Dukes County Commission
Wednesday, October 27, 2010
Dukes County Administration Building
9 Airport Road, Edgartown, MA
Commissioner Present: Carlene Gatting, John Alley, Tristan Israel, Melinda Loberg, Tom Hallahan.
County Staff present: Russell Smith – County Manager, Martina Thornton – Ex. Assistant to County Manager.
Other present: Joanie Ames of MVTV.
1. Meeting was called to order at 5:00 PM
2. New Discount Prescription Card Program – Martin Dettelbach
Mr. Dettelbach from Financial Marketing Concepts, Inc. made a presentation about the program offered to Dukes County residents. The card is free; one card is good for the whole family, and it does not expire. There is no health, age or other restrictions. Four pharmacies on the island are accepting it. Anybody can use the card. Most of MA residents are covered by health insurance, and in general the “co pay” price would be better then the discount price, but people should check. These people can also use it on drugs that are not covered by their plan (birth control pills, Viagra) or for dental prescriptions and pet prescriptions. People with high deductible insurance plan can use it until they reach the deductible maximum. It could be used by people with no health insurance in general. People with Medicare part D that reached the “donut
hole” ($2,800 to $4,000) could use it for the out of pocket expense. You can save on average up to 45% on the retail cost of the drugs, which is about 20% more then with the NACO card. It will be available at the pharmacies, libraries and town halls. You can print it also at the website www.coast2coastRx.com under Dukes County. You can choose any 10-digit number as your card number. All card information is kept confidential, only pharmacies have the info. The website can be translated into 30 languages. There are 60,000 drugs covered under this. It is honored in whole USA and US territories. All pharmacy chains and 95% or the private pharmacies are participating. The card also gives you 50% discount on imaging (MRI) and lab tests
(blood work, etc.) if not covered by insurance. The County receives 50-75 cents per prescription as a royalty, which does not increase the price for users; it comes from the drug’s marketing fee to the pharmacy. There are bigger discounts with the generic drugs. People from near-by areas on the Cape can also use the card; they do not have to be residents of the County. Russell said that there is opportunity also for the seasonal residents to take it home and use it there and it will also benefit the County. Mr. Dettelbach said he spoke with both newspapers and the hospital to also promote the card. They will contact each pharmacy every 2 months to follow up. Martina added that the pharmacies were part of this program prior to Dukes County joining and were providing these discounts to cardholders from other counties already.
3. Steamship Authority (SSA) updates – Marc Hanover
Marc said that SSA did fix the drainage under the bridge. The website will be upgraded with a notification system to give the public the latest news (boats delays, etc.). The cost for ambulance runs increased about $60K per year (from half price to full price). Originally it was supposed to be paid by the hospital but when they realized how much it will be, it was deferred to the ambulance service. 50% of their clients don’t have the insurance to cover the cost. They will have to get into billing the customers to cover the cost. They still get the preferential status. People with repeat chemotherapy or radiation treatment off island get discount on fares (currently 30 people). Melinda said that the hospital is, in this way, shifting the cost to the patients. The Medicare rate is fixed and they will not reimburse for more. Marc said that the
Oak Bluffs Ambulance Service billed last year $1.9 million and received $1 million. It is still a profitable operation for the Town of Oak Bluffs. John said that the VTA minivan is classified by the SSA as ambulance. This is service for the public and everyone needs to have a letter from a doctor. The VTA picks up the cost. Marc said he will look into it. The SSA received a $1 million grant for shore side facilities and they are working with Fred Lapiana on the waste water discharges from the boat. The Governor built in early 50s has some problems. We might have to re-power it to get couple of extra years out of it.
4. County Manager’s Report
Regional Services through Dukes County – There are 3 different ways to provide services (see attached): The first way is through County Departments and employees. The second is by hiring contractors, the advantage is that they are not part of the retirement system and we do not provide benefits to them. They have to have their own insurance. The federal law does not allow people to be hired as contractors if they are required to work certain hours. This works for people that are charged with accomplishing certain tasks that we received a grant for like the Youth Task Force. The third way is through non-profit organizations. Russell reminded the commissioners that he provided them with a letter from Marcia Cini, the County Counsel, who explained the relationship between a government and non-profit organizations. The letter said that
the County can not give money to non-profits or provide them with any other support (housing etc.) unless they are under exclusive control of public officers and public agents. However there are non-profits on the island that enjoy support of the towns. Tristan asked if town can support a non-profit if the county commissioners acted as a board. Russell’s opinion was that it would become a governmental agency at that point. The County has a non-profit status under Section 170 (c) 1, not a 501 (c) 3. Martina said she believes that if the organization received their non-profit status, it could still exist as a non-profit even if governed by a board of public officials. Russell mentioned that the town owned libraries create a non-profit organization as Friends of the library to keep the legal separation. Another way of providing regional services is through the funding process by towns. To put on separate warrant articles at town meetings for each service every year is very unstable.
It would make more sense to do it like the Franklin County Counsel of Governments does it. Once the towns agrees to participate in the program, to include it in the town’s budget in a regional services section and have it go through the regular town budget process (before the finance committee etc.). Carlene said that this is already happening with the MV Commission’s budget. John said that the VTA town portion, which they agreed on 5 years ago to increase services for the elderly, is also as line item in each town’s budget. Tristan asked based on all this information how Russell proposes the County should proceed with the Center 4 Living and the Animal Shelter. Carlene asked how the county commissioners feel about adding employees to the County. Tristan said that if the cost is fully covered by the raised funds and it does not cost the County or the towns any additional money, then it needs to be presented to the towns so they understand the situation. John said that it needs to
be presented to the advisory board that has the ultimate decision on the budget. If there is a strong case for the service the employee is providing and the benefit to the community, there should not be a great difficulty. Tom would like it to be budget neutral – revenue it brings would need to offset the cost. Carlene said that we can never get a guarantee that it will always be budget neutral. Russell’s memo says that the current assessment to towns is over 90% liabilities for previous employees and forward funding future liabilities as required by the state. Carlene does not want to add to this by hiring new employees. Tom said that there will be services that can show a track record of being budget neutral and would be an asset to the community. There will never be a 100% guarantee. Carlene said that the Center 4 Living could be one as long as the towns would guarantee their assessment to this program. Tristan asked what the status of the animal shelter board is. Russell said
they are a County board. Carlene asked why they have not moved forward to become a 501 (c) 3 yet. Russell said they don’t want to do their own administration. Carlene asked why we could not contract with these entities to do the administration for them. Melinda mentioned the MV Commission’s study of potential for cost savings or improved services through regionalization of entities and if the towns agreed that the County would be a good place to manage these services as we are already set up for it, it would mean new employees would be added to the County as the towns would give up employees. John said there are things that make sense to do under County umbrella, like the Veterans’ Agent or the Integrated Pest Management. Tristan said that he thinks the Animal Shelter should become 501(c) 3 as the commissioners asked them previously and proceed without the County and not add county employees. Carlene said that Russell already added the employee at the shelter for legal reasons.
Melinda suggested inviting the animal shelter board chair to explain their reasons why they feel it is important to stay under the County. There is also a question of the property promised to the shelter by MSPCA. Russell explained that the animal shelter had a separate fund administered by the Treasurer and from that fund all shelter expenses are paid, including the salary and benefits for shelter employees. John asked if this board voted to establish an employee at the shelter. Carlene said no, it was decision of the County Manager. Tom said he remembers Noreen saying we have to give the employee benefits, if the person works more then 20 hours per week. Tristan said that there is still the potential long-term cost. Carlene asked Russell to set up the meeting with the animal shelter prior to the commissioners taking a final vote on this. Tristan asked how the Center 4 Living gets their support from towns. Martina said they bill the town for their services and towns pay the bill.
The towns would have to decide to contract for service of the animal shelter before the shelter could receive any financial support as 501(c) 3.
Farm Service Agency came to the Island with U.S. Rep. Delahunt last Friday to inform about loans available through the agency for local agriculture and aquaculture. About 30 people were present and hopefully someone will take advantage of these loans.
State Beach – We re-applied and were approved for the next 5-years funding ($150,000) by the Department of Conservation and Recreation to manage the Sylvia State Beach. We use the money for beach preservation and erosion control.
Big Bridge on State Beach – Tom asked if someone is working on the permanent rail protection for kids on the second bridge. Russell said that what is there now is a temporary fix we did for this summer. They are back working on the bridge, but there is no protection in the plans. Commissioners agreed that there needs to be some protection there permanently.
5. Dept. of Revenue (DOR) Financial Management Review reply
Carlene said that all the commissioners had a chance to give their comments on the report to Martina and Noreen and that the revised report with the comments would be sent back to the State. Tristan said he would like Noreen’s comments other then factual corrections, to be sent as her opinions separately. Tom agreed that if there are opinions on the first section regarding the Counsel of Governments, it should go in a separate letter.
6. Old Business
Veteran’s Services on the Island – in correspondence there is copy of an e-mail received from Mr. Antanaccio form the Veterans Administration in Providence where he is updating us on progress in solving the problem (see attached). The American Legion Post 257 also sent a letter to the Dept. of Veterans Affairs to Mr. Burney expressing their concerns (see attached). Carlene quoted the letter that the 80 and 90 year old World War II veterans have to go to Hyannis and Providence for their care. She said she called the hospital and spoke with Mr. Ferriter. She will have conference call to discuss this issue further. Carlene and Tristan asked Russell to send Mr. Antanaccio a letter asking for a timeline of how long before the VA is ready so sign a contract with the hospital.
7. New Business
Letter of support to Oak Bluffs Counsel on Aging
Roger Wey, of Oak Bluffs Counsel on Aging asked the commissioners for a letter of support for grant application to provide counseling for the elderly on the island. Russell prepared the letter.
Tristan/Melinda moved to approve and sign the letter. So voted. All in favor.
Finance Committee – Tom said that the finance committee will meet next Wednesday to go over the budget calendar. Tristan said that the County Advisory Board should be more involved in the budgetary process this year.
John/Melinda moved to adjourn the meeting at 6:40 p.m. All in favor.
Respectfully Submitted by:
JOSEPH E. SOLLITTO JR., Clerk of the Courts
Documents presented at the meeting and part of the official records:
- Supplying Regional Services
- E-mail from Mr. Antanaccio of the Veterans Administration in Providence
- Letter from The American Legion Post 257 to Dept. of VA Medical Center
- SAA Meeting Memorandum