Nassau County Board of County Commissioners Workshop Session, January 7, 2010, 4:00 p.m.

Nassau County Board of County Commissioners

Workshop Session, January 7, 2010, 4:00 p.m.

Workshop Session, January 7, 2010, 6:00 p.m.

Commission Chambers, 96135 Nassau Place, Yulee, Florida



Call to Order



Present:  Chairman Michael H. Boyle, Commissioners Daniel B. Leeper, Stacy T. Johnson, Barry V. Holloway, and Walter J. Boatright.



Other Officials Present: David A. Hallman, County Attorney; and Edward Sealover, County Coordinator.



Staff Present: Gene Knaga, Clerk’s Fiscal Management Compliance; Ted Selby, Director of the Office of Management and Budget (OMB); and representing the Clerk’s office Brenda Linville, Deputy Clerk.


4:07:02 Butch Hartman, Superintendent of Road and Bridge Department, came forward to provide a brief update regarding the Private Road Agreements. He also noted that the Road and Bridge Department is prepared for inclement weather this weekend.


4:00 P.M. WORKSHOP: To discuss implementing a conservation rate for Nassau Amelia Utilities (NAU) charge.


WS00107 – 4:12:41 Discussion: Doug Hewett, Nassau-Amelia Utilities (NAU), came forward to briefly review the request. Andy Burnham, Burton and Associates, came forward to provide a presentation regarding Water and Sewer Conservation Rates. He discussed the purpose of conservation rates; inclining block rates; scope of rate analysis; current and recommended rate structure; recommended water and sewer rates; bill impact on single-family, multi-family, and general service; and single-family rate survey.


The group discussed reimbursement for customers (private plumbing failures), compliance report, water usage, irrigation regulations as implemented by St. Johns River Water Management District (SJRWMD), the debt service coverage for the Bond Issue, and the capital need of the facility.


Commissioner Leeper read a document he received from the SJRWMD regarding the conservation rate.


Mr. Hewett suggested other changes to the ordinance.


Noted:    Continued to January 11, 2010, scheduling a public hearing to consider implementing a Conservation Rate for NAU charges.


WS100107 – 4:54:54 Meeting recessed until the workshop at 6:00 p.m.



6:00 P.M. WORKSHOP: To discuss Florida Medicaid Reform in Nassau County.


WS100107 – 6:01:45  Discussion: Following the invocation and Pledge of Allegiance to the American Flag, Thomas W. Arnold, Secretary with the Agency for Health Care Administration, came forward to introduce his staff and provided a presentation regarding Florida Medicaid. He discussed the goals of Medicaid Reform in Nassau County; current status; experience with key elements of reform (marketplace, choice counseling, performance measures, patient satisfaction, risk adjustment encounter data, Low Income Pool {LIP}, fraud and abuse prevention, cost savings, enhanced benefits, and responsiveness and adaptation); and the future of Florida Medicaid Reform. Mr. Arnold also reviewed the National Health Reform Proposals.


WS100107 – 6:53:53  Recess.


WS100107 – 7:01:44 Dr. Paul Duncan, University of Florida (UF) Research Foundation, came forward to provide  a brief update regarding UF’s evaluation of the Medicaid Reform Initiative, and a summary of UF’s current observation regarding same.


The group discussed the Georgetown report (provided by Georgetown University); encounter data; and the participation rate of primary care providers.



WS100107 – 7:23:30 Sara Sullivan, Jacksonville Area Legal Aid (JALA), came forward to discuss issues regarding various key elements associated with the reform. She briefly addressed a pilot project for the Medical Home Theory.



WS100107 – 7:34:50 Chris Paterson, Sunshine State Health Plans, came forward to thank the County for the opportunity to service Nassau County residents. He provided a brief background regarding the company.



WS100107 – 7:44:10 Greg Mellowe, Florida Community Health Action Information Network (CHAIN), came forward to provide information regarding Medicaid Reform. He discussed choices of plans, provider access, and payment issues. Mr. Mellowe responded to an inquiry regarding the mission of Florida CHAIN.


Secretary Arnold appeared to address Ms. Sullivan and Mr. Mellowe’s concerns.


Dr. Laureen Pagel, Sutton Place, came forward to discuss consumers’ frustration regarding Medicaid. She commented on the number of providers available in Nassau County and expressed concerns with the drug list and low primary rates for physicians. She commented that she supports Managed Care.


Chairman Boyle read a comment from a report entitled “Florida Medicaid Reform: A Progress Report” by Michael Bond.


Commissioner Holloway inquired regarding the number of primary doctors in Nassau County compared to other counties. Mat Robie, Sunshine State Health Plans, came forward to review a list of providers in Nassau County.


Mr. Robie responded to an inquiry regarding the difference between Sunshine Health Plans and United Health Care.


Dr. Eugenia Seidel, Director of Nassau County Health Department, came forward to clarify the HMO transition and Nassau County Health Department’s continued participation.


Secretary Arnold responded to inquiries regarding the expansion of the program, and concerns regarding Nassau County residents being switched over to the Duval County plan when they go to providers in Duval County, and discrimination issues with Jacksonville Shands Hospital.


Commissioner Holloway commented that the reason for inviting the groups here tonight is to help the Board move forward with the decisions that need to be made in order to provide an appropriate level of service for the citizens.


Commissioner Boatright suggested collecting data from a county comparable in size to Nassau County in order to see what they are doing with the funds they are spending and how their patients are treated in their Medicaid program.


Commissioner Johnson suggested that Secretary Arnold provide the Board with a quarterly or annual encounter data report.


Chairman Boyle expressed that even though he has good insurance coverage, he still has some of the same issues as Medicaid.


There being no further business, the workshop session of the Nassau County Board of County Commissioners adjourned at 8:19 p.m.





Michael H. Boyle, Chairman








John A. Crawford, Ex-Officio Clerk