Board of Supervisors Joint Meeting with School Board and Budget Work Session   2/29/2016

Chairman Acoff will be giving the presentation for the school board.

So would you like to just begin?

Pardon?

I'm trying to bring the mic to you so that it can all be picked up for and we also are live streaming this, so you'll be on camera.

My vice chair and I are going to share the responsibility for this presentation and he will be presenting a snapshot of our 2016-17 funding request.

And now Kate will talk about some of our major challenges.

Now Steve will talk about compensation and benefits.

So this is a significant challenge going forward.

We welcome any questions or discussion.

So how about we start this side?

Can you focus that number for me?

So $500,000 for this year would be the best.

I mean it strikes me that it's incredible that we haven't had a new school for 15 years almost.

That was an elementary school.

maybe this isn't the right time to talk about it.

Kate, one quick question.

Dean's holding up one thing.

I think it's about a million dollars to do that plan.

And that's for the planning and design.

The one million would take care of the planning and design for that addition.

Thank you, Dean.

I just was trying to get a sense and I have one oh I'm sorry Norman are you?

No.

While she was talking about additions I wanted to ask about that.

for eventually to be a two-story one, or is it a two, you know, I'm using this.

Wait, so Woodbrook?

Yeah, Woodbrook.

Build an addition that won't last us five years.

Is that how you deal with overcrowding?

Yes.

I heard today that with the Brookhill development that they're going to proffer land for an elementary school.

We'd have to have another principal, library, cafeteria, building services, et cetera.

We're having to make up some additional money in this year and I wanted to know how that affected you all as well.

is what was in Pam Moran's request, and that's been reduced to 1.08 in Mr. Foley's presentation to you.

So the funding gap, or the request, say that again Steve.

Yeah, right, reduced it to 1.08.

1.08, so that's current as of right now.

Right, and we have not yet addressed any funding shortfall in the current year.

But again, it accurately reflects the gap with those two adjustments to it, is the 1,000,000, 1.08.

Just trying to wrap my head around where we are as of right now.

What's the range of what that shortfall might be?

I'm going to have to rely on, do we know?

and state your name.

As soon as we have that, we will be providing that.

but almost certainly the 1.08 is the best we could hope for and it's probably going to be less than that given those two considerations.

Thanks.

Just wanted you to know that's a savings.

Supervisor Randolph.

Except for parents in the school system, they fully understand the process of change taking place in our public schools and why we are moving towards learning space modernization.

But we have just made a dent across the school system.

over 70 different families speaking different languages throughout the world now in our public school system.

I think we do see some international students coming from university employees and some of the other companies that have been around.

Any other questions?

The information is very good.

I'll clean it up.

I'll clean it up because it's a little, I had the text written, we had the text written and then I've annotated it, but yes, I'd be happy to.

Because I'd like to read it over again.

It's not new, unfortunately, but we need to try to figure out a way to

So does the 4000 student high school when the other two are in the 1200 range.

when we were if we put out to bid because they were coming in at about 30 and 35 percent under and so if we could figure out how to be a little bit more nimble and quick in our response we could actually not only provide the capacity without having to get into these situations but we could protect taxpayer dollars because it certainly would have been cheaper then as well so just something to think about.

So that's indicative of thinking short term rather than thinking longer term as we need to do.

But in having some flexibility and being able to respond more quickly to even the changing market, I mean just the building market

Thank you.

So let's just meet back here a few minutes before four and we'll get started again.

Change out chairs.

and we will let our Director of Human Resources, Lorna Jerome, get started with her presentation.

So this would be what an employee pays and what the employer contribution is compared to the market.

Lorna, just real quick, are these self-funded or?

So I'm going to pass the torch here to Claudine Cloutier and she's again going to walk through an overview of the high deductible plan

And we're going to offer a new plan choice for 16-17, also exciting.

combined with exercise, eating right, making sure people get enough sleep especially during the budget season.

that people have, they know what their bottom line exposure is because really that's what health insurance is for, right, is to limit our financial exposure.

Is there an upper level limit?

If the employee has any money in their piggy bank, they get to keep it, and it grows for next year.

Is that a per person 1000 extra deductible for pharmacy?

Right, three, six, four, eight.

Okay, 16,000 for two people.

It cuts off at that point.

Do you have a series of investment options as to where, what kind of instruments that money can be invested or does it reside with the actual HSA holder in terms of investment choice?

So you're investing your money.

Is that going to count against them?

The Medicaid evaluation for retiree?

Yeah, so if someone is qualifying for Medicaid, one of the big issues that we have with some of our elder folks is that money is, they have too much money in certain investments that they can't actually get to, which counts against them that prohibits them from getting Medicaid coverage.

We'll take Medicaid or Medicare, please.

I guess it's Medicare.

Medicare is for the people over 65, Medicaid is for the indigent, so I just want to be sure I understand the question.

I can't answer that question, but it's a good one, so I will get the answer for you.

So if for some horrible reason an employee had, you know, three million dollars worth of health costs, that's completely covered by that.

Yeah, I think we probably have at least one person every year that probably hits.

We have catastrophic kind of insurance as the county too.

Yes, we have stop loss insurance.

It's like a million dollars per something.

It's a pretty remarkable year.

I'll just make a note that I'm in the HSA at my business and those of us that are on it like it.

All right, so the take, did you have a question?

One question I just had and that is in terms of the deductible HSA versus the traditional plan, if we roll these out in a family and let's say where you don't have both spouses working for the county, one works for the county, one does not, can they choose one to be in an HD HSA and the other to be traditional?

So all that, it's, again, a lot of challenges in helping people understand that.

A very small savings.

It is.

I hope you'll be able to explain a little bit more about that when you get to that point.

There won't be any takeaways.

There's a much broader thing you mentioned like crutches or something but it also covers just eye exams and chiropractic and massage and you know all kinds of things that are just vaguely...

They call them qualified expenses in my world.

So for people who are interested in other kinds of alternatives to just going to the doctor it can be really a big advantage.

And then, question?

For that $10,000 out-of-pocket medical cost, is that what the bills were or what they paid?

Any questions about this one?

That's the monthly chunk that could be put into the HSA.

Absolutely, absolutely.

well yeah I mean is or is it what happens when I when I die my savings account what happens to that money is it inheritable is it transferable absolutely I think you can look at it the same way that you would look at the 457 if you had that account if something happened to you

And how are the payments reimbursed on the high deductible health savings?

Does that answer the question you're asking me?

Thank you.

Who would be more interested in this?

They were very close to retiring.

So you didn't think it was lower income people might choose the high?

So that's why our increase seems particularly high this year.

you were talking about a three year plan to replenish the reserves so we're looking at 14% for the next three?

At this point, yes.

And also I'm back to being concerned about low income, our low income employees and we have quite a few of them opting for the high deductible but then not having sufficient funds to

Very good point.

presentations, do you have some information about your typical broken arm costs, what, and your shoulder repair rotator cuff is $25,000, I mean, those kinds of things, because I think I don't know what all those things are.

Not yet, but thank you for that idea.

So I feel much better about this now, having heard this a couple of times, but I'm still concerned.

So that surprised me a little because public sector's been a little bit slower to implement these plans.

Right, right, exactly.

We have some of those numbers because I have it by increased participation, so you're exactly right, Ms. Acoff, but the first year we're projecting only 5% of our workforce would go to it, so we can certainly get you that.

I mean, that is useful information.

And much of that is predicated on the participation, so the more participation.

Sure, yes.

So we need to be aware of that.

Mr. Alcala, you have a comment?

I'm being facetious on that, but I heard you say that the prescriptions under the HSA would be at the reduced rate.

and you have such expenses that you spend another $1,000 in the drug market.

So $3,000 deductible, additional possible max $1,000 out-of-pocket max for pharmacy.

You hit $3,000 and then you have an additional $1,000 prescription on the co-pay.

Right, right.

Do you have any numbers on that?

So it's relatively new.

Because that might give, you know, some of our... We can get that for you.

I had a question.

Where those two lines would be if 2016 were included.

We're not trying to get back in one year, but it certainly does get that information.

So when you say a three-year plan, this is year, 2016 is year one of the plan?

or is it the seven seven and a half seven and a half we've had a seven percent okay and so each year we're going to be putting how much back into what is this going to look like next year with respect to replenishing the reserves we have a five-year plan for it but it's very hard to predict where your expenses and your claims

I don't want to throw out numbers because I'm not positive.

How big is the question?

Right, it's a question of how much you're plugging in in subsequent years and so, okay, thank you.

Am I correct in guessing that the 2016 year on this picture would already be going up fairly sharply because of the increased, the doubling of the deductible and the increased premium in the year we're in right now?

It's going the right direction.

So I guess all the challenges are titrating these mechanisms to tamp down consumer demand for health services without disadvantaging them health-wise or economically.

Already a reduction in claims, that means we are tamping down on the medical services already in four months.

Do any of the other localities that try this, like Loudoun County or some of the other groups, do they have the same problems that we are facing?

It's very appealing to millennials particularly because of the portability who may not be with an organization for many, many years.

Any other questions?

I don't know.

Thank you very much.

It was great.

I think that our board is going to stay here for a few more minutes to just go over a couple of things unless somebody else has...

Yes, we are taking up...

We are taking up some of the things that we missed out on the other day with respect to our budget.

Okay, but for the school board, I guess we don't have any other business, so we're adjourned.

Yes.

You know, we don't want to chase you away.

Learn something about budgeting.

Well, you all have done your work.

He's good to see you.

okay we're actually not going to do much more if you want to I thought we were going to go over the budget some more but we're not so if we want to just continue and then we'll just do the last and you can what are we doing I just I just have a couple of

Nothing I need to pull out books for?

We'll let Mr. Foley join us back up here and see if he has anything for the board, but I just have one thing I want to go over with the board before we close.

and I just wanted to make sure with the board that that was acceptable.

Are we not starting at three or are we doing something else instead or picking up our budget stuff then?

If we had some more budget stuff, we could consider that.

We're not doing it today, we definitely will.

So we would suggest that if you put it off that we just meet for the night meeting.

I'm reserving the afternoon for something for the first time.

But I think the key that the Chair is mentioning is just that the rush during budget is really not necessary.

The other thing is I'd like to have our discussions around the same time and not separate them by months because I think it's good to just go on and once we started to go on and get it done.

and so forth.

And then it kind of gets us out of that vacation July, August period as well.

We'll plan for May, June.

Which is really for staff and for the community as well who might want to be following us.

So is there anything else that the board would like to share at this time?

We've actually offered it to the Pantops CAC as well to be part of that since Norman both got the north and the Pantops CACs it will be in kind of meeting issues with two of us there.

I'm sorry, the Pantops one will come to that same one, not have their own, right?

Right, yep, make it a little bit more efficient.

So have we decided on that, or are they waiting on me or you or something?

Pretty much waiting on you at this point, but as long as you give a nod, but yeah, it'd be, as Norman's nodding.

So combining CACs on the 21st?

I imagine the time will be seven o'clock but we'll give more details.

and just for clarity the hydraulic CAC is meeting that same night the 21st but we have a community meeting in combination that evening with the CAC so we'll be at Greer so but just so everybody knows that.

I don't think that the Greer one was planning to do a budget overview.

But this one was planned because Sue Albrecht's proposals needed to come to the CAC and needed a community meeting as well, so we're trying to meet a timeline for that.

There may be some of the other CACs that we divide up a little bit with Lori doing the overall presentation but we're working through all that now and I think we have enough of a schedule now to get the word out to the public based on your previous discussion of this.

We were just trying to accommodate Sue as well as staff because the original proposal for this particular, for Sue's community meeting was early February and then we got into not being able to meet everybody's availability and so we ended up with this one in sort of towards the end of March.

and anybody else?

I wanted to share that.

Is it developers?

And so this was a lot of county investment that was done to provide that.

So it's just subsidizing the counties, not for the counties to pass on to other people.

It's sharing funding with localities.

Thank you.

So that's what we're hoping to get.

Anything else from board members?

Tom, do you have anything you'd like to add?

I just wanted you to know that there is a whole model here that we'll share because it has everything to do with that future imbalance that we've talked about at least from one component of the cost center.

Is that also plus the 14.5% increase, or is that instead of?

could be reallocated if experience is stronger, is better than we anticipate, but again, it's one of those ones that you gotta be careful to make sure you hold enough in reserve.

The reserve was reduced, but it got away from us.

So we'll talk a lot more about this.

I just got an email when somebody else went after you.

Again, much more conversation about this.

to be able to look at that.

Our consultants have done that and actually recommended that we do some of the things you're talking about, but you need to hear about that and it's a big piece of this whole discussion, so.

So that would be a health thing we could take a much more affirmative stand on.

I mean, this is our program.

Actually, UVA does that if you get, and I can't remember to save my life if it's $10 or $5, but if you don't smoke, your payment is less.

Yes.

We have 600 employees, that's pretty big, we should jump on that.

We should really, you could take a look at what the model is at UVA and follow that very easily.

Do we have a policy about that or do regular testing or anything?

We should get some comment on that.

I know my son is tested for tobacco, works for Xerox regularly.

you know it's great when you have the good years you can save some money and you get to keep it not going to the companies well the question might be as we look to the future do we see a lot of good years coming and it may be that we don't because of all the changes going on in health care it may be a point in time where we have to reconsider self-insurance I don't know the answers to any of that but we do have to have a full evaluation of potential costs and benefits

What's the timetable for consideration of joining the state plan?

Oh, it got turned down?

Great.

That doesn't mean that there aren't other programs that we could be on instead of health insurance, health self-insurance, but again it's all part of the same consideration of how we go forward with this.

some of it is going to just keep everybody healthier.

It's definitely a benefit that's incredibly important.

Some people would rather have better health insurance and less increase in their salary possibly, for instance.

So if you all can take five minutes tonight to pile on and do whatever you can on that, that would be great.

And just Senator Hanger?

I was going to say, he's the best.

He is, yes, the best choice to be.

Give them any ammo we can.

Nope.

So moved.

McKeel, Palmer, Randolph, Sheffield, Dill