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2020-183-Minutes for Meeting May 04,2020 Recorded 6/8/2020L�0j ES CMG ?� BOARD OF COMMISSIONERS 1300 NW Wall Street, Bend, Oregon (541) 388-6570 Recorded in Deschutes County C J2020.183 Nancy Blankenship, County Clerk Commissioners' ,journal 06/08/2020 1:56:01 PM ,\t F5 ��('� II I I I II I II�II II I I III I I II II II III 2020-183 �F FOR RECORDING STAMP ONLY Virtual Meeting Platform Present were Commissioners Patti Adair, Anthony DeBone (present via Zoom conference connection), and Phil Henderson (present via Zoom conference connection). Also present were Tom Anderson, County Administrator; David Doyle, County Counsel (present via Zoom conference connection); and Sharon Keith, Board Executive Assistant (present via Zoom conference connection). This meeting was conducted via Zoom Meeting and live streamed through the Deschutes County Public Meeting Portal. This meeting was audio and video recorded and can be accessed at the Deschutes County Meeting Portal website http://desch.utescountyor.iqm2.com/Citizens/Default.aspx CALL TO ORDER: Chair Adair called the meeting to order at 1:02 p.m. PLEDGE OF ALLEGIANCE: ACTION ITEMS: 1. Consideration of Grant Application Deputy District Attorney Daniel Reesor presented an application for a grant to provide funding for a special elder abuse investigator. Mr. Reesor reported on the need within the District Attorney's office and the anticipated increase in cases due to economic impacts from COVID-19. BOCC MEETING MAY 4, 2020 PAGE 1 OF 3 Move approval of grant application Second VOTE: DEBONE: HENDERSON: ADAI R: 2. COVID-19 Update Yes Yes Chair votes yes. Motion Carried County Administrator Tom Anderson presented a draft COVID-19 Recovery Framework and pre -requisite checklist based on the discussion at the BOCC meeting of Friday, May 1, 2020. Commissioner DeBone commented this is a work in progress but supports approving a phase 1 document. Commissioner Adair supports having the document submitted by Wednesday this week. Commissioner Henderson commented on the guidelines relative to cases, hospitalizations, and testing. Commissioner Henderson is also supportive of a phased re -opening. n;ror'tnr %A/kitni\/ W.310 Mill I mriato tho rind lmant r,Qt %.UI III I I U I I1%.Qt1UI la V11 Cl.tV1 YYI nu 1%—y I I[ 'I —nl uNuua uI Imo. ­­. ­ ". —C,'. Nathan Garibay was present via conference call and reported on the data for known of hospitalizations from the Oregon Health Authority. Dr. George Conway was present via conference call and feels the tracking criteria will change. Governor Brown has announced a prerequisite checklist where each of the seven prerequisites must be met before a county or region can enter phase 1 of reopening Oregon. Commissioner Henderson expressed his opposition to these prerequisites and would support moving forward as quickly as possible. Commissioner Adair expressed sympathy to the Deschutes County residents that are suffering from the extreme economic impacts associated with the ongoing COVID-19 restrictions. Commissioner DeBone reported on the multitude of communications that are being sent to the Commissioners and expressed the importance of working together in finding the best path to move forward. County Administrator Anderson will revise the Deschutes County reopening strategy to include the prerequisite checklist for the Board to consider at the May 6, 2020 meeting. BOCC MEETING MAY 4, 2020 PAGE 2 OF 3 OTHER ITEMS: County Administrator Anderson reported on a continuing re -opening forum that has been held which includes the Mayors of Bend and Redmond. They have invited a commissioner to join them. Commissioner DeBone has offered to participate. • County Administrator Anderson noted that the COVID-19 discussion scheduled for the Commissioners' meeting on May 6, 2020 will include the short term rental order, special event permits order, proposed non - congregate order, and child care assistance. Commissioner Adair announced the importance of the upcoming Fire Free dates starting on Saturday. Being no further items to come before the Board, the meeting was adjourned at 2:17 p.m. DATED this & Day of 2020 for the Deschutes County Board of ATTEST:r � W �w NI HILIP e HENDERSON, COMMISSIONER BOCC MEETING MAY 4, 2020 PAGE 3 OF 3 Deschutes County Board of Commissioners 1300 NW Wall St, Bend, OR 97703 (541) 388-6570 - www.deschutes.org BOCC MEETING AGENDA DESCHUTES COUNTY BOARD OF COMMISSIONERS 1:00 PM, MONDAY, MAY 4, 2020 Live Streamed Video - 1300 NW Wall Street - - Bend This meeting is open to the public, usually streamed live online and video recorded. To watch it online, visit www. deschutes. org/meetings. 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. Item start times are estimated and subject to change without notice. CALL TO ORDER MEETING FORMAT In response to the COVID-19 public health emergency, Oregon Governor Kate Brown issued Executive Order 20-16 directing government entities to utilize virtual meetings whenever possible and to take necessary measures to facilitate public participation in these virtual meetings. Beginning on May 4, 2020, meetings and hearings of the Deschutes County Board of Commissioners will be conducted in a virtual format. Attendance/Participation options include: Live Stream Video: Members of the public may still view the BOCC meetings/hearings in real time via the Public Meeting Portal at www.deschutes.org/meetings. Citizen Input: Citizen Input is invited in order to provide the public with an opportunity to comment on any meeting topic that is not on the current agenda. Citizen Input is provided by submitting an email to: citizeninput@deschutes.org or by leaving a voice message at 541-385-1734. Citizen input received before the start of the meeting will be included in the meeting record. Zoom Meeting Information: Staff and citizens that are presenting agenda items to the Board for consideration or who are planning to testify in a scheduled public hearing may participate via Zoom meeting. The Zoom meeting id and password will be included in either the public hearing materials or through a meeting invite once your agenda item has been included on the agenda. Upon entering the Board of Commissioners BOCC Meeting Agenda Monday, May 4, 2020 Page 1 of 3 Zoom meeting, you will automatically be placed on hold and in the waiting room. Once you are ready to present your agenda item, you will be unmuted and placed in the spotlight for your presentation. If you are providing testimony during a hearing, you will be placed in the waiting room until the time of testimony, staff will announce your name and unmute your connection to be invited for testimony. Detailed instructions will be included in the public hearing materials and will be announced at the outset of the public hearing. PLEDGE OF ALLEGIANCE ACTION ITEMS 1. Consideration of Grant Application -Daniel Reesor, Deputy District Attorney COVID-19 Update 2. Draft COVID-19 Recovery Framework -Tom Anderson, County Administrator Add -On OTHER ITEMS TI....... .. la., ... . 1v..rv.� —f ;n fiirlarl nn tho rvvonr�iry thrvt tho rnmmiccinnPrc Wich to rfIcrimiz !yc nryrr of I Ilese call Lie any itCems /IVl llia IUMN M -II a1.a. uba...awN a..a..a a. ... ....................._... ....... ... ... ........__ -._ !"'.' -J the meeting, pursuant to ORS 192.640. EXECUTIVE SESSION At any time during the meeting, an executive session could be called to address issues relating to ORS 192.660(2)(e), real property negotiations; ORS 192.660(2)(h), 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 media. ADJOURN Deschutes County encourages persons with disabilities to participate in all programs and activities. This event/location is accessible to people with disabilities. If you need accommodations to make participation possible, please call (541) 617-4747. FUTURE MEETINGS: Board of Commissioners BOCC Meeting Agenda Monday, May 4, 2020 Page 2 of 3 Additional meeting dates available at www.deschutes.org/meetingcalendar Meeting dates and times are subject to change. If you have questions, please call (541) 388-6572. Board of Commissioners BOCC Meeting Agenda Monday, May 4, 2020 Page 3 of 3 -� E S C0G o 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 BOCC Monday Meeting of May 4, 2020 DATE: April 30, 2020 FROM: Daniel Reesor, District Attorney's Office, TITLE OF AGENDA ITEM: Consideration of Grant Application AGENDA REQUEST & STAFF REPORT For BOCC Meeting: Monday, May 4th DATE: 04/30/2020 FROM: Daniel Reesor, Deputy District Attorney, Contact: 541-317-3158 John Hummel, Deputy District Attorney TITLE OF AGENDA ITEM: Consideration of Board Approval of Grant Application for 2020 Competitive grant application for fully funded Elder Abuse Investigator —Enhancing Services for Older Victims of Abuse and Financial Exploitation- U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime BACKGROUND AND POLICY IMPLICATIONS: The U.S. Department of Justice (DOJ), Office of Justice Programs (OJP), Office for Victims of Crime (OVC) is seeking applications to implement projects that enhance services for older victims of abuse and financial exploitation. This program furthers the Department's mission by supporting victims of elder abuse and financial exploitation. This program is intended to improve outcomes, minimize additional trauma, and restore safety and security to older adult victims of abuse and financial exploitation. Elder abuse, sometimes called elder mistreatment, includes any intentional or negligent act that causes harm or creates a serious risk of harm to an older person by a family member, caregiver, or other person in a trusted relationship. Elder abuse may include abuse that is physical, emotional/psychological (including threats), or sexual; neglect (including abandonment); and financial exploitation. Elder financial exploitation also includes fraud, scams, or financial crimes targeted at older people. The proposed Enhancing Services for Older Victims of Abuse and Financial Exploitation Project ESOVAFEP for Deschutes County, Oregon will improve advocacy, assistance, and safety planning within the criminal justice system and with social service agencies and community organizations, in order to restore older victims' lives and help to prevent further victimizations. FISCAL IMPLICATIONS: There will be fiscal implications, but not yet defined. ATTENDANCE: VIA ZOOM MEETING: Daniel Reesor- Deschutes County Deputy District Attorney Enhancing Services for Older Victims of Abuse and Financial Exploitation Deschutes County, Oregon DESCHUTES COUNTY DISTRICT ATTORNEY U.S. DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS OFFICE FOR VICTIMS OF CRIME FY 2020 Competitive Grant Solicitation Project Abstract Elderly victims of abuse have a significant increase in mortality, particularly in the first year after the crime is reported'. The proposed Elder Abuse and Financial Exploitation Team (EAFET) for Deschutes County, Oregon will improve advocacy, assistance, and safety planning within the criminal justice system and with social service agencies and community organizations, in order to restore older victims' lives and help to prevent further victimizations. Through this project, older victims will be given direct service, protecting their safety and confidentiality, ensuring they are treated with dignity and respect. The project intends to assist elder abuse stakeholders with resources to push the gathering and analysis of evidence and victim assistance closer to the discovery of the crime. A final report will be generated, describing project activities, promising practices, challenges encountered, and solutions to address the challenges to improve outcomes for older crime victims. 1 Dong, X.Q., et al., "Elder Self -neglect and Abuse and Mortality Rick in a Community -Dwelling Population." JAMA (2009): 517-526 Deschutes County District Attorney — Project Abstract RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Description of the Issue Community to be served Encompassing an area of 3,018 square miles in the middle of the state, the region is isolated, both by geography and distance, from Oregon's most populated metropolitan areas. Deschutes County is approximately 135 miles from the State's capitol, Salem, and 175 miles from Portland, the State's most populous area. Nearly two-thirds of the State's geography is east of the Cascades. Deschutes County covers 3,055 square miles, with the majority of this property owned by various federal and state agencies. Figure 1. o r,K- -. ad River 5 . Shermo Gillia Morro,. Clockoma Wasco; Marion Wheeler Jefferson Linn Gn Crook Lone Deschutes ouglos ""rne Lake Klamath Iaon The city of Bend is the county seat and the largest city east of the Cascade Range, with a population of 97,5901. There are only four incorporated cities in the county: Bend, LaPine, Redmond, and Sisters. Roughly 40% of the county's population resides outside of these incorporated cities. Deschutes County is mixed urban/rural with a total population of 181,307.2 Latinos, the largest minority group, represent 7.8% of the population.3 Individuals with I US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 2 US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 3 US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 Page 1 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE disabilities make up 12.8% of the population with persons who are deaf or hard of hearing comprising 5.5% of the population.4 Deschutes County has a large older adult and elderly population. According to the US Census 2018 American Community Census, Deschutes County's population includes 26.7% over the age of 60, and 10.9% of those 65 or older are living alone 5. Additionally, 38.4% of grandparents are responsible for their grandchildren in the county6. The County continues to rank as one of Oregon's fastest -growing counties since approximately 2000. The area continues to attract a large number of retirees to the area, increasing the elderly demographics. Problem Statement The trauma of elder abuse can result in premature death, the deterioration of physical and psychological health, destruction of social and familial ties, devastating financial loss and more. Older adults are being mistreated in multiple settings (homes, nursing homes, assisted living facilities) by family members, friends and neighbors, professionals, and strangers..111c Deschutes County District Attorney's Office seeks to minimize this trauma, by utilizing an elder abuse investigator. An elder abuse case has many stages from the incident through investigation, prosecution, and victim recovery. The Deschutes County District Attorney's Office seeks to improve outcomes at each stage by providing resources, training and information, and by promoting a multidisciplinary response to elder abuse. 4 US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 5 US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 6 US Census Bureau. Quickfacts: Deschutes County, Oregon 2020 Page 2 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE The Deschutes County District Attorney's Office, and Deschutes County Parole and Probation, currently has a total of 603 active cases, in which the crime victim is 65 years of age or older. Of that total, 237 cases are property and financial crimes. Offenders include family members, friends and neighbors, professionals, and strangers. Many of these financial cases involve large dollar amounts, and necessitate complex investigations, where often times law enforcement resources are stretched thin. Figure 2. Deschutes County Active Cases Involving Victims 65 Years of Age or Older •1 `i•:: r. �3 Page 3 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE In addition, the Deschutes County District Attorney's office is anticipating an upturn in the number of elder abuse cases in the next twelve to twenty-four months. The recent COVID-19 pandemic has caused an economic crisis for many individuals. Elders with a steady, fixed income, have become even more vulnerable to abuse as a ready source of revenue. Elder abuse thrives in social isolation and the mandated "stay at home" directives have created an environment where this type of crime can thrive and go unnoticed for months. Central Oregon is a very remote, rural location and has limited resources, such as public transportation options, especially outside of the Bend city limits. Over fifty percent of Deschutes County's 181,307 population lives outside of Bend. Elders who have been abused have a significant increased risk of mortality in their first year after the abuse? and an overall 300% higher risk of death when compared to those who have not been mistreated 8. Elderly financial abuse victims experience a dramatic decline in their t•, rt•� t _tit__ .__ _ ______1._ __.]aL _.,.,...,. 1_4Q- ... _A 4-1.,...1,7,i«l., l... — 1;++1-+;�.. _+_ quality of lire and, unlike yvUilgel PrUPIe W1L11 yGQ1J IVIL W W01K, Me e1uc11y MY%, 11L 1%, lull%, W recover from a financial loss9. Table 1 illustrates a portion of the findings of one study, showing the highest levels of depression symptoms and lowest levels of social network and social engagement associated with a "significant increase in risk of mortality" for those reported to social services agency for elder abuselo 7 Dong, X.Q., et al., "Elder Self -neglect and Abuse and Mortality Rick in a Community -Dwelling Population." JAMA (2009): 517-526 8 National Council on Aging. National Council on Aging. n.d. <https://www.ncoa.org/public-policy- action/elder justice/elder-abuse-facts>. I Elder Abuse. Elder Financial Abuse. 2019. <https:Helderabuse.org/financial-elder-abuse>. 10 Dong, X.Q., et al. "Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing." Gerontology (2011): 549-558. Page 4 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Table 1. No elder abuse Reported elder abuse Confirmed elder abuse n = 7,728 deaths/100 n = 113 deaths/100 n = 63 deaths/100 person -years person -years person -years Depression Low 3,265 (43.1) 4.61 35 (31.3) 9.44 20 (31.8) 12.88 Middle 2,668 (35.2) 6.06 28 (25.0) 14.56 17 (26.9) 19.78 High 1,641 (21.7) 7.57 49 (43.8) 15.64 26 (41.3) 22.03 Social Network Low 2,153 (28.0) 7.58 45 (39.8) 19.19 29 (46.0) 28.00 Middle 3,119 (40.6) 5.68 43 (38.1) 10.76 22 (34.9) 19.40 High 2,417 (31.4) 4.84 25 (22.1) 9.23 12 (19.1) 5.74 Social engagement Low 3,002 (39.0) 8.16 58 (51.3) 17.16 32 (50.8) 27.41 Middle 2,416 (31.4) 5.38 30 (26.6) 12.01 18 (28.6) 14.53 High 2,275 (29.6) 3.91 25 (22.1) 8.99 13 (20.6) 10.63 1 '*Confirmed elder abuse cases are a subset of reported elder abuse cases. Community Safety Stakeholders Law enforcement in the area is provided by the Oregon State Police, Deschutes County Sheriff's office, Bend Police Department, and the Redmond Police Department. The city of Sisters contracts law enforcement services with the Sheriff's office, and the unincorporated resorts of Sunriver and Black Butte Ranch have their own, small departments. The Deschutes County elderly population is supported government agencies including the Department of Human Services (DHS) Aging and People with Disabilities, Adult Protective Services. Volunteer and faith -based organizations include the Council on Aging of Central Oregon, United Senior Citizens of Bend, Interfaith Volunteer Caregivers of Central Oregon and Meals on Wheels. These various law enforcement and social service agencies, along with the Deschutes County District Attorney's Office, comprise the Deschutes County Multiple -Disciplinary Team (MDT) for Senior Adults and Adults with Disabilities, which meets on a regular basis throughout 11 Dong, X.Q., et al. "Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing." Gerontology (2011): 517-526. Page 5 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE the year. The Multi -Disciplinary Team (MDT) is a select group of professionals throughout the community who work with Elder and/or Dependent Adults. This MDT meeting for Senior and Adults with Disabilities is organized and managed by Deschutes County Deputy District Attorney Daniel Reesor and is attended by a victim advocate from the Victim Advocacy Program (VAP) of the District Attorney's Office. The purpose of this MDT meeting is to provide collaboration between agencies on getting resources to the elderly and vulnerable population of Deschutes County. The meeting is comprised of professionals from the community present complex cases in confidential meetings and team members provide constructive feedback and identify strategies to reduce risk to these vulnerable adults. The current close collaborations between law enforcement, the DA's Office and victim service programs, combined with a concerted effort to improve evidence collection and investigation of elder abuse crimes, suggests that more coordinated efforts will enhance community response to elder Abuse. Creating all Elder Abuse 111Vcstlgatvr position within the office and creating an Elder Abuse and Financial Exploitation Prevention Team, (EAFET) will facilitate this collaboration. Project Design and Implementation Goals of the Elder Abuse and Financial Exploitation Prevention Team The goal of this project —hiring an Elder Abuse Investigator (EA -Investigator), and creating an Elder Abuse and Financial Exploitation Prevention Team (EAFET), is to support the Deschutes County District Attorney's Office, State and local law enforcement, and social service agencies, with investigations and provide more effective distribution of social services, to older victims of abuse and exploitation. This project will serve the County of Deschutes, Oregon, and more specifically elderly victims of crime. Page 6 of 20 RUNNING HEAD: DESC14UTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Goals of the proposed project. 1. Facilitate communication between agencies and expedite social service resources to elderly victims in the community; 2. Provide assistance to law enforcement with elderly victim interviews, the collection and analyzing of evidence, and financial analysis; and 3. Provide assistance to prosecutors with trial preparation, including with presentation and analysis of evidence for trial. The investigator may be called upon to testify to the facts related to the evidence in the case, including as a fraud examiner or financial analysist. Objectives of the proposed project. 1. Hire, train and supervise an EA Investigator to provide enhanced elder abuse investigations and collaborative response to elder abuse. 2. Create an Elder Abuse and Financial Exploitation Prevention Team to address elder aDl15e cases, CSpeGlcllly lUI:UJGU orl 1111Ctt1W111 cxplvtlAllvu Y1wGcuti0ii aiiu Yic.vCuUivu. 3. Provide multi -disciplinary community training on elder abuse and financial exploitation cases. 4. Continue implementation and enhance elder abuse Training with Deschutes County law enforcement agencies. 5. Provide immediate, confidential victim services to elderly victims referred by law - enforcement and social service agencies. Proposed Project Tasks, Activities, Timelines, and Final Product Phase 1: Proposed Project. • Task # 1: Hire, train and supervise Deschutes County EA -Investigator, with focus on elder abuse and financial exploitation crimes. Page 7 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Activities: 1. Solicit applications for EA Investigator position. (October 2020) 2. Interview and hire EA -Investigator. (November 2020) 3. New EA Investigator training. (November -December 2020) 4. Continue training local law enforcement agencies on coordinating investigations with EA -Investigator. (November 2020) 5. Conduct elder abuse investigations with focus on financial exploitation crimes. (December 2020-September 2023) 6. EA Investigator to attend and play an active role in following up on tasks identified in twice monthly Elder Abuse team meeting. (November 2020-September 2023) 7. EA Investigator to identify gaps and develop training to address any gaps identified including tangible and transferable training product. (November 2020-September 2023) rriu-1 Product* Elder Abuse r1undlerss are 1e1u accountable commensurate with ciuiieo committed; Elder Abuse investigations are enhanced by greater capacity to gather evidence and provide follow up investigation. • Task #2: Develop and implement Elder Abuse and Financial Exploitation Team. Activities: 1. Develop team's intent and function. Utilize Oregon Department of Justice and national models to inform creation of team protocols. (October 2020) 2. Select team members (October 2020) 3. Provide team members training on elder abuse offenders, elder abuse victims and Elder Abuse and Financial Exploitation team functions. (October 2020-November 2020) Page 8 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE 4. Conduct twice -monthly Elder Abuse and Financial Exploitation team meetings, with focus on high -risk DV cases. (November 2020-September 2023) 5. Follow through with tasks assigned at Elder Abuse and Financial Exploitation team meeting; report back at subsequent meeting. (November 2020-September 2023) 6. Participate in community Elder Abuse trainings; attend out-of-state conferences as available. (November 2020-September 2023) Final Product: Coordinated community response to elder abuse and financial exploitation cases, providing greater offender accountability and victim safety. Phase 2: Proposed Project: • Task #3: Provide multi -disciplinary community training on elder abuse and financial exploitation cases. Activities: I. Research training content and opportunities with L.1det ALMSC; allu 1'111ant mi L:,AIJtviLaLiVu team partners. Place focus on elder financial exploitation investigation and prosecution. (November 2020-January 2023) 2. Obtain EA Investigator certification as fraud examiner and/or financial analyst. (by March 2021) 3. Provide "signs and symptoms of elder abuse" training to social service organizations, and bank -tellers and financial community. (by September 2021) Final Product: Participants gain enhanced understanding of elder abuse cases; new investigative methods enhance current investigative processes. • Task #4: Continue implementation and enhance elder abuse Training with Deschutes County law enforcement agencies. Page 9 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Activities: 1. Train new Officers and Advocates on Elder Abuse investigations, including interview techniques, subpoena methods and warrants for financial documents, and other financial evidence gathering techniques. (November 2020-September 2023) 2. Connect elderly victims to local and state elder abuse services. (November 2020- September 2023) 3. Conduct annual in-service training for law enforcement agencies, enhancing knowledge of Elder Abuse investigations and high -risk Elder Abuse cases. (Every spring and fall, November 2020-September 2023) Final Product: Elderly victims are immediately given access to program services; law enforcement investigations are enhanced through ongoing education. • Task #5: Provide immediate, confidential victim services to elderly victims referred by law -enforcement and social service agencies. Activities: 1. Provide follow up calls and in -person advocacy to elderly victims. (November 2020- September 2023) 2. Provide Bilingual Advocate or Trial Assistant for Latina elderly victims. (November 2020-September 2023) 3. Provide emergency shelter, safety planning, protection order support, legal advocacy, therapy and other elder program services to elderly victims. (November 2020-September 2023) 4. Elder abuse prosecutor, EA -Investigator, and victim advocate to attend six Deschutes County Senior and Adults with Disabilities MDT meetings a year, to identify elderly Page 10 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE victims needing services, and provide victim follow-up as needed. (Every other month, November 2020-September 2023) Outcome: Elder abuse victims receive immediate access to elder abuse program services. Deliverables. The strategy to implement the proposed project's goals and objectives: Deliverable #1. Direct service provision to older victims, using trauma -informed approaches that protect safety and confidentiality of victims. Victim safety will be paramount under the proposed project. Direct services are proposed to enhance elder victim safety, by having the EA Investigator immediately follow up with elderly victims, their caregivers, and family, to connect the victim with social services when applicable. The EA Investigator will maintain close contact and relationships with local social service agencies, including the local Department of Human Services (DHS) Aging and People with Disabilities, Adult Protective Services, the Council on Aging of Central Oregon, United Senior Citizens of Bend, Interfaith Volunteer Caregivers of Central Oregon, Central Oregon Veterans Outreach, and Meals on Wheels. Deliverable #2. Resources for service providers and criminal justice stakeholders. The EA Investigator will prioritize and provide follow-up investigations for elder abuse arrests in Deschutes County. A Deschutes County District Attorney Elder -Abuse team, comprised of a deputy district attorney (DDA), an EA -Investigator, and a victim advocate (VA), will convene twice per month to review current elder abuse criminal cases to provide seamless follow-through addressing offender risk and victim safety. The EA Investigator will attend weekly law enforcement detective meetings, with local law agencies. This will enable the EA Investigator in person contact with law enforcement on a Page 1 I of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE weekly basis, and provide collaboration between agencies on complex financial cases, and other elder cases. In regard to social service stakeholders, the EA Investigator will attend all Deschutes County MDT meetings, and assist the DDA in taking and recording minutes of the meetings. The EA Investigator and DDA will then review and collaborate after the MDT meetings, regarding follow up investigation needed, and specific elderly victims identified needing assistance. The EA Investigator will then work with local social service stakeholders in streamlining assistance to elderly victims in need. The EA Investigator will work closely with the elder abuse DDA, with evidence review and trial preparation. This will include working as either a fraud examiner, or financial analyst, reviewing large volumes of financial evidence. The evidence will be formatted in demonstrative exhibits, for use in jury trials. The EA Investigator will be available and called as a State witness in trial, and provide testimony about the financial documents reviewed, interviews, and other trial relevant testimony. Deliverable #3. Advocacy, assistance, and safety planning within the criminal justice system and with social service agencies and community organizations, in order to restore older victims' lives and help to prevent further victimizations. When elder abuse is reported, swift action must be taken to protect the elderly person from further harm. Restraining orders, stalking orders, sexual assault protection orders and emergency protection orders are available in Oregon. The EA Investigator will direct elderly victims, caregivers, and their families, to instructions and forms for persons seeking a restraining Page 12 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE order under the Elderly Persons and Persons with Disabilities Abuse Prevention Act (ORS 124.005 - 124.040). Additionally, the EA Investigator will work in close collaboration with the VAP advocate, and the DDA, to ensure restitution is properly requested and a timely request is given to the court. The EA Investigator will work closely with the VAP advocate, to ensure the elderly victim is fully aware of his or her constitutional rights as a victim in the pending criminal matter. Of particular importance, is the need of many elderly victims' transportation and travel concerns. Many elderly victims do not have easy access to a vehicle or can no longer drive due to physical disabilities or limitations. The EA Investigator will also work closely with the VAP advocate, and DDA, in scheduling and arranging transportation, to grand jury hearings, court hearings, and trial. Deliverable #4. Efforts to support and promote opportunities to ensure older victims of crime are treated with dignity and respect. The EA Investigator will work closely with the Deschutes County District Attorney's Victim Advocate Program (VAP) director, and individual victim advocates of the VAP program. EA Investigator will assist the VAP with scheduling transportation for elderly victims to grand jury hearings, court hearings, and trial. The EA Investigator will work closely with VAP and the DDA, meeting with elderly victims prior to grand jury, court hearings and trial. As the criminal case proceeds through the court system, the EA Investigator will remain in close contact with the elderly victim, caregivers, and victim's family, answering questions that may arise throughout the prosecution of the case. Page 13 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Deliverable #5. A final report describing project activities, promising practices, challenges encountered, and solutions to address those challenges to improve outcomes for older crime victims. Capabilities and Competencies Project management The Deschutes County Board of Commissioners provide oversight of grant -related activities. Supplemental services may be provided by County departments, including grant administration, legal counsel, administrative support, financial management, risk management, and technological system assistance. Deschutes County District Attorney's Office Under the direct supervision of the Deschutes County District Attorney, John Hummel, Deputy District Attorney Daniel Reesor will provide leadership for grant related activities and serve as Project Director with a focus on facilitating and coordinating the training and oversight of the Elder Abuse Investigator position. He will continue to attend and lead every Deschutes County Senior and Adults with Disabilities MDT meeting and be part of the team that supports the hiring, training and integration of the new Elder Abuse Investigator. DDA Reesor has been a prosecutor in Oregon since 2006 and has specialized in financial crimes, and elder abuse crimes for much of his career. DDA Reesor is currently a board member on the Oregon Department of Justice Advisor Committee for Elder Abuse. DDA Reesor has given presentations at the Oregon Department of Justice Annual Conference on Elder Abuse the last two years, training prosecutors, law enforcement, first responders, and social service workers on elder abuse issues. He has attended various national trainings on financial crimes, including for computer forensics at the U.S. Secret Service National Computer Forensics Institute (NCFI), Page 14 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE in Hoover, Alabama, and financial investigation training at the National White Collar Crime Center, in Orange, California. DDA Reesor has attended annual trainings at the U.S. Attorney's Financial Crimes & Digital Evidence Conference, in Salem, Oregon, and the Oregon Department of Justice Annual Elder Abuse Conference. As the lead elder abuse prosecutor for Deschutes County, DDA Reesor has also managed volunteers who assist in investigation and trial preparation of elder abuse cases. Volunteers have included both attorneys and community members. Community outreach has also included annual trainings at law enforcement academies, with a focus on property crimes, drugs, and search and seizure issues. Current District Attorney Resources Focused on Elder Abuse The office currently has one full-time DDA, who manages elder abuse prosecution cases. This DDA organizes and facilitates annual Senior and Adults with Disabilities MDT meetings, acts as a 'liaison to law enforcement and social seI Viee agcnC1rS ailu prosecutes a large criminal case load. Additionally, the office has also had an eight -hour -a -week volunteer investigator for over two years, providing critical staffing to the elder abuse DDA in the preparation and prosecution of elder abuse cases. This individual has a PhD in Human Services, a distinguished military background, and is a Certified Economic Forensic Crime Examiner. The analysis, organization, and preparation of evidence is complex and time consuming, requiring resources previously unavailable to the DA's office. The volunteer's work has assisted not only in the successful prosecution of cases at trial but has aided in support of defendants accepting a plea bargain in lieu of trial. Page 15 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Sustainability Assistance and support to the elder abuse DDA cannot be sustained with one volunteer, even in the area of evidence management and presentation. Additionally, financial elder abuse prosecution requires financial analysis of voluminous amounts of data and evidence. Having a full-time dedicated elder abuse investigator position, with certification and training in fraud examination, will ensure the success of this project. Project Design The proposed Deschutes County Elder Abuse and Financial Exploitation Team (EAFET) will be supervised by the current elder abuse lead prosecutor, Deschutes County Deputy District Attorney Daniel Reesor. The proposed project includes the addition of one full-time Elder Abuse investigator, with distinct skill sets, as a designated elder abuse investigator and fraud examiner. This new position of EA Investigator will work directly with the elder abuse prosecutor and assist victim au' ol:ateJ working w1L11 elderly vi�L1111S. Till. EA I11V %'sLigatvr `v`v'iii also work as the designated liaison to local and State criminal justice stakeholders, and local social service providers and agencies. Criminal justice stakeholders in Deschutes County include but are not limited to the: Federal Bureau of Investigation, Oregon Department of Justice, Oregon State Police, Deschutes County Sheriff, Bend Police Department, Redmond Police Department, Sunriver Police Department, and Black Butte Ranch Police Department. Social service providers include but are not limited to government agencies including the Department of Human Services (DHS) Aging and People with Disabilities, Adult Protective Services. Volunteer and faith -based organizations include the Council on Aging of Central Page 16 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Oregon, United Senior Citizens of Bend, Interfaith Volunteer Caregivers of Central Oregon and Meals on Wheels. The EA Investigator will supplement law enforcement investigation in cases or, in some instances, build cases from the ground up. Work will range from serving subpoenas, reviewing and preparing criminal history reports, to conducting interviews of key witnesses and identifying and tracking down key pieces of evidence. The EA Investigator job description will be as follows: Elder Abuse Investigator Job Description The District Attorney Elder Abuse Investigator will be an OVC grant funded position for 3 years and is responsible for follow up investigations on Elder Abuse cases occurring in Deschutes County at the direction of the District Attorney's Office and in cooperation with law enforcement agencies within the County. An investigator is expected to facilitate the work of the L1St17Ct tiliorney S Vll1Ce by dfJptyutg specialized iuiuwicugc ai3u S►Ciii w u'race iriiviivauvu and people, conduct interviews of a sensitive and sometimes volatile nature, seek out and identify evidence, prepare court exhibits, serve subpoenas and determine information needed. The investigator will frequently do follow-up work on investigations from other law enforcement agencies and will be responsible for doing the detail and follow-up work necessary in preparing for trial. The Elder Abuse Investigator will attend meetings with community partners to address high risk Elder Abuse cases, assist with training on Elder Abuse investigations, be responsible for assisting in the creation of a training module for Elder Abuse investigations, and assist with information collection to assess the position. Page 17 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE Elder Abuse Investigator Essential Functions Conduct follow up investigations to supplement information obtained in investigations; order and/or obtain evidence materials related to evidentiary issues; take photographs and measurements; conduct interviews; prepare and organize exhibits and other evidence for trial. Identify, select and locate relevant records as well as expert and lay witnesses to be subpoenaed. Interview and prepare witnesses, subjects, and others to obtain information about criminal, juvenile, and civil cases; locate missing witnesses and serve subpoenas as required. Work closely with trial assistants in coordinating witness' appearances and attendances at proceedings. Prepare summaries and chronologies for trial preparation based on review of records, reports, agency documentation and law enforcement information. Prepare reports on investigative assignments; attend trial noting development of cases and (:oI1QUCt orlguing 111VGStlgd tloll CLJ trial progresses; may LGSLlly W11G1111e1.eJJa1y. Pcr1V1111 investigatory duties for specific assigned prosecution teams related to Elder Abuse cases. Elder Abuse Investigator Qualifications, Knowledge and Skills Knowledge of the criminal justice system, prosecution and circuit court. Knowledge of courtroom practices, procedures and case presentation, state laws regarding rules of evidence, and investigative procedures and techniques. Must possess organizational skills and practices. Must possess knowledge and ability to conduct investigations related to employment - related matters. Must have certification, or able to obtain certification, as a fraud examiner or financial analyst. Must be available and able to testify as a State witness in trial. The Elder Abuse Investigator will be an essential supplement, to current Deschutes County District Attorney staff members, already employed with Deschutes county. The team Page 18 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE members will work directly with each other, and in coordination with criminal justice stakeholders and State and local agencies and social services. The Elder Abuse and Financial Exploitation Team proposed structure will be as follows: Figure 3. Deschutes County Elder Abuse and Financial Exploitation Team Plan for Collecting the Data Required for the Solicitation's Performance Measures The Elder Abuse and Financial Exploitation team, managed by Deputy District Attorney Daniel Reesor, will track all activity related to elder abuse cases from initial contact from stakeholders to and through the final outcome on each criminal case. The information gathered will be analyzed specific to the length of time from one event to the next, identifying problems and solutions to delays. Interaction with the victim and victim's representatives will also be documented to ensure their needs have been met at each phase of the legal process and to identify and resolve any issues the victim has in the course of the proceedings. The EAFET will be prepared to submit regular performance data demonstrating the results of the work carried out under this grant award. The EAFET will provide the relevant data Page 19 of 20 RUNNING HEAD: DESCHUTES COUNTY DISTRICT ATTORNEY - PROGRAM NARRATIVE by submitting quarterly performance data through the Transforming Victim Services module in the Office for Victims of Crimes (OVC) online Performance Measurement Tool. The EAFET will report performance data into the OVC Performance Measurement Tool quarterly. In January and July of each calendar year, the EAFET will generate a PDF report from the OVC Performance Measurement Tool to upload into the Grants Management System. The EAFET will generate a PDF for each reporting periods. Deputy District Attorney Daniel Reesor will be the point of contact to gather and report performance data, under this grant award. DDA Reesor will work with other staff as needed to gather the required information when it is due. These staff members are, but not limited to, members of the Deschutes County Elder Abuse and Financial Exploitation Team. Page 20 of 20 Rural Challenges US Census: Rural versus Urban The US Census Bureau delineates between urban and rural by defining individual urban areas and defining rural areas as those that are not urban (US Census Bureau). Exhibit 1 is a screen shot from the US Census Bureau's interactive website indicating the city of Bend is an "Urbanized Area", but the balance of the Deschutes County is a "Metropolitan Statistical Area", not an urban area (US Census Bureau). Exhibit 2 is a screen shot from this same website showing the distribution of the population in rural Deschutes County (US Census Bureau). Exhibit 1. Exhibit 2. How Does the U.S. Census Bureau Define "Rural?" �? I Rural Population a prei ous p ;Ma map of the rura area of the U^:tea States. HO r; ;h's �s not�ttl f t a'popularo�s actua ly lne. Mast of;he ru Ipop d' 1 ) f b sHstoncaly thsl � .a heenthe [ase Ipop I -d d 1 p d gf d and oth[v goods ) nearby urban -d d —il —ket alld ng the needs ofh h surround'ng I p p I tl f try 6. More r.[enty nsportat on have fe[tatedamaredstrlhu[ed.attl lnwx Aensty, d�ztribuhon of reside-, population near urban[enters-iopograpby.[rtna:c,,nd tied dep tl b ulture asw--ell as areas devgnated as federal lands a fes'treasonz a pI - g -p Nllement throughout touch of the G pl d t nto tntan We t.'I"po"Jau.ud[nsty nrap on the r,gh, d,pi-tis[hwe,.q Of- ..... ..... .... yfatlonde tl„ M P.M. eaten € N4 AN Demographics Of Oregon's 36 counties, Deschutes County is the seventh largest, situated on the eastern slope of the Cascade Mountains. The majority of the State's population, including the six counties with higher populations the Deschutes, are all west of the Cascades. Deschutes County is approximately 135 miles from the State's capitol, Salem, and 175 miles from Portland, the State's most populous area. Nearly two-thirds of the State's geography is east of the Cascades. Deschutes County covers 3,05S square miles, with the majority of this property owned by various federal and state agencies. The US Census Deschutes County population estimate from July 1, 2019 was approximately 198,000, with 20% of those over the age of 65 (US Census Bureau). The city of Bend is the county seat and the largest city east of the Cascade Range. There are only four incorporated cities in the county: Bend, LaPine, Redmond, and Sisters. Roughly 40% of the county's population resides outside of these incorporated cities. Oregon's Secretary of State lists the population for the cities as follows (State of Oregon): Population Ranking in Oregon 1 City 1 2018 Population 7 Bend 89,505 127 LaPine 1,840 18 Redmond 29,190 103 Sisters 2,725 Examples of services and supports Central Oregon is very rural location and has limited public transportation options, especially outside of the Bend city limits. The elderly population is supported by State agencies such as the Department of Human Services, and several volunteer organizations including faith -based, veterans' groups, and The Council on Aging of Central Oregon. The Veterans Administration has a clinic in Bend, with the Disabled American Veterans (DAV) providing transportation from throughout the Central Oregon area. The DAV also provides transportation, Monday through Friday, for Central Oregon veterans to the VA Hospital in Portland, Oregon. Both the clinic and hospital transports are driven by volunteers. The Council on Aging of Central Oregon provides services to the elderly in the area. During the 2018-2019 fiscal year, the following services and supports were provided (Council on Aging of Central Oregon): Nutrition • 82,085 Meals on Wheels delivered • 39,764 senior lunches served • 1,552 hours of nutrition education Information & Referrals • 12,619 general web inquiries and calls answered • 32,636 hours of Medicare counseling • 31,648 copies of Directions resource guide distributed Outreach • 3,809 adults met at 90 events Volunteers • 116 new volunteers • 17,153 hours of volunteer support Caregiving Services & Support • 10,106 hours of home/personal care • 1,941 hours of paid respite support • 1,993 hours of case management services Health & Fitness Classes • 8,132 hours of physical fitness and fall prevention education • 329 hours of Chronic Disease prevention Transportation • 5,983 subsidized rides for 311 seniors Works Cited Council on Aging of Central Oregon. "Community Impact 2019." 2020. Council on Aging of Central Oregon. 9 April 2020. State of Oregon. Oregon Secretary of State: City Populations. 2018. 9 April 2020, https:Hsos.oregon.gov/blue-book/Pages/local.aspx US Census Bureau. QuickFacts: Deschutes County, Oregon. 1 July 2019. 9 April 2020, https://www.census.gov/quickfacts/fact/table/deschutescountyoregon/PST045219 US Census Bureau. Rural America. 2020. 9 April 2020, https://gis- portal.data.census.gov/arcgis/apps/MapSeries/index.html?appid=7a41374f6b03456e9d 1386014711e01 v1 E S CMG � a 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 BOCC Monday Meeting of May 4, 2020 DATE: FROM: Tom Anderson, Administrative Services, 541-388-6565 TITLE OF AGENDA ITEM: Draft COVID-19 Recovery Framework wCe lik'r P E C V E P v DRAFT: MAY 1, 2020 1 Deschutes County is committed to an evidence -based reopening strategy that considers the health and welfare of our community members, to include economic stability, opportunity, and liberty. Deschutes County recognizes the sacrifice of community members, businesses, first responders, employees, retirees, children and students and healthcare workers have made over six weeks to flatten the curve and stop COVID-19 spreading illness and causing economic hardship. It is imperative that our strategy to re -open is deliberate, thoughtful, comprehensive and inclusive, but also urgent. President Trump and Governor Brown laid out a general framework to re -open our communities, which consists of gating criteria and three preparedness areas. Deschutes County is prepared to meet Phase I of the opening criteria which would include: Dral'ft `.c a (, ' 3,g rili Ha .,. fi rs } .. 1 �,. f . h G. , f 6; i fi C, t;; 1. Symptoms: Declining Numbers Downward trajectory of influenza -like illnesses (ILI) reported within a 14-day period and downward trajectory of COVID-like syndromic cases reported within a 14-day period. Health Services working on data for this section. 2. Cases: Declining Numbers Downward trajectory of documented cases within a 14-day period: Deschutes County Case Count - 14-day moving average 3.0 2.4 2.5 2.5 2.5 zaz4 21 2 1, '� 49 2.2 2.1 2.2 20 gn,z 1 <2.0 1.9 e 2.0 1.7 1.8 1.7 1.5 1.4 1.3 1.2 ,5s.',-.,ry ., 1.0 1.1 1.0 C�c a. •� 0.7 0.6 ' 0.5 1.5 1.4 .4 5 1.4 1 1.4 1.3 1.4 s , t 0.0 O O O C O O O O O O G O O O O O O O O O O O O O O O O O O O O O O O O O O N N N N N N N N N N O O O O O O O O O C Q O O O O O O Q O O O O C O O O O O O O O G O O O N O O N N N N N N N N N N N ti N N N N N N N N ry N N N N N N ry N N\ N ry W N� � •-i N M � in '.O � ,W G' O ti ti ti �.-nt� �N H �N � N N O N N N rc�j n'f n1 M nl r� m M •'J' V v d- d" d� J' d- .T V iS �1 � �t � d' d' J �t V' 2 80 70 60 50 40 30 20 10 0 Deschutes County Known COVID-19 Cases -Cum u I ative r11 O O G O O O O O O O O O O O O O O O O CS O O O O O O N N N N N N N N N O 0 O O O O O O O C� O O O O O O O M to n Cll H M V I� Ol N � \ W O N G lD 07 O N c} lD W 3. Hospital capacity - Regular procedures and adequate testing • Treat all patients without crisis care • Robust testing program in place for at -risk healthcare workers, including emerging antibody testing. Data for this section would need to be provided by St. Charles. 1. Robust testing and case investigation and contact tracing capability 2. Healthcare system capacity and PPE supplies 3. Plans for health and safety In order for Deschutes County to meet the criteria to re -open, we will indicate and establish necessary capacities in each of the above areas. We recognize that even with increased capacity in all three areas, if epidemiological data and public health guidance suggests it, a pause in the timing of early re -opening may be necessary. It is also important to consider many of these capacities are the responsibility of other agencies or organizations, which are all working with Deschutes County, and to the extent possible, the County will support these organizations to increase capacity for testing. Currently, and for the foreseeable future, Deschutes County has sufficient data collection and analysis to support our decision -making and will continue to track trends related to total tests, positive tests, cases, and hospitalizations. This data will 3 inform policy makers that it is appropriate to proceed with re -opening and appropriate levels of restrictions. Deschutes County has been proactive in developing capacity in the three preparedness areas to support re -opening. Deschutes County also considers the diverse nature of our communities and our position within the region and commits to working collaboratively with our cities, community members, businesses, neighboring counties and other stakeholders to re -open responsibly. This framework will expand on the three preparedness areas and describe how Deschutes County intends to meet the benchmarks set forth by Governor Brown: Deschutes County Health Services does not directly provide testing. Testing is accomplished within the medical provider system by the hospital system and multiple other clinics. Deschutes County makes up 4.4% of the Oregon's total population. Deschutes County expects to work with our local hospital and clinics system to support 660 tests per week (a rate of 30 tests per 10,000 residents). Previously in Deschutes County, 200-300 COVID-19 tests have been collected each week. Testing options and capacity are expanding as more primary and urgent care providers are coming on board to provide drive-thru testing options to community members. Testing criteria have also eased up and will be based on two broader important factors: any typical viral symptom (e.g, fever, body aches, runny nose, sore throat, cough, or difficulty breathing) or a known COVID-19 exposure. Local medical provider discretion is essential for this model to work effectively. The addition of point of care Polymerase Chain Reaction testing at St. Charles Health System and health care clinics will enhance the community wide testing availability. Local processing of tests coupled with drive-thru locations will increase community participation and testing capacity in our community. Deschutes County providers are ready for that. Contact Tracing If the State of Oregon expects Deschutes County to maintain responsibility over case investigation and contact tracing, Deschutes County Health Services will need to re -deploy and possibly hire additional staff to accomplish this task. The State of Oregon has indicated a need for 600 additional public health staff needed for COVID-19 response. There has yet to be any granular data related to the make-up or duties of these positions, but based on Deschutes County's percentage of total state population, a total of 21 staff will be assigned to or in direct support of 4 Deschutes County on a needed basis. Currently, we have six employees committed to tracing (some are re -deployed from other positions) and we have been very successful and leading Oregon's efforts. 10 of our 76 positive case have been connected through our tracing efforts. One possibility is that some of these positions will be hired at the state level on an on -call basis, while some will be hired at the local level. Another option is a re- deployment of other County employees possibly underutilized on a part-time basis. Deschutes County Health Services does not currently have funding to hire additional staff. If funding becomes available to hire staff specific to COVID-19, Deschutes County estimates needing at least five additional public health staff to continue to support the local public health response: • Communicable Disease Nurse $118,746 /year full benefits. • Communicable Disease Nurse $118,746 /year • Communicable Disease Health Educator $109,454 /year • Environmental Health Specialist $113,987 /year • Health Communications Specialist $123,744 /year Total expected personnel costs devoted to COVID-19 could be $584,677 annually. However, these needs depend entirely on ongoing scope of the virus in our communities. Additional personnel could be mobilized through state resources to support Deschutes County if an outbreak overwhelms local resources. Non Congregate Sheltering Plan Deschutes County has established a plan to house COVID-19 positive patients who are unhoused, to minimize the threat of spread within the community. This plan is dependent upon securing a hotel or similar location. The estimated cost to accomplish this is up to $175,000 per month. Support Deschutes County has established the need for wrap -around services to support those persons isolated or quarantined due to COVID-19. 5 IS �� 3 e t h c C re system ti_, a p R$ k d t" The Oregon Health Authority has reported 76 known positive cases of COVID-19 in Deschutes County. Of those, 53 have recovered. To date, 2,012 COVID-19 tests have been completed in Deschutes County. 1,936 were negative. 80 70 60 50 40 30 20 10 0 Deschutes County Known COVID-19 Cases - Cumulative W O Q O O O O O O O O O O O O O O O O O O O O O O O N N N N N N ' N N N V N N N N N N N N O O O 0 0 0 O O O Q O O O O O O O O O O O O O O O N N N N N N N N N N N N N N Z0 eA cy \ N N N N M \ •-1 ri .-i .-i \ N \ N N St. Charles Health System (SCHS) has created an impressive medical surge plan related to COVID-19 and is likely able to meet the hospital needs of COVID-19 patients as long as staff and supplies are available. (See attached.) Additionally, Deschutes County has a well -developed plan for an alternate care site to provide up to 100 additional beds for lower acuity patients. (Plan attached). In order to operationalize this alternate care site, Deschutes County would need additional medical personnel and would likely request assistance from the State or Federal governments to provide the personnel and equipment to do so. Deschutes County, has also purchased 30 additional ventilators (which are on backorder), which include 20 transport ventilators and 10 ICU type ventilators. Before the alternate care site is initiated and emergency waivers are created, St. Charles SCHS (inclusive of facilities in Crook, Deschutes and Jefferson counties) can provide a maximum of: • Hospital Beds - St. Charles to input data? • ICU Beds - St. Charles to input data? • Ventilators - St. Charles to input data? 0 With certain waivers in place, SCHS can expand further if absolutely necessary and has developed a tiered response to provide more beds. St. Charles is actively procuring additional Personnel Protective Equipment and will require the following on -hand in order to support re -opening: • N95 masks - St. Charles to input data? • Procedural masks - St. Charles to input data? • Isolation gowns - St. Charles to input data? • Face Shields - St. Charles to input data? • Nitrile Gloves - St. Charles to input data? Deschutes County is providing information and guidance to support acquisition of PPE for first responder agencies, healthcare providers, and safety net providers. Deschutes County is building a local cache of personnel protective equipment and seeks to maintain an inventory of: • N95 Masks - 30,000 • Procedural masks - 50,000 • Isolation gown - 30,000 • Face shields - 5,000 • Nitrile Gloves - 100,000 P-lans for Health and Safety Deschutes County recognizes the need to have plans in place to meet the needs of our community during this pandemic and to consider contingencies. As this incident continues and more is known, we will continue to address issues and develop plans to meet the health and safety needs of our community. Surveillance Strategy Deschutes County is working with critical partners in the healthcare sector, schools, Long Term Care Facilities, and Social Service Organizations to develop effective COVID-1 9 surveillance. (Organization chart attached.) Deschutes County also has an epidemiologist solely focused on communicable diseases who also supports Jefferson and Crook Counties. The regional Epidemiologist will continue to conduct active surveillance and provide timely data reports to help inform decision makers. Communication Strategy Deschutes County continues to maintain a strong capability to communicate with the community in real-time regarding the current situation, best practices, and protective measures. We have a very comprehensive website (www.deschutes.org) and daily e-mail reports (copy attached). Guidance around wearing masks, appropriate distancing, vulnerable populations and environmental concerns are constantly changed. As the medical community is continually learning about the virus, this will require staff dedicated to health communication. Currently this capacity is being provided by a joint Information Center and the Deschutes County Public Health Preparedness Coordinator, and this is not sustainable in the long- term due to those personnel needing to return to their normal duties. A dedicated Public Health Communication Specialist will be needed to continue to provide important and timely communications to the public and our partners. Part of our communication strategy will urge high risk populations to isolate to the extent possible. Long Term Care Facilities Deschutes County has an established program and very successfully coordinates with our 33 Long Term Care Facilities (LTCF). There is a regional Public Health Infection Prevention Nurse (0.8 FTE) who has established relationships with all long term care facilities in Central Oregon related to communicable disease prevention and control training/technical assistance to prevent and respond to communicable disease outbreaks. Due to the fact COVID-1 9 is significantly affecting Long Term Care Facilities in other parts of the country and the population is high -risk, this program may require additional staffing. COVID-19 Positive Unhoused Shelter Plan Deschutes County has developed a plan to shelter unhoused populations who are symptomatic and awaiting test results or are positive for COVID-19. So far we have not initiated any stays but we are organized to do so. Evacuation and Sheltering Plan Deschutes County is located in a fire -risk ecosystem. 80% of Deschutes County is federal lands. Wildland fire is a reality in Deschutes County and every year the potential for evacuations due to wildland fire are present. Working with our partners at the American Red Cross, we have guidelines and strategies in place to minimize the spread of COVID-19 in shelters. These include use of non -congregate shelters, expanded shelter space when congregate shelters are required, and effective screening and shelter management practices to limit spread. Business Sector Guidance Working with staff at our Health Department's Environmental Health Division, and the cities of Bend and Redmond and the Redmond and Bend Chambers of rnmmerrP; Ernnnmir Development of Central Oregon (EDCO) and Visit Bend. Deschutes County is committed to providing sector -specific guidance and direct consultation to support safe and responsible practices at our local businesses. It is anticipated this guidance will be include written checklists, infographics, and videos to support the education of our local business owners. This was developed after listening to the needs and concerns of many of our local business community. Local businesses have communicated the need for a cautious re -opening plan. Additional detail and feedback from local business is included below. Phased Re -opening Strategies Deschutes County recognizes that some businesses can more readily meet the physical distancing, disinfection, and safe practices needed to re -open. In addition, Some businesses by their nature are lower risk and less likely to support community spread. Other businesses may require much more stringent restrictions and change in business practices to facilitate re -opening. When possible, Deschutes County supports a risk -benefit analysis when considering which businesses can re -open sooner. Encouragement of Alternative Business Practices Deschutes County businesses, non -profits, and government agencies should continue to utilize practices that minimize physical contact between employees and patrons. Much has been learned during this time and with the expanded use of technology, environmental design, scheduling, and safer work practices could not only increase public safety, but improve customer service over the long-term. Deschutes County employers should encourage and support telework and other remote work options during this health emergency. Tourism / Mobility Considerations Deschutes County's economy has a strong tourism component. There are also a large number of second homes. Many of these second homes belong to people who live in larger urban areas. An influx of visitors from larger urban areas, possibly those with localized outbreaks, places Deschutes County at a higher -risk. To date, the cities of Deschutes County as well as Deschutes County have discouraged and in some case prohibited out -of -area travel (Deschutes County ordinance on short- term rentals), City of Bend guidance and Redmond airport signage. Monitoring travelers from key communities to Deschutes County and taking proactive measures will be critically important to manage possible disease transmission. If not measured, this non-resident population can significantly affect demand for services (public safety, contact tracing, case investigation, and healthcare). Our capacity is based more on our permanent resident population. Plan for Re -Instituted Restrictions Deschutes County also recognizes the need for a re -instituted restrictions plan to re -implement closures in the event there is a significant resurgence in COVID-19 cases. This plan needs to be based on clear and agreed -upon metrics. Metrics could be based on number of cases, average new daily cases, and/or hospitalizations. We expect guidance from the Governor's Office on this issue. This guidance should be provided to the community in advance to encourage preparedness by community members and businesses. 10 Service Employment The State has issued draft re -opening guidelines for restaurant/food service, retail businesses, and personal services businesses. These guidelines include distancing and occupancy directions, employee protocols and operational parameters. Common themes include six foot distancing for patrons (including seating) and employees, on -premises customer limits, use of PPE, directional signage and barriers, and extensive cleaning/sanitizing directives. The County believes some of these guidelines are achievable. However, we believe it is important that once local businesses implement these protocols there be a change management component of the implementation process to allow businesses to communicate what's working and what isn't. In addition to the state's guidelines, our cities and local chambers of commerce have also conducted focus group meetings with representatives of each of these business sectors. The concerns expressed by businesses raise issues which we believe should be seriously considered given that businesses are the entities with the best operational and financial knowledge of the sector. In other respects, the guidelines are very helpful in addressing the questions raised by businesses. Representatives of the Co inty's Public Health department attended the focus groups, listened closely to the conversation, extended advice, and committed to continual consultation with any business on best practices with respect to preventative practices. The state guidelines now become the starting point by which our public health staff can continue to provide guidance and education to all business within this sector. Businesses in this area also expressed, in conjunction with operational parameters, a desire for the county's assistance in procuring PPE, financial help during the pandemic and ramping back up, and consistency in overseeing compliance with the new rules. The County has been and has committed to continue to be a resource in all three of these areas. The State has also issued guidelines for childcare businesses. This will be a critical piece of any re -opening strategy. Discussions on childcare have been an important planning area within the county's emergency operations center. The draft guidelines however present a serious challenge to implement as written and are unacceptable for local business operators based on information we've received from regional listening sessions. The proposed ratios of staff to children are simply unworkable for many, if not most, childcare centers due to the added cost and thin 11 profit margins associated with these facilities. Nevertheless, as with other business sectors, we will also offer our full guidance and consultation to these businesses on public health questions in the context of the state's guidelines. Traded Sector Employment Economic Development for Central Oregon (EDCO) is the primary economic development agency within Deschutes County. Over the past 30 days, EDCO has conducted roughly 200 outreach calls to area businesses, and has conducted two separate roundtable discussions with key companies. The majority of these businesses have already figured out how to remain solvent within the parameters of the Governor's stay at home order, despite disruptions in supply chains and limitations on retail outlets for their products. They are generally exercising all of the best practices related to temperature testing, visitor limitations, use of PPE, social distancing and cleaning/sanitizing. The vast majority of the businesses however have shared that the longer the shutdown persists, the more uncertain the demand for their products and the more constrained raw material and pieces and parts from other manufacturers becomes. As a group, they urge that re -opening of the economy begins as soon as possible, but in a phased and cohesive fashion, with clear and predictable timelines and information. Tourism/Outdoor Recreation As stated previously, outdoor recreation and tourism are key components of the Deschutes County economy. This sector has been particularly hard hit by the executive order. Area businesses favor a phased re -opening of their industry, but are committed to doing so in a safe and rational manner, for the protection of both their employees and customers. Focus groups and outreach initiated by Visit Bend and the Central Oregon Visitors Association have found that businesses are in favor of a phased approach where gradually larger groups of customers are allowed to congregate, but with strict protocols for social distancing, the use of masks/gloves, and the continual cleaning/sanitizing of equipment and shared space. Pressure will continue to mount as the County enters its prime visitor season. Transit Locally, public transit has not been directed to limit service or make adjustments. Current service reductions are related to service needs and funding. Our local public transit provider is committed to restarting normal service when needed; including making sure they have the appropriate PPE available, along with the ability to provide social distancing on the buses. 12 Re-o�fi en�ng local Wusine Given the above information, we propose that all local businesses listed under the Executive Order 20-12 be allowed to open, following all of the best practice safety guidelines noted above. Also as noted above, although Central Oregon traditionally sees a strong influx of tourists in the summer, State restrictions on non -essential travel should limit that travel this year. This will allow local businesses to re -open without as much demand as they might have in a traditional summer season. We also believe it is important that the following businesses, not outlined in EO 20-12 be allowed to open: attorneys and accountants, churches, childcare, retail and restaurants/bars. 13 PREREQUISITES FOR PHASED REOPENING OF OREGON Each of these seven prerequisites must be met before a county or region can enter phase one of Reopening Oregon. While many of these prerequisites are set at the county level, some are set at the Health Region or Statewide level. Declining prevalence of COVID-19 (OHA detailed reference document: "The Three Health Signs We Must See to Re -open Oregon') a. The percentage of emergency department visits for COVID-19-like illnesses (CLI) are less than the historic average for flu at the same time of year. b. A 14-day decline in COVID-19 hospital admissions. c. This metric only applies to counties with more than 5 cases. 2. Minimum Testing Regimen (OHA detailed reference document: "COVID-19 Strategic Testing Plan for Oregon"and "Oregon COVID-19 Testing and Contact Tracing Strategy') a. Regions must be able to administer COVID-19 testing at a rate of 30 per 10,000 people per week. Regions must implement a testing regimen that prioritizes symptomatic persons and individuals who came into contact with a known COVID-positive person and includes testing of all people in congregate settings when there is a positive test. This includes long-term care facilities and county jails among others. The plan must include frequent tests of frontline and essential workers and industries where workers may not be able to practice optimal physical distancing (e.g., agricultural processing, meat packing). b. Regions must maintain an appropriate number of testing sites to accommodate its population and must fully advertise where and how people can get tested. The region must work with local public health and OHA to use the collected data to track and trace the spread of the virus. Testing must be accessible to low-income and underserved communities. c. This metric is measured at the Health Region level not at the county level. An individual county cannot move into phase one if regional hospital capacity is beneath that level. 3. Contact Tracing System (OHA detailed reference document: "Oregon's Plan to Stop the Spread of COVID-19 , "Oregon COVID-19 Testing and Contact Tracing Strategv"and 'Interim Investigative Guidelines') a. Counties must have a minimum of 15 contact tracers for every 100,000 people. Every county must be prepared to contact trace 95% of all new cases within 24 hours, with OHA certifying a county's readiness. The contract tracing workforce must be reflective of the region and be able to conduct tracing activities in a culturally appropriate way and in multiple languages as appropriate for the population. 4. Isolation Facilities a. Counties must have hotel rooms available for people who test positive for COVID-19 and who cannot self -isolate. The Department of Public Health at the Oregon Health Authority will provide support to local public health to identify needs and help with resources. S. Finalized Statewide Sector Guidelines (011A detailed reference documents: sector -specific guidelines by sector) a. Each sector must adhere to Oregon Health Authority statewide guidelines to protect employees and consumers, make the physical work space safer and implement processes that lower risk of infection in the business. 6. Sufficient Health Care Capacity (OHA detailed reference document: "Guidance on resumption of non-eineWent and elective procedures at hospitals a. To maintain the phased re -opening plan, each region must be able to accommodate a 20% increase in suspected or confirmed COVID-19 hospitalizations compared to the number of suspected or confirmed COVID- 19 hospitalizations in the region at the time Executive Order No. 20-22 was issued. b. This metric is measured at the Health Region level, not at the county level. An individual county cannot move into phase one if regional hospital capacity is beneath that level. Sufficient PPE Supply (011A detailed reference document: "Guidance on resumption of non - emergent and elective procedures at hospitals') a. All hospitals in the health region must report PPE supply daily to OHA's Hospital Capacity system. Large hospitals and health systems in the region must attest to a 30-day supply of PPE, and rural hospitals must have a 14-day supply. This metric is measured at the Health Region level, not at the county level. b. Counties must attest to sufficient PPE supply for first responders in the county. Health Regions Defined: Health region 1: Clatsop, Columbia, Tillamook, Washington, Multnomah, Clackamas Health region 2: Yamhill, Polk, Lincoln, Benton, Marion, Linn Health regions 3 & 5: Lane, Douglas, Coos, Curry, Jackson, Josephine Health regions 6 & 9: Hood River, Wasco, Sherman, Gilliam, Morrow, Umatilla, Union, Wallowa, Baker, Malheur Health region 7: Jefferson, Deschutes, Crook, Wheeler, Grant, Klamath, Lake, Harney Prerequisites Checklist Each of these seven prerequisites must be met before a county or region can enter phase one of Reopening Oregon. While many of these prerequisites are set at the county level, some are set at the Health Region or Statewide level. County Health Region State 1. Declining prevalence of COVID-19 Not required if <5 cases a. The percentage of emergency NA NA Elm department visits for COVID-19-like Data to be provided on OHA web illnesses (CLI) are less than the site. historic average for flu at the same time of year. b. A 14-day decline in COVID-19 NA Data to be provided on OHA web hospital admissions. site. 2. 'Minimum TestingRegimen Regions able to administer testing at a NA mom OHA will evaluate and approve rate of 30 per 10k per week at the region level Sufficient testing sites accessible to NA OHA will evaluate and approve underserved communities at the region level 3. Contact Tracing System County has 15 contact tracers per 100k mom OHA will evaluate and approve people at the county or region level County contact tracing workforce is OHA will evaluate and approve reflective of the county and able to work at the county or region level in needed languages County is prepared to trace 95% of all OHA will evaluate and approve new cases within 24 hours at the county or region level 4. Isolation Facilities Counties have hotel rooms available for OHA will support, evaluate and those who cannot self -isolate approve at the county or region level Counties provide a narrative of how mom OHA will evaluate and approve. they will respond to three different OHA can provide a list. outbreak situations in the county (e.g. nursing home, jail, food processing facility, armworker housing,otherproup living situation 5. Finalized Statewide Sector NA NA mom Guidelines OHA will finalize 6. Sufficient Health Care Capacity Region must be able to accommodate a NA 20% increase in hospitalizations 7. Sufficient PPE Supply Hospitals in region are reporting PPE OHA will certify supply daily through HOSCAP Hospitals in region must have 30 day NA OHA will confirm receipt of supply of PPE Hospital leadership hospital attestation. must attest in writing. Counties must have sufficient PPE for OHA will confirm receipt of first responders. county attestation. County/region applications should be emailed to: Jen Andrew Office of the Governor jennifer.j.andrew@oregon.gov