Good morning, everybody. How's everybody doing this morning? All right. Good deal. Well, I'd like to call the work session for Thursday, October 2nd to order. Appreciate seeing everybody this morning. We have Commissioner Scheer, who has a very bad cold and will be joining us virtually this morning. So can I have a motion and a second? Okay. A motion from Commissioner Peters, a second from Commissioner Flowers. All in favor? Okay. Welcome, Commissioner Scheer. Hope you're doing well. Thank you. I hope you can hear me. We can. We can. And just raise your hand if I may not always see you up there. So if you have to just interrupt, if you've had your hand raised for a while, just let me know. And also, if we could keep our friend and colleague, Commissioner Latvala, in our thoughts and prayers today as he's dealing with some of his own health concerns. So all the thoughts and prayers and love go out to him and his family. And also, I would like to, before I forget, I want to thank our deputies this morning for keeping us safe. We have Deputy Mike Winnick, Tom Manley, and Jeff Atkinson. Thank you, all gentlemen, for being here this morning. And with that, we'll get into our first presentation, which is the Tampa Bay Regional Planning Council Services Update. Good morning. Thank you so much for having me. Thank you. And I'm joined also by our Executive Director, Ren Kroll, and my colleague, Jessica Sorrell. My name's Alana Todd. I'm the Principal Environmental Planner with the Tampa Bay Regional Planning Council. We really appreciate the opportunity to speak with you today and share some of our services from the Tampa Bay Regional Planning Council. So first off, I just want to also thank Renee Flowers, Commissioner Renee Flowers, for your leadership on our board. So our mission at the Regional Planning Council is to serve our citizens and our member governments by providing a forum to foster communication, coordination, and collaboration in identifying and addressing needs regionally. The Tampa Bay Regional Planning Council is actually the first regional planning council in the state of Florida. But now the state's broken up into 10 regional planning councils. Our board meets six times a year. Each of our member governments sends one of their elected officials to serve on our board. And every year, the council elects new leadership. This year, Mayor Moe Freeney is our chair. Pinellas Commissioner Renee Flowers is our vice chair. Commissioner Rebecca Bays is our secretary and treasurer. And then Largo's mayor, Woody Brown, is our immediate past chair. And then also our leadership, as I mentioned, Ms. Kroll is our executive director. We also, you know, Cara Sarah is our executive deputy director. And then Maria Robles is our manager of administration. And so all of our management are available if you need anything from our staff. And so we serve six counties from Citrus County all the way down to Manatee County. And we also, our membership includes 23 municipalities. In addition to our 29-member governments, the council also includes 13 gubernatorial appointees, three ex-officio members from FDOT, DEP, and SWIFT MUD. So our focus areas are responsive to high-priority regional concerns and include economic development, emergency preparedness, environmental planning, and resiliency planning, to just name a few. And our staff are available to assist the county in any of these areas. We support Pinellas County through our three different, I would say, legs of what we do. The first is our government liaison program. We also provide technical assistance, and then we also are a convener. And so I'm going to go into a little bit more of each of these three. So the first, and what brought me here today, is our government liaison program. So we, our government liaison program creates this hive of information. Sorry, I'm going to go back. So that means our staff are working together closely, like we like to say, like bees in a hive. We make a conscious effort to connect with each of our local governments and then share what we learn with the whole team. So that way, everyone gets a very broad view of what's going on. So I am your government liaison, and I, you know, come to your meetings, always look at what's going on in the news, and make sure all of our staff are updated with what's going on with Pinellas County. And we do that with each of our member governments so we can see, you know, what are some through lines, what, you know, what are common, you know, what's going on in Pinellas County and others, and so we can share that out and offer, you know, services tailored to what our governments are going through. So one of the big benefits of working with the TBRPC is that we're a public agency, so Pinellas County can contract directly with us. That eliminates the need to go through procurement, and I've listed some of the services that we have here. So our staff are trained in planning services from, you know, geospatial analysis, 3D visualization, doing vulnerability assessments. We can help you get updated in your CRS scoring, and so all of these services are available, and that's really the second, you know, line of what we do. Besides our government liaison program, we have these technical assistance services that we can provide to you. So please reach out if any of these are of interest. One thing I do want to highlight is our urban design and our 3D visualization. So we're able to help you if you're, you know, changing your land development code or you're revitalizing an area and you want that visualized for communication with the public, I'll show you this is kind of the before, and then this is what it looks like after. So we can help you visualize, you know, if you're rezoning or you have other design concepts that you'd like to communicate to the public. And so our staff completes projects as we receive grant funding, and I want to take a moment to highlight some of our recent projects to give you a full picture of how we can support Pinellas County. So our Project Phoenix has been a resource for the region for over 10 years. You may have seen our video reenactment of a Category 5 hurricane hitting the Tampa Bay area, and so we're going to be updating that project, actually. And it's a really great tool to share with people and show them, you know, what would happen if we did get a direct impact. And then in 2022, our resiliency coalition adopted its first regional resilience action plan. We've already received some funding to complete some of the regional actions that are identified within that plan, including our Clean Air Tampa Bay project, which is the first regional greenhouse gas inventory for this MSA, the Tampa St. Pete Clearwater MSA, and that's been completed under a program funded by the EPA. And then our Resilient Ready project worked with three local governments to provide technical analyses and design services for some of their flood-prone study areas. And one project I'm really excited about, I'm managing this project, is our Tampa Bay Coastal Master Plan. We received a $2 million grant with the National Fish and Wildlife Foundation to develop Florida's first regional coastal master plan. So this is a four-year science and community-driven initiative that will identify flood-prone areas around our region and then prioritize restoration and risk reduction projects that can guide long-term adaptation. So in essence, we're creating this roadmap to guide implementation of flood adaptation. And then the plan's boundaries include all seven counties within our resiliency coalition, and we'll also be looking at flooding both within coastal and inland communities. If you want to learn more about this project, visit CoastalTampaBay.org. And Pinellas County is one of our partners as part of this project. Now, another thing I'd like to highlight in terms of our technical assistance is our economic modeling. So we have some software in plan and Remy, and we're able to perform economic and fiscal impact analyses. So, for example, we recently completed the economic valuation of Tampa Bay. We were able to capture a yearly snapshot of how Tampa Bay contributes to our region and our economy. And then the last sort of arm of what we do is convening, and we do that both through our council, but then we also have various committees. So our agency on bay management, or bay and coastal management, focuses on regional environmental issues, specifically those impacting Tampa Bay. We also have our regional resiliency coalition, which allows local governments to work collaboratively on mitigation and current and future climate hazards. The Stormwater Management, Public Education, and Training Committee provides grants for stormwater communication initiatives to member governments. Pinellas County has received a few of those grants, and so have many of our municipalities. And then we also, as a requirement of federal and state law, the TBRPC facilitates the Local Emergency Planning Committee, the LEPC, which is charged with facilitating regional hazardous materials, emergency response, and in compliance with hazardous materials reporting laws in the Tampa Bay region. So we also coordinate the Courtney Campbell Scenic Highway Corridor Advisory Committee to convene representatives from all local government and planning agencies that touch that highway. And we're currently in the process of forming a committee to implement the comprehensive economic development strategy, the SEDS. So as you can see, we have various different committees and initiatives where we encourage all of our local governments to join, and they're able to talk with one another about common issues and share best practices, and we're able to, you know, create synergies and cross-collaboration. So one other, you know, initiative I want to highlight as part of convening, following the hurricanes last year, we were able to convene all of our local governments within this hurricane, post-hurricane impacts and recovery session. So we had a panel discussion, and, you know, all of the local governments were able to talk about their recovery efforts and what it's been like, you know, going through the process of getting reimbursement and what are some of the current challenges. And, you know, we had a really great turnout for that event, and we wrote up a summary report, which you can find on our website. And so we have our own disaster recovery coordinator on staff, and we provide various other support and resources for disaster recovery on our website. We have a whole hub of different resources, which I encourage you to check out. So lastly, I just want to mention that our next council meeting is October 13th, and if you're able to join us, we would greatly appreciate it. We hope to see you there, Commissioner Flowers. So please join us in person if you can, or you can join online as well. They're open to the public. So that is a wrap-up of my presentation and what the TBRPC can provide. And if you have any questions, let me know. First, I just want to say thank you, Mr. Chair, for allowing Elena to make the presentation before us, because I thought it was important that, along with when I give my reports, but to have a face with a name when it comes to who's been assigned to kind of work with us and work with staff as a first contact, although all of the staff at TBRPC are available to us. That's the first thing. The second thing is she's being a little modest about the Phoenix Project. We've won several awards as it relates to the Phoenix Project because of the accuracy in which it reflects if a Category 5 were to hit us directly and what that impact would be. And it helps us plan on how we can kind of restore ourselves and come back in phases. So that's number two. Number three, we also serve as a conduit with the University of South Florida as well as Eckert College for their marine science programs and their environmental study programs. So there are partnerships with two of the larger universities in our community that work in those areas. And we have a number of college students that provide their or do their internship with us. And we've hired some. Yes. Yeah, so they do the internship with us. And if they remain in this area, what better person to hire? And so I believe so far, too, since I've been a part of the Tampa Bay Regional Planning Council, we've hired two of those interns, and they have done a magnificent job. Pinellas County won an award a few years ago from the Tampa Bay Regional Planning Council when it came to our resiliency plan that was put in place and that we are still building on. So that is absolutely fabulous. And we hosted, just last month, the Florida Regional Planning Councils. So that was people from all over the state. And we had some state representatives from Tallahassee there that presented information. So I thought that that was critically important for them to want to emulate what we do here locally throughout the state that says a lot about us as a county. And the last thing I will say is we are fiscally sound. I know that that is always a question, but we have been really good stewards of our dollars. We've made some transitions and cuts in areas that we may not have needed those services so that we've really trimmed down. We have a very small staff, but a very impactful staff. And so I just wanted to share some of those highlights that Elena did not share. Thank you, Commissioner. I'd like to say to Wren, who's sitting back there in the back, thank you so very much. The executive director, thank you so very much for the work that you do for your leadership and your coordination with Forward Pinellas and all of the other organizations that keep us abreast and aware of what the next things are in order to make sure that we are prepared and that the services that we so desperately need in our community when it comes to our shoreline rejuvenation and things like that, that we really are on the cutting edge. So thank you. Thank you, Mr. Chair, for allowing me to share. Well, again, please reach out to us if there's any, any services that we can provide for you. If you have any questions, like Commissioner Flower says, you know, we have a small staff, but a mighty one. And if we can't answer a question for you, we'll find someone who can. So please reach out. Okay, great. Commissioner Shearer? Yes. Okay, go ahead. I just had a couple of questions. I'm unfamiliar with the regional planning council. So Elena, I had a question. One of your slides says you have 23 municipalities. Is Tampa a member? Is St. Peter a member? Seems like we're missing some municipalities. Yes. Both the city of Tampa and the city of St. Petersburg are members. And do they pay a membership fee? Are you a taxing authority? Yes. As part of their membership, they do pay dues, just as Pinellas County does. So if a city wants to join and use your services, they have to pay a fee. Is it prorated per city or? The cities pay a flat fee of, I think, $2,000 per year. And then our counties pay, you know, per resident. Okay. So what would the counties, what does the county spend on this, on your organization? I don't remember seeing that line item. It changes by county because it's dependent on how many residents are within the county. But I believe the rate is, I think, about $0.40, $0.50. No? Yeah. Thank you, Brad. Is that the bill we just got? I think, is that right? Is that $312,000? $312,000? Is that one of our memberships that I saw? Yeah. I just looked it up. We just got the bill. Okay. And then are we still currently operating a greenhouse gas analysis program? Yes, we are. But can I, may I clarify the dues? Yes, that'd be great. Thank you. I'm Wren Kroll. I'm the executive director for the Tampa Bay Regional Planning Council. We've been in existence since 1962. Our cities have had the same rate of joining us for $2,000 since 1962. And our counties have been at $0.32 per capita since before 2008. So, thank you, Barry, for reminding me of what that amount is. I appreciate that. I wasn't exactly sure what the dollar figure was. But we have been very cognizant of keeping our dues low and also our city's dues low. Okay. And we are continuing our clean air Tampa Bay work. Okay. All right. That's it. I just wanted to get some background. Thank you very much. So, can I make a comment? All right. So, Commissioner Scheer, just historically, the state used to fund the regional planning councils. And then I want to say it was 2014. I don't remember the year when the state stopped funding all regional planning councils. So, the regional planning council does contracts with other agencies and other corporations, I think, because it's been a long time since I've been on your board. So, just so you know, it used to be a state funded. I think it was created by the states. I'm not sure. But the state funded them, and then the state decided not to fund them anymore. And so, they've stood up and stayed very solvent on their own, and they do great work. Thank you. Well, I appreciate that. I appreciate the clarification. I just, at first glance, I just saw some duplication, you know, with Ford Penelope and economic development, floodplain analysis. So, we do a lot of that ourselves, but I just wanted to get familiar with it. That's all. Thank you very much. Thank you. Go ahead. So, have you given any thought? Because I see you do the counties per person, and yet a small city like Treasure Island has to pay $2,000, but yet a big city like St. Petersburg only pays $2,000. And to me, that doesn't seem quite right. Commissioner, you are correct. But like I said, we have, we're very cognizant of our dues structure. And, in fact, during the recession back in 2008, we actually lowered our per capita dues. So, we're trying to, obviously, now is not a good time to be changing people's dues and the structure of those dues. So, we're trying to be good stewards of those dollars. And you're correct. We do not receive funding from the state. That ended with Governor Scott. But we do a lot of work with the state in which the state contracts with us to do the statewide evacuation studies. We're actually in statute to serve. We can serve the legislature as a full statewide project because we're the only multi-jurisdictional group in statute. And so, therefore, when the state wants to find out, wants to pool together the whole state quickly to do an important project, we're the vehicle for that. But no funding from the state. Correct. Mr. Eggers? Yeah. Thank you for the presentation this morning and for the work you do. I was going to touch a little bit on the fee structure only because presumably in your heart of hearts you believe that you bring value to all municipalities and counties in this area. And I would say that with the city of Tampa paying $2,000 and Indian Rocks Beach, as an example, paying $2,000 is not what we're all about here. I mean, if the city of Tampa sees value, the $2,000 is a steal. So, I just think that should or could be addressed so that we spread that a little bit. You said you were small and mighty, your staff. So, when you get a project, a $2 million grant for, was it building resilience? How do you do it? I mean, do you bring in outside folks to help you? Do you do it yourself? How do you ramp up for a project of that nature? For ramping up for a project, that's the beauty of the TBRPC is that we are a partnership group. And we have lots of resources that we can pull together quickly. With the Coastal Master Plan, we are working with several different educational universities, USF, UCF. We work closely with TBEP on this partnership. Can you name some of the other different partners with the Coastal Master Plan? Yeah. So, we've been able to bring the National Wildlife Federation. We're working with the University of Florida. We're also now hiring some contractors to help with this plan, and we plan on hiring two others. So, we do as much as we can in-house. And then, if there's additional services that we need, that our member governments need, then we'll contract those out. And, Commissioner, I have to say that I've been around for a long time with the council, almost 30 years. But I've never worked with a staff this capable. And the folks that are on our staff are all master's degrees or more, double master's. And they're all very, they're experts in their field in flooding and mitigation and emergency management. I can't say enough about the expertise that we have on staff. So, we don't shy away from those big projects because I know this team, and we know how to get it done. Okay. Well, I appreciate that thought. Maybe, at some point, you all could send us your, just trying to get a feel for how you make up your revenue stream, just to know who those folks that are plugging into your organization, maybe you could share that with us. I can absolutely share that. That would be great. I can share that today. Thank you. Appreciate it. I do have one quick question. On the Coastal Master Plan, is that like a 50,000-foot level looking at all six counties? Is that looking at any one specific area of the Tampa Bay region? Can you talk about that a little bit? Yeah, great question. So, part of the project, we'll be doing a 50,000-level view and trying to identify where, you know, certain hot spots of flooding are within the seven-county region because we're also including Sarasota in that to reflect our coalition. And then once we identify those hot spots, we'll be, you know, zooming into those and then trying to identify projects that can help in mitigating the flooding issues there. So, both, but we hope to have a more granular level, you know, view as we propose projects to be included in the final plan. Great. When do you anticipate that being complete? So, it is, it'll be published by the end of 2028. So, we got a little ways to go on it. Yes. And, you know, your staff are involved and they come to our meetings for that. So, we greatly appreciate Pinellas' support on that plan. And they're very excited to have us as a resource. Thank you. Yeah. Anybody else? Yes. The other thing I wanted to note is for some of our smaller communities that don't have departments like we have or other larger cities, that is where Tampa Bay Regional Planning Council is a tremendous asset because now those smaller communities can contract with Tampa Bay Regional Planning Council. We can get the work done through them because they don't have the internal capabilities to handle that. So, that is a great resource for our community and for the member partners. I believe, if I'm not mistaken, we have 100% membership. Do we not throughout the region? We do not. Okay. I'm sorry. That's okay. We aim for it, 100% membership. We are missing some of the beach communities. Okay. And rightfully understand because of their financial impact. The other thing I will say is I'll make sure in our meeting I'm the person that brings up looking at the dues from the cities. Of course, not this year since people have already passed their budgets for the most part, but looking at how we could structure something to be a little bit more equitable. So, I'll bring that up at the executive board meeting and then the full board meeting when we need help to do that. Sounds good. All right. Anything else? Thank you very much. Thank you. Thank you again, Mr. Chair, for letting them come to the board. Thanks for coming. All right. Moving on to our ambulance transport. Thank you, Chair. Good morning, Commissioners. Matt Spohr, Assistant County Administrator. Just to introduce the topic before Jim gets up here. Staff has been communicating with our hospital partners on the topic of non-emergency transport, specifically requirements surrounding prior authorization of said transports. I want to clarify that Pinellas County has not implemented any new prior authorization requirements. These are longstanding insurance company rules that hospitals and skilled nursing facilities must follow for insurance companies to cover the costs of non-emergency transport. When those requirements are not met, patients often face unexpected ambulance bills, and ultimately the Pinellas County taxpayers bear the cost. To provide an overview of the issue, the impacts on our residents, and the collaborative work underway with hospitals and insurers, I'd like to introduce our Safety Emergency Services Director, Jim Fogarty, who will help us through today's presentation. Staff will continue to work with our hospital partners on solutions for Pinellas County, the residents, and the hospital partners. So today is just an overview of the issues. No decisions today. So, Jim. Commissioner, while Jim's coming up, we had a really good meeting yesterday with Brent, and there's more work to do. There's more discussion. And I think it was a very productive discussion. So this is just a beginning point, but, you know, we've got to get down that somebody's paying that bill, right? And who's paying, and the business models, and all those things need to be looked at. And so there's still more work to be done. But we wanted to highlight, and you've gotten comments, you know, and letters and things like that. So we wanted to kind of put the issue out there, and then we continue to work together and bring you something back that you can consider. Good morning. Jim Fogarty, I'm the Bureau Director for Safety and Emergency Services. Thank you for letting me talk about the interesting topic of ambulance billing. I want to recognize my Deputy Director, Dave Hare, the Financial Services Director, Jody Sessler, many of you know, and Pam Bell, who for 30, 35 years now, Pam, has been dealing with these types of issues. They're probably more talented to be able to give this presentation than I am, so I'm at sort of the limit of my knowledge for ambulance services. But really I have two objectives of being here today. Number one is to provide a context of this issue. It's, in my view, a business problem, not necessarily a clinical problem. There might be those that disagree with that. But I want to reassure the Board that we're going to work cooperatively with our partners. Many of them are in the room today. I see the hospital group is here, and our ambulance provider, a very qualified ambulance provider with Sunstar is in the room today. And that we're going to work cooperatively with this, like we always do, when faced with a difficult problem, we figure it out. So you can be rest assured we're going to figure this out. At about seven slides, it'll take about ten minutes to try to describe this for you. But I want to describe first that this is not a 911 issue. The emergency piece of this, you dial 911, you're having a heart attack, or you're having a car crash, it's got nothing to do with preauthorization. Preauthorization is not required on the 911 side. And I also want to reassure you that we're responding to every request for service, emergency and non-emergency. But I also want to reiterate that this, in some cases, creates ambulance bills for people that aren't expecting that. And I'll use an example of Ms. J. I won't say her name, but Ms. J. Found herself, lives in a nursing home in Pinellas County, found herself in a hospital March 5th. Spent about five days in the hospital. The reason she was in the hospital, not really pertinent. But when she was discharged from the hospital, again, she was in there for five days. When she was discharged from the hospital to go back to the nursing home that she lived in, Pinellas County sent her in the case, and we billed Florida Complete Care, Medicare Part C. We billed that for the trip. And within a couple of weeks, we got the all-too-familiar, claim-denied, PR-197. And you'll hear me reference PR-197 several times. PR-197 is the way these third-party insurance companies can tell us, we're not paying your bill. And it's pretty easy because if they see, oh, we require peer authorization and it's not there, they don't even have to research that, whether it was medically necessary, was there a physician that authorized this. All they have to do is send us a denial, and then their problem goes away. So, Mrs. J., who's still in the nursing home, she has received two invoices, and her account now is sent to collections. Of course, none of us like to describe that for someone, an elderly resident in a nursing home. We're not refusing to transport people, but we are getting citizens, our citizens, and our priority is to consider our patient first, then our citizens second, the stakeholders, the ambulance company, and the hospitals third, and the responsiveness that we have as stewards of citizens' money. To give you some context, non-emergency ambulance business is about 28% of what we do. We're a large system. We run a lot of ambulance calls on the emergency side and the non-emergency side. It's a single system. It's not very similar to many of the other systems in the United States or in the state of Florida, and it's a system that's got a single ambulance provider. You don't have two or three different private ambulance providers that can serve the community, whether that's on the emergency or non-emergency side. And that system's been performing really well for 30-plus years. And that system, the attributes of that system, I think, are important for you to understand. These attributes align to both the emergency and the non-emergency side. The reliability, the hospitals are very comfortable with how reliable Sunstar Ambulance is, the timeliness and the quality of the care that's provided, and specifically the timeliness. And, of course, one of the attributes is the cost, the cost associated with providing that service. Emergency services is a very expensive endeavor, and we recognize that. Probably never will be cheap in terms of how expensive are we compared to others. We're probably high middle-of-the-road average. We're not the cheapest. We're not the best, but high middle-of-the-road average. So that's kind of the context. This preauthorization issue was put on our radar screen a number of years ago, over a decade ago, where some audits, not including Pinellas County. Pinellas County has never failed an audit. But in other parts of the United States and some parts of Florida, the audits showed that for some of the private providers, it was fraud. They were using ambulance services when something else probably could have occurred. So the findings really led to, okay, we have to get a handle on this fraud. And it began in 2014 with Medicaid. In the state of Florida, they adopted their Medicaid-managed care program, which said if you were a Medicaid patient and you needed a non-emergency ambulance trip, you had to get permission from the payer group in order for that trip to be considered paid. Now, Medicaid doesn't pay a lot for the ambulance. It really wasn't a big issue financially impacted. But then some of the other payer groups started coming on board. We saw Medicare Part C, the Advantage Plan, some of the commercial providers, even for some of the more routine transports like dialysis patients that go often to different locations to get treatment. And so we saw this sort of a jump on the bandwagon approach in terms of are they going to pay. Now, this is not new for the hospital industry. If the hospital folks were up here, they would tell you, we've been dealing with preauthorization for in-hospital care for years, and it really interferes with the treatment efficiency of the hospital. As a matter of fact, in the hospital, it represents $1.1 billion of added costs. That number doesn't include the preauthorization for prehospital. That's sort of yet another cost than that. So it's a big issue. Yes, sir. Right, so the issue of preauthorization, and I'll define that, and it sounds crass, and I don't intend it to be, as asking permission, the doctor having to ask permission from a third-party payer to do what they feel they need to do for their patients. In the hospital, that could be I need to get a CAT scan or I need to get an X-ray hospital insurance company. Can you please give me authorization to do that? In the prehospital world for non-emergency is I need to discharge my patient, and that patient needs to go by ambulance. Can I please have permission to call an ambulance company and get that ride? That's preauthorization. That represents, in the hospital, over $1 billion. In the prehospital world for Pinellas County, it represents about $1 million annually over the last several years, and that's a conservative million-dollar figure. Now, we're a big system. We bill a lot of ambulance. We generate about $100 million in revenue, so it represents a small part of our – but it's $1 million, and it's not something we shouldn't ignore. Administrative cost for the preauthorization process. Billion and a million. That would be a report that the hospital association provided in terms of their internal costs associated with delays of care, delays in discharging, and so those are the internal hospital costs. I mentioned that just to show that this is not just a prehospital industry problem. The permission to do the next step is probably more and more broad scope of a problem inside the hospitals than it is outside the hospitals. Jim, so you're saying we're losing $1 million annually on this? Well, I have to be cautious to say we're losing $1 million. But, yes, in general, that would be a correct statement. But it's impacting patients. For instance, the insurance carrier that says we're not going to pay because you didn't get preauthorization has increased over the course of the last couple of years dramatically, 164 percent you can see on the slide up there. And that doesn't automatically mean, okay, that's a lost revenue. We have to write it off. That results in a bill going to a patient. And really, that's the issue. This is not a new issue. This has been something that, you know, residents by surprise find out, wow, why did I get a bill? And let me give you another example. This would be. So if you could just hold on one quick second. I know Commissioner Peters had a question, and I have not completed mine. So Sunstar transports the patient. We pay Sunstar. The claim gets denied. So then the county sends a collection letter to the patient. Is that the flow? Well, that's a simple way to put it. There's a lot of steps in between. Sunstar does get paid. The ambulance contractor gets paid. They ran the call. We go to Great Lanes to try to challenge the insurance company and say, wait a second. You know, when they send us a denial, we go back at them saying, well, what do you mean you denied the patient? We had a physician certification statement. The rules of engagement say not only do you need preauthorization in some cases, not all cases, but you also need a physician certification, some doctor that says, yes, this is appropriate for this person to be in the back. So Jody and her team spend all day trying to make sure that we do the right thing, make sure the patient needed to be in the back of an ambulance and an Uber wasn't more appropriate. In most cases, that's not the case. They needed to be in the back of an ambulance. And, again, because of the easy button for the insurance companies is to send that PR-197 code. They don't have to do a lot of work. They say, hey, there's no preauthorization. Deny it. If they deny, and they can deny, even with preauthorization, they can still deny us because they say, well, it wasn't medically necessary. But that takes some work on their behalf. They have to look, and they have to look at what the patient's condition was and see what the environment was, and then they can deny it based on not being medically necessary. So that million dollars, is that just trip charges, or does that include our administrative costs? I'd have to get back with you on that. But I believe that's a conservative figure that is really just the amount that we write off. In other words, when it gets to the point where you can't collect, once we send these accounts to collection, we don't have a very good track record in collecting. Most of these are commercial pays or private citizens that get bills that just can't pay. Now, in many cases, we work with that patient to address a payment plan, and we've got cases that people have been paying $5 a month for the last two or three years. But the million dollars is when we get to the end of the line, and we can't collect, and there's no reason to collect, and we'll have to write that off. And that happens once a year. You get sort of a board item to write off these uncollectable bills. So we never litigate it? Because I know hospitals do the same thing, and they've got the same problem, but not only do they fight it, but then they end up litigating it and end up getting some kind of settlement or something in the middle. So do we actually go that far? We do. In the case of an individual, for instance, we rarely litigate against a citizen that just can't pay their bills. But, again, this doesn't really have to do that. I'm talking about litigating the insurance, not the citizens. So we don't litigate the insurance companies as much as we litigate the responsible party. For instance, in many cases, the responsible party is a skilled nursing facility, right? Skilled nursing facility ordered the care, they ordered the service, they're responsible for the bill, and they don't pay. And so we go down a litigation pathway for that. But, yes, we could go to a litigation pathway with an individual client as well. We don't often do that, but we can. Okay. Now, do you – so is it the county that partners with insurance companies then? I mean, do we partner with insurance companies? Do we contract with insurance companies? Well, you'll see in a couple of slides in terms of, well, what's the solution to this? One of the solutions – it's not a solution, and I suspect there will be many subtle solutions – would be to contract with third-party payers. For instance, a contract with Blue Cross Blue Shield, and it's not as simple as just one contract. But even if you did, if we contracted with, say, Blue Cross Blue Shield, there's about 16 of these transportation brokers and third-party payers. Well, we could actually enter into a contract with, but even if we did, even if we became what's called a PAR versus no PAR, meaning it's a participating provider with a contract, and non-PAR was a non-participating provider with no contract is what we currently are. Now, even if we were to do that, and I suspect we will at some point as part of this solution, there's 16 of them. Only one of those 16s would not require preauthorization. The rest would still require preauthorization. So if you partnered with Medicare, right, because – managed plan, because I believe we don't at this point, correct? That's correct. We don't have a lot, if any, contractual partnerships. But, again, one of the solutions probably would be contractual partnerships. They don't always work. Provide County on the East Coast has contractual partnerships with some of the transportation brokers, third-party payers. There are some contractual relationships with hospitals, you know, hospitals because there's a benefit to these hospitals to effectively transporting these patients out. And, you know, that's quote of the pay-of-last-resort concept. And I've got that concept in a few slides. Okay, I'm going to wait for the slides then because I have more on that. Me too, but it is $1 million in actual costs, not administrative costs. And that's what we're really talking about is how to divide up, you know, where is that? Because these are posts, many of which would be eligible had they been preauthorized. But rather than going on, I think some of the other slides will answer some of the questions. Thank you, Mr. Chair. So, years ago, I worked at Bayfront Medical Center, PCU, stepped down from ICU and ICU. So, typically, when physicians are discharging patients, whether it's back to an ALF or a nursing home or whatever, that's done after rounds are completed, which we would hope that it's first thing in the morning, but there's no guarantee for that, the orders are written for discharge. At that time, they used to call them unit coordinators, but it's the person who is reading the orders that the physicians have written on the chart and then communicating either with the pharmacy, if they need some type of appliances, wheelchair, bath commode, whatever, if transportation is required, all of those things are noted out and calls are made to receive those authorizations. You would hope you get the authorization before time, but typically, a patient wouldn't be discharged until all of those things are in place so that everything is good to go. So, I want to make sure I'm understanding correctly. So, patients are being discharged, even though the authorization has not yet been received in order to cover if they need medical transport. They are being discharged, and then is it that the hospital is saying we need them out, even though you don't have the preauthorization? Because, typically, that preauthorization, just like a referral. I get a referral before I go to the specialist because that specialist wants to make sure that it's been coded properly so that they can get paid when I get there for my visit. So, is it that persons are being discharged from medical facilities, hospitals, to ALF, nursing home, home, whatever the case may be? The authorization is not in place at time of discharge. So, essentially, even though the order may have been written, you've not yet received the response. And so, as a result of transporting before receiving a yes or no, they're denying the claim because the claim or the transport was made prior to the authorization. Is there any way, and maybe this will be something that will come up in one of your solutions, yes, there has to be that physician order there, which is basically saying the doctor said they can go home and go home with all of these things. Is there any way that, in addition to that doctor's order, that that preauthorization number also needs to be provided in order for then the ambulance to make the full transport and that the ambulance doesn't make the transport if that authorization number isn't provided? I know it may be a little issue because sometimes the hospital's wanting patients to kind of get out because they got more patients to put on the floor. They don't want them hanging out in the emergency room. That goes against some of their auditing internal procedures as well. But that would be one way to assure that things are in place so that if that preauthorization number has not been received, then we need to look at some other transport opportunities. Unless they need to be transported with oxygen, they have to have a care ride on because perhaps they're connected to several devices. If it's a heart transplant, a lung transplant patient, probably a cancer patient, something that's really critical where it does, in fact, require that they have to have that transport. Did I ask too much in one? Well, no. Let me try to frame it a little bit without getting too much into the weeds. It's a very complex question that doesn't lend itself to a simple answer, but I'll try the best. If you look at a patient that's in the hospital for a number of days, like the first patient I described, where time is not necessarily of the essence, now that is a key phrase there, not necessarily of the essence, then for almost five years, Sunstar, before they scheduled an ambulance, has been asking the calling entity, typically that would be a hospital that's the discharge planner, and say, hey, I need a Sunstar ambulance. Can you tell me what the preauthorization number is? We've been asking that question for five years. And so often they don't have it, and the reason for that is sometimes it's very, very difficult to get. Even when time isn't of the essence, they've been in the hospital for five days, the various companies, there's really not one standard way to get that preauthorization. Let's just say for the purpose of the discussion that there are 30 different payer groups, and there's probably 100, but let's say there's 30. Each one of those 30 payer groups has a different process for getting that preauthorization. They have a different process for describing what a non-emergency actually is, and they have sometimes hours, sometimes days, before we'll get back with you with that preauthorization number. So you're the discharge nurse in the hospital, and you have Mrs. Jones that wants to go back to her nursing home, and the company that you called for preauthorization said, okay, we'll get back with you in 48 hours. Mrs. Jones wants to go home. And so that's that one. Now, the reason I say it's a complex answer is because that's not the only scenario that we are faced with. In many cases, it's not Mrs. Jones that's being discharged from the hospital. It's Mr. Jones that's at a freestanding emergency department that's been stabilized that needs to go from the freestanding emergency department to a hospital. And the physician says, yeah, we've stabilized them. We're not doing CPR on their chest anymore, but they need to get to the hospital for a CAT scan or whatever it is. And they can't wait for 48 hours or 72. They can't wait for the mother, may I, do this permission. And so we run the call. Again, the qualities of our system is reliability and timeliness, and the quality of care that shows up, whether that's on the scene of a car crash or the non-emergency ambulance that shows up, the system quality is pretty well understood. The reliability and the timeliness is pretty well understood. If you schedule to discharge Mrs. Jones, whether that's to go from this freestanding to the hospital or from the hospital to the nursing home, the contractual requirements that we have with our ambulance provider requires them to be their Johnny on the spot, and pretty much they are, not always, but pretty much they are. So to answer your question, it's not always practical from the hospital standpoint to get that number. It's not always practical from the patient's standpoint to really understand the complexities of this. And the end result of us running the call, Mrs. Jones is home, but she's getting ambulance bills three months after the fact that she's being sent to collections because she thought she was insured for this. So based on the scenario, and I'm going to ask some questions later on, but I just want to wrap this up. Based on the scenario you just gave, which is one of many, and I get it. It depends on what's going on with the patient, what facility they're going to, or whatever. But based on what you just said, I would have to be hesitant as it relates to attempting to retrieve the revenue from that facility, if it's a nursing home or ALF, because they're not the ones that discharge the patient. They're not the ones who are holding up the claim. So perhaps litigation with the insurance company would be more appropriate because you're challenging their decision to refute the claim. So, again, I'm just throwing that out. Your point is a very valid one. And, again, later on into, well, what's the answer to this? One of the solutions, of course, is to challenge the insurance company's ability to say, you need my permission to do your next step, right? They've taken that role on themselves, and I guess legally they have the right to do that. Insured, and if you want to take full advantage of your insurance coverage, you need to do these five things, right? One of those five things is get preauthorization for non-emergency ambulance service, right? That's the crux of the problem. Do they have, and, again, that's a legal question. Perhaps there's a legislative fix. We are partnering with the Florida Ambulance Association. We are partnering with the hospital groups. As a matter of fact, one of the hospital groups in our meetings has promised to arrange meetings with the insurance carriers because the interest of the insurance carriers is to try to prevent fraud, right? They think that people are using ambulances when they really shouldn't. Probably not true in Pinellas County, although you'd probably find an incidence where that's okay, but probably not true. And so working with the insurance or the third-party payers to make sure their interests are met, and so, hey, you know, we're not using an ambulance when it's not appropriate, and there's a physician certification statement, which there always is, and also making sure that the hospital groups are not using ambulances because they're reliable and they're high quality and they're timely. And so long-winded answer to your question, but not a simple problem to solve, but we will solve it. There's so many scenarios, and I don't want to belabor this, but Commissioner, let's say we have a nursing home that sends somebody by ambulance to an ER, whether it's a freestanding or a hospital. And it's freestanding is outpatient, right? So they went by ambulance. There is no criteria that they have met for admission, so now they have to send them. So if they're outpatient, they don't need preauthorization because it's outpatient. So that doesn't even qualify, correct? Again, there's so many different variations of this. There are a lot of different, but then they've got to move them back to that skilled nursing home that they came back to because they don't qualify for admission. But if they have to wait 24, 48, 72 hours for preauthorization, what do they do with that patient? That's why I'm saying it backs up everything. It does. It does. And so it's complex. I get it. And there's so many scenarios that we could talk about that this is really complex. Jim's going to get into solutions. I'm sorry, Jim. It's really going to get into solutions, but it's really who's going to pay, right? Exactly. It's either coming from the insurance company through a preauthorization or the hospital makes a decision, I need the bed, I'm going to just eat it and do that, or it's going on to our EMS levy and our property taxpayers are paying. So somebody's paying, you know, for this cost. And so that's the complexity of it, you know? Everybody has a payer source through this because ultimately we have to pay through Sunstar, right? And so it's dividing up the pie. It's not easy because there's no, you know, it's not like, okay, it's clearly your responsibility or your responsibility, you know? And so Jim's got solutions and ideas, but that's the reason we wanted to kind of sunshine the issue today and then continue to work on it. And I think that's key. We've got solutions and ideas, and I want to make everybody aware that we're all on the same side of this. There's not a hospital is on this side and Pinellas County Sunstar is on that side. We're all on the same side of this issue is to make sure that we do the right thing for the system that's really functioned very well for many, many, many years. Not that it's perfect. One of the rules of engagement, again, you could question whether this is necessary or not, but one of the rules of engagement is Sunstar, we can't be the person that's getting the preauthorization because the world of health care billing sees that as we're approving our own service. And so, you know, you'll hear, say, well, why doesn't Sunstar get the preauthorization? Well, we can't. We're not allowed in many cases. In many cases, it's not necessary. Not every case is necessary, but it's individual to the patient and the type of insurance they have, and even with the type of insurance, the components of that type of insurance. So in many cases, we're not allowed. But the issue then becomes, okay, who does get it? Is that the hospital? In many cases, it is. But then they've got to add staff, and it's, again, they've got the timeliness issue. Let me use an example, which I think kind of demonstrates some of the complexity. We met with many of the hospital payer groups over the course of the last several months. One of those groups was a group called Sable Palms. You may know what Sable Palms is, right? It's a children's health care facility. Sable Palms is a very good partner with us. And they described some really nightmare scenarios to us where they were trying to be good stewards, and they were trying to get preauthorization, and they actually wanted to be here. They said, hey, can we please talk to your board? I said, well, that's probably not the best thing to do because this is a work session, and it's really not that type of an environment. But they wanted to be here, and they wanted to tell you, as they tried to work through preauthorization, they called their third-party payer, their transportation broker, and said, hey, we've got this child on a ventilator. This child on a ventilator needs to go to the hospital for X procedure. It's really critical. We need to get them there. It wasn't really 911 because that facility is kind of at a high level anyway, but they needed an ambulance. And so they went to the transportation broker, called them, and about an hour later, what showed up was essentially a Volvo and an Uber. And that's the result of some of this processing. When we heard that, we said to them, well, did you report that to ACA? That really is clearly a violation of what they're supposed to be doing. And they were so frustrated to say this happens so often, they said eventually we just called you guys and we got the ambulance here and we'll worry about the bill after the fact, which is rightly so. But that's the nature of forcing this into these third-party payer groups to say you can or cannot get an ambulance. You'll show up with a Volvo showing up to try to transport a ventilated child to the hospital. And I'm not using that as an isolated, dramatic example. That happens all day, every day. So to get back on track, there's really not a standardized method. If there was one method to say, okay, you push these buttons and you got prior authorization. It's insurance carrier specific. The timeliness is all over the place. Sometimes you don't need it. Sometimes it takes days. And again, hospitals and physicians and even patients really shouldn't have to wait days for a permission to get authorization. We've been asking this question for five years. Finally, to try to draw attention to this, I sent a letter. You probably got some of the phone calls as a result of that letter that says, hey, guys, we need to address this problem. And that letter said we're going to require preauthorization come July. And, of course, then that created the expected uproar, and that was good because many of the folks, whether those are hospital groups or nursing homes, said we didn't know anything about this, even though we've been asking the question for five or more years. They claim to maybe they didn't know anything, but they know about it now. And so over the course of the last several months, we said we're going to postpone that date. So November 1st is now the magic date that we're going to require preauthorization. And is it a magic date? Maybe it is. Maybe it isn't. But we've had a lot of good, productive meetings with these pair groups, hospitals. We haven't met with insurance carriers yet. We don't have a good inroads to meet with them, and we're hoping our hospital partners can give us those inroads. We've discussed and we've done some site visits. Jody and her team went and viewed a coastal ambulance service on the east coast and met with Brevard County. So we have some ideas on what this might look like in terms of a solution, and I don't think it's going to be one solution. There's probably going to be one set of solutions for the patient that needs to go from standalone to emergency department, another set of solutions from a person that's in the hospital for days that needs to just go home. And so my guess is over the course of the next couple of months as we work this issue, we'll come up with this series of effective solutions that can address this problem reasonably, not draconian, you know, not going to suddenly stop sending ambulances. In Pinellas County, that's really not an option because you don't have the option to call ambulance service B or C or D. You must use Sunstar. And some of those options are what the commissioner said, considering sort of the pair of last resort type of a concept where there's such an urgent need to free this hospital bed up. It's within the business aspect of the requesting facility to just pay the bill. Again, that's not everybody. Not everybody requires prior authorization. But, again, working with insurance companies, doing the types of things that you would expect a governmental department to do when they're faced with a significant community-based problem. One of the things, and I put it up there not as a recommendation, just to show that we've listened and we've heard some of the hospital goes, well, some of the hospitals said, well, why don't we just run our own ambulance service, right? Issue COPCNs and just kind of do it ourselves. It's not the way the system's designed. It doesn't mean the system couldn't change to that type of a model. But that doesn't resolve the problem. You'd like to provide solutions that resolve the problem. It doesn't really matter what ambulance service is providing the service. It still requires preauthorization. So if you name the hospital, Tampa General decided to run ambulance service, they still require prior authorizations. The problem doesn't go away. And there's pluses and minuses to that type of an approach to the model. One of the pluses is we've got a very high-quality, reliable, timely, well-functioning system. And in terms of how costly is costly, it's not as costly as many systems that you might analyze. And so you say, well, why don't we just extract ourselves from the non-emergency business and just focus on emergency? And there's, you know, if I call the cost accountants up here, they would describe a concept of contribution to margin. When you look at the contribution to margin of the non-emergency business to the emergency business, it helps offset the millage that we require of our taxpayer because some of the fixed costs, radios and buildings and traffic preemption systems, some of those fixed costs are there whether you have non-emergency business or not. And that non-emergency business contributes to the offsetting the marginal cost of that, that I suspect if we suddenly jettisoned for that, I'm not recommending we do, but if we did, the marginal costs to the taxpayer would go up dramatically. So that's it. I apologize for the brevity of this. It's a very complex subject. I've asked Jody and Pam to write down any specific questions, the cost of things that we can't answer right away. But we'll try to answer the questions that you might have, and then we can. The certificate of public convenience would simply allow individuals to transport internally for non-emergency situations, but you still say that would not eliminate the need for a pre-authorization. So if a hospital was transferring to one of their SNFs, because a lot of hospitals own their own SNFs, they would still require a pre-authorization for the transport if they desired to be reimbursed for the trip. That's correct. They would require that. That's correct. Okay. All right. I think it's important that you look at our system as a system and holistically, because when you look at other systems, Hillsborough County, Pasco County, Polk County, you look at other systems that have sort of a different organizational structure. What you find is because you've got sort of the private world where you've got private ambulances and there's two or three of them that are out there, and I can't speak to that, but what you have is then not always the reliable quality and responsiveness and the right mix of assets available in good times and bad. Again, right now we have roughly 110 ambulances available running around the county, and today probably not all 110 of them are in service, but my guess is the way the system is designed, if we were to change that, we could, but if we were to change that, and say five years from now, who's ever up here was describing a much different system, then on the emergency side, we would probably have 60 or 65 ambulances. We wouldn't have 110, and then when the storms occurred like they did last year, we would have challenges in terms of moving patients, and so there's some pluses and minuses on both sides of this, and I caution you because the system has operated really well for 30-some-odd years. Our cost of service is average. When I say average, it means it's not the highest, which is by no means the highest and by no means the lowest, but we have a very reliable quality standard. When you schedule on ambulances, it will show up at the time they promise you. Not always. You know, it's like any system that transports 250,000 people a year. You're going to have problems. I'm not claiming that we're perfect, but I'm claiming that other systems have the hospital bed delays. If you look at the hospital bed delays, the discharge process of a hospital in Hillsborough County or Pasco County or Brevard County, often you'll hear the physicians say, we've got hospital bed delays and we've got ERs that are on divert because, you know, the ICU is packed and we can't move these patients. That's not the case in Pinellas County currently. My last question is, you may not have this information, but if you don't, if you could maybe provide of the bills that have not been paid due to pre-authorization, and if we're challenging that pre-authorization to try to get the insurance company to pay by resubmitting all the documentation as it relates to discharge, if maybe you could provide the dollar amount or the number or whatever of cases that we have been able to reverse, even though it may have taken some time, but we've been able to reverse it to actually recoup those dollars. We will get that for you. I can say, in general, you're usually not able to reverse the denial based on either you have pre-authorization or you don't, right? Either you have it or you don't. We do challenge the medical necessity where they say, well, you really didn't need to be in the back of an ambulance. You should have been in a stretcher van. We challenge that often because that's what were the conditions of the patient, and so we can provide both of those numbers to you. And, again, we do have some ideas in terms of solutions going forward. One of the solutions, for instance, I think, would be to partnering with the insurance company on the whole concept of pre-authorization. But by that I mean, okay, we need to move this patient, and the insurance company wants to say you may do that. But rather than do it in advance of moving the patient, move the patient, and then sometime after the fact say, yeah, I get the scenario. You're right. It was right for you to have moved this patient. And so, you know, maybe redefining what pre-authorization means. Authorization, but not necessarily before the trip actually occurs. Because if we can confirm within 24 hours you can get authorization, we'll hold a call open for 24. We won't hold the unit open, but we'll hold the call open and say, okay, we got the authorization now, and now we're good to go. We still are subject to challenging on the medical certification, medical necessity, but we do have some ideas on how that might work. Commissioner Shearer, can you hear us? Yes, Chair. Thank you very much. I just had a few comments. I don't really have any questions. I've been looking this over. It seems obvious to me that, you know, the insurance companies, commercial insurance companies, they're smart. They know our system. They know what they're doing, and they know that it's more expensive to keep somebody in the hospital than to let them get transferred. And so I think they're causing this problem, and so we need to get them an invoice for the last 10 years and start pushing them really hard to change their ways on this because it's just silly, especially, like, for a hospital. It needs to transfer from one of their facilities to another. Number two, I think that we should try to – I'd like to see us allow the COPC in for hospitals as well as the nursing facilities. They're in a much better position than we are as a county to negotiate final invoices with the insurance providers, so maybe they'd be more effective. And then number three, we've known about this problem for 2014, but it seems like we've only been pushing it since the summer. If we can allow the hospital COPC ends to operate their own systems, many of them have their own assets already, but it might take them a little time to get all those – it would take a little time for them to get ambulances and stuff in place to take care of their own transfers. Instead of making a November 1 kickoff, we should give them until January 1 to get ready to take care of their own transfers and go after the insurance companies for the billing for the transfers. Those are just my – that's just my thinking. So if I might comment on that, Commissioner, I appreciate that. That certainly is something that we can and will consider. That would be a significant design change to the system. We, meaning me, I presented this issue to the Medical Control Board twice at their summer meeting and then at their fall meeting, and so they understand that we have an advisory council, the EMS Advisory Council, whose entire charge is to advise you, advise the board on things of this nature. And so at the meeting that we had in September, I said, this is an issue, and we may at some point ask you for your advice on are there system design changes, whether that's issuing more COPCNs to hospitals or not. And really that's the process that would be involved with, yeah, let's do that, rather than just arbitrarily issuing COPCN. And certainly the board has the authority to do that. But when you look at significant system design issues, you do so cautiously and with very strategic view of this. Not only what problems do we solve today, but what problems do we solve or create? For instance, let's just say, for example, a hospital, any hospital, ran their own ambulance service. They could do that and probably would do that. But my guess is they wouldn't have 110 ambulances. We transport thousands and thousands of patients daily. And so when any given hospital, Hospital B, has, say, three ambulances, and they had four patients to move or five patients to move. And it's not unreasonable that any of these hospitals have dozens, if not hundreds, of patients to move. A large urban system like ours is able to flow with the ebbs and flows of patient movement, where it is an individual approach to that. We see this in other areas. It's not impossible to do. But we see this in other areas. Well, what happens when now you're in the emergency room and your three ambulances are four, you pick the number four ambulances are out, you know, one's in Gainesville and one's in South County and one's in North County yet, now you need to move this patient. So you wait? So, I mean, those are the complexities of just issuing CPCNs. And not just that, but if you reconfigure the system and now you drop down because you're reconfiguring how many, I want to understand, and I'm sure you do, the impact on the EMS levy. Because now you've got fixed costs and setting that up and that would be transferred because those are billing sources. Those billing sources then would change on what we can bill. And so now for those that have no payer source that the EMS fund picks up for, well, that cost is going to shift. So we really want to understand that before we make a decision like that, or you could be facing tough choices next year when we get to our EMS levy. I will assure you, the folks in the back of the room there have done an amazing job with going after money owed to us. In Medicare, I mean, they've been so creative and hardworking, and that's what has kept our EMS levy low. And we've been able to reduce that because of their efforts. This is one more payer piece that we can work through before we make system changes. And not to say that we can't make system changes. I think you'd really want to understand that, though, before we make that type of decision. It could have bad unintended consequences for our taxpayer. And, Barry, I've got an undergraduate degree in finance, so I know a little bit about cost accounting. We could do the analysis, and we would do the analysis to make sure the county administrator is properly informed. But a back-of-the-napkin analysis of what the contribution to margin of the non-emergency services to the millage rate, it probably reflects at least at minimum the percentage of services that are provided, so 28%. So we would then lose 28% of the contribution to margin that's currently in place right now, whether that's the cost of the radio system, cost of the dispatch center, cost of the medical director contract, cost of you name the cost of that margin contribution is part of the non-emergency ambulance business. I have some questions, and I'm glad the hospital's here. And if I had questions for them, I hope I can ask them, but right now I don't. So is the primary payer making a payment, and it's the secondary payer that's not? Can you explain all that to me? So I have to paint a scenario picture. So let's paint the picture of a patient in a hospital that's just trying to move from point A to point B. That patient has some sort of medical care coverage. Maybe it's Medicaid, maybe Medicare, maybe it's commercial payer. Maybe they were in a car crash, right? And so the primary payer for the event is dependent on what is the event. If it's a car crash, it's usually an auto insurance carrier. If it's a Medicaid patient, then it's usually the Medicaid managed care program. So when they have that service, the bill is generated and sent to whoever that coverage entity is. If they have absolutely no coverage, it's sent to the patient themselves. And so if it's a car crash, for example, that is sent to the auto carrier. The auto carrier says, no, not a problem. This is a medical problem. They really had a stroke behind the wheel. They didn't have a car crash. And so that bill then is redirected to the Blue Cross Blue Shield carrier to coverage. And all of this is what Jody's team deals with all day long. Eventually, somebody says, we're not paying. And maybe several somebody says, we're not paying. And at the end of the day, and in some cases, we're not allowed to do this. We're not allowed to balance bill the payer and some in the Medicare patient world. And so if we're not allowed to bill them because of either the time constraints, many of these bills have to go out within a 60-day time window. And if we miss that window, we're stuck. But if we don't miss the window and they don't pay, then it becomes a write-off. We can't collect it from anybody. Okay. I'm not sure if I still understand that. But so I have so many notes that I'm not even going to go into those. As far as the, since you're going to continue working on this, then I'm going to, you know, spare you the rest of what I want to go after. So this is my thought. I think, number one, you work with the insurance providers. If we are not partnered with those insurance providers and that's part of the whole, I think that could be a big solution to this problem. Because this way, they're not in network, right? So if we partner with Medicare, then we don't have to worry about somebody not being in the network. So I think the first priority should be working with the insurance providers. I see pushback from you guys on the COPCN. But we're already kind of doing that, right? When Advent has, when they're waiting four or five hours for somebody to get picked up and moved, but we're so busy, they're not getting their ride. They call here and you guys give them permission to move them. So, so there, so one hospital in particular is already able to do that with our permission, right? And my thought is, if we did open up the COPCN, that many of the hospitals are going to contract with Sunstar anyways, because they've got this longstanding relationship with Sunstar. And they're not going to, they're not going to want to wreck that relationship. And Sunstar is still going to be the 911 emergency transport. So, so they're a partner already, but opening it up to allow them and to allow them that option, it puts the, the, the PA on them. So instead of doing number one, if you allow for COPN, they're still taking on that responsibility, but it gives them options. And every other county around us does this. Now, I know many years ago we did this and we had a lot of problems, but I don't think that's a reason to not consider doing it now. Right. So I, I'm not big on the number one option yet. Yet. I think more has to be done on, on number two and considering number three versus number one. So that's, that's where I am. Um, I think you're going to find your solution with the, with the insurance providers is what I think we're going to get the bulk of the solution with the insurance providers. Um, right now the hospitals already have to eat a lot of stuff that non payers, and they eat that a lot. They probably 8% or 9% of their bottom line, they're eating from non payers. So, um, and I'm not supportive of making them push that up to eight and a half or nine and a half percent. Um, but I'm also not supportive in making it so cumbersome that they have a difficult time getting somebody transferred and then it costs them an enormous amount of money and staffing and everything else. I'm not a fan. I'm not supporting that at all. So I, I think as long as you're not making a decision today, my, my recommendation is you work on number two really hard and then you seriously consider working on number three because we're already letting one hospital do that, but they have to get permission. So, so why not let them have that opportunities, potentially save some money? I don't, I understand. I understand why we don't want to let go of that because of the millage. I completely understand that, but this works in every county, everywhere else surrounding us. And so I think we can make it work here. So I really think those are the two that we really need to put the effort on. And if you do number three, then that the whole PA thing falls on them regardless if they're going to do their own. So, um, but I still think the solutions in number two, but I really think that number three is something that we, we should move forward on anyways. Um, take a look at it, see how the ordinance would have to be changed. Cause I know there's, would require an ordinance change, but, um, but I think since we're already letting one hospital do this, why, why not let others? Um, and that does relieve the pressure when we are so busy and it takes four to five hours to get somebody transferred to their skilled nursing home that, that, that, then they have an option that they could use and not have to wait that five hours. And they can free up that bed quicker. I know it doesn't happen a lot. I know Sunstar is great. I'm not, I am not knocking Sunstar. I'm not, but, and, and I love the flexibility of Sunstar because when we had a problem with the emergency rooms to the hospital and you gave them a phone number, that was a very effective tool. I love their flexibility on that. So I'm not, I'm not criticizing Sunstar at all. I think they've been a great partner. I think they've done an outstanding job. Um, and I think they will continue to do an outstanding job and I love their flexibility. Um, but I think it's something that we have to kind of move forward on is, is two and three. Just for, yeah, because we've worked on this issue a few times, you know, a lot of the delays, as we found out are internal to the hospital of getting their own, um, internal approvals to even call for Sunstar. So it's not necessarily always Sunstar that is unable to respond. I mean, these are large systems. They have their own internal bureaucracies. So there's certainly things that we need to do. There's certain things the hospitals need to do, uh, to make, to make the system, to make the system work. We, I, I think, I mean, it's, it, this has been brought up several times, you know, and, and, uh, I think we do need to look at that and look at the system. I'd just like to make sure that we are cautious, you know, as we kind of move forward of the impacts of those decisions. We, again, we have already mentioned to the, you have an EMS advisory council and their role is to advise you. Um, and I've mentioned it to them at the meeting in September that I may come back to you at your meeting in December to say, uh, we need you to look at and form an opinion of changes that you might recommend to the system. Now, there may be none or there may be some, but then that would be brought back to you to say, this is what the EMS advisory council thinks of changes that are necessary or not in the system. You're still authorized to make those changes as the board. One of the things that we're working on, which I think has some degree of impact in this system, and our ambulance contractor has already, um, begun this process is, and again, you're always hesitant to say, oh, the software is going to solve it all. But there's a software platform we're already engaging, and that software platform allows the hospitals themselves to begin the process of scheduling transports. And that software is being populated with information about the client, their insurance coverage. And as we populate that, as we get more familiar with that, perhaps it'll serve a role in identifying folks that, oh, yeah, this particular person, because of the insurance that carries coverage that they have, needs prior authorization or not. Because if we can queue through the patients individually, say this one does, this one doesn't, for instance, the VA doesn't require prior authorization for the most part. And so as we get that software platform up and running, not only does it allow more information to be more selective on, okay, we need prior authorization on this one, but it also provides the hospital a little bit more efficient approach. Now, again, it's like any application software, it comes, you know, over-promise and under-deliver, so I'm cautious about promising things that I'm not quite sure that are going to come to pass. But we're working that issue. It's, I won't say the name of it because it's not relevant. But the idea is to partner with the hospitals when they want to schedule the transport, rather than the old telephone or fax, put a software platform in place so they can both be working on scheduling this. Whether that's two days from tomorrow, we're going to have Aunt Jessie go back to the nursing home and begin the process of reauthorization. Or if it's that urgent care, then they can work with that software platform. Just one of the dozens of solutions we're working on. Okay. Well, I like that. I like that option, too. So, and I didn't mean anything by that. And I do get the bureaucracy on the ambulance gets there, they've got to go tell them, go up, tell the nurse, and the nurse has to do what else. And it sometimes can take a half hour, an hour before the ambulance can leave. So I get that, and I know you've worked with the hospitals on streamlining a lot of that stuff, too. And it's just a matter of continuing to do it, and technology to help us do it better and more efficient. But, yeah, no, I'm glad we're still working on this, and we're not deciding today. But I still kind of stand pretty firm on two and three. But thank you. Commissioner Eckers. Yeah, thanks. I think you still know a little bit about the – I think you still know a little bit about the industry. So at the beginning, your comments were that, you know, you're tapped out and that others know better. But that's not true. These folks will – these, they'll eat my lunch when it comes to – Yeah, well, I'm sure he still does okay, right? Anyway, thank you for the conversation, and I do encourage us to continue looking at that, even if it means we push back that date. We're kind of a self-imposed thing. You know, it seems to me it's just – it's cost shuffling around a little bit, like there's a lot being borne by the hospitals on whether it's administrative, whether it's actual loss of income or whatever. So I think, you know, pushing it, trying to solve that issue, ultimately, lower cost in our medical industry is good for our residents, good for our taxpayers, whether – however we set that up. So for me, it's really about chasing that and making sure that the effectiveness of the system continues to work. I am a little concerned about the model that we have set up, as you said, has worked for a lot of years. The cost structures that we have set up on emergencies versus the other transports are done in such a way to provide balance for the carrier that we've chosen and at the same time provide availability of service in all kinds of situations. So if we go and start shiseling away at that a little – and I'm not saying that it's a good idea or not yet. I'm still waiting on that one. But we have to be careful how that starts to affect the cost structures otherwise. And I just want to make sure we have a good handle on that because that's our contract, right? So – and our residents depend on us having a good service there. So I just want to make sure we review that carefully, continue to get our input from our advisory group, not push things too fast. I know that there's cost issues. You talked about a billion dollars for the industry. Again, I'd like to have a little more definitiveness on that. And so I think there's still a work in progress and don't want to push things too fast. And, you know, it's hard – in deference to Commissioner Valla, who's not here, it's hard for an old guy to understand all of this stuff. So, yeah, so I just want to make sure that you can continue to dummy it down so that I understand it. This is tough stuff. So I appreciate your time and the hospitals who are here today and the folks that are here listening in. Continue, you know, engaging with us. This is a big deal for you all. I know that. And for us as well. So – and for our residents. Thank you. You're lucky Commissioner Valla is not here. I know. He'd be hammering me right now. So I told him I'd do this in deference to him. Commissioner Flowers. Thank you so very much. Commissioner Peters, you shared a couple of things that I've had in my thought process. I know we both have served on boards with HCA, and so I'm very familiar with the timing that we have to have in our emergency rooms or else it's counted against us through the ACA considerations for how you are moving patients both into the emergency room, whether or not you're diagnosing them, sending them upstairs to a room, or discharging them. And if you do it late, you get a red and all of that crazy stuff. I also know that some nursing homes will request transport as an extreme precautionary measure just in case the person begins to decomp quickly. So, yes, some emergency rooms get individuals with urinary tract infections that can be treated with antibiotics, a prescription for antibiotics, and sent right back. So that is considered a non-emergency transport. Others may have sepsis. They may have had a slip, trip, or fall. Maybe they didn't feel the pain or there was no extreme bruising. However, they have broken their hip or leg or whatever the case may be. So I know it can be – it's hard to go through all of that. I would also like to see if you have not already communicated with the AMA. Physicians are the ones who are writing the discharge based on their medical expertise. They're writing the discharge. And they're also writing in that script how that patient should be transported back to their facility, ALF, nursing home, home, based on their medical concerns. So, perhaps that is something that we could also use as a tool in our toolbox. Because now you have a claims adjuster who's on the other line. That's who's making the call. They're not a physician. They're not even – in some cases, they're not a nurse. I think it was Covington that started moving some of their nurses into those positions, especially for workers' comp cases and things like that, but to maybe have them become a part of that because now you have someone who is second-guessing a physician's medical order, which they feel is the safest way to transport someone to cause them the least amount of harm, hurt, or danger. So, perhaps, you know, involving them. I do agree, however, with Commissioner Peters as it relates to number two, certainly. I support Sunstar. I think they've done a wonderful job. I've had a chance to work in the medical field. I'm not a nurse or a doctor. I'm a county commissioner, but just realize some of the nuances that they're having to traverse with insurance companies, whether it's Medicaid, Medicare, or private insurance. People should still receive the best care possible because if you transport incorrectly, you could potentially cause more harm to the patient. And whoever sent an Uber for somebody who was hooked up like that should be ashamed of themselves because that is absolutely ridiculous, and that is a lawsuit not waiting to happen, growing to happen. So I appreciate your information. I look forward to continued discussions on this. If I have any additional questions, if you don't mind, because I just want to think about some of your presentation today, you've given us some good information to think from. But thank you so very much. And, again, like others have said, thank you to those in the room for your being here to kind of see where we're going to go from this point. And my desire is not to hurt any department, industry, or any of that nature, but to see what we can do to make sure patients are getting treated the way that they should or being transported the way that they should and that we're being reimbursed the way that we should. So thank you. Thank you, Mr. Chair. You're welcome. Commissioner Wiggy. Thank you, Chair. Yeah, I mean, I would be in favor of, you know, opening up the COPCN for non-emergency transport. You know, I don't think really, you know, government should kind of be in that field to begin with. You know, I think that should be in the private sector. I don't think it should be the burden of the taxpayers to worry about collecting bills from other people. So if the hospitals want to do that, I don't think government should be standing in the way of allowing them to do that. But I think the conversation is just one-sided, you know, because we're talking about, you know, having to increase the millage rate, but yet we're not talking about, like, the whole Sun Star contract in its totality. So I think, you know, going down that road, I think that's, you know, what we would have to look at, because it's my understanding that, you know, they're prepaid for a set number of rides. Yes? Is that a question? Yes. Yeah, they're prepaid for 13,000 rides a month. Right. So, I mean, I guess if, you know, some of those rides were shifted, what was it, 28%, 30% are non-emergency. I mean, if that was shifted to the private sector, I mean, then that would leave, I would imagine, at least 10% or 15% less rides given every month. And I don't know if they'd still be prepaid that same amount. So, you know, I think it's having to look at the whole contract, but I think we need to open up the COPCNs and, you know, allow hospitals, because this is a very unique system that I really haven't seen anywhere else in the state or the country where it's kind of like a monopoly created by government. You're correct. And, again, I wanted to, certainly we can look and will look at reconfiguring the system. This is a long-term strategy as opposed to, you know, do that next month. And the ambulance contract, which is a competitively bid contract, has to go out every 11 years. It went out last, I think, five years ago. And when that competitively bid process goes out, the assumptions that those bidders work under is a singular ambulance, both for emergency and non-emergency. And they base their bid on this is the expected call volume, this is the expected cost structure. So I would suspect that if we were to fundamentally change the system, we probably would need to put it out for RFP yet again. That makes sense. And I agree. I mean, it would take time. And, you know, I think talking with the insurance companies is a great, you know, value-add tool as well and should be done, you know, first and as soon as possible. You know, but with all the time that that's going to take, I don't think we can have, like, a November timeline for, like, the hospitals to kind of implement. You know, I think, to Commissioner Scheer's point, that that needs to be pushed back, whether it's January 1st or, you know, Q2 of next year. But, you know, it can't be as quickly as November. Let me clarify as much as I can. Come November 1st, we're not going to say no. We're not going to send you a Sun Star Ambulance. The only thing that's likely to happen November 1st, assuming we keep that deadline, is you'll still get the Sun Star Ambulance. We may have a more in-depth conversation with the patient lying there in the bed to say, hey, you realize you might find yourself getting a bill that you weren't expecting. That could be a conversation. We won't stop. It's the only ambulance service in the county, and so we're not going to say no. Who would have that conversation? I'm sorry? Who would have that conversation? Like, someone from the county would go talk to somebody in the hospital bed? Well, the way that would occur, typically the crew that, as they interact with the hospital or maybe as they try to schedule it, that the nurse at the hospital would say, okay, we can schedule this ambulance, but we don't have pre-authorization. So the details of that conversation still have to be worked out. But at the end of the day, you want to have an informed consumer about, where did this $800 ambulance bill come from? I thought my insurance paid for this. Right. Yeah, no, I mean, I agree with what you're saying, and very valuable information you shared today. I think, you know, slow it down, you know, maybe push it back a little bit, and, you know, exploring the insurance and opening up the COPCN. So those are my thoughts. Thank you. I have something on the date. I don't think you have me understanding. I don't know, going into season, right, so the hospitals are going to be the busiest they are all year round, starting in, you know, January, February, March, they're packed. And so I don't think the November 1st is a good timeline. I just don't. And are we going to start putting the cost on them now, November 1st? What does that all mean, that last bullet point of November 1st? What does it all mean? Remember, we've been asking the same question in scheduling an ambulance for five years. Do you have a pre-authorization number? And it was sort of blown off. No, we don't schedule the ambulance. No, we don't schedule the ambulance. And so the conversation was sparked with the letter of the date of, I think it was July 1st. We moved that to November 1st. And since then, we've had any number of conversations with hospitals and third-party payers. And so the effect of that date achieved its goal to get people talking about this. Again, we are not planning to refuse ambulance service. If in other counties, in other areas, if it was a private carrier, and this is happening every day, is say, if you don't have prior authorization, we're not sending you our ambulance. AMR, for example. I'm not going to pick on AMR. But AMR, in many cases, on non-emergency, would say, if you don't have the prior authorization, we're not coming until you have prior authorization. It's not happening in this county. That's not going to happen because I don't want that person that went from the nursing home to the outpatient ER and then needs a transport back to the nursing home. We will move the patient. You're going to move them because we cannot expect them to have to deal with that patient while they wait 24, 48, 72 hours for preauthorization. So I'm not sure I understand what all that means. You're just – what does that mean? They're not changing their billing on anything. It's like consumer protection, what he was saying, about notifying the patient. And then November 1, like you said, achieved the date of getting these hard conversations because right now, you know, others would say, well, you know, let the levy pick it up, you know, or the patient, right, because, you know, they need to get that bed free. Well, it's not that easy. There's so many different complexities as we went through today that we've got to come up with a series of solutions, you know. And so he put a date out there that achieved that goal. November 1, all he's saying is that right now then let's do a consumer notification for the person that you may get a bill. If it's not preauthorized, you may end up getting a bill. We can talk about that date. I mean, it's no magic, but it's not changing the billing. It's occurring right now because the person's still getting a bill right now, okay? That's the problem. They're either getting that bill and paying it or they're getting the bill and it's going to collections and then our EMS levy picks that cost up. That November 1 really isn't doing anything at this point. Well, the reason I'm here today talking to you at a workshop is probably because of the letter I sent back in July that put it on people's radar screen as an important topic. It's an important topic. It forced the conversation, which is a good thing. It's a very good thing because, I mean, as I'm a business person running a business, nursing home, hospital, whatever, well, I'm focused on the things that impact my bottom line and that's their role, not thinking about that somebody's paying that other bill, right? But it's not making them the payer of last resort and we're not billing the hospitals any more money. No, we would have to have an agreement for that and only certain providers even have payers last resort as an option. So we're going to have to work that. And some hospitals are already choosing to do that, not that we contract with them or obligate them to do that, but some hospitals are choosing to do that. Yeah, I think we've got some great hospitals here. Thank you. You're welcome. All right. Jim, I've got a couple of comments here. First of all, great discussion, everybody, a lot of really good comments, a lot of really good questions, and I appreciate all the hospital staff being here and Sunstar. You all are great partners, so thank you so much for being here. I really agree that we really need to work on item number two, really trying to work with the insurance companies. I think that's probably where the silver lining or blue sky in this is, is we need to get a better understanding and better relationship with those people. So I would encourage you, I don't know if there's meeting dates already scheduled, but I think that's one that's really got to be focused on really hard. And I also, I kind of like the idea, like the conversation about opening up the COPCNs. I mean, the one thing that I don't like about the system that we have is that it really is a government monopoly, and it doesn't invite competitive innovation. And that part of it I don't like. So I think if we did consider opening that up, it might breathe some of that competitive innovation into the system. So I really would like to have some more discussion about that. And then as far as the deadline is, you know, November 1st, it sounds like that's more of a soft target than a hard target. So I'll kind of leave that up to you guys to sort of figure that out. But I just want to make sure that we're working with everybody in concert and keeping our relationship solid and making sure that, number one, the patients are getting where they need to go. That's the number one. All right. So anything else? I think they think that horse is officially dead. All right. So all right. Thank you, Jim. Appreciate it. All right. So now we're going to move on to the people first. C-D-B-G-D-R policy discussion. One day I'll get all of that mouthful. Thank you, Chair. Yeah. Matt Spohr, Assistant County Administrator. Nothing like a complex insurance prior authorization discussion to set the table for. To lead right into this. Yeah, to lead right into this. Right, because this is not a big deal at all. That's right. So I'll be quick. I'm going to invite right now Jenna Abbey and Danny Permar up here from Horn, the Director of Government Services. It's Jenna. And Danny's the Senior Manager of Government Services. I'm going to cover the first two slides, and then I'm going to hand it over to them to have a broader detail and policy discussion with you all. So just to kind of, I guess, reframe where we're at, we spent the last two weeks internally several meetings with all of our internal stakeholders to really talk about best practices and policy recommendations for you all based on not only your approved action plan, but also what's worked in other communities. So, you know, we continue to look at other counties around the state of Florida to see what's working, what's not working, what are the lessons learned, and that's how we've created these policy recommendations. Just to remind you, and Commissioner Peters just was contacted this week about when are we doing infrastructure, when are we doing this. We're focused on these five programs right now, but we will, once we get these up and running, we'll be back in front of you to have another policy discussion on the other programs. So today's programs that we're going to talk about are detailed here on the slide with the dollar amount. So we're talking about $620 million of the $813 million. More specifically, these are the five programs that we plan to roll out October 20th. So once we have these up and running, residents can start applying for these on October 20th. And you see the two construction individuals down there in the corner, the homeowner rehab and reconstruction, and the local landlord rehab and reconstruction. We know there were some questions about that the last time we were in front of you. So I'm going to turn it over to Horne now. We're going to kind of start there. Then we're going to talk about just where we're at, and then we're going to talk about each of these five programs and our policy recommendations. Just so you know, at the end of the presentation, we also have a policy recommendation slide. So you can either talk about each one when we talk about each five, or you can just soak it all in, and then at the end, we can recap those five. It's up to you, Chair. But I'm going to hand it over to Danny. Danny's going first. Morning, Danny. Morning. Thank you, Matt. Thank you, Board. A little bit of background about myself. I will be serving as a program manager for the People First program. So this $620 million across these five programs I'll be managing and helping implement. I have a background, actually, in nuclear engineering, MS from University of Florida, Florida native. But over the past eight years, I've been in the disaster recovery world, specifically in individual housing. So that's support from the USVI, North Carolina, and programs all across Florida now. So nearing 12 different hurricanes that I've supported in different programs. So what we're going to go over here in about 15 slides is kind of the overview of the People First program. This is the umbrella program for these five different individual programs that support both owner-occupied residents of Pinellas County, local landlords, as well as renters that can kind of establish themselves into these five different programs. So when we're talking about the homeowner rehab recon and local landlord rehab recon, those require us to procure general contractors for this program. So these awards aren't going directly to a homeowner for these two programs. Those aren't dollar amounts in a check to an applicant. There are the reimbursement programs for repair damage, as well as disaster relief to help offset costs for rent, mortgage, and utilities that will be checks to applicants. These two programs actually go through award process for general contractors to complete the repairs to those homes. So where we are right now in starting with this program design, we'll start drafting out the request for proposals for general contractors to be participants in this program. HORN will implement and manage these general contractors throughout the life of the program. We will work with them, coordinate with them on assigning awards. We monitor their progress. We monitor their scorecard and their performance as their support and residents here in Pinellas County. So as we start this drafting of the RFP, and we'll get that into the next slide of what that RFP actually looks like, we'll perform our cost reasonableness assessment, that independent cost assessment, so we know what contractors can bring the best value to Pinellas County as well. Publish that RFP, and then kind of follow that typical request for proposal process, where we publish in that on our Pinellas Recovers website as well, our overall people first. So there's a place for other interested parties to go in looking to how to become a contractor here to support these programs. At the end of that, when we select these GCs, we'll actually establish a program pricing that these general contractors will operate under and set those GC contracts so we have an open, competitive process and establish pricing for these based on our independent cost estimate as well. I have a question. Yes. So just some understanding. So let's say, I was talking to somebody yesterday, and they feel like they finally came up with a plan to fix their house. And so they want to just, you know, I think they have a two-story house, but the top floor wasn't a lot. But they're going to make that top floor, it's elevating it, just no longer using the bottom. Do they have to use your contractors that you contract with to fix that house for her to be eligible? Correct. Once they are eligible for the program, if their award is to be elevated, that is something that our general contract would do. However, if they're completing that elevation themselves and looking to reimburse, there's a separate program for that. It's a separate, okay, okay. So, all right, well, since she hasn't started. If she hasn't started and wishes just to have that elevation done or those repairs done, and if they're eligible for the program, that would be an assigned general contract to complete that. Okay. That's what I wanted to confirm. So, someone who hasn't started yet, this could be the appropriate way to do it, and she'll probably get more bang for her buck by using your contractors. Correct. Essentially, we want to allow an applicant to, you know, we won't hand a check to an applicant to go pick your contractor, go do your work. We will assign that contract. So, it's a lot like Citizen does. Same thing. Okay. It's what they do. Trust me on that one. So, are you attempting to select one general GC, and that general GC will select its subs, or are you looking, hopefully, that you'll have several GCs that may apply through the RFP process, meet the needs, and they will select their subs? Yeah, and going back to what we were looking at with the action plan, we plan to serve 1,100 applicants in this HRP program, additional in the local landlord program. That is not going to be one general contractor that can do all that work. We will look to establish here, when we draft this RFP, get the, you know, support from county input, from purchasing, Matt's team, legal team, to kind of align that RFP, establish what, you know, the minimum qualifications are going to be, the selection criteria to protest procedures, etc., to all comply both with 2 CFR Part 200, so federal requirements, plus county requirements, to then obtain these general contractors. So, if that is 12 to 15 general contractors that come on board, based on the open competition from that RFP, those would be the ones we would select. Those general contractors would then procure or, you know, establish a subcontractor base, a lot of local trades that will help, you know, complete the projects here in the county. Thank you. Commissioner, just to add to that, I mean, what he just put up there, these are federal guidelines, which means the GCs, and therefore then the subs, have the reporting requirements to comply with these federal guidelines, and that's key to be able to make this program work. While we're on the topic of GCs, you know, I guess I'll just ask. So, we'll have more than one GC besides LeMoyne? Correct. Yes? Yes. Okay. Thank you. Go ahead. And so, when we kind of talk about this draft RFP, again, following these federal guidelines, setting up, talking through the county input on what those protest procedures look like, establishing deadlines, getting that RFP, and then determining what that pool of contractors looks like. With that, part of that scoring and selection would actually be independent reviewers looking at the overall narrative proposal. That would be the qualifications of the firm itself, that general contractor, the qualifications of their staff, the technical approach that they would take to complete these projects here, as well as a cost proposal that they would submit. We would compare that against the independent cost estimate to see if they're in the ballpark within a plus or minus range of really being able to support here in Pinellas County and still see that competitive market, you know, following an RFP process. So, we'll also have a protest procedures, DGC's right to protest. We'll follow, you know, follow similar county guidelines for that. And as Barry was alluding to here, the minimum qualifications for these contractors would be as follows. Something with five years of residential experience in construction field, current license within the area to actually operate here in Pinellas County. And then three years, these two bullet points I want to emphasize here, three years of experience in this CDBGDR world, as well as demonstrated experience with compliance and federal reporting. That is important that we're bringing on the general contractors that have the experience to implement these programs, have the experience to work with subcontractors and trades to be able to complete these projects and follow federal guidelines that we will be implementing and we have to follow as well. But we will have those, you know, general contractors market and they will utilize subcontractors here, local in the area, as well as trades in the area as well. And that's because I can see that, like, oh, my gosh, who are we going to get to do that? Right. But that's where the subs come in. Okay. You've got a general contractor that's got the capability of tracking and reporting on this, which is key for us to meet our HUD guidelines, right? But then they're going to sub with local work to get the work done, and that's how that's going to elevate. But, you know, with any type of federal program, if you don't document it, it did get done, you know? And so you've got to have the experience to be able to comply with these HUD guidelines. I'm good on the reporting piece. That's a HUD guideline, the minimum three-year CDBGDR experience. The reason I'm saying that is because while we've had storms here, we've not had them to the magnitude for the reconstruction and rehabilitation we need now. We may have some large firms that we typically deal with who don't have three-year CDBGDR experience. But now we're looking at contractors from outside of our state who qualify because maybe they've had this in Carolina, North, South, Virginia, et cetera, or fires. So now those opportunities are going to people whose businesses are not established here. So that's just a concern I have because, you know, I hate to say people can make a dime off of someone else's misery, but if I want to give jobs and money, I want to give it to people who are here in the community and not have somebody come from another state to be my prime, and then others have to be subbed because they've not had three years of experience because we haven't had it to this magnitude. Understood. Thank you for that, Commissioner Flowers. So these are not HUD requirements. These are recommended minimum qualifications for this RFP. This is one of the things we'll work closely with the county and Matt's team in purchasing to really dial in before this gets published. But the thought behind requiring three years of CDBGDR experience is, to Barry's earlier point, as a CDBGDR-funded program, this is more than just building houses. If we only select GCs who can build houses and build houses well, we're going to miss some of the federal compliance requirements. So the idea with the CDBGDR experience in particular is to select general contractors who aren't using Pinellas County's CDBGDR portfolio as their first rodeo. They're familiar with the reporting requirements, the bedside manner required to deal with homeowners who have gone through a really traumatic experience, complying with all those documentation standards, in addition to building quality homes. And I'd like to go back, Commissioner Nowicki, to the comment about LeMoyne. I want to be really clear. LeMoyne was on HORN's team, and their scope on HORN's team is to perform construction inspections and damage assessments. So in that role, they will not be able to bid on this and be a general contractor. So while they are a general contractor sometimes, in this particular program, LeMoyne will not be a GC. And if you don't mind, once you kind of go through this process, I'm just interested in how many of our local contractors that apply actually meet the minimum three-year CDBGDR standard. Again, I just want to make sure local folks get local work. Sometimes I know you cannot, and I fully agree with what you're saying. And you want people who are experienced in the global aspect of the project, not just building homes. But I also know since we've not had this happen to us before, persons may not have the experience in it or maybe, you know, I don't know. But anyway, I'd just be interested. I'll be curious. Thank you, Commissioner Flowers. Thank you, Chair, and thank you, you know, for clarifying that. And in regards into the minimum three years, I mean, I think that's for the prime contractor, correct? I think that's maybe not even enough. I think there should be maybe because that's just three years, but that doesn't demonstrate, you know, that they've actually had built homes or constructed. I mean, so maybe you could even look at adding 250 homes completed or 500 homes completed in those for the prime contractor to really show that they've completed stuff, just don't have experience dealing with the program. They've actually done the work. So that's something I would be in favor. Yeah, understood. And when we look at the, you know, kind of that narrative proposal that that team puts together, the qualifications of firm and staff come into play, that's weighted at, you know, say, 50 points of their overall score. So when our independent reviewers are looking at that, they want to know how many houses have you completed in other programs? Is that three years of consecutive work? Is that three years across, you know, the past 20 years that you were kind of, you know, foot in the door with this kind of work? A little bit of explanation of that three years experience as well. You know, it's kind of written, it can be written into that RFP, especially working with purchasing, that these teams can be kind of partnered up with somebody. So if a local is wanting to partner with one of these primes that have that experience, but bring that local presence in as well at that point, subcontractors are welcome to, you know, reach out to us. There'll be something on the Pinellas Recovers website for general contractors. Are you interested in the program to kind of coordinate even after the fact, you know, that the contractors were selected, that those subcontractors and trades can kind of work with these GCs, send that list to GCs. Here's some local trades subcontractors in the area that are willing to work on this program. That three years experience also could be the principals, owners of that organization now with that firm. So they could have received experience in another firm, bringing that to a new company that shows that that principal in charge has that three years experience, as well as not serving just as a prime for those three years, but serving on a program nonetheless that, you know, illustrate three years of CDBGDR experience. I don't want to get into this anymore, but I just, you know, partnerships are important. So you could have a local contractor and a contractor from outside the area that does have the experience. They could partner up and bring both elements to the table. And then I think, you know, again, sense of the numbers that we have. Do you have any sense of that? Like, are we going to have, we've done this in other parts of the state. So do we have issues there with these same kind of things or are we thinking we're going to be okay? That's the first question. The second question, and if we're not with qualifications, can we revisit and open things up in a different way? I just, I have no idea. We're going to get two people or we're going to get 200 people. No, we will have an overabundance of applications where we will have to parse down to a level of, you know, what is accessible, what we actually need to serve 1,100 applicants. So whoever's making that decision on the contractors will select ones that have more experience. Correct. If we have an abundance of them. So we'll just let the process take it. Yeah. Between the narrative and the cost for those duties. Okay. Thank you. Get in and out. Correct. I think Commissioner Shearer has a question as well. Yes, Chair. Thank you. Just on this minimum experience, I am thinking like Commissioner Flowers that we're just going to end up with a bunch of out-of-area contractors working here because they're the only ones that have that experience. And, you know, this is a big contract. It's a lot of money. We're paying our advisors very well. I don't see why we couldn't have in there three years experience or maybe you have an online tutorial explaining compliance to our local contractors so they can take a class or continue an education to qualify to help rebuild our homes. Our local contractors are going to be not – I don't see them being welcome into this, and I think it's wrong. So there should be a way to get them up to speed. Contractors are smart. They can figure it out, and they can comply. We just have to give them a chance. That's all I really have to say about that. So I hear what everyone's saying, but based off of our research, staff's research, these contractors are in Florida right now. They're in communities right now. They've been in Lee County for a while. They've been in Sarasota County. When we talk about the three years experience, those counties and those programs that do not require that are going to have more compliance issues. We're going to need to supervise more. We need people that have experience if we're going to get this up and moving quickly. But to Commissioner Flower's point, and I think Edgar said this as well, they're going to bring in a team. They're going to bring in the subs. They're going to bring in the local. There's going to be plenty of jobs right here in Pinellas County as a result of this program. We just want the prime to have experience and know how to run a federally procured program so that we have less compliance issues. And they're here right now in the state of Florida. They might have started or originated outside of the state of Florida, but they're here now. And we'll track, and we're going to push local work, you know, that when you see a job site, it's going to be local firms doing that. And, you know, it's open and competitive, but it is going to focus back that. So that's different, the work versus the GC. All right, moving on from procurement, People First program ultimately here to serve low and moderate income households. So what that looks like is kind of advertising and making sure folks that are signing up for the program know what this eligibility requirement are, the five programs where they fit if you're up to 120% actual middle income that you may be eligible for, the homeowner rehab, recon, home buyer, home reimbursement as well, and then the 80% LMI folks being eligible for disaster relief and local landlord. What that means for local landlord is actually the incoming tenants that local landlords would then put their unit up for rent and at an affordable rate for income eligible applicant. What we are targeting here for the People First program is actually an October 20th start date. So what that looks like for us to start on October 20th is finishing up our overall program design, our policies, our program guidelines for this program, and then what it looks like and how to apply on October 20th is by visiting the website, the recoverpinellis.gov website. It is actually being worked on right now where there's an application link that would go right into our portal for folks to apply to, calling a hotline and then in person at both the north and south location here in Pinellas County. These are set static locations that will be operable for the period of the People First housing programs where our case managers, case workers will sit, be able to work with applicants throughout the process, you know, from start to finish of their projects. In addition to these two static locations, we will look to work with municipalities to set up pop-up locations in the months of, likely in the months of November and December for, you know, Mondays, Tuesdays, Thursdays, at Largo, et cetera, where we can set up and pop up in a county library to get, or a city library to get more folks signed up into the program and spread that message as well. Two and a half weeks. That's quick. We didn't publish the hotline because everybody would start calling it, you know, today. These locations are not open, so please don't show up there today, you know. But they were trying to show you the expediency that they're trying to get these programs up to try to help people. This is extremely quick, and I'm really proud that they're able to stand this up and have these in-person, individualized assistance for our residents. Thank you. And I can confirm now that these are actually executed leases, so we're actually working on furnishing out these and getting the Internet in there for us to start working. So we're ready to go. A couple of documents that we'll list on the website and work with applicants on, it's important for them to understand what it means for not only when we talk about general contractors following requirements, applicants have requirements, applicants have requirements as well in terms of documentation eligibility. So that being that identification, whatever form of government ID that may be, if you're in any kind of ownership program that you have a proof of home ownership, proof of primary residency here in Lee County, any kind of third-party authorizations that may be required, maybe that's a co-owner consent, a landowner consent form to move that applicant forward, as well as income documentation that the applicants are providing last year's tax returns as a way of confirming that they're income eligible for the program as well. We have a little PTSD on third-party authorization right now. With that, I'll actually turn it over to Jenna to kind of talk through each one of these different programs and the policy recommendations to go along with it. Thank you, Danny. Thank you, Commissioners. So the following slides, we're going to talk a little bit more in detail about the policy eligibility requirements, specifics about each of these programs, who they're geared towards, and what they provide. Some of this will be a refresher, because a lot of this is outlined in the action plan, and we've talked through the action plan several times with you all. On some of these slides, you will see policy recommendations highlighted in the bottom of the slide, and those are the things we'll circle back to on the final slide. And as you recall during the action plan, there were some questions that you all had, and we said, we're going to get to that when we get to program policy. We're going to get to that when we get to program design. We've arrived at program policy and program design, so those policy recommendations you see are some of the more nuanced points of these programs that weren't fleshed out 100% at the action plan level. So starting with the Homeowner Rehabilitation Reconstruction Program, this program is likely the recovery pathway for homeowner occupants who have not started repair of their storm-damaged property with incomes up to 120% AMI. So this program will launch on October 20th. We will prioritize vulnerable households in this program, vulnerable households meaning those at incomes 80% or below with an age-dependent household member, elderly or minor child, or a disability in the household. Middle-income households, those at 80% to 120% AMI, have a set-aside. There's $98 million set aside in this program to ensure that our middle-income households also have access to this assistance, and those will be processed on a first-come, first-served basis. Other qualifying factors for this program include you must have owned and occupied the storm-impacted property as your primary residence at the time of the qualifying event. You must still own that residential property. It must be an eligible structure type. We're looking for single-family permanent homes, no houseboats, campers, tents, etc. And the program will provide up to $375,000 to repair, reconstruct, or replace the storm-impacted property. This is one of those programs that will be served by the GCs procured under that open procurement. So, like Danny mentioned, that $375,000 up to is not going in people's pockets. That benefit will be provided in the form of a repaired, reconstructed, or fully replaced house. Applicants who meet individual baseline eligibility criteria that we just talked about, their income level's appropriate, they owned, they occupied, it's their primary residence, will qualify for an award. And the policy recommendations we have on this slide kind of detail how the program will determine who qualifies for what. So, this slide talks about stick-built structures. If this is a stick-built structure, not a mobile home, if you have a structure that's already been condemned, demolished, deemed infeasible to repair by a licensed structural engineer, or a structure that requires elevation, you will qualify for a fully reconstructed home. If that home requires elevation, it will be a reconstructed, elevated home. You will qualify for a reconstruction award if your estimated cost to repair is equal to or greater than 75% of the market value of your structure, or greater than $150,000. You will qualify for a repair if the inverse of that is true. So, if the estimated cost to repair the property is less than 75% of the market value or $150,000. We are proposing a minimum award. There is an administrative burden to administering these programs. So, to ensure we're not paying more to administer than we are offering in grant funding, we're suggesting a minimum award of $25,000 worth of repair. And the structure type you get, the recommendation is to provide like-for-like, not in terms of finishes, square footage, luxury items, but if you had a CMU block home pre-storm, CMU block home post-storm. If you had a stick-built home, stick-built home. If you had a mobile home, you'll be awarded a mobile home. Moving on to mobile home units, manufactured housing units. I know this has been a really hot topic here in Pinellas. So, those mobile home owners who reach eligibility threshold criteria, primary residence, own, occupy, below the income levels, will receive one of these two awards. They'll either get, if they own their land, the decision tree on the left-hand side of your screen. So, mobile home owners who own their land, we're going to first look at their damage level. If they have damages greater than $15,000 or a mobile home unit that is older than five years old, they're going to, that second decision point, we're going to look to see whether or not they require elevation. If they have more than $15,000, older than five years old, and require elevation, we'll offer them a stick-built elevated reconstruction on-site, if zoning allows, at their current location. If zoning doesn't allow, we will offer those homeowners a mobile home replacement on an alternate parcel. The inverse, if they have damages less than $15,000 and a mobile home that is newer than five years old, we'll repair that mobile home unit on-site. The other big category of mobile homes, those owners who own the unit but maybe lease the land, do not own the land, is the decision tree on the right. So, for those owners, the same thresholds apply for repair. If you have less than $15,000 worth of damage and your unit is newer than five years old, we will repair that unit on-site. If you have more than $15,000 worth of damage or your unit is greater than five years old, we'll do a check to see if your home needs to be elevated. If your home needs to be elevated above five feet, we will offer you mobile home relocation, which means a brand-new replacement mobile home unit on an alternate parcel that does not require elevation. If your mobile home does not need to be elevated above five feet, we will replace that mobile home on-site. Yes, sir. Both scenarios where it says yes and it just says repair, might it also have to be elevated? That's a good question. No. If the mobile home has to be elevated, it would go down the elevation path. So it could be a newer one that still needs to be elevated. You'd throw it over? Correct. Because the cost of elevation is going to be greater than that $15,000 threshold. So when you factor the cost to elevate in, it's going to naturally go down. So the elevation piece takes it above the five feet, becomes an engineered structure. Got you. Okay. Thank you. Good question. Thank you. All right. So moving on to the Homeowner Reimbursement Program. The Homeowner Reimbursement Program is probably the recovery path for you if you are a homeowner occupant of Pinellas County who has completed repairs on your storm-impacted property and paid for those repairs at least in part out of pocket. This program is available on a first-come, first-served basis to households with incomes up to 120% of the area median income. Other eligibility criteria that apply to the Homeowner Reimbursement Program include you must have completed all your repairs before you apply for assistance. We want fully permitted repairs. You must have owned and occupied that storm-impacted property as your primary residence at the time of the event. And same thing, the storm-damaged property must be a permanent residence, no campers, houseboats, et cetera. This program does provide cash directly to awarded applicants, up to $50,000 in eligible reimbursement for repairs completed that have not been covered by other programs. So these repairs were not paid for by FEMA or SBA or insurance. Our policy recommendation here, one of those more nuanced things that wasn't addressed in the action plan level, is we are recommending that reimbursement stands completely separate from the Homeowner Repair and Reconstruction, sorry, too many R's, too many R's, separate from Repair and Recon. So you're either all the way done with your repairs and you can apply for reimbursement, or you have repairs left to do, in which case you would apply for the Repair Recon Program. Next program we're going to launch on October 20th is the Home Buyer Assistance Program. This program is probably the recovery pathway for you if you are not a homeowner but reside in Pinellas County and are interested in becoming a homeowner. This program is available to households with incomes up to 120% of the area median. Other eligibility criteria that applies here, you have to live in Pinellas County. You cannot own other residential property. You can't have a home already. This isn't a second home buyer program. And you must be able to obtain first mortgage financing. Assistance for this program will be prioritized for applicants who have a direct impact from one of the qualifying disasters. After those prioritized households are served, we'll go first come, first serve for those households up to 120%. This program provides up to $80,000 for down payment assistance, closing costs, basically to fill the gap between what is required to purchase a home and what makes that home affordable for these low- and middle-income homeowners. This, too, will not be cashed directly into an applicant's pocket. These funds will be wired, excuse me, or provided directly to that title company where closing is going to take place. One policy nuance recommendation that was not included in the action plan. In the interest of keeping people in safe and resilient housing, we are recommending that this program prohibit people from purchasing mobile home structures that are older than five years old. Just things keep popping in. So back to the slide that showed the owning the mobile home versus not owning, you're renting, and there's one owner. What requirements? We're putting money into these individual units, so to speak. How are we monitoring what the landlords are doing? I mean, in other words, we could be putting money back in, but the landlord may be deciding, so we're just going to basically transport to another site? Is that what we would do? No. So that's a very good question. If the applicant does not own the land where their mobile home sits, before we proceed, we're going to get landowner consent that we can set an MHU there and that MHU can stay there for the length of the compliance period, which will be five years to own and occupy that home as a primary residence. In instances where the landowner cannot or will not consent, that person would qualify for a replacement MHU on an alternate parcel. Because that five years is a significant decision for a property owner, and yet it doesn't waste money if we're putting investment there and then all of a sudden they throw us out. Correct. Thank you. No, it's a problem. Commissioner, do we have a question? Thank you, Chair. Just in the homebuyer assistance, you made a, on who would qualify, you noted like, who live in Pinellas. So is that all Pinellas or excluding St. Petersburg? Excluding the city of St. Petersburg. Thank you for the question. If they qualify, we're going to, we're recommending that we allow them to purchase a home in St. Petersburg if that's the home they find, fall in love with, and qualify to purchase. But to pass that threshold eligibility review, you must have lived in Pinellas County at the time of the event. Outside of St. Pete. Outside of the city of St. Pete. Yes, sorry. Thank you. All right, next program, local landlord program. This one really closely tracks with the homeowner repair and reconstruction program. So this program is the recovery pathway for you if you are a small, we're targeting kind of mom and pop, small landlords who have a storm impacted single family property that you'd like to have rehabilitated or reconstructed for purposes of leasing it to a low income tenant at affordable rents. This program is not income-based for the landlords who own the properties. Income will be considered for tenants who occupy the properties after the homes are rebuilt or repaired. So this program will be implemented on a first-come, first-served basis for landlords starting October 20th, 2025. Other eligibility criteria for these landlords, you have to own unoccupied rental properties within Pinellas County, not in St. Pete. Thank you, Commissioner Nowicki. And you must agree to lease those units to rent and income-restricted tenants. Just like the homeowner recon repair program, this program does not put cash in people's pockets. It provides benefit in the form of reconstructing or repairing that storm-impacted rental unit at a value of up to $375. The nuanced policy recommendation here that was not included in the action plan is we are recommending that one of the eligibility criteria be that landlords cannot own more than five total rental units to keep us targeting those small mom-and-pop landlords and that after construction is completed, landlords must use high home rates for rent rates for those units, which here in Pinellas County for a three-bedroom is $1,581 per month for a three-bedroom. Those rates are controlled by HUD and updated annually. This really will address our short-term rental folks that can't recover. And so this is an option for them. Larger ones can fund them, put them back on the market, get whatever they can get for it. But if they don't have the capital to be able to do that, this is a way for them to repair their units, keep them income-restricted, which helps up our residents for five years, but now they've got the unit. It kind of moves it back into the residential type. It gives a community benefit, but it helps them get their unit back. So please forgive this one. Along the Strip, there are some quote-unquote motels, because they're not hotels. They're motels that are apartments, really, for individuals who have been residing there. They are lower income, five units, maybe six units. But the name of it has the word motel in it. Are those individuals that may qualify for this? Because several of them do have people that live there. You know, it's not a motel. Sure. And some of them were severely damaged, you know, during the storm, and didn't have maybe some of the financial means to get things kicked back off, you know, once the storms were through. So would they fall under this? I think the determining factor for that, Commissioner Flowers, would be how many individual units are in that building. So regardless of the name of the complex, this is intended to provide permanent year-round housing. HUD defines single family as buildings with up to four units. So duplex, quadplex, triplex would all count. But if all five of your units are in the same structure, you have a multifamily structure that's not eligible for this program. Yeah. Commissioner Flowers, Ryan Flannery, Program Director. Also wanted to highlight, so this is kind of something we've talked about quite a bit. So you can technically, you can technically, if you own a condo, for example, or you own a townhouse and a large grouping of townhomes, potentially be eligible for this program. One thing we've discussed is capping the number of units in any given structure and looking more at the structure because there are apartment scenarios where technically HUD would consider to be a single family unit. A traditional, you know, definition of a single family is one to four. And we're focused on that, but we also don't want to preclude, and this is why I'm highlighting it, we don't want to preclude owners who maybe have a townhouse and a larger group of buildings from being able to apply because that could be a good affordable solution for somebody. But this motel scenario, based on the policies we've established so far, I don't believe would apply. Thank you, Chair. Yeah, I mean, I kind of respect the merits of this program, though I guess I just have a couple concerns concerns with it not allowing like a duplex or a triplex because, I mean, I know lots of, you know, woke mom-and-pop landlords having a real estate business that, you know, shelled $20,000, $30,000 out of pocket, renovated their units, got their tenants back in there, but because their two apartments are next to each other in the same structure, they don't qualify, but yet somebody that could have $5 million homes on the beach who flooded, they're going to get up to $375,000 in repairs because they left their units unoccupied because they maybe had the cash and didn't have a mortgage on the property and didn't get any requalifications. And so, but, you know, but if they agree to do income-restricted tenant for five years but could have been renting out the house on the beach for $20,000 a week, you know, I don't, you know, I don't know how I feel about that because you're almost punishing really local, you know, someone that owns a duplex. I don't know. That's just my thoughts on it. Apologies for the lack of clarity. Duplex, triplex, and quadplex are eligible. Yeah, I'm sorry. I thought you said they weren't, but... Oh, my bad. I may have. If I did, I misspoke. I apologize. Okay, thank you. Thank you. And then last but not least, disaster relief payments. So this program may be the recovery path for you if you experienced a financial hardship as a direct result of these disasters. This program is limited to households up to 80% area median income. Homeowners and non-homeowners are both eligible to apply to this program. In addition to income, other eligibility criteria include that you must demonstrate that you had a financial hardship as a result of the disaster. So that is something like job loss, displacement, temporary loss of income. This program does provide cash to eligible applicants. Checks? Cash? No cash. We don't have a cash machine. But cash in hand, up to $15,000 to reimburse for a maximum of six consecutive months of payments they've already made for rent, mortgage, and or utilities. The nuanced policy recommendation that wasn't in the action plan, we are recommending that the applicant demonstrate that the hardship occurred within 60 days of the storm. So if you lost your job as a result of the disaster, you lost it pretty close to when that storm made landfall, not a year later. Okay? And then this is just a slide that summarizes those policy recommendations that we've talked about throughout the way. So I will pause here. There's nothing new here. These are all the nuanced things we talked about as we talked about the programs to see if there are any questions or comments from the commission. So commissioners, what they're really looking for here is consensus around these are good policy decisions. You may say, I don't like number four and you want to change that. Well, then let's talk about that because these are the guidelines that then they're going to use to apply the program. So rather than bringing back a resolution, delaying it three or four weeks so we can get it on an agenda and approve it, we're trying to do this in real time so we can stand up these programs. But it's a lot to take in. But these are the guidelines that are recommended. If you are, if you're good with these, then we get consensus and we move on. On the 60 days, I think on the last one that you mentioned, the rationale behind 60 versus say 30 or 90, just as arbitrary numbers. Any? The rationale is just it was close enough to the disaster. It could easily be 90. It could be 30. If you have a recommendation on that, we'd be happy to consider it. We just wanted to keep it within a reasonable amount of time after that disaster made landfall. And we know, you know, some of the impacts are lingering. So 60 days just felt like a reasonable amount of time to demonstrate impact as a direct result. I don't know what wording we could use to provide a little flexibility if this came in at 63 days, then they're not eligible kind of thing. So whatever. Again, not trying to be nitpicky about it, but just providing some flexibility on that. No, that's a great point, Commissioner Eggers. So what I didn't tell you is every policy up here that is a policy recommendation, not a federal regulation or a HUD requirement, Pinellas County has the authority to authorize a policy exception. So your 63 days example would be a great candidate for something like a policy exception where the county's team, Matt's team, would consider the unique case facts and say, yeah, we'll issue an exception for this. So we have that built in? Yes. For every program we've talked about. Thank you, Chair. I guess for the, you know, circling back for the local landlord, you know, who's going to oversee that they're rented for five years at the affordable price? That's a really good question. We haven't gotten into that too in the weeds yet, but I would anticipate it would be a combination of the Horn team and the Pinellas County team. Commissioner, through CDBG, we monitor programs all the time. So we have, we have compliance processes internal to our team. I, I also want to introduce Anna. So Anna's on our team, our newest, she's going to be our compliance manager. And I'm going to, how do you say it? Sarah Gula. I know I butchered it. But anyway, so she's going to be our, she's going to be our compliance manager. So this is our internal team that's going to work on that with Horn about how we're going to continue to monitor these for that five-year period. Remember this program we're standing up now is a six-year program. So, you know, it's going to, it's going to be around a while. And then the, our actual program managers, Erica Henry, she starts in a couple of weeks. But this, this is our internal team that will work with them and determine those processes. And then I guess for that, thank you, Mr. Burton. And so I guess if enough landlords like, well, I don't want to, you know, agree to that and then nobody or all the money is not used and then are we going to like look at changing that requirement? Yes, absolutely. So everything on here is going to be subject to program subscription. We're going to keep a close eye day over day and meet quarterly with Matt's team to look at where we have maybe oversubscribed or undersubscribed programs so that we can move money around in the action plan to make sure that we're meeting the needs best we can based on demand. And to your, to the commission's previous direction which is to bring that back here and have these types of discussions. You may say, okay, this program, we're not getting a lot of bang for our buck but we've got so many applicants over in this other program we want to spend more here, you know, and shift that money. And remember, we're talking about $600,000 of the $800 or $600 million of the $800 million. So we've also got money outstanding for future programs that again, you could decide you want to shift around differently. Part of it's going to be based upon the need and the applicants and what we see coming in in these programs and we want to bring that here for those discussions in that direction. A hundred percent. And my last point and then I'll yield back. You know, I think it should be for the amount that's like repaid if they are getting a grant. I mean, it should be a hundred percent through maybe like seven years or ten years because I would hate to see somebody get denied because one of the programs uses up all the money and that, you know, they turn around and sell the house in a year versus maybe a family that was going to, you know, be in that house, you know, forever. You know, so I think it should be really, you know, the full amount, you know, within that five years or seven years. But, you know, I don't think it should be a sliding scale down in my opinion. So thank you. Thank you. That actually, I skipped a slide. So that's a perfect transition. Commissioner Nowicki, thank you. So what we're recommending in terms of enforcement of these compliance periods. So for the homeowner rehabilitation, reconstruction, and the homebuyer, the homebuyer program, what is being recommended is a five-year compliance period. During that five-year compliance period, assisted applicants must own and occupy the assisted home as their primary residence. The recommendation is to secure that commitment with a five-year self-extinguishing second mortgage and a promissory note that amortizes on a straight-line scale. So if you breach your compliance period by selling the home or failing to occupy as a primary residence in year one, 100% of the grant needs to be repaid year two, 80, year three, 60, and so on. For the local landlord program, same compliance term, five years, same security, second mortgage, and a promissory note. But their requirement is to rent to income-eligible tenants at affordable rates with the same straight-line amortization. For both of these programs, we're going to require or we're recommending to require that the assisted household or the assisted landlord maintains homeowners insurance and flood insurance if applicable for homeowner applicants who are served at minimum for the first year for landlords for the full five-year period. And thank you, Commissioner Nowicki, for your comments on this. Commissioner Eggers, and we'll go to Commissioner Park. No, you do. Concern about mobile home parks and folks that are whatever situation that they're in and to the extent that we can do, because there's folks there that have lots of confusion about what's going on, desperation in some cases, difficulties, whatever, some extra hand-holding. I don't know if this kind of presentation would be worthwhile to get out to the communities to do that. I mean, I don't know how many communities we're talking about, but this is really, this is what we're talking about, where the rubber meets the road. And so clarifying anything, helping in any way, I think would be, and that's to say, here's the ways you can do it. Maybe the fourth one would be, we're coming to your community to do that. Absolutely. Go ahead. I was going to say, during this presentation, Kevin reached out. We're going to start that next week. Okay, thank you. Ask and you shall receive. All right. And that's all we have for you today, Commissioners. Thank you for your time. As a reminder, these programs are gearing up until October 20th. An application will be published on the website. Interested applicants can call the hotline. It will also be published on the website or visit us in a service center to apply for any of these. Service centers will be fully staffed with an army of case managers to help walk people through the process do that hand-holding to make sure that everybody who is interested has a fair shake to apply. Thank you. I got the hiccups. I haven't had those in years. Gosh. Is there a mechanism in place where someone from outside of the city of St. Petersburg may provide an application to support the homebuyer component piece? They qualify. They meet the standards. They decide to purchase a home in St. Pete, which you said they qualify for. And then, of course, St. Petersburg has their own pot of money that they've set up. I don't know if they have a homebuyer piece within their program, but if they do, is there some mechanism in place that would alert that that individual received X number of dollars from Pinellas County towards their homebuyer program and then also try to get funds from the city of St. Pete? I think you guys are working with St. Pete as well, but is there a mechanism where it's kind of maybe not double dipping if that's something that we want to look at? Yeah, we're going to work really closely with the city of St. Pete. We know two allocations within the same county can be confusing. So data sharing is absolutely a possibility. Somebody who already owns a home would not qualify for a homebuyer assistance program, so if they already purchased, they'd probably be excluded from St. Petersburg's program because they're no longer a homebuyer. Okay. And then my other comment, I guess, is I know that 70%, I believe 70% of our dollars have to go towards low to moderate people. I fully support that. I get it, and I think we won't have any problem having people apply. And I know we want to see this get off the ground, so October 20th I think is a wonderful date because St. Pete's thing isn't supposed to start until next year. So I've already gotten a number of calls as well as I'm sure others about how excited they are that we are forging ahead. But I would like to see us start outlining something to help others it was Commissioner LaBala that asked about what about the people who are over that 120 AMI who, you know, they're struggling too. I ran into a group of people at an event and they were talking about the amount of money above and beyond and things within their flood insurance that, you know, when they spoke with the carrier it was covered and then the carrier was like, well, read the fine print on the back of page 10 or whatever and then they found out that because it was not a wind incident. I don't know how you could say a hurricane is not a wind incident because that was a lot of wind but it was a wind incident so it didn't cover and they had to find $70,000 more. That's nothing to sneeze at, you know. So I would like to see when we may be trying to get to that because those persons fully understand this program and what it stands for but, you know, I would just like some information on that one. And then I fully support the time frames by which to hold individuals accountable so that the property remains affordable and is used for the reason that's intended not to use our money fix it up and then sell it or flip it or whatever. So I fully support that. So if we find that a person has not held because we do have those, I think, annual audits if you will. So if we find that a person is not doing what they're supposed to and we can't solve it amicably and we end up saying you need to give us 60% of the money back or whatever the amount is, that goes back into the pot. Does that have to be then reallocated for the purpose of the pot that it was in or, like Commissioner Nowicki was saying, if we have other areas maybe where they need a little bit more money, is that something you just bring back to the commission and we approve the movement of those dollars or increase in certain program areas? Yeah, so I think they're like, so let me back up. So we are working with the City of St. Pete. We have a meeting with them next week to kind of coordinate our efforts so that we're not confusing residents. So we're going to work through that process. And when it comes to any of the action plan items, we will have that. Those are like future discussions and future decisions, but you're absolutely right. Like if that money is still there or if Commissioner Nowicki said it earlier, like if a program just isn't popular, we're going to come back to you and we're going to talk about program design and different action plan items up to including multifamily. You know, we started with the people first, so we followed HUD's guidelines and HUD's definition of what that is and that's why you have the four units. But as we have these conversations moving forward, if there's money left over, we're going to come back to you and say, what other program would you like to stage up now? So yeah, we'll have those conversations and it will happen. I think Barry said at the last meeting, the budget I showed you is wrong. I mean, if that happens from start to finish, we'd be the first ever. And then I guess just a note, when I think about the mobile home units, especially, well, all over the county, but the ones that I physically saw, of course, coming across Bay Pines to the right, just complete, I mean, they were in the water floating somewhere. And then the ones, some ones further up, Seminole Boulevard that turned into Missouri. But a lot of the, especially a lot of the senior mobile home communities, all of the mobile home people own the mobile home community. And so I know you distinguish between if they own the unit and not the land, if they own the land and the unit. I'm not sure how that would work or how that works. Maybe you all have some idea because again, a lot of the 55 and older, and it'll say on that, you know, and so it's 250 mobile homes in there, 250 people co-own that land and whatever. So I don't know how that will be worked out. But I know that they are really, you know, looking for and needing some help because mobile homes get absolutely destroyed when we have storms like that. Two will take them out. So anyway, if you could. Yes, absolutely. for the question. So it's really difficult to answer the question about the co-op owned mobile homes as a blanket answer because each community is so unique. So when we see applicants who are coming to us with those unique ownership situations, we're going to work with them one-on-one using those case managers to come up with the path that makes the most sense. I will also mention, we didn't talk in depth about it today, but remember, there is a strategic relocation and revitalization program in the action plan that is intended to serve some of those more nuanced, more sticky, particularly mobile home community issues. So as we move through this program, we will undoubtedly find a handful of folks who just don't quite fit the mold, right? And we will work with those communities and use that strategic relocation and revitalization program to address those more unique circumstances. Yes, from start to finish, if someone submits the application on the 20th, it's cut and dry. They submit everything that's needed. Everything's good and in order. Time frame by which you think it would be stamped approved. I saw with the 90-day review thing, but it wouldn't take 90 days. So what kind of time frame do you think? And of course, there are going to be others where you're going to have to ask them for additional documentation or something like that. I get it, but on average. On average, I think eligibility could be determined in less than 90 days, but it's not just eligibility because this is a federally funded program. We also have to do inspections and make sure we do environmental compliance before we notify someone of a ward. So to get through eligibility, initial inspections, and the environmental review process, that's probably 65 to 90 days, depending on the individual circumstances. What I'll say here is anybody who applies, it's going to be in their best interest to cooperate with the program and supply that required information and documentation as quickly as possible, make themselves available for those inspections so that we can move through the entire process unencumbered. Commissioner Shearer, do you have a question? I'm going to follow up on one more. Yes, Chair. I had a couple of just on the homebuyer assistance. I just, I didn't see it anywhere and I'm sorry if I missed it, but I think that should be limited to residents who are living here at the time of the storms rather than people who managed to move here after the storms. This is for input, so just my random thoughts as they were here, they might have lost their home. It is, Commissioner Shearer. Okay, it's not on the slide. Okay, great. And then I had a question about the income levels required for these various programs. Income's a big point of it. Will it be the income at the time of the storms, the person's income upon application or both? Because I think it should be both. It's a HUD requirement that you have to document, determine and document their income at the time of application. We don't have the option of going back to their income at the time of the storms based on how HUD allows for income verification. That's unfortunate. Okay. Mr. Eggers? Yeah. Just talking about the co-op program and you talked about the particular peculiarities, if you will, of each situation. You know, if you have a single owner, you go to the single owner and say you've got five-year commitment here to do the work. We're going to do work for folks in your community, but you have to agree to a five-year situation. And I think the co-op locations need to be fully understanding that very concept today because they may need to take action as a collective body that says the same thing that that individual owner said. And let's not hold things up for weeks and months if we can notify those folks. I don't think there's many of them, but there are. I know there's one along Alt-19 in Palm Harbor, for instance, that has that very situation. I don't, you know, again, it's a complicated thing, but they may have to take a collective action on the condominium ownership. Yeah, and we're going to have to work through all those, but keep in mind one thing when it comes to mobile homes. So we ran the numbers this week, staff did. There's roughly 16,000 mobile home units excluding St. Pete in Pinellas County. Of those, less than 7,000 are homesteaded. HUD requires that the mobile home be your primary residence. That's like the first thing that has to occur before you get anywhere else on any of this discussion. So that's really the first thing we need to get them to understand. If this is not their primary residence, they don't qualify for any of these programs. And that's less than 50% of the mobile homes in Pinellas County right now. I understand. I just, my whole point was if we can do things ahead of time, let these folks know as a condominium group so that they say, yes, we're going to be in effect. If we start making individual commitments, we, the program, we're saying we're going to be in business for the next, you know, we understand we have to make that kind of commitment. It may take some action on their part to get to that point. And we don't want to slow down an application while they're mulling through that whole process. And whether they're owners or not, you know, the primary owners or not. Understood. Yes. Okay. Thanks. Anything else? All right. Thank you. Appreciate it very much. Big discussions today. All right. Why don't we take a 10-minute break? We've got some food over here. We can grab some food and come back and then we'll do agenda review. Sound good? That's right. We've all heard it. Item number five is a city of Treasure Island countywide map amendment from residential medium to recreation open space. The long fending is part of Palms Park. The proposed recreation is a grand agreement and consists of public use. This amendment aligns with the countywide plan and is consistent for three parcels that they're trying to align with the park. It's unanimously recommended. Item number six is City of Largo. It's a countywide map amendment public semi-public to retail and services. Properties owned by the city. It currently houses the city hall. So this is the redevelopment of their government center there. And so it'll change the use for the designations that they want to work this infill redevelopment. Item seven, countywide map amendment residential low medium to semi-public four acres up in unincorporated Palm Harbor. The site is developed with an existing religious institution and two single-family residents. The property owner, which is the church, tends to expand the church facilities to meet the needs of the grand congregation. Item number eight is the map amendment office to retail services, 1.16 acres, Tarpon Woods Boulevard. This is the bank property that we previously discussed that would be changing to a car use. I'm sorry, not a car wash use. Yeah. Neighbors probably heard that. Okay. And we got some various reports, et cetera, and stuff. Item 15 is a ranking of firms for, with First American administrators and IMED. This is our ICARE benefits provider. One's the administration, one's the benefit provider. Item 16 is ranking of firms resilient standard life insurance. This is our disability benefits for our family medical lead back administrative services. On to the regular agenda. Item 17 is a 10th amendment to our agreement with Napa Auto Parts. They provide all of our parts. This is a big cooperative contract and we spend about $2 million annually. Item 18 is interlocal agreement with the sheriff for services at our airport. Item 19 is First Amendment to agreement with AECOM technical services. This is for construction engineering inspection services within our construction group for various projects that we have. So it's on an as-needed basis. Item 20 is the Third Amendment to agreement with Johnson Controls. This is for HVAC. So this is going from a services contract to a services and repair contract just combining what we do. It's really not changing the amount we spend annually. This is a huge nationwide contract that we get very favorable pricing off of and it just merges it into a single contract. It's really what we're spending anyway but we do have some big capital projects within this area. Item 21 is capital project funding agreement with St. Petersburg College for the renovations of Palladium Theater. This is out of your CBB funds of $2.5 million. Barry, back on that air conditioning thing. Are we talking some chiller stuff or are we just talking regular air conditioning systems? It's a big number. I was just in a short period of time. Yeah, so we have 13 projects anticipated for 2026 at $4.2 million. I'd have to bring staff up to go through exactly what those specific homes are. So we have capital projects, we have preventative maintenance, we have standard repairs, and then we have emergency repairs and they're kind of broken down into the different categories. Okay, well, I have the same question. So what they have, like, what they'll have is right now we have a services contract running $1.3 million and then when we, for all those different types of repair contracts, we have individual contracts for that. We're just merging it under this because it's under, it's a national contract and we get favorable pricing under it. Okay, okay, thank you. Thank you, Elaine. Item 22 is, this is similar to a TEFRA bond where you have WastePro that's using the state financing corporation for three facilities in Clearwater and in Tarpon Springs. Again, this has no fiscal impact to the county. They're just using state financing for their projects. Item 23 is a renewal of public defenders, office, jail support, diversion, juvenile crossover case management, information technology staff, and our mental health court, our agreement with them. Item 24 is, authorizing submittal of a public library construction grain application to the state for the East Lake Community Library. Item 25 is, a donation agreement with Suncoast redevelopment for donation of lands. This is a, this property is needed for the Cross Bayou Canal second phase of the capital construction project. Item 26 is a resilient Florida grant agreement for Department of Environmental Protection for the Cross Bayou Canal improvements phase one and phase two. Item 27 is a second agreement with purchase authorization for sidewalk safety corporation. This is for our sidewalk trip and hazard prevention and maintenance program. Item 28 is ranking of firms with FCC Environmental Services for our Waste to Energy facility. So, Paul Sacco's here. If you have any questions, obviously this is the changing of the firms that's going to operate our Waste to Energy facility. So this is a new firm? This is a new firm. It was bid. I believe you do have a bid protest on this. Is that correct? Or not? Yes. And so, you know, any questions you probably want to talk to the county attorney or Paul separately. But this was bid and this is the recommended firm. Item 29 is a word of sole source agreement with Premier Magnesium for magnesium hydroxide and equipment services. So one year, 1.6 million. Item 30 is issuance of two new certificate of public convenience to necessity for non-wheelchair or non-medical wheelchair transport services. Both firms meet the qualifications. So I have a question about that because this is two new COP CNs. So I find that interesting that that came up today. So we're doing, you know, the wheelchair kind of transport but how different is that opening it up with ambulance services? Because it's the same, one to the same, just found that interesting. And timing is just... Well, I think Matt must have an answer because I don't. They're non-emergency. They're non-emergency, but this whole conversation we had earlier for a very long time was about non-emergency transports. So we have non-emergency transports. This is wheelchair. I'm sorry. But it's wheelchair. I get it. It's wheelchair. I get it. It's wheelchair. It's not a bed. Yep. So the hospitals right now can use non-emergency transports for some of the patients you were talking about earlier today. They can do that right now. They can use these wheelchair vans to transport. And in fact, we don't know what's happened. We're looking into the data. But over the last three or four months, we've seen a decline in non-emergency transports by 10%. So that leads us to believe that more of these type of units are being utilized by the hospitals when it's appropriate for the patient. So these are in use now. It is an option for them to use these now. It's just... If we get... I don't want to go back to the previous conversation, but it's just the easy button. Sunstar is the easy button. So if in doubt, just call Sunstar. They'll be there quickly. They'll transport the patient. They'll take care of everything. But these can be used, and they are being used. Right, for non-emergency. I got it. Okay, so we're expanding it this way, but we're considering maybe expanding it the other way. I mean, it was a great discussion today, and this has come up for years about looking at that, and I think it's a valid point. You've got an advisory committee. Let them come up with, you know, scenarios and look at the financing, and then take it through that advisory committee and ultimately bring it to you for consideration. I don't think anybody's necessarily opposed to that. We will understand the financial implications of making those types of changes. Right. Well, I like that we're doing free market for wheelchair. We're doing free market for wheelchair. I think we definitely have to take a serious look. Advisory committee or not, I think we have to take a very serious look at free market at the other as well. I understand. And I love that this is an option and we're expanding that option. I think that's great. So you have my support for this, but great timing. Thanks. And just one little, again, I'm not, I totally agree with the thoughts. I just want to make sure, we just did a contract renewal. Correct. That incorporated those two services. And the rates that we negotiated, if I'm not, again, I'm not, we're set based on that mix. Correct. So if we're going to take away a piece of the mix, how will that affect the contract that we have in place? And I just want to make sure we probably would have to re-bid it or negotiate a change to it. Yeah. And from our standpoint, I mean, I think the one thing this board's been crystal clear about is reducing the property tax rates and reducing the impact. So I want to understand that, how that change impacts that levy before we make a decision, but we'll absolutely look at it. You've been crystal clear that you want us to look at that free market piece or certain parts of the hospital system. And I think we've got, we've probably had more conversation in the last three months with the hospitals around these types of issues than we have, you know, in years. We had a really good conversation with Brent yesterday. I mean, there's a lot that we can really have some pretty thoughtful conversations with hospitals about. We're servicing advisory. They're all our, they're all our same residents. We're all servicing them in the same manner. So our advisory group will make the idea that the transporting requirements for if we were to go that way would be the same as what Sunstar has. I mean, you have to be fully integrated. You have to be fully knowledge. You have to bring, bring the same technical skills. We, we would, we could potentially step out of that and let them, let them manage their own. Okay. We don't have to, it doesn't have to be under our umbrella. Yeah. And that's what some of the, what they're talking about. Um, I just want to understand how that impacts it. Most of the times that, you know, we've gotten involved in this, we heard that it's, you know, a Sunstar delay or whatever. And, you know, I, at least eight out of 10 times, it was actually internal to the hospital. It was their delay and, and processing to be able to get to call for a transport. And, and, and so there's, but that means there's at least two or three times that it was us. So having those types of conversations, I think are, are, are good and healthy. And, um, it's a good time to look at the system and see if it needs to change. And we, we, we support them. I mean, the board's been clear about that and we'll do that. Okay. Um, and then lastly, you've got, um, on, on this, you've got, uh, appointments and reappointments to the emergency medical advisory council. So good timing. Right. Um, and that's, uh, all I have on the agenda. Now who, I don't know the, and you guys probably don't know, you have to look it up. Who appoints people on that one? I know we approve it all, but, but these are not commissioner, these are not commissioner appointed. Just commissioner voted. Correct. Yeah. Right. I know the mayor's council picked one person. That's, that's a great question that Matt will have an answer for you by Tuesday. Um, okay. Cause I just, I don't know. I don't know how, I mean, a lot of them I think are, are designated by like, uh, certain people in the community. I'm just curious. I'd like to get a better answer for you. I know I got put on it by the mayor's council back in 2009 or 10 when I was a mayor. So I know, I know that's one of them, but I just don't know how the others are appointed and I know it's not commissioner appointed. Um, but I'm just curious who's selecting these people. They all sound like really good. I looked at the roster. They're all very intelligent, good representative representation for what it should be, but I'm just curious who's selecting them. Well, and if you read here, it just says, you know, representing the, you know, medical society representative and this one's representing, right. And so it's probably they're, they're making a recommendation to you and it's designated groups, but let us. So it does look like, so citizen representative from, for district. So I just don't recall. We'll, we'll get a, we'll get a good, um, outline for that and send that to you prior to Tuesday. Okay. Thank you. Okay. Um, if I can just, uh, two more, two more things. One, we want to welcome Tristan Summers as our new one of governmental affairs. Welcome Tristan. Tristan. There you go. He's on board now. Um, and, and also want to make you aware of, we're going to do a little reorganization, um, within, um, our, our confines. So Joe Laurel is going to retire next spring. He's our director of administrative services, which is purchasing and risk, um, and fleet. Um, we're going to take purchasing and risk and we're going to put it under OMB, Chris Rose. Um, and we probably will, you know, get a division, make it a separate division over those areas, but he's got to look at how he's going to structure that. Um, and, and then we've taken, um, fleet and we've put it under, um, um, our, uh, Robert Mills. Okay. Which is, uh, our office of asset management. And so we put fleet under there and Robert actually ran fleet for not only, uh, waste management, um, but he also ran it for Leon County. So he has a lot of experience in this area and stuff. And so a little reorganization and so you'll probably see some changes as a result of that, maybe some name changing and stuff like that. Make you aware of that. And that's all I have. Sounds good. All right. Yes. So since we had the little tornado that wanted to spin over Toy Town, did we have any damage or anything or did it just kind of stay over the flat land? I haven't heard of anything. I'll look to staff. Um, I sent Bear a picture. It was, it was kind of, you know, you could see where it was picking up our garbage and debris, but, uh, it was interesting. Not that I've heard of. It was broad daylight, no rain, no rain clouds. It just sat down. Anyway, I was just wondering if we had any, you know, issues or anything. Thank you. Well, if that's all we have, then have a good weekend, everybody. And, uh, we'll see you all on Tuesday. Thank you. Thank you. Thank you. Thank you. Thank you.