[0:00] Sest valuation for this year, for property tax collection next year, is up 13.3% and that's because this was a re-valuation year.

[0:14] Every two years, the assessor re-values property to, in this case, June of 2014 is what these market values represent.

[0:28] value of property at that time and so that's up 13.3% over the two-year period from June of 2012.

[0:41] And that's the first increase since the recession.

[0:46] In your memo, we dropped 24.5% in the valuations through 2010.

[0:56] and then another 6.1% in the valuation through 2012. So now we're coming back of 13.3%

[1:08] the total tax roll taxes to be property taxes to be collected next year are 114 million dollars

[1:20] Approximately, which is a 9.3% increase.

[1:27] The reason that approximates the 13.3% is that we have several districts with fixed no levees.

[1:38] So, as valuation goes out by 13.3%, their property tax collections go up by 13.3%.

[1:45] For example, the hospital, CMC, and the county's open space program all have fixed

[1:56] millevies that would be increasing taxes.

[1:59] There are also some fire-production districts that have a portion of their millevies

[2:04] is fixed as well.

[2:07] So, and we had several elections for increases to both the school districts, the hospital

[2:16] re-upping their no-levy, and so, some of the largest increases, we covered that page,

[2:28] The very small print page with colors on it, the county as a whole, including the open

[2:38] space fund, is increasing $1.7 million. CMC has seen a $1.3 million increase, the two school

[2:48] districts, Aspen and our portion of the rowing for school district are up in total $4 million.

[2:57] to the school districts, two and a half of that, it's Aspen, one and a half rowing fork.

[3:05] And then Aspen Valley Hospital by reading up in there has a one million dollar increase as well.

[3:13] So those are the biggies.

[3:16] And with that, you don't have any questions.

[3:19] We need to use a motion to approve certification and no lunch.

[3:27] My question was, and I sort of, no part of the answer, but what are the title 32 districts?

[3:37] Those are all the special districts.

[3:40] So basically, you have the county, you have municipalities, aspen, basalt, and so on, you have

[3:47] school districts and then we have everybody else who's called a title 32 district. That includes

[3:56] the fire protection districts, water and sanitation districts, metropolitan districts, metro districts,

[4:07] those are all the special districts that are title 32. And the title 32 refers to the color

[4:18] That's their formation of the statute, right?

[4:24] Great, so we're just looking up the mill, right now.

[4:31] Yep.

[4:32] Do you have any questions on it?

[4:33] We have been through this before.

[4:36] Thank you.

[4:36] And at my apologies.

[4:38] I don't know what happened to the alarm just didn't even go on.

[4:41] I'm looking at things.

[4:46] But I brought cookies.

[4:48] And then that makes my cake.

[4:51] That might be a piece of sugar, though, ma'am.

[4:55] So just for the public.

[5:00] This is a statutory requirement that before we produce these millevies. This is like our last official act of this calendar year, we will take our holiday break.

[5:16] So, I would then have to change the motion to.

[5:21] I have another question first.

[5:22] Yeah, okay.

[5:24] So, what we're approving, there's no resale or anything before us.

[5:29] It's just we are approving the participants document,

[5:35] which is entitled Budget 2016 Certification of the University of Canada.

[5:42] Okay, so I'll make a motion to approve a certification of

[5:46] have you seen Reven is for the budget year 2016?

[5:49] Yes.

[5:51] Okay.

[5:51] It's moved in second unto approve the certification

[5:54] and any further discussion on favor say aye.

[5:58] Aye.

[5:59] Thank you.

[6:00] All right.

[6:01] Thank you.

[6:01] I found a lot of money calling.

[6:04] Well, right in the checks to other people.

[6:06] Thank you.

[6:08] Thank you.

[6:12] Okay.

[6:12] Next we, oh, I didn't obtain a motion to adjourn the special meeting.

[6:18] So moved.

[6:20] Sir, second.

[6:22] All in favour of adjourning the special meeting say aye.

[6:25] Aye.

[6:29] Okay next we have Jeanette, you can go on vacation now.

[6:35] Almost.

[6:36] She's not dead yet.

[6:38] Right Jeanette.

[6:42] Next we have point months to various sports and permissions.

[6:47] Okay.

[6:48] Thanks Steve. Every year at your first regular meeting, the Board adopts a resolution,

[6:56] appointing commissioners to different boards and commissions that board members are asked

[7:04] to serve on as well as appointing the chair and vice chair for the Board. What we have in front

[7:12] reviewed today is a request just to seek guidance for preparation of that resolution for the

[7:19] first regular meeting. In your packet is really two things. One for the various commissions

[7:27] and such that the board members serve on. We have the 2015 appointments. And so if there's

[7:37] discussion to be had about change on those appointments. We'd be seeking that guidance today.

[7:46] Additionally, for the Chair and Vice Chair, what the Board has been doing really for almost

[7:55] about the last since 2009, we've been rotating the Chair and Vice Chairmanship by Commissioner

[8:05] district. This isn't a perfect system because there's five of you and there's four

[8:12] year terms and so we from time to time run into cycles like we will run into in

[8:19] 2017 where we would have a first year commissioner in the loop to be chair and

[8:26] typically we do some changing there. The way the rotation works for 2016 we do

[8:34] have that issue. The rotation would have Rachel who is currently the vice chair as the

[8:42] district 2 commissioner stepping into the chair position and Michael Housley from district

[8:49] 3 stepping into the vice chair position. You'll see in 2017 both both districts in the

[9:02] election, what we will have a new district three commissioner who would be set to rotate

[9:09] into the chair position and we have our district five commissioner George and George

[9:16] I'm not going to put you on the spot and ask if you're going to run again and that's sort

[9:20] of thing but a lot of to be determined to be determined but I think we need to see the outcome

[9:29] of that process and have the discussion again next year, obviously, if George came in, we

[9:34] would probably want to flip that and rotate George into the chair position, let the new

[9:39] commissioner have a year of experience gain before they did that, but I think that's a discussion

[9:46] better to have next year. And so what we're looking for today is guidance one that we want to

[9:59] Thank you.

[10:01] And then any discussion about changes that, if any, that we want to make to the 2015 appointment, it's going forward.

[10:11] I appreciate this, because I think it looks like you've reelected me in 2019.

[10:17] Oh, good word, yeah, I'm really really sure about it. I'm sorry, okay. We should have had a TVD there.

[10:23] I mean, it looks pretty good to me right here.

[10:29] We tried to capture those, but you know, we're going to get a year off.

[10:33] I'm going to come, come, come, come, come, come.

[10:40] So with that, I turn it back on me to the board, perhaps it'd be easiest to start with the chair and vice chair discussion and work our way backwards since that's been a pretty standard rotation.

[10:53] Yeah, I truly look forward to my last opportunity to be chair before I'm term-limited out.

[11:02] So my name's not under the STBDs at all.

[11:05] And as I did when I was chair before, I'd be very diligent about getting that alarm earlier

[11:12] than ever.

[11:13] The meeting with John and being here on time to start the meeting.

[11:16] So I do apologize for this morning, especially I really don't know what happened.

[11:22] We've got sugar out to about 20 departments yesterday.

[11:25] I got a lot more to do to that after we're done.

[11:28] But the one thing I would like to, you know,

[11:31] put out there to, you know, and I'm sure Michael would be interested

[11:35] in being a good chair, vice chair, in my absence,

[11:38] is that because we have a rotating chairmanship

[11:41] and, you know, you become chair, whether you're a good

[11:43] a chair or you're bad at chair.

[11:46] It's not a competition in the classic sense where other boards try to keep somebody or decide who does it the best for their boards.

[11:55] And so it's not that situation.

[11:57] I do have other obligations that at times I'm going to miss these meetings here for the public lands, particularly, or CCI.

[12:05] I do never, I've never missed these meetings in order to go to club 20 or, or those, but that one would kind of supersede.

[12:15] So there may be times that I will have to miss a Wednesday meeting and Michael have to chair.

[12:21] So if that, you know, I know Michael, you travel a little bit, so we'd have to talk to the board in advance and see if anybody would need to step in if by chance the two of us being a way fell on the same Wednesday.

[12:33] But that's all, am I only comment?

[12:39] Is that okay with you, Michael?

[12:41] Yeah.

[12:42] Okay.

[12:42] So what are we doing, right?

[12:43] Yeah, that's what we do.

[12:44] I just began with a lot.

[12:45] You know that maybe sometimes when there's direct conflicts,

[12:48] but those positions do take time and

[12:50] some already to work your way into.

[12:53] Let them go for one here.

[12:55] Okay, thank you.

[12:56] Rachel, I appreciate your comments about,

[12:59] you know, we take turns being chair.

[13:02] And I think my experience this year being chair,

[13:06] I think it makes you a better board member to be the chair in the rotation because you understand

[13:13] more than the way the whole process works.

[13:17] I agree with that, Steve.

[13:20] And it's been a good experience for me.

[13:22] I've enjoyed it.

[13:24] And it's sometimes it's stressful.

[13:27] But definitely it's a different view of how the Board of Commissioners works.

[13:35] So we'll prepare, we'll take that as guidance to prepare the resolution for chair and vice chair,

[13:42] for this rotation, so the official changing of guard will happen at the first regular meeting in January.

[13:51] The other items we were seeking guidance on is the appointments to the various boards committees and

[14:02] other areas for the county's represented if there are any changes or discussion there

[14:10] if we should leave those appointments as they stand.

[14:15] Steve?

[14:16] I just want to say that I'm still really confused about the workforce boards and I think most

[14:22] of the people who attend those meetings are still really confused because we really don't

[14:26] have a worrisome region as we had in the past so I mean I go to the meeting if they actually

[14:31] Oh, Khan stigma from some at County asked me to be the

[14:35] Leak the Cleo, which is the chief elected official for this for next year, but I'm not going to do that because it's

[14:43] Most of the meetings are phone meetings, but they all really meet on the I70 corridor

[14:48] And then she travels around the front range sometimes and I don't really know enough about what the workforce does other than it's required by state statute

[15:00] So, that being said, I am going to be participating again in the Colorado Bark Beetle Cooperative. So, those meetings are once, they have four meetings a year and they are held over in Breckenridge at CMC.

[15:16] I'm getting back involved in that because of some of the issues we have run on with our force here, the prescribed burden, we're going to do it 100 creek.

[15:25] There's some funding opportunities through CBBC that I'm working with Gary Tanabam about to see what we might be able to bring out of that.

[15:35] And the other one is with Northwest Colorado Council of Governments.

[15:39] Actually, they have the economic development district which is kind of a sub entity of that.

[15:44] And I'm Vice Chairman of that.

[15:45] I think Rob was chairing that.

[15:48] And we have arranged for the meetings this last year, the meetings were all on our regular Wednesday.

[15:52] So I couldn't go. So they have switched that so that I'll be able to participate. Some of the meetings actually follow North West

[15:58] God. Fog and other meetings. There's a workboard part of it that's, that's going to be on Wednesdays.

[16:04] So I'm going to be attending those as part of North West Cox. So it's the really the economic development district.

[16:11] And that will keep me busy.

[16:13] And Paddy, I think we didn't have the economic development district on this list because it was a separate a point that that's an appointment made by now.

[16:22] Northwest cog independent of the board is that is that how do you understand that?

[16:28] Well,

[16:30] I don't know. They have represented and the representatives are different than

[16:35] people that you normally see at the cog meetings. So I just wanted to make sure that that was

[16:40] because we can check that out before the national January meeting. And the meetings will be separate.

[16:45] The meetings are held on separate days in Northwest Cox. And then the Colorado bark beetle

[16:50] cooperative is that independent so is that something that we want to add it's 13 counties and

[17:00] and there are I think it's 13 counties that are involved so it's Rocky Mountain region then you

[17:05] got Park County Lake County going up that way up the San Luis Valley from what and they

[17:12] they just have an elected official from each jurisdiction. This might be an appropriate one we have

[17:18] then. Yeah.

[17:23] There are two other North West

[17:25] called committees that I've been attending one regularly

[17:31] and they're like, kind of like subcommittees of a whole big picture.

[17:34] Senior council. Well, one is the rack, which is the regional

[17:42] Bizarre Council on the Alpine Agency on H and Pake.

[17:51] The gap is the main representative.

[17:55] And she was, I guess, appointed by Marty Ames.

[18:03] But then your, my name and your name were also on their kind of like,

[18:06] as alternates, we could go to those, and I've only attended that by phone once or twice before.

[18:15] And then the other committee is the regional transportation coordinating committee,

[18:22] which has to do with the transportation for Medicaid, Medicaid,

[18:32] non-emergent, Medicaid cases,

[18:35] and transportation of veterans is involved in it.

[18:40] So that's like a little subgroup of Northwest

[18:43] called that they meet separately.

[18:46] So I've attended that a few times.

[18:49] And they always meet in gypsum at the eco-transit or by-home.

[18:54] So Stephen, are they asking you to represent the county's position

[19:01] in the board's position.

[19:04] Well, the one, the rack one is like it was

[19:07] a body who has pigment gap, it has been doing it

[19:12] for quite a few years, and so she's

[19:14] like the regular representing for Pitkin County.

[19:17] But I would say that would be an official representation

[19:24] at that committee, and I would see Patty and me

[19:28] as being alternates on that, not as the name

[19:31] because Pag is definitely the main person on that.

[19:35] Didn't we approve makes appointment to that?

[19:37] Seems like it came back through a state.

[19:39] At a separate, yeah, because that's a citizen.

[19:43] Yeah, yeah.

[19:45] And the RTCC, I've just been going to it because I know a lot of that

[19:50] transportation and it was just my interest and some of the

[20:01] So I don't know, we may be want to check into the exact official part of that and see if it needs to be in an actual appointment.

[20:14] And

[20:18] the other thing I noticed that on the CCI there is a new legislative committee called

[20:28] Justice and Public Safety that we need to add for that list.

[20:34] It was kind of a sub-heading of general government wasn't it, Rachel?

[20:39] Yeah, and then they created it as it's own.

[20:41] It had so many items on it, they made it separate, and it's called Justice and Justice

[20:46] in public safety.

[20:48] It's dealing a lot, apparently, with issues such as mental illness in the jails and how to

[20:56] try to get treatment instead of jail and other issues such as whenever anyone is incarcerated,

[21:03] they lose whatever Medicaid insurance or things like that they may have had and so for those

[21:11] who are mentally ill, it means losing your medications.

[21:15] And then when you get back out, it takes six months to get back on the system and you

[21:18] had the back in jail before your illness is taken care of again.

[21:22] So those are some of the types.

[21:24] There's also certainly a program that I think Pippin County should be proud of Dan Bird's

[21:31] Don Bird's involvement in the prevention of prison rape.

[21:34] And it's a national program that's been evolving and he's really taking a lead on that.

[21:39] And so issues along those lines?

[21:42] So would you see that as an extension of CCI appointments?

[21:47] Well, I think it's mostly about the voting things that will send us later.

[21:52] Who is the first vote?

[21:53] So we just need to decide if it's right to order me out of the vote.

[21:56] You can be the first vote, and I'll be the alternate to not the meeting.

[22:00] The way we've always worked at one of us is not there, the other one.

[22:04] Is the alternate and is there to vote?

[22:07] Yeah, so we should add it to that list.

[22:09] Also, John's also proxy for all of the committees if neither one of us could be there, but always vote with the exception of the health and human services now, which is the proxy which is going to be in my last question for you.

[22:25] Can anyone understand this by the pages of the document?

[22:29] It means to be right on top of that.

[22:32] All right, so I think what I'm hearing right now is not any changing in positions on the list.

[22:42] I'm hearing that we are looking to add the Colorado Barclad Feetal Cooperative with Patty as the appointee that we'll add a CCI legislative committee for justice and public safety.

[22:57] Again, with Steve and Rachel listed, probably with my self as a proxy, then we have Steve

[23:11] and

[23:12] Patty as alternates for the regional advisory committee for the Alpine area agency on

[23:19] aging, which would be in addition, and then we have Steve as an appointment to the regional

[23:27] transportation, coordinating, committing, as in addition, otherwise, no, no other changes.

[23:35] So that seemed to capture it.

[23:39] We will get that prepared for January that.

[23:46] This is all going quicker than we just made it.

[23:53] And then the last thing, which I think we already addressed, was just called out that CCI

[24:00] It does request for 2016 the designation of CCI Steering Committee, Proxies.

[24:08] I've been the proxy for all committees except for the Health and Human Service Committee,

[24:13] which we've appointed NAND to support comfortable continuing with that.

[24:19] That's all I've got on the appointments then.

[24:27] Okay.

[24:28] Moving on.

[24:29] Are you a future agenda calendar?

[24:32] Yeah, and really we are coming to our last meeting of the year. Congratulations. This is actually this is the last meeting we have been there and almost at the end of it.

[24:46] What I did want to talk about for next year, George, we are working on a January meeting with Biscult's not on yet, but we'll get that had it hopefully over the next week or so.

[24:57] Um, the other thing.

[25:00] We need to talk about is setting aside. I'd like to set aside two days for a retreat. We usually use about a day and a half, but I think at this point if we can block out two days and if we have to go to less, it's a bonus for you guys.

[25:17] But typically we're pretty solid and at least using a day and a half for our discussions.

[25:26] What I'd like to propose are dates and February to give staff some time.

[25:33] We've had a pretty busy end of the year here and so frankly we need some time still to

[25:39] plan for the retreat and organize.

[25:44] In terms of weeks, we've been flexible in the past.

[25:50] Sometimes we've taken more accession dates and use those in addition to another date, we typically try and do our retreat on a week that does not have a regular meeting.

[26:07] The first week in February, any of those dates would work whether it be the first second, third, fourth and fifth to block out.

[26:17] I think that would give us adequate time to plan.

[26:23] Yeah, I just going to say the very first week of February is pretty much the only week for me.

[26:28] And less we did it a Monday, Tuesday and took that work session there.

[26:31] I didn't even look at your books.

[26:32] I know.

[26:33] I'm not saying thank you for me.

[26:35] I mean, yeah, the very first week that Thursday and Friday would be ideal.

[26:40] But the following weekend is CCI Thursday Friday.

[26:42] We have a regular on the 10th.

[26:44] And the following week would be NATO, if I'm fortunate enough to be

[26:47] reelected on public lands.

[26:50] And then the last two days are the Club 20 Ag, Water, and

[26:54] Public Lands meeting.

[26:55] So the first week were great.

[26:57] War Monday and Tuesday in the same zone.

[27:01] Yeah, for me, right now, the Friday, the fifth copy won't work.

[27:05] There's supposed to be a regional transportation forum that day.

[27:10] But the Tuesday and Wednesday, the second and third,

[27:14] Groundhog State.

[27:16] Perfect.

[27:17] Second and third work for me.

[27:19] Okay, we've got three of you for the second and third.

[27:22] The second and third calendar is upstairs.

[27:24] I know the second we can February doesn't work.

[27:28] As well.

[27:28] The first week, as I recall, there's no conflicts.

[27:33] And I'll just have to double check.

[27:35] This is amazing.

[27:36] Because we're doing it early.

[27:38] I don't like.

[27:40] Michael is second and third work for you on February.

[27:42] Why don't we go ahead and block out on the second and third, we can, you know, if the board wants to engage in some discussion now about the nature of the retreater, we can schedule that for, you know, our first work sessions in the new year to talk about what you guys would like out of your retreat this year.

[28:04] That was easy.

[28:06] I know this is all going way too easy.

[28:20] I'm really outside of schedule trying to work.

[28:25] Just schedule joint meeting with basalt and January.

[28:28] And now laying down those retreat dates.

[28:30] At this point I really don't have anything else for future genders for you.

[28:34] I have one heads up.

[28:37] We have been with the Gulf of County Commissioners for a long time.

[28:41] We can put a we can certainly reach out and set up a joint meeting.

[28:48] Did we have been meeting with Gunnison?

[28:51] Please to meet with Gunnison.

[28:52] Gunnison really prefers to meet when there's a specific burning issue for both boards.

[29:01] We like counties been very active with us.

[29:05] I think Garfield County would be up.

[29:07] I think it's a good time to me with Garfield County now.

[29:10] They've had a turn over and I think they're starting to settle down on some of their administrative changes and such and over at the manager level and was on their senior staff at the attorney and manager.

[29:23] So they've certainly had a lot going on and I think it's probably a good time to get together with them and when was the last joining with Carbondale?

[29:32] It's been quite a while meeting with Carbondale.

[29:34] Yeah, we'll have to, maybe think of the scheduling of that this year.

[29:37] Yeah, I don't know.

[29:38] I can't wait.

[29:38] Carmedale and Garfield, I'd see this coming up.

[29:42] Okay.

[29:46] The one thing that I have, um, I will not be here.

[29:51] This is planning way ahead on March 1st for the regular, or for the work session.

[29:56] I'm hoping to, um,

[29:59] Put on and see my mom.

[30:00] I'm for her 91st birthday, March 1st. Those birthdays are getting real, yes, those birthdays are getting real, important, and she's good.

[30:13] I'm not going to surprise at this time because she almost killed me when I did that at Thanksgiving.

[30:19] This is also further out, but I could go ahead and put the state out there for Michael

[30:24] and the board.

[30:25] Should I be fortunate enough to be re-elected on the public lands, I will be missing the

[30:29] February 24th regular meeting, and would not be available to chair that or the Tuesday

[30:35] work session.

[30:36] So those are my naco dates.

[30:39] It's my little spirit.

[30:40] I think we've got to be each other.

[30:42] On February 2nd, we have a joint meeting with City Council right now.

[30:49] Part of that is just housing guidelines.

[30:52] Just for an hour.

[30:53] But we may want to schedule some work session time ahead of that in terms of one adding anything else onto the agenda.

[31:00] We might want to cancel if we're having a retreat that day.

[31:02] Yeah, actually I missed the February

[31:06] Yeah, yeah

[31:07] That's okay. Okay, so we have to see if we can reschedule that city council

[31:11] Okay, yeah, and I think good heads up that good

[31:15] Yeah, I missed that

[31:21] I just saw that it was a work session

[31:23] That's right. Yeah, right

[31:27] Okay, so

[31:29] Next the OTC is that in March

[31:32] Schedule right now

[31:35] We're not out that far, we're just curious if that was-

[31:37] You know, I'm going to have to look up the email for John.

[31:40] I don't know if that's the top charge.

[31:44] I believe it, I think I've went towards the end of the first quarter,

[31:48] which would have us in March.

[32:08] Okay, anything else on the future of Gendus?

[32:15] Open discussion items.

[32:18] Actually, I was just going to email,

[32:21] John Ely was going to come down.

[32:23] He had a letter, he wanted to discuss with you.

[32:28] I wonder if we want to take maybe a five-minute break unless the board has any open discussion items.

[32:33] I've got a couple of things.

[32:34] I have a couple of things by wouldn't I think I'm very first.

[32:37] Yeah.

[32:38] So Rachel?

[32:41] Yeah, I emailed John and NAND this last night.

[32:47] I got a call yesterday morning from Tom Jim Powski with Garfield County,

[32:51] And they, as we all are, are continuing to be concerned about the cost of private and health

[32:58] care insurance in our region and their region, and they, he wanted to know what would our

[33:06] board like to try to do.

[33:08] You know, we're similar to other places, not seeing the real problem with the group insurance rates

[33:12] as much as, again, the private and that's a very limited pool.

[33:17] And so they're thinking that perhaps a bill to make all Colorado one region for rating purposes with the IRS would assist with the problems in rural communities like ours.

[33:32] It's also affecting the front range in places like that, rural communities there, once you get out of the metropolitan area.

[33:40] You know, I don't know, and he was saying, you know, you don't really think of the look that might have ability to pass,

[33:48] given that it would affect other people's rights and potentially bring them up as others can then on.

[33:53] But that it would create the attention and the focus on the problem that the rural areas are having with this issue.

[34:02] And so he had said, you know, why don't we talk to your board about it and see what people think.

[34:07] And then I think that they're having a conference call with Summit and Eagle and Garfield tomorrow,

[34:16] which is a role in that same district now, but we all have the same issue.

[34:20] Later this afternoon, and so I forwarded that information to John to potentially sit in.

[34:25] I don't know if it's something that if you don't think it's really going to pass,

[34:30] it's going to hurt your credibility working on other issues, you know,

[34:33] asking some of our legislators like Millie or their red legislator Bob Rankin to

[34:39] co-sponsor whether it takes one of their five bills that they really could

[34:43] accomplish something with but that seems to be at least one course that people

[34:48] are thinking about how to start to drive a little change on this so I thought I

[34:53] bring that up for you guys to think about. I'm sorry you know I got the call yesterday

[34:58] before our very last night.

[35:00] Well, wasn't that part of the discussion that Caradana van Haten basalt? That was one of her focuses was this, maybe, this proportionate thing with in the Rocky Mountain region, versus front rain, et cetera, that different.

[35:15] Yeah, so just to even to go back a little bit further, this is actually something that we did advocate for at one time

[35:24] It's for the division of insurance to combine rating areas.

[35:29] So I think what we looked at originally, this day was divided, I believe, into 11 different rating areas.

[35:37] And that probably requires a level of discrete data about actual costs in those areas in order to set rates that I think we didn't have a lot of confidence actually existed that the rates are being set on a pretty limited data set within each of those discrete districts.

[36:06] And so we did make the argument to division of insurance two years ago now.

[36:11] I think that was when we were over there, that the 11 rating areas should really be combined down into one until we have better data collection capabilities and analytical capabilities, maybe to break out.

[36:27] The result of that discussion to get to the bottom line was they went from 11 rating areas to 9 rating areas,

[36:35] combining the western slope into one rating area.

[36:39] They took all the the resort regions and such and combined them into one with the exception

[36:44] of Mason County, which sits as a highland, as a more urbanist family in that western slope.

[36:51] Yeah, because of Rocky Mountain Health Care.

[36:52] And because of Rocky Mountain Health Plants, and so it would be a continuation of that discussion.

[37:02] And I thank questioning the information and that it's probably a more accurate representation

[37:10] to go across the whole state rather than to break into discrete regions.

[37:16] I think the argument on the flip side of that division of insurance was looking at or

[37:21] what they came back to us with is to say, well, we also want to be sure there are incentives

[37:28] because we do believe there are areas of the state that have higher health care costs and areas that have lower health care costs.

[37:35] And we want to be sure that there is an appropriate incentive for communities to work, that are high costs to really work on lowering their cost.

[37:45] It kind of feels our pressure on the reality of those costs rather than have them kind of watered down by being averaged out with these lower cost areas.

[37:55] And so I think that's why they wanted to keep the different rating areas alive.

[38:08] I think the level of transparency right now in health care funding financing costs still remains fairly low.

[38:21] in a lot of areas, and so it's very, very difficult for us, I think, to evaluate the accuracy of actual costs within these discrete 11 districts or rating areas that have been set up.

[38:36] So I are not now nine. I'm sorry. Now nine rating areas have been set up.

[38:41] So I do think there is an argument to, if not combine across the state, at least combine into larger regions.

[38:48] And as soon as you do divide into these rating areas, frankly, rural areas are always going to be more expensive.

[38:56] There is no way that rural areas, whether it be the eastern plains or the mountain rural resort regions,

[39:03] are going to enjoy the economies of scale that urban areas are going to enjoy.

[39:09] And so if our goal is really to make health care more accessible, which would be leveraging

[39:16] that rural urban difference into a combined rating area.

[39:21] So all that is to say, I think there's a legitimate discussion to have about combining

[39:26] the rating area.

[39:27] Sorry, kind of wound around that.

[39:29] I know, I appreciate that.

[39:30] You bring it back again.

[39:33] Is there a response to high cost to have the whole state work on the cost reductions?

[39:43] Yeah, and some areas of the state unfairness do have probably lower the national averages and some areas like ours that probably have higher than the national averages.

[39:54] However, I think the solution needs to be a statewide solution you need to.

[40:00] We're covering the resources of the statewide solution to bear. And also opportunities. You know, it can create a more competitive environment if you can get out of your regions to get those services.

[40:13] Yeah, to Michael N. John's point, I was just reading an article last night out of the New Yorker on Healthcare, which I forwarded to John and Ann as well.

[40:23] But it's said that, you know, in areas where there are our towns or whatever, whether for our more hospital or providers,

[40:32] Generally, rates for services are about 15% less than areas that have less than four because of the competition.

[40:41] But the bigger example was the difference between, it was a great article.

[40:46] I'll try to forward it to everyone later if I can find it again.

[40:49] But even between Medicare payments for the same service versus private insurance payments for the same service,

[40:56] wildly different prices from town to town for the exact same service because Medicare can negotiate

[41:04] a price for services with the hospitals and they have a set fee where private insurance

[41:08] companies can't do that.

[41:10] And then on the flip side, private insurance companies can negotiate for lower drug costs,

[41:15] but Medicare was forbidden from doing that.

[41:18] And so it just talked about these wild springs between treatment costs for whether you're on

[41:22] Medicare, Medicaid, or private policy.

[41:27] The other item that we found two years ago

[41:29] in chasing this down was that we have so many employers

[41:32] who have group plans that their data

[41:34] doesn't go into the system the same way.

[41:36] That's part of that transparency that he's talking about.

[41:39] So when you look at a place like this,

[41:41] your major employers all have group policies.

[41:46] So their costs and benefits aren't in the dynamic.

[41:49] It's this very small fraction of people with private policies.

[41:54] And so even employers like City Market, depending on where the process, their payroll

[41:58] is where they consider all their employees to be employed.

[42:02] So they could get the lower rate, you know, for policies where a group policy, because their

[42:07] office is in Denver or something like this, I mean, it just really was incredibly complex.

[42:12] I'm not sure it all made a lot of sense to me.

[42:14] The end of the article came down to it really has a lot to do with the treatment paths and that the type of things that we're working with the Valley Health Alliance of two different towns compared in Texas, roughly similar poverty and illness ratios, roughly similar populations and then one spending two times as much as the other gave me exact same results, but it's the overtreatment and it's the lack of follow-up and all sorts of things.

[42:43] So, you know, I was surprised to hear the Grand Junction actually had the highest single policy

[42:49] prices in the country, because you hear so much about Rocky Mountain Healthcare, keeping

[42:53] their cost down.

[42:55] They also have the lowest Medicare costs in the country, because they do a great job following

[43:00] out.

[43:00] But the whole system is pretty crazy.

[43:03] So anyhow, it sounds like, to me, that it's a good conversation to have, and maybe

[43:08] good bill to support and to see what we can move forward from your analysis with that.

[43:13] At least I have the discussion, I think there's it provides a lot of pathways for us to

[43:18] discuss things that we would like to see in our Valley Health Alliance efforts around

[43:23] information, transparency and that's.

[43:25] So I think Eric Donovan, because she's a descendant again, so that big meeting of the

[43:30] couple months ago. One consideration people are traveling to where they can get the best procedure

[43:41] done for the most cost-effective. For instance, my daughter was sent from Alaska to gold

[43:50] and to have her shoulder operated on. It saved the insurance company. A huge amount of money

[43:56] pay her airfare to go have the surgery done at a place that they had, you know, had probably

[44:05] some sort of an arrangement worked out where it was low, there were lowest costs they could

[44:09] get.

[44:10] And so people here, you don't go to have an organ transplant of the Aspen Valley Hospital or one

[44:17] what you go somewhere else where they are experts at that and so that's just a trend in health

[44:26] care that you don't go to your local, your local, medical facilities for a lot of things,

[44:34] you travel somewhere else, so having it be a statewide thing to me makes a lot more sense

[44:40] and having a just be our region mind.

[44:46] Well, and one of the things that's been interesting

[44:48] when we did the look at the data two years ago

[44:50] is that can actually cut both ways,

[44:53] that sometimes in a community that has a fluent members,

[44:59] like ours does.

[45:02] The travel costs, like if they were going from actually what might have been a lower cost service to a higher cost service area, we're getting counted against our medical experience locally.

[45:14] That was another. So it's an interesting, it's so complicated once you get into it, because you're right, there are centers of excellence that can reduce costs, there are centers of excellence that can actually increase costs the way that we understood as being counted.

[45:29] at least two years ago, and we were looking at this.

[45:34] And the other kind of discussion that

[45:36] becomes important for the rural areas in particular is,

[45:40] how do you provide enough support so that you can

[45:43] maintain services that you want to have in your community?

[45:46] Because if we start sending it all out or cherry-picking,

[45:52] then the question of sustainability of our local services

[45:56] comes into question, which has been a big discussion.

[45:59] And it is, it's remarkably complicated and this kind of takes a lot, if you combine the

[46:11] rating areas, it does take a lot of that off the table, at least initially.

[46:17] Well, Steve, a pretty good example was that I surgery that I had to have it done in Denver

[46:21] by a retinal specialist, but the procedure that I had to stay in Denver because of altitude

[46:25] issues, but my insurance wouldn't cover my stay.

[46:29] That was interesting. I was required by the physician to stay out to two to seven days and that came out of my own pocket.

[46:37] I said, why must I sleep in my car with my head down for four days?

[46:41] I was a little frustrating.

[46:42] But any other example is the friend who went to get her husband's MRI after brain surgery and

[46:47] $500 would better equipment in Denver and $3,500 in the valley.

[46:53] And that, you know, those price discrepancies, you know, affect where you're going to go.

[46:58] I mean, they really do.

[46:59] People who are now shopping for the better deal for healthcare.

[47:03] Well, and frankly, it's supposed to encourage that, you know,

[47:06] it is just down to saying incredibly complex.

[47:09] I recall Dr. Mitchell saying pretty clearly, look, you know, if you were running this like a business,

[47:15] we wouldn't keep the emergency room open after midnight.

[47:18] You know, it's as we wouldn't do it.

[47:19] But people want emergency room 24 hours a day.

[47:22] So we're all paying for that effectively through our rates.

[47:26] But I just want to say before we move on to any other subject,

[47:29] that this does mean that we may, it should reach a stage

[47:33] of being a viable bill or a bill we're introducing,

[47:36] coming down to give testimony, producing some picking county data,

[47:40] us, and information, having the point of view,

[47:43] and proceeding it seriously.

[47:45] So I just want to make sure we knew it was a little bit of a workload

[47:48] we're asking John and staff if we're pursuing him.

[47:53] Okay.

[47:54] That was my only open discussion item.

[47:57] We want to have John on the open discussion,

[48:01] John Mealy.

[48:02] Do you read it?

[48:03] Or are the open discussion item?

[48:05] I haven't kind of took all your space.

[48:06] As you are here before.

[48:09] Yeah.

[48:09] The board with bells being what I would like to do is offer,

[48:15] for your consideration,

[48:16] and the letter that's proposed to be sent to the ELM

[48:26] and response to a new request for an extension of the time.

[48:30] This has to be on a challenge.

[48:33] I did.

[48:34] Is that okay?

[48:37] It's at one point.

[48:39] This is where the extension of the deadline for comment.

[48:47] Go ahead, gentlemen.

[48:48] I'm here for you.

[48:52] So two.

[48:53] It's a nice and kind of letter, it's a letter that's in response to a little time.

[49:03] This is on the edge of the dollar.

[49:05] I don't know if it works.

[49:14] It's okay.

[49:17] All right.

[49:21] I thought they'd already denied these.

[49:22] They did.

[49:23] It's been re-ass for.

[49:25] reiterated.

[49:26] It's correct.

[49:27] The first request was for 90 days, and this is for 45.

[49:57] So the bottom line is John this.

[50:00] That our response is saying, let's just move forward.

[50:04] Yes, the 90 request, the regular request.

[50:09] Because it's really not necessary, just to extend it.

[50:12] Absolutely.

[50:19] I mean, may the county make boycott, I mean, do our meeting.

[50:28] You know, the only thing I get out of reading is the final paragraph is to again kind of close with

[50:35] restating our position more formally.

[50:38] So delay would merely force all parties

[50:42] to continue to tread water waiting for a resolution.

[50:47] We therefore respectfully request that you deny the application

[50:51] to its death.

[50:52] Again, just so it's restated at the bottom.

[50:56] I agree.

[50:57] John, what's the downside of the extension?

[51:01] The downside of the extension is a delay

[51:05] to the process and perhaps taking this out

[51:08] of 2016, which would put us into a new administration,

[51:13] the objective, of course, is to have

[51:16] this process come to conclusion with the same players, so to speak, administrative officials

[51:23] who were there when the process was initiated.

[51:26] It allows for a degree of continuity and a greater understanding comprehension of the issues

[51:33] and the circumstances of what's going on

[51:36] or opposed to go on in Thompson Divide

[51:38] and makes for a smoother process.

[51:42] So that's the primary objective.

[51:50] I am honored with this, but can I ask something else?

[51:54] Let's just be on the comments on this letter.

[51:57] John, are we going to be sending our own

[52:00] to the county letter to the BLN supporting alternative for?

[52:06] Yes.

[52:09] When we do that, I'd like to have, you know, refer to the joint letter that was sent and make a sort of reference to, you know, let's see.

[52:24] With this in mind, we were pleased to see the BLN strap, the IIS container for pose action. Of course, never specifically said what was a pose action.

[52:33] So, I'd like to couch that based on our joint letter, that proposed action that we support

[52:40] is alternate for, so it's a very clear, I'm sorry that the United and this letter

[52:47] politics took president, but I think we can refer to this letter and strengthen this joint

[52:55] letter by saying, and that proposed action is alternate for.

[53:00] And the other jurisdictions may also be referring to the letter from their point of view as well.

[53:06] And that's fine.

[53:13] Yep. So I think we should move on with this letter.

[53:16] OK.

[53:17] Great to change.

[53:19] Is that all right for everyone?

[53:21] OK. Thanks.

[53:22] Thanks, John.

[53:23] Thanks, John.

[53:27] Let's see a light on the light.

[53:30] How do you like the light that stuff and get rid of it for you?

[53:34] We're going to have to hang onto it if you want.

[53:42] Yep.

[53:43] Last night at a Solstice Party, I had a conversation with Brent Gardner Smith, and he was asking

[53:54] where we are in the planning of the way out of our new commissioners meeting room in the

[54:00] new building, and he has real definite ideas about making sure that there's a good press

[54:07] table with electronic connections and monitor and different things.

[54:15] And he said he would contact you, John, not that.

[54:22] And then we had a larger conversation with several people who have been done presentations

[54:28] before elected boards, not stars, but others, and in a variety of meeting rooms from

[54:36] to part of County to Aspen City Council and various places and one was Harry Tegels and on that conversation.

[54:50] And they really hope that we can do as close to the ideal setup for our new meeting room in terms of the layout for it and so.

[55:00] I don't think it's too early to start thinking about it, but then I also thought when we're meeting in the library meeting, we might be an opportunity to try different configurations of how we have our seats in relation to how the public seats are and where the press table would be and all those different items could be.

[55:29] see if there's a certain way that works better for us and for the public and for the press.

[55:37] Well, we're in there.

[55:39] So I thought it's not too soon to bring that subject.

[55:42] I'll be even though we're still kind of with the legal block part of the discussion on what is actually inside the building.

[55:50] So in January we're going to be, we have a work session that we're scheduling really to look at two things.

[55:58] one to bring back the exterior. You guys gave a lot of feedback on the exterior and so we're

[56:06] going to bring back what we understood that to be and how it translates into a proposal now for

[56:14] the building based on those discussions. And also sometimes I decide particularly to talk

[56:21] about the meeting room and so we're going to have a work session on that coming up in January

[56:24] here. Just so we could start to get some of those ideas. We have talked about the need for

[56:33] press work space, you know, because right now the press will come in.

[56:38] Wait, press work space. Yeah, it will be small, don't worry. But, you know, usually with

[56:48] laptops or recording devices and such. And if we can create a better space for the press,

[56:57] so they can accurately report on us, right? Yeah, so we can see the screens of their computers,

[57:03] so we know what they're actually doing. And then you have clear areas for the public. We do not

[57:13] have that delineated yet, but we certainly, that's been part of our discussion. And

[57:18] I'll be difficult to fit all that in, but I think we have the opportunity to, right now, and we'll talk about that in January or some more, and see what you guys think of what we're looking at.

[57:29] Rachel?

[57:30] Yeah, I really appreciate it, and it was a very collaborative work session on the building exterior.

[57:37] I didn't think to mention at the time, but I hope that they're bringing back a couple of options for us to look at on things such as the entryway arch.

[57:45] You know, there were so many different designs shown, and I hope it doesn't come back, it's just a one, and then we start critiquing and going from there, so if you could talk to them, it'd just be my hope that we see a couple different versions of what that entryway arch could look like, or that even what the new roof line for the overhang for this building would look like.

[58:10] So it's not a single thing, and then we start all designing at the table.

[58:16] Yeah, and I think the entryway definitely, that's a pretty interchangeable.

[58:21] The roof line will want to be careful about it.

[58:24] Sure, yeah.

[58:25] Well, and again, the entryway arch, I think at least none of the existing ones were really

[58:31] it, you know, and so that's why, you know, we know when like the real modern metal entryway

[58:37] the other one looked too large and I suggested a pillar or perhaps is enough to demarcate the

[58:43] sidewall. Yeah. So they should just bring back some options. And we also have been talking

[58:47] to the veterans community as well. Yes, that's true. And that's what I'm trying to incorporate that.

[58:53] Okay. Yeah. Good. I have one thing. I don't know. I don't see anybody else with the packet

[58:59] information we got with the letter from Lenny Oates. Did everybody get that? Or I got that. I did

[59:04] covering that okay um and and and you just need to decide how to address that if we want to

[59:12] I don't know what you're talking about. Did you got to get a copy of it in your box?

[59:15] I made up to see on my box. Yeah. Well when you guys read it let's just make a decision on what we want to do.

[59:20] Yeah is it something we might be able to add to the executive session at this point? It's a

[59:26] potential. I think we've discussed it once but we didn't and then it came back. So I don't know

[59:33] John Ely is already responded to that letter we got or what so maybe we could add it to executive

[59:38] possible.

[59:40] I see if John

[59:47] would be great just so we can have it done for the sale of it.

[59:54] That's it for me.

[1:00:02] If, you know, long those lines for

[1:00:09] the executive session, motion, it may be appropriate

[1:00:14] then to do for a acquisitions and for he negotiations, I think that would be appropriate.

[1:00:22] Anyway, because the acquisitions, the discussion.

[1:00:25] requires some negotiations.

[1:00:27] Well, we require both negotiations and that's some least components to it, which are

[1:00:32] probably more appropriate under negotiations.

[1:00:34] And then if we had the discussion about the letter that we received, that would fall under

[1:00:40] negotiations.

[1:00:43] Okay, so I would entertain a motion to go into open a special meeting and entertain a motion

[1:00:53] go into executive session for purposes of acquisitions, CRS-24-S-6-4024-A and negotiations,

[1:01:05] CRS-24-S-6-4024-E.

[1:01:09] So, move.

[1:01:10] Second.

[1:01:13] All in favor say aye.

[1:01:15] Aye.

[1:01:16] Thank you for joining us and have a good holiday.

[1:01:18] Thank you.

[1:01:19] Thank you.

[1:01:22] And we want to give a few minutes that little room rest.

BOCC Work Session - Dec 22nd, 2015

Agenda

Transcript