MACON COUNTY BOARD OF COMMISSIONERS  October 8, 2019 AGENDA  1. Call to order and welcome by Chairman Tate  2. Announcements 3. Moment of Silence 4. Pledge of Allegiance 5. Public Hearing(s) 6. Public Comment Period 7. Additions to agenda  8. Adjustments to and approval of the agenda  9.1 Reports/Presentations  A. Region A broadband update- Sarah Thompson, Executive  Director, Southwestern Commission  10.Old Business  A. Greenway Connector Project- Jack Morgan, Director of Planning, B. Update on Macon Middle School RFQ for Architectural Services- C. Revision to SCC Paving Project Agreement- Derek Roland,  Permitting and. Development.  Todd Gibbs, Macon County School System  County Manager 11.New Business  A. Mainspring Conservation and Trust will request permission to use a portion of county owned property on Siler Road to temporarily access the adjoining parcel of land which they have recently purchased- Dennis Desmond, Mainspring Conservation B. Request from Sunrise Ridge Road residents to change from West Macon to Clarks Chapel FD response area- Warren Cabe,  and Trust  Director of Emergency Management/EMS    C. Discussion concerning review of fire department contracts- Warren Cabe, Director of Emergency Management/EMS D. Nantahala Health Foundation grant request- Warren Cabe, E. Discussion concerning appointment of a new Tax Administrator- Richard Lightner, Tax. Administrator F. 2019 Tax Software update- Richard Lightner, Tax. Administrator G. Contract for services with Community Care Clinic- Chester H. Reject Bid Request No. 4310-09 In Car System and Body I. Frank Myatt (Carolina Motel) Occupancy Tax Penalty waiver  Director of Emergency Management/EMS  Jones, County Attorney  Cameras- Derek Roland, County Manager request- Lori. Hall, Finance Director  12.Consent Agenda - Attachment  All items below are considered routine and will be enacted by one motion. No separate discussion will be held except on request of a member of the Board of B. Budget Amendment #74 South Macon Elementary School Pre-K  Commissioners.  A. September 10, 2019 Board meeting minutes  Playground Equipment C.E Budget Amendments #75-81 D. Budget Amendments # 84-85 F. Tax Office Monthly Report  E. Tax Releases for September in the amount of $2,166.34 G. Macon County Public Health billing guide and fee changes FY H. Brantley Construction Change Order #2 South Macon School  19-20' Project 3.Appointments  A. Macon County Planning Board (1 seat)  14.Closed session (if necessary) 15. Adjourn/Recess    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: N/A  SUBJECT MATTER: Region A Broadband Update  COMMENTS/RECOMMENDATION:  Sarah Thompson, Executive Director of the Southwestern Commission, will provide the board with an update on their efforts related to  broadband expansion in Region A.  Attachments Agenda Item 9A  Yes  X No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019  DEPARTMENT/AGENCY: Planning, Permitting and Development  SUBJECT MATTER: Greenway Connector Project  COMMENISRECOMMENDATION:  Jack Morgan, Director of Planning Permitting and Development will request for the Board of Commissioners to designate Macon County as the lead agency on the East Franklin Greenway Connector Project.  Attachments Agenda Item 10A  X Yes  No    Greenway Connector Project  Estimated project costs as of 9/10/2019  1. Topographic/Route Survey 2. Project engineering and oversight 4. Grading and gravel base 5. Paving, 2" 6. Contingency Total  $2,500 $4,500 $25,000 $24,000 $8,000 $70,000  3. Short footbridge across DOT drainage $6,000    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019  DEPARTMENT/AGENCY: Macon County School System  SUBJECT MATTER: Architectural Services  Update on Macon Middle School RFQ for  COMMENTS/RECOMMENDATION:  Todd Gibbs of the Macon County School System will provide the board with an update concerning the Macon Middle School Project Request  for Qualifications for Architectural Services.  Attachments Agenda Item 10B  Yes X  No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019  DEPARIMENT/AGENCY: Southwestern Community College SUBJECT - MATTER: Revision to SCC Paving Project Agreement  COMMENTS/RECOMMENDATION:  The SCC Paving Agreement must be amended to reflect a change in the SCC Board of Trustees Chairmanship, which had occurred prior to the revised agreement being approved by the Board of Commissioners.  Attachments Agenda Item 10C  Yes X  No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019  DEPARTMENT/AGENCY: Mainspring Conservation and Trust SUBJECT MATTER: Temporary use of County Property  COMMENIS/RECOMMENDATION:  Mainspring Conservation and Trust is requesting the temporary use of county property located on Siler Road for ingress and egress to the adjoining parcel, owned by Mainspring, as they are wishing to make  propertylmprovements to their parcel.  Attachments Agenda Item 11A  X Yes  No        MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019  DEPARTMENT/AGENCY: Emergency Services  SUBJECT MATTER: Chapell FDs  Fire District Change-West Macon, Clarks  COMMENTS/RECOMMENDATION:  Four(4) residents on Sunrise Ridge Road off Sanders Road request change from West Macon to Clarks Chapel FD response area. Houses were not constructed when original maps were created and access is easier for Clarks Chapel FD. No PC ratings change to owners, fire  service fee will increase from $0.0724 to $0.0802.  Attachments X Agenda Item 11B  Yes  No    Richard Fallon 340 Sunrise Ridge Road Franklin, NC 28734 828-369-3396 July 24, 2019 Jimmy" Teem Fire Marshal 104 East Main St. Franklin, NC28734 Dear Mr. Teem:  Macon County Emergency! Management  This is to document our request to have our fire district changed from West Macon to Clarks Chapel. Wer make this request because Clarks Chapel is significantly closer and should provide faster response time. In no way should this request be considered a criticism of West Macon. Below are the names and signatures of the four households making this request. Thank you for your  support in this matter. Sincerely,  gRihgla  Richard Fallon  Billie Stallings BA.S9  Tim McMaham  A  Leo Charette  fo Chartle    BALSAN  Clarks Ghepdiclss  Clarks Chapel  STALLINGSE BILLIEG  CHAREIELEOPNR  EMXTNOTYALEN  FALLONA BRICHARDIA  lacon Class tMacon    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETINGDATE: October 8, 2019  DEPARTMENT/AGENCY: Emergency Services SUBJECT MATTER: Fire Department Contracts COMMENTS/RECOMMENDATION:  Discussion concerning review of fire department contracts. Last revision was in 2014 and changes are necessary to reflect recent revisions in NC Department of Insurance member requirements and any other items that might need updated. Review process needs to begin now so any changes can become effective. July 1, 2020. A copy of one: fire department's contract (Cullasaja FD) is attached for reference  purposes.  Attachments Agenda Item 11C  X Yes  No    STATE OF NORTH CAROLINA COUNTY OF MACON  CERTIFICATE OF FINANCE OFFICER: Budget and Fiscal Control Act,  This instrument has been pre-audited in the manner required by thel Local Government  This the 275 day of Janvary,2014.  ctuhskll Macon County Finance Officer  CONTRACT FOR FIRE: PROTECTION  THIS CONTRACT, made and entered into lisaEye of January ,2014, bys and! MEACUILASNACORCE FREANDRESCUENC.aNaN Carolinanon-profit corporation (hereinafter "DEPARTMENT"), with principal offices located at MACON, aj political subdivision for the State ofNorth Carolina (hereinafter" "COUNTY").  104 River R4  Franklin, Macon County, North Carolina, and the COUNTY OF  WITNESSETH:  WHEREAS, Fire Protection Service Districts have beendulyand properly created, defined and established in the COUNTY pursuant to the provision of Article 16of Chapter 153A of the North Carolina General Statutes in order to provide fire protection services to areas encompassed  bys such districts; and  WHEREAS, the General Assembly ofNorth Carolina didenact into law an: act to authorize automatic aids agreementandn mutual assistancel betweenf fire departmentswhereby: fullauthority may be exercised for fire departments to send fire fighters and apparatus beyond the territorial limits which they normally serve, said act having been codified as N.C.Gen. Stat. 58-83-1;  WIENEASPununtoN.cA Gen. Stat. 5A-235,15A-0lana, 153A-305, the COUNTY may provide fire protection services in defined service districts by contract with one or more  municipal and/or one or more incorporated volunteer fire departments; and  WHEREAS, the COUNTYisauthorized under the provisions ofN.C. Gen. Stat. 153A-305 and 153A-307 to levy property taxes within defined service districts, in addition to those levied throughout the county and in such amount as allowed bya applicablelaw, in ordert to finance, provide    or maintain for the DISTRICT, known as Cullasaja District as shown upon thel Fire District Map approved by the Macon County Board of Commissioners ati its RegularMeeting! held on February 11, 2008, a copy of which is attached hereto as Exhibit B and as further shown on Exhibit B-1 attached hereto, services provided therein in addition to orto a greater extent than those financed,  provided or maintained for the entire county; and  WHEREAS, the COUNTY has heretofore furnished fire protection services in said DISTRICT, to the extent oft the taxes collected pursuant to statutory authorization, by contracting  with the DEPARTMENT to furnish fire protection in said DISTRICT; and  WHEREAS, said DISTRICT! is currently served by thel DEPARTMENT; and WHEREAS, thel Board of County Commissioners, in accordancewitht the provision ofN.C. Gen. Stat, 159A-14, must set a special tax rate based on an annual budget estimate setting forth the monetary requirements for providing fire protection services that year ins said DISTRICT and keep and administer said monies in as separate and special revenue fund (ntereinafter-Revenue. Fund")to be used only for furnishing fire protection services within said DISTRICT; and  WHEREAS, the Board of County Commissioners, alsoacting pursuant to N.C. Gen. Stat. 159-14A,n mustadopta an: annual igtomimnepopriatnge taxmonies levitdandcolectedfrom thei fire protection servicedistricts: anda authorize transfersand expenditures from thel Revenue. Fund only for fire protection services in the respective fire districts as specified in contracts with fire  departments; and  WHEREAS, Chapter 159 of the North Carolina General Statues provides that the County Budget Ordinance may bei inanyf formt thati thel BoardofCounty Commissionersdeemst mostefficient in enabling itt to make the fiscal policy decisions embodied thereina and provides foraf fund fore each  special service district whose taxes are collected byt the COUNTY; and  WHEREAS, pursuant to N.C. Gen. Stat. 153A-13, 153A-233 and 153A-305, both the DEPARTMENT and the COUNTY desire to enter into a continuing contract to provide fire protection: servicesi ins said] DISTRICT: and tol have such contractsupersede and take thej place ofany  contracts previously executed;  NOW THEREFORE, for and in consideration of mutual promises and agreements herein contained and the mutual benefits to be derived therefrom and other good and valuable consideration, thereceiptandsuficieeyrwhahsherehyacknowledget, HeDEPARIMENTand 1. PAYMENT OF TAXES TO THE DEPARTMENT. So long as this Contract remains in effect, the COUNTY agrees to make funds available to the DEPARTMENT from the proceeds oft the special fire protection service district tax levied and collected from within the DISTRICT known as Cullasaja District as shown upon the Firel District Map approved by the Macon County Board of Commissioners at its Regular Meeting held on February 11, 2008, a copy of which is attached hereto as Exhibit B and as further shown on Exhibit B-1  the COUNTY do hereby promise and agree as follows:    attached] hereto. The amount ofs such service tax levys shall be determined by thel Board ofthe County Commissioners from yeart to year. Payments willb bei made on ai monthly basisi issued by the 15" day oft the following month provided this Contract remains in effect. 2. FIRE ROTECTIONSERVICES REQUIRED. So long as this Contract remains in effect, the DEPARTMENT will furnish not less than Class 9S fire protection and emergency medical and rescue services that the DEPARTMENT is licensed and/or trained to provide tos allj popertyloatedwilintiehounharisofaistictDISTRICT.-Thel DEPARTMENTwI. also provide emergency preparednessprotective measures when the COUNTYis exposed to al hazard as defined in 42 U.S.C. 519a. Nothing in the Contract shall be construed to prevent the DEPARTMENT from providing Mutual Aid Assistance to any othe rFire Department wilintiedsmimorhech-clhi-ferolierinChg: TheDEPARIMENTwilL respond and provide automatic aid for structure fires in neighboring districts which have been established. When responding in an automatic capacity, the DEPARTMENT will dispatch aj piece ofi fire apparatus capable ofc carrying ai minimum of 1,000 gallons ofwater. atapproximately thes samet time ast thel Department: in whicho district thei incident occurs. "Fire Protection" shall specifically include the provision ofs such emergency medical, andi rescue services that the DEPARTMENT is licensed or trained to provide in order to protect the persons within said DISTRICT: from injury or death. Nothing shall be construed toj prevent thel DEPARTMENT from providing Fire Service orl Mutual Aid. Assistance sO long as the DEPARTMENT continues to provide service to: said DISTRICT at al level no less than the DEPARIMENT'scument insurancerating: as determined by theNorthCarolina Department ofInsurance. Further, the DEPARTMENT may furnish Fire Service to areas not within the boundariesofany: Fire! District on an equipment and persomnel basis within the discretion of LIMITATIONS ON USE OF FIRE SERVICE DISTRICT TAX. Funds paid by the COUNTY to the DEPARTMENT shall be used: for one or more of the following purposes  the Chiefor Officer in Charge.  3.  and for no other purposes:  A. Purchase and maintenance of equipment; B. Purchase, construction and repair off fire: stations; D. Operations oft the DEPARTMENT; E. Casualty or life insurance upon DEPARTMENT members; and F. Workers Compensation Insurance premiums.  C. Amortization ofloansi incurred for purchase, construction or repair ofequipment of  fire stations;  Funds paid by the COUNTY pursuant to this Contract shalll be expended only as allowed by  applicable federal, state and! local laws, rules, orders and regulations. 4. ANNUAL BUDGET AND FINANCIAL RECORDKEEPING REQUIRED.  A. The DEPARTMENT shall prepare an annual budget, for the fiscal year beginning Julyl ofeachyear, providing for the receipt ande expenditure off funds receivedi from    the COUNTY, the DEPARTMENT shall host at least one meeting in which the general public may attend and review the proposed budget and make comment or inform the residents of their community through newsletter or other form of information distribution of their budgetary needs and subsequent request of the COUNTY. The COUNTY encourages the DEPARTMENT to have at least one person from said DISTRICT whoisn not an: artivememberoftheD DEPARTMENTtO B. Thel DEPARTMENT shall use the funds subject ttothis Contracti in accordance with the annual DEPARTMENT budget. The budget may be amended by the Fire Department Board of Directors within the funds made available by this Contract except that amendments providing for any expenditure that establishes a new operating expense that will extend beyond the current fiscal year shall require the C. The COUNTY may inspect the financial books andi records oft thel DEPARTMENT at reasonable times during regular business hours of the COUNTY. The DEPARTMENT agrees that it will supply such financial books and records oft the DEPARTMENTAIsswmibetaetamdalyrphhiaamshousefe-COUNTy. The DEPARTMENT agrees that it will supply such financial records, information or - verification as may reasonably be requested by the COUNTY. The DEPARTMENTShallmainainawriltenascouningsyptemwhchprovidesadeguite documentation of all its receipts and disbursements including, but not limited to, those related to the funds subject to this Contract. The DEPARTMENT shall also provide an annual report of revenues and expenditures from the previous calendar year certified by the DEPARTMENT's President and Treasurer. D. Copies oft the budget and certified annual reportofrevenues and expenditures shall be filed with thel Macon County Firel Marshal byt the third Fridayi in April preceding E. Int the event that the COUNTY's review of the financial records of the DEPARTMENTAwalsay deficienciesori irregularitiesi in the financial operations ofthel DEPARTMENT, or reportable and/or material issues(s) with regard to compliance of generally accepted accounting principles, the COUNTY shall give written notice thereof to the Fire Chief, the Chairperson of the Board or Chief Executive Officer, and at) least two (2) lesserofficer of the! DEPARTMENT. Within ten (10) calendar days of said notice, the DEPARTMENT shall provide to the COUNTYa written statement that contains an explanation ofe each suchi issue and an action plan (with implementation timetable) for resolving each suchi issue, and: shall provide periodic reports to the COUNTY on progress made in resolution of each issue. Resolution shall be made within thirty (30) days ofl Notice. If this Contract shall terminate before such correction, the DEPARTMENT shall have no further interest in or claim upon such funds. The DEPARTMENT shall be legally liable to the COUNTY for any funds expended in violation ofthe terms oft this Contract.  serve as a Board member.  concurrence oft the Macon County Fire Marshal'sOftice.  the beginning ofthe fiscal year.    F. Should the DEPARTMENT fail tos submit tot the COUNTY thei informationt required int this Paragraph 4 within thet time periods outlinedi in Sub-paragraphs 4B-Eofthis Contract, the COUNTY shall suspend all funds immediately until thei informationis delivered as set forth above, except that thel Macon County Fire Marshal may grant areasonable submittal extension ift the DEPARTMENT is unable to deliver the information for reasons beyond the control oft the DEPARTMENT. ADDITIONAL RECORD KEEPING REQUIREMENTS. The DEPARTMENT will maintain accurate written records regarding personnel training, infectioncontrol, ,Articleso of Incorporation, by-laws, fire district map and description, insurance district resolution, contracts with counties and municipal governments, engine/pumper service test, certified weight tickets for all apparatus, alarm log, meeting minutes, equipment inventory and apparatus inspection forms, which may be inspected at any time by or on behalf of the 6. ROSTER REQUIRED. The DEPARTMENT shall submit a copy oft the roster sent to the office ofthe State Fire Marshal, to the Macon County Firel Marshal by. June 1 ofeach year. The roster must have a minimum of twenty (20) personnel with eight (8) additional 7. EPORTOFRIRALERECONDTIONSAEQURED: TeD:PARIMENTaalaéai aR Report of Rural Fire Conditions on the form provided by the Office of the State Fire Marshal, to the Macon County Fire Marshal by Octoberlofeach calendar year. 8. CALL LIST INFORMATION REQUIRED. The DEPARTMENT shall provide a list of informationir including DEPARIMENTI mailingaddres.plone number, faxnumber, e-mail address, radio call number for all personnel, line officers, board officers, medical certifications, firefighter certifications and contact numbers for all personnel and an apparatus list to the Macon County Fire Marshal by January 31 ofeach calendar year. 9. TERMS OF CONTRACT. This Contract shall be come effective as oft the date set out in Paragraph 14ofthis Agreement, subject to the continued: legal existence ofs said DISTRICT and the DEPARTMENT, and shall continue from fiscal year to fiscal year unless sooner terminated by either party in accordance with Paragraph 10 of this Contract. 10. EBIMATONOFCOANTACTE Hilepwymylminethsc Contractupongivingthe other party at least eight (8) months advance written notiçe. The COUNTY may, in its discretion, immediately terminate this Contract in the event that the DEPARTMENT does not timely correçt deficiencies as provided in Paragraphs 4 and 12 or correct any other material breach of this Contract within ai reasonable time after notice of such breach. From and aftertheeffectiver date ofanyteminationofhis: Contract the DEPARTMENT shallh have no further obligations, including thej provision ofFire Servicesinsaid) DISTRICT, underthis Contract and shalll have no furtherright tor receive any Firel Protection' Taxes collected! by the  5.  COUNTY.  personnel for each substation.  COUNTY within the Fire Protection District.    11. WORKERSCOMPEASATON INSURANCE. The DEPARTMENT will be responsible 12. OPERATIONS DEFICIENCIES. The DEPARTMENT shall provide notice to the Macon County Fire Marshal of any facility, equipment or operations deficiencies (collectively "Operations Deficiency") which have surfaced as ai resultofany inspections conducted by any agency, such as the North Carolina Department of] Insurance or the Insurance Services Office. The COUNTY may, in its discretion, withhold all funds payable to the DEPARTMENT pursuant to this Contract as long as the North Carolina Department of Insurance, the Insurance Services Office or the COUNTYholds the DEPARTMENTto! be in Operations Deficiency. The COUNTY, in its discretion, has the right to terminate this Contract immediately if the DEPARTMENT fails to remedy any Operations Deficiency within a reasonable time, in no case later than eight (8) months from the date the DEPARTMENT was made aware of the Operations Deficiency(s). If this Contract shall terminate without such Operations Deficienciès being corrected, the DEPARTMENT shall 13. AMENDMINTTOCOATACITACITACMiP-Hmmahalymiteagumast 14. EFFECTIVE DATE. This Contract shall become effective as of the date on which the last 15. APPROVALBYDEPARIMENTE-TheDEPARTMENT represents by the executionofthis document by its President thàt this instrument has been duly approved by the 16. SEVERABILITY. Ifany clause, paragraph, or part oft this Contact is determined to be void or unenforceable by a Court of competent jurisdiction, theremainder of this Contract shall 17. INDEPENDENT CONTRATOR. The DEPARTMENT understands and agrees that, in enteringi ginto this agreement and povwdingseritces,lisatingasanimdepmaem contractor; neither the DEPARTMENT nori its employees, members or personnel shall be deemed or 18. ADMNITYAGREMINT Thel D#PARIMENTAaladmiy. and: savet the COUNTY harmless from any and all liability and expenses including attorney's fees, court costs and other costs incurred by COUNTY which are caused by the negligence of the DEPARIMENT, its agents, members, employees and personel, to the extent of the DEPARTMENT's insurance coverage. For this reason, the DEPARTMENT shall procure alli insurance coverages stated inj paragraphs 1,2,6and7ofExhibit. A, attached (paragraphs 3, 4 and 5 are optional), and shall cause the COUNTY to be named as an "Additional  forj payment ofv workers compensation insurance premiums.  have no further interest in or claim upon the funds withheld.  of the parties.  party executes this Contract.  DEPARTMENT.  remain in full: force and effect.  construed tol be employees ofthe COUNTY.  Insured" for liability coverage on all policies procured.    19. ASSIGNMENT. This Contract may not be transferred or assigned by thel DEPARTMENT 20. PRIOR CONTRACTS TERMINATED. All prior Contracts for fire protection entered between the DEPARTMENT and the COUNTY shall be deemed terminated as of the effective date of this Contract and this Contract shall be deemed to supersede any prior  without the prior written consent oft tbe COUNTY.  Contracts or other agreements.  21. NOWAIVER. -CANTeMe PONiSOROTIisCONIRACT at any time, or to request performance by the DEPARTMENT pursuant to any of the provisions of this Contract at any time shall in no way be construed as a waiver of such provisions, nori in any way affectt the validity ofthis Contract, or any partt therof, or the right 22. COMPLIANCE WITHI LAWS.RULES and REGULATIONS. The DEPARTMENT shall comply with all applicable federal, state and locall laws, rules, andi regulations. Failure to do 23. MINIMUM PERFORMANCE STANDARDS. The following minimum performance standards are agreed to by the COUNTY and the DEPARTMENT and are a part oft this A. DISPATCHING PROTOCOLS: Each DEPARTMENT shall comply with the B. ERSONNELONSCENE: Eachl Firel Depamtimentshpuldhaven: adoptedstandard operating guideline that addresses the appropriate number of firefighters needed on all type fire calls. A current, valid copy of the Fire DEPARIMENT'S guideline should be kept on file with the Macon County Fire Marshal's Office. Each Fire Department should have the goal of placing sufficient personnel on the scene when makinginitialatackonal: structure firecalls or whenre repnligloohermegeny C. TRAINING: Each Fire Department shall meet the minimum standard training requirements set forth by the State of North Carolina and the COUNTY where  oft the COUNTY to enforce each and every provision.  sO will be grounds for immediate termination oft this Contract.  contract:  COUNTY dispatching protocols.  situations.  applicable for providing Fire and Rescue services.  D. FIREI INVESTIGATIONS: The Fire Department officeri in charge at all fire scenes shall attempt to determine the origin and cause of every fire. When the officer in charge can not determine the origin and cause ofthe fire or ift the cause is suspected tol bei incendiaryinnature, the officerino charge shallrequesta tai representative: from the Macon County Fire Investigation Support Team, the Macon County Fire Marshal's Office and/or the appropriate law enforcement agency to assist.    E. RECORDS: Eachl Firel Department shall keep all records on site or easily accessible F. MEDICAL FIRSTI RESPONDER: Eachl Firel Departmenti may choose toj participate in the County Medical First Responder Program. Participation is fully voluntary. However, each Fire Department which participatesi in the program shall conform to G. EMERGENCY DISASTER RESPONSE: Each Fire Department shall follow the Macon County Emergency Operations Plan when responding to an emergency H. STATE OF EMERGENCY: The COUNTY may request the Fire Departments to assist with other life saving and property protectionmeasures. as neçessary during a State of Emergency. All operations shall bei in accordance with the Macon County pyomhaslia hd 24. FEES FOR SERVICE. A service fee may be charged for false and frivolous residential or business fire alarm calls as follows: The first such alarmi is free; the second such alarm will resulti in al letter being sent from the DEPARTMENT tot theproperty owner requesting they correct the problem within ten (10) days; and such calls thereafter, within a twelve month period, may result in the DEPARTMENT charging the property owner a service fee. The DEPARTMENT may attempt toi file a claim with an individual, insurance carrier, or other responsible party for reimbursement for consumable supplies or damaged equipment resulting from a hazardous materials incident when such expenses would place an undesirable financiall burden upon the DEPARTMENT.Ihe. DEPARTMENT shall furnish other fire, rescue, medical or other such emergency protection action that they are trained and/or certified to provide without charge to all persons and property located in said DISTRICT in an efficient manner. This provision shall not prohibit the DEPARTMENT omemsfng.hmbpomnstwi thel Federal, Stateorlocal vemmetsoruliyempanis for the provision of emergency protection services not inconsistent with the 25. GOVERNINGLAW.Unlessothervise specified, HiCasialepmalywa laws oft the State ofNorth Carolina, All litigation arising out ofthis Contract shall be brought in 26. HEADINGS. The subject headings of the paragraphs are included for purposes of convenience only and shall not affect the construction or interpretation of any of its provisions. This Contract shall be deemed to have been drafted by both parties and no 27. NOTICES. All notices which may be required by this Contract or any rule ofl law: shall be effective whend deposited! linanofficial depositoryoftheUniteUniedSiatesPosta!: Serviceorwhen  for at least five (5)years.  the Macon County First Responder policies and procedures.  disaster.  DEPARIMENT's duties under this Contract for a fee.  the General Court of Justice in the County ofN Macon, North Carolina.  purposes ofir interpretation shall be made to the contrary.  received by hand-delivery as follows:    NORTHCAROLINA MACONCOUNTY  I Anauds B. Peek Carolina, certifythat Linda H. Heulw  Notary Publici forl Macon County, North personallycamel before met this day  andacknowledged that he (orshe)is Corporate Secretary for Cullasaja Gorgel Fire andl Rescue,I Inc., aNorth Carolina non-profit corporation, and that by authority duly given and as the act of the corporation, the foregoing instrument was signed in its name by its President, sealed with its corporate seal, and attested by himself (or herself) as its secretary foregoing on behalf of the  corporation.  Witness my hand and official seal, this the 3ldayo Januay  2014.  B VOTARY (OFIÇKSEAE 11AS ACONS 90.7  Public  Printed Name afNotary Commission My  AribkL  Expires: 9-04-16  NORTH CAROLINA MACON COUNTY  Pamela F. Remy  NotaryPublici for Macon County,North  Carolina, certify that Kevin Corbin and Mike Decker, personally appeared before me this day and acknowledged that they are the Chairman oft the Macon County Board of Commissioners and the Deputy Clerkt tot thel Macon County BoardolCommisioners forl Macon Coumy,NorthCmoim.and that by authority duly given and as the act of Macon County, North Carolina, the foregoing instrument was: signed bys such Chairman ofthel Macon Countyl BpanlofCommisioners, sealedwith its corporate seal and attested bys such Clerk to thel Macon County Board of Commissioners.  Witness my hand and official seal, this the 22 day of Januang ,2014.  Amu RumelaF. Remmy NotaryPubdg Printed. Name ofNolary ( My Commission Expires: 817-2014  (OFFICIALSEAL) 14411 milllil F. PERP" # st ca    EXHIBIT A  INSURANCE REQUIREMENTS  The DEPARTMENT shall take out and maintain during the term oft the Contract, the following  insurance coverages: 1.  Comprehensive Automobile Liability Insurance providing limits of liability at least in the amount otsl,p00.00combined singlel limits. Coverageshallb be! provided with asymbol"P" forl liability. The policy shall also name volunteers and employees as insureds. The fellow member exclusion shall be removed. Automobile Collision and Comprehensive Insurance written on agreed valuel basis fora all emergency vehiclesexcept; private passengert types. The agreed value shall be for the approximate replacement cost of the vehicles.  2. Campalsmhe@msalahiny Insurancei includingcoverage: forp personal injury,property damage, contractual liability, products and completed operations coverage, and pollution liability for emergency operations and training operations away from premises. Coverage shall be provided for intentional bodily injury and property damage. Policy shall include coverage medical malpractice, not limited to bodily injury and including the failures to render medical services. Policy is to include coverage for failure to respond. Coverage shall also be provided for watercraft ifa any are owned. The limits shall be $1,000,000 combined 3. An Umbrella policy shall be provided with limits of $1,000,000 per occurrence and 4. Directors & Officers coverage shall bej provided with limits of$1,000,000 per occurrence and $2,000,000 aggregate. Coverage shall be included for Civil Rights violations and 5. DEPARIMENTshal! maintain Propertyl Insuranceundera a"special Icaused ofloss" form, The policy shall be written on a replacement cost basis with a guaranteed replacement cost endorsement on the building(s). All portable equipment shall be insured on ai replacement 6. Thel DEPARTMENTshal! namet theCOUNTYasana additional insured for liabilitypurposes only on all policies. The DEPARTMENT shall furnish the COUNTY with Certificates of 7. Because the DEPARIMENTisrweiving tax dollars or grant funds from the COUNTY,the DEPARTMENT shall maintain al Blanket Fidelity Bondinthe amount of at least $100,000.  single limits per occurrence and $2,000,000 aggregate limit.  $1,000,000: aggregate.  Employment Related Practices.  cost basis with a guaranteed replacement cost endorsement attached.  Insurance annually.    EXHIBITB      EXHIBITB-1 Cullasaja Fire District  Hhnllal 30DE  DD    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: EMS  SUBJECT MATTER: Nantahala Health Foundation Grant Request  COMMENTS/RECOMMENDATION:  Request approval for submission of a grant request to the Nantahala Health Foundation to replace/upgrade several pieces of equipment for  EMS.  Attachments Agenda Item 11D  X Yes  No    Nantahala Health Foundation  tpswwngratirquestnseayapxd-aUoSeAL.  Nantahalal Health Foundation Organization! Name Macon County EMS Legal Name Macon County EMS TaxI ID Annual Budget 56-6000930 4006698.00 Year ofI Incorporation 1979 Mission Statement Address 104E, Main Street City Franklin State NC Zip Code Z8734 Website htp/www.maconncorg/ems.ntm) Brief! History  Organization: Information  Macon County Emergency! Medical Services shalls strivet top provide ther most effective out-of-hospital emergency medical care posslble, top provider rapid access  tos suchs service, andp provide for the safetyo of the citizens of Macon County andt those passingt through our community.  Macon County assumedt the operations of Emergency Medical Services In thef Franklin area on. July 1, 1979. Wea assisted the Highlands Fire Department with operating their EMS division beginning Ini 1981 anda assumed fullr responsibility ofE EMS fort thet Highlands aread on July 1,1 1984. EMS operations In Nantahala was We currently have 40 full-time employees with onez 24 hour Paramedic crewi ink Highlands and Nantahala and three 241 hour Paramedic crews in Franklin along witha a2 241 hour Paramedics supervisar ina a quickr response vehicle based inF Franklin tos support allo of our crews. Oura annual call volume is approximately 6,500.  then assumed by Macon County onA August 1, 1998.All of Macon County! EMS went to Paramedic level servicei ini 1996.  Contact Information  Organization Prlmary Contact Prefix First Name Warren Last Name Cabe Title Director ofE Emergency: Services E-mail wcabe@maconnc.org Office Phone 828-349-2067 Request Primary Contact Same as Organization Primary Contact No Prefix First Name Tadd Last Name Doster Title EMS Coardinator E-mail dostergmaconnc.org Office. Phone 828-349-2548  lof5  930/2019,9:22AM    Nantahala Health Foundation  tpsywwwgrattrquesicmptntetiteyapxsaroUos4AL.  Organization Demographics  Staff Composition! ina annual numbers Paid Fulll Time Staff 40 Pald PartT Time Staff 27 Volunteers 0 Interns 0 Other: Staff 1 Other Staff Explanation Total Staff Cckt thei lcntoc calculate 68.0000 Request Information RequestA Amount 100150.00  Wel have ana administrative: assistant shared by other Emergency: Services departments withint thec county.  Request Information  Summarize the Purpose ofRequest (5 sentences orf fewer) andt tralning program at our agency. Project Start Date 12/1/2019 Project End Date 6/30/2020 Organization Overall Goals and Objectives Goals: -Providet the! highest quality prehospital emergency care Ensures staff are weli trained ande equipped -Provide fors safe ande efficlent transport ofp patients Objectives:  Ag greater demand is being plaçed on EMS agencles when It comes tot technology, We are acquiring andt transmitting electrocardiograms (ekg) and digital communications. areb becoming more required. Thep purpose oft thisr request is to upgrade andr replace ouro current laptop computers, install ar more stable wireless access point1 In ourv vehicles, replace one of oura aged cardiac monitors and to acquiree equipment ands supplies to enhance our caret top pediatric patients  -Equip ourf fleet ofa ambulances withe equlpmentt to accomplish our goals inas safe ande efficient  Wep place al high priority ont the education andt training of ours staff. Wer reçently restructured ours staffing model sot that wer now have al Field" Training Officer (FTO) on every shift. Wee encourage ands support ours staffi in seekinga additional educational opportunities through conference and workshop attendance. Almost 30% ofo our Paramedic: staff have attained Critical Care Paramedic Transport certification throught thel University of Maryland, Baltimore College. Wey work to ensure that our ambulances: and processes ares safe ande efficient for both patients and ours staff. We strive tot fosterr relationships with our local medical providers and! hospitals to ensure wea are providing the highest) level oFcare to our patients. Wep participate inc committeest that work tof finds solutions to oura area's challenges concerninga access to healthcare. Wev work closely with our regionals specialty centers to ensure that patients experiencing serious medical conditions such as Stroke and! Heart Attacks as well asi injuries are delivered to ther most appropriate fadlity. These extendedt transports! benefit from enhanced Wes staff fiveF Paramedic Level ambulances ando one Paramedic quick response vehicle 24 hours per day. Wev work closely witha alle eleven county Fire Our Community Cara Paramedic program has fives speclally tralned senlor Paramedics thatp provlde home visitst top program enrollees. The goal oft this program is to help patients manage their medical conditians at home, Improving their quality of life and appreclating signifiçant cost savings by avoiding costly hospltal Emergency Room visits. The Program was recognized by the North Carolina Division of Aging and AduServices! by belng presented the Edwald B. Busse Award. The Busse Award was established' "tor recognize anl Individual ord organization that has! hada a significant Impact on enhancing thel heaith status of older North Carolinians through efforts to direct health-related policies and/or to provide leadershipi in developlng Innovatives solutions tol health care problems." The award Is named for Dr. Ewald W.E Busse, who was president emeritus of the North Carolinal Institute OfM Medicine and a founding director of the Duke University Inz 20171 Macon County EMS received the Southwestern Community College EMS Service oft the Yeara award fort the thirdy yearr running. This awardi is voted onby the graduating Paramedic class based ont their experience while performing clinical ride- alongs with EMS agencies inc oura area. Thiss shows our passion and  technalogy we: ares seekingt tos acquiret through thisf funding opportunlty, Departments whoz all provide First Respander services to assist ouro crews.  Description of current programs anda activities. Please emphasize majora achlevements oft thep past two years.  Center fort the Study ofAging andi Human Development. dedication to thef future ofo ourp profession.  Elght ofo our Paramedics! became the first tot bet trained in Crisis Intervention' Techniques in they western part of thes state.  WeH have provided CPR and First Aidt training tos several area churches.  2of5  9302019,9.22AM    Nantahala Health Foundation  tpsywwwgranrquesieicaptatsrey-epftroUosaAL.  Description off formal andl Informal relationships with other organizations.  Wep partner with various allied health care providerst toa achieve our goals. These Include areal hospitals and primary care physicians where we recelve referrals into our Communlty Care Paramedic program. Wep participate inag group thatf focuses onad demographlc of patlents that are identifieda as High Utilizers' of Emergency Department resources toi identify patlentsy wer may help managet their! healthcare at home and avoid unnecessary hospital visits. We also participate ina another group that addresses patients withf frequent hospital readmissions. We partner with! local Mental and Behavioral Health Providerst to address substance abuse and medication compliancel In this demographic ofp patients. We alsol leada ap post-overdose follow- up program. We work closely with Macon County" Transit to: assist patients witht transportation forf follow-up appointments toe ensure they continuet to receivet thec care they need, We alsop participatedi ina Life Skills Class through the Union Academy where various community leaders and organizations provided sessions related tos successfult transition to aduitl Ilfe toatri risky youth. Wea also partner with Southwestern Community College top provide American Heart Association Basic Life Support (CPR) and First Ald Training Our agency has as significantr need] In upgrading and/or replacing technology ande equipment in order to continue top provide optimal care andt to communicate with destination hospitals and our dispatch center. Ourv wireless access points in our vehicles are a consumer grade praduct thatf falls to meet the demands ofa publics safety agency, Our laptop computers have exceeded their! lifee expectancy ande encounter failures that our IT department canr nol longer rapair, Wel have an inventory oft thirteen cardiac/patient: monitors wer maintain, however many oft these units areo over 6y years olda andv wer need tol implement a capital replacement plan to begin replacingt these aging units. Ouro community Care Paramedic program isi in need ofar mare robust charting system to betier maintain records oft they program's patients. Duet tos stater mandated) protocol changes related tot the care of children, wea arer needing to upgrade our pediatric cares system protocol books anda also hopet to acquire a digital apps so all crew members will have immediate access to information, helpingt toz avoid treatment errors Int this fragile demographic ofp patients. Finally, weh have ar needt tou upgrade ourt training department vith an updated Iibraryo oft textbooks andr replace well-used training 1.A Acquire public safety grade fixed vehicle application LTE routers for EMS vehicles top provide as stable and more effective wireless access forc ouro data 2. Replace oura agedI laptop computers with ther necessary technology required toa accomplish auri intendeds goals inan more efficient manner,  toc community and civic organizations atar reduced cost. Describe the community and/or agency needs or problems this effort wila address,  equipment. Goals and Objectives of project. transmission.  3. Institute ar replacement; planf for our cardiac monitors. 4.A Acquire a chartings system for our Community Care Paramedic Program 5.L Update pediatric treatment systemp protocol books and acquire digitala app foralle employees 6. Acquire needede equipment ands supplies to maintain ande enhance ourt trainings program. Timetable fora eccomplishing stated goals and objectives.  Fiscal year: 2019-2020 Program Methodology  Ther methodology supporting thet technology and capital equipmentr replacement portion ofc our request Ist thec documentation related to the increasing expense ofn maintalning the current units inc ourl Inventory and thel limited useful range of our current mobile wireless network. Our m department hasi indicated to ust that future failure of ouro current laptops willr resulti in them beingr removed from service ast they! have passed their expected useful life, they are obsolete asf far as specifications and the cost of repair exceeds thelr value, Through routine maintenance anda a rotationp policy, we alreadye employ processes to extendt thes serviceable lifed ofour cardiacr monitors toa achieve a maximum return ont these investments. We still haver recognizeda ank Increased need forf factory service due to normal wear andt tear fromf frequent use. Our Community Paramedics currently use a documentation program that was created and donated bya alocale entrepreneur:. This! hass served usv well upt to this point, however we experience difficuity In informations sharing amonga allied healthcare providers and decreasede efficiency. The! N.C. Office ofE EMS recently updatedo ourp protocols related tot treating pediatricp patients leaving usy with printedp protocol baoks that arei in need oft being  updated. Staffing for project. Collaboration with other agencles  Our N.C. OEMS approved teachingi institution isi in need ofu updated equipment ands supplies. Ouro current level ofs staffing wilis suppart the projects int this request.  Thel LTEr routera and Laptop portion of this request has been coordinated with the Macon County Ir department as weilz ast theN Macon County Emergency Services Wev work closely with our areas Fire Departments to ensure compatibility! between our cardlac monitors andt thelr AED'st to help Increase efficiency and hold Thec charting system for our Community Care Paramedic program willf facilitate information: sharing among ourp patients Primary Care Physicians ando other allied Wea also work closely with area Community Collegest toe enhance ourk knowledge, skills anda abilities. We also provide opportunities for our stafft to attends state This request will provide Macon County. thef funds needed toi initiate this bechnology ando capitale equipment replacement program without sacrificing elsewhere in our operations. EMS continuesto: seei increases in service demands related toe equipment, vehicles andp personnel which creates ar funding conundrum finding balance with minimizing thef financial burden tot taxpayers while maintaining al level ofs service the community expects and deserves. The future presents many challenges fort the EMS profession." The U.S. Department dfl Labar projects thatt the: Job Outlook for EMTS and Paramedics willg grow by 15% between 2016-2026. Wich many areas already citing staffings shortages, this wills surely make fora competitlve market. While Macon County EMSI is solid ons staffing currently, wes are proactively lookingt tot thef future. Wep place a priarlty ond oure employees and ourp patlents. We place high expectations on our crews however we also provide them with thet tools and opportunities toe exceed these expectations. To continue to achieve our goals, wer must attracta andr retain good people. Thisi is our  Radio Maintenance department toe ensure this purchase willr meet our current needs as wella as our needi intot the future.  down costs forb both the departments and our patients.  healthcare providers. Sustainability planf forp project.  and national conferences toE ensure we arel keeping upv with trendsi in pre-hospital emergency care.  mission: andt this project willl help ust toz achieve this goal, Geographical, Area Served Select theprimary muntiess sesved! below Jackson (West-W5) Macon (West-W5)  Demographics of populations to bes served byt this Grant Gender/Gender Identity of people served  3of5  9/30/2019, 9:22AM    Nantahala Health Foundation  tps/wwwgranteqpesticmpintefredyepxc-CoAL.  Females (55%) Males (45%) Age Groups Served Infants (0-2) Children (3-9) Preteens (10-12) Adolescents (13-18) Young Adults (19-25) Adults (26-64) Seniors (65+) Evaluation  Evaluation  Explain how you will measure thee effectiveness of your activities. Goa! 1- Acquire public: safety grade Fixed LTE routers for EMS vehicles. Wee expect tos seear marked decrease In thef failure oft the devices andl Increased usable range. Goal2 2-A Acquisition ofn new laptop computers for allE EMS vehicles. Goal3 3- - Replace Zoll> x-serles Cardiac Monitor need for factory repair and related cost savings.  Wee expect to experience higher performance ando decreased need fors service as compared tot that wec currently experience from our aged units. We willl bes able toa acquire digitals signatures, eliminating the need to acquires signatures onp paper forms thatr mustt then be scanned andi importedi intot the patlent chart. This willr reduce cost andi increase efficiency. Several vehicles are currently without a computer duet tof failure and Insufficient fundingt tof facilitate replacement. Byr reviewing maintenance ands servicer records, wey will begin ar replacement of ther most identified unrellablet units sot that wev willa appreciate a decrease Int the Goa! 5- Purchase updated Pediatric Protocal Books and moblie appf fura alle employees. Crews willl bet better equipped tot treat pediatric patients and ther moblle Our Field Training Officersv will! be better able to traine employees onr newt treatments and also allow alle employees to refresh on their skills. Goal 1- Wev willr recognize ar more: stable wireless network allowing ust tor morer reliablyt transmit patiento datal Ine emergency: situatlons, toi integrate with our communlcation center's Computer Aided Dispatch system, decrease thet time system! Is' "down" due toe equipment failure andt to experiencedal wider usable Goal2- Decreasedr maintenance, Increased efficiency by having the capabllity to capture electronic: signatures in place of scanning and attaching paper forms  Goal 4- Acquire Charting System for Community Care Paramedic Program Wev wille experience Increased efficiency and exchange of Information with allled healthcare providers. appy will have lifesaving! Information easily accessiblet to alle employees. Goal 6- Updatec ourt traininge equipment ands supplies Describe your criterlaf fors success,  range through the system's external mounted antennae. and continued integration with our Communication Centers CAD system. Goal 3- Recognize ac decrease Ins spending fore equipment maintenance: andi increased reliability. Goai4- Increased efficiency: and better abilityt to exchange Information. Goal 5- Provide crews with accurate Information tol increase efficiency and sccuracy, Describe ther results you expect tol have achieved byt the end of the funding period. patient carei inat timelyr manner without the equipment ands service failure we currently experlence.  Goal 6- Recognize benefit from updated equipment to allow all employees to maintain proficiency in knowledge, skiils anda abilitles.  Goal 1- Equipment wil bea acquired andi installed. Wev will experience ar morer reliable wireless network andi increased ability to share! Informatian relatedt to Goal 2-E Every patientt transport results Inr multiple documents! being scanned and uploaded Into: aj patient's chart. Patient chartingy will bel less cumbersome for ouro crews sincet thef forms willa already bei inside the charty witht the electronic signature affixed. Our IT department wil spend lesst timet repairing our obsolete Goal 4-1 Increases efficiency of Community Care Paramedics andi increased satisfaction ofa allled healthcare providers through enhanced Information exchange  units.  Goal 3- Wev wills spend lesst time troubleshooting equipment failure and need tos send units offf forr repair. Goal5 5-Crews willl ber more confident ande efficient whent treatingi iH and. injured children.  leading to better access to caref ford ourp patients.  Goal 6- More proficiency fram EMS providers. Increased Knowledge among alle employees leadingt to better patient care.  Attachments  Attachments- Click choose fllet then Upload on each attachment below Audited financial statements fort theia lastn fiscaly year,o or7 TaxF Farm9 990.1 Ifneltherd documentis avallable,! Includen mostr recentf Ananclals  Auditedf financial statements Macon County CAFRI fye 06.30.18.pdf Currenty year's operating budget  Currenty year'so operatingb budgettoinclude! bothp prajected expenses and: revenues. Categorizee expenses under pragram, general anda adminfstrative, andfundralsing.  4of5  9/30/2019, 9:22 AM    Nantahala Health) Foundation  Atps:/www.grantrequestcomprinternendyaspx/sd-6U68OcAL.  Operating Budget.pdf Program budgetv withr narrative Other Funding Sources ABsto offaundatians, Funding Organizations.pdf notarized Letter ofA Authorization. IRSI LTR 147C.pdf Current Board of Directorsl Ilst Showinga ExeautiveCommite, Olrectore employment afliatians ande 2019 Commissioners.pdf Resume or Curriculum' Vitae or orgarization'sp primaryLeader. Doster-cv.2019.pd Latesta annual report Letzer ofA Agreement Letters of Support  Nantahala Health Foundation-Request: Budget with Narrative.pdf  or goveramental: agendesy which fundedt theo organtzationint thel lastf fiscaly year, Including amountso contflutedots1,000: andabova.  Verification oft the organization's orf fiscal agent's tax-exempt status under Section 501(c)3 and! 509(a) oft the IRS code. Ifu using at fiscal agent, please include  Itheprajecf far whichf fundingts sowgntbsacllomation witha athera agendes, Includel letterso ofagreement specifctot thep projectn frome eacho collaborating agency. Combinet theletterso ofagreementi into onepdf.  Uptothrees signed! letterst ofsuppart fromc cammunityl leaderss sperifict tothep prjectrequast, Combine thek lettersofa agreementi intoo anepdf  5of5  9302019,9:22AM    Nantahala Health Foundation, Project Budget 1 Fixed Vehicle application LTE Router 2 Dell Ruggedized Laptop 3 Zoll) X-series cardiac monitor 4 ESO Solutions Community Care Paramedic Software 5 Handtevy Pediatric System Protocol Books & App 6 Training Supplies & Equipment  Item  Priceea Qty Extended cost 925.00 14 2,700.00 14 37,500.00 1 2,000.00 1 2,900.00 1 7,000.00 1  12,950.00 37,800.00 37,500.00 2,000.00 2,900.00 7,000.00 $100,150.00  Total Request  Item #1:  The Fixed' Vehicle application LTE Routeri is al Public Safety rated devicet that willl be mounted in each EMS vehicle in our fleet. Thel Router will replace a consumer grade Wi-Fihotspot that currently plugs into a 12v (cigarette lighter) porti ini the vehicle. Our current units continuously overcharge and damage the battery and unit. They also lack an external antenna which greatly limits their usable range. The router is used tos send patient data wirelessly to receivingf facilities, to a secure: server wheret the information is imported into the patient care record and we also utilize the "Wi-FI" to connect to our  CAD (computer: aided dispatch) center.  Item #2:  Our current laptop computers have exceeded their usable life. We use the laptops to complete patient care reports and toi integrate with the CAD: system. With these new touchs screen devices, we will also be able to capture signatures electronically on disposition forms, billing forms and other documentation. This willi increase our workflow and alleviate the needi to acquire signatures on paper forms which must then be scanned and attached tot the patient care report after thei fact. This will also reduce our cost  since we will not require the printed forms.  Item #3:  We currently! have thirteen cardiac montors/dellbrllator. These monitors are among the most advanced prehospital patient monitoring devices available on today'sr market, providing us the ability to perform 4 and 12 lead ecg, monitor blood pressures, oxygen saturation, end-tidalcarbon dioxide levels, carbon monoxide levels and temperature. Annually, we purchase an extended" warranty and preventive maintenance service fore each monitor. We dor not currently havet the ability to implementar replacement plan on. these devices. Some ofthe units have been in service for over 6y years. With their high replacement cost, replacing multiple units simultaneously would create as significant burden. This award  willi facilitate the replacement of one of these aging units.  Item #4:  Our Community Care Paramedic program currently completes their documentation through a secure program that was developed and donated to us by a local entrepreneur. While this program has served    us wel! sincet the programs' inceptioni in March of 2015, it is an understatement to say that we have outgrowni its capacity. This new software would also allowi for better information: sharing with our  patients primary care physician and other allied healthcare providers.  Item #5:  We purchased a Pediatric Resuscitation; System developed by Dr. Peter Handtevy. This comprehensive system is a platform that is customizedi to our approvéd protocols and has all medications and equipment organized by patient size & weight. This system is supported by peèr reviewed research which showed a3f fold reduction in errors when the: system was used. Duet to a change to our N.C. Approved Protocols, our systems printed guides arei in need of updating. We also desire to purchase the mobile application for our crews so that they have thei information att their fingertips. This request will update all: 15 of our printed guidebooks and ar mobile app fora all of oure employees.  Item #6:  We have a needit to update our library of textbooks and a need to purchase updated training equipment. This equipment would be used in our N.C. Office of EMS Approved EMS Teaching Institutioni to provide in-servicet training to our crews and also to purchase American Heart Association approved CPR manikins so that we may continue to provide CPR training to area Churches, Civic Groups, volunteer organizations  and the general public at little to no cost.    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MIEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: Tax Office  SUBJECT MATTER: Administrator  Discussion concerning appointment of Tax  COMMENTS/RECOMMENDATION:  After 35 years of service as the Macon County Tax Administrator, Richard Lightner is retiring. He will be requesting that the Board of Commissioners consider appointing Mrs. Abby Braswell as Tax Administrator upon his retirement, to fulfill the remainder of his term, Abby is a 15 year employee of the Macon County Tax Office, and is certified as both a tax assessor and tax appraiser by the North Carolina  which expires on January 1,2021.  Department of Revenue.  Attachments Agenda Item 11E  Yes X - No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: Tax Office  SUBECTMATTER: 2019 Tax Software update COMMENTS/RECOMMENDATION:  Tax Administrator Richard Lightner will provide an update to the Board on steps being taken by the Tax Office in preparation for the replacement of Macon County's current tax software system. The  current system has been in operation since 1982.  Attachments Agenda Item 11F  X Yes  No    2019 Tax Office Software Update  Macon County has been on its present software since 1982, at that time, it was basic billing, collection, and land records software. It was developed as part of project with Orange County under the ownership of Fulcrum/Infoce.. At one time, it was one of the largest software programs used in North Carolina for property tax. The programing was done in an engineering program language called Pic. Over the years the software was improved but never totally updated to a new modern software language or newer methods of a modern tax office function. The company was sold ai few times over the years from Infocel to EDS finally to Keystone. All of the sales promised new and enhanced development, but all owners failed to provide a rewrite of the software and only did a conversion which had major limitations. Macon County had chosen tol keep its perpetual license to Keystone's Software and maintain it ourselves through Good-Pickin Software Solutions. At the time there were about nine counties doing this along with Macon County. Ati this current time, only Bertie, Jackson, and Macon have rights to maintain its software from Keystone. Also, Keystone has only two counties that it Macon has had software and digital tablets in the field for the past ten years and only recently (2019) has any county been able to compare to Macon on field mobile units. Those counties are Macon has seen its software become totally obsolete to what is required in today's assessment office. The program is written in an old obsolete programing language that cannot be converted or tied to newer programs. The required reports, tools, and correspondences are not available In order to carry out the upcoming 2023 Reassessment and future office requirements, Iwould like the Board of Commissioners to authorize the tax office to put out for bid a Request for Proposal (RFP) for new operating software to include; Tax Assessment, Tax Collections, Land Records, and Permitting. These bids should be ready for review and presented back to the  supports since two recently left.  Union and Gaston.  tot the tax officials or end users without expensive manipulation of the data.  Board of Commissioners in November 2019.    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: Legal  SUBJECT MATTER: Care Clinic.  Contract for Services with the Community  COMMENTS/RECOMMENDATION:  County Attorney Chester Jones will provide a Contract for Services with the Community Care Clinic for consideration by the Macon County Board of Commissioners. This agreement comes following the September 10, 2019 decision by the Board to appropriate $37,500 to the Community Care Clinic to assist with operations in FY: 19-20'.  Attachments Agenda Item 11G  X Yes  No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: Sheriff SUBJECT MATTER: Reject Bid #4310-09 COMMENIS/RECOMMENDATION:  Bids received for in-car and body camera systems to be used by the Macon County Sheriff's Office failed to be in compliance with the request for proposals issued by Macon County. As a result, the bids which were received must be rejected and the project must be rebid.  Attachments Agenda Item 11H  Yes  X No    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY: Finance  SUBJECT MATTER: Occupancy Tax Penalty Waiver Request  COMMENIS/RECOMMENDATION:  Frank Myatt is requesting for occupancy tax penalties which were previously assessed upon his property (Carolina Motel) to be waived.  Attachments Agenda Item 111  X Yes  No    ECEIVEN SEP23,2019  Carolina Motel 2601 Georgia Road Franklin, North Carolina 28734 877-524-3380  September 19, 2019  Macon County Board of Commissioners 51 West Main Street Franklin, North Carolina 28734  Macon Count Finance/ Kim Camp, Accounting Specialist  RE: Account F-Ompamyledioln. Motel  Dear Sirs,  We would respectfully like to request a waiver on the tax penalties for the above mentioned account. Ify you would be sO kind as to review our record of payment you will notei that we have diligently made our payments in at timely manner, Ont this occasion when our accountant sent the approval via email to us it went  into our spam folder and was unfortunately overlooked.  We will make every effort int thei future to be more observant of this matter.  Respectfullyyours,  Frank  Lemyp  C. Myatt/ Owner    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY:  N/A SUBJECT MATTER: Consent Agenda COMMENTSRECOMMENDATION:  12A. Minutes ofthe September 10, 2019 Regular meeting  12B. Budget Amendment #74 South Macon Elementary School Pre-K  Playground Equipment  12C. Budget Amendments #75-81  12D. Budget Amendments# 84-85. Following approval, Authorize County Manager to enter into appropriate agreement with Highlands 12E. Tax Releases in the Amount of $2,166.34 for the month of  Performing Arts Center.  September  12F. Tax Office Monthly Report  12G. Macon County Public Health billing guide and fee changes FY 12H. Brantley Construction Change Order #2 South Macon School  19-20'  Attachments Agenda Item 12A-12H  X Yes  No    MACONCOUNTYBUDGETAMENDMENT AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  74  South Macon Elementary School Expansion Project  Transfer funds from contingencyt to purchase pre-k playground equipment.  DESCRIPTION  INCREASE  DECREASE 17,929  464097 OOPUBATVR/QUPKENT 464097 579000/CONTINGENCY  17,929  REQUESTED! BY DEPARTMENTI HEAD Allison Guynn- SmEfrindpal RECOMMENDED BYF FINANCE OFFICER ulctbe  APPROVED BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED &E ENTERED ONI MINUTES  10/R/19  meting  DATED  CLERK    QUOTE Date 9/13/2019 PWCQ15681 Quote valid for 30 days.  PLAYWORLD PREFERREDY The world needs play: 11515 Vanstory Drive, Suite 100-Huntersville, NC 28078 P:1-800-459-7241 F:704-584-1034 Bill To: South Macon Elementary School Allison Guynn 855 Addington Bridge Road Franklin, NC28734 P: (828)369-0796 F:  Quote #  Site/End User: Allison Guynn 855 Addington Bridge Road Franklin, NC28734 P: (828)369-0796 F: logoménasnAZne.s  Ship To: Allison Guynn 855 Addington Bridge Road Franklin, NC: 28734 P: (828)3 369-0796 F: Alison.guymn@macon.k12.nc.us  South Macon Elementary School South Macon Elementary School  ongwpmenacnkzne.s 50% Deposit Required. See Terms and Conditions  ShipVia BEST METHOD!  Sales Representative George Burton  Prepared By George Burton Unit Price $11,278.00  Qty Itemf  Description  Ext.Price $11,278.00 -$1,127.80  1 PSD-1102-FTD Tunnel. Junction  QWDISCPW  10.0% Discount SOURCEWELL DISCOUNT SOURCEWELL: Playworld Contract # 030117-LTS Macon County Member ID# 114139 COLORS: See Design Rendering 19-2587A Color  Rev  23 APS-Border12* 12" Playground Border with Spike  $35.00 $600.00 $15.10  $805.00 $600.00 $453.00  1 APS-ADAHalRam ADA Half Ramp System for use with 8" or 12" borders  p 30 EWF-Zeager  Zeager Mulch Engineered Wood Fiber ASTM, IPEMA Certified ADAAccessible (Priced per cubic yard) (Priced per rolly Installation of Equipment accessible area,  1  Geotextile Fabric Geotech Fabric  $165.00 $3,820.00  $165.00 $3,820.00  1 Install-EQ  *Unless noted, pricing is based on at flat, level,  South Macon Elementary  PWCQ15681  Page  1 1of5    Qtyltem #  Description:  UnitPrice  ExtPrice  **Does noti include grading, fence removal, equipment removal or disposal. SCOPE of WORK: Pricei includes installing all playground equipment, GeoTech Fabric (weed guard), EWF Playground grade mulch, border timbers and ADA 1/2 Ramp. "Unless otherwise indicated, installation costi is based on a level (1-2%) and ready site with normal ground conditions. Extraordinary ground conditions, such as slope (3% or greater), buried debris, natural obstructions which require extra attention (such as rock, unmarked service andlor irrigation lines, etc.), repair andlor special digging equipment during installation, will result in additional charges and time. All excavated dirt will be piled or spread on site. "This estimate is based on reasonable access for any trucking, machinerylequpment, material, parking for tradesmen, installs, clean up and "Some site disruption can be expected due to construction traffic. Site repair is limited to cleaning up and raking out disturbed area. Any ground oryard rutting caused by equipment vehicles will be raked or shovel filled with available dirt ons site. Any mud or dirt left on Pavementsidewalks will be flat shoveled or broom swept. The estimate does not include finish landscaping (i.e. new dirt, seed, straw, or "Unless otherwise noted, trash will be stacked neatly on site ORI be placed in the site's "Permitting feeslzoning fees are not included in this proposal, and if required, will come at an "Playworld Preferred will call 811 to locate any PUBLIC underground utility lines. Iti is the responsibility of the Customer toi incur cost and arrange for a PRIVATE utility locator as a safe-guard in case it's believed that the playground area have any PRIVATE lines running through it. Any costs associated with repairing utility lines damaged by installer that were not marked will be the responsibility of the Customer.  demolition.  sod). dumpster. additional cost.  SubTotal Tax Rate Sales Tax Shipping Total  $15,993.20 6.75% $1,210.21 $1,935.85 $19,139.26 Page  17,989.05 PWCQ15681  South Macon Elementary  2 2of5    MACONO COUNTY BUDGETA AMENDMENTK  AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  75  EMS  Approprlate grantr receivedi from Highlands Cashiers Health Foundation.  DESCRIPTION  INCREASE DECREASE 50,000 50,000  113850 445807 DONATIONS-EMS 114370 SEBSCAPTALEQUIPNENT  REQUESTED 8Y DEPARTMENTHEAD RECOMMENDEDI BY FINANCE OFFICER APPROVED BY COUNTYMANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED& ENTERED ONI MINUTES DATED  ERuAdbE 10/R/19  motting  CLERK    MACONCOUNTYBUDGETAMENDMENT  AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  6  EMS  Appropriate grant receivedi from Homeland: Security-Assistance: to Firefighters Grant program to purchase  3power lift systems for thef front line ambulances.  DESCRIPTION  INCREASE  DECREASE 69,955 69,955  113850 435528HOMELAND: SECURITY-AFG 97.044 114370 569502/CAPITAL EQUIPMENT  REQUESTED BY DEPARTMENT HEAD RECOMMENDED BYF FINANCE OFFICER APPROVED! BY COUNTY MANAGER, ACTION BY BOARD OF COMMISSIONERS APPROVED & ENTERED ON MINUTES DATED    ERLdE 1/R/19 mecthg  CLERK    MACON COUNTY BUDGET AMENDMENT  AMENDMENT! DEPARTMENT: HEALTH EXPLANATION:  17  Received" new grant monies (Opiod/RCORP Grant).  Need to increase budget in expenditures and revenue.  ACCOUNT 115128-555124 113511-426010  DESCRIPTION Opioid Consortium Federal Opioid Consortium Federal  INCREASE 60,000 60,000  DECREASE  REBQUESTED BY DEPARTMENTI HEAD faiminRrcco RECOMMENDED BY FINANCEOFFICER bnabu  APPROVED! BYCOUNTYI MANAGER ACTIONE BY BOABDOECOMMISIOAERS APPROVED ANDI ENTEREDONMINUTES DATBD  l0)a/4 merbgy  CLERK    MAÇON COUNTY BUDGET AMENDMENT  Date:  9/25/2019  AMENDMENT! DEPARTMENT: HEALTH money used for Smart Start.  18  EXPLANATION: Using Medicaid Cost Settlement funds to cover the purchase ofo computers, replenishing gcontingency  ACCOUNT 113511-438551 115110-556005 115110-555106  DESCRIPTION Medicaid Cost Settlement Funds Admin- Computer Supplies Admin - Contracted Services  INCREASE $ 12,000.00 $ 6,000.00 $ 6,000.00  DECREASE  REQUESTED: BY DEPARTMENT HEAD 8 pu Clocio dwifio  RECOMMENDED BY FINANCE OFFICER APPROVED BY COUNTY MANAGER  Sesebi  ACTIONI IBY BOARDOF COMMISSIONERS lafela merting  APPROVED AND ENTERED ON MINUTES DATED  CLERK    MACON COUNTY BUDGET AMENDMENT AMENDMENT! H FROM: FINANCE DEPARIMENT: EXPLANATION: 11-3561-4389-03 11-5314-5675-12  September 10, 2019  SOCIAL SERVICES Increase in allocation DESCRIPTION CRISIS FUNDS CRISIS INTERVENTION  INCREASE $9,268 $9,268  DECREASE  REQUESTED BY DEPARIMENTHEAD RECOMMENDED BY FINANCEOFFICER APPROVED BY COUNTY MANAGER ACTIONI BY BOARD OF COMMISSIONERS APPROVED AND ENTERED ONJ MINUTES DATED  1  A  &R  la/8li9 mebiny  CLERK    MACON COUNTY BUDGET AMENDMENT  AMENDMENTE FROM: M. CHRIS STAHL DEPARTMENT: SOLID WASTE  40  EXPLANATION: MOVING MONEY FOR INSURANCE SETTLEMENT  ACCOUNT 60 4715 556011 603839 485000  DESCRIPTION OPERATING INSURANCE SETTLEMENT  INCREASE 516. 516.  DECREASE  REQUESTED BY DEPARTMENT HEAD ChvsSHal  RECOMMENDED BY FINANCE OFFICER APPROVEDBY COUNTY MANAGER ACTION BY BOARDOF COMMISSIONERS APPROVED. AND ENTERED ON MINUTES DATED  Besisefbet  le/s/9 mectng  CLERK    MACON COUNTY BUDGET AMENDMENT  Date:  9/10/2019  AMENDMENT # DEPARTMENT: HEALTH  1  Need to roll 2018-2019 unexpended ECU funds into current FY.  ACCOUNT 115168-565008 113511-438549  DESCRIPTION ECU Telepsych ECU Telepsych  INCREASE $ 12,338.00 $ 12,338.00  DECREASE  REOUESTED BY DEPARTMENTI HEAD  Danphs  RECOMMENDED BY FINANCE OFFICER Buente  APPROVED BY COUNTY MANAGER  ACTION BY BOARD OF COMMISSIONERS 1a/g/9 meting  APPROVED AND ENTERED ONI MINUTES DATED  CLERK    MACON COUNTYBUDGET, AMENDMENT AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  84  Economic Development'Fund  Reverse appropriating economic development fund balance for Highlands Performing Arts Center that  was approved att the August 13,2 2019 board meeting.  DESCRIPTION  INCREASE  DECREASE  119200 575000/SPECIAL APPROPRIATIONS 113981 981020/TRANSFERI FROM ECON DEV 203840 417900ECONI DEVF FUNDI BALANCE 209000 981011 TRANSFER' TO GENERAL FUND  30,000 30,000 30,000 30,000  REQUESTED BYDEPARTMENT HEAD APPROVED! BY COUNTY MANAGER ACTIONI BYI BOARD OF COMMISSIONERS APPROVED: &E ENTERED ONI MINUTES DATED  RECOMMENDEDI BYI FINANCE OFFICER AMNtDL  CLERK    MACON COUNTY BUDGETAMENDMENT AMENDMENT# DEPARTMENT EXPLANATION ACCOUNT  85  Economic Development Fund  Appropriate general fund! balance for Highlands Performing/ Arts Center.  DESCRIPTION  INCREASE  DECREASE 30,000 30,000  119200 575000SPECIAL/ APPROPRIATIONS 113840 417900FUNDI BALANCE. APPROPRIATED  REQUESTED BY DEPARTMENTHEAD APPROVED BY COUNTY MANAGER ACTION BY BOARD OF COMMISSIONERS APPROVED & ENTERED ON MINUTES DATED  RECOMMENDEDI BYF FINANCE OFFICER AAAMIL  CLERK    Tax Collections 10/01/19 Group Number REL*19*09 Seq Date Account Taxbill Nbr Number Number 09/05/19 37083 18A0009811633 BISSETTE, BETTY 12 09/12/19 59196 10A59196.12 BURGESS, JANET LOUISE 13 09/12/19 59196 09A59196.12 BURGESS, JANET LOUISE 09/05/19 15530 18A0000702292 CABE, GNI HEIRS 14 09/13/19 136899 19A65B2372262 COOK, DANNY 09/03/19 136475 19A7530954133 FLOURNOY, ROBERT T. 2 09/03/19 134369 19A6518334099 GARRETT, CHESTER MICHAEL 17 09/25/19 64211 19A64211.14 GREATAMERICA LEASING 18 09/25/19 64211 19A64211.12 GREATAMERICA 15 09/24/19 6B622 19A6590058518  Detail Transactions by Abatement Tax Transaction Code Amount G01 11.34- AO 5.00- 16.34- G01 32.84- F01 3.53- LO1 72.00- 108.37- G01 31.07- P01 3.53- LO1 60.00- 94.60- G01 30.01- AO 5.00- 35.01- G01 93.68- F02 20.05- G01 84,83- F10 6.79- HO1 35.43- F09 32.56- G01 1.14- HO1 0.48- F10 0.09- 1.71- GO1 0.17- F01 0.02- 0.19-  Group  RTC020303 Page  Effective Date 09/03/19  Levy Penalty Add1 Interest 11.34- 0.00 0.00 5.00- 0.00 32.84- 0.00 3.53-. 0.00 0.00 72.00- 0.00 31.07- 0.00 3.53- 0.00 0.00 60.00- 0.00 30.01- 0.00 0.00 5.00- 0.00 93.68- 0.00 20.05- 0.00 84.83- 0.00 6.79- 0.00 35.43- 0.00 32.56- 0.00 1.14- 0.00 0.48- 0.00 0.09- 0.00 0.17- 0.00 0.02- 0.00  Amount Amount Chgs Amount Discnt Amount Trn Cde Check Number Trans Descriptn Rev 11.34- 0.00 5.00- 0.00 0.00 R CLERICA 36.37- 0.00 72.00- 0.00 0.00 R CLERICA 34.60- 0.00 60.00- 0.00 0.00 R CLERICA 30.01- 0.00 5.00- 0.00 0.00 R CLERICA  0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00  113.73- 113.73- 0.00 0.00 0.00 0.00 R CLERICA 127.05- 127.05- 0.00 0.00 0.00 0.00 R CLERICA 205.37- 205.37- 0.00 0.00 0.00 0.00 R CLERICA  GO1 172.81- 172.81- 0.00  1.71- 0.00 0.00 0.00 0.00 R CLERICA 0.19- 0.00 0.00 0.00 0.00 R CLERICA  G01 168.62- 168.62- 0.00    Tax Collections 10/01/19 Group Number REL*19*09 Seq Date Account Taxbill Nbr  Detail Transactions by Group Abatement" Tax Transaction Code Amount G01 89.82- F10 7.19- HOI 37.51- GO1 83.66- F10 2.59- HO1 39.31- G01 501.46- 501.46- 0.00 F01 72.94- G01 13.64- F03 2,05- LO1 72.00- 87.69- G01 13.75- F03 2.19- L01 60.00- 75.94- GO1 14.70- F03 2.34- L01 60.00- 77.04- G01 82.43- F01 11.99- 94.42- L01 95.00- 95.00-  RTC020303 Page 2  Bffective Date 09/03/19  Levy Penalty Addl Interest Discnt Trn Check Amount Amount Chgs Amount Amount Cde Number Trans Descriptn Rev  Number Number HASTINGS, SAMUEL J 09/06/19 49797 19A49797.14 HIGHLAND FOODS INC. 10 09/06/19 49797 18A49797.14 HIGHLAND FOODS INC. 09/05/19 116733 MARLENE P CARING TRUST 09/04/19 84361 10A84361.07 MILLS, KEITH 09/04/19 84361 09A84361.07 MILLS, KEITH 09/04/19 84361 MILLS, KEITH OUTDOOR 76 WOMACK, LOUISE  199.40- 199.40- 0.00 0.00 0.00 0.00 R CLERICA 134.52- 122.29- 12.23- 0.00 0.00 0.00 R CLERICA 125.56- 114.14- 11.42- 0.00 0.00 0.00 R CLERICA 574.40- 574.40- 0.00 0.00 0.00 0.00 R CLERICA  81.65- 8.17- 6.54- 0.65- 34.10- 3.41- 76.05- 7.61- 2.35- 0.24- 35.74- 3.57- 72.94- 0.00 13.64- 0.00 2.05- 0.00 13.75- 0.00 2.19- 0.00 14.70- 0.00 2.34- 0.00 74.94- 7.49- 10.90- 1.09-  0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 0.00 0.00  0.00 72.00- 0.00 0.00 60.00- 0.00 0.00 60.00- 0.00  15.69- 0.00 72.00- 0.00 0.00 R CLERICA 15.94- 0.00 60.00- 0.00 0.00 R CLERICA 17.04- 0.00 60.00- 0.00 0.00 R CLERICA 85.84- 8.58- 0.00 0.00 0.00 R CLERICA 0.00 95.00- 0.00 0.00 0.00: 95.00- 0.00 0.00 R CLERICA  21 09/12/19 136695 19A136695.12 16 09/24/19 136136 19A6598831319    Tax Collections 10/01/19 Group Number REL*19*09 Seq Date Account Taxbill Nbr  Detail Transactions by Group Abatement Tax Transaction Code Amount 10.00- 3.53- 3.53- 84.95- 20.05- 2.34- 2.19- 2.05- 30.78- 32.56- 2.59- 14.07- 14.70- 44.82- 46.48- 39.31- 73.42- 60.00- 120.00- 144.00- 95.00-  RTC020303 Page  Effective Date 09/03/19  Levy Penalty  Number Number  Amount Amount Addi Chgs Interest Amount Discnt Amount Cde Trn Check Number Trans Descriptn Rev  Tax Code Totals A0*18 - ADV COST F01*09- FR FIRE F01*10- FR FIRE F01*19- FR FIRE F02*19- CL CH FR F03*08- OTTO FR F03*09- OTTO FR F03*10- OTTO FR F03*19- OTTO FR F09*19- NANT FR F10*18- HLDS FR F10*19- HLDS FR G01*08- GEN TAX G01*09- GEN TAX G01*10- GEN TAX G01*18- GEN TAX HO1*18- HLD CITY HO1*19- HLD CITY L01*08- LANDFILL L01*09- LANDFILL LO1*10- RES FEE L01*19- RES FBE REL*19*09 ******* Totals By Tax Cycle Cycle A  0.00 0.00 10.00- 0.00 0.00 3.53- 0.00 0.00 0.00 0.00 3.53- 0.00 0.00 0.00 0.00 83.86- 1.09- 0.00 0.00 0.00 20.05- 0.00 0.00 0.00 0.00 2.34- 0.00 0.00 0.00 0.00 2.19- 0.00 0.00 0.00 0,00 2.05- 0.00 0.00 0.00 0.00 30.78- 0.00 0.00 0.00 0.00 32.56- 0.00 0.00 0.00 0,00 2.35- 0.24- 0.00 0.00 0.00 13.42- 0.65- 0.00 0.00 0.00 14.70- 0.00 0.00 0.00 0.00 44.82- 0.00 0.00 0.00 0.00 46.48- 0.00 0.00 0.00 0.00 35.74- 3.57- 0.00 0.00 0.00 70.01- 3.41- 0.00 0.00 0.00 0.00 0.00 60.00- 0.00 0.00 0.00 0.00 120.00- 0.00 0.00 0.00 0.00 144.00- 0.00 0.00 0.00 0.00 95.00- 0.00 0.00  125.01- 117.40- 7.61- 0.00 0.00 0.00  G01*19- GEN TAX 1194.96- 1179.30- 15.66- 0.00 0.00 0.00  Total for Group 2166.34- 1705.11- 32.23-429.00- 0.00 0.00  Current Delinquent 1545.79- 620.55-    MACONO COUNTYN MONTHLY ADV VALOREMT TAXO COLECTIONSREPORT Sep-19 Generall Tax FireD Districts Landfilll UserF Fee 1803669.61 Totals GeneralT Tax FireD Districts Landfillu UserFee Totals  Beginning Levy Less Less Equals Gross 2629432.39 217.5 -557.61 1.24 2629091.04 -345099.07 Beginalng Levy Less Less Equals Gross  Less  Outstanding  MonthtoD Date Balance Added Releases Write-C -Offs Adjlevy Payments Refunds MiscDr/Cr NetPayments Balance  18592174.3 929.61 -5215.41 -5.92 18587882.58 -2597147.91 6144.35 2797.57 2588205.99 15999676.59 23025276.3 1242.11 -6153.02 -7.9 23020357.49 3167335.13 6144.35 3553.3 -3157637.48 19862720.01  470.73 -344628.34 2284462.7 285 -224803.15 1578580.72  95 -380 -0.74 1803383.87 -225088.15  Less  Outstanding Collection  YeartoDate Balance Added Releases Write-Offs Adilevy Payments Refunds MiscDr/Cr NetPayments Balance Percentage  28348706.2 -11014.57 -1139.68 28336551.93 -12369242.1 15091.79 17274.97 -12336875.34 15999676.59 34780775.6 -13538.81 -1316.49 34765920.33 -14938485.75 15091.79 20193.64 -14903200.32 19862720.01 38.18 42.87  3877614.45 -1574.24 -168.63 3875871.58 -1593124.22 2554455 -950 8.18 2553496.82 -976119.43  0 1715.34 -1591408.88 2284462.7 43.54 0 1203.33 -974916.1 1578580.72 41.06  43.54%0 Collectedan2 20190 CountyG GeneralT Taxes, late ListingP Penalties, Discoveriesa andD Deferredl Taxes asof9/30/2019 asc Comparedto42.7884 Collectedo on2 20181 Taxesasof9/30/2018    Requested changes to the Billing and Collection Policy  Page Number Section  Change  3  Payment by Consumer  1. Addition of phrase "nor subject to variation"as recommended by state consultant. 2. Changed wording to indicate we will provide itemized receipt upon request - pers state 3. Added statement that charges incurred during a visit but not paid for on date of visit willl be billed.  consultant.  4 5 6 7  Payment By Third Party Addition of Specialty exams under the Adult Health Compliance With Title Addition of as statement that says we also comply with the  Program. These services will not be billed to an insurance and include CDL Physicals, College Entrance Physicals, etc. current Consolidated and Agreement and all program Agreement Addenda's that are issued by the state. Removal oft the requirement of participation in the Health Risk Assessment - Insurance no longer requires this 1. Addition to clarify that we accept all consumers to 2. Removed "this can be a confidential service" per 3. Added verbiage for confidential service consumers protection from collection process  Vland VII Employee Health Family Planning  process.  the program not just women. state consultant  7-8  Miscelaneou/General Removed Mscelaneous/Seneral Services and clarified Services/Adult Health Adult as previously stated that no insurance will be billed Adult Dental Program Changed Sliding Fee Scalei to 250% of Federal Poverty and  for these services. Removed "womens health colposcopy" the maximum discount to 75% which will match the Child  Added "Other Services" section  9 10 11 11 11  Dental Program. Spelled out DSME and MNT  Nutrition Services Animal Services Guidelines for Determining Elements oft the Sliding Fee Scale  Environmental Health Removed at the will of and replaced with by the Boards  Removed at the will of and replaced with by the Boards Removed HIS and replaced with dental record.  Above revisions approved by Board of Health on 8/20/19.    Formatted: Different first page header  MACON COUNTY PUBLIC  HEALTH  FY1819 19-20  Billing and Collection Policies  And Fee Schedules Effective  Presented to and Approved by Board of] Health on Presented to and Approved by Board of Commissioners on  August 20,2019  April-24,2018  May-8,2018    Macon County Public Health Billing Guide FY19-20  Effective  MACONCOUNTYPUBLICHEALTH BILLINGANDCOLLEOLLECTIONPOLICIES  RATIONALE  North Carolina law' allows al local board ofl health toi impose at fee for services tol bei rendered by a local health department, except where thei imposition ofai fee isp prohibited bys statute or where an employee oft thel local Thep planr must be: approved! Ibyt the Board ofHealth and thel Board ofe Couty Commissioners; And, fees collected undert the authority ofthis subsection: aret to bedeposited tot the account oft thel local health department sot thatt they may be expended for publich health purposes in accordance with the provisions ofthe The State requires local health departments top provide certain, serviçes, andi no onemèy be denied these services. Itis Provide as manyo other recommended: andi needed! healliservices as possible, within thefesources wes still Thel Health] Directorl has ther right to waivef feesforindividuals whof foragoodo cause are unablet top pay. Thej purpose of charging feesi ist toi increase resourcès and uséthem to meeti residents' needsi inaf fair and balanced way. Fees are necessary tol helpi identify and cover thet ful'cost of providing public healths services. As mucha as possible, fees arel basedo ont thet true cost ofprovidinga aj particuinEservice (Calcufted: as direct Costs plusi indirect costs). Throughout thes year, ongoinge costa analses arep performed and fec schiedfesshall bea adjusted! by thel Healthl Director, with approval from thel Board of Health andthel Board bfCommisionersi mteamount oft thei increased cost for Thei information; int the documentbelowi is-thefee-plan forl FY19-20, effectived on. July 1,2019. This Billing Guide for  health department is performing the services as an agent. oft the State. Feest may bel based on ap plan recommendedl by thel HealthI Director; Local Govemnment) Budget and Fiscal Control. Act. int thel besti interest of our community fort thel Health Centerto  Assuret that all residents can get alll legallyr requiredpublicl healths services.  have availablet to use.  prevision ofs saids services. Alist ofHealth Centerf feesi is ayatlablet upon request.  FY119-20replatcs, allEarlier plans COST OTSERVICEI DETERMINATION,  Costsfor services receivedthrough: theHealth Center arel based ont the: actual cost oft thes service Cost analysis takesi into accountall oft thei resourcesa Ssociated vathprovidinga particular service and calculates thes actual costt to provide that service Costa analysisi includest the calculation ofd direct andi indirect costs for services andi then adding Calculating direct cost: Direticostsa are expensest that can! be easily relatedt tot thej provision ofas specific service, ie., physician and support staffsalaries and benefits, medical supplies, labt tests, and other resources Calculatingi indirect costs: Indirect costsi involve resourcest that arer not directly consumed duringt the provision ofas service, but withouti them thep provision oft that service wouldi not be! possible, i.e., administratives staff salaries and benefits, training costs, facility costs, insurancej premiums, office equipment ands supplies, andi recruiting  these figures togethertO.detemine the actualo cost oft the service.  consumed: att thet time oft thes service and marketing expenses.  Northh Carolina General Statue 130A-39(g) ?IAW1 Title) X843(2CFR592)  Page2    MaconCounty Public Health Billing Guide FY1 19-20  Effective  Formatted: Space After: 10pt, Tabs stops:  3.2",Left  Page 3    Macon County Public Health Billing Guide FY19-20  Effective  PAYMENT BY CONSUMERORI RESPONSIBLETHIRD) PARTY (SELFPAY)  Fees arec charged fors services and' collected att thel Health Center. See attachment forf fees schedule. All fees aret ther responsibility oft the consumer, consumer orr responsiblet third party and may bes subjectt to thes slidingf fees scale. No consumer willl ber refused services,nors subjectt toy variation ofs services. solely ont their inability top payf for saids services. All feest may bep paid by cash, check, or major credit card. Full paymenti ise expected att thet time ofs service. Corsumers willl be informed oft their account status ate each visit. Ani itemizedi receipts showing total charges, as wells as any discounts will be providedt toi individuals upon requeste attimeefpayment Thirdp parties authorized or legally responsible top pay forc consumers ator! below 100% ofthel Federal Povertyl Levela are properly billed. Fees for adult dentals services willl bec collected1 before rendered. Prepaymento ofco-pays for alls servicesi inv which co-payments. applyx Wil berequireda ando collectedy when services arer rendered. Anyo chargesi incurred duringa avisit buti not paid for anthat date ofs service willl be! billeds accordingly. Fees willl be charged toi individuals inf families with: annual grossincomes excredings specifiedI levels ofas scale based onc current Federall Poverty Income Guidelines. Verification ofi incofnes and family Siz-must be provided to determinea consumer'seligibilily: status. Falsificationof thisi information) wilp permhanently disqualifyConsumers from using slidingf fees scale, Eligibility willl ber reevaluated: gstongumer'sincome: and households status changes or atl least annually. Ifincome cannot bev verified: att thet time ofs screening thec charge for alls services willbéat 100%p pay anda Payment Agreement willl bep presentedt tot thec consumeri fors signature until verificationi is provided lverification ofi income ISI received within thirty days ofas service, the charge will ber retroacfively: adjustédtor reflect percent payb based on verificationi received. Verificationi receiveda after.t thirty days will beappliede onlytof futures services. Bigibilityo ofMedicaid willl bec determined where applicable. Individuals Willb ber requested to providealls socials security numbers-andn names used fore employment purposes. Ifani individual refusestoprovidei informationoerify income, they will notl bee eligible for the Customary visits services forr mandatory childhoodi immuntzations, community outreach, Tuberculosis (TB), TB related X-rays, Sexually" TransmitedDisease control (SID), and epatrtgine arep provided atr no cost tot the consumer but mayte bledto Medicaido or othethirdp partyagent Separate fees may bec charged for drugs, supplies, laboratory: servicés Krays and othcrtechnologica Servicesifs appropaaté Thec costs ofs services performed by providers nota affiliated with-Mâcon Countyl Public Healtha arether esponsibility of the consumer. Fees may be charged or waived fore educational: services.proyided toi indiyiduals or groupsèsuch as orientation, preceptorship, fieldt training or  thes serviceis  slidingf fèe scale and willl bes at1 100%p pay.  classes.  Chargest not eligiblet for slidings scaled discount include: a. Envionmentall Healthséryices b. Non-mandated: immunizations services  Miselaneousigenen.ls services(see Miscelaneous/General: section below) Out-otcountyr residents (see QurgfCounservicel Restrictions sectionb below) Specifici insurance situations (seeInsurance: seçtiont below for details)  Bills will be mailed monthly toidividuals who have not paid charges in full for services rendered (exception Family Planning: for thoséthât request nomail be sent to their home).. All bills will show total charges, as well as any discount thatr may have been PovideArrangements: may ber made for payment plans whenr required: for goodo cause.  AMENTHYTINDFART  Verification ofe enroliment under Medicare, Medicaid, insurance or other third party payment plani is requiredb by presentation ofay valid carda att thet time ofs service. Thel Health Center isr requiredt tol bill only participating third party payers for services rendered. Servicest thata areb billedt tot third parties arel billed atl 100% oft thet total charge with no discounta appliedi unless therei isac contractedr reimbursementi ratet thatr must beb billed pert thet thirdp party agreement. When the claimi is returned from the third party payer all discounts are applied at that time. (Le, any applicable sliding fee scale adjustment) For services rendered to consumers with insurance where the Health Center is not a participating provider, the consumer willl ber responsiblet for fullp payment ofs service whent thes servicei is delivered. The consumer.  Page4    Macon County Public Health Billing Guide! FY19-20 subjectt tot thes slidingf feee eligibilitys scale.  Effective  isr responsiblef for chargest noto covered byt third party payers. Co-paya amounts must bey paida att thet time ofs services anda arenot  Slidingf fees scale discount does nots applyi int thei followings situations:  Consumers withi insurance in which MCPHis not participating provider. servicesi i.e. Familyl Plannings services and CommumicabieDisease: Services). Insurance co-payments (when) MCPHisa apatidpatingprovide), Services that are offered ass specialty exams under the Adult Health) Pfatram.  Consumers with anyi insurance who choose nott to uset their coverage (exceptiont those requesting confidential  ACCOUNICOUIKCTIONS, ANDI BADDEBT  Thel Health Center willi issue all consumersai monthlys statementofieest thathave beeni incurred and are due. Consumers aree expectedt tor makep payment at thet time services arey réndered. Ifal balnteis carried forwardo consumers who haver not madeap payment ont their account for any servict)rerévelrom! Macon County/Publicl Health for 120 days shall ber requiredt top payt their past duel balancel before another serviceshalll ber rendered (see ServiceDenial for further The Health Center may use the following resources topursue collection of consumer acégunts: billing statements, past due notices, collection agencies or credit bureausAnd theNe Local GovemmertDebt: Setoff Clearinghouse (ref: NCGS 105A-letseq.) )as admihistered! byt thel NCDepartiento ofRevenue Accounts willl ber reviewed annually for baddebtstatus, anda att that timéwith thea approval ofthe) BOH: and the BOCC'st thes amounts may bey written offf for accountng purposesifno further collectioni is anticipated.. Any payments receivedi for write-offdebts will bes accepted: and credited toa appropiateaccomts. Athot time will: a consumer ber notified thatt the account! has beeny writtenoffasal bad debt. Bad,debtr may! ber Einsfated att timéofservicer unless iti is determined  information).  uncollectible (i.e. bankruptcydcati), athicht time itwillle writehopperpanently.  CONSUMERI DONATIONPOLICY  A consumer may chooset omakendonationtot thea agencyThec consumer will never bes askedt tor makea donation, but ifofereithed donation is accepted. Donations aret nofréquired, and arer nota aj prerequisite: fort the provision ofanyservccBlingr requirémentss set out abovéinthe! Payment by Consumer section are noty waived  becausebf consumer donationsfref DonatrgnPolicy 101.9)  RETURNIDGEECKPOLICK  A$25.00f fecwill be charged forreturned check writtent tol Macon Countyl Public Health (MCPH). The consumer willl ber notified viat telephone orl letter. Allfeturned checks willl be made good via cash, money order, and/or certified check. Ifac consumer! hast twor réurned checks withinao one-year period,l he/shey willl ber requiredt top pay for services ina advance via cash, money order, ord certihedchecki forthe periodo ofc one year. After the one-yearg periode expires, ifanotherr returned check occurs, allf futureb bills must! be pati with cash, money order, or certified check prior tot thep provision ofservices. (Exception: Family Planning, Child] Health andMatemal! Healths services for families withi income ato or below? 250% of] Federal Poverty shouldr notp pay morei inc co-paymentsor. additional fees than whatt they otherwise pay when: a Schedule ofDiscountsi is  applied. 42US.C. 300€ ets 5942CFR5950,9).  REFUNDS  Int the event that a consumer or other third-party has overpaid their responsible charges, the credit balance is either: appliedt tof future charges or refundedt tot the payer within thirty (30) days of discovery or request. Refunds for Environmental  Health servicess are determined by attached policy: andp procedure.  Page5    SERVICEDENIAL  Noi individual: mayb be denied] Health Center mandated services e.g. communicable disease services (STD/TB) andi immunizations. These services arej provided atr noo charget tot the consumer. Individuals who dor not meet program guideline criteriai may be denieds specifics serviçes. Consumers covered by Medicaidy who failt tor make required co- payments will notl be denieds services but may be subject toc collections and/or bad debts set-off.. Individuals whol have not! paidp proper charges for previouss services (unless state and federal program rules prohibit services restriction or denial) may be requiredt top pay fees beforehand, be denied: access tos services (see Account Debts), or bec denied subsequent services pending demonstration ofag good faitieffort tor makej payment within the  Collections and] Bad past ninety (90) days.  OUT OF COUNTY: SERVICE. RESTRICTIONS  Macon County supports its low-income citizens by subsiuizingt the cost forcertain) health care services. To assuret that! Macon County citizens] have maximum access tollealth Centers servicesoiily those services mandatedby Federal Law, North Carolina General Statues or approvedinf thisp plan willb bep providedtonon-Macon County residents. Ifani individual moves out ofMacon County,hey are encouragedto obtains services from another provider. Consumers arei requiredt tor report any change ofaddress att time ofservice. COMPLANCEWITHTTLEVAND)ILOFAUSCOD.OIAEERIT language assistance sot theyl havemeaningful: accessiot thea agency' services.  The) MCPH complies with Title VI anglieVoft the Civill Rights Act of 1964: and: allr requirements imposed by or pursuant tot ther regulations. Staffilli notdiseriminate: aganstany consumers because ofe age, sex, race, creed, national origin, or disability. Staffwill ensureconsumersi withLEP are provided adequate Services willl be providedreported: and billedi in compliante Mthther most curent Consolidated, Agreement and  allp program Agreement Addendas. PROGRAMSPECIFICH INFORMATION  COMMINICABLEDISASECONIROL  Deals withthei investigation andf follow-up.of: alli reportable communicable diseases. Testing, diagnosis, treatment, andreferring as appropriate, ofay variety ofSTD's. Provides follow-up and treatment ofTB cases and therrcontacts. Nof fees-are charged directlyt to consumers: for these services as statedi in] Program Rules (exception Medicaid grother third party agent can! bel billed with thec consumer'sp permission).  Eligibility:  Nor residency orf financial requirements  ERLASTANDCERVICALCANCIRCOATROLPROGRAMABCCP)  Provides paps smears, breaste exams and screening mammograms, assists women with abnormal breast camimtosmuammograms, ora abnormal cervical screeningst to obtain additional diagnostice examinations.  Eligibility:  Page6    Must! bea a resident of Macon County; uninsured or underinsured; without Medicarel PartB orl Medicaid;  between ages 40- 641 for breasts screening services and 18- 641 for cervical screenings services; have al householdi income at orl below 250% oft the federalj poverty level. No charge fort thosey who qualify for thep program; family size shall be determined as follows: Consumer, spouse ofc consumer and all children under 18y years of age, includings step-children who live  int thel home. Proofo ofi income must be provided. CHILDHEALTH Choice; Mediçaid Eligibility:  Well child exams conductedby (appropriate provider); exarngladesr mediçal, social, development, nutritionall history, lab work, andp physical exam. MCPHecepiss self-pay,most) Private Insurances; Health  Residents ofN Macon County; Birthi thru >Discounts are used fori incomesbeieen whose incomei isa at orb below  Consumers whose income for Child Health  exceeds 250% ofFederall Poctnluingue. depaftments Schedule of Fees. Consumers  services.  *  Provides acute intended tor  sérvices. This programi is not  MRMAaaE  New employeesithey waitimgperiod for their healthi insurance tos start Employees and retirces andt therdependents ont the county healthi insurance plan Sélect part-time employees as determinedbyt the county manager.  WORKSITEWELINESS  a  Employeel health sèrvices are avalable for all employers inl Macon County. Employee) health services are available on aper program basis orunder anda annual contract arrangement. Individual program fees will vary and arel based on'salary expenset top prepare and deliver thej program; current mileage ratesi iftraveli is required; as well as any materials, laboratory, or medical supplies costs. An: administrative: supplement of 10%i is addedf for each: individualj program. Comprehensivev worksite wellness) programs are available under contract for organizations: and companies with atl least 50€ employees. This program, alsol known as thel LIFE provides employeehealth: screeningsi followed1 by customized programs and consultation services tos address thel health needs oft the employees. Fees for thel LIFE program range from $30t tot $50p per employeey per year depending upon the cost toj providet thes services, the number of programs provided, as well ast the  program,  organization'sa abilityt top providei in-kinda assistance.  IMMUNIZATIONS  Page7    Provide all required and recommended vaccines that are availablef for infnts, school aged children and college boundi individuals. Also providea a wider range of vaccines for adultst toi include foreign travel vaccinations. MCPH acceptsi most Privatel Insurances, Health Choice, Medicaid, and] Medicare. Ins some instances charges doi not apply (e.g. states supplied vaccine). Sliding fee scale does nota apply toi immunizations.  Eligibility:  Noresidency or financial requirements fori immunizations, CARECORDINATIONPOR CHILDREN (CC4C)a  Caser management: assists familiesi ini identification ofanda accesst tos services forchildren with special needst that  will allowt them the maximum opportunityt tor readhtheir development potential.  Eligibility:  Macon County children! birth toagethree whoa are ati riskfordvelopmental. delay or disability, longt term illness and/ors social, emotional disordefs.and children agesbirth tof five whob havel been diagnosed with developmental delay or disabilisy,Cnlethilipes: and/or sqcal, emotional disorder may! be eligible for Services Elinied adossrcsmess weretinp planningt their.cadbearing: schedule; detailed history, lab work, physical exam, counseling and education given by (appropriate provider). MCPH accepts self-pay; most Privatel Insurances; Medicaid or potentially Medicaid eligible.  thej program. FAMILYPLANNING  Flicibility:  This-ean-be-a" conticential SeFVIce  Schedulec ofI Discounts 1sused for incomes between 101 -250% ofFederal! Poverty. Consumers whose income exceeds 250% ofFederal) Poverty arec charged using the departments Schedule ofFees. Consumers whosei incomeiSato orb below1 100% ofFederal) Poverty are not charged for Family Planning Services areprovided withoutr regard tor residence requirements and without ai referralb by aj physician (42 Proof ofi incomei must beprovided. (Exception: fort those requesting" "Confidential Services" that dor not have proof ofi incomeor by producing proof ofi income may putt their confidentiality ati risk, they may write as statement ofd declaration ofi income.) Wherelegally obligated or authorized tor receivet third party reimbursement. including public or private sources all reasonable efforts must be madet to obtain said payment without application of any discounts. FamilyI Income shouldb be accéssed! before determining whether co-payments or additional fees are charged. Families with income ato or below 250% ofFederal Poverty should not! pay morei inc co-payments or additional fees than whatt they otherwise pay whena a Schedule ofI Discountsi is applied. (42U.S.C. 300 et seq. /42 CFR: 59.5(a)(9)). AFamilyl Planning consumery willi never ber refiuseda al Family Plannings service, or askedt tor meet with the Healthl Director duet toad delmquent account;! howevert they may ber referredt tol Debts set-offs so longast that  services.  U.S.C.3 300e etseq./42C CFR595(D)(5).  does not compromise confidentiality.  Page8    Incomei informationi reported ont thel Family Planning financial eligibility screening canl be used through other programs rathert than re-verification ofi income or relying ont the consumer declaration. Pregnancy tests will be charged! based ont the qualifying Schedule ofl Discounts. MISCELLANEOUSCENERALSERMICESADULTHEALTH Include: daycare, DOT, foster care, employment or other specialty physical amsaksmaoysemaes. weehlGeeselpesspie-forthkes: services noi insurances willl bel billed.  Formatted:: Indent: Left: 0.44", Right: 0.53", Line spacing: Exactly 12.6pt  Eligibility:  18 years and older Piw-aymiy*,  Residents ofl Macon County (exception, colposcopies, pregnancy tests, aératery-servies) These: services arer note eligible for slidingf feescale payment. Services will bepaidi for priort to any service beingr rendered. Anya additional fees associatedwith: a visit willl be addedi tot theConsumers: account and  paidi ini full ato checkout. Laboratory Services Eligibility: None Exceptions: None MATERNALHEAITN  OTHER SERVICES  Third party insurancecan! bel billed. theses servicesArenot eligiblefor Sliding) Feel Discount. Prenatal carei ist medicalcarer recommehded: for womend during pregnancy. The: aim ofg good prenatal care ist to detecta any potential problemse carls,toprevent them itpossible (through recommendations. ont adequate murlofcsecieylumin intakecio),a and odirectt the woman to appropriate specialists, hospitals, etc.i if necéssary Visits aremonthly' duringt thei firstt twotrimesters (from week onet tov week 28 ofp pregnancy), every twoyéeks from 28t towéek3 360 of! pregnancy andi weellyafter week 36 (until the day of deliveryt that couldb be betyéen weck 38: and 40wecks). Mepllacceptss self-pay; most Privatel Insurances; Medicaido or potentially  Medicardeligible. Eligibility:  Residents fMacon eligibilityp policy and residency requirements attached Maternall Hcaltficonsumérywill ber requiredt tol have proof ofresidency  Proof of incomeagrequret services.  Schedule ofDiscounts is used fori incomes! between 101 -250% ofFederall Poverty. Consumers whose income exceeds 2509ofFederall Poverty ared chargedu usingt the departments Schedule ofFees. Consumers whosei income: is ato orb below 100%0 of Federall Poverty are not charged forl Maternal Health  OB. CARECORDIMATIONMAMACIMENT.ORCN,  Case manager assists pregnant womeni ini receiving needed prenatal care andj pregnancy related services.  Page9    Eligibility: Residents ofMacon County Primary Care  Provides primary care services for Macon Countyresidents between thes ages of21-64. Consumers are. requiredt toc complete an application to determine eligibility prior tor receiving services. Third partyi insurance willb beb billed appropriately. Self-pay consumers may qualify for slidingf fees scale discount based ont their familys size and houscholdi income withi ther maximum discount of 60%. Sliding fee discounti is based on  Formatted: Font: NotB Bold  250% ofi federal poverty. Eligibility:  Resident ofl Macon Countyl between the ages of21-64  WOMEN,) INFANTS, ANDCHILDRENNUTRTIONPROGRAMKOMIO  Supplemental nutrition and educationp program top povidearctémpuniomalr foods and educatrons servicesto  improvel healths status oft target groups Eligibility: WICi isa available top 5whor meeti the follow criteria: Bearesident OfMacon Cinty Be: ati medicala and/orr nutritionalr risk; CHILDRENS DANTALPROGRAM  postparamomen, infants, and children upt toa age  -- prgcirmdp  Havea ai familyncomel lesst bSkataUs.ep Poverty Level; Medicaid, AFDC,Or foods stsmutomatiallmet thei income eligibility requirement  TheMacon County Chridren's DentalClinic (Molar Roller)p provides comprehensive general dentals services to childreufrom birtht to2 20 yearsof age. Self-pay consumersi may qualify for sliding fee scalel based ont their family sizeand householdi income. Slidingice,dliscounti ist based on 250% ofE Federal Poverty with a maximum  discount 07596 Eligibility:  Resident ofMaconCounty ADULTI DENTALPROGRAM  Thel Macon County Adult] Dental Clinicp provides comprehensive, general dental services to adults 21 years of age and above. Self-pay consumersi may qualify for as sliding fee discountl based on family size and] household income. Sliding fee discounti is basedo on? 2509ofFederall Poverty withar maximum discount of75%. Sliding fee disesntisdeteminedendon39affalaiponeywikemaiawdiscoumtefsPe  Page 10    Eligibility:  Residents ofl Macon County.  Charges not eligible for sliding fee scale discount include: Services not coveredb by Medicaidor Health Choice andt those covered byi insurances which MCPHi isi nots ap participating provider. Feesf for adult dental services willl bec collectedl beforet thes servicei is rendered. Health education/health aningprogamsservices are provided toi indiiduals and/org groups.  (ie. Fluoride treatments for adults)  COMMUNITYEDUCATION ANDTRAINING  Eligibility:  NoR Retrictionsequrenents EXAMPLE XAMPLEE 8  Formatted: Left  Cardiopulmonary resuscititionfcep  Automated First Aid' EXPLANATION Various components of responders areofferedo rastmmcPpgenta arere based  and/or CPR/AED: for lay are offered for afee- -Pre- specifideducational. components are    Formatted: Right: 0.9" Formatted: Indent: Hanging: 0.08", Right: 0.9"  Diabetes SeManagenent asatatPsNESnie  -  Macon County Publicl Health-offers) Diabetes Self-Management) Education/Training: services accredited by thel Atnérican] Diabetes Association The registered dietitians are credentialed: and certified providers with'somet thirdp party payors.-For consumers witht third partyi insurance,, a physcian referral andmédical diagnosis of diabetesi isi requiredi inc order for thei insurancet to be billed and. costs covered accordingly. Self-pay consumers: may qualify fora a sliding fee discount based onfamilys sizandhouseholdi income. Sliding fee discounti is determined on 250% off federal poverty withamaimum discount of2 20%i iny which the consumeri is responsible for payment to the Macon County Public Health offers) Diabetesl Prevention! Program accredited! by The Center for Disease Control and] Prevention. Because therei is no established billing code for this program accepted by third party payors and toe encourage participation, as smallj program fee willb be established: for each participant. Consumers may qualify fors sliding fee scale discount based ont their family size and! household income with thes sliding fee discounti isb based on 250% of federalj poverty. Medicaid or Medicaid eligible consumers may be eligible fora a Center for] Disease Control and Prevention (CDC) sponsoreds scholarship andt therefore arei not charged ai feei fort thej program, but  health center priort to's service being rendered. Diabetes Prevention! Program (DPP)  Page 11    are eligible for thei incentives. Eligibility Declaration ofI Income  Medical Nutrtion Therapy (MNT) Services:  Formatted: Right: 0.9"  Macon Countyl Publicl Health offers Medicall Nutrition Therapy services. Ther registered dietitians are credentialed and certified providers withs somet third partypayers. For consumers witht thirdy party insurance, aj physician referral and a covered medical diagnosisisi requiredi in order for thei insurance to beb billed: and costs covered accordingly. Self-pay consumérs may qualify for a slidingi fee discount based oni family size andl householdi incomeSidmgf fee discounti is determined on 250% off federal poverty witha ai maximum discount of2 2QPanwhichfhec consumeri is responsible for payment tot thel health center priort to service! beingr renderedtocgnsumer.  ENVIRONMENTALHEALTH  Unlikec other health department fees, Environmentall Health and County Commissioners. Envrofmentall for Environmentall Health Services ared  byaHevpee thel Boards of other counties aret takeni into  consideration. Exception, water A costs for supplies/test kits. Fees  S  ANIMALSERVICES  Unlike otherhealth departmentfces,? Ammal-Service) feesare determined by at-the-willeft the! Boards of Health and' CouyCommisgnere Animas Service fees-from other counties aret takeni into consideration.  Fees for Animal Services are dueattime of Service  -  Guidelinesfor Determining) Elements of the Sliding) Fee Scale  Eligibility screeningirequired. on all new consumers or when familys size and/or income changes occur, or at 12 monthi intervals. A consumer'sp percentagéo of pay is documented ont thel Financiall Eligibility. Application int the consumer'si medical recorda and dentaligordinS. Consumer incomei information: reported can be used to determine eligibility for other slidingfeet based programs (i.e. Adult] Health, Child Health, Prenatal, Family Definitioni for] Family Sizea and Countable Gross) Income for the followingclinics: Primary Care, Nutrition Services, Child Health, Maternall Health, Familyl Planning and Dental Af family is defined as ag group ofrelated or non-related: individuals who arel livingt together as one economici unit. Individuals are consideredi members ofas single family or economici unit when their production ofi income and  Planning: and) Dental).  consumption ofg goods arer related. Ane economict unit must! havei its owns source ofi income.  Page 12    Example: consumer with noi income must be considered; part ofal larger economici unitt thatp provides supportt to the household. Groups ofi individuals) livingi int the samel houses with other individuals mayb be considered a separate economic unit, Fore example, iftwos sisters and their childrenl livei int the same house andt both work ands support their  own children, they wouldb be considered: as separatel household. EXCEPTIONSTOECONOMICUNIT  A. Un-emancipated: minors and others requesting confidential: services will be consideredai family unit of  one, andi fees willl bea assessed based ont their owni income. B. Af foster child assignedb by) DSS shall always be comsideredafmifof. one,  Determination ofGross Income:  The dollar amounts represent gross annual income; they refert tot totaicashr receipts beforet taxes from alls sources. Householdi incomes sources include: Salaries andy wages, eaminisf from self-emplorment (deduct business expenses, except depreciation); interesti income, alli investment andr rentalncome; public assistarce, unemployment benefits, worker's compensation, alimony, military allotments; Social Sécurity benefits, VAI benclits; retirement andj pension pay; insurance or annuity plans; gaming proceeds and anyot heri income not represented! heethat contributes tot the  household consumption ofg goods. This listi ist not alli inclusiye Documents: acceptable fori income verifications: Current pays stub (noting the pay timeframei 1 wehbi-wekly etc business name, address and phone number andi mtbel legible Awardl letter from Socialecnity OfVAorF RailreaRefrement Board must bep providedi in order toà tofrbwsinen expenses.  Signed statement from employeri indicating groearnnsfors as specificdpapperiod, statement musti include the  W-21 Forms Unemployment! letter/notiçe 1099's received from) IRS  For Self-employment:. Acitgrandulaomet taxi retumnf fort the most recent calendar year, entiret taxi return  Page 13    Fee Changes Approved by Board of Health on 8/20/19  New clinical charges fori the Integrated Care services  99492 99493 99494  Initial psychiatric collabroative care management first.70 minutes Subsequent psychiatric collaborative care management 60minutes Collaborative care management, each additional 30. mins inamonth  131.00 105.00 55.00  New Labi feel based on outside physicianorder  82679  ESTRONE, SERUM  44.00  New Lab feel based on negotiated rate  86003  ALLERGENSPEGIFIC IgE QVANTTATVEORSEMUANTTATVER4  126:00  units)  Thisi is a decrease in price duet to a negotiated rate fort the 24 unit panel for allergy testing for LabCorp charge. The price is for all 24 units. The previous charge was a per unit charge which added up to $800.  We willl be bringing this document to you throughout they year as price changes are passed on tou us. This willi include increases and decreases inj price, especially immunizationi rates. We also plan to evaluate the dental fees soon based ont thef fact that we are now getting al higher reimbursement from Medicaid.    Change Order AIA Document G701-  OWNER OTHER FIELD  T.Gibbs, MCS D.F Roland, Macon  [xj Ixj  ARCHITECT E. Kite, Novus CONTRACTOR J.I Benson, Brantley [xj  PROJECT:  (name,address) Additions to South Macon Elementary School  CHANGE ORDER NUMBER: 02 DATE: September: 30,2019 ARCHITECTSPROJECT NO: 2015-3105.02 CONTRACTFOR: General  Macon County Government 5West Main St. Franklin, NC: 28734  TOCONTRACTOR:  (name,address) Brantley Construction Services, LLC  TIA Brantley Construction Company, LLC 9A Allman Hill Road Weaverville, NC 28787  The Contract is changed as follows: PR; #006 Active Board Electrical Revisions $5,302.50 PR #009 Controls for 31 fan coll units $8,866.84 PR# #011 Walking track relocation! $4,772.25 PR #012 Asphalt drop-off driver repaving $30,250.76 PR #013 Replace damper actuator HVAC controls @ gym $3,806.13 PR; #014 Fire Alarm Shutdown! HVAC Controls $3,195.29 PR #015 Preferred Glycol for chiller $2,543.08 PR: #016 Drop-in Sinks (health depti required)$3,296.03 PR# #017 Credit for. J-Hooks ($1,908.90)  The Contract Sum: shall be increased as follows: Additional pricing information Is attached  Not valid until signed by the Owner, Architect and Contractor. The original (Contract Sum) WPenesesmP, was Net change by previously authorized Change Orders The (Contract Sum) GMMSANMRuRPs, prior to this Change Order was The (Contract Sum) CMsanseMasawm-, willl be (increased) (deereased) (unehanged) by this Change Order in thes amounto of The new (Contract Sum) CMPeneSNNwP, including this Change Order will be The Contract Time will be (ineroased) ewreaswMunchangeo) by(0)days. The Date of Substantial Completion as of the date of this Change Order thèrefore is July 12, 2019 NOTE: This summary does not reflect changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have been authorized by Construction Change Directives not included in previous Change Orders.  $ 2,854,000.00 24,076.61 2,878,076.61 60,123.98 2,938,200.59  ARCHITECT Novus Architects Address:  CONTRACTOR Address: 9Allman Hill Road Weaverville, NC2 28787 GAA  OWNER Address: 5West Main St. Franklin, NC28734 BY: DATE:  Brantley Gonstruction Services, LLC Macon County  14 S. Pack Square, Syite4 400   BY: DATE:    MACON COUNTY BOARD OF COMMISSIONERS  AGENDA ITEM  MEETING DATE: October 8, 2019 DEPARTMENT/AGENCY:NIA SUBJECT MATTER: Appointments COMMENTS/RECOMMENDATION:  A. Macon County Planning Board (1 Seat)  Attachments X Yes Agenda Item 13A  No    PrintForm  Application for Appointment to Macon County Authorities, Boards, Commissions and Committees Thel Macon County BoardofCommisioner: believes all citizens should have the opportunity to Participate in governmental decisions. The Board wants to appoint qualified, knowledgeable and dedicated people to serve on authorities, boards and committees. Ifyou! have an interest in being considered: for an appointment to any advertised vacancy, please thoroughly complete the form below before the advertised deadline and choose from the: following options.  Mail to: County Manager's Office 5 West Main Street Franklin, North Carolina 28734  or FAX to: 828-349-2400  Any Questions, please call the County Manager's Office at (828): 349-2025 Name of Authority, Board or Committee applying for: Planning Board  Namé Mark Berry Address/PO Box 1533 Telephone: Home 8283712202 Occupation Construction  City Franklin  NCZip 28744  Work same  Business Address 376 Dowdle Mountain Road Franklin NC; 28734 Email Address mercenyle/@gmal.com  Briefly explain any anticipated conflict ofinterest you may have ifappointed:  NoConflicts  Educational Background  Figh School Graduate. Holdl NC septic tank and well drilling license.  Business and Civic Experiences/Skills: Junaluskee Masonic Lodge and Smoky Mountain Shriners Club. Areas of! Expertise and Interest/Skilis:  Own andi manage four businesses over thep past 25) years. Past member of Franklin Daybreak Rotary. Member of  Strong communication skils, Knowledge of protocols and procedures of construction and development. Broad knowledge of  county geography.  List any Authorities, Boards, Commissions or Committees presently serving on:  Board member of Smoky Mountain Shrine Club  SIGNATURE:  DATE: 9-17-19