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HomeMy WebLinkAboutMinutes 02-20-2009 CITIZENS’ BUDGET COMMITTEE Meeting Date: February 20, 2009 Conference Room 3 Meeting convened at 7:30 a.m. MEMBERS PRESENT: Carl Hensley, Chairman Bill Casey Edward Lounds Craig Mundt Nathaniel “Nate” Wells Thomas Hickey (7:31) Richard Pancoast Patricia “Pat” Ferrick Randy Ezell Jay L. McBee (7:31) Steven Messer (7:42) Edith Hepburn Dan Kurek MEMBERS ABSENT: Barry Schrader Bobby Rodriguez OTHERS PRESENT: Faye Outlaw Lee Ann Lowery Marie Gouin Jennifer Hill Bill Hammer Don West James David Lauri Case Paul Hiott Major Patrick Tighe Leo Cordeiro Garry Wilson Toby Long Mark Satterlee Robert O’Sullivan Mike Monahan Jack Southard Sophia Holt Carl Holeva Roger Shinn Beth Ryder Susan Kilmer Diana Lewis Debra Brisson Kathryn Hensley Lisa Savage Mark Godwin Bill Hoeffner Mike Monahan Jeff Furst John Ferrick Wayne Teegardin CALL TO ORDER Mr. Hensley called the meeting to order and thanked staff for attending. He introduced the newest members. Dan Kurek started the Committee 20+ years ago. Edith Hepburn expressed her pleasure to be part of the group. Commissioner Dzadovsky appointed both. Citizens’ Budget Committee February 20 2009 Page 2 ELECT CHAIR AND VICE-CHAIR Mr. Hensley turned the meeting over to Ms. Outlaw to conduct the election. Ms. Outlaw asked for nominations. Ms. Ferrick nominated Mr. Hensley. Mr. Pancoast seconded it. Mr. Casey nominated Mr. Mundt. Mr. Lounds seconded it. Mr. Hensley was elected seven to five. Mr. Hensley asked for nominations for vice-chair. Mr. Lounds nominated Mr. Mundt. Mr. Pancoast seconded. Mr. Mundt was unanimously approved. APPROVAL OF MINUTES st Mr. Lounds made a motion to accept the November 21 minutes. Mr. Pancoast seconded it. They were unanimously approved. th Mr. Lounds made a motion to accept the January 16 minutes. It was seconded by Mr. Pancoast and unanimously approved. APPROVAL OF MEETING DATES FOR 2009 Mr. Lounds made a motion and Mr. Casey seconded it to have the meetings the third Friday of every month at 7:30 am. The Committee approved it. INMATE MEDICAL EXPENSES – WAYNE TEEGARDIN & MARK GODWIN Mr. Teegardin started the Inmate Medical Presentation PowerPoint (see attached). Mr. Casey observed that Prison Health Services (PHS) had an incentive for the medical bills to be higher. Mr. Long disagreed. He said the hospital has an incentive to keep someone longer; but PHS is not an insurer. They will get paid the contract amount. He explained how the contract works. Mr. Lounds asked about the average time it takes to move up to each level of costs. Mr. Teegardin showed an example of last year; but explained that it fluctuates every year depending on the health conditions of the inmates. Major Tighe added more explanation. Mr. Casey asked about cost calculations. Mr. Teegardin answered that PHS gets a detailed billing from the hospital. The Sheriff has a third party consultant that reviews the invoices and makes corrections if needed. If PHS agrees, the bill is sent to Mr. Teegardin for payment. There is a 35% discount applied to invoices from Lawnwood Medical Center. Mr. Casey asked if they could tell how the amount compares to personal insurance. Mr. Long answered that they are charged more. Major Tighe explained that a homeless Citizens’ Budget Committee February 20 2009 Page 3 person off the street would be charged less than a homeless person that was arrested and sent to the hospital in custody. Mr. Casey asked if there was a way to get a more competitive price. Mr. Kurek explained the way the hospital looks at the situation. It is not good for them. It takes more time and effort to treat an inmate. An inmate has to have a private room. Major Tighe added that the security cost is astronomical, especially for high security prisoners. It is not included in the hospital bill. The Sheriff is responsible to provide security. Another hospital is not an option. When the ambulance comes, it has to go to the closest hospital. Mr. Pancoast asked if an inmate has health insurance, could the costs be passed to them. Mr. Teegardin explained the procedure for processing payments. He sends the proof of collection efforts from the provider to the County Attorney’s office to approve. It is a very frustrating process for the providers. Mr. Pancoast observed that it might be another reason they do not feel bad to charge more. Mr. Pancoast asked if National Health Care comes through, how it would affect the situation at the jail. Mr. Teegardin said they would save a tremendous amount of money if the hospital would charge the Medicaid rate instead of current charges. There is constant discussion about ways to reduce costs. Mr. Casey asked if a person was on Medicaid before they were arrested, could you charge Medicaid. It was explained that Medicaid is canceled when they go in. The County pays while in custody and they are put back on Medicaid when they get out. Mr. Long added that Medicare they can and do charge. Medicaid they cannot. Major Tighe explained that if they are arrested and have to go to the hospital, the County is responsible for the medical bill, even if they never make it to the jail. PHS does coordinate the service and manage the invoice from the hospital. Ms. Outlaw added that the Medicaid issue is Statewide. The County has put it in its issues to the delegation for years. Major Tighe added that if a mental health or medical patient goes into custody, Medicaid stops. When they are released it takes 90 to 180 days for it to be reinstated. If you are a mental health patient and need medication, you end up in jail. The delay is a big, big problem. He believes the intent was that a convicted felon loses his benefits. Some people are arrested, released in a few days and not convicted. But they still have to wait. Mr. Casey asked if they are currently lobbying. Major Tighe answered they are and have been for a number of years. Mr. Mundt asked if the contract goes out periodically for bids. Mr. Long answered that they Citizens’ Budget Committee February 20 2009 Page 4 did bid the contract out four years ago. The contract is four years with options. The problem they encountered four years ago was a $600,000 increase. Health care is not like bidding a building. You are not going to get a lower price. There are now limits to the amounts of increase. Mr. Kurek asked about Hunt Insurance Group. It is the catastrophic insurance policy. It is aggregate and individual. Mr. Lounds asked if the security costs were included in any of the numbers. They are not. He asked how much that is. Chief Deputy Wilson answered that it depends on the number of high- risk inmates. Mr. Long answered that it is probably not $100,000 per year. Chief Deputy Wilson added that if there is a high-risk inmate sent to the hospital, they have to send two officers 24/7. Wherever he goes, there is a deputy with him. Mr. Teegardin gave an example of a prisoner who had over $700,000 of medical bills in the last 18 months. Mr. McBee asked if they monitor the term and cost associated with the accused. Mr. Long answered that they work with Mr. Godwin and go to the Judge. Sometimes GPS monitoring is used. Major Tighe added that the Board of County Commissioners pays for a Public Defender that is assigned to the Jail. There are about 30-40 people that come in every 24 hours. The nurses screen them within six hours. If there is severe mental illness or someone with a lesser charge that is going through a mental health hospital, they will be diverted at first appearance. The Public Defender gets the list, confers with the State Attorney, and gets approval from the Judge to send them out. In the more complex cases, they work with Mr. Godwin’s group. Mr. McBee asked if the term of incarnation was reviewed in the case where $700,000 was spent. Mr. Teegardin gave some of the specifics of the case. Mr. Tighe explained further. Mr. Casey asked about an urgent care physician at the Jail. They do have a doctor 24/7. They also have dialysis machines and a psychiatrist. They do as much as they can there. Mr. Godwin introduced Lisa Savage, Pretrial GPS Manager, before he completed the PowerPoint presentation. Mr. Casey asked about the GPS equipment in the shower. Mr. Godwin answered that the units are waterproof. The goal for the next year is a reduction in inmate medical expenses. Mr. Godwin handed out copies of the Detention Center Population Report (see attached). Ms. Savage invited the Committee to come to her office, meet her staff and see the program. Citizens’ Budget Committee February 20 2009 Page 5 Mr. Lounds asked about the sequence of events and how long it takes for a person to be admitted to the GPS system and out of jail. Major Tighe said it could be at first appearance or three to four days later. Ms. Savage said it could be hours. If the Judge wanted to do it at first appearance, they can hook them up. Mr. Lounds summarized that within a week they could get someone out of the jail. Mr. Godwin said if the court orders it, it is rapid. Ms. Savage added that her department has an agreement with the jail that if they receive a call; someone is sent within the hour. Mr. Lounds asked if mental illnesses are taken into account for GPS. Major Tighe said each case is evaluated individually. Major Tighe, Mr. Godwin and Ms. Savage gave examples. Mr. Lounds wanted the record to show that the complicated process takes place. Major Tighe added that they want to establish credibility with the Judges. Mr. Godwin said they want to protect the community. Ms. Savage told about a call she received from Martin County. Mr. Mundt asked about a daily fee and how many are on the system. 127 are in the program. 62 are on GPS. They have started talking to the Judges about payment. The cost of the satellite tracking company is $8 per day compared to about $50 per day cost of jail. Some cases would have a higher cost with medical care. Some, in pretrial status, are not paying. Major Tighe added that with rising health care costs, inmate medical fees are not going to go down. With the graying of America, the population of the jail is aging. They have abused their bodies and are sicker when they come in. That also drives up costs. There are inmates that commit crimes to come to jail to get medical care. Pregnancy is an example. It is a social issue, happening across the country. Substance abuse is another issue. Mr. Lounds asked that the County continue to work with the Sheriff’s department to reduce the cost. Mr. Godwin handed out Detention Center Population Reports and asked the members to call him if they had questions. Mr. Pancoast thinks the Committee should thank Mr. Godwin. He wishes they could share the information with the general public. If the taxpayers knew, they would feel differently. SPECIAL REVENUE FUNDS Ms. Outlaw shared that the pages handed out (see attached) were part of the effort to inform the members about the various funds. She is available for questions. Mr. Casey asked Mr. Furst about property values. Mr. Furst explained that they spend the year gathering the data. Everything that happened in 2008 is used to create the January 1, 2009 number. The State gives them from January to July to submit the number because the process takes time. He is certain it will be less than last year. They are working mostly with Port St. Lucie because the most issues are there. He has told all the taxing Citizens’ Budget Committee February 20 2009 Page 6 bodies that they should imagine a 20% decline. Fort Pierce should not be as drastic as Port St. Lucie because they did not run up as much. New construction is less than $100 million. There was $1.4 billion in 2007 and $660 million in 2008. That will be a big factor in the future. The role looks similar to last year. He does not believe property values will stabilize until the economy does. It is still dropping but not as severe. He thinks they should use the 20% he told them. Mr. Casey asked Ms. Outlaw if she used 20%. She answered that in January they showed the Committee the PowerPoint presentation Mr. Anderson made to the Board of County Commissioners in December. They started with 12-13% decrease and factored in the 20% as the worse case scenario. EQUESTRIAN CENTER/FAIRGROUNDS SUPPORT – DEBRA BRISSON Ms. Brisson informed the group that last year there was discussion about forming a committee for the Fairgrounds. She did form a working committee for the Parks & Rec Department. The Analytica report dealt a lot with the equestrian aspect of what the Fairgrounds could do. The Committee is studying the equestrian topic to see if it is something they might be able to do. Ms. Hensley, Chair of the IFAS Agricultural Extension Board, created a subcommittee and it has merged with Ms. Brisson’s committee. It is a great group and they are studying options for the Fairgrounds to get the most of the asset. Ms. Ferrick asked about a calendar of events for Fairground activities. Ms. Brisson said they are getting late contact from the promoters. Mr. Pancoast asked about an online site. Mr. Lounds asked how the Committee could help generate and track funds. Ms. Brisson answered that they need time to look at the mission for the Fairgrounds. Financing will have to be considered. Mr. Wells asked if the high school graduations could be a marketing tool. Ms. Brisson said unfortunately right now there is nothing to promote. The Fair, Monster Truck Show and graduations are all that are scheduled. Ms. Hensley added that last year their group decided to come up with a plan to help move the Fairgrounds up to an A center. They have the University of Florida resources for information. Hopefully, they can put together a plan to show that the investment has a short time to payoff and will be able to locate funds. Mr. Mundt asked about isolated incidences of lights on over empty fields. Ms. Brisson informed Mr. Mundt about the new tennis court lighting policy. The athletic lights are only turned on when scheduled by a youth provider program. They have asked, but are not always notified when games are canceled. She thinks there will be a substantial savings when compared at the end of the year. Citizens’ Budget Committee February 20 2009 Page 7 OTHER ISSUES Mr. Lounds asked Ms. Outlaw if she thinks they are being conservative enough to overcome additional downturns. Ms. Outlaw answered that even before the increased projection they were limiting travel, memberships, capital equipment and the vacancies that were filled. After the news, they have limited travel to within the tri-county region. She thinks the only things left are cutting back on operations and a reduced workforce. In her opinion, they have scraped the bottom. They are watching closely. Mr. Pancoast asked about savings for equipment failure. Ms. Outlaw said the $300,000 from the auction has been saved in a vehicle replacement account. Mr. Hensley added that there are contingency funds. Mr. Lounds said preventive maintenance is critical in downturn times. Mr. Mundt asked about the $900,000 to relocate Community Services. Ms. Outlaw answered that it has been put on hold. Some of the money was spent on other items and repairs for the current location. The $700,000 on account is being looked at as part of the local stimulus plan. The funds could be used by the Board of County Commissioners to generate work that would employ County residents. Mr. Lounds asked about the investment funds. Ms. Outlaw said that in general we are doing well. The Clerk of the Court has changed a couple funds. Since she does not oversee that area, the Committee may want the Clerk to come for a presentation. She knows he is meeting with his investment committee and they are watching. They may be making a presentation to the Board of County Commissioners. Mr. Lounds asked that the Clerk make a presentation at a time suitable to the Clerk and Ms. Outlaw. The former Clerk made a presentation last fall but an update was requested. Ms. Outlaw will work on scheduling the visit. Ms. Outlaw advised the Committee that the Board of County Commissioners is considering a couple versions of a Local Preference Ordinance. One option is for the local vendor that is within 5% of the low bid to match that bid and get the contract. The other version allows the local vendor, which is up to 5% higher than the low bid, to get the contract at their bid price. The Board of County Commissioners received comments from groups in the area. nd A Public Meeting is scheduled for March 2. Information will be sent to the members. The Local Preference Ordinance is part of the Economic Stimulus Plan the Board of County Commissioners is considering now. There is a special meeting scheduled for rd March 3 at 10:00 am in Conference Room 3. Mr. Wells complimented Ms. Ryder’s staff on the job they did at Christmas with the Toys for Tots program. ADJOURNMENT Citizens’ Budget Committee February 20 2009 Page 8 Mr. Hensley thanked everyone for attending and adjourned the meeting at 8:50 a.m. Ms. Outlaw thanked her staff. Respectfully submitted by: Brenda Marlin