HHS Board Meeting

Thank you. All in favor say aye or hands. Aye. Any opposed? All right, our agenda is confirmed. In accordance with the State Government Ethics Act, it is the duty of every board member to avoid both conflicts of interest and appearance of conflict. So please make that known if appropriate. Thank you. Alright, our next action item is a review of our April board minutes, which you received in email. Are there any edits or adjustments that are needed? Hearing none, I'll need a motion for approval of the minutes. I'll motion to approve. Thank you, Eli. Second? This is Linda. I'll second. Linda, thank you. All in favor of approval of the minutes? Say aye. Hands? Thank you. Any opposed? Okay. Thank you. All right, our minutes are passed as written. All right. So our next item is our presentations of our program committees. First one up is our Community Opportunity Committee, Martha Salyers. Good morning, everybody. Can you hear me or good afternoon? We can hear you. Thank you. Awesome. Well, the front and center was the impending retirement of Philip, the leader of the division. And all we wanted to know was when's the party. And he insists that there's not going to be a party. I'd like to hear more about that. He talked about a number of things as always 1 good thing is that we do have another veteran service. Head there, however, there's still an opening for a veteran service officer. If anybody on the board knows someone who might be qualified or interested in that position. The impacts of the increases in property tax still have to unfold. There's not a huge amount of data about the actual impacts on the community as a whole and the assistance that Buncombe County gets. is kind of a complicated story because by law we're not allowed to exempt people from taxes, property taxes, for example, but if it's rephrased as a general assistance, then there are ways to help people with the large increases in property taxes. But they're so they're currently working on that, changing the requirements for amount of resources that people have for eligibility, et cetera. But that's still in process. Yeah. Trying to see if there's we're going to be talking about the energy plan in just a minute. So I think I'll just leave it at that unless anybody else on our committee has a report. Thank you, Martha. Any questions for the community opportunity group? Or the comments. All right, we'll hear next from our community safety group. I don't see Elizabeth Lima on. So who is representing that group today? I can share, Dr. Frane. Yes, Dr. Lima was not on our call today. I think she had an emergency at the VA that she had to handle. So, we just spent some time talking about some updates. I spent some time talking about some challenges we're having with recruitment of staff. Again, seems like it kind of always cycles back around, but we've had a difficult time filling some positions. So, we have taken on a partnership with our human resources department to do a recruitment campaign for And that has included some really fun videos with our social work staff where they're being recorded talking about the jobs that they do. And that's being posted on Facebook and probably other social media sites as well. I don't do a lot of social media, but that's an effort to just like kind of get people, make people aware of what we do, share some factual information about what child welfare looks like and encourage people to consider a career in child welfare. So I shared a little bit about that as well as some of the other efforts that we are undertaking related to recruitment. And then talked a little bit just about some changes that are that we're going through with some of our programs. For example, we're currently working on transitioning our Transformation Village contract over to the Opioid Settlement Fund. So we're working on making sure that our outcomes and goals and data that we collect related to that fund translate over to the needs of the opioid settlement funds. So that's in process so that that can be sustainable and continue, but it won't sit in our social work services budget any longer. And that program serves mothers and their children who, when the mothers are experiencing substance use, it helps to keep children in the care of their mothers in a more supervised space. while they're undergoing treatment. And then also if the substance use is so severe that the child cannot be with them and we have to take custody, then we are able to work with mothers toward reunifying children with them quickly while they're in that Transformation Village program. So it's an excellent program and we're glad we found a way to kind of sustain it under the Opioid Settlement Funds. Um, so that was an update that we gave and then also talked a little bit about the our partnership with the Family Justice Center that we've been making some efforts to just re align some of our services and resources with the Family Justice Center. They have a new kind of leader over there, Hannah Ledgerton. And so we've been connecting with them, um, making sure that we're participating in their Family Justice Center leadership team, as well as operations team, making sure our staff are oriented to the Family Justice Center services and resources over there, and that their staff understand the work that we're doing in both adult and child services. So just kind of making sure that that partnership is really solid and that we're working collaboratively to address intimate partner violence and elder justice issues in our community. So I think that's mostly what we discussed in our meeting. Thank you. Thank you, Rebecca. Any questions or comments for Rebecca and the community safety team? All right. Thank you. And now moving over to community health. Savannah? Hey, thank you. We had the wonderful Jessica Silver back, our environmental health director. Last month, we talked about wastewater. And this month, we talked more about food inspections, lodging, public swimming pool inspections, lead poisoning, tattoo parlor inspections, including the tattoo convention. Okay. We have 16 field staff that go out into the community and do the actual inspections. And then there's two leaders in that group. One particular call out was around bedbugs. There isn't any funding for people to deal with bed bug problems right now, and it really can add up as a huge expense to people. So we're hoping that that's something that we can work on towards the future, providing funding for people to have their places cleaned up. And the expenses really add up like going to the laundromat, getting all the cleaning supplies, getting the duct tape. And even landlords, apartment complexes can require residents to use a certain service, which then can be really expensive too. So we're hoping that we can work on that in the future, bring some funding to bed bug treatment. And then we're hoping that Jessica will also come back in the fall to talk to us more about looking at environmental health through an equity mindset. The example that she gave to us was that in the 1920s. restaurant inspections for businesses where the owners were people of color were not given ratings above 90%, whereas non-colored establishments were regularly getting ratings, you know, 95 or higher. So we're hoping she'll come back and talk to us more about that in the fall. - Thank you very much, Savannah. Any questions for the community health? So that last point just brings up to me, do we have data that includes race and ethnicity in business ownership or business type? Is that data exists or is that something that's gonna be new to be collected? - No, there is data. - It sounds like it does exist. - Yeah. - Oh, sorry. She has gone to the state archives. She's done a large study around this and has presented the data and the information to the state environmental health supervisor group. Yes, we do have data. You have data. Okay, great. Thank you. All right. Any other questions for our program committees? We will move on to our next item on the agenda, which is the Energy Programs Outreach Plan, which requires a Board approval of this plan each year. So this is an annual approval. So after Phillip's report, we will need a motion to approve this plan. Take it away, Phillip. - Right. As Dr. Frank said, this is the one thing I think I bring every year that has TAB Board approval in it. Now let's start Before we go to the outreach plan for the coming year, I want to give you a little idea of what we did this past year with the energy programs. Remember, the energy programs are broken into two separate pots of money. There's LEAP, or Low Income Energy Assistance Program, and there's SIP, or the Crisis Intervention Program. The SIP program runs July through June, and LEAP runs December through March. And last year, we received $1.3 million in LEAP dollars, and we spent everything but $200,000. And the SIP program, we received $876,000, and we spent every bit of that by December. It was gone early on. And we served a total, between the two programs, of about 5,600 individuals, 5,600 cases, and So, we had hoped that they would, they did the year before this year that they would have reallocated some of our LIAAP dollars to SIP because we could still be spending it right now. And the state and their ultimate wisdom did not do that this year. We asked that $100,000 be reallocated, and that never occurred. So the SIP money you can go through fairly quickly at $600 a pop to LEAP money is was it's a little harder to spend because you're doing it at 300, 400 or $500 depending on the number of people in the house. So, and the, the real, well, problem with LEAP this year was it got real cold early and we had applications like crazy in January and February and then it warmed up and it really slowed down we served everybody who applied uh we didn't serve everybody. It's just that there weren't enough people who applied in March to really carry us over to spend all those dollars. So questions about this past year first. I think it's important to get a little background. Yeah. All right. So the outreach plan for the coming year, it doesn't change much from year to year. What the state requires is you have a committee about outreach. And as I've said in years past, we use our beacon group plan. as our committee. They also serve as our committee for we run a food program for the feds that we get money for every year that we distribute out to some of the beacon member agencies. But if you look at your plan, there's a whole list of people who are involved in our beacon group of folks. uh quite a few quite a few uh helping organizations in buncombe county and then it also goes on to show you in the outreach plan how often we meet every bi-monthly uh and tracy flanker franklin who works my division kind of chairs that a little bit uh does a great job of making sure that people are uh In tune what's going on, so it does list all the meetings that occur and we use that group by providing flyers. You know, information to them about when the app starts, when sip starts, when we have money, don't money have money. So they are kind of our. to some extent, a communications arm. Because what happens is a lot of people may go to those organizations for help. And if we have money for the energy programs, they're going to send them back to us first or help them apply. You can't apply for energy online anymore. And we take the vast majority of our energy applications online. We also use partners and like Council on Aging. We give anyone who wants paper applications, we give those to helping organizations in the community. We still continue to use our Nixle communication system. which what happens is, especially right before LEAP starts, we will message all the folks who are on public assistance programs and let them know that LEAP is getting ready to start. And we also provide applications to some of the low-income elderly apartment areas and such, make sure that we capture that group of people. And then our CAPE team also does all the advertising about the app and they do put something out when SIP starts in July or mid July usually. We start SIP when we get funding. And so, and they've changed the rules with the SIPP program anymore to where so many more people are eligible for SIPP. It used to be you had to have a disconnect notice, and now that's not the case anymore. So, so many more people are eligible for SIPP, and that's why that money gets spent so quickly. And as things get warmer, you know, What happens, what we see is you do not have a lot of people apply for SIP in the summertime, but that's changing over time. A lot of people count on SIP, especially with their cooling costs. That's really the energy outreach plan. Are there questions for me? Bill, one question I have is, you know, there's been a lot of conversation in our community about leveraging the NC Care 360 system for referrals and outreach. How is this program integrating into that or what do you see as being the role of NC Care 360 in the energy outreach plan? Well, I think it could. The problem being is that they still have to apply, either whether that's in person at Forty Cox or online through ePASS. They're still going to have to make that energy application. So the referral does us no good unless they actually make an application. Is there any way to embed the application into the referral process or provide assistance for folks? I mean, just trying to – you didn't spend $200,000 last year, and that means that the outreach – there's opportunities to do outreach better and system better, right? And so it seems like that might be the area. Yeah. Well, I'll give you my answer and then I'll give you what happens in reality. My answer would be yes, that makes a lot of sense. And we've really talked to the state about that. But the energy program, the application, the electronic application sits in NCFAST. And so there is the NCFAS problem again. There in itself lies the whole problem. But what I will say, I think there is hope in the future. I really believe the state is trying to... to develop a better automation system than NC fast. I think their goal is to can NC fast eventually in the next five years. And, and because this is, It's not much better, really, than the old DOS-based systems. It's very inflexible. You can't do a lot with it. You know, with AI-driven systems that exist now, I think the state realizes there's an opportunity. And if they go to something like that, then I think you could do that fairly easily. Yeah. All right, that's good. So it's helpful to know that the NCFAST remains a barrier for this program as well as Medicaid. Yeah, and they're very protective of what they do and don't do in that system. And there's people's data there. Yeah. Yeah, thank you. Any other questions for Phillip about the energy plan? I have a quick question. Are you wanting or needing more organizations to join Beacon for kind of that outreach? We're always looking for organizations to join. Always. What would be the point of contact for that? Tracy Franklin. Okay. 250-5564. Thank you. Yeah, and for awareness, Beacon has been around for a long time, and it is a community gathering. And there is no, every organization is encouraged to be a part of Beacon who participates in emergency assistance in our community. So it's really evolved over the years. To the better. Any other questions about the energy plan? And if there's no more discussion or questions, I will need a motion to approve the energy plan as presented. Move to approve. Thank you, Martha. I'll need a second. Second. Mary, thank you. All in favor say aye. Aye. Excellent. Any opposed? All right. It carries. Thank you very much, Philip. You have your energy plan approved for the next year. Thank you. Very good. All right. Moving on to our next agenda item. We have an educational session around our resource as board members of teams, which we will receive from Kelly Buckner. Well, hey there, everybody. Can you hear me? I am not in my normal atmosphere. So, yes, we can hear you. All right. So what I'm going to do is I want to share my screen. If you let me. never fails come on All right. Can you see my screen? We can see your screen. Okay. That says Buckham County Health and Human Services. That's cut off. Yes. All right. So you will be, everyone will be receiving an invite to this team. What I'm going to tell you is I am actually going to show you this video. I don't know how much everyone understands and knows about Teams, but you have Teams and everything is actually stored in Teams in SharePoint. So SharePoint is the actual storage site, which is a website. And to me, for things like this, for this board are a lot easier to find. And so that's why I'm actually showing you the website. And so I will be sending out the website directly. I recommend because it's one of the things I've done is I just shared. I save it as a bookmark and that way I can go directly into it. But you all will be getting an invite to this after this meeting. And just for clarification, just in case anybody is saying, what is this? So this is the board resource for documents. that we discuss. So minutes of meetings, operations, policies, procedures, board member lists, all those things that we have access. This is the resource that we will all have access to that we have underutilized in the past. And so this is the opportunity to revitalize this and make it so that we can actually get more readily access to the stuff we talk about. Yes. And what happens is whenever you are appointed to the board, we will add you. If you leave us, if you retire from service, you know, or at the end of your term, then we would remove you from the board because it is certain members of HHS as well as board members just leave. to be aware. And I say that because the first thing I'm going to show you is our board mirror list. This is one of those things that we just keep track of and show. But it does have like phone numbers, addresses. It is your work phone numbers and addresses that you provided us. So just to let you know that that is there. We also track trainings and different pieces, but everyone is in there that is active. And that is what we try to do. Whenever we are tracking trainings, just so that you all will know, all the trainings all go back to accreditation. What accreditation requires us to do for every one of our board members. So every board member is required to have accreditation. orientation training. Every board member is required to have annual trainings. So every year of our accreditation period, we are required to show that we have done that training. And that helps us pass accreditation as we go forward. So we also have tracking mechanisms. We're actually, because our accreditation period is ending in September, our October, actually, but we are going to start tracking the next time for accreditation. So already trying to prep for the future around accreditation and tracking pieces. Again, we have like your the term that you were appointed, the second term you're appointed. So all those different pieces have to be kept track of so that we know who is our board member list. We also have, this is our HHS board handbook. And if you'll notice when I clicked on that, it did open to a new tab on the website. And so what this is, is this as a handbook that has all the different administrative codes that cover this board. So if you're ever wondering, what is it that, why do we have this board? Well, here they are. So we have North Carolina-rich legislation, we have administrative codes, juvenile codes, adoptions, child welfare, public health, So all this information is in here and these links are actually out to the statutes and things like that. So as they're updated by the state, they remain up to date. And we do check this handbook every year to make sure that we have got the most information out here for you. Additionally, there are some board resources. So as we have changed websites within the county and we changed our domain, we made sure that we put these out here, our purpose statement, all those different things. So those are different links that you have access to that you can go out if you're ever wondering. what is it that aging and adult services do? Well, here is the state's website to give you, you know, scope and purpose and things like that. So just a broad amount of resources that if you have questions, you can go here. Of course, you can always ask your points of contact within HHS, but you also have it at your fingertips as well. All right, and if I'm going too slow, one, speak out because I'm on my laptop, so if you're raising your hand, I can't see that. I should have said that to begin with. My apologies. For each of your program committees, there is also, if you're having meetings and things like that, the meeting minutes should be stored here. Program Committee has its own, what we call in Teams or in SharePoint, it's your own channel. So you have that information. You can go out there and you can look at that. For things that go across the board, so any type of board trainings that we've given. So if it's been something that we've done or we've had to collect certifications from y'all, we are storing those in here. Again, we have to store those and we have to share those for accreditation purposes. So we try to keep those in one location. And let me see if it's going to let me go back. Again, any training certifications that y'all have had to provide us, you can feel free to go in here and look at all the different certifications or you don't have to. Okay. The other thing about the general channel as well, or the general folder as well, is that within this DSS board here, this is where all the minutes are. And it goes back to fiscal year 2011, when I believe that was the year that we became a consolidated board. So all of the minutes are in here. What I have done is up here at this folder, we can pin it. So if you're looking for anything for this fiscal year, FY26, which is from July 1 to June 30th, it is right here. You can just click on there and all of the agendas, all the meeting minutes are. here for you to peruse at your leisure. So if you had questions or you wanted to go back and you wanted to see a presentation that we were given during the last month, what have you, those all sit here in this site. Again, there are a couple of other things in the general channel. Archived documents, those are things that we have had and we've archived and we just saved them here, but they're no longer valid or active. Board operating procedures is here as well. So one of the things that we do is every year, typically in July, we bring it forward and then in August we review it. But the operating procedures are in here. This tells what is the purpose of this? What are our memberships and terms? Who are the officers? All the different things that are required to say what has to happen in our board is listed in our operating procedures. That's it in a nutshell. It is a handy site. It is one of those where if you're like, we talked about that before, I know it's there. The good part about it is that you can go in and you can search. If you, I don't know if you appear as a search function, so if you typed in April minutes and hit search, it will literally go out and it will try to find any April minutes and it will even go back to April of 2012. So it is there. You have that information and it is available to you as soon as I give you the link to the site. Thank you so much, Kelly. This is really helpful. I think this is something that will help us to be better informed and stay connected as a board. So thank you for reinvigorating this, and we look forward to getting that email and the clickable link, and then we will save it. in our, in our, and we will know that it exists. So there you go. It used to be a lot harder to get into the website that we had. And most of us just gave up a lot easier. Yes. Now it's Krista giving me the head nod that we have a new member and I need to add them. So that's where we're at now. And if you go in here and you have questions or anything, please feel free to contact me. It's not a problem. And I can absolutely help you one-on-one or however, but that's what I can do. Thank you very much. Any questions for Kelly about Teams? Just a big thank you, Kelly. This will make things so much easier. And before it was just kind of floundering, but I've used Teams a lot and it just makes things so smooth and findable. So thanks for all this work. Yeah. No worries. All right. Any. All right. Very good. Our next item for business is to discuss the proposed budget review. Lee Anderson. Hello, how's everyone today? Just fabulous. Thanks for being here. Yes. And Chris is going to be driving this for me. But basically, this is the budget presentation we presented to Avril and to the budget office. Earlier this year, I know we're still going through some tweaking, going back and forth. The budget was presented earlier this month to the Board of Commissioners and they have public comment this week. And then in two weeks on June 2nd, they're looking forward to trying to adopt the budget. So, basically, HHS reviews revenue summary. Basically from FY25, you know, we, that was Helene. And so we did receive a lot of extra additional support from the state and disaster assistance funds. So between there and FY26, that's the dip, the drop in 3.47 because that's how much money we received and able to give out into the community. And then obviously this year, we know with food assistance, with the reduction going from 50% reimbursement down to 25 for the nine months out of the year, which also causes us to have a reduction in revenues of another 1.7 million, which we knew. So that's three quarters of the year. Next slide. And that's been the biggest impact for revenue is really the food assistance dollars and the loss in those additional revenues. Expense summaries. A lot of this is difference between. Okay. A lot of the difference in the expenses going up, obviously, is loss and revenue, more expenses for salary and benefits, which that is typically our largest driver of expenses is salary for staff. We've had some Medicaid expansion, nondiscretionary has went up a little bit for a total of $103 For the net county cost summary, you see the top drivers is the reduction in SNAP revenue, which is increasing our county costs, the salary benefits. A lot of our contractors, we've RFP'd service contracts and Everyone knows everything keeps increasing costs and that's no difference for those people who provide services on our behalf. So we are looking to have an increase, but of this difference of the 7 million, 7.9 million, 1.5 is truly the operational cost. So the other reductions of the 6 million, 6.4, is a lot of things that are out of our control with reduction in revenue and just increases in salary and benefits year over year. Budget by cost center. Here we have increases in changes in revenue. Animal services, we're not getting as much back in monies that we get from the state this year. Direct assistance. We're trying to get more in line with what we actually use. So if we have less less expenses, then we're going to have less revenue due to us having less children in our for board payments and all of that. Public health slight increase in revenue, but basically down from FY26 in revenue of 2.4, which the large reduction of that is the snap. For expenses, obviously here it's where, you know, animal services, our contract has increased that and like for school health, I know for public health, it's, you know, school nurses, direct assistance. We have less children. So obviously we're requesting less money. They're trying to keep in line with what we're actually spending. So we don't have these shortfalls. Just trying to get more in a reality check and projecting our projections and our expenditures. And this is helping us get to a closer point to narrow that gap down that we've had over years. Next slide. And the biggest changes for a lot of our revenues and expenses, obviously, is the SNAP funding and the decrease in cost. And revenues increase in cost and decrease in revenues. So next year, we'll have the full year of 25% versus currently the 50-50 that we have right now. So for FY28, we consider that to probably be an increase of $2.2 million. And obviously to snap some of the different changes that we expect to impact staff, you know, additional requirements, and we're still waiting to hear from the state exactly. I think they have to have that stuff to us by June 1st of what's been given from the feds down to the state and then the state interpreting to us of how this will impact our staff because there's a lot of differences of how people are interpreting things. So. We'll get more clarification from the state on that. So that part of this is the SNAP policy changes, which are a huge thing. Next is expansion requests. Some of these have been removed going through like the first and second pass through with the budget office and with county management. So, I mean, we are asking for an increase of contracted staff for running the energy program. So this will be a contract where we can use a lot of retired employees to help run the energy program during this time. So that's been a great help for that. You know, not as much training having to happen with that. Yeah. The staffing visitation contract is not going forward. We are still looking forward to hopefully increasing security here at 40 Cox. So right now that's still on the plate. And like I said, I think there's still discussions going on between county management and with the commissioners of how to narrow that gap. Because I'm sure you guys have read the news and been involved with that of. between property taxes and what's going to be the property tax value. So next page. The supplemental aging funds we did add because we last year we had brought it down, I believe to 425. And this year we asked to increase that by 50,000. So trying to get it back to the 500,000 it was at. So we did it up from 425 to 475. So that's for that. And the parenting education, helping with parenting groups for our children and for families to better understand. help families get reunified and just to not be needing our services is probably the best thing I should say there. Some of the tech, like I said before, you know, some of the increases to county costs is security, which a lot of that was moved from salary and benefits into a contracted services line. So that's they do that as an expansion program. Increase with nursing, guardianship. We've had more clients trying to increase the rate for that. With our file of management, which is our P2 contract, which does all of our mail, they... open the mail, they've sort through all that stuff. So they do a lot to help with economic services in that. And they're also going to help us this year with doing patient billing for health. So that's one contract we can reduce and further do within what they currently do. Actual humane size asked for a rate increase, special assistance and Obviously you can see here and we had to do with the hiring freeze being lifted from last year. We needed to increase because we're obviously not under a hiring freeze anymore. So those costs did increase from FY25. Vehicle requests, right now, we are looking, it's been approved that we get, just because of the annual savings, we've been able to find the cost savings in these vehicles we use for social work. And originally we were requesting three this year and three next year, but due to the savings, it's why not go ahead and do it because we are finding that savings and reducing it in our client-related travel. So, we're showing they're getting used. It's been a great thing for them, and they're being used. I'm sure they're still being used in order to save those funds. So, right now, the plan is they're going to get six additional vehicles for $27, and these will be leased vehicles. Food and lodging, we've been trying to get food and lodging cars because they're one of the only departments that don't have cars, but we require them to use their car to do their job. So for food and lodging, we're trying to get a pool started to where they each have a vehicle that they can use because we've had some staff that, you know, their vehicles may not be as reliable. So by doing this more sustainable, have better safety features and be less reliability. And I think it's just, you know, equitable too just because even across the state we're one of the very few counties that make our food lodging staff use their personal vehicles. So I think this is a good thing that we hope will move forward and we can start trying to get a pool of vehicles. Personnel we've had, we know we've, we know that the top support positions were supported by management and budget. 1, I believe we're going to have to reclassify, but some of the other positions were not supported this time, but obviously. You know, just with Helene, we've seen how much preparedness stuff Kelly has done so much with preparedness with Nathan on the health side and trying to get someone on the DSS side as well, because that comes more into the sheltering piece. And so, but we're going to keep pushing for that in years to go forward, but we're We feel happy that we feel like we've gotten some wins this year with some of the support for the positions because obviously environmental health. We need more people there just in order to have be able to get the quarterly inspections done like we need to. So, yeah. Eventually, our goal is to is to increase that because when they did the study, we needed six additional. So we're trying to do two a year to get approved over the next three years. OK. Public Health and Environmental Health is supporting a lot of the things of why we are requesting these positions, especially environmental health with all the establishments they have to do and just the different categories of establishments. We have a lot of different ones, so it requires different trainings and different levels of inspections. So, obviously, we want to keep our community safe, prevent outbreaks, and just ensuring their compliance with health standards and handling food. A public health nurse, we are trying to move mobile team over from grant funded to county funded positions. And so our goal is over the next three to five years to move those staff over from mobile team. And by doing that, we're also embedding them more into the clinic. So we can also be generating revenue. So they're kind of also, you know, either in immunizations, providing immunizations, doing foreign travel or working in the clinic. So trying to completely bring them in. And this is the way that we think we can do this and bring that whole team in here and create stability and get it out of the great funds. So that's our goal with moving the nurses over. Links, previously we contracted this out and they were unable to keep the position filled. So we really weren't being able to provide services. So by bringing this in house, we feel like we can better manage this and we won't need any temp salary to do that or any contract services. So just excited that we can hopefully bring this back and help those clients and students that we need to help. Preparedness, this talking about, you know, even the DSS preparedness, this is what public health ESF 8 does, and then you got social services on what their responsibilities are. So this kind of just tells what we're responsible for and what we have to provide when we have a response that we need to respond to. Opioid. This is the settlement budget right now. This is the current things that we fund out of the opioid settlement budget. So you can see that I know. The next slide shows like because of that funding going to be ending soon. But then we also, because if we kept on doing like what we're doing, we would be short, have a shortfall. But with the new, we're going to get another settlement fund. So this is going to allow us to better manage going forward and seeing how we can help in the community. The next one shows the funds that we're anticipating coming. receiving from on the next slide. Well, we can go to this one. I was jumping ahead too much, sorry, but this is some of the outcomes of opioid settlement dollars that we've used and just to showing that it is helping in our community. We've seen decreases in fatal overdoses. increase some people being seen from our port teams with, you know, EMS and them helping also. We have an inclusive connection healing coordinator that works in our, helps with syringe exchange and denloxone. So that's helping justice services. We help with that and trying to just how this all works together and trying to help people. Even with our syringe exchange, we've increased access to harm reduction, shows how much we've distributed the training events. Just from the community of 604 reported overdose reverses. I think we're seeing that they are doing good work, and we are seeing results from that program. And Lee, this is David. Can we pause back on that slide once? When we talk about community reported overdose reversals, that is people we have distributed naloxone to reporting back that they use that naloxone in the community and reversed an overdose. So that is from the distributed naloxone. It's just something to be... Clearly, we're. Thank you. And so we're anticipating the Purdue settlement coming on and us receiving funds from that. So there is a committee on the for opioids that people will submit requests. And then there's a. committee that reviews those requests and they rank them on how they want to support those in the future. So obviously with this anticipated money coming up, we're going to have a lot of more decisions to make and can further see how we can help our community in allocating those funds. Some of our accomplishments and goals for FY26, the federal government shutdown. That was one of the things we managed to get through. We did a food drive, and I believe, was it 15,000 pounds, David, that we were able to get to help distribute to those food banks at the time so they weren't completely depleted on their shelves. Right. that helped sustain them during that government shutdown time. So I think that was a big kudos for us this year, and HHS helped drive that agenda for that outcome. Measles outbreak, I know Ellis is loving that, but now that that seems to be no longer an outbreak and that we're not in their... Any emergency plans or anything like that. So I think that's great that we went through that winter storm fern learning mass care. Some of our goals for FY 27 is we are we have a big part in leading some of the preparedness objectives, not only for health, but also for helping with the county overall and We have four recovery projects that HHS is supporting. And basically, we're still focused on improving customer service, community impact, and employee engagement. So, you know, we've had a lot of plans that we've worked on that I know Kelly has had the large majority on. preparedness plan, recovery plans, strategic plans, and business plans. So we've been working with county management and within our own department to help with these plans that line up with what the county's overall strategic plan is as well. Any questions? I'm sorry, I thought I changed my video, but I'm just on black screen today. Thank you, Lee. That was a lot of information. I know. It's a really big budget and there's a lot of pieces to it of funding gaps and changes, but it seems like you guys have threaded those and given us a lot of good information. So the first question is, there currently is a two-week comment period. Is that correct? Yes. Well, they had public comment this past week, Tuesday, and then they're going to vote on the budget at the June 2nd meeting. But I know they're still trying to figure out a gap in some of the areas in regards to sales tax, not wanting to raise those as much. So trying to see what other solutions or what other else we can cut and if that's part of the community development stuff that they have. So it's kind of just trying to figure out which direction they want to go. And so just waiting for their direction. Yeah. And then David, is there anything that we should be mindful of as being gaps or big concerns of what this budget is not able to address? No. It's important to realize that in every budget cycle, every single agency in the county probably has a bigger list of things they would like to do than what we're going to ultimately be able to be doing. You know, to do, and we're similar to other agencies that that's, that's always probably true, but we are pleased with where we're sitting right now. In the budget process with with the county commission, but the main things now is. You know, waiting to hear because at the end of the day, the funding allocation decisions are by the County Commission. And once they have made their final decisions, we will all get revision instructions if there are any that we need to be aware of. But in terms of things that we're, I mean, we have a number of things in this budget that we're pleased the way it's worked so far. I think it was a, important item for the county manager's office to recognize that we were generating savings through the vehicle fleet program and to say, yeah, I understand you asked for three cars, but why don't we do six now instead of three this year and three next year? Just go ahead and accelerate the savings. And there were things like that in the negotiation process where I thought we had really constructive partnership with the county manager's office and the way this has all been developed so no I have no complaints. Excellent. Any other questions? So this is not a votable thing this is for our information and for us to be equipped if we wanted to make any public comment to the county commissioners as they approve and work through their budget process. Any other questions for Lee or David? Thank you all. All right. Thank you, Lee. And thank you, David. This is -- you guys are doing an amazing job with all of the challenges that are thrown your way. All right. So moving over to the Director's Report. Good afternoon, everybody. Just want to mention a couple of things. This is the month of May is Older Americans Month. And last Tuesday, we did receive a proclamation from the Board of County Commissioners recognizing or I mean, one of our committees did recognizing that. that this is an important month to celebrate the contributions of our older Americans and our older Buncombe County residents. And so just raise that to your level of awareness. Lee mentioned that we've been working a lot of plans. One of those plans that we recently completed and are going to be presenting to department heads this next week in the monthly department head meeting is the shelter plan. County Manager's Office asked us in the wake of Helene. to develop a shelter plan because we did not actually have a shelter plan to annex a specific shelter plan annex. And during the Helene response, we had a lot of experience with working with the Red Cross and others around sheltering. A lot of our staff were involved with sheltering, but there was a request from the or an assignment from the county manager to have a shelter plan annexed. developed and ready to go before June 1st. June 1st, of course, being the start of the official hurricane season. And we presented that to the manager's advisory group last week. And Kelly did a tremendous amount of work with Nathan Green also and others on that shelter plan. And in collaboration with HR and emergency management. And we do have an approved plan now. I've signed it. And so that is a new annex to our emergency preparedness efforts, but a big lift. And so if in the event another disaster comes our way, we'll just be better prepared to help the residents through it. And then 30th of June. So he is planning to retire next month will be his final meeting. And of course, this body will not be together in person again until July. But as was mentioned earlier, Philip has requested no parties. I think a person with 39 years of service deserves to get whichever you want, a party or no party. And so I definitely want to say thank you to Philip. But if you have anything you want to say to Philip before he's leaving, you might want to reach out to Philip. And that's the end of my report. Thank you, David. Any questions for David? I think we will definitely need to talk about how to honor Philip in the next month. So we will come up with a plan. All right. So moving on to the chairperson's report, the last item of business, I have a few things that I need to talk about. So the first is in relationship to some of the things we've been talking about, and I am going to share my screen, if I may. Can I share my screen? Yes, maybe. All right. No, not that. I need -- not that. I need a different screen. Hold on. Stop share. Share. Maybe this. This. Can you see this screen? We do see your screen. You do see the screen with the letter? Yes. Okay. So, so it's come to my attention that, I mean, as a reminder of the board, that one of our roles is to advocate on the behalf of our county when there's opportunities to advocate to legislative officials. And the, the, the SNAP administrative cost. changes to move into our county, which we have just heard is going to be about $1.7, $1.8 million. There is an opportunity for us to advocate on the behalf of our community and our state to delay that administrative plan. The Senate is currently debating the Farm Bill, and I'm not an expert on this, but I have a draft letter of advocacy towards the Senate as they look at this Farm Bill. There are a few states... not North Carolina. There are a few states who are poorly performing in their error rate and SNAP, who are being exempted for two years with this administrative transition. So they are already going to vote to allow a few states to to delay this administrative cost sharing burden for two years. What I'm suggesting, and I think it's a good idea, is that we would advocate for all states to delay by two years of this cost sharing burden to allow us all to prepare better and adequately for the change. And that's what this letter suggests is a desire to delay in the Farm Bill this two-year delay of the administrative cost-sharing burden to all states, treating SNAP agencies equally while providing the necessary time to invest in the staffing, training, and technology needed to sustainably reduce the error rates We know that our error rates are fantastic. Our error rates are some of the lowest around. So in some respects, we're being penalized for being so good. A $1.8 million change in our budget would help our county, would help our Health and Human Services Board to continue to do it. If we could delay that by two years, it would give us more time to figure this out. So I would like to open up to a discussion or questions about that. And then I would like to advocate that we send this letter to our senators, Senators Tillis and Budd, on the behalf of the Health and Human Services Board, which I will sign advocating for this delay. So, I don't know if David or Philip, if you have any other kind of technical information for us to consider. I understand this. Nothing I mean, this is the. North Carolina Association of County, the assess directors association. That organization did send a version of this same communication to the senator's offices. But if it, well, yeah, I mean, the administrative cost shift is not an error rate thing. That's a different set of issues. But the particular ask is that the administrative cost shift, would be delayed for two years because that's going to happen regardless. And but the, the payment error rate penalty shift that will come, that will come. And yes, we are currently doing, doing a good job with that, but the, the we can always improve. But the issue that's being requested in the farm bill is there was a there was a discrepancy between the House and Senate versions. And in one version, there was this race period. And the other version did not have this grace period of two years in the language of the actual bill between the two different branches of Congress. And so what is being advocated for here is that we adopt the version and reconciliation that gives a pause of the cost shift instead of that implementing it this year beginning October 1st. That would be delayed for two years to give everybody in the country an equal opportunity to prepare for that eventual shift. And so should the board be interested in pursuing, expressing support for that with our two senators, that's definitely on the table and at your pleasure. Open it up for discussion. Yes, Martha. I'm a little perplexed by the report about the bill that it's penalizing the people who are doing the right thing or doing well. And... given a break to the people who are, I mean, it's good to give a break to people who are really struggling, but the bottom line is poor performance. So I agree with trying to equalize it across all states and counties. Yeah. I think the reason why there's a few states that had powerful voting ability in order to pass the bill at all, they needed their votes. And so that's why their states are exempted. Was ever thus. Yes. So this would be our advocating, like, if we can exempt some, let's exempt all. Give us a little time. Because $1.8 million, as you saw in the budget, would make a big difference in the next two years for us in our community. Especially after Helene, yes. Especially after Helene. Other discussion. So, as a as a chair's prerogative, I get to to present this as a motion to send on behalf of the Health and Human Services Board a letter. to our two state senators advocating for the delay of two years of this administrative cost-sharing burden. And I would like board approval for that. So I'll need a second. Savannah, I see that as a second. So all in favor, say aye. Aye. Aye. Any opposed? I don't see any abstentions. Okay, thank you very much. So I will send that out on the behalf of the Board to our Senators. Now, each and every one of you can send your own letter too. So this is, this is, we are all voting members of our community. We can send our own individual letters to our representatives about this issue. So I encourage you to do so. The next issue I want to bring up has to do with Medicaid. So some of you may be aware that our state legislature approved a Medicaid budget, which is everybody is very happy about that's SB 686. And while that it funds Medicaid, which is really, really important, it back funds it for the past fiscal year, funds it through, I think, July or June. And then they will debate again. But they they put in some provisions in there that are actually quite concerning that I think it's important for the board to be aware of. and understand, I mean, these actually got passed and signed by the governor, but there's a lot of discussion about what this means moving forward. I'm just going to highlight the ones that are some of the most concerning that will affect, and then I'm going to ask Philip to just chime in a little bit on the perspective. One is this idea of that work requirement is a three-month look-back period. So it's not at the time of application for Medicaid. You have to prove that you've been working for three months prior to the application to Medicaid. And so that is going to really change the dynamics of this whole process of work. The federal government said, I think it was a one-month, That was what the federal government said, one month look back, and our state chose a three-month look back. And so that's a big difference. And it's also going to kind of change this three-month compliance period. It's like really looking at that. They're going to have to reapply every six months, right? And so having three months look back, it's kind of squeezing the whole administrative burden to be almost unwieldy of how to apply and get approved if you're looking to reapply every six months and whatnot. Thank you, Leigh Ann. The other is that there are monthly eligibility reviews. Again, this is all increasing administrative burden to Phillip's team and figuring out how to do that with the staff we have. Then the two most concerning is that they have removed non-citizens from Medicaid eligibility for pregnancy. And children. So these are lawfully resident non-citizens. So they're here based on green cards. These are green card recipients who under current law are able to receive Medicaid pregnancy benefits if they are pregnant and their children who are with them. This Medicaid package removes them from Medicaid at all. That's actually a significant number of people who will be without insurance during a very critical time of health and well-being. And their children who are born in the current state of our Constitution are citizens. And so it really, really does not recognize the importance of prenatal care in the health and well-being of a newborn. And so this is just a real lack of understanding of community health and our society. And what I hear is that the legislature were not fully understanding what this would do and that there may be a fix. coming for that, but it's in there right now. And so then the last one is also a challenge, and that is that any person who applies for Medicaid whose residency status cannot be proven at the time of the application, for whatever reason, for whatever reason, their residency status cannot be proven at the time of application, the DSS employee is required to contact ICE. required. And so that is also going to create a whole lot of challenge and uncertainty and mistrust. And this is just, it cannot be proven for any reason the person forgot their driver's license. can't be proven. They're required to contact ICE. So I'm bringing this up for awareness. And Philip, you know, can you kind of fill in any other kind of contextual understandings of these issues? I think you hit it on the head in a lot of ways. First of all, it creates huge administrative burdens. I mean, you're talking about... Going into Medicaid from reviewing recertifications every 12 months now to a month, meaning that you did one a year and now you're going to do 12 a year. And those are time-consuming. Yeah. I don't want us to be in the business of contacting ICE. I mean, that seems a little bit like overkill in a lot of different ways. I don't know, you know, how that would even occur. And it also adds to – there's a lot of discretion that ends up having to happen in – whether or not residency has been established or not. So you're putting a lot of things on a caseworker that you don't want, a position you don't want to put in. So it just, it really does create a... One last thing I failed to mention, the last one is actually increases the cost of co-pays to the maximum allowable by law. So in the current standpoint, a Medicaid recipient... who is receiving Medicaid because they are of low income, they have a $3 copay for a medical visit. This will change it to where a specialist is at least $30 or $35 per visit, which you can imagine the number of people who will no longer actually show up to their specialty care appointments because of inability to pay the copay. And so, again, these are just increasing burdens. And what we know is we'll decrease care and increase burden to the system. So I'm just giving this as awareness. I'm sure there's going to be lots of discussion about this in the legislature and other places. The safety net. The Healthcare Safety Net Committee met and discussed these and a lot of this information is being collated by Pisgah Legal Services for us to understand it. And I can share what they shared with us at the committee level to this group, if desired. All right. All right. Any other questions or comments about that? The last thing I have is just board members. The board member, we're going to need a whole bunch of board members coming up. And so just keep that in mind. We're going to need board member leadership positions coming up. Keep that in mind. Executive team, board chair, vice chair, these are all going to be positions that are going to be open in July. So be thoughtfully considering your role on this board and stepping up to leadership. And we will be continuing to look for new applicants in certain of the professional roles that will come available, such as physician and psychiatrist, as well as the engineering position, which we continue to look for. And I do believe we have two community member positions as well, at large positions. So please put your feelers out for people who would be good advocates for the community on this board. And that is all I have as the chairperson's report. And I will take a motion to adjourn. Thank you, Savannah. Thank you, Linda. All right. Thank you all for sticking it out. A good long board meeting, but lots of great information. Have a wonderful and safe Memorial Day weekend. And enjoy the rain. Thank you. Bye.