ladies and gentlemen the February 15 2024 Board of county commissioner meeting is now called to order at 6:30 p.m. if you would rise with me heavenly father I come with Thanksgiving on my heart because each new day you awaken us to as a gift from you and a new opportunity to do your will to do good towards others and to do and to serve our community as leaders and to be examples of your will for that I am eternally grateful Heavenly Father we thank you for each person who has come out in person and those who are listening online please help them all and bless them now father I ask that you guide our behavior and actions towards each other as we s display Civility and and courtesy and respect to one another that we keep an open mind and as we are receptive and try to understand the view points of each person father I ask that you please keep your loving arms around America and particularly the innocent our children and adults who are too often caught in the Perils of Violence by those who choose evil gun violence and those who show hate rather than love help her dear Lord to always choose nonviolence and and Lord to always choose love over Hate Now father guide us in our decision making tonight that it be done in the best interest of the community and be pleasing in your sight in Jesus name we pray Amen Let Us pledge flag of the United States of America stands indice at this time we will have our public hearing and I'm going to turn it over to our attorney Mr Commando who would um explain the action and the resolution that we're voting on tonight so Madam chair this resolution is really the collection method should a assessment be put into place um this doesn't actually Levy the assessment this is just the method by which it would be collected so without this resolution the county would have to essentially set up a group of people that would send out bills and then um then collect those bills and then if there were any properties that could not be collected the next year they would be put on the tax B so this is just a way to streamline efficiencies for the county thank you for for explaining that are there um any public comments regarding this resolution okay any questions comment from the board all right um at this time I'll I'll call for a motion resolution did you we just need to read by title okay so I can do that a resolution of the board of County commissioners of Bradford County Florida electing to use the import method of collection non-ad special assessments for more than one year levied in Bradford County Florida to fund the cost incurred by the county in providing fire protection and Emergency Medical Services each year stating the need for such Levy providing for the mailing of this resolution and providing an effective date okay any comments from the public board all right I'll call for a motion approval make a motion to approve the resolution read um motion by commissioner dhy is there second second by commissioner ready okay um are we ready for vote in discussion all in favor sign I I any oppos it's 40 and please again for the record note that Mr Thompson is absent so we have an anonymous approval okay now um um moving on to um public comments at this time we have a few um coming and the first Mr David Ross and again whoever is coming up if you would speak directly into the mic and just um state your name and and so forth my name is David Ross I am a um resident of Bradford County longstanding uh thank you for this time to speak uh to all the people in Authority here um thankful to all of y'all and um I just want to say that tonight I'm speaking on behalf of purpose Behavioral Health and I think that's going to be uh on the agenda tonight it's the vision of one of the most successful people I know and that's my wife patina Hutcherson Ross and I've gotten to know her over the last two years just her dedication to people her dedication to what's been spoken to her as a vision I woke up this morning I'm also a uh uh licensed uh uh LPN I've been a LPN for about two years so I get the chance to work in this community and surrounding communities with people and and help them to to to have a semblance a better quality of health and I just tell you today when I woke up knowing that I was going to be able to speak on behalf of my wife today gave me so much joy because this has been her vision uh this has been something that's been burning inside of her that she wanted to to to see come to pass and just being able to speak just being a able to propose this tonight in front of friends family and the community is is a dream come true and so I just pray and hope that everyone listens uh and hears this Clear Vision of how we can do some diff some change some preventative things and think outside the box here uh for our community when it comes to opioid addiction when it comes to giving people Second Chances when it comes to really seeking to make a difference in this County thank you thank you Mr Ross and excuse me and next we have um Miss Cynthia Ross good evening everybody even I do thank you Commissioners for your service and I'm so thankful to see commissioner Spooner know uh being here tonight and thank God that you're on the men thank you I really had no intention of speaking I'm here in support of anything we can do more in the area of mental health however I thought I would take the opportunity to share um just something that we're doing a small effort but hopefully it will grow um we do just need more positive productive out opportunities for our young people and just for our community in general and I and I thought what better place because I know that you're concerned about a community so I'm going just going to read what's on these little sheets it simply says do you have a talent or skill that you're willing to share with others in our community and to do so in an environment that honors God and then it says you know you answer yes to this who to contact and that would be actually me then on the flip side it says do you want to grow as a person by learning a skill or developing interest and interest or talent and do this in an environment that is safe and honors God no age limit but youth have a priority so I have these little Flyers that I'd like to share with each one of you I wish I a lot more so I could give them to everybody but um I had the first person that responded to me uh on this and I just just really got started and I was so excited just in talking to her she said well you know I said what do you like to do she says well I knit I don't know how many young people are learning to knit but what a great thing so we just want to match talents with people that want to develop talents and abilities in an environment that ARS got and and that isfe so I just want to share that tonight and thank you and I'm very much in support of whatever we can do to advance mental health here in our community so can I hand each one of you one of these sure thank you Miss Ross all right thank you and next we have Mr Tommy Kum board I'm here about the oncoming fire tax and U as you notice I didn't come when y'all voted the electrical one because it was fair and you know I'm not here on a crusade against taxes but we do have a lot of buildings at the S Mill and we do work a lot of people and we don't judge them I don't even check a person record when I hire them and they do right I work but hard times is here and when you start looking at buildings your daddy built and they could be called commercial buildings this is all about protecting the big man we got a big Sawmill Building 25 people under at all times 5,000 amp worth of Disconnect 22500 um it's going to be taxed the same thing per square foot as some building about to fall down The Mill Yard now I'm going to tear the building down but I'm going bit about it when I do it and so really it's your job maybe you got to have electrical tax but it's your job to do things fair and when you take a building that's worth absolutely nothing and tax it the way you do something that's worth millions you might say uh it's not right and you know it's just not right and I don't think I think when you do something ain't right it always comes back to haunt you do you want people say in Bradford County ain't right I mean start with I talk to S Millers all over the country and our tax would be about $95,000 a year if you taed every one more buildings I can tear them down and each time my men has to Cle the mess I'm going to blame it on the County Commissioners when I do it and uh and and some of them pretty big men most of them are big enough I always say I can go anywhere I want to with them come out the other side nobody bother me but I'm not against you know I realize and and I'm really tlor brother Lumber Company is definitely Sitting Duck either way we need the fire department but still a $995,000 a year fire tax is unbearable and uh so it is y'all's job to come up and I don't know why clay elector wouldn't uh pay Bradford County no attention I guarantee if Clay County had have done that they' done it or lway County and so we've already been looked down on our clay electri would have done it that was a fair tax and we're about a $177,000 month lot bills when it's bad time right now probably 20,000 when it booms up so we would probably be around $110,000 a year fire tax I didn't even come down here to fight it because it was fair everybody would pay it including RV parts when they had the million dollar camper they hook up they'd pay it or the mine like the DuPont mine whatever they call it now everybody have to pay their fair share I'm not against fair tax I realize you got to have fire but when you do something that is anybody I've asked I've even asked Kenny Thompson boy did he agree with taxing all them building say with that sill she had he said no and I asked Norah she said no nobody agrees with it so when you start a tax it nobody agrees with you've got to do something different and uh I'm not telling you how to do it that's y'all job I why I don't want to be County Commissioner but anytime you do something when you it's Common Sense can tell you is wrong it always is wrong and it always come back to bite you and I'm sure you know the rich man needs to pay his fair share too and uh and we we could tear all our Sawmill building down and put $4 or5 million Dry Kill in and would have a way lower fire tax and yet have a lot more danger need the fire department a lot more so you know this everybody need to pay the fair share including rich man and y'all need to keep that in mind thank you Mr Tatum um next we have Miss strong my name is B strong post office box 530 ly Florida I came tonight um and kind of like Mr Tatum was alluding to um I pay my fair share of taxes um I pay my 125 uh month a year for um the assessment in the city and the county and I paid the $120 for my trash pickup and it doesn't seem fair to me I can't tell you that I've ever been to the dunk but I paid that assessment now I'm going to have to pay an additional if you decide that you want to assess me for um for the fire I love those guys I love because I want rescued to be where it needs to be when it needs to be if I take my glasses and hat off you'll see that my face is swollen my eyes are swollen I went to the emergency room they gave me something that I don't know what they gave me and I had a reaction so I'm all swollen and if I need those guys I need them to be where they need to be when they need to be there so I want them to be around but I'm being double taxed as it is on trash that's a big bill for me there's one person that lives in my house I don't make enough trash for the one person that I'm paying for let Al for a house full of people but I'm paying for Lord knows enough people for trash I pay it but you're charging me for a lot of people if you put the trash the the tax on for fire I'm gonna pay for that too I have no choice second thing you're entered in an agreement with the sheriff's department where he took over for the city who's going to pay for that the county I'm gonna we're going to have to pay for that too down the road we're not going to be able to afford that but the taxpayers nobody asked if we wanted to take over Stark police but we're going to have to pay for that sooner or later that money is going to come from the taxpayers in this County just the same because we have to pay his budget but nobody came and asked the taxpayers in this County whether or not we wanted to take over for Stark police but we're going to have to pay that and and I have a problem with it thank you Miss strong did I miss any public comments okay thank you you now we're uh agenda item number four is the uh approval of the consent agenda I make a motion to approve the consent agenda have a motion on the floor by commissioner dor second and second by commissioner Andrews are there any questions um all in favor sign I I okay no POS it's below agenda item five is the appointment of Representative to the Swan River Economic Council um board of directors and we did have a recommendation um in our packet is there uh a motion for approval of the recommendation in the packet is she going to continue now there was um a recommendation for um Miss Johnson has she agreed to continue to your knowledge I'm sorry madam Chair say that again please there was um a recommendation for Mrs Johnson and she's agreed to continue there's no recommendation there's just a letter here stating that she currently hold or has held the position previously so if it it could be your it could be your decision to leave her in that position if you choose okay I I would recommend to the board to allow her to continue she's done a good job and has served for a number of years need someone make motion okay I have a motion I make a motion that we continue a motion by Mrs Andrews that we we continue with Miss Janice John Johnson is there second to the motion second second by both um Mr Ric um any further discussions questions all in favor to sign I any oppose is 4 thank you now um item six is the proposals for the opor abatement funding um we'll have a presentation from the Meridian Behavioral Health um Miss Ashley toor is here followed by the um purpose Behavior Health Miss Fatina Ross and Then followed by the bford County Health Department Miss Amy udy and then from the community resource param medicine proposal by Mr Carter in that order so um well welcome um Miss toer is that the correct Miss toer okay and again I when you're U presenting if you speak into that mic so that they can hear you online Okay I I am a little softbook and so make sure that I I stand close here um hello my name is Ashley toer okay is that better um my name is Ashley toer I am here on behalf of morian I am our senior VI Pres president of Medical Services um and so I oversee our mat Clinic which includes uh substance use services and that's what we're going to be focusing on tonight um commissioner Spooner and I spoke some before um I came here today and created this presentation to talk about the amount of dollars that may be potentially allocated to us um that it appears would be around $200,000 and so what I did is created a presentation based upon that and what we could do with that we of course are working with other uh counties within North Central Florida um to spend these dollars and this is just what kind of uh the way the services are going um across the board um in the State of Florida so again um this is specifically for year 1 20124 which is the most amount of money that you all will be receiving and so I am going to do that uh this of course is our site here um I come to find out it appears this has been we've we've owned this for 40 years um in 1984 we acquired the building and to be honest I couldn't find a date um that we actually started services but we have been here for 40 years unfortunately up until this point in time we have had no dollars to provide substance use services so mostly what we do is Outpatient Psychiatric um treatment to include counseling grw counseling and then Outpatient Psychiatric medication management so looking um at an overview of the substance use services that we could uh provide uh we're going to look at some office in office services uh jail bridge program hospital or emergency department bridge program Community bridge program and then co-respondents so our in office services um is it bad that I'm looking back I wonder if I should to the angle and then angle your you're good so um our office services would consist of a counselor an APRN which is an advanced uh registered nurse practitioner and then a peer support um so in these cases an individual would actually come into the office and be seen in person um the way the monies would allow I have um allotted for a part-time APRN and then a full-time counselor and time um to meet that 200,000 is budget so how that would go um is an individual be scheduled to come into the office and they would um first be seen uh to assess for the need of substance use services and what that looks like often time when we're talking about substance use services and more specifically um opioid use uh disorder Services we're talking about mat which is medication assisted treatment so it's a combination of medication and then also therapeutic supports therapy peer supports and so on all working together um and it is required that the individual who's enrolled and engages in all of those um different types of services to be compliant with the program um so from there again they're going to be seeing a counselor to complete an intake assessment and provide ongoing individual and group therapy uh they would see an APRN who would assess for medications medications of course aren't required um you know some individuals going through recovery uh choose to abstain from from medication assisted treatment and that's okay there still is the counseling and peer support uh component that is available and then last but not least would be a peer who is able to provide support resources and referrals and I would see as we would start this program should we be given these dollars that they would be out um you know doing Outreach and engagement in the community um to ual that would be in need of these Services next up is our jail bridge program so um the jail bridge program is something that really has a a lot of um Spotlight on it right now because if you think about it if we can find someone who's in jail while they may have committed a crime um they are alive you know they are there and we can help them at that time and so what we would do in these cases um is at a minimum have a into the jail to educate the individual on the services that we can provide for the subance use issue that they're experiencing the level of services that are provided in the jail depends on the jail desire so at the very least it could be um an individual has an appointment and a contact a bridge if you will for services post relief now we're currently implementing this in the putam county jail and we are going to be providing the full Continuum we're even going to be having our and go into the jail one day a week to see these individuals to start the medications the medications there are three different kinds of medications that individuals um who choose to to use mat can receive that's methadone buprenorphine and Vivitrol and so again any of those could be available now with that being said here specifically in Bradford County we are not credentialed as a methodone provider so if if an individual was interested in that they would have to receive that from our Gainesville Clinic which is about 30 45 minutes away um but we could do um the buprenorphine and the Vivitrol um here in Bradford County uh we also um have a letter of commitment from uh Sheriff Smith here in Bradford County we um are looking at a grant uh that would that's being put out by DCF for jail Bridge services and he did sign a letter of Comm so it is something that um your county is interested in doing and committed to being a part of um should our services be I mean our grant U be awarded and or we be um awarded the money that you all have from the opioid aatman dollar a hospital emergency emergency department Bridge so this would be partnering with local hospitals or in this piece um you have HCA Florida such emergency to intervene when an individual indication is admitted um so we would partner with them and come up with a process as to how they would communicate with us um that this person was there and um needed or wanted to to speak with us the peer would go into the hospital or the emergency department to meet with the individual and educate them on substance use services and what we could provide to them um and then we would bridge to the appropriate level of care which could be detox if the individual um is either a Marchman act or needing some some detox that perhaps the emergency department could not um provide and so that would require uh ambulatory transportation to our detox unit in Gainesville which we would be able to provide that transportation for um or it could be to one of our residential programs um to Services outpatient services here um and whatever we can provide um or further mat treatment again if we're looking at methadone that would be in Gainesville um but I think we really want to focus on offering bu and Vivitrol specifically here in Bradford um and again we are currently providing this service in Alaska in Columbia counties and it seems to be working quite well a community Bridge um I put this in here and then um I remember that I talked with patina um and someone El that this is something we could do and I just included included it because we're doing it in other places but I believe this is something that purpose Behavioral Health would be doing more of um is that Outreach to individuals in their home or other community settings and really meeting the individuals where they're at to encourage um engagement and treatment you know again that bridge to Services um so I'll let fortina speak more about that tonight and then co-respondents um so these are trained staff either counselors who ride along with law enforcement or fire rescue and the goal is to reduce admission to a higher level of care avoid arrest or obtain the medical treatment that they need uh the they respond to calls and then follow up with the individuals they encounter post that initial interaction so in alacha County we actually have a several different teams with GPD and ASO where we have um this happening and they're specifically focused on that um those ride alongs and again being able to follow up post that initial interaction um and it really helps the individual with that you know perceived notion of you know being afraid of law enforcement being afraid to call fire rescue if they're in a situation where they've overdosed because you know I could get arrested I could you know whatever that looks like so this again is another option um those are pretty much the services that we have can based upon how much monies are allocated to us we would just kind of go through that and work with the various Community Partners to make that happen as far as additional funding because of course we're just looking at year one um and again the budget that I had a lot of for this came out to be about $215,000 but of course we want to keep these Services going right we don't want to get them started and then have nothing so merian has additional funding and sources to support ongoing services um ourselves we have LSS Lu services and DCS funding we have store funding which is the state of BU response funds we also accept Medicaid and other private insures and then we could also look at other ways to continue the services by applying for Grants um you know as I mentioned we did the jail Bridge Grant with Sheriff Gordon giving his support for that um and then also um hopefully additional County funds um if we are awarded these opw abatement funds and I know that they go on for about 18 years but of course drastically cut so we would need to pull um from different areas to keep this going but I think if we all work together we can certainly make that happen all right any question any questions any questions okay CH I have a question Miss toer what does your current Staffing situation look like over at Meridian here in in Bradford in Bradford yes yes we have a couple counselors and then we have an APRN who sees for outpatient site Med man Med management um and we have a CMA that would do all of the processing for them to be seen by the APRN but it is quite minimal right now okay do you currently have mental health and drug counseling just mental health just mostly Outpatient Psychiatric okay do you have a mental health counselor that's not currently working in the office like someone available immediately you have one that's out right now like out on leave or are they both full-time right now they're at fulltime as far as I'm I'm aware and I believe they may be doing some services in the school as well okay I think there might have been some concern that came from one of the offices that there's someone that's currently out uh for whatever reason and that that person at this time they can't either backfill that position or you know have any other kind of part time uh because of that person's current situation okay I can I can find out and get back to you okay it's it's a little complicated because I oversee the Med medical services so The Stance use mat treatment and primary care and Med Services so I'm not always privy to exactly what's going on um without patient but I can certainly find out that information and give back to you as to our current Services look like but I can tell you that there is no specific Services focused on substance use treatment thank you any other questions I was just going to ask how many do you see um individuals do you all see I mean per week or so and and so and that's something I fa to mention uh with this Staffing structure and the funding that we've talked about um we could see up to 100 individuals per month how many do you see now well it would depend in Bradford County I can't speak specifically um because there is no subance to services and like I said unfortunately I don't work in outpatient so I don't know um in other places um you know in in alacha we have 1500 um you know in Chapin I think we have around two or 300 it all just depends on the various needs but again with this Staffing structure and the monies that we've discussed we could see up to 200 or 100 sorry thank you all right and you all do have um staff as you mentioned that would be able to um if you had an emergency where someone had to um if they had to do the Marchman act that they would um be those persons that would be able to intervene and do those assessments correct yes okay all right any other questions from anybody okay thank you very much okay thank you all right um and next we have a purpose Behavior Health Miss patina Ross thank you Ashley hello everybody um hello ladies and gentlemen of the board Bradford County Commissioners commissioner Spooner commissioner Thompson and his absence commissioner adultery commissioner reic commissioner Andrews and to everyone present here in the community I would like to first thank you for the opportunity to stand before you today I'm a little nervous but I am filled with a deep sense of purpose and passion for the purpose proposal that I'm bringing to you tonight as my husband said first he came up and talked about purpose behavior and how this has been something that I've been looking forward to and the opportunity has pres presented itself I'm so thankful this proposal is not just a plan but I believe that it will be a be Beacon of Hope in our community in an ongoing battle against opioid addiction growing up in this community attending its schools I'm a Bradford County high school graduate class of 1993 and now working in the community as a licensed mental health counselor I counted a privilege and an honor to serve I have over 20 years working in mental health as a crisis counselor and an adolescent Adolescent and adult substance abuse counselor counselor given that I do work with Meridian I want to put this disclosure out here uh that um Meridian healthcare as a program manager for MRT so we work in crisis response dealing with sub uh with um suicidal audiation or Si or homicidal and so we actually go to them and we rece respond in the schools and in the homes and uh just want to let you know there will be no conflict of interest or competition with Meridian in serving our community as a pro as my program is separate and not related to the services provided but as Ashley just s pointed out we actually will partner together because the services that I'm going to propose tonight we're going to be able to go into the home so we will be able to bridge the gap and so however I do believe that is a added value uh because I understand the people in our community that we serve and want to help make and I want to help make a difference I speak to you not only as a professional dedicated to uh to the feeli of mental health but also as someone intimately equated uh acquainted with the devastating effects of this addiction you never know how bad it is until it affects your life I have witnessed firsthand the damage that this addiction has on individuals families and the entire community and like many of you I have felt the pain of watching loved ones struggle with this horrendous disease in my research I found that in 2022 Governor DeSantis had an Innovative uh initiative uh approach to opioid uh recovery called um coordinated opioid recovery Network called core and I know you may be familiar with that um which is the first comprehensive solution to addiction care in the nation and the results have been positive reduced reducing the number of opioid over overdoses core encompasses a holistic approach treating addiction as a disease this comprehensive approach expands um expands every aspects of Overdose response treatments uh treats all primary and secondary impacts of substance use disorders including coexisting medical um medical mental health conditions many traditional addiction treatments focus on one pillar but with this holistic approach it focuses on so many other that's why it's comprehensive so you're able to go into the home you're able to bridge the gap you're able to uh treat people in a non-traditional way uh many traditional addictions treatment focused on one pillar of care but core encompasses a holistic approach and like excuse me purpose Behavior would like to continue in that approach uh providing an inhome approach where we're going to the clients we're going to them we're C we're going to them to help them to prevent to educate and to treat I would like to make an emphas is on providing treatment in the home like core purpose Behavior uses a non-traditional holistic approach where we will be able to reach those individuals that would not seek treatment traditionally it will Aid as prevention where we are trying to reach them before they need to call the paramedics inhome treatment for addiction um is a service that is not being offered currently in the state of for in the State of Florida uh my proposed opioid addiction treatment program is not just another initiative it is a Lifeline for those who feel trapped in this addiction this program would be comprehensive addressing not only the physical aspects of addiction but also the underlining psychological and emotional factors that often accompany it our will offer a range of evidence-based treatment tailored to meet the needs of each individual who livees Who Lies We Touch most importantly this program will be built on a foundation of compassion understanding empathy as well as a faith based approach we recognize that addiction is not a moral failing but it is a complex medical con condition one that requires support understanding and unwavering commitment to overcome so in response to the pressing need I am proposing a comprehensive one as I said a three to four person team uh this approach combines the expertise of a license or Master's level clinician a care coordinator peer specialist are a mental ad Health Advocate to deliver personalized care and support directly to individuals struggling with opioid Addiction in their homes as well as a registered or licensed nurse to provide medication management and education so the objective of this if you got a four person team three to four person team of approach you have a clinician you have that care coordinator that will provide uh resources be able to go get the resources so the clinician will conduct initial intake assessments to understand the clients's needs challenges and goals develop a personalized treatment plan using evidence-based therapies and relapse prevention strategies provide ongoing individual and a group therapy session to address underlying issues contributing to their opioid addiction monitor the progress adjust treatment plans as needed and provide Crisis Intervention when necessary the care coordinator a bachelor's level uh care coordinator serves as a central point of contact for clients and families coordinating access to various Services as Ashley was talking about miss toer about the services that Meridian offer I work for Meridian and I know those services that we offer so the care coordinators will be able to connect them if they need uh medical assistant treatment and because we'll be in the home we will be able to coordinate those Services the care coordinator they will be able to find the resources that they need providing ongoing individual and group I'm sorry conducting comprehensive assess assessments to identify the additional needs Beyond addic uh addiction treatment such as housing that's what care coordinators would do they will act as a case manager so they will be able to maybe find housing if if that's the issue or uh employment referrals make referrals to Meridian uh for uh mental health counseling um and including primary care physicians detox programs Mental Health Services medication assistments uh Support Services groups this is the most important thing that so many people need that are dealing with addictions is advocacy advocating someone that's going in the home understanding and I know so many like me have family members that have been addicted are still addicted wouldn't it be nice to have a program like this where they voluntarily say you know what I might not go to Meridian the traditional way to seek out the treatment but if somebody comes to you and they say hey I'm here to help you and one of the priority in this population the priority of uh uh people that are dealing with we need to to to get our youth that are struggling with opiod addiction that are on math right now if we're able to help the sist the family those parents where their child have gotten addicted to opioid we'll be able to get that consent from that parent and we'll be able to come into the home and to help that family so we'll advocate for the client ensuring they receive timely and appropriate care the peer specialist provides support and empathetic encouragement to the client based on their own experience with addiction and Recovery offer guidance teach coping skills strategies to help clients manage triggers Cravings as well as build supportive relationships connect the client with Community Resources such as peer supports groups Wellness programs and other p uh positive activities helps the client develop self- advocacy empowerment resilience in their recovery Journey the registered nurse or the licensed practical nurse conducts Comprehensive Health assessments including physical exams medication reconciliation to address the medical needs of clients with opioid addiction monitor V signs educate the client and families about medication management harm reduction strategies and overdose prevention the implementation of this plan how do we get this thing started right so what we do is we recruit thank God I have my ex Pro program manager here buil Levine who is a licensed um social worker um and so I also have a another licensed mental health counselor um that as uh she's been doing substance abuse groups for many years she also worked for Meridian uh she know no longer work work for Meridian right now but I have a wealth of people uh that um that I'm connected to that can really help start something that this may be a pilot program for Bradford County because it's not something that it may be Nationwide I don't know but I do know it's needed so we'll recruit I'll recruit and train a multi-disciplinary team consisting of licensed clinicians Master Level clinician experienced Court care coordinators and peer Specialists mental health Advocates nurses partner with local healthare like Meridian providers like Meridian addiction and mental health treatment facilities social services and Community organ organizations to collaborate and make referrals develop protocols when you going into the home I've been a crisis clinician for a long time okay I used to work in Atlanta and where I was a part of a iffy team and what we did exactly this but we were doing it uh for atrisk Youth and so we would go into their homes a three partner persons team and we would go in as a crisis response I also worked at the uh transition house when I came back in 2017 uh at the transitional house here as a substance abuse counselor um here in Star Florida um and so the protocol of procedure for conducting home visits ensuring the safety confidentiality of both the clients and staff utilizing telea Health sessions when appropriate to supplement in-person visits to continue communication between between teams members and clients and also Implement an evaluation system to track outcomes assess programs Effectiveness and identify areas for improvement since this is a startup thing I just want to put this out there I understand the uh allocation of the the funds that um you know it the dollar amount may be small but I believe if we start off with maybe uh five to 10 families are are our clients we can see how this will help not just Bradford we can see how it can help all of our communities in the St Florida um in conclusion by using experience and expertise of a three to four person team and the home approach we can provide a more holistic accessible and personalized care to clients struggling with opioid addiction uh purpose behavioral comprehensive purpose Behavioral Health Center uh comprehensive treatment program goal is aim to address the complex needs of the client while fostering relationships and collaboration across Healthcare Systems in our community together I believe with over my over with my 20 years of experience working as a crisis counselor in mental health and substance abuse I believe we can make a meaningful difference here in this community towards the opiate epidemic by supporting individuals was on their journey to recovery and wellness thank you for your time thank you Miss Ross any questions from the board all right Madam chair yes commissioner D has the question yes and M Ross so when you said earlier that you will have a team that goes in I know you mentioned there's some folks here that have worked with you in the past so what would you anticipate as far as a team like you know one or two people going in it'll be a three to four person team three to four and then the three to four are like trained professionals yes sir okay that are trained in clinician that will kind of oversee it that's license or Master's level that have worked in crisis response and and going into the homes and then a care coordinator that will be able to provide the recommendations from the clinician they will be able to provide the the recommendations from the clinician they'll be able to make the referrals and uh get the client set up on their way with treatment and then a peer specialist is similar to like a AAA sponsor that's what a peer would be because they are uh usually a peer specialist have dealt with recovery they're still in recovery themselves okay so you said a couple of things that one of them was uh that it's not currently being done in Florida right okay then you also mentioned this being a pilot program as well as a startup program is that right yes sir okay okay and then you also asked the question how do we get it started right that that was the question you asked as far as your presentation it was kind of like a rhetorical one is Sir right no I understand that but um I just I want to bring that up because again you if it's something that's not currently being done and you're considering this a pilot program and a startup you know I was just you know concerned about how I know you said you have a plan of attack on this but you know without this being done and with it being a pilot program just you know what what what would you consider as far as any kind of metrics for Success if you don't have anything you know currently in place yes sir the metric for say is is what I've doing right now as a program manager I've seen it work I've seen it work in Atlanta I've seen what going in the home is just as your Governor DeSantis uh started in 22 with core uh um he's using this non-traditional treatment and he's shown that it does work by providing these inhome Services um this may be something that may not be done right now but that's how things get started it gets started by saying you know what let's take something that another program have been doing like what I do right now currently as a program manager for um for MRT mobile response team we actually do just what I'm proposing we go into the homes if someone is in a mental health crisis the difference is now someone is in a subance abuse crisis so I've seen it work I know it works and um I've seen the results of it myself personally in the community in Atlanta seeing the people that know that they have someone to talk to um that may not have transportation to get to Meridian that may not have transportation to get to mat um so and I'm willing because it's no conflict this is after hours I already have the people that uh have already willing and ready to go so if the money is given we can start running okay and um M Ross I know that you have worked in a similar program but with the youth in Atlanta um so there is um a replication of services that could be rendered um I know in in past um with Meridian not having um the I guess substance dollars it limited what um was able to be provided in the Comm Community is that correct yes ma'am okay and uh it sounds like you have a um a team of experts that could could help Madam chair yes sir so let's say after the first year how do you see this program sustaining as far as funding well um because purpose behavior is Private Practice we also accept insurance so we will be able to also reach out to lsf um I've worked with lsf in the past through another uh agency we work with I'm on the lsf grant right now um through Meridian and so um I want to be able to partner with uh lsf um also we'll be able to use insurances as well any other questions okay thank you Miss Ross um thank you now we have Miss um ra kind of Health Department Miss udy welcome I'm director for the health department in Bradford County um I think the part of the puzzle that we play in this uh opioid funding as far as the settlement is um from the prevention and mitigation uh Viewpoint um we do have two licensed Mental Health Counselors on staff at the health department we do currently go into the braford county jail and provide that counseling we've received substance abuse funding through our fedal qualified Health Center so we are currently providing that service we don't provide mat it's just counseling we don't do medication therapy um but what we do is a lot of health education so from our standpoint it would be more of a prevention and health education campaign that itself can be as large and as small as the funding that's allotted we can do everything from Billboards to newspaper articles to mail outs to education that's provided our hubs and our schools we've done a school assemblies that we've arranged uh it kind of just varies it's really up to the amount of funding that's allotted for that educational campaign so uh we're not really looking at the treatment part of it um we have some great Partners here we don't want to take that on um we would we're more from the uh prevention because while we have substance we definitely have a problem with uh substance use I'm really concerned about the 83 yearold that has an opioid prescription at his house that for chronic arthritis that is taking it appropriately has no intentions to do it any other way but you know people take pick up the wrong pill bottle sometimes and I would hope that everybody in the household that has an opioid prescription also has a Naran prescription that's another service that we give out naron at the health department um I hope it's locked up you know I hope they don't have a four-year old Grand grandchild that's that's some of the concerns I have from doing some of this opioid education so not only do we have those counselors we also um very recently with Chief parter have a agreement that he can we can do direct referrals and we're going to have information exchanged and things where they can PR prefer directly so when they go in those households and see those things and connect them back to us for those Services we I don't have a set dollar amount ask for it's really just as big and large as it can go it canione no go ahead um the when you said the preventative measures is that like an early intervention in the schools do you have something I mean be a health education campaign um we could do we've looked at everything from getting the deta bags that you mail out to every household we got a pricing on that um it's pretty pricey I mean I think was anywhere from 30 to 35,000 for our population that's where you mail a bag to every household they have the ability to dump those prescriptions that are old not just opioids any prescription in a bag mix some water they can throw it right in the trash it just kind of removes prescriptions out of people's houses because we all have medicine there that we got prescribed for something and we didn't need it all or it's two years old and it just happens to be we haven't cleaned that cabinet out so we've looked at things like that we've looked we got prices on billboards um you know we work with the telegraph all the time so we know how much of newspaper articles uh pamphlets handouts uh speakers at the school district we've kind of done it all because we not only do opoids but we do any chronic disease or you know health education is kind of our area so that's what I mean when I say prevention M andw that was my question how much time are you able to spend in the schools and um what kind of resources you have for the schools right for the schools we currently send one of our coun two of our counselors into the school districts um we partner with Meridian they're they're the big player at the school district for counseling but we we kind of just assist a little bit on on because it's a lot so uh we also have our counselor go in there we have an agreement with them um as far as campaigns we have school nurses and we're we're School nurses work for our office so they do health education of just various topics so if this was one that was funded that would be an area that we could them towards we did recently uh first lady d santz had us go in with DJJ and the local sheriff's department to do the facts your the facts your future your future the fact no the facts your future um there were campaigns that did in all 67 counties to specifically talk about about this issue so um it just kind of it just depends on the amount of funding um Miss udy um one of the concerns I have was um the prevention educational materials that could be distributed through the three hubs that you allo operate out in ly and Stark and um now in the Hampton area um that uh information could be shared U through those hubs and then again with the school system and as you look into our community we have uh an increased number of um youth or juveniles that are up using substances and some those result in some fatalities and I think the school district is a a a great partner because you hit a very large number of households for the county um our hubs are a great are great uh Avenue but they are very much in the infancy of beginning um I talked to Anna this week she's over our hubs one of the partners with our hubs and we had about 50 people in three months come in our Hub here in town in Stark and about right under 60 in ly so they're are definitely a great Avenue we definitely would want to put some stuff there but as far as numbers um School District definitely you're going to hit a lot more households that was part of me talking with Chief Carter because he hits a lot I mean he has the potential to hit a lot more households than than we can hit so um I think there's lots of ways that this could go to get that message out there okay any questions from anyone else all right thank you Miss udy um Chief Carter thanks we'll get there and thank you to our it back there in the hidden room back there good evening Madam chair board I'm excited to discuss an initiative that has the potential to redefine our approach to Public Health and emergency response the community param medicine program I'm proposing is a proactive and comprehensive response to the escalating challenges posed by opioid use disorder and substance use disorder within our community these issues not only threaten the lives of our residents but also strain our emergency services to their limits the community paramedicine program is an Innovative and Community centered approach that focuses on prevention education and support with the goal of reducing the incidence of opioid and substance misuse through Strate strategic Partnerships with healthare providers social social services and Community hubs we aim to establish a network that provides targeted interventions I'm sorry that provides targeted targeted interventions ongoing support and resources to individuals struggling with addiction by leveraging the skills and compassion of our First Responders we can extend our impact beyond the immediate crisis response actively engaging with residents to create last Las ing positive change as your fire chief my foremost responsibility is to safeguard the lives and health of our community members opord use disorder and substance use disorder have become critical public health issues and it is our duty to adapt in our approach to address these illnesses I'm committed to transparency accountability and open communication throughout the implementation of this program I welcome constructive feedback and encourage an ongoing dialogue with all of our stakeholders in the folder in front of you you will find a sample of an emergency health record which will be completed on every patient interaction a draft position description for the community paramedic A draft agreement between Bradford County Fire Rescue and our local Health Department as Missi discussed and supporting documentation of how our program exactly meets the requirements of the state together we have the opportunity to Pioneer and model in our community that not only saves lives but strengthens the fabric of our community I appreciate your attention I look forward to addressing your questions and concerns at the end of my presentation this mission statement or one similar to it will serve as a foundational element that will provide Direction purpose and cohesion to our program it will be a tool for inspiring guiding and aligning the collective efforts of all involved toward the achievement of shared goals fostering culture of purpose-driven success our mission is to lead and innovate in the provision of compassionate and comprehensive care for individuals affected by opioid use disorder rooted in the principles of community engagement collaboration and harm reduction our program is dedicated to addressing the unique healthare needs of those struggling with opioid use and to actively contribute to the prevention and reduction of opioid related harm within our community by minimizing or eliminating barriers to care what is C CRP CRP is patient tailored Care Success is built around people care not just patient care the absolute focus of this program will be connecting patients to the proper resources and being the support system they need to overcome this disease we will meet you where you are this program extends Beyond traditional emergency respon response and brings evidence based individualized care directly to the patient's doorstep in essence we are taking the resources provided at the community hubs and placing them in the lap of the people who need them most our goal will be to minimize barriers to Care by tackling major issues such as stigma whether it be the patient's first virtual counseling session or getting them admitted to the res to residential therapy we are with them every step of the way reassuring them they are not alone in their Fight Against Addiction technology let's face it technology can be incredibly confusing and with many follow-up appointments counseling sessions and intake visits being virtual this can be overwhelming for someone whose metaphorical cup is already full something that may be may seem simple to many could be the final drop that causes a person's cup to run over leading to relapse or failure to access the resources they so desperately need our team would have portable Wi-Fi devices computers tablets and phones to assist patients with navigating through apps and web portals and lastly Transportation may be one of the biggest hurdles people suffering from UD face with public transportation being non-existent in our community our team would partner with services such as Swan River Economic Council Florida non-emergency medical transport or even ride share services such as Uber and lift to provide transportation to and from appointments at no cost to the patient you may find yourself asking does Bradford County truly need this type of program according to our bcfr database and keep in mind this does not include the data from our future Partners in 2023 we interacted with 110 patients who admitted to illegal drug use we administered Naran 63 times in 2023 meaning that without intervention these overdose patients would have most certainly been fatal according to the state department of Health's most recent data there were eight overdose deaths in 2022 in Bradford County also in 2022 there were 66 drug related non-fatal emergency department visits and lastly in 2022 there were more than 4,300 patients over 15% of our population prescribed opioids in Bradford County which exposes each of these patients to the possibility of accidental overdose if not properly coached on how to manage their medications one of the main issues facing 911 services across the country is the utilization of EMS and the emergency department as Primary Care often times people suffering from UD are unaware of the resources available to them or if they are aware they're reluctant to utilize those Services due to the stigma surr them so when they're in need of assistance they turn to EMS and the emergency department for health this starts the no option cycle with this repetitive cycle a person begins experiencing symptoms be it side effects from drug use withdrawal or otherwise the patient or bystander calls 911 pcfr arrives on scene evaluates and or treats the patient and at this point the patient may be better served by an UD or sud treatment center but legally our only option is to transport the patient to the emergency department or they can refuse care so the patient is transported to the emergency department where they receive care for their immediate need keep in mind mind the primary goal of the emergency department is to treat acute illness and symptoms they may or may not receive a flyer or pamphlet uh I'm sorry they may or may or may not receive a flyer or pamphlet for addiction resources upon discharge they're eventually discharged home where they receive no follow-up care due to one or more contributing factors as a result of no follow-up care the patient eventually begins experiencing symptoms again and calls 911 thus creating the repetitive cycle Bradford County is certainly not immune to the high frequency 911 users stuck in the no option cycle I would like you to keep this next fact fact in mind as we move through tonight's presentation according to the 2023 Florida EMS cost report the cost for Bradford County fire rescue to run one EMS call is $730 we looked at our most frequent user One Singular patient who called us 54 times in 2023 responses to this one patient cost our service $ 39,42 we expanded our search criteria and looked at patients who utilized our utilized us more than 20 times in a 12-month period of which there were nine accounting for 235 calls for service converted to do converted to dollars are repeat responses to these nine patients totaled $7,550 and lastly we took a look at patients who requested our service more than 12 times in 2023 essentially once a month 30 patients used our service more than 12 times in one year accounting for 617 calls for service which equates to $450,000 I'm sorry 4504 $ 45,41970 Library of Medicine people who suffer from UD and sud in the United States have a higher probability of being uninsured in 2023 we transported 279 uninsured patients and we build those patients for a total of $249,300 197 build we received $2,057 in payments this equates to a 0.8% collection rate for uninsured patients it is a high goal but if we can reduce calls to our repeat users many of whom are UD and sud patients by 55% that one achievement alone will save Bradford County $247,700 a cycle instead of Simply transporting the patient to the emergency department CRP intervenes and provides alternative solutions that will better meet the needs of the individual and the issue of no follow-up care is completely eliminated by our program we will focus on Guiding patients to resources that will address the root of their disease not just treat the acute symptoms not only will we guide them to those resources but we will also arrange virtual sessions in home care and even transportation to and from treatment let's talk about counseling and treatment options UD and S is not a one-sized fits all disease no two cases look the same and this means that the treatment of the these patients will need to be tailored specifically for the individual as well there are 84 UD and sud treatment centers within a 50 mile radius of raford County with Transportation needs being addressed within the Strategic goals of our program why would we not give these patients every opportunity to find a treatment center that best suits their needs additionally we would focus on building robust Partnerships with the programs within a 25 mile radius of raford County let's explore how a patient becomes involved with our program call statistics our initial subset of patients would be the 30 individuals who used our service more than 12 times in 2023 They will receive screenings to see if they are currently or at risk of becom UD or sud patients additionally all UD and sud related calls will be flagged and those patients will be evaluated by our community paramedic [Music] self-referrals uh individuals struggling with substance use disorders May volunteer uh voluntarily seek the help and refer themselves to the CRP for assistance fire rescue our Personnel who encounter individuals with substance use disorders during emergency calls May refer them to CRP for followup care and support law enforcement deputies who encounter individuals involved in substance related incidents May refer them to CRP as part of a community oriented approach to addressing substance abuse and a few others to mention emergency departments Primary Care substance use treatment centers mental health professionals and one of the three Community hubs in addition to our team being on site at the community hubs professionals working in community outreach roles such as Social Work social workers or public public health workers can identify individuals at risk of or currently experiencing substance use disorders and connect them with the CRP Community org Community organizations family members and Friends schools and educational institutions teachers counselors or School nurses May identify students or parents facing substance related challenges and refer them to the CRP and lastly pharmacists pharmacists who observe signs of substance abuse or potential medication related issues May refer individuals to the CRP for further evaluation and support establishing strong communication Channels with these referral sources is crucial for the success of the CRP program collaborative efforts with health care providers Emergency Services Community hubs and other stakeholders can ensure a comprehensive and coordinated approach to addressing substance use disorders in our community it will take work to build the needed relationships with the referral sources but with a full-time employee whose sole responsibility is to make this program as success it is most certainly an attainable goal as a matter of fact in the nine days since this idea was first proposed we've already established a graft a draft agreement with our local Health Department which is in your folder for review what services will our program provide and these are just an an initial snapshot of what our team will offer to those in need Outreach and education Community workshops training sessions on substance abuse and prevention distribution of informational materials and resources about the danger of of substance use we'll Target schools community centers and other public spaces preventative care we'll we'll schedule home visits for atrisk individuals and families for early intervention and education we'll have screening programs to identify the individuals at risk of substance abuse and distribution of Overdose prevention kits including an lockone training treatment navigation medication assisted therapy support assistance with connecting these individuals with healthcare providers for medication assisted therapy follow-up care and monitoring for those individuals who are undergo undergoing medication assisted therapy and education on the benefits and risks of ma th harm reduction Services mental health support Community integration peer support data collection and Analysis telea Health Services Transportation coordination free Narcan distribution utilizing Florida's Heroes program we will provide free Narcan for public distribution throughout braford County these offerings will be a baseline for this program and quite honestly whoever is placed in the role of the community paramedic will have my full support to EXP additional service offerings above and beyond the ones listed above due to the termination of the library to go program the library has generously begun the process of transferring the bookmobile to fire rescue in an effort to support this program a portion of our operating budget will go towards refurbishing the bookmobile and creating the County's Community Response Unit this unit will be on site for all special events events such as fairs festivals and Community Hub days to offer a safe space for patient intake and evaluation Services additionally this unit will be used for potential programs such as Narcan Thursday where we will park the unit in a public place and provide free Narcan as well as UD and sud education essentially the community spon Response Unit will be a community Hub on Wheels delivering services to all areas of Bradford County we will explore explore creative opportunities to partner with organizations such as our local local Health Department to take their substance to counselors on house visits with our community paramedic the cost of which will be covered within the CRP operating budget additionally we will tap into resources such as the LPN program at North Florida Technical College and the UN University of Florida's Health disparities research and Intervention Program to function as interns to give students A New Perspective of inhome prehospital care in addition to our standard data that we collect on all calls for service we will also track many other performance measures including engagement rates 911 call reduction screening and assessment referral and access to treatment Narcan distribution and usage preventative care and education tele Health utilization collaboration and Partnerships cost Effectiveness and sustainability our CRP program absolutely checks the boxes in the program folder provided you will find schedule a and schedule B from the state's list of approved funding uses and core strategies there's a check mark next to all items that are addressed with RCP program our year one expenditures be salary benefits for the CRP a response vehicle for the CRP a response vehicle for the training captain upgrading the bookmobile to a community Response Unit all ALS equipment needed it needs advertisement costs and partnership with our local resources Madam chair and board the potential impact of this initiative is significant not just in enhancing enhancing emergency response but in proactively addressing the complex challenges of substance substance abuse within our community this program represents a crucial step forward towards fostering a healthier safer and more resilient Community the dedication of our paramedics collaboration with healthc Care Professionals and the integration of innovative Innovative strategy strategies will undoubtedly make a meaningful difference we believe that by investing in the well-being of our community members we are not only saving lives but we are also contributing to the long-term prosperity and vitality of our community your continued support is invaluable as we dri to make a positive impact on the lives of those affected by substance use disorders as our County slogan says it's better in Bradford let's make that More Than Just Words and do the best we can for those suffering from opioid or substance use disorders with the funding available from the state we have an incredibly rare opportunity to fund this program for up to six years with a minimum program with a minimum operating budget of $40,000 at no cost to Bradford County taxpayers as a matter of fact Bradford County will undoubtedly see a savings in the provision provision of Emergency Services by reducing the number of high frequency 911 calls I thank you for your commitment to bettering this community and I look forward to the positive transformation this program will potentially bring to our County if there any questions or further further discussion I'm more than happy to address them at this time I got a question sure so so Ben how much money again is Bradford of getting this first year this first year I that up just a commissioner R um I couldn't hear you what was your question I'm sorry yeah just and I remember looking at it in one of the meetings we had but it wasn't it around 300,000 something like that well and yes sir 321,000 right yes right okay and then I see elota counties getting 2.1 million yes all right but but at the same time you're telling us without any extra cost to the county period for six years that we can do this the same program you just proposed and and again I'm all I'll I'll just go ahead and say this now if it's okay but you know I'm I'm all for supporting Meridian and and we do support Meridian um but also I believe it was in our last meeting when elasa County came and gave a great presentation they're already fully funded before this even money even started coming in so what I'm saying if they're already fully funded and they get 2.1 million there's plenty of money that they could you know give to Meridian or anybody else if they're already funded and and make no mistake when I when I'm talking about these Partnerships in this program those Partnerships be will be with programs like Meridian or purpose Behavioral Health I mean that's that's what we will do is is partner with those out you know reach out to those programs and again the health department we already have a great relationship with them um those are the things that we will do with this program is explore other options to where we're not just locking somebody into exploring one one treatment center or one treatment option um again there's there's 84 within a 50 54 mile radius um that's the fact yeah and and also you know I've always noticed that if a police off officer shows up at the door people are a little standoffish but if a firefighter shows up at the door they're welcomed in and um so I'll say that's that is what we do right that is something that you know we have there there are very few um jobs or very few uh careers that you can enter into where you know it it is inherently that we have that public trust but we have to establish that trust with that person within a matter of seconds of getting on scene mhm it's something we're trained to do it's something that we do every single day as we go into these people people's homes and they have that public trust or the public has that trust for us that when they call 911 we're not going to go in there and and you know take anything from their house and I'm not trying to indicate that anybody would ever do that you know going into these homes but again it's just a known thing with fire rescue that they can trust us in this community right and I understand what you're saying and and our police force does a great job Sheriff Gordon Smith does a great job but I'm just saying saying if somebody's overdosed and they got drugs in their house they're they probably don't think they showing up I'll tell you that they don't want to go to jail they want to go to the hospital we don't carry HS right there's that right so that's all I'm saying is that just makes it a little more attractive where people would open up to you all I believe a little bit more than they would anymore and I think we have a unique perspective of being able to capture those patients you know that that a lot of patients wouldn't or a lot of uh may not even show up at a community Hub or or a resource center um this happened literally just last weekend where we had an i11 call for a young lady who was uh was U unresponsive in the ditch and somebody drove by and found her on the side of the road and started CPR on her and when we got there we administered Naran and she started breathing again and and we transported her to the hospital she's one of those patients that will go to the hospital she'll get a pamphlet up on discharge and she'll probably never see the inside of any kind of treatment center or any any kind of uh you know Counseling Center that would be a patient of ours that we would absolutely go knock on that door and say hey we just want to come check on you see how you're doing how can we help you we don't want that to happen again right if you don't want our services here's some Narin let me give you two doses of that keep that with you and give one to your significant other so that way if this does happen again you don't die thanks well I just wanted to say I think that everyone here like you said um has has ideas alike I mean you're in the same business what better person except for the or with your staff reporting to these calls and um with us saving the money on that on those calls that really I mean makes a big big impression on me um I also know that that you would work with these other um groups and individuals to um to bring this about and with Ela County coming and telling us what a great success they've had I just um I think it's a great program that you put together thank you very much M you had some more questions for chief chief Carter sir um you know I I think this program makes a lot of sense because from an auditing standpoint as far as you know you being a department in the county um you know we are you know going to be looked at by other councils as far as you know where this money is being spent is it being spent u in for the intended uses of it um my question uh to you is and that was just a point I was making but my question to you how often could we expect you to report back to the board as far as you know you keeping up with uh the number of calls that have decreased and where we are and and and where we are as far as a um you know from a number like a budget standpoint and and what it's saving the county and the taxpayers absolutely um I would I would mandate this be an annual annual report from you know that Community paramedic whoever's in that role um you know provide provide that annual report and we would present that and I think again this this funding uh extends out to six years again still allowing an operating budget of $40,000 or greater um out to six years and as I said last week if this program is not a vital service within our community and this is not something that people are truly relying on and see as a benefit uh then the program needs to go away and again you got my full uh you know commitment to to being transparent and being upfront with you all as I believe I have been in the past so I think it is a a beneficial program uh to our community and a lot of uh a lot of departments are doing this throughout the state with it with this funding specifically thank you Chief Carter I guess I have a bunch of questions sure um how would you U provide the clinical assessment when you take you're making a call in the community are you employing um licensed clinical persons that accompany you on each call uh no ma'am so what would I mean those would be the type things where if we get a 911 call we respond out we send out our community paramedicine or our community paramedic they would arrive on scene and then we could schedule a time either with you know immediately we could do um an on-site evaluation which is done through the uh the U sasma website I believe it's the acronym but um you know they have they have those uh evaluations there that we can absolutely use to see if this patient is either a current substance user opioid user or um is at risk we also would offer those teleah Health Services to where we would have those Partnerships already built to where if we had someone who was truly in crisis we're not leaving that patient we're not going anywhere until we get them to the places they need to be um but that would be you know those evaluation Services would would either be done um you know by our Personnel on scene initially to say you know they are not there's no evidence of substance abuse there's no evidence of any kind of at risk substance abuse um or yes there is unless get them on a tell Health call with with someone who is you know able to do those those uh official evaluations okay he wasn't asking that when I served as a a a clinician here min many years ago we went on the calls with the emergency Personnel or met them at the hospital or you know went with the Sheriff Deputy to do an immediate assessment at that time and then make the referral so how if you determine that the person uh were needing treatment um locally where would you refer them well and again those those Partnerships will have to be will have to be built I I honestly don't have all of the resources listed in front of me because quite frankly put this together in in nine days um but again we would partner with the health department partner with Meridian partner with all of our uh you know local resources but additionally partner with um you know outside resources from outside of our County as well um to get those those patients to where they need to be those Transport Services would either be handled Again by any of the number of services that I listed or again it could be something as simple as calling an Uber or calling a lift and getting them to the to that place and US following them over there making sure they get there safely and they actually walk through the doors of the of the treatment center okay and um the other thing if they're needing the outpatient services I know in an emergency situation they're going to either go to um Meridian you know to Lake City or if their youth uh or in Gainesville to go to those places um but when they're needing the out patients Services locally how would you help in that regard so again those would be our our the outpatient services are you talking about like follow-up care and things of that nature right so we would schedule those tele Health Services um let's say that they have a follow-up appointment with the doctor's office here in town will be there at their house to make sure they're up at 7: am getting in the truck and going to to that outpatient service if they don't have a vehicle or don't have a driver's license which again a lot of uh UD and Su patient sud patients do not um will'll get that transportation to and from those doctor's appointments at no cost to the patient okay one of the most effective uh modes of treatment for substance abusers is a face Toof face Telecom tele medicine is not a not criti but not an effective intervention for substance abuser they manipulate their way way out of that so that that would be a concern with the focus on just the tele medicine and I know it's a it's a um a service that is offered for medical services but in braffett County we've never had U true you know self distribute funding locally to treat people here without having to transport them far to Gainesville to Lake City but this is an opportunity that we have that we can provide in brafi County I know that in looking at the funding up there the 321,000 is through the managing entity of lsf but Bradford has an additional 130,000 that's inhouse that has nothing to do with that I did hear um from the elat county that you presented last um week that program is fully was fully funded by the city without Ard a b M funds um though they have access to some they didn't take away from that Gainesville have a population of over 230 some thousand but they probably have 30 um I'm maybe exaggerating a bit but different types of treatment including your VA and shans and inpatient outpatient housing different programs that braffett doesn't have um so their funding would take care of all of those different entities um and of course they can provide for Meridian but this is specifically for use in Bradford when I look at the um opiod abatement goal is to expand the ab availability of treatment and then to me it would be important to provide the treatment locally um and to support any evidence-based um services that here to uh asthma so we're looking at how we measure that and show evidence that this is being affected the other um goal was to improve um the oversight of the the treatment for opiate add addiction and then to provide you know wraparound Services when I look at the three hubs that we have in BR in braford County our health department the Meridian the um um purpose Health all of these um I say all the few services that we do have we have a unique opportunity here for the first time ever so that we are not limited to one form of intervention I um applaud you for um proposing a par medicine type program but the county needs more than that so we have an opportunity to have all of the programs that have been presented here tonight and still have what your suggesting I'm suggesting to you and to the board let us do the right thing by the funding that is allocated to the county so that we can help all of the people who needed help you're going to have some people who will not go to traditional treatment some who will not um respond to as the parent medic so you need people from different aspects um but they may accept someone going enter a home but they may not go over to Meridian so we need to capture all of the aspects of treatment and we can do that with the funding that we have here and the funding that we have with the county that is the best that that is a win went for everybody um and if we did that we would be doing right by the funding that is being allocated to our County um their priority was for medication assisted treatment coordination of the um opion U Bridge um Hospital Bridge programs peer support recovery uh Community organization so when we put that together it's not a one type of service for everyone but with all of the various um programs that are presented tonight we can do all of it and I guess I'm asking you to be supportive of that concept but it would still allow you with the $130,000 to still do what you wanting to do but at the same time it doesn't take away the funding from Meridian or purpose or from the health department to do their part as well so we have to collectively work together that effort and I guess I'm asking the board to support that effort so that we will have a a well-rounded wholesome intervention for opiod addiction that we've never had before completely understand I the the 130,000 um that's that's the state funding um will not uh you know purchase cardiac monitors ALS equipment and provide for a full-time employee in that position I I discussed this I believe a little bit last week but um for this program to really be successful it has to be a full-time person in that position it's it's not something that could be added to the duties of someone who's already on on our our payroll um you know that is something that would have to be a dedicated full-time person to this to this uh effort so while I agree with you 100% I I think that we should absolutely support every effort that we can to to this problem um that 130,000 won't sustain that that full-time position and I did hear um I think from Dr um from Mr seor you know the um Meridian person or clinici um could be one of those persons um you know that assist to went with you guys and that would be a cost from that group not necessarily from the funds well and that was my thought right if we were going to to send out you know schedule a time where Meridian does go out with us or the health department their counselors do go out with us and we pay for that we pay them if it's you know $100 an hour to bring their counselor out we pay them that that fee for that time that we use them if we find that to Be an Effective uh you know mode of treatment then we utilize that more often um and that's where that operating budget would be you know flexible and and it would have to be um you know on on a trial basis as far as building this program but we don't really know what uh you know as far as what kind of impact it could have without without digging more into it and and getting that uh that plan in place and those Partnerships in place right and essentially as um um commissioner dor had mentioned with what purp it's a more of a pilot that you would be trying to see if that could be working with that could work for barford County so I'm merely suggesting to do a part of what you're asking but at the same time allow for a well-rounded um treatment intervention from the other agencies Madam chair and chief Carter I don't think you were suggesting taking funding away from anyone I think that um You' also mention that you would partner you know with these other agencies so um you know I wouldn't I wouldn't have any concerns about that but uh that's just uh you made that point and I just want to emphasize that uh that's where we are right now and as far as you know funding and you know with the health department and with Meridian um you know uh Miss Ross mentioned behavioral purpose Behavioral Health U you know currently you know taking insurance and you know things like that so again I I don't see you pulling anything away from anyone but I do see your uh willingness to partner you know with all the agencies so again I'm I'm in support of your your program because uh again I wouldn't call it a pilot program because lch County came in and they showed you know exactly how their programs run so there's there's over 50 of these programs across the state that that are proven to be successful programs um you know but but as you said we're certainly not trying to to you know deviate funding from anywhere else um divert funding from anywhere else but we we certainly want to build those Partnerships with these with these Community uh resources and and and get people the access to those resources the problem is you know with the community hubs how do they get to the community hubs how does that information at the community hubs get to that that person um and again we we meet them where they are we go into their homes already um and and that's just I think that's the missing link with with Bradford County is that we've got to get that information that is in those Community hubs into the homes of the people who need and the most critical piece is the followup um and the the intervention fees um so while um commissioner D that you not trying to divert any funds but if you encom the 321,000 that would take away all of the lsf funding um and then plus the 130 that the County holes so that would take away all of the funding um are I guess I'm going ask are you opposed to having our local um mental health to be able to provide substance um treatment so that people don't necessarily have to go out of town oh don't not not at all certainly want my my heart is for this community and to to make sure these people are taken care of and they get the best care possible my question would be how is it sustainable okay our program is is absolutely sustainable and that's again that's just with funding from the the opioid batement fund right the the there's state grants out there you know they are looking at legislation for uh being able to build for these Services eventually but right now this is a free service that that uh Services across the state are providing to these patients okay um the other thing was that um if um you're you're providing that your Pam medicine service um I know that you had I guess like about 48 calls that were possibly opard related type of calls um but when you look at the other piece of the missing piece of the people who who don't call yeah and and that would be addressed with those referrals right so so the hospital is upon discharge um if they get someone who is you know a general illness because they're starting to have withdrawal symptoms uh our community paramedic would go to the hospital interact with that patient establish a relationship with them um and then when they get discharged instead of just getting a pamphlet they're going to get Naran they're going to get access to our program um same thing with the jail right if they go uh if it's somebody who is a a drug user suffers from UD or S sud is getting released from jail and you know as soon as they get their clothes back their street clothes back they're going to have two things of Ouran sitting in there with it I obviously these are things that are just ideas I mean this is something that we've we've come up with um in a short amount of time that that again I it it is exciting to me to think about what a person fully focused on building this program could do in this position um and it certainly has to be the right person as well so that's that's program success is very dependent on who would be this Ro but those are the type programs that we're that we're looking at and um you know trying to connect the missing pieces in the chain of of this battle against you know this disease for your paramedicine person what is that annual salary so I have the breakdown uh see and it fully depends on who is actually put into that position um but as the as the general uh numbers for this program we took zo in a little bit y see that up my poor eyesight so what is the salary for that one person initial starting salary for that position would be 64,000 and that is uh a lieutenant within our department somebody is already working for our department it would be a promotion for them to go into that role um so that is our average uh annual I'm sorry average hourly rate and then it's uh a 6% increase for promotions in the town and the promotion piece of that is because of the fact that if this person is going to be on scene making transport decisions for this patient we want them to be able to have that authority to have that decision-making Authority and this just gives you a breakdown here I've kind of color color coordinated everything but um you can see here that year one if we look down here at the bottom I'll zoom in on that a little more so year one this is the lsf funding this is now this is a little bit uh confusing because this is is years one and two of the city and county state funding um so this is last year we did not spend this was left in the account this is last year's and this year's funding combined is 131,000 from the uh city and county state fund and then from lsf is a 321,000 so the total available is 452,000 I'm just going to use round numbers um salary benefits so that's the full salary benefits package of that uh community resource paramedic position is $1 19,32 and then that would leave $333,000 left over for operating budget and that would include in this initial year of equipment purchases uh you know those advertising costs and things to get the program actually started Madam chair Chief Carter you mentioned the six-year program and then we talked about the one-ear reporting back as far as the effect effectiveness of this program right um if the program were to fail do we pull the rug out from under it at the one year or do we wait till the six year uh I would say probably give it two years I think after two years we should have enough data and evidence to say this is a successful program and we're making change or we're not okay I would I would defer to you all that well we talked about two programs of one year six year I but mention in the two I would be okay with the two-year but uh certainly not six and then but but have something after uh you know a short period of time right and my thought behind the six year is just saying that this six years gives us enough funding from both sources of of the opioid funds uh to sustain this position again no cost to dord County taxpayers um and leaving a $40,000 operating budget for that role okay so Chief Conor you are aware of the reporting requirements under the lsf funding entity so we have we've confirmed that all of our uh emergency Health reports or health records that we do um automatically fall into that uh reporting requirements if you ask uh the Attorney General's office or if you ask lsf as far as the reporting requirements go they're very loose and very broad right now but they've assured us that are what we already collect in addition to the data that we're going to collect with this program I said is is more than adequate uh for what they're looking for okay and it's separate from the funding requirement that the county has which I know starts I think June is it June of this year um the way the statute reads there is a require a reporting requirement in pal the plan will be implemented June and then in August of any expenditures right but they don't actually have it broken down as to how as to what's required for the data collection it's it's still they're working those uh DCF is working through those those issues right now of the exact metrics that they're looking for but that's not actually outlined anywhere yet okay um I think you'll find that lsf does have some reporting requirements that are broken out but again um I've asked you some poignant questions um but again I have to emphasize to to the board that we have an opportunity to provide a broad array of services here in brafi county and I implore our board to allow these uh agencies to be participants and recipients of the LSS funding as well yes ma'am and my my goal here tonight was just to present you with an option so it is it is your decision Mr what we do this F any other questions for me question um yeah um and let me just say this all four prop proposals tonight were excellent I I thank you I thank every every one of y'all thank you back there all all all four proposals were were awesome um but from listening to all four of them four of them and um from what I'm hearing can see and it seems to me like the best benefit to the actual citizens of Bradford County would come with your proposal that you just made now simply because you're there right from the start you're the ones that's going to be going and picking up these citizens and taking them to the hospital or nor cam whatever they need you're going to be there right from the start you're going to see the patient and um like I said all these proposals are excellent proposals um um but but in my mind I really believe the one that would benefit our citizens the most and be more Hands-On than any other program and also with working with all the other ones would be the one you just presented tonight and um and with that if you want a motion I'll I'll make a motion to move it forward well I haven't asked for one but I will just just now but I also want to employ um Chief Carter I know that we're in a unique situation and trying to seek funding for fire fire rescue but I want to be absolutely um clear that the funding intended for the opior baitman is not to address the funding shortage in our uh rescue agree okay and that it is supposed to be specifically for opot intervention yes ma'am only um no that's not it but I'm asking for a motion to support all of these agency's request for the op or addiction funding including Chief Carter I'll make a motion to um to support the uh proposal that we just was read by Chief Carter and uh that would be my motion for that to be our sole source is to the proposal that Chief Carter has presented now second motion there's a motion in the floor by commissioner reic and second by uh commissioner door did to support Chiefs Carter's um proposal for the opot abatement funding and I I just for the clarification of the motion are you suggesting all of the funds in all categories yes all all the funds whatever he needs to get it started but also like commissioner do said I would definitely like some follow-ups and especially uh annual reports and in two years if this is not working we need to move in another Direction and that's that's my motion okay there's been a motion and a second on the floor um any further discussion um I do I have to throw it in there um that it's going to be important that the funds are appropriately used and to wait a year after or two years is it's too long of a period to evaluate whether something is working um and the reporting requirement is certainly going to be sooner than a year so you'll know in a few months or six months uh or up within that first year that it's not working okay Madam chair I think uh commissioner rck in his motion said two years yes two years but but but also uh Chief Carter said the first year he would give us an annual report and tell us how it's moving forward if I commissioner um and I I would strongly suggest that you did as you had said that you would and hiring the counselors and everything from the other units or from the other um entities here tonight I I didn't think he said that yes he did yes that you would hire them he would hire not but you wouldn't be hiring them yes that's he's saying not hire them pay them I apologize you said that you would pay a counselor $100 to respond to that to a call with you okay what what my statement was is what that we would employ their services right so Health Department uh be it Meridian counselor whoever it would be um you know pay them whatever their hourly rate would be to respond out with our community paramedic um to house calls or or house visits right but not employ them as an employee of Bradford County correct I'm sorry I I didn't say it as well as you Mr Carter all um the motion and a second is on the floor are you all ready to vote all in favor of the motion by commissioner redit motion by the sign I I I and nay um my vote is no okay okay all right uh moving on to the clerk's report we have nothing report Madam chair just keep in mind budget Seasons upon us that be here in deadlines about three and a half months away Sheriff I don't see anyone on our County managers report Mr Mr corn thank you madam chair uh uh at the last meeting uh you reviewed a draft of the um updated and uh amended board policy um we we've got the final version in front of you for approval we would need some yes and uh the change suggested changes have been made and we would like to ask for a a motion and a second for approval and a vote I make a motion that we approve the amendments to okay there's a motion on the floor by um it's okay say that again I do too approval of the amendments to the Bradford County Board of County Commissioners and that we adopted as it is motion by commissioner um Andrews to adopt the amendment to the Brea County Board County Commissioners rules and procedure and that was second by you commissioner Ric okay any questions discussion all in favor by to sign I I four um that's all that's all I have Madam chair thank you okay and the um County attorney Mr Commando you know just briefly Madam chair um I just want to let you know as you know our Law Firm is the County Attorney um for some of the Tuesday the first Tuesday meetings I am most likely going to have a schedule in Conflict so you may be seeing my partner Rob Bradley attend to some of the meetings but we talk about everything that works with Bradford County on a more than weekly basis so I'm confident that you shouldn't have any problems if he has to sit in if I'm having a conflict but if you have any questions I'm still your contact you can always just give me a call thank you okay Commissioners ready I just want to say one thing I thank everybody for being here tonight and uh I know a lot of you all are concerned about the assessment just like I am I I got to sit up here and and and take the shots so I I'm definitely concerned um I agree with you Mr Tatum the um the franchise fee is by far the most fairest tax that we could do but um unless yall have some pool with Clay Electric our T are tied we and we did not um we did not pass it on Florida Power and Light because it it was wasn't fair to pass it on one and not the other but um but like I said that would that would definitely be the the fairest tax there's no doubt but at the same time I I also know that we have excellent service in in Bradford County for fire and rescue so we have to do something um the only I will tell you this the only thing I'm hoping with this assessment that we can definitely lower the millage rate so people that are paying high taxes on their property taxes that we can lower that maybe help offset some of it uh and also I I haven't even seen the proposal from Mr Olive yet so as far as your buildings and stuff I I really I don't know Mr Tatum until I see what he's proposing to us Mr Tatum I'm sorry um this is reserved for the commissioner's comment and then Mr R could speak with you afterwards and I'm sorry I shouldn't have mentioned your name I apologize but but um but anyway that's the one thing I I just wanted to to to say and and again I thank everyone for being here tonight Mr D I don't have any comments commissioner andw yes I do and um it's along the lines with Mr rdick um I have been out to The Sawmill and I have saw the buildings that that um being talked about tonight and I I totally agree it's ridiculous that we would um put attack on those there's nothing but a cover I mean there's polls like a little shelter it's not a building and so just so you know Mr cor and I have had a discussion about that very thing and um and I did Express that I hope that we have some sort of room where we can talk about adjustments on situations like yours um another thing on the clay electorate Mr cor and I called for a meeting they um finally gave us a meeting we went in spoke to them and I will share with you what they told us that their decision was based upon um the survey that they sent out um that it belongs to the people and the people didn't want it and so that's how that happened but um like Mr rck said this is a very hard thing for us we know it's got to be done and I promise you that we are going to try every way we can to make it as Fair as possible um we do want to lower the property taxes and we hope that in some method of doing this will allow us to do that also there was one other thing that I I kind of wanted to clear up um about the transition from the city police to the Sheriff's Department the county was not involved in that um it was a proposal made by the city to the sheriff the sheriff explained what he could do it for and it was done in their meeting the county had nothing to do with that we we weren't asked and we didn't vote and um so just to make sure that you understand that was not a county decision but again thank you for being here thank you for voicing your opinion because it does mean a lot to us it gives us something to look at work from and um I hope you know that we do have your best interest at heart so thank you for being here um I'd like to um thank everyone for being here and particularly um Meridian uh Behavioral Health and purpose Behavior Health the health department um I make a public apology to our community to brafi county for um our County missing the boat here and doing the best and maximizing the use of those funds for our local community that's my apology to you and to the community uh I hope the day will come when we have funding that we can fund our local agencies who are providers of the service but I do thank you all for coming and presenting your proposal and uh I look forward to your your con continued service with within our community and with that um if there's nothing further um this meeting is adjourned