001[Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] [Applause] [Music] we're going to open with first I welcome everyone here tonight and if we could um stand [Music] and to the flag of the United States of America and to the Republic for stands one nation under God indivisible with liy and justice for [Music] all dear lord it's you could please be with us here tonight in this room as we discuss the important things on the agenda um things that are vital to our County important topics we do your work
002and his their will to ensure that our community has um vital services for [Music] heren sorry about that all right and first we're going to open with the approval of the minutes everyone had a a chance to look at them the January minutes can I ask a question before you approve it who does the [Music] minutes a great job well thank you all in [Music] favor and next up we have the executive director's report good evening I have a couple of items for you tonight um I'd like to start with a review of applications for your consideration and there are three applications for you to consider this evening two of them for Community Based organization representatives and one of them for psychologist and you all can uh basically you're reviewing them and you are electing
003to either move them forward to the board of County Commissioners to their consideration to actually make an appointment there is only one position open for the community based organization representative uh however you can choose to advance two applications for the board's consideration if you would like to do that but you're not required to do that I have a question so that communitybased position would be between Eric and Jesse that's correct um has anyone met with them in person that could give us any more details in their [Music] res I didn't know there was only one spot yeah and and when we first brought this up at the last meeting we did not have two applicants for this position since then we gained two of those so if you guys would like to do interviews um
004you are welcome to do that if you would like you're welcome to do that or if you would like to advance to the board of County Commissioners you're welcome to do that however you would like to handle that this is for the community based organization represent yes and that is um Loosely defined in terms of the in terms of the criteria basically anyone that is a representative of an agency that the Human Services Agency would like to partner with or that might um provide services to our clients on a normal [Music] basis you have three right one for psychologist yes the psychologist is is a singular application and a singular position I might suggest that you all start with that [Music] one we have a second to start Mr Childs for [Music] theologist first we
005will discuss Matthew Charles who has applied for the position as psychologist has everyone had a moment to look at Mr child or Dr child's [Music] application off 223 Charlotte [Music] I I would like to offer a motion that we support M Dr Matthew Childs for the position of psychologist and recommend to the full Board of County Commissioners thank you Mr ti do we have a second second thank you and all in favor Dr all right next up we have two people as we discussed that are applying for the um Community Based organization representative we have uh the first is Eric Clen and then Jesse Granger so we could discuss this now or as uh Brandy had mentioned we one option might be that we decided to have a subcommittee to interview them if we wanted
006to look closer not a definite I just maybe we can discuss this Mr gringer I like that Miss oh I'm sorry sorry Miss grer I like that she deals with the older adults in community which is a topic right now for us with meals o meals and just helping that vulnerable population as it is not to discredit the other on resume either those are just some things that stood out did you say that was Miss yeah she she's Jesse could I ask a um question do we have the ability to expand the number of positions to one of the classifications by State Statute the board of County Commissioners has the ability number of positions this is for um appointed by the board of County Commissioners and the state statute allows up to 25 positions there
007are the positions that are required to participate um as noted in terms of the specific uh like dentist pharmacist that sort of thing and several of the others like other person as aidance is something that we've added okay so we will still be left with several vacancies in other categor words I would be open if and still if if representatives of the board or subcommittee would like to meet with these two individuals that that's fine nominated committee what you want to call it but I don't have a problem with submitting both of these this gentleman and this young lady and expand uh the number of O of slots for that category is there a substitute that we could do take one away and add this in or no so have yall ever had um been
008pulled on recipients like on consumers because I actually do think there would be a benefit to having people who were you know working with nonprofits in our County and doing this work like um and if we haven't ever fulfilled all of the consumers I think that would be something valid to consider the other question I had was because Jesse list at her SP um working as family caregiver support and then family caregiver support specialist before I was curious if perhaps you had a parent that led her to this that would qualify her also ask a consumer if that was an option so to answer hope all of your questions please recap it by am not getting them correct but we have not to my knowledge and I would need to go back and look to
009any the facts on that but had all of the consumer positions filled we have always only had one Community Based organization representative and actually when I say always that position was created several years ago um so that hasn't been an always position uh that the board of County Commissioners approved to be included um we cannot Gran to answer your question change positions the the board County Commissioners can elect to have a different number in these buckets but this board can't make that change but we can make a recommendation to the board of County Administration for that and in order to find out the answer about Jesse you need to ask that question I'm not aware that we provide services for a family member but we'll certainly be able to find that out I like your
010idea too about having these Community Based and almost it's almost like these two together make the perfect fit because they're both on opposite ends of community base and I see where Eric mentions his work during Co led him to hospital at home which is new to us in the hospital and very unique and has been amazing for us um so I don't does anybody want to meet with them or put it to the me Madam Madam chairwoman just a little bit of historical kind of thought process if you choose if you ask the Commissioners to expand the board just keep in mind you definitely are going to want to interview them because the more positions you add the higher your Quorum is going to have to be to be able to do the business of
011the board so just remember is as you're adding positions you're also adding the Quorum so that if you may have meetings or you're not allowed to do anything because you don't have cor should we do interviews [Music] so would we do that concurrent or would we interview and then ask them so the way we had done it previously Brandy you you were one of the ones we interviewed um we had a subcommittee that you know went through and met with the applicants and then made a recommendation back to the full board the board then voted on that slate of nominees to send to the Commissioners if you're looking at adding additional person that would be you know and I'm not certainly not trying to speak out a turn but just as you're adding positions just
012keep that in mind that you're going to you're increasing your Quorum that you're going to have to have so not saying don't do it but just but yes on the so get of your question yeah I I would we have historically done the subcommittee and had them interview the candidates to make sure that they are committed and that they're not just here and there and that they're willing to be here when they need to be reference Carla has spoken with them and confirmed that they are committed and that they understand the time uh commitment that sort of thing but in terms of obviously the rest of an interview that process has not occur what a position is added is it hard like when someone that work goes through their time frame and then they no
013let's say they no longer want to stay on are you stuck with that position or do they have to go to the board again to with but I feel certain that the board of County Commissioners could remove a position through the same process that they would add position go but I've never seen that occur my question is um so we have an opening for a psychiatrist and a psychologist do we need both I mean both are stat we have to have you yes who's the mental health but you could move you have two on the consumer of Human Services so could we to your point take one of those position the commission take one of those positions and allocate it to uh one of these currently is it three on the site or four I
014don't know if we have one or two that are currently in consumer I think there therefore and I think that is also State Statute I'm trying to build that up now could we hire one for the community based organization rep and put the other one in the consumer of Human Services but they kind of collaborate together the question I'm sorry I didn't understand the question was it so they're coming on to this volunteer board as obviously both of them are going for the community based organization rep I'm not sure if one would be willing to take up the consumer Human Services like if the one who gets the community based organization rep does that that entitled them to something that the consumer of Human Service they have to actually be a consumer so they act
015to be someone have to be a consumer and willing to switch their application as [Music] well but if they were you know the guardian of someone who was a recipient or a foster parent or you know like then perhaps we can switch we could find that out in an interview if we had if we decided that does anyone have any thoughts I know the last time we had interviews I think it was very insightful and I would just say that I'm a consumer I think I only have 3 months left two or 3 months left on the board so that's just as Emy was saying if a person is receiving any type of benefits you say a foster parent or anything that might be Associated that might be something good to at least interview them
016so you can see where they're coming from what they're back further in depth background information from so may I read just real quickly for your benefit the general statute and I will Paras a little bit just because obviously it's long but um it shall be composed of no more than 25 members and the composition of the board shall reasonably reflect the population make up of the county and shall include eight persons who are consumers of Human Services Public Advocates or family members of clients of the Consolidated Human Services Agency including one person with mental illness one person with a developmental disability one person in recovery from substance abuse one family member of a person with mental illness one family member of a person with a developmental disability one family member of a person with a
017substance abuse problem to Consumers of other Human Services not withstanding subdivision one a Consolidated Human Services Board not I'm sorry I should have just read this verse not exercising the powers and duties of and area mental health or developmental disabilities or substance abuse Services Board shall include four persons consumers of Human Services so that four persons is is required and then eight persons who are professionals each with qualifications in one of these categories on psychologist pharmacist engineer dentist optometrist veterinarian social worker and registered nurse and then two Physicians licensed to practice medicine in the state one of whom shall be a psychiatrist one member of the board of County Commissioners and then other persons including members of the general public representing various occupations and so that's where we have we've changed our number of other
018persons and we have um added the community based organization representative was to me wouldn't it wouldn't be so wise to me I think a consumer would have a lot of voice would need need to have a voice on board as far as I'm concerned you know they one receiving the benefits of something that they have some complaints or want to bring something to the board that might not be so the four consumers are are required those position positions are required so there is not an basically everything on here there's not an opportunity to change so the first thing that we could decide if we're going to set up if we're going to convene a committee I think that would probably be the best given the fact that there are two really solid choices um and
019only one lot I think it is warranted to interview them and actually I think we should interview everybody whether there's more than one person applying for the spot or not to gauge their commitment and their how it yeah exactly any we did interviews but apparently that is not the always the standard I I know takes time um we could do Zoom interviews so folks don't have to drive all the creation or where they're coming from to expedite the process and make it easier and I'll volun volunteer for the since I'm going to be carrying the ball from here I'll be glad to volunteer to be part of the um what do we want to call it review or U appointment subcommittee so that a motion I'll make a motion that we appoint how do you
020want to do it you take we'll take volunteers yeah and how many do you think people we need we need at least three three okay so you got one make a motion we have yeah so um we probably need two volunteers that would give us back an odd number we have three on executive committee so with you we four we need one more and we just have to talk to Janet before the end to get a date and then we could figure out who could do the interview that's how we did it yeah once we have the date chosen I can set up the same for us okay from but I was thinking everybody who's we're going to have a sub committee and everybody on the subcommittee is going to participate unless schedule prohibits in
021the interview correct all right so I'll move we establish a what you want to call it candidate Review Committee subcommittee to interview new candidates uh new applicants for uh appointment to this board second all those in favor any opposition um now with regard to approaching the uh Board of Commissioners it would have it sounds like it would have to be to expand from 19 to 20 like it couldn't be a replacement there any do we think we should I heard what you said as far as the cor and I think haven't y'all ran into that problem at one time should we move for that quite yet before we do this interview and see we may come to this interview and say we have one and we don't need to expand or one bails out should
022do the interviews first and because I don't I don't want to ask to open the open up an extra slot un if we haven't interviewed the person yet to persons so I think that we have decided on that um so with that just for clarity we're going to have the subcommittee how are those members of the subcommittee going to elect themselves to participate or not well either they volunteer or we will select them you gave us a date and we were able to talk amongst ourselves to the executive committee and then whoever volunteers to join it great so what we'll do is Carla will work with you guys to with the executive committee to and these candidates to figure out a day with current three time slots and we will set up those interviews and
023then let everyone know so if anyone's interested in joining us on that please CL um next up we had a request yes for the budget um to review high level info of the current fiscal year 25 budget for Human Services and a review of the summary for fiscal year 26 for the base budget request and so I just wanted to provide you all with a highle review and I want to start by thanking mayor CH who is sitting next to me who um is responsible for all of our budget and fisal activity in unit services and she came in yes uh she and her team uh are part Jackie's uh business operations department and they do an amazing job and so we're going to tag team this and I'm probably going to want do most
024speaking um but what we have put in front of you is simply high level for FY 25 our expenses can we Pi that a little bit larger you can and it is also in your packet all right uh if you flip to page 21 so uh we have the expenses budgeted and what you see is $55 million um that is our general fund expenses that excludes multi-year funds which are really sort of a separate bucket um and then $7 million of Revenue and the portion of that that is County funded is uh uh $28 million which is represents 51% of our total budget and then looking at our EXP expenses incurred year-to date and our Revenue earned year-to dat or actually earned and received uh year to date is more appropriate and that was through
025February which through February we would be looking at approximately 66% of the budget to be expended or earned and you can see the percentages there overall good job for our expenses we're a little little under there at 33 million which is 61% um and our revenue is only both at 12 million so that might raise a red flag and I would love to have Mary speak to this a little bit but I'll I'll let well would you like to just go through it or there there are some very good reasons for that um one of them is that the D DSS reimbursement process through the Department of Health and Human Services is typically at least a two Monon lag in receiving that revenue and um and posting that and sometimes it's longer than that and
026so that is is one of the biggest components and then um with community support and Outreach theirs is a little bit different but the programs in that budget typically have a correlation of one to one expenses to revenues and so um basically if services are requested in some of their larger buckets like uh the LEAP program which is an energy assistance program as a for instance if the expenses aren't incurred the revenue isn't received and so that's that's going to be a one to one there and then with public health there has been an increase use in contract staff and interpreting services in the clinics which has increased expenses a little bit um and and the revenue will come in that a lot of that Revenue that comes in is insurance billing which takes a
027little bit of time uh as well as Medicaid billing which also takes a little bit of time and so uh similarly to the Social Services Revenue there's typically lag in that space as well and then for transportation the claims for reimbursement are submitted quarterly and so that definitely creates a lag that can extend through the following fiscal year but then ultimately is reconciled could I interrupt you for a second could you go through these acronyms on your chart absolutely so community support and Outreach is CSO and that is Stephanie star's department Human Services Administration is the second bucket that is jacking Morgan which is business operations Social Services Ashley Lance is DSS public health is the ph and that is Tracy Kali and environmental health is now a part of the public health department but
028when the budget was created this past year that was not the case and so they're shown broken out separately and for purposes of of looking at this year's budget V in Services Michelle Marano is the BS and ucct is Union County transportation and that is Teresa Torres thank you I apologize for forgetting that one no that's [Music] okay so typically in terms of the revenue that we receive Just For What It's wor we've done a pretty good job of of budgeting the revenue um and while again it seems like maybe we're not track based on what you're seeing now by the end of this year which actually doesn't close until August um even though this year ends in June um August or sometime September but end of August yeah so um yes sir I probably
029more for Ashley you know since we've been in with Medicaid expansion now have we had significant numbers as far as more expenses for you know Manpower for Medicaid since I mean I guess ask how many positions were really yeah we added we added a total of 10 we added a supervisor a tech and eight eligibility Specialists for Medicaid expansion um with nine of those typically well eight and a half nine of those typically being reimbursed at 75% and the county only having to fund about 25% and then the supervisor as you know about 50% of their salary is reimbursed um by Federal dollar so um it's a little easier sometimes for me to add those kinds of Staff because of the reimbursement rates that we get those applications significantly increase just that time yes which
030bucket is that under DSS okay and we'll cover some of that application increase in the data portion so the revenue from DSS is reimbursement from the state so we get we you want to answer Mary you want me to answer let okay um so DSS it's broken up into several different budgets but yes most of it is from the state we get um 75% reimbursement as Ashley said for our Medicaid food stamps a lot of our um child welfare those are all at 50% that we would get reimbursed from the state and those state reimbursements are running at least 2 months behind right it's the process that the state has built out and so we enter the information into their system and then they process it and it takes about two months rest to receive
031it yes get to it when they get to it so that makes the revenue figure kind of misleading because your expenses you are incurring them real time but expenses are lagging two or more months our revenues so revenues yeah so it it makes a deceiving picture when you look at the DSs category it looks like you're artificially behind in the revenue portion correct corre all right okay can can you put an expected Revenue column it is uh so if you [Music] go we did it on well that's that is expens yeah that's the to basically the expenses uh next to in the top section there the total expenses are 25 million mhm and the revenue column of 16 million is the total ultimate expected Revenue so that's what you've submitted for reimbursement whether you've received
032it or not that's what we budgeted and anticipate submitting for reim you're saying how much should I mean you're you're expecting to receive all of it to receive all of it all 16 million okay ultimately okay so that isn't accurate if all things go as planned and the state actually does cut the check for that that's what we should be seeing but as far as getting it in hand there's a la right corre I'm with you not to jump ahead but when you start talking base budgets that's without the salary correct you want to jump ahead well I just wanted to I was trying to see if there was Apples to Apples not [Music] would you like for her to proceed to base budgets anyone have any questions on I have just one quick question
033the fiscal year 25 year to date next to DSS that says the 15 million the revenue up at the top for that is 16 does that mean that you're almost taed out at that amount no the totally sorry total expenses uh that are budgeted are 25 million for DSS so the first column there in the top section and so we've expended 15 of 25 okay oh got it which is 61% and to be on track would be 66 so as far as expenses go to carry that scenario further you're ahead of the game right budget right or or less to we're spending less than we expected to spend right two dat two date but how many more months left do you have till so June right yes so of March April May June so four
034months this was run at the end of February so there may be some expenses that hadn't H yet but that would be 66% that we would have expected to expend through February okay so so you've got 10 million to go for the next four months correct 2 and2 milon say again 2 and half milon a month that's right good okay your math is faster than mine the new year starts July [Music] 1st June 30 good question sorry that is I can see how that's a little confusing so the upper column expenses are total expenses and then the revenue the what covers those expenses because we have to have a balanced budget because that's State LA the counties have to have a balanced budget period is either Revenue that is not County general fund dollars or
035the county funded portion that is County General okay so let me take that a step further if I may down the fiscal year 25 year to date take the DSs figure reimbursements received is that reflect is that actually we've got it in our account or that is what we those dollars that are that have come back into okay so that's where the lag shows upct all right so that makes that [Music] 61% even better yes well so yes but no I'm because one would expect that if we spend less we we will not get reimbursed I for Revenue that sure sure I mean for [Music] okay but all in all yes it's better if that number were much higher than 66% then we might think oh there's maybe an isue through it right so is
036that the 1% difference between the 62 and 61 I'm sorry help me when you yeah we're talking about DSS yes and the percentage expected through February 61 66 sorry [Music] the the the total that has been so that header should actually say percent of amount through that has been expended the word expected should not be included there sorry that was definitely confusing and that makes sense also and so what you're saying if you're dead on your budget of expenses versus Revenue be 66% corre correct yes if we had spent we had spent and earned and received every dollar [Music] gotta any more questions on page 21 before we talk about base budget is is there any any of the budget items in this current physical year that are sticking out from the last physical year
037any increases or decreases from the previous year does that does that make sense um I assume because of was the last physical year when did the expansion of Medicaid really kick in is this the first fiscal year that we're really seeing full okay we fully budgeted for that last fiscal year last fiscal year when we did fy2 when we created that budget this budget this budget okay this fy2 so that would show a contrast to last fiscal year because of the expansion of Medicaid this is the first F full fysical year where that kicks in so if you look back to physical 24 you'd go well why is this DSS figure higher and that's because of the expansion of medic is there anything else in these items that are sticking out either higher or lower
038from physical 2024 does that does that make sense M um in public health we have received some Revenue that we had not previously received that's um basically from a capitation perspective for our yes for our Care Management for Medicaid so we've seen um funding that we had not previously realized we started to see that um and that kind of has helped us with budgeting or or creating the budget for the FY 26 the upcoming budget year so chenes in the system of filing or receiving claims is that what you're saying system improvements it's basically because we have patients who receive cure Management Services through Public Health okay um Medicaid the different PHP plans the different Medicaid plans they give us a payment each month for those children or um pregnant women who are assigned to
039Public Health to receive [Music] Services all right the only other thing that I think is a a bit of a um I think it would we would say through all of the Departments we've seen an increase in our interpret Services um so that's been a cost to all that we've um we've kind of adjusted again as we plan for this next year inter so if you have somebody we have to provide services like if someone comes in and they speak Spanish we have to provide services for them um using an interpreter who can speak to them whether it's DSS Public Health Community Support and Outreach we have had that service available and that cost increased yes yes we've seen um more individuals needing the service that's specific to languages like specific languages like we all
040know Spanish [Music] is Ukrainian a shi in the population is that what you're asking yeah cuz we have discussed that in the previous um meeting we are in that yes have you done a cost comparison between individuals for that interpretation versus uh like language on Wheels like a computer that has all the languages on that's what we use that's what you're using well we we have in-house interpreters as well as we don't call it language on Wheels but V do you know if we exceed 8% of the national average for limited English proficiency as a county do we have more than that for Spanish speaking we are required to provide everything and we we exceed the threshold uh and we are sorry for our Spanish speaking uh presidents we exceed the threshold and we are
041required to provide all of the information in written format as well as the interpreting uh but regardless of a percentage of population we are required by law to be able to provide information uh verbally and provide services to someone so for our interpreters are Spanish and we have one Russian um and then everything else is done through the V how many of those are there there's two teams for interpreting there's one in business operations the team at my shop in business operations we have a supervisor and five interpreters in one part-time and they basically serve DSS and everybody but Public Health because Public Health are um actually also performs some medical so those are different type of interpreting it requires a different type of certification so there's two teams and we do support them on
042my from my team the ones that have passed that certification we can step in we do a lot in dental and Wick to support those teams as well so they have a whole team in public health that focuses on The Clinical Services and we have the team in business office for everything else they also do after hours for Ashley's team for CPS that goes out into the field and then we only use the VRI in gaps when we don't have coverage so notice did come out today that there's going to be a public briefing on language services on the 21st of the month so I'm not sure what announcement is going to be but it came out today from the um Office of the March 10th uh it's going to be on March 21st but
043it came out today the notice Bas budget now anyone have question this before we move on okay so for FY 26 uh this probably isn't everything that you guys were hoping for but it's what we have to provide for you so um and you correctly surmised that the total of 9 million does not include salaries and benefits and so um this is what we were provided and what we have to adjust because salaries and benefits are what they are and that is handled at the Enterprise level um and so our base budget that was presented to us for f26 is 9.4 million and we were requested to provide uh a 2% reduction and you can see that broken down by each of our departments total of $239,000 and uh what we have done is we've
044worked with all of the department directors we obviously met and and Mary and her team have done an excellent job of identifying opportunities for that reduction and there are lots of different reasons for that which really are probably more appropriate for the county manager to be providing as information and so if you're interested I strongly encourage you to watch the budget updates over the coming months um in in that space But but um but effectively we have presented options that would include um cuts to individual line items that might impact service and if there is a service impact then we have the opportunity well we we share what that is uh if we think that it is significant enough to need to um request those funds back then we will um have the opportunity to
045put that to submit that as uh service level we have a service level two which is things that we're already doing that we're requesting to have back and a service or that just are going to cost more for next year for whatever reason than we can't cover with our existing budget and then a service level three which is an expansion request um and uh and So that obviously would have nothing to do with this if we had a need above and beyond what is currently provided servicewise today and so um so we have work through this and and the other thing that sometimes we have an opportunity to enable is revenue obviously that does impact um the the potential production as well of wood um and if our revenues were going to go down for
046instance then we might have to not might we would have to adjust our base budget additionally but the good news is we don't expect uh at this point based on what we know from any federal or state which is limited at best um but we don't expect any Revenue decreases from this year to next year we do expect some increases and so um that all of that we're still working on all of this from my 26 budget perspective and which bucket do the inhome services and senior nutrition come out of so senior nutrition it falls within the community support and Outreach bucket [Music] okay and the in Home Services Falls within the DSs bucket and I would Amy just so I don't forget like to address one thing in association with uh senior nutrition before
047we finish my update portion and so the senior nutrition as a for instance I can tell you that um Stephanie and and her team along with Mary have and Emily Coulson have worked to prepare several sl3 expansion options for consideration with senior nutrition one of them would include our current um service and and just ensuring that we're able to continue providing service to the people currently receiving service or to the volume currently receiving service and then we have everything from that all the way up to um what we had discussed during the board of County Commissioners update which is having everyone off of the waiting list receiving um not only the five Mills during the week that would be either warm or frozen but also weekend um Mills shelf stable Mills so we have multiple
048different options for those components can I ask a question about the meals and wheels is it a possibility to ask atrian to help with some of that funding ah funny you should ask may we come back to that yeah I I can I got something just that way we can do all of that at once is is that cool yeah and actually if if you want well does anyone have any questions about the f26 budget at this point okay if if you want we could hold for a moment on the service and performance I do have one question sorry no that's great just because B budget it doesn't include the salary what happens when you are you know don't have it fully staffed for the year do you lose that funding no so um the
049obviously a large portion of the expenses because most of the services that we provide let's say a physici for instance right coming in receiving services from a nurse or a physician and so that salary is a large portion of the services that is priv if a position is not filled we simp L don't have that expense that expense uh becomes something called lap salary that lap salary is um well money that is not spent that is in the general fund often but not always or and since for the Social Services positions um they are either 50 or 75% or sometimes a balance in between those two but reimbursable if they're reimbursable they're reimbursable at 50 or 75% so if we were to let's just pretend we were to cut a position right if we were
050to cut a position that cost $100,000 total with salary and benefits the county would expect to receive and that if it would fill the county would expect to receive $50,000 of Revenue right for that so the county portion of the 100,000 would only be 50,000 so the we would also then lose that revenue is the point so the expenses would go down and the revenue go down in some positions in other positions there is no reimbursable expense um and so it it is it would be money that the county could choose to realign for that year um assuming again that the position wasn't filled most of our positions are filled uh it just as a they they rotate there there always vacancies so there's always going to be somewh salary that's going to be a
051gring but the intent and the hope would be to balance everyone's work and able to have all the positions filled but isn't how life Works always so the base budget does not include employee expense correct no salary or benefits no salary or benefits that's right so if you basically added that back in to mirror your fiscal year 25 uh uh budget where would we be in relation to that 55 at 55 okay I think right even without the 2% reduction uh just on your base budget so the 2% reduction hasn't been taken yet officially so what we were assigned to do was they said here's what you start with Now find 2% of that so let's say we start with 55 ex that we did but but find 2% on that so if you were
052asked to submit your full or when you're asked to submit your full budget it's going to reflect right at the $55 million figure you don't anticipate that that's correct M so so the way that the well obviously that is strictly up to the county manager in terms of what he presents to you all and what you all uh choose to do but we are not proposing to we we're proposing to maintain all the positions that we have today okay that's what I was looking for [Music] okay um if we have no more questions on that we will move on to next on our agenda is well actually J do you want to cover since we sort of switch to that and then we'll go back to the perance component um so I would like to
053recognize uh commissioner G sides and Community sport Outreach director Stephanie star just to provide a brief update on senior nutrition we've had a little bit of exciting activity uh in that space over the last couple of months [Music] um and um so we have a lot of conversation uh that is occurring with the board of County Commissioners and then internally from an operations perspective um Stephanie is going to be able to provide an update on our waiting list activity and some work that we're doing there to try to refine because obviously everything is a moving tget and um and then also some exciting uh partnership opportunities sobr you asked about Atrium and that's something that um we would like to explore lots of different opportunities uh including with u Municipal um Partnerships potentially and so
054um I'll present PA and Stephanie why don't you start with the update on the waiting list and anything else you want to say there so sure um so just to give everyone an idea um so we've been um working on going through our waiting list um so we have people from 2022 23 24 25 on our waiting list and those are folks um we have not been able to add um to the meals for a variety of reasons um one if they live out in the far areas of the um County they would have to go on Frozen meals we actually have had to decrease our numbers um of people receiving frozen meals um because we lack the funding um to be able to add people back on once people um are off of that
055um and um also with our war meals um I think we've had this conversation already um the meals went up 34% this year and so um when people um have been taken off of our warm meals we haven't been able to add additional folks we have here and there but it we we really haven't been able to um because we were actually short on funding everyone um for meals who are on warm meals this year by started out about 125 130,000 and it's gone down so in terms of our weight list we we get about um 25 people added per month to our weight list and those are people who've been who've called who we've confirmed need meals um we have a a basic screening we prioritize them um so we average about 25 people
056per month um and uh so we decided you know we really do need to go through the waiting list um we've been sending letters out to people um on the wait list um twice a year saying hey if you no longer need meals please contact us it doesn't we really only hear from maybe about 25 30 people that say hey we don't need meals anymore otherwise we don't hear a whole lot so um we really wanted to confirm who is and isn't on the wait list so um unfortunately my Staffing capacity is really small I have mostly part-time people who are only here half a day and either running a meal site or covering a meal site or covering our volunteers or doing assessments on the people who need them twice a year so um
057we've actually engaged quite a few a couple of people not quite a few one of them being Dave who's in the back of the room here um who's helped us out um he's from Jackie shop and um a few other folks from other areas to start making calls and some of my staff um we've been able to get through to 76 and I'm going to read this because it'll make more sense so we've contacted and updated 76 seniors and 43 of those were removed um another 40 are in process so the whole process has been we're going to make a phone call they don't answer we're going to make another phone call they don't answer we're going to contact their emergency contact if they have it don't answer then we sent a letter so in
058process means they've either gotten one two or two calls and we're we're still trying to get a hold of them don't reach them we send a letter to them um we have 28 that are completely unreachable that we've gone through that whole process and we've sent letters to them um and we'll give them two weeks to get back to us and if we don't hear anything we will remove them so we want to give people the opportunity to respond we don't want to just take people off of the list um so it's it's it's very timec consuming um I think Dave can attest to that so um you know so again we we that's the those are our numbers and um we currently have 590 on the wait list um we started with 608 we
059added 25 and we took 43 off so um that's where we're at right now um as you can tell we still have a lot more people to go and call it's going to take time because it's not an immediate response again A lot of times we're making two three calls to the household of unfortunately so um it it's it's just a very timec consuming we don't have any full-time staff to do it so we're taking people who have the time to be able to make those calls I'm sorry how many did you say you started with 600 how many 608 we removed 43 but then we added 25 that month um and again that's out of the 7 you know 76 were're able to contact we have another 28 that we can't reach and 40
060that are in process right now with phone calls so 13 something 140 people that we've reached out to you in total of um list and we're also prioritizing them too when we do get through them so making sure that is completely updated as well so um again taking that time to do that hoping in the next couple months to two three months to get this all taken care of but it again it's very timec consuming and it continues to grow and then um some really great news um is that um Wesley Chapel has agreed to fund um their weightless clients um we reached out to them and and discovered of the seven that we had that um four of them a couple of them were deceased they had passed away in the last 6 months
061so it was pretty recent um one of them actually two of them were one was with a family member one said that they um U living with a family member couple of them said they didn't eat meals anymore um well good news is is we're starting three people we thought it was only going to be two um from Wesley Chapel this week on Thursday um one of them who said they were living with a family member we we um discovered that the daughter who that person lives with is a school teacher and was coming home on in the middle of the day to feed her mom and go back to school which was creating an enormous amount of stress for that family so we added them to the meal so three in total so we're
062excited about that and um other opportunities love to hear about the atrium um idea that you have so yes well that's about all turned out to be was an idea uh I contacted Atrium the um Regional exec or whatever over the hospital I guess works out of pine bill I can't recall the name I was deferred down to somebody and from my conversations adriam directly is not going to be a player but they did give me one of the part of the the board a local executive board for Atrium is serving on a board for a meberg county based organization called nourish up which is the old uh Loaves and Fishes I've reached out to them explained the situation uh they actually handle this service for mecklinburg County mecklinburg County the way they have it
063is they have their senior nutrition and then nourish up actually handles the Meals on Wheels now their model is a little bit different they don't do Frozen and hot meals they do refrigerated meals and they charge a fee anywhere from $1 to5 based on ability to pay they have their own facility in Charlotte and they also are in the process constructing their own commercial kitchen I have not had a response from them of what they may or may not be able to do I don't know if that good news that's bad news but as soon as I get a response I've explained to them I'll hand it off to the appro appropriate people and you guys run with it all I'm doing is just doing a little bird dogging uh I also you might like
064to speak to it um made a contact unbeknownst that you had contacted him as well Stephanie food for families and I understand you have and some of your staff have a meeting the difference with them is they do not provide meals prepared meals per se they provide groceries so you'd almost have to again tear your uh candidates on the waiting list for those that can prepare their own meals uh it it sounds like you're not going to just be able to here's your lunch um with them they don't have that capability so uh hey some help is better than none right so hopefully you will have an opport I'm backing away from from them and your meeting hopefully will have some uh potentially good outcome I uh you'll see in the minutes I made an
065initial run at my colleagues for funding um senior staff County staff worked out and with Miss Payne worked out another opportunity to use the unfilled I'm sorry what did you call that uh unfilled salaries with lap salaries use that funding from this year which is approximately $68,000 they estimated we could feed 110 families that would also commit to continuing to feed those 110 families another 258,000 in the next fiscal year budget so we could pick up pretty quickly feeding 110 additional folks with found money but we would have to commit an additional 258,000 next year to continue through the whole year and unfortunately I'm sad to report my colleagues uh did not support that uh my motion so we're back at square one and that was even with the possible 2 9 cut if if
066it ends up being cut with the 2% uh you mean the funding is cut I mean well the the base budget if it is go does go down 2% that's asked it's 239,000 we're not that far in from a commissioner's standpoint we're not that far into the budget I haven't seen anything yet so I don't know where uh senior County staff is what they're going to do with what miss the options Miss Payne submits I'll say it again I've committed that if we don't offer more resources to eliminating this waiting list I'm not voting for the budget now I'm only one to five um and I don't have to tell you all about the county reassessment all the hoop you know the concerns of our our citizens on that that all comes into play budget
067we all know how it works um so I I can't say but basically we're we're going to have to put our heads together we're going to have to figure out another way it's it's not going to I I have serious concerns if there's going to be significant additional County funding for this it's just I don't want to lead you astray you can ask but um unless unless Miss paint your staff can find money from another place and invert it that hey great let's hope you can do it man' Stephanie I have a question because I kind of took this on a personal level through some networking that I do as well because I was hearing from some people in the community as well that taxes going up to pay for some of this is not
068an option for some too because there's some elderly in Union County who can't afford the tax increase but don't qualify for the Meals on Wheels have you heard of Faith Community Health Ministry their Department of Atrium I didn't know about this either can I make this connection with you before you leave as a possible I spoke with her and they said that they have a network with Blue Cross Blue Shield who has been looking to do some funding that might be an option in this like a grant some sometimes yes yes she doesn't know for sure but she said she's newer on this there used to be a relationship between this group I didn't even know I've been in the system in Atrium since 2007 I didn't know about this um but they are Department
069out of Atrium they do a lot of Community Health work they wouldn't per se do the funding but they do a lot of collaboration work with someone from Blue Cross Blue Shield who um looks for things to help fund um so maybe you two can talk and see if this is something that falls under that's what I was going to ask when you talked with Atrium was it with the um strategic Community um engagement that's where I tried to start yes and I got kicked to somebody else and they brought a partnership with United Way I mean not with United um Healthcare on that say that again United Healthcare like for Grant couldn't tell you is that something that the county has ever had a relationship with before couldn't tell you what was the department
070in a did you're talking about faith community health [Music] Ministry I even thought about Atrium they have a foundation is that you know possible to tap into that for Grants I mean they're not for profit right or nonprofit I would think a little bit I don't sit on their Finance board but that was my first thought with Atrium especially being now we have two hospitals in Union County [Music] and well I don't want to step on what Stephanie's doing so um yeah yeah I mean we're always looking for funding I I believe but I could be wrong that the foundation may only fund nonprofits and certain initiatives I know that they you know kind of like every other Foundation they have certain initiatives they want to fund um but I mean we always come up
071into things doesn't so maybe if like food for families panned out in some area then they could go to well I'm sure they have good source and others foundations for increased funding to help with a possible senior nutrition expansion whatever possibility we also have a new budget director who is also responsible for grant writing and there's supposedly going to be an expansion in that area I would think there are uh nonprofits organizations arms of like Blue Cross Blue Blue Shield that could be approached for something like this I I guess correct me if I'm wrong the hard part is that the foundations are not going to contribute directly to the county to fund something like this it has to go through another nonprofit who is actually doing the work right is that usually the case
072uh not not usually like we've been like had a small amount of fun funding for Meals on Wheels but real small amount and we've applied anytime that's come up right but we we've been turned down a bunch of times but depends upon the foundation I think it really depends upon their criteria going to fund okay you had another question yeah what's just general criteria to get ons for wheels wheels um so it depends upon what your Ty you have to be 60 um 60 and over and so the congregate site 60 and over and or you have um and spouse or a spouse that's 60 and over and you can go with them um for homebound it's a little more those are folks that are more shut in can't can't mobilize don't have anyone to
073also support them um with um providing meals we are not allowed to ask questions about income we do ask questions but we're not allowed to ask um specific we we can ask hey are you um you know are you below the poverty income but we can't ask specific questions that's not allowed from our income or um funding from um our hccb grant so are any of the M deliveries medically pay on they're not right now but then how do you determine if somebody's reallyit like a need versus well we do remember we do first of all we do that screening but we do have to go out and assess them in person um to make sure that they have the needs so we do we have to assess them twice a year um once in
074person and once by phone or in person if we really feel like it needs to be twice we'll do that so they are assessed twice a year how many citizens are we serving right now who with meals um so we have about Homebound and um I believe to go back and look um and then we have a little over 100 in at our congregate sites and that's a separate from the 590 what was that sorry the 590 is on the weight list y we have 590 on the weight list we're more on the weight list than what we're serving yeah so so when we um when we had Co funding we were able to serve more folks in the community um but unfortunately that is gone completely and that is not reflected in in the
075budget numbers either because that comes out special fun is there is there overlap between the homebound in the congregate you have to be either or you you have to be either or you can't like one day decide you want the no no cuz if you have the capacity to go to a congregate site then you cannot be Homebound and receive meals is the congregate sites are those full or are those always taking people we always we we are open to taking people oh okay why is 6 [Music] it's it's a regulation it's required by our um home and um Home and Community block grant and uh that's how it's defined one more and the older Americans act so you know the funding comes from the federal level down to the state and so we get
076state and federal money for the program and that's a federal requirement Stephanie have we done any collaboration or checking with local churches yeah that I was just going to ask about that so we actually our congregate sites are at some of the churches actually um three out of our four sites are at churches um but in terms and we do have a couple churches that actually deliver meals um for us so um all of our meals are delivered by volunteers um so that it takes a bulk of one of my staff's time to be able to manage that we it takes a lot so we have about I think we have 30 routes that we run every day what about um re grocery stores I mean Fresh Market is a North Carolina company right har
077and Harris tutter is too okay and then publ is really coming into this Market I'm just curious any so our meals have to meet certain um FDA require or certain requirements so they have to be 700 calories like they're very strict criteria for them so we contract out with a vendor um to provide those meals and meet all of those [Music] requirements that's nutritional it's nutritional requirement so there's always a nutrition staff on board all of the vendors who um or the vendor who we contract with to um make the menus for the meal all the meals that get delivered and they have to have a certain amount of salt a certain amount you know so very very strict criteria in order to be reimbursed so our meals get reimbursed a certain amount um uh
078so we we do get some reimbursement for each each meal from um USDA as [Music] well there's a lot of detail behind it we certainly we I know we presented information over a year ago but a lot of you weren't here so we can come back and do a presentation if you want yeah that would why don't you bring some of the meals and distribute them that for that evening meal I I did that once to my County Commissioners I had them deliver the Frozen stuff not one of them took it I mean oh shoot I shouldn't say that on camera um but I ended up taking them home and let me tell you it it's not like you're going to Long hor well that was my next question any collaboration with local restaurants again
079we have sorry it's we have to in terms of spending dollars we have procurement rules that we have to follow also I mean when it comes down to it I mean people are starving right 11.9% the keeps going up are some kind [Music] of maybe after so many Star to death they might pull back some regulations allowing like it has to be 700 calories well here's here's the thing for me this is one of the Lynch pins that keeps these folks in their home and not have to go to a family member or God forbid a facility because they can't perform perform you know the duties of Da the um what do you call activities of daily living and cooking their meals is one of and I can promise you one of the gentlemen that
080I deliver to I I deliver on Fridays I go new sing route but um I can promise you that's the only meal he's eating that day I I I can just tell you um so it is it is a dire need and it is growing and it was 570 last time I checked and now we're up over 600 and and calling some of those out so you can see it's it's not going away so the reason I asked about United Healthcare and this would be like a long shot I don't know how you would approach it but I remember reading and I looked it up United he um UNCC Public Health had partnered with a local farm and then United Healthcare gave them the grant funding you know to to feed to to make that
081happen and so it was an interesting you know group right that it that it took it wasn't nonprofits you know but it was the public health um with a local farm and then um they Grant funded it from there um 120,000 it's called Penny Lane and it's in Wake County and um it's it's been expanded to some neighboring counties just a thought I don't know how it you start something like that but it' be [Music] interesting we do have the we are K with Agriculture and we do have public health that we get you know like I don't know what it would look like but something to explore that was and occasionally just want to say that we collaborate with the a centers sometimes we get some produce that we're able to deliver to the
082seniors as well um so we do that when when we're able to do that right the other thing they have is would maybe be for people who were weight listed you know which is some kind of like um it's like a vouter you know for Fresh Foods for people who you know there are probably people who are weight listed who do have they're not homebound but they don't have the [Music] funding so um next on our agenda cuz we went with is the uh information on an update from the Human Services Agency activity performance yes so uh at our last meeting you all indicated an interest and we would like to share data with you um anyway and so wanted to begin that process we collect a lot of data that is used at the
083service level and we compile some of that for state reports and we compile some of that for budget reports and some of that four management reports and one of uh Jackie's um team's components is actually uh business process Improvement quality assurance um and that group is helping uh our department directors build Dash boards and that sort of thing and so um I say all that to say Performance Management is a work in progress It's something that we care about we pay attention to a lot of data and are accountable for a lot of measures um think through the state through agreement agenda um through Federal contracts with the FTA Etc and so what we're showing you tonight uh is two things that you all had specifically indicated that you were interested in seeing the first
084is just a position report so this is just uh for February obviously this could change on any given day or at least every other week in theory um but we have 547 total positions within Human Services that is a combination of full-time part-time uh benefited part-time and the date that this was was run we had 510 of them filled and 37 of them vacant which is uh 6.7% vacancy rate which is really really good um and and honestly most of the churn um is is just normal you know something comes vacant and it takes 2 three 4 months to fill that and then and then we're good to go um do you guys are for my department directors do y'all have anything specifically that you want to talk about in terms of vacancies that are
085ex difficult you feel I extremely excited right now because DSS is running at about a 5% vacancy rate and I haven't seen that I don't know that I've seen that in my seven years here so I think between the combination between um what we've seen happen across the county for staff like we're super grateful to our commissioners I need you to hear that on commissioner sides um really no it's making a difference though we're competitive because the the I'm going to lose staff to counties that surround me sure because you're already trained you can go to Mech you can go to Cabas not many people are going to go as many times to Anon but like they move between where they can get more money and right now we are very competitive and so that
086is showing in the fact that I have a 5% bacy rate Earl you can attest to that I was just going to say Ashley that from way back when I was in there I think that uh Union County is very competitive now I've been hearing from some of the workers oh we just got another we got a raise so the colge minions have done real well in helping out that eligibility staff and and that is cost savings for us I don't have to retrain people we don't have to put them back through all of the things that new staff have to go through they already know what they're doing I don't have to train them for 3 to six months like it's it's just fantastic so thank you I'll just add that that doesn't mean
087that we're ahead of other counties this has just brought us up to be competitive so just speaking from the environmental health um Arena uh this is the first time we have been fully staffed in about a decade it's very difficult for a department to function at a high capacity with efficiency when you're always behind you know you cannot meet the expectations for Service delivery and demand uh from a place of you know poor morale insufficient funding you know unable to you're constantly trying to catch up so it can't be overstated how helpful this has been um to the county overall okay thank you um you're no like on the record not having said that so there there are still some components and and again are all exceedingly grateful there are maybe some positions that are
088more difficult to um recruit for that we've had vacancies in um and and there are there has been some compression uh which is a normal thing and so again we're exceedingly grateful for the adjustments that have been made from a classing comp perspective and and if there are additional um adjustments my guess is that those would be in association with the compression uh if there additional recommendations yes for adjustments that would be in association with the compression call by the increases um that were that were made and there are some specific um position classes for instance Teresa's driver uh classification is one of those where the class en comp adjustment moved the minimum pay roughly $7 um and that was great right um that tells you a lot in in that space But what that
089resulted in and by virtue of the way that the county had to make a decision about how they were going to implement and we have to implement across the board really in terms of salary increases um it resulted in pretty much all of her drivers regardless of whether they had one year of experience or 20 years of experience being at minimum and and no uh separation there so there are some buckets like that specifically that that need some adjustments which in that area makes it hard to [Music] recruit um and and then the other data I think it probably would be in all of our best interest to not go through this line by line um but uh but what I've I've provided for you is um a couple of pages of information that is
090about uh from each of our departments very high level just some different things that we report as part of the budget um process so just to collect that we think are some relevant numbers um there there are others and again I would ask that if any of the directors have anything very specific that they want to call out please um shout out on this but a couple of things that I would mention one is I made a mistake um I'm not sure exactly how it happened but it happen uh in the comments section there there are some components that um should be adjusted down to the first one for instance the senior nutrition Mill served obviously uh that is in the appropriate place and I I'll go ahead and call that one out that that
091number the target number is related to available funding not demand um and so some of these things that the column that says fi25 Target or projected annual isn't necessarily the Target in terms of oh that's good it's just what we anticipate right um some of them may be a Target but typically it's really more what is our projected annual uh final number um but those that that should be adjusted the one that is on the second page is in the contract's executed line um talking about collection efforts that's actually associated with program Integrity collection efforts and the reason for that one is um as it Cas that we have position that doing nwork that is um Frozen for the past buget years cuts and and so they're not doing that work anymore um a couple
092lines down under the dental clinic visits it says results incl covid-19 cases that are no longer um reportable that actually ties to the communicable disease bucket that is on the next page page 27 um so and and then under transportation I think that was the last one uh there's something that talks about safety and it should have been adjusted down by one um so that it it ties to the uh Safety Management Systems versus average miles per trip um in these I know that there were some specific questions so our wi case load uh and wi clients those numbers have gone up just for what it's worth state has increased our goals state has actually also increased funding we have a contract position um that is being funded Now by State dollars that is something
093that will be uh that we are going to present as an expansion request of tied to the budget um and the logic there is that these numbers are going to go down and the state funding is there so it's not c0 dollars that would be needed and but it's easier to hire and maintain and quite correctly the right thing to do if we're going to have an ongoing need to have that build position versus a contract staff member um in the uh looking to let's see on the third page um the communicable disease already mentioned that but the the fourth one down was communicable disease under Public Health that looks like it's a lot lower but it's again due to co and so that's not something that is alarming in fact um actually there are
094number of these um issues that the 2020 all the numbers that you see really prior to this year have been skewed and so there are some isolated buckets that have increased um within that space and get a totally separate presentation about communicable disease um before you leave communicable disease can I ask you a question yes have we had any cases of Nel break out I'm glad you asked that because uh at the uh division report section at the end we're going to give an update on nil and our response and a a general uh obligation and work that we do just as a matter of fact so you know about that still on the third page you asked specifically about the number of uh children in our custody and so um in the middle of
095middle of the third page it uh is entitled children custody and that is just a number there is no target or projected uh this is not the total number this is the average um monthly number average at one in time yes yes um just going down well [Music] so actually the question was is it going down not not so much really and unfortunately the cases though are more complicated in 23 that it just fluctuates it just is so we go 136 150 153 130 back up to 148 this year at mid year about 143 but we've brought about 11 kids in the care in the last month so it just that's just how it [Music] is the complexity though again of those cases is is the component that is most difficult so even looking at
096the um average case load that that doesn't really tell you a whole lot uh similarly I want to call out just a couple down from that the number of adults in here um that one has gone from 50 53 54 56 60 and now this year we're 65 so um that's steadily grow that's relevant and and anticipated to continue and those also are becoming more complex um and then you know you'll see the Medicaid cases going up you from 37,000 in fy20 to 56,000 on average now obviously that's due to Medicaid expansion um and uh some other components in regard to that um I think one thing that I would like to call in in terms of Transportation this is just I'm going to give kudos to Teresa and her team and it's not always
097going to um be this way and there's a lot of times where you can't control this but the Safety Management Systems um the events that occur so prior to 2023 um we had included non-preventable safety events and then beginning in 2023 it only included preventable safety events but that's a really great number in terms of 2.6 and you know one of the goals in that space is is certainly providing service safely and enabling people to access the services they need in a safe manner um and I I think actually on that same page up about half the collaborative cases I think that's relevant just to acknowledge uh part of the reason for that growth is because our staff grew and we were able to build the positions there but just to call out the importance
098of Behavioral Health Services and that's something that the county um is not obligated to invest in but they choose to do and it certainly is is very much needed and and very beneficial to the community and I think those numbers um those numbers certainly reflect that and there are a few things so so in veterans [Music] um one of the things that isn't shown here and and something that maybe next month unless she wants to talk about it this month but um that I think Michelle would tell you if we were looking at veterans numbers is that the numbers they matter but really the outcomes I think that's the case for all of the services that we provide quite frankly um but the outcomes of each individual life that we are able to impact and
099and the claims that are able to be um settled and the assistance that we're able to to get to help change people's lives is really something that is much more meaningful than just the numbers that you would look at in terms of the the raw numbers of people served um on on the subject of veterans how many homeless veterans do we have in un County how could I find that out commissioner there's really no way to track that we do keep in contact with the community um homeless shelter and there's a point of contact there that keeps track of the vet and it's anywhere from 2: to 10: at any given time doesn't include acceptable doesn't include the unhoused right and the VA homeless program defines a homeless veteran as a couch Surfer or someone
100that that stays with their family not necessarily on the Street Homeless right someone that's displaced out of their home shelter at the shelter correct right so there would be more that were unhomed right and I'm sorry what was that so that is what her number the two to 10 would be how many were unsheltered if they were in a shelter and then UNH home or what is it called is that higher than that correct displaced displaced yes displaced that means they're living with family or friend or wherever they can crash on the couch or their car and maybe they haven't checked in anywhere so no one knows their office [Music] well I'll just say as a father of a um my oldest son is serving in the Army and as far as any veteran being
101displaced homeless whatever you want to call it it's unacceptable so what can we this is a loaded question not for this meeting but longer what can we do about it commissioner can I ask something too is there any way that you know right now well that's I guess that's a state thing but there any way that the that the board Commissioners could uh advocate for making the taxes right now I think it's like 27% of your tax real estate taxes non- taxable is anybody they can Advocate makeing like some other states where all of your personal property taxes for your homes are not tax well that's for that's that have to be State legislation Advocate Poss I'd be more than happy to if we can get somebody to write a bill I'd be more than
102happy to advocate for it but as responsible for Union County as far as I'm concerned I'd like to know what Avenues there are to make sure there is no veteran in our County that has served our country that is homeless or displaced or living in their car I think that is you want to talk about a waiting list the 590 names homeless veterans right up there with me yes sir I appreciate that unfortunately the percentage of homeless veterans is due to mental health issues so it's a bigger issue of homelessness it's also a mental health issue and some of them choose to be homeless just because it's easier than having to deal with the parameters that are set under sometimes it's Choice corre they're avoiding the system absolutely I get you thank have you seen
103an increase in job loss in veterans here like they're reporting you know Nationwide or we it hasn't yet no um we've had several phone calls recently about um mortgages not being able to make the mortgage not being able to make their [Music] rent so hopefully well if you guys have any questions about this I think probably would make sense for us to come back to it um if any of the directors have anything you want to call out specifically that I didn't mention just the matters that is a trends that you're seeing right now that that we that will impact us greatly that we may haven't already touched on um please do and then uh I want to mention I mentioned the dashboard information we'll bring some additional information to you um but there are
104things like um that we track like literally just the number of people that walk into this building um so Jackie and her customer service team uh as a for instance uh in FY 245 so so for calendar year 24 that we just finished we had almost 25,000 people just come through the doors that that they greeted and so you know the majority of the services that we provide quite frankly are probably done uh on the phone or electronically or through you know other uh types of engagements and so having that many come through the doors for service as well you know it just that's amazing there's a lot of volume 54,000 calls and 54,000 phone calls holy I have a general question um volunteering do you what is your need for maybe you don't answer
105it what is your need for volunteering do you so uh Stephanie probably speak to oh look excellent somebody's taking us thank you whoever's driving right now um so we we have multiple different volunteering um opportunities obviously as commissioner SIDS mentioned volunteering for senior nutrition at different times of year like right now we have a number of volunteers who are helping with um what we call uh F uh volunteer income tax so preparation for that you don't have to be a math person to to do that probably doesn't hurt um but but you don't have to be a num person you just have to be able to use a calculator and no you pass an exam too and pass an exam uh Christmas obviously we have a number of volunteers and then there are some other
106just opportunities in general and if you you are someone you know is terribly interested in helping support uh operations there are a number things that we couldn't allow assistance with um just due to Hippa and other you know access to information um components but there are a number of things so um Nicole like in Communications you we have a lot of internships and that sort of thing um and and she happens to have an intern now and it's super excited about it and that's not volunteer but it sort of is you know um Stephanie is there something specific uh on the website that you would like to mention sorry about that um I I think right now just clicking up the Vol the nutrition program and um we're always needing people to help deliver meals
107it's not always really I mean it's you know morning time so it's not always easy for everyone love to have kids do it but it's usually not a time where or you know 18 year olds or maybe if they're flexing but it's still really really hard um we also require for our nutrition program that you go through a background check um because it is a vulnerable population we don't want to send someone out who has a sex Fender history um so we do have to um look at that um we'll have some opportunities for like Easter baskets and that kind of thing um you know we'll take donations but in terms of other volunteer opportunities really yearr round with senior nutrition Christmas Bureau um and then volunteer income tax program and that'll that'll be over
108in April so with Library obviously um Nicole and the public Communications team have done an awesome job if you haven't checked out the website I wish that you would have like five years ago and then checked it out now it's really good now but if you compared it from from any number of years ago to today you'd say wow this is such an awesome but in terms of you can see a little bit there librarian Parks and Recreation there are some departments that have opportunities as well that helpful yes thank you and if any of you are or know someone who is considering helping deliver with senior nutrition takes me an hour from door to door it's an hour I'm done I delivered seven it's a usual route um I live in Monroe I pick
109up at the basemore senior center and I've got my farthest way to live delivery is practically at the county edge up in new Sailor and then it's very easy to to do a route and three of mine are right in Monroe but I can do it an hour door too and we have to deliver the meals within an hour so because of the keeping the meals warm like there we have to keep them in temperature and that kind of thing but allow the routes to have shrunk a little bit so it might not even take more than 30 minutes to do the actual route but that's a longer a little bit of a longer route is it just because of the distance across I think my wife drives so it doesn't take long that's good
110all right um we have some good dialogue on that go ahead and um start us on our next one was to receive information on the child Fatality and prevention and Community Child Protection [Music] Team so this report is uh going to be a tag team between Ashley Lance social service director and myself I'm going to present the first part and I wanted to start by just giving you a little bit of background since we have some new members um in the '90s North Carolina established the North Carolina Child fatality prevention system um that's a Statewide multi-disciplinary and multi- agency system um and that includes the uh North Carolina child fatality task force and local child fatality prevention team which is what we are sorry can you hear me better now yes um which is what
111we are part of and what we're going to Pro be providing a report on um so what this the purpose of the local team is to prevent future deaths by identifying gaps in the systems and policies that may have contributed to the deaths of infants or children children in the county um and then we have the ability to make recommendations for improvements uh uh as a part of that North Carolina fatality prevention team we can provide information for that so the report that uh we're going to be giv this evening is for 2024 um during that time frame in 2024 we held four reviews those are quarterly meetings and as I mentioned it's a multi-disciplinary team um and during that time there were 19 child deaths infants and children that occurred and those are kids
112uh from birth to 18 years of age uh the causes of deaths as you see uh in the information six due to perinatal conditions that's prematurity five deaths due to birth birth defects three due to accident no homicides three due to illness or medical conditions no suicides during 24 and two due to other so there were a total of 11 infant deaths the leading cause of deaths for infants uh was a perinatal condition um for this group the age the specific causes of death were uh six of them being perinatal three birth defects one unknown and one illness medical condition there are a total of eight uh child deaths in 2024 four um for this group the specific causes of death were three being accident two being illness or medical condition two birth defects and
113one being of unknown cause of mortality if we break uh these kids up into uh categories five were males six were females two males were black two females were black one male was Hispanic two females Hispanic and one was Asian um Indian um so we made some team recommendations as part of this process one was early intervention uh you know is just important when it comes to substance abuse earlier you can intervene with those types of situation the better the outcome uh uh make sure kids have a flotation device floaties on them if they're uh near uh or have access to a body of water all B all uh infants in the ncu need to be referred to Caremark that's a a referral program that follows high-risk kids and also pregnant women incidentally uh the
114team um has also submitted to the North Carolina Department of Transportation a formal request asking them to review one of the locations where an accident occurred to make sure that the visible signage is appropriate you know enough for that d ous area cuz we're aware that uh there have been several accidents in that area perhaps install speed bumps guard rails whatever is necessary but um a formal request was submitted to NC doot um to evaluate that location so I think um Ashley's going to take over now before she does I just want to give a shout out to Dave flare who has done an amazing job supporting the group this time this is New New job for him he is done thanks um just to clarify one thing on the child fatality prevention team we
115reviewed those deaths in 2024 but they actually happened in 2023 oh excuse me no you're good I just it gets fuzzy sometimes when that happens because um we get them the year after they occur and we review them each quarter um thank you for yeah you're welcome and so in Union County we for the longest have always had a combined child fatality prevention team and Community Child Protection Team and so while we do review the child deaths that happened the year before we also have a section that is community child protection and the way that that operates is we're able to bring very difficult cases within child welfare at DSS to this group and then we have a multi disciplinary team of members who are able to brainstorm and come up with different perspectives of
116ways that we may engage with the family interventions we may be be able to provide and so I was going to cover um the three cases that we went over this past year at our community child uh Protection Team just to kind of give you an idea of what we're doing but like the main task of this group is so we can look at those active like we are in the home working with this family trying to provide services and intervention um so these are very real and in the moment and child fatality prevention is a year after the deaths have occurred so the first case that we reviewed this past year um and of course for confidentiality reasons because this is an uh or was an active DSS case I can't give you any
117um information that would connect people to these cases so this will be a broad kind of overview but we discussed um a first case which involved impr proper supervision uh a young male was de gloved by a piece of exercise equipment um and and the guardian went against medical advice given by the hospital and swn out sold out her own care and the child eventually did receive appropriate treatment a few days later um our team recommended an assessment for the guardian and in home care for the child as part of our recommendations from the team to the social worker um the second case had multiple CPS reports um one was Al was actually for human trafficking the guardian um was unable to work due to medical issues and had little to no income and so
118the kids in an effort to try to take care of the parent were doing what they could do to take care of the parent um the children were not attending school they were having very significant behavioral issues and the team recommended locating um alternative housing and exploring alternative school settings uh for all of the children um the third case involved a dependency report due to a guardian refusing to pick up his 11-year-old from the hospital um the child was admitted due to homicidal ideation toward his family the child is reported to have intellectual disabilities and no insurance the other Guardian had prior CPS reports in another state and so wasn't an option for the child to stay with um the community child protection team made a ton of recommendations to this this one and I
119can tell you that they were very helpful in these recommendations um following up with Charlotte Autism Services Autism Speaks RHA Health Services NC Star Easter Seals UCP um work together NC and the Union County DSS Medicaid Department because there were some issues with the child not qualifying for Medicaid but sometimes they're are other the system is hard to figure out and sometimes there are other ways they may qualify um and so we able to work with our Medicaid department on that um we did report some systemic limitations to the state it's another um part of the community child protection team is to get back with the state and let them know what our county is really struggling with and one of those is limited services or no available Services I will tell you most specifically
120that is in relation to mental health and substance use Services we have some but does it meet the needs of our very fast growing community no it does not so we're letting them know that we we need some help there um Li limited services for youth who have dual diagnosis of mental health and developmental disabilities that's always been difficult um limited access to health care or no health insurance we've seen some of that increase due to Medicaid expansion but there are still gaps um limited Community knowledge about available Services um this is why sometimes DSS ends up getting involved the system is hard y'all trying to figure out how to navigate that as a parent who's already struggling just to feed and keep your kids safe like knowing where to take your kid um if
121they need mental health services how to get insurance like all of that and navigating all of that is part of um what we're trying to do at Social Services and then of course limited finances so those are the um cases we covered in community Child Protection Team yes girl I was just going I was just looking at that your second bullet and the question I was going to ask was about the the human trafficking and you know they always say the sh is the shter area is one of the very large across the United States and I was wondering was any of that trickling down this area that you know of and what comes to mind was I don't know if it was a year and a half ago there was some young girl 15
122or something and and she luckily or thankfully that she was able to get back they got her back she went out to Missouri or Arkansas someplace and then she came but somehow she got back but she was some guy picked her up left walked out of her house and just I'm not sure if that was this particular case but do you see any of that Trend kind of trickling down at Uni County uh yes not not just Bea Charlotte but kind of because we have the interstates um a lot of our connection honestly Charlotte via Atlanta so it comes up that Interstate into our area and then branches out into the suburbs of Charlotte which is Union County and so that is what qualitatively I've noticed throughout PSS that we've been dealing with [Music] mostly
123thank you guys question oh yes comment quick pardon my naivity on this use the word Guardian several times to we ever use the word parents for these not necessarily parents are they parents I I just int I intentionally did that to help lessen whether or not I was giv away any confidential information I know that sounds crazy okay but I just said Guardian okay that's fine that's what I kind of figur I just want just trying to keep it as vague as possible I mean I think I mean this is great that we've had these organizations that these committees and what they do uh it would be more like when I read this I guess coming from where I come from the field we we monitor Trends and it's like this would be more impactful
124to see what impact is this was established in the '90s right so there had to be a reason why it was established was there a problem an issue and hasn't made an impact and so I guess like if if I were to see something like this I see these numbers I go okay that's great but is it or compared to last year or the year before like are these numbers better are they worse I don't know what this is telling me it changes every year I can tell you historically that some of the big initiatives that have come out of child fatality prevention are things that you see like um uh seat belts in cars and child safety seats um those were a big push from Child fatality prevention teams um back when they first
125got started um specifically like there were already seat belts in cars right in the '90s but getting the information and pushing the information out also with uh sudden infant death death syndrome safe sleep there's been a big push out of child fatality I do have I can get the numbers year after year improvement from last year and an improvement that's what I mean I don't know that CU I'm seeing this I'm going okay this is 23 is that better than 22 is that what do we done what are the what are the things that were done to make the impact to make it better that's all I'm asking it's a good presentation but that's what I'm saying it would this is so we're required to report to you just a report out of what we
126did throughout the year the state we also send this to the state they compile the data and then they release a full annual report that will show will show historical Trends okay yeah that's what I'm saying so once we have the full state report we can make sure that that gets emailed out to our board members is that state wricks through in state any other questions on the child fality child protection I just a compliment I think that's a great effort I uh didn't realize like many other things I'm learning I didn't have any idea about this initiative and I want to compliment you all that that's serious work I will say it's the most depressing meeting every I can assess [Music] that there are no other questions on that [Music] that right I'll first
127else all right so Public Health has three things we're just going to touch on one thing I wanted to make you aware of was the recent oyster recall there was some Waters off the coast of Louisiana that were closed due to neuro virus illness associated with oysters um part of what's required when oysters are harvested if is a tag that notifies where those oysters were harvested from so if there is a recall or an illness those oysters can be traced so the oysters that were harvested off the in the waters of Louisiana were tracked to certain states where the products were distributed uh North Carolina was one of them and so the information came from federal to State and then uh North Carolina counties were notified um we were notified because of those North Carolina
128received uh oysters Union County received several bushels so we and environmental health were notified of who purchased those bushels it was a facility here there's no need to say the name um when we arrived there one uh bushel had been sold distributed so it got out before we could get there and the other bushel we were able to stop before it was sold at the retail level so that just represents illness prevention and some of the work we do behind the scenes um the other thing I was going to mention to you and Amy had emailed me about this we were actually already aware of it and we're working on it I don't know if you were uh have heard about the uh Frozen uh Shake recall that was distributed to uh long-term care facilities
129so we pushed that out and that came out in the uh news but we were notified of these uh Frozen Shake products two different brands that were marketed and sold to long-term care facilities there was actually a death and several illnesses associated with it again North Carolina was was identified as receiving those products and and uh that product was traced to North Carolina uh my staff uh and environmental health went out and visited every single long-term care facility or contacted them we did find that product in three long-term care facilities and we're able to remove that from service to those folks so that's just another example of kind of what we're doing over and above just our regulatory inspections that kind of thing um so just wanted to make you aware of that does anybody
130have any questions um any measel outbreaks in the county yes so that's the third thing and these ladies this is uh Ashley Bert she's our nursing director and Megan is our uh supervisor for the communicable disease program so they're going to talk to you about the measles all right so everybody's heard it on the news um measles is a virus it's a respiratory virus um earliest um not that are back in the 9th century um here in the US in the early 1960s a vaccine was developed later in the 1960s That vaccine was improved um and 30ish Years Later by 2000 measles was declared to be gone from the US um we had a lot of years of no ongoing transmission um next slide um so the three C's are the way that the symptoms
131are described it's cough Kiza and conjunctivitis um Kiza is just runny nose conjuctivitis is red or inflamed irritated eyes those three symptoms along with fever which can be up to 104° are classic symptoms followed by a rash um it's flat usually starts at the in the face and then kind of works its way down to the rest of the body um the symptoms start usually a week to two weeks after the person has been exposed um the rash that that comes later um a person is infectious about four days before the rash shows up so they get exposed week to two weeks later they start having you know a runny nose a little cough not really thinking much about it they become contagious and then four days after that you see the rash and go
132oh this is more than a cold um that's kind of how how that progresses um there's not a cure for measles um there's not really a a treatment that's going to make it better there are things that can be done to lessen some of the secondary infections or some of the inflammation that can occur but not anything that really will um will fix it um another symptom that can show up as Copic spots um white spots in the mouth um just kind of as an aside all right um about one in four people who get measles will be hospitalized common complications or diara and ear infections U severe complications can be pneumonia or cytis which is um swelling in the brain um that only happens to about one out of every thousand people that get
133infected um the long-term effect um for measles can be Subacute scor roing pan entis and that is something that happens when somebody's infected with measles they seemingly recover months years down the road they start having some cognition deficits um Behavior changes then um the muscular system is involved there's um like flexing and writhing and eventually more brain um function is lost where they don't breathe um and again there's not any cure for that um this is happens in about one to two people out of a thousand so it's pretty rare but very significant when it does occur um measle spreads very easily um we we kind of hold on to it in our mouth and nose and so then when you sneeze breathe sing anything like that the virus can spread um people that are
134around somebody with measles who were not immune because of vaccination or a previous um infection about 90% of those people will will be infected with measles um already talked about the time frame and how easily could measles come to Union County well we watched it in um you know kind of staying in Texas for a while now it's in 12 different states Virginia is now the closest to us last week I thought okay Florida is the closest that it is well not anymore it's getting closer so it's very likely um that we will have the measel case so far we have not um you know the best thing that we can do is to you know try to make sure people are aware one of the things the the CDC and the state does is
135they send out um notices that we push out to our local providers um some of our providers may have seen measles there's an awful lot of them who haven't ever seen a case of measel um and we want to make sure that they're aware and that that's on their list of things that they're going to check off when they're seeing patients um so in 2000 we said it was a minated um there was a a big jump in that number in 2019 there was a large outbreak um kind of New York State um most of what happens is that Travelers go out of the country they're not vaccinated they get um infected with measles and they come back to their communities where there are other nonvaccinated people and that's where it really can take off
136and spread um and so that's what happened in 2019 and we had a few years where we had 11 cases in the in the country 50 cases in the country but by 2024 we were up um almost to 300 and right now we're at 222 plus um and we're only 3 months into the year wow all right um so many people ask how can we protect ourselves against measles vaccination is going to be the best protection against measles um with two do is it's 97% effective um at protecting against these so preventing those infections um one dose of MMR vaccine is 93% effective at pres preventing against protecting against measles um one thing that we do monitor for so if we get um notification of exposures to measles we can provide post exposure vaccination um
137the downside is it has to be um administered within 72 hours of exposure to be effective um and as many people know I with especially with an 8 day time frame of um infection a lot of times pinpointing how many people are exposed when they were exposed where um and then getting that information out to those that were exposed takes a lot of um man work and time and um we're kind of racing against the clock and and those points um who should be vaccinated so really anybody that does not have evidence of immunity um so that would be evidence of two doses of MMR vaccine separated by at least 28 days um that's adults children um international travel so with routine vaccination children get their first dose at 12 months that's 12 mon yeah
13812 through 15 months of age and then their second dose at 4 through six years of age so if they have high risks such as exposure or travel to um places with indate um measles spread they would get that dose 6 to 11 months um but six is the 6 months is the earliest they can get that first dose um some sometimes it is contraindicated to get an MMR vaccine so anyone who's had a life-threatening um allergic reaction to the MMR or any of its components um anyone who's had um so we screen everybody who comes in every single um appointment for Union County Public Health for up-to-date vaccinations especially children um to ensure if they are sick at that time sometimes it may be advised that they defer that vaccine until they are well
139um also pregnant women should not get the MMR vaccine um and really anybody who has had a another type of vaccine or live vaccine within the last four weeks we'll defer that vaccine until four weeks has [Music] passed and then the big question is what are we doing in Union County um to help protect residents um one is vaccination we screen patients at each visit for their vaccination status um our nurses screen for eligibility and then when vaccination is appropriate we offer that um vaccines are provided according to acip recommendations um and we go by standing ERS um and then for surveillance our CD team we do daily monitoring for reports of communal diseases and emerging conditions um this includes ongoing investigations analysis um we share data about communal disease and vaccine coverage and just
140um as an aside for Union County um for this past year for kindergarten and vaccine rates um coverage rates our exclusion went up to 6.7% um the state average is 2.8% um for exclusion so that's children who enter kindergarten who have um typically it's a religious exemption um for vaccine exclusions and they don't they're not getting those vaccines yeah um is if a person has had measles when they were a kid is how long will that give you some type of immunity do you have to will you ever get it again as it does provide those um antibodies I'm never going to say never um because you know um immunity does Wayne um but it's very unlikely so first also with the vaccine someone had when they were a toddler and now they're much older
141now right that does that last That vaccine forever it again I won't ever say ever but typically um if you you have those two vaccines that you do have proof of immunity um that's considered proof of immunity um just FYI you know I got my mmrs as children when I went into nursing school I had proof of immunity food tiers and a lot of times so when we have these exposures um we can offer those tiers so you know if they don't if people don't know if they have that proof of immunity they don't really want to get vaccinations we can offer um titer as well as as a proof of immunity M do we have the numbers in surrounding counties across North Carolina like compare you said we went up in Union County I
142know the state average we have numbers on the other there's actually a dashboard it's um the kindergarten imization dashboard um and that it will break down like by by County what that um exemption rate is so I have a question on that because I thought on the dashboard that it said we had uh 6 2% of the kindergarteners were not vaccinated for the state an increase of 625 new unvaccinated kids right from the previous year in percentages may have just written down I'm sorry so I think it was flipped but I I don't that I'm you know I'm not sure but that's why I wanted I knew Union was higher than the state yes we are much higher and we are still on the R I guess my question was if it wasn't flipped if
143it was just when we say kindergarteners that just Public School kindergarteners and that could be the difference because it was about it was two different numbers so it said 6.2% of kindergarteners were not vaccinated an increase of 625 more was about the um exemption and so I was like how did they you know don't you have to have the exemption to know like don't you have to file for it you can't just not vaccinate you unless you file for an exemption right unless your home schooling and you're in the age group where you would be vaccinated which means your number could be correct that's what I saying like it could be kindergarten age is 6.2 you know and then the public school was the other that was what I wasn't sure of and the surrounding
144count like in our region we're higher than those counties for exemptions and um are we hard for compliance we yeah for everybody well and compliance but [Music] yeah um so to answer my question we don't have any cases currently not going of measles not in North Carolina not yet okay or in Union County second of all how did yall know I was going to ask a question about measel and get this Con yeah no it's really a current topic because it is it is spreading and that is alarming with our um unvaccinated race now well I had it I had vaccine when I was younger but I only had one shot this is a long time ago but was that the first was one [Music] shot you I have to go back and get another
145one would love to see you Commission ready to catch we don't have any yet we hope we don't get any measles here but we're making a plan for if we do like what education can we get out there how can we make sure medical providers know what to look for and to call us so that if it does happen we're ready to jump on it and hopefully you know minimize the number of people surveillance and brought haven't seen it before they don't know what they're looking at oh you got a cold you got a runny nose surveillance and preventative actions are much easier to manage on the back end they're also much cheaper and less suffering so it's very very important AR there cases in surrounding counties none in North Carolina not yet did you
146have a question yeah I just had a quick question about these these new cases is this occurring in a population that is uh vaccinated already or is it so 92% of the cases that have been identified were reported so far were vaccinated was that number 92 92% yeah and that's from the CDC and the outbreak began in you know Western Texas and a group of unvaccinated folks there vaccinated folks American people from from from a menite from come from other countries I don't know that not necessarily I I've spent time in the Philippines and done medicine in the Philippines and I've seen measles you know I've actually seen lots of measles of beels uh didn't get it at least not them we but I'm vaccinated but so I mean our our country it's generally I
147mean as you pointed out it's very rare because we have a strong vaccinated programs other countries do not the numbers you say I know seem like they're a lot but if you kind of relative to the country that's pretty pretty small numbers but they're probably coming from somewhere but my my point is it's probably not here what they found it's being brought from other places in 2019 was the outbreak in the um in the Jewish population in New York and then here it's it's an unvaccinated group of people who then travel to another country that does not have any her immunity and they bring it back to you know so it's not that somebody's you know coming it's not being imported from a non- US person at Sometimes some many times not always of course
148not always but there's many diseases that were eradicated and now we're bringing them back and really so the big thing is um you know doing education education for not just local providers but um our School nurses child care providers um want to identify any potential pockets of vulnerability so if we have pockets of unvaccinated children no one where that are no one where that is and so you have a low threshold of Suspicion so if for some reason someone did develop symptoms you kind of have it's already on that radar um we're working actively to bundle um a few different um education campaigns to help provide information about measles um vaccination clinical diagnosis testing control measures um so that those populations already have that information um so when the case does come they already know
149the steps they have that foundational knowledge to respond um and then of course response preparation and Comm communication um we send out um Health alerts from the CDC we're working closely with um Community Partners our cchc nurses who serves serve our child care centers um and then you know as information comes from the state we promptly disseminate that any other questions any other question I have a quick just question about TB CU I know Charlotte Mech had a pretty sign significant TV outbreak if we had any more TV cases in the new count oh yeah so there's many we we've we had a significant increase um over the last year um there was one week where we got four cases in one week um and we've worked really hard we responded there were there have
150been no identified epil link cases so no spread um most notably I think we we did an update especially when we had the um Porter Ridge um exposure we did testing um no other cases um were identified with that testing now you know of course some students deferred testing declined parents declined testing um but there were no other um identified infections so we are counting also LTV cases which are late in cases not just TV disease okay yeah there's definitely been an increase so you're saying since that identified pter rdge case we have had more TB cases or yes ma'am not linked to that but no no but just in general do we get updates on that on numbers on that in this setting yeah if you want that we can build that in I'm
151just curious about it we typically get that update um annually with the um CD update but absolutely we can provide that [Music] before thank you any other questions I'm making this quick everyone that received a card or should have received a card we are doing our commit Health assessment um we do that every 3 years and we have surveys that um we need you to do um we have it in English and Spanish there's QR code on here we have got a lot of information out in all our social media and to Our Community Partners it's really important we're trying to get feedback from the community um for you to complete this and um I have some rack cards here if you'd like to bring some back to your work or other places I have
152a lot more upstairs so just let me know numbers we can drop them off we can do whatever you need us to do but we really want to get as many people to [Music] completed um I just want to talk about um the growing need of all human services departments um last year in FY 24 we did over 78,000 trips in transportation of those 78,000 trips 44,000 were for our seniors anyone over 60 um this year we are on track to do over 89,000 trips that is 11,000 more than what we did last year and it is just the Aging population in this community is growing and it's growing rapidly y um and they need all of our departments and this is we have a huge unmet need Transportation only runs Monday through Friday we're
153out there at 4:30 in the morning and we're done by six there is a bigger need than what we are we're doing today and we need to figure out how we get to that adment need so we can go to the board and ask for more time more days more hours to help our population thank you I have a question on that wasn't there a study that we looked at um I can't remember if it was here or or with your other group Stan like um where we looked at transportation and they were they looked at Wilson North Carolina and what they were doing um they looked at expanding cat all the way to wing it and having a like a Matthew stop there were different options we were exploring so Wilson is doing the
154microtransit yeah so what was the outcome with that so I [Music] don't we did so that was Jan Hansen did that um and the the study that we did was inconclusive it wasn't didn't give us much of anything so that's why we have to figure out how we can get to that admit need we know what's out there um we're doing a pilot program right now um someone else is running it and they're hitting the the schools and everywhere else but it's hard to get that information so we go to employers employers come to us they say can you help us sure what do you need well we don't know we've got to figure out what it is that they need they know our hours they know we only work certain times so they're not
155going to call and let us know they know they need trips because they know we don't work those um so that's that's something that in the future near future we're hopefully going to be able to to figure out and do a study on get more information have they seen a shift in the numbers with Medicaid transport changing this year like you know outside of y'all for different um so our numbers have grown from the brok bridge um we're doing a lot more Transportation but there are other other transport out there so one of the things with that is you know for dialysis they're 3 days a week so if they're Tuesday Thursday Saturday they won't give us the trip because we can't do Saturday they'll give it to another transportation [Music] department um but yeah
156there is a there's a lot and that would be something that we would take to the Commissioners for y'all to be able to do Saturday or or that's not what the ask is we need we need to know what that ask is right we need to know how much we're not doing because I can't go to the board and say we need Saturdays they're going to ask me why why do you need Saturdays because you're going to need more employees you're going to need more Vans you're going to need a lot of different things you're going to need dispatch so if I don't have a solid case of exactly what I need so will DHHS have the numbers on that Medicaid transfer with the other Brokers at the end of the year like with the
157expansion I mean I can that's something I can talk to the Brokers about but I'm not sure how much they're going to share their numbers with us [Music] yeah what do you mean by broke you said Brokers so Medicaid Brokers so DHHS transport that Medicaid cor okay how many Vans do we currently have how many drivers do we have so that is a loaded question about vans today we have 28 Vans um today we have 28 Vans right since Co those vehicles are um not built the same so although we have 28 Vehicles we'll have five off the road at any time for repair there are little things that we have Ford vehicles so little things that Ford is not doing recalls that are happening they're just those vehicles are not what they used to
158be so there there's a lot of um mechanical issues that happen with them that take them off the road right now I have five vehicles off the road out of how many 28 we have five off the road yes sir how many miles do you put on average on these Vans each year um I'll tell you we do almost 700,000 Revenue miles so that's miles with someone in our vehicle in those 28 Vehicles so you could say we do anywhere from 40 to 50,000 a year and the useful life on a vehicle is 100,000 miles so at 100,000 miles they have to make that 100,000 miles and I can request another vehicle but it takes me a year to get that vehicle so by the time I get that vehicle we're looking at 150 to
159160 and there was a backlog so some of our vehicles have2 000 miles on them or more so it's really amazing thinking about Teresa and the team the addition of the trips that have been done that we're on on track to do this year are being done with the same siiz Fleet basically and the same Staffing and so from an efficiency perspective as well so not only is the demand there but the team is knocking it out of the park and answer your other question we have 36 drivers so we have a combination of full-time drivers benefited part-time drivers and part-time drivers are those those white Vans with the Union County sticker on them that I see outside of uh the basemore center yes you have to have a CDL to drive those no you
160don't we just under the CDL requirement oh okay how many people do they hold it depends on the vehicle so we have many bans that hold maybe two um which we're getting rid of cuz our demographic is they're just not good for them um and then we have 13 passenger and then we have also have a passenger two wheelchair we need to talk I'm here have a b no get get some more decent ones yeah like a bigle hi Michelle Maran Services first of all I want to apologize I've missed several meetings in the last couple months and I apologize to the board for that um veteran services is doing fine I just want to say like Janet mentioned a lot of what we do is an uncountable measure uh I would love to bring
161some personal statistics to the board at some point with personal stories and how we touch them and how we change their lives um if they would want to come with I would love to have them come share their story um for example in December I'm still kind of on the high of my December win if you want to call it that um one an appeal that we took to the law judge on denial for a disability claim and the gentleman got a back pay of $180,000 I mean that's life altering and he was ready to give up and I refused to let him get up so give up so just those are the kind of stories that I would love to bring to you because those are things that I can't really capture in a
162number except 108,000 good job thank you amazing hey Ashley DSS I don't have an update it's 8:30 that's your [Music] update I don't have anything else except to welcome no our new member who is filling one of our or a position engineering position would you like to introduce yourself sir hey everyone I'm noise aragan you said everything I'm I'm an engineer I moved to UNI County in 2008 so this is my first uh board First Community Service G so thanks for having me I voted for you [Music] I make a motion [Music] to it's still [Music] raining what