[0:48] >> We're She That. Good

[0:48] morning, everyone. Welcome to

[0:50] the MARCH 24th Board of County

[0:56] Commission meetings. Rather

[0:57] packed agenda today. We will

[0:58] start with a moment of silence

[0:58] for first responders and

[1:00] members of our

[1:01] >> armed forces. And then we

[1:04] will have the and vocation

[1:07] performed by Rabbi Rose

[1:08] Durban, which is new to the

[1:09] area. And we will welcome her.

[1:12] And this we are first time

[1:12] reforming the and locations.

[1:27] Please

[1:43] >> We ask you, I don't I sort

[1:47] of wisdom in breath. We gather

[1:47] in a space where decisions

[1:51] carry real consequence where

[1:52] leadership is not abstract but

[1:53] lived in the daily lives of

[1:57] this community. Our tradition

[1:58] calls us to holiness not in

[2:01] retreat, but in responsibility

[2:02] to build a society. Where is

[2:04] our Torah? Teaches we do not

[2:07] stand idly by the Bring our

[2:09] neighbor, but instead pursue

[2:10] justice again and again until

[2:15] it takes root. So we ask Grant

[2:15] these leaders clarity of mind,

[2:18] unsteadiness of heart help

[2:19] them to see beyond the

[2:20] immediate to way. Not only

[2:21] what is expedient, but what is

[2:25] right. As the Prophet Micah

[2:27] reminds us the work of

[2:29] leadership is to do justice to

[2:31] love mercy and to walk humbly

[2:33] with GOD to hold power with

[2:35] compassion and a temper

[2:37] conviction with humility. Is

[2:40] our sages teach the world

[2:43] itself stands on 3 pillars on

[2:46] justice, on truth peace. Let

[2:49] these pillars ground this

[2:49] chamber guiding every

[2:50] conversation shaping every

[2:54] decision. All who serve here.

[2:56] Remember that every person in

[2:57] this county is created.

[3:00] LaMelo. In the image of GOD

[3:00] each life carrying infant

[3:05] dignity and worth. Bless these

[3:05] leaders with the courage to

[3:08] choose wisely the patients to

[3:10] listen deeply and the

[3:11] integrity to serve the common

[3:12] good. Can he rots owed made

[3:13] the speed GOD's will and let

[3:17] us say I

[3:18] >> And thank you, Rabbi. Let's

[3:27] welcome our new robot to I'm

[3:28] standing and join us in the

[3:29] budget led by our county

[3:32] administrator

[3:37] >> like the lag United States

[3:43] of America and nation GOD,

[3:44] indivisible, liberty and

[3:54] justice for all.

[3:55] >> Well, thank you. Fellow

[3:56] commissioners that leads us to

[3:58] any additions or deletions for

[4:03] today's meeting. Its chair

[4:05] move approval have a motion to

[4:06] approve by Commissioner

[4:06] Fletcher in a second by

[4:07] Commissioner. Adam, any

[4:09] further discussions? Hearing?

[4:13] None all in favor. Aye.

[4:14] Commissioners. The next item

[4:17] today will be a a remarkable

[4:18] proclamation of the different

[4:21] Historical Museum and Cultural

[4:22] Center, but MR. Richard Lough

[4:29] ski.

[4:30] >> Thank you. Commissioner

[4:32] joining a Pierre who is the

[4:34] executive director. The museum

[4:34] is going see will say some

[4:38] words. First.

[4:38] >> Thank you. And good

[4:47] morning. Where there's no

[4:50] vision. The people perish.

[4:55] However, 29 18. The Giver

[4:58] Clarkson Centre and Museum is

[5:00] a legacy to the

[5:00] African-American communities

[5:01] throughout Indian River

[5:05] County. Many of us up in it do

[5:08] more than projects. We are

[5:12] connected through families

[5:15] through memories and to really

[5:16] experiences that helped shape

[5:18] giver and surrounding

[5:18] communities across

[5:23] generations. The Carter

[5:26] Center's services already been

[5:27] deeply into was with the

[5:32] contra light of this town. It

[5:34] is an anchor to preserve in

[5:36] the river counties.

[5:36] African-Americans store it

[5:40] past. The giver culture settle

[5:43] with That day news for indoor

[5:46] or outdoor performances and

[5:48] its unique ampitheater.

[5:53] Alright gallery, a gift shop

[5:53] spaces, both social

[5:56] educational and cultural

[5:58] activities all while enjoying

[6:02] that in mind. The King Park.

[6:03] This owner, Rick contribute to

[6:05] the local battalla t of the

[6:08] county. But right in visitors

[6:10] supporting arms is serving as

[6:13] a beacon. But a life long,

[6:17] creative learning. And that

[6:22] verse caught experience We are

[6:22] not become is something

[6:27] separate from the county. We

[6:28] formalizing a responsibility

[6:32] to it. This culture, is

[6:36] somethign sacred to us. So

[6:37] that future generations

[6:39] inherit a space dedicated to

[6:43] cut rate indication, shared

[6:45] history and spirit grounding.

[6:48] Commissioners. You have

[6:50] supported this vision and proj

[6:53] it from the beginning with the

[6:55] resolution of commitment. And

[6:57] we are thankful. For U.S.

[7:03] Support. Together. Let us

[7:05] continue to make Indian River

[7:07] County not only and it's quiz

[7:11] that place to live, but also

[7:13] to visit. We present the gift

[7:26] Cultural Center and museum.

[7:27] >> I stood here so many times

[7:30] for so many reasons. And as

[7:31] always sitting while Jenny was

[7:33] speaking, it sort of hit me.

[7:35] This is for me. This has been

[7:37] a real 100 work on this

[7:39] project. Part of that goes to

[7:41] the fact that all of you been

[7:44] so supportive on every level.

[7:45] Commissioner Fletcher, I

[7:46] remember the first meeting we

[7:47] had when this was just an

[7:50] idea. How encouraging you

[7:52] were, how every commissioner

[7:53] has been supportive, though,

[7:54] everyone on senior staff,

[7:57] everyone on planning staff, it

[7:58] should have never been

[7:59] associated with something was

[8:03] just so fulfilling. You MAY

[8:03] remember because I think some

[8:05] of you were there at the large

[8:06] meeting we had at different

[8:11] community center, the sheer et

[8:14] with led by the Lord

[8:15] Consulting where we went over

[8:16] all the things the community

[8:20] wanted in this project and I'm

[8:21] pleased to say everything's

[8:22] been incorporated. We charged

[8:26] architect. Next Brito of Road

[8:26] splits. Brito to not only

[8:29] fulfill all of those

[8:32] programmatic elements, but to

[8:34] create something that would be

[8:37] truly a lasting icon in Indian

[8:38] River County. And I think

[8:40] you're going to see between

[8:42] this coming cultural center

[8:43] and museum. The new give

[8:45] reviews orchestra that we're

[8:47] creating a cultural center on

[8:49] the mainland truth to rival

[8:51] what we have with the Vero

[8:52] Beach Museum of Art, the

[8:54] Riverside Theater, maybe not

[8:55] quite on the scale, but I

[8:58] think in terms of meaning. So

[9:00] we're going to play a foreman

[9:01] and 39 second video because I

[9:03] know we have time constraints.

[9:05] The architect prepared showing

[9:09] this project. I'm going to be

[9:10] you're going to be watching

[9:10] the video. I'm going to be

[9:11] watching your faces. Thank

[9:13] That.

[14:01] We'll be back soon with the

[14:03] formal sub middle for the

[14:05] project been. I'm sure we can

[14:06] go into details then if you

[14:07] have any questions, happy to

[14:11] Now. Well, know you look like

[14:16] you're happy. Really getting a

[14:19] new that this is going to be a

[14:25] special project. I guess

[14:25] perceived it as a conventional

[14:28] project. That is nothing.

[14:33] >> Like a conventional project

[14:34] mentioned something in the

[14:40] very beginning. Very willful.

[14:41] Extremely wrapped around this

[14:44] project. And always very

[14:47] excited. And then my what was

[14:51] going forward? So fortunate he

[14:54] will be here. To see the

[14:55] e#

[14:55] #

[14:57] of this building. The

[15:04] project. I just I'm

[15:08] overwhelmed by seeing it. As

[15:08] you know, there might be a

[15:12] change in NOVEMBER I can't go

[15:17] away from going to get the

[15:17] gold shovel. I'm going to be

[15:21] here for you. Because this has

[15:22] been a long road. I also

[15:25] sense. After looking at that

[15:26] video that we are going to

[15:29] see. A lot more fundraising

[15:35] kuz. That's a project. We were

[15:36] really confident.

[15:37] >> You know you that, you

[15:39] know, it is it has national

[15:39] impact. We're delighted that

[15:42] the next item is about Jackie

[15:45] Robinson, who is a big part of

[15:46] of the story. We've had the

[15:51] support of the Peter o'Malley

[15:52] and it's exciting again. I

[15:55] think all of you for the

[15:57] support for for everyone

[15:58] leadership staff. It's been a

[16:00] joy to work with you on this

[16:02] and looking forward to that

[16:03] day. When we hand you the

[16:05] golden shovel Joe. Thank you.

[16:06] Thank you Have any questions

[16:08] happy to answer? Well done.

[16:17] Thank you. Thank you. Exciting

[16:21] times for tourists.

[16:24] Commissioner, the next item is

[16:27] exciting as well and thus be

[16:29] presented by Commissioner Joe

[16:30] Herman, which is a

[16:31] proclamation honoring Jackie

[16:33] Robinson and celebrating the

[16:34] 2026. Jackie Robinson

[16:36] celebration game.

[16:36] >> Most of you know that

[16:38] commissioner monies. A

[16:43] professional umpire. All types

[16:44] baseball weather, little

[16:46] league or high school or

[16:47] otherwise. So Commissioner

[16:51] Mirman. Thank you, MR.

[16:51] CHAIRMAN.

[16:52] >> Jackie Robinson, folks come

[17:02] on up. Thank Thanks for being

[17:04] here today. And it's my honor

[17:09] to present this proclamation.

[17:11] CHAIRMAN Said I'm huge

[17:12] baseball fan. Not a probably

[17:12] his biggest fan is Curtis

[17:14] Carpenter is but but I'm a

[17:17] huge baseball fan and I do

[17:19] spend a good part of my time

[17:21] this year, a pirate high

[17:23] school and middle school

[17:24] baseball amendment katial

[17:25] college out Jackie Robinson

[17:27] actually that they come here.

[17:30] So baseball is near dear to my

[17:31] heart. But I'm also a

[17:33] historian in a pan of history

[17:35] and and I have followed this

[17:36] story of Jackie Robinson ever

[17:41] since I was a kid followed

[17:42] well, Khalid Dodger town.

[17:43] That's what I that's what it

[17:44] was when I grew up, it was

[17:46] Dodger town and I was

[17:50] fortunate as a young man to.

[17:51] Have a have a did that had

[17:52] tickets season tickets for all

[17:53] the spring training games we

[17:56] get to go when the adults were

[17:56] going take all my friends and

[17:58] see all the great players play

[18:00] sos. It was really cool.

[18:01] Really impressive. So I've

[18:02] seen I've seen a lot of

[18:05] baseball my time playing a lot

[18:06] of baseballs. Try to play

[18:07] meant softballs about low

[18:11] like-new down. But other than

[18:13] that, this is near and dear to

[18:15] me because of that fact that I

[18:18] am huge baseball So it's my

[18:18] honor to read this

[18:22] proclamation and let me do so.

[18:24] This is a proclamation

[18:26] honoring Jackie Robinson

[18:26] celebrating the 2026 Jackie

[18:28] Robinson celebration game.

[18:34] Where is? 4/15/2026 marks the

[18:37] 79th anniversary of Jackie

[18:39] Robinson breaking Major League

[18:41] Baseball's color barrier in

[18:45] 1947. With the Brooklyn

[18:45] Dodgers becoming the first

[18:46] African-American to play in

[18:49] Major League Baseball. And

[18:53] whereas Jackie Robinson spent

[18:53] 9 spring trainings 1948.

[18:58] Through 1956. At Dodger. Tim

[18:59] in Vero Beach, Florida, where

[18:59] the Brooklyn Dodgers advance

[19:03] to the World Series 5 times

[19:03] and whereas Dodge account

[19:07] became the first fully

[19:08] integrated spring training

[19:12] site in the south in 1948.

[19:13] Serving as a beacon of

[19:14] progress during a time of

[19:17] segregation. And whereas the

[19:19] Jackie Robinson celebration

[19:22] game will take place on

[19:25] Wednesday. 4/15/2026 at home

[19:26] in stadium at the Jackie

[19:28] Robinson training complex with

[19:31] the Jupiter hammerheads and

[19:33] the Palm Beach frozen iguanas

[19:35] facing off to honor of Jackie

[19:37] Robinson's legacy while

[19:38] raising funds for the United

[19:40] Way of Indian River County.

[19:43] Whereas this event brings

[19:45] residents and visitors to

[19:48] gather to celebrate history.

[19:49] Enjoy America's past time and

[19:50] give back to the local

[19:52] community now. Therefore, be

[19:54] it proclaimed by the board of

[19:55] County Commissioners have any

[19:58] river County, Florida that we

[20:01] honor the life and legacy of

[20:02] Jackie Robinson recognize the

[20:02] importance of the Jackie

[20:05] Robinson celebration game and

[20:06] encourage residents and

[20:08] visitors to participate in

[20:13] this meaningful of them on

[20:15] 4/15/2026 adopted this 24 day

[20:18] of MARCH 2026 and signed by

[20:20] all 5 county commissioners.

[20:23] There it is. Welcome. Thank

[20:24] you.

[20:26] >> Thank you. Commissioners.

[20:26] Good Morning. America begin

[20:28] ceo United Way. Usually I

[20:32] stand before you with.

[20:33] >> difficult complicated

[20:34] request. So I'm happy today to

[20:35] be here to celebrate something

[20:38] and not be asking you for some

[20:39] hard decision.

[20:40] >> It's a pleasure to be here

[20:41] to celebrate Jackie Robinson

[20:45] and I love that. We're also

[20:46] celebrating the different

[20:48] cultural museum. I think that

[20:50] that's a testament to the

[20:51] history and the culture and

[20:53] the legacy of our community of

[20:55] Jackie Gifford. So they really

[20:58] some synergy there. I love

[21:00] that. And you said, you know,

[21:02] commissioner, you know, sports

[21:02] has a way of uniting us of

[21:06] uniting our community. Unlike

[21:07] many other things when we have

[21:09] so much sports has a way to

[21:12] bring the community together.

[21:13] And then this cell just around

[21:16] this team is just so sick, so

[21:17] missed. So the fact that we're

[21:19] back for another year or so

[21:21] excited and as you said,

[21:23] Wednesday, APRIL 15th, which

[21:24] is Jackie Robinson Day across

[21:26] all of Major League Baseball

[21:28] this year, it's game is

[21:28] sponsored by our friends from

[21:29] Merrill Lynch. And I'm joined

[21:33] today by branch and Bow

[21:34] Scott's words and Jeremy Hsu,

[21:35] a nurse or so excited. We're

[21:36] all so yes, baseball

[21:37] number-one fan, Chris

[21:40] Carpenter, Board, member of

[21:40] United Way. And you all know

[21:42] Rachel, from Jackie Robinson

[21:45] Training Center. So we are

[21:46] also happy to be here in

[21:46] partnership with Major League

[21:49] Baseball. And the game is more

[21:53] about more than just baseball.

[21:56] It is a tribute to Jackie

[21:57] Robinson is enduring legacy,

[21:57] unite our community. And as

[21:59] you said, raises funds for

[22:03] United Way's 48 programs. We

[22:03] touch one in 4 people in

[22:05] Indian River County with our

[22:07] programs. Think look around

[22:09] the room, right? One in 4

[22:10] people are supported by our

[22:12] program. So the proceeds from

[22:14] the game go to support those

[22:15] vital programs. We hope you'll

[22:16] join us for this special

[22:20] evening. Gates Open at 05:00pm

[22:22] opening ceremony is at 06:00pm

[22:24] followed by the first pitch

[22:27] precisely 6.42. As a nod to

[22:29] Jackie's number. The game

[22:31] began in 2014 is an annual

[22:32] tradition to honor Robinson's

[22:33] historic impact on sports and

[22:37] all of society on APRIL 15th,

[22:39] 1947, he shattered baseball's

[22:40] color barrier by making Major

[22:43] league debut with the Brooklyn

[22:44] Dodgers. The Dodgers, not the

[22:48] Yankees, sir. Right here in

[22:51] Indian River County. And that

[22:51] is an often overlooked the

[22:52] fact that this happened right

[22:55] here in our community and

[22:56] Holman stadium played a

[22:57] pivotal role in his story

[22:58] serving as the first

[22:59] integrated spank spring

[23:01] training facility in all of

[23:03] the south. The game is a

[23:04] testament to the power of

[23:06] sports and how it inspires

[23:07] connects and brings people

[23:10] together for a shared purpose.

[23:11] So commissioners, we are

[23:11] deeply grateful for your

[23:13] support in making this event

[23:15] possible. And for bringing

[23:16] baseball back to our community

[23:18] in a way that also strengthens

[23:20] United Way's mission. Thank

[23:21] you being part of the

[23:23] celebration. And for all you

[23:24] do support Indian River County

[23:25] and we hope to see you all at

[23:27] the ballpark. Thank you very

[23:30] much.

[23:31] >> Thank you, Meredith. I

[23:32] could said it better myself.

[23:36] She We are so lucky. Have

[23:37] great partners and United Way.

[23:37] What they do is amazing. We

[23:40] can put on this event without

[23:40] them.

[23:41] >> I have to echo that and

[23:42] thanking County administration

[23:44] and the commissioners. You all

[23:46] have been so supportive on our

[23:48] vision to carry the Jackie

[23:50] Robinson training complex into

[23:51] its new are in vanilla to do

[23:52] some incredible things,

[23:53] including bringing this came

[23:53] back last year. It's just been

[23:55] a real pleasure to do so and

[23:57] celebrate Jackie's legacy with

[24:00] you all and his impact on this

[24:00] community. So thank you all

[24:01] for your support and looking

[24:02] forward to see many of you out

[24:03] there on APRIL 15th, thank

[24:18] you.

[24:29] >> Thank you. This is where

[24:49] uniform that

[25:24] >> One we Well. Yes, our

[25:26] friends

[25:27] >> Different cultural. We'd

[25:28] like to come up for a photo

[25:28] wearing that t-shirt. Mark

[25:37] this up here. Was all wrong.

[25:40] Need to document. That was the

[25:48] CHAIRMAN More. You got any

[25:53] aren't Well, the they have to

[25:54] be able to find you to get the

[26:13] project Oranges light want all

[26:13] right. It's a tall guy, right?

[26:29] Fun of presents street spread

[26:38] of

[26:45] >> And hurricanes it was has

[26:46] tested. If everything here in

[26:58] to I'm going with thank

[26:59] Commissioners. That brings us

[27:02] to the approval the minutes we

[27:03] did not have any minutes to

[27:05] approve. The next is

[27:06] informational items.

[27:07] >> For the commission required

[27:13] for action. We has a nice

[27:13] opportunity this morning to

[27:16] recognize. Our Office of

[27:18] Management Budget. MR. Rudd

[27:26] Minister.

[27:27] >> Yes, MISTER CHAIRMAN,

[27:28] members of the board Christian

[27:31] Daniels. In the back. It's

[27:34] just gonna make your way up

[27:36] here. And the U.S. Take the

[27:37] opportunity.

[27:40] >> The county continues to be

[27:41] in coordination. Many of the

[27:41] department has put large

[27:45] measure due to the to the hard

[27:48] work of Christian Daniels and

[27:52] their staff Healy's Kaylee,

[27:52] Rhonda, worry, if they do an

[27:56] amazing job every year. And

[27:57] for 35 years in a government

[28:01] finance finance officers

[28:02] Association, this award Indian

[28:03] River County, the

[28:05] Distinguished Budget

[28:06] Presentation Award. And that's

[28:07] the same for this current

[28:11] year. 25 26. And also there

[28:12] was a certificate recognition

[28:15] been presented to the omb as

[28:16] the department. Doesn't. It is

[28:17] primarily responsible for

[28:18] having achieved the ward. And

[28:21] as I mentioned, is the 35th

[28:23] consecutive year. Dovetails

[28:24] nicely with the effort of the

[28:27] clerk of the court and they're

[28:29] on it. And comptroller that

[28:32] just continued reinforcement

[28:33] and that the county is

[28:34] committed to fiscal

[28:36] responsibility and

[28:37] transparency. So we think

[28:40] Kristen and her team for our

[28:41] efforts and for producing an

[28:42] amazing budget document every

[28:45] year.

[28:46] >> Thank you. We certainly

[28:46] appreciate that. The officer,

[28:47] very h#

[28:47] #

[28:47] o#

[28:51] the book hundreds

[28:52] of pages. If anyone would ever

[28:54] like to read it page by But

[28:54] there's a lot of great

[28:57] information on all of the

[28:57] departments throughout the

[29:00] county and what they do. Yeah,

[29:01] what we've read, read Thank

[29:06] you. We appreciate that. He

[29:08] Yeah. And as John mentioned,

[29:09] I'm special thanks to leasing

[29:12] Kaylee in our worked on on the

[29:13] but this past year and they

[29:13] did a great job that takes it

[29:14] takes months to get that book

[29:17] out time. Yeah, they they

[29:18] really they really do great

[29:19] work on it. So thank you. We

[29:20] appreciate it.

[29:20] >> Thank you, Kristen.

[29:28] Congratulations. Our next item

[29:30] on the agenda is public

[29:32] comment any items related to

[29:37] the agenda? Hearing. None are

[29:41] seeing none. I was remiss I

[29:44] would like to Assistant

[29:45] General counsel Chris Hixon to

[29:46] the Diocese Morning. Welcome,

[29:49] Chris. There's that brings us

[29:51] to the consent agenda. What's

[29:56] your pleasure?

[29:56] >> MR. CHAIRMAN move approved

[30:01] second. We have a motion by

[30:01] Commissioner Fletcher and

[30:07] second by. Was one discussion

[30:11] item, MR. Administrator on

[30:13] item.

[30:13] >> 90, I'm be yesterday.

[30:14] Agenda items, correct? We just

[30:17] used to exhibit days and we

[30:18] need to remove the second

[30:22] exhibit because it's related

[30:23] to a different project for

[30:24] station 7. But the the initial

[30:28] exhibit a is correct for the

[30:28] item.

[30:31] >> So no did not appreciate.

[30:31] Attorney Hicks pulling that

[30:36] out for us. We have a motion

[30:38] and we have a second with the

[30:42] so item agenda modification

[30:47] all in favor. And the motion.

[30:48] Next item will be

[30:50] constitutional officers and

[30:51] government agencies. And I see

[30:53] in the audience, we welcome

[30:54] the Honorable Leslie Swan.

[31:00] Welcome.

[31:01] >> Good Morning, Chairman

[31:02] Lauren Commissioners. We've

[31:04] been busy at the supervisor of

[31:05] elections office and I have a

[31:07] couple of different requests

[31:10] for You today. First, I am

[31:11] respectfully requesting to

[31:12] have the revenue that we

[31:15] received from there a fine

[31:16] initiative petitions roll back

[31:21] into our 2025. 2026 budget.

[31:22] You know, the Legislature

[31:24] passed a sweeping initiative

[31:25] petition bill and there was a

[31:28] lot of extra cost that we

[31:28] really kind of had an

[31:29] anticipated. But we were also

[31:31] allowed to raise our price for

[31:35] verifying this petition. So

[31:37] I'm looking to have $20,525

[31:39] rollback in 20 budget. That's

[31:41] first item. The second is we

[31:42] had a special election for the

[31:46] town of Orchid. They have 531

[31:49] voters. So I'm asking to have

[31:53] those funds which were $1593

[31:54] to conduct election. Roll back

[31:57] into my budget. And then the

[31:58] last part has to do with

[32:01] polling places. I'm seeking

[32:04] your approval to move the

[32:05] polling place at the Moose

[32:08] Lodge on 43rd Avenue over to

[32:12] the ig Center in one of the

[32:14] rooms for Election Day. We're

[32:15] having some issues with the

[32:18] mode of being at the Moose

[32:19] Lodge. And so we thought it

[32:21] would be better if we moved it

[32:22] over to the Richardson Center

[32:25] and they've agreed to have us.

[32:28] And also we are going to add a

[32:29] additional polling place

[32:31] because of the growth of the

[32:33] county. And that is going to

[32:38] be at the Wheeler campus. At

[32:38] the Richardson Center that I

[32:39] say the first woman the ig

[32:43] Center. Yeah, it and then this

[32:44] one is going to be at the

[32:46] Richardson Center.

[32:48] >> Commissioners, we have 2

[32:48] items. Hear those separately.

[32:51] What's your pleasure.

[32:55] >> chair go ahead

[32:56] >> move approval for the 2

[32:59] financial request that will

[33:02] ensure that the supervisor

[33:08] elections.

[33:09] >> and return for those

[33:09] requests and that she can

[33:12] place them in her, in fact,

[33:14] into a budget. Second, we have

[33:18] a motion by commissioner.

[33:19] >> Leisure and second by

[33:20] vice-chair moss. Further

[33:23] discussion. Hearing, none all

[33:24] in favor. Aye. The motion

[33:26] passes unanimously. MR.

[33:31] Fletcher.

[33:32] >> Again, for the locations,

[33:35] billion. But the it the 3rd

[33:37] item h c locations.

[33:41] >> I did have a question of.

[33:45] MADAM Supervise. 80's. This

[33:47] how many locations is this to

[33:48] increase and relation to the

[33:51] public relations? We just want

[33:53] just one

[33:54] >> the other one, we're

[33:57] relocating. And you have

[34:01] funding for the location. Yes.

[34:04] Move approval. Emotional

[34:05] second. It any further

[34:09] discussion. Hearing none. We

[34:11] have a motion by Commissioner

[34:11] Fletcher and second by myself

[34:13] all in favor. Aye.

[34:15] >> And the motion passes.

[34:15] Thank you.

[34:16] >> Thank you so much. I

[34:21] appreciate it. Thank you.

[34:22] Commissioner. The next public

[34:26] item. It is will be presented

[34:28] by for omb director Chris, to

[34:29] Daniels, miscellaneous Budget

[34:32] Amendment. Welcome again,

[34:32] Chris.

[34:33] >> Thank you. Good morning

[34:33] commissioners, Kristen

[34:35] Daniels, budget director

[34:36] before you today is Budget

[34:38] Amendment 4 which uses cash to

[34:42] fund various items such as the

[34:43] cia rollover Purchase orders

[34:43] board approved projects

[34:47] necessary budget amendments

[34:49] per Florida statute. One 29.0,

[34:50] 0, 6, 2, f whenever the budget

[34:51] end it using cash, a public

[34:55] hearing must be held. So today

[34:55] staff, Rick, recommends that

[34:57] after the public hearing is

[34:59] held, the board approved a

[35:02] resolution amending the fiscal

[35:03] year. 25 26 budget and I'm

[35:03] available if you have any

[35:07] questions on the amendment

[35:08] >> commissioners hopefully get

[35:08] an opportunity to review this.

[35:11] I hadn't and up discussion

[35:14] would director. What's your

[35:18] pleasure? We do have public

[35:22] hearing.

[35:24] >> This time. Thank you. We

[35:24] will have a public hearing.

[35:25] Anyone will like him to

[35:26] comment on our miscellaneous

[35:30] budget amendments.

[35:32] >> We'll prove that Michael.

[35:36] >> ample time public comment.

[35:37] We will close public comment

[35:37] now. Commissioner for

[35:41] triplets. So we have a motion

[35:42] by commissioner items a second

[35:43] by vice-chair moss, any

[35:48] further discussions. Hearing,

[35:49] none all in favor. And the

[35:50] motion carries. Thank You just

[35:55] can't. Commissioners moving

[35:57] right along to department

[35:58] matters and or community

[36:02] service. 13 be one. We have

[36:05] the children Services Advisory

[36:05] Committee return on

[36:12] investment. Presentation. A of

[36:13] Deputy Administrator Zito and

[36:26] others. Joining us today.

[36:27] Good

[36:30] morning and welcome.

[36:32] >> Good morning to the chair

[36:33] and to the commission and our

[36:34] county administrator. We want

[36:35] to thank you so much. Over the

[36:39] last 3 years you have given

[36:42] the autonomy for our staff to

[36:43] build up really strong

[36:44] oversight measures working

[36:47] with our agencies, providing

[36:49] professional development and

[36:51] also supporting in diversified

[36:52] funding for our our nonprofits

[36:55] and support programs. And

[36:58] today, I'm really excited to

[36:58] have our Human services

[36:59] administrator share the return

[37:01] on investment. And I'm going

[37:02] to give the floor over Megan

[37:04] Kanka.

[37:08] >> Bunge or Commission. I just

[37:10] flew in from Italy last night.

[37:13] So wonderful

[37:14] >> So getting I was like, it's

[37:15] so much different than waking

[37:17] up in Florence having coffee

[37:18] itself. Thank you for having

[37:22] us this morning. Today. We are

[37:23] going to quickly talk about

[37:25] the return on investment and

[37:26] children services. Last year

[37:29] we did a comprehensive return

[37:30] on investment. The board

[37:31] requested some additional more

[37:34] researched more recent data.

[37:34] So that is what we're going to

[37:37] be presenting to you today. If

[37:37] you want to see the full

[37:38] return on investment is on our

[37:47] website. So last year we

[37:48] talked about the return on

[37:50] investment. We showed research

[37:53] that proved anywhere between

[37:56] $2.70 up to $16 was returned

[37:58] for every dollar invested in

[38:00] children. The reason is simple

[38:02] prevention cost less that

[38:04] intervention. Programs that

[38:07] support children early help

[38:08] prevent more costly outcomes

[38:10] later in life and health care,

[38:12] education, remediation, social

[38:13] services and the criminal

[38:17] justice system. Sorry, I was

[38:34] cooking. Just click away. So

[38:34] the investment we make Indian

[38:37] River County is not a

[38:37] coincidence. It is based off

[38:39] of our 5 year. Comprehensive

[38:41] needs assessment. This needs

[38:44] assessment is evaluated every

[38:45] year we talked to local

[38:47] experts across multiple

[38:48] sectors. We go over thousands

[38:50] of pieces of data. Like I

[38:54] said, updated annually and

[38:56] within the last 2 years we

[38:58] have received over 1000

[38:59] responses from parents and

[39:00] community members on what

[39:02] their local deeds are.

[39:06] >> And with that, we have come

[39:06] with 3 funding priorities. You

[39:07] guys have all heard heard

[39:08] them. But for the public, its

[39:11] health and well-being,

[39:12] nurturing families and

[39:13] communities and success in

[39:15] school and life. So we show

[39:17] you the new data around the

[39:18] return on investment is around

[39:19] those funding priorities that

[39:20] were identified in a needs

[39:23] assessment. So the first new

[39:24] piece data came from the MARCH

[39:28] of Dimes 2024 study that show

[39:28] that nationally, one in 10

[39:31] babies born premature. That's

[39:34] about 370,000 babies

[39:34] nationally across the United

[39:37] States. Des Preterm birth cost

[39:40] the United States about 25

[39:41] point 2 billion dollars every

[39:44] year. However, the research

[39:47] shows that with prenatal care,

[39:48] maternal health services it

[39:51] early health support. They

[39:52] dramatically reduce these

[39:54] risks, saving the taxpayers

[39:55] billions of dollars. The

[39:55] bottom line is that healthy

[39:58] start say the u save U.S.

[40:01] billions and create healthier

[40:01] families, stronger workers and

[40:04] a stronger economy. The return

[40:06] on investment around health

[40:08] and well-being. This was the

[40:09] Center of Disease Control and

[40:11] Prevention in 2024, it showed

[40:15] that each year more than 600.

[40:16] 1000 children are confirmed

[40:20] victims of abuse or neglect.

[40:21] The cdc estimates that the

[40:22] lifetime economic burden is

[40:24] that 592 Billion. And that

[40:28] what helps this is parenting,

[40:29] education, family, support and

[40:31] connections to community

[40:32] resources that will help

[40:33] prevent these crisis it before

[40:34] they ever occur. The bottom

[40:36] line here is that healthy

[40:36] start looks sorry. We're going

[40:41] to say. That the bottom line

[40:43] is when we invest in programs

[40:45] that parents and strengthen

[40:45] families, we will have a

[40:49] strong return on investment.

[40:51] The next is around success in

[40:52] school and life Nash and

[40:53] nearly one in 3 children enter

[40:54] kindergarten and not fully

[40:59] ready to learn. This can cost

[41:01] between 15 $50,000 and educate

[41:01] additional education costs

[41:02] from kindergarten through 12th

[41:05] grade. But the research does

[41:06] show that high-quality early

[41:08] childhood programs generate

[41:11] between 14 and 16% return. The

[41:12] bottom line is early.

[41:13] Childhood investments prepare

[41:15] children for school while

[41:18] supporting working families.

[41:19] So they can go to work and

[41:20] know that their child having a

[41:21] safe, healthy environment to

[41:24] thrive in. And finally, this

[41:25] is something that I found very

[41:28] interesting. This is a new

[41:29] study. But as about

[41:30] disconnected youth and I think

[41:32] we see this across the board.

[41:36] But about 11% of youth aged 16

[41:37] 24 feel disconnected from both

[41:39] school and work, which is

[41:42] about 4.3 million youth over a

[41:45] lifetime. This could cost a

[41:47] million dollars in one use.

[41:48] When you look at the juvenile

[41:49] health cost, the burden that

[41:51] it has to some of our social

[41:53] systems. So what the research

[41:55] does show is that mentorship

[41:56] enrichment and college and

[41:58] career pathways that help you

[42:00] feel connected. Well will help

[42:01] us as a community prepare

[42:02] these youth and make the

[42:03] vibrant citizens of the few

[42:10] check. This all goes back to

[42:11] what the parents and

[42:11] caregivers in Indian River

[42:13] County are asking for. We did

[42:16] a survey to see what parents

[42:18] needed. We reached out to

[42:18] community groups. We went to

[42:20] different events all over the

[42:22] county.

[42:23] >> We had our Seas Act funded

[42:23] programs, Bennett out word of

[42:25] mouth, social media. And this

[42:29] is what we found. 82% of

[42:31] people responding to the

[42:32] survey wanted increase in

[42:34] funding and support their

[42:36] children services while 16%

[42:38] said they would like the

[42:40] maintained funding. Only 2% of

[42:41] all respondents asked for a

[42:42] decrease in services or

[42:45] funding. What do they want?

[42:46] This goes right in line to it

[42:49] with the research is they went

[42:49] after school and youth

[42:50] programs. They want housing

[42:53] stability. That's not

[42:53] something. The children

[42:55] services funds at the time.

[42:56] But it is something that is

[42:58] affecting our families and

[42:59] they want more access to

[43:03] mental health. Sir Services,

[43:04] smaller needs but still

[43:05] important. Our special needs

[43:08] and inclusion programs, parent

[43:08] and family support and

[43:13] childcare and early learning.

[43:13] Summer, Jen barriers we saw

[43:17] were food security and

[43:19] transportation. So these

[43:20] results are seeing now to our

[43:22] to open ended questions. We

[43:25] had, I would say probably 90%

[43:27] of the people that do the

[43:28] survey put in their written

[43:28] response, which you usually

[43:31] don't see in surveys. So this

[43:32] is truly what you're hearing

[43:35] from your community. So why is

[43:38] this important and the

[43:39] investment you all know that

[43:40] children services right now

[43:44] has over 21,000 touch points.

[43:46] 93% of all stated outcomes for

[43:47] the programs that are funded

[43:48] through children. Services

[43:51] have that their outcomes and

[43:54] 100% of agencies all attended

[43:55] professional development and

[43:56] are using what they're

[43:57] learning to strengthen their

[44:01] program. I just want to thank

[44:02] the board again for your

[44:03] continued support without you.

[44:06] This would not be happening

[44:08] and we see it every day when

[44:09] we go out to site visits. And

[44:10] it's just wonderful what is

[44:11] occurring out in the

[44:14] community. There's a reference

[44:14] is is anybody would like to

[44:17] take a jacket? And with that,

[44:18] I will turn it over if there's

[44:22] any questions.

[44:25] >> Thank As will say

[44:26] commissioners, I think every

[44:27] one of us have been involved

[44:29] the second some point in our,

[44:31] you know, careers. One thing

[44:34] that stands out to me is the

[44:39] 100% participation the

[44:40] participants showed up and in

[44:41] the past, we know that

[44:44] sometimes those could be.

[44:45] There could be some

[44:46] stragglers, quite frank with

[44:50] you and thanks to. Kendrick

[44:52] and the senator sent. I think

[44:54] that's Froome are other words.

[44:55] They know the direction that

[44:56] expected of them. And proud of

[44:59] that.

[45:00] >> thank you. In fact, are

[45:01] just talking to an

[45:02] organization out in the foyer

[45:06] before you walked in. And they

[45:06] said because of some of the

[45:07] professional development and

[45:08] really strengthening their

[45:10] program, they were able to

[45:11] secure large amount of money

[45:13] for a capital project by

[45:17] sharing this. So we are

[45:19] helping programs not only

[45:20] through the outcomes but

[45:21] really diversified funding. So

[45:22] there's less burden on the

[45:23] taxpayer dollar been too

[45:24] early.

[45:25] >> Thank you very much. And we

[45:30] know that and result is our

[45:31] children and Indian River

[45:31] County are are healthier,

[45:33] smarter happier.

[45:33] Commissioners. Any further

[45:37] comment? Thank you very much.

[45:41] >> Well, there's more thing.

[45:42] >> not done We are now moving

[45:46] to 13 be too.

[45:47] >> And this is the approval of

[45:49] youth internship partnership

[45:54] with Careersource Research.

[45:55] Coast Development.

[45:56] >> Good morning and welcome.

[45:58] Good morning commissioners. So

[45:59] real quick. I just wanted to

[46:00] introduce Terry McGraw. She's

[46:02] with Careersource. When you

[46:03] saw the presentation we talked

[46:05] about disconnected youth. I

[46:05] think all parents can see it

[46:06] when we're looking at are

[46:08] teenagers in the cell phones

[46:10] and just what's going on today

[46:11] that there has to be

[46:13] opportunity to get them out in

[46:14] the real world. And so I was

[46:16] very fortunate to meet Harry

[46:17] Gras. What is going to speak a

[46:17] little bit about their

[46:20] program. But it's a program

[46:21] where we can bring these youth

[46:25] into our county and provide

[46:27] mentorship, provide guidance,

[46:29] showing all of the career

[46:29] opportunities and wonderful

[46:31] things happening in Indian

[46:32] River County and hopefully

[46:34] eventually build a very strong

[46:35] pipeline.

[46:35] >> So with that and then turn

[46:38] it over to Terry. Thank you.

[46:39] >> Again, it's a pleasure to

[46:40] meet you. This is my first

[46:47] time presenting so. So my name

[46:50] again is Terry I am workforce

[46:53] career coach for Careersource

[46:54] Youth connections. We also

[46:54] have an adult. We have an

[46:55] adult side and I work with you

[47:05] 16 to 24. So are you

[47:07] connections, program and

[47:08] targets the disadvantaged

[47:08] populations. So we work with

[47:12] high school seniors in school

[47:16] youth and out of school ages

[47:18] 16 to 24 who are unemployed

[47:20] some of them in at a school

[47:21] have not gotten their high

[47:22] school diploma. So we also

[47:26] help with that. We connect

[47:28] young people a career pathway.

[47:30] >> Post-secondary education or

[47:33] military. And we do that our

[47:37] program with a workforce

[47:38] development program. We are

[47:39] funded year and we have

[47:39] year-round program not just a

[47:40] summer program. We are year

[47:46] round we are comprehensive

[47:48] program is funded by the state

[47:48] of Florida. But the Department

[47:50] of Labor spilling

[47:50] specifically.

[47:54] >> We are not affiliated with

[47:55] the school. We just a

[48:01] workforce program. So in

[48:06] program, that. Elgible for our

[48:08] program, we work with getting

[48:10] a high school diploma or

[48:15] they're a ged attainment. The

[48:17] workforce pettiness program is

[48:17] a 5 module program that they

[48:20] can get done within 2 weeks.

[48:21] We work with them with life

[48:25] skill training. A lot of are

[48:28] youth come in severe anxiety,

[48:32] depression. Lack of

[48:34] self-confidence. And when they

[48:34] come in, they they don't know

[48:37] how to make eye contact. They

[48:40] are really petrified. But when

[48:41] we discuss what our program

[48:44] does for them. They see a

[48:45] light at the end of the

[48:47] tunnel. They have a little

[48:48] smile on their face when they

[48:50] leave and they're in carriage

[48:53] to participate by the time

[48:57] they leave. They more

[48:59] confident their anxiety is

[49:00] decreased. We have seen so

[49:00] many improvement in their

[49:06] mental health. What we do is

[49:11] we do a career exploration to

[49:13] determine what area that they

[49:15] want to look and what their

[49:17] career deck direction, maybe.

[49:19] >> we do some skills

[49:20] assessment, basic math and

[49:21] reading just to see where

[49:22] their level is and we help

[49:23] them up their skill level as

[49:29] well. The short term

[49:30] vocational training so we can

[49:31] do certificates and things

[49:34] like that. The surf, say that

[49:36] they can add to the resume to

[49:39] help them meet be more

[49:41] marketable. We also help them

[49:42] with resume development. Some

[49:42] of them are coming in with

[49:46] nothing on their resume. They

[49:46] haven't worked to. They have

[49:48] no experience. However, we

[49:51] tell them what have you done

[49:53] in your personal life? Okay.

[49:54] So they babysitting guess

[49:57] what? That's a skill that we

[50:00] create that, Reza, that job

[50:01] skill and we were cut into

[50:02] their resume. So they have

[50:06] that experience. We also do

[50:07] interview preparation. You

[50:09] know, some people think it's

[50:11] ok to go to an interviewing in

[50:12] jeans and a t-shirt. What we

[50:13] tell them. No, that's that's

[50:17] not the way to do it. So we do

[50:18] those mock interviews and

[50:21] prepped him for that. We also

[50:25] help with job search strategy.

[50:25] So to determine, you know,

[50:28] where they want to look on,

[50:30] what is the labor market

[50:31] information out there would

[50:33] career? Are you thinking about

[50:34] that is going to be successful

[50:36] as opposed to being a dead-end

[50:37] job, you know, Im not going

[50:42] anywhere. And one thing that

[50:44] we honestly do is do a paid

[50:46] internship. So we'll for our

[50:47] youth that are eligible and

[50:50] that are ready for work. We it

[50:51] offer them a paid internship,

[50:57] $15 an hour. Up to 32 hours a

[50:59] week for the amount of weeks

[51:00] that it it's going to take to

[51:04] learn that skill. So as

[51:06] opposed the recent which MAY

[51:09] need like maybe 100 are 120

[51:10] hours or an administrative

[51:11] assistant or something higher

[51:16] that made need 16200 hours per

[51:18] week. And this is the exciting

[51:19] part that we are going to

[51:21] partner with grew resource

[51:24] with. Hopefully, but we're

[51:25] going to give them jobs at

[51:26] opportunities for. We're going

[51:27] to piloted and human services

[51:28] for them to come in and just

[51:32] see if this is a fit.

[51:33] >> They do work placement for

[51:33] 25 to 30 hours a week. But the

[51:36] best part is it's a paid

[51:37] internship, meaning that they

[51:38] have skin in the game. There's

[51:42] change. There's accountability

[51:42] and there's no liability for

[51:43] the county because that all

[51:45] falls under career resource as

[51:46] absolutely. So we cover the

[51:47] liability and workers comp for

[51:49] that period of time.

[51:51] >> We are the workforce career

[51:52] coach. So we walked with them

[51:55] during that internship and

[51:56] whoever their supervisor as

[51:58] our personal cell phone. And

[51:59] we if anything going on that

[52:01] we need to address, we address

[52:03] it together so that they can

[52:04] learn that this is how the

[52:06] world works works. So we're

[52:12] very excited. Yeah. And if So

[52:15] finally, the ultimate goal is

[52:18] for employment posts, dairy

[52:19] education and dance training

[52:23] of some kind military service.

[52:24] But one key thing is when

[52:25] they're done our program,

[52:27] they're not really done. We

[52:29] follow them for the next 12

[52:30] months. We are their career

[52:31] coach. They are allowed to

[52:38] come back to us to help them

[52:39] update their resume fill out.

[52:39] Help them feel they're faster

[52:40] for college. Now they decided

[52:43] to go to college. So that's

[52:45] one of the things that we, you

[52:46] know, keep in touch with them,

[52:50] even if And we're just hopeful

[52:50] and excited about an

[52:51] opportunity to bring youth and

[52:55] connect with them.

[52:56] >> The mentors and strengthen

[52:57] our community across the

[52:59] board. So thank you for your

[52:59] time. If you have any

[53:00] questions or here to answer

[53:02] that. MISTER CHAIRMAN.

[53:05] >> Thank you, MR.

[53:05] Administrator.

[53:06] >> Is just want echo some of

[53:12] the comments. Been the space

[53:12] Coast we partnered resources

[53:16] that are similar program. It

[53:17] was highly successful. We did

[53:18] just limited to seniors down

[53:23] lower to the juniors.

[53:24] >> And if students and the

[53:25] participants got an

[53:27] opportunity to work in.

[53:30] >> Almost every area of local

[53:31] government. You know, from

[53:35] doing natural resources,

[53:37] writing bridge, fleet fire

[53:38] rescue shadowing working

[53:40] utilities out of the water

[53:42] plant, Duke customer service

[53:46] working on the field. They

[53:48] didn't. Some of the ones in

[53:49] public works welding

[53:50] competition, which is really

[53:53] good and planning building

[53:55] permitting planning

[53:56] development Services building

[53:57] facility services like as I

[53:59] could think of. So I think

[54:00] it's really a great

[54:02] opportunity. One to provide,

[54:05] you know, introduce them to

[54:06] public service, but also

[54:07] provide a level of support

[54:09] while they're going through

[54:10] this.

[54:14] >> And I do like the pipeline

[54:15] component and they would

[54:16] indicated this is a pilot

[54:18] project with community

[54:20] services. I don't anticipate

[54:22] this not being successful and

[54:25] this is a great opportunity in

[54:26] the future to expand this and

[54:30] bring many young individuals,

[54:32] you know, between so they 16

[54:33] 24 into, you know, public

[54:36] service.

[54:39] >> Thank you, MR. Minister

[54:40] Commissioners, does require

[54:43] stamp of approval. The

[54:45] approval second motion by

[54:46] Commissioner Adams and a

[54:47] second by vice-chair Any

[54:49] further discussion. Hearing?

[54:52] None all in favor. Thank you

[54:55] so much for your time. You're

[55:05] Dozens

[55:12] over the time. Now is

[55:14] Commissioners? Up next

[55:15] something extremely important

[55:18] presented by human resources.

[55:20] Director. She's oil and this

[55:21] involves the group Health

[55:22] Insurance Update for MARCH of

[55:32] 2026. Good morning of

[55:34] mourners, MR. Fletcher. Oh,

[55:41] sorry.

[55:43] >> Suzanne Doyle, director of

[55:46] human resources. I last met

[55:48] with you JANUARY 13th and

[55:48] stated that I come back in

[55:49] MARCH. Give you an update on

[55:52] our health plan performance.

[55:55] We did receive information

[55:57] through DECEMBER of 2025. On

[56:00] how our Health plan is

[56:02] performing we are showing for

[56:06] the 1st quarter. And just to

[56:07] remind everyone our plan year

[56:09] for the health plan begins

[56:10] OCTOBER. So we have claims

[56:15] data through DECEMBER for the

[56:16] 1st quarter. And for that 1st

[56:17] quarter, we're showing that we

[56:19] are running at a deficit of

[56:22] 2.0 1 million dollars. I do

[56:25] want to put that into

[56:27] perspective, though. That is

[56:28] one quarter worth of

[56:32] experience. My first 3 months.

[56:35] I am looking at a 31% loss

[56:38] ratio, which means for every

[56:40] dollar of premium that comes

[56:42] in a dollar. And 31 is going

[56:45] out to pay claims. So $0.31

[56:47] short on the dollar to just

[56:51] kind of simplify it. What i

[56:54] look back historically at the

[56:56] plan's performance over time,

[56:58] we typically look back at a 12

[57:00] month rolling period. So if I

[57:02] go back a year and look at how

[57:04] the plan has performed, I have

[57:07] good months. I have bad months

[57:10] and my last ratio is 18%,

[57:14] meaning for every dollar. I'm

[57:17] $0.18 short. So when I say put

[57:20] it in perspective, this $0.31

[57:21] on the dollar short for a

[57:24] rolling 12 month period. $0.18

[57:29] short. The trust is still well

[57:32] funded. So we are not, you

[57:33] know, running at risk of not

[57:36] having a well-funded plan. We

[57:37] are very well funded in the

[57:41] agenda item. You can see.

[57:42] >> That trust as the the

[57:45] balance at the end of DECEMBER

[57:48] 2025. Was 23.8 million

[57:50] dollars. However, when we look

[57:53] into the plan, experience, one

[57:54] of the items that we had

[57:56] talked about previously was

[57:57] our gop one coverage for

[58:00] weight loss medication. I'm

[58:03] looking at over $700,000 being

[58:06] spent in the 1st quarter for

[58:09] the gop. One weight loss

[58:12] medications. But again, we

[58:15] have 2.1 million in a short

[58:15] fall.

[58:16] >> So I also need to consider

[58:19] what's happening on my medical

[58:19] side of things. And what was

[58:20] really interesting to note in

[58:25] this first quarter, I had 27

[58:27] high-cost claimants on the

[58:31] plan. That means I have 27

[58:32] individual people who had

[58:36] major health events that were

[58:38] over $50,000 in total claims

[58:41] in the 1st quarter of the plan

[58:42] year. So that is 2.8 million

[58:46] dollars. When I look at last

[58:49] year's 1st quarter experience

[58:54] from the prior year. I have 13

[58:56] high-cost claimants at a cost

[58:57] of a little over a million

[58:59] dollars. So you can see that

[59:03] on the medical side of things

[59:04] substantially more serious

[59:04] medical conditions happened in

[59:07] the 1st quarter. And with

[59:08] that, I'm going to pause and

[59:12] take any questions.

[59:12] >> Well, thank you as well.

[59:18] And I think everyone appears

[59:18] been in this business for a

[59:20] while and we've seen the

[59:21] trends and one thing that

[59:22] we've learned is not to

[59:24] overreact when we see a a

[59:27] particular trend. And I think

[59:31] you're consultant to agree.

[59:34] One thing, we do need to have

[59:36] a healthy discussion, so to

[59:41] speak on the weight loss. Fact

[59:41] is, we've talked about this

[59:43] for at least 18 months. Fact,

[59:44] last MARCH, we had a

[59:45] significant discussion about

[59:50] it. At some point, the

[59:51] direction that we are

[59:54] commission respect to policy

[59:56] and budget. These in fact,

[59:56] combined these decisions will

[59:58] combine both of those items

[1:00:04] that we are commission to do.

[1:00:05] My suggestion in the past to

[1:00:08] the administrator has been to.

[1:00:12] Notify affected employees as

[1:00:15] well as find the balance of

[1:00:15] the necessity of the

[1:00:19] particular. Weight loss. And I

[1:00:19] would like to administrator

[1:00:23] to. Further discuss that with

[1:00:24] our commissioners, MR.

[1:00:27] Minister. Yes, MR. Chair, as

[1:00:31] we've discussed.

[1:00:32] >> There's a couple things

[1:00:33] we've not yet notified because

[1:00:35] this is the first quarter.

[1:00:36] Mean, I think we wait for the

[1:00:40] 2nd quarter to come in. And I

[1:00:42] think it was made aware during

[1:00:44] the budget process that we

[1:00:46] would monitor it. And we're

[1:00:47] doing that. And then the other

[1:00:52] thing that's at play is

[1:00:52] nationally. There's with the

[1:00:55] The PRESIDENT's Rx plan as

[1:00:56] well as some of the

[1:00:57] pharmaceuticals. I think

[1:00:58] there's a deal struck that

[1:01:00] might offer alternatives to

[1:01:01] lower costs, but I don't think

[1:01:03] it's going to eliminate the

[1:01:05] cause. So I think your point

[1:01:05] about having a discussion on

[1:01:09] it is appropriate and at the

[1:01:11] prior to that, maybe it's the

[1:01:12] next meeting as we will. We

[1:01:14] will definitely provide our

[1:01:17] employees notice. We generally

[1:01:19] want to provide them the

[1:01:19] notice once a decision is

[1:01:20] made, you know, but will

[1:01:20] provide notice in advance. So

[1:01:22] if they need to participate

[1:01:23] in, come in and share their

[1:01:25] story, their experience, but

[1:01:26] you would definitely want to

[1:01:29] provide the appropriate notice

[1:01:30] if we're planning to make a

[1:01:33] change, whether it be 60 days

[1:01:35] out or you know, or whether

[1:01:35] it's in in advance of the

[1:01:37] OCTOBER. First to the next

[1:01:39] year. But I do think it merits

[1:01:42] with the next quarter that we

[1:01:44] provide notice to the

[1:01:45] employees that this discussion

[1:01:48] would be had at that meeting

[1:01:49] because as you indicated, I

[1:01:51] mean, this is really one

[1:01:53] quarter. And if you go back

[1:01:54] and you look at the if you

[1:01:55] flip the page and report,

[1:01:58] you'll find that there is a

[1:02:02] you. We had something like 701

[1:02:02] our claims that were high

[1:02:07] costs last year. Hopefully its

[1:02:09] levels out, some of them to

[1:02:11] the tune of close to $400,000

[1:02:13] or at least one or 2 of them.

[1:02:15] And right now we're at about

[1:02:17] 100 1826 $1000. And when you

[1:02:22] look at the claims, there is

[1:02:23] no because there's a wide

[1:02:24] variety of claims, you know,

[1:02:28] from through issues with a

[1:02:29] pre-term pregnancy, a

[1:02:31] premature approved pregnancy,

[1:02:34] some cancer, just some some

[1:02:37] things that have hit

[1:02:38] catastrophic events and that

[1:02:40] that's not should be it. You

[1:02:42] looked at that that this is a

[1:02:44] trend. I think we should wait

[1:02:47] and see. My recommendation

[1:02:48] would be to get the east

[1:02:49] because we're MARCH now will

[1:02:51] begin the 2nd quarter results

[1:02:53] in shortly in income and come

[1:02:55] back in and have that disk

[1:02:55] that healthy discussion and

[1:02:59] will be for the budget

[1:03:00] preparation for the next

[1:03:04] fiscal year.

[1:03:05] >> appreciate the MR. Men for

[1:03:07] one thing that we should keep

[1:03:08] in mind, although we have look

[1:03:10] at this office and 2

[1:03:11] categories, one being the

[1:03:11] prescription, obviously the

[1:03:15] other being medical.

[1:03:16] Previously stated the medical

[1:03:17] sometimes can can fluctuate

[1:03:18] and Trent different. We all

[1:03:22] know that my follow-up

[1:03:25] question, Suzanne, would be.

[1:03:27] Through the years when we've

[1:03:30] talked the weight loss, we

[1:03:34] fault or perhaps a hoped that

[1:03:35] our medical claims will be

[1:03:39] down. It needs back. Anything

[1:03:39] that would this be associated

[1:03:43] with weight loss? However, we

[1:03:44] have not and fact we've one

[1:03:49] would argue the office. To my

[1:03:51] fellow commissioners, I this

[1:03:52] thing is going backwards and

[1:03:57] heard. And I think a decision

[1:03:57] and were tasked we can kick

[1:04:00] the can and we want. But at

[1:04:04] some point a listen. Sometimes

[1:04:05] bad news is not good news.

[1:04:06] particularly when you're when

[1:04:11] you notify employees of. Of

[1:04:11] certain and this could perhaps

[1:04:16] be the I think we need to be

[1:04:19] and we need to stand up and

[1:04:19] look after the taxpaying

[1:04:21] dollars make a decision. If we

[1:04:23] desire to wait a quarter,

[1:04:28] you're in other words,

[1:04:29] treading water. Commissioner

[1:04:29] Fletcher and I see you have

[1:04:34] something to it. Well, once

[1:04:37] again this taken on.

[1:04:38] >> Many different avenues as

[1:04:40] we were discussing gop one.

[1:04:43] And at the time. The cost

[1:04:48] factor. Was overwhelming. But

[1:04:53] there was no alternative.

[1:04:53] >> There are there's a

[1:04:55] multitude, a lot of

[1:04:58] alternatives that are less

[1:05:03] than 25% of the expense. It

[1:05:07] sounds like we're looking at

[1:05:08] again. None of us on medical

[1:05:11] practitioners. And this is a

[1:05:14] decision between the doctor

[1:05:19] and risk riding entity and the

[1:05:21] patient. The employee. The

[1:05:27] employee's family member. What

[1:05:30] are we actually doing? By

[1:05:32] saying we'll wait another

[1:05:33] Korda is we just kicking the

[1:05:36] can down the road. And how

[1:05:40] Florida we want to do it. I

[1:05:45] recall one of the more recent

[1:05:45] conversations that you said,

[1:05:46] look, you know, we're gonna

[1:05:51] bring this back. And I did

[1:05:52] hear the county administrative

[1:05:53] say that we were going to

[1:05:54] monitor the situation. Well,

[1:05:58] done that. We monitor the

[1:06:00] situation. It has been no

[1:06:05] reduction and other employees.

[1:06:06] Do have medications that are

[1:06:11] not covered. Can't be covered.

[1:06:14] And life depends upon it. They

[1:06:17] are continue. A scrip shuns.

[1:06:23] You know, whether maintenance

[1:06:24] medication, it's just not

[1:06:29] covered. Yet. It will cover

[1:06:31] something that as such a high

[1:06:33] price. I think we need to

[1:06:40] reduce it. Now. And give the

[1:06:42] employees notice so that they

[1:06:43] can make the appropriate plans

[1:06:49] with the doctor. Prescribing

[1:06:51] entity and they can still

[1:06:54] receive the benefit of this.

[1:06:59] We reduction medication in

[1:07:02] different avenue in a

[1:07:03] different way and flawless of

[1:07:05] a burden to our system where

[1:07:09] it's actually compromising the

[1:07:11] health availability for other

[1:07:12] medications because this

[1:07:17] expense is so high. Obviously

[1:07:19] our pro vita is going to look

[1:07:21] at the cost of doing business,

[1:07:22] which going to reflect back to

[1:07:29] us. County. As far as dollars.

[1:07:32] But it's also going to reflect

[1:07:35] on what medications are

[1:07:35] covered and what medications

[1:07:37] on not covered. And if where

[1:07:41] the willing buyer. By it all.

[1:07:47] I think we have to stop it.

[1:07:48] Real estate about the new

[1:07:49] opportunities that are there

[1:07:52] for the patients. For

[1:07:54] commission's. And for the

[1:07:59] people that we serve.

[1:08:03] Commissioner I was under the

[1:08:05] impression of this item was an

[1:08:05] update. But it sounds like you

[1:08:09] guys want to. Push into some

[1:08:12] decision which just to be

[1:08:12] completely honest, I'm not

[1:08:14] comfortable with making that

[1:08:15] decision today because this

[1:08:16] was supposed to be an update.

[1:08:18] And that's what we're here to

[1:08:19] be updated upon. And then if

[1:08:21] you want to set a course for a

[1:08:22] future decision point, I'm

[1:08:24] totally fine with that. But I

[1:08:25] would have questions that I

[1:08:28] would want to be presented as

[1:08:28] part of that decision-making

[1:08:32] process. One. It looks like

[1:08:34] the numbers are actually down

[1:08:36] for the gop wins over last

[1:08:36] year. So I want to see that. I

[1:08:40] want to see that Graff. I

[1:08:41] would like to see what we're

[1:08:43] doing and the way of wellness

[1:08:44] if we're going to take that

[1:08:46] away. Commissioner Lester, you

[1:08:47] talk about all these other

[1:08:48] options. But there really

[1:08:51] isn't any options on our plan

[1:08:51] other than this. We don't pay

[1:08:56] for nutrition. S we don't pay

[1:08:57] for gym memberships and things

[1:08:59] of that nature which would

[1:09:01] support peoples. We lost a

[1:09:04] journey. We don't pay weight

[1:09:06] loss, counseling under this.

[1:09:07] So if you want to get people

[1:09:10] off of medication, have them

[1:09:12] create healthy habits and

[1:09:13] choices. Those are things that

[1:09:14] you need to provide for. So

[1:09:16] I'd like to see what those

[1:09:17] options are, what we are

[1:09:18] doing, what we're not doing,

[1:09:19] what we might be able to add,

[1:09:23] that would be a lower cost and

[1:09:24] a longer-term option for

[1:09:25] people to give them their

[1:09:26] skill sets. But also, you

[1:09:30] know, I don't think that I

[1:09:34] would also like to see that

[1:09:35] which our our plan covers all

[1:09:37] the constitutional is correct.

[1:09:41] Correct. So it's I don't think

[1:09:41] it's completely accurate to

[1:09:43] say that all of our employees

[1:09:46] MAY or MAY not be the only

[1:09:50] effective ones are the ones

[1:09:52] utilizing that resource. There

[1:09:53] are several different

[1:09:56] constitutional is with large

[1:09:56] employee basis. I don't know

[1:09:59] if we can see the breakdown on

[1:10:00] that way, but I would be

[1:10:04] interested to see where the

[1:10:05] majority of those costs are

[1:10:06] coming from, whether it's

[1:10:07] Indian River County, specific

[1:10:11] or different. Office. And I

[1:10:13] think that they need to be put

[1:10:14] on notice that that

[1:10:15] conversation is happening

[1:10:15] because if you're going to

[1:10:17] impact, it's not just our

[1:10:18] employees at this point. We're

[1:10:19] talking about other people's

[1:10:21] employees. And if we're going

[1:10:22] to impact them with the

[1:10:23] decision, they have a right to

[1:10:24] know about that decision and

[1:10:25] be part of the conversation

[1:10:26] before we just unilaterally

[1:10:30] make it so it's in my comments

[1:10:30] for today.

[1:10:31] >> And agreed MR. CHAIRMAN

[1:10:36] just I heard was pointed out

[1:10:41] about options. The options are

[1:10:45] plans. The medications are now

[1:10:46] available that are greatly

[1:10:49] reduced in the burden to the

[1:10:54] system and the medications

[1:10:55] again, not a practitioner and

[1:11:00] none of us are, however, new

[1:11:03] products have become

[1:11:05] available. That alternative. I

[1:11:05] didn't mean that there was

[1:11:08] options like, you know, plans

[1:11:14] and, you know. Programs they

[1:11:19] some that are available. And

[1:11:22] but the medications themselves

[1:11:26] have greatly dropped. And with

[1:11:28] the new products on the market

[1:11:30] that do exactly the same

[1:11:31] thing. And we had talked about

[1:11:34] that because I know the.

[1:11:38] >> The PRESIDENT Has to make

[1:11:38] made a move for certain

[1:11:41] prescriptions to be reduced.

[1:11:42] >> And that will also help us

[1:11:46] out. They're already existing

[1:11:52] options. 4 this medication or

[1:11:53] a similar medication to be

[1:11:56] utilized again, it's c we Jen.

[1:12:00] Money.

[1:12:00] >> So Commissioner Adams, I'm

[1:12:03] hearing that you you would

[1:12:03] like a.

[1:12:06] >> The more road, the more

[1:12:09] analysis of who, what, when,

[1:12:10] where, why?

[1:12:11] >> I think I don't. I mean, I

[1:12:12] think it's a great

[1:12:13] conversation to happy have

[1:12:14] been talking around it. So we

[1:12:16] MAY as well just have it. But

[1:12:17] I would like to see a little

[1:12:19] bit more detail, 2 base that

[1:12:21] conversation.

[1:12:21] >> Great and.

[1:12:24] >> It's not lost on us. That

[1:12:24] in a few days will be the end

[1:12:28] of the 2nd quarter always

[1:12:30] being mindful of our budget

[1:12:31] preparation for health care

[1:12:38] expenses. And some of those

[1:12:40] options that you who and how

[1:12:41] will those be paid for? Would

[1:12:44] that be a wash, so to speak?

[1:12:48] >> I know that we have our

[1:12:48] consultants PRESIDENT And

[1:12:53] sounds like. We need to get

[1:12:53] the information and make a

[1:12:56] solid decision. And I don't

[1:12:58] know that we can wait. Another

[1:13:02] 2 months for an update.

[1:13:04] >> I do. MISTER Chair I don't

[1:13:06] disagree and I don't we're not

[1:13:06] trying to not advocating. We

[1:13:09] kick the can down the road.

[1:13:10] Said okay fact that we get the

[1:13:12] results from the 2nd quarter,

[1:13:14] which is as to your point,

[1:13:17] that is because we did say

[1:13:18] mid-year, come back at it.

[1:13:19] We've had updates. We've been

[1:13:21] monitoring it. We've talked

[1:13:23] with Marathon health about

[1:13:24] alternatives. Will our

[1:13:25] employees and those that use

[1:13:28] the clinic. The JANUARY update

[1:13:31] was really kind of focused on

[1:13:34] will discuss the gop ones. It

[1:13:35] was looking at the prior year

[1:13:36] planned performance because it

[1:13:39] was closed out. So this is

[1:13:41] really the first opportunity

[1:13:42] to look at the 1st quarter. So

[1:13:45] but to your point. Were in

[1:13:49] days, you know, 7 days, we

[1:13:50] will be done with the 2nd

[1:13:50] quarter. I don't know how

[1:13:53] quick those numbers can turned

[1:13:55] around and we can't have that

[1:13:56] conversation.

[1:13:58] >> Well, I can tell you each

[1:14:00] year we come back before the

[1:14:01] board regarding our upcoming

[1:14:03] plan year. And that's in the

[1:14:05] MAY JUNE time frame to discuss

[1:14:06] the plan features for the

[1:14:09] upcoming plan year. We have

[1:14:11] been having a lot of

[1:14:12] discussions locked in and I

[1:14:17] regarding the options

[1:14:18] Commissioner Flasher, you're

[1:14:19] you're you're right. There's

[1:14:19] so many different things

[1:14:23] coming on the market and it

[1:14:25] every week there's something

[1:14:27] new. One of the really

[1:14:29] important things to consider

[1:14:34] is we do you know, 237

[1:14:35] members.

[1:14:40] >> of our group plan who are

[1:14:41] utilizing the gop. One weight

[1:14:45] loss medication and they are.

[1:14:46] >> Seeing a lot of substantial

[1:14:49] improvement in their own

[1:14:50] personal lives. And I think

[1:14:51] it's important that we have a

[1:14:56] plan in place to transition

[1:14:57] them to to help them with

[1:14:59] that. If if the plan decision

[1:15:00] is and it's looking like it,

[1:15:02] it financially MAY need to be

[1:15:06] that way that we remove the

[1:15:08] gop ones as a cover medication

[1:15:11] for weight loss on the plan,

[1:15:13] then we do want to have

[1:15:13] something in place for them to

[1:15:15] move to. And we want to make

[1:15:18] sure that that is well thought

[1:15:19] out and that that transition

[1:15:21] is well communicated. We have

[1:15:24] been looking at nutrition

[1:15:25] support. We are vetting out

[1:15:27] certain programs right now. I

[1:15:29] actually have someone our

[1:15:31] group plan. That's beta

[1:15:34] testing and option that is

[1:15:37] available right now. And they

[1:15:38] were very, very impressed with

[1:15:39] that from it was actually like

[1:15:43] that a telemedicine virtual

[1:15:47] visit with a nutritionist we'd

[1:15:48] be looking at either a low

[1:15:51] cost or no cost a nutrition

[1:15:52] support on the plan. We do

[1:15:55] have some preliminary analysis

[1:15:56] that says that the impact of

[1:15:59] that is quite negligible to

[1:16:00] the plan because the costs

[1:16:04] like $65. A visit as opposed

[1:16:07] to, you know, $1000 for the

[1:16:10] medication we're looking you

[1:16:11] know, getting the information

[1:16:12] as what type of nutrition

[1:16:15] support benefit make sense. Is

[1:16:16] it a certain number of visits

[1:16:19] at 0 copay? Is there to go

[1:16:20] beyond a certain number of

[1:16:21] visits? Does there need to be

[1:16:24] like a prior authorization

[1:16:25] process? So we are looking at

[1:16:27] a lot of a lot of those things

[1:16:28] that you mentioned when you

[1:16:30] look at those dew usc employee

[1:16:31] went.

[1:16:32] >> They MAY or MAY not need to

[1:16:35] put out any kind of.

[1:16:37] >> Survey request for feedback

[1:16:38] on what would actually be

[1:16:41] utilized and be helpful.

[1:16:44] >> We have not to date done

[1:16:45] that. That is something that

[1:16:48] we could send out a global

[1:16:52] number survey related to gop

[1:16:52] ones.

[1:16:53] >> I think it would be helpful

[1:16:56] find out what kind of

[1:16:59] >> benefit would be a benefit

[1:17:02] that people would actually use

[1:17:03] minds.

[1:17:04] >> Then a fission. Yeah, and I

[1:17:07] didn't I didn't mention this

[1:17:08] The nutrition support could be

[1:17:09] in person as well. It doesn't

[1:17:14] need to simply through virtual

[1:17:15] visit because some people do

[1:17:18] like the in-person as well.

[1:17:20] And then we're also

[1:17:22] considering whether it makes

[1:17:23] sense to have some on-site

[1:17:25] support through the health

[1:17:27] center for a nutritionist. So

[1:17:27] there's a lot of different

[1:17:31] options to consider. And then

[1:17:32] the various programs that will

[1:17:35] be available as members maybe

[1:17:36] want to transition our stay on

[1:17:40] the gop won but transition to

[1:17:41] the the self pay options which

[1:17:45] are much more affordable than

[1:17:47] what the planned medication

[1:17:48] costs are, too. Susan. So when

[1:17:50] because I don't disagree with.

[1:17:51] >> The need for a

[1:17:53] conversation. Potentially

[1:17:56] sooner than later. And so I

[1:17:57] guess the question is either

[1:17:59] between with you are a lot in

[1:18:02] when can we get the final

[1:18:04] numbers after the 2nd quarter

[1:18:06] closes? How quickly can we get

[1:18:08] those for the purposes of

[1:18:11] evaluating the board make a

[1:18:11] decision, then from their

[1:18:15] basin, a decision with options

[1:18:15] some answers and the questions

[1:18:19] have been raised here for the

[1:18:20] purposes of notifying the

[1:18:21] employee notify them that they

[1:18:23] discussion is going to happen.

[1:18:24] But after the decision was

[1:18:24] made, then we would notify

[1:18:28] them what date is. So when do

[1:18:28] you think how quickly can you

[1:18:30] turn these numbers around?

[1:18:34] >> So right now we have right

[1:18:37] now we have everything updated

[1:18:39] through FEBRUARY. So MARCH

[1:18:40] data should be available and

[1:18:40] updated in our system by the

[1:18:43] end of APRIL. So timing Wise

[1:18:46] for a commission meeting. I

[1:18:47] know that there's 2 weeks

[1:18:48] required prior to the date of

[1:18:49] that meeting. So would

[1:18:50] probably be looking at the

[1:18:55] second meeting of MAY.

[1:18:58] >> it mean if I've would given

[1:18:59] the fact that there's some

[1:19:02] flexibility with the agenda,

[1:19:02] if I could get it could be

[1:19:06] possibly the first of MAY. If

[1:19:07] we first meeting first

[1:19:08] meeting, I'm a yes since, you

[1:19:11] know. I don't think I think

[1:19:14] it's important. The reason I

[1:19:15] say that first meeting MAY is

[1:19:16] because that's when budgets

[1:19:19] are being entered. And I think

[1:19:20] we're starting to look at that

[1:19:22] and I think we need to

[1:19:23] understand the impact and not

[1:19:25] wait to the second meeting in

[1:19:26] MAY, but I think that also

[1:19:28] might provide time for years.

[1:19:30] Suzanne, for you, your staff

[1:19:32] to continue researching these

[1:19:35] things that we've been

[1:19:37] discussing from since DECEMBER

[1:19:39] So I mean that we have

[1:19:40] monitored and discussed

[1:19:41] alternatives. So I think we're

[1:19:44] prepared to kind of come

[1:19:46] forward and and have that

[1:19:46] discussion. If if the board is

[1:19:48] willing, I just I think you

[1:19:51] need to know the thing is what

[1:19:54] we said before. And so we just

[1:19:55] want to kind of follow through

[1:19:58] with that. I think we can to

[1:19:58] the first meeting in MAY, if

[1:20:01] if the board would. And

[1:20:02] indulge that, we don't want

[1:20:03] kick the can down the road,

[1:20:05] but that would give us helped

[1:20:06] form the budget process for

[1:20:09] next year. CHAIRMAN. Yes, yes,

[1:20:16] sir.

[1:20:17] >> great I agree with

[1:20:18] Commissioner Adams. I think I

[1:20:20] was expecting update was

[1:20:23] expected to discuss the

[1:20:25] specific thing with gop and

[1:20:26] others in other things. Could

[1:20:31] this sounds like? Hr told us

[1:20:35] the, you know? Yeah, we're

[1:20:36] looking at trends. Trends vary

[1:20:37] from quarter to quarter month

[1:20:38] to month, year to year. We

[1:20:42] need to take a that MAY be a

[1:20:43] deeper dive into this to look.

[1:20:46] And I'm not in. A new way

[1:20:47] rethink that. Kicking the can

[1:20:48] down the road. I don't think

[1:20:50] we've done that yet. And I

[1:20:52] don't think we're going to do

[1:20:53] that. I think we know better

[1:20:54] than to do something like

[1:20:57] that. It just seems like

[1:20:59] there's a lot of possible

[1:21:01] options here as we got further

[1:21:03] in the conversation. I've

[1:21:03] heard everything from, you

[1:21:04] know, the Fed's not going

[1:21:07] price different things we can

[1:21:09] do. I think we need to look at

[1:21:12] it. Some of those options. Is

[1:21:14] such as a commissioner. Adam

[1:21:14] said this. We need to get a

[1:21:17] little more information hard

[1:21:18] information make a decision. I

[1:21:23] mean, we've got not only h r

[1:21:24] finance like this, but we've

[1:21:25] got ladies from locked in.

[1:21:26] They can about lot. Actually,

[1:21:29] I'd like to hear what they

[1:21:30] have to say. They've listened

[1:21:31] to the conversation we've had

[1:21:33] for the last 15 minutes and

[1:21:33] and see what they have to say

[1:21:39] about this. But I mean, there

[1:21:40] MAY be things that we can do

[1:21:45] is ease uses copay change or

[1:21:46] since some of best of the

[1:21:46] Suzanne mentioned. I mean,

[1:21:47] there there MAY be a lot of

[1:21:52] I'm not. Financially worried

[1:21:54] today, but I think it it would

[1:21:57] do is do justice to look at

[1:21:58] this is the first of MAY and

[1:21:59] say, where are we going with

[1:22:01] this and and what we need to

[1:22:03] do because this is important

[1:22:04] information does is life

[1:22:07] changing for some people and

[1:22:08] and we don't want to make the

[1:22:10] wrong decision and do

[1:22:12] something drastic take that

[1:22:13] away I think we need to wear

[1:22:14] options, but I would like to

[1:22:15] hear what these ladies have to

[1:22:16] say. If they have anything to

[1:22:18] say about it.

[1:22:19] >> thank you so much. So

[1:22:20] Rachel, Freedom locked in.

[1:22:23] Nice to see you all again. You

[1:22:24] know, listening to the

[1:22:24] conversation, I think this is

[1:22:25] the tone that we're hearing

[1:22:28] from across our bucket ss of

[1:22:28] clients who are covering

[1:22:31] weight loss, gop ones today.

[1:22:32] So those who are still

[1:22:35] covering have looked at

[1:22:35] various tactics from

[1:22:36] increasing costs, share on the

[1:22:38] member for those she'll p

[1:22:40] ones. But at the end of the

[1:22:42] day, those members will still,

[1:22:45] you know, be reaching their

[1:22:46] out-of-pocket maximums. And so

[1:22:47] shifting that cost share to a

[1:22:50] higher co pay is really a

[1:22:50] nominal impact to the overall

[1:22:52] costs that we're seeing of

[1:22:52] these medications. And so

[1:22:57] really, you know, that the

[1:22:57] overall response is that

[1:23:01] clients are ceasing covering

[1:23:01] and pushing that

[1:23:02] responsibility back on the

[1:23:03] member through these more

[1:23:05] affordable, it directs to

[1:23:06] manufacture programs that are

[1:23:07] available where the cost now

[1:23:09] have come down significantly.

[1:23:10] Another trend that we're

[1:23:12] seeing is that some him

[1:23:13] players are choosing to

[1:23:15] subsidize a portion of those

[1:23:19] cash pay options through hra

[1:23:20] programs, whether a funding a

[1:23:21] small dollar amount on to a

[1:23:23] health reimbursement account

[1:23:24] card and then those members

[1:23:26] can use that to pay for those

[1:23:29] lower cash pay options. So

[1:23:32] that's a trend that we're

[1:23:32] seeing so leaving adopted as

[1:23:33] well. It's not to prevailing

[1:23:35] yet, but that's one of the

[1:23:36] newest options that we're

[1:23:41] seeing. The costs of these

[1:23:44] medications are just

[1:23:46] unsustainable. So we're seeing

[1:23:46] continued rise in amount of

[1:23:50] utilize ERs taking the cost of

[1:23:51] the medications through the

[1:23:52] plan are significantly more

[1:23:54] than those cash pay options.

[1:23:55] And so as a result, we're

[1:23:58] seeing these medications trend

[1:23:59] significant. I'm your every

[1:24:01] year. I think our stops are

[1:24:03] 183% per member per month

[1:24:05] increase in the last several

[1:24:06] years. And we expect that to

[1:24:09] continue. But a lot trust our

[1:24:09] pharmacy consultant, chime in

[1:24:12] with any other specifics.

[1:24:14] >> You know, you're right that

[1:24:15] there are a number of

[1:24:16] direct-to-consumer programs

[1:24:18] out there for members as low

[1:24:21] as $199 a month for some of

[1:24:23] the tablet options out there

[1:24:27] up to $450 for some of the

[1:24:30] injectable, you know, Pius

[1:24:31] street medications. You're

[1:24:32] right with the Trump Rx. It

[1:24:36] kind taps into some of the

[1:24:37] direct-to-consumer programs

[1:24:38] are not necessarily a new

[1:24:40] program there. It kind of just

[1:24:41] redirects members to those

[1:24:43] direct to consumer options and

[1:24:45] more and more coming. I know

[1:24:46] the pharmacy benefit manager

[1:24:49] that you guys are currently

[1:24:50] with. They are trying to

[1:24:52] develop a program that would

[1:24:53] allow employers to tap into

[1:24:55] those direct to consumer

[1:24:57] prices. But that's something

[1:24:58] that they're building building

[1:24:59] it pretty quickly. So I would

[1:25:00] hope in the next couple of

[1:25:03] months we would hear from them

[1:25:04] where instead of you paying,

[1:25:05] you know, $1000 a month for

[1:25:06] the medicine, you could be

[1:25:08] tapping into some of those

[1:25:10] lower costs that's run through

[1:25:12] the plan and it wouldn't be

[1:25:13] the member having to go

[1:25:13] outside of the plate and it

[1:25:15] would keep it all their

[1:25:16] current towards their out of

[1:25:18] pocket in deductible if they

[1:25:21] had won. So there is a lot

[1:25:23] changing frequently. So

[1:25:24] hopefully in the next month or

[1:25:26] 2. You know, we've also headed

[1:25:27] one of the manufacturers say

[1:25:30] that beginning 1, 1, 27. They

[1:25:31] are going to allow plans to

[1:25:34] tap into the cause. But, you

[1:25:36] know, it's a lot of talk right

[1:25:37] now. We know, you know,

[1:25:38] members just going to Reagan

[1:25:41] getting that one. 99 to 4.49.

[1:25:42] Is that thing that solid in

[1:25:43] the air out there and we do

[1:25:46] have a number like Rachel

[1:25:47] mention, I know most all of

[1:25:47] the clients that I have that

[1:25:49] covered these meds, remove

[1:25:53] coverage for this year. So

[1:25:53] that is a growing trend. You

[1:25:54] guys would not be outside of

[1:26:01] the norm. If you did that.

[1:26:04] >> You're stating that

[1:26:05] generics available.

[1:26:06] >> There are no generics

[1:26:11] available at No, they're not.

[1:26:12] Alternative, their or direct

[1:26:14] to consumer. Member could go

[1:26:16] direct to the manufacturer of

[1:26:16] those drugs and get it at a

[1:26:23] reduced cost. As they do with.

[1:26:27] >> Botox.

[1:26:28] >> Possibly I hadn't

[1:26:30] necessarily heard that public.

[1:26:33] We don't I don't that we don't

[1:26:35] cover cannabis or the no. We

[1:26:38] do any way we

[1:26:40] >> Botox actually from

[1:26:41] migraines. Covered it my or

[1:26:45] the specific.

[1:26:47] >> for a diagnosis, correct.

[1:26:48] Just saying that. And there

[1:26:54] are many medications that we

[1:26:56] the employees, whether big

[1:26:57] constitutional or

[1:27:05] >> from Commission. It

[1:27:06] compelled to go with the

[1:27:09] alternative letter the year.

[1:27:10] >> Kind of going to war. You

[1:27:12] know, there's the mark. You've

[1:27:13] been for messy out there. And

[1:27:15] that's on pharmacy.

[1:27:15] >> We're a lot of times

[1:27:16] members can buy generic drugs

[1:27:20] or other medications directly

[1:27:21] from those who are sourcing it

[1:27:23] directly from the manufacturer

[1:27:23] and the cost is lower. They

[1:27:26] are so some people decide to

[1:27:26] go outside of their plate,

[1:27:29] especially if they have a high

[1:27:31] deductible or something that

[1:27:35] nature. So ya similar to that.

[1:27:36] Thank you.

[1:27:40] >> Okay. Commissioners, we've

[1:27:41] essentially come to a

[1:27:42] consensus on a meeting in MAY.

[1:27:44] I would strongly recommend

[1:27:44] that you be prepared to make a

[1:27:48] decision upon the date today

[1:27:49] seems a little bit like

[1:27:52] Groundhog Day to me by hearing

[1:27:53] the Let's hurry up and wait on

[1:27:54] the trends. So be prepared

[1:27:57] for. The meeting in MAY to

[1:28:02] make a decision. Thank you as

[1:28:05] Thank you. Brings us. To our

[1:28:09] next item, which is again with

[1:28:11] as Kristen Daniel through

[1:28:13] Office of Management Budget

[1:28:14] through Children, Services,

[1:28:15] funding, allocations for

[1:28:18] fiscal. 26 27. Welcome again.

[1:28:21] Director

[1:28:22] >> Hello again, Kristen his

[1:28:23] budget director as

[1:28:24] Commissioner Laura mention

[1:28:25] fight today's of Children's

[1:28:27] Services funding. You'll be a

[1:28:27] warning for the upcoming

[1:28:30] fiscal year. And 26 27. So

[1:28:32] keeping pace with the board's

[1:28:33] direction previously to fund

[1:28:34] children's services at 1, 8,

[1:28:36] of them now staff is

[1:28:37] recommending the board adopt

[1:28:38] the same allocation for the

[1:28:41] upcoming fiscal year. So that

[1:28:42] would increase of funding for

[1:28:48] next year by $299,346 or 8.6%

[1:28:53] for a total of 3 million,

[1:28:54] $778,838 for children services

[1:28:55] programs in the upcoming

[1:29:07] fiscal year.

[1:29:08] >> shutters, what's your

[1:29:09] pleasure? As we know, we are

[1:29:11] all patiently optimistically

[1:29:16] watching. The Florida

[1:29:17] Legislature with respect to

[1:29:20] what could perhaps next fiscal

[1:29:22] year. So I would suggest that

[1:29:23] will be mindful decisions that

[1:29:24] we make for coming fiscal

[1:29:26] year.

[1:29:29] >> MARCH air, I'd be happy

[1:29:31] stash addition. I think

[1:29:35] includes a robot a step

[1:29:38] forward. Even if it is a

[1:29:39] smaller increase. But it is

[1:29:40] within parameters that we

[1:29:42] can't deal with it depending

[1:29:44] on happens with property taxes

[1:29:45] and it will allow to reach

[1:29:50] more. With children program

[1:29:51] support.

[1:29:52] >> We have we have motion that

[1:29:53] we have a second by

[1:29:57] Commissioner Fletcher and

[1:29:59] certainly understand that. And

[1:30:00] I will yield to Commissioner

[1:30:00] Adam since her involvement

[1:30:06] with that's it. We have a

[1:30:06] motion and a friend just want

[1:30:08] to remind the board the funds

[1:30:11] that you're allocating this

[1:30:12] year.

[1:30:13] >> For for next year are funds

[1:30:14] that were collected this year.

[1:30:17] So we're so we're not like

[1:30:18] tapping into next year's tax

[1:30:21] dollars.

[1:30:25] >> Save the date minister. A

[1:30:26] motion. We have a further

[1:30:30] discussion. All in favor. The

[1:30:31] motion passes unanimously.

[1:30:35] Thank you. Director Daniel. Up

[1:30:36] next, commissioners item 16 be

[1:30:36] with the solid waste

[1:30:42] Authority. I see. Our team in

[1:30:47] the back. Appears to be.

[1:30:48] Director Department had not to

[1:30:55] mother.

[1:30:55] >> Good morning.

[1:30:56] Commissioners. As a managing

[1:30:57] director of solid Waste

[1:31:01] Disposal District leave. The

[1:31:02] first is the approval of the

[1:31:04] breakdown certificate. To come

[1:31:09] from. Approval of the bring

[1:31:12] down certificate. I'm sorry.

[1:31:19] Sorry pass away. Yes, okay. So

[1:31:23] related to this all. Basically

[1:31:26] between the bank and Petro.

[1:31:27] This is a sort of a process

[1:31:28] between the 2 companies. They

[1:31:32] just want to verify that

[1:31:32] there's no outstanding items

[1:31:35] for from the county's

[1:31:35] perspective, Bo's staff and

[1:31:40] legal have reviewed. You know,

[1:31:40] we have not taken any

[1:31:41] exemptions to the agreement.

[1:31:46] Everything that was originally

[1:31:47] contemplating agreement was

[1:31:47] successful. Most of you are

[1:31:49] there for the ribbon cutting

[1:31:51] ceremony, the plant is up and

[1:31:52] running. So this is a sort of

[1:31:53] a customer process between the

[1:31:58] bank and no petro and they

[1:31:59] require the CHAIRMAN To sign

[1:32:00] this. Bring down certificate

[1:32:03] to ensure that there's no

[1:32:05] outstanding issues with the

[1:32:06] project. So staff recommends

[1:32:10] approval. Of the bring down

[1:32:11] certificate. Thank

[1:32:12] Commissioners. I've spoken in

[1:32:15] detail with

[1:32:16] >> Mr Hicks as well as the

[1:32:17] county administrator. And I am

[1:32:19] comfortable with this item.

[1:32:21] The approval. We have a motion

[1:32:22] by commissioner for approval.

[1:32:27] We have a set Fletcher, any

[1:32:28] further discussion hearing?

[1:32:30] None all in favor and the

[1:32:32] motion Good morning again in

[1:32:38] MARCH item. 16 be too.

[1:32:39] >> Good morning commissioners

[1:32:40] of the next item is the

[1:32:41] approval of change orders as

[1:32:42] Cs for the landfill. Gas will

[1:32:47] project as we're working Petro

[1:32:49] to try to capture as much gas

[1:32:52] as possible. We had a project

[1:32:54] where back in NOVEMBER of

[1:32:56] 2024. For the installation of

[1:33:00] 10 additional gas wells. And

[1:33:02] there was total approval of

[1:33:04] $560,000 which some

[1:33:05] contingency funding that could

[1:33:06] be approved. Change orders

[1:33:11] from the county administrator

[1:33:11] requested approval to change

[1:33:15] orders from the county

[1:33:16] administrator. Basically the

[1:33:21] project over the original

[1:33:24] approval by about $36,000. And

[1:33:25] so the purpose of this agenda

[1:33:27] item is to just get board

[1:33:29] approval to approve the change

[1:33:30] orders that the county

[1:33:31] administrator made based on

[1:33:34] the original approval as well

[1:33:35] as some additional funding of

[1:33:41] 30 to $6,323 and that brings

[1:33:43] the total project cost 196

[1:33:45] 3.23, happy to answer any

[1:33:49] questions. Commissioner flush

[1:33:51] It's a much is as far as

[1:33:51] petro.

[1:33:56] >> They are gassy.

[1:33:56] >> And

[1:33:57] >> we knew from the on said

[1:34:00] that. It would be a

[1:34:01] possibility of having to place

[1:34:02] a few more straws into the

[1:34:06] Mount. Exactly. Commissioner

[1:34:07] at the landfill is continuing

[1:34:10] to grow every day.

[1:34:11] >> as we sort of continue to

[1:34:13] build a landfill, we need to

[1:34:15] continue to expand our gas

[1:34:18] system even just for our

[1:34:20] reasons to control orders, to

[1:34:21] reduce the likelihood of fires

[1:34:24] and so on and so forth. But

[1:34:25] having the are into project

[1:34:27] also allows us to capture the

[1:34:30] gas sort of fresh gas, if you

[1:34:32] will. So there will there. It

[1:34:32] was always projected that as

[1:34:34] landfill continues to grow, we

[1:34:35] would add additional gas

[1:34:39] wells. We're we're partnered

[1:34:43] with them. I not the set of 10

[1:34:44] wells were some additional

[1:34:47] work that was Petro starting

[1:34:48] to also participate and

[1:34:52] funding of of gas expansion.

[1:34:54] The next expansion that we're

[1:34:54] we're in discussion with them

[1:34:55] now that would come back to

[1:34:58] the board for a future time.

[1:34:58] They're looking to actually do

[1:34:59] a lot of the work themselves

[1:35:04] and pay for the work. So so

[1:35:05] it's it's really so far a good

[1:35:06] partnership. We definitely

[1:35:07] need to continue to capture as

[1:35:10] much gas as quickly as we can.

[1:35:12] It's good for the environment.

[1:35:13] It's certainly good for the

[1:35:17] partnership with no petrol.

[1:35:17] Their capacity has risen more

[1:35:21] recently.

[1:35:23] >> Then it was in very

[1:35:24] beginning when we we went in,

[1:35:26] they had temporary lines

[1:35:31] brought the expanded it and

[1:35:33] willing bilby bearing some of

[1:35:34] this course fact to with

[1:35:43] connections jus. Really are

[1:35:44] >> We have a motion by

[1:35:45] Commissioner Fletcher second.

[1:35:50] What Commissioner and your how

[1:35:51] your pressures been up there.

[1:35:52] The guests pressures been

[1:35:55] given. Good. Yeah, we were

[1:35:57] definitely. We have a lot more

[1:35:58] monitoring going on You know,

[1:36:00] the team is actively

[1:36:01] monitoring every gas. Well,

[1:36:04] making sure everything is

[1:36:05] working well.

[1:36:06] >> Minimizing water in the

[1:36:07] walls trying to, you know,

[1:36:11] capture capture gas. We're one

[1:36:12] of the one of the challenges

[1:36:14] and it's the reality. I think

[1:36:15] they're working with Florida

[1:36:17] City, gas or gas is trying to

[1:36:18] expand their infrastructure in

[1:36:22] Indian River County. So for,

[1:36:24] for example, in situation

[1:36:25] occurred about, I think it was

[1:36:28] last week where one of the

[1:36:30] primary users is actually the

[1:36:31] legion of operators that we

[1:36:32] have on site that uses gas.

[1:36:37] The pipeline gas and and the

[1:36:38] there was some shut down there

[1:36:41] for just a weekend. Petro

[1:36:42] didn't have the capacity in

[1:36:44] the Florida city gas line, if

[1:36:45] you will, to to inject what

[1:36:47] they're producing. So so it

[1:36:49] was a little bit a little bit

[1:36:51] of delay, but I think that

[1:36:53] kind is is there also motivate

[1:36:55] Florida City gas to continue

[1:36:56] their infrastructure and

[1:36:57] expand their lines throughout

[1:36:58] Indian River thing working on

[1:37:00] a a project to take some of

[1:37:01] those gas all the way to the

[1:37:01] barrier island. So it's a big

[1:37:05] project on their end. But but,

[1:37:06] yeah, we're certainly pulling

[1:37:07] everything we can project is

[1:37:11] moving forward. As we have a

[1:37:12] motion and we have a second.

[1:37:15] Further discussion. Hearing,

[1:37:20] none of those in favor.

[1:37:21] >> Commissioners nearly

[1:37:24] concludes meeting for public

[1:37:26] comment. Any non agenda

[1:37:27] related matters. You have

[1:37:27] public comment. Please come

[1:37:36] forward. Hearing none and

[1:37:39] seeing none. I'm knows 10. 42

Board of County Commissioners on 2026-03-24 9:00 AM

Agenda

Transcript