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2021-412-Minutes for Meeting October 13,2021 Recorded 10/22/20210-TES -0G Q ��BOARD OF COMMISSIONERS 1300 NW Wall Street, Bend, Oregon (541) 388-6570 9:00 AM Recorded in Deschutes County CJ2021-412 Steve Dennison, County Clerk Commissioners' ,Journal 10/22/2021 11:05:35 AM C�V�FSc�G IIIIIII'll'III'IIIIIII�I'III'll Q 2021-412 FOR RECORDING STAMP ONLY BOCC MEETING MINUTES Wed ri, es2xay, October k,, 2021 BARNES & SAWYER 1001\fS VIRTUAL MEETING-- PLATFORM Present were Commissioners Patti Adair, Anthony DeBone, and Phil Chang. Also present were Nick Lelack, County Administrator; David Doyle, County Counsel; and Sharon Keith, Board Executive Assistant (via Zoom conference call). This meeting was audio and video recorded and can be accessed at the Deschutes County Meeting Portal website www.deschutes.org/meetings CALL TO ORDER: Chair DeBone called the meeting to order at 9:00 a.m. PLEDGE OF ALLEGIANCE: CITIZEN INPUT: Michele Hoffman, President of La Pine Chapter of Band of Brothers, was present to thank the Commissioners for their assistance in bringing the Wall that Heals to La Pine, especially expressing gratitude to Commissioner DeBone. She presented a gift (framed flag) to Commissioner DeBone for his support. BOCC IvFE ING OCTOBER 13, 2021 PAGE 1 OF 10 CONSENT AGENDA: Before the Board was Consideration of Approval of the Consent Agenda. ADAIR: Move approval of Consent Agenda, minus Item 4 for discussion CHANG: Second with the addition of pulling Item 1 for discussion VOTE: ADAIR: Yes CHANG: Yes DEBONE: Chair votes yes. Motion Carried 1. Consideration of Board Signature for Order No. 2021-049, authorizing the Deschutes County Property Manager to execute the documents associated with the sale of County -owned property located at the northeast corner of NE 27th Street and NE Conners Avenue, Bend. 2. Consideration of Board Signature for Order No. 2021-050, authorizing the Deschutes County Property Manager to execute the documents associated with the sale of County -owned property located in the La Pine Industrial area, La Pine 3. Consideration of Order No. 2021-052, Rescinding Orders Nos/ 98-065, --- 060, and 99-081, Regarding Designated Speeds on Portions of Lakeview Drive, Shoshone Road, and Choctaw Road 4. Consideration of Board Approval of Deschutes County Employee Benefits Plan 5. Consideration of Board Signature to Appoint Neil Baunsgard to the Deschutes County Bicycle and Pedestrian Advisory Committee 6. Approval of Minutes of the September 27, 2021 BOCC Meeting 7. Approval of Minutes of the September 29, 2021 BOCC Meeting ACTION ITEMS: Consent Agenda Item 9 as pulled for discussion: Consideration of Board Signature for Order No. 2021-049, authorizing the Deschutes County Property Manager to execute the documents associated with the sale of County -owned property located at the northeast corner of NE 27th Street and NE Conners Avenue, Bend. BOCC MEETING OC:11 OBE R 13, 2021 PAGE 2 OF 10 Commissioner Chang would prefer that the County sell the land for less or donate the land and noted the critical need of affordable housing. If selling, would like to commit the proceeds to affordable housing projects. Commissioner Adair prefers to not make revisions to the Order due to the major expansion expenses within the County and need for funding to provide better services to the community. Commissioner Chang feels we can take on the courthouse expansion with additional debt. Commissioner Adair reviewed the expenses of the proposed capital improvement projects and expressed the need to look at the entire picture of the County's responsibilities. Commissioner DeBone supports the choice made through the Order and the investment opportunity to help manage the growth of the County. The transaction was offered by Housing Works. ADAIR: Move approval of Order No. 2021-049 DEBONE: Second VOTE: ADAI R: Yes CHANG: No DEBONE: Chair votes yes. Motion Carried Consent Agenda Item 4 as pulled for discussion: Consideration of Board Approval of Deschutes County Employee Benefits Plan Commissioner Adair noted that Human Resources annually reviews the proposed changes to the Deschutes County Employee Benefits Plan with the BOCC during the Monday work session. She questioned why this was on Consent this year? HR Director Kathleen Hinman reported on the plan presented and reviewed by the Employee Benefits Advisory Committee (EBAC). Commissioner Adair feels this item does not belong on the Consent Agenda and requires a full vetting before the Board. Human Resources has made recommendations as well as recommendations made by the EBAC. Open enrollment begins in November. Commissioner Chang would like to understand the components of the plan that would require deliberation and feels the County Administrator could review this instead of the Commissioners. Commissioner DeBone recommends bringing the item back next week. BOCC: 1\411FE ING CSC:! CABER 13, 2021 PAGE 3 OF 10 8. PRESENTATION: Report of the Housing Shortage Study Katy Brooks, Bend Chamber of Commerce was present via Zoom to provide the results of the housing shortage study. Presentation is attached to the record. 9. COVID19 Update Health Services staff present via Zoom for the update were Dr. George Conway, Dr. Michael Johnson, Nahad Sadr-Azodi, Crystal Sully, and Emily Freeland. Presentation is attached to the record. RECESS: At the time of 11:01 a.m. the Board went into recess and reconvened the meeting at 11:07 a.m. 10.Administration Staffing Request Deputy County Administrator Whitney Hale reported on this request to add a public information officer position that was discussed during the Budget Committee Hearings this year. County Administrator Nick Lelack commented on the needed capacity and recognized the department hasn't increased capacity over the past 13 years. The Board expressed support. CHANG: Move approval of the request to proceed to add a public information officer position to the Administrative Services department ADAIR: Second BOC:C MEETING OC (0BER 13, 202.1 PAGE 4 OF 10 VOTE: CHANG: Yes ADAIR: Yes DEBONE: Chair votes yes. Motion Carried 11.American Rescue Plan Funding Update Chief Financial Officer Greg Munn presented the update. Members of the Deschutes County Childcare Coalition with representatives from East Cascades Works, Oregon State University -Cascades, Central Oregon Community College, Early Learning Hub of Central Oregon, Mountain Star, Neighborlmpact, ReVillage Community Co-op Childcare Center, St. Charles Health System, Bend Chamber and the Boys and Girls Club of Bend spoke on the childcare crisis. Presentation is attached to the record. Commissioner Chang offered support of all four proposed options presented for workforce programs. The total requested Deschutes County investment for Workforce and Center Infrastructure totaled $7,875,000. Discussion held on ARPA funding. Commissioner Chang is comfortable in obligating an additional $6 million. Commissioner DeBone would prefer additional time for review as there is a time certain public hearing at 1:00 p.m. today and doesn't want to make a rushed decision. Commissioner Adair requested the item come back on the Monday October 18 BOCC meeting agenda. Commissioner Chang noted he was hoping the meeting on Monday can adjourn at 2:45 p.m. This item will be further discussed on Wednesday October 20. RECESS: At the time of 12:42 p.m., the Board went into recess and reconvened at 1:00 P.M. 12.PUBLIC HEARING: and Consideration of Cascade Medical Transport as a Proposed Subcontractor to Provide Certain Ambulance Services for the La Pine Rural Fire Protection District OC:C IViE (ING OCTC BER 13, 2021 PAGE 5 OF 10 Chris Bell, Sr. Assistant Legal Counsel presented the background on this item. Commissioner DeBone explained the history on this process. County Counsel Dave Doyle reviewed the hearing procedures. Tom Kuhn, ASA Administrator was present via Zoom. Commissioner DeBone called for testimony for a representative of the La Pine Fire District. Mike Supkis, La Pine Fire Chief presented the background on the need for more service to the community and explained the process involved in the proposed contract with Cascade Medical Transport (CMT) for ambulance service. Chief Supkis commented on services through the public/private partnership. This situation is urgent and needs additional services for the community. Dick Swailes, presented testimony on behalf of the La Pine Rural Fire District and commented on the staffing requirements of the district and the solutions to partner with CMT and noted the urgency of a decision from the Commissioners. JerryHubbarb, resident of Sunriver, provided testimony on the critical process of finding funding to hire firefighter/paramedics to expand emergency services to South County and by adding the resource by CMT would be beneficial. Jim Landles, Director of La Pine Rural Fire Department, provided testimony and stated without the contract more people will be without services. Robin Adams, presented testimony on behalf of the Board and stressed the need is now for services to the community. Vern Walter, spoke on the proposed contract and stated La Pine Fire ambulance is a fee based system and not tax based. Mr. Walter stated that is not true today because the three ambulances were purchased through tax payer money. Mr. Walters stated we are not here based on growth but because La Pine Ambulance has failed to provide ambulance services to address the growth expressing his opinion of poor spending decisions of the district. B0CC (ViEE fl NI CS OC1063IR 13, 2021 PAGE 6 OF 10 Charla DeHate of La Pine Community Health Center, provided history on the issues and concerns with the La Pine Fire District and growing needs of La Pine emergency transport. Ms. DeHate feels the current version of the contract with CMT needs to be revised. Courtney Ignazzitto, La Pine Community Health Center and La Pine City Councilor, presented testimony in the hopes of finding a solution. The public/private partnership would be a great step forward but feels there is a need for a more effective response opportunity included in the CMT contract. Mike Richards, VP of Operations St. Charles Health System, thanked the fire district for the good work they do. Mr. Richards spoke on medical emergencies and the appropriate response time needed. Rex LaSeur, citizen, presented testimony regarding the underserved community with the La Pine Fire District. Mr. LaSeur believes the contract could help but should not only be focused on the community clinics. Mr. LaSeur commented on the lack of resources at the fire district. Mr. LaSeur also commented on his view of the ASA Agreement and its lack of definition for metrics measuring quality of service. Love Pearson, Prairie Memory Care, presented testimony via Zoom conference call on behalf of the memory care facility and the need for expanded services. Ken Kehmna, Redmond Fire & Rescue Chief, presented testimony via Zoom conference call and offered to share input from the Central Oregon's Fire Chiefs Organization (following its meeting on 10/21). jaredjeffcott, Captain of Sunriver Fire Department, presented via Zoom conference call stated the proposed response time of 43 minutes is not acceptable for an emergency response. Drew Norris, City of Bend Fire Department Deputy Chief of EMS, presented via Zoom conference call and commented on ambulance funding possibly through a levy and also commented on the inappropriate response time of 43 minutes. Chief Norris reported on calls dispatched through 911. BOCC MEETING OCTOUR R 13, 2021 PAGE %Cyr= 10 Jared Earnest, Black Butte Ranch Fire Captain, presented via Zoom conference call and commented on concerns with the proposed CMT contract. Mr. Bell pointed out the need of clarification of definition of Fire Med listed in the proposed contract. JeremyAst, Sisters Fire, presented via Zoom conference call and gave comment on the concerns expressed through the ASA Committee. Chief Supkis responded on his concerns of not being included or invited in the ASA Committee meetings where questions could have been answered. Chief Supkis clarified the term Fire Med in the proposed contract. Chief Supkis commented on response times of a rural fire district ambulance service and the need to add more resources. Chief Supkis spoke on tax fee services and the paramedic services provided. Tom Kuhn, via Zoom conference call, spoke on behalf of the ASA Committee and their agreement of the need for additional ambulance services and helping La Pine Fire District achieve the resources they need. Commissioner DeBone noted there is a proposed agreement between CMT and the La Pine Fire District and not necessarily in partnership with Deschutes County Commissioners. Based on the health care needs of Central Oregon, Commissioner Adair recommended a possible solution for the community may be an addition of an emergency department in La Pine. Mike Richards of St. Charles reported they have looked at that option in the past and feel they should revisit. Deliberations on this item will be held during the BOCC meeting of October 27. Written testimony may be submitted until that meeting. Chief Kehnma offered any additional feedback if needed and response from the Central Oregon Fire Chief's Association. OTHER ITEMS: • Commissioner DeBone acknowledged an email received through citizen input on homeless camps and the need to manage the homeless situation. • Commissioner Chang acknowledged the many emails received regarding the Conner's property sale which was an item on today's posted meeting agenda. • Commissioner DeBone attended the BH365 session on black history yesterday. EXECUTIVE SESSION: At the time of 2:37 p.m. the Board went into Executive Session under ORS 192.660 (2) (d) Labor Negotiations. The Board came out of Executive Session at 2:43 p.m. for the following motion: CONVENED AS THE GOVERNING BODY OF 911 SERVICE DISTRICT ADAIR: Move approval of Document No. 2021-828 CHANG: Second VOTE: ADAIR: Yes CHANG: Yes DEBONE: Chair votes yes. Motion Carried RECONVENED AS THE GOVERNING BODY OF DESCHUTES COUNTY Commissioner Adair excused herself at this time for another scheduled meeting. BOCC; IVi F E INN C>CTOBI--R 1:3, 2021 PAGE 93 0l= 10 At the time of 2:44 p.m., the Board went into Executive Session under ORS 192.660 (2) (d) Labor Negotiations. The Board came out of Executive Session at 3:11 p.m. At the time of 3:11 p.m. the Board went into Executive Session under ORS 192.660 (2) (h) Litigation. The Board came out of Executive Session at 3:20 p.m. ADJOURN Being no further items to come before the Board, the meeting was adjourned at 3:20 p.m. DATED this Day of ) _ 2021 for the Deschutes County Board of Commissioners. ANTHONY D BO NE , C HAM Cyr 1 (if �t C �111C G ��f��IR - --------- - ------- PA1 T [ ADAI i ., C O M M S I L} Fie C' BOCC IVIE TING oCl (JE3FR 13, 2021 1'A(-,F 10 or 10 L�0� C S COG BOARD F COMMISSIONERS BOARD OF COUNTY COMMISSIONERS MEETING 9:00 AM, WEDNESDAY, OCTOBER 13, 2021 Barnes Sawyer Rooms - Deschutes Services Bldg - 1300 NW Wall St - Bend (541) 388-6570 1 www.deschutes.org Cl s 1 ,^.' r r :. �. i rn," i r S .� r.xr �ti" V, ✓' '� Mill' �.., MEETING FORMAT In response to the COVID-19 public health emergency, Oregon Governor Kate Brown issued Executive Order 20-16 (later enacted as part of HB 4212) directing government entities to utilize virtual meetings whenever possible and to take necessary measures to facilitate public participation in these virtual meetings. Since May 4, 2020, meetings and hearings of the Deschutes County Board of Commissioners have been conducted primarily in a virtual format. Effective June 30, 2021, COVID-based restrictions have been discontinued. Attendance/Participation options include: A) In Person Attendance and B) 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 by 8:00 a.m. 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 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. For Public Hearings, the link to the Zoom meeting will be posted in the Public Hearing Notice as well as posted on the Deschutes County website at https://www.deschutes.org/bcc/page/public- hearing-notices. CALL TO ORDER PLEDGE OF ALLEGIANCE CITIZEN INPUT: For items not on this Agenda Note: In addition to the option of providing in -person comments at the meeting, citizen input comments may be emailed to citizeninput@deschutes.org or you may leave a brief voicemail at 541.385.1734. To be timely, citizen input must be received by 8:00am on the day of the meeting. CONSENT AGENDA 1. Consideration of Board Signature for Order No. 2021-049, authorizing the Deschutes County Property Manager to execute the documents associated with the sale of County - owned property located at the northeast corner of NE 27th Street and NE Conners Avenue, Bend 2. Consideration of Board Signature for Order No. 2021-050, authorizing the Deschutes County Property Manager to execute the documents associated with the sale of County - owned property located in the La Pine Industrial area, La Pine 3. Consideration of Order No. 2021-052, Rescinding Orders Nos. 98-065, 99-060, and 99- 081, Regarding Designated Speeds on Portions of Lakeview Drive, Shoshone Road, and Choctaw Road 4. Consideration of Board Approval of Deschutes County Employee Benefits Plan 5. Consideration of Board Signature to Appoint Neil Baunsgard to the Deschutes County Bicycle and Pedestrian Advisory Committee 6. Approval of Minutes of the September 27, 2021 BOCC Meeting 7. Approval of Minutes of the September 29, 2021 BOCC Meeting ACTION ITEMS 8. 9:05 a.m. PRESENTATION: Report of the Housing Shortage Study 9. 9:50 a.m. Administration - Staffing Request 10. 10:00 a.m. COVID 19 Update 11. 10:45 a.m. American Rescue Plan Funding Update LUNCH RECESS October 13, 2021 BOARD OF COUNTY COMMISSIONERS MEETING Page 2 of 3 12. 1:00 PM PUBLIC HEARING and Consideration of Cascade Medical Transport as a Proposed Subcontractor to Provide Certain Ambulance Services for the La Pine Rural Fire Protection District OTHER ITEMS These can be any items not included on the agenda that the Commissioners wish to discuss as part of 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. 13. Executive Session under ORS 192.660(2)(d) Labor Negotiations 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. October 13, 2021 BOARD OF COUNTY COMMISSIONERS MEETING Page 3 of 3 1 ES co �z BOARD OF COMMISSIONERS MEETING DATE: October 13, 2021 SUBJECT: Consideration of Board Approval of Deschutes County Employee Benefits Plan RECOMMENDED MOTION: Move approval of County Administrator (Plan Sponsor) signature of Deschutes County Employee Benefits Medical Plan documents and service agreement for the 2022 plan year. BACKGROUND AND POLICY IMPLICATIONS: Deschutes County has established the Deschutes County Group Health Plan (referred to as the "Plan') to provide health care coverage for Eligible Employees and their Dependents. Deschutes County is the Plan Sponsor. This Plan Document contains both the written Plan Document and the Summary Plan Description ("SPD'). This is the latest revision of the medical plan document that will be administered by PacificSource, the Third Party Administrator, and effective 11112022. See attached memo for recommended changes. BUDGET IMPACTS: None ATTENDANCE: Kathleen Hinman, Director Human Resources and Trygve Bolken, Human Resources Analyst Interoffice memorandum Delivered via email Date: October 7, 2021 To: Deschutes County Board of County Commissioners From: Trygve Bolken, HR Analyst Re: Deschutes County Employee Health Benefits Plan Review for 2022 Plan Year The Deschutes County Employee Health Benefits Plan is set to renew for the 2022 Plan Year. This year has been another challenging year as COVID continues to be at the forefront of our strategic planning. With these continuing challenges we have also seen many successes. We have completed the RFP process for services provided at the DOC Clinic and Pharmacy beginning January 2022. Premise Health was awarded the contract and the transition for them to assume services at the clinic has begun. Through temporary changes in the IRS guidelines regarding Flexible Spending Account, employees now have more flexibility in deferring dollars into those accounts. 2021 personal Health Assessments are under way after a break in 2020. Despite all of the challenges, we were able to keep our health benefit plan running smoothly for all of the participants. Stop Loss Coverage: The plan did not experience any claims this year that hit our stop loss deductible of $500,000. One high dollar claim that we anticipated would continue to impact our plan is no longer a concern. As we were finalizing the renewal, or stop loss provider identified a potential high dollar claim that could hit our stop loss deductible this coming year. Due to that potential claim, the renewal rate for stop loss increased from an initial projection of 9.8% to 45%, resulting in a $355,382 increase in premium cost. We are evaluating other stop loss coverage deductible amounts and have sought other competitive bids however, many have declined to bid. . For the 2023 plan year we will need to re -negotiate the contract and will again request additional bids for coverage. Third Party Administrator (TPA): Last year PacificSource (our current TPA) came back with an increase to our rates and we were successful in negotiating the rates to stay flat for the next plan year. This year we will see an increase of 2.9%, resulting in a $16,130 increase to the plan Claims Costs and Rates: This year continued to present challenges in forecasting claims costs due to delayed medical care and unpredictable costs associated with COVID treatment. This is anticipated to continue into the 2022 plan year. The industry anticipates the potential for higher claims costs as medical conditions worsen due to delayed treatment. Currently, Deschutes County claims costs are trending a little higher than anticipated at 6.4%. 1300 NW Wall Street, suite 201 Bend, Oregon 97703 (541) 388-6553 ht@deschutes.org www.deSChLrtes.org In total, the overall plan costs are estimated to increase by 6.3% resulting in an anticipated $1,414,549 increase cost to the plan. Current Cost Trends for Health Benefits Plan S3.M0.000 SZ,EOD,Duo Ss CG0,000 S q,g70.000 S 000 WC.000 $0 Fixed Expenses Dental vision Rx mmNet Medical Funding Below is a list of considerations discussed with the Employee Benefits Advisory Committee (EBAC) this year. Considerations for plan changes came from HR staff review, EBAC, Davidson Benefit Planning (Davidson), and PacificSource. Plan changes are scheduled to take effect when the plan renews on January 1, 2022. The full summary is attached and highlights are listed below. Plan Changes for Consideration: 1. Phvsical Theraav benefit: Change from deductible and coinsurance model to deductible and co -pa model. Currently, physical therapy visits are subject to deductible then coinsurance applied. When benchmarked again this year, 70% of plans do not apply a deductible and services are subject to co - pay. 30% of plans apply deductible then coinsurance. ➢ HR Staff Recommended and EBAC supported making a change to deductible, then $10 co -pay. The estimated cost impact for this change is +$9,500 annually or $0.65 Per Employee Per Month (PEPM.) 2. Alternative Care Benefit: Removing dollar limits for chiropractic_ and acupuncture services. Currently, alternative care services are bundled under a $1500 per member per year allowance. Due to State Benchmark Plan Changes, we are required to unbundle this benefit and remove the dollar limits associated with chiropractic and acupuncture services. ➢ HR Staff Recommended and EBAC supported making a change to 24 visits each per year for chiropractic and acupuncture (48 total) and $1200 annual allowance for massage (approximately 1.3 massages per month.) The estimated cost impact for this change is +$9,500 annually or $0.65 PEPM. 3. Livongo Diabetic Management Program: Two year pilot program. Currently the plan does not offer a specialized diabetic management program for our members. Unmanaged diabetes can lead to high cost claims and a lower quality of life. The plan will only be charged for members who use the program. ➢ HR recommends and EBAC supported adding the Livongo Diabetes Management Program to support those members as a pilot program for two years to gauge utilization and effectiveness. The estimated cost impact for this change is-$21,228 annually or -$1.45 PEPM. This is a soft 1300 NW Wall Street,Suite201 Bend, Oregon 97703 (541 ) 3 8 8 - 6 5 5 3 hr@deschutes.org www.deschutes.org estimate as it factors in avoided claims costs for improved disease management. We anticipate the program being cost neutral. 4. Prescription Insulin: Legislative requirement to cap cost to members. Currently, insulin is a standard prescription benefit that is applied to the plan's deductible, copay, and/or coinsurance. Oregon HB 2623 state formulary prescription insulin is not subject to deductible and may not exceed $75 per 30 day supply. ➢ HR recommends and EBAC supported adding plan language to comply with this legislation. There is no estimated cost to the plan for this change as our plan meets this requirement. 5. Reproductive Health Services: Remove exclusion for abortion and add the service as a covered benefit. Currently, abortions are excluded on the health plan unless the life of the mother is endangered by the continued pregnancy or the pregnancy is the result of rape or incest. PacificSource recommends removing the exclusion to align with coverage under the ORS 743A.067 Oregon Reproductive Health Act (RHA) as they have added this service to all of their fully insured plans in Oregon. The Reproductive Health Act allows for plans to be grandfathered in and continue to exclude abortion services if the plan excluded the services prior to the RHA. The County plan, as a self - insured plan, qualifies for this grandfather status and complies with the RHA with current plan language. ➢ HR Staff recommended keeping current plan language, as our plan meets the requirements under RHA due to the grandfather status. ➢ EBAC voted 9 for, 4 against, and 2 abstaining in support of removing the exclusion and add coverage for abortions as outlined in the RHA. The estimated cost impact for this change is +$12,000 annually or $0.82 PEPM. 6. Update plan language to align with current plan interpretation and TPA best practices. In partnership with our TPA, HR staff have made efforts to clarify plan language. These changes reflect language clarifications to the plan document, not changes in benefit coverage. ➢ HR Staff recommended and EBAC supports making the corrections, clarifications and changes on the attached plan change sheet. The total annual cost to the plan for the changes listed above is $20,200. Other considerations evaluated by HR staff and reviewed by EBAC: 7. Fertility Services as an eligible covered expense. Currently, fertility services is excluded from our health plan. Members asked that we consider adding fertility services as a covered expense under the health plan. When benchmarked, this benefit was not a standard covered benefit on most plans. Employers are considering this benefit to support Diversity, Equity, and Inclusion efforts in their organizations. ➢ HR staff recommended and EBAC supported not making a change at this time, however Staff will continue to benchmark this to identify any changes in trends as employers offering this benefit is expected to grow. A conservative estimated cost impact for adding this change is +$264,000 annually or $18.00 PEPM. 1300 NW Wall Street, Suite 201 Bend, Oregon 97703 (541 ) 388-6553 hr@deschutes.org www.deschiAtes.org 8. Doula Services as an eligible covered expense. Currently, doula services are not a covered service on the plan. Members asked that we consider adding Doula services as a covered expense under the health plan. When benchmarked, this benefit was not a covered service on health plans. Doulas are not considered medical providers and are generally not covered under medical benefits. ➢ HR staff recommended and EBAC supported not making a change at this time. The estimated cost impact for this change is +$1,900 annually or $0.13 PEPM. 9. Dental Plan Annual Limit: Benchmark only. Currently, the annual benefit limit for dental services is $2000 per member. Members asked that we benchmark the annual limit against other dental plants. It was determined that we are competitive with the majority of plans. ➢ HR staff recommended and EBAC supported not making a change at this time. 10. Part Time Buy Up to Standard Plan: Change current calculation. Currently, party time benefit eligible employees have the option of buying up from the High Deductible Health Plan (HDHP) to the Standard Plan. The current calculation is based on % of their FTE. A proposal was submitted by EBAC AFSCME representatives to revise the calculation and factor in the difference between each plan's deductible effectively reducing the buy up cost to the employee. While this particular proposal was not supported, staff will benchmark these costs. ➢ HR staff recommended and EBAC supported not making a change at this time. The estimated cost impact for this change is +$230,471 annually or $15.72 PEPM. 1300 NW Wall Street, Suite 201 bend, Oregon 97703 (541 ) 3 8 8 - 6 5 5 3 hr@deschutes.org www.deschutes.org Recommended changes to Deschutes County Employee Benefits Plan for 2022 Plan Year Changes effective 1/1/2022 Recommended Changes — Benefits Plans Plan Change Recommended Change Reason For Change Physical Therapy — HR has benchmarked the current physical therapy Estimated +9,500 to annual physical Deductible, then copay benefits against other public sector plans in the therapy claims cost. More plans are State and recommends moving to Subject to moving to models that reduce the deductible, then $10 Copay. financial impact on the member encouraging them to complete * Current model is Subject to deductible then 20% physical therapy to offset additional Coinsurance surgical costs in the future. Alternative Care HR recommends 24 visits each per year for Estimated +$9,500 annually. Due to Benefit chiropractic and acupuncture (48 total) and $1200 State Benchmark Plan Changes, we annual allowance for massage. are now required to create visit limits vs. dollar limits for chiropractic and *Current model is $1,500 PMPY acupuncture benefits. Livongo Diabetic HR recommends adding the Livongo Diabetes Estimate-21,228 (likely cost neutral) Management Program Program as a pilot program for two years to gauge cost to the plan annually with an utilization. estimated 29 participants. Pharmacy - Formulary prescription insulin is not subject to a To comply with Oregon HB 2623 Prescription Insulin — deductible and may not exceed $75 per 30 day regarding insulin costs. Core pharmacy supply. Previously the benefit applied to the plan's administration deductible, Copay, and/or coinsurance. Documents Wide - Language to be added or changed throughout the Clarification of plan language. Not a Plan language updates plan documents to clarify benefits, the change to the administration of administration of benefits, or to align with benefits. PacificSource core plan language. Covered Expenses — EBAC recommends changing current coverage by Estimated +12,000 cost to plan for Other Covered adding abortions as a covered benefit. abortion services. PacificSource Services, Supplies, and recommendation for all fully insured Treatments plans. Deschutes County is separate and self -insured and is in compliance of the RHA. -<po-�00*0 0 -{ � %A Dm Dm-I^cn C cn (n 0 0 00 0 0 O O =' S a O. X CD7 Q X CD CD CD 0 w(v ® ° �. 3• �- CD O � O � D Sv � a v c D w O O - sv Cn CO N C c 3 C) 3 n CD iv w (Q (n I - CD CD cn CD, ® -nw v <0 CD (Q toCD —_ CD `C -< Z O 0 ®e CD � U) CD Cn O O QCOD Cl) CD O S; Cn ::r OSD COD CD CD n Z O r� m O �a `� 0 CD n y ° :3 (n C ?O �l D s =ti O c O Q a) o w 3 Q 3 o CD -' CD -�. 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' • .. 4 7 \° t �` \ # ¥< ^ ° � ? < \ � 0 \ : : . \• ?+u «: . #. C) \ ¥, w. ¥ : .y \ Ln ` A : 2) ?•° \} \ - \ . 0 .» - . .\� ¥1 0 C��TES CMG BOARD OF COMMISSIONERS MEETING DATE: October 13, 2021 SUBJECT: Administration - Staffing Request RECOMMENDED MOTION: Move approval to add a Public Information Officer to the County's Administrative Services department. BACKGROUND AND POLICY IMPLICATIONS: During the FY 2022 budget hearings, the Budget Committee approved funding for additional staff capacity in the County's Administrative Services department, pending review and analysis by the new County Administrator. After reviewing current capacity and workload, County Administrator Nick Lelack and staff are seeking Board approval to add a Public Information Officer position to the Administrative Services department. BUDGET IMPACTS: Costs associated with adding a Public Information Officer to the Administrative Services department were included in the FY 2022 budget. ATTENDANCE: Nick Lelack - County Administrator Whitney Hale - Communications Director MEMORANDUM TO: Deschutes County Board of Commissioners FROM: Nick Lelack, AICP, County Administrator Whitney Hale, Communications Director DATE: October 13, 2021 SUBJECT: Request to add a Public Information Officer FTE to the Administrative Services Department I. Summary During the FY 2022 budget hearings, the Budget Committee approved funding for additional staff capacity in the County's Administrative Services department, pending review and analysis by the new County Administrator. After reviewing current capacity and workload, County Administrator Nick Lelack and staff are seeking Board approval to add a Public Information Officer position to the Administrative Services department. This position would provide would provide direct communications support to 19 County departments, including the Board of Commissioners. 11. County Communications Administrative Services is responsible for providing internal and external communication support for all County departments, including the Board of Commissioners. This work includes: • Developing messages and themes to promote County programs and goals across a variety of platforms; • Media relations (interviews with media, issuing press releases, organizing press conferences) • Managing the County's social media channels, • Assisting departments with development of marketing materials and purchasing advertising • Developing public -facing presentations • Developing and maintaining website content • Employee communications • Supporting a range of other responsibilities designed to increase transparency of county government, including the County's electronic newsletter. • Assisting with implementation of communication tactics, strategies, and techniques for public engagement; Adding a Public Information Officer FTE to the Administrative Services department will enable staff to provide more direct support for department's growing communication needs and will provide Administrative Services with much needed additional capacity. Administrative Services Requests: The addition of one (1) full time regular Public Information Officer in the Administrative Services department. IV. FINANCIAL IMPACT Costs associated with adding a Public Information Officer were included in the FY 2022 budget. V. BOARD DIRECTION 1. Approve/deny the addition of one (1) Public Information Officer in the Administrative Services department. -2- E r� I 0 M M 00 01 l� N l� M M bn i L v 4-+ fa L 0 Q E 0 N t O E N (N N E N fa fa Ln Ca fa N O 4-+ N O N fa Q Ln fa v a� a� E 0 t 0 L 4- t10 v , a-J L C: W o U 0 L —_ 0 U U 0 vi �,�,, m cam O d Y O � >U v N N a-•+ O 'A W :E U O N N N = — N 0 N •� L U ai 0 U bLn A N — _ '0 QU 0,0 to -a 0 N v • C U Q i � V o c U N Q Lfi -1 N Q _0 fL � fa -0 � }' f0 U = � O ca v N S L N :3 QJ Q1 E =3 O -Q a-•+ v c o � o.� o o N N N fa 41 U i U A >v s 0 Ca N 4-J Qr) Q) 4 r L f= -�; N m i O W r� •-+ L-� O Q Q i V) C6 V •O .� O CL N L 0 U �--+ _0 V � CO � >- 4A N (� • - U -0 � m U U N WE N n � L L p42 UC UL o� co - < �N . Q u L (B cu t U .� H i O aJ a) z- U 0O U N aj �, �-- -a p s i v Y v a1 ca Q ca L 4= f0 � M M V). 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O i Q. Q N _ 4J d d Q O X ro t Qj QJ ca }' 3 O a-J Ln -c 4-1G E M Ln c i Q d- d E Q Q fB fB *j L", u Q. to U CL E x oz c— � O O N -9-- O U U ' ri a Lf1 0 0 ON L O -0 cB U— ca Q Ov U E 4-O bZ Q L Ln L 0o L O O ;B N Ln Q i -Fj m cn Ln .—i i/? vl? O O 00 O O O 00 O O O O O O Ln to O O O N m O O O M N � k.0 O M -cn MEETING DATE: October 13, 2021 SUBJECT: American Rescue Plan Funding Update RECOMMENDED MOTION: A to -be -determined motion will be required if they Board choses to fund additional projects from ARPA funds. BACKGROUND AND POLICY IMPLICATIONS: This is a recurring agenda item to provide the Board of County Commissioners updates on the status of ARPA funds and the opportunity to review eligible project requests for funding consideration. Discussion items for today's update: Proposal to Expand High Quality Childcare in Deschutes County. 2. Affordable housing proposal development update. 3. Review ARPA funding requests. BUDGET IMPACTS: None. Budget appropriations for the entire $38 million ARPA funding award are included in the FY 2021-22 Adopted Budget. ATTENDANCE: Greg Munn, Treasurer and Chief Financial Officer Dan Emerson, Budget Manager Deschutes County Child Care Coalition Executive Summary: Growing child care so we can get back to work COVID-19 devastated our regional economy, closing businesses and forcing families to adapt to learning and working from home, even as parents lost jobs and wages and as children missed months of important learning and development. To get back to work and see a thriving economy, our region needs more childcare. With nearly 12,000 children under age 5, and only 4,562 childcare spots, Deschutes County is a childcare desert: there are three times as many children as there are licensed childcare slots. This lack of options limits children's access to high -quality learning and care, just as it forces working families to stay out of our workforce because they can't find adequate care. With hundreds of unfilled positions across essential roles, childcare is a critical resource, limiting our recovery. To address this urgent need, we seek county -wide funding to expand and sustain childcare across Deschutes County. The funds requested will increase childcare slots immediately, and also expand long- term capacity: by investing in a well-educated, sustainably-paid workforce; by recommending investments in new childcare facilities and models; by engaging businesses as partners; and by creating a system of well - supported, well-resourced childcare businesses. We are a coalition of partners in workforce, education, business, and early learning, including the region's leaders in this work, and welcoming new partners whose initiative makes us stronger. Together, we seek to accomplish three key goals: 1. Build a workforce pipeline to train and retain 330+ high -quality, trained childcare leaders and teachers for existing and new centers across our region. 2. Invest in facilities and program needs to grow the 3300+ full -day childcare slots needed across Deschutes County, with a focus on rural expansion in Sisters and South County. 3. Sustain childcare as a viable business model across our region by leveraging these above supports to provider businesses with new partnerships with employers, civic and church partners that can make childcare affordable to families, sustainable for teachers, and a thriving business sector for our region. Experts estimate needing two child care slots to serve every three children (https://health.oregonstate.edu/sites/health.oregon state edu/files/early-learners/pdf/research/oregons-child-care-deserts- m2o_pdf). In Deschutes County, that means adding 3327 slots, nearly doubling the full-time capacity in addition to an existing 1000 part-time slots. Childcare staffing ratios vary based on the type of care and age of child. Here, we estimate needing one care provider per 10 children. (See attached full gap analysis for more information, using 2019 US Census and Head Start data.) Deschutes County Total City Seats I Educators Bend 2473 247 Redmond 687 69 Sisters 98 10 La Pine 69 7 Total 3327 333 Solution: There are three key components to growing the system: 1. Create a pipeline of new teachers 2. Build capacity for early learning and childcare centers (including new facilities and new use of existing ones) 3. Establish on -going support to sustain providers and educators This coordinated strategy invests in high -quality programs, new and existing, with capacity to create sustainable, high -impact outcomes. The jobs pipeline, center infrastructure, and ongoing support programs outlined here are rooted in these smart business strategies and values, designed to match high -quality childcare with well -planned, sustainable businesses. Specifically, the programs we highlight demonstrate three criteria: - Sustainable long-term plan - Ensure quality - Leverage funding or match Workforce Pipeline We know that we need 333 early childhood educators to meet current and grow future classroom capacity to meet regional childcare demand. This strategy is a multi -pathway approach to building our network of early childhood educators in Deschutes County. The approach meets future Deschutes County educators where they are. It aligns existing with new pathways to meeting Early Learning Division's (ELD's) requirements for teachers for centers or home providers to achieve licensing. And this proposal leverages Deschutes County, City of Bend, Early Learning Division, OSU-Cascades and COCC resources through three programs: 1. Childcare Sustainability Pathway Program 2. Fasttrack 3. Little Kits Internship Build capacity for early learning and childcare centers Childcare resources cannot grow without expanded infrastructure: more centers in new locations, expansion of existing locations, and new programs which leverage resources in our churches, community centers, and office spaces, alongside new construction across our growing residential communities. The following proposals and programs (submitted to the County with independent funding requests, and/or included here) meet key sustainability criteria above, add new facilities in underserved locations and for key populations, and introduce new models with promise for expansion and duplication. These investments will both expand and multiply capacity, as they create centers for training high -quality childcare educators across Deschutes County, build and strengthen partnerships in rural communities, and introduce needed models of employer -based childcare centers. 1. Little Kits Bend Westside (already funded)- anew model which invests in on -site learning for early education students, while supporting students returning to college after becoming parents. 2. Boys and Girls Clubs, St. Charles, Little Kits Bend Eastside- a new model which leverages St. Charles resources and investment to demonstrate the value of employer -based childcare to employees and business alike. 2 3. Re -Village Coop (Sisters)- a new model which partners with church and community spaces while also training parents as high -quality caregivers, investing in long-term wellbeing for families and expanding first into Sisters, then into other areas of need and partnership. 4. Morning Star Relief Nursery (La Pine) — a trusted and needed provider seeking to expand service in La Pine and provide needed, high -quality care for families in South County. Because many existing providers can expand capacity with investments into their facilities, we propose creating a $500K Small Center Facilities Fund, which will be held by Neighborlmpact, CCR and administered using guidelines and criteria created by this joint childcare coalition, following sustainability guidelines above. Establish on -going support for providers and educators As part of our workforce pipeline, we must invest to Sustain early childhood educators and centers by ensuring living wages and a strong business climate. The Sustain program builds on existing capacity investments, with a focus on key long-term business capabilities: 1. Business and professional development for Center Directors to ensure they understand the business model, 2. Partnership with business sector leaders and workforce leads to leverage more employer contributions to underwrite the cost of childcare tuition, and 3. Sector -wide, regional resource development efforts to expand funding across the sector through new and existing, traditional and non-traditional funding sources, including private foundations, public -private partnerships, and longer term policy changes to attain and sustain on -going living wages for educators to retain them in our workforce. Sustain work is led by key partners including East Cascades Works, Neighborlmpact, BDAB, Bend Chamber, OSU-C, COCC, and community investments in our municipalities and led by regional employers such as St. Charles. Funding Model and Matching Resources: The estimated total cost for this countywide initiative is $15M-$20M, funded from a combination of public and private donors, emergency and ongoing program funds, fees for service, and state, county, and city ARPA funds. Community partners including K-12 and higher education institutions, government organizations, and non-profit partners, will provide valuable space and in -kind staff and planning to move this effort to reality. 3 Program Focus Requested County Investment Matching Funds (operating and capital) Childcare Impact $ $ Highly -qualified educators Workforce $3,325,000 $1,872,496 needed: 333 Business Accelerator $235,000 $125,000 total: 339 Childcare Sustainability Pathway Program $400,000 FastTrack $1,600,000 $405,000 Little Kits Internship $1,000,000 $1,342,496 Center Infrastructure (capital, capacity) $4,550,000 $10,806,000 Childcare Seats Little Kits (Bend West) $1,000,000 $1,500,000 100 Little Kits, Boys and Girls Clubs, St. Charles (Bend East) $2,100,000 $7,606,00* 200 Morningstar (La Pine) $600,000* $400,000 50 Re -Village (Sisters, Bend, Redmond) $350,000 $300,000 80 Small Center Capacity Fund $500,000 $1,000,000 100 (could invest in Manzanita, School of Enrichment, others via criteria) TOTAL: 535 *includes cost to purchase land Key Partners n as Cascades Neighborimpact CENTRAL O R E G O N WORKS ,ORS cvmi)7unrty callege *F�r./ C`,c OFrgon StatcUnivcl5it�, EARLY EDUCATION {LC3fvgfSD Cascades Early__ J Learning S Wellness BEND LAST A If CHAMBER Deschutes County Early Childhood Educator Workforce Development Strategy There is a childcare desert in the Deschutes County. There are three key drivers of this issue, inadequate infrastructure for childcare, high turnover of providers, and insufficient workforce. This strategy is designed to address a portion of the insufficient workforce issue. We know that we need 333 early childhood educators to meet current needs and to grow future classroom capacity to meet regional childcare demand. This strategy is a multi -pathway approach to building our network of early childhood educators in Deschutes County and throughout Central Oregon. The approach meets future Deschutes County educators where they are. It aligns with existing with new pathways to meeting the Early Learning Division's (ELD's) requirements for teachers for centers or home providers to achieve licensing. And this proposal leverages funding, resources, or financial match from multiple entities including, Deschutes County, City of Bend, Early Learning Division, OSU-Cascades, Neighborlmpact, and COCC to address the issue. If successful, these programs will be managed by Neighbor[ mpact-Child Care Resources (CCR), East Cascade Works, and OSU-Cascades. Background: It is important to understand the necessary ELD requirements for teacher qualification. Early i eax Prig Division T acher Re uir ri"tent Goak 333 Teachers • INER 9'' Teacher Aid (1 & 11) Teacher Head Teacher Director (w/in sight of teacher) Home -based Provider (1/Center) CBR, CPR, mandatory reporting, OCC health and safety, OCC safe sleep • 30 college credits, • Bachelors, or • 1 year Associates, or supervision, and or • 1 year Credential • 1 year Credential • Meet head (e.g. (e.g. teacher Apprenticeship), or Apprenticeship), qualifications • 15 college credits+ or • 30 college 1/2 year teaching, credits+ 1 year or • 2 years teaching teaching, or • 2 years teaching Solution: - Grow new and rising educators into well -prepared classroom qualified teachers by providing professional development guidance for teachers to continue with higher education opportunities and ongoing training through a new Fast -track Program (Deschutes County — Neighborlmpact CCR & ECW). - Attract new educators into the workforce through the design and implementation of an Apprentice Program (Early Learning Division - ECW, COCC) and Boost Program (BDAB — ECW, COCC). Planning for these programs have been fully funded and are in the early planning stages. They will not be described below. - Expand access to college degree seeking future educators through a Little Kits Internship Program. Ideally this program will serve as a model and catalyst for future internship sites across Deschutes County, providing additional pathways for teacher qualification (Deschutes County - OSU-C, COCC, ECW, Neigh borlmpact). - Sustain early childhood educators and centers by ensuring strong business acumen and a commitment to professional development, state and national guidelines. A program to provide business and professional development for Center Directors to ensure they understand how to create a sustainable business model. This may be achieved by seeking employer contributions to underwrite the cost of childcare tuition, and pursuing other non-traditional funding source. The outcome will be on -going living wages for educators, retaining them in our workforce. (Neighborlmpact, BDAB, Bend Chamber, OSU-C, COCC). Grow and Sustain: Childcare Sustainability Pathway Program Historically, there have been three primary paths to teacher qualification, professional development and classroom experience, COCC 2-year and certificate programs, and OSU-C 4-year pathways. With access to new funding sources and collaborative approaches between agencies and higher education, we are opening doors to new pathways to becoming a teacher. A future early childhood educator may begin the journey to teacher qualification through the fast track program, Boost program, professional development or a higher education pathway. To ensure future educator access to these programs and promote demand, we are proposing a childcare Sustainability pathway program. Leading this program will be Neighborlmpact CCR, with a new Pathway Director. 1 Teacher Aid (I & ll) Teacher (w/in sight of teacher) t 0"o (, yk Head Teacher Director (I/Classroom) (1/Center) A Pathway Director will ensure awareness of and recruitment into the field of early care and education in Deschutes County. New recruits will receive professional development planning and placement in the pathway to meet their needs. This position will work with new and existing education pathways and placement sites, including outreach to high school Childcare Sustainability• ' programs. YEAR YEAR YEAR Total A new marketing campaign will highlight new education pathways funded by Deschutes County and other funding sources. This campaign will consider the needs of our BIPOC community. Expenses Personnel Expenses Pathway Director 90,000 90,000 90,000 Marketing Campaign 50,000 25,000 15,000 Subtotal Direct Expenses 140,000 115,000 105,000 360,000 Indirect Expenses Total Expenses 15,400 12,650 11,550 39,600 155,400 127,650 116,550 399,600 Outcome: A $400K investment by Deschutes County will support the success. Central Oregon Child Care Business Accelerator SBDC, COCC and CCR program will provide insights into establishing a strong foundation Accelerator YEAR and the framework for continuous quality Expenses improvement to establish and maintain high quality family childcare businesses. The Central Expense per Course Oregon Child Care Business Accelerator Instructor and Advising 17,440 program provides 18 hours of classroom time Class Materials 21,825 Program Management 3,775 on best business practices and support to start Contingency 2,002 a family childcare, 10 hours 1:1 advising, one New Business Seed Money 75,000 year Wonderschool business management subtotal 120,043 software and a $5,000 startup grant upon completion. Total Expenses No. of Pilot Courses 3 Total Project Budget 360,128 Matching Contribution City of Bend 125,000 Ask of Deschutes County;, Total 235,128 Outcome: A $360K investment by Deschutes County will support the retention or launch of 45 childcare programs, in -home or center -based. Grow: Fast Track Teacher Training A skills development program for new teachers and current center directors. Neighborlmpact, CCR will collaborate with East Cascades Works to support the recruitment of unskilled future early educators for early childcare programs throughout Deschutes County. Neighborlmpact, CCR will do this work by developing a FastTrack New Teacher Candidate 6-month training program, allowed through an exemption from the Teacher's Development Plan with the Office of Child Care. This program will provide for skill development in directors, pay prospective teacher wages for the first 3 months while they become classroom qualified teachers. Retention and growth encouraged through ongoing professional development planning. Fast Track Teacher Training Number of trainees 30 30 30 90 Expenses Personnel Expenses Quality Improvement Educator 90,000 90,000 90,000 Program Coordinator 50,000 50,000 50,000 Teacher Candidates 360,000 360,000 360,000 Total Salaries 500,000 500,000 500,000 OPE Subtotal Compensation 500,000 500,000 500,000 1,500,000 Contracted Services Candidate Training Subtotal Direct Expenses Program Administration Total Expenses 30,000 30,000 30,000 30,000 30,000 30,000 90,000 135,000 135,000 135,000 405,000 665,000 665,000 665,000 1,995,000 Matching Contribution Program Administration 135,000 135,000 135,000 Total 135,000 135,000 135,000 405,000 Ask of Deschutes County Total 530,000 530,000 530,000 1,590,000 Outcome: A $1.6M investment by Deschutes County will result in 90 new classroom qualified early childhood educators Expand: Little Kits Internship Program An on-the-job training and education program for future teachers and head teachers. Pathway Director to coach on pathways OSU-Cascades will recruit, Little Kits Internship Program advise, educate, and YEAR YEAR YEAR Total supervise 6-24 teacher candidates per year at Little Number of trainees 6 24 24 54 Kits locations in Deschutes Expenses County. Each intern will be Personnel Expenses enrolled in up to 45 credits Program Coordinator (1.0 FTE) 60,000 61,800 63,654 per calendar year of early Practicum Supervisor (0.5 FTE) 21,501 22,146 22,810 Interns (Trainees) 54,000 222,480 229,154 childhood or education Total Salaries 135,501 306,426 315,619 courses and work supervised OPE 75,110 110,736 112,071 in early childhood classrooms Subtotal Compensation 210,611 417,162 427,689 1,0SS,462 an average of 20 hours per week. Additionally, interns Tuition 58,050 239,166 246,341 Subtotal Direct Expenses 58,050 239,166 246,341 543,557 will complete all OCC required training. This Program Operations & Administration 155,080 27S,609 282,024 712,713 program will qualify early childhood educators as head Total Expenses 423,741 931,937 956,054 2,311,732 teachers. Additionally, it will qualify program participants MatchingContribu#ion to meet Oregon SEIU Early Tuition & Fee Remission 14,513 59,792 61,585 Childhood teacher Program Operations & Administration 226,221 459,991 471,085 requirements to work in Total 240,734 519,782 532,670 1,293,186 public childcare centers. And Ask of Deschutes County finally, program participants Total 183,008 412,154 423,384 1,018,546 will have 1 year of a college degree completed and a living wage job upon completion. Outcome: A $1.0M investment by Deschutes County will result in 54 new early childhood educators. Summary We are seeking Deschutes County investment of $2.6M in three workforce development program, including the Childcare Sustainability Pathway Program, Fasttrack Workforce Development, and Little Kits Internship Program. This investment will be leveraged with contributions in the form of tuition assistance from both the Early Learning Division (PIP Program), OSU-Cascades tuition assistance, City of Bend ARPA funds, and program administration offered by Neighborlmpact-Child Care Resources (CCR), East Cascade Works, COCC, and OSU-Cascades. The outcome will be growing our early childhood workforce by up to 339 new teachers, meeting 100% of need. Goal: 333 Teacher Aids Teachers Total Time 6-mo 1-yr 2-yr 3-yr 6-mo 1-yr 2-yr 3-yr BDAB Boost 15 15 Apprentice 15 15 30 COCC 30 30 30 90 OSU-Cascades 20 20 20 60 14pittIe Kif:s Total 15 0 0 0 30 86 119 89 339 Program Sponsors CENTRAL OREGON COMIMIllity college EARLY CHMDHOOD EDUCATION Neighborimpact ces. , Reso—rl� 0 or'-plistatculliversi", Cascades Little Kits, Boys & Girls Clubs of Bend, St. Charles Health System Early Learning and School Age Enrichment Center (Bend Eastside) Problem: There is a virtual childcare desert in Deschutes County with three key drivers behind this crisis: 1) inadequate facilities for childcare, 2) high turnover of providers, and 3) insufficient workforce. This proposal is designed to directly address the lack of childcare capacity/facilities and will indirectly impact the other two issues related to childcare staffing. There are currently 4,562 childcare slots in Deschutes County, but the Early Learning Hub at High Desert ESD, estimates that we need an additional 3,327 early childhood seats to provide two childcare slots for every three children and meet current childcare needs in Deschutes County (this number is even higher when you consider care for school -aged children). The lack of childcare coupled with the COVID-19 pandemic has been devastating to St Charles, the region's largest employer - many healthcare workers have left the workforce, reduced their hours, or declined offers of employment due to a lack of childcare leaving the hospital struggling to fill key essential positions. This proposal will specifically address the childcare needs for our essential health care workers in Deschutes County by providing critical infant, toddler, pre-K, afterschool, and drop -in care. We know that our health care system operates 24-hours per day and seven days a week so in addition to typical workday care, Monday through Friday 8-5, childcare will be provided during evening and weekend hours. Background: St. Charles Health System is a private, nonprofit organization with a vision of creating America's healthiest community, together. With over 4,600 employees, including 417 active medical staff and 363 visiting medical staff, they have been on the front lines of the COVID-19 pandemic. Right now, St. Charles is struggling to retain and attract a workforce to sustain the growing needs for health care in our community. The round-the-clock hours of hospital operations make it especially challenging for caregivers to find childcare in a tight labor market where already there are not enough seats to meet the demand. St. Charles completed a childcare needs assessment survey in 2019 with nearly 1,000 respondents, approximately 920 of whom were residents of Deschutes County. The assessment reflected a strong demand for childcare services in Bend, with anticipation of care needed for roughly 180 children from infant to school age, including afterschool care programs. An additional 114 respondents anticipated having children over the next three years. Since this assessment two years ago, we have absolutely seen an increase in the amount of births with many employees delaying or choosing not to return based on not being able to secure childcare. To increase workforce stability, promote retention, reduce absenteeism, and attract talent, we must create more childcare seats providing parents with trust and confidence that their child(ren) are being well cared for and to ensure we have the workforce to care for the growing population in Central Oregon. Little Kits Westside is a new modular childcare and early learning center - operated by OSU- Cascades in close coordination with COCC's early childhood program —that will launch formally in late Fall 2022 on the OSU-Cascades campus. However, to meet some of the current demand, OSU-Cascades is operating a pilot Little Beays program until the new facility is built and qualified teachers are hired. To date, Little Kits has hired a Childcare and Early Learning Center Director, opened the first pilot classroom, and is recruiting for new teachers. Pre -design work and informal solicitation of modular builders has begun for the facility while we await distribution of funds. The initial 28 pilot slots are full and an additional 50 children are on the waitlist for childcare. Boys & Girls Clubs of Bend (BGCB), which celebrated 25 years of operations in 2019, has seen demand soar for available, affordable, and safe spaces for after -school and summer programming for school -aged children. The need is real. When our after -school registration for 2021 opened to enroll more than 150 youth, we experienced a wait list within less than 24 hours and had so much traffic to our registration page that it kept crashing. We now have a standing wait list of families, and many parents identify themselves to us as essential workers in healthcare. The timing is right. BGCB is undergoing a strategic planning process right now with an eye to expansion on the east side of Bend. Solution: St. Charles, Boys & Girls Clubs of Bend, and Little Kits are partnering to build two co - located facilities on St Charles land that will serve between 150 to 200 children of our essential health care workers. In this proposal, to maximize efficiency and reduce costs, both buildings will utilize the Little Kits Westside modular building design — the first facility built will replicate the Little Kits operational model while the second facility will eventually become an Eastside branch of Boys & Girls Clubs of Bend and provide after school, evening, and summer enrichment programming. St. Charles is generously offering a 5-acre parcel (located on the corner of Connors Avenue and NE 27t" Street), sufficient land for the two modular structures, parking, and playground space. Additionally, they will provide resources to assist in site work prep and bringing necessary utilities to the buildings. To ensure on -going and sustainable operations and affordable employee pricing for the Center, St. Charles will underwrite an employer contribution. Additionally, the City of Bend recognizes childcare as a priority so has committed to covering the cost of transportation system development charges and will consider permit fee reductions. Little Kits and Boys & Girls Clubs of Bend will operationalize the two Eastside facilities to serve infants to youth from kindergarten to high school, meeting the needs of essential healthcare workers' families and families in East Bend. In Phase One, a flexible 6-classroom facility will be built to serve infants through school age children, configured based on demand. The Center will operate both traditional childcare hours and extended hours of service and weekends to meet the needs of essential health care workers. Little Kits will operate the infant through pre-K childcare and early learning programming while Boys & Girls Clubs of Bend will launch their services in the facility using separate rooms with separate outdoor access to maintain appropriate segmenting of ages, serving up to 100 children. Additionally, the Little Kits Center will be a valuable workforce development site for future early childhood educators across the region. Within the next three -years, BGCB will undertake a community -wide capital campaign to fundraise and build a second modular structure (Phase Two) on the same site that will serve youth from kindergarten through teenage years. This will allow Little Kits to fully take over the first 6-classroom modular structure. We anticipate being able to serve between 70-100 school -age youth in the second modular structure once built. Proposed Site of the Early Learning and School Age Enrichment Center - 5 acre parcel at the corner of Connors Avenue and NE 27th Street. Total Construction Budget - 2 Buildings Budget Direct Construction Land 4,573,800 Site Work 700,000 Facilities Construction (2 buildings) 3,000,000 Landscaping, Parking, Playground 200,000 Subtotal Compensation 8,473,800 Other Costs Design Permits SDCs Other Services Furnished Equipment and Furnishings Subtotal Direct Expenses Project Administration Total Expenses 300,000 150,000 250,000 50,000 200,000 950,000 300,000 �a114 16-3 6 148f , b�, 4-16 1 --217 4_161q r N'.5 H2533 69' - 109' 75-�' 1 QQZ' 4-16 b 3 I 5 4 tf2 �. H2553 H2563 - 4,573,800 233,333 466,667 1,500,000 75,000 75,000 1,808,333 5,115,467 0 0 100,000 75,000 67,000 116,000 25,000 100,000 367,000 0 116,000 100,000 100,000 9,723,800 2,275,333 5,115,467 116,000 100,000 0 (0) 1,500,000 50,000 1,550,000 200,000 75,000 67,000 25,000 100,000 467,000 100,000 2,117,000 Timeline: Based on a typical contracting and construction timeline and current raw materials supply chain constraints, the first facility will open in Spring 2023 (tentative timelines illustrated on next page). All parties will work to expedite the delivery and opening of the new Center through a commitment to work with the City of Bend, local contractors, and modular designers to expedite design, permitting, and construction. The second facility will begin once the capital campaign has been successfully completed and is anticipated to come online in 2024. Summary: Together, St. Charles, Boys & Girls Clubs of Bend and Little Kits will serve up to 200 children in a dynamic Early Learning and School Age Enrichment Center on the East Side of Bend. We will leverage a requested $2.117 M of Deschutes County funding with a more than 3:1 match from project partners. This collaboration creates significant momentum in solving the regional childcare and afterschool enrichment crisis in Deschutes County and addresses the childcare shortage for our critical health care sector. m x �r a 3 m 0_ a p ar C nr m or cn n D iD Q n O C W v_ n D n 0 7 C 0_ -. O 0 O �. M C j "a0 0_ 0_ 0_ Q 0. O 7 n 7 C 0_ O 7 O Q_ 0_ = C 7 (~D 7 "a0 CL Q .t 'n d`�" N N N N rNr C N N tmn —* n Gl rD 03Q tiCiCD CD M O < Do( �. Ln ID D� °0 - D O Da d m 3 a as 3 a 0 oa d m, m 90 a a -1 < �p C �p N O C N ,. tD O < AO ro �. O O ca.— CD = as < v Do m a mm s G� 7/1/2021 �Prl O1 8/1/2021 1 9/1/2021 10/1/2021 x x x x 'rd lop 11/1/2021 x x 12/1/2021 1/1/2022 P~10 2/1/2022 x x 11 x x 3/1/2022 4/1/2022 S x x x b� �l0 x x x x x 11 5/1/2022 x x 6/1/2022 x x x x x x J G�lj 7/1/2022 x x x x x x �P 'l0 11 8/1/2022 x 9/1/2022 x 10/1/2022 x �d x x x loll 11/1/2022 x 12/1/2022 1/1/2023 x x x� P~lo 2/1/2023 x P9 x 3/1/2023 h �101 5/1/2023 6/1/2023 Expanding Childcare in Deschutes County ,(fi-ellgfll(?Iliaq lairdlin to K('('p C iddlell safe, MountainStar is seeking funds to purchase and renovate properties. MountainStar is seeking funds to expand services in both La Pine and Redmond over the next two years. We anticipate adding up to 18 Relief Nursery (ages 0-3) slots in La Pine, and up to 11 Preschool Promise (ages 3-5) slots in both Redmond and La Pine. In La Pine, we propose to purchase two modular units and land with utilities plumbed/connected. Additionally, we plan for exterior renovations to install a play area appropriate for children ages 0-5. We do not currently have a plot identified and are looking to partner with regional partners including Habitat for Humanity, Bend -La Pine School District, Deschutes Children's Foundation, and others. In Redmond, we have secured partial funding to renovate our current building to add a second learning space and need additional funds to replace the expiring roof and finish renovations. MountainStar works with regional childcare leaders Neighborlmpact Child Care Resource and Referral, the Early Learning Hub of Central Oregon, regional child care task forces, OSU-Cascades and COCC. With an estimated $2.7 million cost to build/renovate and operate La Pine and Redmond centers over the next three years, we request $600,000 from Deschutes County Commissioners to purchase and renovate properties, in order to expand high -quality early childhood care and education. Please see attached budget for more detail. MountainStar services help keep vulnerable young children safe and successful. Since 2001, relief nursery staff have been providing trauma -informed early childhood classes, home visits, and family support services documented to 1) keep children out of foster care, 2) improve parenting, and 3) connect high -stress families to community resources. Families enrolled at MountainStar have an average of 14 "risk factors" such as a history of previous involvement with the criminal justice or child welfare systems, unstable housing, food supply issues, poverty, health/mental health issues, etc. These stress factors contribute to the likelihood of child abuse and neglect, and MountainStar exists to strengthen families and keep children safe. Every year over 98% of the children enrolled in MountainStar relief nursery classrooms remain safe from confirmed cases of abuse and neglect. In 2020, MountainStar added Preschool Promise classrooms to our sites in Bend, Madras and Prineville. These classrooms allow for "continuity of care" into the preschool years for families who had been enrolled in relief nursery classrooms. They also meet the need of providing high quality preschool education for children of lower income families. Multiple studies show the short and long-term benefits of investment in early childhood education. Immediate benefits for parents and the community include more adults able to enter the workforce, and better community connections that lead to individual and community -wide resilience. Long-term benefits include higher academic achievement, reduced or eliminated interaction with the child welfare system, reduced health care costs, and increased lifetime earnings. MountainStar is a community -based effort to help families. MountainStar Family Relief Nursery is an independent nonprofit organization focused on preventing child abuse and neglect. Over the last 20 years, MountainStar staff have worked with 5,000 young children and over 20,000 family members in Central Oregon. MountainStar board and staff engage local communities to help carry out this important work and last year raised over $1.25 in private sector funding for every $1 of state government funding invested in our relief nursery. Community volunteers have contributed over 65,000 hours since 2001 by working in classes, serving on the board of directors, and helping with fundraising projects. MountainStar has been providing services to families in La Pine since 2016, and to families in Redmond since 2019. The expansions of MountainStar will provide 2 jobs in Redmond and 4 jobs in La Pine, with an average starting wage of $21.80/hr. These expansions will also begin to meet the need for childcare in these communities, especially for lower income families. We look forward to a conversation to discuss our proposal in more detail. Contacts for more information: • Kara Tachikawa - Executive Director (541) 508-8410 KaraT@mtstar.orR • Tobiah Brown - Program Director (541) 322-6820 TobiahB@mtstar.org Estimated 3-Year Budget - La Pine and Redmond FY 2021-22 FY 2022-23 FY 2023-24 Revenue Donations/Grants 239,124 243,662 248,044 Relief Nursery ELD Contract 190,000 190,000 380,000 Preschool Promise 0 280,000 268,000 Other Government Grants 75,000 0 0 Deschutes County ARPA 600,000 0 0 Total Revenue $1,104,124 $693,662 $896,060 Expenses Personnel - Admin 57,606 59,335 61,710 Personnel - Manager/Coordinator 121,043 124,675 192,070 Personnel - Direct Service Staff 72,110 220,610 309,630 Associated Payroll Expense 73,728 121,386 169,023 Total Personnel 324,487 526,006 732,433 Program/Service Expenses (client or classroom related) 10,701 16,180 18,475 Classroom Start -Up Expense 0 30,000 15,000 La Pine Land Purchase/Utilities 200,000 0 0 La Pine Modular Purchase 295,000 0 0 La Pine Outdoor Renovation (including land, playground, fencing) 55,000 0 0 Redmond Remodel Project (50,000) 125,000 0 0 Ongoing Occupancy Costs 26,996 38,276 38,636 Professional Services (legal, CPA, IT) 28,707 37,320 41,050 Program Administration (insurance, marketing, professional development) 38,233 45,880 50,450 Total Expenses $1,104,124 693,662 896,044 -0 Ln O In O M O M O coo o O O o o O O O O o O a) m c rn c O o 0 o C o 0 u ' I� NO tll O' O o O O O O CL v m m o C o m oM n m C. 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'id ,N V v1 LL i O U;M _ m .. a0� o LO � <;� N Q m 0 Q m U17 m �t m 0 m Ln '-i c-I rl ri Ln v w OT E s CMG n4�BOARD OF COMMISSIONERS MEETING DATE: October 13, 2021 SUBJECT: Public Hearing and Consideration of Cascade Medical Transport as a Proposed Subcontractor to Provide Certain Ambulance Services for the La Pine Rural Fire Protection District RECOMMENDED MOTION: Hold hearing, discuss and consider proposed subcontract, and if the Board is so inclined at the conclusion of the hearing, entertain a motion to authorize CMT as a subcontractor of the La Pine Rural Fire Protection District as described in the proposed subcontracting agreement submitted by the La Pine Rural Fire Protection District. BACKGROUND AND POLICY IMPLICATIONS: On March 24, 2021 the Board of County Commissioners voted to amend Chapter 8.30 of the Deschutes County Code to allow ambulance service franchisees of the County to subcontract with non franchisee ambulance service providers to provide certain emergency and non - emergency transportation services within their ambulance service areas. This amendment primarily came in the form of a new section added to Chapter 8.30 - Section 8.30.070, which became effective June 22, 2021. La Pine Rural Fire Protection District is a County ambulance service franchisee providing ambulance services within the La Pine Ambulance Service Area. Pursuant to Deschutes County Code Section 8.30.070 and its terms, the Board of County Commissioners is authorized to approve subcontractors proposed by ambulance service franchisees such as La Pine RFPD for the provision of certain ambulance services. La Pine RFPD is proposing to subcontract with Cascade Medical Transport to perform certain ambulance services within the boundaries of the La Plne Ambulance Service Area, and seeks approval to do so from the Board of County Commissioners. This is the first such request under Section 8.30.070 from one of the County's franchisees. BUDGET IMPACTS: None ATTENDANCE: Chris Bell, Legal; Tom Kuhn, Public Health, ASA Advisory Committee Administrator PUBLIC PRIVATE PARTNERSHIP AGREEMENT FOR ADVANCED LIFE SUPPORT AMBULANCE SERVICES IN CERTAIN CIRCUMSTACES This Public Private Partnership Agreement ("Agreement") is entered by and between Cascade Medical Transport of Oregon, an Oregon Corporation ("CMTO") and The La Pine Rural Fire Protection District, an Oregon governmental special district organized under ORS 478 ("District") with resect to the laws of Oregon and the Deschutes County Ambulance Service Area franchises ("ASA") to support the needs of patients and medical facilities within the District. RECITALS WHEREAS, the District being a public safety entity and CMTO a private medical transport service provider can leverage the unique benefits of both the private and public sector to provide effective and efficient services to the citizens of the community; and WHEREAS, the citizens of the District by vote established a community paramedic service, which was the first for a rural and remote area of Oregon, that it was to be fee based and not tax supported, and the District is able to provide such service by charging fees for the cost of providing the service and focusing on emergency stabilization and critical emergency advanced life support (ALS) transports only, and not medical interfacility or intrafacility transports where patients are already under a professional medical providers care; and WHEREAS, As per ORS 682 the District has been responsible for the County ASA franchise for the fire district and immediate surrounding area for the last three decades and is currently assigned the 10-year ASA franchise till the next renewal period in July 1, 2028 for the community; and WHEREAS, As per Deschutes County ASA Ordinance sections 8.30.070 and 8.30.090 the District may sub contract emergency and/or non -emergency transports with another ambulance service provider and subcontract for emergency or non -emergency interfacility ambulance transports with a private, non -governmental agency with the review and authorization of the County Board of Commissioners; and WHEREAS, CMTO is a state licensed ambulance provider at both the basic life support (BLS) and advanced life support (ALS) paramedic levels, has multiple units, staffing flexibility, and specializes in medical intrafacility and interfacility transports; and WHEREAS, over the last few years has seen a growth and establishment of fixed site medical facilities within the community that demand intra or inter facility transportation through 911 for ill and/or injured patients, that who cannot receive and/or are provided care at the local facilities, and then require transport to the closest hospital medical facility which is 35 miles away; and WHEREAS, the District does not have the resources or means to keep up with the medical facilities demand and still provide critical fire, rescue and emergency medical services to citizens of the community who are not in professional care; and WHEREAS, CMTO has the ability to provide both emergency and non -emergency medical intrafacility and interfacility transport service meeting all the requirements of the County's ASA Page 1 of 6 plan, however needs to have reasonable assurances private resources allocated for this purpose will be utilized in a consistent and sufficient manner to be commercially viable; THEREFORE: CMTO is authorized, and agrees, to provide both non -emergency and emergency ambulance service to professionally staff medical care facilities within the District During the days and hours as listed in appendix A. CMTO available units shall be listed as an available medical transport resource for the District on the service area computer aided dispatch run assignments and dispatched as an La Pine available resource by 911 meeting all response standards as set in the County ASA for the District. The District will defer cost recovery rights (billing) to CMTO to recover the cost of providing services from the facilities, insurance, Medicaid /Medicare, Veterans Affairs (VA) and/or the individual patient as their business practices require for supporting transports performed by CMTO. CMTO retains the right to set its fee schedule based on its internal cost structure and industry best practices. The District will not be responsible for any cost recovery or payments for transports performed by CMTO. The District's voluntary subscription La Pine - Oregon Fire Med program is not applicable to medical facility transports (emergency or non -emergency). This agreement provides that CMTO is also not obligated to wave fees and/or payments under the La Pine - Oregon Fire Med Program. CMTO shall comply with the terms of this agreement and meet all standards within the current ASA plan, and the applicable terms of ORS Chapter 682, any rules and regulations issued pursuant to ORS Chapter 682, including but not limited to OAR 333-260-0000 to 333-260-0070, and any other applicable state, federal or local laws, rules or regulations. The District reserves the right to enact additional rules and regulations from time to time as it deems necessary to protect the health, interest, safety and welfare of the public in relation to emergency and non - emergency ambulance services, provided that any District rules shall not be inconsistent with the provisions of applicable County or State regulations mentioned in this subsection. CMTO shall obtain and maintain insurance coverage satisfactory to the District, CMTO shall add the District, its officials, officers, agents, employees and volunteers as additional insureds for general liability and property damage insurance coverage and a separate endorsement shall be issued by the insurance company showing the La Pine Rural Fire Protection District as an Addition Insured and provide Notice of Cancellation as set forth under this agreement. Such insurance shall be in the forms and amounts not less than set forth in ORS 30.260 to 30.300. If CMTO, for any reason fails to maintain insurance as required by this agreement, the same shall be deemed a major breach of contract. CMTO shall obtain and maintain at all times during the terms of this agreement workers' compensation insurance within statutory limits and employers' liability insurance in full compliance with the requirements of ORS 656 and with Oregon unemployment insurance requirements. CMTO is a limited liability corporation (private business) and as an independent contractor will be responsible for any federal and state taxes applicable to the services provided within the District. It's employees and agents are CMTO's entirety as private sector employees and are not Page 2 of 6 eligible for any wages and/or benefits through the District and the Oregon Public Employees Retirement System. CMTO shall fully comply with all wage, hour and labor standards required by State or Federal law. Public contracting law, ORS 27913.220 through 279.13235 and 279C.500 through 27913.870 as applicable are incorporated herein by reference. The District and CMTO both agree to comply with the Civil Rights Act of 1964, and 1991 the Americans with Disability Act (ADA) of 1990 as amended, 42 USC§§ 12101-17, 12201-13 (Supp. V 1994), Section 504 of the Rehabilitation Act of 1973, and Title VI as implemented by 45 CFR 80 and 84 which states in part no qualified person shall on the basis of disability, race, color, or national origin be excluded from participation in , be denied the benefit of, or otherwise be subject to discrimination under any program or activity which receives Federal financial assistance. The District and CMTO, each shall defend, indemnify, and hold harmless each other, their elected officials, officers, agents and employees from the damages arising out of the tortious acts of each concern acting within the scope of their employment and duties in performance of this agreement. CMTO is to be staffed and available -in-service with at least one Advanced Life Support (ALS) paramedic ambulance during the operational times of the medical facilities that are within the community. Notably 08:00 hours to 18:00 hours - Monday through Friday. CMTO will increased the number of units available based on call volume and in order to meet the County ASA requirement for La Pine of 43 minutes after dispatch 90% of the time for all calls dispatched through 911 from the service area. It will be a goal of this partnership agreement when sufficient volume is reached to warrant a CMTO ALS paramedic ambulance will be assigned and staged within the La Pine area. The District Duty Officer and/or CMTO may upgrade responses (based on caller information that is received through 911 Emergency Medical Dispatch (EMD)) to add additional medic and/or fire units that may be necessary. CMTO will be allowed to pend non- critical responses (based on caller information that is received through 911 EMD) until appropriate resources become available. CMTO may utilize its resources for other non -emergency or interfacility and intrafacility services within or outside the District's service area. However, those responses are not to negatively impact CMTO's ability to meet the requirements of this agreement. CMTO shall participate in the District disaster response planning and commit its available resources, as applicable, to such. When CMTO has available medic units in service on the District's EMS run card and the district has exhausted its own medic resources CMTO resources are to be available to assist per this agreement at the request of the District Duty Officer. The District shall provide call information through the County 911 system for only calls applicable to this agreement. CMTO shall have at least one radio (currently South County VHS, transitioning to County P25) in their units with the ability to receive and communicate with a District's 911 dispatch call for medics per the applicable run card. CMTO shall continuously monitor that channel during the required times of in service, as well as appropriate text devise linked to the 911 Computer Aided Dispatch System (CADS) for District dispatches. CMTO and its employees shall follow all District radio protocols. Page 3 of 6 CMTO must have and maintain a state license for the provision of Emergency Medical Service (EMS) ALS Ambulance and shall provide the District with a current copy of required license. CMTO shall maintain all required licenses or certifications required for personnel, ambulances, and other equipment in accordance with state, federal ,and local laws rules and regulations. CMTO shall maintain patient records of its transports in accordance to Federal, State and local laws including The Health Insurance Portability and Accountability Act of 1996 (HIPAA) including the 2013 Final Omnibus Rule Updates. The District and CMTO shall have access to generalized response information and data generated at 911. The District and CMTO shall meet at least twice a year to discuss performance and operational issues. This agreement begins August 1, 2021 and shall be renewable every two years per County ASA Ordinance 8.30.90 (c.) with required 45 days' notice to the County Board of Commissioners and end on June 30, 2028. Either party may end the agreement with a 90-day written notice. This agreement is not transferable. For community safety, Time is of essence of this agreement. This agreement shall constitute the entire agreement between the District and CMTO and any prior understandings or representations of any kind preceding this agreement shall not be binding upon either party except to the extent incorporated in this agreement. Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if evidenced in a writing signed by each party or an authorized representative of each part. This Agreement shall be governed by the laws of the State of Oregon. Any action commenced in connection with this Agreement shall be in the Circuit Court of Deschutes County. IN WITNESS WHEREOF, the parties hereto have executed this Public Private Partnership Agreement effective the date first set out above. La Pine Rural Fire Protection District Board of Directors Chair Date Deschutes County Commissioners Chair Date Cascade Medical Transport President/CEO Date Page 4 of 6 PUBLIC PRIVATE PARTNERSHIP AGREEMENT APPENDIX A Hours of Availability One ALS equipped ambulance with one paramedic and one EMT -Basic Monday through Friday 08:00 hours to 18:00 Hours during primary La Pine Community Health Center and St. Charles Clinic hours of operation. During federal holidays CMTO can provide mutual aid to the District, but because medical facilities are closed CMTO may not staff La Pine specific ambulances during those times. Unit Staging Location of ambulance(s) will be at CMTO's discretion but will be able to provide response within time allotted in the Deschutes County ASA agreement under emergency response times. When units are staged in La Pine CMTO may have access to District facilities for rest rooms, etc. Dispatching When operating under this agreement CMTO is to be dispatch seamlessly as any La Pine Fire District unit. Each day CMTO will notify the District Duty Officer and dispatch when they have a crew/unit count of at least 1 available to respond to calls as defined in this agreement. That may be done directly with a Computer Aided Dispatch (CAD) status update. When CMTO is in service for the District it shall respond as (La Pine) Medic 178, If CMTO has a La Pine crew/unit count of 2, (La Pine) Medic 179 will be utilized in addition. County 911 Dispatch frequencies shall be used for District responses only. The District is responsible for units under this agreement and will coordinate with on all administrative needs with the County 911 District Dispatch. In the event of high call volumes District Duty Officer may contact CMTO and dispatch for CMTO to potentially move up and stage in La Pine. CMTO will provide mutual aid to La Pine when available as requested. Run card - automatic responses When CMTO has a standing crew/unit count of 1 or more for the District they will be automatically dispatched to these addresses for all medical transport calls: Page 5 of 6 51600 Huntington Road 51781 Huntington Road 51485 Morsen Street 16161 Burgess Road Based on 911 caller information and 911 notes the District Duty Officer and/or CMTO may request additional resources be added to the call. Medical Protocols CMTO will be under the medical direction of the CMTO physician adviser using Eastern Cascades Emergency Medical Services (ECEMS) protocols. Cost recovery/Billing The transport agency is responsible for its own cost recovery/billing for any and all patients treated and/or transported and will bill per its own policy. Currently, CMTO will the patient's insurance for all transports provided and will balance bill patient as allowed. Page 6 of 6