This is Monday night, August 2nd. I welcome you to the commissioners meeting. At this given time, I would like to ask Commissioner Branch to do an invocation and lead us into pledge allegiance. Let's start. Last break. Dear Wies and precious God, we thank you for this day. We thank this thank you for this opportunity to come out and conduct a business for the citizens of this great county, Dublin. Lord, I ask that you continue to lift us and guide us to do the things that's pleasing in your sight. Father, I ask that you give us the sight to see. Lord, bless us with the ears to hear. And bless us, Lord, with the courage to do the things that's necessary and right for all so that we can all have a better life and a better quality at life. Father continue to work with us, continue to live this, continue to guide us. Lord, there will be many discussions that we will have and we may have differences of opinion but follow us always agree on doing what's necessary for the poor and for those as less fortunate. Continue to give us the strength to carry on in spite of all that we face. For us in your son Jesus' name we do pray, let us all say amen. Amen. to the flag of the United States of America and to the Republic for which it stands one nation under God, indivisible with liberty and justice for all. Thank you Commissioner Branch. Commissioner Branch. At this time I ask is there any additions by any of the board members to the agenda tonight? And by the way, audience, Commissioner Garner is on the phone. Okay, Mr. Davis, I think you have a couple of add-ons. Yes, sir. Mr. Chairman, if it pleases the board, I would like to add Mr. Darrow Waley, your solid waste director, to making emergency requests to purchase a truck. If we could add Mr. Waley just before or just after public comments and before I take any request to be conveyed to DOT and also could we add missers Tracy Simmons Carnegie or Health Director to make a presentation on the current COVID situation in the county if we can do that last on the agenda miss Simmons Carnegie is still at the health department working right now but she will be here that's's all I have Mr. Chairman. Okay, you all heard your request but it's a pleasure to board. Second, I got a motion in a second to accept the agenda. All in favor say aye. All apart. Carried. Okay, Okay. Okay, the minutes of the 19th July 19th meeting, do I have a motion? So we'll... I got a motion down a second. Any discussion? All in favor say aye? All opposed? Carry. All right. All opposed, carry. All right, I need a motion to approve the consent agenda. Second. Second. Got a motion in a second. Any discussion? All in favor say aye. All right. All opposed. Same sign. Carry. Do we have any public comment? Mr. Chairman, no one has signed up for public comments. Okay, so can we ask Mr. Darrell Waley to come in please? Good evening. Good evening. I y'all do a great hope you all. I am. I'm here tonight with a request of a tractor day camp for our Solid Waste Department. We got to put in the budget, uh, 2021-22 year. Uh, we didn't get it, but as of July 1st, uh, one of every day, one of the ones we're running every day turn loose. Engine loaded up, had triple T, check it out, and we've got to have a new engine repair build, and that would be $65,000 with a new engine and new clutch pressure plate. This over flywheel, make a long story short, it's a 2013 Volvo. I have two of these trucks running everyday. With that being said, there's a sister truck to it. I looked for use trucks after, Mr. Davis, the top little bit, use trucks are hard to find during this time that we're going through. The cheapest thing I find was in Texas. It is a Kenworth 280 with 413,000 miles on it and the truck that I replaced and had just right at 400,000. This truck costed $55,900. That being said, it was a Kenworth and the last truck I purchased was a Kenworth. And that's what I had a quote on for the 2122 year was $114,000. By talking with him, I cannot get a truck like this until 2023. I mean, kind of desperate needs. Especially if something goes down now, we're going to be in a tight. I have talked with Triple T. I've got specs on a new Western star. It can be here before the end of the year. He's saying by December 31st, I can have it if we go ahead and purchase it or do the agreement to purchase it now. The price of it was PTO, wetline system and everything is $118,780. And I'm here tonight. But the request of purchase to replace this truck for we run into a bind that we can't hardly dig our cell fight if. Mr. Chairman, if I may. Yes, go ahead. The solid way, the money for this would come out of the solid waste enterprise funds fund balance. The approximate balance in that account right now is $549,063.52. At the end of physical year 20, the audited fund balance was $898,923. We have enough money to make the purchase and I encourage the board to approve the request as it is both justifiable and necessary. However, as you can tell, the fund balance in the Solid Waste Enterprise Fund is rapidly depleting. This is due to the fact that we have had numerous costly purchases of equipment and vehicles that were needed to replace our aging fleet at solid waste. We have also completed two major repairs to our transfer station over the past couple physical years, one to the concrete floor and another to shore up the walls that had deteriorated after years of constant wear and tear. In the past ten years, the tons of waste handled by the Solid Waste Department has gone from 27,200 tons in FY 1112 to 45,221 tons in FY 2021. That's a 60% increase. Our contract with waste industries increases by 2.5% per year, yet our user fee, which was established in 1992 at $69 and raised two years later in 1994 to $90 has not been adjusted in 27 years. We must consider an adjustment to our user fee in the next physical year to sure up the solid waste enterprise fund. If we don't, we're going to run the rest of the county's general fund having to support the solid waste enterprise fund. Cost of business goes up for him every year. Labor costs, fuel costs, replacement of equipment. So I just let the board know that because I want full transparency we need to be looking at this user feed for next year's budget. Trash has increased dramatically over 10 years just unbelievable. Of course more people are coming into the county, more people generate business, you know generate Businesses generate building and poultry products, wine products, I mean it's just all. Just trying to keep up with the times. Well coming back to the request on hand is you're requesting a new truck at $118,000 $70.00. Correct. Yes sir. Compared to repairing the one you have for $65,000, $70,000. Correct. Yes, sir. Compared to repairing the one you have for $65,000. Yes, sir. Which is a 2013. And you're going to have a 2013 transmission rear end clutch. I'm going to put a declutch in it, but transmission I was going to be doing. So what's the pleasure to board? I move that we make the purchase. Second. Okay, I have a motion to approve the request from the Dupelton County Solid Waste Department to purchase a 2022 Western Star 4,700 SF truck with the funds from the Solid Waste Enterprise Funds and for $18,000, $70 and do the budget amendment. $118,000. $118,000, $70. Okay. Any further discussion? I did want to let the board know that even though we're ordering and the truck now we've the earliest thing can get it to us is December 1st. Yeah. And I have the specs. If anybody wants to look over, I'm more than glad you could keep them. I got another set. Anybody's interested? With no further discussion, all in favor say aye. Aye. All opposed? Here it. Thank you. Thank you. Thank you. Appreciate what you do. Thank you, sir. Thank you. Thank you. Appreciate what you do. Thank you. Thank you. Thank you. Mr. Davis. Yes, sir. Mr. Chairman, members of the board, I appear before you now to hear any concerns, reference to our roads or highways in Dupin County that you may have so I can report them to the No Condconner apartment transportation. I have one that I was called on actually on my way over here. I believe it's going to be in the town of Rose Hill. Okay. It's my intent to go by and take a look at it. But is that the intersection of Maple and Ridge Street? Okay. It's the sinkhole on the ditch bank side. But I, like I said, I tend to go by and take any of pictures that I can to for you for further observation. Okay, and if I do determine that it's not DOT, I will call the town manager and Rose Hill and see if they can't get their maintenance. Sounds good, thank you. Thank you. I don't have anything. Mr. Banks. Yes, I don't have anything. Mr. Banks. Yes, sir. Commissioner Garner. Um, take each trial ready. The breathe between the breakout president and President Erwin's rounds. If you're traveling from 11 towards our 40th, we should point degrees that's 40 out of the track It's the breeze that the concrete on half of it's fucking out there and it's about whole up there to come to that bridge Okay I know where you're talking about I will bring that to DOT's attention first thing in the morning Thank you. Does any member of the public have any road concerns that I can convey to DOT? Thank you, Mr. Chairman. Thank you, Mr. Rancid. Right, this time we move in to what's on the agenda's item number three is Melissa Kennedy. Good evening. First thing is a public hearing for Joan Williams to name a lane of the Providence Church Road at the 400 block and she has chosen Savage Family Lane. Okay, we'll open that public hearing. I don't think we'd have to vote on that because we voted last time to have this public hearing. So I don't think we have to vote on this, that correct, to open up public hearing. I don't think you have to vote on, I don't think you have to take action over the public hearing either way. Use open it up. Okay. So we're going to open the public hearing. Any comments? Here and then we're going to close the public hearing. Okay, Melissa. So now I ask for a motion from the board. I move to approve. Second. Okay, I got a motion in a second to approve the request from John S. Williams to name a lane in the 400 block of Providence Church Road teaching North Carolina right fish down here, salvage family lane and accordance with the Dupland County Addressant and Road Name and Orioles. Any discussion? All in favor say aye. All opposed? Carried. Okay, Melissa. The next one is to request a public hearing and I think it's the next meeting is November, September, 7th. Yes, right. From Mr. Dwight Heal and he'll actually have two. The first one he's asked for, Randall Heal Lane and the second one, Montoria Lane in the Wolfs Great Town, she'll pop a pins in the road. You can't put it in the parking lot. I got a motion and a second to approve the request of the two public here in scheduled on September the 7th 2021 to receive public comments or requests from Dwight Hill to name two lanes in the 600 block of Kisney, Melbourne, Mount Olive, North Carolina, Wuskric Township, Randall Hill Lane, and my Toria lane, ordinance. Any further comments? All in favor say aye. All opposed? Carried. Okay, the last one is for Mr. Melvin Bostick on the same night. He's here in Kenosville, 1300 block of South NC50, and he's chosen Bostock Foreign Land. Pleasure, board. I got a motion on a second to approve the request to schedule a public hearing on September 7th, 2021 to receive public comment on a request from Mr. Melvin, Ballstick Jr. to name a lane in the 1300 block of South. N.C. Highway 50, Magno, North Carolina, Kenisville Township, Ballstick Farm Lane, and accordance with the Dupline County, Addressing and Road Name and Coordinates. Any further comments? All in favor say aye. All opposed? and road name and ordinance. Any further comments? All in favor say aye. All opposed? Here. Thank you. Thank you. Mr. Brandon, McMahon. I'm going to make you aware that the contract is on the agenda. The United Health Care is not the United Health Care. We're going to be talking about tonight. It's the well-prepared. My apologies for that. We've been dealing with our team. We've been dealing with a bunch of Medicaid transformation contracts in about 47 pages long with fees so I'm not sure if they got a copy of it. They were emailed with a copy. I guess late last week yes sir. So I appeared before you not to request approval of the well-period contract agreement this is a part of the new Medicaid transformation as of July 1st, all municipal agencies will need to transition to a direct payment system in which a calculated rate will be paid for all emergency and unemerged services provided by EMS regardless of the level of service or number of mileage. Second, I got a motion in a second to approve the Accelerator Provider Participation Agreement between Dupland County and Wellcare Health Plan incorporated per request from the Dupland County Emergency Medical Service. Questions, comments? All in favor say aye. All opposed? Carried. Thank you. All in favor say aye. All opposed? Carry. Thank you. Mr. Tracy Chestnut. Good evening. Good evening. Mr. Chairman, members of the board, I would like to request to approve a contract with Maximus U.S. Services Incorporated. They prepare the annual indirect cost plan, which allows us to pull down federal and state funding for central services. That is a three-year contract in a total of 10,500 in the current budget year. We budgeted $3 3500 for the contract. Second. I got a motion and a second to approve the contract with Maximus US Services Incorporated and authorized a finance officer to execute the contract upon final improvement from our county attorney. Any more discussion? All in favor say aye. All opposed? Karen. Okay. Okay. The second item is I'd like to give some general information to the board and the public. I'm an American Rescue Plan Act and the funds that will be received by the county. And I'll wait for the presentation to come take for a second. All right today I'm going to give you just some brief and general information about the American Rescue Plan Act and the funds that the counties received. The county is allotted 11,400,000, 7751 from the US Treasury. We have received half of that. And our allocation is the amount that you see on the screen. This money is to be obligated by fiscal year 2024 and to be spent by fiscal year 26. So next we have the approved use of funds. There are five different categories. One is support of public health expenditures. So that would be your PPE providing staff support with public health and emergency services, any medical expenses, behavioral health care. The next and approved use of funds is to address negative impacts, economic impacts on public health emergencies including economic harm to workers, household smart businesses, empath and industries and public sector. So that's a broad explanation of what you could use the funds for in the form of some type of economic payment. The next approved use of funds by the Treasury's office is the replacement of loss public sector revenue and that can be used to provide funding for central government services to the extent of the reduction in revenue. And basically what that means is the Recovery Act has put a formula in there that allows us to calculate what we potentially lost in revenue as a result of the pandemic and we'll be talking about that in just a few minutes. The next a previous is Premium Pay for Essential Workers which offers additional support to those who have born and will bear the great help health risk because of their service and critical infrastructure sectors. So any essential employees you could provide premium pay out of this funding. Last you have investment and water sewer and broadband infrastructure making necessary investments to improve access to clean drinking water, support vital waste water and stormwater infrastructure and to expand access to broadband internet. So in one of our previous meetings we've discussed possibly using this fund that funding to help fund the state assistance with the water department. That's been approved. So last I have a brief slide of certain things that I have Brought to Mr. Branson's attention and we'd like to bring to yours as as a potential amount and use of all the funding that we have In support of health public health expenditures Part of this support of public health expenditures can be done in a capital way. For example, if you wanted to put in a drive-through window to keep folks from coming in your building, or you can improve your ventilation system. So our health department is our vital capital that serves the public health needs and is important that we replace some of the air conditioning and ventilation systems in that building to improve the circulation of the air in the building and hopefully avoid those airborne pathogens making someone sick. So that's where you see the 70,000. Replacement of lost public sector revenue. And this is just an estimate, but basically I received a template from the National Government Finance Officer's Association that basically allows me to just input our information and it comes up with an estimate for me. And so for the first fiscal year, or measurement period, which was 1231, 2020, the estimate is 7,909,000 that could be used to set aside for any type of general service experience. Third, provide premium pay for essential workers, some of our counterparts and neighbors or providing these payments to their workers and we are proposing giving all essential workers $1500 as a one-time payment. Investment and water infrastructure, which I alluded to earlier, which is 1.6, that would be the SCADA system system which is yet to be determined where to use the funding and then I have unallocated funds of $776,000 that I haven't quite yet put to one of the use of funds. So does anybody for the board have any questions for me at this time. This is just a proposal. It's not set in stone. We have a great amount of time to spend the money, so we don't have to make a decision anytime soon, but this is just a kind of start the conversation with the board on how to spend this large amount of money that we've been given by the federal government. If I may ask, what is the deadline on having this accomplished? 2024, we have to have it obligated so that either means we have to have a contract in place or we have to have a purchase order on the books to spend the money. Then by 2026, we have to have all our expenses on our books. 2026. These items that you have proposed that you did with us tonight. When would they be spent? The premium pay for essential workers could be paid at any point in time. Water infrastructure that is based on a decision by the board on how to use that funding. And that project is actually ongoing now. So that would have been an immediate expense of 1.6 million for the Skated System. The public sector lost revenue. I would say not to get in a hurry to spend that because we're still waiting for final guidance from the Treasury Office on exactly how to account for that funding. For example, if you wanted to use it for salaries in the general fund, I am waiting for guidance at the federal level to tell me how I have to account for it in the general fund because they have told us to make absolutely sure that we are not creating a rainy day fund of some sort or padding our fund balance or using it to pay off debt service. And so that's why I'm waiting for them to tell us, give us the guidance on how to account for it. But that's the only the first measurement period. You can also measure loss revenue as of December 31st, 21, 22 and 23. So some of the unallocated funds or other purposes we use could be potentially reallocated to loss revenue but we won't know that until those measurement periods come to pass and then the 70th thousand for the support of the public health expenditures is an immediate need for the public health department especially with the most recent uptick in COVID cases. Thank you. Anybody else got questions? Yes, sir. In regards to the broadband, I know the state has been allocated, I think, because about 350 million to go towards the expensive broadband. Is there any conversation about what the state is going to provide to the counties out of that? The governor I don't have the exact figure because I'm just focusing on our budget but a governor has allocated money for that specific purpose and in any of the conversations that I've had or listened to the several phone calls and, they say to let the state give out the money for broadband first and then see where you're at after that. Mr. Grant. Yeah. Commissioner Branch, if I may, if it was going to work like the great grants were then the state awards the grants to a private utility company to provide the broadband service because the county cannot be in the broadband business. But it will have to be a company such as Eastern Carolina broadband ATMC, Century Lane Spectrum. Those type of organizations would apply to the state for grant funding. Thank you. So I would I would say our greatest potential right now is the estimated public sector revenue. And once I receive that final, got it so how to spend it that I'll be providing more information to the board. But to be clear with that seven million plus it still has to be utilized by 2026. Yes, absolutely. And the way the plan act and the interim final rule from the Treasury's office is written it just says for government services it's not very specific. So there are there's a wide array of uses of the money and we're still waiting for that guidance because I would hate to spend $7.9 million and not use it appropriately. I just thank you. Welcome. Yes, sir. How many pay for essential workers? What would the amount you spent that was for workers? Your essential workers is $964,066. That's for a one-time payment of $1,500 to essential workers. And how do we determine the essential workers? If you got somebody to figure that out? Yes sir, I do. I don to figure that out? Yes, sir. I do. I don't have that sheet in front of me. Dave, do you happen to have that? It's fine. Just from my memory off the top of my head, anybody that was required to come into the office and interact with the public or have to work in an office within a proximity of a coworker could is considered an essential worker. So that could potentially cover all employees of the county that were required to come into, coming to the building to work. That's not setting stone yet, correct? No, sorry, that is all. This is just a light suggestion. That's not setting stone yet, correct? No, sir. That is all. This is just a light suggestion. And at some point in time in the next month or two, as we have discussions over this revenue and receive more information from the Treasury's office that I'll be asking the board to make some more solid decisions on how to spend this money. Well, just for me, I don't know what the place is, the rest of the building, but I would have to tell how many employees were required to work the vaccination payments. One of our health departments, those researchers share their media mass. How many employees we had that worked in those, but I think they seem to have to come in on Saturday. But what they're still writing in the middle of it, possibly deserve more than just the strength of cost to board $15 dollars for everyone from me in the county. I will mention that during this time, those employees that were required to come in were paid out their overtime where it's not general county policy to do that out of the pandemic recovery money. Okay we'll take your overtime to the field. I mean to take the away to see thank you for coming in to do it. I will get the health director to provide us some information. You're welcome. And based on the way you presented this, and you said that it was basic information and you're still trying to work through it. Yes, sir. Before you need payouts or made, you come back to the board. Absolutely. So we can talk about some of these other Yes. These other funds. Okay. We're hoping to receive the updated guidance on the revenue in the next month because the final comment period for the interim final rule for the general public comment was due last 16th. So the Treasury's office, I feel sure, will be given us something by the end of August. Okay. All right. Sounds good. Any other questions? Thank you. Yes, sir. And I just didn't want to mention for the public's benefit that if you need any information and depth, you can look up the NC Pro Office for the State Treasurer's Office or you can also look at the US Pro Office for the State Treasurer's Office or you can also look at the U.S. Treasury Office website and it provides detailed information. Thank you very much. Thank you, Assistant. Yes, sir. All right, Will, there's a little stone scum in, please. How are you doing tonight? Great, how are you doing tonight? Wonderful. I'm actually here tonight on behalf of the Dupland County Transportation Committee. I'm the Secretary for the Committee and they have discussed updating the bylaws to include an updated roster. So we have what they feel are appropriate representation on that committee Some of the changes include including the airport commission and the transit advisory board as a voting seat on that committee The municipal association approved the updated version of the bylaws at their July 15th meeting and now we're requesting The county commissioners approved the date bylaws so we can start using the new proposed bylaws to conduct our meetings. Sick. I have a motion and a second to adopt the 2021 version of the Duke and County Transportation Committee bylaw as amended and to allow the chairman to sign the saying. Any further discussion? All in favor say aye. All opposed? Carried. All right, thank you. Thank you. And now with Miss Sarah Straub come forth, please. Good evening. And thank you so much for inviting us to join you. I've got a fairly lengthy presentation that I promise you I can move through it fairly quickly but certainly have time for questions if you have any. With me tonight I have Victoria Jetson and Melissa Reese. Victoria is our chief of external operations and Melissa is our community relations representative in Declan County. So between the three of us hopefully we can share information it will be relevant for you and have a great conversation. So, and then I'm Sarah Stratton as you know I'm the CEO of Beast Point. So, do I have... You'll do it. I agree. So, as this says, I have about 23 years in behavioral health care and Victoria brings about 19 years. He may think I look really old to only have 23 years of experience, but I had a whole other career before I went back to school and I'd involved with behavioral health care. So I am really old. I'm ready for the next slide. So this is just a brief outline of what I want to review with you in my. I'll give you an operations update. We'll talk in particular about Deepland County. Victoria is going to give us some updates from our provider network and then kind of end with where East Point is in relation to the other LME, MCAs in the state. So this is really important, I think. Since 2017, we have invested over $27 million in our providers in our 10 counties that we serve. And the way we did that was through rate increases. I wanna talk to you just a little bit about why we do it that way and why we think it's important. We serve 10 counties, so it's really important that we serve the counties fairly. And the way we think we do that is through our provider network because as you know, since I believe 2008, the LMEs have not been allowed to provide direct services. But the way we provide services is through our provider network. And so keeping those providers in business with appropriate rates and keeping their claims paid in a tally manner is critical to serving the members in all of our counties, and particularly hearing Dupel and Callie. So, that's important and during COVID we did, I believe it was just over 6,6,5 million dollars in the rate increases just during COVID. I also want to talk about the last one. I'll talk about that a little bit more. But it's really important to note that each point has been recognized across the state by our members, not by us, not by the department, but by our members, not by us, not by the department, but by our members as providing the best customer service experience in the state of North Carolina. We'll talk more about that toward the end of the presentation. As I'm going through this tonight, I want to know what are your priorities for behavioral health in deep one county. So if you have things that we don't talk about if you have ideas, if you have questions, we're here to survey. So please let us know what your priorities are and just be thinking about that as we go through the presentation. Okay. So this is a really exciting slide for us. Just last Monday, East Point was selected as one of the LME MCOs to move forward as a tailored plan. Earlier in your program, I heard you approved the contract to work with well care. There are five standard plans in the state who will do the whole person care for the less severely impaired. Each point will now begin in next July, pick up the care for the most severely impaired, those physical and behavioral health. And that will be a big switch because as you know, for years we have only handled, it's not really only, but we have handled the behavioral health care. We have partnered with Will Care and that will be our standard plan partner so we'll be utilizing a lot of the things that they bring to the table including their physical health net or their pharmacy benefit and will help us be a stronger provider. We're on target to meet the July 1 deadline. They just made that announcement this past Monday So we're sprinting to that finish line in 11 months. We've been working a long time on it. Kudos to our team that RFA came out, our RFP came out in November. And folks worked through their Thanksgiving holiday and their Christmas holiday and their New Year's holiday because the due date was I believe it was January 2nd and we got that in and we're proud to say that we were selected. So a little bit about East Point currently right now we have 304 employees. 62 of those 300 and 4 employees work in Deeplin County. And of those 64, 22 of those employees live in Deeplin County. I know this is always important for commissioners, the salaries that are paid to Deeplin County citizens that work at each Point, including benefits, is just over $1 million, $1.1 million that comes back to the county. Not quite. I want to highlight the pie chart just a second, sir. One of the things that East Point believes to be very important is a diverse workforce. And you can see there that our pie chart reflects that diversity. 47% of our employees are Caucasian, 42% African American, 10% Native American, we do have a strong Native American population in our South Eastern counties, and then 1% Hispanic in Asian and that this member is really reflected in our provider community as well. Thank you. Just to highlight our budget, our financials, we have this year, this fiscal year, $351 million dollar budget. Our fund balance stands at almost $139 million, but probably the most important number on that slide is that of that $139 million, only $19 million is unassigned at this time. So we are strong financially and the controls and the operation of our finance department is very strong. So I don't know if you can see that, but Deeplin County is at almost at 12 o'clock, just a little bit to the right. That's the number of covered lives that out of our 10 counties represent Deeplin, and that is 8% of our total population. Your Medicaid population is currently just over 18,000 and that's out of our total Medicaid population of just over 239,000. We have your total population numbers. It just over 58,000 right now. So of that, 18,000 people have Medicaid. The next slide represents the claims paid for members in Deepland County and that's at 7% of our total. It's really interesting, I think, to note that since fiscal year 18, the claims have just continued to increase for Deepland County citizens. It was just over 16 million in fiscal year 18, and in fiscal year 21 17 million $290,730 and we can see that in detail on the next slide. So you can see that just represents fiscal year 20 to 21 claims with an increase of over 136,000. with an increase of a $136,000. Deepland County provides funding of $224,474 dollars and there is a list of the items that you all designate. It would spend the money, all the money that you pay in your maintenance of every is returned to Deepland County for your citizens. is returned to people in county for your citizens. So out of that 18,000 that we talked about in your Medicaid population, in fiscal year 21, just over 1700 people received services. Medicaid services, state-funded services, 440 people. And from Deepland County, we received over 1,500 calls to our access to care center, which lines up very closely with the number of people who received services. And just a reminder, y'all got cards in your packets to my, but that call center operates 24, 7, 365 days a year. Ready for the next slide? Another thing we're very proud of, to prepare for the tailored plan, we needed to switch our accrediting body. We have been accredited for some time with CARF, but we needed to switch to NCQA. Another heavy lift, but we did have that review in March, I believe, and we were given 99.67 points out of a possible 100 which was again something that I was extremely proud of our team for achieving and we were given full accreditation for three years which we understand some of the other LME MCAs did not receive that full accreditation so few days to our teams and we do these things because we want to represent our counties to the best of our ability and serve the citizens and the members that we have charged with serving. So, my next slide, I've got a lot, but so I'm going to run through them quickly. You have the the PowerPoint presentation but I really just want you to know some of the things that are going on in Deeplin County that you may not be aware of. I've already talked about the rate increases and why we do that so we can skip to the next slide. You probably are familiar with the grants that we have given to our counties. Deepwood County has made application and received grants for the past two years. Those grants have gone to your county health department to expand, to begin expanding this whole first and care model. And what your health department chose was to include case management and also a 24-7 process response. A reminder that those grants are out again this year for submission and I believe the D-Day is August 16th. Yep, so right around the corner. Hard to believe we're in August now. Another thing that we have now that is something that's the last time I was here is this We Connect project and that's an app that people can put on their phone and it helps people who are in substance use recovery by allowing them to access the app when they do certain things that are indicative of recovery and it actually allows them to earn money for staying in treatment. And I think I may have how many dollars Today, program wide our members have earned almost two thousand dollars in incentives and about thirteen hundred that has been redeemed. This is a fairly neat project. that has been redeemed. This is a fairly neat project. We are also involved in administering the funding for the Deeplin 4-H Prevention Program. That's 33,000. Melissa is very active in the Deeplin Substance Use Coalition and certainly could answer any questions you have about that. We provided 72 narcanons in 2020 to help prevent opioid everyday. Law enforcement and jail and folks coming out of jail is always an important issue. And every day we scan the law enforcement records and all our counties to identify possible people that are East Point members who maybe have been booked or arrested to engage them if they come out into transition into surfaces. Also the crisis intervention training, this is something that's been going on for a lot of years. I know you're familiar with it. It's such an important training that we do. It's a key piece of helping law enforcement understand facts with issues when they show up on their doorstep. And we have a training that is currently scheduled for September 20th through the 24th. It's a big time commitment but I think it pays off in Zividend. And Melissa was telling me earlier that there are still slots for that training because it encourage your law enforcement EMS anyone you would like to attend that. I'm going to skip through some of these but the second bullet we're continuing to provide ongoing support to four people and county members that are in community housing through it's called Transition the Community Living TCL and our Enriched Reach Efforts and so that's for people who come out of institutions and then we help transition them into the communities and again we were one of if not the only LME-UCA's that maintain those efforts face-to-face through the pandemic and finally we're doing home delivered meals to people who are on the innovation waiver, the developmentally disabled. And we do that through a program called Moms Meals. They get to select their meals and then a week's worth of meals is delivered and we were able to continue doing that through the pandemic as well. We are currently collaborating with UNC and the NC area Health Education Center's Agit to develop curriculum for using motivational interviewing with IDD members and will be the first in the state to do that as well. Another whole person care pilot with UNC and the CARO clinic and again that's just an integration of physical behavioral substance use and pharmacy moving in the direction that we're getting ready to go on. Bless you July 1st next year. Also, during COVID, we did a lot of things to hope for NC to provide help support for people who were affected by COVID. We did a lot of community webinars and we delivered presentations as well. So that work is ongoing. Any questions on what I've covered so far? I ran through it really quickly because I'm in your time. I want to be very respectful of your time. But I'll be happy to address any questions before I turn to the people who are going to talk about the provider network. She knows all things provider related. You want to have a question? All right. Motion is on. I'm good. Thank you, ma'am. Good evening. Good evening. Thank you for allowing us to stand before you today. I'm just going to talk with you briefly about the provider network at East Point. It's going to be high level, really brief. Again, like Sarah said, one to be respectful of your time. Our network, let me first let me just say that our network is provide network is instrumental. They are really important. Our stakeholders you guys are really important to serving the citizens of Dupland County. While I'm charged with the provider network and the oversight of it, one of the main things I always see you always keep so grounded and focused on is serving our members. You know, at any decision that's being made, they are at the forefront of that decision. Each points network, it's It can change day to day, depending on, you know, the provider situation. We are very conscious. Every day we're doing capacity checks. We are annually who do what we call a network adequacy. Reports that's looking at, when I say detailed, every single member in their address, making sure that they have at least two providers of choice. Statewide East Point partners with over 600 providers that offer more than 1,700 point of care options and what that means is our providers, they may have what we call mother companies, right? But up under that company they may have several sites throughout the state. And so right now we're at about 600 providers with 1700-20 care options. In Duplin County we have seven provider agencies, one hospital that's contracted with us, eight providers with 12 sites, which means you have 12 sites throughout Dublin County you know Kenningsville, Wallace, Warsaw, you have we have those sites listed there. Next slide please. There's no wait list. We pride ourselves again in taking care of members, ensuring that they have the care that they receive, and also in sharing some of their wants as well. You know, we get calls every day, every day in ensuring our care coordination department, our clinical team does a really great job in ensuring individuals get the services that they need. The list up here won't go through every last one of them. It's not an exhaustive list. There is so many clinical services that our individuals can access. On here what you will see is some of our community-based services that we're charged with, ABA therapy, ACT, community support teams. These services are provided in the community mostly, right? So we have services that's provided in office, we have services that's provided in the community, and we also have, we're charged with ensuring individuals have access to residential services as well. Mobile crisis, make sure that you all are familiar with mobile crisis. It is critical that anyone who is experienced in a behavioral health crisis have access to care quickly. There is no wrong door. They can contact our member call center which offers 24-7 as Sarah mentioned. They can actually contact the provider. We have about three mobile crisis providers in our network that's serving across the counties. Their response time is two hours or less. When you think about crisis and you think about two hours. That's a long time, right? You may think it's a long time. This type of crisis is not an imminent risk crisis So if there is someone that is at imminent risk to death or there at imminent risk of hurting someone else Then our member call center or the mobile crisis team will dispatch now one more or the mobile crisis team will dispatch 911. At many times they will accompany 911 out to the call as well once the scene has been cleared and didn't get safe. There are licensed clinicians that connects directly to the member in need. I remember call center whenever 911 is involved and it's imminent risk, they will remain on the telephone with that individual until they can confirm that 911 has arrived. And they just continuously provide motivational interviewing, coaching, just ensuring that they are safe at the moment. Sarah talked about this already, the $6.5 million in rate increases again. It is about stabilizing our network so that most importantly the services are there for our individuals to access. That is key, that is most important, that they can access services. Also talked about the grants, the whole person care initiative for Dupland County. It's granted through the Health Department. They're doing the case management, 24-7 response team. And then lastly, on this slide is Value Base. That is a push for the state. The state has push is pushing us towards value-based care. Most importantly, it's because it's about quality of care, right? People can provide care all day long, but if it's not good quality care, what you will see is an increase in hospitalizations, increase in the ED. So our value-based care palette that we launch with the provider, it focuses on keeping individuals that are unnecessarily in the hospitals, keeping those folks out of the hospital. We also, we're working on a value-based project, a second one, around therapeutic foster care for children. We know that child residential services is an area for opportunity of growth and so we've started working with provider on value-based arrangement. I'll turn that over to you. As the March providers go, is there a detriment of mental health providers in Dukeland County, practicing clinicians, practicing providers within the county because I'm not aware that we have one psychiatrist actively practicing in the county. Is that the case? And if so, is there anything that you guys can help us do to try to recruit some more providers to the county to help with some of the transportation needs of some of our citizens. Many of our citizens face. Yeah, great question. Yes, we do have psychiatrists that are practicing here in Diffle County. And Diffle Mentions is one of our provider agencies for our human services is also, so we have, you know, as mentioned, those sort of providers that are here. Now, that doesn't mean that we can't enhance the service array. Whenever there is a gap or a need that's identified, then what we would do is we'd do that deep dive into the data and do what we call the capacity check. And we would put out requests for proposals and requests for information. Back in 2018, we saw here in Declan County that Substance Youth Services were not as robust as it needed to be. And so we put out an RFI to recruit providers for the Substance Youth Survey. And our new dimension and Tarkeleton human services I believe where the providers identify. I have one more question. I was just going to add on to the transportation. Needful, can we talk about the non-alarmic and mental health? Yes. Great point. As a tailored plan, we're going to be charged with having oversight of non-emergency medical transportation. We're in partnership with WellPair. And so what that transportation would be for any member that has Medicaid, that's receiving the Medicaid services, they would be able to access that transportation, who will actually take them to their appointments, whether it's followed appointments, but any medical appointments related to pharmacy, physical health and behavioral health. One other question, I don't know if you can help me with this, but I'd like to see how some of the other counties that you service are, if they're dealing with the same issue with the closure of the behavioral health unit by the end of the day. Our involuntarily commitments. Our Sheriff's Department is having to transport individuals to a husky to Winston-Salem and to Charlotte. There's nowhere any closer. I hear concerns from Sheriff Wallace and Chief Deputy Haphrey about how it is really taxing their resources to have one deputy, sometimes having to have two deputies to transport one individual to Winston-Salem and then back at that takes a long time together with Kingsville to went to Salem to get the individual admitted and come back. Is this the case in all of the counties that you're serving or is there a better option for us? I guess what I'm searching for. It's a working progress. So let me say that. You know when Duke and County shut their doors it did leave an area for it left a gap in a sense. And so what we have to do in that situation is, again, leverage the resources that we have in our network while we work on building within the particular county. Each county has what they have the transportation plan that they're charged with. And then you guys may be familiar with that for the IVC process. And so before the pandemic hit, we were having community crisis collaborative where all of us got sat around the table, discussed what that needs work in the county at the time and also kind of came up with what we call a community crisis plan. The IVCs, your first level reviewer, the way that the new room came out for IVCs is that they wanted to prevent any unnecessary IVCs from influxing your EDs, right, the HOSCO. So that's why we have what we call the first level reviewer. New dimensions is your first-level review site. So anytime someone is IBC, they would go to that site first and they would do a review. That person would be, whether or not they need to really stay on the IBC, or they can be released. And then they would be transported over to the local hospital. Is it the best scenario? No, it's not the local hospital. Is it the best scenario? No, it's not the best scenario. But we are working to build that capacity in our network. To build a hospital unit in the network, it takes time. Then the unit doesn't have to be designed. What's the given option? Okay. So the neighbor is out. Okay. We need to tell the magistrates or tell the little ones that the decision. Because, and again, Victoria is the vegetable attorney with the money that was allocated here. Transferred over to Zostin County Medical. That's the main money that they can. That would be a closure option, not perfect. And are they traveling? Maybe we can talk afterwards too. Let's do that. I'll put you in. It's actually cheap debt. Yeah, let's do that. I'll put you in. And touch with Chief Deputy. Yeah, great, great. Yeah, so we have to probably drill down the reason why they're traveling so far, especially with the closer option within the network. They just give them the commitment papers and they follow their orders. Thank you. Yeah. Yeah, that's excellent. Thank you. You're welcome. Any other questions? I want to thank Mr. Brissen because I was actually I wrote a note down about the mental wilderness piece and was wondering is the behavior therapy that's noted is one in the same or that you kind of break them out where behavior is not consistent with the mental wilderness because as of right now with COVID and all this taking place, there's a huge uptick in the mental illness scenario for a lot more than that's probably able to provide the help for, but is that some of the focus? So we review individuals. They would fall into a category of whether or not they have a mental illness, the mental health realm, if they need substance use services or if they need services because they have an intellectual developmental disability. So that is pretty much how we break down the need. That's how the state has deemed that for us as well. Did that answer your question? Yeah, it's just making certain that there are other options out there for those that as this continues to unfold as an uptick in terms of the just the mental anguish individuals are going through with all of us, you know, focused on COVID. So just having that as part of the toolkit, as you move forward, I think it would be very beneficial for all of us. And let me, I'm just gonna say, talk just a little bit about that. I would have had it right at the time. You should talk a little bit about that, that friends that you have with you, and the school, and think that was really important about the population. Right. So about the population. Right, so we have been working with the division. Division has partnered with us and some of the other LME MCOs. It's called the Hope for NC campaign. And that campaign is educating the general public, right, on ways to handle stress related to the pandemic. Some of the things that we did for Hope for NC is about education and awareness. Letting them know where the services are. We've put flyers, we've put what do you call the transportation pump, the toppers on the transportation pump, with contact information. We've also did videos for our school teachers in Dukeland County and our other counties as well just to educate them on interventions and counseling for individuals whether it's the students or their families. So it's a huge deal around the hope for NC. But let me also mention that when I say that Dupland County has eight providers here, that does not mean that the Dupland County residents cannot access other providers with our network. They can access and utilize any of the providers that we're contracted with. And if there is not a provider that we're contracted with, we have what we call the single case agreements. It's a simple contract. It can be complicated, but it's a simple way for that individual to get that service that they need right then at the moment and without having to go through the full-blown contract and process with us Thank you so much. Thank you. The floor Victoria moves into her role with provider relations. She was, she was a clinical operations and you certainly hear that knowledge reflected in what she shared with us. So I'm just gonna wrap it up real quickly so you can move on. It point out that in fiscal year 20, we exceeded the state's benchmark in every category that we were evaluating. We're required to answer calls coming into the call center within 30 seconds. We're expected to resolve any complaints we may receive within 30 days. Our hospital re-em missions need to be assigned to care coordinations. And I mentioned this early in the presentation. Claims must be processed a clean claim. Must be processed within 30 days. And again, that's really important to the viability of the providers to keep them down. And we met, are exceeded all of those benchmarks last year. And I'll wrap it up with this. So there's an annual survey. I think I talked about this last time I was here. It's done by these audiences, these audiences are surveyed, the adults, the youth, and the families. And the people who are administered this survey are asked about East Horn, ask about service provision, about how responsive we are, any problems. And for, I think it's the third year in the road, would you see the next slide? Yeah, third year in the road. We were the top performing enemy MCA for three years in a row. And I've got the slides. I'm not going to go through them individually but I want you to just scroll through them. You see the purple line, that is each point. And all the other enemy MCAs are below the purple line. And here are some of the questions that were asked. Like, do you know how to make a, um, a vacuum of, sorry. Do you know how to make a complaint. This is the one about complaints. But anyway, just roll for days and you'll see that purple one that represents each point on all of them. So we're really proud of that and we hope that you'll be proud of it too because I think it's representative of the services that are being provided to your citizens because it's not about us it's not about you it's not about us it's really about that person out there who needs care and we hope and believe that we are doing the best job possible for them certainly always willing to improve and that's the name of the game and we'll be happy to answer any additional questions you have. You have my phone number on the card there. I'd love to hear from you anytime. Thank you so much for your time. Hope we didn't take too long. Thank you. Any more questions from the ladies? All right again. Thank you so much. Thank you thank you really appreciate your time. Okay that moves us in the Mr. Gary Rose. Good evening how you all doing? Good. Good. How are you? All right. I'm getting three more surplus properties. We're about to work them down. The first one is parcel 12-EA71. A final baby was submitted June 28th. The amount of $13,200 from Standard Reynolds LLC. This parcel was acquired in 2017 by Duke and County. The original baby was $10,340. And the county is selling it now for $13,200. The yellow crew selling this part for this fee. Which is great. So I have a motion now a second to accept the bid from Standard Reynolds LLC in the amount of $13,200 for partial number, 12-E-O-7-1 located at 817 Beasley Road, Mille Road, Magnoia North Carolina, Magnoia Township, and Arthur Isaac County attorney to prepare a deed for the transfer of the property to standard rentals LLC. Father discussion. All in favor say aye. Carried. So next property is a parcel of 01-702. Final bill is submitted on June 28th, 22nd, amount of $6800 from the T-nose property LLC. Dubant County Tany, this property, August 50, 2019. This bit is more than regional bit. Yeah, the county's worth profit. Submit this for yellow proof. Second. I have a motion and a second to accept the bid from Latinos property LLC in the amount of $6,800 for partial number, O1-702 located on Pine Street in the town of Warsaw, Warsaw Township and authorized the county attorney to prepare a deed for the transfer of the property to Latinos, properties of LLC. All in any further discussion. All in favor say aye. All opposed. Curied. Next, parcel is parcel 01-E251. This was an initial bid. Initial bid was submitted on July 26, 2021 in the amount of $4,000 from George Smith. This property was obtained October 2, 2012. The bid is less than the original bid amount of $4,171. This just fits. Placed initial bid on this for $4,000. And then you tried to withdraw his bid, and you told him if you do, you'll throw your bid and you forfeit the $200 he put down for the bid deposit. big positive. That is the bylaws that we're going by concerning the surplus properties. If you submit a bid then you don't pay or don't follow up then you have to surrender your deposit. The bed is still there. The bed is still there. The other way that can be done is if you are rejected or you are getting accepted. So, have a motion and a second to accept the bed from George Smith in the amount of $4,000 in proceed with the sale of surplus property partial number O1-E251 located at 113 East George Street in the town of Warsaw, North Carolina, Warsaw Township, pursuant to the negotiated offers, advertisements and upset bed process set forth in NCGS 168-269. Any further discussion? All in favor say aye. All opposed? Carried. Thank you so much. Thank you very much. Thank you, good. This Simmons can be. This Simmons can be. Thank you, ma'am. You're welcome. Thank you, come. We heard you were working late so we tried to give you plenty of time to finish your work and you'll probably have to go back when you finish with us. Unfortunately. Thank you so much. Thank you. So good even Mr. Chairman and fellow board members. Thanks for the invitation to come for you guys tonight and to give you a fellow board members. Thanks for the invitation to come before you guys tonight and to give you a current COVID-19 update for the county. Over the last several weeks, the county's positivity rate has continued to increase each day. As of July 6, the county's rate was 3.3%. 3.3% and we currently had 39 individuals in isolation. That means 39 positive individuals that we were following. Followed by on July 13th, we were at 5.7% July 20th, we were at 8.1% and July 27th we were at 11.6%. As of today, our current positivity rate per the DHHS dashboard is 13.5% compared to the state at 10.6%. Please know that those numbers I just gave you are those who have been tested and that are PCR tested. So there is the possibility we have more virus circulating in the community than to be tested. The week of June, January 3rd was the last double digit percent positive until the week of July 18th. So we had gone at least seven months and had been as low down as like 1.9% that was the end of May. So from March 1st, 2020 through July 31st, 2021, looking at some of our cases, 37% of our cases have been between the ages of 25 to 49. 21% of our cases have been between the ages of 50 to 64. 64% of our cases are of the non-Hispanic ethnicity compared to 36% of the Hispanic ethnicity. 72% of the cases are Caucasian. 19% of the cases have been Black or African American. Currently the Health Department has 327 county residents that we are following. Just to give you a note over the weekend we came in this morning there was a hundred positives that had to be interviewed today. Additionally we had three deaths over the weekend bringing us to a total of 146 total fatalities from the beginning of the pandemic. Noted by the CDC, Dupland County is noted as a high level of community COVID-19 transmission. The Delta mutation was first detected in North Carolina in early April. Delta is 200% more transmittable and results in up to a thousand times higher viral load compared to the previous variants. This means that one person on average, one person can infect six to ten people. If you have not been vaccinated, then it is encouraged to get vaccinated because you are a greatest risk of contacting COVID-19. Vaccination is currently the leading public health prevention strategy to end this pandemic. COVID-19 vaccines began to be administered here in Dupland County the week of Christmas. Over the last seven months, vaccine events have been held with and at county employers, including industry, agriculture and produce plants as well as community events. The health department has worked with a number of community partners, including Cooperative Extension, Amonus Unidas, one-to-one youth, American Red Cross, Access East, United Way of Wayne County, NC fields, Mount Calvary, Dupland Christian outreach ministries, and a lot of local churches and businesses for vaccine outreach efforts. Additionally, billboard advertisements and English and Spanish have been purchased to include the three W's and now to include vaccines throughout the county. Of note, approximately of the total amount of vaccines that have been administered, which is roughly around 19,052 percent of the first doses have been administered by the Health Department and 53 percent of the second doses have been administered by the Health Department for our residents of Dupland County. Currently, per the CDC. So there is a little difference if you look at the CDC's dash board on vaccine vaccinations as compared to the states. But I will go with the states for tonight. So total vaccinated in the county is about 30% of our population. They base that off of 58,741. I think it's important to recognize that about 24% of our population of the 58,000 is less than the age of 18. So of the 17,915 who are fully vaccinated in the county, which is a total of 30%. 27% are African-American, 24% are Caucasian, 16% are Asian and Pacific Islander, 26% are Hispanic and 28% are non-Hispanic. Only 9% are from the ages of 12 to 17, and 59% are 75+. So of our older population is where a lot of our vaccines have been administered. Positive cases continue to increase at a fast rapid rate because of the high contagious delta variant. The COVID-19 vaccine can protect individuals against severe illness, future complications of COVID, hospitalizations, and potentially death. So I just wanted to share a few things with you guys of where we are in the county. So as of end of May, first of June, as I mentioned before, our positivity rate was low 1.92% and it started creeping up the first of July, mid-July. Looking at that you can look at there was the mandates or the relaxation of masks in you know from the state perspective happened around that time. So if you look at when the Delta Variate first arrived in the North Carolina was early April, then the mass mandates were loosening up and then that's when we started to see our positivity rate continue to increase incremental, but then we took a huge hit from 3% to 8% and then we almost doubled in two weeks. So our team is back working to give you a sense of where the 327 positivity cases that we're currently working that's what we were working back in January. So vaccine efforts again we are at 30% we are one of the lower counties in the state. There is some work that we're doing with some state guys officials that we're doing with some state guys officials that we're working on has a call tomorrow and on Wednesday talking with them about different things that we are doing. We have tried. We'll we'll be trying the $25 summer incentive cards for those individuals who get their first dose as of we start that initiative as of Thursday night and that will run through the month of August to help for those who have transportation barriers to help if they have to pay somebody to get to a site or take off of work there is a $25 incentive card for those individuals for their first dose. We have been working as you heard me mention like one-to-one access East Mt. Calvary and some of our community-based community health worker groups to go out and do canvasson and try to educate, provide education. There's what they call community health workers, and those individuals go out and do education on the vaccines. They know when our vaccine events are. Every week at the health department, we have a vaccine event on Wednesdays from 1 to 4 and on Fridays from 8, 30 to 11, 30 for Moderna. And then every three weeks, we have the Pfizer event. We've been holding that since June. Also, I think it's important with our school age kids, the River 12 to 15, that EUA extension came in the first of May. So that's why we've been trying to offer some events at night. We actually have one this Thursday night for our school age kids. What do you think of your people? Maybe you have data of these cases or percentage are unvaccinated? As the state, it's a pretty huge number. It's like 97%, I think that they just shared in the last press release as a statewide. I am not for sure as it relates to our current county levels, which I would say a lot of those are not vaccinated. A lot that are in the hospital or have passed those are not vaccinated. A lot that are in the hospital or have passed away or not vaccinated. I read something that 90 and I've got where it was 99.3% of the new cases of hospitalization were all at that time. That's correct. It's high. It's high. And so the vaccine is really to like I said in there earlier, was to prevent severe illness. Future complications that somebody may have from the virus that may linger six months, you know, to 12 months. They do have COVID, what they call COVID long haulers. There is folks who still have symptoms that had COVID last summer that are still having issues and then hospitalizations and deaths. So we have lost three individuals. We stayed at probably 143 deaths for maybe four to six weeks and so these three new deaths you know will be interested in to look at those more into those deaths age-wise you know ethnicity and where they vaccinated or not. This 10% increase that has happened throughout this month is it located in county wide or is it located in pods of certain areas of the county? As it began to increase commissioner it was was certain parts, like certain zip codes or areas. But as Rose called and told me yesterday, Tracy, it is everywhere now. And so it is. And I think, you know, the vaccine now, you know, it still is under emergency use authorization. So it has not been a totally approved by the FDA. That's all the FDA has done right now is what we call under the EUA. So, you know, folks still have the vaccine hesitancy for whatever their reasons may be. And so would that be insured and also not all ages can be vaccinated. And I think it's important when you look at the state dashboard when they say 30% they use the total population and we do have about 18,000 residents that are between the ages of zero and 18. So you will have some of that that currently don't qualify. So that's those as just a little bit. So I think that's why it's sort of better to look at the CDC data. The state has had a call with us and talking about data and compared where is the difference. So the state and the CDC are trying to figure out not only is dupline counties numbers a little bit different, but there are some other counties as well. All right. Have you heard the information in regards to those that are vaccinated has a 99.99% chance of not getting severely infected even if they have a reentries that something that you're aware of? There are some different data and different studies that are out there for those who are vaccinated. And we still have in challenges with the drop off in the vaccination. Yes, we do not have the big push for vaccines as we have had in the past. Do you have anything that you can think of that would help offset that that we could do as a group collectively or as a just more of waiting and see? I think it's a wait and see. I think once you get a full FDA approval, you may see more individuals take that up. There's different myths that folks do have about the vaccine. And again, the state has provided Dupline County. We previously had three community health worker groups, as well as some of the other agencies that were out, what they call canvassingo in door to door, trying to educate and provide education about the vaccine to try to increase those numbers. So I think it's just personal choice if they were wanting to get the vaccine now or not. In terms of getting the information out to our citizens, making sure that everyone is aware. And I know some are a little bit limited as it contains to technology pieces. Is there a way maybe this is for you, Mr. Branson? As far as a Robo call, the citizens could be contacted to make them aware of certain aspects of what's going on with COVID? Yes, we have that capability through our emergency management department. We'd like to do a revolve call. I think it should be done in conjunction with the health department. They'll make sure that the message that we craft is accurate and you know, absolutely. Just in terms of, first and foremost, thank you for coming in to share and the information because I think it's very important that thank you Mr. Branson for the way that you communicate with us as commissioners about where things stand. But I think it's very valuable to have you as our, I would say, such amount of expert to come in and share data based on science and medical aspects so that our citizens are fully aware of what's really taking place and how they play a very intricate role in terms of deflecting or eradicating all this spray fully aware of what's really taking place and how they play a very intricate role in terms of deflecting or eradicating all this spray at their stake in place. And I will also say that there was a group called Ride United which, and I can go back and look at the data, there was very new, we were a pilot county in the east and Wilson County was the other pilot. And they were they this organization bought phone numbers they could purchase phone numbers and so they went through and called the numbers they purchased a high percentage were not interested or did not answer so I mean not only just that is having somebody instead of going door-to-door to knock they were calling so a lot of effort has gone into Dublin County from outside entities from the state level and I just don't think people are interested. Have you seen an increase of people coming in to get vaccinated recently? When I say recently late July, early August, now because of seeing these outbreaks. The only increase that we have seen is in our school age kids from the ages of 12 to 15 who were waiting on the Pfizer vaccine because Moderna, it was, it's only for 18 and older and Pfizer was initially 16 to an older until May and then that's when the federal government gave Pfizer the 12 to 15 So so roughly speaking when you take out the 24% that's under 18 we're just a little over 40% vaccinated close to it but you You've not you've not I guess what I'm trying to say here but there's not been a alert to people on these increases I mean these are drastic increases this happened in a month of July and you know I know there was a lot of people that there's a lot of us that got out and got the vaccine early because we wanted it as soon as we could get it. And you know so most everybody that was desiring the vaccine probably got it. It's great. You know what I would question at this point now that the information is out that we're having a large spread of throughout the county. You know, while we haven't got people reconsidering, and I don't know what to do to get people reconsider. I mean, and that's I think it's a mandate thing by no means. But it's same token I was actually talking with with Commissioner Branch Saturday and you know, we just want to make sure people are aware of what's happening and that's the reason that you were requested to come into night and as he said thank you so much because I can't imagine how busy your schedule is but we just want to make sure that people understand that COVID-19 is not going. It's, you know, we're not over it. And, you know, what the values are, the vaccine versus the risk. I mean, I know it's, there's a lot of questions out there. And I know from my standpoint, what I looked at at and this may be a bad statement, but I looked what was the worst of the evils. And even though there may be something about the vaccine that I don't know, based on the information I do know, there's been a lot less suffering from the vaccine than it has from disease. And that's lot less suffering from the vaccine than it has from disease. And that's the reason I wanted the vaccine. And I've had people to tell me that it was a mistake. But at this given point, I'm proud that I got the vaccine. The age population is that the age group that we would want to target is the 18 to 49 year old group. Those are the ones in the 20% compared to your 65 and older population, 50 to 64 and then your 75 and older. So, you think you're going to fit that crazy out of your community? The age group that we would probably want to target that are in the 20% is the 18 to 49 population. Do you think it's more of a problem for us county government to help in some way whether it's where we said really called or after that I don't know to help educate the public of how say does any clear about clear it is to get vaccinated on the lock side of the numbers are for the same fact that first, I mean, it's just a comical out bad. Well, and we could potentially look at different folks in the community within different race and ethnicities that may could speak on that have been vaccinated that's willing to speak out and do a recording and we share that. You know that could be potentially something to be done as well. I think a junction with Chairman Edwin said a few moments ago in terms of why we're doing this is it a prelude to mandates. I think it's just an opportunity to share information. But by the same token, if things continue to go south as the leaders of the county, all options on the tape. Because at the end of the day, we want to help do our part to preserve life. And if we can get the shod or make sure everybody were to ask whatever it takes, but by the way, we want to make certain of that everybody is aware and fully aware and Taking off the blinders and stop looking for the boogie man. That's not really there at the end of the day It's just a Delta variant that's caused these dumpers to jump It's not the fourth of July holiday weekend and everyone getting together. It's something outside of that is that correct? It is that but also is those who may not be wearing mask. Again, I really feel the mask really helped. When you look at our numbers and the vaccine, the vaccine's been out since December. And so in prior to the Delta, I mean, we, sort of, you can look at the graph. We're just like, um, almost, I mean, 2% is nothing compared to where we were. We've been as high as 26%. And so I really, the mask will help. And the mask is, it's not just me wearing the mask. It would be the me wearing the mask and every one of you guys still wearing the mask, even though we've all potentially been vaccinated. And that just happened at the school system, correct? Yes, that is correct. They voted last Wednesday. I think it was to go universal. And I sort of presented in the same data that I presented you guys when I first started. There's a thought if we were to go in that direction, whereas the mask implementation, is it a timeframe where this variant is subject to go down? let's say I heard somewhere where we were to put that in play maybe for 30, 40, 60 days. So typically when you have an outbreak in which we currently have several outbreaks and clusters that were that were managing, is it's typically going to take two incubation periods, which is two 14 day periods, so total of 28 days. So from this the increased spike that we've seen it's probably going to be the end of August the 1st of September before we see a change. But then when you look at it there's still I mean July 31st the mask mandate expired. So unless you choose to wear a mask or choose to get vaccinated we potentially may not see a difference. Much of a difference. But if everyone that's been vaccinated has to wear a mask, then there's really no difference between being vaccinated or not being vaccinated. So if the people that are vaccinated can't see some benefit, the people that are not vaccinated can't see some benefit. The people are not vaccinated, can't see some benefit into people that are vaccinated. We're not gonna entice more people to get vaccine. If you understand what I'm trying to say, I mean... You may pertinence to me, I mean, we discussed this when we were making the policies at the courthouse. There were a month or two ago. Give them incentive to get back to say it would be, and you tell me you're a ghost on this, because I see you with a mask on now, and I'm guessing you're probably back to say it all the other than the rash, but, you're calm. I'm not going to talk to you. I'm not going to talk to you. I am, and I tested a lot of people this morning, so I'm going to make sure, you know. Do you give them instead of by saying, all right, we're going to mandate the mask again unless you show proof of this fact. Is that a good option? I mean, if you trying to force folks to get vaccinated or to make it mandatory right now, I think as I mean I'll just say from a county perspective I mean if you do that for county employees you're gonna lose some county employees. Well the goal is not to lose the employees. Well the goal is to be you know putting things forward to protect those that's willing to do what is necessary to preserve life. I mean, in every situation you go to have wins and losses, but this is life. This is not anything other than just focusing on the importance of doing our parts to be our brothers and sisters keepers as we move forward. So from you're looking at as the health director and focusing on health, is that the better option? You can try and see in what, you know, what they willing to do. But that's his county employees. Do we know what percentage of our county employees are vaccinated? No, so we have not asked that question. Because they could go anywhere to get the vaccine. So some at the time may have went to Samson County, or may have went to Walgreens because they wanted J&J, and we didn't have J&J. So we do not have that information. Because we didn't ask when they would come through to get vaccinated. So we would have to require them to show their vaccine card. So the fact that is there a chance then that we have more people vaccinated than you have record of? No sir. It's based off a county resident seat and so it goes into a state system and then it comes back based off a county, based off of address and where that falls into the county. So no. This may be a 10 question. Is there anything that prevents us from accent or ascertaining that information from the employees? School of government has said no. So you're welcome to do it. I think that was a good start, but where it is, your friend asked all employers on. So that came out of the governor's recommendation for employers to ask. Federal law is doing it well. So you do. Hospitals and hospitals and I think by this one, do you assume they're going to mandate all vaccines? Somebody else that has heard of it. A lot of the major hospital systems aren't going to mandate the COVID vaccine, but a lot of them already mandate the flu vaccine. Right. But in this county, do know we do not do that for iron employees here. So, yeah, I was just thinking. And that's going to be a lot of questions is you're mandating this, but not the flu vaccine. So, just think, I mean, that's something to think. But a flu vaccine hasn't created a situation where you had so many lives lost at a small period of time. So we just got to look at apples, apples, in terms of what we're looking at. What's your biggest fear as it relates to COVID and the current situation that we currently in? How many more people are going to die? And who are those people going to be? Am I one of those? I could have been number 56 in this county. So when you're in that vein, in that, that lane right there, when you think about it, basically one would be willing to do all that's not illegal anymore on unethical to achieve the goal to preserve life. Correct? Some people, yes, but some people have to be in that. They have to be ready to make that decision. And I don't feel that we should force them, mandate them to do that. They should be ready when they're ready to make that decision. Well, you have school age kids, parents who their kids are not even vaccinated to go to school. But every child that goes to school has to be vaccinated. No, sir. No longer. You can go to school. No, I'm not not about COVID, but I'm talking about the other shots. That's correct. You can do a waiver. Say again. You can do a waiver. For religious reasons. People that have had the virus. Is there, are they protected without the vaccine? Not fully no. Their antibodies antibodies everybody is different and how long their antibodies stay in their system and to what level everybody is different. So you could have antibodies for two months, three months, six months and the only way you would know is to have a lab drone to know what your level is and to monitor that. So a lot of folks were just questioning, I've had COVID, what are my antibodies compared to? If I get the vaccine, I've got natural antibodies because I've had COVID compared to I get the vaccine. What are my antibodies? Have I lost any? Do I have less? So I still think there's a lot of unanswered questions and a lot of the general public has. Is there information on how long those of us that are vaccinated are protected without a booster? No, sir. There's still monitoring that. So the first individuals who were in the studies when they went through the drug studies, they're monitoring those people to help decide when is it time for a booster. There is conversation about Pfizer potentially having to have a booster. There has been a mention of booster through Pfizer, but nothing's been confirmed. So I think that's where they'll start to monitor more of these, what they call the breakthrough cases of those who have been vaccinated, who may be getting COVID now. But a lot of the individuals who have had COVID, who have had a vaccine and may currently have COVID, they've had very mild to no symptoms at all. Did you share earlier what percentage that vaccinated had contacted disease have been positive after vaccination? We do not have that. We do not have that. Okay. And the only way we would be able to collect that is if they reported that within their interview. Do you think the 13% number that we're looking at now, I think that's what you told us and we're currently in as of this meeting? You think that's accurate? that's what you told us and we're currently in as of this meeting. You think that's accurate? The percent positive? No sir, that's of who's been tested. So now where the test is the health. 13.5% that's been tested. That means that they've gone to the health department, they've gone to the hospital, they've gone to a primary care provider. Somewhere that lab that test has been collected and been sent to a lab. So there now there's a lot of home test kits for COVID. So if you do your home test kit at, you know, at home, we don't get that result. How reliable is that home test kit? Well, they're just as reliable as me performing a rapid for you at the health department. And right now the health department, the hospital and the primary care practices. All the only places that's doing tests. Yes. And probably some of the local pharmacies still are too. You can do rapids or what they call PCRs. I said didn't you tell me last week that every case that we know about there's probably 2.5 more cases? They have not been that we have not that are positive that we do not know about. 2.5 more? For every one positive I know about there's probably two and a half additional people that are positive that we don't know about. And like I said, I think it's important to know and to realize how much the health additional people that are positive that we don't know about. And like I said, I think it's important to know and to realize how much the health department is doing and the staff who are doing it. And so now we're venturing into almost, what, I could year and a half. And you talk about vaccines that, you know, 50% of all first doses and 50% of all second doses. So you talk about 19,000 first doses, 50% of those have been administered through your health department. And 50% of your second doses have been administered through your health department. The staff is tired. Hopefully all of your staff is vaccinated. Don't know that answer. They call it they are getting exposed. The ones who are face to face with it and testing and vaccinating, yes they are being exposed. It's close to burnout just for all the footwork. Long the long hours. Summer counting their retirement days. Yes, staff is tired. And in being in Dupland County, we only have a few re, I mean, we have very limited resources. Well, again thank you for all that you've provided. Thank you for all that you're doing. We're going to have to make some tough decisions. And I appreciate the information so that when those decisions have made it's not a scenario where everyone wasn't completely made aware of where we are and what we're facing then and how we need to consider things as we move forward. So again, thank you. Thank you for coming. So that leads us into our closed session. Do I have a motion? So I've got a motion in a second to go in the closed session. All in favor say aye. I. Carried. Again, thank you, ladies. going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you. I'm going to say thank you