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022720Special Meeting Planning Retreat February 27, 2020 The Randolph County Board of Commissioners met in special session at the Randolph County Emergency Services Building, 760 New Century Drive, Asheboro, for a Planning Retreat. Chairman Darrell Frye, Vice -Chairman David Allen, Commissioners Kenny Kidd, Maxton McDowell, and Hope Haywood were present, as well as County Manager Hal Johnson, Assistant County Manager/Finance Officer Will Massie, Associate County Attorney Aimee Scotton, Clerk to the Board Dana Crisco, and Deputy Clerk to the Board Sarah Pack. County Attorney Ben Morgan entered where noted. County Department Heads/staff and outside agencies were in attendance and made presentations where so noted later in these minutes. At 12:30 p.m., Chairman Frye called the meeting to order. Chairman Frye welcomed the Board and audience members to the 2020 Planning Retreat. This is an opportunity for Departments to update the Board on current issues in the County. He asked County Manager Hal Johnson to give an overview of Retreat topics. Mr. Johnson said that the Board is addressing more issues at one time than any Board has had to do in the history of the County. This shows the changing environment of the 21s' century. The budget process will start in the next few weeks with reviewing formal requests from departments. The Planning Retreat is designed to look at strategic issues facing the County. This will be one of the most difficult budgets the County has ever faced due to the many unknown factors influencing the budget. He gave an outline of the Retreat agenda. Rural Health Care Stabilization Fund Application Update Chairman Frye said that he, Vice -Chairman Allen, and County Manager Hal Johnson are members of the Randolph Health Restructuring Committee. They receive updates weekly but things change from week to week. Ben Morgan entered at 12:38 p.m. If the current discussions with a successor hospital continue, the application process will have to be completely redone. The application that was submitted is not the same as what is currently being discussed. It is likely to be April before there will be a firm plan for a successor hospital. Chairman Frye reminded Board members of a Closed Session next week regarding the hospital and that a successor hospital is required in order for the loan of $20 million to be approved as a part of the Rural Health Care Stabilization Act. Donovan Davis, Emergency Services Chief, said Emergency Services will be impacted if the current hospital facility closes. Approximately 30,000 patients visit Randolph Health each year. Assuming that 50% of patients will transport themselves to an out -of -county hospital, approximately 41 patients per day will need ambulance transport requiring four new ambulances. Eighty percent of patients are admitted through the Emergency Department. Four additional telecommunicators will be required as well in order to handle increased call volume. The estimated financial impact on Emergency Services comes to $3.5 million the first year. Subsequent years 2/27/20 will be approximately $2.4 million annually. A standalone emergency department will not eliminate the need for the four additional ambulances unless the new emergency department has its own ambulances available 24 hours a day, seven days a week. Emergency Medical Services (EMS) will still be required to handle transports to the new emergency facility. Chairman Frye asked what role Piedmont Triad Ambulance and Rescue will play. Mr. Davis said Piedmont and Ash -Rand Rescue Squads do a lot of transfers to and from nursing homes or to Hospice. This frees up paramedic ambulances to handle more serious calls. He anticipated that franchised ambulances will possibly become busier. Mr. Davis gave a description of the financial impact on citizens who visit an emergency department with monitoring beds at a new hospital versus simply visiting a standalone emergency department. Citizens will potentially be charged twice if there is only a standalone emergency department; if hospital admission is necessary, the citizens will be transported a second time to a larger area hospital. Going out -of -county in this instance would be cheaper for the citizen. Commissioner Haywood asked why nursing homes do not provide transport services. Mr. Davis said that most nursing homes will provide wheelchair services, but in many instances these patients cannot sit up and require gurney transport. Susan Hayes, Public Health Director, said the mission of Public Health is to preserve, protect, and improve the health of the community. There are certain services that Public Health is statutorily required to provide, contract for, or certify as available. There are several areas of concern if there is no hospital. These include maternal health and women's preventative health including family planning and breast and cervical cancer control. In other cases where a hospital has closed, Counties have lost their maternal care and labor and delivery facilities. Breast and cervical cancer services are currently available through the hospital to women over 55 years of age. It is worrisome if there is not an obstetrician or gynecologist nearby. Prenatal care is a big concern. Most children are Medicaid eligible. Public Health ensures prenatal care for low-income women through the MERCE Clinic. It is difficult to estimate costs affecting Public Health. Last year there were 1600 births in Randolph County, 702 of which were at Randolph Hospital. Commissioner Haywood asked, out of the births last year, how many complications or issues were there requiring immediate care. Ms. Hayes was unsure of the totals. Indigent women are asked to deliver at Chapel Hill if the delivery is not imminent; however, some do not travel to Chapel Hill and instead go to Randolph Health. Mr. Davis said there are probably less than 50 transports made by EMS in regards to birth or delivery issues. Commissioner Haywood shares the same concern with Ms. Hayes about a potential lack of labor and delivery services. As a mother, It is different when it's you and your child. Chairman Frye said that obstetrics and orthopedic services are in Randolph Health's proposal and have been since the beginning. Vice -Chairman Allen agreed and said the proposal is fluid at this point. Ms. Hayes said Public Health will do whatever they can to provide care but there will be costs to make up the gap. 2/27/20 Mr. Johnson asked what the number one Public Health issue facing Randolph County is. Ms. Hayes mentioned that communicable disease is labor intensive. The County also needs prenatal care. It is difficult to rank what is most important. Repayment Terms of Rural Health Loan Will Massie, Finance Officer, discussed payment terms of the Rural Health Care Stabilization program application. Repayment would require a $1 million principal payment plus one percent interest annually with a twenty year term. Repayment will begin at the end of the three-year transition period, in September of 2023. He showed the projected principle and interest amounts and the property tax effects. The revenue sources that are being considered for pay back methods are property taxes, sales taxes, or landfill lease revenue. Mr. Massie asked Commissioners to begin considering the proposed payback methods so that a decision could be made in the future. He described the drawdown of the $20 million proceeds and asked the Board's preference on the process for transferring funds for Randolph Health 2.0. Chairman Frye suggested making a Board decision to draw down funds based on the status of Randolph Health 2.0. Mr. Massie recommended updating the County debt policy. If the County borrows the money, Randolph Health would have to be a component unit for the County. Completion of the Randolph Health 2.0 audit will be critical to the County being able to issue its audited financial statements timely. Commissioner McDowell said that budgeting in this manner is complicated and will have an effect on County financials. Fiscal Year (FY) 20-21 will be the first year affected. Mr. Massie is not sure how the many other agencies under the Randolph Health umbrella will be affected by the bankruptcy. Commissioner McDowell said that the County's contract auditors will be required to review the Randolph Health audits and the timing will be critical. Commissioner Allen said the audit would have to be done on time and still give the County enough time to review before the County's audit is due. Commissioner McDowell said most hospitals' fiscal year end is September 30th so any attempt to change that date may give some kick back. NCACC Risk Management Pools Michael Kelly, Director of the NCACC Risk Management Pools, said that the Worker's Compensation Pool was the first pool established in 1980. In 1986, the Liability and Property Pool started. Pools were established by statute at the request of county commissioners in response to a lack of coverage. Cost was a secondary consideration. These pools are available only to county governments or county -related entities and allow the entity to self -insure. Pools involve similar groups of entities and allow them to design their own "insurance policy." Seed funds are collected to compensate for initial losses. Losses below a specific level are self-insured. Excess coverage, or reinsurance, can be purchased above the retained level. Premiums can be adjusted as needed. There is group buying power on services and customized coverage designed specifically for the members. Mr. Kelly stated that property insurance is extremely volatile. He showed trends for each Pool since 2014 and demonstrated Liability and Property Pool growth. Randolph County has 2.4% of the overall pool. The NCACC Pools are audited annually. The financial objectives are to collect 2/27/20 enough contributions to pay claims to their conclusion, cover operational expenses, and provide surplus for unexpected claims or expenses. Pool sustainability allows member stability. Mr. Kelly said controlling losses allows the NCACC to offer good rates. Base rates have not increased since 2011. Mr. Kelly thanked the County for being a member. Chairman Frye expressed his appreciation to the NCACC. Randolph Room and County Museum Project Ross Holt, Library Director, gave an update on the Randolph Room and the creation of a Randolph County History Museum. These projects move the County toward strategic planning goals of preserving historical resources and drawing visitors to the County. Moving the Randolph Room to the first floor of the Historic Courthouse will more than double available space. There are three phases that ideally would line up with the fiscal years. Phase 1 includes the architectural design phase, staffing needs assessment, and a budget request. Phase 2 includes renovation of the old Administration building, relocation of the Randolph Room, museum planning, and a budget request for the History Museum. Phase 3 will be development of the History Museum. Currently, we are in Phase 1 and preparing for a budget request to include capital outlay and operating expenses. Staffing will need to be addressed. Currently, there are three staff members in the Randolph Room working a total of eighty hours per week. Staffing in the new building will be treated as a small branch library because of an absence of immediate support from the Asheboro library. There is a security issue after hours as well. The museum will require a director or curator who will be involved from the ground up. Mr. Holt proposed a new staffing arrangement that would include a part-time position and three full-time positions. He detailed the proposed Phase 1 costs which equate to a net total of $91,263. Mr. Johnson asked how many people visit the Randolph room annually. Mr. Holt deferred to Mac Whatley who answered that the average is about 25 people per week. Commissioner Allen asked about the financial impact of the museum including additional County revenue. Mr. Holt spoke with Tammy O'Kelley, Tourism Development Authority Director, about it previously and will work with her to predict the total impact. The Board recessed at 2:07 p.m. and reconvened at 2:25 p.m. Capital Proiect Updates Mr. Massie presented the Capital Improvements Plan. He showed the project costs from 2018 forward. The remaining projects to finance include the Courthouse renovation, the Detention Center renovation, and the renovation phase of Asheboro High School. Mr. Massie asked the Board to consider whether the mobile classrooms should be leased with current resources or financed over twenty years. He asked Commissioners to consider if the remainder of the Detention Center project should be financed with additional debt or if it should be a pay-as-you-go project. 2/27/20 Per Fiscal Policy, any Fund balance above 24% of budgeted General Fund expenditures is to be used for capital projects or capital reserve. The June 30, 2019, fund balance is $3,738,125 above the 24%. He asked how best to utilize these funds and described a proposal that includes the Courthouse renovation, Northgate, Randolph Room/Museum, and Detention Center Renovations which comes to $3.7 million. Paxton Arthurs, County Engineer, said his presentation is broken into two parts: an overview of projects and focus on the Detention Center. There are more capital projects now than ever. He gave an update of the renovation work at Northgate Commons. The work is ahead of schedule and under budget, allowing for additional work to be done. He showed photographs of the interior and exterior of the facilities at Northgate Commons. Public Health's Women, Infants, and Children (WIC) Program has a presence at Northgate that has been very successful in helping to meet caseload goals. Dollar General's lease ends in 2020 which will open space for Child Support Services to relocate. The Asheboro Police Department has been looking for a satellite space in north Asheboro. A proposal will be presented to the Commissioners at the regularly scheduled meeting on March 9, 2020, that addresses leasing the Old Bank Building in the Northgate Commons parking lot to the City of Asheboro for a satellite Police Office space. Commissioner McDowell said that citizens are very complimentary of the work done at Northgate. Citizens agree that the cardboard outside of the Dollar General needs to be addressed. Commissioner Haywood said that citizens appreciate repurposing that building and the impact it has had on that end of town. Mr. Arthurs said the old theater is an eyesore. It is in dire need of renovation and repair. The tenant has been notified that their lease will be ending. Chairman Frye asked for costs of renovation. Robert Cross, Maintenance Director, responded that a rough cost estimate for a new roof and two new Heating Ventilation Air and Cooling (HVAC) units would be $180,000. Demolishing the building instead would cost an estimated $30,000. Some potential future projects include the expansion of Social Services facilities, Juvenile Day Reporting Center space needs, and the lease for Cooperative Extension. Commissioner Allen said that the office space for Cooperative Extension worked well, but it may be beneficial to have some "green space." Mr. Arthurs said there are two phases for the renovation of the Detention Center. Phase 1 includes the new housing addition and is currently under contract. Phase 2 is the renovation work that is considered critical. He detailed potential changes and additions and the costs. The total adjusted Guaranteed Maximum Price for both phases will be between $34.6-35.1 million. Phase 1 is projected to be complete in March 2021. The final completion date of Phase 2 is September 2022. Chairman Frye said it has taken a lot of patience and cooperation to complete these items without putting the County at risk or putting the taxpayer at a disadvantage. He commended everyone involved in the process for being on track and completing the project in a timely and orderly fashion. 2/27/20 Commissioner Allen asked what the Detention Center capacity would be at the end of Phase 1 of the renovation. 211 is the current capacity. Colonel Aundrea Azelton, Chief Deputy, answered that capacity would be discussed during the staffing presentation. Detention Center Personnel Needs Colonel Azelton presented a request for staffing the Detention Center expansion. Thirty-four positions will be required in order to staff the facility appropriately. Twenty-eight new positions are requested by April 1, 2021, to staff Master Control, N -Pod (Special Populations), and J- and K -Pods to relieve overcrowding and classification issues. The completion date for Phase 1 is March 1, 2021. She gave an overview of the units projected to open. The expansion will increase the capacity by 207 beds. Currently, administrative units are fully staffed with 22 positions. The total cost is $1,725,276 for the 28 officers in FY20-21. This includes the one-time costs of uniform and duty gear ($4,875 per position). Sheriff Greg Seabolt said he has spoken with a jail inspection representative who said that Randolph County has one of the few Detention Centers in the state that is fully staffed. At times there have been over 300 inmates in the jail. Commissioner McDowell asked if the Detention Center is consistently overpopulated. Sheriff Seabolt said that Randolph County was at the top of the list for overpopulation in the state last year. The Detention Center is currently housing 267 inmates. Commissioner McDowell clarified that the new 28 positions would allow the department to handle the expansion. Chairman Frye asked if these positions are in addition to the positions they've already been given and Sheriff Seabolt said yes; they received and staffed eight fully - funded positions in the FYI 9-20. Commissioner Allen again asked the housing capacity between Phases 1 and 2. Colonel Azelton said it will depend on which unit is being moved and their current capacities. At the end of the process the capacity will be 419. There are a lot of variables that dictate where an inmate can be housed. Next, Sheriff Seabolt presented a request for additional staffing at the Courthouse. Two additional deputies are needed. Since redistricting, the County has received an additional Superior Court Judge and an additional District Court Judge. With the additional court proceedings as a result of gaining two judges, additional deputies are needed. He showed a cost breakdown of the positions with a total $135,854 including the one time costs of uniform and equipment of $7,300 per deputy. There are currently 21 officers staffing the Courthouse. Commissioner McDowell asked how much notice the Sheriff's Office gets about heavy or light court weeks. Sheriff Seabolt said Captain Jeremy Lanier can look at the docket to adjust the number of deputies needed. Captain Lanier said they will know a month or two in advance which courts are running; a week or two in advance the clerks will arrange the dockets. The Sheriff's last request was for two detectives in the Criminal Investigations division. Currently there are 13 detectives. Last year there were 1,883 cases. In 2019, the division became 2/27/20 involved in the Project Safe Neighborhoods (PSN) initiative. In order to handle the ever-increasing caseload and new PSN program, additional detectives are needed. Human trafficking is also becoming an issue for the County. Sheriff Seabolt showed a cost breakdown for two detectives totaling $228,642 including one time costs (uniform, equipment, vehicle purchase, auto setup, laptop/sierra/in-car radio) of $45,982 per position. Commissioner McDowell agreed with the Sheriff that human trafficking is a rising issue. Sheriff Seabolt said staff have received specialized training in order to combat human trafficking. He thanked the Board for their attention and consideration. Emmency Services 12 -Hour Shift Transition Personnel Mr. Davis said that two ambulances have successfully been converted to 12 -hour shifts. There is an increase in morale and energy amongst the staff, the staff is very pleased with the switch. The hope is to move four trucks to 12 -hour shifts in the next fiscal year. The addition of seven positions will be necessary for the conversion of the Archdale and Randleman ambulances in July 2020 and the Liberty and Ramseur ambulances in January 2021. Converting the Trinity, Uwharrie, and Erect ambulances during FY20-21 will complete the conversion. There will be an additional telecommunicator request as well in June during the budget presentation for Emergency Services. The morgue is new to the County; to date, there have been 359 decedents processed through the morgue. If something happens to the hospital morgue, a larger facility will be needed. Chairman Frye called for a recess at 4:00 p.m. and the Board reconvened at 4:15 p.m. Randolph Economic Development Corporation Update Kevin Franklin, Economic Development Corporation (EDC) President, introduced Crystal Gettys, EDC Business Recruitment Director. Ms. Gettys thanked the Board for their support of the EDC. She described what the EDC does for the community and showed the community impact of industry growth and the increase of tax dollars as well as community impact of a declining tax base. She explained how to attract new companies and detailed what companies and site selectors, or "site eliminators" as she called them, look for when locating their operations. Ms. Gettys stated that buildings and sites, referred to as product, and product development are needed in Randolph County. To attract companies, buildings with average ceiling heights of 24' to 36' are needed as well as sites and industrial parks that are controlled by the public sector, have completed environmental studies, have infrastructure already in place, and are ready for construction. Companies look to eliminate communities who are not prepared and ready. A readily available building is the carrot that attracts companies to look at a community. Having product shows belief in the community and preparation for the future. She showed an inventory of facilities in Randolph County listing current building, park, and site availability. A public/private equity arrangement is beneficial to the community because the public sector can obtain control of a property for little or no money down and the private sector can earn more for their property than it is currently worth. This provides the public sector time to develop the property and gives the EDC product to market. The cost, location, accessibility, utilities, and developability are taken into consideration when considering property. 2/27/20 The EDC is asking the Board to consider a public/private approach to obtain control of property or construct a spec building. Ms. Gettys urged the Commissioners to help Randolph County be more competitive on projects and help provide product for the EDC to market to attract new industry. Chairman Frye agreed with Ms. Gettys that a new approach is needed to attracting business to Randolph County. Mr. Franklin said a study on water/sewer availability in conjunction with developable land would make sense. This would allow the EDC the opportunity to find sites that would bring in new business. Randolph Community College (RCC) Capital Needs Update Dr. Robert Shackleford, Randolph Community College (RCC) President, thanked the Board for the opportunity to present RCC's capital needs. He introduced Board Chair Mac Sherrill who was in attendance in the audience. He gave an overview of the projects RCC had completed with the capital funding provided by the County. These included the renovations to the Archdale welding facility, the Richard Petty Education Center, the Continuing Education and Industrial Center, the Cosmetology Center, the Ann Hoover Welcome Center, and the Photographic Technology facility. Dr. Shackleford described the capital improvements facing the college. The Library and the security system infrastructure both need updating. Real property acquisitions are another need to house culinary and construction trades. Chairman Frye asked if property is available to meet this request. Dr. Shackleford said a property with the potential for the construction program may become available soon. Dr. Shackleford spoke of the backlog of renovation projects based on the Master Facilities Plan. This includes replacement of chillers and boilers, roof replacement, HVAC replacement, window upgrades, ductwork replacement, bathroom renovations, and classroom renovations. Dr. Shackleford thanked the Board for their monetary investment and reminded them that RCC will be good stewards of the money. Employee Health Plan Trends Sam Varner, Wellness Administrator, gave an overview of employee health plan trends. Between 2013 and 2018, there was a single digit annual increase to the Health Insurance plan. Last year, there was a double digit increase. Ten of the top twelve drivers of health care costs are related to pharmaceutical costs and high claim medical costs. Two of the twelve drivers are behavior related: diabetes and hypertension. Diabetes treatment costs have declined which can be attributed to the programs available to employees. In order to lower health care costs, some recommended areas to investigate include pharmaceutical prices, high-cost health areas, biometric screening participation, access to a primary care physician, "buy -in" from Department Heads, and Employee Assistance Program (EAP) rebranding. Mr. Varner suggested researching ways of lowering pharmaceutical costs by setting up a task force that would include Commissioner Haywood, Ashley Duggins (Pharmacist and Vice President of the N.C. Board of Pharmacy), Jill Williams (Human Resources Director), 2/27/20 Sam Varner (Wellness Administrator), and others. Health Coaching access, expansion of the diabetes management program, and access to an athletic trainer to reduce musculoskeletal pain and injuries will help lower costs. Biometric screening participation decreased from 85% to 72% over the last five years. Increasing employees' share of health insurance premiums for those who do not qualify will ease the financial strain on the County and encourage greater participation. Easier access to a primary care physician will improve participation as well. An on-site medical clinic is being researched. "Buy -in" from Department Heads will assist in growing participation. Thus far, 73% of employees in the diabetes management program have lowered their Alc since 2017. The added athletic training program has been successful. Expanding Health Coaching and diabetes management programs to dependents and adding hypertension management for employees are great additions to help control chronic conditions. Access to no cost brand name drugs for diabetics has allowed for great cost savings. Rebranding the employee assistance program will give a strong resource to employees. The Health Coaching class at RCC is now accredited, allowing participants to earn certification thus increasing access to health coaches in Randolph County. Sixteen Health Coaches will graduate this year. They facilitate behavior change to improve health. Commissioner Haywood asked what behaviors are addressed in Health Coaching. Mr. Varner answered that any behavior can be addressed; the Health Coach partners with the client to explore behaviors and facilitate change. Budget Priorities for Fiscal Year 2020-2021 Mr. Massie detailed budget priorities for the FY20-21. Next week, County departments will begin working on their budgets. The projected costs of the employee health plan for the FY20-21 has risen by 17% which equates to a $1.2 million increase. The average monthly costs are up 27%. He proposed the question, "Would the Board consider dedicating a specific amount of fund balance as a reserve to cover future excess medical claims?" He suggested putting aside a two or three years' equivalent of an individual stop loss limit. Commissioner McDowell agreed and asked the Chairman to consider the request. The N.C. Local Government Retirement System proposed rate increase is 10.15%, or $470.000. The law enforcement officer increase is an additional .75%. There is an estimated 1% pay plan adjustment ($450,000 before new positions are added). Six positions that were requested were not funded in the FYI 9-20 (five Emergency Services positions and one Building Inspections position). A one percent increase for education funding equates to $284,301. The property tax collection rate through January 31, 2019, was 93.08%, where the rate was 92.02% through January 31, 2020. Sales tax is 6% ahead of budget with online sales shifting collection patterns. Assumed priorities for the upcoming fiscal year included anticipated increases in retirement and health care costs along with a Cost of Living increase for employees. The continued implementation of 12 -hour shifts for Emergency Services staff and phase-in plan for additional Detention Officers are included as assumed priorities as well. The landfill lease allocation contributes a $1,000,000 commitment to capital improvement plan financing. There is an additional inflation adjustment of approx $90,000. There are no new variable tonnage revenues expected for FY 19-20. 2/27/20 Chairman Frye said that the Courthouse Deputy positions are critical to consider in the upcoming budget year. Open Discussion Chairman Frye opened the floor for Commissioner discussion. Commissioner Allen said there is a lot of work to do on this budget. Chairman Frye said there may be money in the vetoed State Budget for community colleges. He thanked the Board and audience members for their attendance. Adjournment At 6:08 p.m., on motion of Allen, seconded by Kidd, the Board voted unanimously to adjourn. Darrell Frye, Chairman David Allen Kenny Kidd Hope Haywood Maxton McDowell Sarah Pack, Deputy Clerk to the Board 2/27/20