2021-442-Minutes for Meeting October 18,2021 Recorded 11/9/202101
ES CQG2�
BOARD OF
COMMISSIONERS
1300 NW Wall Street, Bend, Oregon
(541) 388-6570
1:00 PM
Recorded in Deschutes County CJ2021-442
Steve Dennison, County Clerk 11/09/2021 2:26:33 PM
Commissioners' Journal
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FOR RECORDING STAMP ONLY
BOCC MEETING MINUTES
MONDAY October 18, 2021
Barnes Sawyer Rooms
Live Streamed Video
Present were Commissioners Patti Adair, Anthony DeBone, and Phil Chang. Also present were Nick
Lelack, County Administrator; David Doyle, County Counsel; and Sharon Keith, BOCC Executive Assistant.
One representative of the media was present.
This meeting was audio and video recorded and can be accessed at the Deschutes County
Meeting Portal website www.deschutes.org/meetings
As there was internet connectivity issues throughout Bend, the meeting was audio
recorded and video will be uploaded once technical difficulties are resolved.
CALL TO ORDER: Chair DeBone called the meeting to order at 1:00 p.m.
PLEDGE OF ALLEGIANCE
ACTION ITEMS:
1. Consideration of Deschutes County Adult Treatment Court Grant
(Deschutes County Adult Treatment Court formerly known as
Deschutes County Family Drug Court)
BOCC MEETING OCTOBER 18, 2021 PAGE 1 OF 4
Trevor Stephens, Adult Parole and Probation Department Management
Analyst, presented this item for consideration. The grant from the Oregon
Criminal Justice Commission was applied for this past June and the
department has received notice of the grant award (split between Adult P&P
and the Circuit Court) of $468,313.00. Mr. Stephens reviewed the services
that will be provided through the grant funding.
ADAIR: Move approval of grant acceptance
CHANG: Second
VOTE: ADAIR: Yes
CHANG: Yes
DEBONE: Chair votes yes. Motion Carried
2. Discussion and Consideration of Board Approval of Deschutes County
Employee Benefit Plan
Human Resources Department Director Kathleen Hinman and Human
Resource Analyst Trygve Bolken presented the consideration for the 2022
Employee Benefits Plan renewal. Ms. Hinman reviewed the proposed
updates with recommendations from the Human Resources Department and
from the Employee Benefits Advisory Committee. Six plan changes were
presented including options covering physical therapy, alternative care
benefits, Livongo diabetic management program, other covered expenses,
pharmacy, and documents wide language updates.
The Board expressed support of five proposed changes and provided
discussion on the plan item of other covered expenses. Commissioners
DeBone and Adair are in favor of maintaining the existing level of
reproductive health benefits as recommended by Human Resources.
Commissioner Chang stated this is an employee benefit and supports EBAC's
recommendation to expand benefits for reproductive health.
ADAIR: Move approval of County Administrator signature of Deschutes
County Employee Benefits Medical Plan with options noted as
Human Resources staff recommendation
DEBONE: Second
BOCC MEETING OCTOBER 18, 2021 PAGE 2 OF 4
VOTE: ADAIR: Yes
CHANG: No
DEBONE: Chair votes yes. Motion Carried
Item #2 as posted was deferred until the presenters were able to arrive at the
meeting due to the technical difficulties experienced by County internet.
3. REDI Enterprise Zone - Extended Abatement Agreement - Pacific Coast
Building Supply
Jon Stark, Sr. Director of Redmond Economic Development Inc. presented the
agreement for consideration and reported on the history of the company.
The company is requesting an extended abatement agreement for an
additional year. Extended abatement agreements are reviewed and
approved by the Greater Redmond Area EZ which includes the City of
Redmond, Deschutes County, and the City of Sisters.
ADAIR: Move approval of chair signature of the Oregon Enterprise Zone
Extended Abatement for Pacific Coast Building Supply
CHANG: Second
VOTE: ADAIR: Yes
CHANG: Yes
DEBONE: Chair votes yes. Motion Carried
4. FY 2022 Q2 Discretionary Grant Review
Administrative Analyst Laura Skundrick presented the second quarter
applications. The Board reviewed the requested funding and provided level
of support for the organizations.
BOCC MEETING OCTOBER 18, 2021 PAGE 3 OF 4
OTHER ITEMS:
• Last Thursday, Commissioner Chang attended afield trip with the Deschutes
Collaborative Forest Project and a meeting for the community renewable
advisory board.
• Commissioner Adair reported on the Central Oregon Health Council meeting
last Thursday.
• Commissioner DeBone attended the Canal Commons grand opening on
Thursday and the open house on Friday for Habitat for Humanity.
• Commissioner DeBone acknowledged the Cannabis Advisory Panel meeting
this evening at 6:00 p.m.
EXECUTIVE SESSION: None presented
ADJOURN
Being no further items to come before the Board, the meeting was adjourned at 2:13 p.m.
DATED this Day of )(-�A) 2021 for the Deschutes County Board of
Commissioners.
ATTEST:
RECORDING SECRETARY
ANTHONY DEBONE,�CHAIR
PHIL CHANG, ICE CHAIR
PATTI ADAIR, COMMISSIONER
BOCC MEETING OCTOBER 18, 2021 PAGE 4 OF 4
01 [ S CoG
4,(j 2�BOARD OF
COMMISSIONERS
BOARD OF COUNTY COMMISSIONERS MEETING
1:00 PM, MONDAY, OCTOBER 18, 2021
Barnes Sawyer Rooms - Deschutes Services Bldg - 1300 NW Wall St - Bend
(541) 388-6570 1 www.deschutes.or�
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
ACTION ITEMS
1. 1:00 PM Consideration of Deschutes County Adult Treatment Court Grant (Deschutes
County Adult Treatment Court formerly known as Deschutes County Family Drug Court)
2. 1:30 PM REDI Enterprise Zone - Extended Abatement Agreement - Pacific Coast
Building Supply
3. 1:45 PM Discussion and Consideration of Board Approval of Deschutes County
Employee Benefits Plan
4. 2:15 PM FY 2022 Q2 Discretionary Grant Review
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.
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 18, 2021 BOARD OF COUNTY COMMISSIONERS MEETING Page 2 of 2
E S CO
BOARD OF
COMMISSIONERS
MEETING DATE: October 18, 2021
SUBJECT: Discussion and Consideration of Board Approval of Deschutes County Employee
Benefits Plan
RECOMMENDED MOTION:
Discussion and 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 14, 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 trend, Oregon 97703
(541 ) 3 8 8 - 6 5 5 3 hr@deschutes.org www.deschUteS,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.
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. Physical Therapy benefit: Change from deductible and coinsurance model to deductible and co -pay
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, Suite 201 Fend, Oregon 97703
(541) 3 8 8 - 6 5 5 3 hr@deschutes.org www.deschutes.oig
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) 388-6-553 hr@deschutes.org www.deschutes.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 $1S.72 PEPM.
1300 NW Wall Street, Suite 201 Bend, Oregon 97703
(541) 388-€ 553 hr@deschutes.org www.deschut:es.org
Q�
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
1. Physical Therapy —
EBAC supports HR Recommendation.
Estimated +$9,500 to annual physical
Deductible, then
HR has benchmarked the current physical therapy
therapy claims cost. More plans are
copay
benefits against other public sector plans in the
moving to models that reduce the
State and recommends moving to Subject to
financial impact on the member
deductible, then $10 Copay.
encouraging them to complete
physical therapy to offset additional
* Current model is Subject to deductible then 20%
surgical costs in the future.
Coinsurance
2. Alternative Care
EBAC supports HR Recommendation.
Estimated +$9,500 annually. Due to
Benefit
HR recommends 24 visits each per year for
State Benchmark Plan Changes, we
chiropractic and acupuncture (48 total) and $1200
are now required to create visit limits
annual allowance for massage.
vs. dollar limits for chiropractic and
acupuncture benefits.
*Current model is $1,500 PMPY
3. Livongo Diabetic
EBAC supports HR Recommendation.
Estimate-$21,228 (likely cost neutral)
Management
HR recommends adding the Livongo Diabetes
cost to the plan annually with an
Program
Program as a pilot program for two years to gauge
estimated 29 participants.
utilization.
4. Covered Expenses
HR seeks Board direction:
Estimated +$12,000 cost to plan for
— Other Covered
A. HR Staff recommended keeping current
abortion services. PacificSource
Services, Supplies,
plan language, as our plan meets the
recommendation for all fully insured
and Treatments
requirements under RHA due to the
plans. Deschutes County is separate
grandfather status.
and self -insured and is in compliance
of the RHA.
B. EBAC recommends expanding coverage for
abortions.
S. Pharmacy -
EBAC supports HR Recommendation.
To comply with Oregon HB 2623
Prescription Insulin
Formulary prescription insulin is not subject to a
regarding insulin costs.
— Core pharmacy
deductible and may not exceed $75 per 30 day
administration
supply. Previously the benefit applied to the plan's
deductible, copay, and/or coinsurance.
6. Documents Wide -
EBAC supports HR Recommendation.
Clarification of plan language. Not a
Plan language
Language to be added or changed throughout the
change to the administration of
updates
plan documents to clarify benefits, the
benefits.
administration of benefits, or to align with
PacificSource core plan language.
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\)I ES C0BOARD OF
COMMISSIONERS
MEETING DATE: October 18, 2021
SUBJECT: FY 2022 Q2 Discretionary Grant Review
RECOMMENDED MOTION:
N/A
BACKGROUND AND POLICY IMPLICATIONS:
Each quarter, the Board of Commissioners reviews applications submitted to the Deschutes
County Discretionary Grant Program and makes awards accordingly. On October 18, 2021, the
Board will consider requests made for activities to take place beginning or about the second
quarter of 2021-22.
BUDGET IMPACTS:
Discretionary Grants are made available through the Video Lottery Fund, which is supported by
state lottery proceeds. Discretionary Grant funds available during the second quarter were
budgeted for FY 2021-22.
ATTENDANCE:
Laura Skundrick, Administrative Analyst
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