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061311June 13, 2011 The Randolph County Board of Commissioners met at 6:00 p.m. for a special budget session in the 1909 Randolph County Historic Courthouse Meeting Room, 145 Worth Street, Asheboro, NC Commissioners Holmes, Frye, Kemp, Haywood and Lanier were present. Randolph Arts Guild Derrick Sides, Randolph Arts Guild Director, spoke in support of his agency's request of $20,000 for funding from the County. Via PowerPoint presentation, he reviewed the history of the Arts Guild and summarized the programs and events that the agency offers to Randolph County's citizens. Mr. Sides stressed that the Arts Guild needs local government funding for matching grant requirement of grants it receives for operating expenses from the State. He said that last year, with the County providing no funding for the Arts Guild, he asked for the Community's financial support, and they were able to fill some of the gaps of the budget. However, he does not want to have to ask the community for help this year. Mr. Sides said that the $20,000 request is the keystone to funding all the events and programs in the coming year. Communities In Schools (CIS) Sandi Norman, Communities in Schools Executive Director, reported on CIS activities and successes during the past year and also mentioned that the CIS of Randolph County received national accreditation in January 2011, which ensures that CIS -Randolph County meets the highest standards of business practices, as well as, implementation of services at the school sites. Ms. Norman said that CIS has leveraged the funding that the County has invested in her agency to bring more funding for CIS through grants, United Way funding, contributions from businesses and individuals, state funding and in-kind services directly to the schools. She asked the Board to consider their funding request of $85,000. Randolph Vocational Workshop Larry Bulla spoke in support of Randolph Vocational Workshop's request of $15,000. He said that they currently are working with 35 clients. According to Mr. Bulla, the agency receives $5,000 from Vocational Rehabilitation for every client that is placed in a job. However, due to the poor economy, his agency has placed only one client so far this year, and consequently, is looking at an $80,000 shortfall to their budget. He urged the Commissioners to approve their funding request. Central Boys & Girls Club (CB&GC) Elbert Lassiter, CB&GC Board Chair, and Director Thomas Falgout, spoke in support of the CB&GC's funding request of $25,000 and provided information on the number of youth served (currently 180), the types of services and programs offered and statistics on the effectiveness and successes of the programs. He noted that 85% of members passed the EOG on their first try. He urged the Board to fund their request of $30,000. Partnership for Children (PFC) PFC Director Pauline McKee spoke in support of her agency's request for $29,000 in County funding for the "Parents as Teachers (PAT)" program in Franklinville and Ramseur. The PAT program is a voluntary family education and support program for parents of young children and is based on the beliefs that parents are their children's first and most influential teachers and that the early years lay the foundation for children's success in school and in life. PAT provides the information, support and encouragement parents need to help their children develop optimally during the crucial early years of life. The PAT model focuses on families with children from before birth to kindergarten entry, and includes these four components: personal/home visits by certified parent educators; parent group meetings about early childhood development and parenting; developmental and health screenings for young children; linkages and referrals to community networks and resources. Rev. Jason Golden, Youth Minister at Parks Crossroads Church in Ramseur, also spoke in support of this request, citing examples of the benefits of the program. Ms. McKee said that this is a one-time request; PFC will develop other sources for funding next year. Regional Consolidated Services Becky Muraszewski spoke on behalf of and in support of Regional Consolidated Services' request of $2,000 for its Home Improvement Program (HIP). She said that services are provided to Randolph County residents who are age 60 or over, have a functional disability and may be socially or economically disadvantaged. This program is designed to improve the efficiency and safety of an older adult's residence while maintaining their independence in the home. Types of services routinely provided include: minor plumbing/electrical repairs, installation of locks and other security features, and home modifications (wheelchair ramps, hand rails, grab bars). The HIP may also provide basic household furnishings and home appliance repair or replacement. Ash -Rand Rescue Squad (ARRS) Larry Pugh, Ash -Rand Rescue Squad Director, spoke in support of his funding request of $18,000 rather than only the $16,000 that is included in the Proposed Budget. He also asked the Board to consider ARRS's capital request of $50,000, which is not included in the Proposed Budget, for the replacement of all vehicle mobile and portable two-way radios that are on the ambulances and rescue trucks. ARRS wants to provide all operations officers with new portable radios to allow them the ability to communicate with the Randolph County 911 Center and all other emergency service agencies in the county that are going to the NC Viper Radio Communications system. He said their current radios meet the FCC mandate of narrow frequency banding, but do not meet the specifications to operate on the VIPER system. Randolph Hospital Bob Morrison, Randolph Hospital President, gave a PowerPoint presentation regarding his request of $298,777 to help offset the cost of treating mental health patients in the Emergency Department (ED) of the hospital. Mr. Morrison said that Sandhills Center (the local management entity designated by the state to care for mental health patients in Randolph and seven other nearby counties) does not provide qualified psychiatric care for citizens with mental health issues after hours and on the weekends; therefore, these patients come to the ED of the hospital for care. There is no access to psychiatrists for patients in the ED. The psychiatrists who have been treating the patients cease providing any service "after hours," and the patients are directed to Randolph ED. Once the patient has arrived at the hospital ED, they essentially lose access to the mental health system unless and/or until they are admitted to an inpatient psychiatric hospital, which can be a contributing factor to unnecessary admissions. Also, when long waits for transfer are required, there is no psychiatrist available who could begin adjusting medication during the wait, thereby possibly shortening the hospital stay or allowing the patient to be discharged to home from the ED. A patient many times is held against his will for days awaiting involuntary commitment. These extended waits in the hospital ED holding area oftentimes agitate patients and compounds their problems. Mr. Morrison said that 20-25% of Randolph Hospital ED's capacity is used for mental health holding, thereby causing excessive waits for other patients and increased risk for those patients. The hospital has incurred the cost of creating and staffing a mental health holding area (nurses, security guards, attendants, medications, and support services) at an approximate cost of $1,000,000 annually for a service that is little more than a waiting room for those in need of transfer. Mr. Morrison said that Sandhills has now committed to providing limited psychiatric consultation, but several problems remain: 1) program has yet to be implemented; 2) Sandhills reserves the right to cancel at any time; 3) service applies only to patients in the ED and not to hospital inpatients; 4) service will be provided only five days/week, Monday -Friday; 5) Sandhills will stop funding payments to the Randolph Hospital ED physicians for the critical services they provide. Mr. Morrison requested the following: 1) That Sandhills LME commits to the Randolph County Board of Commissioners that Sandhills will provide psychiatrist services seven days a week to all mental health patients who need it throughout Randolph Hospital and reinstate appropriate compensation to the ED physicians with the funding that the County provides them. 2) If the above cannot be arranged, Randolph Hospital requests that $298,777 from the County's appropriation to Sandhills be reappropriated to Randolph Hospital for "after hours" mental health services, which will: 1) provide consultation, evaluation and medication management services; 2) decrease delays in treatment; 3) decrease unnecessary inpatient psychiatric hospitalizations and reduce costs to taxpayers; and 4) improve patient outcomes. Mr. Morrison answered questions from the Commissioners. When asked by the County Manager about a rumored future lawsuit brought by Randolph Hospital against the County, Mr. Morrison said that the Hospital was not considering a suit against the County; however, they may have no choice but to bring a suit against Sandhills and/or the State if the situation is not rectified. Piedmont Authority for Regional Transportation (PART) County Commissioner Vice -Chair Darrell Frye gave an update on the financial challenges that PART is experiencing. With Federal and State grant funding decreasing, along with the decrease of revenue from the 5% tax on gross receipts of rental cars due to the poor economy, it has become necessary to make the following changes: 1) reduce some routes with low ridership; and 2) increase fares. A third proposed option of imposing a $3 annual license fee in each county was abandoned due to lack of support from Counties. He said that fees were raised as much as legally permitted. He said that the projected shortfall for Randolph County is estimated at $149,000. Commissioner Frye said that if no other funding source is identified, all PART services will be eliminated for Randolph County by the end of August. Budget Public Hearing At 7:32 p.m., Chairman Holmes declared that the duly advertised public hearing on the budget was open for public comment. Paul A. Rossiter, Jr., 6935 Old NC Highway 13, Asheboro, spoke regarding the problem with the mental health patients being seen "after hours" at the Randolph Hospital ED. He said that these people are human beings and should be treated with respect, despite their sometimes inappropriate behavior. He asked the Commissioners to seriously consider the Hospital's dilemma and help them remedy this situation, as proposed by Mr. Morrison. Recil Williamson, Westside Fire Department Chief, spoke in support of Westside Fire Department's request for a fire tax increase, saying that this is the first time that their budget has been in the red. He discussed the need for new equipment and the continued decrease in volunteer firefighters. He also mentioned the expense for the new VIPER radios. Chief Williamson said that he is hopeful that all property in the district will receive an insurance rating of "5" upon the next Dept. of Insurance inspection. Jane D. Bridges, 848 Mountain Valley Place, Asheboro, spoke in support of PART services in Randolph County, saying that she was the first official rider on Route 10 on June 10, 2008. She said this is a much-needed service, especially with gas prices increasing and the large number of citizens who commute to work in Greensboro. She also said that it's the "green thing to do." She said she will continue to try to educate the public on the benefits of public transportation. She also said she would like to see some tax dollars spent for this purpose. Chairman of the Board of Directors Tim Zander, Chief Andy Lyndon and Department Treasurer Daren Fuller, spoke in support of Fairgrove Fire Department's request for a fire tax increase from 6.5¢ to 8¢, and added that they needed the increase two years ago, but due to the economy, they made do. Mr. Zander said that they have made cuts in every area possible. Now, it has become critical in asking for the rate increase. He said that Davidson County is also considering the Department's request for a 1'/z¢ increase there. Jody Osborne, 5470 Taylors Run Dr., Clemmons, NC, spoke in support of Mr. Morrison's request for Randolph Hospital. He said that it was important for the Commissioners to understand the dilemma that emergency room doctors face when mental health patients in crisis come into the emergency room. The ED physicians are not psychiatrists and cannot diagnose or effectively treat or prescribe medications for these patients. He said that these citizens need and deserve a psychiatrist. Kyle Dixon, Franklinville Fire Department Chief, spoke in support of Franklinville Fire Department's request for a fire tax increase, saying that all property owners in this 64 sq. mile district deserve adequate fire protection. However, according to Chief Dixon, there are 190 parcels on the outskirts of the district that have a Class 10 insurance rating. The district needs a third station, but once a station is added, the State requires that the department add eight firefighters to its roster. According to Chief Dixon, the cost to outfit a firefighter is $3,200. He also added that additional funding is needed for the VIPER radios. Tracy Boyles, 4104 Salem Church Rd., Farmer, and President of the Farmer Elementary School PTO, spoke on behalf of the county schools' budget. He said that the community doesn't have any say in the school budget anymore. He believes there are cuts that could be made. He asked the Board to look closely at the schools' budget and to ask plenty of questions. He added that people here are concerned with education in this county. At 8:16 p.m., hearing no further comments on the proposed budget, Chairman Holmes closed the public hearing. Adjournment At 8:16 p.m., there being no further business, the meeting adjourned. J. Harold Holmes, Chairman Darrell L. Frye Phil Kemp Arnold Lanier Stan Haywood Cheryl A. Ivey, Clerk to the Board