Revenue Generated)
$ 5,227.51
Fidelity program that supports the ability of clients to
obtain and keep employment. Program is currently
Darin Darlington 38 unable to serve referred clients and has a waiting $ 9,376.00 $ 761.00 $ 10,137.00 $ 7,071.41 $ 1,767.85 $ 4,833.44
list. At the end of CCBCH this position will revert to
a regular position
Behavioral Health Specialist II, Posting Closed 4/18/18 Intensive Youth Early Assessment &
Licensed (2018-00053) 1.00 BH Services Support Alliance Mo Mitchell 48
(EASA)
Behavioral Health Specialist I
Occupational Therapist (will) be a
BHS II)
Behavioral Health Specialist II
Half the position costs are covered by the ongoing
EASA SE grant. Counselor provides treatment to
individuals experiencing first episode psychosis.
Fidelity program restricts # that can be served
based on # of staff. Currently running in excess of
the number allowed by fidelity
$ 7,395.00 $ 1,400.28 $ 8,795.28 $ 7,859.98 $ 3,772.79 $ 4,708.09
CSS serves high risk SPMI clients that need a
Adult Intensive Community Support significant amount of case management to keep
Not Posted 1.00 BH Ruthie Lai 7 clients stable and out of the hospital. Both of CSS' $ 8,990.00 $ 2,221.55 $ 11,211.55 $ 7,071.41 $ 4,140.14
Services Services (CSS) case manager positions are open leaving the CSS
team with no case managers
Counselor provides treatment to complex need
Not Posted 1.00 BH Hubs South County Hub Hannah Tyer 1 children and families. Capacity to meet demand for $ 9,570.00 $ 512.08 $ 10,082.08 $ 7,859.98 $ 2,222.10
service has been adversely impacted.
Intensive Youth Counselor provides treatment to high risk children
Not Posted 1.00 BH Services Wrap Around Michael Long 97 and families. Capacity to admit children and families $ 7,763.00 $ 1,273.76 $ 9,036.76 $ 7,859.98 $ 1,176.78
to service has been inhibited
Open Positions
Psychiatric Mental Health Nurse
Practitioner
Psychiatric Mental Health Nurse
Practitioner
Peer Support Specialist (MCAT)
Intellectual & Developmental
Disabilities Specialist!
Psychiatrist
Public Health Nurse 1 (CCBHC)
Public Health Nurse II (CCBHC)
Community Health Specialist II (PH
Modernization)
Administrative Support Technician
Public Health Nurse II (EIO)
Epidemiologist (PHM)
Accounting Technician (CCBHC)
Status
Not Posted
Not Posted
Not Posted
Not Posted
FTE
1.00
1.00
1.00
1.00
Not Posted 0.20
Not Posted 1.00
Not Posted 1.00
Not Posted 1.00
Not Posted
1.00
Not Posted 0.60
Not Posted 1.00
Not Posted 1.00
10.80
Division
BH
BH
BH
BH
BH
BH
BH
Public Health
Public Health
Public Health
Administrative Services
Administrative Services
Program
Medical Team
Medical Team
Crisis Services
Developmental Disabilities
Medical Team
Medical Team
Medical Team
Advancement & Prevention
Health People & Families
Advancement & Prevention
Director's Office
Fiscal Office
Team
Medical Team
Medical Team
OPP Grant
Comprehensive Services
Medical Team
Medical Team
Medical Team
Public Health Modernization
Clinical Services (Reproductive
Health)
Communicable Disease
Director's Office
Fiscal Services
Former Employee
NEW
NEW
NEW
Martin Hager
OPEN
Amee Escamilla
Chandra Mola
NEW
Rosa Escobedo
NEW
NEW
Melinda Hardy
Auth # Background & Impact of not filling )osition
Provision of psychiatric services across
programs. Limited resource within the
X community. Difficult to recruit - important to
move quickly when a PMHNP becomes
available.
Provision of psychiatric services across
programs. Limited resource within the
X community. Difficult to recruit - important to
move quickly when a PMHNP becomes
available.
X
Dedicated fundign stream pays for this
position. Grant authorized by BOCC 5/9.
Will not be able to provide follow up and
supports to individuals in crisis served by
the MCAT. Will not be able to free up MCAT
time for other crisis needs.
Provides support services for individuals
with I/DD. Position produces bill -able
8 service events which is necessary for
meeting match fund goals and thus
producing additional revenuels
Provision of psychiatric services across
2 programs. Limited resource within the
community.
RNs provide medical/medication related
services and supports and attend to tasks
that free up LMP time
RNs provide medical/medication related
services and supports and attends to tasks
that free up LMP time
Delays public health modernization efforts
and goal attainment
1 -BH
9 -PH
24
Limits support to reproductive health clinical
8 -PH service team and decreases efficiencies
Limits capacity to respond to high-risk HIV
population
32 -PH
2 Imcumbent detailed to PHM grant through
June, 2019
Directly impacts support to the business
manager and fiscal team for fiscal and other
operational demands