[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] #
[14:55] #
[14:55] #
[14:55] #
[14:55] #
[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] #
[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