Ladies and gentlemen, I would like to call this March 3rd Commissioner's Meeting to Order. I want to welcome everybody here. Thank you for coming out. The beautiful weather we had, it's hard to come into the building and not enjoy the Lord's blessings that He's given us out there. Thank thank you for coming to the meeting. To have an interest in what's going on in our family and sharing with us all of you to stop the presentation to make at a time. I'm going to ask everybody to rise and I'm going to ask Commissioner Branch to lead us in the invitation, but before we do, I would like Commissioner Branch, I'd like for us to pause for a minute and think about and give credit to those that are trapped with all of the hazards we're having, especially since I've got a line up with the fires and all those fighting the fires and that the Lord give them the strength to help get to the crisis and to help mitigate the damage. So let's pause for a minute with that and then lead us in the invocation in a pledge. Let us pray. He wise and precious God, we thank you for this moment. We thank you for this time that you will allow us to share together in the Board of County Commissioners' meeting on this day. Lord, I just like to say thank you for these colleagues that stand before this body tonight. Lord, we are a group of individuals that draw at different paths, but at the end of the day we come together collectively to work together, to come to decisions that are the benefit for the citizens of this county, and I just want to say thank you. Lord, there's a lot of turmoil in the land, but through it all, we know that you sit high and look low. When it's all sit and done, your will will be done. Watch over us this night. Allow us to work together collectively, making the decisions that are in the best interests of the citizens of different county. Continuing to watch over the leadership, each and every one. Continuing to bless those that are similar here this evening. And bless those that would like to be, but for whatever reason could not. As we go forward tonight, God, we ask for you to continue with your divine will to give us the strength to do the things that's necessary, to give us the courage to move forward together collectively, and give us the understanding and every day lower those things that we have no control over. Father, we thank you for this day. We thank you for your mercy. We thank you for your love and we thank you for your grace. This is in the mighty person name of Jesus that I do pray that our hearts say amen. fledgling to the flag of the United States of America and to the Redogduh of which it stands for a nation under God in the livable of liberty and justice for all. Thank you, sir. get the commissioners anything to add to the consent I do not do not consider consider gender not going to ask for back I don't. Got a manager. I don't have anything to hand. Yes, sir. I need to amend the number 9 on the consent agenda in order to re-approved contract to reimburse the annuals and denials for the two pre-engineered building packages authorized the chairman to sign a kinging review and approve about the calendar. Pleasure to board. Motion to approve. With the corrections. Okay, I got a motion by Mr. Garter, second by Commissioner Edwards, any further discussion. Here in none, all in favor say aye. All opposed? Carry. Now, is anybody ever want to add to the agenda tonight? No, do not. I want to add a special presentation after road concerns. After road concern? Yes. Right. Right. Mr. Miller. Madam Clerk. All right. Pleasure to board. Sumo. Yes. Mr. Miller. Madam Clerk. All right. Pleasure to board. Sumo. Yes. right, pleasure to board. Some motion by Mr. Branch, second, Mr. Garner, further discussion. Here and none. All in favor say aye. All opposed, same side. Okay, what? I did retain a motion to accept the minutes as reported from our last commissioners meeting. Some motion by Mr. Branch, Secretary of Mr. Garland, further discussion. Here and then all in favor say I all opposed same side carry All right, I think that brings us to I don't remember one public comment Anybody sign it Okay, so that moves us to item number two row concerns. I Take row concerns at this time from the general public Anybody got anything they want to share about a road concern? All right commissioners, you don't have anything? Yeah. Okay. There's a ditch on the end of just the P all wrote that needs to be cleaned out this Going over to president's ditches into the yards I will say I wrote down yesterday morning to the curb that they're trying to do the corrections and put the new tire in and they're doing a really good job moving along that fast on Lyman Road and the guard rail will be coming shortly when they complete it and I know there was a lot of people that were concerned about us doing something there because of all the accidents that We have unfortunately had and so just another day that I think it'll probably be completed within the next three weeks at least it's not already Want to give an update, positive report. Anything else? It's not a complaint on the road. I call the county manager a few weeks ago and at the intersection of where my mother's house at and the intersection, Tritra trailer had drove over to stop sign and the street sign has questioned down. And I contacted him and they apparently it was out there and had it done before noon of that day. So we thank him for that. And then on Piedembourg Road, there was another bad pot hole where you have to duck over to the left when the oncoming or go to the shoulder and by 10 o'clock the DOT had that fixed or somebody had had it fixed by that time. So we think the kind of manager for moving swiftly on doing both projects in a swiftly time. Even though now someone is trying to run over the sign again if my mother's in a session it carols and and Blanchard wrote it got it leaning but it's not on the ground There the tractor trailers of I don't know if it's the feed trucks or tarheal that is making that turn And they're they're kind of getting too close to it But that's one of those things that happened but we think County manager or moving swiftly Mr. Chairman, you may want to mention the Mayor of Conner's that you know from the personal experience, they'll only do that so many times. Well, I have to say that the state has their limitations that they decide on their roads. I will say that, thank you for your kind of words, Mayor. But when I received the road concerns, I turned away from the DIP and Danny Manager. She taught contact to the U of T and takes care of all those things. So when you say, I took care of them, she really took care of them. Well, we thank her as well. I guess I would add into the fact that I like to think Mr. Jones, Daniel and DOT for their responsiveness to a notation that I made probably a year or so ago and trying to say whatever decisions are being made here in the county. Make sure that the leadership is advised. Even though we may not agree as to what the decisions are, but I can say that whole hardly those guys are doing a lot better and making sure that the information is shared in a timely manner so that we're not caught off guard as it relates to to the changes that takes place in the county. Anything else? That end road concerns that brings us to the Adam the stage. Mr. Chairman, if it so please is the board. Hey, go ahead. With the individuals outside please come in? We have a resolution here in honoring Dexter Edwards to his adduction into the North Carolina Poor Call of Fame, which occurred last week. I would make a motion to approve this resolution and then the board so well and I will Present to him once we have the motion. I'll make the motion to approve the resolution second Motion in a second by the comments You know all in favor say aye Mr. Jones will join this down for a police Resolution on a debt story where they had the deduction to the North Carolina Port Hall thing Where is the North Carolina Port Council is the older state Port producer organization in the nation and has operated under a mandatory check off funding system since this inception. The reason we created is the North Carolina Swine Industry Association. The North Carolina Port Council was chartered in 1962 as the North Carolina non-profit corporation and whereas the North Carolina Port Council Hall thing is the highest honor bestowed by the organization that recognizes individuals with long and outstanding service to the North Carolina Port Industry and to the North Carolina Port Council. And whereas the selection criteria for reduction into the North Carolina Port call of fame include one long lasting contributions to the North, to the both industry, the research, education, management, and our leadership ability to contributions to family, community including church, civic, activities, and volunteer efforts, three awards or special recognition recognition, nations received by received as they relate to the nominees involvement in full production and agriculture. Four TQA plus or NRTQA certified five the nominees record of environmental compliance, if applicable, if applicable, and where is Dexter Edwards, began his career in the North Carolina folk industry. On February 23rd, 1962, and eight to six years old, when he received a gift as a birthday present from his father. And where is Dexter Edwards served 63 years in the folk industry and whereas Dexter Edwards served as Missfield's food general manager of the Central Region whereas Dexter Edwards served his community through youth involvement, civic engagement and religious commitment. Now therefore be it resolved that the Duke and the County Board of Commissioners do hereby recognize Dexter Edwards for his commitment to Duke and County Agents because it is a dutch into the North Carolina, North Hall of Fame. This third day of March 2025, 2025 signed by myself, vice chairman, tested by Jamie Clark. Jamie Clark, Club book. Thank you so much. Well, I want to say, this was a surprise. I did really appreciate the recognition last week. I never in my wildest dream ever thought that I would be inducted into Hall of Fame. And so it is a great honor and I am very proud to receive it. But you're not supposed to surprise me. But, again, thank you to missioners. Thank you to people that help make the county work, and thank you to the people that live in this county. It's a community effort support. I think we got a great county. We have been very blessed in agriculture and I think it's been good for a lot of us, but it definitely has been good to me and this is a wonderful time that I've been able to Receive this while I was here to. And I was receiving it, that's even better. So again, family, if you'll line up, typically we take pictures in front of the commissioners when something happens, so I'm assuming the commissioner will line up behind us and let us have a proof picture here with the commissioners. I don't know if you can get us all in. Okay. Again, thank you everybody. And thank you all. Okay. Okay. Okay. Okay. Okay. Okay. Okay. All right. Well, thank you. Y'all did boo this all. Very slick. Yeah. So that person, back on the agenda, pretty much on time. Six six, 20. Melissa was your time. So we're just about there. So thank you. Come up. Thank you. I'm here on behalf of Mr. Cecil Lennon from Warsaw. He is wanted to name Elaine at the 300 block of Prospect Street. He is chosen Lynn and Lane. Pleasure to board. So I move the second motion by Commissioner Dow second by Commissioner Branch. Father discussion. I'm going in favor say aye Did did carry now I need to ask the question Did we have the public hearing on this no No, that's what I'm hearing. Okay, and you know, I didn't see noted here that they open up for the public. And so, you know, unless the rules have changed, I need to back up and have public hearing. All right, so everybody heard that? We put the car ahead of the horse. So I'm gonna, we're gonna go out of open session and do a public hearing on this road concern. Will you repeat for the public? Yes, Cecil Lennon has chosen Lennon Lane at 300 block of Crossbeck Street. Is there anybody in the public who's got a comment? Duplexes. Yes, ma'am. Yes. Any other comments? Is it where he's got the Duplex or where he's building the Newton's left? He's already got one, he's going to be able to do more. Any more comments, concerns? You read no more comments concerns from the public. I'm a close to public here. I Don't see any reason that we should there was nothing that caused us to come out of it But yet we voted before we got consent from the public Referred to legal, where do we need to go from here? Simply call your fellow commissioners and make sure there's no change in the different door to the motion. We're in the same motion. Good. Same motion. Same, same. Okay. All right. So it is approved. Thank you. Sorry that I fit the car ahead of the horse there, but if that's the only mistake I make, it will be all right. All right, that brings us to item number four. Brandon? Good evening, commissioners. I'm here to not to ask for you to approve Caroline Medical Transport for a private ambulance transport. It franchises in the county per our private ambulance ordinance. Caroline Medical Transport has representation here if you have any questions. But this allowed in to do BLS transports within the county. So discharge from the hospital dialysis trips and things of that nature in the county. Currently we have three other ones that cannot keep up with the man, especially from the discharge from the hospital right now. So they've reached out to us. They've been doing some transports from there and they wish to have a franchise with the county Questions from the board Any no questions pleasure to board Motion Mr. Gardner second commission of Edwards Father comments questions Thank you. Motion and Mr. Gardner, second, the Commission of Edwards, public comments, questions. Here in none all in favor say aye. All opposed same sign. Kerry. Thank you. Welcome to the county. We appreciate your service. But that brings us to item number five. Josh. Yeah, for new commissioners. Here I ask for approval to approve work authorization number 11 with Paris and partners and Duke and County Airport for engineering consulting services for taxiway construction. That's helping the store soon. So we just need to improve the work authorization. Measure them over. Motion by commissioner Edwards. Second by commissioner Branch. Any further discussion? Here Here in the all in favor say aye. All opposed, same sign. Carry. Thank you, Josh. All right, bring it to item number six. We took the minister to join you Jackson. Good evening, okay. Good evening, thank you for allowing us the us to present our annual update from Trillium Health Resources. Victoria Jackson, I'm the South Central Regional Vice President that covers Dukeland County. The beautiful Dukeland County. I can say that. Work in the county for years. I also have with me today, Terrell Austin. He's our associate regional vice president as well. He works in the county also. So just wanna make sure that we give you some information. There's no way that I can give you all the information that are all the things that we've done with the organization in 10 to 15 minutes. So I'll give you the express version. One thing to note though, in your packet, we want to always be accessible to you all. So my business card is in there. It is not a 1-800 number for you to get in contact with me. It is a cell phone. So if you have any questions, please feel free to reach out. In your packet is the PowerPoint that I'll go through, so you can have that for your reference. As you may know, we are one of four LMEMCOs in the state of North Carolina that manage care for individuals with the most severe behavioral health needs that receives Medicaid or they may not have any insurance coverage or they may be underinsured. And so that's key to point out is that this is for individuals that have the most severe mental health needs. And so we'll talk about it further in the presentation to kind of bring that home on why that's important. So most of our work involves connecting our members to contract at network of providers for clinical treatment. So we contract with providers. We don't do the services ourselves. That's why we have our providers, which is a requirement by the state. And so there's no wrong door for individuals to access services with us. They can call us where we have a line 24, 7, 365 days a year or they can actually go to a provider if they know of a provider that they wanna receive here. They can go directly to that provider without having to come through us to make that appointment. So if they call us, we make a referral. If they go to the provider, then we have to authorize services is how it works. So your next slide and for the folks that don't have this in front of them, it is a map of the counties that we cover. We are 46 counties in North Carolina. So we have the majority of the counties in North Carolina out of all of the LNEM CEOs with a total population of about 3.1 million people that we're we're covering in terms of population. There's 80,000 a little over 80,000 that falls within our tailored plan. There's 206,000 a little over 206. That's in the Medicaid direct plan. That's that old plan fee for service, just mental health with the tailored plan, it encompasses the whole person care. So we're managing behavior, physical health, long-term support services, non-emergency medical transportation for those individuals that are eligible for Taylor Plan. For those who are uninsured, we cover about 287,000 and that's across the 46 counties. On the next slide, we highlighted how important it is to have local connections. We are invested in the community. We want to make sure that there is a local presence. We want to make sure that you all can reach us if you have any questions or concerns. We recognize that the geography is large in North Carolina that we cover. So we believe that through creative solutions, clear visibility and open communication, we can help ensure the community stakeholders are heard and in turn We receive essential guidance from you all because your county is unique to each county that we serve as unique and we need to understand what you need So are to do this we have five regions We have a northern region that's at the northern eastern side of the state we have a north central region We have a northern region. That's at the northern eastern side of the state. We have a north central region. We have a mid-state region that's over in the Mecklenburg, sorry, Guilford County area. So that's five counties. And then Dupland County falls in the south central region, which is nine counties, and it spans from Samson all the way over to Carterette County. Each region has a regional advisory board, also a consumer and family average advocacy committee with local appointed representatives. And then our governing board, we have 10 CFACC and regional board representatives on that board along with some at large members of that board. The whole the way that this is set up is so that it will allow for by-directional communication between the groups, our regional advisory board as well as I go up and board. For Duplin County I would be remiss if I did not thank you all for pointing commissioner Dow and commissioner Edwards to our board. They have been wonderful to work with. They have provided some most important information about Dupland County and so we are grateful for your service and commitment to our board. So thank you all. Also listed is the team that is working dupland county their information is listed on here we have kateesha Jones who is the team that is working dupland county. Their information is listed on here. We have Cautisha Jones, who is the community liaison coordinator, talked about Tarell and myself as well. We are recruiting CFAC members for dupland county. Those are individuals with live experience. Are they known as guardians of individuals that's received in behavioral health services. Next on slide six we included some data. I think it's so important that you all see the impact that we have. So from July to December 2024, we served a little over 80,000 unique individuals with severe behavioral health needs. And of that 80,000, a little over 57,000 were mental health, 15,000 substance abuse and 18,000 individuals that have intellectual developmental disabilities and we spent over $802 million on care. Kind of give you an update of the tailored plan. We launched the tailored plan back in July of 2024. You know, as I mentioned before, it provides for kind of a whole person care approach. It was a heavy lift. We launched it. It was extensive. There was lessons learned. What we experienced without call centers, for example, the call volume increased. I mean, next spiked, almost doubling on the calls that we typically take. So we know those are lesson learns, we know that from that instance that communication is key, right? We need to make sure people understand whenever we're getting ready to launch a program of this nature. So listed on your slide, I won't go through all of this because of time, but our lessons learned. And then some of the things that we've implemented around ensuring that this doesn't happen again, which is surrounded around communication. And then also there's some provider flexibilities that could have warranted a better launch or more successful launch. I also think it's important to highlight that we are not your only health plan in the county that covers Medicaid, that manages individuals that's on Medicaid. There's five standard plans, those are those private companies, AmeriHill, Blue Cross Blue Shield, United Health Care, Wailcare of North Carolina, and Carolina complete. So, not only are we managing care, but these private companies are managing care too. And actually, they are managing the majority of individuals that receive Medicaid. And that occurred back in 2021. If you go to your next slide, you are kind of see a Medicaid transformation refresher. Right now, we've gotten through phase one where the standard plans launched in 2021, also the Eastern Band of Cherokee Indians tribal option was launched, as well we continued as an LMEMCO to cover the Medicaid direct program. Phase two was the Taylor Plan that we would launch last year and now we are in phase three. And phase three is the foster care plan. With that foster care plan, it's also known as Children and Families Specialty Plan. This plan was served children and their families in the foster care system and that is statewide. The Department of Health and Human Services announced last year that Blue Cross Blue Shield will be managing this plan and it is slated to start December 1st. all the children and the families that we were currently managing will actually transfer over to Blue Cross Blue Shield December 1st. If things don't change, you know, sometimes things change like the weather in our system. The next couple of slides are just a breakdown of the individuals that are served by us versus the standard plan. You could see on the first slide for the full 46 county catchment area, we only cover 28% of individuals with Medicaid, the standard plans cover 72%. For Dukeland County specifically on your next slide, we cover approximately 24% and standard plans cover 66% that number can change from day to day depending on individual's eligibility. For your next slide, you know, just kind of want to talk about the town halls very briefly. Last year for the 18 real-lining consolidation counties, including one here in Dupland County, there were several things that emerged from the town halls. The purpose of those town halls was to hear from the community what's needed. Also, we can share what we're able to provide by contract with our Department of Health and Human Services and just want to get a feel of what's needed. And so, some of the things that were identified was increased communication with our providers, members, and their families. If you look at bullet number three, you will see some of the things that we've done in terms of a response to those things, such as launching requests for proposals and requests for applications for identified service needs to increase communication to address issues raised. And we're also planning another round of town halls this year, so we will be sure to make sure we push that communication out on when those will be held to you. Next, want to give you an update on some of the projects. On this slide is just an insert of the projects. This is not an all-inclusive list, but just kind of want it to highlight a few of them for you. We have projects to address substance use prevention and schools. Of course, distribution of the lock zone kits to the community and those particular organizations in the community. Listed on the slide as well is the CHES Help and that is the Center for Health Enhancement System Studies. We partner with the North Island Department of Health and Human Services to provide a free app to support individuals who are in recovery. It's a really great app and we're excited to see what outcomes we get from it. It's an evidence-based mobile app that offers options such as daily check-ins. There's also a 24-7 online peer community so an individual can access a peer support specialist 24-7 and it's free of charge to our providers, to our behavioral health providers and also the members that they are certain. The community opportunity centers is another exciting project that we're working on. It is in the very early stages, very early stage. It's a community hub that support members who live in communities that experience health disparities and provides them access to resources that promote health. So it could be workforce development and education, health literacy, and also there's some digital connectivity that's involved with it. So this is very early stages, so be on the lookout for more information around it. And then the last project that we'll highlight on this slide is our Play Together accessible playgrounds. We are super excited about this endeavor. Trillium has been doing this for a couple of years now. The grants offer, all for it helps support building playgrounds that have equipment and features to give individuals of all ages and abilities the chance to play together outside. So it's about making the playgrounds accessible for all. We recently awarded the town of Wallace the grant and we're excited about the partnership. They have been wonderful to work with. And so we are looking forward to seeing the final project in its completion. And for duplicated counting, we will give you some additional data. We just want to make sure you know that we're here. We served 1,228 unduplicated count, which means that the individuals could have both mental health substance use, they could have a combination of those three diagnosis mental health substance use or IDD. So mental health we served 971 individuals 279 for substance use and 128 for IDD and this is for six months time period. This is from July to December of 2024. Lastly, I think this is probably the most important slide in here. That's how people can access services. Talked about our 24-7365 call center for behavioral health crisis line, but we also have a member and recipient service line that individuals can call in with general questions and that operates Monday through Saturday from 7 a.m. to 6 p.m. That concludes my update and I am happy to take any questions you may have. from the the board? Well, of course. Irrigors to funding. I see here where Medicaid direct, except 18%. Yes. So the Medicaid direct, right, we actually manage the Medicaid direct. That's that old funding model. That's fee for service for just behavioral health members. And I believe on the slide, it was about 207,000. Let me get back to it. Yes, about 20 7,000. And just to note, that's a really great question, because part of that 207,000, the state managed some of those individuals. So I think we had the last time we looked at the data about 132,000 that we were managing and then the state is managing the rest of those individuals. So when you were eluded to changes that happened daily? So what that means is that individuals could be eligible for tailored plan and are they could be eligible for Medicaid direct so they can change plans, right? And also as people come in to Medicaid eligibility, getting Medicaid eligibility through the Department of Social Services, then those individuals would be counted in that numbers. Well, if they are eligible for the services that we manage. So it's a day to day. There's a really great dashboard on the North Carolina Department of Health and Human Services website that every day is updated to show the Medicaid eligibility and which plan individuals will follow. Yes sir. Other questions? Thank you. Thank you. Thank you for your services. Thank you for the you. Thank you for your services Thank you for the presentation tonight Thank you All right that brings us out of number seven Mr. Miller Thank you, Mr. Chairman We have face and farmer day farmers day parade Farmer's Day Parade, March 15th, at 11 o'clock AM. They wanted to make sure we extended, or they extended, personal invitation to the board members. And hope you'll be able to attend. We have the board retreat scheduled at the airport this year. Marchst it begins at 9 a.m. Border treat March 21st 9 a.m. We anticipate having financial policies ready for the board to discuss during the retreat. We work with Davenport Public Finance to develop and review the policies and we think they're pretty close for the board to take a look at. This month we will begin the process of rewriting a personnel policy and we anticipate completing the rewriting sometime in the July, August timeframe. We're currently developing the budget and plan to have an initial copy of the budget to you on the day of the retreat. I'm happy to inform the board that the revow is substantially complete. Notices will be sent out by the end of this month and will have those figures as well as a revenue neutral tax calculation available at the board retreat. Also, I wanna let the board know at your next commissioners meeting we anticipate having Ron Lewis who is a former county manager give a presentation about the Charters of Freedom. They provide historical documents such as the Declaration of Independence, the Constitution, the Bill of Rights and the Civil Rights Amendments which are the 13th, 14th, 15th, 19th, and 24th Amendment. So those are the updates that I have. I'm happy to answer any questions. About those updates or answering any questions at all that the Board has about anything. for the board. That was all I had a gentleman call me the other day. He was concerned, he was an older gentleman, he was concerned about getting driver's license. And he had called the DMV office and he was an older gentleman, wasn't allowed to renew on live. He had to go in and he could not get an appointment for three months. And I told him, I don't know what to do, those out of my hands. But before the record, I think we do have a lot of citizens in the county that are trying to read new drivers' license and are not getting the service that they need. Speaking of that at seven o'clock this morning I bet you there was 50 people already in line at seven o'clock this morning. They were lined up both sides of 24 to reach out to DMV and let them know the current state and the concerns of the board. Any other question or comments? Here in none, I would entertain a motion to go out of open session and the closed session for legal matters. One, four, three, dice, three, one One eight one eleven and personnel matters. NCGS one four three dice three one eight one one one. Got a motion from Commissioner Edwards. Second Commissioner Garner. Getty Father questions or comments. Here in none all in favor say aye. All opposed same sign. Ladies and gentlemen thank you so much for attending and we look forward to seeing you next month. All right, is there anything that was forgotten or brought up in closed session that needs to be brought back in an open session. I make a motion we adjourn until April. No, we got recessed into the 20th March 25th at 9 o'clock at airport. Okay, there's a motion on the floor to recess until 9 o'clock on March 21st and that meeting will be at airport. So I have a second. So motion was by Commissioner Garner second was by Commissioner Branch. Any further discussion? Hearing none all in favor say aye. All opposed. Same sign. We'll see you 9 o'clock on March 21st.