Commissioner Sharkozy participated in a Nevada Works meeting in Reno on Feb. 10, and on the 13th, the Search & Rescue meeting in Crescent Valley; and on the 14th, the Fire Department meeting in Crescent Valley.
Chairman Goicoechea met with Forest Service representatives on Feb. 17 regarding implementation of their Record of Decision on grazing; as well as a board meeting with Nevada Cattlemen’s that afternoon. On the18th, the Chairman met with the BLM State Office on their implementation of their grazing plans and will give NRAC an update at their next meeting. He did an interview with NPR out of Washington, D.C. on local government’s role in federal land management regarding cooperation and coordination, and was followed on the program by representatives from Utah discussing the Antiquities Act. The Chairman said it was “more fun to listen than participate” and he reserved the right to amend the news report.
March 3, Goicoechea will participate in the Sage Brush Ecosystem meeting with the Governor’s office about credits on federal land. The Chairman thinks the Conservation Credit system has been fine-tuned and will be ready to roll out March 3 at NDOW’s Reno office.
Ron Damele, Public Works Director, reported all the utility systems are “fine” and Public Works has been working on the Eureka upper ballpark restrooms and raising the fence along foul lines since they “had a couple of people get hit.” They are working with AB Gas out of SLC for fuel support at the airport. Meetings with the County Engineer have begun to start the design process for the pavement maintenance program.
Concerning flooding along the Humboldt River, Damele said the National Weather Service was expecting flooding in the next few days and the Sheriff’s Office had contacted ranches along the river to let them know to prepare for high water.
Mike Sullivan, EMS Coordinator reported Eureka had five calls for service and Crescent Valley four for a year-to-date total of 10 for Eureka and five for Crescent Valley for a county-wide total of 15 which is significantly less than last year. Sullivan said the weather over the past month has “been good” and there haven’t been any wrecks. Staffing remains stable with applicant drivers joining the volunteer service in Crescent Valley and Eureka. Sullivan was interviewed by the Las Vegas Review Journal on rural health care. On Feb. 1 he met with Kinross Mine who has greatly expanded their response area and are willing to respond outside their response area. Sullivan was impressed with their commitment to the community. Feb. 8, Sullivan met with the pool staff on roles and responsibilities and Sullivan said he was “impressed with the young people’s work up there.” Feb. 22 and 23 Sullivan was going to Reno to attend TRIM training will be able to instruct course.
EUREKA DRUG COURT BEING PROPOSED
Judge Gary Fairman of the 7th Judicial District Court came before the Commissioners to discuss the need for a Drug Court program in Eureka County to facilitate testing, treatment, and oversight of certain persons that the court has determined would benefit from the program. Fairman began by giving a background on drug courts and what they’ve been doing in White Pine and Lincoln County. He related that 17 to 18 years ago the State of Florida began a long-term substance abuse treatment program for non-violent offenders that came into justice court system. Prior to that, Fairman said, “Most of the treatment modalities offered for persons who were substance abuse addicts were short-term, 30-60 day inpatient programs with little oversight and structure afterwards and most were not successful.” Drug courts include an 18 to 24 month program for non-violent offenders with “offenses other than robbery, murder, batteries, sexual assaults,” and “offenses against minor children” who would be excluded from the drug court modality.
Fairman said “85-90 percent of all crimes in every court in America has something to do with substances and alcohol” and said it is a “rarity when substances aren’t behind a court appearance” and called it “ an epidemic” in “this day and age” which is why “drug courts become a viable option” for persons who have no extensive criminal record and if they want treatment, have opportunity if they are successful in the drug court program to get their case dismissed; and rather than having a “felony, they can move on; hopefully they change their behavior” and “basically have a fresh start.” If they don’t succeed, they “can go to prison.” Fairman said Drug Court can “inspire someone to change their behavior and manage their addiction.” He said, “Most are homeless or they’re couch surfing; many don’t have driver’s licenses or vehicles” and their “marriages have blown apart” and they’re “not working so they’re not paying taxes” and are a “huge burden on society we all pay from our taxes.”
Fairman said, “When persons come into the drug court system they’re getting structure where they have never had structure before” and “have to go to individual and group substance counseling two to three times a week, AA and NA meetings” and have an 8:30 p.m. curfews unless they’re working; and they “have to come to drug court every Monday to talk to court” and are “tested two to three times a week randomly.” Fairman said statistics have shown through 17 or 18 years that if a person is successful in the program for 18 to 24 months, the percentage of persons who don’t come back in is 60-65 percent “which is big-time.” Fairman said when someone is “successful in drug court, they have a job, are paying taxes, are not in jail, have their children back, got their GED or high school diploma” and get their driver’s licenses back.
Drug Court in Lincoln County started about four years ago and started small. In the past six to eight months, they’ve had two or three cases, and another where they couldn’t offer drug court. A couple ended up violating. Fairman said two persons reside in Eureka serving in White Pine County and one is coming to drug court all the time while the other one is testing all the time. Fairman said the first and third Friday Monday’s of the month neither he or Judge Dubrescu have anything “on the calendar” and could be available for a Eureka Drug Court. “We are the drug court judges” and “have tremendous training for drug court programs. Here’s what you have. You basically have the infrastructure already in place except for counseling.”
Fairman who has sat down with the District Attorney, Sheriff, Public Defender Kelly Brown, and Steve Zimmerman, Juvenile Probation Officer to discuss a Eureka Drug Court said the “big concern the Court has is being able to provide substance abuse counseling and evaluations for the persons.” An application has to be submitted for admission to drug court; then a substance abuse evaluation by someone licensed is required; and then if admitted the person has to have counseling throughout entire program. Presently, Fairman said they “don’t have that person.” They have testing services and an account with Redmond Toxicology for drug tests. Support classes such as NA and AA can be accessed via computer; programs where individuals can log on and get support through the computer.
Employers will know they’re clean and sober and people in Drug Court must tell prospective employers and the employer has to be willing to accommodate the person’s schedule going in.
Fairman said what they “don’t have in Eureka County is someone to counsel them; to provide on-going counseling services” and “many don’t have transportation to get very far” and so they “need to get services here.”
They are in the process of expanding the program to bring in an additional counselor who does take private clients and is getting credentialed with the State. They are looking at the person being available 20 hours a week in White Pine County and they could use somewhere from 12 to 16 hours serving the courtin Eureka County for counseling services. Fairman envisions the services reaching Crescent Valley as well potentially by using televideo “to reach the entire county base with that individual.”
They are looking at starting August or September and “could even be a little later” as it “depends on who we have court-wise.” He pointed out D.A. “Beutel has no idea until cases come to his desk as to who would be suitable for the drug-court program.”
Fairman estimated the cost at $16,000 a year or less. He said, “Clark and Washoe scarfed up 90% of the funds,” but “Judge Dubrescu sits on the panel for funding” and has not yet asked for funding. If they bring on a new person and use that person they would be expanding the existing program in White Pine County and would be looking to get special court funding in the next budget cycle. Drug court enrollees pay $35 a week to be in drug court and not go to jail. Fairman said it is an “incentive for them to pay” and they “have to have a legitimate funding source to pay for drug court participation.” Fairman said the funds received from drug court participants would stay in Eureka county. They now have two persons testing who must pay $50 a month for testing at sheriff’s office to take urine samples for random testing.
Fairman asked the Commission to consider $16,000 for next year and he’ll talk to Judge Dubrescu “and ask it be put back on the Agenda for you to consider establishment of the program.” Fairman said it’s a “great program” that “makes a difference” and is the “only thing that works.” He said you can “put people in jail for selling marijuana and cocaine and nobody ever changed in prison; they just came out and did some more. This is making a change” and is a “whole different approach for non-violent” offenders.
Judge Fairman said he hadn’t talked to Judge Schweble with respect to second offense DUI offenders who may need to be placed in a drug court type program dealing with his court as well. Fairman said Schweble could assign them to the 7th Judicial District drug court program since “second offense DUI’s are a third offense waiting to happen.”
COUNTY MEDICAL CLINIC CONSIDERING OTHER PROVIDERS
Garney Damele, Chair of the Medical Clinics Advisory Committee, gave an update regarding responses to the Request for Information (RFI) for clinical services and asked for further direction to the Committee. Damele said three organizations including Nevada Health Centers are planning to provide an RFI by a deadline of March 15. After that the Advisory Committee “will get out an RFP.”
Damele said, “The most important point to bring to the table is you can expect a completely different model than what we currently have.” Damele said, “All 3 entities indicated that they didn’t think it was financially feasible to continue with that model; that it’s an outdated model.” Damele said there “may be more telemedicine possibly and maybe just a rotating physician and two mid-levels” and the Committee is looking deeper into the 24/7 coverage Eureka has asked for” and “are looking at adjusting the days the clinics are open. Damele said everything is being discussed and the organizations are all going to present “what they believed they could provide to the county financially and feasibly” so the contract they have “in the end can be complied with.”
Damele said the Duckwater Shoshone tribe would like to partner with Eureka County for medical coverage and asked for that coverage option. Damele said if all 3 send an RFI they’ll all receive an RFP.
Damele reported on a February 17th meeting with Kirk Gillis, Vice President of Accountable Care with Renown Health related to the RFI. Gillis asked what the RFI was for and what the County is looking for which is to know what Renown can provide the County.
Damele said Renown is “pushing hard to get into the rurals” primarily in terms of telemedicine. Renown operates Hometown Health, the insurance provider, and the Committee “provided our patient count to help determine” what they can provide. Damele said Renown and NHC talked about discussing a collaboration of sorts to see what together they “can provide here.”
Both Renown and NHC are focused on finding Physician’s Assistants and Nurse Practitioners that want to come to rural areas and Renown’s residency program is starting in Elko County, so hopefully those who do residency will stay.
Damele said they stressed the need for a pharmacy in Eureka and said, “Our goal as a committee is we want the community to be patients at our clinics and open communication with the entity providing service.”
Damele said as of mid-November, Nevada health Centers got a locums in through March 15. The Committee totaled the penalty for Nevada health Centers and have a breakdown of how many clinics days each clinic was open for the first quarter which is “good information to have for the RFP.”
Damele said NHC indicated they “have a mid-level for us” but with the RFI are “hesitating in bringing that person on board.” Damele said they talked about renegotiating the price of the current contract to allow NHC to provide two mid-levels and the Committee asked about renegotiating the price but NHC indicated they didn’t have funds budgeted to do that at this point.
Damele said they also talked about how they “got to this point and how the relationship soured” and agreed to work on communications.
Walter Davis, CEO, and Karl Sundberg, COO, of Nevada Health Centers came before the commission next and said they’d had discussion about the RFI “which caused confusion among staff” and Davis said they now “understand a little more of what” the County is “asking for.”
Davis said NHC “shared with the Committee that it is our desire in our organization” that “people in Eureka county have the best possible care no matter what and if we are not the one to do that” they will understand. Davis said he thinks the service problem is “more about getting providers to come to Eureka” which “has been our stumbling block” and trying “to find someone for us that is on-going” and “understands that the community is open to a different model” and “will be submitting our proposal from NHC’s standpoint.” Davis said they “had conversation with Renown about the telemedicine process” and are “looking to cooperate with them and have follow-up meeting with them to talk about going forward with them” which is a “whole different arena.” Davis said, “What they’re looking for is specialty not primary care. Primary care is a different arena.” Davis said they are open to incorporating specialty care and will “continue on that journey and want clarification on the RFI versus the RFP.”
Goicoechea said they’re looking for “what can you provide” related to “what we need” based “on our model and patient load. What can you provide?” The Chairman said they have “heard time and again” the County’s expectations aren’t “realistic” and don’t “want to ask for a contract” that can’t be met.
Davis said they “always err on having the right type of talent here to support the community” and have “quality concerns moving forward with taking care of that issue” and said “no matter what will have to take care of that stance” and are “ready to address” that “in the RFP process” and “come back and go from there.”
Sharkozy asked if it would be possible to get someone “from the County to be on your board of directors.”
Karl Sundberg said, “This problem is everywhere” including Elko and Jackpot but agreed “having the representation on the Board is important.”
The Governor did award the medical school money to expand residency in Elko and NHC hopes that those residents will rotate out and have some time spent in Eureka “so we find that guy who says that’s where I want to work.” In addition they hope to get kids from Eureka in to medical school so they “come back here, just like JJ.” Of the new training program of 22 students, 25% are going to the rurals.
They are also encouraging old EMTs from Eureka County ready to do something else” to consider medical training.
Eureka County Commissioners approved:
Review Hiring Freeze Waiver Justification and provide authorization to replace the Public Works Senior Department Assistant position, due to a transfer to another department;
Authorizing application to Nevada Public Agency Insurance Pool/Public Agency Compensation Trust (NPAIP/PACT) for a Risk Management Grant that will fund 75% of the purchase of one Power-PRO XT Cot for $14,206.00, one Power Load System for $20,581.00, and installation of the Power Load System for $2,965.16, for an overall cost of $37,752.16, and authorize the Chairman to sign the grant application approval form outside of the meeting (Note: This is for new equipment from the manufacturer priced under an existing contract with NPAIP/PACT and the equipment will be installed on a Crescent Valley ambulance);
Authorizing a contract with the Washoe County Sheriff’s Office Forensic Science Division for forensic services for Fiscal Year 2017-2018;
Signing a Memorandum of Understanding with BLM establishing the County as a cooperating agency on the Barrick-Cortez Deep South Expansion Project EIS;
Becoming a cooperating agency on the Fallon Range Training Complex Modernization EIS, including responding to request by the Navy to: (a) sign a non-disclosure agreement, and (b) identify points of contact for the County;
Accepting a proposal from an individual to provide clerical, administrative, and specialized services in relation to the annual Eureka County Fair, and authorize signing contract outside of the meeting not to exceed $18,000 with understanding receipt of business license;
Accepting the resignation of Cindy Garcia from the Eureka County Fair Board;
Adopting 2017 Meetings in Crescent Valley Ordinance, an ordinance amending 2014 Eureka County Code, Title 2, Commissioners, by amending Chapter 10, General Provisions, Section 30, Meetings;
Adopting 2017 Clerk Recorder Ordinance, an ordinance amending 2014 Eureka County Code, by adding a new title, Title 18, Clerk Recorder;
Adopting 2017 Treasurer Ordinance, an ordinance amending 2014 Eureka County Code, by adding a new title, Title 19, Treasurer;
Authorizing the Eureka Business Network to assume the duties of putting on the Annual Car Show.