Loading...
2018-424-Minutes for Meeting September 05,2018 Recorded 10/15/2018BOARD OF COMMISSIONERS 1300 NW Wall Street, Bend, Oregon (541) 388-6570 Recorded in Deschutes County Nancy Blankenship: County Clerk Commissioners' Journal CJ2O18-424 10/15/2018 4:39:57 PM 111 1111111111 111 fl 11 I 1 II FOR RECORDING STAMP ONLY WORK SESSION MINUTES 1:30 PM WEDNESDAY, September 5, 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. Several citizens and representatives of the media were in attendance. CALL TO ORDER: Chair DeBone called the meeting to order at 1:34 p.m. ACTION ITEMS 1. Brookswood/Baker Road Intersection Discussion Chris Doty, Road Department Director presented this topic involving traffic control decisions. A copy of the power point presentation is attached to the record. Mr. Doty reviewed the timeline of the three-way stop installed at this intersection to assist with detour traffic operations during the City of Bend's Murphy Road Roundabout project and response to community feedback to maintain the three-way stop in place once the project was complete. Commissioner Baney commented on the third party review by ODOT. Mr. Doty considered that as a peer review and determined the data was accurate. A change would be looked at if traffic studies show crashes and BOCC WORK SESSION SEPTEMBER 5, 2018 PAGE 1 OF 5 delays. Commissioner Baney stated this is leaning on the side of safety and should be considered over convenience. Commissioner DeBone supports the three-way stop for safety. Commissioner Henderson is undecided on whether to change the intersection. 2. Mosaic Medical Van at the Drop James Lewis, Property Manager presented the request from Health Services to have a license agreement between Mosaic Medical and Behavioral Health. The van is proposed to be located in the Deschutes Services parking lot at no charge to Mosaic Medical. Janice Garceau and Elizabeth Renteria Holden of Health Services explained the service for intensive youth services. The Drop is the waiting room for the public health reproductive center. Services provided through this program were reviewed. This type of activity in our parking lot may impact the public interaction with other services we provide. There is a plan to ensure the clients would be directed in for services. Commissioner Henderson suggested a place that is closer to the front door. The planned space would not affect traffic flow. Commissioner Henderson noted his concern of providing a space for people to hang around. Mr. Lewis suggested monitoring the activity for a year. Commissioner Baney commented on the Telecare area where there are many people sitting on the curb smoking that looks bad. She suggested to James Lewis and Lee Randall a conversation with Telecare. Commissioner DeBone requested an additional topic of conversation since Mr. Lewis was present to find an update on the status of the industrial land in La Pine and the position of the County relative to the Mayor and La Pine City Council. Mr. Lewis spoke on the IGA with the City of La Pine. There is a Joint Meeting with the City of La Pine on October 9. Mr. Lewis noted the obligations of the City as included in the IGA. BOCC WORK SESSION SEPTEMBER 5, 2018 PAGE 2 OF 5 3. Health Services Department Staff Requests Health Services Department Dave Inbody and Janice Garceau presented the request for staffing. Commissioner DeBone noted in this year's budget presentation and asked for clarification on the staffing request. Mr. Inbody is acting on Dr. Conway's behalf. Mr. Inbody stated the department needs these positions. Commissioner Henderson explained the big issue of this request is trying to understand the programs the positions are being requested for. Commissioner Henderson expressed concern on the funding sources and the staffing requests. Ms. Garceau feels the department needs are outside the timeline. Mr. Inbody explained the positions that are being requested. Commissioner Henderson asked if they have considered moving people to different divisions to cover the needs. Commissioner DeBone spoke on managing change and is not opposed to opening positions for people that have vacated. Commissioner Baney commented on the importance of maintaining a level of service even with the uncertainty of funding. Commissioner Baney expressed the need of filling positions needed for mandated services. Commissioner Henderson expressed concern of being outside of the budget cycle. RECESS: A recess was taken at 3:15 p.m. and the meeting was reconvened at 3:21 p. m. OTHER ITEMS: • 911 Radio Project Update: A meeting is scheduled for in -building issues with the stakeholders. Rick Allen Project Manager will coordinate the permitting process of the new permanent tower site. Mr. Lewis will be working on the lease for the site. Commissioner DeBone suggested looking ahead for any needs of additional towers. Commissioner Baney feels a communication piece to the general public is warranted. The User Board discussion will include coverage areas and determining how to fill the gaps. Commissioner Henderson commented on the importance of providing the best system for BOCC WORK SESSION SEPTEMBER 5, 2018 PAGE 3 OF 5 the County. Commissioner Henderson suggested a preview of the propagation maps prior to the User Board meeting next Tuesday. Commissioner Baney requested ADCOMM Engineer Joe Blaschka provide a summary to the Board prior to the meeting. • County Administrator Anderson noted the deadline of the radio system after action review ended up with 11 proposals from consultants. A draft scoring sheet has been created. Commissioners DeBone and Baney would like to review them. • County Administrator Anderson noted Bill Anderson's term is up the end of the year as a member of the Budget Committee. Bill has been a member for one year as he filled a vacancy. Mr. Anderson inquired if the Board wants to open up the application process or reappoint since he filled one year. The consensus of the Board is to reappoint him for a new term. • Request for a proclamation. Whitney Hale, Public Information Officer presented a request from the One World Center campus and Unity Community of Central Oregon to declare September as One World Peace Month. Though this is a wonderful idea, it would be moving in the wrong direction for Deschutes County proclamations. • Next Wednesday, a proclamation for National Suicide Prevention week will come before the Board. • Harper Bridge Discussion: County Administrator Anderson inquired if a meeting with Sunriver Owners Association should be convened. Discussion on safety improvements was held. Commissioner DeBone feels the proposal for parking should move forward with 45 spots. Commissioner Henderson feels the parking on the north side would be a safer solution. Mr. Anderson reached out to inquire about a joint meeting. • Legislative priorities survey was sent to the Board. Commissioners DeBone and Baney have completed the list. COMMISSIONER UPDATES: none reported. BOCC WORK SESSION SEPTEMBER 5, 2018 PAGE 4 OF 5 EXECUTIVE SESSION: At the time of 4:10 p.m. the Board went into Executive Session under ORS 192.660 (2) (h) Litigation. The Board came out of Executive Session at 5:40 p.m. ADJOURN Being no further items to come before the Board, the meeting was adjourned at DATED this Day of Commissioners. ATTEST: ECORNG SECRETARY BOCC WORK SESSION Lienlel 2018 for the Deschutes County Board of ANTHONY DEBONE, CHA PHILIP G. ENDERSON, VICE CHAIR TAMMY BANEY, 6 MISSIONER SEPTEMBER 5, 2018 PAGE 5 OF 5 G to o 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 1:30 PM, WEDNESDAY, SEPTEMBER 5, 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 1. Brookswood/Baker Road Intersection Discussion - Chris Doty, Road Department Director 2. Mosaic Medical Van at the Drop -Janice Garceau, Interim BH Deputy Director 3. Health Service Department Staff Requests - Dave Inbody, Health Services Deputy Director COMMISSIONER'S UPDATES EXECUTIVE SESSION 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. Board of Commissioners Work Session Agenda of 2 Wednesday, September 5, 2018 Page 1 OTHER ITEMS 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 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.or=/meetingcalendar Meeting dates and times are subject to change. If you have question, please call (541) 388-6572. Board of Commissioners Work Session Agenda of 2 Wednesday, September 5, 2018 Page 2 PLEASE RETURN TO BOCC SECRETARY PAGE# OF PAGES N Z m `— (PLEASE PRINT) WORK SESSION Date: _'.PI J,'> r' t ,,,q 9 AGENCY Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners Work Session of September 5, 2018 DATE: August 30, 2018 FROM: Chris Doty, Road Department, 541-322-7105 TITLE OF AGENDA ITEM: Brookswood/Baker Road Intersection Discussion RECOMMENDATION & ACTION REQUESTED: n/a ATTENDANCE: Chris Doty, PE/PTOE, Director Deschutes County Road Department SUMMARY: A three-way stop was installed at the intersection of Brookswood Boulevard/Baker Road in the spring of 2015 to assist with detour traffic operations during the City of Bend's Murphy Road Roundabout Project. During the course of the Project, the Deschutes County Road Department received feedback from users regarding their preference to keep the three-way stop in place. In an effort to respond to this request, the Road Department performed a traffic analysis at the conclusion of the Project to determine if the three-way stop should be left in place or removed. The traffic analysis (attached) was conducted per the guidance of the Manual of Uniform Traffic Control Devices (MUTCD) - the national signing policy. The analysis determined that the three-way stop should remain in place. As a courtesy to Deschutes County, the analysis was subsequently peer reviewed by professional engineers with the Oregon Department of Transportation and determined to meet the criteria of the MUTCD and was appropriately performed. A presentation will be made at the Work Session which describes the Road Department's use of the MUTCD in determining the appropriate traffic control for intersections and how the process was applied in the analysis for the intersection of Brookswood/Baker Road in 2015. SES Road Department 61150 SE 27th St. • Bend, Oregon 97702 (541) 388-6581 • FAX (541) 388-2719 MEMORANDUM / 3 -WAY STOP ANALYSIS Date: September 22, 2015 To: File From: Chris Doty, PE, Director RE: 3 -way stop analysis at Brookswood Boulevard/Baker Road The intersection of Brookswood Boulevard/Baker Road has been analyzed for installation of a 3 -way stop configuration following the opening of the Brookswood Boulevard to traffic at the conclusion of the Brookswood/Murphy Roundabout Project. To accommodate construction detour traffic associated with the Project, the intersection of Brookswood Boulevard/Baker Road was converted to a 3 -way stop configuration at the onset of the Project (Spring, 2015). This analysis considers whether to leave the 3 -way stop in place or return the intersection to the original stop -controlled configuration. This analysis consists of an evaluation of the Manual of Uniform Traffic Control Devices (MUTCD) multi -way stop criteria, as follows: MUTCD Section 26.07 Multi -Way Stop Applications Support: 01 Multi -way stop control can be useful as a safety measure at intersections if certain traffic conditions exist. Safety concerns associated with multi -way stops include pedestrians, bicyclists, and all road users expecting other road users to stop. Multi -way stop control is used where the volume of traffic on the intersecting roads is approximately equal. 02 The restrictions on the use of STOP signs described in Section 28.04 also apply to multi -way stop applications. Guidance: 03 The decision to install multi -way stop control should be based on an engineering study. 04 The following criteria should be considered in the engineering study for a multi -way STOP sign installation: A. Where traffic control signals are justified, the multi -way stop is an interim measure that can be installed quickly to control traffic while arrangements are being made for the installation of the traffic control signal. B. Five or more reported crashes in a 12 -month period that are susceptible to correction by a multi -way stop installation. Such crashes include right -turn and left -turn collisions as well as right-angle collisions. C. Minimum volumes: 1. The vehicular volume entering the intersection from the major street approaches (total of both approaches) averages at least 300 vehicles per hour for any 8 hours of an average day; and 2. The combined vehicular, pedestrian, and bicycle volume entering the intersection from the minor street approaches (total of both approaches) averages at least 200 units per hour for the same 8 hours, with an average delay to minor -street vehicular traffic of at least 30 seconds per vehicle during the highest hour; but 3. If the 85th -percentile approach speed of the major -street traffic exceeds 40 mph, the minimum vehicular volume warrants are 70 percent of the values provided in Items 1 and 2. D. Where no single criterion is satisfied, but where Criteria 8, C.1, and C.2 are all satisfied to 80 percent of the minimum values. Criterion C.3 is excluded from this condition. Option: 05 Other criteria that may be considered in an engineering study include: A. The need to control left -turn conflicts; B. The need to control vehicle/pedestrian conflicts near locations that generate high pedestrian volumes; C. Locations where a road user, after stopping, cannot see conflicting traffic and is not able to negotiate the intersection unless conflicting cross traffic is also required to stop; and D. An intersection of two residential neighborhood collectors (through) streets of similar design and operating characteristics where multi -way stop control would improve traffic operational characteristics of the intersection. To assist in the evaluation of Criteria B and C, a 12 -hour traffic count was conducted on Wednesday, September 9, 2015 (attached). Analysis: Per the traffic count, Criteria C1 and C2 are not directly satisfied as the major street (Baker Road) approaches average greater than 300 vehicles per hour for an 8 -hour period; however the volume of the minor street approach averages approximately 150 vehicles per hour for the same 8 hours. Criteria C1 and C2 are satisfied to approximately 75% - which in turn satisfies Criteria 3 if 85th - percentile speeds exceed 40 mph. Although the speed limit of the Baker Road approach is 35 mph, a spot speed study indicates that the 85th -percentile speed does indeed exceed 40 mph (measured at 43 mph on 09/18/15). Therefore, Criteria C3 is satisfied for installation of all - way stop control. Per the MUTCD support statement, the volume of traffic on intersecting roads should be approximately equal. Per the traffic count, 23% of the approach volume is on the Brookswood Boulevard leg of the intersection, 31% of the volume is on the eastbound leg of Baker Road and 46% is on the westbound leg of Baker Road. While not "approximately equal" in distribution, it is noted that no approach volume comprises less than 20% or greater than 50% of the total entering volume, in other words, no single approach either dominates or has inconsequential volume. MUTCD Optional Criteria A allows for consideration of an all -way stop where there is need to control left turn conflicts. The left turn movements most impacted by the historic stop controlled configuration where the southbound left (Brookswood to Baker) and to a lesser degree, the eastbound left (Baker to northbound Brookswood). Based on a peak hour traffic analysis, the level of service is not impacted by conversion to all -way stop control. With the conversion, delay on the southbound approach is significantly reduced, whereas delay on specifically the westbound approach is significantly increased — but not to a level considered unacceptable (LOS C). Within the ODOT/DMV database, only three crashes were reported in the prior 2 -year period in which data is available (2012-2013). Observation and Customer Feedback: By observation, traffic has grown accustomed to the 3 -way stop configuration and in several site visits motorists were observed to be in compliance. There were no observances of running the stop sign and very few rolling stops. Vehicle queues in excess of 4 or 5 vehicles were rarely observed. The Road Department received unsolicited input from over 30 customers during the 2 -week evaluation period from September 4th through September 18th. The majority (75%) of those providing input requested that the all -way stop configuration remain in place. Customers requesting the all -way stop remain in place shared satisfaction with speed reduction, ease of access for southbound movements, and an overall sense of safety where previously they felt unsafe. Customers who requested removal of the all -way stop shared concerns of unnecessary delay, acceleration/deceleration noise, and concerns during snow/ice conditions. One customer has reported several instances of vehicles running the stop signs, however the Road Department has received no other reports after the 3 -way stop was initially established in early spring. Recommendation: With satisfaction of Criteria 3, the intersection of Brookswood Boulevard/Baker Road marginally meets the guidance recommendations established by the MUTCD for establishment of all -way stop control. Given the satisfaction of a MUTCD guideline, the successful transition to all -way stop control at the intersection over the past five months, and the likelihood of additional growth and increased traffic volumes in the future, 1 recommend that the 3 -way stop remain in place at the intersection of Brookswood Boulevard/Baker Road. Ag1/ ,„0110: tpif MUTCD: Installation of Multi -Way Stop Section 26.07 Multi -Way Stop Applications $ƒ L /R \\ /% 2 « \ f / ° / \\ ° \^ L */ 0 0 / % u - /} - .� g \\E/ © . Cs-o c 0 ƒ ® // o 0 / / f q \/ 0 E \ ©g = •% u ° / �/ [ 0 c= G £ 0 / e \ / 0 \f % \ y t:10 / k » 0 0 ~ 9 © \ til / t o / . / •E / e 41-, 0- t t , ƒ $ ° e c \ .S y 0 �(� a. \ 00 9 / / 5 \ \ 2 3 / 2 77\ 3 \ 0 \ _ / ® § •_ ®2 % ® G & Z-.3 © 3 \ % ®a ' e z } ƒ �.9 2 0 0 . .o \ E/ f u y= 2u ƒ / / ° / ƒ E �® e y k 7y0 / ® S 39 _( °6/ �\ /2 % a .--e3 § o .\ v.- ,..) '/ / \ \ \ o / •/ƒ ° / y\ @ o R< o o * CL) _ °® .0- e 0 a -0 /\ f G \ /f :9 / \ /// \ Let to ƒ\ t�i.� ƒ 00 3/° \E /\\ as t2/\/ %/� Q %2§ [.t /°®\/\ u\§ -5. / a o $ EaVI 2 E £ d % % « o « 2 -Way Stop, cont. ƒ be considered Other criteria that m A. The need to control left -turn conflicts; B. The need to control vehicle/pedestrian conflicts near locations that generate high pedestrian volumes; Brookswood/Baker Road > � c 2 •- o O a. O C., E � a) >, \ - a« c6 O m c o v L.) +-, a) a) IA > ro v a) c •— 4) > n c -Ci v O S-- D u C6 0- O a>, N 4-1 ✓ c c (1) O a) aJ c N f6 O 0 • O 0 E O N V • p E 4-j CO c a) c -0 O c O u d 4 ro c O O 4- •_+ cr6 6 r —" -0a) a) a. n ct O Ocu bA u c -0•--- :Ei�•) ( 4-J e6 O c c6 w Cl >.S: L V) 0__ • c u +>', 5- bA rC5 V • N _ v 4- .4-j v +-a 073 rt3 `co cO o L. c _,V N V in c C ( LA O 0 O > u 6ri O (1) a) N O_ N u -C p c O i a) toJ 0-07 +�+ c S) > c a) °C. >, E u CL sJ 0 r6 V2 0 M N V Q JI September 2, 2015: County issues the following press release: See next page... QTY LO N 0 0 a) t co a) 0 -o co 17) co Q 0 ed Cl) E 0 0 c.) 0- • u) in '03 Ic ea _ 3 13 CI; Ct5 • Ce CI) cp ct. co > 73 co c 0 • co c.) O 00 48 c/a 0 02 Er - o r § 0 4-- O 2 p o 4-- co ... o E c 0. P.- 02 11' 2 0 a) .6 a) 0 D ,,c 0 CD -2 t co Li= s_ 0c CO (6 a) al 0 cCD 2 -4-- 0 0 4C-6 ft -0 E a) c .L.9-. f- 7,q.' 4-' .., •,-.„ 0 ..5'8 -c 0 a) ri E "5 2 45 E cf) P.. cS t O 8 c a) co 0) .0 0 0 -=-E, 3 .c a p co co s- C 0 a) r 8 .,,,, 174 D Cl 4.-"' 0 0_ o ,- 0- fy 0 cn @ (I) co • , 0 eti 2 o • ':,- --.6 0 0 >,(4) 0) 0 L. • ----- p D 43 co Es! CO a) L- 0-)., -"E5 ....-; v. cp oc - 0 oc > a, co 0 (1) a) o -0 E p O a) DQ) C • a rn t(D- M (..) • a) a3 E 0 O c > 0 a 0 8 .F; u) co ...e u) 0 a) a5 co O ca a 0 g L ..c — E, 2 co a) fn 0 a) a, a) ' co > c co 0w — :E, W 00 ce) 0 5 cri o ...e 0) Cm c—oo>, =-L.,00) O on ccO -§- -0 Tr) 0-0 4E° 2 cii a) Cl 0 D CO 0°) 0 0 1.... S... ..0 rrt 4,.., fn 2 0 0 Ij o 0 -0 2 2 co 0 (I) 0 > c cn 0 CO i— 0 E-- aj -0 CO September 2-16, 2015: a) V) a) o • c .4.73 0 • u • Q) cll cu E E QJ • — O • -▪ 1.-J 4--J • (13 res o a) " 7:3 C n3 0 O L) 4J • 0 4--j tf) _C em • ti) Ti) (i) >, C c a) 0- 0 Lf) C 4-, 0 0- (1.) V) fO v) • 11) 73 a- c LI) u • r13 -k-) E "Rs • E a_ L... a) i?, 0 a) 7:3 (13 IA O rZ Brookswood/Baker Road MU September 22, 2015: 0 a_ I-- \ m 8 - § \ CLOm ° / E~ \\ \K\ E , \\ r 3. If the 85th -percentile approach speed of the major -street traffic exceeds 40 mph, the minimum vehicular volume warrants are 70 percent of the values provided in Items 1 and 2. Additional criteria/considerations: 0 V reported data): Crash Data (D DMV data only available thru Sept z0 EJ 0 u CL 0 4(71, f3 c 0 rt5 ro 4-) • — L._ a.) 4-) 0 ro 0 4- rC1 E ro CS' M Crash Data (DMV reported data): dOtS so? 2. o ra u w La • 0 o • u • 0 o c o • G co -CES -< Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/ AGENDA REQUEST & STAFF REPORT For Board of Commissioners Work Session of September 5, 2018 DATE: August 30, 2018 FROM: Janice Garceau, Health Services, TITLE OF AGENDA ITEM: Mosaic Medical Van at the Drop ATTENDANCE: Janice Garceau, Interim Behavioral Health Deputy Director SUMMARY: Deschutes County Health Services -Behavioral Health Division (DCHS-BH) requests BoCC approval to enter into a lease agreement with Mosaic Medical in order to facilitate the provision of primary health care to children, youth and young adults served through Intensive Youth Services at The Drop located in the Wall Street Services Building. The Drop provides a safe, drop-in space at which youth and young adults can meet basic needs, receive support and potentially engage in needed services. Intensive Youth Services (IYS) serves children, youth and young adults in Deschutes County aged 5-29 with severe mental health disorders, addiction and at risk for homelessness. Many of these young people have no access to routine health care. DCHS-BH seeks to park the Mosaic Mobile Medical Van at the Wall Street Services Building in order to provide primary health care services on Wednesday afternoons from 1:00-5:00 p.m. Facilities has designated an appropriate space that will not interfere with other County business and is involved with other logistics related to this project. Facilities will draft the lease agreement upon approval of this request. EALT H .R" " ORAL EAL Proposal: Mosaic Mobile Van at DCHS "The Drop", at 1340 Wall St, Bend OR, 97701. Project Contact: Elizabeth Renteria Holden, LCSW, Behavioral Health Program Manager, Intensive Youth Services Summary: Deschutes County Health Services -Behavioral Health Division (DCHS-BH) requests BoCC approval to enter into a lease agreement with Mosaic Medical in order to facilitate the provision of primary health care to children, youth and young adults served through Intensive Youth Services at The Drop located in the Wall Street Services Building through the Mosaic Mobile Medical Van. The Drop provides a safe, drop-in space at which youth and young adults can meet basic needs, receive support and potentially engage in needed services. DCHS-BH seeks to park the Mosaic Mobile Medical Van at the Wall Street Services Building in order to provide primary health care services to clients of DCHS. Logistics: • Clinic Hours will be each Wednesday from 1:OOpm to 5:OOpm • Facilities has designated an appropriate parking space that will not interfere with other County business and is involved with other logistics related to this project • Access to Restroom and electrical outlet at The Drop will be required • Facilities will draft lease agreement upon approval of this request • Regular monitoring of project will occur by Deschutes County Staff Rationale: • Some estimates state that people with serious mental illness die on between 10 and 25 years earlier than the general population due to under treated chronic physical health issues. (Walker ER, McGee RE, Druss BG. Mortality in Mental Disorders and Global Disease Burden Implications: A Systematic Review and Meta- analysis. AMA Psychiatry. 2015 Feb 11. doi: 10.1001/jamapsychiatry.2014.2502. [Epub ahead of print] • Intensive Youth Services: Serves an average of 250 children, youth and young adults (ages 5- 29) with serious mental illness annually. Many of the clients have or are pre -morbid for chronic physical health conditions. Potential Impact: • Access to medical care on site can improve physical health outcomes and improved coordination of care between physical health and behavioral health. • May result in a decrease in travel and coordination time of staff members who must currently work with outside physical health providers. • Potential to increase traffic to the area and referrals to DCHS 2577 Ni- Courtney Dive, Bend, Oregon 97701 (5*+)3275()Q>&Z}fl(<i.ilyr?I'VICE'S'.<. �iE:�iC!`i1.1P..S.O"�' �jYVVdV`•1.i7P�iCi1t.IT.£?>.O'-aji-IE'2t:Y' Al Health Services Requested Hiring Freeze Exemptions August 22, 2018 1, 2, 3. Access Team Vacancies — Two BHS II positions (Rebecca Battleson and Christal Rothrock vacancies) and one to two on-call positions (Jackie Clark vacancy) • OHA sets Access to Care timelines (appointment within 14 days of initial contact) for community mental health programs. These are reinforced in the contract with Pacific Source. • Access to Care timelines are managed by the Access Team, which conducts the majority of first appointments for clients. • The result of current Access team vacancies and reduced on-call support is that we are not currently meeting this contractual obligation. We are 3 weeks out in LaPine and are about to exceed two weeks in Bend. Note: this is occurring during our slowest period (summer) and with the exiting staff still providing some level of service as they wind down schedules. By September, wait times will increase unless we address staffing levels. • Consequence of not meeting the timeline: o We will receive a corrective action plan from Pacific Source with the expectation that we remedy within 60 days. o Clients with acute needs may end up in higher levels of care — use Crisis or emergency services. o We lose revenue from billed assessments, particularly during the CCBHC grant period (ends March 31) Request: Refill both Access vacancies and maintain one or two on-call staff for busier periods. 4. ACT Team Nurse — One Public Health Nurse (Stephanie Gallegos vacancy) • Assertive Community Treatment (ACT) is a State and Oregon Performance Plan requirement for community mental health programs. • ACT is a fidelity -based program that provides intensive community based services to adults considered to be the most vulnerable/highest acuity due to serious and persistent mental illness (schizophrenia, schizoaffective and other psychotic disorders). • As a fidelity program, ACT is required to maintain an RN to provide intensive supports such as medication management and administration, health promotion/education and care coordination for complex medical issues. No other position has the credentials to provide these required services. • Consequence of not filling vacancy: o Without an RN, the program will not meet ACT fidelity requirements, and will lose the ability to bill for services at the ACT rate (higher than usual rate). o Without intensive supports, individuals are at risk of hospitalization or incarceration due to the seriousness of their mental illness. o Loss of CCBHC revenue —the RN in this role averaged 21.33 PPS counts per month or $6,484.32/month for time period 4/1/2017 to 3/31/2018. Request: Fill position immediately. 5. I/DD Health Services Supervisor (Refill Jillian Weiser's position) • I/DD Program is a contractual commitment to provide supports and services to individuals from birth to end of life. The services authorized are determined by an annual needs assessment. • Important note: I/DD funding is NOT tied to any OHP dollars nor CCBHC funding stream. • Consequences of not filling the vacancy: o There is zero capacity to absorb this work amongst the existing team. Seven direct reports would need to be redistributed. o Position is state funded through the Workload Model and the funding cannot be allocated elsewhere based on contractual requirements. If funding is left unspent, this would negate the ability to acquire local match revenue ($224,000+ last FY). o This position provides required oversight and inputting of financial authorizations into state billing system, and creates data reports per state requirements. Lack of financial oversight and would risk incorrect authorizations and payments ($23,000,000+ Medicaid dollars authorized in approximately 484 client plans). If need to payback the monies would be required to come from county general fund. • The position is not yet vacant o Jillian Weiser is slated to start her new position 9/1/18 as the new HS Quality and Performance Manager. However, until this position is refilled, Jillian's time will be split with I/DD to allow duties to continue to be fulfilled due to the extensive above mentioned requirements of the position and how they cannot go unmet thus adding a burden to her receiving team. Request: Fill 1/DD Health Services Supervisor position as soon as possible. 6, 7. Adult Outpatient Providers — Two BHS II positions (Marta Richards (Main Clinic) and Alexa Loscutoff (Redmond Clinic) vacancies) • These positions staff outpatient services teams at the Main and Redmond Clinic. • Outpatient teams currently provide complex care to individuals with serious mental health disorders including veterans, who typically present with trauma and co-occurring substance use and chronic health conditions. • Outpatient clinic teams have consistently been the most productive teams at DCHS. Revenue generated by these teams helps to offset costs of other services that are more complicated to fund. • Consequence of not filling vacancy: o Outpatient positions generate significant revenue. A delay in refilling these two positions costs DCHS approximately $ per month in PPS payments. Note: These positions ramp up very quickly due in part to volume and to the fact that exiting clinicians leave up to half an active caseload that needs to be assigned. o Due to volume, timelines for first treatment appointments at the Main and Redmond Clinic have been a challenge. Without these positions, timelines will expand. We will be outside OHA expectations for first treatment appointments (different from intake appointments). o Outpatient Teams serve many individuals at risk for hospitalization and help meet new Pacific Source metrics intended to reduce ED visits and hospitalization. Request: Fill positions immediately. 8. Front Office — On -Call Administrative Support Technicians (Refill clue to three vacancies — Sarah Hansen, Brian Hickey & Kari Hutchison) • In preparation for the loss of one front office position in the FY 2019 budget and to better address coverage issues, the Front Office team hired three on-call employees on May 1, 2018. Since that time, two have been hired into regular positions and one resigned to accept a position outside the county. • These position combined work an average of 84 hours per month. • The front office team currently has 11 employees working in five locations • The front office team processes an average of 9,207 client visits per month • Consequences of not filling vacancy: o Issues in providing coverage at all five locations for vacations and illness. o Loss of efficiency and expedience checking in clients o Need to request support from non -front office staff for coverage negatively impacting quality of service Request: Maintain 2-4 on-call employees to utilize for about 80 hours per month 9. Compliance — On -Call Quality Improvement Analyst (Refill vacant position with on-call) • This will allow all Behavioral Health clinical staff to be audited at least once per year. • Significant improvements were realized when data integrity audits were conducted on all clinical staff instead of a sample. • External audits from OHA and Pacific Source have highlighted that compliance scores and corrective action plans can be improved with more frequent data integrity audits • Data integrity audits have reduced documentation errors resulting in paybacks on impacted claims (approximately $350,000 per year). Request: Hire on-call employee to conduct audits about 80 hours per month in support of one regular, fulltime Quality Improvement Analyst. 10. BH Medical Team - Psychiatric Nurse Practitioner — This position had been posted as a limited duration position. In the FY 2019 budget, regular Behavioral Health Specialist II positions were converted to Psychiatric Nurse Practitioners. Request: Repost as a regular position.