[This transcript was generated automatically from audio using AI and hasn't been reviewed by a person -- it can contain mistakes, including plausible-sounding sentences that were never actually said. Treat it as a starting point, not a verbatim record.]

[0:04] Welcome to the regular meeting of the Multimum Accounting Board of Commissioners. Today's meeting is held virtually and due to construction at the Multumum Accounting Building. All Tuesday board briefings, Thursday regular board meetings and proclamation ceremonies will be held virtually through the end of September. So please bear with us through any technical difficulties. Members of the public can still provide testimony either from an electronic device through the WebEx platform or by calling into the meeting from a phone.
[0:29] And information on how to provide testimony electronically is shared by our board clerks when an individual signs up for public testimony.
[0:37] We're also offering a space in room 126 of the Multnomah County building where people can testify if they have technology and accessibility needs.
[0:46] And of course, people can continue to submit rest written testimony as well.
[0:50] For both members of the public and presenters, please remember to mute your mic when not speaking.
[0:54] And before you present, make sure that your mic is unmuted and that your camera is on.
[0:58] For all presenters please state your name for the record before speaking or responding to questions.
[1:03] If anybody would like to sign up for public testimony or to submit testimony, you can do that by going to
[1:09] maltcode.us and look for the about board meetings link and click on that for the public testimony form.
[1:17] Right. May I have a motion on the consent calendar?
[1:21] To move. Second, Commissioner Jones to extend moves, Commissioner Moyra seconds approval
[1:26] of the consent calendar. All those in favor, please say aye. Aye. Aye. Aye. Aye. All right. The consent calendar
[1:36] is approved. JJ, can we move on to public testimony? Opportunity for public comment on
[1:43] non-agenda matters. This is the time for the board to hear public testimony not for board deliberation.
[1:47] When it's your turn to speak, I will call your name and unmute you. I'll set a timer for three minutes
[1:52] when you begin speaking in an ounce when your time is up,
[1:55] which point, please wrap up your sentence.
[1:58] We have three people signed up for verbal testimony
[2:00] and received eight written testimonies
[2:02] which are shared with board members,
[2:04] hand staff.
[2:06] First step, we have Gus.
[2:10] Gus, you can unmute yourself and begin.
[2:17] Hey, can I kind of go wear some of the bus?
[2:22] Can I go wear some of the time?
[2:24] Oh yes, I will come back to you.
[2:28] We'll go to Ann Casper and you can unmute yourself and begin.
[2:41] Hello, I'm Ann Casper, I'm a student from University of Oregon.
[2:44] I happen to be at the beach now because I am at the peer fusion, so I'm with peers
[2:49] from across Oregon and we're connecting and making plans for what's going to work in mental
[2:55] health and addiction.
[2:57] I would like to first thank you for having the room 126 accessibility open for people
[3:02] to come and testify. Montenamo County is so good in these things. I mean, other places around
[3:07] the country don't do that. So thank you again for that. I'm here to talk about a couple
[3:12] things. We had a mental health chair campaign, a campaigner, mental health chair, candidate
[3:19] forum on TV. It's now in YouTube.
[3:24] And Julie, a commissioner from Edward sent in an introduction,
[3:28] But it didn't touch upon the nine questions that we the audience came up with from around the report in the metric for Alexandria and we're hoping that you will send in the answer to those questions
[3:41] We see those TV show in this community event as a long experience and if whoever becomes chair, it's really important that we learn to communicate and work with each other
[3:52] So it's not too late to send in information.
[3:55] There are 170,000 people signed up in mental health services to be able to have a health
[4:00] services in Montgomery, another 50,000 who are signed up in programs that touch upon mental
[4:07] health.
[4:08] So we really just want a good communication with everybody.
[4:13] And Commissioner Singleton sent in answers, which were put in the video.
[4:17] But some of the answers had more to do with homelessness and houses and addictions and didn't answer the questions from the mental health community.
[4:26] So let's all work together on that to make things better.
[4:29] We know things are not good now, but they really can get better as we plan and do things in a really comprehensive and ways of working together already three times.
[4:43] but together. So let's do that. And also here there's a woman from the Ukraine who's a peer leader,
[4:52] mental health peer leader, telling me at the conference how multicultural trainings and multicultural.
[5:00] roll program, it doesn't always work because you've got people from the state, cultures and
[5:07] languages, and war experiences, other kinds of experiences. So by putting everyone together in
[5:13] multicultural, it doesn't work for everybody. So let's think of new ways. How can we help refugees
[5:20] heal through this war trauma? And that helps all of us and also how to educate people on what
[5:27] trauma really is. We hopefully will never see it in the United States but it's really tough.
[5:34] I want to again thank you all for your hard work during this hard time. Hopefully you do get some
[5:40] respite and thank you very much. I'm going to end now so. Next, we have lightning.
[6:01] Yes, my name is lightning. I represent lightning super creativity. AI is everyone. You may have
[6:09] Now, as you all know, as a good friend, Steve Palmer, from the MBA LA Clippers, he's just
[6:16] having a bad week. He's been suspended for a year. He can't even go to any of the board of
[6:21] governors. And in my opinion, he will be selling the LA Clippers within three months and to avoid
[6:32] any devaluations of all the MBA franchises. So I see him basically selling within three months.
[6:40] I'm looking at it off for somewhere around maybe 8 billion to 10 billion. That's for the team.
[6:46] And that's also for the into it dome itself, which he just developed. So again,
[6:52] state bomber enjoy your retirement. It's been a pleasure. Now getting back to business with Tom
[6:57] done. Again, I want to see him relocate to Texas. Again, in the Texas Building AI Triangle.
[7:08] Again, that is what I call the Elon Musk Space Economy valuations that we will never see on planet Earth.
[7:17] We'll happen within that triangle. Austin is the perfect position to be right in the middle of that.
[7:24] And again, the growth will be unprecedented, then in the Texas triangle will surpass California.
[7:34] The Texas currently is about $2.7 trillion.
[7:39] I believe that California is around $4.2 billion of our trillion if I'm correct.
[7:46] So there's going to be a real gain there on what they can do in Texas.
[7:50] It's the place to be, it's the place you want your MBA franchise.
[7:54] Again, on this outdated mode of center, I want to see a seismic study done on this.
[8:01] A lot of these older buildings like that, there is a reason why they tear them down because
[8:05] they're not up to seismic standards.
[8:08] I want to see that study, then I want to see that building torn to the ground in a new
[8:13] one put in.
[8:14] But by that time, Tom Dundin will already be relocated, it will have to get approval.
[8:18] And again, when Tom Denton gets the green light for me on Vusk, Mike Dale, and various
[8:25] other University of Texas, various other people.
[8:28] When he gets the green light, he can move in there quite easy.
[8:31] His value is going to, without any doubt, value added will probably push him up to $68 billion
[8:36] automatic.
[8:38] And then with that strong economy there, similar to what California used to have until all
[8:44] the businesses started relocating to Texas, he'll be able to match those
[8:48] those numbers. So when you look at Los Angeles Lakers at 12 billion, you're going to
[8:53] be able to bring your valuation up, probably anywhere from 8 to 10 to 12. And again,
[8:59] what just happened to the LA Clippers is a devaluation. And we need to stop that in
[9:05] steep bomber. We need to move on and enjoy your retirement serve. Take care.
[9:20] All right,
[9:26] back in like 2015, 2016, I came through, I went to like one of your, I wonder, one of
[9:33] the monomakani board things like this or so, and during that time, my son or my son
[9:42] was getting the rarest attack by students and teachers, and the more I've done, the more I
[9:53] I received, I said, I was refused the opportunity to continue violence here.
[10:00] Because this was a time done. I after I got hit by a car. So my time was trying to support him.
[10:08] Now, he said, afterwards, the principal, the school, they gave my son, I mean, his mom, father's document saying that he didn't have any problems, even though there was documented proof that things were going on.
[10:23] Now today, all of that kind of got worse in schools to where the kids, you know, get attacked and everything on the sword or getting the rest family fathers mainly being pushed out of being able to volunteer even be positive towards.
[10:44] I think we lost.
[10:49] It looks like.
[10:52] He's no longer in the meeting.
[10:55] Okay, let us know if he comes back on.
[10:58] Okay, if that was our last person sent up for non agenda public testimony.
[11:03] Okay, and if you are reaches back out to you can you let him know he can also send right in testimony.
[11:08] Yes, okay. Thank you.
[11:10] All right, so let's move on to our one.
[11:14] are one. Budget modification number DCJ, DCJ,
[11:19] dash 0.001, dash 27, DCJ, ASD,
[11:23] reallocation of funding from one parole and
[11:27] permission officer to 2.5 Reconnizons,
[11:32] correction technicians.
[11:35] May I have a motion?
[11:37] So moved.
[11:39] Second.
[11:40] Thank you Mr. Chairman and Prince Moved. Commissioner John
[11:42] taken six and seconds approval of R1.
[11:46] So this next item is a DCJ bedmod to reallocate funding
[11:48] from a parole and probation officer position
[11:50] to provide six months of funding for two
[11:52] correction technicians in the recog unit.
[11:56] So I will turn it over to Tera Hubbard
[11:58] and Denise Pena to walk us to this item.
[12:02] Good morning.
[12:03] Thank you. Good morning chair and commissioners.
[12:05] My name is Denise Pena.
[12:07] I am the director here at DCJ
[12:08] and I use she and her pronouns.
[12:10] and joining me for this presentation this morning will be your Hubbard or adult services division director.
[12:16] And today has been stated, we'll be reviewing the budget modification for
[12:19] reallocation of funding from one for all probation officer to 2.5 corrections technicians
[12:25] in our custody and release service program please. Next slide please.
[12:32] For the record, my name is Tira Hubbard and I am the IUCHI her pronouns and I am the adult
[12:37] services division director. We are bringing this budget modification before you today to acknowledge
[12:43] recent revisions that occurred after the fiscal year 27 budget was finalized. Although our
[12:50] PSP, a pre trial monitoring program was removed as a pre pre trial monitoring option,
[12:56] the presiding judge's order that was most recently updated on July 13, 2026, revised the
[13:03] County's responsibility for administering the presiding release order and that included DCJ and MCSO.
[13:11] Due to guidance from the County Attorney's Office, DCJ is temporarily adding the necessary personnel resources to provide continuous coverage for this function.
[13:21] This funding supports the six-month timeframe for the added function for DCJ through December 31, 2026,
[13:29] While the idea is finalized between the county and OJD.
[13:35] Next slide, please.
[13:37] Thank you, Tira.
[13:39] This slide shows the program offer budget impact based on this budget
[13:43] modification, and as you can see, the impact is net neutral as this is a
[13:47] reallocation within personnel expenses to support this transition.
[13:52] Next slide, please.
[13:54] And that concludes our brief presentation, and we are ready for any questions
[13:57] is that the board might have?
[14:00] Hey, thank you, Denise and Tira, and did we have any public testimony on this, Tisha?
[14:10] Yes, we have one person's side, though.
[14:12] Right.
[14:13] Lightning?
[14:16] Yes.
[14:16] Yes, my name is Lightning, I'm representing Lightning, super-connected, yes.
[14:21] Again, I do approve of the modification, but again, I want to stress my position just
[14:27] on the correctional officers, as you know, we had a revealing death that happened in the jail
[14:35] of Dominic, and it showed that in their report that 12 correctional officers circled
[14:41] them in a wheelchair began to rough him up.
[14:45] Then, when he passed away, it showed that he had brain swelling from the use of cocaine.
[14:51] And you as being monomecality experts in the health department, to people normally have severe brains.
[15:03] I want to make sure that we have body-worn cameras on the correction officers. I want to be able to have the family members at the very least to be able to pull up that video to see exactly what happened to their son and their relative, and have a clear understanding of what happened to him.
[15:30] what takes place in these jails. And I don't think that's asking too much from the commissioners
[15:37] in the chair to have transparency, accountability, and for the family members when one of their
[15:44] relatives passes away in the jail, at the very least to have access to that body-worn camera video
[15:51] to where they can review that situation where he was put in the wheelchair in 12
[15:57] for action officer surrounded him and it's my understanding by the statements from the Oregonian
[16:04] rough team up and again he had severe brain swelling so again to the experts from the health
[16:13] industry does ingesting cocaine cause that that is my question because I want to have more facts
[16:21] on that situation. And again, I'm just asking for you as our representatives and to keep
[16:28] the community members safe to get the body worn cameras on the correctional officers,
[16:34] on the patrol officers, and allow the public to at least have a chance to have a clear
[16:39] understanding what happens if one of their relatives dies in the jail and things don't appear
[16:46] to be right. Again, we're just relying upon their written statements and what the correction
[16:53] officers put down on paper. But as you know, a video tells a full story and gives a much
[17:00] better story on what happens. We need that video for the safety of our community members,
[17:07] for the family members that lose one of their relatives and these jails, and as the least,
[17:14] Then mold nomic County can do for them. We have them on the Portland place. They even put them on the ice officers
[17:22] Why is there such a hold out for mold nomic County? I expect those to be put on immediately. Thank you
[17:31] That's all for public testimony
[17:35] Okay, thank you. We'll go to the board to see if there are any questions on this. We'll talk. We'll start with comissures. We'll take. Thank you chair
[17:43] excuse me. I'm not sure that the right people are in the room for these questions, so I will
[17:50] just say I don't have any problem with this budmod, but I continue to be concerned and frustrated
[17:57] by pretrial services and what the next steps of this will look like in the transition.
[18:05] So
[18:05] and particularly having a new PGO signed after our budget pass that pulls you all back
[18:12] to this just and I saw just you come on camera. Do we have an update on the IGA, at least
[18:17] as far as timeline, maybe not the specifics of the negotiations?
[18:23] Good morning, commissioners. For the record, my name is Justin Black. I can give a quick update.
[18:33] So we are in conversations with the courts. We sent them a draft IGA. They sent us back
[18:40] red line version. We actually responded back with some clarifying questions to that are
[18:45] understand where they are. I had a very good conversation with Barbara Gordon
[18:50] Australia last week. We plan to get together and talk further about these. I think the
[18:56] plan is our hope is that we come to some resolution by the middle of October. I think on both
[19:03] sides, that's the timeline that we're committed to. If we are unable to come to an agreement by
[19:09] and you will be hearing more for me.
[19:14] Thank you.
[19:15] I appreciate that, and Denise and Tara,
[19:18] thank you for the presentation today
[19:19] and the ongoing work.
[19:21] Again, Justin, I'll do some more follow-up with you
[19:24] on some of the concerns that I have
[19:26] and those next steps on the IGA negotiations,
[19:28] but I'm supportive of this budget modification today.
[19:32] Thanks, Chair.
[19:34] Thank you, Commissioner.
[19:34] Commissioner, bring my words.
[19:38] No questions.
[19:39] Thanks for bringing this forward.
[19:40] I'm supportive.
[19:42] Thank you. Commissioner John Sixon.
[19:45] Yep. No questions. Supportive. Thank you.
[19:48] Thank you. Commissioner Moira.
[19:50] Can I get kind of a timeline of when we knew that the court was...
[20:00] Not going to step in to do this and how, and when we decided we needed to make this step in adjustment, this happened, right? Like we've had meetings, like this has been happening. I don't remember when the kind of that realization that we would have to do this happened and how, how did that? How was that decision made?
[20:30] Thank you. Thank you for that question, Commissioner Moir. We received the updated PJO on July 13th.
[20:37] That still maintained DCJ doing this part of the work for pre trial and the jails and it also added
[20:44] MCSO to the PJO and that was something that was a change as well and the PJO did though
[20:51] however remove PSP as a monitoring option and so once we were made aware that we were going to
[20:57] to continue the services because DCJ during our FY27 budget process had indicated that we were going
[21:04] to be getting out of the pre-trauer.
[21:06] We did make reductions in CTs out of the recog unit.
[21:10] And so then after consulting with legal, just talking about the implications, if there was
[21:16] going to be a significant delay in a defendant potentially being denied released if they were
[21:22] going to be eligible is when we were given the guidance that we were going to need to continue
[21:27] the services as they had been, to make sure there was not any extended gaps in our services.
[21:34] So was that something that you, I don't know how information came back and forth, but like
[21:42] was that
[21:46] situation made where do you, or you made the COO and the chair available, and then
[21:56] How did we come up with this budget reallocation and timeline and duration?
[22:07] So when we were made aware that we were continuing this via the PGAO as far as still being
[22:12] included, that's when we reached out to the CEO's office and the chair, I believe the
[22:16] CEO's office had also received a copy of the PGAO as well and so that's when we coordinated
[22:22] internally consulted legal to really give a guidance on what is going to be what we need to do
[22:28] forward. The reason that for the allocation, we did have a vacancy in the PL classification,
[22:34] so that is the position that we identified to reallocate and then again the initial discussions
[22:40] have been that we would continue this work through December 31st and then at that point the
[22:45] courts would pick this up in January. There have been some changes to that timeline potentially
[22:52] But all I know is that via this flood mod, this would allow us to continue to 1231, and we would not have the funding, should we need to continue this past January 1.
[23:04] Just to add on that, you know, I think that this is a continuing conversation.
[23:10] And even if we come to some agreement in mid-October with the courts, you know, we may be coming back to the board for further conversation around this.
[23:21] not knowing specifically what the agreement is going to look like.
[23:28] Yeah, I totally understand that.
[23:31] My comments have absolutely nothing to do with DCJ.
[23:38] I think you handled this totally appropriately.
[23:43] And both above and at your level responded quickly.
[23:48] and appropriately, my concern is that this is not an allowable action under our charter, that
[24:02] the action happened before the board approval.
[24:07] That has nothing to do with you guys that
[24:08] has to deal with how decisions are made. And this was an emergency, this was totally not something
[24:17] that was for seeing in the budget process, totally acknowledge that, that it was something that
[24:22] needed to be adjusted due to unforeseen circumstances. We have a process for that in our charter,
[24:34] the budget authority of the county is lies with the Board of County Commissioners, the chief
[24:40] executive being the chair is to execute that is the act of term in our charter is to
[24:46] execute the actions of the board. The chair does not get to change or reallocate funding
[24:53] and then months later come to the board and say, FYI, I did this. We have.
[25:00] To stop this practice. I get that this has been held at Luma County has operated, but it is in violation of our
[25:07] charter and it is not acceptable. We have to go use the governing body that controls the budget. If we need to make
[25:18] budget changes, which, of course, we do. And this is a very good example of a totally appropriate
[25:25] adjustment that needed to be made, it needed to come to the board. We have processes for things that are emergencies.
[25:36] I do understand that it can take a while to get things together,
[25:40] but this is a practice that this county has had that is totally inappropriate and you
[25:48] the power of the board. This has to stop. I could list probably right now. I have the dozen things
[25:56] where I feel like the administration of the county has gotten out and implemented things that
[26:03] did not have the authority to do. And it clearly exceeds what the executive branch is ability to
[26:13] act unilaterally is. I don't know how we changed this practice. We had something I can't
[26:22] remember. It was a little over a year ago that was a similar situation where we were asked
[26:28] to vote on something that had been going on at that point for an extended period of time. That
[26:34] isn't a real process. Like what would happen if we voted no? We get that money back? No, we spent
[26:41] It's gone. That's not a real process for this board. We are not actually making this decision. It was made.
[26:48] That is not appropriate. I'm putting it out there. This practice needs to stop.
[26:55] Again, I don't think anybody has a problem with this decision.
[26:59] And I don't expect that it will fail, but it is now largely symbolic.
[27:05] And that is not the role of the county commission, we are not, you know, a validator of decisions that have already been made.
[27:14] All right.
[27:15] So, we don't have a problem with what we're doing.
[27:17] Have a huge problem with the process.
[27:23] Thank you, Commissioner.
[27:24] I just want to respond to that briefly.
[27:26] I mean, I understand what you're saying.
[27:30] And we always try to bring things to the board ahead of them actually happening.
[27:36] In fact, like, there's been vast improvements with the timing of budget medications, notice of intent for grants, all of these things over the past few years.
[27:46] Like, you know, I would say, like, point out, like, one of the ways that that has happened is the having departments do all their budget modifications before fiscal year ends.
[27:55] When I first started on this forward, we were doing budget modifications for the previous fiscal years months into the new fiscal year.
[28:01] So we're always doing that.
[28:02] We always try to do that.
[28:04] There are sometimes when that's not possible.
[28:07] And I will say, I didn't thought you were a discretion.
[28:10] You don't have the authority to do that.
[28:13] So I was like, there are sometimes when that's not possible.
[28:17] And if that happens for instance,
[28:19] like if a department has a very short timeline
[28:21] for a grant application, they will put the grant application
[28:25] and come to the board.
[28:26] But say, like in the APR, that if the board decides not
[28:30] to support this and they would recent the great application.
[28:33] And I think this was one of those situations
[28:37] where the operational realities got ahead of this.
[28:40] So I'm going to look in.
[28:41] But that's not allowable.
[28:43] So a grandian commissioner, Commissioner,
[28:45] I'm not done.
[28:46] Commissioner, I'm not done.
[28:47] I'm going to look into this because I honestly don't know
[28:50] when this was requested to be on the book.
[28:52] We know like when the APR was put in to put this before
[28:54] the board and I will look into that.
[28:57] And I'll commit to doing that for you
[28:58] because I want to understand the little bit better
[29:00] about the timing of this myself, but but I will say the intent is always to get things to the board in like ahead of when action is taking place.
[29:13] My response is that's not a power you have.
[29:18] You don't have the power to spend money and move money in budgets.
[29:24] Like I get you think that it was necessary.
[29:27] free? You don't have that power. Do you want to grant application that you can then decline
[29:32] as a totally different thing? This is about democracy and you are taking a power that
[29:41] does not belong to you and belongs to the Board of County Commissioners. We have a mechanism
[29:46] for emergency decision making. You could have motioned at any point during any meeting we
[29:52] I've had since July 13th.
[29:55] So can I finish this because that?
[29:57] No, this is mine.
[29:59] Moment.
[30:00] Please, I get, I interrupt to do. I apologize for that. You're interrupting me.
[30:08] I wouldn't make a big deal about this. If I have not been over the last several months, horrified by the number of things that are happening, that have never been approved by this board. So, if you want to state that it is your belief that you have the power to reallocate
[30:32] both position authority and budgets, then say that, and I think that's an issue that needs to be brought forward
[30:39] for a judicial review. That's not your position, and don't execute things that you don't have the authority to do
[30:48] before born approval.
[30:50] So, I would, I have said, and what I will say again is that we work to bring things to the board as quickly as possible
[30:58] when an operational change is being made,
[31:02] that doesn't match what the board is approved in the budget.
[31:04] That's why we have these budget modifications.
[31:06] This one was not as timely as it should have been,
[31:09] and I already said I commit to looking at the timing
[31:11] of this and why it's being brought forward today.
[31:15] But that's where we are.
[31:17] And I think that we can continue this.
[31:19] I also, you know, this is the first time
[31:21] that you brought this issue up recently to me.
[31:25] And so I'm very surprised to hear it today.
[31:27] since you and I just met on Monday for a check-in,
[31:30] and you didn't bring this up as a concern with this item.
[31:34] So I also, you know, if you're saying this now,
[31:37] that's your right, but also, I could have had more answers
[31:41] for you today.
[31:43] I mean, I have talked to you, and I've talked to Chris,
[31:46] and I've talked to multiple-
[31:48] Phil Dougan, the entire Interrupting Me Commissioner.
[31:50] So I just wanted to say, if you had brought this up on Monday
[31:54] in our check-in, I could have gotten more information
[31:56] to understand a little bit about the history and timeline
[31:58] of how this got there.
[32:00] And so, again, I'm committing to doing that research
[32:02] and finding it out.
[32:04] But it is not that I think that these things
[32:07] shouldn't be coming before the board for budget modifications.
[32:10] Absolutely, that's the board's right.
[32:12] That's why we're doing this today.
[32:14] But if the action already took place,
[32:17] you've used circular authority.
[32:19] That's the point.
[32:20] I don't, it's not about, it should have come two weeks after it happened.
[32:26] The point is, it can't happen without board action.
[32:29] I'll let it go, we can move on, but I, one, I would like to make a very clear for
[32:35] the record.
[32:36] I have talked to you and many in leadership about this issue, just because it was not the topic
[32:42] of Monday's meeting.
[32:44] Does not mean we have not spoken about this.
[32:46] This board has talked about this publicly.
[32:50] And so that's not accurate, and two, my concern is not that you inform us quickly after you've made a decision.
[32:59] The point is you don't have the authority to do it.
[33:02] All right, I'll move on.
[33:03] Thank you.
[33:05] All right.
[33:05] I have my hand brace.
[33:08] Oh, commissioner.
[33:09] Yeah.
[33:10] I just want to sort of echo commissioner Moyer's statements.
[33:14] This is not a new issue.
[33:15] I mean, it goes back to when I first joined the commission three years ago, when at the end of the fiscal year, all of a sudden, there was a bunch of retroactive bud mods. So I think this should be framed not in sense of what happened today, but the larger issue of having the commission action not being taken before the commission has approved it, but it's it's not it's not a new issue at all and it's been.
[33:45] publicly discussed. Yeah, thank you commissioner and I did in my remarks speak to the fact of those
[33:52] post-physpossible year budget modifications is something that we work to improve.
[33:55] Commissioner Jones-Dixon.
[33:58] Yeah, great. Thank you. Thank you chair and thank you commissioner Moira for bringing this forward. I was just saying
[34:01] I was just going to add that we should look at this. You're not an export retreat and look at our
[34:06] board rules for how do we make it this moving forward and look forward to let's move forward with
[34:10] vote. Thank you. Thank you. I appreciate the call for the vote to you.
[34:14] Can we have a roll of comment?
[34:17] Commissioner Moere.
[34:19] Yes.
[34:20] Commissioner Singleton.
[34:21] Yes.
[34:22] Commissioner Brementoritz.
[34:24] Yes.
[34:25] Commissioner John Stixon.
[34:27] Yes.
[34:28] Chair, Vega Peterson.
[34:30] Yes.
[34:30] Budget modification is approved.
[34:34] I'm sorry excuse me.
[34:40] Our two first hearing of ordinance
[34:43] demanding county ambulance service plans and mcc-21.400 emergency medical services.
[34:54] In that motion.
[34:55] Thank you.
[34:56] Second.
[34:58] Commissioner John Sticks in move.
[34:59] Commissioner Singleton.
[35:00] Seconds approval of our two. So today we're taking up an action that has been more than two years in the making. Back in 2024, as the county and our partners felt the impact of persistently delayed ambulance response times, the board took two important actions. First, we coalesced around an ambulance staffing model change with the intent of stabilizing staffing and improving response times in short term.
[35:27] That move has led to improvements in response time consistency, but we always knew it wasn't
[35:32] a long-term solution, which is why we took a second critical step when the board of
[35:37] proof funding and set the direction for updates to our ambulance service plan.
[35:42] That began with a comprehensive study of our EMS system by an external third-party evaluator
[35:48] who conducted extensive data and document review, stakeholder engagement with more than
[35:53] interviews and field observations, and the application of best practices and lessons from other
[35:58] EMS systems. The result was an EMS system's assessment report with findings and recommendations
[36:05] that provided strong building blocks for Multnomah County's updated ambulance service plan.
[36:11] So the plan we're considering today strikes an important balance. It codifies what is working
[36:15] and promotes flexibility and innovation, all while still centering a focus on quality care
[36:22] and strong clinical oversight.
[36:25] Under this plan,
[36:26] our staffing model continues progress
[36:27] on using the right resource for the right call,
[36:30] prioritizing specialized skill sets for the emergencies
[36:33] that are most needed on.
[36:36] This model continues to
[36:37] valid value and leverage the existing skills of
[36:41] paramedics and EMTs with clear pathways
[36:44] for career development for developing enhanced skills.
[36:49] Our fire departments
[36:50] are critical partners in emergency response, and this plan affirmatively and explicitly promotes
[36:55] collaboration and partnership between an ambulance provider and our fire departments through
[37:00] subcontracting. This plan also sets realistic response times standards for all areas of the county
[37:06] using objective, consistent state methodology, while still providing a pathway for jurisdiction
[37:12] that may want to build on that foundation for differential response. This plan reflects an
[37:17] a enormous body of work and input to achieve an ambiance service plan for Multnomah County that
[37:22] is both durable and flexible to serve our community into the future. And we have been the consultant
[37:28] in Kenton form every step of the way. I want to thank our EMS team, Dr. Bruno and Erin Monig,
[37:35] as well as Mark Prins Medal and Charles Miller, and the small but mighty EMS program team for all
[37:40] of your work. I also want to thank Renee Hezinger for leading our work in our emergency
[37:46] management systems for my office over the past few years and specifically for
[37:49] her work on this plan. I want to thank you all for the time you've spent both
[37:53] with us in this board room and outside of it with commissioners and staff and
[37:57] partners to answer questions and address concerns. With that I will hand
[38:00] things over to Bruno and Eric. Good morning. Thank you chair. Thank you
[38:05] commissioners. Nice to see you all this morning and thanks for the
[38:08] opportunity to present with you. I'm going to turn it over to Erin
[38:12] who is our EMS administrator, who's going to take us through some slides this morning.
[38:19] And there are slides. Good morning, Chair Vega Peterston and commissioner for the record.
[38:23] My name is Aaron Monning. I'm a county's EMS administrator.
[38:27] And then joined today by Dr. Bruno County Health Officer.
[38:30] Please to prevent the first reading of the ordinance to adopt the revised 2028
[38:35] Multnomah County Ambulance Service Plan and amend Multnomah County Code after 21400.
[38:40] I want to start by thanking everyone who has been involved in the development of this proposed plan.
[38:46] And all of those who are going to give verbal and written testimony is clear.
[38:51] We are all attempting to provide the community high quality care. Next slide please.
[38:58] Our primary objective today is to walk you through the key structure updates in the proposed 2028 ambulance service plan.
[39:05] I will provide a brief overview of the NS system outline the system assessment process that brought us to this milestone.
[39:11] on walk through the major operational changes in detail
[39:15] or next steps towards state approval and procurement.
[39:18] Next slide, please.
[39:23] The ground or discussion,
[39:25] Multnomacanian Emergency Medical Services
[39:27] operates at the critical intersection
[39:29] where public safety, public health, and health care overlap.
[39:34] Our core mission is ensuring the right level
[39:37] of clinical care is delivered to every person
[39:39] at the right time.
[39:41] The county achieves this by providing
[39:43] high-level medical direction, regulatory administration, and overall system coordination across
[39:49] our entire county. Next slide.
[39:54] This diagram illustrates the patient journey through a pre-health
[39:57] system. From the initial 9-1-1.
[40:13] We will now
[40:22] transition into the back-down on the emergency medical services system assessment, which provided the foundational assessment and the assessment and program recommendation, and we will now transition into the back-down on the emergency medical services system assessment.
[40:32] for the revised plan. Next slide.
[40:38] Under Oregon administrative rule, counties are required to maintain an
[40:41] ambulance service plan. Townings act as an agent of the state, following a prescribed format and
[40:49] content for each county plan. A current plan with left updated in 2016, given persistent contracts and
[40:57] science, challenges, evolving clinical best practices, and less than
[41:01] learned from recent operational pilots.
[41:04] We commissioned an independent third party assessment to inform the revision
[41:08] of our system design.
[41:10] Next slide, please.
[41:13] This assessment was designed to move our system from evaluation into action.
[41:20] A real task year, the EMF program,
[41:22] since the five consultant recommendations,
[41:24] than stakeholder feedback, clinical committee review,
[41:28] and board direction to draft an ambulance service plan
[41:32] that updates our pre-hospital framework.
[41:35] Next slide, please.
[41:39] This timeline reflects our process.
[41:42] We engage health care strategists in late 2024
[41:46] to conduct very comprehensive system review.
[41:50] Throughout early 2025,
[41:51] the consultants conducted extensive stakeholder engagement
[41:55] session with fire departments, dispatch agency, hospitals, and clinical advisory committees.
[42:02] Next slide, please.
[42:06] Following the release of the assessment report in December 2025, we opened a multi-month
[42:11] public comment window.
[42:13] We briefed the board in April of 2016, released the draft plan in June, and how they dedicated
[42:20] board work session in August to refine the final language presented to you today.
[42:26] Next slide.
[42:29] Today marks our first reading and public hearing, following a scheduled second reading
[42:34] on September 17.
[42:36] When the county has an adopted plan, it will submit it to the Oregon Health Authority
[42:41] for the state's review and approval.
[42:43] This sets the stage for our 2022 procurement process ahead of an implementation on September
[42:50] 1, 20, 28.
[42:52] Next slide, please.
[42:55] Now, let us examine the core policy and operational recommendations in the 20, 20, 8, and
[43:02] do a service plan.
[43:03] Next slide.
[43:08] The plan introduces the advanced care paramedic or ACP as the highest peer-up county level
[43:13] EMF provider credentialing.
[43:16] While county credentialing has historically recognized the lead paramedic versus non-lead,
[43:21] this formalizes that structure.
[43:23] Under the new plan, all life-threatening 911 calls require the response of it leads
[43:28] of one advanced paramedic. Next slide please.
[43:35] This change directly addresses assessment findings
[43:38] regarding clinical concern of left experience provider workforce by concentrating
[43:43] phyria low frequency for teachers among season paramedics more strategically deployed
[43:49] and use for the highest of security responses. First of the way the plan confirms that holding
[43:55] or deploying ACP is a county-quitable credential and does not impose a mandatory staffing duty
[44:03] or a financial burden on non-contractive municipal fire agencies or other future sponsor agencies.
[44:11] Next slide, please.
[44:16] We are transitioning from a rigid staffing requirement to a flexible
[44:20] acuity-based deployment model, combining advanced life support and basic life support units
[44:26] and quick response vehicle. For time-critical, life-printing calls, the plan mandate
[44:32] a minimum of two paramedics on the field, at least one of whom must be in a advanced
[44:38] character or medic. However, it does not dictate which agencies those conditions belong to
[44:43] or what vehicle they arrive in, but does hold the single, franchise, ambulance provider, agency,
[44:50] responsible for meeting this staffing standard financially and operationally.
[44:57] Next slide, please.
[45:00] This model aligns with system assessment recommendations to match resources to actual patient
[45:06] acuity by enabling EMT staffed basic life support and single-paramedic advanced life support units
[45:13] to handle lower acuity calls. We preserved the high-tier paramedic resources for life-threatening emergencies,
[45:20] build system resilience during workforce shortage and reduce provider burnout. Next slide please.
[45:29] We have updated our response zones,
[45:32] no-minclature to match state regulatory definition
[45:35] under Oregon Administrative Rule 333-200.
[45:40] Defining clear, open, sub-open, rural, frontier,
[45:46] and search and rescue boundaries as required by the state statutes,
[45:50] rule, state and regional trauma requirement.
[45:54] Response time standard benchmarks are now strictly
[45:56] feared by geographic zone and patient activity measured at a 90 percent monthly compliance threshold as required by law.
[46:07] I want to pause here for one added second.
[46:11] Having appropriate achievable clinically relevant response time benchmarks that are appropriate for the response and transport volume are imperative.
[46:21] If the standards are not set up appropriately, they will lead to a failed procurement or an immediately failed contract.
[46:30] The measurement of the 90 percent is directly achievable or not achieved based on the volume being measured.
[46:37] And small numbers that 90 percent effectively becomes 100 percent because a vendor cannot miss any calls due to low numbers.
[46:45] The time and percentage both played directly into our procurement and the measure of a contractor.
[46:52] If we have a county, have a failed procurement, or the chosen vendor has immediate failure due to the benchmark,
[46:59] the county becomes the provider per section 7E until a suitable replacement can be found.
[47:07] Next slide, please.
[47:10] Replacing the land planning metro urban growth boundary with incorporated city limits and state
[47:17] size and density tier ensures legal alignment and equity performance target across the entire county
[47:24] exactly as the state is defined.
[47:27] Furthermore, Section 5CC established a supplemental performance agreement framework, allowing any
[47:34] incorporated city or fire district and contract independently for faster local response times or dedicated staging without stiff and cost the county taxes or deluding overall coverage this proposed base level service reports maintaining the explicitly non county subsidized model and maintain the fee for service model for these poor ambulance services across the entire county.
[48:00] Next slide, please.
[48:06] The plan formally recognizes active call management for ACM.
[48:11] Under this 9-1-1, under this system, 9-1-1-pthap triage low-acuity calls,
[48:17] are routed to a dedicated Q, monitored 24 hours a day, 7 days a week,
[48:22] by experienced paramedics, who actively manage patient needs.
[48:27] Provide telephonic consultation or arrange non-emergency response
[48:31] and Character Pathways.
[48:33] This is a process that the county has previously used
[48:36] during large scale events
[48:37] like extreme weather events
[48:39] that overwhelmed the normal resources.
[48:42] In 2023, this system was activated 24-7,
[48:46] commandage lower activity calls
[48:48] and favor resources for higher activity calls.
[48:52] It is clear that there will always be lower activity calls
[48:55] that the 9-0 and 1 system was not designed for.
[48:59] Many of these calls don't require
[49:00] transport to a hospital.
[49:02] Of note, the low acuity cue call currently
[49:05] have the highest response to transport rate
[49:08] of any call type in the system,
[49:11] with nearly 90% of all of the call being transported.
[49:15] Matching a lower acuity resource,
[49:17] a basic life support ambulance with lower acuity patient.
[49:22] Although this is not strictly limited
[49:24] to basic life support patients,
[49:26] the system continues to receive numerous calls
[49:29] that could be classified as interfacially transferred from one medical facility to another,
[49:35] that are also not time critical in nature and are appropriate to manage and transport
[49:39] as the system has the resources to do without impacting availability for these high
[49:45] activity calls that the 911 system was designed for. Next slide, please. ACM protects
[49:54] emergency transport capacity by preventing unnecessary ambulance dispatches.
[50:00] For non-emergent call, it addresses dispatch feedback by clarifying that the ACM clinicians actively monitor calls post EMD triage under strict protocol set by the county EMS medical director.
[50:15] Next slide.
[50:18] The county maintains unified clinical governance through the office of the medical director under a single county EMS medical director.
[50:26] This structure centralizes clinical quality assurance protocol development,
[50:32] credentialing, and dispatch standards across all system components.
[50:37] Next slide, please.
[50:40] Unified oversight eliminates fragmented care delivery across the municipal line.
[50:45] Both private transport providers and fire departments
[50:48] strongly supported standardized clinical protocols to ensure seamless patient
[50:53] hand off and consistent quality of care across the county. Next slide
[51:04] for operational agency
[51:05] is the plan establishes EMF agency medical directors. These positions report directly
[51:11] to the county EMF medical director are employed by the county and provided dedicated medical
[51:16] consultation and clinical auditing tailored specific to provider agencies. Next slide please.
[51:26] This condition responds to partner feedback requesting dedicated day-to-day physician support by employing agency medical directors through the county while having funding provided by the supported agency.
[51:39] We further observe unified medical authority while delivering tailored clinical oversight.
[51:46] Next slide please.
[51:49] The plan explicitly details the baseline capabilities of municipal fire departments and fire district.
[51:57] It clarifies that fire, of course, responder participation and clinical levels of care remain voluntary, and at the sole direction of each local jurisdiction.
[52:09] Next slide.
[52:13] This section balances operational integration with legal-safe guard if protects municipal
[52:19] fire departments from unfunded credentialing or staffing mandates. Furthermore, to satisfy
[52:25] federal anti-kip-back statute papers, any proposed vendor revenue sharing are passed through
[52:33] requires an independent bear market value study ensuring legally compliant pathways for local
[52:40] partnership. Next slide, please.
[52:47] We will wrap up by reviewing the adoption and procurement
[52:51] roadmap ahead. Next slide.
[52:57] Following today's first reading and public hearing, we look forward
[53:00] to the scheduled second reading on September 17. Upon board adoption, we will submit the completed
[53:09] the Indian Service Plan to the Oregon Health Authority, OHA approval will enable us to send
[53:15] the remainder of 2026 and beginning of 2027 developing competitive procurement ahead. This procurement
[53:25] ahead is complex and will take multiple months for partners to complete their portion related
[53:31] to legally required for our market value studies to support any requested path through payment.
[53:37] And for the county of EONF team and procurement team to design the procurement, the procurement
[53:44] that must be underway no later than March given the September 1, 2028 implementation
[53:53] date.
[53:54] And the large amount of internal infrastructure and capital expenses any vendor will
[54:00] need to have in place in this very short timeline.
[54:03] So, in summary, any day we'll compress our ability to start the procurement.
[54:09] Next slide.
[54:12] We'd like to express our gratitude to county leadership.
[54:16] And for all our public safety and health care partners who contributed to this plan,
[54:22] thank you.
[54:23] And we are now open to your question and back to you, Chair.
[54:28] Thanks so much, Bruno and Erin, and I know we have public testimony on this item, so
[54:33] Tasia can we move through this public testimony?
[54:37] Yes, first up for public testimony, we have Jeff, Teeter, Jeff, you can unmute yourself
[54:48] and begin.
[54:55] there. Can you guys hear me? Yes, we can. Okay. Good morning.
[55:00] Morning chair and county commissioners. My name is Jeff Teter. I'm the President of the Gresham Professional Firefighter Association. I represent 130 members providing fire and EMS services to the citizens of Gresham, throughout the fair view, would village and unincorporate areas of fire district 10.
[55:17] I am here today to advocate the Gresham firefighter stance on the currently proposed response times on the ambulance service plan draft.
[55:26] We're looking to make positive changes on those current numbers to increase services to the communities of East County, East Multimak County.
[55:34] Currently, as proposed in the draft, Multimak County, a lot of the longest response times in all categories except urban.
[55:41] When compared to neighboring Washington County and Cochemous County.
[55:46] When looking at the doubling of the response times in the cities of Trapale, Fairview and Wood Village,
[55:51] I can't help a ponder on what that will look like for our already overloaded emergency medical system.
[55:59] The current response times as proposed will directly impact three of six fire stations that my members operate out of.
[56:07] That would be half our fire department.
[56:10] These response times are currently drafted.
[56:13] As currently drafted, we'll cause ripple effects in Eastland on the county.
[56:16] It will first affect Gresham fire department and then further impact
[56:19] Portland fires most eastern stations fire companies that will have to
[56:24] shift their work in the Gresham area to cover while we're on seeing for longer
[56:27] periods of time.
[56:29] There are many ways to fix this current draft day SP.
[56:32] The one that Gresham firefighters would endorse is looping all the currently
[56:35] described suburban cities into the urban section for the response signs. Giving citizen giving
[56:42] every citizen in the metro area eight minute response times for emergency operation.
[56:48] All in all response times matter in the emergency medical field setting a standard that puts
[56:53] every citizen represented in this county first should be the top priority. Let's work together to
[56:58] correct these response times so the county ambulance service plan reflects this. Thank you so much for
[57:05] Next, we have Nathan George. Nathan, you can unmute yourself and begin.
[57:13] Good morning. I'm Nathan George. The city manager.
[57:17] Good. Thank you. I can see myself.
[57:21] Good morning, commissioners. Thank you for having me to testify.
[57:23] I'm Nathan George City of Magic City of Fairview.
[57:25] I'm asking you not to adopt the Island Service plans.
[57:28] currently proposed. City of Fairview, along with the cities of Troutdown, with village had
[57:32] many concerns. I will focus on three. First collaboration, Fairview, Troutdown, with village
[57:37] were not engaged in the process until very recently, after the assessment was already being written.
[57:43] Next, response and time and equity, our three cities are directly affected by the news
[57:46] suburban response standard, is extremely important to a collaborate with us as well as the
[57:51] rest of the county. Today, we are standing for life-threatening calls as eight minutes, the county
[57:56] in the PIN and Consultant to assess system, that consults a recommended 12-months, counting
[58:01] sheet of staff, chose 15 minutes. That does not show a commitment to equity, cost distribution
[58:05] finally. Last point, our communities are already paying for the system. We ask that services
[58:11] not be reduced, which would shift more of a burden on the cities. The Gresham Fire Department,
[58:15] the contractor, which is the contractor for our three cities, is the first responder on the
[58:19] scene in life, threatening priority calls, more than 80% of the time. We are already paying
[58:23] services, including all our 911 services. In the case of City of Fairview, the expense
[58:28] for public safety are so high, 6.3 million this year. There are 3.2 million dollar
[58:34] property taxes, which is all we collect. Building and cover half, we now have a $55 per household
[58:40] public safety fee this year, just to pay for our public safety costs. Our residents cannot absorb
[58:45] more increases medical emergencies for our residents or just as urgent and important inside the
[58:51] important as they are outside the City of Portland. Please do not adopt this plan as written
[58:55] and need more work for representation and involvement from all citizens of Multnomah County.
[59:00] Thank you.
[59:03] Next, we have Greg Durks. Greg, you can unmute yourself and begin.
[59:10] Thank you very much, Honorable Chair and Commissioners. This opportunity to testify. My name is
[59:14] Greg Durks, the City Manager for the City of Wood Village. I'm asked for you not to adopt
[59:18] payment service plan as apparently proposed and I want to frame our concerns around the county's
[59:22] own commitments to accountability, equity, collaboration, and data-driven decision-making.
[59:27] The County Identify stakeholder engagement for the medical service system assessment
[59:31] occurred December 2024 and February 2025, followed by the County's internal committee in April,
[59:36] with Village, Fairview, and Child Bill, and not engaged until June 25, 2025, when his
[59:40] assessment authority being written.
[59:42] These are the three seasons, directly affected by the New Superb and Response Standard and
[59:46] meaningful collaboration we use involving affected partners while decisions are being developed.
[59:49] Today, our standard for life-threatening calls is 8 minutes.
[59:52] The county-hard independent consultant to assess that system.
[59:55] That consultant recommended 12 minutes.
[59:57] County staff chose 15.
[59:59] The county's parking niche.
[1:00:00] Legislative emphasizes performance, data, benchmarking, and measurable results. It's strategic plan commits to county-to-transparent, data-driven decisions.
[1:00:07] So, show us the data, demonstrating why this disparity is necessary, consistent, which equity and performance commitments.
[1:00:13] We've been told that providing fast-free response for our three cities would cost more.
[1:00:17] But can you members of what Village Fairview and Childhood will not receive a discounted ambulance rate, an exchange for lower service standard?
[1:00:22] The ambulance does not cost less because it took longer to arrive, same system, same ambulance rate, different excretation for service.
[1:00:29] that is difficult to reconcile with the county's commitment to equity.
[1:00:33] And our community is already paying for this system.
[1:00:35] The county's assessment indicated that fire agencies respond to approximately 64% of
[1:00:39] medical calls counting why.
[1:00:41] What it didn't show is that for the four city area fires, the first responder on seeing a
[1:00:45] life-threatening party calls more than 80% of the time.
[1:00:47] The assessment calls these services force multipliers that reduces a number of ambulances needed.
[1:00:52] Our city tax payers fund those fire fire paramedics and the MTs.
[1:00:56] They respond, assess patients, begin treatment, and stabilize some emergencies
[1:00:59] followed by what's not signing that patient in the bill.
[1:01:01] The county does not subsidize Amazon's contractor, but cities and fire agencies provides
[1:01:05] substantial public funding for that EMS system, which makes that model possible.
[1:01:09] We're going to told that multiple ambulance service areas would cost more,
[1:01:12] again, to show us that analysis, what costs more and by how much.
[1:01:15] We're asking you to apply the county's own principles and gauge effective communities,
[1:01:19] to show us the analysis, recognize resources, our community is worried provided,
[1:01:22] and don't establish a lower emergency response simply because of which
[1:01:25] and leave some of those.
[1:01:27] Medical emergency doesn't become less urgent
[1:01:28] when a curse east of 211 for 7 in.
[1:01:31] Please do not adopt this plan as written.
[1:01:33] Thank you.
[1:01:36] Next we have Elizabeth Perez Elizabeth.
[1:01:40] You can unmute yourself and begin.
[1:01:45] Good morning.
[1:01:46] Good morning, Tara Vega Peterson and commissioners.
[1:01:49] I'm Elizabeth Perez and our private
[1:01:50] Services Director for Public Safety at the City of Portland.
[1:01:54] Thank you for including the City and the
[1:01:56] ambulance service plan process.
[1:01:58] We appreciate the collaborative spirit so far.
[1:02:00] City Administrator Lee Sherrod shared our consolidated feedback on August 5th and we were grateful
[1:02:05] for the opportunity to meet last week with Commissioner Jones Dixon, Dr. Bruno, Aaron,
[1:02:11] and the broader team to walk through our concerns and suggestions.
[1:02:15] The City County and our EMS partners share a core commitment
[1:02:18] delivering the fastest, safest, and most effective life-saving services to our community.
[1:02:24] That shared mission should guide how we shape the ASP.
[1:02:27] Because this is a system, changes in ambulance requirements directly influenced Portland
[1:02:32] Fire and Rescue's ability to meet community expectations.
[1:02:36] When response standards aren't met, or when PFNR, paramedics must provide advance care,
[1:02:41] or write in an AMR unit, PFNR units are taken out of service, creating coverage gaps,
[1:02:46] and shifting both workload and cost to the city.
[1:02:50] Clarifying responsibility for advance care staffing is essential to maintaining system reliability.
[1:02:55] There are also significant financial considerations for both PF and R&BOEC.
[1:03:01] While the county sets medical standards, equipment requirements, and training expectations,
[1:03:06] the associated funding does not currently match the operational burden.
[1:03:10] While MCEMS is ultimately responsible for cost sharing as a user on the BOEC user board,
[1:03:16] we understand MCEMS's desire to pass the cost allocation onto the contracted ambulance provider.
[1:03:22] We ask that the ASP incorporate those cost-sharing updates to the EMS dispatch services and mandated training and equipment are sustainably funded.
[1:03:34] Flexibility in the plan is critical as well.
[1:03:37] The ASP should allow county and its partners to introduce future innovations such as nurse triage systems, updated response models,
[1:03:44] and non-emergency-shuttleing solutions without requiring full renegotiation of it the ambulance contract.
[1:03:51] Building an adaptability now ensures that we can evolve the system as the community needs change.
[1:03:59] Going forward, we welcome a more structured collaborative development process for the ASP.
[1:04:05] One that allows city stakeholders to participate earlier in shaping the system requirements rather than reacting once the draft is completed.
[1:04:12] We recognize the complexity of the agreement, standards, and operational structures that support
[1:04:17] EMS services in Montgomery County and the city looks forward to continue partnership as we
[1:04:22] refine the ASP together and ensure the system remains coordinated clinically effective and ready
[1:04:28] for future challenges. Thank you so much.
[1:04:35] Next, we have Travis Stowell. Travis, you can unmute yourself
[1:04:40] begin.
[1:04:44] Good morning, Chair, and commissioners for the
[1:04:48] recommend name is Travis stoleball mayor of city
[1:04:49] aggression. And I'm here on behalf of the city and the
[1:04:52] diverse community that we have the privilege to serve.
[1:04:55] I want to begin by thinking each of you and your staffs,
[1:04:58] county employees, and for the thought.
[1:05:00] Full and collaborative engagement with Gresham over the last several days, regarding the proposed ambulance service plan.
[1:05:06] Gresham wants to be a partner in developing a plan that puts equity, public health, and people at the center of our decisions.
[1:05:13] We also recognize the difficult balance before you. Physical realities, system reliability, ambulance provider capacity, and the equitable service across a large and diverse county.
[1:05:24] As you weigh those considerations,
[1:05:26] Gresham is asking the county to maintain the
[1:05:28] current suburban response standard for life
[1:05:31] threatening calls.
[1:05:32] Today, the standard is eight minutes.
[1:05:34] The proposed plan would increase it to 15.
[1:05:36] Our staff has looked at an ambulance service in systems
[1:05:39] and contracts in our neighboring jurisdictions,
[1:05:42] including Washington and Clark and his counties.
[1:05:44] Those comparisons give us the confidence
[1:05:47] that we can continue working towards a model that
[1:05:50] that provides timely, sustainable service
[1:05:53] without lowering our expectations for care.
[1:05:56] This matters most for those with the fewest alternatives,
[1:05:59] our seniors, people, disabilities,
[1:06:01] lower income families, and historically marginalized communities.
[1:06:04] When someone is experiencing a lack of a redding
[1:06:06] emergency, every second matters, regardless of their zip code,
[1:06:10] our opportunity is not simply to build a system
[1:06:12] that works, it is to build one that can be great
[1:06:15] for all of Montename County.
[1:06:17] None of us can solve this alone,
[1:06:19] But working together, I believe we can build a system that is equitable, sustainable, and worthy of the communities we collectively serve.
[1:06:27] So today on behalf of the City of Gresham, we humbly ask you to adopt a plan that holds the line on service and maintains the current eight minute response standard for life threatening emergencies.
[1:06:38] Gresham stands ready to be a partner in getting there. Thank you very much.
[1:06:43] Next we have David RIPMA. David, you can unmute yourself and begin.
[1:06:54] Mayor, Mayor RIPMA.
[1:06:57] Can you hear me? Yes, we can.
[1:07:00] Yeah, okay. Yes, I'm David Carl RIPMA. I'm Mayor of Troutdale.
[1:07:07] And I don't know what's why I'm not seeing myself, but I'll leave that to the technical people.
[1:07:13] I joined the other cities, the Gresham Fairview and Wood Village in the August 10th
[1:07:25] letter to preceding your work session.
[1:07:30] The commissioners' work session, questioning basically how this new ambulance service plan
[1:07:35] would increase service to persons calling 911 and I endorse everything in that
[1:07:43] letter, but I, and I also endorse the comments of Jeff Teder, Travis Skowall, Nathan
[1:07:53] George, and Greg Dirk's today, question, I mean, the response time standard for
[1:08:03] Troutdale Wood Village and Fairview is clearly inequitable.
[1:08:10] You've greatly increased it for our cities.
[1:08:14] I can understand different response times
[1:08:19] for based on physical distance and so on,
[1:08:23] but the idea that response time standards
[1:08:26] for Troutdale Wood Village and Fairview
[1:08:29] to be practically twice what it is in Gresham and I'm talking adjacent Portland and
[1:08:37] Gresham neighborhoods with the same density of people based on basically city limit
[1:08:44] boundaries, artificial lines on maps is clearly inequitable and I'm asking you please
[1:08:57] to delay, pause this process, delay final adoption, and please engage with the three cities.
[1:09:08] If you would, it's been pointed out that our involvement has been minimal at best, and
[1:09:16] I think that is reflected in the fact that it response time standards for our cities has
[1:09:24] really degraded in this plan.
[1:09:26] So, please pause it. I urge you to reconsider and let's delay final adoption of this. Thank you.
[1:09:44] We also have, oh, Councillor Sue Piazza. You may unmute yourself from you again.
[1:09:58] There we go.
[1:10:00] Good morning, thank you, Chair Vagan Peter, sending commissioners for the opportunity to testify. For the record, my name is
[1:10:05] Supiasa and I serve on the Gretchen City Council. I have been involved with these conversations with many of you about ambulance services,
[1:10:12] paramedics and emergency response for several years now. I worked alongside many of you, and we have tried to improve a system that we all know has faced challenges.
[1:10:22] There is certainly no shortage of history here. You cannot Google ambulance service in Multnomah County without finding years of
[1:10:28] articles, reports, opinions, and debate. I'm not here to rehash all that today and I want
[1:10:34] to thank you for hearing our concerns and for the care I know each one of you brings
[1:10:38] to these decisions. These are difficult choices and I believe all of us come to this conversation
[1:10:44] wanting the same thing, a system that is there for the people when they need it most. As you consider
[1:10:51] this plan, I hope we continue to think about what these respond time standards mean in the real world.
[1:10:56] What does it mean for the person who called 911?
[1:11:00] What does it mean for the firefighter or paramedic already
[1:11:04] if they're side providing care while they wait for an ambulance?
[1:11:08] And what does it mean for the next family that means that same fire crew?
[1:11:12] Those questions matter because our emergency response system is interconnected.
[1:11:17] Our firefighters, paramedics, ambulance providers, cities,
[1:11:22] and the county all have a role in making it work.
[1:11:25] That is also why I believe the communities and first responders most affected by these changes should continue to have a meaningful role in shaping the solution.
[1:11:36] For me, this is deeply personal. I'm a mom, a grandmother. I have family and people I care deeply about living across this county.
[1:11:44] If one of them suffers a heart attack, a stroke, or another life-sentimenty threatening emergency,
[1:11:51] I want them to all have the same expectation that help is coming quickly,
[1:11:56] whether they live in Gresham, Trapdale, Northportland, or the Pearl District.
[1:12:01] I know all of you want this for all of our families in the county. That is why I support maintaining
[1:12:07] the current eight-minute response standard for life-threatening emergencies. We have spent years talking
[1:12:13] about how to improve the system.
[1:12:15] My hope is that this moment gives us the opportunity
[1:12:18] to bring the county, cities, first responders, providers,
[1:12:22] and communities together to build something better.
[1:12:26] So I respectfully ask that you maintain the unit standard
[1:12:30] and continue working with those most impacted
[1:12:32] to find a path forward that strengthens
[1:12:35] emergency, mental care, medical care
[1:12:37] for all of them in county.
[1:12:40] Thank you for listening, and thank you
[1:12:42] your continued partnerships.
[1:12:47] That's everyone signed up for public testimony.
[1:12:51] Okay, thank you so much.
[1:12:52] We'll go to questions from the board.
[1:12:57] I will just say there were a lot of comments about the public engagement process.
[1:13:02] I would like to hear from Erin and Bruno at this point a little bit more about that.
[1:13:07] Public process when you get to some of your responses.
[1:13:09] But for now, let's go to Commissioner Brimitwards.
[1:13:16] Thank you.
[1:13:17] I'd like to focus on a couple of the slides that also coincides with some of the testimony we just heard.
[1:13:27] On slide 17, I'm wondering if we could bring that
[1:13:53] up.
[1:13:56] That's part of the slide.
[1:13:58] There's the bottom of the slide, the feedback and it echoes much of what we heard in the testimony today from the.
[1:14:08] leaders of the cities in the county and as I was listening, it sounded like there was a response
[1:14:19] that was provided of like, here's the response to the feedback that local governments could
[1:14:24] contract separately, but I'm not seeing that on the slide as sort of the county's response to
[1:14:34] the feedback. So I'm wondering if you could read what you said, the sound on the slide of how the
[1:14:42] county is looking at that because what it seemed like it was saying is that in response to the
[1:14:48] feedback, you'd be telling the counties to have separate contracts to address that, so that
[1:14:57] wouldn't be a cost-borne by the county.
[1:15:00] And maybe I was mistaken that I'm pretty sure that's what I heard you say on this slide.
[1:15:08] Okay. I did. I referenced that part of the response to the feedback was that jurisdiction that
[1:15:16] desired a faster response on the floor that the county has in their plan could do supplemental
[1:15:25] to a performance contract with the vendor to get whatever that need is, it is a somewhat common practice in the industry, Clark County, for example, one of our neighbors.
[1:15:43] the county that they poor performance standard and then city of
[1:15:48] or fire district, they're able to contract with the vendor for
[1:15:52] increased unit hours or more a faster response time again with a
[1:16:02] volume of call, the volume of transport and a fee for service system.
[1:16:09] You're only getting that revenue when you're doing the transport
[1:16:13] And when the ambulance is first sitting, waiting ready are not generating that revenue.
[1:16:20] And so you have to have more units available sitting, waiting, not running call in order to drive down that time.
[1:16:31] And so that is something that the fee first service is not paid for letting the ambulance sit in.
[1:16:40] that is how that was addressed and how that came up and I'm going to make sure I answered your
[1:16:47] question.
[1:16:49] He does and when you say the vendor you're talking about in this case, I mean, assuming it's
[1:16:53] the current vendor AMR.
[1:16:55] That's whatever vendor, so that the ambient service plan and the code are vendor agnostic
[1:17:00] we have to go to a procurement process, but I just want to make sure that it's like whoever
[1:17:07] the vendor is like right now, if that were the case.
[1:17:10] right now, it would be the expectation that the cities would go to AMR and have a supplemental
[1:17:18] contract.
[1:17:19] Correct.
[1:17:20] And that would give them direct oversight of whatever that supplemental performant is and the
[1:17:26] ability to negotiate with the vendor or what the cost of that supplemental performant is
[1:17:31] going to cost.
[1:17:36] So, those cities would actually bear the cost of getting back to where to what they had,
[1:17:44] what they have in the current contract.
[1:17:46] So the current contract has a benchmark of eight minutes, which is not met in that current benchmark.
[1:17:54] We've discussed this over the last few years, a lot about the East County 50, but that geographic region is urban. It includes brush from Southdale wood village and fair view all in a single lump to increase the volume.
[1:18:13] The consultant will get the response time to actually occur.
[1:18:17] What's actually occurring, the benchmark if you're going to separate out those areas needs
[1:18:24] to account for the volume and what the actual performance is happening there currently.
[1:18:29] The numbers are being mixed with a much denser call volume area, much higher volume and much
[1:18:35] denser.
[1:18:35] But just to get the practical quality of it and the implications of this is that if they wanted something better than 15 minutes,
[1:18:50] the expectation from this plan would that they would need to contract with AMR or the vendor to get a faster response time.
[1:19:02] Correct. And the other piece of that is, if we choose to have something faster than that,
[1:19:11] they can at the base level. It will require the empty to subdivide that performance,
[1:19:17] because it does not get paid for based on people's service by itself.
[1:19:23] It will require a subsidy from somebody to move it.
[1:19:28] and then this is just this is another question because during my time on the commission
[1:19:35] much at the time there wasn't the ability that you know we had the whole level zeros where
[1:19:42] there weren't enough ambulances so would you anticipate safest a city chose to contract that there
[1:19:48] would actually be the ability for the vendor to provide those services because for the last
[1:19:55] of years, there hasn't been the capacity to even provide the base level.
[1:20:00] Service.
[1:20:01] Yeah, that's a second very question. I can't say. I suspect if you asked any for profit vendor, they usually say, yes,
[1:20:11] if the matter of what it cost them will import paramedics from Australia, they fill the whole, or whatever that happens to be.
[1:20:20] And so we get an answer of, yes, but it's not built in.
[1:20:25] Finally. Yep. Okay. My next question is on slide 25.
[1:20:42] So, and this question, it looks like
[1:20:46] the fire chiefs are looking at supportive of this formalized roles, but I'm concerned about
[1:20:53] equipment and training mandates?
[1:20:58] What is the county's position on the equipment and training
[1:21:05] mandates and funding to ensure that?
[1:21:11] I'll come up with a question, but I will try to take it on. So the first one is that the county,
[1:21:17] on the subsidized system, I don't have any county general funds for the county if they're
[1:21:25] And if we built in the fair market value assessment,
[1:21:33] so if they want to be paid for something,
[1:21:35] we need that to occur under federal regulation.
[1:21:40] So they would need their federal requirement to do a fair market value assessment
[1:21:44] for the cost of once they want to be paid for.
[1:21:47] We would build it into the procurement process and the proposal
[1:21:51] for the system would know what those expenses are.
[1:21:54] There are things that are permitted to be paid for and things that are not permitted to be paid for under CMS regulation.
[1:22:04] The penalties for violating those are very high, including criminal penalties.
[1:22:09] So again, the payment structure is built in there to be compliant with federal regulation.
[1:22:17] We're supportive of having a vendor pay for things that are commercially reasonable and meet the standards that just need to be built into the procurement process.
[1:22:30] The standards themselves related to training and equipment.
[1:22:34] Those have to do with clinical care.
[1:22:37] If you want to be part of the system,
[1:22:39] you have to have equipment that interoperable
[1:22:42] that fly back to how the system eats.
[1:22:46] Each one of the partners interacts with the next one.
[1:22:49] So you need to have medications.
[1:22:50] You need to have protocols.
[1:22:52] You need to have training where everything works interoperably.
[1:22:57] If you're going to have a system instead
[1:22:59] of a bunch of components that are not related or coordinated.
[1:23:02] good.
[1:23:05] Thank you. Um, so I'm going to want to hear the other questions that come up this morning. I'm going to say that was since I'm very, when I got on the board at the very beginning, it was in the middle of the huge ambulance to play issue, including it's like it might just start to the eastern portion of it. And as the commission discuss it, one of the issues that got raised.
[1:23:34] is that the actual contract, not the English service plan, but the initial contract was done
[1:23:40] on the consent agenda, no discussion, things got locked in, and then changes could
[1:23:46] be made. And then when a different approach was brought forward, there was a lot of conversation
[1:23:57] about how we were locked in because of the ambulance service plan and a whole host of other
[1:24:01] reasons of why the county couldn't
[1:24:05] nimbley move to address the delays.
[1:24:08] So I'm concerned about having a vote today on the first reading
[1:24:14] of the ordinance of getting ourselves locked in.
[1:24:18] So I may be later in the meeting,
[1:24:22] voting to table this to a date certain so we can
[1:24:26] have some of these issues addressed.
[1:24:28] I don't want to move ahead and say we're going to address them later and then come to the point where then the response is, well, we already did X and we're locked in.
[1:24:43] We can't address that. I'm concerned that we have leaders from essentially all of our partner cities this morning raising issues that are unresolved.
[1:24:55] I think there's also an expression of interest in partnership.
[1:25:00] The, you know, an anti-recognition that for this to work, we need to have close partnership and collaboration with the cities and the far departments.
[1:25:15] And I would hope that we get to a point when we're voting on the ambulance service plan ordinance that we have everybody who's needs to make the system successful on board with it.
[1:25:27] So I'm just going to put that out there, but we'll wait for all the other questions to come up to be raised by and answered by the commissioners.
[1:25:42] Okay. Thank you commissioner. Commissioner Jen sticks in.
[1:25:45] Yeah. Thank you chair. And I'll just say build off the web.
[1:25:48] Mr. Rimmer, just did it.
[1:25:51] So thank you, Dr. Bruno, for being here this morning
[1:25:54] in Administrator Monica, Erin.
[1:25:56] And thank you for just the last three weeks.
[1:25:58] And Renee, as well, for just your support
[1:26:00] and your help to look at my office and facilitating
[1:26:02] all of the meetings with the City of Portland,
[1:26:05] the City of Gwood Village, Fairview of Prouddale,
[1:26:07] and the City of Gresham, and the fire unions.
[1:26:10] So to build off of what Mr. Rimmer
[1:26:12] Edwards just stated, could you just share
[1:26:15] about this level of engagement that's been made?
[1:26:17] I mean, on slide eight on slide nine, as far as with the cities in East County, if you could just do just the level engagement for 20, 24 up until now. And then also if you can turn the engagement over the last week, you share the difference between the ordinance and the opportunity to the ASP to make changes in the different pockets.
[1:26:44] And you were going to put together a spreadsheet.
[1:26:47] So that would be helpful for us, the board as far as
[1:26:49] maybe the citizens will be bored.
[1:26:51] They go be helpful for all this.
[1:26:57] Let's see if I can try to cover the engagement part.
[1:27:02] So input for our partners is valuable partners
[1:27:05] have been consulted since the outset of the EMF assessment
[1:27:09] and invited to provide feedback in various means.
[1:27:14] In person right along.
[1:27:17] surveys, a lot of that is documented actually in the NSF assessment report about what the
[1:27:24] message was between the public release of the draft ASP in June of 26, the work session
[1:27:33] in August. We received a written feedback from partners both on the assessment and the
[1:27:40] National draft, whatever practical, wherever we could find a way to incorporate it in the appropriate document. Again, we received feedback and sometimes our answer was that doesn't belong in an ambience service plan and to the point that doesn't belong in an ambience service plan where does it belong. So actually a couple of those other tools.
[1:28:03] Our partners all have roles in the system.
[1:28:06] They're here to advocate for their role, their position,
[1:28:10] their component or their jurisdictional boundaries.
[1:28:14] And so our goal is to balance that across looking across the entire
[1:28:19] county geography and ensuring that the service is able to be provided
[1:28:24] across everywhere.
[1:28:27] And we sometimes don't satisfy all of our partners.
[1:28:30] and I will acknowledge we do not always identify all of our partners.
[1:28:35] So, going on to the tool for the ambiance service plan has very specific components and structure
[1:28:43] that is dictated by the state at what has to go in there and must be addressed.
[1:28:50] There are some decisions to be made and there are some descriptions that need to occur and that's a very structured piece.
[1:28:58] In addition to the end-on server plan, we then have county code.
[1:29:04] County code needs to support or supplement the end-on server plan.
[1:29:09] It can't conflict it.
[1:29:12] And that county code is basically the additional legal structure that the board is putting out.
[1:29:20] for us and our partners to follow.
[1:29:25] And so some items go in county code,
[1:29:29] our end-to-end service plan and county code,
[1:29:33] our written provider agnostic,
[1:29:36] meaning we're going to have to put cure for services.
[1:29:39] And there's no predetermination of who's going to do that.
[1:29:43] It could be a private vendor,
[1:29:45] could be a not-for-profit,
[1:29:46] could be a governmental entity or a hybrid,
[1:29:49] where they join a partnership or ultimately it could be the county that provides those
[1:29:55] services depending on how it plays out.
[1:30:00] The ambulance service plan and county code are formally put in place by the board through this ordinance process and readings and vote.
[1:30:12] In addition to that, we then have a procurement that needs to occur.
[1:30:17] And so the board will fit the procurement board when we come to you for our procurement piece, working with Brian Smith and the county procurement team on.
[1:30:29] How we plan to purchase or contract or get agreements for the services, we have a legal obligation
[1:30:37] with the state for that procurement process to be consider all offers to provide the
[1:30:44] service.
[1:30:45] So we can't just assign it to anybody.
[1:30:47] You can't just direct negotiate it with AMR and you're not allowed to give preference
[1:30:53] to existing providers of the service.
[1:30:55] So, some items belong in procurement.
[1:30:59] A lot of those are like the cost.
[1:31:02] If we've been a pay, the fire department
[1:31:04] to ride in on call, or you're going to pay them for training.
[1:31:10] They're federal requirements that need to be met
[1:31:13] in order for us to put that into a procurement
[1:31:15] of somebody to pay.
[1:31:18] So, that's where that would live.
[1:31:20] We have EMS Administrative Rule, those are rules
[1:31:24] that the program publishes or how we accomplished the work and we need to have rockers of every
[1:31:32] enough provider in the county. And we can change the rules at any time. Right. Right. So the administrative
[1:31:39] rule follow our administrative rule process. So those are run by the program and we publish the
[1:31:48] out for public comment for 30 to 60 days, take comments and then the program finalizes those rules
[1:31:56] at a program level. So again, it's how we enact things that are either encoded or are with
[1:32:03] responsibility.
[1:32:06] We have, yeah, that's clinical protocol. The MS clinical protocol or how we treat
[1:32:12] patient has to do with the equipment, the medication, the state organ medical board, that's
[1:32:19] the highest level, but the county medical directors actually allow EMF providers to do those
[1:32:26] things, and so that is under the medical director's statutory authority, just that EMF clinical
[1:32:33] protocol. Again, with those are on the clinical side, and then we have the contracts in the
[1:32:40] government or agreements. And so the context in and in our government or agreement, typically
[1:32:45] document commitments either from the county to an agency or from that agency to the county.
[1:32:54] Those can be payment. Those can be action. I think we sometimes talk about the fire department
[1:33:02] can determine what call the fire department is going to go on or what level of purpose are going
[1:33:09] to run that, and that is documented within an intergovernmental agreement between the fire
[1:33:14] agencies and the county that say that was going to tell you what we're going to do.
[1:33:20] So those are kind of the structure of the common tool that those various things live in.
[1:33:26] And again, we kind of not put payments or financial matters into county code because it doesn't
[1:33:35] makes them to be in that level of document.
[1:33:39] I am sure there's some other document that those are the main ones.
[1:33:43] Yeah, that's, that's, that's a shame the helpful as far as the timeline is concerned
[1:33:46] in a pump-able moving forward, that's, that's such a trouble.
[1:33:51] So the, the questions that I have regarding the ASP, or what's before us today is one,
[1:33:58] just to clarify for the suburban and rural,
[1:34:02] Corvette, they're moving from rural to suburban, is that correct?
[1:34:07] A portion of them does not all of them.
[1:34:10] So the way the state defines the suburban and I'm going to paraphrase and not read it.
[1:34:17] But it's a 10-mile radius from the center of the urban area.
[1:34:23] And so if you look at that map, you'll notice that the pink area is an arch.
[1:34:28] And that's because that's a 10 mile radius from the core of the Oben Center.
[1:34:36] And so that currently rural is outside of the Oben Gross boundary.
[1:34:43] We use the plan planning tool.
[1:34:46] When we move the using the state's actual definition,
[1:34:50] and now it's a radius of 10 miles from the center of the area on the left turn side of the county.
[1:35:00] Because Hillboro and Beaver can open that arch actually starts in a different county.
[1:35:08] To get the suburban area of the west hill, there's also just a teeny tiny river of suburban outside of Portland, because Portland is such a large geographic map that 10 mile radius doesn't go as far.
[1:35:24] the map on the eastern side, where Gresham needs that urban definition to 10 miles goes out quite a bit further because Gresham has a smaller urban geographic map.
[1:35:40] Got it. Got it. Got it.
[1:35:41] Well, I, like I said, we've been doing a lot of conversations over the last two weeks.
[1:35:45] I just wanted to just put on the record.
[1:35:47] We hear just the three cities or just everyone in East County as far as the city managers have been staying over the last two years.
[1:35:54] We need to engage the three cities.
[1:35:58] The fire changed the fire union, so something we've made an effort.
[1:36:01] We need to make a better effort to include the city administrator, the new city administrator as far as the city of Portland and our fire chiefs and things like that as we move forward in the process as far as collaborating as we're building up the system of care.
[1:36:16] And I'm looking forward to hearing the responses from the rest of my colleagues.
[1:36:21] I'd like to be putting forward, I will be putting forward an amendment to the ASP
[1:36:25] as far as the response sounds or all of the smaller cities.
[1:36:30] To eight minutes, I do agree with President Teter as far as making it universal.
[1:36:35] And then we'll have to let the discussion be paid for that or just overall implications.
[1:36:42] I just want to say it overall, just thank you for, I've learned a lot over the last two or three months.
[1:36:48] I'm just learning from you and everyone else.
[1:36:50] I'll just hand it off while you're my time to the rest of my colleagues. Thank you.
[1:36:56] Thank you. Before we go to districts one in districts two, we did have somebody who had signed up for a public testimony who is having technical difficulties who are now, who's now online.
[1:37:04] So, Tejik, can we have them right there testimony now?
[1:37:09] Yes. Frank, Hiltabrand, you can unmute yourself and begin.
[1:37:17] Hey, the morning everyone, can you can hear me all right?
[1:37:20] Yes, okay.
[1:37:22] Well, thank you so much, Apologies. I have not used this format before.
[1:37:30] So, listen, I want to bring you back, all of you back to
[1:37:34] Well, the Molda McKown code 24,
[1:37:39] 2140, or 21400.
[1:37:44] But for again, to do that, my name is Frank Hildebrand,
[1:37:48] I'm the morning commissioner, Schermoing Chair.
[1:37:51] I am the union representative for local Teamsters Local 223.
[1:37:56] I proudly represent the approximately 400 paramedics
[1:38:01] any MTs currently working in Malima County as employees of AMR.
[1:38:07] And so today what I want to bring to your attention or what I want to talk about is labor dispute and neutrality.
[1:38:16] So, but before I get into that, I want to take this opportunity to reassure the board
[1:38:22] that our current relationship with AMR as an employer is cooperative and productive.
[1:38:27] In fact, joint letter to that effect between the teamsters and Amar was recently submitted
[1:38:33] to Multnomah County MS as part of this process.
[1:38:38] So we are going to talk about something that makes some people a little uneasy, but I just
[1:38:43] want you to know that the current situation is very good, and we are prepared to continue
[1:38:49] our support of our teamster employer in areas that provide clear benefits to our members
[1:38:56] of their families. That being said, I'm obligated to bring to your attention to something we view
[1:39:04] as a loss. And that is this deliberate position by Montnomic County that ensures the full
[1:39:15] weight and consequences of bargaining are placed directly in the hands of the bargaining parties.
[1:39:21] So, you probably think of what Lucy talked about.
[1:39:25] So, I'm gonna get there.
[1:39:26] So, previously, we were provided that assurance
[1:39:29] under Multimak County Code 21.406,
[1:39:33] subsection five, which prevented approval
[1:39:36] by Multimak County MS to provide alternative staffing
[1:39:41] in the event of a labor dispute.
[1:39:43] And it was very specific.
[1:39:45] That language, as a part of this process,
[1:39:47] has been struck.
[1:39:48] So we, and I would like you to do some consideration in helping us solve that problem.
[1:39:58] So we're seated in the question.
[1:40:00] We request the Board, please reinstate specific and deliberate position of the
[1:40:03] reality. With the new language, and we'd like to see that new language
[1:40:07] in the local county code 21.417, the medical direction and supervision.
[1:40:14] So, copies of that proposed language have been provided to
[1:40:19] Ms. Zinga, Sprazener, and Mr. Monnick. So, we have an example of what we'd like to see.
[1:40:27] We hope to develop a relationship with you and work with you on the development of the language.
[1:40:35] Thank you so much for this opportunity to speak. I appreciate it.
[1:40:40] All right. Thank you. I'm glad we were able to get that in.
[1:40:43] Okay. We'll go now to further questions from the board.
[1:40:45] We'll start with her will go to Commissioner Morgana.
[1:40:48] Yeah. Thank you.
[1:40:49] Um, I have a question,
[1:40:56] when we went into rewriting, the family service plan was the directive that it be cost neutral or would not encourage additional cost to accounting.
[1:41:09] effective, efficient, sustainable.
[1:41:16] Can what is that mean?
[1:41:18] Yeah.
[1:41:18] I don't have any money coming to me.
[1:41:21] So if you, it is been an explicitly non subsidized system.
[1:41:27] There's no direction to the program that there is a subsidy.
[1:41:33] You'll find it maybe different.
[1:41:35] It's still going to subsidize the system.
[1:41:38] But as proposed with out-to-direction that there's a financial subsidy coming is written as the specific effective and sustainable with out-to-to-to-to.
[1:41:53] Okay.
[1:41:58] If we wanted to achieve faster response times to be on par with, say, Washington County.
[1:42:12] In some of the areas, I have some concern about some unincorporated parts of my district.
[1:42:21] the don't have a city that could make an alternative contract. I am concerned about a sliver
[1:42:32] that is a ten minute drive from downtown Portland, but is considered frontier. I can't tell
[1:42:44] how many people live there because of the map, but I am aware that there are some popular beaches
[1:42:49] that fall into that frontier category, I'm nervous about 120 minute response time for a time
[1:43:01] sensitive call. And so I'm trying to understand the ramifications if we were going to
[1:43:09] want to engage in a conversation of what it would take to get those response times somewhat
[1:43:16] in line with our neighbors, how would we go about understanding the give and take of that?
[1:43:24] Like if I said, I want no where in Multimak County, it to be less than 60 minutes.
[1:43:32] I'm making that up.
[1:43:32] I don't have any idea what that means or doesn't mean.
[1:43:36] But what would you push back or say about like the reality of what it would take to
[1:43:43] you?
[1:43:44] I think my first pushback is going to be we talk with our neighbors, I talk with the
[1:43:51] NF administrators in our neighboring county every week and a child Miller who is actually
[1:43:56] on our team helping with this is actually the NF administrator in Washington County now,
[1:44:04] so I would say we have a fantastic understanding of the differences. We're comparing apples
[1:44:11] an orange or apple from something else when you're kind of
[1:44:17] to compare Malton on the county to our neighbors, the definition
[1:44:22] that their plan have are not currently compliant with the state
[1:44:29] definition of urban, urban, rural, frontier, and search and
[1:44:36] you. We have collectively worked on a fry county map that actually does map out what that looks like
[1:44:44] with them, but their measurement methodology is also different. Our neighboring counties are measuring
[1:44:52] from the time of dispatch to the arrival of the first EMF provider, and they're not holding the
[1:44:59] ambulance vendor.
[1:45:01] So if a fire department shows up, that stops the clock, not the ambulance, and so it's fundamentally a different metric when we're holding the ambulance provider to be the start and stop of that clock.
[1:45:19] So we can go offline or I'm happy to meet with you and talk about what the impact is of those differences, but you're not comparing the same geography,
[1:45:33] be a clock in the county areas on their map that they classify as open or actually sub-open
[1:45:41] and their urban areas are receiving a 10 minute response to the first EMF provider arriving
[1:45:47] so they basically split it down the middle. Under the feedback we received from the state
[1:45:54] the plan will be required to update the geography at the next send they go through.
[1:46:00] So it would be more comparable for the county to county, but right now you're not comparing the same thing when you're comparing them.
[1:46:11] Yeah.
[1:46:12] And I appreciate that.
[1:46:14] I'm not an expert.
[1:46:16] Regardless.
[1:46:19] I am uncomfortable and cannot support.
[1:46:23] A response time on the South Island of 120 minutes for an emergency call,
[1:46:30] especially since they don't really have the same kind of professional
[1:46:36] fire department that some other locations have and so you know I'm trying
[1:46:46] to be responsible knowing that I don't understand all the
[1:46:49] employment implications of of these response times.
[1:46:55] Why did we choose the slow
[1:46:59] like these were minimums and we seem to have adopted the minimum response time in every category.
[1:47:08] Why did we not look to some degree geographically and say 120 minutes for
[1:47:20] And the first obvious island is too long for it to be geographically not that far from downtown Portland.
[1:47:31] I guess I'm not understanding why we chose the thresholds we chose since my understanding is that they're minimums and they're not.
[1:47:40] We could have a higher standard.
[1:47:44] Yes, I guess I will add that those are the bench marks that we are measuring the actual performance against until the ambulance and the fire unit will be dispatched according to dispatch protocols, dispatched in the close to available appropriate resource to the call they will get there and whatever it humanly takes to respond from where they're at to that location.
[1:48:10] the side of the island that you're looking at is Oregon Department of Fish and Wildlife
[1:48:19] Protected land that doesn't actually have a paved road on it and so even under the
[1:48:27] definition it is probably actually search and rescue but we classify it as rural. I mean
[1:48:34] frontier based on the gravel load that goes out there. I actually went out and drove some
[1:48:44] of these and for the lighthouse at the very end of Sobby Island. It takes almost three hours
[1:48:49] to get to drive out to the end of the gravel road and then you have to get out of the vehicle
[1:48:56] and do the rest of it on foot and the ambulance is actually don't get there. So we'll get a
[1:49:03] detailed map to you because the road alongside the island is actually classified as world, it's
[1:49:10] tank and then the Oregon Department of Brisbane Wildlife Area is frontier, which has a benchmark,
[1:49:20] there were 30 fixed calls in that area over the last seven years. And so if you have one call,
[1:49:28] you got zero percent. If you had two calls in a month, which never happened, you would be at 50%
[1:49:36] and so some of those measurements of time and percentage need to be adjusted based on very,
[1:49:44] very, very low volume. I'm not taking away from the activity or the importance of that emergency
[1:49:51] for the individual there, but the benchmark is very tough to measure on exceptionally low numbers
[1:49:58] in very difficult.
[1:50:04] Thank you. Thank you.
[1:50:10] Thank you. Thank you. Thank you, chair. Thank you, chair. And thank you.
[1:50:15] Who's using the Erin and Dr. Bruno for the work in the presentation. Also, I want to thank you, commissioner Jones sticks in for really leading some of the convenings that happened over the past few weeks to get more feedback and input from our cities.
[1:50:31] And, Erin, when you were responding to a question from Commissioner Remembrance, you talked about that the current eight minute benchmark is not being met for some of the areas in our East County.
[1:50:47] Can you tell us what is actually occurring and what the timeline is?
[1:50:51] Yeah, so there have been several different reports for that geography, and they are all pretty
[1:51:00] consistent, which is the actual performance of somewhere in the 14-15-minute timeframe
[1:51:09] for all responders are analysis in terms of that, so they're getting a suburb in level
[1:51:18] respond today. It doesn't mean that that's what they want. It doesn't mean that that's necessarily
[1:51:25] what the community forget, but they've all used and the finances, whether it's the city,
[1:51:31] finances, or the Indians, and their finances. That's what it's paying for resource-wise.
[1:51:37] And if we continue to apply a benchmark without restoresping it for availability, fire, police,
[1:51:46] ambulance, it doesn't matter what it is, you're setting it up for a failure to meet those benchmarks.
[1:51:55] So, again, there's the several studies out.
[1:51:59] They have different methodology, but right now they would meet the suburb and just barely.
[1:52:07] Thank you. And can you speak to the piece that came up in some of the testimony from our colleagues that
[1:52:17] The consultant recommended 12 minutes, but we adopted 15 or we've drafted 15.
[1:52:25] They did, so I guess the first thing is in the assessment report to put the response time benchmark in perspective.
[1:52:37] There is no clinical benefit for this response time after four minutes.
[1:52:43] So, and nobody can afford for a minute, so like the research out, so that the respond time
[1:52:52] that matters is for a minute.
[1:52:54] And the way you get good care for a minute is public access to the defibrillators, CGR program,
[1:53:02] community members out providing care and help those responders get there.
[1:53:06] The consultants recommendation with 12 minutes based on current industry best practices and that 12 minutes only works if you're going to do it across the entire urbanized area and so if you have to have eight minutes at one area and you make the other area 12 minutes.
[1:53:30] The resources still have to be in the eight-minute area.
[1:53:33] We have a legal obligation and so the difference between the consultant report and what you have is the consultant report was looking around the nation around the world about what a good number would be if we didn't have any legal obligation.
[1:53:53] Once you are a related state requirement, you can't actually do 12 minutes across that whole area,
[1:54:01] because you have to have resources to meet the eight minutes in the urban area.
[1:54:06] It becomes absolutely financially impossible, and that's how the state set up those standards.
[1:54:13] the standards are that the whole county across the state to a system that is financially viable.
[1:54:25] Thank you. This is likely a question, maybe you'll know, but there's been a lot of discussion
[1:54:32] around potentially changing the draft to that eight minute requirement in our East County
[1:54:41] as well and additionally Commissioner Moyer wanting to look at some pieces in her jurisdiction
[1:54:48] or in her district. Do you know what it will cost to do these? Like what is the actual dollar
[1:54:54] amount that it would cost the county to make any of these changes?
[1:55:00] We wouldn't be able to pencil it out until you told me exactly what the chain beer, they will all have a cost, the payment, the fee for service, even when our rates go up, we should all be prepared, the rates are going to go up, ambulance rates are going to go up, healthcare, medical care.
[1:55:22] we're probably looking at somewhere between $6 and $10,000 per ambulance transport rate based
[1:55:29] on our pair of mix in an unsubsidivated system. If you subsidize it and ambulance is going to
[1:55:37] cost you about a million dollars for each additional unit and you're paying for unit to fit
[1:55:45] and be available. So you're not paying for them to actually do the work like in order to get
[1:55:50] that are coverage, you need those ambulances to be sitting
[1:55:54] available waiting for a call.
[1:55:57] And then they'll go on a call and they'll make money.
[1:55:59] But the money they're making is not paying
[1:56:01] for the sitting time.
[1:56:03] And so big system, we run somewhere between 50 and 55.
[1:56:10] Ambulins is a day.
[1:56:13] And so you're talking about increasing the number of those.
[1:56:17] And there's another piece to that.
[1:56:18] And that's like, is it even feasible to find the additional staff to put on the units that you want to pay?
[1:56:27] And that's also going to increase the cost.
[1:56:29] So again, we would really want to see what the proposal you're putting forward is,
[1:56:35] so we can understand what the impact is.
[1:56:39] The three cities in eastern Gresham have about nine responses per day and fixed transports.
[1:56:51] That amount of call volume by itself.
[1:56:54] If you created an island and they ran it by itself,
[1:56:57] does not generate enough revenue to have one ambulance,
[1:57:02] and you certainly need more than one ambulance to cover a simultaneous call in the area.
[1:57:06] So you're talking about multiple ambulances and millions of dollars for each of this.
[1:57:14] Thank you. I'll definitely want that cost analysis of any of these that come up.
[1:57:23] And I would say I just also want to appreciate Councillor Piazza and bringing up the impact
[1:57:30] on the people, the human beings who are at the end and needing the services. And so I don't want
[1:57:36] money to be the reason we don't do something, but I do think we have to make an informed decision.
[1:57:42] So I'll be interested to hear folks proposed or amendments that might come up, but I think
[1:57:47] then we need some further analysis on them so that I don't want to vote yes on an unfunded
[1:57:53] mandate when we don't know what the funding requirements will be. So that'll be important to me.
[1:57:59] I also just want to check in about the, I'm grateful that we were able to hear from the team
[1:58:05] is this morning. My office had some conversations with them as well and has this language that
[1:58:12] has also been shared with you all. Is this language in I know it takes some work but is this
[1:58:20] language in the works is there some receptiveness to the need that has been raised by our front
[1:58:30] We received the language last evening.
[1:58:33] We will need to work with county legal and some other people about what the appropriate tool is that we put it in just like I discussed earlier.
[1:58:43] Our code and our plan are vendor agnostic.
[1:58:49] So they're written whether it's a public or not profit or a private or a hybrid.
[1:58:55] And so we're just going to have to go through and figure out where we would recommend putting it.
[1:59:00] I will say that we believe there is a lot of protection from maintaining the services to the community,
[1:59:10] even in the event of a labor dispute or a strike within the plan already.
[1:59:17] So, Section 7A of the selection process requires the vendor to maintain services throughout
[1:59:26] regardless of what's going on and Section 7E have some immediate cakeover provisions.
[1:59:33] Should we find that the public health or community health is at risk to do anything, including
[1:59:39] a labor dispute or a strike.
[1:59:41] And so we wouldn't want to get in the middle of anything.
[1:59:46] We are neutral when it comes to that.
[1:59:48] But we are not neutral when it comes to delivering service
[1:59:52] to the community, even in the white of that strike.
[1:59:56] The service, I might call it 911, we still need to have some.
[2:00:00] And we need to get the right people there. So I believe that there are sufficient protections in there. And we want to ensure that if it's the team's first representing the future staff in that, that they, they also are comfortable that the county is not going to get interfere with them.
[2:00:22] Yeah, I think they're shared alignment on the values that sounds like maybe there's just a miss.
[2:00:29] Not quite matched up on the language yet.
[2:00:31] So that will be something I'll stay in touch with you all on as this piece moves forward.
[2:00:36] Those are all my questions for today.
[2:00:38] I'll depending on kind of what happens from here.
[2:00:41] I know there's a couple of potential motions on the floor.
[2:00:46] Thank you commissioner.
[2:00:48] I see some folks at their hands up.
[2:00:51] You did and I see here's that commissioner for a minute or so.
[2:00:53] I had I still have questions of people who have their means up to make motions.
[2:00:56] I'd like to ask my questions first.
[2:01:00] I added an additional question not.
[2:01:02] I wasn't ready to move emotions.
[2:01:04] So I can wait till when you make extra question, then I'll ask my question.
[2:01:07] But I wasn't raising my hand to make the motion at this.
[2:01:12] Gotcha. Okay. Great. That's that's very.
[2:01:14] Okay. I'll go to you after.
[2:01:15] I finished my question.
[2:01:17] So Aaron, I appreciate this question.
[2:01:19] And I know that, so I will say like the conversations about our EMS system, I've been having
[2:01:25] them for years now.
[2:01:26] I've had conversations with partners, including the chairs of Washington and Clackham as
[2:01:30] County over even in Clackham as County through different administrations over there.
[2:01:37] And one of the things I know is that both Clackham and Washington County have had significant
[2:01:42] increases in their contract costs, even Washington County when they went to a new contract
[2:01:47] and then very soon after signing that new contract,
[2:01:49] they had an increased in costs that they had to deal with
[2:01:54] just because of what was required in that contract.
[2:02:00] And ultimately, we know that the people who end up paying the cost
[2:02:04] and those contract a lot of time are the end users
[2:02:07] of the system, right, of those individuals.
[2:02:10] So can you talk a little bit about that?
[2:02:12] Like I think the risk of having a cost increase,
[2:02:15] you know, if this were to go to a private entity and you know, who we would be contracting with.
[2:02:22] And then like what could potentially be the impacts to people who are the end users of the system,
[2:02:27] who are receiving the ambulance services, they am at the services.
[2:02:31] Medical debt is a real thing.
[2:02:35] And part of the assessment looked at our payer mix of our community and our county.
[2:02:42] That makes currently, when it was assessed with 77% of them are covered by Medicare and Medicaid,
[2:02:50] which pays below the cost of providing the services.
[2:02:54] 11% are uninsured.
[2:02:58] So you're getting penny from those call and the ref is private insurance.
[2:03:04] And so any rate really falls on the private insurers to cover the cost of everything else.
[2:03:14] And we're going to be some changes related to Medicaid, come January, a lot of people are going to lose coverage, and they go into that bucket of uninsured.
[2:03:27] When we have a vendor, they're going to pencil out what they're expecting to collect when they give us what that rate is based on our paramax.
[2:03:37] We can expect that rate's going to be high, because our mix is not covering the cost of providing the services.
[2:03:47] I am not sure that we're not going to get a request for a rate increased from AMR in the last years of the contract.
[2:03:54] The most recent financial report, they lost millions of dollars last this year.
[2:04:00] the previous year, they lost $2.4 million, so the fee per service is not covering the current level of service that we are receiving.
[2:04:13] Even with all of this flexibility in there, if the benchmarks and the pair mix are not good, we won't get a vendor looking at this.
[2:04:23] And that will mean we either need to go back and look at our benchmarks, look at the subsidy or be doing the service ourselves. We should be very prepared based on what this procurement looks like.
[2:04:37] That's what it is. If it's important to put in there for you, it should be so important that you're willing that the county would have to do that ourselves because we might.
[2:04:50] And I hope that answers that question.
[2:04:54] Yeah.
[2:04:54] No, I really appreciate it.
[2:04:55] I mean, I think this is...
[2:04:58] We're trying to balance a lot of different...
[2:05:00] We need desires and realities of the system and providing these really, you know, these critical services to folks. So I, I appreciate everybody's testimony today.
[2:05:10] And I think I'm going conversations and thank you commissioner, John Sticks, and for convening some of the conversations around the stakeholders, especially those in East County.
[2:05:19] And it is, you know, the ambulance service plan is always a really big deal. I appreciate the work that's gotten into it. And I think this board has to consider, you know, ultimately like.
[2:05:30] what we as a county are able to accommodate and what we're not based on on the realities of providing EMS services.
[2:05:39] All right.
[2:05:40] So Commissioner.
[2:05:43] Permitator.
[2:05:46] Thank you.
[2:05:48] So just a follow-up question on just globally.
[2:05:54] I know that early on in some of the conversations there was a inquiry about.
[2:06:02] Just how we structured our ambulance service plans, it's just generally since other counties, some of them have more than one ambulance service plan providing.
[2:06:12] And we, you know, just again, my time so far on the commission.
[2:06:17] There's really struggle just to serve sort of out of East Portland and East County and I'm curious why we haven't looked at or have we, if we have, what are the sort of benefits and the downsides of having
[2:06:39] to end the service plan stage of, I provide service in a more customized way, the better
[2:06:46] meets the needs of East Portland versus them being sort of treated as the carve of the
[2:06:52] long top of like the Portland Urban Plan. I appreciate the question. We received it in feedback.
[2:07:01] Our consultant did look at having more than one ambulance service area. I won't say that it doesn't
[2:07:08] have benefits, the benefits are at ads, capacity, and redundancy and backup because you now have two instead of one.
[2:07:21] The downside of it is each ambulance service area must run independently and have all of the theme administrative overhead and infrastructure.
[2:07:37] And it really drives up the cost of the county system because you're duplicating infrastructure in each one of them and some of that infrastructure.
[2:07:52] for no better reason, so it doesn't just it, but like we have a ambulance for communicable
[2:08:00] to these transports. That's a $40,000 vehicle. It's actually more like a $250,000 vehicle
[2:08:09] if it's new and fancy. Sitting waiting for that call, very after can be on to your now duplicating
[2:08:18] So, and there's not a geographic split in the county that specifically, like, a mountain
[2:08:26] range down the middle or something that splits it in a way that makes sense to have that
[2:08:33] duplication of efforts.
[2:08:35] The consultant reported a draft state in the assessment.
[2:08:39] It recommended one area, again, for efficient and effective provision of services.
[2:08:46] One of the things that happens in the east part of the county is a lot of those transports
[2:08:53] take the ambulance from the east into the core and if those ambulances have to go back out
[2:08:59] east you're adding a dead head drive back to their service area every time instead of a mixing
[2:09:07] and so it also becomes less efficient and it takes more ambulance to make up that
[2:09:13] efficiency, driving the coughs up even further. So what that pretty closely we looked at all
[2:09:20] of the different renditions of it and it makes the system more resilient and significantly
[2:09:30] more expensive without necessarily getting tailored service. Is that what other jurisdictions
[2:09:38] that have more than one, like we done, the benchmarking of the cost of how much there's cost versus when they have multiple providers versus multiple plans versus our one plan.
[2:09:55] a lot of the system that
[2:10:00] We have multiple plans or highly subsidized systems, where the fire district or the city is heavily subsidizing those multiple pieces. They have that infrastructure.
[2:10:14] So, I didn't do the comparison. We can certainly get you some comparable if you're interested.
[2:10:21] Our neighboring counties are primarily one or two ambulance service areas in our local
[2:10:31] of the important metro area. That's further out you go. The lower the volume gets and you start getting more
[2:10:42] automatically than what we have in the Portland natural area, and becomes less comparable.
[2:10:52] Thank you.
[2:10:52] I would be interested in any data that you have that you could share with us.
[2:10:58] So the other question I have relates to sort of just where the sort of the belly button
[2:11:07] of the system is.
[2:11:08] So again, looking at where you live in the county, we have different standards and while I appreciate your statement that it doesn't matter after four minutes,
[2:11:26] I think we heard a lot of testimony, and we've heard a lot of people that like, you know, it's not just the four minutes standard and sort of the agonizing weight when we had really long weight times.
[2:11:37] That to say to somebody, like clinically, it doesn't matter after four minutes,
[2:11:46] I find that hard to square with what I've heard and what I know that may that may be true from like in an an average.
[2:11:57] But I do think saying somebody coming in eight minutes is a lot different than coming in two hours or an hour or twenty twenty five minutes.
[2:12:06] of the length of the time, so I don't want to just let that statement go that, like,
[2:12:13] hey, it doesn't really matter after four minutes because I think we know it does. And
[2:12:18] certainly if it's our loved one, if you're calling an ambulance for,
[2:12:24] we're not going to just hold
[2:12:25] it as standard as a matter after four minutes. If I can, if I can address that commissioner,
[2:12:30] if you'd like me to, I can explain a little bit from the clinical perspective. When we're talking
[2:12:37] about that four-minute benchmark really that is for life-threatening calls, you know, our tax
[2:12:41] stroke seizures, the things that are going to, and when you can have an intervention in
[2:12:46] less than four minutes, those are going to be the ones that have higher survivability rates,
[2:12:51] and there's a lot of been done a lot of research on this. I'm happy to send you some data on this.
[2:12:56] And so when we're kind of discussing the sort of eight-minute versus 12-minute versus 15-minute
[2:13:01] response times, you know, those are kind of past that four minute window where you have that kind
[2:13:07] of opportune intervention opportunity to do that life-saving interventions right away. And as
[2:13:15] I mentioned before, in a lot of times, you know, bystanders, having AEDs nearby, those are going to
[2:13:21] be like really important interventions to put into place within that kind of four minute standard.
[2:13:27] I'll just add that there's clinical impact and there's customer service and perception and so the clinical impact has been well researched and I think we're hearing a lot about the level of service or the feeling of level of service and that doesn't always match that clinical outcome piece.
[2:13:52] I just think we can't say it doesn't matter clinically after four minutes without adding
[2:13:58] what Dr. Bruno just added because that's a very different qualifier than it doesn't matter
[2:14:03] after four minutes I would say say somebody has a brain aneurysm. Every minute counts and maybe
[2:14:12] it's not the first four minutes the counts but the longer it goes the longer the brain bleak goes
[2:14:17] the great of the damage. So I just think we'd be very careful because our communities are listening to that and it's certainly not to hear the county say it doesn't really matter clinically after four minutes without the context that we're talking about a very specific set of responses. I think is not what we what we should be communicating with our community.
[2:14:42] The last thing I want to just raise is, and this is more sort of a commission sort of just process.
[2:14:50] And this may or may not be relevant once we move ahead here, but I'm concerned that on page 27 they have the next steps.
[2:15:00] September 17th is right now. The schedule's second reading and I know Commissioner Moir is not going to be at that meeting.
[2:15:08] And I would hope that we had the flexibility to actually have just given the importance and how it sets the table really for a lot of other decisions that we actually, you know,
[2:15:22] at the meeting have everybody be able to fully participate, especially if it's impacting their district.
[2:15:28] question
[2:15:35] that we push the second reading to October?
[2:15:41] That would be my request.
[2:15:45] I'm just so that we can set the second reading date when we will.
[2:15:51] I don't know what people who's been to be here or not in October if we wanted everyone here.
[2:15:57] So I think we need to check out some dates to see if anybody had any.
[2:16:01] Planned out since this is for October.
[2:16:03] if that's the goal, but I will say I'm curious if,
[2:16:07] I'd be as I know that there's questions about the back or not.
[2:16:11] There's a plan from a backwards calendar of like this needs to,
[2:16:14] you know, when we need to start procurement in March, we would have to,
[2:16:17] you know, go to OHA with a plan that has been approved by the Board,
[2:16:20] there needs to be some back and forth from with OHA on that.
[2:16:24] So I'm just curious, like, does that give us enough time to do the steps
[2:16:30] that we need to take place so that we can go to procurement in March and it may very well
[2:16:38] and that's fine, but I just want to confirm that before we set on a date.
[2:16:46] I don't know if that's a question for me, but I'm going to try.
[2:16:48] That is a question for you, Erin.
[2:16:50] Who ever can help us do the backwards?
[2:16:52] I don't have a Brian Smith or Rob Smith with me today, but what I'm going to say is, we do
[2:16:59] are going to need to be procuring stuff by March.
[2:17:03] That is our notice timeframe with AMR.
[2:17:07] If we need to extend our contract with them
[2:17:10] for some reason, or if we lift that,
[2:17:14] then we won't be doing that, and we will be locked in.
[2:17:17] Again, it's a very large procurement.
[2:17:19] It's going to start having a compression
[2:17:23] on that procurement timeframe.
[2:17:25] And if our partners want to get things paid for,
[2:17:29] that pass through a pathway is going to compress the amount of time they have to do.
[2:17:35] They're far market value studies and get them to us before we can get the procurement out the
[2:17:40] door. So I want to acknowledge it's not just going to impact me or the procurement team.
[2:17:46] It's going to impact the partners ability to get out the stuff for us to do our work.
[2:17:53] It's team compressed a little bit, but for some reason, OHA does improve it the first time around
[2:17:58] in 60 days. We have to come back and do additional reading. It goes back to them. We will, we will be way past a window of getting the procurement done. So a cushion that's starting to go away. I absolutely understand that we have things that you need answered are done, but this cushion is starting to do into a way for a
[2:18:23] madam chair.
[2:18:24] One of the things might be, say if we said date where everybody could be here, that that stills within the window, that works.
[2:18:32] One of the ways that potentially we could get some issue address between.
[2:18:40] Before the second reading is just to have a agenda item on the next couple weeks on our Thursday meeting that if people were going to bring amendments or had questions that we could.
[2:18:53] just address it during that instead of waiting till the moment and then having a whole
[2:19:00] bunch of issues and potentially some new issues coming up. But that way we could move
[2:19:05] some things along that maybe everybody has a agreement upon and so when you get to
[2:19:11] that final second second reading, it doesn't get alongated again because we didn't get
[2:19:17] everything done. Just a suggestion of maybe a way that we could continue to move things
[2:19:22] along. And still meet the window.
[2:19:28] Yeah, I like that idea. I also, but we can't, I mean, we can't guarantee everybody's going to be here for every meeting and every discussion that we have for that because I, you know, so I just want to put that out there. So I am.
[2:19:43] I think that we could probably move the second reading to October 1st and then look
[2:19:51] at some time in September to have a work session.
[2:19:54] Um, either on a Tuesday or Thursday, I think either one is fine, uh, to, to.
[2:20:00] To talk about any amendments that people are going to bring forward, and so we can figure out a date for that, maybe it, it could be the time that we had originally held for the second reading. So we'll take a look at that. All right.
[2:20:12] Okay, so I'm happy to do that.
[2:20:17] And I think that, and that way, hopefully, we'll preclude, hopefully, having a third reading that would be necessary.
[2:20:24] But depending on the amendments that come, we may need to have a third meeting if there are significant amendments that pass.
[2:20:31] So just want to put that out there like that that will be that would require another meeting pass that October date.
[2:20:37] So Erin and Bruno I would be looking for you to like provide some guidance on what our window is
[2:20:50] based on the timelines that we're looking at.
[2:20:52] Okay.
[2:20:53] Are there any so at knowing that we'll have a work session.
[2:20:56] Is there anything anyone wants to bring forward now or are we ready for the vote?
[2:21:03] I don't see any Commissioner of a Jones section.
[2:21:06] Yeah, just for the next meeting on the first, Dr. Bruno, and I'm going to share in a moment
[2:21:12] if you can just bring forward on October 1st, just the numbers as far as if we switch
[2:21:18] the three cities, including city name would, up to the eight minutes response time, Mr.
[2:21:29] and it's just how much that cost would be.
[2:21:32] That would be great.
[2:21:33] And then we'll bring that.
[2:21:34] And then we'll pour it.
[2:21:36] First, I'm going to put you free for it.
[2:21:38] Yeah.
[2:21:39] And I would make.
[2:21:40] It's much information as possible that we keep it ready for when we schedule the work session.
[2:21:43] I think that's going to be the most helpful for our discussions that we have.
[2:21:48] It's just a point of clarity.
[2:21:49] Commissioner Jones six and do you mean for the.
[2:21:52] But not for our October 1st, but for the.
[2:21:55] Whatever the work session that we get scheduled that we have.
[2:21:59] that information. Yes, for the word session, and then we'll, yes, thank you. Okay.
[2:22:05] It may work to make the framework to appreciate that. And then just another point of
[2:22:10] inquiry. So do you, do you envision at the, whatever the word session date that you would be
[2:22:19] bringing an amendment to address the issues that were raised this morning
[2:22:27] during the word session
[2:22:28] or on the first?
[2:22:30] Or just at the work session to put it on the table,
[2:22:32] so we can discuss it.
[2:22:34] Yes.
[2:22:35] Okay.
[2:22:37] Great.
[2:22:39] So I'm going to be okay with,
[2:22:43] I'm not going to move to table it,
[2:22:46] knowing that I think we have a thing to have an agreement
[2:22:50] that we'll have more time between now and October one
[2:22:57] and that we'll have a work session
[2:22:59] the ability to bring issues to the table. There are a number of things that have come up this
[2:23:04] morning that I potentially will have amendments related to, and certainly be interested in
[2:23:14] commissioner John Sticks and in addition, I would be interested in, even though, our language
[2:23:25] with the Ambassador to respond is Vendor Neutral be interested in that labor language that we've taken out,
[2:23:35] and whether even if we're Vendor Neutral that that prevents us from having that language in there.
[2:23:43] So that'll be a follow-up I have. So with that, I will be putting a motion forward to table
[2:23:50] Because I think we have made some adjustments which will allow us to have a consideration of what I think is the issues that were raised by pretty much all of our partners.
[2:24:04] I wouldn't request, though, that in the we receive the talking point that was associated
[2:24:14] with slide 17, that was actually not on the slide, which is the county's response to the
[2:24:24] delayed response time, which is basically you can contract yourself, because I mean, I just
[2:24:30] think that should be part of the record, and we should be talking about that, because if we say,
[2:24:33] we're not going to do it because this is what you think you should do it. We should
[2:24:36] that should bear the count. That should be the count. That's the county's formal response.
[2:24:41] I want to see it in the materials or what we're actually presenting so the community can see what
[2:24:46] the county's actual response is to the feedback.
[2:24:57] I would like to have a comment. I would like to
[2:25:00] We see it in written form following this meeting, but in future presentations, I think that needs to be included because it's obviously a big issue for our partners.
[2:25:10] And we've said we've received the county has said they've received this being back. And here's the response, but they actually didn't provide the alternative response in materials that were presented today, other than a verbal readout.
[2:25:24] I am going to motion that we postpone. I don't know why. We would vote on something that it sounds as if a significant number of commissioners are not supportive of this as written. I don't want to be on the record with the yes vote on this.
[2:25:49] And it would just then require if we do amend it yet another meeting, so I don't see an advantage to proceeding with the vote today.
[2:26:04] I don't want to be on the record support of this, but that's fine. I can vote no, if the majority wishes to do that.
[2:26:13] Commissioner Moyer, are you, is your motion to table it to a time certain,
[2:26:18] although I'm sorry, sorry, Commissioner for my words. So we have a motion to, I'm asking
[2:26:24] her about her motion. I'm wondering if it's a motion. So we should have a second to a second.
[2:26:30] Second, second. But I'd like to know what I'm seconding. But I'll secondary,
[2:26:36] Anyway, are we, are you proposing a indefinite motion to table or to a time certain?
[2:26:50] I would have a hard time not looking at our calendar to definitively say when we should
[2:26:55] vote if we want to do a work session before the vote.
[2:27:00] So I would say a postpone indefinitely with the intent that of course we're bringing this
[2:27:09] we need to move this. But I don't know when we're going to be able to schedule that work session,
[2:27:17] and then to fit to fit this in. I guess my question is I don't know why we would vote on
[2:27:22] something we don't like as is to then amend it and still have to do two more votes. I guess that's my
[2:27:30] two cents I prefer to postpone and fix it. So, so first reading is to move it forward for the second
[2:27:38] and then we have time between now and the second reading to do any work discussions, engagement, and development of any amendments that we have.
[2:27:47] This is really just moving it forward in the process. The process also is not true. That's not what a first reading is.
[2:27:53] First reading is an adoption. All ordinances require two votes. It is silly vote on the substance of, so, so you don't have to vote for it, but I'm saying that this, it is not the final inaction of the ordinance, like it is, it's to move to get it's, it is approved, the, the actual image is that the first reading is approved, like we are approving the first reading of it, but we are not approving the actual ordinance.
[2:28:23] That is not true.
[2:28:25] All ordinance require two affirmative votes of the exact same language.
[2:28:30] Yes, we are voting to approve the language as it is.
[2:28:34] That's on the vote on the substance.
[2:28:37] Yes, but we're not.
[2:28:38] Yes, you're right.
[2:28:39] It does take two votes, but we're not.
[2:28:42] Okay, so you can vote.
[2:28:44] If you want to update, that's fine.
[2:28:46] But we are also.
[2:28:47] We also have time within because it does require two votes to have.
[2:28:53] to have a work session and to have the second reading at a date certain.
[2:29:00] So, but it's all in fact, you're it.
[2:29:04] That's what we're doing it indefinitely.
[2:29:06] That makes me very nervous.
[2:29:08] And that's what I was going to say in my comments.
[2:29:10] It makes me nervous to have an indefinite date for something
[2:29:13] that we know has a very specific timeline that the county
[2:29:16] has to abide by in order to make sure that we have a new
[2:29:20] the service plan that we are contracting for and not being forced to contract to under our old ambulance service plan, which is, which is what happens if we don't have a new one that's approved in the right time one.
[2:29:31] Okay, so I have Commissioner Singleton and then Commissioner for memories.
[2:29:37] So I had some comments before this motion was made so I'll come back to those after this piece.
[2:29:46] I think one we had a time that was already on the agenda for the second reading. I'm unclear on why we're getting so squishy around timelines. Why can't we just use the existing hold that we have.
[2:30:00] Added for first reading and then the second one on October 1, which was just the date that was discussed, or alternatively, if you want to use the first date for more work session, can't we just do this with one vote and an add an emergency clause, if we're worried about timeline.
[2:30:19] Aaron saying no.
[2:30:20] must be approved through non-emergency ordinance procedure per state. I'm not doing that.
[2:30:27] That's why you can't use the emergency class.
[2:30:30] Gotcha. Thank you.
[2:30:33] But I did suggest using the time that we had on the 17 for the second rating for the work session that we could do.
[2:30:41] So I think that would be a good solution.
[2:30:44] I would just like to say that I think Commissioner Moore, very clearly stated that this isn't an indefinite postponement that is really just a matter of looking at the calendar and getting it finding where we can schedule work with a work session and
[2:31:00] us, and after that, a second, well, a first reading and then the second reading. But it's not an indefinite. It's just a matter of we don't need to be spending time in a commission meeting checking everybody's calendar right now. So I don't view this as it might be supportive, but I don't view it as sort of in indefinite. It's just not definite until we have a chance to nail down the.
[2:31:29] the actual dates that we can did the work.
[2:31:38] Okay, so there's three hands-up setup.
[2:31:41] It's focused on this topic.
[2:31:44] Not on this motion, but I still haven't been able to talk about the things I wanted to before this motion was made.
[2:31:50] Okay, so we have a motion on the table and he further discussion on the motion.
[2:31:54] Okay, so we are now.
[2:31:55] Tisha can we have a roll call vote on the motion to postpone indefinitely.
[2:32:00] Commissioner Singleton?
[2:32:06] Chris, you're single to me. Sorry, I'm struggling because I, yeah, the indefinitely threw me there. I think we're postponing the first reading to October 1st. Isn't that correct?
[2:32:16] No, that is not correct. That's that's that's why I said I had a problem with.
[2:32:21] Um, the motion was postponed indefinitely without a date certain.
[2:32:30] Um, yes.
[2:32:33] Commissioner Brim Edwards.
[2:32:35] Yes.
[2:32:36] Mr. Jones sticks in?
[2:32:38] No.
[2:32:40] Commissioner Moyer?
[2:32:42] Yes.
[2:32:43] Chair, vacate the answer.
[2:32:44] No.
[2:32:45] The motion to postpone indefinitely is approved.
[2:32:50] So we're technically done with the discussion on the item.
[2:32:53] Commissioner Singleton, but since you didn't have a chance to talk about your item before,
[2:32:59] I want to give you the space to do that.
[2:33:02] Thank you, Chair.
[2:33:03] And I just wanted to come back to what I had said earlier around the language.
[2:33:10] Commissioner Bramad word you mentioned, as well, wanting to be involved in that conversation.
[2:33:16] So I'm happy to pull you and your team in, we have that language.
[2:33:20] We've already shared it with, from the teamsters.
[2:33:23] We've already shared it with Erin, as well as with the chair staff.
[2:33:27] So I think it's just about finding the right place to put that was what the conversation was earlier.
[2:33:32] so I just wanted to put a fine point on that piece of it.
[2:33:39] Okay, great.
[2:33:40] Thank you, Commissioner.
[2:33:41] Okay.
[2:33:41] So that, so we will come back, we'll find a date for that meeting to have R2 and now is when we
[2:33:49] have time for board comments on non-agenda items.
[2:33:51] So I want to open it up to commissioners to see who have items to discuss today.
[2:33:55] We are five minutes over time, but we didn't, since we were an hour and 15 minutes over
[2:33:59] time last week, we didn't have time for that.
[2:34:02] So we'll, I want to make some time today.
[2:34:07] Commissioner Jones section. Yeah, I just wanted to give a huge shout out to Dr. Armstrong Romero,
[2:34:14] but I believe today's for last day officially, she's going back to Colorado. She was our director
[2:34:19] of the juvenile division. So just want to say thank you. Thank you. Thank you. Thank you.
[2:34:23] Thank you. Remember the first time I heard her speak at lipstick or I think it was a presentation
[2:34:29] for the juvenile division. I was just thoroughly inspired. So just want to say shout out thank you
[2:34:36] for your leadership, Dr. Armstrong,
[2:34:39] Romero, and just for your advocacy for the youth
[2:34:42] and the kids that are under our care and the families.
[2:34:46] And that's the love to you and your family,
[2:34:47] as you transition back to Colorado.
[2:34:53] Thanks so much, Commissioner, for acknowledging that.
[2:34:56] And she will be missed here, but I'm happy for her for her personal-
[2:35:05] Thank you, Chair. I just wanted to, as always, uplift some of the mechanisms that continue to happen in our by this federal regime. Last week, they continued to show us that they do not care about voting rights of all citizens, and it is clear they're trying to set so fear and confusion just before the election.
[2:35:30] I stand by my Commissioner Jones sticks and work to fund grants to organizations to do voter education.
[2:35:37] And I will push back alongside our AG, Rae Field, and Secretary Reed, against Trump, and there continue to tax on voting.
[2:35:46] I think it would be important share if there's particular guidance coming out of our elections division that we start sharing that here.
[2:35:53] If we are like we heard out of Washington that they're encouraging folks to go to drop boxes as opposed to mailing their ballots back.
[2:36:00] I don't know that we're here in that same space,
[2:36:03] but it would be helpful if we can start sharing some guidance
[2:36:05] from our elections division as we near the mid-terms.
[2:36:10] I also want to acknowledge that there continues
[2:36:12] to be an increase in immigration enforcement,
[2:36:15] particularly regarding those who had previously
[2:36:18] held temporary protected status.
[2:36:21] During the last federal budget process,
[2:36:23] those changes were getting less and less information.
[2:36:28] Yes, today reports came out around Leon Youngway, who died hours after being put in the ice custody.
[2:36:38] However, he died almost two weeks ago.
[2:36:41] There's also been additional deaths that have not been shared broadly, or that we don't know about until far after these folks are dying.
[2:36:51] There's been 84 detentions in Oregon and August, as far as recent reports show.
[2:36:57] There's also an increase in detentions of immigrants who do delivery jobs, seeing more
[2:37:03] activity in parking lots and at airports that are traveling domestically.
[2:37:07] I want to continue to urge people to make family plans.
[2:37:10] The Oregon Law Center and Latino network have templates in different languages that people can use.
[2:37:17] Additionally, the Department of Justice has stated that all spades and their departments
[2:37:22] must report undocumented people or they could lose funding.
[2:37:26] This was a rule that came out of the DOJ yesterday, and I want to be very clear that
[2:37:32] I say no to that.
[2:37:34] I will not comply.
[2:37:35] I will advocate for Multnomah County to not comply, and I will stand with others to make
[2:37:39] sure that Oregon does not comply.
[2:37:42] A couple of local issues I want to give a shout out to some of the amazing folks who are working on the Park Rose grocery store.
[2:37:50] They are at 90% of the way to meeting their fundraising goal.
[2:37:54] Donna in the Park Rose community have been doing really incredible work in their neighborhood to bring this sort of life and create a space that is truly centered around the needs of the neighborhood.
[2:38:02] There's still time to donate and to sign on to a letter of recommendation.
[2:38:06] You can find that at www.histarkparkros.com.
[2:38:13] Additionally, I just want to appreciate the City of Portland and Prosper Portland in particular
[2:38:17] for putting out grants for these types of local grocers and small storefronts and supporting
[2:38:23] better foods here in some of our neighborhoods.
[2:38:28] I just also want to highlight, I know Black Business Month has come to a close, but I want
[2:38:33] to thank those who engage with me, the elected that joined me in highlighting businesses,
[2:38:38] and Laquita Elliott and Brie Williams, that won the most clues figured out and visited
[2:38:43] all of these different stores. And for everyone for making Black Business Month a success.
[2:38:48] A couple of stats I want to share. I engage with over 120 Black businesses within Multnomah County.
[2:38:54] I have a list of black owned businesses that I'll share with all departments.
[2:38:58] I want folks to especially know that black owned food and beverage businesses need your help now more than ever.
[2:39:04] And if you don't know where to go, you can visit my county website to get a list along with the location of these different food and beverage businesses.
[2:39:14] And I look forward to working with purchasing and specifically Maggie about how Multnomah County can continue to be a good partner.
[2:39:22] I think that it's been, it's going to be really important for us to look at Commissioner Moyer.
[2:39:28] I know there's some work that we're looking at together, I think, around both local, but also equity in our purchasing power.
[2:39:35] And so I just want to give a shout out to Commissioner Moyer for raising this issue, but also to a procurement who I know you're going to dig in with us and get us to a good place on this.
[2:39:47] excuse me. I also want to just encourage people to apply for the community member
[2:39:52] seed on lipstick. Applications are open until September 26th. And then lastly, I want to
[2:39:58] really encourage people to look at it.
[2:40:00] More and more and consider getting involved in our Multnomah County Charter Commission for the upcoming charter review.
[2:40:06] And I appreciate Dr. I'm sorry, director, press for all of the work that's been happening.
[2:40:12] I see you and your team out of a lot of fairs throughout the community and making sure that we're spreading the word, so that we have a broad range of representation in that next charter review.
[2:40:22] Thank you chair.
[2:40:26] Thank you so much commissioner. Single tank, commissioner.
[2:40:32] just want to take a moment to recognize that on Monday we will be celebrating Labor Day and I want to thank all of the workers at Multnomah County who provide services every day to our community and hope that their Monday is a day of celebration and community with others in the Labor Movement.
[2:40:56] So happy Labor Day and advance to everyone who celebrates.
[2:41:05] Thank you so much Commissioner of Room Edwards.
[2:41:08] Anyone else?
[2:41:10] Okay.
[2:41:10] I just wanted to just note the passing of Gloria Steinem yesterday as a leader and, you know,
[2:41:21] the women's rights movements, the feminist movement.
[2:41:23] I had the opportunity to meet her a couple times in my life, and even as she, you know, even in the further decades of her career and her work, she was still such a force and a power.
[2:41:37] And, you know, I think her central belief that all women are deserving of all rights and privileges and our fully human is something that we need to hear.
[2:41:55] now more than ever. And I think that we are seeing very in addition to all of the work by the federal
[2:42:03] administration to undermine the I work and LGBTQ to IA work and so many else we're seeing
[2:42:12] an intensive effort and a purposeful effort to undermine the rights that women have gained over the
[2:42:19] several decades, and this is something that, you know, as somebody who has worked in so much
[2:42:27] of my career to support women's ability to have economic power and to be able to have the support
[2:42:36] of government and social structures that support and raise up all the work that women do. I will,
[2:42:43] Her passing is a big thing that on top of Dolly part and I feel like we've got a torch that has been passed to all of us in the younger generations that continue to do the really great work that that they have led and they have modeled in their lives.
[2:42:59] Thank you.
[2:43:00] All right.
[2:43:01] Thanks so much.
[2:43:02] That concludes today's business.
[2:43:04] the board will meet in executive session on Tuesday, September 8, 915, our board briefing on
[2:43:10] September 8 has been canceled, and our next public meeting will be the regular meeting scheduled
[2:43:14] for Thursday, September 10th at 930 AM. There being no further business, we are adjourned.