2023-378-Minutes for Meeting October 30,2023 Recorded 12/5/2023�vSES CO
BOARD OF
COMMISSIONERS
1300 NW Wall Street, Bend, Oregon
(541) 388-6570
Recorded in Deschutes County CJ2023-378
Steve Dennison; County Clerk
Commissioners' Journal 12/05/2023 2:05:13 PM
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2023-378
FOR RECORDING STAMP ONLY
Allen Room
1:00 PM MONDAY October 30, 2023 Live Streamed Video
Present were Commissioners Patti Adair and Phil Chang. Also present were County Administrator Nick
Lelack; Deputy County Administrator Erik Kropp; Assistant Legal Counsel Kim Riley; and BOCC Executive
Assistant Brenda Fritsvold.
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: Vice Chair Adair called the meeting to order at 1:00 p.m. and noted
the excused absence of Commissioner DeBone.
CITIZEN INPUT: None
AGENDA ITEMS:
1. Presentation on Deschutes County's Behavioral Health Resource
Network
Holly Harris, Behavioral Health Director, said in 2021, the Legislature approved
Senate Bill 755 which provided for the creation of Behavioral Health Resource
Networks (BHRNs) across the State. A BHRN is an entity or group of entities which
works to increase access to low -barrier addiction services and offer support to
people with substance use disorders or harmful substance use. For Central
Oregon's BHRN, Deschutes County Health Services collaborates with BestCare
Treatment Services, Boulder Care, Healing Reins, Ideal Option, and Rimrock Trails.
BOCC MEETING OCTOBER 30, 2023 PAGE 1 OF 5
Rick Treleaven, BestCare Treatment Services, said BestCare routinely sees people
who have a history of 20 overdoses. He said half of maternal deaths are tied to drug
use and that babies who are exposed to drugs while in the womb are subject to
long-term birth defects. Noting that fentanyl is very cheap, he said BestCare
previously averaged one overdose death each year, but 19 have occurred so far this
year.
Treleaven explained that the BHRN represents an effort to build a continuum of
care. He advised viewing addiction as a chronic disorder such as diabetes and
described the needs of addicted persons, as follows: outreach and engagement,
harm reduction, on -demand treatment access, and recovery support. He listed the
services offered at the Taylor Center —including a needle exchange, employment
counseling and housing vouchers —and emphasized that because fentanyl is so
addictive, it is not ethical to offer treatment without rapid access to medication -
supported recovery.
Deputy County Administrator Erik Kropp asked for an explanation of harm
reduction and how this fits in the treatment strategy. Treleaven said BestCare offers
medication to those who are not in treatment because otherwise the risk of death is
high, and the most basic aim is to prevent deaths by overdose. He said demand for
this treatment is growing and referrals into the medication -assisted clinic have
tripled in the last year.
Commissioner Adair spoke to the devastating complications suffered by babies born
after being exposed to fentanyl in the womb.
In response to Commissioner Chang, Treleaven said the treatment providers in the
Central Oregon BHRN were selected following an open process.
Lisa Bradley, Healing Reins, described the mental health services and equine -
assisted therapy offered by the organization, stating that horses enhance treatment
goals. She shared the objectives of group therapy, reported that 21 persons have
been served in conjunction with the BHRN, and said challenges include staffing
issues and a lack of referrals.
Sara Love Sanderson, community liaison with Boulder Care, provided an overview of
the telehealth and medication -assisted treatment for opioid and alcohol substance
use disorders which are offered, noting that funding from Measure 110 covers the
cost of care but not of medication. She described plans to distribute phones,
increase the community liaison presence for southern Oregon, and work with
PacificSource to secure prescription benefits for clients.
BOCC MEETING OCTOBER 30, 2023 PAGE 2 OF 5
Deschutes County Behavioral Health Director Holly Harris described the County's
Community Mental Health Program which offers crisis services, homeless outreach
and criminal justice diversion. Harris said four peer support specialists were added
to the Stabilization Center to support afterhours operations of the BHRN, and
another six FTE now supplement the harm reduction and homeless outreach
programs.
Heather Daugherty, Ideal Option, provided a synopsis of the organization which
offers low -barrier treatment in eleven states. She explained that medication -
assisted treatment is available for addiction to fentanyl, heroin, meth and alcohol,
and concluded that Ideal Option opened a new clinic in Redmond this past January.
Treleaven added that because the risk of death by overdose multiplies by 27 upon a
release from incarceration, it is very important that medication -assisted treatment
be offered to those in jail.
Katie Keck, Rimrock Trails outreach director, said Rimrock offers a residential
treatment program for persons between the ages of 12 and 17 and additionally
offers outpatient counseling in Bend, Redmond and Prineville. She outlined the
number of counselors and other staff and provided information on the number of
screenings and assessments performed from the fourth quarter of 2022 to the
second quarter of 2023.
Treleaven shared that the waitlist for outpatient services at the Taylor Center is up
to three months, which is unacceptable —ideally, the wait would be less than 72
hours. He judged that the overdose crisis has not yet stabilized but in fact is still
growing.
Commissioner Chang asked if criminalization is needed to motivate people to seek
treatment. Treleaven was not sure if re -criminalizing drug possession would have
any impact, positive or negative. He said while so-called "carrot" approaches such as
outreach efforts and connection with peers in recovery are proven to work, he
believed that both stick and carrot approaches are needed. He added that many
clients express a great fear of fentanyl, yet still are compelled to use it.
Daugherty added that addicted persons are especially fearful of fentanyl
withdrawal.
In response to Commissioner Chang, Treleaven said the BHRN needs substance use
disorder treatment for youth, residential treatment for Latino women and pregnant
women, and treatment services for older persons who are on Medicare.
BOCC MEETING OCTOBER 30, 2023 PAGE 3 OF 5
2. Department Performance Measures Updates for FY'23 Q4 and
FY'24 Q1
Jen Patterson, Strategic Initiatives Manager, said five departments were selected to
provide updates on progress made during FY'23 Q4 and FY'24 Q1 on performance
measures which fall under the County Goals and Objectives of Service Delivery and
Healthy People.
County Clerk Steve Dennison said one of the goals of the Clerk's Office is to contain
the staff cost of elections as measured per 1,000 ballots tallied for countywide
elections. The target was $419 and the actual staff costs for the May 16, 2023,
Special District Election were $251 per 1,000 ballots.
Dennison said the second performance measure involves comparing the number of
election staff FTEs to the volume of voter registrations, with the target being
between 80-110% of comparable counties. In Deschutes County, there are 52.239
registered voters per FTE; the average of comparable counties is 51.710 registered
voters per FTE. Dennison noted that the office had added another FTE in FY 2022 to
help address the low staffing level in its Elections section.
Financial Planning & Budget Manager Dan Emerson described the performance
measure involving coordinating with the Board of Commissioners to distribute ARPA
funds and provide public updates on the investment of ARPA funds. Emerson said
as of June 30, 2023, $38,103,783 of the county's $38.4 million total ARPA award had
been committed to pandemic recovery efforts in the county.
Human Resources Director Kathleen Hinman reported on the performance measure
to compare the percentage of directors, managers, and supervisors in the County's
workforce in relationship to the community's population percentages for women
and minorities. Hinman said both measures trail the community percentages, which
staff is addressing by encouraging departments to open up recruitments to external
applicants and also by looking at different places to advertise openings.
Clinical Services Manager Anne Kilty and Public Health Educator Erin Hoar reviewed
the performance measure to assure that 90% of pregnant women being served by
DCHS receive prenatal care beginning in the first trimester; the actual percentage is
96%.
County Forester Kevin Moriarty presented on the performance measure to maintain
or increase the number of communities participating in the Firewise program. The
number previously was 61; there are now 68 active Firewise communities and
another five pending. Moriarty added that the County has awarded grant funding of
$270,000 total in the last year to 53 of the Firewise communities.
BOCC MEETING OCTOBER 30, 2023 PAGE 4 OF 5
OTHER ITEMS:
• Commissioner Adair reminded of the graduation of the County College
attendees tonight at 6:00 pm.
EXECUTIVE SESSION: None
ADJOURN:
Being no further items to come before the Board, the meeting was adjourned at 3:13 p.m.
DATED this Day of
Commissioners.
iUov.
2023 for the Deschutes County Board of
ANTHONY DEBONE, CHAIR
ATTEST:
PATTI ADAIR, VICE CHAIR
RECORDING SECRETARY PHIL CHANG, OMMISSIONER
BOCC MEETING OCTOBER 30, 2023 PAGE 5 OF 5
E S CO
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BOARD OF
COMMISSIONERS
BOARD OF COUNTY COMMISSIONERS MEETING
1:00 PM, MONDAY, OCTOBER 30, 2023
Allen Room - Deschutes Services Building - 1300 NW Wall Street - Bend
(541) 388-6570 1 www.deschutes.org
MEETING FORMAT: In accordance with Oregon state law, this meeting is open to the public and
can be accessed and attended in person or remotely, with the exception of any executive session.
Members of the public may view the meeting in real time via YouTube using this link:
http://bit.ly/3mminzyr. To view the meeting via Zoom, see below.
Citizen Input: The public may comment on any topic that is not on the current agenda.
Alternatively, comments may be submitted on any topic at any time by emailing
citizen in put@deschutes.org or leaving a voice message at 541-385-1734.
When in -person comment from the public is allowed at the meeting, public comment will also be
allowed via computer, phone or other virtual means.
Zoom Meeting Information: This meeting may be accessed via Zoom using a phone or computer.
• To join the meeting via Zoom from a computer, use this link: http://bit.ly/3h3ogdD.
• To join by phone, call 253-215-8782 and enter webinar ID # 899 4635 9970 followed by the
passcode 013510.
• If joining by a browser, use the raise hand icon to indicate you would like to provide public
comment, if and when allowed. If using a phone, press *6 to indicate you would like to speak and
*9 to unmute yourself when you are called on.
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, call (541) 388-6572 or
email brenda.fritsvold@deschutes.org.
Time estimates: The times listed on agenda items are estimates off. Generally, items will be heard in
sequential order and items, including public hearings, may be heard before or after their listed times.
CALL TO ORDER
CITIZEN INPUT: Citizen Input may be provided as comment on any topic that is not on the
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.
AGENDA ITEMS
Presentation on Deschutes County's Behavioral Health Resource Network
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
October 30, 2023 BOARD OF COUNTY COMMISSIONERS MEETING Page 2 of 2
MEETING DATE:
BOARD OF
COMMISSIONERS
October 30, 2023
SUBJECT: Presentation on Deschutes County's Behavioral Health Resource Network
RECOMMENDED MOTION:
None —informational presentation only.
BACKGROUND AND POLICY IMPLICATIONS:
Senate Bill 755 (2021) provided for the creation of Behavioral Health Resource Networks
(BHRNs) across the State. A BHRN is an entity or group of entities which together work to
provide comprehensive, community -based services and support to people with substance
use disorders or harmful substance use.
Each BHRN must provide trauma -informed, culturally specific, and linguistically responsive
services. Services include but are not limited to:
• Screening for health and social service needs
• Screening and referral for substance use disorder and appropriate outside services
• Individualized intervention planning
• Low -barrier substance use disorder treatment
• Harm reduction services
• Peer support services
• Housing supports
• Referral to appropriate outside services
It is the policy of the State of Oregon that screening, health assessment, treatment and
recovery services for drug addiction are available to all those who need and want access to
those services.
BUDGET IMPACTS:
None
ATTENDANCE:
Holly Harris, Deschutes County Behavioral Health
Rick Treleaven, BestCare Treatment Services, Inc.
Katie Keck, Rimrock Trails
Sara Love Sanderson, Boulder Care
Heather Daugherty, Ideal Options
Lisa Bradley, Healing Reigns
MEASURE 110
The purpose of Measure 110 is to make screening, health
assessment, treatment and recovery services for Substance Use
Disorder available to all those who need and want access to those
services; and to adopt a health approach to substance use by
removing criminal penalties for low-level drug possession. Measure
110 also established the Oversight and Accountability Council (OAC)
which grants funds and approves grants for providers and services
that meet the criteria for a Behavioral Health Resource Network
(13hIRN).
WHAT ISABHRN?
BHRNs are a set of providers, working together as a network,
to increase access to low -barrier addiction services, by
providing specified and unified services related to healthy
management of substance use concerns. Deschutes County
Health Services is collaborating closely with Bestcare
Treatment Services, Boulder Care Provider Group, P.A.,
Healing Reins, Ideal Option, and Rimrock Trails to establish
Central Oregon's BHRN, The Taylor Center.
TAYLOR CENTER, OPENING SPRING 2023
CENTRAL OREGON FUNDING
After the decriminalization of possession of personal amounts of
hard drugs across the state, providers in Central Oregon are set to
receive over $15million through next year for a spectrum of services
related to drug and alcohol treatment. That's more than 5 percent of
the $265 million allocated to county organizations statewide. Who's
getting it?
9.Ideal 00of} ,
$1.17 mil[I
Total Grant a
through:
'
(Deschutes,J
.: ' `
and Crook cc
$15.4 mil
7. Desch#�eSo`
Healtheiea
$2 891'#F1 ""
oulder Care
wv..
0.41million
*car. 10stcare
Lion million
Rimrock Trails
$0 35 million
Jl o rock Trails
�? 9 million
i3 HeaLing Reins
" $0.37 million
HOW IS DCHS SPENDING $2.89 MILLION?
Wages for 3 existing and 11.2 nE
positions
Computers, cell phones, and
staff training
Barrier Removals
Harm Reduction Supplies
Two Vehicles
Shelter Beds Contract
ij Indirect Expenses
DCHS BHRN PLAN OVERVIEW
Funding will be used for harm reduction supplies, two new vehicles,10 shelter beds, barrier removal, 3 existing staff, and fund 11.2 new FTE positions, as follows:
3.2 FTE Recovery Mentor Peer Support Specialist will co -locate within the Deschutes Crisis Stabilization Center.
2 Recovery Mentor Peer Support Specialists, 2 Behavioral Health Specialists -Case Managers, I Community Health Specialist Ill and 1 Behavioral
Health Technician to provide additional intensive recovery focused outreach and engagement to support individuals housed in shelter beds and
unhoused individuals with substance use disorders in need of shelter,
An existing .60 Public Health Nurse III in the Harm Reduction Program, and 50% of a 1.0 FTE Supervisor for the Homeless Outreach Services Team
(HOST) & Harm Reduction Program'(HRP) Team.
MEASURE 110 TIMELINE
Measure 110 Evaluation and voting on all
BHRN applications completed Taylor Center
Passed b OHA and OAC. Hiring Period
_ Y _ _ scheduled to open
Nov.2022 jJune.2022 I Oct. 2022-Feb. 2023
Dec. 2021
August 2022
BHRN application
Final BHRN funding
closes; application
agreements effective for
review begins.
all counties.
Nov. 2022
Services Begin
Spring 2023
VT E S CpG2�
o
BOARD OF
COMMISSIONERS
MEETING DATE: October 30, 2023
SUBJECT: Department Performance Measures Updates for FY'23 Q4 and FY'24 Q1
BACKGROUND AND POLICY IMPLICATIONS:
Five departments have been selected to provide updates on progress made during FY'23
Q4 and FY'24 Q1 on selected performance measures that fall under the County Goals and
Objectives of Service Delivery and Healthy People
Clerk's Office
Objective: Service Delivery - Support and promote Deschutes County
Customer Service "Every Time" standards.
Performance Measure: Election personnel cost comparisons per 1,000 ballots tallied for
countywide elections. Target: Cost to remain within 10% of similar -type elections.
Value/Target: $419
FY'23 Q4 Update: Actual $251. Personnel costs for the May 16, 2023, Special District
Election was $251 per 1,000 ballots tallied.
Objective: Service Delivery - Ensure quality service delivery through the use
of innovative technology and systems.
Performance Measure: Compares election staff FTE to voter registration. Target: 80-110% of
Comparable Counties.
Value: In Progress
FY'23 Q4 Update: Deschutes Registered Voters/FTE = 52,239; Average of Comparable Counties
Registered Voters/FTE = 51,710. The Clerk's Office added an additional FTE in FY 2022 to help
address the low staffing level in Elections.
Finance
Objective: Service Delivery - Maintain strong fiscal practices to support short
and long term county needs.
Performance Measure: Coordinate with the Board of Commissioners to distribute ARPA and
other consistent updates to the community on the investment of ARPA funds.
Value: True
FY'23 Q4 Update: County Finance continues to administer the ARPA funding award,
distribution and reporting functions for the county. As of June 30, 2023, $38,103,783 of the
county's $38.4 million total ARPA award had been committed to pandemic recovery efforts in
the county.
Human Resources
Objective: Service Delivery - Maintain strong fiscal practices to support short -
and long-term county needs,
Performance Measure: Comparison of percent of directors, managers, and supervisors in
County workforce in relationship to percentage in community population for women and for
minorities.
Value: True
FY'23 Q4 Update: The County is trailing the community workforce with 38% of DC
Officials/Administrators (Directors and Managers) identifying as Female, compared to 40% of
Community Officials/Administrators identifying as Female. The County is trailing the community
with 7% of DC Officials/Administrators (Directors and Managers) identifying as Minority,
compared to 8% of Community Officials/Administrators identifying as Minority (Male/Females.)
Health Services
Objective: Healthy People - Support and advance the health and safety of
Deschutes County's residents
Performance Measure: Assure 90% of pregnant women being served by DCHS receive
prenatal care beginning in the first trimester.
Value: 90%
FY'24 Q1 Update: Actual: 96%
Natural Resources
Objective: Healthy People - Help to sustain natural resources and air and
water quality in balance with other community needs
Performance Measure: Maintain or increase the number of communities participating in the
Firewise USA"' Program.
Value: 61
FY'24 Q1 Update: Actual: 68 - We accepted application for our fall fuel reduction grant. We use
the grant to incentivize Firewise USA TM sites.
BUDGET IMPACTS:
No anticipated budget impacts.
ATTENDANCE:
Jen Patterson, Strategic Initiatives Manager
Steve Dennison, County Clerk
Dan Emerson, Manager, Budget Financial Planning
Kathleen Hinman, Human Resources Director
Anne Kilty, Manager, Clinical Services, Health Services
Erin Hoar, Public Health Educator, Health Services
Kevin Moriarty, County Forester
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