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THE BOARD OF COUNTY COMMISSIONERS DURHAM, NORTH CAROLINA Thursday, August
30, 2001 10:00 A.M.
Worksession AGENDA 1.
Citizen Comment?Lavonia I. Allison Dr. Lavonia I. Allison has requested
time on the agenda to make comments to the County Commissioners regarding
education. 2. Substantial Equivalency The North Carolina
State Department of Health and Human Services (DHHS) employees, namely those
employed by the Public Health, Mental Health, Social Services, and Emergency
Management departments are covered by the State Personnel Act (N.C.G.S. §
126). This means these employees follow
state rules for recruitment, selection, salary administration, and
dismissal. The State requires the use
of competitive recruitment and selection procedures as a condition for the
receipt of funding. Substantial Equivalency
refers to the establishment of a local personnel system for DHHS employees that
approximates the State system and allows for the administration of personnel
actions at the County level. Currently the Durham County DHHS
agencies operate under a dual personnel system, the County?s and the
State?s. The Durham County Human
Resources Department administers both of these systems with the final
decision-making authority reserved for the State regarding the agencies
mentioned above. The Durham County
Human Resources Department provides for uniform recruitment, compensation,
benefits, training, and performance management for all County employees. However, DHHS employees operate under state
classification, pay and appeal procedures. In an effort to quickly meet the
recruitment and classification needs of the DHHS agencies and localize
personnel functions, staff is recommending that the BOCC petition the State for
Substantial Equivalency to administer the recruitment, classification, and
compensation components. Resource
Person(s): Jackye Knight, HR Director and Tony Noel,
HR Manager County
Manager?s Recommendation:
Endorse efforts to apply for Substantial Equivalency and move to formal
agenda for approval. 3. Increase of Flexible Benefits Spending Credit In
an effort to offset the out-of-pocket benefit costs for employees, the HR
Department recommends that the funds set aside in contingency to increase the
Flexible Dollar amount from $160 to $165 be added to the Budget for Benefits
for Fiscal Year 2001-2002. Durham
County Government has received its renewal rates for calendar year 2002
(Attachment 1). Increases for health
insurance range from an average of 8% to 15%.
Based on current utilization of health insurance, most employees will
experience a 15% increase in premiums.
In addition to the increase in rates, each of the plans has made changes
to the prescription drug coverage putting more of the cost sharing on
employees. With this erosion of the
Flexible Dollar amount, fewer of our employees will be able to purchase what is
considered our basic package of benefits.
The
County has held the Flexible Dollar amount steady with only one increase in 9
years. The trend for health insurance
premiums is currently at 19-20% and increasing. This is in large partly due to increasing prescription drug costs
and utilization. HR will discuss the
attached data and seek your input as we craft the final recommendation for
renewals. Resource
Person(s): Jackye Knight, Human Resources Director
and Debbi Davidson, Benefits Manager County
Manager?s Recommendation:
This information is presented for discussion and questions from the
Board. I recommend that the request for
the additional Flexible Dollars currently in contingency be added to the
Consent Agenda for the September 10, 2001 meeting. 4. Memorandum of Understanding With the Durham Public
Schools The
Durham County Board of Commissioners and the Board of Education for the Durham
Public Schools have agreed to develop annual Memoranda of Understanding in
order to strategically identify issues/initiatives of mutual interest. The agreement is largely an effort to ensure
strong channels of communication between both boards while working to improve
the quality of education for students attending the Durham Public Schools. The
Superintendent and County Manager have agreed upon a MOU for the 2001-2002
Fiscal Year. The MOU carries forward
all of last year?s understandings.
However, both parties have also recommended that additional language be
included to memorialize the need to pursue joint use of public school
facilities. Resource
Person(s): Mike
Ruffin, County Manager County
Manager?s Recommendation:
The Manager recommends that the Board review the proposed understanding
and advise staff of any additional changes or issues that should be
incorporated therein. 5. Continuum of Care Services for Children at-Risk As the 1998/99 Fiscal Year
progressed, former County Manager David Thompson was informed that the need for
residential treatment for children in the court system was exploding. The county received numerous court orders to
pay for treatment at an alarming cost. Upon further inspection it became
apparent that this trend of increasing demands for services and related costs
was occurring in other County agencies as well. Leaders from DSS, Mental Health, Durham Public Schools, Office of
Juvenile Justice, Youth Coordinating Board, Youth Home, Criminal Justice Resource
Center and District Court Judges were convened in December of 1998 to develop a
clearer understanding of: § annual budget impact due to court-ordered care§
scope of the problem §
need for a strategic response §
proposed process to assess system, determine local
capacity, and develop new resource capacity to meet identified needs After a clinical review of 90% of
the court-ordered care cases (some clients refused to sign consent forms), the
Continuum of Care Committee provided information about the kinds of services
needed for Durham to effectively its use of court-ordered care resources while
keeping children in the community with their families. The Board of County Commissioners charged
the committee with the task of defining and quantifying the specific services
needed along with associated cost and revenue projections. The goal of the Children-at-Risk Initiative
is to ensure that we maintain stability in the lives of Durham?s children who
are most at-risk of needing intensive mental health treatment. Given the significant resources being
allocated to treatment providers outside of Durham County, a primary Committee
recommendation was to transition children back to Durham in order to: § Decrease treatment costs§
Shorten lengths of stay, and §
Increase family involvement in the treatment process, thereby
having a more positive, long-term impact on the child, the family, and the
Durham community. The Mental Health system across the
country is shifting towards strategies that keep children in their local
communities and whenever possible, in their homes, so parents and siblings can
benefit from the treatment process. The
Committee recommends that the Board redirect $500,000 of the court-ordered care
revenue to develop additional services in Durham. These additional services will enhance our ability to serve
children locally, which will further reduce the number of court orders and
improve the success rates of our highest risk children. The proposed services will be
coordinated with new community programs such as the Safe Schools/Healthy
Students Initiative, Durham Youth Services Collaborative, Multi-Systemic Therapy,
Lakeview School, Juvenile Drug Treatment and Family Courts, as well as existing
services funded through the Juvenile Crime Prevention Council, Durham Public
Schools, and County Government. After
careful consideration, the Committee returns a recommendation to redirect
approximately $450,000 of court-ordered care revenue to create the following
services:
The total cost to provide these
services is $712,200. However, an
expenditure of $500,000 will leverage revenue in the amount of $500,000 to
support these local services for children and youth at risk in Durham. Resource
Person(s): Carolyn P. Titus, Deputy County Manager and Anita
Daniels-Kenney, Youth Coordinating Board Director. County
Manager?s Recommendation:
Approve the request to redirect $500,000 of court-ordered care revenue
to increase available treatment for children and youth at risk in Durham. 6. Emergency Medical Services (EMS) Agreement With Duke
University Health Systems, Inc. (DUHS) At its August 13, 2001 meeting, the
Board of County Commissioners requested that staff provide a briefing on the
negotiations for an agreement between Durham County Emergency Medical Services
and Duke University Health Systems, Inc. (DUHS). The attached Agreement has been prepared for submission to
representatives of DUHS and is presented to the Board for information and
feedback. The terms and conditions outlined
in the agreement represent over two (2) years of negotiations between the two
parties in an effort to clearly define terms set forth in the Lease Agreement
(copy attached) entered into in 1998. Resource
Person(s): Carolyn P. Titus, Deputy County Manager, Chuck
Kitchen, County Attorney, and J. M. Tezai, Emergency Medical Services Director County
Manager?s Recommendation:
The Manager recommends that the Board receive the presentation, consider
the issues outlined, and provide feedback to staff. 7.
Closed Session The Board of Commissioners is
requested to adjourn into Closed Session pursuant to N.C.G.S. §
143-318.11(a)(6) to discuss the performance of the County Manager. |
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