November 3, 2014 - 10:00 AM - County Board of Commissioners Meeting Minutes

10 269 Meeting of the Johnston County Board of Commissioners November 3 , 2014 10 00 am The Johnston County Board of Commissioners met in regular session Monday , November 3 , 2014 at 10 00 am in the Commissioners Meeting Room , Johnston County Courthouse Annex , Smithfield , North Carolina The following members were present Present Chairman Jeffrey P Carver , Vice Chairman Tony Braswell , Cookie Pope , Allen L Mims , Jr , DeVan Barbour , Ted G Godwin , and Chad M Stewart Absent None Also Present County Manager Rick J Hester , Clerk to the Board Paula G Woodard , Finance Officer and Assistant County Manager J Chad McLamb , County Attorney Jennifer J Slusser , and Paralegal Deputy Clerk to the Board Dana Cuddington Chairman Jeffrey P Carver called the meeting to order at 10 00 am Commissioner Cookie Pope opened the meeting with a prayer Commissioner DeVan Barbour led those in attendance in the pledge of allegiance to the American flag 1 Introduction and Appointment of County Attorney Chairman Jeffrey P Carver introduced Jennifer Slusser who has accepted the position of Johnston County Attorney Upon a motion by Commissioner Cookie Pope , seconded by Commissioner Allen L Mims , Jr , and carried unanimously , the Board appointed Jennifer Slusser as the Johnston County Attorney 2 Approval Discussion of Agenda Upon a motion by Commissioner Tony Braswell , seconded by Commissioner Cookie Pope , and carried by unanimous vote , the Board approved the agenda as presented 3 Consent Agenda Items Upon a motion by Commissioner Tony Braswell , seconded by Commissioner Ted G Godwin , and carried by unanimous vote , the Board approved the consent agenda items as follows A Approval of Minutes – October 6 , 2014 10 00 am and 6 00 pm B Department of Transportation – Additions to System The Board concurred with the Department of Transportation’s recommendation to add the following roads to the State Maintained System Knights Bridge Road – Saint Johns Wood – Phase 2 – Clayton Township C Veterans Day Proclamation – 2014 adopted as follows PROCLAMATION VETERANS DAY - 2014 WHEREAS , for decades America has paused on the 11th of November , the anniversary of the armistice that concluded World War I , to remember and to honor our veterans of military service in proud and grateful recognition of the hardships and sacrifices by the millions of men and women who have defended our land in war and in peace ; and WHEREAS , the freedoms we enjoy have been purchased and maintained at a high price , as Americans have been willing , throughout our history , to fight and die to preserve their individual rights as guaranteed in the United States Constitution and the Bill of Rights ; and WHEREAS , Americans owe a great debt to all those who have served in defense of this nation throughout the generations ; for their sacrifices , often resulting in permanent injury or death , which have preserved our unique form of government dedicated to human right and respect for the individual , and preserved our freedoms and promise of liberty as an example for oppressed persons of the world ; andPage270 November 3 , 2014 – 10 00 am Continued WHEREAS , in honor of these dedicated men and women , we pledge our continued defense of our nation so that their sacrifice will stand before the entire world as a tribute to the spirit and determination of a people dedicated to the principle of freedom and democracy NOW , THEREFORE , the Johnston County Board of Commissioners does hereby proclaim November 11 , 2014 , as “ Veterans ’ Day ” in Johnston County , and urge our citizens to commend its observance rd Proclaimed this the 3 day of November , 2014 D Alzheimer’s Disease Awareness and Caregivers Month Proclamation – November 2014 adopted as follows PROCLAMATION Alzheimer’s Disease Awareness and Caregivers Month WHEREAS , Alzheimer’s disease is a progressive degenerative disease of the brain causing deterioration in memory and thinking , as well as judgment and reasoning ability ; it also affects behavior , emotions and the ability to perform self - care ; and WHEREAS , more than five million Americans are now living with Alzheimer’s disease and over fifteen million are serving as their caregivers ; and WHEREAS , more than half of all Americans know someone who has or had Alzheimer’s ; and WHEREAS , Alzheimer’s disease affects whole families since it is a long term illness that requires long term care ; and WHEREAS , with early detection and diagnosis , individuals and families can gain access to treatment medications , enroll in critical research trails , and fully participate in planning for the future ; and WHEREAS , the Johnston County Board of Commissioners recognizes individuals , families , friends and caregivers dealing with the devastating effects of Alzheimer’s disease , the researchers who are seeking a cause or causes and cure , and the educational programs and support services provided by Alzheimer’s organizations NOW , THEREFORE , the Johnston County Board of Commissioners does hereby proclaim November 2014 as Alzheimer’s Disease Awareness and Caregivers Month in Johnston County and urges our citizens to commend its observance rd Proclaimed this the 3 day of November , 2014 E Resolution of Support – Drainage Improvement Project adopted as follows RESOLUTION of SUPPORT Drainage Improvement Project NC Hwy 210 in the Vicinity of NC Hwy 50 Near McGee’s Crossroads Johnston County , North Carolina WHEREAS , recent rains have created flooding conditions at several businesses and properties located at NC Hwy 210 in the vicinity of NC Hwy 50 near McGee’s Crossroads ; and WHEREAS , the North Carolina Department of Transportation has inspected the situation and has concluded that the current drainage system is inadequate to accommodate heavy rains ; and WHEREAS , Representative N Leo Daughtry and Representative James H Langdon , Jr have agreed to request funding from Department of Transportation Legislative allocations to correct the drainage problem at an estimated cost of 25,000 ; and WHEREAS , a request for Department of Transportation Legislative funds to correct the drainage problem must be supported by resolution from the local governing jurisdiction NOW , THEREFORE BE IT RESOLVED , that the Johnston County Board of Commissioners hereby supports the drainage improvement project at NC Hwy 210 in the vicinity of NC Hwy 50 near McGee’s Crossroads and requests Representative Daughtry and Representative Langdon to seek funds from the Department of Transportation Legislative allocations to pay for this much needed improvements project rd ADOPTED , this the 3 day of November 2014 F Emergency Services – Call for Public Hearing The Board scheduled a public hearing for the December 1 , 2014 , 10 00 am meeting to allow public comment on proposed revisions to boundaries for the following Fire Service Districts Beulah , Boon Hill , 50 - 210 , and West Johnston which are needed to maximize the five mile coverage area G Land Development Code – Call for Public Hearing – Code of Ordinances Amendment The Board scheduled a public hearing for the December 1 , 2014 6 00 pm meeting to allow public comment on a proposed ordinance amendment to the Land Development Code Section 14 - 593 as it relates to variances The proposed changes would reflect the standards set forth in GS 160A - 388 Page271 November 3 , 2014 – 10 00 am Continued H Tax Releases & Refunds – 09 16 2014 – 10 15 2014 Real Personal Property Releases TRANS DATE TIME USER YR BILL # ACCT # TAXPAYER NAME AMOUNT 9 16 2014 11 58 42 AM ghermane 2014 - 104274 2000178280 CLEANRITE CLEANERS 14355 9 22 2014 11 15 28 AM ghermane 2014 - 102804 2000176032 SEASHORE INSURANC ASSOC INC 39219 9 22 2014 11 20 20 AM ghermane 2014 - 92105 2000176032 SEASHORE INSURANC ASSOC INC 14589 9 22 2014 12 49 04 PM ghermane 2014 - 49885 2000163128 JP MORGAN CHASE BANK NA 11875 9 22 2014 12 59 35 PM ghermane 2014 - 13313 642 BROGDEN ENTERP INC 10395 9 22 2014 2 48 09 PM ghermane 2014 - 72669 2000066477 PINDELL , RICHARD S 22120 9 24 2014 10 15 53 AM dwoodward2 2014 - 79729 2000155193 SADIE RAE PRICE FAMILY TRUST 1,41407 9 24 2014 4 46 00 PM ghermane 2014 - 93349 2000092542 VANIER , SCOTT W 25918 9 29 2014 8 36 28 AM ghermane 2014 - 104278 2000178227 AMERICAN ROOFING & VINYL SIDI 28710 9 29 2014 8 42 49 AM ghermane 2014 - 17063 2000091780 CARROLL , HAROLD GLENN JR 12996 9 29 2014 8 50 49 AM ghermane 2013 - 19235 2000113180 COASTAL FEDERAL CREDIT 11133 9 29 2014 11 31 49 AM cfutch 2014 - 51212 2000166781 KING , JESSIE KATLYN 28585 9 30 2014 10 36 11 AM cfutch 2012 - 15733 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 10 39 15 AM cfutch 2013 - 14766 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 10 43 09 AM dwoodward2 2014 - 30412 2000174995 EVELYN T AYCOCK REV TRUST 7,20090 9 30 2014 10 45 16 AM dwoodward2 2014 - 30417 2000174995 EVELYN T AYCOCK REV TRUST 36693 9 30 2014 10 46 23 AM cfutch 2014 - 14963 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 10 46 35 AM dwoodward2 2014 - 83457 2000174995 EVELYN T AYCOCK REV TRUST 66933 9 30 2014 10 47 56 AM dwoodward2 2014 - 30413 2000174995 EVELYN T AYCOCK REV TRUST 22235 9 30 2014 10 49 19 AM dwoodward2 2014 - 30414 2000174995 EVELYN T AYCOCK REV TRUST 3,69616 9 30 2014 10 50 29 AM dwoodward2 2014 - 30415 2000174995 EVELYN T AYCOCK REV TRUST 2,54489 9 30 2014 10 57 54 AM dwoodward2 2014 - 30416 2000174995 EVELYN T AYCOCK REV TRUST 1,73232 9 30 2014 5 03 45 PM ghermane 2014 - 75211 73639302 RADFORD , GARY KAYE 14517 10 1 2014 2 42 47 PM ghermane 2014 - 36701 2000170105 GRIFOLS THERAPEUTICS INC 34,08915 10 2 2014 9 49 47 AM ghermane 2014 - 201495 2000093400 FOUR OAKS FOOD STORE INC 46414 10 6 2014 2 06 02 PM ghermane 2014 - 104109 2000178053 LOS AMIGOS AUTO REPAIR 22865 10 6 2014 2 08 21 PM ghermane 2014 - 104109 2000178053 LOS AMIGOS AUTO REPAIR - 22865 10 6 2014 2 09 34 PM ghermane 2014 - 104109 2000178053 LOS AMIGOS AUTO REPAIR 22865 10 6 2014 3 07 24 PM ghermane 2014 - 104269 2000178261 UNITED GRADING CONTRACTORS 45951 10 6 2014 4 40 29 PM ghermane 2014 - 23724 2000170949 CUMMINGS , KELLY 16561 10 6 2014 5 08 09 PM ghermane 2014 - 104237 2000178186 MAMBO SPORTS BAR & NIGHT CLUB 58346 10 14 2014 2 03 11 PM ghermane 2014 - 78506 2000143750 ROMERO , ERICA OROZCO 34882 10 15 2014 2 44 46 PM dwoodward2 2014 - 36694 2000167814 GRIFOLS THERAPEUTIC INC 9,50402 Real Personal Property Refunds TRANS DATE TIME USER YR BILL # ACCT # TAXPAYER NAME AMOUNT 9 16 2014 12 33 39 PM blbarbour 2014 - 67409 2000161508 NUNEZ , FERNELY 35767 9 17 2014 12 58 20 PM blbarbour 2014 - 34498 2000083023 GINN , ANTHONY ROGER 29824 9 17 2014 2 21 02 PM astancil 2014 - 33078 2000154084 FSC III LLC 1,04500 9 19 2014 9 09 04 AM astancil 2014 - 67496 2000170562 OAKMONT DEVELOPMENT 34100 9 19 2014 9 23 31 AM jmorrow 2013 - 65883 2000042416 NORRIS , JIMMY WAYNE 11064 9 19 2014 2 23 53 PM LOCKBOX 2014 - 48071 46838690 JOHNSON , STACY GERALD 68226 9 24 2014 4 27 57 PM LOCKBOX 2014 - 34688 2000153074 GM RHODES INVESTMENTS LLC 91346 9 26 2014 8 33 19 AM astancil 2014 - 36981 2000168097 GUHA , SUBRATA J 47500 9 26 2014 2 33 08 PM jmorrow 2014 - 93484 2000096925 VASQUEZ , NELSON SALAS 30000 9 26 2014 3 15 58 PM jmorrow 2013 - 70493 2000094723 PERNELL , SUZANNE SWEARINGEN 37900 9 29 2014 11 32 05 AM cfutch 2014 - 51212 2000166781 KING , JESSIE KATLYN 28585 9 29 2014 2 15 26 PM LOCKBOX 2014 - 56221 2000161352 LIGHTHOUSE CLEVELAND SPGS LLC 2,56841 9 30 2014 10 36 30 AM cfutch 2012 - 15733 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 10 39 33 AM cfutch 2013 - 14766 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 10 47 16 AM cfutch 2014 - 14963 2000155285 BYRD REALTY COMPANY INC 22735 9 30 2014 12 52 08 PM jmorrow 2014 - 80220 2000133640 SANDERS , RONALD MORTIMER 43486Page272 November 3 , 2014 – 10 00 am Continued 10 6 2014 2 10 46 PM LOCKBOX 2014 - 104274 2000178280 CLEANRITE CLEANERS 14355 North Carolina Vehicle Tax System - Pending Refund Report – September 2014 100 + Name Bill # Transaction # Refund Reason Amount Manley , Blake Harper 0021964802 16759904 Assessed In Err 34437 Perry , Douglas Yates 0022497386 25561224 Change of County 10888 Scott Betts & Son Inc 0022086503 34295424 Situs Error 20190 October 21 , 2014 This is to certify that , as authorized by the Board of Commissioners on December 11 , 2000 , I have approved the following tax releases and refunds under 100 , as recommended by the County Tax Administrator , Sheila Garner A complete record of this information is on file in the County Finance Office Totals from 9 16 14 to 10 15 14 Tax refunds - Personal Real Property 55154 Tax releases - Personal Real Property 1,21654 Motor Vehicle releases refunds 1,03180 Recommended by Tax Administrator Sheila Garner Approved by Finance Director J Chad McLamb 4 Public Comments A Jason Thompson with Johnston Ambulance Service Jason Thompson , 215 W Blanche Street , Clayton , speaking on behalf of Johnston Ambulance Service , asked to comment on the agenda item regarding the EMS franchise request by Johnston County Emergency Services Chairman Jeffrey P Carver asked Mr Thompson to wait until the item came up for discussion and stated he would allow anyone in the audience who wished to speak on the item to address the Board at that time 5 Cooperative Extension – Farm City Week and Centennial Celebration Cooperative Extension Director Bryant Spivey presented and requested adoption of proclamations for Farm City Week and the Centennial Celebration Mr Spivey stated Farm City Week is an annual observance for the County and this year the Farm City Week Banquet will be held on November 17 , 2014 Mr Spivey continued this year Cooperative Extension will be celebrating 100 years of service in Johnston County Mr Spivey stated during this time of year , Cooperative Extension likes to remind everyone how important agriculture is to our local economy and to the citizens He shared and reviewed with the Board agricultural statistics for Johnston County pointing out that Johnston County remains a strong agricultural county in the State of North Carolina ranking second in crop production and eighth overall in farm income At the inquiry of Commissioner Tony Braswell , Mr Spivey stated it looks like the County will enjoy a good cotton and soy bean crop although the rains did cause some problems with sweet potatoes in the wet parts of fields as well as there were a few problems with late season tobacco Mr Spivey added even with the rains , overall the County is projected to have very good yields Upon a question by Commissioner Cookie Pope , Mr Spivey stated there are still some sweet potatoes in the ground but it varies from farm to farm He stated with the good sweet potato crop this year farmers have had trouble finding enough storage space to hold the crop , but he believes if the weather holds for another couple of weeks , the farmers will be able to get the remaining crop out of the ground Upon a motion by Commissioner Cookie Pope , seconded by Commissioner Allen L Mims , Jr , and carried by unanimous vote , the Board adopted the following two proclamations NATIONAL FARM - CITY WEEK PROCLAMATION NOVEMBER 17 - 21 , 2014 WHEREAS , agriculture has always been a cornerstone of Johnston County’s way of life , we acknowledge that dedicated farmers improve our wellbeing by working to ensure a healthy and abundant agriculture supply To succeed in this important enterprise , our farmers rely on essential partnerships with non - rural communities to supply , sell , and deliver finished products across the country and around the world During National Farm - City Week , we recognize the importance of this cooperative network to the success of the agriculture industry WHEREAS , farming was America’s first industry and continues today to provide us with many of the necessities of life such as food , clothing , and fuel for our energy needs Agriculture employs a substantial number of workers in Johnston County including farmers , shippers , processors , marketers , retailers , truck drivers , inspectors , and others who annually contribute more than 38 billion in value - added income in Johnston County PagePage pageNumber5273 November 3 , 2014 – 10 00 am Continued WHEREAS , we welcome new opportunities for trade , hard work , and successful cooperation between farmers and city workers to continue to play a vital role in our country’s success and be a critical resource for countless people here and around the nation WHEREAS , Farm - City collaborations help maintain and improve our nation’s food and fiber supply and contribute to a better quality of life for countless citizens We commend the many Johnstonians whose hard work and ingenuity reflect the true spirit of America and help to ensure a prosperous future for all WHEREAS , we gather with family and friends around the Thanksgiving table , it is fitting that we count among our blessings the vital farm - city partnerships that have done so much to improve the quality of our lives Rural and non - rural communities working together have made the most of our rich agricultural resources , and they continue to contribute to the health and well being of our people and to the strength of our economy NOW , THEREFORE , we the Commissioners of Johnston County do hereby proclaim November 17 - 21 , 2014 , as Farm - City Week We call upon citizens in rural and city areas to acknowledge and celebrate the achievements of all those who , working together , produce an abundance of agriculture products that strengthen and enrich our community and nation Proclaimed this the 3rd day of November , 2014 JOHNSTON COUNTY Centennial Proclamation November 17 , 2014 WHEREAS , May 8 , 2014 marks the Centennial of the signing of the Smith - Lever Act which established Cooperative Extension , the nationwide education system operating through land grant universities in partnership with federal , state , and local governments which was authored by US Senator Hoke Smith of Georgia and US Representative AF Lever of South Carolina to expand the “ vocational , agricultural and home demonstration programs in rural America ” by bringing the research - based knowledge of the land - grant universities to the people where they live and work ; and WHEREAS , NC Cooperative Extension in Johnston County is a critical component of the three - part land - grant university mission and works collaboratively with research and academic programs associated with North Carolina State University and North Carolina A & T State University to reach audiences in all communities across North Carolina ; and WHEREAS , the Cooperative Extension System continues to receive federal programmatic leadership and support enabled by the Smith - Lever Act and other legislation through the US Department of Agriculture and thrives through a partnership between county , state , and federal governments and encourages priorities be established locally to meet the needs of each county ; and WHEREAS , NC Cooperative Extension education disseminated through Johnston County for agriculture producers has helped establish North Carolina as a leading agricultural state ; 4 - H youth development has reached millions of youth preparing them for responsible adulthood with citizenship and leadership skills ; family and consumer sciences has prepared people for healthy , productive lives , and breaking the cycle of poverty ; and WHEREAS , NC Cooperative Extension in Johnston County engages with rural and urban learners through practical , community - based , and online approaches , resulting in acquisition of knowledge , skills , and motivation to strengthen the profitability of animal and plant production systems , protect natural resources , help people make healthful lifestyle choices , ensure a safe and abundant food supply , encourage community vitality , and prepare the next generation of leaders NOW , THEREFORE , BE IT RESOLVED , that the Johnston County Board of Commissioners does hereby proclaim November 17 , 2014 as the Johnston County Centennial Celebration in recognition of the significance of the Smith - Lever Act to the establishment of Cooperative Extension and hereby encourages the people of Johnston County to observe and celebrate the centennial with a focus on congratulating the accomplishments of the past 100 years and ensuring a thriving future for Cooperative Extension ; honoring the local Extension Agents and university faculty who dedicate careers to providing trusted education to help people , families , youth , businesses and communities solve problems , develop skills and build a better future ; thanking Cooperative Extension volunteers who provide thousands of hours to promote excellence for 4 - H , Master Gardeners , family and consumer sciences and other programs in their communities ; encouraging continued collaboration and cooperation among federal , state , and local governments to ensure Cooperative Extension’s sustainability as the nation’s premiere non - formal educational network ; and celebrating millions of youth , adults , families , farmers , community leaders , and others who engage in Cooperative Extension learning opportunities designed to extend knowledge and change lives rd Proclaimed this the 3 day of November 2014 6 JCATS – Request for County Match for Community Transportation Program Grant Funds Neal Davis , Executive Director for Community & Senior Services JCATS , first congratulated the County on the recent opening of the new airport terminal at the Johnston Regional Airport Mr Davis spoke on the new facility and how it will present a positive impression to those flying into Johnston County Mr Davis also applauded the Board on the decision to relocate the Economic Development Office to the Airport as that office continues its efforts to market the County PagePage pageNumber6274 November 3 , 2014 – 10 00 am Continued Mr Davis presented his request to the Board to approve a match in the amount of 106,653 for the North Carolina Department of Transportation Community Transportation Program grant for Fiscal Year 2015 - 2016 The total grant from the DOT is 919,812 and is the major administrative and capital grant with which JCATS operates The grant consists of the following 1 Current services provided by JCATS 2 Federal State Certifications and Assurances that the system is meeting all regulatory requirements 3 293,376 Administrative expense request - 194,520 JCATS Administrative Staff - 98,856 other required administrative expenses , ie utilities , vehicle insurance , computer support , etc 4 626,436 Capital budget request - 604,940 - 10 replacement vehicles - 21,496 for other capital expenses ie radio equipment , vehicle lettering , software , anti - virus licenses , etc Mr Davis briefly spoke on the future of JCATS stating as more and more people move into the County , they are hearing from those moving in that public transportation options in other places are further along than Johnston County Mr Davis provided the Board with a brief background on the Community Transportation Grant He informed the Board that the Department of Transportation is capping the funding amount for the Administration portion of the grant which has left a shortfall in the amount of 96,052 to be funded locally Mr Davis requested the Board to consider discussing an additional allocation request of 96,052 to JCATS during the Fiscal Year 2015 - 2016 budget deliberations He noted in an effort to absorb some of the cost of increased demand , JCATS has passed as much of that cost along to the contracted agencies as possible , but their governing board and the Transportation Advisory Board now feels they have burdened those contracted agencies all they fairly can Mr Davis also reported JCATS is transporting more people than ever , putting more and more miles on the vehicles He stated because the capital funding has been reduced by the State they are running vehicles longer than they should and currently 20 of the vehicles in the fleet have exceeded their useful life Mr Davis stated this year they have scheduled to replace 10 of those vehicles to repair that deficit Mr Davis also spoke on changes to the State funding model which has impacted JCATS Mr Davis stated with all the issues facing JCATS as a whole , he is concerned about the future and wants to stay ahead of the issues as much as possible Mr Davis stated the reality is that in the past twelve months , JCATS had to deny over 1,600 rides which they should have been able to provide He noted JCATS has also had to find ways to continue operations with reductions in their Rural Operation Assistant Program grant funding Mr Davis stated JCATS has outgrown their existing facility noting they currently have 40 employees but their building can only accommodate 20 people according to the fire code He stated they are also in great need of a passenger shelter for times of rainy or inclement weather Mr Davis offered to answer any questions Upon a question by Commissioner Allen L Mims , Jr , Mr Davis reported they currently have 32 vehicles in the fleet and the seating capacity varies from seven to fifteen depending on the type of vehicle He stated all the vehicles are wheelchair accessible At the inquiry of Commissioner Chad M Stewart , Mr Davis stated they have had some 15 - passenger vans although they are phasing those out Commissioner Ted G Godwin stated it behooves the Board to look at all operations and make sure they are running as efficiently as possible for the citizens Commissioner Godwin continued that Mr Davis has done an excellent job trimming where he can and he operates under a very astute Board of Directors that holds him very accountable Commissioner Godwin stated it saves the County money in the long run by keeping folks at home as long as possible and JCATS helps with that process for transportation Chairman Jeffrey P Carver agreed and also commented this is another instance whereby the State is forcing the local government to spend more money County Manager Rick Hester recommended the Board approve the match in the amount 106,653 for the Fiscal Year 2015 - 2016 Community Transportation Grant and table discussions on the additional 96,052 allocation request until the Fiscal Year 2015 - 2016 budget deliberations PagePage pageNumber7275 November 3 , 2014 – 10 00 am Continued Commissioner Ted G Godwin moved the Board approve the matching requirement for the NC DOT Community Transportation Program grant for FY 2015 - 2016 for JCATS in the amount of 106,653 and table discussions on the additional 96,052 allocation request until the Fiscal Year 2015 - 2016 budget deliberations Commissioner DeVan Barbour seconded the motion , which carried by unanimous vote 7 Health Department – Approval of Updated Fee Schedules Deputy Health Director Steve Strickland presented updated fee schedules for Preventive Health , Behavioral Health , and Environmental Health as it relates to water sample testing and requested their approval effective December 1 , 2014 Mr Strickland stated on the Behavioral Health schedule , for the most part , many of those fees have gone down He continued the Preventive Health schedule is established according to what it costs to provide the service , which in many cases is quite a bit above what Medicaid reimburses the Health Department Mr Strickland explained at the end of the year , the State determines the difference in the Medicaid reimbursement versus the true cost to provide the service and reimburses that amount to the Health Department He noted the State has informed the County Health Departments that if the fees are not set high enough to cover the cost of the actual service then they would not reimburse the difference which is why some of the proposed fees appear very high Mr Strickland reminded the Board that the Health Department works from a sliding fee scale which takes into account a patient’s family income to determine what they will actually pay for service Mr Strickland continued his presentation by explaining the proposed increases in the Environmental Health water sample fees He explained in the past year , the General Assembly passed legislation that allowed the State Lab to increase their fees to make them a more sustainable agency Mr Strickland reported the State Lab did increase their fees which then pushed those costs on to the local health departments , effective September 1 , 2014 He reviewed the process of water samples as well as the following proposed fees with the Board Category New State Previous State State Current Recommended Costs FY15 Costs FY13 14 Increase Johnston Co Johnston Co Fees Fees 12 1 2014 Microbiology Total Coliform P A 23 309 1991 15 30 35 50 Total Coliform MPN 26 309 2291 30 50 Fecal Coliform 26 309 2291 30 50 Fecal 45 309 4191 30 72 Coliform Streptococcus Enterococcus , MPN 26 309 2291 30 53 Iron Bacteria 28 309 2491 30 55 Sulfur Sulfate - Reducing 35 309 3191 30 62 Pseudomonas – MTF or 26 309 2291 30 53 MPN Heterotrophic Plate Count 20 309 1691 30 47 Inorganic Chemistry Full Inorganic Panel 74 7395 05 New 89 104 Metals Panel 55 315 5185 15 30 67 82 Individual Metals 40 315 3685 15 30 52 67 Anions – Fl , Cl , Sulf 25 315 2185 30 37 52 Disinfection By - products 25 315 2185 30 62 Fluoride – Physician , 25 280 2220 No charge No charge Dentist request Nitrate Nitrite 25 755 1745 30 48 Arsenic Speciation 25 315 2185 30 52 Organic Chemistry Pesticides 74 2399 5001 30 80 Herbicides 74 2399 5001 30 80 Petroleum products 74 2826 4574 30 76 Volatile Organic 74 2691 4709 30 77 Chemicals New Well Sample kit 74 7395 05 7395 74 – no change NOTE The Full Inorganic Panel is the new well kit according to the state lab The 1500 amount is when we allow the public to secure a container and return it to us as a matter of information for them ; we have no mileage or personnel cost in collecting the sample PagePage pageNumber8276 November 3 , 2014 – 10 00 am Continued Mr Strickland stated the Health Department is asking the Board’s permission to raise the fees to cover the increase costs from the State Lab He noted some of the fees will double in cost but again reiterated the costs are being passed on by the State Lab which was given approval to raise their fees by the Legislature Mr Strickland introduced Environmental Health Division Director Larry Sullivan for questions Commissioner Cookie Pope stated it grieves her greatly that in this continuing struggling economy , the State is pushing increased fees upon the counties which in turn must push upon the citizens The Board briefly discussed the sample testing types with Mr Sullivan Motion and Second Commissioner Tony Braswell moved the Board approve the Health Department Fee Schedule updates for Preventive , Behavioral , and Environmental as presented , effective December 1 , 2014 Commissioner Ted G Godwin seconded the motion Discussion Commissioner Allen L Mims , Jr stated he agrees with Commissioner Pope’s earlier comments and stated he always thought that citizens ’ tax dollars to the State were to pay for services such as this Commissioner Mims asked if the State Lab operates like an enterprise fund whereby it must be self - sustaining Mr Strickland reported the State Lab just built a new state - of - the - art lab facility although he is unsure how that plays into the fee increases Health Director Dr Marilyn Pearson noted that while the General Assembly did pass legislation allowing the State Lab to raise their fees , they also requested a study to determine if there are other ways to decrease those costs later Vote The motion passed unanimously to approve the following fee schedules as of December 1 , 2014 Preventive Health JCPHD Current Medicare Recommended Cost Medicaid Rate Fees Code Name per unit Rate copay5 Sick Employee 500 500 10060 I & D abess Simple 20000 8616 20000 10061 I & D abess Complex 35000 14814 30000 10120 FB Removal Uncomp 11100 10750 14381 14400 10140 I & D Hemaatoma 26900 12101 15476 15500 11040 Debridement Abrasion 5500 3733 5500 11055 Cutting Benign Lesion 9600 3760 9600 11100 Biopsy Skin 12600 7847 9646 12600 11111 Forms Flat Fee 500 000 500 11200 Removal Skin Tag 9500 6398 8318 9500 11400 Exc Benign Lesion 13300 9165 11533 13300 11401 Exc Benign Lesion 1c 11300 11289 13969 14000 11720 Debridement of nails 2500 2440 3089 3100 11750 Nail Excision 28700 16687 21454 28700 11900 Injection of Lesion 10800 4315 5208 5200 11981 Insert Drug Implant Device 30500 9881 35700 11982 Removal 30500 11389 40500 20605 Joint Injection Medium 10300 4849 4809 7500 20610 Joint Injection Large 7400 6157 7500 30901 Nasal Bleed Simple 15000 7479 9226 10000 31203 50 Dextrose 200 1050 36415 Phlebotomy 1500 300 1500PagePage pageNumber9277 November 3 , 2014 – 10 00 am Continued 46600 Anoscopy 9500 6462 8403 9500 51701 Catherization 12400 5508 5184 16800 57452 Colpo W O Biopsy 12400 9296 10602 15000 57454 Colpo W Biopsy 28600 13134 15015 20000 57511 Cryosurgery 14200 12352 14188 14200 58100 Endometrial Biopsy 21600 9404 10662 15000 58300 IUD Insertion 18800 6700 20400 58301 IUD Removal 24100 8227 9293 26100 59425 Package Antepartum Care Only 4 - 6 Visits 36528 36528 1,22900 Package Antepartum care only 7 or more 59426 visits 65312 65312 2,20500 59430 Individual Postpartum Care Only 11786 11786 11800 69200 FB Removal Ear 14500 9710 11773 14400 69210 Removal Cerumen 12200 4096 4765 13300 80074 Hep B Panel 6290 6511 6600 81025 Urine Pregnancy Test Flat Fee 2500 884 2500 82270 Hemoccult Stool Mulip 600 454 600 82272 Hemoccult Single 900 454 900 82465 Cholesterol 700 608 700 82947 Serum Glucose 900 548 900 82950 Post Glucose Dose 1000 664 1000 83036 HGB A1C 1500 1356 1500 86580 TB Skin Test Flat Fee 2000 614 2000 86581 NC Candida Control 916 1000 86592 RPR Stat 900 596 900 86735 MMR Titer 11613 11700 86787 Varicella Titer 2880 2880 86803 Hep C Panel 3360 1994 3360 87081 GC 1100 806 1100 87086 Urine Culture 1500 1128 1500 87205 Gram Stain 1000 596 1000 87210 KOH Prep 1000 533 1000 88142 90 thin prep 5600 2831 5600 90378 Synagis 000 000 90384 RHO - D Immune 12700 12700 90389 TIG 000 000 90471 Immunizations Admin 6000 3313 2366 6000 90471EP Immunizations Admin 7500 2800 6000 90472 Immunizations Admin additional 3000 1942 1196 3100 90472EP Immunization Add 3000 1942 1196 3100 90473EP Immunization oral 3800 1330 4100 90474EP Immunization oral add 900 1330 2700 90602 high dose flu 4000 4000 90632 Hep A 4446 4446 90633 Hep A Peds 3056 3056 90636 Hep A and B 7096 7096 90645 HIB 000 000 90647 Pedvax Hib 000 000 90649 HPV 14948 13573 14948 90654 Intra 2500 2500 90655 Flu Preservative 1500 2500 90657 Flu 6 - 35 Months 1500 2500 90658 Flu gt; 3 2500 2500 2500 90660 Flu Mist 2500 2500 90669 Prevnar 8039 8039 90675 Rabies Vaccine 21332 21332 90680 Rotavirus 000 000 90691 Typhoid 7614 7614Page0278 November 3 , 2014 – 10 00 am Continued 90700 Dtap 000 000 90702 DT Ped 000 000 90707 MMR 7001 7001 90710 MMRV 000 000 90713 IPV 000 000 90714 Decavac TD 4800 4800 90715 Tdap 11 - 64 4688 4688 90716 Varicella 10718 10718 90723 Pedianix 000 000 90732 Pneumovax 7500 2703 7500 90734 Menactra 11991 11991 90736 Zostavax 17721 17721 90744 Hep B Peds 000 000 90746 Hep B Vacc 5056 858 5056 90747 Hep B immunocomp Patient 000 000 not 90774 IV Injection 2000 covered 2000 not 90780 IV Infusion 1st Hour 13500 covered 13500 not 90781 IV Infusion ADD hours 9000 covered 9000 not 90782 Therapeutic Inj 1900 covered 1900 not 90788 IM Antibiotic Injection 2000 covered 2000 92551 Screening Audiometry 2700 858 2900 92551EP Screening Audiometry w CH Pysical 000 000 92552 Hearing 1900 1828 1900 92567 Tympanogram 4100 1545 4100 93000 EKG 5000 1852 1593 5600 94150 Peak Flow 2300 1526 2500 94650 O2 Therapy 5000 5000 94664 Nebulizer tx Initial 3600 1119 1590 3900 94665 Nebulizer tx Sub Non - covered Medicaid 3600 3900 94760 Pulse Oxygen 626 179 700 96110 Denver Screening 2000 961 2000 96150 Health Behav ASMI , Initial 15min 1896 2117 2200 97802 Medical Nutrition 4944 2472 3452 5000 97802 MNT Initial 4944 2472 5000 97803 Medical Nutrition 4370 2185 2955 4400 97803 MNT Re assess individual 4370 2185 2955 4400 97804 Group 1400 1554 1400 99000 Handling Fee 1500 1500 99070 Unspec Materials List 1100 1048 1100 99201 Office Visit , Minimum Problem Focused 10200 6210 4121 11100 99202 Office Visit , Expanded Problem Focused 17700 9315 7109 17700 99203 Office Visit , Detailed Exam 21500 13248 10320 21500 99204 Office Visit , Comprehensive Exam 31400 19458 15904 31400 99205 Office Visit , Extended Comprehensive 40000 24426 19858 40000 99211 Office Visit , Minimum Problem Focused 5600 3416 1902 5500 99212 Office Visit , Expanded Problem Focused 10000 5693 4154 11100 99213 Office Visit , Detailed Exam 17300 7866 6986 18700 99214 Office Visit , Comprehensive Exam 26000 12213 10328 28100 99215 Office Visit , Extended Comprehensive 35000 18216 13857 38000 99386 Ages 40 - 64 year 32200 19900 32200 99387 Age 65 + 33700 21500 33700 99396 Ages 40 - 64 year 27100 15800 29300 99397 Ages 65 + 17500 17500 17500 99406 Tobacco Counseling 3 - 10 min 1327 1066 1352 1400 99407 Tobacco Counseling gt; 10 min 2582 221 2669 2700 99408 AUDIT DAST , 15 - 20min 2946 2946 3000Page1279 November 3 , 2014 – 10 00 am Continued 99409 AUDIT DAST , gt; 30 min 5914 5914 6000 99420 Admin Inter PHQ 9 Max 2U Days 2400 814 2400 240663B Super Panel 1920 1920 36415BW Routine Venipuncture 300 300 57452BW Colposcopy 10433 10433 57454BW Colposcopy + BX + ECC 14775 14775 57455BW Colposcopy + BX 13736 13736 57456BW Colposcopy + ECC 12987 12987 80048BW Basic Metabolic Profile 1094 1094 80061BW Automated Lipid Panel 1827 1827 81000BW Urinalysis w Microscopy 443 443 81001QW Complete Urinalysis 600 443 600 81002BW Urinalysis W O Microscopy 357 357 81003QW DIP UA 500 314 500 82270BW Hemoccult 956 956 82465BW Cholesterol Total Serum 593 593 82947BW Glucose Blood 432 432 82947QW Glucose 900 548 900 82951QW 3 hr GH 2000 1799 2000 82952QW Additional Test 630 548 630 83036BW Hemoglobin A1C 1324 1324 83036QW Hemoglobin A1C 1500 1356 1500 83718BW Lipoprotein 432 432 85018QW HGB 500 331 600 8780459QW Influenza B Rapid Flu Test 1676 1601 1700 87804QW Influenza A Rapid Flu Test 1676 1601 1700 87880QW Strep Screen 2100 1601 2100 88170BW Fine Needle 8185 8185 90465EP Admin Fee lt; 8 Years sick 5500 2800 5500 90471EP Child Health Immunizations Adm 7500 2800 7500 90658F Flu FREE 000 000 90676T Rabies Titer 7572 7572 98960BW Individual Face to Face 30 min 3000 3000 98961BW Group Face to Face 30min 3000 3000 98967BW Individual phone 15min 1500 1500 99201BW New Pt Brief 3096 3096 99202BW Limited 5335 5335 99203BW Intermediate 7739 7739 992112BW 30 Minutes 3121 3121 99211BW 15 Minutes 1432 1432 99243BW 40 Minutes 5239 5239 99381EP Initial lt; 1year 9000 9000 10000 99382EP Ages 1 - 4 Year 9000 9000 10000 99383EP Ages 5 - 11 year 32200 9000 32200 99384EP Ages 12 - 17 year Child Health 26400 9000 26400 99384FP Ages 12 - 17 year Family Planning 28400 9683 28400 99385EP Ages 18 - 39 year Child Health 26900 9683 26900 99385FP Ages 18 - 39 year Family Planning 28400 16700 28400 99391EP Periodic lt; 1 year 26400 9000 26400 99392EP Ages 1 - 4 Year 28700 9000 28700 99393EP Ages 5 - 11 year 28600 9000 28600 99394EP Ages 12 - 17 year Child Health 30900 9000 30900 99394FP Ages 12 - 17 year Family Planning 26200 14600 26200 99395EP Ages 18 - 39 Child Health 24800 14200 24800 99395FP Ages 18 - 39 Family Planning 24800 14200 24800 D0145 Oral Evaluation lt; 3 6900 3807 7500Page2280 November 3 , 2014 – 10 00 am Continued D1206 Topical Fluoride 5900 1500 6400 Diabetic Education Program Education Counseling Counseling These Services Slide G0008 Admin Fee for Medicare Flu 2275 2275 G0009 Admi for Pneumovax Medicare 2275 2275 G0101 Medicare Pelvic and Breast 7200 3621 7200 G0101 Pelvic & Breast Exam 3600 3621 3700 G0102 Medicare Prostate 3800 1867 3800 G0102 Prostate DRE 1900 1867 1900 G0103 Prostate PSA 000 000 000 G0107 Hemoccult , Guaiac Up to 3 1600 000 1600 G0108 Individual 5400 5152 5400 G0109 Group 1900 1421 1900 G0351 Therapeutic Inj 1900 1900 G0375 Cessaition gt; 10min 1200 1200 G0376 Cessaition gt; 30min 2200 2200 G0396 AUDIT DAST 15 - 30 min 3212 3565 3600 G0397 AUDIT DAST gt; 30 min 6587 6864 6900 G0402 Welcome to Medicare Exam 11994 15849 15900 G0403 ECG w Welcome to Medicare Exam 1793 1593 2000 G0436 Tobacco counseling 3 - 10 min 1156 1385 1400 G0437 Tobacco counseling gt; 10 min 2499 2735 2800 G0438 Annual Wellness Visit Initial 15938 16348 16400 G0439 Annual Wellness Visit Sub 10635 10910 10900 G0442 Annual Alcohol screening 889 1703 1800 G0444 Annual Depression Screening 1646 1703 1800 J0170 Epinephrine up to 1ml 100 104 092 200 J0560 Bicillin 600,000 2900 001 4075 4100 J0570 Bicillin LA 1,200000 5300 002 4607 4700 J0696 Rocephin 250mg 300 126 148 200 J0715 Rocephin 500mg 300 104 524 600 J1030 Depo - Medrol 40mg 800 235 447 500 J1040 Depo - Medrol 80mg 1400 456 941 1000 J1050 DepoProvera INJ 4900 1390 4050 4900 J1100 Decadron 4mg 016 060 008 100 J1200 Benadryl 50mg 100 003 075 100 J1815 Insulin Per 5 Units 060 010 100 J1820 Insulin Reg 500 010 100 J1820 Solumedrol 125mg 500 199 200 J1885 Toradol 60mg 300 155 200 J1940 Lasix 20mg 073 005 100 J2000 Xylocaine Lidocaine 400 072 100 J2550 Phenegran 50mg 200 080 100 J2920 Solumedrol 500 199 200 J3301 Kenalog 10mg 1cc 1100 279 300 J3303 Aristospan 5mg 200 200 J3420 Vitamin B - 12 200 185 200 J7300 Paragard 18500 24668 18500 55300 J7302 Mirena Flat Fee 36000 30442 28300 71700 J7302F Mirena FREE 000 000 LU102 TB Screen Forms 000 000 000 LU238 Health ED 000 000 LU402 Medicaid Co - Pay 300 300 LU600 Reporting Maternity Clinic Visits for HIS 000 000 000 Q0091 Pap Collection Medicare 8400 4233 8400 Q2038 Flu for Medicare 2500 2500 Q3022 Hep B Medicare 6342 6342Page3281 November 3 , 2014 – 10 00 am Continued S4993 Oral Contraceptives 500 335 500 S9442 Childbirth Classes We don’t bill the Patient 2000 2000 2000 T1002 STD & TB 9800 1950 9800 500 Copy for all Project Access Patients 500 500 Nexplanon 32500 Behavioral Health Current Medicare Recomm Alliance Medicaid IPRS Fees Rates - ended Rate 2012 - 13 2013 - 14 eff 1 14 Code Name Fees 99212 Established Pt - Psychiatric Eval 10 mins 3350 10000 5000 MD - 3350 NP - 2848 4154 99213 Established Pt - Psychiatric Eval 15 mins 5594 15000 7500 MD - 5594 NP - 4755 6986 99214 Established Pt - Psychiatric Eval 25 mins 8429 20000 12500 MD - 8429 NP - 7165 10328 99215 Established Pt - Psychiatric Eval 40 mins 11400 30000 15000 MD - 11400 NP - 9690 13857 99201 Initial Psychiatric Evaluation 10 mins 3318 10000 5000 MD - 3318 NP - 2820 4121 99202 Initial Psychiatric Evaluation 20 mins 5754 17500 7500 MD - 5754 NP - 4891 7109 99203 Initial Psychiatric Evaluation 30 mins 8336 22500 12500 MD - 8336 NP - 7086 10320 99204 Initial Psychiatric Evaluation 45 mins 12927 30000 17500 MD - 12929 NP - 10988 15904 99205 Initial Psychiatric Evaluation 60 mins 16341 37500 22500 MD - 16341 NP - 13890 19858 96372 Injection Administration 5790 , 5795 1704 1704 2500 MD - 1704 NP - 1419 2366 99211 Nurse Evaluation 5 mins 5790 , 5795 1682 3000 3000 MD - 1682 NP - 1430 1902 90658 Flu Vaccine gt; 3 yo - - - - - 2500 2500 - - - - - - - - - - G0180 Physician Certification Medicare - - - - - 6154 5200 n a 5101 G0179 Physician Re - Certification Medicare - - - - - 4673 4000 n a 3920 MD - 5224 LCSW LPC - 90832 Psych Therapy 16 - 37 mins 4137 7500 7500 3918 6363 MD - 6785 LCSW LPC - 90834 Psych Therapy 38 - 52 mins 5806 10000 10000 5089 8439 MD - 9942 LCSW LPC - 90837 Psych Therapy 53 + mins 8542 12500 13000 7457 12633 MD - 12539 90791 Diagnostic Evaluation 9430 15000 15000 LCSW LPC LPA - 9404 13132 MD - 2609 LP - 2557 90853 Adult Group 2557 3000 5000 LCSW LPC - 1918 2592 99495 TCM Moderate Billing Code - - - - - 13500 16000 n a 15687 99496 TCM - - High Billing Code - - - - - 19776 22500 n a 22173 G0436 Tobacco counseling 3 - 10 mins - - - - - 1156 1400 n a 1385 G0437 Tobacco counseling gt; 10 mins - - - - - 2499 2800 n a 2735 99251 Initial Consult 20 mins 10000 12500 MD - 4082 NP - 3470 - - - - - 99252 Initial Consult 40 mins 15000 12500 MD - 6325 NP - 5376 - - - - - 99253 Initial Consult 55 mins 20000 12500 MD - 9602 NP - 8162 - - - - - 99254 Initial Consult 80 mins 25000 15000 MD - 13889 NP - 11806 - - - - - 99255 Initial Consult 110 mins 30000 17500 MD - 16923 NP - 14385 - - - - - 99221 Initial Inpatient 30 mins 8305 15000 12500 MD - 8305 NP - 7059 9853 99222 Initial Inpatient 50 mins 11334 20000 15000 MD - 11334 NP - 9634 13395 99223 Initial Inpatient 70 mins 16689 25000 20000 MD - 16689 NP - 14186 19753 99231 Subsequent Inpt Consult 15 mins 3430 7500 10000 MD - 3430 NP - 2916 3819 99232 Subsequent Inpt Consult 25 mins 6181 10000 10000 MD - 6181 NP - 5254 7020 99233 Subsequent Inpt Consult 35 mins 8853 12500 12500 MD - 8853 NP - 7525 10115 Inpt Same Day Admit Discharge 40 99234 mins - - - - - 15000 15000 MD - 11716 NP - 9959 13116 Inpt Same Day Admit Discharge 50 99235 mins - - - - - 20000 17500 MD - 15391 NP - 13082 16450 Inpt Same Day Admit Discharge 55 mins 99236 + - - - - - 20028 22500 MD - 19129 NP - 16260 21238 99238 Inpt Discharge less than 30 mins 6111 10000 10000 MD - 6111 NP - 5194 7032 99239 Inpt Discharge 30 mins 8881 15000 12500 MD - 8881 NP - 7549 10389 81001 UA - - - - - 1300 600 443 Medicaid n aPage4282 November 3 , 2014 – 10 00 am Continued 81025 Urine Pregnancy Test - - - - - 2500 2500 884 Medicaid n a 83036 A1C - - - - - 1500 1500 1356 Medicaid n a 80048 BMP - - - - - 520 520 Indigent Indigent 93000 EKG ECG - - - - - 5000 5600 1852 Medicaid 1593 36415 Venipuncture - - - - - 950 1500 300 Medicaid n a Environmental Health Category New State Previous State State Current Recommended Costs FY15 Costs FY13 14 Increase Johnston Co Johnston Co Fees Fees 12 1 2014 Microbiology Total Coliform P A 23 309 1991 15 30 35 50 Total Coliform MPN 26 309 2291 30 50 Fecal Coliform 26 309 2291 30 50 Fecal 45 309 4191 30 72 Coliform Streptococcus Enterococcus , MPN 26 309 2291 30 53 Iron Bacteria 28 309 2491 30 55 Sulfur Sulfate - Reducing 35 309 3191 30 62 Pseudomonas – MTF or 26 309 2291 30 53 MPN Heterotrophic Plate Count 20 309 1691 30 47 Inorganic Chemistry Full Inorganic Panel 74 7395 05 New 89 104 Metals Panel 55 315 5185 15 30 67 82 Individual Metals 40 315 3685 15 30 52 67 Anions – Fl , Cl , Sulf 25 315 2185 30 37 52 Disinfection By - products 25 315 2185 30 62 Fluoride – Physician , 25 280 2220 No charge No charge Dentist request Nitrate Nitrite 25 755 1745 30 48 Arsenic Speciation 25 315 2185 30 52 Organic Chemistry Pesticides 74 2399 5001 30 80 Herbicides 74 2399 5001 30 80 Petroleum products 74 2826 4574 30 76 Volatile Organic 74 2691 4709 30 77 Chemicals New Well Sample kit 74 7395 05 7395 74 – no change NOTE The Full Inorganic Panel is the new well kit according to the state lab The 1500 amount is when we allow the public to secure a container and return it to us as a matter of information for them ; we have no mileage or personnel cost in collecting the sample 8 Ebola Update from Health Department At the request of Commissioner Cookie Pope , Health Director Dr Marilyn Pearson updated the Board on the County’s preparation for Ebola She reported the Health Department is meeting weekly with all its partners including Johnston County Emergency Services , Johnston County Human Resources , 911 - Communications , and Johnston Health to review policies and procedures and make sure everyone is prepared in the event an Ebola case is diagnosed in Johnston County She stated they are going through scenarios and plans as well as making sure supplies are kept up to date Dr Pearson noted there were a couple of possible Ebola cases recently at the Smithfield Emergency Department in which all the agencies had a chance to go through the processes She noted those cases were confirmed not to be Ebola 9 Emergency Services – Additional EMS Medical Transport Franchise EMS Division Chief Josh Holloman addressed the Board and introduced EMS Advisory Committee Vice Chairman Joe David Austin Mr Holloman explained that currently Johnston Ambulance Service JAS is the only approved private provider for medical transports in the County He stated for a number of years ,Page5283 November 3 , 2014 – 10 00 am Continued discussions have been held about the possibility of adding another private medical transport company to ensure the County is served appropriately Mr Holloman reported in April 2014 , the EMS Advisory Committee voted to accept applications for additional medical transport franchises with North State Medical Transport of Raleigh and Samaritan Ambulance Service of Wendell both submitting applications He noted the applications were reviewed and on July 14 , 2014 presentations were made by both companies to the Advisory Committee where the Committee voted to table a decision at that time Mr Holloman stated on October 20 , 2014 an Advisory Committee Meeting was held and the Committee voted at that meeting to recommend approval of North State’s application to operate in the County Upon a question by Commissioner Cookie Pope , Mr Holloman confirmed that Rex Critical Care was granted a critical care transport franchise which is presently in service at the Smithfield hospital and they are available to take critical care transports out of the local hospital system Mr Holloman stated that critical care franchise would not affect the convalescent medical care transports being discussed today At the inquiry of Commissioner DeVan Barbour , Mr Holloman reported Rex Critical Care went into service on October 20 , 2014 Commissioner Barbour questioned adding another franchise so quickly after Rex Critical Care has begun operations for critical care transports and should the County wait to see how this will impact the overall system Mr Holloman stated the feelings of the EMS Advisory Committee is that although Rex Critical Care will benefit the critical care patients that are transported out of the local hospital system as well as benefit the hospital in the future as they look to do other things , it does not affect issues that have been previously experienced with patients who are transported out of nursing homes or transported to and from doctor offices Commissioner Barbour asked if there are still problems with the service provided by JAS and why another franchise is needed at this time Mr Holloman acknowledged there has not been a lot of time since Rex began providing critical care transports ; however , he stated the need comes from years of looking at the overall system Mr Holloman stated the EMS Advisory Committee is recommending another franchise Commissioner Allen L Mims , Jr asked if JAS is meeting their contract obligations Mr Holloman stated JAS is meeting their contract obligations , but the issues the EMS Advisory Committee discussed involved the future call volume for medical transports as the County continues to grow He noted there have been occasions of anticipated delays with transporting patients from nursing homes and doctors ’ offices and by adding another franchise it will provide the option of another company to be called for transports Upon a question by Commissioner Chad M Stewart , Mr Holloman stated one of the stipulations of a private transport company being allowed to operate in the County is that they must be able to offer advanced life support service so they would have to have paramedics on hand Commissioner Tony Braswell asked for staff’s recommendation Mr Holloman reported staff’s recommendation to the EMS Advisory Committee was an additional medical transport company is needed Commissioner Barbour asked why the EMS Advisory Committee chose to recommend North State over Samaritan Mr Holloman stated the EMS Advisory Committee recommended North State over Samaritan because the Committee felt North State is located in more areas than Samaritan and seemed to be a more established company He continued North State is also already approved by the State to offer advanced life support services and the comments received from their current customers were all positive Mr Holloman stated the EMS Advisory Committee felt North State could come in and startup services more quickly Commissioner Mims stated it has been a long time since JAS was selected as the single provider in the County , but he remembers the time when there were two providers and the confusion that caused when there were problems He continued when problems arose , because there were two providers , it was difficult to figurePage6284 November 3 , 2014 – 10 00 am Continued out exactly who to blame for the problems and how to address them Commissioner Mims stated because of that , the County chose to go with JAS as a sole provider and he prefers the system the way it is Commissioner Mims questioned if two companies were allowed , what would be done this time to avoid similar problems and confusion Mr Holloman reported the EMS system is prepared to continue with one company ; however , he stated the largest benefit , from a facilities standpoint , is that if a local nursing home feels they are not receiving the service they think they should from JAS , then they would have another company to call for transports Commissioner Mims suggested if there are problems with JAS then perhaps the contract needs to be reviewed and revised Chairman Jeffrey P Carver commented that Rex Critical Care cannot be compared to this situation because they are intended to handle critical care hospital transports Mr Holloman explained that he met with the Johnston Health Administration as well as the Rex Critical Care Administration and together developed a protocol that would allow critical care patients only to be transported on the Rex trucks so they would not impact JAS or their business Upon a question by Commissioner Barbour , Mr Holloman confirmed that if another private transport company is granted a franchise , it would be up to the individual nursing homes as to who they would call for transports Chairman Carver asked if there were any others that wish to speak on the matter to come forward Jason Thompson , 215 W Blanche Street , Clayton , speaking on behalf of Johnston Ambulance Service JAS , addressed the Board and introduced Ben Pinault , Director of Marketing and Public Relations for JAS Mr Thompson stated JAS employs a lot of Johnston County citizens not just on the ambulances , but also in the corporate administration office and as dispatchers Mr Thompson stated the bottom line is if competition is added to the mix there will still be the same amount of personnel which will cause business to decline for JAS Mr Thompson stated Rex Critical Care is already reducing their business He explained JAS offers both medical transports as well as critical care transports and he spoke on a situation last week in which Rex handled a call that JAS could have taken which would have allowed Rex to be free for a heart attack case that happened at the same time Mr Thompson stated he is unsure what kind of protocol was developed but stressed that it is not working Mr Thompson expressed concerns that the EMS Advisory Committee voted on October 20 , 2014 to recommend another franchise be granted which was the same date as Rex Critical Care began service Mr Thompson stated he does not feel there has been enough time to analyze the impact Rex Critical Care will have on the system Mr Thompson stated he thinks competition is good but in this instance he believes an additional franchise will be too much for the system and will end up negatively impacting JAS Mr Thompson stated if an additional franchise was offered as a true backup to JAS then he does not believe there would be problems ; however , he believes at the last EMS Advisory Committee meeting , it was presented differently and not as a backup scenario Commissioner Barbour stated jobs are important and he understands the concerns by JAS ; however , the Commissioners are charged with the health and wellbeing of the citizens Commissioner Stewart stated he would like more information on how the system would work if another franchise were allowed and how any confusion regarding call response would be addressed Mr Thompson stated he feels there has not been an opportunity to sit down and work things out to figure out how to coexist Mr Thompson asked Mr Pinault to comment on the amount of charity work that JAS provides noting if another franchise is added to the mix they will probably not be able to do as much charity work as before At the inquiry of Commissioner Barbour , Mr Holloman confirmed if another franchise were allowed , the contract would be the same as the contract with JAS and the two companies would work together on the charity work so it would not all fall on one company Mr Pinault stated JAS offers approximately 3,000 a week in charity transports , receiving no reimbursement at all He noted if Medicaid reimbursements are factored in , then the charity number increases Page7285 November 3 , 2014 – 10 00 am Continued Mr Pinault stated JAS does the charity transports only in Johnston County because they are currently the sole provider He stated in other counties , they ask for payment upfront or have contracts in place with the hospitals who will reimburse for the transports where patients cannot pay Mr Thompson stated JAS has invested a lot in Johnston County including the purchase of radios in order to communicate with the Johnston County EMS System as well as the 911 system He noted JAS purchased the building they occupy in Smithfield and they are the only approved private ambulance service in North Carolina that is authorized to teach their own employees Mr Thompson reiterated there has not been enough time since Rex Critical Care began offering services to see if another franchise is needed Commissioner Braswell stated to Mr Thompson that in all fairness , the problems began prior to his employment with JAS He continued the breakdown began under prior JAS leadership which led to the EMS Advisory Committee researching the need for another franchise Commissioner Braswell stated at that time , JAS was not meeting all its transports and the EMS system had to backup those transports which led to the need to do something Carlie Coward , Director of Business Development for North State , stated JAS is a great company and they have been in Johnston County for many years ; however , there is a reason why the discussions for an additional franchise began years ago and those reasons remain Ms Coward spoke on the growth of the County noting that nursing homes are continuing to open and the medical transport need is growing She stated while there may be a slight drop in the call volume currently , it will pick up again Ms Coward stated she believes another franchise would help with response times in Johnston County EMS Advisory Committee Vice Chairman Joe David Austin agreed with earlier comments by Commissioner Braswell as far as why a recommendation for another franchise is needed Mr Austin stated the Advisory Committee studied the issue in great detail before making the recommendation to the Commissioners to add another franchise Mr Austin stated they had the same concerns as to whether there has been enough time since Rex Critical Care began providing service when they were debating the issue , but in the end recognized that Rex is offering a different level of care Mr Austin stated the staff has researched the issue of how they will handle two companies and he believes they will have a system in place that can be monitored Chairman Carver stated he must rely on information from those that have been studying this issue since the beginning Chairman Carver noted he does remember there were numerous problems with the service provided by JAS before Mr Thompson’s time Chairman Carver stated he must defer to Commissioner Braswell since he is the Commissioner liaison for the EMS Advisory Committee Commissioner Stewart stated the issue is new to him , but his concerns involve potential confusion with having duel agencies Commissioner Mims reiterated that if the same contract is going to be offered to another company , there will still be problems and he suggests tightening up the contract to avoid future issues Commissioner Ted G Godwin stated if JAS is currently living up to their contract and the County does not want to have the same confusion as it had years ago with dual agencies , then perhaps the matter should be given 90 days since Rex has been added to see how things go Commissioner Godwin stated he respects what the Advisory Committee has recommended , but he feels the situation should be given some time to see if another franchise is needed Commissioner Mims expressed his preference to have one provider so in the event of problems , the County will know exactly who to go to Commissioner Barbour agreed with Commissioner Godwin that perhaps the Board should give the matter some time to see how things are going since Rex began providing critical care transports Commissioner Braswell stated the main issue is does Johnston County need an additional franchise and the staff is telling him that they do Motion to approve franchise to North State failed Commissioner Tony Braswell moved the Board grant a medical transport franchise to North State Ambulance The motion failed for lack of a second Page8286 November 3 , 2014 – 10 00 am Continued Motion to table request for 30 days passed Commissioner DeVan Barbour moved the Board table a decision on the franchise request for 30 days to allow time to receive and review more information Commissioner Chad M Stewart seconded the motion which carried by the following vote Ayes Commissioners Jeffrey P Carver , Cookie Pope , Allen L Mims , Jr , DeVan Barbour , Ted G Godwin , and Chad M Stewart Nays Commissioner Tony Braswell 10 Budget Revisions Assistant County Manager and Finance Officer Chad McLamb requested the Board to approve the budget revisions listed in the agenda packet and offered to answer any questions Commissioner Allen L Mims , Jr moved the Board approve the following budget amendments , seconded by Commissioner Ted G Godwin , and carried by unanimous vote Heritage Cente