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HomeMy WebLinkAboutApproved 2.19 Minutes w.backupCITIZENS' BUDGET COMMITTEE Meeting Date February 19, 2016 Conference Room 3 MEMBERS PRESENT: Dan Kurek Richard Pancoast Jay L. McBee William Donovan Patrick Campion Ed Lounds Carl Hensley Craig Mundt Steven Weaver Jerry Buechler Barry Mucklow Ron Knaggs Gwen Morris MEMBERS ABSENT: James Clasby John Culverhouse OTHERS PRESENT CALL TO ORDER Howard Tipton Asheley Hepburn Jennifer Hill Ed Matthews Leslie Olson Toby Long William Lawhorn Sandra Lerman Francine Sargalski Joseph Sabater Heather Young Mr. Kurek called the meeting to order. all 11 [00191kyi1►yi I:11111 No member of the public spoke. APPROVAL OF JANUARY 15, 2016 MINUTES Mark Satterlee Ron Parrish Don West George Landry Laurie Waldie Garry Wilson Paula Mangarella Ivelisse Chico -Randazzo Ron Parrish Allison Duffy Madeline Yaroma After a motion by Mr. Lounds and a second by Mr. Pancoast, the minutes were unanimously approved. Citizens' Budget Committee February 19, 2016 Page 2 SUNSHINE/ROBERTS RULES Assistant County Attorney, Heather Young, distributed the attached, explained the rules for the Committee members and offered to answer questions. INMATE MEDICAL Mr. Kurek gave the attached PowerPoint presentation. Staff doctors, specialists and pre- existing conditions were discussed. Mr. Landry, Risk Manager, presented the attached PowerPoint that he gave at the last BOCC Informal Meeting. Ms. Morris started discussion on HIV. Mr. Weaver asked about legislative priority, best practices and halfway houses. There was discussion on high cost inmates, trend, private companies, statute, DUI injury expenses, personal insurance, unneeded test prevention, medical staff at the Jail, Lawnwood, prescription drugs, Medicaid, affordable health care, definition of closest and laws in other states. Mr. Tipton thanked all the people working on the issue, outlined the process, advised of some of the issues and efforts. He mentioned Public Safety Coordinating Council, creative solutions, medicine, competition, Tradition, legislative potential, piggybacking, Orlando history and attention paid to the subject. Mr. Lounds started discussion on Lawnwood charging 200% of Medicare rate. Mr. Campion asked about a facility and using leverage. Mr. Pancoast advised the members of information from an article. Strategies were discussed. Mr. Lounds asked how they can help. Options were listed. Mr. Long suggested increase of the pretrial program. The jail population, policing and juvenile numbers were discussed. Mr. Kurek started discussion by listing the elements of the system. Mr. Hepburn reported on the efforts of the Green Belt team. Mr. Kurek applauded the efforts of all who are working on the issue. INFORMAL BOCC MEETING UPDATE Mr. Hepburn reported on the agenda of the last meeting. Citizens' Budget Committee OTHERISSUES February 19, 2016 Page 3 Mr. Lounds praised the St. Lucie County employees that worked the Citrus Trade Show. Ms. Morris started discussion on Economic Development. Mr. Tipton gave a legislative update and answered questions from Mr. Hensley and Ms. Morris about the sales tax increase. Mr. Knaggs started discussion on grants. Mr. West gave an update. Mr. Kurek announced the date of the next meeting. ADJOURNMENT Mr. Kurek adjourned the meeting at 8:54 a.m. Respectfully submitted by: Brenda Marlin The next CBC meeting will be held on Friday, March 18, 2016, at 7:30 a.m., in Conference Room 3, of the St. Lucie County Roger Poitras Administration Annex. INTER -OFFICE MEMORANDUM 5T. LUCIE COUNTY, FLORIDA TO: Citizens' Budget Committee FROM:. Heather Young, Assistant County Attorney 44t� C.A. NO.: 16-0088 DATE: January 22, 2016 SUBJECT: Sunshine Law - Open Meeting Requirements As you are aware, the Citizens' Budget Committee is subject to Florida's Sunshine Law, including the open meeting requirements. Under the Sunshine Law, meetings of local government boards and committees must be noticed in advance, open to the public, and minutes of the meeting must be taken. Unless otherwise prescribed by statute or the entity's operating rules, the notice should be posted a minimum of seven (7) days prior to the meeting. A meeting occurs whenever two (2) or more members of a board meet, whether formally or informally, to discuss matters which might come before the body for action in the foreseeable future. This prohibition extends to conversations conducted in person or through other means such as telephone or email. Accordingly, Committee members should refrain from such discussions unless they occur in a properly noticed meeting held in a location open and accessible to the public. There are penalties associated with violation of the Sunshine Law. A member of a covered entity who knowingly commits a violation is guilty of a misdemeanor of the second degree which may result in imprisonment up to 60 days. In addition, a member who commits an unintentional violation may be prosecuted for a noncriminal infraction and be subject to a civil penalty of up to $500.00. If you have any questions regarding the Sunshine Law, please don't hesitate to contact me at (772) 462-1441. H Y/ 3/11/2016 St. Lucie County Citizens Budget Committee Inmate Medical Important Factors ► Mandatory to care for inmates ► Currently only hospital available is Lawnwood Medical Center • Bills to county is 200% of Medicare. • State rate is 1 10% of Medicare ► Cost of transportation to and from hospital not included 3/11/2016 History of Inmate Medical Cost 2013 2014 2015 Total No. of Inmates 1,206 1,255 1,295 AVG. 1252 Jail Med Sry Contract 3,851,989 3,931,444 4,089,701 11,873,134 Medicines 570,281 605,200 653,000 1,828,481 Hospital & Doctor 1,787,146 1,973,932 3,420,000 7,181,078 Insurance 76,990 95,317 99,202 271,509 Totals 6,286406 6,605,893 8,261,903 21,154,202 Statistics to Think About ► Cost to Operate Jail vs Inmate Medical Cost 2013 2014 2015 28,968,654 31,045,059 33,342,564 6,267,631 6,365,861 6,764,150 21.7% 21.3% 24.8% 3/11/2016 Pretrial release Program Saves Bed Days - Average Daily Cost $60 2012 - 61,500 Bed days = $3.7M 2013 - 87,714 Bed days = $5.3M 0 2014 - 74,085 Bed days = $4.4M ► Total bed days saved through program 223,299 Bed days = $13AM Other Factors ► Overtime cost for deputy to guard inmates in hospital 2015 - $255,714 ► Increase in insurance from 2013 by $22,21 2 ► Reimbursement fr insurance 2013 - $231 ,402 ► Contract with Physician to oversee hospital stays in 2015 - $42,000 year 3/11/2016 INMATE MEDICAL TASK FORCE UPDATE 2/19/2016 PRESENTED BY GEORGE LANDRY Background Per Florida Statues (901 & 951) St. Lucie County is required to pay medical costs for inmates that have no means to pay on their own. These costs are incurred when an inmate has to leave the jail for medical care or when an injury occurs during the arrest process (prior to booking). z 01 3/11/2016 Inmate Medical Expense Trend Inmate medical expenses and HIV medications have continuously increased over the past 3 years. These numbers count for both prior to booking and external medical costs for inmates. 2013: $2.4 million (574k in HIV meds) 2014: $2.6 million (630k in HIV meds) 2015: $4.0 million (675K in HIV meds) 2016: $4.2 million (projected) i Other County Jails & Costs (Annually) • Volusia County $2.4 million for external medical services (1425 average daily population). • Okaloosa County $600,000 for external medical services (700 average daily population). • Brevard County $6.8 million total on inmate medical expense and $889,000 on mental health (1400-1500 average daily population). a N 3/11/2016 Task Force Members • George Landry - BOCC • Captain William Lawhorn - SLCSD • Paula Mangarella - Corizon Others that assist : • Mark Godwin - BOCC • Carlene Busse - BOCC • Dr. Roger Nicosia • Major Pat Tighe - SLCSD MISSION Evaluate the process and costs for inmates that require hospitalization and professional medical services outside the scope of care received by the county jail medical staff. Find ways to reduce costs incurred by the BOCC and SLCSD, while maintaining the high level of quality care already provided by the BOCC and SLCSD. 3 3/11/2016 CURRENTLY • 1250 average daily population (12,000 annually). • Roughly 3% of the annual inmate population is responsible for 80% of the external medical costs. • Prior to booking, medical costs represents roughly 20% of the external medical costs to county. • SLC Sheriff's Department works hard trying to mitigate when an inmate needs external medical care and is fast in their notification to the BOCC. • SLC Pre -Trial staff and Sheriff's Department work together diligently in recommending inmates for the Pre - Trial program. Actions Taken • Retained a doctor to review all inmate medical cases and communicate with medical providers to expedite the return to the jail. • Coordinated with County Health Department to establish timeline to enroll in 340b program (approx. next 12 months) and the Health Department is inquiring with their leadership for feasibility of expanded role to assist with inmate health care. • Established a communication flow between entities for faster notification when inmates require external medical care. L] 3/11/2016 Actions Taken Cont. • Researching best practices from other counties with similar jail population. • Looking for ways to expand inmate medical services to other providers. • Researching companies that provide similar services for external jail medical care (3rd party TPA). 9 Next Steps • Find and implement ways to reduce RX costs. • Continue to push State Legislative Leadership to extend to counties the hospital rates FDOC has negotiated (Medicaid + 10%). • Identify the best options to reduce external medical costs and present those options to the BOCC. • Once measures are implemented, the task force will meet quarterly to review and insure best practices are being utilized. 10 0 3/11/2016 Questions??