e e e e e e e e e e commissioner fleser good morning we're going to go ahead and call the Tuesday June Kim is not on you turn these on there it is okay we're going to go ahead and call the Tuesday June 4th commission meeting to order we'll start the meeting with a moment of Silent reflection for our First Responders and members of the Armed Forces that'll be followed by an invocation by Leslie Swan our lovely supervisor of elections and followed by the Pledge of Allegiance by Bill de braw County attorney if everybody would please rise Lord God creator of Heaven and Earth we paus at the opening of this Gathering to give thanks for all the blessings which you have provided us individually and collectively we thank you Lord God for the freedom to meet together and discuss the needs of our slice of paradise here in Indian River County Lord we thank you for those who have a willing heart to assume the responsibility to lead and direct the Affairs and business of Indian River County and to serve in the sacred public Trust of as commissioners James 1:5 States if anyone desires wisdom let them ask of God and he will get give it we ask that you graciously grant our elected officials wisdom to govern amid the conflicting interests and issues of our times a sense of welfare and true needs of our people a keen thirst for righteousness confidence in what is good and fitting the ability to work together in harmony even when there is honest disagreement and personal peace in the lives and joy in their task we pray for the agenda set before us today please give us an assurance of what would please you and what would benefit those who live and work in and around our beloved County please be with our First Responders and our military serving our country we ask all these things in the name of our Lord and Savior Jesus Christ amen amen I pledge allegiance to the flag of the United States of America and to the Republic for which it stands one nation under God indivisible with liberty and justice for all all right all right Commissioners um the only addition or deletion that I need to make is item 5B which is a proclamation honoring Roger Harrington on his retirement I understand that he's not feeling well and is unable to be here so we'll make sure he gets a copy of of that other than that are there any other additions or deletions Madam chair move approval second we have a motion and a second all in favor opposed motion carries and with that we will move on to proclamations and presentations we do have a proclamation honoring David May on his retirement from the Indian River County Sheriff's Office this will be presented by commissioner flesher and thank you madam chair uh there is David may my former colleagues people come down I will tell you that there there are a few uh people here to help support this uh Proclamation and retirement uh as a come down uh we appreciate them being here um you know uh David there's there's no uh there's no true definition of a good cop okay even w wikipedia doesn't get it right but we all know that if you treat people fairly with respect and dignity in whatever you're doing you're going to be a good cop and you have exemplified that whether it was when people were the guests of the sheriff in in in the jail or out on the road you always had people's back you were always right there 108 and I I'll tell you what I having worked with you I appreciate it in uh with the CNT it's not mentioned but you've you've done quite a bit and it shows because so many of your colleagues have shown to be here with you thank you madam chair thank you and I'll present the proclamation as follows honoring David May on his retirement from in River County Sheriff's Office whereas David May is retiring from in River County Sheriff's Office effective June 7th 2024 and whereas David May began a law enforcement career in 1997 and has served with distinction for over 20 six years working diligently under four sheriffs to protect and serve the citizens of Indie River county in the state of Florida whereas David May during his 26-year law enforcement career has served in many capacities including Corrections Deputy law enforcement deputy and school resource deputy and whereas over his tenure David received many acknowledgements and commendations for his efforts including going the ex ra mile Corrections Deputy of the Year honorable service and exceptional Duty and whereas David's remarkable dedication to his profession has earned him the uh appreciation of sheriff Eric flowers and all those who he has served or had the honor of working with now therefore be proclaimed by the board of County commissioners of Indie River County Florida that the board acknowledges the contributions that David has made uh to the citizens of in River County during the successful law enforcement career and wishes him a happy and prosperous retirement you'll be adopted this fourth day of June 2024 and it is signed by all five County Commissioners thank you all David that's it well I mean it works but I'm sure there's a lot more 26 years Joe it's actually 29 and a half years we started together yeah I worked at St Lucy before I found my home here so 29 and a half years um but I got to say in uh and I thought about what to say and you know the guys in my unit know that I'm usually never at a loss for words but to put it simply um it it's been a great career um I told my wife I wish I went to school resource sooner because I love you know the kids and Elementary and everything but she reminded me that my years of service before going to school resource is what made school resource so great uh in the relationships I built with the kids the parents the staff um and in 16 days my wife and I will celebrate 33 years married wow and congratulations [Applause] I don't know how she put up with me um but um behind every good man is a woman a good woman and uh I just want to thank her for being here and sticking by me in the good days and the bad days and uh it's been a great career I have no regrets and uh welcome to Home Depot what can I help you find today [Applause] oh I'm sorry hey I just want to thank you guys for taking time out of your day today to recognize David May um and of course Roger Harrington who couldn't be here we have some of our Corrections folks in the St in the back so want to thank them for coming out to recognize Roger as well David has been an absolutely incredible asset to our agency uh he's done amazing things in school resource I can tell you that his school is absolutely going to be um sad to see him go they're already prepared and are very much going to miss him and I'm going to miss him at the football games at the corner uh barking out at the folks I know a lot of people uh got a kick out of all the different things that he had to say out there at the football game so I I last the last football game I actually said are you going to come back and volunteer to do this and he said absolutely not so uh he is serious about this he will not be coming back but uh we appreciate your service Dave and thank you for all that you've done thank you guys thank you Madam chair Commissioners if we may after this can we do do have a real quick presentation by Sergeant Garrison of a challenge coin to Deputy May and a presentation of a plaque from Sergeant Roder Smith oh well we can do that now if you want or what do you what would you like y'all do your thing so real Qui we gotb hey Mike and [Applause] ch [Applause] that wide lens you're G have to go somewh hold on guys hold on do we have uh Mrs may come to the podium what she's part of the okay [Music] you said they had to put up again [Applause] congratulations all right [Music] all right so there's no minutes for approval the next item is informational items the event calendar is attached so everybody can check out all the fun events going on in Indi no County with that we'll move on to consent agenda Commissioners would anybody like to pull anything from consent Madam chairman I'd like to pull 8K and 8p 8K and 8p 8p um Madam chairman I'd like to pull 8j 8 J okay any anybody else anybody from the public wish to pull anything from consent 8 8s sir is that 8f or 8s s s s is Sierra yeah all right all right Commissioners anything else if not we will take a motion Madam chair move approval as amended all right we have a motion by commissioner flesher with a second by commissioner irman all in favor I opposed motion carries and Commissioners we're just going to take these in order so we'll start with 8j commissioner Moss yes uh thank you HJ has to do with the uh tourist development counil uh budget recommendations uh for the coming uh year the the I think that the the work being done um by the chambers uh Sebastian and in River County it's good work I enjoyed the video that uh Mr Ben man made I thank Sebastian Chamber of Commerce is doing some very Innovative things however I think uh the vetting process for these dollar amounts is incomplete in that 75% of this budget will not be publicly reviewed by the tour Development Council until August uh 21st I believe it is and these are tourist tax dollars but they're still tax dollars so I think I from my perspective we have a fiduciary responsibility to ensure proper oversight of these uh expenditures um and it's it's changed quite a lot uh the history of it it goes back to um and I was looking at the resolutions last night goes back to 1989 and at that point it was uh $30,000 that was given to the the Chamber of Commerce and interestingly it was the Vero Beach hyphen inding River County uh Chamber of Commerce uh today on this budget uh for the inie River County Chamber of Commerce it's almost a million dollars it's $926,000 uh no I'm sorry that was the request the recommendation is oh still the same $926,000 and for Sebastian chamber it's uh $252,400 which is 75% of the total of 1,575 491 that will not be reviewed um until August publicly reviewed by the tourist Development Council that's what I'm talking about the others uh the other 25% the smaller agencies were reviewed uh prior so um that being said I think that uh we're in need of a public review on this um and probably want to revisit some of the procedures given that this goes back 30 years um and in a way uh you know I think I think we did a good job in reviewing um children's services and this is you know along that line we want to be sure that the accountability is thorough and uh that you know that we have fulfilled our fidu our responsibili so I am not supporting this at this time uh for the reason stated and thank you madam chair Madam chair yes commissioner fleser May uh comment um you know uh again as pointed out this is done by resolution and uh it is uh has been the operating procedure since prior to 1990 um at a time when we we could reflect that perhaps the tourist tax generation a user tax a tax that is paid by those who visit us heads to beds uh that tax was under $500,000 it was a very minimal number and the minimal number was why there was a minimal uh distribution we have to look at the economy of scale and look at the fact that uh 4 cents on every head that hits the bed as a tourist in Indy River County generates those dollars this past year we generated over $4 million so now you have to put that in perspective and I I believe that the the board um which I am the current chairman I know you served as chairman as well I've done a many years you did it for many years um I I believe it's done accurately uh and fairly and the proof is in the result not only that the reason why we don't vet out uh the Because by by uh Direction and by our resolution uh the uh our Chambers uh get a designated uh percentage what they have done with that percentage and their presentation requires several hours of presentation to the board to the general public in this very chamber and that will be done at the very next meeting it is done by design it hasn't been called into question and uh it it has again shown great results the chamber has done many Innovative uh manners to promote this great County and I remind everyone that we do not have a theme park here we do not have a major attraction that people clamor from Oklahoma Wyoming New York imagine that New Jersey Connecticut they come here because of what we have and the promotion that is done to entice them to encourage them to share what we have here in inie River County and it works obviously $4 million is at 4 cents a hand just imagine at four pennies and not all of it goes directly to the tourist development promotion uh there is an equation that is distributed for our sand and uh other Debt Service so uh once again uh I'm not I'm not beset by the fact that the presentation is made later on because I invite everyone in including the commissioner to come to see the presentation as to what the chambers are doing to show how great a place this is and what we do and I it it's an honor to serve thank you thank you commissioner and just to follow up on what you have to say I think um commissioner Moss it's important to note that by resolution both Chambers are designated as the tourism arm of the county and as the process goes while they might not give their presentation until August that presentation is still given before the final budget approval um and it they have to and have submitted their application that does show what and how they intend to spend those dollars so it's all in there if you wanted to look at it you could certainly ask for that um I believe it was in the packet that was presented to the TDC the only thing is they don't do their presentation because that meeting goes so long and by resolution they're already given that 70% so it's more of a um trying to ensure that everything moves along properly but that information is there if you wanted to seek it out okay I don't know that that resolution was intended simply as a pass through but I will certainly look that's what the resolution States so you're welcome to um pull that one as well for information Commissioners we will need if there's no further discussion um a motion one way or another on this Madam chair move approval second all right we have a motion and a second any further discussion seeing none all in favor opposed oos nay motion carries 4 to one with commissioner Moss dissenting with that we'll move on to 8K commissioner irman thank you madam chairman um I I'm just pulling this for conversation purposes only just to let everyone know that uh this is the uh General the first stage of the general obligation bonds for the uh the conservation bond that was passed back in 2022 this is the first 255 million for that and I just wanted to give you a quick update to say that we have the elap committee has reviewed seven properties in the first stage and they'll move into the second stage and we've have 17 more in the queue for uh review so that gives us 24 total uh pieces of conservation property so far that have been sent to us to have been nominated doesn't mean all of them get through the buyer may not want to sell they could have been nominated by somebody else unbeknownst to them but staff reaches out to the those potential nominees to see if they're renter interested in selling it if it meets the criteria so with that really that's the only reason I wanted to pull it to let yall know that where we're at with the fact that we have 24 properties in the queue right now with this so with that Madam chairman mless there's any questions I'll make a motion to approve second all right we have a motion by commissioner Erman with a second by commissioner flusher um and if anybody would like to nominate properties they can do so through the website correct yes you can go to the on the website they can type in elap where it says it in the Q it says good elap and people can review the properties and what's there right wonderful all right if there's no further discussion um there is a motion and a second all in favor I opposed motion carries with that we'll move on to 8p commissioner Erman I believe you pulled this one as well 8 8p yes ma'am amendment number one to the Atkins realis work order for storm water storage treatment facility yes I was when I saw this I was I also agree with staff recommendation is to only pull out a minimum amount of uh tmdls for the for the Lagoon and a $6.5 million uh bid to build the uh cost it looks like not bid a cost to create a storm water uh treatment facility is a little uh bit expensive for the return on the investment that we'll get I just want to encourage the County Administrator and staff that we need to now that we're uh natural resources is is up and running and we've got extra people that we kind of prioritize this of looking at what projects we can do further uh with with regards to uh storm water and treatment and things like that in nature I know there's we've talked about in reference to uh doing something by the West wastewater treatment plant that's been brought up the initial project I brought back a couple years ago with moving water West through the St John's improvement district but that that's kind of been uh the St John's river water V District folks kind of looked at it is maybe we ought to the encourage more storm water uh storage treatment facilities which I agree I think that's a a better approach so my thing is was just to bring this to more of a public attention that we need to concentrate on this a little more to make these projects a priority so with that being said unless anybody has any questions I'll make a motion to approve staff recommendation second all right there is a motion by commissioner irman with a second by commissioner flesher any further discussion seeing none all in favor I opposed motion carries all right next is 8s I believe Mr lindford pulled that welcome thank you thank you madam chair um as many of you know I am an institutionalist I do believe that we have Pro cesses for a reason the simple reason I want to pull this item is because I would like the commission to discuss I think any decision to on any aspect of Taxation is one that is consequential to the community uh I don't want to alarm any of my friends here from the school district this is not a tacit uh effort to block this particular resolution I simply think that it is something that should be discussed given its tremendous uh consequence to the citizens of this County thank you thank you Dr Moore did you want to add to that yeah let's discuss okay um thank you at our last school board meeting our our board unanimously approved um what's in front of you now you probably haven't seen it it was like 11:47 p.m. but none nonetheless we're here today to um continue what the county has put in place since 2008 by I I believe um and when you the voters approve something it's a promise it's a promise that the school district makes to its Community to uphold and improve the school system uh this millage looks at three specific areas one is uh recruiting and retaining High teacher pay and if you read the paper across the uh State there are superintendents and Boards searching for employees not here in the school district of in River County when you look at the last four years we've gone from 28th below the teacher average in teacher pay to six in the state in teacher pay uh above the state average the five districts that are above us um four of them F no four of them are still below us in average teacher pay they've actually done a good job of increasing teacher pay but we have been extremely aggressive and what we have agreed with our teachers union uh we think we're going to go up even higher to be one uh four or five in the state in terms of teacher pay uh we don't have a recruitment problem because we focus in on retention uh we're very very solid there Safety and Security uh we take this very very seriously and we are uh the shiny example across the state of Florida under the leadership of Mr tesy uh supported by Mr Seymour uh counties are constantly coming here to evaluate the systems inst structures that we have in place in order to ensure each and every single one of our students walk into the schools they feel safe they feel comfortable whether it is our state-of-the-art metal detectors whether it is the significantly increased number of cameras that we've put in place whether it is the security monitors that are there whether it is The Vape technology that senses uh the Vapes uh we are on top of it uh each and every single moment upholding the promise that we made to our community uh and then finally uh integrating technology um four years ago uh we did not have the technology that we needed to to be in place to prepare our students and today we have a onetoone initiative meaning every single student from third second grade above receives a device and they have that device which is updated and Char and and replaced until they graduate which allows them uh to take the device home allows us to give the Hotpot so if they don't have internet access at home we can provide that if you walk into our classrooms now uh you're seeing high levels of interactive boards being used uh that students can ultimately be prepared when they graduate from school at the end of the day the school district of Indian River County uh is the state's most improved school system it has improved from 38th uh to thir uh to 13th uh in state rankings no other district has done that and our Collective work uh is to provide our community with world-class education and a place each and every single person can be proud of uh our goal is not just to be the top 13 based on the results that we have now uh we know that we're going to continue to sore up the rankings uh and if we're all about supporting and creating a community we can't do that unless everyone Embraces better schools are everybody's business and this is simple a continuation and we as a District uh and as a school board have taken uh the ability and compassion to ensure that we are great stewards of the people's money uh our fund balance is the highest it's ever been um our ratings four year four and a half years ago when this was approved um it were not were all negative now they're all positive um we have done an absolutely outstanding job of being a great Steward of the people's money the best way I can highlight that is to draw a comparison when you look at Martin County Martin County we all know is the exact same size as us um they have the same uh millage in place but they also claim the sales tax additional sales tax on their Community they receive 13 million more dollars than our children receive in this county yet when it comes to outcomes they're looking up at us uh they are a b District we are an a district and we will continue along that path making sure that we will be fiscally responsible with every dollar and every promise that we make we will uphold and ensure that this community has a school district that is in fact in a with a schools um that ensures when a student walks into our schools parents can feel safe they know they have the technology they need and they have quality Educators in front of them so we thank you for sending this to the voters uh and we thank you for your support thank you thank you Commissioners Madam Chair by Design we're we're placing this uh we're recommending to place this on the ballot at the direction of the school board per the legislation that is mandating that it's on the November ballot uh this this motion will place that opportunity to put it in the taxpayers hands as to their decision as to if this goes forward I just wanted to be make make it clear that we're not pushing this pulling this we are facilitating this request and ensuring that the voters have the right to make their decision for the betterment of the children and the operation of the schools for the future of Indie River County correct it's more ministerial in yes in nature for us they asked us to place it on the ballot we are the ones that have to allow that to happen and so that's what's that's what's going on with this issue commissioner Moss thank you um I just wanted to say I I was I checked last night for my own information to see uh how the school board had voted on this so I was watching the video of that meeting that went I think more than six hours and unlike ours it's not divided by matter so you you have to struggle a bit to to find you know where that where that vote was so I ended up watching um I'll just say quite an an amount of that meeting and so it's not necessarily unanimous on a wide range of matters but it was a solid unanimous vote on this particular matter so I I can I could say that without reservation having done my my homework on that God bless you all all right Commissioners moot motion to approve all right I have a motion by commissioner lore with a second by commissioner flesher any further discussion seeing none all in favor I opposed motion carries thank you all right with that we will move on to our public hearing this while they are getting set up this is going to be a a public hearing which uh on Community Baptist Church inc's request for special exception use and site plan approval for a K12 private school this is a quasi judicial hearing so you guys know the drill we're we'll go through our quasi judicial checklist the parties to the proceeding are Indian no County and Community Baptist Church Commissioners I'm going to ask you to please disclose any exp parte communication site visits or independent investigations commissioner lore none commissioner fleser mam chair none that I'm aware of um I did have a phone call from um Mr kle who had some concerns about the project and I invited him to come to the hearing um so he could convey those but other than that none commissioner Airman none all right please confirm irm that you guys have an open mind and are able to base your decision on the evidence presented um and applicable law commissioner Moss Canon will Canon will Canon will Canon will Canon will all right at this time we'll open the public hearing and I'm going to ask the clerk to swear in all Witnesses collectively so anybody in the audience um that's going to speak or in the room in general that's going to speak on this item please rise to be be sworn in do you swear or affirm to tell the truth the whole truth and nothing but the truth I do all right wonderful with that we will start with the presentation by County staff welcome good morning Madam chair and Commissioners uh for the record Patrick Murphy Senior planning uh the planning and development services as The Madam chair mentioned this is for the Community Baptist Church K through2 private school this a special exception use and site plan approval on the location map you'll see on each of these slides True North is actually the top left corner of the page the school is outlined in a red uh Square it's on the south side of Rosland Road about a mile to the west or south of US1 to the south of that of Sebastian there's RS3 single family residential zoning on the East and the west and rs1 single family residential zoning across the street to the north on an aial map you'll see how the facility is currently laid out the large gray box to the east is the church facility itself uh the building that is outlined in red is actually a multi-purpose building that they're going to be converting into the school so they're not creating a new building they're just repurposing one that's already there there's a pastor residence to the north side of the page and some other miscellaneous structures you see an existing home to the top of the page as well and and rosand road to the the left side there are existing 99 parking spaces on the site of which the church uh is required to have 67 and it's a 56 requirement for the school however the school and the church operates at different times uh the school is going to operate Monday through Friday 8:30 to 3:30 and the church operates Wednesday evenings and Sundays so they don't overlap and they won't be competing for any part spaces for the traffic circulation plan uh there's only the one driveway onto Rosland they're going to make a couple of improvements to the turning radius of the flares if you will that come out of the driveway uh there is not going to be a dedicated drop off Loop the passer has decided that it was going to be a lot better to have all of the parents Park in a parking space and walk their children in the school which should take out any issues with possible queuing and any backing up towards the road again you see the church on the blue build outline and then the schools in that red um outline storm water plan all of the polygons you see shaded in blue are the existing ponds it's all an interconnected system however they're not adding any new impervious to the site so there's no reason to do any improvements to this it's already functioning as it is uh takes us to the landscape plan a type-c landscape buffer will be constructed along Rosland Road and along all the Residential Properties to the north and east they have existing vegetation and where there are gaps in that vegetation they'll be planting new shrubs and trees the dark green circles are existing oak trees of a pretty good size and in the very northeast corner they have a good stand of Oak sh also remain so the odd shaped sort of pale green polygon at the South that's an existing very densely wooded vegetation it's going to serve as sort of an enlarged buffer to that residential further to the South now noted along the the very south side or the right side of your page they're actually requesting a waiver from putting in a buffer along this property line that's allowed for them to request that through the code and the reason being beyond that is a very large parcel of land that's jointly owned by the county and St John's River Water Management District it consists of both wetlands and Uplands there's no residential there there's no buildings going to be there so it it doesn't really serve a purpose to plan all this Landscaping because there's nothing to buffer it from so if the the board is inclined to approve this today um I would request that that be in the motion to make sure that that is um memorialized uh the Planning and Zoning U commission recommended approval by unanimous vote and for staff recommendation staff recommends that the BCC Grant special exception use and site plan approval for the Community Baptist Church K through2 private school with the conditions listed in the staff report those are conditions are that a formal review of The Life Safety plan shall be conducted by the County's Building Division and must be approved prior to issuance of a change of of occupancy permit to convert the existing multi-purpose building into a school a condition that the maximum student enrollment shall not exceed 90 students and that's based on the size of the building in the Florida building code and a condition that any future request to construct any new principal use buildings or add outdoor lighting to any of the playfields will require special exception approval both a review by the PCC and approval by this board with that I'd be happy to answer any questions you may have and I do believe the applicants are in attendance fantastic Commissioners any questions of Staff nope no all right seeing none we'll move on to a presentation by the applicant the applicant is here is there anything welcome thank you guys very much uh I don't think I was fully aware of the amount of things that you guys oversee and do and I want to thank you for your service to our community and recognizing today that our issue is just small issue in the middle of all the Grand ones that you guys uh partake in and so again thank you my name is John Stevens I'm the pastor of Community Baptist Church I also will be the president Headmaster of our uh future desire to have our school about a year and a half ago we really felt called by the Lord to start a school and uh we recognizing that there's a need as well in our community to have the option for private education uh many of our families within our church um have asked us to do this for years and we uh haven't but we really feel like now is the time many of them they would have to go all the way to South virau uh to put their kids in a private school to which they're finding many of those schools are full and so we would love to provide that opportunity here um on our side of the county and uh we believe we're going to be a blessing to our community we always have been as a church that's our goal uh it is never to be a burden but to be a blessing and we know that when we talk about starting a school obviously our minds automatically jump to Major football fields and schools like Sebastian high school but that is not our goal we really want to focus on the quality of our impact on those students rather than the quantity and so we are not stifled by the 90 we're not discouraged by that we believe that that number uh is perfectly fitting to what we desire to be uh as a school we want to intimately connect with each family that comes into our facility uh helping them obviously through education but also growing in their faith in the Lord and we believe that those two elements putting their focus on Jesus Christ and raising them up in their education is going to produce great uh citizens for our community here um we again want to be a blessing we have been as a church we uh every week we see hundreds of people come through our doors that we get to minister to uh we have Outreach opportunities for our community we do annual Trunk or Treats where we see literally 2,000 people come to that uh all of our events are completely free last night we hosted a dinner uh for 250 people where they can come and just enjoy fellowship and for some it's a matter of receiving dignity for others it's just a night off and we want to be a blessing in that way we've offered grief share to help those that are grieving the loss of loved ones we offer Divorce Care those that families that are going through separation uh many times we see them mended uh we offer life recovery groups where we can help those that are struggling with uh the bondage of this life helping them find Freedom in those things and again so we believe our school is just going to be an extension of that opportunity for our community to find healing and hope and and blessing and so I really appreciate you guys taking the time today uh to consider our uh our desire to start a k through 12 school thank you than you thank you Commissioners any questions for the applicant nope all right at this time we'll take any input from the public if anybody from the public wishes to speak on this matter please come to the podium and state your name and address for the record welcome good morning my name is Jeff Klein did you need my address yes 12525 Rosen Road thank you um good morning um I made a few notes here what I wanted to say I did attend that meeting at the Planning and Zoning commission um myself included I don't have any problem with the school I don't think the school is a wonderful idea I'm here because I'm concerned about the traffic I mentioned that at the County Commission meeting Mr Murphy was there he explained to me that explained to everybody that pardon me the uh there was no trigger to change the traffic there wasn't enough traffic to require any amendments for this to happen Okay that's that's not an issue for me um but the traffic on Rosland in the morning now is thick it's even thicker when the snowbirds are here um so the immediate area is going to be impacted by this traffic from the school and I just want to say that the pastor seems like a reasonable guy I think we should use our common sense and I recommend that there was nothing required by the church because nothing was triggered because of the traffic survey but what I'm suggesting is that when students are being dropped off in the morning that they come from 512 so they can make a right-hand turn straight into the church instead of coming from US1 and stacking up because they can't make a leftand turn into the church because the oncoming traffic is pretty thick so just you know in the afternoon 3:30 not an issue they can come from 512 they can come from US1 CU it's 3:30 nobody's rushing to get out to go to work uh the immediate area will be impacted in the morning as people try to go to work so that that's my main concern if if the pastor could work with us and ask students to be dropped off coming from 5 12 versus US1 couple more things the swell is very deep and wide on both sides of the road at that point right where the homes are my home the homes next to me to the West the church the swell is very steep you got a hospital a mile away emergency vehicles are running all the time um if at 8:00 in the morning if they're stacked up I don't know where cars are going to go safely without concerns of getting in the Swale be being able to pull over far enough to let an emergency vehicle go by I think you should consider this I'm not saying I'm against the school again I'm just concerned about the traffic um okay another thing I want to say is half a mile away a half a mile away you got a train running 30 times a day so you're going to get stacked up multiple places along the way I'm just asking these folks to work with us um another thing is there's an alligator in the pond I think that there's going to be some students that first Pond that was that is closest to Rosen Road has an alligator in it so I think they ought to get rid of it okay and then the last thing is this um I spoke with a neighbor several of my neighbors they didn't get the letter to be informed at this meeting was taking place and again Mr Murphy explained got a 300t radius from the center of the church property to contact all those people that fall into that radius so my own nextdoor neighbor who's going to be impacted didn't get the sign and all those folks on 125th Place which is the first street to the north of the church east of the church towards US1 on the north side of Rosland all those folks are going to be impacted uh they didn't get a letter so then I talked to another fellow who lives two houses away on the west side of the church on the south side of rosand he didn't get a letter so I I'm just thinking that I don't know how these rules and regs work for Indian River County but a lot of these people that live immediately near this church were not contacted uh the next thing I want to say is in talking to one of my neighbors he said well I thought they were supposed to post a sign and I brought this up at the last meeting and there was no conversation whatsoever at the Planning and Zoning commission the sign that's posted is 17 in by 11 in the sign is this big it's covered in plastic speed limit is 45 miles an hour right there in front of the church you can't read that sign Mr Murphy explained that's all this County requires I'm saying to you folks I don't think it's right when a sign can't be read with an important issue like this sign's not big enough and then the plastic when you're driving I went by it yesterday when I was coming home and I specifically looked at the sign it the plastic kind of shines from the sunlight you can't read anything I went there I stood in the parking lot I was 10 ft away I could barely read the sign stopped from 10t away so in the future I just recommend the county make bigger signs when you're going to have an issue like this thank you for your time thank you Mr Klein and we can certainly look at the signage issue moving forward um Mr Murphy what when would the traffic be triggered okay thank you I was taking notes here and I'll go ahead and address them in sort of the order that they were were spoken um so chapter 952 which is our traffic section requires a traffic study when a minimum of 400 average daily trips from particular proposed use is going to be um created from the site uh for this type of facility the K through2 school we took a look at the it trip generation manual it's the latest manual it stands for Institute of transplantation engineers and they look at and conduct traffing studies throughout the state throughout the country on particular uses Cobble those together and they come up with factors meaning you have a a certain average daily trip assigned to each use this particular use when you took that factor and you multiplied it by its maximum at buildout that it could possibly have at 90 students it only yielded 232 trips a day so it was far below the minimum threshold it needed to actually require a traffic study uh public work staff looked at this and looked at the um frequency of trips that may be coming to the site and did not deem this necessary to do any types of turn Lanes or any types of improvements um now I think that it may be little misconception that when you hear 90 students that 90 cars are all going to arrive on the site in the same 5 minute period of time and that's really not how these schools operate uh what you'll get is you'll get a lot of siblings that travel in the car you'll get folks that show up at different times in the morning and so the traffic's not going to stack as bad as you might think it is there's going to be intervals to to to come in into and out of the site and this is you know this is not a very big school at all I mean 90 students at buildout which I don't think they're going to even hit in the first few years um is not something that our Traffic Engineers found too much of a concern as far as the radius the 300t radius right out of section 902 that's from the outer property lines now in this area these are larger size properties some of these are acre 2 Acres so if you were to take this site and put it in say vle with a bunch of quarter acre lots and you put that radius out you would hit multiple multiple properties um but on this particular site I think it yielded about 24 different properties within that 300 foot uh um the radius map it curves and it es and flows with the size of the property so we followed all the regulations we notified all the folks there was a sign placed on the property before the Planning and Zoning commission as well as the board of County Commissioners um the plastic is on there to make sure the rain doesn't wash the writing off um we can certainly look in the future at larger signage U driving down 45 miles per hour I don't know what sign you would size you would need to be able to read that while driving uh the understanding is that you would pull off to actually get out and safely read that sign so you know you're not getting own rear ending while you're trying to read a sign but we can certainly look at those things um as far as the alligator I would hope that the pastor would you know call animal control and remove that for everyone's safety um and the the Deep swell that's something that would be a maintenance item that Public Works would need to look at because this is a public road ride away it's not something that the church is responsible for maintaining I think I covered all of those but if you have any followup questions certainly I do okay commission Airman let's say the the school becomes highly successful their attendance increases they need to build another building or multiple buildings whatever they would need to do ises it trigger in traffic studies and stuff like that in the future oh yes we would evaluate that to time to see how many more students are putting in if it gets to that 400 will we require even if it didn't Public Works was going to take a look at the new impact that could be felt along the roadway from however many buildings are going to put in and we look at what whatever improvements may be needed at that time we would also uh evaluate this this school as it is after it's open to see if there is any impacts that may be created and what we can do to alleviate those okay other questions Madam chair does the just curious does the church in the future plan on any busing opportunities for the children in other words they may have a bus already is there any plans to pick up children and and mitigate the traffic flow no at this time we do not have any plans for that um and I do want to say regarding the alligator there is no alligator in our pond at this time we've had one in my seven years as the pastor there called Wildlife they removed it um and so we we look at that pond every single day because we don't just need to worry about it because we have a school we have 80 90 kids every weekend on our campus that we look forward to and so the second we noticed that uh we are absolutely take care of it because we want to make sure that's removed uh also want to remind us that we are talking about 90 stud students maximum we do not anticipate that we'll probably get to that number that fast um but we really honestly don't want a school bigger than 90 and I know that we can dream this big dream but uh we really want to focus on the quality uh rather than the quantity we really want to build into these individual students and that is our desire here today so just wanted to say those things thank you thank you just so in in hearing that Madam chair uh P just made a Target as to how much how many students he would anticipate uh in attendance is that the number you use to calculate the traffic concerns uh or did you go to a higher value so when we look at the concerns we look at what the maximum could potentially be we do not take a number from the applicant and say well we're only looking at 50 students and then do a study based on that we would do it based on the maximum they could put in that building the building is roughly 4,000 ft and when you take out the bathrooms and the hallways and the conference room Administration room the amount of students that could physically be accommodated in there is 90 the affability code would not allow any more than that so we take that maximum number and that's what we're studying because you have to look at what could be the worst case scenario so to speak when you're doing traffic studies thank you and I did hear you say that after it's opened we'll continue to review that yeah okay absolutely yeah if I could uh Madam chair members of the commission Ryan swey assistant Planning Development Services director one thing we find a lot with these schools is operational items you learn over time I can promise you the first day will probably be a little rough every every school is people are going every which way and whatnot within a week they tweak it they say hey K through five gets dropped off between these hours you know 6 through 8 gets dropped off they it's a work in process and it it takes a week or two to figure out and you tweak it over time and that's how that usually gets streamlined okay thank you thank you yep all right anybody else from the public wishing to speak on this item seeing none we will move on to the final presentation by County staff any final presentation it's okay to say no no okay any final presentation by the applicant no all right all right have all documents and tangible evidence been admitted into evidence with the clerk I'm assuming yes and all right with that we'll close the public hearing Madam chair move approval second all right we have a motion by commissioner lore with a second by commissioner flesher any further discussion Madam chair I just want to say to to pasta and and thank you staff for rolling this through the the way you did uh and and answering our concerns um but uh to Pastor you know at a time when and I I don't know if it shows but I I attended faith-based schools uh uh you know sometimes it takes sometimes it does but uh uh with that u i I think it's very important you to be commended to uh want to move forward to drive forward for a a a faith-based school at a time when most faith-based schools are not uh growing in abundance uh and uh I I think I heard the the the concerns Mr Klein I I appreciate your the input um I I think saf has addressed the concerns uh or uh will be addressing the concerns and they'll be continue uh uh monitoring uh until uh successful I I I hope that you you fulfill every one of your desires to fill this school so thank you m shair yeah I was going to ask does the motion cover everything that you needed yeah he yes I I just want to confirm for the record that it didn't it also covered their request for relief from Landscaping along that South prop Lin corre thank you thank you very much okay and so yes all right so there's a motion by commissioner lure with a second by commissioner flesher all in favor I opposed motion carries thank you best of luck all right with that excuse me I just wanted to thank you guys again I want to thank County staff they helped us tremendously get through this I appreciate you all very very much thank you thank you all right with that we are going to move on and I'm going to take just a brief moment of chair's privilege to to give some time to the administrator and the attorney go ahead yes Kylie could you come forward I just want to take an opportunity to introduce Kylie and Chula to the commission I know many of you have meetings scheduled her but also to the to the community Kylie joins Indian River County as our natural resource director uh she previously spent the last eight years serving Martin County as their their Public Works administrator where she oversaw field operations storm water and Mos mosquito control within the public works department prior to Martin County Kylie was a research entomologist studying mosquito interactions with different um viruses at the Florida Medical entomology lab on Oslo Road and kind of a fun fact uh the most interesting place Kylie has lived was in Front Royal Virginia at the Smithsonian conservation Biology Institute where she saw endangered species like red pandas man M wolves and she is every morning and hiked on the Appalachian Trail every afternoon she holds a masters in science and environmental sciences and a PhD in entomology and we are so glad that she's here as our new Natural Resources Director and so we just want to welcome you Kylie to the Indian River County team family and uh we look forward to great things from her yes welcome and based on that resume I mean I hope you find just as dazzling as some of the experiences you've had in the past but definitely looking forward to having you on board um I I've only heard great things I think Martin County is still a little upset with us for I'll use the term we use in the restaurant business poaching you from them but I'm glad to have you on our team and um we're looking forward to to doing anything we can to help you move that department forward well I just want to say thank you to all of you you for having me I'm really excited so today is day six and um based upon these six days I have found that you have a phenomenal team and there is a lot of depth there so I'm really looking forward to supporting the department and also um making your Visions a reality towards the environmental stewardship of Indian River County so thank you for having me and I'm looking forward to meeting with everyone and learning a little bit more about you and some of your priorities Abul thank you welcome thank you welcome Mr de thank you um Shannon want to take a a step forward please we've got a summer intern Shannon Gordon Shannon comes to us from George Mason School law school in Washington DC uh she's here by gr uh by her own choice but she's also supplemented by a grant from the local government section of the Florida bar are so we're pleased that we're going to be able to send her back for her third year uh third and final year at Law School up at George Mason um and we're very excited to have her here uh she's going to be attending lots of meetings and seeing lots of different things we'll try and expose her to as much as possible to enrich her life as far as when she goes back and hopefully she has good stories to tell yes we are an an enriching Bunch so welcome we hope you have a fantastic summer and learn a lot and we'll try to be as exciting as possible for you thank you I'm already really excited so wonderful well welcome aboard thanks thank you where exactly are you from um Alexandria Virginia but yeah I've lived here a while but now I'm back up in Arlington Allington and uh counselor uh is the old adage of where you intern uh an indication of uh where you might land she she has stated that she wants to come back to Indian River County uh after she's done with schools so you never know what happens I I just wanted to just point out a few things oh yeah I'll be back thank youcome aboard thank you thank you Shannon all right with that we will move on to Human Resources item 12 C1 Indian River County everide Health Center six-month update and request for approval of additional Staffing in direct contract for radiology services that is quite a mouthful welcome Suzanne it was quite a mouthful good morning Commissioners and thank you for this opportunity to give you an update on our uh Indian River County everside Health Center uh back in February of 2023 uh the board approved us entering into an agreement with everside to um open a health center for our employees our retirees our dependants uh over the age of two uh for not only the board of County Commissioners but all the Constitutional offices as well and um the total population of insured is about 3,600 lives um in the radius that we thought would serve uh the health would be able to visit the health center we were looking at like 3222 lives total so um following the approval of the board we executed our agreement with everside and then we sought out a location for the health center uh we sought out uh a place that would be convenient uh there was concern expressed at that time or some some guidance that was given by the board uh you were concerned about the quality of the facility you wanted it to be a highquality facility uh you wanted it to be in a location that was convenient um you wanted it to be a professional representation for health care services um in in a real building um for for serving this population of of these employees and their dependence and uh we were successful in being able to do that and uh we launched the opening of the health center at the end of October and uh in November we had our open house and I'm pleased to say that um after 6 months uh there's some requests that I have for you uh at this time related to that Health Center so uh Kim would you be able to open it up a little okay so this is our Wellness update um these are some uh shots of our actual facility um and it just shows the level of of uh professionalism that went into designing and building out this facility uh the total buildout cost was about 144,000 to be able to get this facility up to speed to be able to uh meet the needs of our population uh we have uh several exam rooms we started off with one nurse practitioner two medical assistants it's very close to the hospital it's off of 37th um in a in a great location and um our uh partnership with everide they have a care model that we believe is going to be very successful for our population um our utilization there was a concern expressed by the board that uh are people going to go to this Health Center so the good news is people are going to this Health Center um we've had over 1,69 appointments in the six months that it's been open we have uh 410 patients who have uh established relationship with the health center that's about 16% among our eligible population have already connected in this short period of time uh We've uh had some in-depth physicals uh have been received by 184 of those patients we've accommodated same day next day visits 27% of the visits have been same day or next day and we have uh even the ability to have virtual appointments so what's really cool about this is you can go in get your physical uh get your Labs drawn at the same time and then that follow-up appointment that you might have had to go actually to the doctor's office and wait we can do it virtually um to go over labs and with the with the provider so it's it's really a great great uh benefit and that utilization is is steadily Rising you can see on the screen um how uh the appointments have just consistently gone up up and up uh we have about 99.2% of the population of spouses and 4.5% among dependents so um we're really uh encouraged by these numbers and this trend that's moving up out of the total appointments um it's it's what's wonderful about this is we have like 753 of our appointments have been employee appointments and if you think about the time that when you when you're working and you have to take off to go to the doctor how much time it actually takes maybe you take a whole you know half day off or the morning off or the afternoon off to get to the doctor you go you might have to wait in the waiting room and it's a different experience with our health center um you are really close by you know right off 37th you can get in you don't have to wait you get in you get registered you get taken back you get seen so we're um estimating that at least an hour is saved on Lost productivity for just those 753 employee visits that have been there and if you and you know quantify that with an average salary rate you can see that that's that's a savings in and of itself um we have a really high net promoter score you'll see that ours is 89 and you can see some other brand names that are very well known how we compare to that so uh people are very satisfied with everide some of the comments uh that are here these are actual comments from our our members that go and there's a whole lot more but we couldn't fit them all on one one screen so we have just hundreds of positive comments about the experience that people have been uh receiving when they go to the Health Center the care is very convenient uh this shows you uh the percentage of same day next day appointments and I I want to let you know we actually block two since January we've been blocking two hours out of each day to accommodate same day next day appointments but I really want to emphasize here this is a health center it's not a uh walk-in clinic uh it's not intended to be that although a portion of our visits are set aside for that because we realize that sometimes people wake up in the morning and the child's sick or you're not feeling well and you want to get in so we do have those two hours blocked for same day next day but if we don't if those aren't taken we try to get people in for their Wellness appointments and those appointments are in-depth uh physicals uh time with a provider and um ever the everside team was sending me uh sharing with me some statistics the average um general practice visit if you go into a doctor's office you know about 9.7 minutes is how much time that provider is going to spend with you 41 minutes is what somebody's getting when they go to this Health Center on average 41 minutes of oneon-one time with that Health provider to actually talk with you and identify uh what your health goals are and work work with you to kind of improve in the areas that might be very specific to you and I can't go into all the details but I can tell you that I know personally of people who have gone there and have come back and said they took the time and they found out about this thing in my life and they made some recommendations for me and I have been I have had an improvement as a result of that so this support that you've put towards this Health Center has been very positive and and I think we're just going to see that over time as we as we move along um one of our realities that we're uh facing is because our utilization is high and our utilization is strong it's taking a little bit longer to get in and be seen so the average uh weit time is 19.4 days to get your physical scheduled which is still really good I mean I don't know if you've called a a I mean 19.4 days is really good because other places it's like months out before you get in so we're still doing really good but again we want to make it really really easy and convenient for people to get in to be seen to stay healthy and productive and to have their families healthy and productive as well so uh we are at capacity uh we've been at capacity since we opened up the door uh people I mean I was actually in the lobby we were talking to some folks who said um they were the first PE on the first people that that day one you know that they were open for business they were actually in there so that that was really good we get did a good side a good job communicating because we can see right out of the gate people are going now under our agreement with everide uh the agreement was hey if you're at 66% or above we're going to be recommending to you that you add another practitioner and you might be well gosh you've been at 60 66 or above since you opened why did you wait well they didn't want it to be an anomaly they didn't want it to drop off and add a provider too soon so they wanted to get six months worth of utilization under our belt to say yep the trend is there and this is time um some more good news operational costs are tracking our estimates so this first uh tall bar that's the startup cost um remember I said we spent about $144,000 in startup costs um I may not have spoke it but it was up here um to open up the health center it took a little bit of time to actually find a location and then the expenses related to the build out so it was a little bit more than we initially projected October we were open at the last day of the month so you're not going to see any um uh uh savings from there it was just an expense but then um when you look at November December January February and March green is what was budgeted and then you can see that our charges are coming in below uh what was budgeted uh to date it's about I want to say $356,000 in expenses beyond the initial startup costs and um what we've done is we have um uh separately we pay rent through an everside lease that's running about $6,300 a month for our lease so um those total costs when you put it together it's right around $800,000 annually ually our total costs and we are projected to to fall in line with that um so that's very good news as well we do have some really good news regarding uh savings because one of our goals was to um not only improve People's Health but also to save uh on our costs so the value of visits you're going to see here and this is that number I referenced before 9.7 minutes is the normal uh average duration of Primary Care our visits are for 41 minutes they're higher quality but um when you put a cost of $117 for that average 9.7 minute visit um you're looking at $528,000 in the value of total visits that we're delivering through this Health Center um referrals this is another thing that happens is if the um Kathy our provider decides that you need to be referred to a specialist she's going to do so but she does so after spending that time with it's not just pushing you through and getting you referred on and where you have to go and pay another co-pay to go see a doctor a lot of it is just addressed with that longer visit where she's able to help you get on track with your health care needs but if it's necessary there's going to be a referral to a specialist but our referral rates are going to be lower because again we're not just pushing somebody through getting a co-pay we're looking at the quality of that visit does that make sense so we're saving money there the average uh referral savings cost is looking at like close to $60,000 in reduced referrals then we have emergency room and Urgent Care avoidance um we had 289 same day next day appointments uh those uh a percentage of that is is looking at we avoided the ER we avoided avoided urgent care and those costs so we're looking at an avoidance of uh almost $28,000 for the ER and Urgent Care avoidance in just that six-month period then we have member savings there's remember this health C operates you have no co-pay no no cost for your prescriptions that are that are delivered out of there so the person goes they don't have to pay anything when they get there and we're estimating that to be uh $441,000 in just this six-month period for these members who have gone and sought Services through the health center so overall we're looking at um just under $658,000 of total savings to include that 41,000 of member savings so when we look back to what is our what are our build expenses been it was like $356,000 as compared to our diverted costs and member savings we're doing really really well on our Roi so I'm pleased to report that to you and this is just another way to illustrate it um where we're at all right now we're going to be looking at adding a nurse practitioner um you might think well why a nurse practitioner well you can kind of see the difference in cost between a a physician and a nurse practitioner so uh we believe that the nurse practitioner is delivering a highquality level of care for our members um not only that they have access to physician oversight a refer um the ability to tap in and and speak with a a physician regarding any any questions that might come up through Rubicon MD so they have access to a lot of resources Beyond just that nurse practitioner in the office through ever side they have access to a lot of information and a lot of resources any questions so far with the where we're at doing good okay another thing that we're looking at doing and we're very excited about this and many of you may not know this but a lot of our um area Physicians and our Imaging uh has been has become they've been acquired by the hospital and we have seen an uptick in addition costs that are being charged to our members and it's very very frustrating and and we have no ability um uh under our agreement with Health First and our health plan to cause that to be a different experience for our members and uh so when I was talking with eversight about it I said is there any way we can get a direct contract for radiology Services through this Health Center so that um a member can be referred for radiology have it covered under that Health Center expense without going to through the health plan without the frustrations that members are experiencing in that and they said yes so they are uh currently working with Indian River Radiology they've actually um contacted a few but Indian River Radiology came back with the best overall pricing but we're still working through um some of those nuances just to make sure that it's not only um uh a more efficient way of getting our members to the Radiology care kind of seamlessly but that it's also the cost we're keeping it down um so under this agreement we're looking at overall Savings of about $22,000 uh for radiology Services being delivered this way as opposed through the health plan do you have any questions about that I just have a comment that whoever you end up with for radiology um try to make sure that you can get an appointment with them before like six months to a year I mean it's really ridiculous out there I so and that's one of the things that I've asked everide I want that partnership and that referral process to be everide coming alongside the member and helping get that referral taking place rather than today what happens is you get a referral and and you go home and and you wait maybe for a phone call sometime a few days later so um eversight is aware and they will facilitate that that process in the health center itself and the two medical assistants assisting with getting those uh those things done and nothing locks Us in to a forever relationship with Indian River Radiology if that's who we ultimately end up with we will look for the coste effective um relationship that makes sense and supports our members in in meeting those very goals that you stated any other questions related to that okay um we have another little issue here uh under our agreement with everside we have what's a performance guarantee and it's related to having a percentage of our eligible uh members have that annual physical and that wellness check because that's where we're really going to make a difference uh not just in the overall expense and diversion but hopefully bending the curve of chronic conditions for our members by getting them in and getting them um their labs done and their that that relationship that 41 minute one-on-one discussion about that person's health and hopefully avoid costly chronic conditions or or those those conditions that can arise when somebody's not going to the doctor so we have a performance guarantee in place but we were reading it as we were going through this process and it says 50% of enroll Le under our current agreement it needs to be 50% of eligible members which are people who have connected with the health center does that makes sense so instead of 50% of the 3,200 people it's 50% of the people who have connected with the health center are going to be expected to have met those uh performance guarantees related to the um the annual physical Micah did I state that correctly at the end yes yes okay at the end any questions on that all right uh all right then another big deal um everide is merging with Marathon Health uh Marathon Health has a presence in Bard County I think it is and um so that partnership will bring a lot more resources to us as as everside and Marathon merge together um I was like looking at this and I was like but I really like our green you know I really like that green color and not so much the other one so the good news is we get to keep the green right um there may be some branding that happens down the road related to this but it's I've been assured that it doesn't impact us right we're good okay we're good any questions on the the uh merger okay just one is is um Marathon affiliated with steart health in any way so not to my knowledge okay but I can certainly take that back no no problem thank you okay all right um this is just a statement in their strategic alignment um they really believe that they complement uh each each company complements and and will broaden and and give us uh even more depth of support than we already have today I think through that through that merger any questions on that all right so what am I asking for today it's good things I'm asking for good things I am asking for approval to an employee an additional nurse practitioner uh so that we can provide our services to our Workforce that would result in a staffing of two nurse practitioners and two medical assistants I'm asking for approval for uh everide to enter into a direct contract for radiology and imaging services with the pricing to be reviewed by Lockton and staff for competitiveness so we don't have that pricing locked in yet but I'm I'm asking for approval once we're good that we can go ahead and and start uh referring people uh to receive radiology and imaging Services um and it be built as a pass through expense through the health center and it would be no out-of-pocket cost to the members who are going to get those services and then I'm asking for approval to start once we have that agreement for those referrals to begin through the health center for patients who are coming there who might need a x-ray or or a CT or an MRI for for a medical condition and then I'm authorizing the chairman to execute any necessary Amendment to the agreement with everside to implement the authorized changes that will include the pro um the modification of the language related to that performance guarantee to the to uh reflect that it's not eligible employees but it's enroles right okay um following review by locked in staff and the county attorney for legal sufficiency thank you all right Commissioners questions comments concerns commissioner Moss yes I I have a couple of questions adding uh another nurse practitioner will that affect um my notes Here 15.5 days you have to wait that's the waiting time to get an appointment will that come down yes because we'll be able to see more people okay so that will that will come down um is it currently 10% participation by the employees that's what I thought went by and that's um 16% of our employees 16% yes of our employees so um everyone's eligible right so eligible is total number of employees um so of the total number 16% of our employees are using this and when you compare savings because I know you had um the language was Primary Care visits but Primary Care are you comparing nurses to nurses or are you comparing nurses to doctors so Primary Care visits um at least my experience has been a lot of nurse practitioners in these facilities are providing the primary visits you might have a physician there but they are supplemented by nurse practitioners and many times you'll go in and you'll see a nurse practitioner as well so that that Primary Care visit could be with a doctor it could be with a nurse practitioner but the cost is is the 117 and corre correct we're actually using the ICD this is Tiffany com k kby um Tiffany if you'll so we actually the way that we do the savings is we actually are utilizing like the icd10 codes the icd10 codes so we're actually comparing them so what happens is in our health centers our providers document the exact same way that they would if they were in a communitybased center so that's how we can actually assign a value to the visits that are happening in our Center if you were to correlate them to happen in a primary care setting where it's truly fee for service where they're invoicing back to the insurance plan for reimbursement so that's how we're able to calculate that and to Suzanne's Point often times it is nurse practitioners and we do have some primary cares where they are MDS but often times it's a nurse practitioner model there's no different value assigned to that visit type depending upon who's providing it for reimbursement I don't know I've never heard of that if I make a doctor's appointment I see the doctor I don't see a nurse so I don't know I don't know about this often times but I'm not I'm not going to dispute it um okay thank you yes oh wait take forther Commissioners any other Commissioners have any questions Madam chair I don't I don't have any I'm I'm fine with this and I'm very pleased with the success wonderful uh one thing to note is that our retirees that are eligible and correct if I'm wrong once they get matter care age they're no longer participants um actually if someone chooses to remain on our health plan right after age 65 they can still continue at this at this Health Center okay chairman yes it's I agree with second I'm too pleas I'm very pleased with the results because I know that when I was still with the the fire rescue Department we had discussed this many years ago and it finally came uh to fruition and and we're glad to see it's being being run so well and the quality is there and the facility is very nice so so yes uh job well done I I think we need to keep letting the employees and the Constitutional offices keep knowing more and more that this is available to them and uh I I think we'll even see better results so thank thank you separately um it's not in my agenda item but we do have our health fair that will be coming up um in the middle of August and uh we're partnering with everside uh they are going to be doing the uh the Biometrics the labs so uh we expect to get about 250 lab draws on site in the um the 501c room we'll set that up for for that purpose and then the everside team is going to be there to help the employees register and become uh registered members of the health center and get scheduled so we're we're actually we have a strategy in place to encourage folks and make it really really easy to get registered and get an appointment fabulous I think if that was done on the onset that your numbers would have far exceeded what they are today I I think that the element of participation was Guided by uh not being registered first and then going and then having to go back and make another appointment and and I think your numbers might might have been quite large because we hear nothing but positive uh about the environment and we hope that it's not going to change I hear great things about Marathon as well and I know they're another area provider uh that the facility will not alter it this is merely a business understanding and for enhancement for service and not a change exactly and um what I'm really pleased about is is the everside team that we're working with um they understand what what we value and we make it really clear what we value we value high quality um we value uh uh not rushing people through I mean I can't over and over again people said I don't feel like a number I feel like I'm a person like I'm heard like I'm seen and that's exactly what we want and we don't want to lose that we want to maintain that through through this uh relationship and and they know they're they're on board with that for us well I will I will tell you that a number of employees and we can't identify them for obvious reasons right uh but they have have contacted or even just cross paths and said what an experience oh wonderful wonderful it's that's great it's it's definitely been a positive move well thank you for your support because it would not have been possible without your support so thank you commissioner Moss yes thank you so we are currently at 16% participation rate of by employees what is your expectation in the next uh 6 to 12 months in terms of the percentage of participation where where going with this and as a second question um CU I don't think I heard it today and if I did please repeat it sure what is the cost per patient so the cost per patient would be well if you took the 410 patients and the 356,000 I suppose uh you could say the cost per patient but it's really it's going to vary it's going to vary based on what the number of visits yeah the number of visits the the level of visits is it Ur well average because you know at some point it has to uh to work financially you know it has to U it has to show a true savings right because you have you know we have all these costs associated with it it's probably or could be too early to evaluate it on that basis but I think eventually uh you want to evaluate it on that basis so could I just throw and maybe you could throw that slide back up because I think it's already demonstrating that we are on a trajectory of you know achieving a return on investment in the first one or two years uh it's been my experience and you know I started one of these for employees when I was at another jurisdiction I've been involved with this at four my four stops in terms of uh in my public service career over 25 years so I think you know and there's the number right there and even if you subtract the 41,000 you're still looking can get what 6 and U no 16 thank you $616,000 you know of diverted savings from what we would incur you know through our normal program I mean by somebody going to their primary care phys they're going to build you know everybody's paying their co-pay but also they're going to build a larger amount to the insurance company and we're diverting and reducing those costs now in terms of the participation I it's been my experience and uh that it's the word of mouth Yes the health fair will help but the word of mouth in terms of the patient experience that people are are going through will change will enhance our participation rate and I think with the additional person you know staff member that will be able to enhance the timeliness and because when you call and I can tell you when I first got here I tried to get in with pie a primary care and they said that was in April and they said well we can see you in January could you not to start a new new relationship and so I mean so when you call and you make that and you're able to get in even within 15 days uh and then we also I've been a benefited recently of like being able to get on the same day next day appointment so I would just say that I would expect as with many of the this is a very similar model but it's not just 16% of our our uh primary are employees but we also have 99.2% of their spouses are are visiting the health center uh and 4.5% of dependents so it goes beyond that because they are on our insurance plan as well and and I guess this what we're asking is to continue and I think we've demonstrated to that we are want to provide high quality health care services to our employees while at the same time and importantly manage our long-term health care costs so that it results in a benefit to our employees as well as exercising sound financial stewardship for our taxpayers Madam chair if I can add when we look at this long range let's say four or five years from now uh and we plan on it being successful and I think the administrator can help me with this that has the potential of lowering our lowering our claims rate with blue cross that doesn't mean Blue Cross is going to go down but maybe it'll level off instead of the the rates that we're seeing so we have to be patient to watch these numbers and keep in mind that we're still paying Blue Cross a lot yeah well and I think the whole reason that we started this was because those numbers were Rising those numbers were rising to the point you know that it was starting to become a problem and we tried to come up with a strategy to help minimize those over the long term and one of the things that we talked about was providing an environment where our employees and their dependents and spouses can go before there's a problem because a lot of our employees do not have any kind of health care or medical home where they go and and have these ongoing you know physicals and looking at things you know there are ways to treat diseases and illnesses you know just taking diabetes as as an example if you can catch somebody before they're pre before they're diabetic in the pre-diabetic stage or even when they have become diabetic and give them tools um to try to mitigate weight or mitigate sugar intake or whatever the case may be and you are checking in with them that means that they're not going to have some kind of major medical issue that requires them to go to the hospital um or be on large scale prescription drugs and that keeps our cost down so that was kind of the goal I think even at the sixth month Mark you're almost the savings has almost outweighed what the startup costs are are so I would assume if that Trend continues once we're in a year we'll well have paid for the startup cost and saved ourselves and our program a bunch of money and I would assume as commissioner lore says that Trend continues over time it just keeps those costs down and that's taxpayer dollars that aren't going into to fund our medical expenses right and another thing that it's it's until you go through it you don't realize um the value but when you're going through a medical situation and it's hard to get an appointment and it's hard to get in to get your Imaging done and then there's claims that come in and then you're having to fight with whoever related to all of this that impact to that person who's also working for you and the the time that they're spending in that frustration it's causing that family to go through that experience it's painful it's painful and what I love about this is it's not it's painless it's it's painfree um it's easy it's it's um they walk out with their you know maybe they have an upper respiratory thing going on and here's your prescription and um you know we'll recheck you in a in a week and and they can do it virtually and so it's getting them back to work it's taking away that stress of now I've got to go to the pharmacy and now I've got to wait and you know have somebody pick it up because I can't take any more time away from work I got to get back there's just so much value that um is beyond just the claims diversion uh that that now our employees are experiencing a very very positive thing and it is as as the County Administrator pointed out it is a a great benefit now for our employees and you you got it uh Suzanne uh you know if we can't turn this into a bank statement assessment at this point uh we have to maintain our focus on patient care and employees service that was the original intent I don't believe that uh our insurance will uh then take the time hey you opened up a a centa let's give you a better rate right off the bat it's going to take time we're going to have to prove and they're going to see a reduction in numbers I think it's going to pay off exponentially up the road as uh commissioner pointed out uh it may take a few years it may be year three year five where they say wow your burden upon our system is greatly reduced because you have this facility so I I I think we'd be falling short if we start talking about uh cost benefit and uh analyzing to that value if if that that was done in any other Endeavor it would probably fail on the first year as Mo many small businesses do you can't look at you can't look at the bank statement at first commissioner Ean Mr flusher I completely agree well said commissioner lore same thing it's just the right thing to do period yeah yeah that's all just a right thing to do so you have a motion a second oh okay I didn't realize that commissioner lore made a motion I'm sorry yeah a motion in a sec okay sorry all right any further discussion there is a motion by commissioner lur with a second by commissioner flesher all in favor opposed motion carries thank you for your support thank you thank you guys for all that you're doing for for our employees and their families we appreciate it all right is there anything else for the good of the order you mean it's it's done what almost oh oh yes when that happens it's over yeah anything else thank you madam chair oh I have one more thing sorry thank you for the reminder um this is June so we will start our summer dress code I know commissioner flesher it's his favorite time of year to dress more casually um but you're looking at it um summer dress you um everybody can can you know dress down and be casual since it's the summer and we'll we'll go back to fancy dress in I don't know September generally so with that we stand adjourned